Age-Related Changes in Pharyngeal Lumen Size: A Retrospective MRI Analysis

Age-related loss of muscle bulk and strength (sarcopenia) is often cited as a potential mechanism underlying age-related changes in swallowing. Our goal was to explore this phenomenon in the pharynx, specifically, by measuring pharyngeal wall thickness and pharyngeal lumen area in a sample of young versus older women. MRI scans of the neck were retrospectively reviewed from 60 women equally stratified into three age groups (20s, 60s, 70+). Four de-identified slices were extracted per scan for randomized, blinded analysis: one mid-sagittal and three axial slices were selected at the anterior inferior border of C2 and C3, and at the pit of the vallecula. Pixel-based measures of pharyngeal wall thickness and pharyngeal lumen area were completed using ImageJ and then converted to metric units. Measures of pharyngeal wall thickness and pharyngeal lumen area were compared between age groups with one-way ANOVAs using Sidak adjustments for post-hoc pairwise comparisons. A significant main effect for age was observed across all variables whereby pharyngeal wall thickness decreased and pharyngeal lumen area increased with advancing age. Pairwise comparisons revealed significant differences between 20s versus 70+ for all variables and 20s versus 60s for all variables except those measured at C2. Effect sizes ranged from 0.54 to 1.34. Consistent with existing sacropenia literature, the pharyngeal muscles appear to atrophy with age and consequently, the size of the pharyngeal lumen increases.

Morphological observation and length-weight relationship of critically endangered riverine catfish Rita rita (Hamilton)

The experiment was conducted to investigate the morphological status of the critically endangered riverine catfish Rita rita using morphometric and meristic traits. About 158 species of Rita were collected from the old Brahmaputra river in Mymensingh district and were studied in the laboratory of the Fisheries Biology and Genetics Department, Bangladesh Agricultural University. Measurement of length and weight of Rita were recorded by using measuring scale and electric balance respectively. Significant curvilinear relationship existed between total length and other morphometric characters and between head length and other characters of the head. Relationships between total length and various body measurements of the fish were highly significant (p < 0.01) except the relationship between total length and pelvic fin length of male fish (p < 0.05). In case of meristic characters-dorsal fin rays, pelvic fin rays, pectoral fin rays, anal fin rays, caudal fin rays, number of vertebrae and branchiostegal rays were found to be more or less similar except slight differences. The values of condition factors (k) in the total length body-weight relationships for female and male were found to be 0.41 and 0.38, respectively. The mean values of relative condition factors (kn) were 1.0 and 1.005 for female and male, respectively.

Pulmonary alveolar microlithiasis (PAM) in a child

A 4 year 7 month-old girl of consanguineous parents presented with only fever for 25 days but no cough or respiratory distress. Ches x-ray showed bilateral diffuse nodulo-striate opacities in both lungs. Investigations for any infection were negative including tuberculosis. Thoracoscopic biopsy showed alveolar microliths on histopathology suggesting the diagnosis of pulmonary alveolar microlithiasis (PAM).

Rockall score for risk stratification in adult patients with non-variceal upper gastrointestinal hemorrhage

The Rockall risk score is a simple, validated predictive index that may serve as a useful clinical decision for assessing the risk of subsequent adverse outcomes in patients with non-variceal upper gastrointestinal hemorrhage (UGIH). The observational study was carried out over a period of 6 months from 10th July, 2012 to 09th January, 2013 in Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 60 patients with non-variceal UGIH were taken for the study during study period to see risk stratification by Rockall score and short term hospital outcome in non-variceal upper GI hemorrhage patients. Categorical variables were reported as percentage and Means and proportions were carried out using the Chi-square test of different variables. Among study population age distribution were 42(70%) <60 years, 16(26.7%) from 60-79 years and 02(3.3%) 80 years or above and sex distribution were 39(65%) male and 21(35%) were female patients. Rockall score of patients 11(18.3%) had score 1, 6(10%) had score 2, 13(21.7%) had score 3, 10(16.7%) had score 4, 6(10%) had score 5, 6(10%) had score 6, 4(6.7%) had score 7, 3(5.0%) had score 8 and 1(1.7%) had score 9. Risk stratification showed 30(50%) had low risk (score 3 or <3), 26(43.3%) had moderate risk (score 4-7) and 4(6.7%) had high risk (score 8 or >8). Outcome after initial Rockall scoring and endoscopy were found that 7(11.7%) died, 46(76.6%) survived and 7(11.7%) patients survived with complication. This study showed that Rockall score of ≤3 was predictive of low risk of adverse outcomes, and a score of ≥8 was predictive of high mortality and was useful in identifying patients with non-variceal UGIH who had low-risk scores in order to triage appropriately, without affecting patient outcomes.

Comparative Effectiveness Of Seed Treating And Foliar Insecticides Against Sucking Pests Of Cotton And Impact On Their Natural Enemies

The Imidacloprid insecticide, Gaucho 70 WS at 1.5, 2.5, 3.5, 4.5 and 5.5 g/kg seed was used as seed treatment and monocrotophos 40 WSC at 1120 ml/ha was applied as foliar spray on CB9 cotton cultivar to suppress aphid, whitefly and thrips, and impact on their natural enemies during 2008-2011 at the Regional Cotton Research Station, Dinajpur, Bangladesh. The activity of natural enemies, such as ladybird beetle, lacewing, syrphid, and spider population on the sucking pests attacking cotton cultivar CB9 and yield of cotton were recorded. Imidacloprid significantly reduced aphid, whitefly, and thrips population on cotton crops compared to untreated control or foliar spray of monocrotophos 40 WSC at 1120 ml/ha. Ladybird beetles, lacewings, syrphids, and spiders were abundant in the field but their population decreased in the treated plots compared to untreated control. The CB9 cotton cultivar produced significantly higher yield (1.73 t/ha) with a benefit cost ratio 12.47 when seeds were treated with Imidacloprid at 5.5 g/kg fuzzy seed. This study indicated that Imidacloprid (Gaucho 70 WS) used as a seed treatment may be suggested to the cotton growers for controlling sucking pests. Bangladesh J. Agril. Res. 38(1): 61-70, March 2013 DOI: http://dx.doi.org/10.3329/bjar.v38i1.15190

Antibiotic prophylaxis is unnecessary in clean surgery

A significant number of paediatric surgical patients undergone clean surgical procedures. Most of the paediatric surgeon use perioperative prophylactic antibiotic in this clean procedure because of undue fear of infection in their mind. The objective of this study is to evaluate whether the use of perioperative prophylactic antibiotics have an effect to prevent post operative wound infection in clean operation in paediatric surgical patients. This study was conducted in the paediatric surgery department of Bangabandhu Sheikh Mujib Medical University and some private clinics of Dhaka city from January 2009 to December 2009. Two hundred patients who were undergone clean elective surgical procedure on day case basis were included in this study. They were divided into two equal groups (Group A and Group B). The patients of Group A were given intransverse Cephradine 30 minutes before incision and then oral Cephradine was advised postoperatively for 7 days. The patients of Group B were not given any perioperative antibiotic. All the patients of both groups were advised to come on 3rd, 6th and 10th postoperative day for examination of wound. In Group A (With chemo prophylaxis), five patients (5%) developed postoperative wound infection and in Group B (without chemo prophylaxis), three patients (3%) developed postoperative wound infection. Thus the rate of postoperative wound infection is slightly more in patients with chemo prophylaxis but it was not statistically significant by chi-square test. Based on the result of this study, it may be concluded that the antibiotic prophylaxis is not necessary in clean surgery in paediatric age group.

Serum homocysteine levels in patients with acute myocardial infarction

DOI: http://dx.doi.org/10.3329/jdmc.v21i1.13234 J. Dhaka Med. Coll. 2012; 21(1): 23-27

Melanotic neuroectodermal tumour of infancy

Melanotic neuroectodermal tumour in infancy is rare, mainly benign with little tendency to recur after excision or effective curettage. This pigmented neoplasm of neural crest origin occurring in infants before 1 year of age. The most common site of occurrence is the anterior maxillary alveolar ridge (70%), following by the skull, brain and mandible. The genital organ is the most frequent extra cranial site. We report a 6 months old male baby with a similar tumour arising from right half of cheek involving the maxilla. We diagnosed the case after histological report. We remove the tumour through a sub-labial incision. The mass was blackish in colour, and was mobilized from all side including from the maxillary sinuses. The author thought that this should be reported for improving the clinical awareness and treatment of pigmented soft tissue mass in children. Almost one year follow up of the patients showed no recurrence.

Isolated appendicular tuberculosis (TB) presented as peritonitis

Tuberculosis is very common entity in both developing and under developed countries. Each year 3 million people worldwide died of the disease. Among extra pulmonary TB, alimentary system accounts for about 3.0% cases. The Commonest presentation of alimentary tuberculosis is Ileo-caecal disease, but isolated appendicular involvement is very rarely seen. Although some cases have been reported from our neighboring countries, there is still no such report from Bangladesh. We are here for the first time reporting a case of isolated appendicular tuberculosis which presented to us with peritonitis.

Partial pressure of oxygen in arterial blood in normal pregnant women in Dhaka city

In the present study the partial pressure of oxygen in arterial blood (PaO2) was estimated in 32 women in Dhaka city. For this purpose a total 32 women subjects with age ranged from 25 years to 35 years without any recent history of respiratory diseases were selected and divided into 8 healthy non-pregnant women as control and 24 normal pregnant women as experimental group. Experimental group was further divided into 8 first trimester, 8 second trimester & 8 third trimester of pregnant women. The PaO2 was estimated by using "Easy Blood Gas Auto Analyzer". The PaO2 was estimated during the 1st, 2nd, 3rd trimesters of pregnant women and non-pregnant women. The mean of measured values of PaO2 were analyzed statistically in relation to 1st, 2nd, 3rd trimesters of pregnant women & non-pregnant women. The PaO2 was significantly higher in 1st trimester, 2nd trimester & 3rd trimester of pregnant women than that of non-pregnant women. There were no statistically significant difference of PaO2 between the 1st trimester and 2nd trimester; between the 1st trimester and 3rd trimester; and between the 2nd trimester and 3rd trimester of pregnant women. It may be concluded that the causes of progressively increased PaO2 throughout the pregnancy were most likely to be due to effect of progesterone causing hyperventilation.

SR 141716A differentially attenuates the behavioral effects of delta9-THC in rhesus monkeys

The prototypic cannabinoid CB1 antagonist SR 141716A is one important pharmacologic tool for examining CB1 receptors that mediate the behavioral and physiologic effects of delta9-tetrahydrocannabinol (delta9-THC). This study examined the effects of SR 141716A on the rate-decreasing, hypothermic and discriminative stimulus effects of delta9-THC in rhesus monkeys. In monkeys (n=4) responding under a multiple fixed ratio (FR-10:FR-10) schedule of food presentation and stimulus-shock termination, the potency of i.m. delta9-THC to decrease responding in the food component (ED50=0.64 mg/kg) was threefold greater than its potency in the stimulus-shock termination component (ED50=2.14 mg/kg). In the same monkeys, hypothermia was induced by delta9-THC at a dose (e.g. 0.32 mg/kg) that did not alter responding in either schedule component; the maximum decrease was 2.1 degrees C at a dose of 3.2 mg/kg. A dose of 0.32 mg/kg of SR 141716A, significantly attenuated delta9-THC-induced hypothermia without attenuating the rate-decreasing effects of delta9-THC in either component of the multiple schedule. The largest dose of i.m. SR 141716A that was studied, 1.0 mg/kg, significantly decreased rectal temperature and responding in the food component but did not significantly decrease responding in the stimulus-shock termination component of the multiple schedule. In a separate group of monkeys (n=3) that discriminated i.v. delta9-THC (0.1 mg/kg) while responding under an FR-5 schedule of stimulus-shock termination, SR 141716A (0.32 and 1 mg/kg) significantly increased the ED50 of the delta9-THC by 2.3- and 3.7-fold, respectively. Collectively, these results demonstrate that the behavioral effects of delta9-THC are not equally attenuated by SR 141716A.

Thyrohyoid Approach to Cidofovir Injection: A Case Study

Various techniques for injection into the larynx have been well described, including transoral injection with indirect laryngoscopy or direct laryngoscopy and transcutaneous injection through the thyroid cartilage or cricothyroid membrane. We describe a case not amenable to these techniques, in which entry through the thyrohyoid membrane for injection of cidofovir was successfully performed with a thyrohyoid approach. This technique is described, and comparisons are made with currently available techniques.

A retrospective study on genito urinary Rhabdomyosarcoma

A retrospective study was carried out on Genitourinary Rhabdomyosarcoma in the Department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period January 1990 to December 1999. Total thirteen patients were treated during this period, age ranging from 1 month to 12 years. Eight patients were male and five were female (M: F = 1.6: 1). Diagnosis was made by history, thorough physical examination, digital rectal examination, ultrasonography, intravenous urography, CT scan and biopsy. All the patients were treated with chemoradiation theraphy as a first line of management and surgical excision was done for local residual tumours. Eight children (61.5%) were asymptomatic after completion of chemo-radiation therapy. Three (23.07%) patients discontinued the chemo-radiation schedule. Residual mass was present in one (7.7%) case for which partial cystectomy was done and the patient died in the 5th post operative day. Another patient (7.7%) who had pulmonary metastasis at the time of diagnosis, died during chemo-radiation therapy.

Aromatic amino acid biosynthesis and production of related compounds from p-hydroxyphenylpyruvic acid by rumen bacteria, protozoa and their mixture

Aromatic amino acid biosynthesis and production of related compounds from p-hydroxyphenylpyruvic acid (HPY) by mixed rumen bacteria (B), protozoa (P), and their mixture (BP) in an in vitro system were quantitatively investigated. Microbial suspensions prepared from mature, fistulated goats fed Lucerne ( Medicago sativa) cubes and a concentrate mixture were anaerobically incubated at 39 degrees C for 12 h. Tyrosine (Tyr), phenylalanine (Phe), tryptophan (Trp) and other related compounds in both supernatants and hydrolyzates of all incubations were analyzed by HPLC. Large amounts of Tyr (27.0, 47.0 and 50.8% of disappeared HPY in B, P and BP, respectively) were produced from 1 mM HPY during a 12-h incubation period. The formation of Tyr in P was 1.8 and 1.6 times higher than those in B and BP, respectively. Appreciable amounts of Phe (3-12% of the disappeared HPY) and Trp (2-10% of the disappeared HPY) were also produced from HPY in B, P, and BP. Phe synthesis in B and P was almost similar but Trp synthesis in B was 1.8 times higher than that in P. The biosynthesis of both Phe and Trp from HPY in BP was higher than those in B plus P. A large amount of p-hydroxyphenylacetic acid (about 45% of the disappeared HPY) was produced from HPY in B which was 1.9 times higher than that in P. p-Hydroxybenzoic acid produced from HPY in P was 1.6 times higher than that in B. Considerable amounts of phenylpropionic acid, phenyllactic acid, and phenylpyruvic acid (2-6% of the disappeared HPY) were produced only in B.

Thin layer chromatographical detection of tyrosine produced from L-[U-(14)C]phenylalanine by ruminal microbes

Thin layer chromatographical detection of tyrosine (Tyr) synthesized from L-[U-(14)C]phenylalanine (Phe) (1 mM) by rumen bacteria (B) and protozoa (P) collected from fistulated Japanese Goat was carried out. About 16 and 12% of the added Phe was converted to Tyr by B and P, respectively. Large amount of radioactivity in ether fractions indicated an abundant production of aromatic acids from Phe. Small amount of radioactivity found in CO(2) fractions implied an occurrence of considerable decarboxylation reaction(s) by rumen bacteria and protozoa.

Proton pump inhibitor resistance in the treatment of laryngopharyngeal reflux

OBJECTIVE

To describe the occurrence of relative proton pump inhibitor (PPI) drug resistance in the treatment of laryngopharyngeal reflux (LPR).

STUDY DESIGN AND SETTING

A retrospective review was performed for 1053 consecutive adults undergoing double-probe (simultaneous esophageal and pharyngeal) pH testing in our laboratory. Two hundred five patients who had pH studies performed while taking at least a daily dose of PPI therapy were identified; 167 qualified for further analysis. The pH data was reviewed for the presence of abnormalities in either esophageal or pharyngeal acid exposure to evaluate drug efficacy.

RESULTS

Forty-four percent (74/167) of the study patients demonstrated abnormal levels of acid exposure. Results were further analyzed to compare failure rates based on different dosage regimens. Patients on once daily doses of PPI failed at a rate of 56%, with lower failure rates for higher-dose regimens.

CONCLUSIONS

A significant number of LPR patients on PPI therapy demonstrate relative drug resistance.

Predicting outcome in pediatric coin ingestion

OBJECTIVE

To determine the relationship between coin size, coin location, patient age, and patient weight and likelihood of coin passage through the esophagus following pediatric coin ingestion. A secondary objective is to test the hypothesis that coin denomination can be determined based on radiographic appearance.

METHODS

A retrospective review was performed of all children seen and evaluated for coin ingestion at a single institution over a 25-month period. Outcome measures included the number of coins that were retained in the esophagus, and the number that passed. Various factors were assessed for their predictive value in judging outcome in coin ingestion cases.

RESULTS

Nineteen percent of patients (15/79) in the study passed their ingested coins. Coin denomination could be accurately determined on every patient that had a standard AP or lateral X-ray film. These findings were marked when compared with the lack of reliability of history in determining coin denomination. Patients who passed coins were as a group older (4.6 vs. 3.2 year, P=0.04), but did not differ significantly by weight (19.5 vs. 15.4 kg, P=0.07) from those that retained the coins. Coins located at the gastroesophageal junction had a significantly higher passage rate than coins located elsewhere in the esophagus (89 vs. 8.2%, P<0.01). Coin size was not predictive of coin passage (P=0.7 by chi(2)).

CONCLUSIONS

Radiographic assessment of coin denomination is reliable, but in this study could not be used to predict coin passage. Patient age and coin location at the gastroesophageal junction, however, do correlate with this event.

Vagal neuropathy after upper respiratory infection: a viral etiology?

PURPOSE

To describe a condition that occurs following an upper respiratory illness, which represents injury to various branches of the vagus nerve. Patients with this condition may present with breathy dysphonia, vocal fatigue, effortful phonation, odynophonia, cough, globus, and/or dysphagia, lasting long after resolution of the acute viral illness. The patterns of symptoms and findings in this condition are consistent with the hypothesis that viral infection causes or triggers vagal dysfunction. This so-called postviral vagal neuropathy (PVVN) appears to have similarities with other postviral neuropathic disorders, such as glossopharyngeal neuralgia and Bell's palsy.

MATERIALS AND METHODS

Five patients were identified with PVVN. Each patient's chart was reviewed, and elements of the history were recorded.

RESULTS

Each of the 5 patients showed different features of PVVN.

CONCLUSIONS

Respiratory infection can trigger or cause vocal fold paresis, laryngopharyngeal reflux, and neuropathic pain.

Hemicricoidectomy for voice rehabilitation following hemilaryngectomy with ipsilateral arytenoid removal

The purpose of this article is to describe an approach to reconstruction of the larynx after vertical partial laryngectomy with removal of the ipsilateral arytenoid cartilage. This method addresses the problem of postoperative posterior glottal incompetence (aphonia with or without aspiration). The technique involves resection of the ipsilateral half of the cricoid cartilage, use of an inferiorly based strap muscle flap for vocal fold reconstruction, and placement of a customized stent. This technique may be used at the time of the primary cancer extirpation or as a secondary rehabilitative procedure. Generally, patients who have undergone this procedure have had minimal postoperative breathiness with good phonatory and airway function. We recommend this reconstructive technique for patients with large posterior defects following hemilaryngectomy.

Diagnostic laryngeal electromyography: The Wake Forest experience 1995-1999

BACKGROUND

Laryngeal electromyography (LEMG) is a valuable diagnostic/prognostic test for patients with suspected laryngeal neuromuscular disorders.

OBJECTIVE

To report our experience with diagnostic LEMG at the Center for Voice Disorders of Wake Forest University and to evaluate the impact of LEMG on clinical management.

METHODS

Retrospective chart review of 415 patients who underwent diagnostic LEMG over a 5-year period (1995-1999).

RESULTS

Of 415 studies, 83% (346 of 415) were abnormal, indicating a neuropathic process. LEMG results altered the diagnostic evaluation (eg, the type of radiographic imaging) in 11% (46 of 415) of the patients. Unexpected LEMG findings (eg, contralateral neuropathy) were found in 26% (107 of 415) of the patients, and LEMG results differentiated vocal fold paralysis from fixation in 12% (49 of 415). Finally, LEMG results altered the clinical management (eg, changed the timing and/or type of surgical procedure) in 40% (166 of 415) of the patients.

CONCLUSIONS

LEMG is a valuable diagnostic test that aids the clinician in the diagnosis and management of laryngeal neuromuscular disorders.

Self-consistent linear analysis of slow cyclotron and Cherenkov instabilities

Slow cyclotron and Cherenkov instabilities are analyzed self-consistently for unbounded and cylindrical slow wave systems considering electron beam propagating along the direction of a guiding magnetic field. There are two electromagnetic modes present in the beam that are self-consistent solutions of Maxwell's equations. The wave equation in the beam becomes the Altar-Appelton-Hartree equation in the limit of zero beam velocity. For the unbounded system, the beam couples with the electromagnetic modes corresponding to the X and O modes, resulting in the slow cyclotron and Cherenkov instabilities, respectively. For the cylindrical system, axisymmetric electromagnetic modes in the beam are obtained by superposing the plane normal modes of the unbounded system. Since self-consistent boundary conditions require all field components, axisymmetric electromagnetic modes of cylindrical system are hybrid modes, which are classified as axisymmetric EH and HE modes. The slow cyclotron and Cherenkov instabilities occur for both axisymmetric modes. The temporal growth rate is calculated for each of the instabilities and compared.

Cryopreservation of epididymal spermatozoa collected by needle biopsy from cynomolgus monkeys (Macaca fascicularis)

We have examined the motility, morphology, and cryopreservation of epididymal spermatozoa collected by needle biopsy from cynomolgus monkeys (Macaca fascicularis). At collection, epididymal sperm (23 x 10(6) +/- 4 x 10(6) sperm/sample; 611 x 10(6) +/- 116 x 10(6) sperm/ ml; n = 18) were alive (79 +/- 2%), motile (67 +/- 2%), and exhibited intact membranes (65 +/- 2%). Sperm maintained at room temperature in handling medium exhibited decreased motility over time, but head-to-head agglutination was limited. Tris egg-yolk extender containing 6% glycerol and dimethylsulfoxide (DMSO) did not significantly affect functional morphology, whereas extender containing propanediol significantly reduced motility, survival, and membrane integrity. Cryostorage reduced all measures of functional morphology independent of cryoprotectant. Post-thaw motility was superior for glycerol and DMSO compared to propanediol. Variation in glycerol concentration (4, 6, and 8%) produced equivocal effects on sperm functional morphology post-thaw. Needle biopsy may be a useful technique for laboratory and field-based collection of spermatozoa from nonhuman primates.

Preliminary individual adjuvant therapy for gliomas based on the results of molecular biological analyses for drug-resistance genes

New adjuvant therapy individualized by the results of reverse transcription-polymerase chain reaction (RT-PCR) for drug-resistance genes has been used to treat malignant gliomas. Protocol studies for malignant gliomas were not so encouraging in their therapeutic results because of heterogeneity and the various drug-sensitivities of the tumors. Individualization of glioma therapy is recommended. Drug-resistance genes messenger ribonucleic acid (mRNA) expressions were investigated in drug-resistant human glioma cell lines derived from U87MG and 46 frozen samples of retrospectively examined neuroepithelial tumors (12 low grade neuroepithelial tumors, 16 Grade III gliomas, 11 glioblastomas, and 7 other malignant neuroepithelial tumors such as medulloblastomas and primitive neuroectodermal tumors) by RT-PCR with the specific primers for O6-methylguanine DNA methyltransferase (MGMT), multidrug-resistance gene 1 (MDR1), multidrug-resistance-associated protein (MRP), and glutathione-S-transferase-pi (GST-pi). Thirty-seven preliminary individual adjuvant therapies (IAT) based on RT-PCR results, mainly in MGMT expression, were performed on 30 consecutive patients with neuroepithelial tumors. In the retrospectively examined series, the initial response to 1-(4-amino-2-methyl-5-pyrimidynyl) methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) was correlated most significantly to the MGMT mRNA expression among 11 independent prognostic factors (p = 0.0037) in multivariate logistic regression analysis. In the preliminary IAT, 17 of 32 evaluable therapies had a partial or complete response (53.1% response rate). Our IAT based on RT-PCR seemed to be more effective than conventional therapies for malignant gliomas.