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Books > Medicine > Surgery > Neurosurgery
For centuries the great minds of medical science puzzled over the importance of the cerebrospinal fluid. As far back as Hippocrates, it was thought that this "phlegm" that flooded the intracranial contents had pathological significance. However, not until the late 1800s, when Quincke introduced and popularized lumbar puncture, did physicians take an interest in the study of this fluid in relation to clinical illness. Since then a variety of techniques for obtaining cerebrospinal fluid from various sites have developed, and the relationship of cerebrospinal fluid to a variety of disease processes has received considerable study. In this volume, we have attempted to assemble reviews of some of these important developments during the past century. Chapter 1 contains a historical review of key investigations that helped shape our concepts of cerebrospinal fluid from the earliest recorded description by the author of the Edwin Smith Surgical Papyrus in the seventeenth century B. C. to contemporaries such as Kabat, Glusman, and Knaub, who introduced quantitative determinations of cerebrospinal fluid gamma globulin levels. In Chapter 2 there is a description of our current understanding of the anatomical compartment for the cerebrospinal fluid and the physiology of its formation, circulation, and absorption. Dr. Richard Leech in Chapter 3 contributes a comprehensive description of the disorders associated with excessive quanti ties of cerebrospinal fluid-commonly referred to as hydrocephalus. A variety of techniques for properly collecting and evaluating cerebrospinal fluid are detailed in Chapter 4."
The Omentum explores and assesses the comparatively new approach of using omental attachment in the treatment of a variety of neurologic diseases. Topics discussed include historical images and ideas connected with the greater omentum; angiogenesis and the greater omentum; implications for central nervous system injury of vasoactive chemicals in the omentum; effects of omental-derived lipid fractions on osseous vascularization and bone formation; cerebral revascularization by omental graft for moyamoya disease; omental transposition for treating the sequelae of viral encephalitis; experimental and clinical use of omental transposition for spinal cord pathology; and lumbo-omental shunt for treatment of communicating hydrocephalus. The effect of omentum transposition to the brain on regional cerebral blood flow in stroke patients and on delivery of chemotherapeutic agents to malignant brain tumors is also considered.
Spinal Fusion: Science and Technique puts the experience of top professionals into your own hands. Drs. Jerome M. Cotler and Howard B. Cotler and their impressive group of contributors, including researchers, educators, and clinicians, have joined together to bring you this concise, comprehensive reference. Sections relating to history, basic science, surgical indications and techniques, complications, postoperative management, as well as a philosophical chapter on the future of spine surgery are presented. With the help of over 250 superb illustrations, Spinal Fusion: Science and Technique contains the most current and authoritative compilation of knowledge relating to surgical management of disorders of the spine. It is destined to become an essential tool in your working library.
This volume represents the Proceedings of the Symposium on AIDS, Drugs of Abuse and the Neuroimmune Axis. This meeting was held in San Diego, California, November 11-13, 1995. As in the previous symposia in this series, productive studies were reviewed concerning the relationship between the nervous and the immune systems in regards to the relationship between drugs of abuse and infections, especially infections by the immunode ficiency virus that causes AIDS. In recent years, various investigators have begun to describe the role of illicit drugs and their endogenous counterparts on the brain-immune axis. It is widely recognized that the neuroendocrine system is intimately involved in the effects and manifestations of the interactions of drugs of abuse and the immune system. The meeting on which the chapters in this book are based brought together many biological scientists from an array of various scientific disciplines whose work is focused on the effects of drugs of abuse on the neuroendocrine-immune axis and its relationships to immunodeficiency caused by the AIDS virus. As in the past, the symposium was unique in focusing on the . brain-immune axis from the viewpoint of drugs of abuse rather than from the viewpoint of immunity or the brain itself."
Posttraumatic cerebral contusions, lacerations and hematomas in the past could often only be suspected by clinical symptomatology and be visualized by angiography in a restricted manner, but they are now diag nosed with precision through CT and MRI; they remain in the limelight in our daily management of severe head injuries. Stalhammar's longlasting research in biomechanics is he re condensed in a concise review of the current knowledge in this field, thus providing the basis for our understanding of the parenchymal cerebral posttraumatic lesions. The neuropathological investigations and findings remain fundamental to the clinical features, and in this text there is the advantage that they were carried out and interpreted by a very experienced neurasurgeon, Ion Oprescu, who most regretfully died before the completion of this volume. The special morphological and clinical investigations by Nakamura, concerning diffuse brain injury, contribute to our necessary diagnosis and treatment of this phenomenon where, without grass visible lesions of cerebral tissue, a high mortality occurs. The clinical features, the princip1es of therapy and the outcome are described by Vigouroux and Guillermain, whose clinical study clearly demonstrates the limitations of all our efforts in severe brain injuries, in spite of decades of clinical experience and research."
It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New special ties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their reader ship to the new specialists. International and national meetings, sympo sia and seminars, workshops, and newsletters successfully bring to the attention of physicians within developing specialties wh at is occur ring, but generally only in demonstration form without providing historical perspective, pathoanatomical correlates, or extensive discus sion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has devel oped during the past 15 years. Over this period neurosurgeons have obtained special training in pediatric neurosurgery and then dedicated themselves primarily to its practice. Centers, Chairs, and educational programs have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and invest igative studies into all aspects of surgically treatable diseases of the child's nervous system."
Amaurosis fugax, or "fleeting blindness," has been known as a clinical entity for hundreds of years (1). Since 1859, we also have understood that the phenomenon frequently is related to atheroembolic disease and that it is considered a classic manifestation of ocular transient ischemic attacks and a potential precursor to stroke. However, many questions about this syndrome have remained unanswered until quite recently, when a great deal of new information and thought has been directed to the subject. Transient monocular blindness (TMB) is only one manifestation of a complicated syndrome of ocular, systemic, and cerebral diseases that may include some degree of monocular blindness. The duration of blindness varies from very brief (seconds) to complete and permanent. The per manent type is referred to as ocular infarction or ocular stroke. Retinal infarction is the most severe degree of monocular blindness and usually is due to embolic occlusion of the central retinal artery or one of its branches. Varying types of arterial emboli have been described, including thrombus, cholesterol, platelets, and fibrin.
Tumours of the central nervous system in infancy and childhood show so many di verse pathomorphological characteristics and present so many diagnostic problems that a congress dealing specifically with the subject and thus bringing together a wide range of experts in the field seemed called for. The programme of the congress, . held in Mainz between 22 and 24 October 1981, was designed to provide compre hensive coverage of diagnosis and the various therapeutic procedures, as well as of basic research in the field. The various lectures given are contained in this book, which thus reflects the complete spectrum of topics discussed. The interest generated by the congress amply justified our decision to organize it. Representatives of various specialities, such as neuropathology, paediatrics, on cology, radiology, neurosurgery, paediatric surgery and neurology, and, last but not least, basic research, provided lively and interesting lectures which admittedly raised more problems than they solved. In addition to the actual papers presented, we attached considerable importance to the different opinions voiced during the congress, as reflected in the discussions included at the end of each chapter."
In the rapidly-evolving landscape of neurosciences, it is no easy task to select a limited array of topics to present in a text such as this. The current volume takes as its purpose to provide a representative survey of the current science of brain repair for those seeking to establish a foundation in the field or to replenish a prior knowledge base that may have lapsed in its currency. It also hopes to offer insights into what remains elusive to our collective investigations, defining the frontiers of brain repair for those that are currently immersed in the exciting intersection of biological advances and neuroscientific discoveries. In Chapter 1 the fundamentals of imaging transplanted cells is discussed with emphasis on animal models as well as the horizon for clinical trials. Then, detailed methods on the culture of neural stem cells is reviewed as a foundation for approaching therapeutic goals. Chapter 3 presents the broad scope of animal models that serve as the foundation for developmental and pre-clinical investigation, with mention of recent genetically engineered mouse models that represent the best models for studying disease development and treatment. Chapter 4 provides background on the delivery techniques to animals and patients that are available, providing vital information on the subtleties of technique necessary for optimal cellular grafting. Chapters 5 and 6 discuss new and evolving information on the origins of brain tumors and the indelible role of stromal and microenvironmental influences on oncogenesis and tumor progression. Subsequently, the utility of neural stem cells as cellular vehicles to deliver chemotherapeutics to broad neuropathology is reviewed. In Chapter 8 the scope of treating brain tumors is expanded beyond stem cells, to present the best biological interventions to improve upon current treatment options for brain malignancy. The last two chapters present a comprehensive review on stem cell and gene therapy options for treating cerebrovascular and neurovascular pathology. In amassing this collection, my intention has been to provide the reader with a broad introduction into molecular imaging, stem cell biology, cell therapy, animal models, central nervous system malignancies, stroke, and neurodegeneration. My hope is that Frontiers of Brain Repair will be the intellectual soil from which a deeply rooted and well-nourished vintage of neuroscience will arise."
Recent advances in technology have opened up new possibilities in the diagnosis and treatment of cerebrospinal vascular diseases. It is now possible to use magnetic resonance imaging to map brain function and metabolism as an aid to diagnosis. Novel applications of magnetic resonance angiography allow three-dimensional imaging, and the magnetization transfer contrast technique gives us a new window on cerebral vascular function. This volume presents work in all these fields as well as previewing the techniques of endovascular surgery for cerebrospinal vascular diseases. These include modern stereotactic radiosurgery for arteriovenous malformations and for angiographically occult vascular malformations of the brain. This book presents an overview of the latest applications of technology to this rapidly developing and challenging field.
The current book represents a distillation of the experience gained in diagnosis of intracranial tumors with computed X-ray tomography at the University Hos pitals of Berlin, Mainz, and Miinchen. To what purpose? Standard radiological techniques such as pneumoencephalography with lumbar puncture and cerebral arteriography with puncture of the common carotid artery are invasive proce dures which entail a certain amount of risk as well as discomfort for the patient. Furthermore, diagnoses made with these procedures rely primarily on indirect signs of an intracranial space-occupying lesion - such as displacement of the air-filled ventricles or of normal cerebral vessels. Only a few types of tumor are demonstrated directly with these techniques. In contrast, computed tomography demonstrates the pathology directly in almost all cases, and this with a minimum of risk and discomfort. In addition, normal intracranial structures are demonstrated, so that the tumor's effect on its surroundings can be evaluated. Today, almost a decade after HOUNSFIELD'S revolutionary invention, diagno sis of brain tumors without computed tomography is almost unthinkable, if not in fact irresponsible."
During the last decade a multitude of studies concerning the dynamic changes in cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and intracranial pressure (ICP) in the acute phase after head injury have been published. These studies have been supplemented with studies of cerebral autoregulation, CO2 reactivity and barbiturate reactivity. Other investigations include studies of cerebrospinal fluid pH, bicarbonate, lactate and pyruvate. In this book experimental and clinical studies of the dynamic changes in CBF, CMRO2, CO2 reactivity and barbiturate reactivity are reviewed. The author's own clinical studies of the dynamic changes in CBF and cerebral metabolism are summarized and discussed, and the therapeutical implication as regards the use of artificial hyperventilation, sedation with barbiturate and mannitol treatment are discussed.
The human nervous system-that most complex organization of energy and matter-has yielded a few glimmers of understanding of its operational me chanics during the last two decades. These have mostly been at the biochemical level of structure and function. Throughout history, as one of the mysteries of nature begins to yield some insights into its function, it has been beneficial to look at it from different points of view. We have developed a volume on movement disorders that is primarily directed toward the biochemical understanding of these disorders and their treatment. Each disorder is presented from several points of view. Although this approach leads to some repetition, it is our aim that the final outcome be a more complete understanding. Much has been written about movement: the beauty of the prima ballerina, the strength of the olympic athlete, and the agility of the surgeon. Seldom do we stop to look beneath the surface-the coordination of muscle groups, the finely tuned balance allowing rapid response in either direction, the individual muscle fibers coordinated to maximize strength and agility, and the nerve fibers connecting muscle with nerve centers. Some of these communicate sensory input of position to the centers while others communicate directions of move ment to muscles. We encourage our readers to be constantly alert to the possibility of in creasing their understanding of other nervous system functions, including thought disorder, through an understanding of movement, either in general principle or by specific chemical interaction."
2 3 4 5 6 7 8 9 1011 1 2 3 4111 This book provides coverage of a broad range of topics in the ?eld of neurosurgery, 5 for residents and registrars in training and for recent graduates of training programs. 6 As neurosurgical training incorporates expertise from centers worldwide, there is a 7 need to have input from specialists in neurosurgery from various countries. This text 8 is a compilation by expert authors in the USA and the UK to provide information on 9 the basic knowledge and clinical management required for optimal care of neuro- 2011 surgical patients. 1 The text is an up-to-date synopsis of the ?eld of neurosurgery from American and 2 British perspectives, which covers the most common clinical conditions encountered 3 by neurosurgeons. The chapters are organized under broad topics, including inves- 4 tigative studies, perioperative care, the role of newer techniques and the management 5 of tumors, vascular and traumatic lesions. Additional topics are then covered, includ- 6 ing pediatrics, spine and peripheral nerve lesions, as well as functional neurosurgery 7 and infections. We anticipate that trainees will ?nd this information useful for certi?- 8 cation examinations and recent graduates of neurosurgical training programs can 9 utilize this text as an update of the most important neurosurgical topics.
Recent radiologic procedures in bone and joints, some of which eliminate the need for surgery are exposed, including: trephine biopsies of the thoracic and lumbar spine, sacro-iliac joints, peripheral bones synovial membrane and soft tissues, using either fluoroscopic echographic or CT guidance - chemonucleolysis - vascular embolization of skeletal tumors and management of vertebral hemangiomas - selective steroid injection in a broad spectrum of diseases including vertebral facet syndrom, cervicobrachial nerve root pain, rotator cuff calcium deposits, bone cysts. This unique volume supplies the reader with complete information regarding the performance of all these techniques.
Since the introduction of electrosurgery the techniques of surgery on the nervous system have passed through further improvements (bipolar coagulation, microscope), even if the procedure was not substantially modified. Today, laser represents a new "discipline," as it offers a new way of performing all basic maneuvers (dissection, demolition, hemostasis, vessel sutures). Furthermore, laser offers the possibility of a special maneuver, namely reduction of the volume of a tumoral mass through vaporization. Its application is not restricted to traditional neurosurgery but extends also to stereotactic and vascular neurosurgery. Laser surgery has also influenced the anesthesiologic techniques. At the same time new instrumentation has been introduced: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. I have had the chance to utilize these new technologies all at a time and have come to the conclusion that we are facing the dawn of a new methodology which has already shown its validity and lack of inconveniences, and whose object is to increase the precision of neurological surgery. The technological development is still going on, and some improvements are to be foreseen. Laser scalpel is splitting the initial laser surgery into NO TOUCH and TOUCH surgery with laser. As new instrumentarium will be developed, a variable and tunable beam will become available. For example, in a few years Free Electron Laser will further add to the progress in this field."
The death 'Of a child, 'One wh'Ose vulnerability and unfilled promise c'Omp'Ounds the tragedy 'Of any death, t'Ouches us deeply. When that death 'Occurs due t'O the generally unexpected and sudden loss 'Of brain functi'On, it is particularly P'Oignant. And yet, when death c'Omes, it sh'Ould be diag- nosed expediti'Ously. The professi'Onal resP'Onsibilities 'Of the physician require that he b'Oth rec- 'Ognize brain death and inf'Orm the family 'Of its occurrence. In additi'On, since recent advances in transplantati'On provide the P'Ossibility 'Of using the 'Organs 'Of a brain-dead child t'O save the lives 'Of 'Other children, the c'Oncepts 'Of beneficence an~ charity further c'Ompel physicians t'O facilitate such transplantati'Ons by inf'Orming the family about this P'Ossibility. Criteria 'Of brain death have been refined 'Over about 30 years since the term coma depasse (bey'Ond c'Oma) was coined by M'Ollaret and G'Oulon in 1957 (Kaufman and Lynn, 1986). The last maj'Or criteria ev'Olved 'On a nati'Onal level were th'Ose 'Of the President's C'Ommissi'On in 1981. H'Owever, studies t'O date have c'Oncentrated 'On adults, and relatively little work has been rep'Orted ab'Out devel'Oping brain death criteria f'Or the y'Oung. Indeed, the advis'Ors t'O the President's Com- missi'On suggested that there are significant-although n'Ot well defined~ifferences in the ability of the brains 'Of th'Ose under five years 'Of age t'O rec'Over from clinical states that W'Ould be accepted as indicative 'Of c'Omplete and irreversible l'OSS of brain functi'On in adults.
Radiosurgery is a rapidly developing form of minimally invasive neurosurgery. Selected papers from the first meeting of the International Stereotactic Radiosurgery Society in Stockholm, June 1993, reflect current multidisciplinary approaches to difficult intracranial neurosurgical problems. Neurosurgeons, radiotherapists, oncologists, radiobiologists, physicists and representatives of several other clinical disciplines inform about the state-of-the-art of radiosurgical treatment of a multitude of intracranial problems such as arteriovenous malformations, pituitary and pineal tumors, vestibular schwannomas as well as metastatic brain tumors and gliomas.
Various textbooks on stereotactic neurosurgery have been published during the last few years (Riechert 1980, Schaltenbrand and Walker 1982, Spiegel 1982), all of them dealing with functional stereo tactics as the major subject in the field. Diagnostic and therapeutic stereotactic interventions are only briefly described, whereas localization techniques are not yet mentioned. Since 1980, however, an increasing number of reports has been published on CT guided and computer monitored stereotactic performances which enable the surgeon to combine diagnostic and therapeutic efforts in one session. With recent progress in scanning techniques, including high resolution CT, NMR, and PET imaging of the brain, it has become possible to study and localize any brain area of interest. With the concomitant advances in computer technology, 3-dimensional reconstruction of deep seated lesions in stereotactic space is possible and the way is open for combined surgery with stereotactic precision and computer guided open resection. This type of open surgery in stereotactic space is already being developed in some centers with the aid of microsurgical, fiberoptic, and laser beam instrumentation. With these advances stereotactic techniques will rapidly become in tegrated into clinical neurosurgery. Stereotactics has become a metho dology which enables the surgeon to attack deep seated and subcortical small tumors. Neurosurgeons may abandon therapeutic nihilism, still frequently seen in glioma treatment, in the near future when stereotactic resection will be feasible and remaining tumor cells may be killed by adjuvant treatment modalities still in development."
The sellar region and paranasal sinuses constitute the anatomical sections of the skull base in which pathological entities warrant interdisciplinary management. Processes originating in the paranasal sinuses can reach and involve the skull base in and around the sella, sometimes not respecting the natural dural boundary. On the other hand, lesions involving the sellar block, such as pituitary adenomas and meningiomas, can also extend downwards into the paranasal sinuses. The orbit and cavernous sinus may be subject to involvement and infiltration by both paranasal and sellar pathology. The advancement and new achievements of modern diagnostic procedures, such as high-resolution CT, three-dimensional reconstruc tion, MRI, and MRI angiography, as well as the detailed selective angiographic protocols and endovascular techniques, have increased the possibilities for surgical management of this type of pathology with extra- and intracranial involvement. Long-standing and intense inter disciplinary work has led to sophisticated operative approaches which for benign tumors allow total excision with preservation of structures and function, and for some malignant lesions permit an en bloc resec tion via a combined intracranial-extracranial approach. This volume reflects the work and scientific exchange which took place during the IV International Congress of the Skull Base Study Group, held in Hanover. Leading authorities in the basic sciences including anatomy joined with diagnosticians, clinicians, and surgeons from different fields to evaluate the state of the art of this topic in skull base surgery."
The presence of sophisticated auditory processing in mammals has permitted perhaps the most significant evolutionary development in humans: that of language. An understanding of the neural basis of hearing is thus a starting point for elucidating the mechanisms that are essential to human communication. The cochlear nucleus is the first region of the brain to receive input from the inner ear and is therefore the earliest stage in the central nervous system at which auditory signals are processed for distribution to higher centers. Clarifying its role in the central auditory pathway is crucial to our knowledge of how the brain deals with complex stimuli such as speech, and is also essential for understanding the central effects of peripheral sensorineural hearing loss caused by, for example, aging, ototoxic drugs, and noise. Ambitious new developments to assist people with total sensorineural deafness, including both cochlear and cochleus nuclear implants, require a detailed knowledge of the neural signals received by the brainstem and how these are processed. Recently, many new data have been obtained on the structure and function of the cochlear nucleus utilizing combinations of anatomical, physiological, pharmacological and molecular biological procedures. Approaches such as intracellular dye-filling of physiologically identified neurons, localization of classical neurotransmitters, peptides, receptors and special proteins, or gene expression have opened the door to novel morphofunctional correlations.
It is, of course, a real challenge to summon together an International Sym- posium in and around the Brain Stem and Third Ventricle. Up to this mo- ment the various experiences and papers on this subject were distributed throughout the world literature, making it very difficult for someone in- terested in the matter to have access to the actual state of knowledge. Therefore I believe such a meeting was long overdue and is a considerable attempt to open closed doors for present and future ambitious neurosurgi- cal activities. After succeeding in previous symposiums of similar interest in Hanno- ver, it was obvious that Prof. Madjid Samii and his coworkers took the in- itiative of organizing such a meeting, bringing together - in the pure sense of the word - Neurosurgeons with Anatomists, Neurologists, Neuro- physiologists, Neuroradiologists, ENT-, Maxillofacial-, Stereotactic-, and Radiosurgeons as well as other colleagues. One contribution after the other followed, from the basic sciences up to the operative management con- sidering very new and actual concepts. Through the application of new microsurgical techniques and the incorporation of new understanding for the many problems afflicting the midline of the eNS, and based on a growing closer cooperation between the various disciplines, a wide field has opened up which concerns us all.
At the present time several techniques are available for studying quantitatively global and regional blood flow and metabolism of the human brain. How ever, many scientists working in the clinical and research field who would like to use these tools for their investigations may be less familiar with the indi cations and limitations of the individual methods. The rapid development of both modern imaging techniques and new tracers may have led to some con fusion in answering the question as to which method is appropriate to solve the diagnostic problem of an individuum with brain disease. Scepticism and ignorance as to the methods to be used as tools in differential diagnosis of brain disorders may have prevented their widespread introduction into clinical practice. Thus, the significance of circulatory and metabolic parameters involved in the majority of diseases of the central nervous system may have been overlooked. The contributions compiled in this book describe in detail the individual techniques, outline their indications and limitations and deal in particular with newer methods such as the atraumatic 133Xe technique, stable xenon tomogra phy, three-dimensional techniques such as 133Xe single photon emission tomog raphy and N-isopropyl-P23-iodoamphetamine. Positron emission tomography studies provide information on function and metabolism, particularly that of oxygen and glucose, in regional brain areas of interest. Nuclear magnetic reso nance may be a promising method for studying metabolic parameters; however, accurate circulation measurements can not be performed at present."
Memory is essential for the retention of learning. In the presence of memory deficits, new learning is impaired and performance of previously learned habits deteriorates. What is the nature of memory? Where does it reside in the brain? What biological events are associated with the formation and retrieval of memory? These questions are explored in the first chapter of this volume. The answers are not final, but we have learned a great deal about memory processes during the past few decades. Memory is influenced by most of the pathological processes that influ ence the brain such as infection, trauma, cerebrovascular disorders, and met abolic and degenerative diseases. The nature and course of memory impairment are unique for each of the disorders and are fairly distinguishable. More than fifty conditions are known to cause dementia, which now affects several million Americans. In Alzheimer's disease, memory disorder predominates for two to three years before other intellectual functions are affected. Many neurological diseases, such as Huntington's disease, Friedreich's ataxia, and multiple sclerosis, are associated with progressive memory deficits. Forgetting is a problem that becomes progressively worse with age. Most individuals in their forties begin to experience some difficulty in quick recall of past events. By age sixty definite changes are evident in the process of registration, storage, and recall of memory. At this age the material that is to be remembered is processed more slowly, stored less firmly, and poorly recalled."
Malignant glioma is generally considered one of the most therapeutically difficult cerebral tumors. This book deals with many aspects of gliomas, including factors related to incidence and epidemiology, and surveys the history of glioma therapies. Experimental studies carried out by the Sendai Group of Neurosurgeons are reported, together with the results of many clinical studies of RAFP therapy. This particular theorapy involves the administration of radiation treatment and three chemical compounds: ACNU, Futraful and PSK. A recent technique for evaluating the effectiveness of therapy based on MRI diagnostic methods is introduced. This book thus offers valuable information and guidelines for future developments in treatment. |
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