Functional outcome after low‐grade astrocytoma treatment in childhood

Abstract

The hydrogels assembled from a pair of self‐repulsive but mutually attractive decapeptides are visualized by magnetic resonance imaging (MRI). It is found that in the absence of Gd(III)‐chelate, gelation has little effect on MRI signal intensity. In the presence of Gd(III)‐chelate, gelation leads to significant changes in water relaxation and MR signal intensity. The sol to gel transition is best visualized by T2‐weighted imaging using large echo time with the sol producing a bright spot and the gel producing a dark spot. MRI studies point to high local Gd(III)‐chelate concentration. Small‐angle X‐ray scattering study indicates that this local enrichment of Gd(III)‐chelate has two contributing processes: first, the aggregation of peptides into fibers; second, within peptide fibers, Gd(III)‐chelate further aggregate into clusters. This work demonstrates that the status of peptide‐based hydrogels can be visualized by MRI with the aid of covalently linked Gd(III)‐chelates. This result has implications for monitoring peptide scaffolds in vivo. © 2011 Wiley Periodicals, Inc. Biopolymers (Pept Sci) 96: 734–743, 2011.

Cerebellar pilocytic astrocytoma in childhood: Investigating the long-term impact of surgery on cognitive performance and functional outcome

“…In this study, we did not assess whether our patients were enrolled in special education services such as remedial teaching or whether they repeated classes; future studies shall focus on these aspects to be able to draw more firm conclusion about survivors’ long-term academic welfare. Also, the average follow-up time in this study was 13.29 years (range: 3–21 years); taking a broader follow-up period into account and considering longitudinal instead of cross-sectional data may yield more insight into a phenomenon known as “growing into deficit.” 6 …”

“…4,5 However, at the same time these improved survival rates demand a careful consideration of possible long-term sequelae such as cognitive deficits and functional impairments. A phenomenon commonly referred to as “growing into deficit” 6 highlights the importance of careful follow-ups even for survivors of low-grade CPAs: patients who initially show no deficits may still develop cognitive and functional impairments years after treatment. According to the vulnerability theory, a young age at the time of diagnosis is especially thought to have a detrimental effect on late outcome.…”

“…6 Even though CPA survivors tend to have a better prognosis than, for instance, MB survivors 9 , there is evidence that they still show an elevated risk for deficits in academia: studies evaluating academic performance report incidences of difficulties, ranging from 3% 19 to approximately 45%. 1 At the same time, there is a strong notion in the corresponding literature that CPA patients fare very well and that their overall outcome regarding education, QoL, and cognitive functioning is favorable (see refs.…”

Health-related quality of life and emotional problems in children surviving brain tumor treatment: A descriptive study of 2 cohorts

“…The TACQOL is an excellent instrument to assess HRQoL in chronically ill or children surviving a brain tumor and compare findings with the reference population. Multiple studies using the TACQOL are published, including studies in children surviving a brain tumor [7,9,28]. Reliability and validity are sufficient for research purposes.…”

“…Monitoring of health-related quality of life (HRQoL) is done, for example, in childhood survivors who are treated for a pilocytic astrocytoma [9][10][11], low-grade glioma [12], high-grade glioma [13], craniopharyngioma [14,15], medulloblastoma [16,17], and in heterogeneous groups [18][19][20][21][22][23][24]. In most of these studies, survivors reported a variety of degree of reduction in HRQoL compared with healthy age mates [9,10,[13][14][15][16][18][19][20][21][22][23][24]. This could be explained by the heterogeneity of brain tumors and their treatments.…”