Genetic testing before epilepsy surgery - An exploratory survey and case collection from German epilepsy centers

INTRODUCTION

Genetic testing in people with epilepsy may support presurgical decision-making. It is currently unclear to what extent epilepsy centres use genetic testing in presurgical evaluation.

METHODS

We performed an exploratory survey among members of the German Society for Epileptology to study the current practice of genetic testing in presurgical evaluation at the respective sites. Survey participants contributed educational case reports.

RESULTS

The majority of participants consider genetic testing to be useful in individuals with familial syndromes or phenotypic features suggesting a genetic etiology. We report 25 cases of individuals with a confirmed genetic diagnosis that have previously undergone epilepsy surgery. Our cases demonstrate that a genetic diagnosis has an impact on both the decision-making process during presurgical evaluation, as well as the postoperative outcome.

CONCLUSION

Genetic testing as part of the presurgical work-up is becoming increasingly established in epilepsy centres across Germany. mTORopathies and genetic hypothalamic hamartomas seem to be associated with a generally favourable surgical outcome. Synaptopathies and channelopathies may be associated with a worse outcome and should be considered on a case-by-case level. Prospective studies are needed to examine the impact of an established genetic diagnosis on postsurgical outcome.

Diffusion and precipitation processes in iron-based silica gardens

The time-dependent dynamic evolution of macroscopic silica garden tubes is shown to strongly depend on the used metal cations.

Influence of additives on the structure of surfactant-free microemulsions

In surfactant-free microemulsions, the combination ethanol/antagonistic salt behaves like a surfactant.

Vergleichende Analyse der nach den Extraktionsmethoden von Kirby und Georgiev aus Mäuseleber extrahierten RNS-Fraktionen / Analysis of the RNA Fractions of Mouse Liver: Comparison of the Extraction Methods of Kirby and Georgiev

Ribonucleic acids labeled with 14C- or 3H-orotic acids, respectively were extracted from aliquots of mouse liver homogenates according to the cold-phenol-method of Kirby or the method of Georgiev employing different temperature steps.

This comparative analysis showed that only ca. 50% of the total labeled RNA was extracted by the Kirby method. Especially the high molecular D-RNA and R-RNA were not sufficiently extracted, as was demonstrated by hydroxyapatite- and methylalbumin-Kieselgur column chromatography.

Reextraction of the tissue at 65 °C first extracted by the Kirby method resulted in a recovery of most of the missing nucleic acid species.

Therefore, results obtained by the Kirby and Georgiev methods will be different in regard to the nucleic acid composition. These findings could explain contradictary results about this problem in literature.

The future European standard to determine odour in ambient air by using field inspection

This paper presents the methodologies to determine odour in ambient air by field inspection that will be a new European standard. The objective is to characterise the odour in a defined area. Without making a link with potential annoyance due to the presence of odours, the described methods propose the way to characterise an exposed environment. Two approaches are defined in the new standard: the grid method and the plume method. The grid method can be used to determine the exposure to ambient odours in a defined area of study, using direct observation of recognisable odours in the field by human panel members. This method must be applied over a sufficiently long period of time (6 or 12 months) to be representative of the meteorological conditions of that location. The result is the distribution of the frequency of exposure to odours within the assessment area. The plume method can be used to determine the extent of detectable and recognisable odours from a specific source using direct observation in the field by human panel members under specific meteorological conditions.

Novel SCARB2 mutation in action myoclonus-renal failure syndrome and evaluation of SCARB2 mutations in isolated AMRF features

BACKGROUND

Action myoclonus-renal failure syndrome is a hereditary form of progressive myoclonus epilepsy associated with renal failure. It is considered to be an autosomal-recessive disease related to loss-of-function mutations in SCARB2. We studied a German AMRF family, additionally showing signs of demyelinating polyneuropathy and dilated cardiomyopathy. To test the hypothesis whether isolated appearance of individual AMRF syndrome features could be related to heterozygote SCARB2 mutations, we screened for SCARB2 mutations in unrelated patients showing isolated AMRF features.

METHODS

In the AMRF family all exons of SCARB2 were analyzed by Sanger sequencing. The mutation screening of unrelated patients with isolated AMRF features affected by either epilepsy (n = 103, progressive myoclonus epilepsy or generalized epilepsy), demyelinating polyneuropathy (n = 103), renal failure (n = 192) or dilated cardiomyopathy (n = 85) was performed as high resolution melting curve analysis of the SCARB2 exons.

RESULTS

A novel homozygous 1 bp deletion (c.111delC) in SCARB2 was found by sequencing three affected homozygous siblings of the affected family. A heterozygous sister showed generalized seizures and reduction of nerve conduction velocity in her legs. No mutations were found in the epilepsy, renal failure or dilated cardiomyopathy samples. In the polyneuropathy sample two individuals with demyelinating disease were found to be carriers of a SCARB2 frameshift mutation (c.666delCCTTA).

CONCLUSIONS

Our findings indicate that demyelinating polyneuropathy and dilated cardiomyopathy are part of the action myoclonus-renal failure syndrome. Moreover, they raise the possibility that in rare cases heterozygous SCARB2 mutations may be associated with PNP features.

Dose-dependent memory effects and cerebral volume changes after in utero exposure to valproate in the rat

PURPOSE

Recent clinical studies raised concern of a cognitive teratogenicity of the major antiepileptic drug valproate. To investigate possible cerebral correlates, we established a forced self-application schedule by diluting valproate in the drinking water of pregnant Wistar rats.

METHODS

After application of medium (MD) and high doses (HDs) with mean daily intakes of about 470 and 720 mg/kg during the entire pregnancy, we analyzed effects on offspring performance in a series of behavioral paradigms as well as brain volumetric changes by magnetic resonance imaging (MRI).

RESULTS

While high dosages with peak serum concentrations slightly above 100 microg/ml induced early decrements in general activity and deficits in learning and memory, medium dosages led to improved watermaze performance in 30-day-old rats. MRI analyses indicated increased hippocampal volumes in the MD condition, whereas in the HD condition significantly decreased cortical and brainstem volumes were registered. Cortical volume reduction was correlated with spatial acuity in the watermaze.

CONCLUSIONS

The results indicate that effects of valproate in utero on offspring cognitive capabilities might depend on total drug load differentially affecting cerebral development during adolescence in the rat.

Determining the cytotoxicity of catanionic surfactant mixtures on HeLa cells

The cytotoxicity of commonly used synthetic surfactants and catanionic mixtures of those was evaluated using MTT on HeLa cells. The 50% inhibition concentration (IC(50)) for MTT reduction was calculated. The effect on chain length increase and inclusion of polyoxyethylene groups on the toxicity was tested on single surfactant systems. A general trend of increasing toxicity with increasing chain length and the presence of polyoxyethylene groups was observed. The measured IC(50) values of catanionic systems lie between those of participating surfactants. The increase in toxicity as the cationic surfactant is added to the anionic one is however not linear. A steep decrease of the IC(50) values (and therefore increase in the toxic properties) is observed immediately already at low concentrations of the cationic surfactants. This behavior is analogous to the enzyme activity in catanionic microemulsions.

Properties of a new hydrotrope hydrophobic molecule and its potential applications

In the present contribution, the properties of dipropylene glycol isobornyl ether (Pribelance) are discussed, especially in the context of microemulsion and emulsion formulations. Pribelance is a new low-toxic anti-foaming hydrotrope with excellent co-surfactant properties that has some similarities with long-chain alcohols, but in contrast to them, it is liquid at room temperature. In combination with another, more hydrophilic co-surfactant, it allows significant amounts of oil to be solubilized in water. Possible applications such as in cosmetics, as an anti-foaming agent or as additive to cooling lubricants are discussed. Further potential applications are plasticizers, fermentation systems, agrochemicals and waste-water treatments.

Spontaneous formation of bilayers and vesicles in mixtures of single-chain alkyl carboxylates: effect of pH and aging and cytotoxicity studies

We report the observation of bilayer fragments, some of which close to form vesicles, over a large range of pH at room temperature from mixtures of single-chain biocompatible commercially available nontoxic alkyl carboxylic surfactants after neutralization with HCl. The pH at which the morphological transitions occur is varied only by changing the ratio between two surfactants: the alkyloligoethyleneoxide carboxylate and sodium laurate. The effect of aging of the mixed surfactant systems in the pH region desired for dermatologic application (4.5 < pH < 7) is also studied. Finally, we show results of cytotoxicity studies on the surfactant mixtures.

Co-ion and ion competition effects: ion distributions close to a hydrophobic solid surface in mixed electrolyte solutions

We consider within a modified Poisson-Boltzmann theory an electrolyte, with different mixtures of NaCl and NaI, near uncharged and charged solid hydrophobic surfaces. The parametrized potentials of mean force acting on Na+, Cl-, and I- near an uncharged self-assembled monolayer were deduced from molecular simulations with polarizable force fields. We study what happens when the surface presents negative charges. At moderately charged surfaces, we observe strong co-ion adsorption and clear specific ion effects at biological concentrations. At high surface charge densities, the co-ions are pushed away from the interface. We predict that Cl- ions can also be excluded from the surface by increasing the concentration of NaI. This ion competition effect (I- versus Cl-) may be relevant for ion-specific partitioning in multiphase systems where polarizable ions accumulate in phases with large surface areas.

Specific alkali cation effects in the transition from micelles to vesicles through salt addition

The transition of ionic micelles to vesicles with added salts is explored in this paper. The catanionic surfactant solution was comprised of sodium dodecylsulfate (SDS) and dodecyltrimethylammonium bromide (DTAB) with an excess of SDS. The micellar size increased with concentration for all salts. No anion specificity was found, probably because of the excess of SDS. However, when the cation of the added salt was varied, large differences were observed in the hydrodynamic radii of the aggregates. A classification of the cations according to their ability to increase the measured hydrodynamic radii follows a Hofmeister series. The change in aggregate size can be explained by modified counterion binding and dehydration of the surfactant headgroups.

Hofmeister Effects in Biology: Effect of Choline Addition on the Salt-Induced Super Activity of Horseradish Peroxidase and Its Implication for Salt Resistance of Plants

The effect of choline addition on the salt-induced super activity of horseradish peroxidase (HRP) is investigated. HRP is presented in the literature as an efficient H(2)O(2) scavenger, and choline is the precursor of glycine betaine, a strong osmoprotectant molecule. Both the regulations of H(2)O(2) and of osmoprotectant concentrations are implicated in plants in order to counteract salt-induced cell damage. For the oxidation of 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS), sulfate anions were found to play a crucial role in the increase of HRP activity. This induced super activity can be strongly reduced by adding choline chloride. The phenomena provide an example of physicochemical Hofmeister effects playing a central regulatory role in an important biological system.

Unified concept of solubilization in water by hydrotropes and cosolvents

In the present work hydrophobic dyes, i.e. disperse red 13 (DR-13; (2-[4-(2-chloro-4-nitrophenylazo)-N-ethylphenylamino]ethanol) and Jaune au gras W1201 (1H-indene-1,3(2H)-dione,2-(2-quinolinyl)), are solubilized in water with the help of different additives: acetone and 1-propanol as typical cosolvents, sodium xylene sulfonate (SXS) as a representative of a classical hydrotrope, sodium dodecyl sulfate (SDS) as a typical surfactant, and finally some "solvosurfactants" [ propylene glycol monoalkyl ether derivatives (CiPOj: i = 1, j = 1 and 3; i = 3, j = 1 and 2; i = 4 and tertio-butyl, j = 1) and 1-propoxy-2-ethanol (C3EO1)]. These solvosurfactants are short amphiphiles that do not form well-defined structures in water such as micelles. For all additives an exponential increase in the solubilizations of the two studied hydrophobic dyes was observed when their concentrations in water were increased. Except for the SDS solution, no difference in the overall shapes of the solubilization curves (dye solubility against additive concentration) was found. All the studied molecules were classified according to their hydrotropic efficiencies, i.e., their abilities to solubilize a hydrophobic, sparingly soluble compound in water. The volume of the hydrophobic parts of the studied additives, roughly evaluated by simple calculations, was found to influence strongly the hydrotropic efficiency; i.e. the larger the hydrophobic part of the additive, the better the hydrotropic efficiency. By contrast, the hydrophilic part carrying a charge or not is of minor importance. Taking the hydrophobic part of the molecules as the key parameter, the water solubilization efficiency of cosolvents, hydrotropes, and solvosurfactants can be described in a coherent way.

Hofmeister effects in surface tension of aqueous electrolyte solution

The surface tension of electrolyte solutions shows marked specific ion effects. We here show an important role for both ionic solvation energies and ionic dispersion potentials in determining this ion specific surface tension of salt solutions. The ion self-free energy changes when an ion moves from bulk solution into the interfacial region, with its decreasing water density profile. We will show that the solvation energies of different ions correlate very well with the surface tension of salt solutions. Inclusion of this distance-dependent self-free energy contribution brings qualitative agreement with experiments and the right Hofmeister series. This is so not only for surface tension changes but also for measured surface potentials. The inclusion of ionic dispersion interaction potentials further improves the agreement with experiments. We discuss how further progress in the theory of the surface tension of salts can be achieved.

Adsorption and desorption of polymer/surfactant mixtures at solid-liquid interfaces: substitution experiments

The adsorption of mixtures of aqueous solutions of cationic hydroxyethylcellulose polymer JR400 and anionic surfactant, sodium dodecyl sulfate, using atomic force microscopy (AFM) has been studied. Samples with various compositions from different regions of the ternary phase diagram presented in our previous work were imaged by atomic force microscopy on freshly cleaved mica, and hydrophobically modified mica and silica in soft-contact mode. A series of "washing" (subsequent injection of compositions with gradually decreasing polymer/surfactant ratio) and "scratching" (mechanical agitation of the surface material with an AFM tip) experiments were performed. It was revealed that the morphology of the adsorbed layer altered in a manner following the changes in morphology in the bulk solution. These changes were evidenced in cluster formation in the layer. The results suggest that the influence of the surface was limited to the formation of the adsorbed layer where the local concentrations of polymer and surfactant were higher than those in the bulk. All further modifications were driven by changes in the mixture composition in bulk. Force measurements upon retraction reveal the formation of network structures within the surface aggregates that will greatly slow structural reequilibration.

Adsorption pattern of mixtures of trimethylammonium-modified hydroxyethylcellulose and sodium dodecyl sulfate at solid-liquid interfaces

We studied mixtures of aqueous solutions of cationic hydroxyethylcellulose JR400 polymer and anionic sodium dodecyl sulfate using dynamic light scattering and atomic force microscopy (AFM). A ternary phase diagram was established showing three interesting realms of the polymer-surfactant-water mixture: a preprecipitation area of lowered viscosity (polymer excess) compared to the pure polymer solution, a postprecipitation area (resolubilization at surfactant excess), and highly diluted samples with a stoichiometrical surfactant-polymer ratio close to that of maximum precipitation. Samples with various compositions representing these areas were imaged by atomic force microscopy on mica and on hydrophobically modified silica in contact mode. A correlation between light scattering data concerning particle size and, more important, structuring in the bulk on one hand and AFM images on the other hand was observed. It was revealed that the influence of surface properties is of less importance for adsorption, compared to the influence of the mixture in the bulk, provided that the mixture is prepared prior to adsorption.

P19: a female and tissue specifically expressed gene in Schistosoma mansoni, regulated by pairing with the male

A female-specific sequence was isolated from a cDNA library of Schistosoma mansoni and further characterized. Expression of the corresponding gene (p19) depends on pairing with a male. In situ hybridization and immunohistology experiments revealed exclusive expression of the gene in the cells of the vitellarium, suggesting a function in egg formation. In addition, experimental evidence for cross-linking of the protein under oxidative conditions supports the assumption that the p19 gene may code for an egg-shell precursor protein.