ABSTRACT
While serial sampling of glioma tissue is rarely performed prior to recurrence, cerebrospinal fluid (CSF) is an underutilized longitudinal source of candidate glioma biomarkers for understanding therapeutic impacts. However, the impact of key variables to consider in longitudinal CSF samples, including anatomical location and post-surgical changes, remains unknown. To that end, pre- versus post-resection intracranial CSF samples were obtained at early (1-16 days; n=20) or delayed (86-153 days; n=11) timepoints for patients with glioma. Paired lumbar-versus-intracranial glioma CSF samples were also obtained (n=14). Using aptamer-based proteomics, we identify significant differences in the CSF proteome between lumbar, subarachnoid, and ventricular CSF. Our analysis of serial intracranial CSF samples suggests the early potential for disease monitoring and evaluation of pharmacodynamic impact of targeted therapies. Importantly, we found that resection had a significant, evolving longitudinal impact on the CSF proteome. Proteomic data are provided with individual clinical annotations as a resource for the field. One Sentence Summary: Glioma cerebrospinal fluid (CSF) accessed intra-operatively and longitudinally via devices can reveal impacts of treatment and anatomical location.
ABSTRACT
D-2-hydroxyglutarate (D-2-HG) is a well-established oncometabolite of isocitrate dehydrogenase (IDH) mutant gliomas. While prior studies have demonstrated that D-2-HG is elevated in the cerebrospinal fluid (CSF) of patients with IDH-mutant gliomas 1,2 , no study has determined if CSF D-2-HG can provide a plausible method to evaluate therapeutic response. We are obtaining CSF samples from consenting patients during their disease course via intra-operative collection and Ommaya reservoirs. D-2-HG and D/L-2-HG consistently decreased following tumor resection and throughout chemoradiation in patients monitored longitudinally. Our early experience with this strategy demonstrates the potential for intracranial CSF D-2-HG as a monitoring biomarker for IDH-mutant gliomas.
ABSTRACT
Web-based education brings a new dimension to the issue of measuring faculty workload. Current literature reflects instructor concerns related to the time required to teach web-based courses (McAlpine, Lockerbie, Ramsay & Beaman 2002; Sellani & Harrington, 2002; Smith, Ferguson & Caris, 2001). This descriptive, comparative study seeks to determine the time required to teach web-based graduate nursing courses and compare that to teaching similar courses in the face-to-face setting. Utilizing time records previously collected as part of a federally funded grant, data from 11 web-based and five face-to-face graduate level nursing courses were analyzed. Although a statistically significant difference in teaching time requirements was not demonstrated, several interesting trends did appear. Examples include differences related to preparation time and the division of teacher time while teaching web-based as opposed to face-to-face courses. Future research and continued data collection related to faculty workload and time usage will be needed as web-based courses become a growing part of graduate nursing education.