Publications by authors named "Rutka J"

Congenital infantile brainstem high-grade gliomas (HGGs) are extremely rare. Given the limited literature characterizing this disease, management of these tumors remains challenging. Brainstem HGGs are generally associated with extremely poor prognosis.

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Various birth characteristics may influence healthy childhood development, including the risk of developing childhood brain tumors (CBTs). In this study, we aimed to investigate the association between delivery methods, obstetric history, and birth anthropometrics with the risk of CBTs. This study used data from the Childhood Brain Tumour Epidemiology Study of Ontario (CBREO) which included children 0-15 years of age and newly diagnosed with CBTs from 1997 to 2003.

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Introduction: Our objective was to study convection enhanced delivery (CED) of Lu-labeled metal chelating polymer (MCP) conjugated to gold nanoparticles ([Lu]Lu-MCP-AuNP) alone or combined with anti-PD1 immune checkpoint inhibition (ICI) for improving the survival of immunocompetent C57BL/6J mice with orthotopic GL261 murine glioma tumors.

Methods: C57BL/6J mice with GL261 tumors were treated with [Lu]Lu-MCP-AuNP (0.8 or 2.

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Article Synopsis
  • Computational neurosurgery combines artificial intelligence and computational modeling to enhance the diagnosis and treatment of neurosurgical conditions, aiming to advance clinical neurosciences.
  • The field seeks to integrate ethical considerations to ensure that the use of AI is conducted responsibly and prioritizes patient care, ultimately aiming to prevent errors in treatment.
  • This initiative serves as a guide for practitioners, ethicists, and scientists in the application of ethical standards within computational neurosurgery.
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  • Brain surgeons need standardized rules for handling brain tumors during surgery to improve diagnosis and treatment.*
  • Right now, guidelines mainly exist for one type of brain tumor, but others could also benefit from these rules.*
  • Having experts from different fields work together is important for creating these standardized practices to help patients and research better.*
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Glioblastoma is the most common primary malignant brain tumor in adults, with a median survival of just over 1 year. The failure of available treatments to achieve remission in patients with glioblastoma (GBM) has been attributed to the presence of cancer stem cells (CSCs), which are thought to play a central role in tumor development and progression and serve as a treatment-resistant cell repository capable of driving tumor recurrence. In fact, the property of "stemness" itself may be responsible for treatment resistance.

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Diffuse intrinsic pontine glioma (DIPG) remains a significant therapeutic challenge due to the lack of effective and safe treatment options. This study explores the potential of combining histone deacetylase (HDAC) and carbonic anhydrase 9 (CA9) inhibitors in treating DIPG. Analysis of RNA sequencing data and tumor tissue from patient samples for the expression of the carbonic anhydrase family and hypoxia signaling pathway activity revealed clinical relevance for targeting CA9 in DIPG.

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Background: Atypical teratoid rhabdoid tumor (ATRT) is a rare, devastating, and largely incurable pediatric brain tumor. Although recent studies have uncovered 3 molecular subgroups of ATRTs with distinct disease patterns, and signaling features, the therapeutic profiles of ATRT subgroups remain incompletely elucidated.

Methods: We examined the effect of 465 kinase inhibitors on a panel of ATRT subgroup-specific cell lines.

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Objective: Functional hemispherectomy is an effective surgical intervention for select patients with drug-resistant epilepsy. The last several decades have seen dramatic evolutions in preoperative evaluation, surgical techniques, and postoperative care. Here, the authors present a retrospective review of the medical records of 146 children who underwent hemispherectomy between 1987 and 2022 at The Hospital for Sick Children, providing a unique overview of the evolution of the procedure and patient outcomes over 35 years.

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Network connectivity, as mapped by the whole brain connectome, plays a crucial role in regulating auditory function. Auditory deprivation such as unilateral hearing loss might alter structural network connectivity; however, these potential alterations are poorly understood. Thirty-seven acoustic neuroma patients with unilateral hearing loss (19 left-sided and 18 right-sided) and 19 healthy controls underwent diffusion-weighted and T1-weighted imaging to assess edge strength, node strength, and global efficiency of the structural connectome.

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  • This study investigates dizziness in individuals who have suffered head injuries and differentiates between those with central vestibular dysfunction (CVD) and those with post-traumatic peripheral vestibular issues.
  • The research retrospectively analyzed data from a neurotology database covering head-injured workers, including detailed medical histories, audiovestibular tests, and imaging studies.
  • Results showed that while CVD is rare, it often involves significant symptoms like persistent imbalance and eye movement abnormalities, suggesting more severe brain injuries, which were not always detectable on scans.
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  • Outcomes from vagus nerve stimulation (VNS) improve over time in children with drug-resistant epilepsy, but the benefits of deep brain stimulation (DBS) versus continued VNS optimization were unclear.
  • A study involving 18 children aged 8-17 showed that adding DBS after a year of ineffective VNS led to significantly greater seizure reduction (51.9% vs. 12.3%).
  • While DBS resulted in fewer bothersome seizures, it did not improve the overall quality of life, suggesting that earlier consideration of DBS could be beneficial for children not responding to VNS.
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Diffuse intrinsic pontine glioma (DIPG) is an aggressive brain tumour that occurs in the pons of the brainstem and accounts for over 80% of all brainstem gliomas. The median age at diagnosis is 6-7 years old, with less than 10% overall survival 2 years after diagnosis and less than 1% after 5 years. DIPGs are surgically inaccessible, and radiation therapy provides only transient benefit, with death ensuing from relentless local tumour infiltration.

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Background And Objectives: Gelastic seizures due to hypothalamic hamartomas (HH) are challenging to treat, in part due to an incomplete understanding of seizure propagation pathways. Although magnetic resonance imaging-guided laser interstitial thermal therapy (MRgLITT) is a promising intervention to disconnect HH from ictal propagation networks, the optimal site of ablation to achieve seizure freedom is not known. In this study, we investigated intraoperative post-ablation changes in resting-state functional connectivity to identify large-scale networks associated with successful disconnection of HH.

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Article Synopsis
  • Epilepsy care in Ontario faces significant challenges including limited bed availability in Epilepsy Monitoring Units (EMU), restricted surgical options, and inadequate community support, especially following the COVID-19 pandemic.* -
  • A 44-item survey was conducted across all 11 adult and pediatric epilepsy centers in Ontario, collecting both quantitative and qualitative data on the current state of epilepsy care.* -
  • Findings showed persistent gaps in care due to EMU bed pressures and workforce shortages, prompting the formation of a clinical network to help improve access to epilepsy services in the region.*
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Article Synopsis
  • - The AANS/CNS Section on Tumors, established in 1984, focuses on educating neurosurgeons in neuro-oncology and acts as a resource for national organizations about nervous system tumor treatments.
  • - It was the first national organization dedicated specifically to studying and treating brain and spine tumors, leading to significant developments like satellite meetings and the Journal of Neuro-Oncology.
  • - A review of the section's 40-year history highlights its achievements, challenges, and future opportunities, incorporating insights from past section chairs and their contributions.
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Objective: Extent of resection (EOR) is the most important modifiable prognostic variable for pediatric patients with posterior fossa ependymoma. An understanding of primary and recurrent ependymoma complications is essential to inform clinical decision-making for providers, patients, and families. In this study, the authors characterize postsurgical complications following resection of primary and recurrent pediatric posterior fossa ependymoma in a molecularly defined cohort.

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Picosecond infrared laser mass spectrometry (PIRL-MS) is shown, through a retrospective patient tissue study, to differentiate medulloblastoma cancers from pilocytic astrocytoma and two molecular subtypes of ependymoma (PF-EPN-A, ST-EPN-RELA) using laser-extracted lipids profiled with PIRL-MS in 10 s of sampling and analysis time. The average sensitivity and specificity values for this classification, taking genomic profiling data as standard, were 96.41 and 99.

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Background: Cerebellar mutism syndrome (CMS) is a common and debilitating complication of posterior fossa tumor surgery in children. Affected children exhibit communication and social impairments that overlap phenomenologically with subsets of deficits exhibited by children with Autism spectrum disorder (ASD). Although both CMS and ASD are thought to involve disrupted cerebro-cerebellar circuitry, they are considered independent conditions due to an incomplete understanding of their shared neural substrates.

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Objective: MR-guided laser interstitial thermal therapy (MRgLITT) is associated with lower seizure-free outcome but better safety profile compared to open surgery. However, the predictors of seizure freedom following MRgLITT remain uncertain. This study aimed to use machine learning to predict seizure-free outcome following MRgLITT and to identify important predictors of seizure freedom in children with drug-resistant epilepsy.

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Brain tumors are the most common solid tumor in children and the leading cause of cancer-related deaths. Over the last few years, improvements have been made in the diagnosis and treatment of children with Central Nervous System tumors. Unfortunately, for many patients with high-grade tumors, the overall prognosis remains poor.

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