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Multiple Modalities (multiple + modality)
Selected AbstractsEffect of Perilesional Injections of PEG-Interleukin-2 on Basal Cell CarcinomaDERMATOLOGIC SURGERY, Issue 11 2000Baruch Kaplan MD Background: Multiple modalities are available for the treatment of basal cell carcinoma (BCC). The most commonly used modalities include simple excision, Mohs micrographic surgery, curettage and electrodessication, cryosurgery, and irradiation therapy. Interleukin-2 (IL-2) is a cytokine produced chiefly by activated T lymphocytes and has effects on various components of the immune system. Until now the primary clinical use of IL-2 has been in advanced stages of metastatic melanoma and renal cell carcinoma. Systemic administration of IL-2 is known to cause significant toxicity. Objective: The objective of this study was to evaluate the therapeutic efficacy and safety of perilesional PEG-IL-2 injections in patients with BCC in an open label, uncontrolled pilot study. Methods: Patients with histologically confirmed primary BCC over 18 years of age were included in the study. Lesions were treated by injecting a total volume of 0.5 cc of IL-2 in a radial fashion in the subcutaneous tissue. Injection dosages ranged from 3000 to 1,200,000 IU in one to four weekly dosages. A total of 12 tumors were treated in eight patients. Results: Overall response rates were as follows: complete response in 8 of 12 treated tumors (66.6% cure rate), partial response in 3 of 12 injected tumors (25% partial response rate), stable disease with no improvement in 1 treatment site (8.4%). Side effects included local pain, swelling, and erythema, and in one patient flulike symptoms. There were no significant changes of blood tests as compared to baseline levels. Conclusions: The therapeutic response induced by perilesional PEG-IL-2 injections was found to be an encouraging, safe, and well-tolerated treatment of BCC. Further studies including a larger patient population and long-term follow-up are necessary in order to substantiate these findings. [source] (615) Combined Use of Cervical Spinal Cord Stimulator (SCS) and Occipital Nerve Stimulator (ONS)PAIN MEDICINE, Issue 2 2000Article first published online: 25 DEC 200 Author: Y. Eugene Mironer, Carolinas Center for Advanced Management of Pain A 51-year-old female patient was referred to the clinic in March 1997 with severe cervicalgia and right shoulder girdle pain. She rated her pain at 9/10 on a Visual Analog Scale (VAS). MRI showed multilevel severe spondylosis with significant neural foraminal stenosis at 3 levels. Multiple modalities of treatment (physiotherapy, epidural steroid injections, cervical plexus blocks) and a variety of medications (opioids, NSAIDs, anticonvulsants, antidepressants, etc.) failed to provide any improvement. The patient twice consulted neurosurgeons but was considered a poor surgical candidate. Finally, in July 1997, after a successful trial, a cervical SCS was implanted with the tip of the lead at level C2, achieving excellent coverage of the pain area. For the next 18 months the patient continued to do well, having minimal neck and shoulder discomfort and using only occasional oral analgesics. However, by January 1999, she developed intractable right-sided occipital neuralgia. Occipital nerve blocks were providing extremely short-term relief and the intake of different analgesics, including opioids, started to increase. In March 1999, after successful trial, an ONS was implanted. Unfortunately, it migrated shortly after implantation and had to be revised and re-anchored. After this procedure all headaches were completely controlled without medications. The patient continues to be very active, uses both stimulators daily, does not take any analgesics and rates her pain at 0/10 to 1/10 on VAS. [source] A framework for fusion methods and rendering techniques of multimodal volume dataCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 2 2004Maria Ferre Abstract Many different direct volume rendering methods have been developed to visualize 3D scalar fields on uniform rectilinear grids. However, little work has been done on rendering simultaneously various properties of the same 3D region measured with different registration devices or at different instants of time. The demand for this type of visualization is rapidly increasing in scientific applications such as medicine in which the visual integration of multiple modalities allows a better comprehension of the anatomy and a perception of its relationships with activity. This paper presents different strategies of direct multimodal volume rendering (DMVR). It is restricted to voxel models with a known 3D rigid alignment transformation. The paper evaluates at which steps of the rendering pipeline the data fusion must be realized in order to accomplish the desired visual integration and to provide fast re-renders when some fusion parameters are modified. In addition, it analyses how existing monomodal visualization algorithms can be extended to multiple datasets and it compares their efficiency and their computational cost. Copyright © 2004 John Wiley & Sons, Ltd. [source] A standardized, comprehensive magnetic resonance imaging protocol for rapid and precise quantification of HIV-1-associated lipodystrophyHIV MEDICINE, Issue 7 2007M Bickel Objectives Although multiple methods have been proposed, there is no current gold standard for assessing HIV-1-associated lipodystrophy. Methods HIV-1-infected participants were randomly enrolled and surveyed about changes in the abdomen, thigh, cheek and neck areas. Magnetic resonance imaging (MRI) sequences of these sites were obtained. Participants were grouped according to survey results, and the MRI measurements were compared between groups. Results One hundred participants were included in the study, of whom 79% reported any body fat changes. Persons reporting increased abdominal girth had higher visceral ([mean±standard deviation] 142±75 vs. 59±48 cm2; P<0.0001) and total abdominal adipose tissue than those reporting no change (344±119 vs. 201±95 cm2; P<0.0001). The amount of localized fat was less for persons reporting sunken cheeks and reduced diameter of the legs compared with those who noted no changes (5.9±3.6 vs. 9.3±3.8 cm2; P<0.0001, and 35±28 vs. 112±56 cm2; P<0.0001). Participants reporting increased neck girth had a thicker fat layer in the dorsocervical region compared with those reporting no change (4.0±1.8 vs. 2.3±1.4 cm; P<0.0002). Conclusions MRI is a precise method for rapidly surveying body regions affected by HIV-1-associated lipodystrophy. Our proposed protocol provides a rapid, comprehensive survey of these areas, without the need to combine multiple modalities or to expose subjects to radiation. [source] Task-relevance and temporal synchrony between tactile and visual stimuli modulates cortical activity and motor performance during sensory-guided movementHUMAN BRAIN MAPPING, Issue 2 2009Sean K. Meehan Abstract Sensory-guided movements require the analysis and integration of task-relevant sensory inputs from multiple modalities. This article sought to: (1) assess effects of intermodal temporal synchrony upon modulation of primary somatosensory cortex (S1) during continuous sensorimotor transformations, (2) identify cortical areas sensitive to temporal synchrony, and (3) provide further insight into the reduction of S1 activity during continuous vibrotactile tracking previously observed by our group (Meehan and Staines 2007: Brain Res 1138:148,158). Functional MRI was acquired while participants received simultaneous bimodal (visuospatial/vibrotactile) stimulation and continuously tracked random changes in one modality, by applying graded force to a force-sensing resistor. Effects of intermodal synchrony were investigated, unbeknownst to the participants, by varying temporal synchrony so that sensorimotor transformations dictated by the distracter modality either conflicted (low synchrony) or supplemented (high synchrony) those of the target modality. Temporal synchrony differentially influenced tracking performance dependent upon tracking modality. Physiologically, synchrony did not influence S1 activation; however, the insula and superior temporal gyrus were influenced regardless of tracking modality. The left temporal-parietal junction demonstrated increased activation during high synchrony specific to vibrotactile tracking. The superior parietal lobe and superior temporal gyrus demonstrated increased activation during low synchrony specific to visuospatial tracking. As previously reported, vibrotactile tracking resulted in decreased S1 activation relative to when it was task-irrelevant. We conclude that while temporal synchrony is represented at higher levels than S1, interactions between inter- and intramodal mechanisms determines sensory processing at the level of S1. Hum Brain Mapp, 2009. © 2007 Wiley-Liss, Inc. [source] Review of non-positron emission tomography functional imaging of primary musculoskeletal tumours: Beyond the humble bone scanJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 6 2005YY Ho Summary Bone and soft tissue tumours are rare neoplasms. There are five major roles of imaging in the management of primary musculoskeletal tumours, that is, to differentiate between benignity and malignancy, to evaluate for local tumour extension, to screen for metastases, to judge the effect of chemotherapy, and to monitor for recurrence. To accomplish this, multiple modalities are required because no single examination is able to complete all these tasks. These modalities include plain radiography, CT, MRI, conventional nuclear medicine as well as positron emission tomography (PET) imaging. Elsewhere, PET imaging has been discussed at length, because it is likely to be superior in the assessment of bone and soft tissue tumours over conventional nuclear medicine procedures. However, conventional nuclear medicine may be of value when PET is unavailable. In this review, an overview of anatomical imaging will be given and the role of non-PET functional imaging will be discussed in detail. A variety of illustrative cases will be presented. [source] Self-reported severity of taste disturbances correlates with dysfunctional grade of TMD painJOURNAL OF ORAL REHABILITATION, Issue 11 2009D. R. NIXDORF Summary, Altered central neural processing of sensory information may be associated with temporomandibular disorders (TMD) pain. The objectives of this study were to compare the prevalence of self-reported taste disturbances in TMD pain patients and in a control population, and to determine whether frequency of taste disturbances was correlated with dysfunctional grade of TMD pain. Subjects were 2026 people within a German population sample and 301 consecutive TMD patients diagnosed using the Research Diagnostic Criteria. Taste disturbances were measured using two questions from the Oral Health Impact Profile. Dysfunctional grade of TMD pain was measured with the Graded Chronic Pain Scale. A two-sample test of proportions revealed that TMD patients reported a greater frequency of taste disturbances, 6%, than did the general population subjects, 2% (P < 0·001). Moreover, the frequency of taste disturbances correlated with the dysfunctional grade of TMD pain. For each 1 unit increase in taste disturbance, the odds of observing a higher grade of TMD pain increased by 29% (95% CI: 3,63%, P = 0·03). Analysis by individual taste question and adjustment for age and gender did not substantially affect the results. These findings are consistent with a central neural dysfunction in TMD pain and suggest that a common neural substrate may underlie sensory disturbances of multiple modalities in chronic pain patients. Further research regarding taste disturbances and trigeminally mediated pains such as in TMD is warranted. [source] Auctioning Patronage in Northeast Brazil: The Political Value of Money in a Ritual MarketAMERICAN ANTHROPOLOGIST, Issue 2 2010Aaron Ansell ABSTRACT, Fundraising auctions help people in a small rural town in Northeast Brazil reckon with the effects that currency stabilization and democratization have had on municipal politics. These simultaneous processes have made politics confusing for the people of Passerinho by creating multiple modalities of electoral reciprocity. In this article, I argue that the ritual procedures of the auctions commensurate these modalities of reciprocity through a semiotic procedure in which money signifies both exchange value and more personal forms of value. I consider the auction's impact on municipal politics by looking at its effect on the narrative of democratic progress and on the prestige of grassroots politicians, traditional elites, and voluntary associations. [source] Bacterial exotoxins downregulate cathelicidin (hCAP-18/LL-37) and human ,-defensin 1 (HBD-1) expression in the intestinal epithelial cellsCELLULAR MICROBIOLOGY, Issue 12 2008Krishnendu Chakraborty Summary Cathelicidin (hCAP-18/LL-37) and ,-defensin 1 (HBD-1) are human antimicrobial peptides (AMPs) with high basal expression levels, which form the first line of host defence against infections over the epithelial surfaces. The antimicrobial functions owe to their direct microbicidal effects as well as the immunomodulatory role. Pathogenic microorganisms have developed multiple modalities including transcriptional repression to combat this arm of the host immune response. The precise mechanisms and the pathogen-derived molecules responsible for transcriptional downregulation remain unknown. Here, we have shown that enteric pathogens suppress LL-37 and HBD-1 expression in the intestinal epithelial cells (IECs) with Vibrio cholerae and enterotoxigenic Escherichia coli (ETEC) exerting the most dramatic effects. Cholera toxin (CT) and labile toxin (LT), the major virulence proteins of V. cholerae and ETEC, respectively, are predominantly responsible for these effects, both in vitro and in vivo. CT transcriptionally downregulates the AMPs by activating several intracellular signalling pathways involving protein kinase A (PKA), ERK MAPKinase and Cox-2 downstream of cAMP accumulation and inducible cAMP early repressor (ICER) may mediate this role of CT, at least in part. This is the first report to show transcriptional repression of the AMPs through the activation of cellular signal transduction pathways by well-known virulence proteins of pathogenic microorganisms. [source] | |||||||||||||