The purpose of the current study was to evaluate the difference in prognostic factors between stage IB and II uterine cervical carcinoma patientstreated 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 ...
Summary Background Sorafenib is an oral multikinase inhibitor that blocks cell proliferation via the ERK pathway and angiogenesis via the VEGF pathway. This phase II trial was conducted to determine the efficacy and tolerability of sorafenib for the treatment of patients with metastatic urothelial cancer (UC) who had not had prior chemotherapy for advanced disease. Patients and Methods Seventeen chemo-na?ve UC patients with adequate performance status and organ function were treated with sorafenib 400?mg twice daily on a continuous basis until progression or unacceptable toxicity. The primary endpoint was objective tumor response rate as measured by RECIST criteria. Secondary endpoints included rate of prolonged stable disease (>3?months), time to progression, median and 1?yr survival and ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combination chemotherapy while 3 patients are still undergoing treatment. Stage IIpatients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combiantion chemotherapy while 3 patients are still undergoing treatment. Stage IIpatients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. ...
Summary Purpose BMS-275183 is an oral C-4 methyl carbonate analogue of paclitaxel that has the same mechanism of action, stabilization of tubulin polymerization. The present study was designed to: (i) assess the safety and tolerability of BMS-275183, and (ii) determine a suitable Phase II dose of BMS-275183 when given on a continuous daily schedule to patients with advanced solid tumor(s). Methods This was a multi-institutional, open-label, Phase I, single-arm dose escalation study in which cohorts of eligible patients with advanced malignancies were treated with BMS-275183 orally on a continuous daily schedule. The starting dose level was 6?mg/m2/day administered once daily. Cohorts of 3 patients were treated at each dose level provided no dose-limiting toxicities (DLTs) were observed. Ea...
Abstract in english Type II reaction in leprosy, or erythema nodosum leprosum (ENL), is often characterized by severe clinical symptoms together with nerve function impairment leading to permanent disabilities. Thalidomide has been shown to be a highly effective drug for the treatment of ENL. It is, however, contraindicated for women of childbearing age due to its teratogenicity. On the other hand, pentoxifylline, used to treat hypercoagulable states, is not teratogenic and, like thalidomide (more) , can inhibit the synthesis of tumor necrosis factor-a and other cytokines. In the present randomized double-blind clinical study we compared the effectiveness of orally administered pentoxifylline vs thalidomide in treating type II reaction in 44 patients. Daily doses of 300 mg thalidomide or 1.2 g pentoxifylline were administered for 30 days to multibacillary leprosy ...
BACKGROUNDLifestyle modifications are successfully employed to treat obese and overweight women with polycystic ovary syndrome (PCOS). The aims of the current pilot study were (i) to compare the efficacy on reproductive functions of a structured exercise training (SET) programme with a diet programme in obese PCOS patients and (ii) to study their clinical, hormonal and metabolic effects to elucidate potentially different mechanisms of action.METHODSForty obese PCOS patients with anovulatory infertility underwent a SET programme (SET group, n = 20) and a hypocaloric hyperproteic diet (diet group, n = 20). Clinical, hormonal and metabolic data were assessed at baseline, and at 12- and 24-week follow-ups. Primary endpoint was cumulative pregnancy rate.RESULTSThe two groups had similar demogra...
Summary Penile injury is common as an emergency and should be accurately diagnosed and treated. We analysed 22 patients with penile injury admitted to the emergency unit of Dubrava University Hospital during a 4-year period. According to the American Association for the Surgery of Trauma five-grade classification of penile injuries, there were 14 grade I, 6 grade II and 2 grade III cases. Diagnosis was mainly based on clinical and ultrasonography findings, and in some cases on cavernosography. Nineteen patients underwent immediate surgery and three patients received conservative therapy. On outpatient follow up, sexual function was assessed by use of the 5-item International Index of Erectile Function (IIEF-5) test at 3 and 12-months of injury. At 3-month follow up, moderate, mild and no e...
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...
Objective: To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocarcinoma, especially in the complex cases of which the hepatic ducts are invaded. Methods: Forty-five consecutive patients with hilar cholangiocarcinoma were treated with percutaneous transhepatic placement of two or three self-expandable metallic endoprostheses. The cause of hilar obstructions in these patients were all cholangiocarcinoma, including Bismuth classification type II (n 12), IIIa (n 17), IIIb (n 10), and IV (n 6). Two or 3 stents were placed in the configuration of T, Y or X over the strictures. Results: Stent placement with 2 or 3 endoprostheses was successful in all patients. All patients showed significant decrease in serum bilirubin level. The mortality rate within 30 days of stent placement was 2.2% (1/45). The mean survival and stent ...
This study evaluated whether differences in design of 3-dimensional polylactic acid barriers (EPi-Guide and Guidor) would influence hard tissue results in the treatment of Grade II furcations in humans. A multicenter study was conducted, using 40 patients with moderate to advanced bilateral chronic adult periodontitis of the mandibular first or second molars. After flap access, debridement, and root preparation, surgical bone level measurements were taken and membranes were placed on a random basis. Surgical reentry occurred at 1 year. Data collected from all 3 investigative centers were pooled and analyzed using an analysis of variance appropriate for a counterbalancing design. Both barrier materials resulted in significant gains of attachment level and defect reduction. The composite reduction in the vertical component of the osseous defects was greater in the sites treated with Epi-Guide as compared to those ...
We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)
Thirty-nine previously untreated patients with squamous cell carcinoma of the tongue were treated by irradiation or a combination of irradiation and surgery, with or without chemotherapy, between January 1971 and December 1980. All of the patients had a follow-up period of at least nine years. Twenty-two patients were men and 17 were women. The average age was 50.1 years, with a range of 30 to 74 years. The absolute five-year survival rate was 82.1% and the cumulative ten-year survival rate 76.9% for these 39 patients. Cervical node metastases were clinically found on admission in 14 patients whose five-year survival rate was 64.3%, whereas it was 92.0% for 25 patients without metastasis. The absolute five-year survival rate decreased from 92.3% for patients with stage I lesions to 90.9%, 87.5% and 42.9% for those with ...
Abstract Background- Cyclosporine is used for treatment of transplanted patients and for immune-mediated diseases. Cyclosporine is known to cause a combination of metabolic side effects including hypertension, hyperkalemia, hypercalciuria and hypomagnesemia. These side effects except for hypomagnesemia are the cardinal features of familial hyperkalemia and hypertension (FHHt), also called pseudohypoaldosteronism type II (PHA II). FHHt is caused by mutations in the kinases WNK1 and WNK4 resulting in an increase in renal Na-Cl cotransporter (NCC) apical distribution and function. Therefore, we studied whether cyclosporine-s metabolic side effects are mediated by WNK4 and NCC. Design- Sprague-Dawley (SD) rats were treated by cyclosporine 25-mg-kg-1 subcutaneously for 14-days. Blood pressure, ...
To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading ...
Patientstreated with bleomycin are at risk of developing the acute adult respiratory distress syndrome post-operatively. In a prospective study of 12 patients who had received bleomycin preoperatively...Full Text Available
The main purpose of this work is to report the personal experience with addition of contrast-enhanced multiphase helical CT to unenhanced CT (Lipiodol CT) in the evaluation of patients with hepatocellular carcinoma treated with chemoembolization and to analyze the present role of oily agent CT. It has been retrospectively reviewed the examinations of 42 consecutive patients submitted to globla chemoembolization over a 2-year period. CT was performed 18-30 days after the treatment. The Lipiodol CT study was carried out with volume acquisitions. It has been considered as nodules all well-defined areas with dense oily agent uptake; uptake itself was classified as: 0=absent, I=lower tha 10% of the tumor volume; II=lower than 50%, III=50%, IV=homogeneous. Contrast-enhanced helical CT was performed with the 2-phase technique in 28 patients and with the 3-phase technique in 14; it has been ...
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 ...
PurposeTo identify the extent of persistence (period of time of continuous therapy with the drug prescribed) of glaucoma patientstreated with prostaglandins (latanoprost, bimatoprost,...Full Text Available
BackgroundThe optimal treatment for locally recurrent rectal cancer (LRRC) is still a matter of debate. This study assessed the outcome of LRRC patientstreated with multimodality...Full Text Available
Exercise-training might be a logical method to reverse muscle atrophy and weakness in patientstreated with glucocorticoids. The purpose of the present investigation was to establish whether a treatment...Full Text Available
Objective: To compare the therapeutic effect of unilateral biliary duct drainage with bilateral biliary duct drainage in the treatment of Bismuth-Corlette II-IV type hilar cholangiocarcinoma in order to provide rational and proper clinical options. Methods: Biliary duct drainage was performed in 80 patients with hilar cholangiocarcinoma. The patients were divided into unilateral drainage group (n = 52) and bilateral drainage group (n = 28). The clinical data and the therapeutic results of the two groups were retrospectively analyzed and compared. Results The two groups were quite comparable in the patient's age, sex, clinical type, drainage way, preoperative total and direct bilirubin level, white blood cell, total protein and albumin, etc. After the treatment, the mean reduction value of the total bilirubin and direct bilirubin was 82.73 #mu#mol/L and 31.71#mu#mol/L respectively in unilateral drainage ...
PURPOSE: To determine the recommended dose of radiotherapy when combined with full-dose gemcitabine and erlotinib for unresected pancreas cancer. METHODS AND MATERIALS: Patients with unresected pancreatic cancer (Zubrod performance status 0-2) were eligible for the present study. Gemcitabine was given weekly for 7 weeks (1,000 mg/m(2)) with erlotinib daily for 8 weeks (100 mg). A final toxicity assessment was performed in Week 9. Radiotherapy (starting at 30 Gy in 2-Gy fractions, 5 d/wk) was given to the gross tumor plus a 1-cm margin starting with the first dose of gemcitabine. A standard 3 plus 3 dose escalation (an additional 4 Gy within 2 days for each dose level) was used, except for the starting dose level, which was scheduled to contain 6 patients. In general, Grade 3 or greater gastrointestinal toxicity was considered a dose-limiting toxicity, except for Grade 3 anorexia or Grade 3 fatigue alone. RESULTS: A total of 20 ...
In a group of 32 patients with terminal renal failure the initial hypocalcaemia was corrected after two months' adequate maintenance haemodialysis. In seven patients hypercalcaemia occurred with a...Full Text Available
Background and purpose: We evaluate the feasibility of concomitant and adjuvant docetaxel combined with three-dimensional conformal radiotherapy (3D-CRT) and androgen deprivation in high-risk prostate carcinomas. Methods: Fifty men with high-risk localized prostate cancer (16), locally advanced (28) or very high-risk prostate cancer (6) were included. Seventy Gy were delivered on prostate and seminal vesicles in 35 fractions, concurrently with weekly docetaxel (20 mg/m"2). Three weeks after the completion of 3D-CRT, docetaxel was given for 3 cycles (60 mg/m"2), every 3 weeks. Patients had to receive LHRH agonist during 3 years. Results: The intent to treat analysis shows that four patients out of 15 stopped prematurely the chemotherapy due to grade 3-4 acute toxicity. In the per protocol analysis, 46 patients completed a full-dose chemoradiation regimen representing 413 cycles: five ...
Interleukin 2 (IL-2) and B-cell growth factors I and II (BCGF I and BCGF II) are lymphokines produced by T cells that play a major role in T- and B-cell cooperation. Peripheral blood lymphocytes from...Full Text Available
The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available
The objective of this article is to evaluate two-year clinical and radiological follow-up results for patients who were treated with microdiscectomy and posterior dynamic transpedicular stabilisation...Full Text Available
The localization of gold in the synovial membrane of rheumatoid arthritis patientstreated with sodium aurothiomalate was examined and quantitative analysis of epon-embedded sections was carried out...Full Text Available
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 patientstreated 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 ...
We review the cases of 19 successfully treated plague patients, with emphasis on the clinical and epidemiologic features of the disease. Proper staining and culturing of bubo aspirates; prompt institution...Full Text Available
Neuroleptic malignant syndrome is a life-threatening reaction of neuroleptic medication. The estimated incidence rate of neuroleptic malignant syndrome is between 1% and 1.5% of patientstreated with...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
Cryoanalgesia, the local application of extreme cold to nerves to produce analgesia, has been used to treatpatients with intractable perineal pain. The cryoprobe was inserted percutaneously through...Full Text Available
PurposeWe previously reported a randomized phase II clinical trial combining a poxvirus-based vaccine encoding PSA with radiotherapy in patients with localized prostate...Full Text Available
Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections...Full Text Available
ObjectiveThe objective of this study was to identify patterns of brain activation elicited by erotic visual stimuli in patientstreated with either Selective Serotonin Reuptake Inhibitors...Full Text Available
BackgroundThe natural history of bronchial preinvasive lesions and the risk of developing lung cancer in patients with these lesions are not clear. Previous studies have treated...Full Text Available
BackgroundPatients with ST-elevation myocardial infarction (STEMI) treated with fibrinolysis are increasingly, and ever earlier, referred for routine coronary angiography and where...Full Text Available
We quantified antibody responses to the HCV proteome that are associated with sustained virologic response (SVR) in HIV/HCV co-infected patientstreated with pegylated interferon and ribavirin....Full Text Available
Five methods of personality assessment are evaluated to provide guidance for the psychological treatment of patients with chronic back pain. Patient pain drawings, pentothal pain studies, stress score...Full Text Available
This objective of this work was to summarize the main results obtained in previous papers related to the adsorbent-adsorbate interactions involved in the adsorption of naphthalenesulphonic acids and heavy metals (Cd(II) or Hg(II)) by modified activated carbons. The adsorption of organic compounds (1-naphthalenesulphonic acid, 1,5-naphthalenedisulphonic acid and 1,3,6-naphthalenetrisulphonic acid) and inorganic species (Cd(II) and Hg(II)) was studied on a series of ozonized activated carbon in aqueous phase. Commercial activated carbon (Filtrasorb 400) was treated with different ozone doses to study the effect of ozone treatment on its surface properties and investigate the behavior of the treated carbon samples in the above adsorption processes. After ozonation, carbonyl- and carboxyl-type...
The three projects of the research program are aimed at the epidemiological study of long-term radiation effects in patients injected with radium-224. They are: late effects in "2"2"4Ra treated ankylosing spondylitis patients, late effects in "2"2"4Ra treated juvenile and adult patients, and epidemiology of radiation carcinogenesis. The data from these patients are a unique source of information for risk analysis of incorporated bone seeking radionuclides in man. (R.P.) 5 refs., 3 tabs.
The effect of Escherichia coli lipopolysaccharide (LPS) on the expression of major histocompatibility complex (MHC) class II molecules by bovine mammary macrophages was examined. The ability of LPS-treated...Full Text Available
Between October 1990 and March 1991, 8 patients with cystic lesions in the region of the posterior bladder wall, the seminal vesicles and the prostate were examined by MRI. In all cases there was accurate characterisation of the lesion and of its anatomy. In 3 patients with abnormalities in the retrovesical space there was very good agreement with the operative findings. 4 patients were treated conservatively. In these patients there was good agreement with the findings on cystoscopy, CT and sonography. (orig.).
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.
From 1977 through 1984, 293 previously untreated patients with biopsy proven carcinoma of the uterine cervix were treated by whole pelvis irradiation and high intensity 60Co remote afterloading (RAL) intrauterine tandem techniques in Haiti. The treatment results were analyzed retrospectively to evaluate the therapeutic results and prognostic factors of a strict protocol involving 40 Gy to the whole pelvis (2 Gy/day, 5 days/week). In addition, on the 5th day of the 3rd week, the first outpatient 60Co remote afterloading intracavitary insertion, delivering 7.5 Gy to point A with each insertion, repeated 3 times by a week separation for a total of 4 times. The total TDF for external beam plus RAL was 158 and 175 for early and late effects respectively. One hundred-four patients were evaluable after 1 year or more follow-up, with a median of 26.5 months. No evidence of disease (NED) by Stage at 1 year was: Stage I of 100% ...
Between 1970 and 1981, 348 patients underwent definitive irradiation. Of these patients 6 (1.7 per cent) sustained severe rectal injury as manifest by major rectal bleeding, rectal stricture, rectal mucosal slough and rectal ulceration. Severe rectal injury was observed in 0 of 13 patients (0 per cent) treated with 125iodine, 3 of 329 (1 per cent) treated with 6,400 to 6,800 rad external irradiation, 2 of 39 (5 per cent) treated with 7,000 to 7,300 rad external irradiation, and 1 of 7 (14 per cent) treated with 198gold and external irradiation. The impact of radiation dose, radiation therapy technique and surgical trauma was assessed. Rectal injury was managed by supportive measures in 2 patients and by diverting colostomy in 3 with benefit. One patient underwent abdominoperineal resection. A small ...
Brachytherapy refers to short distance treatment of cancer with radiation from small, encapsulated radionuclide sources. This type of treatment is given by placing sources directly into or near the volume to be treated. The dose is then delivered continuously, either over a short period of time (temporary implants) or over the lifetime of the source to a complete decay (permanent implants). This technique is extensively used in the treatments of gynecological, breast, prostate, head and neck, and other soft tissue cancers. The clinical outcomes of this treatment depend on accurate dosimetry and dose delivery. The patient is generally considered to be water equivalent. So the treatment planning system software generally is based on measured or calculated dose distributions in homogenous water medium. In real situation, the treatment volume is not homogenous water medium, but it is a heterogeneous medium consisting of bone, soft tissue, lung, air ...
Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients. Experiment II compared cancer pain patients matched with benign pain patients on intensity of pain report on the affective dimension of the MPQ. Cancer pain patients reported a reliably higher affective loading to their pain. These data suggest that cancer pain patients employ different criteria than benign pain patients in selecting affective pain descriptors. Possible explanations for ...
Forty-one patients were treated with epidural neurolysis using 50 % ethyl alcohol 2 ml. Thirty eight patients were suffering from cancer pain and three patients were complaining of chronic benign pain. Alcohol block was repeated 2.3 times (mean) in the same patient. Thirty patients were followed after the treatment. Forty-seven percent of the patients reported 70 % or greater pain relief and 20 % of the patients reported about 50 % pain relief. Duration of pain relief was from 9 days to 203 days with a mean duration of 54 days. Adverse effects were reported 43 % of the patients. There is no miserable adverse effect. Adverse effect reported most was pain with epidural injection of drugs after the alcohol block had been performed. PMID:8544293
Equinovarus of the foot is the most common lower extremity deformity following traumatic brain injury. We evaluated outcomes of the split anterior tibialis tendon transfer (SPLATT) for correction of equinovarus in 47 patients with hemiplegic traumatic brain injury and specifically studied differences in outcomes with two tendon fixation techniques. Seventeen patients constituting Group I underwent fixation with one technique and 30 constituting Group II had another technique. Patients in both groups had appropriate procedures based on dynamic electromyography and gait analyses. Both groups were demographically comparable. All 47 feet were corrected to plantigrade position. Thirty-six of 47 patients became brace-free at final followup. There was a notable decrease in the use of ambulatory aids and ambulatory status improved in both groups. There were three fixation-related ...
Systemic sclerosis (SSc) is a disorder characterized by skin thickness and vasculopathy. The objective of the study was to evaluate the therapeutic effect and safety of the association of pentoxyphylline and vitamin E in SSc patients. Twelve SSc patients (American College of Rheumatology criteria) enrolled this 24-week open-label study. Patients received daily 800?mg of pentoxyphylline and 800?UI of vitamin E and were evaluated at 4-week interval. The primary efficacy endpoint was the change in Modified Rodnan Skin Score (MRSS) at week 24. Nine diffuse SSc patientstreated 6?months with cyclophosphamide were used as a historical control group. The mean age of the treated group was 43.6?years, and ten of 12 (84%) patients were women. Their mean MRSS reduced from 25.7 to 18.7 (p?=?0.03) at 1...
Outcome from trauma, surgery, and a variety of other medical conditions has been shown to be positively affected by providing treatment at facilities experiencing a high volume of patients with those conditions. An electronic literature search was made to identify English-language articles available through March 2011, addressing the effect of patient treatment volume on outcome for patients with subarachnoid hemorrhage. Limited data were identified, with 16 citations included in the current review. Over 60% of hospitals fall into the lowest case-volume quartile. Outcome is influenced by patient volume, with better outcome occurring in high-volume centers treating >60 cases per year. Patientstreated at low-volume hospitals are less likely to experience definitive treatment. Furthermore, t...
Objective: To evaluate the effect of PTBD in treating malignant biliary obstruction caused by hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 103 patients(M:62,F:41)with malignant obstructive jaundice caused by hilar cholangiocarcinoma. After taking percutaneous transhepatic cholangiography, metallic stent or plastic external catheter or external-internal catheter for drainage was deployed and then followed up was undertaken with clinical and radiographic evaluation and laboratory. examination. Results: All patients went though PTBD successfully (100%). According to Bismuth classification, all 103 cases consisted of I type(N=30), II type (N=30), III type (N=26) and IV type (N=17). Thirty-nine cases were placed with 47 stents and 64 eases with drainage tubes. 4 cases installed two stems for bilateral drainage, 2 cases installed two stents because of long segmental strictures ...
Purpose: Radiotherapy (RT) has been the predominant local treatment for Ewing's sarcoma of bone at the University of Florida. Twice-daily hyperfractionated RT was initiated in 1982 to improve local control and functional outcome. This retrospective review compares the results of once-daily vs. twice-daily RT in patients with primary Ewing's sarcoma of an extremity, with emphasis on functional outcome. Methods and Materials: Between June 1971 and January 1990, 37 patients were treated at the University of Florida for nonmetastatic Ewing's sarcoma of bone with a primary lesion in an extremity. Three patients underwent amputation. Of 34 patientstreated with RT, 31 had RT alone and 3 had a combination of RT and local excision. Before 1982, 14 patients received once-daily RT; since 1982, 17 patients have received twice-daily ...
OBJECTIVE To present our initial experience of thulium laser resection via a flexible cystoscope for recurrent non-muscle-invasive bladder cancer (ThuRBT), as transurethral resection for bladder tumour (TURBT) is regarded as the reference standard for treating this disease, but alternative laser resection or ablation is suitable especially for recurrent tumours. PATIENTS AND METHODS From January 2005 to October 2005, 32 patients with early recurrent bladder tumour (recurrent within a year after TURBT) were treated with ThuRBT via a flexible cystoscope. The follow-up included urine analysis, ultrasonography and cystoscopy every 3 months. RESULTS All patients were treated successfully with ThuRBT in one session, with no bladder haemorrhage, obturator nerve reflex or vesicle perforation. Rand...
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, ...
Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, ...
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 ...
Background Trauma centers are designated to provide systematized multidisciplinary care to injured patients. Effective trauma systems reduce patient mortality by facilitating the treatment of injured patients at appropriately resourced hospitals. Several U.S. studies report reduced mortality among patients admitted directly to a level I trauma center compared with those admitted to hospitals with less resources. It has yet to be shown whether there is an outcome benefit associated with the ?level of hospital? initially treating severely injured trauma patients in Australia. This study was designed to determine whether the level of trauma center providing treatment impacts mortality and/or hospital length of stay. Methods Outcomes were evaluated for severely injured trauma patients with an ...
Over a 5-year period (1976-1980) 499 patients with non-seminomatous testicular germ cell tumours were included in the Danish Testicular Carcinoma Study (DATECA). The 3-year crude survival for patients in clinical stages I, II and III was 91, 77 and 45 per cent, respectively. In stage I the relapse-free survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival was observed. For stage IIpatients maintenance chemotherapy following radiation combined with bleomycin and vincristine did not improve ...
Over a 5-year period (1976-1980) 499 patients with non-seminomatous testicular germ cell tumours were included in the Danish Testicular Carcinoma Study (DATECA). The 3-year crude survival for patients in clinical stages I, II and III was 91, 77 and 45 per cent, respectively. In stage I the relapse-free survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival was observed. For stage IIpatients maintenance chemotherapy following radiation combined with bleomycin and vincristine did not improve ...
The relationship between serum PG I, PG II levels and extent of atrophic gastritis was examined. The subjects were 64 patients (male: 32, female: 32, 51.9 years old on average) with established diagnosis of either atrophic gastritis or normal. In the X-ray gastric examination, Fuji Computed Radiography (FCR) was used to obtain clear-cut images of the gastric area. Concerning the serum PG I level, patients in the group with atrophic gastritis showed lower levels than those of the people in the group with no atrophic change, but the variation was wide, and no definite tendency was seen in the relationship between the atrophic change and the serum PG I levels. Concerning the serum PG II level, as the atrophic change progresses, the serum PG II level tended to increase gradually. A significant reduction in the PG I/II ratio was seen in the group with atrophic ...
The relationship between serum PG I, PG II levels and extent of atrophic gastritis was examined. The subjects were 64 patients (male: 32, female: 32, 51.9 years old on average) with established diagnosis of either atrophic gastritis or normal. In the X-ray gastric examination, Fuji Computed Radiography (FCR) was used to obtain clear-cut images of the gastric area. Concerning the serum PG I level, patients in the group with atrophic gastritis showed lower levels than those of the people in the group with no atrophic change, but the variation was wide, and no definite tendency was seen in the relationship between the atrophic change and the serum PG I levels. Concerning the serum PG II level, as the atrophic change progresses, the serum PG II level tended to increase gradually. A significant reduction in the PG I/II ratio was seen in the group with atrophic ...
Phase II Randomized Study of the Effect of Zoledronate Versus Observation on Bone Mineral Density of the Lumbar Spine in Patients Undergoing Risk-Reducing Excision of Both Ovaries (GOG-0215). See the protocol summary.
The clinical management of adults with low-grade gliomas (LGGs) remains a challenge. There is no curative treatment, and management of individual patients is a matter of deciding optimal timing as well...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
Rationale: Human data suggest that the incidence of acute lung injury is reduced in patients with type II diabetes mellitus. However, the mechanisms by which diabetes confers protection...Full Text Available
An aqueous house dust mite extract was separated by SDS-PAGE and transferred to nitrocellulose membranes by Western Blotting. Two major allergens, Der pI and Der pII associated with the mite faeces...Full Text Available
The main purpose of this work is to report the personal experience with addition of contrast-enhanced multiphase helical CT to unenhanced CT (Lipiodol CT) in the evaluation of patients with hepatocellular carcinoma treated with chemoembolization and to analyze the present role of oily agent CT. It has been retrospectively reviewed the examinations of 42 consecutive patients submitted to global chemoembolization over a 2-year period. CT was performed 18-30 days after the treatment. The Lipiodol CT study was carried out with volume acquisitions. It has been considered as nodules all well-defined areas with dense oily agent uptake; uptake itself was classified as: 0=absent, I=lower than 10% of the tumor volume; II=lower than 50%, III=50%, IV=homogeneous. Contrast-enhanced helical CT was performed with the 2-phase technique in 28 patients and with the 3-phase technique in 14; it has ...
Twenty-five patients with ovarian carcinoma who had been operated and treated with chemotherapy underwent clinical examination and CT before reintervention (second-look laparotomy) to detect the presence of eventual recurrences. The prediction of recurrence based on CT and clinical findings was compared with the surgical findings at reintervention. CT proved to be more accurate than clinical examination in detecting recurrences; this was especially true for masses in the abdominal cavity, with the exception of small peritoneal nodules. The authors suggest the use of CT for staging the patients candidate to reintervention. This might help to avoid reintervantion in patients with persistent disease and to plan treatment.
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.
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).
Seventy-one patients with intestinal injury secondary to pelvic irradiation had predominantly large bowel lesions. Seventeen cases were treated conservatively and 54 came to surgery, 28 patients having more than one operation. Following this essentially salvage surgery there were more ileal than colonic anastomotic leaks. Thirty-four patients died during the follow-up period (2-12 years), 19 from recurrent malignancy, and nine as a result of continuing radiation effects. Seventy per cent of the patients who had a radiation fistula died as a result of malignancy. Of 42000 cases of pelvic malignancy treated by irradiation over the decade 1972-1982, surgical referrals for complications constituted 1.7%, with an overall radiation-related mortality of 0.2%. It is our opinion that colostomy alone has little part to play in this condition, and a policy based on ...
PurposeTo conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer.Patients and MethodsBetween March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data.ResultsThere was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences...
PurposeAlthough the safety and feasibility of partial adrenalectomy in patients with von Hippel-Lindau syndrome have been established, long-term outcomes have not been examined. In this study we evaluate the recurrence and functional outcomes in a von Hippel-Lindau syndrome cohort treated for pheochromocytoma with partial adrenalectomy with a followup of at least 5 years. Materials and MethodsWe reviewed the records of patients with von Hippel-Lindau syndrome treated with partial adrenalectomy for pheochromocytoma at the National Cancer Institute. Demographic, germline mutation status, surgical indication, oncologic and functional outcome data were collected. Local recurrence was defined as radiographic evidence of recurrent tumor on the ipsilateral side of partial adrenalectomy. Patients ...
The role of MRT in the prebiopsy diagnosis of muscular and vascular inflammatory conditions was evaluated prospectively and an optimal method of examination was investigated. 92 patients with a suspected diagnosis of myositis (60 cases) or vasculitis (32 cases) were examined, in each case two extremities were studied using transverse T_1 and T_2 weighted SE sequences and double echo STIR sequences on a 0.5 Tesla (56 patients) or 1.5 Tesla magnet (36 patients; T5/S15 Gyroscan, Philips). The site of the biopsy depended on the MRT findings. In 41 patients the suspected diagnosis was confirmed histologically, in two patients an infective myositis was diagnosed on clinical grounds despite negative histology. MRT demonstrated muscle oedema in 86% of patients. There were negative findings after immuno-suppressive therapy (two patients), in focal ...
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 ...
1. We have studied determinants of outcome of 7 day courses of treatment in 77 middle aged and elderly patients, in whom the general practitioner's diagnosis of urinary tract infections had been confirmed...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
We describe a case of sacral perineural cyst presenting with complaints of low back pain with neurological claudication. The patient was treated by laminectomy and excision of the cyst. Tarlov cysts...Full Text Available
Aim:Report of 125 pediatric patients of empyema thoracis treated by open decortication, highlighting the presentation, delay in referral, operative findings, the response...Full Text Available
Plasma exchange (PE) is currently being used to treat a variety of disorders involving immune complexes, such as polyarteritis nodosa. This procedure removes endogenous toxic components that accumulate...Full Text Available
Patients with pancreatic cancer normally present with advanced disease that is lethal and notoriously difficult to treat. Survival has not improved dramatically, despite routine use of chemotherapy...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
Sixty glaucomatous eyes of 60 patientstreated 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
Pancreatic islet transplantation into the liver provides a possibility to treat selected patients with brittle type 1 diabetes mellitus. However, massive early β-cell death increases the number...Full Text Available
The indications, contra-indications and technique of caudal epidural injections in the treatment of low back pain and sciatica are described. Of 201 patientstreated by epidural injection, about 56%...Full Text Available
BACKGROUND. Diabetes can be effectively treated and monitored in general practice. Postgraduate medical education at a local level is required to support this strategic shift of medical care from hospital...Full Text Available
PURPOSE:Two different regimens of SWL delivery for treating urinary stones were compared.METHODS:Patients with urinary stones were randomly divided...Full Text Available
ObjectiveTo evaluate the impact of breast carcinoma (T1–2N0) surgery without axillary dissection on axillary and distant relapses, and to evaluate the usefulness of a panel...Full Text Available
Hereditary hemorrhagic telangiectasia is characterized by mucocutaneous and visceral telangiectasia and involves several organs with vascular malformations. It is an autosomal dominant disease and is...Full Text Available
The electrometallurgical treatment process described in this paper builds on our experience in treating spent fuel from the Experimental Breeder Reactor (EBR-II). The work is also to some degree, a spin-off from applying electrometallurgical treatment to spent fuel from the Hanford single pass reactors (SPRs) and fuel and flush salt from the Molten Salt Reactor Experiment (MSRE) in treating EBR-II fuel, we recover the actinides from a uranium-zirconium fuel by electrorefining the uranium out of the chopped fuel. With SPR fuel, uranium is electrorefined out of the aluminum cladding. Both of these processes are conducted in a LiCl-KCl molten-salt electrolyte. In the case of the MSRE, which used a fluoride salt-based fuel, uranium in this salt is recovered through a series of electrochemical reductions. Recovering high-purity uranium from an aluminum-matrix fuel is more challenging than ...
This is a report of 21 patients presenting with epigastric pain, bilious vomiting, upper gastrointestinal bleeding, iron-deficiency anemia, and weight loss, who had undergone Billroth II gastrectomy from 3 to 35 yr earlier. Eighteen of 21 patients were found to have significant enterogastric reflux indices varying from 60% to 95% demonstrated by /sup 99m/Tc HIDA scintigraphy. Thirteen patients had diversion antireflux surgery in the form of a Roux-en-Y procedure, and 1 patient had a Henley loop jejunal interposition. Postoperative /sup 99m/Tc HIDA scintigraphic studies showed the enterogastric reflux indices to have decreased significantly to a range of 2%-26% (p less than 0.00001). There was marked improvement of symptoms, including correction of anemia and weight gain in those patients who had been anemic or who had sustained earlier weight loss. The ...
In a retrospective single-centre study 170 consecutive patients were included who received a Kotz modular prosthesis after resection of bone tumours of the proximal femur to evaluate the management of prosthetic infection. Infection occurred in 12 of 166 patients available for follow-up (six males; six females; mean age, 47?years; range, ten to 75?years) after a mean of 39?months (range, one to 166?months; infection rate, 7.2%). Mean follow-up was 54?months (range, four to 200?months). One patient died of septic shock. Two patients were treated by wound revision only. Treatment of infection in the remaining patients was one-stage revision in eight and hip disarticulation in one. Infection control by one-stage revision was achieved in five of eight patients; re-infection occurred in three p...
This study is for chemoradiotherapy of unresectable and recurrent cholangiocarcinoma (CCC). Between April 2005 and March 2007, 5 patients were evaluated for unresectable and recurrent CCC. All patients were performed percutaneous transhepatic biliary drainage (PTBD) and treated with chemoradiotherapy. The radiation method was an external beam radiotherapy (EBRT) and remote after loading system (RALS). The chemotherapy was 5-fluorouracil (FU) and gemcitabine by intravenous injection. Three patients had unresectable and 2 had recurrent CCC. As for the side effects, 4 patients had a slight neutropenia and 1 had an uncontrollable gastric bleeding. No patient had cholangitis. The mean survival time for unresectable and recurrent CCC was 13.7 months and 17 months, respectively. Our results indicated that chemoradiotherapy had been consistent with efficacy in ...
The diagnosis of dialysis-related amyloid (AB-amyloid) has been based usually on clinical and radiological criteria. Following the discovery that beta 2-microglobulin was the major protein of this amyloid, we isolated and radiolabelled uremic plasma beta 2-microglobulin. After intravenous injection, gamma-camera images of selected joint areas were obtained from 42 patients who were on regular hemodialysis therapy. Positive scans involving the shoulder, hip, knee and carpal regions were found in 13 of 14 patientstreated for more than 10 years and 10 of 16 patientstreated for 5 to 10 years. Patientstreated for less time had negative scans. Specificity was indicated by negative scans in non-amyloid inflammatory lesions in control hemodialysis patients. Up to 48-fold tracer enrichment was detected in excised AB-amyloid ...
Twenty-seven histologically confirmed cases of localised Ewing's sarcoma were treated by two different regimes. Radiotherapy alone was used in 13 cases and a combination of chemotherapy and radiotherapy in 14. Single agent chemotherapy (cyclophosphamide) was given sequentially in nine patients and cyclophosphamide and actinomycin-D in five. There is a significant difference in the response to these different regimes. Only 69.2% of patientstreated by radiotherapy alone were disease-free, for a median period of 10.4 months and metastases were noticed in 53.8% of cases. The disease-free survival in patientstreated by combination therapy (radiotherapy and chemotherapy) was 18.4 months and metastases were seen in only 42.9%. However, no metastases were seen in patients who received cyclophosphamide and actinomycin-D, during a period of 14 ...
Staging bone scans or skeletal surveys were obtained of 97 patients with endometrial carcinoma. Of the 77 patients with Stage I or II disease, no metastases were identified at staging. Three patients in the entire series demonstrated bony metastases; all of these metastases were detectable by radionuclide bone scan and radiographic bone survey. Eighty-nine patients were examined with radionuclide liver/spleen scanning at the time of staging. Four of the 89 initial scans were interpreted as demonstrating hepatocellular disease, and all four patients had abnormal liver function studies. Only one patient demonstrated a possible hepatic metastasis at initial diagnosis. This patient also had abnormal liver function studies. Based on these results, bone surveys and radionuclide bone scans are not indicated as screening ...
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 rate of soft tissue ...
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 ...
Purpose: Efficacy and safety of the own single-center experience with moderately dosed radiosurgery (SRS) for limited (one to four) brain metastases were analyzed and correlated with patient- and treatment-related variables. Patients and Methods: Between 05/1998 and 10/2006, 93 patients received SRS for a total of 142 brain metastases. The median number of brain metastases treated per patient was one (range, one to four). 46 patients (49%) received initial SRS alone, 13 patients (14%) SRS with up-front whole-brain radiotherapy (WBRT), and 34 patients (37%) SRS for recurrent metastases after WBRT. Median dose was 16 Gy (range, 10-20 Gy). Results: Median overall survival (OS) was 7.5 months. The actuarial 6- and 12-month data for OS were 60% and 35%, for local brain control (LBC) 87% and 79%, and for distant brain control ...
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.
The role of radiation therapy in local tumor control and decreased incidence of pulmonary metastasis is reported in 271 patients who were entered into the Intergroup Ewing's Sarcoma Study with more than one year follow-up and on whom all radiotherapy records were reviewed. The majority of the patients were irradiated to the primary tumor with doses of 4500 to 6500 rad in five to six weeks in combination with systemic administration of three drugs (vincristine, actinomycin-D and cyclophosphamide) or four drugs (vincristine, actinomycin-D, cyclophosphamide and adriamycin). One of the groups of patients was treated with three drugs and bilateral pulmonary irradiation (1500 rad, uncorrected dose, in two weeks). Preliminary analysis shows an overall local primary tumor control of 89%. Patients with lesions in the pelvis had a local failure rate of 17% (9 of 52) and in the humerus 23% (7 ...
We reported a relevant activity of the combination between sorafenib and octreotide long-acting release (LAR) in advanced hepatocellular carcinoma (HCC) patients. In this work, we have studied if oxidative...Full Text Available
Background and purpose: Local treatment for non-metastatic Ewing's sarcoma family tumors (ESFTs) is controversial. Results achieved in a single institution in patients with ESFT of the humerus are presented. Materials and methods: Patientstreated between 1983 and 2000 for ESFT of the humerus were included. The impact of local treatment (surgery, radiotherapy or both) on outcome was assessed. Results: 55 patients: 34 males (62%); 21 females (38%); mean age: 17.9 (range: 3-40). Local treatment: surgery in 27 patients (49%), radiotherapy in 17 (31%) and surgery followed by radiotherapy in 11 (20%). After a mean follow-up of 15 years (range: 7-25 years), 27 patients (49%) remained continuously disease free, 27 (49%) relapsed and one died of chemotherapy toxicity. The local recurrence rate was 13% overall: 18% (3/17) after radiotherapy, 7% (2/27) after surgery and ...
Cutaneous T-cell lymphoma is typically a clonal neoplasm of epidermotropic CD4+ T-lymphocytes that includes the entity mycosis fungoides (MF). After identification of patients with recurrent MF treated...Full Text Available
Antibodies to human native and denatured types I, II, III, IV, and V collagens were measured using 125I-radioimmunoassay. Mean levels of binding by sera from 30 rheumatoid arthritis patients were significantly higher than those from 20 normal subjects against all of the collagens tested. The relative antibody concentration was higher in synovial fluid than in simultaneously obtained serum. Many patients with gout or various other rheumatic diseases also had detectable anticollagen antibodies. With a few notable exceptions, the majority of the reactivity detected in all patient groups was directed against covalent structural determinants present on all of the denatured collagens, suggesting a secondary reaction to tissue injury.
The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliative care or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100-150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven ...
Angiotensin II has adverse actions in heart failure including vasoconstriction, aldosterone secretion, and activation of the sympathetic nervous system. Valsartan, a potent specific angiotensin II type 1 receptor blocker, may produce beneficial effects in heart failure. The purpose of this study was to evaluate the steady-state pharmacokinetics of valsartan 40, 80, and 160 mg each given every 12 h for 7 days in heart failure patients. Eighteen patients with chronic stable heart failure and left ventricular ejection fractions power model, showed that doubling the dose increased the AUC and Cmax 1.8 times. The pharmacokinetics of valsartan are predictable in heart failure patients within the dose range of 40-160 mg BID. Age did not appear to have influenced the valsartan clearance in heart failure patients. The pharmacokinetic values were higher in heart failure ...
Purpose To analyze the clinical profile, management and outcome of non-hematological tumors in head and neck region in children less than 18?years of age. Patients and methods Medical records of patients (0?18?years) presenting with non-hematological tumors of head and neck region from 2000 to 2010 were reviewed. Result Out of the 78 patients identified, 50 were males with median age of 14?years (3?months to 18?years). Histologically, 58 out of the 78 patients had malignant tumors and 20 were metastatic at presentation. Common site of tumor origin was noted as thyroid (23/78), salivary glands (21/78) and nasopharynx (13/78). Out of 78 patients, 44 patients were treated by surgery, 26 patients received radiation and 13 patients received chemotherapy, while 9 patients received ...
Purpose: To evaluate the importance of surgical margins for local and systemic control of Ewing's sarcoma family tumors (ESFT). Methods and Materials: Between 1979 and 1999, 512 patients with ESFTs entered 4 different adjuvant and neoadjuvant studies performed at a single institution. Of these patients, 335 were treated with surgery alone (196) or surgery followed by radiotherapy at doses of 44.8 Gy (139). We compared their outcome with that of the 177 patients who were locally treated by radiotherapy at 60 Gy. Results: Local control (88.8% vs. 80.2%, p < 0.009) and 5-year disease-free survival (63.8% vs. 47.6%, p < 0.0007) were significantly better in patientstreated with surgery and, among them, in those with adequate surgical margins (96.6% vs. 71,7%, p < 0.0008, and 69.6% vs. 46.3%, p < 0.0002). Nonetheless, better results ...
Aim: To evaluate the usefulness of routine laboratory parameters in the decision to treat refractory cardiac arrest patients with extracorporeal life support (ECLS). Methods: Sixty-six adults with witnessed cardiac arrest of cardiac origin unrelated to poisoning or hypothermia undergoing cardiopulmonary resuscitation without return of spontaneous circulation (duration: 155min [120-180], median, [25-75%-percentiles]) were included in a prospective cohort-study. ECLS was implemented under cardiac massage, using a centrifugal pump connected to a hollow-fiber membrane-oxygenator, aiming to maintain ECLS flow >=2.5l/min and mean arterial pressure >=60mmHg. Results: Forty-seven of 66 patients died within 24h from multiorgan failure and massive capillary leak. Of 19/66 patients who survived >=24h...
Objective: To investigate the inserting technique of biliary double stents in treating hilar cholangiocarcinoma. Methods: 6 patients with hilar cholangiocarcinoma (Bismuth IV) were treated by percutaneous transhepatic insertion of biliary stents. Double stents were inserted in each patient. Different inserting methods were adopted according to the branch angles formed by left and right hepatic ducts. Results: The jaundice of all patients alleviated or disappeared obviously after stent implantation. The average difference between post-and pre-operation in the serum total bilirubin level was (104 #+-# 29) #mu#mol/L (P<0.01). Stent obstruction was found in 2 cases after 4 and 6 months respectively. Conclusion: Double stents implantation is effective for the treatment of hilar cholangiocarcinoma. Beware of the angulation between main hepatic duct and adopting different inserting ...
Background: Mechanisms underlying the association between myocardial bridge (MB)-stenting and in-stent restenosis (ISR) are still unclear. Objective: To assess the impact of MB on ISR using intravascular ultrasound (IVUS). Methods: In the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, 100 left anterior descending artery (LAD) culprit lesions (79 treated with paclitaxel-eluting stents [PES] and 21 treated with bare metal stents) were imaged with serial IVUS immediately postprocedure and at 13 months. Results: At baseline the LAD stent extended into the MB segment beyond the culprit lesion in seven patients (MB-stent group). In the remaining 93 patients the LAD stent was implanted only in the culprit lesion without extending into t...
Abstract Residual limb pain (RLP) and phantom limb pain (PLP) can be debilitating and can prevent functional gains following amputation. High correlations have been reported between RLP and the stump neuromas following amputation. Many treatment methods including physical therapy, medications, and interventions, have been used with limited success. Pulsed radiofrequency ablation (PRFA) has shown promise in treating neuropathic pain because of the inhibition of evoked synaptic activity. We present 4 amputees who were treated with PRFA after failing conservative management for their RLP and PLP. All 4 patients underwent PRFA and demonstrated at least 80% relief of RLP for over 6 months. One patient reported a complete resolution of phantom sensation while another patient had significantly de...
Objectives To delineate the safety and tolerability profile of methylphenidate and atomoxetine in children and adolescents with attention deficit hyperactivity disorder (ADHD) monitored for more than 1?year. Design A cohort study analyzing data from the national ADHD register on patients from the Lombardy Region treated with MPH or atomoxetine. Participants A total of 229 children (median age 11?years, range 6?17), enrolled in 15 regional centers between June 2007 and May 2010. Results The prevalence rate of pharmacological treatment for ADHD was 0.23%, whereas the estimated ADHD prevalence in the population was 0.95%. In total, 73.8% of patients had been treated with atomoxetine (10?90?mg daily) or MPH (10?75?mg daily); 22% of patients also received an additional psychotropic drug. Of the...
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 ...
PurposeThe purpose of the present study was to compare the effect of submucosal versus intramuscular administration of dexamethasone sodium phosphate on patients' quality of life after surgical removal of impacted lower third molars. Patients and MethodsA randomized, non-blind, clinical trial was planned. The sample was composed of patients requiring extraction under local anesthesia of a single partial bony impacted mandibular third molar with Class II or III and position B or C, according to the Pell and Gregory classification. The patients were randomly distributed into 1 of 3 groups: submucosal dexamethasone, intramuscular dexamethasone, and a control group that received no steroid. A modified translated questionnaire was used to assess the patients' perception regarding different qual...
The treatment of acetabular bone defects presents a great challenge in revision total hip arthroplasty (THA). The purpose of this study was to evaluate the clinical and radiological outcome of revision THA using jumbo cups for acetabular reconstruction after applying the bone-grafting technique. We studied 17?patients with acetabular defects ranging from Type 2A to Type 3A according to Paprosky`s classification. According to the AAOS-score twelve patients were classified as Type II and five patients as Type III. Uncemented press-fit cups with an outer diameter larger than 64?mm were used in all cases. Fifteen patients received morselized bone allografts. In eight patients an additional screw fixation was necessary. The mean follow-up period was 82?months (range 33?149). The mean Harris Hip...
Natural, formaldehyde-treated and copolymer-grafted orange peels were evaluated as adsorbents to remove lead ions from aqueous solutions. The optimum pH for lead adsorption was found to be pH 5. The adsorption process was fast, reaching 99% of sorbent capacity in 10 min for the natural and treated biomasses and 20 min for the grafted material. The treated biomass showed the highest sorption rate and capacity in the batch experiments, with the results fitting well to a pseudo-first order rate equation. In the continuous test with the treated biomass, the capacity at complete exhaustion was 46.61 mg g{sup -1} for an initial concentration of 150 mg L{sup -1}. Scanning electronic microscopy and energy dispersive X-ray spectroscopy indicated that the materials had a rough surface, and that the adsorption of the metal took place on the surface. Fourier transform infrared spectroscopy revealed that the ...
Abstract Capillary permeability is a tightly regulated feature of microcirculation in all organ beds. In sepsis, this feature is fundamentally altered. We have previously reported elevated levels of angiopoietin-2 in patients with septic shock, and have investigated tumor necrosis factor (TNF)-related and weak inducer of apoptosis (TWEAK), which mediates both angiogenesis and inflammation, in those patients. Enzyme-linked immunoassay was used to measure serum TWEAK levels in 20 patients with septic shock, all of whom were treated by direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX), and in 20 non-septic controls. The TWEAK levels were higher in patients with septic shock (192.8--230.5-pg/mL) than in controls (84.1--28.7-pg/mL, P-=-0.043). Between 11 survivors and 1...
BackgroundAlthough benign ampullary tumors are removed endoscopically, due to their potential to progress to malignant disease, the favored treatment for adenocarcinoma is pancreaticoduodenectomy. We reviewed our institutions experience in order to identify which patients were at highest risk of disease progression following surgical resection, as well as evaluate whether localized T1 tumors are best treated by pancreaticoduodenectomy. MethodsWe retrospectively reviewed 157 patients who presented with an ampullary mass, from 2001 to 2010, and identified 51 with benign adenoma and 106 with adenocarcinoma. ResultsPatients with malignant tumors most often presented with larger tumors and jaundice, which alone was predictive of survival (OR = 67). Forty-five percent of patients with pathologic...
To evaluate the predictive factors for treatment response and prognostic factors affecting survival outcomes after concurrent chemoradiotherapy (CCRT) for patients with anal squamous cell carcinoma. Medical records of forty two patients with histologically confirmed analsquamous cell carcinoma, who had complete CCRT between 1993 and 2008, were reviewed retrospectively. Median age was 61.5 years (39-89 years), and median radiotherapy (RT) dose was 50.4 Gy (30.0-64.0 Gy). A total of 36 patients had equal to or less than T2 stage (85.7%). Fourteen patients (33.3%) showed regional nodal metastasis, 36 patients (85.7%) were treated with 5-fluorouracil (5-FU) plus mitomycin, and the remaining patients were treated by 5-FU plus cisplatinum. The median follow--up time was 62 months (2-202 months).The 5-year overall survival, ...
Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 ...
A prospective, side-by-side comparison study of two different lasers for the treatment of solar- induced telangiectasia was carried out in 14 patients at the Beckman Laser Institute and Medical Clinic. The argon tunable dye laser (Coherent, Palo Alto, Calif.) was used in the method modified from Orenstein and Nelson to completely treat discrete telangiectasias on one cheek. Specifically, the argon tunable dye laser (ATDL) was set at 0.7 - 0.8 watts, 585 nm wavelength, shutter-pulsed at 0.1 second duration with a spot size of 0.1 mm, and individual vessels were 'traced out' with 4X loupe magnification. Each patient's opposite cheek was then treated in the standard fashion with the flashlamp pulsed dye laser (Candela, Natick, Mass.) using a technique similar to Polla's et al. Specifically, the flashlamp pulsed dye laser (FPDL) was set at 585 nm wavelength, pulsed mode of 450 microseconds pulse duration, ...
Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of /sup 99m/Tc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be +-7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment, six of these patients showed a so-called 'flare phenomenon' in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a ...
Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of "9"9"mTc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be #+-#7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment, six of these patients showed a so-called 'flare phenomenon' in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a continuously increased uptake ...
We examined 19 patients with post-irradiation intestinal injury in the uterine cervix cancer for 12 years between 1985 and 1996. We discuss the usefulness and complications of surgery, mainly colostomy. The patients aged from 36 to 80 (average age 61) were treated, and their disease states were 12 cases of rectovaginal fistula, 2 of small intestinal fisfula, 1 of rectum posterior membranous fistula, 3 of proctostenosis, and 14 of proctitis with hemorrhage (including duplication). Surgical methods used were 18 cases of colostomy (2 cases were treated under peritoneum mirror) and 2 of enterocolostomy (including duplication). Eleven out of 19 patients who underwent surgery are alive now. Generally the post-irradiation intestinal injury was intractable, and the method of treatments were limited due to the coexistence of various diseases. The colostomy is safe and less invasive. ...
From December 1981 to September 1986, 149 patients were treated at the Radiotherapy Department of the Hospital Clinico y Provincial of Barcelona by means of intracavity irradiation with 137 cesium high 1 sources and 2. To 112 of the total number of patients external radiotherapy to the whole of the pelvis using photons of 6 MeV was also administered. A total of 46 (30.7%) patients presented rectal complications. The rectitis observed was mild in 16 cases (10.7%), moderate in 15(10%) and severe in 15(10%). The 15 patients with severe rectitis had to be treated by unloading colostomy. In patients with severe complications, the maximum total rectal dose administered was between 5,855 and 9,490 cGy, and the maximum rectal dose administered via curietherapy was 1,055 to 7,320 cGy. Maximum total rectal dose administration greater than 4,000 cGy ...
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 patientstreated with concurrent chemotherapy were 88% and 83%, respectively. The 3- and 5-year loco-regional control rates for the 31 patients were 93%...
This paper is a progress report on the role of radiation therapy (RT) in local tumor control and the decreased incidence of pulmonary metastasis in 251 patients entered in the Intergroup Ewing's Sarcoma Study. All were followed for more that 1 year, and their RT records were reviewed. Doses to the primary tumor in the range of 4,500--6,500 rad were administered over approximately 5 to 6 weeks in combination with 4 drugs, i.e., vincristine (VCR), dactinomycin (DAC), cyclophosphamide (CY), and adriamycin, or only the first 3. One group of patients received the 3 drugs and bilateral pulmonary irradiation (approximately 1,500 rad in 2 wk). Preliminary analysis showed a local primary tumor control of approximately 90%. Patients with lesions in the pelvis and humerus had local failure rates of 13% (7 of 54) and 21.4% (6 of 28), respectively. The treatment groups differed significantly in the incidence of pulmonary metastasis. ...
The purpose of this paper is to describe a technique of forced surgical rotation of the mandible used in skeletal Class IIpatients with deep bite and prominent chin. Posterior occlusal composite onlays combined with preoperative orthodontic treatment without anterior intrusion increase the posterior rotational component of the surgical mandibular advancement, when removed during operation. This manoeuvre allows for the surgical closure of the posterior open bite, while anteriorly the deep bite is opened. This technique avoids bimaxillary rotation surgery with dorsal impaction in mild to moderate cases. In any case, a chin setback osteotomy with compromised aesthetics can be avoided.
Minimally invasive treatment for small renal cell carcinoma (RCC) can be necessary in selected patients and, anyway, is desirable. In situ ablation techniques, including RFA, have been developed. The aim of this study is to evaluate the feasibility, safety and short-term local effectiveness of percutaneous US-guided RFA in a small series, as well as mid-term patient outcome. Thirteen patients with a total of 18 tumors (17 small lesions, 35 mm in size or less, and a larger one, 75 mm in size) underwent 19 RFA sessions. Seven patients had a solitary kidney, and three suffered from VHL disease, too. We treated four lesions in a patient with a bilateral tumor. In another patient, three lesions were ablated. Seventeen tumors were RCC; one was a metastasis from lung cancer. Eight lesions were parenchymal, six exophytic, two parenchymal/exophytic, ...
Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in ...
Purpose: To report our clinical experiences with on-board imager (OBI) kV image verification for cranial stereotactic radiosurgery (SRS) and radiotherapy (SRT) treatments. Methods and Materials: Between January 2007 and May 2008, 42 patients (57 lesions) were treated with SRS with head frame immobilization and 13 patients (14 lesions) were treated with SRT with face mask immobilization at our institution. No margin was added to the gross tumor for SRS patients, and a 3-mm three-dimensional margin was added to the gross tumor to create the planning target volume for SRT patients. After localizing the patient with stereotactic target positioner (TaPo), orthogonal kV images using OBI were taken and fused to planning digital reconstructed radiographs. Suggested couch shifts in vertical, longitudinal, and lateral directions were recorded. kV ...
Radioimmunochemical assay was used to study the hypophyseal and peripheral hormones activity in 60 patients with chronic alcoholism, stage II. A correlation has been established between the patient's age and prolactin and FSH concentrations, as well as between the duration of the recent hard drinking and the concentrations of prolactin, testosterone, FSH and interstitial cell stimulating hormone. It has been shown that the manifestation of the alcoholic abstinent syndrome depended on the prolactin concentration. The test sensitivity estimated by the prolactin level rise and the testosterone level reduction reached 92.3%. The specificity of the changes detected comprised 25%. A conclusion has been made that the disorders noted in the patients with chronic alcoholic intoxication can be used as an objective test in the alcoholism diagnosis. PMID:3936321
Equinovarus of the foot is the most common lower extremity deformity following traumatic brain injury. We evaluated outcomes of the split anterior tibialis tendon transfer (SPLATT) for correction of equinovarus in 47 patients with hemiplegic traumatic brain injury and specifically studied differences in outcomes with two tendon fixation techniques. Seventeen patients constituting Group I underwent fixation with one technique and 30 constituting Group II had another technique. Patients in both groups had appropriate procedures based on dynamic electromyography and gait analyses. Both groups were demographically comparable. All 47 feet were corrected to plantigrade position. Thirty-six of 47 patients became brace-free at final followup. There was a notable decrease in the use of ambulatory a...
AbstractBackground: Certolizumab pegol (Cimzia, CZP) was approved for the treatment of Crohn's disease (CD) patients in 2007 in Switzerland as the first country worldwide. This prospective phase IV study aimed to evaluate the efficacy and safety of CZP over 26 weeks in a multicenter cohort of practice-based patients. Methods: Evaluation questionnaires at baseline, week 6, and week 26 were completed by gastroenterologists in hospitals and private practices. Adverse events were evaluated according to World Health Organization (WHO) guidelines. Results: Sixty patients (38F/22M) were included; 53% had complicated disease (stricturing or penetrating), 45% had undergone prior CD-related surgery. All patients had prior exposure to systemic steroids, 96% to immunomodulators, 73% to infliximab, and...
Renal arteriovenous fistula or pseudoaneurysms developing after invasive procedures are either asymptomatic or show only transient symptoms. We describe here a case of symptomatic renal artery pseudoaneurysm that presented with gross hematuria and azotemia. The pseudoaneurysm of renal artery was diagnosed by ultrasonography and abdominal magnetic resonance imaging (MRI), and it was successfully treated by percutaneous transcatheter coil embolization. A high index of suspicion is essential for the early diagnosis and treatment of delayed gross hematuria in patients with history of percutaneous nephrostomy. PMID:17180737
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 patientstreated 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 ...
Abstract Aim:- To describe the first case of ceftriaxone-related haemolysis in a patient with congenital nephrotic syndrome (CNS). Background:- Severe haemolysis caused by an immune reaction to ceftriaxone has mostly been described in patients with underlying haematological or immune dysfunction. Case report:- The authors present a 20-month-old boy with CNS of the Finnish type with several previous severe infections treated with ceftriaxone, admitted for suspected sepsis. Following ceftriaxone administration he developed shock secondary to an acute haemolytic reaction, with severe anaemia. Hypersensitivity to ceftriaxone was documented through positive agglutination tests. Conclusion:- Onset of haemolysis following ceftriaxone administration, particularly in a patient previously exposed to...
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 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 patientstreated 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...
Local control of Ewing's sarcoma was analysed in a series of 67 patientstreated by surgery and/or radiotherapy as well as combination chemotherapy. Radiotherapy was employed with or without surgery in 60 patients and produced an overall local control rate of 55%; complete excision of the primary lesion seemed to be beneficial. There was a marked variation in control rates depending on the site of the primary lesion: limb 85%, rib 53%, pelvis 31% and other sites 33%.Primary tumours greater than 10 cm in diameter were significantly less likely to be controlled. Using daily fractions of approximately 180 cGy, total doses in excess of 6000 cGy seem more likely to produce serious late morbidity amd may not increase the local control rate. No cases of second malignancy arising in irradiated tissue have been observed to date, but one patient developed acute lymphoblastic leukaemia. (author).
The growth of a middle ear cholesteatoma behind a normal tympanic membrane is a rate though possible event. In such cases, CT may provide useful information for diagnosis. The results are presented of a CT study carried out on 14 patients affected with unilateral conductive hearing loss and with normal tympanic membrane. CT allowed the diagnosis of meddle ear cholesteatoma to be made in all cases. All patients were treated with surgery: 8 of them underwent tympanoplasty and 6 explorative tympanotomy. While the diagnosis of cholesteatoma was confirmed in 13 patients, in 1 case tympanosclerosis was diagnosed. CT diagnosis of middle ear cholesteatoma is based on the demonstration of a low-density soft-tissue mass, in association with bone erosion or ossicular dislocation. The author emphasizes the difficulty of a CT diagnosis of cholesteatoma in the patients with middle ear soft-tissue ...
Summary Background:- Cholinesterase inhibitors form the mainstay of treatment for persons with mild-to-moderate Alzheimer-s disease (AD). The rivastigmine patch may increase compliance and the proportion of patients maintaining an efficacious dose compared with oral cholinesterase inhibitors. Objective:- To investigate the proportion of patients who reached and maintained the target rivastigmine patch dose compared with the target rivastigmine capsule dose reported in clinical trials. Methods:- This was a multicentre, 24-week, open-label study in persons with probable AD and a Mini-Mental State Examination (MMSE) score of --10 and --26. The primary outcome was the proportion of patients (ITT population) treated with 9.5-mg/24-h rivastigmine patch for at least 8-weeks at week 24. Secondary ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 percent). Osteoid excess was reduced in 13 patients (68 percent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 per cent). Osteoid excess was reduced in 13 patients (68 per cent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 ...
We used computerized tomography (CT) in the study of eight patients with macronodular splenic tuberculosis prior to the microbiological diagnosis. These patients underwent additional CT controls during and after tuberculostatic therapy. All the patients studed presented the acquired immunodeficiency syndrome (AIDS). Splenomegaly and numerosous round, hypodense lesions that showed no contrast uptake were found in all the subjects. Only three patients presented evidence of tuberculosis in plain radiography and/or chest X-ray. Two patients presented abdominal lymph nodes. None of them showed evidence of hepatic lesions or ascites. follow-up CT scans revealed a progressive reduction of the lesions, which eventually disappeared completely, and splenomegaly was considerably reduced. Anthough it is uncommon, we should suspect splenic involvement in tuberculosis if the clinical and ...
The present study was undertaken in 27 children with localized Ewing's sarcoma treated at our hospital. In 9 cases the lesion was central and in 18 peripheral. Treatment consisted of: 1) Chemotherapy with 6 drugs (vincristine, cyclophosphamide, methotrexate, bleomycin, dactinomycin and doxorubicin) for one year in all patients; 2) Radiotherapy in 24 patients at a dose of 30-40 Gy in the entire bone with a booster dose of 10-15 Gy in the lesion. In 7 patients debulking surgery was performed followed by irradiation. Two cases with tumor in expendable bones and one with extensive destructive lesion in the tibia underwent radical surgery. One patient suffered local recurrence (femur) and 6 developed distant metastases. The remaining 20 (74%) patients were alive and tumor-free after follow-up periods of 17-80 months. Among the 12 patients with ...
Tetracycline is an antibiotic that absorbs ultraviolet light at 355 nm and preferentially binds to atherosclerotic plaque both in vitro and in vivo. Tetracycline-treated human cadaveric aorta was compared with untreated aorta using several techniques: absorptive spectrophotometry; and tissue uptake of radiolabeled tetracycline, which showed 4-fold greater uptake by atheroma than by normal vessel. In addition, intravenous tetracycline administered to patients undergoing vascular surgery demonstrated characteristic fluorescence in surgically excised diseased arteries. Because of tetracycline's unique properties, the authors exposed tetracycline-treated and untreated aorta to ultraviolet laser radiation at a wavelength of 355 nm. They found enhanced ablation of tetracycline-treated atheroma compared with untreated atheroma. The plaque ablation caused by ultraviolet laser radiation was twice as ...
Purpose. To compare erectile function (EF) recovery of patientstreated 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 ...
"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: 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 ...
Purpose: To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma. Patients and Methods: Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patients received local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins. Results: Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients #<=# 14 years at diagnosis had overall survival ...
Background and objectives.Thymidylate synthase (TS) expression levels appear to be related to response to 5-fluorouracil-(5-FU)-based chemotherapy in colorectal cancer (CRC) patients. Three polymorphisms have been proposed as modulators of TS expression: a tandemly repeated sequence (2R/3R) in the 5? UTR, a SNP (G > C) within the 3R allele and a 6 bp deletion in the 3' UTR.To evaluate the influence of TS expression and polymorphisms on clinical outcome of 5-FU-treatedpatients we performed a comprehensive genetic analysis on 63 CRC patients.Methods.TS expression levels were analyzed in normal and tumor tissues. TS coding sequence and UTR polymorphisms were investigated on DNA from normal tissue. LOH analysis was performed to determine tumor genotype.Results.A difference in disease-free sur...
To analyze and review the most common focal lesions of the external auditory canal (EAC), describing the computed tomography (CT) findings. The CT images of EAC were reviewed in a series of 167 patients. Abnormal findings were recorded in 13 cases. The CT images were correlated with otoscopic and/or intraoperative findings. There were four cases of osteoma (one located outside the EAC); all of which were treated surgically, as was the one case of exostosis. Six patients presented debris in EAC, coinciding with clinical evidence of external otitis. There were two cholesteatomas derived from EAC, one of them secondary to survery to treat osteoma. On patient was diagnosed as having a basal cell carcinoma of the ear, extending to EAC, but refused to undergo surgery. Five patients presented small triangular laminae of dense bone arising from the upper wall of the EAC ...
Husband AC, Crawford S, McCoy LA, Pacaud D. The effectiveness of glucose, sucrose, and fructose in treating hypoglycemia in children with type 1 diabetes. Objective: There is a lack of evidence regarding the most effective treatment option for managing naturally occurring hypoglycemia in children with type 1 diabetes. The objectives of this study were (i) to determine if sucrose and fructose are equally effective as glucose in the treatment of spontaneous hypoglycemia in children with type 1 diabetes; and (ii) to determine prestudy and poststudy hypoglycemia treatment preferences. Methods: Thirty-three subjects [aged 5.4-15.5 yr and average duration of type 1 diabetes of 3.1 yr (SD = 2.3)] participated in a randomized, crossover design. The main outcome was the effectiveness of treatment a...
Purpose: To examine the role of brachytherapy in the treatment of cholangiocarcinomas in a relatively large group of patients. Methods and Materials: Using the Surveillance, Epidemiology and End Results database, a total of 193 patients with cholangiocarcinoma treated with brachytherapy were identified for the period 1988-2003. The primary analysis compared patientstreated with brachytherapy (with or without external-beam radiation) with those who did not receive radiation. To try to account for confounding variables, propensity score and sensitivity analyses were used. Results: There was a significant difference between patients who received radiation (n = 193) and those who did not (n = 6859) with regard to surgery (p < 0.0001), race (p < 0.0001), stage (p < 0.0001), and year of diagnosis (p <0.0001). Median survival for ...
Sixteen patients with advanced cutaneous T-cell lymphoma (CTCL) with or without lymph node involvement, but without evidence of extranodal manifestations, were treated with a combination of total skin electron beam therapy (TSEB) and total nodal irradiation (TNI). Fourteen (87%) patients achieved a complete response (CR) lasting from 1 to 84+ months (median, 8+ months) from the completion of treatment. The best results occurred in 6 patients with pretumorous intracutaneous CTCL (Stages IB and IIA) where the CR has lasted in all patients from 8 to 84+ months (median about 27+ months). Radiotherapy was well tolerated with the major toxicity being bone marrow suppression. The authors conclude that combined TSEB and TNI is a relatively safe and effective treatment for patients with CTCL prior to the development of lymph node involvement. Long-term follow-up is ...
Purpose: To report outcomes of a single institution study of stereotactic body radiotherapy (SBRT) for unresectable cholangiocarcinoma. The dose-volume dependency of the observed gastrointestinal toxicity is explored. Methods and materials: Twenty-seven patients with unresectable cholangiocarcinoma (n = 26 Klatskin tumours and one intrahepatic cholangiocarcinoma (IHCC)) were treated by linac-based SBRT. The dose schedule was 45 Gy in three fractions prescribed to the isocenter. Results: The median progression-free survival and overall survival were 6.7 and 10.6 months, respectively. With a median follow-up of 5.4 years, 6 patients had severe duodenal/pyloric ulceration and 3 patients developed duodenal stenosis. Duodenal radiation exposure was higher in patients developing moderate to high-grade gastrointestinal toxicity with the difference in mean maximum dose to 1 cm"3 of duodenum ...
Forty cases of Ewing's sarcoma of various sites had attended the Department of Radiotherapy at the Wanless Hospital and the Miraj Medical Centre, attached to the Government Medical College, Miraj, Maharashtra, from January, 1970 through December, 1979. There were 28 male patients and 12 female patients in the series with a male to female ratio of 2.3:1. The youngest patient in the series was a female of 6 years of age with the tumour in the scapula and the oldest patient was a 32-year-old male with a lesion in the metacarpal bone. Sixty per cent of the cases were seen in the second decade. The average age of the patients was 13.5 years. The bones of the lower extremities were most commonly involved with the highest number (35 per cent) of the cases occurring in the femur. Involvement of the bones of the right side of the body was almost equal to that of the left side. Swelling over ...
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 ...
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
BackgroundMultiple lines of evidence have suggested that valproic acid (VPA) might benefit patients with spinal muscular atrophy (SMA). The SMA CARNIVAL TRIAL was a two part prospective...Full Text Available
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
Radiotherapy has been reported to be of benefit in prolonging the survival of patients with cholangiocarcinoma. This study examined whether radiotherapy in addition to endoscopic stenting improved survival. The survival advantage of radiotherapy in those with a type II/III stricture is seen only in the first 10 months after diagnosis. The costs of radiotherapy and significantly increased time spent in hospital, however, raise doubts over its routine use in the management of non-resectable cholangiocarcinoma. (Author).
The dynamics of spin-lattice relaxation (slr) of metal-organic Pt(II) compounds is studied. Often, such systems are characterized by pronounced zero-field splittings (zfs) of the lowest-lying triplets. Previous expressions for the Orbach slr process do not allow to treat such splitting patterns properly. We discuss the behavior of a modified Orbach expression for a model system and present results of a fit of the temperature dependence of the spin-lattice relaxation rate of Pt(2-thpy)$_2$ based on the modified expression.
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 ...
The serum levels of ferritin in 394 patients, including 339 patients with various malignant tumors and 23 with various non-malignant diseases, and 32 healthy subjects were determined. The normal levels of ferritin were 82.7 +- 42.3 ng/ml for males and 42.0 +- 36.9 ng/ml for females. The positive ratio of serum ferritin level was 28% in patients with malignant tumors and 22% in patients with non-malignant diseases. The usefulness of serum ferritin assay in screening for malignant tumors appeared to be limited. High serum levels of ferritin were found in patients with malignant lymphoma (positive ratio: 42%), pulmonary cancer (38%) and esophageal cancer (37%). According to the histological types, epidermoid cancer appeared to produce a higher serum level of ferritin than adenocarcinoma in patients with pulmonary cancer. It was interesting that malignant lymphoma ...
Two patients, treated for blunt thoracoabdominal trauma with ruptured diaphragm and concomitant avulsion of the pericardial sac in its entirety from the central tendon of the diaphragm, are presented. We do not think this entity has been reported before. We explain this type of lesion on the basis of embryological development of the pericardium at the level of the central tendon of the diaphragm. PMID:15302069
HCV-Ag-specific TH17 cells secrete IL17, a cytokine involved in autoimmune diseases and regulated by IL10 and TGF-b. 5–12% of patients with chronic HCV infection have hypothyroidism. We evaluated...Full Text Available
A 21-year-old male patient was transferred to the emergency room of our hospital after suffering seat belt abdominal injury in a traffic accident. Abdominal computed tomography revealed a massive hematoma...Full Text Available
After baseline studies, 21 patients with osteoporosis were treated with human parathyroid hormone fragment (PTH 1-34) given as once-daily subcutaneous injections for 6-24 months. The dose used did not...Full Text Available
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 ...
Abstract Background Despite the undeniable impact of systemic sclerosis (SS) on quality of life, only a few studies so far have focused on its psychiatric or psychological aspects. We aimed at assessing psychiatric symptoms and self-image in inpatients with SS and comparing them with patients with either a very mild skin condition or a serious skin condition. Methods Three groups were recruited: (i) 38 consecutive female inpatients with SS; (ii) 38 age-matched female outpatients with melanocytic naevi; (iii) 35 age-matched female inpatients with melanoma. All participants completed the Zung Anxiety Scale, the Zung Depression Scale and a self-report questionnaire measuring self-perceived personal qualities. Patients with SS were also clinically interviewed by a psychologist. Results The cli...
Objective: To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: 7 biliary metallic stents were placed in 7 patients with recurrent jaundice after T-tube drainage in cholangiocarcinoma cases. Results: Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment. Conclusions: Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma-induced obstructive jaundice
OBJECTIVE:- To determine the effectiveness and safety of short-term treatment of infliximab (IFX) in a group of Chinese patients with active Crohn's disease (CD). METHODS:- Patients with established diagnosis of active CD were treated with IFX intravenously with a dose of 5-mg/kg at week 0, 2, 6. Clinical assessments were performed at baseline (week 0) and every week after IFX infusion until 8 weeks after the induction dose. RESULTS:- Fourteen patients (nine male, five female) with a mean age of 29.7 years (range from 15 to 65 years) were included in the analysis. The mean subjective scores were decreased from 2.85--0.57 at baseline to 1.3--0.4 at week 14 (P-CONCLUSIONS:- Treatment with three infusions of IFX at a dose of 5-mg/kg was effective for induction of remission for active CD patie...
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 ...
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 ...
Abstract Objective: To compare the vertical dimensional changes with regard to graft height in a long-term follow-up in patientstreated with two different grafting materials used in maxillary sinus floor elevation procedures. Material and methods: Twenty consecutive patients were included. One group was grafted with autogenous bone from the mandible (chin area), and the other group was augmented with a 100%b-tricalcium phosphate (b-TCP). During a 4- to 5-year period, in each patient, at least five panoramic radiographs were made. These panoramic radiographs were used for morphometric measurements, at three different locations. The three locations were the first bone to implant contact at the distal side of the second most posterior implant (L1), halfway between this implant and the most p...
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.
On 10 dialysis patients we performed 12 balloon dilatations, 2 catheter lyses, 6 stent implants (Palmaz stent) and one atherectomy of central venous stenoses or occlusions (v. subclavia, v. brachiocephalica) at the shunt arm of the patient. The primary success rate was, in balloon PTA and lysis, 12/14 interventions, and in stent placement and atherectomy 7/7. The angiographical and clinical primary result after stent implantation was significantly better than after conventional dilatation. After 66% of the balloon dilatations recidivation occurred within the first year; this can be treated by means of repeated PTA. Whether long-term exclusion of recurrence can be achieved by stent implantation, must be established by means of follow-up studies that are at present in progress. (orig.).
Abstract Acute lung injury (ALI) in sepsis is characterized by an increase in microvascular permeability, resulting in pulmonary edema. Several studies have suggested that angiopoietin-1 and -2 play a contributory role in the pathogenesis of ALI. Polymyxin B-immobilized fiber column hemoperfusion is effective for sepsis-induced ALI. We investigated the angiopoietin levels before and after direct hemoperfusion with polymyxin B-immobilized fiber column (PMX) therapy. Enzyme-linked immunoassay was used to measure the serum angiopoietin-1 and -2 levels in 25 patients with septic shock treated with PMX. Eleven of the 25 patients were diagnosed with ALI. There was a significant positive correlation between the angiopoietin-1 level and the PaO2/FiO2 ratio, but there was a significant inverse corr...
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.
Total skin electron beam therapy (TSEB) was used in the treatment of 33 patients with lymphoma and 13 patients with leukemia involving extensive segments of the skin surface. Twenty-two of 23 had lesions as a primary manifestation of lymphoma (primary cutaneous lymphoma-PCL) and 11 developed cutaneous lesions following disseminated nodal lymphoma (secondary cutaneous lymphoma-SCL). A once weekly fractionation scheme was employed to irradiate the entire skin surface with 3.5 to 4 MeV electron beam from a 6 MeV linear accelerator. During each weekly session, 400 rad were delivered to the entire skin and a complete course consisted of 4-6 consecutive weekly sessions. The majority of patients have been previously treated elsewhere for various periods and all patients have been at risk for a median of 12 months, range from 12-117 months following TSEB. Striking predominance of the ...
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 patientstreated 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 ...
Background: Some former retrospective studies have suggested that patients with Ewing's sarcoma might have a very high risk for developing secondary sarcomas if treated with radiotherapy. We have evaluated the risk of second malignancies (SM) in patientstreated in the German Cooperative Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and methods: From January 1981 through June 1991, a total number of 674 patients was registered in the two multicentric Ewing's sarcoma trials CESS 81 (1981 through 1985) and CESS 86 (1986 through June 1991). The systemic treatment consisted in both studies of a four-drug-chemotherapy (VACA= vincristine, actinomycin D, cyclophosphamide and adriamycin; or VAIA= vincristine, actinomycin D, ifosfamide and adriamycin) and a total number of four courses, each lasting nine weeks, was recommended by the protocol. Local therapy was either complete ...
In an epidemiological study of the somatic late effects risk following incorporation of a short lived #alpha#-emitter, 1473 ankylosing spondylitis patientstreated with repeated intravenous injections of "2"2"4Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 #mu#Ci) of "2"2"4Ra each, given at weekly intervals; this would result in an cumulative #alpha#-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for ...
Intracranial atherosclerosis is a major cause of ischemic stroke, and depending on the studied population, it accounts for 8%-15% of all strokes that are due to cerebral atherosclerosis. The prognosis of patients with symptomatic intracranial stenoses seems to depend on the location and extent of intracranial atherosclerosis. Currently, the primary treatment in intracranial atherosclerosis is the control of vascular risk factors such as hypertension, diabetes, hypercholesterolemia, and smoking. Secondary prevention with antiplatelet therapy has been shown to reduce the risk of subsequent vascular events in patients who have suffered a recent ischemic stroke or transient ischemic attack (TIA). Unfortunately, a significant number of patients with intracranial atherosclerosis continue to suffer from repeated strokes or TIA despite maximal medical treatment. Although endovascular revascularization for symptomatic intracranial ...
Objective: To analyze the early response of uveal melanomas in patientstreated with ruthenium-106 brachytherapy. Materials And Methods: In the period between April 2002 and July 2003, 20 patients diagnosed with uveal melanoma were submitted to ruthenium-106 brachytherapy. The calculated dose delivered at the apex of the tumor ranged between 55 Gy and 100 Gy. Patients with lesions greater than 5 mm were submitted to transpupillary thermotherapy concomitantly with ophthalmic plaque insertion. Results: As regards the lesions site, 75% of the lesions were located in the choroid, 15% in the iris, and the remainder 10% in the ciliary body. In a median 19-month-follow-up, the progression-free survival for brachytherapy was 69%, and 87% for associated brachytherapy and transpupillary thermotherapy. A significant tumor height reduction was observed after treatment. No patient was submitted ...
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 ...
Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period 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 ...
We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The ...
Several randomized placebo-controlled trials have consistently shown antidyskinetic effects of amantadine in levodopa treatedpatients with advanced Parkinson's disease (PD). However, all of these were of short duration and there have been claims that the effect of amantadine on levodopa induced dyskinesias (LID's) wear off after about 9 months of treatment. This randomized placebo-controlled parallel-group study was performed to assess the long-term antidyskinetic effect of amantadine in 32 PD patients, who after having been on stable amantadine therapy for LID over at least one year- were switched in a double blind manner to amantadine or placebo and followed for 3 weeks. Dyskinesia duration and intensity were assessed by UPDRS IV items 32 and 33 as well as by patient's diaries. The primary outcome was the score change of UPDRS IV items 32 + 33 between baseline and 3 weeks after treatment as well as ...
ObjectivesTo assess the influence of epigallocatechin-3-gallate (EGCG) on the efficacy of ionizing radiation on prostate cancer cells because of the increased use of dietary interventions, especially by patients with prostate cancer. Radiotherapy is used to treat localized prostate cancer. Some people consume green tea (EGCG) as a chemopreventive agent against prostate cancer. Green tea can act as an antioxidant and induce superoxide dismutase enzymes, which could scavenge the free oxygen radicals generated by radiotherapy. MethodsProstate cancer cell line DU145 cells were treated with EGCG or radiotherapy, or both. Cell death was assessed using trypan blue cell counting, and apoptosis was confirmed by assessing poly (adenosine phosphate ribose) polymerase cleavage. The antioxidant potenti...
The choice of treatment in adult skeletal Class III occlusions often poses a particularly tricky problem for the orthodontist. Faced with the option of either orthodontic camouflage or orthognathic surgery, the clinician's clinical experience is of paramount importance, especially in borderline cases. The aim of our study was to uncover a guide model enabling the practitioner to distinguish between skeletal Class III cases which can be suitably treated with orthodontics and those requiring orthognathic surgery. The lateral headfilms of 47 adult patients exhibiting skeletal Class III occlusions were analyzed. The orthodontic group comprised 22 patients and the surgical group 25. Twenty-seven linear, proportional and angular measurements were scrutinized. Stepwise discriminant analysis was used to identify the dentoskeletal and esthetic variables which most distinguished the two groups. The Holdaway angle was chosen to ...
Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant ...
135 patients with histologically proven Ewing's sarcoma, treated at the Institute Gustave Roussy between 1960-1974 were reviewed in order to establish the effectiveness and the complications associated with radiotherapy. In 133 patients, a dose of at least 60 Gy for long bones, 55 Gy for flat bones and 45 Gy for vertebrae was given. 26 major complications (of which more than one occured in certain patients) were observed: 12 cases of growth retardation, loss of joint function in 7 cases, 3 fractures, 2 osteonecroses, 2 cases of delayed healing, one massive soft tissue fibrosis, 1 abdominocutaneous fistula, 2 cases of symptomatic pulmonary fibrosis with associated infection, 2 cases of radiation enteropathy, 2 of mammary hypoplasia and 1 osteosarcoma developing in an irradiated zone. These complications necessitated 12 surgical interventions, including 4 disarticulations or amputations. The incidence of ...
The purpose of this study was to determine the optimal technique for delivering postoperative radiotherapy for vulvar cancer and other tumors requiring treatment of the inguinal nodes. This project compared tumor coverage and normal tissue sparing for the 5 main radiotherapy techniques that are used to treat vulvar cancer. The intensity-modulated radiation therapy (IMRT) plan was undesirable because it resulted in an excessive dose to portions of the central pelvic structures. The photon thunderbird with skin match was unacceptable because it underdosed a portion of the groin region. The electron thunderbird was ideal for thin patients but was not applicable for most patients because of excessive dose to the skin and subcutaneous tissues. The photon through-and-through and the photon thunderbird with deep match were acceptable in most situations. In thin patients, where the depth of the inguinal vessels ...
Dynamic quantitative bone scintigraphy was performed on 31 men with prostatic carcinoma before orchiectomy as well as 2 weeks, 2 and 6 months postoperatively. After injection of technetium methylene diphosphonate Tc 99m ("9"9"mTc-MDP) the count rate was recorded as serial images over the lower thoracic and all the lumbar vertebrae from 1 to 240 min post-injection. Thirteen men had normal bone scintigrams with no changes in "9"9"mTc-MDP content at the four different investigation times. Eighteen men had skeletal metastases. Throughout the study half of the abnormal vertebrae in these patients showed an abnormal count rate after only 6 min post-injection. After 1 h it was possible in almost all abnormal vertebrae to predict abnormal bone uptake. In response to therapy a 'flare phenomenon' with an increase in count rate was seen 2 weeks after orchiectomy followed by a decrease 2 months postoperatively in most of the abnormal vertebrae. The count rate decreased even ...
Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although ...
Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although ...
OBJECTIVE:- Tumor necrosis factor (TNF) inhibitors can be used to treat inflammatory bowel disease (IBD) but may lead to anti-nuclear antibody (ANA) positivity and lupus-like reactions. Because of its unique structure, certolizumab has lower rates of these complications. We sought to investigate whether patients who have had lupus-like reactions to infliximab or adalimumab would be able to tolerate certolizumab. METHODS:- We performed a retrospective analysis on the 23 patients at the Roberts Inflammatory Bowel Disease Center who received certolizumab for the treatment of Crohn's disease from March 2008 to June 2009. We identified 6 patients who were switched to this drug because of lupus-like reactions from prior anti-TNF therapy and had documented ANA after the reaction and prior to cert...
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 ...
Purpose To investigate the sensitivity and accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for restaging the mediastinum after induction chemotherapy in patients with non-small-cell lung cancer (NSCLC). Patients and Methods One hundred twenty-four consecutive patients with tissue-proven stage IIIA-N2 disease who were treated with induction chemotherapy and who had undergone mediastinal restaging by EBUS-TBNA were reviewed. On the basis of computed tomography, 58 patients were classified as having stable disease and 66 were judged to have had a partial response. All patients subsequently underwent thoracotomy with attempted curative resection and a lymph node dissection regardless of EBUS-TBNA findings. Results Persistent nodal metastases were detected by using EBUS-TBNA in 89 patients (72%). Of the 35 ...
Hematopoietic stem cell transplantation provides the only potential curative option in many patients with hematological malignancies. Finding a suitably matched donor in a timely manner is often difficult. However, most patients have a partially HLA-mismatched (HLA-haploidentical) first-degree relative readily available. Historically, HLA-haploidentical bone marrow transplantation (BMT) has been considered extremely high risk due to high rates of life-threatening graft-versus-host disease (GVHD) and non-relapse mortality (NRM). Modifications of the stem cell graft, such as T-cell depletion, have resulted in poor rates of engraftment. We have recently completed a phase II clinical trial of nonmyeloablative HLA-haploidentical hematopoietic BMT followed by post-transplantation high-cyclophosp...
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 ...
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 ...
Our purpose was to investigate the usefulness of Lipiodol-CT for detection of residual viable neoplastic tissue in hepatocellular carcinoma (HCC) lesions treated by means of percutaneous ethanol injection (PEI). An emulsion of 5 to 20 ml iodized oil and 50 to 70 mg doxorubicin hydrochloride was intraarterially injected in 18 patients with 25 HCC lesions treated by means of PEI one to 24 months before. At CT performed 3 to 5 weeks after injection, retention of Lipiodol was observed in 9 of 13 tumors that still contained viable neoplastic tissue and in 2 of 12 tumors proven to have undergone complete necrosis after PEI. The sensitivity and specificity of Lipiodol-CT were 69.2% and 83.3%, respectively. Thus, Lipiodol-CT seems to have limited diagnostic value after PEI, probably as a consequence of the alcohol-induced vascular damage, accounting for both false-negative and false-positive results. (orig.).
This case report describes the treatment of a 16-year-old girl who had severe bialveolar protrusion. Patients with bialveolar protrusion are commonly treated with four first premolar extractions and retraction of the anterior teeth. Unfortunately in this patient, the mandibular left second molar had to be extracted because of extensive caries. To create sufficient space for retraction of the anterior teeth, the mandibular left posterior teeth were retracted with the mandibular posterior microimplant (1.2 mm in diameter, 6 mm long) placed into the retromolar area followed by en masse retraction of the mandibular anterior teeth. Microimplants can provide anchorage for obtaining a good facial profile even without premolar extraction in the case of bialveolar protrusion with the absence of the second molar. PMID:17319776
Objective: To evaluate the feasibility and clinical application of two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma. Methods: Eighteen patients with hepatic hilar cholangiocarcinoma who had left and right bile duct obstruction were treated with stents insertion via right bile duct puncturing routeway. These two stents were implanted between right and left bile duct, and between right bile duct and common bile duct. Results: Eighteen patients obtained successful two stents placement by right bile duct puncturing tract and succeeded with internal drainage for all biliary tree jaundice subsided distinctly. Conclusions: The technique of two stents insertion via single tract could predigest interventional drainage procedure of high bile duct obstruction, reduce operation trauma, shorten handling time and possess promising application value
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...
Purpose. To examine the impact of residual limb osteomyelitis (RLO) on the rehabilitation of lower limb amputees. Method. Retrospective review of the casenotes of patients with RLO. Information sought included details of amputation, clinical features of investigations for and management of RLO and its effect on rehabilitation. Results. There were seven transfemoral and three transtibial amputees. Indications for amputation were vascular disease in nine cases, trauma in one. In each case, delayed wound healing or residual limb pain prompted radiological, hematological and microbiological investigations. Average time between amputation and diagnosis was 187 days. One patient died before treatment commenced. Two transtibial amputees were treated with intravenous antibiotics while rehabilitati...
We analyzed 16 radiographic features of primary Ewing's sarcoma in 342 patients from the IESS 7299 (Intergroup Ewing's Sarcoma Study) for prognostic significance. Of these, 3 features demonstrated a statistically significant relationship to survival: maximal tumor dimension, tumor location, and an appearance of honeycombing within the lesion. Those individuals with primary lesions centered in the pelvis, femur, or humerus had a worse survival rate than those with lesions centered elsewhere. Similarly, we observed an inverse relationship between the greatest dimension of the osseous portion of the lesion and survival. The radiographic finding of honeycombing also showed a statistical association with improved survival. However, this feature was observed infrequently, and its significance should be assessed further. Otherwise, no other feature that we analyzed showed any relationship to patient prognosis. (orig.).
In a 47-year-old male patient a bronchopleural fistula was apparent 22 days after extended right-sided diaphragma-pericardio-pleuro-pneumonectomy for pleuramesothelioma. The thoracic cavity was infected. Rethoracotomy was performed and the fistula was closed using an omental pedicle flap. The bronchial stump became tight and the cavity fluid became sterile. No abdominal complications were seen. The patient died 8 months later from malignant pericardial infiltration. The ability of greater omentum to revascularize ischemic tissue, to absorb fluid and to resist local infection is proved and used in several subspecialities of surgery. Nevertheless the use of the greater omentum in the management of bronchopleural fistula has been rarely published. The reported case shows that the closure of a large bronchopleural fistula is possible by using the attributes of the omental tissue. PMID:2264043
A successful boron neutron capture treatment (BNCT) of a patient with multiple liver metastases has been first given in Italy, by placing the removed organ into the thermal neutron column of the Triga research reactor of the University of Pavia. In Finland, FiR 1 Triga reactor with an epithermal neutron beam well suited for BNCT has been extensively used to irradiate patients with brain tumors such as glioblastoma and recently also head and neck tumors. In this work we have studied by MCNP Monte Carlo simulations, whether it would be beneficial to treat an isolated liver with epithermal neutrons instead of thermal ones. The results show, that the epithermal field penetrates deeper into the liver and creates a build-up distribution of the boron dose. Our results strongly encourage further studying of irradiation arrangement of an isolated liver with epithermal neutron fields.
Between 1964 and 1977, 94 patients with Ewing's sarcoma of bone were treated at the National Cancer Institute. They received 5000 rad to the whole bone and progressively more aggressive chemotherapy protocols. The patients were divided according to site of primary lesion into central, proximal and distal lesions, with 19%, 33% and 57%, respectively, alive and well. The local control rate is high (93%), with good functional results in the distal lesions, and no changes are needed in radiation therapy dose or volume. Control is not as satisfactory for central and proximal lesions and efforts need to be made to increase control at these sites. We are at present attempting to define more accurately the extent of soft tissue disease, increasing the dose to 6000 rad for central lesions, and using a more aggressive chemotherapy program, in the hope of increasing the local control in these more aggressive tumors.
The authors discuss 84 cases of laparoscopic examination of women with primary or secondary infertility. The patients qualified for this examination had undergone at least 26 weeks of conventional treatment with no effect. In 7 cases the reproductive organ was found to be in order, with fallopian tubes fully patent. In 43 cases tubar inpatency was found (using hysterosalpingographic examination). The remaining patients suffered from other reproductive organ disorders. Therefore, the laparoscopic examination made detailed recognition of the causes of infertility possible and thus helped to establish the proper treatment. Additionally, in some cases it enabled the immediate removal of the source of infertility. (author)
Purpose Suprasellar meningiomas usually present with visual deterioration, including decreased visual acuity and/or visual field defects. Suprasellar meningiomas have a close relationship with the optic apparatus, arteries of the anterior circulation, pituitary stalk and hypothalamus, which makes safe surgical resection a challenge especially with dissection around an already compromised optic apparatus. In this report 21 patients operated on for a suprasellar meningioma over a 4-year period are reviewed. Postoperative outcome and visual recovery are evaluated, including analysis of its determinants. Methods Over a 4-year period (2002?2006), patients surgically treated for suprasellar meningiomas were included in this retrospective study. All tumors were located at the tuberculum sellae an...
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 treatingpatients 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...
The purpose of this study was to compare 2 adaptive radiotherapy strategies with helical tomotherapy. A patient having mesothelioma with mediastinal nodes was treated using helical tomotherapy with pretreatment megavoltage CT (MVCT) imaging. Gross tumor volumes (GTVs) were outlined on every MVCT study. Two alternatives for adapting the treatment were investigated: (1) keeping the prescribed dose to the targets while reducing the dose to the OARs and (2) escalating the target dose while maintaining the original level of healthy tissue sparing. Intensity modulated radiotherapy (step-and-shoot IMRT) and 3D conformal radiotherapy (3DCRT) plans for the patient were generated and compared. The primary lesion and nodal mass regressed by 16.2% and 32.5%, respectively. Adapted GTVs and reduced plan...
LECTURE SERIES 14, 15, 17 January 2008 11:00 to 12:00 - Council Chamber, bldg. 503-1-001 Applications of accelerators to tumour therapy U. AMALDI, TERA Foundation & University of Milano Bicocca The first lecture is devoted to an historical review of the developments of the teletherapy techniques which make use of hadron beams and are collectively called "hadrontherapy". The main emphasis is on the use of protons and light ions, but also neutrons, pions and antiprotons are considered. The second lecture reviews the rationale behind the use of carbon ions in the treatment of radioresistant tumours and the results obtained both with proton and carbon ion beams on the 60 000 patientstreated worldwide. The numbers of patients who would profit from hadrontherapy are presented together with the current landscape of running and planned hospital based centres. The main technical challenges set by this therapeutic modality are ...
There has been a steady increase in the number of revision total knee arthroplasties being performed in the United States. Hinge knee prostheses are used predominantly in complex primary or revision arthroplasties, often as salvage procedures. Significant improvement of the articulation between the rotating hinge mechanism and tibial component has decreased the stresses that contributed to earlier failures in previous generation designs. Two cases of fracture of the tibial metal post in the rotating hinge of a revision total knee arthroplasty were evaluated and treated at our institution within a 1-month period. We present our experience with this construct failure and subsequent patient management.
The CyberKnife Robotic Radiosurgery System (Accuracy Incorporated, Sunnyvale, CA, USA) is used worldwide to treat tumors and neurological disorders anywhere in the body with sub-millimetre beam delivery accuracy. Accuracy has developed a number of new technologies in recent years to enhance the treatment of cancer patients. Such new technologies include a fast Monte Carlo Dose Calculation algorithm, Sequential Optimization dose planning, the IrisTM Variable Aperture Collimator, an 800 MU/min Linear Accelerator, and Optimized Path Traversal. These technologies enable physicists and physicians to plan treatments quickly and easily and deliver them with unrivalled accuracy and precision
Three cases of primitive suprasellar germinomas are reported: the tumors show typical clinical signs (diabetes insipidus, disfunctions), but CT findings are not so specific. It is very important to reach a correct diagnosis based on clinical and radiological findings, because of very high radiosensibility of the tumor. The accuracy of preoparative diagnosis has been enhanced by CT in addition to conventional neuroradiological examinations. Due to the possible risk of meningeal spreading following biopsy, some authors prefer to avoid biopsy and to treat directly the patient by radiotherapy; a rapid reduction of the tumor size at the dose of 30 Gy suggest a possible germinoma.
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.
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).
Neuron differentiation is a complex process involving various cell-cell interactions, and multiple signaling pathways. We showed previously that CD40 is expressed and functional on mouse and human neurons. In neurons, ligation of CD40 protects against serum withdrawal-induced injury and plays a role in survival and differentiation. CD40 deficient mice display neuron dysfunction, aberrant neuron morphologic changes, and associated gross brain abnormalities. Previous studies by Tone and colleagues suggested that five isoforms of CD40 exist with two predominant isoforms expressed in humans: signal-transducible CD40 type I and a C-terminal truncated, non-signal-transducible CD40 type II. We hypothesized that differential expression of CD40 isoform type I and type II in neurons may modulate neuron differentiation. Results show that adult wild-type, and CD40"-"/"- deficient mice predominantly express CD40 type I and II isoforms. ...
In 10 cases of femoral neck fracture treated with prosthetic replacement, the preoperative sup(99m)Tc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head. The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of sup(99m)Tc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases. Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic. This classification of sup(99m)Tc-MDP ...
In IO cases of femoral neck fracture treated with prosthetic replacement, the preopera tive sup(99m)Tc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head. The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of sup(99m)Tc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases. Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic. This classification of sup(99m)Tc-MDP ...
A simple method of estimating the amount of lung irradiated in patients with breast cancer would be of use in minimizing lung complications. To determine whether simple measurements taken at the time of simulation can be used to predict the lung volume in the radiation field, we performed CT scans as part of treatment planning in 40 cases undergoing radiotherapy for breast cancer. Parameters measured from simulator films included: (a) the perpendicular distance from the posterior tangential field edge to the posterior part of the anterior chest wall at the center of the field (CLD); (b) the maximum perpendicular distance from the posterior tangential field edge to the posterior part of the anterior chest wall (MLD); and (c) the length of lung (L) as measured at the posterior tangential field edge on the simulator film. CT scans of the chest were performed with the patient in the treatment position with 1 cm slice intervals, covering lung apex ...
This paper discusses how the U.S. Liquid Metal Reactor Development Program has been restructured to carry out R and D on advanced reactor technology. The program gives particular emphasis to improvements to reactor safety. The new directions are based on the technology of the integral fast reactor (IFR). Much of the basis for superior safety performance using IFR technology has been experimentally verified and aggressive programs continue in EBR-II and TREAT. Progress has been made in demonstrating both the metallic fuel and the new electrochemical processes of the IFR. The FFTF facility is converting to metallic fuel; however, FFTF also maintains a considerable U.S. program in oxide fuels. In addition, generic programs are continuing in steam generator testing, materials development, and with international cooperation, aqueous reprocessing.
Microanalytical methods suitable for the determination of Fe, Cu in HT-29 (human colon adenocarcinoma) cells treated with different iron compounds (Fe(II) sulfate, Fe(III) chloride, Fe(III) citrate and Fe(III) transferrin) and cultured in medium supplemented or not with 10% (v/v) fetal calf serum (FCS) by total reflection X-ray fluorescence spectrometry (TXRF) and simultaneous graphite furnace atomic absorption spectrometry (GF-AAS) were developed. The developed TXRF method was also suitable for Zn determination in the samples. The main advantage of the proposed methods is the execution of all sample preparation steps following incubation and prior to the elemental analysis in the same Eppendorf tubes. Sample preparation was performed at microscale (115mL sample volume) with 65% nitric aci...
Purpose: To evaluate the role of stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) for the treatment of brain metastases in patients with renal cell cancer (RCC). Patients and methods: 88 patients were treated with either SRS (n = 51) or SRS + WBRT (n = 17) for one to three lesions, or with WBRT (n = 20) for more than three brain metastases. Overall survival (OS), intracerebral control (IC) and local control (LC) were retrospectively analyzed. Six potential prognostic factors were assessed: age, gender, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to irradiation. Results: The median times for OS, IC, and LC from the time of diagnosis were 11, 9, and 10 months. The median OS times for SRS, SRS + WBRT, and WBRT were 12, 16, and 2 months. Addition of WBRT to the SRS improved IC (p = 0.032) but not OS ...
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 ...
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 ...
Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study ...
Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study ...
Isocapnic hyperventilation with cold air (IHCA) is a reliable technique for assessing indirect bronchial hyperresponsiveness in patients with asthma. Impedance measurement of the respiratory system by the forced pseudorandom noise oscillation technique is a sensitive technique to assess changes in bronchial tone after IHCA. The aim of this study was to evaluate the effect of 6 weeks of treatment with beclomethasone dipropionate, 1,000 microg x day-1, on IHCA in asthmatic patients, measured with both forced oscillation technique and flow-volume recordings. Forty patients with mild asthma were included in this double-blind, placebo-controlled parallel-group study. Stratification on the basis of sex was performed to overcome differences in airway diameter. At entry and every 2 weeks during the treatment period, IHCA was performed and patient diaries were evaluated. Characteristic changes in forced ...
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 ...
The aim of this retrospective analysis was to evaluate feasibility and effectiveness of definitive chemoradiotherapy without split-course technique in anal cancer patients. From 1993 to 2003, 81 patients were treated; 13 were excluded due to various chemotherapeutic regimes, thus 68 patients were analysed. In case of acute grade 3 toxicities, treatment was halted until improvement or resolution independent of dose. Short interruption was defined as completing treatment without exceeding eight cumulative treatment days beyond scheduled plan, other patients were considered to have had prolonged interruption. Median follow-up was 46 months. Median overall treatment time was 53 days corresponding to an interruption of eight cumulative treatment days. Thirty-five patients (51%) had treatment interruption of <8 days. No acute grade 4 toxicities were observed; ...
Objective was to assess the accuracy of a single versus combined use of ultrasound (US) or computed tomography (CT) in the localization of diseased parathyroid glands. Forty-one patients with hyper-parathyroidism treated surgically between January 2000 to December 2005 at Jordan University Hospital, Amman, Jordan were included in this study. Preoperative ultrasonographic and CT findings were reviewed and compared to the intraoperative and pathologic diagnosis of diseased parathyroid glands. The mean age of patients was 46 years (range 16-70; 15 males and 26 females). Parathyroid adenoma was confirmed in 33 patients and hyperplasia of the parathyroid glands in 8 patients. Preoperative evaluation was carried out in 32 patients (CT scan) and in 23 patients (US). In 18 cases, the diagnosis of parathyroid disease was based on CT findings alone ...
Full text: Many factors including drug efficacy, compliance and antibiotic resistance may influence HP eradication rates. The "1"4C urea breath test is a sensitive method of confirming HP colonisation and eradication. The aim was to study the relationships between the peak "1"4CO_2 counts on the breath test prior to treatment, smoking and HP eradication, and to assess if persistent or recurrent symptoms implied failure of eradication. 117 patients with DU and HP colonisation proved on biopsy or rapid urease test who underwent "1"4C urea breath tests at least one month after eradication treatment was ceased were studied (69 male, 48 female, mean age 41, range 26-87 y). Questionnaire assessment of treatment regimen, smoking history and dyspeptic symptoms was made at the time of the breath test. A sub-group of 43 patients who had pre- and post-treatment breath tests was studied to assess if high peak "1"4CO_2 counts on the pre-treatment breath ...
Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following ...
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 ...
We report the results of a prospective clinical study using a new self-expanding nitinol stent (Enterprise) designed for the treatment of wide-necked intracranial aneurysms. We treated 31 saccular, wide-necked intracranial aneurysms in 30 patients. Ten aneurysms had recanalized after prior endovascular treatment without a stent, and 21 aneurysms had not been treated before. Stent deployment was successful in all procedures. Additional coil embolization was performed in all aneurysms. Initial complete angiographic occlusion was achieved in 6 aneurysms, a neck remnant was left in 18 aneurysms and there were 7 residual aneurysms. Angiographic follow-up examinations of 30 lesions after 6 months demonstrated 15 complete occlusions, 8 neck remnants and 7 residual aneurysms. One patient refused the 6-month angiographic follow-up. Spontaneous occlusion of the aneurysm had occurred in 14 ...
A patient with a totally edentulous maxilla and a seVere Class III intermaxillary relationship in the anterior region was treated by implants. In the mandible, there were 10 teeth between the second premolars. The inclination and width of the maxillary anterior residual bone were measured on cephalometric X-ray film obtained before treatment. The results of cephalometric analysis did not support clockwise rotation of the mandible or lingual angling of the maxillary anterior teeth by use of prosthesis to improve the Class III relationship. Ten implants were simultaneously placed in the maxilla. Then, a maxillary temporary full bridge was seated after reduction of the crown lengths of the mandibular anterior teeth. An apically positioned flap operation was performed to eliminate periodontal pockets and to obtain clinically suitable crown lengths of the mandibular anterior teeth. A noncemented, screw-retained maxillary full bridge and a ...
Haemangiomas usually develop within the first few weeks of life, most regressing spontaneously before the age of 7 years. Some may ulcerate or compromise a vital function, in which case systemic corticosteroids, surgery or radiotherapy may be helpful. All of these treatment modalities are associated with significant morbidity. Treatment with the 585 nm flashlamp pulsed dye laser is safe and effective in the management of superficial vascular malformations. We report seven patients, under 12 months of age, who presented with proliferative haemangiomas, causing functional impairment. Ulcerated lesions were present in four patients. The patients were treated with the 585 nm pulsed dye laser (fluences 7.0-9.25 J/cm2), at intervals of 4-8 weeks. All of the lesions showed a significant reduction in size, together with improvement in the colour and integrity of the overlying skin. Treatment with the 585 nm ...
PurposeThis prospective study followed 61 patients who were partially dentulous and considered to have insufficient bone volume for routine implant treatment and consequently underwent sinus inlay bone grafting.Patients and MethodsThe patients were treated with maxillary sinus floor augmentation with particulated autogenous bone from the mandibular ramus/corpus. After a healing period, dental implants (n = 180) were installed.ResultsRadiographic examination revealed average residual vertical bone heights of 6.5 mm in the first premolar region, 3.8 mm in the second premolar region, 3.5 mm in the first molar region, and 2.6 mm in the second molar region. The average implant lengths were 12 mm in the first premolar region and 11 mm in the second premolar, first, and second molar regions. All ...
In the Department of Radiology of Catholic University S. Cuore in Rome, a review was made of 342 CT examinations with a view towards optimizing the therapeutic planning in patients affected by bone metastases. All patients were submitted to radiological positioning and then to CT evaluation in order to assess the volume to be treated. In 224 cases it was not necessary to perform wide CT examination (3-5 standard tomograms being enough, 2 of which at the superior and inferior margins of the planned field). In the second group of 118 patients it was necessary to perform CT (serial axial scans) - increasing by 1-1.5 cm - up to the superior and inferior margins of the lesion. The existence of 2 types of lesions was confirmed: those involving mainly bony structures and those infiltrating the soft tissues. CT evaluation allowed the definition of the target volume to the real extension of the lesion in 14% of ...
Fourteen patients with cervical hip fractures were treated with internal fixation using titanium screws. The femoral head vitality was evaluated with "9"9Tc"m-MDP scintigraphy and scintimetry within 2 weeks postoperatively and by serial low field magnetic resonance imaging (MR). Two patients with reduced radionuclide uptake (femoral head ratio =# 1.0), MR revealed a focal decrease of the signal intensity in the femoral head or neck at 2, 3 and 7 months after fracture, respectively. The radiographs in one of these patients were normal at 7 months after fracture. The second one showed signs of necrosis at 16 months and the last one developed delayed/non-union. With a non-ferromagnetic osteosynthesis the healing course after femoral neck fracture can be studied with low field MR equipment without disturbing artifacts. The time period between ischaemia and definite abnormalities on MR may embrace several ...
To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine the factors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenous fistula(AVF). Forty-nine cases of insufficient hemodialytic AVF were treated in 44 patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis was performed with urokinase, and was followed by PTA. The initial success rate and complications of PTA were evaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient's age, and the duration of renal failure, patency rates were compared within each subgroup using the Kaplan-Meier logrank test. The initial success rate of PTA for insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was ...
Background and Purpose: In an earlier phase II study, irradiation together with razoxane was shown to improve local control in recurrent rectal cancer. Therefore, the Austrian Society of Radiooncology (OeGRO) initiated a randomized controlled trial in 1992 to compare this combined treatment versus radiation therapy alone. Patients and Methods: Between 1992 and 1999, 36 patients with localized recurrences of rectal cancer were randomized to receive radiotherapy without (group A) or with razoxane (group B). The prognostic variables of the two groups were similar except for a longer median latency period from initial surgery to local recurrence in group A. High-energy photons with daily fractions between 170 and 200 cGy were used. The median total radiation dose was 60 Gy in each group. The patients in group B received a median razoxane dose of 9.6 g (range, 5-12 g). Main outcome measures were local ...
We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate ...
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 selected series of 24 patients with displaced medial femoral neck fracture, treated with closed reduction and osteosynthesis with cancellous bone screws (ASIF), were investigated. During an observation period of 6 to 26 months, serial hip joint scintigraphies were performed and compared with serial X-ray examinations. At the first scintigraphic examination performed on average 5-6 weeks after the fracture, two separate investigators found a decreased amount of activity or no activity in the femoral head of 10 and 8 patients, respectively. At the second scintigraphic examination performed on average 11.1 weeks after the fracture both investigators found no activity or a decreased amount of activity in 8 patients. This figure declined to 7 during the following period, because one patient with decreased activity was recorded as having normal activity 15 months after the fracture. ...
Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still 44% of patient will develop recurrent cancer This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen which is 500-1000 cGy higher than other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was 46%, but only 1 ...
Involvement of the dopaminergic system has been suggested in patients suffering from attention deficit hyperactivity disorder (ADHD) since the symptoms can be successfully treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). This study reports the findings on the status of the DAT in adults with ADHD before and after commencement of treatment with methylphenidate, as measured using [{sup 99m}Tc]TRODAT-1. Seventeen patients (seven males, ten females, aged 21-64 years, mean 38 years) were examined before and after the initiation of methylphenidate treatment (3 x 5 mg/day). All subjects were injected with 800 MBq [{sup 99m}Tc]TRODAT-1 and imaged 3 h p.i. Single-photon emission tomography (SPET) scans were acquired using a triple-headed gamma camera. For semi-quantitative evaluation of the DAT, transverse slices corrected for attenuation were used to calculate specific binding in the striatum, with ...
A few metal complexes of isatin-isonicotinoylhydrazone with Ni(II), Cr(III), Co(II), Cu(II), Zn(II) and Cd(II) have been prepared and characterized on the basis of elemental analyses, infrared and electronic spectra as well as "1H NMR spectra, conductivity and magnetic measurements. In view of the results obtained, it has been found that two molecules of isatin-isonicotinoylhydrazone are chelated to the central metal ion as bis-uninegative ONO tridentate ligand forming non-electrolytic octahedral metal complexes. (author)
Adjuvant-induced arthritis in rats is a chronic inflammatory disease, widely as an animal model for rheumatoid arthritis. In our study the effect of various fractions of dialyzable leukocyte extract (DLE): DLE I-molecular weight below 10 kDa (commercial preparation), DLE II-molecular weight below 5 kDa (suppressor fraction), DLE III-molecular weight 5-10 kDa on rat adjuvant-induced arthritis was studied. The adjuvant arthritic (AA) rats were treated with DLE fractions i.p. in solutions containing an active substance isolated from 12.5 x 10{sup 6} and 6.25 x 10{sup 6} leukocytes from day 1 (adjuvant injected) through day 18, every second day (total 9 times). Various markers in inflammation, immune function and joint destruction were evaluated: hind paw volume, serum hyaluronic acid, serum albumin and biopterin in urine. All these markers showed a significant improvement after using fraction DLE II in comparison with AA ...
Background and purpose: A series of phase I/II clinical trials are being initiated in several UK centres to explore the use of dose-escalated schedules for the treatment of non-small cell lung cancer (NSCLC). Among them the IDEAL-CRT trial (ISRCTN12155469) will investigate the introduction of individualised 'isotoxic' treatment schedules based on the relative mean lung normalised total dose (rNTDmean), an estimator related to lung toxicity. Since treatment planning will be performed using different treatment planning systems (TPSs), for the quality assurance of the trial we have carried out work to quantify the influence of dose calculation algorithms based on the determination of rNTDmean and on the choice of individualised prescription doses. Material and methods: Twenty-five patient plans with stage I, II and III NSCLC were calculated, with the same prescription dose, using the Adaptive Convolve (AC) and Collapsed Cone ...
In this study, adipose-derived stem cells (ASCs) were cocultured with nucleus pulposus (NP) cells using a porous membrane to investigate the effect of NP cell phenotype on ASC chondrogenic differentiation. Human NP cells were collected from 14 patients and classified into two groups (normal vs. degenerative) depending on the level of type II collagen, aggrecan (AGG), type I collagen, and bax gene expression. Human ASCs were then cocultured with each group of NP cells on porous membranes in the absence of chondrogenic supplements. After 2 weeks, real-time-polymerase chain reaction results showed that ASCs cocultured with normal NP cells had much higher type II collagen and AGG gene expression than ASCs cocultured with degenerative NP cells. The production of AGG was also observed only in th...
To evaluate repeated hepatic intraarterial chemotherapy (HIC) as a palliative treatment option for unresectable cholangiocarcinoma and liver metastases of various origins that were progressive under systemic chemotherapy. Between 2002 and 2006, 55 patients were treated in 4-week intervals (mean five sessions). Combined gemcitabine/mitomycin was administered intraarterially within 1 h. Tumor response was evaluated after the third session according to RECIST. Treated tumor entities were colorectal carcinoma (CRC) (n = 12), breast cancer (BC) (n = 12), cholangiocarcinoma (CCC) (n = 10), pancreatic (n = 4), ovarian (n = 3), gastric, cervical, papillary (each n = 2), prostate, esophageal carcinoma, leiomyosarcoma (each n = 1), cancer of unknown primacy (CUP) (n = 5). All patients tolerated the treatment well without any major side effects or complications. In total, there were 1 complete response (CR), 19 ...
Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event free (EFS) and overall survival rates from multi-disciplinary therapy in Ewing's Sarcoma (ES). Materials and Methods: Between 1983 and 1988, 184 children with ES were enrolled onto POG 8346. 178 (97%) met eligibility criteria; 6 had non-ES pathology. Induction treatment of Cyclophosphamide/Adriamycin (C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy (XRT) and C/A, Dactinomycin and Vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. 40 patients were randomized to receive SF, whole bone XRT to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or IF to 55.8 Gy while 84 were assigned to IF XRT. Results: Of 179 eligible ...
The authors assess the role of Computed Topography in the diagnosis and management of multiple myeloma (MM) and investigate if Computed Tomography findings can influence the clinical approach, prognosis and treatment. 273 multiple myeloma patients submitted to Computed Tomography June 1994, to December, 1996. The patients were 143 men and 130 women (mean age: 65 years): 143 were stage I, 38 stage II and 92 stage III according to Durie and Salomon's clinical classification. All patients were submitted to blood tests, spinal radiography and Computed Tomography, the latter with serial 5-mm scans on several vertebral bodies. Computed Tomography despicted vertebral arch and process involvement in 3 cases with the vertebral pedicle sign. Moreover, Computed Tomography proved superior to radiography in showing the spread of myelomatous masses into the soft tissues in a case with solitary permeative lesion in ...
Abstract Aims: This study performed a systematic review and meta-analysis on glycemic control and pregnancy outcomes in women with type 1 diabetes mellitus (T1DM) treated with lispro (LP) versus regular insulin (RI) since before pregnancy. Methods: We performed a MEDLINE and EMBASE search. Abstracts (and full articles when appropriate) were reviewed by two independent researchers. Inclusion criteria were patients with T1DM, data on women treated with RI and LP since before pregnancy until delivery in the same article, at least five pregnancies in each group, and information on at least one pregnancy outcome. Quality assessment was performed using the Newcastle?Ottawa Quality Assessment Scale for cohort studies. Results: Outcome data were summarized with Revman version 5.0 (ims.cochrane.org...
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 ...
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 ...
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) ...
We wanted to evaluate the long-term results of a dual expandable nitinol stent for the palliative treatment of malignant gastroduodenal strictures. The dual stent consists of two stents; an outer partially nylon covered stent and an inner bare nitinol stent. The outer stent was placed into the stricture and this was followed by coaxial placement of the inner bare stent. Using fluoroscopic guidance, dual expandable stents were placed in 86 patients with inoperable malignant gastroduodenal strictures. The technical and clinical success, the complication, survival and the stent patency were evaluated during the follow-up period. Stent placement was technically successful in 83 of the 86 patients. After stent placement, 74 of the 85 patients showed improvement of their symptoms. During the mean follow-up period of 133 days, 24 patients (28%) developed recurrent symptoms due to incomplete expansion (n=1), ...
To evaluate the usefulness of radiation therapy alternative to surgery for clinical N0-N1 non-small cell lung cancer (NSCLC). From 1976 through 1989, 116 patients with NSCLC without mediastinal involvement were treated with definitive radiation therapy alone at Gunma University Hospital. All patients were treated with once-daily standard fractionation using 10 MV X-rays. The total dose ranged from 60 Gy to 80 Gy. The actuarial 2- and 5-year survival rates of the entire group were 43% and 20%, respectively with a median survival time of 19 months. The survival of 76 patients with stage T2 tumors was significantly better than that of 28 patients with T3 tumors (mean survival time 21 versus 15.5 months; p<0.05). Sixty-two patients with tumors less than 5 cm in diameter had a 2-year progression rate of 20%, in comparison with 39% of 54 ...
Purpose Elective laparoscopic sigmoid resection (LSR) for symptomatic diverticular disease is supposed to have significant short-term advantages compared to open surgery (open sigmoid resection (OSR)). This opinion is rather based on inferences from trials on colonic resections for malignant diseases or minor laparoscopic surgery. This randomized controlled trial was conducted to compare quality of life as well as morbidity and clinical outcome after LSR vs. OSR following a midterm follow-up period. Methods Patients presenting with a symptomatic sigmoid diverticular disease stage II/III (Stock/Hansen) were randomly allocated to LSR or OSR in a prospective multicenter trial. Endpoints included the quality of life assessed with a standardized questionnaire, postoperative mortality, and compl...
In the year 1996 the spheres of competence of several DLR-Institutes working in the areas of fluid dynamics, reaction kinetics, combustion, numerical methods and laser measuring techniques have been brought together while contributing to the internal DLR project 'combustion chamber modelling (BKM)', in order to proceed with the computational simulation of combustion processes in combustion chambers of gas turbines. The main issue was the development of a research code for numerical simulation of fluid flow in real combustion chambers. Here the development of computational models of physical and chemical processes was emphasized, among other processes the formation of soot was treated. Moreover, a worldwide outstanding database of measured data for the purpose of code validation has been created within the framework of the BKM project using the laboratory facilities of the DLR, which are in Germany unique for the experimental investigation of the ...
The accuracy of dose computation within the lungs depends strongly on the performance of the calculation algorithm in regions of electronic disequilibrium that arise near tissue inhomogeneities with large density variations. There is a lack of data evaluating the performance of highly developed analytical dose calculation algorithms compared to Monte Carlo computations in a clinical setting. We compared full Monte Carlo calculations (performed by our Monte Carlo dose engine MCDE) with two different commercial convolution/superposition (CS) implementations (Pinnacle-CS and Helax-TMS's collapsed cone model Helax-CC) and one pencil beam algorithm (Helax-TMS's pencil beam model Helax-PB) for 10 intensity modulated radiation therapy (IMRT) lung cancer patients. Treatment plans were created for two photon beam qualities (6 and 18 MV). For each dose calculation algorithm, patient, and beam quality, the following set of clinically relevant dose-volume ...
Platinum(II) complexes have been investigated in the hydration of alkynes. These catalysts offer improved regioselectivity over Hg(II) counterparts. 1 fig., 2 tabs.
Women treated of localised stages of cervix cancer have a very good prognosis. But do health care professionals have a tendency to underestimate the potential need for rehabilitation of this group? To be able to answer this question this study aimed to develop knowledge concerning these women's own perception of their health during a long period after surgical cancer treatment. A total of 398 women who underwent radical hysterectomy in the period from the 1 January 1983 to 31 December 2000 participated in the study at Aarhus University Hospital, Skejby in Denmark 2001-2003. All patients initially filled in an internally validated questionnaire. Subsequently a sample of 100 women filled in the questionnaires Short Form -36 and Sense of Coherence to evaluate their self-reported health. Analy...
Objective: To evaluate the effect of metallic stent combined with stereotactic conformal radiotherapy (SCRT) for hilar cholangiocarcinoma. Methods: Fifty-four patients with hilar cholangiocarcinoma were analyzed, including 31 treated with stent plus stereotactic conformal radiotherapy (combined group) and 23 with metallic stent alone (control group). Results: The mean survival time of combined group was 11.1 #+-# 4.6 months, compared with 5.1 #+-# 2.8 months of the control group, giving a significant difference between the two groups (P<0.01). Conclusion: The combination of metallic stent and stereotactic conformal radiotherapy is more effective than metallic stent alone for unresectable hilar cholangiocarcinoma. (authors)
Abstract Introduction: Transduodenal ampullectomy (TDA) can be performed for benign and premalignant tumors of the ampulla of Vater (AOV) as an alternative to pancreaticoduodenectomy. However, the laparoscopic approach has rarely been attempted. In this report 2 cases of benign ampullary tumor that were treated by totally laparoscopic TDA. Patients and Methods: Case 1 was of a 75-year-old female who was admitted with left knee pain and underwent arthroscopic debridement. On postoperative day 6, she showed elevated levels of alkaline phosphatase, aspirate aminotransferase, alanine transaminase, and gamma-glutamyl transpeptidase, without any other laboratory test abnormality. She had no complaint of abdominal pain, and physical examinations were unremarkable. Computed tomography (CT), magnet...
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...
The aim of this article is to report our experience in the diagnosis of two cases of iliac artery endofibrosis or arteriopathy, a rare entity occurring in high-performance athletes, presenting with intermittent claudication (right-sided in both) after maximal exercise. External iliac artery endofibrosis or arteriopathy is a likely diagnosis in competitive athletes free of cardiovascular risk factors who present with leg claudication. Arteriography and a papaverine-assisted mean pressure gradient across the iliac arteries of more than 10 mmHg is a useful diagnostic approach. Moreover, balloon angioplasty of the iliac artery in that patient, in whom a pressure gradient was detected, resulted in symptomatic relief for 2 months followed by mild symptom recurrence. Thus, although balloon angioplasty is feasible and safe, it might not be adequate to treat this entity and, thus, its value remains undefined.
Sinus lifting and reconstruction of localized alveolar defects are often required after closure of a large oroantral fistula (OAF) to allow for subsequent implant installation. This study describes a combined surgical technique that involves sinus lifting, bony closure, and reconstruction of the alveolar defect at the site of an OAF. The sinus membrane was reconstructed as a continuous layer by combining the residual sinus membrane with a rotated part of oral mucosa around the OAF. Autogenous bone from the chin and/or ramus was grafted into the prepared sinus space and alveolar defect, and the graft was covered by a buccal advancement flap. This technique was used to treat 8 patients who had large OAFs in the posterior maxillary region. The treatment was successful in all cases, and the te...
Stenting for stenosis of the proximal vertebral artery (VA) is commonly performed via a femoral approach. However, iliofemoral occlusive disease such as arteriosclerosis obliterans sometimes prevents safe transfemoral access. In certain situations where both femoral access and ipsilateral brachial access are difficult because of a concomitant vascular diseases or particular anatomic setting, a contralateral brachial approach using the brachiobrachial pull-through technique may allow efficient and accurate stenting. A case of VA origin symptomatic stenosis successfully treated with stenting using the new pull-through technique from the contralateral brachial artery to the brachial artery on the affected side is described. (orig.)
Proton pump inhibitors are highly successful in treating gastroesophageal reflux disease, but a significant proportion of patients have persistent symptoms from weakly or nonacidic reflux. Transient lower esophageal sphincter relaxation (TLESR) represents the dominant mechanism of gastroesophageal reflux and has therefore become the most intensely investigated therapeutic target. The triggering of TLESR involve the vagal pathways and the ?-aminobutyric type B (GABA(B)) and metabotropic glutamate type 5 (mGluR5) receptors. Baclofen is a GABA(B) receptor agonist that is effective in inhibiting TLESR and reducing the number of reflux episodes, but is associated with significant central nervous system (CNS) side effects. The newer GABA(B) agonists, such as AZD9343 and AZD3355, and mGluR5 antag...
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...
Driving is a complex task that can be a significant challenge for individuals with attention-deficit/hyperactivity disorder (ADHD). A slight lapse in attention or inhibition while driving (not uncommon in individuals with ADHD) can result in hazardous consequences for these individuals and their families. This is also an interesting clinical scenario for the treating physician, who is always trying to optimize the various treatment options for the patient. Despite such potentially perilous consequences for society, this subject only recently has received researchers? attention. This review paper highlights the psychological differences between drivers with and without ADHD and examines differences between these groups in various driving simulation models. Research updates involving pharmac...
Malignant tumors of the sinonasal cavities are rare and often diagnosed late in the course of the disease. These tumors can extend into regions such as the orbit and brain, where treatment is difficult. Ten patients with non treated sinonasal malignant neoplasms and radiological evidence of tumor extension into the orbit and brain were studied with computed tomography. Five (50%) tumors were epithelial neoplasms whereas squamous cell carcinoma was the most common type (3 cases). The ethmoidal sinus was the most common site of origin of the tumors (40%), followed by the maxillary sinus (30%) and nasal cavity (30%). A total of 16 orbits were involved since 6 patients (60%) had bilateral orbital involvement. The tumors extended more often into the orbits through erosion of the medial and inferior orbital bones. All orbital compartments were involved in the majority of the orbits. Tumoral extension into the cranial cavity was ...
Pharmacokinetics is studied, radiation doses to patients when using domestic thallium-201 chloride in diagnosis of the heart ischemic disease is estimated; contribution into the total dose of thallium-201 (1.5 %), thallium-201 (0.2 %) and lead-201 + lead-203 (0.05 %) radionuclide impurities is also determined. Internal doses were estimated for a heterogeneous phantom of a standard man; the calculations were carried out using a computer. Scanning of patients which were treated with radiopharmaceuticals to be diagnosed was carried out using a whole body counter and gamma-chamber. Large intestine, kidneys and thyroid are the critical organs when using thallium-201 chloride. The highest contribution into the dose to organs and the whole body from thallium-200 and thallium-202 impurities being contained in thallium-201, doesn't exceed 8.6 %. The contribution into the dose from lead-201 and lead-203 may be ignored. Doses from ...
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 ...
Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Risk factors were derived from epidemiologic studies of patientstreated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may overestimate the true risks by one order of magnitude, yet in ...
Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Risk factors were derived from epidemiologic studies of patientstreated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may overestimate the true risks by one order of magnitude, yet in ...
Biological wound dressings sterilized with gamma radiation, such as amnion and pig skin, are a reality in Mexico. These tissues are currently processed in the tissue bank and sterilized in the Gamma Industrial Irradiation Plant; both facilities belong to the Instituto Nacional de Investigaciones Nucleares (ININ) (National Institute of Nuclear Research). With the strong support of the International Atomic Energy Agency, the bank was established at the ININ and the Mexican Ministry of Health issued its sanitary license on July 7, 1999. The Quality Management System of the bank was certified by ISO 9001:2000 on August 1, 2003; the scope of the system is 'Research, Development and Processing of Biological Tissues Sterilized with Gamma Radiation'. At present, more than 150 patients from 16 hospitals have been successfully treated with these tissues. This paper presents a brief description of the tissue processing, as well as the present Mexican ...
Radiation necrosis of normal CNS tissue represents one of the main risk factors of brain irradiation, occurring more frequently and earlier at higher total doses and higher doses per fraction. At present, it is believed that the necrosis results due to increasing capillary permeability caused by cytokine release leading to extracellular edema. This process is sustained by endothelial dysfunction, tissue hypoxia, and subsequent necrosis. Consequently, blocking the vascular endothelial growth factor (VEGF) at an early stage could be an option to reduce the development of radiation necrosis by decreasing the vascular permeability. This might help to reverse the pathological mechanisms, improve the symptoms and prevent further progression. A patient with radiation-induced necrosis was treated with an anti-VEGF antibody (bevacizumab), in whom neurologic signs and symptoms improved in accordance with a decrease in T1-weighted fluid-attenuated ...
A study has been made of the precipitation and growth processes which occur during cooling from solution treatment and under isothermal hold conditions in a magnesia-partially-stabilized zirconia alloy. Three types of precipitate have been identified which develop during cooling or during isothermal hold treatments just above and below the eutectoid temperature. These precipitate forms are termed (i) primary, (ii) large random, and (iii) secondary. Further precipitation, slow growth of existing precipitates, and subeutectoid decomposition result when an additional 1100/sup 0/C aging treatment is given to the previously cooled material. It is shown that type (iii) secondary precipitates from rapidly within the temperature range of 1300/sup 0/ to 1375/sup 0/C. The secondary precipitates are largely responsible for the improved room-temperature strength properties of the heat-treated samples. The formation and effects on mechanical properties of ...
A study has been made of the precipitation and growth processes which occur during cooling from solution treatment and under isothermal hold conditions in a magnesia-partially-stabilized zirconia alloy. Three types of precipitate have been identified which develop during cooling or during isothermal hold treatments just above and below the eutectoid temperature. These precipitate forms are termed (i) primary, (ii) large random, and (iii) secondary. Further precipitation, slow growth of existing precipitates, and subeutectoid decomposition result when an additional 1100"0C aging treatment is given to the previously cooled material. It is shown that type (iii) secondary precipitates from rapidly within the temperature range of 1300"0 to 1375"0C. The secondary precipitates are largely responsible for the improved room-temperature strength properties of the heat-treated samples. The formation and effects on mechanical properties of each type of ...
Measurements of the Kapitza conductance to liquid helium II across the (100) surface of single crystals of copper are presented. The temperature range of these measurements was 1.6-- 2.1 K. The sample surfaces were subjected to several different treatments. Some surfaces were cleaned by low-energy argon ion bombardment, annealed in an ultrahigh-vacuum system, and preserved under vacuum until purified liquid helium was admitted. Other surfaces were intentionally damaged by machining and/or exposure to the atmosphere. The conductance after these latter treatments was found to be about a factor of three higher than that of the more ideally cleaned and annealed surfaces, and a significant difference in the temperature dependence of the conductance was also observed. Conductances were reproducible for similarly treated surfaces and correlated with surface damage determined by x-ray diffraction. The relationship of these results to the numerous ...
We have been investigating radiation-induced neoplastic transformants of C3H 10T1/2 mouse fibroblasts for evidence of heritable changes. C3H 10T1/2 cells were treated with 8 Gy X rays. After approximately 8 weeks of culture, type II/III foci were isolated from the monolayer using cloning rings. Cell lines developed from these foci, and clones established from these cell lines, were examined for DNA content. The isolated focus-derived populations and derived clones often display aneuploidy and/or polyploidization. In one instance a clone (derived from a single cell) displayed multiple polyploidies. During passage the ploidy of many of the anomalous populations gradually reverted to the ploidy of the non-neoplastically transformed state. The morphological features associated with the neoplastic transformation event were nevertheless retained. The results demonstrate that exposure to radiation can induce, in association with morphological ...
Five cases diagnosed as extraosseous Ewing's sarcoma (EES) during a 15 year period, and the relevant literature, were reviewed. The diagnosis in these cases was difficult to confirm, mainly because the distinction between the osseous form of Ewing's sarcoma (OES) and either periosteal reactions or direct tumour invasion into adjacent bone by EES was often unclear. The literature suggests that other authors have also encountered difficulties. The authors believe that many cases reported as EES are likely to have been OES. This distinction has some importance, as the two conditions are usually treated in differing ways. The following criteria are proposed for the diagnosis of primary EES: (i) no evidence of bony involvement on magnetic resonance imaging; (ii) no evidence of increased uptake in bone or periosteum adjacent to the tumour on static isotope bone scan images; (iii) a small round cell tumour with no differentiating features on light ...
There are few studies that focused on the prognostic value of FDG-PET on small cell lung cancer (SCLC). Not only FDG uptake (maxSUV), but also metabolic size (greatest dimension of PET positive mass) may determine the prognosis of SCLC. Here, we investigated the prognostic significance of maxSUV, and the metabolic size in SCLC patients. Biopsy-proven SCLC patients (n=21; age, means.d.=67.39y; male: female=19: 3) who had underwent FDG-PET within 4 weeks of chemotherapy initiation were enrolled. There were 7 extensive disease (ED) and 14 limited disease (LD) patients. The maxSUV and the metabolic size were measured, and then, size-incorporated maxSUV (SIMaxSUV = maxSUV x metabolic size) were calculated at individual SCLC masses. SIMaxSUV of main lesion (main-SIMaxSUV), and the summed value of SIMaxSUV of all PET positive masses (summed-SIMaxSUV) were obtained. In addition, age, stage, and %expression of glucose transporter ...
Purpose Cisplatin plus gemcitabine is a standard regimen for first-line treatment of advanced non-small-cell lung cancer (NSCLC). Phase II studies of pemetrexed plus platinum compounds have also shown activity in this setting. Patients and Methods This noninferiority, phase III, randomized study compared the overall survival between treatment arms using a fixed margin method (hazard ratio [HR] < 1.176) in 1,725 chemotherapy-naive patients with stage IIIB or IV NSCLC and an Eastern Cooperative Oncology Group performance status of 0 to 1. Patients received cisplatin 75 mg/m(2) on day 1 and gemcitabine 1,250 mg/m(2) on days 1 and 8 (n = 863) or cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 (n = 862) every 3 weeks for up to six cycles. Results Overall survival for cisplatin/pemetrexed was noninferior to cisplatin/ gemcitabine (median survival, 10.3 v 10.3 months, respectively; HR = 0.94; 95% ...
We wanted to assess the usefulness of four-dimensional (4D) ultrasonography (US), i.e., real-time three-dimensional US, as an adjunct for performing various US-guided interventional procedures in superficial lesion. Thirty-three patients were referred for US-guided interventional procedures for superficial lesions, including core biopsy in 19, fine- needle aspriation in eight, therapeutic drug injection in four and needle puncture in two. The procedures were performed under 4D US guidance. We reviewed the pathologic/cytologic results of the core biopsies or needle aspirations, and also the outcomes of drug injection or needle puncture. For all the patients who underwent 4D US-guided core biopsy, the specimens were adequate for making the pathological diagnosis, and specimens were successfully obtained for those patients who underwent 4D US-guided aspiration. The patientstreated ...
Background and purpose: stereotactic radiosurgery (SRS) and also fractionated stereotactic radiotherapy (SRT) offer high local control (LC) rates (> 90%). This study aimed to evaluate three-dimensional (3-D) tumor volume (TV) shrinkage and to assess quality of life (QoL) after SRS/SRT. Patients and methods: from 1999 to 2005, 35/74 patients were treated with SRS, and 39/74 with SRT. Median age was 60 years. Treatment was delivered by a linear accelerator. Median single dose was 13 Gy (SRS) or 54 Gy (SRT). Patients were followed up ? 12 months after SRS/SRT. LC and toxicity were evaluated by clinical examinations and magnetic resonance imaging. 3-D TV shrinkage was evaluated with the planning system. QoL was assessed using the questionnaire Short Form-36. Results: Median follow-up was 50/36 months (SRS/SRT). Actuarial 5-year freedom from progression/overall survival was 88.1%/100% (SRS), and ...
The aim of this study was to determine sensitivity and specificity of magnetic resonance angiography (MRA) for the assessment of durable occlusion of intracranial aneurysms with Guglielmi detachable coils (GDC) and to point out the influence of MRA results in re-intervention strategies. Forty-five patients with 54 aneurysms that were previously treated by endovascular occlusion with GDC were selected for this study. All patients underwent digital subtraction angiography (DSA) and MRA examinations on the same day. The time-of-flight MRA studies were performed on a 1-T scanner. The MRA images were first read by radiologists who were not aware of the DSA results. In a second consensus reading by the neuroradiologists who had performed all interventional procedures of this series, the decision was made as to whether re-treatment was necessary. The distribution of aneurysm sizes, configurations and treatment results were ...
The construction of Heavy Ion Medical Accelerator in Chiba (HIMAC) at the National Institute of Radiological Sciences was completed in December 1993. HIMAC consists of an injector linac, two synchrotron rings, a high energy beam transport system and a beam irradiation system. Its accelerator parameters are based on the medical requirement, and helium, carbon, neon, silicon and argon were selected as the accelerated ion species. It has 3 therapy rooms (A{approx}C). Room A has a vertical irradiation system, Room C horizontal and Room B both vertical and horizontal. Two rings can supply beams independently to the vertical and horizontal irradiation systems. Clinical trial started on June 21 1994, after several basic biological and physics experiments lasting about 2 months. Cancer is the top cause of death in Japan since 1981, and people expect good treatment results at HIMAC. Proton and heavy ion radiotherapy has the advantage of dose distribution and biological effect in comparison with ...
The purpose of this paper is to report the personal experience with helical CT evaluation of hepatocellular carcinoma treated with various percutaneous interventional procedures. From December 1996 to September 1998 it were examined with helical CT 41 patients (73 nodules in all) with hepatocellular carcinoma treated with percutaneous ablation therapies: conventional ethanol injection in 18 subjects (31 nodules), one-shot ethanol injection 3 (8 nodules), radiofrequency thermal ablation in 16 (25 nodules), and combined chemo embolization and ethanol injection in 4 (9 nodules). CT performed was 4-27 days after the last session, acquiring biphasic volumetric images in 14 patients and triphasic volumetric images in 27. A second treatment with subsequent CT study was performed for 28 lesions; 15 underwent 3 serial studies and 6 underwent 4 studies. Compared with pretreatment findings, the diameter was ...
Two neutron emesis experiments were conducted at the Armed Forces Radiobiology Research Institute (AFRRI). In both experiments (described as Phase I and Phase II) the radiation dose required to cause emesis in 50% of subjects (ED50) was determined for both neutron reactor and gamma reactor source radiation. Emesis onset, offset and duration times post-exposure are reported. Neutrons were maximized from the reactor by passing the beam through a 15.25 cm (6 in.) thick lead wall to filter out gamma photons. Gamma rays were maximized by thermalizing neutrons in 30.5 cm (12 in.) of water, then absorbing the thermal neutrons in a gadolinium-cadmium shield. In Phase I, 28 dogs were exposed to radiation: 12 were exposed to gamma photons at the rate of 0.69 Gy/min and 16 were exposed to neutrons at 1.2 Gy/min. In Phase II, 58 dogs in 3 groups were exposed to radiation: 19 were exposed in the gamma group at 0.75 Gy/min, 20 were exposed in the undrugged ...
Hyaluronate (HA) distribution patterns were examined in the cranial mesenchyme underlying the mesencephalic neural folds of mouse embryos maintained in roller tube culture. Using standard image-processing techniques, the digitized images of Alcian blue-stained or 3H-glucosamine-labeled sections digested with an enzyme specific for HA, were subtracted from adjacent, undigested sections. The resultant difference picture images (DPI) accurately depicted the distribution of stained or labeled HA within the cranial mesenchyme. 3H-glucosamine-labeled HA was distributed uniformly throughout the cranial mesenchyme as 12, 18, and 24 hr of culture. By contrast, the mesenchyme was uniformly stained with Alcian blue at 12 hr, but stain intensity decreased in the central regions of the mesenchyme at 18 and 24 hr. HA distribution patterns were also examined in the cranial mesenchyme of embryos cultured in the presence of diazo-oxo-norleucine (DON), a glutamine analogue that inhibits ...
''Paraquat lung'' which is complicated with paraquat poisoning has been a lethal pulmonary pathology presenting intra-alveolar fibrosis, but an effective therapy has not been developed so far. We hypothesized that the type II alveolar cells producing surfactant were damaged by paraquat which was actively accumulated through out the blood by alveolar epithelial cells. To prove this hypothesis, we examined the effect of an intratracheal administration of an artificial lung surfactant (surfacten, Mitsubishi Tanabe Pharma Corporation, Osaka) on mortality in a model of murine paraquat poisoning. Paraquat was given intramuscularly 3 days after the intratracheal surfactant administration. The mice used were C57BL/6J strain and Balb/C strain. The lethal dose, 50% (LD50), of paraquat was about 28 mg/kg in the C57BL/6J strain and about 9 mg/kg in the Balb/C strain, respectively. Mortalities of paraquat poisoning in both strains of mice improved significantly when the mice ...
In an epidemiological study of the somatic late effects risk following incorporation of a short lived {alpha}-emitter, 1473 ankylosing spondylitis patientstreated with repeated intravenous injections of {sup 224}Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 {mu}Ci) of {sup 224}Ra each, given at weekly intervals; this would result in an cumulative {alpha}-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ...
Purpose: Various published reports involving intensity-modulated radiotherapy (IMRT) plans developed using automated optimization (inverse planning) have demonstrated highly conformal plans. These reported conformal IMRT plans involve significant target dose inhomogeneity, including both overdosage and underdosage within the target volume. In this study, we demonstrate the development of optimized beamlet IMRT plans that satisfy rigorous dose homogeneity requirements for all target volumes (e.g., #+-#5%), while also sparing the parotids and other normal structures. Methods and Materials: The treatment plans of 15 patients with oropharyngeal cancer who were previously treated with forward-planned multisegmental IMRT were planned again using an automated optimization system developed in-house. The optimization system allows for variable sized beamlets computed using a three-dimensional convolution/superposition dose calculation and flexible cost ...
Purpose: During recent years, more intensified systemic and local treatment regimens have increased the 5-year survival figures in localized Ewing's sarcoma to more than 60%. There is, however, concern about the risk of second malignancies (SM) in long-term survivors. We have analyzed the second malignancies in patientstreated in the German Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and Methods: From January 1981 through June 1991, 674 patients were registered in the two sequential multicentric Ewing's sarcoma trials CESS 81 (recruitment period 1981-1985) and CESS 86 (1986-1991). The systemic treatment in both studies consisted of a four-drug-regimen (VACA = vincristine, actinomycin D, cyclophosphamide, and adriamycin; or VAIA = vincristine, actinomycin D, ifosfamide, and adriamycin) and a total number of four courses, each lasting nine weeks, was recommended by the protocol. Local therapy in curative ...
Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous ...
Purpose: The purpose of this course is to review the physical principles underlying design, clinical application and execution of interstitial and intracavitary implants in the classical low dose-rate (LDR) range. This year, the course will focus on quality assurance of sources, applicators and treatment planning software. In addition, development of procedures and QA checks designed optimize treatment delivery accuracy and patient safety during each individual procedure will be reviewed. The level of presentation will be designed to accommodate both physicists and physicians. Implementation of recently published AAPM Task Group reports (no. 40, 'Comprehensive Quality Assurance' and No. 43, 'Dosimetry of Interstitial Brachytherapy Sources') will be reviewed. Outline: (A) General Principles (1) QA endpoints: temporal accuracy, positional accuracy, dose delivery accuracy, and safety of the patient, personnel, and the institution (2) QA procedure ...
We wanted to determine the technical and clinical efficacy of placing a self-expandable PTFE-covered nitinol stent for the management of inoperable malignant biliary obstruction. Thirty six patients with inoperable malignant biliary obstructions were treated by placement of self-expandable PTFE-covered nitinol stents (S and G Biotech Corporation, Seongnam, Korea). Clinical evaluation was done with assessment of the serum bilirubin and alkaline phosphatase levels, which were measured before and after stent placement within 1 week, at 1 month and at 3 months. The patient survival rate and stent patency rate were calculated with performing Kaplan-Meier survival analysis. Successful stent placement was achieved in all the patients without procedure-related complication. Pancreatitis as an early complication occurred in two cases. The serum bilirubin and alkaline phosphatase levels were significantly ...
Automatic segmentation of anatomical structures in medical images is a valuable tool for efficient computer-aided radiotherapy and surgery planning and an enabling technology for dynamic adaptive radiotherapy. This paper presents the design, algorithms and validation of new software for the automatic segmentation of CT images used for radiotherapy treatment planning. A coarse to fine approach is followed that consists of presegmentation, anatomic orientation and structure segmentation. No user input or a priori information about the image content is required. In presegmentation, the body outline, the bones and lung equivalent tissue are detected. Anatomic orientation recognizes the patient's position, orientation and gender and creates an elastic mapping of the slice positions to a reference scale. Structure segmentation is divided into localization, outlining and refinement, performed by procedures with implicit anatomic knowledge using standard image ...
New tetradentate N(2)O(2) donor Schiff bases and their mononuclear Co(II), Ni(II), Cu(II), and Pd(II) complexes were synthesized and characterized extensively by IR, (1)H-, (13)C-NMR, mass, ESR, conductivity measurements, elemental and thermal analysis. Specifically the magnetic and electronic spectral measurements demonstrate the octahedral structures of cobalt(II), nickel(II) complexes and square planar geometries of copper(II), palladium(II) complexes. All the ligands and complexes were screened for their in vitro antibacterial activity against two gram-positive bacteria (Bacillus subtilis, Staphylococcus aureus) and two gram-negative bacteria (Escherichia coli, Klebsiella pneumonia). In this study, Pd(II) complexes exhibited potent antibacterial activity against B. subtilis, S. aureus whereas ...
Some acylhydrazine derived ONO donor Schiff bases and their Co(II) and Ni(II) complexes have been prepared having the same metal ion (cation) but different anions. These synthesized metal(II)...Full Text Available
Complex abdominal lesions include a variety of pathologies, such as septated, infected, and hemorrhagic cysts, abscesses, tumors, and fluid collections of different ethiology. These lesions present diagnostic difficulties with both Ultrasonography (US) and Computed Tomography (CT), since findings may not be present or, when present, are not specific. Keeping these limitations in mind, we evaluated 105 patients (111 abdominal lesions) with both US and CT in order to compare their adequacy in predicting the nature of the lesion. On the basis of US and CT results, complex abdominal lesions were divided in four classes: class I includes 43 cases in which both examinations gave the same contribution to the definition of the nature of the lesion, class II (14 lesions, mainly sperimentated cysts), in which US was superior to CT, class III includes 45 cases of hemorrhagic cysts, abscesses, fluid collections and, less frequently, cystic tumors; class IV ...
We examined whether proton magnetic resonance spectroscopy (MRS) could provide accurate information on histological grade and cell proliferation in astrocytomas. We studied 23 patients with astrocytomas: five grade II, 10 grade III and eight with grade IV (glioblastoma multiforme). We performed proton MRS and determined the Ki-67 labeling index (LI), a tumour proliferation marker, in the same areas of the astrocytomas, and examined the statistical relationship between proton MRS and Ki-67 LI. The N-acetylaspartate (NAA)/creatine-phosphocreatine (Cr) and NAA/choline (Cho)-containing compound ratios were always significantly lower and the Cho/Cr ratios significantly higher than those for normal brain. The Cho/Cr ratio correlated positively and the NAA/Cho ratio inversely with Ki-67 LI. These findings suggest that the Cho signal in proton MRS reflects cellular proliferation. In Kaplan-Meier survival analysis, there was no significant difference ...
Early diagnosis of hepatocellular carcinoma (hepatoma) along with surgical resection is the most appropriate therapeutic modality. For this purpose, there have been many reports concerning the diagnostic value of Lipiodol-CT scan. The authors selected 45 patients with hepatoma during the period of Feb.1986 to Jan. 1988 who received a conventional CT scan, hepatic angiography and a Lipiodol-CT scan. The results were as follows: 1. There was no statistical significant between serum AFP level and mass size, morphology and amount of necrosis. 2. Tumor necrosis was observed in a single massive and multinodular type when the tumor size exceeded 5 cm. 3. Pattern II on Lipiodol-CT, homogenous accumulation of Lipiodol except for the area of inner necrosis, was most frequently demonstrated, which means that a tumor mass with hypervascularity and increased blood flow will attract Lipiodol better. 4. Lipiodol-CT was superior to conventional CT in detecting ...
IntroductionCopper(II)-diacetyl-bis(N4-methylthiosemicarbazone), or Cu-ATSM, a hypoxia imaging agent, has been shown to be predictive of response to traditional cancer therapies in patients with a wide range of tumors. It is known that the environment of the tumor results in a myriad of physiological consequences, including hypoxia, alterations in metabolism and proliferation. In an effort to better characterize the relationships between Cu-ATSM and other prominent radiopharmaceuticals, this current study was undertaken to compare the regional distribution of 64Cu-ATSM with [18F]fluoromisonidazole (18F-FMISO), [18F]fluoro-2-deoxy-d-glucose (18F-FDG) and [18F]fluorothymidine (18F-FLT) in 9L tumors.MethodsTaking advantage of the different half-life of 18F (t1/2=110 min) in comparison to 64Cu...
Objective: To investigate the predictive value of ADC value in grading of neuroepithelial tumors. Methods: The clinical data and images of 70 patients with neuroepithelial tumors pathologically proven were collected and analyzed retrospectively. All the patients were classified into low (WHO I or II) and high (WHO III or IV) grade groups which included 40 and 30 cases respectively according to the 2007 WHO classification of tumours of the central nervous system. All the patients underwent plain and contrast-enhanced MR scan and DWI before surgery. The minimum ADC (MinADC) value was measured postoperatively on ADC maps. The Ki-67 labeling index (Ki-67 LI) of tumor tissue was determined by immunohistochemistry. MinADC values for two groups were analyzed using student t test, while the age and Ki-67 LI for the two groups was analyzed using Mann-Whitney test (P<0.05 considered to be significant). Also ...
A structurally conserved element, the trigger loop, has been suggested to play a key role in substrate selection and catalysis of RNA polymerase II (pol II) transcription elongation. Recently resolved...Full Text Available
The insulin/IGF-1 signaling (IIS) pathway is a conserved regulator of longevity, development, and metabolism. In Caenorhabditis elegans IIS involves activation of DAF-2 (insulin/IGF-1...Full Text Available
DNA from the peripheral blood mononuclear cells of 17 different individuals infected with human T-cell lymphoma/leukemia virus type II (HTLV-II) was successfully amplified by the polymerase chain reaction...Full Text Available
The objective of this study was to simplify the opacifying mixing process of the bone cement and contrast used for percutaneous vertebroplasty (PVP). We performed a biomechanical study of polymethyl methacrylate (PMMA) (Corinplast 3) using three different mixtures of PMMA, monomer, and contrast: group I, 2:1; group II, 3:2; group III, 3:2:1 ratio of powder/monomer/iodinated contrast (Omnipaque). In vitro biomechanical testing of ultimate compressive strength was carried out in all samples. Following the conclusion of a proper bone cement mixture regimen drawn from the in vitro study, PVP was performed in 125 patients: 58 with cancer, 12 with hemangioma, and 54 with osteoporotic fracture. The ultimate compressive strength in group III was decreased by 38% compared to groups II and I. Proper fluoroscopic visualization was achieved in all PVP procedures using this mixture. There were no major complications associated with ...
The objective of this study was to simplify the opacifying mixing process of the bone cement and contrast used for percutaneous vertebroplasty (PVP). We performed a biomechanical study of polymethyl methacrylate (PMMA) (Corinplast{sup TM} 3) using three different mixtures of PMMA, monomer, and contrast: group I, 2:1; group II, 3:2; group III, 3:2:1 ratio of powder/monomer/iodinated contrast (Omnipaque). In vitro biomechanical testing of ultimate compressive strength was carried out in all samples. Following the conclusion of a proper bone cement mixture regimen drawn from the in vitro study, PVP was performed in 125 patients: 58 with cancer, 12 with hemangioma, and 54 with osteoporotic fracture. The ultimate compressive strength in group III was decreased by 38% compared to groups II and I. Proper fluoroscopic visualization was achieved in all PVP procedures using this mixture. There were no major complications associated ...
Objective: To evaluate the treatment of malignant biliary stenoses and occlusions using a new stent. Methods: In a prospective study, 25 patients with malignant obstructive jaundice were treated with SMART stents. The handling and the quality of stent expansion were documented. Stent function was assessed 2-4 days after intervention by cholangiography and laboratory tests. A follow-up was performed three months, after stent placement. Results: All lesions were treated successfully, with a total of 35 stents implanted. In 14 patients a further balloon dilatation was performed after stent placement (8-10 mm diameter/40-80 mm length). The mean serum bilirubin level decreased significantly from 11.6 mg/dl to 4.6 mg/dl after intervention (p<0.05). The follow-up showed a mean serum bilirubin level at 4.0 mg/dl. In 4 cases (16%) a further intervention (PTCD or stent) was performed. Six ...
Postamputation pain (PAP) affects over 60% of major limb amputees. One of the main challenges in treating PAP is the difficulty involved in identifying pain mechanism(s), which pertains to both residual limb pain (RLP) and phantom limb pain (PLP). In this study, sympathetic blocks were performed on 17 major limb amputees refractory to treatment, including 2 placebo-controlled blocks done for bilateral amputations. One hour postinjection, mean RLP scores at rest declined from 5.2 (SD 2.8) to 2.8 (SD 2.6) (P = .0002), and PLP decreased from 5.3 (SD 3.1) to 2.3 (SD 2.1) (P = .0009). By 1 week, mean pain scores for RLP and PLP were 4.3 (SD 2.9) and 4.2 (SD 3.0), respectively. Overall, 8 of 16 (50%) patients experienced ?50% reduction in RLP 1-hour postinjection, with the beneficial effects ...
An original device and a method of its application for restoring of the function of relatively incompetent valves (both patented) are elaborated. Application of the new device allows to lower the difficulty of surgical treatment, to decrease the duration of operation and post-operative period. The long-term results of six-year long experience of its application are presented. The patients examination after 2,5-3,0-year post-operation period shows perfect vein valve correction. A device for stone extraction from tubular organs (patented) fabricated with titanium nickelide superelastic alloy is presented. The new suggested design is free of the drawback inherent in the previous one. The working element of the device is formed as a truncated cone or a truncated cone coaxial with the cylinder (the previous design was formed as a full cone) that prevents overstraining and residual strain accumulation during the manipulation process. Since the first publication the ...
Gonadal function was studied in two groups of children previously treated for medulloblastoma with surgery followed by postoperative craniospinal irradiation. In group 1 but not in group 2, the children also received adjuvant chemotherapy for one to two years. All children in group 1 received a nitrosourea (BCNU or CCNU), plus vincristine in four and procarbazine in three patients. The nine children in group 1 showed clinical and biochemical evidence of gonadal damage with elevated serum FSH concentrations and, in the boys, small testes for their stage of pubertal development. In group 2 (n . 8), each child had completed pubertal development normally, the boys had adult sized testes and the girls regular menses. Gonadotropin values were normal in all eight children. We conclude that nitrosoureas were responsible for the gonadal damage in the children in group 1, with procarbazine also contributing to the damage in the three children who ...
Experiments were carried out on mice and the subjects irradiated for cancer therapy to evaluate the protective efficacy of a Chinese medicinal herb-compound (CMHC). The lethality and the degree of leucopenia caused by radiation in mice medicated with CMHC were significantly less in comparison with control mice (p less than 0.01 and p less than 0.001, respectively). CMHC significantly improved the WBC and the thrombocytes in irradiated workers (p less than 0.01 and p less than 0.001, respectively). The WBC count of 40 patients under radiotherapy while treated with CMHC recovered from 3450 +/- 77/c.mm to 5425 +/- 264/c.mm (p less than 0.001); whereas, in the control group, without any medication, the WBC count dropped significantly (p less than 0.001). Our results revealed the applicabilities of CMHC in protection against radiation damage in spaceflight and in other fields.
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 fortgeschrittene Tumoren werden ...
Objective To compare the levels of interleukin (IL)-1?, IL-6, and matrix metalloproteinase (MMP)-8 in the vaginal secretions of pregnant women with a positive fetal fibronectin (fFN) test result with or without asymptomatic bacterial vaginosis (BV) before and after treatment with oral clindamycin. Methods A prospective cohort study was conducted among 43 pregnant women with a positive fFN test result. All patients were treated with clindamycin, and the pre- and post-treatment levels of IL-1?, IL-6, and MMP-8 were compared. Results Before treatment, levels of IL-1? and MMP-8 were significantly higher in women with BV compared with women without BV (P<0.05). Vaginal levels of IL-1? and IL-6, but not MMP-8, decreased after treatment in pregnant women with BV. Conclusions The inability of clin...
Postresection villus hyperplasia is a major compensatory mechanism in the short-bowel patient. Substances capable of augmenting postresection mucosal hyperplasia could have therapeutic implications. Human growth hormone (hGH) and human growth hormone releasing factor (hGHRF) stimulate growth of the gastrointestinal tract; however, the diabetogenic actions of growth hormone limit its usefulness in clinical practice. Plerocercoid larvae of the tapeworm Spirometra mansonoides produce an analog of hGH void of diabetogenic side effects. We assessed effects of plerocercoid growth factor (PGF) on mucosal adaptation following 70% proximal jejunoileal resection in young rats. Mucosal weight, DNA, protein, and total sucrase activity per centimeter of bowel were increased in resected PGF-treated animals compared to resected controls. We conclude PGF augments intrinsic postresection mucosal hyperplasia following extensive intestinal resection. PMID:3665682
In August 1982, a 44-year-old man was diagnosed as having rectal cancer, histologically diagnosed as well differentiated adenocarcinoma, and abdominoperineal resection and colostomy were performed. Postoperatively, he received chemotherapy with mitomycin C up to a total dose of 100 mg. In September 1986, lung metastasis occurred and he was treated with a combination chemotherapy consisting of cisplatin, pirarubicin and 5-fluorouracil. In the following year, radiation treatment (total: 6900 rad) was given for a recurrent pelvic lesion. Peripheral blood on April 30, 1988, showed anemia, thrombocytopenia and appearance of myeloblasts, and a diagnosis of acute myelogenous leukemia (FAB: M1) was made. Combination chemotherapy (including aclarubicin, vincristine, behenoyl ara-C, daunorubicin, 6-mercaptopurine, cytarabine, etoposide and prednisolone) failed to induce remission and the patient died in June 1988. This case was thought to be one of ...
The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The ...
Patients suffering from depression frequently display hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA) resulting in elevated cortisol levels. One main symptom of this condition is anhedonia. There is evidence that exercise training can be used as a rehabilitative intervention in the treatment of depressive disorders. In this scenario, the aim of the present study was to assess the effect of an aerobic exercise training protocol on the depressive-like behavior, anhedonia, induced by repeated dexamethasone administration. The study was carried out on adult male Wistar rats randomly divided into four groups: the "control group" (C), "exercise group" (E), "dexamethasone group" (D) and the "dexamethasone plus exercise group" (DE). The exercise training consisted of swimming (1 h/d, 5 d/wk) for 3 weeks, with an overload of 5% of the rat body weight. Every day rats were injected with either dexamethasone (D/DE) or saline solution (C/E). Proper positive ...
Objective: To retrospectively evaluate the results of conservative therapy using escorpal iodine-125 (model 6711, Amershan) plaque for brachytherapy of choroidal melanoma. Materials And Methods: We evaluated 49 patients with choroidal melanoma treated at 'Hospital do Cancer', Sao Paulo, Brazil, from March 2001 to January 2003. The following clinical parameters were analyzed and correlated with local control and survival rate: gender, age, lesion dimension, treatment duration, as well as doses in apex and base of the tumors. Results: The maximum diameter and height of the base of the tumors treated were 17 mm and 12 mm, respectively. Doses at those points ranged from 213 to 463 Gy (median: 347 Gy) and 51 to 250 Gy (median: 91 Gy), respectively. The actuarial rates of ocular preservation, disease free survival and ocular preservation in 2-years were 96%, 93.5% and 96.3%, respectively. A tumor height < ...
The results of this research centered on the experimental studies of a single superconducting persistent current qubit, the implementation of type-II algorithms using these qubits, and the proposal for adiabatic quantum computing using these qubits. The m...
The in vivo photochemical activity of photosystem II was inferred from modulated chlorophyll fluorescence and photoacoustic measurements in intact leaves of several plant species (Lycopersicon...Full Text Available
Woolfolk, C. A. (University of Washington, Seattle). Reduction of inorganic compounds with molecular hydrogen by Micrococcus lactilyticus. II. Stoichiometry with inorganic...Full Text Available
... and high-quality photospheric-phase Type II SN spectra to constrain core- collapse SN explosions, massive star evolution, and distances in the Universe ...
This document describes payload control at LLNL to ensure that all shipments of CH-TRU waste in the TRUPACT-II (Transuranic Package Transporter-II) meet the requirements of the TRUPACT-II SARP (safety report for packaging). This document also provides specific instructions for the selection of authorized payloads once individual payload containers are qualified for transport. The physical assembly of the qualified payload and operating procedures for the use of the TRUPACT-II, including loading and unloading operations, are described in HWM Procedure No. 204, based on the information in the TRUPACT-II SARP. The LLNL TRAMPAC, along with the TRUPACT-II operating procedures contained in HWM Procedure No. 204, meet the documentation needs for the use of the TRUPACT-II at LLNL. Table 14-1 provides a summary of the LLNL waste generation and ...
Biosorption using activated sludge biomass (ASB) as a potentially sustainable technology for the treatment of wastewater containing different metal ions (Cd(II), Pb(II) and Zn(II)) was investigated. ASB metal uptake clearly competed with protons consumed by microbial biomass compared with control tests with non-activated sludge biomass. Biosorption tests confirmed maximum exchange between metal ions and protons at pH 2.0-4.5. It was revealed by the study that the amount of metal ions released from the biomass increased with biomass sludge concentration. The result showed that maximum absorption of metal ions was observed for Cd(II) at pH 3.5, Pb(II) at pH 4.0, and pH 4.5 for Zn(II) ions. The maximum absorption capacities of ASB for Cd(II), Pb(II) and Zn(II) were determined to be 59.3, 68.5 and 86.5%, ...
Ternary copper(II) complexes [Cu(L1)B](ClO4) (1, 2) and [Cu(L2)B](ClO4) (3, 4), where HL1 and HL2 are tridentate NSO- and ONO-donor Schiff bases and B is a heterocyclic base, viz. dipyrido[3,2-d:2',3'-f]quinoxaline (dpq, 1 and 3) or dipyrido[3,2-a:2',3'-c]phenazine (dppz, 2 and 4), were prepared and their DNA binding and photoinduced DNA cleavage activity studied. Complex 1, structurally characterized by single-crystal X-ray crystallography, shows an axially elongated square-pyramidal (4 + 1) coordination geometry in which the monoanionic L1 binds at the equatorial plane. The NN-donor dpq ligand exhibits an axial-equatorial binding mode. The complexes display good binding propensity to calf thymus DNA, giving a relative order 2 (NSO-dppz) > 4 (ONO-dppz) > 1 (NSO-dpq) > 3 (ONO-dpq). They cleave supercoiled pUC19 DNA to its nicked circular form when treated with 3-mercaptopropionic acid (MPA) by formation of hydroxyl radicals as the ...
Biogerontology is sometimes viewed as similar to other forms of biomedical research in that it seeks to understand and treat a pathological process. Yet the prospect of treating ageing is extraordinary...Full Text Available
Purpose: Antitumor activity of the dichloroplatinum(II)-histamine complexes labeled with I-125 or I-131 was investigated in a transplantable murine adenocarcinoma (MA) model. Methods: The tumor model was obtained in C3H/W female mice after subcutaneous inoculation of the tumor cells derived from the mice bearing a mammary tumor of spontaneous origin. Antitumor activities of the platinum-histamine complexes were investigated in three independent experiments, which differed in applied doses of preparations (PtCl{sub 2}Hist, PtCl{sub 2}[{sup 125}I]Hist, PtCl{sub 2}[{sup 131}I]Hist, PtCl{sub 2}Hist/PtCl{sub 2}[{sup 125}I]Hist and PtCl{sub 2}Hist/PtCl{sub 2}[{sup 131}I]Hist), treatment schedules as well as stages of the disease progress in the animals used. Experiment 1 included long-term, multidose treatment with low single doses (treatment duration 31-32 days; 8-10 doses of ca. 0.25{center_dot}MTD{sub Pt} each). Experiment 2 included short-term, multidose treatment ...
Most common bacterial species causing peritonitis in the course of peritoneal dialysis (PDP) are coagulase-negative staphylococci, Staphylococcus aureus and streptococci. Haemophilus influenzae is rarely associated with PDP. Hereby we present the first known case of APD-associated peritonitis caused by non-type able H. influenzae (NTHi) presenting the beta-lactamase negative, ampicillin-resistant (BLNAR) phenotype. An 18 year old boy who had been treated with the APD for 12 months due to SLE was admitted in good general condition with diagnosis of PDP. Standard diagnostic and therapeutical procedures were initiated. Dialysis fluid was turbid with cytosis of 435 WBC/ml. From dialysis fluid pure culture of Gram-negative coccobacillus was isolated. The isolate was identified as a BLNAR phenotype. The same bacterium was isolated from nasal swab. Blood cultures were negative. After evaluation of antimicrobial susceptibility the treatment was changed for the oral ...
Prostate and cervical cancer patients are often treated with external X-ray beams of bi-lateral incidence. Such treatment may incur some dose effect that cannot be predicted precisely in commercial treatment planning systems (TPS) for patients having undergone total hip replacement. This study performs a Monte Carlo (MC) simulation and an analytical calculation (convolution superposition algorithm which is implemented in ADAC TPS) of a 6 MV, 5x5 cm"2 X-ray beam incident into water with the existence of hip prosthesis, e.g. Ti6Al4V and CoCrMo alloy. The results indicate that ADAC TPS cannot precisely account for the scatter and backscatter radiation that a metal hip prosthesis causes. For percent depth dose (PDD) curves, the maximum underdosage of ADAC TPS up to 5 mm above the interface between dense material and water is 5%, 20% and 27% for PDD_B_o_n_e, PDD_T_i and PDD_C_o, respectively. The dose re-buildup, which occurs ...
Malignant tumors of the sinonasal cavities are rare and often diagnosed late in the course of the disease. These tumors can extend into regions such as the orbit and brain, where treatment is difficult. Ten patients with non treated sinonasal malignant neoplasms and radiological evidence of tumor extension into the orbit and brain were studied with computed tomography. Five (50%) tumors were epithelial neoplasms whereas squamous cell carcinoma was the most common type (3 cases). The ethmoidal sinus was the most common site of origin of the tumors (40%), followed by the maxillary sinus (30%) and nasal cavity (30%). A total of 16 orbits were involved since 6 patients (60%) had bilateral orbital involvement. The tumors extended more often into the orbits through erosion of the medial and inferior orbital bones. All orbital compartments were involved in the majority of the orbits. Tumoral extension into the cranial cavity was ...
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 ...
This study examined whether cognitive behavioural therapy (CBT) could prevent the development or worsening of panic-spectrum psychopathology and anxiety symptoms in chronic obstructive pulmonary disease (COPD). 41 patients with COPD, who had undergone pulmonary rehabilitation, were randomised to either a four-session CBT intervention condition (n = 21) or a routine care condition (n = 20). Assessments were at baseline, post-intervention, and at 6-, 12- and 18-month follow-ups. Primary outcomes were the rates of panic attacks, panic disorder and anxiety symptoms. Secondary outcomes were depressive symptoms, catastrophic cognitions about breathing difficulties, disease-specific quality of life and hospital admission rates. There were no significant differences between the groups on outcome measures at baseline. By the 18-month follow-up assessment, 12 (60%) routine care group participants had experienced at least one panic attack in the previous 6 months, with two ...
We wanted to evaluate the procedural success after percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency and the efficacy of performing mechanical thrombectomy with using the stone basket. From March 2004 to June 2005, 36 thrombosed native hemodialysis access shunts in the upper limbs (brachiocephalic fistulas: 16 and radiocephalic fistulas: 20) were percutaneously treated in 30 patients. Declotting procedures were performed with using urokinase (100,00-200,000 unit) and manual catheter-directed thrombo-aspiration in all the patients. Angioplasty (6 mm in diameter and 4 cm in length) was performed at the identified area of the stenosis and /or with maceration of the thrombus. In 14 cases with massive thrombosis that was refractory to the above mentioned declotting procedures, mechanical thrombectomy with using a Wittich nitinol stone basket (Cook, Bloomington, IN) was performed. Data ...
To evaluate the success rates, long-term patency rates and factors affecting the patency rates of percutaneous transluminal angioplasty(PTA) and thrombolysis in the management of insufficient access during hemodialysis. Between January 1991 and March 1995, 37 insufficient shunts(23 native fistulae and 14 graft fistulae) were treated in 31 patients. PTA was performed in 24 shunts, and thrombolysis in 13;in seven of these latter, thrombolysois was followed by PTA. The success and long-term patency rates of PTA and thrombolysis were evaluated. Shunts were subdivided according to a patient's age, type and age of the shunt, and number and length of the stenosis, and the degree of residual stenosis and in each subgroup, patency rates was compared. The overall success rate of PTA and thrombolysis for insufficient hemodialytic access was 78.4%(29/37). The success rates of PTA and thrombolysis were 91.7%(22/24) and ...
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 ...
Inferior vena cava (IVC) obstruction is a well-described clinical entity. Most IVC obstructions from malignant neoplasms are a direct result of tumor compression [Oviedo J, Cerda S. Vascular invasion by hepatocellular carcinoma. Arch Pathol Lab Med 2001;125: 454-5; Furui S, Sawada S, et al. Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome. Radiology 1995;195:147-52; Fletcher WS, Lakin PC, et al. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998;133:935-8]. The symptoms of IVC obstruction include progressive ascites, scrotal edema and lower body edema. These constellations of symptoms are described as IVC syndrome and are devastating to a patient with end-stage cancer. We describe a palliative therapy utilizing Luminexx nitinol self-expanding stents to treat intracaval hepatoma thrombus obstructing the IVC. The procedure is rapidly ...
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 contrast, for photon beam ...
No prospective studies have evaluated the effects of correction of iron deficiency anemia on insulin resistance in non-diabetic premenopausal women with iron deficiency anemia. All patients were treated with oral iron preparations. Insulin resistance was calculated with the Homeostasis Model Assessment formula. All patients were dichotomized by the median for age and BMI to assess how the relationship between iron deficiency anemia and insulin resistance was affected by the age and BMI. Although the fasting glucose levels did not change meaningfully, statistically significant decreases were found in fasting insulin levels following anemia treatment both in the younger age (<40 years) (P=0.40) women and in the low BMI (27 kg/m) (P=0.22) subgroups but not in the older age (>= 40 years) and the high BMI (>-27Kg/m) subgroups. Post-treatment fasting insulin levels were positively correlated both with BMI (r=0.386, ...
A central problem in diagnostic radiology is to compare a new X-ray picture with a previous picture and from this comparison be able to decide if anatomical changes have occurred in the patient or not. It is of primary interest that these pictures are identical in projection. If not it is difficult to decide with confidence if differences between the pictures are due to anatomical changes or differences in their projection geometry. In this thesis we present a non invasive method that makes it possible to find the relative changes in the projection geometry between the exposure of a previous picture and a new picture. The method presented is based on the projection slice theorem (central section theorem). Instead of an elaborate search for a single new picture a pre-planned set of pictures are exposed from a circular orbit above the patient. By using 3D Fourier transform techniques we are able to synthesize a new X-ray picture from this set of ...
Purpose/Objective: With the advent of computed tomography and magnetic resonance imaging, the three dimensional representation of the patient anatomy has become an invaluable resource for better diagnosis and delineation of the target volume and sensitive structures in radiation therapy. Although the therapeutic linear accelerator industry has made available highly sophisticated equipment, the aggressiveness in dose prescription and delivery has to be complimented by accurate dose computation methods. We have adopted a convolution/superposition algorithm for the calculation of absolute dose that fully accounts for the external shape and internal structure of the patient for photon treatment radiotherapy. In this paper, we will discuss the principles of the convolution algorithm and we will show how the computed dose compares to clinically relevant treatment techniques. Materials and Methods: A computer controlled data acquisition system and a ...
Apart from the vulnerability implied by the START II treaty, it will bear the burden of the general political opposition to the Yeltsin administration. START II will be seen as part of an overall Yeltsin-Andrei Kozyrev foreign policy that is under fire for selling out Russian national interests in Yugoslavia, the Persian Gulf, and elsewhere. This article discusses public opinion concerning START II, the cost of its implementation, and the general purpose of the treaty.
The upgraded CDF II detector has collected first data during the initial operation of the Tevatron accelerator in Run II. The simulation of the CDF electromagnetic and hadronic central and upgraded plug (forward) calorimeter is based on the Gflash calorimeter parameterization package used within the GEANT based detector simulation of the Run II CDF detector. We present the results of tuning the central and plug calorimeter response to test beam data.
PRESTO-II is a computer code developed to evaluate possible health effects from shallow land disposal of low level radioactive wastes. PRESTO-PREP is a data preprocessor that has been developed to expedite the formation of input data sets for PRESTO-II. PRESTO-PREP utilizes a library of nuclide and risk-specific data. Given an initial waste inventory, the code creates the radionuclide portion of the associated input data set for PRESTO-II. 2 references.
The purpose of this paper is to describe the embedded computer systems approach taken at Experimental Breeder Reactor II (EBR-II) for non-safety related systems. The hardware and software structures for typical embedded systems are presented The embedded systems development process is described. Three examples are given which illustrate typical embedded computer applications in EBR-II.
Angiotensin II (Ang II) is a key proapoptotic factor in fibrotic tissue diseases. However, the mechanism of Ang-II-induced cell death in endothelial cells has not been previously elucidated....Full Text Available
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 ...
The goal of this work is to present a systematic Monte Carlo validation study on the clinical implementation of the enhanced dynamic wedges (EDWs) into the Pinnacle"3 (Philips Medical Systems, Fitchburg, WI) treatment planning system (TPS) and QA procedures for patient plan verification treated with EDWs. Modeling of EDW beams in the Pinnacle"3 TPS, which employs a collapsed-cone convolution superposition (CCCS) dose model, was based on a combination of measured open-beam data and the 'Golden Segmented Treatment Table' (GSTT) provided by Varian for each photon beam energy. To validate EDW models, dose profiles of 6 and 10 MV photon beams from a Clinac 2100 C/D were measured in virtual water at depths from near-surface to 30 cm for a wide range of field sizes and wedge angles using the Profiler 2 (Sun Nuclear Corporation, Melbourne, FL) diode array system. The EDW output factors (EDWOFs) for square fields from 4 to 20 cm wide were measured in ...
The purpose of this study was to correlate histopathological with CT findings in patients suffering from hepatocellular carcinoma (HCC) eligible for orthotopic liver transplantation (OLT), with a special focus on the antitumoral effect of transarterial chemoembolization (TACE) therapy. A total of 42 consecutive patients suffering from HCC had been treated prior to OLT by means of TACE. TACE was carried out with a mixture of Lipiodol (10-20 ml) and mitomycin C (max. dosage, 10 mg). TACE was performed at 6- to 8-week intervals. Follow-up investigation included contrast-enhanced multislice CT controls and laboratory control. Liver explants were evaluated macroscopically and microscopically to determine the number and size of the tumor lesions as well as the degree of tumor necrosis. Necrosis was investigated in H and E-stained sections. The degree of necrosis was classified as follows: 0-25%, 26-50%, 51-75%, 75-99%, and ...
Studies have linked cell phone radiation to health problems such as headaches, high blood pressure, cancer and more. There is a latency period for most diseases and it may take years and more studies before the required weight of evidence is established. But the effects are cumulative and precautions should be taken now before it is too late. The aim of the present study was to investigate if supplementation with antioxidants would protect heart and liver tissues from harmful radiation emitted by cell phone. Thirty two male albino rats were randomly divided into four equal groups: I- Control, II- Antioxidants treated group, III- 950 MHz EMR, IV- 950 MHz EMR + antioxidants. A 950 MHz EMR radiation (217-Hz pulse rate, 2-W maximum peak power, SAR Specific Absorption Rate"1.6 W/Kg) was applied to groups III and IV 60 min/day, for 30 days using an experimental exposure device. Antioxidants supplement (Vitamins A, E and C + Se) was administered to ...
Manganese is a common contaminant of mine water and other waste waters. Due to its high solubility over a wide pH range, it is notoriously difficult to remove from contaminated waters. Previous systems that effectively remove Mn from mine waters have involved oxidising the soluble Mn(II) species at an elevated pH using substrates such as limestone and dolomites. However it is currently unclear what effect the substrate type has upon abiotic Mn removal compared to biotic removal by in situ micro-organisms (biofilms). In order to investigate the relationship between substrate type, Mn precipitation and the biofilm community, net-alkaline Mn-contaminated mine water was treated in reactors containing one of the pure materials: dolomite, limestone, magnesite and quartzite. Mine water chemistry and Mn removal rates were monitored over a 3-month period in continuous-flow reactors. For all substrates except quartzite, Mn was removed from the mine water ...
Asynchronous Chinese hamster ovary (CHO) cells treated with conditioning hyperthermia (10 min at 45/sup 0/C) followed immediately by x irradiation with 4 Gy at room temperature display a decreased radiation response when either irradiated, or heated and irradiated again 24 h later. In addition, conditioning by 4 Gy of x radiation alone followed at 24 h by the combined heat and radiation treatment als resulted in a larger radiation D/sub 0/. Since the differential cell-cycle responses to heat- and x-ray-induced lethality are well established for CHO cells, the potential role of cell-cycle redistribution in the observed radiation desensitization was investigated by flow cytometry. At 24 h after the combined treatment, the fraction of the cells found in the G/sub 2/ + M portion of the DNA histograms was about three times that of the controls and there was a concomitant reduction in both the G/sub 1/ and S fractions. Similar observations were made after the ...
Carbalkoxylation of vinyl electrophiles was investigated using platinum complexes. This reaction occurs in two steps: (a) carbonyl insertion of {sigma}-vinyl Pt(II) halides and (b) alcoholysis of vinylic acyl Pt(II) complexes. Alcoholysis of vinylic acyl Pt(II) triflate complexes is investigated kinetically. Vinylic acyl Pt(II) complexes were isolated and characterized. 51 refs., 5 figs., 6 tabs.
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
The subfornical organ is a major receptor area for one of the principal stimuli of thirst, the octapeptide, angiotensin II. In conscious water-sated rats, the authors examined the effects of intravenous infusion of angiotensin II on the rate of glucose utilization in the subfornical organ and in structures anatomically and functionally connected with it. Angiotensin II produced pressor and drinking responses and increased glucose utilization selectively in the subfornical organ and pituitary neural lobe and in no other brain structure. Treatment with the angiotensin II antagonist, sar1-leu8-angiotensin II, before intravenous administration of angiotensin II prevented metabolic stimulation of the subfornical organ and neural lobe. Captopril, an inhibitor of angiotensin-converting enzyme, reduced subfornical organ glucose metabolism to a level similar to that ...
Adsorptive removal of Pb(II) ions from aqueous solution onto a non-activated charcoal (CC) of oak wood origin was studied in comparison with an activated carbon of coal origin. The adsorption capacity for Pb(II) of the non-activated charcoal increased significantly with deceasing particle diameter, whereas the activated carbon (AC) exhibited approximately constant capacity for Pb(II) adsorption as a function of particle size. Adsorption to the ashes prepared from the non-activated charcoal and the activated carbon was also investigated to examine the role of mineral ash. Although the ash from the activated carbon did not show any Pb(II) adsorption, the ash from the charcoal was very effective for Pb(II) adsorption. Furthermore, Pb(II) was hardly adsorbed when the ash was removed from the non-activated charcoal by acid treatment. Based on the results, the ...
The isotherms, kinetics and thermodynamics of Cd(II), Zn(II) and Pb(II) biosorption by Penicillium simplicissimum were investigated in a batch system. The effects of pH, initial metal ions concentration, biomass dose, contact time, temperature and co-ions on the biosorption were studied. Adsorption data were well described by both the Redlich-Peterson and Langmuir model. Chemical ion-exchange was found to be an important process based on free energy value from Dubini-Radushkevich isotherm for all metal ions. The results of the kinetic studies of all metal ions at different temperature showed that the rate of adsorption followed the pseudo second-order kinetics well. The thermodynamics constants {delta}G{sup o}, {delta}H{sup o} and {delta}S{sup o} of the adsorption process showed that biosorption of Cd(II), Zn(II) and Pb(II) ions on Penicillium simplicissimum ...
ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available
Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread...Full Text Available
ObjectiveWe sought to determine the clinical outcomes of patients undergoing surgical aortic valve replacement with hemodynamically confirmed severe pulmonary hypertension and aortic stenosis and compare them with the outcomes of patients not undergoing aortic valve replacement and patients undergoing aortic valve replacement with mild-to-moderate pulmonary hypertension. MethodsA total of 317 patients with severe aortic stenosis (aortic valve area 35 mm Hg) was present in 81 patients, of whom 35 (43.2%) underwent surgical aortic valve replacement. We compared the clinical outcomes of these 35 patients with the 46 patient...
Purpose: To evaluate the success rates of the implantation of stent grafts in the treatment of peripheral aneurysms. Materials and methods: in 13 patients with 15 aneurysms at the common iliac artery (n = 6), external iliac artery (n = 1), hypogastric artery (n = 2), femoral artery (n = 2) or popliteal artery (n = 4), implantation of dacron-covered nitinol stents was performed. The patients were followed up for three to 20 months (mean, 8.8 months) with intravenous digital subtraction angiography, CT or colour-coded Doppler sonography. Results: In all cases, the aneurysm was successfully occluded after stent implantation. In one case with a popliteal aneurysm, kinking of the vessel caused thrombosis of the stent. The stent was successfully reopened. The aneurysm however, had to be surgically treated 9 months later. The primary and secondary patency rates at 6 months were 93% and 100%, respectively. Conclusion: The method ...
An exact cosmological solution of Einstein's equations which has time-dependent rotation is presented. The t-constant sections are of Bianchi type II. The source of this geometry is a fluid which has not been thermalized. (Author).
Exposure of albumin to Cu(II) (10-100 microM) and ascorbate (0.1-2 mM) results in extensive molecular modifications, indicated by decreased fluorescence and chain breaks. The rate of utilization of...Full Text Available
ObjectivesThe updated Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs) include new FGID categories and changes to the Rome II criteria...Full Text Available
In this article are presented main results on electric potential investigations in stellarator/torsatron TJ-II and tokamak T-10 in a comparable regimes of device operation.
Aminopeptidase II, one of the two major aminopeptidases in the giant alga Chara australis, was partially purified. Its molecular weight was estimated to be about 80,000 by gel permeation...Full Text Available
New palladium(II) and platinum(II) complexes of saccharinate (sac), trans-[Pd(py)"2(sac)"2] (1), cis-[Pt(py)"2(sac)"2] (2), trans-[Pd(3-acpy)"2(sac)"2] (3) and cis-[Pt(3-acpy)"2(sac)"2] (4) (py=pyridine and 3-acpy=3-acetylpyridine) have been synthesized. Elemental analysis, UV-Vis, IR, NMR and TG/DTA characterizations have been carried out. The structures of 1-4 were determined by X-ray diffraction. The palladium(II) and platinum(II) ions are coordinated by two N-bonded sac ligands, and two nitrogen atoms of py or 3-acpy, forming a distorted square-planar geometry. The palladium(II) complexes (1 and 3) are trans isomers, while the platinum(II) complexes (2 and 4) are cis isomers. The mononuclear species in the solid state are connected by weak intermolecular C-H...O hydrogen bonds, C-H...@...
BackgroundThe binding of peptide fragments of antigens to class II MHC is a crucial step in initiating a helper T cell immune response. The identification of such peptide epitopes...Full Text Available
The aim of this article was to investigate the interactions of metal cations in aqueous solutions with the biomass of the freshwater macroalga Vaucheria sp. This problem is important when elaborating new applications of biosorption, e.g. the production of mineral feed additives for livestock from the biomass of algae enriched with microelement ions. Potentiometric titration was applied as a quick and cheap screening test to search for new efficient biosorbents. It revealed a variety of functional groups capable of cation exchange on the macroalgal surface, including carboxyl, phosphate, hydroxyl or amino groups. Fourier transform infrared spectroscopy on natural and chromium-loaded Vaucheria sp. confirmed that carboxyl groups played a dominant role in the biosorption. The study also showed that Ca(II), Na(I), K(I), and Mg(II) ions were released from the biomass after biosorption of Cu(II), Mn(II), ...
BackgroundPromoter region plays an important role in determining where the transcription of a particular gene should be initiated. Computational prediction of eukaryotic Pol II promoter...Full Text Available
Rotazyme II, which is a shorter version of Rotazyme (less than 3 h), was compared with electron microscopy and Rotazyme for sensitivity and specificity on 229 human stool specimens. Compared with electron...Full Text Available
The biosorption of lead (II) and copper (II) ions, single component and binary systems, by dried P. putida was investigated in a batch system. The effects of initial pH, temperature, initial single and binary mixture concentrations on the biosorption kinetics and equilibrium uptake of each component, both single and binary mixtures were investigated. The bacterial biomass exhibited the highest single and binary lead (II) and copper (II) ions uptake capacity at 25 and 30 deg. C, respectively, the initial pH value of 5.5 and at the initial metal ions concentration of 100 mg dm{sup -3}. The Freundlich and Langmuir adsorption models were used for the mathematical description of the biosorption equilibrium and isotherm constants were evaluated at different temperatures. Adsorption data were well described by the Langmuir model, although they could be modeled by the Freundlich equation. The thermodynamics ...
BackgroundPerfluorocarbons (PFC) are used to improve gas exchange in diseased lungs. PFC have been shown to affect various cell types. Thus, effects on alveolar type II (ATII) cells...Full Text Available
ATP-binding cassette A3 (ABCA3) is a lipid transport protein required for synthesis and storage of pulmonary surfactant in type II cells in the alveoli. Abca3 was conditionally deleted...Full Text Available
Cytokinesis in animal and fungal cells utilizes a contractile actomyosin ring (AMR). However, how myosin II is targeted to the division site and promotes AMR assembly, and how the AMR coordinates with...Full Text Available
Anaerobic reactions of Rhus vernicifera laccase and its type-2 copper-depleted derivatives with hexacyanoferrate(II) were investigated by absorption and e.s.r. spectroscopy. When native laccase was...Full Text Available
Photobilirubin II, a stereoisomer of bilirubin, binds to human serum albumin at a single binding site (K = 2.2 x 10(6)M-1), presumably the high-affinity bilirubin-binding site. Binding in the secondary...Full Text Available
The identification of MHC class II restricted peptide epitopes is an important goal in immunological research. A number of computational tools have been developed for this purpose, but there is a lack...Full Text Available
ii) Flammability: (iii) A capacity to oxidise: (iv) Corrosiveness: (v) Toxicity (including chronic ...an explosion or fire: (d) For substances with corrosive properties: (i) To reduce the ...likelihood of any unintended corrosion:(ii) To control the adverse effects of any corrosion:
... Screening Adjudication Monitoring Applicants of Information Behavior II I Conducting Investigations ... Applicants of Information Behavior Conducting ...
Titanate nanotubes were hydrothermally synthesized and their adsorption performances for lead(II) ion removal were studied. The results showed that titanate nanotubes ruptured in the adsorption process resulting in two distinct adsorption stages, thus achieving a maximum adsorption capacity of 3.752mmolg^-^1 of lead(II). Furthermore, it was found that the regeneration of titanate nanotubes loaded with the lead(II) ions can be readily achieved using the saturated EDTA disodium salt aqueous solution, thereby avoiding the trouble of disposal of adsorbent. The adsorption mechanism was also discussed in detail.
The interaction between N-donor adsorbates such as ammonia and pyridine with Cu(II)-exchanged montmorillonite, beidellite, flourohectorite into smectite clays has been studied by electron spin resonance. Cu(II) cations exchanged into smectites coordinate five ammonia or pyridine molecules in beidellite, four ammonia of pyridine molecules in hydroxyhectorite. Thus, the Cu(II) cations bound to the interior surfaces of these smectite clays constitute strong Lewis acid sites. 26 refs., 7 figs., 1 tab.
Dual energy X-ray absorptiometry (Hologic QDR-1000) was used to quantitatively analyze the diagnosis and prevention of osteoporosis. The peak bone mineral density (BMD) of the spine appeared in normal men in their twenties and in normal women in their thirties. There was acceleration of bone loss in the 50 to 60 year age bracket (premenopause and postmenopause) in normal women. On the contrary, the peak BMD of the femoral neck in normal men and women appeared in their twenties after which it decreased slightly with age. Comparison showed that the femoral neck BMD of normal women was lower than that of men throughout all ages. The fracture threshold, 0.756 g/cm[sup 2] for the spine, was obtained by scanning 73 females with spinal fractures, the mean BMDs for L2-L4 at the 90th percentile level were used as the fracture threshold. The fracture threshold of femoral neck fracture was the femoral proximal BMD of the 9th decile. Classification by the Public Welfare Silver Science ...
This study was designed to evaluate the suitability of a novel bioabsorbable material in treating bone defects. A poly(desaminotyrosyl-tyrosine-ethyl ester carbonate) (PDTE carbonate) membrane (thickness...Full Text Available
The refractive error in 15 eyes with threshold retinopathy of prematurity treated with diode laser photocoagulation was compared with 25 eyes with the same disease severity treated by cryotherapy. Myopia...Full Text Available
The pyrethroid knockdown resistance gene (kdr) has become widespread in Anopheles gambiae in West Africa. A trial to test the continuing efficacy of insecticide-treated...Full Text Available
Treating brain tumors using inhibitors of angiogenesis is extensively researched and tested in clinical trials. Although anti-angiogenic treatment holds a great potential for treating primary and secondary...Full Text Available
Fasting plasma concentrations of magnesium were measured by neutron activation analysis in 30 non-diabetics and 87 diabetics (55 non-insulin-treated, 32 insulin treated). Plasma concentrations of magnesium...Full Text Available
Proline accumulation in NaCl-treated excised barley (Hordeum vulgare var Larker) leaves was studied. Leaves were treated by placing the cut end in NaCl solutions and allowing the salt...Full Text Available
Dogs are domestic reservoir hosts of Trypanosoma cruzi, the etiological agent of Chagas disease. We evaluated the effect of deltamethrin-treated dog collars (DTDCs) over time...Full Text Available
...treated for leukemia. B' s physician, who is employed by the HMO, is considering a treatment plan that includes six-mercaptopurine, a drug for treating leukemia in most children. However, the drug could be fatal if taken by a small percentage of...
We report the of the existence of RV Tauri stars in the Large Magellanic Cloud (LMC). This class of variable star has hitherto been unidentified in the Magellanic Clouds. In light and color curve behavior the RV Tauri stars appear to be an extension of the Type II Cepheids to longer periods. A single period-luminosity-color relationship is seen to describe both the Type II Cepheids and the RV Tauri stars in the LMC.
Incorporation of /sup 32/P from (gamma-32P)ATP into tyrosine residues of the insulin-like growth factor (IGF)-II receptor was observed in a Triton X-100-insoluble fraction of rat adipocyte plasma membranes. IGF-II receptor phosphorylation proceeded to a stoichiometry of approximately 0.5 mol of phosphate/IGF-II binding site after 10 min of incubation at 4 degrees C. A Km for ATP of 6 microM was calculated for this phosphorylation reaction. Addition of IGF-II caused an approximately 2-fold increase in tyrosine phosphorylation of the IGF-II receptor in this preparation. In contrast, phosphorylation of angiotensin II by the Triton X-100 washed membranes was not stimulated by IGF-II. Incubation of purified receptor immobilized on IGF-II agarose or of receptor-enriched low density microsomal membranes with (gamma-32P)ATP did ...
Fragrance mix II (FM II) is a relatively new screening marker for fragrance contact allergy. It was introduced in the patch test baseline series in Denmark in 2005 and contains six different fragrance chemicals commonly present in cosmetic products and which are known allergens.
Fatty acid biosynthesis is crucial for all living cells. In contrast to higher organisms, bacteria use a type II fatty acid synthase (FAS II) composed of a series of individual proteins, making...Full Text Available
BackgroundXMRV (xenotropic murine leukemia virus-related virus) is the first known example of an exogenous gammaretrovirus that can infect humans. A limited number of reports suggest that XMRV is intrinsically resistant to many of the antiretroviral drugs used to treat HIV-1 infection, but is sensitive to a small subset of these inhibitors. In the present study, we used a novel marker transfer assay to directly compare the antiviral drug sensitivities of XMRV and HIV-1 under identical conditions in the same host cell type.ResultsWe extend the findings of previous studies by showing that, in addition to AZT and tenofovir, XMRV and HIV-1 are equally sensitive to AZddA (3'-azido-2',3'-dideoxyadenosine), AZddG (3'-azido-2',3'-dideoxyguanosine) and adefovir. These results indicate that specific 3'-azido or acyclic nucleoside analog inhibitors of HIV-1 reverse transcriptase (RT) also block XMRV infection with comparable efficacy in vitro. Our data confirm that XMRV is ...
Purpose: This study presents a dosimetric optimization effort aiming to compare intensity-modulated (IM) X-rays and IM protons in 4 different orbital and paraorbital tumors. These are most challenging targets for standard radiotherapy due to their close relationship with the eyes and related structures. Methods and Materials: A primary orbital lymphoma, an optic nerve meningioma, a sphenoidal ridge meningioma protruding into the orbit, and a pediatric parameningeal paraorbital rhabdomyosarcoma were selected for the purpose of this study. Planning target volumes (PTVs) and organs at risk (OAR) were defined in each patient CT data set for each tumor site. IM X-ray and IM proton three-dimensional treatment plans were implemented. The following total tumor doses were prescribed: 30 Gy for the orbital lymphoma, 54 Gy for both meningiomas, and 50.4 Gy for the rhabdomyosarcoma case. Dose-volume histograms (DVHs) were obtained for all targets and OAR with both treatment ...
We evaluated 190 children with very high-risk leukemia, who underwent allogeneic hematopoietic cell transplantation in 2 sequential treatment eras, to determine whether those treated with contemporary protocols had a high risk of relapse or toxic death, and whether non-HLA-identical transplantations yielded poor outcomes. For the recent cohorts, the 5-year overall survival rates were 65% for the 37 patients with acute lymphoblastic leukemia and 74% for the 46 with acute myeloid leukemia; these rates compared favorably with those of earlier cohorts (28%, n = 57; and 34%, n = 50, respectively). Improvement in the recent cohorts was observed regardless of donor type (sibling, 70% vs 24%; unrelated, 61% vs 37%; and haploidentical, 88% vs 19%), attributable to less infection (hazard ratio [HR] = 0.12; P = .005), regimen-related toxicity (HR = 0.25; P = .002), and leukemia-related death (HR = 0.40; P = .01). Survival probability was dependent on ...
Makeup water is distilled internally in an amine gas treating unit by adding it to the reclaimer used to process a slipstream of lean amine from the stripper.
Some acylhydrazine derived ONO donor Schiff bases and their Co(II) and Ni(II) complexes have been prepared having the same metal ion (cation) but different anions. These synthesized metal(II) complexes have been characterized on the basis of their elemental analyses, magnetic moment, molar conductance, and IR and electronic spectral data. All of the Schiff base ligands function as tridentates and the deprotonated enolic form is preferred for coordination. In order to evaluate the effect of anions on the bactericidal activity, these synthesized complexes, in comparison to the uncomplexed Schiff bases have been screened against bacterial species., Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa and the results are reported. PMID:18475936
High-temperature LiCl-KCl molten salt medium provides an efficient way to produce the paramagnetic Eu(II) ion to be magnetically diluted into a diamagnetic host medium. Eu(II) was formed by a dissolution and an auto-reduction processes in a high-temperature LiCl-KCl eutectic melt at 723 K by using Eu{sub 2}O{sub 3} as a starting material. By using EPR and luminescence spectroscopic method, we studied the nature of the magnetically isolated paramagnetic Eu(II) ion diluted in a LiCl-KCl medium. With the aid of these spectroscopic tools, it was found that stable Eu(II) species was formed spontaneously at 723 K under anaerobic conditions. EPR and luminescence spectroscopy provided detailed information regarding the nature of the europium ion in a molten salt.
High-temperature LiCl-KCl molten salt medium provides an efficient way to produce the paramagnetic Eu(II) ion to be magnetically diluted into a diamagnetic host medium. Eu(II) was formed by a dissolution and an auto-reduction processes in a high-temperature LiCl-KCl eutectic melt at 723 K by using Eu_2O_3 as a starting material. By using EPR and luminescence spectroscopic method, we studied the nature of the magnetically isolated paramagnetic Eu(II) ion diluted in a LiCl-KCl medium. With the aid of these spectroscopic tools, it was found that stable Eu(II) species was formed spontaneously at 723 K under anaerobic conditions. EPR and luminescence spectroscopy provided detailed information regarding the nature of the europium ion in a molten salt.
High-temperature LiCl-KCl molten salt medium provides an efficient way to produce the paramagnetic Eu(II) ion to be magnetically diluted into a diamagnetic host medium. Eu(II) was formed by a dissolution and an auto-reduction processes in a high-temperature LiCl-KCl eutectic melt at 723K by using Eu2O3 as a starting material. By using EPR and luminescence spectroscopic method, we studied the nature of the magnetically isolated paramagnetic Eu(II) ion diluted in a LiCl-KCl medium. With the aid of these spectroscopic tools, it was found that stable Eu(II) species was formed spontaneously at 723K under anaerobic conditions. EPR and luminescence spectroscopy provided detailed information regarding the nature of the europium ion in a molten salt.
We determined the chromosomal localization and structure of the gene encoding human type II inosine 5{prime}-monophosphate dehydrogenase (IMPDH, EC 1.1.1.205), an enzyme associated with cellular proliferation, malignant transformation, and differentiation. Using polymerase chain reaction (PCR) primers specific for type II IMPDH, we screened a panel of human-Chinese hamster cell somatic hybrids and a separate deletion panel of chromosome 3 hybrids and localized the gene to 3p21.1{yields}p24.2. Two overlapping yeast artificial chromosome clones containing the full gene for type II IMPDH were isolated and a physical map of 117 kb of human genomic DNA in this region of chromosome 3 was constructed. The gene for type II IMPDH was localized and oriented on this map and found to span no more than 12.5 kb.
In this study we compared various maturity dependent aromatic, steroid and triterpenoid hydrocarbon ratios in bitumens that are freely extractable from sedimentary rocks (Bitumen I) with those in second extracts that comprised hydrocarbons closely associated with the kerogen/mineral matrix (Bitumen II). Bitumen II was released through kerogen isolation and demineralisation using HCl and HF/H3BO3. The samples studied, although of similar age, come from different localities. They represent a range of facies and two kerogen types (II and III), and all were deposited under marine conditions. The results show that the more stable b isomers of methylnaphthalene (MN) and methylphenanthrene (MP) are relatively more abundant in Bitumen II. The difference between the methylnaphthalene ratio (MNR) of...
In this study, the biosorption of Cd(II), Ni(II) and Pb(II) on Aspergillus niger in a batch system was investigated, and optimal condition determined by means of central composite design (CCD) under response surface methodology (RSM). Biomass inactivated by heat and pretreated by alkali solution was used in the determination of optimal conditions. The effect of initial solution pH, biomass dose and initial ion concentration on the removal efficiency of metal ions by A. niger was optimized using a design of experiment (DOE) method. Experimental results indicated that the optimal conditions for biosorption were 5.22 g/L, 89.93 mg/L and 6.01 for biomass dose, initial ion concentration and solution pH, respectively. Enhancement of metal biosorption capacity of the dried biomass by pretreatment with sodium hydroxide was observed. Maximal removal efficiencies for Cd(II), Ni(III) and ...
The radiation reduction of bis(1-ethylimidazole)tartratoplatinum(II) (EITPt(II)) complexes in methanol-water solution have been examined. The yields of Pt(I) depend on the presence of O{sub 2} in solutions as well as the dose applied. The rate constants of e{sub s}{sup -} scavenging by EITPt(II) and cis(diammine-1,1-cyclobutanedicarboxylato) platinum(II) (CBDCAPt(II)) have been determined by pulse radiolysis to be equal to 5.4 x 10{sup 9} and 6.4 x 10{sup 9} M{sup -1} s{sup -1}, respectively. The efficiencies of e{sub t}{sup -} scavenging by EITPt(II) and the rate of e{sub t}{sup -} photobleaching have also been determined in LiCl : H{sub 2}O : CH{sub 3}OH and MgCl{sub 2} : H{sub 2}O : CH{sub 3}OH glasses, respectively. (author).
Coal was treated at high temperature under high pressure in the binary system mixed solvent of water and organic solvent, and the solvent treated coal was liquefied. When the treated coal was treated again by the explosive method in which high temperature and pressure were released immediately, the oil yield was higher than that by the normal method in which high temperature and pressure were reduced gradually to room temperature and atmospheric pressure. In this study, an explosive treatment unit with increased scale of sample amount was newly fabricated. Illinois No.6 coal was treated by the explosive method in a mixed solvent of water and cyclohexanol using this unit. Changes in shape on the surface, specific surface area, and functional groups were analyzed. The explosively treated coal contained more amount of low boiling point components than the normally ...