Sample records for intramedullary low-grade astrocytoma

  1. Current treatment of low grade astrocytoma

    DEFF Research Database (Denmark)

    Pedersen, Christina Louise; Romner, Bertil


    Through a comprehensive review of the current literature, the present article investigates several aspects of low grade astrocytomas (LGA), including prognostic factors, treatment strategies and follow-up regimes. LGA are in general relatively slow-growing primary brain tumours, but they have...... as the course of disease. The current literature seems to support the idea that treatment with radical tumour resection, where possible, yields better long term outcome for patients with LGA. However, adjuvant therapy is often necessary. Administering early postoperative radiotherapy to patients with partially...... effective in discriminating between tumour progression and radiation necrosis. The research into biomarkers is currently limited with regards to their applications in LGA diagnostics, and therefore further studies including larger patient populations are needed....

  2. An Achilles tendinosis masking an intramedullary astrocytoma. (United States)

    Stappers, Jeroen; Herregods, Piet; Chappel, Rudi; Surgeloose, Didier De; Stassijns, Gaëtane


    We report the case of a 53-year-old male with a right Achilles tendinosis, who complains about a mild gait disorder starting after walking several kilometers. In the following months he develops neurological symptoms. MRI lumbar spine shows an intramedullary tumor at level Th12. A biopsy confirms the diagnosis of an intramedullary astrocytoma. Primary intramedullary tumors are relatively rare. Clinical presentation is often insidious. The authors want to make a point to reconsider a diagnosis in case it does not explain completely the anamnestic or clinical findings. According to the literature there is no optimal approach to the management of these tumors.

  3. Conformal proton radiation therapy for pediatric low-grade astrocytomas

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    Hug, E.B. [Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Radiation Medicine; Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Pediatrics and Dept. of Pathology; Darthmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States). Section of Radiation Oncology; Muenter, M.W.; Archambeau, J.O.; DeVries, A.; Loredo, L.N.; Grove, R.I.; Slater, J.D. [Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Radiation Medicine; Liwnicz, B. [Loma Linda Univ. Medical Center, Loma Linda, CA (United States). Dept. of Pathology


    Background: To evaluate the safety and efficacy of proton radiation therapy (PRT) for intracranial low-grade astrocytomas, the authors analyzed the first 27 pediatric patients treated at Loma Linda University Medical Center (LLUMC). Patients and Method: Between September 1991 and August 1997, 27 patients (13 female, 14 male) underwent fractionated proton radiation therapy for progressive or recurrent low-grade astrocytoma. Age at time of treatment ranged from 2 to 18 years (mean: 8.7 years). Tumors were located centrally (diencephatic) in 15 patients, in the cerebral and cerebellar hemispheres in seven patients, and in the brainstem in five patients. 25/27 patients (92%) were treated for progressive, unresectable, or residual disease following subtotal resection. Tissue diagnosis was available in 23/27 patients (85%). Four patients with optic pathway tumors were treated without histologic confirmation. Target doses between 50.4 and 63.0 CGE (cobalt gray equivalent, mean: 55.2 CGE) were prescribed at 1.8 CGE per fraction, five treatments per week. Results: At a mean follow-up period of 3.3 years (0.6-6.8 years), 6/27 patients experienced local failure (all located within the irradiated field), and 4/27 patients had died. By anatomic site these data translated into rates of local control and survival of 87% (13/15 patients) and 93% (14/15 patients) for central tumors, 71% (5/7 patients) and 86% (6/7 patients) for hemispheric tumors, and 60% (3/5 patients) and 60% (3/5 patients) for tumors located in the brainstem. Proton radiation therapy was generally well tolerated. All children with local control maintained their performance status. One child with associated neurofibromatosis, Type 1, developed Moyamoya disease. All six patients with optic pathway tumors and useful vision maintained or improved their visual status. Conclusions: This report on pediatric low-grade astrocytomas confirms proton radiation therapy as a safe and efficacious 3-D conformal treatment

  4. Intramedullary spinal cord and leptomeningeal metastases from intracranial low-grade oligodendroglioma. (United States)

    Verma, Nipun; Nolan, Craig; Hirano, Miki; Young, Robert J


    We present an unusual case of a patient with an intracranial low-grade oligodendroglioma who developed recurrence with an intramedullary spinal cord metastasis and multiple spinal leptomeningeal metastases. The intramedullary spinal cord metastasis showed mild enhancement similar to the original intracranial primary, while the multiple spinal leptomeningeal metastases revealed no enhancement. This is the seventh reported case of symptomatic intramedullary spinal cord metastasis from a low-grade oligodendroglioma.

  5. Supratentorial low grade astrocytoma: prognostic factors, dedifferentiation, and the issue of early versus late surgery

    NARCIS (Netherlands)

    M.L.C. van Veelen; C.J.J. Avezaat (Cees); J.M. Kros (Johan); W.L.J. van Putten (Wim); C. Vecht


    textabstractBACKGROUND: A retrospective study of patients with low grade astrocytoma was carried out because the best management of such patients remains controversial. Prognostic factors were identified by multivariate analysis. Special attention was paid to the effect

  6. IDH1 mutations in low-grade astrocytomas predict survival but not response to temozolomide.

    NARCIS (Netherlands)

    Dubbink, H.J.; Taal, W.; Marion, R. van; Kros, J.M.; Heuvel, I. van; Bromberg, J.E.; Zonnenberg, B.A.; Zonnenberg, C.B.; Postma, T.J.; Gijtenbeek, J.M.M.; Boogerd, W.; Groenendijk, F.H.; Smitt, P.A.; Dinjens, W.N.; Bent, M.J. van den


    BACKGROUND: Mutations in isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) have been implicated in tumorigenesis of gliomas. Patients with high-grade astrocytomas with IDH1 or IDH2 mutations were reported to have a better survival, but it is unknown if this improved survival also holds for low-grade

  7. IDH1 mutations in low-grade astrocytomas predict survival but not response to temozolomide

    NARCIS (Netherlands)

    Dubbink, H. J.; Taal, W.; van Marion, R.; Kros, J. M.; van Heuvel, I.; Bromberg, J. E.; Zonnenberg, B. A.; Zonnenberg, C. B. L.; Postma, T. J.; Gijtenbeek, J. M. M.; Boogerd, W.; Groenendijk, F. H.; Smitt, P. A. E. Sillevis; Dinjens, W. N. M.; van den Bent, M. J.


    Background: Mutations in isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) have been implicated in tumorigenesis of gliomas. Patients with high-grade astrocytomas with IDH1 or IDH2 mutations were reported to have a better survival, but it is unknown if this improved survival also holds for low-grade

  8. Low-Grade Astrocytoma Associated with Abscess Formation: Case Report and Literature Review

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    Tai-Hsin Tsai


    Full Text Available A rare case of low-grade astrocytoma associated with abscess formation occurred in a 52-year-old man presenting with Broca's aphasia. He underwent craniotomy and tumor removal under the impression of brain tumor with necrotic cystic change. Abscess accumulation within the intra-axial tumor was found intraoperatively. Literature related to brain abscess with brain tumor is reviewed, with an emphasis on abscesses with astrocytoma. We discuss the common brain tumors that are associated with abscess, pathogens that coexist with brain tumor, and the pathogeneses of coexisting brain abscess and tumor. It is very important to know how to differentiate between and diagnose a brain abscess and tumor, or brain abscess with tumor, preoperatively from clinical presentation and through the use of computed tomography, conventional magnetic resonance imaging, diffusion-weighted imaging or magnetic resonance spectroscopy.

  9. First-line temozolomide chemotherapy in progressive low-grade astrocytomas after radiotherapy: molecular characteristics in relation to response

    NARCIS (Netherlands)

    Taal, W.; Dubbink, H.J.; Zonnenberg, C.B.; Zonnenberg, B.A.; Postma, T.J.; Gijtenbeek, J.M.M.; Boogerd, W.; Groenendijk, F.H.; Kros, J.M.; Kouwenhoven, M.C.; Marion, R. van; Heuvel, I. van; Holt, B. van der; Bromberg, J.E.; Sillevis Smitt, P.A.; Dinjens, W.N.; Bent, M.J. van den


    Only a few studies examined the effect of temozolomide (TMZ) in recurrent low-grade astrocytoma (LGA) after surgery, none of which included a homogeneous and sufficiently sized group of patients with progression after radiotherapy (RT). We evaluated a cohort of 58 patients treated with TMZ for progr

  10. First-line temozolomide chemotherapy in progressive low-grade astrocytomas after radiotherapy: Molecular characteristics in relation to response

    NARCIS (Netherlands)

    W. Taal (Walter); H.J. Dubbink (Erik Jan); B.A. Zonnenberg; T.J. Postma (Tjeerd); J. Gijtenbeek (Johanna); W. Boogerd (Willem); F.H. Groenendijk (Floris); J.M. Kros (Johan); M.C.M. Kouwenhoven (Mathilde); R. van Marion (Ronald); I. van Heuvel (Irene); B. van der Holt (Bronno); J.E.C. Bromberg (Jacolien); P.A. Smitt (Peter); W.N.M. Dinjens (Winand); M.J. van den Bent (Martin)


    textabstractOnly a few studies examined the effect of temozolomide (TMZ) in recurrent low-grade astrocytoma (LGA) after surgery, none of which included a homogeneous and sufficiently sized group of patients with progression after radiotherapy (RT). We evaluated a cohort of 58 patients treated with T

  11. Low grade astrocytoma transformating primitive neuroectodermal tumour in an adult? A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Xiaofeng Wang; Yuqiang Sun; Zeshi Tan; Anlong Ji; Xu Sun; Xinyu Li; Ningwei Che


    Background:Supratentorial primitive neuroectodermal tumors (sPNET) are rarely occurred in adults.Only 39 cases have been reported in the past decade.The transformation from low grade to aggressive astrocytoma is well known.However,such convert from a low-grade astrocytoma (LGA) into a sPNET between two completely different tumors is rarer.Case Presentation:This report discussed a 36-year-old male,who presented with the chief complaint of partial seizures and left limbs dysfunction and Magnetic resonance imaging (MRI) of whom revealed right frontal lesions which was operated to resect accompanied by the histological diagnosis of sPNET.The patient underwent operation 2.5 years ago because of seizures and was diagnosed with right frontal astrocytoma confirmed by pathology.However,radiotherapy was not preformed on him after the primary surgery.Histology now revealed high grade PNET.Conclusion:It is exactly uncertain that reports revelant to transformation from low-grade astrocytoma to a new kind of tumor or neoplasm induced by radiotation have been published.This case report is accompanied by a review of 39 cases of adult sPNET in the past decade,especially discussing about the transformation of low grade glioma into sPNET.

  12. Analysis of KIAA1549-BRAF fusion gene expression and IDH1/IDH2 mutations in low grade pediatric astrocytomas. (United States)

    Cruz, Gabriela Rampazzo; Dias Oliveira, Indhira; Moraes, Laís; Del Giudice Paniago, Mário; de Seixas Alves, Maria Teresa; Capellano, Andrea Maria; Saba-Silva, Nasjla; Cavalheiro, Sérgio; Cerutti, Janete Maria; Toledo, Silvia Regina Caminada


    Low-grade astrocytomas comprise about 30 % of the central nervous system tumors in children. Several investigations have searched a correlation between the BRAF gene fusions alterations and mutations at IDH1 and IDH2 genes in low grade pediatric astrocytomas. This study identified the expression of KIAA1549-BRAF fusion gene and BRAF V600E mutation, mutations at exon 4 of the IDH1 and IDH2 genes in samples of pilocytic astrocytomas (PA) and grade-II astrocytomas (A-II) pediatric patients. The correlation between these alterations and the clinical profile of the patients was also evaluated. Eighty-two samples of low-grade astrocytomas (65 PA and 17 A-II) were analyzed by PCR and sequencing for each of the targets identified. We identified the KIAA1549-BRAF fusion transcript in 45 % of the samples. BRAF V600E and BRAFins598T mutations were detected in 7 and 1 % of the samples, respectively. Mutations in the R132/R172 residues of the IDH1/IDH2 genes were detected in only two samples, and the G105G polymorphism (rs11554137:C>T) was identified in ten patients. Additionally, we observed two mutations out of the usual hotspots at IDH1 and IDH2 genes. We observed a smaller frequency of mutations in IDHs genes than previously described, but since the prior studies were composed of adult or mixed (adults and children) samples, we believe that our results represent a relevant contribution to the growing knowledge in low grade childhood astrocytomas.

  13. Low-grade astrocytoma: surgical outcomes in eloquent versus non-eloquent brain areas

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    André de Macedo Bianco


    Full Text Available A retrospective study of 81 patients with low-grade astrocytoma (LGA comparing the efficacy of aggressive versus less aggressive surgery in eloquent and non-eloquent brain areas was conducted. Extent of surgical resection was analyzed to assess overall survival (OS and progression- free survival (PFS. Degree of tumor resection was classified as gross total resection (GTR, subtotal resection (STR or biopsy. GTR, STR and biopsy in patients with tumors in non-eloquent areas were performed in 31, 48 and 21% subjects, whereas in patients with tumors in eloquent areas resections were 22.5, 35 and 42.5%. Overall survival was 4.7 and 1.9 years in patients with tumors in non-eloquent brain areas submitted to GTR/STR and biopsy (p=0.013, whereas overall survival among patients with tumors in eloquent area was 4.5 and 2.1 years (p=0.33. Improved outcome for adult patients with LGA is predicted by more aggressive surgery in both eloquent and non-eloquent brain areas.

  14. Low-grade glioma: supratentorial astrocytoma, oligodendroglioma, and oligoastrocytoma in adults. (United States)

    Ashby, Lynn S; Shapiro, William R


    Low-grade glioma is not a single diagnosis but a category of biologically diverse neoplasms. They are indolent, progressive, and, following anaplastic transformation, invariably fatal. Neuro-oncologists have not established a treatment standard for these tumors. However, it is clear that "low-grade" is not synonymous with "benign," and treatment is required sometime in the course of the disease. Previously, achieving a consensus had been limited by a lack of class I evidence. Physicians treated patients based on retrospective series and personal experience. Currently, results from prospective clinical trials are becoming available. These studies have provided data that may serve as treatment guidelines. Additional results regarding the identification of prognostic variables have raised more questions to be answered. Attention is now directed to the importance of translational research to better define these neoplasms. In the future, it will be necessary to distinguish among low-grade gliomas and identify therapies that may differ between them.

  15. A case of an epithelioid glioblastoma with the BRAF V600E mutation colocalized with BRAF intact low-grade diffuse astrocytoma. (United States)

    Kuroda, Jun-Ichiro; Nobusawa, Sumihito; Nakamura, Hideo; Yokoo, Hideaki; Ueda, Ryuta; Makino, Keishi; Yano, Shigetoshi; Kuratsu, Jun-ichi


    Epithelioid glioblastomas are one of the rarest histological variants of glioblastomas, which are not formally recognized by the World Health Organization (WHO) classification. Epithelioid glioblastomas usually occur as primary lesions, but there have been several reports of secondary epithelioid glioblastomas or epithelioid glioblastomas with pre- or co-existing lesions to date. The serine/threonine-protein kinase B-Raf (BRAF) V600E mutation has been found at a high frequency of 54% in epithelioid glioblastomas. We present a case of a 26-year-old female patient with an epithelioid glioblastoma with the BRAF V600E mutation in her right frontal lobe. In the present case, a low-grade diffuse astrocytoma component had colocalized with the epithelioid glioblastoma. The component presented prominent calcification on neuroimages as well as by histology, and low-grade diffuse astrocytoma was considered to be a precursor lesion of an epithelioid glioblastoma. However, the BRAF V600E mutation was detected only in epithelioid glioblastoma but not in low-grade diffuse astrocytoma. To the best of our knowledge, this is the first report demonstrating a discrepancy in the BRAF V600E mutation states between epithelioid glioblastoma and colocalized low-grade astrocytoma.

  16. Concurrent TERT promoter and BRAF V600E mutation in epithelioid glioblastoma and concomitant low-grade astrocytoma. (United States)

    Matsumura, Nozomi; Nakajima, Nozomi; Yamazaki, Tatsuya; Nagano, Takuro; Kagoshima, Kaie; Nobusawa, Sumihito; Ikota, Hayato; Yokoo, Hideaki


    Epithelioid glioblastoma (E-GBM) is a rare variant of glioblastoma (GBM), characterized by epithelioid cells with eosinophilic round cytoplasm devoid of stellate cytoplasmic processes. A number of studies have demonstrated that more than half of E-GBMs harbor a valine to glutamic acid substitution at position 600 of the serine/threonine-protein kinase BRAF (BRAF V600E). However, there are no previous reports on E-GBM with telomerase reverse transcriptase (TERT) promoter mutation in addition to BRAF V600E mutation. Here, we report an E-GBM case in an 18-year-old man with BRAF V600E and TERT promoter mutations. The tumor composed of 80% E-GBM and 20% diffuse astrocytoma-like components, and BRAF V600E and TERT promoter mutations were detected in both. E-GBM generally arises as a primary lesion; however, a few previous cases have been demonstrated to accompany low-grade areas. Demonstration of concurrent BRAF V600E and TERT promoter mutations in low- and high-grade lesions strongly suggested their identical origin, and acquisition of each mutation may be an early event, possibly playing a pivotal role in the genesis and subsequent progression to E-GBM.

  17. IDH1 mutation is prognostic for diffuse astrocytoma but not low-grade oligodendrogliomas in patients not treated with early radiotherapy. (United States)

    Iwadate, Yasuo; Matsutani, Tomoo; Hirono, Seiichiro; Ikegami, Shiro; Shinozaki, Natsuki; Saeki, Naokatsu


    Despite accumulating knowledge regarding molecular backgrounds, the optimal management strategy for low-grade gliomas remains controversial. One reason is the marked heterogeneity in the clinical course. To establish an accurate subclassification of low-grade gliomas, we retrospectively evaluated isocitrate dehydrogenase-1 (IDH1) mutation in clinical specimens of diffuse astrocytomas (DA) and oligodendroglial tumors separately. No patients were treated with early radiotherapy, and modified PCV chemotherapy was used for postoperative residual tumors or recurrence in oligodendroglial tumors. Immunohistochemical evaluation of IDH status, p53 status, O(6)-methylguanine methyltransferase expression, and the MIB-1 index were performed. The 1p and 19q status was analyzed with fluorescence in situ hybridization. Ninety-four patients were followed for a median period of 8.5 years. For DAs, p53 was prognostic for progression- free survival (PFS) and IDH1 was significant for overall survival (OS) with multivariate analysis. In contrast, for oligodendroglial tumors, none of the parameters was significant for PFS or OS. Thus, the significance of IDH1 mutation is not clear in oligodendroglial tumors that are homogeneously indolent and chemosensitive. In contrast, DAs are heterogeneous tumors including some potentially malignant tumors that can be predicted by examining the IDH1 mutation status.

  18. The visuospatial functions in children after cerebellar low-grade astrocytoma surgery: A contribution to the pediatric neuropsychology of the cerebellum. (United States)

    Starowicz-Filip, Anna; Chrobak, Adrian Andrzej; Milczarek, Olga; Kwiatkowski, Stanisław


    The aim of this study was to specify whether cerebellar lesions cause visuospatial impairments in children. The study sample consisted of 40 children with low-grade cerebellar astrocytoma, who underwent surgical treatment and 40 healthy controls matched with regard to age and sex. Visuospatial abilities were tested using the spatial WISC-R subtests (Block Design and Object Assembly), Rey-Osterrieth Complex Figure, Benton Judgment of Line Orientation Test, PEBL Mental Rotation Task, and Benton Visual Retention Test. To exclude general diffuse intellectual dysfunction, the WISC-R Verbal Intelligence IQ, Performance IQ, and Full-Scale IQ scores were analysed. Post-surgical medical consequences were measured with the International Cooperative Ataxia Rating Scale. Compared to controls, the cerebellar group manifested problems with mental rotation of objects, visuospatial organization, planning, and spatial construction processes which could not be explained by medical complications or general intellectual retardation. The intensity of visuospatial syndrome highly depends on cerebellar lesion side. Patients with left-sided cerebellar lesions display more severe spatial problems than those with right-sided cerebellar lesions. In conclusion, focal cerebellar lesions in children affect their visuospatial ability. The impairments profile is characterized by deficits in complex spatial processes such as visuospatial organization and mental rotation, requiring reconstruction of visual stimuli using the imagination, while elementary sensory analysis and perception as well as spatial processes requiring direct manipulation of objects are relatively better preserved. This pattern is analogous to the one previously observed in adult population and appears to be typical for cerebellar pathology in general, regardless of age.

  19. Unusual dissemination patterns of low-grade astrocytomas in childhood Padrões incomuns de disseminação dos astrocitomas de baixo grau na infância

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    Patricia Imperatriz Porto Rondinelli


    Full Text Available CONTEXT: Low-grade astrocytomas are intracerebral lesions of relatively high frequency in the under-18 pediatric population. They often present indolent behaviour, and complete surgical resection is the choice treatment. In cases where the surgery is not possible, chemotherapy and radiotherapy may be used. Medical reports do not recommend examination of the spinal cord at diagnosis or during treatment, since the risk of dissemination of the lesion to the spine is minimal according to medical experience. We describe here four cases of children with low-grade astrocytoma with aggressive dissemination to the neuroaxis.CONTEXTO: Gliomas de baixo grau de malignidade são lesões intracerebrais relativamente freqüentes na população pediátrica menor de 18 anos de idade. Eles freqüentemente são indolentes em seu comportamento e a ressecção cirúrgica completa é o tratmento de eleição. Nos casos em que a cirurgia não é possível, a quimioterapia e a radioterapia podem ser utilizadas. Relatos da literatura não recomendam a avaliação radiológica da coluna espinhal ao diagnóstico ou durante o tratamento, desde que o risco de disseminação destas lesões para a coluna é considerado mínimo. Descrevemos aqui quatro casos de crianças com gliomas de baixo grau de malignidade com disseminação agressiva para o neuroeixo.

  20. Pilocytic astrocytoma

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    Yu-wei CONG


    Full Text Available Background Pilocytic astrocytoma (PA is a low-grade glioma that occurs mainly in children and young adults. The histomorphology of PA located in the cerebellum (WHOⅠ is very typical. This article is to report one case of PA in the cerebellum of an 8-year-old child, and to discuss the clinical, imaging and pathological features of PA and clinicopathological differentiations from relevant tumors.  Methods and Results An 8-year-old girl presented intermittent headache for one month and the headache was aggravated for 7 d. MRI showed circular space-occupying lesion in the left cerebellar hemisphere and cerebellar vermis, and the lesion revealed uneven signals. During the surgery, the tumor was soft and jellylike, with poor blood supply. Histologically, tumor cell nuclei were round or oval; cytoplasmic projections on both ends were slender hair-like, and were arranged around the blood vessels. Part of tumor cells had spindle nuclei, and showed fascicular compact arrangement or loose reticular arrangement. The pathomorphism of this tumro was slightly different from that of typical PA. It had unusually rich blood vessels, and Rosenthal fibers and eosinophilic granules were not obvious. Tumor cells were diffusely positive for glial fibrillary acidic protein (GFAP, synaptophysin (Syn, vimentin (Vim and P53, but negative for cytokeratin (CK, neuronal nuclei (NeuN and neurofilament protein (NF. Ki-67 index was 2%-5%. Vascular endothelial cells were positive for CD34, and scatteredly expressed CD68. Pathological diagosis was pilocytic astrocytoma (WHOⅠ.  Conclusions Pilocytic astrocytoma usually happens in children and adolescents and often occurs in the cerebellum. Rosenthal fibers and eosinophilic granules are helpful to make a clear diagnosis, but they are not necessary conditions of diagnosis. Differential diagnoses should be paid attention, such as pilomyxoid astrocytoma, angiocentric glioma and dysembryoplastic neuroepithelial tumor (DNT

  1. Comparative study of dysembryoplastic neuroepithelial tumor and low grade astrocytoma on MRI%脑内胚胎发育不良性神经上皮瘤与低级别星形细胞瘤的MRI比较研究

    Institute of Scientific and Technical Information of China (English)

    武春雪; 高培毅


    Objective:To investigate the value of MR imaging features in distinguishing DNETs and low grade astro-cytomas. Methods: A retrospective analysis was performed in 35 cases of DNET and 33 cases of low grade astrocytoma which were histologically proved. The data including age, sex and MRI features were evaluated by non-parameter test and logistic regression analysis in SPSS 13.0,and non-numerical variables were assigned. The images of all cases were reviewed independently by 2 neuroradiologists in two different grades before and after the study,and Z test were conducted twice to analyze the diagnostic accuracy and the improvement respectively. Results:The average age of DNETs (19. 09±1. 95) was significant lower than that of low grade astrocytomas (32. 58 ±2. 32),P<0. 01, Z= - 4. 09. There were no significant differences of sex and longest diameter between DNETs and low grade astrocytomas (P = 0. 30 and 0. 07,Z=- 0. 93,t = - 1. 84,respectively). The gyriform structure or multiple cysts ( 3 2 )," triangle sign" (16), well defined margin (33),high signal intensity on T2WI (45), intratumoral septum (14),no peritumoral edema or space occupying effect (0) were mostly seen in DNETs than those in low grade astrocytomas (12,3,20,65,1 and 10, respectively) on MRI (P<0. 05). And low grade astrocytomas got significantly higher scores on "enhancement" (18) than DNETs (3) (P<0. 01 ,Z= - 2. 08). Actually,by logistic regression equation,the age,gyriform structure or multiple cysts in tumor,"triangle sign",well-defined margin, signal intenstiy high on T2WI,no peritumoral edema or no space occupying effect were the most significant parameters between DNETs and low grade astrocytomas (P<0. 05). Diagnostic accuracy of DNET was improved more or less in the second film reading after combining the signs above. The accuracy of 65. 7% was increased dramatically in the low grade doctors by up to 82. 9% (P<0. 01,Z=2. 95). Conclusion:The age less than 24. 5 years old,gyriform structure or

  2. Intramedullary meningioma of spinal cord: case report of a rare tumor highlighting the differential diagnosis of spinal intramedullary neoplasms. (United States)

    Pant, Ishita; Chaturvedi, Sujata; Gautam, Vinod Kumar Singh; Kumari, Rima


    A 15-year-old male presented with progressive weakness of both lower limbs with urinary incontinence. Magnetic resonance imaging revealed a spinal intramedullary mass at D7-D8 level. The child was operated with a preliminary diagnosis of an intramedullary tumor. Atypical ependymoma and astrocytoma were considered in the differential diagnosis. Per- and post-operative histopathological examination reported the case as transitional meningioma (WHO Grade I). Spinal intramedullary meningiomas being a rare entity may be confused with other common intramedullary tumors. Though, rare still the possibility of an intramedullary spinal mass of being a meningioma does exist and therefore should be considered in the differential diagnosis of intramedullary tumors.

  3. Diffuse pontine astrocytoma with lipocytic differentiation. (United States)

    Craver, Randall; Arcement, Christopher; Chrisentery Singleton, Tammuella


    A 7-year-old boy was treated with radiation and chemotherapy for a diffuse pontine glioma. At autopsy, 8 months after diagnosis, the tumor was a diffuse grade II fibrillary astrocytoma with prominent lipocytic differentiation. Literature review suggests that lipocytic differentiation in low-grade astrocytomas occurs in a variety of patient ages, anatomic sites, grades, and astrocytic subtypes. Although the majority of low-grade lipoastrocytomas have behaved benignly, this child's lipoastrocytoma was the underlying cause of death. This outcome suggests that the outcomes of low-grade lipoastrocytic tumors may be expected to be the same as the underlying tumor subtype.

  4. An arachnoid cyst presenting as an intramedullary tumour

    NARCIS (Netherlands)

    Willems, P W; van den Bergh, W M; Vandertop, W P


    A case of thoracic intradural extramedullary arachnoid cyst is presented in which an intramedullary low grade glioma was suspected preoperatively. The cyst was widely fenestrated and postoperatively, the patient experienced considerable improvement in her symptoms. As postoperative MRI studies also

  5. Surgical Management of Intramedullary Spinal Cord Tumors: Surgical Resection and Prognosis

    Institute of Scientific and Technical Information of China (English)

    Gui-huai Wang; Gui-huai Wang; Chung-cheng Wang; Chung-cheng Wang


    BACKGROUND & OBJECTIVE: The majority of intramedullary spinal cord tumors (IMSCT) are low-grade gliomas.Radical resection for IMSCTs remains challenging.Recently, improved neuroimaging and advanced microsurgical technique have made great success in surgical management of the intramedullary spinal cord tumors.METHODS & RESULTS: Twenty-nine patients with intramedullary spinal cord tumors were treated by radical resection during the past 4 years in our institute.The histological results were as follows: 12 ependymomas, 4 astrocytomas, 4 hemangioblastomas, 4 epidermoids, 1 cavernoma, 2 lipomas, 2 metastatics.A gross-total resection (> 95%) was achieved in 25 surgical procedures.Subtotal resections (80-95%) were performed in 4 cases.There was no surgical death.When comparing the preoperative and 3-month postoperative functional grades, 12 patients were stable 14 improved, and 3 deteriorated.Patients with either no deficit or only mild deficit before surgery were rarely impaired by the procedure, reinforcing the importance of early diagnosis and treatment.The major determinant of long-term survival was histological composition of the tumor.Patients in whom an IMSCT was only partially resected (< 80%) fared significantly worse.CONCLUSIONS: The long-term survival and quality of life for patients with low-grade gliomas treated by radical resection alone is comparable or superior to minimal resection plus radiotherapy.The optimal therapy for patients with high-grade glioma is yet to be determined.For benign lesion, such as hemangioblastoma and cavernoma could be cured by total resection of the tumor.For lipoma and epidermoid, fibrous adhesions to the cord make total removal difficult, and thus, removal is not the goal of surgery.The carbon dioxide laser is particularly useful during surgery for this lesion.

  6. [Astrocytoma and epilepsy. Clinical case]. (United States)

    Moreno-Jiménez, Sergio; Miranda-Fernández, Karen Alejandra; García Gutiérrez, Mónica; Vázquez-Estrada, Norma; Müller-Grohmann, Stephanie; Flores-Vázquez, Fabiola


    Pilocytic astrocytoma is a rare tumour, usually occurring in paediatric ages, and mainly located in the posterior fossa. It can cause hydrocephalus and intracranial hypertension and, less frequently, seizures, or a focal neurological deficit. The main imaging study by magnetic resonance imaging, which shows a tumour with solid and cystic components without peri-lesional swelling. The election treatment is surgical, and the patient is considered cured if a total resection is accomplished. The case is presented of 22-year-old female patient with a supratentorial pilocytic astrocytoma and epilepsy. Histopathology reported a low grade glial proliferation, with an extensive fibrillar matrix, small cells without atypia, extensive calcifications and piloid areas consisting of bipolar fusiform cells, and some Rosenthal fibres. There were also spongiotic areas consisting of multipolar cells and associated microcysts. The final report was a pilocytic astrocytoma. Pilocytic astrocytoma is more frequent in paediatric patients and in the posterior fossa. The case presented is of a young female adult with supratentorial location, making it a special case. The surgery achieved a total resection. The long-term prognosis is good, but it is necessary to perform a follow-up, particularly in adult patients because of a higher risk of recurrence. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  7. The Cancer Genome Atlas expression profiles of low-grade gliomas. (United States)

    Gonda, David D; Cheung, Vincent J; Muller, Karra A; Goyal, Amit; Carter, Bob S; Chen, Clark C


    Differentiating between low-grade gliomas (LGGs) of astrocytic and oligodendroglial origin remains a major challenge in neurooncology. Here the authors analyzed The Cancer Genome Atlas (TCGA) profiles of LGGs with the goal of identifying distinct molecular characteristics that would afford accurate and reliable discrimination of astrocytic and oligodendroglial tumors. They found that 1) oligodendrogliomas are more likely to exhibit the glioma-CpG island methylator phenotype (G-CIMP), relative to low-grade astrocytomas; 2) relative to oligodendrogliomas, low-grade astrocytomas exhibit a higher expression of genes related to mitosis, replication, and inflammation; and 3) low-grade astrocytic tumors harbor microRNA profiles similar to those previously described for glioblastoma tumors. Orthogonal intersection of these molecular characteristics with existing molecular markers, such as IDH1 mutation, TP53 mutation, and 1p19q status, should facilitate accurate and reliable pathological diagnosis of LGGs.

  8. PDGFRA gain in low-grade diffuse gliomas. (United States)

    Motomura, Kazuya; Mittelbronn, Michel; Paulus, Werner; Brokinkel, Benjamin; Keyvani, Kathy; Sure, Ulrich; Wrede, Karsten; Nakazato, Yoichi; Tanaka, Yuko; Nonoguchi, Naosuke; Pierscianek, Daniela; Kim, Young-Ho; Mariani, Luigi; Vital, Anne; Perry, Arie; Ohgaki, Hiroko


    Glioblastomas with a proneural expression signature are characterized by frequent IDH1 mutations (i.e. genetic hallmarks of secondary glioblastomas) and PDGFRA (platelet-derived growth factor receptor-α) amplification. Mutations in IDH1/2 are frequent and early genetic events in diffuse astrocytomas (World Health Organization grade II), precursor to secondary glioblastomas, but little is known about the role and timing of PDGFRA amplification in these tumors. We assessed PDGFRA gain in 342 low-grade diffuse gliomas by quantitative polymerase chain reaction. Gain in PDGFRA was detected in 27 (16.3%) of 166 diffuse astrocytomas, significantly more frequent than in oligodendrogliomas (3 [2.6%] of 115, p < 0.0001). Analyses using previously published data from our laboratory showed an inverse correlation between PDGFRA gain and IDH1/2 mutations (p = 0.018) or 1p/19q loss (p < 0.0001). The vast majority of diffuse astrocytomas showed IDH1/2 mutations and/or PDGFRA gain (154 [93%] of 166). Mean survival of diffuse astrocytoma patients with PDGFRA gain was 8.8 ± 1.6 years, similar to that with IDH1/2 mutations (7.8 ± 0.5 years) or TP53 mutations (7.6 ± 0.6 years) but significantly longer than those with MET gain (4.4 ± 0.7 years). Dual-color fluorescence in situ hybridization in 6 diffuse astrocytomas with PDGFRA/MET co-gain identified by quantitative polymerase chain reaction revealed that PDGFRA and MET were typically amplified in different tumor cell populations. Tumor cells with coamplification were also focally observed, suggesting intratumoral heterogeneity, even in diffuse astrocytomas.

  9. Pilocytic astrocytoma: A rare presentation as intraventricular tumor (United States)

    Sattar, Sidra; Akhunzada, Naveed Z.; Javed, Gohar; Uddin, Zeeshan; Khan, Yasir A.


    Background: Pilocytic astrocytoma (PA) is the most prevalent central nervous system (CNS) tumor in pediatric population and accounts for an approximate of 5–6% of all gliomas. This neoplasm can occur at all levels of the neuraxis, with majority (67%) arising in the cerebellum and optic pathway. PAs are World Health Organization Grade I tumors and are the most benign of all astrocytomas characterized by an excellent prognosis. Other differentials include subependymal giant cell astrocytoma (SEGA), ependymoma, meningioma, and low-grade gliomas such as pilocytic or diffuse astrocytoma; calcification is more commonly regarded as a feature of benign or slow-growing tumors. Case Description: We present a case of a 17-year-old female presenting with an unusual cause of hydrocephalus, a rare case of a calcified pilocytic astrocytoma as an intraventricular tumor. Conclusion: PA rarely presents as an intraventricular tumor and should be included in the differential diagnosis of a large mass with massive intratumoral calcification. PMID:28680735

  10. Exophytic intramedullary meningioma of the cervical spinal cord. (United States)

    Sahni, D; Harrop, J S; Kalfas, I H; Vaccaro, A R; Weingarten, D


    Intramedullary spinal cord neoplasms are relatively uncommon. The most common intramedullary tumors are astrocytomas and ependymomas. Meningiomas can occur as an intradural tumor; however, they are typically in the extramedullary compartment. A 42-year-old male presented with progressive sensory loss in the upper extremities and lower extremity weakness. Pre-operative imaging suggested an intramedullary cervical lesion. To treat the progressive neurological abnormality, surgical resection was planned. At surgery, it was noted that the tumor originated in the cervical spinal cord and extended into the extramedullary region. Histology confirmed the lesion to be a meningioma. This meningioma variant has not previously been described. Spinal meningiomas may occur in locations other than intradural, extramedullary locations, and should be included in the differential diagnosis of intramedullary lesions. Intramedullary meningiomas can be successfully treated with surgery.

  11. Intrinsic tectal low grade astrocytomas: is surgical removal an alternative treatment? Long-term outcome of eight cases Astrocitomas tectais de baixo grau: o tratamento cirúrgico é uma alternativa? Análise de oito casos com longa evolução

    Directory of Open Access Journals (Sweden)

    Ricardo Ramina


    Full Text Available Low-grade gliomas arising in dorsal midbrain in children and young patients usually present few neurological symptoms and findings, and patients´ management is controversial. Some authors propose only clinical observation until the patient present signs of increased intracranial pressure when a shunt with or without biopsy, is inserted; others recommend radiotherapy after stereotactic or open biopsy. Microsurgical total removal of tumor may be curative. We present a retrospective analysis of eight patients (mean age 16.6 ±11.5 years-old with low-grade astrocytoma of the tectal region operated on using an infratentorial/ supracerebellar approach between 1981 and 2002. All patients presented hydrocephalus and had a shunt insertion before surgical resection of the lesion. The tumour could be totally resected in seven patients. In one case radical removal was not possible due to infiltrative pattern of the lesion. Postoperative radiotherapy was performed in two cases, one patient at the beginning of this series and in the case with infiltrative tumor. This patient presented progressive tumor growth and died five years after surgery. No recurrence occurred after total removal. Post-surgical follow-up time ranged from 2 1/2 to 22 1/2 years (mean 9.9 ± 5.9 years. Radical microsurgical removal of non invasive tumors is possible without mortality or significant morbidity. It may be curative and should remain as an alternative to be discussed with the patient.Gliomas de baixo grau originários da porção dorsal do mesencéfalo ocorrem em crianças e adultos jovens. Geralmente apresentam pouca sintomatologia e tardia, com hipertensão intracraniana por hidrocefalia não-comunicante. O seu tratamento é controverso. Alguns autores propõem somente observação clínica até o aparecimento de sintomas decorrentes de hipertensão intracraniana, quando é realizada derivação ventrículo-peritoneal (DVP, com ou sem biópsia da lesão. Outros recomendam

  12. Pilocytic astrocytomas. (United States)

    Bornhorst, Miriam; Frappaz, Didier; Packer, Roger J


    Pilocytic astrocytoma (PA) is the most common pediatric brain tumor in children. PAs are a distinct histologic and biologic subset of glioma that have a slow growth rate and may even spontaneously regress. These tumors tend to arise in the cerebellum and chiasmatic/hypothalamic region, but can also occur in other regions of the central nervous system. Dissemination is uncommon, but may occur in newly diagnosed PAs. Alterations in the Ras/RAF/mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) pathway (Ras/ERK) have been discovered in a majority of PAs, with KIAA1549-BRAF fusions being the most commonly identified alteration. Children with neurofibromatosis 1 are predisposed to developing PAs, primarily within the optic pathway. When required, treatment consists of surgery, chemotherapy, and/or radiation, although new molecular agents targeting the Ras/ERK and related signaling pathways are promising new approaches. The 10-year survival rates are greater than 90% in pediatric patients; however, they are poorer in adults. Tumors that are amenable to complete resection (i.e., cerebellum and cortex) have the best overall survival. © 2016 Elsevier B.V. All rights reserved.

  13. Seizure prognosis of patients with low-grade tumors. (United States)

    Kahlenberg, Cynthia A; Fadul, Camilo E; Roberts, David W; Thadani, Vijay M; Bujarski, Krzysztof A; Scott, Rod C; Jobst, Barbara C


    Seizures frequently impact the quality of life of patients with low grade tumors. Management is often based on best clinical judgment. We examined factors that correlate with seizure outcome to optimize seizure management. Patients with supratentorial low-grade tumors evaluated at a single institution were retrospectively reviewed. Using multiple regression analysis the patient characteristics and treatments were correlated with seizure outcome using Engel's classification. Of the 73 patients with low grade tumors and median follow up of 3.8 years (range 1-20 years), 54 (74%) patients had a seizure ever and 46 (63%) had at least one seizure before tumor surgery. The only factor significantly associated with pre-surgical seizures was tumor histology. Of the 54 patients with seizures ever, 25 (46.3%) had a class I outcome at last follow up. There was no difference in seizure outcome between grade II gliomas (astrocytoma grade II, oligodendroglioma grade II, mixed oligo-astrocytoma grade II) and other pathologies (pilocytic astrocytoma, ependymomas, DNET, gangliocytoma and ganglioglioma). Once seizures were established seizure prognosis was similar between different pathologies. Chemotherapy (p=0.03) and radiation therapy (p=0.02) had a positive effect on seizure outcome. No other parameter including significant tumor growth during the follow up period predicted seizure outcome. Only three patients developed new-onset seizures after tumor surgery that were non-perioperative. Anticonvulsant medication was tapered in 14 patients with seizures and 10 had no further seizures. Five patients underwent additional epilepsy surgery with a class I outcome in four. Two patients received a vagal nerve stimulator with >50% seizure reduction. Seizures at presentation are the most important factor associated with continued seizures after tumor surgery. Pathology does not influence seizure outcome. Use of long term prophylactic anticonvulsants is unwarranted. Chemotherapy and

  14. Intramedullary metastasis. (United States)

    Moffie, D; Stefanko, S Z


    Three cases of intramedullary metastases and one of a metastasis into the medulla oblongata are described. In two cases the primary tumour was a bronchial carcinoma and in one case a carcinoma of the breast. In one patient a primary tumour could not be found. The literature on this condition is reviewed and the difficulties of clinical diagnosis are discussed. The question remains unanswered as to the mechanism by which these tumour-cells reach the spinal cord and there is, as yet, no satisfactory explanation for the relative rare occurrence of these metastases.

  15. MGMT promoter hypermethylation is a frequent, early, and consistent event in astrocytoma progression, and not correlated with TP53 mutation

    NARCIS (Netherlands)

    F.H. Groenendijk (Floris); W. Taal (Walter); H.J. Dubbink (Erik Jan); C.R. Haarloo (Cathleen); M.C.M. Kouwenhoven (Mathilde); M.J. van den Bent (Martin); J.M. Kros (Johan); W.N.M. Dinjens (Winand)


    textabstractHypermethylation of the MGMT gene promoter and mutation of the TP53 tumor-suppressor gene are frequently present in diffuse astrocytomas. However, there is only anecdotal information about MGMT methylation status and TP53 mutations during progression of low-grade diffuse astrocytoma (AII

  16. Differential expression of the RNA-binding motif protein 3 in human astrocytoma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hai-tao; ZHANG Zhi-wen; XUE Jing-hui; KONG Hai-bo; LIU Ai-jun; LI Shou-chun; LIU Yu-xiao


    Background The RNA-binding motif protein 3 (RBM3),which is transcriptionally induced by low temperature and hypoxia,has recently been found to be upregulated in human tumors.However,its expression status in human astrocytoma is not well defined.This article focuses on the differential expression of RBM3 in human astrocytomas of different grades and normal brain tissues.Methods RBM3 was detected in astrocytomas and normal brain tissues by quantitative real-time PCR,immunohistochemistry,and Western blotting.Analysis of variance was performed on the data from quantitative real-time PCR.The Fisher's exact test was used to analyze the immunohistochemistry results.A P-value of less than 0.05 indicates a statistically significant difference.Results On one hand,the mRNA expression levels of three X-chromosome-related RBM genes (RBMX,RBM3,and RBM10) were detected by quantitative real-time PCR.The results showed that there were no significant differences in RBMX and RBM10 mRNA expression levels in human astrocytomas of different grades and normal brain tissues.However,RBM3 mRNA expression levels were elevated in high-grade (World Health Organization (WHO) Grade Ⅲ-Ⅳ) astrocytomas versus low-grade (WHO Grade Ⅰ-Ⅱ) astrocytomas (5.06±0.66 vs.1.60±0.58; P <0.05) or normal controls (5.06±0.66 vs.1.03±0.22; P <0.05) as determined by quantitative real-time PCR analysis.On the other hand,immunohistochemistry showed an increased RBM3 labeling index in astrocytomas of different grades and normal brain tissues (positive staining rate:astrocytoma Grade Ⅳ,92.9%; astrocytoma Grade Ⅲ,81.8%; astrocytoma Grade Ⅰ-Ⅱ,50%;normal brain tissues,37.5%; high-grade astrocytoma versus normal brain tissues,P <0.05; high-grade astrocytoma versus low-grade astrocytoma,P <0.05).The higher protein levels of RBM3 were also validated in high-grade astrocytomas and low-grade astrocytomas compared with normal brain tissues by Western blotting.Conclusions These

  17. Gamma Knife treatment of low-grade gliomas in children. (United States)

    Ekşi, Murat Şakir; Yılmaz, Baran; Akakın, Akın; Toktaş, Zafer Orkun; Kaur, Ahmet Cemil; Demir, Mustafa Kemal; Kılıç, Türker


    Low-grade gliomas have good overall survival rates in pediatric patients compared to adults. There are some case series that reported the effectiveness and safety of Gamma Knife radiosurgery, yet they are limited in number of patients. We aimed to review the relevant literature for pediatric low-grade glial tumors treated with stereotactic radiosurgery, specifically Gamma Knife radiosurgery, and to present an exemplary case. A 6-year-old boy was admitted to clinic due to head trauma. He was alert, cooperative, and had no obvious motor or sensorial deficit. A head CT scan depicted a hypodense zone at the right caudate nucleus. The brain magnetic resonance imaging (MRI) depicted a mass lesion at the same location. A stereotactic biopsy was performed. Histopathological diagnosis was low-grade astrocytoma (grade II, World Health Organization (WHO) classification, 2007). Gamma Knife radiosurgery was applied to the tumor bed. Tumor volume was 21.85 cm(3). Fourteen gray was given to 50% isodose segment of the lesion (maximal dose of 28 Gy). The tumor has disappeared totally in 4 months, and the patient was tumor-free 21 months after the initial treatment. The presented literature review represents mostly single-center experiences with different patient and treatment characteristics. Accordingly, a mean/median margin dose of 11.3-15 Gy with Gamma Knife radiosurgery (GKRS) is successful in treatment of pediatric and adult low-grade glial tumor patients. However, prospective studies with a large cohort of pediatric patients should be conducted to make a more comprehensive conclusion for effectiveness and safety of GKRS in pediatric low-grade glial tumors.

  18. Evaluation of invasiveness of astrocytoma using {sup 1}H-magnetic resonance spectroscopy: correlation with expression of matrix metalloproteinase-2

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Kai; Li, Chuanfu; Ma, Xiangxing; Meng, Xiangshui; Feng, Dechao [Shandong University, Department of Radiology, Qilu Hospital, Jinan (China); Liu, Ying [Shandong University, Department of Radiology, Qilu Hospital, Jinan (China); Anhui Provincial Hospital, MRI Department, Hefei (China); Li, Li [Shandong University, Department of Pathology, Qilu Hospital, Jinan (China)


    Even low-grade astrocytomas infiltrate the entire brain, a feature that precludes their successful therapy. So to assess the invasive potential of astrocytoma is very important. The aim of this study was determine whether there is a significant correlation between the results of {sup 1}H-magnetic resonance spectroscopy ({sup 1}H-MRS) and tumor invasive potential of astrocytoma, which is reflected by expression of matrix metalloproteinase-2 (MMP-2). The {sup 1}H-MRS spectra of 41 histologically verified astrocytomas were obtained on a 3-T MR scanner. According to the World Health Organization classification criteria for central nervous system tumors, there were 16 low-grade astrocytomas (2 pilocytic astrocytomas, 14 grade II astrocytomas) and 25 high-grade astrocytomas (5 anaplastic astrocytomas, 20 glioblastomas).The choline/N-acetylaspartate (Cho/NAA) and choline/creatine (Cho/Cr) ratios were calculated. Of the 41 astrocytomas, 19 (8 low-grade and 11 high-grade) were analyzed immunohistochemically. Expression of MMP-2 was determined using streptavidin-peroxidase complex (SP) staining which was quantified by calculating its calibrated opacity density (COD) using an image analysis system. The correlations between metabolite ratios and the quantitative data from the immunohistochemical tests in the 19 astrocytomas were determined. The Cho/NAA and Cho/Cr ratios of high-grade astrocytoma were both significantly greater than those of low-grade astrocytoma (t = -6.222, P = 0.000; t = -6.533, P = 0.000, respectively). MMP-2 COD values of high-grade astrocytomas were also significantly greater than those of low-grade astrocytomas (t = -5.892, P = 0.000). There were strong positive correlations between Cho/NAA ratio and MMP-2 COD (r = 0.669, P = 0.002), and between Cho/Cr ratio and MMP-2 COD (r = 0.689, P = 0.001). {sup 1}H-MRS is helpful in evaluating the invasiveness of astrocytomas and predicting prognosis preoperatively by determining the Cho/NAA and Cho/Cr ratios

  19. Low-grade and anaplastic oligodendroglioma. (United States)

    Van Den Bent, Martin J; Bromberg, Jacolien E C; Buckner, Jan


    Anaplastic oligodendrogliomas have long attracted interest because of their sensitivity to chemotherapy, in particular in the subset of 1p/19q co-deleted tumors. Recent molecular studies have shown that all 1p/19q co-deleted tumors have IDH mutations and most of them also have TERT mutations. Because of the presence of similar typical genetic alterations in astrocytoma and glioblastoma, the current trend is to diagnose these tumors on the basis of their molecular profile. Further long-term follow-up analysis of both EORTC and RTOG randomized studies on (neo)adjuvant procarbazine, lomustine, vincristine (PCV) chemotherapy have shown that adjuvant chemotherapy indeed improves outcome, and this is now standard of care. It is also equally clear that benefit to PCV chemotherapy is not limited to the 1p/19q co-deleted cases; potential other predictive factors are IDH mutations and MGMT promoter methylation. Moreover, a recent RTOG study on low-grade glioma also noted an improved outcome after adjuvant PCV chemotherapy, thus making (PCV) chemotherapy now standard of care for all 1p/19q co-deleted tumors regardless of grade. It remains unclear whether temozolomide provides the same survival benefit, as no data from well-designed clinical trials on adjuvant temozolomide in this tumor type are available. Another question that remains is whether one can safely leave out radiotherapy as part of initial treatment to avoid cognitive side-effects of radiotherapy. The current data suggest that delaying radiotherapy and treatment with chemotherapy only may be detrimental for overall survival.

  20. PET imaging of brain astrocytoma with 1-{sup 11}C-acetate

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Ren-Shyan; Chang, Chi-Wei; Yang, Bang-Hung [Taipei Veterans General Hospital, National PET/Cyclotron Center, Department of Nuclear Medicine, Taipei (Taiwan); National Yang-Ming University Medical School, Taipei (Taiwan); Chang, Cheng-Pei; Chu, Lee-Shing; Chu, Yum-Kung; Hsieh, Hung-Jen; Liao, Su-Quin [Taipei Veterans General Hospital, National PET/Cyclotron Center, Department of Nuclear Medicine, Taipei (Taiwan); Yen, Shan-Hui [Taipei Veterans General Hospital, Cancer Center, Taipei (Taiwan); Huang, Min-Chao [Taipei Veterans General Hospital, Institute of Neurology, Taipei (Taiwan); Yeh, Shin-Hwa [National Yang-Ming University Medical School, Taipei (Taiwan)


    The purpose of this study was to assess the use of 1-{sup 11}C-acetate (ACE) as a metabolic tracer for the detection and characterisation of astrocytomas. Positron emission tomography (PET) studies with ACE and 2-{sup 18}F-fluoro-2-deoxy-D-glucose (FDG) were performed sequentially in 26 patients with primary astrocytomas. Images were analysed by visual interpretation and determination of the tumour to cortex ratio (T/C ratio) and standardised uptake value (SUV). The tumour uptake was visually scored into three grades as compared with the contralateral cortex: clearly lower (-), almost equal (+) and clearly higher (++). There were 85% of astrocytomas with ++ ACE uptake, 15% with + ACE uptake and none with - ACE uptake. Only 19% of astrocytomas had ++ FDG uptake. Thirty-seven percent of high-grade astrocytomas had + FDG uptake and 37% had - FDG uptake. The sensitivity and specificity of the FDG T/C ratio in discriminating high-grade from low-grade astrocytomas were 79% and 100%, respectively, at the cutoff value of 0.75. Using 2.33 as the cutoff value of the ACE T/C ratio, the sensitivity and specificity were 42% and 86%, respectively. FDG was better than ACE in discriminating high-grade from low-grade astrocytomas. T/C ratios and SUVs of FDG uptake of tumours correlated with the histological grades, but those of ACE uptake did not. ACE appears to be a promising tracer for use in the detection of primary astrocytomas, but is of limited value in the differentiation of high- and low-grade astrocytomas. ACE is complementary to FDG for the diagnosis and characterisation of astrocytoma. (orig.)

  1. Novel BRAF Alteration in a Sporadic Pilocytic Astrocytoma

    Directory of Open Access Journals (Sweden)

    Sonika Dahiya


    Full Text Available Pilocytic astrocytoma (PA is the most frequently encountered glial tumor (glioma or astrocytoma in children. Recent studies have identified alterations in the BRAF serine/threonine kinase gene as the likely causative mutation in these childhood brain tumors. The majority of these genetic changes involve chromosome 7q34 tandem duplication, resulting in aberrant BRAF fusion transcripts. In this paper, we describe a novel KIAA1549:BRAF fusion transcript in a sporadic PA tumor associated with increased ERK activation and review the spectrum of BRAF genetic alterations in this common pediatric low-grade central nervous system neoplasm.

  2. Health-related quality of life in stable, long-term survivors of low-grade glioma

    NARCIS (Netherlands)

    F.W. Boele; L. Douw; J.C. Reijneveld; R. Robben; M.J.B. Taphoorn; N.K. Aaronson; J.J. Heimans; M. Klein


    Purpose: Patients with low-grade glioma (LGG) often experience long periods of stable disease, emphasizing the importance of maintaining good health-related quality of life (HRQOL). We assessed the changes in HRQOL in long-term survivors of WHO grade I or II astrocytoma, oligodendroglioma, or oligoa

  3. Health-related quality of life in stable, long-term survivors of low-grade glioma

    NARCIS (Netherlands)

    Boele, F.W.; Douw, L.; Reijneveld, J.C.; Robben, R.; Taphoorn, M.J.B.; Aaronson, N.K.; Heimans, J.J.; Klein, M.


    Purpose: Patients with low-grade glioma (LGG) often experience long periods of stable disease, emphasizing the importance of maintaining good health-related quality of life (HRQOL). We assessed the changes in HRQOL in long-term survivors of WHO grade I or II astrocytoma, oligodendroglioma, or

  4. Adult Pilomyxoid Astrocytoma Mimicking a Cortical Brain Tumor: MR Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Jong Chang; Weon, Young Cheol; Suh, Jae Hee; Kim, Young; Hwang, Jae Cheol [Ulsan University Hospital, Ulsan (Korea, Republic of)


    A pilomyxoid astrocytoma (PMA) is a recently identified low-grade neoplasm that was previously classified as a pilocytic astrocytoma (PA), yet demonstrates unique histological features and more aggressive behavior. Although a PMA is generally a tumor of early childhood and typically occurs in the hypothalamic/chiasmatic region, it can mimic cortical tumors, especially in adults. We report the MR findings of a PMA presenting as a cortical brain tumor in an adult with neurofibromatosis 1 (NF1)

  5. Anorexia: an early sign of fourth ventricle astrocytoma in children. (United States)

    Leroy, Henri-Arthur; Baroncini, Marc; Delestret, Isabelle; Florent, Vincent; Vinchon, Matthieu


    Paediatric low-grade astrocytomas of the fourth ventricle are rare tumours, generally revealed by hydrocephalus. However, some patients present with a history of severe anorexia. It might be a harbinger, which if recognized, could lead to earlier diagnosis. We decided to examine our database in order to evaluate the incidence and signification of anorexia in this context. Retrospective monocentric study of cases of low-grade astrocytomas of the fourth ventricle operated between 1991 and 2012 in our paediatric neurosurgery department. We particularly observed the clinical presentation and long-term clinical, oncological and radiological evolution. Non-parametrical tests were used (Mann-Whitney, Fisher). We reviewed 34 cases, 31 pilocytic astrocytomas and 3 diffuse astrocytomas, 16 boys and 18 girls, (M/F ratio 0.89). Mean age at diagnosis was 8 years old. Seven presented with notable anorexia, the average BMI in this group was ≤2 standard deviation (SD); with clinical signs evolving for 11.5 months. Twenty-seven children had no anorexia; average BMI in this group was +1 SD, with clinical evolution for 6 months on an average of p anorexia, body mass index improved markedly in the postoperative follow-up, which lasted, on average, for 6 years. Anorexia with stunted body weight curve is a non-exceptional presentation in children with low-grade astrocytomas of the fourth ventricle. Unexplained or atypical anorexia with negative etiologic assessment should prompt cerebral imaging. Clinical improvement after surgical resection, could suggest a possible interaction between tumour tissue and appetite-suppressing peptide secretion.

  6. Expression of aquaporin8 in human astrocytomas: Correlation with pathologic grade

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Shu-juan; Wang, Ke-jian; Gan, Sheng-wei; Xu, Jin; Xu, Shi-ye; Sun, Shan-quan, E-mail:


    Highlights: •AQP8 is mainly distributed in the cytoplasm of human astrocytoma cells. •AQP8 over-expressed in human astrocytomas, especially glioblastoma. •The up-regulation of AQP8 is related to the pathological grade of human astrocytomas. •AQP8 may contribute to the growth and proliferation of astrocytomas. -- Abstract: Aquaporin8 (AQP8), a member of the aquaporin (AQP) protein family, is weakly distributed in mammalian brains. Previous studies on AQP8 have focused mainly on the digestive and the reproductive systems. AQP8 has a pivotal role in keeping the fluid and electrolyte balance. In this study, we investigated the expression changes of AQP8 in 75 cases of human brain astrocytic tumors using immunohistochemistry, Western blotting, and reverse transcription polymerase chain reaction. The results demonstrated that AQP8 was mainly distributed in the cytoplasm of astrocytoma cells. The expression levels and immunoreactive score of AQP8 protein and mRNA increased in low-grade astrocytomas, and further increased in high-grade astrocytomas, especially in glioblastoma. Therefore, AQP8 may contribute to the proliferation of astrocytomas, and may be a biomarker and candidate therapy target for patients with astrocytomas.

  7. {sup 201}Thallium SPECT, accuracy in astrocytoma diagnosis and treatment evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kaellen, K


    The aims of the studies included in this thesis were: - to investigate the reliability of {sup 201}Thallium single photon emission computed tomography. Tl SPECT for preoperative diagnosis and histological staging of malignant astrocytomas in comparison with CT; - to develop a method for quantification of cerebral thallium uptake, and to evaluate the quantitative measurement in comparison with CT, for astrocytoma treatment follow-up purposes; - to compare quantitative Tl SPECT and proton magnetic resonance spectroscopy (H-MRS) with conventional MR imagingfor astrocytoma monitoring, and to evaluate associations between change of morphological tumour characteristics during treatment and changes of cerebral thallium uptake and metabolic ratios. Results and conclusions: - High TI-index, calculated as a ratio comparing tumour uptake to uptake in the contralateral hemisphere, is an indicator of highly malignant astrocytoma. Differentiation between the high-grade astrocytomas, the low-grade astrocytomas, and infectious lesions is only partial, with an overlap of Tl-indexes between these groups. High-grade astrocytomas that do not show contrast enhancement on CT, and astrocytomas with central necrosis and moderate ring-enhancement, tend to be underestimated when evaluated by Tl-index calculation. Tl SPECT is not a reliable method for non-invasive tumour staging among the group of highly malignant astrocytomas. - Quantification of cerebral TI-uptake, defining the volume of viable tumour tissue, is a new method for astrocytoma chemotherapy monitoring. Results suggest that the method provides prognostic information, and information of treatment efficacy, at an earlier stage than CT. - We did not find a higher accuracy of quantitative Tl SPECT than of MR for monitoring purposes and our results indicated that treatment induced MR changes were interrelated with TI-uptake variations. - Multi-voxel H-MRS was difficult to apply for astrocytoma treatment monitoring, due to the

  8. Prognostic parameters in benign astrocytomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L


    To elucidate the prognosis of different types of benign astrocytomas and to ascertain whether patients with partially resected benign astrocytomas, or any subtype of these, would benefit from postoperative radiotherapy, we studied retrospectively material comprising 300 patients with benign...... time of patients with non-pilocytic supratentorial benign astrocytomas. The study emphasizes the necessity of a prospective combined multicenter analysis of the effect of radiation on benign astrocytomas....

  9. Intramedullary capillary haemangioma.

    LENUS (Irish Health Repository)

    Kelleher, T


    Intramedullary capillary haemangioma is extremely rare and only four cases have been previously reported. We describe a further case, outlining the clinical, radiological, surgical and pathological features.

  10. Biochemical Signatures of Doppel Protein in Human Astrocytomas to Support Prediction in Tumor Malignancy

    Directory of Open Access Journals (Sweden)

    Paola Rognoni


    Full Text Available Doppel (Dpl is a membrane-bound glycoprotein mainly expressed in the testis of adult healthy people. It is generally absent in the central nervous system, but its coding gene sequence is ectopically expressed in astrocytoma specimens and in derived cell lines. In this paper, we investigated the expression and the biochemical features of Dpl in a panel of 49 astrocytoma specimens of different WHO malignancy grades. As a result, Dpl was expressed in the majority of the investigated specimens (86%, also including low grade samples. Importantly, Dpl exhibited different cellular localizations and altered glycan moieties composition, depending on the tumor grade. Most low-grade astrocytomas (83% showed a membrane-bound Dpl, like human healthy testis tissue, whereas the majority of high-grade astrocytomas (75% displayed a cytosolic Dpl. Deglycosylation studies with N-glycosidase F and/or neuraminidase highlighted defective glycan moieties and an unexpected loss of sialic acid. To find associations between glial tumor progression and Dpl biochemical features, predictive bioinformatics approaches were produced. In particular, Decision tree and Nomogram analysis showed well-defined Dpl-based criteria that separately clustered low-and high-grade astrocytomas. Taken together, these findings show that in astrocytomas, Dpl undergoes different molecular processes that might constitute additional helpful tools to characterize the glial tumor progression.

  11. Extrauterine Low-Grade Endometrial Stromal Sarcoma

    Directory of Open Access Journals (Sweden)

    Yu-Ju Chen


    Conclusions: Low-grade endometrial stromal sarcoma typically has an indolent clinical course and favorable prognosis. Surgical resection is the primary therapeutic approach, and adjuvant therapy with radiotherapy, chemotherapy, or progesterone therapy should be considered for the management of residual or recurrent low-grade endometrial stromal sarcomas.

  12. Dysembryoplastic neuroepithelial tumor originally diagnosed as astrocytoma and oligodendroglioma

    Directory of Open Access Journals (Sweden)

    Diego Cassol Dozza


    Full Text Available Dysembryoplastic neuroepithelial tumor (DNT, described in 1988 and introduced in the WHO classification in 1993, affects predominantly children or young adults causing intractable complex partial seizures. Since it is benign and treated with surgical resection, its recognition is important. It has similarities with low-grade gliomas and gangliogliomas, which may recur and become malignant. OBJECTIVES: To investigate whether DNT was previously diagnosed as astrocytoma, oligodendroglioma, or ganglioglioma and to determine its frequency in a series of low-grade glial/glio-neuronal tumors. METHODS: Clinical, radiological, and histological aspects of 58 tumors operated from 1978 to 2008, classified as astrocytomas (32, including 8 pilocytic, oligodendrogliomas (12, gangliogliomas (7, and DNT (7, were reviewed. RESULTS: Four new DNT, one operated before 1993, previously classified as astrocytoma (3 and oligodendroglioma (1, were identified. One DNT diagnosed in 2002 was classified once more as angiocentric glioma. Therefore, 10 DNT (17.2% were identified. CONCLUSIONS: Clinical-radiological and histopathological correlations have contributed to diagnose the DNT.

  13. Challenges in Drug Discovery for Neurofibromatosis Type 1-Associated Low-Grade Glioma

    Directory of Open Access Journals (Sweden)

    Cora Antoinette Ricker


    Full Text Available Neurofibromatosis type 1 (NF1 is an autosomal dominant disorder that results from germline mutations of the NF1 gene, creating a predisposition to low-grade gliomas (pilocytic astrocytoma; PA in young children. Insufficient data and resources represent major challenges to identifying the best possible drug therapies for children with this tumor. Herein, we summarize the currently-available cell lines, genetically-engineered mouse models, and therapeutic targets for these low-grade gliomas (LGGs. Conspicuously absent are human tumor-derived cell lines or patient-derived xenograft models for NF1-LGG. New collaborative initiatives between patients and their families, research groups and pharmaceutical companies are needed to create transformative resources and broaden the knowledge base relevant to identifying cooperating genetic drivers and possible drug therapeutics for this common pediatric brain tumor.

  14. Updated therapeutic strategy for adult low-grade glioma stratified by resection and tumor subtype. (United States)

    Nitta, Masayuki; Muragaki, Yoshihiro; Maruyama, Takashi; Iseki, Hiroshi; Ikuta, Soko; Konishi, Yoshiyuki; Saito, Taichi; Tamura, Manabu; Chernov, Michael; Watanabe, Atsushi; Okamoto, Saori; Maebayashi, Katsuya; Mitsuhashi, Norio; Okada, Yoshikazu


    The importance of surgical resection for patients with supratentorial low-grade glioma (LGG) remains controversial. This retrospective study of patients (n = 153) treated between 2000 to 2010 at a single institution assessed whether increasing the extent of resection (EOR) was associated with improved progression-free survival (PFS) and overall survival (OS). Histological subtypes of World Health Organization grade II tumors were as follows: diffuse astrocytoma in 49 patients (32.0%), oligoastrocytoma in 45 patients (29.4%), and oligodendroglioma in 59 patients (38.6%). Median pre- and postoperative tumor volumes and median EOR were 29.0 cm(3) (range 0.7-162 cm(3)) and 1.7 cm(3) (range 0-135.7 cm(3)) and 95%, respectively. Five- and 10-year OS for all LGG patients were 95.1% and 85.4%, respectively. Eight-year OS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 70.7%, 91.2%, and 98.3%, respectively. Five-year PFS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 42.6%, 71.3%, and 62.7%, respectively. Patients were divided into two groups by EOR ≥90% and oligodendroglioma. Multivariate analysis identified age and EOR as parameters significantly associated with OS. The only parameter associated with PFS was EOR. Based on these findings, we established updated therapeutic strategies for LGG. If surgery resulted in EOR oligodendroglioma or oligoastrocytoma, which are sensitive to chemotherapy, will be treated with chemotherapy.

  15. Ongoing trials in low-grade lymphoma

    Directory of Open Access Journals (Sweden)

    Alexander Burchardt


    Full Text Available There are many therapies available for the management of low-grade lymphoma. With follicular lymphoma, for example, combination of chemotherapy and rituximab (immuno-chemo - therapy and consecutive maintenance therapy for 2 years is the current standard of care. To date, the most widely used regimen seems to be rituximab combined with cyclo phosphamide, doxorubicin, vincristine, and prednisone (RCHOP. Substitution of liposomal doxorubicin in place of conventional doxorubicin may improve outcomes in this indication, although evidence for its use in low-grade lymphoma is not as relevant as in aggressive lymphoma. Bendamustine, in combination with rituximab, has shown very good efficacy and tolerability in several lymphoma types, particularly follicular lymphoma and other low-grade lymphomas. Other combinations, such as those including bortezomib and lenalidomide, are under investigation in low-grade lymphoma, and the duration of rituximab maintenance therapy following bendamustine−rituximab-containing induction is being researched by the German Study Group for Indolent Lymphoma (StiL.

  16. Current treatment of low grade gliomas

    NARCIS (Netherlands)

    M.J. van den Bent (Martin); T.A.B. Snijders (Tom); J.E.C. Bromberg (Jacolien)


    textabstractLow grade gliomas affect predominantly young adults, and have a relatively favorable prognosis compared to grade III and grade IV gliomas. The challenge for an optimal management of these patients is to find the balance between an optimal survival and the preservation of neurological fun

  17. {sup 1}H magnetic resonance spectroscopy in the diagnosis of paediatric low grade brain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Orphanidou-Vlachou, E., E-mail: [School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT (United Kingdom); Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Auer, D., E-mail: [Division of Academic Radiology, School of Medical and Surgical Sciences, The University of Nottingham, University Park, Nottingham, NG7 2RD (United Kingdom); Children' s Brain Tumour Research Centre, Queens Medical Centre, University of Nottingham (United Kingdom); Brundler, M.A., E-mail: [Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Davies, N.P., E-mail: [School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT (United Kingdom); Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Department of Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB (United Kingdom); Jaspan, T., E-mail: [Children' s Brain Tumour Research Centre, Queens Medical Centre, University of Nottingham (United Kingdom); MacPherson, L., E-mail: [Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Natarajan, K., E-mail: [Birmingham Children' s Hospital NHS Foundation Trust, Whittall Street, Birmingham, B4 6NH (United Kingdom); Department of Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB (United Kingdom); and others


    Introduction: Low grade gliomas are the commonest brain tumours in children but present in a myriad of ways, each with its own treatment challenges. Conventional MRI scans play an important role in their management but have limited ability to identify likely clinical behaviour. The aim of this study is to investigate {sup 1}H magnetic resonance spectroscopy (MRS) as a method for detecting differences between the various low grade gliomas and related tumours in children. Patients and methods: Short echo time single voxel {sup 1}H MRS at 1.5 or 3.0 T was performed prior to treatment on children with low grade brain tumours at two centres and five MR scanners, 69 cases had data which passed quality control. MRS data was processed using LCModel to give mean spectra and metabolite concentrations which were compared using T-tests, ANOVA, Receiver Operator Characteristic curves and logistic regression in SPSS. Results: Significant differences were found in concentrations of key metabolites between glioneuronal and glial tumours (T-test p < 0.05) and between most of the individual histological subtypes of low grade gliomas. The discriminatory metabolites identified, such as choline and myoinositol, are known tumour biomarkers. In the set of pilocytic astrocytomas and unbiopsied optic pathway gliomas, significant differences (p < 0.05, ANOVA) were found in metabolite profiles of tumours depending on location and patient neurofibromatosis type 1 status. Logistic regression analyses yielded equations which could be used to assess the probability of a tumour being of a specific type. Conclusions: MRS can detect subtle differences between low grade brain tumours in children and should form part of the clinical assessment of these tumours.

  18. Proliferating cell nuclear antigen, p53 and micro vessel density: Grade II vs. Grade III astrocytoma

    Directory of Open Access Journals (Sweden)

    Malhan Priya


    Full Text Available Histological classification and grading are prime procedures in the management of patients with astrocytoma, providing vital data for therapeutic decision making and prognostication. However, it has limitations in assessing biological tumor behavior. This can be overcome by using newer immunohistochemical techniques. This study was carried out to compare proliferative indices using proliferating cell nuclear antigen (PCNA, extent of p53 expression and micro vessel morphometric parameters in patients with low grade and anaplastic astrocytoma. Twenty-five patients, each of grade II and grade III astrocytoma were evaluated using monoclonal antibodies to PCNA, p53 protein and factor VIII related antigen. PCNA, p53-labeling indices were calculated along with micro vessel morphometric analysis using Biovis Image plus Software. Patients with grade III astrocytoma had higher PCNA and p53 labeling indices as compared with grade II astrocytoma (29.14 plus/minus 9.87% vs. 16.84 plus/minus 6.57%, p 0.001; 18.18 plus/minus 6.14% vs. 6.14 plus/minus 7.23%, p 0.001, respectively. Micro vessel percentage area of patients with grade III astrocytoma was also (4.26 plus/minus 3.70 vs. 1.05 plus/minus 0.56, p 0.001, higher along with other micro vessel morphometric parameters. Discordance between histology and one or more IHC parameters was seen in 5/25 (20% of patients with grade III astrocytoma and 9/25 (36% of patients with grade II disease. PCNA and p53 labeling indices were positively correlated with Pearson′s correlation, p less than 0.001 for both. Increased proliferative fraction, genetic alterations and neovascularization mark biological aggressiveness in astrocytoma. Immunohistochemical evaluation scores over meet the challenge of accurate prognostication of this potentially fatal malignancy.

  19. Outcome of Patients With Pilocytic Astrocytoma and Leptomeningeal Dissemination

    Energy Technology Data Exchange (ETDEWEB)

    Mazloom, Ali; Hodges, Joseph C.; Teh, Bin S. [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Chintagumpala, Murali [Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Paulino, Arnold C., E-mail: [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States)


    Purpose: To determine the patient, tumor, and treatment characteristics of patients with pilocytic astrocytoma (PA) and leptomeningeal dissemination (LMD). Methods and Materials: A PubMed search of English-language studies pertaining to PA with LMD was performed using a combination of keywords that included juvenile pilocytic astrocytoma, low-grade astrocytoma, low-grade glioma, leptomeningeal dissemination, neuraxis spread, and radiotherapy. We found 26 studies with 58 patients between 1976 and 2005 that met these criteria. Results: The median survival for PA patients with LMD was 65 months. The 1-, 2-, and 5-year overall survival (OS) rate after the diagnosis of LMD was 81.1%, 75.7%, and 55.5%. The 1-, 2-, and 5-year progression-free survival (PFS) rate after the diagnosis of LMD was 69.3%, 66.5%, and 34.6%, respectively. Age, gender, primary site location, timing of LMD presentation (synchronous vs. metachronous), and LMD location did not significantly influence OS or PFS. No statistically significant difference was found in OS or PFS between the chemotherapy and radiotherapy groups. Likewise, no difference was found in OS or PFS according to the use of craniospinal irradiation vs. less extensive RT fields. Conclusions: Approximately one-half of PA patients were alive 5 years after the diagnosis of LMD. Both chemotherapy and radiotherapy have efficacy against LMD. Although the use of craniospinal irradiation did not have an effect on PFS, the patient numbers were small and a larger number treated with craniospinal irradiation is needed to determine its efficacy.

  20. A 31-year-old woman with a transformed low-grade glioma. (United States)

    Warnke, Peter C


    Low-grade gliomas in adults have an incidence of 0.8 to 1.2 per 100,000, and their causes are unknown. Despite their histological classification as low-grade, they cannot be cured by any current treatment mode, and no class I evidence exists to guide initial treatment of these tumors. Median survival ranges between 7.5 years and 10 years, with a 5-year survival probability between 55% and 86%. The prognosis depends on age, World Health Organization (WHO) tumor grade, Karnofsky performance score, cytological type (oligodendroglioma vs astrocytoma), and, potentially, the extent of resection. Oligodendrogliomas with loss of heterozygosity on chromosomes 1p and 19q have a distinctly more favorable prognosis and therapeutic response rate. Low-grade tumors progress to high-grade gliomas with aggressive biological behavior at increasing frequency with advancing age. Ms P is a young woman with a previously treated oligodendroglioma, WHO grade II, with loss of heterozygosity on chromosomes 1p and 19q, which at a third resection had transformed into an oligodendroglioma of WHO grade III. She wants to know her current and future therapeutic options.

  1. Case report 541: Low grade chrondrosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, G.; Wagner, L.D.; Klein, M.J.; Faye-Peterson, O.M.; Lewis, M.M.


    A case of low grade chondrosarcoma of the femur in a 15-year-old female is presented. Although chondrosarcoma is a relatively common primary malignant bone tumor in adults, its incidence in the pediatric age group is low. If it does occur in the very young the lesion usually is a high grade tumor. The atypical radiological pattern and the differential diagnosis are discussed. (orig.).

  2. Low grade metamorphism of mafic rocks (United States)

    Schiffman, Peter


    Through most of this past century, metamorphic petrologists in the United States have paid their greatest attention to high grade rocks, especially those which constitute the core zones of exhumed, mountain belts. The pioneering studies of the 50's through the 80's, those which applied the principles of thermodynamics to metamorphic rocks, focused almost exclusively on high temperature systems, for which equilibrium processes could be demonstrated. By the 1980's, metamorphic petrologists had developed the methodologies for deciphering the thermal and baric histories of mountain belts through the study of high grade rocks. Of course, low grade metamorphic rocks - here defined as those which form at pressures and temperatures up to and including the greenschist facies - had been well known and described as well, initially through the efforts of Alpine and Circum-Pacific geologists who recognized that they constituted an integral and contiguous portion of mountain belts, and that they underlay large portions of accreted terranes, many of oceanic origins. But until the mid 80's, much of the effort in studying low grade rocks - for a comprehensive review of the literature to that point see Frey (1987) - had been concentrated on mudstones, volcanoclastic rocks, and associated lithologies common to continental mountain belts and arcs. In the mid 80's, results of the Deep Sea Drilling Project (DSDP) rather dramatically mitigated a shift in the study of low grade metamorphic rocks.

  3. Differential expression of two fibroblast growth factor-receptor genes is associated with malignant progression in human astrocytomas

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, F.; Saya, H.; Bruner, J.M.; Morrison, R.S. (Univ. of Texas M.D. Anderson Cancer Center, Houston, TX (United States))


    Malignant astrocytomas, which are highly invasive, vascular neoplasms, compose the majority of nervous system tumors in humans. Elevated expression of fibroblast growth factors (FGFs) in astrocytomas has implicated the FGF family of mitogens in the initiation and progression of astrocyte-derived tumors. In this study, the authors demonstrated that human astrocytomas undergo parallel changes in FGF-receptor (FGFR) expression during their progression from a benign to a malignant phenotype. FGFR type 2 (BEK) expression was abundant in normal white matter and in all low-grade astrocytomas but was not seen in malignant astrocytomas. Conversely, FGFR type 1 (FLG) expression was absent or barely detectable in normal white matter but was significantly elevated in malignant astrocytomas. Malignant astrocytomas also expressed an alternatively spliced form of FGFR-1 (FGFR-1[beta]) containing two immunoglobulin-like disulfide loops, whereas normal human adult and fetal brains expressed a receptor form (FGFR-1[alpha]) containing three immunoglobulin-like disulfide loops. Intermediate grades of astrocytic tumors exhibited a gradual loss of FGFR-2 and a shift in expression from FGFR-1[alpha] to FGFR-2 and a shift in expression from FGFR-1[alpha] to FGFR-1[beta] as they progressed from benign to malignant phenotype. These results suggest that differential expression and alternative splicing of FGFRs may be critical in the malignant progression of astrocytic tumors.

  4. Expression patterns of Wnt signaling component, secreted frizzled-related protein 3 in astrocytoma and glioblastoma (United States)



    Secreted frizzled-related protein 3 (SFRP3) is a member of the family of soluble proteins, which modulate the Wnt signaling cascade. Novel research has identified aberrant expression of SFRPs in different types of cancer. In the present study the expression intensities and localizations of the SFRP3 protein across different histopathological grades of astrocytic brain tumors were investigated by immunohistochemistry, digital scanning and image analysis. The results demonstrated that the differences between expression levels and malignancy grades were statistically significant. Tumors were classified into four malignancy grades according to the World Health Organization guidelines. Moderate (P=0.014) and strong (P=0.028) nuclear expression levels were significantly different in pilocytic (grade I) and diffuse (grade II) astrocytomas demonstrating higher expression values, as compared with anaplastic astrocytoma (grade III) and glioblastoma (grade IV). When the sample was divided into two groups, the moderate and high cytoplasmic expression levels were observed to be significantly higher in glioblastomas than in the group comprising astrocytoma II and III. Furthermore, the results indicated that high grade tumors were associated with lower values of moderate (P=0.002) and strong (P=0.018) nuclear expression in comparison to low grade tumors. Analysis of cytoplasmic staining demonstrated that strong cytoplasmic expression was significantly higher in the astrocytoma III and IV group than in the astrocytoma I and II group (P=0.048). Furthermore, lower grade astrocytomas exhibited reduced membranous SFRP3 staining when compared with higher grade astrocytomas and this difference was statistically significant (P=0.036). The present results demonstrated that SFRP3 protein expression levels were decreased in the nucleus in higher grade astrocytoma (indicating the expected behavior of an antagonist of Wnt signaling), whereas when the SFRP3 was located in the cytoplasm an

  5. Expression patterns of Wnt signaling component, secreted frizzled‑related protein 3 in astrocytoma and glioblastoma. (United States)

    Pećina-Šlaus, Nives; Kafka, Anja; Varošanec, Ana Maria; Marković, Leon; Krsnik, Željka; Njirić, Niko; Mrak, Goran


    Secreted frizzled-related protein 3 (SFRP3) is a member of the family of soluble proteins, which modulate the Wnt signaling cascade. Novel research has identified aberrant expression of SFRPs in different types of cancer. In the present study the expression intensities and localizations of the SFRP3 protein across different histopathological grades of astrocytic brain tumors were investigated by immunohistochemistry, digital scanning and image analysis. The results demonstrated that the differences between expression levels and malignancy grades were statistically significant. Tumors were classified into four malignancy grades according to the World Health Organization guidelines. Moderate (P=0.014) and strong (P=0.028) nuclear expression levels were significantly different in pilocytic (grade I) and diffuse (grade II) astrocytomas demonstrating higher expression values, as compared with anaplastic astrocytoma (grade III) and glioblastoma (grade IV). When the sample was divided into two groups, the moderate and high cytoplasmic expression levels were observed to be significantly higher in glioblastomas than in the group comprising astrocytoma II and III. Furthermore, the results indicated that high grade tumors were associated with lower values of moderate (P=0.002) and strong (P=0.018) nuclear expression in comparison to low grade tumors. Analysis of cytoplasmic staining demonstrated that strong cytoplasmic expression was significantly higher in the astrocytoma III and IV group than in the astrocytoma I and II group (P=0.048). Furthermore, lower grade astrocytomas exhibited reduced membranous SFRP3 staining when compared with higher grade astrocytomas and this difference was statistically significant (P=0.036). The present results demonstrated that SFRP3 protein expression levels were decreased in the nucleus in higher grade astrocytoma (indicating the expected behavior of an antagonist of Wnt signaling), whereas when the SFRP3 was located in the

  6. Isocitrate dehydrogenase 1 Gene Mutation Is Associated with Prognosis in Clinical Low-Grade Gliomas.

    Directory of Open Access Journals (Sweden)

    Ming-Yang Li

    Full Text Available Isocitrate dehydrogenase 1 gene mutations are found in most World Health Organization grade II and III gliomas and secondary glioblastomas. Isocitrate dehydrogenase 1 mutations are known to have prognostic value in high-grade gliomas. However, their prognostic significance in low-grade gliomas remains controversial. We determined the predictive and prognostic value of isocitrate dehydrogenase 1 status in low-grade gliomas. The association of isocitrate dehydrogenase 1 status with clinicopathological and genetic factors was also evaluated. Clinical information and genetic data including isocitrate dehydrogenase 1 mutation, O 6-methylguanine DNA methyltransferase promoter methylation, 1p/19q chromosome loss, and TP53 mutation of 417 low-grade gliomas were collected from the Chinese Glioma Genome Atlas database. Kaplan-Meier and Cox proportional hazards regression analyses were performed to evaluate the prognostic effect of clinical characteristics and molecular biomarkers. Isocitrate dehydrogenase 1 mutation was identified as an independent prognostic factor for overall, but not progression-free, survival. Notably, isocitrate dehydrogenase 1 mutation was found to be a significant prognostic factor in patients with oligodendrogliomas, but not in patients with astrocytomas. Furthermore, O 6-methylguanine DNA methyltransferase promoter methylation (p = 0.017 and TP53 mutation (p < 0.001, but not 1p/19q loss (p = 0.834, occurred at a higher frequency in isocitrate dehydrogenase 1-mutated tumors than in isocitrate dehydrogenase 1 wild-type tumors. Younger patient age (p = 0.041 and frontal lobe location (p = 0.010 were significantly correlated with isocitrate dehydrogenase 1 mutation. Chemotherapy did not provide a survival benefit in patients with isocitrate dehydrogenase 1-mutated tumors. Isocitrate dehydrogenase 1 mutation was an independent prognostic factor in low-grade gliomas, whereas it showed no predictive value for chemotherapy response

  7. Isocitrate dehydrogenase 1 Gene Mutation Is Associated with Prognosis in Clinical Low-Grade Gliomas. (United States)

    Li, Ming-Yang; Wang, Yin-Yan; Cai, Jin-Quan; Zhang, Chuan-Bao; Wang, Kuan-Yu; Cheng, Wen; Liu, Yan-Wei; Zhang, Wei; Jiang, Tao


    Isocitrate dehydrogenase 1 gene mutations are found in most World Health Organization grade II and III gliomas and secondary glioblastomas. Isocitrate dehydrogenase 1 mutations are known to have prognostic value in high-grade gliomas. However, their prognostic significance in low-grade gliomas remains controversial. We determined the predictive and prognostic value of isocitrate dehydrogenase 1 status in low-grade gliomas. The association of isocitrate dehydrogenase 1 status with clinicopathological and genetic factors was also evaluated. Clinical information and genetic data including isocitrate dehydrogenase 1 mutation, O 6-methylguanine DNA methyltransferase promoter methylation, 1p/19q chromosome loss, and TP53 mutation of 417 low-grade gliomas were collected from the Chinese Glioma Genome Atlas database. Kaplan-Meier and Cox proportional hazards regression analyses were performed to evaluate the prognostic effect of clinical characteristics and molecular biomarkers. Isocitrate dehydrogenase 1 mutation was identified as an independent prognostic factor for overall, but not progression-free, survival. Notably, isocitrate dehydrogenase 1 mutation was found to be a significant prognostic factor in patients with oligodendrogliomas, but not in patients with astrocytomas. Furthermore, O 6-methylguanine DNA methyltransferase promoter methylation (p = 0.017) and TP53 mutation (p isocitrate dehydrogenase 1-mutated tumors than in isocitrate dehydrogenase 1 wild-type tumors. Younger patient age (p = 0.041) and frontal lobe location (p = 0.010) were significantly correlated with isocitrate dehydrogenase 1 mutation. Chemotherapy did not provide a survival benefit in patients with isocitrate dehydrogenase 1-mutated tumors. Isocitrate dehydrogenase 1 mutation was an independent prognostic factor in low-grade gliomas, whereas it showed no predictive value for chemotherapy response. Isocitrate dehydrogenase 1 mutation was highly associated with O 6-methylguanine DNA

  8. Gemistocytic astrocytoma in the spinal cord in a dog: a case report

    Directory of Open Access Journals (Sweden)

    R.O. Chaves


    Full Text Available ABSTRACT This paper reports a case of a rare variant of the cervical spinal cord astrocytoma diagnosed in a dog with progressive neurological signs, initially asymmetrical, not ambulatory tetraparesis, segmental reflexes and normal muscle tone in all four limbs and absence of pain upon palpation of the cervical spine. Myelography revealed attenuation of the ventral and dorsal contrast line in the third region of the fifth cervical vertebra. At necropsy intramedullary cylindrical mass that stretched from the third to the sixth cervical vertebra, which replaced all the gray matter of the spinal cord was observed. In the histological study, there was the replacement of the substance by neoplastic cells mantle arranged loosely. The cells were large and slightly rounded. The eosinophilic cytoplasm was well defined, sometimes forming processes interconnecting cells. The nucleus was eccentric, round, oval or kidney-shaped, and the nucleolus was evident. Thus, the microscopic changes observed in the cervical spinal cord were consistent with gemistocytic astrocytoma.

  9. Low-grade osteosarcoma of the spine: a case report

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    Kim, Young Chul; Suh, Jin Suck; Kim, Myung In; Choo, Hye Jung; Huh, Yong Min [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    Low-grade osteosarcoma is not typically found in the long bone and pelvis. Most primary osteosarcomas that arise in the spine are high-grade malignancies. A low-grade osteosarcoma arising in the spine has not been previously described. We report here the clinical, radiological, and histological findings of a case of low-grade osteosarcoma that arose in the spine.

  10. High frequency of TP53 mutations in juvenile pilocytic astrocytomas indicates role of TP53 in the development of these tumors

    NARCIS (Netherlands)

    Hayes, VM; Dirven, CMF; Verlind, E; Molenaar, WM; Mooij, JJA; Hofstra, RMW; Buys, CHCM; Dam, A.


    In adults, the TP53 tumor suppressor gene is frequently mutated in astrocytic brain tumors which is supposed to represent an early event in their development. In juvenile pilocytic and low-grade astrocytomas, however, TP53 mutations have until now been reported as rare, which has led to the suggesti

  11. The proliferative potential of the pilocytic astrocytoma : The relation between MIB-1 labeling and clinical and neuro-radiological follow-up

    NARCIS (Netherlands)

    Dirven, CMF; Koudstaal, J; Mooij, JJA; Molenaar, WM


    The proliferative potential of 39 pilocytic and 5 low grade astrocytomas was studied in relation to the Ki-67 activity as measured by the MIB-1 Labelings Index. The results were correlated to the biological behaviour of the tumor as measured by clinical and neuro-radiological (CT- or MRI-scans) foll

  12. MR imaging of intramedullary tumors of the spinal cord: comparison with surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Du Whan; Hwang, Hee Young; Lee, Hyeon Kyeong; Han, Moon Hee; Kim, In One; Kim, Hyen Jip; Chang, Kee Hyung [Seoul National University, College of Medicine, Seoul (Korea, Republic of)


    To evaluate the capability of MR imaging to localize intramedullary tumors of the spinal cord and to distinguish solid from cystic components. MR images of 12 patients with surgically-proven intramedullary spinal cord tumor were retrospectively reviewed and correlated with surgical findings. Histologic diagnosis consisted of 3 astrocytomas, 4 ependymomas, 2 gangliogliomas, and one case of lipoma, lymphoma, and glioblastoma multiform each. MR scans were obtained on a 2.0T or a 0.5T with T1-and T2-weighted spin-echo pulse sequences in sagittal and axial planes. Contrast enhancement was performed with Gd-DTPA in 9 patients. All tumors expanded the spinal cord and showed an extent of involvement ranging from 2 to 5 vertebral heights, except for the gangliogliomas which involved the spinal cord more extensively. Contrast enhancement was seen in all 9 patients. Intratumoral cavities were observed in 1 out of 3 astrocytomas and 2 gangliogliomas. Peritumoral syringomyelia was seen in 2 out of 4 ependymonas and 2 gangliogliomas. In most cases, the MR findings correlated well with the surgical findings with respect to the extent, distinctness of the tumor margin, intratumoral cavity, and associated syringomyelia. It is concluded that MR imaging is a very useful diagnostic tool in the evaluation of intramedullary spinal cord tumors.

  13. Somatic neurofibromatosis type 1 (NF1) inactivation characterizes NF1-associated pilocytic astrocytoma. (United States)

    Gutmann, David H; McLellan, Michael D; Hussain, Ibrahim; Wallis, John W; Fulton, Lucinda L; Fulton, Robert S; Magrini, Vincent; Demeter, Ryan; Wylie, Todd; Kandoth, Cyriac; Leonard, Jeffrey R; Guha, Abhijit; Miller, Christopher A; Ding, Li; Mardis, Elaine R


    Low-grade brain tumors (pilocytic astrocytomas) arising in the neurofibromatosis type 1 (NF1) inherited cancer predisposition syndrome are hypothesized to result from a combination of germline and acquired somatic NF1 tumor suppressor gene mutations. However, genetically engineered mice (GEM) in which mono-allelic germline Nf1 gene loss is coupled with bi-allelic somatic (glial progenitor cell) Nf1 gene inactivation develop brain tumors that do not fully recapitulate the neuropathological features of the human condition. These observations raise the intriguing possibility that, while loss of neurofibromin function is necessary for NF1-associated low-grade astrocytoma development, additional genetic changes may be required for full penetrance of the human brain tumor phenotype. To identify these potential cooperating genetic mutations, we performed whole-genome sequencing (WGS) analysis of three NF1-associated pilocytic astrocytoma (PA) tumors. We found that the mechanism of somatic NF1 loss was different in each tumor (frameshift mutation, loss of heterozygosity, and methylation). In addition, tumor purity analysis revealed that these tumors had a high proportion of stromal cells, such that only 50%-60% of cells in the tumor mass exhibited somatic NF1 loss. Importantly, we identified no additional recurrent pathogenic somatic mutations, supporting a model in which neuroglial progenitor cell NF1 loss is likely sufficient for PA formation in cooperation with a proper stromal environment.

  14. Bioleaching of low-grade copper sulphides

    Institute of Scientific and Technical Information of China (English)

    YIN Sheng-hua; WU Ai-xiang; QIU Guan-zhou


    The bioleaching behavior of low-grade copper sulphides under the condition of preferential solution flow was investigated through experiments.The experiment of bioleaching was conducted within the multifunction autocontrol bioleaching apparatus.The results show that the concentrations of Cu2+ and total Fe increase slowly at the beginning.The recovery rate decreases with the increase of depth of dump.The preferential solution happens within the fine region when the application rate is low,and the recovery rate of the fine region is higher than that of the coarse region.The content of fine ore particles within both fine and coarse regions increases during the leaching period,and the preferential solution flow shifts from fine region to coarse region.The surface of the ores at the top of dump is attacked seriously,and the ores in the middle is attacked slightly.There are plenty of crackles on the surface of bottom ores because of the precipitation layer on the surface.

  15. Beneficiation of a low grade limestone sample

    Institute of Scientific and Technical Information of China (English)

    Rao Danda Srinivas; Vijayakumar Tadiparthi Venkata; Subba Rao Sripada; Bhaskar Raju Guntamadugu; Prabhakar Swarna


    Pilot scale column flotation studies were conducted on a low grade siliceous limestone ore.Silica content was reduced to less than 1% in the concentrate so that it became satisfactory for use in the paper or rubber industries.The limestone sample was crystalline and constituted primarily of calcite that contained quartz,feldspar,pyroxene,and biotite as gangue minerals.Quartz is the major silicate gangue whereas feldspar,pyroxene,and biotite exist in minor to trace quantities.Traces of pyrite were also observed within the sample.A reverse flotation process was adopted where the silicate gangue minerals were floated using two different commercial cationic collectors:Chem-750 F or Floatamine-D.The studies clearly suggest it is possible to produce a limestone concentrate assaying around 96-97% CaCO3 containing less than 1 % SiO2.The effect of feed flow rate,percent solids,froth depth,and wash water on the grade and recovery of the CaCO3 concentrate is discussed.

  16. Leptomeningeal dissemination of pilocytic astrocytoma in a 17-year-old boy. (United States)

    Jandaghi, Ali BabaeI; Bidabadi, Elham; Saadat, Seyed; Alijani, Babak; Daliri, Saeid; Reyhanian, Zoheir; Mashouf, Mehryar


    Pilocytic astrocytoma with leptomeningeal dissemination is a rare phenomenon and can be associated with obstructive hydrocephalus and an unfavorable prognosis. Herein, we report a seventeen-year-old boy with a history of ventriculo-peritoneal shunt insertion due to severe hydrocephalus who presented with progressive headache and vomiting together with ocular and cerebellar signs and symptoms. Neuroimaging confirmed the presence of multiple intracranial masses in the cerebellum and thalamus. Intracranial dissemination of tumor to the the leptomeninges was seen during neuroendoscopy. Simultaneous biopsy and endoscopic third ventriculostomy were performed and the diagnosis of low-grade pilocytic astrocytoma with leptomeningeal dissemination was made by histological examination. The patient underwent chemotherapy in combination with radiotherapy to reduce the risk of reoccurrence of the primary tumor and was followed for one year.

  17. Stereotaxic gamma knife surgery in treatment of critically located pilocytic astrocytoma: preliminary result

    Directory of Open Access Journals (Sweden)

    Hafez Raef FA


    Full Text Available Abstract Background Low-grade gliomas are uncommon primary brain tumors, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Case presentations Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain (thalamic and brain stem were treated with gamma knife surgery. Gamma knife surgery (GKS did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging (MRI studies of the solid part of the tumor and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the (thalamic located lesion and 22 months in the second case with the (brain stem located lesion. Conclusion Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially if they are critically located

  18. Stereotaxic gamma knife surgery in treatment of critically located pilocytic astrocytoma: preliminary result (United States)

    Hafez, Raef FA


    Background Low-grade gliomas are uncommon primary brain tumors, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Case presentations Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain (thalamic and brain stem) were treated with gamma knife surgery. Gamma knife surgery (GKS) did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging (MRI) studies of the solid part of the tumor and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the (thalamic located lesion) and 22 months in the second case with the (brain stem located lesion). Conclusion Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially if they are critically located PMID:17394660

  19. Desalination using low grade heat sources (United States)

    Gude, Veera Gnaneswar

    A new, low temperature, energy-efficient and sustainable desalination system has been developed in this research. This system operates under near-vacuum conditions created by exploiting natural means of gravity and barometric pressure head. The system can be driven by low grade heat sources such as solar energy or waste heat streams. Both theoretical and experimental studies were conducted under this research to evaluate and demonstrate the feasibility of the proposed process. Theoretical studies included thermodynamic analysis and process modeling to evaluate the performance of the process using the following alternate energy sources for driving the process: solar thermal energy, solar photovoltaic/thermal energy, geothermal energy, and process waste heat emissions. Experimental studies included prototype scale demonstration of the process using grid power as well as solar photovoltaic/thermal sources. Finally, the feasibility of the process in reclaiming potable-quality water from the effluent of the city wastewater treatment plant was studied. The following results have been obtained from theoretical analysis and modeling: (1) The proposed process can produce up to 8 L/d of freshwater for 1 m2 area of solar collector and evaporation chamber respectively with a specific energy requirement of 3122 kJ for 1 kg of freshwater production. (2) Photovoltaic/thermal (PV/T) energy can produce up to 200 L/d of freshwater with a 25 m2 PV/T module which meets the electricity needs of 21 kWh/d of a typical household as well. This configuration requires a specific energy of 3122 kJ for 1 kg of freshwater production. (3) 100 kg/hr of geothermal water at 60°C as heat source can produce up to 60 L/d of freshwater with a specific energy requirement of 3078 kJ for 1 kg of freshwater production. (4) Waste heat released from an air conditioning system rated at 3.25 kW cooling, can produce up to 125 L/d of freshwater. This configuration requires an additional energy of 208 kJ/kg of

  20. Low-grade oligodendroglioma: current treatments and future hopes. (United States)

    Lwin, Zarnie; Gan, Hui K; Mason, Warren P


    Current treatment modalities for low-grade gliomas include surgery, radiotherapy and chemotherapy. Management of these ultimately incurable tumors remains controversial, particularly the timing and extent of surgery, and the optimal sequence of radiotherapy and chemotherapy thereafter. Two ongoing Phase III trials should provide definitive answers to some of these controversial issues in the treatment of low-grade gliomas and confirm the impact of molecular predictors of response and outcome. This review will discuss recent progress and topical issues in the treatment of low-grade gliomas.

  1. Low-grade osteosarcoma of the ethmoid sinus

    Energy Technology Data Exchange (ETDEWEB)

    Vlychou, M.; Ostlere, S.J. [Nuffield Orthopaedic Centre, Department of Musculoskeletal Radiology, Oxford (United Kingdom); Kerr, R. [Radcliffe Infirmary, Department of Neurosurgery, Oxford (United Kingdom); Athanasou, N.A. [Nuffield Orthopaedic Centre, Department of Pathology, Nuffield Department of Orthopaedic Surgery, Oxford (United Kingdom)


    Osteosarcoma uncommonly arises in craniofacial bones and has only rarely been reported to arise in the ethmoid sinus. Most primary osteosarcomas arising in paranasal sinuses are high-grade malignancies. A low-grade osteosarcoma arising in the ethmoid sinus has not previously been described. We report the clinical, radiological and histological findings of a case of low-grade (parosteal osteosarcoma-like) osteosarcoma which arose in the ethmoid sinus. (orig.)

  2. Long-term molecular changes in WHO grade Ⅱ astrocytomas following radiotherapy

    Institute of Scientific and Technical Information of China (English)

    Wei-Ying Yu; Ke Sai; Qiu-Liang Wu; Yun-Fei Xia; Su-Huan Yu; Zhong-Ping Chen


    Monitoring the long-term radiotherapy-associated molecular changes in low-grade gliomas (LGGs)facilitates the understanding of LGG response to radiotherapy. In this study, we used immunohistochemistry to analyze the expression of Ki-67,tumor protein P53 (TP53),P21,and P27 in 8paired WHO grade Ⅱ astrocytoma samples.The interval between radiotherapy (RT) and the second surgery was more than 3 months in all cases.The average Ki-67 labeling index (LI) was 5.3% in pre-RT samples and 11.54% in post-RT samples.Ki-67 LI was higher in the primary tumors that underwent malignant transformation observed at the second surgery after radiation.Post-RT Ki-67 LI decreased in 2 cases with an interval of less than 12 months between RT and the second surgery.TP53 expression was found in 3 out of 4 pre-RT samples with malignant transformation and in 1 out of 4 pre-RT samples without malignant transformation.Post-RT TP53 increased in 2 cases in which increased expression of P21 or P27 was also observed.Our study suggests that radiotherapy can inhibit WHO grade Ⅱ astrocytoma proliferation as reflected by Ki-67 LI,but the effect attenuates with time.In addition,there is a tendency of malignant transformation for WHO grade Ⅱ astrocytomas with a high Ki-67 level or TP53 expression in initial samples.

  3. Expression of the neurotrophin receptors Trk A and Trk B in adult human astrocytoma and glioblastoma

    Indian Academy of Sciences (India)

    Shashi Wadhwa; Tapas C Nag; Anupam Jindal; Rahul Kushwaha; Ashok K Mahapatra; Chitra Sarkar


    Neurotrophins and their receptors of the Trk family play a critical role in proliferation, differentiation and survival of the developing neurons. There are reports on their expression in neoplasms too, namely, the primitive neuroectodermal tumours of childhood, and in adult astrocytic gliomas. The involvement of Trk receptors in tumour pathogenesis, if any, is not known. With this end in view, the present study has examined 10 tumour biopsy samples (identified as astrocytoma, pilocytic astrocytoma and glioblastoma) and peritumoral brain tissue of adult patients, for the presence of Trk A and Trk B receptors, by immunohistochemistry. The nature of the tumour samples was also confirmed by their immunoreactivity (IR) to glial fibrillary acidic protein. In the peritumoral brain tissue, only neurons showed IR for Trk A and Trk B. On the contrary, in the tumour sections, the IR to both receptors was localized in the vast majority of glia and capillary endothelium. There was an obvious pattern of IR in these gliomas: high levels of IR were present in the low-grade (type I and II) astrocytoma; whereas in the advanced malignant forms (WHO grade IV giant cell glioblastoma and glioblastoma multiforme) the IR was very weak. These findings suggest that Trk A and Trk B are involved in tumour pathogenesis, especially in the early stage, and may respond to signals that elicit glial proliferation, and thus contribute to progression towards malignancy.

  4. Low-grade proteinuria and microalbuminuria in renal transplantation. (United States)

    Halimi, Jean-Michel


    Nephrotic-range proteinuria has been known for years to be associated with poor renal outcome. Newer evidence indicates that early (1-3 months after transplantation) low-grade proteinuria and microalbuminuria (1) provide information on the graft in terms of donor characteristics and ischemia/reperfusion injury, (2) may occur before the development of donor-specific antibodies, (3) predict the development of diabetes and cardiovascular events, and (4) are associated with reduced long-term graft and patient survivals. Low-grade proteinuria and microalbuminuria are also predictive of diabetes, cardiovascular morbidity, and death in nontransplanted populations, which may help us to understand the pathophysiology of low-grade proteinuria or microalbuminuria in renal transplantation. The impact of immunosuppressive medications, including mammalian target of rapamycin inhibitors, on graft survival is still discussed, and the effect on proteinuria is crucial to the debate. The fact that chronic allograft rejection may exist as early as 3 months after renal transplantation indicates that optimal management of low-grade proteinuria or microalbuminuria should occur very early after transplantation to improve long-term renal function and the overall outcome of renal transplant recipients. The presence of low-grade proteinuria or microalbuminuria early after transplantation must be taken into account to choose adequate immunosuppressive and antihypertensive medications. Limited information exists regarding the benefit of therapeutic interventions to reduce low-grade proteinuria or microalbuminuria. Whether renin angiotensin blockade results in optimal nephroprotection in patients with low-grade proteinuria or microalbuminuria is not proven, especially in the absence of chronic allograft nephropathy. Observational studies and randomized clinical trials yield conflicting results. Finally, randomized clinical trials are urgently needed.

  5. Intramedullary pressure of the patella in Chondromalacia. (United States)

    Björkström, S; Goldie, I F; Wetterqvist, H


    Degenerative changes in load-bearing joints are often combined with altered intramedullary circulation. This may cause an alteration in intramedullary pressures. It has been said that articular symptoms are connected with a change in intramedullary pressures being high they are suspected to cause pain. In this investigation the intramedullary pressure has been evaluated in chondromalacia and osteoarthrosis of the patella. A comparison has been made with normal patellae. A biopsy needle was drilled into the intramedullary bone of the patella and connected with a registering unit. In a control group an average value of 19 mm Hg was registered. In the condromalacia group the mean intramedullary pressure was 44 mm Hg and in osteoarthrosis 37 mm Hg.

  6. Supratentorial low-grade glioma: results and prognostic factors following postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Grabenbauer, G.G.; Roedel, C.M.; Schuchardt, U.; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Radiation Oncology; Paulus, W. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Neuropathology; Ganslandt, O.; Buchfelder, M.; Schrell, U.; Fahlbusch, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Neurochirurgische Klinik mit Poliklinik; Huk, W.J. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Neuroradiology


    Background and Purpose: To assess treatment outcome and prognostic factors following postoperative external radiotherapy in 77 patients with low-grade glioma. Patients and Methods: Between 1977 and 1996, 45 patients with astrocytoma, 14 with oligodendroglioma and 18 with mixed glioma received postoperative radiotherapy with a median total dose of 52 Gy (range, 45 to 61 Gy). Sixty-seven patients were treated immediately following surgery, 10 patients with tumor progression. The influence of various factors including histology, gender, age, seizures, duration of symptoms ({<=}6 weeks vs >6 weeks), CT pattern (enhancement vs no enhancement), type of surgery, total radiotherapy dose and timing of radiotherapy on relapse-free survival and overall survival was investigated. Results: The median overall survival time was 81 months, the 5- and 10-year survival rates were 54% and 31%, respectively. The median time to progression was 56 months, while the 5- and 10-year progression-free survival rates were 45% and 24%. Univariate analyses identified the total radiotherapy dose (p=0.01), duration of symptoms (p=0.05), the presence of seizures (p=0.04), and the CT pattern following intravenous contrast (p=0.005) as significant prognostic factors for overall survival. Progression-free survival rates were influenced by the total dose (p=0.04), the duration of symptoms (p=0.01) and CT pattern (p=0.006). On multivariate analysis, only the CT pattern (enhancement vs no enhancement) remained as independent prognostic factors for both progession-free survival and overall survival. Conclusion: A minimum total dose of 52 Gy is recommended for the postoperative radiotherapy in low-grade glioma. Tumors with CT enhancement seem to need further intensification of treatment. (orig.) [German] Hintergrund: Es sollten Ergebnisse und Prognosefaktoren nach postoperativer Radiotherapie bei 77 Patienten mit Low-grade-Gliomen evaluiert werden. Patienten und Methoden: Zwischen 1977 und 1996 wurden 45

  7. Intramedullary Chondrosarcoma of Proximal Humerus

    Directory of Open Access Journals (Sweden)

    Pratiksha Yadav


    Full Text Available Primary chondrosarcoma is the third most frequent primary malignancy of bone after myeloma and osteosarcoma. It is ranging from slow growing nonmetastasising lesions to highly aggressive lesions. We report a case of primary intramedullary chondrosarcoma of proximal humerus. A 60-year-old female presented with pain and hard swelling involving the left arm for 5 months. Radiograph showed a lucent expansile intramedullary lesion with matrix calcification and associated soft tissue mass. CT confirmed the finding. MRI showed a lobulated lesion which is hyperintense on T2WI with low signal fibrous septae. Increased tracer uptake was seen on bone scan. Histopathology confirmed the radiology diagnosis. The patient underwent wide resection and endoprosthetic reconstruction of proximal humerus.

  8. Low-Grade Oligodendroglioma of the Pineal Region: Case Report. (United States)

    Lamis, Fabricio Correa; de Paiva Neto, Manoel Antonio; Stavale, João Norberto; Cavalheiro, Sergio


    Background Although germ cell tumors and pineal cell tumors account for most of the histologic tumor subtypes, > 17 different tumors can arise in this location. We report a rare case of a low-grade oligodendroglioma that arose in the pineal region. Clinical Presentation A young woman complaining of a headache underwent magnetic resonance imaging that showed a mass in the pineal region and mild hydrocephalus. A ventriculoperitoneal shunt was performed followed by a near-total tumor removal, due to tumor invasion of the tectal plate and thalamus. The histologic examination confirmed the diagnosis of a low-grade oligodendroglioma. The patient then underwent chemotherapy and radiotherapy as adjuvant therapies. Conclusion Although the pineal region is a common place for a large number of tumoral lesions, low-grade oligodendrogliomas are extremely rare in this location. This case is only the second account of a benign oligodendroglioma of the pineal region reported in the literature.

  9. Low-grade leiomyosarcoma of renal vein: A case report

    Directory of Open Access Journals (Sweden)

    Nalan NEŞE


    Full Text Available Leiomyosarcomas originating from renal vein are quite rare malignant tumors since only 30 cases have been reported in the literature. Clinical symptoms which are due to a renal mass along with radiological findings, usually mislead to a preoperative diagnosis of renal cell carcinoma. The correct diagnosis is frequently made on nephrectomy specimens. Low-grade leiomyosarcomas need to be differentiated from leiomyomas. Increased mitotic activity and necrosis are known to be gold standards for differential diagnosis. In this report, we present a case of a 62 year old woman whose tumor in the left kidney diagnosed as low-grade leiomyosarcoma together with a brief review of the literature.

  10. A multivariate analysis of factors determining tumor progression in childhood low-grade glioma: a population-based cohort study (CCLG CNS9702) (United States)

    Stokland, Tore; Liu, Jo-Fen; Ironside, James W.; Ellison, David W.; Taylor, Roger; Robinson, Kathryn J.; Picton, Susan V.; Walker, David A.


    The purpose of this study was to identify risk factors for the progression of low-grade glioma in children from a large population-based cohort. Patient and tumor details of a national cohort of children with low-grade glioma, recruited into an international multidisciplinary clinical strategy, were subjected to univariate and multivariate analyses of progression-free survival and overall survival. From the cohort of 798 patients, 639 patients were eligible, with a median age 6.71 years (0.26–16.75 years); 49% were males; 15.9% had neurofibromatosis type 1, 63.7% pilocytic astrocytoma, 5.9% fibrillary astrocytoma, 4.2% mixed neuronal-glial tumors, and 3.6% others; 21.1% were diagnosed clinically. Anatomically implicated were 31.6% cerebellum, 24.6% chiasma/hypothalamus, 16.0% cerebral hemispheres, 9.9% brain stem, 6.1% other supratentorial midline structures, 5.9% optic nerve only, 4.5% spinal cord, and 1.4% others. The 5-year overall survival and progression-free survival in the whole cohort were 94.6% and 69.4%, respectively. There was a significant association between age and site (P Multivariate analysis identified young age, fibrillary astrocytoma, and extent of surgical resection as significant independent risk factors for progression. Hypothalamic/chiasmatic tumors demonstrated the most sustained tendency to progress. In conclusion, the influence of age and anatomical site upon the risk of tumor progression suggests that these factors strongly influence tumor behavior for the majority of pilocytic tumors. Age <1 year and 1–5 years, fibrillary histology, completeness of resection, and chiasmatic location are candidates for stratification in future studies. PMID:20861086

  11. An intramedullary tumor presenting with hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Chatterjee Sandip


    Full Text Available A case of a cervical intramedullary tumor is reported whose presentation was with disabling hyperhidrosis. The symptom resolved after surgical debulking of the tumor. Hyperhidrosis as a presenting manifestation of an intramedullary tumor has not been reported earlier.

  12. An unusual cystic appearance of disseminated low-grade gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Huang, T.; Zimmerman, R.A. [Dept. of Radiology, Children' s Hospital of Philadelphia, PA (United States); Perilongo, G. [Dipt. di Pediatria, Univ. di Padova (Italy); Kaufman, B.A. [Dept. of Neurosurgery, St Louis Children' s Hospital, St Louis, MO (United States); Holden, K.R. [Division of Pediatric Neurology, Room 511, Children' s Hospital, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425-2232 (United States); Carollo, C. [Division of Neuroradiology, Regione Veneto, Azienda Ospedalieri di Padova, Universita di Padova, Via Giustiniani 3, 35 128 Padua (Italy); Kling Chong, W.K. [Dept. of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)


    We report five cases of pediatric disseminated low-grade gliomas of the brainstem or spinal cord that exhibited an unusual, cystic pattern. Leptomeningeal disease was present in three of these at diagnosis, and was detected shortly afterwards in the other two. Four patients are alive up to 5 years later, following minimal to no intervention, while one is dead. (orig.)

  13. Deformation of chlorite in naturally deformed low-grade rocks

    NARCIS (Netherlands)

    Bons, A.J.


    The intracrystalline deformation of chlorite in naturally deformed low-grade rocks was investigated with transmission electron microscopy (TEM). As in other phyllosilicates, the deformation of chlorite is dominated by the (001) slip plane. Slip along this plane is very easy through the generation an

  14. Polymorphous low-grade adenocarcinoma of the nasal fossa. (United States)

    González-Lagunas, Javier; Alasà-Caparrós, Cristian; Vendrell-Escofet, Gerard; Huguet-Redecilla, Pere; Raspall-Martin, Guillermo


    An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radiotherapy was also administered to the patient.

  15. Nerve growth factor expression in astrocytoma and cerebrospinal fluid: a new biomarker for prognosis of astrocytoma

    Institute of Scientific and Technical Information of China (English)

    LI Qiao-yu; FENG Yun; XU Wen-lin; YANG Yong; ZHANG Yan; ZHANG Zhi-jian; GONG Ai-hua; YUAN Zhi-cheng; LU Pei-song; ZHAN Li-ping; WANG Peng


    Background Recent studies have discovered that nuclear translocation of nerve growth factor (NGF) and its receptor fragments function differently from the traditional model. This study aimed to uncover the nuclear expression of NGF in astrocytoma and its biological significance.Methods Ninety-four paraffin-embedded astrocytoma specimens were subjected to immunohistochemical (IHC) and hemotoxylin & eosin (HE) staining. Preoperative cerebrospinal fluid (CSF) specimens and intraoperative snap-frozen astrocytoma tissues were assayed for NGF expression by ELISA and Western blotting. The outcome of patients who contributed samples was tracked. Each ten tissue samples from patients with traumatic brain injury who had received decompression surgery and CSF samples from patients undergoing spinal anesthesia but with no history of nervous system disease were taken as control.Results NGF-positive immunoreactive products were distributed in both the cytoplasm and nucleus of astrocytoma, but were only located in the cytoplasm of traumatic brain injury (TBI) tissue. NGF nuclear-positive rate (NPR) of grades Ⅲ-Ⅳ astrocytomas (70.0%) was higher than that of grades Ⅰ-Ⅱ astrocytoma (28.6%, P<0.05). NGF-NP expression positively correlated with the NGF concentration in cerebrospinal fluid (CSF) (r=0.755, P<0.01). Kaplan-Meier survival analysis indicated that the median survival time was 25 months for NGF-NP astrocytoma grade Ⅰ-Ⅱ patients and 42 months in NGF nuclear negative (NGF-NN) astrocytoma grade Ⅰ-Ⅱ patients (P<0.05). In astrocytoma Ⅲ-Ⅳ patients, the median survival was 7 months for NGF-NP patients and 24 months for NGF-NN patients (P<0.01). Two types of NGF with molecular weights of 13 and 36 kDa were present in astrocytoma, but only the 36 kDa NGF was found in the CSF. NGF expression elevated as the malignancy increased.Conclusions NGF-NP expression and NGF level in CSF were significant prognostic factors in astrocytoma patients.Because of the easy

  16. Pilocytic astrocytoma of the velum interpositum. (United States)

    Ideguchi, M; Nishizaki, T; Harada, K; Kwak, T; Murakami, T; Ito, H


    A 72-year-old male presented with a pilocytic astrocytoma in the velum interpositum manifesting as a 5-day history of dizziness attacks and unstable gait. Computed tomography and T1-weighted magnetic resonance imaging with gadolinium enhancement demonstrated a small, homogeneously enhanced mass in the velum interpositum. The tumor was removed subtotally, and the structure of the splenium was intact. The histological diagnosis was pilocytic astrocytoma. The MIB-1 growth fraction was 5%. The tumor may have originated from the splenium or the thalamus. The aggressive histology indicates the need for close neuroimaging follow-up.

  17. Exploratory Visual Analysis of Statistical Results from Microarray Experiments Comparing High and Low Grade Glioma

    Directory of Open Access Journals (Sweden)

    Jason H. Moore


    Full Text Available The biological interpretation of gene expression microarray results is a daunting challenge. For complex diseases such as cancer, wherein the body of published research is extensive, the incorporation of expert knowledge provides a useful analytical framework. We have previously developed the Exploratory Visual Analysis (EVA software for exploring data analysis results in the context of annotation information about each gene, as well as biologically relevant groups of genes. We present EVA as a fl exible combination of statistics and biological annotation that provides a straightforward visual interface for the interpretation of microarray analyses of gene expression in the most commonly occurring class of brain tumors, glioma. We demonstrate the utility of EVA for the biological interpretation of statistical results by analyzing publicly available gene expression profi les of two important glial tumors. The results of a statistical comparison between 21 malignant, high-grade glioblastoma multiforme (GBM tumors and 19 indolent, low-grade pilocytic astrocytomas were analyzed using EVA. By using EVA to examine the results of a relatively simple statistical analysis, we were able to identify tumor class-specifi c gene expression patterns having both statistical and biological signifi cance. Our interactive analysis highlighted the potential importance of genes involved in cell cycle progression, proliferation, signaling, adhesion, migration, motility, and structure, as well as candidate gene loci on a region of Chromosome 7 that has been implicated in glioma. Because EVA does not require statistical or computational expertise and has the fl exibility to accommodate any type of statistical analysis, we anticipate EVA will prove a useful addition to the repertoire of computational methods used for microarray data analysis. EVA is available at no charge to academic users and can be found at

  18. Direct SX of uranium from low-grade leach solutions

    Energy Technology Data Exchange (ETDEWEB)

    Grinbaum, B., E-mail: [Bateman Advanced Technologies, Yokneam (Israel)


    Historically, recovery of uranium from high-grade (>400 ppm U) pregnant leach solutions (PLS) was done by solvent extraction (SX), while low-grade feed was treated by ion exchange (IX). Significant improvement in the SX technology, especially application of large pulsed columns instead of mixer-settlers (MS), have now made the SX more attractive for PLS with U below 100 ppm. Recently Bateman carried out three test work programs for direct SX of low-grade (<100 ppm) U PLS, using BPC pulsed columns for extraction and MS for stripping and scrubbing. In all 3 cases the results prove that the direct SX is overall more economical that any combination of IX and SX. Based on these results, two industrial plants, in South Africa and Australia, were erected. (author)

  19. Interventricular low-grade oligodendroglioma with multiple parenchymal relapse. (United States)

    Akhavan, Ali; Binesh, Fariba; Rakhsha, Afshin; Navabii, Hossein


    Oligodendrogliomas can be found anywhere oligodendrocytes exist; however, they mostly occur in frontal lobes. Although intra- and extra central nervous system dissemination of anaplastic oligodendroglioma is a well-known property of this tumour, low-grade oligodendroglioma with intracranial relapse is a very uncommon finding. In this case report, a 37-year-old man with grade II oligodendroglioma relapsed after 18 months with multiple parenchymal masses is presented.

  20. Bioprocessing low grade copper ores - a promising alternative


    Guezennec, Anne-Gwenaëlle; d'Hugues, Patrick


    International audience; This paper presents an overview of the work performed by the BRGM team in the last 10 years on the development of bio-hydrometallurgy dedicated to the processing of low-grade copper ores from the Kupferschiefer deposits. It covers selection and adaptation of microbial consortia, optimization of process operating parameters such as solid contents, the relationship between bioleaching performance and mineralogy, testing operating parameters to overcome chalcopyrite recal...

  1. Bilateral Birdshot Retinochoroiditis and Retinal Astrocytoma

    Directory of Open Access Journals (Sweden)

    Sunil Mamtora


    Full Text Available Background. This case highlights the importance of recognising multiple pathologies within the eye which may not necessarily be linked. Both birdshot retinochoroiditis and astrocytoma are rare conditions. The case underlines the need for early identification and treatment of birdshot retinochoroiditis with steroids and disease modifying drugs. Astrocytoma in the absence of tuberous sclerosis is also uncommon. Case Presentation. A 36-year-old male presented with 3-month history of bilateral progressive flashing lights and floaters. He was systemically well with no significant past medical history. Fundal examination revealed retinal vasculitis and active creamy lesions in the choroid radiating from the optic nerve. In the supranasal periphery of the right eye there was a raised white, jagged lesion protruding into the vitreous. Fluorescein angiogram and indocyanine green showed marked venous vasculitis, hypofluorescence, and disc leakage in keeping with birdshot retinochoroiditis. The supranasal lesion features were in keeping with astrocytoma and this was thought to be a coincidental finding. Conclusions. Retinal astrocytoma may be present as an isolated ocular finding; however, patients must still be investigated for tuberous sclerosis which is the most common association. Birdshot retinochoroiditis typically responds well to steroid therapy, and disease modifying drugs should be considered as soon as possible.

  2. [Low grade parosteal osteosarcoma. Clinical and oncological outcomes]. (United States)

    Albergo, José I; Farfalli, Germán L; Ayerza, Miguel A; Muscolo, Domingo L; Aponte-Tinao, Luis A


    The objective of the study was to analyze a group of patients with low grade parosteal osteosarcoma treated with limb salvage surgery and reconstructed with bone allograft. A retrospective review from our oncologic data base between 1980 and 2010 was done and all patients with diagnosis of low grade parosteal osteosarcoma, treated with limb salvage surgery and reconstructed with allograft were included. Twenty-two patients were included for the analysis. The mean age was 32±11 years (10-59) y the mean follow-up 93±69 months (8-237). Ten year overall survival of the series was 91% (95% CI: 79-100). Four patients developed local recurrence, 2 of them histological classified after the resection dedifferentiated parosteal osteosarcoma. Two patients developed distant recurrence, being the lung the only site of metastasis. Ten year limb salvage reconstruction survival was 65% (95% CI: 44-86). Long term survival rate in low grade parosteal osteosarcoma is over 90%. Surgical resection wide margin should be the elective treatment and biological limb salvage reconstruction is a good alternative.

  3. Genetic and epigenetic characterization of low-grade gliomas reveals frequent methylation of the MLH3 gene. (United States)

    Lhotska, Halka; Zemanova, Zuzana; Cechova, Hana; Ransdorfova, Sarka; Lizcova, Libuse; Kramar, Filip; Krejcik, Zdenek; Svobodova, Karla; Bystricka, Dagmar; Hrabal, Petr; Dohnalova, Alena; Michalova, Kyra


    Diffuse astrocytomas and oligodendrogliomas (WHO grade II) are the most common histological subtypes of low-grade gliomas (LGGs). Several molecular and epigenetic markers have been identified that predict tumor progression. Our aim was in detail to investigate the genetic and epigenetic background of LGGs and to identify new markers that might play a role in tumor behavior. Twenty-three patients with oligodendroglioma or oligoastrocytoma (LGO) and 22 patients with diffuse astrocytoma (LGA) were investigated using several molecular-cytogenetic and molecular methods to assess their copy number variations, mutational status and level of promoter methylation. The most frequent findings were a 1p/19q codeletion in 83% of LGO and copy-neutral loss of heterozygosity (CN-LOH) of 17p in 72% of LGA. Somatic mutations in the isocitrate dehydrogenase 1 or 2 (IDH1/IDH2) genes were detected in 96% of LGO and 91% of LGA. The O-6-methylguanine-DNA-methyltransferase (MGMT) promoter was methylated in 83% of LGO and 59% of LGA. MutL homolog 3 (MLH3) promoter methylation was observed in 61% of LGO and 27% of LGA. Methylation of the MGMT promoter, 1p/19q codeletion, mutated IDH1, and CN-LOH of 17p were the most frequent genetic aberrations in LGGs. The findings were more diverse in LGA than in LGO. To the best of our knowledge, this is the first time description of methylation of the MLH3 gene promoter in LGGs. Further studies are required to determine the role of the methylated MLH3 promoter and the other aberrations detected.

  4. A rare case of infantile cerebellar pilocytic astrocytoma and thrombocytopenia presenting with intratumoral hemorrhage

    Directory of Open Access Journals (Sweden)

    Shashank R Ramdurg


    Full Text Available Incidence of gliomas presenting with hemorrhage is around 3.7–7.2%. Low-grade gliomas account for <1% tumor with hemorrhage. Infants presenting with cerebellar pilocytic astrocytomas (PAs and hemorrhage with thrombocytopenia have not been reported. We report an interesting case of a 9-month-old infant who presented to the emergency department in a drowsy state with recurrent vomiting. Laboratory investigations showed anemia, thrombocytopenia, and coagulopathy. Radiological evaluation showed a large PA with bleed. The patient was treated with retromastoid suboccipital craniotomy and tumor excision and improved postoperatively. Cerebellar PA with bleed and coagulopathy in infants has not been reported in literature till date. Their presentation seems to be acute in nature, and high index of suspicion is required for the diagnosis of these posterior fossa tumors, which can deteriorate rapidly in infants.

  5. reoperation rates following intramedullary nailing versus external ...

    African Journals Online (AJOL)

    Reasons for reoperation among EF patients were infection. (2 patients) ... fixation. Keywords: Orthopaedic surgery, Tanzania, Intramedullary nail, External fixation, Open tibia fracture. INTRODUCTION ..... of surgical site infection. Infect Control ...

  6. Cystic cervical intramedullary schwannoma with syringomyelia

    Directory of Open Access Journals (Sweden)

    Shenoy S


    Full Text Available We report a case of cervical intramedullary cystic schwannoma associated with segmental syrinx in a young adult without evidence of neurofibromatosis. The relevant literature is reviewed.

  7. Clinical Factors for Prognosis and Treatment Guidance of Spinal Cord Astrocytoma (United States)

    Hida, Kazutoshi; Yano, Shunsuke; Aoyama, Takeshi; Koyanagi, Izumi; Sasamori, Toru; Hamauch, Shuji; Houkin, Kiyohiro


    Study Design Retrospective study. Purpose To obtain information useful in establishing treatment guidelines by evaluating baseline clinical features and treatment outcomes of patients with spinal cord astrocytoma (SCA). Overview of Literature The optimal management of SCA remains controversial, and there are no standard guidelines. Methods The study included 20 patients with low-grade and 13 with high-grade SCA surgically treated between 1989 and 2014. Patients were classified according to the extent of surgical resection. Survival was assessed using Kaplan–Meier plots and compared between groups by log-rank tests. Neurological status was defined by the modified McCormick scale and compared between groups by Mann–Whitney U tests. Results Surgical resection was performed for 19 of 20 low-grade (95%) and 10 of 13 high-grade (76.9%) SCA patients. Only nine patients (27.3%) underwent gross total resection, all of whom had low-grade SCA. Of all patients, 51.5% showed deteriorated neurological status compared to preoperative baseline. Median overall survival was significantly longer for low-grade SCA than that (91 months, 78% at 5 years vs. 15 months, 31% at 5 years; p=0.007). Low-grade SCA patients benefited from more aggressive resection, whereas high-grade SCA patients did not. Multivariate analysis revealed histology status (hazard ratio [HR], 0.30; 95% confidence interval [CI], 0.09–0.98; p<0.05) and postoperative neurological status (HR, 0.12; CI, 0.02–0.95; p<0.05) as independent predictors of longer overall survival. Adjuvant radiotherapy had no significant impact on survival rate. However, a trend for increased survival was observed with radiation cordotomy (RCT) in high-grade SCA patients. Conclusions Aggressive resection for low-grade and RCT may prolong survival. Preservation of neurological status is an important treatment goal. Given the low incidence of SCA, establishing strong collaborative, interdisciplinary, and multi-institutional study groups

  8. Experimental Study on Purification of Low Grade Diatomite (United States)

    Xiao, Liguang; Pang, Bo


    This paper presented an innovation for purification of low grade diatomite(DE) by grinding, ultrasonic pretreatment, acid leaching of closed stirring and calcination. The optimum process parameters of DE purification were obtained, the characterizations of original and purified DE were determined by SEM and BET. The results showed that the specific surface area of DE increased from 12.65m2/g to 23.23m2/g, which increased by 45.54%. SEM analysis revealed that the pore structure of purified DE was dredged highly.

  9. Persistent low-grade inflammation and regular exercise

    DEFF Research Database (Denmark)

    Astrom, Maj-Briit; Feigh, Michael; Pedersen, Bente Klarlund


    Persistent low-grade systemic inflammation is a feature of chronic diseases such as cardiovascular disease (CVD), type 2 diabetes and dementia and evidence exists that inflammation is a causal factor in the development of insulin resistance and atherosclerosis. Regular exercise offers protection...... against all of these diseases and recent evidence suggests that the protective effect of exercise may to some extent be ascribed to an anti-inflammatory effect of regular exercise. Visceral adiposity contributes to systemic inflammation and is independently associated with the occurrence of CVD, type 2...

  10. Histopathological spectrum of polymorphous low-grade adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Varun Surya


    Full Text Available Polymorphous low-grade adenocarcinomas (PLGA are distinctive salivary gland neoplasms, with an almost exclusive propensity to arise from the minor salivary glands. PLGA frequently manifests as an asymptomatic, slow-growing mass within the oral cavity, which must be separated from adenoid cystic carcinoma and benign mixed tumor for therapeutic and prognostic considerations. We report a case of a 67-year-old male, who presented with a long-standing mass in the palate. This lesion was diagnosed as PLGA based on histopathological findings, which was further confirmed by the immunohistochemical marker.

  11. Fluorine F 18 Fluorodopa-Labeled PET Scan in Planning Surgery and Radiation Therapy in Treating Patients With Newly Diagnosed High- or Low-Grade Malignant Glioma (United States)


    Adult Anaplastic Astrocytoma; Adult Anaplastic Ependymoma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Diffuse Astrocytoma; Adult Ependymoma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Mixed Glioma; Adult Myxopapillary Ependymoma; Adult Oligodendroglioma; Adult Pilocytic Astrocytoma; Adult Pineal Gland Astrocytoma; Adult Subependymal Giant Cell Astrocytoma; Adult Subependymoma

  12. Magnetic resonance imaging of low-grade fibromyxoid sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Torriani, Martin; Ouellette, Hugue [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States). Dept. of Radiology. Div. of Musculoskeletal Radiology; Etchebehere, Mauricio [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Ortopedia; Amstalden, Eliane M.I. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Patologia


    Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue tumor with a deceptively benign histologic appearance affecting predominantly young adults during the fourth decade of life. (MR) imaging features of a surgically confirmed case of LGFMS, affecting the shoulder is presented. A 30-year-old man presented with a 20-year history of a painless slow-growing mass in the right shoulder. Magnetic resonance images were obtained on a 2.0T scanner (Elscint, Haifa, Israel), demonstrating a well-defined soft tissue mass measuring 12.0 x 7.0 x 9.0 cm located between the deltoid muscle, rotator-cuff muscles, and proximal humerus. The differential diagnosis of LGFMS includes several benign and malignant neoplasms containing variable amounts of myxoid and fibrous tissue. Histologically, the most important differential diagnosis is with myxofibrosarcoma. Low-grade fibromyxoid sarcoma is a rare soft tissue tumor with slow growth and deceptively benign histologic appearance. The possibility of LGFMS must be considered when elaborating differential diagnostic possibilities for young adults with a large soft tissue mass exhibiting MR imaging characteristics of intermixed fibrous and myxoid tissue.

  13. Bioleaching of low grade nickel sulfide mineral in column reactor

    Institute of Scientific and Technical Information of China (English)

    ZHEN Shi-jie; QIN Wen-qing; YAN Zhong-qiang; ZHANG Yan-sheng; WANG Jun; REN Liu-yi


    Jinchuan low grade nickel (0.4%-0.6% Ni,mass fraction) sulfide mineral ore contains a remarkably high content of magnesia (30%-35% MgO,mass fraction) present in the main gangue minerals.Bioleaching was performed to investigate the feasibility to process the mineral due to its relative simplicity,eco-friendly operation and low capital cost requirements.The mixed mesophiles were enriched from acid mine drainage samples collected from several acid mines in China.Considering that the magnesia is easily extracted by acid solution and the excessive Mg2+ will exceed the tolerance of the mixed mesophiles,three effective means were used to reduce the disadvantage of magnesia during the bioleaching operation.They were adaptation of the mixed mesophiles to improve the tolerance; pre-leaching to remove most leachable magnesia and periodic bleeds of a portion of the pregnant leaching solution to control the level of Mg2+ based on the tolerance of the mixed mesophiles.An extraction of nickel (90.3%) and cobalt (88.6%) was successfully achieved within a 300 d leaching process from the Jinchuan low grade nickel sulfide mineral ore using a column reactor at ambient temperature.

  14. Flotation technology of refractory low-grade molybdenum ore

    Institute of Scientific and Technical Information of China (English)

    Du Shuhua; Luo Zhenfu


    Because of the low grade,high oxidation rate and the accumulation of little associated metal sulfide ore in the molybdenum concentrate during flotation,the Qingyang molybdenum ore is difficult to beneflciate.The experimental studies of grinding fineness,the amount of roughing modifier,depressant and collector were completed.In the cleaning process,the contrast experiments of one regrinding.the regrinding and scrubbing,two-stage regrinding was carried.The result shows that the grade of molybdenum ore concentrate is 45.31%,the recovery is 65.98% and the rich ore ratio reaches 20.59% by the regrinding and scrubbing seven cleaning,the regrinding of concentrations from middling of molybdenum-sulfur separation.The regularly-concentrated material from the apparatus was as the middling products.Hence,ideal beneficiation index can be obtained with a rational mineral processing,which offers new beneficiating technology for the refractory low-grade molybdenum ore in China.

  15. Stimulation of systemic low-grade inflammation by psychosocial stress. (United States)

    Rohleder, Nicolas


    Psychosocial stress is an important precursor of disease and reduced quality of life in humans. The biological pathways between stress exposure and pathophysiological processes underlying disease have received substantial scientific attention, although the roles of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system remain insufficiently understood. Recent attention has focused on chronic systemic low-grade inflammation as a promising pathway because elevated inflammation often accompanies chronic psychosocial distress. These alterations of inflammatory activity play a key role in the pathophysiology of diseases that are adversely affected by chronic distress, such as cardiovascular disease. Transient increases in systemic inflammation are observed in response to acute psychosocial stress, with larger responses among individuals reporting adverse psychosocial states or conditions such as depression, lower self-esteem, or lower self-compassion. Recent evidence shows that lower subjective social status and perceived purpose in life are associated with sensitization of inflammatory stress responses to repeated stress exposure. The aims of this selective review article are to summarize current knowledge of the role of acute and chronic psychosocial stress on low-grade inflammation in humans and to discuss potential relationships between inflammatory responses to acute psychosocial stress and long-term development of disease.

  16. Ethanol and other oxygenateds from low grade carbonaceous resources

    Energy Technology Data Exchange (ETDEWEB)

    Joo, O.S.; Jung, K.D.; Han, S.H. [Korea Institute of Science and Technology, Seoul (Korea, Democratic People`s Republic of)] [and others


    Anhydrous ethanol and other oxygenates of C2 up can be produced quite competitively from low grade carbonaceous resources in high yield via gasification, methanol synthesis, carbonylation of methanol an hydrogenation consecutively. Gas phase carbonylation of methanol to form methyl acetate is the key step for the whole process. Methyl acetate can be produced very selectively in one step gas phase reaction on a fixed bed column reactor with GHSV over 5,000. The consecutive hydrogenation of methyl or ethyl acetate produce anhydrous ethanol in high purity. It is also attempted to co-produce methanol and DME in IGCC, in which low grade carbonaceous resources are used as energy sources, and the surplus power and pre-power gas can be stored in liquid form of methanol and DME during base load time. Further integration of C2 up oxygenate production with IGCC can improve its economics. The attempt of above extensive technology integration can generate significant industrial profitability as well as reduce the environmental complication related with massive energy consumption.

  17. Low-grade energy of the ground for civil engineering

    Directory of Open Access Journals (Sweden)

    Potienko Natalia


    Full Text Available The article researches issues related to the relevance of applying renewable energy sources for civil engineering. The aim of the work is the study of modern approaches to designing buildings, using low-grade energy of the ground. The research methodology is based on the complex analysis of international design experience and on identifying the strengths and weaknesses of objects that use low-grade heat. We have identified the prospects of applying it for domestic construction practice. The state policy in the field of the efficient use of energy resources has been analyzed, and the vector of energy-saving programs development for the Samara Region has been defined. The research describes the impact of using geothermal energy on the architectural and planning solutions of buildings, as well as the peculiar features of the latter’s design, which are related primarily to the increase of energy efficiency. As a result, in the article a conclusion is made that the objects under investigation may be considered as one of the vectors of sustainable architecture development.

  18. Low-grade serous carcinoma: new concepts and emerging therapies. (United States)

    Romero, Ignacio; Sun, Charlotte C; Wong, Kwong K; Bast, Robert C; Gershenson, David M


    For the past several years, all women with epithelial ovarian cancer have been treated identically, whether in a clinical trial or off protocol. Over the past decade, we have come to appreciate the magnitude of the heterogeneity of ovarian cancer. The development of the binary grading system for serous carcinoma was a major advance leading to separate clinical trials for patients with this subtype originating from the Gynecologic Oncology Group's Rare Tumor Committee. The mitogen-activated protein kinase (MAPK) pathway appears to play a prominent role in the pathogenesis of this subtype. Approximately 20-40% of low-grade serous carcinomas have a KRAS mutation, while BRAF mutations are rare - about 5%. Primary treatment of low-grade serous carcinoma includes surgery+platinum-based chemotherapy (either adjuvant or neoadjuvant). Clinical behavior is characterized by young age at diagnosis, relative chemoresistance, and prolonged overall survival. Current options for treatment of relapsed disease include secondary cytoreduction in selected patients, salvage chemotherapy, or hormonal therapy. A recently completed trial of a MEK inhibitor for women with recurrent disease demonstrated promising activity. Future directions will include further investigations of the molecular biology and biomarker-driven clinical trials with targeted agent monotherapy and combinations. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Polymorphous low grade adenocarcinoma: review and case report. (United States)

    Pintor, María Fernanda; Figueroa, Liberto; Martínez, Benjamín


    Polymorphous Low-Grade Adenocarcinoma is a rare, malignant salivary gland tumor, which is found almost exclusively in minor salivary glands. It is more frequent in the age range from 30 to 70, with a clear female predilection in a 2:1 ratio. It is usually located in the hard or soft palate, although it may be found in the rest of the oral cavity too. It is rare in major salivary glands. In general it has good prognosis, with recurrence rates in the range of 17% - 24%. Although rare, metastasis to regional lymph nodes may occur in 9% of the cases. This report describes the case of a patient that consulted at the Military Odontological Center (Central Odontológica del Ejército) due to an esthetic alteration of her dental prosthesis, which had been made 8 years before. The patient was sent to the Maxillofacial Surgery Service, where the intraoral examination showed a big mass compromising the hard palate and the alveolar ridge. During examination, a dent in her prosthesis was found to correspond to the tumor mass; it was therefore concluded that the tumor had at least an eight-year-old evolution. An incisional biopsy was carried out, and once the polymorphous low-grade adenocarcinoma diagnosis had been stated, the patient was sent to the Head and Neck Surgery Service of the Military Hospital, where the lesion was treated by wide surgical excision followed by radiation therapy.

  20. Effects of diphenylhydantoin on murine astrocytoma radiosensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Lordo, C.D.; Stroude, E.C.; Del Maestro, R.F.


    Diphenylhydantoin is a well known anticonvulsant used primarily in the treatment of epilepsy. The prophylactic use of diphenylhydantoin has been suggested for certain cerebral metastases, and it is routinely administered to prevent seizures induced by intracranial neoplasms and/or surgery. Patients with malignant gliomas treated with diphenylhydantoin frequently receive radiation therapy. The effects of a clinical concentration of diphenylhydantoin in combination with gamma radiation was investigated using the C6 astrocytoma cell line in both monolayer and three dimensional multicellular spheroid cultures. Diphenylhydantoin at 7.2 X 10(-5) M (20 micrograms/ml) significantly increased the doubling time (23%) of the C6 astrocytoma cells in monolayer, but did not affect their survival as measured by plating efficiency. No changes were seen in spheroid growth or plating efficiency of the cells dissociated from spheroids at this concentration. Diphenylhydantoin at the clinical concentration tested was not associated with an alteration in radiation sensitivity of C6 astrocytoma cells in monolayer or three dimensional multicellular spheroid cultures.

  1. Open Intramedullary Nailing for Segmental Long Bone Fractures: An ...

    African Journals Online (AJOL)

    Epidemiological reports have shown that a large number of ... KEYWORDS: Locked intramedullary nailing, open reduction, segmental fractures ... led to the development of various intramedullary nail instrument ... Trauma Association System, as complex fractures Type C.[27] ..... Financial support and sponsorship. Nil.

  2. Inhibition of STAT3 reduces astrocytoma cell invasion and constitutive activation of STAT3 predicts poor prognosis in human astrocytoma.

    Directory of Open Access Journals (Sweden)

    Qinchuan Liang

    Full Text Available Astrocytoma cells characteristically possess high invasion potentials. Recent studies have revealed that knockdown of signal transducers and activators of transcription 3 (STAT3 expression by RNAi induces apoptosis in astrocytoma cell. Nevertheless, the distinct roles of STAT3 in astrocytoma's invasion and recurrence have not been elucidated. In this study, we silenced STAT3 using Small interfering RNAs in two human glioblastoma multiforme (GBM cell lines (U251 and U87, and investigated the effect on GBM cell adhesion and invasion. Our results demonstrate that disruption of STAT3 inhibits GBM cell's adhesion and invasion. Knockdown of STAT3 significantly increased E-cadherin but decreased N-cadherin, vascular endothelial growth factor, matrix metalloproteinase 2 and matrix metalloproteinase 9. Additionally, expression of pSTAT3(Tyr705 correlates with astrocytoma WHO classification, Karnofsky performance status scale score, tumor recurrence and survival. Furthermore, pSTAT3(Tyr705 is a significant prognostic factor in astrocytoma. In conclusion, STAT3 may affect astrocytoma invasion, expression of pSTAT3(Tyr705 is a significant prognostic factor in tumor recurrence and overall survival in astrocytoma patients. Therefore, STAT3 may provide a potential target for molecular therapy in human astrocytoma, and pSTAT3(Tyr705could be an important biomarker for astrocytoma prognosis.

  3. Persistent low-grade inflammation and regular exercise. (United States)

    Astrom, Maj-Briit; Feigh, Michael; Pedersen, Bente Klarlund


    Persistent low-grade systemic inflammation is a feature of chronic diseases such as cardiovascular disease (CVD), type 2 diabetes and dementia and evidence exists that inflammation is a causal factor in the development of insulin resistance and atherosclerosis. Regular exercise offers protection against all of these diseases and recent evidence suggests that the protective effect of exercise may to some extent be ascribed to an anti-inflammatory effect of regular exercise. Visceral adiposity contributes to systemic inflammation and is independently associated with the occurrence of CVD, type 2 diabetes and dementia. We suggest that the anti-inflammatory effects of exercise may be mediated via a long-term effect of exercise leading to a reduction in visceral fat mass and/or by induction of anti-inflammatory cytokines with each bout of exercise.

  4. Beneficiation of low-grade diasporic bauxite with hydrocyclone

    Institute of Scientific and Technical Information of China (English)

    GAO Shu-ling; LI Xia-an; WEI De-zhou; FANG Ping; JIA Chun-yun; LIU Wen-gang; HAN Cong


    Low-grade diasporic bauxite was treated with hydrocyclone of small cone-angle. The effects of apex diameter, feed pressure and feed concentration on separation indexes were tested, and then the separation process was discussed by hydrokinetics tentatively. The results show that the increase of apex diameter changes the spacial locality of the envelope of zero vertical velocity, resulting in decrease of the ratio of Al2O3/SiO2 in overflow and increase of the recovery of Al2O3 in underflow, while feed pressure and feed concentration have no remarkable effect on the spacial locality of the envelope of zero vertical velocity, however, the separation indexes are improved by the increase of feed pressure, but are worsened by the increase of feed concentration.

  5. Persistent low-grade inflammation and regular exercise

    DEFF Research Database (Denmark)

    Åström, Maj-brit; Feigh, Michael; Pedersen, Bente Klarlund


    Persistent low-grade systemic inflammation is a feature of chronic diseases such as cardiovascular disease (CVD), type 2 diabetes and dementia and evidence exists that inflammation is a causal factor in the development of insulin resistance and atherosclerosis. Regular exercise offers protection...... against all of these diseases and recent evidence suggests that the protective effect of exercise may to some extent be ascribed to an anti-inflammatory effect of regular exercise. Visceral adiposity contributes to systemic inflammation and is independently associated with the occurrence of CVD, type 2...... diabetes and dementia. We suggest that the anti-inflammatory effects of exercise may be mediated via a long-term effect of exercise leading to a reduction in visceral fat mass and/or by induction of anti-inflammatory cytokines with each bout of exercise....

  6. Optimal management of biopsy-proven low-grade gastricdysplasia

    Institute of Scientific and Technical Information of China (English)

    Jung-Wook Kim; Jae Young Jang


    Gastric adenocarcinoma generally culminates via theinflammation-metaplasia-dysplasia-carcinoma sequenceprogression. The prevalence of gastric adenomasshows marked geographic variation. Recently, therate of diagnosis of low-grade dysplasia (LGD) hasincreased due to increased use of upper endoscopy.Many investigators have reported that gastric highgradedysplasia has high potential for malignancy andshould be removed; however, the treatment for gastricLGD remains controversial. Although the risk of LGDprogression to invasive carcinoma has been reported tobe inconsistent, progression has been observed duringfollow-up. Additionally, the rate of upgraded diagnosisin biopsy-proven LGD is high. Therefore, endoscopicresection (ER) may be useful in the treatment anddiagnosis of LGD, especially if lesions are found to haverisk factors for upgraded histology after ER, such aslarge size, surface erythema or depressed morphology.Fatal complications in endoscopic submucosal dissection(ESD) are extremely low and its therapeutic and diagnosticoutcomes are excellent. Therefore, ESD shouldbe applied preferentially instead of endoscopic mucosalresection.

  7. Flotation studies on low grade graphite ore from eastern India

    Institute of Scientific and Technical Information of China (English)

    Vasumathi N.; Vijaya Kumar T.V.; Ratchambigai S.; Subba Rao S.; Bhaskar Raju G


    A low grade graphite ore from eastern India was beneficiated by flotation to improve its quality. The ore was composed of 87.80%ash and 8.59%fixed carbon. Primary coarse wet grinding (d80:186 lm) followed by rougher flotation in Denver flotation cell using diesel as collector and pine oil as frother yielded a rougher concentrate. Regrinding (d80:144 lm) of this rougher concentrate was opted for further libera-tion of graphite. It was followed by cleaning in laboratory flotation column. This combined process of relatively coarse primary grinding followed by regrinding and cleaning in flotation column resulted in final concentrate of 7.44% yield with 89.65% fixed carbon and 6.00% ash. This approach of two-stage grinding to recover the flake graphite at the coarsest possible grind can help to minimize grinding energy costs. A conceptual flow sheet which is cost effective was developed based on this methodology.

  8. Development of low grade waste heat thermoelectric power generator

    Directory of Open Access Journals (Sweden)

    Suvit Punnachaiya


    Full Text Available This research aimed to develop a 50 watt thermoelectric power generator using low grade waste heat as a heat source,in order to recover and utilize the excess heat in cooling systems of industrial processes and high activity radioisotope sources. Electricity generation was based on the reverse operation of a thermoelectric cooling (TEC device. The TEC devices weremodified and assembled into a set of thermal cell modules operating at a temperature less than 100°C. The developed powergenerator consisted of 4 modules, each generating 15 watts. Two cascade modules were connected in parallel. Each modulecomprised of 96 TEC devices, which were connected in series. The hot side of each module was mounted on an aluminumheat transfer pipe with dimensions 12.212.250 cm. Heat sinks were installed on the cold side with cooling fans to provideforced air cooling.To test electricity generation in the experiment, water steam was used as a heat source instead of low grade waste heat.The open-circuit direct current (DC of 250 V and the short-circuit current of 1.2 A was achieved with the following operatingconditions: a hot side temperature of 96°C and a temperature difference between the hot and cold sides of 25°C. The DC poweroutput was inverted to an AC power source of 220 V with 50 Hz frequency, which can continuously supply more than 50 wattsof power to a resistive load as long as the heat source was applied to the system. The system achieved an electrical conversionefficiency of about 0.47 percent with the capital cost of 70 US$/W.

  9. Low grade epithelial stromal tumour of the seminal vesicle

    Directory of Open Access Journals (Sweden)

    Pozzoli Gianluigi


    Full Text Available Abstract Background The mixed epithelial stromal tumour is morphologically characterised by a mixture of solid and cystic areas consisting of a biphasic proliferation of glands admixed with solid areas of spindle cells with variable cellularity and growth patterns. In previous reports the seminal vesicle cystoadenoma was either considered a synonym of or misdiagnosed as mixed epithelial stromal tumour. The recent World Health Organisation Classification of Tumours considered the two lesions as two distinct neoplasms. This work is aimed to present the low-grade epithelial stromal tumour case and the review of the literature to the extent of establishing the true frequency of the neoplasm. Case presentation We describe a low-grade epithelial stromal tumour of the seminal vesicle in a 50-year-old man. Computed tomography showed a 9 × 4.5 cm pelvic mass in the side of the seminal vesicle displacing the prostate and the urinary bladder. Magnetic resonance was able to define tissue planes between the lesion and the adjacent structures and provided useful information for an accurate conservative laparotomic surgical approach. The histology revealed biphasic proliferation of benign glands admixed with stromal cellularity, with focal atypia. After 26 months after the excision the patient is still alive with no evidence of disease. Conclusion Cystoadenoma and mixed epithelial stromal tumour of seminal vesicle are two distinct pathological entities with different histological features and clinical outcome. Due to the unavailability of accurate prognostic parameters, the prediction of the potential biological evolution of mixed epithelial stromal tumour is still difficult. In our case magnetic resonance imaging was able to avoid an exploratory laparotomy and to establish an accurate conservative surgical treatment of the tumour.

  10. Intramedullary foot fixation for midfoot Charcot neuroarthropathy. (United States)

    Lamm, Bradley M; Siddiqui, Noman A; Nair, Ajitha K; LaPorta, Guido


    Midfoot Charcot collapse commonly occurs through the tarsometatarsal and/or midtarsal joints, which creates the characteristic "rocker bottom" deformity. Intramedullary metatarsal fixation spanning the tarsus into the talus and/or calcaneus is a recently developed method for addressing unstable midfoot Charcot deformity. The intramedullary foot fixation technique has various advantages when addressing midfoot Charcot deformity in the neuropathic patient. These advantages include anatomical realignment, minimally invasive fixation technique, formal multiple joint fusion, adjacent joint fixation beyond the level of Charcot collapse, rigid interosseus fixation, and preservation of foot length. The goals of the intramedullary foot fixation procedure are to create a stable, plantigrade, and ulcer-free foot, which allows the patient to ambulate with custom-molded orthotics and shoes.

  11. Intramedullary bronchogenic cyst of the conus medullaris. (United States)

    Yilmaz, Cem; Gulsen, Salih; Sonmez, Erkin; Ozger, Ozkan; Unlukaplan, Muge; Caner, Hakan


    Spinal bronchogenic cysts are rare congenital lesions. The authors describe their experience in the treatment of a 17-year-old boy who presented with back pain and paresthesia in both lower extremities. Lumbar MR imaging revealed the presence of an intramedullary cystic lesion at the conus medullaris and histopathological analysis revealed a bronchogenic cyst. To the best of the authors' knowledge, this is the first report of an intramedullary spinal bronchogenic cyst arising at the conus; all previously reported spinal bronchogenic cysts were either intradural extramedullary or not located at the conus.

  12. Idiopathic thrombocytopenic purpura associated with an astrocytoma (United States)

    Samuelson, Clare; Forman, Kate M; Smith, Stuart


    We present the case of an 8-year-old girl with chronic idiopathic thrombocytopenic purpura (ITP) and a short history suggestive of raised intracranial pressure. Urgent computed tomography scan of the head showed a large bleed into a left cerebellar lesion. She underwent treatment with intravenous immunoglobulin (IVIg) and steroids to increase her platelet count, followed by excision of the lesion, which was found to be a benign pilocytic astrocytoma. The patient made a complete recovery and shortly afterwards underwent splenectomy, following which there was complete resolution of her thrombocytopenia. PMID:22419950


    Slavc, I.; Chocholous, M.; Woehrer, A.; Heumesser, R.; Azizi, A.; Haberler, C.; Peyrl, A.; Dorfer, C.; Dieckmann, K.; Czech, T.


    Low grade gliomas (LGG) comprise a spectrum of different tumor entities corresponding to WHO grade I and II, including pilocytic astrocytoma, diffuse glioma and glioneuronal tumors. LGG in children differ in histologic distribution, molecular profile, localisation in the CNS and outcome from LGGs in adults. We report on a series of patients treated at a single center over 20 years. PATIENTS: Between 1993 and 2012, 339 consecutive patients with a median age of 8 years (range 4 months - 18 years, p25 = 3.7 years, p75 = 13.4 years) were treated at the Medical University of Vienna. 19.5% of the patients were <3 years of age at diagnosis. Gender distribution was equal. Tumors were associated with syndromes in 84 of the patients (NF1: n = 64, TSC: n = 17, and other: n = 3). Localisation was supratentorial midline in 112, cerebral hemispheres in 105, posterior fossa in 86, ventricular system in 27 and spinal in 9 patients. 66 patients with a median age of 4.4 years had optic pathway gliomas. RESULTS: Gross total resection was performed in 109, subtotal resection in 49, partial resection in 57, and biopsy in 22 patients. 83 patients had no surgery (patients with NF1, TSC, tectal glioma or tumors confined to the optic nerves and chiasm), and in the remaining the degree of resection was not evaluable. 37 patients had 2 tumor surgeries, 14 three, 5 four and one had 5 tumor surgeries during their course of disease. Histology was pilocytic astrocytoma in 122, pilomyxoid astrocytoma in 10, diffuse astrocytoma in 42, ganglioglioma in 30, subependymal giant cell astrocytoma in 17, oligoastrocytoma in 11, and other rarer histologies in the remaining patients. Twelve patients (3.5%) died and 84 patients (24.8%) had at least one event. After a median follow-up of 107 months (14-300) the 1-year overall survival (OS) was 100%, the 10-year OS 96.1 ± 1.2%, and the 20-year OS 95.3 ± 1.4%. Event-free survival (EFS) after 1 year was 92.9 ± 1.4%, after 10 years 73.8 ± 2.6% and after 20

  14. MR Imaging in intramedullary cysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Parmar, H.; Patwardhan, V.; Patankar, T.; Prasad, S. [Dept. of Radiology, King Edward VII Memorial Hospital, Parel, Mumbai (India); Shah, J.; Patkar, D. [Dept. of Radiology, Dr. Balabhai Nanavati Hospital and Research Center, Mumbai (India); Castillo, M. [Dept. of Neuroradiology, Univ. of North Carolina (United States)


    Although intramedullary spinal cord cysticercosis (IMC) is uncommon, its presence is being increasingly recognised by magnetic resonance imaging. We studied six patients from an endemic region and present the MRI features and clinical correlation of IMC. Six patients who presented with para- or quadriplegia were studied by contrast enhanced spinal MRI. Prompted by the spinal lesions, all patients underwent brain MRI. Clinical data and laboratory studies were reviewed in all patients. Definite diagnosis was established in the form of response to drug therapy (n=4) and histopathology (n=2). Follow-up MRI studies of spine and brain were obtained in four patients 2 months after they started medical treatment, regardless of surgery. Five patients showed fusiform and focal enlargement of the spinal cord (cervical 2, thoracic 3). Well-defined cysts with a slightly hyperintense mural nodule were identified in five patients in T1-weighted images (T1WI). All cysts were hyperintense on T2WI and merged with the surrounding oedema. Oedema extended one to three vertebral levels above or below the cyst. Post-contrast T1WI showed well-defined, ring enhancing lesions with smooth walls in all patients. Symptoms in all patients correlated with the level of the lesions. Brain studies demonstrated lesions in just two patients. Histopathological confirmation was obtained in two patients. Follow-up spinal MRI was normal in two patients, following 2 months of treatment while residual and smaller lesions were seen in two patients. Two patients were asymptomatic and denied follow-up MRI. MRI of spinal cysticercosis were typical of and similar to those seen in cerebral lesions in our patients and corresponded to the level of symptoms. All cysts were surrounded by oedema. Two of four patients showed residual lesions after 2 months of therapy and 33% of patients showed concomitant intracranial lesions. (orig.)

  15. Outcomes of Multidisciplinary Management in Pediatric Low-Grade Gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kevin S., E-mail: [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI (United States); Hung, Jonathan [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI (United States); Robertson, Patricia L. [Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI (United States); Department of Neurology, University of Michigan Health System, Ann Arbor, MI (United States); Garton, Hugh J.; Muraszko, Karin M. [Department of Neurosurgery, University of Michigan Health System, Ann Arbor, MI (United States); Sandler, Howard M. [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI (United States); Hamstra, Daniel A. [Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI (United States)


    Purpose: To evaluate the outcomes in pediatric low-grade gliomas managed in a multidisciplinary setting. Methods and Materials: We conducted a single-institution retrospective study of 181 children with Grade I-II gliomas. Log-rank and stepwise Cox proportional hazards models were used to analyze freedom from progression (FFP) and overall survival (OS). Results: Median follow-up was 6.4 years. Thirty-four (19%) of patients had neurofibromatosis Type 1 (NF1) and because of their favorable prognosis were evaluated separately. In the 147 (81%) of patients without NF1, actuarial 7-year FFP and OS were 67 {+-} 4% (standard error) and 94 {+-} 2%, respectively. In this population, tumor location in the optic pathway/hypothalamus was associated with worse FFP (39% vs. 76%, p < 0.0003), but there was no difference in OS. Age {<=}5 years was associated with worse FFP (52% vs. 75%, p < 0.02) but improved OS (97% vs. 92%, p < 0.05). In those with tissue diagnosis, gross total resection (GTR) was associated with improved 7-year FFP (81% vs. 56%, p < 0.02) and OS (100% vs. 90%, p < 0.03). In a multivariate model, only location in the optic pathway/hypothalamus predicted worse FFP (p < 0.01). Fifty patients received radiation therapy (RT). For those with less than GTR, adjuvant RT improved FFP (89% vs. 49%, p < 0.003) but not OS. There was no difference in OS between patient groups given RT as adjuvant vs. salvage therapy. In NF1 patients, 94% of tumors were located in the optic pathway/hypothalamus. With a conservative treatment strategy in this population, actuarial 7-year FFP and OS were 73 {+-} 9% and 100%, respectively. Conclusions: Low-grade gliomas in children {<=}5 years old with tumors in the optic pathway/hypothalamus are more likely to progress, but this does not confer worse OS because of the success of salvage therapy. When GTR is not achieved, adjuvant RT improves FFP but not OS. Routine adjuvant RT can be avoided and instead reserved as salvage.

  16. Second Surgery in Insular Low-Grade Gliomas

    Directory of Open Access Journals (Sweden)

    Tamara Ius


    Full Text Available Background. Given the technical difficulties, a limited number of works have been published on insular gliomas surgery and risk factors for tumor recurrence (TR are poorly documented. Objective. The aim of the study was to determine TR in adult patients with initial diagnosis of insular Low-Grade Gliomas (LGGs that subsequently underwent second surgery. Methods. A consecutive series of 53 patients with insular LGGs was retrospectively reviewed; 23 patients had two operations for TR. Results. At the time of second surgery, almost half of the patients had experienced progression into high-grade gliomas (HGGs. Univariate analysis showed that TR is influenced by the following: extent of resection (EOR (P<0.002, ΔVT2T1 value (P<0.001, histological diagnosis of oligodendroglioma (P=0.017, and mutation of IDH1 (P=0.022. The multivariate analysis showed that EOR at first surgery was the independent predictor for TR (P<0.001. Conclusions. In patients with insular LGG the EOR at first surgery represents the major predictive factor for TR. At time of TR, more than 50% of cases had progressed in HGG, raising the question of the oncological management after the first surgery.

  17. Recovery of nickel from low grade laterite by electrochemical leaching

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung-Gyu; Lee, Hwa-Young; Oh, Jong-Kee [Korea Institute of Science and Technology, Seoul (Korea)


    A study on the recovery of nickel from low-grade laterite is carried out by the electrochemical leaching. The results show that the leaching reaction of Ni and Fe increases with time until 60 minutes, after which the leaching rate decreases. The leaching efficiencies of Ni and Fe are 73% and 64% at 2 hr. reaction, respectively. And current density plays an important role in the leaching rate of nickel, but power consumption increases with increase of current density which proportionally corresponds to nickel leaching. Also, the leaching efficiency of nickel appears to decrease in a small amount with increasing solid density. However, so as to reduce power consumption solid density has to be raised so long as the stirring intensity is not restricted due to heavy load. When the pH of the leaching solution is increased to 6.0, iron and nickel are remaining about 10% and 90% of initial concentrations in the leaching solution, respectively. (author). 11 refs., 2 tabs., 10 figs.

  18. Advances in the management of low-grade gliomas. (United States)

    Nageswara Rao, Amulya A; Packer, Roger J


    Low-grade gliomas (LGGs) represent the most common childhood brain tumors and are a histologically heterogenous group of tumors. Most LGGs are surgically resectable with excellent 10-year overall survival outcomes of more than 90 % with surgery alone. Tumors not amenable to surgical resection and those with an aggressive biology are more challenging to treat. Conventional radiotherapy is a more efficacious method of long-term tumor control than chemotherapy. However, radiation is associated with significant cognitive, endocrine, and cerebrovascular late effects, making chemotherapy an often-preferred modality over radiotherapy, especially in younger children. Multiple chemotherapy regimens have been evaluated over the past few decades with comparable survival outcomes and differing toxicity profiles. Newer regimens containing antiangiogenic agents also show promise. Recent molecular studies have implicated the BRAF oncogene, a key regulator of the MAPK pathway, and the AKT/mTOR pathway in pediatric LGG tumorigenesis. This has opened up promising new avenues for targeted therapy, with many agents currently under investigation.

  19. Identification of transcriptional regulatory networks specific to pilocytic astrocytoma

    Directory of Open Access Journals (Sweden)

    Gutmann David H


    Full Text Available Abstract Background Pilocytic Astrocytomas (PAs are common low-grade central nervous system malignancies for which few recurrent and specific genetic alterations have been identified. In an effort to better understand the molecular biology underlying the pathogenesis of these pediatric brain tumors, we performed higher-order transcriptional network analysis of a large gene expression dataset to identify gene regulatory pathways that are specific to this tumor type, relative to other, more aggressive glial or histologically distinct brain tumours. Methods RNA derived from frozen human PA tumours was subjected to microarray-based gene expression profiling, using Affymetrix U133Plus2 GeneChip microarrays. This data set was compared to similar data sets previously generated from non-malignant human brain tissue and other brain tumour types, after appropriate normalization. Results In this study, we examined gene expression in 66 PA tumors compared to 15 non-malignant cortical brain tissues, and identified 792 genes that demonstrated consistent differential expression between independent sets of PA and non-malignant specimens. From this entire 792 gene set, we used the previously described PAP tool to assemble a core transcriptional regulatory network composed of 6 transcription factor genes (TFs and 24 target genes, for a total of 55 interactions. A similar analysis of oligodendroglioma and glioblastoma multiforme (GBM gene expression data sets identified distinct, but overlapping, networks. Most importantly, comparison of each of the brain tumor type-specific networks revealed a network unique to PA that included repressed expression of ONECUT2, a gene frequently methylated in other tumor types, and 13 other uniquely predicted TF-gene interactions. Conclusions These results suggest specific transcriptional pathways that may operate to create the unique molecular phenotype of PA and thus opportunities for corresponding targeted therapeutic

  20. Prophylactic intramedullary nailing in monostotic fibrous dysplasia. (United States)

    Demiralp, Bahtiyar; Ozturk, Cagatay; Ozturan, Kutay; Sanisoglu, Yavuz S; Cicek, Ilker E; Erler, Kaan


    Fibrous dysplasia of bone is an enigma with no known cure. Treatment currently consists of curettage and bone-grafting in an attempt to eradicate the lesion and to prevent progressive deformity. This study presents the results of prophylactic intramedullary nailing in 10 patients with monostotic fibrous dysplasia, pain increasing with movement, and scintigraphically established activity. Ten patients with monostotic fibrous dysplasia in their upper or lower extremities treated between 2001 and 2003 were included in the study. Seven patients were male and 3 were female; their mean age was 26.9 years. The mean duration of follow-up was 33.5 months. Closed intramedullary nail without reaming was used in all cases. Bone grafting was not performed. Patients were allowed full weight bearing on the affected extremities on the second postoperative day. Mean VAS for functional pain was 5.33 +/- 0.65 preoperatively and 2.26 +/- 0.57 at final follow-up (p < 0.05). Radiographs showed no changes in lesion size, and the intramedullary fixation appeared to be stable. Prophylactic intramedullary nailing appeared to be beneficial in monostotic fibrous dysplasia with scintigraphically proven activity and functional pain. It also avoids problems that may occur following pathological fracture.

  1. Low-grade Prehnite-Pumpellyite facies metamorphism in the Bamble sector, SE-Norway


    Velo, Mari Roen


    Low-grade metamorphic minerals have been found within the high-grade terrain in the Bamble sector, SE-Norway. The minerals prehnite and pumpellyite indicative of prehnite-pumpellyite facies conditions have been confirmed around the Kragerø area. The formation of analcime, thomsonite, hydrogarnet, albite and clay minerals is also a part of the low-grade metamorphism. The occurrence of these low-grade minerals is constricted to pseudomorph replacement of earlier mineral phases, hydrothermal vei...

  2. Sexuality after surgery for diffuse low-grade glioma (United States)

    Surbeck, Werner; Herbet, Guillaume; Duffau, Hugues


    Background Although neurological and neurocognitive outcomes have previously been studied after resection of diffuse low-grade glioma (DLGG), the impact of surgery on sexual life has not been investigated. Our aim was to assess whether DLGG surgery could have consequences on sexual experience. Methods Anonymous standardized questionnaires concerning sexual functioning, including the Arizona Sexual Experiences Scale (ASEX) and a subjective statement, were completed by 32 patients who underwent surgery for DLGG. All patients returned to a normal social and professional life following resection, with neither neurological deficits nor depression. No radiotherapy was administered, and patients who received chemotherapy were without treatment for at least 1 year. Results Seventeen patients (53%) reported a postoperative sexual change, with subjective deterioration in 15 (88%) and improvement in 2 (12%). Sexual dysfunction according to ASEX affected 9 of 15 women (60%) and 5 of 17 men (29%). Right-sided resections were associated with more difficulties in reaching orgasm than left-sided resections (P < .02). Men with temporal lobe resection displayed more reduction in sexual drive (P < .003) and sexual arousal (P < .004) than women, resulting in significant higher overall ASEX scores for temporal lobe resections in men (P = .01). Men remaining on antiepileptic drugs who underwent right-sided resection displayed higher overall ASEX scores than women (P = .031). Conclusions This first evaluation of sexual life after surgery for DLGG suggests that sexual dysfunction is common in this population. Therefore, we suggest that sexual health should consistently be addressed during routine pre- and postoperative examination of patients with DLGG. PMID:25699682

  3. Gut microbiota, low-grade inflammation, and metabolic syndrome. (United States)

    Chassaing, Benoit; Gewirtz, Andrew T


    The intestinal tract is inhabited by a large diverse community of bacteria collectively referred to as the gut microbiota. Alterations in gut microbiota composition are associated with a variety of disease states including obesity, diabetes, and inflammatory bowel disease (IBD). Transplant of microbiota from diseased persons (or mice) to germfree mice transfers some aspects of disease phenotype, indicating that altered microbiota plays a role in disease establishment and manifestation. There are myriad potential mechanisms by which alterations in gut microbiota might promote disease, including increasing energy harvest, production of toxic metabolites, and molecular mimicry of host proteins. However, our research indicates that an overarching mechanism by which an aberrant microbiota negatively impacts health is by driving chronic inflammation. More specifically, we hypothesize that the histopathologically evident gut inflammation that defines IBD is a severe but relatively rare outcome of an altered host-microbiota relationship, while a much more common consequence of such disturbances is "low-grade" inflammation characterized by elevated proinflammatory gene expression that associates with, and may promote, metabolic syndrome. In this context, a variety of chronic inflammatory diseases may stem from inability of the mucosal immune system to properly manage a stable healthy relationship with the gut microbiota. While one's ability to manage their gut microbiota is dictated in part by genetics, it can be markedly influenced by the composition of the microbiota one inherits from their early environment. Moreover, the host-microbiota relationship can be perturbed by instigator bacteria or dietary components, which may prove to play a role in promoting chronic inflammatory disease states.

  4. Dramatic regression of presumed acquired retinal astrocytoma with photodynamic therapy

    Directory of Open Access Journals (Sweden)

    Samuray Tuncer


    Full Text Available Photodynamic therapy (PDT has been used for treatment of various intraocular tumors including choroidal hemangioma, vasoproliferative tumor, amelanotic choroidal melanoma and choroidal neovascular membrane due to choroidal osteoma. This case report documents the effect of PDT for a presumed acquired retinal astrocytoma. A 42-year-old female with a juxtapapillary acquired astrocytoma was treated with a single session of PDT using standard parameters. The tumor showed dramatic regression over 6 months into a fibrotic scar. It remained regressed and stable with 20/20 vision after 51 months of follow-up. We believe that PDT can be used as a primary treatment for acquired retinal astrocytoma.

  5. Suprasellar pilocytic astrocytoma in an adult with hemorrhage and leptomeningeal dissemination: case report and review of literature. (United States)

    Soliman, Radwa K; Budai, Caterina; Mundada, Pravin; Aljohani, Bakar; Rushing, Elisabeth J; Kollias, Spyros S


    Pilocytic astrocytoma (PA) is a low-grade tumor. It has an excellent prognosis after total resection. Leptomeningeal dissemination and hemorrhage are very rare to be associated with PA and lead to unfavorable prognosis. A 35-year-old man was diagnosed with a hemorrhagic suprasellar PA in 2006. Subsequent examination in 2007 revealed another large subdural hemorrhagic lesion in the sacral region, which proved to be PA by histopathologic assessment. Other leptomeningeal foci were discovered mainly at the craniocervical junction. The patient underwent subtotal resection and received chemotherapy with disease control for 7 years. Progression of the disseminated disease has recently occurred; however, the patient is still alive with stable disease after radiotherapy. The radiological features, management, and relevant literature are also presented. Our report heightens the awareness of PA in the adult population and the importance of close surveillance for the leptomeningeal spread, especially for sellar region tumors.

  6. Chromosomal patterns in human malignant astrocytomas. (United States)

    Rey, J A; Bello, M J; de Campos, J M; Kusak, M E; Ramos, C; Benitez, J


    Cytogenetic analysis by direct and/or in vitro preparations was performed on 34 malignant astrocytomas. Thirty tumors showed near-diploid chromosome numbers, whereas, tritetraploid chromosome complements were present in four tumors. The most frequent chromosomal changes implied numerical deviations by a gain of chromosomes #7, #19, and #20, and by losses of #10, #22, and Y. Structural rearrangements were present in stem- or side lines of 24 tumors. Although no common chromosomal rearrangement seems to exist among those tumors, chromosomes #1, #6, #7, and #9 were predominantly involved. Polysomy and structural rearrangements of chromosome #7 could be related to the overexpression of epidermal growth factor gene, previously observed in some malignant gliomas.

  7. Pilomyxoid Astrocytoma Occurring in the Third Ventricle

    Directory of Open Access Journals (Sweden)

    Sanghyeon Kim


    Full Text Available Pilomyxoid astrocytoma (PMA is a rare central nervous system tumor that has been included in the 2007 World Health Organization Classification of Tumors of the Central Nervous System. Due to its more aggressive behavior, PMA is classified as Grade II neoplasm by the World Health Organization. PMA predominantly affects the hypothalamic/chiasmatic region and occurs in children (mean age of occurrence = 10 months. We report a case of a 24-year-old man who presented with headache, nausea, and vomiting. Brain CT and MRI revealed a mass occupying only the third ventricle. We performed partial resection. Histological findings, including monophasic growth with a myxoid background, and absence of Rosenthal fibers or eosinophilic granular bodies, as well as the strong positivity for glial fibrillary acidic protein were consistent with PMA.

  8. Malignant transformation of low grade gliomas into glioblastoma a series of 10 cases and review of the literature

    Directory of Open Access Journals (Sweden)

    D. Rotariu1, S. Gaivas1, Z. Faiyad1, D. Haba2, B. Iliescu1, I. Poeata1


    Full Text Available Background: Diffuse infiltrative low-gradegliomas (LGG of the cerebral hemispheresin the adult are tumors with distinctclinical, histological and molecularcharacteristics. WHO (World HealthOrganization classification recognizesgrade II astrocytomas, oligodendrogliomasand oligoastrocytomas. Conventional MRIis used for differential diagnosis, guidingsurgery, planning radiotherapy andmonitoring treatment response.Advanced imaging techniques areincreasing the diagnostic accuracy. Lowgradegliomas have been documented toundergo transformation into high-gradegliomas, and the time interval of thistransformation has been reported togenerally occur within 5 years in about 50%of patients diagnosed with low-gradegliomas.Methods: We have reviewed all adultpatients operated on for hemisphericglioblastoma at N Oblu Hospital in Iasibetween 2006 and 2009 and in particularthose patients with secondary glioblastoma.Results: from the total 110 cases ofglioblastoma, ten of them were secondaryto malignant transformation of anpreviously operated low grade glioma. Ofthe 10 patients with secondaryglioblastoma, the initial histology was: gr IIastocytoma in 6 cases, oligoastocytoma in 2cases and in oligodendroglioma in 2 cases.The mean patient age was 46.1± 0.9 yearsand the most frequent symptom wasrepresented by seizures 70%, the mean timefrom the first symptom to diagnosis was11,2 months. 40% of the cases had subtotalresection and 60% had total resection(defined by the surgeon at the time ofoperation. 5 patients received radiotherapypostoperatively, 2 received both radio andchemotherapy and 3 had no adjuvanttreatment. In our series the median time tomalignant transformation was 32,5 months.Conclusions: Younger age, normalneurological examination andoligodendroglial histology are favorableprognostic factors, total/near total resectioncan improve seizure control, progressionfreeand overall survival, mean whilereducing the risk of malignanttransformation. Early post

  9. Semiautomatic segmentation and follow-up of multicomponent low-grade tumors in longitudinal brain MRI studies

    Energy Technology Data Exchange (ETDEWEB)

    Weizman, Lior, E-mail: [School of Engineering and Computer Science, The Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Sira, Liat Ben [Department of Radiology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv 64239 (Israel); Joskowicz, Leo [School of Engineering and Computer Science and The Edmond and Lily Safra Center for Brain Sciences (ELSC), The Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Rubin, Daniel L.; Yeom, Kristen W. [Department of Radiology, Stanford University, Stanford, California 94305 (United States); Constantini, Shlomi; Shofty, Ben [Tel Aviv Medical Center, Dana Children' s Hospital, Tel Aviv University, Tel Aviv 64239 (Israel); Bashat, Dafna Ben [Tel Aviv Medical Center, Functional Brain Center, Tel Aviv University, Tel Aviv 64239 (Israel)


    Purpose: Tracking the progression of low grade tumors (LGTs) is a challenging task, due to their slow growth rate and associated complex internal tumor components, such as heterogeneous enhancement, hemorrhage, and cysts. In this paper, the authors show a semiautomatic method to reliably track the volume of LGTs and the evolution of their internal components in longitudinal MRI scans. Methods: The authors' method utilizes a spatiotemporal evolution modeling of the tumor and its internal components. Tumor components gray level parameters are estimated from the follow-up scan itself, obviating temporal normalization of gray levels. The tumor delineation procedure effectively incorporates internal classification of the baseline scan in the time-series as prior data to segment and classify a series of follow-up scans. The authors applied their method to 40 MRI scans of ten patients, acquired at two different institutions. Two types of LGTs were included: Optic pathway gliomas and thalamic astrocytomas. For each scan, a “gold standard” was obtained manually by experienced radiologists. The method is evaluated versus the gold standard with three measures: gross total volume error, total surface distance, and reliability of tracking tumor components evolution. Results: Compared to the gold standard the authors' method exhibits a mean Dice similarity volumetric measure of 86.58% and a mean surface distance error of 0.25 mm. In terms of its reliability in tracking the evolution of the internal components, the method exhibits strong positive correlation with the gold standard. Conclusions: The authors' method provides accurate and repeatable delineation of the tumor and its internal components, which is essential for therapy assessment of LGTs. Reliable tracking of internal tumor components over time is novel and potentially will be useful to streamline and improve follow-up of brain tumors, with indolent growth and behavior.

  10. Cumulative irritancy in the guinea pig from low grade irritant vehicles and the angry skin syndrome

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner; Maibach, H I


    A 4-week open cumulative irritancy test in guinea pigs discriminated between two low grade irritant vehicles, nonionic base (anhydrous) and hydrophilic ointment. The procedure might be useful as a predictive test for low grade irritants. The angry skin syndrome was established in the guinea pigs...

  11. DNA methylation signatures of chronic low-grade inflammation are associated with complex diseases

    NARCIS (Netherlands)

    S. Ligthart (Symen); Marzi, C. (Carola); Aslibekyan, S. (Stella); Mendelson, M.M. (Michael M.); K.N. Conneely (Karen N.); T. Tanaka (Toshiko); Colicino, E. (Elena); L. Waite (Lindsay); R. Joehanes (Roby); W. Guan (Weihua); J. Brody (Jennifer); C.E. Elks (Cathy); R.E. Marioni (Riccardo); M.A. Jhun (Min A.); Agha, G. (Golareh); J. Bressler (Jan); C.K. Ward-Caviness (Cavin K.); B.H. Chen (Brian); T. Huan (Tianxiao); K.M. Bakulski (Kelly M.); E. Salfati (Elias); Fiorito, G. (Giovanni); S. Wahl (Simone); K. Schramm (Katharina); Sha, J. (Jin); D.G. Hernandez (Dena); Just, A.C. (Allan C.); J.A. Smith (Jennifer A); N. Sotoodehnia (Nona); L.C. Pilling (Luke); J.S. Pankow (James); Tsao, P.S. (Phil S.); Liu, C. (Chunyu); W. Zhao (Wei); S. Guarrera (Simonetta); Michopoulos, V.J. (Vasiliki J.); Smith, A.K. (Alicia K.); M.J. Peters (Marjolein); D. Melzer (David); Vokonas, P. (Pantel); M. Fornage (Myriam); H. Prokisch (Holger); J.C. Bis (Joshua); A.Y. Chu (Audrey); C. Herder (Christian); H. Grallert (Harald); C. Yao (Chen); S. Shah (Sonia); A.F. McRae (Allan F.); H. Lin; S. Horvath (Steve); Fallin, D. (Daniele); A. Hofman (Albert); N.J. Wareham (Nick); K.L. Wiggins (Kerri); A.P. Feinberg (Andrew P.); J.M. Starr (John); P.M. Visscher (Peter); J. Murabito (Joanne); Kardia, S.L.R. (Sharon L.R.); D. Absher (Devin); E.B. Binder (Elisabeth); A. Singleton (Andrew); S. Bandinelli (Stefania); A. Peters (Annette); M. Waldenberger (Melanie); G. Matullo; Schwartz, J.D. (Joel D.); E.W. Demerath (Ellen); A.G. Uitterlinden (André); Meurs, J.B.J. (Joyce B.J.); O.H. Franco (Oscar); Y.D. Chen (Y.); D. Levy (Daniel); S.T. Turner (Stephen); I.J. Deary (Ian J.); K.J. Ressler (Kerry); J. Dupuis (Josée); L. Ferrucci (Luigi); Ong, K.K. (Ken K.); T.L. Assimes (Themistocles); E.A. Boerwinkle (Eric); W. Koenig (Wolfgang); D.K. Arnett (Donna); A.A. Baccarelli (Andrea A.); E.J. Benjamin (Emelia); A. Dehghan (Abbas)


    textabstractBackground: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for infl

  12. Allergic sensitization at school age is a systemic low-grade inflammatory disorder

    DEFF Research Database (Denmark)

    Chawes, B. L. K.; Stokholm, J.; Malby-Schoos, A.-M.;


    Systemic low-grade inflammation has been demonstrated in a range of the frequent noncommunicable diseases (NCDs) as a possible shared mechanism, but is largely unexplored in relation to allergic sensitization. Therefore, we aimed to investigate the possible association between systemic low-grade...

  13. 纯岛叶低级别胶质瘤的显微外科治疗%Microsurgical treatment of purely insular low grade gliomas

    Institute of Scientific and Technical Information of China (English)

    赵建华; 冯继; 裴玉芳; 冯三平; 陈兴河; 江涛


    Objective To investigate microsurgical method and outcome for purely insular low grade gliomas. Methods The clinical data of 17 patients with purely insular low grade glioma, which was located at the left insula in 8 and right insula in 9, were analyzed retrospectively. All the tumors were removed via pterional transsylvian approach. Results Complete removal of the tumor was achieved in 12 patients and subtotal removal in 5. The diagnosis was established by postoperative pathological analysis, including 8 astrocytomas, 4 oligodendrogliomas and 5 oligoastrocytomas. There was no operative mortality. Early postoperative complications such as hemiplegia occurred in 2 patients and aphasia in 2. Seventeen patients were followed up for 6 to 12 months, hemiparesis occurred in 1 patient, mild aphasia in 1 and no tumor recurrence was found. Conclusions Microsurgery via pterional transsylvian approach is a safe and effective means for purely insular low grade gliomas. The good understanding of the insular anatomy is helpful for resection of insular low grade gliomas to the full extent and alleviation of neurological disorders of patients after operation.%目的 探讨纯岛叶低级别胶质瘤的显微手术方法及疗效.方法 回顾性分析17例纯岛叶低级别胶质瘤病人的临床资料.其中肿瘤位于左侧岛叶8例,右侧岛叶9例,均采用翼点外侧裂入路手术切除肿瘤.结果 肿瘤全切除12例,近全切除5例.病理结果:星形细胞瘤8例,少枝胶质细胞瘤4例,少枝星形细胞瘤5例.无手术死亡,术后早期发生偏瘫、失语各2例.随访17例,时间6~12个月,均未见肿瘤复发,轻偏瘫1例,轻度失语1例.结论 应用显微外科技术经翼点外侧裂入路治疗纯岛叶低级别胶质瘤安全、有效.了解岛叶解剖有助于最大程度切除岛叶低级别胶质瘤,减少病人术后神经功能障碍.

  14. Growth-Factor-Driven Rescue to Receptor Tyrosine Kinase (RTK) Inhibitors through Akt and Erk Phosphorylation in Pediatric Low Grade Astrocytoma and Ependymoma

    NARCIS (Netherlands)

    Sie, Mariska; den Dunnen, Wilfred F. A.; Lourens, Harm Jan; Meeuwsen-de Boer, Tiny G. J.; Scherpen, Frank J. G.; Zomerman, Walderik W.; Kampen, Kim R.; Hoving, Eelco W.; de Bont, Eveline S. J. M.


    Up to now, several clinical studies have been started investigating the relevance of receptor tyrosine kinase (RTK) inhibitors upon progression free survival in various pediatric brain tumors. However, single targeted kinase inhibition failed, possibly due to tumor resistance mechanisms. The present

  15. Les astrocytomes de bas-grade: caractérisation moléculaire et implications cliniques / Low-grade astrocytomas: molecular characterization and clinical implications


    Rorive, Sandrine


    La malignité des astrocytomes est établie sur base de critères morphologiques définis au sein de la classification de l’Organisation Mondiale de la Santé (OMS). Ce système de gradation, qui s’échelonne de I à IV, constitue actuellement l’outil pronostique le plus fiable. Par facilité, les cliniciens regroupent les astrocytomes de grade I (astrocytomes pilocytiques) et les astrocytomes diffus de grade II sous le terme d’« Astrocytomes de bas-grade » par opposition aux astrocytomes de haut-grad...

  16. Immunohistochemical expression of chemokine receptor CXCR3 and its ligand CXCL10 in low-grade astrocytomas and glioblastoma multiforme: A tissue microarray-based comparison

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    Ira Sharma


    Conclusion: GBM shows overexpression of CXCR3 and CXCL10 in comparison to DA, indicating that they play an important role in tumor growth and progression. Inhibition of this receptor-ligand axis may be a potential therapeutic target for arresting tumor growth and development of a glioblastoma.

  17. Spinal intramedullary ependymoma: surgical approaches and outcome. (United States)

    Borges, Lawrence F


    Intramedullary Ependymomas are uncommon tumors that can occur within the medullary substance of the spinal cord. Despite this difficult location, they are typically benign tumors that can most often be removed completely with an acceptable surgical risk. Therefore, the recommended management approach is usually surgical excision. This review will consider the historical context in which surgeons began treating these tumors and then review the more recent literature that guides their current management.

  18. Intramedullary tubercular abscess with syrinx formation

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    Mohd Khalid


    Full Text Available Intramedullary spinal cord tubercular abscess with involvement of whole cord is a rare entity that too with syrinx formation following disseminated meningitis. Accurate diagnosis requires a high index of suspicion with clinical history and imaging features for a favorable outcome. Here-in we present a similar case with tubercular etiology which was also associated with syrinx formation and has not been reported previously in the literature up to the author′s knowledge.

  19. Cervical spinal meningioma mimicking intramedullary spinal tumor. (United States)

    Senturk, Senem; Guzel, Aslan; Guzel, Ebru; Bayrak, Aylin Hasanefendioğlu; Sav, Aydin


    Case report. To report a very unusual spinal meningioma, mimicking an intramedullary spinal tumor. Spinal meningiomas, usually associated with signs and symptoms of cord or nerve root compression, are generally encountered in women aged over 40. Radiologic diagnosis is often established by their intradural extramedullary location on magnetic resonance images. A 60-year-old woman had a 6-month history of progressive weakness in her upper extremities, difficulty in walking, and cervical pain radiating through both arms. Neurologic examination revealed motor strength deficiency in all her extremities, with extensor reflexes, clonus, and bilateral hyper-reflexiveness. A sensory deficit was present all over her body. Magnetic resonance images revealed that the spinal cord appeared expanded with an ill-defined, homogeneously contrast-enhanced, lobulated, eccentric mass at the C1-C3 level. The patient was operated with a preliminary diagnosis of an intramedullary tumor. At surgery, the mass was found to be extramedullary, and gross total resection was performed. Histopathological examination revealed a meningioma characterized by the presence of fibrous and meningothelial components. The patient was able to ambulate with a cane, and extremity strength and sensation improved 2 months after surgery. Spinal meningiomas can mimic intramedullary tumors, and should be considered in differential diagnosis of intradural tumors with atypical appearance.

  20. Spinal Intramedullary Metastasis of Breast Cancer

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    Recep Basaran


    Full Text Available Objective. Breast cancer accounts for approximately one-third of all cancers in females. Approximately 8.5 % of all central nervous system metastases are located in the spinal cord. These patients have rapidly progressing neurological deficits and require immediate examination. The aim of surgery is decompression of neural tissue and histological evaluation of the tumor. In this paper, we present a case of breast cancer metastasis in thoracic spinal intramedullary area which had been partially excised and then given adjuvant radiotherapy. Case. A 43-year-old female patient with breast cancer for 8 years was admitted to our hospital with complaints of weakness in both legs. Eight years ago, she received chemotherapy and radiotherapy. On her neurological examination, she had paraparesis (left lower extremity: 2/5, right lower extremity: 3/5 and urinary incontinence. Spinal MRI revealed a gadolinium enhancing intramedullary lesion. Pathologic examination of the lesion was consistent with breast carcinoma metastasis. The patient has been taken into radiotherapy. Conclusion. Spinal intramedullary metastasis of breast cancer is an extremely rare situation, but it has a high morbidity and mortality rate. Microsurgical resection is necessary for preservation or amelioration of neurological state and also for increased life expectancy and quality.

  1. Synchronous Low-grade Appendiceal Mucinous Neoplasm and Primary Peritoneal Low-grade Serous Carcinoma: A First Description of These 2 Neoplasms Presenting Together as Suspected Peritoneal Carcinomatosis. (United States)

    Sekulic, Miroslav; Pichler Sekulic, Simona; Movahedi-Lankarani, Saeid


    Low-grade appendiceal mucinous neoplasm is a neoplasm typically of appendiceal origin, which is characterized by diffuse peritoneal involvement by pools of mucin with mucinous epithelium lacking high-grade cytologic atypia, and clinically presents as suspected peritoneal carcinomatosis. A similar clinical presentation can sometimes be seen with disseminated low-grade serous carcinomas of the peritoneum, fallopian tubes, or ovaries; however, this neoplasm is histologically characterized by tubal-type epithelium and invasive or confluent growth. In this case report, we describe a patient presenting with a clinical examination and radiologic features suggestive of peritoneal carcinomatosis and a prominent pelvic mass; however, after pathologic review, the patient was proven to have peritoneal involvement by both low-grade appendiceal mucinous neoplasm of appendiceal origin and a low-grade peritoneal primary serous carcinoma. In short, we present the first description of low-grade appendiceal mucinous neoplasm and serous carcinoma of the peritoneum presenting synchronously, providing morphologic characterization and immunohistochemical studies supporting the diagnosis, and illustrating a rare instance in which 2 neoplastic processes are underlying clinically suspected peritoneal carcinomatosis.

  2. Ganglioglioma: comparison with other low-grade brain tumors Ganglioglioma: estudo comparativo com outros tumores cerebrais primarios de baixo grau

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    Paulo Thadeu Brainer-Lima


    Full Text Available METHOD: Forty-two patients with low-grade brain tumor and refractory epilepsy were studied. The mean age was 22.3 years. They were divided into two groups: Group A, patients with ganglioglioma (n=19 and group B, patients with other low-grade tumors (n=23 (14 astrocytoma, 6 oligodendroglioma, 2 dysembryoplastic neuroepithelial tumor, and 1 xanthoastrocytoma. RESULTS: Age at seizure’s onset was 7 years or less in 73% of the patients in group A and in 30.4% of the patients in group B (p=0.045. Complex partial occurred frequently in group A and B (94.7% versus 82%, respectively. Seizure’s frequency was higher in group B (p=0.002.Computerized tomography (CT was normal in 36.8% of group A patients and abnormal in all group B patients. Magnetic resonance imaging (MRI was abnormal in all patients. Surgical removal was complete in 89.5% of the patients in group A and in 78.2% of the patients in group B. CONCLUSION: The association of refractory epilepsy and complex partial seizures, at a relatively low frequency, in young patients potentially normal CT and a MRI hypointense temporal lobe lesion in T1-weighed slices were habitual image findings in ganglioglioma, rather than other low-grade tumor.MÉTODO: Foram estudados 42 pacientes com tumor cerebral primário de baixo grau e epilepsia refratária. A idade média foi 22,3 anos. Eles foram divididos em dois grupos: no grupo A os pacientes com ganglioglioma (n=19 e no grupo B os pacientes com outros tumores primários de crescimento lento (n=23 (14 astrocitomas, 6 oligodendrogliomas, 2 tumores desembrioblástico neuroepitelial e um xantoastrocitoma. RESULTADOS: A idade de início das crises convulsivas foi 7 anos ou menos em 73% dos pacientes no grupo A e 30,4% dos pacientes no grupo B (p=0,045. A crise convulsiva do tipo parcial complexa foi a mais identificada nos grupos A e B (94,7% versus 82%, respectivamente. A freqüência de crise foi mais alta no grupo B (p=0,002. A tomografia computadorizada

  3. Genetic alterations in uncommon low-grade neuroepithelial tumors: BRAF, FGFR1, and MYB mutations occur at high frequency and align with morphology. (United States)

    Qaddoumi, Ibrahim; Orisme, Wilda; Wen, Ji; Santiago, Teresa; Gupta, Kirti; Dalton, James D; Tang, Bo; Haupfear, Kelly; Punchihewa, Chandanamali; Easton, John; Mulder, Heather; Boggs, Kristy; Shao, Ying; Rusch, Michael; Becksfort, Jared; Gupta, Pankaj; Wang, Shuoguo; Lee, Ryan P; Brat, Daniel; Peter Collins, V; Dahiya, Sonika; George, David; Konomos, William; Kurian, Kathreena M; McFadden, Kathryn; Serafini, Luciano Neder; Nickols, Hilary; Perry, Arie; Shurtleff, Sheila; Gajjar, Amar; Boop, Fredrick A; Klimo, Paul D; Mardis, Elaine R; Wilson, Richard K; Baker, Suzanne J; Zhang, Jinghui; Wu, Gang; Downing, James R; Tatevossian, Ruth G; Ellison, David W


    Low-grade neuroepithelial tumors (LGNTs) are diverse CNS tumors presenting in children and young adults, often with a history of epilepsy. While the genetic profiles of common LGNTs, such as the pilocytic astrocytoma and 'adult-type' diffuse gliomas, are largely established, those of uncommon LGNTs remain to be defined. In this study, we have used massively parallel sequencing and various targeted molecular genetic approaches to study alterations in 91 LGNTs, mostly from children but including young adult patients. These tumors comprise dysembryoplastic neuroepithelial tumors (DNETs; n = 22), diffuse oligodendroglial tumors (d-OTs; n = 20), diffuse astrocytomas (DAs; n = 17), angiocentric gliomas (n = 15), and gangliogliomas (n = 17). Most LGNTs (84 %) analyzed by whole-genome sequencing (WGS) were characterized by a single driver genetic alteration. Alterations of FGFR1 occurred frequently in LGNTs composed of oligodendrocyte-like cells, being present in 82 % of DNETs and 40 % of d-OTs. In contrast, a MYB-QKI fusion characterized almost all angiocentric gliomas (87 %), and MYB fusion genes were the most common genetic alteration in DAs (41 %). A BRAF:p.V600E mutation was present in 35 % of gangliogliomas and 18 % of DAs. Pathogenic alterations in FGFR1/2/3, BRAF, or MYB/MYBL1 occurred in 78 % of the series. Adult-type d-OTs with an IDH1/2 mutation occurred in four adolescents, the youngest aged 15 years at biopsy. Despite a detailed analysis, novel genetic alterations were limited to two fusion genes, EWSR1-PATZ1 and SLMAP-NTRK2, both in gangliogliomas. Alterations in BRAF, FGFR1, or MYB account for most pathogenic alterations in LGNTs, including pilocytic astrocytomas, and alignment of these genetic alterations and cytologic features across LGNTs has diagnostic implications. Additionally, therapeutic options based upon targeting the effects of these alterations are already in clinical trials.

  4. BRAF Mutation Is Rare in Advanced-Stage Low-Grade Ovarian Serous Carcinomas (United States)

    Wong, Kwong-Kwok; Tsang, Yvonne T.M.; Deavers, Michael T.; Mok, Samuel C.; Zu, Zhifei; Sun, Charlotte; Malpica, Anais; Wolf, Judith K.; Lu, Karen H.; Gershenson, David M.


    Low-grade ovarian serous carcinomas are believed to arise via an adenoma-serous borderline tumor-serous carcinoma sequence. In this study, we found that advanced-stage, low-grade ovarian serous carcinomas both with and without adjacent serous borderline tumor shared similar regions of loss of heterozygosity. We then analyzed 91 ovarian tumor samples for mutations in TP53, BRAF, and KRAS. TP53 mutations were not detected in any serous borderline tumors (n = 30) or low-grade serous carcinomas (n = 43) but were found in 73% of high-grade serous carcinomas (n = 18). BRAF (n = 9) or KRAS (n = 5) mutation was detected in 47% of serous borderline tumors, but among the low-grade serous carcinomas (39 stage III, 2 stage II, and 2 stage I), only one (2%) had a BRAF mutation and eight (19%) had a KRAS mutation. The low frequency of BRAF mutations in advanced-stage, low-grade serous carcinomas, which contrasts with previous findings, suggests that aggressive, low-grade serous carcinomas are more likely derived from serous borderline tumors without BRAF mutation. In addition, advanced-stage, low-grade carcinoma patients with BRAF or KRAS mutation have a better apparent clinical outcome. However, further investigation is needed. PMID:20802181

  5. Metastatic low-grade endometrial stromal sarcoma of clitoris: report of a case. (United States)

    Androulaki, A; Papathomas, T G; Alexandrou, P; Lazaris, A C


    Low-grade endometrial stromal sarcoma (ESS) is an uncommon neoplasm, which has a highly recurrent nature. A review of the literature revealed that only one case of low-grade ESS, arising within the vulva from a focus of endometriosis, has been previously published. We describe an additional case of low-grade ESS arising within the vulva and to the best of our knowledge the first report of low-grade ESS metastasized to clitoris. A 46-year-old woman was admitted to our hospital due to a heavy uterine bleeding. A physical examination revealed a lesion in clitoris, which exhibited a densely cellular mesenchymal neoplasm on microscopy. On the basis of the pathologic features alone, a differential diagnosis of a low-grade ESS and cellular leiomyoma was considered. Seven months later, the patient presented again with excessive uterine bleeding and a total hysterectomy was performed. A tumor of white-tan, whorled appearance was found. Its features were suggestive of low-grade ESS. Taking into account the possible extrauterine location of an ESS and reviewing the first case, a diagnosis of rare low-grade ESS metastasized to clitoris was made.

  6. Characterization of a novel anti-cancer compound for astrocytomas.

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    Sang Y Lee

    Full Text Available The standard chemotherapy for brain tumors is temozolomide (TMZ, however, as many as 50% of brain tumors are reportedly TMZ resistant leaving patients without a chemotherapeutic option. We performed serial screening of TMZ resistant astrocytoma cell lines, and identified compounds that are cytotoxic to these cells. The most cytotoxic compound was an analog of thiobarbituric acid that we refer to as CC-I. There is a dose-dependent cytotoxic effect of CC-I in TMZ resistant astrocytoma cells. Cell death appears to occur via apoptosis. Following CC-I exposure, there was an increase in astrocytoma cells in the S and G2/M phases. In in vivo athymic (nu/nu nude mice subcutaneous and intracranial tumor models, CC-I completely inhibited tumor growth without liver or kidney toxicity. Molecular modeling and enzyme activity assays indicate that CC-I selectively inhibits topoisomerase IIα similar to other drugs in its class, but its cytotoxic effects on astrocytoma cells are stronger than these compounds. The cytotoxic effect of CC-I is stronger in cells expressing unmethylated O6-methylguanine methyltransferase (MGMT but is still toxic to cells with methylated MGMT. CC-I can also enhance the toxic effect of TMZ on astrocytoma when the two compounds are combined. In conclusion, we have identified a compound that is effective against astrocytomas including TMZ resistant astrocytomas in both cell culture and in vivo brain tumor models. The enhanced cytotoxicity of CC-I and the safety profile of this family of drugs could provide an interesting tool for broader evaluation against brain tumors.

  7. Transcriptional analysis of aggressiveness and heterogeneity across grades of astrocytomas.

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    Chunjing Wang

    Full Text Available Astrocytoma is the most common glioma, accounting for half of all primary brain and spinal cord tumors. Late detection and the aggressive nature of high-grade astrocytomas contribute to high mortality rates. Though many studies identify candidate biomarkers using high-throughput transcriptomic profiling to stratify grades and subtypes, few have resulted in clinically actionable results. This shortcoming can be attributed, in part, to pronounced lab effects that reduce signature robustness and varied individual gene expression among patients with the same tumor. We addressed these issues by uniformly preprocessing publicly available transcriptomic data, comprising 306 tumor samples from three astrocytoma grades (Grade 2, 3, and 4 and 30 non-tumor samples (normal brain as control tissues. Utilizing Differential Rank Conservation (DIRAC, a network-based classification approach, we examined the global and individual patterns of network regulation across tumor grades. Additionally, we applied gene-based approaches to identify genes whose expression changed consistently with increasing tumor grade and evaluated their robustness across multiple studies using statistical sampling. Applying DIRAC, we observed a global trend of greater network dysregulation with increasing tumor aggressiveness. Individual networks displaying greater differences in regulation between adjacent grades play well-known roles in calcium/PKC, EGF, and transcription signaling. Interestingly, many of the 90 individual genes found to monotonically increase or decrease with astrocytoma grade are implicated in cancer-affected processes such as calcium signaling, mitochondrial metabolism, and apoptosis. The fact that specific genes monotonically increase or decrease with increasing astrocytoma grade may reflect shared oncogenic mechanisms among phenotypically similar tumors. This work presents statistically significant results that enable better characterization of different human

  8. Treatment outcome of localized Helicobacter pylori-negative low-grade gastric MALT lymphoma

    Institute of Scientific and Technical Information of China (English)

    Hyung; Soon; Park; Yu; Jin; Kim; Woo; Ick; Yang; Chang; Ok; Suh; Yong; Chan; Lee


    AIM: To investigate treatment outcome of Helicobacter pylori (H.pylori )-negative low-grade gastric mucosaassociated lymphoid tissue (MALT) lymphoma.METHODS: In this study,we retrospectively reviewed the clinical outcome and clinicopathologic factors of stage Ⅰ E H.pylori -negative low-grade gastric MALT lymphoma cases from August 1998 to June 2009.RESULTS: A total of eleven patients with H.pylori -negative low-grade gastric MALT lymphoma were enrolled in the study and received anti-H.pylori eradication tre...

  9. Mitotic recombination of chromosome 17 in astrocytomas

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    James, C.D.; Carlbom, E.; Nordenskjold, M.; Collins, V.P.; Cavenee, W.K. (Ludwig Institute for Cancer Research, Montreal (Canada))


    Allelic combinations at seven loci on human chromosome 17 defined by restriction fragment length polymorphisms were determined in tumor and normal tissues from 35 patients with gliomas. Loss of constitutional heterozygosity at one or more of these loci was observed in 8 of the 24 tumors displaying astrocytic differentiation and in the single primitive neuroectodermal tumor examined. The astrocytomas showing these losses included examples of each adult malignancy grade of the disease, including glioblastoma (malignancy grade IV), and seven of them demonstrated concurrent maintenance of heterozygosity for at least one chromosome 17 locus. Determination of allele dosage together with the genotypic data indicated that the tumor chromosomes 17 were derived by mitotic recombination in 7 of the 9 cases with shared homozygosity of the region 17p11.2-ptr in all cases. In contrast, tumors of oligodendrocytic, ependymal, or mixed cellular differentiation did not exhibit loss of alleles at any of the loci examined. These data suggest that the somatic attainment of homozygosity for loci on chromosome 17p is frequently associated with the oncogenesis of central nervous system tumors, particularly those showing solely astrocytic differentiation, and that mitotic recombination mapping is a useful approach towards the subregional localization of a locus whose rearrangement is involved in this disease.

  10. The molecular biology of WHO grade I astrocytomas. (United States)

    Marko, Nicholas F; Weil, Robert J


    World Health Organization (WHO) grade I astrocytomas include pilocytic astrocytoma (PA) and subependymal giant cell astrocytoma (SEGA). As technologies in pharmacologic neo-adjuvant therapy continue to progress and as molecular characteristics are progressively recognized as potential markers of both clinically significant tumor subtypes and response to therapy, interest in the biology of these tumors has surged. An updated review of the current knowledge of the molecular biology of these tumors is needed. We conducted a Medline search to identify published literature discussing the molecular biology of grade I astrocytomas. We then summarized this literature and discuss it in a logical framework through which the complex biology of these tumors can be clearly understood. A comprehensive review of the molecular biology of WHO grade I astrocytomas is presented. The past several years have seen rapid progress in the level of understanding of PA in particular, but the molecular literature regarding both PA and SEGA remains nebulous, ambiguous, and occasionally contradictory. In this review we provide a comprehensive discussion of the current understanding of the chromosomal, genomic, and epigenomic features of both PA and SEGA and provide a logical framework in which these data can be more readily understood.

  11. Laryngeal lymphoma: the high and low grades of rare lymphoma involvement sites. (United States)

    Azzopardi, Charles Paul; Degaetano, James; Betts, Alexandra; Farrugia, Eric; Magri, Claude; Refalo, Nicholas; Gatt, Alexander; Camilleri, David J


    The larynx is an extremely rare site of involvement by lymphomatous disease. We present two cases of isolated laryngeal high-grade and another low-grade lymphoma, together with a literature review of laryngeal lymphoma management.

  12. Synchronized brain activity and neurocognitive function in patients with low-grade glioma : a magnetoencephalography study

    NARCIS (Netherlands)

    Bosma, Ingeborg; Douw, Linda; Bartolomei, Fabrice; Heimans, Jan J.; van Dijk, Bob W.; Postma, Tjeerd J.; Stam, Cornelis J.; Reijneveld, Jaap C.; Klein, Martin


    We investigated the mechanisms underlying neurocognitive dysfunction in patients with low-grade glioma (LGG) by relating functional connectivity revealed by magnetoencephalography to neurocognitive function. We administered a battery of standardized neurocognitive tests measuring six neurocognitive

  13. Low-grade fibromyxoid sarcoma of the transverse colon: A case report

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    I.S. Farrell


    This is only the second reported case of low-grade fibromyxoid sarcoma of the colon and would potentially have been missed had not the sample been sent for second opinion at a regional specialist centre.

  14. Prospects for production of synthetic liquid fuel from low-grade coal (United States)

    Shevyrev, Sergei; Bogomolov, Aleksandr; Alekssev, Maksim


    In the paper, we compare the energy costs of steam and steam-oxygen gasification technologies for production of synthetic liquid fuel. Results of mathematic simulation and experimental studies on gasification of low-grade coal are presented.

  15. Multiple solid pilocytic astrocytomas in cerebleiium with neurofibromatosis type: A case report

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    Choi, Seo Young; Kim, Myung Soon; Kim, Young Ju [Dept. of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju (Korea, Republic of)


    Pilocytic astrocytoma usually has a classic imaging manifestation of a solitary, cyst-like mass with a strong contrast-enhancing mural nodule. There is only one published report so far of multiple solid and cyst type pilocytic astrocytomas in the cerebellum in neurofibromatosis type 1 (NF1) patient from the United States in 2007. We report a case of pilocytic astrocytoma presenting with only solid, multiple pilocytic astrocytomas in the cerebellum in NF1 patient.

  16. Subtrochanteric femur fracture treated by intramedullary fixation

    Institute of Scientific and Technical Information of China (English)

    Zu-Bin Zhou; Song Chen; You-Shui Gao; Yu-Qiang Sun; Chang-Qing Zhang; Yao Jiang


    Purpose: To discuss surgical technique, operative efficacy and clinical outcome of intramedullary fixation in the treatment of subtrochanteric femur fractures.Methods: From February 2011 to February 2013, 76 cases of subtrochanteric femur fractures were treated by intramedullary fixation in our hospital, including 53 males and 23 females, with the age range of 37 -72 years (mean 53.5 years).According to Seinsheimer classification, there were 2 cases of type Ⅰ, 7 type Ⅱ,15 type Ⅲ, 23 type Ⅳ and 29 type Ⅴ.Firstly, all patients underwent closed reduction with the guidance of C-arm fluoroscopy in a traction table.Two cases of type Ⅰ and 3 cases of type Ⅲ fractures had ideal closed reduction followed by internal fixation.The others needed additional limited open reduction.Radiographic examination was used to evaluate callus formation and fracture healing in postoperative 1, 3, 6 and 12 months follow-up.Functional recovery was evaluated by Harris Hip Scoring (HHS) system.Results: Patients were followed up for 6-12 months.All fractures were healed except one patient with delayed union.The average bone union time was 4.5 months.According to HHS system, 65 cases were considered as excellent in functional recovery, 8 good, 2 fair and 1 poor.The proportion of the patients with excellent and good recovery was 96.05%.Conclusion: Intramedullary fixation is feasible for the treatment of subtrochanteric femur fracture.The accuracy of intraoperative reduction and surgical skill are important for the clinical outcome and the patients' prognosis.

  17. Plasma-enhanced gasification of low-grade coals for compact power plants (United States)

    Uhm, Han S.; Hong, Yong C.; Shin, Dong H.; Lee, Bong J.


    A high temperature of a steam torch ensures an efficient gasification of low-grade coals, which is comparable to that of high-grade coals. Therefore, the coal gasification system energized by microwaves can serve as a moderately sized power plant due to its compact and lightweight design. This plasma power plant of low-grade coals would be useful in rural or sparsely populated areas without access to a national power grid.

  18. Neonates with reduced neonatal lung function have systemic low-grade inflammation


    Chawes, Bo L.K.; Stokholm, Jakob; Bønnelykke, Klaus; Pedersen, Susanne Brix; Bisgaard, Hans Flinker


    Background: Children and adults with asthma and impaired lung function have been reported to have low-grade systemic inflammation, but it is unknown whether this inflammation starts before symptoms and in particular whether low-grade inflammation is present in asymptomatic neonates with reduced lung function. ObjectiveWe sought to investigate the possible association between neonatal lung function and biomarkers of systemic inflammation. Methods: Plasma levels of high-sensitivity C-reactive p...

  19. Intramedullary mature teratoma of the conus medullaris

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    Kadir Oktay


    Full Text Available Teratoma is a tumor that derivatives from all three primitive germ layers and spinal intramedullary teratomas are very rare lesions. The primary treatment modality for these tumors is surgical resection, and total resection should be the aim. However, subtotal resection is a valid alternative to prevent traumatizing adjacent functional neural tissue. In this report, we presented a case of a 12-year-old male patient with spinal teratoma of the conus medullaris. We describe the presentation, evaluation, and treatment of this rare disease.

  20. Radiation-Associated Low-Grade Extraskeletal Osteosarcoma of the Neck Following Treatment for Thyroid Cancer. (United States)

    Jones, Martin; Chebib, Ivan; Deshpande, Vikram; Nielsen, G Petur


    Low-grade extraskeletal osteosarcoma is a rare tumor that may arise de novo or following radiation therapy. Because of the low-grade histology, it may be misdiagnosed as a benign lesion. We present a case of a 59-year-old man with a past history of radiotherapy for papillary carcinoma of the thyroid, presenting 16 years later with a low-grade extraskeletal osteosarcoma of the neck. The patient was treated with surgical excision and is disease free after 12 months of follow-up. The prognosis for patients with low-grade extraskeletal osteosarcoma is relatively good when compared with high-grade sarcomas. While there is a report of a low-grade extraskeletal osteosarcoma arising following radiotherapy for a benign condition, to the best of our knowledge this is the first reported case of a low-grade extraskeletal osteosarcoma occurring following radiotherapy for thyroid cancer, and the only case reported in the soft tissue of the head and neck region. © The Author(s) 2015.

  1. Operative Cost Comparison: Plating Versus Intramedullary Fixation for Clavicle Fractures. (United States)

    Hanselman, Andrew E; Murphy, Timothy R; Bal, George K; McDonough, E Barry


    Although clavicle fractures often heal well with nonoperative management, current literature has shown improved outcomes with operative intervention for specific fracture patterns in specific patient types. The 2 most common methods of midshaft clavicle fracture fixation are intramedullary and plate devices. Through retrospective analysis, this study performed a direct cost comparison of these 2 types of fixation at a single institution over a 5-year period. Outcome measures included operative costs for initial surgery and any hardware removal surgeries. This study reviewed 154 patients (157 fractures), and of these, 99 had intramedullary fixation and 58 had plate fixation. A total of 80% (79 of 99) of intramedullary devices and 3% (2 of 58) of plates were removed. Average cost for initial intramedullary placement was $2955 (US dollars) less than that for initial plate placement (Pcost for removal was $1874 less than that for plate removal surgery (P=.2). Average total cost for all intramedullary surgeries was $1392 less than the average cost for all plating surgeries (Pcost for all intramedullary surgeries requiring plate placement and removal was $653 less than the average cost for all plating surgeries that involved only placement (P=.04). Intramedullary fixation of clavicle fractures resulted in a statistically significant cost reduction compared with plate fixation, despite the incidence of more frequent removal surgeries. [Orthopedics.2016; 39(5):e877-e882.].

  2. Establishment of intramedullary spinal cord glioma model in rats

    Institute of Scientific and Technical Information of China (English)

    REN Tian-jian; WANG Zhong-cheng; ZHANG Ya-zhuo; LI Dan; WANG Hong-yun; LI Zhen-zong


    Background Treating intramedullary spinal cord gliomas is a big challenge because of limited options, high recurrence rate and poor prognosis. An intramedullary glioma model is prerequisite for testing new treatments. This paper describes the establishment of a rodent intramedullary glioma model and presents functional progression, neuroimaging and histopathological characterization of the tumour model.Methods Fischer344 rats (n=24) were randomized into two groups. Group 1 (n=16) received a 5 μl intramedullary implantation of 9L gliosarcomal (105) cells. Group 2 (n=8) received a 5 μl intramedullary injection of Dulbecco's modified Eagle medium. The rats were anesthetized, the spinous process of the T10 vertebra and the ligamentum flavum were removed to expose the T10-11 intervertebral space and an intramedullary injection was conducted into the spinal cord. The rats were evaluated preoperatively and daily postoperatively for neurological deficits using the Basso, Beattie and Bresnahan scale. High resolution magnetic resonance images were acquired preoperatively and weekly postoperatively.When score equal to 0, rats were sacrificed for histopathological examination.Results Rats implanted with 9L gliosarcoma cells had a statistically significant median onset of hind limb paraplegia at (16.0±0.4) days, compared with rats in the control group in which neurological deficits were absent. Imaging and pathological cross sections confirmed intramedullary 9L gliosarcoma invading the spinal cord. Rats in the control group showed no significant functional, radiological or histopathological findings of tumour.Conclusions Rats implanted with 9L cells regularly develop paraplegia in a reliable and reproducible manner. The progression of neurological deficits, neuroimaging and histopathological characteristics of intramedullary spinal cord gliomas in rats is comparable with the behaviour of infiltrative intramedullary spinal cord gliomas in patients.

  3. Intramedullary nailing in distal tibial fracture

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    Damian Arroquy


    Methods The inclusion criteria of this study were skeletally mature patients with displaced fractures of the distal tibia treated with intramedullary nail with a minimum follow up of one year. Gustilo III open fractures and type C fractures of the AO classification (complete articular Stroke were excluded. The sample comprised 35 patients remained. The follow-up was 29.2 months. We evaluated the time of consolidation, malunion and complications. The functional results were described according to the AOFAS score. Results Of the 35 patients with fracture of the distal third of the tibia all of them presented fracture healing. The average time to union was 17.2 weeks (range: 11-26. Of the total sample, 5 patients had delayed union, requiring dynamic nail on average at 12 weeks. The malunion was present in 4 (11.4% patients. We found no  difference (p = 0.201 in the time to union between fractures associated with fractures of the fibula treated (13sem or not (17sem. The AOFAS score was 86 points. Conclusion Intramedullary nailing with multiple distal locks like a good alternative treatment for distal tibia fractures AO type A or B, with low complication rate and a high rate of consolidation.

  4. Primary Intradural Hemangiopericytoma With Intramedullary Invasion

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    Chiang-Wei Chou


    Full Text Available Hemangiopericytoma (HPC is a rare tumor of the central nervous system and is usually found intracranially. Intraspinal HPCs are very rare and mostly involve the extradural bony structures. Primary intradural HPC has only been reported in 10 cases, all of which occurred in the extramedullary region. Intramedullary invasion has never been reported. Here, we describe a case of primary intradural HPC of the thoracic spine that presented initially with paresthesia and paraplegia of both legs. Magnetic resonance imaging of the thoracic spine showed an intradural dumbbell-shaped tumor at the T10 level. The initial impression was neurogenic tumor, meningioma, or metastasis. During operation, the tumor was found to have obvious intramedullary invasion. Gross-total removal was done, and the patient's neurological function improved; there was no recurrence at the 3-year follow-up. There is no consensus as to what constitutes the optimal treatment of HPC, but most neurosurgeons will advocate gross-total resection. A comparative analysis between intradural and extradural HPCs showed a higher chance of gross-total resection for intradural HPCs, while the recurrence rates showed no difference. The role of adjuvant radiotherapy remains uncertain. Due to the high risk of recurrence and metastasis of HPCs, close follow-up for a long period is mandatory. [J Chin Med Assoc 2009;72(10:536–541

  5. Spinal intramedullary tuberculoma and abscess : a rare cause of paraparesis.

    Directory of Open Access Journals (Sweden)

    Devi B


    Full Text Available Five cases of spinal intramedullary tuberculomas (IMT and one case of spinal intramedullary tuberculous abscess (ITA are presented. Gd enhanced MRI revealed ring enhancing lesion with central hypodensity, suggesting granulomatous pathology. Surgical excision of the intramedullary lesions was carried out in four cases, while two patients received presumptive anti-tuberculous chemotherapy only. Repeat MRI after completion of anti-tuberculous therapy showed total resolution of the lesion. In other cases following surgical excision, the patients improved significantly. The management of these rare lesions is discussed and the literature reviewed.

  6. PAX2 Expression in Low Malignant Potential Ovarian Tumors and Low-Grade Ovarian Serous Carcinomas (United States)

    Tung, Celestine S.; Mok, Samuel C.; Tsang, Yvonne T.M.; Zu, Zhifei; Song, Huijuan; Liu, Jinsong; Deavers, Michael; Malpica, Anais; Wolf, Judith K.; Lu, Karen H.; Gershenson, David M.; Wong, Kwong-Kwok


    Ovarian tumors of low-malignant potential and low-grade ovarian serous carcinomas are thought to represent different stages on a tumorigenic continuum and to develop along pathways distinct from high-grade ovarian serous carcinoma. We performed gene expression profiling on 3 normal human ovarian surface epithelia samples, and 10 low-grade and 10 high-grade ovarian serous carcinomas. Analysis of gene expression profiles of these samples has identified 80 genes up-regulated and 232 genes down-regulated in low-grade ovarian serous carcinomas. PAX2 was found to be one of the most up-regulated genes in low-grade ovarian serous carcinoma. The up-regulation of PAX2 was validated by real-time quantitative RT-PCR, Western blot and immunohistochemical analyses. Real-time RT-PCR demonstrated a statistically significant difference in PAX2 mRNA expression (expressed as fold change in comparison to normal human ovarian surface epithelia) among ovarian tumors of low-malignant potential (1837.38, N=8), low-grade (183.12, N=17), and high-grade (3.72, N=23) carcinoma samples (p=0.015). Western blot analysis revealed strong PAX2 expression in ovarian tumors of low-malignant potential (67%, N=3) and low-grade carcinoma samples (50%, N=10) but no PAX2 protein expression in high-grade carcinomas (0%, N=10). Using immunohistochemistry, tumors of low-malignant potential (59%, N=17) and low-grade carcinoma (63%, N=16) samples expressed significantly stronger nuclear staining than high-grade ovarian carcinoma samples (9.1%, N=263). Furthermore, consistent with previous immunohistochemical findings, PAX2 expression was found to be expressed in the epithelial cells of fallopian tubes but not in normal ovarian surface epithelial cells. Our findings further support the two-tiered hypothesis that tumors of low-malignant potential and low-grade ovarian serous carcinoma are on a continuum and are distinct from high-grade ovarian carcinomas. Additionally, the absence of PAX2 expression in normal

  7. Stress induces endotoxemia and low-grade inflammation by increasing barrier permeability

    Directory of Open Access Journals (Sweden)

    Karin ede Punder


    Full Text Available Chronic non-communicable diseases (NCDs are the leading causes of work absence, disability and mortality worldwide. Most of these diseases are associated with low-grade inflammation. Here we hypothesize that stresses (defined as homeostatic disturbances can induce low-grade inflammation by increasing the availability of water, sodium and energy-rich substances to meet the increased metabolic demand induced by the stressor. One way of triggering low-grade inflammation is by increasing intestinal barrier permeability through activation of various components of the stress system. Although beneficial to meet the demands necessary during stress, increased intestinal barrier permeability also raises the possibility of the translocation of bacteria and their toxins across the intestinal lumen into the blood circulation. In combination with modern life-style factors, the increase in bacteria/bacterial toxin translocation arising from a more permeable intestinal wall causes a low-grade inflammatory state. We support this hypothesis with numerous studies finding associations with NCDs and markers of endotoxemia, suggesting that this process plays a pivotal and perhaps even a causal role in the development of low-grade inflammation and its related diseases.

  8. Long-Term Sequelae after Cerebellar Astrocytoma Surgery

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    J Gordon Millichap


    Full Text Available The long-term effects on neurologic, neuropsychological, and behavioral functioning in a consecutive series of 23 children treated surgically for cerebellar pilocytic astrocytoma without additional radio- and chemotherapy are determined in a study at Sophia Children’s Hospital, Rotterdam, The Netherlands, and other medical centers.

  9. Differential expression of Notch family members in astrocytomas and medulloblastomas. (United States)

    Xu, Peng; Yu, Shizhu; Jiang, Rongcai; Kang, Chunsheng; Wang, Guangxiu; Jiang, Hao; Pu, Peiyu


    Notch signaling pathway plays an integral role in determining cell fates in development. Growing evidence demonstrates that Notch signaling pathway has versatile effects in tumorigenesis depending on the tumor type, grade and stage. Notch signaling pathway is deregulated in some brain tumors. To examine the differential expression of Notch family members (Notch1, 2, 3, 4) in human astrocytomas and medulloblastomas, and to evaluate their roles in the development of both tumor types. Immunohistochemical staining and Western blot analysis were used to detect Notch1, 2, 3, 4 expression in tissue microarray and freshly resected tissue samples of normal brain, astrocytomas and medulloblastomas. Notch family members were not expressed or barely detectable in normal brain tissues. Notch1, 3, 4 were highly expressed but Notch2 was not expressed in astrocytomas. The percentage of immunopositive tumor cells and level of Notch1 expression was increased with tumor grade. In addition, overexpression of Notch2 was detected in medulloblastomas in contrast to low or no expression of Notch1, 3, 4. Differential expression of Notch1, 2, 3, 4 is detected in astrocytomas and medulloblastomas, that may be related to their different roles playing in the development of brain tumors.

  10. Static or dynamic intramedullary nailing of femur and tibia. (United States)

    Omerovic, Djemil; Lazovic, Faruk; Hadzimehmedagic, Amel


    The basic principle of non-surgical fracture treatment is to restore the original anatomical position of fractured fragments by different techniques, without direct access to the bone and without further traumatizing of tissues. Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goal to gain strength and permanent placement of the implants. Two techniques of intramedullary osteosynthesis are used: with dynamic or with static intramedullary nail. Dynamization include conversion of static nail by removing screws from the longest fragment. The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results. The study was conducted at the Clinic for Orthopaedics and Traumatology, Clinical Center University Sarajevo from January 2004 to June 2009. The study was retrospective-prospective, manipulative, controlled and it was conducted on a total of 129 patients with closed fractures of the diaphysis of the femur and tibia type A and type B, with different segments of bone, regardless of sex and age structure, with the exception of children under 14 years of age. Precisely there were 47 patients with femoral fractures and 82 patients with tibial fractures. The average number of weeks of healing femoral and tibial fractures was slightly in advantage of static intramedullary osteosynthesis, it was 17.08 weeks (SD=3.382). The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978). We can conclude that static intramedullary nailing osteosynthesis unable movements between fragments which directly stimulates bone formation and formation of minimal callus. Static intramedullary osteosynthesis resolve the problem of stabilizing the fracture, limb shortening and rotation of fragments.

  11. Richter syndrome and brain involvement: low-grade lymphoma relapsing as cerebral high-grade lymphoma. (United States)

    Stuplich, Moritz; Mayer, Karin; Kim, Young; Thanendrarajan, Sharmilan; Simon, Matthias; Schäfer, Niklas; Glas, Martin; Schmidt-Wolf, Ingo G H; Herrlinger, Ulrich


    Richter syndrome (RS) describes the development of high-grade non-Hodgkin's lymphoma (NHL) from low-grade NHL. RS isolated to the brain is very rare and has a poor prognosis. We describe the cases of high-grade large B-cell diffuse NHL in a 56-year-old male with chronic lymphocytic leukemia and in a 71-year-old female with previously unknown low-grade NHL, both with initial appearance of neurological symptoms. This report extends the literature of central nervous system RS and particularly highlights the importance of a thorough diagnostic evaluation of patients with low-grade NHL presenting with neurological symptoms. Copyright © 2011 S. Karger AG, Basel.

  12. Extraction of Copper from Malanjkhand Low-Grade Ore by Bacillus stearothermophilus. (United States)

    Singh, Sradhanjali; Sukla, Lala Behari; Mishra, Baroda Kanta


    Thermophilic bacteria are actively prevalent in hot water springs. Their potential to grow and sustain at higher temperatures makes them exceptional compare to other microorganism. The present study was initiated to isolate, identify and determine the feasibility of extraction of copper using thermophilic heterotrophic bacterial strain. Bacillus stearothermophilus is a thermophilic heterotrophic bacterium isolated from hot water spring, Atri, Orissa, India. This bacterium was adapted to low-grade chalcopyrite ore and its efficiency to solubilize copper from Malanjkhand low-grade ore was determined. The low-grade copper ore contains 0.27% Cu, in which the major copper-bearing mineral is chalcopyrite associated with other minerals present as minor phase. Variation in parameters such as pulp-density and temperatures were studied. After 30 days of incubation, it was found that Bacillus stearothermophilus solubilize copper up to 81.25% at pH 6.8 at 60°C.

  13. Statistical evaluation of manual segmentation of a diffuse low-grade glioma MRI dataset. (United States)

    Ben Abdallah, Meriem; Blonski, Marie; Wantz-Mezieres, Sophie; Gaudeau, Yann; Taillandier, Luc; Moureaux, Jean-Marie


    Software-based manual segmentation is critical to the supervision of diffuse low-grade glioma patients and to the optimal treatment's choice. However, manual segmentation being time-consuming, it is difficult to include it in the clinical routine. An alternative to circumvent the time cost of manual segmentation could be to share the task among different practitioners, providing it can be reproduced. The goal of our work is to assess diffuse low-grade gliomas' manual segmentation's reproducibility on MRI scans, with regard to practitioners, their experience and field of expertise. A panel of 13 experts manually segmented 12 diffuse low-grade glioma clinical MRI datasets using the OSIRIX software. A statistical analysis gave promising results, as the practitioner factor, the medical specialty and the years of experience seem to have no significant impact on the average values of the tumor volume variable.

  14. Thermophysical properties of the products of low-grade fuels thermal recycling

    Directory of Open Access Journals (Sweden)

    Tabakaev Roman B.


    Full Text Available The relevance of the work is caused by reorientation of the modern power engineering to use of local low grade fuel resources. Some types of low grade fuels (peat, brown coal, sapropel, wood chips are considered in this work. Thermotechnical characteristics of the investigated fuels and products of their thermal recycling are determined. Thermal recycling process is accompanied by release of fuel dissociation heat (0.33-3.69 MJ/kg. The results of thermal low grade fuel recycling are solid carbonaceous product (semi-coke with a calorific value higher in 1.5-7 times than the value of natural fuels; pyrolysis resin with calorific value 29.4-36.8 MJ/kg; combustible gas with calorific value 15.16-19.06 MJ/m3.

  15. Recurrent intramedullary epidermoid cyst of conus medullaris.

    LENUS (Irish Health Repository)

    Fleming, Christina


    Spinal intramedullary epidermoid cyst is a rare condition. Recurrent epidermoid cyst in the spine cord is known to occur. The authors describe a case of recurrent conus medullaris epidermoid cyst in a 24-year-old female. She initially presented at 7 years of age with bladder disturbance in the form of diurnal enuresis and recurrent urinary tract infection. MRI lumbar spine revealed a 4 cm conus medullaris epidermoid cyst. Since the initial presentation, the cyst had recurred seven times in the same location and she underwent surgical intervention in the form of exploration and debulking. This benign condition, owing to its anatomical location, has posed a surgical and overall management challenge. This occurrence is better managed in a tertiary-care centre requiring multi-disciplinary treatment approach.

  16. Combined spinal intramedullary arteriovenous malformation and lipomyelomeningocele

    Energy Technology Data Exchange (ETDEWEB)

    Weon, Y.C.; Roh, H.G.; Byun, H.S. [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology, Seoul (Korea); Chung, J.I. [Medimoa Hospital, Department of Radiology, Seoul (Korea); Eoh, W. [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea)


    Combined spinal arteriovenous malformation and lipomyelomeningocele are extremely rare. We present a rare combined case of a lipomyelomeningocele with an intramedullary arteriovenous malformation (AVM) occurred at the L3-L4 level in a 30-year-old man who suffered from low back pain radiating to the lower extremities, dysuria, and frequency for 5 years. The MR studies showed an intradural mass with high-signal intensity on both T1-weighted and T2-weighted images, intermingled with multiple signal-void structures. The mass extended extradurally toward a subcutaneously forming fatty mass on the patient's back. Spinal angiography showed an AVM supplied by the radiculopial branches of the lumbar arteries and drained by tortuous, dilated, perimedullary veins. Endovascular embolization and surgical resection were performed. (orig.)

  17. Persistent Depressive Symptoms are Independent Predictors of Low-Grade Inflammation Onset Among Healthy Individuals

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    Fábio Gazelato de Mello Franco

    Full Text Available Abstract Background: Depressive symptoms are independently associated with an increased risk of cardiovascular disease (CVD among individuals with non-diagnosed CVD. The mechanisms underlying this association, however, remain unclear. Inflammation has been indicated as a possible mechanistic link between depression and CVD. Objectives: This study evaluated the association between persistent depressive symptoms and the onset of low-grade inflammation. Methods: From a database of 1,508 young (mean age: 41 years individuals with no CVD diagnosis who underwent at least two routine health evaluations, 134 had persistent depressive symptoms (Beck Depression Inventory - BDI ≥ 10, BDI+ and 1,374 had negative symptoms at both time points (BDI-. All participants had been submitted to repeated clinical and laboratory evaluations at a regular follow-up with an average of 26 months from baseline. Low-grade inflammation was defined as plasma high-sensitivity C-Reactive Protein (CRP concentrations > 3 mg/L. The outcome was the incidence of low-grade inflammation evaluated by the time of the second clinical evaluation. Results: The incidence of low-grade inflammation was more frequently observed in the BDI+ group compared to the BDI- group (20.9% vs. 11.4%; p = 0.001. After adjusting for sex, age, waist circumference, body mass index, levels of physical activity, smoking, and prevalence of metabolic syndrome, persistent depressive symptoms remained an independent predictor of low-grade inflammation onset (OR = 1.76; 95% CI: 1.03-3.02; p = 0.04. Conclusions: Persistent depressive symptoms were independently associated with low-grade inflammation onset among healthy individuals.

  18. Screening of various low-grade biomass materials for low temperature gasification: Method development and application

    DEFF Research Database (Denmark)

    Thomsen, Tobias Pape; Ravenni, Giulia; Holm, Jens Kai;


    method and the subsequent use of the method to identify promising e but currently unproven, low-grade biomass resources for conversion in Pyroneer systems. The technical assessment is conducted by comparing the results from a series of physical-mechanical and thermochemical experiments to a set of proven...... references. The technical assessment is supplemented by an evaluation of practical application and overall energy balance. Applying the developed method to 4 references and 18 unproven low-grade potential fuels, indicated that one of these unproven candidates was most likely unsuited for Pyroneer...

  19. Neonates with reduced neonatal lung function have systemic low-grade inflammation

    DEFF Research Database (Denmark)

    Chawes, Bo L.K.; Stokholm, Jakob; Bønnelykke, Klaus;


    Background: Children and adults with asthma and impaired lung function have been reported to have low-grade systemic inflammation, but it is unknown whether this inflammation starts before symptoms and in particular whether low-grade inflammation is present in asymptomatic neonates with reduced...... lung function. ObjectiveWe sought to investigate the possible association between neonatal lung function and biomarkers of systemic inflammation.  Methods: Plasma levels of high-sensitivity C-reactive protein (hs-CRP), IL-1β, IL-6, TNF-α, and CXCL8 (IL-8) were measured at age 6 months in 300 children...

  20. Expression of delta-catenin is associated with progression of human astrocytoma

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    MingHao Wang


    Full Text Available Abstract Background δ-Catenin (CTNND2, which encodes a scaffold protein in humans, has been found in a few malignancies. However, the expression pattern and contribution of δ-catenin to astrocytoma progression are unclear. Methods We investigated δ-catenin expression in human astrocytoma samples and its function in astrocytoma cell lines using immunohistochemistry, siRNA knockdown, transfection, MTT, transwell migration and Rac1 pulldown techniques. Results δ-Catenin protein expression was detected in cytoplasm of astrocytoma cells by immunohistochemistry. Analysis showed that grade I astrocytoma (0%, 0/11 and glial cells from normal brain tissue exhibited negative staining. δ-Catenin expression was significantly higher in grade III-IV (35%, 29/84 compared to grade II astrocytoma cells (18%, 11/61; p CTNND2 overexpression promoted proliferation, invasion and Rac1 activity of U251 astrocytoma cells. Treatment of δ-catenin-transfected cells with a Rac1 inhibitor decreased Rac1 activity and invasion. δ-Catenin knockdown in U87 glioblastoma cell decreased cell proliferation, invasion and Rac1 activity. Conclusion The results suggest that δ-catenin expression is associated with the malignant progression of astrocytoma and promotes astrocytoma cell invasion through upregulation of Rac1 activity. δ-Catenin expression levels may serve as a useful marker of the biological behavior of astrocytoma cells.

  1. Inter-hemispheric language functional reorganization in low-grade glioma patients after tumour surgery

    NARCIS (Netherlands)

    Kristo, Gert; Raemaekers, Mathijs; Rutten, Geert Jan; de Gelder, Beatrice; Ramsey, Nick F.


    Despite many claims of functional reorganization following tumour surgery, empirical studies that investigate changes in functional activation patterns are rare. This study investigates whether functional recovery following surgical treatment in patients with a low-grade glioma in the left hemispher

  2. Low-grade and high-grade endometrial stromal sarcoma: A National Cancer Database study. (United States)

    Seagle, Brandon-Luke L; Shilpi, Arunima; Buchanan, Samuel; Goodman, Chelain; Shahabi, Shohreh


    To provide refined prognostic information from large cohorts of women with low-grade or high-grade endometrial stromal sarcoma (ESS). We performed an observational retrospective cohort analysis of women diagnosed with low-grade or high-grade ESS from the 1998-2013 National Cancer Database. Kaplan-Meier and multivariable accelerated failure time survival analyses were performed to identify prognostic factors after multiple imputation of missing data. Recursive partitioning methods were used to rank prognostic factors in high-grade ESS. Matched cohort analyses were performed to hypothesis-test effects of adjuvant treatments. We identified 2414 and 1383 women with low-grade or high-grade ESS, respectively. Women with high-grade ESS had markedly decreased survival compared to women with low-grade ESS (five-year survival (95% CI): 32.6 (30.1-35.3%) versus 90.5% (89.3-91.8%), Pradiotherapy (TR (95% CI): 1.57 (1.32-1.87), Pradiotherapy may increase survival of women with high-grade ESS. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. A new power generation method utilizing a low grade heat source

    Institute of Scientific and Technical Information of China (English)

    Wei-feng WU; Kin-ping LONG; Xiao-ling YU; Quan-ke FENG


    Energy crisis make the effective use of low grade energy more and more urgent.It is still a worldwide difficult conundrum.To efficiently recover low grade heat,this paper deals with a theoretical analysis of a new power generation method driven by a low grade heat source.When the temperature of the low grade heat source exceeds the saturated temperature,it can heat the liquid into steam.If the steam is sealed and cooled in a container,it will lead to a negative pressure condition.The proposed power generation method utilizes the negative pressure condition in the sealed container,called as a condensator.When the condensator is connected to a liquid pool,the liquid will be pumped into it by the negative pressure condition.After the condensator is filled by liquid,the liquid flows back into the pool and drives the turbine to generate electricity.According to our analysis,for water,the head pressure of water pumped into the condensator could reach 9.5 m when the temperature of water in the pool is 25 ℃,and the steam temperature is 105 ℃.Theoretical thermal efficiency of this power generation system could reach 3.2% to 5.8% varying with the altitude of the condensator to the water level,ignoring steam leakage loss.

  4. Diagnostic value of fine motor deficits in patients with low-grade hepatic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    Sergei Mechtcheriakov; Ivo W. Graziadei; Maria Rettenbacher; Ingrid Schuster; Hartmann Hinterhuber; Wolfgang Vogel; Joser Marksteiner


    AIM: The role of motor dysfunction in early diagnosis of low-grade hepatic encephalopathy remains uncertain. We performed a pilot study to comparatively investigate the kinematic characteristics of small and large rapid alternating movements in patients with liver cirrhosis and low-grade hepatic encephalopathy.METHODS: A kinematic analysis of alternating handwriting (7.5 mm) and large drawing movements (DM, 175 mm) was performed in 30 patients with liver cirrhosis (no hepatic encephalopathy: n = 10; minimal hepatic encephalopathy: n = 9; grade I hepatic encephalopathy: n = 11; healthy controls: n = 12). The correlation between kinematic parameters, clinical neuro-psychiatric symptoms of cerebral dysfunction and the grade of encephalopathy was investigated.RESULTS: Both movement types, handwriting and drawing, were significantly slower in cirrhotic patients. In contrast to large DM, the deterioration of handwriting movements significantly correlated with the increase of symptoms of motor dysfunction and differentiated significantly within the group of cirrhosis patients corresponding to the degree of hepatic encephalopathy. CONCLUSION: The deterioration of fine motor control is an important symptom of low-grade hepatic encephalopathy. The kinematic analysis of handwriting allows the quantitative analysis of alterations of motor function and is a possible tool for diagnostics and monitoring of motor dysfunction in patients with low-grade hepatic encephalopathy.

  5. Low-Grade Inflammation Is Associated with Susceptibility to Infection in Healthy Men

    DEFF Research Database (Denmark)

    Kaspersen, Kathrine Agergård; Dinh, Khoa Manh; Erikstrup, Lise Tornvig


    INTRODUCTION: The aim of this study was to examine whether low-grade inflammation (LGI) is associated with a subsequently increased risk of infection. METHODS: We included 15,754 healthy participants from the Danish Blood Donor Study, who completed a questionnaire on health-related items. LGI was...

  6. Prospects for production of synthetic liquid fuel from low-grade coal

    Directory of Open Access Journals (Sweden)

    Shevyrev Sergei


    Full Text Available In the paper, we compare the energy costs of steam and steam-oxygen gasification technologies for production of synthetic liquid fuel. Results of mathematic simulation and experimental studies on gasification of low-grade coal are presented.

  7. Aerobic Training Improved Low-Grade Inflammation in Obese Women with Intellectual Disability (United States)

    Ordonez, F. J.; Rosety, M. A.; Camacho, A.; Rosety, I.; Diaz, A. J.; Fornieles, G.; Garcia, N.; Rosety-Rodriguez, M.


    Background: Obesity is a major health problem in people with intellectual disabilities. It is also widely accepted that low-grade systemic inflammation associated to obesity plays a key role in the pathogenic mechanism of several disorders. Fortunately, physical activity has shown to improve inflammation in people with metabolic syndrome and type…

  8. Evolution of DNA repair defects during malignant progression of low-grade gliomas after temozolomide treatment

    NARCIS (Netherlands)

    Thuijl, H.F. van; Mazor, T.; Johnson, B.E.; Fouse, S.D.; Aihara, K.; Hong, C.; Malmstrom, A.; Hallbeck, M.; Heimans, J.J.; Kloezeman, J.J.; Stenmark-Askmalm, M.; Lamfers, M.L.; Saito, N.; Aburatani, H.; Mukasa, A.; Berger, M.S.; Soderkvist, P.; Taylor, B.S.; Molinaro, A.M.; Wesseling, P.; Reijneveld, J.C.; Chang, S.M.; Ylstra, B.; Costello, J. F.


    Temozolomide (TMZ) increases the overall survival of patients with glioblastoma (GBM), but its role in the clinical management of diffuse low-grade gliomas (LGG) is still being defined. DNA hypermethylation of the O (6) -methylguanine-DNA methyltransferase (MGMT) promoter is associated with an impro

  9. Primary pulmonary amyloidosis due to low-grade B cell lymphoma. (United States)

    Georghiou, Georgios P; Boikov, Olga; Vidne, Bernardo A; Saute, Milton


    Pulmonary involvement is not an infrequent complication of systemic amyloidosis, although affected patients rarely have significant pulmonary symptoms. In contrast, localized (primary) pulmonary amyloidosis is rare. We report a case of pulmonary low-grade B cell lymphoma with amyloid production, causing localized pulmonary amyloidosis.

  10. Heat-to-current conversion of low-grade heat from a thermocapacitive cycle by supercapacitors

    NARCIS (Netherlands)

    Härtel, Andreas; Janssen, Mathijs; Weingarth, Daniel; Presser, Volker; van Roij, Rene


    Thermal energy is abundantly available, and especially low-grade heat is often wasted in industrial processes as a by-product. Tapping into this vast energy reservoir with cost-attractive technologies may become a key element for the transition to an energy-sustainable economy and society. We propos

  11. Endothelial dysfunction and low-grade inflammation and the progression of retinopathy in Type 2 diabetes

    NARCIS (Netherlands)

    Spijkerman, A.M.W.; Gall, M.A.; Tarnow, L.; Twisk, J.W.R.; Lauritzen, E.; Lund-Andersen, H.; Emeis, J.; Parving, H.H.; Stehouwer, C.D.A.


    Aims: To study whether microalbuminuria, endothelial dysfunction and low-grade inflammation are associated with the presence and progression of diabetic retinopathy. Methods: Patients with Type 2 diabetes (n = 328) attending a diabetes clinic were followed for 10 years and examined annually during t

  12. The influence of low-grade glioma on resting state oscillatory brain activity: a magnetoencephalography study

    NARCIS (Netherlands)

    Bosma, I.; Stam, C.; Douw, L.; Bartolomei, F.; Heimans, J.; Dijk, van B.; Postma, T.; Klein, M.; Reijneveld, J.


    Purpose: In the present MEG-study, power spectral analysis of oscillatory brain activity was used to compare resting state brain activity in both low-grade glioma (LGG) patients and healthy controls. We hypothesized that LGG patients show local as well as diffuse slowing of resting state brain activ

  13. Using low-grade hardwoods for CLT production: a yield analysis (United States)

    R. Edward Thomas; Urs. Buehlmann


    Low-grade hardwood logs are the by-product of logging operations and, more frequently today, urban tree removals. The market prices for these logs is low, as is the value recovered from their logs when producing traditional forest products such as pallet parts, railroad ties, landscaping mulch, or chips for pulp. However, the emergence of cross-laminated timber (CLT)...

  14. Endothelial dysfunction and low-grade inflammation and the progression of retinopathy in Type 2 diabetes

    DEFF Research Database (Denmark)

    Spijkerman, Annemieke M W; Gall, Mari-Anne; Tarnow, L


    AIMS: To study whether microalbuminuria, endothelial dysfunction and low-grade inflammation are associated with the presence and progression of diabetic retinopathy. METHODS: Patients with Type 2 diabetes (n = 328) attending a diabetes clinic were followed for 10 years and examined annually durin...

  15. Radiotherapy-induced cerebral abnormalities in patients with low-grade glioma

    NARCIS (Netherlands)

    Postma, TJ; Klein, M; Verstappen, CCP; Bromberg, JEC; Swennen, M; Langendijk, JA; Taphoorn, MJB; Scheltens, P; Slotman, BJ; van der Ploeg, HM; Aaronson, NK; Heimans, JJ


    Abnormalities on CT or MRI and neuropsychological performance in patients with low-grade glioma, with (n = 23) or without (n = 16) prior cerebral radiotherapy, were evaluated. Cerebral atrophy was observed in 14 of 23 patients (61%) treated with prior radiotherapy, and in 1 of 16 patients (6%) witho

  16. Biological formation of caproate and caprylate from acetate: fuel and chemical production from low grade biomass

    NARCIS (Netherlands)

    Steinbusch, K.J.J.; Hamelers, H.V.M.; Plugge, C.M.; Buisman, C.J.N.


    This research introduces an alternative mixed culture fermentation technology for anaerobic digestion to recover valuable products from low grade biomass. In this mixed culture fermentation, organic waste streams are converted to caproate and caprylate as precursors for biodiesel or chemicals. It wa

  17. Low-grade inflammation, diet composition and health: Current research evidence and its translation

    NARCIS (Netherlands)

    Minihane, A.M.; Vinoy, S.; Russell, W.R.; Baka, A.; Roche, H.M.; Tuohy, K.M.; Teeling, J.L.; Blaak, E.E.; Fenech, M.; Vauzour, D.; McArdle, H.J.; Kremer, B.H.A.; Sterkman, L.; Vafeiadou, K.; Benedetti, M.M.; Williams, C.M.; Calder, P.C.


    The importance of chronic low-grade inflammation in the pathology of numerous age-related chronic conditions is now clear. An unresolved inflammatory response is likely to be involved from the early stages of disease development. The present position paper is the most recent in a series produced by

  18. The influence of low-grade glioma on resting state oscillatory brain activity : a magnetoencephalography study

    NARCIS (Netherlands)

    Bosma, I; Stam, C J; Douw, L; Bartolomei, F; Heimans, J J; van Dijk, B W; Postma, T J; Klein, M; Reijneveld, J C


    PURPOSE: In the present MEG-study, power spectral analysis of oscillatory brain activity was used to compare resting state brain activity in both low-grade glioma (LGG) patients and healthy controls. We hypothesized that LGG patients show local as well as diffuse slowing of resting state brain activ

  19. Effect of basicity on ferromanganese production from beneficiated low-grade manganese ore (United States)

    Suharno, Bambang; Noegroho, Adi; Ferdian, Deni; Nurjaman, Fajar


    Indonesia is known to have a large low-grade manganese ore reserve. Nevertheless, it could not be used optimally in producing ferromanganese due to their low Mn/Fe ratio. In this present study, the beneficiation process had been applied to the low-grade manganese ore. Reduction roasting was conducted to this manganese ore at 700°C for an hour and then continued with low-intensity magnetic separation. This process had improved the Mn/Fe ratio from 1.39 to 6.11. The effect of basicity on ferromanganese production from this beneficiated low-grade manganese ore had been investigated clearly in this experiment by using mini submerged arc furnace (SAF). Several basicities for 0.7 and 1.0, was used and it was controlled by the addition of limestone in this smelting process. From this experiment, the ferromanganese containing 60% Mn was obtained from smelting the beneficiated low-grade manganese ore with the optimum basicity 0.7.

  20. Catalytic effect of activated carbon on bioleaching of low-grade primary copper sulfide ores

    Institute of Scientific and Technical Information of China (English)


    The catalytic effect of activated carbon on the bioleaching of low-grade primary copper sulfide ores using mixture of Acidithiobacillus ferrooxidans and Acidithiobacillus thiooxidans was investigated. The results show that the addition of activated carbon can greatly accelerate the rate and efficiency of copper dissolution from low-grade primary copper sulfide ores. The solution with the concentration of 3.0 g/L activated carbon is most beneficial to the dissolution of copper. The resting time of the mixture of activated carbon and ores has an impact on the bioleaching of low-grade primary copper sulfide ores. The 2 d resting time is most favorable to the dissolution of copper. The enhanced dissolution rate and efficiency of copper can be attributed to the galvanic interaction between activated carbon and chalcopyrite. The addition of activated carbon obviously depresses the dissolution of iron and the bacterial oxidation of ferrous ions in solution. The lower redox potentials are more favorable to the copper dissolution than the higher potentials for low-grade primary copper sulfide ores in the presence of activated carbon.

  1. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

    Directory of Open Access Journals (Sweden)

    Julian Arista-Nasr


    Full Text Available ABSTRACT Purpose The vast majority of urothelial carcinomas infiltrating the bladder are consistent with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. Materials and Methods We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes. Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Results Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma. In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin (34BetaE12 and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years. Conclusions The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients.

  2. Locked META intramedullary nailing fixation for tibial fractures via a suprapatellar approach


    Beigang Fu


    Background: Intramedullary nailing is an effective approach for treatment of diaphyseal tibial fractures. However, infrapatellar intramedullary nailing can easily cause angulation and rotation displacement at the fracture ends and increase risk of postoperative infection. Intramedullary nailing via the suprapatellar approach was proved with good reduction and fixation. We used locked intramedullary nailing for the treatment of tibial fractures via a suprapatellar approach in this study. Mater...

  3. Effect of cognitive rehabilitation in a case of thalamic astrocytoma. (United States)

    Lo Buono, Viviana; Corallo, Francesco; De Cola, Maria Cristina; Chillemi, Antonino; Grugno, Rosario; Bramanti, Placido; Marino, Silvia


    We describe the effectiveness of rehabilitative training for a neuropsychological deficit following the removal and treatment of a fibrillary astrocytoma (Grade II) in a young man. The rehabilitative training was based on cognitive and motivational techniques and has been carried out for a period of 3 months (2 times per week). The results, even if limited to a single case, seem to support the idea that cognitive rehabilitation should facilitate the brain's reorganization of basic cognitive functions in the neuro-oncologic field.

  4. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part II. Treatment-related late toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M. [Dept. of Radiooncology, Univ. of Tuebingen (Germany); Taylor, R.E. [Radiotherapy Dept., Cookridge Hospital, Leeds (United Kingdom); Scarzello, G. [Dept. of Radiotherapy, Padua General Hospital (Italy); Gnekow, A.K. [Children' s Hospital Augsburg (Germany); Dieckmann, K. [Dept. of Radiooncology, General Hospital Vienna (Austria)


    Material and Methods: Studies on the use of radiation therapy in children with low-grade glioma were systematically reviewed for data on radiotherapy-induced side effects on brain parenchyma, endocrine dysfunction, growth retardation, neurocognitive dysfunction, vasculopathy, and secondary neoplasms. Results: Data on late effects are scarce and heterogeneous. Past reports included only retrospective series from the 1930s to present days, a time during which treatment policies and radiation techniques widely varied and considerably changed in recent years. Often, considerable uncertainty existed regarding pretreatment health status and radiotherapy-related factors (e.g., total dose, dose per fraction, treatment fields). In spite of these shortcomings and often conflicting observations, it appears that especially younger children and children with neurofibromatosis (NF) are at risk of endocrinopathies in terms of growth retardation and developmental abnormalities, as well as neurocognitive dysfunction expressed as problems in the psychosocial environment such as in education and occupation. However, both observations may be attributed to the higher proportion of NF in the very young who frequently develop large tumors spreading along the entire supratentorial midline. The risk of radiation-induced disturbances in visual function is low (no case reported). Young children with NF appear to have an increased risk of vasculopathies. 33 cases of moyamoya disease were found (preferably in the very young), 18 of whom were NF-positive. Other cerebrovascular accidents (24 cases, of whom 14 were NF-positive) and secondary neoplasms (15 cases, of whom only five occurred in field - four were high-grade astrocytomas) are a rare condition. The latter cannot be distinguished from late relapses with malignant transformation. Modern treatment techniques appear to reduce the risk of radiation-induced late effects. Conclusions: More studies and clear definitions of clinical endpoints

  5. CT and MR findings of supratentorial pilocytic astrocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Kim, Dong Ik; Chung, Tae Sub [Yonsei University College of Medicine, Seoul (Korea, Republic of); Suh, Jung Ho [Ajou University College of Medicine, Suwon (Korea, Republic of)


    Pilocytic astrocytoma is a benign tumor predominantly arising from cerebellum in pediatric age. But it occasionally arises in supratentorium. We describe radiologic findings of supratentorial pilocytic astrocytoma. Eleven CT and 7 MR examination in 11 patients were retrospectively reviewed with attention to location,CT density, MR signal intensity, and degree and pattern of contrast enhancement on CT and MR. The tumors were located around the third ventricle (hypothalamus in three cases, optic chiasm in three cases) and in cerebral hemisphere (temporal lobe in three cases, frontal lobe in one case, thalamus in three cases). On CT, the tumors were all sharply demarcated and rarely associated with edema. The tumors showed moderate to strong contrast enhancement. Necrosis appeared frequently in tumors around the third ventricle in contrast to frequent cyst formation in hemispheric masses. On MR, the tumors appeared hypo- or isointense on T1- weighted images and hyperintense on T2-weighted images. After administration of contrast agent, the tumors showed intense enhancement more than that of CT. The typical location and radiologic findings described above are helpful in the diagnosis of the supratentorial pilocytic astrocytoma.

  6. Malignant transformation of a chiasmatic pilocytic astrocytoma in a patient with diencephalic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Wal, Ester P.J. van der; Edwards-Brown, Mary [Department of Radiology, Indiana University, Division of Neuroradiology, James Whitcomb Riley Children' s Hospital, 702 Barnhill Drive, MRI Suite, Indianapolis, IN 46202-5200 (United States); Azzarelli, Biagio [Department of Pathology, Division of Neuropathology, Indiana University, Medical Science Building, A140, 635 Barnhill Drive, Indianapolis, IN 46202-5120 (United States)


    Chiasmatic gliomas with metastatic spread are rare in children and are usually associated with diencephalic syndrome. They are mostly pilocytic astrocytomas and their transformation to high-grade astrocytomas has never previously been reported in the pediatric population. We report leptomeningeal spread of a chiasmatic pilocytic astrocytoma in a child presenting with diencephalic syndrome. He was treated with chemotherapy and radiation. The tumor recurred with transformation into a high-grade astrocytoma. Radiation therapy may have played a role in transformation of the tumor, but more research is needed to further clarify the biological behavior of this tumor. (orig.)

  7. Phase 2 Study of Temozolomide-Based Chemoradiation Therapy for High-Risk Low-Grade Gliomas: Preliminary Results of Radiation Therapy Oncology Group 0424

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, Barbara J., E-mail: [London Regional Cancer Program, London, Ontario (Canada); Hu, Chen [Radiation Therapy Oncology Group-Statistical Center, Philadelphia, Pennsylvania (United States); Macdonald, David R. [London Regional Cancer Program, London, Ontario (Canada); Lesser, Glenn J. [Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina (United States); Coons, Stephen W. [Barrow Neurological Institute, Phoenix, Arizona (United States); Brachman, David G. [Arizona Oncology Services Foundation, Phoenix, Arizona (United States); Ryu, Samuel [Henry Ford Hospital, Detroit, Michigan (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital Center, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Quebec (Canada); Liu, Junfeng [GCE Solutions, Inc., Bloomington, Illinois (United States); Chakravarti, Arnab [The Ohio State University, The James, Columbus, Ohio (United States); Mehta, Minesh [University of Maryland Medical Systems, Baltimore, Maryland (United States)


    Purpose: Radiation Therapy Oncology Group (RTOG) 0424 was a phase 2 study of a high-risk low-grade glioma (LGG) population who were treated with temozolomide (TMZ) and radiation therapy (RT), and outcomes were compared to those of historical controls. This study was designed to detect a 43% increase in median survival time (MST) from 40.5 to 57.9 months and a 20% improvement in 3-year overall survival (OS) rate from 54% to 65% at a 10% significance level (1-sided) and 96% power. Methods and Materials: Patients with LGGs with 3 or more risk factors for recurrence (age ≥40 years, astrocytoma histology, bihemispherical tumor, preoperative tumor diameter of ≥6 cm, or a preoperative neurological function status of >1) were treated with RT (54 Gy in 30 fractions) and concurrent and adjuvant TMZ. Results: From 2005 to 2009, 129 evaluable patients (75 males and 54 females) were accrued. Median age was 49 years; 91% had a Zubrod score of 0 or 1; and 69%, 25%, and 6% of patients had 3, 4, and 5 risk factors, respectively. Patients had median and minimum follow-up examinations of 4.1 years and 3 years, respectively. The 3-year OS rate was 73.1% (95% confidence interval: 65.3%-80.8%), which was significantly improved compared to that of prespecified historical control values (P<.001). Median survival time has not yet been reached. Three-year progression-free survival was 59.2%. Grades 3 and 4 adverse events occurred in 43% and 10% of patients, respectively. One patient died of herpes encephalitis. Conclusions: The 3-year OS rate of 73.1% for RTOG 0424 high-risk LGG patients is higher than that reported for historical controls (P<.001) and the study-hypothesized rate of 65%.

  8. Intramedullary spinal cord primitive neuroectodermal tumor presenting with hydrocephalus. (United States)

    Alexiou, George A; Siozos, George; Stefanaki, Kalliopi; Moschovi, Maria; Prodromou, Neofytos


    Spinal primitive neuroectodermal tumors are exceedingly rare. Herewith, we present the first case of an intramedullary spinal cord tumor associated with hydrocephalus in a 2-month-old boy that presented with left hemiparesis. The patient had been diagnosed on prenatal ultrasound with enlarged ventricular system. At his current admission, a brain magnetic resonance imaging (MRI) revealed hydrocephalus and an intramedullary lesion extending from the second cervical to the first thoracic vertebrae. Dissemination of the tumor was revealed intracranially and in the spinal canal. After a ventriculoperitoneal shunt placement a radical resection of the tumor was performed, however some small tumor remnants could not be safely removed. Postoperative there was no neurologic deterioration. The tumor was diagnosed as a central nervous system primitive neuroectodermal tumor (World Health Organization grade IV). Spinal intramedullary primitive neuroectodermal tumors are extremely rare. In such rare tumors, multiinstitutional studies are needed for treatment guidelines to be established.

  9. Safe surgical technique: intramedullary nail fixation of tibial shaft fractures. (United States)

    Zelle, Boris A; Boni, Guilherme


    Statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Establishing an appropriate starting point is a crucial part of the surgical procedure. Recently, suprapatellar nailing in the semi-extended position has been suggested as a safe and effective surgical technique. Numerous reduction techiques are available to achieve an anatomic fracture alignment and the treating surgeon should be familiar with these maneuvers. Open reduction techniques should be considered if anatomic fracture alignment cannot be achieved by closed means. Favorable union rates above 90 % can be achieved by both reamed and unreamed intramedullary nailing. Despite favorable union rates, patients continue to have functional long-term impairments. In particular, anterior knee pain remains a common complaint following intramedullary tibial nailing. Malrotation remains a commonly reported complication after tibial nailing. The effect of postoperative tibial malalignment on the clinical and radiographic outcome requires further investigation.

  10. Insulin secretion and cellular glucose metabolism after prolonged low-grade intralipid infusion in young men

    DEFF Research Database (Denmark)

    Jensen, Christine B; Storgaard, Heidi; Holst, Jens Juul;


    We examined the simultaneous effects of a 24-h low-grade Intralipid infusion on peripheral glucose disposal, intracellular glucose partitioning and insulin secretion rates in twenty young men, by 2-step hyperinsulinemic euglycemic clamp [low insulin clamp (LI), 10 mU/m(2) x min; high insulin clamp...... Intralipid infusion. At LI, glucose oxidation decreased by 10%, whereas glucose disposal, glycolytic flux, glucose storage, and glucose production were not significantly altered. At HI, glucose disposal, and glucose oxidation decreased by 12% and 24%, respectively, during Intralipid infusion. Glycolytic flux......, glucose storage, and glucose production were unchanged. Insulin secretion rates increased in response to Intralipid infusion, but disposition indices (DI = insulin action.insulin secretion) were unchanged. In conclusion, a 24-h low-grade Intralipid infusion caused insulin resistance in the oxidative (but...

  11. The association between low-grade inflammation, iron status and nucleic acid oxidation in the elderly

    DEFF Research Database (Denmark)

    Broedbaek, Kasper; Siersma, Volkert Dirk; Andersen, Jon T


    This study applied a case-control approach to investigate the association between low-grade inflammation, defined by high values within the normal range of C-reactive protein (CRP) and interleukin-6 (IL-6), and urinary markers of nucleic acid oxidation. No differences in excretion of urinary...... markers of nucleic acid oxidation between cases and controls were found and multivariable linear regression analysis showed no association between urinary markers of nucleic acid oxidation and inflammatory markers. Post-hoc multivariable linear regression analysis showed significant associations between...... nucleic acid oxidation and various iron status markers and especially a close relationship between nucleic acid oxidation and ferritin. This study shows no association between low-grade inflammation and urinary markers of nucleic acid oxidation in a population of elderly Italian people. The results...

  12. Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy?

    Directory of Open Access Journals (Sweden)

    Eduardo da Silva Alves


    Full Text Available An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury.

  13. Monitoring temozolomide treatment of low-grade glioma with proton magnetic resonance spectroscopy

    DEFF Research Database (Denmark)

    Murphy, P. S.; Viviers, L; Abson, C;


    Assessment of low-grade glioma treatment response remains as much of a challenge as the treatment itself. Proton magnetic resonance spectroscopy ((1)H-MRS) and imaging were incorporated into a study of patients receiving temozolomide therapy for low-grade glioma in order to evaluate and monitor...... tumour metabolite and volume changes during treatment. Patients (n=12) received oral temozolomide (200 mg m(-2) day(-1)) over 5 days on a 28-day cycle for 12 cycles. Response assessment included baseline and three-monthly magnetic resonance imaging studies (pretreatment, 3, 6, 9 and 12 months) assessing...... months, a significant reduction in the mean choline signal was observed compared with the pretreatment (P=0.035) and 3-month scan (P=0.021). The reduction in the tumour choline/water signal paralleled tumour volume change and may reflect the therapeutic effect of temozolomide...

  14. Immunoblastic follicular lymphoma: a very unusual transformation of low-grade follicular lymphoma. (United States)

    Gheith, Shereen; Cornfield, Dennis; Chen, Weiyi; Singh-Kahlon, Pal; Ahmed, Basil


    A 73-year-old man, in clinical remission 17 years after radiation therapy for a localized low-grade follicular lymphoma (FL), developed extensive lymphadenopathy, ascites, and splenomegaly with splenic masses. Axillary lymph node biopsy showed FL composed of nodules of centrocytes side by side with nodules of immunoblasts rather than centroblasts. Immunophenotyping revealed conventional FL markers (BCL-2, BCL-6, and CD10) as well as MUM-1 in the immunoblastic component, suggesting postgerminal center differentiation. Fluorescence in situ hybridization showed t(14;18) in both centrocytic and immunoblastic components and a copy gain of BCL-6 predominantly in the immunoblastic component. Areas of centrocytic and of immunoblastic nodules were macrodissected separately and underwent molecular evaluation for immunoglobulin heavy chain gene rearrangement. Identical base-pair peaks were found, attesting to their clonal identity. This case represents a very unusual example of transformation of a low-grade FL to a nodular immunoblastic FL.

  15. Emerging role of functional brain MRI in low-grade glioma surgery

    DEFF Research Database (Denmark)

    Friismose, Ancuta; Traise, Peter; Markovic, Ljubo

    Learning objectives 1. To describe the use of functional MRI (fMRI) in cranial surgery planning for patients with low-grade gliomas (LGG). 2. To show the increasing importance of fMRI in the clinical setting. Background LGG include brain tumors classified by the World Health Organization as grade I....... Language comprehension and visual tasks can be added to visualize Wernicke’s area or the visual cortex. Diffusion tensor imaging (DTI) is used to map nerve tract course relative to the tumour. Conclusion FMRI has proven its clinical utility in locating eloquent brain areas with relation to tumor site...... be used to map eloquent cortex areas, thus minimizing postoperative deficits and improving surgical performance. Findings and procedure details Patients diagnosed with low-grade gliomas located in eloquent brain areas undergo fMRI prior to surgery. The exams are performed on a 3T MR system (Achieva TX...

  16. Dominance of Acidithiobacillus at ore surface of Zijinshan commercial low-grade copper bioleaching heap

    Institute of Scientific and Technical Information of China (English)

    LIU Xing-yu; CHEN Bo-wei; WEN Jian-kang


    The microbial community structure in the ore surface of Zijinshan commercial low-grade copper bioleaching heap was investigated by 16S rRNA gene clone library.For both bacteria and Archaea,105 clones were sequenced.The dominant bacteria species present in the ore surface were Acidithiobacillus and Leptospirillum,accounting for 51.42% and 48.57%,respectively.However,for the Archaea,only one operational taxonomic unit (OUT) belonged to Ferroplasma acidiphilum.These results indicate that function of genus Acidithiobacillus in the commercial low-grade copper bioleaching heap may be underestimated.More detailed and quantitative information on microbial community structure over time are now under investigation.

  17. Low-grade sarcoma in classical seminoma - the first case reported (United States)

    Petersson, Fredrik; Michal, Michal; Grossmann, Petr; Franco, Marcello; Zámečník, Michal; Hes, Ondrej


    A 30-year-old male with no previous history of neoplastic disease presented with a 5 cm large testicular tumor. Routine histopathological examination and immunohistochemical investigation showed a classical seminoma with a contiguous 8 mm large nodule. The nodule was separated from the tunica albuginea by tubuli seminiferi showing intratesticular germ cell neoplasi not otherwise specified (NOS). The nodule was composed of spindle cells with low-grade nuclear atypia, nuclear and cytoplasmic S100 protein immunoreactivity in 15% of the cells and a proliferative activity of up to 20%. No other germ cell tumor components were found. To the best of our knowledge, we herein present the first tumor of a pure classical seminoma with an associated low-grade sarcomatous component. PMID:20126588

  18. Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy? (United States)

    da Silva Alves, Eduardo; de Aquino Lemos, Valdir; Ruiz da Silva, Francieli; Lira, Fabio Santos; dos Santos, Ronaldo Vagner Thomathieli; Rosa, João Paulo Pereira; Caperuto, Erico; Tufik, Sergio; de Mello, Marco Tulio


    An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury. PMID:23533315


    Directory of Open Access Journals (Sweden)

    Sampath Kumar


    Full Text Available Malignant nerve sheath tumours [syn : Neurogenic sarcoma , Neuro fibro sarcoma] comprise approximately 5% of all soft tissue sarcomas. Only 8to15% of these tumours arises in Head and neck region. Commonest sites in head and neck region a re lateral skull base or along the course of cranial nerves. These tumours in sino nasal region are extreme rare. In this article we report a rare case of low grade MPNST. The tumour was resected by medial maxillectomy via modified Denker extended maxillar y anterior antrostomy , resected tumour Histopathological examination and immunohistochemistry study reported as low grade MPNST and negative for s - 100 protein. Patient was relieved from symptoms and followed for 18 months.

  20. Low-grade osteosarcoma arising from cemento-ossifying fibroma: a case report. (United States)

    Lee, Yong Bin; Kim, Nam-Kyoo; Kim, Jae-Young; Kim, Hyung Jun


    Cemento-ossifying fibromas are benign tumors, and, although cases of an aggressive type have been reported, no cases of cemento-ossifying fibroma transforming into osteosarcoma have been documented previously. Low-grade osteosarcoma is a rare type of primary bone tumor, representing 1%-2% of all osteosarcomas. A 45-year-old female patient was diagnosed with cemento-ossifying fibroma, treated with mass excision several times over a period of two years and eight months, and followed up. After biopsy gathered because of signs of recurrence, she was diagnosed with low-grade osteosarcoma. The patient underwent wide excision, segmental mandibulectomy, and reconstruction with fibula free flap. The aim of this report is to raise awareness of the possibility that cemento-ossifying fibroma can transform into osteosarcoma and of the consequent necessity for careful diagnosis and treatment planning.

  1. Low-grade fibromatosis-like spindle cell carcinoma of the breast. (United States)

    Dwyer, Jessica B; Clark, Beth Z


    Low-grade fibromatosis-like spindle cell carcinoma is a rare tumor in the breast, and represents a variant of the very heterogeneous group of metaplastic carcinomas of the breast. These tumors warrant distinction because of their resemblance to pure fibromatosis, their propensity for local recurrence, and their favorable prognosis among the metaplastic carcinomas of the breast. The diagnosis is potentially challenging, particularly on core needle biopsies, because of the morphologic overlap with other low-grade spindle cell lesions. Recognition of a proliferation of cytologically bland spindle cells with areas of epithelial differentiation in combination with immunohistochemistry using antibodies against cytokeratins and myoepithelial markers should aid in producing a definitive diagnosis. These tumors can be locally aggressive with an increased incidence of local recurrence, but the potential for lymph node or distant metastasis is low. Complete excision with adequate margins is considered curative in the majority of cases.

  2. Collection of low-grade waste heat for enhanced energy harvesting (United States)

    Dede, Ercan M.; Schmalenberg, Paul; Wang, Chi-Ming; Zhou, Feng; Nomura, Tsuyoshi


    Enhanced energy harvesting through the collection of low-grade waste heat is experimentally demonstrated. A structural optimization technique is exploited in the design of a thermal-composite substrate to guide and gather the heat emanating from multiple sources to a predetermined location. A thermoelectric generator is then applied at the selected focusing region to convert the resulting low-grade waste heat to electrical power. The thermal characteristics of the device are experimentally verified by direct temperature measurements of the system and numerically validated via heat conduction simulations. Electrical performance under natural and forced convection is measured, and in both cases, the device with optimized heat flow control plus energy harvesting demonstrates increased power generation when compared with a baseline waste heat recovery system. Electronics applications include energy scavenging for autonomously powered sensor networks or self-actuated devices.

  3. Intraosseous polymorphous low-grade adenocarcinoma of mandible: A rare entity

    Directory of Open Access Journals (Sweden)

    Gayathri Ramesh


    Full Text Available Polymorphous low-grade adenocarcinoma is a rare type of minor salivary gland malignancy. The characteristic features of these tumors are the varied histomorphology and the malignant, albeit indolent behavior. It occurs commonly in the minor salivary glands, with the palate (58.5% being the most common intra oral site. Maxillary area (2%, mandibular mucosal area (1.5% and posterior trigone region (0.5% are the least affected areas. An occasional case has been reported arising from an intraosseous location i.e the maxilla, and only two cases have been reported in the English literature originating from the mandible. One such very rare case of polymorphous low-grade adenocarcinoma of the mandible, which radiographically has a soap bubble appearance, is reported here.

  4. [MALT-type low-grade B-cell lymphomas of the stomach and Helicobacter pylori]. (United States)

    Binek, J; Morant, R; Weber, A; Schmid, U; Hammer, B


    From January 1 1994 to March 1 1995 we observed 6 patients with gastric low-grade B-cell lymphoma of MALT type in association with Helicobacter pylori infection. Endoscopically only 3 of the 6 patients presented with pathological findings. All but one patient with metastatic carcinoma received antibiotic therapy for Helicobacter pylori. Follow-up was not possible in one patient who died unexpectedly. In all 4 patients followed-up, eradication of Helicobacter pylori resulted in regression of the malignant lymphoma. During the median follow-up time of 7 months (2-13 months) no relapse of lymphoma was observed. Our results confirm that gastric low-grade B-cell lymphoma of MALT type can regress after eradication of Helicobacter pylori.

  5. Low-grade inflammation and spinal cord injury: exercise as therapy? (United States)

    da Silva Alves, Eduardo; de Aquino Lemos, Valdir; Ruiz da Silva, Francieli; Lira, Fabio Santos; Dos Santos, Ronaldo Vagner Thomathieli; Rosa, João Paulo Pereira; Caperuto, Erico; Tufik, Sergio; de Mello, Marco Tulio


    An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury.

  6. Is male factor infertility associated with midlife low-grade inflammation?

    DEFF Research Database (Denmark)

    Hærvig, Katia Keglberg; Kierkegaard, Lene; Lund, Rikke


    Male factor infertility is associated with an increased risk of disease and mortality, which has been related to markers of chronic systemic inflammation. The objective of this study was to investigate the association between male factor infertility and low-grade inflammation and furthermore...... to examine the lifetime prevalence of male factor infertility and overall infertility (also including female and couple infertility). The study population consisted of 2140 members of the Metropolit 1953 Danish Male Birth Cohort who had participated in the Copenhagen Aging and Midlife Biobank data collection...... in 2009-2011. Information on male factor infertility and overall infertility was obtained from a questionnaire, and low-grade inflammation was evaluated as the highest plasma levels of C-reactive protein, interleukin-6 and tumour necrosis factor-alpha in the population. The level of interleukin-6...

  7. Exercise as a Mean to Control Low-Grade Systemic Inflammation

    Directory of Open Access Journals (Sweden)

    Neha Mathur


    Full Text Available Chronic noncommunicable diseases (CNCDs, which include cardiovascular disease, some cancers, for example, colon cancer, breast cancer, and type 2 diabetes, are reaching epidemic proportions worldwide. It has now become clear that low-grade chronic inflammation is a key player in the pathogenesis of most CNCDs. Given that regular exercise offers protection against all causes of mortality, primarily by protection against atherosclerosis and insulin resistance, we suggest that exercise may exert some of its beneficial health effects by inducing anti-inflammatory actions. Recently, IL-6 was introduced as the first myokine, defined as a cytokine, which is produced and released by contracting skeletal muscle fibres, exerting its effects in other organs of the body. We suggest that skeletal muscle is an endocrine organ and that myokines may be involved in mediating the beneficial effects against CNCDs associated with low-grade inflammation.

  8. Exploiting molecular biology for diagnosis and targeted management of pediatric low-grade gliomas. (United States)

    Garcia, Michael A; Solomon, David A; Haas-Kogan, Daphne A


    The majority of brain tumors arising in children are low-grade gliomas. Although historically categorized together as pediatric low-grade gliomas (PLGGs), there is significant histologic and genetic diversity within this group. In general, prognosis for PLGGs is excellent, and limitation of sequelae from tumor and treatment is paramount. Advances in high-throughput genetic sequencing and gene expression profiling are fundamentally changing the way PLGGs are classified and managed. Here, we review the histologic subtypes and highlight how recent advances in elucidating the molecular pathogenesis of these tumors have refined diagnosis and prognostication. Additionally, we discuss how characterizing specific genetic alterations has paved the way for the rational use of targeted therapies that are currently in various phase clinical trials.

  9. Magnetic separation studies for a low grade siliceous iron ore sample

    Institute of Scientific and Technical Information of China (English)

    Dwari Ranjan Kumar; Rao Danda Srinivas; Reddy Palli Sita Ram


    Investigations were carried out,on a low grade siliceous iron ore sample by magnetic separation,to establish its amenability for physical beneficiation.Mineralogical studies revealed that the sample consists of magnetite,hematite and goethite as major opaque oxide minerals where as silicates as well as carbonates form the gangue minerals in the sample.Processes involving combination of classification,dry magnetic separation and wet magnetic separation were carried out to upgrade the low grade siliceous iron ore sample to make it suitable as a marketable product.The sample was first ground and each closed size sieve fractions were subjected to dry magnetic separation and it was observed that limited upgradation is possible.The ground sample was subjected to different finer sizes and separated by wet low intensity magnetic separator.It was possible to obtain a magnetic concentrate of 67% Fe by recovering 90% of iron values at below 200 μm size.

  10. Collection of low-grade waste heat for enhanced energy harvesting

    Directory of Open Access Journals (Sweden)

    Ercan M. Dede


    Full Text Available Enhanced energy harvesting through the collection of low-grade waste heat is experimentally demonstrated. A structural optimization technique is exploited in the design of a thermal-composite substrate to guide and gather the heat emanating from multiple sources to a predetermined location. A thermoelectric generator is then applied at the selected focusing region to convert the resulting low-grade waste heat to electrical power. The thermal characteristics of the device are experimentally verified by direct temperature measurements of the system and numerically validated via heat conduction simulations. Electrical performance under natural and forced convection is measured, and in both cases, the device with optimized heat flow control plus energy harvesting demonstrates increased power generation when compared with a baseline waste heat recovery system. Electronics applications include energy scavenging for autonomously powered sensor networks or self-actuated devices.

  11. Fatty acids and chronic low grade inflammation associated with obesity and the metabolic syndrome. (United States)

    Cooke, Aoife A; Connaughton, Ruth M; Lyons, Claire L; McMorrow, Aoibheann M; Roche, Helen M


    The metabolic syndrome is a group of obesity associated metabolic conditions that result in increased risk of cardiovascular disease and type 2 diabetes. Global increases in obesity rates have led to an increase in metabolic syndrome resulting in a demand for increased understanding of the mechanisms involved. This review examines the relationship between adipose tissue biology, lipid metabolism and chronic low grade inflammation relating to obesity and insulin resistance. Copyright © 2016. Published by Elsevier B.V.

  12. Platelet turnover in stable coronary artery disease - influence of thrombopoietin and low-grade inflammation.

    Directory of Open Access Journals (Sweden)

    Sanne Bøjet Larsen

    Full Text Available BACKGROUND: Newly formed platelets are associated with increased aggregation and adverse outcomes in patients with coronary artery disease (CAD. The mechanisms involved in the regulation of platelet turnover in patients with CAD are largely unknown. AIM: To investigate associations between platelet turnover parameters, thrombopoietin and markers of low-grade inflammation in patients with stable CAD. Furthermore, to explore the relationship between platelet turnover parameters and type 2 diabetes, prior myocardial infarction, smoking, age, gender and renal insufficiency. METHODS: We studied 581 stable CAD patients. Platelet turnover parameters (immature platelet fraction, immature platelet count, mean platelet volume, platelet distribution width and platelet large cell-ratio were determined using automated flow cytometry (Sysmex XE-2100. Furthermore, we measured thrombopoietin and evaluated low-grade inflammation by measurement of high-sensitive CRP and interleukin-6. RESULTS: We found strong associations between the immature platelet fraction, immature platelet count, mean platelet volume, platelet distribution width and platelet large cell ratio (r = 0.61-0.99, p<0.0001. Thrombopoietin levels were inversely related to all of the platelet turnover parameters (r = -0.17--0.25, p<0.0001. Moreover, thrombopoietin levels were significantly increased in patients with diabetes (p = 0.03 and in smokers (p = 0.003. Low-grade inflammation evaluated by high-sensitive CRP correlated significantly, yet weakly, with immature platelet count (r = 0.10, p = 0.03 and thrombopoietin (r = 0.16, p<0.001. Also interleukin-6 correlated with thrombopoietin (r = 0.10, p = 0.02. CONCLUSION: In stable CAD patients, thrombopoietin was inversely associated with platelet turnover parameters. Furthermore, thrombopoietin levels were increased in patients with diabetes and in smokers. However, low-grade inflammation did not seem to have a

  13. Childhood bullying involvement predicts low-grade systemic inflammation into adulthood


    Copeland, William E.; Wolke, Dieter; Lereya, Suzet Tanya; Shanahan, Lilly; Worthman, Carol; Costello, E. Jane


    Bullying is a common childhood experience that affects children at all income levels and racial/ethnic groups. Being a bully victim has long-term adverse consequences on physical and mental health and financial functioning, but bullies themselves display few ill effects. Here, we show that victims suffer from greater increases in low-grade systemic inflammation from childhood to young adulthood than are seen in others. In contrast, bullies showed lower increases in inflammation into adulthood...

  14. Low-grade inflammation in young adults exposed to intrauterine hyperglycemia

    DEFF Research Database (Denmark)

    Kelstrup, L.; Clausen, T. D.; Mathiesen, E. R.;


    Aim: To investigate associations between fetal exposure to intrauterine hyperglycemia and plasma concentrations of interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) in adult offspring. Method: We studied 597 offspring, aged 18-27 years, from four different groups concerning...... overweight but not exposure to intrauterine hyperglycemia was associated with low-grade inflammation in adult offspring. (C) 2012 Elsevier Ireland Ltd. All rights reserved....

  15. Adsorption refrigeration-green cooling driven by low grade thermal energy

    Institute of Scientific and Technical Information of China (English)

    WANG Ruzhu; WANG Liwei


    As a type of environmental benign refrigeration technology powered by low grade thermal energy, adsorption refrigeration have aroused more and more attention in recent years. In this paper, the research frontiers of adsorption refrigeration, including adsorbent, adsorption theory, heat recovery process, technology of adsorber, the research achievements, and the development achievements, are summarized. Typical systems for adsorption refrigeration research facing to applications in the recent years are presented. Future applications of adsorption refrigeration are analysed.

  16. Nitroproteins in Human Astrocytomas Discovered by Gel Electrophoresis and Tandem Mass Spectrometry (United States)

    Peng, Fang; Li, Jianglin; Guo, Tianyao; Yang, Haiyan; Li, Maoyu; Sang, Shushan; Li, Xuejun; Desiderio, Dominic M.; Zhan, Xianquan


    Protein tyrosine nitration is involved in the pathogenesis of highly fatal astrocytomas, a type of brain cancer. To understand the molecular mechanisms of astrocytomas and to discover new biomarkers/therapeutic targets, we sought to identify nitroproteins in human astrocytoma tissue. Anti-nitrotyrosine immunoreaction-positive proteins from a high-grade astrocytoma tissue were detected with two-dimensional gel electrophoresis (2DGE)-based nitrotyrosine immunoblots, and identified with liquid chromatography-tandem mass spectrometry (LC-MS/MS). Fifty-seven nitrotyrosine immunopositive protein spots were detected. A total of 870 proteins (nitrated and non-nitrated) in nitrotyrosine-immunopositive 2D gel spots were identified, and 18 nitroproteins and their 20 nitrotyrosine sites were identified with MS/MS analysis. These nitroproteins participate in multiple processes, including drug-resistance, signal transduction, cytoskeleton, transcription and translation, cell proliferation and apoptosis, immune response, phenotypic dedifferentiation, cell migration, and metastasis. Among those nitroproteins that might play a role in astrocytomas was nitro-sorcin, which is involved in drug resistance and metastasis and might play a role in the spread and treatment of an astrocytoma. Semiquantitative immune-based measurements of different sorcin expressions were found among different grades of astrocytomas relative to controls, and a semiquantitative increased nitration level in high-grade astrocytoma relative to control. Nitro-β-tubulin functions in cytoskeleton and cell migration. Semiquantitative immunoreactivity of β-tubulin showed increased expression among different grades of astrocytomas relative to controls and semiquantitatively increased nitration level in high-grade astrocytoma relative to control. Each nitroprotein was rationalized and related to the corresponding functional system to provide new insights into tyrosine nitration and its potential role in the

  17. Fragmentation mechanism of low-grade hematite ore in a high pressure grinding roll

    Institute of Scientific and Technical Information of China (English)

    袁致涛; 李丽匣; 韩跃新; 刘磊; 刘廷


    The fragmentation mechanism of low-grade hematite ore in a high pressure grinding roll (HPGR) was studied based on the characteristics of comminuted products at different specific pressure levels. The major properties included the reduction ratio, liberation, specific surface energy, and specific surface area. The results showed that the fracture of low-grade hematite ore in HPGR was an interactive dynamic process in which the interaction between coarse particles of gangue minerals and fine particles of valuable minerals was alternately continuous with increased compactness and compacting strength of materials. Within a range of 2.8–4.4 N/mm2, valuable minerals were crushed after preferentially absorbing energy, whereas gangue minerals were not completely crushed and only acted as an energy transfer medium. Within a range of 4.4–5.2 N/mm2, gangue minerals were adequately crushed after absorbing the remaining energy, whereas preferentially crushed valuable minerals acted as an energy transfer medium. Within a range of 5.2–6.0 N/mm2 range, the low-grade hematite ore was not further comminuted because of the “size effect” on the strength of materials, and the comminution effect of materials became stable.

  18. Low-grade oligodendroglioma of the pineal gland: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Levidou Georgia


    Full Text Available Abstract Background Gliomas are a very rare subtype of pineal region tumours, whereas oligodendrogliomas of the pineal region are exceedingly rare, since there have been only 3 cases of anaplastic oligodedrogliomas reported this far. Methods-Results We present a case of a low-grade oligodendroglioma arising in the pineal gland of a 37 year-old woman. The patient presented with diplopia associated with a cystic pineal region mass demonstrated on MRI. Total resection was performed and histological examination showed that the cystic wall consisted of tumour cells with a central nucleus a perinuclear halo and minimal pleomorphism. Immnunohistochemical analysis showed that these cells were diffusely positive for CD57, and negative for GFAP, CD10, CD99, cytokeratins, neurofilaments and synaptophysin. FISH analysis was performed in a small number of neoplastic cells, which were not exhausted after immunohistochemistry and did not reveal deletion of 1p and 19q chromosome arms. However, the diagnosis of a low grade oligodendroglioma of the pineal gland was assigned. Conclusion Although the spectrum of tumours arising in the pineal gland is broad, the reports of oligodendrogliomas confined to this location are exceedingly rare, and to the best of our knowledge there is no report of a low-grade oligodendroglioma. However, they should be added in the long list of tumours arising in the pineal gland.

  19. Dedifferentiated high-grade osteosarcoma originating from low-grade central osteosarcoma of the fibula

    Energy Technology Data Exchange (ETDEWEB)

    Kenan, Samuel [New York University-Hospital for Joint Diseases, Department of Orthopedic Surgery, New York, NY (United States); Ginat, Daniel T. [New York University, School of Medicine, New York, NY (United States); Steiner, German C. [New York University-Hospital for Joint Diseases, Department of Orthopedic Pathology, New York, NY (United States); Department of Pathology, New York, NY (United States)


    Low grade central osteosarcoma is a distinct, rare low grade malignant neoplasm characterized histologically by a spindle cell proliferation associated with trabecular bone formation. This tumor usually carries a good prognosis. However, it has the potential to recur, dedifferentiate, and metastasize subsequent to surgical treatment. In extremely rare occasions, LGCOS presents with areas of dedifferentiation upon initial patient evaluation. In this report we describe one such case affecting the fibula of a 39-year-old female, presenting with pain. Initial biopsy demonstrated a high-grade osteosarcoma. No areas of LGCOS were seen histologically. Following biopsy the patient received 3 months of chemotherapy at a different institution. However, the patient continued to exhibit symptoms. X-rays indicated a very aggressive tumor in the diaphysis of the proximal fibula, MRI revealed soft tissue involvement. The tumor and surrounding soft-tissues were excised en bloc at our institution. Microscopically, the lesion consisted of high-grade osteosarcoma as well as an underlying LGCOS that involved the cortex and medullary cavity of the fibula. The two histological components of the tumor were sharply delineated from one another. No chemotherapy effect was appreciated histologically or clinically. Eight months following the surgery, the patient died from lung metastases. This is the third documented case of dedifferentiated LGCOS at initial presentation. This case reveals that the low-grade component was also evident on preoperative radiographs. (orig.)

  20. Putamen involvement and survival outcomes in patients with insular low-grade gliomas. (United States)

    Wang, Yongheng; Wang, Yinyan; Fan, Xing; Li, Shaowu; Liu, Xing; Wang, Jiangfei; Jiang, Tao


    OBJECTIVE Insular glioma has a unique origin and biological behavior; however, the associations between its anatomical features and prognosis have not been well established. The object of this study was to propose a classification system of insular low-grade gliomas based on preoperative MRI findings and to assess the system's association with survival outcome. METHODS A total of 211 consecutively collected patients diagnosed with low-grade insular gliomas was analyzed. All patients were classified according to whether tumor involved the putamen on MR images. The prognostic role of this novel putaminal classification, as well as that of Yaşargil's classification, was examined using multivariate analyses. RESULTS Ninety-nine cases (46.9%) of insular gliomas involved the putamen. Those tumors involving the putamen, as compared with nonputaminal tumors, were larger (p putamen classification (p = 0.014), and IDH1 mutation (p = 0.026) were independent predictors of overall survival. No prognostic role was found for Yaşargil's classification. CONCLUSIONS The current study's findings suggest that the putamen classification is an independent predictor of survival outcome in patients with insular low-grade gliomas. This newly proposed classification allows preoperative survival prediction for patients with insular gliomas.

  1. MRI differentiation of low-grade from high-grade appendicular chondrosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Douis, Hassan; Singh, Leanne; Saifuddin, Asif [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom)


    To identify magnetic resonance imaging (MRI) features which differentiate low-grade chondral lesions (atypical cartilaginous tumours/grade 1 chondrosarcoma) from high-grade chondrosarcomas (grade 2, grade 3 and dedifferentiated chondrosarcoma) of the major long bones. We identified all patients treated for central atypical cartilaginous tumours and central chondrosarcoma of major long bones (humerus, femur, tibia) over a 13-year period. The MRI studies were assessed for the following features: bone marrow oedema, soft tissue oedema, bone expansion, cortical thickening, cortical destruction, active periostitis, soft tissue mass and tumour length. The MRI-features were compared with the histopathological tumour grading using univariate, multivariate logistic regression and receiver operating characteristic curve (ROC) analyses. One hundred and seventy-nine tumours were included in this retrospective study. There were 28 atypical cartilaginous tumours, 79 grade 1 chondrosarcomas, 36 grade 2 chondrosarcomas, 13 grade 3 chondrosarcomas and 23 dedifferentiated chondrosarcomas. Multivariate analysis demonstrated that bone expansion (P = 0.001), active periostitis (P = 0.001), soft tissue mass (P < 0.001) and tumour length (P < 0.001) were statistically significant differentiating factors between low-grade and high-grade chondral lesions with an area under the ROC curve of 0.956. On MRI, bone expansion, active periostitis, soft tissue mass and tumour length can reliably differentiate high-grade chondrosarcomas from low-grade chondral lesions of the major long bones. (orig.)

  2. Histopathological-molecular genetic correlations in referral pathologist-diagnosed low-grade "oligodendroglioma". (United States)

    Sasaki, Hikaru; Zlatescu, Magdalena C; Betensky, Rebecca A; Johnk, Loki B; Cutone, Andrea N; Cairncross, J Gregory; Louis, David N


    Allelic loss of chromosome 1p predicts increased chemosensitivity and better survival in oligodendroglial tumors. Clinical testing for 1p loss in oligodendroglial tumors at our hospital has allowed us to postulate that certain histological appearances are associated with 1p allelic status. Forty-four cases received for genetic testing were diagnosed by referring pathologists as pure low-grade oligodendroglioma. Central neuropathological review divided the series equally into 22 cases with classical oligodendroglioma histology and 22 with more astrocytic features. Molecular genetic analyses demonstrated 1p loss in 19 of 22 classic oligodendrogliomas (86%) and maintenance of both 1p alleles in 16 of 22 gliomas with astrocytic features (73%). No glial fibrillary acidic protein-positive cell type (gliofibrillary oligodendrocyte, minigemistocyte, cellular processes) was associated with 1p allelic status. Fourteen of the 44 cases were treated with chemotherapy at tumor progression: 3 "astrocytic" gliomas with 1p loss responded to PCV chemotherapy and 2 classic oligodendrogliomas that maintained both 1p alleles included a responder and a non-responder. These results suggest that histological appearance correctly predicts genotype in approximately 80% of low-grade gliomas, but that tumor genotype more closely predicts chemosensitivity. As a result, such objective molecular genetic analyses should be incorporated into patient management and into clinical trials of low-grade diffuse gliomas.

  3. Low-grade Schwann cell neoplasms with leptomeningeal dissemination: clinicopathologic and autopsy findings. (United States)

    Rodriguez, Erika F; Blakeley, Jaishri; Langmead, Shannon; Olivi, Alessandro; Tufaro, Anthony; Tabbarah, Abeer; Berkenblit, Gail; Sacks, Justin M; Newsome, Scott D; Montgomery, Elizabeth; Rodriguez, Fausto J


    Leptomeningeal dissemination of low-grade Schwann cell neoplasms is an exceptionally rare occurrence and has not been well documented in the literature. We encountered 2 cases of leptomeningeal dissemination of low-grade Schwann cell neoplasms. Patient 1 was a 63-year-old woman with neurofibromatosis type 1 and a progressive low-grade malignant peripheral nerve sheath tumor developing from a diffuse/plexiform orbital neurofibroma that arose in childhood. The neoplasm demonstrated local and leptomeningeal dissemination intracranially leading to the patient's death. There was partial loss of H3K27 tri-methylation, p16 and collagen IV. Patient 2 was a 60-year-old man without neurofibromatosis type 1 who presented with cranial nerve symptoms and a disseminated neoplasm with a Schwann cell phenotype. The neoplasm stabilized after irradiation and chemotherapy, but the patient died of medical complications. Autopsy findings documented disseminated leptomeningeal disease in the intracranial and spinal compartment. H3K27M tri-methylation was preserved. The clinicopathologic and autopsy findings are studied and presented, and the literature is reviewed.

  4. Low-grade extraskeletal osteosarcoma of the chest wall: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Chetaille Bruno


    Full Text Available Abstract Background Low-grade extraskeletal osteosarcomas (ESOS are extremely rare. Case presentation We present the first case of low-grade ESOS of the chest wall, which occurred in a 30-year-old man. Because of initial misdiagnosis and patient's refusal of surgery, the diagnosis was done after a 4-year history of a slowly growing mass in soft tissues, leading to a huge (30-cm diameter calcified mass locally extended over the left chest wall. Final diagnosis was helped by molecular analysis of MDM2 and CDK4 oncogenes. Unfortunately, at this time, no surgical treatment was possible due to loco-regional extension, and despite chemotherapy, the patient died one year after diagnosis, five years after the first symptoms. Conclusion We describe the clinical, radiological and bio-pathological features of this unique case, and review the literature concerning low-grade ESOS. Our case highlights the diagnostic difficulties for such very rare tumours and the interest of molecular analysis in ambiguous cases.

  5. Simulation of NOx emission in circulating fluidized beds burning low-grade fuels

    Energy Technology Data Exchange (ETDEWEB)

    Afsin Gungor [Nigde University, Nigde (Turkey). Faculty of Engineering and Architecture


    Nitrogen oxides are a major environmental pollutant resulting from combustion. This paper presents a modeling study of pollutant NOx emission resulting from low-grade fuel combustion in a circulating fluidized bed. The simulation model accounts for the axial and radial distribution of NOx emission in a circulating fluidized bed (CFB). The model results are compared with and validated against experimental data both for small-size and industrial-size CFBs that use different types of low-grade fuels given in the literature. The present study proves that CFB combustion demonstrated by both experimental data and model predictions produces low and acceptable levels of NOx emissions resulting from the combustion of low-grade fuels. Developed model can also investigate the effects of different operational parameters on overall NOx emission. As a result of this investigation, both experimental data and model predictions show that NOx emission increases with the bed temperature but decreases with excess air if other parameters are kept unchanged. 37 refs., 5 figs., 5 tabs.

  6. The insulin-like growth factor 1 pathway is a potential therapeutic target for low-grade serous ovarian carcinoma (United States)

    King, Erin R.; Zu, Zhifei; Tsang, Yvonne T.M.; Deavers, Michael T.; Malpica, Anais; Mok, Samuel C.; Gershenson, David M.; Wong, Kwong-Kwok


    Objective To validate the overexpression of insulin-like growth factor 1 (IGF-1) and its receptor (IGF-1R) in low-grade serous ovarian carcinoma (SOC), and to investigate whether the IGF-1 pathway is a potential therapeutic target for low-grade SOC. Methods Gene expression profiling was performed on serous borderline ovarian tumors (SBOTs) and low-grade SOC, and overexpression of IGF-1 in low-grade SOC was validated by RT-PCR and immunohistochemistry. The effect of exogenous IGF-1 on cell proliferation was determined in cell lines by cell proliferation assays, cell migration assays, and Western blot. Signaling pathways downstream of IGF-1 and the effects of the AKT inhibitor MK-2206 were investigated by Western blot analysis and by generating IGF-1R short hairpin RNA stable knockdown cell lines. Low- and high-grade cell lines were treated with the dual IGF-1R- and insulin receptor-directed tyrosine kinase inhibitor OSI-906, and cellular proliferation was measured. Results mRNA analysis and immunostaining revealed significantly higher IGF-1 expression in low-grade SOCs than in SBOTs or high-grade SOCs. In response to exogenous treatment with IGF-1, low-grade cell lines exhibited more intense upregulation of phosphorylated AKT than did high-grade cell lines, an effect that was diminished with IGF-1R knockdown and MK-2206 treatment. Low-grade SOC cell lines were more sensitive to growth inhibition with OSI-906 than were high-grade cell lines. Conclusions IGF-1 is overexpressed in low-grade SOCs compared with SBOTs and high-grade SOCs. Additionally, low-grade SOC cell lines were more responsive to IGF-1 stimulation and IGF-1R inhibition than were high-grade lines. The IGF-1 pathway is therefore a potential therapeutic target in low-grade SOC. PMID:21726895

  7. The pilocytic astrocytoma : immunohistochemical and genetic studies in relation to tumor behavior

    NARCIS (Netherlands)

    Dirven, Clemens Maria Franciscus


    The tumors, studied in this thesis, were named "pilocytic astrocytomas" in the WHO classification of 1979, before that time they had been described under different names, such as gliocytoma embryonale and spongioblastoma. Pilocytic astrocytomas account for 6% of all brain tumors and occur mainly in

  8. CD133 identifies perivascular niches in grade II-IV astrocytomas

    DEFF Research Database (Denmark)

    Christensen, Karina; Schrøder, Henrik; Kristensen, Bjarne


    The aim of the present study was to investigate the localization and distribution of the putative brain tumour stem cell marker CD133 in formalin fixed paraffin embedded astrocytomas. A retrospective analysis of 114 grade II, III and IV astrocytomas was undertaken. The immunohistochemical...

  9. Up-regulation of specific NF1 gene transcripts in sporadic pilocytic astrocytomas

    NARCIS (Netherlands)

    Platten, M; Giordano, MJ; Dirven, CMF; Gutmann, DH; Louis, DN


    Pilocytic astrocytomas of the optic nerve (optic nerve gliomas) are closely associated with neurofibromatosis 1 (NF1), and allelic losses of the NF1 gene region on chromosome 17q occur in sporadic pilocytic astrocytomas. We therefore hypothesized that the NF1 gene nets as a tumor suppressor gene in

  10. Temozolomide: The evidence for its therapeutic efficacy in malignant astrocytomas

    Directory of Open Access Journals (Sweden)

    Ayman I Omar


    Full Text Available Ayman I Omar1, Warren P Mason21Department of Medicine, Princess Margaret Hospital and the University of Toronto, Toronto, Ontario, Canada; 2Department of Medicine, University of Toronto, Toronto, Ontario, CanadaIntroduction: Malignant gliomas are a heterogeneous group of primary central nervous system neoplasms that represent less than 2% of all cancers yet carry a significant burden to society. They are frequently associated with considerable and progressive neurological disability and are ultimately intractable to all forms of treatment. Temozolomide (TMZ is a new second generation DNA alkylating agent that has become part of malignant astrocytoma management paradigms because of its proven efficacy, ease of administration, and favorable toxicity profile. Aims: To review the role of TMZ in the management of malignant astrocytomas (World Health Organization grades III and IV including newly diagnosed (n and recurrent (r anaplastic astrocytomas (AA and glioblastomas.Evidence review: A series of pivotal clinical trials have established a role for TMZ in the treatment of malignant astrocytomas. A large phase II trial examining the role of TMZ in rAA showed a response rate of 35%, and a 6-month progression-free survival of 46%. This led to the accelerated approval of TMZ by the FDA and the EU for the treatment of rAA. Evidence for a role of TMZ in nAA is currently limited but research is ongoing in this area. The role of TMZ in the management of glioblastoma at the time of recurrence (rGBM is less impressive but evidence for its activity was demonstrated in two large phase II trials that led to the approval of TMZ for this indication in Europe and Canada but not in the US. A recent large prospective randomized phase III trial showed that the addition of TMZ during and after radiation therapy (RT in newly diagnosed (nGBM patients prolonged median overall survival by 2.5 months; perhaps more importantly, the 2-year survival rate for patients

  11. Alterations of BCCIP, a BRCA2 interacting protein, in astrocytomas

    Directory of Open Access Journals (Sweden)

    Merlo Adrian


    Full Text Available Abstract Background Loss of heterozygosity of chromosome 10q26 has been shown to be associated with the aggressiveness of astrocytic tumors (or astrocytomas, but the responsible gene(s residing in this region has not been fully identified. The BCCIP gene is located at chromosome 10q26. It encodes a BRCA2 and CDKN1A (p21 interacting protein. Previous studies have shown that down-regulation of BCCIP impairs recombinational DNA repair, G1/S cell cycle checkpoint, p53 trans-activation activity, cytokinesis, and chromosome stability, suggesting a potential role of BCCIP in cancer etiology. In this study, we investigated whether BCCIP is altered in astrocytomas. Methods Genomic DNA from 45 cases of grade IV astrocytic tumor (glioblastoma tissues and 12 cases of normal tissues were analyzed by quantitative PCR. The BCCIP protein expression in 96 cases of grade II–IV astrocytic tumors was detected by immunohistochemistry (IHC. IHC staining of glial fibrillary acid protein (GFAP, a marker for astrocytic cells, was used to identify cells of the astrocytic lineage. Results We found that BCCIP protein is expressed in normal cells with positive staining of GFAP. However, BCCIP protein expression was not detectable in ~45% of all astrocytic tumors, and in > 60% in the grade IV glioblastoma. About 45% glioblastoma have significant (p BCCIP gene copy number when compared to normal DNA. Furthermore, the frequency of lacking BCCIP expression is associated with the aggressiveness of astrocytic tumors. Conclusion Our data implicate a role of BCCIP in astrocytic tumorigenesis, and lack of BCCIP may be used as a marker for astrocytomas.

  12. Potential Utility of Visually AcceSAble Rembrandt Images Assessment in Brain Astrocytoma Grading. (United States)

    Yu, Jing; Wang, Min; Song, Jiacheng; Huang, DongYa; Hong, Xunning


    The aim of this study was to evaluate the predictive value of multivariate factors of Visually AcceSAble Rembrandt Images (VASARI) in brain astrocytoma grading. Presurgical magnetic resonance images of 126 patients with brain astrocytomas (World Health Organization grade 2, n = 38; grade 3, n = 36; grade 4, n = 52) were rated by 2 neuroradiologists for tumor size, location, and tumor morphology by using a standardized imaging feature set VASARI. Significant differences were noted in 12 factors of VASARI including enhancement quality, enhancing proportion, noncontrast enhancing tumor proportion, necrosis proportion, edema proportion, hemorrhage, thickness of enhancing margin, definition of the enhancing margin, pial and ependymal invasion, enhanced tumor crossing midline, and satellites between brain astrocytoma grades (grades 1-IV, P VASARI especially enhancement quality, edema proportion, and noncontrast enhancing tumor proportion provided precise and detailed information of astrocytoma grading and suggested that prediction of astrocytoma grading is based on VASARI as an adjunct to biopsy.


    Institute of Scientific and Technical Information of China (English)

    Zhai Guang; Yuan Xianhou


    Objective:To study the relationship between deletion of P16 gene and occurrence and progression of astrocytomas. Methods: The techniques of polymerase chain reaction (PCR) and immunohistochemistry were used to detect the deletion of exon2 of P16 gene and expression of P16 gene in 52 cases of Brain astrocytoma.Results: The deletion rate of exon2 of P16 gene in the tumors analyzed was 34.6%. Most of them with deletion of exon2 of p16 gene were high grade astrocytomas (grade Ⅲ 42%, grade Ⅳ 50%). 61.5% of the tumors were absent from expression of p16 and the deletion rate of p16 protein increased with the grade of astrocytoma (X2=10.83, P<0.005). Conclusion: Deletion of p16 gene and protein may correlate with the malignant progression of astrocytoma.

  14. The Mystery of Multiple Masses: A Case of Anaplastic Astrocytoma. (United States)

    Sethi, Pooja; Treece, Jennifer; Pai, Vandana; Onweni, Chidinma; Rahman, Zia; Singh, Siddharth


    Though most primary brain gliomas present as a single mass lesion in the brain, this potential diagnosis must be considered in the differential diagnosis when faced with a case of multifocal brain mass lesions. Among the most common brain tumors in humans, glioblastomas can be classified into four classes, one of which consists of anaplastic astrocytomas (AA). Due to its significant malignant potential, a prompt stereotactic brain biopsy should be considered to allow for early diagnosis. Karyotypic analysis of the specimen may allow for the discovery of 1p12q and IDH132 gene mutations. This knowledge can be used to best determine prognosis and guide therapy.

  15. Snapping scapular syndrome secondary to rib intramedullary fixation device

    Directory of Open Access Journals (Sweden)

    Ezequiel E. Zaidenberg


    Conclusion: Surgeons should pay attention to any protrusion of intramedullary rib implants, especially in the evaluation of routine X-rays following surgical treatment. We should be aware of the possibility of this rare cause of snapping scapula syndrome to avoid delayed diagnosis and consider removing the implant will resolve the pain.

  16. 21 CFR 888.3020 - Intramedullary fixation rod. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intramedullary fixation rod. 888.3020 Section 888.3020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of alloys such as cobalt-chromium-molybdenum and stainless steel. It is inserted into the medullary...

  17. KRAS/BRAF Analysis in Ovarian Low-Grade Serous Carcinoma Having Synchronous All Pathological Precursor Regions

    Directory of Open Access Journals (Sweden)

    Kohei Nakamura


    Full Text Available Ovarian low-grade serous carcinoma is thought to begin as a serous cystadenoma or adenofibroma that progresses in a slow stepwise fashion. Among the low-grade serous carcinomas, there is a high frequency of activating mutations in the KRAS or BRAF genes; however, it remains unclear as to how these mutations contribute to tumor progression. This is the first report to track the histopathological progression of serous adenofibroma to low-grade serous carcinoma. Each stage was individually analyzed by pathological and molecular genetic methods to determine what differences occur between the distinct stages of progression.

  18. Extent of surgical resection predicts seizure freedom in low-grade temporal lobe brain tumors. (United States)

    Englot, Dario J; Han, Seunggu J; Berger, Mitchel S; Barbaro, Nicholas M; Chang, Edward F


    Achieving seizure control in patients with low-grade temporal lobe gliomas or glioneuronal tumors remains highly underappreciated, because seizures are the most frequent presenting symptom and significantly impact patient quality-of-life. To assess how the extent of temporal lobe resection influences seizure outcome. We performed a quantitative, comprehensive systematic literature review of seizure control outcomes in 1181 patients with epilepsy across 41 studies after surgical resection of low-grade temporal lobe gliomas and glioneuronal tumors. We measured seizure-freedom rates after subtotal resection vs gross-total lesionectomy alone vs tailored resection, including gross-total lesionectomy with hippocampectomy and/or anterior temporal lobe corticectomy. Included studies were observational case series, and no randomized, controlled trials were identified. Although only 43% of patients were seizure-free after subtotal tumor resection, 79% of individuals were seizure-free after gross-total lesionectomy (OR = 5.00, 95% confidence interval [CI]: 3.33-7.14). Furthermore, tailored resection with hippocampectomy plus corticectomy conferred additional benefit over gross-total lesionectomy alone, with 87% of patients achieving seizure freedom (OR = 1.82, 95% CI: 1.23-2.70). Overall, extended resection with hippocampectomy and/or corticectomy over gross-total lesionectomy alone significantly predicted seizure freedom (OR = 1.18, 95% CI: 1.11-1.26). Age seizure outcome. Gross-total lesionectomy of low-grade temporal lobe tumors results in significantly improved seizure control over subtotal resection. Additional tailored resection including the hippocampus and/or adjacent cortex may further improve seizure control, suggesting dual pathology may sometimes allow continued seizures after lesional excision.

  19. ENabling Reduction of Low-grade Inflammation in SEniors Pilot Study: Concept, Rationale, and Design. (United States)

    Manini, Todd M; Anton, Stephen D; Beavers, Daniel P; Cauley, Jane A; Espeland, Mark A; Fielding, Roger A; Kritchevsky, Stephen B; Leeuwenburgh, Christiaan; Lewis, Kristina H; Liu, Christine; McDermott, Mary M; Miller, Michael E; Tracy, Russell P; Walston, Jeremy D; Radziszewska, Barbara; Lu, Jane; Stowe, Cindy; Wu, Samuel; Newman, Anne B; Ambrosius, Walter T; Pahor, Marco


    To test two interventions to reduce interleukin (IL)-6 levels, an indicator of low-grade chronic inflammation and an independent risk factor for impaired mobility and slow walking speed in older adults. The ENabling Reduction of low-Grade Inflammation in SEniors (ENRGISE) Pilot Study was a multicenter, double-blind, placebo-controlled randomized pilot trial of two interventions to reduce IL-6 levels. Five university-based research centers. Target enrollment was 300 men and women aged 70 and older with an average plasma IL-6 level between 2.5 and 30 pg/mL measured twice at least 1 week apart. Participants had low to moderate physical function, defined as self-reported difficulty walking one-quarter of a mile or climbing a flight of stairs and usual walk speed of less than 1 m/s on a 4-m usual-pace walk. Participants were randomized to losartan, omega-3 fish oil (ω-3), combined losartan and ω-3, or placebo. Randomization was stratified depending on eligibility for each group. A titration schedule was implemented to reach a dose that was safe and effective for IL-6 reduction. Maximal doses were 100 mg/d for losartan and 2.8 g/d for ω-3. IL-6, walking speed over 400 m, physical function (Short Physical Performance Battery), other inflammatory markers, safety, tolerability, frailty domains, and maximal leg strength were measured. Results from the ENRGISE Pilot Study will provide recruitment yields, feasibility, medication tolerance and adherence, and preliminary data to help justify a sample size for a more definitive randomized trial. The ENRGISE Pilot Study will inform a larger subsequent trial that is expected to have important clinical and public health implications for the growing population of older adults with low-grade chronic inflammation and mobility limitations. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  20. Low-Grade Uterine Epithelioid Hemangioendothelioma Presented as a Submucosal Leiomyoma during Labor

    Directory of Open Access Journals (Sweden)

    Anastasios V. Koutsopoulos


    Full Text Available With the exception of leiomyomas, soft tissue tumors of the uterine corpus are not common. This is particularly true for vascular neoplasms, with the epithelioid hemangioendothelioma being a curiosity; not more than twenty-two cases of malignant hemangioendotheliomas have been reported in the literature so far, all of which were high-grade hemangioendotheliomas (hemangiosarcomas. We present herewith a unique case of low-grade epithelioid hemangioendothelioma of the uterus in a pregnant woman aged 29 years. The clinical, histological, and immunohistochemical characteristics of this entity, together with its differential diagnosis, are discussed.

  1. Low-grade meningioma showing nearly equal density with spinal fluid on radiographic images. (United States)

    Tamura, Ryota; Tomita, Hideyuki; Shimizu, Kazuhiko; Sugiyama, Kazutoshi


    A 61-year-old woman had an intracranial tumour that was located on the falx. Meningioma was suspected and the tumour rapidly grew over 1 year. It showed nearly equal density with spinal fluid showing almost no enhancement on radiographic images, like microcystic meningioma. Successful removal of the tumour was achieved. Histopathologically, the tumour was diagnosed as low-grade meningioma. The meningioma had variable sized microcysts and the appearance of solid area was meningothelial meningioma. This is a rare radiographic image for meningothelial meningioma.

  2. Exercise as a mean to control low-grade systemic inflammation

    DEFF Research Database (Denmark)

    Mathur, Neha; Pedersen, Bente Klarlund


    Chronic noncommunicable diseases (CNCDs), which include cardiovascular disease, some cancers, for example, colon cancer, breast cancer, and type 2 diabetes, are reaching epidemic proportions worldwide. It has now become clear that low-grade chronic inflammation is a key player in the pathogenesis...... of most CNCDs. Given that regular exercise offers protection against all causes of mortality, primarily by protection against atherosclerosis and insulin resistance, we suggest that exercise may exert some of its beneficial health effects by inducing anti-inflammatory actions. Recently, IL-6...

  3. Low-grade mucinous neoplasm of the appendix managed with laparoscopic appendectomy

    Directory of Open Access Journals (Sweden)

    Jonas P DeMuro


    Full Text Available Mucocele of the appendix is uncommon and caused by a variety of pathologies. While the gold standard approach to these lesions has historically been exploratory laparotomy and right hemicolectomy, there is increasing experience with a minimally invasive approach and the resection limited to an appendectomy. A case is presented of an appendiceal mucocele diagnosed preoperatively and managed with a laparoscopic appendectomy. The pathology showed a low-grade mucinous neoplasm, with no evidence of recurrence on 30 month follow-up.

  4. Investigating depression-like and metabolic parameters in a chronic low-grade inflammation model

    DEFF Research Database (Denmark)

    Fischer, C. W.; Elfving, B.; Lund, S.


    (registered trademark) 2ML4, infusion rate 2.5l/day), which delivers LPS through a catheter into the abdomen. Depression-like behavior was assessed as increased time spent immobile in the forced swim test (FST). Peripheral markers of a low-grade inflammation was measured using a high sensitivity ELISA kit and central...... disturbances or sickness behavior. Thus, this model might help elucidating some of the mechanisms underlying inflammation-associated depression, in order to assist in developing more effective treatment strategies for this group of patients....

  5. A decomposing technique for scheelite concentrate and low-grade scheelite concentrate

    Institute of Scientific and Technical Information of China (English)

    HUO Guangsheng; SUN Peimei; LI Honggui; LI Yunjiao; ZHAO Zhongwei; SUN Zhaoming; LIU Maosheng


    The effect of different decomposition conditions on tungsten recovery for scheelite concentrate has been examined. The results show that tungsten recovery can be more than 98% under decomposing conditions as follows: the amount of caustic soda is 2.2 and 3.2 times of theoretical respectively, ratio of water and ore is 0.7-0.8, temperature is 160℃, and preservation time is 2.0 h for scheelite concentrate (63.21% WO3) and low grade scheelite concentrate (55.17% WO3).

  6. Polymorphous low-grade adenocarcinoma of parotid gland: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Arathi N


    Full Text Available Polymorphous low-grade adenocarcinoma (PLGA is a rare salivary gland malignant tumor of low aggressiveness, commonly occurring in minor salivary glands. Its occurrence in major salivary gland has been documented albeit rarely. The striking histological feature is architectural diversity combined with benign cytologic features. We report a case of PLGA arising from left parotid in a 25-year-old male patient. On light microscopy, varied patterns were seen .The cells were uniform with bland nuclei. Neural invasion was noted.

  7. Pilomyxoid astrocytoma of the cerebellar vermis in an elderly patient

    Directory of Open Access Journals (Sweden)

    Branko Skovrlj


    Full Text Available Background: Pilomyxoid astrocytoma (PMA has recently been accepted as an aggressive variant of pilocytic astrocytoma with distinct histopathological features. PMAs have been frequently described in the pediatric population with a predilection for the hypothalamic/chiasmatic region. Case Description: A 72-year-old African American male presented with 6 months of memory loss, difficulty expressing himself, and a progressively worsening gait. Magnetic resonance imaging of the brain demonstrated a heterogeneously enhancing cystic mass centered within the cerebellar vermis with mass effect on the fourth ventricle and ventriculomegaly. The patient underwent placement of a ventriculoperitoneal shunt followed by a surgical resection of the lesion, which after immunohistopathologic evaluation, was diagnosed as a World Health Organization grade II PMA. The patient refused further treatment of the lesion and expired 11 months after initial symptom presentation and 4 months after surgery. Conclusion: To our knowledge, this is the first report of PMA of the cerebellar vermis in a previously unreported age group. This case report describes the natural history of this type of tumor in a patient who refused adjuvant therapy following surgical resection.

  8. Clinico-pathological feature of pilomyxoid astrocytomas: three case reports. (United States)

    Nagaishi, Masaya; Yokoo, Hideaki; Hirato, Junko; Yoshimoto, Yuhei; Nakazato, Yoichi


    Pilomyxoid astrocytoma (PMA) is a newly identified variant of pilocytic astrocytoma (PA). We report three cases of PMA with comparison to seven cases of PA in terms of their clinicopathological features. The three cases occurred at the ages of 2, 36 and 6 years, and their tumors were located in the left basal ganglia, the pineal gland, and the cerebellum, respectively. They were diagnosed PMA by surgical specimens that showed a characteristic monomorphous architecture with an angiocentric growth pattern and myxoid background. One patient developed localized relapse at 6 months after the surgery, but the other patients remained alive without tumor progression more than 5 years after treatment. In analysis of the immunohistochemical association in PMA and PA, no specific staining was found to be useful for differential diagnosis of PMA from PA. The expression of biomarkers including O-6-methylguanine-DNA methyltransferase, p53, MIB-1, and EGF receptor neither distinguished PMA from PA nor correlated with outcome. But almost all PMA and PA that demonstrated prominent positivity for nestin showed a high MIB-1 labelling index (LI), and four of these five patients suffered a relapse in the early phase. These results suggest that immunohistochemical expression of nestin and MIB-1 LI may correlate with the aggressiveness of the tumor in PA and PMA.

  9. [A case of astrocytoma of corpus callosum presented diagnostic dyspraxia]. (United States)

    Koshimizu, K; Takeyama, E; Takeyama, E; Kizuki, H; Tei, H; Kubo, O


    A case of astrocytoma whose first clinical presentation was diagnostic dyspraxia was reported. A 38-year-old right-handed male experienced funny motion of his left hand triggered by voluntary movement of his right hand. One day, he tried to insert a coin into the vending machine with his right hand, then the left hand was against the other. One month after that event, he experienced headache and vertigo. On admission, there were no abnormal findings on neurological examination. On neuropsychological examination, he was cooperative, well orientated and attentive, and there were no callosal disconnection symptoms. Frontal lobe function tests were slightly impaired. T1-weighted MRI demonstrated irregular mixed signal intensity mass lesion extending from the genu to the body of the corpus callosum and the cingulate gyrus. This lesion was slightly enhanced with Gd-DTPA. Biopsy was performed and histological diagnosis was fibrillary astrocytoma. After irradiation and chemotherapy, he was discharged from the hospital without evident neurological deficit. About 20 cases of diagnostic dyspraxia have been reported and almost all of them were caused by cerebro-vascular disease. This is the first case of brain tumor who presented diagnostic dyspraxia.

  10. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Lynge, E; Rebolj, M


    cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management......Please cite this paper as: Frederiksen M, Lynge E, Rebolj M. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03130.x. Background If human papillomavirus (HPV) testing will replace....... Selection criteria Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests. Data collection and analysis Information on study design, participants and outcomes was retrieved using a prespecified form...

  11. Knockdown of STAT3 expression by RNAi induces apoptosis in astrocytoma cells

    Directory of Open Access Journals (Sweden)

    Kruger Mathew M


    Full Text Available Abstract Background Astrocytomas are the most common type of primary central nervous system tumors. They are frequently associated with genetic mutations that deregulate cell cycle and render these tumors resistant to apoptosis. STAT3, signal transducer and activator of transcription 3, participates in several human cancers by inducing cell proliferation and inhibiting apoptosis and is frequently activated in astrocytomas. Methods RNA interference was used to knockdown STAT3 expression in human astrocytes and astrocytoma cell lines. The effect of STAT3 knockdown on apoptosis, cell proliferation, and gene expression was then assessed by standard methods. Results We have found that STAT3 is constitutively activated in several human astrocytoma cell lines. Knockdown of STAT3 expression by siRNA induces morphologic and biochemical changes consistent with apoptosis in several astrocytoma cell lines, but not in primary human astrocytes. Moreover, STAT3 is required for the expression of the antiapoptotic genes survivin and Bcl-xL in the A172 glioblastoma cell line. Conclusion These results show that STAT3 is required for the survival of some astrocytomas. These studies suggest STAT3 siRNA could be a useful therapeutic agent for the treatment of astrocytomas.

  12. Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report. (United States)

    Nomura, Tadashi; Sakakibara, Shunsuke; Moriwaki, Aya; Kawamoto, Teruya; Suzuki, Satoshi; Ishimura, Takeshi; Hashikawa, Kazunobu; Terashi, Hiroto


    Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.

  13. Mucinous cystic neoplasm of the liver with low grade dysplasia of the liver. (United States)

    Pirdopska, T; Terziev, I; Taneva, I; Dimitrova, V


    Mucinous cystic neoplasm (MCN) with low grade dysplasia of the liver is rare. It had been previously called hepatobiliary cystadenoma and is seen almost exclusively in women without an associated invasive carcinoma. There are different theories for development of MCN of the liver. One of these is developing from endodermal immature stroma or primary yolk cells implanted during embryogenesis. Another theory refers to the prevalence of hepatic mucinous cystic neoplasm in segment IV, which may support an implant origin because hamartomatous lesions commonly develop in segment IV. The third theory concerns the expression of oestrogen receptor or progesterone receptor in ovarian-like stroma, which also supports a putative role for female hormones in the tumorogenesis. MCN of the liver is a cystic-forming epithelial neoplasm, usually showing no communication with the bile ducts, composed of cuboidal to columnar, variably mucin-producing epithelium, associated with ovarian-type subepithelial stroma. We present a case of MCN with low grade dysplasia of the liver in a young woman whose working surgical diagnosis was Echinococcus cyst. The MCN diagnosis was confirmed with Immunohistochemical study.

  14. Enchondroma versus Low-Grade Chondrosarcoma in Appendicular Skeleton: Clinical and Radiological Criteria

    Directory of Open Access Journals (Sweden)

    Eugenio M. Ferrer-Santacreu


    Full Text Available Objectives. To determine the validity of clinical and radiological features of enchondroma and low grade chondrosarcoma, and contrast the biopsy results with the clinical diagnosis based on the history and imaging. Material and Method. The study included 96 patients with cartilage type lesions suggestive of an enchondroma (E or an low grade chondrosarcoma (LGC according to the clinical and imaging data. The hypotheses were contrasted with the biopsy. Results. Of the 82 patients studied completely, 56 were considered E (68.29%, 8 as LGC (8.33% and in 18 (18.75% were doubtful cases and considered as suspected LGC. Of these, the biopsy showed 4 E (25%, 10 LGC (50% and 4 were not definitive. On the other hand, of the 56 cases diagnosed as E, 15 were biopsied, 5 of these biopsies turned out to be LGC (33.3%. The 8 cases diagnosed as LGC, were also biopsied and only 4 biopsies (50% confirmed the initial diagnosis. Features analyzed in the study showed no statistically significant difference. Correlation analysis between the diagnosis issued initially and the biopsy result gave a value of 0.69 (kappa coefficient, which was considered a good correlation. Conclusion. Features analyzed did not have any statistical significance. However, there was a good correlation between initial diagnosis and biopsy's result.

  15. Harvesting low-grade heat energy using thermo-osmotic vapour transport through nanoporous membranes (United States)

    Straub, Anthony P.; Yip, Ngai Yin; Lin, Shihong; Lee, Jongho; Elimelech, Menachem


    Low-grade heat from sources below 100 ∘C offers a vast quantity of energy. The ability to extract this energy, however, is limited with existing technologies as they are not well-suited to harvest energy from sources with variable heat output or with a small temperature difference between the source and the environment. Here, we present a process for extracting energy from low-grade heat sources utilizing hydrophobic, nanoporous membranes that trap air within their pores when submerged in a liquid. By driving a thermo-osmotic vapour flux across the membrane from a hot reservoir to a pressurized cold reservoir, heat energy can be converted to mechanical work. We demonstrate operation of air-trapping membranes under hydraulic pressures up to 13 bar, show that power densities as high as 3.53 ± 0.29 W m-2 are achievable with a 60 ∘C heat source and a 20 ∘C heat sink, and estimate the efficiency of a full-scale system. The results demonstrate a promising process to harvest energy from low-temperature differences (<40 ∘C) and fluctuating heat sources.

  16. Low-grade myofibroblastic sarcoma arising in fibroadenoma of the breast-A case report. (United States)

    Myong, Na-Hye; Min, Jun-Won


    Myofibroblastic sarcoma or myofibrosarcoma is a malignant tumor of myofibroblasts and known to develop rarely in the breast, but its underlying lesion and tumor cell origin have never been reported yet. A 61-year-old female presented with a gradually growing breast mass with well-demarcated ovoid nodular shape. The tumor was histologically characterized by fascicular-growing spindle cell proliferation with large areas of hyalinized fibrosis and focally ductal epithelial remnants embedded in myxoid stroma, mimicking a fibroadenomatous lesion. It had frequent mitoses of 5-16/10 high-power fields, hemorrhagic necrosis, and focally pericapsular invasion. The spindle cells were diffusely immunoreactive for fibronectin, smooth muscle actin, and calponin, which suggest a myofibroblastic origin. Multiple irregularly thickened vessels with medial or pericytic cell proliferation were found to be merged with the intrinsic tumor cells. The tumor could be diagnosed low-grade myofibroblastic sarcoma arising in an old fibroadenoma. We report a case of a low-grade mammary myofibrosarcoma that showed a background lesion of fibroadenoma first in the worldwide literature and suggest the pericytes or medial muscle cells of the intratumoral vessels as the cell origin of the myofibroblastic sarcoma.

  17. Simultaneous Purification and Perforation of Low-Grade Si Sources for Lithium-Ion Battery Anode. (United States)

    Jin, Yan; Zhang, Su; Zhu, Bin; Tan, Yingling; Hu, Xiaozhen; Zong, Linqi; Zhu, Jia


    Silicon is regarded as one of the most promising candidates for lithium-ion battery anodes because of its abundance and high theoretical capacity. Various silicon nanostructures have been heavily investigated to improve electrochemical performance by addressing issues related to structure fracture and unstable solid-electrolyte interphase (SEI). However, to further enable widespread applications, scalable and cost-effective processes need to be developed to produce these nanostructures at large quantity with finely controlled structures and morphologies. In this study, we develop a scalable and low cost process to produce porous silicon directly from low grade silicon through ball-milling and modified metal-assisted chemical etching. The morphology of porous silicon can be drastically changed from porous-network to nanowire-array by adjusting the component in reaction solutions. Meanwhile, this perforation process can also effectively remove the impurities and, therefore, increase Si purity (up to 99.4%) significantly from low-grade and low-cost ferrosilicon (purity of 83.4%) sources. The electrochemical examinations indicate that these porous silicon structures with carbon treatment can deliver a stable capacity of 1287 mAh g(-1) over 100 cycles at a current density of 2 A g(-1). This type of purified porous silicon with finely controlled morphology, produced by a scalable and cost-effective fabrication process, can also serve as promising candidates for many other energy applications, such as thermoelectrics and solar energy conversion devices.

  18. Scalable Production of Si Nanoparticles Directly from Low Grade Sources for Lithium-Ion Battery Anode. (United States)

    Zhu, Bin; Jin, Yan; Tan, Yingling; Zong, Linqi; Hu, Yue; Chen, Lei; Chen, Yanbin; Zhang, Qiao; Zhu, Jia


    Silicon, one of the most promising candidates as lithium-ion battery anode, has attracted much attention due to its high theoretical capacity, abundant existence, and mature infrastructure. Recently, Si nanostructures-based lithium-ion battery anode, with sophisticated structure designs and process development, has made significant progress. However, low cost and scalable processes to produce these Si nanostructures remained as a challenge, which limits the widespread applications. Herein, we demonstrate that Si nanoparticles with controlled size can be massively produced directly from low grade Si sources through a scalable high energy mechanical milling process. In addition, we systematically studied Si nanoparticles produced from two major low grade Si sources, metallurgical silicon (∼99 wt % Si, $1/kg) and ferrosilicon (∼83 wt % Si, $0.6/kg). It is found that nanoparticles produced from ferrosilicon sources contain FeSi2, which can serve as a buffer layer to alleviate the mechanical fractures of volume expansion, whereas nanoparticles from metallurgical Si sources have higher capacity and better kinetic properties because of higher purity and better electronic transport properties. Ferrosilicon nanoparticles and metallurgical Si nanoparticles demonstrate over 100 stable deep cycling after carbon coating with the reversible capacities of 1360 mAh g(-1) and 1205 mAh g(-1), respectively. Therefore, our approach provides a new strategy for cost-effective, energy-efficient, large scale synthesis of functional Si electrode materials.

  19. Obesity and Low-Grade Inflammation Increase Plasma Follistatin-Like 3 in Humans

    Directory of Open Access Journals (Sweden)

    Claus Brandt


    Full Text Available Background. Rodent models suggest that follistatin-like 3 (fstl3 is associated with diabetes and obesity. In humans, plasma fstl3 is reduced with gestational diabetes. In vitro, TNF-α induces fstl3 secretion, which suggests a link to inflammation. Objective. To elucidate the association between plasma fstl3 and obesity, insulin resistance, and low-grade inflammation in humans. Study Design. Plasma fstl3 levels were determined in a cross-sectional study including three groups: patients with type 2 diabetes, impaired glucose tolerance, and healthy controls. In addition, lipopolysaccharide (LPS, TNF-α, or interleukin-6 (IL-6 as well as a hyperinsulinemic euglycemic clamp were used to examine if plasma fstl3 was acutely regulated in humans. Results. Plasma fstl3 was increased in obese subjects independent of glycemic state. Moreover, plasma fstl3 was positively correlated with fat mass, plasma leptin, fasting insulin, and HOMA B and negatively with HOMA S. Furthermore plasma fstl3 correlated positively with plasma TNF-α and IL-6 levels. Infusion of LPS and TNF-α, but not IL-6 and insulin, increased plasma fstl3 in humans. Conclusion. Plasma fstl3 is increased in obese subjects and associated with fat mass and low-grade inflammation. Furthermore, TNF-α increased plasma fstl3, suggesting that TNF-α is one of the inflammatory drivers of increased systemic levels of fstl3.

  20. Frontal brain asymmetry, childhood maltreatment, and low-grade inflammation at midlife. (United States)

    Hostinar, Camelia E; Davidson, Richard J; Graham, Eileen K; Mroczek, Daniel K; Lachman, Margie E; Seeman, Teresa E; van Reekum, Carien M; Miller, Gregory E


    Frontal EEG asymmetry is thought to reflect variations in affective style, such that greater relative right frontal activity at rest predicts enhanced emotional responding to threatening or negative stimuli, and risk of depression and anxiety disorders. A diathesis-stress model has been proposed to explain how this neuro-affective style might predispose to psychopathology, with greater right frontal activity being a vulnerability factor especially under stressful conditions. Less is known about the extent to which greater relative right frontal activity at rest might be associated with or be a diathesis for deleterious physical health outcomes. The present study examined the association between resting frontal EEG asymmetry and systemic, low-grade inflammation and tested the diathesis-stress model by examining whether childhood maltreatment exposure interacts with resting frontal asymmetry in explaining inflammation. Resting EEG, serum inflammatory biomarkers (interleukin-6, C-reactive protein, and fibrinogen) and self-reported psychological measures were available for 314 middle-aged adults (age M=55.3years, SD=11.2, 55.7% female). Analyses supported the diathesis-stress model and revealed that resting frontal EEG asymmetry was significantly associated with inflammation, but only in individuals who had experienced moderate to severe levels of childhood maltreatment. These findings suggest that, in the context of severe adversity, a trait-like tendency towards greater relative right prefrontal activity may predispose to low-grade inflammation, a risk factor for conditions with inflammatory underpinnings such as coronary heart disease.

  1. Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; vaginal versus other sites. (United States)

    Moschiano, Elizabeth J; Barbuto, Denise A; Walsh, Christine; Singh, Kanwaljit; Euscher, Elizabeth D; Roma, Andres A; Ali-Fehmi, Rouba; Frauenhoffer, Elizabeth E; Montiel, Delia P; Kim, Insun; Djordjevic, Bojana; Malpica, Anais; Hong, Sung Ran; Silva, Elvio G


    Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30% (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5%) with extravaginal recurrence and 3 (7.5%) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.

  2. Polymorphous Low-Grade Adenocarcinoma of the Tongue Base Treated by Transoral Robotic Surgery

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    Jeong Hong Kim


    Full Text Available Polymorphous low-grade adenocarcinoma is a rare malignancy arising from the minor salivary glands in the aerodigestive system, most frequently the hard palate. The treatment of choice is wide surgical resection, and the efficacy of radiotherapy has not been confirmed. A 54-year-old male presenting with a mass at the base of the tongue performed transoral laser microsurgery. The pathologic diagnosis was polymorphous low-grade adenocarcinoma. Complete surgical excision was performed via transoral robotic surgery without a flap reconstruction of the surgical defect. Without complications of bleeding or injury to the hypoglossal nerve, proper surgical margins were obtained, and no recurrence was found after 6 months after surgery. The patient did not complain of dysphagia or aspiration. We conclude that, in surgery for tongue base tumors with unknown malignant potential, transoral robotic surgery can be considered for achieving a definite resection avoiding a mandibulotomy without complications of dysphagia or aspiration after confirmation of malignancy with a frozen biopsy.

  3. Mouse Low-Grade Gliomas Contain Cancer Stem Cells with Unique Molecular and Functional Properties

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    Yi-Hsien Chen


    Full Text Available The availability of adult malignant glioma stem cells (GSCs has provided unprecedented opportunities to identify the mechanisms underlying treatment resistance. Unfortunately, there is a lack of comparable reagents for the study of pediatric low-grade glioma (LGG. Leveraging a neurofibromatosis 1 (Nf1 genetically engineered mouse LGG model, we report the isolation of CD133+ multi-potent low-grade glioma stem cells (LG-GSCs, which generate glioma-like lesions histologically similar to the parent tumor following injection into immunocompetent hosts. In addition, we demonstrate that these LG-GSCs harbor selective resistance to currently employed conventional and biologically targeted anti-cancer agents, which reflect the acquisition of new targetable signaling pathway abnormalities. Using transcriptomic analysis to identify additional molecular properties, we discovered that mouse and human LG-GSCs harbor high levels of Abcg1 expression critical for protecting against ER-stress-induced mouse LG-GSC apoptosis. Collectively, these findings establish that LGG cancer stem cells have unique molecular and functional properties relevant to brain cancer treatment.

  4. Low-grade inflammation disrupts structural plasticity in the human brain. (United States)

    Szabó, C; Kelemen, O; Kéri, S


    Increased low-grade inflammation is thought to be associated with several neuropsychiatric disorders characterized by decreased neuronal plasticity. The purpose of the present study was to investigate the relationship between structural changes in the human brain during cognitive training and the intensity of low-grade peripheral inflammation in healthy individuals (n=56). A two-month training (30 min/day) with a platformer video game resulted in a significantly increased volume of the right hippocampal formation. The number of stressful life events experienced during the past year was associated with less pronounced enlargement of the hippocampus. However, the main predictor of hippocampal volume expansion was the relative peripheral expression of Nuclear Factor-κB (NF-κB), a transcription factor playing a central role in the effect of pro-inflammatory cytokines. Interleukin-6 (IL-6) and C-reactive protein levels were not related to hippocampal plasticity when NF-κB was taken into consideration. These results suggest that more intensive peripheral inflammation is associated with weaker neuronal plasticity during cognitive training. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Low-grade inflammation, diet composition and health: current research evidence and its translation. (United States)

    Minihane, Anne M; Vinoy, Sophie; Russell, Wendy R; Baka, Athanasia; Roche, Helen M; Tuohy, Kieran M; Teeling, Jessica L; Blaak, Ellen E; Fenech, Michael; Vauzour, David; McArdle, Harry J; Kremer, Bas H A; Sterkman, Luc; Vafeiadou, Katerina; Benedetti, Massimo Massi; Williams, Christine M; Calder, Philip C


    The importance of chronic low-grade inflammation in the pathology of numerous age-related chronic conditions is now clear. An unresolved inflammatory response is likely to be involved from the early stages of disease development. The present position paper is the most recent in a series produced by the International Life Sciences Institute's European Branch (ILSI Europe). It is co-authored by the speakers from a 2013 workshop led by the Obesity and Diabetes Task Force entitled 'Low-grade inflammation, a high-grade challenge: biomarkers and modulation by dietary strategies'. The latest research in the areas of acute and chronic inflammation and cardiometabolic, gut and cognitive health is presented along with the cellular and molecular mechanisms underlying inflammation-health/disease associations. The evidence relating diet composition and early-life nutrition to inflammatory status is reviewed. Human epidemiological and intervention data are thus far heavily reliant on the measurement of inflammatory markers in the circulation, and in particular cytokines in the fasting state, which are recognised as an insensitive and highly variable index of tissue inflammation. Potential novel kinetic and integrated approaches to capture inflammatory status in humans are discussed. Such approaches are likely to provide a more discriminating means of quantifying inflammation-health/disease associations, and the ability of diet to positively modulate inflammation and provide the much needed evidence to develop research portfolios that will inform new product development and associated health claims.

  6. An electrochemical system for efficiently harvesting low-grade heat energy (United States)

    Lee, Seok Woo; Yang, Yuan; Lee, Hyun-Wook; Ghasemi, Hadi; Kraemer, Daniel; Chen, Gang; Cui, Yi


    Efficient and low-cost thermal energy-harvesting systems are needed to utilize the tremendous low-grade heat sources. Although thermoelectric devices are attractive, its efficiency is limited by the relatively low figure-of-merit and low-temperature differential. An alternative approach is to explore thermodynamic cycles. Thermogalvanic effect, the dependence of electrode potential on temperature, can construct such cycles. In one cycle, an electrochemical cell is charged at a temperature and then discharged at a different temperature with higher cell voltage, thereby converting heat to electricity. Here we report an electrochemical system using a copper hexacyanoferrate cathode and a Cu/Cu2+ anode to convert heat into electricity. The electrode materials have low polarization, high charge capacity, moderate temperature coefficients and low specific heat. These features lead to a high heat-to-electricity energy conversion efficiency of 5.7% when cycled between 10 and 60 °C, opening a promising way to utilize low-grade heat.

  7. Extracapsular dissection as sole therapy for small low-grade malignant tumors of the parotid gland. (United States)

    Mantsopoulos, Konstantinos; Koch, Michael; Iro, Heinrich


    The aim of the study was to investigate whether extracapsular dissection of a primarily unsuspected lesion in the parotid gland could be oncologically sufficient for carefully selected cases of parotid gland malignomas. Retrospective clinical study. The records of all patients treated for primary malignant tumors of the parotid gland solely by means of extracapsular dissection between 2006 and 2013 were studied retrospectively. Patients with manifestation of malignant tumors in the parotid gland that were not of primary salivary gland origin (squamous cell carcinomas, lymphomas, melanomas) or who had had revision surgery or other malignant tumors in their history, as well as patients with insufficient data, were excluded from our study sample. Nine patients, all with low-grade parotid malignancies, were detected. Our study showed acceptable oncologic and functional outcomes throughout. Our study was able to show very encouraging preliminary results following primary extracapsular dissection as sole surgical therapy for carefully selected low-stage, low-grade, inferiorly located lesions in patients with high compliance. 4. Laryngoscope, 127:1804-1807, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  8. The Outlook for Low-Grade Fuels in Tomsk Region: Research Experience at Tomsk Polytechnic University

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    Khaustov Sergei A.


    Full Text Available The urgency of the discussed issue is caused by the need to substitute in the regional fuel-energy balances imported energy resources with local low-grade fuels. The main aim of the study is to estimate thermal properties of local fuels in Tomsk region and evaluate its energy use viability. The methods used in the study were based standard GOST 52911-2008, 11022-95 and 6382-2001, by means of a bomb calorimeter ABK-1 and Vario micro cube analyzer. The mineral ash of researched fuels was studied agreeing with GOST 10538-87. The results state the fact that discussed low-grade fuels of Tomsk region in the unprepared form are not able to replace imported coal in regional energy balance, because of the high moisture and ash content values. A promosing direction of a low-temperature fue processing is a catalytic converter, which allows receiving hydrogen-enriched syngas from the initial solid raw.

  9. An electrochemical system for efficiently harvesting low-grade heat energy. (United States)

    Lee, Seok Woo; Yang, Yuan; Lee, Hyun-Wook; Ghasemi, Hadi; Kraemer, Daniel; Chen, Gang; Cui, Yi


    Efficient and low-cost thermal energy-harvesting systems are needed to utilize the tremendous low-grade heat sources. Although thermoelectric devices are attractive, its efficiency is limited by the relatively low figure-of-merit and low-temperature differential. An alternative approach is to explore thermodynamic cycles. Thermogalvanic effect, the dependence of electrode potential on temperature, can construct such cycles. In one cycle, an electrochemical cell is charged at a temperature and then discharged at a different temperature with higher cell voltage, thereby converting heat to electricity. Here we report an electrochemical system using a copper hexacyanoferrate cathode and a Cu/Cu(2+) anode to convert heat into electricity. The electrode materials have low polarization, high charge capacity, moderate temperature coefficients and low specific heat. These features lead to a high heat-to-electricity energy conversion efficiency of 5.7% when cycled between 10 and 60 °C, opening a promising way to utilize low-grade heat.

  10. Cytologic diagnosis of low-grade papillary urothelial neoplasms (low malignant potential and low-grade carcinoma) in the context of the 1998 WHO/ISUP classification. (United States)

    Whisnant, Richard E; Bastacky, Sheldon I; Ohori, N Paul


    The 1998 World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification of urothelial neoplasms introduced a category called papillary neoplasm of low malignant potential (LMP) and separated it from low-grade papillary urothelial carcinoma (LGPUC), which was thought to yield abnormal cells in cytology specimens. The objective of our study was to evaluate the effectiveness of urine cytology in diagnosing these lesions. Eighty-six paired transurethral surgical biopsy and corresponding urine cytology specimens representing the spectrum of urothelial papillary lesions were examined. Consensus diagnosis on each biopsy was made, and the distribution was as follows: 16 benign urothelium, 27 LMP, 28 LGPUC, and 15 high-grade papillary urothelial carcinoma (HGPUC). This was followed by a blinded independent review of the urine cytology specimens by three observers. Each cytology case was marked as negative, atypical, suspicious, or positive for malignant cells by using previously published cytologic criteria. When the negative and atypical diagnoses were grouped together as "benign" and the suspicious and malignant diagnoses as "malignant," the detection rate of "malignancy" of the lesions was as follows: LMP, 37%; LGPUC, 25%; and HGPUC, 53%. The false positive rate was 6%, and the positive predictive value (PPV) was 94%. Detection rates of cells that were at least "atypical" were as follows: LMP, 74%; LGPUC, 79%; and HGPUC, 100%. While most of the LMP and LGPUC cases yielded cells that were at least "atypical," there was no significant difference in the distribution of cytologic diagnoses for LMP and LGPUC cases (P > 0.05). Urine cytology in the context of the 1998 WHO/ISUP classification appears to be useful as a screening tool but does not appear to discriminate LMP effectively from LGPUC. Copyright 2003 Wiley-Liss, Inc.

  11. Malignant brain astrocytomas: The outcome of surgical treatment

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    Pavlićević Goran


    Full Text Available Background. The aim of this study was to analyze the outcome after the surgical treatment of patients with malignant brain astrocytomas, as well as the factors influencing the outcome. Retrospective study was performed on 145 operated patients (102 with glioblastoma multiforme, and 43 with anaplastic astrocytomas. Methods. Clinical state was graded according to the Yasargil scale (grades I-IV and the Karnofski score, and the outcome was defined either as good (better or unchanged clinical state or as poor (deteriorated state or death. The outcome was correlated with patients’ age and preoperative clinical condition, as well as with the localization extensiveness and the extent of resection of the tumor. Results. Preoperative clinical state of patients most frequently corresponded to grades II-III (75.9%. Radical resection was done in 48.3%, subtotal in 15.2%, partial in 30.3%, and biopsy was performed in 6.2% of patients, with the total operative mortality of 16.5%, morbidity of 9.7%, and good postoperative outcome in 73.8% of the patients. The incidence of good postoperative outcome did not significantly depend on the tumor location (42.6-78.3%, cortical presentation, the extent of resection (68.2-75.7% and preoperative clinical state (67.8-81.5%. Good outcome was seen in 82.7% of patients with one, and in 53.8% of patients with three or more infiltrated lobes (p<0.01. Patients with poor outcome were significantly older in average than the patients with good outcome (58.9±12.1 and 50.9±13.4 years of age, respectively; p<0.05. Operative mortality was 7.4% and 27.3% for clinical grades II and IV (p<0.05, namely 11% and 23.8% for the patients with the Karnofski score above and under 50 (p<0.05 respectively. Conclusion. The outcome after the operative treatment of malignant cerebral astrocytomas significantly depended on patient’s age and the extensity of the tumor. For such patients operative mortality was also significantly influenced by

  12. Radiotherapy in pediatric pilocytic astrocytomas. A subgroup analysis within the prospective multicenter study HIT-LGG 1996 by the German Society of Pediatric Oncology and Hematology (GPOH)

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    Mueller, K. [Leipzig Univ. (Germany). Dept. of Radiotherapy and Radiation Oncology; Gnekow, A.; Falkenstein, F. [General Hospital of Augsburg (Germany). Hospital for Children and Adolescents] [and others


    Purpose: We evaluated clinical outcomes in the subset of patients who underwent radiotherapy (RT) due to progressive pilocytic astrocytoma within the Multicenter Treatment Study for Children and Adolescents with a Low Grade Glioma HIT-LGG 1996. Patients and methods: Eligibility criteria were fulfilled by 117 patients. Most tumors (65 %) were located in the supratentorial midline, followed by the posterior fossa (26.5 %) and the cerebral hemispheres (8.5 %). Median age at the start of RT was 9.2 years (range 0.7-17.4 years). In 75 cases, external fractionated radiotherapy (EFRT) was administered either as first-line nonsurgical treatment (n = 58) or after progression following primary chemotherapy (n = 17). The median normalized total dose was 54 Gy. Stereotactic brachytherapy (SBT) was used in 42 selected cases. Results: During a median follow-up period of 8.4 years, 4 patients (3.4 %) died and 33 (27.4 %) experienced disease progression. The 10-year overall (OS) and progression-free survival (PFS) rates were 97 and 70 %, respectively. No impact of the RT technique applied (EFRT versus SBT) on progression was observed. The 5-year PFS was 76 {+-} 5 % after EFRT and 65 {+-} 8 % after SBT. Disease progression after EFRT was not influenced by gender, neurofibromatosis type 1 (NF1) status, tumor location (hemispheres versus supratentorial midline versus posterior fossa), age or prior chemotherapy. Normalized total EFRT doses of more than 50.4 Gy did not improve PFS rates. Conclusion: EFRT plays an integral role in the treatment of pediatric pilocytic astrocytoma and is characterized by excellent tumor control. A reduction of the normalized total dose from 54 to 50.4 Gy appears to be feasible without jeopardizing tumor control. SBT is an effective treatment alternative. (orig.)

  13. Investigation of denitrifying microbial communities within an agricultural drainage system fitted with low-grade weirs. (United States)

    Baker, Beth H; Kröger, Robert; Brooks, John P; Smith, Renotta K; Czarnecki, Joby M Prince


    Enhancing wetland characteristics in agricultural drainage ditches with the use of low-grade weirs, has been identified as a best management practice (BMP) to mitigate nutrient runoff from agriculture landscapes. A major objective of utilizing low-grade weirs as a BMP includes fostering environments suitable for the biogeochemical removal of nitrogen via denitrification. This study examined the spatial resolution of microbial communities involved in denitrification in agricultural drainage systems fitted with low-grade weirs. Appropriate sampling scales of microbial communities were investigated using 16S rRNA and denitrification functional genes nosZ, nirS, and nirK via quantitative polymerase chain reaction (qPCR) and terminal-restriction fragment length polymorphism (T-RFLP) analysis. Genes 16S rRNA, nosZ, and nirS were all successfully detected in soil samples, while nirK was below the detection limit throughout the study. Utilizing a combination of three sampling regimes (management, reach, catchment) was found to be effective in capturing microbial community patterns, as ANOVA results revealed nosZ gene abundance was significantly greater at the management rather than reach scale (p = 0.045; F = 3.311), although, no significant differences were observed in 16S rRNA or nirS between sampling scales (p > 0.05). A Pearson correlation matrix confirmed that 16S rRNA and nosZ gene abundances were positively correlated with soil carbon (C), nitrogen (N), and moisture, while nirS abundance was only positively correlated with soil C and soil moisture. This highlights the potential for wetland-like characteristics to be recovered in agricultural drainage systems, as weir proximity is observed to enhance soil moisture and conditions for N remediation. This study provides the basis for additional investigations of these unique environments in the Mississippi Alluvial Valley and a starting point for adaptive management to enhance agricultural drainage systems for microbial

  14. Primary unreamed intramedullary locked nailing in open fractures of tibia

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    Jain Vineet


    Full Text Available Background: Fractures of tibia are among the commonest fractures sustained in road traffic accidents. They are frequently open and contaminated. Unreamed nails are considered superior to external fixator in the management of open fractures of tibia. Method: Forty patients with open fractures of tibia, grade I, II, IIIa, IIIb were included in the study. They were managed by primary unreamed intramedullary nailing with adequate soft tissue management. Results: Functional results were excellent in 26 cases, good in 10 cases and fair in 4 cases. Four cases had delayed union. Average time of union was 16.9 weeks. Conclusion: Primary unreamed intramedullary nailing offers advantage of rigid fixation, low incidence of infection, non-union, good functional results and early return to work. An adequate soft tissue management is mandatory in treatment of these fractures.

  15. Glioma supratentorial de baixo grau em adulto: experiência com 23 pacientes operados Supratentorial low grade tumors in adults: an experience with 23 surgical cases

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    José Carlos Lynch


    Full Text Available Os astrocitomas e oligodendrogliomas supratentoriais dos adultos são tumores infrequentes. Analisamos retrospectivamente 23 pacientes com este tipo de neoplasia que foram operados entre 1986 e 2002. Não ocorreu nenhum óbito no pós-operatório. A sobrevida de 5 e 10 anos de todo o grupo foi 67 e 30% respectivamente, semelhante a outras experiências. Em 14 pacientes obtivemos a remoção completa da lesão (60,8% e em 9 (39,2% ocorreu remoção parcial do tumor. No subgrupo da ressecção total do tumor, 89% sobreviveram 5 anos e 45% alcançaram 10 anos de sobrevida, em contraste com o subgrupo da remoção parcial em que somente 35% alcançaram os 5 anos de sobrevida e nenhum, 10 anos. Devido aos efeitos deletérios da radioterapia, nós preferimos prescrevê-la apenas nos casos de recorrência tumoral.Low-grade supratentorial astrocytomas and oligodendrogliomas in adults are uncommon tumors of the central nervous system. We analyzed retrospectively 23 patients with this type of neoplasia, who were operated on between 1986 and 2002. There were no post-operative deaths. The survival rate at 5 and 10 years post-surgery for the entire sample was 67 and 30% respectively, similar to other outcomes. With 14 patients we achieved a complete removal of the lesion (60.8% and with 9 (39.2% partial removal of the tumor. In the sub-group which underwent total resection of the tumor, 89% survived 5 years and 45% attained 10 years of survival, in contrast with the sub-group that underwent partial removal in which only 35% attained 5 years of survival and none 10 years. Due to the deleterious effects of radiation therapy, we preferred to prescribe it only in cases of tumor recurrence.

  16. Medium-grade astrocytoma in a cougar (Puma concolor). (United States)

    Kondo, Hirotaka; Leone, Angelique M; Erlacher-Reid, Claire; Gary, Joy; Kiupel, Matti; Farina, Lisa L; Abbott, Jeffrey R


    A 17-year-old, male castrated cougar (Puma concolor) was presented minimally responsive and severely depressed, with bilateral mydriasis and absent pupillary light response. On gross examination of the brain, there was a tan-to-gray, invasive mass with a central cavitation on the ventral aspect in the left cerebral hemisphere, rostral to the caudate nucleus. On histopathologic examination, the mass was composed of sheets of medium-sized, round-to-polygonal cells that were multifocally separated by islands of neuropil. Approximately 80% of the neoplastic cells showed strong cytoplasmic labeling for glial fibrillary acidic protein. These findings were consistent with a medium-grade astrocytoma. To the authors' knowledge, neoplastic disease of the central nervous system has not been previously reported in cougars.

  17. Controlled study of CCNU and radiation therapy in malignant astrocytoma. (United States)

    Reagan, T J; Bisel, H F; Childs, D S; Layton, D D; Rhoton, A L; Taylor, W F


    The authors report 63 patients with biopsy-proved malignant (Grades 3 and 4) astrocytomas who were randomly placed in one of three treatment schedules within 2 weeks of surgery. One group (22 patients) received radiation therapy alone; the second group (22 patients) received 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) orally at intervals of 8 weeks; and the third group (19 patients) received combined radiation and drug therapy. Patients who received radiation therapy, with or without the drug, had a significantly longer survival than did those who received the drug alone. There was no difference in survival between the two groups who received radiation. The nitrosourea derivative CCNU does not seem to be an effective agent in the therapy of primary malignant brain tumors.

  18. Practical Aspects of Posttrauma Reconstruction With an Intramedullary Lengthening Nail. (United States)

    Bernstein, Mitchell


    Limb equalization using the Ilizarov method has evolved and adapted the use of internal lengthening devices. One of the newest devices, termed "PRECICE," is a magnetically controlled telescoping nail. Complications such as pin site infection and skin irritation are eliminated. Despite trauma surgeons' familiarity with intramedullary nailing, the Ilizarov method requires sound knowledge of deformity analysis and awareness of specific complications associated with distraction osteogenesis. This manuscript discusses some of the practical preoperative and intraoperative components of limb lengthening.

  19. Aseptic nonunion of the tibia treated by intramedullary osteosynthesis. (United States)

    Gualdrini, G; Rollo, G; Montanari, A; Zinghi, G F


    The authors report 52 cases of aseptic nonunion of the tibia treated by intramedullary osteosynthesis. The means of synthesis used were the Küntscher nail, the Eiffel Tower Rush nail, and the Grosse-Kempf nail. Which means of synthesis was used depended on the site and the features of the nonunion. Healing occurred in all of the cases after an average of 5 months. Mean follow-up was 4.5 years.

  20. Pediatric femoral shaft fractures treated by flexible intramedullary nailing

    Institute of Scientific and Technical Information of China (English)

    K.C.Kapil Mani; R.C.Dirgha Raj; Acharya Parimal


    Background:Nowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization.Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail,or external fixators in the case of open fractures.The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age.Methods:There were 32 cases of femoral shaft fractures which were all fixed with stainless steel flexible intramedullary nail under fluoroscopy.Long leg cast was applied at the time of fixation.Partial weight bearing was started 2 weeks after surgery.Patients were evaluated in follow-up study to observe the alignment of fracture,infection,delayed union,nonunion,limb length discrepancy,motion of knee joint,and time to unite the fracture.Results:We were able to follow up 28 out of 32 patients.The patients were 8.14 years of age on average.The mean hospital stay after operation was 4 days and fracture union time was 9.57 weeks.There were 3 cases of varus angulation,2 cases of anterior angulation,and 4 cases of limb lengthening.Conclusion:Patients aged between 5 and 13 years treated with flexible intramedullary nail for closed femoral shaft fracture have rapid union and recovery,short rehabilitation period,less immobilization and psychological impact,and cost-effective.

  1. Safe surgical technique: intramedullary nail fixation of tibial shaft fractures


    Zelle, Boris A.; Boni, Guilherme


    Statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Establishing an appropriate starting point is a crucial part of the surgical procedure. Recently, suprapatellar nailing in the semi-extended position has been suggested as a safe and effective surgical technique. Numerous reduction techiques are available to achieve an anatomic fracture alignment and the treating surgeon should be familiar with these maneuvers. Open reduction ...

  2. Low-Grade Esthesioneuroblastoma Presenting as SIADH: A Review of Atypical Manifestations

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    Andrew Senchak


    Full Text Available Esthesioneuroblastoma (ENB is a neuroendocrine tumor that typically manifests as advanced stage malignancy in the superior nasal cavity. The hallmark symptoms include nasal obstruction and epistaxis, which result from local tissue invasion. Atypical clinical features can also arise and must be considered when diagnosing and treating ENB. These can include origin in an ectopic location, unusual presenting symptoms, and associated paraneoplastic syndromes. The case described here reports a nasal cavity ENB with atypical clinical features that occurred in a young female. Her tumor was low grade, appeared to arise primarily from the middle nasal cavity, and presented as syndrome of inappropriate antidiuretic hormone (SIADH. She also became pregnant shortly after diagnosis, which had implications on her surgical management. We review the atypical features that uncommonly occur with ENB and the clinical considerations that arise from these unusual characteristics.

  3. High Efficient Enrichment and Activated Dissolution of Refractory Low Grade Rh-containing Material

    Institute of Scientific and Technical Information of China (English)

    WU Xiaofeng; DONG Haigang; TONG Weifeng; ZHAO Jiachun; ZENG Rui


    Aiming to the low-grade rhodium-containing waste materials,a new process was proposed to enrich and activate rhodium by smelting using iron oxide as a trapping agent and activator.A rhodium concentrate was obtained by the separation of base metals and precious metals.The concentrate was reacted with dilute aqua regia to obtain rhodium solution.The factors influencing the enrichment and activation effects were discussed in this paper.The results showed that the dissolution rate is greater than 99% under the optimum conditions.In this process,the activation of rhodium was finished in the enrichment process.The iron oxide is both a trapping agent and activator,which simplifies the process and reduce the cost.

  4. Principles of Treatment for Borderline, Micropapillary Serous, and Low-Grade Ovarian Cancer. (United States)

    Hacker, Kari E; Uppal, Shitanshu; Johnston, Carolyn


    Borderline ovarian tumors (BOTs) are less common than epithelial ovarian cancers (EOCs). Low-grade EOCs (LG-EOCs) occur even less frequently than BOTs. After primary therapy, recurrence rates of BOTs and LG-EOCs are significantly lower and the stage-adjusted survival is higher than for high-grade EOCs. Thus, determining the best management in terms of traditional ovarian cancer staging and debulking procedures is more challenging and has been recently brought to question. This article reviews the particulars of BOTs and LG-EOCs, their similarities and differences, and how they are best managed and treated, and emphasizes the major role of surgery and the controversial role of chemotherapy. Because these tumors disproportionately affect younger women, this review addresses ovarian preservation in circumstances when fertility or hormonal preservation is desired.

  5. Combined Oral Contraception and Obesity Are Strong Predictors of Low-Grade Inflammation in Healthy Individuals

    DEFF Research Database (Denmark)

    Sørensen, Cecilie J; Pedersen, Ole B; Petersen, Mikkel S


    BACKGROUND: C-reactive protein (CRP) is a well-established marker of inflammation. The level of CRP is affected by several lifestyle factors. A slightly increased CRP level, also known as low-grade inflammation (LGI), is associated with increased risk of several diseases, especially cardiovascular...... disease. The aim of this study was to identify predictors of increased CRP levels in healthy individuals. We therefore assessed CRP in a large cohort of blood donors. METHODS: We measured plasma CRP levels in 15,684 participants from the Danish Blood Donor Study. CRP was measured by a commercial assay...... and abdominal obesity strongly predicted LGI among healthy individuals. However, the most striking finding was the high prevalence of LGI among premenopausal women who used combined oral contraception. Although the significance of CRP as a marker of inflammation is well known, the role of CRP in pathogenesis...

  6. Diagnostic Challenges of Low-Grade Central Osteosarcoma of Jaw: a Literature Review

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    Seyd Hosein Tabatabaei


    Full Text Available Low Grade Central Osteosarcoma (LGCO is a rare subtype of osteosarcoma that is less aggressive than conventional osteosarcoma. The importance of LGCO lies in the fact that regarding microscopic and radiographic features, it occasionally simulates some benign jaw lesions and would consequently be misdiagnosed in many patients. The present study was conducted to collect the information and descriptive analyses related to ten cases reported between 1987 and 2010, including a sample reported by the authors emphasizing on diagnostic errors and the prevailing misdiagnosis. The aforementioned reports were gathered in full-texts through Google and PubMed search engines. Conclusion: The results of this study showed that the pathologists should exactly evaluate the clinical, radiographic, and histopathologic features in order to observe the evidence of invasion.

  7. Effect of technological factors on bacterial leaching of low-grade Ni-Cu sulfide ore

    Institute of Scientific and Technical Information of China (English)


    The bioleaching of a low-grade Ni-Cu sulfide ore from Jinchuan Mine with Thiobacillus ferrooxidans (TF5) and Thiobaxillus thiooxxidlans (TT) was investigated. The effect of pH, the initial cell numbers of bacteria, the pulp den sity and the ratio of TF5 and TT on leaching was described, and the favorable bioleaching conditions for the ore were ex perimentally confirmed. The aeration leaching, agitation leaching with air bubbling, and column leaching were respective ly tested. The highest recovery was achieved in the aeration leaching. After leaching for 20 d with pulp density of 15 %, the extractions of Ni, Cu and Co were respectively 95.4 %, 48.6 % and 82.6 %.

  8. Associations of low grade inflammation and endothelial dysfunction with depression - The Maastricht Study

    DEFF Research Database (Denmark)

    van Dooren, Fleur E P; Schram, Miranda T; Schalkwijk, Casper G


    in this association. METHODS: In The Maastricht Study, a population-based cohort study (n=852, 55% men, m=59.8±8.5years), depressive symptoms were assessed with the Patient Health Questionnaire-9 and (major and minor) depressive disorder with the Mini-International Neuropsychiatric Interview. Plasma biomarkers......BACKGROUND: The pathogenesis of depression may involve low-grade inflammation and endothelial dysfunction. We aimed to evaluate the independent associations of inflammation and endothelial dysfunction with depressive symptoms and depressive disorder, and the role of lifestyle factors......E-Selectin) were univariately associated with depressive symptoms and depressive disorder. The sum scores of inflammation and endothelial dysfunction were associated with depressive disorder after adjustment for age, sex, type 2 diabetes, kidney function and prior cardiovascular disease (OR 1.54, p=0.001 and 1...

  9. Waist circumference is related to low-grade inflammation in youth

    DEFF Research Database (Denmark)

    Steene-Johannessen, Jostein; Kolle, Elin; Resaland, GK


    included as controls. Inflammatory markers included C-reactive protein (CRP), leptin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor-alpha (TNF-alpha), hepatocyte growth factor (HGF), resistin and interleukin-6 (IL-6). The CVD risk factors included blood pressure, glucose......Abstract Objectives. To examine markers of inflammation in 9- and 15-year-olds with high waist circumference and compare these with controls, and to examine the relationships between inflammatory markers and cardiovascular disease (CVD) risk factors. Methods. Cross-sectional analysis of data from 2.......51) compared with controls. All CVD risk factors differed between the HW group and controls. The CVD risk factors were not associated with TNFalpha or IL-6, but CRP, HGF and PAI-1 were related to the metabolic risk score. Conclusions. Low grade systemic inflammation is already present in youth with high waist...

  10. Neutral Leaching of Low-Grade Pyrolusite with High Silica Content

    Institute of Scientific and Technical Information of China (English)


    Leaching studies of low-grade pyrolusite, containing 11.84% Mn with high silicon, were carried out using sodium sulfite as a reductant in ammonium sulfate medium. Various process parameters including temperature, leaching time, solid-liquid ratio, quantity of ammonium sulfate, as well as the amount of reducing agent were studied in detail. The manganese extraction yield was the response of the process. Temperature and reagent concentration exerted the most important positive effect on the manganese extraction. The optimized conditions showed that when the amount of reducing agent was a stoichonmetric amount, over 90% manganese extraction and the lowest impurities were achieved, the amount of heavy metal impurities in the manganese leaching liquid was less than 5 mg/L, and almost no iron and aluminum were extracted in 3 mol/L ammonium sulfate concentration at 100 ℃ in 45 min.

  11. Experimental study on preferential solution flow during dump leaching of low-grade ores

    Institute of Scientific and Technical Information of China (English)

    YIN Sheng-hua; WU Ai-xiang; SU Yong-ding; ZHANG Jie


    The phenomenon of preferential solution flow during dump leaching of low-grade ores was studied. The formative mechanism of preferential solution flow was investigated through analyzing the relationship between permeability and ore diameter,and the relationship between surface tension and ore diameter. The preferential solution flow happened within the fine ore area when the dump was unsaturated. And it could happen within the coarse ore area when the dump became saturated. The results of experiment show that the outflow of coarse ore area increases sharply with higher applied rate. The outflow of fine ore area is greater than that of coarse ore area when the applied rate is below 3.2 L/min, and the preferential solution flow happens in fine ore area. But the preferential solution flow happens in coarse ore area when the applied rate is higher than 3.2 L/min. The result of the experiment is consistent with the mechanism analyzing.

  12. Investigating depression-like and metabolic parameters in a chronic low-grade inflammation model

    DEFF Research Database (Denmark)

    Fischer, C. W.; Elfving, B.; Lund, S.


    that elevated markers of inflammation predict a poor response to treatment. Furthermore, increasing evidences show that metabolic abnormalities such as obesity and diabetes mellitus type 2 are associated with a low-grade inflammation. Objectives: The aim of this study is to investigate the effects of a systemic...... levels of pro-inflammatory cytokines (TNF-alpha, IL-1, IL-6) together with the expression of enzymes involved in the tryptophan-kynurenine pathway, will be analyzed in specific brain regions using real-time qPCR. Body weight and food intake was measured once a week, while fasting glucose and insulin...... disturbances or sickness behavior. Thus, this model might help elucidating some of the mechanisms underlying inflammation-associated depression, in order to assist in developing more effective treatment strategies for this group of patients....

  13. Silver-catalyzed bioleaching for raw low-grade copper sulphide ores

    Institute of Scientific and Technical Information of China (English)

    Tianlong DENG; Yafei GUO; Mengxia LIAO; Dongchan LI


    This research was conducted to investigate the biooxidation and copper dissolution from raw low-grade refractory copper sulphide ores located in the Xinjiang Autonomous Region of China using adapted Thiobacillus ferrooxidans bacteria. In order to accelerate the bioleach-ing rate, the adapted mixed bacteria and silver ion catalyst were tested in the leach columns at laboratory scale. The overall acid consumption was 4.3 kg sulphuric acid per kg of dissolved copper and was linearly related to the percent copper dissolution. The calculated copper dissolution rates obey the Shrinking Core Model. The relative activation energy of the whole biooxidative leaching stages was calculated to be 48.58 kJ/mol.

  14. Giant Sporadic Low Grade Malignant Peripheral Nerve Sheath (MPNST) of Left Thigh. (United States)

    Nikumbh, Dhiraj B; Suryawanshi, K H; Dravid, N V; Patil, T B; Rokade, C M


    Malignant Peripheral Nerve Sheath Tumours (MPNST) are rare spindle- cell sarcomas which are derived from the schwann cells or the pleuripotent cells of the neural crest. MPNSTs are usually located in the peripheral nerve trunk roots, extremities and in the head and neck region. These tumours may arise as sporadic variants or in patients with neurofibromatosis1 (NF1). The estimated incidence of MPNSTs in the patients with NF1is 2-5% as compared to a 0.001% incidence in the general population. Herein, we are reporting a case of a giant sporadic (NF1 independent) low grade MPNST of the left thigh in 65 year female patient, which had a good prognosis.

  15. Assessment of quality of life in patients treated for low-grade glioma: a preliminary report. (United States)

    Taphoorn, M J; Heimans, J J; Snoek, F J; Lindeboom, J; Oosterink, B; Wolbers, J G; Karim, A B


    In this pilot study quality of life was assessed in fourteen adult patients who were treated for a low-grade glioma with surgery and radiotherapy at least one year previously. Apart from widely used parameters, such as the neurological and functional status, the patients' cognitive functioning and actual affective status were determined. In addition the patients were interviewed to evaluate various aspects of quality of life. Generally no serious focal neurological deficits were found, although psychological examination showed serious cognitive and affective disturbances in most cases. Self report measures concerning cognitive functioning were not in all cases in accordance with objective test results. When the results of treatment in glioma patients are evaluated assessment of quality of life, including neuropsychological functioning, should be performed, especially as new therapeutic strategies are being developed. PMID:1602310

  16. Plantar fibromatosis may adopt the brain gyriform pattern of a low-grade fibromyxoid sarcoma. (United States)

    Touraine, Sébastien; Bousson, Valérie; Kaci, Rachid; Parlier-Cuau, Caroline; Haddad, Samuel; Laouisset, Liess; Petrover, David; Laredo, Jean-Denis


    We report the case of a 42-year-old man with histologically proven plantar fibromatosis (Ledderhose disease) demonstrating an uncommon brain gyriform pattern at MRI, so far exclusively described in the low-grade fibromyxoid sarcoma (LGFMS). An acoustic posterior enhancement at ultrasound, a high intensity on T2w and post-contrast T1wMR images were unusual and related to a high tumor cellularity at histology with no myxoid tissue. The juxtaposition of areas of high and low cellularity (with more fibrous material) in a multilobulated mass built a brain gyriform pattern at MR, similar to what was so far described exclusively in LGFMS. This case demonstrates that the brain gyriform pattern may also be observed in other soft tissue fibrous tumors with no myxoid material but with high cellularity areas alternating with fibrous zones of low cellularity. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Rapid Multiorgan Dissemination of Low-Grade Myxofibrosarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Yasutaka Murahashi


    Full Text Available Myxofibrosarcoma is one of the most common sarcomas in the extremities of elderly people. It is characterized by a high frequency of local recurrence due to an infiltrative growth property. In contrast, the overall risk of distant metastases is generally low. This makes the prognosis for the patients with myxofibrosarcoma definitely good. In this paper, we will report the case of a 79-year-old female with very aggressive metastatic low-grade myxofibrosarcoma. The disease progression was really unexpected and misled every possible medical interpretation, leading to rapid worsening of the patient's clinical conditions and no chance for therapy. The tumor developed diffuse infiltration in lung, spine, skeletal bone, abdomen, paravertebral muscles, and liver. The patient died 8 months after the diagnosis of remote metastases due to rapid tumor progression.

  18. Adaptability of language-related brain network in a low-grade glioma patient

    Institute of Scientific and Technical Information of China (English)

    Olivera Sveljo; Katarina Koprivsek; Milos Lucic


    Because functional magnetic resonance imaging can be used for dynamic observation of functional cortical changes after brain injuries, we followed up functional magnetic resonance imaging manifestationsof a language-related brain network in a low -grade glioma patient. Disease progressionand therapy during a 3-year period were followed up at different time points: before and after reoperation,after radiation therapy, and 1 year after irradiation. During the whole 3-year follow -up period,the patient exhibited no neurological deficits while functional magnetic resonance imaging revealeddifferent topologies of the language-related brain network. During disease progression and after irradiation,the language-related brain network was extended or completely transferred to the nondominant(right) hemisphere. In addition, after reoperation and 1 year after irradiation, languageareas were primarily found in the language dominant (left) hemisphere. Our results suggest a highlevel of adaptability of the language-related cortical network of the bilateral hemispheres in thislow -grade glioma patient.

  19. Role of immune cells in obesity induced low grade inflammation and insulin resistance. (United States)

    Asghar, Ambreen; Sheikh, Nadeem


    The frequency of obesity is enormously growing worldwide. Obesity results when energy intake exceeds, energy expenditure. Excess adiposity is a major risk factor in the progress of various metabolic disorders accounting insulin resistance, hypertension, Type 2 diabetes, nonalcoholic fatty liver disease, polycystic ovarian disease and several types of cancers. Obesity is characterized by pro-inflammatory condition in which hypertrophied adipose tissue along with immune cells contribute to increase the level of pro-inflammatory cytokines. Immune cells are the key players in inducing low grade chronic inflammation in obesity and are main factor responsible for pathogenesis of insulin resistance resulting Type 2 diabetes. The current review is aimed to investigate the mechanism of pro-inflammatory responses and insulin resistance involving immune cells and their products in obesity. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Sodium sulfide leaching of low-grade jamesonite concentrate in production of sodium pyroantimoniate

    Institute of Scientific and Technical Information of China (English)

    YANG Tian-zu; JIANG Ming-xi; LAI Qiong-lin; CHEN Jin-zhong


    Sodium sulfide leaching of a low-grade jamesonite concentrate in the production of sodium pyroantimoniate through the air oxidation process and the influencing factors on the leaching rate of antimony were investigated.In order to decrease the consumption of sodium sulfide and increase the concentration of antimony in the leaching solution, two-stage leaching of jamesonite concentrate and combination leaching of high-grade stibnite concentrate and jamesonite concentrate were used. The experimental results showthat the consumptions of sodium sulfide for the two-stage leaching process and the combination leaching process are decreased by 20% and 60% compared to those of one-stage leaching process respectively. The final concentrations of antimony in the leaching solutions of both processes are above 100 g/L.

  1. Combustion of low grade fractions of Lubnica coal in fluidized bed

    Directory of Open Access Journals (Sweden)

    Mladenović Milica R.


    Full Text Available In this paper a method of examination of fuel suitability for fluidized bed combustion is presented. The research of combustion characteristics of low grade fractions of Lubnica brown coal in the fluidized bed by the aforementioned methodology has been carried out on a laboratory semi-industrial apparatus of 200 kWt. Description of the experimental fluidized bed combustion facility is given, as well as experimental results, with the focus on furnace temperature distribution, in order to determine the location of the zone of intensive combustion. Based on investigation results, which are focused on combustion quality (combustion completion as well as on satisfying the environmental protection criteria, it can be stated that the investigated coal is suitable for burning in bubbling, as well as in circulating fluidized bed.

  2. Recovery of zinc from low-grade zinc oxide ores by solvent extraction

    Institute of Scientific and Technical Information of China (English)

    覃文庆; 蓝卓越; 黎维中


    The recovery of zinc from low-grade zinc oxide ores with solvent extraction-electrowinning technique was investigated by using D2EHPA as extractant and 260# kerosene as diluent. The results show that it is possible to selectively leach zinc from the ores by heap leaching. The zinc concentration of leach solution in the first leaching cycle is 32.57 g/L, and in the sixteenth cycle the zinc concentration is 8.27g/L after solvent extraction. The leaching solution is subjected to solvent extraction, scrubbing and selective stripping for enrichment of zinc and removal of impurities. The pregnant zinc sulfate solution produced from the stripping cycle is suitable for zinc electrowinning.Extra-pure zinc metal was obtained in the electrowinning test under conventional conditions.

  3. Low grade dysplasia in Barrett’s esophagus:Should we worry?

    Institute of Scientific and Technical Information of China (English)

    Vamshi; P; Jagadesham; Clive; J; Kelty


    The optimal management for low-grade dysplasia(LGD)in Barrett’s esophagus is unclear.In this article the importance of LGD is discussed,including the significant risk of progression to esophageal adenocarcinoma.Endoscopic surveillance is a management option but is plagued by sampling error and issues of suboptimal endoscopy.Furthermore endoscopic surveillance has not been demonstrated to be cost-effective or to reduce cancer mortality.The emergence of endoluminal therapy over the past decade has resulted in a paradigm shift in the management of LGD.Ablative therapy,including radiofrequency ablation,has demonstrated promising results in the management of LGD with regards to safety,cost-effectiveness,durability and reduction in cancer risk.It is,however,vital that a shareddecision making process occurs between the physician and the patient as to the preferred management of LGD.As such the management of LGD should be"individualised."

  4. High-efficient thermochemical sorption refrigeration driven by low-grade thermal energy

    Institute of Scientific and Technical Information of China (English)

    LI TingXian; WANG RuZhu; WANG LiWei


    Thermochemical sorption refrigeration powered by low-grade thermal energy is one of the en ergy-saving and environment friendly green refrigeration technologies. The operation principle of sorption refrigeration system is based on the thermal effects of reversible physicochemical reaction processes between sorbents and refrigerants. This paper presents the developing study on the differ ent thermochemical sorption refrigeration cycles, and some representative high-efficient thermo chemical sorption refrigeration cycles were evaluated and analyzed based on the conventional single-effect sorption cycle. These advanced sorption refrigeration cycles mainly include the heat and mass recovery sorption cycle, double-effect sorption cycle, multi-effect sorption cycle, combined douhie-way sorption cycle, and double-effect and double-way sorption cycle with internal heat recovery.Moreover, the developing tendency of the thermochemical sorption refrigeration is also predicted in this paper.

  5. Roles of Chronic Low-Grade Inflammation in the Development of Ectopic Fat Deposition

    Directory of Open Access Journals (Sweden)

    Lulu Liu


    Full Text Available Pattern of fat distribution is a major determinant for metabolic homeostasis. As a depot of energy, the storage of triglycerides in adipose tissue contributes to the normal fat distribution. Decreased capacity of fat storage in adipose tissue may result in ectopic fat deposition in nonadipose tissues such as liver, pancreas, and kidney. As a critical biomarker of metabolic complications, chronic low-grade inflammation may have the ability to affect the process of lipid accumulation and further lead to the disorder of fat distribution. In this review, we have collected the evidence linking inflammation with ectopic fat deposition to get a better understanding of the underlying mechanism, which may provide us with novel therapeutic strategies for metabolic disorders.

  6. Membrane-free battery for harvesting low-grade thermal energy. (United States)

    Yang, Yuan; Loomis, James; Ghasemi, Hadi; Lee, Seok Woo; Wang, Yi Jenny; Cui, Yi; Chen, Gang


    Efficient and low-cost systems are desired to harvest the tremendous amount of energy stored in low-grade heat sources (membrane in this system raises concerns about the overall cost, which is crucial for waste heat harvesting. Here, we report on a new membrane-free battery with a nickel hexacyanoferrate (NiHCF) cathode and a silver/silver chloride anode. The system has a temperature coefficient of -0.74 mV K(-1). When the battery is discharged at 15 °C and recharged at 55 °C, thermal-to-electricity conversion efficiencies of 2.6% and 3.5% are achieved with assumed heat recuperation of 50% and 70%, respctively. This work opens new opportunities for using membrane-free electrochemical systems to harvest waste heat.

  7. Role of PGC-1α in acute and low-grade inflammation

    DEFF Research Database (Denmark)

    Olesen, Jesper

    inflammation as well as in the inflammatory response in mouse skeletal muscle. 2) Long-term exercise training and/or resveratrol supplementation prevents age-associated low-grade- and skeletal muscle inflammation in mice with PGC-1α being required for these improvements. 3) Exercise training and/or resveratrol....... However, PGC-1α was not mandatory for the exercise training-induced reductions in systemic IL-6 in mice, suggesting that additional factors contribute to the systemic anti-inflammatory effects of exercise training. Study II and III demonstrated that while resveratrol increased the protein content...... of the anti-oxidant enzyme GPX1 and appeared to reduce oxidative stress in mouse skeletal muscle, resveratrol did not elicit any antiinflammatory effects neither in mice nor in human subjects. In contrast, resveratrol even impaired the exercise training-induced reduction in protein carbonylation and TNFα m...

  8. Dedifferentiated liposarcoma of the retro-peritoneum: Histologically low-grade type

    Directory of Open Access Journals (Sweden)

    Parakh Rugvedita


    Full Text Available A dedifferentiated liposarcoma of the retro-peritoneum of a 45-year-old female is described in this case report. It showed dedifferentiation into a histological low-grade type and thus defies the traditional definition of dedifferentiated liposarcoma. The excised specimen was a huge, multi-nodular encapsulated mass surrounding the kidney and infiltrating into it. The mass showed a dedifferentiated focus different in color from the surrounding tumor and containing areas of necrosis and hemorrhage. The sections from the dedifferentiated part of the tumor appeared predominantly as benign spindle cell component on histology but the tumor was infiltrating into the kidney. Hence, a close and long-term follow-up is expected in such cases though they look benign. In the retro-peritoneum, a lipoma-like well-differentiated liposarcoma with spindle cell component, like the present tumor, which shows dedifferentiation, should not be overlooked.

  9. Obesity and Low-Grade Inflammation Increase Plasma Follistatin-Like 3 in Humans

    DEFF Research Database (Denmark)

    Brandt, Claus; Pedersen, Maria; Rinnov, Anders;


    BACKGROUND: Rodent models suggest that follistatin-like 3 (fstl3) is associated with diabetes and obesity. In humans, plasma fstl3 is reduced with gestational diabetes. In vitro, TNF-α induces fstl3 secretion, which suggests a link to inflammation. OBJECTIVE: To elucidate the association between...... plasma fstl3 and obesity, insulin resistance, and low-grade inflammation in humans. STUDY DESIGN: Plasma fstl3 levels were determined in a cross-sectional study including three groups: patients with type 2 diabetes, impaired glucose tolerance, and healthy controls. In addition, lipopolysaccharide (LPS......), TNF-α, or interleukin-6 (IL-6) as well as a hyperinsulinemic euglycemic clamp were used to examine if plasma fstl3 was acutely regulated in humans. RESULTS: Plasma fstl3 was increased in obese subjects independent of glycemic state. Moreover, plasma fstl3 was positively correlated with fat mass...

  10. Thermomagnetic conversion of low-grade waste heat into electrical power (United States)

    El Achkar, G.; Dianoux, A.; Kheiri, A.; Maillet, D.; Mazet, T.; Colasson, S.; Feidt, M.; Rado, C.; Servant, F.; Paul-Boncour, V.


    A theoretical study relying on the thermal modelling of a Curie wheel, used for the conversion of low-grade waste heat into electrical power, is presented in this paper. It allows understanding the thermal behaviour of a Curie wheel operating in steady state in order to optimise its design. To this end, a stationary one-dimensional analytical thermal model, based on a Lagrangian approach, was developed. It allows determining the local distribution over time of the temperature in the magnetocaloric material exposed to a periodic sinusoidal heat source. Thanks to this model, the effects of different parameters (nature of the magnetocaloric material, nature and temperature of the fluid) were highlighted and studied.

  11. Surgical intervention for a pediatric isolated intramedullary spinal aneurysm. (United States)

    Morozumi, Masayoshi; Imagama, Shiro; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Matsumoto, Akiyuki; Tanaka, Satoshi; Machino, Masaaki; Ota, Kyotaro; Nishida, Yoshihiro; Ishiguro, Naoki


    To report the case of a pediatric patient with intramedullary spinal aneurysm. A 9-year-old boy presented with low back pain and subsequent gait disturbance. He had no history of trauma. After admission, MRI revealed an intramedullary spinal cord mass lesion surrounded by hemorrhage at the cervical-thoracic junction. Initial treatment was started with intravenous methylprednisolone and bed rest. Neurological deficit disappeared under careful observation for a few months. Surgical intervention was applied for diagnosis and resection of the mass lesion to prevent recurrent hemorrhage. Intraoperative ultrasound sonography helped to diagnose the lesion as a spinal cord aneurysm, prior to midline myelotomy. Monitoring of transcranial muscle evoked potentials helped to avoid spinal cord damage during surgery. There has been no evidence of spinal aneurysm on MRI for 3 years after surgery and no neurological deterioration. To our knowledge, this is a first report of an intramedullary spinal cord aneurysm at the cervical-thoracic junction in a pediatric patient. Careful observation after initial symptoms followed by surgical intervention was favorable in this case.

  12. Multiple intramedullary nailing of proximal phalangeal fractures of hand

    Directory of Open Access Journals (Sweden)

    Patankar Hemant


    Full Text Available Background: Proximal phalangeal fractures are commonly encountered fractures in the hand. Majority of them are stable and can be treated by non-operative means. However, unstable fractures i.e. those with shortening, displacement, angulation, rotational deformity or segmental fractures need surgical intervention. This prospective study was undertaken to evaluate the functional outcome after surgical stabilization of these fractures with joint-sparing multiple intramedullary nailing technique. Materials and Methods: Thirty-five patients with 35 isolated unstable proximal phalangeal shaft fractures of hand were managed by surgical stabilization with multiple intramedullary nailing technique. Fractures of the thumb were excluded. All the patients were followed up for a minimum of six months. They were assessed radiologically and clinically. The clinical evaluation was based on two criteria. 1. total active range of motion for digital functional assessment as suggested by the American Society for Surgery of Hand and 2. grip strength. Results: All the patients showed radiological union at six weeks. The overall results were excellent in all the patients. Adventitious bursitis was observed at the point of insertion of nails in one patient. Conclusion: Joint-sparing multiple intramedullary nailing of unstable proximal phalangeal fractures of hand provides satisfactory results with good functional outcome and fewer complications.

  13. Predictors of seizure freedom after resection of supratentorial low-grade gliomas. A review. (United States)

    Englot, Dario J; Berger, Mitchel S; Barbaro, Nicholas M; Chang, Edward F


    Seizures are the most frequent presenting symptom in patients with low-grade gliomas (LGGs), and significantly influence quality of life if they are uncontrolled. Achieving freedom from seizures is of utmost importance in surgical planning, but the factors associated with seizure control remain incompletely understood. The authors performed a systematic literature review of seizure outcomes after resection of LGGs causing seizures, examining 773 patients across 20 published series. Rates of seizure freedom were stratified across 7 variables: patient age, tumor location, preoperative seizure control with medication, seizure semiology, epilepsy duration, extent of resection, and the use of intraoperative electrocorticography (ECoG). Gross-total resection was most predictive of complete seizure freedom, when compared with subtotal resection (OR 3.41, 95% CI 2.36-4.93). Other predictors of seizure freedom included preoperative seizure control on antiepileptic medication (OR 2.12, 95% CI 1.33-3.38) and duration of seizures of ≤ 1 year (OR 1.85, 95% CI 1.22-2.79). Patients with simple partial seizure semiology achieved seizure freedom less often than those with complex partial, generalized, or mixed seizure types (OR 0.46, 95% CI 0.26-0.80). No significant differences in seizure outcome were observed between adults versus children, patients with temporal lobe versus extratemporal tumors, or with the use of intraoperative ECoG. Seizure control is one of the most important considerations in planning surgery for low-grade brain tumors. Gross-total resection is a critical factor in achieving seizure freedom.

  14. The significance of "geothermal microzonation" for the correct planning of low-grade source geothermal systems (United States)

    Viccaro, Marco; Pezzino, Antonino; Belfiore, Giuseppe Maria; Campisano, Carlo


    Despite the environmental-friendly energy systems are solar thermal technologies, photovoltaic and wind power, other advantageous technologies exist, although they have not found wide development in countries such as Italy. Given the almost absent environmental impact and the rather favorable cost/benefit ratio, low-enthalpy geothermal systems are, however, likely to be of strategic importance also in Italy during the next years. The importance of geology for a sustainable exploitation of the ground through geothermal systems from low-grade sources is becoming paramount. Specifically, understanding of the lithological characteristics of the subsurface along with structures and textures of rocks is essential for a correct planning of the probe/geo-exchanger field and their associated ground source heat pumps. The complex geology of Eastern Sicily (Southern Italy), which includes volcanic, sedimentary and metamorphic units over limited extension, poses the question of how thermal conductivity of rocks is variable at the scale of restricted areas (even within the same municipality). This is the innovative concept of geothermal microzonation, i.e., how variable is the geothermal potential as a function of geology at the microscale. Some pilot areas have been therefore chosen to test how the geological features of the subsurface can influence the low-enthalpy geothermal potential of an area. Our geologically based evaluation and micro-zonation of the low-grade source geothermal potential of the selected areas have been verified to be fundamental for optimization of all the main components of a low-enthalpy geothermal system. Saving realization costs and limiting the energy consumption through correct sizing of the system are main ambitions to have sustainable development of this technology with intensive utilization of the subsurface. The variegated territory of countries such as Italy implies that these goals can be only reached if, primarily, the geological features

  15. Childhood bullying involvement predicts low-grade systemic inflammation into adulthood. (United States)

    Copeland, William E; Wolke, Dieter; Lereya, Suzet Tanya; Shanahan, Lilly; Worthman, Carol; Costello, E Jane


    Bullying is a common childhood experience that involves repeated mistreatment to improve or maintain one's status. Victims display long-term social, psychological, and health consequences, whereas bullies display minimal ill effects. The aim of this study is to test how this adverse social experience is biologically embedded to affect short- or long-term levels of C-reactive protein (CRP), a marker of low-grade systemic inflammation. The prospective population-based Great Smoky Mountains Study (n = 1,420), with up to nine waves of data per subject, was used, covering childhood/adolescence (ages 9-16) and young adulthood (ages 19 and 21). Structured interviews were used to assess bullying involvement and relevant covariates at all childhood/adolescent observations. Blood spots were collected at each observation and assayed for CRP levels. During childhood and adolescence, the number of waves at which the child was bullied predicted increasing levels of CRP. Although CRP levels rose for all participants from childhood into adulthood, being bullied predicted greater increases in CRP levels, whereas bullying others predicted lower increases in CRP compared with those uninvolved in bullying. This pattern was robust, controlling for body mass index, substance use, physical and mental health status, and exposures to other childhood psychosocial adversities. A child's role in bullying may serve as either a risk or a protective factor for adult low-grade inflammation, independent of other factors. Inflammation is a physiological response that mediates the effects of both social adversity and dominance on decreases in health.

  16. Diagnostic utility of flow cytometry in low-grade myelodysplastic syndromes: a prospective validation study (United States)

    Ogata, Kiyoyuki; Della Porta, Matteo G.; Malcovati, Luca; Picone, Cristina; Yokose, Norio; Matsuda, Akira; Yamashita, Taishi; Tamura, Hideto; Tsukada, Junichi; Dan, Kazuo


    Background The diagnosis of myelodysplastic syndromes is not always straightforward when patients lack specific diagnostic markers, such as blast excess, karyotype abnormality, and ringed sideroblasts. Design and Methods We designed a flow cytometry protocol applicable in many laboratories and verified its diagnostic utility in patients without those diagnostic markers. The cardinal parameters, analyzable from one cell aliquot, were myeloblasts (%), B-cell progenitors (%), myeloblast CD45 expression, and channel number of side scatter where the maximum number of granulocytes occurs. The adjunctive parameters were CD11b, CD15, and CD56 expression (%) on myeloblasts. Marrow samples from 106 control patients with cytopenia and 134 low-grade myelodysplastic syndromes patients, including 81 lacking both ringed sideroblasts and cytogenetic aberrations, were prospectively analyzed in Japan and Italy. Results Data outside the predetermined reference range in 2 or more parameters (multiple abnormalities) were common in myelodysplastic syndromes patients. In those lacking ringed sideroblasts and cytogenetic aberrations, multiple abnormalities were observed in 8/26 Japanese (30.8%) and 37/55 Italians (67.3%) when the cardinal parameters alone were considered, and in 17/26 Japanese (65.4%) and 42/47 Italians (89.4%) when all parameters were taken into account. Multiple abnormalities were rare in controls. When data from all parameters were used, the diagnostic sensitivities were 65% and 89%, specificities were 98% and 90%, and likelihood ratios were 28.1 and 8.5 for the Japanese and Italian cohorts, respectively. Conclusions This protocol can be used in the diagnostic work-up of low-grade myelodysplastic syndromes patients who lack specific diagnostic markers, although further improvement in diagnostic power is desirable. PMID:19546439

  17. Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication

    Directory of Open Access Journals (Sweden)

    Grgov Saša


    Full Text Available Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE, histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15% of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.

  18. MRI-suspected low-grade glioma: is there a need to perform dynamic FET PET?

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, Nathalie L.; Graute, Vera; Cumming, Paul; Bartenstein, Peter; Fougere, Christian la [Ludwig-Maximilians-University Munich, Department of Nuclear Medicine, Munich (Germany); Armbruster, Lena; Suchorska, Bogdana; Tonn, Joerg-Christian; Kreth, Friedrich Wilhelm [Ludwig-Maximilians-University Munich, Department of Neurosurgery, Munich (Germany); Lutz, Juergen [Ludwig-Maximilians-University Munich, Department of Neuroradiology, Munich (Germany); Eigenbrod, Sabina [Ludwig-Maximilians-University Munich, Department of Neuropathology, Munich (Germany)


    Since differentiation between low-grade glioma (LGG) and high-grade glioma (HGG) remains challenging according to MRI criteria alone, we investigated the discriminative value of additional dynamic FET PET in patients with MRI-suspected LGG. Included in this retrospective study were 127 patients with newly diagnosed MRI-suspected LGG and dynamic FET PET prior to histopathological assessment. FET PET lesions were visually classified as having reduced, normal, or increased tracer uptake. Maximal tumour uptake scaled to the mean background uptake (SUV{sub max}/BG), mean tumour uptake (SUV{sub mean}/BG), biological tumour volume and kinetics were evaluated and correlated with individual histopathological findings. Histopathological analysis revealed 71 patients with LGG, 47 patients with HGG (including 5 glioblastoma multiforme), 2 patients with low-grade ganglioglioma and 7 patients with non-neoplastic lesions. Of the 127 patients, 97 had lesions with increased FET uptake, of which 93 were neoplastic. Increased uptake was found in 49/71 LGG (69 %) and 42/47 HGG (89 %). None of the conventional uptake parameters differed significantly between the HGG and LGG groups. Kinetic analysis reliably identified HGG (sensitivity 95 %, specificity 72 %, PPV 74 %, NPV 95 %). Normal tracer uptake was observed in 19 patients (15 with LGG, 1 with HGG and 3 with non-neoplastic lesions) and reduced uptake in 11 patients (7 with LGG and 4 with HGG). Among the MRI-suspected LGG, kinetic but not conventional analysis of FET uptake enabled remarkably high sensitivity for detection of HGG. This held true even for lesions with low or diffuse tracer uptake. Lesions with reduced tracer uptake must be interpreted with caution, as they can also harbour HGG tissue. (orig.)

  19. Behavior of Low Grade Steel Fiber Reinforced Concrete Made with Fresh and Recycled Brick Aggregates

    Directory of Open Access Journals (Sweden)

    Md. Shariful Islam


    Full Text Available In recent years, recycled aggregates from construction and demolition waste (CDW have been widely accepted in construction sectors as the replacement of coarse aggregate in order to minimize the excessive use of natural resources. In this paper, an experimental investigation is carried out to observe the influence of low grade steel fiber reinforcements on the stress-strain behavior of concrete made with recycled and fresh brick aggregates. In addition, compressive strength by destructive and nondestructive tests, splitting tensile strength, and Young’s modulus are determined. Hooked end steel wires with 50 mm of length and an aspect ratio of 55.6 are used as fiber reinforcements in a volume fraction of 0% (control case, 0.50%, and 1.00% in concrete mixes. The same gradation of aggregates and water-cement ratio (w/c=0.44 were used to assess the effect of steel fiber in all these concrete mixes. All tests were conducted at 7, 14, and 28 days to perceive the effect of age on different mechanical properties. The experimental results show that around 10%~15% and 40%~60% increase in 28 days compressive strength and tensile strength of steel fiber reinforced concrete, respectively, compared to those of the control case. It is observed that the effect of addition of 1% fiber on the concrete compressive strength is little compared to that of 0.5% steel fiber addition. On the other hand, strain of concrete at failure of steel fiber reinforced concrete has increased almost twice compared to the control case. A simple analytical model is also proposed to generate the ascending portions of the stress-strain curve of concrete. There exists a good correlation between the experimental results and the analytical model. A relatively ductile failure is observed for the concrete made with low grade steel fibers.

  20. Hypnosis for Awake Surgery of Low-grade Gliomas: Description of the Method and Psychological Assessment. (United States)

    Zemmoura, Ilyess; Fournier, Eric; El-Hage, Wissam; Jolly, Virginie; Destrieux, Christophe; Velut, Stéphane


    Awake craniotomy with intraoperative electric stimulation is a reliable method for extensive removal of low-grade gliomas while preserving the functional integrity of eloquent surrounding brain structures. Although fully awake procedures have been proposed, asleep-awake-asleep remains the standard technique. Anesthetic contraindications are the only limitation of this method, which is therefore not reliable for older patients with high-grade gliomas. To describe and assess a novel method for awake craniotomy based on hypnosis. We proposed a novel hypnosedation procedure to patients undergoing awake surgery for low-grade gliomas in our institution between May 2011 and April 2015. Surgical data were retrospectively recorded. The subjective experience of hypnosis was assessed by 3 standardized questionnaires: the Cohen Perceived Stress Scale, the Posttraumatic Stress Disorder Checklist Scale, the Peritraumatic Dissociative Experience Questionnaire, and a fourth questionnaire designed specifically for this study. Twenty-eight questionnaires were retrieved from 43 procedures performed on 37 patients. The Peritraumatic Dissociative Experience Questionnaire revealed a dissociation state in 17 cases. The Perceived Stress Scale was pathological in 8 patients. Two patients in this group stated that they would not accept a second hypnosedation procedure. The Posttraumatic Stress Disorder Checklist Scale revealed 1 case of posttraumatic stress disorder. Burr hole and bone flap procedures were the most frequently reported unpleasant events during opening (15 of 52 events). The main findings of our study are the effectiveness of the technique, which in all cases allowed resection of the tumor up to functional boundaries, and the positive psychological impact of the technique in most of the patients.

  1. Molecular profiling of low grade serous ovarian tumours identifies novel candidate driver genes. (United States)

    Hunter, Sally M; Anglesio, Michael S; Ryland, Georgina L; Sharma, Raghwa; Chiew, Yoke-Eng; Rowley, Simone M; Doyle, Maria A; Li, Jason; Gilks, C Blake; Moss, Phillip; Allan, Prue E; Stephens, Andrew N; Huntsman, David G; deFazio, Anna; Bowtell, David D; Gorringe, Kylie L; Campbell, Ian G


    Low grade serous ovarian tumours are a rare and under-characterised histological subtype of epithelial ovarian tumours, with little known of the molecular drivers and facilitators of tumorigenesis beyond classic oncogenic RAS/RAF mutations. With a move towards targeted therapies due to the chemoresistant nature of this subtype, it is pertinent to more fully characterise the genetic events driving this tumour type, some of which may influence response to therapy and/or development of drug resistance. We performed genome-wide high-resolution genomic copy number analysis (Affymetrix SNP6.0) and mutation hotspot screening (KRAS, BRAF, NRAS, HRAS, ERBB2 and TP53) to compare a large cohort of ovarian serous borderline tumours (SBTs, n = 57) with low grade serous carcinomas (LGSCs, n = 19). Whole exome sequencing was performed for 13 SBTs, nine LGSCs and one mixed low/high grade carcinoma. Copy number aberrations were detected in 61% (35/57) of SBTs, compared to 100% (19/19) of LGSCs. Oncogenic RAS/RAF/ERBB2 mutations were detected in 82.5% (47/57) of SBTs compared to 63% (12/19) of LGSCs, with NRAS mutations detected only in LGSC. Some copy number aberrations appeared to be enriched in LGSC, most significantly loss of 9p and homozygous deletions of the CDKN2A/2B locus. Exome sequencing identified BRAF, KRAS, NRAS, USP9X and EIF1AX as the most frequently mutated genes. We have identified markers of progression from borderline to LGSC and novel drivers of LGSC. USP9X and EIF1AX have both been linked to regulation of mTOR, suggesting that mTOR inhibitors may be a key companion treatment for targeted therapy trials of MEK and RAF inhibitors.

  2. Low-grade and anaplastic oligodendrogliomas: differences in tumour microvascular permeability evaluated with dynamic contrast-enhanced magnetic resonance imaging. (United States)

    Jia, Zhongzheng; Geng, Daoying; Liu, Ying; Chen, Xingrong; Zhang, Jun


    This study was designed to quantitatively assess the microvascular permeability of oligodendroglioma using the volume transfer constant (K(trans)) and the volume of the extravascular extracellular space per unit volume of tissue (V(e)) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). We aimed to evaluate the effectiveness of K(trans) and V(e) in distinguishing between low-grade and anaplastic oligodendroglioma. The maximal values of K(trans) and V(e) for 65 patients with oligodendroglioma (27 grade II, 38 grade III) were obtained. Differences in K(trans) and V(e) between the two groups were analysed using the Mann-Whitney rank-sum test. Receiver operating characteristic (ROC) curve analyses were performed to determine the cut-off values for the K(trans) and Ve that could differentiate between low-grade and anaplastic oligodendrogliomas. Values for K(trans) and Ve in low-grade oligodendrogliomas were significantly lower than those in anaplastic oligodendrogliomas (p low-grade and anaplastic oligodendrogliomas in a statistically significant manner. Our results suggest that DCE-MRI can distinguish the differences in microvascular permeability between low-grade and anaplastic oligodendrogliomas.

  3. Catalytic decomposition of tar derived from wood waste pyrolysis using Indonesian low grade iron ore as catalyst

    Energy Technology Data Exchange (ETDEWEB)

    Wicakso, Doni Rahmat [Chemical Engineering Department, Faculty of Engineering, Lambung Mangkurat University, Jalan A. Yani KM. 36 Banjarbaru, 70714, South Kalimantan (Indonesia); Chemical Engineering Department, Faculty of Engineering, Gadjah Mada University, Jalan Grafika No. 2 Bulaksumur, Yogyakarta, 55281 (Indonesia); Sutijan; Rochmadi [Chemical Engineering Department, Faculty of Engineering, Gadjah Mada University, Jalan Grafika No. 2 Bulaksumur, Yogyakarta, 55281 (Indonesia); Budiman, Arief, E-mail: [Chemical Engineering Department, Faculty of Engineering, Gadjah Mada University, Jalan Grafika No. 2 Bulaksumur, Yogyakarta, 55281 (Indonesia); Center for Energy Studies, Gadjah Mada University, Sekip K1A, Yogyakarta, 55281 (Indonesia)


    Low grade iron ore can be used as an alternative catalyst for bio-tar decomposition. Compared to other catalysts, such as Ni, Rd, Ru, Pd and Pt, iron ore is cheaper. The objective of this research was to investigate the effect of using low grade iron ore as catalyst for tar catalytic decomposition in fixed bed reactor. Tar used in this experiment was pyrolysis product of wood waste while the catalyst was Indonesian low grade iron ore. The variables studied were temperatures between 500 – 600 °C and catalyst weight between 0 – 40 gram. The first step, tar was evaporated at 450 °C to produce tar vapor. Then, tar vapor was flowed to fixed bed reactor filled low grade iron ore. Gas and tar vapor from reactor was cooled, then the liquid and uncondensable gas were analyzed by GC/MS. The catalyst, after experiment, was weighed to calculate total carbon deposited into catalyst pores. The results showed that the tar components that were heavy and light hydrocarbon were decomposed and cracked within the iron ore pores to from gases, light hydrocarbon (bio-oil) and carbon, thus decreasing content tar in bio-oil and increasing the total gas product. In conclusion, the more low grade iron ore used as catalyst, the tar content in the liquid decrease, the H{sup 2} productivity increased and calorimetric value of bio-oil increased.

  4. Catalytic decomposition of tar derived from wood waste pyrolysis using Indonesian low grade iron ore as catalyst (United States)

    Wicakso, Doni Rahmat; Sutijan, Rochmadi, Budiman, Arief


    Low grade iron ore can be used as an alternative catalyst for bio-tar decomposition. Compared to other catalysts, such as Ni, Rd, Ru, Pd and Pt, iron ore is cheaper. The objective of this research was to investigate the effect of using low grade iron ore as catalyst for tar catalytic decomposition in fixed bed reactor. Tar used in this experiment was pyrolysis product of wood waste while the catalyst was Indonesian low grade iron ore. The variables studied were temperatures between 500 - 600 °C and catalyst weight between 0 - 40 gram. The first step, tar was evaporated at 450 °C to produce tar vapor. Then, tar vapor was flowed to fixed bed reactor filled low grade iron ore. Gas and tar vapor from reactor was cooled, then the liquid and uncondensable gas were analyzed by GC/MS. The catalyst, after experiment, was weighed to calculate total carbon deposited into catalyst pores. The results showed that the tar components that were heavy and light hydrocarbon were decomposed and cracked within the iron ore pores to from gases, light hydrocarbon (bio-oil) and carbon, thus decreasing content tar in bio-oil and increasing the total gas product. In conclusion, the more low grade iron ore used as catalyst, the tar content in the liquid decrease, the H2 productivity increased and calorimetric value of bio-oil increased.

  5. Ultrasonographic findings of low-grade endometrial stromal sarcoma of the uterus with a focus on cystic degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ga Eun; Rha, Sung Eun; Oh, Soon Nam; Lee, Ah Won; Lee, Keun Ho; Kim, Mee Ran [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)


    The goal of this study was to perform a retrospective analysis of the ultrasonographic findings associated with low-grade endometrial stromal sarcoma. Ten pathologically confirmed cases of low-grade endometrial stromal sarcoma at our institution from January 2007 to April 2014 were retrospectively reviewed. All patients underwent a preoperative transvaginal ultrasound. Two radiologists came to a consensus regarding the location, size, margin, and echogenicity of the tumor, as well as the presence of intratumoral cystic degeneration and its extent and configuration. Low-grade endometrial stromal sarcoma manifested as an intramural mass protruding into the endometrial cavity (n=6) or as a purely intramural mass (n=4). The maximal diameter of the lesion ranged from 4 to 9.1 cm (mean, 6.2 cm). The imaging features of low-grade endometrial stromal sarcoma were variable: six cases involved predominantly solid masses containing cystic degeneration, one was a predominantly unilocular cystic mass, two were ill-defined infiltrative solid masses, and one was a well-defined solid mass. Among the seven cases with internal cystic degeneration, five patients showed a multiseptated cystic area or a cystic area with multiple small clusters, while a unilocular cystic area within the tumor was found in two patients. Low-grade endometrial stromal sarcoma is associated with variable ultrasonographic findings with regard to the location, margin, and configuration of the lesion. Multiseptated cystic areas and multiple small areas of cystic degeneration are common.

  6. Radical microsurgical treatment of intramedullary spinal cord tumors

    Institute of Scientific and Technical Information of China (English)

    PENG Lin; QI Song-tao; CHEN Zhuang; FEN Wen-feng; FANG Lu-xiong; HUANG Li-jing; CHENG Jiang-peng


    Background The surgical treatment of intramedullary spinal cord tumor aims at complete removal and minimal postoperative deficit. This study was undertaken to evaluate the microsurgical features of intramedullary spinal cord tumors and the time for surgery and prognosis.Methods Twenty-one patients with intramedullary spinal cord tumor who had been treated at Nanfang Hospital,Guangzhou, China since 2000 were studied retrospectively. Fifteen patients were men and 6 women, aged 2-60 years (mean 29.28 years). Thirteen patients had the tumor in the cervical segments, 4 in medulla-cervical segments, 1 in cervicothoracic segment, and 3 in thoracic spine. All the patients underwent microsurgery for the tumor through posterior approaches by laminectomy. The tumor was exposed through dorsal myelotomy, then tumor plane was removed carefully from the entire rostrocaudal area. The dura was sutured routinely. In case of tumors occupying too many spinal segments, titanium strip was applied to reconstruct the vertebral plate and keep the spinal column stable. All the patients were subjected to MR imaging early after operation. Results Complete removal of the tumor was made in 15 patients, subtotal removal in 5, and partial resection in 1. Neurological recovery was related primarily to preoperative neurological conditions of the patients. Patients with minor neurological deficit showed stable sensory and motor function or minor loss in the early postoperative period, and neurological function tended to improve with time. But those with significant or long-standing deficit could hardly demonstrate any recovery. The dissection interface between the tumor and normal cord tissue was the most important factor influencing the extent of surgical removal.Conclusions Intramedullary spinal cord tumor mostly take place in cervical segments, with glioma as the commonest type. Microsurgery is the major treatment of choice, by which tumor plane could be totally resected. Excellent microsurgical

  7. Prevention against diffuse spinal cord astrocytoma: can the Notch pathway be a novel treatment target? (United States)

    Sun, Jian-Jun; Wang, Zhen-Yu; Li, Ling-Song; Yu, Hai-Yan; Xu, Yong-Sheng; Wu, Hai-Bo; Luo, Yi; Liu, Bin; Zheng, Mei; Mao, Jin-Long; Lou, Xiao-Hui


    This study was designed to investigate whether the Notch pathway is involved in the development of diffuse spinal cord astrocytomas. BALB/c nude mice received injections of CD133(+) and CD133(-) cell suspensions prepared using human recurrent diffuse spinal cord astrocytoma tissue through administration into the right parietal lobe. After 7-11 weeks, magnetic resonance imaging was performed weekly. Xenografts were observed on the surfaces of the brains of mice receiving the CD133(+) cell suspension, and Notch-immunopositive expression was observed in the xenografts. By contrast, no xenografts appeared in the identical position on the surfaces of the brains of mice receiving the CD133(-) cell suspension, and Notch-immunopositive expression was hardly detected either. Hematoxylin-eosin staining and immunohistochemical staining revealed xenografts on the convex surfaces of the brains of mice that underwent CD133(+) astrocytoma transplantation. Some sporadic astroglioma cells showed pseudopodium-like structures, which extended into the cerebral white matter. However, it should be emphasized that the subcortex xenograft with Notch-immunopositive expression was found in the fourth mouse received injection of CD133(-) astrocytoma cells. However, these findings suggest that the Notch pathway plays an important role in the formation of astrocytomas, and can be considered a novel treatment target for diffuse spinal cord astrocytoma.

  8. Prevention against diffuse spinal cord astrocytoma: can the Notch pathway be a novel treatment target?

    Directory of Open Access Journals (Sweden)

    Jian-jun Sun


    Full Text Available This study was designed to investigate whether the Notch pathway is involved in the development of diffuse spinal cord astrocytomas. BALB/c nude mice received injections of CD133 + and CD133− cell suspensions prepared using human recurrent diffuse spinal cord astrocytoma tissue through administration into the right parietal lobe. After 7-11 weeks, magnetic resonance imaging was performed weekly. Xenografts were observed on the surfaces of the brains of mice receiving the CD133 + cell suspension, and Notch-immunopositive expression was observed in the xenografts. By contrast, no xenografts appeared in the identical position on the surfaces of the brains of mice receiving the CD133− cell suspension, and Notch-immunopositive expression was hardly detected either. Hematoxylin-eosin staining and immunohistochemical staining revealed xenografts on the convex surfaces of the brains of mice that underwent CD133 + astrocytoma transplantation. Some sporadic astroglioma cells showed pseudopodium-like structures, which extended into the cerebral white matter. However, it should be emphasized that the subcortex xenograft with Notch-immunopositive expression was found in the fourth mouse received injection of CD133− astrocytoma cells. However, these findings suggest that the Notch pathway plays an important role in the formation of astrocytomas, and can be considered a novel treatment target for diffuse spinal cord astrocytoma.

  9. 星形细胞瘤播散性皮层抑制的MR扩散加权成像与病理学分析%MR Diffusion Weighted Imaging and Pathological Analysis of Disseminated Cortical Inhibition in Astrocytoma

    Institute of Scientific and Technical Information of China (English)

    杨忠; 任伯绪


    目的:探讨星形细胞瘤播散性皮层抑制的MR扩散加权成像(DWI)与病理学特征的相关性。方法采用回顾性研究方法,2012年9月到2016年2月选择在我院诊治的经手术病理证实的星形细胞瘤患者84例,病理分级为低级别星形细胞瘤30例(WHO Ⅰ级10例,WHOⅡ级20例),高级别星形细胞瘤患者54例(WHOⅢ级44例, WHOⅣ级10例),都进行常规MRI检查与播散性皮层抑制的MR DWI检查分析。结果 MRI常规检查显示低级别星形细胞瘤呈等长T1、T2信号的结节或肿块影,瘤周无明显水肿带,边界清晰,无明显占位效应;高级别星形细胞瘤呈稍长T1、T2信号结节影或肿块影,瘤周水肿带明显,占位效应明显,边界模糊;经过判定,MRI对于星形细胞瘤的病理分级诊断敏感性、特异性、准确性为93.3%、90.7%、91.7%。播散性皮层抑制的MR DWI显示低级与高级星形细胞瘤相比,前者瘤体和瘤周的rADC、ADC值均要高一些,对比差异都有统计学意义(P<0.05)。结论星形细胞瘤播散性皮层抑制的MR扩散加权成像能有效反应病理分级情况,能够提供更多的功能信息,提高诊断率,是对常规MRI检查的有益补充,有很好的应用价值。%Objective To study the correlation between MR diffusion weighted imaging (DWI) and pathologic features of disseminated cortical inhibition in astrocytoma.Methods Used retrospective study method, From September 2012 to February 2016 in our hospital, 84 cases with surgically and pathologically proved astrocytoma patients were selected for treatment that included pathological classification for low grade astrocytoma in 30 cases (10 cases of WHO grade Ⅰ, 20 cases of WHO grade Ⅱ), pathological classification for high-grade astrocytoma in 54 cases (44 cases of WHO grade Ⅲ, 10 cases of who grade Ⅳ). All cases were given conventional MRI and spread of cortical inhibition of MR diffusion-weighted imaging

  10. Isolated intramedullary tuberculoma of the dorsal cord:a rare clinico-radiological entity

    Institute of Scientific and Technical Information of China (English)

    Sumeet Bhargava; Rajul Rastogi; Gaurav Jindal; Amrit Kumar Singh; Vaibhav Rastogi


    Tuberculous infection manifesting as an isolated intramedullary tuberculoma of the spinal cord is distinctly unusual. We report a case of a 35 year old woman presenting with an insidious onset of myelopathy, where MRI showed characteristic imaging findings suggestive of intramedullary tuberculosis.

  11. The value of electromyography in differentiating intramedullary tumor from inflammatory demyelinating disease of cervical region

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the value of needle electromyography(EMG)in differentiating intramedullary tumor from inflammatory demyelinating disease of cervical region.Methods Patients hospitalized in the Chinese PLA General Hospital from March 2008 to June 2013 with abnormalities on MRI of cervical vertabra and preliminary diagnosed as intramedullary tumor or inflammatory demyelinating disease of cervical region were enrolled in the

  12. A trimodality approach in the management of metastatic low-grade epithelioid hemangioendothelioma of the bone. (United States)

    Saste, Abhijit; Cabrera Fernandez, Diego Felipe; Gulati, Rohit; Gamalski, Steven


    A 29-year-old man presented with a 2-week history of severe pain in the left foot with no preceding history of trauma. A left foot radiograph demonstrated a cortical lucency in the mid-distal shaft of the third metatarsal bone. MRI of the left foot showed an expansile lesion in the same location. A staging bone scan showed a focal uptake in the known lucency in the left third metatarsal and in the proximal left femur. A subsequent left hip radiograph demonstrated a lucency in the intertrochanteric region. CT scan of the chest, abdomen and pelvis was unremarkable. A biopsy of the left third metatarsal expansile lesion performed during an incision and curettage procedure revealed an epithelioid haemangioma (EHE) of the bone. MRI of the left hip performed in response to the findings on the bone scan showed metastatic disease in the left intertrochanteric region. A prophylactic left hip fixation surgery with an interlocking intramedullary femoral nail was therefore undertaken to avoid a pathological fracture of the left hip from the metastatic disease. Simultaneously, a left hip biopsy was performed, which also revealed an EHE. The patient underwent external beam radiation to the left femoral head and neck. This was followed by fractionated radiosurgery to the left third metatarsal. Once the left foot wound had healed, the patient subsequently received four cycles of doxorubicin and ifosfamide. A restaging positron emission tomography CT carried out after completion of therapy showed no metabolic evidence of residual primary tumour or metastasis. More than 2 years after completing his trimodality therapy, the patient remains fully functional and symptom free.

  13. Production of alcohol by simultaneous saccharification and fermentation of low-grade wheat flour

    Directory of Open Access Journals (Sweden)

    Marcos Antonio das Neves


    Full Text Available Two samples of low-grade wheat flour, namely low-grade 1 (LG1 and low-grade 2 (LG2, with different carbohydrate and fibrous content, were used as substrates. The samples were liquefied using various concentrations of alpha- or beta-amylase, in order to optimize the production of fermentable sugars; the enzyme alpha-amylase revealed higher performance. After liquefaction, the simultaneous saccharification and fermentation was conducted in a jar fermentor. Amyloglucosidase was used for saccharification, and dry baker's yeast, S. cerevisiae, for fermentation simultaneously. Glucose was consumed promptly in both cases, LG1 and LG2; ethanol production was considerably higher in LG1 (38.6 g/L, compared to LG2 (24.9 g/L. The maximum ATP production was observed early in the SSF process. LG1 revealed higher potential as substrate for ethanol production.Dois lotes de amostras de resíduo de farinha de trigo com teor reduzido de amido, especificamente designadas como amostra 1 (LG1 e amostra 2 (LG2, foram utilizados como substrato para fermentação alcoólica. Inicialmente as amostras foram hidrolisadas utilizando-se diferentes concentrações de alfa- ou beta-amilase, com o objetivo de otimizar a produção de açúcares fermentáveis; a enzima alfa-amilase apresentou melhor desempenho. O processo simultâneo de sacarificação e fermentação foi conduzido logo após a hidrólise do amido, em um fermentador com volume de 2 L; o meio contendo amido hidrolisado foi inoculado com amiloglucosidase (enzima utilizada para sacarificação e levedura de panificação desidratada (para fermentação, simultaneamente. Amostras do meio de fermentação foram retiradas regularmente para análise dos teores de glucose, maltose, açúcares redutores e etanol. O teor de Adenosina Tri-Fosfato (ATP também foi analisado. O açúcar glucose foi completamente consumido no início da fermentação, tanto no caso da amostra LG1, quanto LG2, sendo que a produção de etanol

  14. First experiences in treatment of low-grade glioma grade I and II with proton therapy (United States)


    Background To retrospectively assess feasibility and toxicity of proton therapy in patients with low-grade glioma (WHO °I/II). Patients and methods Proton beam therapy only administered in 19 patients (median age 29 years; 9 female, 10 male) for low-grade glioma between 2010 and 2011 was reviewed. In 6 cases proton therapy was performed due to tumor progression after biopsy, in 8 cases each due to tumor progression after (partial-) resection, and in 5 cases due to tumor progression after chemotherapy. Median total dose applied was 54 GyE (range, 48,6-54 GyE) in single fractions of median 1.8 GyE. Median clinical target volume was 99 cc (range, 6–463 cc) and treated using median 2 beams (range, 1–2). Results Proton therapy was finished as planned in all cases. At end of proton therapy, 13 patients showed focal alopecia, 6 patients reported mild fatigue, one patient with temporal tumor localization concentration deficits and speech errors and one more patient deficits in short-term memory. Four patients did not report any side effects. During follow-up, one patient presented with pseudo-progression showing worsening of general condition and brain edema 1–2 months after last irradiation and restitution after 6 months. In the present MR imaging (median follow-up 5 months; range 0–22 months) 12 patients had stable disease, 2 (1) patients partial (complete) remission, one more patient pseudo-progression (differential diagnosis: tumor progression) 4 weeks after irradiation without having had further follow-up imaging so far, and one patient tumor progression approximately 9 months after irradiation. Conclusion Regarding early side effects, mild alopecia was the predominant finding. The rate of alopecia seems to be due to large treatment volumes as well as the anatomical locations of the target volumes and might be avoided by using multiple beams and the gantry in the future. Further evaluations including neuropsychological testing are in preparation. PMID

  15. New Technique: A Novel Femoral Derotation Osteotomy for Malrotation following Intramedullary Nailing

    Directory of Open Access Journals (Sweden)

    S. Jagernauth


    Full Text Available A 19-year-old female patient sustained a closed spiral midshaft femoral fracture and subsequently underwent femoral intramedullary nail insertion. At followup she complained of difficulty in walking and was found to have a unilateral in-toeing gait. CT imaging revealed 30 degrees of internal rotation at the fracture site, which had healed. A circumferential osteotomy was performed distal to the united fracture site using a Gigli saw with the intramedullary femoral nail in situ. The static distal interlocking screws were removed and the malrotation was corrected. Two further static distal interlocking screws were inserted to secure the intramedullary nail in position. The osteotomy went on to union and her symptoms of pain, walking difficulty, and in-toeing resolved. Our paper is the first to describe a technique for derotation osteotomy following intramedullary malreduction that leaves the intramedullary nail in situ.

  16. Cognitive impairments in patients with low grade gliomas and high grade gliomas

    Directory of Open Access Journals (Sweden)

    Eliane C. Miotto


    Full Text Available OBJECTIVE: The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. METHOD: The low-grade (G1, n=19 and high-grade glioma (G2, n=8 patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. RESULTS: There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. CONCLUSION: These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.

  17. Fast Thermal Calibration of Low-Grade Inertial Sensors and Inertial Measurement Units

    Directory of Open Access Journals (Sweden)

    Yalong Ban


    Full Text Available The errors of low-cost inertial sensors, especially Micro-Electro Mechanical Systems (MEMS ones, are highly dependent on environmental conditions such as the temperature. Thus, there is a need for the development of accurate and reliable thermal compensation models to reduce the impact of such thermal drift of the sensors. Since the conventional thermal calibration methods are typically time-consuming and costly, an efficient thermal calibration method to investigate the thermal drift of a full set of gyroscope and accelerometer errors (i.e., biases, scale factor errors and non-orthogonalities over the entire temperature range in a few hours is proposed. The proposed method uses the idea of the Ramp method, which removes the time-consuming process of stabilizing the sensor temperature, and addresses its inherent problems with several improvements. We change the temperature linearly for a complete cycle and take a balanced strategy by making comprehensive use of the sensor measurements during both heating and cooling processes. Besides, an efficient 8-step rotate-and-static scheme is designed to further improve the calibration accuracy and efficiency. Real calibration tests showed that the proposed method is suitable for low-grade IMUs and for both lab and factory calibration due to its efficiency and sufficient accuracy.

  18. Fast thermal calibration of low-grade inertial sensors and inertial measurement units. (United States)

    Niu, Xiaoji; Li, You; Zhang, Hongping; Wang, Qingjiang; Ban, Yalong


    The errors of low-cost inertial sensors, especially Micro-Electro Mechanical Systems (MEMS) ones, are highly dependent on environmental conditions such as the temperature. Thus, there is a need for the development of accurate and reliable thermal compensation models to reduce the impact of such thermal drift of the sensors. Since the conventional thermal calibration methods are typically time-consuming and costly, an efficient thermal calibration method to investigate the thermal drift of a full set of gyroscope and accelerometer errors (i.e., biases, scale factor errors and non-orthogonalities) over the entire temperature range in a few hours is proposed. The proposed method uses the idea of the Ramp method, which removes the time-consuming process of stabilizing the sensor temperature, and addresses its inherent problems with several improvements. We change the temperature linearly for a complete cycle and take a balanced strategy by making comprehensive use of the sensor measurements during both heating and cooling processes. Besides, an efficient 8-step rotate-and-static scheme is designed to further improve the calibration accuracy and efficiency. Real calibration tests showed that the proposed method is suitable for low-grade IMUs and for both lab and factory calibration due to its efficiency and sufficient accuracy.

  19. Low grade bioethanol for fuel mixing on gasoline engine using distillation process (United States)

    Abikusna, Setia; Sugiarto, Bambang; Suntoro, Dedi; Azami


    Utilization of renewable energy in Indonesia is still low, compared to 34% oil, 20% coal and 20% gas, utilization of energy sources for water 3%, geothermal 1%, 2% biofuels, and biomass 20%. Whereas renewable energy sources dwindling due to the increasing consumption of gasoline as a fuel. It makes us have to look for alternative renewable energy, one of which is bio ethanol. Several studies on the use of ethanol was done to the researchers. Our studies using low grade bio ethanol which begins with the disitillation independently utilize flue gas heat at compact distillator, produces high grade bio ethanol and ready to be mixed with gasoline. Stages of our study is the compact distillator design of the motor dynamic continued with good performance and emission testing and ethanol distilled. Some improvement is made is through the flue gas heat control mechanism in compact distillator using gate valve, at low, medium, and high speed engine. Compact distillator used is kind of a batch distillation column. Column design process using the shortcut method, then carried the tray design to determine the overall geometry. The distillation is done by comparing the separator with a tray of different distances. As well as by varying the volume of the feed and ethanol levels that will feed distilled. In this study, we analyzed the mixing of ethanol through variation between main jet and pilot jet in the carburetor separately interchangeably with gasoline. And finally mixing mechanism bio ethanol with gasoline improved with fuel mixer for performance.

  20. Network Plasticity and Intraoperative Mapping for Personalized Multimodal Management of Diffuse Low-Grade Gliomas (United States)

    Ghinda, Cristina Diana; Duffau, Hugues


    Gliomas are the most frequent primary brain tumors and include a variety of different histological tumor types and malignancy grades. Recent achievements in terms of molecular and imaging fields have created an unprecedented opportunity to perform a comprehensive interdisciplinary assessment of the glioma pathophysiology, with direct implications in terms of the medical and surgical treatment strategies available for patients. The current paradigm shift considers glioma management in a comprehensive perspective that takes into account the intricate connectivity of the cerebral networks. This allowed significant improvement in the outcome of patients with lesions previously considered inoperable. The current review summarizes the current theoretical framework integrating the adult human brain plasticity and functional reorganization within a dynamic individualized treatment strategy for patients affected by diffuse low-grade gliomas. The concept of neuro-oncology as a brain network surgery has major implications in terms of the clinical management and ensuing outcomes, as indexed by the increased survival and quality of life of patients managed using such an approach.

  1. Selective Removal of Iron from Low-Grade Ti Ore by Reacting with Calcium Chloride (United States)

    Kang, Jungshin; Okabe, Toru H.


    Recently, titanium metal production by molten salt electrolysis using CaCl2 as molten salt and TiO2 or rutile (94 to 96 pct TiO2) as feedstock has been drawing attention. However, when a low-grade Ti ore (mainly FeTiO3) is used as feedstock, removal of iron (Fe) from the ore is indispensable. In this study, the influence of reaction temperature, reaction time, particle size of the ore, and source country for the ore on the removal of iron by selective chlorination using CaCl2 was assessed. Experimental results showed that the mass percent of iron in the ore decreased from 49.7 to 1.79 pct under certain conditions by selective removal of iron as FeCl2. As a result, high-grade CaTiO3 was produced when the ore particles smaller than 74 µm reacted with CaCl2 at 1240 K (967 °C) for 8 to 10 hours. Therefore, this study demonstrates that the removal of iron from the ore is feasible through the selective chlorination process using CaCl2 by optimizing the variables.

  2. Enhancing Low-Grade Thermal Energy Recovery in a Thermally Regenerative Ammonia Battery Using Elevated Temperatures

    KAUST Repository

    Zhang, Fang


    © 2015 WILEY-VCH Verlag GmbH & Co. KGaA. A thermally regenerative ammonia battery (TRAB) is a new approach for converting low-grade thermal energy into electricity by using an ammonia electrolyte and copper electrodes. TRAB operation at 72°C produced a power density of 236±8 Wm-2, with a linear decrease in power to 95±5 Wm-2 at 23°C. The improved power at higher temperatures was due to reduced electrode overpotentials and more favorable thermodynamics for the anode reaction (copper oxidation). The energy density varied with temperature and discharge rates, with a maximum of 650 Whm-3 at a discharge energy efficiency of 54% and a temperature of 37°C. The energy efficiency calculated with chemical process simulation software indicated a Carnot-based efficiency of up to 13% and an overall thermal energy recovery of 0.5%. It should be possible to substantially improve these energy recoveries through optimization of electrolyte concentrations and by using improved ion-selective membranes and energy recovery systems such as heat exchangers.

  3. A New Heterotrophic Strain for Bioleaching of Low Grade Complex Copper Ore

    Directory of Open Access Journals (Sweden)

    Kaijian Hu


    Full Text Available A new heterotrophic strain, named Providencia sp. JAT-1, was isolated and used in bioleaching of low-grade complex copper ore. The strain uses sodium citrate as a carbon source and urea as a nitrogen source to produce ammonia. The optimal growth condition of the strain is 30 C, initial pH 8, sodium citrate 10 g/L and urea 20 g/L, under which the cell density and ammonia concentration in the medium reached a maximum of 4.83 × 108 cells/mL and 14 g/L, respectively. Ammonia produced by the strain is used as the main lixiviant in bioleaching. Bioleaching results revealed that higher strain growth led to a higher copper recovery, while higher pulp density will cause a greater inhibitory effect on strain growth and ammonia production. The copper extraction reached the highest value of 54.5% at the pulp density of 1%. Malachite, chrysocolla and chalcocite are easy to leach out in this bioleaching system while chalcopyrite is difficult. Results of comparative leaching experiments show that bioleaching using JAT-1 is superior to ammonia leaching at the same condition. The metabolites produced by the strain other than ammonia are also involved in bioleaching.

  4. Current understanding of BRAF alterations in diagnosis, prognosis and therapeutic targeting in paediatric low grade gliomas

    Directory of Open Access Journals (Sweden)

    Catherine Louise Penman


    Full Text Available The mitogen-activated protein kinase (MAPK pathway is known to play a key role in the initiation and maintenance of many tumours as well as normal development. This often occurs through mutation of the genes encoding RAS and RAF proteins which are involved in signal transduction in this pathway. BRAF is one of three RAF kinases which act as downstream effectors of growth factor signalling leading to cell cycle progression, proliferation and survival. Initially reported as a point mutation (V600E in the majority of metastatic melanomas, other alterations in the BRAF gene have now been reported in a variety of human cancers including papillary thyroid cancer, colon carcinomas, hairy cell leukaemia and more recently in gliomas. The identification of oncogenic mutations in the BRAF gene have led to a revolution in the treatment of metastatic melanoma using targeted molecular therapies that affect the MAPK pathway either directly through BRAF inhibition or downstream through inhibition of MEK. This review describes the molecular biology of BRAF in the context of paediatric low grade gliomas, the role of BRAF as a diagnostic marker, the prognostic implications of BRAF and evidence for therapeutic targeting of BRAF.

  5. Nodular lymphoid hyperplasia: A marker of low-grade inflammation in irritable bowel syndrome? (United States)

    Piscaglia, Anna Chiara; Laterza, Lucrezia; Cesario, Valentina; Gerardi, Viviana; Landi, Rosario; Lopetuso, Loris Riccardo; Calò, Giovanni; Fabbretti, Giovanna; Brisigotti, Massimo; Stefanelli, Maria Loredana; Gasbarrini, Antonio


    To evaluate the prevalence of nodular lymphoid hyperplasia (NLH) in adult patients undergoing colonoscopy and its association with known diseases. We selected all cases showing NLH at colonoscopy in a three-year timeframe, and stratified them into symptomatic patients with irritable bowel syndrome (IBS)-type symptoms or suspected inflammatory bowel disease (IBD), and asymptomatic individuals undergoing endoscopy for colorectal cancer screening. Data collection included medical history and final diagnosis. As controls, we considered all colonoscopies performed for the aforementioned indications during the same period. One thousand and one hundred fifty colonoscopies were selected. NLH was rare in asymptomatic individuals (only 3%), while it was significantly more prevalent in symptomatic cases (32%). Among organic conditions associated with NLH, the most frequent was IBD, followed by infections and diverticular disease. Interestingly, 31% of IBS patients presented diffuse colonic NLH. NLH cases shared some distinctive clinical features among IBS patients: they were younger, more often female, and had a higher frequency of abdominal pain, bloating, diarrhoea, unspecific inflammation, self-reported lactose intolerance and metal contact dermatitis. About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients.

  6. Surgery of insular and paralimbic diffuse low-grade gliomas: technical considerations. (United States)

    Michaud, Karine; Duffau, Hugues


    Once considered a "no man's land" especially when invaded by a diffuse low grade glioma (DLGG), the insula remains to this day a surgical challenge. Surgery for insular DLGG involves consideration of its hidden location under the potentially eloquent operculae, the proximity to vascular tree and high density of functions not only in the insular cortex but also in the white fiber pathways passing under the insular lobe. The natural history of DLGG and the potential benefits and consequences of the surgical approach also need a close look. In the last decade, a better knowledge of the functional anatomy and connectivity of this region, as well as an improvement in surgical techniques as direct stimulation mapping, combined with an increasing literature showing a favorable impact of maximal resection for DLGG, were deciding factors in the paradigmatic shift from expectative treatment to early surgical management. Here, our goal is to discuss the structural and functional aspects of the insula, the specificities of insular and paralimbic DLGG by emphasizing the technical considerations of surgery in this region, as well as its oncological and functional outcomes. In summary, this new strategy based upon early maximal safe surgical resection showed both oncological benefit and preservation of quality of life-or even an improvement thanks to epilepsy relief.

  7. A disconnection account of subjective empathy impairments in diffuse low-grade glioma patients. (United States)

    Herbet, Guillaume; Lafargue, Gilles; Moritz-Gasser, Sylvie; Menjot de Champfleur, Nicolas; Costi, Emanuele; Bonnetblanc, François; Duffau, Hugues


    Human empathic experience is a multifaceted psychological construct which arises from functional integration of multiple neural networks. Despite accumulating knowledge about the cortical circuitry of empathy, almost nothing is known about the connectivity that may be concerned in conveying empathy-related neural information. To bridge this gap in knowledge, we studied dispositional empathy in a large-sized cohort of 107 patients who had undergone surgery for a diffuse low-grade glioma. The self-report questionnaire used enabled us to obtain a global measure of subjective empathy but also, importantly, to assess the two main components of empathy (cognitive and emotional). Data were processed by combining voxelwise and tractwise lesion-symptom analyses. Several major findings emerged from our analyses. First of all, topological voxelwise analyses were inconclusive. Conversely, tractwise multiple regression analyses, including all major associative white matter pathways as potential predictors, yielded to significant models explaining substantial part of the behavioural variance. Among the main results, we found that disconnection of the left cingulum bundle was a strong predictor of a low cognitive empathy (pempathy. Finally, although we failed to relate emotional empathy to disruption of a specific tract, correlation analyses indicated a positive association between this component of empathy and the volumes of residual lesion infiltration in the right hemisphere (pempathy. They may help to better understand the pathophysiology of empathy impairments in pathological conditions characterized by abnormalities of long-range anatomical connectivity, such as autism spectrum disorders, schizophrenia and fronto-temporal dementia.

  8. Beneficiation of low grade graphite ore of eastern India by two-stage grinding and flotation

    Directory of Open Access Journals (Sweden)

    Vasumathi N.


    Full Text Available A low grade graphite run-of-mine (r.o.m ore from eastern India was studied for its amenability to beneficiation by flotation technique. The petrography studies indicate that the ore primarily consists of quartz and graphite with minor quantity of mica. It analyzed 89.89% ash and 8.59% fixed carbon. The ore was crushed in stages followed by primary coarse wet grinding to 212 μm (d80. Rougher flotation was carried out in Denver flotation cell to eliminate gangue as much as possible in the form of primary tailings with minimal loss of carbon. Diesel & pine oil were used as collector and frother respectively. Regrinding of rougher concentrate to150 μm (d80 was resorted to further liberate the graphite values and was followed by multi-stage cleaning. This two-stage grinding approach involving a primary coarse grinding and regrinding of rougher float followed by its multi-stage cleaning was found to yield required grade of concentrate for applications such as refractories, batteries and high temperature lubricants. This approach is supposed to retain the flake size of coarse, free and liberated graphite, if available, during primary coarse grinding and rougher flotation stage with minimal grinding energy costs as against the usual practice of single stage grinding in the case of many ores. A final concentrate of 8.97% weight recovery with 5.80% ash and 92.13% fixed carbon could be achieved.

  9. Melatonin ameliorates low-grade inflammation and oxidative stress in young Zucker diabetic fatty rats. (United States)

    Agil, Ahmad; Reiter, Russel J; Jiménez-Aranda, Aroa; Ibán-Arias, Ruth; Navarro-Alarcón, Miguel; Marchal, Juan Antonio; Adem, Abdu; Fernández-Vázquez, Gumersindo


    The aim of this study was to investigate the effects of melatonin on low-grade inflammation and oxidative stress in young male Zucker diabetic fatty (ZDF) rats, an experimental model of metabolic syndrome and type 2 diabetes mellitus (T2DM). ZDF rats (n = 30) and lean littermates (ZL) (n = 30) were used. At 6 wk of age, both lean and fatty animals were subdivided into three groups, each composed of 10 rats: naive (N), vehicle treated (V), and melatonin treated (M) (10 mg/kg/day) for 6 wk. Vehicle and melatonin were added to the drinking water. Pro-inflammatory state was evaluated by plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP). Also, oxidative stress was assessed by plasma lipid peroxidation (LPO), both basal and after Fe(2+)/H2O2 inducement. ZDF rats exhibited higher levels of IL-6 (112.4 ± 1.5 pg/mL), TNF-α (11.0 ± 0.1 pg/mL) and CRP (828 ± 16.0 µg/mL) compared with lean rats (IL-6, 89.9 ± 1.0, P Melatonin lowered IL-6 (10%, P Melatonin improved basal LPO (15%, P melatonin administration ameliorates the pro-inflammatory state and oxidative stress, which underlie the development of insulin resistance and their consequences, metabolic syndrome, diabetes, and cardiovascular disease.

  10. Preparation of manganese sulfate from low-grade manganese carbonate ores by sulfuric acid leaching

    Institute of Scientific and Technical Information of China (English)

    Qing-quan Lin; Guo-hua Gu; Hui Wang; Ren-feng Zhu; You-cai Liu; and Jian-gang Fu


    In this study, a method for preparing pure manganese sulfate from low-grade ores with a granule mean size of 0.47 mm by direct acid leaching was developed. The effects of the types of leaching agents, sulfuric acid concentration, reaction temperature, and agitation rate on the leaching efficiency of manganese were investigated. We observed that sulfuric acid used as a leaching agent provides a similar leach-ing efficiency of manganese and superior selectivity against calcium compared to hydrochloric acid. The optimal leaching conditions in sul-furic acid media were determined; under the optimal conditions, the leaching efficiencies of Mn and Ca were 92.42% and 9.61%, respec-tively. Moreover, the kinetics of manganese leaching indicated that the leaching follows the diffusion-controlled model with an apparent ac-tivation energy of 12.28 kJ·mol−1. The purification conditions of the leaching solution were also discussed. The results show that manganese dioxide is a suitable oxidant of ferrous ions and sodium dimethyldithiocarbamate is an effective precipitant of heavy metals. Finally, through chemical analysis and X-ray diffraction analysis, the obtained product was determined to contain 98% of MnSO4·H2O.

  11. Low-grade fibromatosis-like spindle cell carcinomas of the breast are molecularly exiguous. (United States)

    Takano, Elena A; Hunter, Sally M; Campbell, Ian G; Fox, Stephen B


    Low-grade fibromatosis-like spindle cell carcinomas are very rare breast carcinomas comprising <0.5% of all breast cancers. They demonstrate immunohistochemical (IHC) features of basal-like/metaplastic breast carcinomas, but the underlying molecular characteristics are unknown. We hypothesised that, as with IHC similarities, there may be common genomic alterations between spindle cell and basal-like/metaplastic carcinomas. Genomic mutational profile and genomic copy number aberration (CNA) analyses were performed on three cases of this unusual entity, and findings were compared with that reported for basal-like/metaplastic breast carcinomas. Copy number analyses by molecular inversion probe assays of the three spindle cell carcinoma samples revealed little overall genomic CNAs with only minor changes identified (fraction of the genome altered; 1.3%-6.4%), but with a common 9p21.3 loss in 2 out of 3 samples, with CDKN2A (p16) being a likely candidate. No areas of commonality were identified in an in silico analysis compared with publically available basal-like/metaplastic carcinoma copy number data. These tumours are characterised by low genomic instability, and share no CNAs with other metaplastic carcinomas. These findings favour this entity being a unique group genotype and belie their apparent homogeneous morphology and phenotype. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  12. Low-grade fibromyxoid sarcoma versus fibromatosis: a comparative study of clinicopathological and immunohistochemical features. (United States)

    Meng, Guo-Zhao; Zhang, Hong-Ying; Bu, Hong; Geng, Jian-Guo


    We have studied 11 cases of low-grade fibromyxoid sarcoma (LGFMS) and 15 cases of fibromatosis with respect to clinicopathological features and immunohistochemical expression of Ki-67, nm23, cyclinD1, and p53, in order to investigate the differential diagnosis between this two groups. Formalin-fixed, paraffin-embedded sections from 11 cases of LGFMS and 15 cases of fibromatosis were studied histologically and immunohistochemically. The immunostainings were semiquantitatively evaluated using the Allred score system. Microscopically, LGFMS was composed of bland spindle cells arranged in a whorled pattern showing alternating myxoid zones and fibrous stroma zones with prominent arcade curvilinear capillaries. Cytological atypia, mitotic figures, and tumor necrosis were absent in all 11 cases of LGFMS. In contrast, fibromatosis was less cellular and more fascicular, containing more collagen and showing no alternating fibrous and myxoid zones as compared with LGFMS. The immunostaining scores of nm23 in LGFMS were significantly lower than that in fibromatosis. The immunostaining scores of Ki-67, p53, and cyclinD1 in LGFMS were significantly higher than that in fibromatosis. Thus, we consider that LGFMS can be distinguished from fibromatosis by clinicopathological features, and assessments of the immunohistochemical expression level of cyclinD1, p53, nm23, and Ki-67 are helpful in the differential diagnosis.

  13. A visfatin promoter polymorphism is associated with low-grade inflammation and type 2 diabetes. (United States)

    Zhang, Yuan-Yuan; Gottardo, Lucia; Thompson, Ryan; Powers, Christine; Nolan, David; Duffy, Jill; Marescotti, Maria Cristina; Avogaro, Angelo; Doria, Alessandro


    Visfatin (also known as pre-B cell colony-enhancing factor, or PBEF) is a pro-inflammatory adipokine expressed predominantly in visceral fat. We investigated whether polymorphisms at the visfatin/PBEF locus influence the risk of type 2 diabetes (T2D). Linkage disequilibrium analysis of 52 single nucleotide polymorphisms spanning the entire gene (34.7 kb) plus 20.5 kb of the upstream region and 25.5 kb of the downstream region revealed a single haplotype block that could be tagged by seven single nucleotide polymorphisms. These seven tags were typed in a group of T2D patients (n = 814) and a group of non-diabetic controls (n = 320) of white origin. A significant association was observed at -948C>A, with minor allele frequencies of 0.157 in T2D cases and 0.119 in non-diabetic controls (p = 0.021). In a non-diabetic population (n = 630), the same -948 allele that conferred increased risk of T2D was significantly associated with higher plasma levels of fibrinogen and C-reactive protein (p = 0.0022 and 0.0038, respectively). However, no significant associations were observed with BMI, waist circumference, serum glucose levels, or fasting insulin levels. Our findings suggest that the visfatin/PBEF gene may play a role in determining T2D susceptibility, possibly by modulating chronic, low-grade inflammatory responses.

  14. Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case report and literature review. (United States)

    Oishi, Naoki; Kondo, Tetsuo; Nakazawa, Tadao; Mochizuki, Kunio; Kasai, Kazunari; Inoue, Tomohiro; Yamamoto, Takanori; Watanabe, Hiroyuki; Hatsushika, Kyousuke; Masuyama, Keisuke; Katoh, Ryohei


    Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm characterized by morphological analogy to papillary thyroid carcinoma and abnormal expression of thyroid transcription factor-1 (TTF-1). Here we report a novel case of TL-LGNPPA with literature review. The patient was a 43-year-old woman complaining of nasal obstruction. Laryngoscopic study and computed tomography identified a pedunculated mass located on the posterior edge of the left nasal septum. Histologically, the tumor consisted of papillary growth of cuboidal or columnar epithelium. Tubular architecture and a spindle cell component were also observed focally. Some tumor cells exhibited intra-nuclear cytoplasmic inclusions. Immunohistochemically, the neoplastic cells were positive for pancytokeratin (AE1/AE3), CK7, CK19, TTF-1, vimentin and HBME1, but negative for thyroglobulin, Pax8 and CK5/6. Ki67-labeling index reached 5% in the most concentrated spot. Despite the morphological and immunohistochemical similarity to papillary thyroid carcinoma, no BRAF V600E mutation was detected by mutation-specific immunohistochemistry. The patient had neither local recurrence nor distant metastasis 19 months after removal of the tumor.

  15. Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

    Directory of Open Access Journals (Sweden)

    Wataru Kudaka


    Full Text Available Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS extending to inferior vena cava (IVC and cardiac chambers. Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months. Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.

  16. Co-pyrolysis of a Ukrainian low-grade coal (brown) with plastics

    Energy Technology Data Exchange (ETDEWEB)

    V.N. Shevkoplyas [National Academy of Sciences of Ukraine, Donetsk (Ukraine)


    An effective pathway of the wastes plastics utilization can be its co-pyrolysis with a low-grade (brown) coal. The Dneprovsky deposit brown coal (Ukraine) and waste plastics as a polyethyleneterephthalate in this investigation were taken. The brown coal-plastics mixed used: 19:1; 9:1 and 4:1 ratio that was as 5, 10 and 20 % plastics additive to the brown coal. The co-pyrolysis mix prepared in the temperature region 450-800{sup o}C in a fixed bed reactor has been carried out. The process time was 0, 60 and 120 min., heating rate - 25{sup o}C/min. The influence plastics additive on the co-pyrolysis yield has been estimated. The influence of the co-pyrolysis isothermal time on the yield and properties of the tars produced has been studied. The mass balances of co-pyrolysis brown coal with plastics have been calculated. It was concluded that the co-pyrolysis brown coal with plastics is a way to utilize organic pollutants. 3 refs., 1 fig., 6 tabs.

  17. Dry Separation of Iron Minerals from Low-Grade Coal-series Kaolin

    Institute of Scientific and Technical Information of China (English)

    HUANG Teng; LEI Shaomin; LIU Mochou; JI Mengjiao; LIU Yuanyuan; YIN Xudong; PENG Yongjun


    Dry separation of iron mineral from low-grade coal-series kaolin in Hubei Province of China was investigated. The structure and chemical composition of the kaolin ore were determined by X-ray diffraction (XRD) and X-ray Fluorescence (XRF) analyses. The narrow particle size range classiifcation, dry magnetic separation and calcination were carried out to evaluate the particle size distribution, and the relation between the content of iron and the whiteness. Experimental results revealed that the highest content of iron (3.70%) in kaolin ore was in the particle size range from 60 to 74 μm, and pyrite was the main occurrence of iron in the kaolin ore. Dry magnetic separation showed that the removal rate of iron in kaolin ore could be increased obviously after calcination, and the rate of iron removal was 60% in the particle size range from 60 to 74 μm. As pyrite can be transformed into hematite through calcination, thermodynamic studies and XRD analysis showed that the maximum content of hematite was obtained at 900℃, which would be more beneifcial to magnetic separation.

  18. Ubiquitous Burgess Shale-style "clay templates" in low-grade metamorphic mudrocks (United States)

    Page, Alex; Gabbott, Sarah E.; Wilby, Philip R.; Zalasiewicz, Jan A.


    Despite the Burgess Shale's (British Columbia, Canada) paleobiologicalimportance, there is little consensus regarding its taphonomy.Its organic fossils are preserved as compressions associatedwith phyllosilicate films ("clay templates"). Debate focuseson whether these templates were fundamental in exceptional preservationor if they formed in metamorphism, meaning that it is importantto establish the timing of their formation relative to decay.An early diagenetic origin has been proposed based on anatomy-specificvariations in their composition, purportedly reflecting contrastsin decay. However, we demonstrate that these films bear a remarkablesimilarity to those that occur on organic fossils in graptoliticmudrocks and form as a normal product of low-grade metamorphism.Such phyllosilicates may also occur within voids created byvolume loss in maturation, a process that may have aided theirformation. In bedding-plane assemblages from graptolitic mudrocks,different taxa are associated with distinct phyllosilicates.This likely reflects stepwise maturation of their constituentkerogens in an evolving hydrothermal fluid, with different phyllosilicatesforming as each taxon progressively underwent maturation. Theseobservations provide an analogue for the distribution and compositionof phyllosilicates on Burgess Shale fossils, which we interpretas reflecting variations in the maturation of their constituenttissues. Thus, their clay templates seem unremarkable, formingtoo late to account for exceptional preservation.

  19. Transportation of low-grade thermal energy over long distance by ammonia-water absorption

    Institute of Scientific and Technical Information of China (English)

    MA Qiang; WANG RuZhui; LUO LinGai; XIA ZaiZhong; LIN Peng


    This paper presents the importance and the cycle choice for long-distance transportation of low-grade thermal energy, and the thermodynamic and hydrodynamic feasibility of single-effect ammonia-water absorption system for heat or cold transportation over long distance are also involved. A model of a long-distance thermal energy transportation system is built and analyzed, which shows satisfactory and attractive results. When a steam heat source at 12012 is available, the user site can get hot water output at about 55℃ with the thermal COP of about 0.6 and the electric COP of about 100 in winter, and cold water output at about 10~C with the thermal COP of about 0.5 and the electric COP of 50 in summer.A small-size prototype is built to verify the performance analysis. Basically the experimental data show good accordance with the analysis results. The ammonia-water absorption system is a potential prospective solution for the heat or cold transportation over long distance.

  20. Selective Removal of Iron from Low-Grade Ti Ore by Reacting with Calcium Chloride (United States)

    Kang, Jungshin; Okabe, Toru H.


    Recently, titanium metal production by molten salt electrolysis using CaCl2 as molten salt and TiO2 or rutile (94 to 96 pct TiO2) as feedstock has been drawing attention. However, when a low-grade Ti ore (mainly FeTiO3) is used as feedstock, removal of iron (Fe) from the ore is indispensable. In this study, the influence of reaction temperature, reaction time, particle size of the ore, and source country for the ore on the removal of iron by selective chlorination using CaCl2 was assessed. Experimental results showed that the mass percent of iron in the ore decreased from 49.7 to 1.79 pct under certain conditions by selective removal of iron as FeCl2. As a result, high-grade CaTiO3 was produced when the ore particles smaller than 74 µm reacted with CaCl2 at 1240 K (967 °C) for 8 to 10 hours. Therefore, this study demonstrates that the removal of iron from the ore is feasible through the selective chlorination process using CaCl2 by optimizing the variables.

  1. Integrated utilization of low-grade thermal energy in hot coal mine

    Institute of Scientific and Technical Information of China (English)

    Wei-min CHENG; Yu-dong QI; Yan-bin YU; Gang PAN


    This paper explores the integrated utilization of low-grade thermal energy in hot coal mines,based on analysis of original heating,refrigerating,mine draining,bath draining and air exhaust systems,and in combination with the actual conditions of Tangkou Coal Mine in Shandong Province.It presents a set of comprehensive and integrated utilization schemes for the various different kinds of low quality heat energy.With heat pumps,the recycling of the low quality heat energy from the drainage,bathing water and the exhaust air can occur in winter,and in summer,there exists condensed heat of the refrigerating system.When in conjunction with solar collectors,the thermal utilization of solar power can be realized for the whole year.The system achieves mine drainage and bathing water purification and recycling,as well as purifying exhaust air by water spraying.It also satisfies the demands of a whole year's bathing heat for the coal mine,with refrigeration in summer,and heating for the ground house and shaft house in winter.It is able to integrate different kinds of low quality heat energy and low emission drainage and dust,and can replace the traditional boiler heating system.Finally,the system reduces conventional energy consumption and the amount of mine water drainage.

  2. The association between obesity and fluid intelligence impairment is mediated by chronic low-grade inflammation. (United States)

    Spyridaki, Eirini C; Simos, Panagiotis; Avgoustinaki, Pavlina D; Dermitzaki, Eirini; Venihaki, Maria; Bardos, Achilles N; Margioris, Andrew N


    Published evidence suggests that obesity impairs cognition. Development of chronic low-grade inflammation (CLGI) represents the earliest consequence of obesity. The present study investigated the association between obesity and fluid intelligence impairment and assessed the potential mediating role of CLGI and psychological (depression/anxiety symptoms), lifestyle (exercise) and physiological (metabolic dysfunction indices) factors in this association. Clinically healthy participants (n 188), grouped as per BMI, underwent cognitive (General Ability Measure for Adults), psychological (Beck Depression Inventory-II and State-Trait Anxiety Inventory) and activity (Godin leisure-time physical activity) measurements. Biochemical parameters included the following: (a) indices of CLGI (high-sensitivity C-reactive protein, erythrocyte sedimentation rate and fibrinogen); (b) insulin resistance (Homeostasis Model Assessment of Insulin Resistance index); (c) adiposity (plasma adiponectin). An inverse association between elevated BMI and fluid intelligence was observed, with obese participants displaying significantly poorer performance compared with age-matched normal-weight peers. Structural equation modelling results were consistent with a negative impact of obesity on cognition that was mediated by CLGI. The results of the present study support the hypothesis that reduced general cognitive ability is associated with obesity, an adverse effect mainly mediated by obesity-associated activation of innate immunity.

  3. [Presence of high risk human papilomaviruses (HPV) in the low grade cervical lesion]. (United States)

    Iljazović, Ermina; Mustadenagić-Mujanović, Jasminka; Karasalihović, Zinaida; Cickusić, E; Avdić, S


    Low grade squamous intraepithelial lesion (LGSIL) and atypical squamous cells undetermined significance (ASCUS) are the most frequent verified cellular abnormalities. Their management are still highly controversial mostly caused by uncertainty about their histology and nature of originate. Detection of HPV DNA in the absence of cytological abnormalities can also indicate presence of high-grade cervical intraepithelial neoplasia (CIN). The aim of this study was to show the association of the benign cellular changes, ASCUS and LGSIL with oncogenic types of HPV and to prove the necessity of more intensive screening of this group of patients. Cytology and pathomorphology analyses were performed first. Identification of the presence of human papiloma virus was carried out by the Digene Hybride Capture II test for all patients. Identification of different HPV types for the particular number of patients was carried out by RFLP (Rsetriction Fragments Length of Polymorphism). Out of the 101 patients in the first group 92 (91,08%) were HPV positive, and 41, 58% had no cellular abnormalities, ASCUS or LGSIL. Out of 509 patients of the second group 26.92% were positive for HRHPV, and 78,97% of them had no cellular abnormalities, ASCUS or LGSIL. HPV 16 was detected in 27.36% (ASCUS/LGSIL) of low risk cervical lesion of the first examined period. The combination of smears with the detection of high risk HPV types increases the triage sensitivity especially at patients with mild.

  4. Reduction of Low-grade Manganese Dioxide Ore Pellets by Biomass Wheat Stalk

    Institute of Scientific and Technical Information of China (English)

    Honglei ZHANG; Guocai ZHU; Hong YAN; Yuna ZHAO; Tiancheng LI; Xiujuan FENG


    An investigation on reducing low-grade manganese dioxide ore pellets was carried out by using wheat stalk as reductant.The main impact factors of reduction percent such as particle size,biomass/ore ratio,heating rate,nitrogen flow rate,temperature and time in reduction process were discussed.The morphology and component of manganese dioxide ore particle at different stages were also analyzed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS).The results show the increase of the reduction temperature and time,biomass/ore ratio,and the decrease of particle size,heating rate and nitrogen flow rate can significantly enhance reduction efficiency.The reduction kinetic of the manganese ore is controlled by three-dimensional mass diffusion of gaseous reductive volatiles passing from the surface to the core of the ore particles.The activation energy E and frequency factor A were calculated to be 24.15 kJ.mol-1 and 166 min-1,respectively.Biomass pyrolysis volatiles adsorbed onto the surface of the ore particle leads to serious variation of the microstructures and chemical composition of the manganese ore particles.

  5. Inhibition of Low-Grade Inflammation by Anthocyanins after Microbial Fermentation in Vitro

    Directory of Open Access Journals (Sweden)

    Sabine Kuntz


    Full Text Available The anti-inflammatory effects of anthocyanins (ACNs on vascular functions are discussed controversially because of their low bioavailability. This study was performed to determine whether microorganism (MO-fermented ACNs influence vascular inflammation in vitro. Therefore, MO growth media were supplemented with an ACN-rich grape/berry extract and growth responses of Escherichia coli, E. faecalis and H. alvei, as well as ACN fermentation were observed. MO supernatants were used for measuring the anti-inflammatory effect of MO-fermented ACNs in an epithelial-endothelial co-culture transwell system. After basolateral enrichment (240 min, endothelial cells were stimulated immediately or after 20 h with TNF-α. Afterwards, leukocyte adhesion, expression of adhesion molecules and cytokine release were measured. Results indicate that E. coli, E. faecalis and H. alvei utilized ACNs differentially concomitant with different anti-inflammatory effects. Whereas E. coli utilized ACNs completely, no anti-inflammatory effects of fermented ACNs were observed on activated endothelial cells. In contrast, ACN metabolites generated by E. faecalis and H. alvei significantly attenuated low-grade stimulated leukocyte adhesion, the expression of adhesion molecules E-selectin, VCAM-1 and ICAM-1 and cytokine secretion (IL-8 and IL-6, as well as NF-κB mRNA expression with a more pronounced effect of E. faecalis than H. alvei. Thus, MO-fermented ACNs have the potential to reduce inflammation.

  6. Fractionated resection on low grade gliomas involving Broca's area and insights to brain plasticity

    Institute of Scientific and Technical Information of China (English)

    WU Chen-xing; PU Song; LIN Yi; WANG Yong-zhi; JIANG Tao; XIE Jian; WEI Miao; YI Xiao-li; WANG Xiao-yi


    Background Resent advances on functional mapping have enabled us to conduct surgery on gliomas within the eloquent area. The objective of the article is to discuss the feasibility of a planned fractionated strategy of resection on low-grade gliomas (LGGs) involving Broca's area. We report the first surgical series of planned fractionated resections on LGGs within Broca's area, focusing on language functional reshaping.Methods Four patients were treated with fractionated operations for LGGs involving Broca's area. All cases underwent conventional magnetic resonance (MR) scanning, language functional MR and diffusion tensor imaging (DTI) before operation. The resections were then performed on patients under awake anesthesia using intraoperative electrical stimulation (IES) for functional mapping. Pre- and post-operative neuro-psychological examinations were evaluated. Results Total resections were achieved in all cases as confirmed by the postoperative control MR. After transient language worsening, all patients recovered to normal3-6 months later.Language functional MR scannings have shown the operation.All patients retumed to a normal socioprofessional life.Conclusions By utilizing the dynamic interaction between brain plasticity and fractionated resections,we can totally remove the tumor involving Broca'S structure without inducing permanent postoperative deficits and even improve the qualityof life.

  7. Multiphoton imaging of low grade, high grade intraepithelial neoplasia and intramucosal invasive cancer of esophagus (United States)

    Xu, Jian; Jiang, Liwei; Kang, Deyong; Wu, Xuejing; Xu, Meifang; Zhuo, Shuangmu; Zhu, Xiaoqin; Lin, Jiangbo; Chen, Jianxin


    Esophageal squamous cell carcinoma (ESCC) is devastating because of its aggressive lymphatic spread and clinical course. It is believed to occur through low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and intramucosal invasive cancer (IMC) before transforming to submucosal cancer. In particular, these early lesions (LGIN, HGIN and IMC), which involve no lymph node nor distant metastasis, can be cured by endoscopic treatment. Therefore, early identification of these lesions is important so as to offer a curative endoscopic resection, thus slowing down the development of ESCC. In this work, spectral information and morphological features of the normal esophageal mucosa are first studied. Then, the morphological changes of LGIN, HGIN and IMC are described. Lastly, quantitative parameters are also extracted by calculating the nuclear-to-cytoplasmic ratio of epithelial cells and the pixel density of collagen in the lamina propria. These results show that multiphoton microscopy (MPM) has the ability to identify normal esophageal mucosa, LGIN, HGIN and IMC. With the development of multiphoton endoscope systems for in vivo imaging, combined with a laser ablation system, MPM has the potential to provide immediate pathologic diagnosis and curative treatment of ESCC before the transformation to submucosal cancer in the future.

  8. Nodular lymphoid hyperplasia: A marker of low-grade inflammation in irritable bowel syndrome? (United States)

    Piscaglia, Anna Chiara; Laterza, Lucrezia; Cesario, Valentina; Gerardi, Viviana; Landi, Rosario; Lopetuso, Loris Riccardo; Calò, Giovanni; Fabbretti, Giovanna; Brisigotti, Massimo; Stefanelli, Maria Loredana; Gasbarrini, Antonio


    AIM To evaluate the prevalence of nodular lymphoid hyperplasia (NLH) in adult patients undergoing colonoscopy and its association with known diseases. METHODS We selected all cases showing NLH at colonoscopy in a three-year timeframe, and stratified them into symptomatic patients with irritable bowel syndrome (IBS)-type symptoms or suspected inflammatory bowel disease (IBD), and asymptomatic individuals undergoing endoscopy for colorectal cancer screening. Data collection included medical history and final diagnosis. As controls, we considered all colonoscopies performed for the aforementioned indications during the same period. RESULTS One thousand and one hundred fifty colonoscopies were selected. NLH was rare in asymptomatic individuals (only 3%), while it was significantly more prevalent in symptomatic cases (32%). Among organic conditions associated with NLH, the most frequent was IBD, followed by infections and diverticular disease. Interestingly, 31% of IBS patients presented diffuse colonic NLH. NLH cases shared some distinctive clinical features among IBS patients: they were younger, more often female, and had a higher frequency of abdominal pain, bloating, diarrhoea, unspecific inflammation, self-reported lactose intolerance and metal contact dermatitis. CONCLUSION About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients. PMID:28028368

  9. Study of pyruvate kinase activity in human astrocytomas - Alanine-inhibition test revisted

    Directory of Open Access Journals (Sweden)

    Javalkar V


    Full Text Available Background: Recent studies have confirmed that alterations in the isoenzyme of pyruvate kinase (PK provide tumor cells with selective growth advantage. Aims: Our aim was to establish the mean activity of the enzyme PK in human astrocytomas and to look for any trends in the activity with relation to histological grade. Materials and Methods: The PK (EC activity was measured in the tumor homogenate by spectrophotometric rate determination. ΔAbsorbance at 340 nm (A 340nm per minute was obtained using the maximal linear rate for both the test and the blank. Enzyme activity was estimated in the presence and absence of amino acid alanine. Results: The mean PK level in astrocytomas was 3.5 ± 2.0 mmol/min/mg protein, which was significantly higher (24%; P < 0.001 when compared to 2.8 ± 0.3 mmol/min/mg protein in control brain. Highest PK activity was noted in grade 2 astrocytomas. In controls there was no change in PK activity in the presence of alanine. In grade 2 astrocytomas there was 7% decrease in mean PK activity in the presence of alanine, this difference in grade 3 astrocytomas was 33% and in grade 4 astrocytomas it was 61%. As the tumors were becoming malignant there was a graded increase in the levels of PK inhibition. Conclusions: Mean PK activity was significantly higher in astrocytomas. There was a graded increase in level of PK inhibition as the tumors were becoming more malignant.

  10. Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zimel, Melissa N. [Memorial Sloan Kettering Cancer Center, Orthopaedic Surgery Service, Department of Surgery, New York, NY (United States); Hwang, Sinchun [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Riedel, Elyn R. [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Healey, John H. [Memorial Sloan Kettering Cancer Center, Orthopaedic Surgery Service, Department of Surgery, New York, NY (United States); Weill Medical College of Cornell University, Department of Orthopaedic Surgery, New York, NY (United States)


    This study assessed whether radiolucent carbon fiber reinforced-polyetheretherketone (CFR-PEEK) intramedullary nails decreased hardware artifact on magnetic resonance imaging (MRI) and computed tomography (CT) in vitro and in an oncologic patient population. In vitro and clinical evaluations were done. A qualitative assessment of metal artifact was performed using CFR-PEEK and titanium nail MRI phantoms. Eight patients with a femoral or tibial prophylactic CFR-PEEK nail were retrospectively identified. All patients had postoperative surveillance imaging by MRI, CT, and were followed for a median 20 months (range, 12-28 months). CFR-PEEK images were compared to images from a comparative group of patients with titanium femoral intramedullary nails who had a postoperative MRI or CT. A musculoskeletal-trained radiologist graded visualization of the cortex, corticomedullary junction, and bone-muscle interface, on T1-weighted (T1W), STIR, and contrast-enhanced T1-weighted fat-saturated (T1W FS) sequences of both groups with a five-point scale, performing independent reviews 4 months apart. Statistical analysis used the Wilcoxon rank-sum test and a weighted kappa. Substantially less MRI signal loss occurred in the CFR-PEEK phantom than in the titanium phantom simulation, particularly as the angle increased with respect to direction of the static magnetic field. CFR-PEEK nails had less MRI artifact than titanium nails on scored T1W, STIR, and contrast-enhanced T1W FS MRI sequences (p ≤ 0.03). The mean weighted kappa was 0.64, showing excellent intraobserver reliability between readings. CFR-PEEK intramedullary nail fixation is a superior alternative to minimize implant artifact on MRI or CT imaging for patients requiring long bone fixation. (orig.)

  11. 运动区低级别胶质瘤的手术方法探讨%Surgical treatment of low-grade gliomas involving motor areas

    Institute of Scientific and Technical Information of China (English)

    毛明利; 谢坚; 韩武; 曹晓昱; 曾春; 王江飞; 王磊; 高之宪


    Objective To explore the possibility and strategy of maximally removal of low-grade gliomas which involved the motor areas on the premise of protecting the patient' motor function.Methods The neurosurgical plans and procedures of 30 patients with low-grade gliomas involving the motor areas in Beijing Tiantan Hospital from December 2011 to May 2013 were analyzed retrospectively.Preoperative head magnetic resonance imaging (MRI) was performed in all patients.A ω-shaped or inverted Ω-shaped hand-knob as a logo was used to confirm the precentral gyrus (primary motor area,M1).Intraoperative somatosensory evoked potential (SEP) was used to confirm the central sulcus,M1 and premotor area (PMA).MEP was used to monitor the function of motor pathway.The extent of tumor resection was evaluated by intraoperative B-mode ultrasound at the same time.Postoperative head MRI within 72 hours was used to evaluate the extent of tumor resection.The muscular power was determined instantly after waking up,2 weeks and 3 months following operation separately.Results The M1 was involved in 3 cases,the supplementary motor area (SMA) in 3,the PMA in 11,and the SMA and PMA were simultaneously involved in 13.Subtotal resection was achieved in 27 cases (90%) while partial resection in 3 (10%).The histological results of all patients revealed oligodendroglioma in 2 cases,astrocytoma in 9 and oligo-astrocytoma in 19.Preoperative muscle power was normal in 25 cases,4 of them had one hand less flexible and could not perform accurately,and 2 of them felt trample empty while walking,and 5 cases had grade Ⅳ muscle power.After the surgery,part of patients had transient muscle disorders.Three months after the surgery,muscle power was normal in 23 cases,9 of them had one hand less flexible and could not perform accurately,3 of them felt trample empty while walking.7 cases had grade Ⅲ-Ⅳ muscle power of upper or lower limbs.Conclusions Motor area is consisted of M1,PMA,SMA,corticonuclear tract


    Directory of Open Access Journals (Sweden)

    Srinivasa Rao


    Full Text Available NTRODUCTION: Tuberous sclerosis complex (TSC or Morbus Bourneville - Pringle disease is an autosomal dominant phakomatosis, first described by Desiree - Magloire Bourneville in 1880. Tuberous sclerosis is a genetic disorder characterized by the growth of numerous benign tumours in many parts of the body caused by mutations on either of two genes, TSC1 and TSC2. This rare genetic disorder is usually associated with a triad of seizures, mental retardation and cutaneous lesions. Approximately one half of all patients affected by TS develop at least one retinal astrocytoma in one eye. PRESENTATION OF CASES: In the department of ophthalmology, G.S.L M edical C ollege, Rajahmundry, we came across 3 cases of tuberous sclerosis involving multi organ systems. Out of 3 cases, 2 cases were reported to be familial and 1case is sporadic, with a history of epilepsy with angiofibromatosis lesions over the face, multiple ash - leaf lesions over the abdomen, renal angiomyolipomas, multiple subependymal nodules in brain and retinal astrocytic hamartomas in the retina. CONCLUSION: It is important to be cognizant of the likely presence of systemic and ocular pathology in a child with mental retardation and skin lesions. Identification of retinal phakomatosis during ocular evaluation in any suspected case of Tuberous sclerosis can aid in the establishment of the diagnosis of the disease

  13. Anaplastic astrocytoma 14 years after radiotherapy for pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Masaru; Misumi, Syuuzou; Kurosaki, Syuuhei; Shibasaki, Takashi; Ohye, Chihiro (Gunma Univ., Maebashi (Japan). School of Medicine)


    A case of anaplastic astrocytoma following radiotherapy for growth hormone secreting pituitary adenoma is presented with a review of the literature. A 43 year old female was admitted with signs of acromegaly and hypertension. An eosinophilic pituitary adenoma was subtotally removed by transsphenoidal approach, followed by 60 Gy irradiation using a 2x2 cm lateral field. Fourteen years later at the age of 57, she suffered from headache, recent-memory disturbance and uncinate fits. CT scan and MRI disclosed ring-like enhanced mass lesion in the left temporal lobe, corresponding to the previous irradiated field. {sup 18}F-FDG PET showed hypermetabolism at the lesion. Left frontotemporal craniotomy was performed, and a reddish gray gelatinous tumor containing necrotic center and cyst was partially removed. Histologically, the tumor consisted of hypercellular astrocytic cells with perivascular pseudorosette. Coagulation necrosis at the center of the tumor, and hyalinosis and fibrosis of the blood vessels in and around the tumor, which might have been caused by the antecedent radiotherapy, were recognized. Postoperative radiotherapy and chemotherapy, were given, however, she expired 13 months after the operation. Seven cases, including ours, of malignant glioma following radiotherapy for pituitary adenoma were reported in the literature. A total dose of irradiation varies from 45 to 95 Gy with a mean of 50 Gy. The period of latency before tumor occurrence ranges from 5 to 22 years with a mean of 10 years. The differentiation of radiation-induced gliomas from radionecrosis of the brain is also discussed. (author).

  14. Intramedullary spinal neurocysticercosis treated successfully with medical therapy. (United States)

    Ahmed, Shameem; Paul, Siba Prosad


    Neurocysticercosis caused by Taenia solium and is a common parasitic disease of the cental nervous system. It usually presents with seizures, headaches, progressively worsening focal neurologic symptoms, visual disturbances, loss of bladder control, etc. However, acute onset symptoms may also be seen. MRI scans can accurately diagnose spinal or cerebral lesions and is also helpful in monitoring progress while on treatment. Albendazole is currently the drug of choice along with steroids for medical management of neurocysticercosis. The case of intramedullary spinal neurocysticercosis was treated with praziquantel.

  15. Disseminated coccidioidomycosis presenting with intramedullary spinal cord abscesses: Management challenges

    Directory of Open Access Journals (Sweden)

    Kristina L. Bajema


    Full Text Available Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. We report a case of disseminated coccidioidomycosis in an otherwise healthy 20 year old man with diffuse leptomeningeal enhancement, cerebrospinal fluid findings suggestive of meningitis, and intramedullary spinal cord abscesses. Response to treatment occurred with prolonged systemic liposomal amphotericin B and voriconazole. An extended course of steroids was needed to blunt inflammation.

  16. Subtrochanteric fractures: treatment with cerclage wire and long intramedullary nail. (United States)

    Tomás, Jordi; Teixidor, Jordi; Batalla, Lledó; Pacha, Daniel; Cortina, Josep


    Fracture malalignment and nonunion are not infrequent after treating subtrochanteric fractures with intramedullary nails. The use of a cerclage wire with a minimally invasive approach to aid and maintain reduction in certain subtrochanteric fracture patterns can be an effective surgical strategy to improve outcome. It allows the surgeon to obtain and maintain an anatomic reduction with more bone contact, which will aid in fracture consolidation. This has the added advantage of optimizing the greater trochanteric starting point. It minimizes malreductions of the proximal femoral fragment, and, we believe, that its rational use with a minimally invasive technique is a key factor in achieving good results.


    Cardona, Andres; Jimenez, Enrique; Hakim, Fernando; Useche, Nicolas; Bermudez, Sonia; Arrieta, Oscar; Behaine, Jose; Rodriguez, July; Carranza, Hernan; Otero, Jorge; Vargas, Carlos; Rojas, Leornardo; Ortiz, Leon Dario


    BACKGROUND: LGG are classified as being astrocytoma (DA), oligodendroglioma (OD) or mixed glioma (OA). TP53-m and 1p19q codeletion have been the main molecular abnormalities recorded to date. IDH1/2 mutations have been described in up to 85% of LGG. It has recently been found that ATRX plays a significant role in glioma oncogenesis. METHODS: We searched for P53 and Olig2 protein expression, MGMT methylation status (pMGMT), 1p19q codeletion and IDH/ATRX status in 63 Colombian LGG patients (pts). Overall survival (OS) rate was estimated and compared between groups and according to genotype. RESULTS: Mean age was 40.1-yo (±12.3), 50% of the pts were male, mean lesion diameter was 41.7 mm (±17.2 mm) and histological distribution was 61.9%, 25.4% and 12.7% for AD, OD and OA, respectively. Surgical resection was total in 47.6%, subtotal in 31.7% and biopsy was performed in 20.6% of the cases. Alterations in IDH1/2 were found in 57.1%, pMGMT+ in 65.1%, overexpression of p53 and Olig2 in 30.2% and 44.4%, and 1p19q codeletion in 34.9%. The presence of alterations in ATRX was analysed in 25 patients, being positive in 16% (all IDH1 + /1p19q-). Median follow-up was 15.8 months (95%CI 7.6-42.0), OS was 39.2 months (95%CI 1.3-114) and the variables positively modifying OS were pMGMT+ (p = 0.004), 1p19q codeletion (p = 0.015), the extension of surgical intervention (p = 0.011) and the number of lobes involved (p = 0.021). Multivariate analysis showed that pMGMT and 1p19q codeletion modified the OS in our population (p = 0.039 and 0.047, respectively). CONCLUSIONS: This is the first study which has evaluated the molecular profile in LGG pts from Latin-America. Our findings confirmed the prognostic relevance of pMGMT and 1p19q codeletion, without finding a positive relation for IDH1/2 mutations. This finding could have been explained by sample size and selection bias. Alterations in ATRX are limited to the population of pts having AD/OA and IDH1 + /1p19q-.

  18. The macrophage low-grade inflammation marker sCD163 is modulated by exogenous sex steroids

    DEFF Research Database (Denmark)

    Thomsen, Henrik Holm; Møller, Holger Jon; Trolle, Christian


    Soluble CD163 (sCD163) is a novel marker linked to states of low grade inflammation such as diabetes, obesity, liver disease and atherosclerosis, all prevalent in subjects with Turner and Klinefelter Syndromes. We aimed to assess the levels of sCD163 and the regulation of sCD163 in regards...

  19. Polyphenol intake is associated with low-grade inflammation, using a novel data analysis from the Moli-sani study. (United States)

    Pounis, George; Bonaccio, Marialaura; Di Castelnuovo, Augusto; Costanzo, Simona; de Curtis, Amalia; Persichillo, Mariarosaria; Sieri, Sabina; Donati, Maria Benedetta; Cerletti, Chiara; de Gaetano, Giovanni; Iacoviello, Licia


    The association of polyphenol content of human diet with low-grade inflammation is not yet fully understood. It was the objective of this study to evaluate the association of flavonoid and lignan intake with frequently used and easily applicable in clinical practice low-grade inflammation biomarkers, in a novel holistic approach. A total of 5,948 women and 5,965 men (aged ≥ 35 years) were analysed from the Moli-sani cohort, randomly recruited from the general population. The EPIC-FFQ was used for dietary assessment. Flavonol, flavone, flavanone, flavanol, anthocyanin, isoflavone and lignan intakes were calculated using Eurofir eBASIS and the polyphenol antioxidant content (PAC)-score was constructed to assess the total content of diet in these nutrients. CRP levels, WBC and PLT count and granulocyte to lymphocyte ratio were conceived as low-grade inflammation biomarkers. INFLA-score was constructed summarizing synergistic effects of these biomarkers. The INFLA-score was negatively associated with PAC-score in different levels of adjustment, in both genders (for all β-coefinflammation status (i.e. higher quartile of INFLA-score) in men and women (odds ratio [ORs] 0.92 to 0.95, pinflammation biomarkers in a large population based study. For the first time low-grade inflammation was evaluated in a holistic way through INFLA-score and was associated with polyphenol content of diet.

  20. The role of low-grade inflammation and metabolic flexibility in aging and nutritional modulation thereof: A systems biology approach

    NARCIS (Netherlands)

    Calçada, D.; Vianello, D.; Giampieri, E.; Sala, C.; Castellani, G.; Graaf, A.A. de; Kremer, S.H.A.; Ommen, B. van; Feskens, E.; Santoro, A.; Franceschi, C.; Bouwman, J.


    Aging is a biological process characterized by the progressive functional decline of many interrelated physiological systems. In particular, aging is associated with the development of a systemic state of low-grade chronic inflammation (inflammaging), and with progressive deterioration of metabolic

  1. The role of low-grade inflammation and metabolic flexibility in aging and nutritional modulation thereof: a systems biology approach

    NARCIS (Netherlands)

    Viegas Calcada, D.I.; Vianello, D.; Giampieri, E.; Sala, C.; Castellani, G.; Graaf, de A.; Kremer, B.; Ommen, van B.; Feskens, E.J.M.; Santoro, A.; Franceschi, C.; Bouwman, J.


    Aging is a biological process characterized by the progressive functional decline of many interrelated physiological systems. In particular, aging is associated with the development of a systemic state of low-grade chronic inflammation (inflammaging), and with progressive deterioration of metabolic

  2. Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage (United States)

    Lin, Pei-Yi; Hagan, Katherine; Fenoglio, Angela; Grant, P. Ellen; Franceschini, Maria Angela


    Low-grade germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common complication in extremely premature neonates. The occurrence of GM-IVH is highly associated with hemodynamic instability in the premature brain, yet the long-term impact of low-grade GM-IVH on cerebral blood flow and neuronal health have not been fully investigated. We used an innovative combination of frequency-domain near infrared spectroscopy and diffuse correlation spectroscopy (FDNIRS-DCS) to measure cerebral oxygen saturation (SO2) and an index of cerebral blood flow (CBFi) at the infant’s bedside and compute an index of cerebral oxygen metabolism (CMRO2i). We enrolled twenty extremely low gestational age (ELGA) neonates (seven with low-grade GM-IVH) and monitored them weekly until they reached full-term equivalent age. During their hospital stay, we observed consistently lower CBFi and CMRO2i in ELGA neonates with low-grade GM-IVH compared to neonates without hemorrhages. Furthermore, lower CBFi and CMRO2i in the former group persists even after the resolution of the hemorrhage. In contrast, SO2 does not differ between groups. Thus, CBFi and CMRO2i may have better sensitivity than SO2 in detecting GM-IVH-related effects on infant brain development. FDNIRS-DCS methods may have clinical benefit for monitoring the evolution of GM-IVH, evaluating treatment response, and potentially predicting neurodevelopmental outcome.

  3. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma : long-term follow-up

    NARCIS (Netherlands)

    Douw, Linda; Klein, Martin; Fagel, Selene S. A. A.; van den Heuvel, Josje; Taphoorn, Martin J. B.; Aaronson, Neil K.; Postma, Tjeerd J.; Vandertop, W. Peter; Mooij, Jacob J.; Boerman, Rudolf H.; Beute, Guus N.; Sluimer, Jasper D.; Slotman, Ben J.; Reijneveld, Jaap C.; Heimans, Jan J.


    Background Our previous study on cognitive functioning among 195 patients with low-grade glioma (LGG) a mean of 6 years after diagnosis suggested that the tumour itself, rather than the radiotherapy used to treat it, has the most deleterious effect on cognitive functioning; only high fraction dose r

  4. Successful treatment of low-grade oligodendroglial tumors with a chemotherapy regimen of procarbazine, lomustine, and vincristine

    NARCIS (Netherlands)

    Stege, Elize M Biemond-ter; Kros, Johan M; de Bruin, Hein G; Enting, R H; van Heuvel, Irene; Looijenga, Leendert H J; van der Rijt, Carin D D; Smitt, Peter A E Sillevis; van den Bent, Martin J


    BACKGROUND: Anaplastic oligodendroglioma (OD) tumors, especially those with the combined loss of the short arm of chromosome 1 (1p) and the long arm of chromosome 19 (19q), are sensitive to chemotherapy. Only limited data are available on the role of chemotherapy in low-grade OD. The authors retrosp

  5. Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome (IBS: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Max Schmulson


    Conclusions: Further studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non PI-IBS. Rifaximin has shown itself to be an effective treatment for IBS, regardless of prior factors.

  6. Low-grade intraventricular hemorrhage disrupts cerebellar white matter in preterm infants: evidence from diffusion tensor imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morita, Takashi; Morimoto, Masafumi; Hasegawa, Tatsuji; Morioka, Shigemi; Kidowaki, Satoshi; Moroto, Masaharu; Yamashita, Satoshi; Maeda, Hiroshi; Chiyonobu, Tomohiro; Tokuda, Sachiko; Hosoi, Hajime [Kyoto Prefectural University of Medicine, Department of Pediatrics, Graduate School of Medical Science, Kyoto (Japan); Yamada, Kei [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)


    Recent diffusion tensor imaging (DTI) studies have demonstrated that leakage of hemosiderin into cerebrospinal fluid (CSF), which is caused by high-grade intraventricular hemorrhage (IVH), can affect cerebellar development in preterm born infants. However, a direct effect of low-grade IVH on cerebellar development is unknown. Thus, we evaluated the cerebellar and cerebral white matter (WM) of preterm infants with low-grade IVH. Using DTI tractography performed at term-equivalent age, we analyzed 42 infants who were born less than 30 weeks gestational age (GA) at birth (22 with low-grade IVH, 20 without). These infants were divided into two birth groups depending on GA, and we then compared the presence and absence of IVH which was diagnosed by cerebral ultrasound (CUS) within 10 days after birth or conventional magnetic resonance imaging (MRI) at term-equivalent age in each group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) at the superior cerebellar peduncle (SCP), middle cerebellar peduncle (MCP), motor tract, and sensory tract were measured. In the SCP, preterm born infants with IVH had lower FA values compared with infants without IVH. In particular, younger preterm birth with IVH had lower FA values in the SCP and motor tract and higher ADC values in the MCP. Low-grade IVH impaired cerebellar and cerebral WM, especially in the SCP. Moreover, younger preterm infants exhibited greater disruptions to cerebellar WM and the motor tract than infants of older preterm birth. (orig.)

  7. Research on Experimental and Application for the High Efficient Enrichment of the Low-grade Precious Metal Materials

    Institute of Scientific and Technical Information of China (English)

    FAN Xingxiang; FU Guangqiang; DONG Haigang; WU Yuedong; LIU Yang; ZHAO Jiachun; WU Xiaofeng; LI Bojie; TONG Weifeng


    On the basis of reviewing the progress in the high efficient enrichment from secondary resources of low-grade precious metals at home and abroad,a process route of the high efficient enrichment precious metals from secondary resources of low-grade metals by adding iron oxide as the trapping agent,reducing agent,additive,mixing uniformly and grinding,pelletizing,reduction,grinding and separation,and selectively acid leaching iron has been put forward in this paper.The experiments of reduction,grinding and separation,and selectively acid leaching iron were carried out mainly.Under the decided experiment parameters and conditions,iron generated during the reduction can trap precious metals during reduction,high active alloy powders were obtained from the reduced products by grinding and separation,the concentration of precious metals was obtained by acid leaching high active alloy powders.The better enrichment effect was obtained by adopting the technical route of processing.Other low grade noble metal materials and enrichment ratio of precious metals from the materials to acid products was high through acid leaching.This process has the advantages of simple process,environmental-friendly,strong adaptability of raw materials,high concentration ratio,which was regarded as a kind of the general efficient enrichment technology of low grade precious metal materials.

  8. Effects of low-grade weirs on soil microbial communities to advance agricultural best management practices for nitrate remediation (United States)

    Agricultural activities throughout the Mississippi River Basin have been identified as a major source of nutrient pollution, particularly nitrogen from fertilizer application, to downstream waters including the Gulf of Mexico. Utilizing best management practices, such as low-grade weirs have been id...

  9. Central low-grade osteosarcoma with an unusual localization in the diaphysis of a 12-year old patient. (United States)

    Gilg, Magdalena Maria; Liegl, Bernadette; Wibmer, Christine; Maurer-Ertl, Werner; Leithner, Andreas


    Low-grade central osteosarcoma is a very rare subtype of osteosarcoma with a predilection for the metaphysis of long bones and a peak incidence in the 3(rd) decade of life. Absence of specific clinical symptoms and a good prognosis after wide resection are the characteristics of this entity. Chemotherapy is not indicated in this highly differentiated tumour. A 12-year old girl presented with limping, swelling and pain in the mid of the left femur. Radiography showed a 12 cm long intraosseous expansion with lamellated periosteal reaction and contrast medium enhancement in MRI. Although radiology led to the differential diagnoses of Ewing's sarcoma, osteomyelitis and fibrous dysplasia, the histological specimen showed a hyopocellular spindle-cell proliferation arranged in fascicles with mild cytologic atypia and only single mitotic figures. In synopsis with radiology the diagnosis of low-grade central osteosarcoma was made and confirmed by reference pathology. The tumour was resected with wide margins and reconstruction was performed with a vascularized fibula, a homologous allograft and a plate. Staging was negative for recurrence and metastasis at a follow-up of 16 months. Low-grade osteosarcoma accounts for only 1% of all osteosarcomas with a peak incidence in the 3(rd) decade. The diaphyseal localization and the young age make this case special. To achieve the correct diagnosis of this rare low-grade entity and thereby the adequate treatment, despite a wide range of differential diagnoses, a multidisciplinary approach is essential.

  10. Triple-negative breast cancer: the importance of molecular and histologic subtyping, and recognition of low-grade variants. (United States)

    Pareja, Fresia; Geyer, Felipe C; Marchiò, Caterina; Burke, Kathleen A; Weigelt, Britta; Reis-Filho, Jorge S


    Triple-negative breast cancers (TNBCs), defined by lack of expression of estrogen receptor, progesterone receptor and HER2, account for 12-17% of breast cancers and are clinically perceived as a discrete breast cancer subgroup. Nonetheless, TNBC has been shown to constitute a vastly heterogeneous disease encompassing a wide spectrum of entities with marked genetic, transcriptional, histological and clinical differences. Although most TNBCs are high-grade tumors, there are well-characterized low-grade TNBCs that have an indolent clinical course, whose natural history, molecular features and optimal therapy vastly differ from those of high-grade TNBCs. Secretory and adenoid cystic carcinomas are two histologic types of TNBCs underpinned by specific fusion genes; these tumors have an indolent clinical behavior and lack all of the cardinal molecular features of high-grade triple-negative disease. Recent studies of rare entities, including lesions once believed to constitute mere benign breast disease (e.g., microglandular adenosis), have resulted in the identification of potential precursors of TNBC and suggested the existence of a family of low-grade triple-negative lesions that, despite having low-grade morphology and indolent clinical behavior, have been shown to harbor the complex genomic landscape of common forms of TNBC, and may progress to high-grade disease. In this review, we describe the heterogeneity of TNBC and focus on the histologic and molecular features of low-grade forms of TNBC. Germane to addressing the challenges posed by the so-called triple-negative disease is the realization that TNBC is merely a descriptive term, and that low-grade types of TNBC may be driven by distinct sets of genetic alterations.

  11. [Low-grade systemic inflammation and the development of metabolic diseases: from the molecular evidence to the clinical practice]. (United States)

    León-Pedroza, José Israel; González-Tapia, Luis Alonso; del Olmo-Gil, Esteban; Castellanos-Rodríguez, Diana; Escobedo, Galileo; González-Chávez, Antonio


    Systemic inflammation is characterised by high circulating levels of inflammatory cytokines and increased macrophage infiltration in peripheral tissues. Most importantly, this inflammatory state does not involve damage or loss of function of the infiltrated tissue, which is a distinctive feature of the low-grade systemic inflammation. The term "meta-inflammation" has also been used to refer to the low-grade systemic inflammation due to its strong relationship with the development of cardio-metabolic diseases in obesity. A review is presented on the recent clinical and experimental evidence concerning the role of adipose tissue inflammation as a key mediator of low-grade systemic inflammation. Furthermore, the main molecular mechanisms involved in the inflammatory polarization of macrophages with the ability to infiltrate both the adipose tissue and the vascular endothelium via activation of toll-like receptors by metabolic damage-associated molecular patterns, such as advanced glycation-end products and oxidized lipoproteins, is discussed. Finally, a review is made of the pathogenic mechanisms through which the low-grade systemic inflammation contributes to develop insulin resistance, dyslipidaemia, atherogenesis, type 2 diabetes, and hypertension in obese individuals. A better understanding of the molecular mechanisms of low-grade systemic inflammation in promoting cardio-metabolic diseases is necessary, in order to further design novel anti-inflammatory therapies that take into consideration clinical data, as well as the circulating levels of cytokines, immune cells, and metabolic damage-associated molecular patterns in each patient. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  12. Silencing GFAP isoforms in astrocytoma cells disturbs laminin-dependent motility and cell adhesion. (United States)

    Moeton, Martina; Kanski, Regina; Stassen, Oscar M J A; Sluijs, Jacqueline A; Geerts, Dirk; van Tijn, Paula; Wiche, Gerhard; van Strien, Miriam E; Hol, Elly M


    Glial fibrillary acidic protein (GFAP) is an intermediate filament protein expressed in astrocytes and neural stem cells. The GFAP gene is alternatively spliced, and expression of GFAP is highly regulated during development, on brain damage, and in neurodegenerative diseases. GFAPα is the canonical splice variant and is expressed in all GFAP-positive cells. In the human brain, the alternatively spliced transcript GFAPδ marks specialized astrocyte populations, such as subpial astrocytes and the neurogenic astrocytes in the human subventricular zone. We here show that shifting the GFAP isoform ratio in favor of GFAPδ in astrocytoma cells, by selectively silencing the canonical isoform GFAPα with short hairpin RNAs, induced a change in integrins, a decrease in plectin, and an increase in expression of the extracellular matrix component laminin. Together, this did not affect cell proliferation but resulted in a significantly decreased motility of astrocytoma cells. In contrast, a down-regulation of all GFAP isoforms led to less cell spreading, increased integrin expression, and a >100-fold difference in the adhesion of astrocytoma cells to laminin. In summary, isoform-specific silencing of GFAP revealed distinct roles of a specialized GFAP network in regulating the interaction of astrocytoma cells with the extracellular matrix through laminin.-Moeton, M., Kanski, R., Stassen, O. M. J. A., Sluijs, J. A., Geerts, D., van Tijn, P., Wiche, G., van Strien, M. E., Hol, E. M. Silencing GFAP isoforms in astrocytoma cells disturbs laminin dependent motility and cell adhesion.

  13. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M;


    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  14. Longitudinal Investigation of Adaptive Functioning Following Conformal Irradiation for Pediatric Craniopharyngioma and Low-Grade Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Netson, Kelli L. [Department of Psychiatry and Behavioral Sciences, Kansas University School of Medicine—Wichita, Kansas (United States); Conklin, Heather M. [Department of Psychology, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Wu, Shengjie; Xiong, Xiaoping [Department of Biostatistics, St Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: [Division of Radiation Oncology, St Jude Children' s Research Hospital, Memphis, Tennessee (United States)


    Purpose: Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. Methods and Materials: Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. Results: Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (P<.05) longitudinal decline in VABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (P<.05) at baseline on VABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (P<.05) longitudinal decline limited to VABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. Conclusions: There was relative sparing of postirradiation functional outcomes over time in this sample

  15. The relation of saturated fatty acids with low-grade inflammation and cardiovascular disease. (United States)

    Ruiz-Núñez, Begoña; Dijck-Brouwer, D A Janneke; Muskiet, Frits A J


    The mantra that dietary (saturated) fat must be minimized to reduce cardiovascular disease (CVD) risk has dominated nutritional guidelines for decades. Parallel to decreasing intakes of fat and saturated fatty acids (SFA), there have been increases in carbohydrate and sugar intakes, overweight, obesity and type 2 diabetes mellitus. The "lipid hypothesis" coined the concept that fat, especially SFA, raises blood low-density lipoprotein-cholesterol and thereby CVD risk. In view of current controversies regarding their adequate intakes and effects, this review aims to summarize research regarding this heterogenic group of fatty acids and the mechanisms relating them to (chronic) systemic low-grade inflammation, insulin resistance, metabolic syndrome and notably CVD. The intimate relationship between inflammation and metabolism, including glucose, fat and cholesterol metabolism, revealed that the dyslipidemia in Western societies, notably increased triglycerides, "small dense" low-density lipoprotein and "dysfunctional" high-density lipoprotein, is influenced by many unfavorable lifestyle factors. Dietary SFA is only one of these, not necessarily the most important, in healthy, insulin-sensitive people. The environment provides us not only with many other proinflammatory stimuli than SFA but also with many antiinflammatory counterparts. Resolution of the conflict between our self-designed environment and ancient genome may rather rely on returning to the proinflammatory/antiinflammatory balance of the Paleolithic era in consonance with the 21st century culture. Accordingly, dietary guidelines might reconsider recommendations for SFA replacement and investigate diet in a broader context, together with nondietary lifestyle factors. This should be a clear priority, opposed to the reductionist approach of studying the effects of single nutrients, such as SFA. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Solidification/stabilisation of electric arc furnace waste using low grade MgO. (United States)

    Cubukcuoglu, B; Ouki, S K


    This study aims to evaluate the potential of low grade MgO (LGMgO) for the stabilisation/solidification (S/S) of heavy metals in steel electric arc furnace wastes. Relevant characteristics such as setting time, unconfined compressive strength (UCS) and leaching behaviour assessed by acid neutralisation capacity (ANC), monolithic and granular leaching tests were examined in light of the UK landfill Waste Acceptance Criteria (WAC) for disposal. The results demonstrated that all studied mix designs with Portland cement type 1 (CEM1) and LGMgO, CEM1-LGMgO 1:2 and 1:4 at 40% and 70% waste addition met the WAC requirements by means of UCS, initial and final setting times and consistence. Most of the ANC results met the WAC limits where the threshold pH values without acid additions were stable and between 11.9 and 12.2 at 28d. Granular leaching results indicate fixation of most of the metals at all mix ratios. An optimum ratio was obtained at CEM1-LGMgO 1:4 at 40% waste additions where none of the metals leaching exceeded the WAC limits and hence may be considered for landfill disposal. The monolithic leaching test results showed that LGMgO performed satisfactorily with respect to S/S of Zn, as the metal component present at the highest concentration level in the waste exhibited very little leaching and passed the leaching test requirement at all mix ratios studied. However, its performance with respect to Pb, Cd and Cr was less effective in reducing their leaching suggesting a higher cumulative rate under those leaching regimes.

  17. Quality of life in low-grade glioma patients receiving temozolomide (United States)

    Liu, Raymond; Solheim, Karla; Polley, Mei-Yin; Lamborn, Kathleen R.; Page, Margaretta; Fedoroff, Anne; Rabbitt, Jane; Butowski, Nicholas; Prados, Michael; Chang, Susan M.


    The purpose of this study was to describe the quality of life (QOL) of low-grade glioma (LGG) patients at baseline prior to chemotherapy and through 12 cycles of temozolomide (TMZ) chemotherapy. Patients with histologically confirmed LGG with only prior surgery were given TMZ for 12 cycles. QOL assessments by the Functional Assessment of Cancer Therapy–Brain (FACT-Br) were obtained at baseline prior to chemotherapy and at 2-month intervals while receiving TMZ. Patients with LGG at baseline prior to chemotherapy had higher reported social well-being scores (mean difference = 5.0; p < 0.01) but had lower reported emotional well-being scores (mean difference = 2.2; p < 0.01) compared to a normal population. Compared to patients with left hemisphere tumors, patients with right hemisphere tumors reported higher physical well-being scores (p = 0.01): 44% could not drive, 26% did not feel independent, and 26% were afraid of having a seizure. Difficulty with work was noted in 24%. Mean change scores at each chemotherapy cycle compared to baseline for all QOL subscales showed either no significant change or were significantly positive (p < 0.01). Patients with LGG on TMZ at baseline prior to chemotherapy reported QOL comparable to a normal population with the exception of social and emotional well-being, and those with right hemisphere tumors reported higher physical well-being scores compared to those with left hemisphere tumors. While remaining on therapy, LGG patients were able to maintain their QOL in all realms. LGG patients’ QOL may be further improved by addressing their emotional well-being and their loss of independence in terms of driving or working. PMID:18713953

  18. Phase II TPDCV protocol for pediatric low-grade hypothalamic/chiasmatic gliomas: 15-year update (United States)

    Mishra, Kavita K.; Squire, Sarah; Lamborn, Kathleen; Banerjee, Anuradha; Gupta, Nalin; Wara, William M.; Prados, Michael D.; Berger, Mitchel S.


    To report long-term results for children with low-grade hypothalamic/chiasmatic gliomas treated on a phase II chemotherapy protocol. Between 1984 and 1992, 33 children with hypothalamic/chiasmatic LGGs received TPDCV chemotherapy on a phase II prospective trial. Median age was 3.0 years (range 0.3–16.2). Twelve patients (36%) underwent STRs, 14 (42%) biopsy only, and seven (21%) no surgery. Twenty patients (61%) had pathologic JPAs, nine (27%) grade II gliomas, and four (12%) no surgical sampling. Median f/u for surviving patients was 15.2 years (range 5.3–20.7); 20 of the 23 surviving patients had 14 or more years of follow-up. Fifteen-year PFS and OS were 23.4 and 71.2%, respectively. Twenty-five patients progressed, of whom 13 are NED, two are AWD, and 10 have died. All children who died were diagnosed and first treated at age three or younger. Age at diagnosis was significantly associated with relapse and survival (P = 0.004 for PFS and P = 0.037 for OS). No PFS or OS benefit was seen with STR versus biopsy/no sampling (P = 0.58 for PFS, P = 0.59 for OS). For patients with JPAs and WHO grade II tumors, the 15-year PFS was 18.8 and 22.2% (P = 0.95) and 15-year OS was 73.7 and 55.6% (P = 0.17), respectively. Upfront TPDCV for children with hypothalamic/chiasmatic LGGs resulted in 15-year OS of 71.2% and 15-year PFS of 23.4%. No survival benefit is demonstrated for greater extent of resection. Age is a significant prognostic factor for progression and survival. PMID:20221671

  19. Evidence for low-grade metamorphism, hydrothermal alteration, and diagenesis on mars from phyllosilicate mineral assemblages (United States)

    Ehlmann, B.L.; Mustard, J.F.; Clark, R.N.; Swayze, G.A.; Murchie, S.L.


    The enhanced spatial and spectral resolution provided by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) on the Mars Reconnaissance Orbiter (MRO) has led to the discovery of numerous hydrated silicate minerals on Mars, particularly in the ancient, cratered crust comprising the southern highlands. Phases recently identified using visible/near-infrared spectra include: smectite, chlorite, prehnite, high-charge phyllosilicates (illite or muscovite), the zeolite analcime, opaline silica, and serpentine. Some mineral assemblages represent the products of aqueous alteration at elevated temperatures. Geologic occurrences of these mineral assemblages are described using examples from west of the Isidis basin near the Nili Fossae and with reference to differences in implied temperature, fluid composition, and starting materials during alteration. The alteration minerals are not distributed homogeneously. Rather, certain craters host distinctive alteration assemblages: (1) prehnite-chlorite-silica, (2) analcime-silica-Fe,Mg-smectite-chlorite, (3) chlorite-illite (muscovite), and (4) serpentine, which furthermore has been found in bedrock units. These assemblages contrast with the prevalence of solely Fe,Mg-smectites in most phyllosilicate-bearing terrains on Mars, and they represent materials altered at depth then exposed by cratering. Of the minerals found to date, prehnite provides the clearest evidence for subsurface, hydrothermal/metamorphic alteration, as it forms only under highly restricted conditions (T = 200 400??C). Multiple mechanisms exist for forming the other individual minerals; however, the most likely formation mechanisms for the characteristic mineralogic assemblages observed are, for (1) and (2), low- grade metamorphism or hydrothermal (400??C has not been found.

  20. Value added products with popular low grade rice varieties of Andhra Pradesh. (United States)

    Anitha, G; Rajyalakshmi, P


    Eight Popular Low Grade Rice Varieties (PLRVs) MTU 3626, MTU 1001, MTU 1010, MTU 4870 and NLR 145, NLR 34242, NLR 30491, NLR 34449, (developed and released by ANGR agricultural University, Andhra Pradesh) having poor cooking quality were selected for the study. ANGRAU variety BPT 5204 popularly consumed as staple rice was used as check. Eight products of traditional/commercial importance were standardized incorporating PLRVs as a major ingredient in the form of rice flour (burfi, noodles and extruded snack product and vennaundalu (butter coated balls), palathalikalu (dough rolled into strips, steamed/cooked in milk); rice semolina (instant kheer mix and instant upma mix), and flaked rice (nutritious bar). The products were evaluated for nutritional, cooking quality characteristics, consumer acceptability and shelf-life. Consumer acceptability of the PLR products was carried out with 60 farm women based on 9 point hedonic scale. Shelf-life of the products (packed in both metalized PP and PE pouches) was evaluated monthly for chemical, microbiological and sensory parameters. Energy values of control and PLR products showed no significant difference. Upon cooking, PLR Noodles showed no significant difference with water absorption and volume but more (p control. The percent total solids and suspended solids were more (though not significant) in PLR kheer and palathalikalu. Extruded product (control and PLR) showed no significant difference with length, diameter, weight and volume expansion ratio and water absorption index (WAI). Consumer acceptability was high for PLR products palathalikalu (95%), instant kheer mix (92%) and extruded product (88%). As per sensory scores, all the PLR products were well accepted with no observable changes in flavor or taste upon storage. PLR products showed increased (P control and PLR) showed no microbial growth during the entire storage period. Considering the poor marketability of PLRVs for consumption as staple rice, the study

  1. The Immune Protective Effect of the Mediterranean Diet against Chronic Low-grade Inflammatory Diseases (United States)

    Casas, Rosa; Sacanella, Emilio; Estruch, Ramon


    Dietary patterns high in refined starches, sugar, and saturated and trans-fatty acids, poor in natural antioxidants and fiber from fruits, vegetables, and whole grains, and poor in omega-3 fatty acids may cause an activation of the innate immune system, most likely by excessive production of proinflammatory cytokines associated with a reduced production of anti-inflammatory cytokines. The Mediterranean Diet (MedDiet) is a nutritional model inspired by the traditional dietary pattern of some of the countries of the Mediterranean basin. This dietary pattern is characterized by the abundant consumption of olive oil, high consumption of plant foods (fruits, vegetables, pulses, cereals, nuts and seeds); frequent and moderate intake of wine (mainly with meals); moderate consumption of fish, seafood, yogurt, cheese, poultry and eggs; and low consumption of red meat, processed meat products and seeds. Several epidemiological studies have evaluated the effects of a Mediterranean pattern as protective against several diseases associated with chronic low-grade inflammation such as cancer, diabetes, obesity, atherosclerosis, metabolic syndrome and cognition disorders. The adoption of this dietary pattern could counter the effects of several inflammatory markers, decreasing, for example, the secretion of circulating and cellular biomarkers involved in the atherosclerotic process. Thus, the aim of this review was to consider the current evidence about the effectiveness of the MedDiet in these chronic inflammatory diseases due to its antioxidant and anti-inflammatory properties, which may not only act on classical risk factors but also on inflammatory biomarkers such as adhesion molecules, cytokines or molecules related to the stability of atheromatic plaque. PMID:25244229

  2. Cost-Effectiveness of Radiation and Chemotherapy for High-Risk Low-Grade Glioma. (United States)

    Qian, Yushen; Maruyama, Satoshi; Kim, Haju; Pollom, Erqi L; Kumar, Kiran A; Chin, Alexander L; Harris, Jeremy P; Chang, Daniel T; Pitt, Allison; Bendavid, Eran; Owens, Douglas K; Durkee, Ben Y; Soltys, Scott G


    The addition of PCV (procarbazine, lomustine, vincristine) chemotherapy to radiotherapy (RT) for patients with high-risk (≥ 40 years old or sub-totally resected) low-grade glioma (LGG) results in an absolute median survival benefit of over 5 years. We evaluated the cost-effectiveness of this treatment strategy. A decision tree with an integrated three-state Markov model was created to follow patients with high risk LGG after surgery treated with RT vs. RT+PCV. Patients existed in one of 3 health states: stable, progressive, and dead. Survival and freedom from progression were modeled to reflect the results of RTOG 9802 using time-dependent transition probabilities. Health utility values and costs of care were derived from the literature and national registry databases. Analysis was conducted from the healthcare perspective. Deterministic and probabilistic sensitivity analysis explored uncertainty in model parameters. Modeled outcomes demonstrated agreement with clinical data in expected benefit of addition of PCV to RT. The addition of PCV to RT yielded an incremental benefit of 4.77 quality-adjusted life-years (QALYs) (9.94 for RT+PCV vs. 5.17 for RT alone) at an incremental cost of $48,635 ($188,234 for RT+PCV vs. $139,598 for RT alone), resulting in an incremental cost-effectiveness ratio of $10,186 per QALY gained. Probabilistic sensitivity analysis demonstrates that within modeled distributions of parameters, RT+PCV has 99.96% probability of being cost-effectiveness at a willingness-to-pay threshold of $100,000 per QALY. The addition of PCV to RT is a cost-effective treatment strategy for patients with high-risk LGG.

  3. Longitudinal investigation of adaptive functioning following conformal irradiation for pediatric craniopharyngioma and low-grade glioma. (United States)

    Netson, Kelli L; Conklin, Heather M; Wu, Shengjie; Xiong, Xiaoping; Merchant, Thomas E


    Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (PVABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (PVABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (PVABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. There was relative sparing of postirradiation functional outcomes over time in this sample. Baseline differences in functional abilities before the initiation of irradiation suggested that other factors influence functional outcomes

  4. Direct reduction of low grade nickel laterite ore to produce ferronickel using isothermal - temperature gradient (United States)

    Zulhan, Zulfiadi; Gibranata, Ian


    In this study, low grade nickel laterite ore was processed by means of isothermal-temperature gradient method to produce ferronickel nugget. The ore and coal as reductant were ground to obtain the grain size of less than 0.25 mm and 0.425 mm, respectively. Both ground laterite ore and coal were mixed, agglomerated in the form of cylindrical pellet by using press machine and then reduced at temperature of 1000°C to 1400°C in a muffle furnace. The experiments were conducted at three stages each at different temperature profile: the first stage was isothermal at 1000°C; the second stage was temperature gradient at certain heating rate from 1000 to 1400°C; and the third stage was isothermal at 1400°C. The heating rate during temperature gradient stage was varied: 6.67, 8.33 and 10°C/minute. No fluxes were added in these experiments. By addition of 10 wt% of coal into the laterite nikel ore, product of ferronickel nugget was formed with the size varies from 1-2 mm. However, by increasing the coal content, the size of ferronickel nugget was decreased to less than 0.2 mm. The observation of the samples during the heating stage showed that ferronickel nugget grew and separated from the gangue during temperature gradient stage as it achieved the temperature of 1380°C. Furthermore, the experiment results indicated that the recovery of ferronickel can be increased at lower heating rate during temperature gradient stage and longer holding time for final isothermal stage. The highest nickel recovery was obtained at a heating rate of 6.67°C/minute.

  5. Learning and Memory Following Conformal Radiation Therapy for Pediatric Craniopharyngioma and Low-Grade Glioma

    Energy Technology Data Exchange (ETDEWEB)

    Di Pinto, Marcos [Department of Pediatric Psychology, Children' s Hospital of Orange County, Orange, California (United States); Conklin, Heather M. [Department of Psychology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Li, Chenghong [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: [Division of Radiation Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)


    Purpose: The primary objective of this study was to examine whether children with low-grade glioma (LGG) or craniopharyngioma had impaired learning and memory after conformal radiation therapy (CRT). A secondary objective was to determine whether children who received chemotherapy before CRT, a treatment often used to delay radiation therapy in younger children with LGG, received any protective benefit with respect to learning. Methods and Materials: Learning and memory in 57 children with LGG and 44 children with craniopharyngioma were assessed with the California Verbal Learning Test-Children's Version and the Visual-Auditory Learning tests. Learning measures were administered before CRT, 6 months later, and then yearly for a total of 5 years. Results: No decline in learning scores after CRT was observed when patients were grouped by diagnosis. For children with LGG, chemotherapy before CRT did not provide a protective effect on learning. Multiple regression analyses, which accounted for age and tumor volume and location, found that children treated with chemotherapy before CRT were at greater risk of decline on learning measures than those treated with CRT alone. Variables predictive of learning and memory decline included hydrocephalus, shunt insertion, younger age at time of treatment, female gender, and pre-CRT chemotherapy. Conclusions: This study did not reveal any impairment or decline in learning after CRT in overall aggregate learning scores. However, several important variables were found to have a significant effect on neurocognitive outcome. Specifically, chemotherapy before CRT was predictive of worse outcome on verbal learning in LGG patients. In addition, hydrocephalus and shunt insertion in craniopharyngioma were found to be predictive of worse neurocognitive outcome, suggesting a more aggressive natural history for those patients.

  6. The Mechanism on Biomass Reduction of Low-Grade Manganese Dioxide Ore (United States)

    Zhang, Honglei; Zhu, Guocai; Yan, Hong; Li, Tiancheng; Zhao, Yuna


    The mechanism on biomass reduction of low-grade manganese dioxide ore was studied by investigating influence factors on manganese recovery degree, such as the reaction temperature, time, biomass/ore ratio, compositions of biomass, nitrogen flow rate, and particle size of raw materials, and it was further identified through analysis of gas composition in the outlet gas, X-ray powder diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS) for the reduced sample. The results show that the reduction process involved mainly two steps: (1) The biomass was first pyrolyzed to release reductive volatiles and (2) manganese oxide ore was reacted with the reductive volatiles. By an analysis of gas composition in the outlet gas, it was also found that the ratio of biomass/ore had an important effect on the reduction mechanism. With a low biomass/ore ratio of 0.5:10, the reducing reaction of the reductive volatiles with manganese dioxide ore proceeded mainly in two stages: (1) The condensable volatiles (tar) released from biomass pyrolysis reacted with manganese oxide ore to produce reductive noncondensable gases such as hydrogen, carbon monoxide, and some light hydrocarbons; and (2) the small molecule gases further participated in the reduction. XRD pattern analysis on the reduced manganese dioxide ore revealed that the process of biomass reduction of manganese ore underwent in phases (MnO2 → Mn3O4 → MnO). The kinetics study showed the reduction process was controlled by a gas-solid reaction between biomass volatiles and manganese oxide ore with activation energy E of 53.64 kJ mol-1 and frequency factor A of 5.45 × 103 minutes-1.

  7. Revisiting the prognostic role of gallium scintigraphy in low-grade Non-Hodgkin`s lymphoma

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    Gallamini, A.; Cavallero, G.; Pregno, P.; Grasso, M.; Gallo, E. [Division of Haematology, S. Croce Hospital, Cuneo (Italy); Biggi, A.; Farinelli, C. [Department of Nuclear Medicine, S. Croce Hospital, Cuneo (Italy); Fruttero, A.; Pugno, F. [Department of Pathology, S. Croce Hospital, Cuneo (Italy); Leone, A. [Department of Radiology, S. Croce Hospital, Cuneo (Italy)


    The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin`s lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the {sup 67}Ga uptake by the tumour, and to establish the contribution of {sup 67}Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic {sup 67}Ga score at diagnosis. In addition to {sup 67}Ga scan, other prognostic variables were studied, relating to the neoplastic burden, the biology of the tumour and the host. Univariate and multivariate analyses were used. {sup 67}Ga scan identified only 116/286 (41%) nodes involved by lymphoma that were detected by clinical examination or computed tomography scan. A scintigraphic scoring system with an arbitrary cut-off value of 3 (high scan score) was able to predict patients with a dismal prognosis: with a mean follow-up of 47 months (range: 1-146 months) the median survival time was 28 months in patients with a high scan score and 74 months in patients with a low scan score (P=0.002). CD71 values were 27.4%{+-}14.9% (mean {+-}SD) in the former and 8.9%{+-}7.2% in the latter (P=0.0001). Only performance status and extranodal sites were significant variables for prognosis in multivariate analysis. It is concluded that {sup 67}Ga scan is inaccurate in staging but might be very important in defining the prognosis in LGNHL, in association with other prognostic variables. (orig.) With 2 figs., 3 tabs., 43 refs.

  8. Obesity phenotypes and resorption percentage after breast autologous fat grafting: Rule of low-grade inflammation (United States)

    Gentile, Pietro; Sarlo, Francesca; De Angelis, Barbara; De Lorenzo, Antonio; Cervelli, Valerio


    Background: One of the main reasons why the breast fat grafting was questioned is that there may be lipofilling resorption. In the literature, the resorption rate reported over the 1st year is highly variable (20–90%). Objective: The aim of this work was to identify the biochemical and clinical parameters, which increase fat graft maintenance in breast reconstruction. Materials and Methods: A sample of 19 patients was treated with fat grafting mixed with platelet-rich plasma. A complete screening of anthropometry, body composition, and blood biochemical parameters was assessed using the standardized equipment. Pre- and post-operative evaluation was performed, which included a complete clinical examination, photographic assessment, nuclear magnetic resonance imaging of the soft tissue, and ultrasound. The follow-up period was 2 years. Results: The authors divided the results into two types of patients: “responder” and “not a responder.” In the “responder” group patients with normal weight, gynoid fat distribution, obese, with normal blood biochemical parameters, and atherogenic indices but with high preoperative values of platelet-to-lymphocyte ratio (PLR) (174.49) and neutrophil-lymphocyte ratio (NLR) (2.65) showed a greater increase of fat graft maintenance at 6 and 12 months after the last lipofilling session. In the “not responder group” patients with overweight, android fat distribution, obese, high values of atherogenic indices, but with normal preoperative NLR and PLR ratios showed a lower fat graft maintenance at 6 and 12 months. Conclusion: We assume, the problem of fat resorption may be resolved by analysis of body composition and by examine the predictive role of preoperative markers of low-grade inflammation. PMID:27656603

  9. Effect of dietary Schizochytrium microalga oil on selected markers of low-grade inflammation in rats. (United States)

    Komprda, T; Sládek, Z; Škultéty, O; Křížková, S; Rozíková, V; Němcová, B; Šustrová, T; Valová, M


    The objective of the present study was to evaluate a potential of Schizochytrium microalga oil to alleviate possible negative effects of high-fat-high-energy diets. Forty adult male rats (Wistar Albino) were fed 7 weeks the diet containing beef tallow + evaporated sweetened milk (diet T) intended to cause mild obesity and low-grade systemic inflammation. Consequently, the animals were divided into four groups by 10 animals each and fed either the T-diet (control) or the diet containing 6% of safflower oil (S), 6% of fish oil (F) and 6% of Schizochytrium microalga oil (A), respectively, for another 7 weeks. The A-diet decreased (p  0.05). In comparison with control, higher (p  0.05) on cellular adiponectin content in the EAT. Higher (p < 0.05) EPA+DHA deposition in the liver of the A-rats correlated with higher expression (149% of control; p < 0.05) of the gene coding for peroxisome proliferator-activated receptor gamma, and with lower expression (82% and 66%; p < 0.05) of the genes coding for adiponectin receptors AdipoR1 and AdipoR2; no relationship to the expression of receptor GPR120 was found. The A-diet did not affect amount of the nuclear fraction of the nuclear factor kappa B in the liver, but increased plasma level of anti-inflammatory cytokine TGF-β1 (p < 0.05). The presented data agree with results of other in vivo rodent and human studies, but not with literature data regarding in vitro experiments: it can be concluded that the effects of dietary oils on inflammatory markers need further investigation.

  10. Cortical mapping with navigated transcranial magnetic stimulation in low-grade glioma surgery

    Directory of Open Access Journals (Sweden)

    Paiva WS


    Full Text Available Wellingson S Paiva1, Erich T Fonoff1, Marco A Marcolin2, Hector N Cabrera1, Manoel J Teixeira11Division of Functional Neurosurgery, Hospital das Clinicas, 2TMS Laboratory of the Psychiatry Institute, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, BrazilAbstract: Transcranial magnetic stimulation (TMS is a promising method for both investigation and therapeutic treatment of psychiatric and neurologic disorders and, more recently, for brain mapping. This study describes the application of navigated TMS for motor cortex mapping in patients with a brain tumor located close to the precentral gyrus.Materials and methods: In this prospective study, six patients with low-grade gliomas in or near the precentral gyrus underwent TMS, and their motor responses were correlated to locations in the cortex around the lesion, generating a functional map overlaid on three-dimensional magnetic resonance imaging (MRI scans of the brain. To determine the accuracy of this new method, we compared TMS mapping with the gold standard mapping with direct cortical electrical stimulation in surgery. The same navigation system and TMS-generated map were used during the surgical resection procedure.Results: The motor cortex could be clearly mapped using both methods. The locations corresponding to the hand and forearm, found during intraoperative mapping, showed a close spatial relationship to the homotopic areas identified by TMS mapping. The mean distance between TMS and direct cortical electrical stimulation (DES was 4.16 ± 1.02 mm (range: 2.56–5.27 mm.Conclusion: Preoperative mapping of the motor cortex with navigated TMS prior to brain tumor resection is a useful presurgical planning tool with good accuracy.Keywords: transcranial magnetic stimulation, cortical mapping, brain tumor, motor cortex

  11. Efficacy and safety of hexaminolevulinate photodynamic therapy in patients with low-grade cervical intraepithelial neoplasia. (United States)

    Hillemanns, Peter; Petry, Karl-Ulrich; Soergel, Philipp; Collinet, Pierre; Ardaens, Katty; Gallwas, Julia; Luyten, Alexander; Dannecker, Christian


    Non-surgical therapies are needed to reduce the rate of progression of low-grade cervical intraepithelial neoplasia (CIN 1) to high grade CIN (CIN 2/3). The aim of this study was to assess the efficacy and safety of hexaminolevulinate (HAL) photodynamic therapy (PDT) in the treatment of patients with CIN 1. This phase IIa prospective double-blind study randomized patients with CIN 1 into three groups: HAL vaginal suppository, placebo vaginal suppository or follow-up only. Patients in the first two groups received HAL or placebo suppositories 5 hours before illumination with 50 J/cm(2) red coherent light (633 nm) using a special light catheter. All patients had a follow up including colposcopy, cytology and human papilloma virus (HPV) testing 3 and 6 months and additional biopsy 6 months after PDT. The main outcome measure was efficacy, defined as complete histologic remission 6 months after PDT. Secondary outcomes were histologic remission 3 months and HPV eradication 6 months after first PDT. Seventy patients were randomized: 47 to HAL, 12 to placebo, 11 to follow up only. After 6 months CIN lesions had cleared in 57% of patients in the HAL-PDT group compared to 25% in the combined control group (per protocol population, P = 0.04). Twenty-six patients (37%) reported 44 adverse events (AEs), of which 40 were mild or moderate. Nineteen treatment-related AEs were reported by 15 patients (32%) in the HAL PDT group, one in the placebo PDT group (8%), and none in the follow-up group. The most common adverse events were local discomfort including mild pain/cramping (11) and leucorrhoea (2). HAL PDT shows a favorable efficacy and safety profile and represents a promising alternative to observation and surgical procedures in patients with CIN 1. © 2014 Wiley Periodicals, Inc.

  12. Human papillomavirus testing for triage of women with low-grade squamous intraepithelial lesions. (United States)

    Cuzick, Jack; Thomas Cox, J; Zhang, Guili; Einstein, Mark H; Stoler, Mark; Trupin, Suzanne; Behrens, Catherine M


    Low-grade squamous intraepithelial lesion (LSIL) is a common cytologic finding in cervical screening, yet only about 10-20% have significant histologic abnormalities and these are almost always positive for high-risk human papillomavirus (hrHPV). This analysis aims to clarify the role of hrHPV DNA testing in the triage of women with LSIL cytology. In the ATHENA screening trial, we examined 1,084 cases of LSIL, of which 925 had an evaluable biopsy, to determine the extent to which hrHPV testing can identify those patients who have precursor lesions in need of immediate clinical referral and those who have changes more likely to regress spontaneously. Overall, 71.2% of LSIL cases were hrHPV positive, but the prevalence was age dependent, with only 56.1% in women ≥ 40 years. Among women with LSIL, 11.6% (107/925) had a cervical intraepithelial neoplasia grade 2 or worse (CIN2+) histologic diagnosis and, of these, only nine were hrHPV negative. For CIN3+, 91.7% (44/48) of women with LSIL were hrHPV positive. The negative predictive value of hrHPV testing for CIN3+ in LSIL was 100% for women aged ≥ 40 years. Women who were HPV16 positive had a higher positive predictive value for CIN2+ (25.4%) than those who were positive for 12 other pooled hrHPV types (11.5%). Testing for hrHPV in women with LSIL is effective in identifying high-grade cervical lesions, thereby avoiding unnecessary referrals to colposcopy and potential over-treatment of non-progressive lesions, especially for women aged ≥ 40 years. Copyright © 2012 UICC.

  13. p16 Expression and Biological Behavior of Flat Vulvar Low-grade Squamous Intraepithelial Lesions (LSIL). (United States)

    Lewis, Natasha; Blanco, Luis Z; Maniar, Kruti P


    Flat low-grade squamous intraepithelial lesion (LSIL) of the vulva [vulvar intraepithelial neoplasia (VIN) 1, flat condyloma] is an uncommon entity with poorly understood biological behavior. We aimed to determine the risk of subsequent vulvar high-grade squamous intraepithelial lesion (HSIL) or carcinoma following a diagnosis of vulvar LSIL/VIN 1, as well as the frequency and predictive value of p16 immunohistochemical expression in this setting. Of the 51 included cases, p16 positivity (diffuse block staining) was identified in 2 (4%). Follow-up data were available in 34 cases, of which 2 (5.9%) developed subsequent vulvar HSIL, including 1/2 p16-positive cases and 1/32 p16-negative cases. The difference in HSIL frequency between p16-positive and p16-negative cases was not statistically significant (P=0.116 for VIN 2+, P=0.061 for VIN 3). For the 18 patients with treatment information available, 10 (56%) received medical or surgical treatment after biopsy. Our results indicate that flat vulvar LSIL is infrequently p16 positive, and that few patients with vulvar LSIL develop subsequent vulvar HSIL. Despite the use of destructive treatment in some cases, the data provide support for the nonpreneoplastic nature of the entity. Immunohistochemical expression of p16 may not be a predictor of HSIL risk in vulvar LSIL, although this result may also be related to the very low rates of both p16 positivity and subsequent vulvar HSIL in our sample. It is clear that vulvar LSIL is distinct from LSIL in other lower anogenital sites in terms of its behavior and p16 expression frequency.

  14. Intramedullary spinal cord metastasis from colonic carcinoma presenting as Brown-Sequard syndrome: a case report

    LENUS (Irish Health Repository)

    Kaballo, Mohammed A


    Abstract Introduction Intramedullary spinal cord metastasis is very rare. The majority are discovered incidentally during autopsy. Most symptomatic patients present with rapidly progressive neurological deficits and require immediate examination. Few patients demonstrate features of Brown-Séquard syndrome. Radiotherapy is the gold-standard of therapy for Intramedullary spinal cord metastasis. The overall prognosis is poor and the mortality rate is very high. We present what is, to the best of our knowledge, the first case of Intramedullary spinal cord metastasis of colorectal carcinoma presenting as Brown-Séquard syndrome. Case presentation We present the case of a 71-year-old Caucasian man with colonic adenocarcinoma who developed Intramedullary spinal cord metastasis and showed features of Brown-Séquard syndrome, which is an uncommon presentation of Intramedullary spinal cord metastasis. Conclusion This patient had an Intramedullary spinal cord metastasis, a rare form of metastatic disease, secondary to colonic carcinoma. The metastasis manifested clinically as Brown-Séquard syndrome, itself a very uncommon condition. This syndrome is rarely caused by intramedullary tumors. This unique case has particular interest in medicine, especially for the specialties of medical, surgical and radiation oncology. We hope that it will add more information to the literature about these entities.

  15. [Kapandji intramedullary wire osteosynthesis in proximal humeral fractures]. (United States)

    Werner, A; Böhm, D; Ilg, A; Gohlke, F


    For operative treatment of proximal humeral fractures minimal invasive techniques reduce the risk of iatrogenic damage of blood supply and periarticular scarring. Reported preliminary results are encouraging. We present our experience achieved with an intramedullary wire fixation adapted from a report of Kapandji in 1989. Between 3/95 and 6/00 29 patients were treated with this technique at our institution. All received early functional treatment. 14 patients (average mean age 56 years at time of trauma) who had a minimum follow up of 24 months (mean 36.4 months) and therefore allowed a preliminary conclusion regarding avascular head necrosis (AVN) were reexamined by use of the Constant Score and x-ray. We examined three unstable 2-part, four 3-part and seven 4-part fractures (5 of them valgus-impacted). The mean Constant Score at follow up was 70 points (31-86 points). We saw one total collapse of the humeral head because of AVN. In one patient the distal end of the wires led to a skin irritation and had to be shortened. We observed no secondary fragment displacement or non-unions. In our hands, this technique offers good results, even in valgus-impacted 4-part fractures of the elderly and allows internal fixation in little displaced but unstable fractures with the benefit of early functional treatment instead of longer immobilization. Based on the experience with intramedullary wiring the previously performed technique using threading wires was abandoned and the indication for primary arthroplasty considerably influenced.

  16. Intramedullary Screw and Kirschner Wire Fixation for Unstable Scaphoid Nonunion. (United States)

    Allon, Raviv; Kramer, Aviv; Wollstein, Ronit


    Surgical treatment of scaphoid nonunion is not always successful, often requiring stabilization and bone grafting to achieve healing. Even after intramedullary screw fixation, residual instability may still hinder union. The purpose of this study was to describe the addition of Kirschner wires (KWs) through the capitate and the lunate to supplement an intramedullary screw for temporary enhanced stability, possibly improving healing of unstable fractures. A case-control study reviewing 25 cases with addition of KWs and 19 controls was performed. Demographic and fracture information, time to diagnosis, and healing time were documented. We found no differences in population characteristics, fracture characteristics, or outcome measures between patients treated with this method and those treated with a screw alone. We had no complications related to the addition of KWs. Preoperative lunate type and scapholunate gapping was suggestive but not significantly associated with KW insertion. Addition of KWs is safe and may be considered in scaphoid nonunion in the presence of intraoperative suboptimal stability. Intraoperative stability may possibly be inferred by reviewing preoperative radiographs for signs of instability.


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION Correction of multi-apical long bone deformities in lower limbs is a challenging task. Correction of these deformities with Ilizarov–type external fixators, treating one segment at a time increases the total time of correction and decreases the patients’ compliance with considerable discomfort. Hence we preferred intramedullary nail devices which combines accuracy, minimal invasiveness, with patient compliance and with excellent functional outcome. Temporary external fixator used per-operatively in some cases to retain the correction till the insertion of the nail. Eight patients in the age group of 12-35 yrs. presented to us over the last 1 year with multi-apical lower limb deformities. The radiological parameters described by Paley et al 1 were used to assess the pre and post–operative radiographs. With the help of anatomical axes the CORA was identified. Percutaneous osteotomy and stabilization with intramedullary nail was done to correct the deformity. 13 Femora and 7 Tibiae were subjected to correction by this technique and followed up over a period of 1 year (Nov-2014 to Nov-2015 at MIMS Vizianagaram hospital.

  18. Inhibition of formyl peptide receptor in high-grade astrocytoma by CHemotaxis Inhibitory Protein of S. aureus

    NARCIS (Netherlands)

    Boer, J. C.; Domanska, U. M.; Timmer-Bosscha, H.; Boer, I. G. J.; de Haas, C. J. C.; Joseph, J. V.; Kruyt, F. A. E.; de Vries, E. G. E.; den Dunnen, W. F. A.; van Strijp, J. A. G.; Walenkamp, A. M. E.


    Background: High-grade astrocytomas are malignant brain tumours that infiltrate the surrounding brain tissue and have a poor prognosis. Activation of formyl peptide receptor (FPR1) on the human astrocytoma cell line U87 promotes cell motility, growth and angiogenesis. We therefore investigated the

  19. Dorsal intramedullary spinal epidermoid cysts: Report of two cases and review of literature

    Directory of Open Access Journals (Sweden)

    Cincu Rafael


    Full Text Available Intramedullary epidermoid cysts of the spinal cord are rare tumors, especially those not associated with spinal dysraphism. About 50 cases have been reported in the literature. Of these, only seven cases have had magnetic resonance imaging (MRI studies. We report two cases of spinal intramedullary epidermoid cysts with MR imaging. Both were not associated with spina bifida. In one patient, the tumor was located at D4 vertebral level; while in the other, within the conus medullaris. The clinical features, MRI characteristics and surgical treatment of intramedullary epidermoid cyst are presented with relevant review of the literature.

  20. Intramedullary thoracic spinal cord meningioma: a rare case report and review of the literature. (United States)

    Yuan, Dun; Liu, Dingyang; Yuan, Xian-rui; Xi, Jian; Ding, Xi-ping


    A 33-year-old male presented with a thoracic spinal intramedullary meningioma manifesting as bilateral asymmetric progressive weakness in the lower extremities. Preoperative magnetic resonance imaging (MRI) showed an intramedullary mass at the T1-T3 level. Intraoperative inspection found that the spinal cord was markedly swollen with a normal surface while dural attachment was not confirmed. Gross total removal of the tumor was achieved. The morphologic and immunohistochemical findings were compatible with the diagnosis of meningioma. Postoperatively, the patient recovered from preoperative paraplegia. Although extremely rare, meningiomas should be considered when diagnosing intramedullary tumors. Georg Thieme Verlag KG Stuttgart · New York.

  1. Undetected iatrogenic lesions of the anterior femoral shaft during intramedullary nailing: a cadaveric study

    Directory of Open Access Journals (Sweden)

    Shepherd Lane


    Full Text Available Abstract Background The incidence of undetected radiographically iatrogenic longitudinal splitting in the anterior cortex during intramedullary nailing of the femur has not been well documented. Methods Cadaveric study using nine pairs of fresh-frozen femora from adult cadavers. The nine pairs of femora underwent a standardized antegrade intramedullary nailing and the detection of iatrogenic lesions, if any, was performed macroscopically and by radiographic control. Results Longitudinal splitting in the anterior cortex was revealed in 5 of 18 cadaver femora macroscopically. Anterior splitting was not detectable in radiographic control. Conclusion Longitudinal splitting in the anterior cortex during intramedullary nailing of the femur cannot be detected radiographically.

  2. Expression of the lysosomal-associated membrane protein-1 (LAMP-1) in astrocytomas

    DEFF Research Database (Denmark)

    Jensen, Stine Skov; Christensen, Karina; Aaberg-Jessen, Charlotte

    , the aim of this study was to investigate the immunohistochemical expression of LAMP-1, a membrane bound protein in lysosomes, in formalin fixed paraffin embedded tumor tissue from 23 diffuse astrocytomas, 17 anaplastic astrocytomas and 72 glioblastomas. The LAMP-1 expression was scored and compared...... with both tumor grade and patient survival. Moreover double immunofluorescence stainings with LAMP-1 and the stem cell marker CD133 as well as the macrophage marker CD68 were performed. The results showed that LAMP-1 was expressed in the vast majority of tumors being present in the cytoplasm of single tumor...... cells, cell clusters and in blood vessel endothelial cells. The LAMP-1 expression in glioblastomas was significantly higher than in diffuse and anaplastic astrocytomas (pLAMP-1 and patient overall survival was found. Double immunofluorescence staining...

  3. Expression of the lysosomal-associated membrane protein-1 (LAMP-1) in astrocytomas

    DEFF Research Database (Denmark)

    Jensen, Stine Skov; Christensen, Karina; Aaberg-Jessen, Charlotte

    Targeting lysosomes is a novel approach in cancer therapy providing a possible way of killing the otherwise apoptosis-resistant cancer cells. Recent research has thus shown that lysosome targeting compounds induce cell death in a cervix cancer cell line. Tumor stem cells in glioblastomas have...... recently been suggested to possess innate resistance mechanisms against radiation and chemotherapy possibly explaining the high level of therapeutic resistance of these tumors. Since the presence and distribution of lysosomes in tumor cells and especially in tumor stem cells in astrocytomas is unknown......, the aim of this study was to investigate the immunohistochemical expression of LAMP-1, a membrane bound protein in lysosomes, in formalin fixed paraffin embedded tumor tissue from 23 diffuse astrocytomas, 17 anaplastic astrocytomas and 72 glioblastomas. The LAMP-1 expression was scored and compared...

  4. Everolimus Treatment for an Early Infantile Subependymal Giant Cell Astrocytoma With Tuberous Sclerosis Complex. (United States)

    Fukumura, Shinobu; Watanabe, Toshihide; Takayama, Rumiko; Minagawa, Kimio; Tsutsumi, Hiroyuki


    Subependymal giant cell astrocytomas are benign tumors often observed with tuberous sclerosis complex. These tumors are rarely diagnosed during fetal life or early infancy. Until recently, the only available treatment has been surgical resection. Current clinical research has demonstrated that everolimus can induce these tumors' regression. We report a 19-month-old boy with tuberous sclerosis complex. At 2 months of age, he presented with congenital subependymal giant cell astrocytoma that was complicated by refractory epilepsy and severe mental retardation. Treatment with everolimus was started when he was 10 months old. Three months after initiating everolimus, the tumor was significantly reduced in size, and the reduction was subsequently maintained. His seizures decreased and he showed cognitive and developmental improvement. No severe adverse events have been observed to date. Everolimus has promise as an effective alternative to surgery for subependymal giant cell astrocytomas during early infancy.

  5. Management of optic chiasmatic/hypothalamic astrocytomas in children

    Energy Technology Data Exchange (ETDEWEB)

    Steinbok, P.; Hentschel, S.; Almqvist, P.; Cochrane, D.D. [Univ. of British Columbia, British Columbia' s Children' s Hospital, Div. of Pediatric Neurosurgery, Dept. of Surgery, Vancouver, British Columbia (Canada); Poskitt, K. [Univ. of British Columbia, British Columbia' s Children' s Hospital, Dept. of Radiology, Vancouver, British Columbia (Canada)


    The management of optic chiasmatic gliomas is controversial, partly related to failure to separate out those tumors involving the optic chiasm only (chiasmatic tumors) from those also involving the hypothalamus (chiasmatic/hypothalamic tumors). The purpose of this study was: (i) to analyze the outcomes of chiasmatic and chiasmatic/hypothalamic tumors separately; and (ii) to determine the appropriateness of recommending radical surgical resection for the chiasmatic/hypothalamic tumors. A retrospective chart review of all newly diagnosed tumors involving the optic chiasm from 1982-1996 at British Columbia's Children's Hospital was performed. There were 32 patients less than 16 years of age, 14 with chiasmatic and 18 with chiasmatic/hypothalamic astrocytomas, with an average duration of follow-up of 5.8 years and 6.3 years, respectively. Ten of the patients with chiasmatic tumors and none with chiasmatic/hypothalamic tumors had neurofibromatosis I. Thirteen of the 14 chiasmatic tumors were managed with observation only, and none had progression requiring active intervention. For the chiasmatic/hypothalamic tumors. eight patients had subtotal resections (>95% resection), six had partial resections (50-95%), three had limited resections (<50%), and one had no surgery. There were fewer complications associated with the limited resections, especially with respect to hypothalamic dysfunction. There was no correlation between the extent of resection (subtotal, partial, or limited) and the time to tumor progression (average 18 months). In conclusion, chiasmatic and chiasmatic/hypothalamic tumors are different entities, which should be separated out for the Purposes of any study. For the chiasmatic/hypothalamic tumors, there was more morbidity and no prolongation of time to progression when radical resections were compared to more limited resections. Therefore, if surgery is performed, it may be appropriate to do a surgical procedure that strives only to provide a

  6. Stereotactic Radiosurgery for Recurrent or Unresectable Pilocytic Astrocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Pollock, Bruce E. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Department of Neurological Surgery, Mayo Clinic, Rochester, MN (United States); Schomberg, Paula J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Link, Michael J. [Department of Neurological Surgery, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Stafford, Scott L., E-mail: [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)


    Purpose: To report the outcomes in patients with recurrent or unresectable pilocytic astrocytoma (PA) treated with Gamma Knife stereotactic radiosurgery (SRS). Methods and Materials: Retrospective review of 18 patients (20 lesions) with biopsy-confirmed PA having SRS at our institution from 1992 through 2005. Results: The median patient age at SRS was 23 years (range, 4-56). Thirteen patients (72%) had undergone one or more previous surgical resections, and 10 (56%) had previously received external-beam radiation therapy (EBRT). The median SRS treatment volume was 9.1 cm{sup 3} (range, 0.7-26.7). The median tumor margin dose was 15 Gy (range, 12-20). The median follow-up was 8.0 years (range, 0.5-15). Overall survival at 1, 5, and 10 years after SRS was 94%, 71%, and 71%, respectively. Tumor progression (local solid progression, n = 4; local solid progression + distant, n = 1; distant, n = 2; cyst development/progression, n = 4) was noted in 11 patients (61%). Progression-free survival at 1, 5, and 10 years was 65%, 41%, and 17%, respectively. Prior EBRT was associated with inferior overall survival (5-year risk, 100% vs. 50%, p = 0.03) and progression-free survival (5-year risk, 71% vs. 20%, p = 0.008). Nine of 11 patients with tumor-related symptoms improved after SRS. Symptomatic edema after SRS occurred in 8 patients (44%), which resolved with short-term corticosteroid therapy in the majority of those without early disease progression. Conclusions: SRS has low permanent radiation-related morbidity and durable local tumor control, making it a meaningful treatment option for patients with recurrent or unresectable PA in whom surgery and/or EBRT has failed.

  7. Pilomyxoid astrocytoma with involvement of the sella turcica in an adolescent. (United States)

    Alimohamadi, Maysam; Bidabadi, Mohammad Shirani; Ayan, Zahra; Ketabchi, Ebrahim; Amirjamshidi, Abbas


    Pilomyxoid astrocytoma (PMA) is a recently described tumor typically occurring in the hypothalamic-chiasmatic region of very young children. PMA is characterized by a more aggressive course than pilocytic astrocytoma and exhibits certain differing histological features. We report a PMA in an adolescent patient with visual field disturbance. Imaging studies revealed enlargement of the sella turcica due to a homogenously enhancing sellar and suprasellar mass identifiable both on CT scans and MRI. We believe that PMA may be included in the list of differential diagnoses of the lesions expanding the sella turcica.

  8. Disturbed small-world networks and neurocognitive function in frontal lobe low-grade glioma patients.

    Directory of Open Access Journals (Sweden)

    Qingling Huang

    Full Text Available BACKGROUND: Brain tumor patients often associated with losses of the small-world configuration and neurocognitive functions before operations. However, few studies were performed on the impairments of frontal lobe low-grade gliomas (LGG after tumor resection using small-world network features. METHODOLOGY/PRINCIPAL FINDINGS: To detect differences in the whole brain topology among LGG patients before and after operation, a combined study of neurocognitive assessment and graph theoretical network analysis of fMRI data was performed. We collected resting-state fMRI data of 12 carefully selected frontal lobe LGG patients before and after operation. We calculated the topological properties of brain functional networks in the 12 LGG, and compared with 12 healthy controls (HCs. We also applied Montreal Cognitive Assessment (MoCA in a subset of patients (n = 12, including before and after operation groups and HCs (n = 12. The resulting functional connectivity matrices were constructed for all 12 patients, and binary network analysis was performed. In the range of 0.05 ≤ Kcos t ≤ 0.35, the functional networks in preoperative LGG and postoperative one both fitted the definition of small-worldness. We proposed Knet = 0.20 as small-world network interval, and the results showed that the topological properties were found to be disrupted in the two LGG groups, meanwhile the global efficiency increased and the local efficiency decreased. Lnet in the two LGG groups both were longer than HCs. Cnet in the LGG groups were smaller than HCs. Compared with the Hcs, MoCA in the two LGG groups were lower than HCs with significant difference, and the disturbed networks in the LGG were negatively related to worse MoCA scores. CONCLUSIONS: Disturbed small-worldness preperty in the two LGG groups was found and widely spread in the strength and spatial organization of brain networks, and the alterated small-world network may be responsible for cognitive

  9. Bacterial bioleaching of low grade nickel limonite and saprolite ores by mixotrophic bacteria

    Directory of Open Access Journals (Sweden)

    Chaerun Siti Khodijah


    Full Text Available Utilization of indigenous bacteria should be considered to establish a successful biohydrometallurgical process. In this study, mixrotrophic iron-oxidizing bacterial consortia consisting of Comamonas testosteroni, Alicyclobacillus ferrooxydans and Pantoea septic which were isolated from Indonesian mineral ores were examined to determine their abilities to recover nickel from limonite and saprolite ores in the bioleaching experiments using stirred tank reactors. The nickel bioleaching experiments inoculated with the bacterial consortia were carried out using coarse limonite ores and weathered saprolite ores with pulp density of 10% w/v. Abiotic controls were also carried out replacing the inocula by the sterile medium. The bioleaching processes were monitored by measuring Ni and Fe contents and pH of the leaching solution as well as the total bacterial enzymatic activity measured as FDA hydrolytic activity. The effect of leaching on the mineralogy of laterite ores was investigated by the scanning electron microscope equipped with energy-dispersive spectroscopy (SEM-EDS and X-ray powder diffraction (XRD. After 28 days of incubation, the FDA hydrolytic activity was observed in both bioleaching experiments containing limonite (17.2 μg fluorescein/mL and saprolite ores (16.9 μg fluorescein/mL. The leached Ni and Fe in the bioleaching experiments containing limonite ores (30% Ni and 5.6% Fe was greater than that in abiotic controls (1% Ni and 0.1% Fe with the pH range of 2.5 to 3.5. However, the bacterial consortia were less capable of bioleaching of Ni (2.5% with the similar leached Fe (6% from the saprolite ores. In abiotic controls, the medium pH remained relatively constant (pH 6. It was concluded that these bacterial isolated as the consortium were capable of nickel bioleaching (precious metal more effectively than iron (gangue metal, thus being applicable to the commercial processing of the difficult-to-process low-grade nickel laterite ores

  10. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M;


    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata).......To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  11. Temozolomide chemotherapy versus radiotherapy in high-risk low-grade glioma (EORTC 22033-26033) : a randomised, open-label, phase 3 intergroup study

    NARCIS (Netherlands)

    Baumert, Brigitta G; Hegi, Monika E; van den Bent, Martin J; von Deimling, Andreas; Gorlia, Thierry; Hoang-Xuan, Khê; Brandes, Alba A; Kantor, Guy; Taphoorn, Martin J B; Hassel, Mohamed Ben; Hartmann, Christian; Ryan, Gail; Capper, David; Kros, Johan M; Kurscheid, Sebastian; Wick, Wolfgang; Enting, Roelien; Reni, Michele; Thiessen, Brian; Dhermain, Frederic; Bromberg, Jacoline E; Feuvret, Loic; Reijneveld, Jaap C; Chinot, Olivier; Gijtenbeek, Johanna M M; Rossiter, John P; Dif, Nicolas; Balana, Carmen; Bravo-Marques, Jose; Clement, Paul M; Marosi, Christine; Tzuk-Shina, Tzahala; Nordal, Robert A; Rees, Jeremy; Lacombe, Denis; Mason, Warren P; Stupp, Roger


    BACKGROUND: Outcome of low-grade glioma (WHO grade II) is highly variable, reflecting molecular heterogeneity of the disease. We compared two different, single-modality treatment strategies of standard radiotherapy versus primary temozolomide chemotherapy in patients with low-grade glioma, and asses


    Directory of Open Access Journals (Sweden)

    H. Bagheri


    Full Text Available The aim of study was to investigate and compare the concentric torque of Quadriceps and Hamstring muscles and Timed-Walking test in two groups. Thus, one group of healthy subjects and one group of patients with low grade of tibiofemoral osteoarthritis (OA were selected. Concentric torque of Quadriceps and Hamstring were measured in both groups. Besides, pain measurement, Timed-Walking test, range of motion and the muscle bulk of thigh were assessed in both groups. The independent t-test revealed significant differences between the two groups with regard to concentric torques and Timed-Walking test. However, no significant difference in range of motion and the muscle bulk was seen. In conclusion, patients with low grade of osteoarthritis and minimum clinical signs had weaker muscles and functional limitation in comparison with the matched healthy individuals.

  13. Office-Based Transurethral Devascularisation of Low Grade Non-Invasive Urothelial Cancer Using Diode Laser. A Feasibility Study

    DEFF Research Database (Denmark)

    Hermann, Gregers G.; Mogensen, Karin; Lindvold, Lars René


    Frequent recurrence of non‐muscle invasive bladder tumours (NMIBC) requiring transurethral resection of bladder tumour (TUR‐BT) and lifelong monitoring makes the lifetime cost per patient the highest of all cancers. A new method is proposed for the removal of low grade NMIBCs in an office......‐based setting, without the need for sedation and pain control and where the patient can leave immediately after treatment. An in vitro model was developed to examine the dose/response relationship between laser power, treatment time, and distance between laser fibre and target, using a 980 nm diode laser...... and chicken meat. The relationship between depth and extent of tissue destruction and the laser settings was measured using microscopy and non‐parametric statistical analysis. A patient with low grade stage Ta tumour and multiple comorbidity, and therefore not fit for general anaesthesia, had a tumour...

  14. Upgrading of consumer characteristics of granulated solid fuel from mixture of low-grade coal and biomass (United States)

    Kuzmina, J. S.; Milovanov, O. Yu; Sinelshchikov, V. A.; Sytchev, G. A.; Zaichenko, V. M.


    Effect of torrefaction on consumer characteristics of fuel pellets made of low-grade and agricultural waste is shown. Data on the volatile content, ash content, calorific value and hygroscopicity for initial pellets and pellets, heat-treated at various temperatures are presented. The experimental study of the combustion process of initial and heat-treated pellets showed that torrefaction of pellets leads to a decreasing of the ignition temperature and an increasing of the efficiency of boiler plant.

  15. Comparison of chest radiography and high-resolution computed tomography findings in early and low-grade coal worker's pneumoconiosis. (United States)

    Savranlar, Ahmet; Altin, Remzi; Mahmutyazicioğlu, Kamran; Ozdemir, Hüseyin; Kart, Levent; Ozer, Tülay; Gündoğdu, Sadi


    High-resolution computed tomography (HRCT) is more sensitive than chest X-ray (CXR) in the depiction of parenchymal abnormalities. We aimed to present and compare CXR and HRCT findings in coal workers with and without early and low-grade coal worker's pneumoconiosis (CWP). 71 coal workers were enrolled in this study. All workers were male. The CXR and HRCT of those workers were obtained and graded by two trained readers. HRCT's were graded according to Hosoda and Shida's Japanese classification. After grading, 67 workers with CXR profusion 0/0-2/2 were included in the study. Four patients with major opacity were excluded. Profusion 0/1 to 1/1 cases were accepted as early and profusion 1/2 and 2/2 cases as low-grade pneumoconiosis. Discordance between CXR and HRCT was high. Discordance rate was found higher in the early pneumoconiosis cases with negative CXR than low-grade pneumoconiosis (60, 36 and 8%, respectively). When coal miners with normal CXR were evaluated by HRCT, six out of 10 cases were diagnosed as positive. In low-grade pneumoconiosis group, the number of patients with positive CXR but negative HRCT were low in comparison to patients with CXR negative and early pneumoconiosis findings. Most of the CXR category 0 patients (10/16) were diagnosed as category 1 by HRCT. Eleven cases diagnosed as CXR category 1 were diagnosed as category 0 (7/11) and category 2 (4/11) by HRCT. In CXR category 2 (eight cases), there were four cases diagnosed as category 1 by HRCT. Discordance between CXR and HRCT was high, especially for CXR negative and early pneumoconiosis cases. The role of CXR in screening coal workers to detect early pneumoconiosis findings should be questioned. We suggest using HRCT as a standard screening method instead of CXR to distinguish between normal and early pneumoconiosis.

  16. Refractures of the paediatric forearm with the intramedullary nail in situ (United States)

    van Egmond, Pim W; van der Sluijs, Hans A; van Royen, Barend J; Saouti, Rachid


    Forearm fractures in children are common. When conservative treatment fails, internal fixation with Elastic Stable Intramedullary Nailing (ESIN) become the first choice in the operative treatment of diaphyseal forearm shaft fractures. Refractures with the intramedullary nail in situ are known to occur but formal guidelines to guide management in such fractures are lacking. We present a well-documented case of a radius midshaft refracture in a 12-year-old boy with the intramedullary nail in situ, managed by closed reduction. Literature is reviewed for this type of complication, the treatment of 30 similar cases is discussed and a treatment strategy is defined. The refracture of the paediatric forearm fracture with the intramedullary nail in situ is a rare, but probably under recognised complication which is observed in approximately 2.3% of the study population. Closed reduction may be considered in these cases. PMID:24068378

  17. Articular cartilage damage with intramedullary lesion (bone bruise) in anterior cruciate ligament rupture

    Energy Technology Data Exchange (ETDEWEB)

    Ide, Shuya; Ohdera, Toshihiro; Tokunaga, Masami; Hiroshima, Shiro; Yoshimoto, Eiji [Fukuoka Orthopaedic Hospital (Japan)


    We evaluated the relationship between the intramedullary lesion on MRI and cartilage damage in patients associated with acute anterior cruciate ligament (ACL) rupture. Thirty-two cases documented by MRI and arthroscopy within one month from injury underwent ACL reconstruction using ST-G, and arthroscopy was performed again after surgery. The mean term between reconstruction and postoperative arthroscopy was twelve months. The cartilage damage on arthroscopy was compared with the intramedullary lesion on MRI. Cartilage damage was observed in 9 cases (28.1%) during the initial arthroscopy and in 16 cases (50.0%) during the second arthroscopy. Intramedullary lesion was detected in all 32 cases (total: 73 lesions) on MRI. Intramedullary lesion leading to cartilage damage was common in the geographic-type lateral femoral condyle. There was significant difference between the lateral meniscus tear and the cartilage damage of the lateral compartment. (author)

  18. Effect of Modified Atmosphere Packaging and Vacuum Packaging on Quality Characteristics of Low Grade Beef during Cold Storage. (United States)

    Hur, S J; Jin, S K; Park, J H; Jung, S W; Lyu, H J


    Many studies have been carried out with respect to packaging methods and temperature conditions of beef. However, the effects of packaging methods and temperature conditions on the quality characteristics have not been extensively studied in low-grade beef. Low-grade beef samples were divided into 3 groups (C: ziplock bag packaging, T1: vacuum packaging, and T2: modified atmosphere packaging (MAP), CO2/N2 = 3:7) and samples were stored at 4°C for 21 days. The water-holding capacity (WHC) was significantly lower in T1 than in the other samples up to 14 days of storage. The thiobarbituric acid reactive substances and volatile basic nitrogen values were significantly lower in T1 and T2 than in C after 7 to 14 days of storage. The total bacterial counts were significantly lower in T1 and T2 than in C after 14 days of storage. In a sensory evaluation, tenderness and overall acceptability were significantly higher in T1 and T2 than in C at the end of the storage period (21 days). We propose that the MAP method can improve beef quality characteristics of low-grade beef during cold storage. However, the beneficial effects did not outweigh the cost increase to implement MAP.

  19. Contribution of nuclear morphometric features to differentiation of atypical complex type endometrial hyperplasia and low grade endometrial carcinoma

    Directory of Open Access Journals (Sweden)

    Onder Onguru


    Full Text Available Objective: The differentiation of atypical complex type endometrial hyperplasia (ACEH and low grade endometrial carcinoma (EC may be problematic in endometrial biopsy materials. Desmoplasia and stromal invasion are diagnostic for EC but they are not always demonstrated in endometrial biopsies. In this study, we investigated the contribution of nuclear morphometry to distinction of ACEH and low grade EC. Methods: Ten low grade EC and eight ACEH cases retrieved from the archives of the Department of Pathology. For each case at least 100 nuclei (totally 1000 for both groups were selected using hematoxylen-eosine stained sections and evaluated by a computer assisted system. Measured nuclear morphometric features were nuclear area, nuclear perimeter, circular form factor, diameter equivalent circle, minimum feret, maximum feret, area convex hull, perimeter convex hull. Results: There was no significant differences between these two groups for circular form factor (P=0.871. But all other morphometric features were statistically significant (P<0.05. Conclusion: Our findings suggest that nuclear morphometric features may be used as an ancillary diagnostic tool in addition to conventional histopathological findings in borderline lesion. These findings should be confirmed with expanded case series. [J Exp Integr Med 2011; 1(4.000: 277-280

  20. Computed tomography- and fluoroscopy-guided percutaneous screw fixation of low-grade isthmic spondylolisthesis in adults: a new technique

    Energy Technology Data Exchange (ETDEWEB)

    Amoretti, Nicolas; Huwart, Laurent; Browaeys, Patrick; Nouri, Yasir; Ibba, Caroline [Hopital Archet 2, Centre Hospitalo-Universitaire de Nice, Department of Radiology, Nice (France); Hauger, Olivier [Hopital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Department of Radiology, Bordeaux (France); Marcy, Pierre-Yves [Antoine Lacassagne Cancer Research Institute, Department of Radiology, Nice (France); Boileau, Pascal [Hopital Archet 2, Centre Hospitalo-Universitaire de Nice, Department of Orthopedic Surgery, Nice (France)


    To evaluate the feasibility of computed tomography (CT)- and fluoroscopy-guided percutaneous screw fixation for the treatment of low-grade isthmic spondylolisthesis in adults. Ten consecutive adult patients (four men and six women; mean age: 57.1 [range, 44-78 years]) were prospectively treated by percutaneous screw fixation for low-grade (six grade 1 and four grade 2) isthmic spondylolisthesis of L5. For each patient, two 4.0-mm Asnis III cannulated screws were placed to fix the pars interarticularis defects. All procedures were performed under local anaesthesia by using CT and fluoroscopy guidance. Post-operative outcome was assessed using the visual analogue scale and Oswestry Disability Index (ODI) scores. The procedure time ranged from 45 to 60 min. The mean screw length was 27 mm (range, 24-32 mm). The VAS and ODI measurements {+-} SD decreased from 7.8 {+-} 0.9 preoperatively to 1.5 {+-} 1.1 at the last 2-year follow-up, and from 62.3 {+-} 17.2 to 15.1 {+-} 6.0, respectively (P < 0.001 in both cases). Neither slip progression nor screw failure was noted. This feasibility study showed that CT- and fluoroscopy-guided percutaneous screw fixation could be a rapid, safe and effective method of treating low-grade isthmic spondylolisthesis. (orig.)

  1. Research on curative effect of traditional Chinese medicine treating low-grade fever of children caused by respiratory system infection. (United States)

    Li, Xiangyun


    This study aims to explore the curative effect of traditional Chinese medicine treating low-grade fever of children caused by respiratory system infection. Sixty children who suffered low-grade fever caused by respiratory system infection were selected and divided into treatment group and control group randomly, each with 30 cases. Control group was treated with conventional methods including oxygen uptake, nebulization and anti-infection, etc, while treatment group was given boil-free granules of traditional Chinese medicine besides the treatment which control group received. Then clinical curative effect of two groups was compared. Results showed that 28 cases (93.3%) were cured in treatment group; while 21 cases (70.0%) were cured in control group. Compared with control group, the treatment group showed up better treatment efficiency and the difference between groups was of statistical significance (Pfever of children caused by respiratory system infection; characterized by short treatment cycle and effective treatment effect, Chinese medicine granules in the combination with oxygen atomization inhalation is proved to be able to efficiently remit symptoms such as coughing, gasp and labored breathing, with outstanding curative effect in the treatment of low-grade fever of children caused by respiratory system infection, thus it is worthy of popularization and application clinically.

  2. Impact of Early Low-Grade Proteinuria and Allograft Dysfunction on Survival in Expanded Criteria Donor Kidney Transplant Recipients. (United States)

    López, V; Cabello, M; Ruíz-Esteban, P; Sola, E; Gutiérrez, C; Jironda, C; Burgos, D; González-Molina, M; Hernández, D


    Recent studies have demonstrated a relationship between low-grade proteinuria and worse graft survival, but this has not been fully studied in expanded criteria donor (ECD) kidney transplant recipients. The aim of this study was to assess whether the combination of early low-grade proteinuria (proteinuria (300 mg/d) and median creatinine (Cr; 1.7 mg/dL; interquartile range, 1.4-2.1 mg/dL) at the third month post-transplantation: Group A (Cr proteinuria proteinuria ≥300 mg/24 h; n = 38), Group C (Cr ≥1.7 mg/dL and proteinuria proteinuria ≥300 mg/24 h; n = 55). Death-censored graft survival was significantly lower in Group D compared with the rest (P proteinuria and a lower estimated glomerular filtration rate (eGFR) as associated with graft failure (hazard rate [HR] 2.5, 95% confidence interval [CI], 1.09-5.97; P = .03). The early association of low-grade proteinuria and allograft dysfunction represents an important risk factor for graft loss in ECD kidney transplant recipients. Strategies to optimize renal function could improve the outcome in this specific population. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials. (United States)

    Avila, Edward K; Chamberlain, Marc; Schiff, David; Reijneveld, Jaap C; Armstrong, Terri S; Ruda, Roberta; Wen, Patrick Y; Weller, Michael; Koekkoek, Johan A F; Mittal, Sandeep; Arakawa, Yoshiki; Choucair, Ali; Gonzalez-Martinez, Jorge; MacDonald, David R; Nishikawa, Ryo; Shah, Aashit; Vecht, Charles J; Warren, Paula; van den Bent, Martin J; DeAngelis, Lisa M


    Patients with low-grade glioma frequently have brain tumor-related epilepsy, which is more common than in patients with high-grade glioma. Treatment for tumor-associated epilepsy usually comprises a combination of surgery, anti-epileptic drugs (AEDs), chemotherapy, and radiotherapy. Response to tumor-directed treatment is measured primarily by overall survival and progression-free survival. However, seizure frequency has been observed to respond to tumor-directed treatment with chemotherapy or radiotherapy. A review of the current literature regarding seizure assessment for low-grade glioma patients reveals a heterogeneous manner in which seizure response has been reported. There is a need for a systematic approach to seizure assessment and its influence on health-related quality-of-life outcomes in patients enrolled in low-grade glioma therapeutic trials. In view of the need to have an adjunctive metric of tumor response in these patients, a method of seizure assessment as a metric in brain tumor treatment trials is proposed. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail:

  4. Deep sequencing detects very-low-grade somatic mosaicism in the unaffected mother of siblings with nemaline myopathy. (United States)

    Miyatake, Satoko; Koshimizu, Eriko; Hayashi, Yukiko K; Miya, Kazushi; Shiina, Masaaki; Nakashima, Mitsuko; Tsurusaki, Yoshinori; Miyake, Noriko; Saitsu, Hirotomo; Ogata, Kazuhiro; Nishino, Ichizo; Matsumoto, Naomichi


    When an expected mutation in a particular disease-causing gene is not identified in a suspected carrier, it is usually assumed to be due to germline mosaicism. We report here very-low-grade somatic mosaicism in ACTA1 in an unaffected mother of two siblings affected with a neonatal form of nemaline myopathy. The mosaicism was detected by deep resequencing using a next-generation sequencer. We identified a novel heterozygous mutation in ACTA1, c.448A>G (p.Thr150Ala), in the affected siblings. Three-dimensional structural modeling suggested that this mutation may affect polymerization and/or actin's interactions with other proteins. In this family, we expected autosomal dominant inheritance with either parent demonstrating germline or somatic mosaicism. Sanger sequencing identified no mutation. However, further deep resequencing of this mutation on a next-generation sequencer identified very-low-grade somatic mosaicism in the mother: 0.4%, 1.1%, and 8.3% in the saliva, blood leukocytes, and nails, respectively. Our study demonstrates the possibility of very-low-grade somatic mosaicism in suspected carriers, rather than germline mosaicism. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Chronic Low-Grade Inflammation in Childhood Obesity Is Associated with Decreased IL-10 Expression by Monocyte Subsets (United States)

    Mattos, Rafael T.; Medeiros, Nayara I.; Menezes, Carlos A.; Fares, Rafaelle C. G.; Franco, Eliza P.; Dutra, Walderez O.; Rios-Santos, Fabrício; Correa-Oliveira, Rodrigo; Gomes, Juliana A. S.


    Chronic low-grade inflammation is related to the development of comorbidities and poor prognosis in obesity. Monocytes are main sources of cytokines and play a pivotal role in inflammation. We evaluated monocyte frequency, phenotype and cytokine profile of monocyte subsets, to determine their association with the pathogenesis of childhood obesity. Children with obesity were evaluated for biochemical and anthropometric parameters. Monocyte subsets were characterized by flow cytometry, considering cytokine production and activation/recognition molecules. Correlation analysis between clinical parameters and immunological data delineated the monocytes contribution for low-grade inflammation. We observed a higher frequency of non-classical monocytes in the childhood obesity group (CO) than normal-weight group (NW). All subsets displayed higher TLR4 expression in CO, but their recognition and antigen presentation functions seem to be diminished due to lower expression of CD40, CD80/86 and HLA-DR. All subsets showed a lower expression of IL-10 in CO and correlation analyses showed changes in IL-10 expression profile. The lower expression of IL-10 may be decisive for the maintenance of the low-grade inflammation status in CO, especially for alterations in non-classical monocytes profile. These cells may contribute to supporting inflammation and loss of regulation in the immune response of children with obesity. PMID:27977792

  6. Concurrent cerebellar and cervical intramedullary tuberculoma: Paradoxical response on antitubercular chemotherapy and need for surgery


    Das, Kuntal Kanti; Jaiswal, Sushila; Shukla, Mukesh; Srivastava, Arun Kumar; Behari, Sanjay; Kumar,Raj


    Spinal intramedullary tuberculoma (SIT) is a rare manifestation of neurotuberculosis. Concurrent SIT and intracranial tuberculoma are further unusual. Most of these tuberculomas respond completely to medical therapy, and surgical excision is seldom required. In this report, we describe a 17-year-old boy who developed cervical intramedullary tuberculoma at C3-C6 level with a concurrent lesion involving the right cerebellar hemisphere while on treatment for tubercular meningitis. This patient h...

  7. Lateral sacral artery supply to an intramedullary arteriovenous fistula at the conus medullaris

    Energy Technology Data Exchange (ETDEWEB)

    Mochizuki, T.; Nemoto, Y.; Inoue, Y.; Tashiro, T. (Osaka City Univ. Medical School (Japan). Dept. of Radiology); Sakanaka, H. (Osaka City Univ. Medical School (Japan). Dept. of Orthopedics)


    In this 25-year-old woman, severe low back pain, flaccid paraparesis, sensory disturbance of both legs and sphincter dysfunction resulted from an intramedullary conal arteriovenous malformation fed by an anterior spinal artery arising from the left sixth intercostal artery and by the left lateral sacral artery, a branch of the left internal iliac artery. Magnetic resonance (MR) images showed low signal (flow void) within an intramedullary mass that expanded the conus from T12 to L1. (orig./GDG).

  8. Intramedullary spinal epidermoid cyst of the cervicodorsal region: A rare entity

    Directory of Open Access Journals (Sweden)

    Ashok Kumar


    Full Text Available Intramedullary spinal epidermoid cysts are rare, with only few cases having been reported in the literature. We are reporting a case of a 10-year-old female child who presented with symptoms of meningitis with progressive paraparesis. Magnetic resonance imaging of the spine revealed an intramedullary epidermoid cyst from C6 to D5. Near-total excision of the tumor was performed. Histopathological report confirmed the diagnosis of epidermoid cyst. The patient showed progressive recovery.

  9. Intramedullary Osteosarcoma of the Mandible: A Clinicoradiologic Perspective

    Directory of Open Access Journals (Sweden)

    Bhogisetty Chittaranjan


    Full Text Available Osteosarcoma is a non-hematopoietic primary malignant tumor of bone or mesenchymal tissue. Although osteosarcoma is not a common malignant bone tumor, accounting for approximately 20% of sarcomas, tumor of the jaw bone is uncommon, representing only about 4% of osteosarcomas of long bones. We report a case of a 72-year-old female with a swelling on the left side of the mandible and intra-oral swelling on the floor of the mouth. Conventional radiograph and advanced imaging modalities such as computed tomography and magnetic resonance imaging revealed an intramedullary osteosarcoma of the mandible. This report highlights importance of imaging modalities in the diagnosis of malignant tumors of the jaws.

  10. Insertion of intramedullary nails from the suprapatellar pouch for proximal tibial shaft fractures. A technical note. (United States)

    Jakma, Tijs; Reynders-Frederix, Peter; Rajmohan, Rai


    Intramedullary nailing of proximal tibial fractures can be difficult when using the standard entry portal. We evaluated the suprapatellar portal, using a midline quadriceps tendon incision, to perform intramedullary nailing of the tibia. Seven patients were treated with this adaptation of the standard intramedullary nailing procedure. An arthroscopy was done before and after the nailing procedure. No special equipment was used to perform the intramedullary nailing. We evaluated the handling and necessary modifications of the standard intramedullary technique to introduce the locked tibial nail through the suprapatellar approach. We found this technique not necessarily more difficult than the standard intramedullary nailing of the tibia through the infrapatellar entry portal. Although the patients did not complain of patellofemoral discomfort after the suprapatellar nailing, definitive scuffing of the cartilage in the lower part of the femoral trochlea was visible. Introduction of a locked tibial nail via the suprapatellar approach was found to be possible and even advantageous for some complex upper tibial shaft fractures in compromised limbs. Some possible downsides of this approach need to be taken into account but, in some cases, they can be outweighed by the benefits.

  11. A novel intramedullary nail for micromotion stimulation of tibial fractures.

    LENUS (Irish Health Repository)

    Dailey, Hannah L


    BACKGROUND: Animal studies and clinical trials have suggested that early application of controlled axial micromotion can accelerate healing of long bone fractures compared to rigid fixation. However, experimental investigations of micromotion constructs have been limited to external fixators, which have a higher incidence of complications than intramedullary nails. The purpose of this study was to assess whether a novel intramedullary nail design can generate stimulatory micromotion under minimal weight-bearing loads typical of the early healing period. METHODS: Eight cadaver tibiae were reamed, osteotomised, and implanted with commercially-available IM nails fitted with a custom insert that allowed 1mm of axial micromotion after proximal\\/distal interlocking. Specimens were mounted in a materials testing machine and subjected to cyclic axial loading while interfragmentary motion was measured using an extensometer. Implants were also tested in standard statically-locked mode. FINDINGS: The average force required to cause distraction of the fracture gap in micromotion mode was 37.0 (SD 21.7) N. The mean construct stiffness was 1046.8 (SD 193.6) N\\/mm in static locking mode and 512.4 (SD 99.6) N\\/mm in micromotion mode (significantly different, P<0.001). INTERPRETATION: These results support the development of a micromotion-enabled IM nail because the forces required to cause interfragmentary movements are very low, less than the weight of the hanging shank and foot. In contrast to rigid-fixation nails, which require significant weight-bearing to induce interfragmentary motion, the micromotion-enabled nail may allow movement in non-weight-bearing patients during the early healing period when the benefits of mechanical stimulation are most critical.

  12. Primary intramedullary neurocytoma: Case report and literature analysis (United States)

    Montano, Nicola; Di Bonaventura, Rina; Coli, Antonella; Fernandez, Eduardo; Meglio, Mario


    Background: Primary intramedullary neurocytoma is extremely rare. Due to its rarity, it is difficult to collect a wide series in a single institution to perform a survival analysis and give indications about prognosis and treatment. Case Description: Here, we report on a case of a 37-year-old woman with primary intramedullary neurocytoma and perform a systematic statistical analysis of cases reported in the literature. Of 21 articles found, 15 studies and the present case (22 patients) were eligible for the analysis. We studied the impact of age, sex, number of involved levels (≤2 vs. >2), entity of resection, postoperative radiotherapy (RT), proliferation index (Ki67) on the neurological outcome of patients, and on the recurrence of the tumor. Comparison of categorical variables was performed by the χ2 statistic. The Kaplan–Meier curves were plotted to calculate the progression-free survival (PFS) of these patients. P < 0.05 was considered as statistically significant. The 1-year PFS was 95.45% and the 2-year PFS was 86.36%. A gross total resection was associated to a worsening of the neurological function with no impact on the tumor recurrence. Adjuvant RT significantly improved the neurological function. A lower Ki67 was strongly associated with a lower tumor recurrence. Conclusions: We think that the goal of the surgery should be to preserve a good neurological function even if a residual tumor has to be left. Ki67 should be always evaluated due to its impact on the prognosis. Although adjuvant RT significantly improved the neurological function, its role in preventing the tumor recurrence is not clearly defined. PMID:26673057

  13. Treatment of humeral shaft fractures with antegrade intramedullary locking nail. (United States)

    Tsourvakas, Stefanos; Alexandropoulos, Christos; Papachristos, Ioannis; Tsakoumis, Grigorios; Ameridis, Nikolaos


    Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures. Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department. Eight patients were polytraumatized, and four patients had an open fracture. The mean age of patients was 51.7 years. Forty-eight patients had an adequate duration of clinical follow-up (a mean of 18 months) for analysis. Complications were recorded, and the time to union was measured. Shoulder and elbow functions were assessed using the Constant Score and the Morrey Score, respectively. Forty-six fractures healed, with a mean time to clinical union of 10.3 weeks. Two patients developed pseudarthroses. There were four adverse events: two proximal screws backed out, one superficial infection at the insertion point, and one fracture at the distal end of the nail. Ninety-one percentage of patients had an excellent or good shoulder function. Five further operations were necessary: two for treatment of pseudarthroses, two for removal the backed out proximal screws, and one wound debridement for superficial infection. Antegrade humeral nailing is a valid therapeutic option for stabilization of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results is the rule.

  14. Advanced Energy and Water Recovery Technology from Low Grade Waste Heat

    Energy Technology Data Exchange (ETDEWEB)

    Dexin Wang


    The project has developed a nanoporous membrane based water vapor separation technology that can be used for recovering energy and water from low-temperature industrial waste gas streams with high moisture contents. This kind of exhaust stream is widely present in many industrial processes including the forest products and paper industry, food industry, chemical industry, cement industry, metal industry, and petroleum industry. The technology can recover not only the sensible heat but also high-purity water along with its considerable latent heat. Waste heats from such streams are considered very difficult to recover by conventional technology because of poor heat transfer performance of heat-exchanger type equipment at low temperature and moisture-related corrosion issues. During the one-year Concept Definition stage of the project, the goal was to prove the concept and technology in the laboratory and identify any issues that need to be addressed in future development of this technology. In this project, computational modeling and simulation have been conducted to investigate the performance of a nanoporous material based technology, transport membrane condenser (TMC), for waste heat and water recovery from low grade industrial flue gases. A series of theoretical and computational analyses have provided insight and support in advanced TMC design and experiments. Experimental study revealed condensation and convection through the porous membrane bundle was greatly improved over an impermeable tube bundle, because of the membrane capillary condensation mechanism and the continuous evacuation of the condensate film or droplets through the membrane pores. Convection Nusselt number in flue gas side for the porous membrane tube bundle is 50% to 80% higher than those for the impermeable stainless steel tube bundle. The condensation rates for the porous membrane tube bundle also increase 60% to 80%. Parametric study for the porous membrane tube bundle heat transfer

  15. Chronic low-grade inflammation, lipid risk factors and mortality in functionally dependent elderly

    Directory of Open Access Journals (Sweden)

    Vasović Olga


    Full Text Available Background/Aim. It has been proved that a highly sensitive C-reactive protein (hsCRP can be used as an established marker of chronic inflammation for cardiovascular risk assessment. Since mean values of both low-density cholesterol (LDL-C and high-density lipoprotein cholesterol (HDL-C decrease during aging, the knowledge that increased hsCRP concentration predicts mortality (Mt would influence therapy and treatment outcome. The aim of this study was to examine importance of chronic low grade inflammation and its association with lipid risk factors for all-cause Mt in functionally dependent elderly. Methods. The participants of this longitudinal prospective study were 257 functionally dependent elderly aged 65-99 years. Baseline measurements: anthropometric measurements, blood pressure, fasting plasma total cholesterol (TC, triglyceride (TG, HDL-C, LDL-C, non- HDL-C, hemoglobin A1c (HbA1c were recorded and different lipid ratios were calculated. Inflammation was assessed by the levels of white blood cells, fibrinogen and hsCRP. The participants with hsCRP grater than 10 mg/L were excluded from the study. The residual participants (77.4% women were divided into three groups according to their hsCRP levels: a low (< 1 mg/L, n = 70, average (1 to 3 mg/L, n = 69, and high (3-10 mg/L, n = 69 hsCRP group. Associations of all-cause Mt with different risk factors were examined using logistic regression analysis. Results. The hsCRP level showed a significant positive correlation with waist (r = 0.199, p = 0.004 and hip (r = 0.187, p = 0.007 circumferences, body mass index (r = 0.143, p = 0.040 and serum triglyceride level (r = 0.139, p = 0.045 and significant negative correlation with HDL-C (r = -0.164, p = 0.018. Ratios TC/HDL-C and TG/HDL-C were significantly smaller in the low hsCRP group compared to the average hsCRP group (p = 0.019, p = 0.045, respectively and without significant differences compared with the high hsCRP group. Two years after the

  16. Posterior fossa vermian cystic schwannoma mimicking as pilocytic astrocytoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Alok Umredkar


    Full Text Available Intraparenchymal schwannomas are rare and most of the reported cases are in supratentorial region with frontal lobe being most common. Infratentorial location is very rare. We report a posterior fossa midline large cystic schwannoma with mural nodule mimicking as pilocytic astrocytoma. The pathogenesis and neuroradiological findings of intraparenchymal schwannomas are discussed with review of the related literature.

  17. Multicentric Astrocytoma Presenting withSupra- and Infratentorial Involvement: ACase Report

    Directory of Open Access Journals (Sweden)

    Afshin Borhanihaghighi


    Full Text Available This report describes the case of a 56 year-old man with a history of diplopia. Hisbrain imaging showed multiple lesions with a metastatic appearance, however allinvestigations to determine the primary source of malignancy were negative. Thepatient underwent a brain biopsy, which was positive for anaplastic astrocytoma, arare tumor that should be considered in the differential diagnosis of secondary braintumors.

  18. Tuberous sclerosis complex complicated with extraventricular cystic giant cell astrocytoma: case report

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu-zhu; DAI Jian-ping


    @@ Tuberous sclerosis complex (TSC) is one of the most commonly identified neurocutaneous disorders with a prevalence of 1/6000 to 1/9000 in general population1,2 In the patients with TSC, 10%-15% have subependymal giant cell astrocytoma (SGCA) .3

  19. Diffuse spinal leptomeningeal spread of a pilocytic astrocytoma in a 3-year-old child

    Directory of Open Access Journals (Sweden)

    Ameer Alyeldien


    Full Text Available Pilocytic astrocytomas correspond to lowgrade gliomas and therefore metastasize exceedingly rare. However, pilocytic astrocytomas are able to and leptomeningeal dissemination may be seen. What are the treatment options of these cases? We present a case report of a 3-year-old child with a pilocytic astrocytoma of the optic chiasm with leptomeningeal dissemination of the spinal meninges. Partial resection of the cerebral tumor has been performed. Since the leptomeningeal dissemination was seen all over the spinal meninges, the child did not undergo further surgical treatment. A wait and watch strategy were followed. Chemotherapy was initiated, if a 25% tumor growth was seen. Leptomeningeal dissemination of a pilocytic astrocytoma is seen so infrequently that no standard therapy is established. Since these metastases may occur even up to 2 decades after primary tumor resection, long-term follow- up is indicated. In case of spinal metastases, surgical treatment should be performed if feasible. Otherwise observation should be possessed and/or chemotherapy should be initiated.

  20. Impaired tooth root development after treatment of a cerebellar astrocytoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Eckles, T.A.; Kalkwarf, K.L.


    A young man, previously treated by surgical resection of a grade III cerebellar astrocytoma in combination with irradiation and chemotherapy, was found to display severe generalized root agenesis. This patient also exhibited secondary hypothyroidism and decreased levels of growth hormone. These factors are discussed in relation to their possible role in impaired root development.