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Iwamoto F, Polley MY, Shaw E, Buckner J, Barger G, Coons S, Ricci P, Gilbert M, Brown P, Stelzer K, Rogers CL, Suh J, Schultz C, Howard S, Fisher B, Kim M, Huang J, Haddock M, Won M, Mehta M. CTNI-16. NRG-RTOG 9802 OBSERVATION ARM - LONG TERM RESULT. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac209.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
BACKGROUND
Radiation Therapy Oncology Group 9802 was a phase III trial for patients with centrally confirmed LGG (WHO grade II). Participants ³ 40 years or those with neurosurgeon defined less than gross total resection (GTR) were randomized to radiotherapy (RT) +/- PCV. In a separate cohort, adults age < 40 years with neurosurgeon defined GTR were observed by MRI every 6 months without adjuvant therapy. At last report, outcome for the observation cohort was immature with median follow-up of only 4.4 years. Here, we present mature outcomes for the observation arm.
METHODS
Eligible adults (as above) were observed by MRI every 6 months. OS and PFS were estimated by Kaplan-Meier method and estimated hazard ratios to characterize the prognostic variables.
RESULTS
There were 111 eligible patients (median age 30; median KPS = 100). Median follow-up was 16.1 years with 71 (64%) alive at the last follow-up. 79 patients (71%) had progressed with median PFS of 6.9 years. 5, 10, and 15 year-PFS and OS rates were 54%, 39%, 28% and 94%, 77%, and 65%. 1p19q status was codeleted in 32%, IDH1/2 mutant in 78% and MGMT promoter methylated in 39% of tested cases. Multivariate Cox analyses showed that preoperative tumor size ³ 4 cm (HR = 2.43 for PFS, p = 0.001; HR = 2.58 for death, p = 0.016) and residual disease on imaging ³ 1 cm (HR = 2.97 for PFS, P < 0.001; HR = 2.02 for death, p = 0.05) were associated with worse outcomes. Analyses based on molecular results will be presented.
CONCLUSION
A subset of low-grade gliomas can be observed after the initial resection based on younger age, smaller tumor size, and no residual disease on neuroimaging. This can likely be further refined by prognostic molecular markers. Patients with the most favorable prognostic factors can avoid or delay the acute and long-term side effects of RT and chemotherapy for several years.
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Affiliation(s)
- Fabio Iwamoto
- Division of Neuro-Oncology, New York-Presbyterian/Columbia University Medical Center , New York, NY , USA
| | | | | | | | | | | | - Peter Ricci
- Radiology Imaging Associates , ENglewood , USA
| | - Mark Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health , Bethesda, MD , USA
| | - Paul Brown
- Department of Radiation Oncology, Mayo Clinic , Rochester, MN , USA
| | - Keith Stelzer
- Radiation Oncologists - The Dalles , The Dalles , USA
| | | | - John Suh
- Cleveland Clinic , Cleveland , USA
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Fisher B, Zhang P, Macdonald D, Chakravarti A, Lesser G, Fox S, Coons S, Rogers L, Werner-Wasik M, Doyle T, Bahary JP, Fiveash J, Bovi J, Howard S, Yu M, Dsouza D, Laack N, Roach M, Kwok Y, Wahl D, Stasser J, Won M, Mehta MP. ACTR-02. NRG ONCOLOGY/RTOG 0424: LONG-TERM RESULTS OF A PHASE II STUDY OF TEMOZOLOMIDE-BASED CHEMORADIOTHERAPY REGIMEN FOR HIGH-RISK LOW-GRADE GLIOMAS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | - Glenn Lesser
- Wake Forest School of Medicine, Winston-Salem, NC, NC, USA
| | - Sherry Fox
- Cullather Brain Tumor Quality of Life Center, Richmond, VA, USA
| | - Stephen Coons
- St Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | | | | | | | | | | | - Joseph Bovi
- Froedtert and the Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Michael Yu
- H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - David Dsouza
- London Regional Cancer Program, London, ON, Canada
| | | | - Mack Roach
- University of California at San Francisco, San Francisco, CA, USA
| | - Young Kwok
- University of Maryland, Baltimore, MD, USA
| | | | - John Stasser
- Christiana Care Health Services, Delaware, MD, USA
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Dardis C, Ashby LS, Coons S. Meningioma: Association of mean and "hot spot" MIB1 with grade. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kerrigan JF, Parsons A, Tsang C, Simeone K, Coons S, Wu J. Hypothalamic hamartoma: Neuropathology and epileptogenesis. Epilepsia 2017; 58 Suppl 2:22-31. [DOI: 10.1111/epi.13752] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2016] [Indexed: 01/06/2023]
Affiliation(s)
- John F. Kerrigan
- Hypothalamic Hamartoma Program and Pediatric Neurology Division; Barrow Neurological Institute at Phoenix Children's Hospital; Phoenix Children's Hospital; Phoenix Arizona U.S.A
- Hypothalamic Hamartoma Tissue Research Laboratory; Barrow Neurological Institute; St. Joseph's Hospital and Medical Center; Phoenix Arizona U.S.A
| | - Angela Parsons
- Hypothalamic Hamartoma Tissue Research Laboratory; Barrow Neurological Institute; St. Joseph's Hospital and Medical Center; Phoenix Arizona U.S.A
| | - Candy Tsang
- Hypothalamic Hamartoma Tissue Research Laboratory; Barrow Neurological Institute; St. Joseph's Hospital and Medical Center; Phoenix Arizona U.S.A
| | - Kristina Simeone
- Department of Pharmacology; Creighton University School of Medicine; Omaha Nebraska U.S.A
| | - Stephen Coons
- Division of Neuropathology; Barrow Neurological Institute; St. Joseph's Hospital and Medical Center; Phoenix Arizona U.S.A
| | - Jie Wu
- Hypothalamic Hamartoma Program and Division of Neurology; Barrow Neurological Institute; St. Joseph's Hospital and Medical Center; Phoenix Arizona U.S.A
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Bell EH, Zhang P, Aldape K, McElroy J, Mehta M, Fleming J, Liu Z, Coons S, Johnson D, Chakravarti A. OS01.7 MGMT promoter methylation status independently predicts progression-free survival in NRG Oncology/RTOG 9802: a phase III trial of RT vs RT + PCV in high-risk low-grade gliomas. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Liepa A, Bushnell D, Atkinson T, Debusk K, Mccarrier K, Martin M, Coons S. P1.06-004 Evaluating the Non-Small Cell Lung Cancer Symptom Assessment Questionnaire (NSCLC-SAQ): Preliminary Results from the Quantitative Pilot Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Buckner JC, Shaw EG, Pugh SL, Chakravarti A, Gilbert MR, Barger GR, Coons S, Ricci P, Bullard D, Brown PD, Stelzer K, Brachman D, Suh JH, Schultz CJ, Bahary JP, Fisher BJ, Kim H, Murtha AD, Bell EH, Won M, Mehta MP, Curran WJ. Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade Glioma. N Engl J Med 2016; 374:1344-55. [PMID: 27050206 PMCID: PMC5170873 DOI: 10.1056/nejmoa1500925] [Citation(s) in RCA: 642] [Impact Index Per Article: 80.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Grade 2 gliomas occur most commonly in young adults and cause progressive neurologic deterioration and premature death. Early results of this trial showed that treatment with procarbazine, lomustine (also called CCNU), and vincristine after radiation therapy at the time of initial diagnosis resulted in longer progression-free survival, but not overall survival, than radiation therapy alone. We now report the long-term results. METHODS We included patients with grade 2 astrocytoma, oligoastrocytoma, or oligodendroglioma who were younger than 40 years of age and had undergone subtotal resection or biopsy or who were 40 years of age or older and had undergone biopsy or resection of any of the tumor. Patients were stratified according to age, histologic findings, Karnofsky performance-status score, and presence or absence of contrast enhancement on preoperative images. Patients were randomly assigned to radiation therapy alone or to radiation therapy followed by six cycles of combination chemotherapy. RESULTS A total of 251 eligible patients were enrolled from 1998 through 2002. The median follow-up was 11.9 years; 55% of the patients died. Patients who received radiation therapy plus chemotherapy had longer median overall survival than did those who received radiation therapy alone (13.3 vs. 7.8 years; hazard ratio for death, 0.59; P=0.003). The rate of progression-free survival at 10 years was 51% in the group that received radiation therapy plus chemotherapy versus 21% in the group that received radiation therapy alone; the corresponding rates of overall survival at 10 years were 60% and 40%. A Cox model identified receipt of radiation therapy plus chemotherapy and histologic findings of oligodendroglioma as favorable prognostic variables for both progression-free and overall survival. CONCLUSIONS In a cohort of patients with grade 2 glioma who were younger than 40 years of age and had undergone subtotal tumor resection or who were 40 years of age or older, progression-free survival and overall survival were longer among those who received combination chemotherapy in addition to radiation therapy than among those who received radiation therapy alone. (Funded by the National Cancer Institute and others; ClinicalTrials.gov number, NCT00003375.).
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Affiliation(s)
- Jan C Buckner
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Edward G Shaw
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Stephanie L Pugh
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Arnab Chakravarti
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Mark R Gilbert
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Geoffrey R Barger
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Stephen Coons
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Peter Ricci
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Dennis Bullard
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Paul D Brown
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Keith Stelzer
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - David Brachman
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - John H Suh
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Christopher J Schultz
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Jean-Paul Bahary
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Barbara J Fisher
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Harold Kim
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Albert D Murtha
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Erica H Bell
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Minhee Won
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Minesh P Mehta
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
| | - Walter J Curran
- From the Mayo Clinic, Rochester, MN (J.C.B.); Wake Forest University School of Medicine, Winston-Salem (E.G.S.), and Triangle Neurosurgeons, Raleigh (D. Bullard) - both in North Carolina; NRG Oncology Statistics and Data Management Center, Philadelphia (S.L.P., M.W.); Ohio State University, Columbus (A.C., E.H.B.), and Cleveland Clinic, Cleveland (J.H.S.) - both in Ohio; M.D. Anderson Cancer Center, University of Texas, Houston (M.R.G., P.D.B.); Wayne State University, Detroit (G.R.B., H.K.); Barrow Neurological Institute (S.C.) and Arizona Oncology Services Foundation (D. Brachman) - both in Phoenix; Radiology Imaging Associates, Englewood, CO (P.R.); Mid-Columbia Medical Center, The Dalles, OR (K.S.); Medical College of Wisconsin, Milwaukee (C.J.S.); Centre Hospitalier de l'Université de Montréal, Montreal (J.-P.B.), the London Regional Cancer Program, London, ON (B.J.F.), and the Cross Cancer Institute, Edmonton, AB (A.D.M.) - all in Canada; University of Maryland, Baltimore (M.P.M.); and Emory University, Atlanta (W.J.C.)
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Almefty R, Xu D, Mooney M, Montoure A, Coons S, Porter R, Spetzler R. Cystic Vestibular Schwannomas have Similar Surgical Outcomes and Recurrence Rates as Solid Vestibular Schwannomas. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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9
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Dardis C, Aung T, Shapiro W, Fortune J, Coons S. Langerhans cell histiocytosis in an adult with involvement of the calvarium, cerebral cortex and brainstem: discussion of pathophysiology and rationale for the use of intravenous immune globulin. Case Rep Neurol 2015; 7:30-8. [PMID: 25873887 PMCID: PMC4386111 DOI: 10.1159/000380760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We report a case of Langerhans cell histiocytosis in a 64-year-old male who presented with symptoms and signs of brain involvement, including seizures and hypopituitarism. The diagnosis was confirmed with a biopsy of a lytic skull lesion. The disease affecting the bone showed no sign of progression following a short course of cladribine. Signs of temporal lobe involvement led to an additional biopsy, which showed signs of nonspecific neurodegeneration and which triggered status epilepticus. Lesions noted in the brainstem were typical for the paraneoplastic inflammation reported in this condition. These lesions improved after treatment with cladribine. They remained stable while on treatment with intravenous immune globulin.
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Affiliation(s)
- Christopher Dardis
- Department of Neurology, Barrow Neurological Institute, Phoenix, Ariz., USA
| | - Thandar Aung
- Department of Neurology, Barrow Neurological Institute, Phoenix, Ariz., USA
| | - William Shapiro
- Department of Neurology, Barrow Neurological Institute, Phoenix, Ariz., USA
| | - John Fortune
- Department of Neuropathology, Barrow Neurological Institute, Phoenix, Ariz., USA
| | - Stephen Coons
- Department of Neuropathology, Barrow Neurological Institute, Phoenix, Ariz., USA
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10
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Zieman G, Dardis C, Gomes A, Scheck A, Eschbacher J, Coons S, Ashby L. ED-39 * GANGLIOGLIOMA IN CHILDREN; IDENTIFICATION OF CASES AT RISK OF DEATH DUE TO PROGRESSION FOLLOWING INITIAL SURGERY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou253.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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11
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Mehta M, Won M, Shaw E, Buckner J, Gilbert M, Barger G, Coons S, Ricci P, Bullard D, Brown P, Stelzer K, Brachman D, Suh J, Schultz C, Bahary J, Fisher B, Kim H, Murtha A, Curran W. Mature Survival Data from RTOG 9802: A Phase III Study of Radiation Therapy (RT) With or Without Procarbazine, CCNU, and Vincristine (PCV) for Adult Patients with High-Risk Low-Grade Glioma (LGG). Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Buckner JC, Pugh SL, Shaw EG, Gilbert MR, Barger G, Coons S, Ricci P, Bullard D, Brown PD, Stelzer K, Brachman D, Suh JH, Schultz CJ, Bahary JP, Fisher BJ, Kim H, Murtha AD, Curran WJ, Mehta MP. Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: RTOG 9802 with Alliance, ECOG, and SWOG. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.2000] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Stephanie L. Pugh
- Statistical Center, Radiation Therapy Oncology Group, Philadelphia, PA
| | - Edward G. Shaw
- Wake Forest University, School of Medicine, Winston-Salem, NC
| | - Mark R. Gilbert
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Paul D. Brown
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Jean-Paul Bahary
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montreal University, Montreal, QC, Canada
| | | | - Harold Kim
- Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | | | - Walter J. Curran
- Radiation Therapy Oncology Group; Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
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13
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Yin J, Turner G, Coons S, Maalouf M, Reiman E, Shi J. Association of Amyloid Burden, Brain Atrophy and Memory Deficits in Aged Apolipoprotein ε4 Mice. Curr Alzheimer Res 2014; 11:283-90. [DOI: 10.2174/156720501103140329220007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 12/03/2013] [Accepted: 12/06/2013] [Indexed: 11/22/2022]
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14
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Yin JX, Tang Z, Gan Y, Li L, Shi F, Coons S, Shi J. Pertussis toxin modulates microglia and T cell profile to protect experimental autoimmune encephalomyelitis. Neuropharmacology 2014; 81:1-5. [PMID: 24486709 DOI: 10.1016/j.neuropharm.2014.01.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 12/10/2013] [Accepted: 01/21/2014] [Indexed: 12/11/2022]
Abstract
Pertussis toxin (PTx) has various effects in experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS). This study was designed to explore the protective effects of PTx of different doses and subunits. EAE model was induced with myelin oligodendrocyte glycoprotein (MOG35-55, 200 ug) plus complete Freund's adjuvant in 6-7 week-old female C57BL/6 mice. PTx reduced clinical deficits of EAE by 91.3%. This reduction in clinical deficits was achieved by attenuating demyelination by 75.5%. Furthermore, PTx reduced the lymphocyte infiltration, deactivated microglia activation and changed T cell profile by increasing T helper (type 1 and 2) and T regulatory cells.
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Affiliation(s)
- Jun-Xiang Yin
- Department of Neurology, Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, USA
| | - Zhiwei Tang
- Department of Neurology, Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, USA
| | - Yan Gan
- Department of Neurology, Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, USA
| | - Lejun Li
- Department of Neurology, Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, USA
| | - Fudong Shi
- Department of Neurology, Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, USA
| | - Stephen Coons
- Department of Neuropathology, Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, USA
| | - Jiong Shi
- Department of Neurology, Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, USA.
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Ahmed I, Biswas A, Krishnamurthy S, Julka P, Rath G, Back M, Huang D, Gzell C, Chen J, Kastelan M, Gaur P, Wheeler H, Badiyan SN, Robinson CG, Simpson JR, Tran DD, Rich KM, Dowling JL, Chicoine MR, Leuthardt EC, Kim AH, Huang J, Michaelsen SR, Christensen IJ, Grunnet K, Stockhausen MT, Broholm H, Kosteljanetz M, Poulsen HS, Tieu M, Lovblom E, Macnamara M, Mason W, Rodin D, Tai E, Ubhi K, Laperriere N, Millar BA, Menard C, Perkins B, Chung C, Clarke J, Molinaro A, Phillips J, Butowski N, Chang S, Perry A, Costello J, DeSilva A, Rabbitt J, Prados M, Cohen AL, Anker C, Shrieve D, Hall B, Salzman K, Jensen R, Colman H, Farber O, Weinberg U, Palti Y, Fisher B, Chen H, Macdonald D, Lesser G, Coons S, Brachman D, Ryu S, Werner-Wasik M, Bahary JP, Chakravarti A, Mehta M, Gupta T, Nair V, Epari S, Godasastri J, Moiyadi A, Shetty P, Juvekar S, Jalali R, Herrlinger U, Schafer N, Steinbach J, Weyerbrock A, Hau P, Goldbrunner R, Kohnen R, Urbach H, Stummer W, Glas M, Houillier C, Ghesquieres H, Chabrot C, Soussain C, Ahle G, Choquet S, Faurie P, Bay JO, Vargaftig J, Gaultier C, Nicolas-Virelizier E, Hoang-Xuan K, Iskanderani O, Izar F, Benouaich-Amiel A, Filleron T, Moyal E, Iweha C, Jain S, Melian E, Sethi A, Albain K, Shafer D, Emami B, Kong XT, Green S, Filka E, Green R, Yong W, Nghiemphu P, Cloughesy T, Lai A, Mallick S, Biswas A, Roy S, Purkait S, Gupta S, Julka PK, Rath GK, Marosi C, Thaler J, Ay C, Kaider A, Reitter EM, Haselbock J, Preusser M, Flechl B, Zielinski C, Pabinger I, Miyatake SI, Furuse M, Miyata T, Yoritsune E, Kawabata S, Kuroiwa T, Muragaki Y, Maruyama T, Iseki H, Akimoto J, Ikuta S, Nitta M, Maebayashi K, Saito T, Okada Y, Kaneko S, Matsumura A, Kuroiwa T, Karasawa K, Nakazato Y, Kayama T, Nabors LB, Fink KL, Mikkelsen T, Grujicic D, Tarnawski R, Nam DH, Mazurkiewicz M, Salacz M, Ashby L, Thurzo L, Zagonel V, Depenni R, Perry JR, Henslee-Downey J, Picard M, Reardon DA, Nambudiri N, Nayak L, LaFrankie D, Wen P, Ney D, Carlson J, Damek D, Blatchford P, Gaspar L, Kavanagh B, Waziri A, Lillehei K, Reddy K, Chen C, Rashed I, Melian E, Sethi A, Barton K, Anderson D, Prabhu V, Rusch R, Belongia M, Maheshwari M, Firat S, Schiff D, Desjardins A, Cloughesy T, Mikkelsen T, Glantz M, Chamberlain M, Reardon DA, Wen P, Shapiro W, Gopal S, Judy K, Patel S, Mahapatra A, Shan J, Gupta D, Shih K, Bacha JA, Brown D, Garner WJ, Steino A, Schwart R, Kanekal S, Li M, Lopez L, Burris HA, Soderberg-Naucler C, Rahbar A, Stragliotto G, Song AJ, Kumar AMS, Murphy ES, Tekautz T, Suh JH, Recinos V, Chao ST, Spoor J, Korami K, Kloezeman J, Balvers R, Dirven C, Lamfers M, Leenstra S, Sumrall A, Haggstrom D, Crimaldi A, Symanowski J, Giglio P, Asher A, Burri S, Sunkersett G, Khatib Z, Prajapati CM, Magalona EE, Mariano M, Sih IM, Torcuator R, Taal W, Oosterkamp H, Walenkamp A, Beerenpoot L, Hanse M, Buter J, Honkoop A, Boerman D, de Vos F, Jansen R, van der Berkmortel F, Brandsma D, Enting R, Kros J, Bromberg J, van Heuvel I, Smits M, van der Holt R, Vernhout R, van den Bent M, Weinberg U, Farber O, Palti Y, Wick W, Suarez C, Rodon J, Desjardins A, Forsyth P, Gueorguieva I, Cleverly A, Burkholder T, Desaiah D, Lahn M, Zach L, Guez D, Last D, Daniels D, Nissim O, Grober Y, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Mardor Y. MEDICAL RADIATION THERAPIES. Neuro Oncol 2013; 15:iii75-iii84. [PMCID: PMC3823894 DOI: 10.1093/neuonc/not179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
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Fisher BJ, Lui J, Macdonald DR, Lesser GJ, Coons S, Brachman D, Ryu S, Werner-Wasik M, Bahary JP, Hu C, Mehta MP. A phase II study of a temozolomide-based chemoradiotherapy regimen for high-risk low-grade gliomas: Preliminary results of RTOG 0424. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.2008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2008 Background: The primary endpoint of RTOG 0424 was to compare the 3-year survival (OS) of a regimen of concurrent and adjuvant temozolomide (TMZ) and radiotherapy (RT) in a high-risk low-grade glioma (LGG) population to the 3 year (yr) OS rate of the high risk EORTC LGG patients (pts) reported by Pignatti et al (J Clin Oncol 2002;20(8):2076-84). Secondary endpoints were: progression-free survival (PFS), toxicity, neurocognitive and quality of life data and molecular analysis. Methods: Pts with LGG's and >=3 high risk factors (age> = 40, astrocytoma dominant histology, tumor crossing midline, tumor > = 6 cm or preoperative neurological function status >1) were eligible and treated with conformal RT (54 Gy/30 fractions) plus concurrent TMZ 75 mg/m2 /day for 6 weeks and post-RT TMZ 150-200 mg/m2/day days 1-5 q28 days for up to 12 cycles. The study was designed to detect a 43% increase in median survival time (MST) from 40.5 to 57.9 months, and a 20% improvement in 3 yr OS rate from 54% to 65%, at a 10% significance level (1 sided) and 96% power. Results: Between January 2005-August 2009 136 pts were accrued, 129 (75 males, 54 females) were evaluable. Median age was 49 years, 91% had a Zubrod score 0-1 and 69%, 25% and 6% of pts had 3,4 and 5 high risk factors respectively. With a median follow-up time of 4.1 yrs, minimum follow-up of 3 yrs, MST has not yet been reached. Three year OS rate was 73.1% (95%CI:65.3-80.8%), significantly improved from historical control with a p-value <0.0001. No difference in OS rates for pts with 3, 4 or 5 high risk factors was seen. 3 year PFS was 59.2% (95% CI:50.7-67.8%). Grade 3 adverse events (AE) occurred in 43% of pts and grade 4 AE in 10%, primarily hematologic, constitutional or gastrointestinal (nausea, anorexia) toxicity. One patient died of herpes encephalitis. Secondary analyses are ongoing. Radiation Quality Assurance was per protocol/ acceptable in 95% and 74% of pts completed chemotherapy per protocol. Conclusions: The 3 year OS rate of 73.1% for these high risk LGG pts is significantly higher than those reported for historical controls (54%, p < 0.0001, one-sided) and the study-hypothesized 65%. Supported by RTOG U10 CA21661 and CCOP U10 CA37422 grants from NCI and Merck Clinical trial information: NCT00114140.
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Affiliation(s)
- Barbara Jean Fisher
- Department of Radiation Oncology, London Regional Cancer Program, London, ON, Canada
| | - Jeff Lui
- Radiation Therapy Oncology Group, Philadelphia, PA
| | | | | | | | | | | | | | - Jean-Paul Bahary
- Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
| | - Chen Hu
- Radiation Therapy Oncology Group, Philadelphia, PA
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Abstract
We describe the case of a 59-year-old woman who presented with progressive bilateral vestibidar hypofunction and who was found to have bilateral granulomatous mass lesions of the mesial temporal lobe. Initially, her condition stabilized neurologically with corticosteroids, but a diagnosis of neurosarcoidosis was delayed because of the unusual presentation and persistently normal chest imaging results and serum angiotensin-converting enzyme (ACE) levels. Approximately 1 year after her initial presentation, the patient died of complications of a myocardial infarction and pulmonary embolism. Sarcoidosis should be considered in the differential diagnosis of idiopathic bilateral vestibular hypofunction even if the chest imaging and serum ACE levels are normal, particularly when there is evidence of a multisystem process.
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Affiliation(s)
| | | | - Stephen Coons
- Barrow Neurological Institute, University of Arizona College of Medicine, Phoenix
| | - Terry Douglas Fife
- Barrow Neurological Institute, University of Arizona College of Medicine, Phoenix
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Pati S, Muley SA, Grill MF, Coons S, Walker R. Post-streptococcal vasculopathy with evolution to Degos' disease. J Neurol Sci 2010; 300:157-9. [PMID: 21035145 DOI: 10.1016/j.jns.2010.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Revised: 09/27/2010] [Accepted: 10/05/2010] [Indexed: 10/18/2022]
Abstract
Degos' disease or malignant atrophic papulosis is a rare disseminated occlusive vasculopathy affecting the skin, gastrointestinal tract, central nervous system, and less often other organ systems. The exact etiology of this vasculopathy has not been established. Infections, autoimmune disease and coagulation defects have been proposed as underlying pathogenic mechanisms, but none have been confirmed. Here, we report the clinical, radiological and histopathologic features of Degos' disease in a 41-year-old man following streptococcal throat infection. Prior postulated hypothesis as post-infectious immunologic mechanism may be further supported by this case.
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Affiliation(s)
- Sandipan Pati
- Barrow Neurological Institute, 350 W Thomas Road, Phoenix, AZ 85013, United States.
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Misra A, Smirnov I, Morrow C, Eschbacher J, Schendel C, Kharbanda S, Phillips H, Coons S, Feuerstein BG. Abstract 1132: PTPRD is a frequent tumor suppressor in malignant astrocytoma. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-1132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
A slew of loss of heterozygosity studies for over more than a decade indicated existance of tumor suppressor/s other than p16 on 9p. With high resolution DNA microarray data, infrequent loss of a locus at 9p24 have been reported in neuroblastoma, esophageal, colon and lung cancers. Along with >30% loss of whole arm of 9p, we have observed occasional homo and heterozygous loss of a ∼2.6Mb locus, about 10Mb away from p16 gene on 9p in a few glioblastoma multiforme (GBM). Out of 14 genes located in this minimum deletion region, PTPRD expression was lost in ∼65-88% GBM (n=181) and more than 40% AA (n=48). The TCGA data showed similar frequency of loss of PTPRD expression, and mutation in ∼6% of GBM. Compared to nonneoplastic brain, the anaplastic astrocytoma (AA) and GBM had significant loss (p=0.0003 and 3.7 × 10-7, respectively) of PTPRD in our sample set; and TCGA GBM (p=2.7 × 10-14). Earlier we reported 3 genetic GBM subgroups: proneural, proliferative and mesenchymal where proneural GBM have relatively better survival than the others (Phillips et al, 2006). PTPRD expression loss were more significant in proliferative and mesenchymal GBM (P=3.7 × 10-8 and 2.6 × 10-7, respectively) than in proneural (p=0.0001) GBM, suggesting its expression level could be associated with survival. In a set of 306 TCGA GBM with survival data, PTPRD loss was associated with survival (log rank p<0.05). In a small set of GBM (n=11), PTPRD was lost at different degree and pattern in every tumor. Overexpression of PTPRD in U251 and U87 GBM cell lines with relatively little to no PTPRD expression lead to decreased growth rate (p<0.01) and survival (p<0.00001) in both the lines. PTPRD overexpression in these lines caused apoptosis (increased number of sub G0 cell population, and increased PARP cleavage). Downregulation of PTPRD in immortalized normal human astrocytes increased their growth rate and survival. Gene enrichment analysis identified 25 pathways connected to PTPRD expression level, many of them with key tyrosine kinase genes, and leads to survival or cell death phenotypes. PTPRD overexpression dephysphorylated phosphotyrosine/s of a ∼120Kd protein in U251 GBM cells. PTPRD loss has been reported to increase flank GBM xenograft growth rate (Solomon et al, 2008). PTPRD promoter hypermethylation in GBM, and loss mediated tumorigenecity in normal human astrocytes have also been reported recently (Veeriah et al, 2009). Together, this data suggest that PTPRD is a potent and frequent tumor suppressor in astrocytoma, and could be that elusive other tumor suppressor on 9p.
This work was supported by the Arizona Biomedical Research Commission, Barrow Neurological Foundation, and Diane and Bruce Halle Fund.
Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1132.
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Affiliation(s)
| | - Ivan Smirnov
- 2University of California, San Francisco, San Francisco, CA
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Tu JL, Zhao CB, Vollmer T, Coons S, Lin HJ, Marsh S, Treiman DM, Shi J. APOE 4 polymorphism results in early cognitive deficits in an EAE model. Biochem Biophys Res Commun 2009; 384:466-70. [PMID: 19422789 DOI: 10.1016/j.bbrc.2009.04.153] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 04/26/2009] [Indexed: 10/20/2022]
Abstract
Recent clinical studies have identified an association between APOE 4 and cognitive deficits in patients with multiple sclerosis. We induced experimental autoimmune encephalomyelitis (EAE) in APOE knockout (KO) and human APOE 4 knockin (E4) mice to study the interaction of APOE and neuroinflammation on cognition. After EAE induction, KO and E4 showed significant deficits in spatial learning and recall. Regional decreases in choline acetyltransferase localized to the hippocampus. Induction of EAE in a transgenic APOE animal provides a template from which we can decipher the role APOE has on cognition in the context of neuroinflammation.
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Affiliation(s)
- Jiang-long Tu
- Department of Neurology, Barrow Neurological Institute, 500 W Thomas Road, Phoenix, AZ 85013, USA
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Ladha S, Coons S, Johnsen S, Sambuughin N, Bien-Wilner R, Sivakumar K. Histopathologic progression and a novel mutation in a child with nemaline myopathy. J Child Neurol 2008; 23:813-7. [PMID: 18487519 DOI: 10.1177/0883073808314363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nemaline myopathy is a clinically heterogeneous congenital myopathy caused by mutations in at least 6 genes related to thin filaments. Histologically, they show a characteristic if not homogeneous picture of nemaline rods, essential for the diagnosis. However, little is known regarding the development and progression of muscle histopathologic changes in nemaline myopathy. Results of muscle biopsies at 7 weeks of age and at 15 months of age from a child with nemaline myopathy due to a novel mutation in the ACTA1 gene are presented. The findings of the biopsies, separated by 13 months, demonstrate progression from vague cytoplasmic bodies in the first biopsy to typical nemaline rods in the second biopsy.
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Affiliation(s)
- Shafeeq Ladha
- Neuromuscular Research Center, Scottsdale, AZ 85258, USA.
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Shaw EG, Wang M, Coons S, Brachman D, Buckner JC, Stelzer K, Barger G, Brown PD, Gilbert MR, Mehta MP. Final report of Radiation Therapy Oncology Group (RTOG) protocol 9802: Radiation therapy (RT) versus RT + procarbazine, CCNU, and vincristine (PCV) chemotherapy for adult low-grade glioma (LGG). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.2006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Eschbacher JM, Coons S. Increased expression of SOX2 in Ammon's Horn Sclerosis: Further evidence for neurogenesis in epilepsy. FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.59.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Stephen Coons
- NeuropathologyBarrow Neurological InstitutePhoenixAZ
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Affiliation(s)
| | - Ru‐Fang Yeh
- Center for Bioinformatics & Molecular BiostatisticsUniversity of CaliforniaSan FranciscoSan FranciscoCA
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Abstract
OBJECTIVE The clinical presentation, pathology, treatment, and outcome of a 43-year-old woman with a malignant peripheral nerve sheath tumor arising from a benign schwannoma of the eighth cranial nerve are presented. CLINICAL PRESENTATION Initially, the tumor was debulked. After finding malignant areas within the benign tumor, it was considered to be a malignant transformation of a previously benign tumor. INTERVENTION Aggressive total resection was obtained during a second-stage procedure. Postoperatively, the tumor bed was radiated for palliation. CONCLUSION Despite surgery, radiation, and chemotherapy, the patient died rapidly as a result of disseminated metastatic disease.
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Affiliation(s)
- L Fernando Gonzalez
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA
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26
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Abstract
AbstractOBJECTIVEGlomus tumors are rare lesions that can arise intraosseously along the entire spinal axis. Only four cases have been reported, usually manifesting with severe back pain and involving the midthoracic spine or sacrum. The current report describes the largest such lesion reported in the literature to date and summarizes the clinical and pathological characteristics of these rare tumors.METHODSA single, recent case arising from the lumbar vertebra of L3 is described, and the literature of intraosseous spinal glomus tumors is reviewed.RESULTSThe lesion described arose in a 44-year-old man with a 1-year history of neurological symptoms and a large dumbbell-shaped lesion involving the lumbar vertebra, which extended through the neural foramen at L3. The lesion was resected using a two-stage approach. Severe intraoperative hemorrhage necessitated emergent angiographic embolization. Histopathological examination confirmed the presence of a glomus tumor arising from the smooth muscle cells of the glomus body.CONCLUSIONThese rare lesions may extend into the epidural space and through the neural foramina and abdominal compartments; over time, they grow very large. Preoperative embolization may be indicated for large tumors suspected to be glomus tumors.
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Affiliation(s)
- Nicholas C Bambakidis
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
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Li J, Lopez JI, Powell SZ, Fuller GN, Coons S. Giant Cell Ependymoma: Two New Cases and Review of the Literature. FASEB J 2007. [DOI: 10.1096/fasebj.21.5.a395-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jianyi Li
- PathologyThe Methodist Hospital6565 Fannin st. M227HoustonTX77030
| | - Jose I Lopez
- PathologyHospital de BasurtoAvda. de Montevideo 18Bilbao48013Spain
| | | | - Gregory N Fuller
- PathologyThe Univ. of Texas, MD Anderson Cancer Center1515 Holcombe BlvdHoustonTX77030
| | - Stephen Coons
- NeuropathologyBarrow Neurological Institute350 W Thomas RDPhoenixAZ85013
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Feiz-Erfan I, Spetzler R, Porter R, White W, Heiserman J, Coons S. Clivus Fibrosis: Natural History of a Benign Condition Mimicking Chordoma. Skull Base 2007. [DOI: 10.1055/s-2007-981817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gonzalez LF, Lekovic GP, Eschbacher J, Coons S, Porter RW, Spetzler RF. Are cavernous sinus hemangiomas and cavernous malformations different entities? Neurosurg Focus 2006; 21:e6. [PMID: 16859259 DOI: 10.3171/foc.2006.21.1.7] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cavernous hemangiomas that occur within the cavernous sinus (CS) are different from cerebral cavernous malformations (CMs) clinically, on imaging studies, and in their response to treatment. Moreover, CMs are true vascular malformations, whereas hemangiomas are benign vascular tumors. Because of these differences, the authors suggest that these two entities be analyzed and grouped separately. Unfortunately, despite these differences, much confusion exists in the literature as to the nature, behavior, and classification of these two distinct lesions. This confusion is exacerbated by subtle histological differences and the inconsistent use of nomenclature. The authors use the term "cavernous malformation" to refer to intraaxial lesions only; they prefer to use the term "cavernous sinus hemangioma" to refer to extraaxial, intradural hemangiomas of the CS.
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Affiliation(s)
- L Fernando Gonzalez
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA
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30
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Wu J, Xu L, Kim DY, Rho JM, St John PA, Lue LF, Coons S, Ellsworth K, Nowak L, Johnson E, Rekate H, Kerrigan JF. Electrophysiological properties of human hypothalamic hamartomas. Ann Neurol 2005; 58:371-82. [PMID: 16130091 DOI: 10.1002/ana.20580] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The hypothalamic hamartoma (HH) is a rare developmental malformation often characterized by gelastic seizures, which are usually refractory to medical therapy. The mechanisms of epileptogenesis operative in this subcortical lesion are unknown. In this study, we used standard patch-clamp electrophysiological techniques combined with histochemical approaches to study individual cells from human HH tissue immediately after surgical resection. More than 90% of dissociated HH cells were small (6-9 microm soma) and exhibited immunoreactivity to the neuronal marker NeuN, and to glutamic acid decarboxylase, but not to glial fibrillary acidic protein. Under current-clamp, whole-cell recordings in single dissociated cells or in intact HH slices demonstrated typical neuronal responses to depolarizing and hyperpolarizing current injection. In some cases, HH cells exhibited a "sag-like" membrane potential change during membrane hyperpolarization. Interestingly, most HH cells exhibited robust, spontaneous "pacemaker-like" action potential firing. Under voltage-clamp, dissociated HH cells exhibited functional tetrodotoxin (TTX)-sensitive Na(+) and tetraethylammonium-sensitive K(+) currents. Both GABA and glutamate evoked whole-cell currents, with GABA exhibiting a peak current amplitude 10-fold greater than glutamate. These findings suggest that human HH tissues, associated with gelastic seizures, contained predominantly small GABAergic inhibitory neurons that exhibited intrinsic "pacemaker-like" behavior.
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Affiliation(s)
- Jie Wu
- Division of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
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31
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Yucesoy K, Feiz-Erfan I, Spetzler RF, Han PP, Coons S. Anterior communicating artery aneurysm following radiation therapy for optic glioma: report of a case and review of the literature. Skull Base 2005; 14:169-73. [PMID: 16145601 PMCID: PMC1151688 DOI: 10.1055/s-2004-832263] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 42-year-old female presented with subarachnoid hemorrhage (SAH), presumably from a radiation-induced anterior communicating artery aneurysm. Six years earlier, she had undergone radiation treatment for an optic glioma that was diagnosed based on imaging criteria. The aneurysm was successfully clipped, and the optic glioma was biopsied to verify the diagnosis histologically. Radiation-induced cerebral aneurysms often manifest with a fatal SAH. These aneurysms typically develop in the field of radiation and are diagnosed a mean of 8.52 years after radiation. Rarely, the aneurysm sac thromboses spontaneously. Clipping or coiling of the aneurysm can be an effective treatment.
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Affiliation(s)
- Kemal Yucesoy
- Department of Neurosurgery, Dokuz Eylül University, Izmir, Turkey
| | - Iman Feiz-Erfan
- Divisions of Neurological Surgery and Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Robert F. Spetzler
- Divisions of Neurological Surgery and Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Patrick P. Han
- Divisions of Neurological Surgery and Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Stephen Coons
- Division Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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32
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Bristol RE, Rennert J, Coons S, Berens M. Gene Expression Profiling of Pediatric Brainstem Gliomas. Neurosurgery 2005. [DOI: 10.1093/neurosurgery/57.2.417a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rogers L, Pueschel J, Spetzler R, Shapiro W, Coons S, Thomas T, Speiser B. Is gross-total resection sufficient treatment for posterior fossa ependymomas? J Neurosurg 2005; 102:629-36. [PMID: 15871504 DOI: 10.3171/jns.2005.102.4.0629] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object. The goals of this study were to analyze outcomes in patients with posterior fossa ependymomas, determine whether gross-total resection (GTR) alone is appropriate treatment, and evaluate the role of radiation therapy.
Methods. All patients with newly diagnosed intracranial ependymomas treated at Barrow Neurological Institute between 1983 and 2002 were identified. Those with supratentorial primary lesions, subependymomas, or neuraxis dissemination were excluded. Forty-five patients met the criteria for the study. Gross-total resection was accomplished in 32 patients (71%) and subtotal resection (STR) in 13 (29%). Radiation therapy was given to 25 patients: 13 following GTR and 12 after STR. The radiation fields were craniospinal followed by a posterior fossa boost in six patients and posterior fossa or local only in the remaining patients.
With a median follow-up period of 66 months, the median duration of local control was 73.5 months with GTR alone, but has not yet been reached for patients with both GTR and radiotherapy (p = 0.020). The median duration of local control following STR and radiotherapy was 79.6 months. The 10-year actuarial local control rate was 100% for patients who underwent GTR and radiotherapy, 50% for those who underwent GTR alone, and 36% for those who underwent both STR and radiotherapy, representing significant differences between the GTR-plus-radiotherapy and GTR-alone cohorts (p = 0.018), and between the GTR-plus-radiotherapy and the STR-plus-radiotherapy group (p = 0.003). There was no significant difference in the 10-year actuarial local control rate between the GTR-alone and STR-plus-radiotherapy cohorts (p = 0.370). The 10-year overall survival was numerically superior in patients who underwent both GTR and radiotherapy: 83% compared with 67% in those who underwent GTR alone and 43% in those who underwent both STR and radiotherapy. These differences did not achieve statistical significance. Univariate analyses revealed that radiotherapy, tumor grade, and extent of resection were significant predictors of local control.
Conclusions. Gross-total resection should be the intent of surgery when it can be accomplished with an acceptable degree of morbidity. Even after GTR has been confirmed with postoperative imaging, however, adjuvant radiotherapy significantly improves local control. The authors currently recommend the use of postoperative radiotherapy, regardless of whether the resection is gross total or subtotal.
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Affiliation(s)
- Leland Rogers
- GammaWest Radiation Therapy, Salt Lake City, Utah 84102, USA.
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Deshmukh VR, Smith KA, Rekate HL, Coons S, Spetzler RF. Diagnosis and Management of Pineocytomas. Neurosurgery 2004; 55:349-55; discussion 355-7. [PMID: 15271241 DOI: 10.1227/01.neu.0000129479.70696.d2] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2003] [Accepted: 03/24/2004] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE:
Pineocytomas are associated with the most favorable prognosis of all pineal tumors. However, a subset of pineocytomas may have a predilection for recurrence and therefore behave aggressively.
PATIENTS AND METHODS:
Records of nine patients (five men, four women; mean age, 44 yr; range, 24–63 yr) with histologically diagnosed pineocytomas consecutively treated between 1990 and 2003 were reviewed retrospectively to identify factors predictive of aggressiveness. Eight patients presented with hydrocephalus and four with tectal compression. Three patients underwent gross total resection, and six underwent subtotal resection or biopsy.
RESULTS:
Three local recurrences necessitated reoperation. One recurrence involved the obex of the fourth ventricle. The mean time to recurrence was 3.5 years (range, 1–7 yr). There was no correlation between histological features and tumor recurrence. Patients undergoing radiosurgery showed stable or attenuated local disease (mean follow-up, 19.3 mo; range, 6–36 mo). Mean radiographic follow-up was 34 months (range, 6 mo to 10 yr). Mean clinical follow-up was 36 months (range, 1 mo to 10 yr).
CONCLUSION:
A subset of pineocytomas demonstrates the potential for symptomatic recurrence. We advocate an attempt at gross total tumor resection for all symptomatic patients with tectal plate compression, reserving radiosurgery for small, subtotally resected, or recurrent lesions. Patients must be followed closely for recurrence. Radiosurgery seems to be beneficial for local tumor control. Further investigation is needed to identify histological markers for pineocytomas that behave aggressively.
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Affiliation(s)
- Vivek R Deshmukh
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA
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35
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Castillo MS, Davis FG, Surawicz T, Bruner JM, Bigner S, Coons S, Bigner DD. Consistency of Primary Brain Tumor Diagnoses and Codes in Cancer Surveillance Systems. Neuroepidemiology 2004; 23:85-93. [PMID: 14739573 DOI: 10.1159/000073980] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
High-quality cancer registry data are essential for assessing trends in incidence rates. This study evaluated the consistency of brain tumor surveillance data using a random sample of cases from the Connecticut Tumor Registry. Three neuropathologists independently and blindly reviewed tumor slides from 204 cases and a nosologist blindly reviewed and assigned International Classification of Diseases for Oncology (ICD-O) codes to 326 cases. For the pathology review, absolute concordance was as high as 81% for all primary brain tumors. Absolute concordance rates were high for nerve sheath (89%), meningioma (95%), and pituitary (95%) tumors. Rates were much lower for malignant tumors. ICD-O coding of malignant brain tumors is of relatively high quality with the exception of mixed gliomas and unspecified tumors. A high level of consistency for nonmalignant brain tumor diagnoses suggests that rates for these tumors, when actively reported to a surveillance system, can be of high quality.
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Affiliation(s)
- Monette S Castillo
- Department of Epidemiology/Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL 60612, USA
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Affiliation(s)
- Darin T Okuda
- Division of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
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Kim LJ, Klopfenstein JD, Cheng M, Nagul M, Coons S, Fredenberg C, Brachman DG, White WL. Ectopic intracavernous sinus adrenocorticotropic hormone-secreting microadenoma: could this be a common cause of failed transsphenoidal surgery in Cushing disease? Case report. J Neurosurg 2003; 98:1312-7. [PMID: 12816280 DOI: 10.3171/jns.2003.98.6.1312] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Despite diagnostic advances, it remains difficult to identify intrasellar and ectopic parasellar adrenocorticotropic hormone (ACTH)-secreting microadenomas. The authors present the case of a 61-year-old woman with Cushing disease in whom a significant central-to-peripheral and lateralized right-sided ACTH gradient was demonstrated on inferior petrosal sinus sampling; no discernible abnormality was seen on magnetic resonance imaging. She underwent transnasal transsphenoidal surgery. No tumor was found on sellar exploration and a total hypophysectomy was performed, yet her hypercortisolemia persisted. The patient died of cardiac events 17 days postsurgery. Autopsy revealed an isolated, right-sided, intracavernous ACTH-secreting adenoma with no intrasellar communication. This case represents the first failed transsphenoidal surgery for Cushing disease in which there is postmortem confirmation of a suspected intracavernous sinus lesion. It supports the hypothesis that Cushing disease associated with nondiagnostic imaging studies, a strong ACTH gradient on venography, and negative findings on sellar exploration may be caused by an ectopic intracavernous ACTH-secreting adenoma. There are no premortem means of confirming the presence of such lesions, but these tumors could underlie similar cases of failed surgery. Radiation therapy targeting the sella turcica and both cavernous sinuses, possibly supplemented with medical treatment, is suggested for similar patients in whom transsphenoidal hypophysectomy has failed. Adrenalectomy may also be appropriate if a rapid reduction in ACTH is necessary.
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Affiliation(s)
- Louis J Kim
- Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona 85013, USA
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Abstract
Pena-Shokier phenotype is an early lethal disorder involving multiple joint contractures, facial anomalies, and pulmonary hypoplasia. Alternative terms for this syndrome used in the literature include fetal hypokinesia syndrome, lethal congenital contracture syndrome, and Pena-Shokier syndrome type I. The etiology for the early cases was attributed to neuromuscular disease, with deformations owing to weakness or paralysis of the motor unit. An abnormality of spinal cord motoneurons has been postulated in some cases. Pena-Shokier phenotype can also result from blockade of the neuromuscular junction, as shown by recent observations with women expressing antibodies against the fetal acetylcholine receptor. It has been shown that the Pena-Shokier phenotype may result from intrauterine cerebral dysfunction as well, including acquired brain insults and congenital brain malformations. The ultimate prognosis for children with this disorder is dependent on the underlying etiology and the severity of pulmonary disease. The authors report a fatal case of Pena-Shokier phenotype with congenital polymicrogyria. To our knowledge, the case presented is the first reported Pena-Shokier phenotype associated with this type of brain malformation.
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Affiliation(s)
- Nathaniel Kho
- Division of Pediatric Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
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Mariani L, McDonough W, Beaudry C, Hoelzinger D, Kaczmarek E, Giese A, Coons S, Seiler R, Ross K, Berens M. P311 and DAP3: Glioblastoma invasion genes identified by laser capture microdissection, differential display and QRT-PCR. Nat Genet 2001. [DOI: 10.1038/87200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Zabramski JM, Henn JS, Coons S. Pathology of cerebral vascular malformations. Neurosurg Clin N Am 1999; 10:395-410. [PMID: 10419567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The gross and microscopic features of cerebral arteriovenous malformations, cavernous malformations, capillary telangiectases, and venous malformations are compared and contrasted. The pathogenesis of these lesions and possible interrelationships suggested by transitional lesions are also reviewed.
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Affiliation(s)
- J M Zabramski
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Medical Center, Phoenix, Arizona 85013-4496, USA.
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Stachowiak EK, Maher PA, Tucholski J, Mordechai E, Joy A, Moffett J, Coons S, Stachowiak MK. Nuclear accumulation of fibroblast growth factor receptors in human glial cells--association with cell proliferation. Oncogene 1997; 14:2201-11. [PMID: 9174056 DOI: 10.1038/sj.onc.1201057] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In this study we describe the presence of high affinity FGF-2 binding sites in the nuclei of U251MG glioma cells (K(d)=7 pM). Immunoprecipitation of total cell extracts with FGF receptor (FGFR) 1-4 antibodies showed that U251MG glioma cells express only FGFR1. [125I]FGF-2 cross linking to nuclear extracts followed by FGFR1 immunoprecipitation showed that FGFR1 may account for the nuclear FGF-2 binding sites. Western blot analysis demonstrated the presence of 103, 118 kDa and small amounts of 145 kDa FGFR1 isoforms in the nuclei of glioma cells. All isoforms contain both the C- and N-terminal domains. Nuclear FGFR1 retains kinase activity. Immunocytochemistry using confocal microscopy showed specific FGFR1 immunoreactivity within the nuclear interior. In continuously proliferating glioma cells, nuclear FGFR1 is constitutively expressed, independent of cell density. In contrast, in nontransformed human astrocytes, nuclear FGFR1 levels fluctuate with the proliferative state of the cell. In quiescent, confluent astrocytes nuclear FGFR1 protein was depleted. An accumulation of nuclear FGFR1 was observed following the transition to a subconfluent, proliferating state. Transfection of a pcDNA3.1-FGFR1 expression vector into glioma cells that do not express FGFR1 resulted in the nuclear accumulation of FGFR1, increased cell proliferation, and stimulated transition from the G0/G1 to the S-phase of the cell cycle. The increased proliferative rate was resistant to inhibition by the cell-impermeable FGF binding antagonist, myoinositol hexakis [dihydrogen phosphate]. Our results suggest that the constitutive nuclear presence of FGFR1 contributes to the increased proliferation of glioma cells while the transient nuclear accumulation of FGFR1 in normal astrocytes may play a role in the transition to a reactive state.
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Affiliation(s)
- E K Stachowiak
- Barrow Neurological Institute, Phoenix, Arizona 85013, USA
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Joy A, Moffett J, Neary K, Mordechai E, Stachowiak EK, Coons S, Rankin-Shapiro J, Florkiewicz RZ, Stachowiak MK. Nuclear accumulation of FGF-2 is associated with proliferation of human astrocytes and glioma cells. Oncogene 1997; 14:171-83. [PMID: 9010219 DOI: 10.1038/sj.onc.1200823] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
FGF-2 has been implicated in the neoplastic transformation of glioma cells and in the transition of normal quiescent astrocytes to a proliferating, reactive state. In the present study we have observed that in human glial cells, levels and subcellular localization of FGF-2 are different in quiescent and proliferating cells. FGF-2 was detected in the cytoplasm of non-reactive astrocytes in human brain sections. In contrast FGF-2 was located within the cytoplasm and nuclei of reactive astrocytes in gliotic brain tissue and in neoplastic cells of glioma tumors. In vitro, FGF-2 was found predominantly in the nucleus of subconfluent proliferating astrocytes, but was detected only in the cytoplasm of density arrested quiescent astrocytes. Our results suggest that reduced cell contact stimulates nuclear accumulation of FGF-2, accompanying mitotic activation of reactive human astrocytes. FGF-2 was constitutively localized to the nucleus of continuously proliferating glioma cells independent of cell density. A role for intracellular FGF-2 was further suggested by the observation that glioma cells that are not stimulated to proliferate by extracellular FGF-2 proliferated faster when transfected with FGF-2 expressing vectors. This increased proliferation correlated with nuclear accumulation of FGF-2. Cell proliferation was attenuated by 5'-deoxy-5'-methylthioadenosine, a FGF-2 receptor tyrosine kinase inhibitor that acts within the cell, but was unaffected by myo-inositol hexakis [dihydrogen phosphate] that disrupts FGF-2 binding to plasma membrane receptors. Our results indicate that FGF-2 serves as a nuclear regulator of proliferation in astrocytic cells. In glioma cells, the constitutive presence of FGF-2 in the nucleus may promote proliferation that is insensitive to cell contact inhibition.
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Affiliation(s)
- A Joy
- Barrow Neurological Institute, Phoenix, Arizona 85013, USA
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Coons S. Catholic schools serving disadvantaged students. Future Child 1997; 7:140-144. [PMID: 10892473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Belanich M, Pastor M, Randall T, Guerra D, Kibitel J, Alas L, Li B, Citron M, Wasserman P, White A, Eyre H, Jaeckle K, Schulman S, Rector D, Prados M, Coons S, Shapiro W, Yarosh D. Retrospective study of the correlation between the DNA repair protein alkyltransferase and survival of brain tumor patients treated with carmustine. Cancer Res 1996; 56:783-8. [PMID: 8631014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We tested the hypothesis that the level of the DNA repair protein O6-alkylguanine-DNA alkyltransferase in brain tumors was correlated with resistance to carmustine (BCNU) chemotherapy. Alkyltransferase levels in individual cells in sections from 167 primary brain tumors treated with BCNU were quantitated with an immunofluorescence assay using monoclonal antibodies against human alkyltransferase. Patients with high levels of alkyltransferase had shorter time to treatment failure (P = 0.05) and death (P = 0.004) and a death rate 1.7 times greater than patients with low alkyltransferase levels. Furthermore, the size of the subpopulation of cells with high levels of alkyltransferase was correlated directly with drug resistance. For all tumors the variables most closely correlated with survival, in order of importance, were age, tumor grade, and alkyltransferase levels. For glioblastoma multiforme, survival was more strongly correlated with alkyltransferase levels than with age. These results should encourage prospective studies to evaluate alkyltransferase levels as a method, for identifying brain tumor patients with the best likelihood of response to BCNU chemotherapy.
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Affiliation(s)
- M Belanich
- Applied Genetics Inc., Freeport, New York 11520, USA
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Abstract
STUDY DESIGN The anatomy of baboon and human cervical spines were compared by measuring adult, cadaveric specimens. OBJECTIVE The objective of the study was to compare human and baboon cervical motion segments to determine whether the baboon provides a suitable model for spinal research. SUMMARY OF BACKGROUND DATA Several studies have examined the quantitative anatomy of the human cervical bones and ligaments. Several animal species have been used for cervical spine research; however, no studies have validated whether the animal models resemble the human cervical spine closely enough to provide generalizable data. METHODS Multiple morphologic parameters were measured directly from nine baboon and six human adult cadaveric cervical spine specimens. The bone structure and geometry of each of the seven cervical vertebrae were analyzed; the structure and histology of the ligaments were measured; and histomorphometry of the vertebrae was performed. RESULTS The architectural composition and geometry of individual cervical vertebrae of baboons and humans were similar at each level. The proportional relationship of bone and ligament structures in the two species was almost identical. There were, however, several differences: 1) The baboon spine was about half the size of the human spine; 2) its vertebral arteries were encased fully within the C1 lateral mass; 3) its uncovertebral joints were more prominent; 4) its vertebral endplates were more concave; 5) its pedicles were thinner; 6) its transverse processes were longer; and 7) its spinous processes were horizontal and nonbifid. CONCLUSIONS The geometry and anatomy of the baboon cervical spine closely resemble that of the human cervical spine. It therefore provides an excellent model for in vivo and in vitro research.
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Affiliation(s)
- T Tominaga
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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Dickman CA, Crawford NR, Tominaga T, Brantley AG, Coons S, Sonntag VK. Morphology and kinematics of the baboon upper cervical spine. A model of the atlantoaxial complex. Spine (Phila Pa 1976) 1994; 19:2518-23. [PMID: 7855675 DOI: 10.1097/00007632-199411001-00005] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Quantitative and qualitative analyses were performed to compare the anatomy and biomechanics of baboon and human upper cervical spines. OBJECTIVES This study examined the baboon as a potential model for in vivo and in vitro atlantoaxial research. SUMMARY OF BACKGROUND DATA A variety of animal models have been used for spine research; however, no species have been used for C1-C2 research. Most species have remarkably different C1-C2 morphology compared with that of humans. METHODS Twenty baboon and seven human normal adult cadaveric upper cervical spines were studied morphologically. C1-C2 motion segments were analyzed biomechanically using a flexibility method of testing with physiologic range, nondestructive loading. Motion and load-deformation relationships were studied during flexion, extension, bilateral lateral bending, and bilateral axial rotation. RESULTS The bones and ligaments of the baboon and human upper cervical vertebrae have similarly proportioned structures, identical individual components, and similar geometric configurations. The average size of the baboon vertebrae was 50% to 60% of the human specimens. There were several minor anatomical differences. Baboons had more horizontal C2-C3 facet joints and more vertical C1-C2 articular surfaces; the vertebral arteries were encased in a continuous bony canal in C1. Biomechanical testing demonstrated that baboons and humans had similarly proportioned neutral zones and elastic zones. Compared with humans, baboons had a 2 degrees to 9 degrees wider range of motion in all directions. CONCLUSIONS The baboon and human upper cervical anatomy and biomechanics are similar. The baboon may be useful to study atlantoaxial biomechanics and pathology.
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Affiliation(s)
- C A Dickman
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Abstract
Analysis of MR signal characteristics and histopathologic findings confirms the strong correlation between meningioma subtype and observed signal intensity (SI) changes in 24 patients imaged at 1.5 T. On T2-weighted images, 90% of fibroblastic and transitional tumors were hypointense relative to cerebral cortex (SI intermediate greater than SI T2-weighted images); conversely, 66% of meningothelial subtypes displayed persistent hyperintensity (SI intermediate less than or equal to SI T2-weighted images), and the remaining one-third demonstrated mixed high-signal changes. Subtype specific differences in collagen distribution and cellularity, i.e., tumor geometry, appeared to account for these signal trends. Based solely on SI characteristics, correct histologic subgrouping of tumors as either fibroblastic/transitional or meningothelial/angioblastic was possible in 80% (19 of 24) of patients. Utilization of adjunctive imaging features (i.e., mass effect, peritumoral edema, intratumoral cyst formation) in conjunction with signal changes permitted a correct histologic pattern in 96% (23 of 24) of patients.
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Affiliation(s)
- R D Kaplan
- Division of Neuroradiology, Barrow Neurological Institute, Phoenix, AZ 85013
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Coons S, Johnson PC, Haskett DR. DNA CONTENT OF OLIGODENDROGLIOMAS. CORRELATION WITH OUTCOME, HISTOLOGY, AND CLINICAL VARIABLES. J Neuropathol Exp Neurol 1990. [DOI: 10.1097/00005072-199005000-00187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Coons S, Johnson PC, Dickman CA, Rekate H. Choroid plexus carcinoma in siblings: a study by light and electron microscopy with Ki-67 immunocytochemistry. J Neuropathol Exp Neurol 1989; 48:483-93. [PMID: 2732756 DOI: 10.1097/00005072-198907000-00008] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Choroid plexus carcinomas in siblings aged 11 months and 10 years were examined by light microscopy and immunocytochemistry. One case was studied by electron microscopy. Choroid plexus carcinoma is rare, with approximately 24 reported cases in children. Predicting the behavior of choroid plexus tumors from the histology can be difficult. Neither mitoses nor necrosis were seen in one case, but evaluation of proliferation using Ki-67 monoclonal antibody showed 9% of the cells to be in proliferative phases of the cell cycle, a high value for a glial-derived neoplasm. Ki-67 activity may be a more sensitive measure of proliferation in malignant choroid plexus tumors than the presence of mitoses and necrosis, and additional studies may establish its role in distinguishing between choroid plexus carcinoma and papilloma when histologic classification is equivocal. Both tumors were immunoreactive for keratin, which confirmed previous studies. Both were nonreactive for glial fibrillary acidic protein, S-100, and carcinoembryonic antigen (CEA), unlike a previous study which reported that choroid plexus carcinoma, compared to papilloma, was uniquely S-100-negative and CEA-positive. Choroid plexus carcinoma in siblings has not been reported. Chance occurrence in siblings is extremely unlikely; thus a genetic basis for the neoplasms is likely, although environmental influences cannot be excluded.
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Affiliation(s)
- S Coons
- Division of Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013
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