| 1: J Pediatr Hematol Oncol. 2004 Nov;26(11):756-60. |
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Carboplatinum and vincristine chemotherapy for central
nervous system gliofibroma: case report and review of the literature.
Suarez CR, Raj AB, Bertolone SJ, Coventry S.
Department of Pediatrics, Section of Hematology Oncology, University of
Louisville School of Medicine, Louisville, Kentucky, USA. csuarez@psm.edu
Gliofibromas are bimorphic tumors of the central nervous system. Although
they are composed of astrocytic and fibroblastic elements, their
histogenesis is not clear. An attempt has been made to classify the tumors
as low- or high-grade based on morphology and proliferative labeling index,
but the clinical behavior and the optimal therapeutic strategies remain
unknown. Although they are considered benign, the authors' review shows a
23% mortality rate. The authors report the successful use of carboplatinum
and vincristine as treatment of this disease.
Publication Types:
- Case Reports
- Review
- Review, Tutorial
PMID: 15543013 [PubMed - indexed for MEDLINE]
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| 2: J Clin Oncol. 2004 Nov 15;22(22):4551-60. |
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White matter lesions detected by magnetic resonance
imaging after radiotherapy and high-dose chemotherapy in children with
medulloblastoma or primitive neuroectodermal tumor.
Fouladi M, Chintagumpala M, Laningham FH, Ashley D, Kellie SJ, Langston
JW, McCluggage CW, Woo S, Kocak M, Krull K, Kun LE, Mulhern RK, Gajjar A.
Department of Hematology-Oncology, St Jude Children's Research Hospital,
Memphis, TN 38105-2794, USA. maryam.fouladi@stjude.org
PURPOSE: White matter lesions (WMLs) have been described as a delayed effect
of cranial irradiation in children with brain tumors, or a transient
subacute effect characterized by an intralesional or perilesional reaction.
We report the occurrence of subacute WMLs detected by magnetic resonance
imaging (MRI) in children treated for medulloblastoma or primitive
neuroectodermal tumor (PNET) and document the associated clinical,
radiologic, and neurocognitive findings. PATIENTS AND METHODS: Among 134
patients with medulloblastoma or supratentorial PNET treated prospectively
with risk-adjusted craniospinal irradiation and conformal boost to the tumor
bed, followed by four high-dose chemotherapy (HDC) cycles with stem-cell
rescue, 22 developed WMLs on T1-weighted imaging with and without contrast
and/or T2-weighted imaging on MRI. Patients had > or = 12 months of
follow-up. Neurocognitive assessments included intelligence quotient (IQ)
tests and tests of academic achievement. RESULTS: Twenty-two patients
developed WMLs at a median of 7.8 months after starting therapy (range, 1.9
to 13.0 months). Lesions were predominantly in the pons (n = 8) and
cerebellum (n = 6). Sixteen patients (73%) had WML resolution at a median of
6.2 months (range, 1.68 to 23.5 months) after onset; two patients developed
necrosis and atrophy. Three developed persistent neurologic deficits.
Cumulative incidence of WMLs at 1 year was 15% +/- 3%. Patients with WMLs
had a significant decline in estimated IQ (-2.5 per year; P = .03) and math
(-4.5 per year; P = .003) scores. CONCLUSION: WMLs in medulloblastoma or
PNET patients treated with conformal radiotherapy and HDC are typically
transient and asymptomatic, and may mimic early tumor recurrence. A minority
of patients with WMLs develop permanent neurologic deficits and imaging
changes. Overall, the presence of WMLs is associated with greater
neurocognitive decline.
Publication Types:
- Clinical Trial
- Multicenter Study
PMID: 15542806 [PubMed - indexed for MEDLINE]
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| 3: Arthritis Rheum. 2004 Nov;50(11):3616-8. |
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First reported pediatric case of systemic lupus
erythematosus associated with prolactinoma.
Reuman PD.
Pediatric Rheumatology and Clinical Research, Children's Hospital Medical
Center, One Perkins Square, Akron, OH 44308, USA. PReuman@CHMCA.org
There is much interest in the possibility that prolactin influences disease
activity in systemic lupus erythematosus (SLE). We present the first
reported pediatric case of prolactinoma associated with SLE, in a
13-year-old white female. The diagnosis of SLE was based on the presence of
arthritis, antinuclear antibodies, and double-stranded DNA, and a chest
radiograph showing pleural fluid. The diagnosis of pituitary prolactinoma
was based on the histologic features and the presence of amenorrhea,
galactorrhea, and an elevated serum prolactin level. Neurosurgical resection
and medical therapy with bromocriptine mesylate were independently
associated with decreased prolactin levels, loss of arthritis, and reduced
levels of inflammatory mediators.
Publication Types:
PMID: 15529390 [PubMed - indexed for MEDLINE]
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| 4: J Neurooncol. 2004 Aug-Sep;69(1-3):139-50. |
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Pediatric surgical neuro-oncology: current best care
practices and strategies.
Rutka JT, Kuo JS.
The Arthur and Sonia Labatt Brain Tumour Research Centre and Division of
Neurosurgery, The Hospital for Sick Children, University of Toronto,
Toronto, Ontario, Canada. james.rutka@sickkids.ca
Significant advances have been made in the diagnosis and treatment of
childhood brain tumors. Gross total surgical resection combined with
appropriate adjuvant therapies can achieve a high rate of disease control
for low grade gliomas, ependymomas and medulloblastomas. High grade gliomas,
tumors involving the optic apparatus or diencepahalic structures, diffuse
brainstem lesions, and recurrent or metastatic disease still pose
considerable therapeutic challenges. We review the current treatment
strategies of the three most common types of pediatric brain tumors:
gliomas, medulloblastomas and ependymomas, and discuss current and future
diagnostic and therapeutic modalities.
Publication Types:
PMID: 15527086 [PubMed - indexed for MEDLINE]
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| 5: J Neurosurg. 2004 Oct;101(4):607-12. |
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Postoperative evaluation of microsurgical resection for
cavernous malformations of the brainstem.
Kikuta K, Nozaki K, Takahashi JA, Miyamoto S, Kikuchi H, Hashimoto N.
Department of Neurosurgery, Kyoto University Graduate School of Medicine,
Kyoto, Japan. kikuta@kuhp.kyoto-u.ac.jp
OBJECT: The aim of this study was to propose criteria to determine whether
complete resection of cavernous malformations in the brainstem had been
achieved. METHODS: The authors retrospectively analyzed data in 10 patients
harboring a single cavernous malformation who had presented with hemorrhagic
symptoms and had been followed up for longer than 2 years postsurgery. The
study population consisted of five male and five female patients ranging in
age from 13 to 57 years (mean 36.8 years). When preoperative magnetic
resonance (MR) images demonstrated the lesion as a homogeneous hyperintense
mass, the surgery was defined as complete or incomplete based on
intraoperative findings. When preoperative MR images revealed other
findings, complete resection was determined according to whether
postoperative MR imaging results demonstrated lesions distinct from the
peripheral hemosiderin rim. Among the 13 operations in this series, nine
resulted in complete resection and were associated with no postoperative
clinical relapse of hemorrhage, whereas four operations resulted in
incomplete resection and were correlated with postoperative recurrent
hemorrhage. The seven patients in whom the outcome of the initial operation
was complete demonstrated good neurological recovery in the long-term
follow-up period, whereas the three patients in whom the outcome of the
initial surgery was judged to be incomplete showed inadequate neurological
recovery due to recurrent hemorrhage. CONCLUSIONS: The criteria proposed in
this study to evaluate surgical treatment may be a reliable means of
predicting the recurrence of hemorrhage postoperatively.
PMID: 15481714 [PubMed - indexed for MEDLINE]
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| 6: J Clin Endocrinol Metab. 2004 Oct;89(10):4999-5002. |
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Adult heights attained by children with
hypothalamic/chiasmatic glioma treated with growth hormone.
Kim RJ, Janss A, Shanis D, Homan S, Moshang T Jr.
Division of Endocrinology, Department of Pediatrics, University of
Pennsylvania School of Medicine and Children's Hospital of Philadelphia,
Philadelphia, Pennsylvania 19104, USA.
Hypothalamic/chiasmatic gliomas (H/CG) in children are commonly accompanied
by endocrine dysfunction due to mass effects of the tumor itself or as a
consequence of tumor therapy, with GH deficiency (GHD) being the most common
disorder. We report the height outcomes of GH-treated H/CG patients with
GHD. We reviewed the records of 14 GHD patients with H/CG who were treated
with human GH. A comparison group of non-GH-treated H/CG patients was also
identified. Heights were expressed as sd scores (SDS). For GH-treated
patients, the mean initial height was -0.7 +/- 0.3 (+/-se). Their mean final
height was -0.3 +/- 0.3. The mean change in height SDS for the GH-treated
group was +0.4. The mean initial and final height SDS for the non-GHD
patients were 0.6 (se = 0.4) and 0.0 (se = 0.4), respectively. The mean
change in height SDS was -0.6. The GHD patients had significantly lower
initial height SDS compared with the non-GHD patients (P = 0.01) and had a
significantly greater change in their height SDS (P = 0.04). GH treatment
for H/CG patients restores much of their growth potential and improves adult
height to within normal limits.
PMID: 15472197 [PubMed - indexed for MEDLINE]
 http://jcem.endojournals.org/cgi/reprint/89/10/4999
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| 7: J Clin Pathol. 2004 Oct;57(10):1111-3. |
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Expression of thyroid transcription factor 1 in primary
brain tumours.
Zamecnik J, Chanova M, Kodet R.
Department of Pathology and Molecular Medicine, Charles University, Second
Medical Faculty, 150 06 Prague, Czech Republic.
josef.zamecnik@lfmotol.cuni.cz
BACKGROUND: Thyroid transcription factor 1 (TTF-1) is expressed in a
proportion of carcinomas derived from follicular thyroid cells and
respiratory epithelium. Immunohistochemical detection of this protein was
shown previously to be a helpful aid in tumour diagnosis, specifically in
deciding whether a tumour is primary to the lung/thyroid gland or
metastatic. Recently, TTF-1 expression was also observed in certain areas of
postnatal brain. AIM/METHOD: To investigate the expression of TTF-1 protein
in a spectrum of 73 primary brain tumours including astrocytomas,
glioblastomas, ependymomas, oligodendrogliomas, medulloblastomas, and
gangliogliomas of different sites. RESULTS: All the tumours were negative
for TTF-1 except for two ependymomas of the third ventricle. CONCLUSIONS:
The expression of TTF-1 in brain tumours appears to be site specific rather
than associated with tumour dedifferentiation. The presented expression of
TTF-1 protein in certain primary brain tumours should be taken into
consideration when interpreting the immunohistochemical staining of brain
tumours of uncertain primary site.
PMID: 15452173 [PubMed - indexed for MEDLINE]
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| 8: Cancer. 2004 Nov 1;101(9):2116-25. |
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Parent proxy-reported health-related quality of life and
fatigue in pediatric patients diagnosed with brain tumors and acute
lymphoblastic leukemia.
Meeske K, Katz ER, Palmer SN, Burwinkle T, Varni JW.
Childrens Center for Cancer and Blood Diseases, Childrens Hospital Los
Angeles, Los Angeles, CA 90027, USA. kmeeske@chla.usc.edu
BACKGROUND: Pediatric patients with brain tumors (BT) are often excluded
from health-related quality of life (HRQOL) studies even though they
experience more severe disease and treatment-related sequelae than children
with other types of cancer. Parent proxy assessments of HRQOL allow for
greater inclusion of children who are developmentally immature, physically
ill, or cognitively impaired. METHODS: Parents of children ages 2-18 years
who were diagnosed at Childrens Hospital Los Angeles and Children's Hospital
San Diego with BT (n = 86) or acute lymphoblastic leukemia (ALL; n = 170)
evaluated their children's HRQOL over the previous week using the
parent-proxy versions of the Pediatric Quality of Life Inventory (PedsQL)
4.0 Generic Core scales, the PedsQL 3.0 Acute Cancer Module, and the PedsQL
Multidimensional Fatigue scales. Multiple regression analyses were used to
determine the independent effect of the child's diagnosis on HRQOL. Separate
analyses were conducted for patients receiving treatment, patients who had
not received treatment for < 12 months, and patients who had not received
treatment for > or = 12 months. RESULTS: Patients with BT exhibited more
problems than patients with ALL in the physical, social, psychosocial,
school, cognitive, and fatigue domains of HRQOL. The Core Physical Health,
Core Psychosocial Health, and Fatigue Total scores for patients with BT
demonstrated peak improvements for children who had not received treatment
for < 12 months and sharp declines for children who had not received
treatment for > or = 12 months. The Core Physical Health and Fatigue
Total scores for patients with ALL were highest (better HRQOL) for those who
had not received treatment for > or = 12 months. CONCLUSIONS: Pediatric
patients and survivors of BT experienced more fatigue and HRQOL problems
than patients with ALL, and HRQOL differed by treatment status.
PMID: 15389475 [PubMed - indexed for MEDLINE]
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| 9: Oncogene. 2004 Sep 20;23(43):7267-73. |
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Cancer stem cells in nervous system tumors.
Singh SK, Clarke ID, Hide T, Dirks PB.
The Arthur and Sonia Labatt Brain Tumor Research Centre, The Hospital for
Sick Children, Toronto, Canada.
Most current research on human brain tumors is focused on the molecular and
cellular analysis of the bulk tumor mass. However, evidence in leukemia and
more recently in solid tumors such as breast cancer suggests that the tumor
cell population is heterogeneous with respect to proliferation and
differentiation. Recently, several groups have described the existence of a
cancer stem cell population in human brain tumors of different phenotypes
from both children and adults. The finding of brain tumor stem cells (BTSCs)
has been made by applying the principles for cell culture and analysis of
normal neural stem cells (NSCs) to brain tumor cell populations and by
identification of cell surface markers that allow for isolation of distinct
tumor cell populations that can then be studied in vitro and in vivo. A
population of brain tumor cells can be enriched for BTSCs by cell sorting of
dissociated suspensions of tumor cells for the NSC marker CD133. These
CD133+ cells, which also expressed the NSC marker nestin, but not
differentiated neural lineage markers, represent a minority fraction of the
entire brain tumor cell population, and exclusively generate clonal tumor
spheres in suspension culture and exhibit increased self-renewal capacity.
BTSCs can be induced to differentiate in vitro into tumor cells that
phenotypically resembled the tumor from the patient. Here, we discuss the
evidence for and implications of the discovery of a cancer stem cell in
human brain tumors. The identification of a BTSC provides a powerful tool to
investigate the tumorigenic process in the central nervous system and to
develop therapies targeted to the BTSC. Specific genetic and molecular
analyses of the BTSC will further our understanding of the mechanisms of
brain tumor growth, reinforcing parallels between normal neurogenesis and
brain tumorigenesis.
Publication Types:
PMID: 15378086 [PubMed - indexed for MEDLINE]
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| 10: Cancer. 2004 Sep 15;101(6):1445-54. |
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Medullomyoblastoma: a radiographic and clinicopathologic
analysis of six cases and review of the literature.
Helton KJ, Fouladi M, Boop FA, Perry A, Dalton J, Kun L, Fuller C.
Department of Radiological Sciences, St. Jude Children's Research Hospital,
Memphis, TN 38105-2794, USA. kathleen.helton@stjude.org
BACKGROUND: Medullomyoblastoma (MMB) is a rare cerebellar embryonal neoplasm
that occurs almost exclusively in children. It is biphasic by microscopy,
containing myoblastic and primitive neuroectodermal components. METHODS: The
authors conducted a retrospective review of the radiographic and pathologic
characteristics, treatment, and clinical outcomes of six children with MMB
who were treated at St. Jude Children's Research Hospital (Memphis, TN)
between 1984 and 2003. Fluorescence in situ hybridization (FISH) data were
available for four children. A literature review also was conducted and
focused on imaging and pathologic findings. RESULTS: The median age at
diagnosis was 4.5 years (range, 0.83-7.5 years). Radiographically, all
tumors were cerebellar and exhibited variable enhancement, and 50% of tumors
had necrotic foci. Three tumors contained discrete, magnetic resonance
imaging (MRI) T2-weighted-hypointense/computed tomography (CT)-hyperdense
enhancing regions and separate hyperintense/hypodense nonenhancing regions,
which correlated microscopically with geographic islands of primitive
neuroectodermal and rhabdomyoblastic cells. Large cell/anaplastic (five
tumors), nodular/desmoplastic (two tumors), and classic (two tumors)
medulloblastoma histologies were encountered either alone (five tumors) or
in combination with each other (two tumors). All 4 tumors that were tested
exhibited alterations in chromosome 17 or c-myc amplification. All patients
underwent macroscopic total resection and subsequently received chemotherapy
and craniospinal (five patients) or local conformal (one patient)
radiotherapy. At a median follow-up of 92 months (range, 23-187 months), 3
patients remain alive with no evidence of disease, 2 patients have died of
disease, and 1 patient has died of secondary acute lymphocytic leukemia.
CONCLUSIONS: The results of the current study demonstrated the frequent
correlation of biphasic nodularity (as determined by MRI or CT) with
discrete rhabdomyoblastic and primitive neuroectodermal islands (as revealed
by microscopy) in MMB. These results also support the view that MMB and
medulloblastoma may have common tumorigenic origins, given their similar
histologic and molecular features. Copyright 2004 American Cancer Society.
Publication Types:
PMID: 15368333 [PubMed - indexed for MEDLINE]
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| 11: J Neurosurg. 2004 Sep;101(3):536-40. |
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Endotracheal tube electrodes to map and monitor
activities of the vagus nerve intraoperatively. Technical note.
Mikuni N, Satow T, Taki J, Nishida N, Enatsu R, Hashimoto N.
Department of Neurosurgery, Kyoto University Graduate School of Medicine,
Kyoto, Japan. mikunin@kuhp.kyoto-u.ac.jp
Difficulty swallowing due to damage of the vagus nerve is one of the most
devastating complications of surgery in and around the medulla oblongata;
therefore, intraoperative anatomical and functional evaluation of this nerve
is crucial. The authors applied endotracheal tube surface electrodes to
record electromyography (EMG) activity from vocal cords innervated by the
vagus nerve. The vagal nucleus or rootlet was electrically stimulated during
surgery and vocalis muscle EMG activities were displayed by auditory and
visual signals. This technique was used successfully to identify the vagus
motor nerve and evaluate its integrity during surgery. The advantages of
this method compared with the use of needle electrodes include safe simple
electrode placement and stable recording during surgery. In cases involving
a pontine cavernoma pressing the nucleus or a jugular foramen tumor
encircling the rootlet, this method would be particularly valuable.
Additional studies with a larger number of patients are needed to estimate
the significance of this method as a means of functional monitoring to
predict clinical function.
PMID: 15352615 [PubMed - indexed for MEDLINE]
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| 12: Inf Process Med Imaging. 2003 Jul;18:270-81. |
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Knowledge-driven automated extraction of the human
cerebral ventricular system from MR images.
Xia Y, Hu Q, Aziz A, Nowinski WL.
Biomedical Imaging Lab, Institute for Infocomm Research, 21 Heng Mui Keng
Terrace, Singapore 119613. yanxia@i2r.a-star.edu.sg
This work presents an efficient and automated method to extract the human
cerebral ventricular system from MRI driven by anatomic knowledge. The
ventricular system is divided into six three-dimensional regions; six ROIs
are defined based on the anatomy and literature studies regarding
variability of the cerebral ventricular system. The distribution histogram
of radiological properties is calculated in each ROI, and the intensity
thresholds for extracting each region are automatically determined.
Intensity inhomogeneities are accounted for by adjusting intensity threshold
to match local situation. The extracting method is based on region-growing
and anatomical knowledge, and is designed to include all ventricular parts,
even if they appear unconnected on the image. The ventricle extraction
method was implemented on the Window platform using C++, and was validated
qualitatively on 30 MRI studies with variable parameters.
Publication Types:
- Clinical Trial
- Controlled Clinical Trial
- Validation Studies
PMID: 15344464 [PubMed - indexed for MEDLINE]
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| 13: Cancer Chemother Biol Response Modif. 2003;21:655-81. |
|
Brain tumors.
Pueschel JK, Ashby LS, Shapiro WR.
Barrow Neurological Institute, Department of Neurology, Phoenix, Arizona
85013, USA.
Publication Types:
PMID: 15338768 [PubMed - indexed for MEDLINE]
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| 14: Int J Radiat Oncol Biol Phys. 2004 Sep 1;60(1):204-13. |
|
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Patterns of failure in supratentorial primitive
neuroectodermal tumors treated in Children's Cancer Group Study 921, a phase
III combined modality study.
Hong TS, Mehta MP, Boyett JM, Donahue B, Rorke LB, Yao MS, Zeltzer PM.
Department of Human Oncology, University of Wisconsin School of Medicine,
Madison, WI, USA.
PURPOSE: To analyze the patterns of failure in patients with supratentorial
primitive neuroectodermal tumors (ST-PNETs) treated with combined modality
therapy in a large, randomized, multi-institutional study. METHODS AND
MATERIALS: A total of 44 prospectively staged patients with ST-PNET
confirmed by central pathology review were treated in the Children's Cancer
Group Study 921, which compared two chemoradiotherapy regimens. The patterns
of initial sites of failure were analyzed. These were compared with the
failure patterns of 188 children with posterior fossa (PF) PNETs treated in
the same protocol. RESULTS: The major determinant for progression-free
survival was the initial metastatic stage. The 3-year progression-free
survival for M0 patients was 53% +/- 8.5% compared with 14% +/- 9.4% for M+
patients. The cumulative 5-year relapse incidence was 71.4% +/- 21% for M+
patients compared with 47.5% +/- 8.6% for M0 patients. The overall failure
rate for both M0 and M+ ST-PNETs was greater than that for PF-PNETs (47.5%
+/- 8.6% vs. 29.3% +/- 4.7% for M0 and 71.4% +/- 21% vs. 48.4% +/- 5.5% for
M+). Failure at the primary site, either as the sole site or as a component
of initial failure, was also seen more frequently in ST-PNETs than in
PF-PNETs. For M0 patients, the 5-year local failure rate as a component of
initial failure was 42.0% +/- 8.5% for ST-PNETs compared with 17.7% +/- 3.9%
for PF-PNETs. For patients with primary tumors either in the ST or PF, the
5-year spinal axis failure rate as a component of initial failure was not
significantly different statistically when compared by M stage. For M+
patients, the 5-year spinal axis failure rate as a component of initial
failure was 42.9% +/- 22.8% for ST-PNETs and 34.6% +/- 5.2% for PF-PNETs.
CONCLUSION: Despite aggressive combined modality therapy, ST-PNETs had high
rates of failure, with M+ patients faring especially poorly. Both local and
spinal failure rates remained high, indicating the need to maximize both
local and regional/systemic therapies. Overall, these patients fared worse
than those with high-risk PF-PNETs in terms of progression-free survival and
failure rates.
Publication Types:
- Clinical Trial
- Clinical Trial, Phase III
- Multicenter Study
- Randomized Controlled Trial
PMID: 15337557 [PubMed - indexed for MEDLINE]
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| 15: Cancer. 2004 Sep 1;101(5):1036-42. |
|
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Analysis of interleukin-13 receptor alpha2 expression in
human pediatric brain tumors.
Kawakami M, Kawakami K, Takahashi S, Abe M, Puri RK.
Laboratory of Molecular Tumor Biology, Division of Cellular and Gene
Therapies, Center for Biologics Evaluation and Research, Food and Drug
Administration, Bethesda, MD 20892, USA.
BACKGROUND: Compared with normal brain tissue cells, human malignant glioma
cells express higher levels of interleukin-13 receptor (IL-13R). However,
whether this receptor is expressed in situ has not been carefully examined.
With IL-13R-targeted cytotoxin (IL13-PE38QQR, comprising IL-13 and a mutated
form of Pseudomonas exotoxin [PE]) being tested in three Phase I/II clinical
trials for the treatment of adult human glioma, and with pediatric studies
being planned, the authors set out to analyze pediatric brain tumor tissue
specimens for the expression of IL-13R. METHODS: Using in situ hybridization
and immunohistochemical staining, the authors examined 58 pediatric brain
tumor specimens for expression of the predominant IL-13 binding and
internalizing protein (IL-13Ralpha2) chain at the mRNA and protein levels.
RESULTS: Overall, approximately 83% of pediatric brain tumor samples
expressed IL-13Ralpha2. One hundred percent (11 of 11) high-grade
astrocytoma, 79% (26 of 33) low-grade astrocytoma, 67% (4 of 6)
medulloblastoma, and 67% (2 of 3) ependymoma samples were positive for
IL-13Ralpha2. Among IL-13Ralpha2-positive samples, 88% (42 of 48 samples)
had positive expression in > or = 50% of all tumor fields. The results
obtained using both assays were consistent with each other. CONCLUSIONS: The
current study established that pediatric brain tumor specimens expressed the
IL-13Ralpha2 chain. Because the IL-13Ralpha2 chain is a major binding
component of the IL-13R complex, these results suggest that the targeting of
IL-13R may represent a useful approach for the treatment of pediatric brain
tumors. Copyright 2004 American Cancer Society.
PMID: 15329913 [PubMed - indexed for MEDLINE]
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| 16: Br J Neurosurg. 2004 Jun;18(3):310-3. |
|
Primary midbrain germinoma.
Ben Amor S, Siddiqui K, Baessa S.
Department of Neurosciences, King Faisal Specialist Hospital & RC,
Jeddah, Kingdom of Saudi Arabia. benamor@healthgulf.com
Intracranial germinomas arising primarily in the midbrain are extremely rare
and only one case has been reported in the literature. A 15-year-old boy
presented with headache, diplopia, unsteadiness and personality changes.
Brain MRI showed a heterogeneous lesion in the midbrain. The pineal body
region was free. The preoperative diagnosis included brain-stem glioma,
metastasis and lymphoma. Stereotactic biopsy was permitted in order to take
a specimen and the diagnosis of germinoma was established. The patient
responded well to chemotherapy and radiotherapy. Germinoma should be
included in the differential diagnosis of midbrain lesions. Preoperative
diagnosis is difficult and biopsy is still needed for such lesions.
Publication Types:
- Case Reports
- Review
- Review of Reported Cases
PMID: 15327241 [PubMed - indexed for MEDLINE]
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| 17: Br J Neurosurg. 2004 Jun;18(3):284-9. |
|
Primary cerebellar germinomas of the posterior fossa.
Maiuri F, Cappabianca P, Del Basso De Caro M, Esposito F, de Divitiis E.
Department of Neurological Sciences, Section of Neurosurgery, School of
Medicine, University Federico II, Naples, Italy. fcmaiuri@unina.it
Primary cerebellar germinomas, in the absence of germ-cell tumours outside
the nervous system or elsewhere in the cranial cavity and CSF pathways, are
exceptional; only two previous cases have been reported in the literature.
Two personal observations are described from our 20-year records of
intra-axial posterior fossa tumours. The patients were a 32-year-old man and
a 17-year-old woman with a clinical history of posterior fossa tumour,
studied by computed tomography. The first patient with slight cerebellar
signs had a small right hemispheric cerebellar tumour, and the other had a
left cerebellar mass with hydrocephalus and progressive intracranial
hypertension. Both were treated by tumour removal and irradiation to the
whole posterior fossa. The survival times were 58 and 49 months,
respectively. The diagnosis of primary cerebellar germinoma cannot be
suspected before pathological confirmation. The clinical, neuroradiological
and surgical findings are non-specific and quite similar to those of other
malignant cerebellar tumours, such as anaplastic gliomas or metastases.
Surgery and radiotherapy ensure adequate tumour control in the early stages;
cases of recurrence or disseminated disease may be treated by irradiation
and chemotherapy.
Publication Types:
- Case Reports
- Review
- Review of Reported Cases
PMID: 15327234 [PubMed - indexed for MEDLINE]
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| 18: J Neurol Neurosurg Psychiatry. 2004 Sep;75(9):1309-13. |
|
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Magnetoencephalography (MEG) predicts focal
epileptogenicity in cavernomas.
Stefan H, Scheler G, Hummel C, Walter J, Romstock J, Buchfelder M,
Blumcke I.
Department of Neurology, Epilepsy and Neuro-Center, University of
Erlangen-Nurnberg, Germany. hermann.stefan@neuro.imed.uni-erlangen.de
OBJECTIVE: The aim of this study was to identify the irritative epileptic
zone in patients with cavernomas by means of magnetoencephalography (MEG).
METHOD: Among 82 patients operated for epilepsy, whose presurgical
evaluation had included MEG, histological assessment of the tissue removed
had confirmed cavernomas in eight. These eight patients had epilepsy since
18.6 (SD 12.7) years on average. The monitoring lasted about 2.1 (SD 1.3)
hours and a median 20.9 (SD 14.3) spikes per hour were recorded. Spontaneous
brain activity was recorded by means of a 74 channel dual unit MEG system
(Magnes II, 4-D Neuroimaging) with simultaneous EEG recording (31 scalp
electrodes). Spike analysis was performed using different source (moving
dipole, current density reconstruction) and head models (spherical shells,
BEM). Co-registration of neurophysiological and imaging data (MRI) was based
upon anatomical landmarks. RESULTS: In 6/8 patients co-localisation from the
cavernoma and epileptic zone was found. In two patients the focus was
localised in the parieto-occipital lobe, in three patients in the frontal
lobe and in three patients in the temporal lobe. In one case of temporal and
one case of frontal lobe focus localisation there was no spatial
relationship to the cavernoma. CONCLUSION: In cases of focal seizures due to
a single cavernoma, MEG may precisely delineate the epileptogenic tissue
bordering the lesion. In patients with multiple cavernomas or dual
pathology, MSI may reveal the complexity of the case, and contribute to the
decision about further invasive diagnostics and more sophisticated
therapeutic measures. MEG is a promising method for prediction of the
epileptic zone in cavernoma related epilepsies, and thus it can contribute
to decision making about and planning of epilepsy surgery.
Publication Types:
PMID: 15314122 [PubMed - indexed for MEDLINE]
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| 19: Toxicol Appl Pharmacol. 2004 Sep 1;199(2):118-31. |
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Epidemiology of brain tumors in childhood--a review.
Baldwin RT, Preston-Martin S.
Department of Family Medicine, Division of Preventive Medicine, David Geffen
School of Medicine, University of California-Los Angeles, Los Angeles, CA
90095, USA.
Malignant brain tumors are the leading cause of cancer death among children
and the second most common type of pediatric cancer. Despite several decades
of epidemiologic investigation, the etiology of childhood brain tumors (CBT)
is still largely unknown. A few genetic syndromes and ionizing radiation are
established risk factors. Many environmental exposures and infectious agents
have been suspected of playing a role in the development of CBT. This
review, based on a search of the medical literature through August 2003,
summarizes the epidemiologic evidence to date. The types of exposures
discussed include ionizing radiation, N-nitroso compounds (NOC), pesticides,
tobacco smoke, electromagnetic frequencies (EMF), infectious agents,
medications, and parental occupational exposures. We have chosen to focus on
perinatal exposures and review some of the recent evidence indicating that
such exposures may play a significant role in the causation of CBT. The
scientific community is rapidly learning more about the molecular mechanisms
by which carcinogenesis occurs and how the brain develops. We believe that
advances in genetic and molecular biologic technology, including improved
histologic subtyping of tumors, will be of huge importance in the future of
epidemiologic research and will lead to a more comprehensive understanding
of CBT etiology. We discuss some of the early findings using these
technologies.
Publication Types:
PMID: 15313584 [PubMed - indexed for MEDLINE]
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| 20: Pediatr Nurs. 2004 May-Jun;30(3):238-41. |
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The story of Margaret and her family: forced choices,
obligations, and hope.
Carnevale FA.
McGill University, Montreal, Quebec, Canada.
Publication Types:
PMID: 15311651 [PubMed - indexed for MEDLINE]
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Volume 3, Supplement 20 - 25 December 2004