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Surgical view of the treatment of patients with hepatoblastoma. Results from the First Prospective Trial of the International Society of Pediatric Oncology Liver Tumor Study Group (SIOPEL-1).
Cancer 2002: 94 (4) s.1111-1120, il., tab., bibliogr. 20 poz.
Hasła klasyfikacyjne GBL:
praca opublikowana za granicą
Background. Surgical resection is the cornerstone of treatment for patients with hepatoblastoma (HB). The Society of Pediatric Oncology Liver Tumor Study Group launched its first prospective trial (SIOPEL-1) with the intention to treat all patients with preoperative chemotherapy and delayed surgical resection. The objective of this article was to assess the assumed surgical advantages of primary chemotherapy. Methods. Between 1990 and 1994, 154 patients age 16 years with HB were registered on SIOPEL-1. The pretreatment extent of disease was assessed, and, after undergoing biopsy, patients were treated with cisplatin 80 mg/mý intravenously over 24 hours and doxorubicin 60 mg/mý intravenously over 48 hours by continuous infusion (PLADO). Generally, tumors were resected after four of a total of six courses of PLADO. Results. One hundred twenty eight patients underwent surgical resection (13 patients underwent primary surgery, and 115 patients underwent delayed surgery after PLADO). A pretreatment surgical biopsy was performed in 96 of 128 patients (75 p.c.). Biopsy complications occurred in 7 of 96 patients (7 p.c.). Twenty-two patients showed pulmonary metastases at the time of diagnosis, and 7 patients underwent thoracotomy. Operative morbidity and mortality were 18 p.c. and 5 p.c., respectively. Complete macroscopic surgical resection was achieved in 106 patients (92 p.c.), including 6 patients who underwent orthotopic liver transplantation. The actuarial 5-year event free survival (EFS) rate for all 154 patients in the study was 66 p.c., and the overall survival (OS) rate was (75 p.c.)...
Cheyne-Stokes respiration during sleep: a possible effect of body position.
Med. Sci. Monitor 2002: 8 (7) s.CS61-CS65, il., tab., bibliogr. 21 poz.
Hasła klasyfikacyjne GBL:
dorośli 45-64 r.ż.
Background: Cheyne-Stokes Respiration (CSR) is a common finding in Chronic Heart Failure and Stroke patients. The body position effect during sleep on obstructive breathing abnormalities is well known. However, the effect of body position during sleep on breathing abnormalities of central type like CSR has not been well documented. Material/Methods: Six sleep studies (two complete Polysomnographic (PSG) evaluations and four Pulse Oximetry recordings (PO)), were carried out in a 57-year-old female patient with a recent Cerebro Vascular Accident (CVA who had both Obstructive Sleep Apnea (OSA) and CSR. Results: The first PSG was carried out tow months post-stroke an drevealed a severe, continuous CSR pattern during Non Rapid Eye Movements (NREM) sleep (mainly with central apneas), and Obstructive Sleep Apnea (OSA) during Rapid Eye Movements (REM) sleep, independent of body positon: Supine Respiratory Disturbance Index (SRDI) = 85.2 and Lateral RDI (LRDI) = 95.4. A second PSG was performed three months later after an overall clinical improvement and showed a complete disappearance of CSR during NREM sleep and OSA during REM sleep in her lateral posture (LRDI = 0), while the RDI in the supine posture was only slightly improved (SRDI = 73.2). The CSR pattern was less severe and was characterized mainly by central hypopneas. Two PO recordings between the PSG studies showed similar improvement trends. Two additional PO recordings, two and three weeks after the last PSG (the first one with the patient lying supine and the second one with the patient lying on her side through-out the night),...
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