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1.
Front Physiol ; 12: 621720, 2021.
Article in English | MEDLINE | ID: mdl-33679436

ABSTRACT

A pseudocontinuous arterial spin labeling (PCASL) sequence combined with background suppression and single-shot accelerated 3D RARE stack-of-spirals was used to evaluate cerebrovascular reactivity (CVR) induced by breath-holding (BH) in ten healthy volunteers. Four different models designed using the measured change in PETCO2 induced by BH were compared, for CVR quantification. The objective of this comparison was to understand which regressor offered a better physiological model to characterize the cerebral blood flow response under BH. The BH task started with free breathing of 42 s, followed by interleaved end-expiration BHs of 21 s, for ten cycles. The total scan time was 12 min and 20 s. The accelerated readout allowed the acquisition of PCASL data with better temporal resolution than previously used, without compromising the post-labeling delay. Elevated CBF was observed in most cerebral regions under hypercapnia, which was delayed with respect to the BH challenge. Significant statistical differences in CVR were obtained between the different models in GM (p < 0.0001), with ramp models yielding higher values than boxcar models and between the two tissues, GM and WM, with higher values in GM, in all the models (p < 0.0001). The adjustment of the ramp amplitude during each BH cycle did not improve the results compared with a ramp model with a constant amplitude equal to the mean PETCO2 change during the experiment.

2.
J Int Adv Otol ; 14(2): 334-336, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30256207

ABSTRACT

Different types of otic capsule dehiscence restricted to the cochlea have been described. Here we describe the case of a patient with a cochlear-internal auditory canal dehiscence associated with a cochlear-facial dehiscence not reported before. A 53-year-old patient with severe to profound sensorineural hearing loss due to bilateral Meniere's disease underwent a cochlear implant surgery on the right ear. Preoperative brain magnetic resonance imaging findings were reported to be normal; during surgery, a cerebrospinal fluid gusher occurred at the time of round window opening. Postoperative computed tomography imaging showed a bony dehiscence at two levels of the otic capsule.


Subject(s)
Cerebrospinal Fluid Leak/etiology , Cochlea/abnormalities , Hearing Loss, Sensorineural/surgery , Meniere Disease/complications , Anti-Bacterial Agents/therapeutic use , Cerebrospinal Fluid Leak/diagnosis , Cerebrospinal Fluid Leak/surgery , Cochlea/diagnostic imaging , Cochlear Implantation/methods , Ear Canal/surgery , Gentamicins/administration & dosage , Gentamicins/therapeutic use , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Humans , Injection, Intratympanic , Magnetic Resonance Imaging , Male , Middle Aged , Round Window, Ear/abnormalities , Round Window, Ear/pathology , Semicircular Canals/diagnostic imaging , Semicircular Canals/pathology , Tinnitus/diagnosis , Tinnitus/etiology , Tomography, X-Ray Computed , Treatment Outcome , Vestibular Evoked Myogenic Potentials/physiology
3.
Front Oncol ; 8: 61, 2018.
Article in English | MEDLINE | ID: mdl-29594041

ABSTRACT

Diffuse intrinsic pontine gliomas (DIPGs) are aggressive glial brain tumors that primarily affect children, for which there is no curative treatment. Median overall survival is only one year. Currently, the scientific focus is on expanding the knowledge base of the molecular biology of DIPG, and identifying effective therapies. Oncolytic adenovirus DNX-2401 is a replication-competent, genetically modified virus capable of infecting and killing glioma cells, and stimulating an anti-tumor immune response. Clinical trials evaluating intratumoral DNX-2401 in adults with recurrent glioblastoma have demonstrated that the virus has a favorable safety profile and can prolong survival. Subsequently, these results have encouraged the transition of this biologically active therapy from adults into the pediatric population. To this aim, we have designed a clinical Phase I trial for newly diagnosed pediatric DIPG to investigate the feasibility, safety, and preliminary efficacy of delivering DNX-2401 into tumors within the pons following biopsy. This case report presents a pediatric patient enrolled in this ongoing Phase I trial for children and adolescents with newly diagnosed DIPG. The case involves an 8-year-old female patient with radiologically diagnosed DIPG who underwent stereotactic tumor biopsy immediately followed by intratumoral DNX-2401 in the same biopsy track. Because there were no safety concerns or new neurological deficits, the patient was discharged 3 days after the procedures. To our knowledge, this is the first report of intratumoral DNX-2401 for a patient with DIPG in a clinical trial. We plan to demonstrate that intratumoral delivery of an oncolytic virus following tumor biopsy for pediatric patients with DIPG is a novel and feasible approach and that DNX-2401 represents an innovative treatment for the disease.

4.
Rev. neurol. (Ed. impr.) ; 66(supl.1): S83-S89, 1 mar., 2018. ilus, tab
Article in Spanish | IBECS | ID: ibc-171896

ABSTRACT

Objetivo. Contribuir a la descripción de la amnesia del desarrollo como síndrome específico en niños que sufrieron agresión temprana, pero no masiva, de ambos hipocampos. Sujetos y métodos. Muestra de 24 escolares de ambos sexos, de 6-16 años de edad. Se distribuye en tres grupos: pacientes afectos de encefalopatía hipóxico-isquémica perinatal, con parálisis cerebral espástica, inteligencia normal y fallos de memoria (n = 8); pacientes con similares características, pero sin quejas de memoria (n = 7); y escolares sanos sin antecedentes de riesgo (n = 9) como grupo control. Se aplican escalas y tests para comprobar la normalidad intelectual y atencional, y para medir el perfil de rendimiento en tareas de memoria. En todos los sujetos, mediante resonancia magnética, se estima la presencia y grado de atrofia hipocámpica con la escala de Scheltens, y se calcula el índice espectroscópico NAA/(Cho + Cr). Resultados. El perfil neuropsicológico de los ocho pacientes del primer grupo es claramente sugestivo de amnesia el desarrollo, que contrasta con la normalidad en los otros grupos. En siete escolares con amnesia se constata bilateralmente algún grado de atrofia bihipocámpica o disminución significativa del índice NAA/(Cho + Cr). Conclusiones. La amnesia del desarrollo se caracteriza por afectación de la memoria episódica con preservación del aprendizaje semántico y procedimental. Se explica por daño parcial bihipocámpico temprano. El correcto diagnóstico permite una intervención psicoeducativa específica. En el futuro cabría ensayar terapias farmacológicas asociadas a la intervención psicoeducativa (AU)


Aim. To contribute to neuropsychological profiling of developmental amnesia subsequent to bilateral damage to both hippocampi in early age. Subjects and methods. The total sample of 24 schoolchildren from both sexes is distributed in three groups: perinatal hypoxic-ischaemic encephalopathy and everyday complaints of memory in school age (n = 8); perinatal hypoxic-ischaemic encephalopathy without memory complaints (n = 7); and a group of typically developing (n = 9). All participants in every groups did have normal general intelligence and attention. Both clinical groups had, as another clinical consequence, spastic cerebral palsy (diplegia). Neuropsychological exam consisted on tests of general intelligence, attentional abilities, declarative memory and semantic knowledge. All participants had a brain magnetic resonance image and spectroscopy of hippocampi. Scheltens criteria were used for visual estimation of hippocampal atrophy. Parametric and non-parametric statistical contrasts were made. Results. Despite preservation of semantic and procedural learning, declarative-episodic memory is impaired in the first group versus the other two groups. A significant proportion of bilateral hippocampal atrophy is only present in the first group versus the other two non-amnesic groups using Scheltens estimation on MRI. Two cases without evident atrophy did have diminished NAA/(Cho + Cr) index in both hippocampi. Conclusions. Taken together, these results contribute to delineate developmental amnesia as an specific impairment due to early partial bihippocampal damage, in agreement with previous studies. After diagnosis of developmental amnesia, a specific sychoeducational intervention must be made; also this impairment could be candidate for pharmacological trials in the future (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Brain Damage, Chronic/complications , Hypoxia-Ischemia, Brain/complications , Amnesia/complications , Neuropsychological Tests , Functional Neuroimaging , Cerebral Palsy/complications , Memory Disorders/physiopathology , Hippocampus/physiopathology
5.
PLoS One ; 12(1): e0170501, 2017.
Article in English | MEDLINE | ID: mdl-28107439

ABSTRACT

OBJECTIVE: In this work we set to develop and to validate a new in vivo frameless orthotopic Diffuse Intrinsic Pontine Glioma (DIPG) model based in the implantation of a guide-screw system. METHODS: It consisted of a guide-screw also called bolt, a Hamilton syringe with a 26-gauge needle and an insulin-like 15-gauge needle. The guide screw is 2.6 mm in length and harbors a 0.5 mm central hole which accepts the needle of the Hamilton syringe avoiding a theoretical displacement during insertion. The guide-screw is fixed on the mouse skull according to the coordinates: 1mm right to and 0.8 mm posterior to lambda. To reach the pons the Hamilton syringe is adjusted to a 6.5 mm depth using a cuff that serves as a stopper. This system allows delivering not only cells but also any kind of intratumoral chemotherapy, antibodies or gene/viral therapies. RESULTS: The guide-screw was successfully implanted in 10 immunodeficient mice and the animals were inoculated with DIPG human cell lines during the same anesthetic period. All the mice developed severe neurologic symptoms and had a median overall survival of 95 days ranging the time of death from 81 to 116 days. Histopathological analysis confirmed tumor into the pons in all animals confirming the validity of this model. CONCLUSION: Here we presented a reproducible and frameless DIPG model that allows for rapid evaluation of tumorigenicity and efficacy of chemotherapeutic or gene therapy products delivered intratumorally to the pons.


Subject(s)
Brain Stem Neoplasms/etiology , Disease Models, Animal , Glioma/etiology , Neoplasm Transplantation/methods , Animals , Brain Stem , Cell Line, Tumor , Mice , Mice, Nude , Needles , Neoplasms, Experimental
6.
Neurology ; 80(17): 1620, 2013 Apr 23.
Article in English | MEDLINE | ID: mdl-23610149

ABSTRACT

A 77-year-old woman with multiple myeloma for 5 years presented with obtundation, drowsiness, and disorientation over 15 days. Complete blood count revealed thrombocytopenia (25,000/µL). A brain CT disclosed multiple extraaxial hyperdense foci without bone destruction. Differential diagnosis included tumors (meningiomas, leukemia), subdural hematomas, and intracranial hemorrhages; the lesion's multiplicity and morphology were consistent with intracranial extramedullary hematopoiesis (IEH) (figure). Despite platelet transfusions, she died 2 days later of alveolar hemorrhage. Autopsy confirmed IEH and excluded erythropoiesis, reported in subdural hematomas. The formation of blood cells outside the bone marrow is usually related to anemia or lymphoproliferative disorders and is uncommon in multiple myeloma.(1) IEH can cause seizures, hydrocephalus, or cognitive changes.(2.)


Subject(s)
Brain Diseases/etiology , Hematopoiesis, Extramedullary , Multiple Myeloma/complications , Aged , Brain Diseases/pathology , Female , Humans , Multiple Myeloma/pathology , Tomography, X-Ray Computed
9.
Clin Imaging ; 35(3): 236-41, 2011.
Article in English | MEDLINE | ID: mdl-21513865

ABSTRACT

We quantitatively evaluate the benefits of a higher field strength for functional brain MRI (fMRI) based on the blood oxygenation level-dependent contrast. The 3-T fMRI shows a higher sensitivity for the motor and somatosensory stimulation and more specific localization in the grey substance. The 3-T fMRI detects additional areas of activation with the motor paradigm.


Subject(s)
Brain Mapping/methods , Evoked Potentials, Motor/physiology , Magnetic Resonance Imaging/methods , Motor Cortex/physiology , Movement/physiology , Adult , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
10.
J Plast Reconstr Aesthet Surg ; 63(2): 298-304, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19121986

ABSTRACT

BACKGROUND: Autologous breast reconstruction techniques can be used to create a breast, in particular the superior gluteal artery perforator (SGAP) and deep inferior epigastric artery perforator (DIEP) flaps. Preoperative imaging is an essential planning tool in mapping the location and size of perforator vessels. The aim of this report is to show the usefulness of angio-MR technique for preoperative planning of DIEP and SGAP flaps. Initial experience, surgical findings correlation and imaging findings will be described. METHODS: From February 2007 to September 2007, ten consecutive women considered for breast reconstruction with DIEP (eight patients) and SGAP flaps (two patients) after previous mastectomy for breast cancer were studied. After written informed consent was obtained, a preoperative angio-MR using 3-Tesla equipment and blood-pool contrast medium was performed to localize and evaluate the main perforator vessels in each patient and procedure. RESULTS: Angio-MR showed all the main perforator vessels later observed during the surgical procedure with a very good location concordance, but missed one main perforator vessels in each of two patients. In all patients undergoing SGAP flaps, an accurate identification of the main perforator vessels was achieved. Angio-MR clearly showed the intramuscular course of the perforator vessels for DIEP and SGAP flaps. Exact correlation between angio-MR and surgical findings was observed. CONCLUSIONS: The use of angio-MR for preoperative perforator flaps evaluation yielded promising results and would allow not only to locate perforator vessels but also to globally assess presurgical planning of perforator flaps in a noninvasive, radiation and toxicity-free way.


Subject(s)
Buttocks/blood supply , Epigastric Arteries , Gadolinium , Magnetic Resonance Angiography/methods , Mammaplasty/methods , Organometallic Compounds , Preoperative Care , Surgical Flaps/blood supply , Adult , Contrast Media , Female , Humans , Middle Aged , Treatment Outcome
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