Haemangiopericytoma of the trigeminal nerve

A 41‐year‐old man presented with a 4‐year history of progressive right‐sided diplopia on lateral gaze and right nasolabial paraesthesia. A CT revealed minor bone erosion of Meckel’s cave and of the right petrous apex by a uniformly enhancing lesion at the base of the skull. Magnetic resonance imaging on three occasions over 2 years showed tumour, measuring 4 cm in diameter, with features suggestive of a trigeminal neuroma. At surgery the lesion had the macroscopic appearance of a giant schwannoma. Histopathological findings were that of a meningeal haemangiopericytoma (HPC) of the trigeminal nerve. Intracranial HPC are rare and aggressive tumours of the central nervous system. They usually arise from the falx, tentorium and dural sinuses. The present case is unique as it originates from a cranial nerve.     

Chordoma: Review of clinicoradiological features and factors affecting survival

This study reviews the clinicoradiological features of cranial and sacrospinal chordomas and identifies factors affecting survival. Nineteen patients seen between January 1980 and December 2000 with histopathological diagnosis of chordomas were retrospectively reviewed with reference to clinical presentation, imaging features, treatment modalities and post‐therapy status. Eight had tumours in the skull base while 11 patients had spinal and sacrococcygeal lesions. Surgical resection was performed in 16 patients whose subsequent natural history was used to identify clinical indicators that may influence survival. Completeness of resection, age, gender and postoperative irradiation were subjected to analysis using the Cox proportional hazard models. Kaplan–Meir survival curves illustrate the survival distributions. Diplopia and facial pain are prime clinical presentations in cranial lesions, while extremity weakness and a sacrogluteal mass are common complaints in the sacrospinal group. Lesional calcifications are present in 40% while an osteolytic soft tissue mass is detectable by CT in all cases. Heterogeneous signals and internal septations on T₂‐weighted MRI are predominant features. In sacrospinal tumours, complete excision with adjuvant radiotherapy achieves the best results with a disease‐free survival of more than 5 years. The clinical and imaging findings in this study are in accordance with those of other series. Except for complete surgical excision followed by radiotherapy in the subset of patients with sacrospinal tumours, none of the other clinical indicators show a statistical significant influence on survival.     

呼吸/心跳同步触发多功能撞击致伤装置的研制

0引言创伤,特别是交通伤已成为人类一大公害,国外从本世纪40年代开始进行实验研究,早期实验研究无论是用自由落体式或摆锤式致伤撞击装置,不仅体积大且笨重,最大缺点是不能模拟高速致伤条件［‘·’j．随后有人用撞击枪制造动物创伤模型,显提高了撞击速度,机型较小,使用方便,但其速度和压缩幅度不易掌握．本世纪80年代初美国通用汽车公司首先设计制作出气动式撞击机,使撞击速度大大提高．1993年国内第三军医大学野战外科研究所报道在BIM－1型（自由落体式）生物撞击机基础上研制出一台BIM－I型（气动式）生物撞击机「‘’．我…     

单克隆抗体博来霉素A6偶联物对白血病细胞特异性结合与内化

抗CCT2单克隆抗体博来霉素A6偶联物可吸附胶体金颗粒(McAb-A6-Au)。电镜观察表明,在4℃,1h,表面有McAb-A6-Au颗粒的CEM细胞最高达78%;在37℃,4h,内化McAb-A6-Au颗粒的CEM细胞高达72%。而抗原性无关的U937细胞仅为14%。并且McAb-A6-Au颗粒能直接穿过细胞膜、核膜进入细胞浆和细胞核。37℃,1h已有10～18%的CEM细胞核内有McAb-A 6-Au颗粒。实验结果提示了单抗与博来霉素A6的偶联物与选择性地结合靶细胞,而且进入细胞速度快、穿透力强,有可能成为治疗白血病药物。     

Risk of cardiovascular thrombotic events after surgical castration versus gonadotropin-releasing hormone agonists in Chinese men with prostate cancer

We investigated the cardiovascular thrombotic risk after surgical castration (SC) versus gonadotropin-releasing hormone agonists (GnRHa) in Chinese men with prostate cancer. All Chinese prostate cancer patients who were treated with SC or GnRHa from year 2000 to 2009 were reviewed and compared. The primary outcome was any new-onset of cardiovascular thrombotic events after SC or GnRHa, which was defined as any event of acute myocardial infarction or ischemic stroke. The risk of new-onset cardiovascular thrombotic event was compared between the SC group and the GnRHa group using Kaplan–Meier method. Multivariate Cox regression analysis was performed to adjust for other potential confounding factors. A total of 684 Chinese patients was included in our study, including 387 patients in the SC group and 297 patients in the GnRHa group. The mean age in the SC group (75.3 ± 7.5 years) was significantly higher than the GnRHa group (71.8 ± 8.3 years) (P < 0.001). There was increased risk of new cardiovascular thrombotic events in the SC group when compared to the GnRHa group upon Kaplan–Meier analysis (P = 0.014). Upon multivariate Cox regression analysis, age (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.04–1.11, P< 0.001), hyperlipidemia (HR 2.455, 95% CI 1.53–3.93, P< 0.001), and SC (HR 1.648, 95% CI 1.05–2.59, P = 0.031) were significant risk factors of cardiovascular thrombotic events. In conclusion, SC was associated with increased risk of cardiovascular thrombotic events when compared to GnRHa. This is an important aspect to consider while deciding on the method of androgen deprivation therapy, especially in elderly men with known history of hyperlipidemia.     

IMPACT OF PROPHYLACTIC USE OF COLONY STIMULATING FACTORS ON THE PATTERN OF NEUTROPENIA AND INFECTIONS IN MODERATELY INTENSIVE CHEMOTHERAPY

In this study, colony stimulating factors (CSF) were used to prevent neutropenia during moderately intensive chemotherapy in 26 episodes of chemotherapy (12 of acute lymphoblastic leukaemia (ALL) and 14 patients with other malignancies). CSF was administered in doses of 5 µg/kg of body weight within 24 hours of completion of chemotherapy for 7 days in 6 patients and for 10 days in others. Twenty six age and sex matched patients of ALL were included as controls. In the CSF group, incidence of severe neutropenia (grades 3 and 4) reduced significantly by 42.3 per cent though overall incidence of neutropenia did not differ much. Mean duration of neutropenia reduced by 4 days. Nadir total leucocyte count and absolute neutrophil count were significantly higher. There was no difference in the incidence of anaemia, thrombocytopenia and requirement of blood transfusions. Overall infections were less and incidence of severe infections reduced by 42.3 per cent. The duration of infection and of fever was shortened. Requirement of antibiotics was also reduced. All patients in CSF group recovered from infection, while 1 patient died in the control group. Mean duration of delay in chemotherapy was reduced from 10 days in control group to 3 days in CSF group. CSF administration resulted in an escalation of the cost by 112.24 per cent. However shortened duration of antibiotics, hospitalisation, reduced laboratory expenses compensated it by 66.94 per cent Our study indicates that the prophylactic use of CSF is beneficial and cost effective in moderately intensive chemotherapy with a high incidence of febrile neutropenia. Administration for 10 days appears to be more beneficial than 7 days.KEYWORDS: Chemotherapy, Colony Stimulating Factors, Cost-Benefit Analysis, Neutropenia, Prophylaxis