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Brain Tumours (brain + tumour)
Selected AbstractsBrain tumours in childrenACTA PAEDIATRICA, Issue 10 2009Lars Holmberg No abstract is available for this article. [source] Stereotactic biopsy and cytological diagnosis of solid and cystic intracranial lesionsCYTOPATHOLOGY, Issue 3 2003L. M. Collaço Cytological smears from 115 consecutive cases of stereotactic biopsies of intracranial lesions were reviewed. Ninety-five lesions were solid and 20 cystic. Material from 90 solid and 13 cystic lesions was sent both for cytological and histological examination. In 66 of the solid lesions, the cytological diagnosis was confirmed by histology (five were benign lesions and 61 malignant tumours: 56 primary brain tumours, three metastases and two lymphomas). In 24 cases with discrepant cytology and histology, the histology was inconclusive or insufficient in 14 cases, while cytology established the diagnosis of astrocytoma grade II (seven cases), metastases (two cases), gliosis (one case) and benign (four cases). Necrosis of tumour type was observed cytologically in six patients representing glioblastoma (two cases), anaplastic astrocytoma (one case), lymphoma (one case) and normal brain (two cases) histologically. Three cases reported cytologically as benign were primary brain tumour (two cases) and gliosis (one case). One smear of a glioblastoma was insufficient for cytological diagnosis. Cystic lesions were cytologically benign in 17 cases and malignant in three cases. Histology from the cyst wall confirmed the malignant diagnosis in three cases and showed tumour in six more cases, a benign process (two cases), changes induced by radiotherapy for arteriovenous malformation (one case) and insufficient material (one case). In conclusion, cytology from solid brain lesion allows an accurate diagnosis and subtyping of tumours in a majority of cases, and can thus be used to choose type of therapy. In cystic brain tumours, however, examination of the cystic fluid, is often inconclusive and a biopsy from the cyst wall should be performed if there is clinical or radiological suspicion of tumour. [source] Coma after spinal anaesthesia in a patient with an unknown intracerebral tumourACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2010T. METTERLEIN Spinal anaesthesia is contraindicated in patients with elevated intracranial pressure or space-occupying intracranial lesions. Drainage of the lumbar cerebrospinal fluid (CSF) can increase the pressure gradient between the spinal, supratentorial and infratentorial compartments. This can result in rapid herniation of the brain stem or occluding hydrocephalus. We present a case of a female patient with an occult brain tumour who received a spinal anaesthesia for an orthopaedic procedure. The primary course of anaesthesia was uneventful. Several hours after surgery, the patient became increasingly disoriented and agitated. The next day, she was found comatose. A computed tomogram of the head revealed herniation of the brain stem, resulting in an occluding hydrocephalus due to a prior not known infratentorial mass. By acute relieving of the intracranial pressure by external CSF drainage, the mass was removed 2 days later. The further post-operative course was uneventful and the patient was discharged from the hospital without neurological deficit 3 weeks after the primary surgery. [source] Therapeutic efficacy of 5-fluorouracil-loaded microspheres on rat glioma: a magnetic resonance imaging studyNMR IN BIOMEDICINE, Issue 6 2001L. Lemaire Abstract The aim of this work was to assess the therapeutic efficacy of an intratumoral bolus injection of 5-fluorouracil (FU) compared to that of drug loaded in biodegradable microspheres, for the treatment of brain tumour. Experiments were carried out using a fast-growing C6-glioma rat model. The therapeutic protocols were performed 12 days after the injection of glioma cells. At this stage, the tumours were installed and the mean volume was 13,±,2,µl as measured by proton magnetic resonance (MR) imaging. This technique was used for the follow-up of the tumour volume with respect to time and therapy. In terms of rat survival, both therapies induced a significant 50% increase in animal life span (p,<,0.05) compared to animals receiving no drug or unloaded microspheres. Whilst no cure was observed, analysis of the MR images showed that the local and sustained delivery of FU slowed the tumour development in the vicinity of the microspheres by a factor of 3, compared with the bolus intratumoral injection. Copyright © 2001 John Wiley & Sons, Ltd. [source] Family, demographic and illness-related determinants of HRQL in children with brain tumours in the first year after diagnosis,PEDIATRIC BLOOD & CANCER, Issue 6 2009Anthony Penn MBBCh, MRCPCH Abstract Aims To evaluate the relationship between parent- and child-report Health-Related Quality of Life (HRQL) and demographic, tumour and family variables in children with a brain tumour in the first year after diagnosis and to identify determinants of HRQL at 12 months. Procedure Longitudinal prospective study: Semi-structured interviews took place approximately 1, 6 and 12 months after diagnosis. HRQL was measured using the self- and parent-report PedsQL 4.0 Total Scale Score. Tumour and treatment variables considered included tumour site and grade, hydrocephalus at diagnosis, chemotherapy and radiotherapy. Family variables included measures of family function, family support and family stress, the primary carer's coping strategies and symptoms of depression and anxiety. Univariate analyses were used at all three time points, and to identify potential early predictors of HRQL at 1 year. Regression analysis was then used to identify the most important determinants of HRQL at 1 year. Results Thirty-five patients completed the 12-month interviews. There were consistent significant negative correlations between concurrent family impact of illness and parent and self-report HRQL, and positive correlations between concurrent family support and parent-report HRQL. Treatment with radio- or chemotherapy correlated with child-report HRQL only at some time points. Multivariate analysis showed infratentorial tumour site, and poor HRQL at 1 month best predicted poor self- and parent-report HRQL at 12 months. Conclusion Children with infratentorial tumours and poor HRQL early after diagnosis tend to have poor HRQL at 1 year. While family factors are important modulators of concurrent HRQL, they do not appear important in predicting HRQL. Pediatr Blood Cancer 2009;53:1092,1099. © 2009 Wiley-Liss, Inc. [source] Having a brain tumour: A journey through lifePEDIATRIC BLOOD & CANCER, Issue 3 2002Thomas Green No abstract is available for this article. [source] Beta-catenin status in paediatric medulloblastomas: correlation of immunohistochemical expression with mutational status, genetic profiles, and clinical characteristics,THE JOURNAL OF PATHOLOGY, Issue 1 2009Sarah Fattet Abstract Medulloblastoma is the most frequent malignant paediatric brain tumour. The activation of the Wnt/,-catenin pathway occurs in 10-15% of medulloblastomas and has been recently described as a marker for favourable patient outcome. We report a series of 72 paediatric medulloblastomas evaluated for ,-catenin protein expression, CTNNB1 mutations, and comparative genomic hybridization. Gene expression profiles were also available in a subset of 40 cases. Immunostaining of ,-catenin showed extensive nuclear staining (>50% of the tumour cells) in six cases and focal nuclear staining (<10% of cells) in three cases. The other cases either exhibited a signal strictly limited to the cytoplasm (58 cases) or were negative (five cases). CTNNB1 mutations were detected in all ,-catenin extensively nucleopositive cases. The expression profiles of these cases documented strong activation of the Wnt/,-catenin pathway. Remarkably, five out of these six tumours showed a complete loss of chromosome 6. In contrast, cases with focal nuclear ,-catenin staining, as well as tumours with negative or cytoplasmic staining, never demonstrated CTNNB1 mutation, Wnt/,-catenin pathway activation or chromosome 6 loss. Patients with extensive nuclear staining were significantly older at diagnosis and were in continuous complete remission after a mean follow-up of 75.7 months (range 27.5,121.2 months) from diagnosis. All three patients with focal nuclear staining of ,-catenin died within 36 months from diagnosis. Altogether, these data confirm and extend previous observations that CTNNB1 -mutated tumours represent a distinct molecular subgroup of medulloblastomas with favourable outcome, indicating that therapy de-escalation should be considered. International consensus on the definition criteria of this distinct medulloblastoma subgroup should be achieved. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source] Suppression of putative tumour suppressor gene GLTSCR2 expression in human glioblastomas,THE JOURNAL OF PATHOLOGY, Issue 2 2008Y-J Kim Abstract Glioma tumour-suppressor candidate region gene 2 (GLTSCR2/PICT-1) is localized within the well-known 1.4 Mb tumour-suppressive region of chromosome 19q, which is frequently altered in various human tumours, including diffuse gliomas. Aside from its chromosomal localization, several lines of evidence, including PTEN-phosphorylating and cell-killing activities, suggests that GLTSCR2 participates in the suppression of tumour growth and development. However, little is known about the biological functions and molecular mechanisms of GLTSCR2 as a tumour suppressor gene. We investigated the pathological significance of GLTSCR2 expression in association with the development and progression of glioblastomas, the most common malignant brain tumour. We used real-time PCR and western blot analysis to examine the expression levels of GLTSCR2 mRNA and protein in glioblastomas, normal brain tissue and in non-glial tumour tissue of different origin, and found that GLTSCR2 expression is down-regulated in glioblastomas. In addition, direct sequencing analysis and fluorescence in situ hybridization clearly demonstrates the presence of genetic alterations, such as a nonsense mutation and deletion, in the GLTSCR2 gene in glioblastomas. Finally, our immunohistochemical study demonstrates that GLTSCR2 is sequentially down-regulated according to the histological malignant progression of the astrocytic glial tumour. Taken together, our results suggest that GLTSCR2 is involved in astrocytic glioma progression. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source] A mathematical model of the impact of infused targeted cytotoxic agents on brain tumours: implications for detection, design and deliveryCELL PROLIFERATION, Issue 6 2002Lawrence M. Wein Motivated by the recent development of highly specific agents for brain tumours, we develop a mathematical model of the spatio-temporal dynamics of a brain tumour that receives an infusion of a highly specific cytotoxic agent (e.g. IL-4-PE, a cytotoxin comprised of IL-4 and a mutated form of Pseudomonas exotoxin). We derive an approximate but accurate mathematical formula for the tumour cure probability in terms of the tumour characteristics (size at time of detection, proliferation rate, diffusion coefficient), drug design (killing rate, loss rate and convection constants for tumour and tissue), and drug delivery (infusion rate, infusion duration). Our results suggest that high specificity is necessary but not sufficient to cure malignant gliomas; a nondispersed spatial profile of pretreatment tumour cells and/or good drug penetration are also required. The most important levers to improve tumour cure appear to be earlier detection, higher infusion rate, lower drug clearance rate and better convection into tumour, but not tissue. In contrast, the tumour cure probability is less sensitive to a longer infusion duration and enhancements in drug potency and drug specificity. [source] School experiences after treatment for a brain tumourCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2006P. Upton Abstract Background Children surviving a brain tumour face major difficulties including learning problems, lengthy school absences and psychosocial problems, all of which can impact on school functioning. Our aims were to provide information for parents and teachers about the skills and resources of this group. Specifically, we aimed to: ,,describe the special educational needs of these children; ,,document the impact of diagnosis and treatment on school attendance; ,,compare parent and teacher assessments of social, emotional and behavioural difficulties. Methods Forty families agreed to participate (response rate = 58.82%). The children (19 males and 21 females) were aged from 6 to 16 years and had completed treatment at least 2 years previously (range = 2 years,12 years 5 months). Questionnaires (Strengths and Difficulties and school experience) were completed by mothers and teachers. Results Survivors were experiencing a wide range of physical, learning and interpersonal difficulties, according to parent and teacher reports. Almost half the children (n = 19) had ongoing neurological problems that were significant enough to require special help at school. Literacy and numeracy were the most common learning difficulties. Parents also rated brain tumour survivors as having more behavioural and emotional problems than would be expected from population norms. For example, survivors were rated as having more Total Difficulties (t = 6.86, P < 0.001), Emotional Symptoms (t = 8.82, P < 0.001), Hyperactivity (t = 2.25, P = 0.03), Peer Relationship Problems (t = 7.58, P < 0.001) and poorer Pro-social Behaviour (t = ,3.34, P = 0.002) than would be expected from population norms. These problems were also seen to be having a significant impact on the child's functioning (t = 3.95, P < 0.001). Teachers rated these problems as less serious than parents. Conclusion These children experience significant problems in school some time after diagnosis and when they are considered medically cured. Closer school,hospital liaison is essential to maximize integration and achievement in these children. [source] Stereotactic biopsy and cytological diagnosis of solid and cystic intracranial lesionsCYTOPATHOLOGY, Issue 3 2003L. M. Collaço Cytological smears from 115 consecutive cases of stereotactic biopsies of intracranial lesions were reviewed. Ninety-five lesions were solid and 20 cystic. Material from 90 solid and 13 cystic lesions was sent both for cytological and histological examination. In 66 of the solid lesions, the cytological diagnosis was confirmed by histology (five were benign lesions and 61 malignant tumours: 56 primary brain tumours, three metastases and two lymphomas). In 24 cases with discrepant cytology and histology, the histology was inconclusive or insufficient in 14 cases, while cytology established the diagnosis of astrocytoma grade II (seven cases), metastases (two cases), gliosis (one case) and benign (four cases). Necrosis of tumour type was observed cytologically in six patients representing glioblastoma (two cases), anaplastic astrocytoma (one case), lymphoma (one case) and normal brain (two cases) histologically. Three cases reported cytologically as benign were primary brain tumour (two cases) and gliosis (one case). One smear of a glioblastoma was insufficient for cytological diagnosis. Cystic lesions were cytologically benign in 17 cases and malignant in three cases. Histology from the cyst wall confirmed the malignant diagnosis in three cases and showed tumour in six more cases, a benign process (two cases), changes induced by radiotherapy for arteriovenous malformation (one case) and insufficient material (one case). In conclusion, cytology from solid brain lesion allows an accurate diagnosis and subtyping of tumours in a majority of cases, and can thus be used to choose type of therapy. In cystic brain tumours, however, examination of the cystic fluid, is often inconclusive and a biopsy from the cyst wall should be performed if there is clinical or radiological suspicion of tumour. [source] ,Prospects for microbeam radiation therapy of brain tumours in children'DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2009DN Slatkin MD No abstract is available for this article. [source] The position of the neurologist in neuro-oncology1EUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2002W. Grisold Neuro-oncology is a growing new subspeciality with a strong interdisciplinary character. This position paper explains the role of neurology in the multidisciplinary field of neurosurgeons, radiotherapists and general oncologists, dealing with neuro-oncological patients. The paper delineates the varied spectrum of the field of neuro-oncology which expands from primary brain tumours, to metastatic and non-metastatic effects of systemic cancer on the central and peripheral nervous system, neurotoxicity due to cancer treatment and issues of quality of life. It has been written by the scientific neuro-oncology panel of the European Federation of Neurological Societies (EFNS) to delineate the situation of neuro-oncology in Europe, and facilitate the understanding and implementation of this subspeciality in the future. [source] A survey of neuroimaging research in European neurological departmentsEUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2001K. Herholz In the international neurological literature, neuroimaging research plays an important role. Neuroimaging techniques are also of steadily increasing importance for clinical diagnosis and treatment monitoring. Therefore, neuroimaging research activities were surveyed by a questionnaire, which was completed by 100 neurological centres across Europe. It showed that most groups use magnetic resonance imaging (MRI), fMRI, computerized tomography (CT) and single photon emission computerized tomography (SPECT). Positron emission tomography (PET) and ultrasound are also employed by nearly half of the centres. Neuroimaging research involves co-operation amongst typically five to 10 disciplines. Cerebrovascular disease, dementia, cognitive disorders, epilepsy, movement disorders, brain tumours and multiple sclerosis are frequently being studied. Many groups rely on small budgets, have few full-time scientists and limited access to expensive resources. There is little exchange of scientists amongst laboratories. It was felt that funding and co-operation needed improvement in order to maintain a high standard in neuroimaging research. [source] MNS16A minisatellite genotypes in relation to risk of glioma and meningioma and to glioblastoma outcomeINTERNATIONAL JOURNAL OF CANCER, Issue 4 2009Ulrika Andersson Abstract The human telomerase reverse transcriptase (hTERT) gene is upregulated in a majority of malignant tumours. A variable tandem repeat, MNS16A, has been reported to be of functional significance for hTERT expression. Published data on the clinical relevance of MNS16A variants in brain tumours have been contradictory. The present population-based study in the Nordic countries and the United Kingdom evaluated brain-tumour risk and survival in relation to MNS16A minisatellite variants in 648 glioma cases, 473 meningioma cases and 1,359 age, sex and geographically matched controls. By PCR-based genotyping all study subjects with fragments of 240 or 271 bp were judged as having short (S) alleles and subjects with 299 or 331 bp fragments as having long (L) alleles. Relative risk of glioma or meningioma was estimated with logistic regression adjusting for age, sex and country. Overall survival was analysed using Kaplan,Meier estimates and equality of survival distributions using the log-rank test and Cox proportional hazard ratios. The MNS16A genotype was not associated with risk of occurrence of glioma, glioblastoma (GBM) or meningioma. For GBM there were median survivals of 15.3, 11.0 and 10.7 months for the LL, LS and SS genotypes, respectively; the hazard ratio for having the LS genotype compared with the LL was significantly increased HR 2.44 (1.56,3.82) and having the SS genotype versus the LL was nonsignificantly increased HR 1.46 (0.81,2.61). When comparing the LL versus having one of the potentially functional variants LS and SS, the HR was 2.10 (1.41,3.1). However, functionality was not supported as there was no trend towards increasing HR with number of S alleles. Collected data from our and previous studies regarding both risk and survival for the MNS16A genotypes are contradictory and warrant further investigations. © 2009 UICC [source] Psychiatric disorder as a first manifestation of cancer: A 10-year population-based studyINTERNATIONAL JOURNAL OF CANCER, Issue 12 2009Michael E. Benros Abstract To investigate the possibility that psychiatric symptoms could be caused by a yet undetected cancer or be part of a paraneoplastic syndrome, nationwide population-based registers were linked including the Danish Psychiatric Central Register and the Danish Cancer Registry. Data were analysed as a cohort study using survival analysis techniques and incidence rate ratios (IRRs) were used as measures of relative risk. A total of 4,320,623 persons were followed in the 10-year period 1994,2003, resulting in 37,581,600 person-years at risk, 202,144 persons with a first-time psychiatric contact, and 208,995 persons diagnosed with cancer. During the first month after a first-time psychiatric contact, the incidence of all forms of cancer was elevated; IRR: 2.61 (95% CI, 2.31,2.95). Particularly the incidence of brain tumours was elevated; IRR: 18.85 (95% CI, 14.52,24.48), but also the incidence of lung cancer; IRR: 2.98 (95% CI, 2.16,4.12), and especially small-cell lung cancer; IRR: 6.13 (95% CI, 3.39,11.07) was elevated. The elevated IRR for most cancers decreased towards unity within the first 3 months, except for brain tumours, for which the IRR remained significantly elevated during the first 9 months. One of every 63 patients above 50 years of age was diagnosed with malignant cancer within 1 year of first-time psychiatric contact. These results indicate an increased incidence of cancer, especially for brain tumours and small-cell lung cancer, in the first months after a first-time contact to a psychiatric hospital. Clinicians should be aware that first-onset psychiatric symptoms could be a sign of a yet undetected cancer. © 2009 UICC [source] Blood,brain barrier breakdown in septic encephalopathy and brain tumours*JOURNAL OF ANATOMY, Issue 6 2002D. C. DaviesArticle first published online: 28 JUN 200 Abstract Septic encephalopathy is associated with breakdown of the blood,brain barrier and cerebral oedema. These features are also common properties of brain tumours. Perimicrovessel oedema, disruption of associated astrocyte end feet and neuronal injury occur in a porcine model of acute septic encephalopathy. The adrenergic system has been implicated in the inflammatory response to sepsis and may play a role in controlling blood,brain barrier permeability, since the ,2 -adrenoceptor agonist dopexamine inhibits perimicrovessel oedema formation whereas the ,1 -adrenoceptor agonist methoxamine provokes it. Electron microscopy revealed tight junction opening in high-grade astrocytoma microvessels. Expression of the tight junction protein occludin is reduced in these microvessels and this reduction is inversely correlated with the degree of cerebral oedema. Normal astrocytes secrete factors that induce barrier properties in endothelial cells, whereas high-grade astrocytomas secrete vascular endothelial growth factor, which stimulates angiogenesis, down regulates occludin and increases endothelial cell permeability. The water channel protein aquaporin-4 is normally expressed in astrocyte foot processes around cerebral microvessels. Its expression is massively up-regulated in high-grade astrocytoma and around metastatic adenocarcinoma. There is a significant correlation between aquaporin-4 expression and the degree of cerebral oedema, but it is not clear whether increased aquaporin-4 expression enhances oedema formation or clearance. These results suggest that the pathophysiology of brain oedema is multifactorial, but that there may be common processes operating regardless of the aetiology. [source] Epidermal growth factor receptor and cancer: control of oncogenic signalling by endocytosisJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 5a 2008Michael Vibo Grandal ,,Introduction ,,Endocytosis of EGFR -,Kinase activity -,Clathrin-coated pits -,Ubiquitination -,Effects of EGFR-ErbB2 heterodimerization on EGFR internalization ,,Cellular and molecular requirements for lysosomal degradation of EGFR -,Intracellular EGFR degradation depends on luminal sorting at multivesicular bodies -,Molecular requirements for EGFR sorting in multivesicular endosomes Abstract The epidermal growth factor receptor (EGFR) and other members of the EGFR/ErbB receptor family of receptor tyrosine kinases (RTKs) are important regulators of proliferation, angiogenesis, migration, tumorigenesis and metastasis. Overexpression, mutations, deletions and production of autocrine ligands contribute to aberrant activation of the ErbB proteins. The signalling output from EGFR is complicated given that other ErbB proteins are often additionally expressed and activated in the same cell, resulting in formation of homo-and/or heterodimers. In particular, association of EGFR with ErbB2 prevents its down-regulation, underscoring the importance of the cellular background for EGFR effects. Signalling from ErbB proteins can either be terminated by dissociation of ligand resulting in dephosphorylation, or blunted by degradation of the receptors. Although proteasomal targeting of ErbB proteins has been described, lysosomal degradation upon ligand-induced endocytosis seems to play the major role in EGFR down-regulation. Preclinical and clinical data have demonstrated that EGFR is a central player in cancer, especially in carcinomas, some brain tumours and in non-small cell lung cancer. Such studies have further validated EGFR as an important molecular target in cancer treatment. This review focuses on mechanisms involved in ligand-induced EGFR activation and endocytic down-regulation. A better understanding of EGFR biology should allow development of more tumour-selective therapeutic approaches targeting EGFR-induced signalling. [source] Mixture modelling of medical magnetic resonance dataJOURNAL OF CHEMOMETRICS, Issue 6 2002Ron Wehrens Abstract In clinical decision making, (semi-)automatic unsupervised classification of data for diagnostic purposes is becoming more and more important. This paper describes the application of mixture modelling, a clustering where multivariate Gaussians are used to describe clusters in the data, to in vivo nuclear magnetic resonance data of patients with brain tumours. Images as well as localized spectra are analysed. The method is able to automatically generate meaningful classifications. Moreover, the results of clustering both the image and spectral data are in close agreement. Copyright © 2002 John Wiley & Sons, Ltd. [source] Quality of life in patients with right- or left-sided brain tumours: literature reviewJOURNAL OF CLINICAL NURSING, Issue 11 2008Alvisa Palese Bcsn Aims., To determine if patients with left- or right-sided hemisphere neoplasm perceive their quality of life (QoL) differently. Background., It is not clear whether patients with a lesion in the left hemisphere have a different QoL than those with a lesion in the right hemisphere. (1) In the pre-operative period, patients with a left-sided lesion may have different symptoms according to the position of the tumour. (2) Studies on patients with brain injury demonstrate an association between left frontal lesions and depression: depression can alter the patients' perception of QoL. (3) In the postoperative period, right-handed patients may be disadvantaged by surgical trauma to the motor cortex in the left hemisphere. (4) During the different phases of the disease, the various functions of the two hemispheres may influence the patient's capacity to control QoL; also, as suggested by authors, both the ego and the conscience are mostly located in the left hemisphere. This is the reason that patients with a left-sided lesion may perceive a worse QoL. Methods., A review of literature was carried out using the Medline database (1966,2007) and CINHAL (1982,2007), using the following Mesh Terms and key words: brain neoplasm, tumour or cancer, hemispheric dominance or laterality or right or left hemisphere, QoL. Results., Seven studies emerged that documented non-homogeneous results and which included different populations. The association between QoL and the side of the lesion was evaluated. Conclusions., The lack of a substantial number of recent, robust follow-up studies investigating the QoL in patients at different stages of disease and treatment indicates that more research is needed. Relevance to clinical practice., Understanding the QoL in patients with brain neoplasm and the differences between right and left hemisphere sites of the neoplasm can help nurses develop different interventions and offer more guidance for effective clinical intervention. [source] Update of radiosurgery at the Royal Adelaide HospitalJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2 2006DE Roos Summary This is an update of the Royal Adelaide Hospital radiosurgery experience between November 1993 and December 2004 comprising 165 patients with 168 intracranial lesions. Including re-treatment, there were 175 treatment episodes (163 radiosurgery and 12 stereotactic radiotherapy) at an average of 1.3 per month. The commonest lesions were acoustic neuroma (65), arteriovenous malformation (58), solitary brain metastasis (23) and meningioma (14). The clinical features, treatment details and outcome are described. Our results continue to be well within the range reported in the published work. Radiosurgery provides an elegant, non-invasive alternative to neurosurgery and conventional external beam radiotherapy for many benign and malignant brain tumours. [source] Are cranial germ cell tumours really tumours of germ cells?NEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 6 2006P. J. Scotting Germ cell tumours of the brain and those that occur in the gonads are believed to share a common origin from germ cell progenitors. This ,germ cell theory' rests upon similar histopathology between these tumours in different locations and the belief that endogenous somatic cells of the brain could not give rise to the range of cell types seen in germ cell tumours. An alternative ,embryonic cell theory' has been proposed for some classes of cranial germ cell tumours, but this still relies on the misplacement of cells in the brain (in this case the earliest embryonic stem cells) during early embryonic development. Recent evidence has demonstrated that neural stem cells of the brain can also give rise to many of the cell types seen in germ cell tumours. These data suggest that endogenous progenitor cells of the brain are a plausible alternative origin for these tumours. This idea is of central importance for studies aiming to elucidate the mechanisms of tumour development. The application of modern molecular analyses to reveal how tumour cells have altered with respect to their cell of origin relies on the certain identification of the cell from which the particular tumour arose. If the identity of this cell is mistaken, then studies to elucidate the mechanisms by which the progenitor cell has been subverted from its normal behaviour will not yield useful information. In addition, it will prove impossible to generate an appropriate animal model in which to study the underlying causes of those tumours. This article makes the case that current assumptions of the origins of cranial germ cell tumours are unreliable. It reviews the evidence in favour of the ,germ cell theory' and argues in favour of a ,brain cell theory' in which endogenous neural progenitor cells of the brain are the likely origin for these tumours. Thus, the case is made that cranial germ cell tumours, like other brain tumours, arise by the transformation of progenitor cells normally resident in the brain. [source] Histomorphometry of brain tumoursNEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 4 2004R. Nafe In this review, the results of previous histomorphometric studies of brain tumours are summarized and discussed with respect to their potential value for diagnostic purposes and for tumour research. In the majority of these studies, human gliomas were investigated. In a few studies, human meningiomas and other human or experimental tumour types were investigated. A computerized image analysis system was used for the morphometric analyses in most studies. The three main histologic structures examined were tumour cell nuclei, nucleolar organizer regions and tumour vessels. The current state of knowledge provides evidence that a diagnostic benefit could be provided by histomorphometric investigations of brain tumours, especially for grading of gliomas and with respect to independent prognostic information. Additional studies are necessary to delineate the spectrum of histomorphometric parameters and the investigation of their prognostic significance for cases with the same tumour type and tumour grade. Together with many recently published observations in this field, this review shows that histomorphometry is an important approach towards the investigation of brain tumour biology. [source] Squamous cell carcinoma: a rare complication of dermoid cystsNEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 2 2002K. Ashkan Introduction:, Dermoid cysts constitute 0.3% of all brain tumours. Carcinomatous differentiation has been described only in a handful of cases. Material and methods:, A 44-year-old-man presented with a several-year history of headaches and a 5-week history of progressive visual deterioration in the left eye. Clinical examination confirmed a normal visual acuity but an impaired left visual field. A magnetic resonance imaging scan showed a lesion in the left paraclinoid area compressing the ipsilateral optic nerve. Signal characteristics of the lesion were consistent with a dermoid or epidermoid cyst. At operation, the lesion was thought to be typical of a dermoid cyst and a near-complete excision was achieved leaving behind parts adherent to the optic nerve. Histology showed invasive squamous cell carcinoma arising within the dermoid tumour. Postoperatively the patient received radiotherapy. Results:, The patient's clinical condition initially stabilized. At 15 months follow up, however, there was clinical and radiological evidence of tumour progression and he died 1 year later. Conclusion:, Squamous cell carcinoma may rarely arise from an intracranial dermoid tumour. This may hinder total excision of the lesion and confounds the prognosis. [source] Development of a decision support system for diagnosis and grading of brain tumours using in vivo magnetic resonance single voxel spectraNMR IN BIOMEDICINE, Issue 4 2006Anne R. Tate Abstract A computer-based decision support system to assist radiologists in diagnosing and grading brain tumours has been developed by the multi-centre INTERPRET project. Spectra from a database of 1H single-voxel spectra of different types of brain tumours, acquired in vivo from 334 patients at four different centres, are clustered according to their pathology, using automated pattern recognition techniques and the results are presented as a two-dimensional scatterplot using an intuitive graphical user interface (GUI). Formal quality control procedures were performed to standardize the performance of the instruments and check each spectrum, and teams of expert neuroradiologists, neurosurgeons, neurologists and neuropathologists clinically validated each case. The prototype decision support system (DSS) successfully classified 89% of the cases in an independent test set of 91 cases of the most frequent tumour types (meningiomas, low-grade gliomas and high-grade malignant tumours,glioblastomas and metastases). It also helps to resolve diagnostic difficulty in borderline cases. When the prototype was tested by radiologists and other clinicians it was favourably received. Results of the preliminary clinical analysis of the added value of using the DSS for brain tumour diagnosis with MRS showed a small but significant improvement over MRI used alone. In the comparison of individual pathologies, PNETs were significantly better diagnosed with the DSS than with MRI alone. Copyright © 2006 John Wiley & Sons, Ltd. [source] West Coast study of childhood brain tumours and maternal use of hair-colouring productsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2002Elizabeth A Holly Summary The immature nervous system of the fetus is characterised by rapid cell growth and division and is particularly vulnerable to carcinogens and mutagens. Several epidemiological studies have reported an increased risk for childhood brain tumours (CBT) associated with exposure to N-nitroso compounds (NOC). Hair-colouring products (hair ,dyes') that contain NOC-related aromatic amines have shown mutagenicity in vitro and carcinogenic properties in vivo. The potential public health impact of the relationship between hair dye use and carcinogenesis has prompted epidemiological research, given that a large proportion of American women have used hair dyes. A large population-based case,control study was conducted on the west coast of the USA to investigate risk factors for CBT including exposure to NOC. Eligible CBT patients (<20 years of age and diagnosed between 1984 and 1991) were identified from cancer registries in Los Angeles County, the San Francisco Bay Area in California and the Seattle area in Washington state. A total of 540 biological mothers of these children were interviewed, and 801 control subjects who were frequency matched to the CBT patients on birth year and sex were obtained using random digit dialling. Mothers were asked details about personal use of hair dyes during the index pregnancy including frequency of use, trimester of use and type of dye used. Results from age- and sex-adjusted unconditional logistic regression analyses showed no association between risk for CBT and use of hair dyes 1 month before and/or during pregnancy nor during specific trimesters. A nearly twofold increased risk for CBT was associated with single-interval use during the 1 month before pregnancy, but the confidence interval (CI) was imprecise and the estimate was not different from unity (OR = 1.9, 95% CI [0.5, 7.0]). Exclusive use of permanent dye, temporary dye or hair darkeners was not associated with risk for CBT. A twofold increased risk (OR = 2.0, 95% CI [0.83, 4.7]) was observed with exclusive use of semi-permanent dye during the month before or during pregnancy. Exclusive use of semi-permanent dye during the month before pregnancy and/or first trimester also was associated with an elevated risk for CBT, again not different from unity and with an imprecise CI (OR = 2.5, 95% CI = [0.58, 10.3]). There was no evidence of an association between risk for CBT by histological subtypes and use of hair dyes during the index pregnancy or the month before conception. Together with results from previous studies, these results provide no consistent evidence of an association between risk for CBT and use of hair dyes during pregnancy. [source] Family, demographic and illness-related determinants of HRQL in children with brain tumours in the first year after diagnosis,PEDIATRIC BLOOD & CANCER, Issue 6 2009Anthony Penn MBBCh, MRCPCH Abstract Aims To evaluate the relationship between parent- and child-report Health-Related Quality of Life (HRQL) and demographic, tumour and family variables in children with a brain tumour in the first year after diagnosis and to identify determinants of HRQL at 12 months. Procedure Longitudinal prospective study: Semi-structured interviews took place approximately 1, 6 and 12 months after diagnosis. HRQL was measured using the self- and parent-report PedsQL 4.0 Total Scale Score. Tumour and treatment variables considered included tumour site and grade, hydrocephalus at diagnosis, chemotherapy and radiotherapy. Family variables included measures of family function, family support and family stress, the primary carer's coping strategies and symptoms of depression and anxiety. Univariate analyses were used at all three time points, and to identify potential early predictors of HRQL at 1 year. Regression analysis was then used to identify the most important determinants of HRQL at 1 year. Results Thirty-five patients completed the 12-month interviews. There were consistent significant negative correlations between concurrent family impact of illness and parent and self-report HRQL, and positive correlations between concurrent family support and parent-report HRQL. Treatment with radio- or chemotherapy correlated with child-report HRQL only at some time points. Multivariate analysis showed infratentorial tumour site, and poor HRQL at 1 month best predicted poor self- and parent-report HRQL at 12 months. Conclusion Children with infratentorial tumours and poor HRQL early after diagnosis tend to have poor HRQL at 1 year. While family factors are important modulators of concurrent HRQL, they do not appear important in predicting HRQL. Pediatr Blood Cancer 2009;53:1092,1099. © 2009 Wiley-Liss, Inc. [source] Neurological comorbidity and epilepsy: implications for treatmentACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009G. Zaccara Epilepsy is a chronic condition that may be associated with several other diseases. In these cases, we should consider the following points: (1) antiepileptic drug (AED) treatment may positively or negatively affect comorbid disease, (2) drugs used for treatment of co-morbid disease may influence seizure threshold, (3) AED toxicity can be affected by a comorbid condition and (4) co-administration of AEDs with drugs used for treatment of comorbid conditions can be associated with clinically relevant drug,drug interactions. In this article, we discuss problems that are usually encountered when an appropriate AED treatment has to be selected in newly diagnosed epileptic patients who also have (an)other neurological disease(s). Comorbidity of epilepsy with cerebrovascular diseases, dementias, mental retardation, attention deficit and hyperactivity disorder, brain tumours, infections of the CNS, migraine, sleep disturbances (obstructive sleep apnoea syndrome), substance abuse and multiple sclerosis is discussed. [source] Clinical applications of 1H-MR spectroscopy in the evaluation of epilepsies , What do pathological spectra stand for with regard to current results and what answers do they give to common clinical questions concerning the treatment of epilepsies?ACTA NEUROLOGICA SCANDINAVICA, Issue 4 2003T. Hammen Nuclear magnetic resonance spectroscopy (1H-MRS) is a non-invasive method in detecting abnormal spectra of various brain metabolites containing N -acetylaspartate (NAA), Choline (Cho), Creatine (Cr), , -Aminobutyric acid (GABA) and Glutamate. Technical processing of the MR-systems, improved automated shimming methods and further development of special shim coils increase the magnetic field homogeneity and lead to a better spectral quality and spectral resolution. The handling of the systems becomes more user-friendly and is more likely to be used in routine diagnostics. The 1H-MRS has become a diagnostic tool for assessing a number of diseases of the central nervous system mainly including epilepsies and brain tumours. The role of 1H-MRS in the assessment of epilepsies will probably increase in future. In the following article, the principles of 1H-MRS and an overview of it in the evaluation and treatment of epilepsies with special regard to temporal lobe epilepsies (TLE) has been illustrated. [source] Does imprint cytology of brain tumours improve intraoperative diagnoses?ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2003T. Brommeland Objectives , To evaluate the diagnostic accuracy using frozen sections only and a combination of imprint cytology and frozen sections. Material and methods , After introduction of imprint cytology as a supplement to frozen sections in 1999, 153 patients with brain tumours underwent stereotactic or open surgery. An equal number of cases prior to 1999 were chosen for comparison. Intraoperative diagnoses were compared with final diagnoses based on paraffin sections of the same tissue samples. The number of delayed intraoperative diagnoses was noted in each patient group. Results , The combined use of the two techniques improved intraoperative diagnostic accuracy from 87 to 91% while the delayed intraoperative diagnoses were significantly reduced from 30 to 8. The choice of surgical procedure did not affect the outcome of the pathological investigations. Conclusion , A combination of frozen sections and imprints significantly reduced the number of delayed intraoperative diagnoses. Intraoperative diagnostic accuracy was improved, although not to a statistically significant level. Choice of surgical procedure did not affect the diagnostic outcome. [source] | |||||||||||||||||||||||||||||||