[Observation of efficacy and safety of stereotactic-EEG-guided three-dimensional radiofrequency thermocoagulation for the treatment of drug-resistant insular epilepsy].

Objective: To investigate the safety and efficacy of stereotactic-EEG (SEEG)-guided radiofrequency thermocoagulation (RF-TC) with three-dimensional lesioning in the treatment of drug-resistant insular epilepsy. Methods: Seven patients with drug-resistant insular epilepsy who underwent SEEG-guided RF-TC with three-dimensional ablation at the Department of Neurosurgery of Xuanwu Hospital, Capital Medical University from February 2017 to June 2019 were retrospectively enrolled. Presurgical evaluation including semiology, EEG and imaging results suggested that the epileptogenic zone was located in the insular lobe. All patients underwent SEEG recording and three-dimensional RF-TC. Postoperative follow-up was conducted by outpatient visits or telephone, the clinical efficacy was evaluated based on Engel classification and the relevant complications were documented. Results: Seven patients were followed up at 18 months after surgery. Among them, 4 were seizure free (Engel ⅠA), 2 had nondisabling simple partial seizures (Engel ⅠB) and 1 achieved 75% decrease (Engel ⅢA) in seizure frequency. Postoperative complications occurred in 3 patients which included decreased sensation in the right lower extremity, decreased strength in the right upper extremity, glossolalia, decline in memory and comprehension. No permanent neurological dysfunction was detected. Conclusion: SEEG-guided RF-TC with three-dimensional lesioning is minimally invasive, safe and effective in the treatment of drug-resistant insular epilepsy and can serve as a complementary method for resection surgery.

[Safety and short-term efficacy of domestic magnetic resonance-guided laser interstitial thermotherapy in the treatment of drug-resistant epilepsy].

Objective: To investigate the safety and short-term efficacy of domestic magnetic resonance-guided laser interstitial thermotherapy (MRgLITT) in the treatment of drug-resistant epilepsy. Methods: Patients with drug-resistant epilepsy treated with a domestic MRgLITT system in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University from October 2020 to April 2021 were prospectively enrolled. The damage volume ratio was assessed immediately after surgery, and perioperative complications were recorded and followed up. The clinical safety and short-term efficacy were evaluated using the Engel classification. Results: A total of 22 patients were included, including 12 males and 10 females, aged from 3 to 45 years old [(24±13) years]. There were 5 cases of medial temporal lobe epilepsy (MTLE), 3 cases of hypothalamic hamartoma (HH), 7 cases of focal cortical dysplasia (FCD), and 7 cases of other types, respectively. The mean operation time and blood loss was (173±49) min and (3.7±1.6) ml. The postoperative length of hospital stay was (5.5±1.8) days, and the average damage volume ratio was 92.6%. Among them, only 2 patients (FCD of the parietal lobe) showed transient contralateral limb weakness, without any serious complications such as symptomatic intracranial hemorrhage and cerebral infarction. The follow-up time was 14 to 168 days. There were 13 Engel class Ⅰ cases (59.1%), 2 Engel class Ⅱ cases (9.1%), 2 Engel class Ⅲ cases (9.1%) and 5 Engel class Ⅳ cases (22.7%), respectively. Short-term incident-free rates were MTLE 5/5and FCD4/7, respectively. Conclusion: Domestic MRgLITT system is stable, reliable and safe in the treatment of drug-refractory epilepsy, and has better short-term efficacy in MTLE and FCD patients.

[The effect of glucagon and concanavalin A on cholesterol accumulation in mouse peritoneal macrophages and human aorta intima cells]. / Vliianie gliukagona i konkanavalina A na akkumuliatsiiu kholesterina peritoneal'nymi makrofagami myshi i kletkami intimy aorty cheloveka.

Glucagon and concanavalin A were administered into cell cultures of mice peritoneal macrophages and human intima aorta simultaneously with atherogenous blood serum, obtained from patients with ischemic heart disease, or with acetylated and native low density lipo-proteins. Their effect was dissimilar: glucagon decreased accumulation of intracellular cholesterol and the rate of 3H-thymidine incorporation into these cells, while concanavalin A increased the patterns studied. Cellular lysosomes appear to participate in atherogenesis, these results suggest that regulation of lysosomal apparatus may occur at the step of secondary lysosomes formation.

[The effect of eicosapentaenoic acid and various prostaglandins on cholesterol accumulation and proliferation of intima cells from human aorta]. / Vliianie éikozapentaenovoi kisloty u prostaglandinov razlichnogo riada na akkumuliatsiiu kholesterina i proliferatsiiu kletok intimy aorty cheloveka.

Consumption of 15 g of 40% eicosapentaenic acid within 3 days resulted in 3-fold increase of its content in blood serum of healthy persons and of patients with heart ischemic disease, whereas concentration of arachidonic acid was unaltered. Administration of blood serum containing increased content of eicosapentaenic acid into cell culture of human aorta intima caused a decrease in accumulation of the intracellular cholesterol and in 3H-thymidine incorporation. Simultaneous addition of the blood serum containing eicosapentaenic acid and the structure derivative of A2 thromboxane V 46619 into the aorta intima cell culture led to a distinct decrease in the atherosclerotic effect of the latter drug. Combination of the blood serum with carbocycline or with prostaglandin I2 resulted in the most pronounced lowering of intracellular cholesterol content and of the cell proliferating activity. The antiatherosclerotic effect of eicosapentaenic acid appears to relate not only to the fact that the drug is precursor of prostaglandine I2 and I3 but also to the regulating effect on a balance of various prostaglandins.