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Review of Systems

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125381. Neurotrophic cross-talk between the nervous and immune systems: implications for neurological diseases. (Abstract)

Neurotrophic cross-talk between the nervous and immune systems: implications for neurological diseases. Inflammatory reactions in the central nervous system usually are considered detrimental, but recent evidence suggests that they also can be beneficial and even have neuroprotective effects. Intriguingly, immune cells can produce various neurotrophic factors of various molecular families. The concept of "neuroprotective immunity" will have profound consequences for the pathogenesis (...) and treatment of neuroinflammatory diseases such as multiple sclerosis. It also will prove important for neurodegenerative disorders, in which inflammatory reactions often occur. This review focuses on recent findings that immune cells produce brain-derived neurotrophic factor in multiple sclerosis lesions, whereas neurons and astrocytes express the appropriate tyrosine kinase receptor TrkB. Together with functional evidence for the neuroprotective effects of immune cells, these observations support

2003 Annals of Neurology

125382. Prospective study of photorefractive keratectomy for myopia using the VISX StarS2 excimer laser system. (Abstract)

Prospective study of photorefractive keratectomy for myopia using the VISX StarS2 excimer laser system. To evaluate the safety, efficacy, and predictability of excimer laser photorefractive keratectomy (PRK) for compound myopic astigmatism using the VISX StarS2 excimer laser system with international version 3.1 software.We report a prospective consecutive study of myopic excimer laser PRK, performed in a multi-surgeon environment with 200 eyes of 117 patients, to correct naturally occurring (...) compound myopic astigmatism of between -0.50 to -5.90 D manifest refractive sphere and up to -3.50 D manifest refractive astigmatism. Patients were assessed prior to surgery and at 1, 3, 6, and 12 months after treatment.One hundred and ninety-eight of 200 treatments (99%) were reviewed 1 year after surgery; 193 of 198 eyes (97%) achieved 20/40 or better uncorrected visual acuity and 163 of 198 eyes (82%) achieved 20/20 or better. One eye lost two lines of Snellen visual acuity assessed at 12 months

2002 Journal of Refractive Surgery

125383. Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery. (Abstract)

Initial experience using the transconjunctival sutureless vitrectomy system for vitreoretinal surgery. To describe the initial experience and to evaluate the safety and feasibility of using the 25-gauge Transconjunctival Sutureless Vitrectomy System (TSV) for a variety of vitreoretinal procedures.Retrospective review of a consecutive interventional case series.Thirty-five eyes of 33 patients, including cases of idiopathic epiretinal membrane (12 cases), retinal detachment (6 cases), macular

2002 Ophthalmology

125384. Effect of age on biochemical disease-free outcome in patients with T1-T3 prostate cancer treated with definitive radiotherapy in an equal-access health care system: a radiation oncology report of the Department of Defense Center for Prostate Disease Resea (Abstract)

Effect of age on biochemical disease-free outcome in patients with T1-T3 prostate cancer treated with definitive radiotherapy in an equal-access health care system: a radiation oncology report of the Department of Defense Center for Prostate Disease Resea It has traditionally been a common perception that young age is a negative prognostic factor in prostate cancer (CaP). Furthermore, many urologists believe that younger patients are better suited to surgery rather than radiotherapy (RT (...) ) because of this perception. However, the data on the effect of age on outcome in patients with CaP are unclear. The records of the Department of Defense Center for Prostate Disease Research were queried for the biochemical disease-free results of patients after definitive RT and analyzed by age.The records of 1018 patients with T1-T3 CaP treated with definitive RT between 1988 and 2000 were reviewed. The records of patients receiving adjuvant hormonal therapy or adjuvant or salvage RT postoperatively

2003 Biology and Physics

125385. Craniotomy for central nervous system metastases in epithelial ovarian carcinoma. (Abstract)

Craniotomy for central nervous system metastases in epithelial ovarian carcinoma. Although central nervous system (CNS) metastases from epithelial ovarian carcinoma are rare, recent studies indicate that the incidence may be increasing. Numerous series have reported various modalities for treatment with median survivals of 3 to 5 months, but the role of craniotomy has not been specifically addressed.We conducted a retrospective review of all patients who underwent craniotomy between 1989

2002 Gynecologic Oncology

125386. Quality of life in patients undergoing systemic therapy for advanced breast cancer. (Abstract)

Quality of life in patients undergoing systemic therapy for advanced breast cancer. To date no published reviews have examined the effects of systemic therapy on health-related quality of life (HRQOL) in patients with advanced breast cancer. We did a systematic review identifying 19 randomised controlled trials, with 5732 participants. Most of the trials (12) involved chemotherapy, but six involved hormonal therapies, and one a biological therapy. 15 studies assessed HRQOL as a secondary

2002 Lancet Oncology

125387. Current uses of isolated limb perfusion in the clinic and a model system for new strategies. (Abstract)

Current uses of isolated limb perfusion in the clinic and a model system for new strategies. Isolated limb perfusion with melphalan is the treatment of choice for multiple (small) melanoma-in-transit metastases. The use of tumour necrosis factor alpha (TNFalpha) in isolated limb perfusion is successful for treatment of locally advanced limb soft-tissue sarcomas and other large tumours; this approach can avoid the need for amputation. TNFalpha was approved in Europe after a multicentre trial (...) in patients with locally advanced soft-tissue sarcomas, deemed unresectable by an independent review committee; the response rate to isolated limb perfusion with TNFalpha plus melphalan was 76% and the limb was saved in 71% of patients. Moreover, the trial showed the efficacy of isolated limb perfusion of TNFalpha and melphalan against various other limb-threatening tumours such as skin cancers and drug-resistant bony sarcomas. Laboratory models of isolated limb perfusion have helped to elucidate

2003 Lancet Oncology

125388. Tumors of the nervous system and pituitary gland associated with atomic bomb radiation exposure. (Abstract)

registries, medical records, and death certificates. Pathologists reviewed slides and medical records to provide histologic diagnoses. Poisson regression analyses were used to characterize radiation effects on tumor incidence, which are expressed as excess relative risk per sievert (ERR(Sv)). All statistical tests were two-sided.A statistically significant dose-related excess of nervous system tumors was observed in the cohort (ERR(Sv) = 1.2, 95% confidence interval [CI] = 0.6 to 2.1). The highest ERR(Sv (...) Tumors of the nervous system and pituitary gland associated with atomic bomb radiation exposure. The risk of developing nervous system tumors following exposure to ionizing radiation is not well quantified. We characterized the incidence of nervous system tumors among atomic bomb survivors as a function of radiation dose.Tumors of the nervous system and pituitary gland diagnosed between 1958 and 1995 among 80 160 atomic bomb survivors were ascertained using the Hiroshima and Nagasaki tumor

2002 Journal of the National Cancer Institute

125389. Relationship between a history of systemic allergic reactions and risk of subsequent carboplatin hypersensitivity. (Abstract)

systemic allergic reactions and the subsequent development of carboplatin hypersensitivity.The medical records of all women treated in the Gynecologic Cancer Program of the Cleveland Clinic from June 1995 to May 2002 who received >6 cycles of platinum-based chemotherapy were retrospectively reviewed for a history of prior systemic hypersensitivity (e.g., medications, environmental exposure). The incidence of "positive" allergic histories was then examined in relation to the subsequent risk of patients (...) Relationship between a history of systemic allergic reactions and risk of subsequent carboplatin hypersensitivity. The establishment of clinical features identifying patients at a heightened risk for the development of carboplatin hypersensitivity may assist in the management of this important toxicity. Based on a previous report suggesting a history of "bee sting" allergy predicted for paclitaxel hypersensitivity, we attempted to determine if there was a relationship between a history of prior

2003 Gynecologic Oncology

125390. Facilitation of radiotherapeutic error by computerized record and verify systems. (Abstract)

treatments administered during this period) were identified and reviewed. Nine cases (0.04% of treatments) representing four types of record and verify (R&V)-related errors were identified, in which the department's R&V system played a contributory role in the treatment error.The common denominator among these R&V-related errors was excessive reliance upon the computer system by therapists. R&V systems eliminate some, but not all, pathways of radiotherapeutic error. Although R&V systems have assumed (...) Facilitation of radiotherapeutic error by computerized record and verify systems. To examine the impact of computerized record and verify (R&V) systems on types of radiotherapeutic error.Radiation therapy treatment errors reported by therapists at the University of Utah between July 1, 1999 and June 30, 2000 were retrospectively reviewed.During a 1-year period in which 22,542 external beam radiation therapy treatments were administered, 38 treatment errors (representing 0.17% of external beam

2003 Biology and Physics

125391. In-depth evaluation of the AJCC/UICC 1997 staging system of nasopharyngeal carcinoma: prognostic homogeneity and proposed refinements. (Abstract)

important clues for the addition or better categorization of the different defining criteria.We performed a retrospective review of the data from 1294 consecutive biopsy-proven nonmetastatic nasopharyngeal carcinoma patients and staged the extent of disease according to the defining criteria of the three staging systems. All patients had undergone detailed pretreatment assessment by fiberoptic endoscopy and CT. Radical-intent radiotherapy was given using the Ho technique according to our standard (...) In-depth evaluation of the AJCC/UICC 1997 staging system of nasopharyngeal carcinoma: prognostic homogeneity and proposed refinements. To critically evaluate the American Joint Commission on Cancer (AJCC)/International Union Against Cancer (UICC) 1997 staging system and look back on its achievements by comparing it with the AJCC/UICC 1992 and Ho 1978 staging systems. To identify areas for additional refinement, we analyzed the prognostic heterogeneity within each stage in depth, which provided

2003 Biology and Physics

125392. Cardiac scoring systems--what is their value? (Abstract)

Cardiac scoring systems--what is their value? Estimating the peri-operative risk of major adverse cardiac events is one of the functions of cardiac risk scoring systems. Fortunately, peri-operative cardiac complications are relatively infrequent in most patients. Clinical algorithms use sequential screening tests to detect patients most at risk of cardiac complications. However, because the sensitivity and specificity of the tests used are low, the predictive performance of the commonly-used (...) cardiac screening tests may not be completely satisfactory. The purpose of this review is to describe measures of performance of cardiac screening tests and illustrate their potential benefits and weaknesses.

2003 Anaesthesia

125393. Clinical and immunologic features of systemic contact dermatitis from ingestion of Rhus (Toxicodendron). (Abstract)

Clinical and immunologic features of systemic contact dermatitis from ingestion of Rhus (Toxicodendron). Oral or parenteral exposure to certain contact allergens may elicit an eczematous skin reaction in sensitized individuals. This phenomenon has been called systemic contact dermatitis (SCD) and is relatively rare when compared with classical contact dermatitis. We reviewed and analysed the clinical and immunologic features of 42 patients with SCD caused by ingestion of Rhus (Toxicodendron

2003 Contact Dermatitis

125394. Negative venom skin test results in patients with histories of systemic reaction to a sting. (Abstract)

Negative venom skin test results in patients with histories of systemic reaction to a sting. For more than 20 years venom immunotherapy has been the preferred treatment for Hymenoptera allergy and venom skin testing the preferred diagnostic test. Most allergists consider venom skin tests to be highly accurate and interpret a negative venom skin test result to indicate the absence of insect allergy. Furthermore, current practice guidelines do not adequately address the question of how best (...) to manage the patient with a convincing history of insect allergy but negative skin test results. Recent case reports and published studies have forced us to reexamine this important management issue and to consider what role in vitro venom testing might have in the management of insect allergy. We reviewed the current status of what is known about the management of individuals with a history of insect allergy but negative venom skin test results and suggested modifications of current working guidelines.

2003 Journal of Allergy and Clinical Immunology

125395. Prognostic significance of grading and staging systems using MIB-1 score in adult patients with soft tissue sarcoma of the extremities and trunk. (Abstract)

Prognostic significance of grading and staging systems using MIB-1 score in adult patients with soft tissue sarcoma of the extremities and trunk. The predictive value of histologic grading and staging systems for overall survival in different types of adult soft tissue sarcoma of the extremities and trunk is unclear.Histologic slides from 193 patients with primary tumors were reviewed for diagnosis, and Ki-67 (MIB-1) immunostaining was performed for grading in all patients. Univariate (...) type, MIB-1 score, grades based on three criteria (tumor differentiation/histologic type, necrosis, and either mitosis or MIB-1 score) and disease stage, as assessed by tumor size, depth, and grade, were associated with overall survival. Among these variables, grading and staging systems using the MIB-1 score had better predictive value compared with the MIB-1 score and standard grading and staging models in the main histologic categories. Because survival curves for the different tumor grades

2002 Cancer

125396. Central nervous system metastases in neuroblastoma: radiologic, clinical, and biologic features in 23 patients. Full Text available with Trip Pro

Central nervous system metastases in neuroblastoma: radiologic, clinical, and biologic features in 23 patients. Central nervous system (CNS) metastases rarely occur in patients with neuroblastoma, although recent reports suggest an increase in the rate. CNS recurrence may represent a different mechanism of spread than bone and bone marrow metastases and may be associated with unique genetic determinants. Further definition of the radiologic, clinical, and biologic features may provide clues (...) to the predisposing factors and mechanisms of CNS dissemination.A retrospective analysis of all children ages 0-21 years with Stage IV neuroblastoma who were diagnosed at the Institut Curie and the Institut Gustave-Roussy between 1985 and 2000 was performed with direct review of medical records and magnetic resonance images, computed tomography scans, and iodine-123 or iodine-131 metaiodobenzylguanidine scintiscans (MIBG scans). When tumor tissue was available, genetic analysis was performed using comparative

2003 Cancer

125397. The continuing increase in the incidence of primary central nervous system non-Hodgkin lymphoma: a surveillance, epidemiology, and end results analysis. (Abstract)

The continuing increase in the incidence of primary central nervous system non-Hodgkin lymphoma: a surveillance, epidemiology, and end results analysis. Primary central nervous system lymphoma (PCNSL) is an extranodal form of non-Hodgkin lymphoma arising in the craniospinal axis. The incidence of PCNSL appears to be increasing.PCNSL incidence data from 1973-1997 were obtained from the nine Surveillance, Epidemiology and End Results (SEER) registries. To limit the influence of the human (...) immunodeficiency virus on incidence rates, data of never-married males and females and persons of unknown marital status were excluded. As a surrogate for new technology, SEER data were reviewed by dates of diagnosis (surrogate for imaging) and compared with glioma incidence (surrogate for stereotactic neurosurgery and improved diagnostic neuropathology). Age-adjusted incidence rates were estimated and compared for the period prior to computed tomography (CT) (1973-1984) and the magnetic resonance imaging (MRI

2002 Cancer

125398. Controversies in the adjuvant systemic therapy of endocrine-non-responsive breast cancer. (Abstract)

Controversies in the adjuvant systemic therapy of endocrine-non-responsive breast cancer. Treatment of breast cancer requires a fully integrated multidisciplinary management as well as an ongoing dialogue with laboratory scientists. The growing amount of data generated by randomized clinical trials need to be interpreted by the clinicians and discussed with patients, so that treatment decisions might be better individualized. In early breast cancer, three consensus panels have been developed (...) to help with this task: the Early Breast Cancer Trialists Collaborative Group or Oxford Overview, the NIH Consensus Conference on Adjuvant Therapy for Breast Cancer and the St. Gallen International Consensus Panel on the Treatment of Primary Breast Cancer. Nevertheless, even these panels leave us with a good deal of uncertainty about the optimal adjuvant systemic treatment of the disease, especially when it is classified as "endocrine non-responsive". The two most problematic issues regarding

2002 Cancer Treatment Reviews

125399. Impact of the AutoPap (currently Focalpoint) primary screening system location guide use on interpretation time and diagnosis. (Abstract)

Impact of the AutoPap (currently Focalpoint) primary screening system location guide use on interpretation time and diagnosis. AutoPap (currently Focalpoint) is a computerized scanning system for the primary screening of cervicovaginal smears. For smears indicated to require further review, the system provides maps (PapMaps) to identify the most abnormal areas of the smear.To study the effect of PapMaps on diagnosis, 481 smears (from 4656 successfully processed smears using AutoPap) were first

2003 Cancer

125400. A feasibility study of the use of the AutoPap screening system as a primary screening and location-guided rescreening device. (Abstract)

for the study. Smears were processed first with the AutoPap system and were classified into three different categories: 1) no further review (NFR), 2) review, and 3) process review (PR). Conventional manual reading was performed by 10 experienced cytopathologists.After AutoPap processing, 2398 smears were classified as NFR (16.9%), and 1818 smears were classified as PR (12.8%). Overall, there were 188 inadequate smears (1.3%) at conventional review and 125 inadequate smears (0.88%) at AutoPap review. Six (...) -month repeat smears were prompted by 330 conventional reviews (2.3%) and by 222 AutoPap reviews (1.56%). Similarly, referral to colposcopy was prompted by 179 conventional reviews (1.2%) and by 147 AutoPap reviews (1.0%). Overall, 32 patients were diagnosed with high-grade cervical intraepithelial neoplasia as a result of assessment. Conventional reading detected 31 patients (28 patients were referred for colposcopy, and 3 patients were referred for repeat cytology), and the AutoPap system detected

2003 Cancer

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