1. The structural requirements of an allosteric barbiturate binding site on acetylcholine receptor-rich membranes isolated from Torpedo electroplaques have been characterized by the ability of fourteen...Full Text Available
BackgroundCerebral malaria (CM) is a neurological syndrome that includes coma and seizures following malaria parasite infection. The pathophysiology is not fully understood and cannot...Full Text Available
Therapeutic hypothermia is a promising method for controlling intracranial pressure (ICP) in severely brain-injured patients. However, clinical data regarding the effect of brain hypothermia on overall outcome of these patients is limited. This may be because there are specific pitfalls associated with the clinical management of induced hypothermia in patients with severe traumatic brain injury (TBI). These pitfalls may be avoided by preventing specific risk factors when cooling is induced and with rewarming. However, these risk factors have not been well systematically discussed in the literature. In this paper, three categories of clinical issues regarding the management of brain hypothermia are discussed: (1) stress-induced secondary brain injury mechanisms; (2) technical aspects of intensive care unit (ICU) cooling management; and (3) rewarming rates and methods. For patients with a Glasgow Coma Scale (GCS) score of less than 8, management of stress-induced ...
Purpose. To report a comparative prospective long-term functional analysis after Riboflavin UV A corneal cross-linking (CXL) in three different age groups of patients affected by progressive keratoconus (KC). Methods. Functional analysis comprised paediatric patients (?18 years) included 152 eyes (29.5%); intermediate group (19-26 years) 286 eyes (55.4%), and adults (?27 years) 78 eyes (15.1%). CXL was performed according to the Siena protocol by using the Vega CBM (Caporossi-Baiocchi-Mazzotta) X linker (CSO, Florence, Italy) at Siena University by the same authors. Pre- and post-op examinations included UCVA, BSCVA, corneal topography, and surface aberrometry (CSO Eye Top, Florence, Italy), at 48 months followup. Results. At 48 months followup paediatrics, intermediate, and adult patients showed a mean gain in UCVA of +0.2, +0.14 and +0.12 Snellen lines. BSCVA gained by a mean of +0.21, +0.2, and +0.1 Snellen lines. K(max) was reduced by a mean value of -0.9?D, -0.6?D, and -0.5?D, ...
Abstract P/2004 A1 (LONEOS) is one of the few active objects in the dynamical class of Centaurs. It has been recently injected into an inner orbit with a perihelion distance-q-= 5.5 au. The aim of this paper is to characterize the dust coma of this peculiar object, 2.5 yr after its first -new- perihelion passage inside the Solar system. Broad-band visible images taken at the TNG telescope in 2007 February were analysed in order to characterize the dust coma of the Centaur: it was still quite active at-rh-= 6.5 au post-perihelion, with a coma and a well-developed wide tail-like structure, with a measured-R-Af= 162 10-cm in an aperture radius = 104 km. The (V---R) colour and the reddening values depict a scenario of a slightly red dust coma. A dust mass-loss rate of--= 133 kg-s-1 is derived ...
We present the results of an isophotal shape analysis of three samples of galaxies in the Coma cluster. Quantitative morphology, together with structural and photometric parameters, is given for each galaxy. Special emphasis has been placed on the detailed classification of early-type galaxies. The three samples are: i) a sample of 97 early-type galaxies brighter than m_B = 17.00 falling within one degree from the center of the Coma cluster; these galaxies were observed with CCD cameras, mostly in good to excellent resolution conditions; ii) a magnitude complete sample of 107 galaxies of all morphological types down to m_B = 17.00 falling in a circular region of 50 arcmin diameter, slightly offcentered to the North-West of the cluster center; the images for this and the next sample come from digitized photographic plates; iii) a complete comparison sample of 26 galaxies of all morphological types down to m_R = 16.05 (or m_B \\simeq 17.5), also ...
Barbiturates substituted at the 5-position with organyltelluroalkyl or organylselenoalkyl groups were prepared by ring annulation of appropriately substituted diethyl malonates with urea or thiourea. The substituted diethyl malonates (phenyltellurobutyl(ethyl), i-propyltelluropropyl(ethyl), i-propyltelluropropyl(allyl), i-propyselenopropyl(ethyl), and phenylselenohexyl(methyl)) were prepared in 55-91% yield by reaction of diethyl omega-bromoalkyl(alkyl)malonates with organyltellurolates or selenolates (RXNa; X = Se, Te) in ethanol/benzene. The following barbiturates were obtained in 28-84% yield: phenyltellurobutyl(ethyl), m.p. 100/sup 0/C; i-propyltelluropropyl(ethyl), m.p. 119/sup 0/C; i-propylselenopropyl(ethyl), m.p. 137/sup 0/C; phenyl-selenohexyl(methyl), m.p. 124/sup 0/C. The 5-substituted thiobarbiturates i-propyltelluropropyl(ethyl)-(m.p. 75/sup 0/C) and i-propylselenopropyl(ethyl)thiobarbiturate (m.p. 83/sup 0/C) were isolated in 32 ...
... or she will start intensive rehabilitation. This includes physical therapy and occupational therapy. Physical and occupational therapies aim at strengthening the remaining ...
The abuse of volatile solvents may be due to their ability to produce an intoxication similar to that produced by classical central nervous system depressants such as the barbiturates and ethanol. To evaluate this hypothesis, mice were trained to discriminate pentobarbital from saline injections in a two-lever operant task. Stimulus generalization was examined following 20-min inhalation exposures to toluene (300-5400 ppm). In 8 of 10 subjects, pentobarbital-lever responding occurred following toluene exposure indicating an overlap in the discriminative stimulus properties of toluene and pentobarbital.
The diffuse background light in the Coma cluster is measured using isodensity tracings of B, G, V, and R photographic plates taken with the Palomar 1.2-m Schmidt telescope. The isodensity contours are calibrated using the star profile derived by Kormendy (1973). Between 4 and 14 arc min from the center, the surface brightness of the diffuse light decreases from approximately 26 to approximately 28 G magnitudes arc sec"-"2. The total magnitude in this annulus is G = 11.22, which is approximately 45 percent of the light in galaxies alone, or approximately 30 percent of the total. This does little to alleviate the ''missing mass'' problem. The isodensity contours and the equivalent profile of the diffuse light closely parallel the distribution of light in galaxies, implying no strong mass segregation. However, the background light appears to be bluer than the galaxies. This is consistent with the hypothesis that the background consists of stars tidally stripped from ...
We compared experimental wave aberrations in pseudophakic eyes with aspheric intraocular lenses (IOLs) to simulate aberrations from numerical ray tracing on customized computer eye models using corneal topography, angle ?, ocular biometry, IOL geometry, and IOL tilt and decentration measured on the same eyes. We found high correlations between real and simulated aberrations even for the eye with only the cornea, and these increased on average when the IOL geometry and position were included. Relevant individual aberrations were well predicted by the complete eye model. Corneal spherical aberration and horizontal coma were compensated by the IOL, and in 58.3% of the cases IOL tilt and decentration contributed to compensation of horizontal coma. We conclude that customized computer eye models are a good representation of real eyes with IOLs and allow understanding of the relative contribution of optical, geometrical and surgically-related factors ...
Abstract The authors provide a survey of how images are used in radiation therapy to improve the precision of radiation therapy plans, and delivery of radiation treatment. In contrast...Full Text Available
The anticonvulsant drugs carbamazepine, phenobarbital, trimethadione, valproic acid and ethosuximide at pharmacologically relevant concentrations inhibit (/sup 3/H)diazepam binding to astrocytes in primary cultures but have much less effect on a corresponding preparation of neurons. Phenytoin as well as pentobarbital (which is not used chronically as an anticonvulsant) are equipotent in the two cell types. The convulsants picrotoxinin and pentylenetetrazol, the convulsant benzodiazepine RO 5-3663 and the two convulsant barbiturates DMBB and CHEB similarly inhibit diazepam binding to astrocytes but have little effect on neurons. On the basis of these findings it is suggested that these convulsants and anticonvulsants owe at least part of their effect to an interaction with the astrocytic benzodiazepine receptor, perhaps by interference with a calcium channel.
There is limited information on the incidence of acute kidney injury (AKI) in patients with traumatic brain injury (TBI) although AKI may contribute to morbidity and mortality. We investigated the incidence of AKI in patients with moderate and severe TBI and the association of AKI with risk factors and outcomes in these patients. We studied all TBI patients over 16 years of age admitted to the two designated trauma hospitals in the state of Victoria, Australia from 1 January to 31 December 2008. Patients were included if they had head trauma and presented with a Glasgow coma scale (GCS) <13. Prospectively collected data from the hospital trauma registries, ICUs, and pathology databases were analyzed retrospectively. Risk injury failure loss end (RIFLE) criteria were used to categorize rena...
The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in ...
BackgroundTransarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers...Full Text Available
Forty-four patients with histologically proven Hodgkin's disease underwent initial treatment with extended-field radiation therapy. Nineteen of these patients also received combination chemotherapy....Full Text Available
The importance of intact host defense mechanisms for successful antimicrobial therapy was investigated in an animal model. Recovery from lobar pneumococcal pneumonia as a result of penicillin therapy...Full Text Available
Radionuclide bone metastases therapy is a major achievement of nuclear medicine. Development of less radiotoxic and more effective radiopharmaceuticals is therefore a challenge for radiopharmacists and industry. This paper reviews the application of rhenium-188 HEDP as a reactor- or generator-produced nuclide for bone metastases therapy. (author)
The current therapy for extrinsic and intrinsic asthma, together with that of ‘wheezing bronchitis’, is presented, with special attention to bronchodilators and adrenocorticosteroids....Full Text Available
The eye is an easily accessible, highly compartmentalised and immune-privileged organ that offers unique advantages as a gene therapy target. Significant advancements have been made in understanding...Full Text Available
PurposeTo determine the dosimetric impact of inter-fraction anatomical movements in prostate cancer patients receiving proton therapy.Full Text Available
1 Recommendations for correct therapy with digoxin from twenty-five sources are reviewed. 2 Some recommendations may be unsuitable for use with high bioavailability...Full Text Available
... radiation during clinical therapy and exposures due to radiation accidents or attacks, in which the doses are uncontrolled ... only be used off-label in victims of radiation accidents or attacks. The idea...
The synthesis of ["1"1C]phenobarbital, ["1"1C]pentobarbital and["1"1C]amobarbital labelled in the 5-[1-"1"1C]ethyl position is reported. The malonic esters R- CH(CO_2Et)_2 [R phenyl-, 1-methylbutyl-, and 3- methylbutyl- were alkylated with [1-"1"1C]ethyl iodide prepared from ["1"1C]carbon dioxide. Ring closure of the 2-[1-"1"1C]ethyl-labelled malonic esters with urea afforded 5-[1-"1"1C]ethyl-phenobarbital,-phenobarbital, -pentobarbital and -amobarbital synthesis times of 42-47 min, counted from ["1"1C] carbon dioxide. In typical syntheses starting with 3 GBq pentobarbitol and (81 mCi) ["1"1C]carbon dioxide, 150-215 MBq (4-6 mCi) were produced in 25-30% decay corrected -amobarbital radiochemical yields with radiochemical purities greater than 98%. (author).
To determine if barbiturates would protect brain at high doses of radiation, survival rates in rats that received whole-brain x-irradiation during pentobarbital- or lidocaine-induced anesthesia were compared with those of control animals that received no medication and of animals anesthetized with ketamine. The animals were shielded so that respiratory and digestive tissues would not be damaged by the radiation. Survival rates in rats that received whole-brain irradiation as a single 7500-rad dose under pentobarbital- or lidocaine-induced anesthesia was increased from between from 0% and 20% to between 45% and 69% over the 40 days of observation compared with the other two groups (p less than 0.007). Ketamine anesthesia provided no protection. There were no notable differential effects upon non-neural tissues, suggesting that pentobarbital afforded protection through modulation of ambient neural activity during radiation exposure. Neural suppression during ...
The effect of chronic administration of phenobarbital on the binding of phorbol-12,13-dibutyrate (({sup 3}H)PDBu), an activator of protein kinase C (PKC), was examined in rat liver microsomes. A significant increase in the number of binding sites was observed in microsomes of Fisher 344 rats. However, no change appeared in liver cytosol binding of PDBu. Consequently, a translocation process of PKC is unlikely. The increase in ({sup 3}H)PDBu binding in liver microsomes is significant 24 h. after one injection of phenobarbital and reaches its maximum in 2 days. In other strains of rats (ACI and lean Zucker), significant differences were found in the increase of ({sup 3}H)PDBu binding in microsomes. Fisher 344 were the most sensitive, lean Zucker rats, the least sensitive. Those results parallel the pentoxy-resorufin O demethylase activity in the microsomes of the same animals. EC{sub 50} values for inhibition of ({sup 3}H)PDBu binding by pentobarbital were determined in control ...
We present the results of a search for Extreme Ultraviolet emission in A4059, a cluster with an X-ray emitting cluster gas. Our analysis of Extreme Ultraviolet Explorer (EUVE) Deep Survey observations of this cluster shows that it is associated with diffuse EUV emission. Outside the central 2 arcmin radius the entire EUV emission detected is explained by the low energy tail of the X-ray emitting gas. Within the central 2 arcmin region of the cluster we find a deficit of EUV emission compared to that expected from the X-ray gas. This flux deficit is discussed in the context of the cluster's cooling flow. The results derived for A4059 are compared to EUVE results obtained for other clusters such as Coma, Virgo, A1795, and A2199. As part of the study we have carried out a detailed investigation of the stability of the EUVE Deep Survey detector background. Based on long integrations of blank sky over 27 months we disprove claims of substantial time dependent changes in ...
Radiation therapy has shown definite technical improvement due to application of proton beam irradiation. Clinical results of proton beam therapy also suggested enlargement of indication ranges in radial treatment and decrease of post radiation damages of the treatment of cancers in deep-seated organs. Inprovement of result in cancer therapy could be expected by this treatment technique in the future.
BackgroundTo compare two strategies of dynamic intensity modulated radiation therapy (dIMRT) with 3-dimensional conformal radiation therapy (3DCRT) in the setting of hypofractionated...Full Text Available
Radiotherapy can be very significant as the treatment for ocular lesions, eyes need to be preserved as properly as possible on their functions and cosmetics. The application of conventional X ray therapy has been gradually abandoned as conventional X ray therapy ceased to be accepted as the general treatment for malignant tumors. Consequently the necessity of electron beam therapy has been rising even as the substituted method for conventional X ray therapy. The department of radiology of Gunma University was obliged to establish a new therapy for ocular lesions, and has been trying electron beam therapy since 1973. It is concluded that electron beam therapy is not at all inferior to conventional X ray therapy as reported above. Basic therapeutic methods for ocular lesions are the following: 1) For epidermoid carcinoma, ...
The side effects of cancer therapy on normal tissues limit the success of therapy. Generation of reactive oxygen species (ROS) has been implicated for numerous chemotherapeutic agents including doxorubicin...Full Text Available
BackgroundIt remains unclear if certain antiretroviral medications, particularly abacavir, compromise response to hepatitis C virus (HCV) therapy. Such data can inform...Full Text Available
BackgroundAdolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART) care. However, data on outcomes...Full Text Available
A simple device is described which is used to determine treatment distance and beam direction in electron therapy employing one collimation. A technique for the production of irregular field templates and localization films is given.
ObjectivesTo investigate the effect of group cognitive behavioural therapy (CBT) for fatigue self-management, compared with groups receiving fatigue information alone, on fatigue...Full Text Available
BackgroundTo assess the relationship between improved regional and global myocardial function in patients with ischemic cardiomyopathy in response to β-blocker therapy or...Full Text Available
Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively...Full Text Available
Epidermal growth factor receptor (EGFR) related therapies – mainly tyrosine kinase inhibitors (TKIs) such as erlotinib and gefitinib, but also monoclonal antibodies targeting EGFR, for example,...Full Text Available
BackgroundThe aim of this study was to compare and to validate different dose calculation algorithms for the use in radiation therapy of small lung lesions and to optimize the treatment...Full Text Available
BackgroundThe lack of adequate randomized clinical trials (RCT) has hindered identification of new therapies that are safe and effective for patients with primary focal segmental...Full Text Available
Adaptive radiation therapy (ART) is the incorporation of daily images in the radiotherapy treatment process so that the treatment plan can be evaluated and modified to maximize the amount of radiation...Full Text Available
Photodynamic therapy (PDT) is an established endoscopic technique for ablating Barrett’s esophagus with high-grade dysplasia or early-stage intraepithelial neoplasia. The most common clinically...Full Text Available
BackgroundArtemisinin-based combination therapy, currently considered the therapy of choice for uncomplicated Plasmodium falciparum malaria in endemic countries,...Full Text Available
Several compact proton accelerator systems for use in proton therapy have recently been proposed. Of paramount importance to the development of such an accelerator system is the maximum kinetic energy...Full Text Available
The effect of Photofrin-based photodynamic therapy (PDT) and adjuvant treatment with serum vitamin D3-binding protein-derived macrophage-activating factor (DBPMAF) was examined using a mouse SCCVII...Full Text Available
BackgroundHerpes simplex virus (HSV) suppressive therapy reduces genital and plasma HIV-1 RNA over periods up to three months but the longer-term effect is unknown.Full Text Available
Somatic cell nuclear transfer or therapeutic cloning has provided great hope for stem cell-based therapies. However therapeutic cloning has been experiencing both ethical and technical difficulties....Full Text Available
ObjectiveTo evaluate the effect of different concomitant disease modifying antirheumatic drugs (DMARDs) on the persistence with antitumour necrosis factor (anti-TNF) therapies in...Full Text Available
Suppressed IL-12 production and maladaptive immune activation, both of which are ameliorated by successful highly active antiretroviral therapy (HAART), are thought to play important roles in the immunopathogenesis...Full Text Available
Purpose: Understanding the kinetics of tumor growth∕shrinkage represents a critical step in quantitative assessment of therapeutics and realization of adaptive radiation therapy....Full Text Available
Purpose:The risks and benefits of continuing bisphosphonate therapy beyond 5 years in patients with primary osteoporosis have not been well established.Methods:We...Full Text Available
The heterogeneity of metastatic breast cancer mandates the need to select therapies taking into account tumor and patient characteristics. Chemotherapy is indicated in the palliative setting especially...Full Text Available
Some studies suggest that giving radiation therapy after surgery for hilar cholangiocarcinoma improves the survival rate; however, many of these studies did not specify numbers of subjects or provide an impartial analysis. Thus, we evaluated the effectiveness of radiation therapy as adjuvant treatment after surgery and attempted to establish appropriate adaptation standards. We reviewed the records of 69 patients who underwent surgery for hilar cholangiocarcinoma between June 1980 and April 1998. Thirty-nine patients were treated with surgery followed by radiation therapy and 30 were treated with surgery alone. The clinicopathologic features that might have influenced prognosis were similar in the patients who received radiation therapy and those who did not. Radiation as adjuvant therapy did not have a beneficial effect on overall survival (P=0.554, log-rank test); however, it ...
Multiple disease-specific systematic reviews on the effectiveness of physical therapy intervention for shoulder dysfunction have been inconclusive. To date, there have been two systematic reviews that...Full Text Available
IntroductionThe optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT)...Full Text Available
... and at that point she had already failed physical therapy, which someone else had prescribed, and so ... MRI, we may try a brief course of physical therapy to see if they feel better, but ...
PurposeA dosimetric comparison between multiple static-field intensity-modulated radiation therapy (IMRT), multi-arc intensity-modulated arc therapy (IMAT) and single-arc...Full Text Available
ObjectiveTo report the efficacy and safety of combined photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) injection in the treatment of idiopathic polypoidal choroidal...Full Text Available
Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing blood loss, workload, and costs. Early clotting is related to bioincompatibility,...Full Text Available
This study was an evaluation of the performance of self-applied, blue light, light-emitting diode therapy in the treatment of mild-to-moderate inflammatory acne on the face, concerning: 1) time to improvement...Full Text Available
This joint statement was developed by the CMA and the Canadian Pharmaceutical Association, a national association of pharmacists, and includes the goal of drug therapy, strategies for collaboration...Full Text Available
BackgroundPostnatal glucocorticoid therapy in premature infants diminishes chronic lung disease, but it also increases the risk of hypertension in adulthood. Since glucocorticoid...Full Text Available
Adjuvant therapy aims to prevent outgrowth of residual disease but can induce serious side effects. Weighing conflicting treatment effects and communicating this information with patients is not elementary....Full Text Available
In many radiotherapy clinics, geometric uncertainties in the delivery of 3D conformal radiation therapy and intensity modulated radiation therapy of the prostate are reduced by aligning the...Full Text Available
The proton therapy gives an irradiation adapted to the shape and the depth of tumors ( eyes, head and neck) with a millimetric, even sub millimetric precision for the ophthalmological tumors. It is equally an excellent tool for the pediatrics tumors. For numerous treatments in France the proton therapy is associated to the photons treatments (x radiation). however, others physical treatments could modulate the medical offer, such thermal therapy or treatments by ultrasonic waves. (N.C.)
An electron accelerator unit is described for electron beam therapy, comprising: a source of an electron beam; means for finally directing at least a portion of the beam to a therapy site, the directing means being mechanically independent of, and electrically isolated from, the source, and having a target area; and means for aligning the source with the directing means, the aligning means comprising means for projecting at least one beam of light from the source toward the target area.
An electron accelerator unit is described for electron beam therapy, comprising: a source of an electron beam; means for finally directing at least a portion of the beam to a therapy site, the directing means being mechanically independent of, and electrically isolated from, the source, and having a target area; and means for aligning the source with the directing means, the aligning means comprising means for projecting at least one beam of light from the source toward the target area.
The Monte Carlo transport codes LAHET and MCNP were used to calculate energy fluence spectra at three neutron therapy facilities. The results compare very favourably with measured data. Kerma spectra and the ratio of ICRU muscle tissue kerma to A-150 kerma, along the carbon to oxygen kerma ratio, were determined. Absorbed dose rate calculations are in reasonable agreement with measured values. Use of these codes to study modifications to existing therapy beams is briefly discussed. (author).
The anesthetic agents methohexital (Brevital), Innovar, and ketamine (Ketaject) were examined for their effect on seizure duration following electroconvulsive stimulation in a rat model of electroconvulsive therapy (ECT). Compared to unanesthetized control animals, methohexital anesthesia shortened seizure duration by 42%, ketamine anesthesia tended to increase seizure duration, and Innovar anesthesia had no effect on duration of seizures. PMID:7349626
Objectives: To minimize movement artifacts during tracer imaging studies, the animals are generally sedated. Although many reports describe the effect of barbiturates on brain function, less is published about the general impact on the extracerebral metabolism and tracer biodistribution. This report describes the influence of pentobarbital on tumor uptake of ["1"2"3I]-2-iodo-L-phenylalanine (["1"2"3I]-2I-L-PA) using dissection and nuclear imaging. Methods: R1M tumor-bearing athymic mice were divided into two populations: untreated and pentobarbital-treated. Each group was subjected to dynamic and static planar imaging and organ dissection after ["1"2"3I]-2I-L-PA injection. Two-compartment blood modeling was performed. Analysis of variance (ANOVA), t test and clustered boxplot analyses were used to compare the results between the treatment groups and between the data acquisition methods. Results: Two-compartment blood modeling demonstrated that pentobarbital ...
The patient positioning and repositioning control in radiation therapy all along the treatment can be conducted using a variety of X-ray sources and imaging detector devices. The development of image guided radiation therapy techniques leads to more frequent use of this imaging control. In this article we summarize the current methods for measuring the dose delivered by X-ray imaging devices used in radiation therapy, as well as basic proposals to take account of these imaging doses for prescribing, recording and reporting radiation therapy treatment. (authors)
AbstractBackground: So far, infliximab (IFX) therapy for the treatment of Crohn's disease (CD) has generally been guided by clinical symptoms. Data on treatment response as ascertained by endoscopy in IFX therapy are scarce. The aims of this study were to measure the endoscopic response rate during IFX induction and maintenance therapy in luminal CD, and also evaluate the role of endoscopy in monitoring IFX therapy. Methods: Data obtained from 71 patients with active luminal CD and treated with IFX were analyzed retrospectively. The endoscopy findings were scored according to mucosal activity as: 0 (remission), 1-2 (mild), 3-4 (moderate), and 5-6 (severe). A positive endoscopic response was determined by a decrease in score of at least two points and mucosal healing was assigned a score of...
Purpose: A retrospective analysis was undertaken to determine the indications for, the efficacy of, and the long-term complications of two courses of total skin electron beam therapy for mycosis fungoides. Methods and Materials: A retrospective analysis of 15 patients with the pathologic diagnosis of mycosis fungoides treated in the Department of Radiation Oncology at Stanford University Medical Center between 1968 and 1990 was performed. All patients received two courses of high-dose electron beam therapy to the skin. The mean dose for the total skin treatment for the first course was 32.6 Gy and 23.4 Gy for the second course of treatment. Results: Following the first course of total skin electron beam therapy, 11 of 15 had a complete response, with a mean duration of 11.6 months. All patients received adjuvant therapies between the first and second courses of high-dose total skin electron beam ...
Little clinical evidence has been provided to show the minimization of radiation resistance of tumors using high linear energy transfer radiation. We therefore investigated the radiobiological and molecular pathological aspects of carbon beam therapy. A total of 27 patients with squamous cell carcinoma (SCC) of the cervix were treated using a carbon beam and 50 control patients with SCC of the cervix using a photon beam. The expression of Ki-67, p53, and p27 proteins before radiotherapy and 5 and 15 days after therapy initiation were investigated using immunohistochemistry. Similar changes were observed in Ki-67 labeling index (LI) and p53 LI during carbon and photon beam therapies. However, for carbon beam therapy, the mean p27 LI significantly decreased from 25.2% before treatment to 18.6% on the 5th day after treatment initiation, followed by a significant increase to 36.1% on the 15th day. In ...
Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means ...
Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means ...
Acute vertebrobasilar occlusion (VBO) is associated with a high risk of stroke and death. Although local thrombolysis may achieve recanalization and improve outcome, mortality is still between 35% and 75%. However, without recanalization the chance of a good outcome is extremely poor, with mortality rates of 80-90%. Early treatment is a fundamental factor, but detailed studies of the exact time management of the diagnostic and interventional workflow are still lacking. Data on 18 patients were retrospectively evaluated. Time periods between symptom onset, admission to hospital, time of diagnosis, and beginning of intervention were correlated with postinterventional neurological status. The Glasgow Coma Scale and National Institute of Health Stroke Scale (NIHSS) were used to examine patients before and after local thrombolysis. Additionally, multivariate statistics were applied to reveal similarities between patients with neurological improvement. Primary ...
Background: the fact that therapeutic irradiation can induce significant stenosis in the arteries of the head, neck, and chest, as welt as in the aorta and the iliac arteries, is familiar in daily practice and well documented in the literature. By contrast, radiation-induced renal artery stenosis seems to be a less widely known complication. Patients and methods: the sudden onset of medically refractory arterial hypertension and coma in a 27-year-old man is reported, who had been treated at age 20 with chemotherapy and radiotherapy for Ewing's sarcoma in the lumbar region. This treatment had been performed at the hospital of Sion, Switzerland in 2001. Also, the relevant literature from 1965 to 2007 is reviewed to underscore various aspects of this problem and to demonstrate the clinical relevance of renal artery stenosis as a potential long-term sequela of radiotherapy. Conclusion: radiation-induced renal artery stenosis has only rarely been described in the ...
Under support from the French Space Agency (CNES), a 3D+t dusty-gas model of Comet 67P/Churyumov-Gerasimenko is being developed, to compute, from the first 2014 Rosetta orbital data, the aerodynamic forces exerted on the Rosetta orbiter and on the descent lander. We report the recently developed dust dynamics part of the code. The multi-species (presently H2O and CO) gas code is optimized in terms of computational speed owing to the use of two complementary methods: (a) 3D+t Direct Simulation Monte Carlo (DSMC) runs in the non-equilibrium regions adjacent to the surface and very distant from it, and (b) solutions of the Navier-Stokes equations in-between. The model is used presently using Lamy et al. (Space Sci. Rev., 2007, 128, 23) coarse information on 67P nucleus shape and rotation, and a range of possible gas production rates Q for the early Rosetta observations at rh 3 AU (Q 1026 - 1027 s-1). In the interim version, simplifying assumptions are made with respect to the physical ...
For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed. (review)
Electron beam therapy has often been used for radiation therapy of carcinomas of the buccal mucosa, though side effects, including stomatitis and dermatitis, are known to exist. We experimented using the additional back scatter and transit with the phantom under a lead plate within the irradiation field, in order to better focus the dose on the target volume moreover, we fabricated a mouthpiece fitted with a lead plate shaped to the target volume, and with respect to the influence of the mouthpiece on stomatitis and dermatitis, obtained good clinical results. (author).
Electron beam therapy has often been used for radiation therapy of carcinomas of the buccal mucosa, though side effects, including stomatitis and dermatitis, are known to exist. We experimented using the additional back scatter and transit with the phantom under a lead plate within the irradiation field, in order to better focus the dose on the target volume moreover, we fabricated a mouthpiece fitted with a lead plate shaped to the target volume, and with respect to the influence of the mouthpiece on stomatitis and dermatitis, obtained good clinical results. (author).
Conformal radiation therapy represents a considerable and attractive challenge in oncology. Its aim is mainly to improve local control by increasing the dose with an acceptable rate of complications. This work overviews the world literature on this subject. The technical and theoretical requirements are highlighted. These requirements include a precise definition of the target volume by digital imaging (essentially CT scan), but also clear view of the target volume and the organs at risk, a specific collimation of the beam, 3-D dose calculations, optimization procedures, and a rigid immobilization of the patient with verification of his position. Moreover, the clinical applications of conformal radiation therapy are reviewed and discussed. (authors). 80 refs., 1 tab.
Prostate cancer can be successfully treated using dynamic adaptive external beam radiation techniques along with interstitial brachytherapy to deliver curative therapies with low urinary, rectal and erectile function morbidity. Through the use of sophisticated, state-of-the art radiographic imaging for staging and treatment planning, a precise, individual design for treatment is accomplished. Symptom management and patient education are of paramount importance and are integrated throughout the treatment process.
Innovative therapy may appear to coincide with medical experimentation, raising ethical and legal issues, for instance on informed consent and institutional review. Medical treatments may be classified,...Full Text Available
Background and ObjectivePulsed dye laser (PDL) treatment of cutaneous vascular lesions is associated with variable and unpredictable efficacy. Thus, alternative treatment...Full Text Available
Objectives: Acupuncture has served as a major complementary and alternative therapy that supplements conventional medicine and is the subject of growing public interest. This study was conducted to estimate the usage rate of acupuncture as a supplemental treatment in acute ischaemic stroke patients and to identify factors associated with the choice to use this therapy. Methods: Using the registry of stroke patients admitted to an academic medical centre in Korea, the use of acupuncture therapy was recorded and analysed, along with the patients' socio-demographic characteristics, hospital access variables, risk factors for ischaemic stroke and clinical characteristics. The data were analysed using descriptive statistics, chi-square tests and multiple logistic regression analyses. Results: O...
Mycosis fungoides (MF) in deep-seated lymph nodes, spleen or liver appears to be associated with a lack of response of the disease to topical external therapy. Fourteen patients with mycosis fungoides...Full Text Available
Summary: The increasing emergence of antimicrobial-resistant organisms, especially methicillin-resistant Staphylococcus aureus (MRSA), has resulted in the increased...Full Text Available
Despite high local control rate in Ewing's sarcoma the exact indication of radiation therapy is still controversial as well as the choice of the target volume and the optimal dose of radiation. The importance of the quality of radiotherapy has been stressed in recently published data and has shown a significant impact on long term local control with adequate radiation therapy. The dramatic improvement of precision allowed by the conformal therapy and three dimensional dosimetry allow to expect a decrease of late effects expected for second malignancies. However, late sequelae and radio-induced osteosarcoma still remain the major side effects after radiotherapy. The authors discuss the results of the main trials on Ewing's sarcoma on the choice of dose and target volume. Surgery is still the preferred choice for small tumors if the foreseen outcome is identical. (authors). 28 refs.
Structured abstractObjectiveAlthough most reviews of Pseudomonas aeruginosa therapeutics focus on antibiotics currently in use or...Full Text Available
The success of monoclonal antibodies in clinical practice is dependent on good design. Finding a suitable target is the most important part as other properties of the antibody can be altered by genetic...Full Text Available
Penile rehabilitation therapy following radical prostatectomy is a much debated topic. Erectile dysfunction is still a significant contributor to postoperative morbidity following radical prostatectomy, despite meticulous nerve-sparing technique. Secondary smooth muscle changes in the penis have been identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and fibrosis. Initial observations that intracavernous injection therapies used on a regular basis postoperatively resulted in improvements in the return of spontaneous erectile function led to the development of penile rehabilitation protocols. Chronic dosing of PDE-V inhibitors is now commonly used by urologists after radical prostatectomy. Despite the current enthusiasm of penile rehabilitation therapy, current scientific evidence with clinical trials is still limited. PMID:19255627
PurposeTo identify the extent of persistence (period of time of continuous therapy with the drug prescribed) of glaucoma patients treated with prostaglandins (latanoprost, bimatoprost,...Full Text Available
BackgroundStump and phantom pains are debilitating sequelae of amputations that are often resistant to treatment. The efficacy of pharmacologic therapies, including...Full Text Available
Modern advances in the concept and the techniques of megavoltage radiation therapy have revolutionized the treatment of medulloblastoma. Five-year survivals of 50 to 70 percent are achieved by craniospinalaxis...Full Text Available
BackgroundLymphangioleiomyomatosis (LAM) is a rare lung disease characterised by progressive airflow obstruction. No effective medical treatment is available but therapy with sirolimus...Full Text Available
SYNOPSISPreterm infants are at risk for both iron deficiency and iron overload. The role of iron in multiple organ functions suggests that iron supplementation is essential for...Full Text Available
Hyperglycemia frequently occurs with acute medical illness, especially among patients with cardiovascular disease, and has been linked to increased morbidity and mortality in critically ill patients....Full Text Available
Invasive fungal infections can be devastating, particularly in immunocompromised patients, and difficult to treat with systemic drugs. Furthermore, systemic administration of those medications...Full Text Available
Development of Portable Normobaric Hypoxia and Pulsed Magnetic Field Firmware System for Enhancement of Radio- and Non-specific Resistance in Workers of Environmentally Hazardous Industries
An elderly man receiving chlorambucil for chronic lymphatic leukaemia developed focal fits. The onset and frequency were dose related. There was no evidence of metabolic disturbance or of meningeal...Full Text Available
The potential of radiolabelled phenylpiperazines as agents for the detection and therapy of tumours of neural crest origin was evaluated by in vitro pharmacological studies with human neuroblastoma...Full Text Available
The clinical results of electron beam therapy using intraoral cone in 8 cases of primary and recurrence carcinoma of tongue (T1 and smaller T2) were reported. The primary and recurrence cases were 5 and 3, respectively. In the 5 cases, a total dose of 10-30 Gy external radiation therapy were combined prior to electron beam therapy. The total dose of electron beam therapy varied from 40 to 60 Gy. In all cases, tumor showed good response and disappeared clinically. Radiation stomatitis, pain of the tongue with masticatory disturbance due to tenderness were complicated in all cases. These complications gradually disappeared 2 to 6 months after treatment. However, loss of body weight and bone exposure were not recognized in any case. Intraoral-cone electron beam therapy is thought to be available and has less complications comparing interstitial irradiation therapy ...
Purpose: The purpose of this study was to evaluate the efficacy and toxicity of replication-competent adenovirus-mediated double suicide gene therapy in an adjuvant setting with external beam radiation therapy (EBRT) in an experimental prostate cancer model in preparation for a Phase I clinical study in humans. Methods: For efficacy studies, i.m. DU145 and intraprostatic LNCaP C4-2 tumors were established in immune-deficient mice. Tumors were injected with the lytic, replication-competent Ad5-CD/TKrep adenovirus containing a cytosine deaminase (CD)/herpes simplex virus thymidine kinase (HSV-1 TK) fusion gene. Two days later, mice were administered 1 week of 5-fluorocytosine + ganciclovir (GCV) prodrug therapy and fractionated doses of EBRT (trimodal therapy). Tumor control rate of trimodal therapy was compared to that of EBRT alone. For toxicology studies, immune-competent male mice ...
BackgroundTo investigate the effects of intravenous lignocaine infusions (IV lignocaine) in fibromyalgia.MethodsProspective study...Full Text Available
SynopsisAttention-deficit / hyperactivity disorder (ADHD) is a valid and impairing psychological disorder that persists into adulthood in a majority of cases and is associated...Full Text Available
BackgroundAlthough advances in rehydration therapy have made cholera a treatable disease with low case-fatality in settings with appropriate medical care, cholera continues...Full Text Available
... mammography or on ultrasound but not found on physical examination, we consider them non-palpable or not ... lot of this. We send every patient for physical therapy, no matter what type of reconstruction we ...
Previous research with individuals undergoing surgery or diagnostic procedures provided a conceptual framework for analysis of radiation therapy, a common form of cancer treatment. The present...Full Text Available
Antimony toxicity occurs either due to occupational exposure or during therapy. Occupational exposure may cause respiratory irritation, pneumoconiosis, antimony spots on the skin and gastrointestinal...Full Text Available
Adaptive radiation therapy for liver cancer has the potential to reduce normal tissue complications and enable dose escalation, allowing the potential for tumor control in this challenging site....Full Text Available
BackgroundAdequate pain assessment is critical for evaluating the efficacy of analgesic treatment in clinical practice and during the development of new therapies. Yet the currently...Full Text Available
BackgroundHamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol...Full Text Available
A previously healthy young man experienced several episodes of syncope while being treated with tenofovir, emtricitabine and nevirapine initiated during primary HIV-1 infection. Symptoms disappeared after discontinuation of antiretroviral therapy and we suggest that syncope may be a side effect to one of the three antiretroviral drugs that has not been described previously.
During the past 10 years, five infants with Kasabach-Merritt syndrome (K-M) receiving radiation therapy were reported. We investigated whether radiation therapy for K-M was useful and what the unfavorable factors of K-M were. During the past 10 years, we have treated five infants with K-M. The syndrome occurred at ages ranging from birth to 4 months. The incidence of female to male ratio was 3:2. Among 5 cases, the site of hemangioma was as follows; shoulder, anterior chest wall, lower abdominal wall, face and neck and inguinal site. All 5 cases received medication to control the coagulopathy including prednisone and blood transfusion at first. Because the platelet count and the bleeding tendency did not improve in any case, these cases received radiation therapy. Total dose ranged from 5 to 10 Gy and fraction-size ranged from 0.5 to 1.75 Gy. Irradiation session was 2 or 3 times per week. In 5 cases, 4 cases showed cure of ...
A tiered communications architecture for managing network traffic in a distributed system. Communication between client or control computers and a plurality of hardware devices is administered by agent and monitor devices whose activities are coordinated to reduce the number of open channels or sockets. The communications architecture also improves the transparency and scalability of the distributed system by reducing network mapping dependence. The architecture is desirably implemented in a proton beam therapy system to provide flexible security policies which improve patent safety and facilitate system maintenance and development.
OBJECTIVE: To present recent evidence on the use of ovarian hormone therapy (OHT) for osteoporosis and outline safe and effective regimens. OPTIONS: Estrogen alone, estrogen and progestins, progestins...Full Text Available
Recent literature indicates that torsion of the left ventricle (LV) is a promising predictor for response to cardiac resynchronisation therapy (CRT). Among patients with severe heart failure, 45 to 75% of patients show rigid body rotation, where the base and apex rotate in the same direction, instead of normal, opposite rotation. The occurrence of this phenomenon seems to be a good indicator for response to CRT. From this review, it can be concluded that LV torsion might be a welcome addition to current selection criteria.
In the 21st century, eighty years after William Baer presented his groundbreaking work treating bone and soft tissue infections with live maggots, thousands of therapists around the globe have rediscovered...Full Text Available
Purpose: To assess the relationship between large intracranial vessel occlusive vasculopathy (vasculopathy) and radiation therapy, and to clarify the clinical efficacy of magnetic resonance (MR) imaging in the diagnosis and screening of the vasculopathy. Methods and Materials: We retrospectively evaluated the medical records and serial MR images for 32 pediatric patients, in whom radiation therapy had been given to fields including the circle of Willis and major cerebral arteries. All children had periodically undergone follow-up neurologic assessment and MR imaging examinations at Kanagawa Children's Medical Center for more than one year after radiation therapy (range 1.3-14 years). Patients who had not remained free of tumor progression up to the time of final evaluation were excluded. Results: Vasculopathy developed in 6 of 32 patients 2-13 years after radiation therapy. Three of them presented with ...
Cell therapy is a promising novel option for treatment of cardiovascular disease. Because the role of bone marrow-derived circulating progenitor cells (BM-CPCs) after cell therapy is less clear, we...Full Text Available
Electron beam therapy applied to a lymph node metastasis from a squamous cell carcinoma was followed by the development of histologically and immunologically typical bullous pemphigoid, the lesions being initially strictly confined to the irradiation area. This observation suggests that the bullous pemphigoid antigen may be altered or unmasked by electron beam radiotherapy, leading subsequently to the production of autoantibodies. The disease in this case effectively responded to the administration of tetracycline and niacinamide, a therapeutic regimen described recently.
A case is presented in which the diagnosis of acute myelomonocytic leukemia was made 16 months after the start of irradation and chemotherapy for Ewing's sarcoma. The association of these two diseases is rare. The etiologic role of therapy in the development of leukemia is speculative in this case. However, there is need for surveillance for secondary neoplasms of all types so that the benefits of therapy may be properly weighed against the risks.
The outcome was retrospectively examined and prognostic factors were discussed for arterial chemo-infusion therapy (ACT) through an implanted reservoir system and radiation therapy (RT) in patients with unresectable intrahepatic cholangiocarcinoma (CCC). ACT plus RT were conducted to 25 patients (mean age 61.7 y, M/F 12/13, stage III-IVB) during 10 years from 1996 to 2005 with various regimens of cisplatin (CDDP), 5- fluorouracil (FU), epirubicin (FARM), mitomycin C (MMC) plus 39-50 Gy of radiation in a fractionated manner partly involving internal RT (2 cases, 15 Gy) and RT for metastatic bone (1, 25 Gy). The survival rates at 1, 2 and 3 years after ACT+RT were respectively 52.5, 43.7 and 28.1%; total efficacy (PR) was 36% (9/25) at 6 months; and significantly good prognostic factors were found to be female and absence of metastasis remote and/or lymphatic around artery. Authors concluded that ACT+RT was a meaningful treatment for highly ...
Sprengel deformity is a congential malformation with usually unilateral elevation and medial rotation of the scapula. An omovertebral bone is generally present. Associated skeletal malformations are frequently present. Though functional impairment is mild, the cosmetic and psycho-social impairment can be considerable. The prognosis of early surgical therapy is good. The presented case also justifies surgical correction in the older child. (orig.) [German] Die Sprengel-Deformitaet ist eine angeborene Fehlbildung mit meist einseitiger Elevation und Medialrotation der Skapula. Meist ist ein Os omovertebrale vorhanden. Assoziierte skelettale Fehlbildungen sind haeufig. Obgleich funktionell wenig einschraenkend, ist die kosmetische und psycho-soziale Beeintraechtigung oft erheblich. Die Prognose der fruehen operativen Therapie ist gut. Der vorliegende Fall ermutigt zur operativen Therapie auch im hoeheren Kindesalter. (orig.)
Until recently no active treatment for advanced or metastatic gastrointestinal stroma tumors (GIST) was available. The tyrosine kinase inhibitor imatinib has revolutionized the treatment of this disease and the median overall survival now reaches 5 years. The standard dose of imatinib is 400 mg per day. Locally advanced GIST should be treated with systemic therapy prior to surgical resection. Imatinib was recently licensed for adjuvant therapy following complete surgical removal of GIST in patients with a significant risk of recurrence. (orig.) [German] Bis vor einigen Jahren existierte keine wirksame systemische Therapie fuer fortgeschrittene oder metastasierte gastrointestinale Stromatumoren (GIST). Der Tyrosinkinaseinhibitor Imatinib hat die Behandlung dieser Tumoren revolutioniert, die mediane Ueberlebenszeit liegt heute bei etwa 5 Jahren. Die Standarddosierung von Imatinib betraegt initial 400 mg/Tag. Lokal ...
Two cases of primary Ewing's sarcoma of the rib are reported, in which radiation therapy was quite effective. Case 1 was an 18-year-old female who had had an operation and radiation therapy for Ewing's sarcoma of the left 7th rib. She was referred to our hospital after a recurrent tumor was found. Radiation therapy (tumor dose 46.2 Gy) and chemotherapy were given. The tumor disappeared and there has been no relapse for 1 year and 3 months after the treatment. Case 2 was a 2-year-old-infant. Radiation therapy (tumor dose 74 Gy) was given for primary Ewing's sarcoma of the left 6th rib. The tumor became small and was successfully removed at operation. There has been no relapse or distant metastasis for 8 months following the operation. We emphasize the importance of multidisciplinary treatment in case 1 and the usefulness of preoperative radiotherapy in case 2. (author).
Purpose: The results of therapy in 288 men with pathologic Stage C prostate cancer who underwent radical retropubic prostatectomy (RRP) were analyzed to determine the effects of adjuvant therapy. Methods and Materials: Twenty-seven of the 288 patients received preoperative neoadjuvant hormonal therapy (leuprolide acetate). Postoperatively, 60 patients received adjuvant radiotherapy (RT) to the prostate bed. Follow-up ranged from 3 to 83 months (median = 32 months). Freedom from failure (FFF) was defined as maintaining a serum PSA level of #<=# 0.3 ng/ml. Results: The FFF was 61% at 3 years and 45% at 5 years for the entire group. The FFF following RRP plus RT was 75% at 3 years and 57% at 5 years as compared to 56% at 3 years and 40% at 5 years for RRP without RT (p = 0.049). The FFF following RRP plus neoadjuvant hormonal therapy was 58% at 3 years and 40% at 5 years as compared to 60% at 3 years ...
Retrospective analyses were performed to evaluate the therapeutic efficacy of intra-oral cone (IOC) radiation therapy for carcinoma of the oral tongue, especially about its faculty of local control and complications. Thirty-nine patients with squamous cell carcinoma of the oral tongue were treated with IOC radiation therapy alone or in combination with external irradiation. IOC radiation therapy was given not only for T1 and T2, but also for T3 tumors. Hypofractionation was used for IOC radiation therapy. The 2 year local control rates, including surgical salvage, for T1, T2, T3 and T4 were 100%, 73.3%, 40% and 0%, respectively. The 5 year actuarial survival rates for Stage I, II, III and IV were 100%, 65.3%, 35.4% and 0%, respectively. The incidences of radiation complications, i.e. soft tissue ulceration and osteoradionecrosis, were 42.9% and 2.9%, respectively. It is suggested that relatively high ...
The results of 144 previously untreated cases of primary Ewing's sarcoma of bone are reported with a minimum follow-up of 5 years. This series was treated between 1972 and 1982 at Istituto Ortopedico Rizzoli with a combined therapy. The local control of the disease consisted of amputation (ten cases), resection followed by radiation therapy (35-45 Gy) (48 cases) and radiation therapy alone (40-60 Gy) (86 cases). Adjuvant chemotherapy, rigorously standardized, was performed according two different protocols: the first (85 cases treated in the period 1972-1978) consisted of vincristine (VCR) Adriamycin (doxorubicin) (ADM), and cyclophosphamide (EDX); the second (59 cases treated in the period 1979-1982) of VCR, ADM, EDX and dactinomycin (DACT). At a follow-up of 5 to 16 years (median, 9), 59 patients (41%) are continuously disease-free (CDF), 81 (56%) developed metastatic disease and/or local recurrence, and four (3%) had a ...
Objective A number of effective treatments for bulimia nervosa have been developed, but they are infrequently used, in part due to problems with dissemination. The goal of this study was to examine the cost effectiveness of telemedicine delivery of cognitive behavioral therapy for bulimia nervosa. Method A randomized controlled trial of face-to-face versus telemedicine cognitive behavioral therapy for bulimia nervosa. One hundred twenty eight women with DSM-IV bulimia nervosa or eating disorder, not otherwise specified subsyndromal variants of bulimia nervosa were randomized to 20 sessions of treatment over 16 weeks. A cost effectiveness analysis from a societal perspective was conducted. Results The total cost per recovered (abstinent) subject was $9324.68 for face-to-face CBT, and $7300....
Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The ...
Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The ...
The invention refers a procedure of radiation dose control in irradiated tissues during electron-beam therapy. It aims at meeting the planned radiation dose for diseased tissues and taking care of the healthy ones. Therefore, the dose distribution required is determined before irradiation in consideration of such factors as energy-dependence of detector sensitivity, self-absorption within the tissue, and relative biological effectiveness. Furthermore, the expected intensity distribution of secondary quantum radiation excited in the irradiated tissue is calculated. A radiation detector for local resolution is used for registration. During irradiation the calculated intensity distribution is compared with the measured one. The invention is applicable in radiation therapy with monoenergetic electron beams.
Portal localization images for high-energy electron beam therapy are necessary to confirm the treatment field by comparing them with a simulation image obtained before treatment or portal verification images after treatment. In this study, portal localization images were acquired using the computed radiography (CR) system and bremsstrahlung X-rays generated in the electron beam irradiations. All images obtained with phantom and the irradiations of in the electron energy of 8, 10, 12 and 15 MeV were feasible for clinical use. The CR system used in this study included general diagnostic imaging cassette and storage phosphor plate, but none of other special devices. The system can usually supply portal localization images, which maintains the quality assurance of high-energy electron beam therapy. (author)
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-#alpha# antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-#alpha# antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
Therapeutic decisions are quite clear-cut for asymptomatic gallstone disease and acute cholecystitis. However, the appropriate therapeutic course for older patients with chronic cholecystitis may be less obvious. Watchful waiting may be reasonable for patients with mild and infrequent symptoms. For healthy patients, cholecystectomy is recommended if symptoms are becoming more frequent and severe. Laparoscopy may reduce the complication rate and be safely performed even in those with underlying medical illness. Oral dissolution therapy can be attempted for qualifying symptomatic patients who are at poor surgical risk or who refuse surgery. Shock wave lithotripsy and contact dissolution therapy show some promise but are currently experimental. PMID:8339941
A long-term follow-up of a patient with beta thalassaemia with intra- and extraspinal extramedullary haematopoietic tissue compressing the spinal cord is presented. Extramedullary haematopoietic nodules are a rare cause of spinal cord compression and should be included in the differential diagnosis, especially in patients from Mediterranean countries. Treatment with radiation therapy solely failed, giving rise to the need of surgical intervention. Surgical decompression of the spine and the removal of the culprit lesion compressing the spine were performed. Postinterventional radiation therapy was applied to the spine. A relapse had to be treated again by surgical means combined with postinterventional radiation therapy. A complete relief of the symptoms and control of the lesion could be obtained.
The philosophy pervading the treatment approach to Ewing's sarcoma was to have therapy encompass all foci of disease, including sites of occult or potential involvement in addition to obvious clinical manifestations. The experience with integrated methods of treatment in 66 consecutive patients at the National Cancer Institute is reviewed. A median survival of 18 months (44 percent 2 year survival rate) for patients with recognizable metastases on admission bears impressive witness to the value of adjuvant therapy in Ewing's sarcoma. Even more encouraging, an uncorrected 5 year survival rate of 53 percent (42 percent continuously free of disease) for patients given ''pyrophylactic'', adjuvant therapy indicates the potential for permanent control of disease in a significant fraction of cases with clinically localized primary tumors. (U.S.).
This study investigated dose to bone tissue in electron beam therapy. Measurements were made using films and thermoluminescent dosimeters in a polystyrene phantom containing bone inhomogeneity for 15-MeV, 12-MeV, and 9-MeV electron beams. An increase in dose of approximately 18%, 12%, and 11%, for the three electron energies respectively, relative to the dose in polystyrene, was found for bone material having an electron density (relative to water) of 1.73. Measurements were also made using films for 15- and 9-Mev electrons in a phantom with a mandibular bone and teeth. A dose enhancement in bone of approximately 10% and 7%, respectively, for the two energies was found in the phantom where the electron density of bone was about 1.60. These results suggest that injury to bone is possible in those clinical situations where high doses of electrons are used for therapy.
This study investigated dose to bone tissue in electron beam therapy. Measurements were made using films and thermoluminescent dosimeters in a polystyrene phantom containing bone inhomogeneity for 15-MeV, 12-MeV, and 9-MeV electron beams. An increase in dose of approximately 18%, 12%, and 11%, for the three electron energies respectively, relative to the dose in polystyrene, was found for bone material having an electron density (relative to water) of 1.73. Measurements were also made using films for 15- and 9-Mev electrons in a phantom with a mandibular bone and teeth. A dose enhancement in bone of approximately 10% and 7%, respectively, for the two energies was found in the phantom where the electron density of bone was about 1.60. These results suggest that injury to bone is possible in those clinical situations where high doses of electrons are used for therapy.
In everyday radiotherapy we must carry out the determination of absorbed dose measurement according to JARP's protocol. We explained an outline of JARP's 1974 and 1986 protocol in electron beam therapy, and mentioned it about the matter that should examined. To use it easily in clinic, a simplified procedure based on precisely to JARP's 1986 protocol is practical, the character of this procedure settles briefly the determination of mean incident energy of electron beams and get ready to table of ionization to absorbed dose conversion factor for various ionization chamber. Also, this procedure almost not influence on the accuracy of determination. We described systematically practical procedure for requisite absorbed dose calculation in a patient in electron beam therapy. (author).
Primary percutaneous coronary intervention (PPCI) is superior to thrombolysis (TL) as reperfusion therapy in ST-elevation myocardial infarction (STEMI). TL is a rapidly available, but semi-effective therapy (effective reperfusion in 50% of patients only), whereas PPCI is a potentially delayed, but highly effective therapy (effective reperfusion in >90%). Since TL loses its efficacy beyond 2?3?h after symptom onset, it is a significant reperfusion alternative to PPCI in early presenters only. The individual decision to treat an early presenter with PPCI or TL requires the evaluation of the time delay between potential start of TL or PPCI, the PCI-related delay (PRD). PRD is greatest, if TL is given in the prehospital setting. Until now, prehospital TL as the most rapidly available reperfusi...
In this study we investigated cultural, familial, and individual beliefs that influenced international students? perceptions of therapy and help-seeking behaviors. Included were changes in perception or behavior before and after the students came to the US, and factors that influenced help-seeking behaviors. Six international students from East Asian countries where English is a foreign language, including Taiwan, Mainland China, Japan, and South Korea, were interviewed. We used semi-structured interviews and participant observations for collecting data. The findings indicated changes after students came to the US. Further discussions focus on encouraging and discouraging factors relative to seeing therapists, and culturally sensitive interventions for family therapy clinicians.
Records of 154 patients with Ewing's sarcoma treated at the National Cancer Institute were reviewed to assess the incidence and risk of developing isolated central nervous system (CNS) Ewing's sarcoma. Sixty-two of the 154 patients had received CNS irradiation and intrathecal (i.t.) methotrexate as part of their initial therapy to prevent the occurrence of isolated CNS Ewing's sarcoma. The risk of developing isolate CNS Ewing's sarcoma was greatest within the first two years after diagnosis and was approximately 10%. The overall risk of CNS recurrence in the group of patients receiving DNS treatment was similar to the group receiving no therapy directed to the CNS. The occurrence of isolated CNS involvement was not prevented by the use of CNS irradiation and i.t. methotrexate. Because of a lack of efficacy to the CNS irradiation regimen, current treatment regimens do not include therapy directed to CNS.
A nonviral vector for highly efficient site-specific integration would be desirable for many applications in transgenesis, including gene therapy. In this study we directly compared the genomic integration...Full Text Available
Atypical hemolytic uremic syndrome (aHUS) is a heterogeneous disease that is caused by defective complement regulation in over 50% of cases. Mutations have been identified in genes encoding both complement...Full Text Available
AbstractThe optimal definition of the size, shape and location of gross tumour volume is one of the most important steps in the planning of radiation therapy, and necessitates a proper...Full Text Available
PurposeWe conducted a comparative study of Clinical Target Volume (CTV) definition of pelvic lymph nodes by multiple GU radiation oncologists looking at the levels...Full Text Available
Albeit the considerable progress that has been made both in our understanding of the pathophysiology of acute renal failure (ARF) and in its treatment (continuous renal replacement therapies), the morbidity...Full Text Available
AbstractThere is an urgent need for innovative therapies against ovarian cancer, one of the leading causes of death from gynecological cancers in the United States. Immunotherapy employing...Full Text Available
Background: Patients with a typical depression are more likely to respond to monoamine oxidase inhibitors than to tricyclic antidepressants. They are frequently offered psychotherapy...Full Text Available
HIV-1 nonsubtype B variants account for the majority of HIV infections worldwide. Drug resistance in individuals who have never undergone antiretroviral therapy can lead to early failure and...Full Text Available
Two large, prospective, randomized, controlled trials have shown a beneficial effect of intensive insulin therapy (IIT) on the kidney function of critically ill patients. The data from these trials...Full Text Available
Most breast cancers are multicentric in origin. They drain into two primary lymphatic depots—the axilla and internal mammary chain of nodes. The incidence of metastasis to the internal mammary...Full Text Available
Recent reports confirm that, due to the presence of long-lived, latently infected cell populations, eradication of human immunodeficiency virus type 1 (HIV-1) from infected patients by using antiretroviral...Full Text Available
For intensity modulated radiation treatment (IMRT) dose reconstruction, multileaf collimator (MLC) log files have been shown applicable for deriving delivered fluence maps. However, MLC log files are...Full Text Available
The difficulties created by the lack of generally accepted views on classification, diagnostic criteria and natural history of the cutaneous lymphomata are discussed. Only the lymphomata which remain...Full Text Available
After lifestyle and behavioral measures to control overactive bladder, the mainstay of pharmacological treatment is the use of antimuscarinic therapy. Overactive bladder predominantly affects older...Full Text Available
PurposeTo date there remains no effective therapy for metastatic melanoma and at the molecular level disease progression remains poorly understood. Recent work by...Full Text Available
Monogenic autoinflammatory diseases encompass a distinct and growing clinical entity of multisystem inflammatory diseases with known genetic defects in the innate immune system. The diseases...Full Text Available
Shoulder pain is a common orthopedic condition seen by physical therapists, with many potential contributing factors and proposed treatments. Although manual physical therapy interventions for the cervicothoracic...Full Text Available
Human antibodies targeting prostate cancer cell surface epitopes may be useful for imaging and therapy. The objective of this study was to evaluate the tumor targeting of an internalizing human...Full Text Available
Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following...Full Text Available
Chronic pain patients who show aberrant drug-related behavior often are discontinued from treatment when they are noncompliant with their use of opioids for pain. The purpose of this study was...Full Text Available
Microplanar beam radiation therapy has been proposed to treat brain tumors by using a series of rapid exposures to an array of parallel x-ray beams, each beam having uniform microscopic thickness and...Full Text Available
Oxidative stress contributes to the pathophysiology of exposure to heavy metals/metalloid. Beneficial renal effects of some medications, such as chelation therapy depend at least partially on the ability...Full Text Available
... 46 DOUGLAS BOCCUZZI, MS, DABR: There are some electromagnetic fields in the room, not strong. You can ... 5 weeks or is she feeling any side effects? 00:43:33 SUSAN Y. KIM, MD: She ...
Patients with Alport syndrome progressively lose renal function as a result of defective type IV collagen in their glomerular basement membrane. In mice lacking the α3 chain of type IV collagen...Full Text Available
BackgroundDiscovery of biomarkers that are correlated with therapy response and thus with survival is an important goal of medical research on severe diseases, e.g. cancer. Frequently,...Full Text Available
Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS associated with BPH. Mainstays...Full Text Available
Although major inroads into making antiretroviral therapy available in resource-poor countries have been made, there is an urgent need for an effective vaccine administered shortly after birth, which...Full Text Available
Recurrent or primary carcinoma of the breast en cuirasse, which may involve the skin of the entire thorax and abdomen, cannot be controlled by means of surgery or conventional local irradiation. The...Full Text Available
IntroductionIrradiation of normal, non-malignant bone during cancer therapy can lead to atrophy and increased risk of fracture at several skeletal sites, particularly...Full Text Available
The etiology of major depression remains unknown, but dysfunction of serotonergic signaling has long been implicated in the pathophysiology of this disorder. p11 is an S100 family member recently...Full Text Available
BackgroundIn β-thalassemia, profound anemia and severe hemosiderosis cause functional and physiological abnormalities in various organ systems. In recent years, there have...Full Text Available
SummaryRadiotherapy is used commonly in the treatment of gynecologic malignancies. Many patients experience emotional distress prior to the initiation of radiotherapy, during...Full Text Available
Incidence of esophageal cancer (EC) is rising more rapidly in the Western world than that of any other cancer. Despite advances in therapy, more than 50% of patients have incurable disease at the time...Full Text Available
BackgroundThe aim of this double-blind randomized study is to test the efficacy of a radio electric stimulator device using an auricular reflex therapy protocol for stress-related...Full Text Available
BackgroundThis study aimed to assess whether endoscopic implantation of an injectable esophageal prosthesis, the Gatekeeper Reflux Repair System (GK), is a safe and effective therapy...Full Text Available
Erectile dysfunction following radical prostatectomy remains a frequent problem despite the development of nerve-sparing techniques. This erectile dysfunction is believed to be neurogenic, enhanced by hypoxia-induced structural changes which result in additional veno-occlusive dysfunction. Recently, daily use of intracavernous vasoactive substances and oral use of PDE5-inhibitors have been clinically studied for treatment of postprostatectomy erectile dysfunction. Since these studies showed benefits of "penile rehabilitation therapy," these effects have been studied in a preclinical setting. We reviewed experimental literature on erectile tissue preserving and neuroregenerative treatment strategies, and found that preservation of the erectile tissue by the use of intracavernous nitric oxide donors or vasoactive substances, oral PDE5-inhibitors, and hyperbaric oxygen therapy improved erectile function by antifibrotic effects and preservation of ...
Idiopathic frozen shoulder is a common medical diagnosis for patients seeking physical therapy. Radiographic and surgical evidence exists that describes the coracohumeral ligament (CHL) as a major contributor...Full Text Available
1 Measuring total plasma levels of disopyramide (DP) and the main metabolite mono-N-dealkyldisopyramide (MND) in patients on maintenance therapy with DP has shown concentrations of MND comparable with...Full Text Available
Eight patients who had received megavoltage therapy for Cushings' disease 5-12 years previously have been reviewed. The long term response to this therapy was assessed with respect to efficacy of treatment in inducing continued remission and disturbance of hypothalamic-pituitary function. One patient showed clear evidence of relapse of Cushings' disease. One patient had unequivocal hypopituitarism. Basal levels of growth hormone (GH), TSH, LH, and FSH were not statistically different from controls, but provocative testing revealed significant abnormalities of response of cortisol/ACTH, GH, prolactin and LH. Six out of eight patients had absent diurnal cortisol variation and five patients had elevated serum prolactin levels. Thus, in this group of patients normal pituitary-adrenal function has not been satisfactorily restored. It is clear that significant disturbances of hypothalamic-pituitary function follow megavoltage ...
Eight patients who had received megavoltage therapy for Cushings' disease 5-12 years previously have been reviewed. The long term response to this therapy was assessed with respect to efficacy of treatment in inducing continued remission and disturbance of hypothalamic-pituitary function. One patient showed clear evidence of relapse of Cushings' disease. One patient had unequivocal hypopituitarism. Basal levels of growth hormone (GH), TSH, LH, and FSH were not statistically different from controls, but provocative testing revealed significant abnormalities of response of cortisol/ACTH, GH, prolactin and LH. Six out of eight patients had absent diurnal cortisol variation and five patients had elevated serum prolactin levels. Thus, in this group of patients normal pituitary-adrenal function has not been satisfactorily restored. It is clear that significant disturbances of hypothalamic-pituitary function follow megavoltage ...
The ability to achieve tumor selective expression of therapeutic genes is an area that needs improvement for cancer gene therapy to be successful. One approach to address this is through the...Full Text Available
BackgroundThe aim of the study was to compare the prevalence and types of HIV-related oral lesions between children and adult Tanzanian patients on HAART with those not on HAART...Full Text Available
BackgroundReplication capacity (RC) of specific HIV isolates is occasionally blamed for unexpected treatment responses. However, the role of viral RC in response to antiretroviral...Full Text Available
Cognitive rehabilitation is an effective intervention for addressing cognitive impairments in patients with schizophrenia. Previous research has shown that the early application of Cognitive...Full Text Available
Voxel-based prescriptions of deliberately non-uniform dose distributions based on molecular imaging, so-called dose painting or theragnostic radiation therapy, require specification of a transformation...Full Text Available
Since the beam width on the helical tomotherapy machine produced by TomoTherapy, Inc. is typically a few centimeters in the longitudinal direction (into the bore), the optimizer must choose...Full Text Available
BackgroundStem cell characteristics are an important feature of human cancer cells and play a major role in the therapy resistance of tumours. Strategies to target cancer stem cells...Full Text Available
BackgroundRetinitis pigmentosa (RP) is characterized by progressive night blindness, visual field loss, altered vascular permeability and loss of central vision. Currently there...Full Text Available
The long-term goal of nuclear transfer or alternative reprogramming approaches is to create patient-specific donor cells for transplantation therapy, avoiding immunorejection, a major complication in...Full Text Available
Neurodegenerative and infectious disorders including Alzheimer’s and Parkinson’s diseases, amyotrophic lateral sclerosis, and stroke are rapidly increasing as population’s...Full Text Available
The 37/67-kd laminin receptor, LAMR, is a multifunctional protein that associates with the 40S ribosomal subunit and also localizes to the cell membrane to interact with the extracellular matrix. LAMR...Full Text Available
BackgroundThe precise mechanisms involved in the initiation and progression of rheumatoid arthritis (RA) are not known. Early stages of RA often have non-specific symptoms, delaying...Full Text Available
BackgroundIntrafractional motion results in local over- and under-dosage in particle therapy with a scanned beam. Scanned beam delivery offers the possibility to compensate target...Full Text Available
1 An in vitro technique is described for measuring the uptake of 86Rb by human erythrocytes. 2 Fifteen patients were treated with digoxin for atrial fibrillation and other fast arrhythmias. 3 86Rb uptake...Full Text Available
In 1871, the observation of yellowish nodules in the enlarged spleen of a cow was considered to be the first reported case of bovine leukemia. The etiological agent of this lymphoproliferative disease,...Full Text Available
BackgroundThe proteomics approach termed proteome pattern analysis has been shown previously to have potential in the detection and classification of breast cancer. Here we aimed...Full Text Available
Tea ranks second only to water as a major component of fluid intake worldwide and has been considered a health-promoting beverage since ancient times. For the past two decades, we and others...Full Text Available
Patients with haemarthros of the knee were examined by MRI and arthroscopy to identify the bleeding source and to determine surgical or conservative therapy. A prospective study was performed on 120 patients who underwent MRI and arthroscopy, point lesions and bleeding sources were documented separately on a standardised form. Arthroscopy demonstrated a ruptured anterior cruciate ligament in 86%, meniscal tears in 55%, disruption of collateral ligaments in 17%, osteochondral lesions in 5% and tears of capsule or plicae in 13%. Disruption of cruciate ligaments caused haemorrhage in all but three cases. In contrast, only meniscal tears located very adjacent to the meniscal basement had bled. Those types of osteochondral lesions caused haemorrhage characterised on MRI by destruction of the subchondral plate and overlying cartilage. Severe lesions of the knee were diagnosed by MRI in 71% to 100%, slight lesions in 13% to 40% of the cases. Single, combined and bland ...
35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG) [Deutsch] 35 Patienten mit klinischem Verdacht auf Aussenbandruptur wurden mit der MRT untersucht. 13 Patienten wurden operiert, 22 konzervativ therapiert. Letztere wurden nach drei Monaten erneut mit MRT und gehaltenen Aufnahmen untersucht. Die MRT-Befunde stimmten in 12 von 13 Faellen mit den operativ erhobenen Befunden ueberein. Nach dreimonatiger konzervativer Therapie waren alle 22 Sprunggelenke stabil. Die rupturierten Baender stellten sich verdickt und durchgaengig dar. (orig./MG)
In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)
Despite the demonstrated clinical efficacy of CD20 monoclonal antibody (mAb) for lymphoma therapy, the in vivo mechanisms of tumor depletion remain controversial and variable. To identify the molecular...Full Text Available
Sixty glaucomatous eyes of 60 patients treated with laser trabeculoplasty as primary therapy were reviewed retrospectively. There were 42 eyes with capsular glaucoma and 18 with simple glaucoma. The...Full Text Available
Penile rehabilitation has been an area of intense study and debate over the last decade. Interest in this topic was stimulated by the observation that erectile dysfunction remained a significant problem after radical prostatectomy despite meticulous nerve-sparing technique. Smooth muscle alterations and fibrotic changes in the penis were identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and Peyronie's-like changes that were observed after surgery. Initial observations that intracavernous injection therapies used on a regular basis postoperatively resulted in improvements in the return of spontaneous erectile function led to the development of penile rehabilitation protocols. Chronic dosing of oral type V phosphodiesterase inhibitors is now commonly used by urologists after radical prostatectomy despite a lack of convincing evidence from randomized, placebo-controlled clinical trials. Use of local therapies to ...
BackgroundHuman immunodeficiency virus type 1 (HIV-1) infection frequently causes neurologic disease, which is the result of viral replication and activation of macrophages and microglia...Full Text Available
A Legionella-like organism (strain 1087-AZ-H) was isolated from a pleural-fluid specimen from a renal transplant patient undergoing immunosuppressive therapy. Growth characteristics and gas-liquid chromatography...Full Text Available
Path analysis was used to determine the interrelationships between postpartum administration of gonadotrophin releasing hormone and cloprostenol and the occurrence of reproductive disease and reproductive...Full Text Available
Bolus infusion of insulin along with a meal is a standard procedure with continuous subcutaneous insulin infusion. Modern insulin pumps allow applying this bolus in four different ways: infusion of...Full Text Available
The development of azole resistance in Candida albicans is most problematic in patients with AIDS who receive long courses of drug for therapy or prevention of oral candidiasis. Recently,...Full Text Available
It is possible to slow down the progression of Alzheimer's disease with pharmacological treatment. When this treatment is given to people with types of dementia that affect the frontal and temporal lobes (Frontotemporal Dementia) the results are discouraging. It is observed that the patients show pronounced restlessness and mania. In this article we describe a nonpharmacological psychosocial approach, music therapy, and how it is possible to work with this method when constitutional, regulative, dialogical, and integrative aspects are included. The focus is on therapeutic singing where well-known songs are applied in order to build up structure and stability and/or as means of arousal regulation. Songs with personal meaning make it possible to acknowledge the person's emotions, breaking the social isolation, and meeting the music therapy participant's psychosocial needs. The clinical approach is an integration of a relational music ...
Immunotherapy has shown promise in a number of tumor types, but its exact role in sarcoma remains to be defined. Advanced bone and soft tissue sarcomas are challenging diseases to treat with an unmet...Full Text Available
ContextResponse Evaluation Criteria in Solid Tumors [RECIST (unidimensional)], World Health Organization [WHO (bi-dimensional)] and European Association for Study...Full Text Available
Neuropilin-1 (NRP1) acts as a co-receptor for class 3 semaphorins and vascular endothelial growth factor and is an attractive angiogenesis target for cancer therapy. In addition to the transmembrane...Full Text Available
The identification of host cell factors for virus replication holds great promise for the development of new anti-viral therapies. Recently, high-throughput screening methods have emerged as...Full Text Available
Human blinding disorders are often initiated by hereditary mutations that insult rod and/or cone photoreceptors and cause subsequent cellular death. Generally, the disease phenotype can be predicted...Full Text Available
BackgroundRecessive mutations in guanylate cyclase-1 (Gucy2d) are associated with severe, early onset Leber congenital amaurosis-1(LCA1). Gucy2d...Full Text Available
Background:Stem cells can differentiate into multiple cell types, and therefore can be used for cellular therapies, including tissue repair. However, the participation of stem cells...Full Text Available
BackgroundSeveral diseases, many of which nowadays pandemic, consist of multifactorial pathologies. Paradigmatic examples come from the immune response to pathogens, in which cases...Full Text Available
BackgroundIn patients with Stage 5 Chronic Kidney Disease who require renal replacement therapy a major decision concerns modality choice. However, many patients defer the decision...Full Text Available
BackgroundHerbs and other dietary supplements are among the most commonly used complementary medical therapies. However, clinicians generally have limited knowledge, confidence and...Full Text Available
Patients experiencing several cancers can be a challenge, as optimal treatment options for the different cancers might interfere with each other. In this case report, we present a woman diagnosed with...Full Text Available
Inhaled corticosteroids (ICS) are often prescribed as first-line therapy for patients with asthma Despite their efficacy and improved safety profile compared with oral corticosteroids, the potential...Full Text Available
SummaryEpigenetic drugs have been shown to enhance gene expression and drug sensitivity in ovarian cancer cell lines and animal models. Based on promising pre-clinical studies,...Full Text Available
Colistin is increasingly used as last-line therapy against Gram-negative pathogens. The pharmacokinetic (PK)/pharmacodynamic (PD) index that best correlates with the efficacy of colistin remains undefined....Full Text Available
BackgroundAn artemisinin-based combination therapy, artesunate (AS) plus sulphadoxine-pyrimethamine (SP), was compared to SP monotherapy to provide evidence of further treatment...Full Text Available
BackgroundDespite numerous treatments available for deteriorated cutaneous wound healing such as a diabetic foot, there is still the need for more effective therapy. Adipose-derived...Full Text Available
Glioblastoma, the most common malignant brain tumor, is among the most lethal and difficult cancers to treat. Although epidermal growth factor receptor (EGFR) mutations are frequent in glioblastoma,...Full Text Available
Background:Continuous renal replacement therapy is used to manage fluid and solute imbalances in critically ill patients but may affect the clearance of concurrently administered...Full Text Available
Purpose:To investigate the clinical usage of dose verification of Helical Tomotherapy plans by using 2D-array ion chambers, and to develop an efficient way to validate the dose delivered...Full Text Available
Authors developed a C-arm type radiosurgery system of the linear accelerator suitable for stereotactic radiation therapy and a software for arranging 3-dimensional therapy in the system. In this system, the gantry far conical irradiation of 4 MV (0.6-3 Gy/min) and 6 MV (0.9-4.5 Gy/min) X ray or electron beam for the therapy was connected to a newly designed C-arm and was made capable of rotating around either of the axes crossing vertically. With this system, it became unnecessary to move the bed table of the patient for getting suitable distribution of radiation dose. The local accuracy which was measured by the CCD videocamera on the gantry, was within 0.5 mm from the radiation center. The system made it possible to shorten the irradiation time and to improve the local accuracy of irradiating site. The clinical trial was begun from June, 1996. (K.H.)
Recent preclinical and clinical data suggest that TP53 status and TP53 mutations may be important in determining tumour aggressiveness and therapy response. In this study we investigate the feasibility...Full Text Available
Lung cancer is the leading cause of cancer deaths worldwide. Standard chemotherapy has been shown to improve quality of life and has a modest influence on overall survival. This modest improvement in...Full Text Available
The results of clinical trials conducted in Europe and North America have been incorporated into treatment strategies for breast cancer in Japan. Despite the use of similar treatment regimens, why has...Full Text Available
Prostatic neoplasms are not uniformly distributed within the prostate volume. With recent developments in three-dimensional intensity-modulated and imageguided radiation therapy, it is possible to treat...Full Text Available
BackgroundLoss to follow-up (LTF) challenges the reporting of antiretroviral treatment (ART) programmes, since it encompasses patients alive but lost to programme and deaths misclassified...Full Text Available
PurposeA major obstacle in glioblastoma (GBM) therapy is the restrictive nature of the blood-brain barrier (BBB). Convection-enhanced delivery (CED) is a novel method...Full Text Available
Clinical applications of genetic therapies, including delivery of short, interfering RNAs (siRNAs) for RNA interference (RNAi), are limited due to the difficulty of delivering nucleic acids...Full Text Available
BackgroundPolyethyleneimine (PEI), which can interact with negatively charged DNA through electrostatic interaction to form nanocomplexes, has been widely attempted to use as a gene...Full Text Available
BackgroundTo compare the differences in dose-volume data among coplanar intensity modulated radiotherapy (IMRT), noncoplanar IMRT, and helical tomotherapy (HT) among patients with...Full Text Available
Compact dielectric wall (DWA) accelerator technology is being developed at the Lawrence Livermore National Laboratory. The DWA accelerator uses fast switched high voltage transmission lines to generate pulsed electric fields on the inside of a high gradient insulating (HGI) acceleration tube. Its high electric field gradients are achieved by the use of alternating insulators and conductors and short pulse times. The DWA concept can be applied to accelerate charge particle beams with any charge to mass ratio and energy. Based on the DWA system, a novel compact proton therapy accelerator is being developed. This proton therapy system will produce individual pulses that can be varied in intensity, energy and spot width. The system will be capable of being sited in a conventional linac vault and provide intensity modulated rotational therapy. The status of the developmental new technologies that make the compact system possible ...
Objective: To further delineate the clinicopathological and radiological features of solid pseudopapillary tumor (SPT) of the pancreas and summarize the surgical therapy strategy for this tumor. Methods:...Full Text Available
Background & AimsData are conflicting on the benefit of selective serotonin reuptake inhibitors (SSRIs) for patients with irritable bowel syndrome (IBS);...Full Text Available
We presented data showing that the CART-19 cells expressing the 4-1BB signaling domain can have unprecedented and massive in-vivo expansion, traffic to tumor sites, persist long term in vivo, and induce...Full Text Available
Carotid artery stenosis is a major risk factor for stroke, and treatments for this condition to decrease the risk of stroke include medical therapy, carotid endarterectomy (CEA), and, more recently,...Full Text Available
BackgroundInadequate platelet inhibition despite aspirin and clopidogrel therapy during and after a percutaneous coronary intervention is associated with an impaired clinical outcome....Full Text Available
Stem cell therapies for neurodegenerative disorders require accurate delivery of the transplanted cells to the sites of damage. Numerous studies have established that fluid injections to the hippocampus...Full Text Available
The diagnostic accuracy of computed tomography (CT) in several patterns of thoracic and abdominal fatty masses, has been examined. In selected cases our findings overlap the features of the recent literature. The possibility of surgical therapy in peculiar cases of adipose deposits, commonly esteemed benign, is considered.
Low bone mineral density (BMD) is prevalent in human immunodeficiency virus (HIV)–infected subjects. Initiation of antiretroviral therapy is associated with a 2%–6% decrease...Full Text Available
- flushing Chemotherapy - what to ask your doctor Dry Mouth Oral mucositis Peripherally inserted central catheter Radiation therapy - what to ask your doctor Safe drinking during...
Nitric oxide (NO)-based therapies effectively inhibit neointimal hyperplasia in animal models of arterial injury and bypass grafting, but are not available clinically. We created a simple, effective,...Full Text Available
Antiplatelet resistance has been proposed as a possible mechanism to explain recurrent cardiovascular events in patients who have coronary artery disease and who are undergoing dual antiplatelet therapy....Full Text Available
The two categories of anti-albumin antibodies (AAA), namely precipitins (AA-P) and agglutinins (AA-Aggl), were investigated in 260 patients with morphologically diagnosed chronic liver diseases (CLD)....Full Text Available
Oncolytic viruses (OVs) represent a relatively novel anti-cancer modality. Like other new cancer treatments, effective OV therapy will likely require combination with conventional treatments. In order...Full Text Available
Background/AimTobacco use reduces the effect of non-surgical periodontal therapy. Host-modulation with low-dose doxycycline (LDD) might favour repair and promote...Full Text Available
Recombinant adenoviruses have been widely used for various applications, including protein expression and gene therapy. We herein report a new and simple cloning approach to an efficient and robust...Full Text Available
Purpose: Reverse helical cone-beam computed tomography (CBCT) is a scanning configuration for potential applications in image-guided radiation therapy in which an accurate anatomic image...Full Text Available
Purpose: Patients with mycosis fungoides [cutaneous T-cell lymphoma (CTCL)] may benefit from adjuvant therapy after completing total skin electron beam therapy (TSEBT). We report the results for (T1(T2)) CTCL patients treated with adjuvant oral psoralen plus ultraviolet light (PUVA) with respect to overall survival (OS), disease-free survival (DFS), salvage of recurrence, and toxicity. Methods and Materials: Between 1974 and 1993, TSEBT was administered to a total of 213 patients with CTCL. Records were reviewed retrospectively, and a total of 114 patients were identified as having T1 or T2 disease. Radiotherapy was provided via a 6-MeV linac to a total of 36 Gy, 1 Gy/day, 4 days/week, for 9 weeks. Beginning in 1988, patients were offered adjuvant PUVA within 2 months of completing TSEBT. This was started at 0.5-2 J/m"2, 1-2 treatments/week, with a taper over 3-6 months. Therapy then continued once per month. There were 39 ...
The radiotherapy is the prime treatment for the cavum cancer. It is also useful to treat the tumor recurrences, in this case the reirradiation stays the only efficient therapy option to give a correct local control. The reirradiation, exclusive or in association with other therapies can contribute to the local control of cavum cancer recurrences with a survival rate at five years of 36 to 58%. (N.C.)
Results are presented applying an enteral nutrition by means of probes with Cosilat in complex therapy of patients with radiotherapeutic late effects of the colon. This nutrition was prescribed with the intention to gave the colon a functional recovery and to guarantee optimal conditions for repair of radiation injuries. Good results were seen in 27 of 28 patients (96.7%), the situation of one patient (3.3%) continued without any change. Cosilat has a high nutritive value, good organoleptic qualities and is well digested without any complications. (author).
Of the radionuclides with physical properties most suited for use with monoclonal antibody for tumor imaging or therapy, few are more available or desirable than Pb-203, 212 and Bi-212. Yet no clinical studies have as yet been possible solely due to the lability in vivo of known complexes. We now report that bismuth complexes of the ligands p-SCN-Bz-DOTA and p-SCN-Bz-trans-cyclohexylDTPA are effective at protecting Bi-206 from release when linked to immunoproteins. Practicable, efficient ligand syntheses will be reported. Initial studies reveal that antibody is labeled efficiently with radiolead DOTA complexes. Preliminary studies indicate stability in vivo.
Transplantation has emerged as the therapy of choice for many patients with end organ failure. One of the major goals is to tailor immunosuppressive therapy to the individual needs of every patient to balance the risk for rejection and over-immunosuppression. This will require diagnostic tools that can detect harmful processes in the allograft early, and that can be measured repeatedly. This review will consider recent advances in our understanding of the molecular nature of these processes and how this information is being utilized to design novel diagnostic assays to non-invasively monitor allografts. Highlighted is the need for large-scale prospective multi-centre studies to validate assays that show early promise in single centre studies.
Forty-three patients with basal and squamous cell carcinomata arising on the pinna were treated radically using a 10 MeV electron beam. The technique and dosage are described and discussed. Primary cancer control with retention of the pinna was achieved in 34 patients. Salvage pinnectomy was performed in four patients for recurrence and one patient for radiation necrosis. Two patients with large primary tumours failed to resolve and died of their disease. The advantages for the patient of the policy of primary radical electron beam therapy are discussed.
The long and resource intensive process of drug discovery and development is confronted with the basic challenge of providing effective and safe therapies at reasonably low costs. The better the mechanism of a disease is known, the higher the probability to find an appropriate therapy. Also, the better and earlier a disease can be diagnosed and characterized, the higher the chance to be able to interfere in this process with a chemical entity. This reasoning sets the framework for the use of imaging in drug discovery. We discuss the relevance of magnetic resonance imaging and spectroscopy to derive anatomical, functional, metabolic and target-related information in the context of pharmacological research in vivo. (author)
The document represents a guide for the external decontamination of persons accidentally radio contaminated due to the use, production or transport of radioactive materials. The general conditions, from the medical point of view, to be kept in mind, in the event of accidental overexposures as decontamination treatment and the handling of samples are detailed throughout report. The external contamination without injury in skin or with wound its considered. The distribution of measures and responsibilities for the therapy of the irradiated patients with radioactive materials are enumerated. The preparations of decontaminate solutions are detailed in this work. Moreover, forms for the reception, physical evaluation of the patient and external contamination are presented. (author)
Comparison of dosimetry measured in a noncylindrical Rando-Alderson phantom by two-field, four-field, and six-field total-skin electron-beam therapy (TSEBT) techniques with our dual-field rotational (DFR) technique reveals a superior dosimetry for the latter. Our technique of dual-field rotational DFR-TSEBT is described in detail, and its advantages and indications for the primary management of cutaneous T-cell lymphoma (CTCL) and Kaposi's sarcoma (KS) are discussed.
Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).
Purpose: To evaluate the effect of low-dose radiation therapy and surgery on local control in patients with Ewing's Sarcoma. Materials and Methods: Between 1979 and 1995 24 patients (ages 4-47) with Ewing's sarcoma were treated with combined modality therapy that included multi agent chemotherapy, surgical resection, and radiation therapy. Twelve patients had metastatic disease at the time of presentation (pleura = 3, lung = 5, bone 4). Tumor location was central in 16 and peripheral in 8. Multi agent chemotherapy consisted of vincristine/actinomycin D/cyclophosphamide/doxorubicin in 19. The same agents with the addition of ifosfamide and etoposide were given in 5. The extent of resection was considered to be radical in 14 and of the 16 patients who received preoperative chemotherapy, 5 were found to have a pathologic complete response. All patients with lung metastases at diagnosis received whole-lung irradiation to 1400 ...
Clinical studies have proved the effectiveness of local ablading methods in pations with non-resectable liver metastases of a colorectal carcinoma. RF ablation and LITT are a potentially curative therapy option and an alternative to systemic chemotherapy; the latter is carried out primarily for reducing tumour size with the goal of secondary resectability. The number of R0-sesectable metastases can be enhanced by a combined therapy of surgery and local ablading methods, e.g. by preoperative, intraoperative or postoperative ablasion of further non-resectable tumours during surgery. Systemic chemotherapy combined with surgery as an adjuvant method is not recommended unless in cases of non-abladable tumour recidivation. Currently, systemic chemotherapy is used as a neo-adjuvant therapy for tumour size reduction with the goal of secondary resectability or, in case of inoperability, local ablation. (orig.) [German] Abladierende ...
Purpose: Evaluation of the diagnostic efficacy and cost-benefit of contrast enhanced CT (CT) and MRI pre- and post-SPIO-particles in focal hepatic disease with consideration of therapeutic outcome. Results: In 34/52 (65.4%) of the cases the correct diagnosis was primarily stated by CT (sensitivity [se.] 85.2%, specificity [sp.] 44.0%). In additional 10/52 of the cases unenhanced MRI (se. 91.4%, sp. 75.0%) enabled correct diagnoses, and in another 6 cases the diagnosis was established only by SPIO-MRI (se. 100%, sp. 86.7%). Considering the possible therapeutic recommendation arising from each modality, CT would have induced needless therapy costs of 191,042 DM, unenhanced MRI of 171,035 DM, and SPIO-MRI of 7,311 DM. In comparison to the real therapy costs of 221,873 DM, this would have corresponded to an unnecessary increase of therapy costs of 86.1%, 77.1%, and 3.3%, respectively. In two cases (91 hemangioma, 1 regenerative ...
From 1979 to 1986, 182 patients with biopsy proven diagnosis of Ewing's sarcoma of bone were observed. One hundred of the 182 patients (72 males, 28 females, median age 15.8 years) with localized disease and no previous treatment were treated with chemotherapy (VCR, ADM, CTX, D-ACT) for 15-18 months. Local treatment was radiotherapy (42 patients), surgery (31 patients), or a combination of both (27 pts). Radiation doses ranged from 45 to 64 Gy given with conventional fractionation. Median follow-up was 51.2 months (24-106). Overall and disease-free survival were, respectively, 58.7 and 42.6%. Resected patients tended to have a better local control (Surgery 93.6%, Surgery + Radiation therapy 92.6%, Radiation therapy 69.1%). Disease-free survival was significantly related to the volume of the primary tumor (bulky: 33.2%, not-bulky: 57.7%), to site (extremities 54.6%, central sites 16.6%, other sites 40.9%), and to local treatment (Radiation ...
Brain glucose metabolism was evaluated in four patients with acquired immunodeficiency syndrome (AIDS) dementia complex using ["1"8F]fluorodeoxyglucose (FDG) and positron emission tomography (PET) scans at the beginning of therapy with 3'-azido-2',3'-dideoxythymidine (AZT, zidovudine), and later in the course of therapy. In two patients, baseline, large focal cortical abnormalities of glucose utilization were reversed during the course of therapy. In the other two patients, the initial PET study did not reveal pronounced focal alterations, while the post-treatment scans showed markedly increased cortical glucose metabolism. The improved cortical glucose utilization was accompanied in all patients by immunologic and neurologic improvement. PET-FDG studies can detect cortical metabolic abnormalities associated with AIDS dementia complex, and may be used to monitor the metabolic improvement in response to AZT treatment.
A thermoluminescence (TL) sheet and its spatial readout system for in vivo measurement of spatial dose distribution around sources has been newly developed for intracavitary high dose-rate radiation therapy. The TL sheet (40 cm x 50 cm x 200 {mu}m), which is composed of teflon mixed with BaSO{sub 4} (Eu doped) powder, has a linear response with a very wide dynamic range from at least 0.002 cGy to 5000 cGy for {sup 60}Co sources. Phantom test of the TL sheet readout system demonstrated that absorbed dose with TL sheet and that with ionization chamber as standard dosimeter agreed well. For clinical application, TL sheet was attached on an applicator of intracavitary radiation therapy for rectal cancer. After irradiation with high dose-rate {sup 60}Co sources, the in vivo dose distribution on the surface of the rectum was determined. The TL sheet was suggested to provide a convenient means of measuring the dose distribution around {sup 60}Co ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography showed complete ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography showed complete ...
Between 1984 and 1988, seven women with breast cancer were treated with intraoperative electron beam therapy (IOEBT). All patients were Caucasian. Patient age ranged from 37 to 62 (median 53) years. Histopathology was infiltrating duct carcinoma (6/7) or medullary carcinoma (1/7). Four tumors were staged T1 N0 MO, one T1 N1 MO, one T2 N1 MO, and one lesion was recurrent. At the time of primary lumpectomy or axillary node dissection, a dose of 10 or 15 Gy IOEBT was administered to the tumor bed with 6 or 9 MeV electrons through the lumpectomy wound. All patients received 45 or 50 Gy over five to six weeks with 6 MV photons to the breast and, in four patients, to the regional nodes. Three patients received adjuvant chemotherapy and tamoxifen. No post-operative complications were observed. All patients are alive as of August, 1989, with no evidence of recurrent disease. Excellent cosmesis is the rule. Clinical and technical aspects of treatment are presented along ...
The present work was carried out to illuminate the relation between high cholesterol diet and incidence of prostate caner. Also, in this study, the effect of DHEA, selenium or oxygen therapy were tested in order to show to what extent they are valid to ameliorate the deleterious effects of prostate cancer. The obtained results revealed that prostate cancer caused a significant (p<0.01) elevation of TAP, PAP, PSA, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol and prostate COX-2, whereas, testosterone, free testosterone, DHEA-S, FT_4 and FT_3 were decreased significantly as compared with the corresponding levels in control rats in both normal and high cholesterol diet. Supplementation of DHEA, selenium or oxygen therapy ameliorated all variables recorded herein but, their values did not revert to normal. Any how, the results of this investigation showed that the above mentioned antioxidants possess potential benefits in ...
In the treatment of prostatic cancer using a newly proposed intermittent multiportal therapy (DIMT), acute reactions, change in tumor marker levels, and complications more than 6 months after treatment were evaluated. From June 1989 to September 1990, 26 patients with prostatic cancer (stage A2, 3 patients; B, 9; C, 2; D, 10; recurrence, 2) were treated. Fifteen patients were followed up for more than one year, with a mean period of 11.6 months. The treatment schedule is 52.5 Gy in 16 fractions in 4 weeks for radical treatment, and 30.0 Gy in 8 fractions in 2 weeks for palliative treatment. The 360 degree rotation about the patient was divided into 16 fractions, and 2 opposing fractions were used in one day as parallel opposed portals to treat the target volume. The fractions were serially treated one per day, so that 8 treatment days produced a total dose of distribution similar to that for conventional conformational therapy. The size of the ...
Background: Recent series describing the clinical presentation, response to therapy, and long-term outcome of Zollinger-Ellison syndrome are limited. Aims: To assess the clinical characteristics and long-term outcome of patients with Zollinger-Ellison syndrome. Methods: Over a 20-year period, patients with Zollinger-Ellison syndrome were enrolled in a prospective trial evaluating the efficacy of lansoprazole. Following dose stabilization, patients were followed on a 6-monthly basis with interval history, physical examination, endoscopy with gastric biopsies, gastric acid analysis and laboratory studies. Results: 72 patients (mean age 54+/-12 years, % male 58%, % Caucasian 69%) were prospectively enrolled. The clinical presentation was stereotypical for Zollinger-Ellison syndrome. Symptoms ...
We present our initial experience with a new biodegradable (BD) esophageal stent in two patients, one for a therapy-resistant benign esophageal stricture, and the other as a temporary measure during curative radiotherapy for oesophageal carcinoma. The BD stents need to be loaded into a conventional pull-back delivery system but are then placed in a standard fashion. Pre-dilatation should be avoided to reduce the risk of migration, however if migration occurs the stents can be left to dissolve in the stomach. The stents are radiolucent but easily identified on CT with minimal artefact and thus might even aid with radiotherapy planning. BD stents offer an exciting new strategy for therapy-resistant benign strictures as well as a supportive measure for oesophageal cancer undergoing non-surgical treatment. (orig.)
This book examines the applications of Monte Carlo (MC) calculations in therapeutic nuclear medicine, from basic principles to computer implementations of software packages and their applications in radiation dosimetry and treatment planning. It is written for nuclear medicine physicists and physicians as well as radiation oncologists, and can serve as a supplementary text for medical imaging, radiation dosimetry and nuclear engineering graduate courses in science, medical and engineering faculties. With chapters is written by recognised authorities in that particular field, the book covers the entire range of MC applications in therapeutic medical and health physics, from its use in imaging prior to therapy to dose distribution modelling targeted radiotherapy. The contributions discuss the fundamental concepts of radiation dosimetry, radiobiological aspects of targeted radionuclide therapy and the various components and steps required for ...
Patients with acute myocardial infarction (AMI) and diabetes mellitus, as well as patients admitted with elevated blood glucose without known diabetes, have impaired outcome. Therefore intensive glucose-lowering therapy with insulin (IGL) has been proposed in diabetic or hyperglycaemic patients and has been shown to improve survival and reduce incidence of adverse events. The current manuscript provides an overview of randomised controlled trials investigating the effect of IGL. Furthermore, systematic glucose?insulin?potassium infusion (GIK) has been studied to improve outcome after AMI. In spite of positive findings in some early studies, GIK did not show any beneficial effects in recent clinical trials and thus this concept has been abandoned. While IGL targeted to achieve normoglycaemi...
In this paper the measurements of radon-222 concentration in the air of Kowary Radon Inhalatorium in the vicinity of Jelenia Gora, Lower Silesia, Poland, performed by Radiation Protection and Radiobiology Department of National Institute of Hygiene in Warsaw, have been presented. For the measurements the integration method with the application of charcoal canisters have been used. The radon concentration was found within the very broad ranges from about 4 to 420 kBq m"-"3 depending of the season of the year. Basing on the radon concentration measurements during the inhalation therapy session and taking into account the equilibrium factor of 0.8 the doses to the bronchi of the patients in range from 1.2 to about 204 mSv (0.12-20.4 rem) have been assessed. The majority of patients (ca. 76%) received the doses between 115 and 204 mSv. (author)
Purpose To evaluate disease failure patterns and overall survival (OS) of women with triple-negative (TN) breast cancer who underwent breast-conserving therapy (BCT) and to understand the relationship of TN tumors with other prognostic factors. Patients and Methods The Surveillance, Epidemiology, and End Results (SEER) registry identified 562 women diagnosed and/or treated with unilateral invasive breast cancer during 2003?2004 at three Emory hospitals. After medical record review, 193 eligible women, with all tumor types, received BCT. Primary endpoints (local, regional, and distant recurrences) and secondary endpoint (OS) were evaluated using chi-square tests and Cox proportional hazards models. Results Of the 193 women, 33 (17.1%) had TN tumors and 160 (82.9%) had non-TN tumors. Patient...
The main goal of local drug delivery is to increase the concentration of a specific therapeutic agent in a target tissue with minimal nontarget distribution. Compared to systemic therapy, local drug delivery provides a high level of therapeutic efficacy with minimal systemic effects. The current primary imaging modality for drug delivery has been x-ray angiography, but it has major limitations including anatomical ambiguity and inability to visualize the targeted tissues. Due to these inherent problems, MR guidance has been explored as an alternative imaging modality for guiding and monitoring of drug therapy. Recently, interventional MR (XMR) systems have been implemented that have both dual x-ray and MRI capabilities in a single suite and allow for real-time interventional procedures to ...
The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.
BACKGROUND: Epinephrine injection is the most common endoscopic therapy for peptic ulcer bleeding. Controversy exists concerning the optimal dose of proton pump inhibitors (PPI) for patients with bleeding peptic ulcers after successful endoscopic therapy. The objective of this study was to determine the optimal dose of PPI after successful endoscopic epinephrine injection in patients with bleeding peptic ulcers. METHODS: A total of 200 peptic ulcer patients with active bleeding or nonbleeding visible vessels (NBVV) who had obtained initial hemostasis with endoscopic injection of epinephrine were randomized to receive omeprazole 40 mg infusion every 6 h, omeprazole 40 mg infusion every 12 h or cimetidine (CIM) 400 mg infusion every 12 h. Outcomes were checked at 14 days after enrollment. RE...
This study emphasizes the need for a systematic and in-depth connection between the progress in quantum theory of energetic ion collisions and applications to hadron therapy. Scattering theory for fast ion beams has reached its stage of development where accurate and robustly applicable methodologies can advantageously be exported to applied fields such as space research, fusion energy program, medicine, etc. In particular, distorted wave collision theories at high energies readily provide total, partial and fully differential cross sections for inelastic collisions of ionic projectiles with any target system. By numerous and thorough testings, such theoretical cross sections were found to exhibit excellent agreement with experimental data on atomic targets. Adequate extensions of these me...
Abstract Tumor necrosis factor (TNF)- is a pro-inflammatory cytokine associated with psoriasis pathogenesis. Anti-TNF- therapies are effective in psoriasis. A significant weight gain has been reported in patients treated with anti-TNF- agents. The aim of the present study was to evaluate the body composition changes in psoriatic patients receiving anti-TNF- therapies according with disease phenotype. Forty patients affected with psoriasis were followed up for 24 weeks and divided into two groups: psoriasis vulgaris (PsO) and psoriatic arthritis (PsA). Anthropometric, blood biochemical, body composition parameters, resting metabolic rate, and disease activity indexes were measured at baseline and at week 24. After 24 weeks of anti-TNF- administration, the disease activity indexes and concen...
Effect of different factors on survival of patients with Ewing sarcoma (20 people), primary bone reticulosarcoma (43) and myeloma (10) of pelvic bones, has been studied. Independently of the method of treatment, the rate of 3-year survival from reticulosarcoma start constituted (31.5+-7.1)%, Ewing sarcoma - (33.0+-10.8)%, myeloma - (36.0+-15.9)%. Index of 5-year survival in case of reticulosarcoma constituted (20.9+-6.4)%, Ewing sarcoma - (23.6+-11.0)%, myeloma - (36.0+-15.9)%. Improvement of delayed results after prophylactic therapy courses is pointed out. Degree of pelvic bone affection is of a very important prognostic value.
The treatment of chronic pain conditions continue to present a challenge to the medical field. Physical therapy treatment needs to approach the management of chronic pain differently than the approach used to resolve acute pain. Patients with chronic pain often have many factors that have perpetuated the pain condition. These factors, as well as pain itself, influence their ability to reactivate and perform functional daily activities. Physical therapists can begin to address some of the factors, including fear and deconditioning, by building confidence and body awareness in a self-care model including a slow graduated reactivation program. There is evidence that patients with chronic pain conditions have altered motor control that may be influencing reoccurrences and possible flares of pa...
Purpose. To compare erectile function (EF) recovery of patients treated by early penile rehabilitation therapy (PRT) with sildenafil and with control group. Method. Forty men treated by bilateral nerve sparing radical prostatectomy (NSRP) and with a normal pre-operative EF were enrolled. Fourteen days after surgery, they were randomised to a flexible-dose sildenafil group and to a control group. The International Index of Erectile Function (IIEF) questionnaire was completed before surgery and at 3, 6, 12 and 24 weeks after NSRP. Results. In the group treated, the mean IIEF score before surgery was 26.2 and 14.1, 16.2, 22.5 and 25.2 at 3, 6, 12 and 24 weeks after NSRP, respectively. In the control group, the respective scores were 26.5 and 12.4, 15.8, 15.3 and 17.4. There was a significant ...
Introduction: Restrictions in prescribing broad spectrum antimicrobials have been part of a strategy to reduce Clostridium difficile cases in the UK in recent years. However, there has been little work on assessing the safety of alternative antimicrobial agents. Methods: We performed an uncontrolled prospective observational survey over a 1-year period to determine the effectiveness and safety of a new antimicrobial stewardship programme in a district hospital in the UK. Results: In total, 227 Gram-negative bacteraemias (203 episodes) occurred in the study period. Guidelines were adequate in 194 of 203 (95%) episodes and 163 episodes (80.2%) received adequate therapy. Patients in the inadequate therapy group had >2-fold increased likelihood of death [odds ratio (OR) = 2.63, 95% confidence ...
Asthma, affecting as many as 400 million individuals worldwide, is one of the most prevalent chronic health condition in the United States. With an increasing number of patients with asthma and the frequent inability of conventional lifestyle modification and therapy to effectively control the problem, nutritional and dietary therapies are being sought. This study was undertaken to investigate the efficacy of the purple passion fruit peel (PFP) extract, a novel mixture of bioflavonoids, on asthma symptoms. Patients with asthma were studied in a 4-week randomized, placebo-controlled, double-blind trial with oral administration of PFP extract (150 mg/d) or placebo pills. The effects of PFP extract were evaluated by assessing the clinical symptoms of asthma and spirometry tests. Most clinical...
Allogeneic stem-cell transplantation (SCT) is potentially curative therapy in AML by providing both dose-intensive chemo-radiotherapy and induction of graft-versus-leukemia (GvL) effect. Historically, more emphasis was given to the intensity of conditioning. Over the last decade the pendulum turned more towards induction of GvL as the primary goal. A plethora of non-myeloablative (NMA) and reduced-intensity conditioning regimens (RIC) were introduced trying to reduce transplant-related toxicities and allow SCT in elderly and medically infirm patients. In addition, reduced-toxicity myeloablative regimens (RTC) based on fludarabine and myeloablative alkylating-agent doses were designed to allow safer administration of dose-intensive therapy. Conditioning dose-intensity is highly correlated w...
Abstract Background. Complementary and alternative medicine (CAM) use is common among breast cancer patients. Several CAM therapies may have negative side effects or interact with conventional therapies. We studied biologically based CAM use with and without vitamins/minerals in relation to patient and tumor characteristics as well as treatment in an ongoing prospective cohort of 855 primary breast cancer patients. Methods. Patients from two hospitals in southern Sweden were included. Pre-operative and follow-up questionnaires containing questions on food intake, lifestyle, and concomitant medications, including natural remedies, were completed up to five years postoperatively. Clinical information was obtained from clinical records and tumor characteristics from pathology reports. Results...
Antibodies directed against markers on cancer cells are gaining in importance for the purpose of targeting diagnostic and therapeutic agents. In the past, this approach has had very limited success principally because the classical methods for producing antibodies from blood serum of animals immunized with cancer cells or extracts were unsatisfactory. The situation has changed dramatically since 1975 following the design of procedures for 'immortalizing' antibody-producing cells (lymphocytes) by fusing them with cultured myeloma cells to form hybridomas which continuously secrete antibodies. Since these hybridomas produce antibodies coded for by a single antibody-producing cell, the antibodies are called monoclonal. Building on these advances in biomedical research, it is now possible to reproducibly manufacture monoclonal antibodies on a scale suitable for use in cancer detection and therapy.
The technical complexity of intraoperative radiotherapy (IORT) requires modification of the standard physical and dosimetric methods used in external electron beam therapy. At the National Cancer Institute, a number of technical innovations have been integrated into ongoing clinical studies of IORT. These include: (1) an electron beam applicator system that is significantly different from other IORT systems and includes customized squircle applicators; (2) peripheral dose shields; (3) a modified surgical table replacing the standard radiation treatment couch; and (4) routine use of multiple IORT fields that necessitates field matching. The IORT applicator system and related devices and techniques are dosimetrically characterized in detail both for use in the IORT program and in order to illustrate many useful facets of electron dosimetry.
Purpose: The aim of this study was to assess interinstitutional variations in planning for stereotactic body radiation therapy (SBRT) for lung cancer before the start of the Japan Clinical Oncology Group (JCOG) 0403 trial.Methods and Materials: Eleven institutions created virtual plans for four cases of solitary lung cancer. The created plans should satisfy the target definitions and the dose constraints for the JCOG 0403 protocol.Results: FOCUS/XiO (CMS) was used in six institutions, Eclipse (Varian) in 3, Cadplan (Varian) in one, and Pinnacle3 (Philips/ADAC) in one. Dose calculation algorithms of Clarkson with effective path length correction and superposition were used in FOCUS/XiO; pencil beam convolution with Batho power law correction was used in Eclipse and Cadplan; and collapsed co...
One of the research challenges in oncology is to develop new biochemical methods for noninvasive tumor therapy evaluation to determine whether the chemotherapeutics is effective. Vascular endothelial growth factor (VEGF) was labeled with radioiodine and evaluated in vitro as well as in vivo, using A2058, a melanoma cell line overexpressing VEGFR-1 and -2. Saturation binding analysis with [{sup 125}I]-VEGF resulted in a K {sub d} of 0.1 nM. Internalization assays indicate the preserved ligand induced internalization and metabolization of the tracer. Biodistribution studies with [{sup 123}I]-VEGF in wild type and A2058 tumor-bearing athymic mice showed low background activity and a tumor to reference tissue ratio of maximum 6.12. These results suggest that [{sup 123}I]-VEGF is a potentially suitable tracer for tumor therapy evaluation.
The author discusses the pervasive difficulty psychotherapists seem to have in discussing patient morality, relating it to the fear of imposing (and feeling) shame and guilt. A way of nonjudgmentally discussing moral values with patients is presented, which places emphasis not on moral abrogations, but rather on the "virtues" of altruism, responsibility, justice, egalitarianism, and honesty. Drawing on empirical studies of prosocial behavior, the author gives a rationale for how these virtues may, whether the therapist is conscious of it or not, be inherently promoted through the group therapy process. Ways are suggested by which the therapist can help the group deal with thorny moral issues and confront the morally confused patient without causing shame. PMID:8473062
Discovery of better biomarkers for diagnosis, prognosis, and therapy-response prediction is the most critical task of a scientific quest aimed at developing newly designed, tailor-made therapies for patients with cancer. Consequently, a proteome wide analysis, in addition to genomic studies, is an absolute requirement for a complete functional understanding of tumor biology. Ultra-sensitive, high-performance Fourier transform ion cyclotron resonance (FTICR) mass spectrometry (MS) currently holds an important role in fulfilling the demands of biomarker discovery. In this review, we describe the applicability of FTICR MS for breast cancer proteomics, particularly for the analysis of complex protein mixtures obtained from a limited number of cells typically available from clinical specimens.
Context. Cardiovascular medication overdoses can be difficult to treat. Various treatment modalities are currently recommended. Objective. To describe patient outcomes and adverse events of high-dose insulin therapy in consecutive overdose patients in cardiogenic shock after implementation of a high-dose insulin protocol (1-10 U/kg/h, while avoiding or tapering off vasopressors). Methods. This is an observational consecutive case series of patients identified from a registry. Data were collected by retrospective chart review of patients treated by our toxicology service with this protocol from February 2007 until March 2010. Results. Twelve patients were treated with high-dose insulin. The mean age was 36.5 years (SD 11.7). Seven patients had pre-existing vasopressor therapy, and all were ...
"Pillar pain" is a relatively frequent complication after surgical release of the median nerve at the wrist. Its etiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms two or even three years after surgery. The aim of this study was to investigate the efficacy of low-energy, flux density-focused extracorporeal shock wave therapy (ESWT) in the treatment of pillar pain. We treated 40 consecutive patients with ESWT who had pillar pain for at least six months after carpal tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this c...
Purpose: In this paper, we present an alternative to the originally proposed technique for the delivery of spatially fractionated radiation therapy (GRID) using multi-leaf collimator (MLC) shaped fields. We employ the MLC to deliver various pattern GRID treatments to large solid tumors and dosimetrically characterize the GRID fields. Methods and materials: The GRID fields were created with different open to blocked area ratios and with variable separation between the openings using a MLC. GRID designs were introduced into the Pinnacle3 treatment planning system, and the dose was calculated in a water phantom. Ionization chamber and film measurements using both Kodak EDR2 and Gafchromic EBT film were performed in a SolidWater phantom to determine the relative output of each GRID design as w...
This document is the report of a task group of the Radiation Therapy Committee of the AAPM and has been prepared primarily to advise hospital physicists involved in external beam treatment of patients with pelvic malignancies who have high atomic number (Z) hip prostheses. The purpose of the report is to make the radiation oncology community aware of the problems arising from the presence of these devices in the radiation beam, to quantify the dose perturbations they cause, and, finally, to provide recommendations for treatment planning and delivery. Some of the data and recommendations are also applicable to patients having implanted high-Z prosthetic devices such as pins, humeral head replacements. The scientific understanding and methodology of clinical dosimetry for these situations is still incomplete. This report is intended to reflect the current state of scientific understanding and technical methodology in clinical dosimetry for radiation oncology patients ...
Abstract Background Atopic dermatitis (AD) affects health and quality of life and it has great impact on both health-care costs and costs to the society. Objectives The objective of this study was to develop a model to analyse the cost-effectiveness of a barrier-strengthening moisturizing cream as maintenance therapy compared with no treatment after initial treatment with betamethasone valerate in adult patients with AD in Sweden. A further aim was to apply a similar health-economic analysis for Denmark, Norway and Finland. Methods A Markov simulation model was developed including data from three sources: (i) efficacy data from a randomized controlled trial including patients with moderate AD treated with either a moisturizing cream or no treatment, (ii) resource utilization and quality of...
Summary Objectives To describe the pattern of incident illness in children after initiation of antiretroviral therapy (ART) in a large public health sector programme in Lusaka, Zambia. Methods Systematic chart review to retrospectively extract data from medical records of children (i.e. <15 years) initiating ART in the Lusaka, Zambia public sector. Incident conditions were listed separately and then grouped according to broad categories. Predictors for incident diagnoses were determined using univariate and multivariable analysis. Results Between May 2004 and June 2006, 1705 HIV-infected children initiated ART. Of these, 1235 (72%) had their medical records reviewed. Median age at ART initiation was 77 months and 554 (45%) were females. Eight hundred and forty-one (68%) children had an inc...
Summary Background- Treatments that achieve sustainable steroid-free clinical remission in Crohn-s disease are needed; however, long-term steroid-sparing efficacy data are limited. Aim- To evaluate steroid-sparing efficacy and the impact of steroid discontinuation on adverse events during treatment of Crohn's disease with adalimumab in the phase III randomised, double-blind 1-year CHARM trial and for an additional 2-years in its open-label extension ADHERE. Methods- Steroid-free remission and response and steroid-sparing (-50% steroid dose reduction) remission rates were evaluated over 3-years in patients who were taking corticosteroids at CHARM baseline. Results- Of 778 patients randomised in CHARM (including those who did not achieve clinical response to open-label induction therapy), 31...
Glioblastoma multiforme is the most aggressive form of human brain tumor, which has no effective cure. Previously, we have demonstrated that overexpression of the C-terminal fragment of the human telomerase reverse transcriptase (hTERTC27) inhibits the growth and tumorigenicity of human cervical cancer HeLa cells. In this study, the therapeutic effect and molecular mechanisms of hTERTC27-mediated cancer gene therapy were further explored in vivo in established human glioblastoma xenografts in nude mice. We showed that intratumoral injection of adeno-associated virus carrying hTERTC27 (rAAV-hTERTC27) is highly effective in reducing the growth of the subcutaneously transplanted glioblastoma tumors. Histological analyses showed that rAAV-hTERTC27 treatment leads to profound necrosis, apoptosi...
A non-resonant RF cavity loaded with amorphous alloy cores has been designed and tested. The cavity has a re-entrant structure loaded with 8 amorphous alloy toroidal core and its characteristic impedance is designed as 450 Omega . The RF power is fed by 1 kW solid state amplifier using a step-up transformer with 1:9 impedance ratio. In the high power test, an accelerating gap voltage of more than 900 V was measured with input power of 1 kW in the frequency range of 1 to 10 MHz. The voltage standing wave ratio (VSWR) was less than 2.0. The results prove that the cavity may be used successfully within a compact proton synchrotron for a cancer therapy facility. (3 refs).
The clinical manifestation of wounds of the heart is determined by the mode, site and size of the injury as well as the structure of the pericardial and myocardial lesion. Diagnosis can be confirmed by ECG and echocardiography. Only 20% of the patients with penetrating wounds of the heart live for more than 30 minutes. Pericardio-centesis should be used only to gain time for a safe sternotomy, cardiac decompression and suture of the wound of the heart. An aggressive surgical approach is mandatory. Cardiopulmonary bypass is necessary only to correct of concomitant lesions. PMID:1983618
Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such ...
Lymphomatous processes involving the skin can be managed effectively by total skin electron beam irradiation. A technique using weekly doses (400 rad for each of 6 successive weeks) has been employed...Full Text Available
The use of absorbable polyglactin 910 mesh (Vicryl) is described in a case of Ewing's sarcoma of the pelvis. An operation was performed to hold the small bowel and colon out of the pelvis for a temporary period during which radical radiotherapy was delivered. The mesh allowed the temporary displacement of bowel and obviated bowel radiation morbidity. (author).
The book is divided into two approximately equal parts. The first four chapters are relatively lengthy and cover the basic principles of radiation biology, carcinogenesis and therapy, along with a brief introduction to radiological physics to orient the reader without background in this specialized related discipline. The remainder consists of twenty-four relatively brief chapters, each covering the radiation biology of a specific organ, tissue, or systems tissues, with emphasis on the tumorigenic and tumoricidal action of ionizing radiations.
Chronic HTLV-I (human T cell lymphotropic virus type I) infection may cause adult T cell leukemia/lymphoma (ATL), a disease with dismal long-term prognosis. The HTLV-I transactivator, Tax, initiates...Full Text Available
Telavancin is a bactericidal lipoglycopeptide with a multifunctional mechanism of action. We conducted a randomized, double blind, active-control phase II trial. Patients ≥18 years of age with...Full Text Available
The synthesis of novel b-functionalized derivatives of the clinically used photosensitizer Temoporfin has been achieved by nucleophilic addition reactions to a corresponding diketo chlorin. The b-substituted dihydroxychlorin products exhibit a strong absorption in the red spectral region, a high singlet oxygen quantum yield, and were found to be highly effective in in vitro assays against HT-29 tumor cells.
The paper is concerned with the results of a morphological study following chemoradiotherapy in 25 patients with Ewing's sarcoma and 14 patients with reticulum cell carcoma. The signs of therapeutic pathomophosis were observed in the first 3 days, and substitution of the connective tissue for a necrotized tumor started by the 3rd-4th week after the initiation of therapy. In some cases tumor growth and recurrences at the site of a treated tumor were observed.
BackgroundHIV infection causes a qualitative and quantitative loss of CD4+ T cell immunity. The institution of anti-retroviral therapy (ART) restores CD4+ T...Full Text Available
The evaluation of radiotherapy and surgery as exclusive local treatment in comparably selected subgroups of patients with Ewing's sarcoma on the basis of the CESS 86-data. In the German multicenter Ewing's sarcoma study CESS 86, treatment consisted for four 9-week-courses of VACA- or VAIA-chemotherapy plus local therapy. VACA (vincristine, actinomycin D, cyclophosphamide, adriamycin) was given in low-risk extremity tumors with a tumor volume below 100 cm"3. Highrisk patients with central lesions or a tumor volume >100 m"3 received VAIA (ifosfamide instead of cyclophosphamide). Local therapy started after one complete chemotherapy course in week 10. Based on an individual decision in each patient, local therapy was either radical surgery or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy. Because of poor results with radiotherapy in a preceeding study, it was intended to restrict ...
A set of eight questions was put to advanced nuclear medicine physicians-in-training participating in a continuing assessment exercise in practical therapeutic nuclear oncology. Using the particular example of {sup 131}I-MIBG treatment of neuroblastoma in children, the questions were directed to the rationale of therapy and the contribution of other forms of treatment to toxic effects. The best answer to the questions are reproduced together with an introduction by the examiner, Dr. H. Turner. tabs.
Resistance exercise has been widely reported to have positive rehabilitation effects for patients with neuromuscular and orthopaedic conditions. This paper presents an optimal design of magneto-rheological fluid dampers for variable resistance exercise devices. Adaptive controls for regulating the resistive force or torque of the device as well as the joint motion are presented. The device provides both isometric and isokinetic strength training for various human joints.
Two patients receiving maintenance dialysis therapy developed osteonecrosis, the first in the humeral head and the second in the talus. Both patients lacked known risk factors for developing osteonecrosis. A possible pathogenic role of secondary hyperparathyroidism in this disorder is suggested. Rheumatologists evaluating patients receiving maintenance dialysis with rheumatic manifestations should be aware of this potential complication. PMID:2185360
Caffeine and related xanthines were identified as potent stimulators for the bacterial cellulose production in A. xylinum. These compounds are present in several plants whose infusions are useful as culture-medium supplements for this acetobacterium. The proposed target for these native purine-like inhibitory substances is the novel diguanyl nucleotide phosphodiesterase(s) that participates in the bacterial cellulogenic complex.
Distribution of Lipiodol within hepatic tumor was evaluated using serial computed tomography. Imagistic Lipiodol transition into the tumor via hepatic artery was slower than that of water soluble contrast medium, spreading to central part first and turn to peripheral part of the tumor. This method was thought to be useful to clarify Lipiodol distribution in hepatic tumor and to decide the method or necessity of additional trans-arterial therapy. (author).
The reconstruction of coronal and Sagittal Image of Brain C. T. is helpful to diagnosis of Brain. Three Dimensional Reconstruction software package allows to display three dimensional Image clerived from a series of Horizontal, Sagittal and Coronal Brain C. T. images. It useful in determine approach of operation, to define portals of deep radiation therapy.
AbstractThe gag p6 region of HIV-1 has various nonsubstitutionary mutations, including insertions, duplications, deletions, and premature stop codons. Studies have linked gag p6 mutations...Full Text Available
Twenty-four high-risk Ewing's sarcoma patients were treated on an intensive combined modality protocol including low-dose fractionated total body irradiaiton (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. Local failure as a manifestation of initial relapse occurred in only three patients (15%), each having synchronous distant failure. Eight patients failed initially with only distant metastases, usually within 1-2 years following a complete clinical response. Two patterns of granulocyte recovery following consolidative therapy (including TBI and ABMI) were recognized. The time to platelet recovery was different for the groups with early and late granulocyte recovery. Patients with late recovery ...
As an alternative to surgery, endovascular therapy with stent grafts has become the second main treatment option for infrarenal abdominal aortic aneurysms. Unlike surgery, endovascular treatment with stent grafts is also applicable in patients unfit for open repair. Despite current improvements in endovascular repair devices, significant anatomic barriers still exclude this technique for a large number of patients. Computed tomography, magnetic resonance imaging, and ultrasound are essential for diagnostics, preintervention planning, and postintervention follow-up of abdominal aneurysms treated with stent grafts. This review covers etiology, pathology, and diagnostic aspects. Materials and methods for endovascular treatment of abdominal aortic aneurysms are presented in detail, and clinical results and complications are discussed. (orig.) [German] Die endovaskulaere Therapie des infrarenalen Bauchaortenaneurysmas hat sich als Alternative zur ...
A discussion is presented of the 750-KeV chopper experience with both proton and negative ion beams and the ability of these systems to tailor the Linac beam to the diverse requirements of its users; normal accelerator injection, neutron therapy beam, and electron cooling experiments. This flexibility plus a cleaner beam pulse, improved thyratron operation, and mechanical modularity are the results of recent improvements. Additional benefits have been increased reliability and ease of service to the 750-KeV chopper. 3 refs.
External radiation dose exceeded 5,000 rad in three cases, and intravaginal radiation dose was 5,000 rad in one case. Radiation damage including perforation was seen in the end of ileus in one case, in the sigmoid and rectum in two cases, and in the end of ileus, sigmoid and rectum in the last case. Satisfactory results were obtained by the removal of the ileocecum in the case of the damage in the end of the ileus. However, only colostomy was performed for the damage in the sigmoid and rectum.
... and pathogen transmission. Because the ultimate object of stem cell research is cell-based clinical therapy, hES cells should ... 4%) Supported by grants (SC12021 and SC11012) from Stem Cell Research...
Using an adenoviral system as a delivery mediator of therapeutic gene, we investigated the therapeutic effects of the use of combined MDR1 shRNA and human NIS (hNIS)...Full Text Available
Parathyroid hormone (PTH) is used clinically in osteoporotic patients to increase bone mass by enhancing bone formation. PTH therapy is not uniformly effective at all skeletal sites and “lifestyle”...Full Text Available
Increasing frequency of skin cancer, mycosis fungoides, Kaposi sarcoma etc, it need to treatment dose planning for total skin electron beam (TSEB) therapy. Appropriate treatment planning for TSEB therapy is needed to give homogeneous dose distribution throughout the entire skin surface. The energy of 6 MeV electron from the 18 MeV medical linear accelerator was adapted for superficial total skin electron beam therapy. The energy of the electron beam was reduced to 4.2 MeV by a 0.5cmx90cmx180cm acryl screen placed in a feet front of the patient. Six dual field beam was adapted for total skin irradiation to encompass the entire body surface from head to toe simultaneously. The patients were treated behind the acryl screen plate acted as a beam scatterer and contained a parallel-plate shallow ion chamber for dosimetry and beam monitoring. During treatment, the patient was placed in six different positions due to be homogeneous ...
Purpose: In this paper, we present an alternative to the originally proposed technique for the delivery of spatially fractionated radiation therapy (GRID) using multi-leaf collimator (MLC) shaped fields. We employ the MLC to deliver various pattern GRID treatments to large solid tumors and dosimetrically characterize the GRID fields. Methods and materials: The GRID fields were created with different open to blocked area ratios and with variable separation between the openings using a MLC. GRID designs were introduced into the Pinnacle"3 treatment planning system, and the dose was calculated in a water phantom. Ionization chamber and film measurements using both Kodak EDR2 and Gafchromic EBT film were performed in a SolidWater phantom to determine the relative output of each GRID design as well as its spatial dosimetric characteristics. Results: Agreement within 5.0% was observed between the Pinnacle"3 predicted dose distributions and the measurements for the ...
PurposeUsing a retrospective analysis of treatment plans submitted from multiple institutions accruing patients to the RTOG #0236 non-small cell SBRT protocol, this...Full Text Available
PurposeRTOG protocol 95-17 was a phase I/II trial to evaluate multi-catheter brachytherapy as the sole method of adjuvant breast radiotherapy for stage I/II breast...Full Text Available
A prospective pilot trial was performed in 20 patients randomised to receive either {sup 131}I-Lipiodol therapy alone (n=10) or {sup 131}I-Lipiodol combined with a short low-dose cisplatin infusion (n=10), the aim being to evaluate the possible positive influence of a radiosensitiser on toxicity and tumour response. An activity of 1,354-2,128 MBq (mean 1,824 MBq) [36.6-57.5 mCi (mean 49.3 mCi)] {sup 131}I-labelled Lipiodol was administered by selective instillation in the hepatic artery. Cisplatin was given in a dose of 30 mg/m{sup 2} at day -1 and day +6 (day 0: {sup 131}I-Lipiodol). The primary endpoint of this trial was toxicity of therapy; points of secondary interest were tumour response and survival at 6 months. With the use of cisplatin we found a higher percentage of stable or diminished tumour size (90%, vs 40% without). A benefit in group survival at 6 months was not evident. Low-grade stomatitis in one patient and minor changes in ...
BackgroundCardiovascular magnetic resonance (CMR) allows volumetric carotid plaque measurement that has advantage over 2-dimensional ultrasound (US) intima-media thickness (IMT)...Full Text Available
This study focuses on the effects of long-term renin-angiotensin system suppression and/or incretin mimetic therapies on the regulation and binding affinity of GLP-1 to its receptor in the coronary...Full Text Available
Total 125 patients with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with pulmonary metastases received bilateral pulmonary RT. Local recurrence rate was analyzed according to ...
BackgroundSeveral studies have demonstrated the efficacy of artemisinin-combination therapy (ACT) across malaria zones of the world. Fixed dose ACT with shorter courses and fewer...Full Text Available
The overall goal of acne management for all patients is to select treatments that effectively address as many pathogenic factors as possible while minimizing side effects. Acne therapy in darker skin...Full Text Available
Topics of this proceedings are: DNA damage and repair; Space research; Cell and tissue radiobiology; Treatment planning 1: The role of clinical RBEs; Treatment planning 2: Dose optimization and inverse planning; Dosimetry; Clinical results of particle therapy and new techniques; Status reports and future developments. Separate abstracts were prepared for 79 chapters. (orig./SR)
Patients with haemarthros of the knee were examined by MRI and arthroscopy to identify the bleeding source and to determine surgical or conservative therapy. A prospective study was performed on 120 patients who underwent MRI and arthroscopy, point lesions and bleeding sources were documented separately on a standardised form. Arthroscopy demonstrated a ruptured anterior cruciate ligament in 86%, meniscal tears in 55%, disruption of collateral ligaments in 17%, osteochondral lesions in 5% and tears of capsule or plicae in 13%. Disruption of cruciate ligaments caused haemorrhage in all but three cases. In contrast, only meniscal tears located very adjacent to the meniscal basement had bled. Those types of osteochondral lesions caused haemorrhage characterised on MRI by destruction of the subchondral plate and overlying cartilage. Severe lesions of the knee were diagnosed by MRI in 71% to 100%, slight lesions in 13% to 40% of the cases. Single, combined and bland ...
Purpose: Evaluation of the diagnostic efficacy and cost-benefit of contrast enhanced CT (CT) and MRI pre- and post-SPIO-particles in focal hepatic disease with consideration of therapeutic outcome. Results: In 34/52 (65.4%) of the cases the correct diagnosis was primarily stated by CT (sensitivity [se.] 85.2%, specificity [sp.] 44.0%). In additional 10/52 of the cases unenhanced MRI (se. 91.4%, sp. 75.0%) enabled correct diagnoses, and in another 6 cases the diagnosis was established only by SPIO-MRI (se. 100%, sp. 86.7%). Considering the possible therapeutic recommendation arising from each modality, CT would have induced needless therapy costs of 191,042 DM, unenhanced MRI of 171,035 DM, and SPIO-MRI of 7,311 DM. In comparison to the real therapy costs of 221,873 DM, this would have corresponded to an unnecessary increase of therapy costs of 86.1%, 77.1%, and 3.3%, respectively. In two cases (91 hemangioma, 1 regenerative ...
Portal verification images were generated from the photon contamination in electron beams produced by a linear accelerator during treatment of patients receiving high-energy electron radiation therapy (8-14 MeV). An experimental storage phosphor system was used to record the images and display them on laser-printed film. Images were obtained from four or more treatment fractions from 21 cases of head and neck cancer. Precision in field placement was estimated by determining the position of a selected anatomic landmark relative to the center of the field for each series of images. The average standard deviation in the field-position measurements was 3.8 mm. Several procedural problems were also detected and corrected after review of the verification images. The results indicate that the emphasis placed on monitoring and control of field-positioning error in high-energy electron treatments should be similar to the emphasis placed on this aspect of error in photon ...
The main objectives were to evaluate efficacy and acceptability of a developmentally sensitive cognitive behavioral therapy for anxiety-based school refusal in adolescence. Twenty school-refusing adolescents meeting DSM-IV anxiety disorder criteria participated in a non-randomized trial, together with parents and school staff. Outcome was assessed at post-treatment and 2-month follow-up. Treated adolescents showed significant and maintained improvements across primary outcome variables (school attendance; school-related fear; anxiety), with medium to large effect sizes. Half of the adolescents were free of any anxiety disorder at follow-up. Additional improvements were observed across secondary outcome variables (depression; overall functioning; adolescent and parent self-efficacy). The treatment was rated as acceptable by adolescents, parents, and school staff, which may help explain the very low attrition rate. Social anxiety disorder was the most common disorder ...
Background: The outcome of acute myocardial infarction (AMI) complicated with cardiogenic shock is poor. The aim of this study was to analyse, whether upfront abciximab administration could improve the outcomes of cardiogenic shock. Methods: This multicentre open trial randomized 80 patients with AMI complicated by cardiogenic shock expected to undergo primary PCI into group A (routine upfront-pre-procedural-abciximab bolus followed by 12-h abciximab infusion) and group B (standard therapy). The study primary objective was 30-day combined outcome (death/reinfarction/stroke/new severe renal failure). Results: PCI was technically successful in 90% (A) versus 87.5% (B) patients. Abciximab was used in 100% (A) versus 35% (B). The primary endpoint occurred in 17 group A patients (42.5%) and 11 ...
RADIANT{trademark} is manufactured by United States Surgical Corporation, Vascular Therapies Division, (formerly Progressive Angioplasty Systems). The system comprises a liquid {beta}-radiation source, a shielded isolation/transfer device (ISAT), modified over-the-wire or rapid exchange delivery balloons, and accessory kits. The liquid {beta}-source is Rhenium-188 in the form of sodium perrhenate (NaReO{sub 4}), Rhenium-188 is primarily a {beta}-emitter with a physical half-life of 17.0 hours. The maximum energy of the {beta}-particles is 2.1 MeV. The source is produced daily in the nuclear pharmacy hot lab by eluting a Tungsten-188/Rhenium-188 generator manufactured by Oak Ridge National Laboratory (ORNL). Using anion exchange columns and Millipore filters the effluent is concentrated to approximately 100 mCi/ml, calibrated, and loaded into the (ISAT) which is subsequently transported to the cardiac catheterization laboratory. The delivery catheters are modified ...
Prognosis of 95 consecutive patients with non-small cell lung cancer with brain metastases were evaluated. Three factors, therapy for brain metastases, general performance status (PS) and distant metastases to other organs had significant impact on survival. Among these 3 factors, PS was independent from the other 2 factors. Significant correlation was present, however, between therapy and other organ metastases, and few patients with brain and other distant metastases received aggressive treatment for brain metastases. Cranial irradiation had significant impact on survival even in those patients with brain and other distant metastases. Cranial irradiation also reduced death from brain metastases in responders. Our results indicate that there are several subgroups with different prognosis in patients with non-small cell lung cancer with brain metastases, therefore the most beneficial treatment modality should be selected for each group of ...
Infrainguinal peripheral occlusive disease is increasingly being treated by endovascular techniques. Bare metal stainless steel, self-expanding nitinol stents, drug-eluting and covered stents (stent grafts) are becoming increasingly more important adjuncts to percutaneous translumninal angioplasty in the treatment of peripheral artery disease. In this article the available evidence supporting the use of stents in the femoropopliteal and tibial arteries will be described as well as their limitations. Future stent developments will also be discussed. (orig.) [German] Die endovaskulaere Therapie spielt bei der Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) eine wichtige Rolle. Unbeschichtete ballonexpandierbare Stahlstents, selbstexpandierende Nitinolstents sowie medikamentenbeschichtete und ''covered stents'' (Stentgrafts) haben eine zunehmende Bedeutung als Zusatztherapie zusammen mit der ...
Several configurations of moderating and shielding materials have been designed and measured on the LVR-15 reactor for boron neutron capture therapy (BNCT) purposes. To determine the neutron and gamma ray space-energy distributions in the cylindrical geometry, the two-dimensional code DOT with the coupled neutron-gamma data library DLC-36 was used. The experimental verification of the beam parameters was performed in the LVR-15 reactor thermal column empty space with layers of graphite, aluminium, alumina, lead and bismuth. Attention was paid to establishing techniques and instrumentation for monitoring the neutron and gamma ray dose and beam quality. The thermal and epithermal flux densities were measured by activation foils, the neutron spectrum was determined with a Bonner spectrometer and gamma ray background with a scintillation spectrometer. The distribution of thermal neutrons in the human head phantom was mapped with a small semiconductor detector (Si[sup ...
Several configurations of moderating and shielding materials have been designed and measured on the LVR-15 reactor for boron neutron capture therapy (BNCT) purposes. To determine the neutron and gamma ray space-energy distributions in the cylindrical geometry, the two-dimensional code DOT with the coupled neutron-gamma data library DLC-36 was used. The experimental verification of the beam parameters was performed in the LVR-15 reactor thermal column empty space with layers of graphite, aluminium, alumina, lead and bismuth. Attention was paid to establishing techniques and instrumentation for monitoring the neutron and gamma ray dose and beam quality. The thermal and epithermal flux densities were measured by activation foils, the neutron spectrum was determined with a Bonner spectrometer and gamma ray background with a scintillation spectrometer. The distribution of thermal neutrons in the human head phantom was mapped with a small semiconductor detector (Si"6Li). ...
The present case report documents the hitherto unusual application of camouflage orthodontics in one of our patients. Our female patient had previously been treated orthodontically alio loco and had also undergone bimaxillary orthognathic surgery. She presented with TMJ complaints, with associated pains. Despite a dental Class I and centrally seated condyles, her discs had prolapsed anteriorly without reduction and she had developed a massive degenerative-inflammatory TMJ disease. Skeletally, she was a Class II case despite previous orthognathic surgery. In addition, there was also an initial suspicion of rheumatic involvement that could not be confirmed. We distalized the entire lower dental arch without bicuspid extraction. Then we advanced the mandible with the Mandibular Anterior Repositioning Appliance (MARA).We discuss exactly how the modified camouflage therapy was structured and how the individual treatment steps took place. PMID:20354841
In this study, a miniature fiber-optic radiation detector has been developed using a water-equivalent organic scintillator for electron beam therapy dosimetry. Usually, two kinds of light signals such as fluorescent and Cherenkov lights are generated in a fiber-optic radiation detector when a high-energy electron beam is irradiated. The fluorescent light signal is produced in the scintillator and is transmitted through a plastic optical fiber to a remote light-measuring device such as a PMT or a photodiode. The Cherenkov light could be also produced in the plastic optical fiber itself and be detected by a light-measuring device. Therefore, it could cause problems or limit the accuracy of the detection of a fluorescent light signal that is proportional to dose. The objectives of this study are to measure, characterize and eliminate Cherenkov light generated in a plastic optical fiber used as a component of a fiber-optic radiation detector and to detect a real ...
In the case of total skin electron therapy without the beam guide, the electron beam is scattered just outside the gantry exit, dose uniformity in the field is broken, and dose is spread outside the light field. The aims of this study were to measure the mean energy of the off-axis incident electron beam without the beam guide and to establish a reference for the clinical situation. For the measurement, a 4 MeV electron beam was selected among several energies from the linear accelerator. A scintillating fiber beam energy monitor measured the mean energy of the incident electron beam. This energy monitor is a small, light-weight piece of equipment composed of a wedge absorber, scintillation fiber, and photodiode. We found the relationship between electron energy and the indicated value of the energy monitor by means of the estimation of correction factors for five different kinds of electron energy. The preferable linear correlation of 0.997 of the coefficient of ...
Megavoltage photon intensity-modulated radiation therapy (IMRT) is typically used in the treatment of prostate cancer at our institution. Approximately 1% to 2% of patients with prostate cancer have hip prostheses. The presence of the prosthesis usually complicates the planning process because of dose perturbation around the prosthesis, radiation attenuation through the prosthesis, and the introduction of computed tomography artifacts in the planning volume. In addition, hip prostheses are typically made of materials of high atomic number, which add uncertainty to the dosimetry of the prostate and critical organs in the planning volume. When the prosthesis is bilateral, treatment planning is further complicated because only a limited number of beam angles can be used to avoid the prostheses. In this case study, we will report the observed advantages of using noncoplanar beams in the delivery of IMRT to a prostate cancer patient with bilateral hip prostheses. The ...
In 1981, the German Society of Pediatric Oncology initiated a multi-institutional study for the treatment of Ewing's sarcoma. The protocol (Cooperative Ewing's Sarcoma Study, CESS 81) consisted of four courses of a four-drug-regimen (VACA), each course taking nine weeks. Local therapy (radical surgery or resection plus irradiation or radiotherapy alone) was performed after the second course. The results of CESS 81 can be summarized as follows: VACA-chemotherapy is effective in controlling systemic disease. Initial tumor mass and response to initial chemotherapy are of major prognostic value for local control and survival. Permanent local control is a problem, especially in irradiated patients. The high local failure rate in irradiated patients in CESS 81 could be attributable to the following reasons: Late start of local therapy (after 18 weeks of chemotherapy), uneven distribution of prognostic parameters: Large tumors were more often ...
In the paper six cases of facial osteomyelitis as a complication of chronic sinusitis in hemophiliac-AIDS patients are reported. Osteomyelitis was suggested by an increasing of erythrocyte sedimentation rate. The diagnosis was confirmed by a positive {sup 99m} Tc MDP scintigraphy. The patients were submitted to clinical treatment. The erythrocyte sedimentation rate and 67-gallium citrate scans were used in the follow-up of the therapy. Three patients had negative gallium after three weeks of organism-specific antibiotic therapy; in two patients the gallium scintigraphy remained positive. One patient did not undergo the radionuclide scan for this clinical conditions. These results suggest that MDP scans showed higher sensitivity and specificity in detection of bone disease in chronic sinusitis. Gallium scans appeared to be valuable tool in the follow-up of the infection. There are no reports in the literature of osteomyelitis as a complication ...
The current study investigated relations among ethnic similarity in caregiver-therapist pairs of youth participating in Multisystemic Therapy, therapist adherence, and youth long-term behavioral and criminal outcomes. Participants were 1,979 youth and families treated by 429 therapists across provider organizations in 45 sites. Relations were found, independently, and in the presence of ethnic similarity, between adherence and reductions in youth externalizing and internalizing behavior problems 1-year posttreatment and youth criminal charges 4 years posttreatment. Relations between ethnic similarity and outcomes were found only for reductions in youth externalizing behavior problems and not when adherence was included in the model. Adherence ratings were higher, however, in ethnically similar caregiver-therapist pairs, and evidence was found that this increased adherence predicted slightly better outcomes for youth. Implications for further research and clinical ...
Early effects of boron neutron capture therapy (BNCT) on malignant glioma are characterized by reduction of the enhancement area and regression of the peritumoral edema radiologically. The aim of this study was to investigate the early histological changes of tumors and inflammatory cells after BNCT in the rat brain. Rats were treated with BNCT using boronophenylalanine (BPA) 7 days after implantation of C6 glioma cells. The tumors were assessed with magnetic resonance imaging and histopathological examination at 4 days after BNCT. The mean tumor volumes were 39#+-#2 mm"3 in the BNCT group and 134#+-#18 mm"3 in the control group. In the BNCT group, tumor cells showed a less pleomorphic appearance with atypical nuclei and mitotic figures. The Ki-67 labeling index was 6.5%#+-#4.7% in the BNCT and 35%#+-#3.8% in the control group. The reactions of the inflammatory cells were examined with ED-1 as macrophage marker and OX42 as microglia marker. ED-1- and OX-42-positive ...
A prototype electron applicator system providing circular and rectangular fields for use in intraoperative electron beam therapy with a Varian Clinac 18 linear accelerator has been fabricated. The dosimetric properties of this system for a variety of electron-beam energies, applicator sizes, and x-ray collimator settings was documented. Significant findings include: (a) surface dose values are in excess of 90% for electron energies of 12 MeV and above; (b) for the 18-MeV beam, the deepest depth where the central axis dose is 90% of its maximum value is in excess of 50 mm for circular applicators whose diameters are in excess of 5 cm; and (c) the treatment time to deliver 1000 rads ''given dose'' (at a given dose rate of 300 MU/min) is on the order of 3--4 min. Cross-field behavior is acceptable for the intended application and x-ray contamination is less than 4% for any applicator/electron energy combination. A system for irregular field blocking and TLD ...
Background: the authors report on the conception and first clinical application of a donut-shaped high-dose configuration for proton therapy (PT). This approach allows one to intensify target volume dose coverage for targets encompassing a critical, dose-limiting structure - like here, the cauda equina -, whilst delivering minimal dose to other healthy structures surrounding the target, thereby reducing the integral dose. Methods and results: intensity-modulated PT methods (IMPT) for spot scanning were applied to create and deliver a donut-shaped high-dose configuration with protons, allowing treating > 75% of the target with at least 95% of the prescribed dose of 72.8 CGE, whilst restricting dose to the cauda equina to 60-65 CGE. Integral dose was lower by a factor of 3.3 as compared to intensity-modulated radiotherapy with photons (IMXT). Conclusion: IMPT and spot scanning technology allow a potentially clinically useful approach which is also applicable ...
Background: the authors report on the conception and first clinical application of a donut-shaped high-dose configuration for proton therapy (PT). This approach allows one to intensify target volume dose coverage for targets encompassing a critical, dose-limiting structure - like here, the cauda equina -, whilst delivering minimal dose to other healthy structures surrounding the target, thereby reducing the integral dose. Methods and results: intensity-modulated PT methods (IMPT) for spot scanning were applied to create and deliver a donut-shaped high-dose configuration with protons, allowing treating > 75% of the target with at least 95% of the prescribed dose of 72.8 CGE, whilst restricting dose to the cauda equina to 60-65 CGE. Integral dose was lower by a factor of 3.3 as compared to intensity-modulated radiotherapy with photons (IMXT). Conclusion: IMPT and spot scanning technology allow a potentially clinically useful approach which is also applicable to ...
The low in vivo transduction efficiency of recombinant adeno-associated virus (rAAV) and the undesirably strong immunogenicity of adenovirus (rAdv) have limited their clinical utilization in cancer gene therapy. We have previously demonstrated that intratumoral injection of rAAV expressing a C-terminal polypeptide of human telomerase reverse transcriptase (rAAV-hTERTC27) effectively inhibits the growth of glioblastoma xenografts in nude mice. To further improve its efficacy, we combined rAAV-hTERTC27 with rAdv and investigated the efficiency of the cocktail vectors in vivo. At a nontherapeutic dose (1 x 108 plaque-forming units (PFUs)), rAdv-null and rAdv-hTERTC27 were equipotent in enhancing the therapeutic efficacy of rAAV-hTERTC27 (1.5 x 1011?v.g.), and complete tumor regression w...
Hematopoietic stem cells (HSCs) have remained at the forefront of stem cell research for the past 50 years, since the therapeutic potential of bone marrow transplantation was realized. Uniquely, among stem and progenitor cells, research progress has been made in parallel between the laboratory benchtop and hospital bedside during this period. Integral to this work has been the role of the transfusion medicine services in the collection, storage, and processing of HSCs. The next decade promises to bring further developments: with new fields of cellular therapies, stem cell vaccination, and stem cell drug testing opening up. This article summarizes exciting areas of research concerning the behavior and potential clinical applications of HSCs. For the purposes of clarity, we describe in turn the trafficking and transfer of HSCs; ex vivo expansion of HSC units from different sources; and finally, applications of specifically selected subsets of hematopoietic cells and ...
Therapeutic effect of p-aminobenzoic acid-N-xyloside Na (K-247) were studied. Eleven patients with a variety of solid tumors were treated with K-247 alone. K-247 was given orally 800 mg daily for 4 weeks. As for side effect of the drug, only mild gastritis was observed in a few patients. Partial response (over 25% reduction of tumor size) with a median duration of two months was observed in 3 patients. These cases were metastatic tumor of lung from the carcinoma of thyroid, metastatic tumors of lung from the carcinoma of kidney, and mediastinal tumor. In eight patients the response was classified as no change and in one patient there was progressive disease. Thus K-247 has some therapeutic activity in patients with solid tumor. Combination therapy of irradiation and administration of K-247 were also studied. In the twelve patients receiving the combination therapy, partial response was observed in 7 patients with complete response in 3 ...
While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent ...
Quantitative bone scintigraphy was performed on 23 white females with post-menopausal osteoporosis and vertebral compression fractures. These patients were then entered into a randomized, double-blind clinical trial or sodium fluoride therapy (NaF=14, placebo=9) which included repeat bone scintigraphy every six months. Scintigraphic images were acquired for 500K counts per image over the total body with computer acquisition over the posterior thoracic and lumbar spine. Images were obtained on a wide field-of-view gamma camera two hours after injecting 15 mCi of Tc-99m MDP. Data analysis showed a significant reduction in the activity ratio of abnormal vertebral body to normal vertebral body in those patients treated with sodium fluoride (paired t-test p=0.0095). No significant change was observed in the control group of (p=0.142). These results suggest that sodium fluoride therapy promotes more rapid healing of osteoporotic vertebral fractures. ...
The research on the therapy of brain tumors and others by the thermal neutron irradiation using research reactors is to kill tumor cells by accumulating boron at a tumor part, and using {alpha} particles and {sup 7}Li generated by {sup 10}B(n, {alpha}){sup 7}Li reaction of thermal neutrons, which is known as boron neutron capture therapy (BNCT). In Japan Atomic Energy Research Institute, the medical irradiation facility was installed in the thermal neutron column of the JRR-2, and as of March, 1994, 22 cases of irradiation have been carried out. In order to monitor the variation of thermal neutron flux during irradiation, the real time measurement using a simultaneous monitor is carried out, but there is the variation of measured values in the Si semiconductor, p-n junction detector possibly due to its direction dependence. The experiment was carried out to quantity the direction dependence of the detector by using the neutron radiography ...
Electron beam therapy of lesions such as cutaneous metastatic carcinoma and reticulum cell sarcoma is performed via multiple portals for a wide irradiation field. However, the dose distribution in border areas is generally uneven, resulting in hot and cold dose areas depending on the intervals of the portals. We performed electron irradiation by the pendulum technique, especially on curved areas, and evaluated the technique in various respects. Pendulum electron beam irradiation is indicated when the length of the cone must be reduced in order to deliver the target volume near the skin surface as well as to avoid the occurrence of hot spots deep in the body. We prepared a 15cm rotating cone by cutting a 30cm fixed irradiation cone. The modification posed no disadvantages in terms of extent and flatness of the beam, or stability during rotation. After determining the relationship between the rotation speed and the dose, the technique was successfully applied to a ...
To quantify the number of cases and clinical courses of Acanthamoeba keratitis treated at the King Khaled Eye Specialist Hospital (KKESH) between December 1982 and May 2005, and to review their clinical course and response to medical and surgical therapy. Retrospective review of medical records of all patients with Acanthamoeba keratitis diagnosed by the KKESH Microbiology or Pathology or Pathology Laboratory since the opening of the hospital. During a period of over 22 years, only six cases of confirmed. Acanthamoeba keratitis were diagnosedand treated at KKESH. In two cases the diagnosis was made by corneal biopsy, while four cases required examination of a histopathology specimen obtained at the time of therapeutic keratoplasty to establish the diagnosis. One eye was cured by medical therapy, while five eyes required one (4eyes) or two (1 eye) therapeutic penetrating keratoplasty (PKP) to achieve a clinical cure. Three eyes achieved good ...
Objective The aim of this study was to analyze the clinical results of our adaptive radiation therapy scheme of a two-step intensity-modulated radiotherapy (IMRT) method for nasopharyngeal cancer (NPC) at Kinki University Hospital. Methods Between 2000 and 2007, 35 patients with Stage I-IVB NPC treated by IMRT were included. For all patients, treatment-planning computed tomography was done twice before and during IMRT to a total dose of 60-70 Gy/28-35 fractions (median 68 Gy). Chemotherapy (cisplatin 80 mg/m2/3 weeks x 1-3 courses) was given concurrently with IMRT for 31 patients. Results The 3- and 5-year overall survival rates for the 31 patients treated with concurrent chemotherapy were 88% and 83%, respectively. The 3- and 5-year loco-regional control rates for the 31 patients were 93%...
Gantries in the proton/carbon cancer therapy machines represent the major cost and are of the largest size. This report explains a new way to the gantry design. The size and cost of the gantries are reduced and their use is simplified by using the fixed magnetic field. The ''new'' gantry is made of a very large momentum acceptance non-scaling Fixed Field Alternating Gradient (FFAG) quarter and half arc beam lines. The gantry is made of combined function magnets with a very strong focusing and small dispersion function. Additional magnets with a fast response are required to allow adjustments of the beam position for different energies at the beginning of the gantry. Additional strong focusing magnets following the gantry have also to be adjustable to provide required spot size and radial scanning above the patients. The fixed field combined function magnets could be made of small permanent magnets for the proton machine, or of ...
A novel compact CT-guided intensity modulated proton radiotherapy (IMPT) system is described. The system is being designed to deliver fast IMPT so that larger target volumes and motion management can be accomplished. The system will be ideal for large and complex target volumes in young patients. The basis of the design is the dielectric wall accelerator (DWA) system being developed at the Lawrence Livermore National Laboratory (LLNL). The DWA uses fast switched high voltage transmission lines to generate pulsed electric fields on the inside of a high gradient insulating (HGI) acceleration tube. High electric field gradients are achieved by the use of alternating insulators and conductors and short pulse times. The system will produce individual pulses that can be varied in intensity, energy and spot width. The IMPT planning system will optimize delivery characteristics. The system will be capable of being sited in a conventional linac vault and provide intensity modulated rotational ...
Because toxicity with the use of 3000 centiGray (cGy) of total lymphoid irradiation (TLI) was observed in an earlier study, 2000-cGy treatments were delivered in a 2-portal format to 7 patients and in a modified 3-portal fashion to 6 patients, as part of a randomized, investigator-blinded trial of TLI treatment for refractory rheumatoid arthritis. Analysis of combined data from the 13 patients revealed statistically significant improvement in 5 clinical indicators of disease activity at the end of TLI and 6 and 12 months later, accompanied by T4-specific immunosuppression. Management considerations resulted in the introduction of prednisone therapy in 5 patients, methotrexate in 4, and azathioprine in 1 during the interval of 8-12 months post-TLI. Herpes zoster occurred in 5 patients prior to the initiation of this additional therapy. These data indicate that, in patients with rheumatoid arthritis, a TLI dose of 2000 cGy is sufficient to ...
Combined treatment of 131 patients aged 3-16 with local form of Ewing's sarcoma is carried out. Survival rate per year was studied in patients without diagnosed metastases depending on chemiotherapy method. It is stated that improved results of treatment of children with Ewing's sarcoma may be achieved by combining radiotherapy with long-term systemic polychemotherapy. The most efficient and expedient method of radiotherapy of long bone sarcoma in children is dialy three-field irradiation with 2 Gy at SFD to the tumor 60 Gy, and adjacent tissues - 40 Gy.
Lupus pernio of the nose is the most characteristic cutaneous lesion of sarcoidosis. It is cosmetically disfiguring and can be the cause of significant morbidity. In particular, the affected skin is often red or purple due to increased vasculature. It is particularly resistant to both surgical and medical therapy. We describe a patient with lupus pernio affecting her nose, which showed a dramatic improvement following treatment with the pulse dye laser (PDL). A biopsy taken after treatment showed the continued presence of sarcoidal granulomas. We therefore feel that treatment with the PDL is an effective tool in improving the cosmetic appearance of lupus pernio, but does not influence the underlying disease process. PMID:11360426
Computer assisted energy-spectral analyses were obtained on EEG recordings of unilateral non-dominant hemisphere ECT-induced seizures using the different pre-ECT anesthetic agents methohexital (Brevital), Innovar, and ketamine (Ketalar). The previously postulated predominance of electrical energy over the stimulated (right) hemisphere early in ECT-induced seizures is confirmed. There appears to be marked reduction in total seizure energy with methohexital anesthesia, whereas ketamine anesthesia appears to be associated with increased overall seizure energy. The greatest right to left energy transfer during the seizure occurred with Innovar anesthesia. PMID:7172456
Advances in the diagnosis of Ewing's sarcoma of the rib were considered and retrospective analysis of the treatment of 32 patients (76% of them were children at the age of 10-15 y.o.) in the clinic of children oncology was performed. It was shown that the diagnosis of Ewing's sarcoma of the rib in children ought to be combined taking into account the course, morphology and radiation examination techniques. Most optimum treatment consisted of combined therapy (cyclic polychemotherapy, lesion focus irradiation at the summary focus dose of 57 Gy, surgery with subsequent polychemotherapy for not less than 1.5 years
It may result in acute radiation syndrome after body is exposed to ionizing radiation. The one of long-term effects of irradiation injury is leukemia. The bone marrow cells (BMC) transplantation including stem cells is the only effective therapy for acute radiation syndrome patients. Recently, with the advancement of stem cell research that the stem cells have multipotential and can convert each other, it may supply the new stem source for the irradiation injury patients. At the same time with the further research of radioprotective reagents, the hematopoietic stem cells proliferation after irradiation injury is promoted
The discussion focuses on the ways in which the 3 panelists in their lives and work embody fourth wave feminism, which combines politics, psychology, and spirituality in an overarching vision of change. Jane Fonda's emphasis on the importance of making narratives of gender a central organizer for personal and societal transformation, Hedda Bolgar's insistence that psychoanalysts recognize the complex dialectic between unconscious dynamics and sociocultural realities in order not to conflate conflicts rooted in social inequalities with individual issues, and Sue Shapiro's understanding of the ambiguous role of individual therapy in situations of historical and social trauma such as the tsunami in Indonesia are all examples of fourth wave feminism in practice. The unfinished business of the ...
The proton beam has an advantage of the sharp dose falloff in dose distribution called Bragg peak while conventional radiation therapy modalities such as photons exhibit considerable amount of exit dose. To take advantage of this property it is important to know the exact location of the distal dose falloff. An error can cause overdose to the normal tissue or underdose to the tumor volume. The only way of finding out the dose distribution in-situ in particle therapy is to measure the gammas produced by nuclear reactions with tissue materials. Two kinds of gammas can be used: one is prompt gamma and the other is coincident gamma from the positron-emission isotopes. We chose to detect prompt gammas, and developed a prompt gamma scanning system (PGS). The proton beams of the proton therapy facility at National Cancer Center were used. The gamma distribution was compared to the dose distribution measured by an ionization ...
Abstract The term -stem cell- most commonly refers to embryonic stem cells, particularly in the lay media; however, it also describes other cell types. A stem cell represents a cell of multi-lineage potential with the ability for self-renewal. It is now clear that the plasticity and immortality of a given stem cell will depend on what type of stem cell it is, whether an embryonic stem cell, a fetal-placental stem cell or an adult stem cell. Stem cells offer great promise as cell-based therapies for the future. With evolving technology, much of the socio-political debate regarding stem cells can now be avoided.
The short range of low-energy electrons has made them suitable for the treatment of skin lesions, especially when extensive areas must be irradiated with special considerations to save the normal underlying tissue. This report covers some salient features of total body electron irradiation: the construction of the large fields required, x-ray contamination levels, and multiple-field techniques. While the investigation is essentially experimental, we also indicate the results of calculations. We conclude most generally that treatment planning with whole skin irradiations can be as precise as with smaller fields.
Anxiety disorders are a highly prevalent and disabling class of psychiatric disorders. This review focuses on new directions in neurobiological research and implications for the development of novel psychopharmacological treatments. Neuroanatomical and neuroimaging research in anxiety disorders has centered on the role of the amygdala, reciprocal connections between the amygdala and the prefrontal cortex, and, most recently, alterations in interoceptive processing by the anterior insula. Anxiety disorders are characterized by alterations in a diverse range of neurochemical systems, suggesting ample novel targets for drug therapies. Corticotropin-releasing factor (CRF) concentrations are elevated in a subset of anxiety disorders, which suggests the potential utility of CRF receptor antagoni...
Dyspnea is the most distressing symptom experienced by those suffering from advanced stages of chronic obstructive pulmonary disease (COPD). Activity-related dyspnea in COPD is multifactorial but is associated with increased central neural drive, impaired dynamic respiratory mechanics and abnormal respiratory muscle function. Each of these components can potentially be targeted for pharmacotherapy. Recent advances in the pharmacotherapy of COPD include the development of new long-acting bronchodilators which, when combined, provide sustained improvements in dyspnea. Additionally, novel applications of older therapies such as opiates, furosemide, helium-oxygen, and statins show early promise as dyspnea-relieving interventions in COPD. Effective pharmacological manipulation of the affective ...
This text-book (electronic book - multi-media CD-ROM) constitutes a course-book - author's collection of lectures. It consists of 13 lectures in which the reader acquaints with the basis of radiobiology: Introduction to radiobiology; Physical fundamentals of radiobiology; Radiation of cells; Modification of radiation damage of cells; Reparation of radiation damage of cells; Radiation syndromes and their modification; Radiation injury; Radiation damage of tissues; Effect of radiation on embryo and fetus; Biological effects of incorporated radionuclides; Therapy of acute irradiation sickness; Delayed consequences of irradiation; Radiation oncology and radiotherapy. This course-book may be interesting for students, post-graduate students of chemistry, biology, physics, medicine as well as for teachers, scientific workers and physicians. (author)
Purpose: We present an update analysis of the multiinstitutional Ewing's sarcoma study CESS 86. Methods and Materials: From January 1986 through June 1991, 177 patients with localized Ewing's sarcoma of bone, aged 25 years or less, were recruited. Chemotherapy consisted of four 9-week courses of vincristine, actinomycin D, cyclophosphamide, and adriamycin (VACA) in low-risk tumors (extremity tumors =# 100 cm"3). Local therapy was an individual decision in each patient and was either radical surgery (amputation, wide resection) or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy (45 Gy plus boost). Irradiated patients were randomized concerning the type of fractionation in either conventional fractionation (once daily 1.8-2.0 Gy, break of chemotherapy) or hyperfractionated split-course irradiation simultaneously with the VACA/VAIA chemotherapy (twice daily 1.6 Gy, break of 12 days after 22.4 Gy and 44.8 Gy, total dose and ...
Control of human filarial infections currently depends on chemotherapeutic strategies predominantly directed at microfilariae. Doxycycline therapy in an extended daily dose regimen sterilizes and kills adult stages, but the utility of this drug for routine field use remains an issue of concern. No macrofilaricidal drugs with efficacy after one or two doses are available for use, delaying the achievement of the elimination or eradication of onchocerciasis and lymphatic filariasis. Moxidectin, a macrocyclic lactone, is currently in clinical trials for onchocerciasis. A few other drugs that have already been approved for use in veterinary practice or in human medicine for other indications are available for investigation. Early drug discovery pipelines are poorly populated and the process of ...
Periosteal Ewing's sarcoma is an uncommon, but well documented origin of this malignant condition with radiography signs, different from intramedullary growing tumours. Imaging modalities like CT or MRI supply proof of macroscopically intact endosteal cortical surface and free medullary cavity in long bones affected by this periosteal type of malignancy. Definite confirmation is valid after a careful microscopic investigation of the resected specimen. The prognosis of this type of Ewing's sarcoma may be favourable than that of the central type. Early diagnosis and therapy are thus essential. A clinical survey of six observations is given. (orig.).
Oral mucositis associated with head and neck radiotherapy can substantially hinder completion of cancer therapy. Alleviation of this often severe stomatitis can provide enhanced patient comfort and facilitate appropriate care. A double-blind format was used in a pilot project to measure, against a control rinse, the effectiveness of an oral rinse consisting of hydrocortisone, nystatin, tetracycline, and diphenhydramine in controlling radiation-related mucositis. A combination of clinical evaluation and patient responses to a questionnaire was used to judge the results of the topical medications. Patients using the experimental medication developed less mucositis than did patients in the control group.
The long-term survival of certain patients after treatment with radiation or chemotherapeutic agents has allowed the realization that agents that effectively control cancer in the human subject may also possess an oncogenic potential, resulting in secondary malignancies in a significant proportion of surviving patients. A quantitative assessment of the oncogenic effects of these agents at a cellular level is important, as is information on conditions and agents that may effectively alter the development of the neoplastic state. Cell culture systems where the neoplastic transformation of cells can be scored after exposure to carcinogens offer powerful tools for evaluating the oncogenic potential of radiation and chemotherapeutic agents.
Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and "1"3"1I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of "1"3"1I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 ...
Transdifferentiation of an individual's own cells into functional differentiated cells to replace an organ's lost function would be a personalized approach to therapeutics. In this two part series, we will describe the progress toward establishing functional transdifferentiated adrenal cortical cells. In this article (Part 2), we describe the disorders of the adrenal cortex, therefore establishing why there is the need for personalized cell-based therapy for individuals with these disorders. We then present our pilot studies of cell transdifferentiation toward an adrenal cortical fate using genes described in the first article of this pair (Part 1).
The interest of irradiation by carbon ions is in the fact that the carbon ions leave all their energy to a determined depth. ( phenomenon known under the name of Bragg peak)This high diffusion in tissue gives an RBE particularly high. The indications of this therapy are chordomas, and chondrosarcomas of the skull base, some cyst adenoid carcinomas, pulmonary cancer, sarcomas, hepato carcinomas, melanomas. In the light of results in term of efficiency, the place of irradiation by carbon ions should widen. (N.C.)
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-{alpha} antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-{alpha} antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
An in vitro system for studying Pu uptake by, and removal from, macrophages was developed to provide data for the actinide therapy program. We have shown that "2"3"9PuO_2 particle uptake in vitro resembles the process in vivo with respect to the intracellular localization of phagocytized particles. At the end of 7 days of culture of Pu-loaded cells, 54% of the cells were viable even though 71% of the cells in the culture initially contained enough "2"3"9PuO_2 to deliver more than 53 intracellular #alpha#-disintegrations.
Spinal cord stimulation (SCS) is frequently used for relief of chronic benign pain resistant to conservative therapies. Clinical practice suggests, at least in patients with failed back surgery syndrome (FBSS), the possibility that SCS significantly improves motor performances. We present here the case of a 41-years-old female patient with FBSS, who showed a clear improvement in muscle strength after SCS, persisting at 6-months follow-up. We speculate that the electrical stimulation of posterior columns could potentiate the caudal, segmental spinal reflexes resulting in a facilitation of motoneurons activation. PMID:16175150
This report is a summary of the progress and research produced for the Idaho National Engineering and Environmental Laboratory (INEEL) Boron Neutron Capture Therapy (BNCT) Research Program for calendar year 1996. Contributions from the individual investigators about their projects are included, specifically, physics: treatment planning software, real-time neutron beam measurement dosimetry, measurement of the Finnish research reactor epithermal neutron spectrum, BNCT accelerator technology; and chemistry: analysis of biological samples and preparation of {sup 10}B enriched decaborane.
This report summarizes the major activities and accomplishments of the Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Radiotherapy Research Program for calendar year 2001. Applications of supportive research and development, as well as technology deployment in the fields of chemistry, radiation physics and dosimetry, and neutron source design and demonstration are described. Contributions in the fields of physics and biophysics include development of advanced patient treatment planning software, feasibility studies of accelerator neutron source technology for Neutron Capture Therapy (NCT), and completion of major modifications to the research reactor at Washington State University to produce an epithermal-neutron beam for NCT research applications.
This report summarizes the major activities and accomplishments of the Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Radiotherapy Research Program for calendar year 2001. Applications of supportive research and development, as well as technology deployment in the fields of chemistry, radiation physics and dosimetry, and neutron source design and demonstration are described. Contributions in the fields of physics and biophysics include development of advanced patient treatment planning software, feasibility studies of accelerator neutron source technology for Neutron Capture Therapy (NCT), and completion of major modifications to the research reactor at Washington State University to produce an epithermal-neutron beam for NCT research applications.
It is possible to produce energetic beams of radioactive nuclei, as secondary beams, from the heavy-particle compound accelerator called BEVALAC. These beams can be focused into experimental areas without significant contamination using suitable magnetic filters and proper beam-optics. Properly selected high-energy beams of radioactive nuclei (those which defay by positron emission) can provide a truly unique opportunity to evaluate the effectiveness of these beams in localizing the Bragg peak on a tumor volume - necessary in heavy-particle therapy. Preliminary data are presented here to demonstrate the possible use of these beams in radiotherapy treatment-planning verification.
Objective: To estimate exposure dose of personnel around patients by Monte Carlo method and integration method. Methods: Exposures were estimated by a Monte Carlo practical program with Visual Basic 6.0 and integration method using 'pen-and-paper'. Results: Exposures for rectangle and ellipse sources were calculated. The difference between different methods for various sources were 0.88% and 0.61%, respectively. Conclusion: The results estimated by Monte Carlo method are close to those of integration method. It is illustrated that doses of other people estimated by Monte Carlo method are significant
We present the case of a 12-year-old girl who presented with a pathological fracture through a benign-appearing osteolytic lesion that was presumed to represent fibrous dysplasia. The fracture healed, and over the next 2.5 years there was further refracturing and healing with progressive osteolysis. A biopsy was performed and revealed Ewing's sarcoma. The disease was locally controlled by neoadjuvant chemotherapy and radiation therapy. The patient is disease free with excellent function 6 years following the discovery of the lesion. We illustrate and discuss the sequence of events. (orig.)
Two patients are described in whom sunburn and electron beam radiodermatitis, respectively, were critical determinants in localizing the initial presentation of drug eruptions. In the first instance, a severe sunburn of the back and thighs was followed 7 months later by the appearance of a toxic epidermal necrolysis drug reaction to trimethoprim-sulfamethoxazole in the exact sites of the previous bullous sunburn reaction. In the second patient, a radiodermatitis of the left upper arm due to electron beam therapy for metastatic breast cancer was followed 7 weeks later by a codeine drug reaction confined to the area of the radiodermatitis. In both instances, oral rechallenge with the offending drug reproduced the eruption.
Delayed cerebral necroses after irradiation are to be divided into hemispheric and midline lesions, as they differ from each other in several aspects. Apart from the symptoms, they are differing in the duration of latency, in the course and prognosis, and also with regard to morphology. Though there is no doubt that radiation tolerance of cerebral midline structures is relatively limited, on biological grounds, evidence of a difference between the tolerated doses could not be given from the existent inhomogeneous radiation data, with the help of the NSD-concept. Radiation planning for the region of the head, nevertheless, carefully should avoid in every case to involve the structures of the cerebral midline.
The purpose of this study is to clarify the confusing nomenclature and pathogenesis of Developmental Facial Paralysis, and how it can be differentiated from other causes of facial paralysis present at birth. Differentiating developmental from traumatic facial paralysis noted at birth is important for determining prognosis, but also for medicolegal reasons. Given the dramatic presentation of this condition, accurate and reliable guidelines are necessary in order to facilitate early diagnosis and initiate appropriate therapy, while providing support and counselling to the family. The 30 years experience of our center in the management of developmental facial paralysis is dependent upon a thorough understanding of facial nerve embryology, anatomy, nerve physiology, and an appreciation of well...
Optimal neutron energy for boron neutron capture therapy (BNCT) has been studied. Epithermal neutron is superior to thermal neutrons in treating deep-seated tumors. Design of the epithermal neutron column for BNCT has been performed by using a two-dimensional transport calculation code. Aluminum and heavy water are used as moderation materials. A thermal neutron column is also designed using heavy water as thermalization material. The configuration of the facility for treatment and research of BNCT and also for basic radio-biological studies of neutrons has been presented.
Optimal neutron energy for boron neutron capture therapy (BNCT) has been studied. Epithermal neutron is superior to thermal neutrons in treating deep-seated tumors. Design of the epithermal neutron column for BNCT has been performed by using a two-dimensional transport calculation code. Aluminum and heavy water are used as moderation materials. A thermal neutron column is also designed using heavy water as thermalization material. The configuration of the facility for treatment and research of BNCT and also for basic radio-biological studies of neutrons has been presented. (author).
A new phenylboric acid derivative entrapped lipiodol (PBAD-lipiodol) was developed as a boron carrier for the boron neutron capture therapy (BNCT) of hepatoma in Taiwan. The biodistribution of both PBAD-lipiodol and BPA-fructose was assayed in GP7TB hepatoma-bearing rat model. The highest uptake of PBAD-lipiodol was found at 2 h post injection. The application of BNCT for the hepatoma treatment in tumor-bearing rats is suggested to be 2-4 h post PBAD-lipiodol injection.
The radiation properties of the #alpha# emitter "2"1"1At are in favor of its application malignant tumor therapy. As a basis for further investigations the biokinetics of At"-, At x H_2O, At I_2"-, and [At(thio)_2]"+ were determined after i.v. injection into healthy and tumor-bearing mice. The estimation of the ion mobility of the carrier-free compounds allowed the use of uniquely characterized initial compounds. The organ distribution of all species examined was similar to the distribution of astatide. Accumulation was found in the thyroid and other inner organs. (author).
Excessive irradiation due to unexpected leakage was found on a patient receiving electron beam therapy. The cause of this leakage was analyzed and the amount of leakage was measured for different electron beam energies. The highest leakage occurred with a 6 x 6 cm cone using a 12 MeV electron beam. The leakage dose measured along the side of the cone could be as great as 40%. Until the cones are modified or redesigned, it is advised that all patient setups be carefully reviewed to assure that no significant patient areas are in the side scatter region.
Patients with end stage renal failure (ESRD) require renal replacement therapy in the form of dialysis or renal transplantation. There is an increasing number of people receiving maintenance dialysis as patients with ESRD are increasing faster than the supply of transplantable organs. The mortality rate on dialysis is 4-6 times that of the general population and is substantially reduced by transplantation. For the past 8 years, dialysis research has focused on improving patient outcomes and quality of life on dialysis. This review examines recent advances in haemodialysis and peritoneal dialysis in a historical context and considers future research possibilities. PMID:19329705
We encountered a case of Ewing's sarcoma. The patient was a 19 year-old girl, who visited a local physician because of pain in the left scapular region, and was referred to us. Roentgenograms of her left scapula revealed an irregular moth-eaten shadow which was suspected to be a malignant bone tumor. The histological diagnosis of Ewing's sarcoma was comfirmed by needle biopsy. The initial stage of treatment consisted of radiation therapy (6000 rads) and chemotherapy (VAC and ADR). At the end of the initial stage, the symptoms were improved, the size of the local lesion was reduced on the roentgenogram and there was no evidence of distant metastases. (author).
Purpose : To detect differentially expressed genes in the patients with uterine cervical cancer during the radiation therapy. Materials and Methods : In patients with biopsy proven uterine cervical cancer, we took a tumor tissue just before radiation therapy and at 40 minutes after external irradiation of 1.8 Gy. Total RNAs isolated from non-irradiated and irradiated tumor tissue samples were analyzed using the differential-display reverse transcription-polymerase chain reaction (DDRT-PCR). Complementary DNA (cDNA) fragments corresponding to differentially expressed messenger RNAs(mRNAs) were eluted, and cloned. The differential expression of the corresponding mRNAs was confirmed by reverse northern blot. Differentially expressed cDNA bands were sequenced. Nucleotide sequence data were analyzed in the Gene Bank and EMBL databases via the BLAST network server to identify homologies to known genes or cDNA fragments. Expression pattern of ...
Two children with cutaneous lymphoma and leukemia who were treated with total skin electron beam therapy (TSEB) are described here. Patient 1. A 7-year-old boy was admitted because of a mass over the bilateral parotis and anemia. The white blood cell count on admission was 5,000/ul. Bone marrow examination revealed 70 per cent monoblasts (M5a type by FAB classification). Complete remission was obtained following the regimen of daunomycin, cytosine arabinoside, 6-mercaptopurine and prednisolone. He was again admitted because of a skin nodule on the left thigh 19 months after initial diagnosis. A biopsy of the skin nodule demonstrated monoblastic infiltration. He received 20 Grays (Gy) to the left thigh and this led to resolution of the skin nodule. At that time, other skin nodules appeared on the right upper and lower extremities. He was treated with TSEB. Daily doses of 1 Gy were given twice a week with a 4 MeV electron beam and a total dose of 10 Gy was ...
Clinical information is indispensable for swift and cost-effective clarification of diseases of the larynx. While quality clarification of neurological changes in the area of the posterior cranial fossa and in the course of the vagus nerve as a cause of glottis malfunction is possible with MRI, localized disease of the larynx can more effectively be assessed with low-artifact CT. In the particularly difficult assessment of the post-operative larynx, a recurrence can be diagnosed only after a baseline study has been carried out after the end of therapy. With knowledge of the pretherapeutic findings, the findings immediately post-therapy, and the operation technique used, the optimal CT examination, which can be carried out quickly, will be able to provide more information about recurrence. (orig.) [Deutsch] Zur schnellen und kostenguenstigen Abklaerung von Erkrankungen des Larynx ist die klinische Information unabdingbar: Wenn neurologische ...
Gastrointestinal lymphomas are almost exclusively of a non Hodgkin's type. The Western form is characterized by a higher incidence of stomach location (50 %), a MALT type (mucosa associated lymphoid tissue) (40 %), a B-cell type (90 %), and a high grade (55 %). Chronic infection with Helicobacter pylori is an important risk factor. Mediterranean lymphomas form a particular clinical and pathological entity with diffuse involvement of the small bowel and are frequently being associated with a chronic malabsorption disorder. Eradication of Helicobacter pylori in early lymphomas, and the use of tetracyclines in early Mediterranean lymphomas, have been shown to induce durable remissions. For more advanced gastric lymphomas, treatment usually consists of anthracycline-based chemotherapy followed by involved field radiotherapy. Surgery is usually reserved for complications such as perforation or bleeding, or in some selected cases for salvage after failure of non-surgical ...
Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 years). Because of selection bias for radiotherapy, the majority of primary tumors were centrally located ...
From 1981 up to February 1985, a total of 93 protocol patients entered the study CESS 81. The protocol recommended an initial 18-week period of polychemotherapy (VACA) followed by local therapy and two additional cycles of chemotherapy. Local therapy consisted either of radical surgery or of incomplete resection plus postoperative irradiation with 36 Gy or of radiotherapy alone (46 and 60 Gy). Centrally located lesions were always irradiated with 60 Gy. This article summarizes the data after 5 years. Data of 93 patients were analysed in October 1986 after a median follow-up of 37 months. The projected 5-year survival is 50%. The relapse rate was 42%, distant relapses occurred in 19%, local (plus distant) relapses in 23%. Most of the relapses occurred during the first 3 years of observation. Failure rate was high in patients undergoing irradiation alone (44%). Initial tumour mass (> 100 ml) and histopathologic response to initial chemotherapy ...
As a series of estimations of population doses and of risk estimates from medical exposures in Japan, the malignancy significant dose (MSD) and the fatal malignant risk from beam therapy were estimated based on a nationwide survey of radiotherapeutic treatments, using a malignancy significant factor and a weighting factor determined from the data on the cancer mortality among the atomic bomb survivors in Nagasaki. The effective dose was defined as a sum of the product of the weighting factor and the organ or tissue doses with respect to the malignant diseases. The organ or tissue doses were determined with ionization chambers placed at the positions of their center in a MixDp-phantom simulated lung tissues by a block of cork, using a telecobalt unit, a conventional X-ray unit and a medical linear accelerator. The organ or tissue doses were categorized into three dose components; namely 1) dose from useful beams; 2) scattered radiation dose from irradiated materials ...
Background: EGFR (epidermal growth factor receptor) and VEGF (vascular endothelial growth factor) inhibitors confer clinical benefit in metastatic colorectal cancer when combined with chemotherapy. An emerging strategy to improve outcomes in rectal cancer is to integrate biologically active, targeted agents as triple therapy into chemoradiation protocols. Material and methods: cetuximab and bevacizumab have now been incorporated into phase I-II studies of preoperative chemoradiation therapy (CRT) for rectal cancer. The rationale of these combinations, early efficacy and toxicity data, and possible molecular predictors for tumor response are reviewed. Computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO and ASTRO meetings. Results: the combination of cetuximab and CRT can be safely applied without dose compromises of the respective treatment components. Disappointingly low ...
An increased compendium of drugs useful in ocular motor system dysfunction has expanded our capacity to treat selected ocular motility disorders. Adjunctive therapeutic modes (e.g., Fresnel prisms and orthoptic exercises) can also be beneficial. PAN and see-saw nystagmus can be treated with baclofen. Downbeat nystagmus may respond to clonazepam therapy, and prisms may help if the nystagmus can be modified with convergence. Congenital nystagmus may respond minimally to drugs (e.g., baclofen), but prisms or surgical procedures, or both, are still the primary treatment modalities. Innovar may be helpful in patients with severe, incapacitating vestibular disorders, and scopolamine alone or in combination with promethazine may be beneficial in patients with milder ambulatory acute peripheral vestibular disorders. Benign positional vertigo is best treated initially with positional exercises before drug therapy is instituted. Opsoclonus and ocular ...
Purpose: To analyze p53, bcl-2, c-myc, and cyclooxygenase-2 protein expression changes and examine their relationship with various antioxidant enzymes in esophageal carcinoma patients. Methods and Materials: Patients in Group 1 underwent transhiatal esophagectomy and those in Group 2 were administered chemoradiotherapy followed by surgery after 4 weeks of neoadjuvant therapy. Results: The relationship analysis among the various protein markers and antioxidant enzymes showed an inverse correlation between bcl-2 and superoxide dismutase/catalase in tumor tissues, irrespective of the treatment arm followed. An important positive association was observed between bcl-2 and reduced glutathione levels in the tumor tissue of patients receiving neoadjuvant therapy. Another apoptosis-modulating marker, c-myc, in the tumor tissue of Group 2 patients showed similar pattern levels (high and low) as that of superoxide dismutase/catalase. The association of ...
Background and purpose: In order to investigate the feasibility, toxicity and antitumor efficacy of hyperfractionated radiation therapy, 37 adult patients with incompletely resected supratentorial low-grade glioma were entered into a phase II study. Materials and methods: The radiation therapy dose was 55 Gy in 50 fractions in 25 treatment days over 5 weeks to the tumor plus a 2-cm margin, with an additional 17.6 Gy given in 16 fractions in 8 treatment days over 1.5 weeks to the tumor plus a 1-cm margin, using 1.1 Gy b.i.d. fractionation with a 6 h interfraction interval. The total tumor dose was 72.6 Gy in 66 fractions in 33 treatment days over 6.5 weeks. Results: The median survival time (MST) for all 37 patients has not yet been attained, while 5- and 7-year survival rates were 75% and 69%, respectively. The median time to tumor progression (MTP) has also not yet been attained, while 5- and 7-year progression-free survival (PFS) rates were ...
Changes in the phosphate metabolism of the transplanted SCCVII (squamous cell carcinoma VII) tumor were studied before and after irradiation using in vivo [sup 31]P-magnetic resonance spectroscopy (MRS). Phosphocreatine (PCr), [gamma]-, [alpha]-, [beta]-ATP, inorganic phosphate (Pi), phosphomonoester (PME), and phosphodiester (PDE) were detected in [sup 31]P-MR spectra of tumor tissues. The curve fitting method was employed for calculating each peak of [sup 31]P-MR spectra (PCr, [beta]-ATP, Pi, PME, PDE). The values of PCr, PCr/Pi, [beta]-ATP/Pi and pH decreased in proportion to the growth of tumor, whereas that of Pi, PME and PDE increased. But the changes of [beta]-ATP were minimal in degree. Based on the fact that the ratio of PCr/Pi highly correlated with tumor volume and showed the most remarkable change among various parameters, it might be the useful index for the tumor growth. Because the phospholipid metabolite PME was detected in the earlier stage of tumor growth, PME might ...
Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD) (follicle-stimulating hormone (FSH), 10 +/- 15 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml) and 17 ..beta..-estradiol (E/sub 2/) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developd persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 109 +/- 29 mlU/ml; LH, 72 +/- ...
Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD (follicle-stimulating hormone (FSH), 10 +/- 5 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml) and 17 beta-estradiol (E2) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developed persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 108 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) ...
The purpose of the current study was to evaluate the difference in prognostic factors between stage IB and II uterine cervical carcinoma patients treated with postoperative radiation therapy. Between May 1988 and May 1998, a total of 94 patients including 47 patients with stage IB and 47 patients with stage II uterine cervical carcinoma were treated with postoperative radiation therapy at Tokyo Metropolitan Komagome Hospital. All patients were treated with 10 MV X-rays using an anterior-posterior parallel opposed field which covered the whole pelvis. Fractionation was 2 Gy per day, five fractions per week, to a total dose of 50 Gy. The 5-year overall survival rates of stage IB and II were 89.4% and 79.3%, respectively. In multivariate analysis for all patients, lymph node status, histology, and surgical margin status were recognized as prognostic factors. Limited to stage IB patients, lymph node status was the only independent prognostic ...
The low in vivo transduction efficiency of recombinant adeno-associated virus (rAAV) and the undesirably strong immunogenicity of adenovirus (rAdv) have limited their clinical utilization in cancer gene therapy. We have previously demonstrated that intratumoral injection of rAAV expressing a C-terminal polypeptide of human telomerase reverse transcriptase (rAAV-hTERTC27) effectively inhibits the growth of glioblastoma xenografts in nude mice. To further improve its efficacy, we combined rAAV-hTERTC27 with rAdv and investigated the efficiency of the cocktail vectors in vivo. At a nontherapeutic dose (1 x 10(8) plaque-forming units (PFUs)), rAdv-null and rAdv-hTERTC27 were equipotent in enhancing the therapeutic efficacy of rAAV-hTERTC27 (1.5 x 10(11) v.g.), and complete tumor regression was achieved in 25% of the treated animals. Importantly, the combination of rAAV-hTERTC27 and a therapeutic dose (2.5 x 10(9) PFU) of rAdv-hTERTC27 significantly augmented the ...
Neurotensin (NT) and its high affinity receptor (NTR1) are involved in several neoplastic processes. Thus, NT-based radiopharmaceuticals are potential tracers for targeted diagnosis and therapy of NTR-positive tumours. A new analogue based on NT(8-13), NT-XIX, with the three enzymatic cleavage sites stabilised, was synthesised and tested. The synthesis was performed by Boc strategy. Labelling with "9"9"mTc/"1"8"8Re was performed using the tricarbonyl technique. Metabolic stability was tested in vitro and in vivo. NT-XIX was further characterised in vitro in HT-29 cells and in vivo in nude mice with HT-29 xenografts. NT-XIX showed much longer half-lives than non-stabilised analogues. Binding to NTR1 was highly specific, although the affinity was lower than that of natural NT. Bound activity rapidly internalised into HT-29 cells and 50% remained trapped after 24 h. In the time-course biodistribution, the highest uptake was found in the tumour at all p.i. times. In ...
Purpose: Budd-Chiari syndrome is a fairly uncommon disease in Europe. This often leads to its late diagnosis. The syndrome is characterised by portal hypertension and splanchnic congestion due to obstruction of hepatic venous outflow. This paper describes the treatment of three patients with Budd-Chiari syndrome by interventional therapeutic techniques and discusses alternative treatment modalities. Patients and Methods: The first patient presented with veno-occlusive disease and was treated by the placement of a transjugular intrahepatic portosystemic stentshunt. The second patient showed an occlusion of the major hepatic veins. After percutaneous recanalisation, a stent was placed in the right hepatic vein which remained patent. The third patient had a membranous obstruction of the right hepatic vein which was treated by percutaneous balloon dilatation. Results: In all patients the clinical symptoms resolved completely after treatment and no complications were encountered. ...
Purpose: The occurrence of extraosseous Ewing's sarcoma (ES) in deep soft tissues has been well described, but cases in which this tumor occurs in a primary cutaneous or subcutaneous site have rarely been reported. The superficial variant may be less aggressive than are the more common bony and deep soft tissue counterparts with an apparently favorable outcome. A retrospective review of patients with cutaneous or subcutaneous ES was conducted to analyze outcome and patterns of failure. Methods and Materials: Between July 1985 and March 1997, 14 patients with cutaneous or subcutaneous ES were treated at St. Jude Children's Research Hospital. The median age at presentation was 16 years (range 7-21 years). Anatomic locations included trunk and pelvis (7), upper or lower extremity (4), and head and neck (3). The median size of the lesion was 3 cm (range, 1-12 cm). Thirteen had definitive surgical resections, and one had biopsy of the mass at the time of referral. They were enrolled on ...
Clinical and hormonal indices of androgenic activity were compared in 118 males chronically intoxicated with alcohol. The population was divided into two groups with respect to their clinical and hormonal androgenic indices: 76 patients with (Group 1), and 46 patients without (Group 2) androgenic insufficiency. Distinct signs and syndromes of alcohol addiction were shown to correlate with the extent of cross-regulation impairment within hypothalamo-hypophyseo-gonadal system. This was particularly derived from comparison of clinical picture of chronic alcohol intoxication and hormone activity in the groups. Conventional therapy failed to restore the neuroendocrine indices that was apparently due to inhibition of cross-regulation links in the hypothalamo-hypophyseo-gonadal system at several stages of alcohol addiction. PMID:3223149
Background Adrenalectomy remains the definitive therapy for most adrenal neoplasms. Introduced in the 1990s, laparoscopic adrenalectomy is reported to have lower associated morbidity and mortality. This study aimed to evaluate national adrenalectomy trends, including major postoperative complications and perioperative mortality. Methods The Nationwide Inpatient Sample was queried to identify all adrenalectomies performed during 1998?2006. Univariate and multivariate logistic regression were performed, with adjustments for patient age, sex, comorbidities, indication, year of surgery, laparoscopy, hospital teaching status, and hospital volume. Annual incidence, major in-hospital postoperative complications, and in-hospital mortality were evaluated. Results Using weighted national estimate, 4...
Chest computed tomography (CT) was valuable in detecting extrinsic tracheal compression by mediastinal masses in two pediatric patients. This prompted an independent evaluation by CT of 14 children with masses involving the middle mediastinum and possible intrathoracic tracheal narrowing. Computer programs permit precise calculation of tracheal cross-sectional areas. Any apparent decrease in tracheal area may be compared with CT-derived data in normal children. Chest CT not only demonstrates the presence of extrinsic airway compression in pediatric patients with mediastinal masses, but also is capable of precisely measuring the extent of this narrowing. This method identifies children at potential risk for respiratory compromise and may aid in subsequent therapy.
The studies using phantoms confirmed that the reduction of electron beam energy and minimization of X-ray contamination could be achieved when electron beam was interposed by an acrylic plate placed 20 cm anterior to a patient. Four patients of mycosis fungoides were treated with 8 MeV electron beam of a linear accelerator at UOEH Hospital from October 1981 to December 1986. Two of them were treated with this technique by placing 2 cm thick acrylic plate anterior to the patients and satisfactory results were obtained. Cutaneous lesions subsided remarkably with the dosage of 2000 cGy given in 2 months. Leucopenia due to bone marrow suppression was mild and the patients tolerated the treatment well. (author).
Thyroid cancer is the most frequently diagnosed endocrine cancer and causes more deaths than all other endocrine cancers combined. Research findings support the concept that a subpopulation of thyroid cancer cells displays properties characteristic of stem cells. These putative cancer-forming entities drive tumorigenesis as a result of their dual ability to undergo self-renewal and to differentiate into various types of cancer cells; they also mediate metastasis and are resistant to the effects of chemotherapy and radiation therapy. This Review discusses the cellular origin of thyroid cancer and the properties of the thyroid cancer stem cell niche. The article critically evaluates the methods used to identify molecular markers expressed by thyroid-cancer-initiating cells and outlines prosp...
Boron neutron capture therapy (BNCT) trials for human glioma (glioblastoma multiform) were initiated September 1994 at the Brookhaven National Laboratory (BNL). Patients are given p-boronophenylalanine-fructose (BPA-F) intravenously as the boron carrier followed by exposure to the epithermal-neutron beam at the Brookhaven Medical Research Reactor (BMRR). The initial phase of the study is to determine safety and toxicity of the drug and irradiation procedure. The epithermal-neutron beam was developed in a joint effort by BNL and Idaho National Engineering Laboratory (INEL) researchers. For the human trials, treatment planning and radiation dose estimation is performed using the BNCT-Rtpe and the rtt-MC computer codes developed by the INEL BNCT program. This paper discusses our initial experience using these treatment planning codes for human subjects. The basic principles of BNCT have been previously documented.
The prevalence of hepatic cysts is 0.1% to 0.5% based on autopsy studies, and 2.5% based on US examinations. Percutaneous therapies are a new alternative to surgery. They include simple percutaneous aspiration, catheter drainage alone, and catheter drainage with sclerotherapy. We present an 11-year-old boy admitted to hospital because of abdominal pain. A diagnosis of simple hepatic cyst was made, which was treated with aspiration and tetracycline hydrochloride solution (5%) injection into the cystic cavity. Complete regression was seen on US and MRI examination at 3 months, with total collapse and deflation of the cyst. The cyst regressed totally, leaving a hyperechoic linear scar on US examination at 1 year. On the basis of the clinical and imaging results obtained, percutaneous sclerotherapy of hepatic cysts can be recommended as the treatment of choice and as a valid alternative to laparoscopy in children. (orig.)
Abstract Male infertility continues to be a clinical challenge of increasing significance. While male factors such as decreased semen quality are responsible for 25% of all infertility issues, the etiology of suboptimal semen quality is poorly understood. Many physiological, environmental, and genetic factors have been implicated, including oxidative stress. Oxidative stress is induced by reactive oxygen species (ROS), or free radicals, and although ROS are required for critical aspects of sperm function, excessive levels of ROS can negatively impact sperm quality. The origin of ROS generation, and the etiologies of increased ROS in men with suboptimal sperm quality have only recently been elucidated, offering multiple targets for potential therapy. Here, we present a critical review of th...
Study Type - Therapy (case series)Level of Evidence 4 OBJECTIVE To present our experience of retroperitoneoscopic partial adrenalectomy (RPA) for small adrenal tumours, as with modern imaging methods small adrenal lesions are being diagnosed more commonly, and retroperitoneoscopic adrenal surgery for small adrenal tumours (PATIENTS AND METHODS We retrospectively reviewed the records of 389 consecutive retroperitoneoscopic adrenalectomies from September 2005 to December 2008, 88 of which were small adrenal tumours and treated by RPA. Ultrasonography and computed tomography (CT) were used in all patients before RPA, and magnetic resonance imaging or positron emission tomography/CT in some patients. We used RPA for adrenal tumours and total adrenalectomy for adrenal cancer. During the surgery...
Abstract Background- Pemphigus vulgaris is a chronic disease not currently curable. Physical involvement and the impact of chronic therapies can lead patients to changes in psychological and relational areas. Objectives- To provide a measure of psychological distress, dysfunctional investment in one's appearance, and their relationship. Methods- Self-administered questionnaires (ASI, HADS) were given to 74 pemphigus inpatients. Results- Strong associations between psychological distress and dysfunctional investment in one's appearance were observed [adjusted odds ratio (OR) = 7.36, 95% confidence intervals (CI) 1.20-45.11; OR 5.38, 95% CI 0.81-35.87, respectively, for appearance stereotyping and body-image vulnerability], together with a perceived high disease severity (OR 6.03, 95% CI 1.9...
Idiopathic pulmonary fibrosis is the most lethal form of diffuse lung fibrosis, killing approximately half of those affected within 2-3 years of diagnosis. Until recently, no therapies had been shown to have an impact on disease progression. The Clinical Studies Assessing Pirfenidone (Esbriet) in IPF: Research of Efficacy and Safety Outcomes (CAPACITY) program comprised two almost identical double-blind placebo-controlled studies assessing the effects of pirfenidone on change in forced vital capacity, the primary end point, over a 72-week period. One of these studies was positive, matching in magnitude the benefit seen in two previous positive Japanese studies. The other study did not meet its primary end point but positive trends were consistent in this and a number of secondary end point...
ABSTRACT Introduction. Postprostatectomy erectile dysfunction (ED) remains a serious quality-of-life issue. Recent advances in the understanding of the mechanism of postprostatectomy ED have stimulated great attention toward penile rehabilitation. Aim. This review presents and analyzes a contemporary series of the recent medical literature pertaining to penile rehabilitation therapy after radical prostatectomy (RP). Main Outcome Measures. The laboratory and clinical studies related to penile rehabilitation are analyzed. The validity of the methodology and the conclusion of the findings from each study are determined. Methods. The published and presented reports dealing with penile rehabilitation following RP in human and cavernous nerve injury in animal models are reviewed. Results. Exciti...
Between 1983 and 1986, 35 of 90 patients with acquired immunodeficiency syndrome (AIDS) had double-contrast esophagograms to rule out opportunistic esophagitis. The radiographs were reviewed without knowledge of the clinical or endoscopic findings. Candida esophagitis was diagnosed radiographically in 17 patients who had varying degrees of plaque formation and viral esophagitis in three who had discrete ulcers without plaques. All three patients with viral esophagitis (herpes in 2 and cytomegalo virus in one) and 15 of 17 with Candida esophagitis had endoscopic and/or clinical corroboration of the radiographic diagnosis. Thus, the authors' experience suggests that fungal and viral esophagitis can often be differentiated on double-contrast esophagography, so that appropriate antifungal or antiviral therapy can be instituted without need for endoscopic intervention.
Abstract Objectives: This investigation reviewed experimental studies of laser irradiation of wound healing in mice and rats published from 2003 to August 2008, respectively, to assess putative stimulatory effects of this treatment. Background: Animal models, including rodents, attempt to reflect human wound healing and associated problems such as dehiscence, ischemia, ulceration, infection, and scarring. They have played a key role in furthering understanding of underlying mechanisms involved in impaired wound healing, and in testing new therapeutic strategies including laser irradiation. Method: Original research papers investigating effects of laser or monochromatic light therapy on wound healing in mice and rats and published from January 2003 to August 2008 were retrieved from library...
Many existing agents for diabetes therapy are unable to restore or maintain normal glucose homeostasis or prevent the eventual emergence of hyperglycemia-related complication. Therefore, agents based on novel mechanisms are sought to complement and extend the current therapeutic approaches. Based on the initial paper research, we focused on active STAT3 as an attractive pharmacological target for type 2 diabetes. The subsequent text mining with a unique query to identify suppressors but not activators of STAT3 revealed the ERK2/STAT3 pathway as a novel diabetes target. The description of ERK2 inhibitors as diabetes target had not been found in our text mining research at present. The mechanism-based peptide inhibitor for ERK2 was identified using the knowledge of the KIM sequence, which ha...
This introductory paper surveys potential sources of electric magnetic, and electro-magnetic fields. Various cases are discussed to exemplify the total frequency range: nuclear magnetic resonance tomography, high-voltage transmission lines, transformer stations, effect lighting balls, military transmitters, transmitter towers of the Postal Services and other operators, mobile radiotelephone equipment, large broadcasting transmitters, radar radiation, high-frequency heat therapy. There is evidence suggesting that electric, magnetic and electro-magnetic fields may possibly represent a certain nuisance or health hazard even at field strength occuring in equipment used for every-day-life purposes, with an emphasis on their possible actions and effects in children and adolescents. The author discusses, in conclusion, the aerial equipment ordinance issued by Lower Saxony. (Uhe).
In 15 patients (16 hip joints) we found the clinical and radiological signs of BMOS. On T1-weighted MRI images areas of low signal intensity could be observed in the head, neck and the intertrochanteric region of the femur in various extensions. These areas showed a significant increase in signal intensity on the T2-weighted images. Because pain was resistant to conservative therapy all these patients were treated by core decompression of the femoral head in a prospective study. Bone cores were evaluated histologically using undecalcified sections and quantitative microradiography. The existence of intramedullary oedema in exactly the regions exhibiting the MRI pattern of bone marrow oedema was verified histologically; however, bone and marrow changes similar to those of early avascular necrosis (AVN) were also visible. (orig.)
Colorectal cancer is the second most common cause of cancer death in the world and about half of the patients with colorectal cancer require adjuvant therapy after surgical resection. Therefore, the eradication of cancer cells via chemotherapy constitutes a viable approach to treating patients with colorectal cancer. In this study, the effects of bufalin isolated from a traditional Chinese medicine were evaluated and characterized in HT-29 and Caco-2 human colon cancer cells. Contrary to its well-documented apoptosis-promoting activity in other cancer cells, bufalin did not cause caspase-dependent cell death in colon cancer cells, as indicated by the absence of significant early apoptosis as well as poly(ADP-ribose) polymerase and caspase-3 cleavage. Instead, bufalin activated an autophagy...
"9"9"mTechnetium -heat damaged erythrocyte were used as spleen scanning agents in 12 patients from July, 1985 to April, 1986. We used this scan to evaluate situs inversus, asplenia, accessory spleen, hypersplenism, splenic infarction, tumor staging and evaluation of therapy, especially when the "9"9"mTc-tin colloid scans were not definite for diagnosis. The techniques applied to these scans were in vivo/in vitro-labeling method and heating-method to damage the erythrocytes. Liver-to-spleen uptake ratios were increased upto 100:1 and interference from the left lobe of the liver was eliminated. These scans were helpful to evaluate the spleen. (Author).