Proton magnetic resonance spectroscopy in childhood brainstem lesions

Background Diagnosis of brainstem lesions in children based on magnetic resonance imaging alone is a challenging problem. Magnetic resonance spectroscopy (MRS) is a noninvasive technique for spatial characterization of biochemical markers in tissues and gives information regarding cell membrane proliferation, neuronal damage, and energy metabolism. Methods We measured the concentrations of biochemical markers in five children with brainstem lesions and evaluated their potential diagnostic significance. Images and spectra were acquired on a 1.5-T imager. The concentrations of N-acetylaspartate, tetramethylamines (e.g., choline), creatine, phosphocreatine, lactate, and lipids were measured within lesions located at the brainstem using Point-resolved spectroscopy sequences. Results Diagnosis based on localized proton spectroscopy included brainstem glioma, brainstem encephalitis, demyelination, dysmyelination secondary to neurofibromatosis type 1 (NF 1), and possible infection or radiation necrosis. In all but one patient, diagnosis was confirmed by biopsy or by clinical follow-up. Conclusions This small sample of patients suggests that MRS is important in the differential diagnosis between proliferative and nonproliferative lesions in patients without neurofibromatosis. Unfortunately, in cases of NF 1, MRS can have a rather misdiagnosis role.     

Turcot syndrome confirmed with molecular analysis

Turcot syndrome is clinically characterized by the occurrence of primary brain tumor and colorectal tumor and has, in previous reports, been shown associated with germline mutations in the genes APC , MLH1 , MHS6 , and PMS2 . To date, only few families have been documented by molecular analysis. We report two new families with Turcot syndrome to illustrate and review its characteristics and facilitate diagnosis. Molecular analysis revealed two germline mutations, one in the MLH1 gene and one in MSH2 . The latter has never been describe in the literature. Personal and familial relevant anamnestic data from patients with glioma might aid in the diagnosis of genetic disorders. The subsequent molecular characterization may contribute to the appropriate care of affected patients and asymptomatic gene carriers.     

^H磁共振波谱在恶性胶质瘤与脑单发转移瘤鉴别诊断中的应用

目的:探讨1H磁共振波谱(1HMRS)鉴别恶性胶质瘤与脑单发转移瘤的价值.材料和方法:选择经病理证实的22例单发脑肿瘤患者(14例脑胶质瘤,8例脑转移瘤)术前行常规和增强MRI扫描及1HMRS.对其中16例患者术后6个月后进行MRI复查.结果:14例脑胶质瘤患者胆碱复合物波高高于脑转移瘤;肿瘤增强区肌醇波高及肿瘤周围区谷氨酸及谷氨酰胺(Glu-n)波高高于脑转移瘤.8例脑转移瘤患者肿瘤增强区Glu-n波高高于脑胶质瘤.术后复查MRI,3例出现复发,1HMRS显示Glu-n及脂质波高显著升高(占18.8%).结论:1HMRS鉴别恶性胶质瘤与脑单发转移瘤有诊断价值,并可对预后判定提供帮助.     

Circumscribed low grade astrocytomas in the dominant opercular and insular region: A pilot study

Summary Intraoperative mapping techniques allow a reliable identification or exclusion of eloquent brain areas and are well tolerated by the patients. In dominant opercular tumours radical surgery can only be achieved without lasting deficits with intraoperative histological examination of the resection line and mapping. If an early post-operative MRI shows residual opercular tumour in non-eloquent areas re-operation is recommended.In large dominant insular or opercular-insular tumours only biopsy is recommended, because only an incomplete removal can be accomplished, because the trial of radical removal carries a high risk of postoperative deficits due to possible vascular damage of the lenticulo-striate arteries or internal capsule. Because subtotal removal of low grade gliomas does not increase the progression free interval, we would not recommend surgery in these cases, as they carry a significant risk of a further deficit.     

Nasal glioma: An immunohistochemical and ultrastructural study

A case of a 14 month old Japanese female infant presenting with nasal glioma Is reported. The tumor had been noticed at the nasal radix since birth and had slowly and progressively enlarged. There was no communication between the tumor and the cranial cavity on radiological examination. The tumor was macroscopically anchored to the nasal septum by a fibrous stalk, and histologically consisted of nests or trabeculae of either polygonal or spindle cells with plump eosinophilic cytoplasm and oval nuclei, separated by vascular-rich connective tissue intermingled with multinu-cleated giant cells. These tumor cells were immunohisto-chemically positive for glial fibrillary acidic protein as well as for S-100 protein and vimentin. An electron microscopic examination revealed collagen fibers and basal lamina between the tumor cells and the fibroblasts. Tumor cells possessed abundant intermediate filaments, which showed occasional Rosenthal fiber-like structures, in their cytoplasm and processes. A few oligodendrocytes and cilia of 9 micro-tubule doublets either with or without 2 central microtubules were also noted. These clinicopathological findings suggested that this tumor was once an encephalo(meningo)cele, which probably degenerated as a result of the loss of intracranial communication and then appeared to be isolated from the intracranial tissue.     

人脑胶质瘤的实验系列研究

1979～1989年,我室建立了人脑胶质瘤的体外和体内模型,在实验肿瘤的生物学、形态学、动力学、遗传学、神经生化,免疫组化、细胞杂交、单抗分子生物学、放射免疫、生物导弹和实验治疗等多方面进行了探索,其中大部分的结果己经或即将发表。本文旨在系统归纳,以利同道检索。     

Migratory, invasive and metastatic capacity of NCAM transfected rat glioma cells

A cDNA encoding a transmembrane 140 kDa isoform of the neural cell adhesion molecule, NCAM, was transfected into the rat glioma cell line BT4Cn. Transfectants with a homogeneously high expression of NCAM-B showed a decreased capacity for penetration of an artificial basement membrane when compared to cells transfected with expression-vector alone or untransfected cells. However, when injected subcutaneously into nude mice, both NCAM expressing cells and control cells produced invasive tumors. Nude mice injected with NCAM positive cells developed tumors with slower growth rates as compared to those induced by NCAM negative cells. This implies that NCAM may not only be involved in adhesive and motile behaviour of glioma cells, but also in their growth regulation.     

外源性p21WAF1/CIP1基因转染对人胶质瘤细胞生长和细胞周期的影响

目的：探讨外源性p21^WAF1／CIP1基因对胶质瘤细胞生长和细胞周期的影响．方法：采用脂质体介导法将p21^WAF1／CIP1基因质粒转导人人胶质瘤细胞系SHG44细胞，然后用电镜、流式细胞仪等技术对细胞形态、生长及细胞周期进行观察。结果：酶切电泳和斑点杂交显示p21^WAF1／CIP1基因成功的转染至SHG44细胞。转染p21^WAF1／CIP1基因的细胞光镜及电镜下可见凋亡产生；生长速度明显慢于亲代细胞，其倍增时间约是对照细胞的二倍；细胞周期发生明显改变，G1期明显增多，S期明显减少．结论：外源性p21^WAF1／CIP1基因对SHG44细胞的生长和细胞周期有明显的抑制作用，并可诱导细胞凋亡产生。