scholarly journals Anatomical localization of intracranial grade II meningiomas in North-Eastern Romania

2019 ◽  
pp. 232-238
Author(s):  
A. I. Cucu ◽  
Claudia Florida Costea ◽  
Mihaela Dana Turliuc ◽  
Cristina Mihaela Ghiciuc ◽  
B. Costachescu ◽  
...  
Keyword(s):  
Skull Base ◽  
Histopathological Diagnosis ◽  
Chordoid Meningioma ◽  
Female Ratio ◽  
Tumour Localization ◽  
Included Patient ◽  
Male Female Ratio ◽  
Anatomical Localization ◽  
Grade Ii ◽  
Atypical Meningiomas

Objective. Our research aims to assess a possible connection between tumour localization and histological subtypes of grade II meningiomas. Material and methods. 143 patients with grade II WHO meningiomas underwent surgical resection in "Prof. Dr. N. Oblu" Emergency Clinical Hospital Ia?i between 1990 and 2015. The collected data included: patient age, gender, tumour localization and histopathological diagnosis (atypical, clear cells and chordoid meningioma). Results. 135 (94.4%) of all 143 patients with grade II meningiomas were atypical meningiomas, 6 (4.2%) were cell clear meningiomas and only 2 (1.4%) were chordoid meningiomas. As concerns their distribution by gender, 79 (55.2%) were female and 64 (44.8%) were male. Grade II meningiomas were most commonly located at convexity 49.7% (n=71), followed by skull base in 30.8% (n=44) of the cases and parasagittal/falcine in 14.7% (n=21) of the patients. Conclusions. The most common localization of grade II meningiomas was convexity, followed by skull base, parasagittal/falcine and intraventricular areas. We have also noticed that convexity meningiomas are more frequent in women, unlike the other anatomical localizations in which the male-female ratio is almost equal. Therefore, further research is necessary to determine the role of embryological, anatomopathological and genetic factors in underlying the connection between meningioma grade and anatomical localization.

Morphoconstitutional analysis of a series of 166 urinary stones in Western Algeria for a period of two years (2015-2017)

2018 ◽  
Vol 7 (3) ◽  
pp. 107-112
Author(s):  
Bouzana Fatima ◽  
Sbahi Khayra ◽  
Kerroumi Slimane ◽  
Attar Abderahmane ◽  
Seghir Madjhouda Omar ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Sequential Analysis ◽  
Left Kidney ◽  
Urinary Stones ◽  
Female Ratio ◽  
Composition And Structure ◽  
Male Female Ratio ◽  
Anatomical Localization ◽  
Western Algeria ◽  
The Right

A stone is not only an obstacle, sometimes painful, on the urinary tract justifying an emergency urological gesture to restore their permeability. It is primarily a symptom of crystallogenic pathologies or urinary imbalances of nu-tritional origin whose recurrence is the rule if the cause has not been correctly identified. It is therefore recommended in the patient's interest; analyze the calcul or its fragments to determine its composition and structure, one and / or the other orienting towards the pathology in question. A series of 166 urinary stones were collected nearby the hospitals of western Algeria after urological intervention or spontaneous expulsion and sequential analysis of the nucleus at the surface by Fourier transform infrared spectrophotometry. The male / female ratio was 1.78. The study of the anatomical localization of the stones showed a predominance of the high urinary tract with a rate of 76.9%. 27.3% of the stones were located in the left kidney compared to 25.7% in the right kidney. Analysis of the crystalline composition showed that calcium oxalate was predominant in 65.8% of the calculs and in 58.5% of the nuclei. In all, whewellite was present in 46.9% of cases and weddellite in 18.9%. uric acid anhydrous was the major component of 12.2% of the calculations analyzed. It was present in 23.3% of cases with predominance in subjects over 60 years. Our results show that the lithiasis of the urinary tree in western Algeria tends to evolve in the same direction as that of the industri-alized countries.

Adjuvant Radiotherapy in Grade II, Atypical Meningioma of the Skull Base

2021 ◽  
Author(s):  
David P. Bray ◽  
Bryan E. Buster ◽  
Joseph W. Quillin ◽  
Robert H. Press ◽  
Bree R. Eaton ◽  
...  
Keyword(s):  
Skull Base ◽  
Adjuvant Radiotherapy ◽  
Recurrence Rates ◽  
Time To Recurrence ◽  
Grade Ii ◽  
Atypical Meningiomas ◽  
Mean Time ◽  
Two Populations ◽  
Initial Resection

Abstract Introduction Atypical meningiomas (AM) are meningiomas that are more aggressive than their grade-I counterparts and have a higher rate of recurrence. The effect of adjuvant radiotherapy (ART) on AM of the skull base is not defined. Methods A retrospective review of all AM's of the skull base primarily resected at our institution from 1996 to 2018 was completed. ART was defined as radiotherapy (RT) that occurred within 6 months of initial resection, regardless of Simpson's grade. Minimum time length of follow-up after resection was 2 years. Statistical analysis was performed using SAS. Results There were a total of 59 skull base–located (SBL) AMs resected at our institution from 1996 to 2018. The average age of our cohort was 53.2 years. Gross total resection, defined as Simpson's grades I to III resection, was achieved in 36 (61%) of cases. Thirty-five of 59 (59%) patients received ART. Recurrence was observed in 14 patients (24%), and mean time to recurrence was 63.8 months. Patients who received ART had a lower observed rate of recurrence (8 vs. 46%); however, time to recurrence was not significantly different between the two populations. Conclusion We observe that AM in the skull base location have higher recurrence rates than we would expect from grade-I meningioma. These data suggest that ART may offer benefit to the overall observed frequency of recurrence of SBL AM; however, the time to recurrence between patients who received ART and those who did not was not statistically significant in survival analysis.

scholarly journals Endoscopic endonasal surgical management of chondrosarcomas with cerebellopontine angle extension

2014 ◽  
Vol 37 (4) ◽  
pp. E13 ◽  
Author(s):  
Paulo M. Mesquita Filho ◽  
Leo F. S. Ditzel Filho ◽  
Daniel M. Prevedello ◽  
Cristian A. N. Martinez ◽  
Mariano E. Fiore ◽  
...  
Keyword(s):  
Skull Base ◽  
Posterior Fossa ◽  
Cerebellopontine Angle ◽  
Tumor Resection ◽  
Petrous Bone ◽  
Petrous Apex ◽  
Total Resection ◽  
Endoscopic Endonasal ◽  
Female Ratio ◽  
Male Female Ratio

Object Skull base chondrosarcomas are slow-growing, locally invasive tumors that arise from the petroclival synchondrosis. These characteristics allow them to erode the clivus and petrous bone and slowly compress the contents of the posterior fossa progressively until the patient becomes symptomatic, typically from cranial neuropathies. Given the site of their genesis, surrounded by the petrous apex and the clival recess, these tumors can project to the middle fossa, cervical area, and posteriorly, toward the cerebellopontine angle (CPA). Expanded endoscopic endonasal approaches are versatile techniques that grant access to the petroclival synchondrosis, the core of these lesions. The ability to access multiple compartments, remove infiltrated bone, and achieve tumor resection without the need for neural retraction makes these techniques particularly appealing in the management of these complex lesions. Methods Analysis of the authors’ database yielded 19 cases of skull base chondrosarcomas; among these were 5 cases with predominant CPA involvement. The electronic medical records of the 5 patients were retrospectively reviewed for age, sex, presentation, pre- and postoperative imaging, surgical technique, pathology, and follow-up. These cases were used to illustrate the surgical nuances involved in the endonasal resection of CPA chondrosarcomas. Results The male/female ratio was 1:4, and the patients’ mean age was 55.2 ±11.2 years. All cases involved petrous bone and apex, with variable extensions to the posterior fossa and parapharyngeal space. The main clinical scenario was cranial nerve (CN) palsy, evidenced by diplopia (20%), ptosis (20%), CN VI palsy (20%), dysphagia (40%), impaired phonation (40%), hearing loss (20%), tinnitus (20%), and vertigo/dizziness (40%). Gross-total resection of the CPA component of the tumor was achieved in 4 cases (80%); near-total resection of the CPA component was performed in 1 case (20%). Two patients (40%) harbored high-grade chondrosarcomas. No patient experienced worsening neurological symptoms postoperatively. In 2 cases (40%), the symptoms were completely normalized after surgery. Conclusions Expanded endoscopic endonasal approaches appear to be safe and effective in the resection of select skull base chondrosarcomas; those with predominant CPA involvement seem particularly amenable to resection through this technique. Further studies with larger cohorts are necessary to test these preliminary impressions and to compare their effectiveness with the results obtained with open approaches.

scholarly journals Study of glottic lesions in patients undergoing microlaryngeal surgery

2020 ◽  
Vol 6 (2) ◽  
pp. 277
Author(s):  
Vikrant Mittal ◽  
Manish Munjal ◽  
Rohit Verma ◽  
Parth Chopra ◽  
Hemant Chopra
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Detailed Examination ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Histopathological Correlation ◽  
Male Female Ratio ◽  
Male Preponderance ◽  
Vocal Nodules ◽  
Microlaryngeal Surgery

<p class="abstract"><strong>Background:</strong> Vocal cords are the most common site of laryngeal pathologies. Hoarseness is the sentinel symptom for lesions affecting the glottis. The aim of this study was to categorize various types of lesions affecting the glottis in patients undergoing microlaryngeal surgery. Patients’ demographic profile, gender, occupational factors were studied. Clinical, microlaryngeal and histopathological correlation of the lesions was done.</p><p class="abstract"><strong>Methods:</strong> 50 patients with glottic pathologies undergoing microlaryngeal surgery were included. Patients underwent detailed examination including indirect laryngoscopy, flexible fibreoptic laryngoscopy, followed by microscopic laryngeal examination under general anaesthesia. The lesions were excised using standard microlaryngeal instruments and the specimens were subjected to histopathological examination. The data was analysed.  </p><p class="abstract"><strong>Results:</strong> There was male preponderance (male: female ratio of 1.27:1). Housewives formed the largest group (28%). Commonest pathologies were vocal nodules (34%), vocal polyps (22%) and carcinoma (22%). Microlaryngoscopy was found to be the best means of visualizing the lesions and reaching a clinical diagnosis. In 10 (20%) patients, the final histopathological diagnosis was different from clinical diagnosis.</p><p class="abstract"><strong>Conclusions:</strong> In this study, vocal nodules were the commonest lesions to affect the glottis. Microlaryngoscopy proved to be the best method for examination. Also, there was discrepancy in the clinical and histopathological diagnosis in 20% cases.</p>

Paranasal sinus mucoceles with skull-base and/or orbital erosion: Is the endoscopic approach sufficient?

2008 ◽  
Vol 139 (4) ◽  
pp. 570-574 ◽  
Author(s):  
Nathan B. Sautter ◽  
Martin J. Citardi ◽  
Julian Perry ◽  
Pete S. Batra
Keyword(s):  
Skull Base ◽  
Paranasal Sinus ◽  
Chart Review ◽  
Endoscopic Approach ◽  
Endoscopic Drainage ◽  
Female Ratio ◽  
Retrospective Data Analysis ◽  
Male Female Ratio ◽  
Time Of Presentation

Objective The objective of this study was to review the management of paranasal sinus mucoceles with skull-base and/or orbital erosion in the endoscopic era. Study Design A retrospective data analysis. Methods A chart review was performed on 57 patients treated from January 2001 to March 2007. Results The average age at the time of presentation was 50.6 years with a 1:1 male: female ratio. The most common site was the frontal sinus (54.4%), followed by frontoethmoid (29.8%) and sphenoid (8.8%). Areas of erosion included skull base (40.4%), orbit (50.9%), and both orbit and skull base (8.8%). Endoscopic drainage using image guidance was used in all 57 patients without complications. Fifty-six cases (98.2%) had a functionally patent mucocele opening with a median follow-up of 15 months. Conclusions The endoscopic approach can be safely used for the management of mucoceles with skull-base and/or orbital erosion. Open adjunct approaches can be avoided in most cases.

scholarly journals OS6 - 210 Gliomas in Young Adults: Presence of Mutations in Histone Genes

2016 ◽  
Vol 43 (S4) ◽  
pp. S3-S3
Author(s):  
D. G. Munoz ◽  
S. Ryall ◽  
S. Das ◽  
C. Hawkins
Keyword(s):  
Young Adults ◽  
Who Grade ◽  
Female Ratio ◽  
University Of Toronto ◽  
Male Female Ratio ◽  
Genes Encoding ◽  
Droplet Pcr ◽  
Diffuse Gliomas ◽  
Grade Ii ◽  
The University

A point mutation resulting in a specific amino acid change(K27M) in either one of the genes encoding histone H3, H3F3A (H3.3) or HIST1H3B/C/I (H3.1)is present in most pediatric intrinsic pontine gliomas, and has been described in other midline locations. The objective of the present study was to determine the frequency and location of this mutation in diffuse infiltrating gliomas in young adults. The study group consisted of 22 consecutive diffuse gliomas in patients under the age of 40 treated at St. Michael’s Hospital, an adult hospital in the University of Toronto system. Ultra-sensitive digital droplet PCR, a method capable of highly sensitive and specific mutation detection affecting either H3.3 or H3.1, was performed on sample DNA to determine H3K27M status. The H3K27M mutation was detected in the gliomas of five patients, aged 17 to 34 years. The male: female ratio was 3:2. The allele frequency ranged from 26% to 44%, reflecting the infiltrating character of the tumors. Three of the tumors where located in the thalamus, one in the medulla, and one was intraventricular. In terms of grading, one tumor was considered WHO grade II, two III, and two IV. In contrast, most tumors in patients with gliomas lacking the K27M mutation (17 subjects, age 19 to 39 years) were located in the lobes of the cerebral hemispheres, with the following exceptions: 1 in the thalamus, 1 in the hypothalamus, 1 in the cerebellum, and 1 periventricular. WHO grades were 1 II, 9 III, 7 IV. Correlation with patient outcome is ongoing. We conclude that the H3K27M is common in thalamic gliomas in young adult patients, and rare or absent in lobar hemispheric gliomas.

scholarly journals UPPER GASTROINTESTINAL ENDOSCOPIC BIOPSY

2015 ◽  
Vol 22 (12) ◽  
pp. 1574-1579
Author(s):  
Farzana Memon ◽  
Kanwal Baloch ◽  
Ameer Afzal Memon
Keyword(s):  
Endoscopic Biopsy ◽  
Female Ratio ◽  
Upper Gi ◽  
Inflammatory Conditions ◽  
Biopsy Specimens ◽  
Wide Range ◽  
Male Female Ratio ◽  
Upper Gi Endoscopy ◽  
Frequent Site ◽  
Grade Ii

Background: Upper GI endoscopy is an established procedure for investigatinga wide range of upper GI conditions especially inflammatory and malignant diseases ofstomach and esophagus. A good correlation in diagnosis can be achieved by complementingendoscopic findings with histology of biopsy specimens. Aims and objectives: 1) To evaluatemorphological patterns of upper GI conditions. 2) To correlate endoscopic characterization ofupper GI lesions with histopathological assessment of biopsy specimens. Study design: Aretrospective descriptive study. Period: Four year period from January 2010 to December 2013.Setting: Department of Pathology, LUMHS and were histologically assessed. Material andmethods: A total of 433 upper GI endoscopic biopsies were received. Patient’s age, gender andpresenting complaints were noted. Results: Stomach was the most frequent site of endoscopicbiopsy (51.3%) followed by esophagus (39%) and duodenum (9.7%). Majority of patients (51%)presented with dysphagia and abdominal pain. Mean age of presentation was 40 years; agerange, 9-90 years and male: female ratio is 1:1.6. Esophageal malignancy was the commonestneoplastic lesion with squamous cell carcinoma being the dominant histological type.Interestingly, inflammatory conditions were more common in the stomach. In the duodenum,celiac disease was clinically suspected and histopathological grading confirmed the diagnosiswith majority of the cases showing grade-II pathology. Conclusion: This large retrospectiveinstitutional based study showed a good correlation between endoscopic and histologicaldiagnosis. It further shows that esophagus is the predominant site of upper GI malignancy withstrong female predominance. Further studies are needed to identify the underlying risk factors.

scholarly journals OS8.2 Risk stratification in chordoid meningioma depends on mutation status and epithelial differentiation

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii16-iii16
Author(s):  
M M Georgescu ◽  
Y Li ◽  
A Olar ◽  
B Mobley ◽  
P Faust ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Skull Base ◽  
Recurrence Risk ◽  
Epithelial Differentiation ◽  
Chordoid Meningioma ◽  
Who Grade ◽  
Patient Risk ◽  
Grade Ii ◽  
Well Differentiated ◽  
Base Location

Abstract BACKGROUND Meningiomas are heterogenous tumors and their pathologic classification in the WHO Classification of Tumors of the CNS comprises 13 recognized histologic variants. Chordoid meningioma is a rare and more aggressive histologic variant of meningioma. Due to paucity of cases, the molecular profiling and patient risk stratification were not addressed in this variant. MATERIAL AND METHODS We performed an integrated clinical, NHERF1 immunohistochemical (IHC) and next generation sequencing (NGS) analysis of WHO grade II chordoid meningiomas from 30 patients (35 cases), representing the largest study to date. The NGS was performed by using a custom Agilent-generated 295-gene library containing genes with recurrent mutations in adult and pediatric, primary and metastatic brain cancer. Five of these cases cases were confirmed by performing NGS at Tempus on the xT panel containing 596 genes, and an additional 10 atypical (non-chordoid) meningioma, WHO grade II, cases were sequenced at Tempus, for comparison. RESULTS The patients with chordoid meningioma have demographic characteristics different from the general population: younger age of onset (45 vs 65), skull base (SB) location for the female patients (6:1), and increased recurrence rate (25% at 5 years). NHERF1 microlumen extent directly correlated with skull base location (p=0.0002), and segregated tumors into three cell differentiation categories -fibroblastic (13.3%), epithelial/poorly-differentiated (26.7%) and epithelial/well-differentiated (60%). NGS identified NF2 and TRAF7, as the most common mutated genes, correlating with the location and epithelial differentiation of the tumors. Mutations in AKT1, KLF4 and MN1 were found in isolated well-differentiated skull base tumors. Mutations in genes not previously involved in meningioma pathogenesis were also found. CONCLUSION The integrated tumor analysis stratified the patients into: (1) HIGH RECURRENCE RISK , characterized by tumors harboring NF2 mutations and low epithelial differentiation and (2) LOW RECURRENCE RISK , characterized by tumors exhibiting either epithelial differentiation, skull base location and TRAF7/AKT1/KLF4 mutations, or fibroblastic differentiation, non-skull base location and other mutations. This is the first study of the integrated mutational landscape of chordoid meningioma with important implications for patient risk stratification and management.

Suicide in Nógrád County, Hungary, 1970-1994

Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Tamás Zonda
Keyword(s):  
High Risk ◽  
Psychiatric Disorders ◽  
Suicide Rate ◽  
Risk Groups ◽  
The Elderly ◽  
Female Ratio ◽  
Suicide Notes ◽  
Suicidal Intention ◽  
Male Female Ratio

The author examined completed suicides occurring over a period of 25 years in a county of Hungary with a traditionally low (relatively speaking) suicide rate of 25.8. The rates are clearly higher in villages than in the towns. The male/female ratio was close to 4:1, among elderly though only 1.5:1. The high risk groups are the elderly, divorced, and widowed. Violent methods are chosen in 66.4% of the cases. The rates are particularly high in the period April-July. Prior communication of suicidal intention was revealed in 16.3% of all cases. Previous attempts had been undertaken by 17%, which in turn means that 83% of suicides were first attempts. In our material 10% the victims left suicide notes. Psychiatric disorders were present in 60.1% of the cases, and severe, multiple somatic illnesses (including malignomas) were present in 8.8%. The majority of the data resemble those found in the literature.

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