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Bytowska ZK, Korewo-Labelle D, Kowalski K, Libionka W, Przewłócka K, Kloc W, Kaczor JJ. Impact of 12 Weeks of Vitamin D 3 Administration in Parkinson's Patients with Deep Brain Stimulation on Kynurenine Pathway and Inflammatory Status. Nutrients 2023; 15:3839. [PMID: 37686871 PMCID: PMC10490466 DOI: 10.3390/nu15173839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
The current study aimed to investigate whether a 12-week Body Mass Index (BMI)-based (the higher the BMI, the higher the dosage) vitamin D3 administration may affect both the kynurenine pathway (KP) and the inflammatory state in Parkinson's disease (PD) patients with deep brain stimulation (DBS) and may be useful for developing novel therapeutic targets against PD. Patients were randomly assigned to two groups: supplemented with vitamin D3 (VitD, n = 15) and treated with vegetable oil (PL, n = 21). Administration lasted for 12 weeks. The isotope dilution method by LC-MS/MS was applied to measure KP and vitamin D metabolites. Serum concentrations of cytokines such as IL-6 and TNF-α were measured using ELISA kits. After administration, the serum concentration of TNF-α decreased in PD patients with DBS. Moreover, in KP: 3-hydroksykynurenine (3-HK) was increased in the PL group, picolinic acid was decreased in the PL group, and kynurenic acid tended to be higher after administration. Furthermore, a negative correlation between 3-HK and 25(OH)D3 and 24,25(OH)2D3 was noticed. Our preliminary results provide further evidence regarding a key link between the KP substances, inflammation status, and metabolites of vitamin D in PD patients with DBS. These findings may reflect the neuroprotective abilities of vitamin D3 in PD patients with DBS.
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Affiliation(s)
- Zofia Kinga Bytowska
- Division of Bioenergetics and Physiology of Exercise, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland; (Z.K.B.); (K.P.)
| | - Daria Korewo-Labelle
- Department of Physiology, Faculty of Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Konrad Kowalski
- Masdiag-Diagnostic Mass Spectrometry Laboratory, Stefana Żeromskiego 33, 01-882 Warsaw, Poland;
| | - Witold Libionka
- Department of Neurosurgery, University Clinical Centre in Gdansk, 80-952 Gdansk, Poland;
| | - Katarzyna Przewłócka
- Division of Bioenergetics and Physiology of Exercise, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland; (Z.K.B.); (K.P.)
| | - Wojciech Kloc
- Department of Neurosurgery, Copernicus Medical Center, 80-803 Gdansk, Poland;
- Department of Psychology and Sociology of Health and Public Health, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Jan Jacek Kaczor
- Department of Animal and Human Physiology, Faculty of Biology, University of Gdansk, 80-309 Gdansk, Poland
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Gielniewski B, Poleszak K, Roura AJ, Szadkowska P, Jacek K, Krol SK, Guzik R, Wiechecka P, Maleszewska M, Kaza B, Marchel A, Czernicki T, Koziarski A, Zielinski G, Styk A, Kawecki M, Szczylik C, Czepko R, Banach M, Kaspera W, Szopa W, Bujko M, Czapski B, Zabek M, Iżycka-Świeszewska E, Kloc W, Nauman P, Cieslewicz J, Grajkowska W, Morosini N, Noushmehr H, Wojtas B, Kaminska B. Targeted sequencing of cancer-related genes reveals a recurrent TOP2A variant which affects DNA binding and coincides with global transcriptional changes in glioblastoma. Int J Cancer 2023. [PMID: 37338006 DOI: 10.1002/ijc.34631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/28/2023] [Accepted: 05/08/2023] [Indexed: 06/21/2023]
Abstract
High-grade gliomas are aggressive, deadly primary brain tumors. Median survival of patients with glioblastoma (GBM, WHO grade 4) is 14 months and <10% of patients survive 2 years. Despite improved surgical strategies and forceful radiotherapy and chemotherapy, the prognosis of GBM patients is poor and did not improve over decades. We performed targeted next-generation sequencing with a custom panel of 664 cancer- and epigenetics-related genes, and searched for somatic and germline variants in 180 gliomas of different WHO grades. Herein, we focus on 135 GBM IDH-wild type samples. In parallel, mRNA sequencing was accomplished to detect transcriptomic abnormalities. We present the genomic alterations in high-grade gliomas and the associated transcriptomic patterns. Computational analyses and biochemical assays showed the influence of TOP2A variants on enzyme activities. In 4/135 IDH-wild type GBMs we found a novel, recurrent mutation in the TOP2A gene encoding topoisomerase 2A (allele frequency [AF] = 0.03, 4/135 samples). Biochemical assays with recombinant, wild type (WT) and variant proteins demonstrated stronger DNA binding and relaxation activity of the variant protein. GBM patients carrying the altered TOP2A had shorter overall survival (median OS 150 vs 500 days, P = .0018). In the GBMs with the TOP2A variant we found transcriptomic alterations consistent with splicing dysregulation. luA novel, recurrent TOP2A mutation, which was found exclusively in four GBMs, results in the TOP2A E948Q variant with altered DNA binding and relaxation activities. The deleterious TOP2A mutation resulting in transcription deregulation in GBMs may contribute to disease pathology.
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Affiliation(s)
- Bartlomiej Gielniewski
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Katarzyna Poleszak
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Adria-Jaume Roura
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Paulina Szadkowska
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Karol Jacek
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Sylwia K Krol
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Rafal Guzik
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Paulina Wiechecka
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Marta Maleszewska
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Beata Kaza
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Andrzej Marchel
- Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Czernicki
- Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Koziarski
- Department of Neurosurgery, Military Institute of Medicine, Warsaw, Poland
| | - Grzegorz Zielinski
- Department of Neurosurgery, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Styk
- Department of Neurosurgery, Military Institute of Medicine, Warsaw, Poland
| | - Maciej Kawecki
- Department of Oncology, Military Institute of Medicine, Warsaw, Poland
- The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Cezary Szczylik
- Department of Oncology, Military Institute of Medicine, Warsaw, Poland
| | - Ryszard Czepko
- Department of Neurosurgery, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Mariusz Banach
- Department of Neurosurgery, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Wojciech Kaspera
- Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland
| | - Wojciech Szopa
- Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland
| | - Mateusz Bujko
- The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Bartosz Czapski
- Department of Neurosurgery, Mazovian Brodnowski Hospital, Warsaw, Poland
| | - Miroslaw Zabek
- Department of Neurosurgery, Mazovian Brodnowski Hospital, Warsaw, Poland
- Department of Neurosurgery and Nervous System Trauma, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Wojciech Kloc
- Department of Neurosurgery, Copernicus PL, Gdansk, Poland
- Department of Psychology and Sociology of Health and Public Health School of Public Health Collegium Medicum, University of Warmia - Mazury, Olsztyn, Poland
| | - Pawel Nauman
- Institute of Psychiatry and Neurology, Warsaw, Poland
- Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Siedlce, Poland
| | - Joanna Cieslewicz
- Gdansk University of Technology, Faculty of Chemistry, Gdansk, Poland
| | - Wieslawa Grajkowska
- Department of Pathology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Natalia Morosini
- Department of Neurosurgery, Henry Ford Cancer Institute, Detroit, Michigan, USA
| | - Houtan Noushmehr
- Department of Neurosurgery, Henry Ford Cancer Institute, Detroit, Michigan, USA
| | - Bartosz Wojtas
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Bozena Kaminska
- Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
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Bytowska ZK, Korewo-Labelle D, Berezka P, Kowalski K, Przewłócka K, Libionka W, Kloc W, Kaczor JJ. Effect of 12-Week BMI-Based Vitamin D 3 Supplementation in Parkinson's Disease with Deep Brain Stimulation on Physical Performance, Inflammation, and Vitamin D Metabolites. Int J Mol Sci 2023; 24:10200. [PMID: 37373347 DOI: 10.3390/ijms241210200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease. To manage motor symptoms not controlled adequately with medication, deep brain stimulation (DBS) is used. PD patients often manifest vitamin D deficiency, which may be connected with a higher risk of falls. We administered a 12-week vitamin D3 supplementation based on BMI (with higher doses given to patients with higher BMI) to investigate its effects on physical performance and inflammation status in PD patients with DBS. Patients were randomly divided into two groups: treated with vitamin D3 (VitD, n = 13), and supplemented with vegetable oil as the placebo group (PL, n = 16). Patients underwent functional tests to assess their physical performance three times during this study. The serum 25(OH)D3 concentration increased to the recommended level of 30 ng/mL in the VitD group, and a significant elevation in vitamin D metabolites in this group was found. We observed significant improvement in the Up and Go and the 6 MWT in the VitD group. In inflammation status, we noticed a trend toward a decrease in the VitD group. To conclude, achieving the optimal serum 25(OH)D3 concentration is associated with better functional test performance and consequently may have a positive impact on reducing falling risk in PD.
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Affiliation(s)
- Zofia Kinga Bytowska
- Division of Bioenergetics and Physiology of Exercise, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Daria Korewo-Labelle
- Department of Physiology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Paweł Berezka
- Department of Animal and Human Physiology, Faculty of Biology, University of Gdansk, 80-309 Gdansk, Poland
| | - Konrad Kowalski
- Masdiag-Diagnostic Mass Spectrometry Laboratory, Stefana Żeromskiego 33, 01-882 Warsaw, Poland
| | - Katarzyna Przewłócka
- Division of Bioenergetics and Physiology of Exercise, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Witold Libionka
- Department of Neurosurgery, University Clinical Centre in Gdansk, 80-952 Gdansk, Poland
| | - Wojciech Kloc
- Department of Neurosurgery, Copernicus Medical Center, 80-803 Gdansk, Poland
- Department of Psychology and Sociology of Health and Public Health, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Jan Jacek Kaczor
- Department of Animal and Human Physiology, Faculty of Biology, University of Gdansk, 80-309 Gdansk, Poland
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Antkowiak L, Stogowski P, Klepinowski T, Balinski T, Mado H, Sumislawski P, Niedbala M, Rucinska M, Nowaczyk Z, Rogalska M, Kocur D, Kasperczuk A, Sordyl R, Kloc W, Kaspera W, Kammler G, Sagan L, Rudnik A, Tabakow P, Westphal M, Mandera M. External validation of the Chicago Chiari Outcome Scale in adults with Chiari malformation type I. Neurosurg Focus 2023; 54:E3. [PMID: 36857789 DOI: 10.3171/2022.12.focus22625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 10/30/2022] [Accepted: 12/29/2022] [Indexed: 03/03/2023]
Abstract
OBJECTIVE The Chicago Chiari Outcome Scale (CCOS) serves as a standardized clinical outcome evaluation tool among patients with Chiari malformation type I (CM-I). While the reliability of this scale has been proven for pediatric patients, the literature lacks CCOS validation when used solely in adults. Therefore, this study aimed to determine the validity of the CCOS in an external cohort of adult patients. METHODS The authors retrospectively analyzed the medical records of symptomatic patients with CM-I who underwent posterior fossa decompression between 2010 and 2018 in six neurosurgical departments. Each patient was clinically assessed at the latest available follow-up. Gestalt outcome was determined as improved, unchanged, or worsened compared with the preoperative clinical state. Additionally, the CCOS score was calculated for each patient based on the detailed clinical data. To verify the ability of the CCOS to determine clinical improvement, the area under the receiver operating characteristic (AUROC) curve was evaluated. A logistic regression analysis using all four components of the CCOS (pain symptoms, nonpain symptoms, functionality, and complications) was performed to establish predictors of the improved outcome. RESULTS Seventy-five individuals with a mean age of 42 ± 15.32 years were included in the study. The mean follow-up duration was 52 ± 33.83 months. Considering gestalt outcome evaluation, 41 patients (54.7%) were classified as improved, 24 (32%) as unchanged, and 10 (13.3%) as worsened. All patients with a CCOS score of 14 or higher improved, while all those with a CCOS score of 8 or lower worsened. The AUROC was 0.986, suggesting almost perfect accuracy of the CCOS in delineating clinical improvement. A CCOS score of 13 showed high sensitivity (0.93) and specificity (0.97) for identifying patients with clinical improvement. Additionally, a meaningful correlation was found between higher CCOS scores in each component and better outcomes. Patient stratification by total CCOS score showed that those categorized as improved, unchanged, and worsened scored prevalently between 13 and 16 points, 10 and 12 points, and 4 and 9 points, respectively. CONCLUSIONS In this adult cohort, the CCOS was found to be almost perfectly accurate in reflecting postoperative clinical improvement. Moreover, all four CCOS components (pain symptoms, nonpain symptoms, functionality, and complications) significantly correlated with patient clinical outcomes.
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Affiliation(s)
- Lukasz Antkowiak
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Piotr Stogowski
- 2Department of Neurosurgery, Copernicus Medical Center, Gdansk, Poland
| | - Tomasz Klepinowski
- 3Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
| | - Tristan Balinski
- 4Department of Neurosurgery, Wroclaw Medical University, Wroclaw, Poland
| | - Hubert Mado
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Piotr Sumislawski
- 5Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcin Niedbala
- 6Department of Neurosurgery, Medical University of Silesia in Katowice, Regional Hospital, Sosnowiec, Poland
| | - Michalina Rucinska
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Zuzanna Nowaczyk
- 3Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
| | - Marta Rogalska
- 7Faculty of Medicine, Medical University of Warsaw, Poland
| | - Damian Kocur
- 8Department of Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Anna Kasperczuk
- 9Faculty of Mechanical Engineering, Institute of Biomedical Engineering, Bialystok University of Technology, Bialystok, Poland
| | - Ryszard Sordyl
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Wojciech Kloc
- 2Department of Neurosurgery, Copernicus Medical Center, Gdansk, Poland.,10Department of Psychology and Sociology of Health and Public Health, School of Public Health, Collegium Medicum, University of Warmia-Mazury in Olsztyn, Poland; and
| | - Wojciech Kaspera
- 6Department of Neurosurgery, Medical University of Silesia in Katowice, Regional Hospital, Sosnowiec, Poland
| | - Gertrud Kammler
- 5Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leszek Sagan
- 3Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland.,11Department of Pediatric Neurosurgery, Zdroje Hospital, Szczecin, Poland
| | - Adam Rudnik
- 8Department of Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Pawel Tabakow
- 4Department of Neurosurgery, Wroclaw Medical University, Wroclaw, Poland
| | - Manfred Westphal
- 5Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marek Mandera
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
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Antkowiak L, Rogalska M, Stogowski P, Bruzzaniti P, Familiari P, Rybaczek M, Klepinowski T, Grzyb W, Zimny M, Weclewicz M, Kasperczuk A, Kloc W, Rudnik A, Sagan L, Lyson T, Mariak Z, Santoro A, Mandera M. External validation of the Ruptured Arteriovenous Malformation Grading Scale (RAGS) in a multicenter adult cohort. Acta Neurochir (Wien) 2022; 165:975-981. [PMID: 36473981 PMCID: PMC10068653 DOI: 10.1007/s00701-022-05433-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022]
Abstract
Abstract
Purpose
While Ruptured Arteriovenous Malformation Grading Scale (RAGS) has recently been validated in children, the literature lacks validation on adults exclusively. Therefore, we aimed to determine the validity of RAGS on the external multicenter adult cohort and compare its accuracy with other scales.
Methods
A retrospective analysis was performed in five neurosurgical departments to extract patients who presented with the first episode of acute brain arteriovenous malformation (bAVM) rupture between 2012 and 2019. Standard logistic regression and area under the receiver operating curve (AUROC) calculations were performed to determine the value of the following scales: intracerebral hemorrhage (ICH), AVM-associated ICH (AVICH), Spetzler-Martin (SM), Supplemented SM (Supp-SM), Hunt and Hess (HH), Glasgow Coma Scale (GCS), World Federation of Neurological Surgeons (WFNS), and RAGS to predict change in categorical and dichotomized modified Rankin Scale (mRS) across three follow-up periods: within the 6 months, 6 months to 1 year, and above 1 year.
Results
Sixty-one individuals with a mean age of 43.6 years were included. The RAGS outperformed other grading scales during all follow-up time frames. It showed AUROC of 0.78, 0.74, and 0.71 at the first 6 months, between 6 and 12 months, and after 12 months of follow-up, respectively, when categorized mRS was applied, while corresponding values were 0.79, 0.76, and 0.73 for dichotomized mRS, respectively.
Conclusion
The RAGS constitutes a reliable scale predicting clinical outcomes following bAVM rupture among adults. Furthermore, the RAGS proved its generalizability across medical centers with varying treatment preferences.
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Sierpowska J, Rofes A, Dahlslätt K, Mandonnet E, ter Laan M, Połczyńska M, Hamer PDW, Halaj M, Spena G, Meling TR, Motomura K, Reyes AF, Campos AR, Robe PA, Zigiotto L, Sarubbo S, Freyschlag CF, Broen MPG, Stranjalis G, Papadopoulos K, Liouta E, Rutten GJ, Viegas CP, Silvestre A, Perrote F, Brochero N, Cáceres C, Zdun-Ryżewska A, Kloc W, Satoer D, Dragoy O, Hendriks MPH, Alvarez-Carriles JC, Piai V. The Aftercare Survey: Assessment and intervention practices after brain tumor surgery in Europe. Neurooncol Pract 2022; 9:328-337. [PMID: 35855456 PMCID: PMC9290892 DOI: 10.1093/nop/npac029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background People with gliomas need specialized neurosurgical, neuro-oncological, psycho-oncological, and neuropsychological care. The role of language and cognitive recovery and rehabilitation in patients' well-being and resumption of work is crucial, but there are no clear guidelines for the ideal timing and character of assessments and interventions. The goal of the present work was to describe representative (neuro)psychological practices implemented after brain surgery in Europe. Methods An online survey was addressed to professionals working with individuals after brain surgery. We inquired about the assessments and interventions and the involvement of caregivers. Additionally, we asked about recommendations for an ideal assessment and intervention plan. Results Thirty-eight European centers completed the survey. Thirty of them offered at least one postsurgical (neuro)psychological assessment, mainly for language and cognition, especially during the early recovery stage and at long term. Twenty-eight of the participating centers offered postsurgical therapies. Patients who stand the highest chances of being included in evaluation and therapy postsurgically are those who underwent awake brain surgery, harbored a low-grade glioma, or showed poor recovery. Nearly half of the respondents offer support programs to caregivers, and all teams recommend them. Treatments differed between those offered to individuals with low-grade glioma vs those with high-grade glioma. The figure of caregiver is not yet fully recognized in the recovery phase. Conclusion We stress the need for more complete rehabilitation plans, including the emotional and health-related aspects of recovery. In respondents' opinions, assessment and rehabilitation plans should also be individually tailored and goal-directed (eg, professional reinsertion).
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Affiliation(s)
- Joanna Sierpowska
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Medical Psychology, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Adrià Rofes
- Department of Neurolinguistics, University of Groningen, Groningen, the Netherlands
| | | | | | - Mark ter Laan
- Department of Neurosurgery, Radboud Institute of Health Science, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Monika Połczyńska
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | | | - Matej Halaj
- Department of Neurosurgery, University Hospital Olomouc, Olomouc, Czech Republic
| | | | - Torstein R Meling
- Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland
| | - Kazuya Motomura
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Andrés Felipe Reyes
- Experimental Psychology Lab, Faculty of Psychology, Universidad El Bosque, Bogotá, Colombia
- Graduate School for the Humanities (GSH), University of Groningen, Groningen, the Netherlands
| | - Alexandre Rainha Campos
- Department of Neurosurgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Pierre A Robe
- Department of Neurology and Neurosurgery, University Medical Center of Utrecht, Utrecht, the Netherlands
| | - Luca Zigiotto
- Department of Neurosurgery, “S. Chiara” Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, “S. Chiara” Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, “S. Chiara” Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
- Structural and Functional Connectivity Lab Project, “S. Chiara” Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | | | - Martijn P G Broen
- Department of Neurology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - George Stranjalis
- Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
| | - Konstantinos Papadopoulos
- Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
| | - Evangelia Liouta
- Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
| | - Geert-Jan Rutten
- Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | | | - Ana Silvestre
- Department of Neurosurgery, Hospital Garcia de Orta, Lisbon, Portugal
| | - Federico Perrote
- Department of Neurosurgery and Neurology, Private University Hospital of Córdoba, Córdoba, Argentina
| | - Natacha Brochero
- Department of Neurosurgery and Neurology, Private University Hospital of Córdoba, Córdoba, Argentina
| | - Cynthia Cáceres
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Agata Zdun-Ryżewska
- Department of Quality-of-Life Research, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Kloc
- Department of Psychology and Sociology of Health and Public Health School of Public Health Collegium Medicum, University of Warmia—Mazury in Olsztyn, Olsztyn, Poland
- Department of Neurosurgery, Copernicus PL, Gdansk, Poland
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus MC—University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Olga Dragoy
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Marc P H Hendriks
- Academic Centre for Epileptology, Kempenhaeghe, Heeze, the Netherlands
- Department of Neurosurgery, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Juan C Alvarez-Carriles
- Clinical Neuropsychology Unit, Liaison Mental Health Service, Hospital Universitario Central de Asturias, Oviedo, Spain
- Department of Psychology, University of Oviedo, Oviedo, Spain
- ISPA, Health Research Institute of Principado de Asturias, Oviedo, Spain
| | - Vitória Piai
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Medical Psychology, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
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Stogowski P, Antkowiak L, Trzciński R, Rogalska M, Dułak N, Anuszkiewicz K, Kloc W. Content quality and audience engagement analysis of online videos for anterior lumbar interbody fusion. World Neurosurg 2022; 160:e636-e642. [DOI: 10.1016/j.wneu.2022.01.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/30/2022]
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8
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Skrobot W, Perzanowska E, Krasowska K, Flis DJ, Dzik KP, Kloc W, Kaczor JJ, Antosiewicz J. Vitamin D Supplementation Improves the Effects of the Rehabilitation Program on Balance and Pressure Distribution in Patients after Anterior Cervical Interbody Fusion-Randomized Control Trial. Nutrients 2020; 12:nu12123874. [PMID: 33352920 PMCID: PMC7766157 DOI: 10.3390/nu12123874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/07/2020] [Accepted: 12/13/2020] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN A double-blinded, randomized controlled trial. BACKGROUND Surgery is effective in reducing pain intensity in patients with cervical disc disease. However, functional measurements demonstrated that the results have been not satisfactory enough. Thus, rehabilitation programs combined with the supplementation of vitamin D could play an essential role. METHODS The study recruited 30 patients, aged 20 to 70 years, selected for anterior cervical interbody fusion (ACIF). The patients were randomly divided into the placebo (Pl) and vitamin D (3200 IU D3/day) supplemented groups. The functional tests limits of stability (LOS), risk of falls (RFT), postural stability (PST), Romberg test, and foot pressure distribution were performed before supplementation (BS-week 0), five weeks after supplementation (AS-week 5), four weeks after surgery (BSVR-week 9), and 10 weeks after supervising rehabilitation (ASVR-week 19). RESULTS The concentration of 25(OH)D3 in the serum, after five weeks of supplementation, was significantly increased, while the Pl group maintained the same. The RFT was significantly reduced after five weeks of vitamin D supplementation. Moreover, a further significant decrease was observed following rehabilitation. In the Pl group, no changes in the RFT were observed. The overall postural stability index (OSI), LOS, and the outcomes of the Romberg test significantly improved in both groups; however, the effects on the OSI were more pronounced in the D3 group at the end of the rehabilitation program. CONCLUSIONS Our data suggest that vitamin D supplementation positively affected the rehabilitation program in patients implemented four weeks after ACIF by reducing the risk of falls and improving postural stability.
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Affiliation(s)
- Wojciech Skrobot
- Department of Functional Diagnostics and Kinesiology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (E.P.); (K.K.)
- Correspondence: (W.S.); (J.A.)
| | - Ewelina Perzanowska
- Department of Functional Diagnostics and Kinesiology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (E.P.); (K.K.)
| | - Katarzyna Krasowska
- Department of Functional Diagnostics and Kinesiology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (E.P.); (K.K.)
| | - Damian J. Flis
- Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (D.J.F.); (K.P.D.); (J.J.K.)
| | - Katarzyna P. Dzik
- Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (D.J.F.); (K.P.D.); (J.J.K.)
| | - Wojciech Kloc
- Department of Neurosurgery, Copernicus Hospital, 80-803 Gdansk, Poland;
- Department of Neurology and Neurosurgery, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Jan Jacek Kaczor
- Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (D.J.F.); (K.P.D.); (J.J.K.)
| | - Jędrzej Antosiewicz
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdansk, 80-211 Gdansk, Poland
- Correspondence: (W.S.); (J.A.)
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Gannon V, Albright T, Wells T, Cahak C, Harrington AM, Buchan B, Ledeboer N, Kloc W. Error Reduction in Specimen Processing of Irretrievable Body Fluids. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.285] [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: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
A lack of standardized processes for laboratory handling of irretrievable body fluid specimens, such as cerebrospinal fluid, serous fluids, synovial fluids, and aspirates, can result in failures that put the patient at risk by delaying testing results and/or requiring specimen recollection. We noted increased patient safety issues with irretrievable specimens in our laboratory and implemented a process improvement plan to mitigate patient harm.
Herein, we report our findings of this intervention.
Methods
A task force was organized with wide representation across the laboratory to design a new workflow for irretrievable specimens. Hospital Patient Safety Reporting data was used to identify flaws in the pre-analytical processes pre-intervention and to monitor effectiveness of process change, post-intervention. Our intervention consisted of developing a standardized pre-analytical process for both technical and non-technical staff that could be enforced through consistent and proper training, with well-defined responsibilities for each department involved including specimen processing, microbiology, hematology, and chemistry. Our process included a centralized sterile processing location within the Micro department as well as a standardized sample log in and sample distribution process that incorporated a chain of custody form.
Results
Pre-intervention, we had 23 patient safety reports during a 3-month period (5-10/month; average 8/month) on irretrievable specimens; post-intervention, we had 9 patient safety reports over a 5-month period (0-4/month; average 2/month). Pre-intervention, failures identified included inconsistent workflows and training among staff, the absence of established protocols, and inadequate communication. Post-intervention, failures were noted due to improper and inconsistent training (n=4) or deviation from the established procedure by staff members. These failures were investigated and addressed through retraining or corrective actions as needed.
Conclusion
Our data shows that the implementation of a standardized process within the laboratory significantly decreases patient safety events by improving testing turn-around-times and quality of results and by preventing the need for specimen recollections.
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Affiliation(s)
- V Gannon
- Hematology, Wisconsin Diagnostic Laboratories, Cedar Grove, Wisconsin, UNITED STATES
| | - T Albright
- Hematology, Wisconsin Diagnostic Laboratories, Cedar Grove, Wisconsin, UNITED STATES
| | - T Wells
- Laboratory Quality, Wisconsin Diagnostic Laboratories, Milwaukee, Wisconsin, UNITED STATES
| | - C Cahak
- Microbiology, Wisconsin Diagnostic Laboratories, Milwaukee, Wisconsin, UNITED STATES
| | - A M Harrington
- Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, UNITED STATES
| | - B Buchan
- Microbiology, Medical College of Wisconsin, Milwaukee, Wisconsin, UNITED STATES
| | - N Ledeboer
- Microbiology, Medical College of Wisconsin, Milwaukee, Wisconsin, UNITED STATES
| | - W Kloc
- Pre-Analytical Services, Wisconsin Diagnostic Laboratories, Milwaukee, Wisconsin, UNITED STATES
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10
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Krasowska K, Skrobot W, Liedtke E, Sawicki P, Flis DJ, Dzik KP, Libionka W, Kloc W, Kaczor JJ. The Preoperative Supplementation With Vitamin D Attenuated Pain Intensity and Reduced the Level of Pro-inflammatory Markers in Patients After Posterior Lumbar Interbody Fusion. Front Pharmacol 2019; 10:527. [PMID: 31191300 PMCID: PMC6539202 DOI: 10.3389/fphar.2019.00527] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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] [Received: 01/28/2019] [Accepted: 04/26/2019] [Indexed: 12/17/2022] Open
Abstract
The aim of this experimental study was to assess whether 5 weeks of preoperative supplementation with vitamin D affects the intensity of pain and the level of inflammatory markers in patients undergoing posterior lumbar interbody fusion (PLIF) followed by rehabilitation. 42 patients were divided, by double-blind randomization, into two groups: supplemented (SUPL) vitamin D (3200 IU dose of vitamin D/day for 5 weeks) and placebo group (PL) treated with vegetable oil. The 10-week program of early rehabilitation (3 times a week) was initiated 4 weeks following PLIF. Measurements of serum 25(OH)D3 and CRP, IL-6, TNF-α, and IL-10 were performed. Pain intensity was measured using VAS. After supplementation with vitamin D serum, the concentration of 25(OH)D3 significantly increased in the SUPL group (∗ p < 0.005) and was significantly higher as compared to the PL group (∗ p < 0.001). A significant reduction in pain intensity was observed 4 weeks after surgery and after rehabilitation in both groups. In the SUPL group, serum CRP and IL-6 concentration significantly decreased after rehabilitation, compared with the postsurgical level (a p < 0.04). The level of TNF-α was significantly lower after rehabilitation only in the supplemented group (∗ p < 0.02). There were no significant changes in the IL-10 level in both groups during the study. Our data indicate that supplementation with vitamin D may reduce systemic inflammation and when combined with surgery and early postsurgical rehabilitation, it may decrease the intensity of pain in LBP patients undergoing PLIF. Data indicate that LBP patients undergoing spine surgery should use vitamin D perioperatively as a supplement.
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Affiliation(s)
- Katarzyna Krasowska
- Department of Kinesiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Wojciech Skrobot
- Department of Kinesiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Ewelina Liedtke
- Department of Kinesiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Piotr Sawicki
- Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Damian Jozef Flis
- Department of Bioenergetics and Nutrition, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Katarzyna Patrycja Dzik
- Department of Neurobiology of Muscle, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Witold Libionka
- Department of Neurobiology of Muscle, Gdansk University of Physical Education and Sport, Gdańsk, Poland
- Department of Neurosurgery, Copernicus Hospital Gdansk, Gdańsk, Poland
| | - Wojciech Kloc
- Department of Neurosurgery, Copernicus Hospital Gdansk, Gdańsk, Poland
- Department of Neurology and Neurosurgery, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Jan Jacek Kaczor
- Department of Neurobiology of Muscle, Gdansk University of Physical Education and Sport, Gdańsk, Poland
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Chojnacka-Szawłowska G, Kloc W, Zdun-Ryżewska A, Basiński K, Majkowicz M, Leppert W, Kurlandt P, Libionka W. Impact of Different Illness Perceptions and Emotions Associated with Chronic Back Pain on Anxiety and Depression in Patients Qualified for Surgery. Pain Manag Nurs 2019; 20:599-603. [PMID: 31103510 DOI: 10.1016/j.pmn.2019.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/22/2018] [Accepted: 02/23/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Anxiety and depression are known comorbidities of chronic back pain. Their psychological predictors are not well established in patients with chronic back pain qualified for neurosurgery. AIMS The purpose of this study was to determine the psychological predictors of depression and anxiety in patients with chronic back pain qualified for surgery. DESIGN This was a cross-sectional study. SETTINGS A neurosurgical ward in Gdańsk, Poland. PARTICIPANTS/SUBJECTS All patients who were admitted to the neurosurgical ward and met the inclusion criteria were recruited for the study. Finally, 83 patients with chronic back pain waiting for surgery were recruited. METHODS A battery of questionnaires, including Illness Perceptions Questionnaire-Revised, Multidimensional Health Locus of Control Scale, Hospital Anxiety and Depression Scale, and Brief Pain Inventory, was used in 83 spinal surgery candidates. RESULTS Higher anxiety was predicted by stronger beliefs about negative consequences of illness (β = .205, p < .05), worse illness coherence (β = .204, p < .05), negative emotional representations of illness (β = .216, p < .05), and depression (β = .686, p < .001). Higher depression was predicted by anxiety (β = .601, p < .001), pain interference (β = .323, p < .01), lower personal control over pain (β = -.160, p < .05), and lower external control of health (β = -.161, p < .05) but, surprisingly, higher internal control of health (β = .208, p < .01). CONCLUSIONS Anxiety and depression commonly coexist in chronic back pain sufferers qualified for spine surgery but are derived from dissimilar beliefs. The results highlight the usefulness of advising about the disease and treatment in comprehensive care for this group of patients.
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Affiliation(s)
| | - Wojciech Kloc
- Department of Neurosurgery, Copernicus Hospital, Gdańsk, Poland; Department of Neurology and Neurosurgery, University of Warmia and Mazury, Olsztyn, Poland
| | - Agata Zdun-Ryżewska
- Department of Quality of Life Research, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Basiński
- Department of Quality of Life Research, Medical University of Gdańsk, Gdańsk, Poland.
| | - Mikołaj Majkowicz
- Institute of Health Sciences, Pomeranian Academy in Słupsk, Słupsk, Poland
| | - Wojciech Leppert
- Department of Palliative Medicine, Poznań University of Medical Sciences, Poznań, Poland
| | - Patryk Kurlandt
- Department of Neurosurgery, Copernicus Hospital, Gdańsk, Poland
| | - Witold Libionka
- Department of Neurosurgery, Copernicus Hospital, Gdańsk, Poland; University of Physical Education and Sport, Gdańsk, Poland
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12
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Gril B, Paranjape AN, Woditschka S, Hua E, Dolan EL, Hanson J, Wu X, Kloc W, Izycka-Swieszewska E, Duchnowska R, Pęksa R, Biernat W, Jassem J, Nayyar N, Brastianos PK, Hall OM, Peer CJ, Figg WD, Pauly GT, Robinson C, Difilippantonio S, Bialecki E, Metellus P, Schneider JP, Steeg PS. Reactive astrocytic S1P3 signaling modulates the blood-tumor barrier in brain metastases. Nat Commun 2018; 9:2705. [PMID: 30006619 PMCID: PMC6045677 DOI: 10.1038/s41467-018-05030-w] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 06/07/2018] [Indexed: 02/08/2023] Open
Abstract
Brain metastases are devastating complications of cancer. The blood-brain barrier (BBB), which protects the normal brain, morphs into an inadequately characterized blood-tumor barrier (BTB) when brain metastases form, and is surrounded by a neuroinflammatory response. These structures contribute to poor therapeutic efficacy by limiting drug uptake. Here, we report that experimental breast cancer brain metastases of low- and high permeability to a dextran dye exhibit distinct microenvironmental gene expression patterns. Astrocytic sphingosine-1 phosphate receptor 3 (S1P3) is upregulated in the neuroinflammatory response of the highly permeable lesions, and is expressed in patients' brain metastases. S1P3 inhibition functionally tightens the BTB in vitro and in vivo. S1P3 mediates its effects on BTB permeability through astrocytic secretion of IL-6 and CCL2, which relaxes endothelial cell adhesion. Tumor cell overexpression of S1P3 mimics this pathway, enhancing IL-6 and CCL-2 production and elevating BTB permeability. In conclusion, neuroinflammatory astrocytic S1P3 modulates BTB permeability.
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Affiliation(s)
- Brunilde Gril
- Women's Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA.
| | | | - Stephan Woditschka
- Women's Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA
- Department of Biology and Marine Biology, University of North Carolina at Wilmington, 601 South College Road, Wilmington, NC, 28403, USA
| | - Emily Hua
- Women's Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA
| | - Emma L Dolan
- Women's Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA
| | - Jeffrey Hanson
- Laboratory of Pathology, CCR, NCI, Bethesda, 20892, MD, USA
| | - Xiaolin Wu
- Genomics Laboratory, Frederick National Laboratory for Cancer Research, Frederick, 21702, MD, USA
| | - Wojciech Kloc
- Department of Neurology & Neurosurgery, Varmia & Masuria University, Olsztyn, 10-719, Poland
- Department of Neurosurgery, Copernicus Hospital Gdańsk, Gdańsk, 80-803, Poland
| | - Ewa Izycka-Swieszewska
- Department of Pathology & Neuropathology, Medical University of Gdańsk, Gdańsk, 80-210, Poland
- Department of Pathomorphology, Copernicus Hospital Gdańsk, Gdańsk, 80-803, Poland
| | - Renata Duchnowska
- Department of Oncology, Military Institute of Medicine, Warsaw, 04-141, Poland
| | - Rafał Pęksa
- Department of Pathology, Medical University of Gdańsk, 7 Dębinki St, 80-211, Gdańsk, Poland
| | - Wojciech Biernat
- Department of Pathology, Medical University of Gdańsk, 7 Dębinki St, 80-211, Gdańsk, Poland
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, 80-211, Poland
| | - Naema Nayyar
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, 02114, MA, USA
| | - Priscilla K Brastianos
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, 02114, MA, USA
| | - O Morgan Hall
- Genitourinary Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA
| | - Cody J Peer
- Genitourinary Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA
| | - William D Figg
- Genitourinary Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA
| | - Gary T Pauly
- Chemical Biology Laboratory, CCR, NCI, Frederick, 21702, MD, USA
| | - Christina Robinson
- Laboratory Animal Sciences Program, Frederick National Laboratory for Cancer Research, Frederick, 21702, MD, USA
| | - Simone Difilippantonio
- Laboratory Animal Sciences Program, Frederick National Laboratory for Cancer Research, Frederick, 21702, MD, USA
| | - Emilie Bialecki
- Département de Neurochirurgie, Hôpital Privé Clairval, Ramsay Général de Santé, Marseille, 13009, France
| | - Philippe Metellus
- Département de Neurochirurgie, Hôpital Privé Clairval, Ramsay Général de Santé, Marseille, 13009, France
- Institut de Neurophysiopathologie-UMR 7051, Aix-Marseille Université, Marseille, 13344, France
| | - Joel P Schneider
- Chemical Biology Laboratory, CCR, NCI, Frederick, 21702, MD, USA
| | - Patricia S Steeg
- Women's Malignancies Branch, CCR, NCI, Bethesda, 20892, MD, USA.
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Derenda M, Borof D, Kowalina I, Wesołowski W, Kloc W, Iżycka-Świeszewska E. Primary Spinal Intradural Mesenchymal Chondrosarcoma with Several Local Regrowths Treated with Osteoplastic Laminotomies: A Case Report. Surg J (N Y) 2017; 3:e117-e123. [PMID: 28825035 PMCID: PMC5553510 DOI: 10.1055/s-0037-1604159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Received: 01/15/2017] [Accepted: 05/30/2017] [Indexed: 12/26/2022] Open
Abstract
Mesenchymal chondrosarcomas (MCSs) are rare malignant tumors of the bone and soft tissues. Only a few cases of such tumors originating from the spinal canal meninges have been described in the literature. The authors report on a case of a 22-year-old woman with MCS of the arachnoid at the T12-L1 level with a 14-year-long observation. The tumor was totally resected using osteoplastic laminotomy with reconstruction of laminar roof. This small spindle cell tumor was initially microscopically suspected of synovial sarcoma, but correctly verified with widened immunophenotyping and molecular studies as MCS. At its first recurrence, the neoplasm showed microscopically a typical bimorphic pattern of small round cell component with foci of hyaline cartilage. The patient experienced three local recurrences: 4, 6, and 10 years after the initial resection, respectively. The techniques of laminotomy and relaminotomy were also used during three following operations. The repeated surgical removal, radiotherapy, and chemotherapy were the methods of complex oncological treatment. The patient remains now in complete remission, fully self-dependent with slight motor disturbance, and mild sensory deficits. Current views on the clinicopathological characteristics and treatment modalities of the chondrosarcomas of the spinal canal are discussed.
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Affiliation(s)
- Marek Derenda
- Department of Neurosurgery, Regional Hospital, Elblag, Poland
| | - Damian Borof
- Department of Neurosurgery, Regional Hospital, Elblag, Poland
| | | | | | - Wojciech Kloc
- Departments of Neurology & Neurosurgery, University of Varmia & Masuria University, Olsztyn, Poland
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Gril B, Lyle LT, Lockman PR, Adkins CE, Mohammad AS, Sechrest E, Hua E, Palmieri D, Liewehr DJ, Steinberg SM, Kloc W, Izycka-Swieszewska E, Duchnowska R, Naema N, Brastianos PK, Steeg PS. Abstract 4933: Desmin+pericyte subpopulations correlated with blood-tumor barrier permeability in brain metastases of breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4933] [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
Breast cancer brain metastases remain incurable. The blood-brain barrier (BBB) is a multicellular dynamic structure regulating exchanges between the blood and the central nervous system. As cancer cells colonize the brain, the BBB evolves into a blood-tumor barrier (BTB). The BTB limits compound penetration and therefore contributes to poor efficacy of chemotherapy. While the BBB has been well characterized in developmental and neurodegenerative disease studies, the BTB composition remains unknown.
We have characterized the BTB in three model systems of brain metastasis of breast cancer developed in the laboratory: a triple negative (231-BR6), and two HER2 overexpressing (SUM190-BR3, JIMT-1-BR3) subtypes. Using Texas Red dextran (TRD) as a marker of permeability and quantitative immunofluorescence staining, we analyzed the cellular and molecular composition of: 1) unaltered BBB vs. BTB, and 2) BTB in highly permeable metastases vs. BTB in poorly permeable metastases.
The BTB developed from the BBB in a series of alterations, including a neuroinflammatory reaction with astrogliosis, endothelial cell dilation, increased VEGF, reduced astrocyte endfoot polarity, and decrease in PDGFR+ pericytes. Only 10% of the metastatic lesions harbored a profound TRD exudation, which correlated with paclitaxel efficacy. We hypothesized that specific cellular and molecular changes account for the heterogeneity and increase in TRD diffusion. When metastases with relatively low- and high-TRD diffusion were compared, highly permeable metastases correlated with an increased expression of desmin+ pericytes in three models (231-BR6 p=0.0002; JIMT-1-BR3 p=0.004; SUM190-BR3 p=0.008) and a decrease in CD13+ pericytes in two model systems (231-BR6 p=0.014; JIMT-1-BR3 p=0.002). Decreased expression of laminin α2 in the parenchymal basement membrane (231-BR6 p=0.001; JIMT-1-BR3 p=0.049; SUM190-BR3 p=0.023) were associated with higher permeability. Desmin+ pericytes have been associated with pathological conditions such as fibrosis and spinal cord injury. Seven over nine human craniotomy specimens were positive for Desmin staining, validating clinically the relevance of our findings. We subsequently hypothesized that the desmin+ pericyte subpopulation functionally contributes to increased permeability. Desmin+ pericytes were produced in vitro by co-culturing primary mouse pericytes with astrocytes. When desmin+ or CD13+ pericytes were added to in vitro transendothelial electrical resistance (TEER) models of the BBB, the desmin+ pericytes exhibited less resistance, indicative of higher permeability. The data suggest that desmin+ pericytes may facilitate the permeability of the BTB. These studies show that the BTB in brain metastasis model systems involves consistent molecular changes. These data may identify new strategies to selectively permeabilize the BTB and enhance chemotherapeutic efficacy.
Citation Format: Brunilde Gril, L. Tiffany Lyle, Paul R. Lockman, Chris E. Adkins, Afroz Shareef Mohammad, Emily Sechrest, Emily Hua, Diane Palmieri, David J. Liewehr, Seth M. Steinberg, Wojciech Kloc, Ewa Izycka-Swieszewska, Renata Duchnowska, Nayyar Naema, Priscilla K. Brastianos, Patricia S. Steeg. Desmin+pericyte subpopulations correlated with blood-tumor barrier permeability in brain metastases of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4933. doi:10.1158/1538-7445.AM2017-4933
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Affiliation(s)
| | - L. Tiffany Lyle
- 2 Purdue University College of Veterinary Medicine, West Lafayette, IN
| | - Paul R. Lockman
- 3West Virginia University Health Sciences Center, Morgantown, WV
| | - Chris E. Adkins
- 3West Virginia University Health Sciences Center, Morgantown, WV
| | | | - Emily Sechrest
- 3West Virginia University Health Sciences Center, Morgantown, WV
| | | | | | | | | | - Wojciech Kloc
- 5University of Varmia & Masuria University, Olsztyn, Poland
| | | | | | - Nayyar Naema
- 8Massachusetts General Hospital Cancer CenterHarvard Medical School, Boston, MA
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15
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Lyle LT, Lockman PR, Adkins CE, Mohammad AS, Sechrest E, Hua E, Palmieri D, Liewehr DJ, Steinberg SM, Kloc W, Izycka-Swieszewska E, Duchnowska R, Nayyar N, Brastianos PK, Steeg PS, Gril B. Alterations in Pericyte Subpopulations Are Associated with Elevated Blood-Tumor Barrier Permeability in Experimental Brain Metastasis of Breast Cancer. Clin Cancer Res 2016; 22:5287-5299. [PMID: 27245829 DOI: 10.1158/1078-0432.ccr-15-1836] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 05/19/2016] [Indexed: 01/23/2023]
Abstract
PURPOSE The blood-brain barrier (BBB) is modified to a blood-tumor barrier (BTB) as a brain metastasis develops from breast or other cancers. We (i) quantified the permeability of experimental brain metastases, (ii) determined the composition of the BTB, and (iii) identified which elements of the BTB distinguished metastases of lower permeability from those with higher permeability. EXPERIMENTAL DESIGN A SUM190-BR3 experimental inflammatory breast cancer brain metastasis subline was established. Experimental brain metastases from this model system and two previously reported models (triple-negative MDA-231-BR6, HER2+ JIMT-1-BR3) were serially sectioned; low- and high-permeability lesions were identified with systemic 3-kDa Texas Red dextran dye. Adjoining sections were used for quantitative immunofluorescence to known BBB and neuroinflammatory components. One-sample comparisons against a hypothesized value of one were performed with the Wilcoxon signed-rank test. RESULTS When uninvolved brain was compared with any brain metastasis, alterations in endothelial, pericytic, astrocytic, and microglial components were observed. When metastases with relatively low and high permeability were compared, increased expression of a desmin+ subpopulation of pericytes was associated with higher permeability (231-BR6 P = 0.0002; JIMT-1-BR3 P = 0.004; SUM190-BR3 P = 0.008); desmin+ pericytes were also identified in human craniotomy specimens. Trends of reduced CD13+ pericytes (231-BR6 P = 0.014; JIMT-1-BR3 P = 0.002, SUM190-BR3, NS) and laminin α2 (231-BR6 P = 0.001; JIMT-1-BR3 P = 0.049; SUM190-BR3 P = 0.023) were also observed with increased permeability. CONCLUSIONS We provide the first account of the composition of the BTB in experimental brain metastasis. Desmin+ pericytes and laminin α2 are potential targets for the development of novel approaches to increase chemotherapeutic efficacy. Clin Cancer Res; 22(21); 5287-99. ©2016 AACR.
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Affiliation(s)
- L Tiffany Lyle
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Paul R Lockman
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Chris E Adkins
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Afroz Shareef Mohammad
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Emily Sechrest
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Emily Hua
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Diane Palmieri
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - David J Liewehr
- Biostatistics and Data Management Section, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Seth M Steinberg
- Biostatistics and Data Management Section, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Wojciech Kloc
- Departments of Neurology & Neurosurgery, University of Varmia & Masuria University, Olsztyn, Poland.,Department of Neurosurgery, Copernicus Hospital Gdańsk, Poland
| | - Ewa Izycka-Swieszewska
- Departments of Pathology & Neuropathology, Medical University of Gdańsk, Poland.,Department of Pathomorphology, Copernicus Hospital, Gdańsk, Poland
| | - Renata Duchnowska
- Department of Oncology, Military Institute of Medicine, Warsaw, Poland
| | - Naema Nayyar
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Priscilla K Brastianos
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Patricia S Steeg
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Brunilde Gril
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland.
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Pankowski R, Roclawski M, Dziegiel K, Ceynowa M, Mikulicz M, Mazurek T, Kloc W. Transient Monoplegia as a Result of Unilateral Femoral Artery Ischemia Detected by Multimodal Intraoperative Neuromonitoring in Posterior Scoliosis Surgery: A Case Report. Medicine (Baltimore) 2016; 95:e2748. [PMID: 26871822 PMCID: PMC4753918 DOI: 10.1097/md.0000000000002748] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This is to report a case of 16-year-old girl with transient right lower limb monoplegia as a result of femoral artery ischemia detected by multimodal intraoperative spinal cord neuromonitoring (MISNM) during posterior correction surgery of adolescent idiopathic scoliosis.A patient with a marfanoid body habitus and LENKE IA type scoliosis with the right thoracic curve of 48° of Cobb angle was admitted for posterior spinal fusion from Th6 to L2. After selective pedicle screws instrumentation and corrective maneuvers motor evoked potentials (MEP) began to decrease with no concomitant changes in somato-sensory evoked potentials recordings.The instrumentation was released first partially than completely with rod removal but the patient demonstrated constantly increasing serious neurological motor deficit of the whole right lower limb. Every technical cause of the MEP changes was eliminated and during the wake-up test the right foot was found to be pale and cold with no popliteal and dorsalis pedis pulses palpable. The patient was repositioned and the pelvic pad was placed more cranially. Instantly, the pulse and color returned to the patient's foot. Following MEP recordings showed gradual return of motor function up to the baseline at the end of the surgery, whereas somato-sensory evoked potentials were within normal range through the whole procedure.This case emphasizes the importance of the proper pelvic pad positioning during the complex spine surgeries performed in prone position of the patient. A few cases of neurological complications have been described which were the result of vascular occlusion after prolonged pressure in the inguinal area during posterior scoliosis surgery when the patient was in prone position. If incorrectly interpreted, they would have a significant impact on the course of scoliosis surgery.
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Affiliation(s)
- Rafal Pankowski
- From the Department of Orthopedic Surgery, Medical University of Gdansk, Poland (RP, MR, MC, MM, TM); and Department of Neurology and Neurosurgery, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland (KD, WK)
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Miekisiak G, Kloc W, Janusz W, Kaczmarczyk J, Latka D, Zarzycki D. Current use of methylprednisolone for acute spinal cord injury in Poland: survey study. Eur J Orthop Surg Traumatol 2014; 24 Suppl 1:S269-73. [PMID: 24496913 DOI: 10.1007/s00590-014-1422-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 01/26/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The controversial practice of methylprednisolone (MP) application in acute spinal cord injury (ASCI) is gradually decreasing. This is a survey study designed to assess the current use of MP in ASCI in Poland. METHODS The questionnaire comprised of five questions was distributed among 251 spinal surgeons, members of the Polish Society of Spinal Surgery. One hundred and ten (43.8 %) responded, and data from 108 were included in the study. RESULTS Majority of respondents (73.1 %) declared the use of MP in ASCI. Most of them (41.7 %) adhered to the NASCIS II protocol, and 24.1 % rather used the NASCIS III protocol. Predominant rationale for the use of steroids was fear of litigation (36.7 %), 30.4 % declared it is as an institutional standard, nearly one-third believed in the effectiveness of drug in improving neurological outcomes. The subgroup analyses revealed no statistically significant interaction for specialty, age, personal involvement in care and institutional case volume. CONCLUSIONS As opposed to the literature data from similar studies performed in other countries, the rate of use of MP in ASCI remains high.
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Affiliation(s)
- Grzegorz Miekisiak
- Department of Neurosurgery, Specialist Medical Center, ul. Jana Pawla II 2, 57-320, Polanica-Zdroj, Poland,
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Skorek A, Liczbik W, Stankiewicz C, Kloc W, Plichta Ł. Personal experience in transnasal endoscopic resection of the olfactory groove meningiomas. What can an otolaryngologist offer to a neurosurgeon? Eur Arch Otorhinolaryngol 2013; 271:1037-41. [PMID: 23907369 PMCID: PMC3978380 DOI: 10.1007/s00405-013-2645-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 07/17/2013] [Indexed: 11/10/2022]
Abstract
Olfactory groove meningioma is a demanding therapeutic problem involving two medical specialties, otolaryngology and neurosurgery. The use of transnasal endoscopic (TNE) approach to the tumour has been proved effective in many publications. Three patients with meningiomas localized in olfactory groove were treated in 2011 and 2012 by the otolaryngologist-neurosurgeon team using TNE approach and neuronavigation. The diagnosis was based on MR and CT images. In all patients after tumour removal an endoscopic anterior cranial fossa floor reconstruction was performed using homogeneous cartilage or titanium mesh and Hadad-Bassagasteguy flap. During postoperative period in all patients lumbar drainage was used. There were no cerebrospinal fluid leakage episodes. No recurrence was observed in 22, 12 and 8 months of follow-up, respectively. The authors describe otolaryngological and neurosurgical aspects of TNE approach to anterior cranial fossa with special regard to possible radical resection (according to Simpson) and reconstruction of the bony postoperative defect. TNE is a feasible operative method in olfactory groove meningioma management due to good tumour visibility, lack of brain traction, limited neurovascular structure manipulation and acceptable risk of neurological deficiencies when compared to open approach. Cosmetic aspect and short hospitalization is also of great importance.
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Affiliation(s)
- Andrzej Skorek
- Otolaryngology Department, Medical University in Gdańsk, Gdańsk, Poland,
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Wojtkiewicz J, Kowalski IM, Kmiec Z, Crayton R, Babinska I, Bladowski M, Szarek J, Kiebzak W, Majewski M, Barczewska M, Grzegorzewski W, Kloc W. The effect of lateral electrical surface stimulation (LESS) on motor end-plates in an animal model of experimental scoliosis. J Physiol Pharmacol 2012; 63:285-291. [PMID: 22791643] [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] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 06/18/2012] [Indexed: 06/01/2023]
Abstract
The treatment of idiopathic scoliosis is challenging because of its diverse etiology, age of onset, and long duration of intensive treatment. We examined the effect of lateral electrical surface stimulation (LESS) in an animal model of experimental scoliosis (ES) assessing the number of motor end-plates (MEPs) as a study end-point. The control group (n=5) was adapted to the experimental apparatus without stimulation, whereas ES was induced in rabbits by one-sided LESS of the longissimus dorsi muscle (LDM) for a duration of 2 months. The ES group (n=5) were subjected to a short-term corrective electrostimulation applied at the contralateral side of the spine compared to the previous LESS stimulation for 2 h daily for 3 (n=5) or 6 months (n=5). Another group of ES rabbits was subjected to a long-term corrective electrostimulation applied for 9 h daily for 3 (n=5) or 6 months (n=5). LESS applied for 2 months (ES), significantly increased the number of MEPs in LDM. The short-term corrective electrostimulation for 3 months resulted in an increased number of MEPs. However, a decrease was observed in the animals treated for 6 months. The long-term corrective electrostimulation for 3 months did not change the density of MEPs in the LDM, but for 6 months the number of MEPs in the LMD significantly decreased by ES and control groups. Thus, the results of the present study clearly show that the short-term LESS is able to influence both the number of MEPs and the effectiveness of muscle correctional adaptation in a more efficient and harmless manner than the long-term procedure.
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Affiliation(s)
- J Wojtkiewicz
- Department of Neurology and Neurosurgery, Division of Neurosurgery, University of Warmia and Mazury, Olsztyn, Poland.
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Pankowski R, Smoczynski A, Roclawski M, Ceynowa M, Kloc W, Wasilewski W, Jende P, Liczbik W, Beldzinski P, Libionka W, Pierzak O, Adamski S, Niedbala M. Operative treatment of isthmic spondylolisthesis with posterior stabilization and ALIF. Cages versus autogenous bone grafts. Stud Health Technol Inform 2012; 176:311-314. [PMID: 22744517] [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: 06/01/2023]
Abstract
In the following study the use of cages and autogenous bone grafts were compared in the operative treatment of isthmic spondylolisthesis with the posterior stabilization and Anterior Lumbosacral Interbody Fusion (ALIF). 55 patients were divided into two groups. Autogenous bone grafts were used in the first group (34 patients) and titanium interbody implants (cages) in the second group (21 patients). The mean follow up period in the first group was 8.6 years and 3.4 years in the second group. The radiological outcome was based upon the evaluation of the degree of spondylolisthesis, the angle of the lumbar lordosis, the height of the interbody space and intervertebral foramen and the evaluation of the spinal fusion. The objective clinical outcome assessment was based on Oswestry Disability Index. Subjective clinical evaluation was performed with the use of Visual Analog Pain Score (VAS) and the two questions concerning the evaluation of success of the operative treatment and a possible agreement to the following operation if necessary. The use of autogenous bone grafts alone in ALIF was related to the significant loss of achieved segmental spine anatomy restoration. The implantation of the cages prevented the loss of slippage correction, permanently reconstructed the anatomical conditions in the area of the operated spinal segment.
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Affiliation(s)
- Rafal Pankowski
- Department of Orthopaedics of Medical University of Gdansk, Pomeranian Centrum of Traumatology of Gdansk, Poland
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21
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Roclawski M, Pankowski R, Smoczynski A, Ceynowa M, Kloc W, Wasilewski W, Jende P, Liczbik W, Beldzinski P, Libionka W, Pierzak O, Adamski S, Niedbala M. Secondary scoliosis after thoracotomy in patients with aortic coarctation and patent ductus arteriosus. Stud Health Technol Inform 2012; 176:43-46. [PMID: 22744454] [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: 06/01/2023]
Abstract
The aim of this study was to determine the influence of lateral thoracotomy on the development of scoliosis in subjects undergoing repair of coarctation of the aorta (CoAo) and patent ductus arteriosus (PDA). A group of 133 patients with CoAo and PDA was evaluated. Forty-five patients with CoAo and 38 with PDA were operated on using lateral thoracotomy (operative group) while 12 patients with CoAo and 31 with PDA were treated using balloon dilatation and stent or coil implantation (non-operative group). Clinical examination and the evaluation of spinal roentgenograms were performed. Among the operated patients 46.6% of those with CoAo and 39.5% of those with PDA had clinical scoliosis. In the non-operated patients scoliosis was present in only 16.6% of those with CoAo and 12.9% of those with PDA. Scoliosis ranged between 10° and 42° and it was mild in the majority of cases. In 90.4% of the operated scoliotic patients with CoAo and 73.3% of those with PDA the curve was thoracic and in 47.6% of the CoAo group and 53,3% of the PDA group the curve was left sided. All curves were right sided in non-operated subjects. Scoliosis in the operated group was higher in males than in females (63.3% versus 60% in CoAo and 68.2% versus 37.5% in PDA). The prevalence of scoliosis after thoracotomy was significantly higher than after non-surgical methods of treatment of both CoAo and PDA as well as in the general population. The rate of single thoracic and the rate of left thoracic curves in patients after thoracotomy is higher than in patients treated non-surgically or in idiopathic scoliosis. The rate of scoliosis after thoracotomy is higher in males than females especially following thoracotomy for PDA.
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Affiliation(s)
- Marek Roclawski
- Department of Orthopaedics of Medical University of Gdansk, Gdansk, Poland
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Pankowski R, Dziegiel K, Roclawski M, Smoczynski A, Ceynowa M, Kloc W, Wasilewski W, Jende P, Liczbik W, Beldzinski P, Libionka W, Pierzak O, Adamski S, Niedbala M. Intraoperative Neurophysiologic Monitoring (INM) in scoliosis surgery. Stud Health Technol Inform 2012; 176:319-321. [PMID: 22744519] [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: 06/01/2023]
Abstract
Even among skilled spinal deformity surgeons, neurologic deficits are inherent potential complications of spine surgery. The aim was to assess the meaning of changes and to evaluate the critical rates of Somatosensory Evoked Potentials (SEP) and Motor Evoked Potentials (MEP) for Neurologic Deficit (ND) occurrence associated with scoliosis surgery. A Group of 30 patients with idiopathic scoliosis treated surgically by posterior correction and stabilisation were included. Patients were matched by age, sex, aetiology, Cobb angle, and surgical criteria. Data on three planar scoliosis correction and concomitant (INM) alarms were compared. Radiographic assessment was performed from radiographs taken before surgery and just after it. The (INM) was performed with the use of ISSIS (Inomed) in every patients the same fashion. The average thoracic curve correction was 69.7% and lumbar 69.8%. The average preoperative Apical Vertebral Rotation was 23.5° for thoracic and 27.9° for lumbar curves and postoperatively 10.9° and 14.3° respectively. There was a significant variability of SEP during surgery with only 7 (23%) patients with stable SEP. 15(50%) patients had a decrease of SEP below 50% and 8(27%) had severe decrease of SEP below 50% what caused us to stop surgery or to decrease correction of curves. There was a MEP decrease in 11(37%) patients and in 6 (20%) directly after correction up to 50% of normal value. In 5 of 30 (17%) patients there was a significant decrease of MEP below 50% and we immediately released the implant. The SEP decrease up to 50% without any MEP change did not influenced the outcome. There was no correlation between flexibility and correction of the curve and SEP and MEP decrease. The safe level for MEP was not determined but its meaning for the outcome was more important than SEP value. The need of (INM) during scoliosis surgery to avoid (ND) was confirmed.
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Affiliation(s)
- Rafal Pankowski
- Department of Orthopaedics, Medical University of Gdansk, Pomeranian Centrum of Traumatology of Gdansk, Poland
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Kloc W, Libionka W, Pierzak O, Liczbik W, Beldzinski P, Szopa B, Roclawski M, Pankowski R, Smoczynski A, Ceynowa M. The effectiveness of percutaneous vertebroplasty in the treatment of different aetiology Vertebral Body Fractures. Stud Health Technol Inform 2012; 176:372-374. [PMID: 22744532] [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: 06/01/2023]
Abstract
Percutaneous Vertebroplasty (PV) has gained widespread popularity in the treatment of Vertebral Body Fractures (VBFs). The procedure involves the injection of polymethylmethacrylate (PMMA) cement into the fractured vertebral body via a needle that is placed percutaneously using either a transpedicular or extrapedicular approach. Health Related Quality of Life (HRQoL) evaluation is a widespread method of measure of the disease severity and the outcome of the treatment. The subjective feeling of pain in VBFs is crucial for the HRQoL. The aim of the study was to determine the effectiveness of percutaneous vertebroplasty in the treatment of VBFs. A group of 187 patients with VBFs of different etiology resulting from osteoporosis, trauma or tumors were treated with PV in Pomeranian Center of Traumatology in Gdansk from 2010 to 2011. The effectiveness of the treatment was evaluated with Visual Analog Scale (VAS), Hospital Anxiety and Depression Scale (HADS-M), Rolland Morris Scale (RMS), 36-Item Short Form Health Survey (SF-36) and Oswestry Disability Index (ODI) questionnaires administered before and one month after surgery. PV decreased significantly VAS score, depression and anxiety level, what improved significantly HRQoL in patients with VBFs.
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Affiliation(s)
- Wojciech Kloc
- Department of Neurosurgery, Pomeranian Centrum of Traumatology of Gdansk, Poland
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Abstract
We discuss a case of 49-year-old man admitted to our Department with headache and tumor of frontal region since 3 months. We report clinical features and imaging data of mucocele of frontal sinus that penetrates into cranial cavity. The mucocele had damaged anterior and posterior walls of frontal sinus with intracranial penetration. There was intact dura of anterior fosse. External approach with coronal incision was performed, mucocele was evacuated and mucosa was removed. Then frontal sinus was cranialized with reconstruction of anterior wall and finally wide nasal drainage was performed. Intracranial mucocele of the frontal sinus is rere evidence. The key difficulties may be related to dura preservation and reconstruction of anterior wall of frontal sinus.
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Affiliation(s)
- Dariusz Babiński
- Katedra i Klinika Chorób Uszu, Nosa, Gardła i Krtani, Gdański Uniwersytet Medyczny kierownik.
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Stefanowicz J, Iżycka-Świeszewska E, Szurowska E, Bień E, Szarszewski A, Liberek A, Stempniewicz M, Kloc W, Adamkiewicz-Drożyńska E. Brain metastases in paediatric patients: characteristics of a patient series and review of the literature. Folia Neuropathol 2011; 49:271-281. [PMID: 22212917] [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: 05/31/2023] Open
Abstract
In contrast to the occurrence of brain metastases advanced malignant tumours in adult cancer patients, the dissemination of solid tumours to the brains of paediatric cancer patients is very uncommon. We present a neuro-pathological and clinical study of a group of children and adolescents with brain metastases (BM) from extracranial solid malignancies. The analysed patients were diagnosed with soft tissue sarcomas (three), germ cell tumours (three), or osteosarcoma, neuroblastoma, clear cell sarcoma of the kidney, or pleuropulmonary blastoma (one each). In our series, BM frequently coexisted with pulmonary metastases. Three different metastatic patterns were discernible: a solitary tumour, multiple lesions and diffuse parenchymal dissemination. Two cases showed haemorrhagic presentation. Most of the children died due to BM progression, while children with germ cell tumours showed the best prognosis. The histopathological pictures of BM can be different from the primary tumour, showing dedifferentiation or a diverse neoplastic component. The autopsy examination can still be helpful in the final diagnosis of certain cases with atypical clinical presentations.
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Affiliation(s)
- Joanna Stefanowicz
- Department of Paediatrics, Haematology, Oncology and Endocrinology, Medical University of Gdańsk, Poland.
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Nord H, Hartmann C, Andersson R, Menzel U, Pfeifer S, Piotrowski A, Bogdan A, Kloc W, Sandgren J, Olofsson T, Hesselager G, Blomquist E, Komorowski J, von Deimling A, Bruder CEG, Dumanski JP, Díaz de Ståhl T. Characterization of novel and complex genomic aberrations in glioblastoma using a 32K BAC array. Neuro Oncol 2010; 11:803-18. [PMID: 19304958 DOI: 10.1215/15228517-2009-013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Glioblastomas (GBs) are malignant CNS tumors often associated with devastating symptoms. Patients with GB have a very poor prognosis, and despite treatment, most of them die within 12 months from diagnosis. Several pathways, such as the RAS, tumor protein 53 (TP53), and phosphoinositide kinase 3 (PIK3) pathways, as well as the cell cycle control pathway, have been identified to be disrupted in this tumor. However, emerging data suggest that these aberrations represent only a fraction of the genetic changes involved in gliomagenesis. In this study, we have applied a 32K clone-based genomic array, covering 99% of the current assembly of the human genome, to the detailed genetic profiling of a set of 78 GBs. Complex patterns of aberrations, including high and narrow copy number amplicons, as well as a number of homozygously deleted loci, were identified. Amplicons that varied both in number (three on average) and in size (1.4 Mb on average) were frequently detected (81% of the samples). The loci encompassed not only previously reported oncogenes (EGFR, PDGFRA, MDM2, and CDK4) but also numerous novel oncogenes as GRB10, MKLN1, PPARGC1A, HGF, NAV3, CNTN1, SYT1, and ADAMTSL3. BNC2, PTPLAD2, and PTPRE, on the other hand, represent novel candidate tumor suppressor genes encompassed within homozygously deleted loci. Many of these genes are already linked to several forms of cancer; others represent new candidate genes that may serve as prognostic markers or even as therapeutic targets in the future. The large individual variation observed between the samples demonstrates the underlying complexity of the disease and strengthens the demand for an individualized therapy based on the genetic profile of the patient.
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Affiliation(s)
- Helena Nord
- Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, SE-75185 Uppsala, Sweden
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Wasilewski W, Kloc W, Skorek A, Stankiewicz C, Iżycka-Świeszewska E. Tumors of Nasal Sinus and Anterior Skull Base. Skull Base 2007. [DOI: 10.1055/s-2007-983975] [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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Izycka-Swieszewska E, Szurowska E, Kloc W, Rzepko R, Dubaniewicz-Wybieralska M, Skorek A, Drozyńska E, Stempniewicz M. Cerebellopontine angle tumours: radiologic-pathologic correlation and diagnostic difficulties. Folia Neuropathol 2006; 44:274-81. [PMID: 17183454] [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: 05/13/2023] Open
Abstract
A group of 119 cases of cerebellopontine angle (CPA) tumours was studied looking at the pathological composition, relative incidence of tumour types, their radiological features and the pathological-radiological correlations. Tumours with preoperative radiological diagnosis and verified pathologically were analyzed. Histopathologically the material consisted of 77 schwannomas and 42 non-acoustic tumours. Radiological retrospective evaluation of CT and/or MRI documentation was performed in 84 patients. The tumours were classified according to Koos's staging scale. Diagnostic discrepancies (histopathological vs radiological) according to the clinical stage of CPA tumours were analyzed. In our series non-acoustic tumours made up 37% of CPA lesions. Sharp tumour-pyramis angle and intracanalicular fraction are not exclusive features of schwannomas. Tumours in stage IV are the most heterogeneous and diagnostically difficult group.
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Affiliation(s)
- Ewa Izycka-Swieszewska
- Department of Pathomorphology, Medical University of Gdansk, 7 Debinki St., 80-211 Gdansk, Poland.
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29
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Izycka-Swieszewska E, Kloc W, Plata-Nazar K, Stefanowicz J, Drozyńska E, Woźniak A, Gasecki D, Debiec-Rychter M. Heterogeneity of extraparenchymal primitive neuroectodermal tumors within the craniospinal axis. Folia Histochem Cytobiol 2004; 42:229-34. [PMID: 15704649] [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: 05/01/2023] Open
Abstract
Four cases of primitive neuroectodermal tumors (PNETs) with unusual localization (three intraspinal extramedullary and one pontocerebellar) are reviewed. Histologically, they were small round blue cell tumors with diverse patterns. Immunohistochemically, all tumors were positive for at least two neuronal markers, two cases were Mic-2 positive and one showed glial differentiation. The paraffin-embedded tumor specimens were examined by interphase FISH using dual-color probes specific for EWS, HER-2 and BCR loci. Molecular cytogenetic study revealed the presence of EWS rearrangement in two cases and the presence of i(17q) in one tumor. Three tumors exhibited 22 disomy and one was 22 polyploid. Extraparenchymal PNETs within craniospinal axis are heterogeneous from the clinical, histological, immunohistochemical and molecular point of view. These PNETs can be of a central or peripheral type. Multidisciplinary approach is of a basic importance in differential diagnosis of such cases.
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30
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Izycka-Swieszewska E, Debiec-Rychter M, Kloc W. Primitive neuroectodermal tumor in the cerebellopontine angle with isochromosome 17q presenting as meningioma in a woman 26 years of age. Clin Neuropathol 2003; 22:66-70. [PMID: 12670052] [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: 03/01/2023] Open
Abstract
An unusual posterior fossa neoplasm in a 26-year-old woman with short history of the cerebellar symptoms is presented. CT and MR images showed the tumor within the cerebellopontine angle, suspected as meningioma. At surgery, the tumor was dura-attached and did not infiltrate the arachnoid. Histologically, the neoplasm was a small blue cell tumor with solid and microcystic pattern, consistent with primitive neuroectodermal tumor (PNET). Immunohistochemically the cells were strongly positive for NCAM and GFAP. Fluorescence in situ hybridization (FISH) was performed with the cosmids G9 and F7 (flanking EWSR1/22q12 region) DNA probes and dual-color spectrum-orange LSI HER-2/neu (17q11.2)/spectrum green CEP17 (17p11.1-q11.1) DNA probe. The presence of isochromosome 17q within neoplastic cells was found. The tumor was classified as a medulloblastoma. We demonstrate the utility of a multidisciplinary approach to nervous system tumor diagnosis. The clinical features together with histological, immunohistochemical, and characteristic molecular alteration allowed classification of the presented case.
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31
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Kloc W. [Results of the disk microsurgery of lumbar herniated nucleus pulposus]. Chir Narzadow Ruchu Ortop Pol 2000; 65:59-64. [PMID: 10838770] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Results of microsurgical discectomy (MSD) carried out in 151 patients with lumbar disc herniations are presented. The advantage of microsurgical discectomy is reduction of surgical trauma, better differentiation of anatomical structures, gentler manipulation around nerve roots and the dural sac, and the possibility of a meticulous hemostasis preventing profuse bleeding. Further advantages of MSD are: possibility of direct insight in intervertebral space, limited risk of peri- and postoperative complications and infection, reduction of nursing care, favourable psychological and cosmetic effects. Also possibility of improving microsurgical technique be performing these frequent in neurosurgical practice procedures is not insignificant. Final results were evaluated 6 months after MSD using the Functional Economic Rating Scale developed by Prolo et al. Very good outcome (score 8-10) was achieved in 129 patients (85.4%), good (score 6-7) in 18 (11.9%) and unsatisfactory only in 4 (2.7%).
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Affiliation(s)
- W Kloc
- Katedra i Klinika Neurochirurgii, Akademia Medyczna w Gdańsku
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32
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Kloc W, Wasilewski W, Imieliński BL. [Surgical treatment of lateral extraforaminal lumbar disc herniation]. Neurol Neurochir Pol 2000; 34:755-65. [PMID: 11105307] [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: 02/18/2023]
Abstract
Extraforaminal lumbar disc herniations with spinal nerve compression are a well-recognised entity. The diagnosis is difficult although the clinical syndrome is quite characteristic. Myelography fails to disclose these lesions, while CT, MRI or discography are helpful. The best approach to the extreme-lateral lumbar disc herniation is microsurgical decompression of the spinal nerve via the intertransverse muscle, ligament and fascia. With this approach, there is no facet destruction and satisfactory nerve root decompression is safe and effective in relieving radicular pain.
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Affiliation(s)
- W Kloc
- Katedry i Kliniki Neurochirurgii Akademii Medycznej w Gdańsku.
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33
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Kloc W, Imieliński BL, Wasilewski W, Jende P, Puzyrewski R. [Repeated operations for recurrent lumbar disc herniations]. Neurol Neurochir Pol 1999; 33:1367-72. [PMID: 10791038] [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: 02/16/2023]
Abstract
A study of 73 patients who underwent reoperation for persistent or new complaints following initial lumbar discectomy is presented. 32 patients showed true recurrence of disc herniation (6 on the contralateral side) and 41 at a different level. 14 patients needed 3rd operation. Final results were evaluated using the Functional Economic Rating Scale elaborated by Prolo. Mean score for group operated on twice was 8.1 according to Prolo and 7.1 for group operated on 3 times.
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Affiliation(s)
- W Kloc
- Katedry i Kliniki Neurochirurgii, Akademii Medycznej w Gdańsku.
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34
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Kloc W, Zapaśnik A, Wasilewski W, Karwacki Z. [MRI of traumatic superficial temporal artery aneurysm. Case report]. Pol Merkur Lekarski 1999; 6:328-9. [PMID: 10481547] [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] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
A case of 14-years-old girl with superficial temporal artery aneurysm is presented. She sustained head injury six weeks before the first symptom. Presence of the recent blunt trauma in confrontation with MRI lead to establishing of the final diagnosis. It must be considered in the differential diagnosis of masses located in the temporal fossa. Surgical resection of the involved segment of the vessel is indicated in the cases without the need of reconstruction. The result of treatment in our case was excellent and all symptoms have resolved. The aneurysmal character of the lesion was confirmed by histopathological examination.
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Affiliation(s)
- W Kloc
- Katedry i Kliniki Neurochirurgii AM w Gdańsku
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35
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Abstract
Meningiomas of the lateral ventricles of the brain are rare tumours, accounting for approximately 0.5-5% of all intracranial meningiomas. Their natural history and symptomatology and the possibilities of early diagnosis are presented. The intraventricular location of the slow-growing benign mass provides a compensatory mechanism in the form of reserve space, which contributes to the delay in clinical demonstration of symptoms and signs. This makes the choice of diagnostic procedure an essential problem. CT and MRI are useful in detecting these masses, and magnetic resonance angiography (MRA) has also proved to be of great value in demonstrating the vascular supply of the tumour. This paper deals with two cases. In case 1 CT, MRI and MRA and in case 2 CT examination proved to be very useful. The tumours were removed by a transcortical approach in the posterior area.
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Affiliation(s)
- W Kloc
- Department of Neurosurgery, Medical University of Gdañsk, Poland
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36
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Kloc W. [Gaseous degeneration of the intervertebral disc within the lumbar spine]. Chir Narzadow Ruchu Ortop Pol 1998; 63:117-22; discussion 123-4. [PMID: 9684494] [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] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The finding of gas within the vertebral disc space (vacuum phenomenon) is relatively common. This disorder often presents major diagnostic and therapeutic challenges, especially in the presence of multiple degenerative changes and chronic back pain in elderly patients. The author describes pathophysiology and diagnostics of gaseous degeneration associated with the herniated disc. Degenerative spine disease, gaseous degeneration of the intervertebral disc and epidural gas can be disclosed by imaging studies. The presence of epidural gas is attributed to gaseous disc degeneration. This pathology may cause radicular pain similar to sciatic pain produced by disc herniation. Surgery might be indicated in these cases.
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Affiliation(s)
- W Kloc
- Katedry i Kliniki Neurochirurgii AM w Gdańsku
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37
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Imieliński BL, Kloc W, Wasilewski W, Liczbik W, Puzyrewski R, Karwacki Z. Posterior fossa tumors in children--indications for ventricular drainage and for V-P shunting. Childs Nerv Syst 1998; 14:227-9. [PMID: 9694333 DOI: 10.1007/s003810050217] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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: 02/08/2023]
Abstract
A clinical analysis of 95 patients with posterior fossa tumors treated in the Department of Neurosurgery of the Medical University in Gdansk over a period of 16 years (1979-1995) is presented. The following preoperative factors were studied: localization, size and suspected type of tumor, size of the ventricular system, and presence or absence of the "halo" symptom. The indications for ventricular drainage (Fisher) versus V-P shunting as a preliminary treatment are discussed. Finally, the advantages of each of these procedures are emphasized.
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Affiliation(s)
- B L Imieliński
- Department of Neurosurgery, Medical University of Gdańsk, Poland.
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38
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Kloc W, Wasilewski W, Imieliński BL, Karwacki Z. [Epidural gas aggregation in the course of gaseous degeneration of lumbar intervertebral disk as a cause of foot paresis]. Neurol Neurochir Pol 1998; 32:699-704. [PMID: 9770706] [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: 02/09/2023]
Abstract
The finding of gas within the vertebral disc space ("vacuum phenomenon") is relatively common. Degenerative spine disease, gaseous degeneration of the intervertebral disc, and epidural gas were disclosed on imaging study. The epidural gas could be attributed to gaseous disc degeneration. The nerve root in presented patient was compressed by epidural gas. Following surgery the clinical syndrome including foot drop has thoroughly resolved.
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Affiliation(s)
- W Kloc
- Katedry i Kliniki Neurochirurgii AM w Gdańsku
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39
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Imieliński BL, Kloc W. Meningiomas of the lateral ventricles of the brain. Zentralbl Neurochir 1998; 58:177-82. [PMID: 9487654] [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] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Meningiomas of the lateral ventricles of the brain are rare tumours with an approximate incidence of 0.5-4.5% among all intracranial meningiomas. Four cases of intraventricular meningioma arising from the trigone are presented. In 1-st case the calcified mass was visible on straight radiographs. In 2-nd and 3-rd cases CT and angiography was performed. In 4-th case MRI and MRA proved to be very useful. The tumours were removed by transcortical approach in the posterior parietal area. The available literature on intraventricular meningiomas has been discussed.
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Affiliation(s)
- B L Imieliński
- Department of Neurosurgery, Medical University of Gdańsk
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40
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Wasilewski W, Kloc W, Imieliński BL, Jende P. Intraventricular extension of spontaneous intracerbral hematoma as additional aggravating factor. Clin Neurol Neurosurg 1997. [DOI: 10.1016/s0303-8467(97)81524-7] [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: 11/17/2022]
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41
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Kloc W, Majkowicz M, Wasilewski W, Jende P, Imieliński BL. Statistical contribution to prognostic factors in spontaneous intracerebral hematomas. Of v-cramer coefficient and discriminative analysis. Clin Neurol Neurosurg 1997. [DOI: 10.1016/s0303-8467(97)81307-8] [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: 11/15/2022]
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42
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Mierzejewska E, Mechlińska-Baczkowska J, Kloc W, Sawicki T. [Primary brain lymphoma: diagnostic problems]. Neurol Neurochir Pol 1996; 30:1033-42. [PMID: 9173325] [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: 02/04/2023]
Abstract
Diagnostic difficulties in a patient with primary malignant lymphoma of the brain are presented. Computerized tomography scans disclosed, at the beginning, a large mass located in the frontocallosal region, and 15 months later another focus in the cerebellum. Differential diagnostic considerations based on CT and NMR pictures, included infectious diseases, demyelinating diseases also metastatic tumours. The patient was successfully treated surgically, and had than radiotherapy.
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43
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Kloc W, Jende P, Skaja D. [Anterior cranial fossa injury with telescopic antenna penetrating through the orbit with rhinorrhea and brain damage]. Neurol Neurochir Pol 1995; 29:257-62. [PMID: 7651599] [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: 01/26/2023]
Abstract
The authors report a case of injury of the anterior cranial fossa by foreign body penetrating through the orbit with rhinorrhoea and brain damage in a child. Early operation prevented primary and secondary complications.
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Affiliation(s)
- W Kloc
- Katedry i Kliniki Neurochirurgii AM w Gdańsku
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44
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Imieliński BL, Kloc W. [Intracranial epidermal cysts (true cholesteatoma) dermoids]. Neurol Neurochir Pol 1993; 27:859-67. [PMID: 8164781] [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: 01/29/2023]
Abstract
Three cases of intracranial epidermoids treated surgically are reported. Typical course, histological appearance, diagnostic value of radiological investigations and surgical procedure are presented. In differential diagnosis dermoids and cholesterol granulomas (cholesteatomas) are widely discussed.
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45
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Kloc W, Iwaniukowicz A, Imieliński BL. [Spontaneous chronic spinal epidural haematoma in a 14-year-old boy. Case report]. Neurol Neurochir Pol 1992; 26:733-8. [PMID: 1291914] [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: 12/26/2022]
Abstract
An unusual case of a 14-year-old boy with spontaneous chronic spinal epidural haematoma treated surgically with full success is reported. The clinical presentation and aetiology are discussed. The result of treatment depends mainly on the time of duration of neurological deficit. Immediate transfer to neurosurgical department gives a chance of good recovery.
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Affiliation(s)
- W Kloc
- Katedry i Kliniki Neurochirurgii AM, Gdańsku
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46
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Kurzaj E, Kloc W. [A case of metastasis of a pineal germinoma to the vertebral canal]. Neurol Neurochir Pol 1986; 20:489-91. [PMID: 3587520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A case of pinealoma is described in a patient aged 16 years who had been treated initially conservatively with ventriculoperitoneal shunting and cobalt irradiation of the whole brain. The spine was not irradiated because of absence of histological examination. After 6 months the patient returned to hospital with paraparesis and pains in the sacral area. Myelography demonstrated contrast stop at the Th10-11 level. The surgically removed tumour was a pinealoblastoma. Improvement was achieved after postoperative treatment with methotrexate, vincristine and belustin.
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