Carcinoma Of The Vulva
cancer; gynecologic-oncology-group; malignant-melanoma; management; Obstetrics & Gynecology; pagets-disease; prognostic factors; radiation; squamous-cell carcinoma; survival
Vulvar cancer is relatively rare and accounts for 3% to 5% of all gynecologic malignancies. This malignancy usually is diagnosed in the elderly population, with the mean age in the late sixties, although it can be diagnosed in any age group. The pathologic cell type is usually squamous cell carcinoma, accounting for 85% of these malignancies. The remaining 15% are unusual or rare cell types. This article presents an overview of vulvar malignancies, including a discussion of etiology, symptoms, diagnosis, pathologic types, natural history spread of the disease, staging, and treatment.
Hopkins M P; Nemunaitis-Keller J
Obstetrics and Gynecology Clinics of North America
2001
2001-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/s0889-8545(05)70236-9" target="_blank" rel="noreferrer noopener">10.1016/s0889-8545(05)70236-9</a>
Gnathic And Postcranial Skeleton Of The Largest Known Arctocyonid 'condylarth' Arctocyon Mumak (mammalia, Procreodi) And Ecomorphological Diversity In Procreodi
adaptations; artiodactyla; eocene; locomotor behavior; morphology; origin; Paleontology; radiation; revision
Procreodi is an order of Paleocene and Eocene mammals thought to lie at the base of the radiation of the paraphyletic condylarths.' Taxa within the order have been linked to the origins of other condylarth groups, and of some living orders. Within the order, there are specializations indicative of a range of behaviors, and a considerable size range including some of the largest Paleocene mammals. Arctocyon mumak is the largest known arctocyonid. Several craniodental specimens from the Tiffanian of western North America and one partial skeleton, preserving parts of the fore- and hind limbs, pelvic and pectoral girdles, and some vertebrae, with associated teeth and other bony elements, are described here for the first time. Skeletal elements of A. mumak are larger than those of other species of Arctocyon and Anacodon, but are otherwise similar in overall morphology. Certain features of the tarsus, such as the large plantar tubercle on the navicular and the well-developed groove below the sustentaculum tali, are shared between A. mumak and Anacodon to the exclusion of Artcocyon and are suggestive of plantigrady and a degree of fossoriality. Univariate and multivariate statistical analyses of six ecomorphological ratios successfully distinguishes a taxonomically diverse group of 47 extant taxa with differing locomotor specializations. When calculated for Arctocyon mumak, these ratios support the view that this taxon was a terrestrial, possibly semi-fossorial taxon. Other taxa within Procreodi are recovered as more arboreal or more terrestrial. Significant ecological and morphological variation exists within this understudied group. SUPPLEMENTAL DATASupplemental materials are available for this article for free at www.tandfonline.com/UJVP
Gould F D H; Rose K D
Journal of Vertebrate Paleontology
2014
1905-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1080/02724634.2014.841707" target="_blank" rel="noreferrer noopener">10.1080/02724634.2014.841707</a>
Physicochemical characterization of a model digestive mixture by 2H NMR.
Deuterium; Lipids/*chemistry; Magnetic Resonance Spectroscopy; Radiation; Scattering
2H nuclear magnetic resonance (NMR) spectra were obtained at 30.87 MHz for 8% (w/v) aqueous dispersions of mixtures of bile salts (MBS), mixed intestinal lipids (MIL; myristic acid, monomyristoylglycerol, dimyristoylphosphatidylcholine = 5:1:1), and cholesterol, in which a single lipid component is selectively
Westerman P W
Journal of lipid research
1995
1995-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Reexamining interstitial radiotherapy for PCa.
Humans; Male; Ultrasonography; Treatment Outcome; Forecasting; *Brachytherapy/adverse effects/instrumentation/methods/trends; *Radioisotopes/adverse effects; Prostatectomy; Prostatic Neoplasms/diagnostic imaging/*radiotherapy; Dose-Response Relationship; Radiation
Summers J L
Contemporary urology
1994
1994-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Glycinergic "inhibition" mediates selective excitatory responses to combinations of sounds.
Animals; Acoustic Stimulation/methods; Neural Inhibition/drug effects/*physiology; *Sound; Excitatory Amino Acid Antagonists/pharmacology; Action Potentials/drug effects/physiology; Auditory Pathways/*physiology; Glycine Agents/pharmacology; Glycine/*physiology; Chiroptera/physiology; Drug Interactions; GABA Agents/pharmacology; Inferior Colliculi/cytology/drug effects/*physiology; Iontophoresis/methods; Neurons/drug effects/physiology/radiation effects; Piperazines/pharmacology; Dose-Response Relationship; Receptors; Radiation; GABA/physiology; N-Methyl-D-Aspartate/antagonists & inhibitors/physiology
In the mustached bat's inferior colliculus (IC), combination-sensitive neurons display time-sensitive facilitatory interactions between inputs tuned to distinct spectral elements in sonar or social vocalizations. Here we compare roles of ionotropic receptors to glutamate (iGluRs), glycine (GlyRs), and GABA (GABA(A)Rs) in facilitatory combination-sensitive interactions. Facilitatory responses to 36 single IC neurons were recorded before, during, and after local application of antagonists to these receptors. The NMDA receptor antagonist CPP [(+/-)-3-(2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid], alone (n = 14) or combined with AMPA receptor antagonist NBQX (n = 22), significantly reduced or eliminated responses to best frequency (BF) sounds across a broad range of sound levels, but did not eliminate combination-sensitive facilitation. In a subset of neurons, GABA(A)R blockers bicuculline or gabazine were applied in addition to iGluR blockers. GABA(A)R blockers did not "uncover" residual iGluR-mediated excitation, and only rarely eliminated facilitation. In nearly all neurons for which the GlyR antagonist strychnine was applied in addition to iGluR blockade (22 of 23 neurons, with or without GABA(A)R blockade), facilitatory interactions were eliminated. Thus, neither glutamate nor GABA neurotransmission are required for facilitatory combination-sensitive interactions in IC. Instead, facilitation may depend entirely on glycinergic inputs that are presumed to be inhibitory. We propose that glycinergic inputs tuned to two distinct spectral elements in vocal signals each activate postinhibitory rebound excitation. When rebound excitations from two spectral elements coincide, the neuron discharges. Excitation from glutamatergic inputs, tuned to the BF of the neuron, is superimposed onto this facilitatory interaction, presumably mediating responses to a broader range of acoustic signals.
Sanchez Jason Tait; Gans Donald; Wenstrup Jeffrey J
The Journal of neuroscience : the official journal of the Society for Neuroscience
2008
2008-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1523/JNEUROSCI.3572-07.2008" target="_blank" rel="noreferrer noopener">10.1523/JNEUROSCI.3572-07.2008</a>
Impact of reirradiation of painful osseous metastases on quality of life and function: a secondary analysis of the NCIC CTG SC.20 randomized trial.
*Quality of Life; 80 and over; Adult; Aged; Bone Neoplasms/complications/psychology/*radiotherapy/*secondary; Dose Fractionation; Emotions; Female; Health Status; Humans; Male; Mental Health; Middle Aged; Pain Measurement; Pain/diagnosis/etiology/*prevention & control/psychology; Radiation; Retreatment; Surveys and Questionnaires; Time Factors; Treatment Outcome; Young Adult
PURPOSE: We previously demonstrated that 48% of patients with pain at sites of previously irradiated bone metastases benefit from reirradiation. It is unknown whether alleviating pain also improves patient perception of quality of life (QOL). PATIENTS AND METHODS: We used the database of a randomized trial comparing radiation treatment dose fractionation schedules to evaluate whether response, determined using the International Consensus Endpoint (ICE) and Brief Pain Inventory pain score (BPI-PS), is associated with patient perception of benefit, as measured using the European Organisation for Resesarch and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and functional interference scale of the BPI (BPI-FI). Evaluable patients completed baseline and
Chow Edward; Meyer Ralph M; Chen Bingshu E; van der Linden Yvette M; Roos Daniel; Hartsell William F; Hoskin Peter; Wu Jackson S Y; Nabid Abdenour; Tissing-Tan Caroline J A; Oei Bing; Babington Scott; Demas William F; Wilson Carolyn F; Wong Rebecca K S; Brundage Michael
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
2014
2014-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1200/JCO.2014.57.6264" target="_blank" rel="noreferrer noopener">10.1200/JCO.2014.57.6264</a>
Leading inhibition to neural oscillation is important for time-domain processing in the auditory midbrain.
*Periodicity; Acoustic Stimulation/methods; Action Potentials/drug effects/physiology; Animals; Anura; Auditory Pathways/physiology; Bicuculline/pharmacology; Chiroptera; Dose-Response Relationship; Echolocation/*physiology; GABA Antagonists/pharmacology; Mesencephalon/*cytology/physiology; Neural Inhibition/drug effects/*physiology; Neurons/drug effects/*physiology; Newborn; Radiation; Reaction Time/drug effects/*physiology; Sound; Species Specificity; Time Factors
A number of central auditory neurons exhibit paradoxical latency shift (PLS), a response characterized by longer response latencies at higher sound levels. PLS neurons are known to play a role in target ranging for echolocating bats that emit frequency-modulated sounds. We recently reported that early inhibition of unit's oscillatory discharges is critical for PLS in the inferior colliculus (IC) of little brown bats. The goal of this study was to determine in echolocating bats and in non-echolocating animals (frogs): 1) the detailed characteristics of PLS and whether PLS was dependent on sound level, frequency, and duration; 2) the time course of inhibition underlying PLS using a paired-pulse paradigm. We found that 22% of IC neurons in bats and 15% in frogs exhibited periodic discharge patterns in response to tone pulses at high sound levels. The firing periodicity was unit specific and independent of sound level and duration. Other IC neurons (28% in bats; 14% in frogs) exhibited PLS. These PLS neurons shared several response characteristics: 1) PLS was largely independent of sound frequency and 2) the magnitude of shift in first-spike latency was either duration dependent or duration tolerant. For PLS neurons, application of bicuculline abolished PLS and unmasked the unit's periodical firing pattern that served as the building block for PLS. In response to paired sound pulses, PLS neurons exhibited delay-dependent response suppression, confirming that high-threshold leading inhibition was responsible for PLS. Results also revealed the timing of excitatory and inhibitory inputs underlying PLS and its role in time-domain processing.
Galazyuk Alexander V; Lin Wenyu; Llano Daniel; Feng Albert S
Journal of neurophysiology
2005
2005-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1152/jn.00056.2005" target="_blank" rel="noreferrer noopener">10.1152/jn.00056.2005</a>
Single versus multiple fractions of repeat radiation for painful bone metastases: a randomised, controlled, non-inferiority trial.
*Dose Fractionation; *Radiotherapy; Aged; Analgesics – Therapeutic Use; Analgesics/therapeutic use; Australia; Bone Neoplasms; Bone Neoplasms – Complications; Bone Neoplasms – Radiotherapy; Bone Neoplasms/complications/*radiotherapy/*secondary; Brief Pain Inventory; Canada; Cauda Equina; Chi Square Test; Chi-Square Distribution; Clinical Assessment Tools; Clinical Trials; Computer-Assisted; Computer-Assisted – Adverse Effects; Computer-Assisted/adverse effects; Europe; Female; Fractures; Funding Source; Human; Humans; Intention to Treat Analysis; Israel; Logistic Models; Logistic Regression; Male; Middle Age; Middle Aged; New Zealand; Odds Ratio; Pain – Diagnosis; Pain – Drug Therapy; Pain – Etiology; Pain – Radiotherapy; Pain Measurement; Pain/diagnosis/drug therapy/*etiology/*radiotherapy; Questionnaires; Radiation; Radiation Dosage; Radiotherapy; Radiotherapy Planning; Risk Factors; Scales; Spinal Cord Compression – Etiology; Spinal Cord Compression/etiology; Spontaneous – Etiology; Spontaneous/etiology; Surveys and Questionnaires; Time Factors; Treatment Outcome; Treatment Outcomes
BACKGROUND: Although repeat radiation treatment has been shown to palliate pain in patients with bone metastases from multiple primary origin sites, data for the best possible dose fractionation schedules are lacking. We aimed to assess two dose fractionation schedules in patients with painful bone metastases needing repeat radiation therapy. METHODS: We did a multicentre, non-blinded, randomised, controlled trial in nine countries worldwide. We enrolled patients 18 years or older who had radiologically confirmed, painful (ie, pain measured as \textgreater/=2 points using the Brief Pain Inventory) bone metastases, had received previous radiation therapy, and were taking a stable dose and schedule of pain-relieving drugs (if prescribed). Patients were randomly assigned (1:1) to receive either 8 Gy in a single fraction or 20 Gy in multiple fractions by a central computer-generated allocation sequence using dynamic minimisation to conceal assignment, stratified by previous radiation fraction schedule, response to initial radiation, and treatment centre. Patients, caregivers, and investigators were not masked to treatment allocation. The primary endpoint was overall pain response at 2 months, which was defined as the sum of complete and partial pain responses to treatment, assessed using both Brief Pain Inventory scores and changes in analgesic consumption. Analysis was done by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00080912. FINDINGS: Between Jan 7, 2004, and May 24, 2012, we randomly assigned 425 patients to each treatment group. 19 (4%) patients in the 8 Gy group and 12 (3%) in the 20 Gy group were found to be ineligible after randomisation, and 140 (33%) and 132 (31%) patients, respectively, were not assessable at 2 months and were counted as missing data in the intention-to-treat analysis. In the intention-to-treat population, 118 (28%) patients allocated to 8 Gy treatment and 135 (32%) allocated to 20 Gy treatment had an overall pain response to treatment (p=0.21; response difference of 4.00% [upper limit of the 95% CI 9.2, less than the prespecified non-inferiority margin of 10%]). In the per-protocol population, 116 (45%) of 258 patients and 134 (51%) of 263 patients, respectively, had an overall pain response to treatment (p=0.17; response difference 6.00% [upper limit of the 95% CI 13.2, greater than the prespecified non-inferiority margin of 10%]). The most frequently reported acute radiation-related toxicities at 14 days were lack of appetite (201 [56%] of 358 assessable patients who received 8 Gy vs 229 [66%] of 349 assessable patients who received 20 Gy; p=0.011) and diarrhoea (81 [23%] of 357 vs 108 [31%] of 349; p=0.018). Pathological fractures occurred in 30 (7%) of 425 patients assigned to 8 Gy and 20 (5%) of 425 assigned to 20 Gy (odds ratio [OR] 1.54, 95% CI 0.85-2.75; p=0.15), and spinal cord or cauda equina compressions were reported in seven (2%) of 425 versus two (\textless1%) of 425, respectively (OR 3.54, 95% CI 0.73-17.15; p=0.094). INTERPRETATION: In patients with painful bone metastases requiring repeat radiation therapy, treatment with 8 Gy in a single fraction seems to be non-inferior and less toxic than 20 Gy in multiple fractions; however, as findings were not robust in a per-protocol analysis, trade-offs between efficacy and toxicity might exist. FUNDING: Canadian Cancer Society Research Institute, US National Cancer Institute, Cancer Council Australia, Royal Adelaide Hospital, Dutch Cancer Society, and Assistance Publique-Hopitaux de Paris.
Chow Edward; van der Linden Yvette M; Roos Daniel; Hartsell William F; Hoskin Peter; Wu Jackson S Y; Brundage Michael D; Nabid Abdenour; Tissing-Tan Caroline J A; Oei Bing; Babington Scott; Demas William F; Wilson Carolyn F; Meyer Ralph M; Chen Bingshu E; Wong Rebecca K S
The Lancet. Oncology
2014
2014-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/S1470-2045(13)70556-4" target="_blank" rel="noreferrer noopener">10.1016/S1470-2045(13)70556-4</a>
Predictive model for survival in patients having repeat radiation treatment for painful bone metastases.
*Models; Aged; Bone metastases; Bone Neoplasms/*mortality/*radiotherapy/secondary; Dose Fractionation; Female; Humans; Male; Middle Aged; Predictive model; Predictive Value of Tests; Proportional Hazards Models; Radiation; Randomized Controlled Trials as Topic/methods; Re-irradiation; Statistical; Survival; Survival Analysis; Survival Rate
PURPOSE: To establish a survival prediction model in the setting of a randomized trial of re-irradiation for painful bone metastases. METHODS: Data were randomly divided into training and testing sets with an approximately 3:2 ratio. Baseline factors of gender, primary cancer site, KPS, worst-pain score and age were included with backward variable selection to derive a model using the training set. A partial score was assigned by dividing the value of each statistically significant regression coefficient by the smallest statistically significant regression coefficient. The survival prediction score (SPS) was obtained by adding together partial scores for the variables that were statistically significant. Three risk groups were modelled. RESULTS: The training set included 460 patients and the testing set 351 patients. Only KPS and primary cancer site reached the 5%-significance level. Summing up the partial scores assigned to KPS (90-100, 0; 70-80, 1; 50-60, 2) and primary cancer site (breast, 0; prostate, 1.3; other, 2.6; lung, 3) totalled the SPS. The 1/3 and 2/3 percentiles of the SPS were 2 and 3.6. For the testing set, the median survival of the 3 groups was not reached, 11.3 (95% C.I. 8.5 - not reached) and 5.2 months (95% C.I. 3.7-6.5). The 3, 6 and 12 month survival rates for the worst group were 64.4% (95% C.I. 55.3-72.1%), 43.0% (95% C.I. 34.0-51.8%) and 19.7% (95% C.I. 12.4-28.1%) respectively, similar to that in the training set. CONCLUSION: This survival prediction model will assist in choosing dose fractionation. We recommend a single 8 Gy in the worst group identified.
Chow Edward; Ding Keyue; Parulekar Wendy R; Wong Rebecca K S; van der Linden Yvette M; Roos Daniel; Hartsell William F; Hoskin Peter; Wu Jackson S Y; Nabid Abdenour; Leer Jan Willem; Vonk Ernest; Babington Scott; Demas William F; Wilson Carolyn F; Brundage Michael; Zhu Liting; Meyer Ralph M
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
2016
2016-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.radonc.2015.10.018" target="_blank" rel="noreferrer noopener">10.1016/j.radonc.2015.10.018</a>