Redefining Ventricular Target Volume in Germinoma: Is Inclusion of Temporal Horns Necessary?

Purpose: We reviewed the outcomes of a retrospective germinoma cohort and analyzed radiation therapy plans to determine dosimetric differences for critical structures.

Methods And Materials: Data from pediatric patients treated with photon radiation for intracranial germinoma were analyzed for clinical outcomes and dosimetry to critical structures, with particular interest in the temporal ventricular horns (TVHs). A consensus contour was generated for TVH-sparing ventricular clinical target volumes (CTVs) via deformable image registration.

Unusual finding in the karyotype of a neonate with glandular hypospadias with chordee.

A 37-week, 2700 g vaginally delivered baby was admitted for respiratory distress which was attributed to transient tachypnoea of newborn. A clinical finding of glandular hypospadias with ventral chordee was detected. The penis was normal in size, and gonads were palpable bilaterally in the scrotal sac.

Effective and safe tumor inhibition using vinblastine in medulloblastoma.

Most medulloblastoma protocols worldwide include vincristine during radiation and chemotherapy. A significant dose-limiting toxicity is peripheral neuropathy; however, there is a paucity of data to support the view that omission of vincristine does not impact survival. Herein we report two adolescent patients with Group 4 and SHH medulloblastoma, where vinblastine successfully replaced vincristine with resolution of their peripheral neuropathy.

Conformal Radiation Therapy for Pediatric Ependymoma, Chemotherapy for Incompletely Resected Ependymoma, and Observation for Completely Resected, Supratentorial Ependymoma.

Purpose: The Children's Oncology Group trial ACNS0121 estimated event-free survival (EFS) and overall survival for children with intracranial ependymoma treated with surgery, radiation therapy, and-selectively-with chemotherapy. Treatment was administered according to tumor location, histologic grade, and extent of resection. The impacts of histologic grade, focal copy number gain on chromosome 1q, and DNA methylation profiles were studied for those undergoing surgery and immediate postoperative conformal radiation therapy (CRT).

Survival and functional outcomes of molecularly defined childhood posterior fossa ependymoma: Cure at a cost.

Background: Posterior fossa ependymoma (PFE) comprises 2 groups, PF group A (PFA) and PF group B (PFB), with stark differences in outcome. However, to the authors' knowledge, the long-term outcomes of PFA ependymoma have not been described fully. The objective of the current study was to identify predictors of survival and neurocognitive outcome in a large consecutive cohort of subgrouped patients with PFE over 30 years.

Challenges to curing primary brain tumours.

Despite decades of research, brain tumours remain among the deadliest of all forms of cancer. The ability of these tumours to resist almost all conventional and novel treatments relates, in part, to the unique cell-intrinsic and microenvironmental properties of neural tissues. In an attempt to encourage progress in our understanding and ability to successfully treat patients with brain tumours, Cancer Research UK convened an international panel of clinicians and laboratory-based scientists to identify challenges that must be overcome if we are to cure all patients with a brain tumour.

Case of Solitary Peritoneal Metastasis From Atypical Bronchopulmonary Carcinoid on 18F-FDG PET/CT.

Atypical lung carcinoids frequently metastasize to mediastinal nodes, liver, bone, lungs, and brain and rarely to ovaries, pancreas, subcutaneous, and skin. Solitary peritoneal metastasis is extremely rare and unreported previously. We present a case of a 36-year-old woman with cough, hemoptysis, dyspnea with detection of lung mass, and incidental detection of pelvic mass.

PPAR and GST polymorphisms may predict changes in intellectual functioning in medulloblastoma survivors.

Purpose: Advances in the treatment of pediatric medulloblastoma have led to improved survival rates, though treatment-related toxicity leaves children with significant long-term deficits. There is significant variability in the cognitive outcome of medulloblastoma survivors, and it has been suggested that this variability may be attributable to genetic factors. The aim of this study was to explore the contributions of single nucleotide polymorphisms (SNPs) in two genes, peroxisome proliferator activated receptor (PPAR) and glutathione-S-transferase (GST), to changes in general intellectual functioning in medulloblastoma survivors.

The Patient Management and Professionalism Scale to Assess Dental Students' Behavior in Clinic.

The Ten Item Personality Inventory (TIPI) is a widely used instrument based on a personality framework measuring five dimensions: Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Openness to Experiences. The aim of this study was to establish a scale to assess dental students' professionalism by adding to the TIPI's five dimensions a set of descriptors that define professional behavior in dental students. The resulting Patient Management and Professionalism Scale (PMPS) was then tested with a cohort of graduating students at the University of Michigan School of Dentistry.

MR Imaging-Based Radiomic Signatures of Distinct Molecular Subgroups of Medulloblastoma.

Background And Purpose: Distinct molecular subgroups of pediatric medulloblastoma confer important differences in prognosis and therapy. Currently, tissue sampling is the only method to obtain information for classification. Our goal was to develop and validate radiomic and machine learning approaches for predicting molecular subgroups of pediatric medulloblastoma.

Significance of molecular classification of ependymomas: C11orf95-RELA fusion-negative supratentorial ependymomas are a heterogeneous group of tumors.

Extensive molecular analyses of ependymal tumors have revealed that supratentorial and posterior fossa ependymomas have distinct molecular profiles and are likely to be different diseases. The presence of C11orf95-RELA fusion genes in a subset of supratentorial ependymomas (ST-EPN) indicated the existence of molecular subgroups. However, the pathogenesis of RELA fusion-negative ependymomas remains elusive.

Craniospinal irradiation as part of re-irradiation for children with recurrent intracranial ependymoma.

Background: The goal of this study was to evaluate outcomes in children with relapsed, molecularly characterized intracranial ependymoma treated with or without craniospinal irradiation (CSI) as part of a course of repeat radiation therapy (re-RT).

Methods: This was a retrospective cohort study of 31 children. Patients with distant relapse received CSI as part of re-RT.

Pediatric Brain Tumor Genetics: What Radiologists Need to Know.

Brain tumors are the most common solid tumors in the pediatric population. Pediatric neuro-oncology has changed tremendously during the past decade owing to ongoing genomic advances. The diagnosis, prognosis, and treatment of pediatric brain tumors are now highly reliant on the genetic profile and histopathologic features of the tumor rather than the histopathologic features alone, which previously were the reference standard.

Publisher Correction: Notch1 regulates the initiation of metastasis and self-renewal of Group 3 medulloblastoma.

The original version of this Article omitted Suzana A. Kahn, Siddhartha S. Mitra & Samuel H.

The Status of Interdisciplinary Education in Advanced Education Programs at U.S. Dental Schools.

Interdisciplinary education (IDE) during dental residencies can help produce dentists who work more efficiently to provide continuous and reliable patient care. The aim of this study was to assess the extent and type of interdisciplinary education in dental residency programs at U.S.

BMI1 is a therapeutic target in recurrent medulloblastoma.

Medulloblastoma (MB) is the most frequent malignant pediatric brain tumor, representing 20% of newly diagnosed childhood central nervous system malignancies. Although advances in multimodal therapy yielded a 5-year survivorship of 80%, MB still accounts for the leading cause of childhood cancer mortality. In this work, we describe the epigenetic regulator BMI1 as a novel therapeutic target for the treatment of recurrent human Group 3 MB, a childhood brain tumor for which there is virtually no treatment option beyond palliation.

Bioinformatic Strategies for the Genomic and Epigenomic Characterization of Brain Tumors.

Genomics has significantly advanced our knowledge of the biology of brain tumors, and refined our classification over the past 10 years. These advances have relied on the unbiased analysis of large cohorts of brain tumors, where they are clustered in an unbiased manner prior to ascribing clinical and biological features. Indeed, this has resulted in the identification of several layers of heterogeneity not previously appreciated by morphology alone.

Notch1 regulates the initiation of metastasis and self-renewal of Group 3 medulloblastoma.

Medulloblastoma is the most common malignant brain tumor of childhood. Group 3 medulloblastoma, the most aggressive molecular subtype, frequently disseminates through the leptomeningeal cerebral spinal fluid (CSF) spaces in the brain and spinal cord. The mechanism of dissemination through the CSF remains poorly understood, and the molecular pathways involved in medulloblastoma metastasis and self-renewal are largely unknown.

Developmental phosphoproteomics identifies the kinase CK2 as a driver of Hedgehog signaling and a therapeutic target in medulloblastoma.

A major limitation of targeted cancer therapy is the rapid emergence of drug resistance, which often arises through mutations at or downstream of the drug target or through intrinsic resistance of subpopulations of tumor cells. Medulloblastoma (MB), the most common pediatric brain tumor, is no exception, and MBs that are driven by sonic hedgehog (SHH) signaling are particularly aggressive and drug-resistant. To find new drug targets and therapeutics for MB that may be less susceptible to common resistance mechanisms, we used a developmental phosphoproteomics approach in murine granule neuron precursors (GNPs), the developmental cell of origin of MB.

Fabrication of a bilayer scaffold for small diameter vascular applications.

One of the greatest challenges plaguing cardiovascular tissue engineering has been the development of a compliant vascular graft. In this work, we report the development of a synthetic vascular graft with compliance similar to native arteries at physiological pressures. A bilayer scaffold was fabricated from a solid polymeric lumen made from poly(1,8 octanediol-co-citrate) (POC) and a microfibrous medial layer composed of type I collagen, elastin, and POC.

Spatially similar surface energy flux perturbations due to greenhouse gases and aerosols.

Despite distinct geographic distributions of top-of-the-atmosphere radiative forcing, anthropogenic greenhouse gases and aerosols have been found to produce similar patterns of climate response in atmosphere-and-ocean coupled climate model simulations. Understanding surface energy flux changes, a crucial pathway by which atmospheric forcing is communicated to the ocean, is a vital bridge to explaining the similar full atmosphere-and-ocean responses to these disparate forcings. Here we analyze the fast, atmosphere-driven change in surface energy flux caused by present-day greenhouse gases vs aerosols to elucidate its role in shaping the subsequent slow, coupled response.

Clinical and pre-clinical utility of genomics in medulloblastoma.

Integrated genomics has significantly advanced our understanding of medulloblastoma heterogeneity. It is now clear that it actually comprises at least four distinct molecular subgroups termed Wnt/Wingless (WNT), Sonic Hedgehog (SHH), Group 3, and Group 4 with stark clinical and biological differences. Areas covered: This paper reviews advances in the classification and risk stratification of medulloblastoma, specifically integrating subgroup with clinical and cytogenetic risk factors, with a summary of the potential to lead to more precise therapies.