Purpose The purpose of this study is to report the complications of superselective intra‐arterial chemotherapy with melphalan in children undergoing treatment for advanced intraocular retinoblastoma.
...Methods 49 eyes of 43 children with advanced intraocular retinoblastoma (Reese‐Ellsworth Group Vb or International Classification Group D) were treated with superselective intra‐ophthalmic artery infusion of melphalan. 22 eyes of 43 children were first diagnosis. 27 eyes of 43 children had previously failed traditional management with systemic chemotherapy and focal therapies and underwent intra‐ophthalmic artery infusion of melphalan as an alternative option to enucleation. Serial complications RETCAM images were collected.
Results Ophthalmic artery cannulation was successfully performed in 49 eyes of 43 patients. 9 eyes out of 43 (20.9%) patients were enucleated. 4 eyes out of 43 (9.3%) patients were lost to follow‐up. No severe systemic side effects occurred. Grade III neutropenia was seen in 3 patients (0.6%). No transfusions were required. 25 (58.1%) patients developed eyelid hyperaemia, 10 (23.2%) frontal region skin rash, 12 (27.9%) emiptosis, 6 (13.9%) eyelid edema, 2 (4.6%) frontal alopecia, 2 (4.6%) eyelashes loss, 2 (4.6%) chorioretinal atrophy, 1 (2.3%) acute ischemic optic neuropathy, all resolved spontaneously. 1 case (2.3%) with permanent ptosis underwent surgery. 1 case (2.3%) presented Roth’s spots.
Conclusion Ophthalmic intra‐arterial infusion with melphalan is a promising globe‐conserving treatment option in advanced retinoblastoma cases with minimal systemic side effects.
Background Extended resections (ER) for lung cancer may improve survival in selected patients. However, analysis on large series is still lacking. We reviewed our experience to identify prognostic ...factors useful for patient selection. Methods Between 1998 and 2010, 167 patients with involvement of one or more mediastinal organs underwent operations with the intent to perform ER. At thoracotomy, 42 patients (25%) were considered unresectable (explorative thoracotomy ET), and 125 (75%) underwent ER. The types of ER were superior vena cava in 43 patients (34.4%), carina in 33 (26.4%), combined with superior vena cava in 18 (14.4%), with the left atrium in 35 (28%), and with the aorta in 14 (11.2%). We excluded Pancoast tumors and vertebral resections. The minimum follow-up was 6 months. Kaplan-Meier method and log-rank test were used for statistical analysis of survival. Results There were 136 men (81.4%), with mean age of 63 years (range, 36 to 81 years). Of the 167 patients, induction chemotherapy was administered in 119 (71.3%), including 34 ET patients (81%) and 85 ER patients (68%). Complete resection was achieved in 106 patients (84.8%). The overall 5-year survival was 23% (27% in ER and 13% in ET, p = 0.41). Overall 30-day mortality was 4.8% and morbidity was 34.1%. Factors affecting survival were complete resection ( p < 0.01), pStage 0-I-II disease ( p < 0.0007), and age younger than 60 years ( p < 0.01). Conclusions ER for lung cancer invading mediastinal organs could improve long-term survival (46% at 5-years in pN0). The best surgical candidates are young patients without lymph nodes involvement who undergo radical resection. Multimodality treatment is suggested in case of mediastinal lymph node involvement.
Background The Glasgow prognostic score (GPS) is an inflammation-based score based on albuminemia and C-reactive protein concentration proved to be associated with cancer-specific survival in several ...neoplasms. The present study explored the immediate postoperative value of the GPS for patients undergoing pneumonectomy for lung cancer. Methods The value of the GPS preoperatively was studied in 250 patients undergoing pneumonectomy for non-small cell lung cancer (NSCLC). We analyzed overall postoperative complications, pulmonary and cardiac complications, 30-day postoperative death, reoperation for early complications, intensive care unit (ICU) length of stay and total length of hospital stay. Results Patients with a GPS of 0 and 1 had a mean ICU length of stay of 0.8 days, whereas patients with a GPS of 2 had a mean ICU stay of 5.0 days ( p = 0.004). The postoperative mortality rate in patients with a GPS of 2 was much higher than in patients with a GPS of 1 and 2, although it was not statistically significant ( p = 0.083). Conclusions A preoperative GPS of 2 effectively predicts a prolonged ICU stay in patients who undergo pneumonectomy for cancer. The score may be proposed as an easy-to-determine, economical, and fast preoperative tool to plan and optimize ICU admissions after elective pneumonectomy.
Giant orbital retinoblastoma: a case report HADJISTILIANOU, T; DE FRANCESCO, S; BORRI, M ...
Acta ophthalmologica (Oxford, England),
September 2010, 2010-09-00, Letnik:
88, Številka:
s246
Journal Article
Recenzirano
Odprti dostop
Purpose The authors report a case of giant orbital Retinoblastoma following primary enucleation for intraocular tumor. The presence of worms was documented inside the necrotic tumoral mass.
Methods ...The child was diagnosed with unilateral advanced retinoblastoma at the age of one month and enucleated. Chemotherapy and/or radiotherapy had no been performed. 3 months later a mass started growing in the anophthalmic socket and when the child arrived to our referral center the mass was as big as the child’s head. Complete excision of the mass and exenteration have been performed and the presence of worms has been documented in the necrotic part of tumor. Diagnostic workup included computed tomography (CT) and magnetic resonance (MR) of the head and orbit, bone scintigraphy, lumbar puncture with cell count and examination of the cytocentrifugate and bone marrow aspiration.
Results The child died 6 months after.
Conclusion We describe an extraordinary case of a giant orbital Retinoblastoma following enucleation.
Background We describe preoperative computed tomography (CT)–guided injection of radiotracer technetium99m macroaggregates (99m Tc-MAA) in challenging small lung nodules, intraoperative localization, ...and resection. Methods Between November 2007 and February 2010, 44 patients with 47 lung nodules which were detected incidentally or at screening and that were18 F-fluorodeoxyglucose positron emission tomography (18 F FDG-PET) positive or increasing in size at subsequent CT scans were candidates for surgical biopsy. Inclusion criteria for preoperative percutaneous CT-guided (low-dose technique)99m Tc-MAA localization included having at least one of the following characteristics: nodule size less than 1 cm, subsolid morphology, or distance from the pleura greater than 1 cm. Results Mean nodule size was 11 mm (range, 5 to 24 mm); 24 nodules were nonsolid, 15 nodules were partially solid, and 8 nodules had a solid morphology. Mean distance from the pleura was 11 mm (range, 0 to 35 mm). Localization complications included 13 minor asymptomatic pneumothoraces, 9 parenchymal hemorrhage suffusions, 1 mild allergic reaction to contrast medium, and 2 patients with chest pain after the procedure. Nine patients had mild extravasation of radiotracer into the pleura. In 2 cases, there was an extravasation of a significant quantity of radiotracer into the pleural cavity. Thoracoscopic biopsy was performed in 30 cases, 2 cases were converted to thoracotomy, and 12 patients underwent intentional thoracotomy. Conclusions Asymptomatic subjects with suspicious nodules detected by screening or incidental CT are best candidates due to small lesion size and high percentage of nonsolid morphology, making thoracoscopic biopsy potentially difficult. Radiotracer localization is a safe, versatile, simple technique to help perform diagnosis with a minimally invasive approach in nonpalpable lung lesions.
A 3D silicon sensor fabricated at Stanford with electrodes penetrating throughout the entire silicon wafer and with active edges was tested in a 1.4
T magnetic field with a 180
GeV/
c pion beam at ...the CERN SPS in May 2009. The device under test was bump-bonded to the ATLAS pixel FE-I3 readout electronics chip. Three readout electrodes were used to cover the
400
μ
m
long pixel side, this resulting in a p–n inter-electrode distance of
∼
71
μ
m
. Its behavior was confronted with a planar sensor of the type presently installed in the ATLAS inner tracker. Time over threshold, charge sharing and tracking efficiency data were collected at zero and 15° angles with and without magnetic field. The latest is the angular configuration expected for the modules of the Insertable B-Layer (IBL) currently under study for the LHC phase 1 upgrade expected in 2014.
Human recombinant interleukin 1 beta produced in Escherichia coli and in Saccharomyces cerevisiae was purified to homogeneity by a combination of ion exchange, gel filtration and hydroxylapatite ...column chromatography. The two proteins, both expressed in the mature form, differ in that the protein secreted from yeast is glycosylated and lacks the first four amino acids. The biological activity of IL-1 obtained from E. coli is comparable to that of the natural protein, while the protein produced from yeast showed very low specific activity. The analysis of the state of oxidation of the two cysteine residues present in the IL-1 molecule and the evaluation of the immunoreactivity of the two proteins have proved that a different conformation is at the basis of the different biological activity of the two proteins.
We develop two unconditionally stable displacement based time stepping schemes for the non-linear dynamic response of beams. The first algorithm guarantees the exact discrete conservation of energy ...and momentum. The second is associated with an energy decay inequality that achieves control of the unresolved frequencies by means of a numerical dissipation mechanism.
Both schemes emanate from a weak form of the equations of dynamic equilibrium referred to a fixed pole. Space and time discretizations are based on the exponential parameterization of motion. This implies that the beam reference line and the trajectories of the beam nodes are helicoids in space. The exponential mapping approach allows a unified treatment of translations and rotations, greatly simplifying the derivation of the algorithms and their analysis.
The capabilities and performance of the new schemes are demonstrated and discussed with the aid of numerical simulations.
The paper deals with the mechanical behaviour of "bimrock" (block in matrix rock), characterized by a heterogeneous structure, constituted by rock blocks included in a small-grained, well-cemented ...material (matrix) with lower mechanical characteristics. The bimrock is a very peculiar material that may give rise to serious problems in engineering applications. To properly model this kind of problems it is necessary to suitably characterize the bimrock. In order to contribute to the understanding of the bimrock mechanical behaviour and to individuate strength and deformability laws suitable for the bimrock as an equivalent continuum, a number of unconfined or laterally confined tests on bimrock specimens have been numerically simulated. The finite difference and the finite element methods, implemented in the FLAC 2D and the ADINA 2D and 3D codes, respectively, have been used to investigate possible model-dependent responses. Novel approaches have been used, in which the size, orientation and position of rock blocks contained in a two and three-dimensional specimen are generated according to a random process that produces representative samples of block populations with assigned statistical properties. Different volumetric proportions and aspect ratios of the blocks have been considered and the effects on the strength and deformability of bimrock are presented. The numerical results from both 2D and 3D analyses show the influence of the volume proportion of the blocks on the strength and deformability of bimrock. Furthermore, the results suggest that the interfaces between the blocks and the matrix play an important role, and may have an influence on the mechanical behaviour of bimrock.
This study was carried out with the aim of developing a production process for the manufacture of a highly purified factor VIII concentrate which is virus inactivated by pasteurization in liquid ...phase. Beside standard plasma protein separation techniques, the procedure uses a chromatographic step on anion exchanger, whose selectivity is increased by using high, but not destabilizing salt concentrations. The final product before stabilization has a specific activity higher than 300 IU/mg of protein, namely the highest specific activity reported for human factor VIII concentrates purified without the use of immunoadsorbents.
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