18 research outputs found
Post-radiation gliomas.
No full textAIMS AND BACKGROUND:
Radiotherapy is important in the treatment of neoplasm of the central nervous system, but various side effects, particularly neoplastic, have been described. Recently, post-radiation gliomas have been reported.
METHODS:
The authors review 88 cases of cerebral glioma following radiotherapy in patients operated for neoplasms of the nervous system, including 6 personal cases of post-radiation gliomas treated in the Neurosurgical Division of the Department of Neurological Sciences, "La Sapienza" University, Rome. The criteria used to define this unusual pathologic association are discussed.
RESULTS:
There was a male predominance. Post-radiation gliomas were particularly malignant, the average dose was 33 Gy, and average free latency was 9.6 years. The first disease was most frequently acute lymphatic leukemia.
CONCLUSIONS:
Post-radiation gliomas have particular features but do not present a histologic or clinical behavior different from analogous spontaneous gliomas. The fact that 88 cases have been reported in recent years suggests that a thorough biological, clinical studies be carried out on this association
Multicentric gliomas. Report of seven cases.
No full textMultifocal gliomas fall into four main categories: diffuse, multiple, multicentric and multiple-organ. Multicentric gliomas are uncommon lesions of the central nervous system. Even more so are multicentric gliomas lying both above and below the tentorium (16 cases to date, as far we know). We report a clinical series of 7 cases, including 3 supra-infratentorial tumors. The distinctive features of multicentric gliomas are mainly the absence of gross or microscopic connections and absence of seeding along easily accessible routes like the cerebrospinal fluid pathways or the median commissures. We consider the pathogenetic hypotheses and problems of diagnosis, especially differential from other multifocal diseases of the central nervous system
Packing of Intervertebral Spaces with Oxidized Regenerated Cellulose to Prevent the Recurrence of Lumbar Disc Herniation
No full textAbstract
OBJECTIVE
To investigate the impact of packing of intervertebral spaces with oxidized regenerated cellulose (ORC) on the incidence of recurrence of lumbar disc herniation (LDH).
METHODS
We retrospectively reviewed 158 consecutive patients who underwent surgery for a newly diagnosed LDH and had a minimum of 18 months of follow-up. Single-level (151 patients) and two-level (7 patients) procedures accounted for 165 microdiscectomies. After microsurgical removal of disc herniation and curettage, the interspaces were tightly packed with ORC.
RESULTS
The average hospital stay was 1.47 days, without any relevant and permanent complications. In particular, complications related to intervertebral ORC packing were never observed. At a median follow-up of 29 months (range, 18–51 mo), the pain decreased or disappeared in almost all patients and the patient satisfaction rate was very high. A recurrence of LDH was observed in two patients (1.34%), both of whom needed a second operation. Three patients (2.01%) experienced a disc herniation involving another intervertebral space.
CONCLUSION
Our preliminary results suggest that the packing of intervertebral spaces with ORC at the end of microdiscectomy is a safe technique that may reduce the incidence of recurrent LDHs, although the true impact of this technique on long-term follow-up is still unclear. At the moment, it seems reasonable to assume that this technique should be used only under the auspices of large clinical investigations with prospective and randomized protocols.
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Accumulation of p53 and Ki-67 Expression Do Not Predict Survival in Patients with Fibrillary Astrocytomas or the Response of These Tumors to Radiotherapy
No full textLack of correlation between Ki-67 labelling index and tumor size of anterior pituitary adenomas
No full textAbstract Aims and background The Ki-67 is a nuclear antigen detected by the monoclonal antibody MIB-1 and its Labeling Index (LI) is considered a marker of normal and abnormal cell proliferation. Pituitary adenomas are generally well differentiated neoplasms, even if in about one third of cases they are invasive of surrounding tissues. The aim of this study is to evaluate the correlation between Ki-67 labelling index and tumor size of pituitary adenomas extimated by means CT and MRI and confirmed at operation. Methods Using the monoclonal antibody MIB-1, we evaluated the expression of Ki-67 in 121 anterior pituitary adenomas consecutively operated on in a 48-month period. Results In relation to neuroradiological (CT and MRI) and surgically verified tumor size, we identified 24 microadenomas, 27 intrasellar macroadenomas, 34 intra-suprasellar macroadenomas, and 36 intra-supra-parasellar macroadenomas. The adenomas were non-infiltrating (76 cases) and infiltrating (45 cases) adenomas. The wall of the cavernous sinus (CS) was infiltrated in 18 cases. Forty-eight adenomas were non-functioning and 73 functioning. The overall mean ± SD Ki-67 LI was 2.72 ± 2.49% (median 1.6). It was 2.59 ± 1.81 in microadenomas, 2.63 ± 3.45 in intrasellar macroadenomas, 1.91 ± 2.11 in intra-suprasellar macroadenomas, and 3.29 ± 5.45 in intra-supra-parasellar macroadenomas (p = 0.27). It was 3.73 ± 5.13% in infiltrating and 2.03 ± 2.41% in non-infiltrating adenomas (p = 0.02), and 5.61 ± 7.19% in CS-infiltrating versus 2.09 ± 2.37% in CS-non-infiltrating adenomas (p = 0.0005). Conclusions Our preliminary results seem to exclude significative correlations between Ki-67 LI and tumor size of anterior pituitary adenomas, even if this index can be considered a useful marker in the determination of the infiltrative behaviour of these tumors.</p
Lack of correlation between Ki-67 labelling index and tumor size of anterior pituitary adenomas
No full textAnterior clinoidal meningiomas: Report of a series of 33 patients operated on through the pterional approach
No full textEfficacy of the Morphine-Adcon-L Compound in the Management of Postoperative Pain after Lumbar Microdiscectomy
No full textAnterior pituitary adenomas in patients aged more than 65 years: analysis of growth fraction (using the MIB-1 monoclonal antibody) and of clinical features in comparison to younger patients
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