MRS在鉴别颅脑原发性肿瘤及转移瘤中的探讨

目的 探究颅脑原发性肿瘤与转移瘤鉴别中应用磁共振波谱的临床价值。方法 回顾性分析2012年1月~2018年5月在我院接受治疗的颅脑原发性肿瘤患者32例以及颅脑转移瘤患者25例的临床资料,分别记为甲组与乙组,诊断时均行MRS检查,计算并比较两组Cho/Cr、NAA/Cr、Cho/NAA。结果 经MRS诊断,甲组Cho/Cr、Cho/NAA分别为(3.12±1.02)、(3.18±1.05),乙组分别为(1.96±0.53)、(2.03±0.65),甲组高于乙组,差异有统计学意义（P＜0.05）,甲组NAA/Cr为(1.12±0.31),乙组为(1.47±0.37),甲组低于乙组,差异有统计学意义（P＜0.05）。结论 颅脑原发性肿瘤与转移瘤实质区代谢物相对浓度存在较大差异,临床中可使用MRS诊断对其进行鉴别,协助诊断,为治疗提供科学依据。     

磁共振波谱联合MRI常规多参数扫描方案在前列腺癌中的诊断价值

目的 探讨磁共振波谱(MRS)联合磁共振成像常规多参数扫描(MP-MRI)方案在前列腺癌(PCa)中的诊断价值.方法 将104例疑诊PCa患者作为研究对象,均给予MRS联合MP-MRI检查,比较二者诊断价值和Cho/Cit和(Cho+Cre)/Cit水平.结果 病理结果显示,52例为前列腺增生,52例为PCa.MRS联...     

后纤维环T_2弛豫时间与腰椎间盘突出的相关性

目的探讨腰椎间盘后纤维环T2弛豫时间和腰椎间盘突出之间的相关性。方法采用3. 0T磁共振成像系统对54例腰痛研究对象共256个腰椎间盘进行矢状位T2WI和T2mapping扫描,分析扫描图像并根据椎间盘突出或膨出的程度进行分级及分组;正常椎间盘为G1组,存在侧面突出和膨出的椎间盘为G2组,存在正中、中间侧面和旁正中局限性后部突出的椎间盘为G3组。计算各组的Pfirrmann得分,通过后处理计算得到各纤维环、后10%椎间盘(PAF-10)和后20%椎间盘(PAF-20)的T2弛豫时间,进行统计学分析。结果 256个椎间盘中G1组104个(40. 6%),G2组116个(45. 3%),G3组36个(14. 1%),各组Pfirrmann平均得分依次为(2. 16±0. 55)分、(2. 59±0. 71)分、(3. 21±0. 74)分。经过后处理计算,G1组,G2组及G3组椎间盘PAF-10和PAF-20的T2弛豫时间分别为(32. 6±5. 6) ms/(67. 8±12. 3) ms、(34. 2±5. 4) ms/(55. 6±10. 2) ms、(40. 2±7. 2) ms/(46. 9±9. 8) ms。PAF-20的T2值从G1组到G3组逐渐降低,而PAF-10的T2弛豫时间呈现相反的变化趋势,从G1组到G3组逐渐升高。和G2组比较,G3组PAF-10的T2值明显升高,且和髓核的T2弛豫时间无相关性。而G3组PAF-20的T2弛豫时间和髓核之间存在一定的相关性。结论 MR T2mapping能对腰椎间盘T2弛豫时间进行定量评估,且PAF-10的高T2值与椎间盘突出存在明显的相关性。     

HER2状态与脑膜瘤分级及复发的相关性

目的 探讨HER2、细胞增殖指标Ki-67、胸苷激酶1(TK1)与脑膜瘤分级和良性脑膜瘤复发的相关性.方法 按2007年WHO神经系统肿瘤分类分级标准选取良性未复发的脑膜瘤、不典型脑膜瘤及恶性脑膜瘤石蜡标本各20例,并选取间期良性复发的脑膜瘤石蜡标本20例,将实验对象分为4组:良性非复发组、良性复发组、不典型组及恶性组.采用免疫组织化学MaxVision法对4组石蜡切片进行HER2、Ki-67、TK1蛋白的检测;并运用双色荧光原位杂交(FISH)法检测HER2蛋白表达阳性样本的HER2基因扩增情况.结果 免疫组织化学:(1)良性非复发组、良性复发组、不典型组和恶性组脑膜瘤的HER2阳性的例数分别为3例(15%)、6例(30%)、7例(35%)和10例(50%),随恶性程度增加,HER2蛋白阳性率升高(P<0.05);良性复发组HER2阳性率高于良性非复发组(P<0.05);(2)良性非复发组Ki-67和TK1的标记指数(U)均分别低于不典型组和恶性组(P<0.05);不典型组低于恶性组(P<0.05),随着恶性程度增高,Ki-67、TK1 LI升高;且良性复发组高于良性非复发组(P<0.05);(3)HER2与Ki-67、TK1均呈正相关(均P<0.01),Ki-67与TK1呈正相关(P<0.05).FISH法:(1)在26例HER2蛋白阳性表达的脑膜瘤组织中HER2/neu基因的扩增率为26.9%(7/26);HER2蛋白表达3+、2+者HER2/neu基因扩增比例分别为3,/4和4/6,均多于1+者(均P<0.01),3+者与2+者比较差异无统计学意义(P>0.05).(2)26例HER2蛋白阳性表达的脑膜瘤组织中9例存在17号染色体的非整倍性(34.6%),但HER2蛋白表达1+、2+、3+者间17号染色体的非整倍性出现率差异均无统计学意义(均P>0.05).结论 HER2阳性且Ki-67或TK1 LI高提示脑膜瘤恶性程度较高或复发可能性较大.脑膜瘤组织中存在HER2/neu基因的扩增.HER2、Ki-67和TK1蛋白可能可以作为临床判断脑膜瘤生物学行为的参考指标.     

弥散加权成像联合磁共振波谱分析在脑梗死中的应用研究

目的探讨脑梗死弥散加权成像(DWI)和磁共振波谱分析(MRS)的特点和影响因素,及二者对评估脑梗死的临床价值。方法采用Philips Achieva 1.5T双梯度超导磁共振扫描仪,对72例临床疑是脑梗死患者行常规T1WI、T2WI、FLAIR、DWI、MRS检查,在工作站上测定梗死核心区、内缘区、外缘区、周围区和镜像区的ADC值和代谢物Lac、NAA、Cr、Cho、NAA/Cr、Lac/Cr、Lac/NAA值。结果 DWI显示的梗死灶范围较常规MRI像更加准确、清晰;超急性期、急性期、亚急性期和慢性期梗死核心区的Lac/Cr值和Lac/NAA值高于对侧镜像区,ADC值和NAA/Cr值低于对侧镜像区,存在统计学差异(P<0.05);DWI的影响因素有b值、扩散系数、T2穿透效应和各向异性等,MRS的影响因素有磁场均匀性、压水压脂性能、体素、TE与TR、组织代谢物浓度和波谱采集链等。结论 DWI结合MRS能更加全面地评估缺血半暗带,更精确地对脑梗死进行分期和定位。     

质子磁共振波谱分析在颅内病变诊断中的应用

目的:探讨氢质子磁共振波谱(MRS)检查技术在颅内占位性病变诊断中的临床应用价值.方法:对40例经立体定向活检确诊的颅内占位性病变病例行常规MRI检查,同时行MRS检查,并计算病变区Cho/Cr,NAA/Cr,Cho/NAA值,分别依据单纯常规MRI和MRI结合MRS作出术前诊断,最后再与病理结果比较.结果:不同的疾病有不同的波谱特征;与病理诊断比较,常规MRI诊断正确率为37.5% (15/40),而MRI结合MRS诊断正确率为80%(32/40),二者相比差异有统计学意义(P＜0.05).结论:MRS可提供组织生化和代谢方面的信息,可以提供比常规MRI之外更多的信息,对颅内占位性病变的诊断提供帮助.     

3.0T超导型MRI灌注加权成像联合动态增强扫描技术在乳腺早期良恶性病变鉴定中的研究

目的探讨3.0 T超导型MRI灌注加权成像(PWI)联合动态增强扫描(DCE)在乳腺早期良恶性病变鉴定中的价值。方法选择术后经病理确诊为良恶性的乳腺早期病变女性患者61例,年龄24~65岁,平均年龄30.12岁。所有患者均经3.0 T超导型MRI PWI常规T2加权成像(T2WI)和T1加权成像(T1WI)平扫后行三维(3D)动态增强扫描技术,并根据病理结果分为恶性病变和良性病变,对比病变形态学变化、时间-信号强度曲线(TIC)及表观弥散系数(ADC)值,并分析PWI联合DCE对乳腺早期良恶性病变鉴别诊断价值。结果病理结果为恶性病变27例,良性病变34例;DCE-MRI扫描结果为恶性病变患者20例,良性病变患者26例,病变检出率75.41%;PWI扫描结果为恶性病变患者21例,良性病变患者27例,病变检出率78.69%。乳腺早期良性病变形态以类圆形(76.5%)、边缘以光滑(70.6%)为主,乳腺早期恶性病变形态以分叶形(63.0%)、边缘以毛刺征(59.3%)为主;乳腺早期良恶性病变DCE-MRI扫描形态学特征对比,差异有显著统计学意义(χ^2=43.557、37.459,P=0.000、0.000)。乳腺早期良性病变TIC形态以Ⅰ型(61.8%)为主,乳腺早期恶性病变TIC形态以Ⅲ型(77.8%)为主,两者比较,差异有显著统计学意义(χ^2=121.852,P=0.000);22例(81.5%)恶性病变患者ADC值≤1.195×10-3 mm2/s,28例(82.4%)良性病变患者ADC值>1.195×10-3 mm2/s,两者差异有显著统计学意义(χ2=26.148,P=0.000)。二者联合鉴别诊断乳腺早期良恶性病变的灵敏度、特异度及准确度与DCE-MRI、PWI单一诊断更高(P<0.05)。结论 3.0 T超导型MRI PWI联合DCE在乳腺早期良恶性病变鉴定中具有较高的临床价值。     

葡聚糖包裹超顺磁性氧化铁纳米材料用于关节软骨磁共振T2-Map成像研究

本研究制备了粒径(18±2)nm的葡聚糖包裹的超顺磁性氧化铁纳米颗粒,作为磁共振T2造影剂,对兔关节软骨进行增强磁共振T2-Map成像,并分析注射前后24 hT2弛豫时间的变化,发现T2弛豫时间均下降。行组织病理学普鲁士兰染色,发现软骨基质及细胞内均有氧化铁纳米颗粒的存在,说明葡聚糖包裹超顺磁性氧化铁纳米材料可应用于关节软骨磁共振增强成像。     

首发精神分裂症患者脑磁共振质子波谱的对照研究

目的研究首发精神分裂症患者脑磁共振质子波谱(1HMRS)的变化。方法对26例首发精神分裂症患者和12例正常人分别进行MRI常规扫描和1HMRS检查,1HMRS采用定点分辨率波谱序列(TR2000毫秒,TE135毫秒),所测定的代谢产物包括N-乙酰基天门冬氨酸(NAA)、肌酸复合物(Cr)、胆碱复合物(Cho)、肌醇(MI)、乳酸(Lac)、谷氨酸及谷氨酰胺(Glu-Gln)。结果精神分裂症患者前额叶背外侧回中NAA/Cr值和NAA/Cho值显著低于对照组前额叶背外侧回(1.83±0.15/2.42±0.13,t=3.202,P<0.01,2.37±0.16/2.06±0.24,t=2.453,P<0.05);患者组海马区中NAA/Cr值(1.65±0.19)和NAA/Cho值(1.12±0.21)显著低于对照组海马中的NAA/Cr值(1.83±0.27,t=2.532,P<0.05)和NAA/Cho值(1.34±0.12,t=2.641,P<0.05);且NAA/Cr的水平与简明精神障碍评定量表阴性症状总分呈负相关(r=-0.416,P<0.05);而丘脑、颞叶颞横回、枕叶脑区的NAA/Cr和NAA/Cho两组无显著性差异(P>0.05)。结论精神分裂症患者的1HMRS与正常人存在显著差异,提示精神分裂症存在神经元功能的异常,其前额叶背外侧回和海马两处脑区功能低下。     

首发抑郁症患者海马质子磁共振波谱成像研究

目的:探讨首发抑郁症患者海马的磁共振质子波谱(1HMRS)特点.方法:应用1HMRS成像技术检测21例未用药首发抑郁症患者和14例健康志愿者海马N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)3种代谢物,计算NAA/Cr和Cho/Cr比值.结果:首发抑郁症患者组双侧海马NAA/Cr比值低于对照组,差异有统计学意义(右侧:0.88±0.29/1.37±0.51,P=0.004;左侧:0.76±0.33/1.40±0.99,P=0.034);Cho/Cr比值两组间无统计学差异(P＞0.05);双侧海马NAA/Cr和Cho/Cr与抑郁严重度无相关性(P＞0.05).结论:首发抑郁症患者可能存在双侧海马神经元活力和功能下降.     

Role of p53 gene mutation in tumor aggressiveness of intracranial meningiomas.

The mutations that occur in the p53 tumor suppressor gene have been studied in various human malignant tumors. However, little is known about this gene in meningiomas. To investigate the relationship and frequency of p53 gene mutations, the p53 polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and immunohistochemical study were performed on the 41 intracranial meningiomas (21 benign, 11 atypical, and 9 malignant). The higher the p53 protein expression rate, the poorer the histologic grade (9.5%, 72.7%, and 88.9% in benign, atypical and malignant meningioma, respectively) (p=0.000). The p53 protein expression rate was higher in recurrent meningioma (71.4%) than in nonrecurrent meningioma (10.5%) (p=0.002). PCR-SSCP method was performed in positive p53 protein immunoreactivity cases. p53 gene mutation rate was higher in the atypical (62.5%) and malignant (25%) meningiomas than in the benign meningioma (0%) (p=0.232). Also, the rate was higher in recurrent menigioma (20%) than in nonrecurrent meningioma (0%) (o=0.495). Among five to eight exons of the p53 gene, the mutation was observed on exon 7 more frequently. In conclusion, p53 immunoreactivity and p53 gene mutation are closely correlated with histologic grade and histologic atypia of intracranial meningiomas. p53 gene mutation would be considered as a useful marker to detect the progression of intracranial meningiomas.     

Expression of cytokeratin by malignant meningiomas: diagnostic pitfall of cytokeratin to separate malignant meningiomas from metastatic carcinoma.

Based on clinical and histologic features, differentiating metastatic carcinomas from benign or malignant meningiomas usually is not difficult. Occasionally, however, in some patients without a clinical history of carcinoma, malignant meningiomas can morphologically simulate metastatic carcinoma, necessitating an immunohistochemical study for cytokeratin to make a correct diagnosis. However, the utility of immunohistochemical markers to separate malignant meningioma from metastatic carcinoma has not been investigated. The immunoperoxidase method with antigen retrieval was used to characterize the expression of three cytokeratins (AE1/AE3, CAM 5.2, and Pan cytokeratin), EMA, CEA, Ber-EP4, CD 15, and B72.3 in 12 previously diagnosed malignant meningiomas, 20 benign meningiomas, and 20 metastatic carcinomas. Cytokeratin expression was detected in 75% of malignant meningiomas, 0% of benign meningiomas, and 100% of metastatic carcinomas. While epithelial markers of Ber-EP4, CEA, B72.3 and CD-15 were positive in 90, 80, 70 and 65% of the metastatic carcinoma, respectively, they were negative in all 12 malignant meningioma examined. Vimentin immunoreactivity was seen in all benign and malignant meningiomas, and in 20% of metastatic carcinomas. Our results indicated that cytokeratin is not a reliable immunohistochemical marker to separate a malignant meningioma from metastatic carcinoma. A panel of epithelial markers including Ber-EP4, CEA, B72.3 and CD-15, and vimentin may be needed to separate malignant meningioma from metastatic carcinoma. Cytokeratin expression can be a potential pitfall for confusing a malignant meningioma with a metastatic carcinoma.     

Intracellular Na concentration and Rb uptake in proximal convoluted tubule cells and abundance of Na/K-ATPase alpha1-subunit in NHE3-/- mice

Proximal solute and fluid absorption is greatly reduced in mice in which the gene encoding the Na/H exchanger isoform 3 has been ablated (NHE3-/-). To obtain information on the intracellular functional consequences of such selective NHE3 deficiency, Na, Cl and K concentrations and cell Rb uptake were measured using electron microprobe analysis after a 30-s infusion of Rb (an index of basolateral Na/K-ATPase activity) in proximal convoluted tubule (PCT) cells of NHE3-/- and wild-type (NHE3+/+) mice. In addition, the relative abundance of the alpha1-subunit of the Na/K-ATPase in the outer cortex was determined by Western blot analysis. PCT cell Na concentration in NHE3-/- mice was slightly but significantly lower than in NHE3+/+ [13.1+/-0.6 ( n=64) vs. 14.9+/-0.6 ( n=62) mmol/kg wet wt.; means +/-SEM]. The lower intracellular Na concentration was associated with significantly reduced Rb uptake rates [9.7+/-0.6 ( n=59) vs. 14.8+/-0.8 ( n=50) mmol/kg wet wt./30 s], but the abundance of the alpha1-subunit of the Na/K-ATPase was not different between NHE3-/- and NHE3+/+ mice. Intracellular Cl concentration was higher (14.2+/-0.4 vs. 12.8+/-0.4 mmol/kg wet wt.) and K concentration unchanged (122.7+/-2.7 vs. 121.6+/-2.5 mmol/kg wet wt.) in PCT cells in NHE3-/- compared with NHE3+/+ mice. These findings suggest that the elimination of apical NHE3 in PCT cells of NHE3-/- mice reduces apical Na entry and, due to lower cell Na concentrations, Na/K-ATPase activity. The observed changes in intracellular Na concentration did not affect the expression of Na/K-ATPase in the renal cortex of NHE3-/- mice. There were no significant changes of cell Na concentration and Rb uptake in distal convoluted tubule, connecting tubule, principal and intercalated cells.     

Na transport compartment in rabbit urinary bladder

Electron microprobe analysis was used to determine cellular electrolyte concentrations in rabbit urinary bladder. Under control conditions the mean cellular electrolyte concentrations were for Na 11.6±2.0, for K 124.1±15.3, and for Cl 26.0±5.1 mmol/kg wet weight. The dry weight content was 19.0±2.0 g/100 g. Inhibition of the Na/K-pump with ouabain resulted in drastic changes of the cellular element concentrations. Similar changes also occurred when in addition to ouabain the apical side was kept Na-free. In all epithelial layers the Na and Cl concentrations increased by 90 and 30 mmol/kg wet weight, whereas the K concentration and the dry weight content decreased by 90 mmol/kg wet weight and 6 g/100 g wet weight, respectively. With Na-free choline-Ringer's solution on the basal side ouabain led to a decrease in the K concentration by about 60 mmol/kg wet weight while the Na and Cl concentrations remained unchanged. These data indicate that the basolateral membrane is permeable to Na, choline, Cl, and K. Nystatin produced drastic changes in the cellular electrolyte concentrations when Na- or Rb-sulfate Ringer's solutions were present on the apical side. With Na-sulfate Ringer's solution the Na concentration increased by about 25, the Cl concentration by 30 mmol/kg wet weight and the dry weight content decreased by 4.5 g/100 g, respectively. With Rb-Ringer's solution about 20 mmol/kg wet weight of the cellular K was exchanged against Rb. The concentration changes were identical in all epithelial layers supporting the idea that the rabbit urinary bladder represents a functional syncytium with regard to the transepithelial Na transport.     

Choline transport by lung epithelium

The uptake of [3H]choline was investigated using isolated perfused rat lungs and primary cultures of granular pneumocytes isolated by tryptic digestion of rat lungs. Metabolic products were separated from free choline by chloroform:methanol extraction and column chromatography. Tissue-associated [3H]choline increased progressively in the perfused lung, and estimated mean intracellular concentration at 2 h was 12 times the extracellular concentration (5 microM). Choline uptake was inhibited by ventilation with CO and by perfusion with the choline analog, hemicholinium-3 (HC-3). Isolated granular pneumocytes also accumulated choline against a concentration gradient by an energy-dependent process. The concentration for half-maximal uptake, after correction for the diffusion component, was estimated at 18 +/- 4 microM (mean +/- SE; n = 3), and the estimated maximal rate of uptake was 213 +/- 44 pmol/min/microliter cell water. HC-3 inhibited uptake by approximately 50% at a concentration of 10(-4) M. There was no effect on uptake when Na+ in the medium was replaced by Li+ or N-methylglucamine+. These results indicate that granular pneumocytes possess a transport system that results in accumulation of choline against a concentration gradient. The characteristics of uptake indicate that this system is similar to the low affinity choline transport system of other organs.     

Osteopontin predicts the behaviour of atypical meningioma

Lin C‐K, Tsai W‐C, Lin Y‐C & Hueng D‐Y
(2012) Histopathology  60, 320–325
Osteopontin predicts the behaviour of atypical meningioma Aim: Although the World Health Organization (WHO) histological criteria distinguishing benign from atypical and malignant meningioma are clear, discerning benign from atypical meningioma is still somewhat difficult, leading to interobserver diagnostic variability. Osteopontin (OPN) and cortactin play important roles in tumorigenesis, invasion and metastasis of several human cancers. The aim of this study was to evaluate the usefulness of OPN and cortactin immunohistochemistry for distinguishing between benign, atypical and malignant meningioma and predicting their recurrence. Methods and results: Seventy‐five specimens (48 benign, 17 atypical and 10 malignant meningiomas) were investigated immunohistochemically. The mean immunohistochemical scoreimmunohistochemical score ± SE of the mean of both OPN and cortactin were significantly higher in grade II or grade III meningiomas than in grade I meningioma. Discriminant analysis of immunohistochemical OPN expression showed correct classification of 97.7% of WHO grade I meningiomas and 88.2% of WHO grade II meningiomas (95.4% accuracy). However, the same analysis of cortactin expression showed correct classification of 95.8% of WHO grade I meningiomas and only 23.5% of WHO grade II meningiomas (76.9% accuracy). A cut‐off for predicting grades I and II meningioma recurrence was determined for OPN (3.0) but not for cortactin. Finally, logistic regression identified both this cut‐off (P < 0.05) and WHO grade (P < 0.05) as independent risk factors for recurrence. Conclusions: OPN expression is a valuable marker for diagnosis of atypical meningioma and prediction of grades I and II meningioma recurrence.     

Crush preparations of meningiomas: Can grading be accomplished?

Crush preparations (CP) for the diagnosis of meningioma are routinely performed in the frozen section suite when tissue is submitted for intraoperative consultation. The goal of this study was to examine the cytologic features of meningiomas in CP and evaluate if benign meningioma (Grade 1), atypical meningioma (Grade 2), and malignant meningioma (Grade 3) can be diagnosed on CP. All cases of meningioma (1999-2007), which were submitted for frozen section at our institution, were retrospectively reviewed. These cases were examined intraoperatively by frozen section and CP. The final histologic diagnosis was taken as the gold standard. A total of 107 meningiomas cases were reviewed. The cytological features of all these cases were studied, and features such as pleomorphism, hemorrhage, necrosis, mitosis, and presence or absence of nucleoli were recorded. Using the final histopathologic diagnosis as the gold standard, there were 72 (Grade 1), 22 (Grade 2), and 13 (Grade 3) meningioma cases, which were studied. In conclusion, this study reviews the salient cytologic features of Grades 1-3 meningiomas. It demonstrates that it is difficult to separate Grade 1 from Grade-2 meningioma on CP, and last, Grade-3 meningioma can be easily diagnosed on CP.     

A role for chromosome 9p21 deletions in the malignant progression of meningiomas and the prognosis of anaplastic meningiomas

Meningiomas display significant variability in terms of recurrence and survival rates, even within tumor grade. Although several recent modifications of the grading system have improved our ability to predict biologic behavior, additional prognostic markers are needed. Inactivation of the cell cycle regulator, p16 (CDKN2A), has recently been observed in a small subset of atypical and the majority of anaplastic meningiomas. To assess the potential clinical utility of this marker, we performed dual-color FISH on 117 well-characterized archival meningiomas using paired commercial probes to the chromosome 9 centromeric (CEP9) and p16 (9p21) regions. Benign meningiomas (N = 42) were divided into non-recurring versus recurring groups. Atypical meningiomas (N = 52) consisted of proliferative and brain invasive subsets. The 23 anaplastic meningiomas were not further stratified. Deletion of p16 or monosomy 9 was seen in 17% of benign, 52% of atypical, and 74% of anaplastic meningiomas (p < 0.001). No statistically significant differences were found among subsets of benign or subsets of atypical meningioma, though there were more recurrences in those with deletion. Despite potential effects on cell cycle regulation, p16 deletions were not restricted to meningiomas with a high proliferative index. Most importantly, p16 deletion was strongly associated with survival in the anaplastic meningioma cohort, with a risk ratio for death of 6.79 (p = 0.016). Conversely, absence of deletion identified a subset of anaplastic meningioma patients (26%) with prolonged survival. We conclude that chromosome 9p21 deletions are associated with malignant progression of meningiomas and poor prognosis in anaplastic meningiomas.     

Effect of glycogen loading on skeletal muscle cross-sectional area and T2 relaxation time

This study was performed to investigate if glycogen loading of skeletal muscles, by binding water, would effect the cross-sectional area (CSA) and if an altered water content would alter the transverse relaxation time (T2) measured by magnetic resonance imaging (MRI). Five healthy volunteers participated in a programme with 4 days of extremely carbohydrate-restricted meals followed by 4 days of extremely high carbohydrate intake. The CSA and T2 of thigh and calf muscles were related to the intramuscular glycogen content evaluated at days 4 and 8. An increase in glycogen content from 281 to 634 mmol kg(-1) dry wt increased the CSA of the vastus muscles by 3.5% from 78 +/- 11 to 80 +/- 12 cm2 and the thigh circumference by 2.5% from 146 +/- 20 to 150 23 cm2. Calf circumference increased non-significantly by 4% from 78 +/- 15 to 82 +/- 19 cm2. Mono-exponential T2 decreased in m. tibialis anterior from 27.8 +/- 1.2 to 26.9 +/- 1.7 ms, did not change in m. vastus lateralis 26.5 +/- 1.9 ms/26.6 +/- 1.3 ms or in m. gastrocnemius 29.5 +/- 1.0 ms/29.8 +/- 1.9 ms. Glycogen loading increased the signal intensity mainly at different echo times (TE) 15 and 30 ms. The study shows that increased glycogen filling in the muscles increases muscle CSA and that this can be detected by MRI. The signal intensity increased the most at shorter TEs suggesting a more tight intracellular binding of water in glycogen loaded muscles.     

Immunocytochemical study of the cellular immune response in meningiomas.

Twenty four meningiomas (17 benign and seven "atypical" were reacted with a panel of monoclonal antibodies to macrophages, lymphocytes, and HLA DR antigens. All the tumours contained macrophages but these cells were more numerous in the atypical meningiomas. Lymphocytes, almost exclusively of the CD8 subtype, were also present in 70% of benign meningiomas and in all atypical meningiomas and were more abundant in the latter. B lymphocytes were present in minimal numbers in three atypical meningiomas and in one benign meningioma. CD4 positive T lymphocytes were present in small numbers in one benign meningioma and in moderate numbers in one atypical meningioma. HLA DR antigen expression on tumour cells was present in about 60% of both tumour groups. The numbers of macrophages and T and CD8 lymphocytes in meningiomas seem to be related to atypical histological features, and the presence of these cells raises questions about host immune response and the relation of this to prognosis.