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T Maraziotis

Publications and source records attributed to T Maraziotis.

17 recordsLinked to original sources
PubMed2005

The predictive value of external continuous lumbar drainage, with cerebrospinal fluid outflow controlled by medium pressure valve, in normal pressure hydrocephalus.

BACKGROUND: Although sporadic studies have described temporary external cerebrospinal fluid (CSF) lumbar drainage as a highly accurate test for predicting the outcome after ventricular shunting in normal pressure hydrocephalus (NPH) patients, a more recent study reports that the positive predictive value of external lumbar drainage (ELD) is high but the negative predictive value is deceptively low. Therefore, we conducted a prospective study in order to evaluate the predictive value of a continuous ELD, with CSF outflow controlled by medium pressure valve, in NPH patients. METHOD: Twenty-seven patients with presumed NPH were admitted to our department and CSF drainage was carried out by a temporary (ELD) with CSF outflow controlled by a medium pressure valve for five days. All patients received a ventriculoperitoneal shunt using a medium pressure valve based upon preoperative clinical and radiographic criteria of NPH, regardless of ELD outcome. Clinical evaluation of gait disturbances, urinary incontinence and mental status, and radiological evaluation with brain CT was performed prior to and after ELD test, as well as three months after shunting. FINDINGS: Twenty-two patients were finally shunted and included in this study. In a three-month follow-up, using a previously validated score system, overall improvement after permanent shunting correlated well to improvement after ELD test (Spearman's rho = 0.462, p = 0.03). When considering any degree of improvement as a positive response, ELD test yielded high positive predictive values for all individual parameters (gait disturbances 94%, 95% CI 71%-100%, urinary incontinence 100%, 95% CI 66%-100%, and mental status 100%, 95% CI 66%-100%) but negative predictive values were low (< 50%) except for cognitive impairment (85%, 95% CI 55%-98%). CONCLUSION: This study suggests that a positive ELD-valve system test should be considered a reliable criterion for preoperative selection of shunt-responsive NPH patients. In case of a negative ELD-valve system test, further investigation of the presumed NPH patients with additional tests should be performed.

Adult↗
PubMed2004

Multiple spinal epidural abscesses extending to the whole spinal canal.

Spinal epidural abscess (SEA) is a rare life-threatening disease mostly affecting patients with an altered immune system. It presents as a sequela of adjacent infection or hematogenous spread. MRI is the method of choice in evaluating patients with suspected SEAs and should always include the whole spinal canal, excluding the exceedingly rare possibility of multiple epidural collections. We present a rare case of a patient with no predisposing factors suffering from multiple SEAs, extending to the whole spinal canal.

Aged↗
PubMed2001

Segmental myoclonus as the sole manifestation of a choroid plexus papilloma in the posterior fossa. Case report.

The authors describe the case of a 22-year-old woman with involuntary contractions of the sternocleidomastoid and trapezius muscles that resulted in turning movements of the head. The jerks displayed the clinical and neurophysiological characteristics of segmental myoclonus (SM) restricted to muscles supplied bilaterally by the first four cervical segments. Magnetic resonance imaging disclosed a tumor in the midline above the cisterna magna that was later histologically proven to be a choroid plexus papilloma. The patient's involuntary movements did not extend to other muscle groups or, in particular, to the palate, as one might have expected in the case of brainstem lesions. Myoclonus was the sole clinical manifestation of the tumor in this patient; other signs and symptoms invariably reported in other cases of posterior fossa papilloma, such as increased intracranial pressure or cranial nerve palsies, were absent. Release from suprasegmental control is suggested as a possible pathophysiological mechanism in this case of SM.

Adult↗
PubMed2001

Aberrant localization of the neuronal class III beta-tubulin in astrocytomas.

BACKGROUND: The class III beta-tubulin isotype (betaIII) is widely regarded as a neuronal marker in development and neoplasia. In previous work, we have shown that the expression of betaIII in neuronal/neuroblastic tumors is differentiation dependent. In contrast, the aberrant localization of this isotype in certain nonneuronal neoplasms, such as epithelial neuroendocrine lung tumors, is associated with anaplastic potential. OBJECTIVE: To test the generality of this observation, we investigated the immunoreactivity profile of betaIII in astrocytomas. DESIGN: Sixty archival, surgically excised astrocytomas (8 pilocytic astrocytomas, WHO grade 1; 18 diffuse fibrillary astrocytomas, WHO grade 2; 4 anaplastic astrocytomas, WHO grade 3; and 30 glioblastomas, WHO grade 4), were studied by immunohistochemistry using anti-betaIII monoclonal (TuJ1) and polyclonal antibodies. A monoclonal antibody to Ki-67 nuclear antigen (NC-MM1) was used as a marker for cell proliferation. Antibodies to glial fibrillary acidic protein (GFAP) and BM89 synaptic vesicle antigen/synaptophysin were used as glial and neuronal markers, respectively. RESULTS: The betaIII immunoreactivity was significantly greater in high-grade astrocytomas (anaplastic astrocytomas and glioblastomas; median labeling index [MLI], 35%; interquartile range [IQR], 20%-47%) as compared with diffuse fibrillary astrocytomas (MLI, 4%; IQR, 0.2%-21%) (P <.0001) and was rarely detectable in pilocytic astrocytomas (MLI, 0%; IQR, 0%-0.5%) (P <.0001 vs high-grade astrocytomas; P <.01 vs diffuse fibrillary astrocytomas). A highly significant, grade-dependent relationship was observed between betaIII and Ki-67 labeling and malignancy, but this association was stronger for Ki-67 than for betaIII (betaIII, P <.006; Ki-67, P <.0001). There was co-localization of betaIII and GFAP in neoplastic astrocytes, but no BM89 synaptic vesicle antigen/synaptophysin staining was detected. CONCLUSIONS: In the context of astrocytic gliomas, betaIII immunoreactivity is associated with an ascending gradient of malignancy and thus may be a useful ancillary diagnostic marker. However, the significance of betaIII-positive phenotypes in diffuse fibrillary astrocytomas with respect to prognostic and predictive value requires further evaluation. Under certain neoplastic conditions, betaIII expression is not neuron specific, calling for a cautious interpretation of betaIII-positive phenotypes in brain tumors.

Adolescent↗
PubMed1998

Multiple spontaneous intracerebral hemorrhages in a patient with progressive systemic sclerosis.

A 64-year-old woman with a two-year history of diffuse scleroderma responsible for severe interstitial lung disease was admitted for recurrent loss of consciousness. Her treatment at the time consisted of a corticosteroid and monthly cyclophosphamide pulses. Computed tomography and magnetic resonance imaging of the brain revealed two hemorrhagic lesions in the left frontal and temporal lobes, respectively. Amyloidosis and/or vasculitis may have contributed to these lesions.

Aged↗
PubMed1996

Simultaneous three-level disc herniation in a patient with multiple sclerosis.

A rare case is presented of symptomatic simultaneous multilevel disc herniation in the cervical, thoracic and lumbar spine of a 38-year-old man, which were operated on at three different timepoints. Following the third operation, the patient was diagnosed with multiple sclerosis, based on pathological visual evoked potentials and cerebrospinal fluid examination. Spinal surgeons should be aware of the uncommon simultaneous presence of symptomatic disc herniations at different spinal levels, and of the possibility that such multilevel disc herniations may coexist with demyelinating diseases and may confuse the diagnosis.

Adult↗
PubMed1994

Ki-67 immunoreactivity in human central nervous system tumors: a study with MIB 1 monoclonal antibody on archival material.

Paraffin-embedded surgical specimens from 136 primary human central nervous system (CNS) tumors, including 50 meningiomas, 24 astrocytomas, 26 anaplastic astrocytomas, 9 glioblastomas, 8 oligodendrogliomas, 4 ependymomas, 1 anaplastic ependymoma, 2 subependymomas, 9 medulloblastomas, and 3 paragangliomas, were immunostained, following microwave processing, using a streptavidin/peroxidase method and the MIB 1 monoclonal antibody (mAb) against the Ki-67 antigen. The following mean Ki-67 labeling index (LI) values +/- SD were found: meningiomas, 2.47 +/- 1.83; astrocytomas, 2.03 +/- 2.03; anaplastic astrocytomas, 12.80 +/- 6.29; glioblastomas, 14.57 +/- 6.77; oligodendrogliomas, 5.06 +/- 4.78; ependymomas, 2.63 +/- 2.58; anaplastic ependymoma, 6.89; subependymomas, 1.79 +/- 1.54; medulloblastomas, 18.77 +/- 9.65; and paragangliomas, 2.19 +/- 2.51. Our findings indicate that while malignant CNS tumors always exhibited high Ki-67 LI values, and benign CNS tumors generally displayed lower values, increased immunoreactivity for Ki-67 epitopes (Ki-67 LI higher than 4) was noted in a number of meningiomas, astrocytomas, ependymomas, oligodendrogliomas and paragangliomas, contrasting with their benign histological features. Further investigations of the Ki-67 immunoreactivity in CNS tumors and systematic correlation with the postoperative follow-up of patients are necessary to determine the value of Ki-67 LI in predicting the biological behavior of CNS neoplasms.

Antibodies, Monoclonal↗
PubMed1994

Spontaneous burst fracture of the thoracolumbar spine in osteoporosis associated with neurological impairment: a report of seven cases and review of the literature.

This is a report of seven patients suffering from osteoporosis, who sustained unstable burst fractures in the thoracolumbar spine associated with neurological impairment, without trauma. The manner of presentation, the neurological involvement, the radiological findings, as well as the surgical treatment with respect to functional and neurological recovery are discussed.

Aged↗
PubMed1993

Upregulation of A1 adenosine receptors in human temporal lobe epilepsy: a quantitative autoradiographic study.

A significant increase of A1 adenosine receptor binding (48% increase of mean) was detected in human neocortex obtained from patients suffering from temporal lobe epilepsy as compared to control neocortex from non-epileptic patients. Such increase was equally distributed in the six cortical layers and reached similar levels in each of the five specimens tested independently of age, sex and pharmacological treatment of the patient. Since adenosine exerts a depressant effect on neocortical neurons in slices obtained from epileptic patients, this upregulation of A1 receptor binding may constitute a protective mechanism against subsequent seizures, which is exerted by elevating the depressant response of the brain to endogenous adenosine.

Adenosine↗
PubMed1993

Proliferating cell nuclear antigen immunoreactivity in human central nervous system neoplasms.

Formalin-fixed, paraffin-embedded surgical specimens from 140 primary human central nervous system tumors, including 51 meningiomas, 26 astrocytomas, 26 anaplastic astrocytomas, 9 glioblastomas, 1 gliosarcoma, 8 oligodendrogliomas, 5 ependymomas, 2 subependymomas, 9 medulloblastomas, and 3 paragangliomas, were immunostained using a streptavidin/peroxidase method and the PC10 monoclonal antibody, which recognizes an epitope on the proliferating cell nuclear antigen (PCNA). The following PCNA labeling index (LI) mean values were found for the above neoplasms: meningiomas, 3.80 +/- 7.35%; astrocytomas, 0.65 +/- 1.03%; anaplastic astrocytomas, 8.46 +/- 7.95%; glioblastomas, 10.26 +/- 11.21; gliosarcoma, 46.34%; oligodendrogliomas, 2.31 +/- 3.59%; ependymomas, 1.12 +/- 2.10%; medulloblastomas, 23.91 +/- 11.95%; and paragangliomas, 2.07 +/- 1.86%. Collectively, our findings indicate that while benign central nervous system tumors generally have low PCNA LI values, consistent over-expression of PCNA epitopes was noted in some examples, especially in a number of meningiomas. Among the malignant neuroectodermal tumors, medulloblastomas were found to have the highest PCNA LI values, corresponding to their histological grade of malignancy, and malignant glial tumors generally displayed significantly higher PCNA LI values, than their benign counterparts. Although in our study mean PCNA LI values seemed to reflect histological grading, large discrepancies were noted in all tumor groups. Our data, therefore, suggest than PCNA immunoreactivity can not be considered reliable for predicting the prognosis of the disease in individual cases.

Antigens, Neoplasm↗
PubMed1992

Neuron-associated class III beta-tubulin isotype, retinal S-antigen, synaptophysin, and glial fibrillary acidic protein in human medulloblastomas: a clinicopathological analysis of 36 cases.

Surgical specimens from 36 medulloblastomas (25 classic and 11 desmoplastic) were studied by peroxidase-antiperoxidase (PAP) immunohistochemistry with antibodies against the class III beta-tubulin isotype (beta-tubulin), synaptophysin, retinal S-antigen (S-Ag), and glial fibrillary acidic protein (GFAP). We found that neoplastic cells expressed beta-tubulin in 91% of the tumors (23 classic and 10 desmoplastic), synaptophysin in 75% (19 classic and 8 desmoplastic), S-Ag in 44% (11 classic and 5 desmoplastic), and GFAP in 11% of medulloblastomas (2 classic and 2 desmoplastic). Synaptophysin and beta-tubulin positivities were observed in undifferentiated neoplastic cells, in cells forming neuroblastic rosettes, and in pale islands, while S-Ag immunopositivity was noted in undifferentiated cells, occasionally in beta-tubulin-negative neuroblastic rosettes, and exceptionally in pale islands. Large pale islands, in two desmoplastic medulloblastomas, exhibited distinct patterns of immunoreactivity to the above markers, suggesting neuronal and glial differentiation in the central area, and intense neuritic development in the peripheral zone. Our findings confirm the predominant capacity of medulloblastoma cells to differentiate along neuronal cell lines and indicate that large pale islands, in desmoplastic medulloblastomas, represent well-organized areas for neuronal and, to a lesser degree, astroglial differentiation. Furthermore, it appears, in our cases, that immunohistochemical features do not represent clear-cut prognostic indicators in patients with medulloblastomas.

Adolescent↗
PubMed1991

Granular cell brain tumors of the laboratory rat: an immunohistochemical approach.

We have studied paraffin-embedded specimens of 17 rat granular cell brain tumors (GCBT) from four long-term drug safety carcinogenicity studies by peroxidase-antiperoxidase (PAP) immunohistochemistry with either polyvalent or monoclonal antibodies against glial fibrillary acidic protein (GFAP), S-100 protein (S-100), Leu-7 epitopes, vimentin (VIM), keratin, desmin, and myelin basic protein. We have found that 9 of the 17 GCBT contained GFAP-positive, S-100-positive, and VIM-positive astrocytes, while GFAP-positive and VIM-positive granular cells were observed in 5 of these 9 tumors. Our findings indicate that astroglial cells are involved in rat GCBT and suggest that an astrocytic origin should be considered for these neoplasms.

Animals↗
PubMedDate not supplied

Prognostic significance of Hsp-27 in astrocytic brain tumors: an immunohistochemical study.

Formalin-fixed paraffin-embedded tumor specimens from 95 patients with supratentorial astrocytic brain tumors were immunostained by a monoclonal antibody against the heat shock protein-27 (Hsp-27) using the streptavidin/peroxidase method. The immunohistochemical analysis was scored in a semiquantitative fashion incorporating both the intensity and distribution of specific staining (score): the immunohistochemical results were correlated with the histological grade of the tumors and patients' sex and age. Furthermore, Hsp-27 expression was studied in two groups into which the patients were further divided: group (a) previously untreated patients (n = 76) whose biopsy or surgical resection was related to their initial presentation and diagnosis and group (b) patients (n = 19) with reccurent disease who underwent radiotherapy and/or chemotherapy. Strong Hsp-27 cytoplasmic immunopositivity was observed in 42 out of 51 (82%) glioblastomas, in 8 out of 20 (40%) anaplastic astrocytomas and in 2 out of 24 (8%) astrocytomas. The mean Hsp-27 score was 45.2 in glioblastomas, 6.5 in anaplastic astrocytomas and 0.4 in astrocytomas. The expression of Hsp-27 immunoreactivity appeared to be independent of the age and sex of the patients. A non significant difference was defined between untreated patients and previously treated patients. Hsp-27 immunoreactivity was observed in the microvascular endothelial proliferations and in tumor blood vessels. Normal astrocytes were Hsp-27 negative. These findings indicate that, in contrast with the low Hsp-27 expression found in benign astrocytomas, the expression of Hsp-27 in a number of poorly differentiated tumors, including glioblastomas and anaplastic astrocytomas, is consistent and independent of previous treatment of the patients. We support the involvement of Hsp-27 in the growth of astrocytic brain tumors.

Adult↗
PubMedDate not supplied

Microvessel density in brain tumors.

Sections from formalin fixed paraffin embedded tumor tissue from 165 patients with brain tumors including 62 meningiomas, 80 supratentorial astrocytomas (19 astrocytomas-grade I/II, 20 anaplastic astrocytomas-grade III, 41 glioblastomas-grade IV), 7 cerebellar astrocytomas-grade I/II, one gliosarcoma, 7 oligodendrogliomas, 3 ependymomas and 5 medulloblastomas were immunostained for factor VIII-related antigen in order to highlight microvessel endothelial cells. Microvessel count (MVC; the highest number of microvessels in three areas of highest vascular density at X200 magnification) was determined and correlated with histological grade of tumors and patients' sex and age. The mean MVC was 27.9 in meningiomas. Astrocytic tumors, particularly malignant astrocytomas (grade III, IV), were highly vascular. The mean MVC as regards the supratentorial astrocytic neoplasms was 14.5 in astrocytomas (grade I/II), 42.3 in anaplastic astrocytomas (grade III) and 50.2 in glioblastomas (grade IV). All cerebellar astrocytomas studied, even though well differentiated (grade I/II), were highly vascularised tumors (MVC: 41.1. A comparison of the mean MVC vlaues showed that there was a statistically significant difference between supratentorial astrocytomas (Grade I-II) and cerebellar astrocytomas (Grade I-II) (p = 0.0004), anaplastic astrocytomas (Grade I-II) (p = 0.00004) and glioblastomas (p = 0.00001). There was no significant difference between cerebellar astrocytomas and anaplastic astrocytomas (p = 0.8) and glioblastomas (p = 0.4). Astrocytic neoplasms showed statistically significant higher mean MVC from meningiomas (p = 0.002). The mean MVC was 14.1 in oligodendrogliomas, 22.7 in ependymomas and 19.6 in medulloblastomas. In one gliosarcoma that was studied the MVC was 40. The MVC appeared to be independent of the age and sex of patients. This study supports the importance of microvessel density as a measure of angiogenesis, as well as a further morphologic feature in the classification of brain tumors. The determination of microvessel density may become useful in the planning and monitoring of anti-angiogenesis therapies of these tumors.

Adult↗
PubMedDate not supplied

Does sex steroid receptor status have any prognostic or predictive significance in brain astrocytic tumors?

Formalin-fixed paraffin-embedded tumor specimens from 90 patients with supratentorial astrocytic brain tumors were immunostained following microwave pretreatment using monoclonal antibodies against estrogen receptor (ER), progesterone receptor (PgR), and PS2 protein (PS2) and the streptavidin/peroxidase method. The immunohistochemical analysis was scored in a semiquantitative fashion incorporating both the intensity and distribution of specific staining (SCORE) and the immunohistochemical results were correlated with histologic grade of tumors and patient's sex and age. Strong PgR nuclear immunopositivity was observed in 27 of 46 (59%) glioblastomas, in 9 of 20 (45%) anaplastic astrocytomas, and in 2 of 24 (8%) astrocytomas. The mean PgR score was 18.5 in glioblastomas, 11.3 in anaplastic astrocytomas, and 0.9 in astrocytomas. The expression of PgR immunoreactivity appeared to be dependent on the age and independent of the sex of patients. All tumors were negative for ER and PS2 protein. Normal astrocytes remained consistently negative for both sex steroid receptors and PS2. Our findings indicate a consistent expression of PgR in a number of poorly differentiated tumors including glioblastomas and anaplastic astrocytomas contrasting with the low PgR score values found in benign astrocytomas. The absence of ER and PS2 immunoreactivities supports the hypothesis that estrogen receptor in astrocytic tumors is probably truncated. However, regional tumor heterogeneity may be a limiting factor for the use of ER, PgR, PS2 immunohistochemistry in the evaluation of routine pathology specimens examination.

Adolescent↗