The unfavorable prognosis of malignant gliomas can also be explained by the incomplete knowledge of their molecular pathways. Studies regarding the regulatory process of apoptosis in glioblastoma (GBM), the most common malignant glioma, are few, and better knowledge of the expression of pro and anti-apoptotic proteins could collaborate with the development of new treatments founded on molecular basis. The objective of this study was to evaluate by immunohistochemistry the expression of caspase-3 and Bcl-2 in 30 samples of GBMs. The expression of caspase-3 (mean 17.67%) was lower than Bcl-2 (mean 30.92%), a statistically significant result (p<0.0001), suggesting low apoptotic activity in these tumors. Other studies of proteins related to the intrinsic and extrinsic pathway of apoptosis are required to provide additional information of this mechanism in GBMs. Key words: glioblastoma, apoptosis, immunohistochemistry.Expressão de caspase-3 e Bcl-2 em glioblastomas: um estudo imunohistoquímico RESUMO O prognóstico desfavorável dos gliomas malignos também pode ser explicado pelo pouco conhecimento dos seus mecanismos moleculares. Estudos relacionados à regulação do processo de apoptose em glioblastoma (GBM), o glioma maligno mais comum, são poucos, e o melhor conhecimento da expressão de proteínas pró e anti-apoptóticas poderia colaborar com o desenvolvimento de novos tratamentos fundamentados sobre a base molecular. O objetivo deste estudo foi avaliar por imunohistoquímica, a expressão de caspase-3 e Bcl-2 em 30 amostras de GBM. A expressão de caspase-3 (média de 17,67%) foi menor que a de Bcl-2 (média de 30,92%), com resultado estatisticamente significante (p<0.0001), sugerindo menor atividade apoptótica nestes tumores. Outros estudos envolvendo proteínas relacionadas à via extrínseca e intrínseca da apoptose são necessários para fornecer informações complementares deste mecanismo em GBMs. Palavras-chave: glioblastoma, apoptose, imunohistoquímica.
ABSTRACT:Temporal lobe epilepsy (TLE) is the most common form of partial epilepsy and affects 40% of the patients. Seizures arising from the mesial temporal lobe structures (i.e., amygdala and hippocampus) are common, whereas neocortical seizures are rare. In recent years, many studies aimed to identify the pattern of gene expression of neurotransmitters involved in molecular mechanisms of epilepsy. We used real-time PCR to quantify the expression of GABA A (subunits a1, b1, b2) and NMDA (subunits NR1, NR2A, and NR2B) receptor genes in amygdalae of 27 patients with TLE and 14 amygdalae from autopsy controls. The NR1 subunit was increased in patients with epilepsy when compared with controls. No differences were found in expression of NMDA subunits NR2A and NR2B or in a1, b1, and b2 subunits of GABA A receptors. Our results suggest that the NR1 subunit of NMDA receptors is involved in the amygdala hyperexcitability in some of the patients with TLE. V V C 2010 Wiley Periodicals, Inc.
Objective: To analyze the clinical outcome of patients with foramen magnum (FM) meningiomas. Method: Thirteen patients (11 Feminine / 2 Masculine with FM meningiomas operated on through lateral suboccipital approach were studied. Clinical outcome were analyzed using survival (SC) and recurrence-free survival curves (RFSC). Results: All tumors were World Health Organization grade I. Total, subtotal and partial resections were acchieved in 69.2%, 23.1% and 7.7%, respectively, and SC was better for males and RFSC for females. Tumor location, extent of resection and involvement of vertebral artery/lower cranial nerves did not influence SC and RFSC. Recurrence rate was 7.7%. Operative mortality was 0. Main complications were transient (38.5%) and permanent (7.7%) lower cranial nerve deficits, cerebrospinal fluid fistula (30.8%), and transient and permanent respiratory difficulties in 7.7% each. Conclusions: FM meningiomas can be adequately treated in public hospitals in developing countries if a multidisciplinary team is available for managing postoperative lower cranial nerve deficits.Keywords: foramen magnum meningiomas, surgical treatment, extent of resection, survival, postoperative complications. RESUMOObjetivo: Analisar as evoluções clínicas de 13 pacientes com meningiomas do forame magno (FM). Método: Foram estudados 13 pacientes com meningiomas do FM (11 Feminino / 2 Masculino) operados por abordagem suboccipital lateral. As evoluções clínicas foram analisadas usando curvas de sobrevida (SC) e de sobrevida livre de doença (RFSC). Resultados: Os 13 tumores eram Grau I da Organização Mundial de Saúde. Ressecções total, subtotal and parcial foram obtidas em 69,2%, 23,1 e 7,7%, respectivamente. A SC foi melhor para homens e a RFSC foi melhor para mulheres. Localização/ extensão da ressecção/envolvimento da artéria vertebral/nervos cranianos baixos não influenciaram a SC/RFSC. A taxa de recorrência foi 7,7%. A mortalidade operatória foi zero. As principais complicações foram déficits de nervos cranianos baixos transitórios (38,5%) e permanentes (7,7%); fístula de líquido cefalorraquidiano (30,8%) e dificuldades respiratórias transitórias e permanentes em 7,7% cada. Conclusões: Meningiomas do FM podem ser adequadamente tratados em hospitais públicos em países em desenvolvimento se houver uma equipe multidisciplinar para cuidar de déficits de nervos cranianos baixos pós-operatórios.Palavras-chave: meningiomas do forame magno, tratamento cirúrgico, extensão da ressecção, sobrevida, complicações pós-operatórias.Foramen magnum (FM) meningiomas are those arising anteriorly from the inferior third of the clivus to the superior edge of the C2 body, laterally from the jugular tubercle to the C2 laminae, and posteriorly from the anterior border of the occipital squama to the spinal process of C2
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