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  • 1
    ISSN: 1471-4159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Accumulation of intracellular Ca2+ is known to be critically important for the expression of NMDA receptor-mediated glutamate neurotoxicity. We have observed, however, that glutamate can also increase the neuronal intracellular Mg2+ concentration on activation of NMDA receptors. Here, we used conditions that elevate intracellular Mg2+ content independently of Ca2+ to investigate the potential role of Mg2+ in excitotoxicity in rat cortical neurons in vitro. In Ca2+-free solutions in which the Na+ was replaced by N-methyl-d-glucamine or Tris (but not choline), which also contained 9 mM Mg2+, exposure to 100 µM glutamate or 200 µM NMDA for 20 min produced delayed neuronal cell death. Neurotoxicity was correlated to the extracellular Mg2+ concentration and could be blocked by addition of NMDA receptor antagonists during, but not immediately following, agonist exposure. Finally, we observed that rat cortical neurons grown under different serum conditions develop an altered sensitivity to Mg2+-dependent NMDA receptor-mediated toxicity. Thus, the increase in intracellular Mg2+ concentration following NMDA receptor stimulation may be an underestimated component critical for the expression of certain forms of excitotoxic injury.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 51 (1996), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The knee-chest position for lumbar spine surgery is favoured because decreased filling of the epidural veins is associated with reduced peroperative bleeding. However, the position may be unfavourable from a circulatory point of view. In the present study, non-invasive assessment of circulation in the lower limbs was performed in 21 unanaesthetised, healthy volunteers who were placed in the surgical knee-chest position. Measurements included blood flow velocity (colour Doppler ultrasonography), oscillotonometric arterial blood pressure from upper and lower limbs and pulse oximetry from a toe. There was a statistically significant reduction in the posterior tibial artery flow velocity, maximally 31.6%, when the subject was moved from the prone to the knee-chest position. An enlargement of the trunk-femoral angle at the hip did not improve arterial flow. In 10 of the 21 volunteers, no flow in the posterior tibial vein was detected in the knee-chest position. In spite of the deteriorated blood flow, pulse oximetry indicated sufficient capillary flow in the very periphery of the lower limb. The change from prone to knee-chest position resulted in an increase in arterial blood pressure of the upper limb; the increase in diastolic arterial pressure was statistically significant (p 〈 0.001). It is concluded that the surgical knee-chest position involves deterioration of both the arterial and venous flow of the lower limbs. This should be considered in patients undergoing surgery in this position and, in particular, in those at risk of developing cardiovascular complications.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Annals of oncology 8 (1997), S. 803-806 
    ISSN: 1569-8041
    Keywords: advanced ovarian cancer ; first-line treatment ; paclitaxel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We wanted to assess the efficacy and toxicity of paclitaxel(Taxol) in previously untreated patients with advanced ovarian cancer. Nosuch study had been performed at the time of initiation of this study. Patients and methods: The study population in this analysis consisted of35 previously untreated stage III ovarian cancer patients, suboptimallyresected at primary surgery. The initial paclitaxel dose was 175mg/m2 given as a three-hour i.v. infusion every three weeks. Results: A total of 225 paclitaxel courses were given to 35 patients ofwhom 34 were evaluable for clinical response. Nine (26%) patientsobtained a complete response to paclitaxel, ten (29%) a partialresponse, seven (21%) stable disease and eight (24%) hadprogressive disease. Thus, the total response rate to paclitaxel treatmentwas 55% (19 of 34). The median duration of response for the 19responding patients was eight months (range 1–44.5+). The medianduration for nine patients with clinical complete response was 16 months(range 2–44.5+). A second-look laparotomy was performed in 15 patients after six coursesof paclitaxel. Of these, five obtained a histopathologically completeremission, five a partial remission and five stable disease. The fivepatients with pathologically complete remissions are alive with a medianprogressive-free survival of 24.5 months (range 15+–44.5+). The medianprogression-free survival for all patients was 6.1 months (range1–44.5+). Toxicity consisted mainly of neutropenia, easily controlled.Other toxicities were myalgia/arthralgia and peripheral neuropathy. Threepatients experienced a severe anaphylactic reaction during the first course.Conclusion: This study showed that paclitaxel is an effective and safe drugfor first-line treatment of ovarian cancer.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1569-8041
    Keywords: CA 125 ; consensus ; management ; ovarian cancer ; prognostic factors ; second-line treatment ; surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: During an international workshop held in September 1998, a group of specialists in the field of ovarian cancer reached consensus on a number of issues with implications for standard practice and for research of advanced epithelial ovarian cancer. Methods: Five groups of experts considered several issues which included: biologic factors, prognostic factors, surgery, initial chemotherapy, second-line treatment, the use of CA 125, investigational drugs, intra-peritoneal treatment and high-dose chemotherapy. The group attempted to arrive at answers to questions such as: Are there prognostic factors, which help to identify patients who will not do well with current therapy? What is the current best therapy for advanced ovarian carcinoma? What directions should research take in advanced ovarian cancer? These issues were discussed in a plenary meeting. Results: One of the major conclusions drawn by the consensus committee was that in previously untreated advanc ed ovarian cancer, cisplatin plus paclitaxel has been shown to be superior to previous standard therapy with cisplatin plus cyclophosphamide (level I evidence). However, for many patients, carboplatin plus paclitaxel is a reasonable alternative because of toxicity and convenience considerations. Most participants felt that the benefits in terms of toxicity for the paclitaxel-carboplatin are such that its widespread adoption at this stage is justified. Until mature survival data are available a minority of investigators would recommend continued use of cisplatin plus paclitaxel, specifically for those patients with advanced disease with the best prognostic characteristics. For future clinical research in this area, new end points for randomised clinical trials, together with a new Trials Network, are proposed.
    Type of Medium: Electronic Resource
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