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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Neurosurgical review 8 (1985), S. 207-220 
    ISSN: 1437-2320
    Keywords: Dopamine-agonists ; giant pituitary adenomas ; operative treatment ; results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Out of a series of 515 pituitary adenomas 77 giant tumours seen between 1953 and 1983 were selected and the current problems of their management discussed. Since CT became available the incidence of discovery of giant pituitary adenoma became higher at 20% against 11%, especially in elderly patients. The extent and the form of giant adenomas and the different types of expanding and invasive adenomas are described in detail. A large group — most invasive adenomas of younger aged patients comprises mostly giant prolactinomas. A second large group of expansive endocrine inactive group seems to be characteristic for older age groups. Previously reported extremely high mortality can be lowered thanks to microsurgery and in our experience also due to the use of CUSA and Laser. In this series mortality dropped from 30% to 10%, and even to 6% in the last five years. However the morbidity rate, even if transient, remained high. Operative approaches, according to site and extent are discussed. The preoperative therapy with Dopamine-agonists in form of depot-injection, may open up a new possibility of lowering the operative risk in giant prolactinomas, by reducing the tumour size and signs.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Neurosurgical review 12 (1989), S. 133-140 
    ISSN: 1437-2320
    Keywords: Brain edema ; brain swelling ; CT-densitometry ; head injury ; hyperaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two-hundred and fifty-two computerized tomography (CT) scans of 107 patients with head injuries were analyzed. The most frequent consequence of trauma was a diffuse swelling of the brain in 91% of the cases. The severity of brain swelling and its course can be estimated by the compression of (or absence of) the intracranial cerebrospinal fluid space. These observations may be of prognostic value as well. By measurement of theHounsfield units (HU) in 52 cases the blood or water content in the brain tissues was assessed. An increase in blood content of the tissues (hyperaemia) can account for an increase in Hounsfield values. A decrease in HU suggests brain edema. The density measurements showed that in the first hours and days following head injury, the diffuse brain swelling was caused by severe cerebrovascular congestion in the majority (53%) of the cases. Immediate brain edema without a preceeding hyperaemic phase occurs less frequently (32%). Between the 1st and 4th day after injury, edema started to prevail, and between the 5th and 8th day the edematous type of brain swelling was present almost exclusively.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7373
    Keywords: apoptosis ; proliferation ; p53 ; Bcl-2 ; transglutaminase ; immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Several protocols for the adjuvant treatment of glioblastoma multiforme (GBM) are currently being evaluated. In this context, little is known about the influence of radiochemotherapy on apoptosis and the expression of apoptosis-related proteins in vivo. We have analyzed the incidence of apoptosis using in situ nick translation (ISNT) and expression of Ki-67 (MIB-1), p53 (DO-1 and DO-7), Bcl-2 and transglutaminase II (TGase II) by immunohistochemistry in 41 patients with GBM and their matched relapses. Sixteen patients received radiochemotherapy, 18 irradiation and 7 no treatment. Radiochemotherapy resulted in an increase in Bcl-2+ cells (p=0.013). Irradiation caused the reduction of MIB-1+ (p=0.0015), DO-7+ (p=0.0043) and the increase of Bcl-2+ cells (p=0.016). We calculated a positive correlation between high TGase II scores in patients preceding radiochemotherapy (p=0.0186) and no treatment (p=0.0158), low ISNT scores (p=0.0018) and high DO-1 scores (p=0.0233) in patients preceding irradiation and short time to progression. These data show that distinct postsurgical radiochemotherapy protocols differentially alter cellular proliferation and expression of p53 and Bcl-2 in GBM relapses. Furthermore, we show that ISNT, DO-1 and TGase II labeling scores are therapy-specific predictors of time to progression in GBM patients.
    Type of Medium: Electronic Resource
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