| 11. |
- Toporski, Jacek, et al.
(författare)
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High-dose iodine-131-metaiodobenzylguanidine with haploidentical stem cell transplantation and posttransplant immunotherapy in children with relapsed/refractory neuroblastoma.
- 2009
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Ingår i: Biology of Blood and Marrow Transplantation. - : Elsevier BV. - 1083-8791. ; 15:9, s. 1077-1085
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated the feasibility and efficacy of using high-dose iodine-131-metaiodobenzylguanidine ((131)I-MIBG) followed by reduced-intensity conditioning (RIC) and transplantation of T cell-depleted haploidentical peripheral blood stem cells (designated haplo-SCT) to treat relapsing/refractory neuroblastoma (RRNB). Five RRNB patients were enrolled: 4 with relapse (3 after autologous SCT) and 1 with induction therapy failure. The preparative regimen included high-dose (131)I-MIBG on day -20, followed by fludarabine (Flu), thiotepa, and melphalan (Mel) from day -8 to -1. Granulocyte-colony stimulating factor (G-CSF)-mobilized, T cell-depleted haploidentical paternal stem cells were infused on day 0 together with cultured donor mesenchymal stem cells. A single dose of rituximab was given on day +1. After cessation of short immunosuppression (mycophenolate, OKT3), 4 children received donor lymphocyte infusion (DLI). (131)I-MIBG infusion and RIC were well tolerated. All patients engrafted. No primary acute graft-versus-host disease (aGVHD) was observed. Four children developed aGVHD after DLI and were successfully treated. Analysis of immunologic recovery showed fast reappearance of potentially immunocompetent natural killer (NK) and T cells, which might have acted as effector cells responsible for the graft-versus-tumor (GVT) effect. Two children are alive and well, with no evidence of disease 40 and 42 months after transplantation. One patient experienced late progression with new bone lesions (sternum) 38 months after haplo-SCT, and is being treated with local irradiation and reinstituted DLI. One patient rejected the graft, was rescued with autologous backup, and died of progressive disease 5 months after transplantation. Another child relapsed 7 months after transplantation and died 5 months later. High-dose (131)I-MIBG followed by RIC and haplo-SCT for RRNB is feasible and promising, because 2 of 5 children on that regimen achieved long-lasting remission. Further studies are needed to evaluate targeted therapy and immune-mediated tumor control in high-risk neuroblastoma.
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| 12. |
- Kölbel, Tilo, et al.
(författare)
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Extensive acute deep vein thrombosis of the iliocaval segment: midterm results of thrombolysis and stent placement.
- 2007
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Ingår i: Journal of Vascular and Interventional Radiology. - : Elsevier BV. - 1051-0443. ; 18:2, s. 243-250
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate patency and clinical outcome in patients treated with catheter-directed thrombolysis and stent placement for acute extensive thrombosis affecting the iliocaval segment. MATERIALS AND METHODS: During a 10-year period (1994-2005), 37 patients with 44 limbs (26 female, median age 31 years) with acute extensive venous thrombosis affecting the iliocaval segment were treated with catheter-directed thrombolysis. Angioplasty and stent placement was performed in 36 limbs (82%) for underlying stenosis or residual thrombosis. A prospectively registered database was analyzed in combination with a telephone interview about clinical symptoms. RESULTS: Technical success was achieved in all 44 limbs and clinical success in 42 of 44 (96%) limbs. Primary patency after a median imaging follow-up interval of 16 months was 34 of 44 (77%) limbs, assisted primary patency was 38 of 44 (86%) limbs, and secondary patency was 39 of 44 (89%) limbs. Thirty of 44 (68%) limbs were asymptomatic after a median clinical follow-up of 27 months, eight (18%) limbs were moderately improved, two (5%) limbs were unchanged, two (5%) limbs were moderately worse, and two (5%) limbs had no clinical follow-up. Complications occurred in six (16%) patients, three (8%) of which were major complications. No patient developed symptomatic pulmonary embolism. CONCLUSIONS: Catheter-directed thrombolysis and stent placement is a safe and effective treatment for acute iliocaval thrombosis. Clinical midterm results are encouraging. Thrombolyzed and stented segments remain patent in the vast majority of patients after 16 months. Primary and aggressive stent placement in the iliocaval vein segments can prevent rethrombosis and ensure patency.
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| 16. |
- von Schewelov, Thord, et al.
(författare)
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Total hip replacement with a zirconium oxide ceramic femoral head: a randomised roentgen stereophotogrammetric study.
- 2005
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Ingår i: Journal of Bone and Joint Surgery: British Volume. - 2044-5377. ; 87:12, s. 1631-1635
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the wear characteristics and clinical performance of four different total hip joint articulations in 114 patients. Wear and migration was measured by roentgenstereophotogrammetric analysis at five years or at the last follow-up. The mean annual wear was 0.11 mm for a stainless steel/Enduron articulation, 0.34 mm for stainless steel/Hylamer cup, 0.17 mm for zirconium oxide ceramic/Enduron and 0.40 mm for zirconium oxide ceramic/ Hylamer. The difference between the groups was significant (p < 0.008) except for stainless steel/Hylamer vs zirconium oxide ceramic/Hylamer (p = 0.26). At present, 12 patients have undergone a revision procedure, four at five years and eight thereafter. No patient who received a stainless steel/Enduron articulation at their primary replacement required revision. Conflicting results have been reported about the performance of the zirconium oxide ceramic femoral head, but our findings suggest that it should not be used with a polymethylmethacrylate acetabular component. Hylamer has already been withdrawn from the market.
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| 17. |
- Abul-Kasim, Kasim, et al.
(författare)
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Tonsillar ectopia in idiopathic scoliosis: does it play a role in the pathogenesis and prognosis or is it only an incidental finding?
- 2009
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Ingår i: Scoliosis. - : Springer Science and Business Media LLC. - 1748-7161. ; 4, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: There is an ongoing controversy about the significance of tonsillar ectopia among patients with idiopathic scoliosis (IS). AIM: To find out if tonsillar ectopia occurs more frequently among patients with IS and if it plays any etiological or prognostic role in IS. STUDY DESIGN: Retrospective study. METHODS: Retrospective analysis of 155 consecutive spine MRIs (79 patients with IS and 76 controls; aged 7-25 years; 55% were female) with regard to the position of the cerebellar tonsils in relation to foramen magnum and the sagittal diameter of foramen magnum. All images were evaluated independently by two neuroradiologists. Interobserver and intraobserver reliability analysis was performed by calculation of kappa-value, intraclass correlation coefficient, and systematic and random errors. The occurrence of tonsillar ectopia among patients with IS and controls was estimated and the association of tonsillar ectopia with different predictors has been tested. Statistical significance was set to P
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| 18. |
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| 19. |
- Anderson, Thomas, et al.
(författare)
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Tibiotalocalcaneal fusion using retrograde intramedullary nails as a salvage procedure for failed total ankle prostheses. Sixteen cases primarily operated on due to rheumaoid arthritis
- 2005
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Ingår i: Foot & Ankle Surgery. - : Elsevier BV. - 1268-7731. ; 11:3, s. 143-147
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Tidskriftsartikel (refereegranskat)abstract
- Between 1996 and 2002, 16 patients with rheumatoid arthritis and failed total ankle prosthesis underwent tibiotalocalcaneal fusion using retrograde intramedullary nails. The functional outcome was evaluated using the AOFAS scoring system and the patients were also asked about their satisfaction. Radiographs were obtained for all 16 cases minimum 1 year after surgery. Thirteen of the 16 ankles were considered radiographically healed, 11 at the first attempt and two after repeat arthrodesis. The median AOFAS pain and total scores were 40 and 58, respectively. Two deep infections resulted in a fused ankle after antibiotic treatment. In patients with rheumatoid arthritis and a failed total ankle prosthesis, tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail resulted in primary healing in two-thirds of the cases. Only two patients with a fused ankle were dissatisfied with the final result. The procedure is recommended in selected cases as an alternative to external fixation.
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| 20. |
- Belyaev, IY, et al.
(författare)
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Exposure of rat brain to 915 MHz GSM microwaves induces changes in gene expression but not double stranded DNA breaks or effects on chromatin conformation
- 2006
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Ingår i: Bioelectromagnetics. - : Wiley. - 0197-8462 .- 1521-186X. ; 27:4, s. 295-306
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Tidskriftsartikel (refereegranskat)abstract
- We investigated whether exposure of rat brain to microwaves (MWs) of global system for mobile communication (GSM) induces DNA breaks, changes in chromatin conformation and in gene expression. An exposure installation was used based on a test mobile phone employing a GSM signal at 915 MHz, all standard modulations included, output power level in pulses 2 W, specific absorption rate (SAR) 0.4 mW/g. Rats were exposed or sham exposed to MWs during 2 h. After exposure, cell suspensions were prepared from brain samples, as well as from spleen and thymus. For analysis of gene expression patterns, total RNA was extracted from cerebellum. Changes in chromatin conformation, which are indicative of stress response and genotoxic effects, were measured by the method of anomalous viscosity time dependencies (AVTD). DNA double strand breaks (DSBs) were analyzed by pulsed-field gel electrophoresis (PFGE). Effects of MW exposure were observed on neither conformation of chromatin nor DNA DSBs. Gene expression profiles were obtained by Affymetrix U34 GeneChips representing 8800 rat genes and analyzed with the Affymetrix Microarray Suite (MAS) 5.0 software. In cerebellum from all exposed animals, I I genes were upregulated in a range of 1.34-2.74 fold and one gene was downregulated 0.48-fold (P <.0025). The induced genes encode proteins with diverse functions including neurotransmitter regulation, blood-brain barrier (BBB), and melatonin production. The data shows that GSM MWs at 915 MHz did not induce PFGE-detectable DNA double stranded breaks or changes in chromatin conformation, but affected expression of genes in rat brain cells. Bioelectromagnetics 27:295-306, 2006. (c) 2006 Wiley-Liss, Inc.
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