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Biomedical subjects

D Afra

Publications and source records attributed to D Afra.

At least 37 records · Page 2Linked to original sources

[Simultaneous occurrence of pituitary adenoma and thyrogenic hyperthyroidism].

Subtotal tumour removal had been performed in a 34-year-old female patient for an extensive intra- and suprasellar expansive process. The considerably increased prolactin level did not decrease postoperatively, but normalised only after a three months bromocriptine treatment. The primary hyperthyroidism has been recovering after administering methimazolum. In a second case was reported on a 65-year-old female patient, suffering from rachitic dwarfism, stenosis of the aortic valve and tumour of the hypophysis, causing acromegaly, whose diabetes mellitus of contrainsular type could have been hardly balanced with insulin of a 128-unit-dose daily, and whose hyperthyroidism was due to an autonomous adenoma of the thyroid gland, first I-131 treatment was administered and she got into an euthyroid state. Six weeks following the removal of the acidophilic adenoma of the hypophysis administration of insulin could have been ceased, and the results of her growth hormone became normal. The clinical picture partly corresponds with Troell-Junet's syndrome.

Acromegaly↗

Medulloblastoma: survey of factors possibly influencing the prognosis.

In a series of 310 cases the role of the factors age, sex, location of the tumour (midline or lateral), and medulloblastoma type (classic or desmoplastic) were analysed with regard to the prognosis. The influence of therapy is not considered because of the inhomogeneity of the material and the view nowadays that treatment is insufficient. The occurrence of lateral (or hemispheric) medulloblastomas increases in the group of the 11-15 years old patients. The proportion of the desmoplastic type is greater in adults than in children, but they are distributed almost equally medially and laterally. There seems to be no definite correlation between sex and the survival time. The mean survival time increases with age. With regard to the histological subclassification into children and adults, the mean survival times are nearly identical. The only obvious factor with a decisive influence on the prognosis seems to be the time of appearance of the tumour. Additionally, the data support the conclusion that a desmoplastic medulloblastoma should be considered as a histological variant without clinical relevance.

Adolescent↗

Ependymomas extending into both lateral ventricles: CT-diagnosis and operability.

Two ependymomas in adults, extending into both lateral ventricles have been reported. The final diagnosis was achieved by cranial computed tomography. This was particularly important in the first case while the clinical course and the previous diagnostic methods as angiography and isotope scintigraphy were misleading, suggesting a demyelinating process. This patient died because of a rare complication: intraoperatively evolved extradural, frontobasal hematoma which diagnosed again by CT-scan, but the removal of the hematoma was not performed on due time. In the second case a similar, but larger tumor could be removed successfully after CT diagnosis. The importance of CT-scan in diagnosis and operative decision of intraventricular tumors was emphasized.

Adult↗

Cysts in malignant gliomas. Identification by computerized tomography.

The clinical course, computerized tomography (CT) scans, and postmortem reports for 265 patients treated for malignant brain tumors were reviewed. Forty-one patients underwent reoperation for tumor recurrence and one had needle aspiration as a diagnostic procedure; of these patients, seven (3% of 265 and 17% of 42) were diagnosed as harboring tumor cysts and 10 (25% of 41) as having necrotic tumor centers. The CT scans on the 17 patients harboring tumors with surgically confirmed cysts and necrotic centers were reviewed; criteria for distinguishing between cysts and central necrosis are suggested. The relative benefits of repeated aspiration and surgical therapy for these cystic lesions are discussed.

Astrocytoma↗

Supratentorial recurrences of gliomas. Results of reoperations on astrocytomas and oligodendrogliomas.

On the basis of our previous investigation regarding histological transformation of recurrent astrocytomas and oligodendrogliomas we report the clinical results of reoperations. The present observations deal with 121 cases: grade 1 astrocytomas (45), oligodendrogliomas (12), grade 2 astrocytomas (47), and oligodendrogliomas (17), respectively. In all these a second reoperation was performed in 14 cases. Operative mortality was relatively high, but without significant difference in the two groups of maligancy: 24.5% and 29.6%. Survival times in both groups showed striking individual differences. We achieved post-reoperation survivals exceeding one year in 18 and 14 cases, respectively. The results of second reoperations were generally poor. We find no remarkable differences in survival time following reoperations in primary grade 1 and grade 2 tumours. Similarly, malignant change proved to be not decisive for survival times. On the contrary, most of our patients with unchanged grade 1 astrocytomas, reoperated on after a longer interval, achieved a short second survival only. Prolongation of life expectancy by radiotherapy is doubtful. Irradiation seems to be necessary with malignantly transformed tumours if the patient did not have any treatment before reoperation.

Adolescent↗

[Cytophotometric investigations of the nuclear DNA content in ependymomas and plexuspapillomas (author's transl)].

Report on Feulgen-cytophotometric DNA investigations in 10 ependymomas and 2 plexuspapillomas. All ependymomas represent in their karyograms aneuploidic stem lines. In most of them one observes duplication peaks (G2 cells) as expression of proliferation behaviour. The histological benign ependymomas exhibit stem lines between the hyperdiploid and hypotetraploid values. With increasing malignancy the stem lines are elevated in higher ploidy levels and a reduction of a predominant stem line is recognizable. One of the ependymomas represents a distribution of DNA values like in a "mosaic" tumour. The measurements in the plexuspapillomas in good conformity with the histologic picture reflect the DNA distribution of a benign euploid neoplasm.

Adult↗

Supratentorial recurrences of gliomas. Morphological studies in relation to time intervals with astrocytomas.

We report 137 recurrent supratentorial astrocytomas. The primary tumours diagnosed on the basis of a grading system with three stages were 72 astrocytomas I and 65 astrocytomas II. In the first group 14% of the recurrences were not changed, 55.5% became astrocytomas II, and 30.5% became glioblastomas. In the second group 55.4% were unchanged, and 44.6% became glioblastomas. The postoperative intervals untile reintervention or death were statistically examined. It seems that the recurrence time chielfy depends on the nature of the primary tumour. The transformation of an astrocytoma I to a glioblastoma takes longer than the transformation of an astrocytoma II into a glioblastoma. In about two thirds of all astrocytomas an increase of malignancy is to be expected. From the histological picture it is not possible in an individual case to predict the likelihood or speed of malignant change. With regard to the effect of irradiation the authors conclude that radiotherapy most probably does not produce malignancy.

Adolescent↗

Supratentorial recurrences of gliomas. Morphological studies in relation to time intervals with oligodendrogliomas.

On the basis of a three stage grading system we report 23 stage one recurrent oligodendrogliomas (O 1), and 29 stage two recurrent oligodendrogliomas (O 2). In the O 1 group after the first interval 15 became O 2 and 2 became glioblastomas. Twenty tumours of the O 2 group after the first interval were not changed, three became oligodendroglioma-astrocytomas stage 2, and six became glioblastomas. The time relation for the recurrent phase in the primary O 1 group is calculated as 42 months, and in the primary O 2 group as 22 months, but this is without significance. For the development of malignancy, especially for the change to glioblastoma, a prominent participation by transformed local astrocytes seems to be essential. Postoperative irradiation most probably does not favour malignant change. A prolongation of the expectation of life by radiotherapy is not noticed.

Adolescent↗

Uptake of labeled dianhydrogalactitol into human gliomas and nervous tissue.

The distribution of iv administered 3H-dianhydrogalactitol (DAG) in the plasma, cerebrospinal fluid (CSF), brain, and tumor tissue was studied in 11 patients. DAG entered the CSF and was slowly eliminated, with a half-life of 20 hours. Unchanged DAG accounted for about 6%-30% of the total radioactivity in the CSF. All the tumors accumulated the drug to a higher extent than the intact white matter, except the one meningioma studied. The highest uptake was observed in the relatively benign astrocytic tumors.

Adult↗