ABSTRACT
Objective: To prospectively evaluate the preliminary efficacy and safety of whole-brain irradiation plus three-dimensional conformal boost combined with concurrent topotecan in patients with brain metastases from lung cancer. Methods: Between March 2009 and March 2012, 38 lung cancer patients with brain metastases were prospectively recruited in concurrent radiochemotherapy (CRCT) group to receive whole-brain irradiation (40 Gy/20 fractions) plus three-dimensional conformal boost (for patients with no more than 3 lesions and the diameter ≥ 2 cm, a three-dimensional conformal localized boost was given to increase the dosage to 56-60 Gy) combined with concurrent topotecan (1.75 mg/m2, once a week for 4-6 weeks). Another 38 patients with brain metastasis from lung cancer were selected to be recruited in simple radiotherapy (SRT) group to receive simple radiotherapy in the same period. The efficacy and the adverse reactions were evaluated. All the patients were followed-up, and the survival was analyzed. Results: In CRCT group and SRT group, the median progression-free survival (PFS) time of intracranial metastases were 6 and 3 months, respectively; one-year PFS rates were 42.8% and 11.6%, respectively; two-year PFS rates were 21.6% and 8.7%, respectively; the PFS of CRCT group was higher than that of SRT group (χ2 = 6.020, P = 0.014). In CRCT group and SRT group, the median survival (OS) time were 13 and 10 months, respectively; one-year OS rates were 50.8% and 40.4%, respectively; twoyear OS rates were 37.9% and 16.5%, respectively; the OS of CRCT group was not obviously higher than that of SRT group (χ2 = 1.811, P = 0.178). In CRCT group and SRT group, the one-year control rates of intracranial metastases were 75.9% and 41.6%, respectively; two-year control rates of intracranial metastases were 65.2% and 31.2%, respectively; there was a significant difference between the CRCT group and SRT group (χ2 = 3.892, P = 0.049). In CRCT group and SRT group, the one-year control rates of extracranial lesions were 47.8% and 32.5%, respectively; two-year control rates of extracranial lesions were 28.7% and 24.4%, respectively; there was no significant difference between the CRCT group and SRT group (χ2 = 0.610, P = 0.435). The major adverse reactions were myelosuppression and gastrointestinal reactions with no significant difference between the two groups (P > 0.05). Conclusion: Compared with simple radiotherapy, whole-brain irradiation plus three-dimensional conformal boost combined with concurrent topotecan can significantly improve the PFS rate and the control rate of intracranial lesion in patients with brain metastases from lung cancer, and no significant increase in side effects was observed.
ABSTRACT
<p><b>OBJECTIVE</b>To introduce 8 patients with isolated congenital anosmia and to discuss the clinical manifestations, imaging characteristics and family characteristics of this rarely seen disorder.</p><p><b>METHODS</b>Eight patients with isolated congenital anosmia treated between April 2007 and April 2012 were reviewed retrospectively. There were 4 males and 4 females. A detailed medical history collection, physical examination, nasal endoscopy, T&T and Sniffin'Sticks subjective olfactory function tests, olfactory event-related potentials sinonasal computed tomography scan and sex hormones level monitoring were performed in all patients. Seven cases underwent magnetic resonance image of olfactory pathway examination.</p><p><b>RESULTS</b>All patients were anosmia without evidence of other defects. ENT physical examination, nasal endoscopy and computed tomography scan were normal except 4 cases with obvious nasal septum deviation, 2 cases with concha bullosa. Subjective olfactory test indicated all of them were anosmia. Olfactory event-related potentials were obtained in only 1 patient. Magnetic resonance imaging revealed the smaller or atrophy olfactory bulb and olfactory tract in five cases, the absence of olfactory bulbs and tracts in two case. A female patient did not have MRI examination because of wearing IUDs. Detection of 8 patients of sex hormones were normal. Family characteristics: 3 patients showed family inheritance pattern.</p><p><b>CONCLUSIONS</b>The diagnosis of isolated congenital anosmia should be based on chief complaint, medical history, physical examination, olfactory test, nasal endoscopy, olfactory testing, olfactory imaging and olfactory event-related potentials. Magnetic resonance image of olfactory pathway and olfactory event-related potentials have important value for the diagnosis. More attention should be paid to the genetic susceptibility of the family.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Magnetic Resonance Imaging , Olfaction Disorders , Diagnosis , Genetics , Olfactory Pathways , Retrospective StudiesABSTRACT
Objective: To screen differentiated expressed proteins in plasma of ovarian serous cystadenocarcinoma patients by using surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) associated with bioinformatic support vector machines (SVM) and discuss how to establish algorithmic logical model for diagnosis of ovarian serous cys-tadenocarcinoma and its significance. Methods: SELDI-TOF-MS and CM10 chip were used to analyze the plasma samples from 26 ovarian serous cystadenocarcinoma women and 51 control women including 12 cases of ovarian cyst, 31 cases of uterous leiomyoma, 8 cases of ovarian benign cystadenoma. The data was analyzed by Biomarker Wizard software. The plasma proteomic diagnostic model for ovarian serous cys-tadenocarcinoma patients and control subjects were established by using SVM (a bioinformatic method). Results: Seventy-one differentiated protein peaks were screened by Biomarker Wizard software which were captured by SELDI-TOF-MS from CM10 chip (P <0.01). The proteomic profiling for ovarian serous cystadenocarcinoma was optimized by SVM re-screening. The key m/z value of these 7 proteins was 4 099, 4 477, 4 123, 4 081 and 3 938 (up-regulated), 8 785 and 13 783 (down-regulated). Three-fold cross validation followed by blinded determination demonstrated that the sensitivity and specificity of the established model were 84.62% and 96.08% separately, and the positive predictive value was 92.21% for differential diagnosis of ovarian serous cystadenocarcinoma patients. Conclusion: ProteinChip-mass spectrometry technology can rapidly and effectively screen differentiated proteins from the plasma of ovarian serous cystadenocarcinoma patients. Combined with SVM, a diagnostic model was generated from proteomic patterns of ovarian serous cystadenocarcinoma, which had potential significance for establishing diagnostic methods for ovarian cancer.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the function of central auditory, Speech-perception-in-noise test (SPIN test) was used to assess that whether temporal lobe epilepsy patients have central auditory processing disorders.</p><p><b>METHODS</b>Four audiological test were performed in 9 patients with temporal lobe epilepsy and 19 age-matched normal hearing persons as controls, which include pure tone audiometry, acoustic immittance measurement, ABR (auditory brainstem response) and SPIN test. All the temporal lobe epilepsy patients were performed by CT or MRI and diagnosed by the neurologists prior to the test. The testing materials of speech and noise in SPIN test was recorded in independent tracks and the S/N was identified by -25 dB by pre-experiment. In the test, every words were read twice and both the results were recorded.</p><p><b>RESULTS</b>In the ABR test, only wave V latency showed longer values in the left ear, other waves like I, III and inter-peak intervals had'nt shown significant statistical differences in both ears of temporal lobe epilepsy patients. However, in the SPIN test, there's no significant statistical differences in both left and right ears of the controls by the first-time hearing (P = 0.107), and the differences showed by the second-time hearing (P = 0.048); but in the comparison of both ears in temporal lobe epilepsy patients, both time of hearing showed no significant statistical differences with P = 0.174 and P = 0.163. In additional, the SPIN recognition score of the temporal lobe epilepsy patients, whether in the fist or second time hearing, whether in the monaural or binaural models, presented significant statistical differences compared to the controls (P = 0.000).</p><p><b>CONCLUSIONS</b>There was no statistically significant difference in pure tone audiometry and ABR test for all the groups. But the speech recognition score obtained from SPIN test of tempol lobe epilepsy patients is lower than the normal persons, which has statistically significant difference. (P < 0.001) Then we can come to the conclusion that Temporal lobe epilepsy patients had central auditory dysfunctions and SPIN test is a sensitive way to assess this abnormal.</p>