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排序方式: 共有1215条查询结果,搜索用时 62 毫秒
51.
David M. Gershenson M.D. Mitchell Morris M.D. Thomas W. Burke M.D. Charles Levenback M.D. John J. Kavanagh M.D. Geri L. Fromm M.D. Elvio G. Silva M.D. Donna Warner R.N. J. Taylor Wharton M.D. 《Gynecologic oncology》1995,58(3)
Purpose. The primary goal of this trial was to evaluate the clinical activity and the toxicity of a combination of cisplatin and carboplatin for women with advanced-stage epithelial ovarian cancer. Patients and methods. Fifty-one consecutive evaluable patients with untreated stage III and IV epithelial ovarian cancer received 360 mg/m2 carboplatin on Day 1 and 50 mg/m2 cisplatin on Day 2 administered intravenously every 28 days for six cycles. Drug doses were adjusted for hematologic toxicity based on nadir counts during the prior therapy course. Dose levels included 300-400 mg/m2 carboplatin and 50-75 mg/m2 cisplatin. Second-look surgery was optional. Endpoints were clinical response, surgical response, progression-free survival, and survival. Results. Of 8 patients with measurable disease, 3 (37.5%) had a clinical compete response, and 3 (37.5%) had a clinical partial response, for an overall clinical response rate of 75%. Of 39 patients who began chemotherapy with abnormal serum levels of CA 125, 31 (79%) achieved normalization of CA 125 at the completion of chemotherapy. Thirteen patients underwent second-look laparotomy. Of these, 7 (54%) had a pathological compete response, and 2 (15%) had a partial response. The median progression-free survival was 14 months, and the overall median survival was 32.5 months. Neutropenia and thrombocytopenia were the main dose-limiting toxicities. In addition, 9 patients developed grade 2 and 3 developed grade 3 ototoxicity. Conclusion. This regimen is very active against advanced-stage epithelial ovarian cancer. The degree of ototoxicity observed is worrisome, but such toxicity may be ameliorated by limiting the dose of cisplatin and increasing the dose of carboplatin. 相似文献
52.
Three recent publications have reported the development of erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens-Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens-Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation. 相似文献
53.
Passive intestinal permeability in 33 newborn babies was studied using feeds containing lactulose and mannitol. Each marker is thought to pass across the gut wall by a different route; lactulose by a paracellular and mannitol by a transcellular pathway. Neither is metabolised and both are wholly and solely excreted by the kidney; urinary recovery is a measure of the intestinal uptake. Babies born before 34 weeks' gestation exhibited a higher intestinal permeability to lactulose than more mature babies, and all preterm babies showed an appreciable decline in lactulose absorption during the first week of oral feeds. Babies of 34 to 37 weeks' gestation achieved a 'mature' intestinal permeability to lactulose within four days of starting oral feeds. These findings may reflect the immaturity of the gut of the preterm baby rather than a process essential to adaptation to enteral nutrition. 相似文献
54.
Rupert Bartsch Sabine Fromm Margaretha Rudas Catharina Wenzel Stefanie Harbauer Karl Roessler Klaus Kitz Guenther G. Steger Hajo-Dirk Weitmann Richard Poetter Christoph C. Zielinski Karin Dieckmann 《Radiotherapy and oncology》2006,80(3):313-317
BACKGROUND: Brain metastases have evolved from a rare to a frequently encountered event in advanced breast cancer due to advances in palliative systemic treatment. PATIENTS AND METHODS: All Patients treated at our centre from 1994 to 2004 with WBRT for brain metastases from breast cancer were included. We performed a multivariate analysis (Cox regression) to explore which factors are able to influence significantly cerebral time to progression (TTP) and overall survival (metastatic sites [visceral versus non-visceral], Karnofsky performance score [KPS], age, intensified local treatment [boost irradiation, neuro-surgical resection] further systemic treatment). RESULTS: Overall 174 patients, median age 51 years, range 27-76 years, were included. Median TTP was 3 months (m), range 1-33+ m. Median overall survival was 7 m, range 1-44 m. Factors significantly influencing TTP were KPS (p = 0.002), intensified local treatment (p < 0.001), and palliative systemic treatment (p = 0.001). Factors significantly influencing survival were intensified local treatment (p = 0.004), metastatic sites (p = 0.008), KPS (p = 0.006), and palliative systemic treatment (p < 0.001). CONCLUSION: As shown by the significant influence of metastatic sites, some patients die from their advanced systemic tumour situation before they would die from cerebral progression. In other individuals however, intensified local treatment and systemic treatment appear to influence cerebral time to progression and overall survival. 相似文献
55.
Ki-ras mutations are an early event and correlate with tumor stage in transplacentally-induced murine lung tumors 总被引:2,自引:2,他引:2
Leone-Kabler S; Wessner LL; McEntee MF; D'Agostino RB Jr; Miller MS 《Carcinogenesis》1997,18(6):1163-1168
A previous study from this laboratory demonstrated that treatment of
pregnant mice with 3-methylcholanthrene (MC) caused lung tumors in the
offspring at 1 year after birth, the incidence of which correlated with
fetal inducibility of Cyp1a1. Analysis by PCR amplification and allele-
specific hybridization (ASO) of paraffin-embedded tumors generated from
that study revealed the presence of point mutations in exon 1 of the Ki-
ras gene. This work has now been expanded by PCR amplification and ASO
analysis of 31 additional lesions. Point mutations were found in 37 of the
47 (79%) lesions analyzed in this and the previous study, the majority of
which were G-->T transversions in the first or second base of codon 12.
The mutational spectrum appeared to be dependent on the relative stage of
differentiation of the lesion, as both the incidence of mutation and type
of mutation produced correlated with malignant progression. Mutations
occurred in 60% of the hyperplasias, 80% of the adenomas and 100% of the
adenocarcinomas. In the lesions with mutations, GLY12-->CYS12
transversions occurred in 100% of the hyperplasias, 42% of the adenomas and
14% of the adenocarcinomas. The GLY12-->VAL12 transversions occurred in
none of the hyperplasias, 42% of the adenomas and 57% of the
adenocarcinomas. The remaining mutations, which consisted of ASP12
transitions and ARG13 transversions, occurred only in adenomas (17%) and
adenocarcinomas (29%). Between this study and our previous analyses, the
identity of the mutations obtained by ASO were confirmed by sequence
analysis of eight of the 37 lesions that harbored mutations at the Ki-ras
gene locus. There were no differences in the type or incidence of mutations
relative to the metabolic phenotype or sex of the mice. These data suggest
that mutational activation of the Ki-ras gene locus is an early event in
transplacental lung tumorigenesis, and that the type of mutations produced
by exposure to chemical carcinogens can influence the carcinogenic
potential of the tumor. This may have prognostic significance in
determining the malignant progression of the neoplasm.
相似文献
56.
The prevalence of dyslipidaemia in children with insulin dependent diabetes mellitus (IDDM) and its relation to glycaemic control was studied in a group of 51 diabetic children and a control population of 132 schoolchildren. The prevalence of dyslipidaemia in the fasting state was increased in the diabetic group (39%) compared with control subjects (17%). Serum cholesterol concentration alone was raised in 25% of diabetic subjects while serum cholesterol and triglycerides were raised in 14%, compared with 16% and 0.7% respectively in control subjects. Serum total cholesterol (5.1 v 4.5 mmol/l), low density lipoprotein cholesterol (3.2 v 2.6 mmol/l), non-esterified fatty acids (0.91 v 0.50 mmol/l), and triglycerides (0.94 v 0.76 mmol/l) were higher in diabetic children. Serum total cholesterol, triglycerides, and apolipoprotein (apo)B concentrations increased with worsening control, while serum high density lipoprotein cholesterol and apoA-I concentrations were unaltered. There were also positive correlations between glycated haemoglobin and total cholesterol, triglycerides, and apoB in diabetic children. Thus, abnormalities in circulating lipids are common in young subjects with IDDM but largely disappear if blood glucose concentrations are reasonably controlled. 相似文献
57.
58.
59.
Brunkhorst R; Fromm S; Wrenger E; Berke A; Petersen R; Riede G; Westphale J; Zamore E; Ledebo I 《Nephrology, dialysis, transplantation》1998,13(12):3189-3192
Background. Automated peritoneal dialysis (APD) has
the possibility of increasing the dialysis efficacy by using higher fill
volumes, frequent dialysate exchanges, and tidal techniques. It is then
possible to treat patients adequately without residual renal function. The
drawbacks of the required high amounts of dialysis solution of up to 30
litres per session are the high costs of lactate-based dialysate bags and
difficulties for the patients in handling these bags. So far,
bicarbonate-based peritoneal dialysate, which may be more biocompatible, is
only available for CAPD in double-chamber bags. In APD this could be
overcome by 'on-line' preparation of bicarbonate-buffered dialysate using
advanced technologies originally designed for on-line preparation of
substitution fluid for haemofiltration. Methods. Four
patients without residual renal function were treated with APD five times
weekly in a crossover study design. Patients received standard
lactate-based (35 mmol/l) treatment (25 litres per session each) in weeks 1
and 3. In week 2 on-line-produced bicarbonate-buffered (37 mmol/l)
dialysate was used. This dialysate was prepared by an AK 100 Ultra
haemodialysis machine. The machine was modified for adding glucose from a
50% concentrate to the desired concentration of 1.7%. Electrolytes, pH,
pCO2, and dialysis efficacy parameters were measured. Micro-biological
testing was carefully performed. Results. Creatinine
clearances, Kt/V, and pCO2 did not vary between the different treatment
phases, whereas the pH showed a distinct increase during the bicarbonate
phase. Repeated determinations of endotoxins and culturing showed no
contamination of the dialysate. The composition of the produced dialysate
was reproducible with respect to pH, pCO2, sodium, calcium and bicarbonate,
whereas the glucose concentration varied by ±20%.
Conclusions. On-line preparation of PD fluid with the
AK 100 Ultra is easy and safe to handle. APD with dialysate containing 37
mmol/l bicarbonate provides improved acid-base balance and possibly
improved biocompatibility, and may lead to a significant cost reduction.
Further development in order to provide smaller machines and more precise
ways of achieving a desired dialysate glucose concentration is necessary. 相似文献
60.