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California Conservation Corps

The California Conservation Corps, or the CCC, is a department of the government of California, falling under the state cabinet-level California Resources Agency. The CCC is a voluntary work development program specifically for men and women between the ages of 18 and 25 (up to 29 for veterans ), offering work in environmental conservation, fire protection, land maintenance, and emergency response to natural disasters. Members of the CCC are referred to as "Corpsmembers", and are paid a monthly stipend; starting July 2022, the amount was $2,600.

History
The bill to create the California Conservation Corps was co-authored by California State Senator Ruben Ayala. The legislation was signed into law by Governor Jerry Brown on July 7, 1976, modeling the corps after the federal Civilian Conservation Corps that started with Franklin D. Roosevelt and the New Deal in the 1930s. Brown envisioned a department marketed specifically to the state's young people as "a combination Jesuit seminary, Israeli kibbutz, and Marine Corps boot camp." Prominent amongst the early CCC administrators was war hero B. T. Collins. The CCC replaced the California Ecology Corps that was created by executive order of Governor Ronald Reagan in 1971 as an "alternative service" option for Conscientious Objectors during the Vietnam War. Following the end of his governorship, Brown's successor, Governor George Deukmejian, signed legislation to eliminate the CCC's sunset clause by making it a permanent department under the California Resources Agency in 1983.

The duties of operation falling to the CCC include trail maintenance, riparian zone restoration, tree planting and exotic plant species removal, construction, and emergency flood and wildfire response. Other organizations pay the CCC to do the work. Corpsmembers are offered the chance to complete their high school diploma through independent CCC schools and are trained in cooking, office work, chainsaw, and vehicle maintenance. The CCC also encourages corpsmembers to seek higher education or vocational training by offering scholarships.

Corpsmembers in some centers across the state participate in CAB (Corpsmember Advisory Board), an employee/ resident board established to be the middle ground. The board is responsible for community check ups and upholding a strong morale among the center's population, as well as bringing up pressing concerns the community faces on a weekly basis.

Since 1992, the California Department of Finance has allotted less funding to the CCC, forcing the closure of numerous residential centers throughout the state.

The CCC has received presidential praise as well as numerous awards for its work.

Related organizations
There are Fourteen local conservation corps groups in California  that are certified annually by the CCC to offer similar job training, education, and environmental projects in other areas of California.

 * Cesar Chavez Environmental Corps – Tehachapi, CA
 * Civicorps – Oakland, CA
 * Conservation Corps North Bay – San Rafael, CA
 * Conservation Corps of Long Beach – Long Beach, CA
 * Fresno Local Conservation Corps – Fresno, CA
 * Greater Valley Conservation Corps – Stockton, CA
 * Los Angeles Conservation Corps – Los Angeles, CA
 * Orange County Conservation Corps – Anaheim, CA
 * Sacramento Regional Conservation Corps – Sacramento, CA
 * San Francisco Conservation Corps – San Francisco, CA
 * San Jose Conservation Corps – San Jose, CA
 * Sequoia Community Corps – Visalia, CA
 * Urban Conservation Corps of the Inland Empire – San Bernardino, CA
 * Urban Corps of San Diego County – San Diego, CA

Urban Corps of San Diego
The San Diego local corps was founded in 1989 with help from former Representative Lynn Schenk and then-Mayor Maureen O'Connor, with an initial budget of $125,000. They engage in a variety of community service and conservation projects, including stadium cleanup, trash pickup and graffiti removal. There are about 200 Corpsmembers employed at any given time.

title: California Conservation Corps


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Demographic history of Palestine (region)

The population of the region of Palestine, which approximately corresponds to modern Israel and the Palestinian territories, has varied in both size and ethnic composition throughout the history of Palestine.

Studies of Palestine's demographic changes over the millennia have shown that a Jewish majority in the first century CE had changed to a Christian majority by the 3rd century CE, and later to a Muslim majority, which is thought to have existed in Mandatory Palestine (1920-1948) since at least the 12th century CE, during which the total shift to Arabic language was completed.

Iron Age
During the seventh century BC, no fewer than eight nations were settled in Palestine. These included the Arameans of the kingdom of Geshur; the Samaritans who replaced the Israelite kingdom in Samaria; the Phoenicians in the northern cities and parts of Galilee; the Philistines in the Philistine pentapolis; the three kingdoms of the Transjordan– Ammon, Moab and Edom; and the Judaeans of Kingdom of Judah.

According to Finkelstein and Broshi, the population of Palestine at the end of the eighth century BC was around 400,000. In the area of Judah in the central hills, Benjamin and Jerusalem, the population was approximately 110,000. By the early sixth century, Ofer's survey results suggest that around 100,000 lived in the kingdom of Judah, with the population in the central hills, Benjamin and Jerusalem about 69,000.

A study by Yigal Shiloh of The Hebrew University suggests that the population of Palestine in the Iron Age could have never exceeded one million. He writes: "... the population of the country in the Roman-Byzantine period greatly exceeded that in the Iron Age..." Shiloh accepted Israeli archaeologist Magen Broshi's estimates of Palestine's population at 1,000,000–1,250,000 and noted that Iron Age Israel's population must have been less considering population growth. "...If we accept Broshi's population estimates, which appear to be confirmed by the results of recent research, it follows that the estimates for the population during the Iron Age must be set at a lower figure." One study of population growth from 1,000 BCE to 750 BCE estimated the population of Palestine (Judah and Israel) had an average natural growth of 0.4 per cent per annum.

Persian period
After the Babylonian conquest of Judah and exile, the population and settlement density of Jerusalem, the Shephelah and the Naqab desert dropped significantly. The Persian province of Yehud Medinata was sparsely-populated and predominantly rural, with around half of the settlements of late Iron age Judah and a population of around 30,000 in the 5th to 4th centuries BC. On the other hand, settlement continuity is discerned in the northern parts of the Judean mountains and the Benjamin area. Cities such as Tell en-Nasbeh, Gibeon and Bethel managed to escape destruction and remained continuously inhabited until the early Achaemenid rule.

As early as the 7th century BC, Edomites had lived in the Naqab desert and southern Judah, and by the time Judah fell in 586 BC there was already a substantial Edomite population in southern Judah. When the kingdom of Edom itself succumbed, those people continued its traditions in the south, which the Arabic-speaking Qedarites controlled. This area, which became known as Idumaea, was inhabited by a diverse population of Edomites, Judahites, Phoenicians, Qedarites and other Arabs. Based on analysis of epigraphic material and ostraca from the region, around 32% of recorded names were Arabic, 27% were Edomite, 25% were Northwest Semitic, 10% were Judahite (Hebrew) and 5% were Phoenician. A few names were also classified Egyptian and Old Iranian.

The exilic returnees resettled during the time of Cyrus the Great, perhaps with a heightened sense of their ethnic identity. Along the coast of western Palestine, the Phoenicians expanded their presence, while Moabites and Ammonites took refuge in the Cisjordan after the destruction of their kingdoms in 582 BC.

Hellenistic and Hasmonean period
Following the Macedonian conquest of the Achaemenid Empire and the subsequent Wars of the Diadochi, Palestine came under Hellenistic rule and was contested by the Seleucids and Ptolemaics.

Between 167 and 160 BC, the Jewish rebel faction of the Maccabees revolted against Seleucid rule, ultimately leading to the independence of the Hasmonean dynasty. Under John Hyrcanus, the Hasmoneans expanded their territories beyond the traditional confines of Judea and incorporated non-Jewish areas in the process. 1 Maccabees relates that the non-Jewish inhabitants of Gezer and Joppa were expelled by Simon Thassi, who settled Jews in their place. Coinciding with the account of Josephus, archaeological evidence attests to significant destruction in the urban and rural settlements in Idumaea, Samaria and the coastal cities from the Hasmonean conquests, followed by the resettlement of Jews in the newly conquered territories. Nevertheless, there's evidence that some of the non-Jewish inhabitants stayed in all of the newly conquered areas.

Many sites in Idumaea experienced destruction, including Maresha, Khirbet el-Rasm, Tel Arad, Khirbet 'Uza and possibly Lachish. The lower city of Maresha and Tel Beersheba were soon abandoned, and evidence for an increased Idumaean presence in Egypt suggests some immigrated there. Idumaeans were eventually forcibly proselytized and co-opted into the Jewish nation by John Hyrcanus. Further north, the Galilee received significant Jewish migration from Judea after its conquest, contributing to a 50% increase in settlements, while the pagan population was greatly reduced. By the end of Alexander Jannaeus' reign, the Galilee was also predominantly Jewish. However, unlike John Hyrcanus, Alexander Jannaeus did not compel the non-Jews to assimilate to the Jewish ethnos and permitted minority ethnē to exist within Hasmonean borders, with the exception of Phoenician coastal cities in the north whom Josephus claims he enslaved.

Roman period
The Roman conquest of Judea led by Pompey took place in 63 BC. The Roman occupation encompassed the end of Jewish independence in Judea, the last years of the Hasmonean kingdom, the Herodian age and the rise of Christianity, the First Jewish–Roman War, and the fall of Jerusalem and the destruction of the Second Temple. The total population of Pharisees, the forerunners of modern Rabbinic Judaism, was around 6,000 ("exakischilioi"), according to Josephus. Local population displacements occurred with the expulsion of the Jews from Jerusalem – "In the earlier revolt in the previous century, 66–73 CE, Rome destroyed the Temple and forbade Jews to live in the remaining parts of Jerusalem; for this reason, the Rabbis gathered instead on the Mediterranean coast in Yavneh near Jaffa". Dispersal to other parts of the Roman Empire occurred, but some earlier settlements were also established as early as 4 BC.

Modern estimates vary: Applebaum argues that in the Herodian kingdom, there were 1.5 million Jews, a figure Ben David says covers the numbers in Judea alone. Salo Wittmayer Baron estimated the population at 2.3 million at the time of Roman emperor Claudius (reigned 41–54). According to Israeli archeologist Magen Broshi, west of the Jordan River the population certainly did not exceed 1 million: "'... the population of Palestine in antiquity did not exceed a million persons. It can also be shown, moreover, that this was more or less the size of the population in the peak period – the late Byzantine period, around AD 600'" Broshi made calculations based on the grain-producing capacity of Palestine and on its role in the indigenous diet, assuming an average annual per-capita consumption of 200 kg. (with a maximum of 250 kg.), which would work out to the limit of a sustainable population of 1,000,000 people, a figure which, Broshi states, remained roughly constant down to the end of the Byzantine period (600 CE). The proportion of Jews to gentiles is also unknown.

The Bar Kokhba revolt in the 2nd century saw a major shift in the population of Palestine. The sheer scale and scope of the overall destruction, according to a late epitome of Dio Cassius's Roman History, where he states that Roman war operations in the country had left some 580,000 Jews dead, with many more dying of hunger and disease, while 50 of their most important outposts and 985 of their most famous villages were razed to the ground. "Thus," writes Dio Cassius, "nearly the whole of Judaea was made desolate." Goodblatt contends that while Bar Kokhba rendered much of the Judaean Mountains and the Hebron Hills desolate, Jewish communities continued to thrive in other parts of Judea and Palestine as a whole.

"'The destruction of the Jewish metropolis of Jerusalem and its environs and the ventual refoundation of the city as the Roman colony of Aelia Capitolina had lasting repercussions. However, in other parts of Palestine the Jewish population remained strong. Literary and archaeological evidence indicates that in the Late Roman-early Byzantine era Jewish commuinities thrived along the eastern, southern and western edges of Judah, in the Galilee, Golan and the Beit Shean region. And a strong Jewish presence continued throughout this period in many poleis, including Caesarea Maritima and Scythopolis.'"

When exactly Jews became a minority is disputed. Eschel argues that a combination of three events: the rise of Christianity, the Jewish-Roman wars and Jewish Diaspora made Jews in the minority. David Goodblatt contends that Jews suffered a setback following the Bar Kokhba revolt (132–136), noting that Jews were still in the majority until the 3rd century and even beyond, when Christianity became the empire's official religion, and continued to thrive in different parts of Palestine. According to Doron Bar, archaeological evidence of synagogue remains demonstrate a central Jewish presence throughout Palestine during the entire Byzantine period.

The 'ascension' of Constantine the Great in 312 and Christianity becoming the official state religion of Rome in 391, consequently brought to an end Jewish dominance in Palestine. Already by the mid-3rd century the Jewish majority had been reported to have been lost, while others conclude that a Jewish majority lasted much longer – "What does seem clear is a different kind of change – immigration of Christians and the conversion of pagans, Samaritans, and Jews eventually produced a Christian majority". After the Bar Kokhba revolt of 132–136 CE the make-up of the population of Palestine remains in doubt due to the sparsity of data in the historical record. Figures vary considerably as to the demographics of Palestine in the Christian era.

No reliable data exist on the population of Palestine in the pre-Muslim period, either in absolute terms or in terms of shares of total population. Although many Jews were killed, expelled or sold off into slavery after the AD 66–70 and the 123–125 rebellions, the degree to which these transfers affected the Jewish dominance in Palestine is rarely addressed. What is certain is that Palestine did not lose its Jewish component. Goldblatt concludes that the Jews may have remained a majority into the 3rd century AD and even beyond. He notes that 'Jewish followers of Jesus' (Jewish Christians) would not have taken part in the rebellions. Moreover, non-Christian conversions from Judaism after the Bar Kochba revolt were not given much attention. "'Indeed, many must have reacted to the catastrophe with despair and total abandonment of Judaism. Apostates from Judaism (aside from converts to Christianity) received little notice in antiquity from either Jewish or non-Jewish writers, but ambitious individuals are known to have turned pagan before the war, and it stands to reason that many more did so after its disastrous conclusion. It is impossible to determine the number who joined the budding Christian movement and the number who disappeared into the polytheist majority.'"

Byzantine period

The administrative reorganization of the region in 284–305 AD by the Eastern Romans produced three Palestinian provinces of "Greater Palestine" which lasted from the 4th to the early 7th centuries: Palaestina Prima, which included the historic regions of Philistia, Judea and Samaria with the capital in Caesarea Maritima; Palaestina Secunda, which included the Galilee, the Golan Heights, as well as parts of Perea (western Transjordan) and the Decapolis, with its capital being Scythopolis; and Palaestina Salutaris which included Idumaea, the Naqab desert, Arabia Petraea, parts of Sinai, and Transjordan south of the Dead Sea, with its capital in Petra.

Under the Byzantines, the religious landscape of Palestine underwent a significant transformation, propelled by the widescale Christianization of the local Jewish, pagan and Samaritan communities, as well as immigration of Christian pilgrims and monks into the Holy land. After the failure of Bar Kokhba revolt in 135, Jews were barred from living in a large part of former Judaea. During this period, Jews were concentrated in the Galilee, the Golan and marginal areas of the Judaean hills, between Eleutheropolis and Hebron in the Daromas, with significant Jewish settlement in the strip between Ein Gedi and Ascalon. Jews also lived in the southern Jordan Valley near Jericho, where they were employed in date and Balsam plantations; around Narbata, in Samaria and in the Jezreel Valley. However, the main centres of Jewish life and culture during this period were the cosmopolitan cities of the coastal plains, particularly Lydda, Jamnia, Azotus and Caesarea Maritima. Samaritans, originally concentrated in communities around Mount Gerizim, had spread beyond Samaria proper in the second century and established communities in the coastal plains, Judea and the Galilee, with some Samaritan villages located as far as Golan. However, the Samaritan revolts against the Byzantines in 484–573 and their forced conversion to Christianity under Maurice (582–602) and Heraclius (610–641) significantly diminished their numbers.

Pagan tradition flourished in the period before Constantine, and pagans were a majority in the coastal plains, Judea, Samaria, the Naqab and much of the urban centers. Although proscribed in the Bible, pagan cults had thrived in Palestine throughout the First and Second Temple period, and many Jews did not escape it. According to E. Friedheim, many Jews in Palestine also embraced paganism and pagan cults again following the destruction of the Second Temple in 70 CE. Talmudic tradition forbid customs relating to 'the Amorite ways', showing a persistence of ancient Canaanite customs among the non-Jewish population and their inconsistent penetration into Jewish circles.

Christian presence at the start of this period was mainly evidenced in Hellenistic cities and some of the villages in southern Judea. However, Christianity's early influence in either the Jewish, Samaritan or pagan rural areas was minor and came at a much later stage around the sixth century, when many of the community churches in Judea, western Galilee, the Naqab and other places were built. By the fifth century, many pagan temples in Palestine including those in Jerusalem, Bethlehem, Mamre, Tel Qadesh and Tel Dan, had been demolished, and churches were erected in their place. In the rural sector, vast areas of Palestine, such as Galilee and Samaria, had Jewish and Samaritan majorities, and Christianity spread in these areas far more gradually and at a slower pace, achieving real momentum only during the second half of the Byzantine period. Christianity had also spread in the Nabataean cities, towns and villages in southern Palestine, where a mixed Christian and pagan population lived, with elaborate churches built in Abdah, Mampsis and Subeita.

Palestine reached its peak population of around 1 to 1.5 million during this period. However, estimates of the relative proportions of Jews, Samaritans and pagans vary widely and are speculative. By counting settlements, Avi-Yonah estimated that Jews comprised half the population of the Galilee at the end of the 3rd century, and a quarter in the other parts of the country, but had declined to 10–15% of the total by 614. On the other hand, by counting churches and synagogues, Tsafrir estimated the Jewish proportion to be 25% in the Byzantine period. Stemberger, however, considers that Jews were the largest population group at the beginning of the 4th century, closely followed by the pagans. According to Schiffman, DellaPergola and Bar, Christians only became the majority of the country's population at the beginning of the fifth century,

Islamic Period

Prior to the Muslim conquest of Palestine (635–640), Palaestina Prima had a population of 700,000, of which around 100,000 were Jews and 30-80,000 were Samaritans, with the remainder being Chalcedonian and Miaphysite Christians.

The pace of conversion to Islam among the Christian, Jewish, and Samaritan communities in Palestine varied during the early period (638–1098), and opinions vary regarding the extent of Islamization during the early Islamic period. While some argue Palestine was already majority Muslim by the time of arrival of the First Crusade, others contend that Christians were still in the majority and the process of mass adoption of Islam took place only from the 13th century onwards, during the Mamluk period. Archaeologist Gideon Avni argues that archaeological surveys show that most Christian settlements and sites preserved their identity up to the crusader period, supplemented by the numerosity of churches and monasteries all over Palestine. The early Muslim population, on the other hand, was confined to the Umayyad palaces in the Jordan Valley and around the Sea of Galilee, the ribat fortresses along the coast and the farms of the Naqab desert. Thus, conversion to Islam only gained real momentum in Palestine after Saladin's conquest of Jerusalem in 1187 and the expulsion of Franks. Michael Ehrlich, on the other hand, believes conversion was rather quick and finalized by the time the crusades arrived in 1099.

Urban centers continued to flourish after the Islamic conquest, but changes took place in the 9th and 10th centuries. According to Ellenblum, climate disasters and earthquakes in the late 10th & 11th centuries created internal chaos and famines throughout the Middle East, as well as population decline. Ehrlich argues the decline in urban centers likely caused local ecclesiastical administrations to weaken or disappear altogether, leaving Christians most susceptible to conversion. When certain urban centers collapsed, surrounding communities would have converted to Islam. Per Ellenblum, the eastern Galilee and central Samaria, where Jews and Samaritans were concetrated respectively, were converted rather quickly and had a Muslim or Jewish-Muslim majority by the crusader period. In Samaria, the sedentarization of nomadic tribes that penetrated Samaria was complemented by the mass conversion of the Samaritan population starting from the Tulunid period (884–905). By the 12th century, central Samaria was the only fully Islamized region in Palestine, while Christians predominated in southern Samaria, the Sinjil-Jerusalem area, the western Galilee and the Hebron Hills, which only converted in later periods. The introduction of Islam in the Hebron hills is archaeologically attested in Jewish villages but not Christian ones, mainly in Susya and Eshtemoa, where the local synagogues were repurposed as mosques.

Coastal cities such as Ramla and Ascalon thrived under the Fatimids (969–1099), where many Shiite scholars sought refuge and Shiite shrines were built, and the hinterland of Ramla was predominantly Muslim when the crusaders conquered it. On the other hand, Sufis played an important role in the Islamization of the hinterland of Jerusalem, where they built many religious buildings during the Mamluk period, transforming the cultural landscape. According to Nimrod Luz, when a Sufi settled in a Christian village, the local population often converted to Islam. According to Reuven Atimal, conversion to Islam appears to have halted and apparently even been reversed under the Kingdom of Jerusalem (1099–1291). With the advent of the Ayyubids (1187–1260) and then the consequent Mamluk takeover (1260–1517), it appears that the process of religious conversion to Islam was accelerated. By the start of the Ottoman period in 1516, it is commonly thought that the Muslim majority in the country was more-or-less like that of the mid-19th century. Conversion among the Samaritan families of Nablus to Islam continued well into the 19th century.

Early Ottoman period
During the first century of the Ottoman rule, i.e., 1550, Bernard Lewis in a study of Ottoman registers of the early Ottoman Rule of Palestine reports a population of around 300,000: "From the mass of detail in the registers, it is possible to extract something like a general picture of the economic life of the country in that period. Out of a total population of about 300,000 souls, between a fifth and a quarter lived in the six towns of Jerusalem, Gaza, Safed, Nablus, Ramle, and Hebron. The remainder consisted mainly of peasants (fellahin), living in villages of varying size, and engaged in agriculture. Their main food-crops were wheat and barley in that order, supplemented by leguminous pulses, olives, fruit, and vegetables. In and around most of the towns there was a considerable number of vineyards, orchards, and vegetable gardens." According to Justin McCarthy, the population of Palestine throughout the 17th and 18th centuries (1601–1801) was likely not much smaller than when it in 1850 (~340,000), after which it started to increase.

Late Ottoman period
In the late nineteenth century, prior to the rise of Zionism, Jews are thought to have comprised between 2% and 5% of the population of Palestine, although the precise population is not known.

Jewish immigration had begun following the 1839 Tanzimat reforms; between 1840 and 1880, the Jewish population of Palestine rose from 9,000 to 23,000.

According to Alexander Scholch, Palestine in 1850 had about 350,000 inhabitants, 30% of whom lived in 13 towns; roughly 85% were Muslims, 11% were Christians and 4% Jews.

The Ottoman census of 1878 indicated the following demographics for the three districts that best approximated what later became Mandatory Palestine; that is, the Mutasarrifate of Jerusalem, the Nablus Sanjak, and the Acre Sanjak. In addition, some scholars estimate approximately 5,000-10,000 additional foreign-born Jews at this time:

According to Ottoman statistics studied by Justin McCarthy, the population of Palestine in the early 19th century was 350,000, in 1860 it was 411,000 and in 1900 about 600,000 of which 94% were Arabs.

The estimated 24,000 Jews in Palestine in 1882 represented just 0.3% of the world's Jewish population.

1914 Ottoman census listed the following population figures:

Per McCarthy's estimate, in 1914 Palestine had a population of 657,000 Muslim Arabs, 81,000 Christian Arabs, and 59,000 Jews. McCarthy estimates the non-Jewish population of Palestine at 452,789 in 1882, 737,389 in 1914, 725,507 in 1922, 880,746 in 1931 and 1,339,763 in 1946.

Based on the work of Roberto Bachi, Sergio Della Pergola estimated that Palestine's population in 1914 was 689,000, comprising 525,000 Muslims, 94,000 Jews, and 70,000 Christians.

According to another estimate, the Jewish population in 1914 was 85,000 and subsequently fell to 56,000 in 1916–1919 as a result of World War I. During the war, the Ottoman authorities deported many Jews with foreign citizenship, while others left after they were presented with a choice of taking Ottoman citizenship or leaving Palestine. By December 1915 about 14% of the Jewish population had left, mainly for Egypt, where they awaited the war's end so they could return to Palestine.

According to Dr. Mutaz M. Qafisheh, the number of people who held Ottoman citizenship prior to the British Mandate in 1922 was just over 729,873, of which 7,143 were Jews. Qafisheh calculated this using population and immigration statistics from the 1946 Survey of Palestine, as well as the fact that 37,997 people acquired provisional Palestinian naturalization certificates in September 1922 for the purpose of voting in the legislative election, of which all but 100 were Jews. The 1922 census of Palestine lists 3,210 Christians as members of Armenian churches, 271 being Armenian Catholic (176 in Jerusalem-Jaffa, 10 in Samaria, and 85 in Northern) and 2,939 being Armenian Apostolic (11 in Southern, 2,800 in Jerusalem-Jaffa, eight in Samaria, and 120 in Northern) along with 2,970 Armenian speakers, including 2,906 in municipal areas (2,442 in Jerusalem, 216 in Jaffa, 101 in Haifa, four in Gaza, 13 in Nablus, one in Safad, 20 in Nazareth, 13 in Ramleh, one in Tiberias, 37 in Bethlehem, 25 in Acre, four in Tulkarem, 21 in Ramallah, six in Jenin, one in Beersheba, and one in Baisan).

Official reports
In 1920, the British Government's Interim Report on the Civil Administration of Palestine stated that there were hardly 700,000 people living in Palestine:

There are now in the whole of Palestine hardly 700,000 people, a population much less than that of the province of Gallilee alone in the time of Christ. Of these 235,000 live in the larger towns, 465,000 in the smaller towns and villages. Four-fifths of the whole population are Moslems. A small proportion of these are Bedouin Arabs; the remainder, although they speak Arabic and are termed Arabs, are largely of mixed race. Some 77,000 of the population are Christians, in large majority belonging to the Orthodox Church, and speaking Arabic. The minority are members of the Latin or of the Uniate Greek Catholic Church, or—a small number—are Protestants.

The Jewish element of the population numbers 76,000. Almost all have entered Palestine during the last 40 years. Prior to 1850 there were in the country only a handful of Jews. In the following 30 years a few hundreds came to Palestine. Most of them were animated by religious motives; they came to pray and to die in the Holy Land, and to be buried in its soil. After the persecutions in Russia forty years ago, the movement of the Jews to Palestine assumed larger proportions. Jewish agricultural colonies were founded. They developed the culture of oranges and gave importance to the Jaffa orange trade. They cultivated the vine, and manufactured and exported wine. They drained swamps. They planted eucalyptus trees. They practised, with modern methods, all the processes of agriculture. There are at the present time 64 of these settlements, large and small, with a population of some 15,000.

By 1948, the population had risen to 1,900,000, of whom 68% were Arabs, and 32% were Jews (UNSCOP report, including Bedouin).

Report and general abstract of the Jewish agriculture was taken by the Palestine Zionist Executive in April 1927.

Object of the Census:

(p 85) Demography: to enumerate all Jewish inhabitants living in the agricultural and semi-agricultural communities.

(p 86) Number of Settlements: 130 places have been enumerated. If we consider the large settlements and the adjacent territories as one geographical unit, then we may group these places into 101 agricultural settlements, 3 semi-agricultural places (Affule, Shekhunath Borukhov and Neve Yaaqov) and 12 farms scattered throughout the country. In addition, there were a few places which, owing to technical difficulties, were not enumerated in the month of April. (Peqiin, Meiron, Mizpa and Zikhron David, numbering in the aggregate 100 persons).

Of these agricultural settlements, 32 are located in Judea, 12 in the Plain of Sharon, 32 are located in the Plain of Jesreel, 16 in Lower Galilee, and 9 in Upper Galilee. Most of them have a very small population – about one half being inhabited by less than 100 persons each. In 42 settlements there are from 100 to 500 persons, and in only five does the population exceed 1.000. viz. (p 86) Number of Inhabitants: The aggregate population living in the agricultural and semi-agricultural places were 30.500.

 * Length of Residence in Palestine

(p 87 & p 98) The pre-war population accounts for 9,473 persons, which is slightly less than one-third of the present population, whereas the rest are post-war immigrants. Some 10.000 persons settled since 1924, since the so-called middle-class immigration.

Ottoman period, 1800–1918
At the end of the 18th century, there was a bi-directional movement between Egypt and Palestine. Between 1829 and 1841, thousands of Egyptian fellahin (peasants) arrived in Palestine fleeing Muhammad Ali Pasha's conscription, which he reasoned as the casus belli to invade Palestine in October 1831, ostensibly to repatriate the Egyptian fugitives. Egyptian forced labourers, mostly from the Nile Delta, were brought in by Muhammad Ali and settled in sakināt (neighborhoods) along the coast for agriculture, which set off bad blood with the indigenous fellahin, who resented Muhammad Ali's plans and interference, prompting the wide-scale Peasants' revolt in Palestine in 1834. After Egyptian defeat and retreat in 1841, many laborers and deserters stayed in Palestine. Most of these settled and were quickly assimilated in the cities of Jaffa and Gaza, the Coastal plains and Wadi Ara. Estimates of Egyptian migrants during this period generally place them at 15,000–30,000. At the time, the sedentary population of Palestine fluctuated around 350,000. Palestine experienced a few waves of immigration of Muslims from the lands lost by the Ottoman Empire in the 19th century. Algerians, Circassians and Bosnians were mostly settled on vacant land and unlike the Egyptians they did not alter the geography of settlement significantly.

The Naqab desert further south preserved its Bedouin population, who had reportedly lived in the area since the 7th century. Many Bedouin tribes moved from the Hejaz and Transjordan in the 14th and 15th centuries. According to the 1922 census of Palestine, "The Ottoman authorities in 1914 placed the tribal population of Beersheba at 55,000, and since that date there has been a migration of tribes from the Hejaz and Southern Transjordan into the Beersheba area mainly as a result of succession of adequate rainfalls and of pressure exerted by other tribes east of the River Jordan." For 1922, the census gives a figure of 74,910 including 72,998 in the tribal areas.

Demographer Uziel Schmelz, in his analysis of Ottoman registration data for 1905 populations of Jerusalem and Hebron kazas, found that most Ottoman citizens living in these areas, comprising about one quarter of the population of Palestine, were living at the place where they were born. Specifically, of Muslims, 93.1% were born in their current locality of residence, 5.2% were born elsewhere in Palestine, and 1.6% were born outside Palestine. Of Christians, 93.4% were born in their current locality, 3.0% were born elsewhere in Palestine, and 3.6% were born outside Palestine. Of Jews (excluding the large fraction who were not Ottoman citizens), 59.0% were born in their current locality, 1.9% were born elsewhere in Palestine, and 39.0% were born outside Palestine.

British Mandate period, 1919–1948
According to Roberto Bachi, head of the Israeli Institute of Statistics from 1949 onwards, between 1922 and 1945 there was a net Arab migration into Palestine of between 40,000 and 42,000, excluding 9,700 people who were incorporated after territorial adjustments were made to the borders in the 1920s. Based on these figures, and including those netted by the border alterations, Joseph Melzer calculates an upper boundary of 8.5% for Arab growth in the two decades, and interprets it to mean the local Palestinian community's growth was generated primarily by natural increase in birth rates, for both Muslims and Christians.

According to a Jewish Agency survey, 77% of Palestinian population growth in Palestine between 1914 and 1938, during which the Palestinian population doubled, was due to natural increase, while 23% was due to immigration. Arab immigration was primarily from Lebanon, Syria, Transjordan, and Egypt (all countries that bordered Palestine).

The overall assessment of several British reports was that the increase in the Arab population was primarily due to natural increase. These included the Hope Simpson Enquiry (1930), the Passfield White Paper (1930), the Peel Commission report (1937), and the Survey of Palestine (1945). However, the Hope Simpson Enquiry did note that there was significant illegal immigration from the surrounding Arab territories, while the Peel Commission and Survey of Palestine claimed that immigration played only a minor role in the growth of the Arab population. The 1931 census of Palestine considered the question of illegal immigration since the previous census in 1922. It estimated that unrecorded immigration during that period may have amounted to 9,000 Jews and 4,000 Arabs. It also gave the proportion of persons living in Palestine in 1931 who were born outside Palestine: Muslims, 2%; Christians, 20%; Jews, 58%. The statistical information for Arab immigration (and expulsions when the clandestine migrants were caught), with a contrast to the figures for Jewish immigration over the same period of 1936–1939, is given by Henry Laurens in the following terms
 * Palestinian immigration, 1936–1939
 * {| class="wikitable"
 * {| class="wikitable"

! Jews !! Arabs
 * rowspan=1 | 69,716 || 2,267
 * }
 * Expulsions of illegals, 1937–1938
 * {| class="wikitable"
 * Expulsions of illegals, 1937–1938
 * {| class="wikitable"

! Jews !! Arabs (et al.).
 * rowspan=1 | 125 || 1,704
 * }
 * }
 * }

According to Mark Tessler, at least some of the Arab population growth was the result of immigration, mostly from the Sinai, Lebanon, Syria, and Transjordan, stimulated by the relatively favorable economic conditions in Palestine, but he noted differing opinions among scholars over how substantial it was. He cited one study as putting the Arab population growth attributable to immigration between 1922 and 1931 at 7%, meaning that 4% of the Arab population in 1931 was foreign-born, while noting another estimate put the growth in the Arab population attributable to immigration at 38.7%, which would mean that 11.8% of the Arab population in 1931 was foreign-born. Tessler wrote that "Israeli as well as Palestinian scholars have disputed this assertion, however, concluding that it is at best a theory and in all probability a myth." In a 1974 study, demographer Roberto Bachi estimated that about 900 Muslims per year were detected as illegal immigrants but not deported. He noted the impossibility of estimating illegal immigration that was undetected, or the fraction of those persons who eventually departed. He did note that there was an unexplained increase in the Muslim population between 1922 and 1931, and he did suggest, though qualifying it as a "mere guess", that this was due to a combination of unrecorded immigration (using the 1931 census report estimate) and undercounting in the 1922 census.

While noting the uncertainty of earlier data, Bachi also observed that the Muslim population growth in the 19th century appeared to be high by world standards: "[B]etween 1800 and 1914, the Muslim population had a yearly average increase of an order of magnitude of roughly 6–7 per thousand. This can be compared to the very crude estimate of about 4 per thousand for the "less developed countries" of the world (in Asia, Africa, and Latin America) between 1800 and 1910. It is possible that some part of the growth of the Muslim population was due to immigration. However, it seems likely that the dominant determinant of this modest growth was the beginning of some natural increase."

According to Justin McCarthy, "... evidence for Muslim immigration into Palestine is minimal. Because no Ottoman records of that immigration have yet been discovered, one is thrown back on demographic analysis to evaluate Muslim migration." McCarthy argues that there is no significant Arab immigration into mandatory Palestine: From analyses of rates of increase of the Muslim population of the three Palestinian sanjaks, one can say with certainty that Muslim immigration after the 1870s was small. Had there been a large group of Muslim immigrants their numbers would have caused an unusual increase in the population and this would have appeared in the calculated rate of increase from one registration list to another... Such an increase would have been easily noticed; it was not there. The argument that Arab immigration somehow made up a large part of the Palestinian Arab population is thus statistically untenable. The vast majority of the Palestinian Arabs resident in 1947 were the sons and daughters of Arabs who were living in Palestine before modern Jewish immigration began. There is no reason to believe that they were not the sons and daughters of Arabs who had been in Palestine for many centuries. McCarthy also concludes that there was no significant internal migration to Jewish areas attributable to better economic conditions: Some areas of Palestine did experience greater population growth than others, but the explanation for this is simple. Radical economic change was occurring all over the Mediterranean Basin at the time. Improved transportation, greater mercantile activity, and greater industry had increased the chances for employment in cities, especially coastal cities... Differential population increase was occurring all over the Eastern Mediterranean, not just in Palestine... The increase in Muslim population had little or nothing to do with Jewish immigration. In fact the province that experienced the greatest Jewish population growth (by .035 annually), Jerusalem Sanjak, was the province with the lowest rate of growth of Muslim population (.009). Fred M. Gottheil has questioned McCarthy's estimates of immigration. Gottheil says that McCarthy didn't give proper weight to the importance of economic incentives at the time, and that McCarthy cites Roberto Bachi's estimates as conclusive numbers, rather than lower bounds based on detected illegal immigration.

Gad Gilbar has also concluded that the prosperity of Palestine in the 45–50 years before World War I was a result of the modernization and growth of the economy owing to its integration with the world economy and especially with the economies of Europe. Although the reasons for growth were exogenous to Palestine the bearers were not waves of Jewish immigration, foreign intervention nor Ottoman reforms but "primarily local Arab Muslims and Christians." However, Gilbar did attribute the rapid growth of Jaffa and Haifa in the final three decades of Ottoman rule in part to migration, writing that "both attracted population from the rural and urban surroundings and immigrants from outside Palestine."

Yehoshua Porath believes that the notion of "large-scale immigration of Arabs from the neighboring countries" is a myth "proposed by Zionist writers". He writes: As all the research by historian Fares Abdul Rahim and geographers of modern Palestine shows, the Arab population began to grow again in the middle of the nineteenth century. That growth resulted from a new factor: the demographic revolution. Until the 1850s there was no "natural" increase of the population, but this began to change when modern medical treatment was introduced and modern hospitals were established, both by the Ottoman authorities and by the foreign Christian missionaries. The number of births remained steady but infant mortality decreased. This was the main reason for Arab population growth. ... No one would doubt that some migrant workers came to Palestine from Syria and Trans-Jordan and remained there. But one has to add to this that there were migrations in the opposite direction as well. For example, a tradition developed in Hebron to go to study and work in Cairo, with the result that a permanent community of Hebronites had been living in Cairo since the fifteenth century. Trans-Jordan exported unskilled casual labor to Palestine; but before 1948 its civil service attracted a good many educated Palestinian Arabs who did not find work in Palestine itself. Demographically speaking, however, neither movement of population was significant in comparison to the decisive factor of natural increase.

Modern era
, Israeli and Palestinian statistics for the overall numbers of Jews and Arabs in the area west of the Jordan, inclusive of Israel and the Palestinian territories, are similar and suggest a rough parity in the two populations. Palestinian statistics estimate 6.1 million Palestinians for that area, while Israel's Central Bureau of Statistics estimates 6.2 million Jews living in sovereign Israel. Gaza is estimated by the Israeli Defense Forces (IDF) to have 1.7 million, and the West Bank 2.8 million Palestinians, while Israel proper has 1.7 million Arab citizens. According to Israel's Central Bureau of Statistics, as of May 2006, of Israel's 7 million people, 77% were Jews, 18.5% Arabs, and 4.3% "others". Among Jews, 68% were Sabras (Israeli-born), mostly second- or third-generation Israelis, and the rest are olim – 22% from Europe and the Americas, and 10% from Asia and Africa, including the Arab countries.

According to these Israeli and Palestinian estimates, the population in Israel and the Palestinian territories stands at from 6.1 to 6.2 million Palestinians and 6.1 million Jews. According to Sergio DellaPergola, if foreign workers and non-Jewish Russian immigrants in Israel are subtracted, Jews are already a minority in the land between the river and the sea. DellaPergola calculates that Palestinians as of January 2014 number 5.7 million as opposed to a "core Jewish population" of 6.1 million.

The Palestinian statistics are contested by some right-wing Israeli think-tanks and non-demographers such as Yoram Ettinger, who claim they overestimate Palestinian numbers by double-counting and counting Palestinians who live abroad. The double-counting argument is dismissed by both Arnon Soffer, Ian Lustick and DellaPergola, the latter dismissing Ettinger's calculations as 'delusional' or manipulated for ignoring the birth-rate differentials between the two populations (3 children per Jewish mother vs 3.4 for Palestinians generally, and 4.1 in the Gaza Strip). DellaPergola allows, however, for an inflation in the Palestinian statistics due to the counting of Palestinians who are abroad, a discrepancy of some 380,000 individuals.

Demographics of the State of Israel
The latest Israeli census was conducted by Israel Central Bureau of Statistics in 2019. Israeli census excludes the Gaza Strip. It also excludes all West Bank Palestinian localities, including those in Area C, while it includes the annexed East Jerusalem. It also includes all Israeli settlements in the West Bank. The census also includes the occupied Syrian territory of Golan Heights.

As per this census, the total population in 2019 was 9,140,473. Israeli population consists of 7,221,442 "Jews and others", and 1,919,031 Arabs, almost all of which Palestinians, with 26,261 in Golan Subdistrict, being Syrian, mostly Druze, and a small number Alawite. The population includes the Druze community of Israel (i.e. not Syrian Druze) as well, who generally self-identify as Israeli, and are the only Arab-speaking community that has mandatory military service in the IDF.

Demographics of the State of Palestine
The latest Palestinian Census was conducted by Palestinian Central Bureau of Statistics in 2017. The Palestinian census covers the Gaza Strip and the West Bank, including East Jerusalem. The Palestinian census does not cover Israeli settlements in the West Bank including those in East Jerusalem. The census does not provide any ethnic or religious distinction. However, it is reasonable to assume that almost everyone counted is Palestinian Arab.

As per this census, the total population of the Palestinian territories was 4,780,978. The West Bank had a population of 2,881,687, whereas the Gaza Strip had a population of 1,899,291.

Note: Israeli definitions
The definition of what constitutes the population of Israel varies depending on which territories are counted and which population groups are counted in each territory.

The Israel Central Bureau of Statistics ("CBS") definition of the Area of the State of Israel:
 * includes East Jerusalem since 1967, which Israel unilaterally annexed
 * includes the Golan Heights since 1982, which Israel unilaterally annexed
 * excludes the West Bank other than East Jerusalem

The CBS' definition of the Population of Israel, however:
 * includes non-Israeli Palestinians (as well as Israeli Arabs/Palestinians) in East Jerusalem who have permission to live there
 * includes Israeli settlers and others with Israeli residency permits living in the Area C of West Bank
 * excludes Palestinian/Arab/other residents of Area C and East Jerusalem who do not have Israeli citizenship or residence
 * excludes persons who are not registered (from 2008 on) and/or entered illegally, and foreign workers

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/


text:
Prolactinoma

A prolactinoma is a tumor (adenoma) of the pituitary gland that produces the hormone prolactin. It is the most common type of functioning pituitary tumor. Symptoms of prolactinoma are due to abnormally high levels of prolactin in the blood (hyperprolactinemia), or due to pressure of the tumor on surrounding brain tissue and/or the optic nerves. Based on its size, a prolactinoma may be classified as a microprolactinoma (<10mm diameter) or a macroprolactinoma (>10mm diameter).

Signs and symptoms
The most common symptoms at the time of diagnosis often differ between males and females. Women tend to experience more symptoms related directly to prolactin levels, such as amenorrhea and galactorrhea. By contrast, men frequently exhibit fertility issues and hormonal disruptions, such as a loss of libido, but are also more likely to show signs of the tumor compressing their brain tissue, such as headaches, vision changes, and other symptoms outlined below.

The symptoms due to a prolactinoma are broadly divided into those that are caused by increased prolactin levels or mass effect. Those that are caused by increased prolactin levels are:
 * Amenorrhea (disappearance of ovulation periods)
 * Galactorrhea (Milk production; infrequent in men)
 * Loss of axillary and pubic hair
 * Hypogonadism (Reduced function of the gonads.)
 * Gynecomastia (an increase in male breast size)
 * Erectile dysfunction (in males)

Those that are caused by mass effect are:
 * Headaches
 * Vision Changes-visual field deficits, blurred vision, decreased visual acuity
 * Cranial nerve palsies-especially with invasive tumors or with pituitary apoplexy
 * Seizures, Hydrocephalus, Unilateral exophthalmos are rare presentations
 * Hypopituitarism
 * Pituitary apoplexy is a medical emergency because of spontaneous hemorrhage into the pituitary tumor and presents with severe headaches, vision changes, and acute panhypopituitarism.

Infertility
A prolactinoma can cause infertility, temporary or permanent, in both male and female patients. It is one of the most common causes of infertility in women, with some sources estimating as much as 20% of female infertility being caused by hyperprolactinemia. It represents a smaller proportion of male infertility. However, among people who have prolactinomas, males are more likely to experience infertility, as their tumors are often more aggressive and more frequently cause hypogonadism.

Causes
Prolactinoma is most frequently a sporadic tumor, occurring in people without any concrete risk factors or family members with similar conditions. In a minority of cases, genetics predispose the patient to having one or more pituitary gland tumors during their lifetime. Most cases of prolactinoma have no known causes or risk factors.

Pathogenesis
Though most pituitary tumors are sporadic, some genetic syndromes include increased risk for pituitary adenomas including Multiple endocrine neoplasia type 1 (caused by a mutation in the MEN1 gene), multiple endocrine neoplasia type 4 (MEN4 gene), Carney complex, and Familial isolated pituitary adenoma (FIPA). Despite their frequent association with genetic syndromes that cause multiple cancers in affected body tissues, the large majority of prolactinomas are monoclonal in origin (originating from a single cell developing a random mutation), even in cases where the tumor begins producing multiple distinct hormones aside from prolactin.

A micro-prolactinoma usually does not grow to become a macro-prolactinoma, and also does not often become metastatic. As such, it is considered a benign tumor, even if it causes symptoms due to excess prolactin. However, it is still recommended that patients with known microprolactinomas should receive an MRI and visual field assessment every 6 to 12 months, to detect unexpected progression and expansion of the tumor before it becomes an emergency.

Splicing factor 3B1
Among cases of sporadic prolactinoma, in patients with no family history of pituitary tumors, the splicing factor 3B1 gene (SF3B1) has been found as a common causative mutation. This mutation, most commonly a missense mutation replacing a single amino acid, has also been identified in some familial cases of prolactinoma. However, it is more commonly a somatic mutation, occurring later in life in someone who was not born with the mutated gene. This gene is responsible for splicing a wide variety of RNA products inside the cell, and a mutation of it can thus cause the creation of numerous abnormal proteins as RNA templates are produced in unpredictable ways.

Sporadic cases of prolactinoma which are not related to a mutation of SF3B1 remain poorly understood. However, many studies show a link between estrogen and prolactinoma. This is theorized to be related to why prolactinomas are more common in women than men.

Vision problems and headaches
While headaches are a symptom common to any tumor within the cranium, vision problems are especially frequent in pituitary adenomas because the pituitary gland rests over the optic chiasm. As the tumor grows, it begins to compress one or both optic nerves, depending on the size and direction of growth. This is an example of mass effect. As such, smaller tumors which may produce excess prolactin or other hormones may not cause any vision problems, while still having major symptomatic effects on the body.

Other causes of elevated prolactin
The majority of moderately raised prolactin levels (up to 5000 mIU/L) are not due to microprolactinomas but other causes. The effects of some prescription drugs are the most common. Other causes are other pituitary tumours and normal pregnancy and breastfeeding.

Diagnosis
Prolactinoma is often one of the first diagnoses considered by a physician when a patient presents with symptoms of hyperprolactinemia. Specifically, the presence of several of these symptoms in the same person are indicative of elevated prolactin:

 * Galactorrhea
 * Amenorrhea (in women)
 * Erectile dysfunction (in men)
 * Infertility
 * Diminished libido
 * Weight gain

If these symptoms occur with the simultaneous presence of mass effects, particularly vision problems or severe neurological symptoms such as seizures or coma, aggressive prolactinoma is highly likely. A patient with these symptoms should immediately undergo MRI to assess the size and extent of the tumor. MRI is also useful in patients with smaller tumors, as it can be used to monitor the tumor for signs of growth, allowing a surgical intervention to be performed before it becomes a medical emergency.

Imaging
All patients with hyperprolactinemia should receive MRI imaging to determine the size and characteristics of the tumor. Prolactinomas have somewhat variable appearance on MRI, most commonly appearing hypointense on T1 weighted MRI, and heterogenous or hyperintense on T2 weighted MRI. If MRI is not available, other imaging techniques may be used if they can examine the region around the sella turcica in sufficient detail. Identification of pituitary tumor on MRI, with accompanying symptoms, is considered a definitive diagnosis of prolactinoma.

Unlike macroprolactinomas which compress the optic nerves, microprolactinomas are usually not large enough to be seen on MRI. However, the addition of gadolinium contrast enhancement can make them much easier to detect. Thus, evaluation of a suspected prolactinoma usually uses this form of contrast enhancement. Notably, this contrast can also visualize a pituitary gland with no disease at all, so precise measurement of the gland's size and shape is essential.

Biochemical testing
Elevated prolactin levels in the patient's serum are indicative of hyperprolactinemia, but are not specific to prolactinoma, meaning that other diseases causing similar symptoms could produce the same test results. Similarly, tests that use dopamine agonists to suppress prolactin production are not able to rule out other diagnoses. As a result, biochemical testing is used only in a supplementary role, and MRI is the only definitive diagnostic tool available. Dopamine agonist testing can, however, be used to determine the effectiveness of DAs like bromocriptine as a potential non-surgical treatment option.

Treatments
The goal of treatment is to return prolactin secretion to normal, reduce tumor size, correct any visual abnormalities, and restore normal pituitary function. The impact of stress should be ruled out before the diagnosis of prolactinoma is given. Exercise can significantly reduce stress and, thereby, prolactin levels. In the case of very large tumors, only partial reduction of the prolactin levels may be possible.

Medications
Dopamine is the chemical that normally inhibits prolactin secretion, so clinicians may treat prolactinoma with drugs that act like dopamine such as bromocriptine and cabergoline. This type of drug is called a dopamine agonist. These drugs shrink the tumor and return prolactin levels to normal in approximately 80% of patients. Both bromocriptine and cabergoline have been approved by the Food and Drug Administration for the treatment of hyperprolactinemia. Bromocriptine is associated with side-effects such as nausea and dizziness and hypotension in patients with already low blood pressure readings. To avoid these side-effects, it is important for bromocriptine treatment to start slowly.

Bromocriptine treatment should not be interrupted without consulting a qualified endocrinologist. Prolactin levels often rise again in most people when the drug is discontinued. In some, however, prolactin levels remain normal, so the doctor may suggest reducing or discontinuing treatment every two years on a trial basis. Recent studies have shown increased success in remission of prolactin levels after discontinuation, in patients having been treated for at least 2 years prior to cessation of bromocriptine treatment.

Cabergoline is also associated with side effects such as nausea and dizziness, but these may be less common and less severe than with bromocriptine. However, people with low blood pressure should use caution when starting cabergoline treatment, as the long half-life of the drug (4–7 days) may inadvertently affect their ability to keep their blood pressure within normal limits, creating intense discomfort, dizziness, and even fainting upon standing and walking until the single first dose clears from their system. As with bromocriptine therapy, side effects may be avoided or minimized if treatment is started slowly. If a patient's prolactin level remains normal for 6 months, a doctor may consider stopping treatment. Cabergoline should not be interrupted without consulting a qualified endocrinologist.

Other dopamine agonists that have been used less commonly to suppress prolactin include dihydroergocryptine, ergoloid, lisuride, metergoline, pergolide, quinagolide, and terguride.

Surgery
Surgery should be considered if medical therapy cannot be tolerated or if it fails to reduce prolactin levels, restore normal reproduction and pituitary function, and reduce tumor size. If medical therapy is only partially successful, this therapy should continue, possibly combined with surgery or radiation treatment.

The results of surgery depend a great deal on tumor size and prolactin level. The higher the prolactin level the lower the chance of normalizing serum prolactin. In the best medical centers, surgery corrects prolactin levels in 80% of patients with a serum prolactin less than 250 ng/ml. Even in patients with large tumors that cannot be completely removed, drug therapy may be able to return serum prolactin to the normal range after surgery. Depending on the size of the tumor and how much of it is removed, studies show that 20 to 50% will recur, usually within five years.

Prognosis
People with microprolactinoma generally have an excellent prognosis. In 95% of cases, the tumor will not show any signs of growth after a 4 to 6-year period.

Macroprolactinomas often require more aggressive treatment otherwise they may continue to grow. There is no way to reliably predict the rate of growth, as it is different for every individual. Regular monitoring by a specialist to detect any major changes in the tumor is recommended.

Osteoporosis risk
Hyperprolactinemia can cause reduced estrogen production in women and reduced testosterone production in men. Although estrogen/testosterone production may be restored after treatment for hyperprolactinemia, even a year or two without estrogen/testosterone can compromise bone strength, and patients should protect themselves from osteoporosis by increasing exercise and calcium intake through diet or supplementation, and by avoiding smoking. Patients may want to have bone density measurements to assess the effect of estrogen/testosterone deficiency on bone density. They may also want to discuss testosterone/estrogen replacement therapy with their physician.

Pregnancy and oral birth control
If a woman has one or more small prolactinoma, there is no reason that she cannot conceive and have a normal pregnancy after successful medical therapy. The pituitary enlarges and prolactin production increases during normal pregnancy in women without pituitary disorders. Women with prolactin-secreting tumors may experience further pituitary enlargement and must be closely monitored during pregnancy. However, damage to the pituitary or eye nerves occurs in less than one percent of pregnant women with prolactinoma. In women with large tumors, the risk of damage to the pituitary or eye nerves is greater, and some doctors consider it as high as 25%. If a woman has completed a successful pregnancy, the chances of her completing further successful pregnancies are extremely high.

A woman with a prolactinoma should discuss her plans to conceive with her physician, so she can be carefully evaluated prior to becoming pregnant. This evaluation will include a magnetic resonance imaging (MRI) scan to assess the size of the tumor and an eye examination with measurement of visual fields. As soon as a patient is pregnant, her doctor will usually advise that she stop taking bromocriptine or cabergoline, the common treatments for prolactinoma. Most endocrinologists see patients every two months throughout the pregnancy. The patient should consult her endocrinologist promptly if she develops symptoms — in particular, headaches, visual changes, nausea, vomiting, excessive thirst or urination, or extreme lethargy. Bromocriptine or cabergoline treatment may be renewed and additional treatment may be required if the patient develops symptoms from growth of the tumor during pregnancy.

At one time, oral contraceptives were thought to contribute to the development of prolactinomas. However, this is no longer thought to be true. Patients with prolactinoma treated with bromocriptine or cabergoline may also take oral contraceptives. Likewise, post-menopausal estrogen replacement is safe in patients with prolactinoma treated with medical therapy or surgery.

Epidemiology
Autopsy studies indicate that 6-25% of the U. S. population have small pituitary tumors. Forty percent of these pituitary tumors produce prolactin, but most are not considered clinically significant. Clinically significant pituitary tumors affect the health of approximately 14 out of 100,000 people. In non-selective surgical series, this tumor accounts for approximately 25-30% of all pituitary adenomas. Some growth hormone (GH)–producing tumors also co-secrete prolactin. More than 90% of prolactinoma is microprolactinomas, which are much more common than macroprolactinomas.

title: Prolactinoma


text: User:Mirv/navbox

title: User:Mirv/navbox


text: User talk:146.129.225.230

title: User talk:146.129.225.230


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Tokyo Game Show

Tokyo Game Show (東京ゲームショウ), commonly known as TGS, is a video game trade fair and convention held annually in September in the Makuhari Messe, in Chiba, Japan. It is presented by the Computer Entertainment Supplier's Association (CESA) and Nikkei Business Publications, Inc. The main focus of the show is on Japanese games, but some international video game developers use it to showcase upcoming releases/related hardware. The duration of the event is four days. The first two days of Tokyo Game Show are open only to industry attendees (business) and the general public can attend during the final two days.

History
The first Tokyo Game Show was held in 1996. From 1996 to 2002, the show was held twice a year: once in the Spring and once in Autumn (in the Tokyo Big Sight). Since 2002, the show has been held once a year. 2011’s show hosted over 200,000 attendees and the 2012 show bringing in 223,753. The busiest TGS was in 2016 with 271,224 people in attendance and 614 companies had exhibits. The event has been held annually since 1996 and was never canceled, however the 2020 and 2021 editions were online only as a result of the COVID-19 pandemic. The 2022 edition returned to in-person exhibits. The 20th anniversary of TGS was celebrated in 2016. The 2016 attendance record was topped by 2018's attendance of 298,690 people.

Layout
The TGS layout varies per year. Such as in 2015, Tokyo Game Show showcased eleven exhibition areas consisting of business, general public, education and other areas to buy merchandise.

General Exhibition

The General Exhibition Area is the heart of the show, taking up the largest amount of space, and is held where digital gaming entertainment or any related products or services are showcased. Many well-known companies such as Namco Bandai, Capcom, Sony Computer Entertainment and Square Enix have demo areas here, in addition to emerging companies.

Game Device
This area covers gaming devices such as headphones, controllers, furniture and other devices associated with home-use gaming consoles and portable gaming devices.

Asia New Stars
An exhibition introduced at the 2012 Tokyo Game Show is geared towards introducing emerging game developers from Asia.

Merchandise Sales
This area is designated for merchandising of game-related goods. Vendors include Konami and Square-Enix.

Smartphone and social games
This area focuses on games for smart devices (smartphones and tablets) and social games. Despite record numbers during TGS 2012, many large companies had a smaller presence. For example, Microsoft, which previously had one of the largest booths, was absent in 2012. Social and mobile gaming surged, filling the gap. Microsoft returned to the show in 2013 with the release of the Xbox One.

Personal computing
The PC area houses major Japanese computing companies, showcasing products such as Japanese desktop and notebook computers.

Children
This area showcases new games that are aimed at a younger audience. Companies such as Taito and Sega are housed there.

Game school
The Game School area showcases information on Japanese universities and colleges offering information about digital art, animation, computer programming, and other programs of study related to the video game industry. These booths also display student work. It houses colleges such as Numazu Professional College of Information Technology and Tokyo Designer Gakuin College.

Sales
This is the main area in the games convention where most of the sales and business transactions between companies and consumers are carried out. Companies housed there include Nikkei Business Publications.

Cosplay

The Tokyo Game Show attracts many cosplayers. Cure, Japan's largest cosplay community website, hosts Cosplay Collection Night, a parade in stage show with more than 100 cosplayers on Saturday's night. The show starts from 6:30pm until 8 pm and it is hosted by Yunmao Ayakawa and Tatsumi Inui from the production team company CURE World Cosplay, with background music by DJ & MC: WAN. The participants are members of Worldcosplay website with a few international cosplayers who won contests in countries like Spain, Philippines, South Korea, Singapore, Indonesia, Turkey, the US, and China and others.

Business solutions
This is the main business area and is not open to the public.

Cloud/data center pavilion
The Cloud/Data Center is dedicated to improving infrastructure and environment of social and network games.

Street Fighter tournaments
The Tokyo Game Show has featured a Mad Catz-sponsored Street Fighter tournament since 2014. The competition is part of Capcom's official Pro Tour, making it a qualifying event for the Capcom Cup. The 2016 event was the first to not be sponsored by Mad Catz, as the company got in severe financial trouble during its 2016 fiscal year.

Sense of Wonder Night
Sense of Wonder Night (SOWN) is a presentation session held yearly at the TGS for showcasing innovative and experimental computer games mainly made by small game studios and independent game developers from all over the world, similar to and inspired by the GDC Experimental Gameplay Workshop. The first edition was held in 2008. Among former and current judges are Keita Takahashi and Simon Carless.

title: Tokyo Game Show


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Fess Parker

Fess Elisha Parker Jr. (born F. E. Parker Jr.; August 16, 1924 – March 18, 2010) was an American film and television actor best known for his portrayals of the title characters in the Walt Disney television miniseries Davy Crockett (1954–55; ABC) and the television series Daniel Boone (1964–70; NBC).

Early years
Parker was born in Fort Worth, Texas, and raised on a farm in Tom Green County near San Angelo. His father – born Fess Parker but later added the initial "E." – was a tax assessor. The name Fess had been given to him in honor of the educator and politician Simeon D. Fess. The future actor decided to change his name from F.E. Parker Jr. to Fess Elisha Parker Jr. He selected the middle name himself, when he was a teenager (about 1937), because it sounded rhythmic and matched his middle initial.

He enlisted in the U.S. Navy in the latter part of the Second World War,  hoping to become a pilot. He was turned down because he was too tall at 6 ft. He then tried to become a radioman gunner, but he was found too large to fit comfortably into the rear cockpit. He was finally transferred to the United States Marine Corps as a radio operator and shipped out to the South Pacific shortly before the war ended.

Discharged in 1946, he enrolled at Hardin–Simmons University in Abilene, Texas, with assistance from the GI Bill. After an automobile collision, he was stabbed in the neck by the other driver during an argument. He was an active member of the H-SU Players Club and transferred to the University of Texas at Austin in 1947 as a history major and continued to be active in drama. One of his roommates there was the future actor L.Q. Jones. Parker graduated from UT in 1950 with a degree in history. He had been initiated into the Pi Kappa Alpha fraternity. Having one year remaining on his GI Bill benefits, he studied drama at the University of Southern California, where he pursued a master's degree in theater history.

Career
Parker began his show-business career in the summer of 1951 when he had a $32-a-week job as an extra in the play Mister Roberts, although he is credited with the voice of Leslie the chauffeur in the 1950 film Harvey. Within months, he was on location with a minor part in Untamed Frontier with Joseph Cotten and Shelley Winters.

Parker became a contract player with Warner Bros., appearing in small roles in several films such as Springfield Rifle (1952), Island in the Sky, The Bounty Hunter, and Battle Cry. In 1954, he appeared as Grat Dalton in the Jim Davis syndicated Western Stories of the Century in the episode "The Dalton Brothers".

Davy Crockett

James Arness was first considered for the role of Davy Crockett. Parker had recently graduated to being a contract weekly actor but listened to his agent and appeared in a Warner Bros. science fiction film about giant ants called Them!, which required only one day's work. During the screening of this film, Walt Disney looked past Arness and discovered Parker. Disney was impressed by Parker's portrayal of a man who was unswerving in his belief in what he saw despite the forces of authority against him. They asked him to drop by the Disney Studio. When he did, he brought his guitar, met Disney, sang a song, and then said goodbye. Several weeks later, Disney informed him that he had been selected over Arness and several others for the role.

Disney's three-episode version of Crockett depicted his exploits as a frontiersman, congressman, and tragic hero of the Alamo. The episodes have been called the first television miniseries, though the term had not yet been coined. Davy Crockett (1954–55) was a tremendous hit and led to a merchandising frenzy for coonskin caps and more.

Parker became a contract star for Disney and appeared in The Great Locomotive Chase, Westward Ho, the Wagons!, Old Yeller, and The Light in the Forest. He complained that they were all basically the same role. Disney refused to lend Parker for roles outside that persona, such as Jeffrey Hunter's role opposite John Wayne in The Searchers and Marilyn Monroe's leading man in Bus Stop.

Parker was dissatisfied with Disney's proposal to use him only in a small role in Tonka. He was put on suspension for refusing the role, and subsequently left Disney.

Post Disney
Parker made guest appearances on many television programs, and composed and sang. He performed the occasional role of Tom Conrad, editor of the Diablo Courier in the syndicated western series, Annie Oakley (1954–1957), starring Gail Davis, Brad Johnson, and Jimmy Hawkins.

Parker was contracted to Paramount Pictures from 1958 to 1962. He appeared in a small assortment of Paramount movies, including a cameo as an unnamed frontiersman in Bob Hope's Western comedy Alias Jesse James and supporting roles in The Hangman (1959) with Robert Taylor, The Jayhawkers! (1959) with Jeff Chandler, and Hell Is for Heroes (1962) with Steve McQueen.

In 1962, he starred in the title role of the TV series Mr Smith Goes to Washington, portraying the same idealistic character that James Stewart had played in the 1939 film. Parker took to the stage in 1963, in a traveling production of Oklahoma! as Curly. The movie roles he sought were elusive. In 1966, Parker starred in the movie Smoky, directed by George Sherman where he played the role of Clint Barkley, who finds a black stallion named Smoky, a wild stallion who eventually becomes a wonderful cutting horse and the best friend an old cowboy could ever want.

Daniel Boone
Parker's Daniel Boone television series portraying another historic figure of America's frontier days began filming in 1964. Over its six years (1964 to 1970) as one of the highest-rated shows of its time, Parker was not only the star of the series, but also the co-producer and director of five of its most popular episodes.

Turning down the title role of McCloud, Parker retired from acting at the age of 49 after a sitcom pilot called The Fess Parker Show was broadcast on March 28, 1974, but was not subsequently picked up by the network.

Awards
Fess Parker was nominated for best new personality Emmy in 1954, but lost to George Gobel. He was never nominated again, nor was his show Daniel Boone.

In 1991, he was named a Disney Legend.

In 2003, Parker received the Texas Cultural Trust's "Texas Medal of Arts Award", established only the year before.

For his work with Disney, Parker was honored in December 2004 with his own tribute window on a façade in the Frontierland section of Disneyland.

Business and politics
Parker became interested in opening a Davy Crockett-themed amusement park. In the late 1960s, he optioned land in northern Kentucky at the intersection of Interstates 71 and 75, with the intention of building Frontier Worlds. However, when the Taft Broadcasting Company of Cincinnati, Ohio, began building Kings Island Amusement Park in nearby Mason, Ohio, less than a 2-hour drive from Parker's site, financing for Parker's venture dried up. Plans for the Frontier World park were eventually revitalized in Santa Clara, California and developed into California's Great America.

Fess Parker Winery
After his acting career, Parker devoted much of his time to operating his Fess Parker Family Winery and Vineyards in Los Olivos, California. The winery is owned and operated by Parker's family, and has produced several different types of award-winning wines. Parker's son, Eli, is president and director of winemaking and vineyard operations, while daughter, Ashley, is vice president of marketing and sales.

The Parker operation includes over 1500 acre of vineyards, and a tasting room and visitor center along the Foxen Canyon Wine Trail. In addition to wine, the winery is known for selling coonskin caps and bottle toppers inspired by Parker's Crockett and Boone characters, and for its appearance under another name in the movie Sideways. In reminiscence of his acting days, Parker's wine labels have a logo of a golden coonskin cap.

Politics
In 1985, Parker briefly flirted with running in 1986 for the United States Senate as a Republican for the seat of incumbent Democrat Alan Cranston. He considered himself a conservative in the mold of Ronald Reagan.

Personal life and death
Parker married Marcella Belle Rinehart on January 18, 1960. They had two children, Fess Elisha Parker III and Ashley Allen Rinehart, along with 11 grandchildren and a great-grandson.

Parker died of natural causes on March 18, 2010, at his home in Santa Ynez, California, near the Fess Parker Winery. He is buried in the Santa Barbara Cemetery with a simple headstone, and a coonskin hat inscribed below his name.

Television

 * Dragnet: The Big Winchester (March 5, 1954 - Season 3, Episode 27)
 * "Annie Oakley: (May 8th, 1954), Annie and the Texas Sandman"
 * Death Valley Days: (1954) Season 2, Ep 15, Kickapoo Run
 * Davy Crockett (miniseries 1954–1955)
 * City Detective (1 episode, 1955)
 * Mr. Smith Goes to Washington (1962–1963)
 * The Alfred Hitchcock Hour (1963) (Season 2 Episode 6: "Nothing Ever Happens in Linvale") as Sheriff Ben Wister
 * Daniel Boone (lead cast member from 1964 to 1970, with Ed Ames, Patricia Blair, Darby Hinton, and Veronica Cartwright)
 * Climb an Angry Mountain (1972)
 * The Fess Parker Show (1974) (unsold pilot)
 * Oz and James's Big Wine Adventure (2007) (as himself, discussing wine making)

title: Fess Parker


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Oligodendroglioma

Oligodendrogliomas are a type of glioma that are believed to originate from the oligodendrocytes of the brain or from a glial precursor cell. They occur primarily in adults (9.4% of all primary brain and central nervous system tumors) but are also found in children (4% of all primary brain tumors).

Signs and symptoms
Oligodendroglioma arise mainly in the frontal lobe and in 50–80% of cases, the first symptom is the onset of seizure activity, without having any symptoms beforehand. Headaches combined with increased intracranial pressure are also a common symptom of oligodendroglioma. Depending on the location of the tumor, many different neurological and neuropsychological deficits can be induced, including, but not limited to, visual loss, motor weakness, cognitive decline, and anxiety. A computed tomography (CT) or magnetic resonance imaging (MRI) scan is necessary to characterize tumor size, location, and hetero- or homogeneity. Final diagnosis relies on biopsy and histopathologic examination of the tumor mass.

Cause
The cause of oligodendrogliomas is unknown. Some studies have linked oligodendroglioma with a viral cause. A 2009 Oxford Neurosymposium study illustrated a 69% correlation between NJDS gene mutation and the tumor initiation. A single case report has linked oligodendroglioma to irradiation of pituitary adenoma.

Microscopic appearance

Oligodendrogliomas cannot currently be differentiated from other brain lesions solely by their clinical or radiographic appearance. As such, a brain biopsy is the only method of definitive diagnosis. Oligodendrogliomas recapitulate the appearance of the normal resident oligodendroglia of the brain. (Their name derives from the Greek roots 'oligo' meaning "few" and 'dendro' meaning "trees".) They are generally composed of cells with small to slightly enlarged round nuclei with dark, compact nuclei and a small amount of eosinophilic cytoplasm. They are often referred to as "fried egg" cells due to their histologic appearance (though, the perinuclear halo on permanent sections is an artifact of tissue drying; fresh tissue lacks this characteristic "fried egg" appearance). They appear as a monotonous population of mildly enlarged round cells infiltrating normal brain parenchyma and producing vague nodules. Although the tumor may appear to be vaguely circumscribed, it is by definition a diffusely infiltrating tumor.

Classically they tend to have a vasculature of finely branching capillaries that may take on a "chicken wire" appearance. When invading grey matter structures such as cortex, the neoplastic oligodendrocytes tend to cluster around neurons exhibiting a phenomenon referred to as "perineuronal satellitosis". Oligodendrogliomas may invade preferentially around vessels or under the pial surface of the brain.

Oligodendrogliomas must be differentiated from the more common astrocytoma. Non-classical variants and combined tumors of both oligodendroglioma and astrocytoma differentiation are seen, making this distinction controversial between different neuropathology groups. Molecular diagnostics may make this differentiation obsolete in the future. Although, in normal brain tissue, OLIG2 expresses on oligodendrocytes but not on mature astrocytes, it expresses similarly on both adult astrocytoma (including both IDH-mutant diffuse astrocytoma and anaplastic astrocytoma, as well as IDH-wildtype glioblastoma) and oligodendroglioma. Therefore, OLIG2 should not be used to differentiate these classes of adult gliomas, although the expression level might predict the IDH mutation status in some clinical circumstances.

Other glial and glioneuronal tumors with which they are often confused due to their monotonous round cell appearance include pilocytic astrocytoma, central neurocytoma, the so-called dysembryoplastic neuroepithelial tumor, or occasionally ependymoma.

Histopathological grading
The histopathologic grading of oligodendrogliomas is controversial. Currently, the most commonly used grading schema is based on the year 2007 World Health Organization (WHO) guidelines. An updated classification is in progress. Oligodendrogliomas are generally dichotomized into grade II (low grade) tumor.

Unfortunately, the WHO guidelines include subjective criteria in grade II. In addition, the presence of low mitotic activity, vascular proliferation and necrosis, including pseudopallisading necrosis, is insufficient by itself to elevate the grade of this tumor. This leads to inevitable interobserver variability in diagnosis by pathologists. The ultimate responsibility for making treatment decisions and interpretation of this diagnosis lies with the oncologist in consultation with the patient and their family.

It has been proposed that WHO guidelines should contain a category for grade IV oligodendrogliomas which essentially appear to be glial neoplasms with overwhelming features of glioblastoma multiforme (GBM) arising from known lower grade oligodendrogliomas or GBM with a significant proportion of oligodendroglial differentiation. The diagnostic utility of this latter category is uncertain as these tumors may behave either like glioblastoma or grade III Anaplastic oligodendrogliomas. As such, this is an exceptionally unusual diagnosis.

The updated WHO guidelines published in 2007 recommends classifying such tumors for the time being as 'glioblastoma with oligodendroglioma component'. It remains to be established whether or not these tumors carry a better prognosis than standard glioblastomas.

Molecular genetics
In WHO 2021 CNS5 Classification, oligodendroglioma is named "Oligodendroglioma, IDH-mutant, and 1p/19q-codeleted", and requires the presence of IDH1 or IDH2 mutations and the codeletion of chromosome 1p and 19q arms. Interestingly, oligodendroglioma has a higher rate of IDH2 mutation than astrocytoma, so the IHC antibody against the common IDH1 p.R132H mutant might not pick up the mutation.

By far, the most common structural deformity found is co-deletion of chromosomal arms 1p and 19q. The high frequency of co-deletion is a striking feature of this glial tumour and is considered as a "genetic signature" of oligodendroglioma. Allelic losses on 1p and 19q, either separately or combined, are more common in classic oligodendrogliomas than in either astrocytomas or oligoastrocytomas. In one study, classic oligodendrogliomas showed 1p loss in 35 of 42 (83%) cases, 19q loss in 28 of 39 (72%), and these were combined in 27 of 39 (69%) cases; there was no significant difference in 1p/19q loss of heterozygosity status between low-grade and anaplastic oligodendroglioma. 1p/19q co-deletion has been correlated with both chemosensitivity and improved prognosis in oligodendrogliomas. The gene products lost as a consequence of this codeletion may include mediators of resistance to genotoxic therapies. Alternatively, 1p/19q loss might be an early oncogenic lesion promoting the formation of glial neoplasms, which retain high sensitivity to genotoxic stress. Most larger cancer treatment centers routinely check for the deletion of 1p/19q as part of the pathology report for oligodendrogliomas. The status of the 1p/19q loci can be detected by FISH, loss of heterozygosity (LOH) analysis or virtual karyotyping. Virtual karyotyping has the advantage of assessing the entire genome in one assay, as well as the 1p/19q loci. This allows assessment of other key loci in glial tumors, such as EGFR and TP53 copy number status.

Whereas the prognostic relevance of 1p and 19q deletions is well established for mixed oligoastrocytomas, the prognostic relevance of the deletions for low-grade gliomas is more controversial. In terms of low-grade gliomas, a recent study also suggests that 1p/19q co-deletion may be associated with a (1;19)(q10;p10) translocation which, like the combined 1p/19q deletion, is associated with superior overall survival and progression-free survival in low-grade glioma patients. Oligodendrogliomas show only rarely mutations in the p53 gene, which is in contrast to other gliomas. Epidermal growth factor receptor amplification and whole 1p/19q codeletion are mutually exclusive and predictive of completely different outcomes, with EGFR amplification predicting poor prognosis. There is a strong correlation between 1p/19q codeletion and the expression of proneural genes, suggesting that gliomas with a 1p19q codeletion represent a subgroup of proneural gliomas.

Treatment
Oligodendrogliomas are generally considered to be incurable using current treatments. However compared to the more common astrocytomas, they are slowly growing with prolonged survival. In one series, median survival times for oligodendrogliomas were 11.6 years for grade II.

However, such figures can be misleading since they do not factor in the types of treatment nor the genetic signature of the tumors. A recent study analyzed survival based on chromosomal deletions and the effects of radiation or chemotherapy as treatment, with the following results (both low-grade and anaplastic oligodendrogliomas): 1p/19q deletion with radiation = 121 months (mean), 1p/19q deletion with chemotherapy = over 160 months (mean not yet reached), no 1p/19q deletion with radiation = 58 months (mean), and no 1p/19q deletion with chemotherapy = 75 months (mean).

Given the indolent nature of this tumor and the potential morbidity associated with neurosurgery, chemotherapy and radiation therapy, most neurooncologists will initially pursue a course of watchful waiting and treat patients symptomatically. Symptomatic treatment often includes the use of anticonvulsants for seizures and steroids for brain swelling.

The standard dosing schedule of temozolomide is five consecutive days of daily dosing during 28-day cycles. However, different dosing schedules may produce better results, such as continuous daily dosing using lower amounts of drug (e.g. 21-day dosing during 28-day cycles). As an example of an altered dosing schedule, promising results have been shown using lower daily doses on each day for 7 weeks, followed by a 4-week off periods. Regarding the duration of dosing, for oligodendrogliomas the duration prescribed by oncologists varies considerably ranging from 6 cycles to over 32 cycles (i.e. over three years). In one study, researchers compared patients who received temozolomide for at least 12 months on the 5/28 day cycle, dividing such patients into two groups: "short term" patients receiving temozolomide for 12–18 cycles and those "long term" patients receiving 19 or more cycles (range was 19 to 32 cycles). Researchers found that there was a statistically significant advantage for "long term" treatment (median progression free survival for "short term" patients was 95 weeks (follow-up of 73 weeks), but for "long term" patients the median progression free survival was not yet reached (follow-up of 134 weeks)).

Due to the diffusely infiltrating nature, oligodendrogliomas cannot be completely resected and are not curable by surgical excision. If the tumor mass compresses adjacent brain structures, neurosurgeons typically remove as much of the tumor as possible without damaging other critical, healthy brain structures. Surgery may be followed up by chemotherapy, radiation, or a mix of both, however recent studies suggest that radiation does not improve overall survival (even when age, clinical data, histological grading, and type of surgery are considered).

Prognosis
Oligodendrogliomas, like all other infiltrating gliomas, have a very high (almost uniform) rate of recurrence and gradually increase in grade over time. Recurrent tumors are generally treated with more aggressive chemotherapy and radiation therapy. Recently, stereotactic surgery has proven successful in treating small tumors that have been diagnosed early.

Long-term survival is reported in a minority of patients. With aggressive treatment and close monitoring, it is possible to outlive the typical life expectancies for low grade oligodendroglioma. Westergaard's study (1997) showed that patients younger than 20 years had a median survival of 17.5 years. For patients that are over 30, the survival rate is lower but as treatment options grow, the survival rate is higher. However, a patient with bad general health is more likely to die sooner than those that have good general health. Another study shows a 34% survival rate after 20 years. However, as discussed above, such figures can be misleading since they do not factor in the types of treatment nor the genetic signature of the tumors. Additionally, such historic data loses significance due to the relatively long survival of patients (compared to other types of brain tumors) and the introduction of newer treatment options over time.

title: Oligodendroglioma