43 research outputs found

    Primary adult choroid plexus carcinomas: a single-center experience with a systematic review

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    ObjectivePrimary adult choroid plexus carcinomas (PACPCs) are extremely rare brain tumors. The existing literature primarily comprises case reports, which limits our understanding of this uncommon disease. This study aims to describe the clinical characteristics and prognosis of PACPCs, as well as to identify optimal treatment strategies.MethodsWe conducted a comprehensive analysis of clinical data from 7 patients with PACPCs who underwent surgical treatment at the Department of Neurosurgery, Beijing Tiantan Hospital, between March 2011 and March 2023. Additionally, a thorough search of the PubMed database was performed using the keywords “choroid plexus carcinoma” or “choroid plexus carcinomas” within the time frame of August 1975 to April 2023, which yielded a total of 28 identified cases. Subsequently, we evaluated risk factors for progression-free survival (PFS) and overall survival (OS) based on the pooled cases.ResultsThe pooled cohort, consisting of 7 cases from our institution and 28 cases from the literature, included 20 males and 15 females with a mean age of 44.3 ± 14.7 years (range: 21-73 years). Gross-total resection (GTR) and non-GTR were achieved in 22 (62.9%) and 13 (37.1%) patients, respectively. Radiotherapy and chemotherapy were administered to 29 (90.6%) and 13 (40.6%) patients, respectively. After a mean follow-up of 21.0 ± 26.7 months (range: 2-132 months), 18 patients were alive, and 11 patients had died. The multivariate Cox regression model demonstrated that non-GTR (HR 5.262, 95% CI 1.350-20.516, p=0.017) was a negative prognostic factor for OS. However, we did not find any risk factors for PFS.ConclusionComplete surgical resection should be considered as the primary treatment approach for this rare disease. Chemotherapy and radiotherapy appear to have limited effectiveness in treating this condition. Further research with large cohorts is needed to validate our conclusions

    Clinical features and surgical outcomes of high grade pleomorphic xanthoastrocytomas: a single-center experience with a systematic review

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    PurposeHigh grade pleomorphic xanthoastrocytomas (HGPXAs) are very rare and their management and prognostic outcomes remain unclear. To better understand the disease, we aimed to evaluate the risk factors for progression-free survival (PFS) and overall survival (OS), and propose a treatment protocol based on cases from our institute and cases from the literature.MethodsThe authors reviewed the clinical data of 26 patients with HGPXAs who underwent surgical treatment in Department of Neurosurgery of Beijing Tiantan Hospital between August 2014 and September 2021. We also searched the PubMed database using the keywords “anaplastic” combined with “pleomorphic xanthoastrocytoma(s)” between January 1997 and October 2022. Risk factors for PFS and OS were evaluated in the pooled cases.ResultsThe authors’ cohort included 11 males and 15 females with a mean age of 36.7 ± 20.3 years (range: 5.5-71 years). Gross-total resection (GTR) and non-GTR were achieved in 17 (65.4%) and 9 (34.6%) patients, respectively. Radiotherapy and chemotherapy were administered to 22 and 20 patients, respectively. After a mean follow-up of 20.5 ± 21.2 months (range: 0.5-78.1 months), 7 patients suffered tumor recurrence and 6 patients died with a mean OS time of 19.4 ± 10.8 months (range: 8-36 months). In the literature between January 1997 and October 2022, 56 cases of HGPXAs were identified in 29 males and 27 females with a mean age of 29.6 ± 19.6 years (range; 4-74 years). Among them, 24 (44.4%) patients achieved GTR. Radiotherapy and chemotherapy was administered to 31 (62%) patients and 23 (46%) patients, respectively. After a median follow-up of 31.4 ± 35.3 months (range: 0.75-144 months), the mortality and recurrence rates were 32.5% (13/40) and 70% (28/40), respectively. Multivariate Cox regression model demonstrated that non-GTR (HR 0.380, 95% CI 0.174-0.831, p=0.015), age≥30 (HR 2.620, 95% CI 1.183-5.804, p=0.018), no RT (HR 0.334,95% CI 0.150-0.744, p=0.007) and no CT (HR 0.422, 95% CI 0.184-0.967, p=0.042) were negative prognostic factors for PFS. Non-GTR (HR 0.126, 95% CI 0.037-0.422, p=0.001), secondary HGPXAs (HR 7.567, 95% CI 2.221-25.781, p=0.001), age≥30 (HR 3.568, 95% CI 1.190-10.694, p=0.023) and no RT (HR 0.223,95% CI 0.073-0.681, p=0.008) were risk factors for OS.Conclusion:High grade pleomorphic xanthoastrocytomas are very rare brain tumors. Children and younger adults have better clinical outcome than elderly patients. Secondary HGPXAs had worse OS than primary HGPXAs. Complete surgical excision plus RT and CT is recommended for this entity. The frequency of BRAF mutations in HGPXAs is 47.5% (19/40) in this study, however, we do not find the connections between BRAF mutations and clinical outcomes. Future studies with larger cohorts are necessary to verify our findings

    Exploiting Magnetic Resonance Angiography Imaging Improves Model Estimation of BOLD Signal

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    The change of BOLD signal relies heavily upon the resting blood volume fraction () associated with regional vasculature. However, existing hemodynamic data assimilation studies pretermit such concern. They simply assign the value in a physiologically plausible range to get over ill-conditioning of the assimilation problem and fail to explore actual . Such performance might lead to unreliable model estimation. In this work, we present the first exploration of the influence of on fMRI data assimilation, where actual within a given cortical area was calibrated by an MR angiography experiment and then was augmented into the assimilation scheme. We have investigated the impact of on single-region data assimilation and multi-region data assimilation (dynamic cause modeling, DCM) in a classical flashing checkerboard experiment. Results show that the employment of an assumed in fMRI data assimilation is only suitable for fMRI signal reconstruction and activation detection grounded on this signal, and not suitable for estimation of unobserved states and effective connectivity study. We thereby argue that introducing physically realistic in the assimilation process may provide more reliable estimation of physiological information, which contributes to a better understanding of the underlying hemodynamic processes. Such an effort is valuable and should be well appreciated

    Feasibility of Calculating Standardized Precipitation Index with Short-Term Precipitation Data in China

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    At present, high-resolution drought indices are scarce, and this problem has restricted the development of refined drought analysis to some extent. This study explored the possibility of calculating the standardized precipitation index (SPI) with short-term precipitation sequences in China, based on data from 2416 precipitation observation stations covering the time period from 1961 to 2019. The result shows that it is feasible for short-sequence stations to calculate SPI index, based on the spatial interpolation of the precipitation distribution parameters of the long-sequence station. Error analysis denoted that the SPI error was small in east China and large in west China, and the SPI was more accurate when the observation stations were denser. The SPI error of short-sequence sites was mostly less than 0.2 in most areas of eastern China and the consistency rate for the drought categories was larger than 80%, which was lower than the error using the 30-year precipitation samples. Further analysis showed that the estimation error of the distribution parameters β and q was the most important cause of SPI error. Two drought monitoring examples show that the SPI of more than 50,000 short-sequence sites can correctly express the spatial distribution of dry and wet and have refined spatial structure characteristics

    Early Warning Signals of Dry-Wet Transition Based on the Critical Slowing Down Theory: An Application in the Two-Lake Region of China

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    In recent years, the dry-wet transition (DWT), which often leads to regional floods and droughts, has become increasingly frequent in the Poyang Lake basin and the Dongting Lake basin (hereinafter referred to as the two-lake region). This study aims to investigate the early warning signals (EWSs) for DWT events. Firstly, based on the standardized precipitation index (SPI) at 161 meteorological stations in the two-lake region from 1961 to 2020, the two-lake region is divided into four sub-regions by the Rotational Empirical Orthogonal Function (REOF) analysis method. Then, the occurrence time of the DWT events in each sub-region is determined by the moving t-test (MTT) technique. Finally, by using two indicators (variance and the auto-correlation coefficient) to describe the critical slowing down (CSD) phenomenon, the EWSs denoting the DWT events in all sub-regions are investigated. The results reveal that there was a significant dry-to-wet (wet-to-dry) event around 1993 (2003) in the two-lake region during the last 60 years. The phenomenon of CSD, where the auto-correlation coefficient and variance increases are found in all sub-regions around 10 years before the DWT, suggests that it can be taken as an EWS for the DWT events. This study confirms the effectiveness of applying the slowing down theory in investigating the EWSs for abrupt changes in the two-lake region, aiming to provide a theoretical basis for effective prevention and mitigation against disasters in this region. Moreover, it is expected to be well-applied to the middle and lower reaches of the Yangtze River

    Early-Warning Signals of Drought-Flood State Transition over the Dongting Lake Basin Based on the Critical Slowing Down Theory

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    In this study, the standardized precipitation index (SPI) data in Hunan Province from 1961 to 2020 is adopted. Based on the critical slowing down theory, the moving t-test is firstly used to determine the time of drought-flood state transition in the Dongting Lake basin. Afterwards, by means of the variance and autocorrelation coefficient that characterize the phenomenon of critical slowing down, the early-warning signals indicating the drought-flood state in the Dongting Lake basin are explored. The results show that an obvious drought-to-flood (flood-to-drought) event occurred around 1993 (2003) in the Dongting Lake basin in recent 60 years. The critical slowing down phenomena of the increases in the variance and autocorrelation coefficient, which are detected 5–10 years in advance, can be considered as early-warning signals indicating the drought-flood state transition. Through the studies on the drought-flood state and related early-warning signals for the Dongting Lake basin, the reliabilities of the variance and autocorrelation coefficient-based early-warning signals for abrupt changes are demonstrated. It is expected that the wide application of this method could provide important scientific and technological support for disaster prevention and mitigation in the Dongting Lake basin, and even in the middle and lower reaches of the Yangtze River
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