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  • Brain Neoplasms
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  • 1
    Language: English
    In: Journal of Neuro-Oncology, 1997, Vol.33(3), pp.213-221
    Description: Beginning in 1987, selected patients with metastatic braintumors were treated with permanent implants of low-activityradioactive iodine-125 ( 125 I) seeds. These patients underwent craniotomy,gross total resection of the metastatic lesion, andplacement of the seeds. In general, criteria fortreatment included the presence of a recurrent tumorwith a volume too large to permit radiosurgery,and a Karnofsky Performance Score of 70 orhigher. Thirteen patients underwent 14 implant procedures; allreceived external whole-brain radiotherapy. Implant dose ranged from43 Gy to 132 Gy, with a meanof 83 Gy. Survival after implantation ranged from2 weeks to almost 9 years, with amedian of 9 months. Clinical and radiographic localcontrol was obtained in 9 patients. Two patientsdied of acute, postoperative complications within a monthof implantation, so no information regarding tumor controlis available for them. Late complications included abone flap infection in one patient and aCSF leak in another; both were treated withoutfurther sequelae. These results demonstrate that permanent I implants canresult in good survival and quality of life,and occasionally can yield long-term survival. Potentially, itis a cost-effective treatment in that a separateprocedure for stereotactic implantation or radiosurgery is notneeded, as is the case with the useof temporary high-activity seeds. The permanent implantation itselfadds less than 10 minutes to the craniotomy,and the risk of symptomatic radiation necrosis islow. We recommend consideration of this procedure inpatients harboring large, recurrent metastatic tumors that requirefurther surgery.
    Keywords: brachytherapy ; cancer ; intracranial neoplasms ; metastatic tumors ; radiation therapy
    ISSN: 0167-594X
    E-ISSN: 1573-7373
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  • 2
    In: Cancer, Jan 1, 1997, Vol.79(1), p.127(5)
    Description: BACKGROUND: Gangliogliomas are rare tumors occurring in both children and adults that are characterized by the presence of neoplastic cells resembling both neurons and glia.METHODS: The authors reviewed 18 adults patients with intracranial gangliogliomas treated at the study institutions between October 1987 and November 1995.RESULTS: The median age at diagnosis was 33.7 years, with a range of 21 to 55 years. Median follow-up was 37.7 months, with a range of 4 months to 13 years. Clinical manifestations among the patients included seizures (13), headache (2), ataxia (1), and hemiparesis and paresthesias (1 patient each). Tumors were located in the temporal lobe (6 patients), temporal lobe and thalamus (1 patient), frontal lobe (5 patients), cerebellum (4 patients), and insula or thalamus (1 patient each). Thirteen patients underwent gross total resection, 4 underwent incomplete resection, and 1 underwent only a stereotactic biopsy. Treatment modalities included surgery only, surgery plus radiation, and surgery plus radiation and chemotherapy. Median survival was 90.3 months, with a range of 14 months to 13 years. Three patients were dead at follow-up with a mean survival of 32.3 months. These patients showed anaplastic features in their pathology at initial surgery or surgery for recurrence.CONCLUSIONS: In adults, gangliogliomas have a relatively favorable prognosis; however, the presence of anaplastic features predicts a worse outcome.
    Keywords: Nervous System Tumors -- Case Studies ; Astrocytomas -- Case Studies
    ISSN: 0008-543X
    E-ISSN: 10970142
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  • 3
    In: Cancer, August 15, 1996, Vol.78(4), p.864(10)
    Description: BACKGROUND: There appears to be a growing movement in favor of core needle biopsy (CNB) over fine-needle aspiration (FNA) cytology in detecting breast carcinoma in women. The authors compared the sensitivity and specificity of these two methods in patients who presented to The University of Texas M. D. Anderson Cancer Center for evaluation of a palpable breast mass.METHODS: One hundred and twenty-four women (mean age, 51 years; range, 28-86 years) with a clinically suspicious palpable mass (mean size, 4.4 cm; range, 1-12 cm) underwent concurrent FNA and CNB. For the FNA, an average of three needle passes were made. FNA was followed by three CNBs using the Bard Monopty needle. CNB samples were submitted for frozen section to determine adequacy, and an additional three cores were performed if the first batch was deemed inadequate. All patients ultimately had histologic confirmation of their neoplasms either by the core needle procedure or by definitive open surgical biopsy. Features of cases with discrepant diagnoses were examined in relation to tumor size and histologic type.RESULTS: Specificity of both FNA and CNB was 100%. The sensitivity in detecting a malignant neoplasm was higher for FNA than for CNB (97.5% vs. 90%, P 〈 0.004).CONCLUSIONS: In our experience, FNA of palpable breast lesions is a more sensitive method for the detection of carcinoma regardless of tumor type, size, or differentiation. Contrary to other reports, not only was FNA alone more sensitive than CNB alone, the addition of CNB to an already negative FNA failed to increase sensitivity in the detection of carcinoma. However, CNB did contribute to a more definitive diagnosis in some cases. The authors also found FNA to be more cost effective than CNB for palpable breast lesions when time and effort are taken into consideration. This reinforces the benefit of FNA over CNB in the detection of early stage breast carcinoma.
    Keywords: Astrocytomas -- Care And Treatment ; Pediatric Tumors -- Care And Treatment ; Radiotherapy -- Usage ; Magnetic Resonance Imaging
    ISSN: 0008-543X
    E-ISSN: 10970142
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  • 4
    In: International Journal of Epidemiology, 2003, Vol.32(2), pp.225-233
    Description: Background To better understand patterns of occurrence or diagnosis of brain tumours in different segments of the population, we evaluated associations between sociodemographic variables and the relative incidence of brain tumours as part of a multi-faceted case-control study. Methods The study was conducted at hospitals in three US cities between 1994 and 1998. In all, 489 glioma cases (354 high-grade, 135 low-grade), 197 meningioma cases, 96 acoustic neuroma cases, and 799 controls admitted to the same hospitals for any of a variety of non-neoplastic diseases or conditions were enrolled and interviewed. Logistic regression was used to estimate odds ratios (OR), calculate 95% CI, and test for trends. Results The OR showed significant positive associations with household income for low-grade glioma, meningioma, and acoustic neuroma, but not for high-grade glioma. Positive associations were observed with level of education for low-grade glioma and acoustic neuroma, but not for high-grade glioma or meningioma. Jewish religion was associated with a significantly elevated risk for meningioma (OR = 4.3; 95% CI: 2.09.0). Being single at the time of tumour diagnosis or enrolment was associated with significantly reduced risks for meningioma (OR = 0.4; 95% CI: 0.30.6) and low- or high-grade glioma (OR = 0.6; 95% CI: 0.50.8), but not for acoustic neuroma. Conclusions Associations with sociodemographic variables varied considerably among the different subtypes of brain tumour, including between low-grade and high-grade glioma. The general pattern was for associations with indicators of affluence and education to be stronger for tumours that tend to grow more slowly and have less catastrophic effects, although the evidence was mixed for meningioma. We cannot isolate the specific factors underlying the observed associations, but intrapopulation differences in the completeness or timing of diagnosis may have played a role. There is less opportunity for such influences to operate for the rapidly progressing, high-grade gliomas than for more slowly growing tumours.
    Keywords: Brain Cancer; Brain Tumours; Social Class; Glioma; Meningioma; Acoustic Neuroma; Epidemiology
    ISSN: 0300-5771
    E-ISSN: 1464-3685
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  • 5
    In: Neurosurgery, 2000, Vol.46(2), pp.419-419
    Description: OBJECTIVE:: Retinoids are known to exhibit a broad spectrum of biological activities, and they participate in the onset of differentiation and the inhibition of growth in a wide variety of cancer cells. Some of these vitamin A derivatives are already in clinical use. However, data on retinoid actions in glial tumors are rather sparse. Therefore, we studied the effects of the natural retinoic acid (RA) forms all-trans-RA, 9-cis-RA, and 13-cis-RA on glioma cell lines and primary cultures from patients with glioblastomas multiforme. METHODS:: Six human glioma cell lines, one rat glioma cell line, and 20 primary cultures established from biopsies from patients with glioblastomas multiforme were investigated. Tumor cell proliferation was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and cell-counting assays. Random migration out of tumor spheroids was quantified using a video-morphometry system. Invasion was investigated using a confrontational coculture test system. Retinoid receptor (RA receptor [RAR]α, -β, and -γ and retinoid X receptor [RXR]α, -β, and -γ) expression status was determined using reverse transcription-polymerase chain reaction studies. RESULTS:: Treatment of five human glioma cell lines with the different retinoids at concentrations up to 10 mol/L produced no reduction of proliferation, using various incubation times. For one human glioma cell line (U343MG-A) and one rat glioma cell line (C6), which were previously reported to be sensitive to retinoids, we could confirm strong inhibitory effects on proliferation and clear changes in morphological features after retinoid treatment. Application of the different retinoids to low-passage primary cultures of human glioblastomas resulted in marked inhibition of proliferation (30–95%) for all tested samples. Using three-dimensional spheroid cultures, we detected retinoid-induced decreases in cell migration (24–65%). Invasion was not affected by these vitamin A derivatives. In an analysis of the expression patterns for retinoid receptors (RARs and RXRs), all primary culture samples yielded positive results for RARγ and RXRα and negative results for RARα, RARβ, and RXRγ, whereas the results of RXRβ expression were heterogeneous among different patients. The cell lines, irrespective of their RA sensitivities, did not exhibit any major differences in receptor expression. CONCLUSION:: Retinoids strongly inhibit proliferation and migration in primary cultures of human glioblastomas multiforme. Our data support a clinical trial of retinoids for the treatment of human malignant gliomas. We observed that most established cell lines were not sensitive to RA. This difference between long-term cell lines and primary cultures cannot be explained by different retinoid receptor expression patterns.
    Keywords: Brain Neoplasms -- Pathology ; Cell Division -- Drug Effects ; Glioblastoma -- Pathology ; Retinoids -- Pharmacology ; Tumor Cells, Cultured -- Drug Effects;
    ISSN: 0148-396x
    ISSN: 0148396X
    E-ISSN: 15244040
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  • 6
    In: The New England Journal of Medicine, 2001, Vol.344(2), pp.79-86
    Description: Background Concern has arisen that the use of hand-held cellular telephones might cause brain tumors. If such a risk does exist, the matter would be of considerable public health importance, given the rapid increase worldwide in the use of these devices. Methods We examined the use of cellular telephones in a case–control study of intracranial tumors of the nervous system conducted between 1994 and 1998. We enrolled 782 patients through hospitals in Phoenix, Arizona; Boston; and Pittsburgh; 489 had histologically confirmed glioma, 197 had meningioma, and 96 had acoustic neuroma. The 799 controls were patients admitted to the same hospitals as the patients with brain tumors for a variety of nonmalignant conditions. Results As compared with never, or very rarely, having used a cellular telephone, the relative risks associated with a cumulative use of a cellular telephone for more than 100 hours were 0.9 for glioma (95 percent confidence interval, 0.5 to 1.6), 0.7 for meningioma (95 percent confidence interval, 0.3 to 1.7), 1.4 for acoustic neuroma (95 percent confidence interval, 0.6 to 3.5), and 1.0 for all types of tumors combined (95 percent confidence interval, 0.6 to 1.5). There was no evidence that the risks were higher among persons who used cellular telephones for 60 or more minutes per day or regularly for five or more years. Tumors did not occur disproportionately often on the side of head on which the telephone was typically used. Conclusions These data do not support the hypothesis that the recent use of hand-held cellular telephones causes brain tumors, but they are not sufficient to evaluate the risks among long-term, heavy users and for potentially long induction periods. Hand-held cellular telephones were introduced to the U.S. market in 19841 but were not widely used until the mid-1990s. By early 2000, the number of subscribers to cellular-telephone services had grown to an estimated 92 million in the United States and 500 million worldwide.2,3 Some concern has arisen about adverse health effects, especially the possibility that the low-power microwave-frequency signal transmitted by the antennas on handsets might cause brain tumors or accelerate the growth of subclinical tumors.4–8 It is generally agreed that the heating of brain tissue by cellular telephones is negligible, and that any carcinogenic effect would . . .
    Keywords: Adult–Etiology ; Aged–Etiology ; Aged, 80 and Over–Etiology ; Brain Neoplasms–Etiology ; Case-Control Studies–Adverse Effects ; Female–Etiology ; Glioma–Adverse Effects ; Humans–Statistics & Numerical Data ; Male–Utilization ; Meningeal Neoplasms–Utilization ; Meningioma–Utilization ; Microwaves–Utilization ; Middle Aged–Utilization ; Neuroma, Acoustic–Utilization ; Radio Waves–Utilization ; Risk–Utilization ; Socioeconomic Factors–Utilization ; Telephone–Utilization ; Abridged;
    ISSN: 0028-4793
    E-ISSN: 1533-4406
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  • 7
    Language: English
    In: RIGHI, VALERIA, OVIDIU C. ANDRONESI, DIONYSSIOS MINTZOPOULOS, PETER M. BLACK, and A. ARIA TZIKA. 2010. “High-resolution magic angle spinning magnetic resonance spectroscopy detects glycine as a biomarker in brain tumors.” International Journal of Oncology 36 (2): 301-306. doi:10.3892/ijo_00000500. http://dx.doi.org/10.3892/ijo_00000500.
    Description: The non-essential amino acid neurotransmitter glycine (Gly) may serve as a biomarker for brain tumors. Using 36 biopsies from patients with brain tumors [12 glioblastoma multiforme (GBM); 10 low-grade (LG), including 7 schwannoma and 3 pylocytic astrocytoma; 7 meningioma (MN); 7 brain metastases (MT), including 3 adenocarcinoma and 4 breast cancer] and 9 control biopsies from patients undergoing surgery for epilepsy, we tested the hypothesis that the presence of glycine may distinguish among these brain tumor types. Using high-resolution magic angle spinning (HRMAS) 1H magnetic resonance spectroscopy (MRS), we determined a theoretically optimum echo time (TE) of 50 ms for distinguishing Gly signals from overlapping myo-inositol (Myo) signals and tested our methodology in phantom and biopsy specimens. Quantitative analysis revealed higher levels of Gly in tumor biopsies (all combined) relative to controls; Gly levels were significantly elevated in LG, MT and GBM biopsies (P≤0.05). Residual Myo levels were elevated in LG and MT and reduced in MN and GBM (P〈0.05 vs. control levels). We observed higher levels of Gly in GBM as compared to LG tumors (P=0.05). Meanwhile, although Gly levels in GBM and MT did not differ significantly from each other, the Gly:Myo ratio did distinguish GBM from MT (P〈0.003) and from all other groups, a distinction that has not been adequately made previously. We conclude from these findings that Gly can serve as a biomarker for brain tumors and that the Gly:Myo ratio may be a useful index for brain tumor classification.
    Keywords: Brain/Cns Cancers ; Tumor Biomarkers
    ISSN: 1019-6439
    E-ISSN: 17912423
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  • 8
    Language: English
    In: American journal of epidemiology, 01 January 2007, Vol.165(1), pp.63-71
    Description: Previous studies have suggested an association of personal hair dye use with bladder and hematopoietic cancers. Risks for brain tumors are not well understood. The authors investigated associations between use of synthetic hair dyes and risk of brain tumors in a hospital-based case-control study. The study included adults newly diagnosed with glioma (n = 489), meningioma (n = 197), or acoustic neuroma (n = 96) between 1994 and 1998 at three urban US hospitals and 799 controls. Odds ratios were estimated and 95% confidence intervals were calculated using unconditional logistic regression. Detailed exposure histories were obtained by interview. There was no consistent pattern of elevated odds ratios for glioma, meningioma, or acoustic neuroma with use or prolonged use of permanent, semipermanent, temporary, or gradual hair dyes. Although use of permanent brown hair dye for 20 or more years was associated with glioma among women, the estimate was imprecise (odds ratio = 3.8, 95% confidence interval: 1.2, 12.5) and was based on just 13 exposed cases; thus, this could be a chance finding. Overall, there was little consistent evidence for an association of synthetic hair dye use with glioma, meningioma, or acoustic neuroma. However, prolonged use of dark-colored permanent dyes warrants further investigation given the high prevalence of hair dyeing.
    Keywords: Brain Neoplasms -- Epidemiology ; Environmental Exposure -- Adverse Effects ; Glioma -- Epidemiology ; Hair Dyes -- Toxicity ; Meningioma -- Epidemiology ; Neuroma, Acoustic -- Epidemiology
    ISSN: 0002-9262
    E-ISSN: 14766256
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  • 9
    In: The Lancet, April 22, 1995, Vol.345(8956), p.1008(5)
    Description: Chemotherapy for brain tumours has been limited because of difficulty in achieving adequate exposure to the tumour without systemic toxicity. We have developed a method for local sustained release of chemotherapeutic agents by their incorporation into biodegradable polymers. Implantation of the drug-impregnated polymer at the tumour site allows prolonged local exposure with minimal systemic exposure. We conducted a randomised, placebo-controlled, prospective study to evaluate the effectiveness of biodegradable polymers impregnated with carmustine to treat recurrent malignant gliomas. In 27 medical centres, 222 patients with recurrent malignant brain tumours requiring re-operation were randomly assigned to receive surgically implanted biodegradable polymer discs with or without 3[multiplied by]85% carmustine. Randomisation balanced the treatment groups for all of the prognostic factors examined. Median survival of the 110 patients who received carmustine polymers was 31 weeks compared with 23 weeks for the 112 patients who received only placebo polymers (hazard ratio=0[multiplied by]67, p=0[multiplied by]006, after accounting for the effects of prognostic factors). Among patients with glioblastoma, 6-month survival in those treated with carmustine-polymer discs was 50% greater than in those treated with placebo (mortality=32 of 72 [44%] vs 47 of 73 [64%], p=0[multiplied by]02). There were no clinically important adverse reactions related to the carmustine polymer, either in the brain or systemically. Interstitial chemotherapy delivered with polymers directly to brain tumours at the time of surgery seems to be a safe and effective treatment for recurrent malignant gliomas. Lancet 1995; 345: 1008-12
    Keywords: Gliomas -- Drug Therapy ; Carmustine -- Health Aspects ; Biocompatible Polymers -- Physiological Aspects ; Drug Delivery Systems -- Research
    ISSN: 0140-6736
    E-ISSN: 1474547X
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  • 10
    Language: English
    In: International journal of oncology, April 2011, Vol.38(4), pp.1113-27
    Description: Recent advents in magnetic resonance spectroscopy (MRS) techniques permit subsequent microarray analysis over the entire human transcriptome in the same tissue biopsies. However, extracting information from such immense quantities of data is limited by difficulties in recognizing and evaluating the relevant patterns of apparent gene expression in the context of the existing knowledge of phenotypes by histopathology. Using a quantitative approach derived from a knowledge base of pathology findings, we present a novel methodology used to process genome-wide transcription and MRS data. This methodology was tested to examine metabolite and genome-wide profiles in MRS and RNA in 55 biopsies from human subjects with brain tumors with ~100% certainty. With the guidance of histopathology and clinical outcome, 15 genes with the assistance of 15 MRS metabolites were able to be distinguished by tumor categories and the prediction of survival was better than when either method was used alone. This new method, combining MRS, genomics, statistics and biological content, improves the typing and understanding of the complexity of human brain tumors, and assists in the search for novel tumor biomarkers. It is an important step for novel drug development, it generates testable hypotheses regarding neoplasia and promises to guide human brain tumor therapy provided improved in vivo methods for monitoring response to therapy are developed.
    Keywords: Brain Neoplasms -- Diagnosis ; Gene Expression Profiling -- Methods ; Magnetic Resonance Spectroscopy -- Methods
    ISSN: 10196439
    E-ISSN: 1791-2423
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