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Sample records for meningiomas associates gain

  1. Genomic profiling of atypical meningiomas associates gain of 1q with poor clinical outcome

    PubMed Central

    Gabeau-Lacet, Darlene; Engler, David; Gupta, Sumeet; Scangas, George A.; Betensky, Rebecca A.; Barker, Fred G.; Loeffler, Jay S.; Louis, David N.; Mohapatra, Gayatry

    2010-01-01

    Atypical meningiomas exhibit heterogeneous clinical outcomes. It is unclear which atypical meningiomas require aggressive multimodality treatment with surgery and radiation therapy versus surgery alone to prevent recurrence. Detailed molecular-genetic characterization of these neoplasms is necessary to better understand their pathogenesis and to identify genetic markers. Oligonucleotide array comparative genomic hybridization was used to identify frequent genetic alterations in 47 primary atypical meningiomas resected at Massachusetts General Hospital between August 1987 and September 2006. Eighty five percent of samples exhibited loss of 22q, including the NF2 gene. The second most frequent regions of loss were confined to the short arm of chromosome 1, particularly 1p33-p36.2 (70%) and 1p13.2 (64%). Other frequent regions of loss, detected in more than 50% of samples, included 14q, 10q, 8q, 7p, 21q, 19, 9q34, and 4p16. Frequent regions of gain were detected along 1q (59%), 17q (44%), 9q34 (30%) and 7q36 (26%). Univariate marker-by-marker analysis of all frequently identified copy number alterations showed potential correlation between gain of 1q and shorter progression free survival. Given the heterogeneous treatment outcomes of atypical meningioma, investigation of large-scale and focal genomic alterations in multi-institutional efforts may help clarify molecular-genetic signatures of clinical utility. PMID:19918127

  2. Meningioma

    MedlinePlus

    ... brain tissue, nerves or vessels may cause serious disability. Meningiomas occur most commonly in women, and are often discovered at older ages, but ... meningioma. Female hormones. Meningiomas are more common in women, ... tumors. Obesity. A high BMI (body mass index) is an established risk ...

  3. Gain of chromosome arm 1q in atypical meningioma correlates with shorter progression-free survival

    PubMed Central

    Jansen, M.; Mohapatra, G.; Betensky, R.A.; Keohane, C.; Louis, D.N.

    2013-01-01

    Aims Atypical (WHO grade II) meningiomas have moderately high recurrence rates; even for completely resected tumours, approximately one-third will recur. Postoperative radiotherapy (RT) may aid local control and improve survival, but carries the risk of side effects. More accurate prediction of recurrence risk is therefore needed for patients with atypical meningioma. Previously, we used high-resolution array CGH to identify genetic variations in 47 primary atypical meningiomas and found that approximately 60% of tumors show gain of 1q at 1q25.1 and 1q25.3 to 1q32.1 and that 1q gain appeared to correlate with shorter progression-free survival. This study aimed to validate and extend these findings in an independent sample. Methods 86 completely resected atypical meningiomas (with 25 recurrences) from two neurosurgical centres in Ireland were identified and clinical follow up was obtained. Utilizing a dual-colour interphase FISH assay, 1q gain was assessed using BAC probes directed against 1q25.1 and 1q32.1. Results The results confirm the high prevalence of 1q gain at these loci in atypical meningiomas. We further show that gain at 1q32.1 and age each correlate with progression-free survival in patients who have undergone complete surgical resection of atypical meningiomas. Conclusions These independent findings suggest that assessment of 1q copy number status can add clinically useful information for the management of patients with atypical meningiomas. PMID:21988727

  4. MENINGIOMAS

    PubMed Central

    Rogers, Leland; Barani, Igor; Chamberlain, Marc; Kaley, Thomas; McDermott, Michael; Raizer, Jeffrey; Schiff, David; Weber, Damien C.; Wen, Patrick Y.; Vogelbaum, Michael A.

    2016-01-01

    Evolving interest in meningioma, the most common primary brain tumor, has refined contemporary management of these tumors. Problematic, however, is the paucity of prospective clinical trials that provide an evidence-based algorithm for managing meningioma. The current review summarizes the published literature regarding the treatment of newly diagnosed and recurrent meningioma, with an emphasis on outcomes stratified by World Health Organization (WHO) tumor grade. In particular this review focuses on patient outcomes following treatment (either adjuvant or at recurrence) with surgery or radiation therapy inclusive of radiosurgery and fractionated irradiation. Phase II trials for patients with meningioma have recently completed accrual within the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) consortia, and phase III studies are being developed. However, at present, there are no completed prospective, randomized trials assessing the role of either surgery or radiotherapy. Successful completion of future studies will require a multidisciplinary effort, dissemination of the current knowledge base, improved implementation of WHO grading criteria, standardization of response criteria and other outcome endpoints, and concerted efforts to address weaknesses in present treatment paradigms, particularly for patients with progressive or recurrent low grade meningioma, or with high-grade meningioma. In parallel efforts, Response Assessment in Neuro-Oncology (RANO) subcommittees are developing a manuscript on systemic therapies for meningioma, and a separate article proposing standardized endpoint and response criteria for meningioma. PMID:25343186

  5. Meningioma

    MedlinePlus

    ... based dye is used to augment the picture. Magnetic resonance imaging (MRI). With this imaging study, a magnetic field ... Accessed Dec. 2, 2013. Pinto PS, et al. Magnetic resonance imaging features of meningioma in children and young adults: ...

  6. Imaging diagnosis--hyperostosis associated with meningioma in a dog.

    PubMed

    Mercier, Miyu; Heller, Heidi L Barnes; Bischoff, Matthew G; Looper, Jayme; Bacmeister, Cynthia X

    2007-01-01

    A 5-year-old neutered male Beagle mix dog had a 5-day history of generalized tonic-clonic seizures. Before the seizures, the dog had a 1-2-month history of progressive right hemiparesis. In computed tomography images, a presumed extraaxial mass with hyperostosis and destruction of the skull covering the mass were identified. Surgical excision was performed and the histopathologic diagnosis was meningioma. Hyperostosis is frequently associated with feline meningioma, but this report documents that hyperostosis may also occur secondary to meningioma in the dog.

  7. Association of hyperplastic polyposis syndrome, colorectal cancer and meningioma.

    PubMed

    Muzaffar, Mahvish; Irlam, John; Mohamed, Iman

    2011-01-01

    Recent research has provided compelling evidence that a subset of hyperplastic polyps may be associated with a risk of colorectal cancer. Colorectal cancer with extracolonic manifestation is usually seen in a hereditary syndrome setting, but some association with meningioma has been reported. The association of colorectal cancer with hyperplastic polyposis and meningioma is extremely rare. This report in a 57-year-old female with no family history of colon cancer or polyps, could be the first case of hyperplastic polyposis syndrome, colorectal cancer and meningioma. Hyperplastic polyposis syndrome was diagnosed as per WHO criteria at the time of colon cancer diagnosis. Within 4 months of colon cancer diagnosis she developed seizures. Imaging of the brain revealed meningioma of the left cerebellopontine angle. The patient underwent surgery followed by chemotherapy.

  8. Interstitial loss and gain of sequences on chromosome 22 in meningiomas with normal karyotype.

    PubMed

    Prowald, Alexandra; Wemmert, Silke; Biehl, Claudia; Storck, Simone; Martin, Thomas; Henn, Wolfram; Ketter, Ralf; Meese, Eckart; Zang, Klaus D; Steudel, Wolf-Ingo; Urbschat, Steffi

    2005-02-01

    In nearly half of sporadic low grade meningiomas no chromosome aberration can be detected. In the majority of the other half chromosome 22 is lost. In higher grade meningiomas this loss is followed by characteristic secondary chromosome aberrations. Regarding the molecular findings in Schwannomas, homozygous loss or mutation of the NF2 gene located on chromosome 22, was supposed also to be the primary event in meningioma development. However, in nearly all high grade but in only a minority of low grade meningiomas the loss of the NF2 protein is observed. Therefore, both the hypothetical combined heterozygous loss of or inactivation of two or more tumour suppressor genes (at least one of them located on chromosome 22) or the homozygous loss of a regulatory gene on chromosome 22 different from NF2 was discussed. In search for microdeletions or/and structural recombinations of chromosome 22 we investigated primary cell cultures of 43 meningiomas by conventional G-banding (26 without, 17 with loss of chromosome 22). Twenty-seven tumours were analysed with spectral karyotyping (SKY) and 16 with fluorescence in situ hybridisation (FISH) with DNA probes for the chromosomal regions of 22q11.2, 22q11.23q12.1, 22q12.1 and 22q13.3. SKY analysis confirmed G-banding data for chromosome 22 and could specify marker chromosomes and translocations containing material from chromosome(s) 22. Confirming our assumption microdeletions on chromosome 22 were detected by FISH in 6/8 cytogenetically non-aberrant meningiomas. Surprisingly, in 2/8 cases we observed gains of the 22q13.3 and in 2/8 gains of the 22q12.1 region. Here we present first evidence for an uncommon mechanism during early meningioma development at least for a meningioma subgroup: i) duplication and translocation of sequences from chromosome 22 to different chromosomes. ii) deletion of the original sequences on chromosome 22, resulting in disomy again (only visible as translocation in metaphase FISH). iii) loss of

  9. Global epigenetic profiling identifies methylation subgroups associated with recurrence-free survival in meningioma.

    PubMed

    Olar, Adriana; Wani, Khalida M; Wilson, Charmaine D; Zadeh, Gelareh; DeMonte, Franco; Jones, David T W; Pfister, Stefan M; Sulman, Erik P; Aldape, Kenneth D

    2017-03-01

    Meningioma is the most common primary brain tumor and carries a substantial risk of local recurrence. Methylation profiles of meningioma and their clinical implications are not well understood. We hypothesized that aggressive meningiomas have unique DNA methylation patterns that could be used to better stratify patient management. Samples (n = 140) were profiled using the Illumina HumanMethylation450BeadChip. Unsupervised modeling on a training set (n = 89) identified 2 molecular methylation subgroups of meningioma (MM) with significantly different recurrence-free survival (RFS) times between the groups: a prognostically unfavorable subgroup (MM-UNFAV) and a prognostically favorable subgroup (MM-FAV). This finding was validated in the remaining 51 samples and led to a baseline meningioma methylation classifier (bMMC) defined by 283 CpG loci (283-bMMC). To further optimize a recurrence predictor, probes subsumed within the baseline classifier were subject to additional modeling using a similar training/validation approach, leading to a 64-CpG loci meningioma methylation predictor (64-MMP). After adjustment for relevant clinical variables [WHO grade, mitotic index, Simpson grade, sex, location, and copy number aberrations (CNAs)] multivariable analyses for RFS showed that the baseline methylation classifier was not significant (p = 0.0793). The methylation predictor, however, was significantly associated with tumor recurrence (p < 0.0001). CNAs were extracted from the 450k intensity profiles. Tumor samples in the MM-UNFAV subgroup showed an overall higher proportion of CNAs compared to the MM-FAV subgroup tumors and the CNAs were complex in nature. CNAs in the MM-UNFAV subgroup included recurrent losses of 1p, 6q, 14q and 18q, and gain of 1q, all of which were previously identified as indicators of poor outcome. In conclusion, our analyses demonstrate robust DNA methylation signatures in meningioma that correlate with CNAs and stratify patients by recurrence

  10. Cytoplasmic iron deposition is associated with the expression of oxidative DNA damage marker in meningiomas.

    PubMed

    Nagaishi, Masaya; Yokoo, Hideaki; Osawa, Tadashi; Nobusawa, Sumihito; Tanaka, Yuko; Ikota, Hayato; Yoshimoto, Yuhei; Nakazato, Yoichi

    2013-10-01

    Angiomatous meningiomas are rare meningioma subtypes, which are characterized by abundant, well-formed vessels. We encountered two cases of newly diagnosed angiomatous meningiomas exhibiting tumor cells with brown pigments, which were histochemically proven to be iron. In an attempt to understand its pathological significance, we assessed this unusual finding in representatives for each grade of meningiomas and immunoexpression of transferrin receptor (CD71) and the oxidative DNA damage marker, 8-hydroxy-2'-deoxyguanosine (8-OHdG). Iron deposition in the tumor cells was observed in 8/15 (53%) angiomatous meningioma cases, 2/6 (33%) microcystic meningiomas and 2/20 (10%) meningothelial meningiomas, which included clustered microvessels, but not in fibrous, atypical or anaplastic meningiomas (P = 0.001). Cytoplasmic CD71 expression was largely negative in angiomatous meningioma cases, but positive in meningothelial and high-grade meningiomas, suggesting that the transferrin-dependent iron transporter was involved in iron uptake in meningiomas. Nuclear expression of 8-OHdG was observed in ≥ 50% of the tumor cells in all 15 cases of angiomatous meningioma and was associated with the presence of regressive histopathological findings, such as hyalinized vessels and cystic changes. In addition, the fraction of iron-containing tumor cells was correlated to those expressing 8-OHdG (P = 0.005). Our finding indicates that cytoplasmic iron deposition in tumor cells is characteristic of highly vascularized benign meningiomas and related to increased oxidative DNA damage markers. © 2013 Japanese Society of Neuropathology.

  11. Association between prediagnostic glucose, triglycerides, cholesterol and meningioma, and reverse causality.

    PubMed

    Bernardo, Brittany M; Orellana, Robert C; Weisband, Yiska Lowenberg; Hammar, Niklas; Walldius, Goran; Malmstrom, Hakan; Ahlbom, Anders; Feychting, Maria; Schwartzbaum, Judith

    2016-06-28

    Although meningioma is a benign tumour, it may cause significant morbidity. Obesity and diabetes are positively associated with meningioma. To evaluate the potential effects of obesity-related prediagnostic glucose, triglycerides and cholesterol on meningioma and of prediagnostic meningioma on these biomarkers, we conducted a cohort study. We identified 41 355 individuals in the Apolipoprotein MOrtality RISk cohort with values for these biomarkers within 15 years before meningioma diagnosis, death, migration or the end of follow-up. We then estimated hazard ratios (HRs) and their interactions with time and age using Cox regression. Meningioma was diagnosed in 181 women and 115 men whose median follow-up time was 7 years. Fasting serum glucose level was inversely related to meningioma among women (Ptrend=0.0006) but not men (Ptrend=0.24). Prediagnostic diabetes was inversely related to meningioma in both sexes combined (HR=0.45, 95% confidence interval (CI) 0.29-0.71), as was serum cholesterol within the year before diagnosis (HR=0.50, 95% CI 0.34-0.72). Paradoxically, hyperglycaemia is inversely associated with meningioma in women. This finding does not necessarily negate the positive role of obesity or diabetes in meningioma development; rather, it may indicate that their effects depend on the stage of development. Furthermore, the prediagnostic tumour may reduce serum cholesterol levels.

  12. Association between prediagnostic glucose, triglycerides, cholesterol and meningioma, and reverse causality

    PubMed Central

    Bernardo, Brittany M; Orellana, Robert C; Weisband, Yiska Lowenberg; Hammar, Niklas; Walldius, Goran; Malmstrom, Hakan; Ahlbom, Anders; Feychting, Maria; Schwartzbaum, Judith

    2016-01-01

    Background: Although meningioma is a benign tumour, it may cause significant morbidity. Obesity and diabetes are positively associated with meningioma. To evaluate the potential effects of obesity-related prediagnostic glucose, triglycerides and cholesterol on meningioma and of prediagnostic meningioma on these biomarkers, we conducted a cohort study. Methods: We identified 41 355 individuals in the Apolipoprotein MOrtality RISk cohort with values for these biomarkers within 15 years before meningioma diagnosis, death, migration or the end of follow-up. We then estimated hazard ratios (HRs) and their interactions with time and age using Cox regression. Results: Meningioma was diagnosed in 181 women and 115 men whose median follow-up time was 7 years. Fasting serum glucose level was inversely related to meningioma among women (Ptrend=0.0006) but not men (Ptrend=0.24). Prediagnostic diabetes was inversely related to meningioma in both sexes combined (HR=0.45, 95% confidence interval (CI) 0.29-0.71), as was serum cholesterol within the year before diagnosis (HR=0.50, 95% CI 0.34-0.72). Conclusions: Paradoxically, hyperglycaemia is inversely associated with meningioma in women. This finding does not necessarily negate the positive role of obesity or diabetes in meningioma development; rather, it may indicate that their effects depend on the stage of development. Furthermore, the prediagnostic tumour may reduce serum cholesterol levels. PMID:27253176

  13. Genomic landscape of high-grade meningiomas

    PubMed Central

    Bi, Wenya Linda; Greenwald, Noah F.; Abedalthagafi, Malak; Wala, Jeremiah; Gibson, Will J.; Agarwalla, Pankaj K.; Horowitz, Peleg; Schumacher, Steven E.; Esaulova, Ekaterina; Mei, Yu; Chevalier, Aaron; Ducar, Matthew; Thorner, Aaron R.; van Hummelen, Paul; Stemmer-Rachamimov, Anat; Artyomov, Maksym; Al-Mefty, Ossama; Dunn, Gavin P.; Santagata, Sandro; Dunn, Ian F.; Beroukhim, Rameen

    2017-01-01

    High-grade meningiomas frequently recur and are associated with high rates of morbidity and mortality. To determine the factors that promote the development and evolution of these tumors, we analyzed the genomes of 134 high-grade meningiomas and compared this information with data from 587 previously published meningiomas. High-grade meningiomas had a higher mutation burden than low-grade meningiomas but did not harbor any statistically significant mutated genes aside from NF2. High-grade meningiomas also possessed significantly elevated rates of chromosomal gains and losses, especially among tumors with monosomy 22. Meningiomas previously treated with adjuvant radiation had significantly more copy number alterations than radiation-induced or radiation-naïve meningiomas. Across serial recurrences, genomic disruption preceded the emergence of nearly all mutations, remained largely uniform across time, and when present in low-grade meningiomas, correlated with subsequent progression to a higher grade. In contrast to the largely stable copy number alterations, mutations were strikingly heterogeneous across tumor recurrences, likely due to extensive geographic heterogeneity in the primary tumor. While high-grade meningiomas harbored significantly fewer overtly targetable alterations than low-grade meningiomas, they contained numerous mutations that are predicted to be neoantigens, suggesting that immunologic targeting may be of therapeutic value. PMID:28713588

  14. First insight into the somatic mutation burden of neurofibromatosis type 2-associated grade I and grade II meningiomas: a case report comprehensive genomic study of two cranial meningiomas with vastly different clinical presentation.

    PubMed

    Dewan, Ramita; Pemov, Alexander; Dutra, Amalia S; Pak, Evgenia D; Edwards, Nancy A; Ray-Chaudhury, Abhik; Hansen, Nancy F; Chandrasekharappa, Settara C; Mullikin, James C; Asthagiri, Ashok R; Heiss, John D; Stewart, Douglas R; Germanwala, Anand V

    2017-02-13

    Neurofibromatosis type 2 (NF2) is a rare autosomal dominant nervous system tumor predisposition disorder caused by constitutive inactivation of one of the two copies of NF2. Meningiomas affect about one half of NF2 patients, and are associated with a higher disease burden. Currently, the somatic mutation landscape in NF2-associated meningiomas remains largely unexamined. Here, we present an in-depth genomic study of benign and atypical meningiomas, both from a single NF2 patient. While the grade I tumor was asymptomatic, the grade II tumor exhibited an unusually high growth rate: expanding to 335 times its initial volume within one year. The genomes of both tumors were examined by whole-exome sequencing (WES) complemented with spectral karyotyping (SKY) and SNP-array copy-number analyses. To better understand the clonal composition of the atypical meningioma, the tumor was divided in four sections and each section was investigated independently. Both tumors had second copy inactivation of NF2, confirming the central role of the gene in meningioma formation. The genome of the benign tumor closely resembled that of a normal diploid cell and had only one other deleterious mutation (EPHB3). In contrast, the chromosomal architecture of the grade II tumor was highly re-arranged, yet uniform among all analyzed fragments, implying that this large and fast growing tumor was composed of relatively few clones. Besides multiple gains and losses, the grade II meningioma harbored numerous chromosomal translocations. WES analysis of the atypical tumor identified deleterious mutations in two genes: ADAMTSL3 and CAPN5 in all fragments, indicating that the mutations were present in the cell undergoing fast clonal expansion CONCLUSIONS: This is the first WES study of NF2-associated meningiomas. Besides second NF2 copy inactivation, we found low somatic burden in both tumors and high level of genomic instability in the atypical meningioma. Genomic instability resulting in altered gene

  15. [Multiple meningiomas].

    PubMed

    Terrier, L-M; François, P

    2016-06-01

    Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1-9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are 2 main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. NF2 gene mutation is an important intrinsic risk factor in the etiology of multiple meningiomas and some exogenous risk factors have been suspected but only ionizing radiation exposure has been proven. These tumors can grow anywhere in the skull but they are more frequently observed in supratentorial locations. Their histologic types are similar to unique meningiomas of psammomatous, fibroblastic, meningothelial or transitional type and in most cases are benign tumors. The prognosis of these tumors is eventually good and does not differ from the unique tumors except for the cases of radiation-induced multiple meningiomas, in the context of NF2 or when diagnosed in children where the outcome is less favorable. Each meningioma lesion should be dealt with individually and their multiple character should not justify their resection at all costs.

  16. Analysis of Gene Expression Profiling in Meningioma: Deregulated Signaling Pathways Associated with Meningioma and EGFL6 Overexpression in Benign Meningioma Tissue and Serum

    PubMed Central

    Wang, Xuanchun; Gong, Ye; Wang, Daijun; Xie, Qing; Zheng, Mingzhe; Zhou, Yu; Li, Qin; Yang, Zhen; Tang, Hailiang; Li, Yiming; Hu, Renming; Chen, Xiancheng; Mao, Ying

    2012-01-01

    Molecular mechanisms underlying the pathogenesis of meningioma are not fully elucidated. In this study, we established differential gene expression profiles between meningiomas and brain arachnoidal tissue by using Affymetrix GeneChip Human U133 Plus 2.0 Array. KEGG pathway analysis demonstrated that PI3K/Akt and TGFβ signaling pathways were up-regulated in fibroblastic meningioma, and focal adhesion and ECM-receptor interaction pathways were activated in anaplastic meningioma. EGFL6 was one of the most up-regulated genes in fibroblastic meningioma by microarray analysis. Quantitative real-time PCR demonstrated that benign meningiomas had significantly higher levels of EGFL6 mRNA than brain arachnoidal tissue and atypical and anaplastic meningiomas (P<0.001). EGFL6 gene was also highly expressed in ovarian cancer, but expressed lowly in other investigated tumors. ELISA analysis showed that patients with benign meningiomas and ovarian cancers had the highest serum levels of EGFL6 (mean concentration: 672 pg/ml for benign meningiomas, and 616 pg/ml for ovarian cancers). Healthy people and patients with other tumors, however, had low levels of serum EGFL6. In conclusion, we proposed that activation of PI3K/Akt and integrin-mediated signaling pathways was involved in the pathogenesis of benign and anaplastic meningiomas, respectively. We also presented evidence that EGFL6 was overexpressed in benign meningioma tissues and serum. PMID:23285163

  17. Analysis of gene expression profiling in meningioma: deregulated signaling pathways associated with meningioma and EGFL6 overexpression in benign meningioma tissue and serum.

    PubMed

    Wang, Xuanchun; Gong, Ye; Wang, Daijun; Xie, Qing; Zheng, Mingzhe; Zhou, Yu; Li, Qin; Yang, Zhen; Tang, Hailiang; Li, Yiming; Hu, Renming; Chen, Xiancheng; Mao, Ying

    2012-01-01

    Molecular mechanisms underlying the pathogenesis of meningioma are not fully elucidated. In this study, we established differential gene expression profiles between meningiomas and brain arachnoidal tissue by using Affymetrix GeneChip Human U133 Plus 2.0 Array. KEGG pathway analysis demonstrated that PI3K/Akt and TGFβ signaling pathways were up-regulated in fibroblastic meningioma, and focal adhesion and ECM-receptor interaction pathways were activated in anaplastic meningioma. EGFL6 was one of the most up-regulated genes in fibroblastic meningioma by microarray analysis. Quantitative real-time PCR demonstrated that benign meningiomas had significantly higher levels of EGFL6 mRNA than brain arachnoidal tissue and atypical and anaplastic meningiomas (P<0.001). EGFL6 gene was also highly expressed in ovarian cancer, but expressed lowly in other investigated tumors. ELISA analysis showed that patients with benign meningiomas and ovarian cancers had the highest serum levels of EGFL6 (mean concentration: 672 pg/ml for benign meningiomas, and 616 pg/ml for ovarian cancers). Healthy people and patients with other tumors, however, had low levels of serum EGFL6. In conclusion, we proposed that activation of PI3K/Akt and integrin-mediated signaling pathways was involved in the pathogenesis of benign and anaplastic meningiomas, respectively. We also presented evidence that EGFL6 was overexpressed in benign meningioma tissues and serum.

  18. The protein expression profile of meningioma cells is associated with distinct cytogenetic tumour subgroups.

    PubMed

    Domingues, Patrícia Henriques; Teodósio, Cristina; Otero, Álvaro; Sousa, Pablo; Gonçalves, Jesus Maria; Nieto, Ana Belen; Lopes, Maria Celeste; de Oliveira, Catarina; Orfao, Alberto; Tabernero, Maria Dolores

    2015-04-01

    Limited information exists about the impact of cytogenetic alterations on the protein expression profiles of individual meningioma cells and their association with the clinicohistopathological characteristics of the disease. The aim of this study is to investigate the potential association between the immunophenotypic profile of single meningioma cells and the most relevant features of the tumour. Multiparameter flow cytometry (MFC) was used to evaluate the immunophenotypic profile of tumour cells (n = 51 patients) and the Affymetrix U133A chip was applied for the analysis of the gene expression profile (n = 40) of meningioma samples, cytogenetically characterized by interphase fluorescence in situ hybridization. Overall, a close association between the pattern of protein expression and the cytogenetic profile of tumour cells was found. Thus, diploid tumours displayed higher levels of expression of the CD55 complement regulatory protein, tumours carrying isolated monosomy 22/del(22q) showed greater levels of bcl2 and PDGFRβ and meningiomas carrying complex karyotypes displayed a greater proliferation index and decreased expression of the CD13 ectoenzyme, the CD9 and CD81 tetraspanins, and the Her2/neu growth factor receptor. From the clinical point of view, higher expression of CD53 and CD44 was associated with a poorer outcome. Here we show that the protein expression profile of individual meningioma cells is closely associated with tumour cytogenetics, which may reflect the involvement of different signalling pathways in the distinct cytogenetic subgroups of meningiomas, with specific immunophenotypic profiles also translating into a different tumour clinical behaviour. © 2014 British Neuropathological Society.

  19. Management of Recurrent Trigeminal Neuralgia Associated with Petroclival Meningioma

    PubMed Central

    Bir, Shyamal C.; Maiti, Tanmoy Kumar; Bollam, Papireddy; Nanda, Anil

    2015-01-01

    Objective Petroclival meningioma (PM) presents with trigeminal neuralgia (TN) in < 5% of cases. Neurosurgeons often face the dilemma of formulating a treatment protocol when TN recurs. In this study, we sought to set up a protocol in patients with PM who had a recurrent TN. Materials and Methods We performed a retrospective review of 57 patients with PM. Of the 57 patients, only 7 patients presented with TN, and six patients experienced recurrent TN. The study population was evaluated clinically and radiographically after treatment. Results Overall improvement of pain control after various treatments was 67%, and tumor control was 100%. The pain-free period was 2 years for the Gamma Knife radiosurgery (GKRS) group and 4 years for the resection group when treated as a primary treatment (p = 0.034). Of the six patients, four patients had Barrow Neurosurgical Institute (BNI) score I (no TN, no medication), and two patients had BNI score III (some pain controlled with medication). The Karnofsky performance scale score was significantly improved after treatment compared with the pretreated status (78 versus 88; p = 0.044). Conclusion Microsurgical resection is superior to GKRS in achieving and maintaining pain-free status in patients with recurrent trigeminal pain associated with PM. PMID:26949588

  20. [Cytogenetic aberrations in histologically benign infiltratively growing sphenoid wing meningiomas].

    PubMed

    Korshunov, A G; Cherekaev, V A; Bekiashev, A Kh; Sycheva, R V

    2007-01-01

    Meningiomas of the sphenoid wing (SW) frequently show an invasive pattern of growth and cause destruction of the adjacent structures. As a result, the rate of recurrent SW meningiomas is as high as 30%. Cytogenetic investigations showed no aberrations specific to invasively growing meningiomas. During this study, the authors evaluated 10 invasive and 5 non-invasive SW meningiomas via comparative genome hybridization (CGH) (matrix CGH), by using the gene chips of GenoSensor Array micromatrixes. The mean number of aberrations in the tumor cells was much greater in case of invasive meningiomas (67.4 versus 40.5 in case of non-invasive SW meningiomas. Furthermore, in invasive SW meningiomas, there were frequently losses in loci 1p, 6q, and 14q and gains in loci 15q and 10, which had been predetermined as molecular markers of stepwise progression of meningioma. Thus, the presence of a complex cytogenetic profile and progression-associated chromosome aberrations in benign SW meningiomas is linked with the increase of their invasive potential. Due to the fact that there are no well-defined adjuvant therapy regimens for recurring meningiomas at present, the revealed genomic aberrations may become potential targets for searching for drugs and a therapeutic intervention in future.

  1. [Hydrocephalus Associated with Small Clinoidal Meningioma that Resolved after Tumor Removal:A Case Report].

    PubMed

    Fujiwara, Hidemoto; Aiba, Toyotaka; Watanabe, Toru; Hiraishi, Tetsuya; Fujii, Yukihiko

    2016-12-01

    Small meningiomas causing hydrocephalus without obstruction of the ventricular system are rare. Herein, we report a case of small clinoidal meningioma with communicating hydrocephalus, which resolved after tumor removal. A 70-year-old woman presented with a 1-month history of memory disturbance followed by gait disturbance. MR images revealed a right clinoidal meningioma, 2 cm in diameter, and dilatation of the ventricles suggesting communicating hydrocephalus. The cerebrospinal fluid(CSF)pressure was 130 mmH2O, as determined via a lumbar puncture. High concentrations of protein(65mg/dL)were detected in the lumbar CSF. The tumor was completely removed via a frontotemporal craniotomy. Higher protein concentrations(94mg/dL)were detected in the CSF obtained intraoperatively from the sylvian cistern. The histopathological diagnosis was meningothelial meningioma. The patient's symptoms improved markedly after surgery. Postoperative MR images revealed resolution of the hydrocephalus. The lumbar CSF protein concentration returned to normal(43mg/dL). Neither tumor recurrence nor progression of hydrocephalus has been observed for 4 years. Communicating hydrocephalus, associated with a small meningioma at the supratentorial region, has not been described. Previous studies have shown that patients with meningioma may develop communicating hydrocephalus after tumor removal or stereotactic radiosurgery. Thus, it is interesting that the small supratentorial meningioma in our case developed communicating hydrocephalus without any therapeutic intervention. Considering the CSF protein concentration, we speculate that the hydrocephalus was the result of CSF malabsorption associated with high CSF protein concentration and CSF pathway obstruction at the suprasellar cistern caused by the tumor.

  2. Thorotrast induced adhesive arachnoiditis associated with meningioma and schwannoma.

    PubMed

    Meyer, M W; Powell, H C; Wagner, M; Niwayama, G

    1978-05-01

    Adhesive arachnoiditis, a meningioma and a schwannoma were found at autopsy in a 56 year old man who had undergone Thorotrast myelography 33 years previously. Thorotrast was demonstrated in tissue sections by transmission and scanning electron microscopy, radioautography, and x-ray spectrometry.

  3. Cerebral cavernous malformations associated to meningioma: High penetrance in a novel family mutated in the PDCD10 gene.

    PubMed

    Garaci, Francesco; Marsili, Luisa; Riant, Florence; Marziali, Simone; Cécillon, Michaelle; Pasquarelli, Roberto; Sangiuolo, Federica; Floris, Roberto; Novelli, Giuseppe; Tournier-Lasserve, Elisabeth; Brancati, Francesco

    2015-06-01

    Multiple familial meningiomas occur in rare genetic syndromes, particularly neurofibromatosis type 2. The association of meningiomas and cerebral cavernous malformations (CCMs) has been reported in few patients in the medical literature. The purpose of our study is to corroborate a preferential association of CCMs and multiple meningiomas in subjects harbouring mutations in the PDCD10 gene (also known as CCM3). Three members of an Italian family affected by seizures underwent conventional brain Magnetic Resonance Imaging (MRI) with gadolinium contrast agent including gradient echo (GRE) imaging. The three CCM-causative genes were sequenced by Sanger method. Literature data reporting patients with coexistence of CCMs and meningiomas were reviewed. MRI demonstrated dural-based meningioma-like lesions associated to multiple parenchymal CCMs in all affected individuals. A disease-causative mutation in the PDCD10 gene (p.Gln112PhefsX13) was identified. Based on neuroradiological and molecular data as well as on literature review, we outline a consistent association between PDCD10 mutations and a syndrome of CCMs with multiple meningiomas. This condition should be considered in the differential diagnosis of multiple/familial meningioma syndromes. In case of multiple/familial meningioma the use of appropriate MRI technique may include GRE and/or susceptibility-weighted imaging (SWI) to rule out CCM. By contrast, proper post-gadolinium scans may aid defining dural lesions in CCM patients and are indicated in PDCD10-mutated individuals.

  4. Cerebral cavernous malformations associated to meningioma: High penetrance in a novel family mutated in the PDCD10 gene

    PubMed Central

    Garaci, Francesco; Marsili, Luisa; Riant, Florence; Marziali, Simone; Cécillon, Michaelle; Pasquarelli, Roberto; Sangiuolo, Federica; Floris, Roberto; Novelli, Giuseppe; Tournier-Lasserve, Elisabeth

    2015-01-01

    Multiple familial meningiomas occur in rare genetic syndromes, particularly neurofibromatosis type 2. The association of meningiomas and cerebral cavernous malformations (CCMs) has been reported in few patients in the medical literature. The purpose of our study is to corroborate a preferential association of CCMs and multiple meningiomas in subjects harbouring mutations in the PDCD10 gene (also known as CCM3). Three members of an Italian family affected by seizures underwent conventional brain Magnetic Resonance Imaging (MRI) with gadolinium contrast agent including gradient echo (GRE) imaging. The three CCM-causative genes were sequenced by Sanger method. Literature data reporting patients with coexistence of CCMs and meningiomas were reviewed. MRI demonstrated dural-based meningioma-like lesions associated to multiple parenchymal CCMs in all affected individuals. A disease-causative mutation in the PDCD10 gene (p.Gln112PhefsX13) was identified. Based on neuroradiological and molecular data as well as on literature review, we outline a consistent association between PDCD10 mutations and a syndrome of CCMs with multiple meningiomas. This condition should be considered in the differential diagnosis of multiple/familial meningioma syndromes. In case of multiple/familial meningioma the use of appropriate MRI technique may include GRE and/or susceptibility-weighted imaging (SWI) to rule out CCM. By contrast, proper post-gadolinium scans may aid defining dural lesions in CCM patients and are indicated in PDCD10-mutated individuals. PMID:26246098

  5. Association between Inflammatory Infiltrates and Isolated Monosomy 22/del(22q) in Meningiomas

    PubMed Central

    Domingues, Patrícia Henriques; Teodósio, Cristina; Otero, Álvaro; Sousa, Pablo; Ortiz, Javier; Macias, María del Carmen García; Gonçalves, Jesús María; Nieto, Ana Belén; Lopes, María Celeste; de Oliveira, Catarina

    2013-01-01

    Meningiomas contain highly variable levels of infiltrating tissue macrophages (TiMa) and other immune cells. In this study we investigated the potential association between the number and immunophenotype of inflammatory and other immune cells infiltrating the tumor as evaluated by multiparameter flow cytometry, and the clinico-biological, cytogenetic and gene expression profile (GEP) of 75 meningioma patients. Overall, our results showed a close association between the amount and cellular composition of the inflammatory and other immune cell infiltrates and the cytogenetic profile of the tumors. Notably, tumors with isolated monosomy 22/del(22q) showed greater numbers of TiMa, NK cells and (recently)-activated CD69+ lymphocytes versus meningiomas with diploid and complex karyotypes. In addition, in the former cytogenetic subgroup of meningiomas, tumor-infiltrating TiMa also showed a more activated and functionally mature phenotype, as reflected by a greater fraction of CD69+, CD63+, CD16+ and CD33+ cells. GEP at the mRNA level showed a unique GEP among meningiomas with an isolated monosomy 22/del(22q) versus all other cases, which consisted of increased expression of genes involved in inflammatory/immune response, associated with an M1 TiMa phenotype. Altogether, these results suggest that loss of expression of specific genes coded in chromosome 22 (e.g. MIF) is closely associated with an increased homing and potentially also anti-tumoral effect of TiMa, which could contribute to explain the better outcome of this specific good-prognosis cytogenetic subgroup of meningiomas. PMID:24098347

  6. Diffusion-Weighted Imaging in Meningioma: Prediction of Tumor Grade and Association with Histopathological Parameters.

    PubMed

    Surov, Alexey; Gottschling, Sebastian; Mawrin, Christian; Prell, Julian; Spielmann, Rolf Peter; Wienke, Andreas; Fiedler, Eckhard

    2015-12-01

    To analyze diffusion-weighted imaging (DWI) findings of meningiomas and to compare them with tumor grade, cell count, and proliferation index and to test a possibility of use of apparent diffusion coefficient (ADC) to differentiate benign from atypical/malignant tumors. Forty-nine meningiomas were analyzed. DWI was done using a multislice single-shot echo-planar imaging sequence. A polygonal region of interest was drawn on ADC maps around the margin of the lesion. In all lesions, minimal ADC values (ADCmin) and mean ADC values (ADCmean) were estimated. Normalized ADC (NADC) was calculated in every case as a ratio ADCmean meningioma/ADCmean white matter. All meningiomas were surgically resected and analyzed histopathologically. The tumor proliferation index was estimated on Ki-67 antigen-stained specimens. Cell density was calculated. Collected data were evaluated by means of descriptive statistics. Analyses of ADC/NADC values were performed by means of two-sided t tests. The mean ADCmean value was higher in grade I meningiomas in comparison to grade II/III tumors (0.96 vs 0.80 × 10(-3) mm(2)s(-1), P = .006). Grade II/III meningiomas showed lower NADC values in comparison to grade I tumors (1.05 vs 1.26, P = .015). There was no significant difference in ADCmin values between grade I and II/III tumors (0.69 vs 0.63 × 10(-3) mm(2)s(-1), P = .539). The estimated cell count varied from 486 to 2091 (mean value, 1158.20 ± 333.74; median value, 1108). There were no significant differences in cell count between grade I and grade II/III tumors (1163.93 vs 1123.86 cells, P = .77). The mean level of the proliferation index was 4.78 ± 5.08%, the range was 1% to 18%, and the median value was 2%. The proliferation index was statistically significant higher in grade II/III meningiomas in comparison to grade I tumors (15.43% vs 3.00%, P = .001). Ki-67 was negatively associated with ADCmean (r = -0.61, P < .001) and NADC (r = -0.60, P < .001). No significant correlations between

  7. Meningioma after radiotherapy for malignancy.

    PubMed

    Morgenstern, Peter F; Shah, Kalee; Dunkel, Ira J; Reiner, Anne S; Khakoo, Yasmin; Rosenblum, Marc K; Gutin, Philip

    2016-08-01

    Complications of radiation exposure have gained importance with increasing cancer survivorship. Secondary malignancies have been associated with cranial radiation exposure. We present our experience with intracranial radiation-induced meningioma (RIM) and discuss the implications of its presentation and natural history for patient management. Patients diagnosed with meningioma who had received radiation therapy between 1960 and 2014 were identified. Records were retrospectively reviewed for details of radiation exposure, previous malignancies, meningioma subtypes, multiplicity and pathologic descriptions, treatment and follow-up. Thirty patients were diagnosed with RIM. Initial malignancies included acute lymphocytic leukemia (33.3%), medulloblastoma (26.7%) and glioma (16.7%) at a mean age of 8.1years (range 0.04-33years). The mean radiation dose was 34Gy (range 16-60Gy) and latency time to meningioma was 26years (range 8-51years). Twenty-one patients (70%) underwent surgery. Of these, 57.1% of tumors were World Health Organization (WHO) grade I while 42.9% were WHO II (atypical). The mean MIB-1 labeling index for patients with WHO I tumors was 5.44%, with 33.3% exhibiting at least 5% staining. Mean follow-up after meningioma diagnosis was 5.8years. Mortality was zero during the follow-up period. Meningioma is an important long-term complication of therapeutic radiation. While more aggressive pathology occurs more frequently in RIM than in sporadic meningioma, it remains unclear whether this translates into an effect on survival. Further study should be aimed at delineating the risks and benefits of routine surveillance for the development of secondary neoplasms after radiation therapy.

  8. Meningioma after radiotherapy for malignancy

    PubMed Central

    Morgenstern, Peter F.; Shah, Kalee; Dunkel, Ira J.; Reiner, Anne S.; Khakoo, Yasmin; Rosenblum, Marc K.; Gutin, Philip

    2017-01-01

    Complications of radiation exposure have gained importance with increasing cancer survivorship. Secondary malignancies have been associated with cranial radiation exposure. We present our experience with intracranial radiation-induced meningioma (RIM) and discuss the implications of its presentation and natural history for patient management. Patients diagnosed with meningioma who had received radiation therapy between 1960 and 2014 were identified. Records were retrospectively reviewed for details of radiation exposure, previous malignancies, meningioma subtypes, multiplicity and pathologic descriptions, treatment and follow-up. Thirty patients were diagnosed with RIM. Initial malignancies included acute lymphocytic leukemia (33.3%), medulloblastoma (26.7%) and glioma (16.7%) at a mean age of 8.1 years (range 0.04–33 years). The mean radiation dose was 34 Gy (range 16–60 Gy) and latency time to meningioma was 26 years (range 8–51 years). Twenty-one patients (70%) underwent surgery. Of these, 57.1% of tumors were World Health Organization (WHO) grade I while 42.9% were WHO II (atypical). The mean MIB-1 labeling index for patients with WHO I tumors was 5.44%, with 33.3% exhibiting at least 5% staining. Mean follow-up after meningioma diagnosis was 5.8 years. Mortality was zero during the follow-up period. Meningioma is an important long-term complication of therapeutic radiation. While more aggressive pathology occurs more frequently in RIM than in sporadic meningioma, it remains unclear whether this translates into an effect on survival. Further study should be aimed at delineating the risks and benefits of routine surveillance for the development of secondary neoplasms after radiation therapy. PMID:27068012

  9. Morbidity and Mortality Associated With Meningioma After Cranial Radiotherapy: A Report From the Childhood Cancer Survivor Study.

    PubMed

    Bowers, Daniel C; Moskowitz, Chaya S; Chou, Joanne F; Mazewski, Claire M; Neglia, Joseph P; Armstrong, Gregory T; Leisenring, Wendy M; Robison, Leslie L; Oeffinger, Kevin C

    2017-05-10

    Purpose Little is known about neurologic morbidity attributable to cranial radiotherapy (CRT) -associated meningiomas. Materials and Methods From 4,221 survivors exposed to CRT in the Childhood Cancer Survivor Study, a diagnosis of meningioma and onset of neurologic sequelae were ascertained. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% CIs to evaluate the factors associated with neurologic sequelae after subsequent meningioma. Results One hundred ninety-nine meningiomas were identified among 169 participants. The median interval from primary cancer to meningioma diagnosis was 22 years (5 to 37 years). The cumulative incidence of a subsequent meningioma by age 40 years was 5.6% (95% CI, 4.7% to 6.7%). CRT doses of 20 to 29.9 Gy (HR, 1.6; 95% CI,1.0 to 2.6) and doses ≥ 30 Gy (HR, 2.6; 95% CI, 1.6 to 4.2) were associated with an increased risk of meningioma compared with CRT doses of 1.5 to 19.9 Gy ( P < .001). Within 6 months before or subsequent to a meningioma diagnosis, 20% (30 of 149) reported at least one new neurologic sequela, including seizures (8.3%), auditory-vestibular-visual deficits (6%), focal neurologic dysfunction (7.1%), and severe headaches (5.3%). Survivors reporting a meningioma had increased risks of neurologic sequelae > 5 years after primary cancer diagnosis, including seizures (HR, 10.0; 95% CI, 7.0 to 15.3); auditory-vestibular-visual sensory deficits (HR, 2.3; 95% CI, 1.3 to 4.0); focal neurologic dysfunction (HR, 4.9; 95% CI, 3.2 to 7.5); and severe headaches (HR, 3.2; 95% CI, 1.9 to 5.4). With a median follow-up of 72 months after meningioma diagnosis (range, 3.8 to 395 months), 22 participants (13%) were deceased, including six deaths attributed to a meningioma. Conclusion Childhood cancer survivors exposed to CRT and subsequently diagnosed with a meningioma experience significant neurologic morbidity.

  10. Meningiomas of the central nervous system occurring below the age of 17: report of 24 cases not associated with neurofibromatosis and review of literature.

    PubMed

    Amirjamshidi, A; Mehrazin, M; Abbassioun, K

    2000-07-01

    The objective of this work was to gain more insight into the controversial characteristics of meningiomas occurring during childhood and adolescence. Management of meningiomas is an important field in pediatric neurosurgery. Every pediatric neurosurgeon has tried to resolve the problems relating to the clinical characteristics, biological behavior and outcome of this interesting and almost benign pathology, which rarely occurs in the first two decades of life. The records on central nervous system (CNS) tumors held by the two major neurosurgery centers of Tehran Medical University and Arad General Hospital were prospectively collected during last 15 years. Complete medical records are available for all 24 cases, and long-term follow-up was achieved 19 patients. All the cases were diagnosed and treated after the introduction of computed tomographic (CT) scanning. Angiography and magnetic resonance imaging (MRI) were performed as complementary studies in some cases. The sample consisted of 13 girls and 11 boys. The age range at the time of diagnosis varied between 2 and 17 years, with a mean of 9.47 and standard deviation of 3.43. Fifteen patients were below 10 years of age (62.5%), and 9 of them were between 10 and 17 years old (37.5%). The most common presenting symptoms, in declining order of frequency, were headache, epilepsy and focal neurological deficits. Similar cases associated with neurofibromatosis either at the time of presentation with meningioma or during the follow-up period were excluded (5 cases). The size of the presenting tumor was more than 5 cm in diameter in 17 cases. The locations of the lesions, taken as the site of the presumed widest dural base in each case were: spinal, orbital, ethmoidal and sphenoethmoidal in 1 case each, petroclival in 2, and tentorial or supratentorial in 18 patients. The only predisposing factor in this series of childhood meningiomas was whole-axis irradiation for previous malignancy in the case presenting with

  11. CCM3 Mutations Are Associated with Early-Onset Cerebral Hemorrhage and Multiple Meningiomas.

    PubMed

    Riant, F; Bergametti, F; Fournier, H-D; Chapon, F; Michalak-Provost, S; Cecillon, M; Lejeune, P; Hosseini, H; Choe, C; Orth, M; Bernreuther, C; Boulday, G; Denier, C; Labauge, P; Tournier-Lasserve, E

    2013-04-01

    Mutations of CCM3/PDCD10 cause 10-15% of hereditary cerebral cavernous malformations. The phenotypic characterization of CCM3-mutated patients has been hampered by the limited number of patients harboring a mutation in this gene. This is the first report on molecular and clinical features of a large cohort of CCM3 patients. Molecular screening for point mutations and deletions was used to identify 54 CCM3-mutated index patients. Age at referral and clinical onset, type of inaugural events and presence of extra-axial lesions were investigated in these 54 index patients and 22 of their mutated relatives. Mean age at clinical onset was 23.0 ± 16 years. Clinical onset occurred before 10 years in 26% of the patients, and cerebral hemorrhage was the initial presentation in 72% of these patients. Multiple extra-axial, dural-based lesions were detected in 7 unrelated patients. These lesions proved to be meningiomas in 3 patients who underwent neurosurgery and pathological examination. This 'multiple meningiomas' phenotype is not associated with a specific CCM3 mutation. Hence, CCM3 mutations are associated with a high risk of early-onset cerebral hemorrhage and with the presence of multiple meningiomas.

  12. Pediatric intracranial clear cell meningioma associated with a germline mutation of SMARCE1: a novel case.

    PubMed

    Raffalli-Ebezant, Helen; Rutherford, Scott A; Stivaros, Stavros; Kelsey, Anna; Smith, Miriam; Evans, D Gareth; Kilday, John-Paul

    2015-03-01

    Intracranial clear cell meningioma (CCM) represents a rare and potentially more aggressive subgroup of meningioma that is observed more frequently in children and adolescents. Despite its characterization as a histological entity, there is little evidence identifying tumorigenic etiologies. Recently, a novel mutation in SMARCE1, encoding a subunit of the SWI/SNF chromatin remodeling complex, was identified in a cohort of spinal CCMs. To date, no intracranial CCM has been subjected to analysis. We report the case of an isolated intracranial CCM in a 14-year-old girl. Gross total resection was achieved following a two-stage approach with no evidence of tumor recurrence 8 months following presentation. Exon sequencing identified a germline mutation in SMARCE1, which was also present in tumor DNA. Extensive literature review confirmed our study is the first to seek and report a genetic anomaly for childhood intracranial CCMs outside of the NF2 gene locus, and the first to make an association between a germline SMARCE1 mutation and childhood intracranial CCMs. Together with the previous description of SMARCE1 mutations in spinal CCMs, our report suggests that SMARCE1 aberrations may be implicated in establishing a clear cell histology irrespective of meningioma location. We would advocate that, where feasible, genetic sequencing is performed on future new cases of childhood neuraxial CCMs and includes interrogation of the SMARCE1 gene.

  13. Maternally Expressed Gene 3, an imprinted non-coding RNA gene, is associated with meningioma pathogenesis and progression

    PubMed Central

    Zhang, Xun; Gejman, Roger; Mahta, Ali; Zhong, Ying; Rice, Kimberley A.; Zhou, Yunli; Cheunsuchon, Pornsuk; Louis, David N.; Klibanski, Anne

    2010-01-01

    Meningiomas are common tumors, representing 15-25% of all central nervous system tumors. NF2 gene inactivation on chromosome 22 has been shown as an early event in tumorigenesis; however, few factors underlying tumor growth and progression have been identified. Chromosomal abnormalities of 14q32 are often associated with meningioma pathogenesis and progression; therefore it has been proposed that an as yet unidentified tumor suppressor is present at this locus. MEG3 is an imprinted gene located at 14q32 that encodes a non-coding RNA with an anti-proliferative function. We found that MEG3 mRNA is highly expressed in normal arachnoidal cells. However, MEG3 is not expressed in the majority of human meningiomas or the human meningioma cell lines IOMM-Lee and CH157-MN. There is a strong association between loss of MEG3 expression and tumor grade. Allelic loss at the MEG3 locus is also observed in meningiomas, with increasing prevalence in higher grade tumors. In addition, there is an increase in CpG methylation within the promoter and the imprinting control region of MEG3 gene in meningiomas. Functionally, MEG3 suppresses DNA synthesis in both IOMM-Lee and CH157-MN cells by approximately 60% in BrdU incorporation assays. Colony-forming efficiency assays show that MEG3 inhibits colony formation in CH157-MN cells by approximately 80%. Furthermore, MEG3 stimulates p53-mediated transactivation in these cell lines. Therefore, these data are consistent with the hypothesis that MEG3, which encodes a non-coding RNA, may be a tumor suppressor gene at chromosome 14q32 involved in meningioma progression via a novel mechanism. PMID:20179190

  14. Posttraumatic meningioma.

    PubMed

    Schiffer, J; Avidan, D; Rapp, A

    1985-07-01

    This report concerns three patients with intracranial meningioma developing at the site of an old head injury with skull fracture. These cases, along with literature reports, suggest a causal relationship between head trauma and the subsequent development of meningioma.

  15. The effects of PK11195 on meningioma was associated with allopregnanolone biosynthesis, which was mediated by translocator protein 18 KDa.

    PubMed

    Gao, Zhuo-Wei; Huang, Jing-Bin; Lin, Qing; Qin, Qiang; Liang, Yao-Jun; Zhou, Lu; Luo, Min

    2016-01-01

    Meningioma is one of the common brain tumors in adults. It had been shown that the allopregnanolone biosynthesis was associated with tumorigenesis and PK11195, the translocator protein 18 KDa (TSPO) antagonist, had the effects of the allopregnanolone biosynthesis. However, little is known about the association between the effects of PK11195 on meningioma and the allopregnanolone biosynthesis. To evaluate this, the meningioma cell line IOMM-LEE was applied. Cell viability and proliferation were determined by CCK-8 assay. The IC50 of PK11195 on the IOMM-LEE was 1.505 ± 0.08 nM. The cell viability and proliferation of AC-5216 (TSPO selective ligand, 2 and 4 nM) was blocked by PK11195 (1.5 nM). Further, we evaluated the role of allopregnanolone biosynthesis in the effects of TSPO on meningioma. Enzyme-Linked ImmunoSorbent Assay (ELISA) was used in the measurement of the allopregnanolone level. It showed that the allopregnanolone level was increased by AC-5216 (2 and 4 nM) and the increase was reversed by PK11195 (1.5 nM). Collectedly, it firstly indicated that the effects of PK11195 on meningioma were relevant to the decrease of allopregnanolone biosynthesis, which was mediated by TSPO.

  16. Identification of Gene Markers Associated with Aggressive Meningioma by Filtering across Multiple Sets of Gene Expression Arrays

    PubMed Central

    Stuart, Jourdan E.; Lusis, Eriks A.; Scheck, Adrienne C.; Coons, Stephen W.; Lal, Anita; Perry, Arie; Gutmann, David H.

    2013-01-01

    Meningiomasare common intracranial tumors but relatively little is known about the genetic events responsible for their clinical diversity. While recent genomic studies have provided clues, the genes identified often differ among publications. We used microarray expression profiling to identify genes that are differentially expressed, with at least a 4-fold change, between grade I and grade III meningiomas. We filtered this initial set of potential biomarkers through a second cohort of meningiomas and then verified the remaining genes by quantitative polymerase chain reaction followed by examination using a third microarray expression cohort. Using this approach, we identified 9 overexpressed (TPX2, RRM2, TOP2A, PI3, BIRC5, CDC2, NUSAP1, DLG7, SOX11) and 2 underexpressed (TIMP3, KCNMA1) genes in grade III vs. grade I meningiomas. As a further validation step, we analyzed these genes in a fourth cohort and found that patients with grade II meningiomas with high topoisomerase 2-α protein expression (greater than 5% labeling-index) had shorter times to death than patients with low expression. We believe that this multistep, multi-cohort approach provides a robust method for reducing false positives while generating a list of reproducible candidate genes that are associated with clinically aggressive meningioma and are suitable for analysis for their potential prognostic value. PMID:21157382

  17. Case Report: Pulmonary metastases of malignant meningioma

    PubMed Central

    Basunaid, Suhail; Franssen, Frits M.E.; Accord, Ryan; Hamid, Myrurgia Abdul; Mahesh, Shekar; Baumert, Brigitta G.; Schijns, Olaf E.M.G.

    2014-01-01

    Meningioma accounts for approximately one-third of primary central nervous system tumors. Most meningiomas are benign, although up to one third are classified as atypical or malignant. We describe a 63-year Caucasian male presenting with pleural metastases from an intracranial meningioma. Distant metastases from meningiomas are infrequently found in clinical practice and mostly are associated with atypical or malignant meningiomas. There is no standard treatment; however surgical resection of both the primary and metastatic lesions is the safest therapy. The overall prognosis of atypical meningiomas is poor. Our patient died one week after discharge from our hospital. PMID:25254095

  18. Association of Morbidity with Extent of Resection and Cavernous Sinus Invasion in Sphenoid Wing Meningiomas*

    PubMed Central

    Ivan, Michael E.; Cheng, Jason S.; Kaur, Gurvinder; Sughrue, Michael E.; Clark, Aaron; Kane, Ari J.; Aranda, Derick; McDermott, Michael; Barani, Igor J.; Parsa, Andrew T.

    2012-01-01

    Sphenoid wing meningiomas (SWMs) typically are histologically benign, insidious lesions, but the propensity of these tumors for local invasion makes disease control very challenging. In this review, we assess whether the degree of resection and extent of cavernous sinus invasion affects morbidity, mortality, and recurrence in patients with SWM. A comprehensive search of the English-language literature was performed. Patients were stratified according to extent of resection and extent of cavernous sinus invasion, and tumor recurrence rate, morbidity, and mortality were analyzed. A total of 23 studies and 131 patients were included. Overall recurrence and surgical mortality rate were 11% and 2%, respectively (average follow-up = 65 months). Cranial nerve III palsy was significantly associated with incompletely versus completely resected SWMs (7 to 0%) as well as meningiomas with cavernous sinus invasion versus no sinus invasion (14 vs. 0%). No significant difference in tumor recurrence rate was noted between these groups. In conclusion, complete excision of SWMs is always recommended whenever possible, but surgeons should acknowledge that there is nonetheless a chance of recurrence and should weigh this against the risk of causing cranial nerve injuries. PMID:23372999

  19. Hormonal therapy for fertility and huge meningioma: a purely random association?

    PubMed

    Frassanito, Paolo; De Bonis, Pasquale; Mattogno, Pier Paolo; Novello, Mariangela; Anile, Carmelo

    2012-09-01

    Sexual hormones have been related to the growth of meningiomas, also due to the almost constant expression of hormonal receptors by tumoral cells. A case of a woman with previous history of multiple treatment for infertility, harboring a huge meningioma is here described. The tumor was surgically resected and the immunohistochemical examination revealed a high expression of progesterone receptors on tumoral cells surface. A putative role of past progesterone administration in the growth of meningioma has been hypothesized. Particular caution should be paid whenever adopting sexual hormonal therapy, especially for fertility. A radiological examination (ideally MRI) could be advised before starting therapy, in order to rule out any intracranial meningioma.

  20. Aneurysm of azygos anterior cerebral artery associated with falcine meningioma: Case Report and review of the literature

    PubMed Central

    Meguins, Lucas C.; Hidalgo, Raquel C. T.; Spotti, Antônio R.; de Morais, Dionei F.

    2017-01-01

    Background: The azygos anterior cerebral artery (ACA) is an uncommon intracranial vascular anomaly of the circle of Willis. Identification of aneurysm from azygos ACA with anterior falcine meningioma is an extremely rare association. The aim of the present study is to report the case of an adult female with a ruptured aneurysm from azygos ACA in association with an anterior falcine meningioma. Case Description: A 65-year-old female was admitted in the Emergency Department reporting sudden onset of severe headache. Computed tomography (CT) revealed an intracerebral hematoma and an expansive calcified lesion. AngioCT showed the presence of a large aneurysm in the distal portion of the azygos ACA. During the surgical procedure, it was possible to visualize the aneurysm in contact with an expansive lesion arising from the anterior third of the falx. Microsurgical clipping of the aneurysm was performed uneventfully and partial resection of the tumor was done. Histopathological analysis showed a fibrous meningioma. The patient was discharged home on the seventh postoperative day in good clinical conditions. Conclusion: The association of aneurysm from azygos ACA and falcine meningioma is an extremely rare event and must be remembered when expansive masses are present in the vicinity of vascular lesions. PMID:28303205

  1. Association of tamoxifen with meningioma: a population-based study in Sweden

    PubMed Central

    Sundquist, Jan; Sundquist, Kristina

    2016-01-01

    Previous studies suggest that hormone therapy may play an important role in the development of meningioma. However, it is unclear whether medication with tamoxifen can prevent meningioma. Our study cohort included all women who were diagnosed with breast cancer between 1961 and 2010, and a total of 227 535 women were identified with breast cancer with a median age at diagnosis of 63 years. Women diagnosed with breast cancer after 1987 were defined as tamoxifen exposed; those diagnosed with breast cancer before or during 1987 were defined as not exposed to tamoxifen. Standardized incidence ratios (SIRs) were used to calculate the risk of subsequent meningioma. Of these women, 223 developed meningioma. For women without tamoxifen exposure, the risk of meningioma was significantly increased, with an SIR of 1.54 (95% confidence interval 1.30–1.81); the risk was not increased in those with tamoxifen exposure (SIR=1.06, 95% confidence interval 0.84–1.32). The increased risk of meningioma in women without tamoxifen exposure persisted during 10 years of follow-up. In this historical cohort study, we found that women diagnosed with breast cancer but not treated with tamoxifen had an increased incidence of meningioma, whereas the incidence was close to that of the general population in patients treated with tamoxifen. This suggests that tamoxifen may prevent the development of meningioma. PMID:25642792

  2. Association of tamoxifen with meningioma: a population-based study in Sweden.

    PubMed

    Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

    2016-01-01

    Previous studies suggest that hormone therapy may play an important role in the development of meningioma. However, it is unclear whether medication with tamoxifen can prevent meningioma. Our study cohort included all women who were diagnosed with breast cancer between 1961 and 2010, and a total of 227 535 women were identified with breast cancer with a median age at diagnosis of 63 years. Women diagnosed with breast cancer after 1987 were defined as tamoxifen exposed; those diagnosed with breast cancer before or during 1987 were defined as not exposed to tamoxifen. Standardized incidence ratios (SIRs) were used to calculate the risk of subsequent meningioma. Of these women, 223 developed meningioma. For women without tamoxifen exposure, the risk of meningioma was significantly increased, with an SIR of 1.54 (95% confidence interval 1.30-1.81); the risk was not increased in those with tamoxifen exposure (SIR=1.06, 95% confidence interval 0.84-1.32). The increased risk of meningioma in women without tamoxifen exposure persisted during 10 years of follow-up. In this historical cohort study, we found that women diagnosed with breast cancer but not treated with tamoxifen had an increased incidence of meningioma, whereas the incidence was close to that of the general population in patients treated with tamoxifen. This suggests that tamoxifen may prevent the development of meningioma.

  3. Activation of Yes-Associated Protein in Low-Grade Meningiomas Is Regulated by Merlin, Cell Density, and Extracellular Matrix Stiffness.

    PubMed

    Tanahashi, Kuniaki; Natsume, Atsushi; Ohka, Fumiharu; Motomura, Kazuya; Alim, Adiljan; Tanaka, Ichidai; Senga, Takeshi; Harada, Ichiro; Fukuyama, Ryuichi; Sumiyoshi, Naoyuki; Sekido, Yoshitaka; Wakabayashi, Toshihiko

    2015-07-01

    The NF2 gene product Merlin is a protein containing ezrin, radixin, and moesin domains; it is a member of the 4.1 protein superfamily associated with the membrane cytoskeleton and also interacts with cell surface molecules. The mammalian Hippo cascade, a downstream signaling cascade of merlin, inactivates the Yes-associated protein (YAP). Yes-associated protein is activated by loss of the NF2 gene and functions as an oncogene in meningioma cells; however, the factors controlling YAP expression, phosphorylation, and subcellular localization in meningiomas have not been fully elucidated. Here, we demonstrate that merlin expression is heterogeneous in 1 NF2 gene-negative and 3 NF2 gene-positive World Health Organization grade I meningiomas. In the NF2 gene-positive meningiomas, regions with low levels of merlin (tumor rims) had greater numbers of cells with nuclear YAP versus regions with high merlin levels (tumor cores). Merlin expression and YAP phosphorylation were also affected by cell density in the IOMM-Lee and HKBMM human meningioma cell lines; nuclear localization of YAP was regulated by cell density and extracellular matrix (ECM) stiffness in IOMM-Lee cells. These results suggest that cell density and ECM stiffness may contribute to the heterogeneous loss of merlin and increased nuclear YAP expression in human meningiomas.

  4. Angiosarcoma arising in schwannoma of cerebellopontine angle and later associating with meningioma in a patient with neurofibromatosis type 2.

    PubMed

    Sakai, Yasuhiro; Hirose, Takanori; Tomono, Ayako; Kawakami, Fumi; Nakai, Tokiko; Ohbayashi, Chiho; Mizowaki, Takashi; Tanaka, Kazuhiro; Kohmura, Eiji; Itoh, Tomoo

    2014-10-01

    Here, we describe an extremely rare case of angiosarcoma arising in schwannoma of the cerebellopontine angle and later associating with meningioma in a patient with neurofibromatosis type 2. A 33-year-old disabled Japanese man with right drop foot after surgery for an unspecified tumor demonstrated multiple tumors, suspected to be schwannoma, in the bilateral cerebellopontine angles, the cervical and lumbar spinal cord, and on the right nuchal skin. Also present were several tumors in the medulla and thoracic spinal cord suspected to be ependymoma or astrocytoma. The patient was diagnosed with neurofibromatosis type 2 according to the diagnostic criteria by the U.S. National Institutes of Health. The bilateral tumors in the cerebellopontine angle were resected to reduce symptoms and brain stem compression. Histopathological analysis revealed angiosarcoma arising in schwannoma of the bilateral tumors, and angiosarcoma was proportionally larger in the right tumor than in the left. At age 36, the patient underwent a second resection of the regrown tumor in the left cerebellopontine angle, and histopathology demonstrated mixed angiosarcoma and meningioma. That angiosarcoma arises in schwannoma is a pathogenesis within the realm of conjecture, especially that the phenomenon of mixed meningioma and angiosarcoma has not been reported to date.

  5. Exposure to Ionizing Radiation during Dental X-Rays Is Not Associated with Risk of Developing Meningioma: A Meta-Analysis Based on Seven Case-Control Studies

    PubMed Central

    Xu, Ping; Luo, Hong; Huang, Guang-Lei; Yin, Xin-Hai; Luo, Si-Yang; Song, Ju-Kun

    2015-01-01

    Background Many observational studies have found that exposure to dental X-rays is associated with the risk of development of meningioma. However, these findings are inconsistent. We conducted a meta-analysis to assess the relationship between exposure to dental X-rays and the risk of development of meningioma. Methods The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and 95% confidence intervals (95% CIs) were used to compute the risk of meningioma development according to heterogeneity. Subgroup and sensitivity analyses were performed to further explore the potential heterogeneity. Finally, publication bias was assessed. Results Seven case-control studies involving 6,174 patients and 19,459 controls were included in the meta-analysis. Neither exposure to dental X-rays nor performance of full-mouth panorex X-rays was associated with an increased risk of development of meningioma (overall: OR, 0.97; 95% CI, 0.70–1.32; dental X-rays: OR, 1.05; 95% CI, 0.89–1.25; panorex X-rays: OR, 1.01; 95% CI, 0.76–1.34). However, exposure to bitewing X-rays was associated with a slightly increased risk of development of meningioma (OR, 1.73; 95% CI, 1.28–2.34). Similar results were obtained in the subgroup and sensitivity analyses. Little evidence of publication bias was observed. Conclusion Based on the currently limited data, there is no association between exposure to dental X-rays and the risk of development of meningioma. However, these results should be cautiously interpreted because of the heterogeneity among studies. Additional large, high-quality clinical trials are needed to evaluate the association between exposure to dental X-rays and the risk of development of meningioma. PMID:25658814

  6. Exposure to ionizing radiation during dental X-rays is not associated with risk of developing meningioma: a meta-analysis based on seven case-control studies.

    PubMed

    Xu, Ping; Luo, Hong; Huang, Guang-Lei; Yin, Xin-Hai; Luo, Si-Yang; Song, Ju-Kun

    2015-01-01

    Many observational studies have found that exposure to dental X-rays is associated with the risk of development of meningioma. However, these findings are inconsistent. We conducted a meta-analysis to assess the relationship between exposure to dental X-rays and the risk of development of meningioma. The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and 95% confidence intervals (95% CIs) were used to compute the risk of meningioma development according to heterogeneity. Subgroup and sensitivity analyses were performed to further explore the potential heterogeneity. Finally, publication bias was assessed. Seven case-control studies involving 6,174 patients and 19,459 controls were included in the meta-analysis. Neither exposure to dental X-rays nor performance of full-mouth panorex X-rays was associated with an increased risk of development of meningioma (overall: OR, 0.97; 95% CI, 0.70-1.32; dental X-rays: OR, 1.05; 95% CI, 0.89-1.25; panorex X-rays: OR, 1.01; 95% CI, 0.76-1.34). However, exposure to bitewing X-rays was associated with a slightly increased risk of development of meningioma (OR, 1.73; 95% CI, 1.28-2.34). Similar results were obtained in the subgroup and sensitivity analyses. Little evidence of publication bias was observed. Based on the currently limited data, there is no association between exposure to dental X-rays and the risk of development of meningioma. However, these results should be cautiously interpreted because of the heterogeneity among studies. Additional large, high-quality clinical trials are needed to evaluate the association between exposure to dental X-rays and the risk of development of meningioma.

  7. Grading Meningioma

    PubMed Central

    Okuchi, Sachi; Okada, Tomohisa; Yamamoto, Akira; Kanagaki, Mitsunori; Fushimi, Yasutaka; Okada, Tsutomu; Yamauchi, Moritaka; Kataoka, Masako; Arakawa, Yoshiki; Takahashi, Jun C.; Minamiguchi, Sachiko; Miyamoto, Susumu; Togashi, Kaori

    2015-01-01

    Abstract The purpose was to compare capability of fluorine-18 fluorodeoxyglucose (FDG)-PET and thallium-201 (Tl)-SPECT for grading meningioma. This retrospective study was conducted as a case-control study under approval by the institutional review board. In the hospital information system, 67 patients (22 men and 45 women) who had both FDG-PET and Tl-SPECT preoperative examinations were found with histopathologic diagnosis of meningioma. The maximum FDG uptake values of the tumors were measured, and they were standardized to the whole body (SUVmax) and normalized as gray matter ratio (SUVRmax). Mean and maximum Tl uptake ratios (TURmean and TURmax, respectively) of the tumors were measured and normalized as ratios to those of the contralateral normal brain. Receiver-operating characteristic curve analyses of the 4 indexes were conducted for differentiation between low- and high-grade meningiomas, and areas under the curves (AUCs) were compared. Correlation coefficients were calculated between these indexes and Ki-67. Fifty-six meningiomas were classified as grade I (low grade), and 11 were grade II or III (high grade). In all 4 indexes, a significant difference was observed between low- and high-grade meningiomas (P < 0.05). AUCs were 0.817 (SUVmax), 0.781 (SUVRmax), 0.810 (TURmean), and 0.831 (TURmax), and no significant difference was observed among the indexes. Their sensitivity and specificity were 72.7% to 90.9% and 71.4% to 87.5%, respectively. Correlation of the 4 indexes to Ki-67 was statistically significant, but coefficients were relatively low (0.273–0.355). Tl-SPECT, which can be used at hospitals without a cyclotron or an FDG distribution network, has high diagnostic capability of meningioma grades comparable to FDG-PET. PMID:25674763

  8. Spinal meningiomas: surgical management and outcome.

    PubMed

    Gottfried, Oren N; Gluf, Wayne; Quinones-Hinojosa, Alfredo; Kan, Peter; Schmidt, Meic H

    2003-06-15

    Advances in imaging and surgical technique have improved the treatment of spinal meningiomas; these include magnetic resonance imaging, intraoperative ultrasonography, neuromonitoring, the operative microscope, and ultrasonic cavitation aspirators. This study is a retrospective review of all patients treated at a single institution and with a pathologically confirmed diagnosis of spinal meningioma. Additionally the authors analyze data obtained in 556 patients reported in six large series in the literature, evaluating surgical techniques, results, and functional outcomes. Overall, surgical treatment of spinal meningiomas is associated with favorable outcomes. Spinal meningiomas can be completely resected, are associated with postoperative functional improvement, and the rate of recurrence is low.

  9. Meningioma in Breast Cancer Patients: Population-based Analysis of Clinicopathologic Characteristics.

    PubMed

    Milano, Michael T; Grossman, Craig E

    2017-02-01

    Although an association between meningioma and breast cancer (BC) has been postulated, clear mechanisms remain obscure. By conducting population-based analyses in women with both BC and meningioma, hypothesis-generating causal links were pursued. Using the US SEER 18 registry (2004 to 2009), clinicopathologic and demographic characteristics from cohorts of women with only BC (n=279,821) or meningioma (n=19,570) diagnoses were compared with 412 women with both diagnoses (BC-meningioma). BC diagnosis preceded meningioma by >2 months in 48% of women; 20% had synchronous (within 2 mo) disease. Median meningioma size was 1.9 and 2.4 cm in the BC-meningioma and meningioma cohorts, respectively (P=0.0009). Among BC-meningioma patients, meningioma size was similar whether diagnosed >2 months prior, synchronously, or >2 months after BC. Meningioma was pathologically confirmed in 38% of BC-meningioma and 51% of meningioma patients. Distribution of BC histologies was comparable in patients with and without meningioma, with ductal type predominating (80% in BC-meningioma, 83% in BC). Although hormone receptor status of invasive BC was not significantly different between BC-meningioma and BC groups, the BC-meningioma cohort had fewer women with ER+/PR+ in situ disease (P=0.006). BC stage among women with meningioma was more advanced versus women with BC only. Women with BC and meningioma have smaller-sized meningiomas and more advanced BCs compared with women having only 1 diagnosis. As there was no temporal relationship between size and latency between tumor diagnoses, the disparity in meningioma size between BC-meningioma and meningioma cohorts may have BC-associated biological components that warrant further study.

  10. Primary Intraosseous Meningioma.

    PubMed

    Chen, Thomas C

    2016-04-01

    Primary intraosseous meningiomas are a subtype of primary extradural meningiomas. They represent approximately two-thirds of extradural meningiomas and fewer than 2% of meningiomas overall. These tumors originate within the bones of the skull and can have a clinical presentation and radiographic differential diagnosis different from those for intradural meningiomas. Primary intraosseous meningiomas are classified based on location and histopathologic characteristics. Treatment is primarily surgical resection with wide margins if possible. Sparse literature exists regarding the use of adjuvant therapies. The literature regarding primary intraosseous meningiomas consists primarily of clinical case reports and case series. This literature is reviewed and summarized in this article.

  11. Acute recurrent haemorrhage of an intracranial meningioma.

    PubMed

    Bellut, David; Nern, Christian; Burkhardt, Jan-Karl; Könü, Dilek; Bertalanffy, Helmut; Krayenbühl, Niklaus

    2011-07-01

    Meningioma-associated haemorrhages are rare. To our knowledge this is the first report of a patient with an acute two-stage haemorrhage of a benign intracranial meningioma (World Health Organization grade I) verified by cranial CT scan and histopathological examination. Early surgery with complete tumour removal led to a good outcome for the patient. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Meningioma in Down Syndrome.

    PubMed

    Yamamoto, Takahiro; Shinojima, Naoki; Todaka, Tatemi; Nishikawa, Shigeyuki; Yano, Shigetoshi; Kuratsu, Jun-ichi

    2015-09-01

    Down syndrome comprises multiple malformations and is due to trisomy of chromosome 21. There is epidemiologic evidence that individuals with Down syndrome are at decreased risk for solid tumors including brain tumors. It has been suggested that some genes expressed on the extra copy of chromosome 21 act as tumor suppressor genes and contribute to protection against tumorigenesis. We report the first case to our knowledge of a patient with Down syndrome, an 8-year-old boy, with an intracranial meningioma, in which the status of chromosome 21 was examined. The diagnosis was based on histologic examination of the surgically resected tumor. Postoperatively, the patient's neurologic status improved, and there was no tumor regrowth in the next 2 years. Fluorescence in situ hybridization for chromosome 22 confirmed high allele loss involving the neurofibromin 2 gene locus, a finding typical in meningiomas. Fluorescence in situ hybridization also revealed chromosome 21 heterogeneity in tumor cells; not only cells with trisomy 21 but also cells with disomy and monosomy 21 were present. All blood cells from the patient manifested trisomy 21. Deletion of the chromosome 21 allele may be associated with tumorigenesis of meningioma in Down syndrome. This supports the hypothesis that some genes whose expression is increased on the extra copy of chromosome 21 function as tumor suppressor genes and that they contribute to the reduced tumor incidence in individuals with Down syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Meningioma patients diagnosed 2007-2009 and the association with use of mobile and cordless phones: a case-control study.

    PubMed

    Carlberg, Michael; Söderqvist, Fredrik; Hansson Mild, Kjell; Hardell, Lennart

    2013-07-19

    To study the association between use of wireless phones and meningioma. We performed a case-control study on brain tumour cases of both genders aged 18-75 years and diagnosed during 2007-2009. One population-based control matched on gender and age was used to each case. Here we report on meningioma cases including all available controls. Exposures were assessed by a questionnaire. Unconditional logistic regression analysis was performed. In total 709 meningioma cases and 1,368 control subjects answered the questionnaire. Mobile phone use in total produced odds ratio (OR) = 1.0, 95% confidence interval (CI) = 0.7-1.4 and cordless phone use gave OR = 1.1, 95% CI = 0.8-1.5. The risk increased statistically significant per 100 h of cumulative use and highest OR was found in the fourth quartile (>2,376 hours) of cumulative use for all studied phone types. There was no statistically significant increased risk for ipsilateral mobile or cordless phone use, for meningioma in the temporal lobe or per year of latency. Tumour volume was not related to latency or cumulative use in hours of wireless phones. No conclusive evidence of an association between use of mobile and cordless phones and meningioma was found. An indication of increased risk was seen in the group with highest cumulative use but was not supported by statistically significant increasing risk with latency. Results for even longer latency periods of wireless phone use than in this study are desirable.

  14. Meningioma patients diagnosed 2007–2009 and the association with use of mobile and cordless phones: a case–control study

    PubMed Central

    2013-01-01

    Background To study the association between use of wireless phones and meningioma. Methods We performed a case–control study on brain tumour cases of both genders aged 18–75 years and diagnosed during 2007–2009. One population-based control matched on gender and age was used to each case. Here we report on meningioma cases including all available controls. Exposures were assessed by a questionnaire. Unconditional logistic regression analysis was performed. Results In total 709 meningioma cases and 1,368 control subjects answered the questionnaire. Mobile phone use in total produced odds ratio (OR) = 1.0, 95% confidence interval (CI) = 0.7-1.4 and cordless phone use gave OR = 1.1, 95% CI = 0.8-1.5. The risk increased statistically significant per 100 h of cumulative use and highest OR was found in the fourth quartile (>2,376 hours) of cumulative use for all studied phone types. There was no statistically significant increased risk for ipsilateral mobile or cordless phone use, for meningioma in the temporal lobe or per year of latency. Tumour volume was not related to latency or cumulative use in hours of wireless phones. Conclusions No conclusive evidence of an association between use of mobile and cordless phones and meningioma was found. An indication of increased risk was seen in the group with highest cumulative use but was not supported by statistically significant increasing risk with latency. Results for even longer latency periods of wireless phone use than in this study are desirable. PMID:23870102

  15. Meningioma recurrence

    PubMed Central

    Bencze, János; Varkoly, Gréta; Kouhsari, Mahan C; Klekner, Álmos

    2016-01-01

    Abstract Meningioma accounts for more than 30% of all intracranial tumours. It affects mainly the elderly above the age of 60, at a female:male ratio of 3:2. The prognosis is variable: it is usually favourable with no progression in tumour grade and no recurrence in WHO grade 1 tumours. However, a minority of tumours represent atypical (grade 2) or anaplastic (grade 3) meningiomas; this heterogeneity is also reflected in histopathological appearances. Irrespective of the grade, the size of the tumour and the localisation may have severe, sometimes lethal consequences. Following neurosurgical interventions to remove the tumour, recurrence and progression in WHO grade may occur. Our knowledge on predisposing histomorphological and molecular factors of recurrence is rather limited. These can be classified as I) demographic II) environmental, III) genetic and epigenetic IV) imaging, V) neuropathological, and VI) neurosurgical. In view of the complex background of tumour recurrence, the recognition of often subtle signs of increased risk of recurrence requires close collaboration of experts from several medical specialties. This multidisciplinary approach results in better therapy and fewer complications related to tumour recurrence. PMID:28352788

  16. Association of methionine synthase rs1801394 and methionine synthase reductase rs1805087 polymorphisms with meningioma in adults: A meta-analysis

    PubMed Central

    ZENG, XIAN-TAO; LU, JUN-TI; TANG, XIANG-JUN; WENG, HONG; LUO, JIE

    2014-01-01

    Several epidemiological studies suggested that methionine synthase (MTRR) rs1801394 and methionine synthase reductase (MTR) rs1805087 polymorphisms may be involved in the risk of meningioma in adults; however, the results from different case-control studies have been inconsistent. Therefore, we performed a meta-analysis to investigate the association of MTRR and MTR polymorphisms with meningioma. PubMed, Web of Knowledge, China National Knowledge Infrastructure and Wanfang databases were searched up to October 30, 2013 and 3 publications, involving 7 case-control studies, were finally included. Following data extraction, a meta-analysis was conducted using Stata 12.0 software. The pooled results based on the fixed effects model demonstrated that the MTRR rs1801394 polymorphism was associated with an increased risk of meningioma [odds ratio (OR)=1.18, 95% confidence interval (CI): 1.05–1.32 for G vs. A; OR=1.41, 95% CI: 1.12–1.77 for GG vs. AA; OR=1.08, 95% CI: 0.94–1.33 for AG vs. AA; OR=1.19, 95% CI: 1.01–1.40 for (AG+GG) vs. AA; and OR=1.32, 95% CI: 1.07–1.63 for GG vs. (AG+AA)]; however, an association between the MTR rs1805087 polymorphism and the risk of meningioma was not identified [OR=0.99, 95% CI: 0.88–1.12 for G vs. A; OR=1.09, 95% CI: 0.80–1.48 for GG vs. AA; OR=0.95, 95% CI: 0.82–1.11 for AG vs. AA; OR=0.97, 95% CI: 0.84–1.13 for (AG+GG) vs. AA; and OR=1.09, 95% CI: 0.80–1.48 for GG vs. (AG+AA)]. Therefore, the currently available evidence suggests that the MTRR rs1801394 polymorphism may increase the risk of meningioma, whereas the MTRR rs1801394 polymorphism is not associated with meningioma. PMID:24748989

  17. Meckel's cave meningiomas with subarachnoid hemorrhage.

    PubMed

    Rosenberg, G A; Herz, D A; Leeds, N; Strully, K

    1975-06-01

    Two patients with Meckel's Cave meningiomas were initially hospitalized as a result of subarachnoid hemorrhage. Four-vessel angiography was necessary to exclude other causes of bleeding while demonstrating these lesions. Apoplectic presentation in both cases led to early diagnosis and successful surgical therapy. A review of the literature reveals subarachnoid hemorrhage to be a rarity in association with meningiomas. The two patients currently reported are believed to be the only examples on record of hemorrhagic meningiomas arising from the region of Meckel's Cave.

  18. Pooled analysis of Swedish case-control studies during 1997-2003 and 2007-2009 on meningioma risk associated with the use of mobile and cordless phones.

    PubMed

    Carlberg, Michael; Hardell, Lennart

    2015-06-01

    A pooled analysis of two case-control studies on meningioma with patients diagnosed during 1997-2003 and 2007-2009 was conducted. Both genders were included, aged 20-80 and 18-75 years, respectively, at the time of diagnosis. Population-based controls, matched according to age and gender, were enrolled. Exposure was assessed by questionnaire. In the entire study, cases with all brain tumor types were included. The whole reference group was used in the unconditional logistic regression analysis on meningioma, with adjustments for gender, age, year of diagnosis and socio-economic index (SEI). In total, 1,625 meningioma cases and 3,530 controls were analyzed. Overall no association with use of mobile or cordless phones was found. In the fourth quartile of use (>1,436 h) somewhat increased risk was found for mobile phones yielding an odds ratio (OR)=1.2, 95% confidence intervals (CI)=0.9-1.6 and cordless phones OR=1.7, 95% CI=1.3-2.2. Higher risk was calculated in the highest decile (>3,358 h), OR=1.5, 95% CI=0.99-2.1 and OR=2.0, 95% CI=1.4-2.8, respectively. In addition, the longest latency time gave somewhat increased risk for both phone types although the result was not statistically significant. There was no association for ipsilateral use or anatomical tumor location. The present study showed a somewhat increased risk among heavy users of mobile and cordless phones. Since meningioma is generally a slow-growing tumor, longer latency period is necessary for definitive conclusions.

  19. Meningioma Genomics: Diagnostic, Prognostic, and Therapeutic Applications

    PubMed Central

    Bi, Wenya Linda; Zhang, Michael; Wu, Winona W.; Mei, Yu; Dunn, Ian F.

    2016-01-01

    There has been a recent revolution in our understanding of the genetic factors that drive meningioma, punctuating an equilibrium that has existed since Cushing’s germinal studies nearly a century ago. A growing appreciation that meningiomas share similar biologic features with other malignancies has allowed extrapolation of management strategies and lessons from intra-axial central nervous system neoplasms and systemic cancers to meningiomas. These features include a natural proclivity for invasion, frequent intratumoral heterogeneity, and correlation between biologic profile and clinical behavior. Next-generation sequencing has characterized recurrent somatic mutations in NF2, TRAF7, KLF4, AKT1, SMO, and PIK3CA, which are collectively present in ~80% of sporadic meningiomas. Genomic features of meningioma further associate with tumor location, histologic subtype, and possibly clinical behavior. Such genomic decryption, along with advances in targeted pharmacotherapy, provides a maturing integrated view of meningiomas. We review recent advances in meningioma genomics and probe their potential applications in diagnostic, therapeutic, and prognostic frontiers. PMID:27458586

  20. Signals of apoptotic pathways in several types of meningioma.

    PubMed

    Sabbatini, Maurizio; Comi, Cristoforo; Chiocchetti, Annalisa; Piffanelli, Valentina; Car, Pier Giorgio; Dianzani, Umberto; Monaco, Francesco; Cannas, Mario

    2011-03-01

    Meningiomas are intracranial tumour derived from meningothelial cells, which aggressive behaviour has been frequently associated to cell apoptosis. In this paper activation of several factors involved in apoptosis has been investigated on biopsies of primary, non recurrent meningiomas. Benign (meningotheliomatous, transitional, fibrous, angiomatous), atypical and anaplastic meningiomas were analysed by immunohistochemistry and western blot, to visualize the occurring of different apoptotic pathways and their association with clinical grading. Apoptotic cell have been detected by a double colorimetric staining for TUNEL and caspase-3 active form. Apoptotic signal positive cells have been detected in all type of meningiomas analysed, with exception of meningotheliomatous meningiomas. Differences have been found in the activation of apoptotic pathways between several types of grade I meningiomas and among benign, anaplastic and atypical meningiomas. An intense expression of several apoptotic inhibitor occurred in grade I meningiomas. The correlation among expression of apoptotic and inhibitory factors and cell proliferation index may suggest that in grade I meningiomas apoptosis may be related to mechanisms involved into tumor cells surviving. Instead in grade II and III meningiomas the same correlation seems indicate an high turnover of tumor cells that might be useful as index of cell proliferation and tumor mass growth.

  1. Pathology and Molecular Genetics of Meningioma: Recent Advances

    PubMed Central

    SHIBUYA, Makoto

    2015-01-01

    Meningiomas are the most common intracranial primary neoplasm in adults. Although the spectrum of clinical and molecular genetic issues regarding meningiomas remains undefined, novel genetic alterations that are associated with tumor morphology, malignancy, or location have recently been discovered. This review focuses on recent advances in understanding of the heterogenous pathology of meningiomas, particularly on associations between the clinical, histological, etiological, epidemiological, and molecular genetical aspects of the neoplasm. PMID:25744347

  2. The Influence of Pretreatment Characteristics and Radiotherapy Parameters on Time Interval to Development of Radiation-Associated Meningioma

    SciTech Connect

    Paulino, Arnold C.; Ahmed, Irfan M.; Mai, Wei Y.; Teh, Bin S.

    2009-12-01

    Purpose: To identify pretreatment characteristics and radiotherapy parameters which may influence time interval to development of radiation-associated meningioma (RAM). Methods and Materials: A Medline/PUBMED search of articles dealing with RAM yielded 66 studies between 1981 and 2006. Factors analyzed included patient age and gender, type of initial tumor treated, radiotherapy (RT) dose and volume, and time interval from RT to development of RAM. Results: A total of 143 patients with a median age at RT of 12 years form the basis of this report. The most common initial tumors or conditions treated with RT were medulloblastoma (n = 27), pituitary adenoma (n = 20), acute lymphoblastic leukemia (n = 20), low-grade astrocytoma (n = 19), and tinea capitis (n = 14). In the 116 patients whose RT fields were known, 55 (47.4%) had a portion of the brain treated, whereas 32 (27.6%) and 29 (25.0%) had craniospinal and whole-brain fields. The median time from RT to develop a RAM or latent time (LT) was 19 years (range, 1-63 years). Male gender (p = 0.001), initial diagnosis of leukemia (p = 0.001), and use of whole brain or craniospinal field (p <= 0.0001) were associated with a shorter LT, whereas patients who received lower doses of RT had a longer LT (p < 0.0001). Conclusions: The latent time to develop a RAM was related to gender, initial tumor type, radiotherapy volume, and radiotherapy dose.

  3. Molecular and Clinical Evidence for an ARMC5 Tumor Syndrome: Concurrent Inactivating Germline and Somatic Mutations Are Associated With Both Primary Macronodular Adrenal Hyperplasia and Meningioma

    PubMed Central

    Trovato, Alessia; Kloth, Michael; Gentz, Enno; Finke, Reinhard; Spranger, Joachim; Galas, David; Weber, Susanne; Wolf, Cristina; König, Katharina; Arlt, Wiebke; Büttner, Reinhard; May, Patrick; Allolio, Bruno; Schneider, Jochen G.

    2015-01-01

    Context: Primary macronodular adrenal hyperplasia (PMAH) is a rare cause of Cushing's syndrome, which may present in the context of different familial multitumor syndromes. Heterozygous inactivating germline mutations of armadillo repeat containing 5 (ARMC5) have very recently been described as cause for sporadic PMAH. Whether this genetic condition also causes familial PMAH in association with other neoplasias is unclear. Objective: The aim of the present study was to delineate the molecular cause in a large family with PMAH and other neoplasias. Patients and Methods: Whole-genome sequencing and comprehensive clinical and biochemical phenotyping was performed in members of a PMAH affected family. Nodules derived from adrenal surgery and pancreatic and meningeal tumor tissue were analyzed for accompanying somatic mutations in the identified target genes. Results: PMAH presenting either as overt or subclinical Cushing's syndrome was accompanied by a heterozygous germline mutation in ARMC5 (p.A110fs*9) located on chromosome 16. Analysis of tumor tissue showed different somatic ARMC5 mutations in adrenal nodules supporting a second hit hypothesis with inactivation of a tumor suppressor gene. A damaging somatic ARMC5 mutation was also found in a concomitant meningioma (p.R502fs) but not in a pancreatic tumor, suggesting biallelic inactivation of ARMC5 as causal also for the intracranial meningioma. Conclusions: Our analysis further confirms inherited inactivating ARMC5 mutations as a cause of familial PMAH and suggests an additional role for the development of concomitant intracranial meningiomas. PMID:25279498

  4. Meningiomas with Rhabdoid or Papillary Components : Prognosis and Comparison with Anaplastic Meningiomas

    PubMed Central

    Kim, Jeong-Kwon; Jung, Shin; Lee, Kyung-Hwa; Kim, Seul-Kee; Lee, Eun Jung

    2016-01-01

    Papillary and rhabdoid meningiomas are pathologically World Health Organization (WHO) grade III. Any correlation between clinical prognosis and pathologic component is not clear. We analyzed the prognoses of patients with meningiomas with a rhabdoid or papillary component compared to those of patients with anaplastic meningiomas. From 1994 to June 2013, 14 anaplastic meningiomas, 6 meningiomas with a rhabdoid component, and 5 meningiomas with papillary component were pathologically diagnosed. We analyzed magnetic resonance imaging (MRI) findings, extent of removal, adjuvant treatment, progression-free survival (PFS), overall survival (OS), and pathologic features of 14 anaplastic meningiomas (group A), 5 meningiomas with a predominant (≥50%) papillary or rhabdoid component (group B1), and 6 meningiomas without a predominant (<50%) rhabdoid or papillary component (group B2). Homogeneous enhancement on MRI was associated with improved PFS compared to heterogeneous enhancement (p=0.025). Depending on pathology, the mean PFS was 134.9±31.6 months for group A, 46.6±13.4 months for group B1, and 118.7±19.2 months for group B2. The mean OS was 138.5±24.6 months for group A and 59.7±16.8 months for group B1. All recurrent tumors were of the previously diagnosed pathology, except for one tumor from group B1, which recurred as an atypical meningioma without a papillary component. Group B1 tumors showed a more aggressive behavior than group B2 tumors. In group B2 cases, the pathologic findings of non-rhabdoid/papillary portion could be considered for further adjuvant treatment. PMID:27446516

  5. Jugular fossa meningioma: presentation and treatment options.

    PubMed

    Rutt, Amy L; Chen, Xiaoli; Sataloff, Robert T

    2009-10-01

    Primary jugular fossa meningiomas are among the rarest subtypes of meningioma. They are intimately related to the lower cranial nerves, the jugular bulb and vein, and the temporal bone, and they have a tendency to extend both intra- and extracranially. The most common morbidity associated with jugular fossa lesions is lower cranial nerve deficits. In these cases, the differential diagnosis and preoperative radiographic diagnosis are very important because preoperative management and operative planning for the jugular fossa subtype differ considerably from those of other types of meningioma. Because of the rarity of this condition, our understanding of its treatment, long-term follow-up, and recurrence is limited. As experience with radiosurgical treatment of all meningiomas is accumulating, we may find that radiosurgery of jugular fossa meningiomas is appropriate. In the meantime, cure is still possible with complete surgical resection, and surgical morbidity can be minimized through meticulous planning and surgical technique. We describe a case of primary jugular fossa meningioma in a 45-year-old man who presented with complaints of chronic left aural fullness, hearing loss, and difficulty understanding voices. Imaging revealed the presence of a destructive jugular fossa mass. The patient underwent surgical resection without complication, and he was free of recurrence at 1 year of follow-up.

  6. NDRG4 is a novel oncogenic protein and p53 associated regulator of apoptosis in malignant meningioma cells

    PubMed Central

    Kotipatruni, Rama P.; Ren, Xuan; Thotala, Dinesh; Jaboin, Jerry J.

    2015-01-01

    Aggressive meningiomas exhibit high levels of recurrence, morbidity and mortality. When surgical and radiation options are exhausted, there is need for novel molecularly-targeted therapies. We have recently identified NDRG4 overexpression in aggressive meningiomas. NDRG4 is a member of the N-Myc Downstream Regulated Gene (NDRG) family of the alpha/beta hydrolase superfamily. We have demonstrated that NDRG4 downregulation results in decreased cell proliferation, migration and invasion. In follow up to our prior studies; here we demonstrate that the predominant form of cell death following NDRG4 silencing is apoptosis, utilizing Annexin-V flow cytometry assay. We show that apoptosis caused by p53 upregulation, phosphorylation at Ser15, BAX activation, Bcl-2 and BcL-xL downregulation, mitochondrial cytochrome c release and execution of caspases following NDRG4 depletion. Sub-cellular distribution of BAX and cytochrome c indicated mitochondrial-mediated apoptosis. In addition, we carried out the fluorescence cytochemical analysis to confirm mitochondrial-mediated apoptosis by changes in mitochondrial membrane potential (Ψm), using JC-1 dye. Immunoprecipitation and immunofluorescence confirmed binding of NDRG4 to p53. In addition, we demonstrate that apoptosis is mitochondrial and p53 dependent. The proapoptotic effect of p53 was verified by the results in which a small molecule compound PFT-α, an inhibitor of p53 phosphorylation, is greatly protected against targeting NDRG4 induced apoptosis. These findings bring novel insight to the roles of NDRG4 in meningioma progression. A better understanding of this pathway and its role in meningioma carcinogenesis and cell biology is promising for the development of novel therapeutic targets for the management of aggressive meningiomas. PMID:26053091

  7. Recurrence-associated chromosomal anomalies in meningiomas: Single-institution study and a systematic review with meta-analysis.

    PubMed

    Och, Waldemar; Szmuda, Tomasz; Sikorska, Beata; Springer, Janusz; Jaskólski, Dariusz; Zakrzewska, Magdalena; Liberski, Paweł P

    Complete removal of a meningioma (MG) does not guarantee relapse-free survival. Alterations on several chromosomes responsible for MG recurrence were suggested, although their role was not validated by a systematic review. Following the analysis of own 161 cases, all previously published data has been collected for evidence synthesis. Based on own series, WHO grade >I (odds ratio (OR)=92.0; 95%CI: 19.1-443.5) and a combination of loss of heterozygosity (LOH) on 1p and 14q (OR=10.2; 95%CI: 19-55.7) were the independent recurrence-specific prognosticators. The deleterious role of LOH on 1p/14q was demonstrated in a subset of parasagittal and falcine MGs. A total of 742 cases and 10 studies were pooled for the Individual Patient Data and Aggregate Data models of meta-analysis, respectively. The prognostic role of WHO classification (OR=90.4) and anomaly of chromosome 14 (OR=3.5) was confirmed. LOH on 14 showed lesser impact on recurrence than suggested by the WHO grading (area under the curve 0.65 for LOH vs. 0.74 for WHO). Fixed effect model of meta-analysis provided high summarized OR values for 1p (OR=5.4; 95%CI: 3.6-8.1) and 14q (OR=7.6; 95%CI: 4.3-13.6), and low for chromosome 22 (OR=1.6; 95%CI: 1.1-2.4). Final appraisal of recurrence-associated chromosomal alterations indicated that arms 1p and 14q deserve attention while predicting MG recurrence. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  8. Fatty acid synthase as a novel target for meningioma therapy

    PubMed Central

    Haase, Daniela; Schmidl, Stefan; Ewald, Christian; Kalff, Rolf; Huebner, Christian; Firsching, Raimund; Keilhoff, Gerburg; Evert, Matthias; Paulus, Werner; Gutmann, David H.; Lal, Anita; Mawrin, Christian

    2010-01-01

    High levels of fatty acid synthase (FAS) expression have been reported in hormone receptor-positive tumors, including prostate, breast, and ovarian cancers, and its inhibition reduces tumor growth in vitro and in vivo. Similar to other hormone receptor-positive tumor types, meningiomas are progesterone receptor- and estrogen receptor-immunoreactive brain tumors. To define the role of FAS in human meningioma growth control, we first analyzed the FAS expression using a tissue microarray containing 38 meningiomas and showed increased FAS expression in 70% of atypical WHO grade II and anaplastic WHO grade III meningiomas compared with 10% of benign WHO grade I tumors. We next confirmed this finding by real-time PCR and Western blotting. Second, we demonstrated that treatment with the FAS inhibitor, cerulenin (Cer), significantly decreased meningioma cell survival in vitro. Third, we showed that Cer treatment reduced FAS expression by modulating Akt phosphorylation (activation). Fourth, we demonstrated that Cer treatment of mice bearing meningioma xenografts resulted in significantly reduced tumor volumes associated with increased meningioma cell death. Collectively, our data suggest that the increased FAS expression in human meningiomas represents a novel therapeutic target for the treatment of unresectable or malignant meningioma. PMID:20511185

  9. Genetic landscape of meningioma.

    PubMed

    Yuzawa, Sayaka; Nishihara, Hiroshi; Tanaka, Shinya

    2016-10-01

    Meningioma is the most common intracranial tumor, arising from arachnoid cells of the meninges. Monosomy 22 and inactivating mutations of NF2 are well-known genetic alterations of meningiomas. More recently, mutations in TRAF7, AKT1, KLF4, SMO, and PIK3CA were identified by next-generation sequencing. We here reviewed 553 meningiomas for the mutational patterns of the six genes. NF2 aberration was observed in 55 % of meningiomas. Mutations of TRAF7, AKT1, KLF4, PIK3CA, and SMO were identified in 20, 9, 9, 4.5, and 3 % of cases, respectively. Altogether, 80 % of cases harbored at least one of the genetic alterations in these genes. NF2 alterations and mutations of the other genes were mutually exclusive with a few exceptions. Clinicopathologically, tumors with mutations in TRAF7/AKT1 and SMO shared specific features: they were located in the anterior fossa, median middle fossa, or anterior calvarium, and most of them were meningothelial or transitional meningiomas. TRAF7/KLF4 type meningiomas showed different characteristics in that they occurred in the lateral middle fossa and median posterior fossa as well as anterior fossa and median middle fossa, and contained a secretory meningioma component. We also discuss the mutational hotspots of these genes and other genetic/cytogenetic alterations contributing to tumorigenesis or progression of meningiomas.

  10. Temporal bone meningiomas.

    PubMed

    Hooper, R; Siu, K; Cousins, V

    1990-10-01

    Meningiomas should be considered in the differential diagnosis of space-occupying lesions of the temporal bone. Five cases of meningiomas of the temporal bone are described and the literature reviewed. These tumours may stimulate Schwannomas and glomus tumours in their presentation and radiological findings. The tumours were managed by combining standard neurosurgical approaches with temporal bone and skull base techniques.

  11. Obesity and diabetes genetic variants associated with gestational weight gain

    PubMed Central

    Stuebe, Alison M.; Lyon, Helen; Herring, Amy; Ghosh, Joyee; Wise, Alison; North, Kari E.; Siega-Riz, Anna Maria

    2011-01-01

    Objective To determine whether genetic variants associated with diabetes and obesity predict gestational weight gain. Study Design 960 participants in the Pregnancy, Infection and Nutrition cohorts were genotyped for 27 single-nucleotide polymorphisms (SNPs) associated with diabetes and obesity. Results Among white and black women (n=960), KCNQ1 risk allele carriage was directly associated with weight gain (p < 0.01). In Bayesian hierarchical models among white women (N=628), we found posterior odds ratios > 3 for inclusion of TCF2 and THADA SNPs in our models. Among black women (n=332), we found associations between risk allele carriage and weight gain for the THADA and INSIG2 SNPs. In Bayesian variable selection models, we found an interaction between the TSPAN8 risk allele and pre-gravid obesity, with lower weight gain among obese risk allele carriers. Conclusion We found evidence that diabetes and obesity risk alleles interact with maternal pre-gravid BMI to predict gestational weight gain. PMID:20816152

  12. Allergy reduces the risk of meningioma: a meta-analysis

    PubMed Central

    Wang, Peng-fei; Ji, Wen-Jun; Zhang, Xiao-hui; Li, Shou-wei; Yan, Chang-Xiang

    2017-01-01

    Meningiomas are the most common brain tumours; however, little is known regarding their aetiology. The data are inconsistent concerning atopic disease and the risk of developing meningioma. Thus, we conducted a meta-analysis to investigate the association between allergic conditions and the risk of developing meningioma. A systematic literature search was conducted using PubMed and Web of SCI from Jan 1979 to Feb 2016. Two investigators independently selected the relevant articles according to the inclusion criteria. Eight case-control studies and 2 cohort studies were included in the final analysis, comprising 5,679 meningioma cases and 55,621 control subjects. Compared with no history of allergy, the pooled odds ratio (OR) for allergic conditions was 0.81 (0.70–0.94) for meningioma in a random-effects meta-analysis. Inverse correlations of meningioma occurrence were also identified for asthma and eczema, in which the pooled ORs were 0.78 (0.70–0.86) and 0.78 (0.69–0.87), respectively. A reduced risk of meningioma occurrence was identified in hay fever; however, the association was weak (0.88, 95% CI = 0.78–0.99). The source of this heterogeneity could be the various confounding variables in individual studies. Overall, the current meta-analysis indicated that allergy reduced the risk of developing meningiomas. Large cohort studies are required to investigate this relationship. PMID:28071746

  13. Exercise during pregnancy and its association with gestational weight gain.

    PubMed

    Harris, Shericka T; Liu, Jihong; Wilcox, Sara; Moran, Robert; Gallagher, Alexa

    2015-03-01

    We examined the association between exercise during pregnancy and meeting gestational weight gain recommendations. Data came from the 2009 South Carolina Pregnancy Risk Assessment Monitoring System (n = 856). Women reported their participation in exercise/sports activities before and during pregnancy, including the number of months and types of exercise. We developed an exercise index (EI), the product of the number of months spent in exercise and average metabolic equivalents for specific exercise. The 2009 Institute of Medicine's guideline was used to categorize gestational weight gain into three classes: inadequate, adequate, and excessive. Multinomial logistic regression models were used to adjust for confounders. Over 46 % of women exceeded the recommended weight gain during pregnancy. Nearly one third (31.9 %) of women reported exercising ≥3 times a week at any time during pregnancy. Compared to women who did not report this level of exercise during pregnancy, exercising women were more likely to meet gestational weight gain recommendations (32.7 vs. 18.7 %) and had a lower odds of excessive gestational weight gain [adjusted odds ratio (AOR) 0.43, 95 % confidence interval 0.24-0.78]. Women with an EI above the median value of those women who exercised or women who exercised ≥3 times a week for 6-9 months during pregnancy had lower odds of excessive gestational weight gain (AOR for EI 0.20, 0.08-0.49; AOR for months 0.26, 0.12-0.56, respectively). Our findings support the need to promote or increase exercise during pregnancy to reduce the high proportion of women who are gaining excessive weight.

  14. Transformation of a meningioma with atypical imaging

    PubMed Central

    Kumar, Ashish; Deopujari, Chandrashekhar; Karmarkar, Vikram

    2016-01-01

    Meningiomas are benign tumors of the central nervous system. They have long term curability if they are excised completely. If not, they can recur after a prolonged period and can lead to increased morbidity during re-surgery. Recurrence is rarely associated with invasiveness. Usually de-differentiation in case of meningiomas is uncommon without any predisposing factors including different genetic mutations or radiation to the involved region. We report a case of a 38-year-old female who was operated for a benign para-sagittal meningioma 8 years back and subsequently developed an invasive recurrence off late. Also this time, the imaging morphology was slightly different for a meningioma and gross as well as microscopic findings were very atypical. Awareness for such cases must be there while dealing with recurrent meningiomas as invasiveness may not always be associated with adverse predisposing factors like radiation. As invasiveness is always a histopathological diagnosis, picking up such features on imaging is a daunting task and if done, can help neurosurgeons prognosticate such invasive recurrences in a better fashion. PMID:27366271

  15. Disseminated extracranial metastatic meningioma.

    PubMed

    Chua, Felicia H Z; Low, Sharon Y Y; Tham, Chee K; Ding, Cristine; Wong, Chin F; Nolan, Colum P

    2016-11-01

    Meningiomas are usually low-grade, solitary lesions that rarely metastasize. In this group of central nervous system tumours, the higher grade subtypes are notorious for resistance to conventional chemo-radiation therapies. Recent studies have shown efficacy in the use of bevacizumab in patients with recurrent and, or progressive anaplastic meningioma. The authors report a case of a young patient with recurrent anaplastic meningioma who despite being treated with bevacizumab, progressed with disease dissemination to multiple extracranial sites. Although the majority of meningiomas are amendable to treatment, the higher grade subtypes remain therapeutically challenging. The unexpected resistance to anti-angiogenic therapy in this patient adds another layer of complexity to an elusive subset of a supposedly benign disease. This patient report reflects the need for in-depth studies, molecular characterization and overall, better disease understanding in order to improve prognosis for affected patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Fast-Growing Meningioma in a Woman Undergoing Fertility Treatments

    PubMed Central

    Elashaal, Abdurrahim

    2016-01-01

    Meningiomas have long been known to be associated with sexual hormones. We discuss here the case of a woman with a huge meningioma that rapidly grew over the course of a couple years while the patient was simultaneously taking fertility treatments. There is substantial evidence suggesting that fertility treatments can fuel the growth of meningiomas. The potential risks should be considered in women with a previous or family history of meningiomas who plan to undergo fertility treatment. These patients need to be evaluated and a screening imaging of brain MRI (Magnetic Resonant Imaging) should be offered in the middle or toward the end of such a treatment to control and prevent complications of these meningiomas. PMID:28116188

  17. Prospective associations of eating behaviors with weight gain in infants

    PubMed Central

    Shepard, Desti N.; Chandler-Laney, Paula C.

    2015-01-01

    Objective To examine whether maternal reports of infant eating behaviors are stable over time and whether eating behaviors are prospectively associated with weight gain. Methods In an ongoing study of infant growth, weight and length were measured at 2-weeks, 3-months, and 5-months of age. Food responsiveness (FR), satiety responsiveness (SR), enjoyment of feeding (EF), and slow eating (SE) were assessed with the Baby Eating Behavior Questionnaire. Repeated measures ANOVA were used to examine changes in eating behaviors from 2-weeks to 5-months. Simple Pearson correlations examined associations among eating behaviors across time, and associations of eating behaviors with subsequent change in weight-for-length z-scores. Results Among 31 infants studied from 2-weeks to 3-months, FR and SR remained consistent (P<0.05), and among 21 infants studied from 3- to 5-months, FR, EF, and SE were consistent (P<0.01). Infants ate more quickly (P<0.01), and tended to have greater SR with age (P=0.09). Only SE at 3-months was associated with subsequent gain in weight-for-length (P<0.05). Conclusions Consistent with previous research, SE was predictive of weight gain during infancy. Given that eating behaviors were largely consistent after 3-months of age, it may be important to encourage the development of healthy eating behaviors during early infancy. PMID:26242892

  18. Management of Spinal Meningiomas.

    PubMed

    Ravindra, Vijay M; Schmidt, Meic H

    2016-04-01

    Spinal meningiomas are the most common spinal tumors encountered in adults, and account for 6.5% of all craniospinal tumors. The treatment for these lesions is primarily surgical, but emerging modalities may include chemotherapy and radiosurgery. In this article, the current management of spinal meningiomas and the body of literature surrounding conventional treatment is reviewed and discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Gains in Life Expectancy Associated with Higher Education in Men

    PubMed Central

    Bijwaard, Govert E.; van Poppel, Frans; Ekamper, Peter; Lumey, L. H.

    2015-01-01

    Background Many studies show large differences in life expectancy across the range of education, intelligence, and socio-economic status. As educational attainment, intelligence, and socio-economic status are highly interrelated, appropriate methods are required to disentangle their separate effects. The aim of this paper is to present a novel method to estimate gains in life expectancy specifically associated with increased education. Our analysis is based on a structural model in which education level, IQ at age 18 and mortality all depend on (latent) intelligence. The model allows for (selective) educational choices based on observed factors and on an unobserved factor capturing intelligence. Our estimates are based on information from health examinations of military conscripts born in 1944–1947 in The Netherlands and their vital status through age 66 (n = 39,798). Results Our empirical results show that men with higher education have lower mortality. Using structural models to account for education choice, the estimated gain in life expectancy for men moving up one educational level ranges from 0.3 to 2 years. The estimated gain in months alive over the observational period ranges from -1.2 to 5.7 months. The selection effect is positive and amounts to a gain of one to two months. Decomposition of the selection effect shows that the gain from selection on (latent) intelligence is larger than the gain from selection on observed factors and amounts to 1.0 to 1.7 additional months alive. Conclusion Our findings confirm the strong selection into education based on socio-economic status and intelligence. They also show significant higher life expectancy among individuals with higher education after the selectivity of education choice has been taken into account. Based on these estimates, it is plausible therefore that increases in education could lead to increases in life expectancy. PMID:26496647

  20. Gains in Life Expectancy Associated with Higher Education in Men.

    PubMed

    Bijwaard, Govert E; van Poppel, Frans; Ekamper, Peter; Lumey, L H

    2015-01-01

    Many studies show large differences in life expectancy across the range of education, intelligence, and socio-economic status. As educational attainment, intelligence, and socio-economic status are highly interrelated, appropriate methods are required to disentangle their separate effects. The aim of this paper is to present a novel method to estimate gains in life expectancy specifically associated with increased education. Our analysis is based on a structural model in which education level, IQ at age 18 and mortality all depend on (latent) intelligence. The model allows for (selective) educational choices based on observed factors and on an unobserved factor capturing intelligence. Our estimates are based on information from health examinations of military conscripts born in 1944-1947 in The Netherlands and their vital status through age 66 (n = 39,798). Our empirical results show that men with higher education have lower mortality. Using structural models to account for education choice, the estimated gain in life expectancy for men moving up one educational level ranges from 0.3 to 2 years. The estimated gain in months alive over the observational period ranges from -1.2 to 5.7 months. The selection effect is positive and amounts to a gain of one to two months. Decomposition of the selection effect shows that the gain from selection on (latent) intelligence is larger than the gain from selection on observed factors and amounts to 1.0 to 1.7 additional months alive. Our findings confirm the strong selection into education based on socio-economic status and intelligence. They also show significant higher life expectancy among individuals with higher education after the selectivity of education choice has been taken into account. Based on these estimates, it is plausible therefore that increases in education could lead to increases in life expectancy.

  1. [Ptosis secondary to cavernous sinus meningioma].

    PubMed

    Louis, M; Goga, D; François, P; Laure, B

    2013-12-01

    Meningiomas of the cavernous sinus are often the cause of neuro-ophthalmologic manifestations. Fifty percent of affected patients present with ptosis. We report a case of ptosis acquired during the first year of life due to oculomotor nerve palsy secondary to a cavernous sinus meningioma. We then discuss the causes of third cranial nerve palsy and treatment options for ptosis associated with CN III palsy. A fifteen-year-old female patient presented with ptosis due to a third cranial nerve palsy appearing within the first year of life. Magnetic resonance imaging (MRI) revealed a cavernous sinus meningioma. The ptosis was treated by frontalis suspension using autologous temporalis fascia. The meningioma required regular follow-up. Ptosis due to third cranial nerve palsy is rare in children. The most common etiologies are congenital and represent 33 to 40% of cases in various studies. Other etiologies are traumatic, tumoral, vascular and infectious. The cause needs to be found by imaging over the entire course of the nerve. Cavernous sinus meningioma is one cause of third cranial nerve palsy. The surgical treatment of ptosis due to third cranial nerve palsy is levator resection or frontalis suspension with a strip of fascia lata or temporalis fascia. Copyright © 2013. Published by Elsevier Masson SAS.

  2. Cognitive behavioural therapy for weight gain associated with antipsychotic drugs.

    PubMed

    Khazaal, Yasser; Fresard, Emmanuelle; Rabia, Sophie; Chatton, Anne; Rothen, Stephane; Pomini, Valentino; Grasset, François; Borgeat, François; Zullino, Daniele

    2007-03-01

    Overweight and obesity are common concerns in individuals with severe mental disorders. In particular, antipsychotic drugs (AP) frequently induce weight gain. This phenomenon lacks current management and no previous controlled studies seem to use cognitive therapy to modify eating and weight-related cognitions. Moreover, none of these studies considered binge eating or eating and weight-related cognitions as possible outcomes. The main aim of this study is to assess the effectivity of cognitive and behavioural treatment (CBT) on eating and weight-related cognitions, binge eating symptomatology and weight loss in patients who reported weight gain during AP treatment. A randomized controlled study (12-week CBT vs. Brief Nutritional Education) was carried out on 61 patients treated with an antipsychotic drug who reported weight gain following treatment. Binge eating symptomatology, eating and weight-related cognitions, as well as weight and body mass index were assessed before treatment, at 12 weeks and at 24 weeks. The CBT group showed some improvement with respect to binge eating symptomatology and weight-related cognitions, whereas the control group did not. Weight loss occurred more progressively and was greater in the CBT group at 24 weeks. The proposed CBT treatment is particularly interesting for patients suffering from weight gain associated with antipsychotic treatment.

  3. Molecular Genetics of Intracranial Meningiomas with Emphasis on Canonical Wnt Signalling.

    PubMed

    Pećina-Šlaus, Nives; Kafka, Anja; Lechpammer, Mirna

    2016-07-15

    Research over the last decade recognized the importance of novel molecular pathways in pathogenesis of intracranial meningiomas. In this review, we focus on human brain tumours meningiomas and the involvement of Wnt signalling pathway genes and proteins in this common brain tumour, describing their known functional effects. Meningiomas originate from the meningeal layers of the brain and the spinal cord. Most meningiomas have benign clinical behaviour and are classified as grade I by World Health Organization (WHO). However, up to 20% histologically classified as atypical (grade II) or anaplastic (grade III) are associated with higher recurrent rate and have overall less favourable clinical outcome. Recently, there is emerging evidence that multiple signalling pathways including Wnt pathway contribute to the formation and growth of meningiomas. In the review we present the synopsis on meningioma histopathology and genetics and discuss our research regarding Wnt in meningioma. Epithelial-to-mesenchymal transition, a process in which Wnt signalling plays an important role, is shortly discussed.

  4. Genetic profiling by single-nucleotide polymorphism-based array analysis defines three distinct subtypes of orbital meningioma.

    PubMed

    Ho, Cheng-Ying; Mosier, Stacy; Safneck, Janice; Salomao, Diva R; Miller, Neil R; Eberhart, Charles G; Gocke, Christopher D; Batista, Denise A S; Rodriguez, Fausto J

    2015-03-01

    Orbital meningiomas can be classified as primary optic nerve sheath (ON) meningiomas, primary intraorbital ectopic (Ob) meningiomas and spheno-orbital (Sph-Ob) meningiomas based on anatomic site. Single-nucleotide polymorphism (SNP)-based array analysis with the Illumina 300K platform was performed on formalin-fixed, paraffin-embedded tissue from 19 orbital meningiomas (5 ON, 4 Ob and 10 Sph-Ob meningiomas). Tumors were World Health Organization (WHO) grade I except for two grade II meningiomas, and one was NF2-associated. We found genomic alterations in 68% (13 of 19) of orbital meningiomas. Sph-Ob tumors frequently exhibited monosomy 22/22q loss (70%; 7/10) and deletion of chromosome 1p, 6q and 19p (50% each; 5/10). Among genetic alterations, loss of chromosome 1p and 6q were more frequent in clinically progressive tumors. Chromosome 22q loss also was detected in the majority of Ob meningiomas (75%; 3/4) but was infrequent in ON meningiomas (20%; 1/5). In general, Ob tumors had fewer chromosome alterations than Sph-Ob and ON tumors. Unlike Sph-Ob meningiomas, most of the Ob and ON meningiomas did not progress even after incomplete excision, although follow-up was limited in some cases. Our study suggests that ON, Ob and Sph-Ob meningiomas are three molecularly distinct entities. Our results also suggest that molecular subclassification may have prognostic implications.

  5. Cervical spinal extradural meningioma: Case report.

    PubMed

    Benzagmout, M; Azzal, F; Bitar, A; El Faïz Chaoui, M; Van Effenterre, R

    2010-10-01

    Extradural meningiomas account for approximately 7% of all spinal meningiomas and are most commonly located in the thoracic spine. Although rare, they should be included in the differential diagnosis of an extradural contrast-enhancing mass. Prognosis depends greatly on the extent of surgical resection. If considered safe, complete resection should be attempted to decrease the risk of recurrence. We report a case of spinal epidural meningioma diagnosed in an elderly woman complaining of right cervicobrachial pain of several years duration, associated with diffuse paresthesia and permanent numbness of her right index finger. The surgical removal of the tumor was incomplete because of the deep lateral extension of the lesion. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  6. Lipomatous meningioma: A rare subtype of benign metaplastic meningiomas

    PubMed Central

    Yüksel, Mehmet Onur; Gürbüz, Mehmet Sabri; Tanrıverdi, Osman; Özmen, Sevilay Akalp

    2017-01-01

    Lipomatous meningiomas are extremely rare subtypes of benign meningiomas and are classified as metaplastic meningioma in the World Health Organization classification. We present a 77-year-old man presented with the history of a gradually intensifying headache for the last 3 months. A right frontoparietal mass was detected on his cranial magnetic resonance imaging. The patient was operated on via a right frontoparietal craniotomy, and histopathological diagnosis was lipomatous meningioma. Distinctive characteristics of lipomatous meningiomas were discussed with special emphasis to importance of immunohistochemical examinations, particularly for its differentiation from the tumors showing similar histology though having more aggressive character. PMID:28149104

  7. Posterior approach to ventrally located spinal meningiomas

    PubMed Central

    Voulgaris, Spyridon; Mihos, Evaggelos; Karagiorgiadis, Dimitrios; Zigouris, Andreas; Fotakopoulos, George; Drosos, Dimitrios; Pahaturidis, Dimitrios

    2010-01-01

    For the resection of anteriorly located meningiomas, various approaches have been used. Posterior approach is less invasive and demanding; however, it has been associated with increased risk of spinal cord injury. We evaluated ten consecutive patients that underwent surgery for spinal meningiomas. All patients were preoperative assessed by neurological examination, computed tomography and magnetic resonance imaging. All tumors were ventrally located and removed via a posterior approach. Transcranial motor-evoked potentials (TcMEPs), somatosensory-evoked potential (SSEP) and free running electromyography (EMG) were monitored intraoperative. Postoperative all patients had regular follow-up examinations. There were four males and six females. The mean age was 68.2 years (range 39–82 years). In nine out of ten cases, the tumor was located in the thoracic spine. A case of a lumbar meningioma was recorded. The most common presenting symptom was motor and sensory deficits and unsteady gait, whereas no patient presented with paraplegia. All meningiomas were operated using a microsurgical technique via a posterior approach. During the operation, free running EMG monitoring prompted a surgical alert in case of irritation, whereas TcMEP and SSEP amplitudes remained unchanged. Histopathology revealed the presence of typical (World Health Organisation grade I) meningiomas. The mean Ki-67/MIB-1 index was 2.75% (range 0.5–7). None of our patients sustained a transient or permanent motor deficit. After a mean follow-up period of 26 months (range 56–16 months), no tumor recurrence and no instability were found. Posterior approach for anteriorly located meningiomas is a safe procedure with the use of intraoperative monitoring, less invasive and well-tolerated especially in older patients. Complete tumor excision can be performed with satisfactory results. PMID:20127494

  8. Posterior approach to ventrally located spinal meningiomas.

    PubMed

    Voulgaris, Spyridon; Alexiou, George A; Mihos, Evaggelos; Karagiorgiadis, Dimitrios; Zigouris, Andreas; Fotakopoulos, George; Drosos, Dimitrios; Pahaturidis, Dimitrios

    2010-07-01

    For the resection of anteriorly located meningiomas, various approaches have been used. Posterior approach is less invasive and demanding; however, it has been associated with increased risk of spinal cord injury. We evaluated ten consecutive patients that underwent surgery for spinal meningiomas. All patients were preoperative assessed by neurological examination, computed tomography and magnetic resonance imaging. All tumors were ventrally located and removed via a posterior approach. Transcranial motor-evoked potentials (TcMEPs), somatosensory-evoked potential (SSEP) and free running electromyography (EMG) were monitored intraoperative. Postoperative all patients had regular follow-up examinations. There were four males and six females. The mean age was 68.2 years (range 39-82 years). In nine out of ten cases, the tumor was located in the thoracic spine. A case of a lumbar meningioma was recorded. The most common presenting symptom was motor and sensory deficits and unsteady gait, whereas no patient presented with paraplegia. All meningiomas were operated using a microsurgical technique via a posterior approach. During the operation, free running EMG monitoring prompted a surgical alert in case of irritation, whereas TcMEP and SSEP amplitudes remained unchanged. Histopathology revealed the presence of typical (World Health Organisation grade I) meningiomas. The mean Ki-67/MIB-1 index was 2.75% (range 0.5-7). None of our patients sustained a transient or permanent motor deficit. After a mean follow-up period of 26 months (range 56-16 months), no tumor recurrence and no instability were found. Posterior approach for anteriorly located meningiomas is a safe procedure with the use of intraoperative monitoring, less invasive and well-tolerated especially in older patients. Complete tumor excision can be performed with satisfactory results.

  9. Glioblastoma Mimicking Meningioma: Report of 2 Cases.

    PubMed

    Patel, Mohit; Nguyen, Ha Son; Doan, Ninh; Gelsomino, Michael; Shabani, Saman; Mueller, Wade

    2016-11-01

    Glioblastoma can mimic various pathologies, including arteriovenous malformation, hemorrhage from ischemic stroke, cerebral contusion, metastatic disease, lymphoma, and infection. The literature is limited regarding diagnostic confusion with meningioma. Herein, we present 2 patients that exhibited imaging, including cerebral angiography during preoperative embolization, which was consistent with meningioma, but where final surgical diagnosis revealed glioblastoma. Case 1 was a 57-year-old woman presenting with headache, ataxia, and memory lapses for the past month. Brain magnetic resonance imaging (MRI) demonstrated a heterogeneous-enhancing right temporoparietal mass with broad contact along the right tentorium, cerebrospinal fluid (CSF) cleft sign, and dural tail sign-consistent with meningioma. Patient underwent angiography with successful polyvinyl alcohol foam (PVA) particle embolization of the petrosquamosal branch of the right middle meningeal artery (MMA) and meningeal branch of the right occipital artery, resulting in significant devascularization of the tumor blush. Subsequently, the patient underwent tumor resection, where pathology revealed glioblastoma. Case 2 was a 60-year-old man presenting with right hemiparesis. Brain MRI demonstrated a left parasagittal, heterogeneous-enhancing mass abutting the falx with a dural tail sign-consistent with meningioma. Patient underwent angiography with successful PVA particle embolization of the left MMA, resulting in significant devascularization of the tumor blush. Patient underwent a tumor resection where pathology revealed glioblastoma. Glioblastoma can mimic meningioma on MRI with dural tail sign, CSF cleft sign, and broad dural contact. Moreover, cerebral angiography can reveal tumor feeders commonly associated with meningioma. These features can contribute to diagnostic confusion. Based on these 2 cases, preoperative embolization of tumor feeders is possible with glioblastoma. Copyright © 2016 The Author

  10. Association of gestational weight gain expectations with advice on actual weight gain

    USDA-ARS?s Scientific Manuscript database

    To examine pregnant women's gestational weight gain expectations/advice from various sources (i.e., self, family/friends, physician) and the impact of these sources of expectations/advice on actual measured gestational weight gain. Pregnant women (n=230, 87.4% Caucasian, second pregnancy) in a cohor...

  11. Primary pulmonary meningioma

    PubMed Central

    Huang, Shucheng; Chen, Li; Mao, Yuping; Tong, Hongwei

    2017-01-01

    Abstract Rationale: Primary extracranial meningiomas are rare outside the head and neck region. Patient concerns: A 44-year-old female patient had chest pain for more than 1 year. Diagnoses: Preoperative chest computed tomography (CT) scan revealed a nodule in the right lower lobe, 1.8 cm in diameter. Tumor tissues were examined by immunohistochemistry for vimentin and S-100. Interventions: Histopathologically, the tumor was characterized by whorled nests of spindle-shaped cells accompanied by psammoma bodies. Immunohistochemistry demonstrated tumor cell positivity for vimentin and S-100. This case was diagnosed as a primary pulmonary meningioma. The tumor was removed by a thoracoscopic pulmonary wedge resection. Outcomes: Postoperative cranial and spinal CT scan did not show any intracranial or spinal mass. No recurrence of the tumor was reported at the time of writing up this case report. Lessons: A primary pulmonary meningioma should be considered in the differential diagnosis workup of pulmonary nodules. PMID:28489736

  12. Definitive Embolization of Meningiomas

    PubMed Central

    Bateman, B.T.; Lin, E.; Pile-Spellman, J.

    2005-01-01

    Summary This review examines the possible role for definitive embolization as a primary therapy for intracranial meningiomas. Surgery or radiosurgery are currently considered the standard of care for most benign meningiomas. However, each of these carries substantial risks. The perioperative mortality for surgical resection, as reported in large series, is between 3.7-9.4%; these studies report a similarly high rate of new neurological deficits following surgery. The rate of complications from radiosurgery is reported between 2-16% and it may take months to years before improvement in symptoms occurs following this therapy. There are a few reports of treating meningiomas by embolization without subsequent surgery. While these studies include small numbers of patients and have limited follow-up, the initial results are very promising. Given the risks and limitations of surgery and radiosurgery, prospective trials are now needed to determine the safety and efficacy of definitive embolization. PMID:20584499

  13. Meningiomas of Meckel's cave.

    PubMed

    Nijensohn, D E; Araujo, J C; MacCarty, C S

    1975-08-01

    A retrospective review of 12 cases of meningioma of Meckel's cave involving the Gasserian ganglion or the trigeminal posterior root (or both) seen at the Mayo Clinic during a 20-year period suggested three clearly defined clinical groups. One group (the largest) had typical trigeminal neuralgia and an excellent prognosis after the removal of the easily detachable mass that was impinging on the ganglion. A second group, with meningiomas en plaque embedded in the ganglion, had a history of atypical trigeminal face pain without neurological deficit, but the prognosis for pain relief was not as good as in the previous group. A third group had a history of face dysesthesias and pain, objective trigeminal sensory loss, and multiple cranial nerve deficit; these patients had meningiomas with histological signs of mitotic activity and a poor prognosis, with return of intractable pain and recurrence of the tumor.

  14. Exogenous hormone use, reproductive factors, and risk of intracranial meningioma in females

    PubMed Central

    Claus, Elizabeth B.; Calvocoressi, Lisa; Bondy, Mellisa L.; Wrensch, Margaret; Wiemels, Joseph L.; Schildkraut, Joellen M.

    2013-01-01

    Object The 2-fold higher incidence of meningioma in women compared with men has long suggested a role for hormonally mediated risk factors, but specific mechanisms remain elusive. Methods The study included data obtained in 1127 women 29–79 years of age with intracranial meningioma diagnosed among residents of Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 Texas counties between May 1, 2006, and October 6, 2011, and data obtained in 1092 control individuals who were frequency matched for age group and geography with meningioma patients. Results No association was observed for age at menarche, age at menopause, or parity and meningioma risk. Women who reported breastfeeding for at least 6 months were at reduced risk of meningioma (OR 0.78, 95% CI 0.63–0.96). A significant positive association existed between meningioma risk and increased body mass index (p < 0.01) while a significant negative association existed between meningioma risk and current smoking (p < 0.01). Among premenopausal women, current use of oral contraceptives was associated with an increased risk of meningiomas (OR 1.8, 95% CI 1.1–2.9), while current use of hormone replacement therapy among postmenopausal women was not associated with a significant elevation in risk (OR 1.1, 95% CI 0.74–1.67). There was no association between use of fertility medications and meningioma risk. Conclusions The authors’ study confirms associations for body mass index, breastfeeding, and cigarette smoking but provides little evidence for associations of reproductive and menstrual factors with meningioma risk. The relationship between current use of exogenous hormones and meningioma remains unclear, limited by the small numbers of patients currently on oral hormone medications and a lack of hormone receptor data for meningioma tumors. PMID:23101448

  15. Is gestational weight gain associated with diet quality during pregnancy?

    PubMed

    Shin, Dayeon; Bianchi, Leonard; Chung, Hwan; Weatherspoon, Lorraine; Song, Won O

    2014-08-01

    The gestational weight gain (GWG) guidelines of the Institute of Medicine (IOM) aim to optimize birth outcomes and reduce pregnancy complications. The GWG guidelines are set based on the prepregnancy weight status and optimal weight gain at different trimesters of pregnancy. Dietary references intakes (DRIs) of the IOM are set for each trimester of pregnancy for energy intake and other essential nutrients by age groups (≤ 18, 19-30, 31-51 years). The DRIs, however, do not take into account the differing energy and nutrient requirements of women with different prepregnancy weights. In this cross-sectional study, we tested the hypothesis that diet quality during pregnancy is associated with adequate GWG at different stages of pregnancy. Diet quality during pregnancy was assessed from a 24-h recall measured by the healthy eating index of 2005 (HEI-2005). Both GWG and diet quality data were from 490 pregnant women aged 16-43 years included in National Health and Nutrition Examination Survey 2003-2006, a program of studies designed to assess the health and nutritional status of adults and children in the US, during which pregnant women were oversampled. Logistic regression models adjusted for age, trimester of gestation, race/ethnicity, education level, marital status, family poverty income ratio, daily supplement use, physical activity, and prepregnancy BMI were used to investigate if HEI-2005 is a determinant of GWG status at different trimesters of pregnancy. We found that HEI-2005 scores were not determinants of adequate GWG, although inadequate intake of total vegetables (OR 3.8, CI 1.1-13.2, p = 0.03) and oils were associated with excessive GWG (OR 2.8, CI 1.2-6.4, p = 0.02) when covariates were controlled. Although adequate GWG was not associated with diet quality as measured by HEI-2005 during pregnancy in this study, comprehensive prenatal counseling is still important to reduce adverse birth outcomes.

  16. Sporadic pediatric meningiomas: a neuroradiological and neuropathological study of 15 cases.

    PubMed

    Huntoon, Kristin; Pluto, Charles P; Ruess, Lynne; Boué, Daniel R; Pierson, Christopher R; Rusin, Jerome A; Leonard, Jeffrey

    2017-08-01

    OBJECTIVE Sporadic meningiomas have been classified in many different ways. Radiographically, these lesions can be described as occurring in either typical or atypical locations. The purpose of this study was to determine if there are any histopathological differences between sporadic meningiomas that arise in these varying locations in children. METHODS The neuroimaging, histopathological findings, and clinical records in patients with sporadic pediatric meningiomas not associated with neurofibromatosis Type 2 or prior radiation therapy were retrospectively reviewed. Tumors were classified by radiological findings as either typical or atypical, and they were categorized histopathologically by using the latest WHO nomenclature and grading criteria. RESULTS Fifteen sporadic meningiomas in pediatric patients were biopsied or resected at the authors' institution between 1989 and 2013. Five (33%) were typical in radiographic appearance and/or location and 10 (67%) were atypical. Four (80%) typical meningiomas were WHO Grade I tumors. Most (60%) of the atypical meningiomas were WHO Grade II or III. CONCLUSIONS This study is the largest series of sporadic pediatric meningiomas in atypical locations to date. Although sporadic meningiomas are relatively infrequent in children, those with atypical imaging, specifically those with apparently intraparenchymal and intraosseous locations, may be more common than previously recognized. In this study, pediatric sporadic meningiomas arising in atypical locations, in particular intraparenchymal meningiomas, may be of higher histopathological grade. The authors' findings should alert clinicians to the potential for more aggressive clinical behavior in these tumors.

  17. Human epidermal growth factor receptor 2/neu protein expression in meningiomas: An immunohistochemical study

    PubMed Central

    Telugu, Ramesh Babu; Chowhan, Amit Kumar; Rukmangadha, Nandyala; Patnayak, Rashmi; Phaneendra, Bobbidi Venkata; Prasad, Bodapati Chandra Mowliswara; Reddy, Mandyam Kumaraswamy

    2016-01-01

    Background: Meningiomas are common slow-growing primary central nervous system tumors that arise from the meningothelial cells of the arachnoid and spinal cord. Human epidermal growth factor receptor 2 (HER2) or HER2/neu (also known as c-erbB2) is a 185-kD transmembrane glycoprotein with tyrosine kinase activity expressed in meningiomas and various other tumors. It can be used in targeted therapy for HER2/neu positive meningiomas. Aim: To correlate the expression of HER2/neu protein in meningiomas with gender, location, histological subtypes, and grade. Materials and Methods: It was 3½ years prospective (March 2010–October 2011) and retrospective (May 2008–February 2010) study of histopathologically diagnosed intracranial and intraspinal meningiomas. Clinical details of all the cases were noted from the computerized hospital information system. Immunohistochemistry for HER2/neu protein was performed along with scoring. Statistical analysis was done using Chi-square test to look for any association of HER2/neu with gender, location, grade, and various histological subtypes of meningiomas at 5% level of significance. Results: A total of 100 cases of meningiomas were found during the study period. Of which, 80 were Grade I, 18 were Grade II, and 2 were Grade III meningiomas as per the World Health Organization 2007 criteria. The female-male ratio was 1.9:1 and the mean age was 47.8 years. HER2/neu protein was expressed in 75% of Grade I and 72.2% of Grade II and none of Grade III meningiomas. About 72.7% brain invasive meningiomas showed HER2/neu immunopositivity. Conclusion: HER2/neu protein was expressed in 73% of meningiomas. Statistically significant difference of HER2/neu expression was not seen between females and males of Grade I and Grade II/III meningiomas, intracranial and spinal tumors, Grade I and Grade II/III cases, and various histological subtypes of meningiomas. PMID:27695231

  18. Human epidermal growth factor receptor 2/neu protein expression in meningiomas: An immunohistochemical study.

    PubMed

    Telugu, Ramesh Babu; Chowhan, Amit Kumar; Rukmangadha, Nandyala; Patnayak, Rashmi; Phaneendra, Bobbidi Venkata; Prasad, Bodapati Chandra Mowliswara; Reddy, Mandyam Kumaraswamy

    2016-01-01

    Meningiomas are common slow-growing primary central nervous system tumors that arise from the meningothelial cells of the arachnoid and spinal cord. Human epidermal growth factor receptor 2 (HER2) or HER2/neu (also known as c-erbB2) is a 185-kD transmembrane glycoprotein with tyrosine kinase activity expressed in meningiomas and various other tumors. It can be used in targeted therapy for HER2/neu positive meningiomas. To correlate the expression of HER2/neu protein in meningiomas with gender, location, histological subtypes, and grade. It was 3½ years prospective (March 2010-October 2011) and retrospective (May 2008-February 2010) study of histopathologically diagnosed intracranial and intraspinal meningiomas. Clinical details of all the cases were noted from the computerized hospital information system. Immunohistochemistry for HER2/neu protein was performed along with scoring. Statistical analysis was done using Chi-square test to look for any association of HER2/neu with gender, location, grade, and various histological subtypes of meningiomas at 5% level of significance. A total of 100 cases of meningiomas were found during the study period. Of which, 80 were Grade I, 18 were Grade II, and 2 were Grade III meningiomas as per the World Health Organization 2007 criteria. The female-male ratio was 1.9:1 and the mean age was 47.8 years. HER2/neu protein was expressed in 75% of Grade I and 72.2% of Grade II and none of Grade III meningiomas. About 72.7% brain invasive meningiomas showed HER2/neu immunopositivity. HER2/neu protein was expressed in 73% of meningiomas. Statistically significant difference of HER2/neu expression was not seen between females and males of Grade I and Grade II/III meningiomas, intracranial and spinal tumors, Grade I and Grade II/III cases, and various histological subtypes of meningiomas.

  19. Cervical spinal meningioma mimicking intramedullary spinal tumor.

    PubMed

    Senturk, Senem; Guzel, Aslan; Guzel, Ebru; Bayrak, Aylin Hasanefendioğlu; Sav, Aydin

    2009-01-01

    Case report. To report a very unusual spinal meningioma, mimicking an intramedullary spinal tumor. Spinal meningiomas, usually associated with signs and symptoms of cord or nerve root compression, are generally encountered in women aged over 40. Radiologic diagnosis is often established by their intradural extramedullary location on magnetic resonance images. A 60-year-old woman had a 6-month history of progressive weakness in her upper extremities, difficulty in walking, and cervical pain radiating through both arms. Neurologic examination revealed motor strength deficiency in all her extremities, with extensor reflexes, clonus, and bilateral hyper-reflexiveness. A sensory deficit was present all over her body. Magnetic resonance images revealed that the spinal cord appeared expanded with an ill-defined, homogeneously contrast-enhanced, lobulated, eccentric mass at the C1-C3 level. The patient was operated with a preliminary diagnosis of an intramedullary tumor. At surgery, the mass was found to be extramedullary, and gross total resection was performed. Histopathological examination revealed a meningioma characterized by the presence of fibrous and meningothelial components. The patient was able to ambulate with a cane, and extremity strength and sensation improved 2 months after surgery. Spinal meningiomas can mimic intramedullary tumors, and should be considered in differential diagnosis of intradural tumors with atypical appearance.

  20. SMARCE1 mutations in pediatric clear cell meningioma: case report.

    PubMed

    Evans, Linton T; Van Hoff, Jack; Hickey, William F; Smith, Miriam J; Evans, D Gareth; Newman, William G; Bauer, David F

    2015-09-01

    Clear cell meningioma (CCM) is an uncommon variant of meningioma. The authors describe a case of a pediatric CCM localized to the lumbar spine. After resection, sequencing revealed an inactivating mutation in the SWI/SNF chromatin remodeling complex subunit SMARCE1, with loss of the second allele in the tumor. The authors present a literature review of this mutation that is associated with CCM and a family history of spine tumors.

  1. Transglutaminase 2 Expression Is Increased as a Function of Malignancy Grade and Negatively Regulates Cell Growth in Meningioma

    PubMed Central

    Huang, Yin-Cheng; Wei, Kuo-Chen; Chang, Chen-Nen; Chen, Pin-Yuan; Hsu, Peng-Wei; Chen, Carl P.; Lu, Chin-Song; Wang, Hung-Li; Gutmann, David H.; Yeh, Tu-Hsueh

    2014-01-01

    Most meningiomas are benign, but some clinical-aggressive tumors exhibit brain invasion and cannot be resected without significant complications. To identify molecular markers for these clinically-aggressive meningiomas, we performed microarray analyses on 24 primary cultures from 21 meningiomas and 3 arachnoid membranes. Using this approach, increased transglutaminase 2 (TGM2) expression was observed, which was subsequently validated in an independent set of 82 meningiomas by immunohistochemistry. Importantly, the TGM2 expression level was associated with increasing WHO malignancy grade as well as meningioma recurrence. Inhibition of TGM2 function by siRNA or cystamine induced meningioma cell death, which was associated with reduced AKT phosphorylation and caspase-3 activation. Collectively, these findings suggest that TGM2 expression increases as a function of malignancy grade and tumor recurrence and that inhibition of TGM2 reduces meningioma cell growth. PMID:25247996

  2. Uptake of AV-1451 in meningiomas.

    PubMed

    Bruinsma, Tyler J; Johnson, Derek R; Fang, Ping; Senjem, Matthew; Josephs, Keith A; Whitwell, Jennifer L; Boeve, Bradley F; Pandey, Mukesh K; Kantarci, Kejal; Jones, David T; Vemuri, Prashanthi; Murray, Melissa; Graff-Radford, Jonathan; Schwarz, Christopher G; Knopman, David S; Petersen, Ronald C; Jack, Clifford R; Lowe, Val J

    2017-09-08

    AV-1451 is an imaging agent labeled with the positron-emitting radiolabel Fluorine-18. 18F-AV-1451 binds paired helical filament tau (PHF-tau), a pathology related to Alzheimer's disease. In our study of AV-1451 uptake in the brains of cognitively normal subjects, we noted a case of a meningioma with visually significant uptake of AV-1451. We initiated the present retrospective study to further examine cases of meningioma that underwent AV-1451 imaging. We searched the patient records of 650 patients who had undergone AV-1451 at our institution for the keyword "meningioma" to identify potential cases. PET/CT and MRI results were visually reviewed and semi-quantitative analysis of PET was performed. A paired student's t test was run between background and tumor standard uptake values. Fisher's exact test was used to examine the association between AV-1451 uptake and presence of calcifications on CT. We identified 12 cases of meningioma, 58% (7/12) of which demonstrated uptake greater than background using both visual analysis and tumor-to-normal cortex ratios (T/N + 1.90 ± 0.83). The paired student's t test revealed no statistically significant difference between background and tumor standard uptake values (p = 0.09); however, cases with a T/N ratio greater than one showed statistically higher uptake in tumor tissue (p = 0.01). A significant association was noted between AV-1451 uptake and presence of calcifications (p = 0.01). AV-1451 PET imaging should be reviewed concurrently with anatomic imaging to prevent misleading interpretations of PHF-tau distribution due to meningiomas.

  3. Extensive gene gain associated with adaptive evolution of poxviruses

    PubMed Central

    McLysaght, Aoife; Baldi, Pierre F.; Gaut, Brandon S.

    2003-01-01

    Previous studies of genome evolution usually have involved one or two genomes and have thus been limited in their ability to detect the direction and rate of evolutionary change. Here, we use complete genome data from 20 poxvirus genomes to build a robust phylogeny of the Poxviridae and to study patterns of genome evolution. We show that, although there has been little gene order evolution, there are substantial differences between poxviruses in terms of genome content. Furthermore, we show that the rate of gene acquisition is not constant over time and that it has increased in the orthopox lineage (which includes smallpox and vaccinia). We also tested for positive selection on 204 groups of genes and show that a disproportionately high proportion of genes in the orthopox clade are under positive selection. The association of an increased rate of gene gain and positive selection is indicative of adaptive genome evolution. Many of the genes involved in these processes are likely to be associated with host–parasite coevolution. PMID:14660798

  4. Surgical Treatment for Falcotentorial Meningiomas

    PubMed Central

    Hong, Chang Ki; Hong, Je Beom; Park, Hunho; Moon, Ju Hyung; Chang, Jong Hee; Lee, Kyu Sung

    2016-01-01

    Among intracranial meningiomas, falcotentorial meningiomas, occurring at the junction of the falx cerebri and tentorial dural folds, are extremely rare. Because of their deep location, they are surrounded by critical structures, and have been regarded as one of the most challenging lesions for surgical treatment. In this study, we describe our surgical strategy for falcotentorial meningiomas and provide a review of our experience. PMID:27189300

  5. Cystic meningioma: unusual imaging appearance of a common intracranial tumor

    PubMed Central

    Layton, Kennith F.; Finn, S. Sam; Snipes, George J.; Opatowsky, Michael J.

    2010-01-01

    Meningiomas are common tumors of the central nervous system that account for approximately 15% of all intracranial tumors and are the most common extra-axial neoplasm. Most meningiomas are benign, although atypical and malignant meningiomas also exist. Typical imaging characteristics include a well-circumscribed, homogeneously enhancing, extra-axial mass on both computed tomography and magnetic resonance imaging. The presence of an associated cyst is an uncommon imaging feature that may make it difficult to distinguish the tumor from a primary intra-axial glial neoplasm. The presence of peritumoral edema can also be a misleading finding. We present a case of a woman who presented with a history of multiple recent falls, decreased energy, and increased somnolence and was found to have a “cystic meningioma.” Typical imaging characteristics, histologic subtypes, treatment, and prognosis are also discussed. PMID:21240328

  6. [Multifocal clear cell meningioma in the sacral and lumbar spine. Case report and literature review].

    PubMed

    Lista-Martínez, Olalla; Santín-Amo, Jose María; Facal-Varela, Sonia; Rossi-Mautone, Eduardo; Rivas-López, Luis Alfredo; Amaro-Cendón, Santiago

    2012-11-01

    Clear cell meningioma is a rare morphological form of meningioma. This case report describes a very rare case of multifocal clear cell meningioma in the sacral and lumbar spine. The patient was a 20-year-old female who presented back pain. Magnetic resonance imaging (MRI) revealed a large tumour at L4 to S2 level associated with two, smaller, satellite tumours at the lumbar level. An intra-extradural tumour was surgically removed and the pathological diagnosis of clear cell meningioma was confirmed. Both satellite lesions were also resected and their histopathological diagnosis was the same. Therefore, clear cell meningioma should be considered in young patients with suggested meningioma in the lumbar spine, as well as the possibility of multifocal origin and postoperative recurrence. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  7. Association between Stock Market Gains and Losses and Google Searches

    PubMed Central

    Arditi, Eli; Yechiam, Eldad; Zahavi, Gal

    2015-01-01

    Experimental studies in the area of Psychology and Behavioral Economics have suggested that people change their search pattern in response to positive and negative events. Using Internet search data provided by Google, we investigated the relationship between stock-specific events and related Google searches. We studied daily data from 13 stocks from the Dow-Jones and NASDAQ100 indices, over a period of 4 trading years. Focusing on periods in which stocks were extensively searched (Intensive Search Periods), we found a correlation between the magnitude of stock returns at the beginning of the period and the volume, peak, and duration of search generated during the period. This relation between magnitudes of stock returns and subsequent searches was considerably magnified in periods following negative stock returns. Yet, we did not find that intensive search periods following losses were associated with more Google searches than periods following gains. Thus, rather than increasing search, losses improved the fit between people’s search behavior and the extent of real-world events triggering the search. The findings demonstrate the robustness of the attentional effect of losses. PMID:26513371

  8. Association between Stock Market Gains and Losses and Google Searches.

    PubMed

    Arditi, Eli; Yechiam, Eldad; Zahavi, Gal

    2015-01-01

    Experimental studies in the area of Psychology and Behavioral Economics have suggested that people change their search pattern in response to positive and negative events. Using Internet search data provided by Google, we investigated the relationship between stock-specific events and related Google searches. We studied daily data from 13 stocks from the Dow-Jones and NASDAQ100 indices, over a period of 4 trading years. Focusing on periods in which stocks were extensively searched (Intensive Search Periods), we found a correlation between the magnitude of stock returns at the beginning of the period and the volume, peak, and duration of search generated during the period. This relation between magnitudes of stock returns and subsequent searches was considerably magnified in periods following negative stock returns. Yet, we did not find that intensive search periods following losses were associated with more Google searches than periods following gains. Thus, rather than increasing search, losses improved the fit between people's search behavior and the extent of real-world events triggering the search. The findings demonstrate the robustness of the attentional effect of losses.

  9. Modifiable predictors associated with having a gestational weight gain goal.

    PubMed

    Tovar, Alison; Guthrie, Lauren B; Platek, Deborah; Stuebe, Alison; Herring, Sharon J; Oken, Emily

    2011-10-01

    The goal of this paper was to determine predictors of having a weight gain goal in early pregnancy. In 2008, we administered a 48-item survey to 249 pregnant women attending obstetric visits. We examined predictors of women having a goal concordant or discordant with 1990 Institute of Medicine (IOM) guidelines, vs. no goal, using binary and multinomial logistic regression. Of the 292 respondents, 116 (40%) had no gestational weight gain goal, 112 (39%) had a concordant goal and 61 (21%) had a goal discordant with IOM guidelines. Predictors of a guideline-concordant goal, vs. no goal, included sugar sweetened beverage consumption < vs. ≥ 1 serving per week (OR = 2.4, 95%CI: 1.1, 5.7), physical activity ≥ vs. <2.5 h per week (OR = 3.6, 95%CI: 1.7, 7.5), agreeing that 'I tried to keep weight down not to look pregnant' (OR = 14.3, 95%CI: 1.4, 140.5). Other predictors only of having a discordant goal (vs. no goal) included agreeing that 'as long as I am eating well, I don't care how much I gain' (OR = 0.3, 95%CI: 0.2, 0.8) and agreeing that 'if I gain too much weight one month, I try to keep from gaining the next' (OR = 4.1, 95%CI: 1.6, 10.4). Women whose doctors recommended weight gains consistent with IOM guidelines were more likely to have a concordant goal (vs. no goal) (OR = 5.3, 95%CI: 1.5, 18.6). Engaging in healthy behaviors and having health providers offer IOM weight gain recommendations may increase the likelihood of having a concordant gestational weight gain goal, which, in turn, is predictive of actual weight gains that fall within IOM guidelines.

  10. A role for matrix remodelling proteins in invasive and malignant meningiomas.

    PubMed

    Jalali, Shahrzad; Singh, Sanjay; Agnihotri, Sameer; Wataya, Takafumi; Salehi, Fatemeh; Alkins, R; Burrell, Kelly; Navab, Roya; Croul, Sidney; Aldape, Kenneth; Zadeh, Gelareh

    2015-02-01

    Meningiomas are one of the most common brain tumours in adults. Invasive and malignant meningiomas present a significant therapeutic challenge due to high recurrence rates and invasion into surrounding bone, brain, neural and soft tissues. Understanding the molecular mechanism of invasion could help in designing novel therapeutic approaches in order to prevent the need for repeat surgery, decrease morbidity and improve patient survival. The aim of this study was to identify the key factors and underlying mechanisms which govern invasive properties of meningiomas. Formalin-fixed paraffin-embedded (FFPE) as well as frozen tumour tissues from bone-invasive, non-invasive and malignant meningiomas were used for RNA microarray, quantitative real-time PCR or Western blot analyses. Malignant meningioma cell lines (F5) were subject to MMP16 downregulation or overexpression and used for in vitro and in vivo functional assays. Subdural xenograft meningioma tumours were generated to study the invasion of tumour cells into brain parenchyma using cell lines with altered MMP16 expression. We establish that the expression level of MMP16 was significantly elevated in both bone-invasive and brain invasive meningiomas. Gain- and loss-of-function experiments indicated a role for MMP16 in meningioma cell movement, invasion and tumour cell growth. Furthermore, MMP16 was shown to positively regulate MMP2, suggesting this mechanism may modulate meningioma invasion in invasive meningiomas. Overall, the results support a role for MMP16 in promoting invasive properties of the meningioma tumours. Further studies to explore the potential value for clinical use of matrix metalloproteinases inhibitors are warranted. © 2014 British Neuropathological Society.

  11. Papillary meningioma: an aggressive variant meningioma with clinical features and treatment: a retrospective study of 10 cases.

    PubMed

    Li, Bin; Tao, Bangbao; Bai, Hongmin; Zhong, Jun; Wu, Xiangru; Shi, Juanhong; Sun, Hui; Li, Shiting

    2016-10-01

    Papillary meningioma is a rare subtype of malignant meningiomas. The aim of this retrospective study was to investigate the clinical, radiological, histopathological features and prognosis for papillary meningioma at our institutions. Ten patients with clinically, radiologically and histopathologically confirmed papillary meningiomas were treated at our hospitals. The clinical data, imaging characteristics, histopathological features, surgical treatment and postoperative follow-up, were analyzed retrospectively. The patients with a mean age of 36.9 years at the time of their initial operations. The papillary meningiomas were predominantly located in the convexity (n = 6). At their initial operation, six patients underwent gross total resection and four patients underwent subtotal resection. The mean post-operative follow-up period was 42.6 months (range: 12-90 months). Six patients underwent multiple surgical resections. The mean time to first recurrence was 21.5 months. On magnetic resonance imaging scan, marked enhancements and dural tail signs were displayed in all lesions. All lesions showed peritumoral edema. Cysts were seen in four lesions. Bone hyperostosis or destruction was seen in six lesions. Cerebrospinal fluid dissemination was seen in three lesions. Incomplete surgical resection was associated with recurrence. MIB-1 labeling index was associated with progression-free survival for patients (p = 0.0442). Papillary meningioma has a tendency to present in middle-aged patients, and it has specific clinical and histopathological characteristics. MIB-1 labeling index and the extent of resection might predict the recurrence. Cystic formation, peritumoral edema, osseous change and CSF dissemination might be neuroimaging characteristics of papillary meningioma, especially in recurrence papillary meningioma.

  12. Epidural Cystic Spinal Meningioma

    PubMed Central

    Zhang, Ji; Chen, Zheng-he; Wang, Zi-feng; Sun, Peng; Jin, Jie-tian; Zhang, Xiang-heng; Zhao, Yi-ying; Wang, Jian; Mou, Yong-gao; Chen, Zhong-ping

    2016-01-01

    Abstract Cystic spinal meningioma (CSM) is an uncommon meningioma variant. Extradural CSMs are particularly rare and difficult to distinguish from other intraaxial tumors. This study presents a case of a 36-year-old woman with intraspinal extradual CSM at the thoracolumbar spine. She experienced persistent weakness, progressive numbness, and sensory disturbance in the right lower limb. Magnetic resonance imaging (MRI) of the patient revealed an irregular cystic mass at the thoracic 11 to lumbar 3 levels dorsally. This case was misdiagnosed as other neoplasms prior to surgery because of the atypical radiographic features and location of the tumor. Extradural CSMs should be considered in the differential diagnosis of intraspinal extradural cystic neoplasms. Complete removal of cystic wall provides an optimal outcome, rendering the lesion curable. PMID:26986119

  13. Third ventricular meningiomas.

    PubMed

    Li, Puxian; Diao, Xingtao; Bi, Zhiyong; Hao, Shuyu; Ren, Xiaohui; Zhang, Junting; Xing, Jun

    2015-11-01

    We report 13 patients with third ventricular meningiomas (TVM) and discuss the clinical, radiological, pathological and surgical features, as well as follow-up of these tumors. TVM are rare intracranial tumors, and because of this, there are few reports in the literature. Of 11,600 intracranial meningiomas that were surgically treated and pathologically confirmed at Beijing Tian Tan Hospital over a period of 10 years (2003-2013), 13 TVM were selected for a retrospective review. We recorded the clinical, radiological, pathological, and surgical data and statistically analyzed the preoperative, postoperative and 6 month postoperative Karnofsky performance scale (KPS) scores. TVM represented 0.11% of intracranial meningiomas. Radiologically, TVM were divided into three groups: anterior (n=3), posterior (n=3), and entire third ventricle (n=7). Three patients (23.1%) were misdiagnosed preoperatively. Total removal was achieved in 61.5% (8/13) of patients, and subtotal resection was achieved in 38.5% (5/13). Pathologically, the tumors were World Health Organization (WHO) Grade I in 11 patients (84.6%) and WHO Grade II in two (15.6%). There were no statistically significant differences in the preoperative, postoperative, or 6 month postoperative KPS scores (F=0.814; p=0.401). TVM without dural attachments are rare neoplasms that should be differentiated from choroid plexus papilloma, craniopharyngioma, and pineocytoma. Surgery is the optimal treatment and may result in a favorable prognosis, and understanding of the radiological subtype can help with the choice of surgical approach.

  14. Long-Term Results of Gamma Knife Radiosurgery for Intracranial Meningioma.

    PubMed

    Jang, Chang Ki; Jung, Hyun Ho; Chang, Jong Hee; Chang, Jin Woo; Park, Yong Gou; Chang, Won Seok

    2015-10-01

    The predominant treatment modality for meningioma is surgical resection. However, gamma knife radiosurgery is also an important treatment modality for meningioma that is small or cannot be completely removed because of its location. In this study, we evaluated the effectiveness and long-term results of radiosurgical treatment for meningioma in our institution. We studied 628 patients (130 men and 498 women) who underwent gamma knife radiosurgery for intracranial meningioma, which is radiologically diagnosed, from Jan 2008 to Nov 2012. We included patients with single lesion meningioma, and followed up after 6 months with imaging, and then at 24 months with a clinical examination. Patients with high-grade meningioma or multiple meningiomas were excluded. We analyzed each of the factors associated with progression free survival. The median patient's age was 56.8 years. Maximal dosage was 27.8 Gy and marginal dosage was 13.9 Gy. The overall tumor control rate was 95%. Twenty-eight patients (4.4%) showed evidence of tumor recurrence. Ninety-eight patients (15%) developed peritumoral edema (PTE) after gamma-knife surgery; two of them (2%) underwent surgical resections due to PTE. Nine patients had craniotomy and tumor removal after gamma knife surgery. Gamma knife surgery for intracranial meningioma has proven to be a safe and effective treatment tool with successful long-term outcomes. Gamma knife radiosurgery can be especially effective in cases of remnant meningioma after surgical resection or where PTE is not present.

  15. Long-Term Results of Gamma Knife Radiosurgery for Intracranial Meningioma

    PubMed Central

    Jang, Chang Ki; Jung, Hyun Ho; Chang, Jong Hee; Chang, Jin Woo; Park, Yong Gou

    2015-01-01

    Background The predominant treatment modality for meningioma is surgical resection. However, gamma knife radiosurgery is also an important treatment modality for meningioma that is small or cannot be completely removed because of its location. In this study, we evaluated the effectiveness and long-term results of radiosurgical treatment for meningioma in our institution. Methods We studied 628 patients (130 men and 498 women) who underwent gamma knife radiosurgery for intracranial meningioma, which is radiologically diagnosed, from Jan 2008 to Nov 2012. We included patients with single lesion meningioma, and followed up after 6 months with imaging, and then at 24 months with a clinical examination. Patients with high-grade meningioma or multiple meningiomas were excluded. We analyzed each of the factors associated with progression free survival. The median patient's age was 56.8 years. Maximal dosage was 27.8 Gy and marginal dosage was 13.9 Gy. Results The overall tumor control rate was 95%. Twenty-eight patients (4.4%) showed evidence of tumor recurrence. Ninety-eight patients (15%) developed peritumoral edema (PTE) after gamma-knife surgery; two of them (2%) underwent surgical resections due to PTE. Nine patients had craniotomy and tumor removal after gamma knife surgery. Conclusion Gamma knife surgery for intracranial meningioma has proven to be a safe and effective treatment tool with successful long-term outcomes. Gamma knife radiosurgery can be especially effective in cases of remnant meningioma after surgical resection or where PTE is not present. PMID:26605265

  16. The suboccipital midline approach to foramen magnum meningiomas.

    PubMed

    Della Puppa, Alessandro; Rustemi, Oriela; Scienza, Renato

    2015-05-01

    Anterior and anterolateral meningiomas of the foramen magnum (FM) can be resected either through extensive skull base approaches or through the classical suboccipital midline approach with limited bone removal. This paper describes the suboccipital midline approach focusing on some peculiar technical features that serve to achieve the necessary space for safe resection of these challenging tumors. In our experience, by adopting appropriate strategies to gain space (some of them natural, others acquired) the suboccipital midline approach can achieve the safe resection of anterior and anterolateral FM meningiomas in the majority of cases.

  17. Epidemiology and etiology of meningioma

    PubMed Central

    Wrensch, Margaret; Claus, Elizabeth B.

    2010-01-01

    Although most meningiomas are encapsulated and benign tumors with limited numbers of genetic aberrations, their intracranial location often leads to serious and potentially lethal consequences. They are the most frequently diagnosed primary brain tumor accounting for 33.8% of all primary brain and central nervous system tumors reported in the United States between 2002 and 2006. Inherited susceptibility to meningioma is suggested both by family history and candidate gene studies in DNA repair genes. People with certain mutations in the neurofibromatosis gene (NF2) have a very substantial increased risk for meningioma. High dose ionizing radiation exposure is an established risk factor for meningioma, and lower doses may also increase risk, but which types and doses are controversial or understudied. Because women are twice as likely as men to develop meningiomas and these tumors harbor hormone receptors, an etiologic role for hormones (both endogenous and exogenous) has been hypothesized. The extent to which immunologic factors influence meningioma etiology has been largely unexplored. Growing emphasis on brain tumor research coupled with the advent of new genetic and molecular epidemiologic tools in genetic and molecular epidemiology promise hope for advancing knowledge about the causes of intra-cranial meningioma. In this review, we highlight current knowledge about meningioma epidemiology and etiology and suggest future research directions. PMID:20821343

  18. Long-term follow-up of 287 meningiomas in neurofibromatosis type 2 patients: clinical, radiological, and molecular features

    PubMed Central

    Goutagny, Stéphane; Bah, Alpha Boubacar; Henin, Dominique; Parfait, Béatrice; Grayeli, Alexis Bozorg; Sterkers, Olivier; Kalamarides, Michel

    2012-01-01

    Decision-making criteria for optimal management of meningiomas in neurofibromatosis type 2 (NF2) patients is hampered by lack of robust data, particularly long-term natural history. Seventy-four NF2 patients harboring 287 cranial meningiomas followed up for a mean period of 110.2 months were studied retrospectively. The median number of meningiomas per patient was 3. The mean maximum diameter of meningiomas at diagnosis was 14.3 mm, with a mean annual growth rate of 1.5 mm. Sixty-six percent of tumors showed no or minimal growth. In a subgroup of patients with 3D MRI, 7.3% of meningiomas (28% of patients) had a volumetric growth rate 20% or more per year. Twenty-five de novo meningiomas appeared during the follow-up (8.7%) and demonstrated a higher growth rate than other meningiomas (6.6 mm/year). Fifty-six meningiomas (23%) in 34 NF2 patients (45.9%) were operated on during the follow-up period. Among symptomatic resected meningiomas, grades II and III tumors were found in 29% and 6% of cases, respectively, with a remarkable intratumor histological heterogeneity. Single nucleotide polymorphism array analysis of 22 meningioma samples in 14 NF2 patients showed increasing chromosome instability with increasing grade, the most frequent losses being on 22q, 1p, 18q, and 6p. This study provides clues to improve tailored treatment of meningiomas: de novo and brain edema-associated meningiomas require active treatment. Future clinical trials in NF2 need to focus specifically on meningiomas as the primary endpoint and should include patients with meningiomas growing 20% or more per year in order to assess new treatments. PMID:22711605

  19. [Extradural spinal meningioma: case report].

    PubMed

    Dagain, A; Dulou, R; Lahutte, M; Dutertre, G; Pouit, B; Delmas, J-M; Camparo, P; Pernot, P

    2009-12-01

    We report a case of purely extradural spinal meningioma and discuss the potential pitfalls in differential diagnosis. Spinal meningiomas account for 20-30% of all spinal neoplasms. Epidural meningiomas are infrequent intraspinal tumors that can be easily confused with malignant neoplasms or spinal schwannomas. A 62-year-old man with a previous history of malignant disease presented with back pain and weakness of the lower limbs. Magnetic resonance imaging revealed a well-enhanced T4 intraspinal lesion. The intraoperative histological examination showed a meningioma (confirmed by postoperative examination). Opening the dura mater confirmed the purely epidural location of the lesion. The postoperative course was uneventful with no recurrence 12 months after surgery. Purely extradural spinal meningiomas can mimic metastatic tumors or schwannomas. Intraoperative histology is mandatory for optimal surgical decision making.

  20. Bevacizumab in Treating Patients With Recurrent or Progressive Meningiomas

    ClinicalTrials.gov

    2017-03-01

    Acoustic Schwannoma; Adult Anaplastic Meningioma; Adult Ependymoma; Adult Grade I Meningioma; Adult Grade II Meningioma; Adult Meningeal Hemangiopericytoma; Adult Papillary Meningioma; Neurofibromatosis Type 1; Neurofibromatosis Type 2; Recurrent Adult Brain Tumor

  1. Amantadine for weight gain associated with olanzapine treatment.

    PubMed

    Deberdt, Walter; Winokur, Andrew; Cavazzoni, Patrizia A; Trzaskoma, Quynh N; Carlson, Christopher D; Bymaster, Frank P; Wiener, Karen; Floris, Michel; Breier, Alan

    2005-01-01

    Patients with schizophrenia (Sch), schizoaffective, schizophreniform, or bipolar (BP) I disorders [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)]; not manic or acutely psychotic [Brief Psychiatric Rating Scale (BPRS) total score < or =45]; treated with olanzapine for 1-24 months; and who had gained > or =5% of their initial body weight were examined to determine whether amantadine could attenuate weight gain or promote weight loss. Olanzapine (Olz; 5-20 mg/day) was co-administered with double-blind treatment of 100-300 mg/day amantadine (Olz+Amt, n=60) or placebo (Olz+Plc, n=65). Visit-wise analysis of weight showed that weight change from baseline [last-observation-carried-forward (LOCF)] in the Olz+Amt group was significantly different from the Olz+Plc group at weeks 8 (P=0.042), 12 (P=0.029), and 16 (primary endpoint, mean+/-S.D.: -0.19+/-4.58 versus 1.28+/-4.26 kg, P=0.045). Mean BPRS total score, positive subscale, and anxiety-depression scores improved comparably in both groups, and Montgomery-Asberg Depression Rating Scale (MADRS) total score improved in the Olz+Amt group. Overall, amantadine was safe, was well tolerated, and attenuated weight gain or promoted weight loss in some patients who had gained weight during olanzapine therapy.

  2. Development of a measure to evaluate gains among spanish dementia caregivers: The gains associated with caregiving (GAC) scale.

    PubMed

    Fabà, Josep; Villar, Feliciano; Giuliani, M Florencia

    The study is aimed at developing a new measure devised to evaluate gains associated with caregiving for a person with dementia. We conducted two studies with Spanish informal caregivers. In Study 1 a total of 152 participants responded to a preliminary set of 62 items referred to gains related with caregiving. After exploring their psychometric properties, we studied its factor structure, concurrent validity, and internal consistency reliability by means of, respectively, an exploratory factor analysis (EFA), its correlation with the similar measures, and Cronbach's alpha coefficients. In Study 2 we undertook a confirmatory factor analysis (CFA) to obtain further evidence regarding the scale dimensionality and we studied its construct validity by calculating its correlations with the Zarit Burden Interview (ZBI), the Geriatric Depression Scale - Short Form (GDS-SF), and the Satisfaction With Life Scale (SWLS). The final version of the Gains Associated with Caregiving (GAC) scale comprised 22 items, all of which seemed to belong to the same factor according to both the EFA and the CFA. The correlation between the GAC scale and similar measures was statistically significant and strong, and the Cronbach's α coefficient was 0.95. Statistically significant correlations in the expected direction were found between the GAC and the ZBI, the GDS-SF, and the SWLS. The high internal consistency of the GAC scale, and its adequate concurrent and construct validity suggest that it is a suitable instrument for evaluating gains among Spanish informal dementia caregivers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. A microRNA expression signature predicts meningioma recurrence.

    PubMed

    Zhi, Feng; Zhou, Guangxin; Wang, Suinuan; Shi, Yimin; Peng, Ya; Shao, Naiyuan; Guan, Wei; Qu, Hongtao; Zhang, Yi; Wang, Qiang; Yang, Changchun; Wang, Rong; Wu, Sujia; Xia, Xiwei; Yang, Yilin

    2013-01-01

    The aberrant expression of microRNAs (miRNAs) is associated with a variety of diseases, including cancer. In our study, we examined the miRNA expression profile of meningiomas, which is a common type of benign intracranial tumor derived from the protective meninges membranes that surround the brain and spinal cord. To define a typical human meningioma miRNA profile, the expression of 200 miRNAs in a training sample set were screened using quantitative reverse transcription polymerase chain reaction analysis, and then significantly altered miRNAs were validated in a secondary independent sample set. Kaplan-Meier and univariate/multivariate Cox proportional hazard regression analyses were performed to assess whether miRNA expression could predict the recurrence of meningioma after tumor resection. After a two-phase selection and validation process, 14 miRNAs were found to exhibit significantly different expression profiles in meningioma samples compared to normal adjacent tissue (NAT) samples. Unsupervised clustering analysis indicated that the 14-miRNA profile differed between tumor and NAT samples. Downregulation of miR-29c-3p and miR-219-5p were found to be associated with advanced clinical stages of meningioma. Kaplan-Meier analysis showed that high expression of miR-190a and low expression of miR-29c-3p and miR-219-5p correlated significantly with higher recurrence rates in meningioma patients. Cox proportional hazard regression analysis revealed that miR-190a expression level is an important prognostic predictor that is independent of other clinicopathological factors. Our results suggest that the use of miRNA profiling has significant potential as an effective diagnostic and prognostic marker in defining the expression signature of meningiomas and in predicting postsurgical outcomes. Copyright © 2012 UICC.

  4. Spinal meningiomas: clinicoradiological factors predicting recurrence and functional outcome.

    PubMed

    Maiti, Tanmoy K; Bir, Shyamal C; Patra, Devi Prasad; Kalakoti, Piyush; Guthikonda, Bharat; Nanda, Anil

    2016-08-01

    OBJECTIVE Spinal meningiomas are benign tumors with a wide spectrum of clinical and radiological features at presentation. The authors analyzed multiple clinicoradiological factors to predict recurrence and functional outcome in a cohort with a mean follow-up of more than 4 years. The authors also discuss the results of clinical studies regarding spinal meningiomas in the last 15 years. METHODS The authors retrospectively reviewed the clinical and radiological details of patients who underwent surgery for spinal tumors between 2001 and 2015 that were histopathologically confirmed as meningiomas. Demographic parameters, such as age, sex, race, and association with neurofibromatosis Type 2, were considered. Radiological parameters, such as tumor size, signal changes of spinal cord, spinal level, number of levels, location of tumor attachment, shape of tumor, and presence of dural tail/calcification, were noted. These factors were analyzed to predict recurrence and functional outcome. Furthermore, a pooled analysis was performed from 13 reports of spinal meningiomas in the last 15 years. RESULTS A total of 38 patients were included in this study. Male sex and tumors with radiological evidence of a dural tail were associated with an increased risk of recurrence at a mean follow-up of 51.2 months. Ventral or ventrolateral location, large tumors, T2 cord signal changes, and poor preoperative functional status were associated with poor functional outcome at 1-year follow-up. CONCLUSIONS Spine surgeons must be aware of the natural history and risk factors of spinal meningiomas to establish a prognosis for their patients.

  5. Large spinal meningioma with hemorrhage after selective root block in the thoraco-lumbar spine.

    PubMed

    Lee, Heui Seung; Lee, Sang Hyung; Chung, Young Seob; Yang, Hee-Jin; Son, Young-Je; Park, Sung Bae

    2013-12-01

    Spinal meningioma accounts for 25% of all spinal cord tumors and occurs mostly in the thoracic region. Spontaneous intraspinal bleeding associated with spinal meningioma has rarely been reported. Most cases of hemorrhage associated with meningiomas are extratumoral and subarachnoid, whereas subdural and intratumoral hemorrhage cases have been reported to occur rarely. We experienced a case of a 58-year-old woman with thoracolumbar spinal meningioma accompanied by intraspinal subdural hematoma. She presented with progressively worsened back pain and newly developed weakness in the right lower extremity after a selective nerve root block in the lumbar spine. She underwent the operation and progressively showed neurological recovery during the postoperative course. We report a thoracolumbarspinal meningioma with subdural and intratumoral hemorrhage after a spinal procedure that caused a sudden neurological deterioration.

  6. Large Spinal Meningioma with Hemorrhage after Selective Root Block in the Thoraco-Lumbar Spine

    PubMed Central

    Lee, Heui Seung; Lee, Sang Hyung; Chung, Young Seob; Yang, Hee-Jin; Son, Young-Je

    2013-01-01

    Spinal meningioma accounts for 25% of all spinal cord tumors and occurs mostly in the thoracic region. Spontaneous intraspinal bleeding associated with spinal meningioma has rarely been reported. Most cases of hemorrhage associated with meningiomas are extratumoral and subarachnoid, whereas subdural and intratumoral hemorrhage cases have been reported to occur rarely. We experienced a case of a 58-year-old woman with thoracolumbar spinal meningioma accompanied by intraspinal subdural hematoma. She presented with progressively worsened back pain and newly developed weakness in the right lower extremity after a selective nerve root block in the lumbar spine. She underwent the operation and progressively showed neurological recovery during the postoperative course. We report a thoracolumbarspinal meningioma with subdural and intratumoral hemorrhage after a spinal procedure that caused a sudden neurological deterioration. PMID:24891860

  7. Metastasis to a spinal meningioma.

    PubMed

    Bansil, Rohit; Walia, Bipin S; Khan, Zahid; Abrari, Andleeb

    2017-01-01

    Metastasis of one cancer to another is rare. Here, we report a spinal meningioma that was infiltrated by metastatic deposits from another cancer. A 62-year-old male presented with a progressive spastic paraparesis. Magnetic resonance (MR) imaging of the spine suggested a well-defined intradural extramedullary (IDEM) T8 mass in the dorsal spinal canal. When excised, it proved histologically to be a meningothelial meningioma infiltrated by metastatic deposits from an adenocarcinoma. Tumor to tumor metastasis rarely occurs, and meningioma, owing to its biological character and increased vascularity, is one of the most common recipients of a metastases from other lesions.

  8. Frontal cutaneous meningioma - Case report*

    PubMed Central

    Ramos, Leonor; Coutinho, Ines; Cardoso, José Carlos; Garcia, Helena; Cordeiro, Margarida Robalo

    2015-01-01

    Cutaneous meningiomas are rare tumors most commonly located on the scalp. We report the case of a 55-year-old male who presented with a 2x3 cm tumoral lesion on the forehead. The lesion was hard, adherent and covered by normal skin. Incisional biopsy revelead a proliferation of monomorphic round cells, organized in nests and focally forming pseudovascular spaces. Immunohistochemical study revealed positivity for epithelial antigen membrane and vimentin. Vascular markers, cytokeratins and S100 protein were negative. A brain CT scan did not show any evidence of intracranial meningioma. The authors describe the case of a cutaneous frontal meningioma in probable relation with previous cranioencephalic trauma. PMID:26312695

  9. Posterior Fossa Meningioma

    PubMed Central

    Saleh, Essam A.; Taibah, Abdel Kader; Achilli, Vittorio; Aristegui, Miguel; Mazzoni, Antonio; Sanna, Mario

    1994-01-01

    Posterior fossa meningioma is the second most common tumor in the cerebellopontine angle. It has a higher rate of postoperative morbidity and mortality compared to acoustic neuroma. Forty posterior fossa meningioma patients managed in our centers were reviewed. Thirty-nine patients were managed surgically with 42 surgical procedures. The approaches used were the translabyrinthine approach in 18 patients (43%), the modified transcochlear in 11 cases (26%), the petro-occipital transsigmoid in 5 cases (12%), the suboccipital in 4 cases (10%), the petro-occipital trassigmoid transcervical in 2 cases (5%), the petro-occipital transsigmoid transtentorial in 1 case (2%), and a subtemporal transtentorial for another case (2%). Facial nerve anatomical integrity was preserved in 87% of procedures but was interrupted in 5 cases, with 4 of the latter subsequently repaired. Total tumor removal was accomplished in 38 cases. A second-stage total tumor removal is planned for the remaining case. There was only one case of perioperative death and no cases of radiological recurrence so far. ImagesFigure 1Figure 2Figure 3Figure 4p206-bFigure 5p207-bFigure 5 PMID:17171173

  10. O9.07COGNITIVE IMPROVEMENT AFTER MENINGIOMA SURGERY

    PubMed Central

    Meskal, I.; Gehring, K.; van der Linden, S.; Rutten, G.-J.; Sitskoorn, M.

    2014-01-01

    A significant proportion of brain tumour patients has cognitive impairments. Most studies have focussed on patients with glioma. Meningioma patients have been infrequently studied; we found only seven studies in the literature. Most of these studies lack preoperative measurements, a priori limiting conclusions on the impact of surgery on cognition. We examined cognitive functioning in 100 meningioma patients prior to, and three months after surgery. This study is part of a larger and prospective study in our hospital in which craniotomy patients are routinely tested with a computerized screening battery of neuropsychological tests (i.e., CNS Vital Signs). Testing takes approximately 30 - 45 minutes and results in quantified scores on the domains of memory, psychomotor speed, reaction time, complex attention, cognitive flexibility, processing speed, and executive functioning. For this study we applied stringent exclusion criteria to minimize possible cognitive effects of comorbidity (eg, we excluded patients with a history of intracranial treatment or major neurological disease) and this left us with a group of 68 patients. Average diameter of meningioma was 4.3 cm. Both before and after surgery, meningioma patients showed significantly lower scores on all cognitive domains in comparison with healthy controls. Three months after surgery, significantly improved test performances were found on all cognitive domains, with the exception of psychomotor speed and reaction time. To gain insight in individual test performance, the number of patients scoring ‘low’ or ‘very low’ (i.e, 1.5 and 2 SD below average) was counted. The percentage of these patients decreased from 69% before surgery to 44% three months after surgery. We conclude that (1) cognitive impairments are already present in the majority of untreated meningioma patients, (2) surgery improves these impairments, and (3) a computerized test battery seems an adequate (and time-efficient) clinical instrument

  11. Giant sacrolumbar meningioma. Case report.

    PubMed

    Feldenzer, J A; McGillicuddy, J E; Hopkins, J W

    1990-06-01

    A case of giant sacral meningioma with presacral and lumbar extension is presented. The difficulties in diagnosis and management are emphasized including the staged multidisciplinary surgical approaches and preoperative tumor embolization.

  12. Recurrent rhabdoid meningioma with lymph node, pulmonary and bone metastases: a diagnostic and therapeutic challenge.

    PubMed

    Kakkar, Aanchal; Baghmar, Saphalta; Garg, Ajay; Suri, Vaishali; Raina, Vinod; Sarkar, Chitra; Sharma, Mehar Chand

    2016-07-01

    Rhabdoid meningioma is a rare meningioma variant, classified as WHO grade III. Although this tumor is known for its aggressive behavior and poor prognosis, extracranial metastasis is rare. We report the rare case of a 31-year-old patient with rhabdoid meningioma which recurred several times despite gross total resection, radiation therapy, and gamma knife radiosurgery, and the last recurrence was associated with metastases to lungs, lymph node and bone. The patient showed no response to paclitaxel-carboplatin, or vincristine-cyclophosphamide-adriamycin chemotherapy, and succumbed to the disease. Metastases from rhabdoid meningioma prove to be a diagnostic challenge, and treatment for metastatic meningiomas is not optimized, thus necessitating documentation and interdisciplinary consensus on management protocols.

  13. [Chronic epidural haematoma mimicking meningioma].

    PubMed

    Beculić, Hakija; Skomorac, Rasim; Jusić, Aldin; Mekić-Abazović, Alma; Bajtarević, Alma

    2011-02-01

    The study presents a rare case of organised chronic epidural haematoma that imitated a meningioma. A patient was admitted to the Department of Neurology of the Cantonal Hospital Zenica due to loss of consciousness and right hemiparesis. Non-contrast Computed Tomography (CT) scan had shown an expansive intracranial process in the left parietal region which was radiologically diagnosed as a meningioma. During the operation a linear skull fracture and organised chronic epidural haematoma were found.

  14. Risk factors for meningiomas in men in Los Angeles County

    SciTech Connect

    Preston-Martin, S.; Yu, M.C.; Henderson, B.E.; Roberts, C.

    1983-05-01

    A case-control study among men in Los Angeles County was conducted to investigate further the causes of intracranial meningiomas. Meningioma patients and a neighbor of each one were interviewed about past experiences that might be associated with tumor development. Analysis of information from the 105 matched pairs showed an association with meningioma occurrence for various factors relating to head trauma and head X-rays: 1) ever boxed as a sport (odds ratio (OR) . 2.0, P . 0.03), 2) had a serious head injury (OR . 1.9, P . 0.01), and 3) had X-ray treatment to the head before 20 years of age and/or had five or more full mouth dental X-ray series before 1945 (OR . 3.5, P . 0.02). Of the 105 subjects, 72 (69%) had a history of exposure to at least one of these factors.

  15. Risk factors for meningiomas in men in Los Angeles County.

    PubMed

    Preston-Martin, S; Yu, M C; Henderson, B E; Roberts, C

    1983-05-01

    A case-control study among men in Los Angeles County was conducted to investigate further the causes of intracranial meningiomas. Meningioma patients and a neighbor of each one were interviewed about past experiences that might be associated with tumor development. Analysis of information from the 105 matched pairs showed an association with meningioma occurrence for various factors relating to head trauma and head X-rays: 1) ever boxed as a sport [odds ratio (OR) = 2.0, P = 0.03], 2) had a serious head injury (OR = 1.9, P = 0.01), and 3) had X-ray treatment to the head before 20 years of age and/or had five or more full mouth dental X-ray series before 1945 (OR = 3.5, P = 0.02). Of the 105 subjects, 72 (69%) had a history of exposure to at least one of these factors.

  16. Factors associated with knowledge of personal gestational weight gain recommendations.

    PubMed

    Ledoux, Tracey; Van Den Berg, Patricia; Leung, Patrick; Berens, Pamela D

    2015-08-13

    Excess adiposity (obesity and excess gestational weight gain, GWG) during pregnancy (EADP) increases risk for gestational diabetes, preeclampsia, and child and maternal obesity. Personal GWG goals predict total GWG. Some estimates suggest only 30% of pregnant women have personal GWG goals that are congruent with Institute of Medicine GWG recommendations. The primary purpose of this study was to determine the extent to which perceived pre-pregnancy weight status, healthcare provider advice, knowledge of EADP risks, and value for healthy GWG predicted knowledge of GWG recommendations. The secondary purpose was to determine sources of GWG information among pregnant women. Pregnant women with a confirmed singleton pregnancy completed a one-time survey in obstetric clinic waiting rooms. Logistic regression analysis was used. 246 predominantly African American, low income, overweight/obese women completed surveys. Average age was 25 (SD 5.3) and gestation age ranged from 7 to 40 weeks. Knowledge of pre-pregnancy weight status was the only unique predictor of GWG recommendation knowledge (B = .642, p = .03). The top three sources of GWG information were physicians, internet, and books. The least frequently reported sources of GWG information were other healthcare providers, community programs, and television. In low income diverse overweight/obese pregnant women, accurate pre-pregnancy weight status perception was the only significant unique predictor of knowledge of GWG recommendations. Physicians were the preferred source of GWG information. Clinicians should have frequent, ongoing conversations about weight status with women before, during, and after pregnancy.

  17. Microsurgical treatment of tentorial meningiomas: Report of 30 patients

    PubMed Central

    Aguiar, Paulo Henrique; Tahara, Adriana; de Almeida, Antonio Nogueira; Kurisu, Kaoru

    2010-01-01

    Background: Tentorial meningiomas represent about 5% of intracranial meningiomas. This article reviews our recent institutional series of patients with tentorial meningiomas, proposes a simplified classification and analyzes postoperative evolution, discussing the salient features in the management of these patients. Methods: From 1998 to 2005, 30 patients (22 female and 8 male) with tentorial meningiomas were operated at our institution. Thirteen patients had tumor restricted to the infratentorial space; 12, to the supratentorial space; and in 5 cases, the tumor involved both compartments. Follow-up ranged from 1 to 8 years. A total of 35 surgical procedures were performed in 30 patients, where 26 procedures were performed through a single approach (2, ITSC; 10, RS; 5, SOIH; 5, ST; and 4, TT); and 9, through combined approaches (7, ITSC/ SOIH; and 2, RS/ST). Results: Simpson I resection was achieved in 17 patients. Tumors involving both compartments, involving the petrous sinus, and attached to the torcula limited complete resection. Twenty-two out of 30 patients were able to return to their regular life with no or minimal neurological sequelae. Most frequent complications in our series were shunt dependence, CSF fistulae, diffuse brain injury and visual field defects. Overall, our series revealed 3% mortality and 23% morbidity. Conclusion: Tentorial meningiomas are associated with significant morbidity related to the nervous and vascular structures surrounding the tumor. Partial tumor removal may be necessary in some cases. PMID:20847917

  18. Intraparenchymal Angiomatous Meningioma: A Diagnostic Dilemma

    PubMed Central

    Bansal, Divya; Gogoi, Priyanka; Nazir, Wazid; Tandon, Anupama

    2015-01-01

    Meningioma arises from the arachnoid cap cells of the cerebrum. Intraparenchymal meningiomas or meningiomas without dural attachment are rare. We report a case of 40-year-old male who presented with a history of headache, dizziness and gradual loss of vision since one year. Clinicoradiological diagnosis of a high grade glioma was considered. Tumour was excised and haematoxylin and eosin stained sections revealed a tumour comprised predominantly of variable sized blood vessels showing hyalinization in a background of plump spindle cells with oval vesicular nuclei. In view of these features angiomatous meningioma was suspected. However, to confirm the diagnosis, a panel of immunohistochemical markers including vimentin, EMA and GFAP was done and a final diagnosis of angiomatous meningioma was offered. Angiomatous meningioma is a rare variant of meningioma and even much rarer in the intraparenchymal location. Angiomatous meningioma should be considered in the differential diagnosis of highly vascular intraparenchymal brain tumours. PMID:26557529

  19. Intraparenchymal Angiomatous Meningioma: A Diagnostic Dilemma.

    PubMed

    Bansal, Divya; Diwaker, Preeti; Gogoi, Priyanka; Nazir, Wazid; Tandon, Anupama

    2015-10-01

    Meningioma arises from the arachnoid cap cells of the cerebrum. Intraparenchymal meningiomas or meningiomas without dural attachment are rare. We report a case of 40-year-old male who presented with a history of headache, dizziness and gradual loss of vision since one year. Clinicoradiological diagnosis of a high grade glioma was considered. Tumour was excised and haematoxylin and eosin stained sections revealed a tumour comprised predominantly of variable sized blood vessels showing hyalinization in a background of plump spindle cells with oval vesicular nuclei. In view of these features angiomatous meningioma was suspected. However, to confirm the diagnosis, a panel of immunohistochemical markers including vimentin, EMA and GFAP was done and a final diagnosis of angiomatous meningioma was offered. Angiomatous meningioma is a rare variant of meningioma and even much rarer in the intraparenchymal location. Angiomatous meningioma should be considered in the differential diagnosis of highly vascular intraparenchymal brain tumours.

  20. De novo glioblastoma in the territory of a recent middle cerebral artery infarction and a residual meningioma: pathogenesis revisited.

    PubMed

    Yaghmour, Waseem; Kurdi, Maher E; Baeesa, Saleh S

    2016-04-18

    The pathogenesis of glioblastoma is complex, and the implicated molecular mechanisms are yet to be understood. There are scattered reports describing a possible relationship between meningioma and glioblastoma and more rarely a relationship between infarction and glioblastoma. We are reporting a 32-year-old male who developed left middle cerebral artery (MCA) infarction as a surgical complication for sphenoid meningioma. He developed recurrent symptoms 4 months later due to development of a glioblastoma adjacent to both the territory of the prior MCA infarct and the residual meningioma. This case adds further contribution to the literature of the possible pathological association between glioblastoma and brain infarction on a background of meningioma.

  1. Neighborhood factors associated with physical activity and adequacy of weight gain during pregnancy

    EPA Science Inventory

    Healthy diet, physical activity, smoking, and adequate weight gain are all associated with maternal health and fetal growth during pregnancy. Neighborhood characteristics have been associated with poor maternal and child health outcomes, yet conceptualization of potential mechani...

  2. Neighborhood factors associated with physical activity and adequacy of weight gain during pregnancy

    EPA Science Inventory

    Healthy diet, physical activity, smoking, and adequate weight gain are all associated with maternal health and fetal growth during pregnancy. Neighborhood characteristics have been associated with poor maternal and child health outcomes, yet conceptualization of potential mechani...

  3. Expression of CD163 prevents apoptosis through the production of granulocyte colony-stimulating factor in meningioma

    PubMed Central

    Kanno, Hiromi; Nishihara, Hiroshi; Wang, Lei; Yuzawa, Sayaka; Kobayashi, Hiroyuki; Tsuda, Masumi; Kimura, Taichi; Tanino, Mishie; Terasaka, Shunsuke; Tanaka, Shinya

    2013-01-01

    Background CD163 is a 130-kDa transmembrane protein expressed in human monocytes and macrophages, and the aberrant expression of CD163 in breast and colorectal cancer associated with patients' poor prognosis was reported. Here, we analyzed the expression of CD163 in meningioma, a common intracranial tumor, and its molecular mechanism in association with meningioma progression. Methods First, we performed immunohistochemical analysis using 50 human meningioma specimens. Next, we established CD163-overexpressing human meningioma cell lines and investigated its roles in tumor progression in vitro and in vivo. Results Immunohistochemically, 26 of 50 human meningioma specimens (52.0%) were positive for CD163 in tumor cells, including benign grade I (48.5%) and grade II (71.4%) cases. Furthermore, CD163 expression was correlated with histological atypical parameters that directly predict the prognosis of meningioma. CD163-overexpressing meningioma cells showed significant suppression of apoptosis and accelerated tumor growth in nude mice. In addition, unexpected splenomegaly affiliated with the xenograft predicted tumor-derived granulocyte colony-stimulating factor (G-CSF) production, which was confirmed by reverse-transcription polymerase chain reaction and enzyme-linked immunosorbent assay. Conclusions To our knowledge, this is the first report that demonstrates CD163 expression in meningioma not only by immunohistochemistry but also by reverse-transcription polymerase chain reaction, using primary culture cells, and provides the novel molecular function of CD163 to prevent apoptosis through the production of G-CSF in meningioma. PMID:23539121

  4. Expression of CD163 prevents apoptosis through the production of granulocyte colony-stimulating factor in meningioma.

    PubMed

    Kanno, Hiromi; Nishihara, Hiroshi; Wang, Lei; Yuzawa, Sayaka; Kobayashi, Hiroyuki; Tsuda, Masumi; Kimura, Taichi; Tanino, Mishie; Terasaka, Shunsuke; Tanaka, Shinya

    2013-07-01

    CD163 is a 130-kDa transmembrane protein expressed in human monocytes and macrophages, and the aberrant expression of CD163 in breast and colorectal cancer associated with patients' poor prognosis was reported. Here, we analyzed the expression of CD163 in meningioma, a common intracranial tumor, and its molecular mechanism in association with meningioma progression. First, we performed immunohistochemical analysis using 50 human meningioma specimens. Next, we established CD163-overexpressing human meningioma cell lines and investigated its roles in tumor progression in vitro and in vivo. Immunohistochemically, 26 of 50 human meningioma specimens (52.0%) were positive for CD163 in tumor cells, including benign grade I (48.5%) and grade II (71.4%) cases. Furthermore, CD163 expression was correlated with histological atypical parameters that directly predict the prognosis of meningioma. CD163-overexpressing meningioma cells showed significant suppression of apoptosis and accelerated tumor growth in nude mice. In addition, unexpected splenomegaly affiliated with the xenograft predicted tumor-derived granulocyte colony-stimulating factor (G-CSF) production, which was confirmed by reverse-transcription polymerase chain reaction and enzyme-linked immunosorbent assay. To our knowledge, this is the first report that demonstrates CD163 expression in meningioma not only by immunohistochemistry but also by reverse-transcription polymerase chain reaction, using primary culture cells, and provides the novel molecular function of CD163 to prevent apoptosis through the production of G-CSF in meningioma.

  5. A Pilocytic Astrocytoma Mimicking a Clinoidal Meningioma

    PubMed Central

    Hong, Christopher S.; Lehman, Norman L.; Sauvageau, Eric

    2014-01-01

    Pilocytic astrocytomas and meningiomas are benign, primary brain tumors that may involve the optic tract. Classically, the presence of a dural “tail” sign may differentiate a meningioma from other intracranial lesions. In this report, we describe a mass with the typical appearance of a clinoidal meningioma on magnetic resonance imaging (MRI) but postoperatively diagnosed as a pilocytic astrocytoma. This case illustrates the rare occurrence of a pilocytic astrocytoma mimicking a meningioma on MRI. PMID:24744944

  6. A new germline mutation of the PTCH gene in a Japanese patient with nevoid basal cell carcinoma syndrome associated with meningioma.

    PubMed

    Tate, Genshu; Li, Min; Suzuki, Takao; Mitsuya, Toshiyuki

    2003-01-01

    We employed polymerase chain reaction and DNA sequencing analysis to characterize the PTCH gene in a Japanese nevoid basal cell carcinoma syndrome (NBCCS) patient suffering from meningioma, multiple basal cell carcinoma and epidermal cysts. Direct sequence analyses revealed a novel single base deletion at nucleotide 2613 in exon 16 (2613delC) in one PTCH allele, resulting in the frame shift and the introduction of a premature termination codon in this mutated allele.

  7. Optic Nerve Sheath Meningiomas.

    PubMed

    Radhakrishnan, Sunita; Lee, Michael S

    2005-01-01

    Optic nerve sheath meningiomas (ONSMs) grow slowly and, if untreated, patients may have stable visual function for up to several years. Treatment of an ONSM may lead to vision loss (radiation retinopathy or optic neuropathy). Therefore, observation is recommended for a patient with ONSM and relatively preserved visual acuity, color vision, pupils, and visual fields. Follow-up every 4 to 6 months initially is recommended extending to annual examinations if visual function and tumor size remain stable for a few years. Neuroimaging can be repeated every 12 months. An undisputed decline in visual function or any intracranial extension warrants treatment of the ONSM. The treatment of choice for a tumor confined to the orbit is stereotactic fractionated radiation. Stereotactic fractionated radiation uses multiple small doses of radiation using tight margins. A reasonable alternative, three-dimensional conformal fractionated radiation uses computed tomography-guided planning but usually requires wider margins. Conventional radiation uses much wider margins and would not be recommended for treatment of ONSM. The radiation can be administered during 5 to 6 weeks in 28 daily fractions of 1.8 to 2 Gy/fraction to a total of 50.4 to 56 Gy. Many patients have improvement or stabilization of their visual function. Gamma knife radiosurgery does not have a role in ONSM because the required dose is toxic to the optic nerve. A tumor that extends intracranially may be treated with fractionated radiation if any vision remains. Surgical excision can be considered for significant intracranial extension but this often leads to complete vision loss in the ipsilateral eye. A blind, disfigured eye also may be treated with en bloc surgical resection of the meningioma.

  8. Meningiomas of Meckel's cave.

    PubMed

    Delfini, R; Innocenzi, G; Ciappetta, P; Domenicucci, M; Cantore, G

    1992-12-01

    A series of 16 patients with meningiomas of Meckel's cave is reported. Trigeminal neuralgia, typical or atypical, was the initial symptom in 10 patients (62.5%). At admission, trigeminal signs and symptoms were present in 15 patients (93.7%); in 7 patients (43.7%), trigeminal dysfunction was combined with the impairment of other cranial nerves. On retrospective analysis, these patients fall into two clinical groups that differ also in prognosis. Group 1 comprises eight patients with trigeminal signs and symptoms only. These patients had small meningiomas strictly affecting Meckel's cave. Total removal of the tumor was achieved in seven of eight patients, without adjunctive postoperative neurological deficits. In this group, there were no tumor recurrences. Group 2 comprises the other eight patients in whom trigeminal dysfunction was combined with impairment of other cranial nerves. These patients had large tumors arising from Meckel's cave and secondarily invading the cavernous sinus (five patients) or extending into the posterior fossa (two patients) or largely growing into the middle fossa (one patient). Total removal was achieved in only one patient, and a worsening of the preoperative neurological status was observed in four patients; there were three cases of tumor progression. A subtemporal intradural approach (used in the past in every case) is still used for the small tumors of Group 1 with good results. Since 1985, for tumors involving the cavernous sinus, we have employed a frontotemporal craniotomy with extradural clinoidectomy and superior and lateral approach to the cavernous sinus. When the tumor extends toward the posterior fossa, we use a combined temporosuboccipital-transpetrosal approach.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Histopathological study of spinal meningioma originating from the arachnoid villi.

    PubMed

    Ohnishi, Yu-ichiro; Iwatsuki, Koichi; Morii, Eiichi; Kobayashi, Maki; Hori, Yumiko; Moriwaki, Takashi; Ishihara, Masahiro; Yoshimura, Kazunori; Umegaki, Masao; Yoshimine, Toshiki

    2011-02-01

    Although the histogenesis of meningiomas remains unclear, it is believed that arachnoid cells are the most likely origin of this type of neoplasm. Further, little attention has been paid to the histopathology of spinal meningiomas arising from the arachnoid villi. We came across a case of spinal meningioma that was locally attached to the arachnoid membrane. The associated arachnoid villi were investigated by light microscopy and immunohistochemical analysis. We confirmed the presence of tumor cells under the fibrous capsule that forms the outer component of the arachnoid villi. Tumor cells grew out from the apical portion of the arachnoid villi. Furthermore, immunohistochemical study suggested that arachnoid cells made the transition to tumor cells on the arachnoid cell layer.

  10. Meningioma in a Bengal tiger (Panthera tigris tigris).

    PubMed

    Akin, Erin Y; Baumgartner, Wes A; Lee, Jung Keun; Beasley, Michaela J

    2013-09-01

    A 17-yr-old female ovariectomized Bengal tiger (Panthera tigris tigris) was presented dead on arrival to the Mississippi State University College of Veterinary Medicine. The tiger was a resident of a sanctuary for big cats and had a history of juvenile-onset blindness of unknown cause. The tiger suffered two seizures the morning of presentation and expired shortly after resolution of the second seizure. Gross necropsy findings included a meningioma attached to the left frontal bone and associated with the left frontal lobe. Histologically, the mass was composed of meningothelial cells arising from the meninges, forming whorls and streams. Cells often formed syncytia and psammoma bodies were present. Neoplastic cells were immunohistochemically positive for vimentin, S100, and cytokeratin, but negative for GFAP. All findings were consistent with a meningioma. This is the first documentation of a meningioma in a Bengal tiger.

  11. Cavernous angioma within an olfactory groove meningioma. Case report.

    PubMed

    Klein, Olivier; Freppel, Sébastien; Auque, Jean; Civit, Thierry

    2006-02-01

    The authors present the case of a 60-year-old woman who was admitted to their institution after suffering a subarachnoid hemorrhage (SAH). Neuroimaging data demonstrated an olfactory groove meningioma surrounded by a slight edema, but there was no evidence of SAH, although results of the lumbar puncture demonstrated xanthochromic cerebrospinal fluid. Angiography confirmed the diagnosis of meningioma, but results of magnetic resonance imaging led the authors to suspect a cavernoma within the meningioma. This diagnosis was established by pathological examination of the resected lesion. The patient did well and was discharged soon after surgery. This very rare association and the propensity of each of these lesions to be revealed by hemorrhage are discussed.

  12. Coincidental Optic Nerve Meningioma and Thyroid Eye Disease.

    PubMed

    Garg, Aakriti; Patel, Payal; Lignelli, Angela; Baron, Edward; Kazim, Michael

    2015-01-01

    A 57-year-old woman with diabetes mellitus, hypertension, obesity, and Graves disease presented with clinical evidence of thyroid eye disease (TED) and optic neuropathy. She was referred when a tapered dose of steroids prompted worsening of her TED. CT and MRI were consistent with TED and bilateral optic nerve meningioma. To the authors' knowledge, this is the first reported case of concurrent TED and unsuspected bilateral optic nerve meningioma. When investigating the etiology of TED-associated optic neuropathy, careful attention to orbital imaging is required because coexisting pathology may exist.

  13. Altered expression of E-Cadherin-related transcription factors indicates partial epithelial-mesenchymal transition in aggressive meningiomas.

    PubMed

    Wallesch, Maren; Pachow, Doreen; Blücher, Christina; Firsching, Raimund; Warnke, Jan-Peter; Braunsdorf, Werner E K; Kirches, Elmar; Mawrin, Christian

    2017-09-15

    E-Cadherin has been suggested to be involved in meningioma progression but is also known as a key player of epithelial to mesenchymal transition (EMT). We wondered whether the adherens junction protein E-Cadherin, the tight junction protein Zo-1, and transcription factors suppressing E-Cadherin expression (Slug, Snail, Twist, Zeb-1) are differentially expressed between histopathological subtypes of meningioma, and if the expression of these factors is related to biological features of meningiomas. Analyzing 85 meningiomas of various histopathological subtypes and grades of malignancy by immunohistochemistry and 50 of them in addition by real-Time-PCR, we observed significantly reduced expression of Zeb-1, Twist and Slug, together with slightly increased expression levels for E-Cadherin and Zo- 1 in fibroblastic WHO-grade I tumors compared to meningothelial WHO grade I tumors, contradicting the hypothesis of EMT in the fibroblastic meningiomas characterized by mesenchymal appearance. However, comparing aggressive WHO grade II or III meningiomas with WHO-grade I tumors, we observed altered expression levels (loss of E-Cadherin and Zo-1, increased expression of Zeb-1 and Slug) indicating molecular features of EMT in aggressive meningiomas. This was supported by reduced E-Cadherin and increased Slug levels in recurrent compared to non-recurrent meningiomas. The expression levels of E-cadherin and Zo-1 were positively correlated with expression of NF2 mRNA. In primary meningioma cultures and IOMM-Lee meningioma cells, EMT induction by TGF-ß resulted in altered morphology and increased expression of EMT associated transcription factors. Meningioma cells with allelic losses of NF2 showed generally higher levels of various EMT relevant proteins, but were unresponsive to TGF-ß treatment. Our data indicate that aggressive meningiomas of WHO grade II/III are characterized by molecular alterations indicating partial EMT. This might contribute to the aggressive biology of

  14. Gamma Knife Radiosurgery for Atypical and Anaplastic Meningiomas.

    PubMed

    Wang, Wei-Hsin; Lee, Cheng-Chia; Yang, Huai-Che; Liu, Kang-Du; Wu, Hsiu-Mei; Shiau, Cheng-Ying; Guo, Wan-You; Pan, David Hung-Chi; Chung, Wen-Yuh; Chen, Ming-Teh

    2016-03-01

    Atypical and anaplastic meningiomas have much higher recurrence rates after surgical resection compared with benign meningiomas, but the role of adjuvant radiosurgery remains unclear. This study was undertaken to evaluate the outcomes of gamma knife radiosurgery for patients with atypical and anaplastic meningiomas. In this retrospective analysis of a prospectively maintained database, 46 patients with histologically proven atypical or anaplastic meningiomas by current World Health Organization (WHO) criteria underwent postoperative Gamma Knife radiosurgery between 1993 and 2013. The median follow-up period was 32.6 months. The median tumor volume and margin dose were 11.7 mL (range, 2-53 mL) and 13.1 Gy (range, 12.0-16.5 Gy), respectively. Local control at 3 and 5 years was 50.6% and 32.1%, respectively. Gender (P = 0.013) and marginal dose less than or equal to 13 Gy (P = 0.049) were associated with the local control. The 3- and 5-year overall survival for patients with WHO grade II was 97.1% and 88.3%, respectively, compared with 66.7% and 66.7% for patients with WHO grade III meningiomas. Radiation therapy before Gamma Knife radiosurgery (GKRS; P = 0.018) and tumor grade (P = 0.019) were the factors associated with a worse overall survival rate. Fourteen patients (30.4%) developed adverse radiation effects after GKRS treatment, and all were Radiation Therapy Oncology Group grade I. Postoperative GKRS treatment for patients with atypical and anaplastic meningioma is challenging. More aggressive treatment, including of safely maximizing the extent of surgical resection and using a higher margin dose (>13Gy), should be applied to achieve better local control. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. APOBEC3B expression in human leptomeninges and meningiomas

    PubMed Central

    Johnson, Mahlon D.; Reeder, Jay E.; O'Connell, Mary

    2016-01-01

    Nucleic acid-editing enzymes of the apolipoprotein B mRNA-editing enzyme (APOBEC) family have been associated with somatic mutation in cancer. However, the role of APOBEC catalytic subunit 3B (APOBEC3B) editing in the pathogenesis of base substitutions in meningiomas is unknown. In the present study, the expression of APOBEC3B was examined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analyses in five fetal and one adult human leptomeninges and 38 meningiomas. Genomic DNA was sequenced using the Illumina Tru-Seq Cancer Panel. Three meningioma primary cultures were also established and treated with cerebrospinal fluid form patients without neurological disease or platelet-derived growth factor-BB (PDGF-BB), prior to evaluation of APOBEC3B expression. By western blotting, APOBEC3B was revealed to be present in 100% of the fetal leptomeninges, and in 88% of World Health Organization grade I, 100% of grade II and 83% of grade III meningiomas tested, but was not different between grades. RT-qPCR revealed no difference in the mRNA expression of APOBEC3B between grades. Sequencing revealed no elevated levels of the C>T mutations that are characteristic of APOBEC3B editing of genomic DNA. Treatment with cerebrospinal fluid and PDGF-BB had no effect on APOBEC3B protein expression in the leptomeningeal or meningioma cells. These findings suggest that the mutations associated with increased APOBEC3B expression may not be central to the pathogenesis of meningiomas. PMID:28101245

  16. Dietary energy density but not glycemic load is associated with gestational weight gain

    PubMed Central

    Deierlein, Andrea L.; Siega-Riz, Anna Maria; Herring, Amy

    2009-01-01

    Background The majority of pregnant women are gaining outside of the recommended weight gain ranges. Excessive weight gains have been linked to pregnancy complications and long term maternal and child health outcomes. Objective To examine the impact of dietary glycemic load and energy density on total gestational weight gain and weight gain ratio (observed weight gain/expected weight gain). Design Data are from 1231 women with singleton pregnancies who participated in the Pregnancy, Infection, and Nutrition Cohort Study. Dietary information was collected at 26–29 weeks gestation using a semi-quantified food frequency questionnaire. Linear regression models were used to estimate the associations between glycemic load (in quartiles) and energy density (in quartiles) with total gestational weight gain and weight gain ratio. Results Dietary patterns of pregnant women significantly differed across many sociodemographic and behavioral characteristics, with the greatest contrasts seen for glycemic load. After adjustment for covariates, in comparison to women in the first quartile, consuming a mean dietary energy density of 0.77 kcal/g (reference), women in the second quartile, consuming a mean energy density of 0.95 kcal/g, gained an excess of 0.91 kg (95% CI: 0.02–1.79) and women in the third quartile, consuming a mean energy density of 1.09 kcal/g, gained an excess of 1.47 kg (95% CI: 0.58–2.36). All other comparisons of energy intakes were not statistically significant. Glycemic load was not associated with total gestational weight gain or weight gain ratio. Conclusions Dietary energy density is a modifiable factor that may assist pregnant women in managing gestational weight gains. PMID:18779285

  17. Alternative Splicing of CHEK2 and Codeletion with NF2 Promote Chromosomal Instability in Meningioma1

    PubMed Central

    Yang, Hong Wei; Kim, Tae-Min; Song, Sydney S; Shrinath, Nihal; Park, Richard; Kalamarides, Michel; Park, Peter J; Black, Peter M; Carroll, Rona S; Johnson, Mark D

    2012-01-01

    Mutations of the NF2 gene on chromosome 22q are thought to initiate tumorigenesis in nearly 50% of meningiomas, and 22q deletion is the earliest and most frequent large-scale chromosomal abnormality observed in these tumors. In aggressive meningiomas, 22q deletions are generally accompanied by the presence of large-scale segmental abnormalities involving other chromosomes, but the reasons for this association are unknown. We find that large-scale chromosomal alterations accumulate during meningioma progression primarily in tumors harboring 22q deletions, suggesting 22q-associated chromosomal instability. Here we show frequent codeletion of the DNA repair and tumor suppressor gene, CHEK2, in combination with NF2 on chromosome 22q in a majority of aggressive meningiomas. In addition, tumor-specific splicing of CHEK2 in meningioma leads to decreased functional Chk2 protein expression. We show that enforced Chk2 knockdown in meningioma cells decreases DNA repair. Furthermore, Chk2 depletion increases centrosome amplification, thereby promoting chromosomal instability. Taken together, these data indicate that alternative splicing and frequent codeletion of CHEK2 and NF2 contribute to the genomic instability and associated development of aggressive biologic behavior in meningiomas. PMID:22355270

  18. Disentangling the Ultrafiltration Rate–Mortality Association: The Respective Roles of Session Length and Weight Gain

    PubMed Central

    Curhan, Gary C.; Brunelli, Steven M.

    2013-01-01

    Summary Background and objectives Rapid ultrafiltration rate is associated with increased mortality among hemodialysis patients. Ultrafiltration rates are determined by interdialytic weight gain and session length. Although both interdialytic weight gain and session length have been linked to mortality, the relationship of each to mortality, independent of the other, is not adequately defined. This study was designed to evaluate whether shorter session length independent of weight gain and larger weight gain independent of session length are associated with increased mortality. Design, setting, participants, & measurements Data were taken from a national cohort of 14,643 prevalent, thrice-weekly, in-center hemodialysis patients dialyzing from 2005 to 2009 (median survival time, 25 months) at a single dialysis organization. Patients with adequate urea clearance and delivered dialysis session ≥240 and <240 minutes were pair-matched on interdialytic weight gain (n=1794), and patients with weight gain ≤3 and >3 kg were pair-matched on session length (n=2114); mortality associations were estimated separately. Results Compared with delivered session length ≥240, session length <240 minutes was associated with increased all-cause mortality (adjusted hazard ratio [95% confidence interval], 1.32 [1.03 to 1.69]). Compared with weight gain ≤3, weight gain >3 kg was associated with increased mortality (1.29 [1.01 to 1.65]). The associations were consistent across strata of age, sex, weight, and weight gain and session length. Secondary analyses demonstrated dose-response relationships between both and mortality. Conclusions Among patients with adequate urea clearance, shorter dialysis session length and greater interdialytic weight gain are associated with increased mortality; thus, both are viable targets for directed intervention. PMID:23493384

  19. Association of Second and Third Trimester Weight Gain in Pregnancy with Maternal and Fetal Outcomes

    PubMed Central

    Drehmer, Michele; Duncan, Bruce Bartholow; Kac, Gilberto; Schmidt, Maria Inês

    2013-01-01

    Objective To investigate the association between weekly weight gain, during the second and third trimesters, classified according to the 2009 Institute of Medicine (IOM/NRC) recommendations, and maternal and fetal outcomes. Methods Gestational weight gain was evaluated in 2,244 pregnant women of the Brazilian Study of Gestational Diabetes (Estudo Brasileiro do Diabetes Gestacional – EBDG). Outcomes were cesarean delivery, preterm birth and small or large for gestational age birth (SGA, LGA). Associations between inadequate weight gain and outcomes were estimated using robust Poisson regression adjusting for pre-pregnancy body mass index, trimester-specific weight gain, age, height, skin color, parity, education, smoking, alcohol consumption, gestational diabetes and hypertensive disorders in pregnancy. Results In fully adjusted models, in the second trimester, insufficient weight gain was associated with SGA (relative risk [RR] 1.72, 95% confidence interval [CI] 1.26–2.33), and excessive weight gain with LGA (RR 1.64, 95% CI 1.16–2.31); in third trimester, excessive weight gain with preterm birth (RR 1.70, 95% CI 1.08–2.70) and cesarean delivery (RR 1.21, 95% CI 1.03–1.44). Women with less than recommended gestational weight gain in the 2nd trimester had a lesser risk of cesarean deliveries (RR 0.82, 95% CI 0.71–0.96) than women with adequate gestational weight gain in this trimester. Conclusion Though insufficient weight gain in the 3rd trimester was not associated with adverse outcomes, other deviations from recommended weight gain during second and third trimester were associated with adverse pregnancy outcomes. These findings support, in part, the 2009 IOM/NRC recommendations for nutritional monitoring during pregnancy. PMID:23382944

  20. Radiation-induced meningiomas: a shadow in the success story of childhood leukemia.

    PubMed

    Banerjee, Joanna; Pääkkö, Eija; Harila, Marika; Herva, Riitta; Tuominen, Juho; Koivula, Antero; Lanning, Marjatta; Harila-Saari, Arja

    2009-10-01

    While the prognosis of acute childhood leukemia has improved, long-term survivors are increasingly experiencing late effects of the treatment. Cranially irradiated survivors are predisposed to the development of CNS tumors. Our aim was to describe the incidence of secondary brain tumors and to define the significance of treatment-related risk factors and host characteristics in a cohort of childhood leukemia survivors. Our cohort consisted of 60 consecutive cranially irradiated adult survivors of childhood leukemia treated in Oulu University Hospital (Oulu, Finland); MRI of the brain was performed on 49. The sites of the tumors, their histology, and details of the leukemia treatment were determined. Of the 49 patients, 11 (22%) 1-8 years of age at the time of diagnosis developed meningioma later in life, while no other brain tumors were seen. In this cohort, the development of meningioma seemed to show undisputable linkage with long latency periods (mean, 25 years; range, 14-34 years) and an increasing incidence 20 years after the treatment (47%). Three patients had multiple meningiomas, two had recurrent disease, and one had an atypical meningioma. Age at the time of irradiation, gender, or cumulative doses of chemotherapeutic agents showed no significant association with the development of meningiomas. The high incidence of meningiomas in this study was associated with long follow-up periods. Although the cohort is small, it seems probable that the increasing incidence of meningioma will shadow the future of cranially irradiated leukemia survivors. Systematic brain imaging after the treatment is therefore justifiable.

  1. Differential expression of genes in the liver associated with gain and intake in beef steers

    USDA-ARS?s Scientific Manuscript database

    The purpose of this study was to identify genes associated with gain and intake in the liver in beef cattle. The liver uses 25% of the body’s energy, while constituting less than 2% of total body weight. It is likely that the liver plays a key role in gain and intake due to its high energy utilizati...

  2. Prolonged cerebral "luxury perfusion" after removal of a convexity meningioma.

    PubMed

    Lunsford, L D; Selker, R G

    1979-04-01

    Following total removal of a convexity meningioma, serial computerized tomographic scans disclosed massive hemispheric contrast enhancement compatible with "luxury perfusion". Maximum enhancement occurred one month following the operation and resolved two months postoperatively. Luxury perfusion appeared to be associated with slowly resolving cerebral edema.

  3. Surgical Resectability of Skull Base Meningiomas

    PubMed Central

    GOTO, Takeo; OHATA, Kenji

    2016-01-01

    With recent advances in surgical technology such as preoperative imaging, neuro-monitoring, and surgical instruments, the surgical resectability of intracranial meningiomas has increased over the last two decades. This study reviewed clinical articles regarding the surgical treatment of meningiomas to clarify the role of surgical excision, with a focus on skull base meningiomas. We sub-classified clinical articles about skull base meningiomas into two categories (anterior and middle fossa meningiomas; and posterior fossa meningiomas) and reviewed papers in each category. In cases with anterior and middle fossa meningiomas, surgical resectability has reached a sufficient level to maximize functional preservation. In cases of posterior fossa meningioma, however, surgical respectability remains insufficient even with full use of recent surgical modalities. Continuous refining of operative procedures is required to obtain more satisfactory outcomes, especially for posterior fossa meningioma. In addition, recent long-term outcomes of stereotactic radiosurgery (SRS) were acceptable for controlling the skull base meningiomas. Therefore, combination with surgical excision and SRS should be considered in complicated skull base meningiomas. PMID:27076382

  4. Totally ossified metaplastic spinal meningioma.

    PubMed

    Ju, Chang Il; Hida, Kazutoshi; Yamauchi, Tomohiro; Houkin, Kiyohiro

    2013-09-01

    A 61-year-old woman with a very rare case of totally ossified large thoracic spinal metaplastic meningioma, showing progressing myelopathy is presented. Computed tomographic images showed a large totally ossfied intradural round mass occupying the spinal canal on T9-10 level. Magnetic resonance imaging revealed a large T9-10 intradural extramedullary mass that was hypointense to spinal cord on T1- and T2-weighted sequences, partial enhancement was apparent after Gadolinium administration. The spinal cord was severely compressed and displaced toward the right at the level of T9-10. Surgical removal of the tumor was successfully accomplished via the posterior midline approach and the histological diagnosis verified an ossified metaplastic meningioma. The clinical neurological symptoms of patient were improved postoperatively. In this article we discuss the surgical and pathological aspects of rare case of spinal totally ossified metaplastic meningioma.

  5. Totally Ossified Metaplastic Spinal Meningioma

    PubMed Central

    Hida, Kazutoshi; Yamauchi, Tomohiro; Houkin, Kiyohiro

    2013-01-01

    A 61-year-old woman with a very rare case of totally ossified large thoracic spinal metaplastic meningioma, showing progressing myelopathy is presented. Computed tomographic images showed a large totally ossfied intradural round mass occupying the spinal canal on T9-10 level. Magnetic resonance imaging revealed a large T9-10 intradural extramedullary mass that was hypointense to spinal cord on T1- and T2-weighted sequences, partial enhancement was apparent after Gadolinium administration. The spinal cord was severely compressed and displaced toward the right at the level of T9-10. Surgical removal of the tumor was successfully accomplished via the posterior midline approach and the histological diagnosis verified an ossified metaplastic meningioma. The clinical neurological symptoms of patient were improved postoperatively. In this article we discuss the surgical and pathological aspects of rare case of spinal totally ossified metaplastic meningioma. PMID:24278660

  6. Descriptive Epidemiology of Spinal Meningiomas in the United States.

    PubMed

    Kshettry, Varun R; Hsieh, Jason K; Ostrom, Quinn T; Kruchko, Carol; Benzel, Edward C; Barnholtz-Sloan, Jill S

    2015-08-01

    Cross-sectional study of US cancer registry data. To present the current population-based descriptive epidemiology of spinal meningiomas in the United States. Meningioma is the most common primary spinal tumor, yet there is a paucity of population-based data evaluating incidence according to age, sex, race, and ethnicity. Such data are necessary to assess the burden of spinal meningiomas on varying populations and to inform health care planning and future research. The Central Brain Tumor Registry of the United States, which contains the largest aggregation of population-based data on the incidence of primary central nervous system tumors in the United States, was used. Age-adjusted incidence rates of spinal meningiomas from 2004 to 2010 were calculated by age at diagnosis, sex, race, and ethnicity. Annual percent change was calculated using Joinpoint to characterize temporal trends. From 2004 to 2010, there were 7148 newly diagnosed spinal meningiomas, resulting in an overall age-adjusted incidence of 0.33 per 100,000 population. There was a nonsignificant increase in incidence over time (annual percent change: 0.8%, 95% confidence interval: -1.4 to 3.0). The highest incidence occurred in the 75- to 84-year old age group. Females had a much higher incidence than males (incidence rate ratio: 3.37; P < 0.0001). Asian Pacific Islanders and Caucasians had the highest incidence. Compared with Caucasians, African Americans and American Indian/Alaskan Native individuals had a significantly lower incidence (incidence rate ratio: 0.72, P < 0.0001; 0.52, P = 0.0003, respectively). Non-Hispanics had a significantly lower incidence than Hispanics (incidence rate ratio: 0.81, P < 0.0001). Approximately 1000 spinal meningiomas were diagnosed in the United States per year, and the incidence was relatively stable. Advanced age, female sex, Asian Pacific Islander and Caucasian race, and Hispanic ethnicity were all associated with an increased incidence of spinal meningioma. This

  7. Spinal osteoblastic meningioma with hematopoiesis: radiologic-pathologic correlation and review of the literature.

    PubMed

    Cochran, Elizabeth J; Schlauderaff, Abraham; Rand, Scott D; Eckardt, Gerald W; Kurpad, Shekar

    2016-10-01

    Spinal meningiomas associated with bone formation and hematopoiesis are rare tumors with only 3 prior case reports in the literature. We describe a case report of a woman who presented with back pain and an isolated event of urinary incontinence. A calcified spinal canal mass at T8 was identified on computed tomographic and magnetic resonance imaging. A gross total resection of the tumor was performed and pathologic examination showed a meningioma, World Health Organization grade 1, containing bone and bone marrow elements. A review of previously reported cases and a discussion of possible mechanisms of bone and hematopoiesis development in meningioma are presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. "Malignancy" in meningiomas: a clinicopathologic study of 116 patients, with grading implications.

    PubMed

    Perry, A; Scheithauer, B W; Stafford, S L; Lohse, C M; Wollan, P C

    1999-05-01

    Due to the rarity of malignancy in meningiomas, prior studies have been limited to small series. Controversies regarding the definition of malignant meningioma have complicated matters further. Although histologic anaplasia and extracranial metastasis are established criteria, the former is difficult to define and the latter represents a clinical finding. Traditionally, brain invasion has also been accepted, although this has recently been debated. In a prior series, the authors were unable to prove that 23 meningiomas that had invaded the brain were more aggressive than atypical meningiomas. The authors expanded their analysis to include 116 patients diagnosed with "malignant meningioma" due to brain invasion, frank anaplasia (20 mitoses per 10 high-power fields or histology resembling carcinoma, sarcoma, or melanoma), and/or extracranial metastasis. Patients were followed until death or for a median of 3.7 years. Survival time was highly variable, ranging from 10 days to 24 years. In multivariate analysis, histologic anaplasia (P=0.0035), subtotal resection (P=0.0038), 20 mitoses per 10 high-power fields (P=0.0071), and nuclear atypia (P=0.0068) were associated with poor survival. Of the 89 cases of meningioma that had invaded the brain, 23% were otherwise benign, 61% were otherwise atypical, and 17% were frankly anaplastic. Those without anaplasia behaved similarly to atypical meningiomas from the authors' prior study. In contrast, anaplastic meningiomas were usually fatal, associated with a median survival of 1.5 years. Based on these findings, the authors suggest that brain invasion constitutes an additional criterion for the diagnosis of atypical meningioma (World Health Organization [WHO] Grade II), whereas frank anaplasia indicates high grade (WHO Grade III-IV) malignancy.

  9. Maternal obesity and gestational weight gain are modestly associated with umbilical cord DNA methylation

    USDA-ARS?s Scientific Manuscript database

    Maternal obesity (OB) and excessive gestational weight gain (GWG) are strong independent contributors that augment obesity risk in offspring. However, direct evidence of epigenetic changes associated with maternal habitus remains sparse. We utilized Bisulfite Amplicon Sequencing (BSAS) to conduct t...

  10. Molecular Genetics of Intracranial Meningiomas with Emphasis on Canonical Wnt Signalling

    PubMed Central

    Pećina-Šlaus, Nives; Kafka, Anja; Lechpammer, Mirna

    2016-01-01

    Research over the last decade recognized the importance of novel molecular pathways in pathogenesis of intracranial meningiomas. In this review, we focus on human brain tumours meningiomas and the involvement of Wnt signalling pathway genes and proteins in this common brain tumour, describing their known functional effects. Meningiomas originate from the meningeal layers of the brain and the spinal cord. Most meningiomas have benign clinical behaviour and are classified as grade I by World Health Organization (WHO). However, up to 20% histologically classified as atypical (grade II) or anaplastic (grade III) are associated with higher recurrent rate and have overall less favourable clinical outcome. Recently, there is emerging evidence that multiple signalling pathways including Wnt pathway contribute to the formation and growth of meningiomas. In the review we present the synopsis on meningioma histopathology and genetics and discuss our research regarding Wnt in meningioma. Epithelial-to-mesenchymal transition, a process in which Wnt signalling plays an important role, is shortly discussed. PMID:27429002

  11. High incidence of activating TERT promoter mutations in meningiomas undergoing malignant progression.

    PubMed

    Goutagny, Stéphane; Nault, Jean C; Mallet, Maxime; Henin, Dominique; Rossi, Jessica Z; Kalamarides, Michel

    2014-03-01

    Meningiomas are common central nervous system tumors. The World Health Organization (WHO) defines three grades, predictive of the risk of recurrence. These tumors can relapse frequently and sometimes undergo malignant transformation. Maintenance of telomere length is a key process in malignant progression, and mutations in TERT promoter have recently been identified in various types of cancer. We sequenced the TERT promoter in 85 meningiomas from 73 patients. We found a high incidence of TERT promoter mutations in patients with meningiomas undergoing malignant histological progression (28%, n = 5/18 patients). In this subset of patients with histological progression, TERT promoter mutations were found in both the lowest and the highest grade tumors, and in both NF2-mutated and nonmutated samples. In contrast, one mutation was identified in 35 meningiomas without recurrence or progression, belonging to various histological grades. This sample was an aggressive meningioma in a patient who died shortly after surgery. Interestingly, tumors showing relapse without histological progression were not mutated for TERT promoter (n = 20). Finally, TERT promoter mutations were associated with a marked increase in TERT expression. Thus, TERT promoter mutations are pivotal genetic alterations involved in malignant progression of meningiomas and could be used as a biomarker to identify meningiomas at risk of malignant transformation. © 2013 International Society of Neuropathology.

  12. Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone Study Group, Germany).

    PubMed

    Schüz, Joachim; Böhler, Eva; Berg, Gabriele; Schlehofer, Brigitte; Hettinger, Iris; Schlaefer, Klaus; Wahrendorf, Jürgen; Kunna-Grass, Katharina; Blettner, Maria

    2006-03-15

    The widespread use of cellular telephones has generated concern about possible adverse health effects, particularly brain tumors. In this population-based case-control study carried out in three regions of Germany, all incident cases of glioma and meningioma among patients aged 30-69 years were ascertained during 2000-2003. Controls matched on age, gender, and region were randomly drawn from population registries. In total, 366 glioma cases, 381 meningioma cases, and 1,494 controls were interviewed. Overall use of a cellular phone was not associated with brain tumor risk; the respective odds ratios were 0.98 (95% confidence interval (CI): 0.74, 1.29) for glioma and 0.84 (95% CI: 0.62, 1.13) for meningioma. Among persons who had used cellular phones for 10 or more years, increased risk was found for glioma (odds ratio = 2.20, 95% CI: 0.94, 5.11) but not for meningioma (odds ratio = 1.09, 95% CI: 0.35, 3.37). No excess of temporal glioma (p = 0.41) or meningioma (p = 0.43) was observed in cellular phone users as compared with nonusers. Cordless phone use was not related to either glioma risk or meningioma risk. In conclusion, no overall increased risk of glioma or meningioma was observed among these cellular phone users; however, for long-term cellular phone users, results need to be confirmed before firm conclusions can be drawn.

  13. Risk factors for meningioma in postmenopausal women: results from the Iowa Women's Health Study

    PubMed Central

    Johnson, Derek R.; Olson, Janet E.; Vierkant, Robert A.; Hammack, Julie E.; Wang, Alice H.; Folsom, Aaron R.; Virnig, Beth A.; Cerhan, James R.

    2011-01-01

    Few risk factors for meningioma, aside from increasing age and female sex, have been identified. We investigated risk factors for meningioma in elderly women, a group with a high incidence. We evaluated associations of demographic, lifestyle, medical history, and anthropometric variables with risk of meningioma in the Iowa Women's Health Study (IWHS), a population-based, prospective cohort study. Risk factors were collected via questionnaires mailed in 1986 and 1992. Incident meningiomas were identified via linkages to Medicare. Cox regression models were used to examine the association of risk factors with meningioma incidence. The mean age at baseline of the 27,791 women in the analysis cohort was 69.3 years (range, 65.0–84.6 years). During 291,021 person-years of follow-up, 125 incident meningiomas were identified. After adjusting for age, lower levels of physical activity (relative risk [RR] , 0.68 for high versus low; P for trend = .039), greater body mass index (BMI; RR, 2.14 for ≥35 versus 19.5–24.9 kg/m2; P for trend = .0019), greater height (RR, 2.04 for >66 versus ≤62 inches; P for trend = .013), and a history of uterine fibroids (RR, 1.72; 95% confidence interval, 1.19, 2.50) were positively associated with meningioma risk in multivariate analysis. BMI at age 18 and 30 years were not associated with risk. There were no associations with menstrual or reproductive factors or other medical history and lifestyle factors. Physical activity, BMI, height, and history of uterine fibroids were associated with meningioma risk in older women. The positive association with height suggests a role for early life influences on risk, whereas the associations with BMI and physical activity suggest a role for modifiable factors later in life. PMID:21750006

  14. Triad of Intraspinal Meningioma, Schwannoma, and Ependymoma: Report of an Extremely Rare Case.

    PubMed

    Rasheed, Faiza; Fatima, Saira; Ahmad, Zubair

    2016-02-01

    Mixed tumors composed of schwannoma and meningioma are extremely rare and are usually associated with neurofibromatosis type 2. So far, all the cases reported have involved the cerebellopontine angle. Only 3 reported cases did not have a clear association with neurofibromatosis type 2. We report a mixed tumor comprising schwannoma admixed with meningioma and ependymoma in the cervical spinal cord of a 22-year-old male. © The Author(s) 2015.

  15. Health characteristics associated with gaining and losing private and public health insurance: a national study.

    PubMed

    Jerant, Anthony; Fiscella, Kevin; Franks, Peter

    2012-02-01

    Millions of Americans lack or lose health insurance annually, yet how health characteristics predict insurance acquisition and loss remains unclear. To examine associations of health characteristics with acquisition and loss of private and public health insurance. Prospective observational analysis of 2000 to 2007 Medical Expenditure Panel Survey data for persons aged 18 to 63 on entry, enrolled for 2 years. We modeled year 2 private and public insurance gain and loss. year 2 insurance status [none (reference), any private insurance, or public insurance] among those uninsured in year 1 (N=13,022), and retaining or losing coverage in year 2 among those privately or publicly insured in year 1 (N=47,239). age, sex, race/ethnicity, education, income, region, urbanity, health status, health conditions, year 1 health expenditures, year 1 and 2 employment status, and (in secondary analyses) skepticism toward medical care and insurance. In adjusted analyses, lower income and education were associated with not gaining and with losing private insurance. Poorer health status was associated with public insurance gain. Smoking and being overweight were associated with not gaining private insurance, and smoking with losing private coverage. Secondary analyses adjusting for medical skepticism yielded similar findings. Social disadvantage and poorer health status are associated with gaining public insurance, whereas social advantage, not smoking, and not being overweight are associated with gaining private insurance, even when adjusting for attitudes toward medical care. Private insurers seem to benefit from relatively low health risk selection.

  16. Genetic/molecular alterations of meningiomas and the signaling pathways targeted

    PubMed Central

    Domingues, Patrícia; González-Tablas, María; Otero, Álvaro; Pascual, Daniel; Ruiz, Laura; Miranda, David; Sousa, Pablo; Gonçalves, Jesús María; Lopes, María Celeste; Orfao, Alberto; Tabernero, María Dolores

    2015-01-01

    Meningiomas are usually considered to be benign central nervous system tumors; however, they show heterogenous clinical, histolopathological and cytogenetic features associated with a variable outcome. In recent years important advances have been achieved in the identification of the genetic/molecular alterations of meningiomas and the signaling pathways involved. Thus, monosomy 22, which is often associated with mutations of the NF2 gene, has emerged as the most frequent alteration of meningiomas; in addition, several other genes (e.g. AKT1, KLF4, TRAF7, SMO) and chromosomes have been found to be recurrently altered often in association with more complex karyotypes and involvement of multiple signaling pathways. Here we review the current knowledge about the most relevant genes involved and the signaling pathways targeted by such alterations. In addition, we summarize those proposals that have been made so far for classification and prognostic stratification of meningiomas based on their genetic/genomic features. PMID:25965831

  17. Cigarette Smoking and Risk of Meningioma: The Effect of Gender

    PubMed Central

    Claus, Elizabeth B.; Walsh, Kyle M.; Calvocoressi, Lisa; Bondy, Melissa L.; Schildkraut, Joellen M.; Wrensch, Margaret; Wiemels, Joseph L.

    2013-01-01

    Background A number of studies have reported on the association between smoking and meningioma risk, with inconsistent findings. We examined the effect of gender on the association between cigarette smoking and risk of intra-cranial meningioma in a large population-based, case-control study. Methods The data includes 1433 intra-cranial meningioma cases aged 29–79 years diagnosed among residents of the states of Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area and eight Texas counties between May 1, 2006 and April 28, 2011 and 1349 controls that were frequency-matched on age, sex and geography. The data are analyzed separately and in a meta-analysis with six previously reported studies. Results Female cases who reported having ever smoked were at significantly decreased risk of intra-cranial meningioma (Odds ratio (OR) = 0.8, 95% confidence interval (CI), 0.7–0.9) in contrast to male cases who were at increased risk (OR:1.3, 95%CI: 1.0–1.7). Similar findings were noted for current and past smokers. Smoking-induced risk for females did not vary by menopausal status. For males, increased duration of use (p = 0.04) as well as increasing number of pack-years (p = 0.02) was associated with elevated risk. A meta-analysis including 2614 cases and 1,179,686 controls resulted in an OR for ever smoking of 0.82 (95%CI: 0.68–0.98) for women and 1.39 (95%CI: 1.08–1.79) for men. Conclusion The association of cigarette smoking and meningioma case status varies significantly by gender with women at reduced risk and men at greater risk. Impact Whether the observed differences are associated with a hormonal etiology will require additional investigation. PMID:22473761

  18. Dental X-rays and Risk of Meningioma

    PubMed Central

    Claus, Elizabeth B.; Calvocoressi, Lisa; Bondy, Melissa L.; Schildkraut, Joellen M.; Wiemels, Joseph L.; Wrensch, Margaret

    2011-01-01

    Context Ionizing radiation is a consistently identified and potentially modifiable risk factor for meningioma, the most frequently reported primary brain tumor in the United States. Objective To examine the association between dental x-rays, the most common artificial source of ionizing radiation, and risk of intra-cranial meningioma. Design and Setting Population-based case-control study design. Participants The study includes 1433 intra-cranial meningioma cases aged 29-79 years diagnosed among residents of the states of Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area and eight Houston, Texas counties between May 1, 2006 and April 28, 2011 and 1350 controls that were frequency-matched on age, sex and geography. Main Outcome Measure The association of intra-cranial meningioma diagnosis with self-report of bitewing, full-mouth, and panorex dental x-rays. Results Over a lifetime, cases were more than twice (Odds ratio (OR) = 2.0, 95% confidence interval (CI), 1.4-2.9) as likely as controls to report having ever had a bitewing exam. Regardless of the age at which the films were received, persons who reported receiving bitewing films on a yearly or greater frequency had an elevated risk with odds ratios of 1.4 (95%CI: 1.0-1.8), 1.6 (95%CI: 1.2-2.0), 1.9 (95%CI: 1.4-2.6), and 1.5 (95%CI: 1.1-2.0) for ages <10, 10-19, 20-49, and 50+ years, respectively. Increased risk of meningioma was also associated with panorex films taken at a young age or on a yearly or greater frequency with persons reporting receiving such films under the age of 10 years at 4.9 times (95%CI: 1.8-13.2) increased risk of meningioma. No association was appreciated with location of tumor above or below the tentorium. Conclusion Exposure to some dental x-rays performed in the past, when radiation exposure was greater than in the current era, appears to be associated with increased risk of intra-cranial meningioma. As with all sources of artificial ionizing radiation, considered

  19. Dental x-rays and risk of meningioma.

    PubMed

    Claus, Elizabeth B; Calvocoressi, Lisa; Bondy, Melissa L; Schildkraut, Joellen M; Wiemels, Joseph L; Wrensch, Margaret

    2012-09-15

    Ionizing radiation is a consistently identified and potentially modifiable risk factor for meningioma, which is the most frequently reported primary brain tumor in the United States. The objective of this study was to examine the association between dental x-rays-the most common artificial source of ionizing radiation-and the risk of intracranial meningioma. This population-based case-control study included 1433 patients who had intracranial meningioma diagnosed at ages 20 to 79 years and were residents of the states of Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 counties in Houston, Texas between May 1, 2006 and April 28, 2011 (cases). A control group of 1350 individuals was frequency matched on age, sex, and geography (controls). The main outcome measure for the study was the association between a diagnosis of intracranial meningioma and self-reported bitewing, full-mouth, and panorex dental x-rays. Over a lifetime, cases were more than twice as likely as controls (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.4-2.9) to report having ever had a bitewing examination. Regardless of the age at which the films were obtained, individuals who reported receiving bitewing films on a yearly basis or with greater frequency had an elevated risk for ages <10 years (OR, 1.4; 95% CI, 1.0-1.8), ages 10 to 19 years (OR, 1.6; 95% CI, 1.2-2.0), ages 20 to 49 years (OR, 1.9; 95% CI, 1.4-2.6), and ages ≥40 years (OR, 1.5; 95% CI, 1.1-2.0). An increased risk of meningioma also was associated with panorex films taken at a young age or on a yearly basis or with greater frequency, and individuals who reported receiving such films at ages <10 years had a 4.9 times increased risk (95% CI, 1.8-13.2) of meningioma. No association was appreciated for tumor location above or below the tentorium. Exposure to some dental x-rays performed in the past, when radiation exposure was greater than in the current era, appears to be associated with an

  20. Pulmonary metastases from benign calvarial meningioma: a case report.

    PubMed

    Cho, Byung-Rae; Yoon, Wan-Soo

    2017-04-01

    The most common intracranial tumour is meningioma, which rarely presents with extracranial metastasis, especially in benign cases. We report a case of meningioma recurrence with multiple pulmonary metastases in a patient who had a benign meningioma removed 12 years prior.

  1. Expansive Extracranial Growth of Intracranial Meningioma in Neurofibromatosis Type 2.

    PubMed

    Friedrich, Reinhard E; Hagel, Christian

    2016-06-01

    The purpose of this report is to detail three rare cases of neurofibromatosis type 2 (NF2) with symptomatic extracranial extension of intracranial meningioma. We present ocular findings, imaging techniques applied, pathological findings of the space-occupying lesions, and therapy. One of these patients, the daughter of one of the other individuals, presented with a large neck mass, but no surgically treatable findings associated with the external growth of the meningioma. The patients complained of symptoms associated with the extracranial portion of the intracranial meningioma, rather than of the intracranial primaries. However, facial and neck surgical care is very limited in patients with such advanced-stage tumours. The prolongation of life was unquestionably predominantly determined by the behaviour of the intracranial tumour. Head and neck surgeons should be aware of the rare possibility that solid tumours of this region could be extracranial-extending meningioma in an inherited disease. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Identification of a third protein 4.1 tumor suppressor, protein 4.1R, in meningioma pathogenesis

    SciTech Connect

    Robb, Victoria A.; Li, Wen; Gascard, Philippe; Perry, Arie; Mohandas, Narla; Gutmann, David H.

    2003-06-11

    Meningiomas are common tumors of the central nervous system, however, the mechanisms under lying their pathogenesis are largely undefined. Two members of the Protein 4.1 super family, the neuro fibromatosis 2 (NF2) gene product (merlin/schwannomin) and Protein 4.1B have been implicated as meningioma tumor suppressors. In this report, we demonstrate that another Protein 4.1 family member, Protein 4.1R, also functions as a meningioma tumor suppressor. Based on the assignment of the Protein 4.1R gene to chromosome 1p32-36, a common region of deletion observed in meningiomas, we analyzed Protein 4.1R expression in meningioma cell lines and surgical tumor specimens. We observed loss of Protein 4.1R protein expression in two meningioma cell lines (IOMM-Lee, CH157-MN) by Western blotting as well as in 6 of 15 sporadic meningioma as by immuno histo chemistry (IHC). Analysis of a subset of these sporadic meningiomas by fluorescent in situ hybridization (FISH) with a Protein 4.1R specific probe demonstrated 100 percent concordance with the IHC results. In support of a meningioma tumor suppressor function, over expression of Protein 4.1R resulted in suppression of IOMM-Lee and CH157MN cell proliferation. Similar to the Protein 4.1B and merlin meningioma tumor suppressors, Protein 4.1R localization in the membrane fraction increased significantly under conditions of growth arrest in vitro. Lastly, Protein 4.1R interacted with some known merlin/Protein 4.1B interactors such as CD44 and bII-spectrin, but did not associate with the Protein 4.1B interactors 14-3-3 and PRMT3 or the merlin binding proteins SCHIP-1 and HRS. Collectively, these results suggest that Protein 4.1R functions as an important tumor suppressor important in the molecular pathogenesis of meningioma.

  3. Body mass index, physical activity, and risk of adult meningioma and glioma: A meta-analysis.

    PubMed

    Niedermaier, Tobias; Behrens, Gundula; Schmid, Daniela; Schlecht, Inga; Fischer, Beate; Leitzmann, Michael F

    2015-10-13

    Whether adiposity and lack of physical activity affect the risk for developing meningioma and glioma is poorly understood. Our objective was to characterize these associations in detail. We conducted a systematic review and meta-analysis of adiposity and physical activity in relation to meningioma and glioma using cohort and case-control studies published through February 2015. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified 12 eligible studies of body mass index (BMI) and 6 studies of physical activity, comprising up to 2,982 meningioma cases and 3,057 glioma cases. Using normal weight as the reference group, overweight (summary relative risk [RR] = 1.21, 95% confidence interval [CI] = 1.01-1.43) and obesity (RR = 1.54, 95% CI = 1.32-1.79) were associated with increased risk of meningioma. In contrast, overweight (RR = 1.06, 95% CI = 0.94-1.20) and obesity (RR = 1.11, 95% CI = 0.98-1.27) were unrelated to glioma. Similarly, dose-response meta-analyses revealed a statistically significant positive association of BMI with meningioma, but not glioma. High vs low physical activity levels showed a modest inverse relation to meningioma (RR = 0.73, 95% CI = 0.61-0.88) and a weak inverse association with glioma (RR = 0.86, 95% CI = 0.76-0.97). Relations persisted when the data were restricted to prospective studies, except for the association between physical activity and glioma, which was rendered statistically nonsignificant (RR = 0.91, 95% CI = 0.77-1.07). Adiposity is related to enhanced risk for meningioma but is unassociated with risk for glioma. Based on a limited body of evidence, physical activity is related to decreased risk of meningioma but shows little association with risk of glioma. © 2015 American Academy of Neurology.

  4. Association between maternal nutritional status of pre pregnancy, gestational weight gain and preterm birth.

    PubMed

    Xinxo, Sonela; Bimbashi, Astrit; Z Kakarriqi, Eduard; Zaimi, Edmond

    2013-01-01

    Maternal nutritional status of pre pregnancy and gestational weight gain affects the preterm birth. The association between maternal nutritional status of pre pregnancy and preterm birth appears to be complex and varied by studies from different countries, thus this association between the gestational weight gain and preterm birth is more consolidated. The study aims to determine any association between the pre pregnancy maternal nutritional status, gestational weight gain and the preterm birth rate in the Albanian context. In case control study, we analyzed women who have delivered in obstetric institutions in Tirana during the year 2012. Body mass index and gestational weight gain of 150 women who had a preterm delivery were compared with those of 150 matched control women who had a normal delivery regarding the gestation age. The self-reported pre pregnancy weight, height, gestational weight gain, age, education and parity are collected through a structured questioner. The body mass index and gestational weight gain are categorized based on the Institute of Medicine recommendation. The multiple logistic regression is used to measure the association between the nutritional status of pre pregnancy and gestational weight gain and the preterm birth rate. The women which have a underweight status or obese of pre pregnancy are more likely to have a preterm birth compared to the women of a normal pre-pregnancy nutritional status (respectively OR =2.7 and 4.3 p<0.05). Women who do not reach the recommended gestational weight gain are more likely to have a preterm birth compared to the women which reach this weight (OR=1.8 p< 0.05). Maternal nutritional status and gestational weight gain affects the risk for preterm birth. Pre-pregnancy and gestation nutritional assessments should be part of routine prenatal visits.

  5. Cystic Meningioma Masquerading as a Metastatic Tumor: A Case Report

    PubMed Central

    Ramanathan, Nithya; Kamaruddin, Khairul Azmi; Othman, Aizzat; Mustafa, Fadhli; Awang, Mohamed Saufi

    2016-01-01

    Cystic meningioma is a rare form of intracranial meningioma. Meningiomas are typically solid tumors but may rarely have cystic components. The diagnosis of cystic meningioma is clinically challenging as the finding of multiple intra-axial tumors, including metastatic tumors, is relatively common. We report a case of cystic meningioma initially diagnosed as a metastatic tumor from a recurrence of acute lymphoid leukemia. However, postoperative histopathological examination demonstrated an atypical meningioma. PMID:27418876

  6. DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis.

    PubMed

    Sahm, Felix; Schrimpf, Daniel; Stichel, Damian; Jones, David T W; Hielscher, Thomas; Schefzyk, Sebastian; Okonechnikov, Konstantin; Koelsche, Christian; Reuss, David E; Capper, David; Sturm, Dominik; Wirsching, Hans-Georg; Berghoff, Anna Sophie; Baumgarten, Peter; Kratz, Annekathrin; Huang, Kristin; Wefers, Annika K; Hovestadt, Volker; Sill, Martin; Ellis, Hayley P; Kurian, Kathreena M; Okuducu, Ali Fuat; Jungk, Christine; Drueschler, Katharina; Schick, Matthias; Bewerunge-Hudler, Melanie; Mawrin, Christian; Seiz-Rosenhagen, Marcel; Ketter, Ralf; Simon, Matthias; Westphal, Manfred; Lamszus, Katrin; Becker, Albert; Koch, Arend; Schittenhelm, Jens; Rushing, Elisabeth J; Collins, V Peter; Brehmer, Stefanie; Chavez, Lukas; Platten, Michael; Hänggi, Daniel; Unterberg, Andreas; Paulus, Werner; Wick, Wolfgang; Pfister, Stefan M; Mittelbronn, Michel; Preusser, Matthias; Herold-Mende, Christel; Weller, Michael; von Deimling, Andreas

    2017-05-01

    The WHO classification of brain tumours describes 15 subtypes of meningioma. Nine of these subtypes are allotted to WHO grade I, and three each to grade II and grade III. Grading is based solely on histology, with an absence of molecular markers. Although the existing classification and grading approach is of prognostic value, it harbours shortcomings such as ill-defined parameters for subtypes and grading criteria prone to arbitrary judgment. In this study, we aimed for a comprehensive characterisation of the entire molecular genetic landscape of meningioma to identify biologically and clinically relevant subgroups. In this multicentre, retrospective analysis, we investigated genome-wide DNA methylation patterns of meningiomas from ten European academic neuro-oncology centres to identify distinct methylation classes of meningiomas. The methylation classes were further characterised by DNA copy number analysis, mutational profiling, and RNA sequencing. Methylation classes were analysed for progression-free survival outcomes by the Kaplan-Meier method. The DNA methylation-based and WHO classification schema were compared using the Brier prediction score, analysed in an independent cohort with WHO grading, progression-free survival, and disease-specific survival data available, collected at the Medical University Vienna (Vienna, Austria), assessing methylation patterns with an alternative methylation chip. We retrospectively collected 497 meningiomas along with 309 samples of other extra-axial skull tumours that might histologically mimic meningioma variants. Unsupervised clustering of DNA methylation data clearly segregated all meningiomas from other skull tumours. We generated genome-wide DNA methylation profiles from all 497 meningioma samples. DNA methylation profiling distinguished six distinct clinically relevant methylation classes associated with typical mutational, cytogenetic, and gene expression patterns. Compared with WHO grading, classification by

  7. TERT Promoter Mutations and Risk of Recurrence in Meningioma.

    PubMed

    Sahm, Felix; Schrimpf, Daniel; Olar, Adriana; Koelsche, Christian; Reuss, David; Bissel, Juliane; Kratz, Annekathrin; Capper, David; Schefzyk, Sebastian; Hielscher, Thomas; Wang, Qianghu; Sulman, Erik P; Adeberg, Sebastian; Koch, Arend; Okuducu, Ali Fuat; Brehmer, Stefanie; Schittenhelm, Jens; Becker, Albert; Brokinkel, Benjamin; Schmidt, Melissa; Ull, Theresa; Gousias, Konstantinos; Kessler, Almuth Friederike; Lamszus, Katrin; Debus, Jürgen; Mawrin, Christian; Kim, Yoo-Jin; Simon, Matthias; Ketter, Ralf; Paulus, Werner; Aldape, Kenneth D; Herold-Mende, Christel; von Deimling, Andreas

    2016-05-01

    The World Health Organization (WHO) classification and grading system attempts to predict the clinical course of meningiomas based on morphological parameters. However, because of high interobserver variation of some criteria, more reliable prognostic markers are required. Here, we assessed the TERT promoter for mutations in the hotspot regions C228T and C250T in meningioma samples from 252 patients. Mutations were detected in 16 samples (6.4% across the cohort, 1.7%, 5.7%, and 20.0% of WHO grade I, II, and III cases, respectively). Data were analyzed by t test, Fisher's exact test, log-rank test, and Cox proportional hazard model. All statistical tests were two-sided. Within a mean follow-up time in surviving patients of 68.1 months, TERT promoter mutations were statistically significantly associated with shorter time to progression (P < .001). Median time to progression among mutant cases was 10.1 months compared with 179.0 months among wild-type cases. Our results indicate that the inclusion of molecular data (ie, analysis of TERT promoter status) into a histologically and genetically integrated classification and grading system for meningiomas increases prognostic power. Consequently, we propose to incorporate the assessment of TERT promoter status in upcoming grading schemes for meningioma.

  8. Natural History of Meningioma Development in Mice Reveals: A Synergy of Nf2 and p16Ink4a Mutations

    PubMed Central

    Kalamarides, Michel; Stemmer-Rachamimov, Anat O; Takahashi, Masaya; Han, Zhi-Yan; Chareyre, Fabrice; Niwa-Kawakita, Michiko; Black, Peter M; Carroll, Rona S; Giovannini, Marco

    2008-01-01

    Meningiomas account for approximately 30% of all primary central nervous system tumors and are found in half of neurofibromatosis type 2 patients often causing significant morbidity. Although most meningiomas are benign, 10% are classified as atypical or anaplastic, displaying aggressive clinical behavior. Biallelic inactivation of the neurofibromatosis 2 (NF2) tumor suppressor is associated with meningioma formation in all NF2 patients and 60% of sporadic meningiomas. Deletion of the p16INK4a/p14ARF locus is found in both benign and malignant meningiomas, while mutation of the p53 tumor suppressor gene is uncommon. Previously, we inactivated Nf2 in homozygous conditional knockout mice by adenoviral Cre delivery and showed that Nf2 loss in arachnoid cells is rate-limiting for meningioma formation. Here, we report that additional nullizygosity for p16Ink4a increases the frequency of meningioma and meningothelial proliferation in these mice without modifying the tumor grade. In addition, by using magnetic resonance imaging (MRI) to screen a large cohort of mutant mice, we were able to detect meningothelial proliferation and meningioma development opening the way to future studies in which therapeutic interventions can be tested as preclinical assessment of their potential clinical application. PMID:17924978

  9. Radiation-induced meningiomas in pediatric patients

    SciTech Connect

    Moss, S.D.; Rockswold, G.L.; Chou, S.N.; Yock, D.; Berger, M.S.

    1988-04-01

    Radiation-induced meningiomas rarely have latency periods short enough from the time of irradiation to the clinical presentation of the tumor to present in the pediatric patient. Three cases of radiation-induced intracranial meningiomas in pediatric patients are presented. The first involved a meningioma of the right frontal region in a 10-year-old boy 6 years after the resection and irradiation of a 4th ventricular medulloblastoma. Review of our pediatric tumor cases produced a second case of a left temporal fossa meningioma presenting in a 15-year-old boy with a history of irradiation for retinoblastoma at age 3 years and a third case of a right frontoparietal meningioma in a 15-year-old girl after irradiation for acute lymphoblastic leukemia. Only three cases of meningiomas presenting in the pediatric age group after radiation therapy to the head were detected in our review of the literature.

  10. Recurrent spinal meningioma: a case report.

    PubMed

    Choi, Hoi Jung; Paeng, Sung Hwa; Kim, Sung Tae; Jung, Yong Tae

    2012-09-01

    Meningiomas are the second most common intradural spinal tumors accounting for 25% of all spinal tumors. Being a slow growing and invariably benign tumor, it responds favorably to surgical excision. In addition, spinal meningioma has low recurrence rates. However, we experienced a case of intradural extramedullary spinal meningioma which recurred 16 years after the initial surgery on a 64-year-old woman. She presented with progressive neurological symptoms and had a surgical history of removal of thoracic spinal meningioma 16 years ago due to bilateral low leg weakness. She underwent a second operation at the same site and a pale yellowish tumor was excised, which was histopathologically confirmed as meningothelial meningioma, compared with previously transitional type. she showed neurological recovery after the operation. We, therefore, report the good results of this recurrent intradural spinal meningioma case developed after 16 years with literature review.

  11. Radiation-induced meningiomas in pediatric patients.

    PubMed

    Moss, S D; Rockswold, G L; Chou, S N; Yock, D; Berger, M S

    1988-04-01

    Radiation-induced meningiomas rarely have latency periods short enough from the time of irradiation to the clinical presentation of the tumor to present in the pediatric patient. Three cases of radiation-induced intracranial meningiomas in pediatric patients are presented. The first involved a meningioma of the right frontal region in a 10-year-old boy 6 years after the resection and irradiation of a 4th ventricular medulloblastoma. Review of our pediatric tumor cases produced a second case of a left temporal fossa meningioma presenting in a 15-year-old boy with a history of irradiation for retinoblastoma at age 3 years and a third case of a right frontoparietal meningioma in a 15-year-old girl after irradiation for acute lymphoblastic leukemia. Only three cases of meningiomas presenting in the pediatric age group after radiation therapy to the head were detected in our review of the literature.

  12. Diagnosis and Management of Hereditary Meningioma and Vestibular Schwannoma.

    PubMed

    Shaw, Adam

    2016-01-01

    Bilateral vestibular schwannomata and meningiomata are the tumours most commonly associated with neurofibromatosis type II (NF2). These tumours may also be seen in patients with schwannomatosis and familial meningioma, but these phenotypes are usually easy to distinguish. The main diagnostic challenge when managing these tumours is distinguishing between sporadic disease which carries low risk of subsequent tumours or NF2 with its associated morbidities and reduced life expectancy. This chapter outlines some of the diagnostic and management considerations along with associated evidence.

  13. Primary cutaneous extravertebral meningioma. Case report.

    PubMed

    Zaaroor, M; Borovich, B; Bassan, L; Doron, Y; Gruszkiewicz, J

    1984-05-01

    A case of cutaneous extravertebral meningioma is presented. It was diagnosed in infancy as a lumbar meningocele. Operation was initially refused but was subsequently demanded for cosmetic reasons. The findings were a very thick corrugated skin and a cutaneous meningioma connected by a fibrous tract to the dura mater. The presence of a fibrous stalk linking the tumor to the dura mater might have been the pathogenetic connection between the meningocele and cutaneous meningioma.

  14. Coexisting cranial and multiple spinal meningioma in a child-report of a case.

    PubMed

    Shukla, Sujeet Kumar; Trivedi, Adarsh; Sharma, Vivek; Singh, Kulwant

    2011-03-01

    Von Ricklinghausen's disease is commonly associated with simultaneous cranial and spinal meningioma but these are not true meningiomas. Craniospinal meningiomas without Von Ricklinghausen's disease are very rare. We report a 13-year-old girl who presented with two episodes of right focal seizure with secondary generalisation of three year's duration, weakness of both lower limbs for 6 months, and retention of urine of three month's duration. MRI brain showed enhancing lesion in the left fronto-parietal region. MRI spine revealed enhancing intradural extramedullary lesion at D(4-5), D(9-10), and L(1-2). The tumours were excised completely in a single stage, first by craniotomy then by multi level laminectomy. On histology the spinal meningioma had predominant meningothiliomatous. We followed up for 6 months and the patient recovered with power grade 4/5 both lower limb.

  15. Unilateral vocal cord palsy and dysphagia: an unusual presentation of cerebellopontine angle meningioma

    PubMed Central

    Senior, Andrew; Douglas, James Andrew; Thompson, Stuart

    2015-01-01

    Cerebellopontine angle (CPA) tumours are the most common neoplasms in the posterior fossa, accounting for 5–10% of intracranial tumours. Most CPA tumours are benign, with most being vestibular schwannomas. Meningiomas arising from the jugular foramen are among the rarest of all with very few being described in the literature. Treatment options vary considerably as experience with these tumours is limited. One option is a skull base approach, but this depends on size, location and ability to preserve lower cranial nerve function. This can be extremely challenging and is accompanied by high mortality risk; therefore, a more conservative option must be considered. This case report highlights the difficulty in management of patients with jugular fossa meningiomas, including appropriate investigations, analysis of surgical versus conservative treatment and associated complications. Furthermore, we elaborate the decision-making process pertaining to the tailoring of the surgical route used for the resection of jugular foramen meningiomas. (Jugular Foramen Meningioma, cerebellopontine angle). PMID:26486157

  16. Hormone-dependent shrinkage of a sphenoid wing meningioma after pregnancy: case report.

    PubMed

    Kerschbaumer, Johannes; Freyschlag, Christian F; Stockhammer, Günter; Taucher, Susanne; Maier, Hans; Thomé, Claudius; Seiz-Rosenhagen, Marcel

    2016-01-01

    Meningiomas are known to be associated with female sex hormones. Worsening neurological symptoms or newly diagnosed meningiomas have been described in the context of elevated levels of sex hormones, for example, in pregnancy. To the authors' knowledge, tumor shrinkage after the normalization of hormones has not been described, even if it is known that neurological deficits due to meningioma compression may improve after giving birth. A 32-year-old female patient presented with severe headache and vision disturbances at the end of her second pregnancy. Magnetic resonance imaging revealed an extended mass at the lateral left-sided sphenoid wing that was suspected to be a meningioma. After delivery, the patient's symptoms improved, and MRI obtained 2 months postpartum showed significant shrinkage of the lesion. Significant tumor shrinkage can occur after pregnancy. Thus, repeat imaging is indicated in these patients.

  17. Surgical treatment and radiation therapy of frontal lobe meningiomas in 7 dogs.

    PubMed

    Uriarte, Ane; Moissonnier, Pierre; Thibaud, Jean-Laurent; Reyes-Gomez, Edouard; Devauchelle, Patrick; Blot, Stéphane

    2011-07-01

    The cases of 7 adult dogs with generalized seizures managed by surgical excision and radiation therapy for frontal lobe meningiomas were reviewed. The neurological examination was unremarkable in 6 of the 7 dogs. Five dogs were operated on using a bilateral transfrontal sinus approach and 2 using a unilateral sinotemporal approach to the frontal lobe. One dog was euthanized 14 d after surgery; radiation therapy was initiated 3 wk after surgery in the remaining 6 dogs. Long-term follow-up consisted of neurological examination and magnetic resonance imaging (MRI) and/or computed tomography (CT) scan after radiation therapy. The mean survival time for dogs that had surgery and radiation therapy was 18 mo after surgery. Frontal lobe meningiomas have been associated with poor prognosis. However, the surgical approaches used in these cases, combined with radiation therapy, allow a survival rate for frontal lobe meningiomas similar to that for meningiomas located over the cerebral convexities.

  18. Surgical treatment and radiation therapy of frontal lobe meningiomas in 7 dogs

    PubMed Central

    Uriarte, Ane; Moissonnier, Pierre; Thibaud, Jean-Laurent; Reyes-Gomez, Edouard; Devauchelle, Patrick; Blot, Stéphane

    2011-01-01

    The cases of 7 adult dogs with generalized seizures managed by surgical excision and radiation therapy for frontal lobe meningiomas were reviewed. The neurological examination was unremarkable in 6 of the 7 dogs. Five dogs were operated on using a bilateral transfrontal sinus approach and 2 using a unilateral sinotemporal approach to the frontal lobe. One dog was euthanized 14 d after surgery; radiation therapy was initiated 3 wk after surgery in the remaining 6 dogs. Long-term follow-up consisted of neurological examination and magnetic resonance imaging (MRI) and/or computed tomography (CT) scan after radiation therapy. The mean survival time for dogs that had surgery and radiation therapy was 18 mo after surgery. Frontal lobe meningiomas have been associated with poor prognosis. However, the surgical approaches used in these cases, combined with radiation therapy, allow a survival rate for frontal lobe meningiomas similar to that for meningiomas located over the cerebral convexities. PMID:22210938

  19. Association between sleep duration, weight gain, and obesity for long period.

    PubMed

    Nagai, Masato; Tomata, Yasutake; Watanabe, Takashi; Kakizaki, Masako; Tsuji, Ichiro

    2013-02-01

    Although previous studies showed the long-term effects of sleep duration on risk of weight gain, Western tends to gain weight irrespective of sleep duration over a long period. Conversely, it is showed that body mass index (BMI) decreases during a long period in Japanese and thus, the long-term effect of sleep duration on weight gain and obesity is still unclear in Asia. We followed up 13,629 participants aged 40-79years and prospectively collected data from 1995 to 2006. We divided the participants into five groups according to their self-reported sleep duration: ⩽5h (short sleep), 6h, 7h (reference), 8h, and ⩾9h (long sleep). The main outcome was ⩾5kg weight gain or BMI⩾25kg/m(2) (obesity). We used logistic regression analyses to derive odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for several confounding factors. We observed no association between sleep duration and risk of ⩾5kg weight gain and obesity. After stratification by BMI, long sleepers had a significantly increased risk of ⩾5kg weight gain (OR: 1.36, 95%CI: 1.09-1.70) in obese participants. Among community-dwelling Japanese, only obese long sleepers have a significantly increased long-term risk of ⩾5kg weight gain. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Clinical and Radiological Characteristics of Angiomatous Meningiomas

    PubMed Central

    Hwang, Juyoung; Kong, Doo-Sik; Seol, Ho Jun; Nam, Do-Hyun; Lee, Jung-Il

    2016-01-01

    Background Angiomatous meningioma is a rare histological subtype of meningioma. Therefore, this specific medical condition is rarely reviewed in the literature. In the present work, we report the clinical and radiological features with postoperative outcomes of angiomatous meningioma. Methods This retrospective study included the patients who were pathologically diagnosed with angiomatous meningioma after surgical resection between February 2010 and September 2015 in our institute. We analyzed the clinical data, radiological manifestation, treatment and prognosis of all patients. Results The 15 patients (5 males and 10 females) were diagnosed with angiomatous meningioma during the study period. The median age of patients at the time of surgery was 63 years (range: 40 to 80 years). According to Simpson classification, 7, 5, and 3 patients achieved Simpson grade I, II, and IV resection, respectively. In the follow-up period, recurrence was noted in one patient. Ten out of the 15 patients showed homogeneous enhancement. Two patients demonstrated cystic changes. There was no occurrence of calcification or hemorrhage in our patients. Characteristically, 14 out of 15 patients showed signal voids of vessels. Significant peritumoral edema was observed in the majority of tumors (67%). Conclusion Angiomatous meningiomas are rare benign meningioma. Brain images of angiomatous meningioma usually demonstrate signal void signs and peritumoral edema. In the present study, angiomatous meningiomas showed good prognosis after surgical resection. PMID:27867918

  1. Emergency decompressive craniectomy after removal of convexity meningiomas

    PubMed Central

    Missori, Paolo; Domenicucci, Maurizio; Paolini, Sergio; Mancarella, Cristina; Tola, Serena; D’Elia, Alessandro; Marotta, Nicola; Seferi, Arsen; Esposito, Vincenzo

    2016-01-01

    Background: Convexity meningiomas are benign brain tumors that are amenable to complete surgical resection and are associated with a low complication rate. The aim of this study was to identify factors that result in acute postoperative neurological worsening after the removal of convexity meningiomas. Methods: Clinical evaluation and neuroradiological analysis of patients who underwent removal of a supratentorial convexity meningioma were reviewed. Patients were selected when their postoperative course was complicated by acute neurological deterioration requiring decompressive craniectomy. Results: Six patients (mean age: 43.3 years) underwent surgical removal of a supratentorial convexity meningioma. Brain shift (mean: 9.9 mm) was evident on preoperative imaging due to lesions of varying size and perilesional edema. At various times postoperatively, patient consciousness worsened (up to decerebrate posture) with contralateral paresis and pupillary anisocoria. Computed tomography revealed no postoperative hematoma, however, did indicate increased brain edema and ventricular shift (mean: 12 mm). Emergency decompressive craniectomy and brief ventilator assistance were performed in all patients. Ischemia of the ipsilateral posterior cerebral artery occurred in 3 patients and hydrocephalus occurred in 2 patients. Outcome was good in 2, fair in 2, 1 patient had severe disability, and 1 patient died after 8 months. Conclusions: Brain shift on preoperative imaging is a substantial risk factor for postoperative neurological worsening in young adult patients after the removal of convexity meningiomas. Emergency decompressive craniectomy must be considered because it is effective in most cases. Other than consciousness impairment, there is no reliable clinical landmark to guide the decision to perform decompressive craniectomy; however, brain ischemia may have already occurred. PMID:27857859

  2. Expression and clinical value of EGFR in human meningiomas

    PubMed Central

    Backer-Grøndahl, Thomas; Ytterhus, Borgny; Granli, Unn S.; Lydersen, Stian; Gulati, Sasha; Torp, Sverre H.

    2017-01-01

    Background Meningiomas are common intracranial tumors in humans that frequently recur despite having a predominantly benign nature. Even though these tumors have been shown to commonly express EGFR/c-erbB1 (epidermal growth factor receptor), results from previous studies are uncertain regarding the expression of either intracellular or extracellular domains, cellular localization, activation state, relations to malignancy grade, and prognosis. Aims This study was designed to investigate the expression of the intracellular and extracellular domains of EGFR and of the activated receptor as well as its ligands EGF and TGFα in a large series of meningiomas with long follow-up data, and investigate if there exists an association between antibody expression and clinical and histological data. Methods A series of 186 meningiomas consecutively operated within a 10-year period was included. Tissue microarrays were constructed and immunohistochemically analyzed with antibodies targeting intracellular and extracellular domains of EGFR, phosphorylated receptor, and EGF and TGFα. Expression levels were recorded as a staining index (SI). Results Positive immunoreactivity was observed for all antibodies in most cases. There was in general high SIs for the intracellular domain of EGFR, phosphorylated EGFR, EGF, and TGFα but lower for the extracellular domain. Normal meninges were negative for all antibodies. Higher SIs for the phosphorylated EGFR were observed in grade II tumors compared with grade I (p = 0.018). Survival or recurrence was significantly decreased in the time to recurrence analysis (TTR) with high SI-scores of the extracellular domain in a univariable survival analysis (HR 1.152, CI (1.036–1.280, p = 0.009)). This was not significant in a multivariable analysis. Expression of the other antigens did not affect survival. Conclusion EGFR is overexpressed and in an activated state in human meningiomas. High levels of ligands also support this growth factor

  3. [Spinal meningioma surgery after 75 years of age].

    PubMed

    Sacko, O; Rabarijaona, M; Loiseau, H

    2008-08-01

    Spinal meningioma surgery is usually not difficult and is commonly associated with good outcome. However, advanced age and severe neurological deficit have been considered to be predictors of poor surgical outcome. Therefore, we attempted to assess the surgical outcome of spinal meningiomas in the elderly and to analyze the role of outcome predictors. From 1990 to 2006, 32 patients 76 years or older with spinal meningiomas were operated on in our Neurosurgery Departments. All patients had MRI. Neurological status was assessed using the Solero score. Neurological evaluations were conducted three months and one year after surgery. The mean follow-up was 36 months. A multiple logistic regression was applied to establish the relationship between the risk factors and outcome. The median age was 79.3 years. The mean duration of symptoms until surgery was 12.7 months. One patient was rated Solero grade I, 11 grade II, 17 grade III and three patients were rated grade IV. Radical tumor removal was performed in 30 patients (94%). All meningiomas were benign. There was no recurrence, morbidity was 9%, and 1-year mortality was 0%. One year after surgery, all patients had improved, 56 % had recovered completely. Among 20 patients with severe paraparesis or paraplegia, 30 % had recovered completely. There was no statistical correlation between outcome and various risk factors: age, gender, ASA, tumor size, quality of tumor removal, and location. Only preoperative Solero score and duration of symptoms before surgery were statistically significant. Surgery is the only treatment of symptomatic spinal meningioma. Advanced age did not seem to contraindicate surgery, even in those with severe preoperative neurological deficits, because quality of life can be improved in the vast majority of cases. There was a correlation between duration and severity of deficit and outcome.

  4. Family and personal medical history and risk of meningioma

    PubMed Central

    Claus, Elizabeth B.; Calvocoressi, Lisa; Bondy, Melissa L.; Schildkraut, Joellen M.; Wiemels, Joseph L.; Wrensch, Margaret

    2011-01-01

    Object Little is known about the epidemiology of meningioma, the most frequently reported primary brain tumor in the US. The authors undertook a case-control study to examine the relationship between family and personal medical history and meningioma risk. Methods The authors compared the personal and first-degree family histories of 1124 patients with meningioma (age range 20–79 years) in Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 Houston counties between May 1, 2006, and February 26, 2010, and the histories of 1000 control individuals who were frequency-matched for age, sex, and geography. Results The patients were more likely than the controls to report a first-degree family history of meningioma (OR 4.4, 95% CI 1.6–11.5), and there was an even stronger association in younger cases. The patients were less likely than controls to report immune conditions including allergy (OR 0.6, 95% CI 0.5–0.7) but were more likely to report a history of thyroid cancer (OR 4.7, 95% CI 1.02–21.5) or leukemia (OR 5.4, 95% CI 1.2–24.1) (most after radiotherapy). Among women, patients were more likely than controls to report hormonally related conditions—uterine fibroid tumors (OR 1.2, 95% CI 1.0–1.5), endometriosis (OR 1.5, 95% CI 1.5–2.1), and breast cancer (OR 1.4, 95% CI 0.8–2.3). Conclusions The influence of genetics, the immune system, and radiation near the head on meningioma risk is suggested in the authors’ findings; the role of hormones is intriguing but requires further study. PMID:21780859

  5. Fried food intake estimated by the multiple source method is associated with gestational weight gain.

    PubMed

    Sartorelli, Daniela S; Barbieri, Patrícia; Perdoná, Gleici C S

    2014-08-01

    This present study aimed to test the association between fried food intake estimated by a semiquantitative food frequency questionnaire (FFQ), multiple 24-hour dietary recalls (24hRs), and the application of the multiple source method (MSM) in relation to gestational weight gain at the second and third trimesters and weight gain ratio (observed weight gain/expected weight gain). We hypothesized that distinct relationships with weight gain would be found given the measurement errors of self-reported dietary approaches. A prospective study was conducted with 88 adult pregnant women. Fried food intake during pregnancy was assessed using a validated 85-item FFQ, two to six 24hRs per woman, and the MSM with and without frequency of food intake as covariate. Linear regression models were used to evaluate the relationship between fried food estimated by the methods and weight gain. For every 100-g increment of fried food intake, the β (95% confidence interval) for weight gain was β 1.87 (0.34, 3.40) and β 2.00 0.55, 3.45) for estimates using MSM with and without the frequency of intake as covariate, respectively, after multiple adjustments. We found that fried food intake estimated by the FFQ and 24hRs β 0.40 (-0.68, 1.48) and β 0.49 (-0.53, 1.52), respectively, was unrelated to weight gain. In relation to weight gain ratio, a positive association was found for estimates using the MSM with [β 0.29 (0.03, 0.54)] and without the frequency of intake as covariate [β 0.31 (0.07, 0.55)]; and no associations were found for estimates by the FFQ or 24hRs. The data showed that fried food intake estimated the MSM, but not by the FFQ and 24hRs, is associated with excessive weight gain during pregnancy. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. A novel mutation of the FAT2 gene in spinal meningioma

    PubMed Central

    Tate, Genshu; Kishimoto, Koji; Mitsuya, Toshiyuki

    2016-01-01

    Meningiomas may be classified as neurofibromin 2 (NF2)-associated and non-NF2 meningiomas depending on the presence or absence of molecular alterations in the NF2 gene. One of the characteristic histological features of meningiomas is the whorl formation of neoplastic arachnoid cells. NF2 is a human homolog of the Drosophila gene, Merlin (Mer). In humans, NF2 is the gene responsible for the disease neurofibromatosis type II, which results in the development of brain tumors, including acoustic neurinoma and meningioma. The present study aimed to investigate the molecular pathogenesis of spinal meningioma. It was hypothesized that the whorl formation of meningiomas may occur as a result of a disturbance in the planar cell polarity (PCP) of arachnoid cells, thus, genes understood to govern PCP signaling were analyzed for alterations. Whole exome sequencing followed by Sanger sequencing validation was performed for the analysis of spinal meningioma tissue obtained from a 42-year-old Japanese female. The sequencing identified a nonsynonymous mutation of c.3597G>C, resulting in p.Q1199H, in the FAT atypical cadherin 2 (FAT2) gene. FAT2 is homologous to the Drosophila Fat (Ft) gene, which belongs to the cadherin superfamily. Drosophila Fat is involved in PCP, tumor suppression and Hippo (Hpo) signaling, which is associated with Mer. Taken together, the results of the present study concluded that human FAT2 may function as a key molecule that governs not only PCP, but also NF2-Hpo signaling in arachnoid cells; thus, a mutation in this gene may result in spinal meningioma. PMID:27900010

  7. A novel mutation of the FAT2 gene in spinal meningioma.

    PubMed

    Tate, Genshu; Kishimoto, Koji; Mitsuya, Toshiyuki

    2016-11-01

    Meningiomas may be classified as neurofibromin 2 (NF2)-associated and non-NF2 meningiomas depending on the presence or absence of molecular alterations in the NF2 gene. One of the characteristic histological features of meningiomas is the whorl formation of neoplastic arachnoid cells. NF2 is a human homolog of the Drosophila gene, Merlin (Mer). In humans, NF2 is the gene responsible for the disease neurofibromatosis type II, which results in the development of brain tumors, including acoustic neurinoma and meningioma. The present study aimed to investigate the molecular pathogenesis of spinal meningioma. It was hypothesized that the whorl formation of meningiomas may occur as a result of a disturbance in the planar cell polarity (PCP) of arachnoid cells, thus, genes understood to govern PCP signaling were analyzed for alterations. Whole exome sequencing followed by Sanger sequencing validation was performed for the analysis of spinal meningioma tissue obtained from a 42-year-old Japanese female. The sequencing identified a nonsynonymous mutation of c.3597G>C, resulting in p.Q1199H, in the FAT atypical cadherin 2 (FAT2) gene. FAT2 is homologous to the Drosophila Fat (Ft) gene, which belongs to the cadherin superfamily. Drosophila Fat is involved in PCP, tumor suppression and Hippo (Hpo) signaling, which is associated with Mer. Taken together, the results of the present study concluded that human FAT2 may function as a key molecule that governs not only PCP, but also NF2-Hpo signaling in arachnoid cells; thus, a mutation in this gene may result in spinal meningioma.

  8. Growth of a progesterone receptor-positive meningioma in a female patient with congenital adrenal hyperplasia

    PubMed Central

    O’Shea, T; Crowley, R K; Farrell, M; MacNally, S; Govender, P; Feeney, J; Gibney, J

    2016-01-01

    Summary Meningioma growth has been previously described in patients receiving oestrogen/progestogen therapy. We describe the clinical, radiological, biochemical and pathologic findings in a 45-year-old woman with congenital adrenal hyperplasia secondary to a defect in the 21-hydroxylase enzyme who had chronic poor adherence to glucocorticoid therapy with consequent virilisation. The patient presented with a frontal headache and marked right-sided proptosis. Laboratory findings demonstrated androgen excess with a testosterone of 18.1 nmol/L (0–1.5 nmol) and 17-Hydroxyprogesterone >180 nmol/L (<6.5 nmol/L). CT abdomen was performed as the patient complained of rapid-onset increasing abdominal girth and revealed bilateral large adrenal myelolipomata. MRI brain revealed a large meningioma involving the right sphenoid wing with anterior displacement of the right eye and associated bony destruction. Surgical debulking of the meningioma was performed and histology demonstrated a meningioma, which stained positive for the progesterone receptor. Growth of meningioma has been described in postmenopausal women receiving hormone replacement therapy, in women receiving contraceptive therapy and in transsexual patients undergoing therapy with high-dose oestrogen and progestogens. Progesterone receptor positivity has been described previously in meningiomas. 17-Hydroxyprogesterone is elevated in CAH and has affinity and biological activity at the progesterone receptor. Therefore, we hypothesise that patients who have long-standing increased adrenal androgen precursor concentrations may be at risk of meningioma growth. Learning points: Patients with long-standing CAH (particularly if not optimally controlled) may present with other complications, which may be related to long-standing elevated androgen or decreased glucocorticoid levels. Chronic poor control of CAH is associated with adrenal myelolipoma and adrenal rest tissue tumours. Meningiomas are sensitive to

  9. Pediatric intracranial meningiomas--do they differ from their counterparts in adults?

    PubMed

    Arivazhagan, A; Devi, B Indira; Kolluri, Sastry V R; Abraham, R G; Sampath, S; Chandramouli, B A

    2008-01-01

    Meningiomas are very rare in children comprising only 0.44.1% of pediatric age tumors and only 1.5-1.8% of all intracranial neoplasms. We analyzed the clinical, pathological and management profile of these rare tumors and elucidated their differences from meningiomas in adults. From 1990 to 2005, 33 patients belonging to the pediatric age group with intracranial meningiomas were treated in NIMHANS. There were 19 male and 14 female children. The duration of symptoms ranged from 1 to 60 months. The study had a mean follow-up of 23.4 months. The commonest presenting symptoms were headache (90.9%) and visual disturbances (51.5%). Three patients had associated neurofibromatosis. Calcification was noticed in 22% of the tumors. Intraventricular meningiomas were the commonest (24.2%). Gross total or near total resection was possible in 22 out of 33 patients. Nine patients had reversible postoperative motor deficits. Fibrous meningioma was the commonest histological subtype (24.2%). Five patients had atypical or anaplastic subtypes. Adjuvant radiotherapy was administered in 4 patients. Six patients had recurrences and underwent surgery. Ten patients required either staged procedures or multiple surgeries for the recurrence/residual tumors. Pediatric meningiomas are rare tumors and differ from those in adults by their male predominance, atypical locations, higher rates of malignant subtypes, recurrence and association with neurofibromatosis. Surgical management is challenging because of atypical location. (c) 2008 S. Karger AG, Basel.

  10. Clinical features and surgical management of intracranial meningiomas in the elderly

    PubMed Central

    Yamamoto, Junkoh; Takahashi, Mayu; Idei, Masaru; Nakano, Yoshiteru; Soejima, Yoshiteru; Akiba, Daisuke; Kitagawa, Takehiro; Ueta, Kunihiro; Miyaoka, Ryo; Nishizawa, Shigeru

    2017-01-01

    Meningioma accounts for ~25% of all primary intracranial neoplasms and the incidence increases with age. Prvios population-based studies demonstrated that the annual incidence of intracranial meningiomas was 1.2–3.1/100,000 population. In particular, the incidence of this disease among the elderly is high. Recently, increased life expectancy and greater use of diagnostic radiological imaging led to an increased incidence in the diagnosis of intracranial meningiomas, both symptomatic and asymptomatic, in the elderly. Thus, neurosurgeons may be increasingly confronted with the management of intracranial meningiomas in the elderly. In practice, it is often difficult for physicians to determine whether traditional surgical resection is the optimal management strategy for intracranial meningiomas in the elderly. However, reported clinical studies about the outcome of surgical resection of intracranial meningiomas in the elderly are limited. Increased risk of mortality and morbidity associated with surgical treatment for intracranial meningiomas in the elderly compared with younger patients have been controversial. In the present study, the clinical features of intracranial meningiomas in 70 consecutive intracranial meningioma patients that underwent surgical treatment at the affiliated hospital of University of Occupational and Environmental Health between 2007 and 2013 were assessed. In addition, patient selection and surgical management of intracranial meningioma in elderly patients was discussed. Preoperative factors, including symptoms, tumor location, tumor size, Karnofsky Performance Scale (KPS) score and American Society of Anesthesiology (ASA) score, and postoperative factors, including pathological diagnosis, tumor proliferation index (Ki-67), resection rate (Simpson grade), length of hospital stay and discharge destination were retrospectively analyzed in patients aged ≥75 years (n=16; elderly group) and <75 years (n=54; younger group). Outcomes were

  11. Clinical Features, Treatment, and Prognostic Factors of Chordoid Meningioma: Radiological and Pathological Features in 60 Cases of Chordoid Meningioma.

    PubMed

    Yang, Yang; Li, Da; Cao, Xiao-Yu; Hao, Shu-Yu; Wang, Liang; Wu, Zhen; Zhang, Jun-Ting

    2016-09-01

    As one subtype of meningiomas, chordoid meningiomas (CMs) are rarely described. In this study, the authors aimed to analyze the incidence, clinical features, treatment, and prognostic factors of CMs. Among 9873 cases of meningioma surgically treated between 2003 and 2013 at Beijing Tiantan Hospital, cases of CM were chosen for analysis and were reviewed retrospectively. To ascertain which factors were related with progression-free survival (PFS), statistical analysis was performed. Sixty cases of pathologically confirmed and surgically treated CMs were identified. They accounted for 0.61 % of the entire series of meningioma. Simpson Grade I, II, III, and IV resection was performed in 26, 19, 9, and 6 patients, respectively. Fifty-four patients were followed up for 25-141 months after operation. Of these patients, 19 received postoperative adjuvant radiotherapy. Seventeen patients experienced tumor progression, and median PFS was 54 months. The 3- and 5-year PFS rates were 89.7% and 57.1%, respectively. Two patients died of tumor recurrence and 1 died of unrelated reason. Univariate analysis demonstrated tumor shape and extent of resection were significantly associated with prognosis. Multivariate analysis revealed only extent of resection was an independent prognosis factor for PFS. CM is a rare subtype of World Health Organization grade II meningioma. It more frequently involved the adult patients and was without sex predilection. The confirmed diagnosis relied on pathological validation. Total resection whenever possible is recommended to prolong PFS of patients. The value of adjuvant radiotherapy for CM need to be further studied. Copyright © 2016. Published by Elsevier Inc.

  12. Meningioma mimics: five key imaging features to differentiate them from meningiomas.

    PubMed

    Starr, C J; Cha, S

    2017-09-01

    There are a wide variety of intracranial mass lesions, both benign and malignant, which can closely mimic meningioma on imaging. We present five characteristic imaging features that can alert the radiologist to consider other differential diagnoses. Of the five imaging characteristics that were rarely seen in meningiomas, but common and specific for meningioma mimics, absence of dural tail is the most common (83.7%). Homogeneous T2 hyperintensity or T2 hypointensity are seen in nearly half of meningioma mimics and osseous destruction and leptomeningeal extension are present in 40.5% and 21.6% of meningioma mimics, respectively. The distinction between meningioma and its mimics is important because a large portion of the meningioma mimics requires substantially different clinical and surgical management. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  13. Longitudinal Associations Among Posttraumatic Stress Disorder, Disordered Eating, and Weight Gain in Military Men and Women

    PubMed Central

    Mitchell, K. S.; Porter, B.; Boyko, E. J.; Field, A. E.

    2016-01-01

    Obesity is a major health problem in the United States and a growing concern among members of the military. Posttraumatic stress disorder (PTSD) has been associated with overweight and obesity and may increase the risk of those conditions among military service members. Disordered eating behaviors have also been associated with PTSD and weight gain. However, eating disorders remain understudied in military samples. We investigated longitudinal associations among PTSD, disordered eating, and weight gain in the Millennium Cohort Study, which includes a nationally representative sample of male (n = 27,741) and female (n = 6,196) service members. PTSD at baseline (time 1; 2001–2003) was associated with disordered eating behaviors at time 2 (2004–2006), as well as weight change from time 2 to time 3 (2007–2008). Structural equation modeling results revealed that the association between PTSD and weight change from time 2 to time 3 was mediated by disordered eating symptoms. The association between PTSD and weight gain resulting from compensatory behaviors (vomiting, laxative use, fasting, overexercise) was significant for white participants only and for men but not women. PTSD was both directly and indirectly (through disordered eating) associated with weight change. These results highlight potentially important demographic differences in these associations and emphasize the need for further investigation of eating disorders in military service members. PMID:27283146

  14. Differential activation of orexin neurons by antipsychotic drugs associated with weight gain.

    PubMed

    Fadel, Jim; Bubser, Michael; Deutch, Ariel Y

    2002-08-01

    Weight gain is one side effect of many antipsychotic drugs (APDs). A small number of lateral hypothalamic/perifornical area (LH/PFA) neurons express the orexins, peptides that are critically involved in body weight regulation and arousal. We examined the ability of APDs to activate orexin neurons, as reflected by induction of Fos. APDs with significant weight gain liability increased Fos expression in orexin neurons, but APDs with low or absent weight gain liability did not. The weight gain liability of APDs was correlated with the degree of Fos induction in orexin neurons of the lateral LH/PFA. In contrast, amphetamine, which causes weight loss, increased Fos expression in orexin neurons of the medial but not lateral LH/PFA. We compared the effects of amphetamine and clozapine, an APD with weight gain liability, on orexin neurons innervating the prefrontal cortex. Clozapine induced Fos in 75% of the orexin neurons that project to the cortex, but amphetamine induced Fos in less than a third of these cells. These data suggest that APD-induced weight gain is associated with activation of distinct orexin neurons and emphasize the presence of anatomically and functionally heterogeneous populations of orexin neurons.

  15. Specific Metabolic Markers Are Associated with Future Waist-Gaining Phenotype in Women

    PubMed Central

    Merz, Benedikt; Nöthlings, Ute; Wahl, Simone; Haftenberger, Marjolein; Schienkiewitz, Anja; Adamski, Jerzy; Suhre, Karsten; Wang-Sattler, Rui; Grallert, Harald; Thorand, Barbara; Pischon, Tobias; Bachlechner, Ursula; Floegel, Anna; Peters, Annette; Boeing, Heiner

    2016-01-01

    Objective Our study aims to identify metabolic markers associated with either a gain in abdominal (measured by waist circumference) or peripheral (measured by hip circumference) body fat mass. Methods Data of 4 126 weight-gaining adults (18–75 years) from three population-based, prospective German cohort studies (EPIC, KORA, DEGS) were analysed regarding a waist-gaining (WG) or hip-gaining phenotype (HG). The phenotypes were obtained by calculating the differences of annual changes in waist minus hip circumference. The difference was displayed for all cohorts. The highest 10% of this difference were defined as WG whereas the lowest 10% were defined as HG. A total of 121 concordant metabolite measurements were conducted using Biocrates AbsoluteIDQ® kits in EPIC and KORA. Sex-specific associations with metabolite concentration as independent and phenotype as the dependent variable adjusted for confounders were calculated. The Benjamini-Hochberg method was used to correct for multiple testing. Results Across studies both sexes gained on average more waist than hip circumference. We could identify 12 metabolites as being associated with the WG (n = 8) or HG (n = 4) in men, but none were significant after correction for multiple testing; 45 metabolites were associated with the WG (n = 41) or HG (n = 4) in women. For WG, n = 21 metabolites remained significant after correction for multiple testing. Respective odds ratios (OR) ranged from 0.66 to 0.73 for tryptophan, the diacyl-phosphatidylcholines (PC) C32:3, C36:0, C38:0, C38:1, C42:2, C42:5, the acyl-alkyl-PCs C32:2, C34:0, C36:0, C36:1, C36:2, C38:0, C38:2, C40:1, C40:2, C40:5, C40:6, 42:2, C42:3 and lyso-PC C17:0. Conclusion Both weight-gaining men and women showed a clear tendency to gain more abdominal than peripheral fat. Gain of abdominal fat seems to be related to an initial metabolic state reflected by low concentrations of specific metabolites, at least in women. Thus, higher levels of specific PCs may play

  16. Weight-Gain Velocity in Newborn Infants Managed with the Kangaroo Method and Associated Variables.

    PubMed

    Nobre, Raquel Guimarães; de Azevedo, Daniela Vasconcelos; de Almeida, Paulo César; de Almeida, Nádia Maria Girão Saraiva; Feitosa, Francisco Edson de Lucena

    2017-01-01

    Objectives The Kangaroo method helps promote maternal breastfeeding and adequate growth of low birthweight preterm infants. The objective of this study was to analyze the association between weight-gain velocity during use of the Kangaroo method and maternal and infant variables. Methods A nested cross-sectional study in a cohort of newborn infants managed using the Kangaroo method was carried out at a reference center for the method in Brazil. Data on low birthweight and preterm infants managed using the Kangaroo Method (n = 78) and on their respective mothers (n = 70) was collected between January and July 2014. Maternal and infant variables were associated and correlated with weight-gain velocity (g/kg/day) at each phase of the method (p < 0.05). Results Mean weight-gain velocity increased from 0.12 ± 11.11 g/kg/day in the first phase to 13.47 ± 4.84 g/kg/day in the third phase (p < 0.001), and percentage of adequate weight increased at phase 3 (p < 0.001). Birthweight was inversely correlated with weight-gain velocity at phases 1 and 2 of the Kangaroo method. Birthweight of under 1500 g was associated with a lower likelihood of inadequate weight-gain velocity of the newborn at phase 1 (OR = 0.1; 95 % CI 0.01-0.78; p = 0.012). In phase 3, maternal age was directly correlated with weight-gain velocity. Conclusions Weight-gain velocity was associated with maternal (age) and infant (gestational age at birth, birthweight, weight for gestational age at birth, length of hospital stay and five-minute Apgar score) variables. Knowledge of the factors influencing weight-gain velocity and its behavior at each phase of the method can help guide conduct toward potentializing factors that promote adequate weight-gain.

  17. Expression of cell adhesion molecules and doublecortin in canine anaplastic meningiomas.

    PubMed

    Ide, T; Uchida, K; Suzuki, K; Kagawa, Y; Nakayama, H

    2011-01-01

    Tumor cell invasion into the surrounding nervous tissue is one of the histologic hallmarks of anaplastic meningiomas. To identify other possible markers for aggression in canine meningiomas, the relationship between histologic features and the expression of molecules involved in cell adhesion, cell proliferation, and invasion was examined. Immunohistochemistry for epithelial cadherin (E-cadherin), neural cadherin (N-cadherin), β-catenin, doublecortin (DCX), and Ki-67 was performed for 55 cases of canine meningioma. DCX was preferentially expressed in tumor cells invading the brain parenchyma (12 of 14 cases), suggesting its involvement in the invasion process. Regardless of the histologic type, E-cadherin and N-cadherin expression was observed in 31 of 55 and 44 of 55 cases, respectively. There was a significant positive correlation between DCX and N-cadherin expression and a significant negative correlation between E-cadherin and N-cadherin expression, suggesting that decreased E-cadherin and increased N-cadherin expression induce DCX expression. Typical membranous β-catenin expression was observed in 10 of 55 cases, whereas nuclear translocation was observed in 33 cases. Nuclear β-catenin expression was frequently found in anaplastic meningiomas (12 of 14 cases). The Ki-67 labeling indices were significantly higher in anaplastic meningiomas than in other types. These findings indicate that the expression of N-cadherin and DCX and the nuclear translocation of β-catenin are closely associated with the presence of invasion and anaplasia in canine meningiomas. Notably, granular cell meningiomas were negative for almost all the molecules examined, suggesting that they have a different tumor biology than other meningiomas.

  18. Does amount of weight gain during pregnancy modify the association between obesity and cesarean section delivery?

    PubMed

    Graham, Lauren E; Brunner Huber, Larissa R; Thompson, Michael E; Ersek, Jennifer L

    2014-03-01

    Two-thirds of reproductive-aged women in the United States are overweight or obese and at risk for numerous associated adverse pregnancy outcomes. This study examined whether the amount of weight gained during pregnancy modifies the prepregnancy body mass index (BMI)-cesarean delivery association. A total of 2,157 women aged 18-45 who participated in the 2008-2009 North Carolina Pregnancy Risk Assessment Monitoring System had complete information on prepregnancy BMI, maternal weight gain, and mode of delivery on infant birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95 percent confidence intervals (CIs) to model the association between prepregnancy BMI and cesarean delivery, and a stratified analysis was conducted to determine whether maternal weight gain was an effect modifier of the prepregnancy BMI-cesarean delivery association. Obese women had 1.78 times the odds of cesarean delivery as compared with women with a normal BMI (95% CI: 1.44-2.16). When adjusted for race/ethnicity, live birth order, household income, and education, the association increased in magnitude and remained statistically significant (OR = 2.01, 95% CI: 1.63-2.43). In stratified analyses, the obesity-cesarean delivery association persisted and remained statistically significant among all maternal weight gain categories. Health care practitioners should stress the importance of achieving a healthy prepregnancy weight and gaining an appropriate amount of weight during pregnancy to reduce the risk of cesarean delivery and other adverse pregnancy outcomes. © 2014, Copyright the Authors Journal compilation © 2014, Wiley Periodicals, Inc.

  19. Oxidative stress is associated with weight gain in recipients at 12-months following kidney transplantation.

    PubMed

    Cho, Young-Eun; Kim, Hyung-Suk; Lai, Chen; Stanfill, Ansley; Cashion, Ann

    2016-02-01

    Weight gain after kidney transplantation (Tx) is considered a risk factor for poor outcomes. Increased oxidative stress is associated with not only chronic renal disease and Tx, but also obesity and cardiovascular disease. The aim of this pilot study was to test whether oxidative stress is related to weight gain at 12-months after kidney Tx and to obtain preliminary insight into potential mechanisms involved. Recipients (n=33) were classified into two groups; weight loss and weight gain, based on their weight changes at 12-months post-transplant. Total antioxidant capacity (TAOC) and lipid peroxidation (TBARS) were measured to evaluate oxidative stress from plasma at baseline and 12-months. A secondary data analysis was conducted to identify potential gene regulation. Seventeen recipients lost (-6.63±5.52kg), and sixteen recipients gained weight (8.94±6.18kg). TAOC was significantly decreased at 12-months compared to baseline for the total group, however, there was no significant difference between groups at either time point. TBARS was higher in weight gain group, at both time points, and it was significantly higher at 12-months (p=0.012). Gene expression profiling analysis showed that 7 transcripts annotated to reactive oxygen species related genes in adipose tissue were expressed significantly lower in weight gain group at baseline, which might be a negative feedback mechanism to reduce oxidative stress. These results may indicate that elevated oxidative stress (TBARS) is associated with weight gain after kidney Tx and that incorporating early clinical prevention strategies known to decrease oxidative stress could be recommended. Published by Elsevier Inc.

  20. Spinal meningiomas in dogs: Description of 8 cases including a novel radiological and histopathological presentation

    PubMed Central

    José-López, Roberto; de la Fuente, Cristian; Pumarola, Martí; Añor, Sonia

    2013-01-01

    Clinical, imaging, and histological features of 8 canine spinal meningiomas, including a cervical cystic meningioma with imaging and intraoperative features of an arachnoid cyst, are described. All meningiomas were histologically classified and graded following the international World Health Organization human classification for tumors. Six meningiomas were located in the cervical spinal cord. Myelography showed intradural/ extramedullary lesions in 3/4 cases. Magnetic resonance imaging revealed hyperintense intradural/extramedullary masses on pre-contrast T1-weighted and T2-weighted images with homogeneous contrast enhancement in 7/8 cases. One dog had a cerebrospinal fluid-filled subarachnoid cavity dorsal to the cervical spinal cord. A spinal arachnoid cyst was diagnosed on imaging, but the histopathological study of the resected tissue revealed a grade I meningothelial cystic meningioma. There were no differences in outcome associated with tumor grade and surgical treatment (6/8). Cystic meningioma should be considered in the differential diagnosis of intraspinal cystic lesions, and biopsy is necessary for definitive diagnosis. PMID:24155414

  1. Aldosterone and progesterone-secreting adrenocortical adenocarcinoma in a cat with a concurrent meningioma

    PubMed Central

    Leshinsky, Jana; Beatty, Julia A; Fawcett, Anne; Voss, Katja; Makara, Mariano; Krockenberger, Mark B; Barrs, Vanessa R

    2016-01-01

    Case summary A 12-year-old, male neutered domestic shorthair cat was referred for investigation of suspected hyperaldosteronism due to persistent hypokalaemia, hindlimb ataxia, weakness of 1 month’s duration and a left adrenal mass that was detected on abdominal ultrasound. Neurological examination findings at referral were suggestive of a concurrent left forebrain lesion. Hyperaldosteronism and concurrent hyperprogesteronism were confirmed on endocrine testing. On computed tomography (CT) of the abdomen and thorax there was no evidence of local vascular invasion by the adrenal mass or of metastatic disease. CT and magnetic resonance imaging featured a large, focal rim-enhancing extra-axial left forebrain lesion consistent with a meningioma. Surgical excision of the forebrain mass was followed by adrenalectomy 2 weeks later. The tumours were classified on histopathology as a psammomatous meningioma and an adrenocortical adenocarcinoma, respectively. Immunohistochemical staining of the meningioma confirmed the presence of progesterone receptors. The cat remains well 2 years later. Relevance and novel information In humans, elevated serum progesterone levels have been associated with rapid growth of meningiomas due to the presence of progesterone receptors on the tumour. This is the first report of a cat with a progesterone and aldosterone-secreting adrenocortical adenocarcinoma and a concurrent meningioma. Clinicians should be aware of the potential effect of elevated progesterone on meningiomas in cats. PMID:28491405

  2. Recurrent lumbosacral metastases from intracranial meningioma. Report of a case and review of the literature.

    PubMed

    Conrad, M D; Schonauer, C; Pelissou-Guyotat, I; Morel, C; Madarassy, G; Deruty, R

    2001-09-01

    We report a case of a 31 year-old woman who in 1991 presented a clinical history of headaches, nausea and vomiting. CT scan showed a right frontotemporal meningioma. The first operation achieved a macroscopically complete resection. The tumour was histologically classified as a transitional meningioma. There were recurrences of the intracranial meningioma in 1994, 1996, 1997 and 1998. These recurrences were accompanied by differentiation to atypical and anaplastic meningioma. In all of these operations, a macroscopically complete resection of the tumour was performed. In 1996 adjuvant radiation therapy was given. In 1998 therapy with bromocriptine was adopted. In April 1999, the patient presented with lumbosacral pain associated with L5 bilateral sciatica. MRI showed a gadolinium enhancing mass lesion at L5-S1 level. Complete tumour resection was performed. The histological findings were the same as in 1998. In December 1999 the patient presented with perineal pain and MRI showed a L4 and S3 recurrence and the tumour was resected. The histological findings were those of a malignant meningioma. In February 2000 an intracranial recurrence was detected and operated on. The histological diagnosis was malignant meningioma. A review of the literature was undertake and is discussed.

  3. 5,10-Methylenetetrahydrofolate reductase (MTHFR), methionine synthase (MTRR), and methionine synthase reductase (MTR) gene polymorphisms and adult meningioma risk.

    PubMed

    Zhang, Jun; Zhou, Yan-Wen; Shi, Hua-Ping; Wang, Yan-Zhong; Li, Gui-Ling; Yu, Hai-Tao; Xie, Xin-You

    2013-11-01

    The causes of meningiomas are not well understood. Folate metabolism gene polymorphisms have been shown to be associated with various human cancers. It is still controversial and ambiguous between the functional polymorphisms of folate metabolism genes 5,10-methylenetetrahydrofolate reductase (MTHFR), methionine synthase (MTRR), and methionine synthase reductase (MTR) and risk of adult meningioma. A population-based case–control study involving 600 meningioma patients (World Health Organization [WHO] Grade I, 391 cases; WHO Grade II, 167 cases; WHO Grade III, 42 cases) and 600 controls was done for the MTHFR C677T and A1298C, MTRR A66G, and MTR A2756G variants in Chinese Han population. The folate metabolism gene polymorphisms were determined by using a polymerase chain reaction–restriction fragment length polymorphism assay. Meningioma cases had a significantly lower frequency of MTHFR 677 TT genotype [odds ratio (OR) = 0.49, 95 % confidence interval (CI) 0.33–0.74; P = 0.001] and T allele (OR = 0.80, 95 % CI 0.67–0.95; P = 0.01) than controls. A significant association between risk of meningioma and MTRR 66 GG (OR = 1.41, 95 % CI 1.02–1.96; P = 0.04) was also observed. When stratifying by the WHO grade of meningioma, no association was found. Our study suggested that MTHFR C677T and MTRR A66G variants may affect the risk of adult meningioma in Chinese Han population.

  4. Npc1 haploinsufficiency promotes weight gain and metabolic features associated with insulin resistance.

    PubMed

    Jelinek, David; Millward, Veronica; Birdi, Amandip; Trouard, Theodore P; Heidenreich, Randall A; Garver, William S

    2011-01-15

    A recent population-based genome-wide association study has revealed that the Niemann-Pick C1 (NPC1) gene is associated with early-onset and morbid adult obesity. Concurrently, our candidate gene-based mouse growth study performed using the BALB/cJ NPC1 mouse model (Npc1) with decreased Npc1 gene dosage independently supported these results by suggesting an Npc1 gene-diet interaction in relation to early-onset weight gain. To further investigate the Npc1 gene in relation to weight gain and metabolic features associated with insulin resistance, we interbred BALB/cJ Npc1(+/-) mice with wild-type C57BL/6J mice, the latter mouse strain commonly used to study aspects of diet-induced obesity and insulin resistance. This breeding produced a hybrid (BALB/cJ-C57BL/6J) Npc1(+/-) mouse model with increased susceptibility to weight gain and insulin resistance. The results from our study indicated that these Npc1(+/-) mice were susceptible to increased weight gain characterized by increased whole body and abdominal adiposity, adipocyte hypertrophy and hepatic steatosis in the absence of hyperphagia. Moreover, these Npc1(+/-) mice developed abnormal metabolic features characterized by impaired fasting glucose, glucose intolerance, hyperinsulinemia, hyperleptinemia and dyslipidemia marked by an increased concentration of cholesterol and triacylglycerol associated with low-density lipoprotein and high-density lipoprotein. The overall results are consistent with a unique Npc1 gene-diet interaction that promotes both weight gain and metabolic features associated with insulin resistance. Therefore, the NPC1 gene now represents a previously unrecognized gene involved in maintaining energy and metabolic homeostasis that will contribute to our understanding concerning the current global epidemic of obesity and type 2 diabetes mellitus.

  5. Associations of maternal obesity and excessive weight gain during pregnancy with subcutaneous fat mass in infancy.

    PubMed

    Jharap, Varsha V; Santos, Susana; Steegers, Eric A P; Jaddoe, Vincent W V; Gaillard, Romy

    2017-05-01

    Not much is known about the associations of maternal obesity and excessive gestational weight gain with body fat in infancy. To examine the associations of maternal pre-pregnancy body mass index and gestational weight gain with infant subcutaneous fat. In a population-based prospective cohort study among 845 mothers and their infants, we obtained maternal pre-pregnancy body mass index and measured maternal weight during pregnancy. At 1.5, 6 and 24months, we estimated infant total subcutaneous fat (sum of biceps, triceps, suprailiacal and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat). Maternal body mass index was positively associated with higher infant body mass index from 6months onwards. Maternal body mass index was not associated with infant subcutaneous fat measures at 1.5 or 6months. A 1-standard deviation scores (SDS) higher maternal body mass index was associated with a 0.09 (95% Confidence Interval 0.01, 0.17) SDS higher infant total subcutaneous fat at 24months, but not with central-to-total subcutaneous fat ratio. No associations were present for maternal total or period-specific gestational weight gain with infant fat. Maternal body mass index was positively associated with infant body mass index and total subcutaneous fat in late infancy. Maternal total and period-specific gestational weight gain were not associated with infant body fat mass measures. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Associations Among Obesity, Acute Weight Gain, and Response to Treatment with Olanzapine in Adolescent Schizophrenia

    PubMed Central

    Correll, Christoph U.; Tohen, Mauricio; DelBello, Melissa P.; Ganocy, Stephen J.; Findling, Robert L.; Chang, Kiki

    2013-01-01

    Abstract Objective The purpose of this study was to investigate associations between body weight and illness characteristics, including weight gain and therapeutic efficacy, in adolescents with schizophrenia. Methods Adolescents ages 13–17 years (n=107) with American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) schizophrenia enrolled in a 6 week, double-blind, placebo-controlled trial comparing olanzapine and placebo. Therapeutic response was assessed by the Brief Psychiatric Rating Scale for Children (BPRS-C). Secondary outcomes included the Clinical Global Impressions-Severity (CGI-S) scale and Positive and Negative Syndrome Scale (PANSS). Obesity was defined as sex-/age-adjusted body mass index (BMI)≥95th percentile. Linear regression was used to analyze the relationship between weight gain and psychiatric symptom improvement; logistic regression was conducted to identify predictors of baseline obesity. Results Weight gain was significantly correlated with greater BPRS-C reduction among olanzapine-treated subjects (r=−0.31, p<0.01), whereas a trend was observed among placebo-treated subjects (r=−0.31, p=0.08). However, this relationship became nonsignificant when analyses were controlled for duration of olanzapine treatment (p=0.12), and a treatment by weight gain interaction did not emerge in a repeated-measures mixed model analysis that included time in the study (t=1.27, p=0.21). Additionally, weight gain ≥7% was not significantly associated with response or remission. Among 17 adolescents (16%) with obesity at study entry, obesity was not significantly associated with endpoint BPRS-C illness severity. However, girls (p=0.03), individuals hospitalized within the past year (p=0.02), and those with less severe overall (p=0.03) and negative symptoms (p=0.003) according to the CGI-S and PANSS negative subscale, respectively, were more likely to be obese at baseline. Conclusion Baseline obesity was

  7. Associations among obesity, acute weight gain, and response to treatment with olanzapine in adolescent schizophrenia.

    PubMed

    Kemp, David E; Correll, Christoph U; Tohen, Mauricio; Delbello, Melissa P; Ganocy, Stephen J; Findling, Robert L; Chang, Kiki

    2013-10-01

    The purpose of this study was to investigate associations between body weight and illness characteristics, including weight gain and therapeutic efficacy, in adolescents with schizophrenia. Adolescents ages 13-17 years (n = 107) with American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) schizophrenia enrolled in a 6 week, double-blind, placebo-controlled trial comparing olanzapine and placebo. Therapeutic response was assessed by the Brief Psychiatric Rating Scale for Children (BPRS-C). Secondary outcomes included the Clinical Global Impressions-Severity (CGI-S) scale and Positive and Negative Syndrome Scale (PANSS). Obesity was defined as sex-/age-adjusted body mass index (BMI) ≥ 95th percentile. Linear regression was used to analyze the relationship between weight gain and psychiatric symptom improvement; logistic regression was conducted to identify predictors of baseline obesity. Weight gain was significantly correlated with greater BPRS-C reduction among olanzapine-treated subjects (r = -0.31, p<0.01), whereas a trend was observed among placebo-treated subjects (r = -0.31, p = 0.08). However, this relationship became nonsignificant when analyses were controlled for duration of olanzapine treatment (p=0.12), and a treatment by weight gain interaction did not emerge in a repeated-measures mixed model analysis that included time in the study (t = 1.27, p = 0.21). Additionally, weight gain ≥ 7% was not significantly associated with response or remission. Among 17 adolescents (16%) with obesity at study entry, obesity was not significantly associated with endpoint BPRS-C illness severity. However, girls (p = 0.03), individuals hospitalized within the past year (p = 0.02), and those with less severe overall (p = 0.03) and negative symptoms (p = 0.003) according to the CGI-S and PANSS negative subscale, respectively, were more likely to be obese at baseline. Baseline obesity was associated with lower illness

  8. Coexistent intracerebral metastatic melanoma and meningioma.

    PubMed

    Shinde, Sweety V; Shenoy, Asha S; Savant, Hemant V; Balasubramaniam, Srikant B

    2017-01-01

    Coexistence of multifocal neural crest tumors, namely meningioma, melanoma, and nerve sheath tumors, is termed as neurocristopathy. Neurofibromatosis is the commonest form of neurocristopathy. We report a rare case of frontal lobe metastatic melanoma coexistent with a parietal lobe meningioma, in the absence of any stigmata of neurofibromatosis.

  9. Osteoblastic meningioma of the fourth ventricle.

    PubMed

    Johnson, M D; Tulipan, N; Whetsell, W O

    1989-04-01

    Meningiomas of the fourth ventricle are rare neoplasms. Only meningothelial and fibroblastic subtypes, purportedly arising from the tela choroidea, have been described. In this report we describe clinical, neuroradiological and pathological findings in a 52-year-old man with mild hydrocephalus produced by a large, calcified, osteoblastic meningioma of the fourth ventricle.

  10. Association between weight gain, obesity, and sleep duration: a large-scale 3-year cohort study.

    PubMed

    Kobayashi, Daiki; Takahashi, Osamu; Deshpande, Gautam A; Shimbo, Takuro; Fukui, Tsuguya

    2012-09-01

    Previous research suggests that sleep duration is associated with obesity and weight gain. However, the majority of these studies are of cross-sectional design, with only a few cohort studies. In order to validate previous findings in a more real-world context, we evaluated the association between sleep duration, obesity, and weight gain in a large, 3-year cohort study. A retrospective cohort study was conducted involving 21,469 apparently healthy individuals aged 20 years or older who underwent annual health check-ups at the Center for Preventive Medicine, St. Luke's International Hospital, between 2005 and 2008. The participants were divided into four groups according to their self-reported average nightly sleep duration (≤5, 6, 7, and ≥8 h). We identified individuals with obesity (body mass index ≥25 kg/m(2)) and weight gain. Multivariate linear regression analysis and logistic regression analysis were used to explore the association between these variables and sleep duration, adjusting for age, gender, alcohol consumption, current smoking, past medical history, and level of physical activity. Compared with those who slept 7 h, the individuals who slept ≤5 h night were more likely to experience weight gain (β coefficient = 0.03; 95% CI = 0.03-1.1) and to become obese (OR = 1.5; 95% CI = 1.1-2.0). No significant difference was seen between subjects who slept more than 8 h and those sleeping 7 h (OR = 1.3; 95% CI = 0.9-1.8). Short sleep (≤5 h) is significantly associated with weight gain and obesity in both male and female adults.

  11. The Association of FTO SNP rs9939609 with Weight Gain at University.

    PubMed

    Meisel, Susanne F; Beeken, Rebecca J; van Jaarsveld, Cornelia H M; Wardle, Jane

    2015-01-01

    We tested the hypothesis that the obesity-associated FTO SNP rs9939609 would be associated with clinically significant weight gain (≥ 5% of initial body weight) in the first year of university; a time identified as high risk for weight gain. We collected anthropometric data from university students (n = 1,411, mean age: 22.4 ± 2.5 years, 49.1% male) at the beginning and end of the academic year. DNA was analysed for FTO rs9939609. Associations of FTO genotype with BMI at baseline were analysed using ANCOVA, and with risk of 5% weight gain over follow-up with logistic regression; both analyses adjusting for age and sex. The alpha level was reduced to 0.0125 to account for multiple testing. Using an additive model, FTO status was not associated with higher BMI at baseline (22.2 vs. 21.9 kg/m2, p = 0.059). Dropout was high but unrelated to genotype. Among the 310 (21.9%) completing follow-up, those with AT genotypes had twice the odds of ≥ 5% weight gain compared with TTs (OR = 2.05, 95% CI = 1.05-4.01, p = 0.036), but this was no longer significant after Bonferroni correction. There was a trend for AA carriers for ≥ 5% weight gain compared with TT carriers (p = 0.089), but sample size was small. This study provides nominal evidence for the genetic susceptibility hypothesis, but findings need to be replicated. © 2015 S. Karger GmbH, Freiburg.

  12. Ectopic orbital meningioma: Fact or fiction?

    PubMed

    Tan, Lee Teak; Stewart, Christopher M; Sheerin, Fintan; MacDonald, Brendan; Silva, Priy; Norris, Jonathan H

    2017-06-01

    Primary intraorbital ectopic meningiomas are rare and their existence remains controversial. We present a 30-year-old female with painless, non-axial proptosis and a palpable superomedial mass. The MRI demonstrated that the mass had no optic nerve sheath or sphenoid wing involvement and was initially reported to have no intracranial extension. The patient was initially thought to have an ectopic orbital meningioma. Subsequent multidisciplinary team (MDT) consultation and further specialist review of the MRI revealed a subtle dural tail connecting to an enhancing mass in the olfactory groove. Biopsy revealed a WHO Grade 1 transitional meningioma with an infiltrative pattern. We argue that some previously reported cases of ectopic meningioma may lack the requisite imaging to discover the primary disease. Our report highlights the importance of MRI in this group of patients and the role of a skull-base MDT with specialist neuroradiology input to determine the true origin and extent of these extradural orbital meningiomas.

  13. Paraventricular meningioma revealed by mental disorder

    PubMed Central

    Hilmani, Said; Houass, Yassine; El Azhari, Abdessamad

    2016-01-01

    Background: Ventricular meningioma constitutes 2% of intracranial meningioma, representing a challenging disease for neurosurgeons. Although cognitive impairment is one of the major symptoms of ventricular tumors, few studies have reported the details of cognitive impairment before and after their surgical removal. The expected effects on cognitive function should also be considered when choosing a surgical approach. Case Descriptions: We report the case of a large lateral ventricle meningioma revealed by cognitive dysfunction and moderate intellectual disability. The patient underwent subtotal resection of the tumor which had partial improvement in cognitive disorders. It is important to precisely assess neuropsychological function in patients with large brain tumors, and judicious preoperative plan, adequate knowledge of anatomy, and use of correct microsurgical techniques are fundamental in achieving complete resection of paraventricular meningioma with low morbidity. Conclusion: Pre and postoperative precise neuropsychological examinations may identify the potential cognitive impairment and beneficial effects of surgery in patients with large lateral ventricle meningiomas. PMID:28144473

  14. Association between timing of adiposity rebound and body weight gain during infancy.

    PubMed

    Koyama, Satomi; Sairenchi, Toshimi; Shimura, Naoto; Arisaka, Osamu

    2015-02-01

    To investigate whether increments of weight gain in early infancy are related to the timing of adiposity rebound (AR). A total of 271 children (147 boys and 124 girls) in 1 community were enrolled in the study. Serial measurements of body mass index were carried out at the ages of 4, 8, and 12 months and 1.5, 2, 3, 4, 5, 6, 7, 8, 9, and 10 years, based on which the age of AR was determined. We also calculated body weight increments in 3 separate periods: birth to 4 months, 4-8 months, and 8-12 months. There was no significant relationship between weight gain in any period of infancy and the age of AR. Weight gain between birth and 4 months was positively correlated only with body mass index at 7 years of age. We could not find an association between body weight gain during infancy and the timing of AR. This suggests that infantile weight gain is not related to childhood obesity through AR. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Extent of resection and overall survival for patients with atypical and malignant meningioma.

    PubMed

    Aizer, Ayal A; Bi, Wenya Linda; Kandola, Manjinder S; Lee, Eudocia Q; Nayak, Lakshmi; Rinne, Mikael L; Norden, Andrew D; Beroukhim, Rameen; Reardon, David A; Wen, Patrick Y; Al-Mefty, Ossama; Arvold, Nils D; Dunn, Ian F; Alexander, Brian M

    2015-12-15

    The prognosis for patients with atypical and malignant meningioma is guarded; whether the extent of resection is associated with survival-based outcomes in this population remains poorly defined. This study investigated the association between gross total resection (GTR) and all-cause mortality in patients with atypical and malignant meningioma. The Surveillance, Epidemiology, and End Results program was used to identify 575 and 64 patients betweens the ages of 18 and 70 years who were diagnosed with atypical and malignant meningioma, respectively, between 2004 and 2009. Multivariate Cox proportional hazards regression was used to assess the adjusted impact of GTR versus subtotal resection on all-cause mortality. Baseline patient characteristics were similar for patients who did undergo GTR and patients who did not undergo GTR. The 5-year overall survival rates were 91.3% (95% confidence interval [CI], 86.2%-94.5%) and 78.2% (95% CI, 70.0%-84.3%) for patients with atypical meningioma who did and did not undergo GTR, respectively, and 64.5% (95% CI, 45.9%-78.1%) and 41.1% (95% CI, 17.9%-63.1%) for patients with malignant meningioma who did and did not undergo GTR, respectively. After adjustments for available, pertinent confounding variables, GTR was associated with lower all-cause mortality in patients with atypical (hazard ratio, 0.39; 95% CI, 0.23-0.67; P < .001) and malignant meningioma (hazard ratio, 0.35; 95% CI, 0.15-0.81; P = .01). The extent of resection is a powerful predictor of outcome for patients with atypical and malignant meningioma. These data highlight the hazard associated with the presence of gross tumor bulk after surgery and suggest a value for more extensive resections that should be balanced against the additional potential morbidity. © 2015 American Cancer Society.

  16. Associations Between 25-Hydroxyvitamin D and Weight Gain in Elderly Women

    PubMed Central

    Rizzo, Joanne H.; Pedula, Kathryn L.; Ensrud, Kristine E.; Cauley, Jane; Hochberg, Marc; Hillier, Teresa A.

    2012-01-01

    Abstract Background 25-Hydroxyvitamin D [25(OH)D] levels are lower in obese individuals. Determining whether low vitamin D status can predispose weight gain requires a longitudinal study. Methods From a community-based multicenter U.S. prospective cohort of 9704 (Study of Osteoporotic Fractures [SOF]), 4659 women aged ≥65 with baseline 25(OH)D measurement were followed for 4.5 years. They were weighed at baseline and follow-up visits, and a subset (n=1054) had 25(OH)D levels remeasured at follow-up. Results Women with 25(OH)D levels ≥30 ng/mL had lower baseline weight (141.6 pounds) compared to women with 25(OH)D levels <30 ng/mL (148.6 pounds) (p<0.001). Overall, 25(OH)D status was not associated with weight change over 4.5 years, although there was a significant interaction between 25(OH)D status and weight change category (loss, gain, stable) (p<0.0001). In women who gained ≥5% weight, those with baseline 25(OH)D levels ≥30 ng/mL gained 16.4 pounds (12.2% of baseline weight) over 4.5 years compared to 18.5 pounds (13.9% of baseline weight) in women with levels <30 ng/mL (p=0.04). In women who lost ≥5% weight or remained stable (<5% weight change), there was no association between 25(OH)D status at baseline and weight change. Among women who gained weight and had 25(OH)D measured at both visits, having sustained or developing 25(OH)D levels ≥30 ng/mL was associated with less weight gain between visits (14.81 vs. 16.34 pounds, p=0.04). Conclusions Higher 25(OH)D levels are associated with lower weight gains, suggesting low vitamin D status may predispose to fat accumulation. PMID:22731629

  17. Association between market concentration of hospitals and patient health gain following hip replacement surgery

    PubMed Central

    Pistollato, Michele; Charlesworth, Anita; Devlin, Nancy; Propper, Carol; Sussex, Jon

    2015-01-01

    Objectives To assess the association between market concentration of hospitals (as a proxy for competition) and patient-reported health gains after elective primary hip replacement surgery. Methods Patient Reported Outcome Measures data linked to NHS Hospital Episode Statistics in England in 2011/12 were used to analyse the association between market concentration of hospitals measured by the Herfindahl-Hirschman Index (HHI) and health gains for 337 hospitals. Results The association between market concentration and patient gain in health status measured by the change in Oxford Hip Score (OHS) after primary hip replacement surgery was not statistically significant at the 5% level both for the average patient and for those with more than average severity of hip disease (OHS worse than average). For 12,583 (49.1%) patients with an OHS before hip replacement surgery better than the mean, a one standard deviation increase in the HHI, equivalent to a reduction of about one hospital in the local market, was associated with a 0.104 decrease in patients’ self-reported improvement in OHS after surgery, but this was not statistically significant at the 5% level. Conclusions Hospital market concentration (as a proxy for competition) appears to have no significant influence (at the 5% level) on the outcome of elective primary hip replacement. The generalizability of this finding needs to be investigated. PMID:25213207

  18. Association between market concentration of hospitals and patient health gain following hip replacement surgery.

    PubMed

    Feng, Yan; Pistollato, Michele; Charlesworth, Anita; Devlin, Nancy; Propper, Carol; Sussex, Jon

    2015-01-01

    To assess the association between market concentration of hospitals (as a proxy for competition) and patient-reported health gains after elective primary hip replacement surgery. Patient Reported Outcome Measures data linked to NHS Hospital Episode Statistics in England in 2011/12 were used to analyse the association between market concentration of hospitals measured by the Herfindahl-Hirschman Index (HHI) and health gains for 337 hospitals. The association between market concentration and patient gain in health status measured by the change in Oxford Hip Score (OHS) after primary hip replacement surgery was not statistically significant at the 5% level both for the average patient and for those with more than average severity of hip disease (OHS worse than average). For 12,583 (49.1%) patients with an OHS before hip replacement surgery better than the mean, a one standard deviation increase in the HHI, equivalent to a reduction of about one hospital in the local market, was associated with a 0.104 decrease in patients' self-reported improvement in OHS after surgery, but this was not statistically significant at the 5% level. Hospital market concentration (as a proxy for competition) appears to have no significant influence (at the 5% level) on the outcome of elective primary hip replacement. The generalizability of this finding needs to be investigated. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain

    PubMed Central

    STUEBE, Alison M.; OKEN, Emily; GILLMAN, Matthew W.

    2009-01-01

    Objective We sought to identify modifiable risk factors for excessive gestational weight gain (GWG). Study Design We assessed associations of diet and physical activity with excessive gain among 1388 women from the Project Viva cohort study. Results 379 (27%) of women were overweight (BMI>=26kg/m2) and 703 (51%) experienced excessive GWG, according to Institute of Medicine guidelines. In multivariable logistic regression models, we found that intake of total energy (OR 1.10, 95%CI 1.00–1.22, per 500 kcal/day), dairy (1.08, 95%CI 1.00–1.17, per serving/day), and fried foods (OR 3.47, 95%CI 0.91–13.24, per serving/day) were directly associated with excessive GWG. First trimester vegetarian diet (0.46, 95%CI 0.28–0.78) and mid-pregnancy walking (0.91, 95%CI 0.82–1.00, per half-hour/day) and vigorous physical activity (0.76, 95%CI 0.60–0.97, per half-hour/day) were inversely associated with excessive GWG. Conclusion Healthful diet and greater physical activity are associated with reduced risk for excessive gestational weight gain. PMID:19467640

  20. EGFR Soluble Isoforms and Their Transcripts Are Expressed in Meningiomas

    PubMed Central

    Bessette, Barbara; Chaunavel, Alain; Pommepuy, Isabelle; Projetti, Fabrice; Robert, Sandrine; Caire, François; Rabinovitch-Chable, Hélène; Labrousse, François

    2012-01-01

    The EGFR (epidermal growth factor receptor) is involved in the oncogenesis of many tumors. In addition to the full-length EGFR (isoform a), normal and tumor cells produce soluble EGFR isoforms (sEGFR) that lack the intracellular domain. sEGFR isoforms b, c and d are encoded by EGFR variants 2 (v2), 3 (v3) and 4 (v4) mRNA resulting from gene alternative splicing. Accordingly, the results of EGFR protein expression analysis depend on the domain targeted by the antibodies. In meningiomas, EGFR expression investigations mainly focused on EGFR isoform a. sEGFR and EGFRvIII mutant, that encodes a constitutively active truncated receptor, have not been studied. In a 69 meningiomas series, protein expression was analyzed by immunohistochemistry using extracellular domain targeted antibody (ECD-Ab) and intracellular domain targeted antibody (ICD-Ab). EGFRv1 to v4 and EGFRvIII mRNAs were quantified by RT-PCR and EGFR amplification revealed by MLPA. Results were analyzed with respect to clinical data, tumor resection (Simpson grade), histological type, tumor grade, and patient outcome.Immunochemical staining was stronger with ECD-Ab than with ICD-Ab. Meningiomas expressed EGFRv1 to -v4 mRNAs but not EGFRvIII mutant. Intermediate or high ECD-Ab staining and high EGFRv1 to v4 mRNA levels were associated to a better progression free survival (PFS). PFS was also improved in women, when tumor resection was evaluated as Simpson 1 or 2, in grade I vs. grade II and III meningiomas and when Ki67 labeling index was lower than 10%.Our results suggest that, EGFR protein isoforms without ICD and their corresponding mRNA variants are expressed in meningiomas in addition to the whole isoform a. EGFRvIII was not expressed. High expression levels seem to be related to a better prognosis. These results indicate that the oncogenetic mechanisms involving the EGFR pathway in meningiomas could be different from other tumor types. PMID:22623992

  1. Loss of p53 expression is accompanied by upregulation of beta-catenin in meningiomas: a concomitant reciprocal expression.

    PubMed

    Pećina-Šlaus, Nives; Kafka, Anja; Vladušić, Tomislav; Tomas, Davor; Logara, Monika; Skoko, Josip; Hrašćan, Reno

    2016-04-01

    Crosstalk between Wnt and p53 signalling pathways in cancer has long been suggested. Therefore in this study we have investigated the involvement of these pathways in meningiomas by analysing their main effector molecules, beta-catenin and p53. Cellular expression of p53 and beta-catenin proteins and genetic changes in TP53 were analysed by immunohistochemistry, PCR/RFLP and direct sequencing of TP53 exon 4. All the findings were analysed statistically. Our analysis showed that 47.5% of the 59 meningiomas demonstrated loss of expression of p53 protein. Moderate and strong p53 expression in the nuclei was observed in 8.5% and 6.8% of meningiomas respectively. Gross deletion of TP53 gene was observed in one meningioma, but nucleotide alterations were observed in 35.7% of meningiomas. In contrast, beta-catenin, the main Wnt signalling molecule, was upregulated in 71.2%, while strong expression was observed in 28.8% of meningiomas. The concomitant expressions of p53 and beta-catenin were investigated in the same patients. In the analysed meningiomas, the levels of the two proteins were significantly negatively correlated (P = 0.002). This indicates that meningiomas with lost p53 upregulate beta-catenin and activate Wnt signalling. Besides showing the reciprocal relationship between proteins, we also showed that the expression of p53 was significantly (P = 0.021) associated with higher meningioma grades (II and III), while beta-catenin upregulation was not associated with malignancy grades. Additionally, women exhibited significantly higher values of p53 loss when compared to males (P = 0.005). Our findings provide novel information about p53 involvement in meningeal brain tumours and reveal the complex relationship between Wnt and p53 signalling, they suggest an important role for beta-catenin in these tumours.

  2. Associations of gestational weight gain with short- and longer-term maternal and child health outcomes.

    PubMed

    Oken, Emily; Kleinman, Ken P; Belfort, Mandy B; Hammitt, James K; Gillman, Matthew W

    2009-07-15

    The authors investigated the rate of gestational weight gain associated with the lowest combined risk of 5 short- and longer-term maternal and child health outcomes for 2,012 mother-child pairs recruited in 1999-2002 into Project Viva, a prebirth cohort study in Massachusetts. Within each maternal prepregnancy body mass index (BMI, kg/m(2)) stratum, they performed a logistic regression analysis predicting all 5 outcomes, from which they determined the rate of gain at which average predicted prevalence of the adverse outcomes was the lowest. The mean rate of total gestational weight gain was 0.39 kg/week (standard deviation, 0.14). The prevalence of small for gestational age was 6%, large for gestational age was 14%, preterm delivery was 7%, substantial postpartum weight retention was 16%, and child obesity was 10%. The lowest predicted outcome prevalence occurred with a 0.28-kg/week gain for women whose BMI was 18.5-24.9, a 0.03-kg/week loss for a BMI of 25.0-29.9, and a 0.19-kg/week loss for a BMI of >or=30.0 kg/m(2)--the lowest observed weight changes in overweight and obese women. For normal-weight and overweight women, lowest-risk gains varied modestly with adjustment for maternal characteristics and with different outcome weightings. For obese women, the lowest-risk weight change was weight loss in all models. Recommendations for gestational weight gain for obese women should be revised.

  3. Association of infant child care with infant feeding practices and weight gain among US infants.

    PubMed

    Kim, Juhee; Peterson, Karen E

    2008-07-01

    To assess whether child care arrangements influence infant feeding practices and weight gain among US infants. Cross-sectional analysis of data collected by the US Department of Education, National Center for Education Statistics. A nationally representative sample of infants enrolled in the Early Childhood Longitudinal Study, Birth Cohort at baseline. A total of 8150 infants aged 9 months. Age (in months) at initiation and type and intensity of child care. Breastfeeding initiation, early introduction of solid foods (<4 months), and weight gain (birth to 9 months). A total of 55.3% of infants received regular, nonparental child care and half of these infants were in full-time child care. Among infants in child care, 40.3% began at younger than 3 months, 39.3% began between 3 and 5.9 months of age, and 20.7% began at 6 months or older. Infants who initiated child care at younger than 3 months were less likely to have been breastfed (odds ratio, 0.58; 95% confidence interval [CI], 0.43-0.74) and were more likely to have received early introduction of solid foods (odds ratio, 1.73; 95% CI, 1.43-2.04) than those in parental care. Infants in part-time child care gained 175 g (95% CI, 100-250 g) more weight during 9 months than those in parental care. Infants being cared for by relatives had a lower rate of breastfeeding initiation, a higher rate of early introduction of solid foods, and greater weight gain compared with infants receiving parental care. The early introduction of solid foods was a risk factor for weight gain. Child care factors were associated with unfavorable infant feeding practices and more weight gain during the first year of life in a nationally representative cohort. The effects of early child care on breastfeeding and introduction of solid foods warrant longer follow-up to determine subsequent risk of childhood overweight.

  4. Ramelteon attenuates age-associated hypertension and weight gain in spontaneously hypertensive rats.

    PubMed

    Oxenkrug, Gregory F; Summergrad, Paul

    2010-06-01

    The neuroendocrine theory of aging suggests the common mechanisms of developmental (prereproductive) and aging (postreproductive) processes and identified a cluster of conditions (hypertension, obesity, dyslipidemia, type 2 diabetes, menopause, late onset depression, vascular cognitive impairment, impairment of immune defense, and some forms of cancer) as age-associated neuroendocrine disorders (AAND). Obesity, dyslipidemia, hypertension, and type 2 diabetes were later described as metabolic syndrome (MetS). Because melatonin attenuated development of MetS is age-dependent, that is, in young and old, but not in middle-aged rats, we studied the effect of the selective melatonin agonist, Ramelteon, on the two core symptoms of MetS/AAND: hypertension and body weight gain in spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto male rats (WKY). SHR rats developed hypertension at the time of maximal weight gain that coincided with the onset of reproductive activity (8-10 weeks old). Chronic (but not acute) administration of Ramelteon (in drinking water, 8 mg/kg/day, from 4 to 12 weeks of age) attenuated age-associated increase of systolic blood pressure (tail-cuff method) by 45%, and age-associated body weight gain by 30%. Acute and chronic Ramelteon did not affect blood pressure and body weight in normotensive WKY rats. Ramelteon-induced attenuation of age-associated hypertension and weight gain suggests that Ramelteon might attenuate the other symptoms of MetS/AAND and might be useful in the treatment of MetS/AAND during puberty, menopause, and old age.

  5. Clusters of week-specific maternal gestational weight gain pattern and their association with birthweight: an observational cohort study.

    PubMed

    Liang, Huan; Yin, Chuanmin; Dong, Xinran; Acharya, Ganesh; Li, Xiaotian

    2017-10-01

    Gestational weight gain varies widely among different populations, and an inappropriate gestational weight gain is associated with adverse pregnancy outcomes. We aimed to investigate week-specific serial changes in gestational weight gain in an urban Chinese population to derive clusters of gestational weight gain patterns and explore the impact of gestational weight gain patterns on birthweight. This was an observational cohort study of 6130 women delivered at a university hospital in Shanghai, China. Pre-pregnancy bodyweight, height, week-specific and total gestational weight gain, pregnancy outcome and birthweight were extracted using electronic medical records. The association between gestational weight gain and gestational age was tested using linear regression, and week-specific reference percentiles for gestational weight gain were calculated. Hierarchical clustering was used to derive gestational weight gain clusters. Mean birthweight among the clusters was compared using Dunnet's test. We found a significant linear association between gestational weight gain and gestational age (r = 0.56; p < 0.00001). Seven distinct clusters of gestational weight gain pattern were identified. The birthweight significantly correlated with gestational weight gain (r = 0.28; p < 0.00001). Compared with the cluster that had normal gestational weight gain throughout the pregnancy, the mean birthweight among the clusters that had abnormal gestational weight gain (inadequate or excessive) in the third trimester was significantly different (p < 0.001), but those who achieved normal gestational weight gain (between 5 and 95 percentile) in the third-trimester had similar mean birthweight. Women with abnormal gestational weight gain before the third-trimester still had a fair chance of delivering a normal birthweight baby if their gestational weight gain was normal in the third-trimester, suggesting that interventions started even late in pregnancy may have a positive

  6. Depressive and anxiety disorders: Associated with losing or gaining weight over 2 years?

    PubMed

    de Wit, Leonore M; van Straten, Annemieke; Lamers, Femke; Cuijpers, Pim; Penninx, Brenda W J H

    2015-06-30

    This longitudinal study examines to what extent different depressive and anxiety disorders and clinical characteristics are associated with subsequent weight change, while controlling for baseline weight, sociodemographics, health status, psychotropic medication use and (un)healthy lifestyle factors. Data are from a sample of 2447 respondents aged 18-65 years of the Netherlands Study of Depression and Anxiety (NESDA). Baseline depressive disorders and anxiety disorders were determined with the Composite International Diagnostic Interview (CIDI). Weight at baseline and after 2 years was measured and analyzed as continuous change score (mean change in weight 1kg) and in categories of significant weight loss (<1S.D. weight change equaling <4kg), weight maintenance and weight gain (>1S.D., >6kg). After full adjustment for covariates baseline comorbid anxiety and depressive disorder and baseline Major Depressive Disorder (MDD) were associated with significant 2-year weight gain. Both current and remitted MDD at baseline and a baseline dysthymia, but none of the anxiety disorders, were associated with significant weight loss. This longitudinal study confirms a U-curved link between depression and weight change over 2 years. Furthermore, a dose-response effect of depression severity on 2-year weight gain was found.

  7. Pleomorphism and drug resistant cancer stem cells are characteristic of aggressive primary meningioma cell lines.

    PubMed

    Khan, Ishaq; Baeesa, Saleh; Bangash, Mohammed; Schulten, Hans-Juergen; Alghamdi, Fahad; Qashqari, Hanadi; Madkhali, Nawal; Carracedo, Angel; Saka, Mohamad; Jamal, Awatif; Al-Maghrabi, Jaudah; AlQahtani, Mohammed; Al-Karim, Saleh; Damanhouri, Ghazi; Saini, Kulvinder; Chaudhary, Adeel; Abuzenadah, Adel; Hussein, Deema

    2017-01-01

    Meningioma tumors arise in arachnoid membranes, and are the most reported central nervous system (CNS) tumors worldwide. Up to 20% of grade I meningioma tumors reoccur and currently predictive cancer stem cells (CSCs) markers for aggressive and drug resistant meningiomas are scarce. Meningioma tissues and primary cell lines were investigated using whole transcriptome microarray analysis, immunofluorescence staining of CSCs markers (including CD133, Sox2, Nestin, and Frizzled 9), and drug treatment with cisplatin or etoposide. Unsupervised hierarchical clustering of six meningioma samples separated tissues into two groups. Analysis identified stem cells related pathways to be differential between the two groups and indicated the de-regulation of the stem cell associated genes Reelin (RELN), Calbindin 1 (CALB1) and Anterior Gradient 2 Homolog (AGR2). Immunofluorescence staining for four tissues confirmed stemness variation in situ. Biological characterization of fifteen meningioma primary cell lines concordantly separated cells into two functionally distinct sub-groups. Pleomorphic cell lines (NG type) grew significantly faster than monomorphic cell lines (G type), had a higher number of cells that express Ki67, and were able to migrate aggressively in vitro. In addition, NG type cell lines had a lower expression of nuclear Caspase-3, and had a significantly higher number of CSCs co-positive for CD133+ Sox2+ or AGR2+ BMI1+. Importantly, these cells were more tolerant to cisplatin and etoposide treatment, showed a lower level of nuclear Caspase-3 in treated cells and harbored drug resistant CSCs. Collectively, analyses of tissues and primary cell lines revealed stem cell associated genes as potential targets for aggressive and drug resistant meningiomas.

  8. Spinal meningioma in childhood: clinical features and treatment.

    PubMed

    Wang, Xiao-Qiang; Zeng, Xian-Wei; Zhang, Bi-Yun; Dou, Ya-Fang; Wu, Jin-Song; Jiang, Cheng-Chuan; Zhong, Ping; Chen, Hong

    2012-01-01

    The purpose of this retrospective study is to determine the clinical characteristics and the prognosis of the spinal meningioma in childhood (under 18 years of age) based on the treatment at our institution. Ten spinal meningioma cases in children were treated during the last 9 years. The clinical data was retrospectively analyzed and the results were compared with those in the literature. The series included eight males and two females and the mean age was 13.2 years. The most common initial symptoms were pain (6/10) and the common signs were limb weakness (4/10) and gait disturbance (2/10) and distal paresthesia (1/10) and bladder disturbance (1/10). Four patients had other clinical signs of neurofibromatosis type II (NF-2) such as tumors elsewhere. All the tumors were located in cervical and thoracic vertebrae. Resection according to Simpson Grade I (6/10), II (2/10), III (1/10), and IV (1/10) were performed. Grade II meningiomas accounted for 3/10 in this series. All patients were followed up with mean follow-up period of 43 months. Seven patients had recurrence of the tumor in that period and one had died. Spinal meningioma is an uncommon pediatric neoplasm and has a poor prognosis. It has a male predominance and is inclined to be associated with NF-2, and those that are associated with higher pathologic subtypes and NF-2 have more unfavorable outcome. Every effort should be made to achieve total removal which may decrease the incidence of recurrence.

  9. Morbidity in survivors of child and adolescent meningioma

    PubMed Central

    Kotecha, Rishi S; Jacoby, Peter; Cole, Catherine H; Gottardo, Nicholas G

    2013-01-01

    Background The extent of initial surgical resection has been identified as the strongest prognostic indicator for survival in child and adolescent meningioma. Given the paucity of data concerning long-term outcome, the authors undertook a meta-analysis to analyze morbidity in survivors of this disease. Methods Individual patient data were obtained from 19 case series published over the last 23 years through direct communication with the authors. Ordinal logistic regression models were used to assess the influence of risk factors on morbidity. Results Of 261 patients, 48% reported a completely normal life with no morbidity, and 25% had moderate/severe meningioma-associated morbidity at last follow-up. Multivariate analysis identified relapse as the only independent variable associated with an increased risk of morbidity (odds ratio, 4.02; 95% confidence interval, 2.11-7.65; P ≤ .001). Univariate analysis also revealed an increased risk for patients with neurofibromatosis (odds ratio, 1.90; 95% confidence interval, 1.04-3.48; P = .04). Subgroup analysis identified a higher incidence of morbidity among patients who had intracranial tumors with a skull base location compared with a nonskull base location (P ≤ .001). Timing at which morbidity occurred was available for 70 patients, with persistence of preoperative tumor-related symptoms in 67% and as a result of therapy in 20%. Conclusions The majority of survivors of child and adolescent meningioma had no or only mild long-term morbidity, whereas 25% had moderate/severe morbidity, with a significantly increased risk in patients with relapsed disease. In the majority, morbidity occurred as a consequence of the tumor itself, justifying aggressive surgery to achieve gross total resection. However, for patients with neurofibromatosis and skull base meningioma, a more cautious surgical approach should be reserved. PMID:24052192

  10. SPECT and PET Imaging of Meningiomas

    PubMed Central

    Valotassiou, Varvara; Leondi, Anastasia; Angelidis, George; Psimadas, Dimitrios; Georgoulias, Panagiotis

    2012-01-01

    Meningiomas arise from the meningothelial cells of the arachnoid membranes. They are the most common primary intracranial neoplasms and represent about 20% of all intracranial tumors. They are usually diagnosed after the third decade of life and they are more frequent in women than in men. According to the World Health Organization (WHO) criteria, meningiomas can be classified into grade I meningiomas, which are benign, grade II (atypical) and grade III (anaplastic) meningiomas, which have a much more aggressive clinical behaviour. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are routinely used in the diagnostic workup of patients with meningiomas. Molecular Nuclear Medicine Imaging with Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) could provide complementary information to CT and MRI. Various SPECT and PET tracers may provide information about cellular processes and biological characteristics of meningiomas. Therefore, SPECT and PET imaging could be used for the preoperative noninvasive diagnosis and differential diagnosis of meningiomas, prediction of tumor grade and tumor recurrence, response to treatment, target volume delineation for radiation therapy planning, and distinction between residual or recurrent tumour from scar tissue. PMID:22623896

  11. SPECT and PET imaging of meningiomas.

    PubMed

    Valotassiou, Varvara; Leondi, Anastasia; Angelidis, George; Psimadas, Dimitrios; Georgoulias, Panagiotis

    2012-01-01

    Meningiomas arise from the meningothelial cells of the arachnoid membranes. They are the most common primary intracranial neoplasms and represent about 20% of all intracranial tumors. They are usually diagnosed after the third decade of life and they are more frequent in women than in men. According to the World Health Organization (WHO) criteria, meningiomas can be classified into grade I meningiomas, which are benign, grade II (atypical) and grade III (anaplastic) meningiomas, which have a much more aggressive clinical behaviour. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are routinely used in the diagnostic workup of patients with meningiomas. Molecular Nuclear Medicine Imaging with Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) could provide complementary information to CT and MRI. Various SPECT and PET tracers may provide information about cellular processes and biological characteristics of meningiomas. Therefore, SPECT and PET imaging could be used for the preoperative noninvasive diagnosis and differential diagnosis of meningiomas, prediction of tumor grade and tumor recurrence, response to treatment, target volume delineation for radiation therapy planning, and distinction between residual or recurrent tumour from scar tissue.

  12. Meningiomas of the cerebellopontine angle.

    PubMed

    Matthies, C; Carvalho, G; Tatagiba, M; Lima, M; Samii, M

    1996-01-01

    Meningiomas of the cerebellopontine angle (CPA) represent a clinically and surgically interesting entity. The opportunity of complete surgical excision and the incidence of impairment of nerval structures largely depend on the tumour biology that either leads to displacement of surrounding structures by an expansive type of growth or to an enveloping of nerval and vascular structures by an en plaque type of growth. As the origin and the direction of growth are very variable, the exact tumour extension in relation to the nerval structures and the tumour origin can be identified sometimes only at the time of surgery. Out of a series of 230 meningiomas of the posterior skull base operated between 1978 and 1993, data of 134 meningiomas involving the cerebellopontine angle are presented. There were 20% male and 80% female patients, age at the time of surgery ranging from 18 to 76 years, on the average 51 years. The clinical presentation was characterized by a predominant disturbance of the cranial nerves V (19%), VII (11%), VIII (67%) and the caudal cranial nerves (6%) and signs of ataxia (28%). 80% of the meningiomas were larger than 30 mm in diameter, 53% led to evident brainstem compression or dislocation and 85% extended anteriorly to the internal auditory canal. Using the lateral suboccipital approach in the majority of cases and a combined presigmoidal or combined suboccipital and subtemporal approaches in either sequence in 5%, complete tumour removal (Simpson I and II) was accomplished in 95% and subtotal tumour removal in 5%. Histologically the meningiotheliomatous type was most common (49%) followed by the mixed type (19%), fibroblastic (16%), psammomatous (7%), hemangioblastic (7%) and anaplastic (2%) types. Major post-operative complications were CSF leakage (8%) requiring surgical revision in 2% and hemorrhage (3%) requiring revision in 2%. While the majority of neurological disturbances showed signs of recovery, facial nerve paresis or paralysis was

  13. The gain and loss of long noncoding RNA associated-competing endogenous RNAs in prostate cancer

    PubMed Central

    Wang, Shuyuan; Dai, Enyu; Jiang, Leiming; Wang, Jing; Yang, Qian; Yang, Feng; Zhou, Shunheng; Jiang, Wei

    2016-01-01

    Prostate cancer (PC) is one of the most common solid tumors in men. However, the molecular mechanism of PC remains unclear. Numerous studies have demonstrated that long noncoding RNA (lncRNA) can act as microRNA (miRNA) sponge, one type of competing endogenous RNAs (ceRNAs), which offers a novel viewpoint to elucidate the mechanisms of PC. Here, we proposed an integrative systems biology approach to infer the gain and loss of ceRNAs in PC. First, we re-annotated exon microarray data to obtain lncRNA expression profiles of PC. Second, by integrating mRNA and miRNA expression, as well as miRNA targets, we constructed lncRNA-miRNA-mRNA ceRNA networks in cancer and normal samples. The lncRNAs in these two ceRNA networks tended to have a longer transcript length and cover more exons than the lncRNAs not involved in ceRNA networks. Next, we further extracted the gain and loss ceRNA networks in PC. We found that the gain ceRNAs in PC participated in cell cycle, and the loss ceRNAs in PC were associated with metabolism. We also identified potential prognostic ceRNA pairs such as MALAT1-EGR2 and MEG3-AQP3. Finally, we inferred a novel mechanism of known drugs, such as cisplatin, for the treatment of PC through gain and loss ceRNA networks. The potential drugs such as 1,2,6-tri-O-galloyl-beta-D-glucopyranose (TGGP) could modulate lncRNA-mRNA competing relationships, which may uncover new strategy for treating PC. In summary, we systematically investigated the gain and loss of ceRNAs in PC, which may prove useful for identifying potential biomarkers and therapeutics for PC. PMID:27528026

  14. Postpartum Regression of a Presumed Cavernous Meningioma

    PubMed Central

    Phang, See Yung; Whitfield, Peter

    2016-01-01

    Meningiomas are known to be more common in females than males. They are also known in rare cases to grow in size during pregnancy, which can complicate its management. We describe a 31-year-old Caucasian woman who presented with blurring of her vision and diplopia during the third trimester of her pregnancy. Magnetic resonance imaging (MRI) showed a small left cavernous sinus meningioma. The patient was treated conservatively until her uncomplicated delivery. A postpartum MRI scan showed complete regression of the suspected meningioma. Currently the patient is contemplating a further pregnancy. PMID:27066285

  15. Frontal cutaneous meningioma--Case report.

    PubMed

    Ramos, Leonor; Coutinho, Ines; Cardoso, José Carlos; Garcia, Helena; Cordeiro, Margarida Robalo

    2015-01-01

    Cutaneous meningiomas are rare tumors most commonly located on the scalp. We report the case of a 55-year-old male who presented with a 2 x 3 cm tumoral lesion on the forehead. The lesion was hard, adherent and covered by normal skin. Incisional biopsy revealed a proliferation of monomorphic round cells, organized in nests and focally forming pseudovascular spaces. Immunohistochemical study revealed positivity for epithelial antigen membrane and vimentin. Vascular markers, cytokeratins and S100 protein were negative. A brain CT scan did not show any evidence of intracranial meningioma. The authors describe the case of a cutaneous frontal meningioma in probable relation with previous cranioencephalic trauma.

  16. Meningioma with metastasis from follicular carcinoma thyroid.

    PubMed

    Chaturvedi, Sujata; Gupta, Sanjeev; Kumari, Rima

    2010-01-01

    A 45-year-old female presented with loss of vision in the left eye, numbness on left half of face and left-sided hemicrania for two months. On the basis of radiological investigations, provisional diagnosis of basal meningioma was made. Tissue sent for histopathological evaluation revealed a dual tumor-meningioma with metastasis from follicular carcinoma, thyroid. To the best of authors' knowledge, this is the first report of a tumor metastasizing to another tumor, where a follicular carcinoma thyroid metastasized to meningioma.

  17. Is weight gain associated with the incidence of periodontitis? A systematic review and meta-analysis.

    PubMed

    Nascimento, Gustavo G; Leite, Fábio R M; Do, Loc G; Peres, Karen G; Correa, Marcos B; Demarco, Flávio F; Peres, Marco A

    2015-06-01

    This study aimed to conduct a systematic review assessing the effects of weight gain on the incidence of periodontitis in adults. Electronic searches in four databases were performed up to and including February 2015. Only prospective longitudinal studies assessing the association between weight gain and the incidence of periodontitis in adults were eligible to be included in this study. All studies should state a clear description of nutritional status (Body Mass Index; Waist Circumference) as well as the case definition of periodontitis. Pooled relative risks (RR) for becoming overweight and obese on the incidence of periodontitis were estimated by meta-analysis. Quality was assessed with the Newcastle-Ottawa scale for cohort studies. Five articles were included in this review and meta-analysis with 42,198 subjects enrolled. Subjects who became overweight and obese presented higher risk to develop new cases of periodontitis (RR 1.13; 95%CI 1.06-1.20 and RR 1.33 95%CI 1.21-1.47 respectively) compared with counterparts who stayed in normal weight. A clear positive association between weight gain and new cases of periodontitis was found. However, these results are originated from limited evidence. Thus, more studies with longitudinal prospective design are needed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Investigation of molecular serum profiles associated with predisposition to antipsychotic-induced weight gain.

    PubMed

    Schwarz, Emanuel; Steiner, Johann; Guest, Paul C; Bogerts, Bernhard; Bahn, Sabine

    2015-01-01

    Metabolic disturbances are major adverse side effects in the treatment of schizophrenia patients with antipsychotics. A substantial proportion of patients discontinue treatment with second-generation antipsychotics due to weight gain. The objective of this study was to investigate molecular factors predisposing patients to the development of such metabolic disturbances. We investigated whether serum molecules measured before treatment initiation were associated with subsequent weight gain following a 6-week treatment with antipsychotics. The concentrations of 191 molecules were measured longitudinally in serum from 77 schizophrenia patients using multiplex immunoassays. This showed that the levels of 10 serum molecules at T0 were significantly associated with ΔBMI, which included interleukin-6 receptor, epidermal growth factor and thyroid stimulating hormone. Our results suggest that patients who experience antipsychotic-induced weight gain have specific molecular alterations already prior to treatment. Further studies are required to validate and evaluate current findings in the context of response and side-effect development. This may ultimately lead to molecular tests that can aid in the selection of antipsychotic treatments.

  19. Pharmacogenetic Associations of Antipsychotic Drug-Related Weight Gain: A Systematic Review and Meta-analysis.

    PubMed

    Zhang, Jian-Ping; Lencz, Todd; Zhang, Ryan X; Nitta, Masahiro; Maayan, Lawrence; John, Majnu; Robinson, Delbert G; Fleischhacker, W Wolfgang; Kahn, Rene S; Ophoff, Roel A; Kane, John M; Malhotra, Anil K; Correll, Christoph U

    2016-11-01

    Although weight gain is a serious but variable adverse effect of antipsychotics that has genetic underpinnings, a comprehensive meta-analysis of pharmacogenetics of antipsychotic-related weight gain is missing. In this review, random effects meta-analyses were conducted for dominant and recessive models on associations of specific single nucleotide polymorphisms (SNP) with prospectively assessed antipsychotic-related weight or body mass index (BMI) changes (primary outcome), or categorical increases in weight or BMI (≥7%; secondary outcome). Published studies, identified via systematic database search (last search: December 31, 2014), plus 3 additional cohorts, including 222 antipsychotic-naïve youth, and 81 and 141 first-episode schizophrenia adults, each with patient-level data at 3 or 4 months treatment, were meta-analyzed. Altogether, 72 articles reporting on 46 non-duplicated samples (n = 6700, mean follow-up = 25.1wk) with 38 SNPs from 20 genes/genomic regions were meta-analyzed (for each meta-analysis, studies = 2-20, n = 81-2082). Eleven SNPs from 8 genes were significantly associated with weight or BMI change, and 4 SNPs from 2 genes were significantly associated with categorical weight or BMI increase. Combined, 13 SNPs from 9 genes (Adrenoceptor Alpha-2A [ADRA2A], Adrenoceptor Beta 3 [ADRB3], Brain-Derived Neurotrophic Factor [BDNF], Dopamine Receptor D2 [DRD2], Guanine Nucleotide Binding Protein [GNB3], 5-Hydroxytryptamine (Serotonin) Receptor 2C [HTR2C], Insulin-induced gene 2 [INSIG2], Melanocortin-4 Receptor [MC4R], and Synaptosomal-associated protein, 25kDa [SNAP25]) were significantly associated with antipsychotic-related weight gain (P-values < .05-.001). SNPs in ADRA2A, DRD2, HTR2C, and MC4R had the largest effect sizes (Hedges' g's = 0.30-0.80, ORs = 1.47-1.96). Less prior antipsychotic exposure (pediatric or first episode patients) and short follow-up (1-2 mo) were associated with larger effect sizes. Individual antipsychotics did not

  20. Phase II study of monthly pasireotide LAR (SOM230C) for recurrent or progressive meningioma

    PubMed Central

    Norden, Andrew D.; Ligon, Keith L.; Hammond, Samantha N.; Muzikansky, Alona; Reardon, David A.; Kaley, Thomas J.; Batchelor, Tracy T.; Plotkin, Scott R.; Raizer, Jeffrey J.; Wong, Eric T.; Drappatz, Jan; Lesser, Glenn J.; Haidar, Sam; Beroukhim, Rameen; Lee, Eudocia Q.; Doherty, Lisa; Lafrankie, Debra; Gaffey, Sarah C.; Gerard, Mary; Smith, Katrina H.; McCluskey, Christine; Phuphanich, Surasak

    2015-01-01

    Objective: A subset of meningiomas recur after surgery and radiation therapy, but no medical therapy for recurrent meningioma has proven effective. Methods: Pasireotide LAR is a long-acting somatostatin analog that may inhibit meningioma growth. This was a phase II trial in patients with histologically confirmed recurrent or progressive meningioma designed to evaluate whether pasireotide LAR prolongs progression-free survival at 6 months (PFS6). Patients were stratified by histology (atypical [World Health Organization grade 2] and malignant [grade 3] meningiomas in cohort A and benign [grade 3] in cohort B). Results: Eighteen patients were accrued in cohort A and 16 in cohort B. Cohort A had median age 59 years, median Karnofsky performance status 80, 17 (94%) had previous radiation therapy, and 11 (61%) showed high octreotide uptake. Cohort B had median age 52 years, median Karnofsky performance status 90, 11 (69%) had previous radiation therapy, and 12 (75%) showed high octreotide uptake. There were no radiographic responses to pasireotide LAR therapy in either cohort. Twelve patients (67%) in cohort A and 13 (81%) in cohort B achieved stable disease. In cohort A, PFS6 was 17% and median PFS 15 weeks (95% confidence interval: 8–20). In cohort B, PFS6 was 50% and median PFS 26 weeks (12–43). Treatment was well tolerated. Octreotide uptake and insulin-like growth factor–1 levels did not predict outcome. Expression of somatostatin receptor 3 predicted favorable PFS and overall survival. Conclusions: Pasireotide LAR has limited activity in recurrent meningiomas. The finding that somatostatin receptor 3 is associated with favorable outcomes warrants further investigation. Classification of evidence: This study provides Class IV evidence that in patients with recurrent or progressive meningioma, pasireotide LAR does not significantly increase the proportion of patients with PFS at 6 months. PMID:25527270

  1. Relationships between tumor microenvironment and clinicopathological parameters in meningioma

    PubMed Central

    Ding, Yuanyuan; Qiu, Lin; Xu, Qian; Song, Lixue; Yang, Sufang; Yang, Tao

    2014-01-01

    Objective: To evaluate the relationship between the subtype of cells/cellular constituents (the density of T lymphocyte subsets, B lymphocyte, macrophages, and FOXP3 positive cells in 93 patients with meningioma, WHO grades I and II) in the tumor microenvironment and clinicopathological parameters (gender, age, tumor location, size, recurrence and pathological type) of meningioma. Methods: Immunohistochemical demonstrations of CD20 and CD4 lymphocytes, CD68, and FOXP3 expression were performed. In order to assess the densities of CD4, CD20, CD68 and FOXP3 positive cells in 93 meningioma patients, the results were derived from independent reviews by two pathologists. Chi-square test was used for independent samples. Results: There were no relationships between the CD4+, CD68+ cell subsets and patients’ age, sex, tumor size, grade and the recurrence of tumor. However, patients with recurrence had a significantly higher density of CD20+ B cells compared to patients with no recurrence (P = 0.003). For the Foxp3+ cell subset, results showed us that more female patients had high density of Foxp3+ cells compared with male patients, while the opposite results were observed in the low density group (P = 0.009). Furthermore, the density of Foxp3+ cells was significantly correlated with the tumor size (P = 0.004) and the pathological types (P = 0.004). Conclusion: Results in this study demonstrate that higher CD20+ B cell density in the tumor is associated with lower tumor recurrence and the density of Foxp3+ cells is significantly correlated with the patients’ sex, tumor size and the pathological types. The results also suggest that understanding of the cellular constituents of tumors and the tumor microenvironment may help investigate the tumor pathogenesis and immunotherapies in meningioma. PMID:25400783

  2. Foramen magnum meningioma: The midline suboccipital subtonsillar approach.

    PubMed

    Dobrowolski, S; Ebner, F; Lepski, G; Tatagiba, M

    2016-06-01

    Foramen magnum meningiomas (FMMs) represent a technical challenge even for experienced neurosurgeons, because they grow in close contact with osteoarticular, nervous, and vascular structures that cannot be sacrificed or retracted during surgery. Our goal is to present our experience with 24 cases of surgically resected foramen magnum meningiomas used the midline suboccipital subtonsillar approach and discussed the present risks associated with the treatment of this condition. We retrospectively reviewed all patients who underwent surgery treatment for foramen magnum meningiomas operated on between August 2005 and July 2013. A total of 24 cases were included. Data regarding age, sex, symptoms and sign types, locations, surgical aspects, postoperative new deficits, and follow-up are presented. There were 18 female and 6 male patients (mean age: 52 years). The symptom among most patients (14 patients) was cervico-occipital pain, dysphagia and gait unsteadiness in five, and paresthesia of the upper limbs in four. Total removal of the tumor was achieved in 20 patients, subtotal in two, and partial resection in four patients. Two patients had permanent deficits. Follow-up was 45.6 months (range, 6 months to 8 years), there was no recurrence among tumors totally removed but 1 patient of regrowth among the cases with subtotal removal. Our experience confirmed that the midline suboccipital subtonsillar approach was accurate in safely removing anterior, anterolateral, and posterior FMMs. There was no significant postoperative complication in the remainder of the patientes, and their conditions improved after surgery. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Associations between Anxiety, Depression, Antidepressant Medication, Obesity and Weight Gain among Canadian Women

    PubMed Central

    Grundy, Anne; Cotterchio, Michelle; Kirsh, Victoria A.; Kreiger, Nancy

    2014-01-01

    Purpose Some mental illnesses have been suggested to be associated with obesity, although results are somewhat inconsistent and research has focused mainly on depression. Methods Associations between anxiety, depression, medications for these illnesses, and obesity were investigated cross-sectionally among women aged 25–74 (n = 3004) who participated as population controls in a cancer case-control study. Participants self-reported information on anxiety, depression, height, current weight and weight at age 25. Results No association was observed between either anxiety or depression and either current overweight or obesity status. However, depressed women taking antidepressants were more likely to be obese [OR = 1.71 (95%CI  =  1.16–2.52) daily antidepressant use; OR = 1.89 (95%CI = 1.21–2.96) ever tricyclic antidepressant use]. In the full study sample consistent positive associations between anxiety, depression and obesity among women with a history of antidepressant use, and generally negative associations among women without, were suggested. Finally, weight gain was associated with history of anxiety [5–19 kg OR = 1.29 (95% CI = 1.06–1.57); ≥20 kg OR = 1.43 (95% CI = 1.08–1.88)] and depression [≥20 kg OR = 1.28 (95% CI = 0.99–1.65)]. Conclusions These results suggest depression and anxiety may be associated with weight gain and antidepressant use may be associated with obesity. PMID:24932472

  4. Adoption of American Heart Association 2020 ideal healthy diet recommendations prevents weight gain in young adults.

    PubMed

    Forget, Geneviève; Doyon, Myriam; Lacerte, Guillaume; Labonté, Mélissa; Brown, Christine; Carpentier, André C; Langlois, Marie-France; Hivert, Marie-France

    2013-11-01

    In 2010, the American Heart Association established the concept of ideal cardiovascular health. Nationally representative data estimated that <1% of Americans meet the seven health metrics required for achieving ideal cardiovascular health, with the main challenge residing in meeting the criteria for an ideal Healthy Diet Score. In a cohort of young adults (N=196), we aimed to investigate the prevalence of ideal cardiovascular health and ideal Healthy Diet Score and its association to weight gain over a 4-year follow-up period. Anthropometric measures, blood pressure, and blood samples were taken according to standardized procedures. Dietary intake was measured by a 3-day food diary and verified by a registered dietitian. We observed that only 0.5% of our sample met the criteria for ideal cardiovascular health and only 4.1% met the criteria for an ideal Healthy Diet Score. The components of the Healthy Diet Score with the lowest observance were consumption of fruits and vegetables (9.7%) and whole grains (14.8%). Meeting zero or one out of five of the Healthy Diet Score components was associated with increased risk of weight gain over 4 years compared with meeting at least two components (P=0.03). With the exception of dietary criteria, prevalence was high for achieving ideal levels of the remaining six cardiovascular health metrics. In conclusion, in this sample of young adults, a very low prevalence of ideal overall cardiovascular health was observed, mainly driven by poor dietary habits, and a poor Healthy Diet Score was associated with increased weight gain.

  5. TOX and ADIPOQ Gene Polymorphisms Are Associated with Antipsychotic-Induced Weight Gain in Han Chinese

    PubMed Central

    Li, Shen; Xu, Chengai; Tian, Yuan; Wang, Xueshi; Jiang, Rui; Zhang, Miaomiao; Wang, Lili; Yang, Guifu; Gao, Ying; Song, Chenyu; He, Yukun; Zhang, Ying; Li, Jie; Li, Wei-Dong

    2017-01-01

    To find the genetic markers related to the antipsychotic-induced weight gain (AIWG), we analyzed associations among candidate gene single-nucleotide polymorphisms (SNPs) and quantitative traits of weight changes and lipid profiles in a Chinese Han population. A total of 339 schizophrenic patients, including 86 first-episode patients (FEPs), meeting the entry criteria were collected. All patients received atypical antipsychotic drug monotherapy and hospitalization and were followed for 12 weeks. Forty-three SNPs in 23 candidate genes were calculated for quantitative genetic association with AIWG, performed by PLINK. The TOX gene SNP rs11777927 (P = 0.009) and the ADIPOQ gene SNP rs182052 (P = 0.019) were associated with AIWG (in body mass index, BMI). In addition, the BDNF SNP rs6265 (P = 0.002), BDAF SNP rs11030104 SNP (P = 0.001), and ADIPOQ SNPs rs822396 (P = 0.003) were significantly associated with the change of waist-to-hip ratio (WHR) induced by atypical antipsychotics. These results were still significant after age and gender adjustments. These findings provide preliminary evidence supporting the role of TOX, ADIPOQ and BDNF in weight and WHR gain induced by atypical antipsychotics. PMID:28327672

  6. MITOTIC INDEX IS AN INDEPENDENT PREDICTOR OF RECURRENCE-FREE SURVIVAL IN MENINGIOMA

    PubMed Central

    Olar, Adriana; Wani, Khalida M; Sulman, Erik P; Mansouri, Alireza; Zadeh, Gelareh; Wilson, Charmaine D; DeMonte, Franco; Fuller, Gregory N; Aldape, Kenneth D

    2014-01-01

    While World Health Organization (WHO) grading of meningioma stratifies patients according to recurrence risk overall, there is substantial within-grade heterogeneity with respect to recurrence-free survival (RFS). Most meningiomas are graded according to mitotic counts per unit area on H&E sections, a method potentially confounded by tumor cellularity, as well as potential limitations of accurate mitotic figure detection on routine histology. To refine mitotic figure assessment we evaluated 363 meningiomas with phospho-histoneH3(Ser10), and determined the mitotic index (number of mitoses per 1000 tumor cells). The median mitotic indices among WHO grades I (n=268), II (n=84), and III (n=11) tumors were 1, 4, and 12, Classification and regression tree analysis to categorize cutoffs identified 3 subgroups defined by mitotic indices of 0–2, 3–4, and ≥5, which on univariate analysis were associated with RFS (p<0.01). In multivariate analysis, mitotic index subgrouped in this manner was significantly associated with RFS (p<0.01) after adjustment for Simpson grade, WHO grade, and MIB-1 index. Mitotic index was then examined within individual WHO grade, showing that for grade I and II meningiomas, mitotic index can add additional information to RFS risk. The results suggest that the use of a robust mitotic marker in meningioma could refine risk stratification. PMID:25040885

  7. Molecular genetic approach to human meningioma: loss of genes on chromosome 22

    SciTech Connect

    Seizinger, B.R.; De La Monte, S.; Atkins, L.; Gusella, J.F.; Martuza, R.L.

    1987-08-01

    A molecular genetic approach employing polymorphic DNA markers has been used to investigate the role of chromosomal aberrations in meningioma, one of the most common tumors of the human nervous system. Comparison of the alleles detected by DNA markers in tumor DNA versus DNA from normal tissue revealed chromosomal alterations present in primary surgical specimens. In agreement with cytogenetic studies of cultured meningiomas, the most frequent alteration detected was loss of heterozygosity on chromosome 22. Forty of 51 patients were constitutionally heterozygous for at least one chromosome 22 DNA marker. Seventeen of the 40 constitutionally heterozygotic patients (43%) displayed hemizygosity for the corresponding marker in their meningioma tumor tissues. Loss of heterozygosity was also detected at a significantly lower frequency for markers on several other autosomes. In view of the striking association between acoustic neuroma and meningioma in bilateral acoustic neurofibromatosis and the discovery that acoustic neuromas display specific loss of genes on chromosome 22, the authors propose that a common mechanism involving chromosome 22 is operative in the development of both tumor types. Fine-structure mapping to reveal partial deletions in meningiomas may provide the means to clone and characterize a gene (or genes) of importance for tumorigenesis in this and possibly other clinically associated tumors of the human nervous system.

  8. Mitotic Index is an Independent Predictor of Recurrence-Free Survival in Meningioma.

    PubMed

    Olar, Adriana; Wani, Khalida M; Sulman, Erik P; Mansouri, Alireza; Zadeh, Gelareh; Wilson, Charmaine D; DeMonte, Franco; Fuller, Gregory N; Aldape, Kenneth D

    2015-05-01

    While World Health Organization (WHO) grading of meningioma stratifies patients according to recurrence risk overall, there is substantial within-grade heterogeneity with respect to recurrence-free survival (RFS). Most meningiomas are graded according to mitotic counts per unit area on hematoxylin and eosin sections, a method potentially confounded by tumor cellularity, as well as potential limitations of accurate mitotic figure detection on routine histology. To refine mitotic figure assessment, we evaluated 363 meningiomas with phospho-histone H3 (Ser10) and determined the mitotic index (number of mitoses per 1000 tumor cells). The median mitotic indices among WHO grade I (n = 268), grade II (n = 84) and grade III (n = 11) tumors were 1, 4 and 12. Classification and regression tree analysis to categorize cut-offs identified three subgroups defined by mitotic indices of 0-2, 3-4 and ≥5, which on univariate analysis were associated with RFS (P < 0.01). In multivariate analysis, mitotic index subgrouped in this manner was significantly associated with RFS (P < 0.01) after adjustment for Simpson grade, WHO grade and MIB-1 index. Mitotic index was then examined within individual WHO grade, showing that for grade I and grade II meningiomas, mitotic index can add additional information to RFS risk. The results suggest that the use of a robust mitotic marker in meningioma could refine risk stratification.

  9. Leptin serum concentrations are associated with weight gain during lithium augmentation.

    PubMed

    Ricken, Roland; Bopp, Sandra; Schlattmann, Peter; Himmerich, Hubertus; Bschor, Tom; Richter, Christoph; Stamm, Thomas J; Bauer, Frank; Heinz, Andreas; Hellweg, Rainer; Lang, Undine E; Adli, Mazda

    2016-09-01

    Meta-analytical data show lithium augmentation (LA) as an effective treatment strategy in major depression. Weight-gain is a common side effect of LA. The proteohormone leptin is discussed to be involved in the pathophysiology of weight gain induced by psychopharmacological treatment. The purpose of our study was to investigate the association of leptin and body mass index (BMI) during LA in a prospective cohort study. Leptin serum concentrations and body mass index (BMI) were measured in a total of 89 acute depressive patients before and then after four weeks of LA. In a linear mixed model analysis the following variables had a significant positive effect on BMI: time (equal with "treatment effect of LA"; F1.83=6.05; p=0.016) and leptin (F1.111=13.83; p=0.0003) as well as the covariates male gender (F1.89=5.08; p=0.027) and adiposity (F1.85=105.13; p<0.0001). If the reported effect of leptin on BMI is specific to LA remains unclear without a control group. Leptin signalling might be involved in lithium-induced weight-gain. Copyright © 2016. Published by Elsevier Ltd.

  10. Weight gain is associated with medial contact site of subthalamic stimulation in Parkinson's disease.

    PubMed

    Růžička, Filip; Jech, Robert; Nováková, Lucie; Urgošík, Dušan; Vymazal, Josef; Růžička, Evžen

    2012-01-01

    The aim of our study was to assess changes in body-weight in relation to active electrode contact position in the subthalamic nucleus. Regular body weight measurements were done in 20 patients with advanced Parkinson's disease within a period of 18 months after implantation. T1-weighted (1.5T) magnetic resonance images were used to determine electrode position in the subthalamic nucleus and the Unified Parkinson's disease rating scale (UPDRS-III) was used for motor assessment. The distance of the contacts from the wall of the third ventricle in the mediolateral direction inversely correlated with weight gain (r = -0.55, p<0.01) and with neurostimulation-related motor condition expressed as the contralateral hemi-body UPDRS-III (r = -0.42, p<0.01). Patients with at least one contact within 9.3 mm of the wall experienced significantly greater weight gain (9.4 ± (SD)4.4 kg, N = 11) than those with both contacts located laterally (3.9 ± 2.7 kg, N = 9) (p<0.001). The position of the active contact is critical not only for motor outcome but is also associated with weight gain, suggesting a regional effect of subthalamic stimulation on adjacent structures involved in the central regulation of energy balance, food intake or reward.

  11. Efficient surface plasmon amplification in gain-assisted silver nanotubes and associated dimers

    SciTech Connect

    Yu, HaiQun; Jiang, ShuMin; Wu, DaJian

    2015-04-21

    SPASER (surface plasmon amplification by stimulated emission of radiation) properties in active SiO{sub 2}–Ag nanotubes and associated dimers have been investigated by using the scattering theory and the finite element method. In the active Ag nanotube, as the gain coefficient of the core increases to a critical value, a super-resonance occurs. The SPASER phenomenon also can be found in the active Ag nanotube dimer. The strong couplings between two nanotubes lead to larger gain threshold for the active Ag nanotube dimer compared with the active Ag nanotube. At the super-resonance, the maximal surface enhanced Raman scattering factor at the “hot spot” in the active Ag nanotube dimer can achieve about 8 × 10{sup 18}, which is large enough for single molecule detection. Furthermore, with increasing the separation between two Ag nanotubes, the gain threshold value for the super-resonance of the active Ag nanotube dimer decreases, while the corresponding super-resonance wavelength increases first and then decreases.

  12. Bupropion treatment of olanzapine-associated weight gain: an open-label, prospective trial.

    PubMed

    Gadde, Kishore M; Zhang, Wei; Foust, Mariko S

    2006-08-01

    To examine the effectiveness of bupropion in reducing bodyweight gained during treatment with olanzapine. Eight subjects, who received olanzapine for an average duration of 26 months and had gained an average of 13.3 kg bodyweight, participated in a 24-week study in which they received open-label bupropion 150-300 mg/d while continuing olanzapine. The subjects were also provided low-key nutritional counseling. Change in bodyweight was the primary outcome of interest. Changes in fasting blood glucose and lipids were also examined in addition to changes in body composition and bone mineral density. Seven subjects completed the full 24-week study treatment. In the intent-to-treat sample, mean [SE] bodyweight decreased significantly over time (99.6 [5.9] kg to 96.2 [5.8] kg; F = 4.0; P < 0.001); average weight change for the eight subjects was -3.4 kg. Four of eight subjects lost > or =3% bodyweight. There was a significant reduction in total cholesterol. Weight loss did not have a negative effect on bone mineral density. Side effects were generally mild. Bupropion combined with a low-key dietary intervention appeared to be beneficial in reducing olanzapine-associated weight gain in some subjects in this open-label study.

  13. Spontaneous Regression of an Incidental Spinal Meningioma.

    PubMed

    Yilmaz, Ali; Kizilay, Zahir; Sair, Ahmet; Avcil, Mucahit; Ozkul, Ayca

    2016-03-15

    The regression of meningioma has been reported in literature before. In spite of the fact that the regression may be involved by hemorrhage, calcification or some drugs withdrawal, it is rarely observed spontaneously. We report a 17 year old man with a cervical meningioma which was incidentally detected. In his cervical MRI an extradural, cranio-caudal contrast enchanced lesion at C2-C3 levels of the cervical spinal cord was detected. Despite the slight compression towards the spinal cord, he had no symptoms and refused any kind of surgical approach. The meningioma was followed by control MRI and it spontaneously regressed within six months. There were no signs of hemorrhage or calcification. Although it is a rare condition, the clinicians should consider that meningiomas especially incidentally diagnosed may be regressed spontaneously.

  14. Meningioma with hemorrhagic onset: two case reports.

    PubMed

    Vij, Mukul; Jaiswal, Sushila; Jaiswal, Awadhesh Kumar; Kumar, Sheo; Behari, Sanjay

    2012-01-01

    Haemorrhage is a rare complication of meningiomas that can occur spontaneously, after embolization, stereotactic radiation and perioperatively. Our first case was a 16 year old male, admitted with spastic quadriparesis, and retention of urine. Magnetic Resonance Imaging (MRI) revealed anteriorly placed cervical intradural extramedullary mass. Patient underwent emergency surgery following sudden worsening of neurological symptoms and intratumoral bleed was noted peroperatively. Tumor was labeled as angiomatous meningioma with hemorrhage. The second case was of a 45 year female who presented with history of sudden onset weakness in right upper and lower limb followed by unconsciousness. MRI revealed heterogeneous lesion in left parasagittal area with intratumoral bleed. Left frontal craniotomy with tumour decompression was performed. Tumour was labelled as meningothelial meningioma with haemorrhage. Meningiomas with hemorrhagic onset remain rare, and pathophysiology is still incompletely understood. Prevention and outcome of intratumoral haemorrhage highly depends on early diagnosis and adequate treatment.

  15. Primary extracranial meningioma of the mandible.

    PubMed

    Mosqueda-Taylor, Adalberto; Domínguez-Malagon, Hugo; Cano-Valdez, Ana-Maria; Montiel-Hernandez, Ana-Maria

    2009-04-01

    Meningiomas are benign tumors of mesodermal origin that arise from arachnoid cell clusters that penetrate the dura to form arachnoid villi. These neoplasms represent one of the most common neoplasms developing within the central nervous system and are usually located at points of entry of vessels and nerves through the dura. Extracranial meningiomas (EM) comprise only 2% of all meningiomas, and only six cases of primary EM of the jawbones have been described to date. They may arise as an extension of intracranial meningiomas or as primary tumors and may be clinically indistinguishable from other benign tumours of the jaws, as they usually present as a well-delineated unencapsulated tumors. In this article a case of primary intramandibular primary EM that appeared as a well-defined osteolytic radiolucent lesion of the jaw is reported. The salient clinico-pathological features of this case is compared to those previously reported in the literature and differential diagnosis and therapeutic considerations are discussed.

  16. Gain of function in IKs secondary to a mutation in KCNE5 associated with atrial fibrillation

    PubMed Central

    Ravn, Lasse S.; Aizawa, Yoshiyasu; Pollevick, Guido D.; Hofman-Bang, Jacob; Cordeiro, Jonathan M.; Dixen, Ulrik; Jensen, Gorm; Wu, Yuesheng; Burashnikov, Elena; Haunso, Stig; Guerchicoff, Alejandra; Hu, Dan; Svendsen, Jesper H.; Christiansen, Michael; Antzelevitch, Charles

    2008-01-01

    BACKGROUND Atrial fibrillation (AF) is the most common clinical arrhythmia and a major cause of cardiovascular morbidity and mortality. Among the gene defects previously associated with AF is a gain of function of the slowly activating delayed rectifier potassium current IKs, secondary to mutations in KCNQ1. Coexpression of KCNE5, the gene encoding the MiRP4 β-subunit, has been shown to reduce IKs. OBJECTIVE The purpose of this study was to test the hypothesis that mutations in KCNE5 are associated with AF in a large cohort of patients with AF. METHODS One-hundred fifty-eight patients with AF were screened for mutations in the coding region of KCNE5. RESULTS A missense mutation involving substitution of a phenylalanine for leucine at position 65 (L65F) was identified in one patient. This patient did not have a history of familial AF, and neither KCNQ1 nor KCNE2 mutations were found. Transient transfection of Chinese hamster ovary (CHO) cells expressing IKs (KCNQ1+KCNE1) with KCNE5 suppressed the developing and tail currents of IKs in a concentration-dependent manner. Transient transfection with KCNE5-L65F failed to suppress IKs, yielding a current indistinguishable from that recorded in the absence of KCNE5. Developing currents recorded during a test pulse to +60 mV and tail currents recorded upon repolarization to -40 mV both showed a significant concentration-dependent gain of function in IKs with expression of KCNE5-L65F vs KCNE5-WT. CONCLUSION The results of this study suggest that a missense mutation in KCNE5 may be associated with nonfamilial or acquired forms of AF. The arrhythmogenic mechanism most likely is a gain of function of IKs. PMID:18313602

  17. Evaluation of potential power gain with imputed genotypes in genome-wide association studies.

    PubMed

    Becker, Tim; Flaquer, Antonia; Brockschmidt, Felix F; Herold, Christine; Steffens, Michael

    2009-01-01

    With the beginning of the era of genome-wide association studies methods to obtain 'in silico' genotypes have gained importance. In this context, an evaluation of genome-wide power levels of current marker panels and the power gain achievable with imputed genotypes are of high interest. Power for single-marker analysis of imputed genotypes is evaluated via a simulation study based on HapMap data. Power values for genome-wide significance of marker panels of 1,000,000 SNPs are considered for small effect sizes typical of common diseases and large case-control samples. In order to evaluate the performance of imputing, we consider a method that is conceptually related to previous approaches. We introduce various modifications which together lead to an alternative implementation of the imputation idea. In particular, a Monte-Carlo (MC) simulation method for association testing of imputed markers is introduced. We show that the incorporation of imputed genotypes can lead to a substantial power gain for common disease variants if the training sample is large enough. In addition, we show that the MC approach is valuable to for validating association results obtained with imputed genotypes. Our simulation study also shows that even denser marker panels than those currently available are needed when sample size is limited. We thus expect that full genome SNP panels will lead to the identification of additional disease variants in the future. Until then, it is desirable that large and ethnically matched training samples genotyped on dense marker panels are available in each country. (c) 2009 S. Karger AG, Basel.

  18. Elevation of liver enzyme levels during psychopharmacological treatment is associated with weight gain.

    PubMed

    Himmerich, Hubertus; Kaufmann, Christian; Schuld, Andreas; Pollmächer, Thomas

    2005-01-01

    Increased circulating levels of liver enzymes emerging during treatment with psychotropic drugs are frequently encountered and, in general, attributed to drug metabolism or toxic effects. Because obesity was shown to be associated with elevated liver enzyme levels in different non-psychiatric study samples, we hypothesized that drug-induced weight gain might be an additional causative factor. We tested this hypothesis in 67 inpatients who received psychopharmacological treatment across five weeks. Stepwise linear regression was used to predict changes in the serum levels of aspartate-amino transferase (ASAT) and alanine-amino transferase (ALAT) by changes in the body mass index (BMI), by changes in other biological parameters related to body weight (tumor necrosis factor-alpha [TNF-alpha], soluble TNF receptors [sTNF-R], interleukin-6 [IL-6], leptin plasma levels) and by the respective liver enzyme baseline level. BMI changes from baseline to endpoint were significantly associated with the changes in ALAT and ASAT levels across five weeks of treatment and with ALAT and ASAT levels at the end point of the study. The baseline levels of ALAT and ASAT also had a significant impact on these liver enzyme level changes, whereas all other variables had not. These results suggest that weight gain-associated metabolic changes occurring during treatment with psychotropic drugs have consistent and clinically relevant effects on the liver.

  19. Alterations to Melanocortinergic, GABAergic and Cannabinoid Neurotransmission Associated with Olanzapine-Induced Weight Gain

    PubMed Central

    Weston-Green, Katrina; Huang, Xu-Feng; Deng, Chao

    2012-01-01

    Background/Aim Second generation antipsychotics (SGAs) are used to treat schizophrenia but can cause serious metabolic side-effects, such as obesity and diabetes. This study examined the effects of low to high doses of olanzapine on appetite/metabolic regulatory signals in the hypothalamus and brainstem to elucidate the mechanisms underlying olanzapine-induced obesity. Methodology/Results Levels of pro-opiomelanocortin (POMC), neuropeptide Y (NPY) and glutamic acid decarboxylase (GAD65, enzyme for GABA synthesis) mRNA expression, and cannabinoid CB1 receptor (CB1R) binding density (using [3H]SR-141716A) were examined in the arcuate nucleus (Arc) and dorsal vagal complex (DVC) of female Sprague Dawley rats following 0.25, 0.5, 1.0 or 2.0 mg/kg olanzapine or vehicle (3×/day, 14-days). Consistent with its weight gain liability, olanzapine significantly decreased anorexigenic POMC and increased orexigenic NPY mRNA expression in a dose-sensitive manner in the Arc. GAD65 mRNA expression increased and CB1R binding density decreased in the Arc and DVC. Alterations to neurotransmission signals in the brain significantly correlated with body weight and adiposity. The minimum dosage threshold required to induce weight gain in the rat was 0.5 mg/kg olanzapine. Conclusions Olanzapine-induced weight gain is associated with reduced appetite-inhibiting POMC and increased NPY. This study also supports a role for the CB1R and GABA in the mechanisms underlying weight gain side-effects, possibly by altering POMC transmission. Metabolic dysfunction can be modelled in the female rat using low, clinically-comparable olanzapine doses when administered in-line with the half-life of the drug. PMID:22438946

  20. Anthropometric measures, physical activity and risk of glioma and meningioma in a large prospective cohort study

    PubMed Central

    Michaud, Dominique S.; Bové, Gerald; Gallo, Valentina; Schlehofer, Brigitte; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Dahm, Christina C.; Teucher, Brigit; Boeing, Heiner; Steffen, Annika; Trichopoulou, Antonia; Bamia, Christina; Kyrozis, Andreas; Sacerdote, Carlotta; Agnoli, Claudia; Palli, Domenico; Tumino, Rosario; Mattiello, Amalia; Bueno-de-Mesquita, H. Bas; Peeters, Petra H. M.; May, Anne M.; Barricarte, Aurelio; Chirlaque, Maria-Dolores; Dorronsoro, Miren; Sánchez, Maria José; Rodríguez, Laudina; Duell, Eric J; Hallmans, Göran; Melin, Beatrice S.; Manjer, Jonas; Borgquist, Signe; Khaw, Kay-Tee; Wareham, Nick; Allen, Naomi E.; Travis, Ruth C.; Romieu, Isabelle; Vineis, Paolo; Riboli, Elio

    2011-01-01

    Body fatness has been associated with increased risk of a number of hormone-dependent cancers. Recent studies suggest that body mass index may be related to meningiomas, which are more common in women than men, and for which estrogens are believed to play a role. Using data from a large European propective cohort, 203 incident cases of meningioma and 340 cases of glioma were included in the analysis for measures of body fat, height, and physical activity among 380,775 participants. All analyses were conducted using Cox proportional hazards model and controlling for age, sex, country and education. A 71% increase in risk of meningioma was observed among men and women in the top quartile of waist circumference (HR = 1.71, 95% CI = 1.08–2.73, p-trend=0.01). A positive association was also observed for body mass index and meningioma (HR = 1.48, 95% CI = 0.98–2.23, for BMI ≥30 compared with a BMI of 20–24.9, p trend=0.05). An association with height and meningioma was also suggestive (HR = 1.24, 95% 0.96–1.51, for each 10cm increase). In contrast, no associations were observed for height and different measures of body fat and risk of glioma. Physical activity was not related to either type of brain tumors. Results from this study support an increase in risk of meningioma with higher body fatness among both men and women. No association was observed between anthropometric measures and risk of glioma. PMID:21685234

  1. [Double spinal cord compression by dorsal meningioma and Paget's disease of a vertebra. A propos of 2 cases treated surgically].

    PubMed

    Rousseaux, P; Lerais, J M; Scherpereel, B; Bernard, M H; Pluot, M

    1982-01-01

    A spinal cord compression due to intradural meningioma appeared in two patients with vertebral X-Rays lesions of foreknown Paget's disease. These lesions were located at the same level that the meningioma in the second case and three vertebra below the meningioma in the first case. In both cases, it took one year between the first clinical symptoms and the surgical decision. We truly think the Paget's disease and its X-Rays vertebral lesions to be responsible for the waist of time in myelography and surgical schedule. No other case of meningioma associated with Paget's disease has been found through literature. Because the treatment of Paget's disease paraplegia is now mostly medical, we thought important to report our experience in order to avoid other delays in this unusual diagnosis.

  2. Association between Maternal Fish Consumption and Gestational Weight Gain: Influence of Molecular Genetic Predisposition to Obesity

    PubMed Central

    Larsen, Sofus C.; Ängquist, Lars; Laurin, Charles; Morgen, Camilla S.; Jakobsen, Marianne U.; Paternoster, Lavinia; Smith, George Davey; Olsen, Sjurdur F.; Sørensen, Thorkild I. A.; Nohr, Ellen A.

    2016-01-01

    Background Studies suggest that fish consumption can restrict weight gain. However, little is known about how fish consumption affects gestational weight gain (GWG), and whether this relationship depends on genetic makeup. Objective To examine the association between fish consumption and GWG, and whether this relationship is dependent on molecular genetic predisposition to obesity. Design A nested case-cohort study based on the Danish National Birth Cohort (DNBC) sampling the most obese women (n = 990) and a random sample of the remaining participants (n = 1,128). Replication of statistically significant findings was attempted in the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 4,841). We included 32 body mass index (BMI) associated single nucleotide polymorphisms (SNPs) and 5 SNPs found associated with GWG. BMI associated SNPs were combined in a genetic risk score (GRS). Associations between consumption of fish, GRS or individual variants and GWG were analysed, and interactions between fish and the GRS or individual variants were examined. Results In the DNBC, each portion/week (150 g) of fatty fish was associated with a higher GWG of 0.58 kg (95% CI: 0.16, 0.99, P<0.01). For total fish and lean fish, similar patterns were observed, but these associations were not statistically significant. We found no association between GRS and GWG, and no interactions between GRS and dietary fish on GWG. However, we found an interaction between the PPARG Pro12Ala variant and dietary fish. Each additional Pro12Ala G-allele was associated with a GWG of -0.83 kg (95% CI: -1.29, -0.37, P<0.01) per portion/week of dietary fish, with the same pattern for both lean and fatty fish. In ALSPAC, we were unable to replicate these findings. Conclusion We found no consistent evidence of association between fish consumption and GWG, and our results indicate that the association between dietary fish and GWG has little or no dependency on GRS or individual SNPs. PMID:26930408

  3. Association between Maternal Fish Consumption and Gestational Weight Gain: Influence of Molecular Genetic Predisposition to Obesity.

    PubMed

    Larsen, Sofus C; Ängquist, Lars; Laurin, Charles; Morgen, Camilla S; Jakobsen, Marianne U; Paternoster, Lavinia; Smith, George Davey; Olsen, Sjurdur F; Sørensen, Thorkild I A; Nohr, Ellen A

    2016-01-01

    Studies suggest that fish consumption can restrict weight gain. However, little is known about how fish consumption affects gestational weight gain (GWG), and whether this relationship depends on genetic makeup. To examine the association between fish consumption and GWG, and whether this relationship is dependent on molecular genetic predisposition to obesity. A nested case-cohort study based on the Danish National Birth Cohort (DNBC) sampling the most obese women (n = 990) and a random sample of the remaining participants (n = 1,128). Replication of statistically significant findings was attempted in the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 4,841). We included 32 body mass index (BMI) associated single nucleotide polymorphisms (SNPs) and 5 SNPs found associated with GWG. BMI associated SNPs were combined in a genetic risk score (GRS). Associations between consumption of fish, GRS or individual variants and GWG were analysed, and interactions between fish and the GRS or individual variants were examined. In the DNBC, each portion/week (150 g) of fatty fish was associated with a higher GWG of 0.58 kg (95% CI: 0.16, 0.99, P<0.01). For total fish and lean fish, similar patterns were observed, but these associations were not statistically significant. We found no association between GRS and GWG, and no interactions between GRS and dietary fish on GWG. However, we found an interaction between the PPARG Pro12Ala variant and dietary fish. Each additional Pro12Ala G-allele was associated with a GWG of -0.83 kg (95% CI: -1.29, -0.37, P<0.01) per portion/week of dietary fish, with the same pattern for both lean and fatty fish. In ALSPAC, we were unable to replicate these findings. We found no consistent evidence of association between fish consumption and GWG, and our results indicate that the association between dietary fish and GWG has little or no dependency on GRS or individual SNPs.

  4. Atypical Growth Pattern of an Intraparenchymal Meningioma

    PubMed Central

    Chen, Xiaoxi

    2016-01-01

    Meningiomas are the most common primary nonneuroglial extra-axial neoplasms, which commonly present as spherical or oval masses with a dural attachment. Meningiomas without dural attachment are rare and, according to their locations, are classified into 5 varieties, including intraventricular, deep Sylvain fissure, pineal region, intraparenchymal, or subcortical meningiomas. To the best of our knowledge, intraparenchymal meningioma with cerebriform pattern has never been reported. In this paper, we report a 34-year-old Chinese male patient who presented with paroxysmal headaches and progressive loss of vision for 10 months and blindness for 2 weeks. A thorough physical examination revealed loss of bilateral direct and indirect light reflex. No other relevant medical history and neurologic deficits were noted. Computed tomography and magnetic resonance imaging scans showed an irregular mass with a unique cerebriform pattern and extensive peritumoral edema in the parietal-occipital-temporal region of the right cerebral hemisphere. The initial diagnosis was lymphoma. Intraoperatively, the tumor was completely buried in a sulcus in the parietal-occipital-temporal region without connecting to the dura. The histological diagnosis was intracranial meningioma based on pathological examination. Therefore, when an unusual cerebriform growth pattern of a tumor is encountered, an intraparenchymal meningioma should be considered as a differential diagnosis. PMID:27752384

  5. Adjuvant radiation therapy, local recurrence, and the need for salvage therapy in atypical meningioma

    PubMed Central

    Aizer, Ayal A.; Arvold, Nils D.; Catalano, Paul; Claus, Elizabeth B.; Golby, Alexandra J.; Johnson, Mark D.; Al-Mefty, Ossama; Wen, Patrick Y.; Reardon, David A.; Lee, Eudocia Q.; Nayak, Lakshmi; Rinne, Mikael L.; Beroukhim, Rameen; Weiss, Stephanie E.; Ramkissoon, Shakti H.; Abedalthagafi, Malak; Santagata, Sandro; Dunn, Ian F.; Alexander, Brian M.

    2014-01-01

    Background The impact of adjuvant radiation in patients with atypical meningioma remains poorly defined. We sought to determine the impact of adjuvant radiation therapy in this population. Methods We identified 91 patients with World Health Organization grade II (atypical) meningioma managed at Dana-Farber/Brigham and Women's Cancer Center between 1997 and 2011. A propensity score model incorporating age at diagnosis, gender, Karnofsky performance status, tumor location, tumor size, reason for diagnosis, and era of treatment was constructed using logistic regression for the outcome of receipt versus nonreceipt of radiation therapy. Propensity scores were then used as continuous covariates in a Cox proportional hazards model to determine the adjusted impact of adjuvant radiation therapy on both local recurrence and the combined endpoint of use of salvage therapy and death due to progressive meningioma. Results The median follow-up in patients without recurrent disease was 4.9 years. After adjustment for pertinent confounding variables, radiation therapy was associated with decreased local recurrence in those undergoing gross total resection (hazard ratio, 0.25; 95% CI, 0.07–0.96; P = .04). No differences in overall survival were seen in patients who did and did not receive radiation therapy. Conclusion Patients who have had a gross total resection of an atypical meningioma should be considered for adjuvant radiation therapy given the improvement in local control. Multicenter, prospective trials are required to definitively evaluate the potential impact of radiation therapy on survival in patients with atypical meningioma. PMID:24891451

  6. Analysis of Several PLA2 mRNA in Human Meningiomas

    PubMed Central

    Denizot, Yves; De Armas, Rafael; Durand, Karine; Robert, Sandrine; Moreau, Jean-Jacques; Caire, François; Weinbreck, Nicolas; Labrousse, François

    2009-01-01

    In view of the important oncogenic action of phospholipase A2(PLA2) we investigated PLA2 transcripts in human meningiomas. Real-time PCR was used to investigate PLA2 transcripts in 26 human meningioma tumors. Results indicated that three Ca2+-dependent high molecular weight PLA2 (PLA2-IVA, PLA2-IVB, PLA2-IVC), one Ca2+-independent high molecular weight PLA2 (PLA2-VI) and five low molecular weight secreted forms of PLA2 (PLA2-IB, PLA2-IIA, PLA2-III, PLA2-V, and PLA2-XII) are expressed with PLA2-IVA, PLA2-IVB, PLA2-VI, and PLA2-XIIA as the major expressed forms. PLA2-IIE, PLA2-IIF, PLA2-IVD, and PLA2-XIIB are not detected. Plasma (PLA2-VIIA) and intracellular (PLA2-VIIB) platelet-activating factor acetylhydrolase transcripts are expressed in human meningiomas. However no difference was found for PLA2 transcript amounts in relation to the tumor grade, the subtype of meningiomas, the presence of inflammatory infiltrated cells, of an associated edema, mitosis, brain invasion, vascularisation or necrosis. In conclusion numerous genes encoding multiples forms of PLA2 are expressed in meningiomas where they might act on the phospholipid remodeling and on the local eicosanoid and/or cytokine networks. PMID:20339511

  7. Long Term Surgical Outcome and Prognostic Factors of Atypical and Malignant Meningiomas

    PubMed Central

    Wang, Yu-Chi; Chuang, Chi-Cheng; Wei, Kuo-Chen; Chang, Cheng-Nen; Lee, Shih-Tseng; Wu, Chieh-Tsai; Hsu, Yung-Hsin; Lin, Tzu-Kan; Hsu, Peng-Wei; Huang, Yin-Cheng; Tseng, Chen-Kan; Wang, Chun-Chieh; Chen, Yao-Liang; Chen, Pin-Yuan

    2016-01-01

    Atypical and malignant meningiomas are rare. Our aim was to examine the treatment outcomes following surgical resection, and analyze associations between clinical characteristics and overall survival (OS) or relapse free survival (RFS). 102 patients with atypical or malignant meningiomas underwent microsurgical resection between June 2001 and November 2009 were analyzed retrospectively. We compared demographics, clinical characteristics, treatment, and complications. The five-year and ten-year overall survival rates were 93.5% and 83.4%, respectively. Three factors significantly reduced OS: Malignant meningiomas (p < 0.001), which also decreased RFS (p < 0.001); female patients (p = 0.049), and patients with Karnofsky Performance Status (KPS) < 70 at diagnosis (p = 0.009). Fifty two patients (51%) experienced tumor relapse. Total resection of tumors significantly impacted RFS (p = 0.013). Tumors located at parasagittal and posterior fossa area lead to higher relapse rate (p = 0.004). Subtotal resection without adjuvant radiotherapy lead to the worst local control of tumor (p = 0.030). An MIB-1 index <8% improved OS and RFS (p = 0.003). Total resection of atypical and malignant meningiomas provided better outcome and local control. Adjuvant radiation therapy is indicated for patients with malignant meningiomas, with incompletely excised tumors; or with tumors in the parasagittal or posterior fossa area. The MIB-1 index of the tumor is an independent prognostic factor of clinical outcome. PMID:27760993

  8. Comparative Analysis of the Magnetic Resonance Imaging Features Between Anaplastic Meningioma and Atypical Meningioma.

    PubMed

    Liu, Hong; Zhou, Junlin; Li, Wenyi; Liu, Guangyao

    2016-05-01

    The aim of the study was to investigate the differences in the imaging feature between anaplastic meningioma (World Health Organization grade III) and atypical meningioma (World Health Organization grade II), summarize its specificity of image features, and provide the basis for accurate preoperative diagnosis. The magnetic resonance imaging features of 20 patients of anaplastic meningioma were compared with those of 30 patients of atypical meningioma retrospectively, all of which were confirmed by surgery and pathology. The imaging features of the 2 groups of tumors were statistically analyzed using χ tests. The 2 tumor types differed in several features, including lobulated or irregular shape (P < 0.05), cystic and necrotic changes (P < 0.05), peritumoral edema (P < 0.05), and brain-tumor interface (P < 0.01). There were no significant differences in hemorrhage, homogeneous enhancement of the tumor, dural tail sign, or adjacent bone change (P > 0.05). Differences in the imaging feature between anaplastic meningioma and atypical meningioma can improve the differential diagnosis and allow a more appropriate approach to therapy. The article focuses on examining the differences of the magnetic resonance imaging features between anaplastic meningiomas and atypical meningiomas have been examined in only a few studies.

  9. Factors Associated With Excessive Gestational Weight Gain: Review of Current Literature

    PubMed Central

    Steer, Jonathan; Michelis, L. Daniela; Carroll, Lisa; Holland, Erica; Perkins, Rebecca

    2016-01-01

    Background: Excessive gestational weight gain (EGWG) places women at increased risk for complications during pregnancy and also increases the likelihood that they will remain overweight after pregnancy. The Institute of Medicine (IOM) has recommended weight gain guidelines based on pre-pregnancy body mass index (BMI), but evidence-based strategies to achieve these goals are limited. Objective: This review discusses factors associated with EGWG with the goal of identifying targets for future intervention. Methods: A search was performed using the PubMed database to identify all English-language papers published between 1995 and 2014 related to excessive weight gain in pregnancy. Papers were grouped by theme: preconception BMI, sociodemographics, diet and exercise, psychosocial characteristics, and type of prenatal care. Results: Studies found that women who were overweight or obese at the time of conception were at higher risk of EGWG and that increased physical activity protected against EGWG. Studies on diet and sociodemographic characteristics were inconclusive. Psychological factors, specifically accurate perceptions of BMI, also appear to play a role in EGWG. Limited studies on methods of prenatal care delivery did not show improvement of weight parameters with group compared to one-on-one visits. Conclusion: Pre-pregnancy BMI is most strongly associated with EGWG, indicating that healthy weight habits throughout adult life may be especially important in periods of expected weight change, such as pregnancy. To decrease EGWG, providers should focus on improving pre-conception BMI through appropriate counseling on healthy eating and increased physical activity as well as encouraging pregnant women to continue moderate exercise during pregnancy when appropriate. PMID:26937318

  10. MicroRNA-224 targets ERG2 and contributes to malignant progressions of meningioma

    SciTech Connect

    Wang, Maomao; Deng, Xiaodong; Ying, Qi; Jin, Tingyan; Li, Ming; Liang, Chong

    2015-05-01

    MicroRNA-224 is overexpressed in various malignant tumors with poor prognosis, which plays a critical role in biological processes including cell proliferation, apoptosis and several developmental and physiological progressions. However, the potential association between miR-224 and clinical outcome in patients with meningiomas remains unknown. Here, we investigate miR-224 expression and biological functions in meningiomas. MiR-224 expression was measured by Northern blot analysis and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) in meningioma and normal brain tissues. Kaplan–Meier analysis and Cox regression analysis were used to exam its correlation with clinicopathological features and prognostic value. The biological effects of miR-224 on the cell proliferation and apoptosis in meningioma cells were examined by MTT assay and apoptosis assay. We found the expression levels of miR-224 were significantly higher in meningioma tissues than that in normal brain, positively correlated with advanced pathological grade. Kaplan–Meier analysis indicated that meningioma patients with low miR-224 expression exhibited significantly prolonged overall and recurrence-free survival. Furthermore, we demonstrated that ERG2 was an identical candidate target gene of MiR-224 in vitro. Our results indicated that downregulation of miR-224 suppressed cell growth and resulted in the enhancement of cell apoptosis through activation of the ERG2-BAK-induced apoptosis pathway. Our findings imply the miR-224 expression could predict the overall survival and recurrence-free survival of patients with meningioma and it might be a promising therapeutic target for treating malignant meningiomas. - Highlights: • MiR-224 expression is correlates with prognosis in meningioma patients. • ERG2 is a novel downstream target of miR-224. • MiR-224 suppressed cell growth and enhanced apoptosis in IOMM-Lee and CH157 cells. • MiR-224 is an upstream regulator of the ERG2

  11. Genetic changes of MLH1 and MSH2 genes could explain constant findings on microsatellite instability in intracranial meningioma.

    PubMed

    Pećina-Šlaus, Nives; Kafka, Anja; Bukovac, Anja; Vladušić, Tomislav; Tomas, Davor; Hrašćan, Reno

    2017-07-01

    Postreplicative mismatch repair safeguards the stability of our genome. The defects in its functioning will give rise to microsatellite instability. In this study, 50 meningiomas were investigated for microsatellite instability. Two major mismatch repair genes, MLH1 and MSH2, were analyzed using microsatellite markers D1S1611 and BAT26 amplified by polymerase chain reaction and visualized by gel electrophoresis on high-resolution gels. Furthermore, genes DVL3 (D3S1262), AXIN1 (D16S3399), and CDH1 (D16S752) were also investigated for microsatellite instability. Our study revealed constant presence of microsatellite instability in meningioma patients when compared to their autologous blood DNA. Altogether 38% of meningiomas showed microsatellite instability at one microsatellite locus, 16% on two, and 13.3% on three loci. The percent of detected microsatellite instability for MSH2 gene was 14%, and for MLH1, it was 26%, for DVL3 22.9%, for AXIN1 17.8%, and for CDH1 8.3%. Since markers also allowed for the detection of loss of heterozygosity, gross deletions of MLH1 gene were found in 24% of meningiomas. Genetic changes between MLH1 and MSH2 were significantly positively correlated (p = 0.032). We also noted a positive correlation between genetic changes of MSH2 and DVL3 genes (p = 0.034). No significant associations were observed when MLH1 or MSH2 was tested against specific histopathological meningioma subtype or World Health Organization grade. However, genetic changes in DVL3 were strongly associated with anaplastic histology of meningioma (χ(2) = 9.14; p = 0.01). Our study contributes to better understanding of the genetic profile of human intracranial meningiomas and suggests that meningiomas harbor defective cellular DNA mismatch repair mechanisms.

  12. Relevance of Simpson grading system and recurrence-free survival after surgery for World Health Organization Grade I meningioma.

    PubMed

    Nanda, Anil; Bir, Shyamal C; Maiti, Tanmoy K; Konar, Subhas K; Missios, Symeon; Guthikonda, Bharat

    2017-01-01

    OBJECTIVE The clinical significance of the Simpson system for grading the extent of meningioma resection and its role as a predictor of the recurrence of World Health Organization (WHO) Grade I meningiomas have been questioned in the past, echoing changes in meningioma surgery over the years. The authors reviewed their experience in resecting WHO Grade I meningiomas and assessed the association between extent of resection, as evaluated using the Simpson classification, and recurrence-free survival (RFS) of patients after meningioma surgery. METHODS Clinical and radiological information for patients with WHO Grade I meningiomas who had undergone resective surgery over the past 20 years was retrospectively reviewed. Simpson and Shinshu grading scales were used to evaluate the extent of resection. Statistical analysis was conducted using Kaplan-Meier curves and Cox proportional-hazards regression. RESULTS Four hundred fifty-eight patients were eligible for analysis. Overall tumor recurrence rates for Simpson resection Grades I, II, III, and IV were 5%, 22%, 31%, and 35%, respectively. After Cox regression analysis, Simpson Grade I (extensive resection) was revealed as a significant predictor of RFS (p = 0.003). Patients undergoing Simpson Grade I and II resections showed significant improvement in RFS compared with patients undergoing Grade III and IV resections (p = 0.005). Extent of resection had a significant effect on recurrence rates for both skull base (p = 0.047) and convexity (p = 0.012) meningiomas. Female sex and a Karnofsky Performance Scale score > 70 were also identified as independent predictors of RFS after resection of WHO Grade I meningioma. CONCLUSIONS In this patient cohort, a significant association was noted between extent of resection and rates of tumor recurrence. In the authors' experience the Simpson grading system maintains its relevance and prognostic value and can serve an important role for patient education. Even though complete tumor

  13. Maternal obesity and gestational weight gain are modestly associated with umbilical cord DNA methylation.

    PubMed

    Thakali, Keshari M; Faske, Jennifer B; Ishwar, Arjun; Alfaro, Maria P; Cleves, Mario A; Badger, Thomas M; Andres, Aline; Shankar, Kartik

    2017-09-01

    Maternal obesity (OB) and excessive gestational weight gain (GWG) are strong independent contributors that augment obesity risk in offspring. However, direct evidence of epigenetic changes associated with maternal habitus remains sparse. We utilized Bisulfite Amplicon Sequencing (BSAS) to conduct targeted DNA methylation association analysis of maternal obesity and excessive GWG with DNA methylation of select metabolism-related and imprinted genes. Umbilical cord (UC) tissue from infants born to normal weight and overweight/obese women from the Glowing study were utilized (n = 78). In multivariable linear regression adjusted for relevant confounders, Institute on Medicine (IOM) GWG category and infant sex were significantly associated with UC IGFBP1 methylation, while gestation length was significantly associated with UC PRKAA1 methylation. In addition, infant fat mass (%) at 2 weeks of age was significantly associated with umbilical cord methylation of RAPTOR. While regression tree analysis confirmed findings from multivariable models demonstrating that maternal early pregnancy BMI and IOM GWG category are associated with fetal UC DNA methylation patterns for select metabolic and imprinted genes, in general, effect sizes were quite small and statistical significance was not maintained when accounting for multiple testing. Our findings suggest that maternal obesity and excessive GWG are weakly correlated with offspring DNA methylation patterns at birth. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Tuberculum sellae meningiomas: clinical outcome considering different surgical approaches.

    PubMed

    Nakamura, Makoto; Roser, Florian; Struck, Melena; Vorkapic, Peter; Samii, Madjid

    2006-11-01

    Tuberculum sellae meningiomas present a special challenge because of their proximity to arteries of the anterior circulation, anterior visual pathways, and the hypothalamus. The authors report on the clinical outcome after surgical treatment of tuberculum sellae meningiomas in our neurosurgical department. A retrospective study was conducted analyzing the charts of the patients, including surgical records, discharge letters, histological records, follow-up records, and imaging studies. Patients with associated neurofibromatosis Type 2 were excluded from the study. One thousand eight hundred meningiomas were operated on between 1978 and 2002. Seventy-two of these patients had tuberculum sellae meningiomas; four had undergone previous surgical procedures in outside hospitals. Fifty-five patients were women; 17 were men. Their mean age was 54.3 years (range, 30-86 yr). All patients had visual disturbances at presentation. Tumors were operated through the bifrontal approach (n = 21, from 1978 through 1995), the pterional/frontotemporal approach (n = 21, from 1982 through 2002), and the frontolateral approach (n = 30, from 1984 through 2002). Total tumor removal was achieved in most patients (Simpson 1 + 2, 91.7%). The perioperative mortality rate was 2.8% (two out of 72 patients). Immediate postoperative improvement of visual disturbance was observed in 65% of patients. Visual improvement was dependent on the duration of preoperative visual symptoms, but not on preoperative visual acuity or tumor size. The visual improvement rate was significantly better in patients who underwent frontolateral tumor resection (77.8%) compared with those who underwent bifrontal craniotomy (46.2%). The overall recurrence rate was 2.8% (two out of 72 patients). The mean follow-up time for all patients was 4 to 238 months (mean, 45.3 mo [3.8 yr]). From 1978 through 2002, tuberculum sellae meningiomas were removed microsurgically using three different surgical approaches. Considering the

  15. Parity-associated weight gain and its modification by sociodemographic and behavioral factors: a prospective analysis in US women.

    PubMed

    Wolfe, W S; Sobal, J; Olson, C M; Frongillo, E A; Williamson, D F

    1997-09-01

    To examine how the relationship between parity increase and weight gain is modified by sociodemographic and behavioral factors. Prospective longitudinal data from the first National Health and Nutrition Examination Survey (NHANES I, 1971-75) and its follow-up of those aged 25 y and older, the NHANES I Epidemiologic Follow-up Survey (NHEFS, 1982-84). The analytical sample was nationally representative of the United States and included 2952 white or African-American non-pregnant women aged 25-45 y at baseline, who were re-measured approximately 10 y later. Statistical interactions in multiple linear and logistic regression models were examined to identify how eight sociodemographic and three behavioral factors modified the effect of parity increase on body weight change and risk of substantial weight gain. Factors that increased parity-associated weight gain included being African-American, living in a rural area, not working outside the home, having fewer children, lower income and lower education, and being unmarried. Among white women, being younger and having higher body weight at baseline increased parity-associated weight gain, while among African-American women, being older and having lower body weight increased parity-associated weight gain. African-American smokers gained less weight with an increase in parity, while the interactions between smoking and physical activity with parity-associated weight gain in whites were complex. The effects of sociodemographic and behavioral factors on parity-associated weight gain varied by race and parity change, with the most consistent findings being that unmarried and unemployed white women had greater parity-associated weight gain, while both white and African-American women who smoked, had higher education, or higher parity had lower parity-associated weight gain. This information may contribute to better targeting and more effective interventions to prevent postpartum weight retention.

  16. Genomic gain of the PRL-3 gene may represent poor prognosis of primary colorectal cancer, and associate with liver metastasis.

    PubMed

    Nakayama, N; Yamashita, K; Tanaka, T; Kawamata, H; Ooki, A; Sato, T; Nakamura, T; Watanabe, M

    2016-01-01

    PRL-3 genomic copy number is increased in colorectal cancer (CRC), and PRL-3 expression is closely associated with lymph node and liver metastasis of CRC. However, the clinical significance of PRL-3 genomic gain for CRC remains obscure. Here, PRL-3 genomic status in 109 primary CRC tumors and in 44 CRC tumors that had metastasized to the liver, was quantified using real time PCR. Association of PRL-3 genomic status with clinicopathological factors and prognosis was assessed in detail. PRL-3 genomic gain was identified in 31 primary CRC (27.4 %) and was more frequently seen in stage III than in stage II (p = 0.025). Among the clinicopathological factors assessed, PRL-3 genomic gain was significantly associated with poorly differentiated histology (p = 0.0039). Moreover, CRC patients with PRL-3 genomic gain exhibited poorer prognosis than those with no gain in stage II-IV CRC (p = 0.017). PRL-3 genomic gain was identified in 18 (41 %) of the liver metastasis tumors, and this frequency of gain was significantly increased as compared to that of the corresponding primary CRCs (11 %) (p = 0.001). Our findings suggested that PRL-3 genomic gain may represent an aggressive phenotype of primary CRC, and may associate with liver metastasis.

  17. Genes in skeletal muscle associated with gain and intake identified in a multi-season study of crossbred beef steers

    USDA-ARS?s Scientific Manuscript database

    The purpose of this study was to identify genes differentially expressed in the muscle of beef cattle associated with gain and intake regardless of breed of origin and season or year of study. Crossbred animals of 19 different breeds with variation in body weight gain and feed intake were selected f...

  18. Sclerosing Meningioma : Radiological and Clinical Characteristics of 21 Cases

    PubMed Central

    Kang, Ho; Se, Young-Bem; Dho, Yun-Sik; Choi, Seung Hong; Park, Sung-Hye

    2016-01-01

    Objective A rare subtype of meningioma, sclerosing meningioma is not included in the current World Health Organization classification of meningiomas and is classified into the category of other morphological variation subtypes. Sclerosing meningioma is often misdiagnosed to other non-benign meningioma or malignant neoplasm, so it is important to diagnose sclerosing type correctly. We analyzed the radiological and clinical characteristics of a series of sclerosing meningiomas. Methods Twenty-one patients who underwent surgery in one institute with a histopathologically proven sclerosing meningioma were included from 2006 to 2014. Eighteen tumors were diagnosed as a pure sclerosing-type meningioma, and 3 as mixed type. Magnetic resonance image was taken for all patients including contrast enhancement image. Computed tomography (CT) scan was taken for 16 patients. One neuroradiologist and 1 neurosurgeon reviewed all images retrospectively. Results In the all 16 patients with preoperative CT images, higher attenuation was observed in the meningioma than in the brain parenchyma, and calcification was observed in 11 (69%). In 15 of the 21 patients (71%), a distinctive very low signal intensity appeared as a dark color in T2-weighted images. Nine of these 15 tumors (60%) exhibited heterogeneous enhancement, and 6 (40%) exhibited homogeneous enhancement that was unlike the homogeneous enhancing pattern shown by conventional meningiomas. Ten patients had a clear tumor margin without peritumoral edema. Conclusion Although these peculiar radiological characteristics are not unique to sclerosing meningioma, we believe that they are distinctive features that may be helpful for distinguishing sclerosing meningioma from other subtypes. PMID:27847571

  19. Developmental Trajectories of Bottle-Feeding During Infancy and Their Association with Weight Gain.

    PubMed

    Ventura, Alison K

    To describe patterns of bottle-feeding across the first year postpartum and explore whether bottle-feeding trajectories are differentially associated with infant weight gain. Data came from 1291 mothers who participated in the Infant Feeding Practices Study 2. Mothers completed a prenatal questionnaire and monthly surveys of infant feeding and growth between birth and 12 months. Group-based trajectory mixture modeling was used to describe developmental trajectories of bottle-feeding intensities across the first year. Growth curve modeling was used to explore associations between bottle-feeding intensity trajectory group membership and weight-for-age z-score (WAZ) trajectories from birth to 12 months. Four qualitatively distinct trajectories of bottle-feeding were identified: (1) High-Stable: ∼100% of feeds from bottles across infancy; (2) Rapid-Increase: <30% of feeds from bottles during the neonatal assessment, increasing to ∼100% by 6 months; (3) Gradual-Increase: <10% of feeds from bottles during the neonatal assessment, gradually increasing to ∼100% by 12 months; and (4) Low-Stable: <5% of feeds from bottles across the majority of infancy. Bottle-feeding groups had significantly different WAZ trajectories across infancy; by 12 months, the High-Stable and Rapid-Increase groups had significantly higher WAZs compared with the Gradual-Increase and Low-Stable groups (p < .001). The association between bottle-feeding group membership and WAZ trajectories was not confounded by sociodemographic characteristics or the extent to which infants received breast milk. High-intensity bottle use during early infancy may place infants at higher risk for excess weight gain. Supports and policies that help mothers delay high-intensity bottle use until later infancy are warranted.

  20. Effects of sex on the incidence and prognosis of spinal meningiomas: a Surveillance, Epidemiology, and End Results study.

    PubMed

    Westwick, Harrison J; Shamji, Mohammed F

    2015-09-01

    Most spinal meningiomas are intradural lesions in the thoracic spine that present with both local pain and myelopathy. By using the large prospective Surveillance, Epidemiology, and End Results (SEER) database, the authors studied the incidence of spinal meningiomas and examined demographic and treatment factors predictive of death. Using SEER*Stat software, the authors queried the SEER database for cases of spinal meningioma between 2000 and 2010. From the results, tumor incidence and demographic statistics were computed; incidence was analyzed as a function of tumor location, pathology, age, sex, and malignancy code. Survival was analyzed by using a Cox proportional hazards ratio in SPSS for age, sex, marital status, primary site, size quartile, treatment modality, and malignancy code. In this analysis, significance was set at a p value of 0.05. The 1709 spinal meningiomas reported in the SEER database represented 30.7% of all primary intradural spinal tumors and 7.9% of all meningiomas. These meningiomas occurred at an age-adjusted incidence of 0.193 (95% CI 0.183-0.202) per 100,000 population and were closely related to sex (337 [19.7%] male patients and 1372 [80.3%] female patients). The Cox hazard function for mortality in males was higher (2.4 [95% CI1.7-3.5]) and statistically significant, despite the lower lesion incidence in males. All-cause survival was lowest in patients older than 80 years. Primary site and treatment modality were not significant predictors of mortality. Spinal meningiomas represent a significant fraction of all primary intradural spinal tumors and of all meningiomas. The results of this study establish the association of lesion incidence and survival with sex, with a less frequent incidence in but greater mortality among males.

  1. Immunocytochemical analysis of glucose transporter protein-1 (GLUT-1) in typical, brain invasive, atypical and anaplastic meningioma.

    PubMed

    van de Nes, Johannes A P; Griewank, Klaus G; Schmid, Kurt-Werner; Grabellus, Florian

    2015-02-01

    network embedded within the pattern of GLUT-1 staining. Taken together, GLUT-1 staining cannot be applied as a substitute for histologic grading in order to predict tumor behavior. However, assessment of tumor hypoxia in association with "spontaneous" necrosis and foci of small cell change may substantially contribute to the neuropathologic diagnosis of WHO grades II and III meningioma.

  2. Association of sports drinks with weight gain among adolescents and young adults.

    PubMed

    Field, Alison E; Sonneville, Kendrin R; Falbe, Jennifer; Flint, Alan; Haines, Jess; Rosner, Bernard; Camargo, Carlos A

    2014-10-01

    Sales of regular soda were declining, but sales of other sweetened beverages, such as sports drinks, were increasing. Our objective was to determine the prospective associations between sports drinks and body mass index (BMI) gains among adolescents and young adults. 4121 females and 3438 males in the Growing Up Today Study II, aged 9-16 in 2004, from across the United States were followed prospectively. Data were collected by questionnaire in 2004, 2006, 2008, and 2011. Servings per day of various beverages were assessed with a food frequency questionnaire. Among the girls, each serving per day of sports drink predicted an increase of 0.3 BMI units (95% confidence interval (CI) CI 0.03-0.54) more than their peers over the next 2-3 years. Among the males, each serving of sports drinks predicted a 0.33 BMI (95% CI 0.09, 0.66) increase. In addition, boys who increased their intake over the 2-3 year interval gained significantly more than their peers during the same time interval. Intake of sports drinks predicted larger increases in BMI among both females and males. Our results suggest that school policies focused on obesity prevention should be augmented to restrict sports drinks. Copyright © 2014 The Obesity Society.

  3. Association of sports drinks with weight gain among adolescents and young adults

    PubMed Central

    Field, Alison E.; Sonneville, Kendrin R.; Falbe, Jennifer; Flint, Alan; Haines, Jess; Rosner, Bernard; Camargo, Carlos A.

    2014-01-01

    Objective Sales of regular soda are declining, but sales of other sweetened beverages, such as sports drinks, are increasing. Our objective was to determine the prospective associations between sports drinks and body mass index (BMI) gains among adolescents and young adults. Design and Methods We prospectively followed 4,121 females and 3,438 males in the Growing Up Today Study II, aged 9–16 in 2004, from across the United States. Data was collected by questionnaire in 2004, 2006, 2008, and 2011. Servings per day of various beverages were assessed with a food frequency questionnaire. Results Among the girls, each serving per day of sports drink predicted an increase of 0.3 BMI units (95% confidence interval (CI) CI 0.03–0.54) more than their peers over the next 2–3 years. Among the males, each serving of sports drinks predicted a 0.33 BMI (95% CI 0.09, 0.66) increase. In addition, boys who increased their intake over the 2–3 year interval gained significantly more than their peers during the same time interval. Conclusions Intake of sports drinks predicted larger increases in BMI among both females and males. Our results suggest that school policies focused on obesity prevention should be augmented to restrict sports drinks. PMID:25044989

  4. Ossified spinal meningiomas: Clinical and surgical features.

    PubMed

    Alafaci, Concetta; Grasso, Giovanni; Granata, Francesca; Salpietro, Francesco M; Tomasello, Francesco

    2016-03-01

    Meningiomas constitute 25% of primary spinal tumors and predominantly involve the thoracic spinal cord. Although calcifications are commonly seen in intracranial meningiomas, gross calcifications are observed in only 1-5% of all spinal meningiomas. We report the clinical findings, surgical strategy and histological features of 9 patients with ossified spinal meningiomas (OSMs). Clinical and surgical features of 9 patients with ossified spinal meningiomas were retrospectively reviewed. There were 8 women and 1 man with a mean age of 59 years. In 7 patients, the lesions were localized in the thoracic segment of the spine while in 2 patients in the lower cervical segment. All patients presented with weakness of the lower limbs and hypoesthesia below the site level of the lesion. Only 2 patients presented with urinary incontinence. Gross-total resection of the tumor was achieved in 6 patients while in 3 a subtotal removal of the meningioma was obtained. In all patients the postoperative course was uneventful. Six patients presented with a significant neurological improvement while in 3 patients a mild improvement was observed. Microscopically, all tumors showed typical histological pattern of ossified meningioma. OSMs are amenable to surgery if the complete removal can be achieved. Because of their hard-rock consistency complete resection can be challenging. In difficult cases, subtotal removal can be advised and follow-up imaging is mandatory. Overall, the risk of long-term recurrence of the lesions is low, and a good clinical outcome after total or subtotal removal can be expected. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Assessment of Autoantibodies to Meningioma in a Population-based Study

    PubMed Central

    Wiemels, Joseph L.; Bracci, Paige M.; Wrensch, Margaret; Schildkraut, Joellen; Bondy, Melissa; Pfefferle, Jon; Zhou, Mi; Sison, Jennette; Calvocoressi, Lisa; Claus, Elizabeth B.

    2013-01-01

    Meningioma is an intracranial tumor with few confirmed risk factors. Recent research points to an impact on meningioma risk from factors related to immune function and development, such as allergy, immunoglobulin E, and Varicella infection status. To further explore an association with immune function, the authors assessed individual seroreactivity to meningioma tumor-associated antigens among participants enrolled in a multicenter, population-based US case-control study of meningioma (2006–2009). Serum samples from cases (n = 349) and controls (n = 348) were screened for autoantibody reactivity to 3 proteins identified in previous studies: enolase 1 (ENO1), NK-tumor recognition protein (NKTR), and nuclear mitotic apparatus protein 1 (NUMA1). Case-control differences were not strong overall (adjusted odds ratio (OR)ENO1 (continuous) = 1.1, 95% confidence interval (CI): 0.6, 1.9 (Ptrend = 0.3); adjusted ORNKTR (continuous) = 1.3, 95% CI: 0.7, 2.4 (Ptrend = 0.02); and adjusted ORNUMA1 (continuous) = 1.1, 95% CI: 0.7, 1.8 (Ptrend = 0.06)); however, antibodies to NKTR and NUMA1 were detected at higher levels in cases than in controls, particularly among men (for men, adjusted ORENO1 (continuous) = 1.6, 95% CI: 0.5, 4.7 (Ptrend = 0.24); adjusted ORNKTR (continuous) = 4.3, 95% CI: 1.2, 15 (Ptrend = 0.009); and adjusted ORNUMA1 (continuous) = 3.6, 95% CI: 1.1, 11 (Ptrend = 0.006)). These results indicate that men with meningioma commonly react with a serologic antimeningioma response; if supported by further research, this finding suggests a distinctive etiology for meningioma in men. PMID:23221727

  6. A comprehensive analysis of mitochondrial genes variants and their association with antipsychotic-induced weight gain.

    PubMed

    Mittal, Kirti; Gonçalves, Vanessa F; Harripaul, Ricardo; Cuperfain, Ari B; Rollins, Brandi; Tiwari, Arun K; Zai, Clement C; Maciukiewicz, Malgorzata; Müller, Daniel J; Vawter, Marquis P; Kennedy, James L

    2017-09-01

    Antipsychotic Induced Weight Gain (AIWG) is a common and severe side effect of many antipsychotic medications. Mitochondria play a vital role for whole-body energy homeostasis and there is increasing evidence that antipsychotics modulate mitochondrial function. This study aimed to examine the role of variants in nuclear-encoded mitochondrial genes and the mitochondrial DNA (mtDNA) in conferring risk for AIWG. We selected 168 European-Caucasian individuals from the CATIE sample based upon meeting criteria of multiple weight measures while taking selected antipsychotics (risperidone, quetiapine or olanzapine). We tested the association of 670 nuclear-encoded mitochondrial genes with weight change (%) using MAGMA software. Thirty of these genes showed nominally significant P-values (<0.05). We were able to replicate the association of three genes, CLPB, PARL, and ACAD10, with weight change (%) in an independent prospectively assessed AIWG sample. We analyzed mtDNA variants in a subset of 74 of these individuals using next-generation sequencing. No common or rare mtDNA variants were found to be significantly associated with weight change (%) in our sample. Additionally, analysis of mitochondrial haplogroups showed no association with weight change (%). In conclusion, our findings suggest nuclear-encoded mitochondrial genes play a role in AIWG. Replication in larger sample is required to validate our initial report of mtDNA variants in AIWG. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Imaging of Meningioma Progression by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry

    PubMed Central

    Agar, Nathalie Y.R.; Malcolm, James G.; Mohan, Vandana; Yang, Hong W.; Johnson, Mark D.; Tannenbaum, Allen; Agar, Jeffrey N.; Black, Peter M.

    2010-01-01

    Often considered benign, meningiomas represent 32% of intracranial tumors with 3 grades of malignancy defined by the WHO histology based classification. Malignant meningiomas are associated with less than 2 years median survival. The inability to predict recurrence and progression of meningiomas induces significant anxiety for patients and limits physicians in implementing prophylactic treatment approaches. This report presents an analytical approach to tissue characterization based on MALDI TOF mass spectrometry imaging (MSI) which is introduced in an attempt to develop a reference database for predictive classification of brain tumors. This pilot study was designed to evaluate the potential of such approach and to begin to address limitations of the current methodology. Five recurrent and progressive meningiomas for which surgical specimens were available from the original and progressed grades were selected and tested against non-progressive high-grade meningiomas, high-grade gliomas, and non-tumor brain specimens. The common profiling approach of data acquisition was compared to imaging and revealed significant benefits in spatially resolved acquisition for improved spectral definition. A preliminary classifier based on support vector machine showed the ability to distinguish meningioma image spectra from non-tumor brain and from gliomas, a different type of brain tumors, and to enable class imaging of surgical tissue. Although the development of classifiers was shown to be sensitive to data preparation parameters such as recalibration and peak picking criteria, it also suggested the potential for maturing into a predictive algorithm if provided with larger series of well-defined cases. PMID:20196536

  8. Obesity and Risk for Brain/CNS Tumors, Gliomas and Meningiomas: A Meta-Analysis

    PubMed Central

    Sergentanis, Theodoros N.; Tsivgoulis, Georgios; Perlepe, Christina; Ntanasis-Stathopoulos, Ioannis; Tzanninis, Ioannis-Georgios; Sergentanis, Ioannis N.; Psaltopoulou, Theodora

    2015-01-01

    Objective This meta-analysis aims to examine the association between being overweight/obese and risk of meningiomas and gliomas as well as overall brain/central nervous system (CNS) tumors. Study Design Potentially eligible publications were sought in PubMed up to June 30, 2014. Random-effects meta-analysis and dose-response meta-regression analysis was conducted. Cochran Q statistic, I-squared and tau-squared were used for the assessment of between-study heterogeneity. The analysis was performed using Stata/SE version 13 statistical software. Results A total of 22 studies were eligible, namely 14 cohort studies (10,219 incident brain/CNS tumor cases, 1,319 meningioma and 2,418 glioma cases in a total cohort size of 10,143,803 subjects) and eight case-control studies (1,009 brain/CNS cases, 1,977 meningioma cases, 1,265 glioma cases and 8,316 controls). In females, overweight status/obesity was associated with increased risk for overall brain/CNS tumors (pooled RR = 1.12, 95%CI: 1.03–1.21, 10 study arms), meningiomas (pooled RR = 1.27, 95%CI: 1.13–1.43, 16 study arms) and gliomas (pooled RR = 1.17, 95%CI: 1.03–1.32, six arms). Obese (BMI>30 kg/m2) females seemed particularly aggravated in terms of brain/CNS tumor (pooled RR = 1.19, 95%CI: 1.05–1.36, six study arms) and meningioma risk (pooled RR = 1.48, 95%CI: 1.28–1.71, seven arms). In males, overweight/obesity status correlated with increased meningioma risk (pooled RR = 1.58, 95%CI: 1.22–2.04, nine study arms), whereas the respective association with overall brain/CNS tumor or glioma risk was not statistically significant. Dose-response meta-regression analysis further validated the findings. Conclusion Our findings highlight obesity as a risk factor for overall brain/CNS tumors, meningiomas and gliomas among females, as well as for meningiomas among males. PMID:26332834

  9. Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults.

    PubMed

    Hootman, Katie C; Trezzi, Jean-Pierre; Kraemer, Lisa; Burwell, Lindsay S; Dong, Xiangyi; Guertin, Kristin A; Jaeger, Christian; Stover, Patrick J; Hiller, Karsten; Cassano, Patricia A

    2017-05-23

    Metabolomic markers associated with incident central adiposity gain were investigated in young adults. In a 9-mo prospective study of university freshmen (n = 264). Blood samples and anthropometry measurements were collected in the first 3 d on campus and at the end of the year. Plasma from individuals was pooled by phenotype [incident central adiposity, stable adiposity, baseline hemoglobin A1c (HbA1c) > 5.05%, HbA1c < 4.92%] and assayed using GC-MS, chromatograms were analyzed using MetaboliteDetector software, and normalized metabolite levels were compared using Welch's t test. Assays were repeated using freshly prepared pools, and statistically significant metabolites were quantified in a targeted GC-MS approach. Isotope tracer studies were performed to determine if the potential marker was an endogenous human metabolite in men and in whole blood. Participants with incident central adiposity gain had statistically significantly higher blood erythritol [P < 0.001, false discovery rate (FDR) = 0.0435], and the targeted assay revealed 15-fold [95% confidence interval (CI): 13.27, 16.25] higher blood erythritol compared with participants with stable adiposity. Participants with baseline HbA1c > 5.05% had 21-fold (95% CI: 19.84, 21.41) higher blood erythritol compared with participants with lower HbA1c (P < 0.001, FDR = 0.00016). Erythritol was shown to be synthesized endogenously from glucose via the pentose-phosphate pathway (PPP) in stable isotope-assisted ex vivo blood incubation experiments and through in vivo conversion of erythritol to erythronate in stable isotope-assisted dried blood spot experiments. Therefore, endogenous production of erythritol from glucose may contribute to the association between erythritol and obesity observed in young adults.

  10. Coexistence of cervico-thoracic extradural en-plaque meningioma with multiple intracranial meningiomas.

    PubMed

    Kale, Aydemir; Akyol, Cetin; Keskin, Emrah; Aydoğmuş, Evren; Aydın, Hasan Ali; Barut, Figen; Gül, Sanser; Kalaycı, Murat

    2014-01-01

    Meningioma is one of the most common tumors in the spinal cord. Extradural and en-plaque variety of meningioma occur less frequently. A 47-year-old woman is presented with radiculopathy signs. Magnetic resonance imaging revealed a lesion from C6 through T3 vertebral levels compressing the cord both anteriorly and posteriorly. Subtotally excision was performed and histopathologic signs showed transitional type of meningioma (WHO Grade 1). Post operatively, she had good neurological recovery. Intraoperative findings point out that the en-plaque meningioma was pure extradural. Twelve cases of pure extradural en-plaque meningioma have been reported in the literature. Besides, to the best our knowledge coexistence of "en plaque" spinal epidural meningioma with meningiomas in cranial cavity has not been reported. Complete resection is mandatory to prevent recurrence. Moreover, it is considerably difficult to remove the parts of tumor over anterior of the dura without complication. Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  11. The WHO Grade I Collagen-forming Meningioma Produces Angiogenic Substances. A New Meningioma Entity.

    PubMed

    Haybaeck, Johannes; Smolle, Elisabeth; Schökler, Bernadette; Kleinert, Reinhold

    2016-03-01

    Meningiomas arise from arachnoid cap cells, the so-called meningiothelial cells. They account for 20-36% of all primary intracranial tumours, and arise with an annual incidence of 1.8-13 per 100,000 individuals/year. According to their histopathological features meningiomas are classified either as grade I (meningiothelial, fibrous/fibroblastic, transitional/mixed, psammomatous, angiomatous, microcystic, secretory and the lympholasmacyterich sub-type), grade II (atypical and clear-cell sub-type) or grade III (malignant or anaplastic phenotype). A 62-year-old female patient presented to the hospital because of progressive obliviousness and concentration difficulties. In the magnetic resonance imaging (MRI) of the brain, an occipital convexity-meningioma was found in the left hemisphere, which was subsequently resected. Within the tumour tissue there were multiple spheroid precipitates, i.e. secretion products that turned out to consist of collagen. Part of the tumour cells displayed positive reactions for vasogenic substances, namely for vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR). Correspondingly, the diagnosis "WHO Grade I collagen-forming meningioma" seems to be most appropriate. The "WHO Grade I collagen-forming meningioma" reported herein produces collagen and angiogenic substances. To the best of our knowledge, no such entity has been reported on in previous literature. We propose this collagen-producing meningioma as a novel WHO grade I meningioma sub-type. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  12. The preterm placental microbiome varies in association with excess maternal gestational weight gain

    PubMed Central

    Antony, Kathleen M.; Ma, Jun; Mitchell, Kristen B.; Racusin, Diana A.; Versalovic, James; Aagaard, Kjersti

    2016-01-01

    OBJECTIVE Although a higher maternal body mass index is associated with preterm birth, it is unclear whether excess gestational weight gain (GWG) or obesity drives increased risk. We and others have shown that the placenta harbors microbiota, which is significantly different among preterm births. Our aim in this study was to investigate whether the preterm placental microbiome varies by virtue of obesity or alternately by excess GWG. STUDY DESIGN Placentas (n = 320) were collected from term and preterm pregnancies. Genomic DNA was extracted and subjected to metagenomic sequencing. Data were analyzed by clinical covariates that included the 2009 Institute of Medicine’s GWG guideline and obesity. RESULTS Analysis of 16S recombinant RNA–based metagenomics revealed no clustering of the microbiome by virtue of obesity (P = .161). Among women who spontaneously delivered preterm, there was again no clustering by obesity (P = .480), but there was significant clustering by excess GWG (P = .022). Moreover, among pretermbirths, detailed analysis identified microbial genera (family and genus level) and bacterial metabolic gene pathways that varied among pregnancies with excess GWG. Notably, excess GWG was associated with decreased microbial folate biosynthesis pathways and decreased butanoate metabolism (linear discriminate analysis, >3.0-fold). CONCLUSION Although there were no significant alterations in the microbiome by virtue of obesity per se, excess GWG was associated with an altered microbiome and its metabolic profile among those women who experienced a preterm birth. PMID:25557210

  13. The preterm placental microbiome varies in association with excess maternal gestational weight gain.

    PubMed

    Antony, Kathleen M; Ma, Jun; Mitchell, Kristen B; Racusin, Diana A; Versalovic, James; Aagaard, Kjersti

    2015-05-01

    Although a higher maternal body mass index is associated with preterm birth, it is unclear whether excess gestational weight gain (GWG) or obesity drives increased risk. We and others have shown that the placenta harbors microbiota, which is significantly different among preterm births. Our aim in this study was to investigate whether the preterm placental microbiome varies by virtue of obesity or alternately by excess GWG. Placentas (n=320) were collected from term and preterm pregnancies. Genomic DNA was extracted and subjected to metagenomic sequencing. Data were analyzed by clinical covariates that included the 2009 Institute of Medicine's GWG guideline and obesity. Analysis of 16S recombinant RNA-based metagenomics revealed no clustering of the microbiome by virtue of obesity (P=.161). Among women who spontaneously delivered preterm, there was again no clustering by obesity (P=.480), but there was significant clustering by excess GWG (P=.022). Moreover, among preterm births, detailed analysis identified microbial genera (family and genus level) and bacterial metabolic gene pathways that varied among pregnancies with excess GWG. Notably, excess GWG was associated with decreased microbial folate biosynthesis pathways and decreased butanoate metabolism (linear discriminate analysis, >3.0-fold). Although there were no significant alterations in the microbiome by virtue of obesity per se, excess GWG was associated with an altered microbiome and its metabolic profile among those women who experienced a preterm birth. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Genome-wide association study on antipsychotic-induced weight gain in the CATIE sample.

    PubMed

    Brandl, E J; Tiwari, A K; Zai, C C; Nurmi, E L; Chowdhury, N I; Arenovich, T; Sanches, M; Goncalves, V F; Shen, J J; Lieberman, J A; Meltzer, H Y; Kennedy, J L; Müller, D J

    2016-08-01

    Antipsychotic-induced weight gain (AIWG) is a common side effect with a high genetic contribution. We reanalyzed genome-wide association study (GWAS) data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) selecting a refined subset of patients most suitable for AIWG studies. The final GWAS was conducted in N=189 individuals. The top polymorphisms were analyzed in a second cohort of N=86 patients. None of the single-nucleotide polymorphisms was significant at the genome-wide threshold of 5x10(-8). We observed interesting trends for rs9346455 (P=6.49x10(-6)) upstream of OGFRL1, the intergenic variants rs7336345 (P=1.31 × 10(-5)) and rs1012650 (P=1.47 × 10(-5)), and rs1059778 (P=1.49x10(-5)) in IBA57. In the second cohort, rs9346455 showed significant association with AIWG (P=0.005). The combined meta-analysis P-value for rs9346455 was 1.09 × 10(-7). Our reanalysis of the CATIE GWAS data revealed interesting new variants associated with AIWG. As the functional relevance of these polymorphisms is yet to be determined, further studies are needed.The Pharmacogenomics Journal advance online publication, 1 September 2015; doi:10.1038/tpj.2015.59.

  15. Genome-wide association study for feedlot average daily gain in Nellore cattle (Bos indicus).

    PubMed

    Santana, M H A; Utsunomiya, Y T; Neves, H H R; Gomes, R C; Garcia, J F; Fukumasu, H; Silva, S L; Leme, P R; Coutinho, L L; Eler, J P; Ferraz, J B S

    2014-06-01

    The genome-wide association study (GWAS) results are presented for average daily gain (ADG) in Nellore cattle. Phenotype of 720 male Bos indicus animals with information of ADG in feedlots and 354,147 single-nucleotide polymorphisms (SNPs) obtained from a database added by information from Illumina Bovine HD (777,962 SNPs) and Illumina BovineSNP50 (54,609) by imputation were used. After quality control and imputation, 290,620 SNPs remained in the association analysis, using R package Genome-wide Rapid Association using Mixed Model and Regression method GRAMMAR-Gamma. A genomic region with six significant SNPs, at Bonferroni-corrected significance, was found on chromosome 3. The most significant SNP (rs42518459, BTA3: 85849977, p = 9.49 × 10(-8)) explained 5.62% of the phenotypic variance and had the allele substitution effect of -0.269 kg/day. Important genes such as PDE4B, LEPR, CYP2J2 and FGGY are located near this region, which is overlapped by 12 quantitative trait locus (QTLs) described for several production traits. Other regions with markers with suggestive effects were identified in BTA6 and BTA10. This study showed regions with major effects on ADG in Bos indicus in feedlots. This information may be useful to increase the efficiency of selecting this trait and to understand the physiological processes involved in its regulation.

  16. Radiation therapy for primary optic nerve meningiomas.

    PubMed

    Smith, J L; Vuksanovic, M M; Yates, B M; Bienfang, D C

    1981-06-01

    Optic nerve sheath meningiomas, formerly thought to be rare, have been encountered with surprising frequency since the widespread use of computed tomography. Early diagnosis led to an enthusiastic surgical approach to these lesions, but this has been tempered by the realization that even in the best of hands, blindness followed such surgery with distressing frequency. Optic nerve sheath meningiomas may be divided into primary, secondary, and multiple meningioma groups. Five patients with primary optic nerve sheath meningiomas treated with irradiation therapy are presented in this report. Improvement in visual acuity, stabilization to increase in the visual field, and decrease in size to total regression of optociliary veins, have been documented following irradiation therapy of the posterior orbital and intracanalicular portions of the optic nerve in some of these cases. Although each patient must be carefully individualized, there is no question that visual palliation can be achieved in some cases of optic nerve sheath meningioma. Further investigation of this therapeutic modality in selected cases in advised.

  17. Frequent NF2 gene transcript mutations in sporadic meningiomas and vestibular schwannomas

    SciTech Connect

    Deprez, R.H.L.; Groen, N.A.; Zwarthoff, E.C.; Hagemeijer, A.; Van Drunen, E.; Bootsma, D.; Koper, J.W.; Avezaat, C.J.J. ); Bianchi, A.B.; Seizinger, B.R. )

    1994-06-01

    The gene for the hereditary disorder neurofibromatosis type 2 (NF2), which predisposes for benign CNS tumors such as vestibular schwannomas and meningiomas, has been assigned to chromosome 22 and recently has been isolated. Mutations in the NF2 gene were found in both sporadic meningiomas and vestibular schwannomas. However, so far only 6 of the 16 exons of the gene have been analyzed. In order to extend the analysis of an involvement of the NF2 gene in the sporadic counterparts of these NF2-related tumors, the authors have used reverse transcriptase-PCR amplification followed by SSCP and DNA sequence analysis to screen for mutations in the coding region of the NF2 gene. Analysis of the NF2 gene transcript in 53 unrelated patients with meningiomas and vestibular schwannomas revealed mutations in 32% of the sporadic meningiomas (n = 44), in 50% of the sporadic vestibular schwannomas (n = 4), in 100% of the tumors found in NF2 patients (n = 2), and in one of three tumors from multiple-meningioma patients. Of the 18 tumors in which a mutation in the NF2 gene transcript was observed and the copy number of chromosome 22 could be established, 14 also showed loss of (parts of) chromosome 22. This suggests that in sporadic meningiomas and NF2-associated tumors the NF2 gene functions as a recessive tumor-suppressor gene. The mutations detected resulted mostly in frameshifts, predicting truncations starting within the N-terminal half of the putative protein. 23 refs., 2 figs. 3 tabs.

  18. Does Histologic Subtype Influence the Post-Operative Outcome in Spinal Meningioma?

    PubMed

    Zham, Hanieh; Moradi, Afshin; Rakhshan, Azadeh; Zali, Alireza; Rahbari, Ali; Raee, Mohammadreza; Ashrafi, Farzad; Ahadi, Mahsa; Larijani, Leila; Baikpour, Masoud; Khayamzadeh, Maryam

    2016-04-01

    Postoperative outcome of spinal meningiomas is an important issue in surgery decision-making. There are limited and conflicting data in the literature about the prognostic factors influencing recovery, especially about the histopathologic subtypes. This study was carried out to evaluate the effect of some of these factors on postoperative outcome. This study was performed on 39 patients operated for spinal meningioma between October 1998 and January 2012; their histopathologic subtype was determined according to WHO criteria. The follow up period ranged between 8 - 120 months. The influence of histopathologic subtype, grade, age, sex, surgical approach, local adhesion and anatomical location was assessed according to Frankel classification of neurologic deficit. From a total number of 39 spinal meningiomas, 34 cases were WHO grade I, from which 15 cases were psammomatous, 7 cases were meningothelial, 9 cases were transitional and 3 cases were fibroblastic. Five cases were grade II, 3 of which had clear cell appearance and the remaining 2 had chordoid appearance. The mean age was 51.6 (22 to 76) years; 25 cases were female and 14 cases were male. This study revealed that grade II meningioma cases had poor prognosis in all 5 cases and psammomatous subtype had poor postoperative outcome in 40% of cases while the other subtypes had good outcome in all cases (P = 0.026). Cervical location of the tumor was also related with poor outcome in 37.5% of the cases, while 22.5% had poor outcome in other locations (P = 0.029). Age below and above 45 years and sex had no significant influence on the outcome. Spinal meningiomas of psammomatous type and grade II spinal meningiomas are associated with less favorable postoperative neurologic outcome. Cervical location has also a negative correlation with a good outcome.

  19. A study of prognostic factors in 45 cases of atypical meningioma.

    PubMed

    Endo, Toshiki; Narisawa, Ayumi; Ali, Hosam Shata Mohamed; Murakami, Kensuke; Watanabe, Takashi; Watanabe, Mika; Jokura, Hidefumi; Endo, Hidenori; Fujimura, Miki; Sonoda, Yukihiko; Tominaga, Teiji

    2016-09-01

    Atypical meningioma differs from Grade I meningioma in terms of high recurrence rate and short life expectancy. We evaluated the clinical course of atypical meningioma and investigated prognostic factors affecting its outcomes. We reviewed 45 patients with atypical meningioma who underwent surgical intervention between January 2000 and December 2013. The mean age of the patients and mean follow-up period was 58.7 years and 81.0 months, respectively. Analyses included factors such as patient age, gender, location and size of tumor, extent of surgical resection (Simpson Grading System), and MIB-1 labeling index (LI). Univariate analysis was used to detect prognostic factors associated with recurrence and survival. The 5-year recurrence-free rate for all 45 patients was 58.4 %; 5- and 10-year survival rates were 83.2 % and 79.9 %, respectively. In univariate analyses, age >60 years, and MIB-1 LI correlated with disease recurrence, whereas age >60 years, subtotal surgical resection, MIB-1 LI, and indication for radiotherapy correlated with death. MIB-1 LI levels higher than 12.8 % and 19.7 % predicted recurrence and death, respectively. In our cohort, 26 patients received postoperative radiotherapy including conventional radiation (n = 21) or gamma knife radiosurgery (n = 5). Postoperative radiotherapy did not decrease recurrence rates in our cohort (p = 0.63). Six and two patients who died during the study period underwent conventional radiation and radiosurgery, respectively. Age, male gender, extent of surgical resection, and higher MIB-1 LI influenced the outcome of atypical meningioma. In our cohort, postoperative radiotherapy failed to provide long-term tumor control. Following incomplete surgical resection of atypical meningioma in elderly patients, adjuvant postoperative radiotherapy may not be an ideal treatment option, particularly when MIB-1 LI is higher than 19.7 %.

  20. Will an Asymptomatic Meningioma Grow or Not Grow? A Meta-analysis.

    PubMed

    Zeng, Lingcheng; Liang, Pei; Jiao, Jiantong; Chen, Jian; Lei, Ting

    2015-09-01

    The treatment strategy for patients with an asymptomatic meningioma is still controversial. Key to an optimal decision is a careful evaluation of the growth possibilities of the meningioma by taking the patient's clinicoradiologic factors into consideration. However, previous studies have disagreed about the risk factors relating to tumor growth. A comprehensive search of PubMed, Embase, and the ISI Web of Knowledge was performed. Using a meta-analysis with nine subsidiary studies including 777 patients, we analyzed the correlation of the growth pattern of meningioma with patient gender, tumor location, tumor calcification, magnetic resonance imaging (MRI) T2 signal intensity, and peritumoral brain edema. The growth rate of meningioma was negatively correlated with tumor calcification (odds ratio [OR]: 0.23; 95% confidence interval (CI), 0.11-0.46; p < 0.001) but positively associated with MRI T2 signal intensity (OR: 2.75; 95% CI, 1.75-4.33; p < 0.001). No correlations were found between tumor growth and other factors such as gender (OR: 1.29; 95% CI, 0.84-1.99; p = 0.24), skull base location (OR: 0.80; 95% CI, 0.25-2.58; p = 0.70), and peritumoral brain edema (OR: 1.24; 95% CI, 0.29-5.27; p = 0.77). Two factors, tumor calcification and low MRI T2 signal intensity, indicate the possibility of a slow growth meningioma. In such cases of asymptomatic meningioma, a follow-up strategy can be preferentially considered. Georg Thieme Verlag KG Stuttgart · New York.

  1. A2BP1 gene polymorphisms association with olanzapine-induced weight gain.

    PubMed

    Dong, Licai; Yan, Hao; Huang, Xuebing; Hu, Xiaofeng; Yang, Yongfeng; Ma, Cuicui; Du, Bo; Lu, Tianlan; Jin, Chao; Wang, Lifang; Yu, Hao; Dong, Zheng; Li, Wenqiang; Ruan, Yanyan; Zhang, Hongyan; Zhang, Hongxing; Mi, Weifeng; Ma, Wenbin; Li, Keqing; Lv, Luxian; Zhang, Dai; Yue, Weihua

    2015-09-01

    The ataxin-2 binding protein 1 (A2BP1) gene is reported to be one of the susceptibility genes in schizophrenia, autism, and obesity. The aim of this study was to explore the association of A2BP1 gene polymorphisms with antipsychotic induced weight gain (AIWG) in Chinese Han population. Three hundred and twenty-eight patients with schizophrenia were followed-up for an 8-week period of treatment with olanzapine. The fasting weights of 328 patients were measured before and after the 8-week course of treatment. Four single nucleotide polymorphisms (SNPs: rs8048076, rs1478697, rs10500331, and rs4786847) of the A2BP1 gene were genotyped by polymerase chain reaction (PCR). We analyzed putative association of A2BP1 polymorphisms with AIWG of olanzapine using linear regression analysis and found that SNP rs1478697 was significantly associated with AIWG caused by olanzapine (p=0.0012; Bonferroni corrected p=0.0048). The association was replicated in another independent sample including 208 first-episode and drug-naïve patients presenting with schizophrenia after a 4-week treatment with olanzapine (p=0.0092; Bonferroni corrected p=0.0368; meta p=5.33×10(-5)). To explore the biological plausibility of A2BP1 in the pathogenesis of AIWG, we made expression analyses and eQTL analyses; these analyses showed that A2BP1 was highly expressed in whole brain tissues using the HBT database, and that rs1478697 has an expression quantitative trait locus effect in human cerebellar cortex tissues using the BRAINEAC database (p=2.50E-04). In conclusion, the rs1478697 in A2BP1 may be associated with AIWG induced by 8-week treatment with olanzapine. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Dorsal spinal epidural psammomatous meningioma in an adult male

    PubMed Central

    Pandey, Sharad; Singh, Kulwant; Sharma, Vivek; Ghosh, Amrita; Suman, Saurabh

    2016-01-01

    Meningiomas are benign in nature and arise from the arachnoid cells. They are mostly situated in the intracranial compartment, whereas spinal meningiomas are rare. Approximately, in 10% of cases, an extradural component is seen but an exclusively extradural meningioma is quite uncommon. However, WHO Grade II (atypical) and Grade III (anaplastic) tumors can behave aggressively. We reported a case of purely extradural psammomatous meningioma in an adult male affecting the dorsal spine although uncommon meningiomas should be included in the differential diagnosis of extradural intraspinal masses. PMID:26933358

  3. Dorsal spinal epidural psammomatous meningioma in an adult male.

    PubMed

    Pandey, Sharad; Singh, Kulwant; Sharma, Vivek; Ghosh, Amrita; Suman, Saurabh

    2016-01-01

    Meningiomas are benign in nature and arise from the arachnoid cells. They are mostly situated in the intracranial compartment, whereas spinal meningiomas are rare. Approximately, in 10% of cases, an extradural component is seen but an exclusively extradural meningioma is quite uncommon. However, WHO Grade II (atypical) and Grade III (anaplastic) tumors can behave aggressively. We reported a case of purely extradural psammomatous meningioma in an adult male affecting the dorsal spine although uncommon meningiomas should be included in the differential diagnosis of extradural intraspinal masses.

  4. Intraventricular meningioma after cranial irradiation for childhood leukemia.

    PubMed

    Ney, Douglas E; Huse, Jason T; Dunkel, Ira J; Steinherz, Peter G; Haque, Sofia; Khakoo, Yasmin

    2010-10-01

    Meningiomas are among the most common brain tumors in adults. They are most commonly located over the cerebral convexities and are infrequently found in an intraventricular location. Ionizing cranial radiation is a risk factor for late occurrence of meningiomas within the radiation field. While pathologic grading of meningiomas is straightforward, significant variability often exists between pathologists in applying standard grading criteria. This has implications for prognosis. Radiation-induced meningiomas may also have predilection to recur. The authors describe a case of an intraventricular meningioma occurring 23 years after cranial irradiation for childhood acute lymphoblastic leukemia.

  5. Meningiomas involving the anterior clinoid process.

    PubMed

    Risi, P; Uske, A; de Tribolet, N

    1994-01-01

    We report a series of 34 clinoidal meningiomas treated surgically and analyse the results according to cavernous sinus involvement. Fifteen tumours extended into the cavernous sinus. Only four of these could be resected completely, and global outcome was improved or stable in 10 cases. Overall, 20 tumours had a total resection and 14 had a partial resection. Complete removal of the sphenoid wing, including the anterior clinoid and part of the planum sphenoidale, allows early devascularization of the tumour and minimizes brain retraction when associated with resection of the zygomatic arch. The most frequent postoperative complication was transient CSF leak, occurring in three patients. Two patients died postoperatively, and three suffered permanent complications. There was no recurrence after total removal, but five patients showed signs of progressive tumour growth after partial removal, treated by radiotherapy in three and by surgery in two cases. Twenty patients showed preoperative visual impairment. Outcome of vision was improved or stable in 13 (68%) and worse in six cases (32%). We suggest that progressive visual impairment should lead to aggressive surgical treatment, especially when complete resection of cavernous sinus involvement can be performed.

  6. The association between quitting smoking and weight gain: a systemic review and meta-analysis of prospective cohort studies.

    PubMed

    Tian, J; Venn, A; Otahal, P; Gall, S

    2015-10-01

    This systematic review and meta-analysis aimed to quantify weight gain after smoking cessation and the difference in weight gain between quitters and continuing smokers. Five electronic databases were searched before January 2015. Population-based prospective cohort studies were included if they recorded the weight change of adult smokers from baseline (before smoking cessation) to follow-up (at least 3 months after cessation). Thirty-five cohort studies were identified, including 63,403 quitters and 388,432 continuing smokers. The mean weight gain was 4.10 kg (95% confidence interval [CI]: 2.69, 5.51) and body mass index (BMI) gain was 1.14 kg m(-2) (95% CI: 0.50, 1.79) among quitters. Compared with continuing smoking, quitting smoking was significantly associated with absolute weight (adjusted mean difference [MD]: 2.61 kg; 95% CI: 1.61, 3.60) and BMI gain (adjusted MD: 0.63 kg m(-2) ; 95% CI: 0.46, 0.80). Subgroup analyses using geographic region found that the difference in weight gain was considerably greater in studies from North America than from Asia. Follow-up length was identified as a source of heterogeneity, such that studies with longer follow-up showed greater difference in weight gain. Effective strategies are needed to encourage smokers to quit irrespective of potential weight gain and to help quitters avoid excess weight gain. © 2015 World Obesity.

  7. Prevalence and factors associated with excessive weight gain in pregnancy in health units in the southwest of Bahia.

    PubMed

    Magalhães, Elma Izze da Silva; Maia, Daniela Santana; Bonfim, Carla Fabrícia Araújo; Netto, Michele Pereira; Lamounier, Joel Alves; Rocha, Daniela da Silva

    2015-01-01

    To determine the prevalence of excessive gestational weekly weight gain and to identify its association with demographic, socioeconomic, obstetric, anthropometric, and behavioral characteristics. This cross-sectional study included 328 pregnant women attending all health units in the urban area of Vitória da Conquista, Bahia. The data were collected from May 2010 to June 2011. The weekly weight gain was evaluated according to the current recommendations of the Institute of Medicine. The association among the studied factors and the excessive weekly weight gain was observed in pregnant women in the second and third trimesters, using the Poisson regression with robust variance. The prevalence rate of excessive weekly weight gain in pregnant women in the second and third trimesters was found to be 42.5%. The determinants of excessive weekly weight gain were family income < 1 minimum wage (PR: 2.65; 95%CI 1.18 - 4.83) and pregestational weight status overweight/obesity (PR: 1.33; 95%CI 1.01 - 1.75). The results emphasize the importance of monitoring the weight gain during pregnancy. The evaluation of the weekly weight gain enables early interventions with the goal of preventing the excessive total weight gain and its consequences for both the mother and the child.

  8. Association of LEPR and ANKK1 Gene Polymorphisms with Weight Gain in Epilepsy Patients Receiving Valproic Acid

    PubMed Central

    Li, Hongliang; Wang, Xueding; Zhou, Yafang; Ni, Guanzhong; Su, Qibiao; Chen, Ziyi; Chen, Zhuojia; Li, Jiali; Chen, Xinmeng; Hou, Xiangyu; Xie, Wen; Xin, Shuang; Zhou, Liemin

    2015-01-01

    Background: Weight gain is the most frequent adverse effect of valproic acid (VPA) treatment, resulting in poor compliance and many endocrine disturbances. Similarities in the weight change of monozygotic twins receiving VPA strongly suggests that genetic factors are involved in this effect. However, few studies have been conducted to identify the relevant genetic polymorphisms. Additionally, the causal relationship between the VPA concentration and weight gain has been controversial. Thus, we investigated the effects of single nucleotide polymorphisms (SNPs) in several appetite stimulation and energy homeostasis genes and the steady state plasma concentrations (Css) of VPA on the occurrence of weight gain in patients. Methods: A total of 212 epilepsy patients receiving VPA were enrolled. Nineteen SNPs in 11 genes were detected using the Sequenom MassArray iPlex platform, and VPA Css was determined by high-performance liquid chromatography (HPLC). Results: After 6 months of treatment, 20.28% of patients were found to gain a significant amount of weight (weight gained ≥7%). Three SNPs in the leptin receptor (LEPR), ankyrin repeat kinase domain containing 1 (ANKK1), and α catalytic subunit of adenosine monophosphate-activated protein kinase (AMPK) showed significant associations with VPA-induced weight gain (p < 0.001, p = 0.017 and p = 0.020, respectively). After Bonferroni correction for multiple tests, the genotypic association of LEPR rs1137101, the allelic association of LEPR rs1137101, and ANKK1 rs1800497 with weight gain remained significant. However, the VPA Css in patents who gained weight were not significantly different from those who did not gain weight (p = 0.121). Conclusions: LEPR and ANKK1 genetic polymorphisms may have value in predicting VPA-induced weight gain. PMID:25740917

  9. Association of LEPR and ANKK1 Gene Polymorphisms with Weight Gain in Epilepsy Patients Receiving Valproic Acid.

    PubMed

    Li, Hongliang; Wang, Xueding; Zhou, Yafang; Ni, Guanzhong; Su, Qibiao; Chen, Ziyi; Chen, Zhuojia; Li, Jiali; Chen, Xinmeng; Hou, Xiangyu; Xie, Wen; Xin, Shuang; Zhou, Liemin; Huang, Min

    2015-03-03

    Weight gain is the most frequent adverse effect of valproic acid (VPA) treatment, resulting in poor compliance and many endocrine disturbances. Similarities in the weight change of monozygotic twins receiving VPA strongly suggests that genetic factors are involved in this effect. However, few studies have been conducted to identify the relevant genetic polymorphisms. Additionally, the causal relationship between the VPA concentration and weight gain has been controversial. Thus, we investigated the effects of single nucleotide polymorphisms (SNPs) in several appetite stimulation and energy homeostasis genes and the steady state plasma concentrations (Css) of VPA on the occurrence of weight gain in patients. A total of 212 epilepsy patients receiving VPA were enrolled. Nineteen SNPs in 11 genes were detected using the Sequenom MassArray iPlex platform, and VPA Css was determined by high-performance liquid chromatography (HPLC). After 6 months of treatment, 20.28% of patients were found to gain a significant amount of weight (weight gained ≥7%). Three SNPs in the leptin receptor (LEPR), ankyrin repeat kinase domain containing 1 (ANKK1), and α catalytic subunit of adenosine monophosphate-activated protein kinase (AMPK) showed significant associations with VPA-induced weight gain (p < 0.001, p = 0.017 and p = 0.020, respectively). After Bonferroni correction for multiple tests, the genotypic association of LEPR rs1137101, the allelic association of LEPR rs1137101, and ANKK1 rs1800497 with weight gain remained significant. However, the VPA Css in patents who gained weight were not significantly different from those who did not gain weight (p = 0.121). LEPR and ANKK1 genetic polymorphisms may have value in predicting VPA-induced weight gain. © The Author 2015. Published by Oxford University Press on behalf of CINP.

  10. Evolved tooth gain in sticklebacks is associated with a cis-regulatory allele of Bmp6

    PubMed Central

    Cleves, Phillip A.; Ellis, Nicholas A.; Jimenez, Monica T.; Nunez, Stephanie M.; Schluter, Dolph; Kingsley, David M.; Miller, Craig T.

    2014-01-01

    Developmental genetic studies of evolved differences in morphology have led to the hypothesis that cis-regulatory changes often underlie morphological evolution. However, because most of these studies focus on evolved loss of traits, the genetic architecture and possible association with cis-regulatory changes of gain traits are less understood. Here we show that a derived benthic freshwater stickleback population has evolved an approximate twofold gain in ventral pharyngeal tooth number compared with their ancestral marine counterparts. Comparing laboratory-reared developmental time courses of a low-toothed marine population and this high-toothed benthic population reveals that increases in tooth number and tooth plate area and decreases in tooth spacing arise at late juvenile stages. Genome-wide linkage mapping identifies largely separate sets of quantitative trait loci affecting different aspects of dental patterning. One large-effect quantitative trait locus controlling tooth number fine-maps to a genomic region containing an excellent candidate gene, Bone morphogenetic protein 6 (Bmp6). Stickleback Bmp6 is expressed in developing teeth, and no coding changes are found between the high- and low-toothed populations. However, quantitative allele-specific expression assays of Bmp6 in developing teeth in F1 hybrids show that cis-regulatory changes have elevated the relative expression level of the freshwater benthic Bmp6 allele at late, but not early, stages of stickleback development. Collectively, our data support a model where a late-acting cis-regulatory up-regulation of Bmp6 expression underlies a significant increase in tooth number in derived benthic sticklebacks. PMID:25205810

  11. Evolved tooth gain in sticklebacks is associated with a cis-regulatory allele of Bmp6.

    PubMed

    Cleves, Phillip A; Ellis, Nicholas A; Jimenez, Monica T; Nunez, Stephanie M; Schluter, Dolph; Kingsley, David M; Miller, Craig T

    2014-09-23

    Developmental genetic studies of evolved differences in morphology have led to the hypothesis that cis-regulatory changes often underlie morphological evolution. However, because most of these studies focus on evolved loss of traits, the genetic architecture and possible association with cis-regulatory changes of gain traits are less understood. Here we show that a derived benthic freshwater stickleback population has evolved an approximate twofold gain in ventral pharyngeal tooth number compared with their ancestral marine counterparts. Comparing laboratory-reared developmental time courses of a low-toothed marine population and this high-toothed benthic population reveals that increases in tooth number and tooth plate area and decreases in tooth spacing arise at late juvenile stages. Genome-wide linkage mapping identifies largely separate sets of quantitative trait loci affecting different aspects of dental patterning. One large-effect quantitative trait locus controlling tooth number fine-maps to a genomic region containing an excellent candidate gene, Bone morphogenetic protein 6 (Bmp6). Stickleback Bmp6 is expressed in developing teeth, and no coding changes are found between the high- and low-toothed populations. However, quantitative allele-specific expression assays of Bmp6 in developing teeth in F1 hybrids show that cis-regulatory changes have elevated the relative expression level of the freshwater benthic Bmp6 allele at late, but not early, stages of stickleback development. Collectively, our data support a model where a late-acting cis-regulatory up-regulation of Bmp6 expression underlies a significant increase in tooth number in derived benthic sticklebacks.

  12. Intraspinal meningioma with malignant transformation and distant metastasis.

    PubMed

    Ito, Kenyu; Imagama, Shiro; Ando, Kei; Kobayashi, Kazuyoshi; Shido, Yoji; Go, Yoshida; Arima, Hideyuki; Kanbara, Shunsuke; Hirose, Takanori; Matsuyama, Yukihiro; Nishida, Yoshihiro; Ishiguro, Naoki

    2017-02-01

    Meningioma is typically considered to be a benign tumor. Malignant transformation and metastasis of meningiomas are rare. Moreover, most meningiomas are intracranial, and there are few reports on intraspinal meningiomas. This report aimed to describe the clinical features and pathological findings of a case of malignant transformation and distant metastasis of intraspinal meningioma, with a review of the literature. A 44-year-old man with a bilateral lower limb paresis was diagnosed with an intradural extramedullary tumor of the thoracic spine. Primary tumor resection was performed, and the histological findings revealed atypical meningioma. The meningioma recurred 2 years after the primary surgery, and a second resection was performed, but only partial resection was possible because of decreased motor evoked potential. At age 48, the patient's lower limb weakness returned, and a third resection was performed, and the histological finding remained atypical meningioma. At age 54, the tumor increased and stereotactic irradiation was performed. At age 60, the patient was diagnosed with metastatic tumors of the rib, lumbar vertebra, cervical spine, and sacrum. Biopsy of the rib metastatic tumor was performed, and the histological findings revealed anaplastic meningioma. This case is the first report of an intraspinal meningioma that transformed from atypical to anaplastic meningioma with distant hematogenous metastasis.

  13. Intraspinal meningioma with malignant transformation and distant metastasis

    PubMed Central

    Ito, Kenyu; Imagama, Shiro; Ando, Kei; Kobayashi, Kazuyoshi; Shido, Yoji; Go, Yoshida; Arima, Hideyuki; Kanbara, Shunsuke; Hirose, Takanori; Matsuyama, Yukihiro; Nishida, Yoshihiro; Ishiguro, Naoki

    2017-01-01

    ABSTRACT Meningioma is typically considered to be a benign tumor. Malignant transformation and metastasis of meningiomas are rare. Moreover, most meningiomas are intracranial, and there are few reports on intraspinal meningiomas. This report aimed to describe the clinical features and pathological findings of a case of malignant transformation and distant metastasis of intraspinal meningioma, with a review of the literature. A 44-year-old man with a bilateral lower limb paresis was diagnosed with an intradural extramedullary tumor of the thoracic spine. Primary tumor resection was performed, and the histological findings revealed atypical meningioma. The meningioma recurred 2 years after the primary surgery, and a second resection was performed, but only partial resection was possible because of decreased motor evoked potential. At age 48, the patient’s lower limb weakness returned, and a third resection was performed, and the histological finding remained atypical meningioma. At age 54, the tumor increased and stereotactic irradiation was performed. At age 60, the patient was diagnosed with metastatic tumors of the rib, lumbar vertebra, cervical spine, and sacrum. Biopsy of the rib metastatic tumor was performed, and the histological findings revealed anaplastic meningioma. This case is the first report of an intraspinal meningioma that transformed from atypical to anaplastic meningioma with distant hematogenous metastasis. PMID:28303067

  14. Calcification in the human choroid plexus, meningiomas and pineal gland.

    PubMed

    Alcolado, J C; Moore, I E; Weller, R O

    1986-01-01

    Calcification in the stroma of adult telencephalic choroid plexus was studied of 20 postmortem brains and one biopsy by light microscopy, transmission and scanning electron microscopy and compared with calcification in psammoma bodies in normal arachnoid, five spinal meningiomas and in calcospherites of six pineal glands. Fifteen fetal and newborn choroid plexuses were also examined by light microscopy. Calcium deposition was observed in the subepithelial regions of the adult choroid plexus, in the walls of blood vessels but was mostly seen in spherical psammoma bodies. Collagen whorls 20-60 microns in diameter and surrounded by arachnoid cells, were observed in the stroma of the choroid plexus; calcium, phosphorous and iron were deposited in the collagen whorls to form psammoma bodies. Matrix vesicles and spicules resembling hydroxyapatite were associated with the arachnoid cells surrounding the collagen whorls and with the collagen fibres within the whorls. The dense amorphous calcified core of each psammoma body was surrounded by an outer coating of entwined collagen fibres readily visible by scanning electron microscopy. Similar psammoma bodies were occasionally observed in normal arachnoid. Psammoma bodies in meningiomas resembled those in the choroid plexus stroma. Calcospherites in the pineal differed from psammoma bodies; they were lobulated, more irregular in shape and did not have a collagen base. The results of this study suggest that psammoma bodies in the choroid plexus, as in meningiomas, form by a process of dystrophic calcification associated with arachnoid cells and collagen fibres. The presence of iron in the choroid plexus psammoma bodies may be a result of haemorrhage into the stroma. The mechanism of calcification in pineal remains unclear.

  15. Predictors of Gestational Weight Gain among White and Latina Women and Associations with Birth Weight

    PubMed Central

    Wang, Monica L.; Bodenlos, Jamie S.; Sankey, Heather Z.

    2016-01-01

    This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8–6.5) and obese (OR = 4.5, CI = 2.3–9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8–8.8). GWG was positively associated with neonate birth size (p < 0.001). Interventions targeting prepregnancy overweight or obese women and those with excessive first-trimester GWG are needed. PMID:27688913

  16. Radiosurgical planning of meningiomas: compromises with conformity.

    PubMed

    Rowe, Jeremy G; Walton, Lee; Vaughan, Paul; Malik, Irfan; Radatz, Matthias; Kemeny, Andras

    2004-01-01

    The radiosurgical planning of meningiomas frequently necessitates compromises between irradiating tumour and risking damage to adjacent structures. In selected cases, we resolved this by excluding part of the tumour from the prescription isodose volume. Most of these compromises or 'suboptimal' plans achieved growth control. Growth control could not be related to conformity indices or to various measures of the radiation dose received by the meningioma. Examining recurrences, 75% arose from dura outside the original treatment field. These findings are discussed in terms of dose prescription protocols and the use of conformity indices in planning. The importance of the dural origin of meningiomas is well established in surgical practice, as reflected by Simpson's grades, but may be equally significant in radiosurgical practice.

  17. Pediatric spinal clear cell meningioma. Case report.

    PubMed

    Colen, Chaim B; Rayes, Mahmoud; McClendon, Jamal; Rabah, Raja; Ham, Steven D

    2009-01-01

    In this report the authors describe a unique case of spinal clear cell meningioma in a 13-year-old girl. Clear cell meningiomas (CCMs) are not uncommon. To the authors' knowledge, 14 cases of pediatric CCM occurring in the spinal canal have been reported. Factors lending resistance to meningioma initiation and invasion are analyzed. This 13-year-old girl presented with pain radiating down her left leg. Admission MR imaging showed an inhomogeneous enhancing intradural-extramedullary mass at the L4-5 level. Resection revealed a CCM, and radiotherapy was subsequently administered. Postoperatively there has been no recurrence in > 2 years. In this paper the authors report a case of CCM and provide a comprehensive literature review on this disease. Current recommendations for its management are still debatable, especially in the pediatric population, and the authors propose an algorithm for its treatment and surveillance.

  18. Spinal subdural hematoma following meningioma removal operation.

    PubMed

    Jun, Hyo Sub; Oh, Jae Keun; Park, Young Seok; Song, Joon Ho

    2014-03-01

    Although blood contamination of cerebrospinal fluid (CSF) after an intracranial operation can occur, the development of a symptomatic spinal hematoma after craniotomy has been anecdotally reported and it is uncommon reported after a supratentorial meningioma removal operation. We report a case of spinal subdural hematoma following a supratentorial meningioma removal operation and discuss the mechanism of spinal subdural hematoma (SSDH) development. A 54-year-old woman presented with lumbago and radicular pain on both legs 4 days after a right parietooccipital craniotomy for meningioma removal. Only the straight leg raising sign was positive on neurologic examination but the magnetic resonance imaging (MRI) demonstrated a lumbosacral spinal subdural hematoma. The patient received serial lumbar tapping, after which her symptoms showed improvement.

  19. Spinal Subdural Hematoma Following Meningioma Removal Operation

    PubMed Central

    Jun, Hyo Sub; Oh, Jae Keun; Park, Young Seok

    2014-01-01

    Although blood contamination of cerebrospinal fluid (CSF) after an intracranial operation can occur, the development of a symptomatic spinal hematoma after craniotomy has been anecdotally reported and it is uncommon reported after a supratentorial meningioma removal operation. We report a case of spinal subdural hematoma following a supratentorial meningioma removal operation and discuss the mechanism of spinal subdural hematoma (SSDH) development. A 54-year-old woman presented with lumbago and radicular pain on both legs 4 days after a right parietooccipital craniotomy for meningioma removal. Only the straight leg raising sign was positive on neurologic examination but the magnetic resonance imaging (MRI) demonstrated a lumbosacral spinal subdural hematoma. The patient received serial lumbar tapping, after which her symptoms showed improvement. PMID:24891866

  20. Primary pulmonary meningioma: A case report.

    PubMed

    Huang, Shucheng; Chen, Li; Mao, Yuping; Tong, Hongwei

    2017-05-01

    Primary extracranial meningiomas are rare outside the head and neck region. A 44-year-old female patient had chest pain for more than 1 year. Preoperative chest computed tomography (CT) scan revealed a nodule in the right lower lobe, 1.8 cm in diameter. Tumor tissues were examined by immunohistochemistry for vimentin and S-100. Histopathologically, the tumor was characterized by whorled nests of spindle-shaped cells accompanied by psammoma bodies. Immunohistochemistry demonstrated tumor cell positivity for vimentin and S-100. This case was diagnosed as a primary pulmonary meningioma. The tumor was removed by a thoracoscopic pulmonary wedge resection. Postoperative cranial and spinal CT scan did not show any intracranial or spinal mass. No recurrence of the tumor was reported at the time of writing up this case report. A primary pulmonary meningioma should be considered in the differential diagnosis workup of pulmonary nodules.

  1. Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas.

    PubMed

    Fatemi, Nasrin; Dusick, Joshua R; de Paiva Neto, Manoel A; Malkasian, Dennis; Kelly, Daniel F

    2009-05-01

    Endonasal and supraorbital "eyebrow" craniotomies are increasingly being used to remove craniopharyngiomas and tuberculum sellae meningiomas. Herein, we assess the relative advantages, disadvantages, and selection criteria of these 2 keyhole approaches. All consecutive patients who had endonasal or supraorbital removal of a craniopharyngioma or tuberculum sellae meningioma were analyzed. Of 43 patients, 22 had a craniopharyngioma (18 endonasal, 4 supraorbital), and 21 had a meningioma (12 endonasal, 7 supraorbital, 2 both routes); 33% had prior surgery. Craniopharyngiomas were primarily retrochiasmal in location in 78% of endonasal cases versus 25% of supraorbital cases (P = 0.08). Meningiomas were larger when approached by the supraorbital route versus the endonasal route (33 +/- 10 versus 25 +/- 8 mm, respectively; P = 0.008). Endoscopy was used in 84% of endonasal approaches and in 31% of supraorbital approaches (P = 0.001). Of patients having first-time surgery for a craniopharyngioma (n = 14) or meningioma (n = 15), total/near total removal was achieved in 83% and 80% of patients by the endonasal route and in 50% and 80% of patients by the supraorbital route, respectively. Vision improved in 87% and 70% of patients who had surgery by an endonasal versus supraorbital route, respectively (P = 0.3). Visual deterioration occurred in 2 patients with meningiomas, 1 by endonasal (7%), and 1 by supraorbital (11%) removal. The endonasal approach was associated with a higher rate of postoperative cerebrospinal fluid leaks (16 versus 0%; P = 0.3), 4 of 5 of which occurred in patients with meningioma. The endonasal route is preferred for removal of most retrochiasmal craniopharyngiomas, whereas the supraorbital route is recommended for meningiomas larger than 30 to 35 mm or with growth beyond the supraclinoid carotid arteries. For smaller midline tumors, either approach can be used, depending on surgeon experience and tumor anatomy. Compared with traditional craniotomies

  2. A retrospective analysis of survival and prognostic factors after stereotactic radiosurgery for aggressive meningiomas

    PubMed Central

    2014-01-01

    Background While most meningiomas are benign, aggressive meningiomas are associated with high levels of recurrence and mortality. A single institution’s Gamma Knife radiosurgical experience with atypical and malignant meningiomas is presented, stratified by the most recent WHO classification. Methods Thirty-one patients with atypical and 4 patients with malignant meningiomas treated with Gamma Knife radiosurgery between July 2000 and July 2011 were retrospectively reviewed. All patients underwent prior surgical resection. Overall survival was the primary endpoint and rate of disease recurrence in the brain was a secondary endpoint. Patients who had previous radiotherapy or prior surgical resection were included. Kaplan-Meier and Cox proportional hazards models were used to estimate survival and identify factors predictive of recurrence and survival. Results Post-Gamma Knife recurrence was identified in 11 patients (31.4%) with a median overall survival of 36 months and progression-free survival of 25.8 months. Nine patients (25.7%) had died. Three-year overall survival (OS) and progression-free survival (PFS) rates were 78.0% and 65.0%, respectively. WHO grade II 3-year OS and PFS were 83.4% and 70.1%, while WHO grade III 3-year OS and PFS were 33.3% and 0%. Recurrence rate was significantly higher in patients with a prior history of benign meningioma, nuclear atypia, high mitotic rate, spontaneous necrosis, and WHO grade III diagnosis on univariate analysis; only WHO grade III diagnosis was significant on multivariate analysis. Overall survival was adversely affected in patients with WHO grade III diagnosis, prior history of benign meningioma, prior fractionated radiotherapy, larger tumor volume, and higher isocenter number on univariate analysis; WHO grade III diagnosis and larger treated tumor volume were significant on multivariate analysis. Conclusion Atypical and anaplastic meningiomas remain difficult tumors to treat. WHO grade III diagnosis and treated

  3. Diagnostic and prognostic significance of genetic regional heterogeneity in meningiomas1

    PubMed Central

    Pfisterer, Wolfgang K.; Hank, Nicole C.; Preul, Mark C.; Hendricks, William P.; Pueschel, Jeanette; Coons, Stephen W.; Scheck, Adrienne C.

    2004-01-01

    We analyzed the frequency and regional distribution of cells with genetic abnormalities of chromosomes 1, 14, and 22 in meningiomas. This data was evaluated for correlation to the clinical outcome of the patients. Eight defined areas of each of 77 paraffin-embedded meningioma samples (59 grade I, 13 grade II, and 5 grade III) were analyzed by fluorescent in situ hybridization using bacterial artificial chromosome probes localized to chromosomes 1p36.32, 1q25.3, 14q13.3, 14q32.12, 22q11.2, and 22q12.1-3. Chromosome deletion was considered to be regionally heterogeneous if <7 regions showed cells with chromosome deletions. Deletion of 1p occurred in 35% of the grade I tumors. Distribution of cells with 1p deletion was regionally heterogeneous in 25% and homogeneous in 10% of grade I tumors. Distribution of cells with deletion of 1p was regionally heterogeneous in 23% and homogeneous in 69% of the grade II tumors. All grade III meningiomas had homogeneous distribution of cells with deletion of chromosome 1p. Distribution of cells with deletion of 14q was regionally heterogeneous in 27% and homogeneous in 2% of the grade I meningiomas, heterogeneous in 31% and homogeneous in 62% of the grade II tumors, and heterogeneous in 40% and homogeneous in 60% of the grade III meningiomas. Distribution of cells with deletion of 22q was regionally heterogeneous in 15% and homogeneous in 3% of the grade I tumors, heterogeneous in 15% and homogeneous in 31% of grade II tumors, and homogeneous in 20% of the grade III meningiomas. Distribution of cells with trisomy 22q was regionally heterogeneous in 10% of grade I tumors, heterogeneous in 23% of grade II, and homogeneous in 80% of grade III meningiomas. The proportion of patients with a deletion of 22q (either homogeneous or heterogeneous) who had recurrence was greater than the proportion of those without 22q deletion who had recurrence, and deletion of 22q was significantly associated with radiologically detected recurrence (P < 0

  4. Papillary meningioma: clinical and histopathological observations

    PubMed Central

    Wang, Dai-Jun; Zheng, Ming-Zhe; Gong, Ye; Xie, Qing; Wang, Yin; Cheng, Hai-Xia; Mao, Ying; Zhong, Ping; Che, Xiao-Ming; Jiang, Cheng-Chuan; Huang, Feng-Ping; Zheng, Kang; Li, Shi-Qi; Gu, Yu-Xiang; Bao, Wei-Min; Yang, Bo-Jie; Wu, Jing-Song; Xie, Li-Qian; Tang, Hai-Liang; Zhu, Hong-Da; Chen, Xian-Cheng; Zhou, Liang-Fu

    2013-01-01

    Papillary meningioma is a rare subtype of malignant meningiomas, which is classified by the World Health Organization as Grade III. Because of lack of large sample size case studies, many of the specific characteristics of papillary meningioma are unclear. This study investigated by retrospective analysis the clinical, radiological and histopathological findings of 17 papillary meningioma patients who underwent surgical resection or biopsy, to assess the characteristics of papillary meningioma. Eight female and nine male patients were included, with a mean age of 40 (range: 6 to 55) years. Tumors were mostly located in the cerebral convexity and showed irregular margins, absence of a peritumoral rim, heterogeneous enhancement and severe peritumoral brain edema on preoperative images. Brain invasion was often confirmed during the operations, with abundant to exceedingly abundant blood supply. Intratumoral necrosis and mitosis was frequently observed on routinely stained sections. The average MIB-1 labeling index was 6.9%. Seven cases experienced tumor recurrence or progression, while seven patients died 6 to 29 months after operation. Radiation therapy was given in 52.9% of all cases. Univariate analysis showed that only the existence of intratumoral necrosis and incomplete resection correlated with tumor recurrence. The 3-year progression free survival was 66.7% after gross total resection and 63.6% for other cases. The 3-year mortality rate was 50% after gross total resection and 63.6% for other cases. Papillary meningioma has specific clinical and histopathological characteristics. Tumor recurrence (or progression) and mortality are common. Gross total tumor resection resulted in less recurrence and mortality. PMID:23638219

  5. Histone deacetylase inhibitor AR-42 differentially affects cell cycle transit in meningeal and meningioma cells, potently inhibiting NF2-deficient meningioma growth

    PubMed Central

    Burns, Sarah S.; Akhmametyeva, Elena M.; Oblinger, Janet L.; Bush, Matthew L.; Huang, Jie; Senner, Volker; Chen, Ching-Shih; Jacob, Abraham; Welling, D. Bradley; Chang, Long-Sheng

    2012-01-01

    Meningiomas constitute ~34% of primary intracranial tumors and are associated with increased mortality in NF2 patients. To evaluate potential medical therapies for these tumors, we have established a quantifiable orthotopic model for NF2-deficient meningiomas. We showed that telomerase-immortalized Ben-Men-1 benign meningioma cells harbored a single nucleotide deletion in NF2 exon 7 and did not express the NF2 protein, merlin. We also demonstrated that AR-42, a pan-histone deacetylase inhibitor, inhibited proliferation of both Ben-Men-1 and normal meningeal cells by increasing expression of p16INK4A, p21CIP1/WAF1, and p27KIP1. Also, AR-42 increased pro-apoptotic Bim expression and decreased anti-apoptotic BclXL levels. However, AR-42 predominantly arrested Ben-Men-1 cells at G2/M, while inducing cell-cycle arrest at G1 in meningeal cells. Consistently, AR-42 substantially decreased the levels of cyclin D1, E, and A, and PCNA in meningeal cells while significantly reducing the expression of cyclin B, important for progression through G2, in Ben-Men-1 cells. In addition, AR-42 decreased Aurora A and B expression. To compare the in vivo efficacies of AR-42 and AR-12, a PDK1 inhibitor, we generated and used luciferase-expressing Ben-Men-1-LucB cells to establish intracranial xenografts that grew over time. While AR-12 treatment moderately slowed tumor growth, AR-42 caused regression of Ben-Men-1-LucB tumors. Importantly, AR-42-treated tumors showed minimal regrowth when xenograft-bearing mice were switched to normal diet. Together, these results suggest that AR-42 is a potential therapy for meningiomas. The differential effect of AR-42 on cell-cycle progression of normal meningeal and meningioma cells may have implications for why AR-42 is well-tolerated while it potently inhibits tumor growth. PMID:23151902

  6. Human capital gains associated with robotic assisted laparoscopic pyeloplasty in children compared to open pyeloplasty.

    PubMed

    Behan, James W; Kim, Steve S; Dorey, Frederick; De Filippo, Roger E; Chang, Andy Y; Hardy, Brian E; Koh, Chester J

    2011-10-01

    Robotic assisted laparoscopic pyeloplasty is an emerging, minimally invasive alternative to open pyeloplasty in children for ureteropelvic junction obstruction. The procedure is associated with smaller incisions and shorter hospital stays. To our knowledge previous outcome analyses have not included human capital calculations, especially regarding loss of parental workdays. We compared perioperative factors in patients who underwent robotic assisted laparoscopic and open pyeloplasty at a single institution, especially in regard to human capital changes, in an institutional cost analysis. A total of 44 patients 2 years old or older from a single institution underwent robotic assisted (37) or open (7) pyeloplasty from 2008 to 2010. We retrospectively reviewed the charts to collect demographic and perioperative data. The human capital approach was used to calculate parental productivity losses. Patients who underwent robotic assisted laparoscopic pyeloplasty had a significantly shorter average hospital length of stay (1.6 vs 2.8 days, p <0.05). This correlated with an average savings of lost parental wages of $90.01 and hospitalization expenses of $612.80 per patient when excluding amortized robot costs. However, cost savings were not achieved by varying length of stay when amortized costs were included. Robotic assisted laparoscopic pyeloplasty in children is associated with human capital gains, eg decreased lost parental wages, and lower hospitalization expenses. Future comparative outcome analyses in children should include financial factors such as human capital loss, which can be especially important for families with young children. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Contemporary Endovascular Embolotherapy for Meningioma

    PubMed Central

    Dubel, Gregory J.; Ahn, Sun Ho; Soares, Gregory M.

    2013-01-01

    Preoperative endovascular tumor embolization has been used for 40 years. Meningiomas are the most common benign intracranial tumor in which preoperative embolization has been most extensively described in the literature. Advocates of embolization report that it reduces operative blood-loss, and softens the tumor, thus making surgery safer and easier. Opponents suggest that it adds additional risk and cost for patients without controlled studies showing conclusive benefit. The literature suggests a 3 to 6% neurological complication rate related to embolization. The combined external and internal carotid artery blood supply and complex anastomoses of the meninges can make embolization challenging. Positive outcomes require thorough knowledge of the pertinent vascular anatomy, familiarity with the neurovascular equipment and embolics, and meticulous technique. There remains debate on several aspects of embolization, including tumors most appropriate for embolization, embolic agent of choice, ideal size of embolic, and the choice of vessel(s) to embolize. This detailed review of pertinent vascular anatomy, embolization technique, results, and complications should allow practitioners to maximize treatment outcomes in this setting. PMID:24436548

  8. Glioblastoma induction after radiosurgery for meningioma.

    PubMed

    Yu, J S; Yong, W H; Wilson, D; Black, K L

    2000-11-04

    A 70-year-old woman developed a glioblastoma in the irradiated field 7 years after stereotactic radiosurgery for meningioma. Glioma induction has been previously reported after external beam radiation for leukaemia, pituitary adenoma, tinea capitus, and meningioma. This radiosurgery-induced malignancy may portend further reports of tumour induction. The theoretical risk of tumour induction by low doses of radiation to normal neural tissue after radiosurgery is now confirmed. Reports of additional cases of radiosurgery-induced tumours might temper the use of this increasingly used technique for benign surgically accessible lesions.

  9. Meningioma after radiotherapy for Hodgkin's disease.

    PubMed

    Deutsch, M; Rosenstein, M; Figura, J H

    1999-08-01

    The most common second primary tumors after treatment of childhood Hodgkin's disease are leukemia, lymphoma, breast cancer, soft tissue sarcoma, and thyroid cancer. Although intracranial meningioma has been reported after radiotherapy to the scalp for benign conditions and for intracranial primary brain tumors, this appears to be an extremely rare sequelae of treatment for Hodgkin's disease. The authors describe a 15-year-old boy who underwent radiotherapy for Hodgkin's disease and in whom a meningioma developed in the posterior fossa 27 years later.

  10. Predicting Meningioma Consistency on Preoperative Neuroimaging Studies

    PubMed Central

    Shiroishi, Mark S.; Cen, Steven Y.; Tamrazi, Benita; D'Amore, Francesco; Lerner, Alexander; King, Kevin S.; Kim, Paul E.; Law, Meng; Hwang, Darryl H.; Boyko, Orest B.; Liu, C. Jason

    2016-01-01

    Synopsis This article provides an overview of the neuroimaging literature focused on pre-operative prediction of meningioma consistency. A validated, non-invasive neuroimaging method to predict tumor consistency can provide valuable information regarding neurosurgical planning and patient counseling. Most of the neuroimaging literature indicates conventional MRI using T2-weighted imaging (T2WI) may be helpful to predict meningioma consistency, however, further rigorous validation is necessary. Much less is known about advanced MRI techniques such as diffusion MRI, MR elastography (MRE) and MR spectroscopy (MRS). Of these methods, MRE and DTI appear particularly promising. PMID:27012379

  11. Meningiomas of the velum interpositum: surgical considerations.

    PubMed

    Lozier, Alan P; Bruce, Jeffrey N

    2003-07-15

    Meningiomas of the third ventricle are a rare subtype of pineal region tumor that arise from the posterior portion of the velum interpositum, the double layer of pia mater that forms the roof of the third ventricle. The authors review the literature concerning these meningiomas and present a case in which the lesion was resected via the supracerebellar-infratentorial approach. The relationship of the tumor to the deep venous system and the splenium of the corpus callosum guides the selection of the most advantageous surgical approach. Posterior displacement of the internal cerebral veins demonstrated on preoperative imaging provides a strong rationale for use of the supracerebellar-infratentorial approach.

  12. Giant velum interpositum meningioma in a child.

    PubMed

    Moiyadi, Aliasgar V; Shetty, Prakash

    2012-07-01

    Intraventricular meningiomas are rare, but are relatively more often seen in children. Large size at presentation often obscures anatomical details. A particular subset of such tumors arising from the velum interpositum pose a significant surgical challenge. Thorough preoperative imaging, especially with respect to the course of the deep venous structures, provides useful evidence as to the origin. Preservation of venous anatomy at surgery is vital. We describe a 3-year-old girl with a giant velum interpositum meningioma that was completely excised with excellent outcome. This is probably the youngest such case reported.

  13. Dynamic susceptibility contrast and dynamic contrast-enhanced MRI characteristics to distinguish microcystic meningiomas from traditional Grade I meningiomas and high-grade gliomas.

    PubMed

    Hussain, Namath S; Moisi, Marc D; Keogh, Bart; McCullough, Brendan J; Rostad, Steven; Newell, David; Gwinn, Ryder; Foltz, Gregory; Mayberg, Marc; Aguedan, Brian; Good, Valerie; Fouke, Sarah J

    2016-06-10

    IV astrocytomas (p < 0.001 for both). Preoperative DCE imaging indicated mean kTrans values of 0.49 ± 0.20 min(-1) in Grade I meningiomas of the meningoepithelial subtype (n = 12), 0.27 ± 0.12 min(-1) for Grade IV astrocytomas (n = 54), and 1.35 ± 0.74 min(-1) for Grade I meningiomas of the MM subtype (n = 6). The kTrans was significantly higher in the MM variants than in the corresponding nonmicrocystic Grade 1 meningiomas and Grade IV astrocytomas (p < 0.001 for both). Intraoperative blood loss tended to increase with increased normalized CBV (R = 0.45, p = 0.085). CONCLUSIONS An enhancing cystic lesion with a normalized CBV greater than 10.3 ml or a kTrans greater than 0.88 min(-1) should prompt radiologists and surgeons to consider the diagnosis of MM rather than traditional Grade I meningioma or high-grade glioma in planning surgical care. Higher normalized CBVs tend to be associated with increased intraoperative blood loss.

  14. [Socio-demographic and occupational factors associated with gains and losses perceived by employees nearing retirement in a public university].

    PubMed

    Pissinati, Paloma de Souza Cavalcante; Haddad, Maria do Carmo Fernandez Lourenço; Dalmas, José Carlos; Birolim, Marcela Maria

    2016-10-10

    The aim was to analyze socio-demographic and occupational factors associated with gains and losses perceived by employees nearing retirement in a public university. In an exploratory, cross-sectional, and quantitative survey, employees (n = 164) approaching retirement in a public university in northern Paraná State, Brazil, assigned scales of importance to gains and losses. The data were analyzed with simple and multiple linear regression, based on the sizes of the scales, with socio-demographic and occupational variables as predictors. Employees assigned greater importance to retirement gains than losses. Increasing age was associated with less appreciation for total gains and time for relationships. Longer time on the job contributed to appreciation of total losses and tangible aspects of work. It is necessary to create spaces for reflection in employer institutions that promote listening to workers' needs, especially for older employees with longer time on the job.

  15. A prognostic cytogenetic scoring system to guide the adjuvant management of patients with atypical meningioma.

    PubMed

    Aizer, Ayal A; Abedalthagafi, Malak; Bi, Wenya Linda; Horvath, Margaret C; Arvold, Nils D; Al-Mefty, Ossama; Lee, Eudocia Q; Nayak, Lakshmi; Rinne, Mikael L; Norden, Andrew D; Reardon, David A; Wen, Patrick Y; Ligon, Keith L; Ligon, Azra H; Beroukhim, Rameen; Dunn, Ian F; Santagata, Sandro; Alexander, Brian M

    2016-02-01

    The appropriate use of adjuvant therapy in patients with gross totally resected atypical meningioma requires an accurate assessment of recurrence risk. We sought to determine whether cytogenetic/genetic characterization may facilitate better estimation of the probability of recurrence. We first analyzed our clinical database, including high-resolution DNA copy number data, to identify 11 common copy number aberrations in a pilot cohort of meningiomas of all grades. We summed these aberrations to devise a cytogenetic abnormality score (CAS) and determined the CAS from archived tissue of a separate cohort of 32 patients with gross totally resected atypical meningioma managed with surgery alone. Propensity score adjusted Cox regression was used to determine whether the CAS was predictive of recurrence. An association between higher CAS and higher grade was noted in our pilot cohort with heterogeneity among atypical tumors. Among the 32 patients who underwent gross total resection of an atypical meningioma, the CAS was not significantly associated with age, gender, performance status, or tumor size/location but was associated with the risk of recurrence on univariable analysis (hazard ratio per aberration = 1.52; 95% CI = 1.08-2.14; P = .02). After adjustment, the impact of the dichotomized number of copy aberrations remained significantly associated with recurrence risk (hazard ratio = 4.47; 95% CI = 1.01-19.87; P = .05). The number of copy number aberrations is strongly associated with recurrence risk in patients with atypical meningioma following gross total resection and may inform the appropriate use of adjuvant radiation therapy in these patients or be useful for stratification in clinical trials. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Long-term impact of cognitive deficits and epilepsy on quality of life in patients with low-grade meningiomas.

    PubMed

    Waagemans, Martin L; van Nieuwenhuizen, David; Dijkstra, Monica; Wumkes, Miriam; Dirven, Clemens M F; Leenstra, Sieger; Reijneveld, Jaap C; Klein, Martin; Stalpers, Lukas J A

    2011-07-01

    WHO Grade I meningiomas are common, usually benign, primary brain tumors. Little is known about the health-related quality of life (HRQOL) of patients with meningiomas. To investigate the long-term HRQOL in patients with meningiomas and its association with cognitive deficits and epilepsy. HRQOL was assessed by the Short-Form Health Survey questionnaire (SF-36) in 89 patients with WHO Grade I meningiomas at least 1 year following neurosurgery with or without radiotherapy. Cognitive functioning was measured by a neuropsychological test battery, and epileptic seizure frequency and antiepileptic drug (AED) use were determined for each patient. HRQOL of patients was compared to that of 89 healthy controls individually matched for age, sex, and educational level. As a group, patients with meningiomas did not differ from healthy controls on 7 out of 8 SF-36 scales; the only difference was that patients reported more role limitations caused by physical problems (P < .05). Patients with meningiomas had significant impairment in 4 of 6 cognitive domains, most pronounced in the domain of executive functioning. Both impaired cognitive functioning and AED use were associated with a compromised HRQOL. Of the 23 patients using AEDs, HRQOL was significantly impaired on 5 out of 8 SF-36 scales. In patients using AED, neither cognitive functioning nor HRQOL differed between those with and those without seizure control. The HRQOL of most patients with WHO Grade I meningiomas is comparable to that of the general population. However, HRQOL is worse in patients with major cognitive deficits and those using AEDs, irrespective of seizure control.

  17. Loss of presenilin function is associated with a selective gain of APP function

    PubMed Central

    Deyts, Carole; Clutter, Mary; Herrera, Stacy; Jovanovic, Natalia; Goddi, Anna; Parent, Angèle T

    2016-01-01

    Presenilin 1 (PS1) is an essential γ-secretase component, the enzyme responsible for amyloid precursor protein (APP) intramembraneous cleavage. Mutations in PS1 lead to dominant-inheritance of early-onset familial Alzheimer’s disease (FAD). Although expression of FAD-linked PS1 mutations enhances toxic Aβ production, the importance of other APP metabolites and γ-secretase substrates in the etiology of the disease has not been confirmed. We report that neurons expressing FAD-linked PS1 variants or functionally deficient PS1 exhibit enhanced axodendritic outgrowth due to increased levels of APP intracellular C-terminal fragment (APP-CTF). APP expression is required for exuberant neurite outgrowth and hippocampal axonal sprouting observed in knock-in mice expressing FAD-linked PS1 mutation. APP-CTF accumulation initiates CREB signaling cascade through an association of APP-CTF with Gαs protein. We demonstrate that pathological PS1 loss-of-function impinges on neurite formation through a selective APP gain-of-function that could impact on axodendritic connectivity and contribute to aberrant axonal sprouting observed in AD patients. DOI: http://dx.doi.org/10.7554/eLife.15645.001 PMID:27196744

  18. Loss of presenilin function is associated with a selective gain of APP function.

    PubMed

    Deyts, Carole; Clutter, Mary; Herrera, Stacy; Jovanovic, Natalia; Goddi, Anna; Parent, Angèle T

    2016-05-19

    Presenilin 1 (PS1) is an essential γ-secretase component, the enzyme responsible for amyloid precursor protein (APP) intramembraneous cleavage. Mutations in PS1 lead to dominant-inheritance of early-onset familial Alzheimer's disease (FAD). Although expression of FAD-linked PS1 mutations enhances toxic Aβ production, the importance of other APP metabolites and γ-secretase substrates in the etiology of the disease has not been confirmed. We report that neurons expressing FAD-linked PS1 variants or functionally deficient PS1 exhibit enhanced axodendritic outgrowth due to increased levels of APP intracellular C-terminal fragment (APP-CTF). APP expression is required for exuberant neurite outgrowth and hippocampal axonal sprouting observed in knock-in mice expressing FAD-linked PS1 mutation. APP-CTF accumulation initiates CREB signaling cascade through an association of APP-CTF with Gαs protein. We demonstrate that pathological PS1 loss-of-function impinges on neurite formation through a selective APP gain-of-function that could impact on axodendritic connectivity and contribute to aberrant axonal sprouting observed in AD patients.

  19. Gain-of-function mutations in complement factor B are associated with atypical hemolytic uremic syndrome

    PubMed Central

    de Jorge, Elena Goicoechea; Harris, Claire L.; Esparza-Gordillo, Jorge; Carreras, Luis; Arranz, Elena Aller; Garrido, Cynthia Abarrategui; López-Trascasa, Margarita; Sánchez-Corral, Pilar; Morgan, B. Paul; de Córdoba, Santiago Rodríguez

    2007-01-01

    Hemolytic uremic syndrome (HUS) is an important cause of acute renal failure in children. Mutations in one or more genes encoding complement-regulatory proteins have been reported in approximately one-third of nondiarrheal, atypical HUS (aHUS) patients, suggesting a defect in the protection of cell surfaces against complement activation in susceptible individuals. Here, we identified a subgroup of aHUS patients showing persistent activation of the complement alternative pathway and found within this subgroup two families with mutations in the gene encoding factor B (BF), a zymogen that carries the catalytic site of the complement alternative pathway convertase (C3bBb). Functional analyses demonstrated that F286L and K323E aHUS-associated BF mutations are gain-of-function mutations that result in enhanced formation of the C3bBb convertase or increased resistance to inactivation by complement regulators. These data expand our understanding of the genetic factors conferring predisposition to aHUS, demonstrate the critical role of the alternative complement pathway in the pathogenesis of aHUS, and provide support for the use of complement-inhibition therapies to prevent or reduce tissue damage caused by dysregulated complement activation. PMID:17182750

  20. Novel nonsense gain-of-function NFKB2 mutations associated with a combined immunodeficiency phenotype.

    PubMed

    Kuehn, Hye Sun; Niemela, Julie E; Sreedhara, Karthik; Stoddard, Jennifer L; Grossman, Jennifer; Wysocki, Christian A; de la Morena, M Teresa; Garofalo, Mary; Inlora, Jingga; Snyder, Michael P; Lewis, David B; Stratakis, Constantine A; Fleisher, Thomas A; Rosenzweig, Sergio D

    2017-09-28

    NF-κB signaling through its NFKB1-dependent canonical and NFKB2-dependent noncanonical pathways plays distinctive roles in a diverse range of immune processes. Recently, mutations in these 2 genes have been associated with common variable immunodeficiency (CVID). While studying patients with genetically uncharacterized primary immunodeficiencies, we detected 2 novel nonsense gain-of-function (GOF) NFKB2 mutations (E418X and R635X) in 3 patients from 2 families, and a novel missense change (S866R) in another patient. Their immunophenotype was assessed by flow cytometry and protein expression; activation of canonical and noncanonical pathways was examined in peripheral blood mononuclear cells and transfected HEK293T cells through immunoblotting, immunohistochemistry, luciferase activity, real-time polymerase chain reaction, and multiplex assays. The S866R change disrupted a C-terminal NF-κΒ2 critical site affecting protein phosphorylation and nuclear translocation, resulting in CVID with adrenocorticotropic hormone deficiency, growth hormone deficiency, and mild ectodermal dysplasia as previously described. In contrast, the nonsense mutations E418X and R635X observed in 3 patients led to constitutive nuclear localization and activation of both canonical and noncanonical NF-κΒ pathways, resulting in a combined immunodeficiency (CID) without endocrine or ectodermal manifestations. These changes were also found in 2 asymptomatic relatives. Thus, these novel NFKB2 GOF mutations produce a nonfully penetrant CID phenotype through a different pathophysiologic mechanism than previously described for mutations in NFKB2.

  1. Erlotinib in Treating Patients With Recurrent Malignant Glioma or Recurrent or Progressive Meningioma

    ClinicalTrials.gov

    2014-07-09

    Adult Anaplastic Astrocytoma; Adult Anaplastic Oligodendroglioma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Grade I Meningioma; Adult Grade II Meningioma; Adult Grade III Meningioma; Adult Mixed Glioma; Recurrent Adult Brain Tumor

  2. Federal Support for Family Planning Clinics Associated with Dramatic Gains in Cervical Cancer Screening.

    PubMed

    Nikpay, Sayeh S

    2016-01-01

    Since the 1990s, policymakers have successfully increased cervical cancer screening through federal and state public policies. However, the most dramatic gains in Pap smear use occurred in the 1960's and 70's, during the establishment of federal support for family planning clinics through the War on Poverty and Title X. This study estimated the effect of this support on cervical cancer screening, and quantified its role in dramatic increases in Pap smear use. Using a natural experiment in the timing and receipt of federal family planning grants, the screening behavior of women who did and did not have access to a federally funded family planning clinic were analyzed. Cross-sectional probability models of annual and lifetime Pap smear use using the 1970 National Fertility Survey were estimated and linked to administrative data on grant timing and receipt between 1964 and 1973. Federal support for family planning clinics was associated with a 7-percentage point increase in annual use (p < .01), and a 5-percentage point decrease in never use of the Pap smear (p < .001). Scaled by the fraction of women who used funded clinics, federal support for family planning was associated with a roughly 70% increase in Pap smear use. Estimates suggest that the establishment of federal support could explain as much as 15% of the national increase in Pap smear use between 1966 and 1973. Federal support for family planning played an important--and previously unacknowledged--role in promoting cervical cancer screening and investments in future health. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  3. Movement disorder in GNAO1 encephalopathy associated with gain-of-function mutations.

    PubMed

    Feng, Huijie; Sjögren, Benita; Karaj, Behirda; Shaw, Vincent; Gezer, Aysegul; Neubig, Richard R

    2017-08-22

    To define molecular mechanisms underlying the clinical spectrum of epilepsy and movement disorder in individuals with de novo mutations in the GNAO1 gene. We identified all GNAO1 mutations reported in individuals with epilepsy (early infantile epileptiform encephalopathy 17) or movement disorders through April 2016; 15 de novo mutant alleles from 25 individuals were introduced into the Gαo subunit by site-directed mutagenesis in a mammalian expression plasmid. We assessed protein expression and function in vitro in HEK-293T cells by Western blot and determined functional Gαo-dependent cyclic adenosine monophosphate (cAMP) inhibition with a coexpressed α2A adrenergic receptor. Of the 15 clinical GNAO1 mutations studied, 9 show reduced expression and loss of function (LOF; <90% maximal inhibition). Six other mutations show variable levels of expression but exhibit normal or even gain-of-function (GOF) behavior, as demonstrated by significantly lower EC50 values for α2A adrenergic receptor-mediated inhibition of cAMP. The GNAO1 LOF mutations are associated with epileptic encephalopathy while GOF mutants (such as G42R, G203R, and E246K) or normally functioning mutants (R209) were found in patients with movement disorders with or without seizures. Both LOF and GOF mutations in Gαo (encoded by GNAO1) are associated with neurologic pathophysiology. There appears to be a strong predictive correlation between the in vitro biochemical phenotype and the clinical pattern of epilepsy vs movement disorder. © 2017 American Academy of Neurology.

  4. Association of Elevated Reward Prediction Error Response With Weight Gain in Adolescent Anorexia Nervosa.

    PubMed

    DeGuzman, Marisa; Shott, Megan E; Yang, Tony T; Riederer, Justin; Frank, Guido K W

    2017-06-01

    Anorexia nervosa is a psychiatric disorder of unknown etiology. Understanding associations between behavior and neurobiology is important in treatment development. Using a novel monetary reward task during functional magnetic resonance brain imaging, the authors tested how brain reward learning in adolescent anorexia nervosa changes with weight restoration. Female adolescents with anorexia nervosa (N=21; mean age, 16.4 years [SD=1.9]) underwent functional MRI (fMRI) before and after treatment; similarly, healthy female control adolescents (N=21; mean age, 15.2 years [SD=2.4]) underwent fMRI on two occasions. Brain function was tested using the reward prediction error construct, a computational model for reward receipt and omission related to motivation and neural dopamine responsiveness. Compared with the control group, the anorexia nervosa group exhibited greater brain response 1) for prediction error regression within the caudate, ventral caudate/nucleus accumbens, and anterior and posterior insula, 2) to unexpected reward receipt in the anterior and posterior insula, and 3) to unexpected reward omission in the caudate body. Prediction error and unexpected reward omission response tended to normalize with treatment, while unexpected reward receipt response remained significantly elevated. Greater caudate prediction error response when underweight was associated with lower weight gain during treatment. Punishment sensitivity correlated positively with ventral caudate prediction error response. Reward system responsiveness is elevated in adolescent anorexia nervosa when underweight and after weight restoration. Heightened prediction error activity in brain reward regions may represent a phenotype of adolescent anorexia nervosa that does not respond well to treatment. Prediction error response could be a neurobiological marker of illness severity that can indicate individual treatment needs.

  5. Genetic and epigenetic alteration of the NF2 gene in sporadic meningiomas.

    PubMed

    Lomas, Jesus; Bello, M Josefa; Arjona, Dolores; Alonso, M Eva; Martinez-Glez, Victor; Lopez-Marin, Isabel; Amiñoso, Cinthia; de Campos, Jose M; Isla, Alberto; Vaquero, Jesus; Rey, Juan A

    2005-03-01

    The role of the NF2 gene in the development of meningiomas has recently been documented; inactivating mutations plus allelic loss at 22q, the site of this gene (at 22q12), have been identified in both sporadic and neurofibromatosis type 2-associated tumors. Although epigenetic inactivation through aberrant CpG island methylation of the NF2 5' flanking region has been documented in schwannoma (another NF2-associated neoplasm), data on participation of this epigenetic modification in meningiomas are not yet widely available. Using methylation-specific PCR (MSP) plus sequencing, we assessed the presence of aberrant promoter NF2 methylation in a series of 88 meningiomas (61 grade I, 24 grade II, and 3 grade III), in which the allelic constitution at 22q and the NF2 mutational status also were determined by RFLP/microsatellite and PCR-SSCP analyses. Chromosome 22 allelic loss, NF2 gene mutation, and aberrant NF2 promoter methylation were detected in 49%, 24%, and 26% of cases, respectively. Aberrant NF2 methylation with loss of heterozygosity (LOH) at 22q was found in five cases, and aberrant methylation with NF2 mutation in another; LOH 22q and the mutation were found in 16 samples. The aberrant methylation of the NF2 gene also was the sole alteration in 15 samples, most of which were from grade I tumors. These results indicate that aberrant NF2 hypermethylation may participate in the development of a significant proportion of sporadic meningiomas, primarily those of grade I.

  6. Discrimination between spinal extradural meningioma and both intra and extradural meningioma: Case Report.

    PubMed

    Ito, Kenyu; Imagama, Shiro; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Tsushima, Mikito; Matsumoto, Akiyuki; Morozumi, Masayoshi; Tanaka, Satoshi; Nishida, Yoshihiro; Ishiguro, Naoki

    2017-02-01

    Meningiomas are common spinal tumor and mostly located at intradura. Recurrence rate after surgery for extradural meningioma was higher than intradural meningioma. A patient with intra and extradural spinal meningioma was treated and discussed its features and clinical management. A 41-year-old woman noted numbness of bilateral legs, gait disturbance, and mild bladder disturbance for over the two-month period. Magnetic resonance imaging revealed an epidural mass at T8-9 involving the dura mater from the left side. Intraoperatively, ultrasonography showed extradural tumor suppress the dura from the left side and no subarachnoid space. Therefore, it was difficult to diagnose the tumor was located at only extradural or both intra and extradural. The extradural tumor was resected as much as possible, then ultrasonography was performed for the second time. The spinal cord was decompressed and subarachnoid space was appeared with intradural tumor. The dura mater was opened in the midline for intradural exploration, and the intradural tumor appeared beside the spinal cord. The dura mater with attachment to the tumor was rescected. To prevent a recurrence, ultrasonography after removing extradural tumor is recommended to detect intra dural tumor and invasion of tumor into dura mater. In such case, removing only extradural meningioma is not enough, and gross total resection including intradural meningioma and dura mater is required.

  7. Discrimination between spinal extradural meningioma and both intra and extradural meningioma: Case Report

    PubMed Central

    Ito, Kenyu; Imagama, Shiro; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Tsushima, Mikito; Matsumoto, Akiyuki; Morozumi, Masayoshi; Tanaka, Satoshi; Nishida, Yoshihiro; Ishiguro, Naoki

    2017-01-01

    ABSTRACT Meningiomas are common spinal tumor and mostly located at intradura. Recurrence rate after surgery for extradural meningioma was higher than intradural meningioma. A patient with intra and extradural spinal meningioma was treated and discussed its features and clinical management. A 41-year-old woman noted numbness of bilateral legs, gait disturbance, and mild bladder disturbance for over the two-month period. Magnetic resonance imaging revealed an epidural mass at T8-9 involving the dura mater from the left side. Intraoperatively, ultrasonography showed extradural tumor suppress the dura from the left side and no subarachnoid space. Therefore, it was difficult to diagnose the tumor was located at only extradural or both intra and extradural. The extradural tumor was resected as much as possible, then ultrasonography was performed for the second time. The spinal cord was decompressed and subarachnoid space was appeared with intradural tumor. The dura mater was opened in the midline for intradural exploration, and the intradural tumor appeared beside the spinal cord. The dura mater with attachment to the tumor was rescected. To prevent a recurrence, ultrasonography after removing extradural tumor is recommended to detect intra dural tumor and invasion of tumor into dura mater. In such case, removing only extradural meningioma is not enough, and gross total resection including intradural meningioma and dura mater is required. PMID:28303070

  8. Anaplastic and meningothelial meningiomas in a single tumor: A "dedifferentiated meningioma"?

    PubMed

    Shintaku, Masayuki; Adachi, Yasushi; Arai, Atsushi; Koyama, Junji

    2016-12-01

    The patient was a 74-year-old man, who developed progressive cognitive impairment and gait instability. Neuroradiological examination demonstrated a large and predominantly extra-axial tumor spreading over the bilateral frontal base, indicative of olfactory groove meningioma. The greater part of the resected tumor consisted of a dense, patternless proliferation of large, round or polygonal cells, and compactly fascicular growth of spindle cells. Tumor cells showed markedly anaplastic cytological features. In small areas of the tumor, a typical meningothelial meningioma showing no cellular atypism was found. Both tumor components were closely juxtaposed and no pathological features of an intermediate grade (atypical meningioma) were noted. Shortly after the operation, the patient developed a local recurrence of the tumor and multiple metastases to the cerebrum, bone and skin. Anaplastic meningioma is a rare, highly malignant neoplasm which arises de novo or as a result of the progressive transformation of a low-grade meningioma. The coexistence of anaplastic and low-grade components in a single meningeal tumor has been rarely reported. This dimorphic appearance is reminiscent of "dedifferentiation", a phenomenon infrequently seen in various mesenchymal and salivary gland neoplasms. We think that the term "dedifferentiated meningioma" can be appropriately applied to tumors such as that reported herein. © 2016 Japanese Society of Neuropathology.

  9. Maternal Obesity and Excessive Gestational Weight Gain Are Associated with Components of Child Cognition.

    PubMed

    Pugh, Sarah J; Richardson, Gale A; Hutcheon, Jennifer A; Himes, Katherine P; Brooks, Maria M; Day, Nancy L; Bodnar, Lisa M

    2015-11-01

    Maternal overweight and obesity affect two-thirds of women of childbearing age and may increase the risk of impaired child cognition. Our objective was to test the hypothesis that high/low gestational weight gain (GWG) and high/low prepregnancy BMI were associated with offspring intelligence quotient (IQ) and executive function at age 10. Mother-infant dyads (n = 763) enrolled in a birth cohort study were followed from early pregnancy to 10 y postpartum. IQ was assessed by trained examiners with the use of the Stanford Binet Intelligence Scale-4th edition. Executive function was assessed by the number of perseverative errors on the Wisconsin Card Sorting Test and time to complete Part B on the Trail Making Test. Self-reported total GWG was converted to gestational-age-standardized GWG z score. Multivariable linear regression and negative binomial regression were used to estimate independent and joint effects of GWG and BMI on outcomes while adjusting for covariates. At enrollment, the majority of women in the Maternal Health Practices and Child Development cohort were unmarried and unemployed, and more than one-half reported their race as black. The mean ± SD GWG z score was -0.5 ± 1.8, and 27% of women had a pregravid BMI ≥ 25. The median (IQR) number of perseverative errors was 23 (17, 29), the mean ± SD time on Part B was 103 ± 42.6 s, and 44% of children had a low average IQ (≤ 89). Maternal obesity was associated with 3.2 lower IQ points (95% CI: -5.6, -0.8) and a slower time to complete the executive function scale Part B (adjusted β: 12.7 s; 95% CI: 2.8, 23 s) compared with offspring of normal-weight mothers. Offspring of mothers whose GWG was >+1 SD, compared with -1 to +1 SD, performed 15 s slower on the executive function task (95% CI: 1.8, 28 s). There was no association between GWG z score and offspring composite IQ score (adjusted β: -0.32; 95% CI: -0.72, 0.10). Prepregnancy BMI did not modify these associations. Although GWG may be important

  10. Maternal Obesity and Excessive Gestational Weight Gain Are Associated with Components of Child Cognition123

    PubMed Central

    Richardson, Gale A; Hutcheon, Jennifer A; Himes, Katherine P; Brooks, Maria M; Day, Nancy L; Bodnar, Lisa M

    2015-01-01

    Background: Maternal overweight and obesity affect two-thirds of women of childbearing age and may increase the risk of impaired child cognition. Objective: Our objective was to test the hypothesis that high/low gestational weight gain (GWG) and high/low prepregnancy BMI were associated with offspring intelligence quotient (IQ) and executive function at age 10. Methods: Mother–infant dyads (n = 763) enrolled in a birth cohort study were followed from early pregnancy to 10 y postpartum. IQ was assessed by trained examiners with the use of the Stanford Binet Intelligence Scale–4th edition. Executive function was assessed by the number of perseverative errors on the Wisconsin Card Sorting Test and time to complete Part B on the Trail Making Test. Self-reported total GWG was converted to gestational-age–standardized GWG z score. Multivariable linear regression and negative binomial regression were used to estimate independent and joint effects of GWG and BMI on outcomes while adjusting for covariates. Results: At enrollment, the majority of women in the Maternal Health Practices and Child Development cohort were unmarried and unemployed, and more than one-half reported their race as black. The mean ± SD GWG z score was −0.5 ± 1.8, and 27% of women had a pregravid BMI ≥25. The median (IQR) number of perseverative errors was 23 (17, 29), the mean ± SD time on Part B was 103 ± 42.6 s, and 44% of children had a low average IQ (≤89). Maternal obesity was associated with 3.2 lower IQ points (95% CI: −5.6, −0.8) and a slower time to complete the executive function scale Part B (adjusted β: 12.7 s; 95% CI: 2.8, 23 s) compared with offspring of normal-weight mothers. Offspring of mothers whose GWG was >+1 SD, compared with −1 to +1 SD, performed 15 s slower on the executive function task (95% CI: 1.8, 28 s). There was no association between GWG z score and offspring composite IQ score (adjusted β: −0.32; 95% CI: −0.72, 0.10). Prepregnancy BMI did not

  11. Association between adult weight gain and colorectal cancer: a dose-response meta-analysis of observational studies.

    PubMed

    Chen, Qi; Wang, Jing; Yang, Jinghui; Jin, Zhichao; Shi, Wentao; Qin, Yingyi; Yu, Feifei; He, Jia

    2015-06-15

    This study investigated the association between adult weight gain and risk of colorectal cancer (CRC). Using terms related to weight gain and CRC, we searched PubMed, Embase and Web of Science for relevant studies published before June 2014. Two evaluators independently selected studies according to the selection criteria, and eight studies were included (three case-control and five cohort studies). Summary estimates were obtained using fixed- or random-effects models. The relative risk (RR) of the association between adult weight gain and CRC was 1.25 (95% confidence interval [CI], 1.10-1.43); the RR was 1.30 (95% CI, 1.14-1.49) for colon cancer (CC) and 1.27 (95% CI, 1.02-1.58) for rectal cancer (RC) for the highest versus lowest category. For every 5-kg increase in adult weight, the risk increased by 5% (RR, 1.05; 95% CI, 1.02-1.09) for CRC, 6% (RR, 1.06; 95% CI, 1.02-1.11) for CC and 6% (RR, 1.06; 95% CI, 1.03-1.08) for RC. The subgroup analyses showed a positive association between adult weight gain and risk of CRC only in men, and the RR was 1.65 (95% CI, 1.42-1.92) for the highest versus lowest category of adult weight gain and 1.10 (95% CI, 1.06-1.15) for a 5-kg increase in adult weight. In conclusion, there is evidence that adult weight gain is associated with an increased risk of CRC. However, the positive association between adult weight gain and risk of CRC is stronger among men than among women.

  12. SU11657 Enhances Radiosensitivity of Human Meningioma Cells

    SciTech Connect

    Milker-Zabel, Stefanie Bois, Angelika Zabel-du; Ranai, Gholamreza; Trinh, Thuy; Unterberg, Andreas; Debus, Juergen; Lipson, Kenneth E.; Abdollahi, Amir; Huber, Peter E.

    2008-03-15

    Purpose: To analyze the effect of the multireceptor tyrosine kinase inhibitor SU11657 (primarily vascular endothelial growth factor, platelet-derived growth factor) in combination with irradiation in freshly isolated primary human meningioma cells. Methods and Materials: Tumor specimens were obtained from meningioma patients undergoing surgery at the Department of Neurosurgery, University of Heidelberg, Germany. For the present study only cells up to passage 6 were used. Benign and atypical meningioma cells and human umbilical vein endothelial cells (HUVEC) were treated with SU11657 alone and in combination with 6-MV photons (0-10 Gy). Clonogenic survival and cell proliferation were determined alone and in coculture assays to determine direct and paracrine effects. Results: Radiation and SU11657 alone reduced cell proliferation in atypical and benign meningioma cells as well as in HUVEC in a dose-dependent manner. SU11657 alone also reduced clonogenic survival of benign and atypical meningioma cells. SU11657 increased radiosensitivity of human meningioma cells in clonogenic survival and cell number/proliferation assays. The anticlonogenic and antiproliferative effects alone and the radiosensitization effects of SU11657 were more pronounced in atypical meningioma cells compared with benign meningioma cells. Conclusion: Small-molecule tyrosine kinase inhibitors like SU11657 are capable of amplifying the growth inhibitory effects of irradiation in meningioma cells. These data provide a rationale for further clinical evaluation of this combination concept, especially in atypical and malignant meningioma patients.

  13. Gain of chromosome 8q is associated with metastases and poor survival of patients with clear cell renal cell carcinoma.

    PubMed

    Klatte, Tobias; Kroeger, Nils; Rampersaud, Edward N; Birkhäuser, Frédéric D; Logan, Joshua E; Sonn, Geoffrey; Riss, Joseph; Rao, P Nagesh; Kabbinavar, Fairooz F; Belldegrun, Arie S; Pantuck, Allan J

    2012-12-01

    The aim of this study was to evaluate the prevalence of chromosome 8q gain in clear cell renal cell carcinoma (CCRCC) and to correlate the findings with tumor phenotype and disease-specific survival (DSS). The tumor karyotypes of 336 consecutive patients with CCRCC were prospectively evaluated with classical cytogenetic analysis. Chromosome 8q status was correlated with clinicopathological variables, and its impact on DSS was evaluated. Gain of 8q occurred in 28 tumors (8.3%). Gain of 8q was associated with a higher risk of regional lymph node (21.4% vs 6.2%, P = .011) and distant metastases (50.0% vs 24.4%, P = .006), and greater tumor sizes (P = .030). Patients with gain of 8q had a 3.22-fold increased risk of death from CCRCC (P < .001). In multivariable analysis, gain of 8q was identified as an independent prognostic factor (hazard ratio, 2.37; P = .006). The concordance index of a multivariable base model increased significantly following inclusion of 8q gain (P = .0015). Gain of chromosome 8q occurs in a subset of CCRCCs and is associated with an increased risk of metastases and death from CCRCC. Because the proto-oncogene c-MYC is among the list of candidate genes located on 8q, our data suggest that these tumors may have unique pathways activated, which are associated with an aggressive tumor phenotype. If confirmed, defining tumors with gain of 8q may assist in identifying patients who would benefit for specific c-MYC inhibitors or agents that target the MAPK/ERK (mitogen-activated protein kinase) pathway. Copyright © 2012 American Cancer Society.

  14. Comparison of conventional magnetic resonance imaging and nonenhanced three dimensional time-of-flight magnetic resonance angiography findings between dogs with meningioma and dogs with intracranial histiocytic sarcoma: 19 cases (2010-2014).

    PubMed

    Ishikawa, Chieko; Ito, Daisuke; Kitagawa, Masato; Watari, Toshihiro

    2016-05-15

    OBJECTIVE To compare conventional MRI and nonenhanced 3-D time-of-flight (TOF) magnetic resonance angiography (MRA) findings between dogs with meningioma and dogs with intracranial histiocytic sarcoma (IHS). DESIGN Retrospective case series. ANIMALS 14 dogs with meningioma and 5 dogs with IHS. PROCEDURES Medical records of dogs with meningioma or IHS that were examined at a tertiary veterinary hospital from 2010 through 2014 and underwent 3-D TOF MRA in conjunction with conventional MRI were reviewed. Findings for conventional MRI and 3-D TOF MRA were compared between the 2 groups of dogs to evaluate whether there were any characteristics that could be used to differentiate meningioma from IHS. RESULTS Tumor type was significantly associated with signal intensity on conventional T2-weighted and fluid-attenuated inversion recovery MRI images; most meningiomas were hyperintense, and most IHSs were isointense or hypointense on those images. Tumor type was not associated with signal uniformity, tumor location, tumor origin, or the presence of edema, midline shift, or brain herniation. On MRA, blood vessels adjacent to the tumor were identified and characterized for 9 of 14 dogs with meningioma and all 5 dogs with IHS. Vessels adjacent to meningiomas were displaced in 8 of 9 dogs, whereas vessels adjacent to IHSs were not displaced. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated nonenhanced 3-D TOF MRA findings provided additional information that can be assessed in conjunction with conventional MRI findings to help differentiate meningiomas from IHSs in dogs.

  15. Association between common variants near the melanocortin 4 receptor gene and severe antipsychotic drug-induced weight gain.

    PubMed

    Malhotra, Anil K; Correll, Christoph U; Chowdhury, Nabilah I; Müller, Daniel J; Gregersen, Peter K; Lee, Annette T; Tiwari, Arun K; Kane, John M; Fleischhacker, W Wolfgang; Kahn, Rene S; Ophoff, Roel A; Meltzer, Herbert Y; Lencz, Todd; Kennedy, James L

    2012-09-01

    Second-generation antipsychotics (SGAs) are increasingly used in the treatment of many psychotic and nonpsychotic disorders. Unfortunately, SGAs are often associated with substantial weight gain, with no means to predict which patients are at greatest risk. To identify single-nucleotide polymorphisms associated with antipsychotic drug–induced weight gain. Pharmacogenetic association study. The discovery cohort was from a US general psychiatric hospital. Three additional cohorts were from psychiatric hospitals in the United States and Germany and from a European antipsychotic drug trial. The discovery cohort consisted of 139 pediatric patients undergoing first exposure to SGAs. The 3 additional cohorts consisted of 73, 40, and 92 subjects. Patients in the discovery cohort were treated with SGAs for 12 weeks. Additional cohorts were treated for 6 and 12 weeks. We conducted a genomewide association study assessing weight gain associated with 12 weeks of SGA treatment in patients undergoing first exposure to antipsychotic drugs. We next genotyped 3 independent cohorts of subjects assessed for antipsychotic drug-induced weight gain. Our genome-wide association study yielded 20 single-nucleotide polymorphisms at a single locus exceeding a statistical threshold of P<10(-5). This locus, near the melanocortin 4 receptor (MC4R) gene, overlaps a region previously identified by large-scale genome-wide association studies of obesity in the general population. Effects were recessive, with minor allele homozygotes gaining extreme amounts of weight during the 12-week trial. These results were replicated in 3 additional cohorts, with rs489693 demonstrating consistent recessive effects; meta-analysis revealed a genome-wide significant effect (P=5.59 X 10 (-12). Moreover, we observed consistent effects on related metabolic indices, including triglyceride, leptin, and insulin levels. These data implicate MC4R in extreme SGA-induced weight gain and related metabolic disturbances. A

  16. Expression of the tumor suppressor genes NF2, 4.1B, and TSLC1 in canine meningiomas.

    PubMed

    Dickinson, P J; Surace, E I; Cambell, M; Higgins, R J; Leutenegger, C M; Bollen, A W; LeCouteur, R A; Gutmann, D H

    2009-09-01

    Meningiomas are common primary brain tumors in dogs; however, little is known about the molecular genetic mechanisms involved in their tumorigenesis. Several tumor suppressor genes have been implicated in meningioma pathogenesis in humans, including the neurofibromatosis 2 (NF2), protein 4.1B (4.1 B), and tumor suppressor in lung cancer-1 (TSLC1) genes. We investigated the expression of these tumor suppressor genes in a series of spontaneous canine meningiomas using quantitative real-time reverse transcription polymerase chain reaction (RT-PCR) (NF2; n = 25) and western blotting (NF2/merlin, 4.1B, TSLC1; n = 30). Decreased expression of 4.1B and TSLC1 expression on western blotting was seen in 6/30 (20%) and in 15/30 (50%) tumors, respectively, with 18/30 (60%) of meningiomas having decreased or absent expression of one or both proteins. NF2 gene expression assessed by western blotting and RT-PCR varied considerably between individual tumors. Complete loss of NF2 protein on western blotting was not seen, unlike 4.1B and TSLC1. Incidence of TSLC1 abnormalities was similar to that seen in human meningiomas, while perturbation of NF2 and 4.1B appeared to be less common than reported for human tumors. No association was observed between tumor grade, subtype, or location and tumor suppressor gene expression based on western blot or RT-PCR. These results suggest that loss of these tumor suppressor genes is a frequent occurrence in canine meningiomas and may be an early event in tumorigenesis in some cases. In addition, it is likely that other, as yet unidentified, genes play an important role in canine meningioma formation and growth.

  17. Seizures in supratentorial meningioma: a systematic review and meta-analysis.

    PubMed

    Englot, Dario J; Magill, Stephen T; Han, Seunggu J; Chang, Edward F; Berger, Mitchel S; McDermott, Michael W

    2016-06-01

    OBJECT Meningioma is the most common benign intracranial tumor, and patients with supratentorial meningioma frequently suffer from seizures. The rates and predictors of seizures in patients with meningioma have been significantly under-studied, even in comparison with other brain tumor types. Improved strategies for the prediction, treatment, and prevention of seizures in patients with meningioma is an important goal, because tumor-related epilepsy significantly impacts patient quality of life. METHODS The authors performed a systematic review of PubMed for manuscripts published between January 1980 and September 2014, examining rates of pre- and postoperative seizures in supratentorial meningioma, and evaluating potential predictors of seizures with separate meta-analyses. RESULTS The authors identified 39 observational case series for inclusion in the study, but no controlled trials. Preoperative seizures were observed in 29.2% of 4709 patients with supratentorial meningioma, and were significantly predicted by male sex (OR 1.74, 95% CI 1.30-2.34); an absence of headache (OR 1.77, 95% CI 1.04-3.25); peritumoral edema (OR 7.48, 95% CI 6.13-9.47); and non-skull base location (OR 1.77, 95% CI 1.04-3.25). After surgery, seizure freedom was achieved in 69.3% of 703 patients with preoperative epilepsy, and was more than twice as likely in those without peritumoral edema, although an insufficient number of studies were available for formal meta-analysis of this association. Of 1085 individuals without preoperative epilepsy who underwent resection, new postoperative seizures were seen in 12.3% of patients. No difference in the rate of new postoperative seizures was observed with or without perioperative prophylactic anticonvulsants. CONCLUSIONS Seizures are common in supratentorial meningioma, particularly in tumors associated with brain edema, and seizure freedom is a critical treatment goal. Favorable seizure control can be achieved with resection, but evidence does

  18. Post-operative hematoma after surgery for intracranial meningiomas: causes, avoidable risk factors and clinical outcome.

    PubMed

    Gerlach, Rüdiger; Raabe, Andreas; Scharrer, Inge; Meixensberger, Jürgen; Seifert, Volker

    2004-01-01

    Intracranial meningiomas are mainly benign lesions amenable for surgical resection. However, removal of an intracranial meningioma carries a higher risk of post-operative hemorrhage compared to surgery for other intracranial neoplasms. Because avoidance of post-operative hematoma is of vital interest for neurosurgical patients, the aim of this retrospective study was to analyze risk factors of post-operative hematoma associated with meningioma surgery. Two hundred and ninety six patients with intracranial meningiomas, operated between June 1998 and June 2002, were included in this study. Patients who developed a space-occupying post-operative intracranial hemorrhage and were treated surgically were identified. Data of patients with and without hematoma were retrospectively analyzed to identify risk factors associated with post-operative hematoma. Variables analyzed included patients' age, invasion of venous sinus by the meningioma, tumor vascularization, arachnoidal infiltration, pre-operative prophylaxis of thromboembolic events, peri-operative coagulation abnormalities, residual tumor, location and histology of the tumor. Outcome of patients with post-operative hematoma was assessed according to the Glasgow Outcome Scale (GOS) at discharge and at three months. 21 patients (7.1 %) of 296 patients developed a post-operative intracranial hematoma requiring surgical evacuation. Age was significantly higher in the hematoma group 62.4 +/- 14.0 years compared to patients without post-operative hematoma 56.1 +/- 12.0 (p < 0.05; t-test). Patients older than 70 years had a six-fold increased risk to develop a post-operative hematoma (Chi2 test, 95% CI 1.949-13.224). Patients with post-operative hemorrhage had significant lower post-operative prothrombin time, fibrinogen and platelets immediately after surgery and lower platelets at day 1. None of the other parameters, including pre-operative routine coagulation values, differed significantly between patients with and

  19. Seizures in supratentorial meningioma: a systematic review and meta-analysis

    PubMed Central

    Englot, Dario J.; Magill, Stephen T.; Han, Seunggu J.; Chang, Edward F.; Berger, Mitchel S.; McDermott, Michael W.

    2016-01-01

    Object Meningioma is the most common benign intracranial tumor, and patients with supratentorial meningioma frequently suffer from seizures. The rates and predictors of seizures in patients with meningioma have been significantly under-studied, even in comparison with other brain tumor types. Improved strategies for the prediction, treatment, and prevention of seizures in patients with meningioma is an important goal, because tumor-related epilepsy significantly impacts patient quality of life. Methods The authors performed a systematic review of PubMed for manuscripts published between January 1980 and September 2014, examining rates of pre- and postoperative seizures in supratentorial meningioma, and evaluating potential predictors of seizures with separate meta-analyses. Results The authors identified 39 observational case series for inclusion in the study, but no controlled trials. Preoperative seizures were observed in 29.2% of 4709 patients with supratentorial meningioma, and were significantly predicted by male sex (OR 1.74, 95% CI 1.30–2.34); an absence of headache (OR 1.77, 95% CI 1.04–3.25); peritumoral edema (OR 7.48, 95% CI 6.13–9.47); and non–skull base location (OR 1.77, 95% CI 1.04–3.25). After surgery, seizure freedom was achieved in 69.3% of 703 patients with preoperative epilepsy, and was more than twice as likely in those without peritumoral edema, although an insufficient number of studies were available for formal meta-analysis of this association. Of 1085 individuals without preoperative epilepsy who underwent resection, new postoperative seizures were seen in 12.3% of patients. No difference in the rate of new postoperative seizures was observed with or without perioperative prophylactic anticonvulsants. Conclusions Seizures are common in supratentorial meningioma, particularly in tumors associated with brain edema, and seizure freedom is a critical treatment goal. Favorable seizure control can be achieved with resection, but

  20. Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study.

    PubMed

    Liouta, Evangelia; Koutsarnakis, Christos; Liakos, Faidon; Stranjalis, George

    2016-06-01

    OBJECT Current recommendations stress the need for cognitive parameters to be integrated in the evaluation of outcomes for intracranial meningioma surgery. The aim of this prospective study was to examine neurocognitive function in meningioma patients pre- and postoperatively. METHODS Patients with skull base (anterior and middle fossa) and convexity (anterior and posterior) meningiomas (n = 54) underwent neuropsychological examination prior to and 1 year after surgery. A control group (n = 52) of healthy volunteers matched for age, sex, and education underwent the same examination. Assessments included executive, memory, and motor functions with standardized testing. Patients with convexity meningiomas were clinically assessed for parietal association cortex functions. RESULTS All patients performed significantly worse (p < 0.05) in most neurocognitive domains than controls. The skull base group showed more disturbances in memory than the convexity group (p < 0.05). The anterior convexity group showed more deficits in executive function than the posterior convexity group, which presented with parietal association cortex deficits. Verbal deficits were more pronounced in the left hemisphere than in the right hemisphere. Patients with a large tumor (> 4 cm) had more severe neurocognitive deficits than those with a small tumor (< 4 cm). Postoperatively, patients showed no deterioration in neurocognitive function. Instead, significant improvement (p < 0.05) was observed in some executive, motor, and parietal association cortex functions. CONCLUSIONS According to the authors' findings, intracranial meningiomas may cause neurocognitive deficits in patients. Surgery does not cause a deterioration in cognitive function; instead, it may lead to improvements in some functions. Permanent neuropsychological postoperative deficits should be interpreted as tumor-induced rather than due to surgery.

  1. Intraventricular trigonal meningioma: Neuronavigation? No, thanks!

    PubMed Central

    Silva, Danilo O. A.; Matis, Georgios K.; Costa, Leonardo F.; Kitamura, Matheus A. P.; Birbilis, Theodossios A.; Azevedo Filho, Hildo R. C.

    2011-01-01

    Background: Most of the time meningiomas are benign brain tumors and surgical removal ensures cure in the vast majority of the cases. Thus, whenever possible, complete surgical resection should be the goal of the treatment. Methods: This is a report of our surgical technique for the operative resection of a trigonal meningioma in a resource-limited setting. The necessity of accurate and deep knowledge of the regional anatomy is outlined. Results: A 44-year-old male presented to our outpatient clinic complaining of cephalalgia increasing in frequency and intensity over the last month. His neurological exam was normal, yet a brain computed tomography scan revealed a lesion in the right trigone of the ventricular system. The diagnosis of possible meningioma was set. After thoroughly informing the patient, tumor resection was decided. An intraparietal sulcus approach was favored without the use of any modern technological aids such as intraoperative magnetic resonance imaging or neuronavigation. The postoperative course was uneventful and a postoperative computed tomography scan demonstrated the complete resection of the tumor. The patient was discharged two days later with no neurological deficits. In a two-year-follow-up he remains recurrence-free. Conclusion: In the current cost-effective era it is still possible to safely remove an intraventricular trigonal meningioma without the convenience of neuronavigation. Since the best neuronavigator is the profound neuroanatomical knowledge, no technological advancement could replace a well-educated and trained neurosurgeon. PMID:21886886

  2. Occipital Falcine Anaplastic Hemangiopericytoma Mimicking Meningioma

    PubMed Central

    Kanesen, Davendran; Kandasamy, Regunath; Idris, Zamzuri

    2016-01-01

    The rarity of hemangiopericytoma (HPC) and its controversial histological classification result in its frequent misdiagnosis and thus make the treatment quite challenging. It is often difficult to distinguish these tumors from meningiomas based on clinical features and radiological findings. This is a case report of a man, diagnosed clinically and radiologically as meningioma, which turned out to be anaplastic HPC on histological examination. A 30-year-old man presented with 3 months of progressively worsening of headache and blurring of vision. Clinical examination revealed the right homonymous hemianopia with reduced visual acuity and papilledema bilaterally. Magnetic resonance imaging revealed a multilobulated and heterogenous extraaxial lesion attached to the occipital falx. It measured 9.0 cm (AP) × 5.5 cm (W) × 5.8 cm (CC) and expands bilaterally with major bulk on the left. An occipital craniotomy followed by a subtotal tumor excision was only achieved due to profuse bleeding intraoperatively. Histopathology confirmed an anaplastic HPC (WHO Grade 3). The importance of differentiation between HPCs and meningiomas cannot be overemphasized. A preoperative correct diagnosis is difficult, but it is important that it should be made. Multilobulated (mushroom appearance), prominent internal signal voids, relatively narrow dural attachment, and lytic destruction without calcifications are useful findings to distinguish HPCs from meningiomas. PMID:28163517

  3. Occipital Falcine Anaplastic Hemangiopericytoma Mimicking Meningioma.

    PubMed

    Kanesen, Davendran; Kandasamy, Regunath; Idris, Zamzuri

    2016-12-01

    The rarity of hemangiopericytoma (HPC) and its controversial histological classification result in its frequent misdiagnosis and thus make the treatment quite challenging. It is often difficult to distinguish these tumors from meningiomas based on clinical features and radiological findings. This is a case report of a man, diagnosed clinically and radiologically as meningioma, which turned out to be anaplastic HPC on histological examination. A 30-year-old man presented with 3 months of progressively worsening of headache and blurring of vision. Clinical examination revealed the right homonymous hemianopia with reduced visual acuity and papilledema bilaterally. Magnetic resonance imaging revealed a multilobulated and heterogenous extraaxial lesion attached to the occipital falx. It measured 9.0 cm (AP) × 5.5 cm (W) × 5.8 cm (CC) and expands bilaterally with major bulk on the left. An occipital craniotomy followed by a subtotal tumor excision was only achieved due to profuse bleeding intraoperatively. Histopathology confirmed an anaplastic HPC (WHO Grade 3). The importance of differentiation between HPCs and meningiomas cannot be overemphasized. A preoperative correct diagnosis is difficult, but it is important that it should be made. Multilobulated (mushroom appearance), prominent internal signal voids, relatively narrow dural attachment, and lytic destruction without calcifications are useful findings to distinguish HPCs from meningiomas.

  4. Paraclinoid aneurysm concealed by sphenoid wing meningioma.

    PubMed

    Petrecca, Kevin; Sirhan, Denis

    2009-02-01

    The coexistence of brain tumours and aneurysms is rare. In all previously reported cases the aneurysm was detectable by angiography. We report here a case in which a paraclinoid internal carotid artery aneurysm was coexistent and concealed from angiographic detection by an adjacent parasellar meningioma.

  5. Metaplastic conus meningioma and its applied aspects

    PubMed Central

    Reddy, Srikanth; Pulligopu, Aneel Kumar; Kumar, Ashish; Sahu, Barada Prasad

    2015-01-01

    Cranial meningiomas may present with or without major deficits depending on their location and morphology. Spinal meningiomas account for 25% of all the spinal tumors. Most commonly encountered in the dorsal spine in middle-aged females, these intradural-extramedullary tumors can usually be excised without difficulty. Rarely, they can be encountered in the lumbar spine and may create many tactical problems for the surgical team especially if it is calcified and contains metaplastic bone. We report a 55-year-old patient who presented with backache and investigations revealed a calcified lesion at L1 level that was thought of as an ependymoma initially. Intraoperatively, the lesion was calcified in parts, and the histopathology revealed it to be a metaplastic meningioma with calcification. The patient had a transient hip weakness, which recovered completely later on. Calcification in meningiomas is common. However, frank bony metaplasia is extremely rare. More importantly, the applied aspect of their presence in the region of conus lies in the careful dissection to prevent damage to the surrounding neural structures. Awareness regarding the same may help us preventing complications in the future. PMID:25972958

  6. Metaplastic conus meningioma and its applied aspects.

    PubMed

    Reddy, Srikanth; Pulligopu, Aneel Kumar; Kumar, Ashish; Sahu, Barada Prasad

    2015-01-01

    Cranial meningiomas may present with or without major deficits depending on their location and morphology. Spinal meningiomas account for 25% of all the spinal tumors. Most commonly encountered in the dorsal spine in middle-aged females, these intradural-extramedullary tumors can usually be excised without difficulty. Rarely, they can be encountered in the lumbar spine and may create many tactical problems for the surgical team especially if it is calcified and contains metaplastic bone. We report a 55-year-old patient who presented with backache and investigations revealed a calcified lesion at L1 level that was thought of as an ependymoma initially. Intraoperatively, the lesion was calcified in parts, and the histopathology revealed it to be a metaplastic meningioma with calcification. The patient had a transient hip weakness, which recovered completely later on. Calcification in meningiomas is common. However, frank bony metaplasia is extremely rare. More importantly, the applied aspect of their presence in the region of conus lies in the careful dissection to prevent damage to the surrounding neural structures. Awareness regarding the same may help us preventing complications in the future.

  7. Paraneoplastic symptoms caused by extracranial meningioma metastases?

    PubMed Central

    Mindermann, Thomas

    2016-01-01

    Background: There are only few reports on distant metastases of cranial meningiomas WHO I. In one-third of the cases, distant metastases seem to be clinically silent. This is the first case of distant metastases which may have manifested with a paraneoplastic syndrome. Case Description: A 52-year-old white male patient was diagnosed with distant metastases to the bones and liver 11 and 12 years following craniotomy and removal of a tentorial meningioma WHO I. At that time, the patient had developed paresthesia, unsteady gait, and a slight cognitive impairment, which in retrospect had no other explanation than that of a paraneoplastic syndrome. Eighteen years following craniotomy, a small intracranial tumor rest is under control following two single session radiosurgery treatments. At present, the patient has a multitude of bone and liver metastases, which seem to cause his paraneoplastic symptoms. Conclusion: Screening for malignancies in patients with paraneoplastic symptoms and a history of cranial meningioma should include screening for distant metastases from the meningioma. PMID:28168092

  8. [Operative neurosurgery: personal view and historical backgrounds. (5) Meningioma].

    PubMed

    Yonekawa, Yasuhiro

    2009-01-01

    The author reports his experience of 410 surgeries of meningiomas on 365 cases during the last 13.5 years, including 51 surgeries on recurrent meningiomas and 8 surgeries with the change of initial approach on the same meningiomas. In the surgical management of meningiomas, following comments are to be emphasized: Appropriate approach and interruption of blood supply are of cardinal importance in surgical management of meningiomas. For the latter purpose, preoperative embolization of feeding arteries is recommended especially in deep seated and large meningiomas more than 3 cm in diameter for carrying out their surgical extirpation fast and radically. Olfactory groove meningiomas, planum sphenoidal meningiomas, tuberculum sellae meningiomas and sphenoid ridge meningiomas are managed with pterional approach. The latter two meningiomas may necessitate selective extradural anterior clinoidectomy SEAC. For the management of large midline meningiomas, combination with interhemispheric approach is necessary to manage pial supply appropriately for the preservation of circulation of the anterior cerebral artery ACA. Extension of the former two meningiomas to the other side can be managed with falcal incision and/or drilling out of the crista galli without performing a bifrontal approach. Reduction of exophthalmos due to sphenoid ridge meningiomas infiltrating Periorbita and extraocular muscles is hardly to be expected even after subtotal removal and extensive decompression of the orbita at the superior and lateral walls in combination with SEAC. Accidental compromise of the lenticulostriate arteries arising from M1 portion embraced by tumor nodules should be managed with oxycellulose and fibrin glue at first without their bipolar coagulation, as resulting infarction in the territory causes persistent hemiparesis. Meningiomas in the cavernous sinus should be observed as long as possible in case of no growth, as they remain the same in their size and extension mostly for a

  9. Longer sleep duration associates with lower adiposity gain in adult short sleepers.

    PubMed

    Chaput, J-P; Després, J-P; Bouchard, C; Tremblay, A

    2012-05-01

    The objective of this longitudinal, observational study was to verify whether a favorable change in sleep duration over 6 years could impact objective indicators of adiposity in adults aged 18-64 years. Short-duration sleepers (≤6 h per day; n=43) at baseline were divided into two groups: (i) those who increased their sleep duration to a 'healthy' length of 7-8 h per day at year 6 (mean increase: 1.52±0.66 h per day; n=23); and (ii) those who maintained their short sleep duration habits (mean change: -0.11±0.38 h per day; n=20). Adult individuals who reported sleeping 7-8 h per day at both baseline and year 6 (n=173) were used as a control group. Change in adiposity indicators for each sleep-duration group was compared by analysis of covariance. We observed that the two short-sleep-duration groups had similar baseline characteristics. However, short-duration sleepers who maintained their short sleep duration experienced a greater increase in body mass index (BMI) (difference: 1.1±0.36 kg m(-2), P<0.05) and fat mass (difference: 2.4±0.64 kg, P<0.05) over the 6-year follow-up period than short-duration sleepers who increased their sleep duration, even after adjustment for relevant covariates. We did not observe any significant difference in adiposity changes between the control group and short-duration sleepers who increased their sleep duration. This study suggests for the first time that shifting sleep duration from a short to a healthier length is associated with an attenuation of fat mass gain.

  10. Spontaneous resolution of visual loss due to optic pathway meningioma: A case report and a review of the literature.

    PubMed

    Pinzi, Valentina; Caldiera, Valentina; Schembri, Lorella; Cerniauskaite, Milda; Fariselli, Laura

    2016-01-01

    Meningiomas of the anterior cranial fossa are often diagnosed after impaired visual function occurrence. Some epidemiologic studies suggest an association between exogenous or endogenous hormones and meningioma risk. The aim of this study is to briefly review the literature and relate a case report. This study presents a case of a 51-year-old woman with a moderate visual loss of 6/10 and markedly constricted visual field in the right eye. A normal visual acuity and peripheral reduction of visual field in the left eye was documented. During medical interview, she reported a prolonged assumption of oral contraceptive. Her visual deterioration had progressed over the previous 3 months and was associated with occasional headache. MRI scanning showed a small optic pathway meningioma. After various examinations, it was decided to 'wait and see' and no therapy was administered. The patient noticed a progressive improvement in the vision in her right eye, with corresponding improvement in the bilateral visual field. The case reports on the spontaneous resolution of visual loss due to the volume reduction of the anterior visual pathway compressive intracranial meningioma after interruption of prolonged assumption of oral contraceptive and focuses on the correlation between sexual hormone pathway and intracranial meningioma.

  11. Proteome analysis of human cerebrospinal fluid as a diagnostic biomarker in patients with meningioma

    PubMed Central

    Kim, Jae Ho; Lee, Sang Kwang; Yoo, Yong Cheol; Park, Nam Hyun; Park, Dan Bi; Yoo, Jong Shin; An, Hyun Joo; Park, Young Mok; Cho, Kyung Gi

    2012-01-01

    Summary Background To identify meningioma-specific proteins, cerebrospinal fluid (CSF) from 4 patients with a meningioma and 4 patients with a non-brain tumorous lesion were analyzed. Material/Methods Two-dimensional electrophoresis and electrospray quadrupole time-of-flight tandem mass spectrometry analyses revealed 10 unique spots, containing 11 independent proteins (spot #2 and #4 each contained 2 proteins and spot #3 was not identified) were evident in CSF associated with human meningioma: serum albumin precursor (3 different isoforms), Apolipoprotein E (Apo E), Apolipoprotein J precursor (Apo J), Transthyretin precursor (TTR), Prostaglandin D2 synthase 21kDa (PTGDS), proapolipoprotein, Chain D hemoglobin Ypsilanti, alpha-1-antitrypsin (AAT), and beta-2-microglobulin precursor (β2M). Results The contents of Apo E, Apo J and AAT were increased, while PTGDS, TTR and β2M were decreased. Conclusions The results observed by 2-dimensional electrophoresis were verified by Western blot analysis. The unique proteins may represent possible candidate biomarkers of meningioma. PMID:23111736

  12. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood

    PubMed Central

    Fraser, Abigail; Tilling, Kate; Macdonald-Wallis, Corrie; Sattar, Naveed; Brion, Marie-Jo; Benfield, Li; Ness, Andy; Deanfield, John; Hingorani, Aroon; Nelson, Scott M; Smith, George Davey; Lawlor, Debbie A

    2012-01-01

    Background We aimed to examine the association of gestational weight gain (GWG) and pre-pregnancy weight with offspring adiposity and cardiovascular risk factors. Methods and results Data from 5,154 (for adiposity and blood pressure) and 3,457 (for blood assays) mother-offspring pairs from a UK prospective pregnancy cohort were used. Random effects multilevel models were used to assess incremental GWG (median and range of repeat weight measures per woman: 10 (1, 17)). Women who exceeded the 2009 Institute of Medicine recommended GWG were more likely to have offspring with greater body mass index, waist, fat mass, leptin, systolic blood pressure, CRP and IL-6 levels, and lower HDLc and Apolipoprotein A1 levels. Children of women who gained less than the recommended amounts had lower levels of adiposity, but other cardiovascular risk factor tended to be similar in this group to offspring of women gaining recommended amounts. When examined in more detail greater pre-pregnancy weight was associated with greater offspring adiposity and more adverse cardiovascular risk factors at age 9. GWG in early pregnancy (0 to 14 weeks) was positively associated with offspring adiposity across the entire distribution, but strengthened in women gaining more than 500g/week. By contrast, between 14 and 36 weeks GWG was only associated with offspring adiposity in women gaining at least 500g/week. GWG between 14-36 weeks was positively and linearly associated with adverse lipid and inflammatory profiles with these associations largely mediated by the associations with offspring adiposity. Conclusions Greater maternal pre-pregnancy weight and GWG up to 36 weeks gestation are associated with greater offspring adiposity and adverse cardiovascular risk factors. Before implementing any GWG recommendations, the balance of risks and benefits of attempts to control GWG for short- and long-term outcomes in mother and child should be ascertained. PMID:20516377

  13. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood.

    PubMed

    Fraser, Abigail; Tilling, Kate; Macdonald-Wallis, Corrie; Sattar, Naveed; Brion, Marie-Jo; Benfield, Li; Ness, Andy; Deanfield, John; Hingorani, Aroon; Nelson, Scott M; Smith, George Davey; Lawlor, Debbie A

    2010-06-15

    We sought to examine the association of gestational weight gain (GWG) and prepregnancy weight with offspring adiposity and cardiovascular risk factors. Data from 5154 (for adiposity and blood pressure) and 3457 (for blood assays) mother-offspring pairs from a UK prospective pregnancy cohort were used. Random-effects multilevel models were used to assess incremental GWG (median and range of repeat weight measures per woman: 10 [1, 17]). Women who exceeded the 2009 Institute of Medicine-recommended GWG were more likely to have offspring with greater body mass index, waist, fat mass, leptin, systolic blood pressure, C-reactive protein, and interleukin-6 levels and lower high-density lipoprotein cholesterol and apolipoprotein A1 levels. Children of women who gained less than the recommended amounts had lower levels of adiposity, but other cardiovascular risk factors tended to be similar in this group to those of offspring of women gaining recommended amounts. When examined in more detail, greater prepregnancy weight was associated with greater offspring adiposity and more adverse cardiovascular risk factors at age 9 years. GWG in early pregnancy (0 to 14 weeks) was positively associated with offspring adiposity across the entire distribution but strengthened in women gaining >500 g/wk. By contrast, between 14 and 36 weeks, GWG was only associated with offspring adiposity in women gaining >500 g/wk. GWG between 14 and 36 weeks was positively and linearly associated with adverse lipid and inflammatory profiles, with these associations largely mediated by the associations with offspring adiposity. Greater maternal prepregnancy weight and GWG up to 36 weeks of gestation are associated with greater offspring adiposity and adverse cardiovascular risk factors. Before any GWG recommendations are implemented, the balance of risks and benefits of attempts to control GWG for short- and long-term outcomes in mother and child should be ascertained.

  14. Prophylactic use of anticoagulation and hemodilution for the prevention of venous thromboembolic events following meningioma surgery.

    PubMed

    Moussa, Wael Mohamed Mohamed; Mohamed, Mohamed Abbas Aly

    2016-05-01

    Brain tumors may be associated with postoperative venous thromboembolic (VTE) events with possible devastating consequences. Meningioma has the highest incidence of postoperative VTE events among all brain tumors. Hemodilution and anticoagulation both proved efficacy in deep venous thrombosis (DVT) prophylaxis that is why we theorized that this regimen would be beneficial for VTE prophylaxis in operated intracranial meningioma patients without added risk to the patients. A retrospective double-blinded study, where the records of consecutive intracranial meningioma patients were revised comparing the efficacy of two regimens of postoperative VTE prophylaxis. Patients were divided into 2 groups; group A was submitted to the use of compressive stockings, low-molecular weight heparin (LMWH) administration and hemodilution, while group B was submitted only to the use of compressive stockings. The study included 194 patients. Mean age of patients was 55 years (range from 27 to 78 years). VTE events were diagnosed in 16 patients (8.2%) all of them belonged to group B. The median time for VTE events was 12 days. Older age (P=.0001), larger size tumor (p=0.0438), delayed ambulation postoperatively (p=0.0351) as well as skull base location of meningioma (p=0.0163) were associated with higher incidence of postoperative VTE. Overall, group A patients showed more favorable outcome as compared to group B. In addition to the use of elastic stockings, we recommend starting hemodilution at the outset of surgery, LMWH administration starting 12h postoperatively as well as refraining from the use of diuretics during and after intracranial meningioma surgery till the patient became fully ambulatory to reduce the incidence of postoperative VTE events. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. 5-Aminolevulinic acid fluorescence-guided surgery for spinal meningioma.

    PubMed

    Muroi, Carl; Fandino, Javier; Coluccia, Daniel; Berkmann, Sven; Fathi, Ali-Reza; Landolt, Hans

    2013-01-01

    Fluorescence-guided surgery for cranial meningioma has been reported to be useful. There are no reports about spinal cases using this technique. We report on a meningioma of the cervical spine for which fluorescence-guided surgery was used. A 78-year-old female patient with a meningioma located in the cervical spine underwent surgery using fluorescence guidance. After complete removal of the meningioma and removal and coagulation of the dural attachment (equal to Simpson grade II resection), a fluorescence-positive remnant could be identified and successfully removed. The remnant was found to harbor meningioma tissue on histological examination. Fluorescence-guided microsurgery is helpful in achieving a total resection of spinal meningiomas, and might therefore reduce the risk of recurrence. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Meningioma involving Meckel's cave: transpetrosal surgical anatomy and clinical considerations.

    PubMed

    Choo, Daniel I; Steward, David L; Pensak, Myles L

    2002-09-01

    Meningiomas originating in Meckel's cave (MC) are uncommon lesions that represent 1% of all intracranial meningiomas. Innovations in skull base surgery have enabled resection of these lesions with less morbidity, but require an intimate knowledge of both lesional pathology and regional microneuroanatomy. To review the surgical and clinical considerations involved in the management of MC meningiomas, we retrospectively reviewed data from patients who underwent transpetrosal resection of primary MC meningiomas between 1984 and 1998. Of 146 patients who underwent transpetrosal removal of meningiomas, 7 were believed to have tumors originating in MC. All 7 patients presented with trigeminal dysfunction, facial pain, and/or headache. Complete tumor removal was achieved in 5 of the 7 patients. Facial hypoesthesia or anesthesia, paralysis of cranial nerve VI, and ophthalmoplegia were among the postoperative complications encountered. Meningiomas of MC represent treatable lesions whose diagnosis requires prompt imaging of patients with trigeminal dysfunction and symptoms of facial pain and headache.

  17. Tophaceous gout of the lumbar spine mimicking a spinal meningioma.

    PubMed

    Ribeiro da Cunha, Pedro; Peliz, António Judice; Barbosa, Marcos

    2016-11-05

    Although gout is a common metabolic disorder, it usually affects distal joints of the appendicular skeleton. Axial spine involvement is rare, with only 131 cases reported in the literature. The authors report a rare case of lumbar spinal gout mimicking a spinal meningioma. A 77-year-old man with a history of gout presented with chronic low back pain and progressive paraparesis. Imaging revealed a lumbar spine compressive mass lesion with a dural tail signal. The differential diagnosis was thought to be straightforward favoring a spinal meningioma. Tophaceous gout was never considered. The presence of a dural tail associated with the lesion is an interesting detail of this case, that strongly misguided it and to the best of our knowledge it is the first one reported in the literature. The patient underwent surgery and intra-operative findings were surprisingly different from those expected, revealing a chalky white mass lesion firmly adherent and compressing the dural sac. It was completely excised, leaving the dura intact. Histopathology confirmed the diagnosis of tophaceous gout. The patient was sent to physical therapy and had a complete remission of pain and neurological deficit, regaining his walking capacity. Although spinal gout is rare, it should be considered in the differential diagnosis for patients presenting with symptoms of spinal stenosis, a suspicion of neoplastic lesion of the spine, and a previous history of gout. Early diagnosis can ensure proper and timely medical management, perhaps avoiding neurological compromise and the need for surgery.

  18. Surgical outcome in an elderly population with intracranial meningioma.

    PubMed Central

    Umansky, F; Ashkenazi, E; Gertel, M; Shalit, M N

    1992-01-01

    Thirty seven patients aged 70 and over (mean = 74 years) with an intracranial meningioma who had craniotomy between the years 1978-88 were reviewed. There were 20 women and 17 men. Resection was total in 28 (76%) and subtotal in 9 (24%) cases and each tumour was histologically verified. The location of the tumours were: base of skull 11, convexity 10, parasagittal 9, falx 6, and tentorial 1. The most frequent associated diseases were: hypertension (35%), chronic ischaemic heart disease (22%) chronic obstructive pulmonary disease (19%), and diabetes (14%). The Karnofsky Scale (KS) score before surgery ranged from 30 to 90 (mean = 59). It was less than 40 in ten patients. The length of anaesthesia during the surgical procedure varied from 4 to 12 hours and was not related to the outcome. There were two perioperative deaths (mortality = 5.4%). There were major complications in 8 patients and minor complications in 7 patients. In a mean follow up period of 29 months (shortest 6 and longest 96 months) the results were: excellent (KS 90-100) 39%, good (KS 70-80) 49%, fair (KS 60) 6%, and poor (KS 40-50) 6%. The difference between the mean preoperative KS value (KS = 59) and the mean postoperative KS value (KS = 80) was statistically significant (P less than 0.001). The results support a more aggressive therapeutic approach to the elderly patient with an intracranial meningioma. PMID:1619416

  19. [A case of Mycobacterium fortuitum meningitis following surgery for meningioma].

    PubMed

    Fujikawa, Keita; Suenaga, Akihito; Motomura, Masakatsu; Fukuda, Taku; Ooe, Nobuharu; Eguchi, Katsumi

    2006-07-01

    A 57-year-old woman had undergone surgery for meningioma. After the surgery, she suffered from repeated fever and headache. One year after surgery, she was admitted to our hospital for further examination. Cerebro-spinal fluid (CSF) findings indicated bacterial meningitis infection. Germ culture, acid-fast bacterium culture, PCR for mycobacteriosis and cryptococcus antigens as well as cytological examination of CSF were checked repeatedly. However, all examinations were negative and etiology was unknown. We treated with many anti-bacterial, anti-fungal and anti-tubercular drugs, but CSF findings were not improved. We repeated CSF examination and finally Mycobacterium fortuitum (M. fortuitum) was isolated. Clarithromycin (CAM) was started for M. fortuitum meningitis. After drug sensitivity testing, levofloxacin (LVFX), which was effective against M. fortuitum, was added to CAM, after which clinical and CSF findings improved dramatically. M. fortuitum rarely causes CNS infection. Several English literatures on M. fortuitum meningitis after traumatic injury and surgery have been published. Its CSF findings distinctly resemble those of bacterial meningitis, but are resistant to the usual antituberculosis drugs. We reported a case of M. fortuitum meningitis associated with surgery for meningioma.

  20. Association between socioeconomic and biological factors and infant weight gain: Brazilian Demographic and Health Survey--PNDS-2006/07.

    PubMed

    Silveira, Jonas Augusto C; Colugnati, Fernando Antônio B; Poblacion, Ana Paula; Taddei, José Augusto A C

    2015-01-01

    To examine the associations between socioeconomic and biological factors and infant weight gain. All infants (0-23 months of age) with available birth and postnatal weight data (n = 1763) were selected from the last nationally representative survey with complex probability sampling conducted in Brazil (2006/07). The outcome variable was conditional weight gain (CWG), which represents how much an individual has deviated from his/her expected weight gain, given the birth weight. Associations were estimated using simple and hierarchical multiple linear regression, considering the survey sampling design, and presented in standard deviations of CWG with their respective 95% of confidence intervals. Hierarchical models were designed considering the UNICEF Conceptual Framework for Malnutrition (basic, underlying and immediate causes). The poorest Brazilian regions (-0.14 [-0.25; -0.04]) and rural areas (-0.14 [-0.26;-0.02]) were inversely associated with CWG in the basic causes model. However, this association disappeared after adjusting for maternal and household characteristics. In the final hierarchical model, lower economic status (-0.09 [-0.15; -0.03]), human capital outcomes (maternal education < 4th grade (-0.14[-0.29; 0.01]), higher maternal height (0.02[0.01; 0.03])), and fever in the past 2 weeks (-0.13[-0.26; -0.01]) were associated with postnatal weight gain. The results showed that poverty and lower human capital are still key factors associated with poor postnatal weight gain. The approach used in these analyses was sensitive to characterize inequalities among different socioeconomic contexts and to identify factors associated with CWG in different levels of determination. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Downregulated MicroRNA-200a in Meningiomas Promotes Tumor Growth by Reducing E-Cadherin and Activating the Wnt/β-Catenin Signaling Pathway▿

    PubMed Central

    Saydam, Okay; Shen, Yiping; Würdinger, Thomas; Senol, Ozlem; Boke, Elvan; James, Marianne F.; Tannous, Bakhos A.; Stemmer-Rachamimov, Anat O.; Yi, Ming; Stephens, Robert M.; Fraefel, Cornel; Gusella, James F.; Krichevsky, Anna M.; Breakefield, Xandra O.

    2009-01-01

    Meningiomas, one of the most common human brain tumors, are derived from arachnoidal cells associated with brain meninges, are usually benign, and are frequently associated with neurofibromatosis type 2. Here, we define a typical human meningioma microRNA (miRNA) profile and characterize the effects of one downregulated miRNA, miR-200a, on tumor growth. Elevated levels of miR-200a inhibited meningioma cell growth in culture and in a tumor model in vivo. Upregulation of miR-200a decreased the expression of transcription factors ZEB1 and SIP1, with consequent increased expression of E-cadherin, an adhesion protein associated with cell differentiation. Downregulation of miR-200a in meningiomas and arachnoidal cells resulted in increased expression of β-catenin and cyclin D1 involved in cell proliferation. miR-200a was found to directly target β-catenin mRNA, thereby inhibiting its translation and blocking Wnt/β-catenin signaling, which is frequently involved in cancer. A direct correlation was found between the downregulation of miR-200a and the upregulation of β-catenin in human meningioma samples. Thus, miR-200a appears to act as a multifunctional tumor suppressor miRNA in meningiomas through effects on the E-cadherin and Wnt/β-catenin signaling pathways. This reveals a previously unrecognized signaling cascade involved in meningioma tumor development and highlights a novel molecular interaction between miR-200a and Wnt signaling, thereby providing insights into novel therapies for meningiomas. PMID:19703993

  2. Maternal pregnancy weight gain and cord blood iron status are associated with eosinophilia in infancy.

    PubMed

    Weigert, R; Dosch, N C; Bacsik-Campbell, M E; Guilbert, T W; Coe, C L; Kling, P J

    2015-08-01

    Allergic disease is multifactorial in origin. Because iron nutrition affects immune responses and maternal pregnancy weight gain impairs fetal iron delivery while increasing fetal demands for growth, the study examined maternal pregnancy weight gain, newborn iron status and an index of atopic disease, infant eosinophilia. Within a larger prospective study of healthy newborns at risk for developing iron deficiency anemia, umbilical cord iron indicators were compared to infant eosinophil counts. Infants who developed eosinophilia exhibited higher cord reticulocyte-enriched zinc protoporphyrin/heme ratio, P<0.05 and fewer cord ferritin values in the highest (best) quartile, P<0.05. If cord ferritin was in the upper three quartiles, the negative predictive value for infant eosinophilia was 90%. High maternal pregnancy weight gain predicted infant eosinophil counts, P<0.04, and contributed to cord ferritin predicting eosinophilia, P<0.003. Poor fetal iron status may be an additional risk factor for infant eosinophilia.

  3. Monocular nasal hemianopia from atypical sphenoid wing meningioma.

    PubMed

    Stacy, Rebecca C; Jakobiec, Frederick A; Lessell, Simmons; Cestari, Dean M

    2010-06-01

    Neurogenic monocular nasal field defects respecting the vertical midline are quite uncommon. We report a case of a unilateral nasal hemianopia that was caused by compression of the left optic nerve by a sphenoid wing meningioma. Histological examination revealed that the pathology of the meningioma was consistent with that of an atypical meningioma, which carries a guarded prognosis with increased chance of recurrence. The tumor was debulked surgically, and the patient's visual field defect improved.

  4. Sleep disruption and duration in late pregnancy is associated with excess gestational weight gain among overweight and obese women.

    PubMed

    Gay, Caryl L; Richoux, Sarah E; Beebe, Kathleen R; Lee, Kathryn A

    2017-06-01

    Poor sleep during pregnancy has been associated with poorer birth outcomes. High body mass index (BMI) is often associated with poor sleep, but little is known about the relationship between gestational weight gain and sleep in late pregnancy. The purpose of this study was to evaluate the relationships of both gestational weight gain and pre-pregnancy BMI to objective and subjective measures of sleep during late pregnancy. Pregnant women (n=128) were recruited from prenatal clinics and childbirth classes primarily serving low-income women. Their sleep (disruption and duration) was objectively assessed in their last month of pregnancy with 72 hours of wrist actigraphy monitoring. Their perceived sleep quality was assessed with the Pittsburgh Sleep Quality Index. Pre-pregnancy and late pregnancy height and weight were assessed by self-report and used to calculate BMI and gestational weight gain, which were then grouped into standardized categories. Mean Pittsburgh Sleep Quality Index score was 6.8 ± 3.1 (range 2-16). Sixty percent had excess gestational weight gain and it was associated with poorer perceived sleep quality, but was unrelated to objective measures of sleep duration and disruption. Pre-pregnancy BMI was unrelated to all sleep parameters. However, analyses of the interaction of pre-pregnancy BMI and gestational weight gain indicated that excess weight gain was associated with shorter sleep duration and more sleep disruption, but only among women who were overweight before pregnancy. Pregnancy is an opportunity to promote long-term women's health with a better understanding of the relationship between weight management and healthy sleep habits. © 2017 Wiley Periodicals, Inc.

  5. Systematic Review of Antiretroviral-Associated Lipodystrophy: Lipoatrophy, but Not Central Fat Gain, Is an Antiretroviral Adverse Drug Reaction

    PubMed Central

    de Waal, Reneé; Cohen, Karen; Maartens, Gary

    2013-01-01

    Background Lipoatrophy and/or central fat gain are observed frequently in patients on antiretroviral therapy (ART). Both are assumed to be antiretroviral adverse drug reactions. Methods We conducted a systematic review to determine whether fat loss or gain was more common in HIV-infected patients on ART than in uninfected controls; was associated with specific antiretrovirals; and would reverse after switching antiretrovirals. Results Twenty-seven studies met our inclusion criteria. One cohort study reported more lipoatrophy, less subcutaneous fat gain, but no difference in central fat gain in HIV-infected patients on ART than in controls. Randomised controlled trials (RCTs) showed more limb fat loss (or less fat gain) with the following regimens: stavudine (versus other nucleoside reverse transcriptase inhibitors (NRTIs)); efavirenz (versus protease inhibitors (PIs)); and NRTI-containing (versus NRTI-sparing). RCTs showed increased subcutaneous fat after switching to NRTI-sparing regimens or from stavudine/zidovudine to abacavir/tenofovir. There were no significant between-group differences in trunk and/or visceral fat gain in RCTs of various regimens, but results from efavirenz versus PI regimens were inconsistent. There was no significant between-group differences in central fat gain in RCTs switched to NRTI-sparing regimens, or from PI-containing regimens. Conclusions There is clear evidence of a causal relationship between NRTIs (especially thymidine analogues) and lipoatrophy, with concomitant PIs possibly having an ameliorating effect or efavirenz causing additive toxicity. By contrast, central fat gain appears to be a consequence of treating HIV infection, because it is not different from controls, is not linked to any antiretroviral class, and doesn't improve on switching. PMID:23723990

  6. Medical Care Costs Associated With Long-term Weight Maintenance Versus Weight Gain Among Patients With Type 2 Diabetes.

    PubMed

    Nichols, Gregory A; Bell, Kelly; Kimes, Teresa M; O'Keeffe-Rosetti, Maureen

    2016-11-01

    Weight loss is recommended for overweight patients with diabetes but avoidance of weight gain may be a more realistic goal. We calculated the 4-year economic impact of maintaining body weight versus gaining weight. Among 8,154 patients with type 2 diabetes, we calculated weight change as the difference between the first body weight measure in 2010 and the last measure in 2013 and calculated mean glycated hemoglobin (A1C) from all measurements from 2010 to 2013. We created four analysis groups: weight change <5% and A1C <7%; weight gain ≥5% and A1C <7%; weight change <5% and A1C ≥7%; and weight gain ≥5% and A1C ≥7%. We compared change in medical costs between 2010 and 2013, adjusted for demographic and clinical characteristics. Patients who maintained weight within 5% of baseline experienced a reduction in costs of about $400 regardless of A1C. In contrast, patients who gained ≥5% of baseline weight and had mean A1C ≥7% had an increase in costs of $1,473 (P < 0.001). Those who gained >5% of their baseline weight with mean A1C <7% had a modest increase in costs ($387, NS). Patients who gained at least 5% of their baseline body weight and did not maintain A1C <7% over 4 years experienced a 14% increase in medical costs, whereas those who maintained good glycemic control had a mean cost increase of 3.3%. However, patients who maintained weight within 5% of baseline had costs that were ∼5% lower than baseline. Avoidance of weight gain may reduce costs in the long-term. © 2016 by the American Diabetes Association.

  7. Cytomorphology of Recurrent Osseous Extracranial Meningioma of Right Pubic Ramus:: Report of a Case and Literature Review.

    PubMed

    Bokhari, Aqiba; Hibshoosh, Hanina; Tiscornia-Wasserman, Patricia G

    2016-07-01

    Meningiomas are well-recognized neoplasms of the central nervous system. Primary extracranial meningiomas (ECMs) are extremely rare and arise in various anatomic sites. We present a 56-year-old female with 13-year history of primary grade I meningothelial meningioma of right pubic symphysis, orthotopic heart transplant, and right total hip arthroplasty, who presented with progressive right hip pain for 3 weeks. Primary intracranial, intraspinal and other tumors were excluded. Imaging revealed a destructive lytic lesion at right superior and inferior pubic rami and body, associated with extensive bone destruction and soft tissue mass. Touch imprint (TI) cytology of computed tomography (CT)-guided core biopsy from the right pubic ramus (PRA) lesion showed a spindle cell neoplasm, with classical syncytial, lobular, and whorling cellular arrangement, composed of spindle, oval or round nuclei with occasional pseudoinclusions, consistent with known history of osseous meningioma. Tumor was further characterized by histopathology as grade 1 meningioma with meningothelial features. To our knowledge, primary osseous ECM arising specifically at the PRA has not been reported previously. ECM at this site may pose a diagnostic challenge for cytologists as its features may resemble other more commonly observed lesions. Accurate diagnosis requires awareness of occurrence of ECM at PRA and recognition of its characteristic cytomorphology. TI cytological features of our case are presented and previously described cytology of ECMs and diagnostic pitfalls are reviewed. Diagn. Cytopathol. 2016;44:618-622. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. Association of physical violence by an intimate partner around the time of pregnancy with inadequate gestational weight gain in Oklahoma

    PubMed Central

    Beydoun, Hind A.; Tamim, Hala; Lincoln, Alicia M.; Dooley, Suzanna D.; Beydoun, May A.

    2012-01-01

    Intimate partner violence has been previously examined in relation to numerous pregnancy, labor and delivery outcomes. We evaluated whether women who experienced physical violence by their intimate partners around the time of pregnancy were less likely to achieve weight gain according to Institute of Medicine (IOM) guidelines. A cross-sectional study was conducted using the 2000–2006 Oklahoma Pregnancy Risk Assessment Monitoring Survey (PRAMS) data for post-partum women, 20 years and older. Physical violence perpetrated by an intimate partner before and/or during pregnancy was prevalent in nearly 6.5% of women. Weight gain was adequate in 38.8%, deficient in 28.4% and excessive in 32.8% of these women, respectively. After adjusting for maternal age, marital status, education, pregnancy intention, stressful life events, third-trimester use of tobacco and alcohol and gestational age at delivery, physical violence by an intimate partner around the time of pregnancy was positively but non-significantly associated with excessive (but not deficient) gestational weight gain. After stratifying by age group, positive and significant associations between physical violence by an intimate partner around the time of pregnancy and inadequate gestational weight gain were observed only among women 35 years and older. With the exception of mothers ≥ 35 years of age, deficient and excessive gestational weight gains were not significantly related to experiences with physical violence by an intimate partner prior to delivery. Prospective cohort studies are needed to establish whether other forms of violence, including emotional and sexual abuse, can affect gestational weight gain and whether gestational weight gain can mediate the effect of physical, sexual and emotional abuse on pregnancy, labor and delivery outcomes. PMID:21324411

  9. Extradural en-plaque spinal meningioma with intraneural invasion.

    PubMed

    Tuli, Jayshree; Drzymalski, Dan Michael; Lidov, Hart; Tuli, Sagun

    2012-01-01

    Extradural spinal meningiomas are rare. Our understanding of purely extradural spinal meningiomas is incomplete because most reports rarely differentiate purely extradural meningiomas from extradural meningiomas with an intradural component. Occasionally, reports have described involvement of the adjacent nerve root, but there has never been a description of an extradural meningioma that actually infiltrates the nerve root. A 42-year-old woman presented with progressive lower extremity weakness and numbness below T3 during the span of 4 months with imaging evidence of an extradural lesion compressing the cord from T4 through T6. Surgical resection revealed an extradural mass extending through the foramen at T5-6 and encompassing the cord and T5 root on the left. Pathologically, the lesion was a World Health Organization grade I meningioma with nerve root invasion and a concerning elevated mindbomb homolog 1 (MIB-1) of 9.4%. Purely extradural meningiomas are rare, and our case is one of the first to describe a patient with an extradural meningioma that actually infiltrates the nerve root. Extradural spinal meningiomas are usually not adherent to the dura, but only appear to be adherent or invade (as in our patient) the adjacent nerve root. They are easily mistaken preoperatively and grossly intraoperatively for malignant metastatic tumors and can change the proposed surgical treatment. The long-term prognosis remains uncertain, but our patient's last follow-up suggests a favorable prognosis. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. [Primary osteolytic intraosseous meningioma of the occipital bone].

    PubMed

    Bernal-García, Luis Miguel; Cabezudo-Artero, José Manuel; Marcelo-Zamorano, María Bella; Fernández-Alarcón, Luis; Gilete-Tejero, Ignacio

    2015-01-01

    Primary intraosseous meningiomas are considered extradural meningiomas when no dural attachment is present. Most of them arise from the cranial bones and can present either as an osteoblastic or an osteolytic lesion. Osteolytic intraosseous meningiomas are the rarest and very few cases have been reported. Given that many of these may develop signs of malignancy, early histological confirmation is important in order to ensure appropriate treatment. The recommended therapy is surgery, with complete resection whenever possible. We present the case of a large primary intraosseous osteolytic meningioma within the occipital bone, which was completely excised five years ago, currently presenting no signs of recurrence.

  11. Review of controversies in management of non-benign meningioma.

    PubMed

    Paldor, Iddo; Awad, Mohammed; Sufaro, Yuval Z; Kaye, Andrew H; Shoshan, Yigal

    2016-09-01

    Meningiomas are one of the most common brain tumors. World Health Organisation (WHO) Grade II and Grade III meningiomas are grouped together as non-benign meningioma (NBM). There are several controversies surrounding NBM management, including the significance of extent of resection and the efficacy of post-operative radiation and drug treatment. We reviewed the literature to develop recommendations for management of NBM. The questions we sought to answer were: Does gross total resection (GTR) improve patient outcome? Is radiation therapy (RT) warranted after complete or after incomplete resection of NBM? What drug therapies have been proven to improve outcome in patients with NBM? We found that GTR improves outcome in WHO Grade II meningioma, and should be attempted whenever considered safe. GTR correlates less closely to outcome in Grade III meningioma compared to subtotal resection (STR). Extreme measures to completely resect Grade III meningioma are not warranted. RT following GTR of Grade II meningioma does not improve patient outcome, and may be reserved for recurrence. RT improves outcome following STR of Grade II meningioma. RT improves outcome after resection of Grade III meningioma. No drug therapy has been shown to improve outcome in NBM. This review elucidates recommendations for some of the controversies involving NBM. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Clear cell meningioma: case report and review of the literature.

    PubMed

    Oviedo, Angelica; Pang, Dachling; Zovickian, John; Smith, Matthew

    2005-01-01

    Clear cell meningioma (CCM) is a rare variant of meningioma. Only 17 cases have been previously reported in children. Although it has bland cytologic features, it has a higher rate of recurrence than does conventional meningioma. This variant has been reported in sites such as spinal/intradural (lumbar and thoracic), cerebellopontine angle, and supratentorial. The differential diagnosis of CCM includes microcystic meningioma, hemangioblastoma, and clear cell ependymoma. The characteristic histology and immunohistochemistry leads to the diagnosis. We present a case of a 7-year-old boy with a CCM of the cauda equina and a review of pediatric CCM.

  13. Differences in transcript abundance of genes on BTA15 located within a region associated with gain in beef steers

    USDA-ARS?s Scientific Manuscript database

    Six markers on the Illumina Bovine 50k BeadChip within a 229 Kb region on bovine chromosome 15 were associated (P=0.002) with average daily gain (ADG) in beef cattle. We chose to evaluate seven genes located within this region for variation in RNA transcript abundance in a library of tissue samples ...

  14. Spinal intradural clear cell meningioma following resection of a suprasellar clear cell meningioma. Case report and recommendations for management.

    PubMed

    Dhall, Sanjay S; Tumialán, Luis M; Brat, Daniel J; Barrow, Daniel L

    2005-09-01

    The authors report on 32-year-old woman with a history of a previously resected suprasellar clear cell meningioma (CCM), who returned to their institution after 3 years suffering from progressively worsening leg and back pain associated with leg weakness and bowel and bladder dysfunction. A magnetic resonance image of the thoracic and lumbar spine demonstrated a homogeneously enhancing intradural mass that filled and expanded the thecal sac. The patient underwent multiple-level laminectomies for resection of the lesion. Results of pathological studies confirmed distant recurrence of a CCM. Since its initial recognition as a rare but aggressive histological variant of meningothelial tumors, the body of literature on CCMs has grown to include more than 40 cases. Nevertheless, the natural history of this neoplastic entity remains ill defined, as are the recommendations for management. Of particular concern is the treatment of patients who have undergone subtotal resection or present with recurrence. To the authors' knowledge, the present case represents the sixth distant recurrence of CCM reported in the literature. The radiographic and histological studies are reviewed along with the current literature on this subtype of meningioma. Recommendations for surveillance and treatment are made.

  15. Identifying Variables Associated with First Grade Reading Gain. PREPS Research Project, 1978-79.

    ERIC Educational Resources Information Center

    Abram, Marie J.; Cobb, Robert A.

    A study investigated whether various home and school factors were related to first grade reading gain. Parents of all second grade students in a school district were asked to complete questionnaires eliciting the number of persons living in the household, the strictness of parental discipline, number of hours spent reading to the child each week,…

  16. Multi-Level Assessment of Scientific Content Knowledge Gains Associated with Socioscientific Issues-Based Instruction

    ERIC Educational Resources Information Center

    Klosterman, Michelle L.; Sadler, Troy D.

    2010-01-01

    This study explored the impact of using a socioscientific issue (SSI) based curriculum on developing science content knowledge. Using a multi-level assessment design, student content knowledge gains were measured before and after implementation of a three-week unit on global warming (a prominent SSI) that explored both the relevant science content…

  17. Multi-Level Assessment of Scientific Content Knowledge Gains Associated with Socioscientific Issues-Based Instruction

    ERIC Educational Resources Information Center

    Klosterman, Michelle L.; Sadler, Troy D.

    2010-01-01

    This study explored the impact of using a socioscientific issue (SSI) based curriculum on developing science content knowledge. Using a multi-level assessment design, student content knowledge gains were measured before and after implementation of a three-week unit on global warming (a prominent SSI) that explored both the relevant science content…

  18. Association of diarrhoea and upper respiratory infections with weight and height gains in Bangladeshi children aged 5 to 11 years.

    PubMed Central

    Torres, A. M.; Peterson, K. E.; de Souza, A. C.; Orav, E. J.; Hughes, M.; Chen, L. C.

    2000-01-01

    INTRODUCTION: The association between infection and growth delay is not well documented in school-age children in developing countries. We conducted a prospective cohort study to examine the association between infectious disease and weight and height gains among Bangladeshi children. METHODS: A one-year follow-up study was performed to elucidate the determinants and consequences of physical growth of children under five years of age. The study included 135 households randomly selected from four villages in the Matlab area. RESULTS: The most frequent infections were upper respiratory infections (mean = 4 episodes or 27 days per year) followed by non-dysenteric diarrhoea (mean = 2.3 episodes or 15 days per year) and dysentery (mean = 0.2 episodes or 2 days per year). The number of episodes and their duration decreased significantly with age. Over a 12-month period the mean weight gain was 1.3 kg and the mean increase in height was 2.9 cm. The total number of days when diarrhoea occurred was negatively associated with annual weight gain (regression coefficient beta = -7 g per day, P = 0.02), with adjustment for age, sex, energy and protein intake, and household land ownership. The incidence of diarrhoeal disease was significantly associated with weight gain in intermediate models but only marginally associated with it in the final multivariate model (P = 0.08). Neither the incidence nor the duration of upper respiratory infections was associated with weight gain. Height gain was not significantly associated with the duration or incidence of either category of illness. Diarrhoea was a significant correlate of retarded weight gain among children above preschool age, whereas upper respiratory infections were not. DISCUSSION: Diarrhoeal morbidity slowed growth in children well beyond the weaning age, suggesting that increased attention should be given to the study of the continuous impact of diarrhoea in children aged over 5 years. An understanding of the determinants of

  19. Genetic variants and increased risk of meningioma: an updated meta-analysis

    PubMed Central

    Han, Xiao-Yong; Wang, Wei; Wang, Lei-Lei; Wang, Xi-Rui; Li, Gang

    2017-01-01

    Purpose Various genetic variants have been reported to be linked to an increased risk of meningioma. However, no confirmed conclusion has been obtained. The purpose of the study was to investigate potential meningioma-associated gene polymorphisms, based on published evidence. Materials and methods An updated meta-analysis was performed in September 2016. After electronic database searching and study screening, we selected eligible case-control studies and extracted data for meta-analysis, using Mantel–Haenszel statistics. P-values, pooled odds ratios (ORs), and 95% confidence intervals were calculated. Results We finally selected eight genes with ten polymorphisms: MLLT10 rs12770228, CASP8 rs1045485, XRCC1 rs1799782, rs25487, MTHFR rs1801133, rs1801131, MTRR rs1801394, MTR rs1805087, GSTM1 null/present, and GSTT1 null/present. Results of meta-analyses showed that there was increased meningioma risk in case groups under all models of MLLT10 rs12770228 (all OR >1, P<0.001), compared with control groups. Similar results were observed under the allele, homozygote, dominant, and recessive models of MTRR rs1801394 (all OR >1, P<0.05), and the heterozygote and dominant models of MTHFR rs1801131 in the Caucasian population (all OR >1, P<0.05). However, no significantly increased meningioma risks were observed for CASP8 rs1045485, XRCC1 rs25487, rs1799782, MTHFR rs1801133, MTR rs1805087, or GSTM1/GSTT1 null mutations. Conclusion Our updated meta-analysis provided statistical evidence for the role of MLLT10 rs12770228, MTRR rs1801394, and MTHFR rs1801131 in increased susceptibility to meningioma. PMID:28405167

  20. Change in Plasma Vascular Endothelial Growth Factor after Gamma Knife Radiosurgery for Meningioma: A Preliminary Study

    PubMed Central

    Hwang, Jeong-Hyun; Hwang, Sung-Kyoo

    2015-01-01

    Objective The purpose of this study was to investigate changes in the plasma level of vascular endothelial growth factor (VEGF) after Gamma Knife radiosurgery (GKRS) for the treatment of meningioma. Methods Fourteen patients with meningiomas had peripheral venous blood collected at the time of GKRS and at 1 week, 1 month, 3 month and 6 month visits. Plasma VEGF levels were measured using commercially available enzyme-linked immunosorbent assay. For controls, peripheral blood samples were obtained from 20 healthy volunteers. Results The mean plasma VEGF level (29.6 pg/mL) in patients with meningiomas before GKRS was significantly lower than that of the control group (62.4 pg/mL, p=0.019). At 1 week after GKRS, the mean plasma VEGF levels decreased to 23.4 pg/mL, and dropped to 13.9 pg/mL at 1 month, 14.8 pg/mL at 3 months, then increased to 27.7 pg/mL at 6 months. Two patients (14.3%) with peritumoral edema (PTE) showed a level of VEGF 6 months after GKRS higher than their preradiosurgical level. There was no significant association found in an analysis of correlation between PTE and tumor size, marginal dose, age, and sex. Conclusion Our study is first in demonstrating changes of plasma VEGF after stereotactic radiosurgery (SRS) for meningioma. This study may provide a stimulus for more work related to whether measurement of plasma level has a correlation with tumor response after SRS for meningioma. PMID:25733986

  1. Change in plasma vascular endothelial growth factor after gamma knife radiosurgery for meningioma: a preliminary study.

    PubMed

    Park, Seong-Hyun; Hwang, Jeong-Hyun; Hwang, Sung-Kyoo

    2015-02-01

    The purpose of this study was to investigate changes in the plasma level of vascular endothelial growth factor (VEGF) after Gamma Knife radiosurgery (GKRS) for the treatment of meningioma. Fourteen patients with meningiomas had peripheral venous blood collected at the time of GKRS and at 1 week, 1 month, 3 month and 6 month visits. Plasma VEGF levels were measured using commercially available enzyme-linked immunosorbent assay. For controls, peripheral blood samples were obtained from 20 healthy volunteers. The mean plasma VEGF level (29.6 pg/mL) in patients with meningiomas before GKRS was significantly lower than that of the control group (62.4 pg/mL, p=0.019). At 1 week after GKRS, the mean plasma VEGF levels decreased to 23.4 pg/mL, and dropped to 13.9 pg/mL at 1 month, 14.8 pg/mL at 3 months, then increased to 27.7 pg/mL at 6 months. Two patients (14.3%) with peritumoral edema (PTE) showed a level of VEGF 6 months after GKRS higher than their preradiosurgical level. There was no significant association found in an analysis of correlation between PTE and tumor size, marginal dose, age, and sex. Our study is first in demonstrating changes of plasma VEGF after stereotactic radiosurgery (SRS) for meningioma. This study may provide a stimulus for more work related to whether measurement of plasma level has a correlation with tumor response after SRS for meningioma.

  2. Adjuvant Stereotactic Radiosurgery Reduces Need for Retreatments in Patients with Meningioma Residuals.

    PubMed

    Frostell, Arvid; Hakim, Ramil; Dodoo, Ernest; Sinclair, Georges; Ohlsson, Marcus; Förander, Petter; Milovac, Biljana; Brundin, Lou; Svensson, Mikael

    2016-04-01

    Radical surgical resection of cerebral meningiomas involving the dura mater of venous sinuses is challenging, and tumor residuals are frequently left after surgery. This study sought to evaluate the effect of adjuvant stereotactic radiosurgery (aSRS) on the time to significant growth of meningioma residuals requiring retreatment. A total of 119 consecutive patients (2004-2013) receiving primary surgical treatment for a meningioma in proximity to a venous structure were included. The patients were assessed retrospectively, with a focus on retreatments and mortality. Radicality of initial tumor surgery was scored using postoperative magnetic resonance imaging. Three subgroups were identified: 1) radical total resection (RTR); 2) near-total resection (NTR), followed by aSRS (NTR + aSRS); and 3) NTR but no aSRS (NTR - aSRS). In the NTR - aSRS group, intervention was initiated after radiologic (magnetic resonance imaging) findings verified growth of residual tumor, in contrast to the NTR + aSRS group, which received aSRS before regrowth. Time to first retreatment, progression-free survival (PFS), and overall survival were analyzed with the log-rank test and multiple-events Cox regression. RTR was associated with the best prognosis. The patients in the NTR + aSRS group had significantly longer time to first retreatment compared with NTR - aSRS patients (P < 0.001). There was also a significant difference in mortality (P < 0.05) and a tendency to prolonged PFS (P = 0.07) in the NTR + aSRS group. The Cox regressions confirmed the positive effects of NTR + aSRS on time to retreatment (hazard ratio, 7.3; P < 0.01) and PFS (hazard ratio, 3.69; P = 0.055). aSRS of meningioma residuals had a positive effect on tumor control and should be considered in patients with meningioma residuals. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Adjuvant radiation therapy, local recurrence, and the need for salvage therapy in atypical meningioma.

    PubMed

    Aizer, Ayal A; Arvold, Nils D; Catalano, Paul; Claus, Elizabeth B; Golby, Alexandra J; Johnson, Mark D; Al-Mefty, Ossama; Wen, Patrick Y; Reardon, David A; Lee, Eudocia Q; Nayak, Lakshmi; Rinne, Mikael L; Beroukhim, Rameen; Weiss, Stephanie E; Ramkissoon, Shakti H; Abedalthagafi, Malak; Santagata, Sandro; Dunn, Ian F; Alexander, Brian M

    2014-11-01

    The impact of adjuvant radiation in patients with atypical meningioma remains poorly defined. We sought to determine the impact of adjuvant radiation therapy in this population. We identified 91 patients with World Health Organization grade II (atypical) meningioma managed at Dana-Farber/Brigham and Women's Cancer Center between 1997 and 2011. A propensity score model incorporating age at diagnosis, gender, Karnofsky performance status, tumor location, tumor size, reason for diagnosis, and era of treatment was constructed using logistic regression for the outcome of receipt versus nonreceipt of radiation therapy. Propensity scores were then used as continuous covariates in a Cox proportional hazards model to determine the adjusted impact of adjuvant radiation therapy on both local recurrence and the combined endpoint of use of salvage therapy and death due to progressive meningioma. The median follow-up in patients without recurrent disease was 4.9 years. After adjustment for pertinent confounding variables, radiation therapy was associated with decreased local recurrence in those undergoing gross total resection (hazard ratio, 0.25; 95% CI, 0.07-0.96; P = .04). No differences in overall survival were seen in patients who did and did not receive radiation therapy. Patients who have had a gross total resection of an atypical meningioma should be considered for adjuvant radiation therapy given the improvement in local control. Multicenter, prospective trials are required to definitively evaluate the potential impact of radiation therapy on survival in patients with atypical meningioma. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Preformed titanium cranioplasty after resection of skull base meningiomas - a technical note.

    PubMed

    Schebesch, Karl-Michael; Höhne, Julius; Gassner, Holger G; Brawanski, Alexander

    2013-12-01

    Meningiomas of the fronto-basal skull are difficult to manage as the treatment usually includes extensive resection of the lesion, consecutive reconstruction of the meninges and of the skull. Especially after removal of spheno-orbital and sphenoid-wing meningiomas, the cosmetic result is of utmost importance. In this technical note, we present our institutional approach in the treatment of skull base meningiomas, focussing on the reconstruction of the neurocranium with individually preformed titanium cranioplasty (CRANIOTOP(®), CL Instruments, Germany). Two female patients (40 years, 64 years) are presented. Both patients presented with skull base lesions suggestive of meningiomas. The preoperative thin-sliced CT scan was processed to generate a 3D-model of the skull. On it, the resection was mapped and following a simulated resection, the cranioplasty was manufactured. Intra-operatively, the titanium plate served as a template for the skull resection and was implanted after microsurgical tumour removal, consecutively. The cosmetic result was excellent. Immediate postoperative CT scan revealed accurate fitting and complete tumour removal. Control Magnetic Resonance Imaging (MRI) within 12 weeks was possible without any artifacts. The comprehensive approach described indicates only one surgical procedure for tumour removal and for reconstruction of the skull. The titanium plate served as an exact template for complete resection of the osseous parts of the tumour. Cosmetic outcome was excellent and control MRI was possible post operatively. CRANIOTOP(®) cranioplasty is a safe and practical tool for reconstruction of the skull after meningioma surgery. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. The Simpson grading revisited: aggressive surgery and its place in modern meningioma management.

    PubMed

    Gousias, Konstantinos; Schramm, Johannes; Simon, Matthias

    2016-09-01

    OBJECTIVE Recent advances in radiotherapy and neuroimaging have called into question the traditional role of aggressive resections in patients with meningiomas. In the present study the authors reviewed their institutional experience with a policy based on maximal safe resections for meningiomas, and they analyzed the impact of the degree of resection on functional outcome and progression-free survival (PFS). METHODS The authors retrospectively analyzed 901 consecutive patients with primary meningiomas (716 WHO Grade I, 174 Grade II, and 11 Grade III) who underwent resections at the University Hospital of Bonn between 1996 and 2008. Clinical and treatment parameters as well as tumor characteristics were analyzed using standard statistical methods. RESULTS The median follow-up was 62 months. PFS rates at 5 and 10 years were 92.6% and 86.0%, respectively. Younger age, higher preoperative Karnofsky Performance Scale (KPS) score, and convexity tumor location, but not the degree of resection, were identified as independent predictors of a good functional outcome (defined as KPS Score 90-100). Independent predictors of PFS were degree of resection (Simpson Grade I vs II vs III vs IV), MIB-1 index (< 5% vs 5%-10% vs >10%), histological grade (WHO I vs II vs III), tumor size (≤ 6 vs > 6 cm), tumor multiplicity, and location. A Simpson Grade II rather than Grade I resection more than doubled the risk of recurrence at 10 years in the overall series (18.8% vs 8.5%). The impact of aggressive resections was much stronger in higher grade meningiomas. CONCLUSIONS A policy of maximal safe resections for meningiomas prolongs PFS and is not associated with increased morbidity.

  6. Long-term follow-up of surgical resection of microcystic meningiomas.

    PubMed

    Kalani, M Yashar S; Cavallo, Claudio; Coons, Stephen W; Lettieri, Salvatore C; Nakaji, Peter; Porter, Randall W; Spetzler, Robert F; Feiz-Erfan, Iman

    2015-04-01

    Microcystic meningioma is a rare tumor with myxoid and microcystic features. Our objective was to evaluate the efficacy of surgical resection of microcystic meningioma. Between December 1985 and October 2000 we treated 25 microcystic meningioma patients with surgical resection. We retrospectively analyzed the results including the long-term follow-up of this patient population. We identified 15 women and 10 men with a mean age of 53.8 years (24-76 years) who had microcystic meningiomas treated with surgery. Based on the Simpson grade, we found four Grade I (16%), 16 Grade II (64%), three Grade III (12%) and two Grade IV (8%) resections. The mean preoperative Karnofsky Performance Scale (KPS) score was 80.3 (range 60-100). The mean postoperative KPS score was 90.4 (range 60-100). At a mean follow-up of 101.7 months (range 16-221) the KPS score improved to a mean of 93.8. The recurrence/progression free survival (RFS/PFS) rates at 3 and 5 years were 96% and 88%, respectively. The 3 and 5 year RFS/PFS rates based on the Simpson grade were evaluated. The 3 year RFS/PFS rates for Grade I, II, III and IV were 100%, 100%, 66.6% and 100%, respectively. The 5 year RFS/PFS rates were 66.6%, 90%, 66.6% and 100%, respectively. Microcystic meningioma is a rare tumor, which is characterized by extracellular microcystic spaces filled by edematous fluid and peritumoral edema. Following surgical resection these tumors have a positive prognosis with a benign course. The surgical outcomes seem to be associated with the risks related to the surgical procedure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Low Cognitive Impulsivity Is Associated with Better Gain and Loss Learning in a Probabilistic Decision-Making Task

    PubMed Central

    Cáceres, Pablo; San Martín, René

    2017-01-01

    Many advances have been made over the last decades in describing, on the one hand, the link between reward-based learning and decision-making, and on the other hand, the link between impulsivity and decision-making. However, the association between reward-based learning and impulsivity remains poorly understood. In this study, we evaluated the association between individual differences in loss-minimizing and gain-maximizing behavior in a learning-based probabilistic decision-making task and individual differences in cognitive impulsivity. We found that low cognitive impulsivity was associated both with a better performance minimizing losses and maximizing gains during the task. These associations remained significant after controlling for mathematical skills and gender as potential confounders. We discuss potential mechanisms through which cognitive impulsivity might interact with reward-based learning and decision-making. PMID:28261137

  8. Low Cognitive Impulsivity Is Associated with Better Gain and Loss Learning in a Probabilistic Decision-Making Task.

    PubMed

    Cáceres, Pablo; San Martín, René

    2017-01-01

    Many advances have been made over the last decades in describing, on the one hand, the link between reward-based learning and decision-making, and on the other hand, the link between impulsivity and decision-making. However, the association between reward-based learning and impulsivity remains poorly understood. In this study, we evaluated the association between individual differences in loss-minimizing and gain-maximizing behavior in a learning-based probabilistic decision-making task and individual differences in cognitive impulsivity. We found that low cognitive impulsivity was associated both with a better performance minimizing losses and maximizing gains during the task. These associations remained significant after controlling for mathematical skills and gender as potential confounders. We discuss potential mechanisms through which cognitive impulsivity might interact with reward-based learning and decision-making.

  9. Stereotactic radiotherapy of meningiomas compressing optical pathways

    SciTech Connect

    Hamm, Klaus-Detlef . E-mail: khamm@erfurt.helios-kliniken.de; Henzel, Martin; Gross, Markus W.; Surber, Gunnar; Kleinert, Gabriele; Engenhart-Cabillic, Rita

    2006-11-15

    Purpose: Microsurgical resection is usually the treatment of choice for meningiomas, especially for those that compress the optical pathways. However, in many cases of skull-base meningiomas a high risk of neurological deficits and recurrences exist in cases where the complete tumor removal was not possible. In such cases (fractionated) stereotactic radiotherapy (SRT) can offer an alternative treatment option. We evaluated the local control rate, symptomatology, and toxicity. Patients and Methods: Between 1997 and 2003, 183 patients with skull-base meningiomas were treated with SRT, among them were 65 patients with meningiomas that compressed optical pathways (64 benign, 1 atypical). Of these 65 cases, 20 were treated with SRT only, 27 were subtotally resected before SRT, and 18 underwent multiple tumor resections before SRT. We investigated the results until 2005, with a median follow-up of 45 months (range, 22-83 months). The tumor volume (TV = gross tumor volume) ranged from 0.61 to 90.20 cc (mean, 18.9 cc). Because of the risk of new visual disturbances, the dose per fraction was either 2 or 1.8 Gy for all patients, to a total dose of 50 to 60 Gy. Results: The overall survival and the progression-free survival rates for 5 years were assessed to 100% in this patient group. To date, no progression for these meningiomas have been observed. Quantitatively, tumor shrinkage of more than 20%, or more than 2 mm in diameter, was proved in 35 of the 65 cases after SRT. In 29 of the 65 patients, at least 1 of the symptoms improved. On application of the Common Toxicity Criteria (CTC), acute toxicity (Grade 3) was seen in 1 case (worsening of conjunctivitis). Another 2 patients developed late toxicity by LENT-SOMA score, 1 x Grade 1 and 1 x Grade 3 (field of vision loss). Conclusion: As a low-risk and effective treatment option for tumor control, SRT with 1.8 to 2.0 Gy per fraction can also be recommended in case of meningiomas that compress optical pathways. An

  10. Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain and pregnancy complications

    PubMed Central

    Laraia, Barbara A.; Siega-Riz, Anna Maria; Gundersen, Craig

    2010-01-01

    Background Household food insecurity is positively associated with weight among women. The association between household food insecurity and pregnancy related weight gain and complications is not well understood. Objective To identify if an independent association exists between household food insecurity and pregnancy related complications. Design Data from the Pregnancy, Infection and Nutrition prospective cohort study were used to assess household food insecurity retrospectively using the United States Department of Agriculture (USDA) 18-item Core Food Security Module (CFSM) among 810 pregnant women with incomes ≤ 400% of the income/poverty ratio, recruited between January 2001 and June 2005 and followed through pregnancy. Main outcome measures Self-reported pregravid body mass index, gestational weight gain, second trimester anemia, pregnancy-induced hypertension, and gestational diabetes mellitus. Statistical analyses performed: Multivariate linear, multinomial logistic and logistic regression analyses. Results Among 810 pregnant women, 76% were from fully food secure, 14% were from marginally food secure, and 10% were from food insecure households. In adjusted models, living in a food insecure household was significantly associated with severe pregravid obesity [adjusted odds ratio (AOR) 2.97, 95% confidence intervals (CI) 1.44, 6.14], higher gestational weight gain [adjusted β coefficient 1.87, 95% CI 0.13, 3.62] and with a higher adequacy of weight gain ratio [adjusted β 0.27, CI 0.07, 0.50]. Marginal food security was significantly associated with gestational diabetes mellitus [AOR 2.76, 95% CI 1.00, 7.66]. Conclusions This study highlights the possibility that living in a food insecure household during pregnancy may increase risk of greater weight gain and pregnancy complications. PMID:20430130

  11. Even transient rapid infancy weight gain is associated with higher BMI in young adults and earlier menarche

    PubMed Central

    Salgin, Burak; Norris, Shane A.; Prentice, Philippa; Pettifor, John. M.; Richter, Linda M.; Ong, Ken K.; Dunger, David B.

    2015-01-01

    Background Early postnatal rapid “catch-up” weight gain has been consistently associated with subsequent higher obesity risk and earlier pubertal development. In many low- and middle-income countries, infancy catch-up weight gain is transient and often followed by growth faltering. We explored the hypothesis that even transient catch-up weight gain during infancy is associated with later obesity risk and earlier puberty. Methods 2352 (1151 male, 1201 female) black South African children in the Birth to Twenty (Bt20) prospective birth cohort study (Johannesburg-Soweto) underwent serial measurements of body size and composition from birth to age 18 years. At age 18 years, whole-body fat mass and fat-free mass were determined using dual energy x-ray absorptiometry. Pubertal development was assessed by the research team between ages 9 and 10 years, and recorded annually from age 11 years using a validated self-assessment protocol. Results Catch-up weight gain from birth to age 1 year, despite being followed by growth faltering between ages 1 and 2 years, was associated greater mid-upper arm circumference (p=0.04) and skin fold thickness (p=0.048) at age 8 years, and with higher weight (p<0.001) and BMI (p=0.001) at age 18 years after adjustment for sex, age, smoking during pregnancy, birth order, gestational age, formula-milk feeding and household socio-economic status. Infancy catch-up weight gain was also associated with younger age at menarche in girls (p<0.001). This association persisted after adjustment for smoking during pregnancy, birth order, gestational age, formula-milk feeding and household socio-economic status (p=0.005). Conclusion Transient catch-up weight gain from birth to age 1 year among children born in a low-income area of South Africa was associated with earlier menarche and greater adiposity in early adulthood. This observation suggests that modifiable determinants of rapid infancy weight gain may be targeted in order to prevent later obesity

  12. SU-D-207B-02: Early Grade Classification in Meningioma Patients Combining Radiomics and Semantics Data

    SciTech Connect

    Coroller, T; Bi, W; Abedalthagafi, M; Aizer, A; Wu, W; Greenwald, N; Beroukhim, R; Al-Mefty, O; Santagata, S; Dunn, I; Alexander, B; Huang, R; Aerts, H

    2016-06-15

    Purpose: The clinical management of meningioma is guided by its grade and biologic behavior. Currently, diagnosis of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor behavior are needed. We investigated the association between imaging features extracted from preoperative gadolinium-enhanced T1-weighted MRI and meningioma grade. Methods: We retrospectively examined the pre-operative MRI for 139 patients with de novo WHO grade I (63%) and grade II (37%) meningiomas. We investigated the predictive power of ten semantic radiologic features as determined by a neuroradiologist, fifteen radiomic features, and tumor location. Conventional (volume and diameter) imaging features were added for comparison. AUC was computed for continuous and χ{sup 2} for discrete variables. Classification was done using random forest. Performance was evaluated using cross validation (1000 iterations, 75% training and 25% validation). All p-values were adjusted for multiple testing. Results: Significant association was observed between meningioma grade and tumor location (p<0.001) and two semantic features including intra-tumoral heterogeneity (p<0.001) and overt hemorrhage (p=0.01). Conventional (AUC 0.61–0.67) and eleven radiomic (AUC 0.60–0.70) features were significant from random (p<0.05, Noether test). Median AUC values for classification of tumor grade were 0.57, 0.71, 0.72 and 0.77 respectively for conventional, radiomic, location, and semantic features after using random forest. By combining all imaging data (semantic, radiomic, and location), the median AUC was 0.81, which offers superior predicting power to that of conventional imaging descriptors for meningioma as well as radiomic features alone (p<0.05, permutation test). Conclusion: We demonstrate a strong association between radiologic features and meningioma grade. Pre-operative prediction of tumor behavior based on imaging features offers

  13. Craniotomy for Resection of Meningioma: An Age-Stratified Analysis of the MarketScan Longitudinal Database.

    PubMed

    Connolly, Ian D; Cole, Tyler; Veeravagu, Anand; Popat, Rita; Ratliff, John; Li, Gordon

    2015-12-01

    We sought to describe complications after resection for meningioma with the use of longitudinal administrative data, which our group has shown recently to be superior to nonlongitudinal administrative data. We identified patients who underwent resection for meningioma between 2010 and 2012 in the Thomson Reuters MarketScan database. Current Procedural Terminology coding at inpatient visit was used to select for meningioma resection procedure. Comorbidities and complications were obtained by use of the International Classification of Diseases, Ninth Revision or Current Procedural Terminology coding. Associations between complications and demographic and clinical factors were evaluated with logistic regression. We identified a total of 2216 patients. Approximately 41% developed 1 or more perioperative complications. Approximately 15% were readmitted within 30 days of their procedure. The most frequent complications that occurred in our cohort were new postoperative seizures (11.8%), postoperative dysrhythmia (7.9%), intracranial hemorrhage (5.9%), and cerebral artery occlusion (5.4%). General neurosurgical complications and general neurologic complications occurred in 4.4% and 16.1% of patients, respectively. Nearly 55% of elderly patients (≥ 70 years) developed 1 or more perioperative complication (vs. 39% of nonelderly patients). After we adjusted for comorbidities, elderly status and male sex were found to be significantly associated with increased odds for a variety of complications. In this study, we report complication rates in patients undergoing resection for meningioma. Because of the longitudinal nature of the MarketScan database, we were able to capture a wide array of specific postoperative complications associated with meningioma resection procedures. Care should be taken in the selection of candidates for meningioma resection. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Gamma Knife radiosurgery of large skull base meningiomas.

    PubMed

    Starke, Robert M; Przybylowski, Colin J; Sugoto, Mukherjee; Fezeu, Francis; Awad, Ahmed J; Ding, Dale; Nguyen, James H; Sheehan, Jason P

    2015-02-01

    Stereotactic radiosurgery (SRS) has become a common treatment modality for intracranial meningiomas. Skull base meningiomas greater than 8 cm3 in volume have been found to have worse outcomes following SRS. When symptomatic, patients with these tumors are often initially treated with resection. For tumors located in close proximity to eloquent structures or in patients unwilling or unable to undergo a resection, SRS may be an acceptable therapeutic approach. In this study, the authors review the SRS outcomes of skull base meningiomas greater than 8 cm3 in volume, which corresponds to a lesion with an approximate diameter of 2.5 cm. The authors reviewed the data in a prospectively compiled database documenting the outcomes of 469 patients with skull base meningiomas treated with single-session Gamma Knife radiosurgery (GKRS). Seventy-five patients had tumors greater than 8 cm3 in volume, which was defined as a large tumor. All patients had a minimum follow-up of 6 months, but patients were included if they had a complication at any time point. Thirty patients were treated with upfront GKRS, and 45 were treated following microsurgery. Patient and tumor characteristics were assessed to determine predictors of new or worsening neurological function and tumor progression following GKRS. After a mean follow-up of 6.5 years (range 0.5-21 years), the tumor volume was unchanged in 37 patients (49%), decreased in 26 patients (35%), and increased in 12 patients (16%). Actuarial rates of progression-free survival at 3, 5, and 10 years were 90.3%, 88.6%, and 77.2%, respectively. Four patients had new or worsened edema following GKRS, but preexisting edema decreased in 3 patients. In Cox multivariable analysis, covariates associated with tumor progression were 1) presentation with any cranial nerve (CN) deficit from III to VI (hazard ratio [HR] 3.78, 95% CI 1.91-7.45; p<0.001), history of radiotherapy (HR 12.06, 95% CI 2.04-71.27; p=0.006), and tumor volume greater than 14 cm3

  15. [Factors associated with excessive gestational weight gain among patients in prenatal care at a public hospital in Recife, Pernambuco, Brazil].

    PubMed

    Andreto, Luciana Marques; de Souza, Ariani Impieri; Figueiroa, José Natal; Cabral-Filho, José Eulálio

    2006-11-01

    This study assessed excessive weight gain in the second and third trimesters of pregnancy and the influence of biological, socio-demographic, behavioral, and reproductive factors and co-morbidity. The cross-sectional sample included 240 pregnant women at low risk of obstetric complications, followed from May 2000 to July 2001. There were 347 patient records in the original database, but 107 were excluded because of age (42 patients were younger than 18 years) or lack of data on weight (65 women). Excessive weight gain was common in all categories of baseline nutritional status, but was more frequent in the second trimester among women who were already overweight or obese upon entering pregnancy. In the third trimester, variables associated with excessive weekly weight gain were schooling and marital status.

  16. ALS-associated mutant FUS induces selective motor neuron degeneration through toxic gain of function.

    PubMed

    Sharma, Aarti; Lyashchenko, Alexander K; Lu, Lei; Nasrabady, Sara Ebrahimi; Elmaleh, Margot; Mendelsohn, Monica; Nemes, Adriana; Tapia, Juan Carlos; Mentis, George Z; Shneider, Neil A

    2016-02-04

    Mutations in FUS cause amyotrophic lateral sclerosis (ALS), including some of the most aggressive, juvenile-onset forms of the disease. FUS loss-of-function and toxic gain-of-function mechanisms have been proposed to explain how mutant FUS leads to motor neuron degeneration, but neither has been firmly established in the pathogenesis of ALS. Here we characterize a series of transgenic FUS mouse lines that manifest progressive, mutant-dependent motor neuron degeneration preceded by early, structural and functional abnormalities at the neuromuscular junction. A novel, conditional FUS knockout mutant reveals that postnatal elimination of FUS has no effect on motor neuron survival or function. Moreover, endogenous FUS does not contribute to the onset of the ALS phenotype induced by mutant FUS. These findings demonstrate that FUS-dependent motor degeneration is not due to loss of FUS function, but to the gain of toxic properties conferred by ALS mutations.

  17. Maternal and female fetal testosterone levels are associated with maternal age and gestational weight gain.

    PubMed

    Kallak, Theodora Kunovac; Hellgren, Charlotte; Skalkidou, Alkistis; Sandelin-Francke, Lotta; Ubhayasekhera, Kumari; Bergquist, Jonas; Axelsson, Ove; Comasco, Erika; Campbell, Rebecca E; Sundström Poromaa, Inger

    2017-10-01

    Prenatal androgen exposure has been suggested to play a role in polycystic ovary syndrome. Given the limited information on what maternal characteristics influence maternal testosterone levels, and the even less explored routes by which female fetus androgen exposure would occur, the aim of this study was to investigate the impact of maternal age, BMI, weight gain, depressed mood and aromatase SNPs on testosterone levels in maternal serum and amniotic fluid of female fetuses. Blood samples from pregnant women (n = 216) obtained in gestational weeks 35-39, and pre-labor amniotic fluid samples from female fetuses (n = 56), taken at planned Caesarean section or in conjunction with amniotomy for induction of labor, were analyzed. Maternal serum testosterone and amniotic fluid testosterone and cortisol were measured by tandem mass spectrometry. Multiparity (β = -0.28, P < 0.001), self-rated depression (β = 0.26, P < 0.001) and weight gain (β = 0.18, P < 0.05) were independent explanatory factors for the maternal total testosterone levels. Maternal age (β = -0.34, P < 0.001), weight gain (β = 0.19, P < 0.05) and amniotic fluid cortisol levels (β = 0.44, P < 0.001) were independent explanatory factors of amniotic fluid testosterone in female fetuses, explaining 64.3% of the variability in amniotic fluid testosterone. Young maternal age and excessive maternal weight gain may increase the prenatal androgen exposure of female fetuses. Further studies are needed to explore this finding. © 2017 The authors.

  18. A prospective study of weight gain associated with chronotype among college freshmen

    PubMed Central

    Culnan, Elizabeth; Kloss, Jacqueline D.; Grandner, Michael

    2013-01-01

    A prospective study of chronotype as a predictor of increased weight gain and body mass index (BMI) among college freshman was undertaken. At baseline, 137 college freshmen were characterized as morning, neutral, or evening types using the reduced version of the Morningness-Eveningness Questionnaire. Additionally, information was collected regarding weight, BMI, and health habits (e.g., junk food and alcohol consumption). These additional measures consisted of a descriptive questionnaire, the Pittsburgh Sleep Quality Index, the International Physical Activity Questionnaire, the Gray-Donald Eating Patterns Questionnaire, and the Positive and Negative Affect Scale. Participants included 79 females and 80 males with a mean age of 18.25 (SD=0.56) yrs. Eight weeks later, participants returned (N=54) to complete follow-up measures, which were identical to baseline assessments with the exception of the descriptive questionnaire, in which demographic questions were removed. Evening types had a significantly greater BMI gain (p<0.05) when compared with morning/neutral types. Health behaviors did not differ by chronotype. Future studies should seek to clarify the mechanisms underlying the chronotype-BMI/weight gain relationship. PMID:23688114

  19. A prospective study of weight gain associated with chronotype among college freshmen.

    PubMed

    Culnan, Elizabeth; Kloss, Jacqueline D;