Angiocentric glioma from a perspective of A-B-C classification of epilepsy associated tumors

Angiocentric glioma (AG) is a newly-classified, very rare, WHO grade I central nervous system (CNS) lesion, occurring usually in children and young adults. Only 52 patients with AG have been reported so far, making it one of the rarest neuropathological entities. Hereby we present two new cases of AG in young subjects with detailed neuropathological investigations and a neuroradiological picture along with a brief summary of all already published literature reports of this tumor. Histopathological examination of the resected tissue from both cases revealed similar changes characteristic of AG. The tumors were composed of spindle-like, elongated cells, forming characteristic pseudorosettes around vessels and diffusively infiltrating surrounding tissue, trapping neurons between tumor cells. Noticeably, some neoplastic cells encrusting vessels extended far beyond the main tumor mass. Hypothetically, this may be responsible for the recurrence of the tumor even in the case of apparently total excision. In immunohistochemistry, AG cells were glial fibrillary acidic protein (GFAP) and vimentin positive, also exhibiting a strikingly significant epithelial membrane antigen (EMA) dot-like staining pattern. In one of the cases, electron microscopy revealed ependymal differentiation features such as microvilli and cilia. Taken together, all these data strongly confirm a dual astroglial-ependymal nature of the tumor. Follow up corroborates benign character of this neoplasm. Both AGs reported here were immunonegative for the product of the mutated IDH-1 gene what, according to our best knowledge, has never been reported so far. It may suggest that in their pathogenesis AGs differ from grade II astrocytomas, which in most cases harbor a mutation of IDH-1. Noteworthy, neuroimaging in our cases was relatively characteristic but not conclusive, therefore biopsy (at least) is mandatory. A newly proposed so called "A-B-C" classification of long-term epilepsy-associated tumors (LEATs) places AG in a category named ANET. The authors shortly review the A-B-C classification of LEATs

Raman Spectroscopy of Lignite Gasification Char Morphotypes

The purpose of this study is to characterize and compare the microstructural features of the main morphotypes occurring in the char obtained at 850–950 °C by fluidized bed gasification of lignite from the “Szczerców” deposit (Central Poland), and to bring new insights into the knowledge on the origin of these morphotypes. Optical microscopy and Raman spectroscopy were used. The char is composed mostly of crassinetwork and inertoid, accompanied by tenuinetwork and small amounts of fusinoid. Tenuinetwork originates mainly from textinite, crassinetwork is formed from attrinite, while inertoid results from transformation of strongly gelified macerals such as densinite and ulminite. Similarities in the microstructure of tenuinetwork and crassinetwork as well as inertoid and fusinoid are observed. Inertoid and fusinoid are composed of larger aromatic systems, with lower amount of alkyl-aryl structures, and their microstructure is better organized compared to tenuinetwork and crassinetwork. Inertoid and fusinoid differ in microscopic appearance and were formed from different starting materials, but their microstructural properties converged during gasification. Different morphological features of the network morphotypes (tenuinetwork, crassinetwork) are not reflected in the differences in their microstructural characteristics

Micro-Raman Spectroscopy of Selected Macerals of the Huminite Group: An Example from the Szczerców Lignite Deposit (Central Poland)

Lignite (ulminite reflectance Rr = 0.27%) from the Szczerców deposit (Central Poland) is dominated by huminite group macerals, containing a high proportion of attrinite and densinite. Densinite and ulminite are more abundant in small aromatic units than attrinite, which may result from their stronger gelification. The differences in Raman spectral characteristics between attrinite and ulminite are more pronounced than between attrinite and densinite. Fusinite, in comparison with the huminite group macerals, is composed of larger, more varied aromatic systems. The D4 (1190–1200 cm−1) and D5 bands (1280–1290 cm−1), most likely, correspond to different chemical structures, and their origin should be further investigated

Raman Spectroscopy of Lignite Gasification Char Morphotypes

The purpose of this study is to characterize and compare the microstructural features of the main morphotypes occurring in the char obtained at 850–950 °C by fluidized bed gasification of lignite from the “Szczerców” deposit (Central Poland), and to bring new insights into the knowledge on the origin of these morphotypes. Optical microscopy and Raman spectroscopy were used. The char is composed mostly of crassinetwork and inertoid, accompanied by tenuinetwork and small amounts of fusinoid. Tenuinetwork originates mainly from textinite, crassinetwork is formed from attrinite, while inertoid results from transformation of strongly gelified macerals such as densinite and ulminite. Similarities in the microstructure of tenuinetwork and crassinetwork as well as inertoid and fusinoid are observed. Inertoid and fusinoid are composed of larger aromatic systems, with lower amount of alkyl-aryl structures, and their microstructure is better organized compared to tenuinetwork and crassinetwork. Inertoid and fusinoid differ in microscopic appearance and were formed from different starting materials, but their microstructural properties converged during gasification. Different morphological features of the network morphotypes (tenuinetwork, crassinetwork) are not reflected in the differences in their microstructural characteristics

Health related quality of life of the patient with Immunoglobulin G4-related cranial hypertrophic pachymeningitis (IgG-HP) causing disturbances of cognitive control treated with neurofeedback

Health related quality of life (HRQoL) is the most desired patient centered outcome of medical care (Leplége et al. 1997). In patients with long term illness, such as Hypertrophic Pachymeningitis (HP) still under diagnosis, therefore no possible to properly cure, it might be the only outcome achievable (Netuveli et al. 2005; Trystuła 2017). The problem becomes even more serious when occurs in young person: starting a family and caring for children becomes hard or even impossible, because of his/her physical and psychical conditions. Most clinicians are aware of the importance for quality of life of this functional limitation, but there are no articles describing this problem in the literature. We aimed to fill this gap in knowledge. 29 year old patient, a car mechanic, married, with 4-year-old son, with the long his- tory of the illnes, and especially persistent, diffuse, non-specific headaches, frequent seizures and cognitive deterioration which have been particularly troublesome recently. He was finalny diagnosed with Hypertrophic Pachymeningitis (HP) associated with Immunoglobulin G4-related (IgG4) with the use of specific diagnostic criteria for HP associated with IgG4-RD (IgG4-HP), which rely on histopathologic analysis (Lindstrom et al. 2010; Lu et al 2014). Computed tomography (CT) of the head showed massive calcifications visible along the cerebellar tentorium on the right side, along the cerebral falx, as well as on dura mater on the cranial vault of both cerebral hemispheres. The patient was diagnosed with common variable immunodeficiency (D 83), thrombocytopenia, chronic EBV hepatitis and epilepsy. IgG4-HP was confirmed by CT, MRI and biopsy (IGg4-RHP antibody was detected). The treatment with steroids, and immunosuppressive therapy (RTX) was introduced (as it was suggested by Levraut et al. (2019). It should be stressed that he had a significantly reduced health-related quality of life (HRQoL), mainly because of long-lasting illness, diverse symptoms, often hospitalization, complex differential diagnosis, and especially biopsy which requires neurosurgical intervention, which affect his physical and mental well-being, especially cognitive control, and not possibility to take care of his family. To help the patient we introduce HBI methodology (Kropotov 2016), that is an evaluation of working brain in milliseconds. Quantitative electroencephalography (qEEG), event-related potentials (ERPs) and low-resolution sLORETA tomography were performed. We did not found any paroxysm of 3 Hz rhythm in Eyes Closed (EO) and in Eyes Open (EO) conditions, however the ERPs deviations from the reference indicate deficit of cognitive control (decrease of P3 NOGO wave in comparison to 100 persons from the normative data base from the Human Brain Index in Chur, Switzerland). Therefore, the patient was offered Transcranial Direct Current Stimulation (atDCS) combined with goal-oriented psychotherapy program. It was found that after 40 days of therapy, cognitive control returned, which was translated into a better quality of life related to the patient's health, measure in the 36-Item Short Form Survey (SF-36). The patient returned to his previous job as a head of car mechanic service. Final diagnosis of IgG4-HP and subsequently, proper farmacotherapy, and introduction of HBI methodology allowing for the selection of an adequate method of neurotherapy, for our patient the transcranial direct current stimulation (atDCS) combined with goal- oriented psychotherapy, was helpful in the improvement of his quality of life

Evaluation of the effectiveness of electroencephalographic training with neurofeedback (EEG-NFB) for a patient with dysexecutive syndrome after neurosurgery of two brain aneurysms detected after COVID-19 disease

The purpose of this study is to evaluate the effectiveness of functional neuromarker- based electroencephalographic training with neurofeedback (EEG-NFB) for a patient with dysexecutive syndrome following neurosurgical operation of two brain aneurysms of the left and right middle cerebral artery (MCA) detected after COVID-19 disease. A right-handed, 56-years-old, not vaccinated, patient, became infected with SARS- CoV-2 and contracted COVID-19 with the manifestation of respiratory symptoms, high fever, dyspnea and low saturation of 79% Sa02. She was hospitalized at the Infectious Disease Unit, where a positive RT PCR test for COVID-19 was confirmed. The acute phase of COVID-19, during which oxygen therapy was administered, lasted two weeks and was complicated by brain fog and transient hypertension (175/100). There were no signs of focal damage to the central nervous system. She was discharged home in a good general and neurological condition. After returning home, the patient was unable to cope with daily functioning, as she said her brain fog continued to persist, manifesting itself as executive dysfunction. Eight weeks after the infection, the patient's neuropsychiatric condition worsened. On CT and MRI examination of the cerebral vessels, she was diagnosed with the presence of two aneurysms located on the left and right middle cerebral arteries (MCA). She was operated on at the Department of Neurosurgery and Neurotraumatology, where a pterional craniotomy and clipping of both brain aneurysms was performed. The Yasargil titanium clip was placed on the aneurysm neck. During the surgery procedures, performed two months apart, there were no signs of a history of subarachnoid haemorrhage and the post-operative period was uneventful, except for a drooping right-eye eyelid (after the second surgery) with a tendency to improve. Each time, the patient was mobilized and walked independently and was discharged home in a good general condition, with no neurological symptoms, except for executive dysfunction. Approximately five months after the SARS-CoV-2 infection (four weeks after the second surgery), her executive dysfunction worsened. Neuropsychological testing using Mindstreams™ Interaction Computer Tests revealed moderate Dysexecutive Syndrome (DES), while neurophysiological testing using qEEGs, ERPs and sLORETA tomography, a functional neuromarker of frontotemporal area dysfunction. The EEG pattern was characterized by excessive, slow (about 6 Hz) activity in frontotemporal areas, which indicated the progressive loss of cognitive control over time. The patient was offered an electroencephalographic training protocol with neurofeedback (EEG-NFB) based on the detected functional neuromarker, which reduced DES. The improvement achieved during therapy was statistically significant [compared to the normative database (Human Brain Index, HBI)]. In effect, the patient's quality of life improved, as she herself pointed out. Her symptoms of brain fog and DES disappeared and she returned to her previous work as a waitress. The Human Brain Index (HBI) methodology can be successfully used in the neurodiagnosis and implementation of individualized electroencephalographic training with neurofeedback (EEG-NFT) for patients with executive dysfunction after contracting longCOVID

The long-time effects of group therapy intervention on marriage communication between fluent and non-fluent aphasic patients and their spouses : who benefits the most?

Our study aims to assess the long-time effects of group therapy intervention on marriage communication between fluent and non-fluent aphasic patients and their spouses. From the initial cohort of 150 couples four experimental groups have been selected, each comprising 20 subjects: (1) patients with fluent aphasia (FAP) (2) patients with fluent aphasia spouses (FAPS) (3) patients with non-fluent aphasia (NFAP) (4) patients with non-fluent aphasia spouses (NFAPS). All aphasic patients had mild or moderate fluent or nonfluent aphasia, as confirmed by the Cracow Neuropsychological Battery for Aphasia Examination – CNBA (Pąchalska, 1999). To assess the 3 aspects of interactions between spouses: support, engagement and depreciation we use the Communication in Marriage Questionnaire – KKM scores (Kaźmierczak, Plopa, 2008). These patients attended the groups sessions administered according to Pąchalska’s Model of Aphasia Group Therapy (1991a; 1991b) . It was found that after the long-time group intervention the experimental and the control groups of aphasic patients as well as their spouses differ one from another. NFAP as well as FAP therapy patients had higher KKM scores in the support received from their spouses and their spouses engagement in communication and lower scores in depreciation in their spouses’ behavior than did the controls. Also NFAPS evaluated support and engagement expressed by their aphasic partner higher than the control group. However FAPS and the control group KKM scores were quite similar, except for the support expressed by their aphasic partner. Long-time group therapy for patients with aphasia with the presence of caregivers not only improves the communication with significant others but also it is associated with better marital interactions and communication after therapy as reflected in the KKM scores than in the case of the controls, and improves the patient’s and caregivers’ perception of quality of life

Pain reduction as the main parameter for monitoring improvement in Health-Related Quality of Life (HRQoL) following endovascular treatment of Pelvic Congestion Syndrome (PCS)

The purpose of this study was to evaluate pain reduction as the main parameter for monitoring improvements in Health-Related Quality of Life (HRQoL) in a female patient following endovascular treatment of Pelvic Congestion Syndrome (PCS). A 38-year-old female patient with chronic intermittent, “dragging” abdominal pain, lasting more than two years, mainly in the lower abdomen, radiating to the sacral region, underwent SARS CoV-2 infection in October 2021, and COVID-19, which lasted 10 days. Eight months later, complaints of pain in the lower abdominal area, during the menstrual cycle, during prolonged standing, after sports activities and during and after intercourse, increased. The patient was compelled to begin diagnosis of these complaints due to the severe pain and concerns about whether she had contracted cancer of the cervix uteri. She was diagnosed on transvaginal ultrasound-Doppler and Angio-MR of the pelvic vessels with PCS. Treatment was undertaken at the Department of Vascular Surgery and Endovascular Interventions, St. John Paul II Hospital, Krakow, Poland. Intraoperatively, after confirmation through selective angiography, of previously diagnosed insufficiency of the left ovarian vein (LOV) and of the parametrial veins (PMV), the selective obliteration was performed with an adhesive dedicated to endovascular closure of veins and vascular malformations (Glubran®2). The range of pain intensity, according to theVisual Analogue Scale (VAS), in Exam. 1 (before surgery), was in the premenstrual period (BM) 7.0 points, which increased during menstruation (DM) or after intense activity (AIA) to 8.0 points, and occasionally during and after intercourse even to 9.0 points. These values were very high, indicating that pain significantly affected the patient's quality of life. The extent of pain severity decreased significantly in Study 2 (two months after surgery) and Study 3 (four months after surgery) and was 2.0 points in the premenstrual period (BM), which increased only slightly during menstruation (DM) or after intense activity (AIA) to 3.0 points, and decreased again to 2.0 points during and after intercourse. The patient reported that the procedure significantly and positively affected her functioning in daily life, especially in caring for a young child, which is evidence of the achievement of HRQoL improvement. Endovascular treatment for Pelvic Congestion Syndrome (PCS) was effective in reducing pain and improving the Health-Related Quality of Life (HRQoL) of a patient with PCS