134 research outputs found
INDO-AUSTRALIAN POMPILIDAE (Hym.) II. An annotated list of the oriental species of the genus Hemipepsis DAHLB
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ONINDO-AUSTRALIAN BEMBECINUS, WITH SPECIAL REFERENCE TO THE SPECIES OCCURRING IN JAVA (Hym., Sphec.)
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DESCRIPTIONS AND RECORDS OF ORIENTAL AND PAPUAN SOLITARY VESPIDAE (HYM.).
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INDO-AUSTRALIAN POMPILIDAE (Hym.) I. Leptodialepis "bipartitus (LEP.) and some similarly coloured species
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THE HEM/PEPSIS SPECIES OF JAVA
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Paraneoplastic cerebellar degeneration associated with antineuronal antibodies: analysis of 50 patients
Paraneoplastic cerebellar degeneration (PCD) is a heterogeneous group of
disorders characterized by subacute cerebellar ataxia, specific tumour
types and (often) associated antineuronal antibodies. Nine specific
antineuronal antibodies are associated with PCD. We examined the relative
frequency of the antineuronal antibodies associated with PCD and compared
the neurological symptoms and signs, associated tumours, disability and
survival between groups of PCD with different antibodies. Also, we
attempted to identify patient-, tumour- and treatment-related
characteristics associated with functional outcome and survival. In a
12-year period, we examined >5000 samples for the presence of antineuronal
antibodies. A total of 137 patients were identified with a paraneoplastic
neurological syndrome and high titre (> or =400) antineuronal antibodies.
Fifty (36%) of these patients had antibody-associated PCD, including 19
anti-Yo, 16 anti-Hu, seven anti-Tr, six anti-Ri and two anti-mGluR1.
Because of the low number, the anti-mGluR1 patients were excluded from the
statistical analysis. While 100% of patients with anti-Yo, anti-Tr and
anti-mGluR1 antibodies suffered PCD, 86% of anti-Ri and only 18% of
anti-Hu patients had PCD. All patients presented with subacute cerebellar
ataxia progressive over weeks to months and stabilized within 6 months.
The majority of patients in all antibody groups had both truncal and
appendicular ataxia. The frequency of nystagmus and dysarthria was lower
in anti-Ri patients (33 and 0%). Later in the course of the disease,
involvement of non-cerebellar structures occurred most frequently in
anti-Hu patients (94%). In 42 patients (84%), a tumour was detected. The
most commonly associated tumours were gynaecological and breast cancer
(anti-Yo and anti-Ri), lung cancer (anti-Hu) and Hodgkin's lymphoma
(anti-Tr and anti-mGluR1). In one anti-Hu patient, a suspect lung lesion
on CT scan disappeared while the PCD evolved. Seven patients improved by
at least 1 point on the Rankin scale, while 16 remained stable and 27
deteriorated. All seven patients that improved received antitumour
treatment for their underlying cancer, resulting in complete remission.
The functional outcome was best in the anti-Ri patients, with three out of
six improving neurologically and five were able to walk at the time of
last follow-up or death. Only four out of 19 anti-Yo and four out of 16
anti-Hu patients remained ambulatory. Also, survival from time of
diagnosis was significantly worse in the anti-Yo (median 13 months) and
anti-Hu (median 7 months) patients compared with anti-Tr (median >113
months) and anti-Ri (median >69 months). Patients receiving antitumour
treatment (with or without immunosuppressive therapy) lived significantly
longer [hazard ratio (HR) 0.3; 95% confidence interval (CI) 0.1-0.6; P =
0.004]. Patients > or =60 years old lived somewhat shorter from time of
diagnosis, although statistically not significant (HR 2.9; CI 1.0-8.5; P =
0.06)
Second-line chemotherapy with temozolomide in recurrent oligodendroglioma after PCV (procarbazine, lomustine and vincristine) chemotherapy: EORTC Brain Tumor Group phase II study 26972
BACKGROUND: Oligodendroglial tumors are chemosensitive, with two-thirds of
patients responding to PCV combination chemotherapy with procarbazine,
lomustine (CCNU) and vincristine. Temozolomide (TMZ), a new alkylating and
methylating agent has shown high response rates in recurrent anaplastic
astrocytoma. We investigated this drug in recurrent oligodendroglial
tumors (OD) and mixed oligoastrocytomas (OA) after prior PCV chemotherapy
and radiation therapy. PATIENTS AND METHODS: In a prospective
non-randomized multicenter phase II trial patients were treated with TMZ
150 mg/m(2) on days 1-5 in cycles of 28 days for 12 cycles. Eligible
patients had a recurrence after prior PCV chemotherapy, with measurable
and enhancing disease as shown by magnetic resonance imaging. Pathology
and all responses were centrally reviewed. RESULTS: Thirty-two eligible
patients were included. In four patients the pathology review did not
confirm the presence of an OD or OA. Twelve of 24 patients [50%, 95%
confidence interval (CI) 29% to 71%] evaluable for response to first-line
PCV chemotherapy had responded to PCV. Temozolomide was in general well
tolerated; the most frequent side-effects were hematological. One patient
discontinued treatment due to toxicity. In seven of 28 patients (25%, 95%
CI 11% to 45%) with histologically confirmed OD an objective response to
TMZ was observed. Median time to progression for responding patients was
8.0 months. After 6 and 12 months from the start of treatment, 29% and 11%
of patients, respectively, were still free from progression. CONCLUSIONS:
TMZ may be regarded as the preferred second-line treatment in OD after
failure of PCV chemotherapy. Further studies on TMZ in OD are indicated
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