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At least 649 records · Page 36Linked to original sources
PubMed2004

Controversies on minimally invasive procedures for radio-guided surgery of parathyroid tumours.

The definitive treatment of primary hyperparathyroidism (PHPT) is the surgical approach which traditionally consists of bilateral neck exploration with visualization of at least 4 parathyroid glands and removal of the enlarged ones. However, the most frequent cause of PHPT is a solitary parathyroid adenoma so that a limited neck exploration in order to remove the solitary adenoma alone appears adequate to many surgeons. The recent significant improvements achieved in the pre-operative parathyroid localization techniques, mainly the parathyroid scintigraphy, and the introduction in surgical practice of measurement of quick parathyroid hormone, endoscopic procedures, and intra-operative gamma probes used together specific radiopharmaceuticals allowed to offer the PHPT patient a limited neck exploration as the unilateral neck exploration and the minimally invasive parathyroidectomy. The present article deals with the role of the intra-operative gamma probes used together with specific radio-pharmaceuticals, discussing the principal advantages and disadvantages of each currently used radio-guided approach.

Adenoma↗
PubMed2005

[Guidelines for radio-iodine (131I) therapy in Graves' disease and thyroid cancer].

Radio-iodine (131I) therapy has been using in Graves' disease and well differentiated thyroid cancer. The rules of control in the discharge from radio-isotope hospital were notified in 1999 in Japan. Guideline of the 131I therapy in Graves' disease and thyroid cancer were prepared by sub-group of Japanese Society of Nuclear Medicine.

Graves Disease↗
PubMed2005

Iso-osmolar radio contrast iodixanol in patients with chronic kidney disease.

BACKGROUND: Although radio contrast volume has been associated with worsening post-procedural kidney function, this relationship has not been extensively studied using an iso-osmolar contrast agent in chronic kidney disease patients. METHODS: We retrospectively studied patients undergoing cardiac catheterization at the University of Minnesota from 2000 to 2004, using the iso-osmolar contrast agent, iodixanol. All patients were included who had calculated creatinine clearance (CCR) < 60 mL/min, not on dialysis, and serum creatinine measured on the same day and within 7 days after the procedure. Comparison of a subgroup with severe chronic kidney disease and diabetes mellitus was compared to a similar historical control group that used the low-osmolar contrast agent, iohexol. RESULTS: Serum creatinine and CCR were 2.9 +/- 1.5 mg/dL and 33.4 +/- 12.0 mL/min (mean +/- standard deviation), respectively, at baseline in 117 cases. Peak creatinine increased by 0.03 +/- 0.7 mg/dL after 84.3 +/- 67.3 mL of iodixanol was used. Contrast-induced nephropathy definition was fulfilled in 22 (18.8%) cases. A non-significant negative correlation was found between the volume of iodixanol and the change in creatinine (r2 = 0.0011, p = 0.7254). A subgroup with severe chronic kidney disease and diabetes mellitus with iodixanol had a significantly lower creatinine increase (n = 25, 0.09 +/- 0.5 mg/dL), compared to historical controls (n = 42, 0.7 +/- 0.8 mg/dL) with iohexol (p < 0.001). A non-significant positive correlation between volume of contrast and change in creatinine was found in this subgroup who received iodixanol (n = 25, r2 = 0.0756, p = 0.1835), but was significant in the historical controls who received iohexol (n = 42, r2 = 0.135, p = 0.017). CONCLUSIONS: The volume of iso-osmolar radio contrast does not affect the incidence of contrast-induced nephropathy in patients with chronic kidney disease. A randomized trial evaluating the incidence of contrast nephropathy would verify the safety of ad hoc versus staged angiographic procedures in this population.

Adult↗
PubMedDate not supplied

Superior vena cava replacement in thymic tumours treated with radio-chemotherapy.

From 1987 to 2000 108 patients were operated on for thymic tumours. Two of these underwent replacement of the superior vena cava with polytetrafluoroethylene prostheses because the tumours invaded the superior vena cava. One of these was affected by myasthenia gravis, and was treated preoperatively with concurrent radio-chemotherapy and lymphocytopheresis. The other received preoperative chemotherapy and post-operative radio-chemotherapy because of minimal residual disease. The clinical courses of the two patients are reported here and we conclude that eradication of thymic malignancies is suitable even when superior vena cava replacement is required, and that neither antimyasthenic therapy nor adjuvant and/or neoadjuvant treatment interfere with aggressive surgical management or vice versa. Moreover, the long-term survival of one of these patients despite relapse of disease shows that extended surgery is indicated in these cases.

Adult↗
PubMedDate not supplied

Predictive biological markers for response of invasive breast cancer to anthracycline/cyclophosphamide-based primary (radio-)chemotherapy.

BACKGROUND: The role of biological markers for the prediction of neoadjuvant chemotherapy and radio-chemotherapy may be evaluated using pathological complete response [pCR] in patients with invasive breast cancer. MATERIALS AND METHODS: To investigate this, pre-treatment biopsies from 517 patients with locally advanced breast cancer were analyzed for expression of estrogen receptor [ER], progesterone receptor [PgR], Her-2/neu, epidermal growth factor receptor [EGF-R], p53, Bcl-2 and MIB-1 by immunohistochemistry [IHC], and these data were compared to the pathological response after preoperative epirubicine/cyclophosphamide [EC] chemotherapy (+/- radiotherapy). RESULTS: pCR was more frequent (28.30%, 56/198) in tumors that received radio-chemotherapy compared to chemotherapy alone (11.9%, 38/319, p < 0.0001). Patients with high grading, lower ER, PgR, Bcl-2 or a higher proliferation had a significantly greater benefit from chemotherapy. The overexpressions of Her2/neu or EGF-R were weakly correlated to pCR, while p53 staining did not have any predictive value. Younger patients, with negative PgR and high proliferation index, had the highest benefit from EC therapy (56% pCR). The different multivariate indices of binary regression, PLS-DA and SIMCA, had similar predictive quality and were slightly superior to univariate factors. CONCLUSION: This study emphasizes the value of traditional biological markers and Bcl-2 for use in the individual selection of a primary therapy regimen.

Adult↗
PubMedDate not supplied

Plasma radio-frequency-based diskectomy for treatment of cervical herniated nucleus pulposus: feasibility, safety, and preliminary clinical results.

BACKGROUND AND PURPOSE: Several techniques, including chymopapain, mechanical aspiration, laser-based disk decompression, and endoscopic keyhole surgery, have been proposed as minimally invasive alternatives to fusion for treating cervical disk herniation, though none has gained wide acceptance. The purpose of this study was to assess feasibility, safety, and preliminary clinical results of percutaneous plasma-mediated radio-frequency-based diskectomy for cervical disk herniation. METHODS: Patients (N = 55) with cervical soft disk protrusion were treated over a 29-month period. They had radicular pain; 3 patients also had moderate myelopathy. The procedure was performed with the Perc-DC SpineWand by using an anterior approach. Most cases were conducted with local anesthetic on an outpatient basis. Clinical outcomes were graded by using the Macnab criteria. RESULTS: At 2 months, outcomes were good or excellent in 44/55 (80%) patients; the success rate was similar at 6 months, when 44 (85%) patients (n = 52/55) had good or excellent results. One clinically relevant complication (infectious diskitis) occurred within the first month postprocedure and was successfully treated. One technical complication (in situ rupture of the device tip) was observed; however, the patient remained asymptomatic during the 2-year follow-up. The 3 patients with clinical myelopathy experienced regression of cord compression symptoms; MR imaging in 2 patients showed morphologic evidence of reduction of cord compression. CONCLUSIONS: Plasma radio-frequency-based diskectomy in the cervical spine appears to be a minimally invasive low-risk approach, which is easy to perform, associated with only minimal discomfort to the patient, and effective in the short term.

Adult↗
PubMed2006

[A case of an elderly patient having advanced hepatocellular carcinoma with tumor thrombus in the inferior vena cava treated with chemo-radio-therapy--intraarterial infusion of weekly high dose 5-FU (WHF)].

The patient was an 81-year-old man, diagnosed with advanced huge hepatocellular carcinoma (HCC) with tumor thrombus extending into the inferior vena cava (Vv3), for which resection was judged impossible. The radio therapy (51 Gy) for tumor thrombus was carried out, and he received a weekly hepatic arterial infusion therapy (weekly high-dose 5-fluorouracil (5-FU)) for these legions. After 8 cycles, the CT scan revealed a minor response of the tumor (SD), and,the tumor marker reduced. After 10 months, these legions had markedly regressed (PR), the tumor thrombus in the inferior vena cava was not detectable. There were no severe side effects. Ten months since the start of chemo-radio therapy, the positron emission tomography (PET) revealed a metastatic tumor of the femoral bone in recurrence. In conclusion, some elderly patients of advanced HCC with tumor thrombus may obtain a long term survival through this treatment.

Aged, 80 and over↗
PubMed1991

[Treatment of N2-3 pulmonary carcinoma. Preoperative radio-chemotherapy].

Preoperative integrated neo-adjuvant radio-chemotherapy was performed in 8 patients suffering from NSCLC bronchial carcinoma at stages IIIA-IIIB (N3 mediastinal). After treatment, 7 patients underwent apparently radical pulmonary exeresis, whereas the patient with adenocarcinoma (T2 N2 M0) was not operated due to the recurrence of disease following supraclavicular lymph node metastasis. Preoperative radio-chemotherapy allows the sub-staging of the disease and the insertion of these patients into the operating programme.

Adult↗
PubMed1990

[Dissolution and radio-opacity of apatite cement].

Dissolution and remineralization behaviors of self-setting apatite cement is organic acids and synthetic saliva and the effect of barium apatite (BaAp)on physicochemical and mechanical properties of the apatite cement were investigated. One-week solubility of several types of apatite cement was considerably smaller than that of commercially available dental cements in 1 mM of acetic, lactic and citric acids (pH4.0 at 37 degrees C). For example, the one-week solubility in citric acids was less than 4.5%. To investigate the dissolution behavior of the apatite cement in detail, two types of 45Ca labeled apatite cement were prepared. In one, the seed apatite was labeled with 45Ca(45Ca-HAp cement) and in the other the matrix apatite was labeled with 45Ca through use of 45Ca-DCPD (45Ca-DCPD cement). Solubility, estimated from the concentration of 45Ca released in 1mM of the organic acid was approximately zero for 45Ca-HAp cement, whereas the solubility of 45Ca-DCPD cement was similar to that of unlabeled cements. This suggests cat dissolution of the matrix apatite governs dissolution of the set cement. In synthetic saliva, the solution phosphate decreased with time once the set cement was introduced to the solution, whereas the solution calcium increased. The former finding suggests that some phosphate compounds precipitated in the synthetic saliva and the latter finding indicates that some portion of the set cement dissolved. The thermodynamic analysis of the solution compositions strongly suggests that remineralization is a major process and dissolution a minor one. In fact, in systhetic saliva labeled with 45Ca having a degree of supersaturation with respect to apatite comparable to rest saliva, 45Ca concentration in solution decreased once the cement pellet was introduced. This finding clearly suggests that the set apatite cement has the ability to remineralize but not to dissolve in synthetic saliva even if the degree of supersaturation with respect to apatite is relatively low. Addition of barium hydroxyapatite (BaAp) successfully bestowed clinically acceptable radio-opacity to the apatite cement. To accelerate the setting reaction which was retarded by Ba2+ released from BaAp at a lower pH during the first stage of spatulation, calcium hydroxyapatite (CaAp) was added to the cement mixture. At 20wt% of BaAp and 20wt% CaAp, the setting reaction proceeded at a neutral or weak alkaline pH, which is one of the most promising aspects of the apatite cement. The cement spaturated at L/P = 0.4 set within 10 minutes and its radio-opacity was comparable to or more than that of tooth enamel.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetates↗
PubMed1990

Identification of malignant cell clones in radio-induced murine thymic lymphomas by viral and cellular probes.

The role of B ecotropic recombinant retroviruses in the emergence and the progression of radio-induced thymic lymphomas was evaluated by analyzing the cell populations present in nine primary and in in vivo propagated tumors. For this, tumor DNAs were analyzed by the Southern method using probes specific for newly acquired proviral sequences, T-cell receptor beta-chain, and immunoglobulin heavy chain genes. Our results show that primary radio-induced tumors are composed of several tumoral cell clones but do not support that malignant cell transformation and proliferation are conferred, solely, by the newly acquired ecotropic recombinant retroviral sequences.

Animals↗
PubMed1989

Radio-functional analysis of the cervical spine using the Arlen method. A study of 699 subjects. Part One: Methodology.

The authors describe successively the radiological technique and measurement method of Arlen's radio-functional analysis of the cervical spine, the characteristics of antero-posterior cervical spine mobility in a control population and the variations observed in these characteristics according to age and sex. A few typical diagrams of radio-functional analysis obtained in various types of pathology are offered as examples. The ease with the Arlen method can be used in routine practice; its diagnostic and prognostic value and its role in the follow-up of patients with cervical diseases or injuries are emphasized.

Adolescent↗
PubMed1987

Heterophyle antibodies causing false positive radio-immunoassay results. A case report.

A case report of falsely elevated serum hormone values measured by radio-immunoassay (RIA) is described. The radio-immunoassays concerned have a first antibody raised in rabbits and mostly a separation technique based on a second antibody-solid phase system. The presence of heterophyle (anti-rabbit) antibodies in patients' serum is proved.

Adrenocorticotropic Hormone↗
PubMed1988

[Radio frequency catheter ablation of the atrioventricular conduction system in a canine model].

Twenty dogs underwent catheter ablation of the AV conduction system with monopolar 300 KHz output to assess the efficacy and the safety of using radio frequency energy at catheter ablation. The energy (15 to 120 W) was delivered between the distal electrode and the back pad until 3 second after complete AV block, which was certified at ECG monitoring. Pathological observation was done with 7 dogs in 2 hours, 6 dogs in 4 to 7 weeks and compared with 10 dogs which underwent catheter ablation with DC energy. Complete AV block was achieved in 15 dogs and there was no return of AV conduction during observed period. The QRS complex of the escape rhythm was similar to those found in sinus rhythm in all dogs. Complete AV block was achieved only when the catheter was located where the H-V interval was longer than 26 msec at the His bundle electrogram before ablation. The damaged area was limited near His bundle and well delineated. AV node was intact in all dogs. Electron micrograph of the damaged areas in acute phase showed the swelling of mitochondria without broken cytoskeletal filaments, which indicate there were no mechanical shocks. There was no patchy fibrosis seen in chronic phase. I conclude that the catheter ablation of the AV conduction system with radio frequency energy is effective and safe, and the minimal damage of the tissue suggests the benefit and the possibility of clinical use.

Animals↗
PubMed1988

Effects of trypsin on the measurement of inactive renin in rat plasma by radio-immunoassay: decrease in inactive renin following nephrectomy.

We have examined the effect of trypsin treatment of rat plasma on the rate of angiotensin (Ang) I generation and measurement of this peptide by radio-immunoassay. Trypsin increased the renin incubation blank but did not alter the kinetics of the renin reaction with exogenous renin. The quantity of immunoreactive material detected in trypsin-treated plasma was not proportional to the volume of plasma assayed. Consequently, the level of inactive renin was dependent upon the volume of plasma subjected to the assay. This discrepancy occurred with two independent radio-immunoassay systems. The rate of Ang I generation was linear and significantly elevated following the addition of renin substrate to trypsin-treated plasma. However, if trypsin degradation of endogenous renin substrate was extensive and additional renin substrate was not provided, non-linear rates of Ang I generation occurred. Multiple additions of trypsin were necessary to activate maximally inactive rat plasma renin. Inactive renin accounted for 79 +/- 2% of the total enzyme activity in normal rats. Although active renin declined following bilateral nephrectomy, the ratio of active to inactive renin did not change. The data suggest that the kidney is the primary source of inactive renin in the normal rat.

Angiotensin I↗
PubMed1979

[Radio-immunometric determination of the ferritin for evaluation of the iron storage pool (author's transl)].

Seventy-three patients with several haematological diseases have been studied with radio-iron-kinetic, cyto-chemical measurement of iron in the bone marrow, and radio-immunometric determination of the ferritin in the serum. This method gives results which correlate significantly with other methods which evaluate the iron storage pool, in normal or iron-deficient patients. In some cases, an excess of serum ferritin, contrasting with normal serum iron, is confirmed by cytochemical and/or Fe-kinetic studies. In myeloproliferative diseases however, secretion of ferritin by immature cells may induce an excess of serum ferritin. In such cases, the dosage of ferritinaemia cannot be considered as an index of the iron storage pool. Future development of specific dosage of isoferritins could enable to measure the true iron stores, as well as to give an index estimating the evolution of the abnormal cell population.

Bone Marrow↗
PubMedDate not supplied

[Radio-chemotherapy of inoperable malignant brain gliomas].

Numerous studies have proved the benefit of the use of postoperative radiotherapy in the treatment of malignant cerebral gliomas. The data concerning the efficiency of the treatment of unoperated gliomas are rather scarce. The data obtained in 28 cases of malignant cerebral gliomas, defined as inoperable and treated with radio-chemotherapy, are reported. The diagnosis was obtained through radiological and bioptic examination (21 out of 28). Using a proper treatment with cortisone "dexamethasone" at a dose of 8-16 mg/day, with telecobaltotherapy, we have reached in almost all cases (26 out of 28) doses of 60 Gy, without significant side-effects. All patients were given BCNU as chemotherapy at a dose of 80 mg/m2 every 8 weeks. The resulting average survival rate of 36 weeks, verified through CT, confirms the validity of radio-chemotherapeutical treatment. This type of treatment has been proved useful not only for prolonging the life of these patients, but also improving the quality of their life.

Adult↗
PubMed1985

Congenital proximal radio-ulnar synostosis. Natural history and functional assessment.

We evaluated the cases of twenty-three patients with thirty-six congenital proximal radio-ulnar synostoses who had been followed between 1938 and 1984. None of the patients had had any attempt at surgical correction or any ipsilateral congenital anomalies. Emphasis was placed on analyzing the natural history of the lesion in these patients who had not been operated on, and on determining the effect of a fixed position of the forearm on function. Ten patients had unilateral and thirteen, bilateral synostosis. Their mean age when last examined was twenty-two years (range, three to fifty years). Eight patients were female and fifteen, male. The forearms were fixed in an average of 30 degrees of pronation. The position of the forearm was not found to be related to subjective functional limitations, employment status, or the results of the hand-function test of Jebsen et al. Most patients had few or no functional limitations, and were employed in jobs that demanded extensive use of the forearm. Contrary to the findings of other studies, we observed four distinct radiographic patterns based on the presence of an osseous synostosis and the position of the radial head. However, we noted no relationship between any of these patterns and function. We concluded that operative treatment of congenital radio-ulnar synostosis is rarely indicated, that less emphasis should be placed on the single factor of the position of the forearm, and that objective functional tests should be included in the assessment of these patients.

Activities of Daily Living↗
PubMed1985

Free and conjugated zeranol residues determined by radio-immunoassay in urine and plasma of calves treated with Forplix.

Anti-zeranol 7-hemisuccinate-bovine serum albumin was raised in rabbits. This antiserum was used in a radio-immunoassay of zeranol residues in urine and plasma of calves implanted with Forplix. The antibody was specific for zeranol but cross-reacted with its metabolite zearalenone and the mycotoxin zearalenone. Detection limits in plasma and in urine were 100 pg/ml and 1 ng/ml respectively. In veal calves treated with zeranol containing implant, no residues were detected in plasma even if plasma proteins were hydrolysed with pronase before the radio-immunoassay. Free and conjugated residues in urine were easily measured. The urine concentration of conjugated residues increased markedly after the 20th day of treatment and was still high (19 ppb) at day 40.

Anabolic Agents↗