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J M Crook

Publications and source records attributed to J M Crook.

At least 37 records · Page 2Linked to original sources
PubMed1997

Evaluation of radiation effect, tumor differentiation, and prostate specific antigen staining in sequential prostate biopsies after external beam radiotherapy for patients with prostate carcinoma.

BACKGROUND: Sequential systematic biopsies after radiotherapy (RT) for prostate carcinoma were evaluated with respect to radiation effect, tumor differentiation, and prostate specific antigen (PSA) staining, and these histopathologic parameters were correlated with local outcome. METHODS: Since 1990, transrectal ultrasound-guided biopsies have been used to follow patients with localized prostate carcinoma after radical external RT at the General Hospital division of the Ottawa Regional Cancer Centre. Eighty-nine patients with residual tumor in 1 or more biopsies at 10-78 months of follow-up were selected for review. All patients had undergone biopsy on more than one occasion. The 198 biopsies were stained for PSA, high molecular weight keratin, and proliferative cell nuclear antigen (PCNA). Therapy effect was graded by nuclear and cytoplasmic changes. RESULTS: Of these 89 selected patients, 25 progressed to local failure (LF), 38 had delayed tumor clearance, and 26 remained biopsy positive without local or biochemical progression. In the 24- and 36-month biopsies, RT effect correlated with mean nadir serum PSA (Grade 4-6 RT effect: 0.7 ng/mL; Grade 0-3 RT effect: 1.3 ng/mL [P = 0.01]) and with local outcome (Grade 0-2 RT effect: 55% LF; Grade 3-4 RT effect: 30% LF; and Grade 5-6 RT effect: 0% LF [P = 0.003]). Of tumors with minimal RT effect, 61% were PCNA positive, compared with 34% for moderate and 17% for marked RT effect (P < 0.001). Adjacent areas within biopsies showed varied RT effect in 27 patients, of whom 41% had local failure, compared with 18% of patients with uniform RT effect (P = 0.03). Gleason score was assigned only if RT effect was minimal (36 patients/59 biopsies); 74% had the same Gleason score (+/-1) as the original, whereas 23% were 2 points lower. Only 1 biopsy lost PSA staining completely and 10% stained faintly, whereas 34% stained moderately and 55% strongly. CONCLUSIONS: PSA staining is apparently retained in residual tumor after RT, despite obvious RT effect. RT effect correlates with serum PSA nadir, PCNA staining, and local outcome. Varied RT effect is commonly observed in biopsies, and correlates with local failure. There is no convincing evidence for tumor dedifferentiation after RT.

Aged↗
PubMed1996

GABA-induced inactivation of functionally characterized sites in cat visual cortex (area 18): effects on direction selectivity.

1. Microiontophoresis of gamma-aminobutyric acid was used to reversibly inactivate small sites of defined orientation and direction specificity at a horizontal distance of 400-700 microns from single cells recorded in cat area 18. There was extensive or complete overlap between the receptive fields of cells at the recording and inactivation sites. A cell's directionality index [DI: 1 - (response to nonpreferred direction/response to preferred direction)], the response to the preferred direction, and orientation tuning width (measured at half the maximum response) were compared before and during inactivation of either iso-orientation sites (where the orientation preference was within 22.5 degrees) or cross-orientation sites (where it differed by 45-90 degrees). 2. During iso-orientation inactivation, 40 (73%) of 55 cells showed a significant (> 0.20) change in DI; the mean change in DI for these cells was 0.59. An additional cell showed a marked increase in response to the preferred direction that did not result in a change in DI. With one exception, the effects occurred in the absence of a significant (> 25%) change in orientation tuning width. 3. In most cases, the results were broadly predictable in the sense that iso-orientation inactivation predominantly affected a cell's response to the direction of motion of an optimally oriented bar that was closest to the preferred direction at the inactivation site: viz., a decrease in response to the preferred direction and an increase in response to the preferred or nonpreferred direction. 4. It is argued that the decreases in response were due to a reduction in the strength of intracortical iso-orientation excitatory connections made primarily between cells with similar direction preferences, whereas the increases in response involved a loss of iso-orientation inhibition. 5. In cases where remote inactivation caused an increase in response to the nonpreferred direction, comparable effects could be elicited when a mask left exposed only the excitatory subregion of the receptive field in S cells or the most responsive part of the excitatory discharge region in C cells. This implies extensive or complete spatial overlap between the profiles of excitation and inhibition in a cell's nonpreferred direction. 6. During cross-orientation inactivation, a significant change in DI was seen in only 14 (19%) of 73 cells and, with one exception, these changes were accompanied by increases in response to non-optimal orientations and significant broadening of orientation tuning. The effects of cross-orientation inactivation on directionality were presumably due to the loss of cross-orientation inhibition, which contributes primarily to orientation tuning. 7. Inactivation of the same site could cause an increase in response to the nonpreferred direction in cells recorded at iso-orientation sites and an increase in response to nonoptimal orientations and broadening of orientation tuning in cells recorded at cross-orientation sites. This is consistent with the notion that a single inhibitory neuron can contribute to the directionality or orientation tuning of different target cells depending on their location in the orientation map. 8. The results provide evidence for a major contribution of intrinsic mechanisms to the orientation tuning and direction selectivity of cells in cat area 18. It is proposed that two different intracortical processes are involved in the enhancement of orientation and direction selectivity: 1) suppression of responses to nonoptimal orientations and directions as a result of cross-orientation inhibition and iso-orientation inhibition; and 2) facilitation of responses to optimal orientations/directions via iso-orientation excitatory connections.

Animals↗
PubMed1996

The density of muscarinic M1 receptors is decreased in the caudate-putamen of subjects with schizophrenia.

Changes in cholinergic neurons have been implicated in the pathology of schizophrenia. Clozapine, an atypical anti-psychotic drug, has been shown to bind with high affinity to the muscarinic1 (M1) receptor suggesting this receptor could be involved in the therapeutic efficacy of the drug. Because of this we measured the density of M1 receptors in the caudate-putamen, obtained at autopsy, from 19 schizophrenic subjects and 19 non-schizophrenic subjects. The density of M1 receptors was decreased in the caudate-putamen from the schizophrenic subjects (181 +/- 20 vs 287 +/- 10 fmol mg-1 TE; mean +/- s.e.m.; P < 0.001). Furthermore, preliminary studies would not suggest that the change in the density of M1 receptors in the tissue from the schizophrenic subjects had resulted from drug treatment prior to death. These data raise the possibility that changes in muscarinic receptors may be involved in the pathology of schizophrenia.

Adult↗
PubMed1995

Prostate motion during standard radiotherapy as assessed by fiducial markers.

From November 1993 to August 1994, 55 patients with localized prostate carcinoma had three gold seeds placed in the prostate under transrectal ultrasound guidance prior to the start of radiotherapy in order to track prostate motion. Patients had a planning CT scan before initial simulation and again at about 40 Gy, just prior to simulation of a field reduction. Seed position relative to fixed bony landmarks (pubic symphysis and both ischial tuberosities) was digitized from each pair of orthogonal films from the initial and boost simulation using the Nucletron brachytherapy planning system. Vector analysis was performed to rule out the possibility of independent seed migration within the prostate between the time of initial and boost simulation. Prostate motion was seen in the posterior (mean: 0.56 cm; SD: 0.41 cm) and inferior directions (mean: 0.59 cm; SD: 0.45 cm). The base of the prostate was displaced more than 1 cm posteriorly in 30% of patients and in 11% in the inferior direction. Prostate position is related to rectal and bladder filling. Distension of these organs displaces the prostate in an anterosuperior direction, with lesser degrees of filling allowing the prostate to move posteriorly and inferiorly. Conformal therapy planning must take this motion into consideration. Changes in prostate position of this magnitude preclude the use of standard margins.

Algorithms↗
PubMed1995

Routine prostate biopsies following radiotherapy for prostate cancer: results for 226 patients.

OBJECTIVES: To determine the time course of histologic resolution of prostate cancer following radiotherapy (RT) and to correlate biopsy results with clinical outcome. METHODS: Since July 1990, all patients treated with radical external beam RT for prostate cancer at the General Division of the Ottawa Regional Cancer Centre have had systematic transrectal ultrasound (TRUS) and TRUS-guided biopsies beginning 12 months after RT and then every 6 months until negative or until clinical failure. Thus, 226 patients have had 375 TRUS with four to seven specimens per examination. Stage distribution was T1b: 32, T1c: 11, T2a: 45, T2b: 82, T3: 50, and T4: 6. Median follow-up was 33 months. RESULTS: Biopsy results were negative in 69.5% of patients by 30 months of follow-up. Thirty-two (14%) had local failure (T1b: 12.5%, T1c: 0%, T2a: 11%, T2b: 15%, T3: 18%, T4: 33%). Seven (3%) had chemical failure, and 47 (21%) had biopsy-only failure. Median follow-up for the biopsy-only failure group is only 19.5 months and mean prostate-specific antigen (PSA) is 1.0 ng/mL. Thirty-nine patients, initially with biopsy-only failure, have converted to negative biopsies at a median of 26 months. Nadir PSA for patients with local failure was 3.9 ng/mL at 14 months versus 0.7 ng/mL at 23 months for those without failure. Patients with late conversion to negative biopsy results had a later nadir PSA of 1.3 ng/mL at 27.3 months. CONCLUSIONS: Routine prostate biopsy specimens after RT in an unselected population show tumor clearance that is in agreement with long-term clinical follow-up, although tumor may take more than 30 months to resolve. Nadir PSA can be used to predict outcome.

Aged↗
PubMed1994

Velocity invariance of preferred axis of motion for single spot stimuli in simple cells of cat striate cortex.

Directional tuning for motion of a long bar and a spot was compared quantitatively over a wide range of velocities in 23 simple cells of cat striate cortex whose "on" and "off" receptive field subregions had been mapped with optimally oriented, stationary flash-presented bars. Tuning curves were derived using stimuli whose polarity of contrast was appropriate for the dominant receptive field subregion of each cell (i.e. light stimuli for on-subregions and dark stimuli for off-subregions); stimulus sweep was centred accurately on the centre of that subregion. Bar stimuli were of optimal width, and spot diameter was equal to the width of the bars. In all simple cells, preferred axis of motion for a long bar was invariant with velocity, being orthogonal to preferred orientation, as assessed with a stationary flash-presented bar. In 20 of 23 simple cells, preferred axis for spot motion was approximately orthogonal to that for bar motion (i.e., parallel to preferred orientation) at all velocities tested, including those just above threshold for spot stimuli. However, tuning for the spot became sharper as velocity was increased, due to an increase in response to the spot moving along the preferred axis and a decrease in response to spot motion along other axes, including the preferred axis for the bar. Both preferred and upper cut-off velocity were consistently higher for spot than for bar motion. The remaining 3 simple cells showed no response to spot motion at any velocity, and their preferred axis of motion for the shortest bar which evoked a consistent response was the same as the long bar.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Effect of intersource spacing on local control and complications in brachytherapy of mobile tongue and floor of mouth.

From 1971 to 1988, 133 T1 and 141 T2 biopsy-proven squamous cell carcinomas of mobile tongue and floor of mouth were definitively managed by Iridium-192. Implantations were performed using either guide gutters or afterloading plastic catheters. The prescribed dose at the reference isodose (85% of the basal dose rate, Paris system) was 60-70 Gy. Total dose was not adjusted to dose rate or tumor volume. Results of the 274 implants have been analysed to look for a possible influence of intersource spacing on local control and necrosis. Follow up for patients free of local recurrence is 1-180 months with median of 35 months. The 274 tumors were divided into two groups according to intersource spacing: 9-14 mm (n = 204), and 15-20 mm (n = 70). At 5 years, the estimated local control (Kaplan Meier) was 86% and 76%; respectively (p = 0.13); the necrosis rate was 33% and 46%, respectively (p = 0.04). Multivariate analysis shows that dose and activity of wires were significantly related to local control, while only tumor site was predictive of necrosis; there was a non-statistically significant relationship between intersource spacing of wires and local control (p = 0.055). When considering only patients with oral tongue cancers, necrosis was significantly related to activity of wires (p = 0.013), and there was a non-significant trend to a relationship between necrosis and intersource spacing (p = 0.066) and tumor diameter (p = 0.065). For patients with floor of mouth cancer, none of these factors was significantly related to necrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

GABA-induced inactivation of functionally characterized sites in cat visual cortex (area 18): effects on orientation tuning.

Microiontophoresis of the inhibitory transmitter GABA was used to reversibly inactivate small sites of defined orientation specificity at a horizontal distance of some 600 microns from single cells recorded in area 18 of cat visual cortex, and the effects on orientation tuning were studied. The receptive fields of cells at the recording and inactivation sites overlapped extensively. During the inactivation of sites where the orientation preference differed by 45 degrees or more from that of a recorded cell ("cross-orientation" sites), 65% of 54 cells tested showed significant broadening of orientation tuning, with a mean increase in tuning width (measured at half the maximum response) of 93%, and an almost fourfold increase in the relative response to the orientation orthogonal to the optimum, compared with the response to the optimum; four cells essentially lost their orientation tuning. Broadening of tuning reflected an increase in response to nonoptimal orientations and was reversible upon termination of GABA application. The effects on orientation tuning typically peaked within 10-15 min of the onset of GABA iontophoresis with 50-100 nA ejecting currents, and could not be replicated by inactivating sites where the orientation preference was similar to that of a recorded cell; when the orientation preference at the inactivation sites was within 22.5 degrees of that of a recorded cell ("iso-orientation" sites), only 3 of 22 cells showed significant broadening of tuning, and in these cases, the effects were relatively weak (mean increase in tuning width of 39% and a negligible change in the relative response to the orientation orthogonal to the optimum). The effect of inactivating "iso-orientation" sites consisted primarily in an increase in response magnitude. The difference in the magnitude of the effects on orientation tuning elicited by inactivating "cross-orientation" and "iso-orientation" sites was highly statistically significant. Additionally, inactivation of "cross-orientation" or "iso-orientation" sites elicited differential effects on orientation tuning in 10 of the 13 cells in which direct comparisons were made. It is argued that the observed broadening of tuning was due to the loss of a "cross-orientation" inhibitory input, which normally sharpens orientation tuning by suppressing responses to nonoptimal orientations.

Animals↗
PubMed1991

The neurophysiological correlates of colour and brightness contrast in lateral geniculate neurons. I. Population analysis.

The colour of an object is changed by surround colours so that the perceived colour is shifted in a direction complementary to the surround colour. To investigate the physiological mechanism underlying this phenomenon, we recorded from 260 neurons in the parvo-cellular lateral geniculate nucleus (P-LGN) of anaesthetized monkeys (Macaca fascicularis), and measured their responses to 1.0-2.0 degrees diameter spots of equiluminant light of various spectral composition, centered over their receptive field (spectral response function, SRF). Five classes of colour opponent neurons and two groups of light inhibited cells were distinguished following the classification proposed by Creutzfeldt et al. (1979). In each cell we repeated the SRF measurement while an outer surround (inner diameter 5 degrees, outer diameter 20 degrees) was continuously illuminated with blue (452 nm) or red (664 nm) light of the same luminance as the center spots. The 1.0-1.5 degree gap between the center and the surround was illuminated with a dim white background light (0.5-1cd/m2). During blue surround illumination, neurons with an excitatory input from S- or M-cones (narrow- and wide-band/short-wavelength sensitive cells, NS- and WS-cells, respectively) showed a strong attenuation of responses to blue and green center spots, while their maintained discharge rate (MDR) increased. During red surround illumination the on-minus-off-responses of NS- and WS-cells showed a clear increment. L-cone excited WL-cells (wide-band/long-wavelength sensitive) showed a decrement of on-responses to red, yellow and green center spots during red surround illumination and, in the majority, also an increment of MDR. The response attenuation of narrow-band/long-wave-length sensitive (NL)-cells was more variable, but their on-minus-off-responses were also clearly reduced in the average during red surrounds. Blue surround illumination affected WL-cell responses little and less consistently than those of NL-cells, but often broadened the SRF also in the WL-cells towards shorter wavelengths. The M-cone excited and S-cone suppressed WM-cells were strongly suppressed by blue but only little affected by red surround illumination. The changes of spectral responsiveness came out clearly in the group averages of the different cell classes, but showed some variation between individual cells in each group. The zero-crossing wavelengths derived from on-minus-off-responses were also characteristically shifted towards wavelengths complementary to those of the surround.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1991

Effect of dose rate on local control and complications in definitive irradiation of T1-2 squamous cell carcinomas of mobile tongue and floor of mouth with interstitial iridium-192.

From 1971 to 1988, 134 T1 and 145 T2 biopsy-proven squamous cell carcinomas of mobile tongue and floor of mouth were definitively managed by iridium-192. Implantations were performed using either guide gutters or afterloading plastic catheters. The prescribed dose at the reference isodose (85% of the basal dose rate, Paris system) was 60-70 Gy. Total dose was not adjusted to dose rate or tumor volume. Results of the 279 implants have been analysed to look for a possible influence of dose rate on local control and necrosis. Follow-up patients free of local recurrence is 1-180 months with average of 51 months. The 279 tumors were divided in four groups according to dose and dose rate: greater than or equal to 62.5 Gy and greater than or equal to 0.5 Gy/h (n = 130), greater than or equal to 62.5 Gy and less than 0.5 Gy/h (n = 36), less than 62.5 Gy and greater than or equal to 0.5 Gy/h (n = 81), less than 62.5 Gy and less than 0.5 Gy/h (n = 32). The four groups were comparable according to age, sex, tumor diameter and macroscopic aspect. At 5 years, the estimated local control (Kaplan Meier) was 93, 87, 79 and 52%, respectively (dose adjusted to dose rate: p less than 0.001, dose rate adjusted to dose: p less than 0.01, Log-rank); the necrosis rate was 44, 24, 37 and 5%, respectively (dose adjusted to dose rate: p = 0.08, dose rate adjusted to dose: p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1991

Influence of GABA-induced remote inactivation on the orientation tuning of cells in area 18 of feline visual cortex: a comparison with area 17.

We have investigated the effect of iontophoretically applying the inhibitory transmitter gamma-aminobutyric acid (GABA) through four pipettes, each located at a horizontal distance of some 500-600 microns from the recording site, on the orientation tuning of cells in areas 17 and 18 of the cat visual cortex for moving the stationary flash-presented bar stimuli. Forty-five of 74 cells tested in area 18 (61%) showed a significant (greater than 25%) increase in orientation tuning width (at half the maximum response) during GABA application, which reflected an increase in response to non-optimal orientations. The mean orientation tuning width of these cells increased by 79%, and the ratio of responses to the orientation orthogonal to the optimum and to the optimum increased from 0.16 to 0.46. The results were similar to those from area 17, in which 36 of 54 cells (66%) showed significant broadening of orientation tuning during GABA application, with a 90% increase in mean tuning width and an increase in the relative response to the orientation orthogonal to the optimum from 0.17 to 0.42. The distributions of cells in areas 17 and 18 with respect to the magnitude of GABA-induced effects on orientation tuning width were not significantly different (mean increase in tuning width: area 17, 102%; area 18, 87%). Although most cells were tested only with moving bars, comparable effects of remote GABA application on orientation tuning were observed when stationary flash-presented bars were used. Of 11 cells thus tested in area 18, seven showed significantly broader tuning during GABA application, with a 132% increase in mean tuning width. In some 25% of cells in each area which showed a significant effect of GABA application on orientation tuning the response to at least one non-optimal orientation exceeded, during GABA application, the response to the previous optimum. There was essentially no correlation between the changes in orientation tuning and changes in the level of spontaneous activity or in the response to the optimum orientation during GABA application. Thus, an increase in the general excitability of recorded cells or the loss of an unspecific inhibitory input cannot account for the effects of GABA application on orientation tuning. Remote GABA application presumably inactivated cells with different preferred orientations from that of the recorded cell. It is thus argued that the observed broadening of orientation tuning during GABA application reflected the loss of an inhibitory input tuned to non-optimal orientations.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1990

Directional tuning of cells in area 18 of the feline visual cortex for visual noise, bar and spot stimuli: a comparison with area 17.

Directional tuning for visual noise, bar and single spot stimuli was compared over a wide range of velocities in cells from areas 17 and 18 of the visual cortex in lightly-anaesthetized cats. In each area, S-cells were predominantly insensitive to motion of a field of visual noise. C-cells were more sensitive to noise motion than B-cells, but showed heterogeneity in noise sensitivity, which was associated with other response properties: strongly noise-sensitive C-cells had relatively high spontaneous activity and broad directional tuning, and were predominantly direction-selective and binocularly-driven. Frequently, directional tuning for noise was unimodal at low velocity, but became progressively more bimodal as velocity was increased: a trough of depressed response corresponding to the peak in tuning for the bar separated two progressively more widely disparate preferred directions. In area 18, cells with velocity tuned (VT) functions for bar motion developed bimodal tuning for noise well below the optimum velocity for bar or for noise motion, while velocity high-pass (VHP) cells became progressively more bimodally tuned for noise over a wide range of velocities, in parallel with a steep increase in response to bar and noise motion. A high proportion of VT and VHP cells was bimodally tuned for noise at all velocities, one VHP cell showing two discrete lobes of tuning for noise below the threshold velocity for bar motion. Among cells which remained unimodally tuned for noise, VT and VHP cells in area 18 had radically dissimilar preferred directions for noise and bar motion at all velocities. With the exception of VHP cells, velocity bandpass was higher for noise than for bar motion. These results, together with other novel observations on the modality of tuning for noise in preferred and opposite directions of motion, demonstrate that bimodality of tuning for noise cannot simply be an effect of upper cut-off velocity for bar motion (Movshon et al. 1980; Orban 1984). It is argued that the trough between the lobes of tuning arises through laterally-directed inhibitory convergence from superficial- and deep-layer, large basket cells. In 40% of noise-sensitive cells, tuning for bar motion was broader on the flank closest to the preferred direction for noise and for a moving sport, while some 25% of cells showed variations in tuning for bar motion with velocity, which were associated with velocity-dependent changes in tuning for noise.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1990

Modulatory influences of a moving visual noise background on bar-evoked responses of cells in area 18 of the feline visual cortex.

The modulatory influence of a synchronously moving visual noise background on responsiveness to an optimally-oriented moving bar stimulus was investigated in visual cortical area 18 of the lightly-anaesthetized cat. The bar and noise background were swept along the axis orthogonal to bar orientation, with the same phase, velocity and amplitude of motion. Cells which were insensitive to motion of visual noise per se or weakly responsive to individual 'grains' in the noise sample showed suppression of bar-evoked responses by simultaneous motion of the noise background. Percent suppression declined with increase in bar length, over a range which could exceed the maximum estimate of receptive field length. The decline in percent suppression was non-linear, becoming progressively flatter in slope as bar length was increased until an asymptotic value was reached; observations on end-stopped cells and on end-free cells with restricted length summation verified that percent suppression was related specifically to the length of the comparison bar and not to the strength of response it evoked. Percent suppression and the extent over which it declined with increase in bar length were comparable for preferred and opposite directions of bar motion even in cells with radically different length-response functions in the two directions, including end-stopped cells with direction-selective end-zones. In contrast to end-inhibition, which was maximal at or near the preferred velocity for a bar of optimal length, percent suppression by motion of the noise background was essentially velocity-invariant; in velocity tuned and velocity high-pass cells, background motion reduced the slope(s) of the velocity-response function, implying that the suppressive action of moving noise backgrounds is divisive rather than subtractive. It is argued that the suppression derives predominantly from an axo-somatic noise-sensitive inhibitory input from superficial- and deep-layer, large basket cells in orientation 'columns' at some distance from those of their target cells.

Animals↗
PubMed1990

GABA-induced remote inactivation reveals cross-orientation inhibition in the cat striate cortex.

We investigated the contributions of lateral intracortical connections to the orientation tuning of area 17 cells using micro-iontophoresis of the inhibitory transmitter gamma-aminobutyric acid (GABA) to inactivate small cortical sites in the vicinity of a recorded cell. GABA was ejected from an array of micropipettes each with an average horizontal distance of 500 microns from the recording site. Of 54 cells tested, 33 showed a reduction and 3 a loss of orientation selectivity due to an increase in responses to non-optimal orientations during GABA inactivation. The response to the optimal orientation remained constant in more than half of the cells and increased or decreased in others. Given that a complete cycle of orientations occupies a tangential distance of 1000 microns, the observed broadening of orientation tuning is presumably due to GABA-mediated inactivation of inhibitory interneurones with different preferred orientations from those of their target cell.

Animals↗
PubMed1990

Interstitial iridium 192 for cutaneous carcinoma of the external nose.

Several implantation techniques useful for nasal skin carcinoma have been developed at the Henri Mondor Hospital in Créteil, France and are described in detail. Iridium 192 wires, 0.3 mm in diameter, are afterloaded into either supple plastic tubes or rigid needles implanted according to the rules of the Paris system. Dosimetry is performed by computer, based on either direct measurements of active lengths and spacing, orthogonal films or a tomogram oriented in the central plane of the implant. According to a recent review by the European Curietherapy Group of 468 implants, the optimal dose is 60 Gy. The overall failure rate was 2.6%. Indications for implantation and choice of technique, based on tumor size, site, and gross morphology are discussed.

Brachytherapy↗
PubMed1990

Iridium 192 implantation of T1 and T2 carcinomas of the mobile tongue.

Between 1970 and 1986, 166 patients with T1 or T2 epidermoid carcinomas of the mobile tongue were treated by iridium 192 implantation (70 T1N0, 83 T2N0, 13 T1-2 N1-3). Five-year actuarial survival was 52% for T1N0, 44% for T2aN0, and 8% for or T1-2 N1-3. Cause specific survivals were 90%, 71%, and 46%, respectively. Local control was 87% for both T1N0 and T2N0, and 69% for T1-2 N1-3. Seven of 23 failures were salvaged by surgery, increasing local control to 96% for T1 and 90% for T2. Thirty-six patients developed a minor or moderate necrosis (16% T1, 28% T2). Half of these involved bone but only five required surgical intervention. Both local control (LC) and necrosis (nec) increased with increasing dose but improvement beyond 65 Gy is minimal (less than or equal to 60 Gy: LC = 78% nec = 13%; 65 Gy: LC = 90% nec = 29%; greater than or equal to 70 Gy: LC = 94% nec = 23%). For N0 patients, neck management consisted of surveillance (n = 78), elective neck dissection followed with external irradiation for pathologically positive nodes (n = 72), or irradiation (n = 3). Clinically positive nodes (13 patients) were managed by either neck dissection followed by external irradiation if pathologically positive (n = 10) or irradiation alone (n = 3). Regional control was 79% for N0 patients, improving to 88% after surgical salvage, and was 9/13 for N1-3 patients. We recommend that T1 and T2 carcinomas of the mobile tongue be treated by iridium 192 implantation to deliver 65 Gy. Mandibular necrosis should be reduced by using an intra-oral lead-lined dental mold.

Adult↗
PubMed1990

Prognostic factors of local outcome for T1, T2 carcinomas of oral tongue treated by iridium 192 implantation.

The results of Iridium 192 implantation for 121 node negative T1 or T2 squamous carcinomas of mobile tongue were reviewed to look for predictors of local control and necrosis. Age, sex, total dose, dose rate, linear activity, and intersource spacing were examined. Minimum follow-up was 2 years but no patient with local recurrence or necrosis was excluded. There were 57 T1N0 tumors, 45 T2aN0 (2.1-3.0 cm), and 19 T2bN0 (3.1-4.0 cm). Local failures occurred in 14% of T1, 11% of T2a, and 26% of T2b. Univariate analysis showed that local control increased with increasing dose (55-60 Gy: 73%; 65-75 Gy: 92%, p = 0.005), whereas multivariate analysis revealed both sex and total dose to be significant. Radiation necrosis occurred in 17% of T1, 29% of T2a, and 47% of T2b (p = 0.034). Half were limited to soft tissue and the majority healed with conservative management. Univariate analysis showed that necrosis increased with increasing dose (55-60 Gy: 16%; 65-75 Gy: 33%, p = 0.037), as well as increasing dose rate, linear activity, and intersource spacing. With multivariate analysis only stage, dose rate, and spacing remained predictive of necrosis. Total dose was not adjusted for dose rate or tumor volume. This analysis suggests that within the therapeutic range of low dose rate brachytherapy, correction of total dose according to dose rate is unnecessary. We recommend 65 Gy. Lower dose rate (0.4-0.5 Gy/hr) and closer intersource spacing (12-14 mm) should be aimed for to minimize necrosis.

Adult↗