Optic pathway/hypothalamic gliomas (OP/HGs) are rare astrocytic tumors that appear more commonly among young children and often are unresectable. They comprise approximately 2% of all central nervous system tumors and account for 3–5% of pediatric intracranial tumors. Initial manifestations are often visual disturbances, endocrinopathies and hypothalamic dysfunction such as the diencephalic syndrome, and sometimes hydrocephalus due to cerebrospinal fluid (CSF) outflow obstruction. In many cases, the tumors are diagnosed late in the clinical course because they silently enlarge. These tumors consist mostly of histologically benign, World Health Organization (WHO) grade I tumors represented by pilocytic astrocytomas (PA), the rest being pilomyxoid astrocytomas (PXA) – WHO grade II tumors. In young pediatric patients, however, can be seen PXA that show aggressive clinical course such as CSF dissemination. Our small series of 14 non-Neurofibromatosis type 1 (NF-1) OP/HGs PA patients underwent extended resection without any adjuvant treatments. The median age at initial treatment was 11.5 ± 6.90 years (range, 1–25 years) and median follow up 85.5 ± 25.0 months. Surgical resection for OP/HGs results in acceptable middle-term survival, tumor control and functional outcome equivalent to chemotherapy. There is, however, no longer doubt that chemotherapy with or without biopsy and as-needed debulking surgery remains the golden standard in management of OP/H. Clinical conditions and treatment plans for OP/HGs vary depending on their structure of origin.
A new
analytical platform called PiTMaP was developed for high-throughput
direct metabolome analysis by probe electrospray ionization/tandem
mass spectrometry (PESI/MS/MS) using an R software-based data pipeline.
PESI/MS/MS was used as the data acquisition technique, applying a
scheduled-selected reaction monitoring method to expand the targeted
metabolites. Seventy-two metabolites mainly related to the central
energy metabolism were selected; data acquisition time was optimized
using mouse liver and brain samples, indicating that the 2.4 min data
acquisition method had a higher repeatability than the 1.2 and 4.8
min methods. A data pipeline was constructed using the R software,
and it was proven that it can (i) automatically generate box-and-whisker
plots for all metabolites, (ii) perform multivariate analyses such
as principal component analysis (PCA) and projection to latent structures-discriminant
analysis (PLS-DA), (iii) generate score and loading plots of PCA and
PLS-DA, (iv) calculate variable importance of projection (VIP) values,
(v) determine a statistical family by VIP value criterion, (vi) perform
tests of significance with the false discovery rate (FDR) correction
method, and (vii) draw box-and-whisker plots only for significantly
changed metabolites. These tasks could be completed within ca. 1 min.
Finally, PiTMaP was applied to two cases: (1) an acetaminophen-induced
acute liver injury model and control mice and (2) human meningioma
samples with different grades (G1–G3), demonstrating the feasibility
of PiTMaP. PiTMaP was found to perform data acquisition without tedious
sample preparation and a posthoc data analysis within ca. 1 min. Thus,
it would be a universal platform to perform rapid metabolic profiling
of biological samples.
We were able to obtain an ICG fluorescence imaging inside the cerebral ventricles by new D-light P system comprised of a camera head telescope. ICG fluorescence with neuroendoscopy can provide useful information for choosing the point of biopsy of intra- and periventricular tumors. However, we need to assess if the ICG accumulation site is the most appropriate for biopsy.
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