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[Ultrastructure of brain tumor].

Ultrastructure of 15 brain tumors (6 astrocytomas, 5 meningiomas, 2 medulloblastomas and 2 Schwannomas) was observed by transmission electron microscope. In astrocytoma, both the fibrous and protoplasmic astrocytes were found. There were abundant capillaries among the tumor cells. The glia limitans outside the base membrane of certain capillaries were destroyed to different degrees. It indicates that the blood brain barrier may be damaged. Ultrastructurally, medulloblastoma cells may be divided into types I and II. The former was poorly differentiated but the latter was differentiated differently. Meningioma was similar to Schwannoma with complex cell membrane projections. The former had a lot of round mitochondria and filaments in the projections, between which desmosomes were observed. Schwannoma had the typical collagenous fibers among the projections. As to the epithelioid ultrastructure of meningioma, the authors speculate that the majority of meningiomas originate from the mesothelial cells of the arachnoid granulations.

Astrocytoma↗

Brain tumors in children. III. Advances in chemotherapy.

In parts I and II of this article, we touched on some of the newer innovative therapeutic approaches that are presently being evaluated in brain tumors in children, such as monoclonal antibody-directed therapy of brain tumors, implantation irradiation techniques, and related techniques. Nevertheless, the potential uses of the many conventional chemotherapeutic agents now available in our treatment of brain tumors in children are far from exhausted. In some senses, pediatric neuro-oncologists have achieved the same level of sophistication, and similar outcome, that our pediatric oncologists achieved 25 years ago in the treatment of Wilms' tumor. By 1960, children with Wilms' tumor were achieving 50% cure rates following early attempts at incorporating chemotherapy into the therapeutic armamentarium. Did researchers anticipate that their coordinated efforts, through multicenter cooperative group trials, would lead to more than 80% cure rates in the 1980s? Of course, there is no preordained guarantee that children with brain tumors will achieve the same therapeutic successes that children with Wilms' tumor have achieved. Nevertheless, our modest successes with chemotherapy over the past 10 years should offer encouragement to our colleagues as well as to our patients. These successes may finally dispel the pessimism and trepidation with which too many physicians have approached the problem of the child with a brain tumor for so long.

Antineoplastic Combined Chemotherapy Protocols↗

[Skeletal manifestations of malignant, nonosseous tumors in childhood].

Skeletal involvement in childhood nonosseous tumors can be due to primary involvement, arrosion or metastasis, secondary due to therapy induced alterations or osteomyelitis following diminished immunity. The occurence of bone changes differs widely from those in adults. Neuroblastoma, rhabdomyosarcoma and malignant lymphoma are discussed in detail. Rare tumors are listed for synopsis. As diagnostic screening method skeletal scintigraphy is recommended, whereas in localized disease X-rays should be performed. Beside roentgenmorphology-particularly in primary disease-localisation, frequency and age dependency may give essential diagnostic hints. Prognosis depends on primary tumor.

Adolescent↗

[Neurospecific proteins in human malignant brain tumors].

The content of neurospecific proteins S-100, GFA and D2 was measured in malignant cerebral tumors by electrophoresis with the use of monospecific antisera. Concomitant measurement of proteins S-100 and GFA is a more reliable diagnostic criterion as to the tumor histogenesis than study of each protein alone. D2 protein appeared to be the most stable specific marker.

Biopsy↗

[Computer tomography in intracranial tumors. A cooperative study of 1658 neoplasms (author's transl)].

This paper decribes the results of the CT teams of the University Clinics Berlin, Mainz and Munich. 1658 patients with cerebral tumors have been examined so far (EMI Scanner Mark I, Matrix 160/160) revealing a diagnostic accuracy of 98.4%. The findings of various kinds of tumors (306 glioblastomas, 255 astrocytomas and oligodendrogliomas, 248 meningiomas, 212 metastases, 200 pituitary adenomas and craniopharyngeomas) are discussed and illustrated by typical images. Differential diagnostic problems and the importance of additional neuroradiological procedures are discussed.

Adolescent↗

[Correlation of encephalotomography and computer tomography in space occupying lesions in the midline and cerebellopontine angle (author's transl)].

The diagnostic value of encephalotomography and computer tomography in neuroradiology of midline tumors is discussed. Characteristic differences of both methods are summarized. The following conclusions of clinical importance are derived from our experiences: 1. Computer tomography is the most valuable method in the diagnostic procedure of midline tumors. Encephalography is not necessary is cases with density differences of tumor and surrounding brain tissue or contrast enhancement. 2. Encephalotomography should be performed in cases with dislocation of cisternes and ventricles without density differences or contrast enhancement. 3. Encephalotomography is the method of choice in patients with unclear computer tomography and contradictory clincial symptomatology.

Adult↗

[Results of supratentorial low-grade astrocytoma--effects of combined radiochemotherapy].

The retrospective analysis of 53 cases with supratentorial low-grade (grade 1 or 2 due to WHO grading) astrocytomas included the years 1965-84. The 5-year and 10-year survival rates were 61.9% and 52.1%, respectively. The recurrence of tumors occurred in 15 cases (28.3%), almost within 3 years after the initial treatment, and early recurrent cases indicated poor results. Among them, 6 cases were noticed increasing malignancy of histological findings. According to our investigations, the factors which influence to the survival rate were age of patients, duration of symptoms before treatment, presence of neurological deficits and degree of surgical removal of tumor. The patients with good prognosis were under 20-year old, over 6 months of duration, with no neurological signs and with total or subtotal removal. But, 5-year survival rate was not so improved by postoperative radiation therapy. Analysis on the effects of chemotherapy for low-grade astrocytoma was little reported. We treated 26 patients with RAFP therapy (Radiation + ACNU + FT-207 + PSK). Only 2 cases out of 26 showed the recurrence till now. The rate of reduction of their tumors was 46.2% by CT scan. So, it was considered that RAFP therapy was effective for supratentorial low-grade astrocytoma.

Adolescent↗

[Computerized cisternography with metrizamide].

Metrizamide, a new water-soluble contrast medium with low toxicity, was used for cranial computed tomography (computerized cisternography) in 26 patients. When injected by lumbar puncture, the pericerebral cisterns (posterior fossa and sella turcica especially), can be visualized with much greater precision than with classical computed tomography. It also allows the normal and pathological circulation of the CSF to be studied. The authors report on 6 cases of tumours of the posterior fossa, 10 cases of pituitary tumours, 2 cases of "empty" sella, 2 cases of CSF rhinorrhoea, 2 cases of normal pressure hydrocephalus, and 2 cases of syringomyelia, studied by this method. The examination was normal in 3 cases. The authors stress the rapidity, reliability, and good tolerance of this new method.

Adenoma↗

[Hamartoma of the internal auditory canal and cerebropontile space in a child. Trans-temporo-extradural excision methods].

A progressive facial paralysis in a child of 14 years allowed the diagnosis of a hamartoma to be made. The discovery of such a benign lesion should always be followed by a search for other lesions elsewhere, i.e. to see if there is not a phacomatosis. Persistent sciatic pains which this child now has lead one to fear a second lesion, compressing a nerve root or trunk of the sciatic nerve. There is a strong possibility that this tumor of the auditory canal is only the first manifestation of a neurocristopathy.

Adolescent↗

[Effects of the use of cranial radiotherapy. Findings obtained by computerized axial tomography and intellectual function tests].

Authors report their brain computerized axial tomography findings (CAT) and intellectual performance, in fourteen children treated with cranial radiotherapy either as part of conventional prophylaxis with intrathecal methotrexate use in malignant lymphoproliferative processes or as treatment for a primitive cerebral tumor. They comment on myelinating leukoencephalopathy and neuropsychologic sequelae that can appear.

Astrocytoma↗