Search

Abstract Focal cortical dysplasia type I (FCD I) is the most common cause of pharmaco-resistant epilepsy with the poorest prognosis. To understand the epileptogenic mechanisms of FCD I, we obtained tissue resected from patients with FCD I epilepsy, and from tumor patients as control. Using whole-cell patch clamp in acute human brain slices, we investigated the cellular properties of fast-spiking interneurons (FSINs) and pyramidal neurons (PNs) within the ictal onset zone. In FCD I epilepsy, FSINs exhibited lower firing rates from slower repolarization and action potential broadening, while PNs had increased firing. Importantly, excitatory synaptic drive of FSINs increased progressively with the scale of cortical activation as a general property across species, but this relationship was inverted towards net inhibition in FCD I epilepsy. Further comparison with intracranial electroencephalography (iEEG) from the same patients revealed that the spatial extent of pathological high-frequency oscillations (pHFO) was associated with synaptic events at FSINs.

Objective: Reclassification of variants of uncertain significance (VUS) may allow for improved cancer prevention, screening, targeted therapy, as well as surgical and reproductive decisionmaking. We reinterpreted BRCA1/2 VUS results in patients with epithelial ovarian cancer and assessed whether the clinical significance of VUS was changed. Methods: We retrospectively reviewed the medical records of 253 epithelial ovarian cancer patients who underwent BRCA1/2 genetic testing from 2010 to 2020. The VUSs in BRCA1/2 were reanalyzed using the 2015 American College of Medical Genetics and Genomics and the Association for Molecular Pathology standards and guidelines (ACMG/AMP 2015 guidelines) and the VUS were reclassified into 5 categories: "pathogenic," "likely pathogenic," "VUS," "likely benign," and "benign." Results: Forty-nine patients were identified as carrying either one or more VUS in BRCA1/2. Among the 49 patients, 44 patients (89.9%) were reclassified as benign (including likely benign) or pathogenic (including likely pathogenic) variants. Four patients (8.2%) were reclassified as "pathogenic or likely pathogenic," 40 patients (81.6%) were reclassified as either "benign" or "likely benign," and the remaining 5 patients (10.2%) were still classified as VUS category. There was a family history of ovarian cancer or breast cancer in the group of patients reclassified as a pathogenic variant (p=0.053). Although there was no statistically significant difference in survival, the survival rate of patients classified as pathogenic was higher. Conclusion: Reclassification of VUS should be done periodically, which is crucial to improve clinical decision-making. In particular, reclassification is necessary for VUS patients with a family history of ovarian cancer or breast cancer. [ABSTRACT FROM AUTHOR]

Objective: Ovarian cancer has highest mortality rate among gynecological cancers. In particular, in the case of peritoneal metastasis, the prognosis is poor. As a solution to this, hyperthermic intraperitoneal chemotherapy (HIPEC) has begun to be implemented. In this study, we sought to compare the results of HIPEC conducted at our hospital based on existing studies' results. Methods: We retrospectively reviewed the electronic medical record (EMR) of patients who were diagnosed with ovarian cancer and underwent HIPEC between January 2018 and December 2021. We reviewed EMR focusing on surgical outcomes and prognostic factors after HIPEC. Among these, the surgical results of patients who underwent HIPEC through primary or interval cytoreductive surgery (ICS) were compared with those who underwent HIPEC after recurrence. Results: Recurrence occurred in 76.5% of patients who underwent HIPEC and the average operation time was 501 minutes. The average of estimated blood loss was 796 mL, and postoperative side effects occurred in 8.8%. We compared the prognostic factors of patients who underwent ICS and HIPEC with those who took HIPEC after recurrence. The results were not significant, but both overall survival (OS) and progression free survival (PFS) were longer by 13 months and 9 months, respectively, in patients who underwent ICS and HIPEC (p=0.0694, p=0.1391). Conclusion: Based on existing study, the results of HIPEC at our hospital showed that the operation time and duration of hospitalization were longer. Although it was not a significant result, considering that OS and PFS results in ICS and HIPEC, it can be assumed that HIPEC after recurrence is not effective. [ABSTRACT FROM AUTHOR]

Objective: Screening is necessary for women with family members diagnosed with breast or ovarian cancer to prevent ovarian or breast cancer. We investigated the frequency of breast cancer in ovarian cancer patients and analyzed the related factors. Methods: We retrospectively reviewed the medical records of 253 epithelial ovarian cancer patients who had completed a cancer pedigree from 2010 to 2020. We compared and analyzed differences between patients who had both ovarian cancer and breast cancer and those who had only ovarian cancer according to family history, BRCA mutation status, and time of onset. Results: In our study, among 253 patients with epithelial ovarian cancer, 20 had been treated for both ovarian cancer and breast cancer. Ten patients developed breast cancer after ovarian cancer and another 10 developed ovarian cancer after breast cancer. Patients treated for both breast and ovarian cancer exhibited a higher incidence of a family history of ovarian or breast cancer compared to those with only ovarian cancer (40.0% vs. 9.9%, p=0.001). Additionally, patients with both breast and ovarian cancer had a higher incidence of BRCA mutation than those with only ovarian cancer (50.0% vs. 20.2%, p=0.002). However, 9 patients (45.0%) had both ovarian and breast cancer without a family history of either cancer or BRCA mutation. Conclusion: Even in cases where there is no family history or genetic mutation, breast cancer could develop in ovarian cancer patients at a similar frequency. Therefore, periodic breast cancer screening is essential for all epithelial ovarian cancer patients, regardless of family history or genetic mutation. [ABSTRACT FROM AUTHOR]