scholarly journals Stereotactic Brainstem Biopsy: Technical Aspects with Emphasis on Role of Awake Craniotomy

2020 ◽  
Vol 9 (02) ◽  
pp. 080-084
Author(s):  
Reddy Kanala Ramnadh ◽  
Krishna Yerramneni Vamsi ◽  
Thirumal Yerragunta ◽  
Kumar Vupuloori Arvind ◽  
Varshesh Shah
Keyword(s):  
Stereotactic Biopsy ◽  
Tissue Sample ◽  
Low Grade ◽  
Middle Cerebellar Peduncle ◽  
Brainstem Lesions ◽  
Pediatric Age Group ◽  
Technical Modifications ◽  
Cerebellar Peduncle ◽  
Brainstem Biopsy

Abstract Introduction The role of frame-based stereotactic biopsy in brainstem lesions has been well established in literature. Transfrontal, transtentorial, and transcerebellar routes are used to access various targets within the brainstem. While the transfrontal approach is preferable in midbrain lesions, a transcerebellar approach via the middle cerebellar peduncle forms the shortest possible trajectory for pontine and medullary lesions. Objective Authors to describe the technical nuances of frame-based stereotactic biopsy of lower brainstem lesions to increase the procedural safety and efficacy. Materials and Methods Technical modifications in frame fixation were done to acheive the desired trajectory to the target. In adult cases biopsy was performed with patient awake during the procedure. Results Total of five patients underwent biopsy with the technical modifications. Three patients were adults and two were in pediatric age group. Their age ranged from 12 to 50 years. No complications were encountered. Two of the biopsies showed demyelination and the other three turned out to be low-grade glioma, pilocytic astrocytoma, and lymphoma, respectively. Conclusion Despite obvious inherent risks, the transcerebellar biopsy in semi-sitting position is a well-tolerated and effective method of obtaining a diagnostic tissue sample in brainstem lesions. We have noted that adoption of the technical modifications described in this article has aided in improving the safety and ease of the procedure.

A contralateral, transfrontal, extraventricular approach to stereotactic brainstem biopsy procedures

2005 ◽  
Vol 102 (3) ◽  
pp. 565-570 ◽  
Author(s):  
Eric W. Amundson ◽  
Matthew J. McGirt ◽  
Alessandro Olivi
Keyword(s):  
Stereotactic Biopsy ◽  
Diagnostic Yield ◽  
Intravenous Sedation ◽  
Safe Alternative ◽  
Middle Cerebellar Peduncle ◽  
Operative Morbidity ◽  
Content Type ◽  
Cerebellar Lesions ◽  
Cerebellar Peduncle ◽  
Brainstem Biopsy

✓ The authors report on the technique and results of stereotactic biopsy for intrinsic lateral pontine and medial cerebellar lesions via a contralateral, transfrontal, extraventricular approach. Multiplanar stereotactic magnetic resonance imaging was used to plan an intraparenchymal approach, thus limiting the number of crossed pial surfaces to one and eliminating the need to cross ependymal surfaces. After the administration of a local anesthetic agent with light intravenous sedation, six patients harboring intrinsic lateral pontine lesions underwent biopsies via this intraparenchymal approach with 100% diagnostic yield and no operative morbidity. In comparison to the ipsilateral transfrontal approach, the contralateral approach laterally expands the infratentorial area accessible during biopsy to include the lateral pons and middle cerebellar peduncle. The contralateral, transfrontal, extraventricular approach is a useful, straight-forward and safe alternative to the suboccipital transcerebellar and ipsilateral, transfrontal, transtentorial routes for reaching lesions of the lateral pons and middle cerebellar peduncle.

scholarly journals Stereotactic Transcerebellar Approach to Pontine Lesions through the Middle Cerebellar Peduncle

1999 ◽  
Vol 5 (1) ◽  
pp. 19-25 ◽  
Author(s):  
F. Parker ◽  
M.F. Levesque ◽  
J. Bittoun ◽  
D. Doyon ◽  
M. Tadie
Keyword(s):  
Clinical Outcome ◽  
Mr Studies ◽  
Neurological Deficits ◽  
High Yield ◽  
Low Grade ◽  
High Grade ◽  
Inappropriate Therapy ◽  
Middle Cerebellar Peduncle ◽  
Cerebellar Peduncle ◽  
Pontomedullary Junction

A stereotactic approach to the pons through the middle cerebellar peduncle based on MR studies was used to biopsy 18 patients. The stereotactic coordinates and angles were defined with reference to three orthogonal planes (mid-sagittal, IVth ventricular floor and pontomedullary junction). The pathological diagnoses were in keeping with clinical outcome and comprised five high-grade astrocytomas, three low-grade astrocytomas, two glioblastomas multiforme, two oligodendrogliomas, two primitive neuroectodermic tumours, two lymphomas, one medulloblastoma, and one tuberculosis. This approach provides a high yield of positive histological diagnoses with little morbidity (transient neurological deficits in two cases) and thereby avoids inappropriate therapy.

The Role of Epicardial Adipose Tissue Lymphocytes in Low-Grade Inflammation and Coronary Artery Disease

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 469-P
Author(s):  
MILOS MRAZ ◽  
ANNA CINKAJZLOVA ◽  
ZDENA LACINOVÁ ◽  
JANA KLOUCKOVA ◽  
HELENA KRATOCHVILOVA ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Epicardial Adipose Tissue ◽  
Low Grade ◽  
Artery Disease ◽  
Low Grade Inflammation

scholarly journals Evaluating Targeted Therapies in Ovarian Cancer Metabolism: Novel Role for PCSK9 and Second Generation mTOR Inhibitors

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3727
Author(s):  
Dafne Jacome Sanz ◽  
Juuli Raivola ◽  
Hanna Karvonen ◽  
Mariliina Arjama ◽  
Harlan Barker ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lipid Metabolism ◽  
Cell Survival ◽  
Drug Testing ◽  
Cancer Metabolism ◽  
Ex Vivo ◽  
Specific Inhibitor ◽  
Low Grade ◽  
Serous Ovarian Cancer

Background: Dysregulated lipid metabolism is emerging as a hallmark in several malignancies, including ovarian cancer (OC). Specifically, metastatic OC is highly dependent on lipid-rich omentum. We aimed to investigate the therapeutic value of targeting lipid metabolism in OC. For this purpose, we studied the role of PCSK9, a cholesterol-regulating enzyme, in OC cell survival and its downstream signaling. We also investigated the cytotoxic efficacy of a small library of metabolic (n = 11) and mTOR (n = 10) inhibitors using OC cell lines (n = 8) and ex vivo patient-derived cell cultures (PDCs, n = 5) to identify clinically suitable drug vulnerabilities. Targeting PCSK9 expression with siRNA or PCSK9 specific inhibitor (PF-06446846) impaired OC cell survival. In addition, overexpression of PCSK9 induced robust AKT phosphorylation along with increased expression of ERK1/2 and MEK1/2, suggesting a pro-survival role of PCSK9 in OC cells. Moreover, our drug testing revealed marked differences in cytotoxic responses to drugs targeting metabolic pathways of high-grade serous ovarian cancer (HGSOC) and low-grade serous ovarian cancer (LGSOC) PDCs. Our results show that targeting PCSK9 expression could impair OC cell survival, which warrants further investigation to address the dependency of this cancer on lipogenesis and omental metastasis. Moreover, the differences in metabolic gene expression and drug responses of OC PDCs indicate the existence of a metabolic heterogeneity within OC subtypes, which should be further explored for therapeutic improvements.

scholarly journals Developmentally anomalous cerebellar encephalocele arising within the cerebellopontine angle and extending into the adjacent skull base in a pediatric patient

2021 ◽  
Author(s):  
Forrest A. Hamrick ◽  
Michael Karsy ◽  
Carol S. Bruggers ◽  
Angelica R. Putnam ◽  
Gary L. Hedlund ◽  
...  
Keyword(s):  
Skull Base ◽  
Pediatric Patient ◽  
Cerebellopontine Angle ◽  
Resonance Imaging ◽  
Middle Cerebellar Peduncle ◽  
Cerebellar Tissue ◽  
Cerebellar Peduncle ◽  
Histopathologic Analysis ◽  
The Right ◽  
Internal Acoustic Canal

AbstractLesions of the cerebellopontine angle (CPA) in young children are rare, with the most common being arachnoid cysts and epidermoid inclusion cysts. The authors report a case of an encephalocele containing heterotopic cerebellar tissue arising from the right middle cerebellar peduncle and filling the right internal acoustic canal in a 2-year-old female patient. Her initial presentation included a focal left 6th nerve palsy. Magnetic resonance imaging was suggestive of a high-grade tumor of the right CPA. The lesion was removed via a retrosigmoid approach, and histopathologic analysis revealed heterotopic atrophic cerebellar tissue. This report is the first description of a heterotopic cerebellar encephalocele within the CPA and temporal skull base of a pediatric patient.

scholarly journals Impact of sex in the prevalence and progression of glioblastomas: the role of gonadal steroid hormones

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Claudia Bello-Alvarez ◽  
Ignacio Camacho-Arroyo
Keyword(s):  
Cell Proliferation ◽  
Steroid Hormones ◽  
Physiological State ◽  
Migration And Invasion ◽  
Low Grade ◽  
Main Body ◽  
Protective Effects ◽  
Gonadal Steroid Hormones ◽  
Gonadal Steroid

Abstract Background As in other types of cancers, sex is an essential factor in the origin and progression of glioblastomas. Research in the field of endocrinology and cancer suggests that gonadal steroid hormones play an important role in the progression and prevalence of glioblastomas. In the present review, we aim to discuss the actions and mechanism triggered by gonadal steroid hormones in glioblastomas. Main body Glioblastoma is the most common malignant primary brain tumor. According to the epidemiological data, glioblastomas are more frequent in men than in women in a 1.6/1 proportion both in children and adults. This evidence, and the knowledge about sex influence over the prevalence of countless diseases, suggest that male gonadal steroid hormones, such as testosterone, promote glioblastomas growth. In contrast, a protective role of female gonadal steroid hormones (estradiol and progesterone) against glioblastomas has been questioned. Several pieces of evidence demonstrate a variety of effects induced by female and male gonadal steroid hormones in glioblastomas. Several studies indicate that pregnancy, a physiological state with the highest progesterone and estradiol levels, accelerates the progression of low-grade astrocytomas to glioblastomas and increases the symptoms associated with these tumors. In vitro studies have demonstrated that progesterone has a dual role in glioblastoma cells: physiological concentrations promote cell proliferation, migration, and invasion while very high doses (out physiological range) reduce cell proliferation and increases cell death. Conclusion Gonadal steroid hormones can stimulate the progression of glioblastomas through the increase in proliferation, migration, and invasion. However, the effects mentioned above depend on the concentrations of these hormones and the receptor involved in hormone actions. Estradiol and progesterone can exert promoter or protective effects while the role of testosterone has been always associated to glioblastomas progression.

scholarly journals Inflammatory Mediators and Insulin Resistance in Obesity: Role of Nuclear Receptor Signaling in Macrophages

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Lucía Fuentes ◽  
Tamás Rőszer ◽  
Mercedes Ricote
Keyword(s):  
Insulin Resistance ◽  
Nuclear Receptor ◽  
Cytokine Production ◽  
Current Knowledge ◽  
Liver Steatosis ◽  
Visceral Obesity ◽  
M2 Macrophage ◽  
Low Grade ◽  
The Impact

Visceral obesity is coupled to a general low-grade chronic inflammatory state characterized by macrophage activation and inflammatory cytokine production, leading to insulin resistance (IR). The balance between proinflammatory M1 and antiinflammatory M2 macrophage phenotypes within visceral adipose tissue appears to be crucially involved in the development of obesity-associated IR and consequent metabolic abnormalities. The ligand-dependent transcription factors peroxisome proliferator activated receptors (PPARs) have recently been implicated in the determination of the M1/M2 phenotype. Liver X receptors (LXRs), which form another subgroup of the nuclear receptor superfamily, are also important regulators of proinflammatory cytokine production in macrophages. Disregulation of macrophage-mediated inflammation by PPARs and LXRs therefore underlies the development of IR. This review summarizes the role of PPAR and LXR signaling in macrophages and current knowledge about the impact of these actions in the manifestation of IR and obesity comorbidities such as liver steatosis and diabetic osteopenia.

Sign in / Sign up

Export Citation Format

Share Document