Retrospective evaluation of the safety of low-level laser therapy/photobiomodulation in patients with head/neck cancer.

BACKGROUND: The standard therapeutic approach for locally advanced head and neck cancer is optimal use of radiation therapy with or without concomitant chemotherapy. The most common and distressing acute complication of such therapies is oral/pharyngeal mucositis that may be associated with severe morbidity and can interfere with the planned administration of therapy. METHODS: We have identified all patients diagnosed with head/neck cancer between 2005 and 2009, having received radiotherapy with or without cisplatin-based chemotherapy. Radiotherapy consisted of intensity-modulated radiation therapy (IMRT) in all patients. In patients with grade > 2 mucositis, photobiomodulation (PBM) consisted of three sessions of low-level laser irradiation weekly, in accordance with recently published recommendations for PBM. Patients who did not receive PBM were those for whom that approach was not requested by the radiotherapists and those who declined it. RESULTS: Two hundred twenty-two patients (62%) received PBM and 139 did not (39%). The patient's characteristics were equally distributed between the two groups. For overall survival, time to local recurrence, and progression-free survival, there was no statistical evidence for a difference in prognosis between patients with and without PBM. In a multivariate analysis, after adjusting for known prognostic factors, we found no statistical evidence that PBM was related to overall survival, progression-free survival, or local recurrence. CONCLUSIONS: Our results show evidence of no effect of PBM upon overall survival, time to local recurrences, and disease-free survival of patients with head and neck cancer treated with radiotherapy with/without chemotherapy.

Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French Sarcoma Group (FSG) database.

BACKGROUND: Solitary fibrous tumors (SFT) are rare unusual ubiquitous soft tissue tumors that are presumed to be of fibroblastic differentiation. At present, the challenge is to establish accurate prognostic factors. PATIENTS AND METHODS: A total of 214 consecutive patients with SFT diagnosed in 24 participating cancer centers were entered into the European database (www.conticabase.org) to perform univariate and multivariate analysis for overall survival (OS), local recurrence incidence (LRI) and metastatic recurrence incidence (MRI) by taking competing risks into account. A prognostic model was constructed for LRI and MRI. Internal and external validations of the prognostic models were carried out. An individual risk calculator was carried out to quantify the risk of both local and metastatic recurrence. RESULTS: We restricted our analysis to 162 patients with local disease. Twenty patients (12.3%) were deceased at the time of analysis and the median OS was not reached. The LRI rates at 10 and 20 years were 19.2% and 38.6%, respectively. The MRI rates at 10 and 20 years were 31.4% and 49.8%, respectively. Multivariate analysis retained age and mitotic count tended to significance for predicting OS. The factors influencing LRI were viscera localization, radiotherapy and age. Mitotic count, tumor localization other than limb and age had independent values for MRI. Three prognostic groups for OS were defined based on the number of unfavorable prognostic factors and calculations were carried out to predict the risk of local and metastatic recurrence for individual patients. CONCLUSION: LRI and MRI rates increased between 10 and 20 years so relapses were delayed, suggesting that long-term monitoring is useful. This study also shows that different prognostic SFT sub-groups could benefit from different therapeutic strategies and that use of a survival calculator could become standard practice in SFTs to individualize treatment based on the clinical situation.

On a mathematical model of a human root dentin.

OBJECTIVE: On the basis of recent experimental data, a new mathematical model that predicts creep in human root dentin has been developed. METHOD: The chosen constitutive model comprises fractional derivatives of stress and strain and the restrictions on the coefficients that follow from the Clausius-Duhem inequality. RESULTS: The four constants describing mechanical properties of the human dentin at constant temperature are calculated from a highly non-linear system involving Mittag-Leffler-type functions. Special attention is paid to thermodynamical restrictions that should be observed in determining parameters of the model from experimental results. SIGNIFICANCE: The proposed model allows us to predict behavior of a human dentin in different load situations. Also it could be used for describing mechanical properties of dentin that are important in the development of 'dentin-like' restorative materials.

Risk factors for accelerated atherosclerosis in young women with hyperprolactinemia.

Prolactin is a metabolic hormone. The hypothesis is that hyperprolactinemia can cause metabolic and inflammatory changes which are associated with accelerated atherosclerotic process, but the treatment of hyperprolactinemia with dopamine agonists, leads to reversibility of these processes. The first aim of this study was to determine whether hyperprolactinemia in premenopausal women is accompanied with the increase in body mass index (BMI), changes in body composition, lipid disturbances, the presence of inflammation and changes in systolic and diastolic blood pressure as risk factors for the development of early atherosclerosis. The second aim was to know whether the therapy of hyperprolactinemia and prolactin normalization lead to improvement of the observed parameters. Twenty female patients with prolactinomas, before and during treatment with dopamine agonists and 16 healthy controls were evaluated. Prolactin, BMI, total body fat, free fat mass, total body water, total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL) and fibrinogen as well as systolic and diastolic blood pressure were measured at baseline and during the therapy. Hyperprolactinemic patients had pathologic and significantly higher levels of prolactin (PRL) than the controls (p=0.000). The BMI, body fat, total body water (TBW), total cholesterol, triglycerides, LDL were in normal range and higher in the patients than in the controls. HDL was lower in hyperprolactinemic females than controls. The difference was significant only for body fat (fat % p=0.006; fat kg p=0.009). Fibrinogen was slightly increased in patients compared with the controls. Hyperprolactinemic patients had normal, but increased levels of systolic and diastolic blood pressure compared with the controls. The difference with border significance was found in diastolic blood pressure (p=0.065). The correlation of PRL with all the observed parameters was positive apart from HDL, but relatively significant only with diastolic blood pressure (r=0.31). The therapy with dopamine agonists caused the decrease of all the observed parameters, but significant decreases was achieved only in BMI (p=0.028), total cholesterol levels (p<0.001) and LDL (p<0.002). Changes in BMI, body composition, serum lipids and lipoproteins, fibrinogen level and blood pressure confirm our hypothesis about the possible role of hyperprolactinemia in developing adverse metabolic disturbances which are reversible after treatment.

Determination of furanochromones and pyranocoumarins in drugs and Ammi visnaga fruits by combined solid-phase extraction-high-performance liquid chromatography and thin-layer chromatography-high-performance liquid chromatography.

A new, simple and rapid solid-phase extraction method for the determination of furanochromones and pyranocoumarins in Ammi visnaga L. fruits and pharmaceuticals by reversed-phase high-performance liquid chromatography (RP-HPLC) was developed. The isolation of compounds examined was carried out on octadecyl BakerBond SPE columns using various concentrations of methanol, acetonitrile and tetrahydrofuran in water. High and reproducible recoveries were obtained. To compare the results of quantitative analysis a preparative TLC procedure was also elaborated and carried out.

[Aneurysm within the optic nerve. Case report]. / Tetniak wewnatrz nerwu wzrokowego. Opis przypadku.

In a group of 65 aneurysms of the anterior communicating artery treated in the years 1977 to 1984 in the Department of Neurosurgery, Medical Academy in Katowice in one case the aneurysm had an atypical situation penetrating into the optic nerve. A similar case of an aneurysm of the internal carotid artery was reported in the Polish literature only by Tokarz et al. in 1977.

[Risk of hemorrhage and size of hematoma in patients with cerebral arteriovenous malformations]. / Ryzyko krwawienia i rozmiary krwiaka sródmózgowego u chorych z naczyniakami tetniczo-zylnymi mózgu.

The occurrence of intracranial haemorrhage, epileptic seizures and focal neurological signs was estimated in the group of 40 patients with AVMs. Size of AVM, its localization was established by angiography. Maximum diameter of a haematoma was measured on preoperative CT. We found that small AVMs (diameter < 3 cm) are more often the source of intracranial haemorrhage than larger ones. Intracerebral haematoma was the larger the lesser was AVM. Intracerebral haematoma has no influence on immediate and long-term results of operative treatment of AVMs.

[Surgical treatment of cerebral hematoma using an endoscopic method]. / Leczenie operacyjne krwiaków sródmózgowych metoda endoskopowa.

In the period from January 1990 to March 1991 in the Neurosurgery Department, Mining Industry Health Service Hospital in Sosnowiec 21 operations of evacuation of supratentorial intracranial haematomas were carried out by the endoscopic method using a neuroendoscope produced by K. Storz. The indication to this operation was a serious condition of the patients up to 10 points of the Glasgow scale, strictly limited extent of haematoma and ventricular system shifting over 5 mm in computed tomography. The mass of the haematoma could be evacuated in 70-90% and the patients were spared extensive craniotomy. Two patients had reoperations due to renewed haematoma formation. 48% of the patients left the hospital in good condition without neurological deficits and 42.5% had focal neurological signs.

[[Microsurgical treatment of cerebral hemangioma]. / Mikrochirurgiczne leczenie naczyniaków mózgu.

The authors present the results of microsurgical treatment of 16 patients with intracranial arteriovenous malformations. The applied technique made possible considerable sparing of healthy brain tissue and closing feeders closely to haemangioma. The patients in I to III degree according to Spetzler's scale left the hospital in good condition. The patients in IV and V degree in 4 cases were operated on twice and in control examination have presented mild neurological dysfunction. Severe disability was observed only in 1 patient. Control angiography revealed in 3 of these patients the presence of small parts of haemangioma.

[Intracranial hemorrhages in patients with renal polycystic degeneration]. / Krwotoki sródczaszkowe u chorych z torbielowatoscia nerek.

A female patient is described in whom symptoms of cholecystitis developed after operation for intracranial aneurysm. Enlarged polycystic kidney was recognized erroneously as gallbladder and this error led to laparotomy. In another case meningocerebral haemorrhage developed in a hypertensive patient with polycystic kidney degeneration.

[Spontaneous resorption of an epidural hematoma. Description of 2 cases]. / Samoistna resorpcja krwiaka nadtwardówkowego. Opis dwóch przypadków.

Two patients with subacute epidural haematomas without shifted ventricular system are described in whom the diagnosis was made by computer tomography 8 and 9 days after trauma. Both patients were treated successfully checking the progress with computer tomography and using agents reducing brain oedema.

[Two cases of colloid cysts of the third ventricle with nasal rhinorrhea]. / Dwa przypadki torbieli koloidowej III komory z plynotokiem przez nos.

The authors present 2 cases of tumours of third ventricle with intracranial hypertension and cerebrospinal fluid rhinorrhea. The cause of the CSF rhinorrhea most often was thinning of lamina ethmoidalis and dura mater and rarely intussusception of arachnoidea into the intrasellar space in patients with oval orifice for the stalk of pituitary body due to prolonged intracranial hypertension. Efficacious treatment of CSF rhinorrhea comprises not only removing of the tumor but also introducing the valve and in some cases tightening of the base of the anterior and middle fossa.

[Surgical treatment of a giant aneurysm of the middle cerebral artery]. / Chirurgiczne leczenie olbrzymich tetniaków tetnicy srodkowej mózgu.

Four patients with giant aneurysms of the middle cerebral artery over 2.5 cm in diameter were treated surgically. The aneurysms were excised during operations carried out under hypotension achieved with sodium nitroprusside, with administration of large amounts of mannitol and with arrest of blood flow in the middle cerebral artery for 3-10 minutes. Two patients had reoperations for postoperative complications. After the operation the patient who was initially in grade III of Botterell's scale died, and three other patients were in a good condition after one years with moderate paresis of the upper extremity.

[A case of acoustic neurinoma in a girl aged 13]. / Przypadek nerwiaka nerwu sluchowego u 13-letniej dziewczynki.

A 13-year-old girl with large richly vascularized acoustic neurinoma is reported. The family history and clinical evidence failed to suggest neurofibromatosis in the family. The clinical syndrome included paroxysmal headaches, vertigo, loss of consciousness and left ear hearing loss. The application of Nd-YAG laser during the operation reduced bleeding and enabled radical removal of the tumour.

[Misleading CT image in a case of giant cerebral aneurysm]. / Mylacy obraz CT w przypadku olbrzymiego tetniaka mózgu.

A giant intracranial aneurysm is described in a woman aged 70. CT image suggested an expanding lesion.

[Application of alteplase in prevention of cerebral vasospasm and its sequelae in patients after aneurysmal subarachnoid hemorrhage from ruptured cerebral aneurysm]. / Zastosowanie rekombinowanego tkankowego aktywatora plazminogenu w profilaktyce skurczu naczyniowego oraz jego nastepstw u chorych po krwotoku podpajeczynówkowym z peknietego tetniaka mózgu.

15 patients after SAH from ruptured cerebral aneurysm were operated on within 72 hours after SAH. During the operation after clipping of aneurysm 10 mg of rtPA was administered into basal cisterns, Control group consisted of patients who did not receive rtPA. All the patients on the basis of CT scan were classified to III grade according to Fisher's classification. Control CT scan revealed dissolution of most clots in basal cisterns. In comparison with control group the patients who received rtPA rarely experienced radiological signs of vasospasm and delayed neurological deficit.

The influence of hyperprolactinemia on coagulation parameters in females with prolactinomas.

INTRODUCTION: Currently there is little information on the effects of prolactin (PRL) on the coagulation and fibrinolytic systems. OBJECTIVE: The aim of this study was to evaluate the effects of hypeprolactinemia on the parameters of the hemostatic system and activation of the coagulation system. METHODS: We studied PRL levels, body mass index (BMI), values of activated partial thromboplastin time (aPTT), prothrombin time (PT), thrombin time (TT), D-dimer level, von Willebrand factor antigen (vWFAg) and fibrinogen in 15 young female patients with microprolactinomas before and after therapy and in 15 healthy female controls. RESULTS: As expected, pretreatment PRL levels were significantly higher in patients than in controls (140.90 +/- 42.87 vs. 12.53 +/- 4.05 ng/ml; p < 0.001). PT, although still in the normal range, was prolonged in patients with hyperprolactinemia as compared to the control group (13.53 +/- 1.39 vs. 12.65 +/- 0.53 s; p = 0.03) and normalized after therapy (12.69 +/- 0.65 vs. 12.65 +/- 0.53 s; p = 0.88). TT, although in normal range, was significantly shorter in the hypeprolactinemic patients than in the controls (14.34 +/- 4.52 vs. 17.21 +/- 1.35 s; p < 0.025) and after treatment remained significantly shorter than in the controls (15.17 +/- 1.55 vs. 17.21 +/- 1.35 s; p < 0.0001). D-dimer values before treatment in the patients with hyperproplactinemia were above the normal range (239.47 +/- 107.93 vs. 131.27 +/- 50.64 ng/ml, p = 0.002) and decreased to normal values after therapy (239.47 +/- 107.93 vs. 146.60 +/- 39.15 ng/ml; p < 0.001). D-dimer levels correlated with PRL (r = 0.30) and the change in serum D-dimer values significantly correlated with the change in PRL levels during therapy (r = 0.62). aPTT, vWFAg and fibrinogen were similar in patients and controls. CONCLUSION: In our study, increased thrombin generation that resulted in elevated D-dimer levels may be one of the contributing factors to the prethrombotic state in patients with hyperprolactinemia.