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  • 1
    Publication Date: 2014-04-13
    Description: Background The aim of this study was to assess the objective response rate (ORR) of children and young adults with recurrent medulloblastoma/primitive neuroectodermal tumor (MB/PNET) treated with temozolomide (TMZ). The secondary purpose was to analyze the toxicity profile of TMZ when administered orally for 5 days in 3 divided daily doses every 28 days. Methods Forty-two patients with recurrent MB/PNET, aged 21 years and younger, were recruited. Patients were treated with oral TMZ. Starting doses ranged from 120 to 200 mg/m 2 /day based on previous treatments. A craniospinal MRI was performed prior to the first cycle of TMZ and following every 2 cycles of treatment. Results Median age was 10 years (range, 2–21 years). Forty of 42 patients were assessed for response and toxicity. The objective response rate was 42.5%: 6 patients achieved a complete response, 11 had a partial response, and 10 had stable disease. Progression-free survival rates for all patients at 6 and 12 months were 30% and 7.5%, respectively. Their median overall survival rates at 6 and 12 months were 42.5% and 17.5%, respectively. No major extrahematological effects or life-threatening events were reported. The most common grade 3/4 toxicity included thrombocytopenia (17.5%), neutropenia (7.5%), and anemia (2.5%). Conclusions TMZ proved to be an effective agent in children and young adults with MB/PNET, heavily pre-treated, with a tolerable toxicity profile.
    Print ISSN: 1522-8517
    Electronic ISSN: 1523-5866
    Topics: Medicine
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 27 (1985), S. 313-317 
    ISSN: 1432-1920
    Keywords: Eclampsia ; CT ; toxemia of pregnancy ; gestosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cranial CT was performed in five patients with eclampsia: densitometric modifications were present in all cases. Only one patient, who later died, displayed multiple foci of cerebral haemorrhage; all others presented bilateral, symmetrical, nonenhancing hypodensities with mass effect interpreted as cerebral oedema. At CT performed 7–14 days after interruption of the pregnancy, these characteristic hypodense lesions were no longer present while neurological symptoms disappeared.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1920
    Keywords: Key words Optic glioma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serial MRI over 60 months demonstrated regression after biopsy of a pilocytic opticochiasmatic astrocytoma in a 20-year-old woman with no signs of neurofibromatosis, together with improvement in vision. The patient did not receive radio- or chemotherapy. Close MRI follow-up of optic gliomas is recommended. Aggressive treatment should be limited to cases with clear clinical and radiological progression.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1920
    Keywords: Dandy-Walker syndrome ; Hydrocephalus ; Posterior fossa cyst ; Brain, ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A case of Dandy-Walker syndrome was diagnosed by ultrasound during the 30th week of pregnancy, observed again more clearly at 33 weeks and confirmed by CT after birth.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 0942-0940
    Keywords: Cortical dysplasias ; epilepsy ; callosotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Four patients suffering for severe drug-resistant epilepsy from bihemispheric cortical dysplasias underwent anterior callosotomy. One of these patients also presented mental retardation of mild degree associated with the epileptic syndrome. There were no operative complications in this series. Clinical signs of interhemispheric disconnection were not detectable postoperatively. Twenty-eight to 53 months after surgery, the generalized seizures were completely suppressed in 2 cases, and were reduced by 89–97% in frequency in the other 2 cases. Partial seizures were less affected by callosotomy being reduced by 14–87%. In an additional fifth case of intractable epilepsy from bihemispheric cortical dysplasias with associated severe mental retardation operated upon elsewhere for callosotomy and followed at our institution, the outcome for seizures was completely unsatisfactory. Neurophysiological studies revealed that the interhemispheric transfer (IHT) of visuo-motor responses was functionally impaired after callosotomy only in one patient who harboured bilateral cortical dysplasias in the occipital lobes. This malformation might affect the pattern of axonal projection to the posterior portion of the corpus callosum which is considered of crucial importance for the integration of crossed visuo-motor responses. From this paper the following conclusions can be drawn: a) epileptic patients with severe drug-resistant epilepsy due to bihemispheric cortical dysplasias are good candidates for callosotomy, b) one-stage extensive anterior callosotomy sparing the splenium is the procedure of choice, c) associated severe mental retardation seems to contra-indicate callosotomy, d) the neurophysiological study of the IHT can yield information on the functional status of the corpus callosum.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 0942-0940
    Keywords: Tethered spinal cord ; spinal dysraphism ; magnetic resonance imaging ; post-repair myelomeningocele
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Late deterioration of the neurological condition in patients operated on for myelomeningocele repair has been repeatedly reported in the literature. At the present time magnetic resonance imaging (MRI) allows one to recognize various pathological conditions which can be amenable to surgical correction in these patients, such as Chiari type II malformation, hydro/syringomyelia, decompensated hydrocephalus, and tethered spinal cord. The authors report their experience with 26 myelodysplastic children operated on for myelomeningocele repair in the early neonatal period, who exhibited late deterioration at variable time intervals from the first operation. The children were examined pre-operatively by means of MRI; the results were compared with those provided by MRI in 46 myelodysplastic children who underwent the investigation as a routine follow-up control. The MRI findings were subdivided into 4 main groups of increasing severity from 1 to 4; in some subjects, associated pathological conditions (Chiari II malformation, hydromyelia, etc.) were detected as well. Twenty-two out of the 26 patients with late neurological deterioration were operated on. Eleven of them (grades 2 to 4) underwent detethering of the fixed conus, with an improvement of their clinical picture from mild to good. On the other hand the remaining 11 subjects (grades 1 to 2) improved their condition following the correction of the associated abnormalities (malfunctioning CSF shunt: 5 cases; hydromyelia: 4 cases; symptomatic Chiari II malformation: 2 cases).
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 7 (1997), S. S231 
    ISSN: 1432-1084
    Keywords: Key words: Contrast-enhanced studies ; MR ; Central nervous system ; MR ; Brain neoplasm ; MR ; Spine neoplasm ; MR
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Because of its high intrinsic contrast resolution, magnetic resonance imaging (MRI) has largely replaced computed tomography (CT) in the diagnosis of central nervous system (CNS) diseases, and the use of contrast media in MRI of the CNS has increased progressively, gadolinium chelates being, by far, the most used ones. Our paper will focus on the current indications for contrast-enhanced MR imaging of the CNS and will outline the current role and the future trends in contrast medium (CM) administration in the diagnosis of CNS disease. Gadolinium chelates are now routinely employed in MRI of the brain and spine and have been shown to be relatively safe and well tolerated at standard doses of 0.1 mmol/kg b. w. Although there is general consensus on the usefulness of CM administration in MRI of the CNS, some controversy still persists on the type of CM to be used, on the administration scheme, and on the imaging protocol. The current trend is toward selective employment of CM, the effect of which can be enhanced by Magnetization Transfer (MT) techniques, to increase the sensitivity of the procedure. Double or triple doses of CM can be useful in the detection of small parenchymal lesions with faint enhancement, in functional/dynamic studies of the brain parenchyma and in MR angiography. Gadoteridol (ProHance®) closely resembles the features of an optimal CM, because it is non-ionic, has a low osmolality and a low viscosity, and may be particularly efficacious when high doses are required.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Abdominal imaging 8 (1983), S. 255-259 
    ISSN: 1432-0509
    Keywords: Gallbladder disease, diagnosis ; Cerulein, diagnostic use ; Cholecystography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Five hundred and two patients with good opacification of the gallbladder were studied by means of ceruletide-assisted cholecystography. A high percentage (15.7; 79 patients) was found to have hyperplastic cholecystoses. So far 26 of these patients have been operated upon because of gallstones or painful symptoms. The x-ray diagnosis was confirmed in all cases. Compared with routine cholecystography, the powerful contraction induced by ceruletide appears to lead to a more frequent recognition of hyperplastic cholecystoses.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 247 (2000), S. 559-561 
    ISSN: 1432-1459
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Neurological sciences 19 (1998), S. 329-329 
    ISSN: 1590-3478
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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