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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 39 (1997), S. 804-810 
    ISSN: 1432-1920
    Keywords: Key words Gliomas ; cerebral ; Malignant transformation ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During a 15-year period 37 patients with primary low-grade astrocytoma have been operated upon twice in our institute. CT and histological data at the time of the first and second operations were compared. The majority of primary astrocytomas showed as a low-density area without contrast enhancement; minimal, mainly marginal enhancement was present in six cases. At reoperation 10 tumours were histologically unchanged; the corresponding CT studies displayed a nonenhancing lesion, although insignificant contrast uptake could be seen in three cases. There were 18 tumours which had transformed into anaplastic astrocytoma: CT before repeat surgery showed more or less marked enhancement. In all nine cases which progressed into glioblastoma multiforme strong contrast enhancement was seen on CT at the time of recurrence. Although the grade of contrast uptake varied, the appearance of or increase in enhancement was a sign of some degree of anaplastic change, particularly convincing in cases of dedifferentiated glioblastoma multiforme.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neuropathologica 4 (1965), S. 299-311 
    ISSN: 1432-0533
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Late changes in human brains, which were observed 3–21 months after an one-time intracavital irradiation of tumors with Co60 pellets are described. In all cases, macroscopically there was much deformation of the irradiated hemisphere with mass displacement and incarceration signs due to extensive edema. Around the cavity due to radiation, there was widespread necrosis. The cavity, which in the first months after irradiation is filled with coarse crumbles of necrotic material, then showed numerous large cysts. The total white matter of the irradiated hemisphere was soft, edematous and partically cystic, whereas the morphological structure of the cortex was fairly intact, even with extensive pathological changes of the white matter. The histological findings are described in detail and compared with the observations available from the literature. These severe late changes show that the one-time application of a high radiation dosis is extremely dangerous. Satisfactory destruction of the tumors was not achieved.
    Notes: Zusammenfassung Es werden die Spätveränderungen im menschlichen Hirn beschrieben, die 3–21 Monate nach einer einmaligen intracavitären Tumorbestrahlung mit Co60-Perlen beobachtet wurden. Bei allen Fällen fand sich bereits makroskopisch eine hochgradige Deformierung der bestrahlten Hemisphäre mit Massenverschiebungen und Einklemmungserscheinungen infolge eines erheblichen Ödems. In unmittelbarer Nähe der Bestrahlungshöhle waren ausgedehnte Nekrosen zu beobachten. Die Höhle, die in den ersten Monaten nach der Bestrahlung mit derben bröckeligen Nekrosemassen ausgefüllt ist, war mit großen Cysten durchsetzt. Das ganze Marklager der bestrahlten Hemisphäre erwies sich als weich, ödematös und zum Teil cystisch verändert, während die morphologische Struktur der Rinde auch bei schweren Veränderungen des Marklagers weitgehend erhalten war. Die histologischen Befunde werden im einzelnen beschrieben und mit den bisherigen Beobachtungen an Hand der vorliegenden Literatur verglichen. Diese schwerwiegenden Spätveränderungen zeigen, daß die einzeitige Applikation einer hohen Strahlendosis erhebliche Gefahren in sich birgt. Eine befriedigende Tumorzerstörung war nicht zu erzielen.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 64 (1982), S. 215-224 
    ISSN: 0942-0940
    Keywords: Medulloblastoma ; histological variants ; biological behaviour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 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.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 21 (1969), S. 139-151 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Autoren haben Gewebskulturen von folgenden menschlichen Hirntumoren gezüchtet: Glioblastoma multiforme, malignes Astrozytom und endotheliomatöses Meningeom. Die Wirkung von zwei Antibiotika, Actinomycin C (Sanamycin) und Actinomycin D, auf diese Kulturen wurden untersucht. Die Ergebnisse wurden quantitativ durch Bestimmung der Wachstums-Hemmungsrate und des Mitosen-Index der Explantate gemessen; qualitativ durch Untersuchung der Änderung der Zellstruktur. Im Vergleich zu den Meningeomen reagierten die malignen Gliome empfindlicher auf beide Medikamente. In den Gliom-Kulturen wurden quantitative Unterschiede hinsichtlich der Reaktion auf beide Pharmaka beobachtet: Man benötigt eine höhere Konzentration von Actinomycin D als von Actinomycin C, um die gleiche Wirkung zu erzielen. In den Meningeom-Kulturen hatte eine identische Konzentration beider Medikamente ungefähr die gleiche Wirkung. Die Autoren besprechen das Problem der in vitro-Testung und in vivo-Anwendung von chemotherapeutischen Mitteln. Sie empfehlen die Durchführung von Empfindlichkeits-Tests in Gewebskulturen vor Beginn einer Chemotherapie.
    Abstract: Résumé Les auteurs ont préparé des cultures de tissu à partir de tumeur du cerveau de l'homme tels que glioblastome multiforme, astrocytome malin et méningiome endothélial. Les effets cytostatiques de 2 antibiotiques: Actinomycine C — Sanamycine et Actinomycine D ont été étudiés sur ces cultures. Quantitativement, les résultats sont enregistrés par la détermination de l'inhibition de la croissance et de l'index mitotique des prélèvements; qualitativement, par l'évaluation de l'altération de la morphologie cellulaire. Par comparaison avec les méningiomes, les gliomes malins paraissent plus sensibles aux 2 drogues. Dans les cultures de gliome, des différences quantitatives ont été observées dans la réponse aux 2 drogues: une plus forte concentration d'Actinomycine D a été nécessaire pour obtenir le même effet qu'avec l'Actinomycine C. Dans les cultures de méningiome, une concentration identique des 2 drogues atteint à peu près le même effet. Les auteurs discutent le problème tu test in vitro et de l'application in vivo de drogues chimiothérapiques. Ils proposent l'idée de réaliser un test de sensibilité avant les cultures de tissu par chimiothérapie.
    Notes: Summary The authors prepared tissue cultures from the following human brain tumours-glioblastoma multiforme, astrocytoma malignum and meningeoma endotheliomatosum. The cytostatic effects of two antibiotics, Actinomycin C (Sanamycin) and Actinomycin D were studied on these cultures. Quantitatively, the results were rated by the determination of the growth inhibition rate and the mitotic index of the explants; qualitatively, by evaluating the alteration of cellular morphology. As compared with the meningiomas, the malignant gliomas reacted more sensitively to both drugs. In the glioma cultures quantitative differences were observed between the responses to both drugs: a higher concentration of AD was required to obtain the same effect as with AC. In the meningioma cultures the identical concentration of both drugs brought about the same effect. The authors discuss the problem of thein vitro testing andin vivo application of chemotherapeutic drugs. They raise the idea of performing a sensitivity test in tissue culture prior to chemotherapy.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 37 (1977), S. 75-91 
    ISSN: 0942-0940
    Keywords: Supratentorial astrocytomas ; Recurrences of astrocytomas ; Classification of gliomas ; Recurrence intervals ; Radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 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 until reintervention or death were statistically examined. It seems that the recurrence time chiefly 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.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 0942-0940
    Keywords: Astrocytomas ; supratentorial ; oligodendrogliomas ; supratentorial ; recurrent gliomas ; reoperation ; radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 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 malignancy: 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.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0942-0940
    Keywords: Pilocytic astrocytoma ; supratentorial lobar gliomas ; subependymal plate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 45 cases with supratentorial, lobar—mainly temporo-parietal—pilocytic astrocytoma are analysed. The mostly highly vascularized tumours frequently present with histologically different tissue components. Formation of cysts of various size was found in 67%. The tumour usually ran a benign clinical course with a comparatively low incidence of recurrence. Malignant transformation of recurrent tumours was not observed. Radiotherapy of conventional dosage did not prove to have any influence on survival, neither post-operatively nor after re-operation. Transformation of persisting pluripotential cells of the subependymal periventricular plate after migration to the surface of the brain is being discussed as the origin of this variant of pilocytic astrocytoma.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0942-0940
    Keywords: Ependymoma ; grading of glioma ; recurrences of ependymomas ; supratentorial lobar gliomas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report 80 supratentorial lobar ependymomas, including 46 recurrences. All underwent operation. In the total collection 34.5% survived for more than 5 years. The behaviour of children and adults was nearly identical. Based on a histological grading into three steps of malignancy (E 1, E 2, E 3), the ependymomas in low grade 1 showed a 5 years' survival time of 41.5%. Compared to a 28.5% survival in group E 2 at the same time. Results in group E 3, which histologically resembled malignant glioma or glioblastoma, are not relevant because of the small number of cases. More than 50% of the E 1 recurrences showed transformation to E 2. No transformation into a lower grade of malignancy has been observed.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The results of combined irradiation and intravenous Vincristine therapy applied to 18 malignant glioma patients after operation and reoperation are reported. Histological examination of the first 15 tumours showed that 12 were glioblastomas and 3 malignant astrocytomas. Tumours removed by reoperation were glioblastomas. Combination therapy consisted of the immediate postoperative administration of 6–12 mg VCR (0.08–0.1 mg/kg) over an 8–14 days period followed by 2 courses of telecobalt irradiation giving a total dose of 5,000 rads. Most patients received a second course of 8–12 mg VCR 6 months after surgery. The total dose of VCR was 15–22 mg. Irreversible toxic effects were not observed. The results obtained with combination therapy were somewhat better than those achieved with radiotherapy alone. The mean survival time was 9 months. Patients lived after re-operation for at least as long as they had after a first operation. Death did not occur within a period of 6 months following surgery.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 0942-0940
    Keywords: Supratentorial oligodendrogliomas ; Recurrences of oligodendrogliomas ; Classification of gliomas ; Recurrence intervals ; Radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 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.
    Type of Medium: Electronic Resource
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