The electromyogram in obstetric brachial palsy is too optimistic: fiber size or another explanation?
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Brachial Plexus↗
Biomedical subjects
G Blaauw
Publications and source records attributed to G Blaauw.
Progestin receptors in meningiomas. Comparison of cytosolic assays with immunocytochemical identification in cryostat and paraffin sections.
The results are reported of ligand binding and enzyme immunoassays in tumour cytosols, and of immunoperoxidase assays in cryostat and paraffin sections measuring oestrogen (ER) and progestin receptors (PR) in 22 meningiomas and three non-meningioma tumours (two neurinomas and one haemangiopericytoma). With regard to the meningioma tissues, cytochemical immunoperoxidase PR-staining was present in all cryostat sections and in all but one of the paraffin sections. There was a good degree of qualitative accordance between all assay methods; they revealed the picture of "typical" meningioma: high PR and low ER. In this series, immunoperoxidase staining for the detection of PR-receptors, both in cryostat and paraffin sections, rendered encouraging results, thus offering a method for the detection of progestin receptors, which can compete with cytosolic methods.
Adult↗
Oestrogen receptor independent expression of progestin receptors in human meningioma--a review.
Human meningiomas are rich in progestin receptors (PR), which are expressed in this tissue in an oestrogen independent fashion. In the search for an explanation of this observation, the existence of a protein in human meningioma cytosol which is capable of binding to a synthetic oestrogen responsive element (ERE) has been demonstrated. Using reverse transcriptase, PCR mRNA encoding for the wild-type oestrogen receptor (ER) was found. In addition, several splice variants of ER mRNA have been identified in human meningioma tissue, including variants lacking exons 4, 5 and 7. We found the ER delta 4 protein to have no transcriptional activity and the ER delta 7 protein reportedly is dominant negative. These mutants therefore probably are not responsible for the autonomous PR synthesis in human meningioma. The ER delta 5 protein, by contrast, has been reported to have oestrogen independent transcriptional activity and it is tempting to speculate that this protein is similar or identical to the ERE binding protein we have found in human meningioma. The role of wild type ER mRNA is presently unclear. Activation of other signal transduction pathways in meningioma does not lead to an increased PR concentration. The promoter area of the meningioma PR gene should be investigated for the possible sensitivity to other transcription factors.
Base Sequence↗
Proliferating cell nuclear antigen immunostaining and survival in cerebral astrocytoma.
In order to test the prognostic value of a proliferation index in cerebral astrocytoma, proliferating cell nuclear antigen immunostaining was performed on formalin-fixed and paraffin-embedded biopsies of 42 astrocytomas (21 serial stereotactic and 21 open surgical biopsies). Tumours were categorized as having a low (< 50%) or high (> 50%) labelling index. Tumour grading was also carried out. Several clinico-therapeutic factors were recorded. At least 40 months follow-up was available on all surviving patients. Survival estimated by the Kaplan and Meier method was significantly longer in tumours with a low proliferation index than in those with a high one (mean 20.4 months v. 10 months). According to Cox multiple regression analysis, the age of the patient and grading were significantly related to survival, whereas the proliferation index lost its significance.
Adult↗
Late posttraumatic nonvascular pulsating eye.
A patient is reported with unilateral intermittent pulsating eye caused by the combination of an orbital encephalocele and hydrocephalus, thirty four years after a head injury. Treatment of the hydrocephalus resulted in disappearance of the eye pulsations and encephalocele, as well as in improvement of the gait.
Cerebrospinal Fluid Shunts↗
Intracavitary brachytherapy of cystic craniopharyngiomas.
Visual function, endocrinological status, and radiological outcome are reported in 31 patients harboring a cystic craniopharyngioma, who underwent 35 intracavitary brachytherapy procedures with yttrium-90. In 26 of these patients intracavitary brachytherapy was the primary treatment. The follow-up period ranged from 2 to 80 months (41 +/- 22 months, mean +/- standard deviation). Five patients died from tumor-related causes. Endocrine recovery was modest. Prior to brachytherapy, visual acuity was diminished in 38 eyes and field defects were present in 46. Funduscopy before treatment revealed optic atrophy in 47% of the eyes. Visual acuity improved in 29% of the eyes studied, remained stable in 13%, and deteriorated in 58%. Visual field defects improved in 28% of the eyes studied, remained stable in 20%, and deteriorated in 52%. The possible causes for deterioration in visual function are discussed. Complete resolution of 10 cysts was noted. In 12 patients the size of the cyst decreased; however, in three of these patients new cyst formation took place. The cyst size stabilized in six cases and increased in three. Although there is still a substantial degree of visual function deterioration following intracavitary brachytherapy, morbidity is otherwise low, making this treatment modality a reasonable alternative to craniotomy.
Adolescent↗
Computed tomographic determination of coordinates for stereotaxis.
A visual, a computer-assisted and a trigonometric method for obtaining coordinates for stereotaxis are compared. Each method had its own deficiencies and produced comparable results.
Brain Neoplasms↗
Growth hormone secretion patterns in relation to LH and estradiol secretion throughout normal female puberty.
Pulsatile growth hormone secretion patterns were studied in relation to luteinizing hormone and estradiol release in 33 healthy (pre)pubertal girls. Plasma GH was determined every 10 min, plasma LH and E2 every hour. Night-time GH release was always higher than daytime GH release. During daytime, all GH secretion parameters, except for the basal GH level, increased significantly from the prepubertal stage to stage B4 before (m-) the menarche (p = 0.05) and decreased thereafter (p = 0.05). During night-time, mean GH level and the fraction of GH in pulses also tended to increase from stage B1 to stage B4m-. The number of high pulses (greater than 8 micrograms/l) during day and night together tended to increase until stage B4m- and decreased after the menarche (p = 0.05). Height velocity did not correlate with the number of high pulses (Kendall tau = 0.14, p = 0.14). From stage B1 to B4m- high correlations were observed between E2 levels and GH secretion parameters, particularly during the day (tau = 0.59-0.71, p less than or equal to 0.01). The correlations between LH levels and GH secretion were high as well (tau = 0.50-0.81, p less than or equal to 0.01), but equal during day and night. It is concluded that during puberty 1. spontaneous GH release in girls increases 2-3 fold until the menarche and decreases thereafter, primarily as the result of an increasing and decreasing GH pulse amplitude; 2. diurnally increasing estradiol levels correlated with increasing GH secretion.
Adolescent↗
Neuro-ophthalmological assessment for pituitary macroadenomas.
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Adenoma↗
Histogenesis of intracranial haemangiopericytoma and haemangioblastoma. An immunohistochemical study.
An immunohistochemical study was performed on three meningeal haemangiopericytomas and four cerebellar haemangioblastomas (paraffin embedded) in an attempt to elucidate the uncertain histogenesis of these tumours. The tumour cells of all meningeal haemangiopericytomas show no expression of alpha-smooth muscle actin and, thus, no immunohistochemical proof of their true pericytic nature can be obtained. The stromal cells of cerebellar haemangioblastomas show foci of positive staining for S-100 protein, neuron-specific enolase and synaptophysin, thereby clearly indicating their neuroectodermal origin. These results allow the conclusion that the present nomenclature of these tumours is at least arguable and probably incorrect.
Cerebellar Neoplasms↗
Computed tomography-guided and stereotactic techniques in the diagnosis and treatment of cerebral tuberculoma.
The advantages of computed tomography-guided preoperative localization of brain lesions are illustrated in four cases of solitary tuberculoma and in one case of tuberculous abscess of both the cerebrum and the cerebellum. The role of stereotactic diagnostic techniques is emphasized. The clinical presentation and the computed tomography findings in these patients were equivalent to those from glial or metastatic tumors. Synchronous pulmonary tuberculosis was not present in these patients, but in three patients there was metachronous tuberculosis. Tuberculous meningitis had not developed in any of the patients.
Adult↗
Growth hormone secretion patterns in relation to LH and testosterone secretion throughout normal male puberty.
Pulsatile growth hormone secretion patterns were studied in relation to LH and testosterone release in 30 healthy prepubertal boys and 2 adult men. Plasma GH was measured every 10 min, plasma LH and testosterone every hour. Night-time GH secretion parameters were 2-3 times higher than daytime values. During daytime, mean GH level and the fraction of GH in pulses increased from Tanner stage G2 to G4 (p = 0.01); during night-time these parameters increased as well (p less than or equal to 0.1) and decreased from stage G5 to adulthood (p = 0.05). GH pulse number did not increase; the number of high-amplitude (greater than 8 micrograms/l pulses, however, increased from stage G2 to G4 (p = 0.05) during the day. Height velocity correlated with their number of high pulses during day and night (tau = 0.39, p less than 0.003). From stage G2 to G4 significant correlations were observed between nocturnal testosterone levels and GH secretion parameters (tau = 0.53-0.57), in contrast to nocturnal LH levels. It is concluded that during puberty 1. GH secretion increases as a result of an increased pulse amplitude; 2. there is no consistent correlation between GH and LH levels; 3. increasing nocturnal testosterone levels are correlated with the increasing GH secretion; therefore GnRH does not seem to influence GH secretion directly, but an indirect effect via testosterone is more conceivable, and 4. height velocity is correlated with the number of high GH pulses.
Adolescent↗
[Late recurrence of a hemangiopericytoma with lipomatous components].
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Actins↗
[Patients' condition one year following surgery for a lumbosacral radicular syndrome].
In 492 patients with a lumbosacral radicular syndrome caused by a lumbar intervertebral disc herniation or by a stenosis of the lumbar spinal canal, the situation 1 year after a root decompressing operation was compared with the situation before surgery. About 75% of the patients reported satisfactory improvement, while about 10% were not satisfied. The judgement of the physicians is somewhat more favourable: 80% and 5%, respectively. The best results are obtained in patients in whom the preoperative diagnosis of lumbar disc herniation is highly probable; the worst results are obtained in patients undergoing a second operation. Back pain, sometimes serious, persists after surgery in about 50% of the patients. Such persistent back pain occurs most frequently in patients with a lumbar canal stenosis; one-third even mention a postoperative increase in back pain. About 50% of the patients who were on sick leave before operation resumed work afterwards.
Adult↗
[Effect of surgery on neurological involvement caused by a lumbosacral radicular syndrome].
Results of neurological assessment one year after surgical treatment of herniated lumbar intervertebral disc and lumbar stenosis are reported in 443 patients. Follow-up was performed during one year after operation. Preoperatively, surgeons found motor loss more frequently than patients, (28 and 12% respectively) and, postoperatively, motor loss was still present in 25% and 24%, respectively, of these cases. The operation had caused motor loss in 5% and aggravated motor loss in 3%. Sensibility was reported as abnormal one year after surgery by both patients and surgeons in one-third of the cases. Sensory loss, considered by the patient to have been caused or aggravated by the operation, occurred in 15% of the cases and in 12% of these the surgeons agreed. Preoperatively, unilaterally diminished knee and Achilles tendon reflexes were found in 9% and 42% respectively; one year after surgery, these had recovered in 65% and 57%, respectively. Surgery caused or aggravated unilaterally diminished knee or ankle jerks in 3% and 10%, respectively.
Adult↗
[Intracranial tuberculoma, a special space-occupying process].
In four men and in one woman we found an intracranial local tuberculous infection (4 tuberculomas and 1 tuberculous abscess) in the period 1982-1988. Clinical presentation and computer tomography do not allow discrimination of intracranial tuberculomas from other space-occupying lesions. The value of the stereotactic biopsy for the diagnosis is emphasized and some characteristics of this intracranial process are discussed.
Adult↗
Pitfalls in diagnostic stereotactic brain surgery.
Some of the problems and dangers inherent to stereotaxis are discussed in a series of 243 procedures. Neurological deterioration, either due to haemorrhage or to traumatic oedema, was rare. One fatal accident occurred. Infections were not present although the patient's head was not shaved. Provided he can manipulate the proper instruments accurately stereotaxis can nowadays be performed by any surgeon who can make a burr hole and perform simple arithmetic calculations. This procedure can be considered to lie within the scope of any neurosurgeon.
Biopsy↗
Chondroblastoma of the temporal bone.
A chondroblastoma within the temporal bone in a 16-year-old boy is reported. The tumor recurred after intracapsular resection and curettage. After reoperation, radiotherapy was performed. The data from 137 cases of chondroblastoma are summarized.
Adolescent↗