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PubMedDate not supplied

[Theory of cooperative transition of DNA complexes with multimodal ligands].

The theory of the cooperative transition of DNA.ligand complexes have been developed, in which a model was implied where the multimodal ligands simultaneously interacted with DNA. Obtained formula express the dependence of the experimentally estimated values of the changes of transition point and width of transition on the concentration of the ligands. These expressions make possible to obtain the thermodynamic parameters of the interaction of the multimodal ligands with DNA (binding constants, number of base pairs corresponding to one binding site of DNA etc.) by comparing the theoretical and the experimental data.

DNA↗
PubMed1995

Multimodality treatment in advanced primary liver cancer.

This paper reports the long-term results of multimodality treatment in 1639 patients with pathologically proven primary liver cancer (PLC) over the past three decades. In this series, patients in subclinical stage constituted 23.9% (391/1639), moderate stage 63.0% (1032/1639), and late stage 13.2% (216/1639). There were 381 patients (23.2%) with small PLC (< = 5 cm). The PLC was coexistent with liver cirrhosis in 86.4% (1416/1639). The 5-year survival after resection of PLC was 45.5% for the whole series (n = 896), and 62.7% for patients with a tumor < = 5 cm (n = 345). The 5-year survival after hepatic artery ligation (HAL) and hepatic artery infusion (HAI) (n = 124) was 18.1%, while the 5-year survival after palliative resection (n = 175) was 12.5%. The 5-year survival of 40 patients receiving second-look resection after cytoreduction therapy was 68.4%. Cryosurgery was performed on 107 PLC patients, the 5-year survival being 22.0% for the whole series, and 48.8% for the 32 patients with small PLC. The 5-year recurrence rate after resection was 55.3%. The 5-year survival after reoperation for recurring tumor (n = 90) was 40.8%. It is suggested that surgery remains the modality of choice, and it plays a more important role in the treatment of PLC. The results of palliative surgery (HAL + HAI) seem better than those of palliative resection; combined multimodality treatment and second-look resection, and new surgical techniques might offer hope for unresectable advanced PLC.

Adolescent↗
PubMed1994

[Evaluation of prognostic nutritional index (PNI) as a prognostic indicator in multimodal treatment for gynecological cancer patients].

We assessed the usefulness of PNI (PNI = 10 x serum albumin + 0.005 x peripheral lymphocytes) as a prognostic indicator and determinant of multimodal treatment for 30 gynecological patients (control group: 12 patients with gynecological benign disease; good prognostic group: 10 with more than two-year survival having gynecological cancer; poor prognostic group: 8 with less than one-year survival having gynecological cancer). It was concluded that 1) PNI of the poor prognostic group was significantly lower than that of good prognostic group and control group (p < 0.01); 2) PNI is effective as a prognostic indicator; and 3) PNI is useful in clinical practice as a determinant of the multimodal treatment and high risk group.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[Multimodality treatment of thoracic esophageal carcinoma].

Current multimodality treatment of thoracic esophageal carcinoma in our institution was described. The rate of superficial carcinomas is increasing in recent years, and they are treated by endoscopic mucosal resection (EMR), transhiatal esophagectomy (THE) or with the thoracotomy approach. Treatment is based on precise diagnosis of the depth of cancer invasion and nodal involvement using endoscopy with endoscopic ultrasound (EUS). Three-field lymphadenectomy for thoracic esophageal carcinoma, including superficial one, was started in 1983 as a standard operation, and its indications have been gradually decreasing for the past 10 years. As a result of accurate, individualized treatment, life table analysis revealed no significant difference between 2- and 3-field lymphadenectomy. Multimodality treatment of advanced cases is mainly composed of 3-field lymphadenectomy. Adjuvant chemotherapy of systemic therapy is regarded as more important than concurrent irradiation of local therapy. Recently powerful chemotherapy is becoming more frequent pre- or postoperatively. Our routine regimen is CDDP and infusional 5-FU with leucovorin as a biochemical modulator.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Multimodality therapy in locally advanced cervical cancer.

In the past decade, neoadjuvant and concomitant multimodality therapies have been studied in patients with cervical cancer. The past year has witnessed more pilot studies confirming the feasibility of multimodality therapy. It is now time to move to prospective randomized clinical trials to determine the effects on disease-free intervals, to examine survival rates, and to define the ideal chemotherapeutic regimen and relationship to radiation therapy or surgery.

Chemotherapy, Adjuvant↗
PubMed1993

Multimodality treatment in the management of locally advanced breast cancer.

Forty-two patients with locally advanced breast cancer were treated with multimodality therapy comprising neoadjuvant chemotherapy (cyclophosphamide, vincristine, doxorubicin and prednisolone) and radiotherapy to the breast and lymph-draining areas, followed by tamoxifen and then selective surgery. The objective response rate (UICC criteria) of the primary tumours to chemotherapy alone was 72%, which increased to 83% following radiotherapy. The patients have been followed up for 13-56 months and the probability of local control at 36 months was 0.83. The probabilities of distant disease-free survival and overall survival were 0.50 and 0.65 respectively, at 36 months. However, if the patients' breast cancers had shown a response to chemotherapy/radiotherapy then the distant disease-free survival and overall survival of these subgroups of patients were 0.61 and 0.83 respectively, at 36 months. Toxicity included nausea, vomiting, alopecia, and peripheral neuropathies (two patients), but with no episodes of severe infection or bleeding. This multimodality therapy has achieved good local control and satisfactory overall and distant disease-free survivals with excellent patient compliance.

Adult↗
PubMed1993

[The diagnostic value of nuclear magnetic resonance tomography, multimodal evoked potentials and cerebrospinal fluid examination in multiple sclerosis].

Seventy patients with multiple sclerosis (according to Poser's criteria) were clinically assessed and examined with MRI, multimodal evoked potentials (VEP, AEP, SSEP) and CSF analysis (transformed lymphocytes, IgG-Index, oligoclonal banding). In relation to the clinical criteria of McAlpine 40 patients had possible, 16 patients probable and 14 patients definite MS. 81% of the patients (73% possible MS, 94% probable MS, 93% definite MS) had multiple white matter lesions detected by MRI, 79% (78% possible MS, 94% probable MS, 64% definite MS) had an abnormal CSF profile and 67% (60% possible MS, 75% probable MS, 79% definite MS) abnormal results in multimodal EP testing. Of the patients who experienced only one attack (n = 40) 78% had multiple lesions on MRI, 88% had abnormal CSF-findings and 60% had pathologic EPs. Patients with two or more attacks showed in 87% multiple lesions on MRI, in 77% abnormal EPs and in 70% abnormal CSF findings. The number of abnormal MRI and EPs increases with the duration of the disease. 13 patients with a normal MRI were discussed separately. MRI is the most sensitive method in detecting the spatial pattern of disseminated lesions. To monitor the dissemination over time a careful clinical follow-up is still mandatory.

Adolescent↗
PubMed1995

Interpretation of multimodal medical images using connectionist and variational methods.

Our medical objective is to match multimodal 3D medical images into a coherent model of the patient, from which diagnosis can be assessed and therapeutics guided. 3D image segmentation is absolutely necessary to reach this objective. We investigate two complementary approaches for segmenting 3D medical images. First we present some definitions, basic properties and recent theoretical results about formal neural networks, and show that these results can be applied to brain tumour segmentation. A variational approach (called the 'snake spline' method) is then detailed. We finally show how segmented 3D images can be used for multimodal image matching.

Algorithms↗
PubMed1995

Multimodality therapy including surgical resection for limited small cell lung cancer.

From 1975 through 1990, 199 patients with limited small cell lung cancer (LSCLC) were subjected to multimodality treatment including surgical resection combined with chemotherapy or chemoradiotherapy in our department. The median postoperative survival time of the 199 patients was 39 months, and the 5-year survival rate was 26%, which was decreased with increase of tumor-stage. In comparison of the survival time of patients in Stage I and those in Stage IIIa, there was a significant difference (P < 0.01). There were no significant differences in survival rate of 3 and 5 years between the patients receiving chemotherapy prior to or after surgical resection. The improvement in survival was documented by surgical resection combined with chemotherapy or chemoradiotherapy for LSCLC. The effect of multimodality treatment is correlated with tumor P-TNM staging, the involvement of lymph node, especially that of the mediastinal lymph node, is a negative factor influencing the prognosis. Surgical resection is an initial management, followed by chemotherapy or chemoradiotherapy may be indicated in LSCLC patients of Stage I, Stage II and some Stage IIIa as the cancer can be resected completely.

Adult↗
PubMed1995

Principles of multimodal imaging.

Current medical practice deals with a variety of multimodal information (X-ray film, ultrasound, CT, MR, ECG and EEG, laboratory results, medical records, etc.) Diagnosis and treatment demand an integrated view of this information including the patient's record and history. This paper describes multimodal imaging approaches to such a system with regard to (i) user interface, (ii) data management (including access control), (iii) registration and modality matching based on reference models, and (iv) interface to the modalities.

Data Display↗
PubMed1997

Significance of multimodality evoked potential abnormalities in sarcoidosis.

To assess central nervous system (CNS) involvement with normal CNS examination, multimodality evoked potentials were obtained in 25 patients with confirmed multisystem sarcoidosis. Twelve patients had abnormal evoked potentials: brainstem auditory evoked potentials (BAEP) were abnormal in 5, median nerve somatosensory evoked potentials (SEP) were abnormal in 4, and visual evoked potentials (VEP) were abnormal in 6 patients. Contrast-enhanced magnetic resonance imaging (MRI) of the brain in two patients with abnormal evoked potentials revealed no supportive structural lesions. Multimodality evoked potentials can detect subclinical neurosarcoidosis and are an important adjunct to neuroradiology in the diagnosis of neurosarcoidosis.

Adult↗
PubMed1997

A forty-year experience with anal carcinoma: changing trends and impact of multimodality therapy.

Anal canal carcinoma is a rare clinical entity accounting for 1 to 3 per cent of all gastrointestinal malignancies. Abdominoperineal resection used to be the primary modality of treatment. However, recurrence rates of 20 to 40 per cent were observed after this mutilating procedure. In recent years, multimodality therapy with radiation and chemotherapy has shown at least equal results with the intention to preserve sphincter function. The objective of this study is to describe our experience at Harbor-UCLA Medical Center during the past 4 decades (1955-95), emphasizing changes in demographics, clinical presentation, and impact of multimodality therapy. Seventy-eight patients with the diagnosis of anal canal carcinoma were included. A steady increase in the incidence of anal carcinoma in younger people was observed (24% less than 64 years old for the 1955-65 period versus 75% for 1986-95 period). A female predominance was found in 1955-65 period, with F:M ratio 1.5, and a majority of male cases was seen in the last period (1986-95). Abdominoperineal resection was the preferred treatment during 1955-65, whereas during 1986-95 chemoradiation was the treatment of choice. We observed a trend from primary surgical treatment toward chemoradiotherapy with improvement in survival and preservation of ano-rectal function. Since 1988, we have not performed an abdominoperineal resection for primary treatment of anal carcinoma. Survival analysis was made grouping the patient population according to primary treatment. Higher survival rates were observed in the groups that received chemoradiotherapy (P = 0.0368) either as adjuvant or primary therapy. Chemoradiotherapy should be recommended as primary therapy to most patients.

Abdomen↗
PubMed1997

Extrapleural pneumonectomy in the setting of multimodality therapy for diffuse malignant pleural mesothelioma.

Diffuse malignant pleural mesothelioma, a rare disease, is characterized by an aggressive local behavior and scant response to therapy. The first series using single modality therapy showed failure in terms of survival and local control. More recently, multimodality therapy has been used against this disease with better results, but still with more room for substantial improvement. The current multimodality series reported are isolated, single-institutional experiences with different treatment schemes, using different staging systems, most of which have not been validated. There is an enormous need for multiinstitutional prospective trials to evaluate the current treatment schemes in light of the steady increase in the incidence of this lethal tumor. The trimodality therapy used at the Brigham and Women's Hospital for selected patients is described.

Adult↗
PubMed1998

Complications of multimodality therapy.

Multimodality therapy may further increase treatment-related complications. However, such therapy may be necessary for advanced or biologically aggressive tumors, and information gained from patient entry into prospective trials may attenuate current and future treatment-related complications. Ad hoc use of multimodality therapies is generally not recommended.

Antineoplastic Agents↗
PubMed1997

The roles of multimodality treatment and lymphadenectomy in the management of esophageal cancer.

PURPOSE: To review the current status of multimodality treatment and lymphadenectomy in the management of esophageal cancer. DATA SOURCES: Literature review. STUDY SELECTION: Multimodality treatment and lymphadenectomy in esophageal cancer. DATA EXTRACTION: Results in research papers published selected by literature search. RESULTS: Numerous studies have been carried out attempting to define the roles of various neoadjuvant or adjuvant regimens in the treatment of esophageal cancer. These included the use of radiotherapy or chemotherapy alone or in different combinations, with or without surgical resection. Randomized trials have failed to show significant improvement compared with surgical resection alone, although downstaging of disease and benefits on subgroups of patients could be demonstrated. Whether the extent of resection can influence outcome was tested by varying the surgical approach, and by increasing the extent of lymphadenectomy. Although indirect evidence exists suggesting more extensive resection may improve long term prognosis, definitive proof is lacking. CONCLUSIONS: More well organized randomized controlled trials are needed to further elucidate the roles of these approaches in the treatment of esophageal cancer.

Combined Modality Therapy↗
PubMed2026

Integrating histology and spatial transcriptomics via multimodal transformers and contrastive representation learning for accurate gene expression prediction.

Predicting spatial gene expression from Histological images is a fundamental task in understanding tissue organization and molecular phenotypes. However, existing methods often rely on single-model representations or lack effective alignment between image and transcriptomic features. To address these limitations, we propose a unified multimodal learning framework that integrates histological imaging and spatial transcriptomics through a shared latent representation space. Specifically, histological H&E images are encoded by a ResNet50-based convolutional stem and a MobileViT Transformer backbone to extract hierarchical visual representations. Both modalities are projected into a shared latent space via linear-GELU-dropout transformation blocks, enabling cross-modal alignment through a contrastive learning objective that maximizes agreement between the corresponding image and the spot embeddings. Experimental results on the 10x Genomics Visium dataset of human liver tissue demonstrate that MViTGene achieves significantly higher prediction accuracy than existing methods across multiple gene subsets, with improvements of 20%, 33%, and 12% in predicting marker genes, highly expressed genes, and highly variable genes, respectively. The significant improvement in relevance indicates that the model can more accurately capture the true correspondence between tissue morphology and gene expression, therefore enabling more reliable biological interpretation. It provides a computational tool for high-throughput spatial gene expression prediction that balances performance and interpretability.

Humans↗
PubMed2002

Response to commentary on the multimodal treatment study of ADHD (MTA): mining the meaning of the MTA.

In the December 2000 issue of the Journal of Abnormal Child Psychology, we published a set of papers presenting secondary analyses of the Multimodal Treatment Study of ADHD (MTA), and R. A. Barkley (2000) provided a commentary. A critique of the design of the study (MTA Cooperative Group, 1999) was presented based on a theoretical perspective of a "behavioral inhibition" deficit that has been hypothesized as the core deficit of ADHD (R. A. Barkley, 1997). The commentary questioned the design and analysis of the MTA in terms of (1) the empirical criteria for selection of components of behavioral (Beh) intervention, (2) the effectiveness of the Beh intervention, (3) the methods for analyses at the group and individual level, (4) implications of the MTA findings for clinical practice, (5) the role of genetics in response to treatment, and (6) the lack of a nontreatment control group. In this response, we relate the content of the papers to the commentary, (1) by reviewing the selection criteria for the Beh treatment, as outlined by K. C. Wells, W. E. Pelham, et al. (2000), (2) by addressing the myth that the MTA Beh treatment was ineffective (Pelham, 1999), (3) by describing the use of analyses at the level of the individual participant, as presented by J. S. March et al. (2000) and W. E. Pelham et al. (2000) as well as elsewhere by J. M. Swanson et al. (2001) and C. K. Conners et al. (2001), (4) by relating some of the suggestions from the secondary analyses about clinically relevant factors such as comorbidity (as presented by J. S. March et al., 2000) and family and parental characteristics (as presented by B. Hoza et al., 2000, S. P. Hinshaw et al., 2000, and K. C. Wells, J. N. Epstein, et al., 2000), (5) by discussing the statistical concept of heritability and the lack of a significant difference in the presence of ADHD symptoms in parents of the MTA families compared to parents in the classmate-control families (as presented by J. N. Epstein, et al., 2000), and (6) by acknowledging that an ethically necessary weakness of the MTA design is that it did not include a no-treatment control group. We discuss the use of secondary analyses to suggest how, when, and for what subgroups effectiveness of the Beh treatment may have been manifested. Finally, we invite others to use the large and rich data set that will soon be available in the public domain, to perform secondary analyses to mine the meaning of the MTA and to evaluate theories of ADHD and response to treatments.

Attention Deficit Disorder with Hyperactivity↗
PubMed2026

Breaking the Debilitating Cycle: Pathophysiology, Assessment, and Multimodal Intervention of Secondary Debilitation After Hip Fracture in Older Adults-A Narrative Review.

Hip fractures pose a serious threat to the quality of life among older adults and impose a heavy burden on both society and families. Although current surgical techniques for hip fractures have become increasingly refined, postoperative quality of life and overall function in older adult populations often steeply decline. This decline is marked by "secondary debilitation," characterized by exacerbated sarcopenia, functional impairment, and physiological reserve depletion-a process that becomes a risk factor for recurrent fractures, creating a "vicious cycle" with hip fractures. This article provides a comprehensive overview of the pathophysiological mechanisms underlying "secondary debilitation," discusses the clinical application of risk assessment tools, and presents a phased, stepwise intervention strategy aimed at interrupting the "vicious cycle." The strategy includes early rapid rehabilitation, nutritional support, and prevention of complications; a mid-phase multimodal approach involving multidisciplinary management, comanaged wards, fracture liaison services, and systematic rehabilitation; and, finally, late-phase exploration of emerging pharmacotherapies and treatment methods. This review seeks to offer an evidence-based foundation for optimizing clinical risk assessment and developing precise interventional strategies.

Humans↗