p53 protein expression in vivo does not correlate with the outcome of patients with primary GBM. Therefore, p53 protein content per se does not appear to be a helpful prognostic factor for prognosis-adapted therapy in primary GBM. By contrast, primary GBM cells in vitro show different and independent responses in their p53 and p21 pathways to ionizing radiation. The failure of G1 arrest seems to be due to a functional defect in the p53 pathway, either because p21 was not induced or because of an unidentified defect downstream from p21.

Purpose: To identify subgroups in glioblastoma multiforme (GBM) with different susceptibilities to radiochemotherapy by p53 protein and Ki-67 expression.Patients and Methods: Thirty-one patients with primary GBM underwent a combined radio-chemotherapy with topotecan. Percentage of cells expressing p53 protein and Ki-67 antigen was determined immunohistochemically. Additionally, the cell density within the tumour tissue was measured.Results: Median percentages of p53 and Ki-67 expressing cells were 4.3% (range ϭ 0-28%) and 12.0% (range ϭ 0-28%), respectively. Dividing the cases into two groups by high or low p53 protein 1-year diseasefree survival rates were 13.3% and 23.6%. High or low Ki-67 expression showed one-year disease-free survival rates of 18.8% and 17.1%. Neither p53 nor Ki-67 expression showed a significant correlation with disease-free survival or overall survival. Median cell density was 252 cells/field (range ϭ 42-595). 1-year disease-free survival rates were 14.5% and 21.7% in high and low cell density group, respectively. A significant correlation with progression-free survival was observed, whereas the stratification into two groups revealed no significance. Cell density showed a significant inverse correlation with p53 and Ki-67 immunopositivity.Conclusion: p53 protein and Ki-67 expression seem to be inappropriate for the estimation of prognosis in patients receiving a combined radio-chemotherapy with topotecan.

In general, the main advantage of well-known CT software simulation when compared to conventional simulation is the relief of the real X-ray simulator which is feasible with fast planning software (EXOMIO) and the presented movable laser system.

Several publications report strokes early after embolotherapy for pulmonary arteriovenous malformations (pAVM) (1-3). Various mechanisms are discussed for this event, including embolization of newly formed thrombotic material originating from the aneurysmal sac after occlusion of the arterial feeder (2).To reduce the risk of peri-interventional stroke in a 22-year-old woman with a giant pAVM (66 ϫ 47 ϫ 70 mm 3 ) (Figs. 1A and 1B), after occlusion From the