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Abstrak :
"This new book carries on a strong tradition of diagnostically oriented texts established by the Biopsy Interpretation Series, in the present case focused on lesions of the Central Nervous System. Our purpose is to provide a practical guide and concise reference that can be a companion text for the general surgical pathologist, trainees in pathology and neuropathology, and clinicians who treat patients with neurological diseases that require surgical sampling. Given the heavy orientation of the Biopsy Interpretation Series to the busy and serious-minded diagnostician, we have taken this opportunity to create something new and, we think, useful. While there are certainly several excellent books on neuropathology and surgical neuropathology, the majority are reference texts that are comprehensive and encyclopedic, making them less than optimal on a daily basis to assist with interpretation. Because the central concern here is with establishing the correct diagnosis, the content is aimed at anticipating difficult diagnostic decisions and providing concise and reliable guide to their resolution"--Provided by publisher.

Abstrak :
The most recent developments in diagnostic and therapeutic aspects of gliomas (glioblastoma) in the brain are presented. The importance of personalized medicine and clinical validation for targeted therapy are discussed. The identification of various types of biomarkers (determined by molecular genetics) is included, along with their advantages and limitations as markers in tumor detection and diagnosis. The identification and validation of brain cancer (glioblastoma) genes are discussed. The role of cancer stem cells in the initiation and persistence of malignant gliomas is explained, response of glioblastoma cancer stem cells to various growth factors, such as epidermal growth factor receptor kinase inhibitor, is explained. The use of surgical resection, chemotherapy (e.g., temozolomide), immunotherapy, and radiation therapy for glioblastoma patients is included. Biological impediments for chemotherapy and radiotherapy for malignant glioblastoma are pointed out. Standard (established) as well as newer imaging modalities (proton magnetic resonance spectroscopy) are discussed. Also included are proton magnetic resonance spectroscopy in intracranial gliomas, and the use of proton magnetic spectroscopic imaging in determining the infiltration zone in gliomas. The role of molecular signaling in the CNS cancer development is explained, including cell death signaling in glioblastoma multiforme.

Abstrak :
This book provides a comprehensive overview of the development of the human central nervous system (CNS) in the context of its many developmental disorders due to genetic, environmental, and hypoxic/​ischemic causes. The introductory chapters give an overview of the development of the human brain and the spinal cord, the mechanisms of development as obtained in experimental studies of various invertebrates and vertebrates, and the causes of congenital malformations. In the main part, the developmental disorders of the human brain and the spinal cord are presented in a regional, more or less segmental way, starting with neurulation and neural tube defects, and ending with developmental disorders of the cerebral cortex. These are underlined by carefully chosen clinical case studies, including imaging data and, when available, postmortem verification of the developmental disorders involved. Numerous color photographs and illustrations complement the text. This second edition emphasizes the prenatal diagnosis by ultrasound, MRI, and DTI and implements new classifications of developmental disorders.

Abstrak :
ABSTRAK
Latar belakang : Cytomegalovirus (CMV) merupakan salah satu infeksi oportunistik pada pasien dengan sindrom immunodefisiensi (AIDS). Gejala klinis dan CT scan tidak dapat menegakkan diagnosa definitif ensefalitis CMV. Oleh karena itu diperlukan uji alternatif untuk menegakkan diagnosis infeksi CMV pada pasien HIV dengan infeksi otak. Salah satu uji yang sensitif dan spesifik adalah Real Time Polymerase Chain Reaction (rPCR). Tujuan : Mendapatkan uji deteksi molekular CMV pada pasien HIV dengan tersangka infeksi otak. Metode : Penelitian dilakukan dalam 3 tahap. Tahap 1 adalah optimasi konsentrasi primer, probe, suhu annealing, volume elusi ekstraksi DNA, dan volume cetakan. Tahap 2 adalah uji spesifisitas (reaksi silang) dan uji sensitivitas (ambang batas deteksi DNA) rPCR dan tahap 3 adalah penerapan uji rPCR yang sudah dioptimasi terhadap sampel plasma, urin, dan LCS. Hasil : Kondisi optimal uji rPCR telah diperoleh dengan konsentrasi primer dan probe 0,1 μM, dengan kondisi suhu reaksi rPCR: aktivasi enzim pada 950C selama 3 menit; 45 siklus pada 950C selama 15 detik (denaturasi) dan 560C selama 1 menit (annealing dan ekstensi). Volume elusi ekstraksi DNA yang optimal untuk ketiga jenis sampel (LCS, plasma dan urin) adalah 40 μL, dan volume cetakan rPCR untuk LCS, plasma, dan urin, masing-masing adalah 5, 4, dan 3 μL. Uji rPCR mampu mendeteksi DNA pada 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, EBV,HSV,dan VZV. Penerapan uji rPCR pada sampel klinis memberikan hasil negatif pada semua sampel LCS, 72,22% positif pada sampel plasma, dan 72,22% positif pada sampel urin. Kesimpulan: Telah dilakukan optimasi uji rPCR dengan minimal deteksi DNA CMV 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan mikroorganisme yang berpotensi menyebabkan positif palsu (false positive).ABSTRACT
Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.

Abstrak :
Metastasis sistem saraf pusat (SSP) pada otak maupun spinal terjadi pada 10-40% pasien kanker. Metastasis SSP memiliki kesempatan yang sama untuk menyebabkan malnutrisi akibat gejala neurologis yang terjadi mamupun efek sistemik karena kanker. Malnutrisi berkaitan dengan sistem imun. Rasio neutrofil limfosit (RNL) dapat digunakan untuk menentukan prognosis. Kriteria malnutrisi berdasarkan Global Leadership Initiative on Malnutrition (GLIM) lebih sensitif untuk menegakkan malnutrisi. Penelitian bertujuan untuk mengetahui hubungan antara malnutrisi menurut kriteria GLIM dengan RNL pada metastasis SSP. Studi merupakan studi potong lintang pada pasien kanker metastasis SSP di RSCM. Terdapat 62 pasien mengalami metastasis SSP. Mayoritas subjek metastasis otak (60,3%) dan perempuan (61,3%), dengan rerata usia 46 tahun. Tumor primer tersering adalah payudara (24,1%), kepala leher (17,7%), paru dan saluran cerna (masing-masing 11,2%). Prevalens malnutrisi serupa pada metastasis otak (76,3%) dan spinal (70,8%). Mayoritas subjek dengan defisit neurologis seperti disfagia, nyeri kepala, nyeri kanker, kelemahan anggota gerak, dan gangguan otonom mengalami malnutrisi. Median RNL 7,09 (0,97–35,59). Rerata RNL secara signifikan lebih tinggi pada kelompok yang mengalami malnutrisi (p=0,002). Perbedaan rerata pada dua kelompok adalah 4,70 dengan KI95% (1,2-8,2). Malnutrisi berhubungan dengan RNL, subjek yang mengalami malnutrisi memiliki NLR yang lebih tinggi dibandingkan dengan yang tidak malnutrisi. ......Central nervous system (CNS) metastases to the brain or spine occur in 10-40% of cancer patients. CNS metastases have an equal chance of causing malnutrition due to neurological symptoms and systemic effects due to cancer. Malnutrition is related to the immune system. Neutrophil lymphocyte ratio (RNL) can be used to determine prognosis. Malnutrition criteria based on Global Leadership Initiative on Malnutrition (GLIM) are more sensitive for establishing malnutrition. This study aims to determine the relationship between malnutrition according to GLIM and RNL in CNS metastases. This is a cross-sectional study of CNS metastatic cancer patients at RSCM. There were 62 patients experiencing CNS metastases. Most of the subjects had brain metastases (60.3%), female (61.3%), with an average age of 46 years. The most common primary tumors were breast (24.1%), head and neck (17.7%), lung and gastrointestinal tract (11.2% each). The prevalence of malnutrition was similar in brain (76.3%) and spine (70.8%) metastases. Most subjects experienced neurological deficits. Median RNL 7.09 (0.97–35.59). The mean RNL was significantly higher in the malnourished group (p=0.002) with the mean difference 4.70 with KI95% (1.2-8.2).Malnutrition is related to RNL, subjects who experience malnutrition have a higher NLR compared to those who are not malnourished.

Abstrak :
Latar belakang: Infeksi susunan saraf pusat (SSP) dapat berakibat fatal bagi anak. Salah satu komplikasi infeksi SSP adalah gangguan keseimbangan natrium yang dapat menyebabkan keterlambatan diagnosis, memperberat gejala infeksi SSP, dan berkaitan dengan luaran buruk. Meskipun demikian, masih sedikit penelitian yang berupaya memprediksi gangguan keseimbangan natrium pada anak dengan infeksi SSP. Tujuan: Penelitian ini bertujuan untuk mengidentifikasi dan memprediksi gangguan keseimbangan natrium pada anak dengan infeksi SSP. Metode: Penelitian ini merupakan studi prognostik dengan rancangan penelitian kohort retrospektif di RSCM menggunakan data rekam medis dari Januari 2020-Desember 2023. Subyek yang diteliti ialah anak berusia >1 bulan sampai 18 tahun yang mengalami infeksi SSP. Prediktor yang diteliti adalah penurunan kesadaran saat masuk rumah sakit, dugaan patogen penyebab, sepsis, kelainan struktural kranioserebral sebelumnya, dan kejang sebelum masuk RS. Hasil: Terdapat 76 subyek yang mengalami infeksi SSP. Median usia subyek ialah 1,61 tahun (rentang 0,09-17,14 tahun). Proporsi lelaki dan perempuan hampir sama dengan lelaki sebanyak 39 (51,3%). Jenis infeksi SSP terbanyak ialah meningitis bakterialis (22 pasien, 28,9%). Terdapat 54 episode gangguan keseimbangan natrium pada 48 subyek (63,1%). Etiologi gangguan keseimbangan natrium diketahui pada 13 pasien dengan penyebab terbanyak ialah cerebral salt wasting (CSW) pada empat subyek. Pada analisis multivariat regresi logistik hanya penurunan kesadaran saat masuk rumah sakit yang dapat memprediksi gangguan keseimbangan natrium pada subyek dengan infeksi SSP probable dan terkonfirmasi dengan RR 1,5 (IK 95% 1,033-2,176), nilai p=0,033. Gangguan keseimbangan natrium pada infeksi SSP probable dan terkonfirmasi meningkatkan risiko kematian dengan RR 7,8 (IK 95% 1,074-56,65), nilai p=0,015. Simpulan: Penurunan kesadaran saat masuk rumah sakit merupakan prediktor gangguan keseimbangan natrium pada anak dengan infeksi SSP probable dan terkonfirmasi. Gangguan keseimbangan natrium pada populasi ini dapat meningkatkan risiko kematian secara signifikan. ......Background: Central nervous system (CNS) infection can be fatal for children. One of the complications of CNS infection is impaired sodium balance which can cause delayed diagnosis, aggravate symptoms of CNS infection, and is associated with poor outcomes. However, few studies have attempted to predict sodium balance disturbances in children with CNS infections. Objective: This study aims to identify and predict impaired sodium balance in children with central nervous system infection. Methods: This is a prognostic study with an retrospective cohort design at RSCM using medical record data from January 2020-December 2023. The subjects studied were children aged >1 month to 18 years who had CNS infections. The predictors studied were decreased consciousness at admission, suspected causative pathogen, sepsis, previous craniocerebral structural abnormalities, and seizures before admission. Results: There were 76 subjects with central nervous system infection. The median age of the subjects was 1.61 years (range 0.09-17.14 years). The proportion of males and females was almost equal with males 39 (51.3%). The most common type of CNS infection was bacterial meningitis (22 subjects, 28.9%). There were 54 episodes of sodium balance disorder in 48 subjects (63.1%). The etiology of sodium balance disorders was known in 13 patients with the most common cause was cerebral salt wasting (CSW) in four subjects. In multivariate logistic regression analysis, only decreased consciousness at hospital admission predicted sodium balance disturbance in subjects with probable and confirmed CNS infection with RR 1,5 (95% CI 1,033-2,176), p value=0,033. Impaired sodium balance in probable and confirmed CNS infection increased the risk of death with RR 7,8 (95% CI 1,074-56,65), p value=0,015. Conclusion: Decreased consciousness at hospital admission is a predictor of impaired sodium balance in children with probable and confirmed CNS infection. Impaired sodium balance in this population can significantly increase the risk of death.

Abstrak :
This book is a significant new resource for anyone interested in conditions such as multiple sclerosis(MS), myasthenia gravis, and neurological infections. It is a practical and balanced guide to the diagnosis and treatment of neuroimmunological disease. A primer of neuroimmunological disease distinguishes itself by providing a range of features not generally included in texts on neuroimmunology. These include broad presentation of information in the form of figures and tables, strong cohesion among topics by focusing on a few prototypic neuroimmunological diseases, which serve as a foundation from which to explore other neuroimmunological diseases, a single author perspective, with references across chapters, and a focus on the overlap between neuroimmunological and neuroinfectious diseases.

Abstrak :
Now, the eighth in the set returns to the topic of brain tumors, dealing with seven distinct types, astrocytoma, medulloblastoma, retinoblastoma, chordoma, craniopharyngioma, oligodendroglioma, and ependymoma. After updating the classification of medulloblastoma the volume provides an overview of ependymoma as well as describing the delineation of prognosis based on the genetic aberrations of the latter patients. The material offers key insights into the molecular pathways involved in tumor biology, such as the role of E-cadherin gene instability, carbonic anhydrase II, urokinase plasminogen activator, and Wnt signaling in meningioma. Contributors explain the genetic and clinical features associated with recurring meningioma, including the role played by erythropoietin receptor, and examine the way in which OTX2 transcription factor functions as an oncogene in medulloblastoma.

Abstrak :
This book is intended as an introduction to neuroradiology and aims to provide the reader with a comprehensive overview of this highly specialized radiological subspecialty. One hundred illustrated cases from clinical practice are presented in a standard way. Each case is supported by representative images and is divided into three parts: a brief summary of the patient’s medical history, a discussion of the disease, and a description of the most characteristic imaging features of the disorder. The focus is not only on common neuroradiological entities such as stroke and acute head trauma but also on less frequent disorders that the practitioner should recognize.