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E J Rushing

Publications and source records attributed to E J Rushing.

At least 37 records · Page 2Linked to original sources
PubMed1997

Frequency of unilateral and bilateral mesial temporal sclerosis in primary and secondary epilepsy: a forensic autopsy study.

Controversy exists regarding the pathogenetic relationship of mesial temporal sclerosis (MTS) to epileptogenesis. Some investigators view hippocampal sclerosis as the primary cause of temporal lobe epilepsy, whereas others interpret the changes to be the result of chronic seizure activity. The present autopsy-based study attempts to clarify the etiologic relationship between mesial temporal sclerosis and epilepsy. To investigate the assumption that bilateral MTS is more likely to be the result of chronic seizure activity associated with a seizure focus outside the hippocampus, two subject groups were identified. The first group comprised 43 patients who had no extrahippocampal pathology and were classified as having primary epilepsy. The second group comprised 35 patients who, had identifiable extrahippocampal pathology and were classified as having secondary epilepsy. Fifteen of the 35 cases of secondary epilepsy also had MTS; seven of these were unilateral and eight were bilateral. Of the 43 cases with primary epilepsy, only one had MTS, and it was unilateral. Significantly more cases of primary epilepsy than secondary epilepsy had no MTS (p < 0.001), suggesting that both unilateral and bilateral forms of MTS occur with greater frequency in subjects with seizure foci outside the hippocampus. These results also suggest that unilaterality of MTS does not exclude an extrahippocampal cause.

Adolescent↗
PubMed1997

Expression of telomerase RNA component correlates with the MIB-1 proliferation index in ependymomas.

Although there is general agreement that certain morphologic subtypes of ependymoma are benign, the biologic behavior of other ependymal neoplasms is poorly understood and not clearly related to conventional histopathologic criteria. The absence of universally accepted standards has prompted the search for more objective biologic markers. Telomerase is an RNA-containing enzyme associated with immortality in proliferating stem cells and many tumors. We investigated the proliferative activity of 26 ependymomas as determined by MIB-1 immunolabeling and compared the results with the in situ expression of human telomerase RNA (hTR) and WHO tumor grade. The study included 9 WHO grade I ependymomas (6 subependymomas and 3 myxopapillary ependymomas), 13 WHO grade II ependymomas, and 4 anaplastic (WHO grade III) ependymomas. The proliferation index (PI) and telomerase RNA expression were significantly increased in grade III ependymomas (p < 0.0001 for PI and p = 0.0015 for hTR). In these tumors, the PI and hTR expression were highly correlated (p = 0.0001). Of note, a single case designated grade II showed both increased proliferative activity and the highest hTR expression detected in this series of ependymal neoplasms. Our results suggest that the PI and hTR expression may be important biologic markers, independent of other histopathologic criteria of tumor grade. Future studies examining the correlation of MIB-1 cell kinetics and hTR expression with clinical parameters in selected ependymoma subtypes are needed to determine the prognostic relevance of these markers.

Adolescent↗
PubMed1997

Human telomerase RNA expression and MIB-1 (Ki-67) proliferation index distinguish hemangioblastomas from metastatic renal cell carcinomas.

Hemangioblastomas are low-grade, capillary rich neoplasms of the cerebellum and spinal cord that can occur sporadically or in the setting of Von Hippel-Lindau syndrome. The present study analyzed the utility of proliferation potential in differentiating hemangioblastoma from RCC metastatic to the central nervous system using a MIB-1 (Ki-67) labeling index and assessment of expression of the RNA component of telomerase. Immunohistochemical analysis for epithelial membrane antigen (EMA) and MIB-1 was performed on paraffin-embedded sections of 27 hemangioblastomas and 5 RCC metastatic to the central nervous system. All but one hemangioblastoma demonstrated low or negative MIB-1 immunoreactivity, while 4 of 5 RCC metastases had moderate or high labeling indices. Telomerase RNA expression was assessed in 10 hemangioblastomas and in all 5 metastatic RCC by in Situ hybridization. All 10 hemangioblastomas demonstrated a lack of expression of telomerase RNA, while all 5 metastatic RCCs showed moderate to strong expression. Our results suggest that the MIB-1 labeling index is useful in differentiating hemangioblastoma from metastatic RCC and assessment of telomerase expression can also provide novel information on the difference in growth potential of these tumors.

Adolescent↗
PubMed1997

Congenital central nervous system tumors.

Congenital central nervous system (CNS) tumors are a rare and diverse group of tumors with variable biological behavior depending on location and histology. This review summarizes the published literature and describes the definition, epidemiology, diagnosis and evaluation, and treatment of congenital central nervous system tumors.

Brain Neoplasms↗
PubMed1997

Rosenthal fibers and eosinophilic granular bodies in a classic acoustic schwannoma.

We describe unique features seen in a case of classic acoustic schwannoma. In the central portion of the tumor, abundant Rosenthal fibers and occasional eosinophilic granular bodies were present. Rosenthal fibers are homogeneous eosinophilic structures commonly seen in central nervous system lesions, such as pilocytic astrocytoma, or in the gliotic tissues adjacent to slowly growing neoplasms and some congenital malformations. Eosinophilic granular bodies are also structural markers of slow-growing, well-differentiated neuroglial neoplasms, such as pleomorphic xanthoastrocytoma, ganglion cell tumors, and pilocytic astrocytoma. To the best of our knowledge, however, these two structures have never before been described in schwannomas.

Adult↗
PubMed1996

Mesenchymal chondrosarcoma: a clinicopathologic and flow cytometric study of 13 cases presenting in the central nervous system.

BACKGROUND: Mesenchymal chondrosarcomas arising in the central nervous system are extremely rare. Morphologic features have not been found to correlate reliably with prognosis. METHODS: Eight intracranial and five intraspinal mesenchymal chondrosarcomas were reviewed with regard to location, treatment, and long term follow-up data. The histopathologic and immunohistochemical results, including Ki-67 nuclear staining frequency, were critically reviewed, and deoxyribonucleic acid content was analyzed by flow cytometry. RESULTS: Microscopically, all 13 cases were remarkably similar. Immunoreactivity in the small cell component included vimentin in 100% and cytokeratin and glial fibrillary acidic protein in 25% of cases. S-100 immunoreactivity was noted in the cartilaginous component of 100% of cases, and in rare cells in the small cell component along the interface. Flow cytometry of the eight tumors studied revealed a diploid pattern in six, aneuploidy in two, and a wide range of S-phase fractions (0-36.5%). CONCLUSIONS: Review of the literature and the findings of the current series indicates that mesenchymal chondrosarcomas presenting in the brain and spinal cord pursue a progressive course that correlates most reliably with extent of surgical resection. This limited retrospective study also suggests that survival may be shorter for those patients with a high S-phase fraction and a high Ki-67 staining frequency.

Adolescent↗
PubMed1996

Infrequency of p53 gene mutations in ependymomas.

Ependymomas, which comprise 5% of central nervous system tumors, have not been extensively characterized genetically. The p53 tumor suppressor gene is frequently mutated in human cancer, and is important in the pathogenesis of other central nervous system (CNS) tumors. Chromosomal DNA corresponding to the p53 tumor suppressor gene was amplified by the polymerase chain reaction (PCR) from 31 archival ependymoma specimens. DNA was screened for the presence of p53 mutations by single strand conformational polymorphism (SSCP) analysis; samples with altered mobility were further tested for the presence of mutation by direct DNA sequence analysis. Of the 31 ependymomas tested, one contained a detectable DNA sequence change in the p53 gene. Sequencing revealed a silent mutation in exon 6, at codon 213, which represents a known p53 sequence polymorphism. These finding suggest that in contrast to many other human cancers, p53 mutation is not important in the pathogenesis or progression of ependymomas.

Adolescent↗
PubMed1995

Tumors of pineal parenchymal cells: a correlation of histological features, including nucleolar organizer regions, with survival in 35 cases.

We studied 35 parenchymal neoplasms arising in the pineal gland, including 11 pineoblastomas, 21 pineocytomas, and three mixed pineocytoma-pineoblastomas. Pineoblastomas were most commonly found in children (mean age, 12.6 years). The median postsurgical length of survival for seven patients, including five with remote metastases, with fatal outcome was 24 months. The 21 pineocytomas were found in older individuals (mean age, 26.8 years). Four patients with pineocytoma died; two before surgery and two in the immediate postoperative period. The remaining 17 patients survived for intervals between 6 and 118 months after surgery. Two mixed pineocytoma-pineoblastomas were found in infants who died a few months after biopsy, whereas a third patient, an adult, was alive at 46 months after excision and irradiation. Both pineoblastoma and pineocytoma exhibited variable immunoreactivity to neurofilament proteins, synaptophysin, glial fibrillary acidic protein, S-100 protein, retinal-S antigen, and rhodopsin; the highest percentages of positive cells stained with synaptophysin. Three pineocytomas exhibited ganglionic differentiation and two of them also showed a glial component. Prognosis could not be correlated with the degree of divergent differentiation. Comparison of silver-stained nucleolar organizer region (AgNOR) counts between pineoblastomas and pineocytomas suggests that the former are more actively proliferative than the latter, with mixed pineocytoma-pineoblastoma showing intermediate activity. There was no correlation between AgNOR score and prognosis within the three tumor groups.

Adolescent↗
PubMed1994

Optic pathway glioma infiltrating into somatostatinergic pathways in a young boy with gigantism. Case report.

The authors report gigantism in a 16-month-old boy with an extensive optic pathway glioma infiltrating into somatostatinergic pathways, as revealed by magnetic resonance imaging and immunocytochemical studies. Stereotactic biopsies of areas showing hyperintense signal abnormalities on T2-weighted images in and adjacent to the involved visual pathways provided rarely obtained histological correlation of such areas. The patient received chemotherapy, which resulted in reduction of size and signal intensity of the tumor and stabilization of vision and growth velocity.

Astrocytoma↗
PubMed1993

Cerebellopontine angle masses: radiologic-pathologic correlation.

The cerebellopontine angle cistern is a cerebrospinal fluid-filled space bound by the pons, cerebellum, and petrous temporal bone. Masses in this region are readily identified on cross-sectional images. Differential diagnosis of masses in this region can be simplified by using an algorithmic approach that combines morphologic and enhancement characteristics with established demographic data. Schwannomas are enhancing, round masses, most commonly arising from the vestibular nerve near the porus acusticus and associated with enlargement of the internal auditory canal. Meningiomas are enhancing, oval or hemispheric lesions with a broad attachment to the tentorium or petrous dura mater. Congenital epidermoid inclusion cysts are nonenhancing masses that have undulating margins, molding their shape to conform to the adjacent structures. Aneurysms without significant internal thrombus have prominent flow voids on magnetic resonance images.

Adult↗
PubMed1992

Pineal region masses: differential diagnosis.

Most pineal region masses are malignant germ cell neoplasms that occur in young male patients. The most common is a germinoma, which is a homogeneous mass with signal intensity and attenuation similar to those of gray matter; the mass engulfs a densely calcified pineal gland. Teratomas are multilocular heterogeneous masses containing lipid areas. Other types of pineal region masses include choriocarcinoma, endodermal sinus tumor, and embryonal carcinoma. Pineal parenchymal neoplasms are usually either pineocytomas or pineoblastomas, which may "explode" preexisting pineal calcifications. Unlike the germinomas, they have no sexual predilection and may be seen in patients who are 20 years of age or older. Although the correct histologic diagnosis may be suggested with a careful evaluation of the morphologic features, attenuation, and signal intensity characteristics, very few of these tumors have a truly pathognomonic imaging pattern. Thus, histologic verification is necessary for most pineal region masses that appear to be neoplastic.

Brain Diseases↗
PubMed1982

Precipitins to an aflatoxin-producing strain of Aspergillus flavus in patients with malignancy.

Serum samples from 121 patients in whom malignant disease had been diagnosed, were assayed for precipitins to fungal isolates from leukemia-associated environments. Control sera were from age-, sex-, and race-matched patients with no history of malignant disease. Sera from 36 (30%) malignancy patients and seven (6%) controls yielded a precipitin band to an aflatoxin-producing Aspergillus flavus isolate from a leukemia-associated house (x2 = 222, p less than 0.05%). No significant numbers of precipitins were obtained to either of the other fungal isolates from that and another such house. Although A. fumigatus has frequently been incriminated as a source of infection in patients with malignancy, only 9% of malignancy patients had a precipitin response to it, as did 1.6% of controls. Also, the presence of the precipitins to A. flavus was not connected with past radiation or immunosuppressive therapy. However, among patients with precipitins to A. fumigatus there was a higher death rate in the year following the study. Precipitins to A. flavus may be related to heavy environmental exposure possibly leading to aflatoxin exposure which may contribute to development of malignancy though immunosuppressive effects.

Adolescent↗
PubMedDate not supplied

Suppression of phytohemagglutinin response by fungi from a "leukemia" house.

Fungal isolates from the house of a husband and wife who both developed acute myelomonocytic leukemia were assayed for effects on the in vivo response to phytohemagglutinin in guinea pigs. Skin responses to intradermal phytohemagglutinin were measured following injections of sterile fungal extracts. Isolates of Penicillium canescens, Curvularia, Fusarium sambucinum, Fusarium equiseti and Trichoderma koningii from the leukemia-associated house depressed the responses to phytohemagglutinin, but none of the fungal isolates obtained from a nearby control house depressed responses to phytohemagglutinin. Such environmental agents may contribute to development of malignancy by suppression of immune responses.

Aged↗
PubMedDate not supplied

Problems in the nosology of desmoplastic tumors of childhood.

Several types of central nervous system tumors primarily consisting of a combination of astrocytes and fibrocollagen and occurring most commonly in infancy have been separately introduced as new diagnostic entities. The names applied to these tumors have included 'gliofibroma', 'desmoplastic cerebral astrocytoma', and 'desmoplastic infantile ganglioglioma', a group containing ganglion cells as well as the astrocytes and mesenchymal tissue. We studied a gliofibroma arising in the fourth ventricle of a 6-month-old infant and three examples of desmoplastic cerebral astrocytoma in infants utilizing routine histological and immunocytochemical methods, and at the ultrastructural level in two tumors. In view that the desmoplastic cerebral astrocytomas contain poorly differentiated neuroepithelial cells and rarely, a ganglion cell, we suggest that gliofibroma and desmoplastic astrocytoma are basically the same entity and that the desmoplastic infantile ganglioglioma is a variant containing primitive or mature ganglion cells.

Astrocytes↗
PubMedDate not supplied

Alpha-internexin expression in medulloblastomas and atypical teratoid-rhabdoid tumors.

OBJECTIVE: To determine whether medulloblastomas and atypical teratoid/rhabdoid tumors express alpha-internexin, an intermediate filament protein that is expressed in normal neurons undergoing maturation and differentiation. MATERIALS AND METHODS: 28 medulloblastomas and 5 atypical teratoid/rhabdoid tumors were examined for the immunohistochemical expression of alpha-internexin, as well as the neuronal markers peripherin and synaptophysin, and glial fibrillary acidic protein. RESULTS: Overall, 21 of 28 medulloblastomas (75%) expressed alpha-internexin. More specifically, alpha-internexin expression was observed in 6 of 10 (60%) classic medulloblastomas, 12 of 14 (86%) desmoplastic medulloblastomas, 2 of 3 (67%) nodular medulloblastomas, and in one medullomyoblastoma. Similarly, 4 of 5 (80%) atypical teratoid/rhabdoid tumors expressed alpha-internexin. The extent of staining for alpha-internexin tended to be less than that of synaptophysin for both medulloblastomas (75% vs 93%) and atypical teratoid/rhabdoid tumors (80% vs 100%). In contrast to alpha-internexin, peripherin was expressed in only 4 medulloblastomas and one atypical teratoid/rhabdoid tumor. CONCLUSIONS: Alpha-internexin is expressed in the majority of medulloblastomas and atypical teratoid/rhabdoid tumors, indicating that these primitive tumors usually exhibit neuronal differentiation.

Adolescent↗
PubMedDate not supplied

Neuropathology of the brain and spinal cord in human West Nile virus infection.

OBJECTIVE: To describe the histopathology of the brain and spinal cord in human West Nile virus (WNV) infection. MATERIALS AND METHODS: Single case report, including premortem clinical and laboratory findings, and autopsy. RESULTS: An 83-year-old female presented with acute confusion, high fevers, dysarthria and generalized subjective weakness, with decreased deep tendon reflexes and weakness on physical examination. Electromyography showed evidence of a sensorimotor axonal polyneuropathy of the right-sided extremities. She became ventilator-dependent and died after a 2-week ICU stay, following withdrawal of life support. WNV infection was confirmed premortem by detection of IgM antibodies from serum and CSF and postmortem by RT-PCR from brain tissue. Examination of the brain parenchyma showed scattered microglial aggregates accompanied by perivascular chronic inflammation. The leptomeninges showed focal lymphocytic infiltrates. Examination of the spinal cord showed lymphocytic infiltrates in nerve roots and within the cord proper, with focal microglial nodules and neuronophagia in the ventral horns. Special stains were negative for a demyelinating process. General autopsy revealed only emphysema and atelectasis. CONCLUSIONS: The findings in this case suggest direct viral infection of the spinal cord and nerve roots as the mechanism of the flaccid paralysis often observed in patients infected with WNV. Findings are reviewed in comparison with other reports of neuropathologic findings in human WNV infection.

Aged↗