Comparative Analysis of Amino Acid Profiles in Patients with Glioblastoma and Meningioma Using Liquid Chromatography Electrospray Ionization Tandem Mass Spectrometry (LC-ESI-MS/MS).

Brain tumors account for 1% of all cancers diagnosed de novo. Due to the specificity of the anatomical area in which they grow, they can cause significant neurological disorders and lead to poor functional status and disability. Regardless of the results of biochemical markers of intracranial neoplasms, they are currently of no diagnostic significance. The aim of the study was to use LC-ESI-MS/MS in conjunction with multivariate statistical analyses to examine changes in amino acid metabolic profiles between patients with glioblastoma, meningioma, and a group of patients treated for osteoarthritis of the spine as a control group. Comparative analysis of amino acids between patients with glioblastoma, meningioma, and the control group allowed for the identification of statistically significant differences in the amino acid profile, including both exogenous and endogenous amino acids. The amino acids that showed statistically significant differences (lysine, histidine, α-aminoadipic acid, phenylalanine) were evaluated for diagnostic usefulness based on the ROC curve. The best results were obtained for phenylalanine. Classification trees were used to build a model allowing for the correct classification of patients into the study group (patients with glioblastoma multiforme) and the control group, in which cysteine turned out to be the most important amino acid in the decision-making algorithm. Our results indicate amino acids that may prove valuable, used alone or in combination, toward improving the diagnosis of patients with glioma and meningioma. To better assess the potential utility of these markers, their performance requires further validation in a larger cohort of samples.

Current Treatment of Melanoma Brain Metastases.

Melanoma is a type of skin cancer in which there is a strong correlation between its occurrence and exposure to ultraviolet radiation. Although it is not the most common skin cancer, it has the highest mortality rate of all skin cancers. The prognosis of patients is significantly worsened by melanoma metastasis to the brain, which often occurs in patients with advanced disease. The formation and development of melanoma metastases to the brain involve a very complex process, and their mechanisms are not fully understood. One of the ways for metastatic melanoma cells to survive and develop cancer in the brain environment is the presence of oncogenic BRAF mutation, which occurs in up to 50% of metastatic melanoma cases. Before discovering new methods of treating metastases, the overall survival of patients with this disease was 6 months. Currently, research is being conducted on new drugs using immunotherapy (immune checkpoint inhibitors: anti-PD-1, anti-CTLA-4) and targeted therapy (BRAF and MEK inhibitors) to improve the prognosis of patients. In this article, we summarize the current state of knowledge about the results of treating brain metastases with new systemic therapies.

Intracranial hemorrhages associated with meningiomas: Own experience and literature review.

Intracranial hemorrhage associated with meningioma is rare. Relatively, few such cases are described in the source literature, and it is estimated that intracranial meningiomas presenting with hemorrhage account for about one percent of all meningiomas. Hemorrhage can occur in both meningioma tissue and on the tumor surface. It can lead to intracerebral, subdural and subarachnoid hematoma. This can in turn cause high intracranial pressure with rapid neurological deterioration. Urgent neurosurgical intervention is often necessary. In our department, three patients with meningioma-related hemorrhage were treated surgically from 2006 to 2020. One patient was operated on as an emergency, due to the patient's poor neurological condition, while the two others underwent surgery following supplementary diagnosis several days following their admission. The outcomes of the three patients were good. The three meningiomas associated with hemorrhage described in the present manuscript constitute 2.2% of all 136 meningiomas treated surgically from 2006 to 2020 at our department. All three hemorrhages described in this study were associated with WHO I convexity meningiomas. Similar data can be found in some sources also describing meningioma WHO I-related hemorrhages; nevertheless, other literature references indicate a higher risk of bleeding into meningiomas of a higher degree of malignancy. The hemorrhage mechanism remains unclear; however, the proposed mechanism is rupture of defective intratumoral blood vessels and stretching of the superficial veins including bridge veins by the growing tumor, leading to their rupture. Our observations regarding the incidence of meningioma hemorrhage and tumor location are consistent with the source literature data.

The influence of IONPs core size on their biocompatibility and activity in in vitro cellular models.

Although the key factor affecting the biocompatibility of IONPs is the core size, there is a lack of regular investigation concerning the impact of the parameter on the toxicity of these nanomaterials. Therefore, such studies were carried out in this paper. Their purpose was to compare the influence of PEG-coated-magnetite NPs with the core of 5, 10 and 30 nm on six carefully selected cell lines. The proliferation rate, viability, metabolic activity, migration activity, ROS levels and cytoskeleton architecture of cells have been evaluated for specified incubation periods. These were 24 and 72-h long incubations with IONPs administered in two doses: 5 and 25 µg Fe/ml. A decrease in viability was observed after exposure to the tested NPs for all the analyzed cell lines. This effect was not connected with core diameter but depended on the exposure time to the nanomaterials. IONPs increased not only the proliferation rate of macrophages-being phagocytic cells-but also, under certain conditions stimulated tumor cell divisions. Most likely, the increase in proliferation rate of macrophages contributed to the changes in the architecture of their cytoskeleton. The growth in the level of ROS in cells had been induced mainly by the smallest NPs. This effect was observed for HEK293T cells and two cancerous lines: U87MG (at both doses tested) and T98G (only for the higher dose). This requires further study concerning both potential toxicity of such IONPs to the kidneys and assessing their therapeutic potential in the treatment of glioblastoma multiforme.

Intracranial complications after surgical removal of nasal polyps.

Acute otitis media can be caused by viruses (nonsuppurative inflammation) and bacteria (suppurative inflammation). The suppurative inflammation is a risk factor for endocranial complications, including subdural empyema burdened with a high mortality. The authors present a clinical case of a 67-year-old man treated by surgery for a subdural empyema in the course of the acute suppurative otitis media.

Atypical Course of Vertebral Artery Outside the Cervical Spine: Case Report and Review of the Literature.

BACKGROUND: The vertebral arteries are branches of the subclavian arteries supply blood to the posterior part of the encephalon, forming vertebrobasilar circulation. Disorders of vertebrobasilar circulation have significant clinical implications. Symptoms of these disorders include dizziness, vomiting, collapse, vision and cerebellar disorders. The vertebral artery usually ascends in the transverse foramina of the cervical vertebrae to reach the posterior cranial cavity by entering the magnum foramen. Although most often the vertebral artery enters the C6 transverse process, anatomic variation may occur. CASE DESCRIPTION: In this case, a 16-year-old male patient with casuistic anatomic variant of vertebral artery course is described. In this case report, left vertebral artery ascended outside the transverse foramina of cervical vertebrae C6-C3 and entered transverse foramen of axis. The patient suffered from collapse and dizziness during neck and head movements as a result of arterial folding. After rehabilitation and posture and proper movement learning, the frequency of symptoms subsided. CONCLUSIONS: Variability of the vertebral arteries may have clinical implications, and knowledge of its topography is important for mechanism of vertebrobasilar circulatory disorder understanding and for surgical approach to the cervical spine and neck anatomic structures.

Comparison of ultrasmall IONPs and Fe salts biocompatibility and activity in multi-cellular in vitro models.

In the paper, the results of the first regular studies of ultra-small iron oxide nanoparticles (IONPs) toxicity in vitro were presented. The influence of PEG-coated NPs with 5 nm magnetite core on six different cell lines was examined. These were: human bronchial fibroblasts, human embryonic kidney cells (HEK293T), two glioblastoma multiforme (GBM) cell lines as well as GBM cells isolated from a brain tumor of patient. Additionally, mouse macrophages were included in the study. The influence of IONPs in three different doses (1, 5 and 25 µg Fe/ml) on the viability, proliferation and migration activity of cells was assessed. Moreover, quantifying the intracellular ROS production, we determined the level of oxidative stress in cells exposed to IONPs. In the paper, for the first time, the effect of Fe in the form of IONPs was compared with the analogical data obtained for iron salts solutions containing the same amount of Fe, on the similar oxidation state. Our results clearly showed that the influence of iron on the living cells strongly depends not only on the used cell line, dose and exposure time but also on the form in which this element was administered to the culture. Notably, nanoparticles can stimulate the proliferation of some cell lines, including glioblastoma multiforme. Compared to Fe salts, they have a stronger negative impact on the viability of the cells tested. Ultra-small NPs, also, more often positively affect cell motility which seem to differ them from the NPs with larger core diameters.

Plasma HGF concentration in patients with brain tumors.

The Hepatocyte Growth Factor is a strong mitogenic factor and seems to play important role in tumor angiogenesis. The purpose of this study was to analyse the plasma concentration of this factor in patients treated surgically because of intracranial tumors. The study included 47 patients, both sexes treated surgically for intracranial tumors and 30 adult volunteers of both sexes, without cancer diagnosis. In study group 4 measurements of plasma HGF were taken: measurement 1: within 24 hours to 1 hour before the operation (preoperative), measurement 2: on the first day after the operation, i.e. after 24 hours, measurement 3: between the third and fifth day following the treatment, i.e. within 72-120 hours, and measurement 4: on the seventh day after the operation, i.e. after 840 hours. In control group only one measurement was taken. The distribution of the analyzed parameters was different from the normal distribution, therefore nonparametric statistics were used. The result values are presented in the form of a median (Me). The analysis revealed that HGR plasma levels in the patients with intracranial tumors in all 4 measurements (Me1 = 543.16 pg/ml, Me2 = 762.59 pg/ml, Me3 = 819.82 pg/ml, Me4 = 804.82 pg/ml) in the perioperative period were elevated in comparison to healthy subjects (Me = 361.04 pg/ml). The association has been shown to exist between postoperative HGF plasma levels and the clinical condition of patients with intracranial tumors (p = 0.0342). Postoperative HGF levels correlated negatively with the patients' postoperative condition. It was also found that in patients with supratentorial tumors HGF plasma levels were higher (Me = 557.74 pg/ml) in comparison to patients with posterior fossa tumors (Me = 325.00 pg/ml). These results suggest increased angiogenic and mitogenic activity in patients with intracranial tumors and its even greater intensity in the postoperative period. Greater angiogenic activity appears to occur in patients with supratentorial tumors.

The Influence of Polyphenol Compounds on Human Gastrointestinal Tract Microbiota.

: Polyphenols form a diverse group of compounds containing at least two hydroxyl groups in their chemical structure. Because of the common presence in plant kingdom, polyphenols are considered a significant component of food and an important group of compounds with antioxidant properties. The absorption of polyphenols present in food depends mostly on the activity of intestinal microflora. However, little is known about the processes and interactions responsible for such phenomenon in guts ecosystem. There are only few available publications that examine the effect on polyphenols on intestinal microbiota. Therefore, this work will focus on describing the relationship between polyphenol compounds present in food and bacteria colonizing the intestines, their mechanism, and impact on human's health.

Impact of Vitamin D on Physical Efficiency and Exercise Performance-A Review.

Vitamin D deficiency amongst athletes and the general population seems to be a prominent problem. The most recognized role of vitamin D is its regulation of calcium homeostasis; there is a strong relationship between vitamin D and bone health. Moreover, its concentrations are associated with muscle function and immune response in both the general and athletic populations. Vitamin D level is strongly connected with the presence of VDRs (vitamin D receptors) in most human extraskeletal cells. Expression of multiple myogenic transcription factors enhancing muscle cell proliferation and differentiation is caused by an exposure of skeletal muscles to vitamin D. The aim of this review is to summarize current understanding of the significance of vitamin D on exercise performance and physical efficiency, as well to analyze the impact of vitamin D on multiple potential mechanisms. More high-quality research studies, considering free 25(OH)D as a better marker of vitamin D status, the baseline level of 25(OH)D and multiple pathways of vitamin D acting and usage in athletes are required.

Serum VEGF-A concentrations in patients with central nervous system (CNS) tumors.

Angiogenesis plays an essential role in tumors development. In case of central nervous system tumors, the most important role in this process plays VEGF-A. The purpose of this study was to determine the plasma concentration of this agent in patients treated surgically because of intracranial tumors. The study involved 48 adult patients, both sexes, treated surgically because of a brain tumor. The control group consisted of 50 adult volunteers of both sexes, without cancer diagnosis. Based on the studies, it was found that serum VEGF-A levels before surgery are higher in patients with central nervous system tumors (10.39-150.57 pg/ml, median 41.70 pg/ml) than in non-cancer patients (0.00-130.77 pg/ml, median 22.56 pg/ml). The association between serum VEGF-A level and malignancy and histological type of intracranial tumor has not beed confirmed. The highest average preoperative serum VEGF-A level was found in patients with low grade gliomas, slightly lower (close to each other) in those with high grade gliomas and meningiomas, while the lowest level was characteristic for metastatic tumors. High variation in results was observed in patients with low grade gliomas (52.56 pg/ml)-higher than those reported in patients with high grade gliomas (32.38 pg/ml). In the rest types of tumors the differentiation was similar and oscillated within 23.08-27.50 pg/ml.

Application of the functional capacity scale in the early assessment of functional efficiency in patients after aneurysm embolization: Preliminary reports.

BACKGROUND: While data on the long-term (e.g., 1 year and subsequent years) outcomes of intracranial aneurysms treatment is relatively well-documented mainly in the clinical aspect (comparability of treatment, mortality, and complications), little is known about the early results, in terms of the functional outcome. OBJECTIVES: The aim of the study was to analyze the use of Functional Capacity Scale (FCS) in the evaluation of patients in the early period after endovascular treatment of intracranial aneurysms. MATERIAL AND METHODS: The study was conducted in the Neurosurgery Clinic, University Hospital Collegium Medicum in Bydgoszcz, on a group of 118 consecutively admitted patients with the diagnosis of intracranial aneurysm, qualified for treatment using the endovascular method (embolization). The assessment was performed twice. In the clinical assessment the Glasgow Coma Scale (GCS) was used to evaluate the level of consciousness and the Hunt and Hess Scale (H&H) to assess the patient's condition. To assess the final outcome and early functional capacity Glasgow Outcome Scale (GOS), Barthel Index (BI), Modified Rankin Scale (mRS) and the new Functional Capacity Scale were used. RESULTS: The assessment performed with the FCS was comparable to the assessment conducted with standardized tools such as BI, mRS or GOS. The clinical condition assessed with the GCS (p < 0.001) and H&H (p < 0.001) differentiates the functional condition assessed using the FCS. Statistically significant correlations were found between FCS and BI (r = -0.78), GOS (r = -0.69) and mRS (r = 0.68). CONCLUSIONS: The study indicates that the FCS correlates with other scales used in the assessment of patients with intracranial aneurysm, which means that the proposed tool can be applied successfully in practice. However, further randomized multicenter studies are necessary in order to clarify the final conclusion.

Functional Capacity Scale as a new tool for early functional assessment in patients after surgical treatment of intracranial aneurysms: a prospective study involving 128 patients.

BACKGROUND: Functional assessment of a patient focuses on the assessment of independence in activities of daily living. The aim of the study was to verify the usefulness of a new tool (Functional Capacity Scale - FCS) for early functional assessment of patients after surgical treatment of an intracranial aneurysm. MATERIAL/METHODS: The study was conducted in the Neurosurgical Department and Clinic, CM in Bydgoszcz, NCU, within a group of 128 patients after surgical treatment of an intracranial aneurysm. Direct observation and measurement were used in the study. In clinical assessment, the Hunt and Hess Scale was applied. For the final functional assessment, the Functional Capacity Scale (FCS), the Glasgow Outcome Scale, the Functional Index "Repty", the Barthel Index, and the Rankin Scale were used. RESULTS: The study shows that on the day of discharge almost 60% of patients are independent or slightly dependent on others for functional capability, and 15% are significantly or totally dependent. FCS significantly correlates with FIR (0.93, p<0.001), GOS (0.89, p<0.01), RS (-0.88, p<0.01) and BI (0.82, p<0.001). CONCLUSIONS: 1. Fifty percent of patients with intracranial aneurysm assessed at the early postoperative stage leave the ward as functionally capable of performing everyday activities. 2. There are significant correlations between FCS and the other scales used for functional assessment. 3. There is a significant relationship between functional capacity of the patient on the day of discharge and clinical condition before the surgical treatment.

Functional capacity of patients in the early period after the embolization of cerebrovascular malformations: preliminary findings.

Research into outcomes of endovascular intervention for cerebral blood vessel malformations has previously focused on the clinical picture of the disease, death rate, comparison of surgical methods, and the most common postoperative and postbleeding complications. From the nursing standpoint, the crucial elements in assessing postoperative patients are functional outcome defining patients' ability to function in life and recognition of impairments in which patients will be dependent on the nursing staff. The aim of the study was to assess functional capacity of patients before and after the embolization of cerebral blood vessel malformations in the aspect of nursing care. The study included 38 patients after embolization of cerebral blood vessels. The assessment of their condition using the Functional Capacity Scale was performed twice: before and after the surgical procedure. The research shows that on the day of admission to hospital, patients had greatest difficulty performing hygienic activities (p < .0001), satisfying physiological needs (p < .0001), and consuming their meals (p < .004). Headache (p < .002) and poor psychological state (p < .0001) manifesting itself through mild depression constituted other serious problems. After the surgery, vast majority of patients were independent in terms of self-care (p ≤ .03). Headache occurred in the case of 21% of patients, and psychological state improved in 34% of patients, which shows that there is a major demand for care in this sphere.

[Catheter-directed thrombolytic treatment with high doses of rtPA of a lower limb ischemia complicated by peripheral embolism]. / Celowane leczenie trombolityczne za pomoca duzych dawek rtPA ostrego niedokrwienia konczyny dolnej z powiklaniem w postaci zatorowosci obwodowej.

Catheter-directed thrombolytic treatment in an alternative method of treatment compared to the surgery of acute lower limbs ischemia. A case of acute lower limb ischemia due to occlusion of the vascular by-pass treated with guided thrombolysis with the use of a high doses of rtPA administered in a short period of time. Restoration of patency (revascularization) was achieved, and simultaneously complication in the form of peripheral embolism was found. After performing angioplasty of arteries occluded with embolism, total vascular revascularization and finally a very good clinical result were achieved.

[Treatment of recurrent splenic artery aneurysm with covered stents]. / Leczenie nawrotowego tetniaka tetnicy sledzionowej stentem pokrywanym.

Aneurysms of the visceral arteries occur the most frequently in splenic artery. They can be managed surgically or endovascularly. The endovascular techniques include embolization with coils, glue or covered stent. The case of recurrent splenic artery aneurysm treated with self-expandable stent covered with fabric PTFE is presented. The total exclusion of the aneurysm from the circulation was obtained.

Effect of selected factors on the functional capacity of patients in the early period following intracranial aneurysm surgery.

Background. Many authors believe that the functional capacity of patients in the early period following intracranial aneurysm surgery influences their long-term capacity and quality of life. The purpose of our study was to estimate whether selected factors such as gender, age, aneurysm location, clinical manifestation, type of surgery, length of hospitalization and clinical condition prior to surgery have an effect on the functional capacity of patients in the early period following intracranial aneurysm surgery. Material and methods. The study was conducted in the Neurosurgery and Neurotraumatology Department of the Jurasz Clinical Hospital in Bydgoszcz. We examined 97 patients after intracranial aneurysm surgery, using direct observation and measurement. The patients' condition was assessed using standard neurosurgical scales (Hunt.