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Objective@#To explore the characteristics of demand of reexamination of patients with low grade gliomas in various stages postoperative, so as to satisfy the demand and increase efficiency for health education of discharged patients with low grade gliomas as well as provide basis for personalized health education and continuous nursing.@*Methods@#The convenient sampling was conducted during the outpatients in Neurosurgical department of Beijing Tiantan Hospital Affiliated to Capital Medical University from April to March in 2017. The 170 outpatients were surveyed with the author designed questionnaire.@*Results@#The total rate of demand in 170 patients was 100%. Patients had the highest demand for the knowledge of recurrence, which rate was 91.8%. The longer the postoperative time, the lower the overall demand. The lowest rate was more than 12 months after operation, which scored 24 (17, 39). The higher the demand for the knowledge of recurrence. The highest rate was more than 12 months after operation, which scored 16 (11, 16). Professional consultation was a normal and expected way for patients to solve health problems (respectively 95.3% and 95.9%).@*Conclusions@#The demand of postoperative patients with low grade gliomas are not high, but relatively have more demand on the knowledge of recurrence. They have different demand in different postoperative stages, genders, age groups, marital status, current employment status, glioma grades. Professional consultation was a method of health education which patients most willing to take.
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Objective To explore the characteristics of demand of reexamination of patients with low grade gliomas in various stages postoperative, so as to satisfy the demand and increase efficiency for health education of discharged patients with low grade gliomas as well as provide basis for personalized health education and continuous nursing. Methods The convenient sampling was conducted during the outpatients in Neurosurgical department of Beijing Tiantan Hospital Affiliated to Capital Medical University from April to March in 2017. The 170 outpatients were surveyed with the author designed questionnaire. Results The total rate of demand in 170 patients was 100% . Patients had the highest demand for the knowledge of recurrence, which rate was 91.8% . The longer the postoperative time, the lower the overall demand. The lowest rate was more than 12 months after operation, which scored 24 (17, 39). The higher the demand for the knowledge of recurrence. The highest rate was more than 12 months after operation, which scored 16 (11, 16). Professional consultation was a normal and expected way for patients to solve health problems (respectively 95.3% and 95.9% ). Conclusions The demand of postoperative patients with low grade gliomas are not high, but relatively have more demand on the knowledge of recurrence. They have different demand in different postoperative stages, genders, age groups, marital status, current employment status, glioma grades. Professional consultation was a method of health education which patients most willing to take.
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Patients afflicted with low-grade glioma frequently suffer from seizures.The mechanisms for seizure initiation in these patients remain poorly understood.Tumor location is correlated with seizure initiation.However,these correlative studies rely on dichotomized data analysis which is based on arbitrary lobe assignments.As a result,the lesion-symptom correlation may be incorrectly interpreted.Categorizing patients according to tumor involvement in a single brain lobe might cause the neglect of important information,such as lesion location and lesion volume.Tumors that invaded more than one brain lobe may could be counted repeatedly.The anatomic correlation of the tumor-induced seizures is therefore difficult to be identified.Investigations based on voxelwise quantitative lesion analysis could avoid the above statistical bias.According to the voxel-wise analysis,the increased seizure risks were identified for patients with low-grade gliomas that involved the left premotor area.
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Objective:To compare the therapy effects of chemotherapy and non-chemotherapy groups and to determine the value of chemotherapy for adult diffuse low-grade gliomas. Methods:We reviewed and analyzed 64 patients with adult diffuse low-grade glio-mas admitted to the Beijing Tiantan Hospital from May 2005 to April 2008. Among the patients, 18 received 4 to 12 cycles of temozolo-mide chemotherapy after operation and radiotherapy, whereas the other 46 cases only received radiotherapy. The progression-free survival of the two groups was compared. Results:The median progression-free survival of the chemotherapy and the control groups were 67.8 and 51.3 months, respectively. The results of the comparison implied a significant difference (χ2=8.741, P=0.003). Conclu-sion:Chemotherapy can improve the progression-free survival of the patients with adult diffuse low-grade gliomas, and thus, can be recommended as its effective therapy.
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Objective To present a surgical series of patients with low grade temporal gliomas causing intractable epilepsy, focusing on long-term seizure outcome.Method A retrospective study was conducted with patients with temporal low-grade gliomas (LGG).Results Sixty five patients with were operated in our institution. Males were more affected than females and the mean age at surgery was 32.3 ± 8.4 (9-68 years). The mean age at seizure onset was 25.7 ± 9.2 (11-66 years). Seizure outcome was classified according with Engel classification. After one year of follow up, forty two patients (64.6%) were Engel I; seventeen (26.2%) Engel II; four (6.2%) Engel III and two (3.1%) Engel IV. Statistically significant difference in seizure outcome was obtained when comparing the extension of resection. Engel I was observed in 39 patients (69.6%) with total resection and in only 3 (33.3%) patients with partial resection.Conclusion Gross-total resection of temporal LGGs is a critically important factor in achieving seizure-freedom.
Objetivo Apresentar uma série cirúrgica de pacientes com gliomas temporais de baixo grau, causando epilepsia de difícil controle.Método Estudo retrospectivo de pacientes com diagnóstico de glioma temporal de baixo grau temporais.Resultados 65 pacientes com foram operados em nossa instituição. A média de idade de início das crises foi de 25,7 ± 9,2 (11-66 anos). Após um ano de acompanhamento, quarenta e dois pacientes (64,6%) estavam Engel I; dezessete (26,2%) Engel II; quatro (6,2%) Engel III e dois (3,1%) Engel IV. Houve diferença estatisticamente significativa no resultado do controle das crises quando se compara a extensão da ressecção. Engel I foi observada em 39 pacientes (69,6%) com a ressecção total e em apenas 3 (33,3%) pacientes com ressecção parcial.Conclusão A ressecção total de glioma temporal de baixo grau temporais é um fator extremamente importante no controle das crises.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Brain Neoplasms/surgery , Drug Resistant Epilepsy/surgery , Glioma/surgery , Seizures/surgery , Temporal Lobe/surgery , Brain Neoplasms/complications , Brain Neoplasms/pathology , Drug Resistant Epilepsy/etiology , Drug Resistant Epilepsy/prevention & control , Electroencephalography , Glioma/complications , Glioma/pathology , Kaplan-Meier Estimate , Magnetic Resonance Imaging , Neoplasm Grading , Retrospective Studies , Seizures/etiology , Seizures/prevention & control , Time Factors , Treatment Outcome , Temporal Lobe/pathologyABSTRACT
Objective To explore the property of brain functional networks and cognitive function changes in patients with frontal lobe low-grade gliomas (LGG).Methods 8 cases of suspected frontal lobe LGG patients were undergone with resting-fMRI scanning to analyze the small-world property of the LGG,meanwhile the LGG groups had Montreal (MoCA) cognitive score exam compared with the control group.Results The value of MoCA was 22.5 ± 1.5,21.8 ± 2.0,and 27.9 ± 2.1 respectively with statistical significance (P ＜ 0.05) in the LGG groups and the control groups.The LGG group cognitive score was significantly lower than that in the control group with statistical significance (P＜ 0.05).As to threshold,the two groups were consistent with the small world property.The LGG local efficiency was smaller than that of the controls,the postoperative small world properties (σ=2.49) were lower than that the pre-operative (σ =2.68),the largest brain function areas of preoperative information transmission were respectively the supramarginal gyrus,posterior cingulate,insula,and the postoperative being the precuneus,calcarine sulcus and superior frontal gyrus.The maximum cluster coefficient of the preoperative functional network were respectively the entorhinal cortex,transverse temporal gyrus and the calcarine sulcus,and postoperative were Wilson,transverse temporal gyri and occipital gyrus.Preoperative information transmission path was less than the postoperative,and the small world properties were positively correlated with MoCA.Conclusion LGG accompany by the changes of cognitive function,and with the small world network property preand post-operation.
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Dysembryoplastic neuroepithelial tumor (DNT), described in 1988 and introduced in the WHO classification in 1993, affects predominantly children or young adults causing intractable complex partial seizures. Since it is benign and treated with surgical resection, its recognition is important. It has similarities with low-grade gliomas and gangliogliomas, which may recur and become malignant. OBJECTIVES: To investigate whether DNT was previously diagnosed as astrocytoma, oligodendroglioma, or ganglioglioma and to determine its frequency in a series of low-grade glial/glio-neuronal tumors. METHODS: Clinical, radiological, and histological aspects of 58 tumors operated from 1978 to 2008, classified as astrocytomas (32, including 8 pilocytic), oligodendrogliomas (12), gangliogliomas (7), and DNT (7), were reviewed. RESULTS: Four new DNT, one operated before 1993, previously classified as astrocytoma (3) and oligodendroglioma (1), were identified. One DNT diagnosed in 2002 was classified once more as angiocentric glioma. Therefore, 10 DNT (17.2%) were identified. CONCLUSIONS: Clinical-radiological and histopathological correlations have contributed to diagnose the DNT.
O tumor neuroepitelial disembrioplásico (DNT), descrito em 1988 e incorporado na classificação da OMS em 1993, acomete predominantemente crianças ou adultos jovens, causando crises convulsivas parciais complexas farmacorresistentes. Como é benigno e tratável com ressecção cirúrgica, seu reconhecimento é importante. Tem semelhanças com gliomas de baixo grau e gangliogliomas, que podem recidivar e malignizar. OBJETIVOS: Investigar se o DNT foi originalmente diagnosticado como astrocitoma, oligodendroglioma ou ganglioglioma e determinar sua frequência numa série de neoplasias gliais/glioneuronais de baixo grau. MÉTODOS: Foram revistos aspectos clínicos, radiológicos e histológicos de 58 neoplasias operadas entre 1978 e 2008, classificadas como astrocitomas (32, sendo 8 pilocíticas), oligodendrogliomas (12), gangliogliomas (7) e DNT (7). RESULTADOS: Foram identificados quatro novos DNT, um operado antes de 1993, originalmente diagnosticado como astrocitoma (3) e oligodendroglioma (1). Um DNT diagnosticado em 2002 foi reclassificado como glioma angiocêntrico. Portanto, 10 DNT (17,2%) foram identificados. CONCLUSÕES: Correlações clínico-radiológicas e histopatológicas contribuíram para o diagnóstico do DNT.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Humans , Young Adult , Brain Neoplasms/pathology , Neoplasms, Neuroepithelial/pathology , Astrocytoma/pathology , Biopsy , Diagnosis, Differential , Epilepsy/complications , Ganglioglioma/pathology , Magnetic Resonance Imaging , Oligodendroglioma/pathology , Retrospective Studies , Tomography, X-Ray Computed , World Health OrganizationABSTRACT
OBJECTIVE: The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. METHOD: The low-grade (G1, n=19) and high-grade glioma (G2, n=8) patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. RESULTS: There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. CONCLUSION: These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.
OBJETIVO: A associação entre tumores cerebrais e déficits cognitivos é bem estabelecida na literatura. No entanto, estudos sobre a cognição de pacientes com gliomas de baixo e alto grau são escassos, especialmente, em sujeitos com baixa escolaridade. Este estudo investigou o funcionamento cognitivo de uma amostra de pacientes com gliomas de baixo e alto grau antes da intervenção cirúrgica. MÉTODO: Os pacientes com glioma de baixo grau (G1, n=19) e alto grau (G2, n=8) foram avaliados quanto à memória, funções executivas, habilidades visuo-perceptivas e visuo-espaciais, nível intelectual e linguagem. RESULTADOS: Houve prejuízo significativo em G2 na memória episódica verbal e visual, funções executivas incluindo flexibilidade mental, fluência verbal nominal e categórica e velocidade de processamento de informações. G1 demonstrou apenas déficits específicos de evocação verbal e visual, flexibilidade mental e velocidade de processamento. CONCLUSÃO: Estes achados demonstraram níveis diferenciados de comprometimento nos domínios executivos e mnésticos de pacientes com gliomas de baixo e alto grau.