Meningiomas represent one of the most common intracranial tumours. They are generally thought to progress from low to high-grade lesions. However, the molecular mechanisms underlying their pathogenesis remain still uncertain. Abnormalities of chromosome 14q32 where a novel Maternally Expressed Gene 3 (MEG3) is located have been recently reported in high-grade/recurrent tumours. As MEG3 is capable of interacting with GDF15, MDM2, p53, VEGF and cAMP in different tissues, the aim of the project is to answer the question how, if at all do the interactions play a role in tumour progression, survival, recurrence, and response to radiotherapy in meningiomas. We suppose the existence of a correlation between the parameters that will help to predict more precisely their biological behaviour and response to therapy. Identification of meningioma molecular subgroups may have significant potential to improve clinical management, through molecular disease-risk stratification strategies and the identification of patients who could benefit from silencing targeted molecular therapeutics.

Meningeomy představují jedny z nejčastějších intrakraniálních nádorů. V důsledku genetických abnormalit můžou progredovat od nízkostupňových k malignějším formám. V současnosti přesný mechanizmus jejích patogeneze zůstává nejasný. V poslední době byly u vysokostupňových/rekurentních nádoru pozorovaný abnormality chromozómu 14q32, kde je lokalizovaný také nově popsaný Maternálně exprimovaný gen 3 (MEG3). Vzhledem k tomu, že MEG3 interaguje s GDF15, MDM2, p53, VEGF a cAMP v rozličných typech tkání, cílem této studie je odpovědět na otázku jestli tyto interakce hraji roli také v meningeomové progresi, rekurenci, přežívání či odpovědi na radioterapii u těchto pacientů. Na základě těchto poznatků se domníváme, že identifikace takových korelací by mohla pomoci předpovědět vývoj onemocnění a odpověď na podanou léčbu. Navíc identifikace molekulárně odlišných podskupin meningeomů muže mít významný vliv na zlepšení léčebného procesu v důsledků stanovení molekulárního rizika onemocnění a identifikace pacientů, který by mněli užitek z potlačení abnormalit specifické signální transdukce.

• MeSH
• genetické testování MeSH
• meningeom MeSH
• mikro RNA MeSH
• nádorové biomarkery MeSH
• radioterapie MeSH
• sekvenční analýza hybridizací s uspořádaným souborem oligonukleotidů MeSH
• staging nádorů MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• genetika, lékařská genetika
• onkologie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR

Background: Optimal surgical treatment of blood-blister aneurysms (BBA) remains controversial. Some surgeons prefer clipping reconstruction while others favor primary bypass with trapping. Objective: To analyze of benefit of double bypass technique to surgical outcomes in patients with ruptured BBA in poor initial neurological condition (PINC). Methods: Retrospective analysis of clinical, radiological, and surgical data in 9 patients treated between January 2009 and December 2015. Intraoperative middle cerebral artery blood pressure (MCABP) measurement was used for selection of bypass procedure. Results: Seven patients presented with World Federation of Neurosurgical Societies (WFNS) subarachnoid hemorrhage (SAH) score 4 or 5. No pulse pressure in the MCA after internal carotid artery (ICA) clamping was found in 3 patients, although their ACoA or PCoA were well visualized on preoperative angiograms. By contrast, only a minimal drop in MCABP following ICA clamping was detected in two cases, although their collaterals were slim/nonvisualized on imaging. Although angiographic vasospasms were not observed in our patients, two of them experienced cerebral infarction, attributable more to the mass effect and postoperative ICA thrombosis than to SAH-induced vasospasm. There were 2 premature intraoperative ruptures, but no perioperative mortality, aneurysm recurrence, or rebleeding. Five patients with WFNS SAH score 4 or 5 achieved favorable outcomes. Conclusion: Early double bypass technique guided by MCABP measurement and combined with trapping (or rarely clipping) seems to be a safe method with excellent long-term outcomes in patients in PINC. This study may thus contribute to the debate on the optimal treatment strategy for BBA.

BACKGROUND: Regional variability in dural sinus (DS) wall thickness in posterior cranial fossa (PCF) have not been studied in detail yet. OBJECTIVE: To clarify the possible regional variability in DS wall thickness and determine the occurrence and localization of the chordae Willisii (CW) in PCF. METHODS: Fifty-nine human cadaveric DSs of PCF were investigated. A measurement of the DS walls/dura mater/CW thickness of parafin-embedded/hematoxylin-eosin stained axial sections was performed by using Cell Sens Science Imaging Software (Olympus Corporation, Tokyo, Japan). RESULTS: The osseus wall (OW) was the thickest one in the confluens sinuum (CS) and the thinnest one in the jugular bulb (JB) and sigmoid sinus (P < .05). The biggest differences between individual walls were observed in the JB where the superior wall was almost twice as thick as the OW. At the transverse-sigmoid junction, the thickness of the walls was comparable. In the CS and transverse sinuses, the OW was even thicker than the surrounding dura mater. The occurrence and thickness of the CW increased from the JB towards CS and prevailed on the right side. An overall number of the CW in PCF was comparable to that observed in the superior sagittal sinus. CONCLUSION: The present study displayed for the first time the regional variability in the DS walls thickness and occurrence of the CW in PCF. Application of these findings may afford greater freedom in exposure of the DSs or neoplasms adhering to the DSs. Copyright © 2018 by the Congress of Neurological Surgeons.

• MeSH
• dospělí MeSH
• dura mater * anatomie a histologie   MeSH
• individualita MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mrtvola MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sinus durae matris * anatomie a histologie   MeSH
• zadní jáma lební * anatomie a histologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH