Hyperglycaemia-related occipital lobe seizures.

Recognition of the role of hyperglycaemia in seizures is vital, because they tend to refractory to antiepileptic drugs and respond to insulin therapy and hydration.

Restriction Spectrum Imaging Improves Risk Stratification in Patients with Glioblastoma.

BACKGROUND AND PURPOSE: ADC as a marker of tumor cellularity has been promising for evaluating the response to therapy in patients with glioblastoma but does not successfully stratify patients according to outcomes, especially in the upfront setting. Here we investigate whether restriction spectrum imaging, an advanced diffusion imaging model, performed after an operation but before radiation therapy, could improve risk stratification in patients with newly diagnosed glioblastoma relative to ADC. MATERIALS AND METHODS: Pre-radiation therapy diffusion-weighted and structural imaging of 40 patients with glioblastoma were examined retrospectively. Restriction spectrum imaging and ADC-based hypercellularity volume fraction (restriction spectrum imaging-FLAIR volume fraction, restriction spectrum imaging-contrast-enhanced volume fraction, ADC-FLAIR volume fraction, ADC-contrast-enhanced volume fraction) and intensities (restriction spectrum imaging-FLAIR 90th percentile, restriction spectrum imaging-contrast-enhanced 90th percentile, ADC-FLAIR 10th percentile, ADC-contrast-enhanced 10th percentile) within the contrast-enhanced and FLAIR hyperintensity VOIs were calculated. The association of diffusion imaging metrics, contrast-enhanced volume, and FLAIR hyperintensity volume with progression-free survival and overall survival was evaluated by using Cox proportional hazards models. RESULTS: Among the diffusion metrics, restriction spectrum imaging-FLAIR volume fraction was the strongest prognostic metric of progression-free survival (P = .036) and overall survival (P = .007) in a multivariate Cox proportional hazards analysis, with higher values indicating earlier progression and shorter survival. Restriction spectrum imaging-FLAIR 90th percentile was also associated with overall survival (P = .043), with higher intensities, indicating shorter survival. None of the ADC metrics were associated with progression-free survival/overall survival. Contrast-enhanced volume exhibited a trend toward significance for overall survival (P = .063). CONCLUSIONS: Restriction spectrum imaging-derived cellularity in FLAIR hyperintensity regions may be a more robust prognostic marker than ADC and conventional imaging for early progression and poorer survival in patients with glioblastoma. However, future studies with larger samples are needed to explore its predictive ability.

Internal Movement of Erwinia amylovora Through Symptomless Apple Scion Tissues into the Rootstock.

Shoot tips of potted Empire and Golden Delicious trees on the susceptible dwarfing rootstock M.26 in the greenhouse were injected with inoculum containing 5 × 109 CFU/ml Erwinia amylovora. At intervals after inoculation, trees were sampled at increments between the shoot tip and the roots by excising stem segments. Segments were ground in phosphate buffer and assayed for the presence of E. amylovora by plating on semi-selective medium and by a polymerase chain reaction (PCR)-based detection method. Eleven days after inoculation, E. amylovora was detected by PCR in symptomless scion tissue >50 cm below the shoot-tip in Empire and Golden Delicious, and in 2-year-old tissue in Golden Delicious. By 21 days, E. amylovora was detected in the M.26 rootstock of Empire trees, and by 41 days in the M.26 rootstock of Golden Delicious. In a similar experiment the following year, Empire trees on M.26 rootstock were inoculated with E. amylovora at early (16 May), mid- (11 June), and late (6 July) phenophase of shoots. Three weeks after inoculation, E. amylovora was detected by PCR from M.26 rootstocks of five of six plants inoculated at the late phenophase, compared to zero of six plants inoculated at the early or mid-phenophase. Late-season fire blight infections of the scion may be particularly hazardous for the health of the rootstock.