جستجوی مقالات مرتبط با کلیدواژه « تومور مغزی » در نشریات گروه « پزشکی »

 Increased nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) signaling in neuroblastoma cells may represent an autocrine system to support cancer growth, invasion, and metastasis. Therefore, this research aimed to assess the simultaneous effect of aerobic exercise and nano curcumin supplementation on the expression of BDNF and NGF genes in rats with brain tumors.

 A total of 35 male Wistar rats were randomly assigned to seven groups of five: healthy base control, healthy control of 4 weeks, base cancer control, four weeks of cancer control, cancer+nanocolumns, cancer+aerobic, and cancer exercise+aerobic exercise+nanocolumns. After injecting cancer cells into the mice's forehead cortex, with 80 mg/kg supplement gauges for 28 days, five days a week, enter the main aerobic exercise program on the rotating tape for four weeks, three days a week. At 18 m/min, they were 25-40 minutes. In the end, the mice were sacrificed, and data were collected.

The expression of the BDNF gene in the training+nano curcumin group was significantly decreased compared to the baseline cancer control and 4-week cancer (P<0.05). Moreover, the expression of the NGF gene in the exercise group showed a significant decrease compared to the baseline cancer control and 4-week cancer (P<0.05). Nonetheless, no significant difference was observed in the nano curcumin group and nanocurcumin +exercise (P>0.05).

It seems that aerobic exercise along with nanocurcumin can possibly increase neurogenesis in rats with brain cancer by reducing BDNF and NGF gene expression through receptors.

Brain tumors are considered to be one of the most dangerous types of cancer, despite decades of research and treatment efforts. The activation of the telomerase enzyme is a critical factor in the immortality of these cells. Mutations in the promoter region of the TERT gene, particularly in the promoter hot spots, can influence the binding of activating transcription factors and inhibit the binding of negative regulatory factors of the TERT gene, ultimately regulating the gene's expression. This study aimed to identify and investigate the mutations of the TERT gene promoter region in glioblastoma, a malignant brain tumor, using bioinformatics.

A study was conducted using the case-control method where 35 patients with glioblastoma multiform brain tumor were examined along with 40 people who were examined as control samples. In this research, the Touchdown PCR technique and direct DNA sequencing were used to detect mutations in the promoter region of the TERT gene in patients with glioblastoma. Furthermore, bioinformatic analyses were conducted to investigate the pathogenic effect of nucleotide changes in this gene region.

In the core region of the TERT gene promoter, three-point mutations were identified (c.*146C>T، c.*144C>G and c.*143G>C). Two of these mutations were novel and have been observed for the first time in glioblastoma multiform. The remaining mutation was located in the promoter core's hot spot of the gene. This mutation was known as c.*146C>T.

In this research, the harmful impact of TERT promoter region mutations as a biomarker for glioblastoma was examined. These findings suggest that mutations in regulatory regions, as well as coding sequences, could be significant contributory factors in the process of carcinogenesis.

Vestibular schwannoma tumor in advanced levels can cause a wide range of disorders, the aim of this study was to determine the frequency of balance disorders in patients with vestibular schwannoma tumor after surgery in Isfahan city.

The present study is a cross-sectional descriptive study that was conducted in 1402. In this study, the files of all patients with Vestibular schwannoma tumor who were referred to the teaching hospitals of Isfahan, including Kashani, Al-Zahra, Seyyed al-Shohada and Imam Hossein (AS) between 1392 and 1401, were examined. The sampling method was census and included 55 patients.

The average age of the patients was about 46 years and ranged from 10 to 78 years. 61.8% were men, 87.3% were married and only 1.8% had a family history of tumor. 15 patients (27.3%) had balance disorder after surgery, and muscle strength was lower in patients with balance disorder. Three of the patients had also died.

Based on the obtained results, following up the condition of patients, especially balance disorders, can be fruitful for improving the quality of life of patients.

Any abnormal growth of cells in the brain in an uncontrolled manner leads to the formation of tumor cell masses and disruption of the normal functional functions of the brain, including sensory-motor problems. The aim of the present study was to evaluate the The effectiveness of moderate-intensity continuous exercise and nanocurcumin supplementation on sensorimotor disorders in mice with brain tumors.Subjects and

35 healthy male Wistar rats randomly divided into 7 groups of 5, basal control (BC), 4-week control (4wC), basal cancer control(BT), 4-week cancer control(4wT), cancer-training (TE), cancer - Nanocurcumin (TN), Cancer-Exercise-Nanocurcumin (TEN) were divided. One week after the injection of cancer cells in the frontal cortex, the animals entered the main exercise program on the tape by performing the 6-parameter behavioral test (18 points) of Garcia and gavage of nano curcumin supplement at the rate of 80 mg/kg (28 days, 5 days a week). (4 weeks, at a speed of 18 meters per minute, 25-40 minutes and 3 days a week). At the end, rats were victim and data were collected and analyzed.

Continuous exercises with moderate intensity Simultaneously with nano-curcumin supplementation significantly reduced tumor volume in the TEN group (p≤0.05). It also led to a significant increase in behavioral testing in the study groups compared to the 4 wT group.

It seems that the combination of continuous exercises with nano curcumin can be used as a therapeutic supplement along with other methods to reduce brain tumor size and improve sensory-motor functions.

The pineal gland is a small, pinecone-shaped endocrine gland that participates in the biological rhythm regulation of vertebrates. Tumors of the pineal region account for approximately 3–11% of pediatric brain neoplasms. The present study aimed to determine the demographic and clinical characteristics of patients with tumors in the pineal region.

This research was a cross-sectional descriptive study that was conducted in 2023. 20 people with pineal tumor were identified who had referred to the hospitals of Isfahan city, Iran (Al-Zahra, Kashani and Imam Hossein) during the last 8 years. Data were collected by checklist and described and analyzed in SPSS version 22 software.

Ten of patients were males and The mean age of the patients at the time of surgery was 19.25 years (range: 16.0 to 66.0 years). Histologically, GCT and PPT comprised 45 % and 25% of pineal region neoplasms. The median tumor size was 24 mm. The rates of radiotherapy administration were 60%. older age, and lack of radiotherapy use were prognostic factors that negatively influence survival. The lowest survival rate was observed in the first year, but as the number of years of life increased, so did the survival rate.

Given that patients with tumors in the pineal region are predominantly in the young age group, and young individuals represent the productive workforce in any society, it is imperative to implement appropriate measures and strategies to enhance these patients' long-term well-being. Implementing these measures and strategies will ultimately improve the overall quality of life for these patients over the years.

Any defect and abnormal growth in brain cells in an uncontrolled manner leads to the creation of a tumor and disruption of its normal functional capabilities. Therefore, the present study aimed to investigate the effectiveness of aerobic exercise along with nano curcumin supplementation in behavioral-motor disorders in rats with brain tumors.

A total of 35 male Wistar rats were randomly assigned to seven groups of 5: basic healthy control, four weeks healthy, basic cancer control, four weeks cancer, cancer-nano curcumin, cancer-exercise, and cancer-exercise-nano curcumin groups. One week after the injection of cancer cells in the frontal cortex, the animals entered the main training program on the treadmill (4 weeks, with a speed of 18 meters per minute, 25-40 minutes, three days a week). The data were analyzed in SPSS software (version 26) using the statistical test of one-way analysis of variance.

The results pointed out that behavioral-motor disorders in the training group, nano curcumin, and the training group-nano curcumin were significantly less than in the 4-week cancer control group (P=0.001).

It seems that aerobic exercise, along with a suitable dose of nano curcumin as a therapeutic supplement along with other methods, can reduce behavioral-motor disorders in cancerous rats, possibly by increasing brain blood flow, neurogenesis, and nerve synapses.

Intraoperative ultrasound (IOUS) is a non-invasiveness, affordability, and the possibility of repeated use during surgery without significant time consumption. One of the attractions of this modality is the real-time imaging of the lesion. According to the nature of brain tumors, tissue movement can occur in each step of the surgery (including opening dura and start of resection). Thus, real-time intraoperative ultrasonography significantly helps the surgeon to identify the real-time location of the mass and close structures

Between 2019 and 2022, patients with brain tumors were evaluated. To select the samples, 33 patients with intra-axial brain tumors were initially selected. Then, the decisions of two neurosurgeons were collected regarding the possibility of gross total resection of tumors in these cases. As a result, 4 patients were excluded from the study, and 29 patients were included. In the next step, tumor resection was performed using IOUS. According to the pathology results, 10 patients with pathologies other than glioma were excluded, and 19 patients with glioma lesions were evaluated.The patient was admitted with a brain tumor, and initial imaging was done. During surgery, the ultrasound probe with a sterile cover entered the surgical field before opening the dura. The exact location of the tumor was determined over the dura, and so the dura was opened. With the ultrasound guide, the location of the lesion was determined, and the resection of the lesion began. Then, ultrasound was performed intermittently to determine the tumor area, and surgery continued until the complete resection of the lesion. Within 72 hours after the surgery, an MRI was performed to evaluate the extent of resection.In order to measure the tumor volume, MRI images with the same cut distance were evaluated. Therefore, the tumor area in all MRI imaging slices was added together and multiplied by the slice distance. Then, the amount of resection was calculated by comparing the volume of the tumor before and after surgery.

19 patients were selected to participate in the study. Three patients died after surgery and during hospitalization and were therefore not included in the follow-up, but only in the pre-surgical examinations.The characteristics of the patients are listed in table 1. In this study, there were 7 women and 12 men, whose average age was 46.5 years (average 40 years for women and 50 years for men). Most of the patients were middle-aged adults. Regarding the alertness and functional status of the patients, the average GCS was 13, and the median GCS of the samples was 14. The minimum GCS was 9, corresponding to a 58-year-old man with recurrent glioblastoma. Also, the median KPS of the patients was 80, the minimum of which was 10 and related to the same patient with glioblastoma recurrence.Regarding the location of the lesions, most of the lesions were observed in the frontal lobe and mostly on the left side. In 32% of patients (6 out of 19 patients), the tumor was located in the eloquent area, and the lesion had an ill margin in 17 out of 19 patients.3 patients died after surgery and they were excluded from the analysis. In the remaining 16 patients, the average length of surgery was 3 hours, with a minimum of 1.5 hours and a maximum of 5 hours. The average intraoperative bleeding was 350 cc. Also, in examining the consciousness, the average GCS was 10.4 in one hour after surgery, 12.3 in 6 hours after surgery, and 12.8 in 24 hours after surgery. The average length of hospitalization in 16 patients with glioma who survived was9.3 days, with a minimum hospitalization time of 3 days and a maximum of 38 days.In 16 patients of this study, the size and amount of tumor resection were calculated according to the imaging done before and after the surgery. The mean size of the tumor in pre-surgical imaging was 30.44 cc. The smallest tumor was 3.5 cc in a 47-year-old woman with complaints of headache and convulsions, whose lesion was located in the right parietal, with glioblastoma pathology. There were no lesions left in imaging after surgery. Also, the largest tumor was 74 cc in a 52-year-old man with a complaint of anxiety. In imaging, a butterfly-type glioma was observed with frontal involvement on both sides (predominantly on the right side). In the post-surgery examination, only 56% of the tumor was resected, which happened due to the proximity of the lesion to the lateral ventricle and preventing the opening of the ventricle.In the post-surgery imaging, the mean tumor size was 4 cc. In evaluating the extent of resection, an average of 90.5% of the tumor was resected. The largest residual tumor of 32 cc was related to the patient with a butterfly tumor, which was mentioned earlier.Out of 16 patients examined, 11 patients were extubated in the operating room. The reason for non-extubation in 5 other patients was low GCS.Based on the extent of resection, the amount of resection was divided into three categories: gross total resection (GTR) with a tumor removal rate of more than 95%, subtotal resection (STR) with a tumor removal rate between 80 and 95%, and partial resection (PR) with a tumor removal rate of less than 80%. According to this classification, there was only one patient with partial resection in the study.In the comparison between the amount of resection and the complications after surgery, it was observed that resection of GTR is related to the amount of dysphagia experienced by the patient after surgery. It was also observed that the rate of extubation in women is significantly higher than in men. All 6 women in the study were extubated in the operating room, whereas only 5 out of 10 men were extubated during surgery. The study did not find any correlation between complications and the amount of tumor resection or bleeding, nor hospitalization of patients. However, more comprehensive studies are needed for a more detailed investigation.

Ultrasound during surgery can be used as a modality in brain tumor surgery because it has efficient results, and its use is easy and cheap. Although ultrasound cannot be considered as a substitute for other modalities during surgery to monitor the patient, its use can be beneficial for the patient.Among the important advantages of using ultrasound during surgery that were observed in the patients of this study, we can mention the possibility of detecting the ventricles in the periphery of the tumor and preventing entry into the ventricle during surgery, which prevents the occurrence of significant complications such as ventriculitis. One of the reasons why complete resection was not performed in some patients was the long interval between preoperative imaging and surgery, which caused some tumor foci to be missed during surgery.

Surgery, chemotherapy and radiotherapy are the main pillars of brain tumor treatment. Radiotherapy is usually done with photon, which with this method, photon radiates to healthy tissue and causes secondary cancers. Proton therapy is a new method in radiotherapy that addresses many of these concerns. Considering the newness of this treatment method, we decided to introduce this method and its applications to review the systematic review of proton therapy in the treatment of brain tumors.

In this systematic review, Scopus, Medline PubMed, Google Scholar, CINAHL, Trip and Magiran, SID databases were searched between 2017 and 2022. The search was done based on the keywords, Proton therapy, Brain Tumor, Proton radiotherapy and suitable Mesh words and using the PRISMA checklist, and 16 articles were included in the study out of 40 articles searched.

Proton therapy in adults is effective in treating low-grade glioma tumors and benign tumors such as meningioma. They are also used as an effective treatment in the control of chondrosarcoma and chordoma tumors that are resistant to other types of radiation therapy. The role of this therapeutic method in the treatment of brain tumors, craniopharyngiomas, ependymomas, germ cell tumors, low-grade gliomas, medulloblastomas and atypical teratoid/rhabdoid tumors in children is very important because it does not spread to the surrounding tissue and reduces the possibility of late toxicity of the central nervous system. Gives.

Considering the benefits of proton therapy, such as reducing the damage of healthy tissue around the tumor, its use in the treatment of tumors resistant to radiotherapy and its wide application in the treatment of all types of brain tumors in children, this treatment method is recommended in the country for patients with tumors. brain to plan and execute.

Functional magnetic resonance imaging (fMRI) has been widely used for pre-neurosurgical planning and may eventually become a routine pre- surgical imaging modality. The validity of fMRI for the clinical application depends on various factors such as proper task selection, correct statistical analysis, and threshold setting with appropriate patient cooperation. To compare the potential of five functional magnetic resonance imaging (fMRI) language paradigms in activating language areas in Persian-speaking volunteers in order to optimize these tasks for clinically useful protocol.

16 healthy right-handed Persian-speaking volunteers were studied. Each individual performed five tasks during the fMRI scan: word generation (WG), object naming (ON), word reading (WR), word production (WP), and reverse word reading (RWR). In the current study's first phase, each task's ability to activate classical language areas was assessed using group analysis. In addition, the lateralization index (LI) for each subject-task was calculated and compared. In the second phase, the optimized protocol was assessed on 40 patients with different types of brain mass lesions or hippocampal sclerosis to assess the role of appropriate patient selection for achieving a reliable fMRI result.

We found that WP, RWR, and WG robustly activated language-related areas in the dominant hemisphere. ON and WR failed to sufficiently delineate these activation areas. The highest activation intensities in the frontal lobe (including Broca's area) were seen with WP, whereas RWR showed the highest LI among all examined tasks. In the patient population, we found that accurate and reproducible fMRI strongly depends on the patient’s cooperation. In present study, we observed that a pre-test mock fMRI session held by a radiologist might help to predict which patients are more or less suitable candidates for fMRI.

Our results demonstrated that the Persian version of WG and newly presented WP and RWR tasks could be reliably used for the localization of language-related areas in Persian speakers. This type of language evaluation also can be used in the pre-surgical planning of neurosurgical procedures in the Persian population. We recommend the application of WP and RWR in routine clinical practice to avoid significant morbidities after brain lesion surgery.

Glioblastoma multiform is one of the most common primary malignant brain tumors in adults. Recent studies have shown that micronutrients, such as selenium, have the potential to have positive effects in the treatment of glioblastoma and can be a promising candidate combined with surgical and radiochemical therapies. The aim of this study was to evaluate the anti-cancer effects of selenium on brain tumor damages.

Rats were randomly divided into three main groups: control and selenium-received groups at doses of 0.5 and 1.5 mg/kg. A 1 × 106 rat Glioma C6 cells were transplanted in the right caudate nucleus of the rat brain. Five days after surgery, the treatment groups received selenium intraperitoneally for five days. Motor activity, animal weight, tumor volume, survival rate, and histopathological changes were assessed.

Selenium 0.5 mg/kg reduced tumor volume, improved locomotor activity, and attenuated weight loss of the animals. Also, histological analysis showed a significant reduction in tumor volume and invasion of tumor cells to the surrounding tissues of tumor in rats treated by selenium 0.5 mg/kg.

According to the present results, it can be stated that selenium has sufficient potential to inhibit brain tumor damages.

In addition to heart disease, ECG also changes in non-heart disease, which due to its similarity, can lead to misdiagnosis of heart disease in patients. ECG changes in brain lesions such as ischemic and hemorrhagic strokes, brain traumas, etc. and have been studied in many articles, but the effects of brain midline shift on ECG changes have not been studied. In this study, we want to examine these changes.

This is a prospective cross-sectional descriptive study. Patients with brain tumors who were referred to Al-Zahra and Kashani hospitals in Isfahan from April 2019 to March 2021 were selected. Patients with a history of heart disease, patients receiving medications that cause ECG changes, patients with ECG changes due to non-cardiac and cerebral causes, and individuals under 15 years of age were not included in the study. Patients whose ECG changes were due to electrolyte disturbances or acute heart problems were also excluded from the study. After obtaining informed consent from patients, a CT scan or brain MRI was taken and patients were divided into two groups with and without midline shift. Then the ECG was taken and ECG changes (T wave, ST segment, QTc Interval, QRS prolongation) were compared in two groups of brain tumors with and without midline shift.

136 patients were included in the study. Of these, 69 patients were in the without midline shift group and 67 patients were in the midline shift group. In the midline shift group, 3% of patients had ST segment changes and 23.9% had T wave changes, which were 1.4% and 10.1% in the without midline shift group, respectively. The mean QTc Interval in the two groups without and with midline shift was 338.26 (4 28.438) and 388.66 (37.855), respectively, and the mean QRS in the without midline shift group was 86.09 (88.9.88) ms and in the midline shift group was 94.63 (±12.83) ms.

Brain midline shifts can cause QRS widening, QTc interval prolongation, and T-wave changes in patients' ECGs.

Cancer and its special treatments and hospitalization in the cold environment of the hospital have deep psychological effects on children.  The present study was conducted with the aim of determining the effectiveness of the cognitive intervention program and family-oriented play therapy on depression and anxiety of children with cancer.

Methods and Materials:

 The study is a time series quasi-experimental design with multiple groups. The sample included 45 children between 7 and 10 years old with brain tumors selected from Mahak's Pediatric Cancer Hospital purposefully and by considering the inclusion and exclusion criteria. After matching in terms of age and gender, the subjects were randomly replaced in 3 groups of 15 people (group 1: cognitive rehabilitation; group 2: cognitive rehabilitation with play therapy; group 3: control group). The experimental groups received relevant interventions in 8 sessions. The pre-test, post-test and 1-month follow-up of the participants of all 3 groups were conducted with the Children's Depression Inventory (CDI) and the Spence Children's Anxiety Scale (SCAS). In order to analyze the data, split-plot ANOVA design (SPANOVA) was used.

The results of the study indicated that both interventions had created significant changes in the variables of depression and anxiety in the experimental groups (significance level 0.01). Depression and anxiety in children of both experimental groups, especially in the cognitive rehabilitation group with play therapy, were reduced compared to the control group.

Based on the findings of the study, it can be concluded that rehabilitation and play therapy, especially rehabilitation with play therapy, which had a more stable effect, can be used to reduce depression and anxiety in children with various types of brain tumors. Therefore, the use of rehabilitation therapy integrated with recreational play therapy is recommended to resolve these children's problems more deeply and permanently.

Meningioma is a benign tumor of the brain, which shows a good response to treatment, surgery and benign pathology, but there is a possibility of recurrence. Therefore, the present study was conducted to investigate the relationship between recurrent meningioma risk factors and the rate of meningioma recurrence in Yazd City.

This descriptive-analytical study was performed on all the patients who have surgery for meningioma in Shahid Rahnemoun and Mortaz Hospitals in Yazd City for 10 years. Patient's information, including age, sex, size, grade, diseases and bone changes were extracted from the patients' records. After determining the recurrence status of the disease, information was entered into SPSS version 16 software for Chi-square, Anova and T-test.

The most common meningioma was in the age group of 50 to 70 years. In this study, out of 300 patients with meningioma who underwent surgery, 50 (16.7%) had a recurrence of the disease. The recurrence rate was significantly associated with meningioma size, disease grade, and radiotherapy and diabetes (P <0.05). The recurrence rate in this study decreased with the increasing age of the patients.

According to the results, considering factors such as age, disease grade, tumor size, radiotherapy and diabetes, which are important predictors of disease recurrence, in managing meningioma patients after surgery and identifying high-risk individuals for disease recurrence are helpful. In the following, due to the involvement of effective factors in the disease, more extensive and retrospective studies are recommended.

 Cancerous brain tumors are among the most dangerous diseases that lower the quality of life of people for many years. Their detection in the early stages paves the way for the proper treatment. The present study aimed to present a two-dimensional Convolutional Neural Network (CNN) for detecting brain tumors under Magnetic Resonance Imaging (MRI) using the deep learning method.

The proposed method has two stages of feature extraction and classification. A 12-layer CNN was used to extract the features of the MRI images and then the softmax activation function was used to classify these features. The proposed method was applied to a standard database consisting of three brain tumor types of meningioma, glioma, and pituitary.

 The proposed method had better performance compared to previously presented methods. Its accuracy was reported as 98.68%.

 Meningioma, glioma, and pituitary tumors are the most common types of brain tumors. Early detection of these tumors can decrease the risk of death. Because of its fully connected structure, the use of proposed deep CNN can help physicians to correctly detect brain tumors with MRI images.

Thyroid cancer is one of the most common secondary malignancies as a result of receiving therapeutic doses to the head and neck. In this study, the probability of secondary thyroid cancer risk due to neutron contamination of 15 MV Siemens Linear Accelerator (LINAC) in brain tumor 3D-Conformal Radiation Therapy (3D-CRT) was calculated.

Neutron fluence and neutron dose were measured at different points at the treatment table using an energy-independent neutron detector consisting of a sphere moderator and a Boron Trifluoride (BF3</sub>) counter, and the neutron dose equivalent to the thyroid was determined to calculate the probability of secondary cancer risk.

The neutron dose equivalent was obtained at the central axis (0.304 mSv/Gy) and at 4 cm (0.285 mSv/Gy), 15 cm (0.229 mSv/Gy), 45 cm (0.125 mSv/Gy), and 150 cm (0.02 mSv/Gy) inferior. The neutron dose equivalent reaching the thyroid for the total prescribed dose was 12.366 mSv. According to that, the probability of secondary thyroid cancer risk was obtained as 0.001%.

The thyroid dose in high-energy radiation therapy of brain tumor cannot cause significant biological damage. Therefore, the risk of secondary thyroid cancer due to neutron contamination is relatively low.

Brain tumors are less common than other cancers; however, they are associated with serious symptoms and poor prognosis.Most brain tumors are treated through surgery combined with radiotherapy and chemotherapy. These therapeutic methods are associated with neurotoxic complications and decrease the quality of life of patients. Intraoperative Radiation Therapy (IORT) is an innovative combination of surgery and radiotherapy, in which the direct radiation to the tumor bed during tumor resection is done. IORT is a new therapeutic method; therefore, the present 5-year systematic review was conducted to introduce IORT and its advantages and disadvantages in the treatment of brain tumors.

In this systematic review study, PubMed, Google Scholar, Cochrane Database, and Trip Medical Database, and CINAHL Database were searched for the published articles over a five year (2014 to 2019) using the keywords, including IORT and Brain Tumor and Intraoperative Radiation Therapy AND Brain Tumor. Articles were checked with the PRISMA checklist. Finally, 50 articles were included in the study.

IORT method has been used in the treatment of brain tumors, especially glioblastoma. The effective radiation dose to treat brain tumors is 15-40 Gy. However, the appropriate technique and patient selection is the key to success with IORT. It is also used to treat recurrent pelvic, head and neck, and colorectal cancers, but it has shown more effective to treat brain tumors.

IORT is an effective treatment for brain tumors, especially glioblastoma. It is more effective than external radiation therapy, due to the reduced tumor recurrence, maximal protection of healthy tissue, shorter duration of treatment, and cost-effectiveness.

Pan-hypopituitarism is a rare but life threatening disorder that occurs due to reduction of anterior pituitary hormones. In this condition, major depressive disorders are presented by depressed mood and markedly diminished interest in many activities during a day. Some disorders are associated with psychiatric symptoms at presentation, therefore, the diagnosis of mood disorder due to a medical condition should also be considered. This study presents a middle aged man admitted with symptoms of major depressive disorder involving suicidal ideation whose condition did not improve despite treatment with different antidepressant agents. He had past history of brain tumor surgery, chemotherapy, and radiotherapy. Due to the possibility of pituitary axis deficits since the time that radiotherapy was initiated, the patient was evaluated for these axes and the decrease in adrenal, thyroid, gonad and growth hormone axis function was confirmed by lab tests.In patients with persistent and severe depression, underlying medical causes such as endocrine disorders especially hypo-pituitarism should also be considered.

Sensorineural hearing loss is a radiotherapy complication in patients with brain tumors.The auditory system of patients with brain tumors often is placed inside of radiation field and receives a significant amount of radiation dose resulting in hearing loss.The purpose of this study was to compare contouring and delivery dose to cochlea and inner ear in two techniques of 3D conformal radiotherapy vs 2D conventional radiotherapy in patients with brain tumors.
Methods and materials:Computerized tomography (CT) scan of43 patients(23male and20 female) were used.Patients were treated for brain tumor at the radiotherapy unit of Isfahan Milad Hospital 2016.Contouring of cochlea and inner ear were done on patients CT.by Radiation oncologist.using TiGRTtreatment planning system.Dose volume histograms (DVHs) for methods of 2D (two parallel and opposite fields) and 3D (two parallel and opposite field and a vertex field using wedge and Multileaf collimators(MLC)) were compared.
The mean dose in 2D technique for the cochlea was 2624 ± 338.7and for the inner ear was 2718.3 ± 341.3,and in 3D radiotherapy technique for the cochlea 2507±294.6,and for inner ear was 2581± 295.6.The mean dose of inner ear and cochlea in 3D was 5.3% and 4.6%lower than 2D,respectively.
The study of dosimetric parameters of the auditory system in treatment planning of two methods of radiation therapy showed that there was no significant difference between the doses of cochlea and inner ear in 2D and 3D methods (Pvalues=0.86,0.85).Therefore in treatment planning of these two radiotherapy techniques, contour of cochlea can be replaced by inner ear.

Patients with brain tumors due to limited treatment, poor prognosis, and adverse consequences of illness, experience high anxiety that reaches maximum levels at the time of surgery. The aim of this study was to evaluate the effect of preoperative education on preoperative anxiety in patients with brain tumor under stereotaxic biopsy.
In this quasi-experimental study, 40 patients with brain tumors were selected with the convenience sampling method. The sample underwent face to face training before the surgery for thirty minutes. Before and after training, patient's anxiety levels were measured by the DASS questionnaire. Data were analyzed using the PASW software and through descriptive and inferential statistics. P of The sample included 24 males (60%) and 16 females (40%), aged 18 to 63 years, with mean age of 42.9 ± 13.6. Most cases were married (92.5%) and had primary education to diploma (47.5%). The mean score of patient's anxiety before sampling was 21.5 ± 5.7, and after the education it was reduced to 16.1 ± 6.2 (P = 0.001).
Face to face training is a training method that could be used to reduce preoperative anxiety. In this way, nurses could adjust training and present content according to the needs of patients.