Drug-resistant epilepsy in children with hemophilia: how can we do it surgically?

BACKGROUND: Drug-resistant epilepsy can occur in patients with intracranial hemorrhage (ICH) caused by hemophilia, there is a paucity of literature reporting the surgical treatment of these patients because of the high risk of bleeding and comprehensive management such as factor replacement during the period of perioperation. METHODS: The data of 216 children with drug-resistant epilepsy who underwent surgically treatment in the Pediatric Epilepsy Center of the Capital Institute of Paediatrics were retrospectively reviewed. Seizure response and procedure complications were evaluated. Two cases children with hemophilia underwent surgical treatment at 29 months (case 1) and 6 years of age (case 2) were identified and followed up. RESULTS: Both children have achieved seizure free without complications such as bleeding or infection after 28 months (case 1) and 21 months (case 2) follow-up. CONCLUSION: For children with drug-resistant epilepsy associated with hemophilia, surgery that meets certain conditions can improve the prognosis safely and effectively.

Enhancement of Tendon Repair Using Tendon-Derived Stem Cells in Small Intestinal Submucosa via M2 Macrophage Polarization.

(1) Background: Reconstruction of Achilles tendon defects and prevention of postoperative tendon adhesions were two serious clinical problems. In the treatment of Achilles tendon defects, decellularized matrix materials and mesenchymal stem cells (MSCs) were thought to address both problems. (2) Methods: In vitro, cell adhesion, proliferation, and tenogenic differentiation of tendon-derived stem cells (TDSCs) on small intestinal submucosa (SIS) were evaluated. RAW264.7 was induced by culture medium of TDSCs and TDSCs-SIS scaffold groups. A rat Achilles tendon defect model was used to assess effects on tendon regeneration and antiadhesion in vivo. (3) Results: SIS scaffold facilitated cell adhesion and tenogenic differentiation of TDSCs, while SIS hydrogel coating promoted proliferation of TDSCs. The expression of TGF-ß and ARG-1 in the TDSCs-SIS scaffold group were higher than that in the TDSCs group on day 3 and 7. In vivo, the tendon regeneration and antiadhesion capacity of the implanted TDSCs-SIS scaffold was significantly enhanced. The expression of CD163 was significantly highest in the TDSCs-SIS scaffold group; meanwhile, the expression of CD68 decreased more significantly in the TDSCs-SIS scaffold group than the other two groups. (4) Conclusion: This study showed that biologically prepared SIS scaffolds synergistically promote tendon regeneration with TDSCs and achieve antiadhesion through M2 polarization of macrophages.

Bi-amino acid functionalized biomimetic honeycomb chitosan membrane as a multifunctional hydrophilic probe for specific capture of N-linked glycopeptides in nasopharyngeal carcinoma's disease patient's serum.

In this work, a novel porous bifunctionalized composite material was synthesized via a simple method. Gold nanoparticles are uniformly dispersed on the surface of the biomimetic honeycomb chitosan membrane through the interaction between amino and Au, and then cysteine and glutathione are successfully grafted onto the surface of the Au by the Au-S bond. The modification of cysteine and glutathione makes this bifunctionalized composite material have significant advantages of superhydrophilicity and small steric hindrance simultaneously. This material manifests excellent property in glycopeptides enrichment, with high selectivity (1:5000), low detection limit (0.1 fmol·µL-1 ), high recovery rate (99.4 ± 0.5%), and good repeatability. In addition, with the help of nano-flow liquid chromatography tandem mass spectrometry, this composite achieved excellent performance in efficiently enriching glycopeptides in the serum of healthy people and nasopharyngeal carcinoma's disease patient. More excitingly, further gene ontology analysis of molecular function and biological process indicated that 41 original glycoproteins of the identified glycopeptides from serum of nasopharyngeal carcinoma's disease patient significantly partake in numerous cancer-associated events, including protease binding, calcium ion binding, enzyme binding, extracellular matrix organization, cellular response to tumor necrosis factor, and inflammatory response.

Negative or positive imaging: ganglioglioma in a boy with epilepsy.

Ganglioglioma is a rare primary tumour of the central nervous system, which characteristically contain both neuronal and glial neoplastic components mainly in children and adolescents. The most common clinical presentation is refractory epilepsy. The imaging findings of ganglioglioma are obvious and varied. However, ganglioglioma with normal neuroimaging is rare. We report a 12-year-old boy presented with intractable focal epilepsy with normal CT and almost negative MRI. The epileptogenic focus was found to be located in the left posterior superior temporal gyrus by comprehensive evaluation including PET-CT imaging and stereo electroencephalography monitoring. The epileptogenic focus was resected, and the histological examination of the surgical specimen confirmed ganglioglioma. He was seizure-free at last follow-up 14 months after surgery.

[Establishment of a Wistar rat model bearing brain glioma C6 cells and its experimental application].

OBJECTIVE: To establish a rat model bearing brain glioma and investigate the optimal conditions for its experimental application. METHODS: C6 cells were implanted into the unilateral brain hemisphere of 20 Wistar rats. The growth behaviors of the brain tumor and behavioral changes of the rats were observed at different time points after the implantation. RESULTS: On day 3 after the implantation, only a slight increase of signal intensity was observed on T2-weighted images. By day 5, the tumor became visible in 15/18 of the rats in at least two sections. By day 11, 16/18 of the rats showed space-occupying effect in the brain, and by day 14, the tumor occupied over 1/2 of the hemisphere in 14/18 of the rats. By day 20, 14/18 of the rats showed a tumor mass occupying over 2/3 of the hemisphere, and some tumor cells had migrated into the contralateral hemisphere. CONCLUSION: In this model of brain glioma, the optimal time widow for experiment is between 14 and 18 days after the cell implantation. The cell density and viability for implantation and the site of implantation may also affect the experimental time widow.

Localization and distribution of magnetic chemotherapeutic drugs with magnetic targeting in rat brain.

BACKGROUND: Magnetic targeting therapy may be a new method for the treatment of malignent tumors. The purpose of this study was to investigate the localization and distribution of ferrofluid microsphere of human serum albumin methotrexate (FM-HSA-MTX) carriers in the brain and to explore the magnetic targeting chemotherapy for malignant brain tumor. METHODS: Ninety SD rats were divided into three groups: targeting group, non-magnetic targeting group, and control group. Synthesized FM-HSA-MTX carriers (MTX 25 mg/kg) were injected into the systemic circulation via the caudal vein (magnetic targeting group, n = 30). A 0.6 T magnetic field was placed around the right hemisphere. The non-magnetic targeting group (n = 30) was administered with FM-HSA-MTX without external magnetic field, meanwhile the control group (n = 30) was treated with MTX and a magnetic field. Random serial sacrifices (n = 10) were conducted at 15, 30 and 45 minutes after drug administration. Bilateral hemispheres were collected respectively, and analyzed for total MTX content. RESULTS: MTX content in the right hemisphere of the magnetic targeting group was significantly higher than that in the other two groups at 15, 30 and 45 minutes after drug administration (P < 0.05) No difference was seen between the non-targeting group and control group. In the magnetic targeting group, MTX returned to the peak level [(0.564 +/- 0.018) mg/g, q15-45 = 32.252, P < 0.05] 45 minutes after the injection but it deceased in the other two groups [non-magnetic targeting group: (0.060 +/- 0.015) mg/g, q15-45 = 9.245, P < 0.05, control group: (0.074 +/- 0.045) mg/g, q15-45 = 6.299, P < 0.05]. In the magnetic targeting group, the concentration of MTX in the right hemisphere was significantly higher than that in the left hemisphere (t45min = 21.135, P = 0.000) but no difference was observed between bilateral hemispheres in the other two groups (non-magnetic targeting group: t45min = 0.434, P = 0.670; control group: t45min = 0.533, P = 0.600). CONCLUSION: In the presence of the external magnetic field, FM-HSA-MTX can distribute successfully in the targeting areas of the brain.