Role of pyroptosis in COVID-19

Aim: In this study, we aimed to investigate the relationship between gasdermin-D, caspase-1, IL-1β and NLRP3, biomarkers that play an important role in COVID-19, and pyroptosis. Material and Methods: This study was carried out with 58 participants, 28 (48.28%) of whom were diagnosis with COVID-19, and 30 (51.72%) of whom were healthy volunteers (control group). Results: There were no statistically significant differences between the gasdermin-D, caspase-1, IL-1β, and NLRP3 levels as a result of all statistical comparisons performed. However, IL-1β values both during the discharge period and during the hospitalization period were considerably higher than those of the control group. At the discharge period, IL-1β values of the patients with severe COVID-19 category had higher than moderate patients, and the patients with moderate than the patients with mild patients. Conclusion: It was observed that IL-1β, which is one of the cytokines released as a result of cell death in the pyroptosis mechanism, was higher in the COVID-19 patients in both the hospitalization and discharge periods compared to the control group. Although not statistically significant these results could support the relationship between pyroptosis and COVID-19

The reliability and interobserver reproducibility of T2/FLAIR mismatch in the diagnosis of IDH-mutant astrocytomas

PURPOSE:The reliability and reproducibility of T2-weighted imaging/ fluid-attenuated inversion recovery (T2/FLAIR) mismatch were investigated in the diagnosis of isocitrate dehydrogenase (IDH) mutant astrocytoma between WHO grade II and III diffuse hemispheric gliomas.METHODS:WHO grade II and grade III diffuse hemispheric gliomas (n=133) treated in our institute were included in the study. Pathological findings and molecular markers of the cases were reviewed with the criteria of WHO 2016. The finding of mismatch between T2-weighted and FLAIR images in preoperative magnetic resonance imaging (MRI) of the cases was evaluated by two different radiologists. The readers reviewed MRIs independently, blinded to the histopathologic diagnosis or molecular subset of tumors. The cases were classified as IDH-mutant astrocytoma, oligodendroglioma and IDH-wildtype (IDH-wt) astrocytoma according to molecular and genetic features.RESULTS:T2/FLAIR mismatch positivity was observed in 46 patients (34.6%). T2/FLAIR mismatch positivity was observed in 42 of 75 IDH-mutant astrocytomas (56%) and 4 of 43 oligodendrogliomas (9.30%), while it was not seen among IDH-wt astrocytomas (0/15, 0%). The T2/FLAIR mismatch ratio was significantly different between IDH-mutant astrocytomas (WHO grade II and grade III) and oligodendrogliomas (chi-square, p <0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of T2/FLAIR mismatch in predicting IDH-mutant astrocytomas were 58.7%, 90.7%, 91.7%, 61.4%, and 70.3% respectively. Radiologist 1 diagnosed T2/FLAIR mismatch in 48 of 133 cases (36.1%) and Radiologist 2 in 66 of 133 cases (49.6%). The interrater agreement for the T2/FLAIR mismatch sign was 0.61 (p <0.05), 95% CI (0.55, 0.67).CONCLUSION:T2/FLAIR mismatch appears to be an important MRI finding in distinguishing IDH-mutant astrocytomas from other diffuse hemispheric gliomas. However, it should be kept in mind that T2/FLAIR mismatch sign can be seen in a minority of oligodendrogliomas besides IDH-mutant astrocytomas

Proton spectroscopic findings in children with epilepsy owing to tuberous sclerosis complex.

ABSTRACTTuberous sclerosis complex is an autosomal dominant disorder that often causes refractory seizures. The presence of multiplelesions makes it difficult to identify a single lesion responsible for the epilepsy. Our purpose is to assess the single-voxelproton spectroscopic findings of the tubers in 11 children with tuberous sclerosis complex. Prior to age 4 years, all of thepatients had presented with epileptic seizures and multiple bilateral tubers in magnetic resonance images. Single-voxelproton spectroscopy was performed from the tubers especially showing epileptogenic activity using both the long andshort echo time and in 14 controls. The results were analyzed using the Mann-Whitney U-test. Compared with the controlgroup, the spectroscopic findings of tubers were characterized by decreased N-acetylaspartate to creatine ratios (1.43 ±0.33; P &lt; .001) in both the long and short echo time spectra, increased choline to creatine ratios (0.91 ± 0.082; P &lt; .05), andmyo-inositol to creatine ratios (0.97 ± 0.19; P &lt; .01) in the short echo time spectra. A lactate peak was detected in theregions corresponding to an epileptic focus on electroencephalography in six patients. Single-voxel proton spectroscopycould be a useful noninvasive method to evaluate epileptogenic tubers. (J Child Neurol 2005;20:517–522)

Reversible Posterior Leucoencephalopathy (PLES) Syndrome

Scientific background: The posterior leucoencephalopathy (PLES) is a clinico-radiological syndrome characterised by headache, nausea, vomiting, disturbances in cognition, depressed level of consciousness, visual abnormalities and convulsions. It is commonly associated with malignant hypertension, toxemia of pregnancy or use of immunosuppressive agents. O b j e c t i v e: We, here, report a case of reversible posterior leucoencephalopathy syndrome in a patient submitted with headache, hypertension, quadranopia and the importance of performing cranial imaging and the benefit of diffusion MRI in the differential diagnosis of P L E S. F i n d i n g s: MRI and diffusion MRI studies have been performed in a 35 year old male patient with hypertension and renal failure, and diffuse posterior system lesions have been found. C o n c l u s i o n: The patient’s clinical and radiologic recovery occurs following control of blood pressur

Susceptibility-Weighted Imaging in Grading of Infiltrative Glial Tumors

Purpose: Histopathological and radiological examination is necessary for the evaluation of tumor types and staging. Histopathologic examination is considered as the gold standard, while the radiological examination is used for preoperative evaluation. The purpose of the present study was to evaluate susceptibility-weighted imaging (SWI) the in grading of infiltrative glial tumors. Materials and Methods: The SWI sequences in pre-operative magnetic resonance imaging (MRI) images were retrospectively assessed in a total of 67 patients (mean age, 36.7 years; age range, 4–79 years; 29 female, 38 male) who were diagnosed with a glial tumor based on histopathological examination. The numbers of punctate intratumoral susceptibility sign (ITSS) in the SWI sequence in the tumors were determined by two radiologists on a consensus-based approach. Lesions with no ITSS were graded as Grade 0, while those having 1–5, 6–15, >15 ITSS were categorized as Grade 1, Grade 2, and Grade 3, respectively. No susceptibility was classified as ITSS, “non-punctate with blurred margins” and diffuse susceptibility were categorized as >15. ITSS grades were compared to the results of histopathological grading and diagnosis. Results: The sensitivity, specificity, negative predictive value, and positive predictive value of the presence of ITSS regarding differentiating high and low-grade glial tumors were 97.6%, 88%, 95.65%, and 93.18%, respectively. Conclusion: In diffuse glial tumors, while the presence of ITSS is indicative of high-grade tumors, its absence is associated with low-grade tumors. These data suggest that the presence rather than the number of ITSS yields more information on the grade of this type of tumor

Leukoencephalopathy With Brain Stem and Spinal Cord Involvement and Lactate Elevation (LBSL) A Case With Long-term Follow-up

Introduction: Leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation (LBSL) is caused by a recessive mutation in the DARS2 gene and can be recognized by specific magnetic resonance imaging patterns. Case Report: A girl who developed leg tremors at age 4 years was diagnosed at age 17 years with LBSL -after evolution of ataxia and sensory loss. Examination at age 29 revealed mild spastic gait, ataxia, and sensory loss, and she did not require assistance to walk. Conclusion: This report illustrates the clinical and magnetic resonance imaging characteristics of a slowly progressive long-term course of childhood-onset LBSL