Intracranial hemangiopericytoma: treatment outcomes in a consecutive series.

OBJECTIVE: The purpose of this study was to analyse a series of patients harbouring an intracranial hemangiopericytoma (HPC) with respect to clinical presentation, treatment results and long-term follow-up outcomes. PATIENTS AND METHODS: Clinical data were retrospectively obtained in a series of 12 patients who underwent microsurgical resection for HPC at two neurosurgical institutions between 1987 and 2004. RESULTS: The main presenting symptoms in the seven men and five women (mean age 38 years) were headache in 50% and epileptic seizures in 33% of the patients. A Simpson grade I resection was achieved in seven patients (58%) and none of these patients developed local tumour recurrence after a mean follow-up period of 127 months (10.6 yrs). Only one of these patients received adjuvant radiotherapy. A recurrence of the HPC was observed in all patients (42%) who underwent subtotal tumour resection at first surgery (Simpson grade II or higher). Recurrences occurred after a mean period of 39 months (3.2 yrs) after primary surgery and were effectively controlled by surgical excision, radiotherapy and gamma knife radiosurgery. Two patients (17%) developed extraneural metastases which were treated by surgical excision, radiotherapy and salvage chemotherapy. Poly-chemotherapy was ineffective with respect to tumour control in this study. CONCLUSIONS: The study emphasises the importance of total resection of HPC, defined as a Simpson grade I removal, at first surgery. Adjuvant radiotherapy is recommended after subtotal tumour resections. A life-long vigilant follow-up of these patients is mandatory.

A dermatologic decision support system that processes lexical knowledge from standard textbooks.

We present a decision support system that processes lexical fuzzy knowledge from standard pathology textbooks. The user can choose among four methods: full text and hypertext approaches (classic lexical retrieval methods) and two possibilistic, knowledge-based approaches (the fuzzy logic computation and an adapted evidence combination scheme based upon the theory of belief functions). All these methods, including their algorithms, are presented in this paper. The effectiveness of these approaches is demonstrated by examples from dermatopathology. At the top of the lists of differential diagnoses generated by the system the degree of conformity between the approaches is high.

[Diagnosis in the aged from the pathologic-anatomic viewpoint]. / Diagnostik im Alter aus pathologisch-anatomischer Sicht.

The preciseness of clinical diagnostics for two different age groups was reviewed among 2033 unselected autopsies looking at eight single diagnoses. The younger age group was up to 59 years of age, the older one over 59 years. In the older age group myocardial infarction, hepatocirrhosis, bronchial and gastric carcinomas were less frequently diagnosed compared to the younger group. Pulmonary embolism, pulmonary tuberculosis, colon and breast carcinomas were almost evenly diagnosed before death in both groups. The multimorbidity in aged patients is discussed. Also in the geriatric diagnostic a high autopsy rate--86% in our collective--is important.