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Margarita Gutova, Linda Flores, Vikram Adhikarla, Lusine Tsaturyan, Revathiswari Tirughana, Soraya Aramburo, Marianne Metz, Joanna Gonzaga, Alexander Annala, Timothy W Synold, Jana Portnow, Russell C Rockne, Karen S Aboody
Neural stem cells (NSCs) are inherently tumor-tropic, which allows them to migrate through normal tissue and selectively localize to invasive tumor sites in the brain. We have engineered a clonal, immortalized allogeneic NSC line (HB1.F3.CD21; CD-NSCs) that maintains its stem-like properties, a normal karyotype and is HLA Class II negative. It is genetically and functionally stable over time and multiple passages, and has demonstrated safety in phase I glioma trials. These properties enable the production of an "off-the-shelf" therapy that can be readily available for patient treatment...
2019: Frontiers in Oncology
James Turro, Pratiksha Singh, Manbeer Singh Sarao, Satish Tadepalli, Pramil Cheriyath
Background : Burkitt lymphoma is a rare, aggressive and rapidly fatal, B-cell non-Hodgkin's lymphoma. It has an incidence of 0.4/100,000 age-adjusted to the USA standard population. Here we describe the case of a 77-year-old patient who presented with Burkitt lymphoma. Case : A 77-year-old male presented to his primary care physician with fatigue and listlessness and was referred to the hospital with a white blood cell count (WBC)-23.7 K/uL (neutrophils 37%, lymphocyte 11%, blasts 9%) and platelets-19 K/uL...
2019: Journal of Community Hospital Internal Medicine Perspectives
Kazuya Miyoshi, Hirotoshi Takahashi, Maya Uno, Masaaki Akai, Eiji Moriyama, Tomio Nakagawa, Tsunehisa Nomura
Leptomeningeal metastasis(LM)is a rare complication in patients with breast cancer. We report 3 cases of LMs in patients with breast cancer who were treated with intrathecal methotrexate via an Ommaya reservoir. In 2 patients, a significant neurological improvement was observed, whereas in 1 patient there was no response. The overall survivals for the patients who experienced improvements were 22 and 9 months. Although we have no evidence for the efficacy of intrathecal chemotherapy for LMs in patients with breast cancer, its effects for some patients could be promising, after reservoir management and drug selection establishment...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Mariano Montes de Oca Delgado, Bernardo Cacho Díaz, José Santos Zambrano, Vicente Guerrero Juárez, Manuel Salvador López Martínez, Elvira Castro Martínez, Javier Avendaño Méndez-Padilla, Sonia Mejía Pérez, Ignacio Reyes Moreno, Axayacatl Gutiérrez Aceves, Alberto González Aguilar
Object: Leptomeningeal Carcinomatosis (LCM) represents a state of systemic malignant disease with poor prognosis. The purpose of this study is to compare overall survival (OS) between intraventricular chemotherapy through Ommaya reservoir (OR) and chemotherapy through lumbar puncture (LP) in LCM. Patients and Methods: Forty adult patients with LCM were included. All patients underwent lumbar puncture and Magnetic resonance imaging (MRI). Thirty patients received chemotherapy through LP and 10 undergone colocation of Ommaya reservoir for intraventricular chemotherapy...
2018: Frontiers in Oncology
Jonathan C Lau, Suzanne E Kosteniuk, Thomas Walker, Alla Iansavichene, David R Macdonald, Joseph F Megyesi
BACKGROUND: The use of image guidance (IG) in neurosurgery is ubiquitous, even though evidence from patient outcome data has remained limited to smaller, mostly observational, studies. Ommaya reservoir insertion (ORI) has been available as a treatment option for targeted intraventricular pharmacotherapy since the 1960's, far preceding the modern neuronavigation era. We conducted a systematic review and meta-analysis investigating the impact of IG on surgical outcome from ORI. METHODS: A systematic database search of MEDLINE and EMBASE was performed to identify studies on operative outcomes from ORI...
November 14, 2018: World Neurosurgery
Khilen B Patel, Anna Gaidis, Angela Stephens, Thomas Z Thompson, Heather Williams, Bunja Rungruang
•CNS metastases involving leptomeninges (LM) are extremely rare in patients with ovarian cancer.•Prognosis for ovarian cancer patients with LM metastases is very poor and treatment is palliative in nature.•Chemotherapy is administered intrathecally via an Ommaya reservoir or intra-CSF via repeated lumbar punctures.•Early recognition of LM metastases can help maintain the patients' quality of life by minimizing neurological deficits.
November 2018: Gynecologic Oncology Reports
Arthur Wang, Michael S Tenner, Meic Schmidt, Christian Bowers
OBJECTIVE: Placement of intraventricular catheters in oncology patients is associated with high complication rates. Placing Ommaya reservoirs with the Zero-Error Precision Protocol (ZEPP), a combination of neuronavigation (AxiEM stealth frameless neuronavigation system) and direct verification of catheter tip placement with a flexible neuroendoscope is associated with decreased complication rates as a result of increased catheter placement accuracy. However, ZEPP costs more than traditional methods of catheter placement and the question of whether this increased accuracy with ZEPP is cost-effective is unknown METHODS: We performed a single-center retrospective chart review of 50 consecutive Ommaya reservoir patient placements between 2010 and 2017...
November 4, 2018: World Neurosurgery
Rihito Aizawa, Megumi Uto, Keiichi Takehana, Yoshiki Arakawa, Susumu Miyamoto, Takashi Mizowaki
Cystic brain necrosis (CBN) is a rare form of BN. It typically occurs as a very late complication, and no standard treatment has been established. We report a case of a 59-year-old man who developed CBN 10 years after radiation therapy for metastatic brain tumors. The therapy consisted of whole brain radiotherapy followed by linac-based stereotactic radiosurgery as a boost. Initially, the CBN continued to expand despite treatment with corticosteroids and bevacizumab. Therefore, we resected the tumor and implanted an Ommaya reservoir, which successfully stabilized the lesion...
November 2018: Oxford Medical Case Reports
Marija Stevic, Dusica Simic, Nina Ristic, Ivana Budic, Vesna Marjanovic, Marija Jovanovski-Srceva, Nikola Repac, Milica Rankovic-Janevski, Goran Tasic
Purpose: Preterm newborns, due to many factors, are at increased risk for poor neural development, intraventricular hemorrhages, infections, and higher rate of mortality. The aim of this study was to evaluate the risk factors associated with poor outcome in preterm neonates with late-onset neonatal sepsis (LONS) who had posthemorrhagic hydrocephalus and underwent neurosurgical procedures for treatment of the hydrocephalus. Patients and methods: Preterm neonates who had undergone insertion of ventriculoperitoneal shunt or Ommaya reservoir, during the 10-year period at University Children's Hospital, were retrospectively analyzed...
2018: Therapeutics and Clinical Risk Management
Gurpreet S Bhalla, Muqtadir Malik, Manbeer S Sarao, Kuntal Bandyopadhyay, Pratiksha Singh, Satish Tadepalli, Lavan Singh
Meningitis is a common and life-threatening infection of the central nervous system (CNS) in infants with long-term and disabling sequelae like hydrocephalus. Hydrocephalus is treated by diverting cerebrospinal fluid (CSF) either to another body cavity (via CSF shunt) or externally (via CSF drain) which are prone to infection. Though rare, Candida parapsilosis ( C. parapsilosis ) is a known pathogen in device-associated CNS infections and has been reported in both, infants and adults. A six-month-old male infant was brought to the hospital with disproportionate head enlargement of three months duration...
August 14, 2018: Curēus
Joakim Bergman, Joachim Burman, Jonathan D Gilthorpe, Henrik Zetterberg, Elena Jiltsova, Tommy Bergenheim, Anders Svenningsson
OBJECTIVES: To perform a phase 1b assessment of the safety and feasibility of intrathecally delivered rituximab as a treatment for progressive multiple sclerosis (PMS) and to evaluate the effect of treatment on disability and CSF biomarkers during a 1-year follow-up period. METHODS: Three doses of rituximab (25 mg with a 1-week interval) were administered in 23 patients with PMS via a ventricular catheter inserted into the right frontal horn and connected to a subcutaneous Ommaya reservoir...
November 13, 2018: Neurology
Lonnie G Petersen, Justin S Lawley, Alexander Lilja-Cyron, Johan C G Petersen, Erin J Howden, Satyam Sarma, William K Cornwell, Rong Zhang, Louis A Whitworth, Michael A Williams, Marianne Juhler, Benjamin D Levine
KEY POINTS: During long-term missions, some astronauts experience structural and functional changes of the eyes and brain which resemble signs/symptoms experienced by patients with intracranial hypertension. Weightlessness prevents the normal cerebral volume and pressure 'unloading' associated with upright postures on Earth, which may be part of the cerebral and ocular pathophysiology. By placing the lower body in a negative pressure device (LBNP) that pulls fluid away from cranial compartments, we simulated effects of gravity and significantly lowered pressure within the brain parenchyma and ventricle compartments...
October 4, 2018: Journal of Physiology
Min-Gi Lee, Jin-Gyu Choi, Byung-Chul Son
Herein, we describe a fatal case of central nervous system (CNS) pseudallescheriasis following near-drowning. A 13-year-old boy, who had been successfully resuscitated after near-drowning, presented with a transient episode of mental confusion during a hospital stay after recovering from severe aspiration pneumonia and respiratory failure. A magnetic resonance imaging (MRI) scan of the brain showed a small brain abscess in the left basal ganglia and ventriculitis in the left lateral ventricle. The brain abscess and ventriculitis did not respond to 4 weeks of antibiotic treatment and appeared even worse on a follow-up MRI...
July 2018: Asian Journal of Neurosurgery
Albert Sii-Hieng Wong, Vincent Boon-Hean Chen
Introduction: This study describes a technique using gravity for guidance in stereotactic brain biopsy. This will be especially useful in hospitals where the stereotactic equipment is unavailable. Objectives: The aim of this study is to describe the technique, develop a formula to define its limits of accuracy, and report on its clinical application. Methods: Using the positioning laser grid lines on the computed tomography scanner, a small metallic marker is placed on the scalp at the intended biopsy site...
July 2018: Asian Journal of Neurosurgery
Yoon Hwan Byun, Ho Shin Gwak, Ji-Woong Kwon, Kwang Gi Kim, Sang Hoon Shin, Seung Hoon Lee, Heon Yoo
OBJECTIVE: The purpose of this pilot study was to examine the safety and function of the newly developed cerebrospinal fluid (CSF) reservoir called the V-Port. METHODS: The newly developed V-Port consists of a non-collapsible reservoir outlined with a titanium cage and a connector for the ventricular catheter to be assembled. It is designed to be better palpated and more durable to multiple punctures than the Ommaya reservoir. A total of nine patients diagnosed with leptomeningeal carcinomatosis were selected for V-Port insertion...
September 2018: Journal of Korean Neurosurgical Society
Maria-Jesus Lobon-Iglesias, Vicente Santa-Maria Lopez, Patricia Puerta Roldan, Santiago Candela-Cantó, Monica Ramos-Albiac, Marta Gomez-Chiari, Stephanie Puget, Stephanie Bolle, Liliana Goumnerova, Mark W Kieran, Ofelia Cruz, Jacques Grill, Andres Morales La Madrid
OBJECTIVE Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive and lethal brainstem tumor in children. In the 1980s, routine biopsy at presentation was abandoned since it was claimed "unnecessary" for diagnosis. In the last decade, however, several groups have reincorporated this procedure as standard of care or in the context of clinical trials. Expert neurosurgical teams report no mortality and acceptable morbidity, and no relevant complications have been previously described. The aim of this study was to review needle tract dissemination as a potential complication in DIPG...
September 7, 2018: Journal of Neurosurgery. Pediatrics
Meric A Altinoz, Ayhan Bilir, İlhan Elmaci
BACKGROUND: PPAR-δ is a transcription factor which has crucial roles in stimulating oligodendroglial differentiation and myelination and its activation was also shown to differentiate malignant C6 glioma cells into oligodendrocytes. OBJECTIVE: One of the ligands of PPAR-δ is erucic acid (EA), an edible omega-9 fatty acid consumed more by Asian populations and exists highly in Chinese womens milk. There exist epidemiological evidence that pediatric brain tumor incidence is among the lowest in the Chinese population...
October 1, 2018: Chemico-biological Interactions
Uday Yanamandra, Eshita Raju, Rajan Kapoor, Suman Pramanik, Ankur Ahuja, Tathagata Chatterjee, Satyaranjan Das
No abstract text is available yet for this article.
July 2018: Indian Journal of Hematology & Blood Transfusion
Ruairi Wilson, Caroline Osborne, Christina Halsey
Prophylactic eradication of central nervous system (CNS) leukaemia is the current standard of care in treating childhood acute lymphoblastic leukaemia (ALL). This is conventionally achieved through regular lumbar punctures with intrathecal injections of methotrexate into the cerebrospinal fluid (CSF). Ommaya reservoirs are subcutaneous implantable devices that provide a secure route of drug delivery into the CSF via an intraventricular catheter. They are an important alternative in cases where intrathecal injection via lumbar puncture is difficult...
August 2018: Paediatric Drugs
Pietro Meneghelli, Alberto Pasqualin, Piergiuseppe Zampieri, Michele Longhi, Roberto Foroni, Antonio Sini, Nicola Tommasi, Antonio Nicolato
OBJECTIVE: The goal of this study is to report our experience in the surgical treatment of cerebral arteriovenous malformations (cAVMs) related permanent symptomatic adverse radiation effects (PSAREs), to clarify an appropriate surgical management and to identify the risk factors related to their development. METHODS: We evaluated 549 patients treated with Gamma Knife radiosurgery (GKRS) for cAVMs with a follow-up of at least 8 years. Univariate and multivariate analyses were used to test different risk factors related to the development of PSARE...
June 2018: World Neurosurgery
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