ABSTRACT
AIMS: To explain the use of Stereotactic Radiosurgery for intracranial lesions and report Dunedin Hospital's early experience with this treatment. METHODS: Review of a prospective computer database and departmental clinical files. RESULTS: 74 patients underwent 78 radiosurgical procedures between 30 July 1994 to 18 December 1997. 28 patients with arteriovenous malformations were treated with an obliteration rate of 82% (95% CI: 48% to 98%) at two years. Seventeen vestibular schwannomas (acoustic neuroma's) were treated, with follow-up magnetic resonance imaging available in eleven in whom there was no tumour progression after a mean period of twelve months. There was preservation of some hearing in all patients not already deaf, but one developed a new facial palsy and another had worsening palsy as late side effects. Other tumours, including selected metastases, gliomas and skull base tumours have been treated in smaller numbers. CONCLUSION: Rates of arteriovenous malformation obliteration, vestibular schwannoma control, and side effects of radiosurgery in Dunedin are comparable to those reported in other uncontrolled series. Radiosurgery is quick and has a low procedure-related morbidity but does have important limitations and delayed side effects, which means the decision to treat needs to be based on thorough multidisciplinary review.
Subject(s)
Brain Neoplasms/surgery , Ear Neoplasms/surgery , Intracranial Arteriovenous Malformations/surgery , Radiosurgery , Stereotaxic Techniques , Vestibular Diseases/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Humans , Middle Aged , Neurilemmoma/surgery , Retrospective StudiesSubject(s)
Breast/anatomy & histology , Estrogen Antagonists/adverse effects , Puberty/physiology , Tamoxifen/adverse effects , Adolescent , Breast/drug effects , Estrogen Antagonists/therapeutic use , Female , Fibroma, Desmoplastic/drug therapy , Head and Neck Neoplasms/drug therapy , Humans , Tamoxifen/therapeutic useABSTRACT
A fatal case of disseminated strongyloidiasis is described, abruptly following a single high dose of dexamethasone before stereotactic radiosurgery. The mechanism of steroid-induced dysregulation of Strongyloides infection is unclear. Treatment failure and the use of rectal thiabendazole in the presence of bowel obstruction is discussed. This case reinforces the need to screen selected patients for strongyloidiasis before any high-dose steroid therapy, particularly in the presence of persistent eosinophilia.
Subject(s)
Dexamethasone/adverse effects , Glucocorticoids/adverse effects , Strongyloides stercoralis/drug effects , Strongyloidiasis/parasitology , Animals , Fatal Outcome , Humans , Male , Middle Aged , Radiosurgery , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: This study compares the use of standard overhead fluorescent phototherapy units with the BiliBlanket a woven fibreoptic pad which delivers high intensity light with no ultraviolet or infrared irradiation in the treatment of jaundice in preterm infants. METHODOLOGY: We chose to study infants between 800 and 2500 g, with strict criteria for commencing and ceasing phototherapy. Serum bilirubin levels were followed at 12-24 h intervals until 24 h after cessation of phototherapy. Infants were allocated at random to receive either conventional phototherapy or the BiliBlanket. RESULTS: There were 24 infants in the conventional group and 20 in the BiliBlanket group. Mean duration of phototherapy was compared and was 44 h for the conventional group versus 42 h for the BiliBlanket group. CONCLUSIONS: We have shown that the BiliBlanket is as effective as conventional phototherapy and was well accepted by nursing staff and parents.
Subject(s)
Fiber Optic Technology , Infant, Premature , Jaundice, Neonatal/therapy , Phototherapy/instrumentation , Bilirubin/blood , Equipment Safety , Humans , Infant, Newborn , Jaundice, Neonatal/blood , Phototherapy/adverse effects , Treatment OutcomeABSTRACT
A 77 year old woman presenting with a malignant phyllodes tumour of of the right breast with exclusively stromal metastases to axillary lymph nodes refractory to both radiotherapy and chemotherapy.
Subject(s)
Breast Neoplasms/pathology , Breast/pathology , Phyllodes Tumor/secondary , Aged , Axilla , Breast Neoplasms/therapy , Combined Modality Therapy , Female , Humans , Lymphatic Metastasis , Phyllodes Tumor/diagnosis , Phyllodes Tumor/therapySubject(s)
Dementia/diagnosis , Memory , Aged , Aged, 80 and over , Dementia/psychology , Humans , Mental Status ScheduleABSTRACT
Control of central nervous system (CNS) disease and overall survival have been analysed in a group of 829 children with leukaemia entered into the UKALL VIII trial to determine whether scheduling of the cranial irradiation is of prognostic significance. We show that short gaps in treatment do not influence prognosis and that current radiotherapy practice need not be modified.
Subject(s)
Brain/radiation effects , Precursor Cell Lymphoblastic Leukemia-Lymphoma/radiotherapy , Age Factors , Antineoplastic Agents/therapeutic use , Brain Neoplasms/prevention & control , Child , Combined Modality Therapy , Dose-Response Relationship, Radiation , Humans , Radiotherapy DosageABSTRACT
Bronchial carcinoma was initially diagnosed in a 48-year-old man on the basis of radiology showing an apical lung lesion with erosion of the first rib. Biopsy ultimately showed this to be osteomyelitis.
Subject(s)
Carcinoma, Bronchogenic/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Osteomyelitis/diagnostic imaging , Ribs/diagnostic imaging , Staphylococcal Infections/diagnostic imaging , Biopsy , Carcinoma, Bronchogenic/pathology , Diagnosis, Differential , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Osteomyelitis/pathology , Radiography , Ribs/pathology , Staphylococcal Infections/pathologySubject(s)
Bronchi/injuries , Bronchial Neoplasms/radiotherapy , Carcinoma, Bronchogenic/radiotherapy , Radiation Injuries/etiology , Subcutaneous Emphysema/etiology , Adult , Bronchial Neoplasms/diagnostic imaging , Carcinoma, Bronchogenic/diagnostic imaging , Humans , Male , Radiography , Subcutaneous Emphysema/diagnostic imagingABSTRACT
A malignant angiosarcoma developed at the site of a benign cavernous haemangioma 33 years after the lesion was treated with radiotherapy. The possible mechanisms for this association are discussed.
