Einleitung: In seltenen Fällen kann eine Rhinoliquorrhoe spontan und ohne adäquates Trauma auftre... more Einleitung: In seltenen Fällen kann eine Rhinoliquorrhoe spontan und ohne adäquates Trauma auftreten. Eine mögliche Ursache hierfür ist ein persistierender lateraler craniopharyngealer (Sternberg) Kanal. Dieser angeborene Defekt findet sich bei ca. 4% der Erwachsenen in der [for full text, please go to the a.m. URL]
Pineal lesions in the pediatric patient are often complicated by the development of hydrocephalus... more Pineal lesions in the pediatric patient are often complicated by the development of hydrocephalus due to obstruction of the aqueduct or the third ventricle by tumor masses. In such cases, hydrocephalus treatment has the highest priority and should be performed prior to any surgical treatment of the pineal tumor itself. The golden standard in obstructive hydrocephalus treatment remains placement of a temporary or permanent cerebrospinal fluid shunt, although there are many long-term complications associated with a shunt system. To avoid these and to render the patients independent from a failure-prone shunt system, we employed endoscopic third ventriculostomy for permanent relief of elevated intracranial pressure prior to surgical removal of the pineal lesions. The present study summarizes the results of this approach in 7 pediatric patients with obstructive hydrocephalus. No complications of the endoscopic procedure were encountered, and the ventriculostomy remained patent in all cases, as confirmed by motion sensitive MRI. The advantages of endoscopic third ventriculostomy as compared with other techniques are discussed, and its increasing role in the management of children with space occupying lesions of the pineal region is defined.
Cancer Epidemiology, Biomarkers and Prevention, 2003
The expression of human leukocyte antigen (HLA) alleles plays an important role in the developmen... more The expression of human leukocyte antigen (HLA) alleles plays an important role in the development and recurrence of benign and malignant diseases. Association of single HLA alleles or haplotypes with neoplastic processes has been investigated previously, and correlation between HLA and solid tumors, such as head and neck cancers or uterine cervical squamous epithelial lesions, were reported. However, there is no published data on the influence of the HLA system on the development of symptomatic cerebral meningioma, a mostly benign intracranial tumor of mesenchymal origin in adults. The present investigation is comparing the frequency of single HLA alleles and haplotypes in 81 adult Caucasian patients with symptomatic central nervous system meningiomas to that of 157 area- and race-matched healthy controls. Both standard serological and molecular genetic (PCR) techniques were used for HLA typing. Our results suggest an association between single HLA alleles and occurrence of clinica...
Gene therapy offers signi®cant advantages to the ®eld of oncology with the addition of speci®call... more Gene therapy offers signi®cant advantages to the ®eld of oncology with the addition of speci®cally and uniquely engineered mechanisms of halting malignant proliferation through cytotoxicity or reproductive arrest. To confer a true bene®t to the therapeutic ratio (the relative toxicity to tumor compared to normal tissue) a vector or the transgene it carries must selectively affect or access tumor cells. Beyond the selective toxicities of many transgene products, which frequently parallel that of contemporary chemotherapeutic agents, lies the potential utility of targeting the vector. This review presents an overview of current and potential methods for designing vectors targeted to CNS malignancies through selective delivery, cell entry, transport or transcriptional regulation. The topic of delivery encompasses physical and pharmaceutic means of increasing the relative exposure of tumors to vector. Cell entry based methodologies are founded on increasing relative uptake of vector thr...
This 68-years old Caucasian male presented with sudden acute onset of occipital headache and doub... more This 68-years old Caucasian male presented with sudden acute onset of occipital headache and double vision. Neurological exam diagnosed right-sided facial and abducent nerve palsy. The attack was preceded by mild unsteadiness and sensorineural hearing loss of two months duration. CT and MRI demonstrated a large cerebellopontine angle cyst with fluid level and intracavitary blood. The cyst was excised and histological examination revealed acoustic neuroma. This is a rare case of isolated hemorrhage into a cystic acoustic neuroma with atypical acute presentation and ipsilateral facial and abducent nerve palsy on the background of hearing loss of short duration. Differential diagnosis of acute facial and abducent nerve palsy may have to include such lesions. Objective and importance A coustic neuroma (AN) presenting as hemorrhage in a cystic structure is an uncommon entity. Hemorrhage with AN may take the form of a subarachnoid and/or intratumoral bleed and is likely to be related to t...
The expression of human leukocyte antigen (HLA) alleles plays an important role in the developmen... more The expression of human leukocyte antigen (HLA) alleles plays an important role in the development and recurrence of benign and malignant diseases. Association of single HLA alleles or haplotypes with neoplastic processes has been investigated previously, and correlation between HLA and solid tumors, such as head and neck cancers or uterine cervical squamous epithelial lesions, were reported. However, there is no published data on the influence of the HLA system on the development of symptomatic cerebral meningioma, a mostly benign intracranial tumor of mesenchymal origin in adults. The present investigation is comparing the frequency of single HLA alleles and haplotypes in 81 adult Caucasian patients with symptomatic central nervous system meningiomas to that of 157 area- and race-matched healthy controls. Both standard serological and molecular genetic (PCR) techniques were used for HLA typing. Our results suggest an association between single HLA alleles and occurrence of clinica...
Diseases and conditions which cause instability of the craniocervical junction and the adjacent u... more Diseases and conditions which cause instability of the craniocervical junction and the adjacent upper cervical spine are relatively common and potentially life-threatening. Direct internal occipitocervical fusion (OCF) is a modern means of surgical treatment in such cases, and has some advantages over simple immobilization of the affected segments. The present study was designed to evaluate surgical handling, results, and complications with a recently developed instrumentation for OCF, the Cotrel-Dubousset rod-and-hook system (CD). Fourteen consecutive patients with occipito-cervical instability due to fractures, degenerative or neoplastic disease or malformations underwent OCF with the CD system. Autologous or allogeneic bone and bone substitutes such as hydroxyapatite were used to augment the CD fusion. Patients were followed clinically and neuroradiologically for 1 to 4 years (mean 20 months). Assessments were routinely performed at 1 week, 1 month, 3 months, 1/2 year, and every year after surgery. There was no immediate surgery-related morbidity or mortality, and no major late complications due to hardware failure. A stable bony fusion according to radiological criteria was achieved in all cases. No implant breaks or loosening and dislocation of the hooks or the screws were encountered. In no case did neurological deterioration occur after surgery. Short-term evaluation at 1 week after surgery showed no difference with respect to neurological symptoms as compared with the pre-operative findings, except for a patient reporting improvement of paraesthesia on the first postoperative day. The long-term effects were, however, beneficial to most patients, as the fusion alleviated neck pain in 13 cases and improved neurological deficits in 3 of the 4 cases with pre-operative motor weakness or paraesthesia. In conclusion, internal OCF with the CD system, an implant which is easy to handle and safe for the patient, is a technique with a high rate of successful bony fusion. Since no halo placement is needed after surgery, patients have considerable gain of quality of life as compared to other standard surgical techniques.
Idrugs the Investigational Drugs Journal, Jun 1, 2003
Pentosan polysulfate (PPS) acts by imitating the physiological roles of the heparans. It binds to... more Pentosan polysulfate (PPS) acts by imitating the physiological roles of the heparans. It binds to heparan binding sites on proteins and alters the physiological actions of these proteins. PPS acts as a prophylactic agent against infection with prions both in vivo and in vitro. Low concentrations (10 mg/ml) are needed extracellularly for this effect to be seen but, due to cellular uptake, it is believed that a much higher concentration is found intracellularly. The prophylactic effect of PPS is observed if the drug is administered to mice between 3 months before and approximately 30 days after the inoculation of the disease. After that point it is considered that the infection has entered the nervous system, and that the drug cannot penetrate the blood-brain barrier. The prophylaxis of humans with oral PPS and the current therapeutic activity of the drug when given by intracerebroventricular infusion to symptomatic, prion-infected animals are discussed.
Einleitung: In seltenen Fällen kann eine Rhinoliquorrhoe spontan und ohne adäquates Trauma auftre... more Einleitung: In seltenen Fällen kann eine Rhinoliquorrhoe spontan und ohne adäquates Trauma auftreten. Eine mögliche Ursache hierfür ist ein persistierender lateraler craniopharyngealer (Sternberg) Kanal. Dieser angeborene Defekt findet sich bei ca. 4% der Erwachsenen in der [for full text, please go to the a.m. URL]
Pineal lesions in the pediatric patient are often complicated by the development of hydrocephalus... more Pineal lesions in the pediatric patient are often complicated by the development of hydrocephalus due to obstruction of the aqueduct or the third ventricle by tumor masses. In such cases, hydrocephalus treatment has the highest priority and should be performed prior to any surgical treatment of the pineal tumor itself. The golden standard in obstructive hydrocephalus treatment remains placement of a temporary or permanent cerebrospinal fluid shunt, although there are many long-term complications associated with a shunt system. To avoid these and to render the patients independent from a failure-prone shunt system, we employed endoscopic third ventriculostomy for permanent relief of elevated intracranial pressure prior to surgical removal of the pineal lesions. The present study summarizes the results of this approach in 7 pediatric patients with obstructive hydrocephalus. No complications of the endoscopic procedure were encountered, and the ventriculostomy remained patent in all cases, as confirmed by motion sensitive MRI. The advantages of endoscopic third ventriculostomy as compared with other techniques are discussed, and its increasing role in the management of children with space occupying lesions of the pineal region is defined.
Cancer Epidemiology, Biomarkers and Prevention, 2003
The expression of human leukocyte antigen (HLA) alleles plays an important role in the developmen... more The expression of human leukocyte antigen (HLA) alleles plays an important role in the development and recurrence of benign and malignant diseases. Association of single HLA alleles or haplotypes with neoplastic processes has been investigated previously, and correlation between HLA and solid tumors, such as head and neck cancers or uterine cervical squamous epithelial lesions, were reported. However, there is no published data on the influence of the HLA system on the development of symptomatic cerebral meningioma, a mostly benign intracranial tumor of mesenchymal origin in adults. The present investigation is comparing the frequency of single HLA alleles and haplotypes in 81 adult Caucasian patients with symptomatic central nervous system meningiomas to that of 157 area- and race-matched healthy controls. Both standard serological and molecular genetic (PCR) techniques were used for HLA typing. Our results suggest an association between single HLA alleles and occurrence of clinica...
Gene therapy offers signi®cant advantages to the ®eld of oncology with the addition of speci®call... more Gene therapy offers signi®cant advantages to the ®eld of oncology with the addition of speci®cally and uniquely engineered mechanisms of halting malignant proliferation through cytotoxicity or reproductive arrest. To confer a true bene®t to the therapeutic ratio (the relative toxicity to tumor compared to normal tissue) a vector or the transgene it carries must selectively affect or access tumor cells. Beyond the selective toxicities of many transgene products, which frequently parallel that of contemporary chemotherapeutic agents, lies the potential utility of targeting the vector. This review presents an overview of current and potential methods for designing vectors targeted to CNS malignancies through selective delivery, cell entry, transport or transcriptional regulation. The topic of delivery encompasses physical and pharmaceutic means of increasing the relative exposure of tumors to vector. Cell entry based methodologies are founded on increasing relative uptake of vector thr...
This 68-years old Caucasian male presented with sudden acute onset of occipital headache and doub... more This 68-years old Caucasian male presented with sudden acute onset of occipital headache and double vision. Neurological exam diagnosed right-sided facial and abducent nerve palsy. The attack was preceded by mild unsteadiness and sensorineural hearing loss of two months duration. CT and MRI demonstrated a large cerebellopontine angle cyst with fluid level and intracavitary blood. The cyst was excised and histological examination revealed acoustic neuroma. This is a rare case of isolated hemorrhage into a cystic acoustic neuroma with atypical acute presentation and ipsilateral facial and abducent nerve palsy on the background of hearing loss of short duration. Differential diagnosis of acute facial and abducent nerve palsy may have to include such lesions. Objective and importance A coustic neuroma (AN) presenting as hemorrhage in a cystic structure is an uncommon entity. Hemorrhage with AN may take the form of a subarachnoid and/or intratumoral bleed and is likely to be related to t...
The expression of human leukocyte antigen (HLA) alleles plays an important role in the developmen... more The expression of human leukocyte antigen (HLA) alleles plays an important role in the development and recurrence of benign and malignant diseases. Association of single HLA alleles or haplotypes with neoplastic processes has been investigated previously, and correlation between HLA and solid tumors, such as head and neck cancers or uterine cervical squamous epithelial lesions, were reported. However, there is no published data on the influence of the HLA system on the development of symptomatic cerebral meningioma, a mostly benign intracranial tumor of mesenchymal origin in adults. The present investigation is comparing the frequency of single HLA alleles and haplotypes in 81 adult Caucasian patients with symptomatic central nervous system meningiomas to that of 157 area- and race-matched healthy controls. Both standard serological and molecular genetic (PCR) techniques were used for HLA typing. Our results suggest an association between single HLA alleles and occurrence of clinica...
Diseases and conditions which cause instability of the craniocervical junction and the adjacent u... more Diseases and conditions which cause instability of the craniocervical junction and the adjacent upper cervical spine are relatively common and potentially life-threatening. Direct internal occipitocervical fusion (OCF) is a modern means of surgical treatment in such cases, and has some advantages over simple immobilization of the affected segments. The present study was designed to evaluate surgical handling, results, and complications with a recently developed instrumentation for OCF, the Cotrel-Dubousset rod-and-hook system (CD). Fourteen consecutive patients with occipito-cervical instability due to fractures, degenerative or neoplastic disease or malformations underwent OCF with the CD system. Autologous or allogeneic bone and bone substitutes such as hydroxyapatite were used to augment the CD fusion. Patients were followed clinically and neuroradiologically for 1 to 4 years (mean 20 months). Assessments were routinely performed at 1 week, 1 month, 3 months, 1/2 year, and every year after surgery. There was no immediate surgery-related morbidity or mortality, and no major late complications due to hardware failure. A stable bony fusion according to radiological criteria was achieved in all cases. No implant breaks or loosening and dislocation of the hooks or the screws were encountered. In no case did neurological deterioration occur after surgery. Short-term evaluation at 1 week after surgery showed no difference with respect to neurological symptoms as compared with the pre-operative findings, except for a patient reporting improvement of paraesthesia on the first postoperative day. The long-term effects were, however, beneficial to most patients, as the fusion alleviated neck pain in 13 cases and improved neurological deficits in 3 of the 4 cases with pre-operative motor weakness or paraesthesia. In conclusion, internal OCF with the CD system, an implant which is easy to handle and safe for the patient, is a technique with a high rate of successful bony fusion. Since no halo placement is needed after surgery, patients have considerable gain of quality of life as compared to other standard surgical techniques.
Idrugs the Investigational Drugs Journal, Jun 1, 2003
Pentosan polysulfate (PPS) acts by imitating the physiological roles of the heparans. It binds to... more Pentosan polysulfate (PPS) acts by imitating the physiological roles of the heparans. It binds to heparan binding sites on proteins and alters the physiological actions of these proteins. PPS acts as a prophylactic agent against infection with prions both in vivo and in vitro. Low concentrations (10 mg/ml) are needed extracellularly for this effect to be seen but, due to cellular uptake, it is believed that a much higher concentration is found intracellularly. The prophylactic effect of PPS is observed if the drug is administered to mice between 3 months before and approximately 30 days after the inoculation of the disease. After that point it is considered that the infection has entered the nervous system, and that the drug cannot penetrate the blood-brain barrier. The prophylaxis of humans with oral PPS and the current therapeutic activity of the drug when given by intracerebroventricular infusion to symptomatic, prion-infected animals are discussed.
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Papers by Nikolai Rainov