ABSTRACT
Results from clinical trials do not allow definitive conclusions about the role of chemoembolization (ChE) in the treatment of colorectal cancer (CRC) liver metastases. The aim of present phase II study was to investigate toxicity and efficacy of ChE for patients, with unresectable colorectal liver metastases after failure of 5-FU based chemotherapy. Secondary endpoint was clinical benefit measurement. Eleven patients were enrolled in first stage (two-stage Simon design), 2 males/9 females, median age 60 (46-71). Performance status was I in 8 patients and II in 3 patients. All patients had radical surgery, 7 of them adjuvant chemotherapy and 4 systemic chemotherapy. The ChE regimen consisted of an injection of iodinated oil Lipiodol with mitomycin C (3 mg/ml). Repeated treatments were performed at 9- to 12-week intervals. We applied 17 ChE (median 1/pts.). Clinical benefit was a composite of measurements of pain, ECOG performance status, weight and tumor fever. Study was stopped after first stage because non of the patients (pts) achieved objective response (RECIST). Stable disease occurred in 5 pts (45%). Median time to progression was 3 months (range 3-9 months). Median survival was 9 months (range 4-16 months). A decrease of the baseline carcinoembryonic antigen level occurred in 0% of the cases. Clinical benefit was recorded in one patient. Common toxicity included a "postembolization syndrome," which consisted of fever, pain in the right upper quadrant, nausea, and vomiting. Grades 3-4 toxicity (NCI-CTC) followed transaminases 6/11, LDH 4/11. In addition, a drop in F V levels was noted in 5 pts, F VII in 9, F IX in 2 and F X in 10 pts. Decrease in At III levels occurred in 6 pts and FDP appeared in one. Thus, The ChE as performed in the present study did not appear to bring any benefit; furthermore, significant liver toxicity compromises the safety of such procedure.
Subject(s)
Chemoembolization, Therapeutic/adverse effects , Colorectal Neoplasms/pathology , Iodized Oil/administration & dosage , Liver Neoplasms/secondary , Liver Neoplasms/therapy , Mitomycin/administration & dosage , Aged , Combined Modality Therapy , Disease-Free Survival , Female , Humans , Liver Neoplasms/mortality , Male , Middle Aged , Palliative Care , Survival Analysis , Treatment Failure , Treatment OutcomeABSTRACT
On the basis of data from literature and personal experience, the authors precise indications for surgery of the fractured temporal bone. They suggest that after appeasement of neurosurgical phase of the disease operation should only be carried out if peripheric paralysis of the facial nerve, conductive deafness and otoliquorrheoa, are evident. In addition to these indications they also suggest operation in patients with chronic otitis due to injury or if this process preceded the injury.
Subject(s)
Skull Fractures/surgery , Temporal Bone/injuries , Humans , Skull Fractures/complicationsABSTRACT
The authors investigated the relations between the mastoid segment of the facial canal and the temporomandibular joint, the posterior wall of the cavum tympani and the external wall of the mastoid process in 19 cases with congenital ear malformations and 10 cases with normal ears. A significantly reduced distance was found between the facial canal and the temporomandibular joint as well as between the facial canal and the posterior wall of the cavum tympani in the groups with malformed ears as compared to the control group with normal ears.
Subject(s)
Ear, Middle/abnormalities , Ear, Middle/diagnostic imaging , Mastoid/diagnostic imaging , Temporomandibular Joint/diagnostic imaging , Tomography, X-Ray Computed , Cephalometry , Child , Child, Preschool , Ear, Middle/pathology , Facial Nerve , Humans , Mastoid/pathology , Temporomandibular Joint/pathology , Tomography, X-Ray Computed/methodsABSTRACT
Fine arterial branches on the superior surface of corpus callosum were investigated on 22 human brains under stereomicroscope. These branches were directed toward: 1. the upper surface of corpus callosum (3-6 branches, mean 8), 2. the depths of the sulcus corporis callosi (4-13 branches, mean 7), and 3. the cingulate gyrus (1-10 branches, mean 5). All the vessels composing the pericallosal pial plexus have a uniformed caliber of 0.9-0.6 mm at their origins, and 0.7-0.3 mm after branching. In 9 cases a longitudinal vessel within the stria longitudinalis medialis, connected with the pial plexus was found. Important details of morphology of this plexus and their significance are discussed.
Subject(s)
Corpus Callosum/blood supply , Arteries/anatomy & histology , Female , Humans , MaleABSTRACT
The authors present a patients with oncocytoma, a rare tumor of the nasal cavity and the ethmoidal and sphenoidal sinuses. By using computerised tomography (CT) they localised the tumor and through pathohistological analysis confirmed the nature of the disease. Recurring tumors can also be localised by use of CT.
Subject(s)
Adenoma/surgery , Ethmoid Sinus , Nose Neoplasms/surgery , Sphenoid Sinus , Follow-Up Studies , Humans , Middle Aged , Neoplasm Recurrence, Local/surgery , Paranasal Sinus Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
By the use of computerized tomography (CT) the authors have examined and precisely defined the radiological anatomical characteristics of the attic and its relation to other structures of the middle and inner ear. The identification of individual morphological structures has been made on axial, semi-axial and frontal CT sections. Each type of original CT section has been compared with the corresponding original anatomical section.
