RESUMO
Leptomeningeal involvement in patients with CLL is relatively rare and the prognosis is usually considered to be poor. The authors reviewed all CLL patients treated in a tertiary referral center to assess the incidence and outcome of leptomeningeal involvement (LI) in CLL. They found an incidence of 1-2% of LI. Most of the patients with LI had a longterm survival, despite failure to clear the cerebrospinal fluid from tumor cells.
Assuntos
Leucemia Linfocítica Crônica de Células B/mortalidade , Neoplasias Meníngeas/mortalidade , Neoplasias Meníngeas/secundário , Meninges/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Aracnoide-Máter/efeitos dos fármacos , Aracnoide-Máter/patologia , Aracnoide-Máter/efeitos da radiação , Estudos de Coortes , Comorbidade , Demência Vascular/etiologia , Humanos , Incidência , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Leucemia Linfocítica Crônica de Células B/radioterapia , Masculino , Neoplasias Meníngeas/tratamento farmacológico , Neoplasias Meníngeas/radioterapia , Meninges/efeitos dos fármacos , Meninges/efeitos da radiação , Pessoa de Meia-Idade , Pia-Máter/efeitos dos fármacos , Pia-Máter/patologia , Pia-Máter/efeitos da radiação , Radioterapia/efeitos adversos , Radioterapia/métodos , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
The axial periodicity of rat arachnoid and dura mater collagen fibrils exposed to 910 MHz for 2 h/day for 30 consecutive days was measured by means of image analysis of electron-optical data. Such measurements were compared with those from sham-exposed animals. These measurements reveal that on exposure, the intermolecular interactions during collagen fibril assembly are affected.
Assuntos
Aracnoide-Máter/efeitos da radiação , Colágeno/efeitos da radiação , Dura-Máter/efeitos da radiação , Campos Eletromagnéticos/efeitos adversos , Animais , Biologia Computacional/métodos , Cabeça , Masculino , Microscopia Eletrônica/métodos , Periodicidade , Doses de Radiação , Lesões Experimentais por Radiação/patologia , Radiação não Ionizante/efeitos adversos , Ratos , Ratos Wistar , Fatores de TempoRESUMO
OBJECTIVE: Clinical studies have revealed a significant association between the presence of extensive postlumbar discectomy peridural scar formation and the reoccurrence of low back and radicular pain. Low-dose perioperative radiation therapy has been shown to inhibit scar formation. Its effect on peridural fibrosis, however, has not been studied. METHODS: Thirty male Sprague-Dawley rats underwent L5 laminectomies. Ten rats each received a single fraction of 700-cGy external beam radiation to the lumbar spine 24 hours before surgery; 10 rats each received 700 cGy 24 hours after surgery. The remaining 10 rats served as a control group. All of the rats were killed 30 days after surgery. The spines were harvested, and axial histological sections through the laminectomy defect were evaluated. Each specimen was scored for extent, density, and arachnoidal involvement by fibrosis. RESULTS: There was a statistically significant difference between the treatment and control groups regarding the extent of fibrosis along the dura (P < 0.001), the density of fibroblasts (P < 0.005), and the arachnoid involvement (P < 0.01). There was no difference in fibrosis reduction between the groups receiving pre- and postlaminectomy radiation. CONCLUSION: Low-dose external beam radiation therapy administered before or after laminectomy in a rat model significantly decreases the extent, density, and arachnoidal involvement of peridural fibrosis. This technique may improve the outcome of patients who undergo reoperations for recurrent radicular and/or low back pain after successful lumbar discectomy in whom there is a significant amount of peridural fibrosis.
Assuntos
Aracnoide-Máter , Dura-Máter , Laminectomia/métodos , Animais , Aracnoide-Máter/patologia , Aracnoide-Máter/efeitos da radiação , Aracnoide-Máter/cirurgia , Relação Dose-Resposta à Radiação , Dura-Máter/patologia , Dura-Máter/efeitos da radiação , Dura-Máter/cirurgia , Fibroblastos/patologia , Fibrose/patologia , Fibrose/radioterapia , Fibrose/cirurgia , Região Lombossacral , Masculino , Ratos , Ratos Sprague-DawleyRESUMO
Vectors based on adeno-associated virus (AAV) are under investigation for use in gene therapy applications. Critical aspects of AAV vector biology remain undefined, in particular the intracellular events and activities mediating transduction and determining host cell permissiveness for transduction. Using cultured primary human fibroblasts, we previously showed that AAV vectors preferentially, but not exclusively, transduce cells in the S phase of the cell cycle, and that transduction can be markedly enhanced by pretreatment of target cells with physical and chemical agents that perturb DNA metabolism. In this study, we tested whether similar improvements in AAV vector performance might be achievable in vivo. The adult rat brain and overlying scalp muscle were selected for vector inoculation because of the presence of well-defined populations of dividing, quiescent, and post-mitotic cells, and gamma irradiation was chosen as a reproducible means of inducing DNA repair in these cells. We find that gamma irradiation markedly enhances the transduction of dividing cell populations in the pia-arachnoid and choroid epithelium within the central nervous system, and of mature nondividing muscle cells in the scalp, whereas gamma irradiation did not increase the basal transduction level of post-mitotic neurons in the hippocampus. These data confirm that replicative cellular DNA synthesis is not required for transduction by AAV vectors and show that the mitotic state of target cells is not necessarily predictive of responsiveness to transduction-enhancing treatments. Most importantly, these data demonstrate that target cells can be manipulated in vivo to render them more permissive for AAV vector transduction.