Concomitant chemoradiotherapy and malignant glial tumors in the adult

The prognosis of adult patients with malignant gliomas remains poor despite advances in neurosurgery and radiotherapy. Even if chemotherapy has done little to improve on these results, except in the treatment of oligodendrogliomas, many authors have proposed to test the effect of radiotherapy by adding concomitant chemotherapy. Unfortunately, the analysis of these studies is difficult because all these protocols are different with a small number of patients. Furthermore, there are only a few studies evaluated in well controlled clinical trials with homogeneous patient population. Important factors such as tumor grade, patient age, and Karnofsky score, which have a strong influence on survival in malignant gliomas, are not clearly evaluated. Whatever, all these studies suggest that concomitant radio-chemotherapy seems not be promising in the treatment of malignant gliomas.     

Desmoplastic cerebral astrocytoma of infancy: a case report

Strips of human right atrial appendages were preincubated with [3H]noradrenaline and then superfused with physiological salt solution containing inhibitors of uptake1 and uptake2. Tritium overflow was evoked by transmural electrical stimulation (standard frequency: 2 Hz). Prostaglandin E2 (PGE2) inhibited the electrically evoked tritium overflow; at the highest concentration investigated, tritium overflow was reduced by about 80% and the pIC50% value was 7.14. The effect of PGE2 was not affected by rauwolscine, which, by itself, increased the evoked overflow. Naproxen failed to affect the evoked tritium overflow and its inhibition by PGE2. The inhibitory effect of PGE2 on the electrically evoked tritium overflow was mimicked by prostaglandin E1, the EP1/EP3-receptor agonist sulprostone and the EP2/EP3-receptor agonist misoprostol with the rank order of potency (pEC50%): sulprostone (7.68) > misoprostol (7.10) > PGE1 (6.39). In contrast, PGF2alpha, the IP/EP1-receptor agonist iloprost and the stable thromboxane A2 analogue U46619 (9,11-dideoxy-11alpha,9alpha-epoxy-methanoprostaglandin++ + F2alpha) did not change evoked tritium overflow. PGD2 caused facilitation. These results suggest that the sympathetic nerve fibres innervating human atrial appendages are endowed with presynaptic inhibitory EP3 and facilitatory DP-receptors. The EP3-receptors appear not to be tonically activated and do not interact with the alpha2-autoreceptors.     

Early detection of chemotherapy-related pancreatic enlargement in children using abdominal sonography: a preliminary report

At least two chemotherapeutic agents, prednisone and L-asparaginase, have been demonstrated to produce pancreatic injury. Early diagnosis of pancreatitis is frequently not possible, as symptoms are vague, physical findings may be minimal, and laboratory studies are frequently inconclusive until the injury is severe. Abdominal echography, as a monitor of pancreatic size, has proven to be helpful in the diagnosis of subclinical and early pancreatic injury of 14 of 19 selected children receiving prednisone and/or L-asparaginase therapy for acute leukemia or non-Hodgkin's lymphoma at the M.D. Anderson Hospital and Tumor Institute. Employment of this new diagnostic method permits prompt withdrawal of the causative agent(s), thus preventing further insult.     

Subependymal giant-cell astrocytoma associated with tuberous sclerosis: case report

Tuberous sclerosis is a neurocutaneous syndrome with a wide variety of clinical, pathologic, and radiologic manifestations. Intracranial phakomatosis has been reported to include subependymal nodules; cortical tubers, and subependymal giant-cell astrocytomas. Subependymal giant-cell astrocytomas are rare, benign brain tumors of unknown histogenesis which cause increased intracranial pressure, seizures, and focal neurologic signs. The only treatment of these tumors is total surgical removal, because they are not sensitive to irradiation and chemotherapy. We report a patient with tuberous sclerosis who underwent surgery for a large subependymal giant-cell astrocytoma.     

Cerebrovascular response in infants and young children following severe traumatic brain injury: a preliminary report

PURPOSE: Endotoxin (lipopolysaccharide [LPS])-induced systemic organ injury leads to disruption of normal systemic organ metabolic processes, which are manifest clinically by signs of accelerated anaerobic metabolism (e.g., tissue acidosis and hyperlactatemia) and altered VO2-DO2 relationships. The association of increased anaerobic metabolism with VO2-DO2 alterations has led to the notion that ischemia/ reperfusion (I/R) injury may be a prerequisite for the development of VO2-DO2 alterations during endotoxemia. However, in contrast to sepsis, in which oxygen consumption is often increased, oxygen consumption is severely decreased after I/R injury. Based on these observations, we hypothesized that I/R injury would result in systemic organ VO2-DO2 alterations, which are distinct from those that occur in sepsis. MATERIALS AND METHODS: We used the in situ autoperfused feline ileal preparation to simultaneously examine microvascular permeability, reflected as the ileal lymph to plasma protein concentration ratio (CL/CP), and ileal VO2-DO2 relationships after either intravenous LPS (2.0 mg/kg; n = 5) or I/R injury (n = 5), and in matching controls (n = 5). RESULTS: As expected, all LPS-treated and I/R-injured animals were found to have extensive ileal histological damage and marked increases in the CL/CP compared with controls (0.315 +/- 0.009 and 0.329 +/- 0.034, respectively, v 0.097 +/- 0.009; P < .001, both comparisons). In addition, the critical DO2 (DO2c) was elevated, and the critical oxygen extraction was decreased in both the I/R and LPS groups relative to controls. However, as initially hypothesized, the VO2 at the critical DO2 was markedly decreased in the I/R group compared with that of the LPS group. CONCLUSIONS: These data indicate that I/R injury is insufficient to account for the systemic organ VO2-DO2 alterations that occur with LPS injury.     

Clinical course of supratentorial brain tumors in children and adolescents

The classical concept concerning the character of development of the blastomatose process in the brain is frequently altered when applied to children and adolescents with supratentorial newgrowths. An analysis of 102 cases with verified newgrowths of a different histological nature and localization in the supratentorial space permitted to distinquish 4 types of a clinical development of this kind of pathology: (1) with an acute onset and short-term development of the tumor process; 2) with a gradual, progressive increase of symptoms, but with expressed and long-term remissions; 3) with a slowly progressive development of the disease and a sudden severe syndrome of decompensation or terminal state; 4) with acute clinical signs of a newgrowth and a replacement by a subsequent progressive remittent development.     

Retrovesical leiomyosarcoma responsive to preoperative chemoradiotherapy: a case report

A 70-year-old man with dysuria was referred to our hospital. Computed tomography scan and magnetic resonance imaging demonstrated a large solid tumor in the retrovesical space. Transurethral needle biopsy revealed leiomyosarcoma. Since the size of the tumor decreased markedly by intraarterial chemotherapy with cisplatin, methotrexate and pirarubicin, in combination with radiotherapy (40 Gy), surgical extirpation of the tumor was performed. Neither infiltration to the adjacent organs or lymph node metastasis was recognized. The patient had been free of recurrence for 12 months after operation.     

Laser intraductal photocoagulation of bilateral parotid ducts for reducing drooling of cerebral palsied children: a preliminary report

The serotonergic system is implicated in the pathogenesis of affective disorders. In particular, the role of the postsynaptic 5-hydroxytryptamine (serotonin) type 2 receptor (5-HT2) has been documented by several studies. The 5-HT2A receptor gene located on chromosome 13 (13q14-21) can be considered a candidate gene for bipolar affective disorder (BPAD). We tested association between a 5-HT2A receptor DNA variant and BPAD using a case-control design. Eighty-three BPAD patients and 129 unrelated normal controls, carefully matched for sex and geographical origin, were studied. Allele and genotype frequencies as well as homo-heterozygote distribution at the 5-HT2A receptor polymorphism were compared between the two groups. No significant allelic or genotypic associations were observed. There was no significant difference for homo-heterozygote distribution between the two groups. These preliminary results may indicate that in our sample the 5-HT2 receptor polymorphism studied is unlikely to play a role in the genetic susceptibility to BPAD.     

Allogeneic stem cell transplantation for advanced low-grade lymphoproliferative disorders: report of six cases

BACKGROUND: Allogeneic stem cell transplantation is being increasingly used to treat young patients with poor-prognosis low-grade lymphoproliferative disorders. We report our single-center experience. PATIENTS AND METHODS: Six adults (four with advanced chronic lymphocytic leukemia, one follicular center cell lymphoma and one mantle cell lymphoma) underwent allogeneic stem cell transplantation (SCT). Five received bone marrow while one received peripheral blood stem cells. Donors were HLA-identical siblings in five cases and an HLA-haploidentical sibling in one. The conditioning regimen included in five cases cyclophosphamide, TB1 and high-dose chlorambucil, without the latter in the patient with follicular lymphoma. RESULTS: Five patients successfully engrafted, while the patient who received the haploidentical marrow suffered primary graft failure. There were two cases of grade 2 acute GVHD and one limited chronic GVHD. Four patients are alive in complete remission (CR) with a follow-up of 17+ to 118+ months. Additionally, there is no evidence of residual disease by immunologic and molecular techniques in three cases, while one patient has residual disease assessed by molecular methods. CONCLUSIONS: These results suggest that allogeneic SCT can achieve prolonged remissions in advanced chronic lymphoproliferative disorders.     

The Day After: A preliminary report on its effects on children.

Contends, on the basis of the findings of J. Schofield and M. Pavelchak (see record 1986-11372-001), that the TV movie, The Day After, was a salient emotional stimulus and that developmental differences in self-reported nuclear war fears should be expected. Preliminary data collected by the present authors, using 126 2nd–6th graders, suggest that Ss' fears were both reactive to environmental events and developmentally mediated. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classification and grading of low-grade astrocytic tumors in children

This article reviews current perspectives in the classification and grading of astrocytomas in children and calls attention to several histologically distinct groups of low-grade tumors that characteristically arise during childhood. Recognition of these tumors and the range of histological features that they may exhibit is essential for making rational assessments regarding their expected behavior and, more importantly, for guiding therapeutic intervention. For example, pleomorphic xanthoastrocytoma, which may exhibit "anaplastic" features, generally carries a relatively favorable prognosis and should not be classified with other high-grade gliomas, such as anaplastic astrocytoma and glioblastoma multiforme. Similarly, the finding of anaplastic features, such as vascular proliferation or necrosis, in pilocytic astrocytomas does not automatically portend the unfavorable prognosis that such features would imply for "diffuse" astrocytomas. Increased appreciation of the morphological diversity of astrocytomas in children should help to improve the management of children with low-grade astrocytic tumors by avoiding potentially dangerous overtreatment of otherwise indolent lesions.     

Colonic anastomosis-a new approach: preliminary report

A case of fetal death from abruptio placentae is reported in which the placenta was the seat of multiple chorangiomata. This association is believed not to have been fortuitous and a possible mechanism is suggested by which chorangioma may contribute to the pathogenesis of placental abruption. The incidence, morphological variation and clinical manifestations of placental chorangiomata are briefly discussed.     

Clinical use of etomidate for anesthesia induction: a preliminary report

Etomidate (0.3 mg/kg) and thiopental (4 mg/kg) were administered IV for induction of general anesthesia, comparing heart rate, blood pressure, respiration, and side effects. No significant difference between the drugs was found in the circulatory parameters, but respiration was more depressed by thiopental. A high incidence of the side effects of myoclonia and pain on injection was seen with etomidate. The incidence of side effects was not affected by speed of injection or type of premedication. Mechanisms to reduce the incidence of side effects are needed for etomidate to become a useful induction agent.     

Prefabricated flaps for the head and neck: a preliminary report

Three cases of diffuse subcortical gray matter heterotopias in children are reported. Generalised seizures and mild mental retardation were the most frequent signs. No specific electroencephalographic pattern was recognized. Magnetic resonance imaging scans showed the thick diffuse layer of heterotopic gray matter which was surrounded by normal white matter. Gyration was normal, and no associated malformation was observed. This neuronal migrational disorder happens between the 10th and 16th gestational week. Nineteen observations (17 girls) are reported in the literature. The filiation with agyria-pachygyria and the possible genetic transmission are discussed.     

Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas

OBJECTIVES: The purpose of this study was to identify behaviors associated with change in body mass index or with weight gain at the waist. METHODS: A cohort of 79236 White, non-Hispanic, healthy adults was questioned in 1982 and 1992 about diet and 10 physical activities. Estimates were made of the mean effects of stable behaviors on 10-year change in body mass index and on odds ratios for gain at the waist. RESULTS: Ten-year changes in body mass index was associated positively with meat consumption and smoking cessation and inversely with vegetable consumption, vitamin E supplementation, continued smoking, and some vigorous activities (e.g., jogging/running). Women's body mass index decreased with walking 4 or more hours per week and with regular alcohol intake, but these behaviors had a smaller effect on men's body mass index. weight gain was inversely associated with high vegetable consumption, walking 4 or more hours per week, and jogging/running 1 to 3 hours per week but not with less demanding physical activities. CONCLUSIONS: Simple derivation of behaviors associated with weight loss or reduced abdominal obesity may enhance programs designed to prevent obesity and chronic diseases.     

Blood lipids in metropolitan caracas school children. A preliminary report (author''s transl)

A study was made of EP recorded in the visual projection area of the cerebral cortex in children with normal sight and in those with disturbed refraction when presented with blank and checkered patterns, the dimensions of the chess squares equalling 10, 20, 40, 60 and 120 angular minutes. In children with normal sight the patterns were defocussed by eyeglass lenses of --1 to +/- 6 dioptries. The investigation revealed a different EP configuration on the presentation of blank and checkered patterns. There was a similarity between the EP change when a blank pattern was replaced by a checkered one, and when the checkered pattern was made sharper. It is assumed that these EP changes results from enhanced lateral inhibition due to the contrast boundaries of the checkered pattern, The experiments carried out on children with disturbed refraction indicated that the maximal EP amplitude corresponded to the optimal optic correction, which shows that theuse of EP is a promising cue in determing vision acuity.     

Male factors in infertility--a preliminary report

Findings in 325 consecutive primary seminal analysis done at the Infertility Treatment Centre of IPGMR, are discussed. The clinical profile of the infertile couples was recorded. Semen was examined for quantity, sperm density, motility and morphology. An attempt was also made to correlate past illnesses with the quality of semen. 65 patients (20%) showed azoospermia, while 29 (8.9%) showed sperm count of less than 10 million/ml. History of past illnesses which contribute to azoospermia/oligospermia was obtained in 46% of azoospermia cases compared to only 10% in subjects showing sperm count of over 10 million/ml. Commonest association between azoospermia and past illness was found in the case of small-pox, where out of 31 subjects with past history of small-pox, 15 showed complete azoospermia, one showed sperm density of less then 10 million/ml.