Anna Michel

Photic stimulation during the subjective night induces the expression of Fos among a discrete population of cells in the suprachiasmatic nuclei (SCN) region of the Syrian hamster. Light appears to stimulate Fos expression only when administered at circadian times (CTs) at which exposure causes a phase shift. Different populations of SCN cells express Fos in response to light pulses that result in phase advances versus phase delays, raising the possibility that different cell populations in the suprachiasmatic hypothalamus participate in light-induced phase advances and delays of the circadian oscillator. Microinjection of excitatory amino acid (EAA) antagonists into the region of the SCN attenuates light-induced phase advances of the free-running activity rhythm and light-induced Fos expression in the hamster SCN. However, injection of N-methyl-D-aspartate (NMDA) at CT 18, which results in a widespread pattern of Fos expression in the hypothalamus that includes the retinorecipient zone of the SCN, does not produce phase advances of the circadian oscillator. The results demonstrate that both light-induced Fos expression and light-induced phase advances are dependent upon EAA neurotransmission within the SCN region. However, expression of Fos in the SCN induced by the EAA agonist NMDA is not sufficient to cause phase advances of the SCN oscillator.

BACKGROUND: Glioblastoma (GBM) is the most common malignant brain tumor in adults and still carries a dismal prognosis. As several studies detected a connection between inflammation and GBM prognosis, we sought to explore possible associations between routinely investigated inflammatory parameters and GBM outcome. PATIENTS AND METHODS: Patients treated for GBM at our Institution between 2004 and 2014 were included. White blood cell count (WBC), C-reactive protein (CRP) and the ratio of platelets and WBC (Plt/WBC) were evaluated preoperatively. Medical records were reviewed for clinical parameters (age, sex, preoperative clinical condition, genetic alterations). Study endpoints were overall (OS) and 1- and 2-year survival. RESULTS: In the final cohort consisting of 565 individuals with GBM, univariate analysis showed significant associations for WBC, CRP and Plt/WBC ratio with OS. Kaplan-Meier survival plot confirmed significantly poorer OS in patients with WBC>12/nl and with CRP≥2.9 mg/dl. In multivariate analysis, a WBC of >12/nl was an independent prognostic factor for all three outcome parameters and CRP≥2.9 mg/dl for OS and 1-year survival. CONCLUSION: Preoperative WBC and CRP values were confirmed as independent predictors of GBM outcome. This emphasizes the need for further evaluation of the role of inflammation in the prognosis of GBM.

Objective: Spinal cord ependymomas account for 3–6% of all central nervous system tumors and around 60% of all intramedullary tumors. The aim of this study was to analyze the neurological outcome after surgery and to determine prognostic factors for functional outcome. Patients and Methods: Patients treated surgically due to a spinal cord ependymoma between 1990 and 2018 were retrospectively included. Demographics, neurological symptoms, radiological parameters, histopathology, and neurological outcome (using McCormick Score [MCS]) were analyzed. Possible prognostic factors for neurological outcome were evaluated. Results: In total, 148 patients were included (76 males, 51.4%). The mean age was 46.7 ± 15.3 years. The median follow-up period was 6.8 ± 5.4 years. The prevalence was mostly in the lumbar spine (45.9%), followed by the thoracic spine (28.4%) and cervical spine (25.7%). Gross-total resection was achieved in 129 patients (87.2%). The recurrence rate was 8.1% and depended on the extent of tumor resection ( p = 0.001). Postoperative temporary neurological deterioration was observed in 63.2% of patients with ependymomas of the cervical spine, 50.0% of patients with ependymomas of the thoracic spine, and 7.4% of patients with ependymomas of the lumbosacral region. MCS 1–2 was detected in nearly two-thirds of patients with cervical and thoracic spinal cord ependymoma 36 months after surgery. Neurological recovery was superior in thoracic spine ependymomas compared with cervical spine ependymomas. Poor preoperative functional condition (MCS >2), cervical and thoracic spine location, and tumor extension >2 vertebrae were independent predictors of poor neurological outcome. Conclusion: Neurological deterioration was seen in the majority of cervical and thoracic spine ependymomas. Postoperative improvement was less in thoracic cervical spine ependymomas compared with thoracic spine ependymomas. Poor preoperative status and especially tumor extension >2 vertebrae are predictors of poor neurological outcome (MCS >2).