Biomedical subjects

M L Estes

Publications and source records attributed to M L Estes.

75 records · Page 5Linked to original sources

PubMedDate not supplied

Stereotactic and computer-assisted neurosurgery at the Cleveland Clinic: review of 501 consecutive cases.

BACKGROUND: Stereotactic and computer-assisted techniques have revolutionized the diagnosis and treatment of many disorders of the brain by directing surgical instruments, the surgeon's hands, or focused radiation to an imaged target along predefined routes. METHODS: This report reviews the basic principles and techniques of stereotactic and computer-assisted procedures in 501 consecutive procedures. RESULTS: Procedures performed include biopsy; decompression of cysts, hematomas, ventricles, and abscesses; "point," computer-assisted volumetric, and frameless stereotactic resection of brain lesions; placement of depth electrodes; treatment of movement or pain disorders; implantation of radioactive seeds in malignant tumors; and radiosurgery. CONCLUSIONS: Overall, image-directed stereotactic neurosurgery proved safe, accurate, and versatile.

Adolescent↗

PubMedDate not supplied

The search for diagnostic criteria in Alzheimer's disease: an update.

BACKGROUND: Although the pathologic findings in Alzheimer's disease are well documented, definitive diagnostic criteria are lacking. OBJECTIVE: To review the histopathologic findings in Alzheimer's disease. SUMMARY: In Alzheimer's disease, the brain may be normal in size or atrophic. There is selective neuronal loss associated with neurofibrillary tangles and senile plaques with amyloid deposits. Amyloid protein may also be deposited within arterioles. There may be granulovacuolar degeneration and Hirano bodies in the hippocampus. Two diagnostic schemes have been proposed based on the presence of senile plaques, but neither is entirely satisfactory. CONCLUSIONS: The pathologic diagnosis is usually made in conjunction with the clinical history. Probably, neither definitive diagnostic criteria nor effective treatment for Alzheimer's disease will be possible until we understand more about its etiology. Clinicians should attempt to rule out other, potentially curable causes of dementia in elderly patients such as trauma, depression, metabolic abnormalities, infection, vascular disease, and other central nervous system diseases.

Alzheimer Disease↗

PubMedDate not supplied

Dysembryoplastic neuroepithelial tumor: a clinicopathologic and immunohistochemical study of 11 tumors including MIB1 immunoreactivity.

The dysembryoplastic neuroepithelial tumor (DNT) is a rare, recently recognized neoplasm, characterized by a mixed glial-neuronal cell proliferation. We studied 11 cases of DNT including 6 males and 5 females (age range 2.1-39.4 years, mean 13.8 years). All patients presented with chronic epilepsy of 4.8 years mean duration. Nine tumors were located in the temporal lobe and 2 in the frontal lobe. Four tumors were located on the right side and 7 on the left. All tumors were characterized by a predominant oligodendrocyte-like cell component with intermixed normal appearing neurons and astrocytes. All were focally microcystic and 7 of 9 evaluable tumors were multinodular. Other observed histologic features included a focal arcuate vascular pattern in 7 tumors, calcification in 4 tumors, and a rare mitotic figure in 2 tumors. Necrosis and vascular hyperplasia were not observed in any of the tumors. Cortical architectural disorganization (cortical dysplasia) was observed in 9 of 10 evaluable cases. MIB1 (a marker of cellular proliferation) immunostaining was performed in all 11 tumors and MIB1 indices (number of positive tumor cells/100 tumor cells counted) ranged from 0-0.6 (mean 0.2). Four patients required at least 1 additional surgical procedure for tumor recurrence, related to an incomplete initial excision 2.1-4.4 years after their initial operation. All patients are seizure-free at their last follow-up. DNTs are low grade neoplasms which typically present with chronic epilepsy, are most frequently located in the temporal lobe, and occur most frequently in pediatric patients. Their appearance and association with cortical dysplasia suggest a maldevelopmental origin. The generally slow growth and relatively benign nature of DNT is reflected by their low MIB1 index.

Adolescent↗