Biomedical subjects

Tadej Strojnik

Publications and source records attributed to Tadej Strojnik.

8 recordsLinked to original sources

PubMed2006

Different approaches to surgical treatment of arachnoid cysts.

Although most arachnoid cysts remain static fluid-filled compartments throughout life, some become enlarged, exerting a mass effect on adjacent neural structures. The decision-making process for patients with arachnoid cysts still represents a challenge for the neurosurgeon. We report three cases of intracranial arachnoid cysts treated with different surgical approaches: (i) endoscopic fenestration of the cyst into the lateral ventricle; (ii) a cystoperitoneal shunt; (iii) a cystoperitoneal shunt and establishment of communication between the cyst and the fourth ventricle with the help of an endoscope. Given the advances in instrumentation over the past decade, it is probable that most arachnoid cysts will be managed endoscopically in the future.

Adult↗

PubMed2005

Cathepsin L in glioma progression: comparison with cathepsin B.

OBJECTIVE: Lysosomal cysteine cathepsins have been implicated in tumor progression. This study is aimed to reveal differential expression and compare the prognostic significance of cathepsins B and L in glioma patients. METHODS: The histological slides of 82 patients with primary astrocytic tumors were reviewed. We evaluated the immunostaining of the cathepsins in tumor and endothelial cells. RESULTS: Cathepsins B and L stained positive in 98 and 88% of cases, respectively. The total score was significantly higher in malignant than in benign tumors, both for cathepsin B (p<0.001) and for cathepsin L (p<0.01). The IHC score in endothelial cells in the malignant group was significantly higher only for cathepsin B (p<0.0001). Survival analysis indicated that in contrast to the prognostic significance of total cathepsin B and endothelial cells associated cathepsin B for shorter patients' survival, the prognostic role of cathepsin L was not confirmed. CONCLUSION: Cathepsin L is preferentially expressed in tumor cells, increasing with glioma progression, but is not significantly associated with new vasculature of glioblastoma. In contrast to cathepsin B, cathepsin L has no prognostic impact, suggesting different roles of the two cathepsins in glioma progression.

Adolescent↗

PubMed2005

A colloid cyst of the third ventricle -- the cause of episodic headache and sudden unexpected death in an adolescent girl.

An 18-year-old girl was found dead in her bed. The autopsy revealed a colloid cyst of the third ventricle. The cyst obstructed the flow of cerebrospinal fluid, leading to prominent internal hydrocephalus with consecutive brain edema and compression of the caudal medulla at the foramen magnum. The girl's only previous complaints were episodic headaches for the previous 2-3 years. Computed tomography and magnetic resonance imaging were not performed prior to her death. This case report highlights the importance of early diagnosis of colloid cyst of the third ventricle and the need to perform computed tomography and magnetic resonance imaging in patients with episodic headaches even when they show no neurologic deficit. Although it is a very rare disorder, it should be included in the differential diagnosis of headaches in children and young adults, and also in the differential diagnosis of conditions causing increased intracranial pressure, in view of the life-saving management required to prevent a fatal outcome.

Adolescent↗

PubMed2004

A review of civilian gunshot wounds to the head in northeast Slovenia: 1992 to 2002.

BACKGROUND: Surgical management of gunshot wounds to the head has remained a controversial issue. There are considerable regional differences in the causes of civilian gunshot wounds (GSW) to the head and various devices are used in different countries. The aim of our study was to review the demographic factors, treatment and outcome of patients with GSW to the head over the past 10 years at Maribor Teaching Hospital. PATIENTS AND METHODS: Thirty-seven patients with GSW to the head (35 male and 2 female; mean age 43.3 +/- 15.5 years) were included in the study. Clinical and radiological findings are described. Statistical analysis was used to find the effects of all independent variables on mortality and prognostic factors. RESULTS: The great majority (86.5%) of our patients suffered self-inflicted wounds. The weapon used was a stunning device in 54% of cases and a handgun in 46%. Alcohol consumption was documented in 40% patients. Nearly half (48.9%) of our patients were either industrial workers or farmers. Postresuscitation Glasgow Coma Scale (GCS) scores of 3-8 were recorded in 54%. The pupils were fixed and dilated in 32.4% of our patients; hypotension was documented in 8.1% and apnea in 27%. These parameters were significantly correlated with poor outcome. A bihemispheric lesion was found in 37.8%, a transventricular lesion in 54% and a multilobar lesion in 70.3% of patients. Those factors were also associated with poor outcome. The majority of patients (56.8%) underwent operation immediately, in 13.5% the operation was delayed and 29.7% of patients had no surgery. The overall mortality was 51.4%, a poor outcome was noted in 24.3% and a good one was achieved in 24.3%. CONCLUSION: The results of our study support previous ones stating that patients with GSW to the head can benefit from aggressive treatment and still make satisfactory recoveries. Clearly, there are ethical dilemmas involved in withholding operative treatment from any individual. Guidelines dictating when to surgically intervene must be made.

Adolescent↗

PubMed2004

Brain abscess after milk tooth self-extraction.

Brain abscesses are rare, especially in children, but they can be life-threatening infections. To date, dental pathology has been linked to only a small number of brain abscesses. To our best knowledge this is the first reported case of a brain abscess following self-extraction of a milk tooth. We are reporting on a 12-year-old previously healthy boy who developed a brain abscess in the vicinity of the left precentral gyrus. Clinical examination prior to surgery showed a severe right hemiparesis, more pronounced in his leg. We performed an ultrasonographically guided puncture and aspiration of the abscess through a small craniotomy. Immediately after the procedure he became hemiplegic. Bacteriological examination of the aspirated pus revealed Streptococcus intermedius, Streptococcus beta-haemolyticus group F, Fusobacterium species and gram-negative rods. The same species of microorganisms were identified in a smear from the vicinity of the extracted tooth. The patient was carefully screened for possible other sources of infection, but none was found. Following appropriate antimicrobial treatment he recovered completely and returned home without any neurological deficit.

Anti-Bacterial Agents↗

PubMed2002

Lysosomal enzymes, cathepsins in brain tumour invasion.

The expression patterns of different classes of peptidases in central nervous system (CNS) tumours have been most extensively studied in astrocytomas and meningiomas. Although the two types of tumours are very different in most respects, both may invade locally into normal brain. This process of invasion includes increased synthesis and secretion of lysosomal proteolytic enzymes - cathepsins. Aspartic endopeptidase cathepsin (Cat) D levels were found to be elevated in high-grade astrocytoma and partial inhibition of glioblastoma cell invasion by anti-Cat D antibody suggests that the enzyme activity is involved in the invasion process. Several studies on cysteine endopeptidase (CP) Cat B in gliomas agreed that transcript abundance, protein level and activity of Cat B increased in high-grade astrocytoma cultures compared with low-grade astrocytoma cultures and normal brain. Moreover, in glioma biopsies Cat B levels correlated with evidence of clinical invasion and it has been demonstrated that Cat B both in tumour cells and in endothelial cells can serve as a new biological marker for prognosis in glioblastoma patients. A high level of Cat B protein was also a diagnostic marker for invasive types of meningioma, distinguishing between histomorphologically benign, but invasive meningiomas and noninvasive, so-called clear-benign meningiomas. Cat L was also significantly increased in high-grade astrocytoma compared with low-grade astrocytoma and normal brain. Specific Cat L antibodies and antisense Cat L RNA transfection significantly lowered glioblastoma cell invasion. In meningioma, Cat L was a less-significant marker of invasion than Cat B. In contrast to cathepsins, the activities of endogenous cysteine peptidase inhibitors (CPIs), including stefins, cystatins and kininogens, were significantly higher in benign and atypical meningioma cell extracts than in malignant meningioma, and low-grade compared to high-grade astrocytoma. However, very low levels of stefins A and B were found in meningioma and glioblastoma tissues. Further studies on the expression levels and balance between cysteine endopeptidases (CPs) and CPIs would improve the clinical application of cathepsins in prognosis, which would lead to more-informed therapeutic strategies.

Animals↗

PubMedDate not supplied

Immunohistochemical staining of cathepsins B, L and stefin A in human hypophysis and pituitary adenomas.

BACKGROUND: New biological markers are needed for diagnosis of atypical pituitary adenoma. The study aimed to evaluate cathepsins B and L and inhibitor stefin A in relation to their aggressive progression. PATIENTS AND METHODS: We evaluated 19 adenomas and 10 normal hypophyses. Adenomas were divided according to their histological features and according to their functional activity, e.g. hormones secretion. Immunohistochemical labelling was scored for cathepsins and stefin A. RESULTS: High immunohistochemical scores for cathepsins B and L were more frequent in atypical pituitary adenoma. Higher cathepsin B scores were also observed in functional compared with non-functional tumours, independently of their histology. Stefin A labelling was observed in 90% of normal hypophyses, but only in 10% of adenomas: CONCLUSION: The levels of cathepsins B and L antigens are significantly higher in histologically atypical adenomas. Cathepsin B is also a marker of functional activity of the neoplastic glands. Therefore, we propose that this enzyme is evaluated as a diagnostic marker for tumour progression in non-functional adenomas, to distinguish atypical from benign tumours.

Adenoma↗

PubMedDate not supplied

Experimental model and immunohistochemical analyses of U87 human glioblastoma cell xenografts in immunosuppressed rat brains.

BACKGROUND: To study the neuropathology and selected tumour markers of malignant gliomas, an animal glioma model was developed using the implantation of human glioblastoma clone U87 into rat brains. MATERIALS AND METHODS: The U87 cell suspension, or precultured U87 tumour spheroids, were inoculated into the brain of 4-week-old cyclosporin A immunosuppressed Wistar rats. The resulting first generation tumours were then transferred, through serial transplantations to rats, to obtain second and third generation tumours. Brain tumour sections were examined for various known tumour markers by routine HE staining and immunohistochemical analyses. RESULTS: The immunohistochemical analyses showed that p53, S100 protein, glial fibrillary acidic protein (GFAP) and synaptophysin expressions, initially present in the tissue culture, were gradually lost in later tumour generations, whereas nestin and musashi expressions increased, possibly indicating progressive tumour cell dedifferentation. Persistent kallikrein, CD68 and vimentin expressions in U87 cells, as well as in all the generations of tumours, may be related to the preservation of the mesenchymal cell phenotype in this tumorigenesis model. Decreased cathepsins expression indicated lower invasive potential, but increasing Ki-67 expression marked higher proliferation activity in the subsequent tumour generations. The strong immune reaction for FVIII in the second and third generation tumours correlated with the observed increase in vascular proliferation in these tumours. CONCLUSION: A simple, and well-defined rat model of fast-growing glioma was established, providing a basis for further experimental studies of genetic and protein expression fingerprints during human glioma tumorigenesis.

Animals↗