120 results on '"Sobstyl M"'
Search Results
2. Chordoid Meningioma. Case Report and Review of the Literature
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Prokopienko, M, primary, Wierzba-Bobrowicz, T, additional, Grajkowska, W, additional, Stępień, T, additional, and Sobstyl, M, additional
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- 2022
- Full Text
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3. EP475 Immunohistochemical expression of LHRH receptor in different anatomical compartments of endometrial cancer patients
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Barczynski, B, primary, Fraszczak, K, additional, Sobstyl, M, additional, Wertel, I, additional, Zakrzewska, E, additional, Nowicka, A, additional, and Kotarski, J, additional
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- 2019
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4. Farmakologiczne leczenie endometriozy
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Sobstyl, M., Tkaczuk-Włach, J., and Grzegorz Jakiel
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leczenie ,lcsh:R ,lcsh:Medicine ,endometrioza - Abstract
Mimo wielu badań biochemicznych i molekularnych endometrioza należy do chorób, których etiopatogenezajest mało poznana i przysparza wiele trudności w postępowaniu leczniczym. Rozpoczynając terapię endometriozy,należy wziąć pod uwagę rodzaj i stopień nasilenia objawów oraz status prokreacyjny kobiety. Ponadto,klasyczna definicja endometriozy (obecność komórek gruczołowych i podścieliska) zakłada konieczność pobraniamateriału do badania histopatologicznego. Nie zawsze jednak laparoskopia jest pierwszym krokiem w rozpoznawaniui terapii endometriozy. Leczenie objawów, takich jak ból związany z endometriozą czy zaburzeniamiesiączkowania, rozpoczyna się od podania leków I rzutu – tabletek antykoncepcyjnych oraz niesteroidowychleków przeciwzapalnych (NLPZ). Dwuskładnikowe tabletki antykoncepcyjne najczęściej poleca się do stosowaniaw terapii ciągłej. Nieskuteczne leczenie bólu (min. 3 miesiące) daje podstawę do wdrożenia innej metodyleczniczej: laparoskopii lub terapii II rzutu, czyli zastosowania analogów GnRh, Danazolu i progestagenów. Dużenadzieje wiąże się inhibitorami aromatazy, inhibitorami czynnika martwicy nowotworów α (TNF-α), lekamihamującymi angiogenezę oraz inhibitorami metaloproteinaz tkankowych.
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- 2010
5. Osteoporoza – obraz kliniczny, czynniki ryzyka i diagnostyka
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Tkaczuk-Włach, J., Sobstyl, M., and Grzegorz Jakiel
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diagnosis of osteoporosis ,lcsh:R ,fracture risk assessment ,lcsh:Medicine ,bone mineral density ,osteoporosis - Abstract
Osteoporosis is defined as a skeletal disease with low bone mass and micro-architectural deterioration of bonetissue. Osteoporosis is an insidious disease and usually develops for some time before being detected. Usually thefirst indication of osteoporosis is fracture. Common sites for osteoporotic fracture are hip, spine and wrist.Osteoporosis is categorized as either primary or secondary. The aim of osteoporosis management is toreduce fracture risk. The primary clinical goal is identification of patients at high risk of fracture rather thanidentification of women or men with osteoporosis. Bone mineral density (BMD) is most commonly measuredfor information about bone strength but it is only one component of fracture risk. A large number of clinical riskfactors for fracture have been identified and can provide information on fracture risk independently of BMD.
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- 2010
6. Diagnostyka hormonalna łysienia kobiet
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Sobstyl, M., Tkaczuk-Włach, J., and Grzegorz Jakiel
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łysienie androgenne ,flutamid ,lcsh:R ,lcsh:Medicine ,testosteron ,dehydroepiandosteron ,octan cyproteronu - Abstract
Prawidłowa diagnostyka łysienia u kobiet umożliwia wdrożenie leczenia warunkującego sukces terapeutyczny.Łysienie androgenne wymaga oznaczenia stężenia androgenów (testosteronu, 3α-androstendiolu, dehydroepiandrosteronu)oraz białka wiążącego hormony płciowe w surowicy. W diagnostyce różnicowej oprócznadmiaru androgenów należy brać pod uwagę inne choroby ogólnoustrojowe: nadczynność bądź niedoczynnośćtarczycy, hiperinsulinemię, zespół policystycznych jajników lub hiperprolaktynemię. Dlatego przydatne wydajesię oznaczanie dodatkowo tyreotropiny, tyroksyny, prolaktyny, glikemii i insulinemii. W leczeniu łysienia androgennegonajwiększą rolę odgrywają antyandrogeny: spironolakton, octan cyproteronu, często w połączeniuz doustną tabletką antykoncepcyjną. Wykorzystywane są również inhibitory 5α-reduktazy: finasteryd, duosterydoraz stosowany miejscowo minoksydyl.
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- 2010
7. P149 – 2652: Neuroimaging findings in two common NBIA subtypes, PKAN and MPAN
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Kmiec, T., primary, Jurkiewicz, E., additional, Nowak, K., additional, Malczyk, K., additional, Chełstowska, S., additional, Bilska, M., additional, Jóźwiak, S., additional, Turska-Kmieć, A., additional, Hartig, M., additional, Iuso, A., additional, Haack, T.B., additional, Prokisch, H., additional, Meitinger, T., additional, Sobstyl, M., additional, and Mandat, T., additional
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- 2015
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8. Caesarean Scar Endometriosis May Require Abdominoplasty
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Barczyński Bartłomiej, Sobstyl Małgorzata, Frąszczak Karolina, and Sobstyl Anna
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Medicine (General) ,R5-920 - Abstract
Endometriosis is defined as an ectopic presence of endometrium-like tissue outside uterine cavity, which most commonly involves intraperitoneal organs. However, one of the less frequent forms of the disease is abdominal wall endometriosis usually developing in surgical scars following obstetric and gynaecological surgeries involving uterine cavity entering, that is, caesarean section, myomectomy or hysterectomy. In this case report we present a case of a patient with extensive caesarean scar endometriosis, who required complex surgical management. Successful surgical treatment involved not only radical tumour resection and application of mesh in postoperative hernia prevention but also adequate wound closure ensuring satisfactory cosmetic results, which was most challenging. The abdominal wall defect could not be sutured by traditional technique, thus polypropylene mesh was used and partial abdominoplasty was performed. The wound healed without complication and 24-month follow-up showed no evidence of local recurrence and satisfactory cosmetic result. In case of extensive endometrial abdominal wall tumours surgical treatment may involve application of advanced plastic surgery techniques, like abdominoplasty or skin/musculocutaneous flaps transposition.
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- 2021
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9. Chronic bilateral pallidal stimulation in a patient with DYT-1 positive primary generalized dystonia. A long-term follow-up study
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Sobstyl, M., Miroslaw Zabek, Koziara, H., and Dzierczeki, S.
10. A patient with parkinsonism related to Gaucher's disease type I successfully treated by unilateral pallidotomy - A 3-year follow-up
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Sobstyl, M., Miroslaw Zabek, Koziara, H., and Dzierzecki, S.
11. Changes in carbohydrate metabolism of PCOS patients in cycle stimulated by rFSH,Zmiany gospodarki weglowodanowej u pacjentek z PCOS w cyklu stymulowanym rFSH
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Sobstyl, M., Bakalczuk, S., Smoleń, A., Bakalczuk, G., and Grzegorz Jakiel
12. Bilateral pallidotomy for the treatment of advanced Parkinson disease,Obustronna pallidotomia w leczeniu zaawansowanej postaci choroby Parkinsona
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Sobstyl, M., Miroslaw Zabek, Koziara, H., and Kadziołka, B.
13. Stereotactic ventrolateral thalamotomy in the treatment of Holmes tremor,Stereotaktyczna brzuszno-boczna talamotomia w leczeniu drzenia Holmesa
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Sobstyl, M., Miroslaw Zabek, Koziara, H., and Kadziołka, B.
14. Recognition of biological movements and cognitive functioning in patients with central nervous system tumours
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Kupryjaniuk, A., Sobstyl, M., Angelika Stapińska-Syniec, and Manera, V.
15. Deep brain stimulation of the right nucleus accumbens in a patient with Tourette syndrome. Case report
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Miroslaw Zabek, Sobstyl, M., Koziara, H., and Dzierzecki, S.
16. Rare iatrogenic iliac artery injury during lumbar disc surgery - a case report
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Bojarski, P., Solonynko, B., Stapinska-Syniec, A., Sobstyl, M., and Nazarewski, S.
17. Problem of HPV infection in perimenopausal and postmenopausal women,Problem infekcji wirusem brodawczaka ludzkiego (HPV) w wieku około-i pomenopauzalnym
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Robak-Chołubek, D., Sobstyl, M., Tkaczuk-Włach, J., Chołubek, G., and Grzegorz Jakiel
18. Nod-like receptors: The relevant elements of glioblastoma`s prognostic puzzle.
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Grabiec M, Sobstyl M, and Skirecki T
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- Humans, Prognosis, Animals, NLR Proteins metabolism, Inflammasomes metabolism, Inflammasomes immunology, Glioblastoma metabolism, Glioblastoma immunology, Glioblastoma pathology, Brain Neoplasms metabolism, Brain Neoplasms pathology, Brain Neoplasms immunology, Brain Neoplasms genetics
- Abstract
Despite considerable improvements in understanding the biology of glioblastoma (GB), it still remains the most lethal type of brain tumor in adults. The role of innate immune cells in the development of GB was recently described. In particular, the tumor-immune cell interactions are thought to be critical in enabling tumor tolerance and even protection against therapeutics. Interestingly, the GB cells express proteins belonging to the family of intracellular pattern-recognition receptors, namely the NOD-like receptors (NLRs). Their activation may trigger the formation of the inflammasome complex leading to the secretion of mature IL-1β and IL-18 and thus resulting in cell death. Intrudingly, the expression of most NLRs was found to be correlated with tumor progression and poor prognosis. We speculate that recognizing the role of NOD-like receptors in GB has the potential to improve the effectiveness of diagnostic tools and prognosis, while also encouraging the development of novel precision medicine-based therapies., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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19. Clear cell meningioma of the filum terminale in a 44-year-old woman - case report.
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Glinka P, Sobstyl M, Acewicz A, and Bojarski P
- Abstract
Clear cell meningioma (CCM) is a rare subtype of meningioma, especially unusual as a neoplasm of the filum terminale. Clear cell meningioma seems to have a more aggressive nature and a higher risk of recurrence than WHO grade I meningiomas. A 44-year-old woman presented with lower back pain radiating to the left leg and mild weakness in the left leg. Magnetic resonance imaging (MRI) showed a well-demarcated, intradural lesion filling the spinal canal at the L3-S1 levels and compressing the cauda equina. The patient underwent laminectomy from L3 to S1. During the operation, the filum terminale was identified as a structure that was disappearing into the tumor. The filum terminale was cut and the tumor was totally removed in one piece. Pathological findings were indicative of the diagnosis of clear cell meningioma, CNS WHO G2. Postoperative magnetic resonance imaging at 6 months showed no residual mass. Total surgical excision of the CCM of the spinal cord should be chosen as the optimal treatment. In addition, radiological follow-up is equally important due to the high risk of recurrence. Our case is unusual in that the tumor's location was the filum terminale.
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- 2024
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20. Battery depletion in patients treated with anterior thalamic stimulation for drug-resistant epilepsy.
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Sobstyl M, Konopko M, and Wierzbicka A
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- Humans, Adult, Anterior Thalamic Nuclei physiopathology, Deep Brain Stimulation methods, Female, Male, Neuropsychological Tests, Young Adult, Drug Resistant Epilepsy therapy, Drug Resistant Epilepsy physiopathology
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- 2024
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21. The PD-1/PD-L1 Gateway: Peripheral Immune Regulation in the Pathogenesis of Endometriosis.
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Sobstyl M, Mertowska P, Mertowski S, Zaborek-Łyczba M, Dudziński D, Polak G, and Grywalska E
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- Humans, Female, Adult, T-Lymphocytes immunology, T-Lymphocytes metabolism, Endometriosis metabolism, Endometriosis immunology, Endometriosis pathology, B7-H1 Antigen metabolism, Programmed Cell Death 1 Receptor metabolism, B-Lymphocytes immunology, B-Lymphocytes metabolism
- Abstract
Endometriosis is a chronic inflammatory disease characterized by the presence of endometrial-like tissue outside the uterine cavity, causing pain and infertility. Despite the rather unclear etiopathogenesis, recent studies suggest the involvement of the immune system in the development and progression of endometriosis. The role of the PD-1/PD-L1 axis in the modulation of the immune response in this disease seems to be particularly interesting. This preliminary study aimed to investigate the expression of PD-1 and PD-L1 on T and B lymphocytes in peripheral blood in patients with endometriosis to assess their potential impact on disease progression. Our study involved peripheral blood samples from 80 patients diagnosed with endometriosis and 20 healthy women as a control group were analyzed. Flow cytometry was used to assess the expression of PD-1 and PD-L1 on T and B lymphocytes, and enzyme-linked immunosorbent assays were used to assess their soluble forms in serum and peritoneal fluid.in our research we observe significantly higher expression of PD-1 and PD-L1 on T and B lymphocytes was found in patients with endometriosis compared to the control group. Higher expression of both tested molecules correlated with the stage of endometriosis. The results of our preliminary studies indicate a potential role of the PD-1/PD-L1 axis in the modulation of the immune response in endometriosis. Modified expression of these proteins may contribute to immune evasion by ectopic tissues, supporting their survival and proliferation. These findings suggest that targeting PD-1/PD-L1 could be explored as a therapeutic option for the treatment of endometriosis, though further research with larger sample sizes is necessary to confirm these results and clarify the role of PD-1/PD-L1 in the pathogenesis of the disease.
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- 2024
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22. Deep brain stimulation of the subiculum in the treatment for refractory temporal lobe epilepsy due to unilateral mesial temporal lobe sclerosis.
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Sobstyl M, Kowalska M, Konopko M, Wierzbicka A, Karamon K, and Nagańska E
- Abstract
Temporal lobe epilepsy (TLE) is the most common form of drug-resistant epilepsy. The main pathological changes primarily involve hippocampal sclerosis (HS). Early resective surgery of the sclerotic hippocampus is typically associated with favorable clinical outcomes. However, not all patients are suitable candidates for resective surgery of mesial temporal lobe structures. Therefore, alternative treatment modalities should be considered. We present the case of a 50-year-old right-handed woman with left HS who underwent unilateral subiculum stimulation for drug-resistant epilepsy (DRE). Since the age of 10, the patient had been experiencing focal to bilateral tonic-clonic seizures (FBTCS). Despite multiple antiseizure medications, she experienced 12 to 17 FBTCS per month in the last two years. Due to concerns about potential memory decline and personal preferences, she refused resective surgery. As an alternative, the patient underwent left unilateral subiculum stimulation. The stimulation resulted in a nearly 67 % reduction in seizure frequency at the last follow-up (20 months after surgery). This case highlights that drug-resistant epilepsy may be effectively treated with subicular stimulation in patients with HS., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Inc.)
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- 2024
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23. Deep brain stimulation of hippocampus in treatment of refractory temporal lobe epilepsy.
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Sobstyl M, Konopko M, Wierzbicka A, Pietras T, Prokopienko M, and Sipowicz K
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- Humans, Treatment Outcome, Deep Brain Stimulation adverse effects, Deep Brain Stimulation methods, Drug Resistant Epilepsy physiopathology, Drug Resistant Epilepsy therapy, Epilepsy, Temporal Lobe physiopathology, Epilepsy, Temporal Lobe therapy, Hippocampus physiopathology
- Abstract
Introduction: Temporal lobe epilepsy (TLE) is the most common cause of focal onset seizures, affecting 40% of adolescents and adults with epilepsy. TLE is also one of the most common drug resistant forms of epilepsy. Surgical resection remains the treatment of choice for TLE, but not all patients with TLE are suitable candidates for resective neurosurgery. For such patients, deep brain stimulation (DBS) of the hippocampus remains a reversible and efficient treatment alternative., State of the Art: We undertook a systematic review of the literature on hippocampal DBS efficacy and safety in the management of patients with TLE. A search using two electronic databases, the Medical Literature, Analysis, and Retrieval System on-line (MEDLINE) and the Cochrane Central Register of Controlled Trials (CEN-TRAL), was conducted., Clinical Implications: We found 14 articles related to hippocampal DBS for the treatment of TLE. The responder rate (defined as at least 50% reduction in seizure frequency) for all patients was 83.4%, Of 99 patients treated by hippocampal DBS, 82 were regarded as responders, and 17 as non-responders., Future Directions: Hippocampal DBS appears to be a safe and efficacious treatment alternative for patients who are not candidates for temporal lobectomy or selective amygdalohippocampectomy due to serious postoperative cognitive deficits. In selected patients with TLE, this neuromodulatory therapy may be very safe and efficacious.
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- 2024
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24. Deep brain stimulation of anterior nucleus and centromedian nucleus of thalamus in treatment for drug-resistant epilepsy.
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Sobstyl M, Konopko M, Wierzbicka A, Prokopienko M, Pietras T, and Sipowicz K
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- Humans, Treatment Outcome, Deep Brain Stimulation methods, Drug Resistant Epilepsy therapy, Anterior Thalamic Nuclei, Intralaminar Thalamic Nuclei
- Abstract
Introduction: Drug-resistant epilepsy (DRE) remains poorly-controlled in c.33% of patients, and up to 50% of patients suffering from DRE are deemed not to be suitable candidates for resective surgery. For these patients, deep brain stimulation (DBS) may constitute the last resort in the treatment of DRE., State of the Art: We undertook a systematic review of the current literature on DBS efficacy and the safety of two thalamic nuclei-anterior nucleus of the thalamus (ANT) and the centromedian nucleus of the thalamus in the management of patients with DRE. A search using two electronic databases, the Medical Literature, Analysis, and Retrieval System on-line (MEDLINE) and the Cochrane Central Register of Controlled Trials (CEN-TRAL) was conducted., Clinical Implications: We found 30 articles related to ANT DBS and 13 articles related to CMN DBS which were further analysed. Based on the clinical research articles, we found a mean seizure frequency reduction for both thalamic nuclei. For ANT DBS, the mean seizure frequency reduction ranged from 48% to 75%, and for CMN DBS from 46.7% to 91%. The responder rate (defined as at least 50% reduction in seizure frequency) was reported to be 53.2-75% for patients after ANT DBS and 50-90% for patients after CMN DBS., Future Directions: ANT and CMN DBS appear to be safe and efficacious treatments, particularly in patients with refractory partial seizures and primary generalised seizures. ANT DBS reduces most effectively seizures originating in the temporal and frontal lobes. CMN DBS reduces mostly primary generalised tonic-clonic and atypical absences and atonic seizures. Seizures related to Lennox-Gastaut syndrome respond very favourably to CMN DBS.
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- 2024
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25. Transformation of IDH-wildtype glioblastoma to gliosarcoma with features of osteosarcoma.
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Sobczyk P, Sobstyl M, Acewicz A, Rosa J, Grabiec M, and Grajkowska W
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- Humans, Middle Aged, Male, Glioblastoma genetics, Glioblastoma pathology, Gliosarcoma genetics, Gliosarcoma pathology, Brain Neoplasms genetics, Brain Neoplasms pathology, Osteosarcoma genetics, Osteosarcoma pathology, Isocitrate Dehydrogenase genetics
- Abstract
Gliosarcoma (GS) is a rare variant of IDH-wildtype glioblastoma. It is classified as grade 4 in the latest WHO CNS classification of both glial and mesenchymal components. Gliosarcoma may arise de novo or secondary from glioblastoma. It occurs in up to 2% of patients diagnosed with glioblastoma. We present a case report of a 51-year-old patient who was initially diagnosed with glioblastoma multiforme, which transformed into secondary gliosarcoma with an osteosarcoma component 16 months after the initial diagnosis. We believe that increasing reporting of secondary gliosarcoma (sGS) will be helpful in understanding, diagnosing and providing more effective treatment for this cancer.
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- 2024
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26. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the dura mimicking meningioma: a case report and literature review.
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Glinka P, Sobstyl M, Rymkiewicz G, Wierzba-Bobrowicz T, Paszkiewicz-Kozik E, and Grajkowska W
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- Humans, Female, Adult, Diagnosis, Differential, Lymphoma, B-Cell, Marginal Zone pathology, Lymphoma, B-Cell, Marginal Zone diagnosis, Meningioma pathology, Meningioma diagnosis, Dura Mater pathology, Meningeal Neoplasms pathology, Meningeal Neoplasms diagnosis
- Abstract
MALT lymphoma of the dura is a very rare type of low-grade B-cell lymphoma. Little more than 100 cases have been reported in the literature to date. We report a 43-year-old woman who was referred to hospital because of a series of three tonic-clonic seizures on the day of admission. Neurological examination revealed confusion and aphasia. Magnetic resonance imaging (MRI) showed a contrast-enhanced, broad-based lesion along the dura in the left parieto-occipital area. The suspicion of an en plaque meningioma was raised. The tumour invaded the brain parenchyma with visible extension into the brain sulci. There was a marked brain oedema surrounding the lesion and causing the midline shift 8 mm to the right. After stabilization of neurological condition (intravenous diuretics and steroids), the operation was performed. The diagnosis of dural MALT lymphoma was established. During the pathological examination, it was especially problematic to distinguish MALT lymphoma from follicular lymphoma, but the final diagnosis was MALT lymphoma. Surgical partial removal with additional R-CVP immunochemotherapy (rituximab, cyclophosphamide, vincristine and prednisone) resulted in complete remission. The follow-up period is 1 year. Our presented case of a MALT lymphoma highlights the fact that surgical partial removal with additional immunochemotherapy is an available option in these rare intracranial tumours.
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- 2024
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27. The sense of loneliness and meaning in life in post-COVID convalescents-a preliminary study.
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Sipowicz K, Pietras T, Mosiołek A, Sobstyl M, Ring M, Kamecki K, Stefańczyk I, and Kosmalski M
- Abstract
Introduction: The COVID-19 epidemic has provided opportunity to study the impact of a well-defined severe illness on the development of a depressive episode and the associated sense of loneliness and lack of meaning in life., Materials and Methods: The aim of the study was to assess the occurrence of a reactive depressive episode, the severity of depression, a sense of loneliness and meaning in life in subjects who approximately a year earlier than the date of the study had suffered from a pulmonary form of SARS-CoV-2 infection with radiologically documented interstitial lesions of the lungs, requiring and not requiring hospitalization compared to people who did not develop the disease as a result of infection with that virus. The study included 63 subjects hospitalized for pulmonary lesions, 67 not hospitalized and 60 healthy controls. The severity of depressive symptoms was measured using a Polish-language standardized version of the Beck Depression Inventory, a sense of loneliness using the De Jong Gierveld Loneliness Scale, and a sense of meaning in life using the Life Attitude Profile-Revised., Results: The frequency of depression and its severity were found to be the highest in hospitalized patients compared to those treated at home and healthy people. A significant difference in the frequency of depression and its severity between outpatients and healthy people was also observed. The feeling of loneliness turned out to be greatest in the group of hospitalized people. Also, the severity of loneliness was found to be higher in the outpatient compared to the control group. The sense of meaning in life reached its lowest level among hospitalized patients, was moderately reduced in the outpatient group, and typical of the Polish population in the control group., Discussion: Both pulmonary SARS-CoV-2 infection and hospitalization have been shown to be a risk factor for depression, increased feeling of loneliness and a reduced sense of meaning in life. The effect of trauma and the presence of depression can be the explanation for the increased sense of loneliness after the illness and the partial breakdown of the lifeline manifested by a decrease in the sense of meaning in life., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sipowicz, Pietras, Mosiołek, Sobstyl, Ring, Kamecki, Stefańczyk and Kosmalski.)
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- 2023
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28. Multifocal drug-resistant epilepsy in a patient with a newly discovered mutation in tuberous sclerosis complex 1 gene treated by deep brain stimulation in the anterior thalamic nucleus.
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Sobstyl M, Jezierski P, Konopko M, and Stapińska-Syniec A
- Abstract
Tuberous sclerosis complex (TSC) is an autosomal dominant disorder caused by mutations in the tumor suppressor genes TSC1 or TSC2. TSC is characterized by the formation of multiple tumors in various organs. The most common neurological manifestation of the disorder is epilepsy present in 79-90% of cases. At least one-third of TSC patients develop drug-resistant epilepsy (DRE) which remains a great challenge for clinicians. Neuromodulation is an option in cases of multifocal epilepsy, epilepsy originating in eloquent areas, or the inability to identify the ictal onset zone. Deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) may be used in the treatment of multifocal DRE. Here, we present a case of a patient with multifocal DRE caused by TSC, who was treated with ANT-DBS. A follow-up period of eight months showed that the patient's multifocal DRE was successfully treated by ANT-DBS., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Inc.)
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- 2023
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29. The ventral capsule and ventral striatum-Stereotactic targets for the management of treatment-resistant depression. A systematic literature review.
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Sobstyl M, Prokopienko M, and Pietras T
- Abstract
Background: Deep brain stimulation (DBS) is still an experimental treatment modality for psychiatric disorders including treatment-resistant depression (TRD). There is preliminary evidence that stimulation of brain reward circuit structures including the ventral striatum (VS) may exert an antidepressant effect. The main nucleus of the reward circuit is the nucleus accumbens (NAc). The NAc is a major structure of VS that plays a critical role in reward-seeking behavior, motivation, and addiction., Aims: This study aimed to review the current studies including randomized clinical trials, open-label trials, and case reports of NAc/VS and VC DBS for TRD in humans., Method: The literature was reviewed using a medical database-Medical Literature, Analysis, and Retrieval System Online (MEDLINE) on NAc/VS or VC DBS in TRD. The identified studies were assessed based on the patient's characteristics, clinical outcomes, and adverse events related to DBS as well as the stereotactic technique used to guide the implantation of DBS electrodes. The inclusion and exclusion criteria of DBS for TRD were presented and discussed., Results: The searched literature revealed one case report, three open-label studies (OLS), one multicenter open-label study (mOLS), and two randomized clinical trials (RCTs). There were three additional studies reporting the clinical outcomes in the long term in TRD patients included in the two mentioned RCTs. The total number of patients with TRD treated by NAc/VS or VC is estimated to be 85 individuals worldwide. The response rate to DBS defined as a 50% reduction of postoperative Montgomery-Asberg Depression Rating Scale (MADRS) scores was achieved in 39.8% of the operated patients (range, 23-53%). The remission defined as MADRS scores of < 10 was found in 17.8% after DBS (range, 0-40%). The mean follow-up was 19.7 months (range 3.7-24 months)., Conclusion: The current results of NAc/VS and VC DBS are still limited by a relatively small number of patients treated worldwide. Nevertheless, the results suggest that NAc/VS and VC can be regarded as promising and efficacious targets for DBS, taking into account the response and remission rates among TRD patients with no other treatment option. The adverse events of NAc/VS and VC DBS are reversible due to the adjustment of stimulation parameters. The most common adverse events were hypomanic/manic states, suicidal thoughts/attempts, and suicides. Patients with TRD after NAc/VS and VC DBS should be strictly followed to prevent or diminish these stimulation-induced adverse events., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sobstyl, Prokopienko and Pietras.)
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- 2023
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30. Deep brain stimulation in a patient with progressive myoclonic epilepsy and ataxia due to potassium channel mutation (MEAK). A case report and review of the literature.
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Sobstyl M, Kożuch N, Iwaniuk-Gugała M, Stapińska-Syniec A, Konopko M, and Jezierski P
- Abstract
Progressive myoclonic epilepsy (PME) is characterized by prominent myoclonus, generalized tonic-clonic seizures, and less often focal, tonic, or absence seizures. The KCNC1 mutation is responsible for specific clinical phenotype of PME which has been defined as myoclonic epilepsy and ataxia due to potassium channel mutation (MEAK). We present a case of a 44 years-old male patient with genetically proven MEAK who underwent subthalamic nucleus/substantia nigra (STN/SNr) deep brain stimulation (DBS) for his pharmacological-refractory myoclonus and drug-resistant epilepsy (DRE). Since the age of 4-5 years, the patient had been suffering from intention tremor, and later the myoclonic jerks, ataxia involving the upper limbs and walking difficulties worsened. The first bilateral tonic-clonic seizure (BTCS) occurred at the age of 22. The patient agreed to staged bilateral implantation of DBS electrodes placed in the STN/SNr region. The follow-up lasts more than 24 months. The myoclonic jerks assessed by Unified Myoclonus Rating Scale (UMRS) were reduced by nearly 70 % and BTCS was completely abolished. The patient's ataxia and dysarthria did not improve. Early diagnosis with genetic testing may significantly help in counseling patients with PME and enables to undertake the surgical approach targeting the STN/SNr., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Inc.)
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- 2023
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31. Clinical efficacy and safety of anterior thalamic deep brain stimulation for intractable drug resistant epilepsy.
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Sobstyl M, Konopko M, Sienkiewicz-Jarosz H, Kurkowska-Jastrzębska I, Nagańska E, Stapińska-Syniec A, Glinka P, and Rylski M
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- Adult, Humans, Middle Aged, Prospective Studies, Treatment Outcome, Seizures surgery, Drug Resistant Epilepsy surgery, Anterior Thalamic Nuclei physiology, Deep Brain Stimulation methods
- Abstract
Background: Deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) is a neuromodulation therapy for patients with refractory focal seizures evolving into bilateral tonic-clonic seizures when pharmacotherapy as well other neuromodulation techniques including vagus nerve stimulation or responsive neurostimulation have failed., Objective: We performed a prospective single-center study investigating the clinical efficacy and exact ANT DBS lead location in patients with DRE., Methods: The primary outcome measure was the proportion of patients with more than 50 % reduction in diary-recorded seizures when compared to three preoperative months (baseline seizure frequency). The close postoperative follow-up was performed every 3 months. The seizure frequency, stimulation settings and adverse events were closely monitored during follow-up visits. We also analyzed the seizure outcome with location of ANT DBS active contacts., Results: Between May 2020 and October 2022, 10 adult patients with a mean age of 38.5 years (range, 30-48 years) underwent bilateral ANT DBS surgery (mean duration of DRE 28.6 years, range 16-41 years). The median seizure count in three months period preceding surgery (baseline seizure count) was 43.2 (range, 4-150). Nine patients achieved more than 50 % seizure reduction at the last follow-up (mean range 3-33 13.6 months, months). ANT DBS caused seizure reduction 3 months after procedure as well as at last follow-up by 60.4 % and 73.3 %, respectively. Due to relatively small number of studying individuals we cannot precisely locate the area within ANT associated with good clinical outcome. Patients with temporal lobe epilepsy had a remarkable reduction of seizure frequency. No patient suffered transient or permanent neurological deficits., Conclusions: Clinical efficacy of ANT DBS may support more widespread utilization of this neuromodulation technique especially for seizures originating from temporal lobes., Competing Interests: Conflict of interest No potential conflict of interest was reported by the authors of this article., (Copyright © 2023 Elsevier B.V. All rights reserved.)
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- 2023
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32. Sylvian fissure lipoma associated with fusiform aneurysm in the middle cerebral artery trifurcation: A case report and literature review.
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Karamon KS, Sobstyl M, Rylski M, and Wieczorek K
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Background: The intracranial lipomas are rare congenital malformations accounting for approximately 0.1-1.3% of all intracranial tumors, of which Sylvian fissure lipomas account for <5%. These lesions are frequently associated with dysgenesis of neuronal brain tissues and vascular malformations and in the majority are asymptomatic. Intracranial lipomas on magnetic resonance imaging (MRI) may mimic late subacute hemorrhage due to similar radiological features. Due to the tight adhesion of the lipoma to the surrounding nerve structures and vessels, complete removal is difficult and does not guarantee the disappearance of symptoms., Case Description: We present the case of a 42-year-old woman with chronic headaches and short-term memory impairment who was admitted to the emergency room after an out-of-hospital brain MRI with suspected ruptured right middle cerebral artery (MCA) aneurysm and late subacute intracranial hemorrhage. In the hospital, after clinical evaluation, emergency computed tomography (CT) angiography was performed, which revealed an unruptured fusiform aneurysm located in the right MCA trifurcation surrounded by an extremely hypodense lesion corresponding to fat in the right Sylvian fissure. No features of intracranial hemorrhage were present. The diagnosis of intracranial lipoma was finally confirmed after the MRI of the brain with a fat suppression sequence. Surgical treatment was not attempted, and the patient was treated conservatively with a satisfactory general outcome., Conclusion: A Sylvian fissure lipoma may be associated with a fusiform aneurysm in the MCA trifurcation. By modifying the standard MRI protocol and performing a CT scan, an intracranial lipoma can be detected and a late subacute intracranial hemorrhage can be excluded., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Surgical Neurology International.)
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- 2023
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33. Skin-related complications following deep brain stimulation surgery: A single-center retrospective analysis of 525 patients who underwent DBS surgery.
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Stapińska-Syniec A, Sobstyl M, and Paskal W
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- Humans, Retrospective Studies, Tremor complications, Postoperative Complications epidemiology, Postoperative Complications etiology, Dystonia etiology, Deep Brain Stimulation adverse effects, Parkinson Disease surgery, Parkinson Disease complications, Essential Tremor surgery, Essential Tremor complications, Dystonic Disorders complications, Tourette Syndrome surgery, Tourette Syndrome complications
- Abstract
Background: Although Deep Brain Stimulation (DBS) is a safe and proven treatment modality for patients suffering from debilitating movement and neuropsychiatric disorders, it is not free from complications. Management of skin erosion and infection following DBS surgery constitutes a challenge in everyday clinical practice., Objectives: Skin-related complications were evaluated in patients who underwent DBS surgery due to Parkinson's disease (PD), dystonia, essential tremor (ET), and other indications including Tourette syndrome (TS), Obsessive-Compulsive Disorder (OCD), and epilepsy., Methods: A retrospective analysis of clinical data was performed on patients who underwent DBS surgery between November 2008 and September 2021 at the Department of Neurosurgery, Institute of Psychiatry and Neurology, Warsaw., Results: 525 patients who underwent 927 DBS leads implantations were included in the analysis. There were 398 patients with PD, 80 with dystonia, 26 with ET, 7 with drug-resistant epilepsy, 5 with Multiple Sclerosis, 4 with Holme's or cerebellar tremor, 3 with TS, and 2 with OCD. 42 patients (8,0%) had 78 skin infection episodes. The overall level of skin erosion was 3,8% (20/525 patients). The risk of developing infection episode was connected with younger age at diagnosis (p = 0.017) and at surgery (p = 0.023), whereas the development of skin erosion was connected with the dystonia diagnosis (p = 0.012). Patients with dystonia showed the highest rate of infections and erosions (11/70 and 7/70 patients retrospectively)., Discussion: Postoperative skin complications are a serious side effect of DBS surgery., Conclusion: Our study suggests that dystonic patients are at higher risk of developing skin-related complications after DBS surgery., Competing Interests: Conflict of interest The authors declare no potential conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)
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- 2023
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34. Large haemorrhage within glioblastoma mimicking haemorrhagic stroke and coexistance of meningioma: a case of collision tumours.
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Sobstyl M, Nagańska E, Glinka P, Wierzba-Bobrowicz T, Acewicz A, and Kuls-Oszmaniec A
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- Male, Humans, Middle Aged, Magnetic Resonance Imaging, Hemorrhage, Meningioma complications, Meningioma diagnosis, Meningioma pathology, Glioblastoma complications, Glioblastoma diagnosis, Glioblastoma pathology, Meningeal Neoplasms complications, Meningeal Neoplasms diagnosis, Meningeal Neoplasms pathology, Hemorrhagic Stroke, Brain Neoplasms complications, Brain Neoplasms diagnosis, Brain Neoplasms pathology
- Abstract
Intracranial collision tumours are rare pathologies in which two distinct neoplasms are found in the same location. We present an unusual case of an intracranial collision tumour composed of meningothelial meningioma (CNS WHO G1) and glioblastoma (IDH-wildtype, CNS WHO G4). This collision tumour was found in a 64-year-old man. This patient was hospitalized urgently due to left-sided hemiparesis. The computed tomography (CT) revealed large multilobar intracranial haemorrhage located in the right hemisphere. The history of hypertension and obesity pointed to the misdiagnosis of a typical haemorrhagic stroke. Despite extensive physiotherapy after initial improvement, the magnetic resonance imaging (MRI) showed signs of a marginal contrast enhancement with a suspicion of a brain tumour. Moreover, the meningioma in the same location was suspected. The neuropathological findings confirmed two neoplasms with fragments of the dura mater infiltrated by malignant glioma cells and small nests of meningothelial cells with psammoma bodies. The presented case is extremely rare showing that more malignant tumour may infiltrate a meningioma. Moreover, this case highlights the clinical observation that glioblastoma may mimic a haemorrhagic stroke. In such cases when pharmacological treatment is not effective, suspicions should be raised about a possible underlying brain tumour.
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- 2023
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35. Surgical management of spontaneous intracranial hypotension syndrome: a literature review.
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Sobczyk P, Bojarski P, and Sobstyl M
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- Humans, Cerebrospinal Fluid Leak complications, Magnetic Resonance Imaging adverse effects, Neurosurgical Procedures, Treatment Outcome, Intracranial Hypotension diagnostic imaging, Intracranial Hypotension surgery
- Abstract
Introduction: Spontaneous intracranial hypotension (SIH) is a highly disabling but often misdiagnosed disorder. The optimal management options for patients with SIH remain uncertain. The aim of this study was to review studies reporting the management of SIH with a special emphasis on the surgical treatment of SIH including clinical trials, case series and case reports related to the issue of various neurosurgical procedures performed for SIH treatment., Objective: The clinical outcomes of patients diagnosed with SIH treated with either only surgery or with surgery as the primary method of treatment were analysed., Material and Methods: The PubMed, Scopus and Google Scholar databases were searched according to the established criteria., Results: The literature search revealed seven clinical trials, five case series and eight case reports regarding surgical treatment of patients diagnosed with SIH. Manuscripts reporting at least five individuals treated surgically for SIH were considered as case series. In most published articles, surgery provided clinical benefit, resulting in a success rate of 82.6-100% for complete relief of SIH symptoms., Conclusions: Our literature review has revealed that SIH can be diagnosed reliably by MRI and cisternography. The identification of the location of SIH is mandatory for its successful surgical treatment. The clinical outcome is related to the location of SIH in the spinal canal. Most often, cerebrospinal fluid leakage occurs in the thoracic region. Surgical treatment is very effective and the obtained treatment results are complete and permanent. of the location of SIH is mandatory for its successful surgical treatment. The clinical outcome is related to the location of SIH in the spinal canal. Most often, cerebrospinal fluid leakage occurs in the thoracic region. Surgical treatment is very effective and the obtained treatment results are complete and permanent.
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- 2023
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36. Reoperations for degenerative spinal disease in Poland reported to the National Health Fund over 12 months with estimation of reoperation rate and of risk factors associated with reoperations.
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Sobstyl M
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- Humans, Reoperation, Poland, Spine, Risk Factors, Retrospective Studies, Postoperative Complications, Spinal Diseases surgery, Spinal Fusion
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- 2023
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37. [Communication in psycho-oncology].
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Kupryjaniuk A and Sobstyl M
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- Humans, Quality of Life, Communication, Psycho-Oncology, Neoplasms complications, Neoplasms therapy
- Abstract
One of the foundations of effective and good oncological treatment is proper communication between the medical staff and the patient. In the face of the observed increase in the level of awareness and education of the society, there is also a growing need to provide patients with as much information about their health as possible. Quality of life is more and more often pointed to, not just the quantity of life. Proper communication, both within the facility and with external entities, is considered an important factor in improving the quality of life. The aim of the article is to briefly present the principles of effective communication in healthcare entities. The paper pays attention to verbal and non-verbal communication. The importance of constructive communication was emphasized and the negative features of communication were presented. The purpose of this article is to recall the general principles of communication and the problems encountered in this area, the constant updating of which should serve not only patients, but also people who are responsible for providing oncological care. This work also aims to indicate the application of psycho-oncology in oncology., (© 2022 MEDPRESS.)
- Published
- 2022
38. [Chemobrain - cognitive disorders after chemotherapy].
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Kupryjaniuk A and Sobstyl M
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- Humans, Cognition, Neuropsychological Tests, Chemotherapy-Related Cognitive Impairment, Cognition Disorders chemically induced, Cognitive Dysfunction chemically induced, Neoplasms drug therapy
- Abstract
In recent years, more and more attention has been paid to the deterioration of cognitive functioning after the use of chemotherapy. The article presents the problems of cognitive disorders caused by chemotherapy in cancer patients. These deficits in scientific terminology are called chemobrain. Patients in particular indicate disorders of: longterm verbal memory and executive functions (planning, verbal fluency and working memory). This is confirmed by the results of neuroimaging studies. It has been observed that higher doses of cytostatics may contribute to the development of cognitive deficits. This article is a general introduction to the problems of chemobrain - the definition of the phenomenon and a discussion of neuroanatomical issues related to the influence of chemotherapy on the central nervous system. Moreover, the article tries to draw attention to the application of neuropsychological rehabilitation after chemotherapy., (© 2022 MEDPRESS.)
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- 2022
39. DNA Hydroxymethylation in High-Grade Gliomas.
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Stapińska-Syniec A, Grabiec M, Rylski M, Acewicz A, and Sobstyl M
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- Humans, DNA Methylation, Genetic Markers, Epigenesis, Genetic, DNA, Glioma genetics, Glioblastoma
- Abstract
Background: Since the new World Health Organization (WHO) classification of nervous system tumors (2016, revised, 4th edition) has been released, gliomas are classified depending on molecular and genetic markers in connection with histopathology, instead of histopathology itself as it was in the previous classification. Over the last years, epigenetic analysis has taken on increased importance in the diagnosis and treatment of different cancers. Multiple studies confirmed that deoxyribonucleic acid (DNA) methylation and hydroxymethylation play an important role in the regulation of gene expression during carcinogenesis., Methods: In this review, we aim to present the current state of knowledge on DNA hydroxymethylation in human high-grade gliomas (WHO grades III and IV)., Results: The correlation between DNA hydroxymethylation and survival in glioblastoma multiforme (GBM) patients was evaluated by different studies. The majority of them showed that the expression of 5-hydroxymethylcytosine (5-hmC) and ten-eleven translocation (TET) enzymes were significantly reduced, sometimes almost undetectable in high-grade gliomas in comparison with the normal brain. A decreased level of 5-hmC was associated with poor survival in patients, but high expression of the TET3 enzyme was related to a better prognosis for GBM patients. This points to the relevance of DNA hydroxymethylation in molecular diagnostics of human gliomas, including survival estimation or differentiating patients in terms of response to the treatment., Conclusion: Future studies may shed some more light on this epigenetic mechanism involved in the pathogenesis of human high-grade gliomas and help develop new targeted therapies., Competing Interests: None declared., (Thieme. All rights reserved.)
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- 2022
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40. Deep brain stimulation in the treatment of refractory obsessive-compulsive disorder: a literature review.
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Sobstyl M, Kupryjaniuk A, Stajszczak M, Pietras T, and Święcicki Ł
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- Humans, Clinical Trials as Topic, Treatment Outcome, Deep Brain Stimulation adverse effects, Obsessive-Compulsive Disorder psychology, Obsessive-Compulsive Disorder therapy
- Abstract
Aim of the Study: The aim of this review is to present the overview of DBS outcomes for OCD. Moreover, we have discussed the current OCD pathophysiology with its implications for DBS. We have also presented the current indications and contraindications for DBS in OCD patients as well as still existing limitations in neuromodulation for OCD., Methods: We have performed a literature review of DBS studies for OCD. We have found 8 well-conducted trials or open label trials with at least 6 individuals in each trial. Other reports present the data of the case series or single case reports of OCD for DBS., Results: A number of well-conducted trials have demonstrated that the response rates (more than 35 % YBOCS score reduction) of OCD symptomatology remain in 50 to 80 % range. The study individuals in these trials have proven refractoriness and severity of OCD. The most common adverse events are related to the stimulation and include hypomanic episodes, suicidal ideation and other mood changes., Conclusions: Our review suggests that DBS for OCD cannot be regarded as an established therapy for OCD. DBS for OCD should be regarded as palliative treatment in severely affected patients, but it is not curative. DBS should be considered if available non-operative forms of OCD treatment have failed.
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- 2022
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41. Deep Brain Stimulation for Morbid Obesity: An Underutilized Neuromodulatory Treatment for Severely Obese Patients?
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Stapińska-Syniec A, Kupryjaniuk A, and Sobstyl M
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- Body Mass Index, Brain, Humans, Hypothalamus surgery, Deep Brain Stimulation methods, Obesity, Morbid therapy
- Abstract
Background: Morbid obesity (MO) has been steadily increasing in the last few years. Pharmacotherapy and bariatric surgeries remain the main treatment modalities for MO, although in the long-term they may lose their effectiveness. Other treatment approaches are urgently needed and deep brain stimulation (DBS) is a promising therapy. Disturbed energy homeostasis caused by intake of highly palatable and caloric foods may induce hedonic eating. The brain nuclei responsible for energy homeostasis and hedonia are the hypothalamic nuclei and nucleus accumbens. These brain structures constitute the stereotactic targets approached with DBS to treat MO., Material and Methods: We have performed a literature search of all available clinical applications of DBS for MO in humans. We were able to identify three case series reports and additional six case reports involving 16 patients. The selected stereotactic targets included lateral hypothalamus in eight patients, ventromedial hypothalamus in two patients, and nucleus accumbens in six patients., Results: In general, the safety profile of DBS in refractory MO patients was good. Clinical improvement regarding the mean body mass index could be observed in obese patients., Conclusions: MO is a demanding condition. Since in some cases standardized treatment is ineffective, new therapies should be implemented. DBS is a promising therapy that might be used in patients suffering from MO, however, more studies incorporating more individuals and with a longer follow-up are needed to obtain more reliable results concerning its effectiveness and safety profile., Competing Interests: None declared., (Thieme. All rights reserved.)
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- 2022
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42. Bilateral Pallidal Stimulation in a Family With Myoclonus Dystonia Syndrome Due to a Mutation in the Sarcoglycan Gene.
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Sobstyl M, Stapińska-Syniec A, Zaremba J, Jurek M, Kupryjaniuk A, and Rylski M
- Subjects
- Globus Pallidus physiology, Humans, Mutation genetics, Sarcoglycans genetics, Treatment Outcome, Deep Brain Stimulation, Dystonia, Dystonic Disorders genetics, Dystonic Disorders therapy, Myoclonus
- Abstract
Objectives: The study aimed to present a family with myoclonus dystonia (M-D) syndrome due to a mutation in the epsilon sarcoglycan gene (SGCE). Three members of the family suffered from treatment-refractory severe myoclonic jerks of the neck, trunk, and upper extremities. The mild dystonic symptoms recognized as cervical dystonia or truncal dystonia affected all individuals. The efficacy of pharmacotherapy, including anticholinergic, dopaminergic, and serotoninergic drugs, has failed. One individual developed an alcohol dependency and suffered from alcoholic epilepsy., Materials and Methods: The patients were referred for stereotactic surgery. All individuals underwent bilateral implantation of deep brain stimulation (DBS) leads into the posteroventrolateral segment of the globus pallidus internus (GPi). Surgeries were uneventful. The formal preoperative objective assessment included the Unified Myoclonus Rating Scale (UMRS) and the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). The postoperative UMRS and BFMDRS assessments were done only under continuous stimulation at 3, 6, and 12 months after the surgery and at the last available follow-up ranging from 6 to 15 months (mean, 10 months follow-up)., Results: At the last follow-up visit, the rest and action parts of UMRS were improved by 93.3% and 88.2%, respectively, when compared to the baseline scores. The motor and disability scales of BFMDRS were improved by 77% and 43% at the last follow-up visit compared to the baseline BFMDRS scores. There were no hardware or stimulation-induced complications over the follow-up period. Positive social adjustment allowed two patients to regain jobs and one patient continued his education and hobbies., Conclusion: Our experience gathered in three individuals in the family with a mutation in SGCE indicates that bilateral GPi DBS can be an effective and safe treatment for disabling pharmacological resistant, intractable M-D syndrome., (Copyright © 2022 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)
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- 2022
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43. The Role of Microbiota in the Immunopathogenesis of Endometrial Cancer.
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Sobstyl M, Brecht P, Sobstyl A, Mertowska P, and Grywalska E
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- Bacteria, Dysbiosis, Endometrium, Female, Humans, Tumor Microenvironment, Endometrial Neoplasms, Microbiota physiology
- Abstract
The female reproductive tract hosts a specific microbiome, which plays a crucial role in sustaining equilibrium and good health. In the majority of reproductive women, the microbiota (all bacteria, viruses, fungi, and other single-celled organisms within the human body) of the vaginal and cervical microenvironment are dominated by Lactobacillus species, which benefit the host through symbiotic relationships, in comparison to the uterus, fallopian tubes, and ovaries, which may contain a low-biomass microbiome with a diverse mixture of microorganisms. Although disruption to the balance of the microbiota develops, the altered immune and metabolic signaling may cause an impact on diseases such as cancer. These pathophysiological modifications in the gut-uterus axis may spark gynecological cancers. New information displays that gynecological and gastrointestinal tract dysbiosis (disruption of the microbiota homeostasis) can play an active role in the advancement and metastasis of gynecological neoplasms, such as cervical, endometrial, and ovarian cancers. Understanding the relationship between microbiota and endometrial cancer is critical for prognosis, diagnosis, prevention, and the development of innovative treatments. Identifying a specific microbiome may become an effective method for characterization of the specific microbiota involved in endometrial carcinogenesis. The aim of this study was to summarize the current state of knowledge that describes the correlation of microbiota with endometrial cancer with regard to the formation of immunological pathologies.
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- 2022
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44. Subjective and Objective Quality-of-Life Assessment of Outcome Measures in Cervical Spine Surgery for Degenerative Changes.
- Author
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Prokopienko M and Sobstyl M
- Subjects
- Cervical Vertebrae surgery, Diskectomy methods, Humans, Treatment Outcome, Quality of Life, Spinal Fusion methods
- Abstract
Cervical spine diskectomy is a commonly used procedure in degenerative disease of cervical spine surgery. However, it is difficult to assess the quality of life after this widely applied and variously modified procedure. This literature review presents cervical diskectomy results, according to various scales and measures in multidirectional surgical strategies. Using relevant databases, we tried to find the best treatment options for degenerative disk disease and the best method of quality-of-life assessment, searching for modalities that may influence the outcome., Competing Interests: None declared., (Thieme. All rights reserved.)
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- 2022
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45. [Psychotic depression caused by the COVID-19 pandemic - a case report].
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Kupryjaniuk A, Podlecka M, Sobstyl M, and Pietras T
- Subjects
- Aged, Depression etiology, Female, Humans, Pandemics, SARS-CoV-2, COVID-19 complications, Depressive Disorder, Major
- Abstract
Depressive syndromes are the most common mental disorders after the age of 60. It is estimated that symptoms of depression are found in over 15% of people over 65 years of age., A Case Report: We present a description of a 74-year-old woman diagnosed with psychotic depression probably caused by SARS-CoV- 2 infection confirmed by PCR test. The patient took part in a neuropsychological examination which showed the presence of cognitive deficits., Conclusions: This case is a good example of how COVID-19 could potentially trigger psychiatric symptoms. The existing literature in this field describes cases in which productive symptoms developed., (© 2022 MEDPRESS.)
- Published
- 2022
46. Significant epidural electrode migration out of the spinal canal due to prolonged latent infection of the spinal cord stimulation hardware.
- Author
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Środa R, Prokopienko M, and Sobstyl M
- Subjects
- Electrodes, Implanted adverse effects, Female, Humans, Middle Aged, Spinal Canal, Failed Back Surgery Syndrome, Latent Infection, Spinal Cord Stimulation adverse effects, Spinal Cord Stimulation methods
- Abstract
Electrode migration is one of the most common complication of Spinal Cord Stimulation (SCS). Usually the lead migrates cranio-caudally or laterally and in the vast majority of cases occurs during the first few months after implantation. One method of preventing lead migration is the use of open-surgical insertion of paddle electrodes., A Case Report: 51-year old woman was admitted for a revision of postoperative wound after implantation of Spinal Cord Stimulator, which was inserted 4 years earlier due to Failed Back Surgery Syndrome (FBSS). Two years after surgery the patient reported severe pain at the site of electrode implantation. After removal of scar tissue pulling on electrode wires the symptoms subsided. In the following months impaired healing of the postoperative wound was observed. For a long time, the patient would not consent to removal of SCS hardware because of good therapeutic effect. When she was finally admitted for surgery, radiological examination demonstrated significant electrode migration out of the vertebral canal. Surgery was performed to remove all of the hardware., Conclusions: In this case, electrode migration out of the vertebral canal resulted from prolonged infection of SCS hardware. The importance of an infection prevention in neuromodulation procedures should be highlighted. According to our best knowledge, this is the first presented case of paddle type electrode extraspinal migration., (© 2022 MEDPRESS.)
- Published
- 2022
47. The Profiles of Tet-Mediated DNA Hydroxymethylation in Human Gliomas.
- Author
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Brągiel-Pieczonka A, Lipka G, Stapińska-Syniec A, Czyżewski M, Żybura-Broda K, Sobstyl M, Rylski M, and Grabiec M
- Abstract
Gliomas are the most common primary malignant intracranial brain tumors. Their proliferative and invasive behavior is controlled by various epigenetic mechanisms. 5-hydroxymethylcytosine (5-hmC) is one of the epigenetic DNA modifications that employs ten-eleven translocation (TET) enzymes to its oxidation. Previous studies demonstrated altered expression of 5-hmC across gliomagenesis. However, its contribution to the initiation and progression of human gliomas still remains unknown. To characterize the expression profiles of 5-hmC and TET in human glioma samples we used the EpiJET 5-hmC and 5-mC Analysis Kit, quantitative real-time PCR, and Western blot analysis. A continuous decline of 5-hmC levels was observed in solid tissue across glioma grades. However, in glioblastoma (GBM), we documented uncommon heterogeneity in 5-hmC expression. Further analysis showed that the levels of TET proteins, but not their transcripts, may influence the 5-hmC abundance in GBM. Early tumor-related biomarkers may also be provided by the study of aberrant DNA hydroxymethylation in the blood of glioma patients. Therefore, we explored the patterns of TET transcripts in plasma samples and we found that their profiles were variously regulated, with significant value for TET2 . The results of our study confirmed that DNA hydroxymethylation is an important mechanism involved in the pathogenesis of gliomas, with particular reference to glioblastoma. Heterogeneity of 5-hmC and TET proteins expression across GBM may provide novel insight into define subtype-specific patterns of hydroxymethylome, and thus help to interpret the heterogeneous outcomes of patients with the same disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Brągiel-Pieczonka, Lipka, Stapińska-Syniec, Czyżewski, Żybura-Broda, Sobstyl, Rylski and Grabiec.)
- Published
- 2022
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48. Subcallosal Cingulate Cortex Deep Brain Stimulation for Treatment-Resistant Depression: A Systematic Review.
- Author
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Sobstyl M, Kupryjaniuk A, Prokopienko M, and Rylski M
- Abstract
Background: Deep brain stimulation (DBS) is considered a relatively new and still experimental therapeutic modality for treatment-resistant depression (TRD). There is clinical evidence to suggest that stimulation of the subcallosal cingulate cortex (SCC) involved in the pathogenesis of TRD may exert an antidepressant effect., Aims: To conduct a systematic review of current studies, such as randomized clinical trials (RCTs), open-label trials, and placebo-controlled trials, examining SCC DBS for TRD in human participants., Method: A formal review of the academic literature was performed using the Medical Literature, Analysis, and Retrieval System Online (MEDLINE) and Cochrane Central Register of Controlled Trials (CENTRAL) databases. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Suitable studies were screened and assessed based on patient characteristics, clinical outcomes, adverse events related to DBS, and the stereotactic technique used to guide the implantation of DBS electrodes., Results: The literature search identified 14 clinical studies that enrolled a total of 230 patients with TRD who underwent SCC DBS. The average duration of follow-up was 14 months (range 6-24 months). The response and remission rates at the last available follow-up visit ranged between 23-92% and 27-66.7%, respectively., Conclusion: The current results of SCC DBS are limited by the relatively small number of patients treated worldwide. Nevertheless, studies to date suggest that SCC can be a promising and efficacious target for DBS, considering the high response and remission rates among patients with TRD. The adverse events of SCC DBS are usually transient and stimulation-induced., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sobstyl, Kupryjaniuk, Prokopienko and Rylski.)
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- 2022
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49. Surgical treatment of spontaneous intracranial hypotension syndrome secondary to the cervical cerebrospinal leak - a case report.
- Author
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Sobczyk P, Bojarski P, and Sobstyl M
- Subjects
- Adult, Humans, Magnetic Resonance Imaging, Cervical Vertebrae diagnostic imaging, Cervical Vertebrae surgery, Headache diagnostic imaging, Intracranial Hypotension complications, Intracranial Hypotension diagnostic imaging
- Abstract
Spontaneous Intracranial Hypotension (SIH) is formed as a result of the leakage of cerebrospinal fluid (CSF) into the extradural space. The most common symptom caused by SIH is headache associated with changes in body position. Imaging, especially magnetic resonance imaging (MRI) of the head and spine with contrast, is the most important examination method in the diagnosis of SIH. In the case of no improvement after symptomatic treatment, surgery is very effective, especially in the case of finding the site of CSF leakage within the spinal canal., A Case Report: We present a case of a 28-year-old patient with 2- month history of severe increasing headaches. The patient denied any head injuries, nasal CSF leakage or lumbar puncture in the past. The neurological examination showed no abnormalities. MRI of the head showed typical features of the intracranial hypotension syndrome. MRI of the cervical spine revealed potential sites for leakage of the cerebrospinal fluid at the C1-C2 level. The patient was qualified for surgical treatment - dural plastic surgery in the cervical section. After treatment the symptoms of intracranial hypotension resolved, and subsequent control MRI examinations showed regression of typical changes of the spontaneous intracranial hypotension., Conclusions: The authors would like to take notice that imaging diagnostics due to headaches should include MRI of the head and spine, as it is the most important test in diagnosing SIH. Moreover, surgical treatment is a quick and very effective method of treatment., (© 2022 MEDPRESS.)
- Published
- 2022
50. Atypical clinical presentation mimicking stroke in an adult patient caused by a rare diffuse leptomeningeal glioneuronal tumour.
- Author
-
Stapińska-Syniec A, Gogol A, Acewicz A, Sobstyl M, Wierzba-Bobrowicz T, and Grajkowska W
- Subjects
- Male, Humans, Adult, Middle Aged, Adolescent, Magnetic Resonance Imaging, Brain Ischemia, Stroke, Central Nervous System Neoplasms pathology, Meningeal Neoplasms diagnostic imaging, Meningeal Neoplasms pathology
- Abstract
A diffuse leptomeningeal glioneuronal tumours (DLGNT) are very rare tumours of the central nervous system, typically characterized by enhancement of subarachnoid space with cystic lesions, diffuse leptomeningeal infiltration, and no primary mass. We report an atypical clinical presentation of DLGNT. A 48-year-old male was admitted to hospital with symptoms of ischaemic stroke. Magnetic resonance imaging of the head revealed contrast enhancement of the meninges and other parts of the brain. A stereotactic frame biopsy was performed on the patient, which revealed the DLGNT. Diffuse leptomeningeal glioneuronal tumours are mostly seen in individuals less than 18 years old and are characterized by slow growth and low-grade histological appearance. Diffuse leptomeningeal glioneuronal tumours can be aggressive in adults.
- Published
- 2022
- Full Text
- View/download PDF
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