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  1. Article ; Online: Customized polymethylmethacrylate cranioplasty using a low-cost 3-dimensional printed mold

    Bogdanović Ivan / Milisavljević Filip / Miljković Aleksandar / Jovanović Nemanja / Ilić Rosanda

    Srpski Arhiv za Celokupno Lekarstvo, Vol 150, Iss 1-2, Pp 91-

    2022  Volume 95

    Abstract: Introduction. Significant cranial defects result from a decompressive craniectomy following head trauma, malignant brain edema, intracranial hemorrhage, or resection of tumor affected bone. Unrepaired cranial defects are not just a tremendous esthetic ... ...

    Abstract Introduction. Significant cranial defects result from a decompressive craniectomy following head trauma, malignant brain edema, intracranial hemorrhage, or resection of tumor affected bone. Unrepaired cranial defects are not just a tremendous esthetic problem. The underlying brain is unprotected, prone to injury, and this state can lead to the so-called “syndrome of the trephined” with mood instability, headaches, and even a neurological deficit. Currently, there is no widely accepted uniform technique of cranial vault shape restoration. Combining 3D technology with the use of polymethylmethacrylate is a challenging field that can bring good functional and aesthetic results and, in the case of smart design, become efficient, low-cost technology. We offer a possible solution to a problem that would be acceptable in neurosurgical practice. Case outline. We present a 37-year-old male patient with a massive hemicranial defect as a consequence of previous decompressive craniectomy following severe craniocerebral injury the previous year. Together with engineers from the appropriate 3D modeling studio, we have designed a two-part mold by laser printing technology using biocompatible advanced polyamide. We made a customized polymethylmethacrylate graft intraoperatively using this mold and achieved good aesthetic results. Conclusion. Reports of 3D printing assisted cranioplasties are growing, describing different techniques and cost- estimation. We hope to introduce a low-cost and simple method for repairing a skull defect.
    Keywords craniectomy ; cranioplasty ; skull defect ; polymethylmethacrylate ; 3d printing ; Medicine ; R
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Serbian Medical Society
    Document type Article ; Online
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  2. Article ; Online: Neurogenic pulmonary edema in aneurysmal subarachnoid hemorrhage - what is next?

    Nastasovic, Tijana / Lazic, Igor / Stosic, Mila / Ilic, Rosanda / Brzanov, Aleksandra Gavrilovska

    Neurosurgical review

    2023  Volume 46, Issue 1, Page(s) 203

    MeSH term(s) Humans ; Pulmonary Edema/etiology ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/surgery
    Language English
    Publishing date 2023-08-16
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 6907-3
    ISSN 1437-2320 ; 0344-5607
    ISSN (online) 1437-2320
    ISSN 0344-5607
    DOI 10.1007/s10143-023-02115-z
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  3. Article ; Online: A unique case of intracranial collision tumor composed of ganglioglioma WHO gr I and supratentorial ependymoma WHO gr III: case-based literature review.

    Nedeljkovic, Aleksandra / Ilic, Rosanda / Nedeljkovic, Zarko / Milicevic, Mihailo / Raicevic, Savo / Grujicic, Danica

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2023  Volume 39, Issue 9, Page(s) 2407–2411

    Abstract: Purpose: Intracranial collision tumor is a rare entity that represents the coexistence of two histopathological different tumor types in the same area without histological admixture or an intermediate cell population zone. So far, several cases of ... ...

    Abstract Purpose: Intracranial collision tumor is a rare entity that represents the coexistence of two histopathological different tumor types in the same area without histological admixture or an intermediate cell population zone. So far, several cases of collision tumors with ganglioglioma as its component have been reported in the literature, while supratentorial ependymoma has never been reported as a collision tumor component. We are presenting a unique case of collision tumor in patient without previous history of head trauma, neurological surgery, radiotherapy, or phakomatosis.
    Methods and results: A 17-year-old male with no previous history of head trauma, neurological surgery, radiotherapy, or phakomatosis was presented to our clinic with grand mal seizure. Brain magnetic resonance imaging with gadolinium contrast was done revealing a contrast-enhancing lesion of right frontal lobe closely related to dura, surrounded by perifocal edema. The patient underwent a gross total tumor resection. Histological examination revealed collision tumor with two distinct components: ganglioglioma and supratentorial ependymoma.
    Conclusion: To our best knowledge, no previous reports of collision tumor composed of ganglioglioma and supratentorial ependymoma in a single patient have been reported. We believe that this report could significantly contribute to further surgical practice as well as to treatment decision for these types of collision tumors.
    MeSH term(s) Male ; Humans ; Adolescent ; Ganglioglioma/diagnostic imaging ; Ganglioglioma/surgery ; Neurocutaneous Syndromes/complications ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Magnetic Resonance Imaging ; Craniocerebral Trauma/complications ; Ependymoma/diagnostic imaging ; Ependymoma/surgery ; World Health Organization ; Supratentorial Neoplasms/diagnostic imaging ; Supratentorial Neoplasms/surgery
    Language English
    Publishing date 2023-06-17
    Publishing country Germany
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-023-06028-6
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  4. Article ; Online: Ligamentum flavum hypertrophy in a patient with Pott’s disease

    Aleksić Vuk / Ilić Rosanda / Milićević Mihailo / Milisavljević Filip / Joković Miloš

    Srpski Arhiv za Celokupno Lekarstvo, Vol 148, Iss 11-12, Pp 757-

    2020  Volume 760

    Abstract: Introduction. The spine is involved in less than 1% of all tuberculosis (TB) cases, and it is a very dangerous type of skeletal TB as it can be associated with neurologic deficit and even paraplegia due to compression of adjacent neural structures and ... ...

    Abstract Introduction. The spine is involved in less than 1% of all tuberculosis (TB) cases, and it is a very dangerous type of skeletal TB as it can be associated with neurologic deficit and even paraplegia due to compression of adjacent neural structures and significant spinal deformity. The spine TB is one of the most common causes for an angular kyphotic deformity of spine. Patients with kyphosis angle ≥ 60° at dorsolumbar spine are at great risk to develop late onset neurological deficit and paraplegia due to chronic compression and stretching of the spinal cord over bonny ridges. In a small number of cases, other conditions may lead to neurological deficit in patients with long standing angular kyphosis which also alters the treatment strategy that otherwise involves prolonged and mutilant surgery. Case outline. We present a case of a 61-year-old male patient with concomitant 90° dorsolumbar spine kyphosis due to spinal TB and ligamentum flavum hypertrophy which led to spinal canal stenosis with myelopathy, and consequent paraplegia. The patient underwent dorsal decompression with hypertrophic yellow ligament removal after which he recovered to the level of walking. Conclusion. Many authors propose guidelines for treatment of spinal TB, taking into account the stage of the disease, the age of the patient, the angle of kyphosis, and other factors. We find that personalized medical approach is the best approach for each patient.
    Keywords kyphotic deformity ; late onset paraplegia ; tb spine ; spinal canals stenosis ; flavum hypertrophy ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher Serbian Medical Society
    Document type Article ; Online
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  5. Article ; Online: Germline Variants in Cancer Predisposition Genes in Pediatric Patients with Central Nervous System Tumors.

    Jovanović, Aleksa / Tošić, Nataša / Marjanović, Irena / Komazec, Jovana / Zukić, Branka / Nikitović, Marina / Ilić, Rosanda / Grujičić, Danica / Janić, Dragana / Pavlović, Sonja

    International journal of molecular sciences

    2023  Volume 24, Issue 24

    Abstract: Central nervous system (CNS) tumors comprise around 20% of childhood malignancies. Germline variants in cancer predisposition genes (CPGs) are found in approximately 10% of pediatric patients with CNS tumors. This study aimed to characterize variants in ... ...

    Abstract Central nervous system (CNS) tumors comprise around 20% of childhood malignancies. Germline variants in cancer predisposition genes (CPGs) are found in approximately 10% of pediatric patients with CNS tumors. This study aimed to characterize variants in CPGs in pediatric patients with CNS tumors and correlate these findings with clinically relevant data. Genomic DNA was isolated from the peripheral blood of 51 pediatric patients and further analyzed by the next-generation sequencing approach. Bioinformatic analysis was done using an "in-house" gene list panel, which included 144 genes related to pediatric brain tumors, and the gene list panel Neoplasm (HP:0002664). Our study found that 27% of pediatric patients with CNS tumors have a germline variant in some of the known CPGs, like
    MeSH term(s) Humans ; Child ; Genetic Predisposition to Disease ; Germ-Line Mutation ; Central Nervous System Neoplasms/genetics ; Central Nervous System Neoplasms/pathology ; Brain Neoplasms ; Germ Cells/pathology
    Language English
    Publishing date 2023-12-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms242417387
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  6. Article: A potential role of mechano-gated potassium channels in meningioma-related seizures.

    Bogdanović, Ivan / Opačić, Miloš / Baščarević, Vladimir / Raičević, Savo / Ilić, Rosanda / Grujičić, Danica / Spasojević, Ivan / Ristić, Aleksandar J

    Heliyon

    2023  Volume 9, Issue 10, Page(s) e20761

    Abstract: Every third patient with intracranial meningioma develops seizures of poorly understood etiology. Tumor and peritumoral edema may exert mechanical pressure on the cortex that may affect mechano-gated potassium channels - KCNK2 and KCNK4. These channels ... ...

    Abstract Every third patient with intracranial meningioma develops seizures of poorly understood etiology. Tumor and peritumoral edema may exert mechanical pressure on the cortex that may affect mechano-gated potassium channels - KCNK2 and KCNK4. These channels regulate neuron excitability and have been related to seizures in some other conditions. The objective of the present study was to explore a potential relation between the levels of these proteins in tumor tissue and adjacent cortex and seizures development. The study included 19 meningioma patients that presented one or more preoperative seizures and 24 patients with no seizures. Tissue samples were collected in the course of surgical removal of the meningioma. Postoperative seizure freedom was achieved in 11 out of 19 patients. The relative level of KCNK2 in the cortical tissue was lower in patients with preoperative seizures. On the other hand, cortical tissue level of KCNK4 was higher in patients that became seizure-free after the surgery. In addition, relative levels of KCNK4 in the cortical and tumor tissue appear to be lowered by the treatment with anti-seizure medication levetiracetam. These results imply that KCNK2 and KCNK4 may be involved in the development of meningioma-related seizures and may represent promising therapeutic targets.
    Language English
    Publishing date 2023-10-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2023.e20761
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  7. Article ; Online: Total diagnostic interval in children with brain tumours in a middle-income country: national experience from Serbia.

    Jovanović, Aleksa / Ilić, Rosanda / Pudrlja Slović, Marija / Paripović, Lejla / Janić, Dragana / Nikitović, Marina / Grujičić, Danica / Ilić, Vesna

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2023  Volume 39, Issue 11, Page(s) 3169–3177

    Abstract: Purpose: The aim was to evaluate the total diagnostic interval (TDI) and presenting complaints in children with brain tumours in Serbia.: Methods: This study retrospectively analysed 212 children aged 0-18 years newly diagnosed with brain tumours in ... ...

    Abstract Purpose: The aim was to evaluate the total diagnostic interval (TDI) and presenting complaints in children with brain tumours in Serbia.
    Methods: This study retrospectively analysed 212 children aged 0-18 years newly diagnosed with brain tumours in two tertiary centres from mid-March 2015 to mid-March 2020 covering virtually all children with brain tumours in Serbia. TDI was calculated as the difference between the date of diagnosis and the date of symptom onset presented as a median in weeks. This variable has been evaluable for 184 patients.
    Results: Overall TDI was 6 weeks. TDI was significantly longer in patients with low-grade tumours (11 weeks) than in patients with high-grade tumours (4 weeks). Children with the most frequent complaints (headache, nausea/vomiting and gait disturbance) were more likely to be diagnosed sooner. Patients with a single complaint had significantly longer TDI (12.5 weeks) contrasted to patients with multiple complaints (5 weeks).
    Conclusion: TDI with a median of 6 weeks is similar to other developed countries. Our study supports the view that low-grade tumours will present later than high-grade tumours. Children with the commonest complaints and children with multiple complaints were more likely to be diagnosed sooner.
    MeSH term(s) Child ; Humans ; Retrospective Studies ; Serbia/epidemiology ; Brain Neoplasms/diagnosis ; Brain Neoplasms/epidemiology ; Brain Neoplasms/pathology ; Vomiting ; Headache
    Language English
    Publishing date 2023-04-25
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-023-05958-5
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  8. Article ; Online: Factors associated with preoperative and early and late postoperative seizures in patients with supratentorial meningiomas.

    Bogdanovic, Ivan / Ristic, Aleksandar / Ilic, Rosanda / Bascarevic, Vladimir / Bukumiric, Zoran / Miljkovic, Aleksandar / Milisavljevic, Filip / Stepanovic, Aleksandar / Lazic, Igor / Grujicic, Danica

    Epileptic disorders : international epilepsy journal with videotape

    2023  Volume 25, Issue 2, Page(s) 244–254

    Abstract: Objective: Risk factors for epilepsy in meningioma patients are not yet clearly defined, however, seizure freedom is a significant factor for quality of life after surgery.: Methods: We performed a retrospective study of the 333 adult patients who ... ...

    Abstract Objective: Risk factors for epilepsy in meningioma patients are not yet clearly defined, however, seizure freedom is a significant factor for quality of life after surgery.
    Methods: We performed a retrospective study of the 333 adult patients who received surgery for supratentorial meningioma at our center. Various clinical, radiological, and surgical variables were included in the multivariate regression, and the outcomes measured were the occurrence of seizure(s) preoperatively, during the hospitalization, and during the follow-up period.
    Results: A total of 89 (26.7%) patients experienced preoperative seizures, of whom 62.9% were seizure free after the surgery. Of 244 patients without epilepsy before surgery, 11.9% had at least one seizure postoperatively. In total, 63 of our patients (18.9%) experienced seizures after the surgery, of whom 20 had refractory epilepsy. Multivariate analysis identified the following predictors of preoperative seizures: the absence of headache (OR: 0.23, CI: 2.55-8.50), the presence of significant peritumoral edema (OR: 4.35, CI: 2.57-7.35), and younger age (OR: 0.97 per year increase, CI: 0.95-0.99). Factors associated with early postoperative seizures were: younger age (OR: 0.96 per year increase, CI: 0.93-0.99) and the presence of preoperative seizures (OR: 2.73, CI: 1.13-6.57), while the presence of preoperative seizures (OR: 4.73, CI: 2.05-10.92), tumor progression (OR: 5.38, CI: 2.25-12.89), and neurological worsening (OR: 5.21 CI: 1.72-15.81) were significant for late postoperative seizures.
    Significance: Our results from a single-center meningioma cohort confirm, in general, data from some previous studies regarding patients' characteristics for both preoperative and overall postoperative epilepsy. Besides previously described risk factors, younger age was important for preoperative and early postoperative seizures. Epilepsy is common in patients with recurrence of meningioma, but the variables of significance for refractory seizures in these patients require further examination.
    MeSH term(s) Adult ; Humans ; Meningioma/complications ; Meningioma/surgery ; Meningioma/diagnosis ; Retrospective Studies ; Quality of Life ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/diagnosis ; Seizures/complications ; Epilepsy/complications ; Supratentorial Neoplasms/complications ; Supratentorial Neoplasms/surgery ; Supratentorial Neoplasms/diagnosis ; Meningeal Neoplasms/complications ; Meningeal Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2023-05-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2086797-9
    ISSN 1950-6945 ; 1294-9361
    ISSN (online) 1950-6945
    ISSN 1294-9361
    DOI 10.1002/epd2.20021
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  9. Article ; Online: Oncogene-induced senescence in meningiomas-an immunohistochemical study.

    Mijajlović, Vladimir / Miler, Marko / Ilić, Rosanda / Rašić, Dejan / Dunđerović, Duško / Raičević, Savo / Soldatović, Ivan / De Luka, Silvio / Manojlović-Gačić, Emilija

    Journal of neuro-oncology

    2023  Volume 166, Issue 1, Page(s) 143–153

    Abstract: Purpose: Meningiomas are tumours originating from meningothelial cells, the majority belonging to grade 1 according to the World Health Organization classification of the tumours of the Central Nervous System. Factors contributing to the progression to ... ...

    Abstract Purpose: Meningiomas are tumours originating from meningothelial cells, the majority belonging to grade 1 according to the World Health Organization classification of the tumours of the Central Nervous System. Factors contributing to the progression to the higher grades (grades 2 and 3) have not been elucidated yet. Senescence has been proposed as a potential mechanism constraining the malignant transformation of tumours. Senescence-associated beta-galactosidase (SA-β-GAL) and inhibitors of cyclin-dependent kinases p16 and p21 have been suggested as senescence markers.
    Methods: We analysed 318 meningiomas of total 343 (178 grade 1, 133 grade 2 and 7 grade 3). Tissue microarrays were constructed and stained immunohistochemically, using antibodies for SA-β-GAL, p16 and p21.
    Results: The positive correlation of the tumour grade with the expression of p16 (p = 0.016) and SA-β-GAL (p = 0.002) was observed. The expression of p16 and SA-β-GAL was significantly higher in meningiomas grade 2 compared to meningiomas grade 1 (p = 0.006 and p = 0.004, respectively). SA-β-GAL positivity positively correlated with p16 and p21 in the whole cohort. In grade 2 meningiomas, a positive correlation was only between SA-β-GAL and p16. Correlations of senescence markers in meningiomas grade 2 were not present.
    Conclusion: Our findings suggest the senescence activation in meningiomas grade 2 as a potential mechanism for the restraining of tumour growth and give hope for applying of promising senolytic therapy.
    MeSH term(s) Humans ; Meningioma ; Cellular Senescence/physiology ; Oncogenes ; beta-Galactosidase/metabolism ; Central Nervous System/chemistry ; Central Nervous System/metabolism ; Cyclin-Dependent Kinase Inhibitor p16/metabolism ; Meningeal Neoplasms
    Chemical Substances beta-Galactosidase (EC 3.2.1.23) ; Cyclin-Dependent Kinase Inhibitor p16
    Language English
    Publishing date 2023-12-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604875-4
    ISSN 1573-7373 ; 0167-594X
    ISSN (online) 1573-7373
    ISSN 0167-594X
    DOI 10.1007/s11060-023-04532-y
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  10. Article ; Online: The influence of endothelial hyperplasia on pseudoprogression development in patients with glioblastoma

    Petrović Marko / Ilić Rosanda / Milićević Mihailo / Peulić Miodrag / Grujičić Danica

    Srpski Arhiv za Celokupno Lekarstvo, Vol 147, Iss 5-6, Pp 311-

    2019  Volume 315

    Abstract: Introduction/Objective. Pseudoprogression represents an enlarging contrast-enhancing lesion that occurs after chemoradiation and stabilizes with time without any changes in the therapeutic procedure. This phenomenon is highly significant, because it can ... ...

    Abstract Introduction/Objective. Pseudoprogression represents an enlarging contrast-enhancing lesion that occurs after chemoradiation and stabilizes with time without any changes in the therapeutic procedure. This phenomenon is highly significant, because it can have influence on further therapeutic procedures; however, precise criteria for pseudoprogression diagnosis have not yet been defined. The main goal of this study is to examine the endothelial hyperplasia influence on pseudoprogression. Methods. We analyzed a group of 106 patients with glioblastoma who had undergone surgical treatment from 2010–2012, at the Clinic of Neurosurgery, Clinical Center of Serbia, who received Stupp protocol. Pre- and post-treatment imaging was evaluated using RANO criteria. Lesions that improved or stabilized were defined as pseudoprogression, and lesions that progressed were defined as true progression. Endothelial hyperplasia was identified based on the hematoxylin and eosin pathohistological examination. Results. Thirty-two (30.2%) of the patients were diagnosed with pseudoprogression. Endothelial hyperplasia was observed in 51 (48.1%) of glioblastoma tissue samples, and 28 (87.5%) of all the patients with pseudoprogression were found to have endothelial hyperplasia. The group of 51 (68.9%) patients without pseudoprogression did not show the presence of endothelial hyperplasia. Statistical analysis showed significantly higher incidence of pseudoprogression in patients with endothelial hyperplasia. (χ2 = 26.269, p < 0.01) Conclusion. Taking into account that there are no precise diagnostic methods that could determine the presence of endothelial hyperplasia with certainty, it could be an indicator, as a pathohistological entity, of a higher likelihood of pseudoprogression, which could be used in everyday clinical practice. In order to reach definite conclusions, we believe it is necessary to conduct prospective controlled studies with larger sample sizes.
    Keywords glioblastoma ; endothelial hyperplasia ; pseudoprogression ; Medicine ; R
    Subject code 610 ; 616
    Language English
    Publishing date 2019-01-01T00:00:00Z
    Publisher Serbian Medical Society
    Document type Article ; Online
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