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Revista de Neurologia Jul 2010Partial seizures of extratemporal origin may present unique challenges in the patient with medically refractory seizures. Extratemporal focal cortical resections may be... (Review)
Review
INTRODUCTION
Partial seizures of extratemporal origin may present unique challenges in the patient with medically refractory seizures. Extratemporal focal cortical resections may be less effective than anterior temporal lobectomy for intractable epilepsy.
DEVELOPMENT
Surgical complications may be increased in individuals with extratemporal epilepsy because eloquent cortex may involved, and larger cortical resections may be needed to significantly reduce epileptogenicity. 30-40% of patients with newly diagnosed epilepsy will develop medically refractory seizure disorders.
CONCLUSIONS
The most effective treatment for intractable partial epilepsy is a focal cortical resection with excision of the epileptogenic zone, i.e., area of ictal onset and initial seizure propagation. The preoperative evaluation and surgical strategy in patients with partial epilepsy of extratemporal origin associated with pharmacoresistant seizures is determined by the anatomical localization of the epileptogenic zone and the presence of a lesion-related epilepsy. Prior to surgical treatment patients with extratemporal epilepsy will require a comprehensive preoperative evaluation including routine EEG, long-term EEG monitoring, neuropsychological studies, and magnetic resonance imaging.
Topics: Electrodes, Implanted; Electroencephalography; Epilepsies, Partial; Humans; Magnetic Resonance Imaging; Neuropsychological Tests; Positron-Emission Tomography; Prognosis; Tomography, Emission-Computed, Single-Photon
PubMed: 20602314
DOI: No ID Found -
Intractable & Rare Diseases Research Feb 2019Trisomy 9 including mosaic and partial trisomy is less frequently seen chromosomal abnormality in live born children. The pure or partial trisomy 9 frequently been...
Trisomy 9 including mosaic and partial trisomy is less frequently seen chromosomal abnormality in live born children. The pure or partial trisomy 9 frequently been reported in prenatal diagnosis and product of conception. However few studies reported partial trisomy 9 in live born children. In addition data on genotype and phenotype correlation of partial trisomy is not well understood except few case reports. Here we report a case of partial trisomy 9 and monosomy 14 with a 46,XY,der(9)t(9;14)(q22.1;q11.2)pat,-14 karyotype in a 5-year old dysmorphic child. The proband was confirmed as trisomic for 9pter->9q22.1 and monosomic for 14pter->q11.2 due to paternal t(9;14)(q22.1;q11.2) balanced translocation using a combination of conventional and molecular cytogenetic (fluorescence in situ hybridization, array-comparative genomic hybridization) techniques. The clinical features similar to pure trisomy 9 is due to duplication of the large region of chromosome 9. However, the present report of partial trisomy 9 and monosomy 14 is a novel case report and showing comparatively longer survival which have not been previously reported in the literature. The parent of the proband was counseled for the future pregnancies.
PubMed: 30881863
DOI: 10.5582/irdr.2019.01000 -
Archivos Espanoles de Urologia Oct 2019The use of intraoperatory laparoscopic ultrasound for nephron sparring surgery (partial nephrectomy) in patients with technically challenging tumors has emerged during... (Review)
Review
OBJECTIVES
The use of intraoperatory laparoscopic ultrasound for nephron sparring surgery (partial nephrectomy) in patients with technically challenging tumors has emerged during the last years. The objective of this work is to present a literature review and analysis of the published series, as well as the surgical technique of intraoperatory laparoscopic guided partial nephrectomy.
METHODS
Pubmed and Scopus serch was performed in January 2019 including the following keywords: "intraoperative ultrasonography", "laparoscopic ultrasonography" and "partial nephrectomy", the published series are presented. We describe the laparoscopic technique of intraoperatory ultrasound during partial nephrectomy.
RESULTS
All the published series present similar results in terms of tumour size which varies from 2.3 to 4 cm. Complications results are also very similar in the comparative series to the ones published in partial nephrectomies. They show promising oncological results during follow up with a rate superior to 90% of negative margins, comparable to those of exophytic tumor partial nephrectomies.
CONCLUSIONS
The use of intraoperatory ultrasound during laparoscopic surgery to localize intraparenchymatous renal lesions can expand the indications of partial nephrectomy to more technically challenging tumors. These indications are not yet well standardized. Due to its complexity, the need of previous surgical experience is required to achieve good results and corroborate the security and feasibility of this procedure. Prospective randomized trials are needed to confirm the benefits of intraoperatory laparoscopic ultrasound for nephron sparring surgery (partial nephrectomy).
Topics: Humans; Kidney Neoplasms; Laparoscopy; Nephrectomy; Prospective Studies; Ultrasonography
PubMed: 31579030
DOI: No ID Found -
Archives of Disease in Childhood Oct 1988The prognosis of partial epilepsy in childhood (excluding cases of benign partial epilepsy) was studied; the average follow up period was 7.4 years. Improvement rate of...
The prognosis of partial epilepsy in childhood (excluding cases of benign partial epilepsy) was studied; the average follow up period was 7.4 years. Improvement rate of seizure status was 82.3%. We studied favourable prognostic factors and found that those most often associated with seizure improvement were familial convulsions and idiopathic forms, no generalised seizures before partial onset, low frequency of seizures after 12 months of treatment, short duration of epilepsy, and no background activity abnormalities on electroencephalography. We also observed such factors as mental retardation, neurological abnormalities, and behaviour and cognitive disorders. Factors that determined the prognosis for social adjustment were similar to those for seizure improvement. We discuss the favourable prognosis of partial seizures in childhood and the predictive factors.
Topics: Adolescent; Behavior; Child; Child, Preschool; Cognition Disorders; Electroencephalography; Epilepsies, Partial; Female; Follow-Up Studies; Humans; Infant; Intellectual Disability; Male; Nervous System Diseases; Prognosis
PubMed: 3143314
DOI: 10.1136/adc.63.10.1192 -
The Journal of Surgical Research Jun 2021Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become a standard adjunct for the management of life-threatening truncal hemorrhage, but the...
BACKGROUND
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become a standard adjunct for the management of life-threatening truncal hemorrhage, but the technique is limited by the sequalae of ischemia distal to occlusion. Partial REBOA addresses this limitation, and the recent Food and Drug Administration approval of a device designed to enable partial REBOA will broaden its application. We conducted a systematic review of the available animal and clinical literature on the methods, impacts, and outcomes associated with partial REBOA as a technique to enable targeted proximal perfusion and limit distal ischemic injury. We hypothesize that a systematic review of the published animal and human literature on partial REBOA will provide actionable insight for the use of partial REBOA in the context of future wider clinical implementation of this technique.
METHODS
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols guidelines, we conducted a search of the available literature which used partial inflation of a REBOA balloon catheter. Findings from 22 large animal studies and 14 clinical studies met inclusion criteria.
RESULTS
Animal and clinical results support the benefits of partial REBOA including extending the resuscitative window extended safe occlusion time, improved survival, reduced proximal hypertension, and reduced resuscitation requirements. Clinical studies provide practical physiologic targets for partial REBOA including a period of total occlusion followed by gradual balloon deflation to achieve a target proximal pressure and/or target distal pressure.
CONCLUSIONS
Partial REBOA has several benefits which have been observed in animal and clinical studies, most notably reduced ischemic insult to tissues distal to occlusion and improved outcomes compared with total occlusion. Practical clinical protocols are available for the implementation of partial REBOA in cases of life-threatening torso hemorrhage.
Topics: Animals; Aorta; Balloon Occlusion; Endovascular Procedures; Humans; Resuscitation; Shock, Hemorrhagic
PubMed: 33561721
DOI: 10.1016/j.jss.2020.12.054 -
Nagoya Journal of Medical Science Nov 2021Massive splenomegaly and hypersplenism in patients with biliary atresia after Kasai portoenterostomy were treated with partial splenic embolization or total splenectomy....
Massive splenomegaly and hypersplenism in patients with biliary atresia after Kasai portoenterostomy were treated with partial splenic embolization or total splenectomy. We performed partial splenectomy to reduce the complications of partial splenic embolization and avoid overwhelming post-splenectomy infection. This study aimed to evaluate the long-term effects of partial splenectomy for hypersplenism on postoperative liver and spleen function in patients with biliary atresia. Among jaundice-free patients with biliary atresia who underwent Kasai portoenterostomy between January 1992 and December 2012, 15 underwent partial splenectomy for massive splenomegaly and hypersplenism at our institution. Changes in the laboratory data 10 years post partial splenectomy were retrospectively investigated, and these along with the latest data were measured. A total of four patients (27%) required living-donor liver transplantation after partial splenectomy, a proportion similar to those who did not undergo partial splenectomy. Compared to the preoperative baseline, the platelet counts were significantly higher at 1 and 3 years after surgery (). Aspartic aminotransferase-to-platelet ratio index was significantly lower at 1, 7, and 10 years after partial splenectomy (). No further surgeries were required for hypersplenism after partial splenectomy over 10 years, and there were no cases of overwhelming post-splenectomy infection after partial splenectomy. Partial splenectomy is safe and effective for the treatment of hypersplenism with biliary atresia over a long time period. It could be considered as an alternative to partial splenic embolization as it can suppress hypersplenism for a long time and induces fewer postoperative complications.
Topics: Aged; Aged, 80 and over; Biliary Atresia; Female; Humans; Hypersplenism; Liver Transplantation; Living Donors; Male; Middle Aged; Portoenterostomy, Hepatic; Retrospective Studies; Splenectomy; Splenomegaly; Treatment Outcome
PubMed: 34916720
DOI: 10.18999/nagjms.83.4.765 -
Epilepsia 2005The concept of genetic focal epilepsies is relatively new as compared to awareness of the importance of genetic factors in the generalized epilepsies. However, in the... (Comparative Study)
Comparative Study Review
The concept of genetic focal epilepsies is relatively new as compared to awareness of the importance of genetic factors in the generalized epilepsies. However, in the past decade, there has been increasing recognition of families with dominantly inherited partial epilepsies. Better definition of the phenotypes allows identification of distinct syndromes. The main familial focal epilepsies are autosomal-dominant nocturnal frontal lobe epilepsy (ADNFLE), familial mesial TLE (FMTLE), familial lateral TLE (FLTLE), and familial partial epilepsy with variable foci (FPEVF). The only genes identified so far are those for ADNFLE and FLTLE. In these disorders, functional studies are the next step and could provide advances leading to clarification of the pathophysiology as well as to new therapeutic strategies. At present, we can provide genetic counseling and a more accurate prognosis for most of the familial focal epilepsies. Greater awareness of the genetic basis in this group of disorders by the treating physicians is essential for identification of new families. This will allow further linkage studies, candidate gene screening, and identification of new genes, which will hopefully result in genetically based prevention and treatment.
Topics: Adolescent; Adult; Child; Chromosome Mapping; Epilepsies, Partial; Epilepsy, Temporal Lobe; Family Health; Female; Functional Laterality; Genetic Counseling; Humans; Male; Pedigree; Penetrance; Phenotype
PubMed: 16359475
DOI: 10.1111/j.1528-1167.2005.00361.x -
Preventive Nutrition and Food Science Jun 2020The objective of this study was to examine the quality enhancement of puffed products made with partial gelatinized waxy and non-waxy type rice. The partial...
The objective of this study was to examine the quality enhancement of puffed products made with partial gelatinized waxy and non-waxy type rice. The partial gelatinization process increased water holding capacity of samples, regardless of the gelatinization time, with the puffed waxy rice exhibiting higher water holding capacities than the puffed non-waxy rice. The hardness of puffed rice using partial gelatinized waxy or non-waxy type rice was lower compared with non-partial gelatinized samples. Partial gelatinization also increased the final viscosity of the samples, which was decreased by the puffing treatment. The setback viscosity was higher in the partially gelatinized rice than in the non-gelatinized rice and was lower for the puffing treatment. The starch digestibility of waxy and non-waxy type rice was improved by a puffing treatment. These results suggest that puffed rice using partial gelatinization treatment enhances the quality and digestibility of soft-textured foods.
PubMed: 32676475
DOI: 10.3746/pnf.2020.25.2.225 -
Nucleus (Austin, Tex.) 2018Polycystic ovary syndrome (PCOS) is a common disorder with a high phenotypic variability. Frequently, it is associated with a mild to moderate insulin resistance (IR)... (Review)
Review
Polycystic ovary syndrome (PCOS) is a common disorder with a high phenotypic variability. Frequently, it is associated with a mild to moderate insulin resistance (IR) caused by an interaction between polygenic diathesis and the environment. However, PCOS may be a complication of an underlying syndrome of severe IR such as insulin receptor autoantibodies, mutations in the insulin receptor or in the signalling pathway downstream from the insulin receptor or, most frequently, a defect in function or in the development of the subcutaneous adipose tissue. Such conditions are clinically characterized by lipodystrophy. Lipodystrophy in some cases is produced by a single-gene defect. In our experience, PCOS secondary to a missense mutation in the LMNA gene, known as familial partial lipodystrophy type 2 (FPLD2), is the most frequent form of PCOS secondary to severe IR due to genetically determined lipodystrophy. These forms should be identified as they benefit from tailored therapies.
Topics: Female; Humans; Lamin Type A; Lipodystrophy, Familial Partial; Polycystic Ovary Syndrome
PubMed: 30131000
DOI: 10.1080/19491034.2018.1509659 -
Neurosurgical Review Oct 2003Structural and functional neuroimaging studies are essential in the evaluation of individuals with partial epilepsy syndromes. Magnetic resonance imaging (MRI) is... (Review)
Review
Structural and functional neuroimaging studies are essential in the evaluation of individuals with partial epilepsy syndromes. Magnetic resonance imaging (MRI) is important to delineate structural abnormalities underlying seizure disorders, commonly including hippocampal sclerosis or cortical dysplasias. Identification of a structural lesion is often a reliable indicator of the site of seizure onset. Magnetic resonance spectroscopy (MRS) allows us to investigate cerebral metabolites and some neurotransmitters. Reduction in various metabolite concentrations has proven to be prognostically valuable when no structural abnormality is identified. Positron emission tomography (PET) using deoxyglucose demonstrates areas of reduced glucose metabolism, which are the hallmark of epileptogenic zones and usually extend beyond the underlying anatomical region. It is useful in temporal lobe epilepsy for lateralization; however, results in extratemporal lobe epilepsy have been less favorable. More promising is the use of benzodiazepine receptor ligands, which are reduced in the epileptogenic zone in a more restricted distribution. This appears to be helpful in the localization of extratemporal seizure foci. Peri-ictal single photon emission computed tomography measures increased blood flow during the ictal event and is beneficial in patients with normal MRI studies to determine lateralization and localization of the ictal onset zone. All imaging modalities should be correlated with clinical and neurophysiological data.
Topics: Brain; Diagnostic Imaging; Epilepsies, Partial; Humans; Radiography; Radionuclide Imaging
PubMed: 12938000
DOI: 10.1007/s10143-003-0293-6