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Microscopic Anterior Callosotomy for Management of Intractable Epilepsy (Al-Azhar Experience)

Open Journal of Modern Neurosurgery 2021年第3期11卷 180-193页

作者： Alaa Rashad Ibrahim Mohammed Attia Neurosurgery Department Faculty of Medicine Al-Azhar University Cairo Egypt

Background: Anterior Corpus Callosotomy is a palliative treatment for drug-resistant generalized or multifocal epilepsy patients where focus excision is not an option for management. Callosotomy prevents propagation of epileptic discharge from one cerebral hemisphere to the other. Objective: To describe Al-Azhar University Hospitals experience and clinical outcome of Anterior Corpus Callosotomy for management of drug-resistant generalized epilepsy patients as an inexpensive palliative method. Patients and Methods: In this study, there are 15 patients admitted to Neurosurgery Department in Al-Azhar University Hospitals with drug-resistant generalized epilepsy. These patients were not candidates for lesionectomy. They were managed by anterior two thirds Corpus Callosotomy between February 2017 and December 2019. They were followed at outpatient clinic for at least 14 months. Clinical outcome regarding seizure control was assessed using Engel classification. Results: All 15 patients in this study underwent anterior two thirds corpus callosotomy and followed for at least 14 months. The post-operative improvement of seizure frequency has been evaluated using Engel outcome scale with 12 patients (80%) of the patients becoming Engel class II and 3 patients (20%) becoming Engel class III. Only 3 patients (20%) had minor transient postoperative complications;one patient (6.67%) had contra-lateral lower limb heaviness Grade 4 which was transient, one patient (6.67%) had contra-lateral lower limb Jacksonian focal fits and one patient (6.67%) had behavioral changes for one month. Conclusion: Corpus callosotomy is a palliative procedure and inexpensive method for management of patients with intractable focal with generalization and generalized drug-resistant epilepsy who are not suitable for resective surgery and with good outcome.

关键词： Drug-Resistant Epilepsy palliative treatment Corpus Callosotomy Engel Surgery Outcome Scale

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The Effects of Surgical Exploration on Survival of Unresectable Pancreatic Carcinoma:A Retrospective Case-Control Study

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Journal of Biomedical Science and Engineering 2017年第1期10卷 1-9页

作者： Daniel Akerberg Daniel Ansari Roland Andersson Bobby Tingstedt Department of Surgery Clinical Sciences LundLund UniversitySkane University HospitalLundSweden

Background: Surgery may trigger the release of inflammatory factors, including cytokines, growth factors and angiogenic factors, which may stimulate tumor growth and progression. The present study was undertaken to evaluate the impact of surgical exploration on survival of patients with potentially resectable pancreatic cancer, who intraoperatively were found to have unresectable disease. Methods: Patients with pancreatic adenocarcinoma undergoing surgical exploration, without tumor resection, at our institution between 2009 and 2014, were selected and case-matched to patients who underwent primary palliative treatment. Results: A total of 116 patients were included. The surgical exploration group (n = 29) had significantly lower CRP levels at the time of diagnosis compared to the palliative controls (n = 87), 4 mg/L vs 12 mg/L;p = 0.004. The percentage of patients who received palliative chemotherapy was comparable between groups, but the time until start of chemotherapy was significantly longer in the surgical exploration group, 2 months vs 1 months;p Conclusion: In this case-control study, we could not detect any survival disadvantage due to surgical exploration in the setting of unresectable pancreatic cancer. Surgical exploration was associated with delayed start of palliative chemotherapy, but the percentage of patients who ultimately received chemotherapy was comparable to patients undergoing primary palliative treatment.

关键词： Pancreatic Cancer Surgical Exploration palliative treatment Survival

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Hormone-Naïve Metastatic Prostate Cancer: A Presentation of 110 Cases in a Urology Center in the City of Douala, Cameroon

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Open Journal of Urology 2022年第1期12卷 83-97页

作者： Cyril Kamadjou Calson Ambomatei Landry Mbouche Zacharie Sando Achille Mbassi Fru Angwafor Medical Surgical Center of Urology and Minimal Invasive Surgery Douala Cameroon Department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Health Search Association Douala Cameroon Gyneco-Obstetric and Pediatric Hospital Yaounde Cameroon Urology Service Central Hospital Yaounde Cameroon

Aim: According to World Health Organization, prostate cancer is one of the increasing malignancies in men worldwide. This paper aims to describe the epidemiological, clinical, diagnostic, therapeutic, and evolutionary aspects of patients with early metastatic prostate cancer in a urology center in the city of Douala in Cameroon. Materials and Methods: It is a retrospective and descriptive study of 110 patients with prostate cancer that was immediately metastatic at diagnosis over a period of six years (from January 2014 to December 2020). Results: The average age of patients at diagnosis was 67.5 years (range: 45 years to 88 years) and 53.63% of patients had body mass indexes greater than 25. Disorders of the lower urinary tract were the main presenting complaint in 55.45% of cases, followed by bone and joint pain in 46.36% of cases. Digital rectal examination was suggestive of prostate cancer in 96.36% of cases with an average total prostatic specific antigen (PSAT) level of 676.9 ng/ml (range: 21.8 to 8832 ng/ml). The diagnosis was made through prostate biopsy in 57 (51.81%) patients or after palliative endoscopic resection of the prostate indicated for lower urinary tract symptoms or even acute urinary retention in 53 (48.18%) patients. Adenocarcinoma of the prostate was the main histologic type, and in 47.27% of cases, the tumor was poorly differentiated with a Gleason’s score of greater than 7. The sites of metastasis were mainly the lymph node (87.27%), bone (56.36%), and both (44.54%). The treatment was palliative and dominated by bilateral pulpectomy in 60% of cases and luteinizing hormone-releasing hormone agonists (Triptorelin 11.25 mg every 3 months) in 44 (40%) of cases. Conclusion: Prostate cancer is a real public health problem in developed countries but also in Africa, especially in Cameroon. It is aggressive cancer that is often diagnosed when metastasis has already occurred. Its man

关键词： Prostate Cancer Metastasis Hormone Therapy palliative treatment

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Pancreatic cancer–palliative therapy: chemotherapy

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The Chinese-German Journal of Clinical Oncology 2007年第2期6卷 142-148页

作者： Anne Katrin Berger Dirk Jger Medizinische Onkologie Nationales Centrum für Tumorerkrankungen Universittsklinik Heidelberg Im Neuenheimer Feld 350 69120 Heidelberg Germany

Single-agent Gemcitabine has been the standard treatment for advanced pancreatic adenocarcinoma in the past years. Due to the aggressive and often chemotherapy-refractory character of this malignancy, systemic treatment options still remain limited. Many combination therapies have been evaluated in clinical trials to improve survival over Gemcitabine alone, until recently without satisfying results. Based on the positive results of a recent randomized trial, the combination of Gemcitabine and Capecitabine might become a new standard as first-line treatment for advanced pancreatic cancer. The clinical advantage of Erlotinib as a novel targeted agent in combination with Gemcitabine seems to be only marginal. Due to the small number of studies, there is still no standard of care in second-line therapy, but Oxaliplatin seems to be an active treatment option in Gemcitabine refractory disease. This article will review the development of cytotoxic antitumoral treatment for advanced pancreatic adenocarcinoma (locally advanced, irresectable and/or metastatic disease) including monotherapies and newer approaches with combination therapies.

关键词： pancreatic adenocarcinoma chemotherapy Gemcitabine palliative treatment

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Hilar Cholangiocarcinoma with Synchronous Metastases to Breast and Skeletal Muscle: A Case Report and Literature Review

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The Chinese-German Journal of Clinical Oncology 2006年第3期5卷 216-218页

作者：丁光辉杨家和程树群龚华刘凯戴炳华龚彪赵丽华丛文铭吴孟超上海第二军医大学东方肝胆外科医院 200438

Hilar cholangiocarcinoma has been reputed as a slow growth tumor in the past. Skeletal muscle is one of the most unusual sites of metastasis from any malignancy. We report herein a case of hilar cholangiocarcinoma with synchronous metastases to skeletal muscle and breast, and review the literature. The patient was a 48-year-old woman who presented with jaundice and weight loss. An inoperable hilar cholangiocarcinoma was diagnosed. She was treated with a combination of endoscopic plastic stent biloiary drainage and three-dimensional conformal radiotherapy （3DCRT）. Good response was achieved. Ten months later, she exhibited with a painful metastatic mass in the muscle rectus femoris of left thigh and a painless mass in the left breast. She underwent operation to relieve the pain, but died from liver failure after 8 months. The literature only offers isolated cases of cholangiocarcinoma with distant metastases, of which the common sites were cervical lymph node, bone, and portal venous system. Most patients were presented with multiple metastases with extensive local disease.

关键词： hilar cholangiocarcinoma distant metastasis endoscopic stent three-dimensional conformal radiotherapy palliative treatment

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