Telomerase Activity and Correlation with Histological Malignancy and Prognosis in Brain Tumors

OBJECTIVE: Telomerase, a ribonucleoprotein adds telomeric sequences repeatedly to the ends of telomeres to compensate for the progressive loss. A favorable prognosis might be associated with low or no telomerase activity in some tumors. We present the correlation of the telomerase activity and the prognosis of patients with brain neoplasms. METHODS: Between March 1998 and December 1999, 62 patients with brain tumors underwent surgery and their surgical specimens were studied. Telomerase activity was investigated by telomeric repeats amplification protocol assay and the survival time was analyzed, retrospectively. The significance and the correlation of data were also assessed statistically. RESULTS: There was no significant difference in the expression of telomerase activity among histological types. However, a significant difference was noted in the expression of telomerase activity between high-grade gliomas and low-grade gliomas(p=0.022). The overall mean survival time of telomerase-positive and telomerase-negative groups in 11 dead patients were 11.4+/-6.6 months and 15.0+/-8.4 months respectively, and its difference was statistically significant(p=0.038). CONCLUSION: Our data suggests that telomerase may play a role in biological malignancy of the gliomas and also can be used as a prognostic indicator for the survival time of brain tumors.

Dual Pedicle Artery Giant Aneurysm: Case Report

The term of "pedicle aneurysm" has been only cited in combination with the arteriovenous malformation (AVM). However, authors report a case with a pure pedicle aneurysm, which is not associated with AVM. A 29-year-old female patient presented with postpartum seizure and vomiting. Four days before, she delivered her second baby through Cesarean section. On admission, neuroimaging studies demonstrated the Fisher Grade II subarachnoid hemorrhage with a large round partially thrombosed supra- and retrosellar vascular mass. The subsequent magnetic resonance and cerebral angiography revealed a giant saccular aneurysmal sac which was fed by two pedicle arteries. Despite the intraoperative rupture, the aneurysm was completely obliterated via orbitozygomatic approach and the dural pedicle arteries were verified. On postoperative third day, hypothalamic ischemic infarction with moderate hemispheric brain swelling developed. She died on the 4th postoperative days . We report a special case of dual pedicle artery giant aneurysm supplied from the anterior and posterior cerebral circulation simultaneously.