Biomarker concordance between molecular stereotactic biopsy and open surgical specimens in gliomas

Aims. To compare 1p/19q codeletion, MGMT promoter methylation, and IDH mutation status in stereotactic biopsy and open craniotomy specimens.Clinical rationale. The latest WHO classification of gliomas requires assessment of the expression of molecular markers. Samples can be obtained for molecular assays via open craniotomy or molecular stereotactic biopsy (MSB). However, there is uncertainty as to whether MSB is representative of the entire tumour, and therefore how reliable it is for treatment planning.Patients and methods. We examined 11 patients diagnosed with brain tumours suspicious of glioma who underwent open craniotomy after stereotactic biopsy and in whom multiple biomarkers were assessed in both sets of samples by methylation-specific multiplex ligation-dependent probe amplification. Institutional Review Board ethical approval was granted (KB 694/2018).Results. The initial histopathological grade as determined by stereotactic biopsy was the same as in the samples obtained by open surgery. Further, the marker profile used here was valid in both high- and low-grade gliomas.Conclusion and clinical implication. MSB is a reliable way to obtain material for precision medicine approaches

An update on the epidemiology, imaging and therapy of brain metastases

Introduction.The incidence of brain metastases (BM) is rapidly increasing, with most cases occurring in patients aged 50–80 years and in 10–40% of patients with systemic neoplastic disease. The Graded Prognostic Assessment (GPA) is the most impartial prognostic method, according to which the average survival rate of patients with brain metastases is only 7.18 months. Purpose.To present a systematic review of the currently available evidence-based literature on the epidemiology, dia­gnosis, and treatment of BM. Methods.The authors searched PubMed up to March 2020 using the phrases “brain metastases”, “brain metastasis surgery”, and “brain metastases treatment”, which returned 65 citations. Conclusions.The choice of imaging and therapy for brain metastases remains a significant clinical problem. MRI, including T1, T1 + C, T2, FLAIR, and SWI sequences, is the most sensitive method for solitary BM detection, while other techniques such as spectroscopy, perfusion imaging, or fractional anisotropy contribute to diagnosis precision and neurological deficit avoidance in cases eligible for surgery. According to current treatment algorithms, three main methods are used to mana­ge BM: surgery, chemotherapy, and radiotherapy, depending on the expected effect and the patient’s clinical condition. Surgery is most often used, offering neurological deficit remission in 60 to 90% of patients. Most chemotherapeutics do not cross the blood-brain barrier, so immunotherapy with antibodies such as pembrolizumab and ipilimumab, as well as antineoplastic vaccines, are a promising therapeutic prospect

Badanie rezonansem magnetycznym przeprowadzone bez powikłań u chorego z wszczepionym kardiowerterem-defibrylatorem

The number of patients with cardiac pacemakers (PM), implantable cardioverter-defibrillators (ICD) and cardiac resynchronisationtherapy PM systems is increasing. The number of magnetic resonance imaging (MRI) examinations is also growingand amounts to about 60 million tests per year worldwide. The presence of an ICD is still considered to be an absolute contraindicationto MRI by most experts. We present a patient with an implanted ICD who successfully underwent brain MRIwith use of special precautions

Pro Libris: Lubuskie Pismo Literacko-Kulturalne, nr 3 (2008)

152 s. : il.

The 42nd Symposium Chromatographic Methods of Investigating Organic Compounds : Book of abstracts

The 42nd Symposium Chromatographic Methods of Investigating Organic Compounds : Book of abstracts. June 4-7, 2019, Szczyrk, Polan

An update on the epidemiology, imaging and therapy of brain metastases

Introduction.The incidence of brain metastases (BM) is rapidly increasing, with most cases occurring in patients aged 50–80 years and in 10–40% of patients with systemic neoplastic disease. The Graded Prognostic Assessment (GPA) is the most impartial prognostic method, according to which the average survival rate of patients with brain metastases is only 7.18 months. Purpose.To present a systematic review of the currently available evidence-based literature on the epidemiology, dia­gnosis, and treatment of BM. Methods.The authors searched PubMed up to March 2020 using the phrases “brain metastases”, “brain metastasis surgery”, and “brain metastases treatment”, which returned 65 citations. Conclusions.The choice of imaging and therapy for brain metastases remains a significant clinical problem. MRI, including T1, T1 + C, T2, FLAIR, and SWI sequences, is the most sensitive method for solitary BM detection, while other techniques such as spectroscopy, perfusion imaging, or fractional anisotropy contribute to diagnosis precision and neurological deficit avoidance in cases eligible for surgery. According to current treatment algorithms, three main methods are used to mana­ge BM: surgery, chemotherapy, and radiotherapy, depending on the expected effect and the patient’s clinical condition. Surgery is most often used, offering neurological deficit remission in 60 to 90% of patients. Most chemotherapeutics do not cross the blood-brain barrier, so immunotherapy with antibodies such as pembrolizumab and ipilimumab, as well as antineoplastic vaccines, are a promising therapeutic prospect.Introduction. The incidence of brain metastases (BM) is rapidly increasing, with most cases occurring in patients aged 50–80 years and in 10–40% of patients with systemic neoplastic disease. The Graded Prognostic Assessment (GPA) is the most impartial prognostic method, according to which the average survival rate of patients with brain metastases is only 7.18 months. Purpose. To present a systematic review of the currently available evidence-based literature on the epidemiology, diagnosis, and treatment of BM. Methods. The authors searched PubMed up to March 2020 using the phrases “brain metastases”, “brain metastasis surgery”, and “brain metastases treatment”, which returned 65 citations. Conclusions. The choice of imaging and therapy for brain metastases remains a significant clinical problem. MRI, including T1, T1 + C, T2, FLAIR, and SWI sequences, is the most sensitive method for solitary BM detection, while other techniques such as spectroscopy, perfusion imaging, or fractional anisotropy contribute to diagnosis precision and neurological deficit avoidance in cases eligible for surgery. According to current treatment algorithms, three main methods are used to manage BM: surgery, chemotherapy, and radiotherapy, depending on the expected effect and the patient’s clinical condition. Surgery is most often used, offering neurological deficit remission in 60 to 90% of patients. Most chemotherapeutics do not cross the blood-brain barrier, so immunotherapy with antibodies such as pembrolizumab and ipilimumab, as well as antineoplastic vaccines, are a promising therapeutic prospect.

Artykuł oryginalnyZjawisko restenozy w stencie, a nie typ implantowanego stentu wieńcowego wiąże się z upośledzeniem wazodylatacji indukowanej przepływem

Background: Precise mechanisms leading to restenosis are not fully understood. The type of implanted stent and the intensity of atherogenic processes may affects the restenosis rate. Aim: To compare the long-term effects of the coronary stent implantation – paclitaxel-eluting stent (PES) or bare-metal stents (BMS) – on endothelial-dependent flow-mediated dilation (FMD), platelet-derived growth factor (PDGF) and asymmetric dimethylarginine (ADMA) serum levels and to assess the relationship between FMD, PDGF, ADMA and every-stage in-stent restenosis (eISR). Methods: The study population included 40 patients with coronary artery disease, who underwent elective percutaneous coronary intervention (PCI) of the left anterior descending artery (LAD) with stent implantation (PES – 21 patients; BMS – 19 patients). Follow-up examination was performed 12 months after PCI. Results: There were no differences between the PES and the BMS patients regarding FMD (PES: 11.8±7.8%, BMS: 10.5±9.2%), PDGF (PES: 5540±2209 pg/ml, BMS: 4923±2924 pg/ml) and ADMA (PES: 0.474±0.04 µmol/l, BMS: 0.456±0.03 µmol/l) serum levels. The follow-up angiography was performed when clinically indicated in 25 patients: in 15 patients with PES and 10 patients with BMS implanted. The eISR was found in 12 subjects: in 7 (47%) with PES and in 5 (50%) with BMS (NS). In all patients with eISR, the FMD values were significantly lower (6.1±3.5%, p=0.003) compared to the patients without eISR (14.3±7.8%). FMD was the only independent risk factor for eISR (OR=0.631, 95% CI 0.412-0.942, p=0.0003). The cut-off point for FMD Ł8.4% as a parameter predicting eISR was established (p=0.0001, sensitivity: 83.3%, specificity: 92.3%, PPV: 90.9%, NPV: 85.7%). Conclusions: The type of stent implanted into LAD does not affect the FMD, PDGF and ADMA serum levels assessed one-year after a PCI procedure. The occurrence of an early in-stent restenosis is associated with impaired FMD at the time of one-year follow-up.Cel: Porównanie odległego wpływu rodzaju implantowanego stentu wieńcowego [stenty uwalniające paklitaksel (ang. paclitaxel-eluting stents, PES) vs stenty metalowe (ang. bare-metal stents, BMS)] na zależną od śródbłonka wazodylatację indukowaną przepływem (ang. flow-mediated dilation, FMD), na stężenia płytkopochodnego czynnika wzrostu (ang. platelet-derived growth factor, PDGF) i asymetrycznej dimetylargininy (ang. asymmetric dimethylarginine, ADMA) w surowicy krwi oraz ocena związku FMD, PDGF i ADMA z obserwowaną po roku od zabiegu restenozą w stencie (ang. every-stage in-stent restenosis, eISR). Metody: Badaniami objęto łącznie 40 osób z chorobą wieńcową po przebytym zabiegu elektywnej angioplastyki przedniej tętnicy zstępującej z implantacją stentu (PES – 21 chorych, BMS – 19 chorych). Badania kliniczne, w tym FMD i oznaczenie stężeń PDGF, ADMA w surowicy krwi przeprowadzano po roku od zabiegu. Wyniki: Nie stwierdzano znamiennych różnic pomiędzy badanymi grupami (PES i BMS) w zakresie FMD (PES: 11,8±7,8%, BMS: 10,5±9,2%), PDGF (PES: 5540±2209 pg/ml, BMS: 4923±2924 pg/ml) i ADMA (PES: 0,474±0,04 mmol/l, BMS: 0,456±0,03 mmol/l) w badanych grupach. Po uwzględnieniu wskazań klinicznych u 25 badanych, w tym 15 chorych z grupy PES i 10 chorych z grupy BMS, wykonano kontrolną koronarografię. Wystąpienie eISR stwierdzono u 12 chorych: 7 z PES (47%) i 5 z BMS (50%). U wszystkich badanych z eISR wartości FMD były znamiennie niższe (6,1±3,5%, p=0,003) w porównaniu z badanymi bez eISR (14,3±7,8%). Wartość FMD była jedynym niezależnym czynnikiem ryzyka eISR (OR=0,631; 95% CI 0,412–0,942; p=0,0003). Punkt odcięcia dla FMD jako parametru wskazującego na eISR wynosił 8,4% (p=0,0001; czułość – 83,3%; specyficzność – 92,3%; PPV – 90,9%, NPV – 85,7%). Wnioski: Typ implantowanego stentu nie ma istotnego wpływu na wartości FMD oraz stężenia PDGF i ADMA w surowicy obserwowane po roku od elektywnej angioplastyki przedniej tętnicy zstępującej. Obecność restenozy w stencie związana jest z upośledzonym FMD po roku obserwacji