1/34. Neuromyotonia of the abducens nerve after hypophysectomy and radiation.The clinical signs of the rarely encountered ocular neuromyotonia consist of transient involuntary tonic contraction and delayed relaxation of single or multiple extraocular muscles, resulting in episodic diplopia. With a mean time delay of 3.5 years, this motility disorder frequently follows tumor excision or adjuvant radiation near the skull base. Ocular neuromyotonia may reflect inappropriate discharge from oculomotor neurons with unstable cell membranes because of segmental demyelinization by tumor compression and radiation-induced microangiopathy. In the present paper, the authors present the case of a 53-year-old patient with a history of transsphenoidal hypophysectomy and adjuvant radiotherapy, who underwent strabismus surgery for abducens palsy.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/34. Functional magnetic resonance image-guided surgery of tumors in or near the primary visual cortex.OBJECTIVE: To assess the accuracy of functional magnetic resonance imaging (fMRI) of the primary visual cortex in patients undergoing surgery for tumors in the occipital lobe. methods: Two patients with nondominant occipital lobe tumors were studied, one with a solitary lung metastasis and another with radiation necrosis after radiosurgery for a low-grade astrocytoma. At surgery, visual evoked potentials (VEPs) were stimulated using light-emitting-diode goggles and recorded using cortical grids placed immediately after brain exposure. The location of the peak VEP was compared to that predicted by the registered functional scan. RESULTS: In each case, the epicenter of visual activation as represented on the registered fMRI corresponded to the site of peak VEP recording. Prediction error for the visual cortex, measured in patient 1, was 1.0 mm. Visual confirmation showed the registration in the second patient to be accurate as well. CONCLUSION: As previously demonstrated for sensorimotor fMRI, visual fMRI accurately predicts the location of the primary visual cortex. Additional confirmation is expected with more clinical experience.- - - - - - - - - - ranking = 4keywords = near (Clic here for more details about this article) |
3/34. Lhermitte's sign following head and neck radiotherapy.Lhermitte's sign is an uncommon sequel of radiotherapy to the cervical spinal cord. Although the exact mechanism underlying its occurrence remains unclear; it is felt to be the result of a temporary interference with the turnover and synthesis of myelin, leading to focal demyelination. We have undertaken a detailed analysis of the radiation delivered to four patients who developed the sign after irradiation for malignancies of the head and neck. Our data support the view that radiation dose is crucial to its development, but calculations using the linear-quadratic radiobiological model raise interesting questions regarding the dose-response relationship. In particular, we find that calculations of biologically effective doses are predictive of a late rather than an early normal tissue response. The onset of symptoms after irradiation was apparent in all four patients within 4 months, with resolution in all being complete within a further 6 months. The recognition of this benign transient form of radiation-induced paraesthesia and its differentiation from the later onset, progressive and unremitting symptoms associated with radiation myelopathy is essential in reassuring patients undergoing head and neck irradiation.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
4/34. Extensive acute lung injury following limited thoracic irradiation: radiologic findings in three patients.The aim of our study was to describe the radiologic findings of extensive acute lung injury associated with limited thoracic irradiation. Limited thoracic irradiation occasionally results in acute lung injury. In this condition, chest radiograph shows diffuse ground-glass appearance in both lungs and thin-section CT scans show diffuse bilateral ground-glass attenuation with traction bronchiectasis, interlobular septal thickening and intralobular smooth linear opacities.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
5/34. A pivoting appliance for intracavitary brachytherapy in patients with reduced mouth opening.PURPOSE: The risks of radiotherapy to normal tissues are well known. In many cases, a tumor patient suffering a relapse cannot undergo radiotherapy a second time. One exception may be the local application of brachytherapy. Afterloading devices allow the position of radiating materials near the site for treatment exactly according to three-dimensional treatment planning. This report shows the technical procedure for the fabrication of an intracavitary afterloading radiation device. MATERIALS AND methods: A 48-year-old woman who had received neutron radiotherapy and tumor surgery for adenoid cystic carcinoma had to be treated for relapse. The mouth opening was limited to 15 mm. The mixing tip of a silicone impression system was used as an axis for a pivoting appliance. RESULTS: Two years after reradiation, the patient was free of relapse symptoms, although an increased limitation of mouth opening was recorded. CONCLUSION: Even if the mouth opening is severely limited after tumor surgery and/or radiation, intracavitary brachytherapy still can be performed in edentulous patients using a pivoting device.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/34. Photoretinitis: an underestimated occupational injury?Non-ionizing radiation, which is produced in large amounts by welding arcs, may induce photophthalmia, keratoconjunctivitis and cataracts. Retinal injuries resulting from exposure to electric welding arcs have been reported, but such injuries are not commonly seen and may be misdiagnosed. A case is described of bilateral maculopathy in a millwright exposed to metal arc inert gas-shielded welding and oxygen lance light. insurance adjudicators denied his claim, as they did not acknowledge the cause-and-effect relationship between welding and retinopathy. welding emits a wide spectrum of radiation, ranging from IR to UV and beyond. UV and far-IR radiation are adsorbed by the cornea and the lens, whereas visible light and near-IR radiation penetrate to the retina. According to the intensity and time of exposure, they may cause thermal or photochemical retinal damage, which may be permanent and sight-threatening. Workers covered by compulsory collective insurance should be eligible for compensation in every case of welding light-induced retinal damage.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
7/34. Ocular neuromyotonia: a case report.Ocular neuromyotonia is a rare motility disorder occurring after tumor irradiation near the skull base or as a consequence of vascular abnormalities. Ocular myasthenia, convergence spasm and a cyclic third nerve palsy must be considered as differential diagnoses. The case of a 32-year-old woman suffering from intermittent diplopia six months after radiation therapy of a recurrent pituary gland adenoma is presented.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
8/34. Buccal mucosal cancer patient who failed to recover taste acuity after partial oral cavity irradiation.PURPOSE: We report a patient who suffered from prolonged loss of taste acuity after partial oral cavity irradiation. methods: The electric taste threshold (ETT) of each point in the oral cavity was measured with an electric gustometer to evaluate quantitative local taste acuity. A subjective total taste acuity (STTA) scale was used to evaluate subjective total taste acuity. CASE: A 61-year-old male patient with right buccal mucosal cancer underwent radiation therapy more than 11 years ago, and has suffered from loss of taste acuity since then. He received electron beam irradiation to part of the oral cavity and right upper neck, mainly the right buccal mucosa near the retromolar trigone and a metastatic right submandibular node. He did not receive irradiation to the anterior portion of the tongue or left side of the posterior portion of the tongue. His ETT scores for each point were equal to or greater than 26, and his STTA score was grade 3. CONCLUSION: The present case implies that radiation damage to part of the oral cavity can cause the loss of subjective total taste acuity.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
9/34. Bilateral renal artery stenosis after abdominal radiotherapy for Hodgkin's disease.A 49-year-old woman was admitted with fatigue, dyspnoea, pretibial oedema and decreased daily urination. Seven years ago she was treated with doxorubicin, bleomycin, vinblastine and dacarbazine, alternating with mechlorethamine, vincristine, procarbazine and prednisone and 80 Gy abdominal radiotherapy for Hodgkin's disease. Two years later, malignant hypertension was diagnosed. Angiotensin-2 antagonist and beta-blocker treatment was given. After increased serum creatinine levels were determined, renal angiography was performed and total obstruction in the left renal artery and near total obstruction in the right side was observed. She was admitted to our clinic with oliguria, and acute renal failure was diagnosed. Balloon angioplasty and stent implantation was performed to the right renal artery. After a polyuric period, serum creatinine reduced to near normal levels. Angiotensin-2 antagonist treatment worsened the course in this patient. patients with resistant hypertension occurring years after abdominal radiotherapy should be evaluated for renal artery stenosis.- - - - - - - - - - ranking = 2keywords = near (Clic here for more details about this article) |
10/34. nasolacrimal duct obstruction associated with radioactive iodine therapy for thyroid carcinoma.A 50-year-old woman presented with a 5-year history of unilateral epiphora that began shortly after 131I therapy for thyroid carcinoma. A recent recombinant human thyroid-stimulating hormone (Thyrogen) scan had shown a focus of uptake adjacent to the right eye that was initially thought to be a possible metastasis. Probing and irrigation revealed complete blockage of the right nasolacrimal duct. The patient underwent a right dacryocystorhinostomy (DCR) and biopsy of the lacrimal sac. Histopathologic examination of the lacrimal sac and nasal mucosa revealed foreign-body reaction and fibrosis with no malignant cells. A repeat Thyrogen scan after DCR showed no residual focus of activity in the nose or near the lacrimal sac and confirmed reestablishment of lacrimal drainage on the right side. This case demonstrates that 131I therapy for thyroid carcinoma can be associated with nasolacrimal duct obstruction. The appearance of a focus of uptake near the lacrimal sac on Thyrogen scanning in a patient with a history of thyroid carcinoma may not be due to a new focus of metastasis and may indeed be due to pooling of 131I in the lacrimal sac due to nasolacrimal duct blockage.- - - - - - - - - - ranking = 2keywords = near (Clic here for more details about this article) |
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