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41.
A.L. Batchelor A.W. Horne E.V. Hulse C.E. Stuart 《International journal of radiation biology》2013,89(6):583-591
SummaryRabbits were given acute whole-body irradiation with either neutrons (mean energy 0·7 mev, dose range 400–1500 rads) or gamma-rays (mean energy 2·5 mev, dose range 1000–3000 R). The last acute death was at 32 days and the LD50/32 was 572 rads for neutrons and 1389 R for gamma-rays, giving an RBE of 2·4.Acute deaths were primarily due to haemopoietic failure, but damage to the alimentary tract probably also played a part. Coprophagia (re-ingestion), which is normal in rabbits, may have increased the liability to post-irradiation infection.Sub-acute lesions, between 2 and 7 months after irradiation, occurred only after exposure to neutrons and not after gamma-rays. Just over half were local lesions of limbs, related to the entry dose of neutrons, and the remainder were intrathoracic effusions. When these sub-acute effects were taken into account the RBE rose to 3·0. 相似文献
42.
D D Correa L Maron H Harder M Klein C L Armstrong P Calabrese J E C Bromberg L E Abrey T T Batchelor D Schiff 《Annals of oncology》2007,18(7):1145-1151
BACKGROUND: Treatment-related neurotoxicity has been recognized as a significant problem in patients with primary central nervous system lymphoma (PCNSL) as effective treatment has increased survival rates. There is, however, a paucity of research on cognitive functions in this population. DESIGN: In a review of the literature, a total of 17 articles that described cognitive outcome in adult PCNSL patients were identified. RESULTS: The studies that assessed cognitive functions after whole-brain radiotherapy combined with chemotherapy reported cognitive impairment in most patients. Patients treated with chemotherapy alone had either stable or improved cognitive performance in most studies. Methodological problems, however, limited the ability to ascertain the specific contribution of disease and various treatment interventions to cognitive outcome. On the basis of the literature review, a battery of cognitive and quality-of-life (QoL) measures to be used in prospective clinical trials was proposed. The battery is composed of five standardized neuropsychological tests, covering four domains sensitive to disease and treatment effects (attention, executive functions, memory, psychomotor speed), and QoL questionnaires, and meets criteria for use in collaborative trials. CONCLUSION: The incorporation of formal and systematic cognitive evaluations in PCNSL studies will improve our understanding of treatment-related neurotoxicity in this population. 相似文献
43.
Seizure remission and antiepileptic drug discontinuation in children with tuberous sclerosis complex 总被引:6,自引:0,他引:6
BACKGROUND: Epilepsy is a common neurologic complication of tuberous sclerosis complex (TSC) and it is often refractory to treatment. Therefore, treating physicians are often reluctant to discontinue antiepileptic drugs (AEDs) in individuals with TSC who have attained seizure remission. To our knowledge, seizure remission and AED discontinuation in children with TSC has not been studied. OBJECTIVE: To characterize seizure remission and AED discontinuation in children with TSC. METHODS: Retrospective medical record and neuroimaging analysis of 15 children with TSC and epilepsy who had seizure remission, with a subsequent trial of discontinuation of AED treatment. RESULTS: The seizure remission rate for the group of patients with TSC and epilepsy was 14.2%. From the group of 15 patients who had a remission, the absolute relapse rate was 26.7% after a mean follow-up of 5 years 7 months. Patients with sustained remission were more likely to have normal intelligence and only a few cortical or subcortical lesions on neuroimaging. CONCLUSIONS: The proportion of children with TSC and epilepsy who achieve seizure remission is small. Nevertheless, some do attain seizure remission, and AEDs may be successfully discontinued. Mild cerebral involvement is a general clinical marker for seizure remission. The relapse rate in those who have undergone a trial of discontinuation of AED therapy is comparable with the rate in the general pediatric population with epilepsy. 相似文献
44.
Tandon S. P.; Bullock R.; Batchelor A.; Gascoigne A.; Warnell I.; Shaw I.; Hayes N.; Griffin S. M.; Baudouin S. V. 《British journal of anaesthesia》2000,84(5):671
Respiratory complications are a major cause of morbidity andmortality following oesophagectomy.1 We hypothesized that patientswho develop postoperative respiratory failure would have anunstable intraoperative course. Two stage oesophagectomy requiresa period of one lung ventilation (OLV) and one measure of intraoperativeinstability is desaturation during OLV. We therefore studiedthe relationship between SaO2 during OLV and postoperative course.Previous work has focused on preoperative factors associatedwith postoperative complications.2 There is little informationon intraoperative factors that may influence outcome. We performed a retrospective analysis of all elective oesophagectomiesperformed between January 1998 and August 1999. Seventy-sevenpatients had a 2-stage sub-total oesophagectomy requiring OLV.Oxygen saturation recorded on the anaesthetic chart during OLVwas plotted on a fixed linear scale of 0100% againsttime for each patient. The area above the curve was calculated,as a measure of intraoperative oxygenation during OLV. Thiswas standardized by dividing the area by the OLV duration, thusobtaining the Area Per Unit Time (APUT). The postoperative courseof each patient was recorded including outcome, total durationof ITU stay and the worst PaO2/FO2 ratioattained. ARDS was defined using the American-European ConsensusConference on ARDS criteria. Twenty-one patients had a prolongedITU stay (>48 h) and all had a persistent PaO2/FO2<27. Thirteen patients (17% of the total) fulfilled the ConsensusConference criteria for ARDS and seven of these died in hospital. Total OLV time was not significantly different between the groupsbut patients who developed ARDS had significantly greater intraoperativehypoxaemia as measured by the APUT (Table 17). We conclude thatintraoperative hypoxaemia is associated with respiratory failurefollowing oesophagectomy. 相似文献
45.
46.
Diagnostic evaluation of neurologic metastases 总被引:2,自引:0,他引:2
47.
48.
Enhancement of Renal Allografts in Rats and Man 总被引:6,自引:0,他引:6
49.
A 38-year-old woman presented with an infiltrative tumor of the right frontal lobe and genu of the corpus callosum that was deemed only partially resectable. A stereotactic biopsy was performed, which revealed a right frontal oligoastrocytoma that had some anaplastic features as well as allelic loss of chromosome arms 1p and 19q. The patient was treated with temozolomide for 24 months. The partial response of the tumor to chemotherapy rendered the lesion amenable to gross total resection, which was performed subsequently. The patient remains alive and well without evidence of recurrence 7 months after resection and 48 months after initial diagnosis. Thus, preoperative chemotherapy decreased tumor mass to a degree that subsequently enabled a gross total resection. This treatment strategy, although common in the treatment of other solid tumors, is rarely utilized in adult neuro-oncology and raises another potential role for chromosome testing in oligodendroglial tumor management. 相似文献
50.