RESUMO
The aim of the present study was to investigate the in vivo antiproliferative effect of interferon alpha (IFN-alpha) in patients with metastatic renal cell carcinoma (mRCC). Core needle biopsies of metastatic and/or the primary kidney cancer were obtained before interleukin-2 (IL-2)- and IFN-alpha-based immunotherapy in 34 patients and repeated after 5 weeks in 25 patients. Tumour proliferation was assessed by use of the anti-Ki-67 antibody MIB-1 and evaluated in multiple, random systematic sampled fields of vision. Ki-67 labelling index (LI) at baseline was median 13.6% (range 1.2-85.0) and median 10.6% (range 1.3-48.6%) at week 5 with a median overall decline of 15.2% (range -95 to +258%) from baseline to week 5. There was no difference between responding and nonresponding patients. Ki-67 LI at week 5 was significantly correlated to survival. Thus, median survival of patients with Ki-67 LI
Assuntos
Antineoplásicos/imunologia , Antineoplásicos/uso terapêutico , Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/imunologia , Interferon-alfa/imunologia , Interferon-alfa/uso terapêutico , Antígeno Ki-67/análise , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/imunologia , Adulto , Idoso , Biópsia por Agulha , Carcinoma de Células Renais/patologia , Divisão Celular , Feminino , Humanos , Interleucina-2/imunologia , Interleucina-2/uso terapêutico , Antígeno Ki-67/imunologia , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Prognóstico , Análise de SobrevidaRESUMO
Following iotrolan cervical myelography 14 consecutive patients were evaluated with respect to intracranial contrast distribution and elimination, side effects, EEG-changes and psychometric assessments. The contrast medium is distributed in the subarachnoid space, in the ventricles and finally extracellularly in the cortex. Headache was the most prevalent side effect, occurring in half of the patients, 43% of "severe" grade. Eight patients showed mild nonspecific EEG-changes and all patients showed neuropsychologic disturbances.
Assuntos
Encéfalo/efeitos dos fármacos , Meios de Contraste/efeitos adversos , Eletroencefalografia/efeitos dos fármacos , Mielografia , Ácidos Tri-Iodobenzoicos/efeitos adversos , Encéfalo/metabolismo , Feminino , Cefaleia/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Testes Psicológicos , Fatores de TempoRESUMO
Cervical myelography (CM) was taken from 14 cases with cervical root-compression symptoms. Prior to myelography, there was complete cranial CT registration to assess the subarachnoid, intraventricular, subcortical and periventricular densities. Control scans at 3,6,24 and 48 h following myelography disclosed intracranial contrast medium at level of basal cisterns, the fourth ventricle and fissura Sylvii. Nine and 11 patients, respectively, had enhancement in the third and lateral ventricles. All patients had subcortical enhancement, and 9 patients had periventricular enhancement; at the 3-h control CT after myelography a minor subcortical edema was disclosed, which declined during the following hours. Two days after myelography, a minimal residual contrast was disclosed subcortically at the level of fissura Sylvii and in the subarachnoid space at the level of fissura Sylvii and the convexity. Hence, we recommend, that diagnostic cranial CT is performed before or postponed until 3 days after cervical myelography. The patients were questioned about adverse effects, and they underwent psychometric assessment and EEG-recordings: 11 had adverse effects, chiefly mild and exclusively transient, without sequelae. Three patients had no side effect. The psychometric assessment, however, disclosed pronounced deterioration in all patients at test 28 h after myelography, especially marked in the verbal paired associates test, however these disturbances were totally absent at retest one week later. No EEG-abnormalities developed; consistently, no patient had seizures. In conclusion, following CM iohexol is taken up by the brain parenchyma, gradually disappearing within 48 h, during which time a brain CT will be disturbed. During the same period some deterioration of psychometric tests may be found.