Biomedical subjects

J Murovic

Publications and source records attributed to J Murovic.

7 recordsLinked to original sources

PubMed1992

Pediatric spinal axis tumors.

Pediatric spinal cord tumors occur in the intramedullary or extramedullary spaces. The extramedullary tumors are further divided into those in intradural-extramedullary or extradural locations. Tumors in the intradural-extramedullary region include nerve sheath tumors, meningiomas, and "embryonal" tumors. In the extradural space are neuroblastomas, sarcomas, and other primary tumors of bone. The radiographic findings, histology, and management of each type of tumor are included in this article, which focuses on extramedullary tumors.

Biomarkers, Tumor↗

PubMed1986

Gd-DTPA in clinical MR of the brain: 1. Intraaxial lesions.

Over 35 intraaxial lesions in 15 patients suspected of having intracranial tumors were studied with MR before and after injection of Gadolinium-DTPA (Gd-DTPA). Diseases included primary and metastatic brain tumors, plaques of multiple sclerosis, occult arteriovenous malformations, lymphoma, toxoplasmosis, and pituitary adenoma. The precontrast T2-weighted sequence (SE 2000/30, 60) was found to be most sensitive in detecting intraaxial lesions, showing 17 lesions that were not seen on the post-Gd-DTPA T1-weighted sequence (SE 500/30). In one case of multiple sclerosis, several lesions seen on the pre-Gd-DTPA study on T2-weighted images faded after injection of Gd-DTPA (due to T2 shortening). In two patients with large metastatic foci, other small metastatic lesions were seen better after Gd-DTPA on both T1- and T2-weighted sequences. Four other patients with only one focal-enhancing lesion and one patient with multifocal lesions on T1-weighted images actually had a much larger single glioma depicted on pre-Gd-DTPA T2-weighted images. In a patient with AIDS, a ring-enhancing lesion thought to be an abscess proved to be lymphoma. The cryptic arteriovenous malformations enhanced but showed more characteristic findings, such as hemorrhage, on pre-Gd-DTPA studies. Our experience suggests that Gd-DTPA may not improve sensitivity of MR in the detection of intraaxial lesions. However, functional aspects of brain disease, such as the presence of perfusion of a lesion and active breach of the blood-brain barrier, are depicted well with Gd-DTPA and are vital for proper diagnosis in many instances.

Adult↗

PubMed1986

Gd-DTPA in clinical MR of the brain: 2. Extraaxial lesions and normal structures.

Fifteen patients with suspected extraaxial tumors were evaluated with MR before and after intravenous injection of Gadolinium-DTPA (Gd-DTPA). Meningiomas (7), neurinomas (4), chordomas (2), a previously irradiated dural metastasis, and a giant aneurysm were studied. All the lesions except the dural metastasis enhanced. In two patients with asymptomatic meningiomas, the use of Gd-DTPA with MR allowed definitive diagnosis of the lesions when the routine MR did not. Gd-DTPA also provided improved definition of intracranial tumor margins, produced differential enhancement of dura and nasopharyngeal mucosa from tumor, and caused enhancement of the choroid plexus, some venous structures, the pituitary gland, and its stalk. The enhancement of the pituitary suggests a role for Gd-DTPA in the diagnosis of microadenomas. Routine T2-weighted images without Gd-DTPA were useful in differentiating neurinomas from meningiomas. Judicious use of Gd-DTPA should improve the ability of MR to detect extraaxial lesions, delineate their extent, and characterize their perfusion.

Aged↗

PubMed1986

Computerized tomography in the prognosis of malignant cerebral gliomas.

Ninety-seven patients with supratentorial malignant gliomas who received postoperative radiation therapy and chemotherapy at the University of California, San Francisco, from 1977 through 1984 showed improvement in their follow-up computerized tomography (CT) scans. Twenty-one of these 97 "CT responders" were designated "complete responders" because on serial CT scans they had complete disappearance of the tumor mass and contrast enhancement, which had been present postoperatively. In the remaining 76 patients, CT scans showed reduction in the size, but not disappearance, of the lesions, and these were designated "partial responders." Fifty-eight partial responders had glioblastoma multiforme (GM); their median survival time was 72 weeks. The median survival time for the 11 complete responders with GM has not yet been achieved, but survival at the 53rd percentile is 172 weeks. Among patients with highly anaplastic astrocytoma, the median survival time was 211 weeks for the 10 complete responders and 125 weeks for the 18 partial responders. Eleven of the 21 complete responders are alive at a median postoperative follow-up time of 163 weeks (range 114 to 470 weeks). Eighteen of these patients had subtotal resection of tumor; three patients had gross total tumor resections, but postoperative CT scans showed evidence of residual or possibly recurrent tumor within 1.5 to 4.5 months. Resolution of the tumor mass and contrast enhancement took 9 to 151 weeks; the time to resolution did not depend upon the configuration of the remaining tumor mass and contrast enhancement after surgery. In this study, patients with malignant gliomas whose CT scans eventually showed sustained complete disappearance of the tumor mass and contrast enhancement had a more favorable prognosis than did patients whose CT scans showed improvement, but not complete disappearance, of the tumor. These CT findings may prove useful in determining the prognosis of patients with malignant gliomas.

Adolescent↗

PubMed1986

Phase II study of combined carmustine, 5-fluorouracil, hydroxyurea, and 6-mercaptopurine (BFHM) for the treatment of malignant gliomas.

The Neuro-oncology Service of the University of California Brain Tumor Research Center conducted a nonrandomized phase II study to evaluate, in patients with recurrent malignant glioma, the benefit of a four-drug combination (BFHM) consisting of carmustine (1,3-bis (2-chloroethyl)-1-nitrosourea), 5-fluorouracil, hydroxyurea, and 6-mercaptopurine. There were 29 evaluable glioblastoma multiforme patients and 45 nonglioblastoma anaplastic glioma patients available for analysis. Tumor progression was analyzed as the primary study endpoint. Of the glioblastoma patients, 16 of 29 (55%) responded or stabilized on therapy; of the other anaplastic gliomas, 32 of 45 (71%) responded or stabilized. For patients who stabilized or responded to treatment, BFHM achieved a median time to tumor progression of 46 weeks with a 25th percentile time to tumor progression of 68 weeks for anaplastic gliomas and a median time to tumor progression of 23 weeks with a 25th percentile time to tumor progression of 36 weeks for glioblastoma multiforme patients. A Cox multivariate analysis demonstrated that age and Karnofsky score were important prognostic variables for these patients.

Adolescent↗

PubMed1985

Cell kinetic studies of in situ human brain tumors with bromodeoxyuridine.

At the time of surgery, 18 patients with various brain tumors were given a 1-h i.v. infusion of bromodeoxyuridine (BrdUrd), 150-200 mg/m2. At an infusion rate of 200 mg/m2/h, serum BrdUrd levels of 8 microM were achieved. After the infusion, tumor tissue was obtained and divided into two portions. One portion was fixed in 70% ethanol, embedded in paraffin, and sectioned; the sections were deparaffinized, denatured with 2 N HCl, and reacted with monoclonal antibodies against BrdUrd (anti-BrdUrd MAb). BrdUrd-labeled nuclei were demonstrated satisfactorily by an indirect peroxidase method. The other portion was dissociated into single cells with a DNase enzyme cocktail and reacted with FITC-conjugated anti-BrdUrd MAb to determine the percentage of BrdUrd-labeled cells or with chromomycin A3 for DNA analysis. The single-cell suspensions were analyzed by flow cytometry. The fraction of S-phase cells in the tissue sections was similar to both the percentage of BrdUrd-labeled nuclei and the S-phase fraction determined by flow cytometric analysis. The results obtained with BrdUrd-labeled nuclei were similar to those obtained from previous autoradiographic studies of various brain tumors exposed to a pulse of 3H-thymidine. Since BrdUrd is not radioactive and is nontoxic at the dosage used, these techniques, together with the histopathological diagnosis, may help to predict the biological malignancy of individual tumors.

Antibodies, Monoclonal↗

PubMed1985

Immunocytochemical demonstration of S-phase cells by anti-bromodeoxyuridine monoclonal antibody in human brain tumor tissues.

Five patients with various brain tumors received bromodeoxyuridine (BrdU), 150-200 mg/m2 i.v., at the time of craniotomy. Biopsied materials were fixed in 70% ethanol, sectioned, denatured with hydrochloric acid, and reacted with monoclonal antibodies against BrdU. Immunofluorescence and immunocytochemical methods were used to visualize BrdU-labeled nuclei. Our results showed that both methods demonstrated BrdU-labeled nuclei satisfactorily in tissue sections. Thus, BrdU can be used to measure the proliferative potential of human tumors in situ.

Aged↗