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As currently practiced, SRS with the Gamma Knife preserves serviceable hearing in the majority of patients. Tumor volume and anatomy relate to the hearing level before radiosurgery and influence technique. A low radiosurgical dose to the cochlea enhances hearing preservation.

There is an increasing awareness that anatomical approaches based on measurements of tumor size have significant limitations for assessing therapy response. Functional imaging techniques are increasing being used to monitor response to therapies with novel mechanisms of action, often predicting the success of therapy before conventional measurements have changed. Dynamic contrast-enhanced and diffusion magnetic resonance imaging (MRI) are the most advanced in their evidence base, and in this manuscript we focus on them as response parameters. Technology, data gathering methods, and current limitations for these techniques are addressed. With few exceptions, most studies shows that successful treatment is reflected by increases in tumor water diffusion values visible as increased apparent diffusion coefficient values. Most response assessment studies also show that successful treatment results in decreases in tumor vascularization and microvessel permeability.

Data in this study provide further evidence that SRS is a relatively safe procedure that reduces the rebleeding rate for CCMs located in high-surgical-risk areas of the brain.

Object The authors performed a retrospective review of prospectively collected data to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) for the treatment of patients harboring symptomatic solitary cavernous malformations (CMs) of the brainstem that bleed repeatedly and are high risk for resection. Methods Between 1988 and 2005, 68 patients (34 males and 34 females) with solitary, symptomatic CMs of the brainstem underwent Gamma Knife surgery. The mean patient age was 41.2 years, and all patients had suffered at least 2 symptomatic hemorrhages (range 2–12 events) before radiosurgery. Prior to SRS, 15 patients (22.1%) had undergone attempted resection. The mean volume of the malformation treated was 1.19 ml, and the mean prescribed marginal radiation dose was 16 Gy. Results The mean follow-up period was 5.2 years (range 0.6–12.4 years). The pre-SRS annual hemorrhage rate was 32.38%, or 125 hemorrhages, excluding the first hemorrhage, over a total of 386 patient-years. Following SRS, 11 hemorrhages were observed within the first 2 years of follow-up (8.22% annual hemorrhage rate) and 3 hemorrhages were observed in the period after the first 2 years of follow-up (1.37% annual hemorrhage rate). A significant reduction (p < 0.0001) in the risk of brainstem CM hemorrhages was observed following radiosurgical treatment, as well as in latency period of 2 years after SRS (p < 0.0447). Eight patients (11.8%) experienced new neurological deficits as a result of adverse radiation effects following SRS. Conclusions The results of this study support a role for the use of SRS for symptomatic CMs of the brainstem, as it is relatively safe and appears to reduce rebleeding rates in this high-surgical-risk location.

Thirty cases of phyllodes tumour (cystosarcoma phyllodes) of the breast that presented to the Clinical Oncology Unit at Guy's Hospital were reviewed. Tumours were classified as benign, malignant or borderline according to the following histological criteria: mitotic rate, nuclear pleomorphism, stromal overgrowth and tumour margins. In 14 (46.5%) cases the tumours were considered histologically benign, in 11 (36.5%) malignant, and in five (17%) borderline. Recurrence was seen in a similar proportion of patients with tumours classified as benign (21 %) and malignant (18 %) according to histological criteria. Malignant lesions tended to recur earlier. Infiltrating tumour margins were noted in all patients and stromal overgrowth in all hut one in whom recurrence was observed. Risk of recurrence also appeared to he related to tumour size. Only one patient developed distant metastases and died of her disease. Because of treatment variation no conclusion can he made regarding optimal therapy but the importance of adequate clearance, either through wide excision or mastectomy, is emphasized for all phyllodes tumours irrespective of histological features.

Abstract[VIVO(acac)2] (acac = acetylacetonate) was treated with ligands CH2(H2L)2 in methanol heated at reflux to yield two neutral binuclear VIV complexes with the formula [CH2{VIVOL(H2O)}2], namely, 1 and 2. Ligands CH2(H2L)2 I and II were derived from 5,5′‐methylenebis(salicylaldehyde) and S‐benzyldithiocarbazate [CH2(H2sal‐sbdt)2, I] or S‐methyldithiocarbazate [CH2(H2sal‐smdt)2, II]. Aerial oxidation of 1 and 2 in the presence of KOH or CsOH·H2O resulted in the formation of dioxidovanadium(V) complexes, K2[CH2{VVO2(sal‐sbdt)}2]·2H2O (3), Cs2[CH2{VVO2(sal‐sbdt)}2]·2H2O (4), K2[CH2{VVO2(sal‐smdt)}2]·2H2O (5) and Cs2[CH2{VVO2(sal‐smdt)}2]·2H2O (6). The compounds were characterized in the solid state and in solution, namely, by spectroscopic techniques (IR, UV/Vis, EPR, 1H, 13C and 51V NMR spectroscopy). It is demonstrated that the VVO2 complexes 3–6 are efficient and selective towards the oxidative bromination by H2O2 of styrene to yield 1,2‐dibromo‐1‐phenylethane, 1‐phenylethane‐1,2‐diol and 2‐bromo‐1‐phenylethane‐1‐ol, and of salicylaldehyde to yield 5‐bromosalicylaldehyde, 3,5‐dibromosalicylaldehyde and 2,4,6‐tribromophenol; they therefore act as functional models of vanadium‐dependent haloperoxidases. It is also shown that Cs2[CH2{VVO2(sal‐sbdt)}2]·2H2O (4) and Cs2[CH2{VVO2(sal‐smdt)}2]·2H2O (6) are catalyst precursors for the catalytic oxidation of styrene by peroxide to yield styrene oxide, benzaldehyde, 1‐phenylethane‐1,2‐diol, benzoic acid and phenylacetaldehyde. Plausible intermediates involved in these catalytic processes were established by UV/Vis, EPR and 51V NMR spectroscopic studies. The VVO2 complexes along with ligands I and II were also screened against HM1:1MSS strains of Entamoeba histolytica; the IC50 values of compounds 3, 4 and 5 were significantly lower than that of metronidazole, thereby suggesting that they may be promising drugs for the treatment of amoebiasis.