A novel indication of thioredoxin-interacting protein as a tumor suppressor gene in malignant glioma.

Malignant glioma, the most common form of primary brain tumor, is associated with substantial morbidity and mortality, owing to the lack of response shown by patients to conventional therapies. Additional therapeutic targets and effective treatment options for these patients are therefore required. In the present study, a possible association of thioredoxin-interacting protein (TXNIP) with malignant glioma was evaluated. Initially, semi-quantitative and quantitative analysis of the expression levels of TXNIP in clinical specimens of primary glioma was performed via immunohistochemistry (IHC) and reverse transcription-quantitative polymerase chain reaction (RT-qPCR), respectively, and expression levels were further correlated to the overall survival time of the patients. The proliferative, migratory and invasive properties of the glioblastoma U251 cell line, engineered to downregulate TXNIP by lentiviral transfection of a specific short hairpin RNA, were evaluated by means of in vitro assays. Consequently, IHC and RT-qPCR analysis revealed a negative association between the expression level of TXNIP and the histopathological grade of the tumor. Higher TXNIP expression level was associated with extended patient survival time. In vitro analysis revealed increased growth, migration and invasion in U251 cells with downregulated TXNIP expression compared with their non-transfected counterparts. These findings strongly indicate that TXNIP functions as a tumor suppressor in malignant glioma cells and underscore its potential as a novel therapeutic target and prognostic indicator of the condition.

Assessment and Treatment of Peritumoral Cortical Veins in Parasagittal Meningiomas with Application of 3-Dimensional Imaging Fusion Model.

BACKGROUND: Operation of cortical veins is the keystone of parasagittal meningioma (PSM) resection. Little is known about pathologic changes of the veins and proper treatment. We built 3-dimensional (3D) image fusion models by neuronavigation to analyze the features of peritumoral cortical veins for PSMs and explore intraoperative treatment options. METHODS: We performed a prospective study of 42 consecutive surgically treated PSM patients who underwent preoperative evaluation of peritumoral cortical veins using a 3D venous-tumor fusion model established by a neuronavigation system. We categorized cortical veins into 3 types: single-end anastomosis (type a), tumor-to-end anastomosis (type b), and end-to-end anastomosis (type c). We present surgical strategies to operate these veins. RESULTS: Preoperative evaluation demonstrated 39 patients with peritumoral cortical veins. The 3D models show 100% of the veins (95 in total), which were confirmed intraoperation. The postoperative complication rates after vein injury were 60% (type a), 16.7% (type c), and 0% (type b). Ten patients (23.8%) had residual tumor because of venous protection (equal to Simpson grade III). After correlation analysis, type b and c cortical veins were positively correlated with tumor volume. CONCLUSIONS: The anastomoses of cortical veins may provide compensation for venous transaction. There may be a time-evolution relationship between different cortical veins (type a to c to b). Treatment of cortical veins should follow the following principles: single-end veins must be protected, tumor-to-end veins should be transacted directly, and end-to-end veins could be cut selectivity based on the degree of occlusion of the superior sagittal sinus. Detailed preoperative assessment of peritumoral cortical veins is critical for proper treatment.

Development of prognostic models for patients with traumatic brain injury: a systematic review.

Outcome prediction following traumatic brain injury (TBI) is a widely investigated field of research. Several outcome prediction models have been developed for prognosis after TBI. There are two main prognostic models: International Mission for Prognosis and Clinical Trials in Traumatic Brain Injury (IMPACT) prognosis calculator and the Corticosteroid Randomization after Significant Head Injury (CRASH) prognosis calculator. The prognosis model has three or four levels: (1) model A included age, motor GCS, and pupil reactivity; (2) model B included predictors from model A with CT characteristics; and (3) model C included predictors from model B with laboratory parameters. In consideration of the fact that interventions after admission, such as ICP management also have prognostic value for outcome predictions and may improve the models' performance, Yuan F et al developed another prediction model (model D) which includes ICP. With the development of molecular biology, a handful of brain injury biomarkers were reported that may improve the predictive power of prognostic models, including neuron-specific enolase (NSE), glial fibrillary acid protein (GFAP), S-100ß protein, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), myelin basic protein (MBP), cleaved tau protein (C-tau), spectrin breakdown products (SBDPs), and ubiquitin C-terminal hydrolase-L1 (UCH-L1), and sex hormones. A total of 40 manuscripts reporting 11 biomarkers were identified in the literature. Many substances have been implicated as potential biomarkers for TBI; however, no single biomarker has shown the necessary sensitivity and specificity for predicting outcome. The limited number of publications in this field underscores the need for further investigation. Through fluid biomarker analysis, the advent of multi-analyte profiling technology has enabled substantial advances in the diagnosis and treatment of a variety of conditions. Application of this technology to create a bio-signature for TBI using multiple biomarkers in combination will hopefully facilitate much-needed advances. We believe that further investigations about brain injury biomarkers may improve the predictive power of the contemporary outcome calculators and prognostic models, and eventually improve the care of patients with TBI.

Immature teratoma of the posterior cranial fossa in a 4-month-old infant: A case report.

The present study analyzed a case of immature teratoma in the posterior cranial fossa of an infant and compared the clinical data with the associated literature. Ventricular drainage was initially performed upon the patient's admission to the hospital. Following adequate pre-operative preparations, the tumor in the posterior cranial fossa was resected on the third day. No significant neurological function deficiency was observed following the surgery and no recurrence was noted within an 18-month follow-up period. In such cases, treatment should be conducted in a stepwise manner, with the hydrocephalus relieved first, followed by complete tumor resection subsequent to full preparation. Post-operative chemotherapy was not performed by conventional means as the infant was too weak, therefore, periodic reviews and long-term follow-up were required.