A three‐dimensional point process model for the spatial distribution of disease occurrence in relation to an exposure source

We study methods for how to include the spatial distribution of tumours when investigating the relation between brain tumours and the exposure from radio frequency electromagnetic fields caused by mobile phone use. Our suggested point process model is adapted from studies investigating spatial aggregation of a disease around a source of potential hazard in environmental epidemiology, where now the source is the preferred ear of each phone user. In this context, the spatial distribution is a distribution over a sample of patients rather than over multiple disease cases within one geographical area. We show how the distance relation between tumour and phone can be modelled nonparametrically and, with various parametric functions, how covariates can be included in the model and how to test for the effect of distance. To illustrate the models, we apply them to a subset of the data from the Interphone Study, a large multinational case‐control study on the association between brain tumours and mobile phone use. Copyright © 2015 John Wiley & Sons, Ltd.     

低频重复经颅磁刺激治疗老年人失眠症的疗效观察

目的 观察低频重复经颅磁刺激（rTMS）对失眠症老年人睡眠和情绪的影响。 方法 选取34例失眠症老年患者,按照随机数字表法将其分为试验组（18例）和对照组（16例）。试验组采用低频rTMS刺激右背外侧前额叶皮质（DLPFC)治疗,对照组给予交变磁场治疗。治疗前及治疗4周后（治疗后）,使用匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对患者进行评估。为了消除睡眠变化对患者HAMA和HAMD评分的影响,对此两项评分去除睡眠相关项得分后的分值（标记为HAMA-A、HAMD-A）进行评估。 结果 治疗前,2组患者的PSQI、HAMA和HAMD评分比较,差异无统计学意义（P>0.05）。治疗后,试验组与对照组患者的PSQI、HAMA、HAMD评分均明显下降（P<0.05）,且试验组PSQI［(8.44±1.82)分］、HAMA［(10.66±2.59)分］、HAMD［(11.78±3.64)分］较对照组低,差异有统计学意义（P<0.05）。除去HAMA与HAMD的睡眠相关选项得分后,试验组患者治疗后HAMA-A、HAMD-A较组内治疗前低（P<0.05）,对照组患者治疗后HAMA-A、HAMD-A虽较组内治疗前低,但差异无统计学意义（P>0.05）。试验组患者治疗后HAMA-A［(11.11±2.72)分］、HAMD-A［(10.17±3.28)分］较对照组低（P<0.05）。 结论 rTMS治疗老年失眠症的疗效优于交变磁场,能显著改善患者睡眠和情绪。     

Exposure to Extremely Low Frequency Magnetic Fields Has No Effect on Growth Rate or Clonogenic Potential of Multipotential Haemopoietic Progenitor Cells

Abstract

Recent reports indicate an increased risk of acute myeloid leukaemia in children exposed to extremely low frequency magnetic fields (ELFMFs) emitted by high voltage power lines, suggesting that ELFMFs may act as weak tumour promoters. We have investigated possible interactions of weak ELFMFs with primitive haemopoietic cells in vitro using the multipotential progenitor cell line FDCP-mix(A4). We have determined the proliferative activity and clonogenic potential of cells under both optimal and sub-optimal growth conditions and exposed to either ambient laboratory ELFMFs or three other ELFMF regimes representative of those produced by high voltage power lines: nulled fields, Ca²⁺ion cyclotron resonance conditions at 50 Hz, and vertical 50 Hz fields of 6 μT_RMS. Using exposures of 1, 4, 7 and 21 days, we found no significant alteration of growth rate, cell-cycle state or clonogenic efficiency indicating that neither the proliferation nor self-renewal of multipotential FDCP-mix(A4) cells was perturbed.     

The Influence of Pituitary Adenoma Size on Vision and Visual Outcomes after Trans-Sphenoidal Adenectomy: A Report of 78 Cases

Objective

The aims of this study were to investigate the quantitative relationship between pituitary macroadenoma size and degree of visual impairment, and assess visual improvement after surgical resection of the tumor.

Methods

The medical records of patients with pituitary adenoma, who had undergone trans-sphenoidal adenectomy between January 2009 and January 2011, were reviewed. Patients underwent an ocular examination and brain MRI before and after surgery. The visual impairment score (VIS) was derived by combining the scores of best-corrected visual acuity and visual field. The relationship between VIS and tumor size/tumor type/position of the optic chiasm was assessed.

Results

Seventy-eight patients were included (41 male, 37 female). Thirty-two (41%) patients experienced blurred vision or visual field defect as an initial symptom. Receiver operating characteristic curve analysis showed that tumors <2.2 cm tended to cause minimal or no visual impairment. Statistical analysis showed that 1) poor preoperative vision is related to tumor size, displacement of the optic chiasm in the sagittal view on MRI and optic atrophy, and 2) poorer visual prognosis is associated with greater preoperative VIS. In multivariate analysis the only factor significantly related to VIS improvement was increasing pituitary adenoma size, which predicted decreased improvement.

Conclusion

Results from this study show that pituitary adenomas larger than 2 cm cause defects in vision while adenomas 2 cm or smaller do not cause significant visual impairment. Patients with a large macroadenoma or giant adenoma should undergo surgical resection as soon as possible to prevent permanent visual loss.     

胶质母细胞瘤的治疗策略

胶质母细胞瘤（glioblastoma multiforme,GBM）是一种破坏性极强、难以治愈的神经系统肿瘤。临床治疗以手术切除为主,并结合放疗、化疗及电场治疗等多种治疗手段。但GBM侵袭性强、手术难以彻底根除,故患者预后差、死亡率居高不下。因此,延长患者生存时间并提升其生存质量一直是GBM治疗的重要目标。本文将基于GBM治疗策略加以探讨。