scholarly journals Checkpoint inhibitors and radiotherapy in refractory malignant melanocytic schwannoma with Carney complex: first evidence of efficacy

2021 ◽  
Vol 14 (5) ◽  
pp. e240296
Author(s):  
Jyoti Bajpai ◽  
Akhil Kapoor ◽  
Rakesh Jalali ◽  
Mrinal M Gounder
Keyword(s):  
Progressive Disease ◽  
Checkpoint Inhibitors ◽  
External Beam Radiotherapy ◽  
Carney Complex ◽  
Spinal Nerve ◽  
The Novel ◽  
Nerve Roots ◽  
Novel Approach ◽  
History Of

Melanocytic schwannoma (MS) is a rare nerve sheath tumour characterised by melanin-producing neoplastic schwann cells that typically affects the posterior spinal nerve roots. We report an ultrarare case of recurrent/metastatic MS associated with Carney complex in a young woman with family history of breast cancer. This highlights the novel approach of combined checkpoint inhibitors (CPI) and radiotherapy. The patient was initially treated with Nivolumab along with concurrent external beam radiotherapy. There was sustained clinical benefit achieved for over 15 months with preserved quality of life. Addition of Ipilimumab, which she tolerated reasonably well, helped to control the progressive disease again for another 12 months. She harboured a rare PRKAR1A R228 mutation (Carney complex) and received appropriate targeted therapy. She survived for 51 and 35 months from her initial diagnosis and start of CPI, respectively, which to the best of our knowledge is the longest documented survival in this rare entity.

An Efficient and Effective Approach to Developing Engineering E-Training Courses

2011 ◽  
pp. 26-39
Author(s):  
Judy C.R. Tseng ◽  
Wen-Ling Tsai ◽  
Gwo-Jen Hwang ◽  
Po-Han Wu
Keyword(s):  
New Technologies ◽  
Experimental Results ◽  
Traditional Learning ◽  
The Novel ◽  
Learning Materials ◽  
Challenging Issue ◽  
Novel Approach ◽  
Training Courses ◽  
Oriented Approach

In developing traditional learning materials, quality is the key issue to be considered. However, for high technical e-training courses, not only the quality of the learning materials but also the efficiency of developing the courses needs to be taken into consideration. It is a challenging issue for experienced engineers to develop up-to-date e-training courses for inexperienced engineers before further new technologies are proposed. To cope with these problems, a concept relationship-oriented approach is proposed in this paper. A system for developing e-training courses has been implemented based on the novel approach. Experimental results showed that the novel approach can significantly shorten the time needed for developing e-training courses, such that engineers can receive up-to-date technologies in time.

scholarly journals Management of HAM/TSP

2020 ◽  
pp. 10.1212/CPJ.0000000000000832 ◽  
Author(s):  
Abelardo Araujo ◽  
Charles R.M. Bangham ◽  
Jorge Casseb ◽  
Eduardo Gotuzzo ◽  
Steve Jacobson ◽  
...  
Keyword(s):  
Progressive Disease ◽  
Spastic Paraparesis ◽  
Oral Prednisolone ◽  
Interferon Α ◽  
High Dose ◽  
First Line Therapy ◽  
Methyl Prednisolone ◽  
Disease Modifying Therapy ◽  
History Of

Purpose of reviewTo provide an evidence-based approach to the use of therapies that are prescribed to improve the natural history of HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP)—a rare disease.Recent findingsAll 41 articles on the clinical outcome of disease-modifying therapy for HAM/TSP were included in a systematic review by members of the International Retrovirology Association; we report here the consensus assessment and recommendations. The quality of available evidence is low, based for the most part on observational studies, with only 1 double-masked placebo-controlled randomized trial.SummaryThere is evidence to support the use of both high-dose pulsed methyl prednisolone for induction and low-dose (5 mg) oral prednisolone as maintenance therapy for progressive disease. There is no evidence to support the use of antiretroviral therapy. There is insufficient evidence to support the use of interferon-α as a first-line therapy.

Avascular necrosis of the jaw in multiple myeloma (MM) patients (pts) treated with bisphosphonates (BP)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18538-18538
Author(s):  
L. Curreli ◽  
A. D. Palmas ◽  
G. Latte ◽  
A. Murgia ◽  
A. Gabbas
Keyword(s):  
Oral Cavity ◽  
Progressive Disease ◽  
Alveolar Bone ◽  
High Dose ◽  
Allogenic Bone ◽  
History Of Disease ◽  
Aggressive Surgical Approach ◽  
History Of ◽  
The Right

18538 Background: Oral cavity avascular bone necrosis (ABN) has been recently reported as an emerging serious complication in pts receiving BP for the treatment of hypercalcemia related to MM or metastatic solid tumors. Methods: We report the cases of 6 pts with MM treated initially with pamidronate and later with zoledronic acid (ZA). Results: Pts characteristics : M/F 3/3; mean age 58.4 (46–78); 4 IgG κ,1 γ and 1 κ MM; 5 St IIIA and 1 IIIB; mean history of disease 61.3 mo. (23–103); 5 pts had a relapsing MM refractory to several lines of therapy but 1 pt had received only high dose dexametazone (D); 2 pts had received autologous stem cell transplantation and 1 pt allogenic bone marrow transplantation; mean n.° of BP doses was 41.3 (17–81). At the time of ABN onset all pts were receiving ZA along with, respectively: D (2 pts); cyclophosphamide plus D (1 pt), bortezomib plus D (2 pts) and oral melphalan (1 pt). ABN was localized in 2 pts at alveolar bone of the right maxilla and presented as an inflammation of the gum, followed by a painful bone exposure. In the other 4 pts ABN was localized at mandible and presented as dental abscesses followed in 2/4 pts by cutaneous fistulization. Treatment has included in all pts discontinuation of ZA, antibiotics, chlorhexidine mouthwashes, pain control, minor regional débridement, and bone trimming. In 1 pt a more aggressive surgical approach was attempted at an other Institution and postoperative course was complicated by massive haemorrhage and complete loss of chewing. Four pts dead with progressive disease with a mean overall survival after ABN presentation of 6 mo.; 2 pts are alive after 3 and 4 mo. after ABN presentation; however in all pts ABN significantly worsened quality of life. Conclusions: Oral cavity ABN is a severe complication in refractory MM pts receiving BP. Mechanisms of action of BP that determine a reduction in osteoclastic activity and an accumulation of nonvital osteocytes with microfractures of old mineral matrix appear to play an important role. However other causes may be involved as a long history of disease; an uncontrolled progressive disease; type and doses of previous and present therapies, primarily steroids; status of oral cavity and teeth of pts and possibly the n.° of doses of BP. No significant financial relationships to disclose.

Neuromodulation for Overactive Bladder

2017 ◽  
Author(s):  
Natalie Gaines ◽  
Priyanka Gupta ◽  
Larry Sirls ◽  
Kenneth M Peters
Keyword(s):  
Overactive Bladder ◽  
Sacral Neuromodulation ◽  
Urge Urinary Incontinence ◽  
Spinal Nerve ◽  
Nerve Roots ◽  
Tibial Nerve Stimulation ◽  
Pudendal Neuromodulation ◽  
History Of ◽  
Third Line Therapy ◽  
Third Line

Neuromodulation is an FDA-approved treatment modality for overactive bladder. The AUA/SUFU guidelines for management of overactive bladder include neuromodulation as a third-line therapy after failure of more conservative therapies, such as behavioral modifications and pharmacotherapy. In this review, a brief history of the technology required to develop the implantable neuroprosthesis is discussed. We examine relevant neuroanatomy and the most recent discoveries for the pathophysiology of overactive bladder, and our current best understanding of the mechanism of action of neuromodulation is considered. The three routes for neuromodulation, sacral, pudendal, and posterior tibial, are discussed individually, with outcomes, complication, and cost data reviewed for each modality. Finally, an update of future developments in neuromodulation is included. This review contains 8 highly rendered figures, 2 tables, and 71 references Key words: adverse event, implantable neurostimulators, neuromodulation, overactive, percutaneous tibial nerve stimulation, pudendal neuromodulation, sacral neuromodulation, spinal nerve roots, surgical intervention, urge urinary incontinence, urinary bladder

scholarly journals Calving-related intradural avulsion injuries of the thoracolumbar spinal nerve roots in a calf

2020 ◽  
Vol 32 (6) ◽  
pp. 968-971
Author(s):  
Hayate Nishiura ◽  
Shino Jou ◽  
Toru Ogata ◽  
Hiroki Kondo ◽  
Toshihiro Ichijo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cord Compression ◽  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Traumatic Neuroma ◽  
Old Japanese ◽  
History Of ◽  
Nerve Fascicle ◽  
Calving Difficulty

Calving difficulty may lead to traumatic peripheral nerve injury. A male, 8-mo-old, Japanese Black calf with a history of secondary dystocia as a result of fetal gigantism had lameness and gait disturbance. At autopsy, multifocal dural thickening with adhesions to the adjacent spinal cord was observed at T12–13 and L4–5 vertebral levels. Microscopically, numerous traumatic neuroma-like fascicles of nerve twigs were embedded in the dura mater with abundant collagenous connective tissue. By immunohistochemistry, axons and Schwann cells were confirmed in each nerve fascicle. Our observations suggest that avulsion injuries in the preganglionic fibers of the spinal nerve roots, and secondary spinal cord compression, resulted in the development of neurologic signs.

A virtual e-bespoke men's shirt based on new body measurements and method of pattern drafting

2020 ◽  
Vol 90 (19-20) ◽  
pp. 2223-2244
Author(s):  
Jiaqi Yan ◽  
Victor E Kuzmichev
Keyword(s):  
New Technologies ◽  
Apparel Industry ◽  
Morphological Features ◽  
Evaluation Procedure ◽  
Body Measurements ◽  
The Novel ◽  
Novel Approach ◽  
The One ◽  
High Level

Customization is prevailing in the apparel industry with increasing requirements from consumers and the popularization of new technologies. This study aimed to establish the novel approach of applying existing and new body measurements to customize the pattern block of a men's shirt, to enrich the anthropometric database, and to develop the fit evaluation procedure. New body measurements were extracted from 156 scanned male mesh bodies in accordance with the morphological features and developing method of pattern block sketching. Owing to these new body measurements, the customized shirt with assured high-level fit can be obtained by generating original patterns as bespoke, on the one hand, and by transforming ready-to-wear patterns, on the other hand. The first way is e-bespoke tailoring that utilizes the developed schedule of body morphological features, improved shirt pattern of desired style (body fit, slim fit, regular fit, and comfort fit), and virtual try-on software CLO 3D. The proposed method of virtual e-bespoke design allows readily completing a well-fitted and balanced men's shirt, which will contribute to the efficiency of customization and quality of end-products for the apparel industry.

scholarly journals Immunotherapy in Gastrointestinal Cancers

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Letizia Procaccio ◽  
Marta Schirripa ◽  
Matteo Fassan ◽  
Loredana Vecchione ◽  
Francesca Bergamo ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Public Health Problem ◽  
Predictive Biomarkers ◽  
Major Public Health Problem ◽  
Gastrointestinal Cancers ◽  
Hepatocellular Carcinomas ◽  
History Of ◽  
Gi Cancers ◽  
Clinical And Translational Research

Gastrointestinal cancers represent a major public health problem worldwide. Immunotherapeutic strategies are currently under investigation in this setting and preliminary results of ongoing trials adopting checkpoint inhibitors are striking. Indeed, although a poor immunogenicity for GI has been reported, a strong biological rationale supports the development of immunotherapy in this field. The clinical and translational research on immunotherapy for the treatment of GI cancers started firstly with the identification of immune-related mechanisms possibly relevant to GI tumours and secondly with the development of immunotherapy-based agents in clinical trials. In the present review a general overview is firstly provided followed by a focus on major findings on gastric, colorectal, and hepatocellular carcinomas. Finally, pathological and molecular perspectives are provided since many efforts are ongoing in order to identify possible predictive biomarkers and to improve patients’ selection. Many issues are still unsolved in this field; however, we strongly believe that immunotherapy might positively affect the natural history of a subgroup of GI cancer patients improving outcome and the overall quality of life.

scholarly journals Cancer Immunotherapy with Immune Checkpoint Inhibitors-Biomarkers of Response and Toxicity; Current Limitations and Future Promise

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 124
Author(s):  
Brian Healey Bird ◽  
Ken Nally ◽  
Karine Ronan ◽  
Gerard Clarke ◽  
Sylvie Amu ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Immune Cell ◽  
Checkpoint Inhibitors ◽  
Highly Active ◽  
Programmed Death ◽  
Cell Gene Expression ◽  
History Of ◽  
Faecal Microbiome

Immune checkpoint inhibitors are monoclonal antibodies that are used to treat over one in three cancer patients. While they have changed the natural history of disease, prolonging life and preserving quality of life, they are highly active in less than 40% of patients, even in the most responsive malignancies such as melanoma, and cause significant autoimmune side effects. Licenced biomarkers include tumour Programmed Death Ligand 1 expression by immunohistochemistry, microsatellite instability, and tumour mutational burden, none of which are particularly sensitive or specific. Emerging tumour and immune tissue biomarkers such as novel immunohistochemistry scores, tumour, stromal and immune cell gene expression profiling, and liquid biomarkers such as systemic inflammatory markers, kynurenine/tryptophan ratio, circulating immune cells, cytokines and DNA are discussed in this review. We also examine the influence of the faecal microbiome on treatment outcome and its use as a biomarker of response and toxicity.

scholarly journals Melanotic schwannoma of the lumbar spine: a case report and literature review

2015 ◽  
Vol 14 (2) ◽  
pp. 149-151
Author(s):  
João Bernardo Sancio Rocha Rodrigues ◽  
Nathália Ambrozim Santos Saleme ◽  
Charbel Jacob Junior ◽  
José Lucas Batista Junior ◽  
Igor Machado Cardoso ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Carney Complex ◽  
Spinal Nerve ◽  
Benign Tumors ◽  
Nerve Roots ◽  
Melanotic Schwannoma ◽  
Immunohistochemical Studies ◽  
Weighted Sequences ◽  
Slow Growing ◽  
Usual Development

<p>Schwannomas are benign tumors, usually solitary, encapsulated, slow-growing, which have their origin in differentiated neoplastic Schwann cells with extramedullary intradural usual development related to nerve roots. The melanotic schwannoma is a variant of these tumors whose location in almost one third of cases is on the posterior spinal nerve root, with a nonspecific clinical presentation. Magnetic resonance imaging is the most widely used test for the diagnosis, revealing hyperintense T1-weighted sequences and hypointense T2-weighted sequences. Diagnostic confirmation is obtained by histological and immunohistochemical studies, in which there is intense cytoplasmatic pigmentation. There are two distinct types of melanotic schwannomas: sporadic and psammomatous, the latter related to the called Carney complex, a form of multiple endocrine neoplasm with familiar character. In literature we found few cases of these neoplasms, the largest series consisting of five cases. The objective of this study is to report a rare case of melanotic schwannoma of the lumbar spine of the sporadic type of extramedullary location. We also present a brief review of the literature containing the main characteristics of the tumor, including its different forms, differential diagnoses, data from histological and immunohistochemical studies as well as the currently recommended approach in order to contribute to a better understanding of this neoplasm.</p>

An Efficient and Effective Approach to Developing Engineering E-Training Courses

2008 ◽  
pp. 1901-1914
Author(s):  
Judy C.R. Tseng ◽  
Wen-Ling Tsai ◽  
Gwo-Jen Hwang ◽  
Po-Han Wu
Keyword(s):  
New Technologies ◽  
Experimental Results ◽  
Traditional Learning ◽  
The Novel ◽  
Learning Materials ◽  
Challenging Issue ◽  
Novel Approach ◽  
Training Courses ◽  
Oriented Approach

In developing traditional learning materials, quality is the key issue to be considered. However, for high technical e-training courses, not only the quality of the learning materials but also the efficiency of developing the courses needs to be taken into consideration. It is a challenging issue for experienced engineers to develop up-to-date e-training courses for inexperienced engineers before further new technologies are proposed. To cope with these problems, a concept relationship-oriented approach is proposed in this paper. A system for developing e-training courses has been implemented based on the novel approach. Experimental results showed that the novel approach can significantly shorten the time needed for developing e-training courses, such that engineers can receive up-to-date technologies in time.

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