Medulloblastoma in adulthood: Prognostic factors influencing survival and recurrence

Summary Thirty adult patients presenting with medulloblastoma between 1974 and 1991 were studied and treated at Puerta de Hierro Clinic. After diagnosis, all patients were treated by surgery followed by radiotherapy and eight of them received adjuvant chemotherapy. We have studied the influence of some factors such as age, sex, location of tumour in the cerebellum, amount of surgical resection and histological variants on survival and recurrence of the disease. Only the histological type has a statistically significant influence on survival and recurrence: we have found that patients presenting classic medulloblastoma have a long survival and a long relapse-free interval.     

Conservatively Treated Breast Cancer: Outcome by Histologic Subtype

Abstract: Between 1970 and 1990, 1,008 patients with early-stage breast cancer were treated by conservative surgery without axillary dissection followed by radiation therapy to the intact breast in the Department of Therapeutic Radiology at Yale-New Haven Hospital. The patient population, broken down by histologic subtype, was as follows: 761 patients presented with infiltrating ductal carcinoma, 70 patients with pure intraductal, 38 intraductal with focal invasion, 54 infiltrating lobular, 21 tubular, 17 medullary, 16 mucinous, and 29 with other various histologic subtypes. Patients were followed on a regular basis by the referring physicians and radiation oncologists. Diagnostic studies for distant metastases were performed as clinically indicated. Annual mammography was a routine component of the follow-up program. As of 3/96, with a median follow-up of 10.5 years, 83 patients developed an ipsilateral breast tumor recurrence, and 109 patients developed distant metastases resulting in an overall 10-year breast recurrence-free rate of 84%, and a 10-year distant metastasis-free rate of 78%. There were significant differences in clinical stage, pathological nodal involvement, and administration of systemic therapy between various histologic subtypes. As expected, those patients with histologies of low metastatic potential (such as intraductal, tubular, and mucinous) had significantly superior distant recurrence-free survival rates. With respect to breast relapse rates, there were no statistically significant differences in the 5- and 10-year breast recurrence-free rates between any of the histologic subtypes. Patients with intraductal carcinoma with or without focal invasion had similar breast relapse rates as those with other histologic subtypes. Patients with lobular carcinoma in situ as a histologic component also had a similar overall breast relapse-free recurrence rate. In conclusion, long-term follow-up of conservatively treated breast cancer patients demonstrates no significant differences in ipsilateral breast tumor recurrence rates between various histologic subtypes. There are no histologies which had a statistically significantly higher breast-relapse rate than infiltrating ductal carcinomas and therefore no primary histologic subtype represents a relative contraindication to breast conservation therapy.     

《内经》俞、输、腧探源

《素问》用“俞”，《灵枢》用“输”与“腧”表示腧穴，三字用法基本相同。“俞”源于用船运送，“输”源于用车运送，均引申为转运气血的穴位。“腧”是“俞”的今字，其字形代表的意义最符合中医学中腧穴的含义。应以“腧”作为规范的词语，表示腧穴的各种意义。     

一例~(192)Ir极不均匀外照射局部极重度放射损伤的临床观察

目的对１例１９２Ｉｒ极不均匀外照射局部极重度放射损伤病人进行临床观察。方法系统观察了病变的临床过程和应用红外线热成像技术测定了损伤部位的温度变化。结果照射后２小时出现肢体麻木、抽搐，最早照后４小时出现红斑、肿胀，５４小时出现水疱，第５天出现坏死和剧痛，最晚出现红斑、肿胀是照射后４１天，４７天出现水疱和糜烂创面。红外线热成像显示：损伤早期温度升高，水疱、坏死区和损伤后期温度降低，温度升高越早，损伤越重，温度改变区域与损伤范围相一致。结论大剂量极不均匀外照射放射损伤的初期反应早，放射病与局部损伤相互加重病情，症状先后不一，轻重不等，致残率高和疼痛剧烈，红外线热成像温度变化可以作为临床诊断的指标之一。     

恶性淋巴瘤自体造血干细胞移植后复发的研究进展

自体造血干细胞移植 (ASCT)是治疗复发性、难治性和侵袭性恶性淋巴瘤的有效方法 ,但因存在体内肿瘤细胞负荷过多和移植物被肿瘤细胞污染 ,使移植后的复发率增高。为了提高ASCT的疗效 ,可采取 :①移植前美罗华体内净化 ,除去外周血B细胞 ,清除移植物的肿瘤细胞污染 ;②移植后用美罗华和非交叉耐药药物交替联合化疗 ,以杀伤体内肿瘤细胞 ;③移植前或后累及野放射治疗 (IFRT)辅助 ,降低原发灶的复发率     

A slim needle-shaped multiwire microelectrode for intracerebral recording

The construction of a needle-shaped multiwire microelectrode is described. It can be made with simple mechanical tools. The presented electrode assembly consists of 12 insulated nichrome wires (core diameter 25 μm) which are embedded in epoxylite resin. The straight-cut wire tips are aligned lengthwise and have a relative spacing of 150 μm. Outer dimensions vary from 100 × 180 μm at the level of the 1st electrode channel, to 100 × 100 μm at the level of the 12th channel at the tip. The configuration of this electrode was determined by its application: the laminar analysis of evoked potentials in the cortex of the rat. However, the number of channels, the diameter of the (nichrome) wire which determines the surface area of these channels, and the channel spacing can be easily adjusted during construction to meet other experimental requirements, such as the recording of single-unit activity. The electrode which is composed of biocompatible materials is suited for the study of field potentials and multiple-unit activity, in both acute and chronic experiments, and can be used repeatedly. To demonstrate the performance of the electrode assembly, a depth profile of field potentials is presented, accompanied by the corresponding current source density distribution. The potentials were recorded in the somatosensory cortex of the rat following stimulation of the median nerve under ketamine anesthesia.     

Germ cell tumor in the hypothalamo-neurohypophysial region: clinical features and treatment

Twenty-one patients with germ cell tumors (17 germinomas and 4 teratomas) involving the hypothalamic-neurohypophysial (HN) region were reviewed retrospectively. Eleven patients were males and 10 females, and their ages ranged from 7 to 45 years (average 18.5 years). Diabetes insipidus was the initial and the most prominent symptom in most germinomas; in teratomas the most prominent symptom was visual disturbance. Fifteen patients with germinomas were treated by radiotherapy, and 4 with teratomas were treated by surgical resection alone. Two recent germinoma patients with extensive CSF dissemination were treated with systemic chemotherapy consisting of anticancer platinum drugs and etoposide, which resulted in a complete disappearance of the tumors. Patients with germinoma treated after the introduction of CT scanning had a greatly improved mortality rate, and their actual survival rate was 87.5% over 10 years. On the basis of this review, the authors consider that diagnosis at an early stage of the disease and chemotherapy, which can be an effective therapeuric alternative to radiation therapy, may improve not only the mortality rate but also the quality of life of patients with HN germ cell tumors.     

蝎毒素Ⅳ的中枢镇痛作用

从东亚钳蝎粗毒中分离纯化出蝎毒素Ⅳ，经套管注入侧脑室，用辐射热测痛和屈肌反射检测两种方法，观察蝎毒素Ⅳ的中枢镇痛作用，结果蝎毒索Ⅳ可以明显延长大鼠缩腿潜伏期，并可显著抑制Ｃ纤维诱发的屈肌反射。提示蝎毒素Ⅳ具有显著的中枢镇痛作用。     

云芝多糖对小鼠超氧化物歧化酶活力的影响(英文)

目的:研究云芝多糖(CVP,ip)对小鼠有关组织中超氧化物歧化酶(SOD)活力的作用。方法:实验在正常,荷瘤和~(60)Co-γ线辐射损伤小鼠中同步进行。SOD活力测定采用肾上腺素自氧化法。结果:CVP既能不同程度地增强正常小鼠和正常迟发型超敏感性(DH)小鼠淋巴细胞,脾及胸腺中SOD的活力,又能明显恢复或防止肿瘤或辐射对小鼠DH和淋巴细胞,脾及胸腺中SOD的抑制效应。CVP对肿瘤生长和肿瘤组织中SOD活力均有明显抑制作用。结论:CVP对小鼠SOD活性有促进作用,CVP的抗肿瘤和免疫恢复作用与其对SOD的作用有一定的联系。