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At least 1,441 records · Page 80Linked to original sources
PubMed1981

Multimodal treatment of primary breast carcinoma: analysis of accomplishments and problem areas.

The management of primary breast carcinoma has undergone a successful change during the decade of the 1970s. Chemotherapy administered after mastectomy in patients with involved axillary nodes has not only prolonged disease-free survival in certain patient groups but has lengthened their over-all survival in comparison to patients treated with mastectomy alone. The concepts for use of chemotherapy after surgery, established in murine tumor models, have been extended to human subjects with breast cancer and proved of value. It remains to be determined which drug regimens have the best therapeutic index and which are most useful in specific subgroups of patients. Other breast carcinoma patients besides those with involved axillary nodes may also benefit from this surgery-plus-chemotherapy mode of treatment. We review the past, present and future clinical trials of chemotherapy after mastectomy and discuss the various aspects which bear on their successes and failures.

Antineoplastic Agents↗
PubMed1984

Multimodality preoperative treatment for advanced cancer of the head and neck.

Neoadjuvant induction chemotherapy with cisplatin, methotrexate, and bleomycin appears to improve the results of treatment of advanced stage IV head and neck cancer, compared with results in historical control subjects. Patients treated with induction chemotherapy and radiation therapy had a 29 percent overall survival rate at 3 years, which represents approximately a twofold improvement in the survival rate. Patients who were treated with chemotherapy and radiation therapy followed by surgery had more than a threefold increase in the survival rate (49 percent at 3 years), compared with historical data from our institution and elsewhere for such patients [9-11]. Distant metastases developed in 25 percent of the patients, and it thus appears that long-term, effective consolidation and maintenance chemotherapy [12,13] need to be developed for patients who receive combination therapy before surgery for head and neck cancer.

Actuarial Analysis↗
PubMed1982

Bilateral and multimodal sensory interactions of single cells in the pigeon's midbrain.

Standard microelectrode recording techniques were employed to monitor single unit activity in the pigeon's nucleus intercollicularis and medial substantia grisea et fibrosa periventricularis in response to visual, tactile and auditory stimuli. Approximately 40% of the units were driven exclusively by visual stimuli, 8% by tactile stimuli, 47% by both visual and tactile stimuli and a very small percentage by auditory stimuli. Visual receptive fields were generally excitatory in the contralateral eye and suppressive in the ipsilateral eye. Most units were movement selective and some demonstrated direction sensitivity, summation and habituation. Units were generally insensitive to stimulus shape or contrast reversal. Somatosensory receptive fields were located on both sides of the body and were either excitatory or suppressive or both. Ipsilateral visual and somatosensory bimodal inputs were most often of the same sign while ipsilateral visual and contralateral somatosensory bimodal inputs tended to be of opposite sign. Visual and somatosensory receptive field locations of bimodal units tended to be in register.

Animals↗
PubMed1990

Interactions of visual and auditory mossy fiber inputs in the paraflocculus of the rat: a gating action of multimodal inputs.

We have demonstrated previously that visual and auditory inputs reach the rat paraflocculus via dorsolateral pontine gray from the secondary regions of the visual and auditory cortices. It has also been demonstrated that mossy fiber responses can be evoked to physiological acoustic stimuli in unanesthetized preparations. In this study, we investigated the interaction of auditory and visual inputs in the paraflocculus. Activity of parafloccular neurons was recorded in immobilized, locally anesthetized hooded rats. Selected images and tones were presented to animals. Orientation, position, and velocity of visual stimuli and different parameters of acoustic stimuli were controlled by a computer. Visual and auditory stimuli were also presented in combination or in different temporal sequences. We discovered that visual and auditory stimuli have coextensive termination zones in paraflocculus, and influence the same neurons in 60% of the cases. Combined auditory and visual stimuli produced synergistic responses in parafloccular neurons in comparison with single modality stimuli. Augmentation of responses could be observed even when one of the stimuli was subthreshold and did not alter per se the neuronal activity. Our findings suggest that within the cerebro-cerebellar system, subthreshold inputs are capable of powerful control over the neuronal activity and may alter responses to subsequent stimuli when properly biased by inputs from paired modalities.

Acoustic Stimulation↗
PubMed1992

A multimodality approach lengthens warm ischemic time during aortic cross-clamping.

To evaluate the effects of exsanguination, cerebrospinal fluid drainage (CSFD), steroids alone and in conjunction with CSFD on spinal cord perfusion pressure (SCPP), and neurological outcome following 70 min of normothermic spinal cord ischemia, we monitored proximal (Px BP) and distal (Ds BP) aortic blood pressure, cerebrospinal fluid pressure, and somatosensory evoked potentials (SEP) in 29 mongrel dogs. In all animals Px BP during aortic cross-clamping was controlled with partial exsanguination (40-50% circulating blood volume). Dogs were randomized into four groups (gp): gp 1 (n = 6) control; gp 2 (n = 8) steroids only (methylprednisolone 30 mg/Kg 10 min before aortic occlusion and 4 hr later); gp 3 (n = 8) CSFD only; gp 4 (n = 7) steroids and CSFD. Partial exsanguination effectively controlled Px BP during aortic cross-clamping in all groups. After the statistically significant decrease from preclamp values, mean Px BP did not differ among groups (78.9, 81.2, 80.5, and 80.3 mm Hg, respectively, P greater than 0.05). Mean Ds BP decreased from systemic values to 12.6, 16.8, 16.7, and 17 mm Hg, respectively, after aortic occlusion (P less than 0.05); these values did not differ from one another. CSFP did not change significantly from its baseline value while the aorta was cross-clamped in gp 1; CSFP was significantly reduced to 6.2 mm Hg in gp 2, steroid-treated animals (P less than 0.05 vs gp 1); a further significant reduction in CSFP was noted in gp 3 and 4 undergoing CSFD (0.07 and 0.67 mm Hg, respectively, P less than 0.05 vs gp 1 and 2).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Differentiation between cortical and subcortical lesions following focal ischemia in cats by multimodality evoked potentials.

Regional ischemia was induced in cats by occluding the middle cerebral artery. Evoked and spontaneous electrical activity as well as regional cerebral blood flow (rCBF) were recorded with platinum depth macroelectrodes in three primary cortical areas: the auditory cortex (A, middle ectosylvian gyrus) and the front and hind limb somatosensory cortex (SF and SH, lateral and medial posterior sigmoid gyrus). To distinguish among the various evoked potentials after click, median or tibial nerve stimulation, electrical field interactions had to be eliminated using a multiplex stimulation and analysis system. Spontaneous electrocortical activity was evaluated by power spectral analysis. In all areas, evoked potentials were abolished 10 min after arterial occlusion. However, rCBF behaved differently in these regions: it was severely reduced in A, decreased moderately in SF and remained unchanged in SH. The graded reduction of rCBF in the three cortical areas was related to changes in electrophysiological activity during the first minutes of ischemia. In A, auditory potentials were abolished within 3 min after occlusion, whereas in SH, the decrease of somatosensory responses started after about 5 min. In SF, two components of the EP changes were found: an early decrease immediately and a later decrease about 5 min after occlusion. The different rates of EP impairment possibly correspond to two types of ischemia. The fast EP abolishment seems to be caused by local cortical damage whereas the delayed EP decrease probably reflects impairment of subcortical white matter structures. Thus, this method may be useful for distinguishing between gray and white matter ischemia.

Acoustic Stimulation↗
PubMed1986

Multimodal sensory discrimination deficits in Korsakoff's psychosis.

A consistent impairment in odor identification was observed among a group of 21 amnesic patients, diagnosed as having Korsakoff's psychosis. In a subsequent study of eight Korsakoff and matched alcoholic control subjects, a comparable olfactory deficit was again demonstrated, as well as impairment in color discrimination and auditory perception. No such deficit was observed for a picture identification task designed to control for the non-sensory demands of the olfactory test. Stepwise multiple regression analysis showed a significant correlation between odor identification scores and the concentration of the primary metabolite of norepinephrine in lumbar cerebrospinal fluid. The data demonstrate a consistent coincidence between memory impairment and deficient sensory perception among patients with Korsakoff's psychosis.

Adult↗
PubMed1993

Multimodality imaging of cervicofacial actinomycosis.

Actinomycosis is an uncommon chronic disease usually caused by Actinomyces israelii. It affects the soft tissue mainly but sometimes spreads to involve salivary glands, bone, or even the skin of the face and neck. Five cases have been seen in our department. Several imaging modalities were used to assist in making the diagnosis. The cases are presented and the literature reviewed. Ultrasonography was found to be a useful diagnostic tool especially in developing the differential diagnosis.

Actinomycosis↗