scholarly journals The Diagnostic Value of Brain Magnetic Resonance Imaging in Detecting CNS Diseases Among Advanced AIDS Patients

2014 ◽  
Vol 3 (4) ◽  
pp. 173-178
Author(s):  
Fang Zhao ◽  
Li-qing Sun ◽  
Yi-mei Tian ◽  
Liu-mei Xu ◽  
Pu-xuan Lu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
T Cell ◽  
Statistical Significance ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Aids Patients ◽  
Cns Diseases ◽  
Group A ◽  
Group B

Abstract Objective To investigate the diagnostic value of brain magnetic resonance imaging in detecting central nervous system diseases among AIDS patients of different levels of T cells. Methods Total of 164 AIDS patients who did not receive antiviral treatment were divided into 2 groups according to their baseline CD4+ T cell counts. Group A had CD4+ T cell below or equal to 50 cells/μl (n = 81) and group B had CD4+ T cells over 50 cells/μl (n = 83). All patients underwent brain MRI scan. Imaging analysis and the prevalence of the central nervous system disorders were compared between two groups. Results Among them 48 cases were found of abnormal brain MRI, group A was higher than group B (35.8% vs. 22.9%) although without statistical significance (P = 0.065). Altogether 48 cases were diagnosed as AIDS related central nervous system disorders based on clinical symptoms, signs and laboratory findings. The prevalence of CNS disorders was higher in group A than in group B (41.9% vs. 16.8%) with statistical significance (P < 0.01). Conclusions The patients with CD4+ T cell count less than or equal to 50 cells/μl had high prevalence of CNS diseases. Brain MRI plays an important role in the diagnosis and differentiation of CNS diseases in advanced AIDS patients. This study suggests patients with low CD4+ T cell count (≤ 50/μl) should routinely undergo MRI examination.

Cocktail Therapy Increased the Survival Rate of APL.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 899-899
Author(s):  
Jin Zhou ◽  
Ran Meng ◽  
Limin Li ◽  
Jie Yu ◽  
Baofeng Yang
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Survival Rate ◽  
Arsenic Trioxide ◽  
Trans Retinoic Acid ◽  
All Trans Retinoic Acid ◽  
Group A ◽  
The Central Nervous System ◽  
Group B ◽  
Central Nervous System Infiltration

Abstract Background Arsenic trioxide provides significant benefits in newly diagnosed and relapsed acute promyelocytic leukemia (APL) respectively. However, the high relapsed rate is still threatened the life of APL patients. Which regimen should be used to overcome or reduce the relapse in consolidated treatment is a key problem at present. We performed a pilot study about that. Objective To Compare the effectiveness and security of cocktail therapy with single arsenic trioxide therapy in APL consolidated treatment. Methods Sixty-Five APL patients, who once received arsenic trioxide treatment and obtained complete remission, were enrolled in this study. Patients were divided into two groups according to the different consolidated regimens. After reinforced treated with DA (daunomycin and cytarabine) or HOAP (harringtonine, vincristin, cytarabine and prednisone) for two course, Group A involved twenty cases received single arsenic trioxide consolidated, Group B included forty-five cases treated with the cocktail therapy, alternatively treated with arsenic trioxide, all trans-retinoic acid and chemotherapy (DA or HOAP). The relapse rates, the survival rates and the central nervous system infiltration rates in 3 years followed up were compared. Results The relapsed rate of Group A was 55%, which was higher than that of Group B(17.8%). The re-remission rate after the first relapse in Group A was 22%, which was lower than that of Group B(42.8%). The central nervous system infiltration rate of Group A was 28%, which was higher than that of Group B(6%). The average survival time of Group A was 10.5±4.2months, which was shorter than that of Group B (22.5±5.5 months). The three-year survival rate of Group A was 15%, which was less than that of Group B (65.8%). Conclusions Cocktail therapy —alternatively treated with arsenic trioxide, all trans-retinoic acid and chemotherapy will be the reasonable regimen for APL consolidated treatment. Which provided benefited on inhibiting relapse and central nervous system infiltration of APL.

The effect of nivolumab treatment for central nervous system metastases in non-small cell lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20601-e20601 ◽  
Author(s):  
Hiromi Watanabe ◽  
Toshio Kubo ◽  
Takashi Ninomiya ◽  
Kadoaki Ohashi ◽  
Eiki Ichihara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Group A ◽  
Group B ◽  
Nsclc Patients ◽  
Cns Lesions

e20601 Background: Central nervous system (CNS) metastases (mets) occur in 30% of patients with advanced non-small cell lung cancer (NSCLC) and are associated with poor overall survival (OS). Although nivolumab, a programmed death-1 immune checkpoint inhibitor antibody, has demonstrated a longer survival benefit compared with docetaxel in previously treated NSCLC patients (CheckMate 017 and 057; N Engl J Med, 2015), patients with symptomatic or untreated CNS mets were excluded in these trials. In CheckMate 012 Arm M, 2 of 12 patients (16.7%) with untreated CNS mets showed intracranial responses, but the effect of nivolumab treatment for CNS mets was not fully investigated. Methods: To investigate the effect and safety of nivolumab for CNS mets in NSCLC patients, we retrospectively analyzed 48 patients with NSCLC who were treated with nivolumab from February 2016 to December 2016 at Okayama University Hospital. Results: Twenty-nine patients (60%) had no CNS lesions (group A) and 19 patients (40%) had brain mets (BM) (group B). In group B, 15 patients (79%) received radiotherapy (RT) for BM, including 5 patients who received RT just before nivolumab treatment. The responses of extra-CNS lesions to nivolumab are shown in the table. The PFS was longer in group A than in group B (p=0.14). In group B, the PFS of patients who received prior RT tended to be longer than in those without RT (p=0.42); OS was not reached in either group. In group B, the effects of nivolumab treatment for CNS mets were evaluated in 12 patients: SD occurred in 3 patients (25%), PD in 4 patients (33%), and NE in 5 patients (42%). All 4 patients with PD in the CNS lesion also showed PD in the extra-CNS lesion. In group A, no patients showed progression only in the CNS lesion. Conclusions: In this retrospective study, there were no patients treated only with nivolumab who showed a response to CNS mets. RT prior to nivolumab might be more effective, so future investigations should involve additional cases and prospective studies. [Table: see text]

Characteristic brain magnetic resonance imaging abnormalities in central nervous system aquaporin-4 autoimmunity

2010 ◽  
Vol 16 (10) ◽  
pp. 1229-1236 ◽  
Author(s):  
Woojun Kim ◽  
Min Su Park ◽  
Sang Hyun Lee ◽  
Su-Hyun Kim ◽  
In Ja Jung ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Aquaporin 4 ◽  
Resonance Imaging ◽  
Brain Involvement

Background: Although neuromyelitis optica has been traditionally regarded as a disease without brain involvement, brain abnormalities are not uncommon in patients with neuromyelitis optica-related disorders. Methods: We aimed to characterize the brain magnetic resonance imaging (MRI) abnormalities in neuromyelitis optica spectrum disorder patients who are seropositive for anti-aquaporin-4 autoantibody (AQP4 Ab). Of 236 consecutive patients with inflammatory demyelinating central nervous system diseases, we retrospectively analyzed MRI characteristics of 78 patients who were seropositive for AQP4 Ab. Results: For an average observational period of 6.3 years, 62 patients (79%) had brain lesions on MRI. Twenty-four patients (31%) had brain MRI abnormalities at the onset of disease, and 35 (45%) had symptomatic brain involvement. Characteristic brain MRI abnormalities were classified into five categories: (1) lesions involving corticospinal tracts (e.g. posterior limb of internal capsule and cerebral peduncle (44%); (2) extensive hemispheric lesions likely due to vasogenic edema (29%); (3) periependymal lesions surrounding aqueduct and the third and fourth ventricles (22%); (4) periependymal lesions surrounding lateral ventricles (40%); and (5) medullary lesions, often contiguous with cervical lesions (31%). Fifty-four patients (69%) showed at least one kind of brain abnormality among the five characteristic MRI lesions. Ten patients showed gadolinium-enhancing lesions, which were characterized by multiple patchy enhancing patterns with blurred margins. Conclusions: In central nervous system AQP4 autoimmunity, brain MRI abnormalities were more common than is generally appreciated and were characterized by their unique localization and configuration.

scholarly journals Primary central nervous system T-cell lymphoma in AIDS patients: case report and literature review

2010 ◽  
Vol 17 (5) ◽  
Author(s):  
S. Latta ◽  
Z.W. Myint ◽  
B. Jallad ◽  
T. Hamdi ◽  
M.N. Alhosaini ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
T Cell ◽  
Literature Review ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Aids Patients

scholarly journals A clinical study of 31 individuals with midline facial defects with hypertelorism and a guideline for follow-up

2007 ◽  
Vol 65 (2b) ◽  
pp. 396-401 ◽  
Author(s):  
Vera Lúcia Gil-da-Silva-Lopes ◽  
Andréa Trevas Maciel-Guerra
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Distinct Pattern ◽  
Multiple Congenital Anomalies ◽  
Facial Bones ◽  
Facial Defects ◽  
Group A ◽  
Group B ◽  
Etiologic Diagnosis

In order to contribute to clinical delineation of midline facial defects with hypertelorism (MFDH) and to etiologic diagnosis of the isolated form, 31 patients with MFDH unaffected by known syndromic associations were evaluated. Group A included patients personally examined by the authors, while Group B included those previously evaluated by other geneticists. Among the 14 patients from Group A, there were 7 with distinct pictures of multiple congenital anomalies. In Group B, 5 of the 17 patients also exhibited a distinct pattern of defects. Among isolated MFDH, there was association with anomalies of the skull and facial bones (13/14), otorhinologic (11/16), central nervous system (9/16), and ocular (6/7), and audiologic (3/16); 1/3 of the cases had a relevant gestational intercurrences. Isolated FNM may have involvement of environmental components in some cases; the possibility of a syndromic picture should be extensive investigated. Follow-up of such patients must include the examinations herein performed.

Disseminated nocardiosis involving the central nervous system in the context of newly diagnosed HIV infection: A case report

2021 ◽  
pp. 095646242110009
Author(s):  
Yuan Liu ◽  
Zhiliang Hu ◽  
Hongxia Wei ◽  
Yaling Chen ◽  
Cong Cheng ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Brain Mri ◽  
Lower Lobe ◽  
Brain Magnetic Resonance Imaging ◽  
Diagnosis And Treatment ◽  
Newly Diagnosed ◽  
The Central Nervous System ◽  
Disseminated Nocardiosis

Background: A newly diagnosed HIV patient with tuberculosis-like symptoms was confirmed with disseminated nocardiosis involving the central nervous system (CNS). This case report provides novel insights into the diagnosis and treatment of nocardiosis. Case presentation: A 44-year-old male newly diagnosed HIV patient presented on March 20, 2017, with the major symptoms of fever and headache. Computed tomography (CT) of the chest showed a mass in the lower lobe of the right lung. Brain magnetic resonance imaging (MRI) revealed multiple abnormal signals and ring enhancement. Blood culture suggested the presence of mycobacteria and positive acid-fast staining, and the strain was identified as Nocardia. He was administered an anti-infective therapeutic regimen consisting of cefotaxime sodium and sulbactam sodium (2.25 g, qid, iv), linezolid (0.6 g, bid, iv), moxifloxacin (0.4 g, qd, iv), sulfamethoxazole (1.44 g, qid, per os), and amikacin (0.4 g, qd, iv). After treatment, fever and skin nodules resolved, and reexamination by chest CT and brain MRI suggested improvement compared with the pretreatment situation. Conclusions: At present, there are few reports of disseminated Nocardia infection involving the CNS in HIV patients in China. This case report will help to enhance the understanding of disseminated Nocardia infection. In the process of clinical diagnosis and treatment, Nocardia may be initially misdiagnosed as disseminated TB. In the present case, tuberculosis-like symptoms actually corresponded to disseminated nocardiosis involving the CNS.

scholarly journals ML-01 Pathological characteristics of primary central nervous system lymphoma with atypical radiological finding

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii15-ii15
Author(s):  
Madoka Inukai ◽  
Ichiyo Shibahara ◽  
Hajime Handa ◽  
Wakiko Saruta ◽  
Sumito Sato ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Blood Flow ◽  
Nervous System ◽  
Blood Vessels ◽  
Central Nervous System Lymphoma ◽  
Radiological Findings ◽  
Adc Value ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: If the brain tumor is suspected to be a primary central nervous system lymphoma (PCNSL) on radiological findings, it is general to perform biopsy to obtain the pathological diagnosis. Glioblastomas (GBs) must be distinguished from PCNSLs. In addition to commonly used contrast-enhanced T1-weighted imaging, diffusion-weighted image (DWI), and apparent diffusion coefficient (ADC) value, the following characteristics of PCNSLs were reported to be essential for this purpose: 1) no increase in blood flow on perfusion images obtained by the arterial spin labeling (ASL) method; 2) less microbleeding on T2*-weighted images (T2*). However, we experienced some exceptional cases. Purpose: To clarify the histopathological features of PCNSLs those had atypical radiological findings. Method: 62 consecutive PCNSL cases (40 males, 22 females, mean age 65.4 years, range 35–84) treated in our department from April 2013 to March 2020 were retrospectively analyzed. We compared the following features between 47 biopsy cases showing typical image findings as PCNSLs (Group A) and 15 surgically resected cases with atypical findings (Group B), 1) number of blood vessels per hyper 10 fields, 2) occupying area of blood vessels per unit area, 3) immunoreactivity of vascular endothelial growth factor (VEGF), and 4) germinal center B-cell (GCB) subtype. Results: In Group A, the number of blood vessels in the tumor was 39.3 on average, and the area occupied by blood vessels was 3.8%. In Group B, the former was 133.2, and the latter was 9.9%. There was no significant difference in VEGF expression and GCB subtype. Conclusion: In PCNSLs showing with high blood flow and microbleeds, the blood vessels were rich and partial bleeding was confirmed histologically. We should analyze much more cases to set the threshold both of the ADC value and the absolute value of blood flow calculated by the ASL method to distinguish between PCNSLs and GBs.

scholarly journals ML-07 R-MPV-A THERAPY FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA IN THE ELDERLY: OUTCOME AND PROBLEM

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii33-ii33
Author(s):  
Hirotaka Fudaba ◽  
Yasutomo Momii ◽  
Kouhei Onishi ◽  
Daigo Asou ◽  
Minoru Fujiki
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Partial Response ◽  
Central Nervous System Lymphoma ◽  
Whole Brain Radiotherapy ◽  
Complete Response ◽  
The Other ◽  
Brain Radiotherapy ◽  
Group A ◽  
Group B

Abstract PURPOSE R-MPV-A therapy has recently been reported to improve the outcomes of primary central nervous system lymphoma (PCNSL). Our patients have received R-MPV-A therapy since 2017 and elderly patients have only been treated with whole brain radiotherapy when they do not show a complete response after induction chemotherapy. We report the therapeutic outcomes and problems of elderly PCNSL patients treated with R-PMV-A. MATERIALS & METHODS Eight newly diagnosed PCNSL patients received R-MPV therapy from September 2017 to June 2019. We retrospectively reviewed the cycles of R-MPV therapy, radiotherapy, consolidation high-dose Ara-C (HD-Ara-C) therapy, and the G8 score (a geriatric assessment). RESULTS Patients were divided into three groups: Group A (71–75 years; n=2), Group B (76–80 years; n=4), and Group C (&gt;81 years; n=2). All Group A patients finished 5 cycles of R-MPV therapy, showed a complete response, and underwent consolidation HD-Ara-C therapy. Two Group B patients showed a complete response on R-MPV therapy. One of the other patients showed a partial response after 3 cycles of R-MPV therapy, and a &gt;3 kg reduction in body weight. The patient’s G8 score was 12 points. Whole brain radiotherapy (23.4 Gy) was administered followed by local radiotherapy (21.6 Gy). One patient showed a partial response after 7 cycles of R-MPV therapy and started radiotherapy. One Group C patient received radiotherapy after 3 cycles of R-MPV because of a new lesion. The other Group C patient showed acute renal damage after 3 cycles of R-MPV. CONCLUSION R-MPV-A therapy was relatively safe for our elderly PCNSL patients. Notably, patients &gt;76 years of age sometimes had severe adverse effect with increased R-MPV cycles. A promising therapeutic strategy based on age and geriatric assessment is needed.

Chemotherapy with cisplatin for AFP-secreting germ-cell tumors of the central nervous system

1986 ◽  
Vol 65 (4) ◽  
pp. 470-475 ◽  
Author(s):  
Yoshihisa Kida ◽  
Tatsuya Kobayashi ◽  
Jun Yoshida ◽  
Kyouzou Kato ◽  
Naoki Kageyama
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Germ Cell Tumors ◽  
Pineal Region ◽  
The Other ◽  
Content Type ◽  
Suprasellar Region ◽  
Group A ◽  
The Central Nervous System ◽  
Group B

✓ Therapeutic results in 17 cases of alpha-fetoprotein (AFP)-secreting tumors of the central nervous system are reported. Twelve of the patients were male and five female. The patients' ages ranged from 5 years to 25 years (mean 13.6 years). The tumors originated in the pineal region in 10 cases, in the suprasellar region in four cases, and in both regions in one case; of the other two tumors, one originated in the basal ganglia and one in the sacrococcygeal region. Extraneural metastases or subarachnoid dissemination occurred in seven cases. Increased AFP titer in the serum or cerebrospinal fluid was verified in 13 cases. The patients were divided into two groups: those treated before (Group A) and those treated after (Group B) the introduction in 1980 of cisplatin as a chemotherapeutic agent. All seven Group A patients died, even after extensive therapy consisting of surgery, radiotherapy, and chemotherapy (ACNU or adriamycin) in some of the cases. The mean survival time following diagnosis for Group A was 23.7 months. Six of the 10 Group B patients died an average of 25.8 months after diagnosis; however, the other four were still alive and well an average of 25.3 months after diagnosis. The tumors responded well to chemotherapy consisting of cisplatin either alone or combined with bleomycin and vinblastine. The initial response rate to treatment in Group B was 100% and five cases had a complete remission, verified by computerized tomography or the serum AFP level. Once the tumor recurred, the response to cisplatin was markedly decreased. It is suggested that an effective therapy must still be sought for recurrent tumors.

scholarly journals Microglia Polarization in Heat-Induced Early Neural Injury

2021 ◽  
Author(s):  
lei wang ◽  
zhao jing ◽  
yi zhang
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Early Brain Injury ◽  
Central Nervous System Injury ◽  
Control Group ◽  
Protein Markers ◽  
Microglia Polarization ◽  
Group A ◽  
Group B ◽  
Brain Tissues

Introductionobserve the polarization of microglia in response to heat-induced early nerve injury and to explore its possible mechanism of action.Material and methods18 dogs were divided into control (group A) and experimental groups (group B, C and D) ，Western blot analysis was used to detect the expression of microglia-specific markers CD45, iNOS, Arginase, and CD206 in normal and heat-damaged brain tissues at different time points (1 h, 6 h, 24 h).ResultsCD45 and iNOS were detected in group A. The two protein markers in group B were significantly higher than those in group A (P < 0.05), and in group C were still higher than those in group A (P < 0.05). Arginase and CD206 were also detected in group A. they in group B were higher than those in group A (P < 0.05), and in group C were even higher than those in group A (P < 0.05). Immunofluorescence co-localization of CD45 and Arginase showed significantly increased fluorescence density at 6 h and 24 h after thermal injury (P < 0.001).ConclusionsAfter heat-induced disease, microglia were found active in the brain tissues of dogs. The microglia activated in the early 1-6 h of central nervous system injury were mainly the M1 type, which were then converted to the M2 type after 6 h. The 24 h M2 type was dominant. The relationship between M1/M2 polarization trends and early brain injury in heat-induced disease may be a key to understanding central nervous system injury in heat-induced disease.

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