No abstract available.
Ataxia* ; Brain Stem Neoplasms* ; Mesencephalon*

PURPOSE: Three dimensional conformal radiotherapy planning is being used widely for the treatment of patients with brain tumor. However, it takes much time to develop an optimal treatment plan, therefore, it is difficult to apply this technique to all patients. To increase the efficiency of this technique, we need to develop standard radiotherapy plans for each site of the brain. Therefore we developed several 3 dimensional conformal radiotherapy plans (3D plans) for tumors at each site of brain, compared them with each other, and with 2 dimensional radiotherapy plans. Finally model plans for each site of the brain were decided. MATERIALS AND METHODS: Imaginary tumors, with sizes commonly observed in the clinic, were designed for each site of the brain and drawn on CT images. The planning target volumes (PTVs) were as follows; temporal tumor-5.7x8.2x7.6 cm, suprasellar tumor-3x4x4.1 cm, thalamic tumor-3.1x5.9x3.7 cm, frontoparietal tumor-5.5x7x5.5 cm, and occipitoparietal tumor-5x5.5x5 cm. Plans using parallel opposed 2 portals and/or 3 portals including fronto-vertex and 2 lateral fields were developed manually as the conventional 2D plans, and 3D noncoplanar conformal plans were developed using beam's eye view and the automatic block drawing tool. Total tumor dose was 54 Gy for a suprasellar tumor, 59.4 Gy and 72 Gy for the other tumors. All dose plans (including 2D plans) were calculated using 3D plan software. Developed plans were compared with each other using dose-volume histograms (DVH), normal tissue complication probabilities (NTCP) and variable dose statistic values (minimum, maximum and mean dose, D5, V83, V85 and V95). Finally a best radiotherapy plan for each site of brain was selected. RESULTS: 1) Temporal tumor; NTCPs and DVHs of the normal tissue of all 3D plans were superior to 2D plans and this trend was more definite when total dose was escalated to 72 Gy (NTCPs of normal brain 2D plans : 27%, 8% 3D plans : 1%, 1%). Various dose statistic values did not show any consistent trend. A 3D plan using 3 noncoplanar portals was selected as a model radiotherapy plan. 2) Suprasellar tumor; NTCPs of all 3D plans and 2D plans did not show significant difference because the total dose of this tumor was only 54 Gy. DVHs of normal brain and brainstem were significantly different for different plans. D5, V85, V95 and mean values showed some consistent trend that was compatible with DVH. All 3D plans were superior to 2D plans even when 3 portals (fronto-vertex and 2 lateral fields) were used for 2D plans. A 3D plan using 7 portals was worse than plans using fewer portals. A 3D plan using 5 noncoplanar portals was selected as a model plan. 3) Thalamic tumor; NTCPs of all 3D plans were lower than the 2D plans when the total dose was elevated to 72 Gy. DVHs of normal tissues showed similar results. V83, V85, V95 showed some consistent differences between plans but not between 3D plans. 3D plans using 5 noncoplanar portals were selected as a model plan. 4) Parietal (fronto- and occipito-) tumors; all NTCPs of the normal brain in 3D plans were lower than in 2D plans. DVH also showed the same results. V83, V85, V95 showed consistent trends with NTCP and DVH. 3D plans using 5 portals for frontoparietal tumor and 6 portals for occipitoparietal tumor were selected as model plans. CONCLUSION: NTCP and DVH showed reasonable differences between plans and were thought to be useful for comparing plans. All 3D plans were superior to 2D plans. Best 3D plans were selected for tumors in each site of brain using NTCP, DVH and finally by the planner's decision.
Brain Neoplasms* ; Brain Stem ; Brain* ; Humans ; Rabeprazole ; Radiotherapy ; Radiotherapy, Conformal*

Although fibromas are the most common renal medullary tumor identified at autopsy. their small sized and benign course make clinical detection extremely difficult. Only 9 clinical cases of renal medullary fibromas have been reported. Many fibromas of the renal medulla, previously considered as bamahomas. seemed to be composed of tumerous transformation of renomedullary interstitial calls Herein we report on a patient with huge renal medullary fibroma treated by right radical nephrectomy.
Autopsy ; Brain Stem Neoplasms ; Fibroma ; Humans ; Nephrectomy

Magnetic resonance imaging (MRI) is an excellent exploring method for possibility of early and precise diagnosis, especially in the brain tumors and medullary lesions. The author presents special 9 cases of brain tumors and medullary lesions,which have been diagnosed by MRI, and operated at the section of Neurosurry Ha noi Saint- Paul Hospital in 1997
Magnetic Resonance Spectroscopy ; Brain Stem Neoplasms ; diagnosis

The purpose of this study is to verify the dosimetric effect on real PTV (planning target volume) coverage and safety of OARs (organs at risk) at various image fusion protocol-based radiosurgery plan for pituitary adenomas. Real PTV coverage and its variation was acquired and maximum dose and the volume absorbing above threshold dose were also measured for verifying the safety of optic pathway and brainstem. The protocol that can reduce superior-inferior uncertainty by using both axial and coronal MR (magnetic resonance) image sets shows relatively lower values than that of case using only axial image sets. As a result, the image fusion protocol with both axial and coronal image sets can be beneficial to generate OAR-weighted radiosurgery plan.
Brain Stem ; Pituitary Neoplasms ; Radiosurgery ; Uncertainty

Idiopathic facial palsy of the peripheral type is the most common facial palsy. However, the rate of incident is much lower in children under 10 years. In children, many other conditions can cause peripheral facial nerve palsy. We present the cases of 2 children with whom the initial manifestation of their leukemia and brain stem tumor were shown through the peripheral type of facial nerve palsy. These cases should alert physicians to consider other serious causes in younger children with facial palsy.
Brain Stem Neoplasms* ; Brain Stem* ; Brain* ; Child ; Facial Nerve* ; Facial Paralysis ; Humans ; Leukemia* ; Paralysis*

Despite recent advances in the development of novel targeted chemotherapies, the prognosis of malignant glioma remains dismal. The chemo-resistance of this tumor is attributed to tumor heterogeneity. To explain this unique chemo- resistance, the concept of cancer stem cells has been evoked. Cancer stem cells, a subpopulation of whole tumor cells, are now regarded as candidate therapeutic targets. Here, the author reviews and discusses the cancer stem cell concept.
Brain ; Brain Neoplasms ; Glioma ; Neoplastic Stem Cells ; Population Characteristics ; Prognosis

Gliomatosis cerebri is an uncommon primary brain tumor characterized by diffuse neoplastic proliferation of glial cells, with the preservation of anatomical architecture and the sparing of the neurons. In this report, we present a gliomatosis cerebri in a 16-year-old girl which occurred in brain stem and unilateral cerebellar hemisphere.
Adolescent ; Brain Neoplasms ; Brain Stem* ; Brain* ; Cerebellum ; Female ; Humans ; Neoplasms, Neuroepithelial* ; Neuroglia ; Neurons

Central neurogenic hyperventilation (CNH) is characterized by sustained tachypnea inspite of an elevated arterial PaO2, pH and a low arterial PaCO2. CNH is common in patients with brainstem injury accompanied by a decreased level of consciousness but this also has been described in some alert patients with an invasive brainstem tumor. We report one case with CNH resulting from a unilateral pontine infarction. His consciousness was clear, and CNH spontaneously disappeared without any medication.
Brain Stem ; Brain Stem Neoplasms ; Consciousness ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation* ; Infarction* ; Tachypnea

Orthostatic hypotension rarely occurs as a result of central vasomotor failure. We report a 74-year-old man who presented with progressive orthostatic dizziness, and intermittent syncope that resulted from a ponto-medullary tumor. Orthostatic hypotension may develop due to the sympathetic failure of the vasomotor center, which is located in the rostral ventrolateral medulla.
Aged ; Brain Stem Neoplasms* ; Brain Stem* ; Dizziness* ; Humans ; Hypotension, Orthostatic ; Syncope