Publications by authors named "Juraj Steno"

Gliomas are the most common and lethal forms of malignant brain tumors. We attempted to identify the role of the aging-suppressor gene and Klotho protein in the immunopathogenesis of gliomas. We examined genetic variants by PCR-RFLP and measured serum Klotho levels using the ELISA method.

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Article Synopsis
  • * Out of 86 surgeries, 3D-US successfully visualized 80% of aneurysms, especially those located at the middle cerebral artery (MCA), where visibility reached 86.4%.
  • * The results suggest that while most aneurysms can be seen using this technology, further research with a larger sample is necessary to validate these findings and assess their clinical significance.
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Inflammation and immunity belong to the main factors influencing tumor growth. In this study, we attempted to identify a profile of biomarkers associated with gliomas. We found decreased serum levels of sTREM-1 (soluble triggering receptor expressed on myelocytes) and increased levels of IL-10 in all grades of glioma patients in comparison with healthy controls (sTREM-1: grade II: p=0.

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•Preservation of LSAs is extremely important during resections of insular gliomas.•Navigated 3D-US power Doppler may enable intraoperative visualization of LSAs.•Quality of ultrasound scanner is important when LSAs should be visualized.

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HLA-G is an immune checkpoint molecule with immunosuppressive and anti-inflammatory activities, and its expression and level of its soluble form (sHLA-G) may play an important role in tumor prognosis. The HLA-G 14bp ins/del polymorphism and the plasma level of soluble HLA-G (sHLA-G) were investigated by a polymerase chain reaction and ELISA, respectively, in 59 glioma patients. A significantly higher proportion of glioma patients had the 14 nt insert in both homozygous and heterozygous states compared to the control group.

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Background: Human leukocyte antigen G (HLA-G) belongs to non-classical MHC class I molecules that is involved in the suppression of immune response. As HLA-G plays important role in the maintenance of fetal tolerance, its overexpression has been associated with tumor progression. For the regulation of HLA-G levels, genetic variants within the 5' upstream regulatory region (5'URR) are of crucial importance.

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While benefits of neurosurgical intraoperative ultrasound (IOUS) are reported frequently, this method still has some significant pitfalls, which are described less often. However, sufficient knowledge on dealing with IOUS drawbacks, particularly various image artifacts, is important for successful surgery. We report a case of failed IOUS-guided pediatric cerebellar pilocytic astrocytoma resection, incorrectly evaluated as gross total resection according to IOUS.

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Background And Study Aims:  A great number of unsuccessful intervertebral herniated disk surgeries in the lumbosacral region have highlighted the importance of a comprehensive knowledge of the different types of nerve root anomalies. That knowledge gained by anatomical studies (and intraoperative findings) might contribute to better results. In our study we focused on intraspinal extradural lumbosacral nerve root anomalies and their possible role in radiculopathy.

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Background: The data showing usefulness of navigated 3D-ultrasound (3DUS) during awake resections of eloquent gliomas are sparse. Results of surgeries performed using 3DUS were never compared to procedures guided by standard neuronavigation. The aim of this work is to assess the effectiveness of 3DUS during awake resections of eloquent low-grade gliomas (LGGs) by comparing surgical results of two series of patients operated on using conventional neuronavigation and using 3DUS.

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Purpose: The aim of this work is to point out the intraspinal anatomical variations of nerve roots and their possible participation in radiculopathy.

Methods: The anatomical study was performed in 33 cadavers. There were 25 male cadavers aged 30-75 years and 8 female cadavers aged 45-77 years, with a mean age of 46.

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Introduction: The aim of this work is to point out the intraspinal extradural anatomical variations of nerve roots and their possible participation in radiculopathy.

Methods: The anatomical study was performed in 33 cadavers at a mean age of 46.5 and up to 24h from death.

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OBJECTIVE Resection of insular gliomas is challenging. In cases of intraoperative injury to the lenticulostriate arteries (LSAs), the usual result is a dense hemiplegia. LSAs are usually localized just behind the medial tumor border but they can also be encased by the tumor.

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Direct electrical stimulation (DES) of the optic radiation (OR) during an awake tumor resection has been repeatedly reported. In all cases, visual function monitoring was performed in patients with open eyes which were looking at a picture. We report a new modification of the standard method, OR stimulation in patient with closed and covered eyes.

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Background: The postoperative biological behavior of nonfunctioning pituitary adenomas (NFPAs) is variable. Some residual NFPAs are stable long-term, others grow, and some recur despite complete removal. The usual histological markers of tumor aggressiveness are often similar between recurring, regrowing, and stable tumors, and therefore are not reliable as prognostic parameters.

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Background: The significance of the majority of the factors influencing the recurrence rate (RR) of craniopharyngiomas remains unclear, and the management of this significance is controversial. The present study aimed to evaluate the influence of patient age and tumor topography on the RR, the efficacy of radiotherapy, and the safety of surgery for recurrences.

Methods: The RR was analyzed in 38 children (follow-up, 2-256 months [mean, 147.

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We report a case of awake resection of temporal low-grade glioma infiltrating the optic radiation (OR). The OR was localized by direct electrical stimulation (DES) and the tumor was delineated by navigated intraoperative 3D ultrasound. Ultrasound artifacts were eliminated by 3D-ultrasound data acquisition with a miniature probe inserted into the resection cavity.

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Background: Lateral approaches to the brain stem for the resection of the cavernous malformations are preferred in order to avoid the structures within the floor of the fourth ventricle. The entry behind the pyramidal tract (PT) is usually carried out through the posterolateral surface of the brain stem. The more straightforward lateral approach below the temporal lobe is used rarely because of potential risks.

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Purpose: Two main modes of management of craniopharyngiomas, namely, radical tumor removal and intentional incomplete removal followed by radiotherapy, are used. Recently, a half-way solution was added. Radical removal is reserved only for the tumors not involving hypothalamus.

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Persisting embryonal infundibular recess (PEIR) is a rare anomaly of the third ventricular floor that has an unclear pathogenesis. In all 7 previously described cases, PEIR was present in adult patients and was invariably associated with hydrocephalus and, in 4 reported cases, with an empty sella. These associated findings led to speculations about the role of increased intraventricular pressure in the development of PEIR.

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Objective: To disclose the relationships of primarily supradiaphragmatic craniopharyngiomas with the third ventricular floor (3rdVF) by means of preoperative magnetic resonance imaging (MRI) and thus to select the surgical approach avoiding the hypothalamic structures.

Methods: MRI findings in 76 consecutive patients with craniopharyngiomas operated on between June 1991 and December 2002 were interpreted on the basis of the results of the authors' own previous microanatomic studies. The assumed tumor-3rdVF relationships were then correlated with the operative findings.

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