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Enzinger PC, Yock T, Suh W, Fidias P, Mamon H, Choi N, Lehman N, Lawrence C, Lynch T, Fuchs C. Phase II cisplatin, irinotecan, cetuximab and concurrent radiation therapy followed by surgery for locally advanced esophageal cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4064] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4064 Background: Weekly irinotecan, cisplatin, and concurrent radiation therapy is a well-tolerated, active regimen in locally advanced esophageal cancer. (Ilson. JCO 2003) Cetuximab, an EGFR inhibitor, is a potent radiation sensitizer in head and neck cancer. (Bonner. Proc ASCO 2004) Methods: In this phase II trial, patients (pts) with T2–4N0–1M0–1A esophageal adenocarcinoma (A) or squamous cell carcinoma (S) receive 5040 cGy/28 fractions of radiation therapy (RT) and concurrent weekly cisplatin 30mg/m2 plus irinotecan 65 mg/m2 on weeks 1, 2, 4, and 5, followed by surgery 4–8 weeks after completion of RT. Additionally, pts receive weekly infusions of cetuximab 250 mg during RT, up to one week before surgery, and for 6 months following surgery. Results: Seventeen pts have been entered: male: female = 14:3, median age 54, ECOG PS 0:1 = 6:11, A:S = 17:0, stage IIA:IIB:III:IVA = 6:1:8:2, tumor location-esophagus-mid:lower:gastroesophageal junction = 1:4:12, >10% weight loss-yes:no = 8:9. Of 17 pts entered, 15 pts have proceeded to surgery, 1 pt died from Aspergillus infection resulting in respiratory failure and sepsis, and 1 pt is pending surgery. Of the 15 pts who underwent surgery, 2 (13%) had a complete pathologic response; pathologic stage for other pts: 0 = 1, I = 3, IIA = 3, IIB = 1, III = 4, IV = 1. Grade III/IV toxicity (17 pts) was: diarrhea 9 pts, neutropenia 9 pts, febrile neutropenia 5 pts, anorexia 5 pts, vomiting 4 pts, fatigue 3 pts, mucositis 1 pt. Chemotherapy dose attenuation was required for diarrhea in 5 pts, for neutropenia in 4 pts, and for folliculitis in 1 pt. One patient was removed from study during week 6 for prolonged diarrhea/ dehydration. Due to the 2-step design of the trial, accrual is on hold pending a 3rd required pathologic CR in the first 17 patients. Conclusions: Compared to other trials of irinotecan, cisplatin, radiation therapy, and surgery in similar groups of esophageal cancer patients, early results for this combination with cetuximab suggest a lower complete response rate and higher overall toxicity. Additional data will be available at ASCO. Supported by Bristol-Myers Squibb. No significant financial relationships to disclose.
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Wong KK, Fracasso PM, Bukowski RM, Munster PN, Lynch T, Abbas R, Quinn SE, Zacharchuk C, Burris H. HKI-272, an irreversible pan erbB receptor tyrosine kinase inhibitor: Preliminary phase 1 results in patients with solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3018] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3018 Background: HKI-272 is a potent, low molecular weight, orally active, irreversible pan erbB receptor tyrosine kinase inhibitor. It inhibits the growth of tumor cells that express erbB-1 (epidermal growth factor receptor, EGFR) and erbB-2 (HER-2) in culture and xenografts. HKI-272 also inhibits the growth of cultured cells that contain sensitizing and resistance-associated EGFR mutations (Kwak et al, Proc Natl Acad Sci USA 102:7665–70, 2005). We are conducting a phase 1 study in patients (pts) with advanced-stage tumors that express EGFR or HER-2 to assess HKI-272 for tolerability, safety, pharmacokinetics, and preliminary antitumor activity. Methods: Pts (3–6/cohort) received 40, 80, 120, 180, 240, 320, or 400 mg HKI-272 orally once on day 1 and then once daily beginning on day 8. Timed blood samples were collected on days 1 and 21 for pharmacokinetic analysis. Results: Enrollment of 73 pts is complete. Preliminary data for 51 pts as of 28 Nov 2005 are presented. Patients were a median 60 years and 26% men. The most frequently occurring tumor types at primary diagnosis were breast (23 pts), non-small cell lung (9), and colorectal, ovarian, and renal (3 pts each). Dose escalation ended when 2 pts who received 400 mg HKI-272/day had drug-related dose-limiting toxicity of grade 3 diarrhea. Thus, the maximum tolerated dose (MTD) was 320 mg HKI-272/day. HKI-272-related adverse events (AEs), any grade, that occurred in ≥10% of pts were diarrhea (84%), nausea (55%), asthenia (45%), anorexia (31%), vomiting (29%), chills (12%), and rash (10%). Grade 3 related AEs that occurred in >1 pt were diarrhea (11) and asthenia (4). HKI-272 Cmax and AUC increased in a dose-dependent manner. At steady state at the MTD, mean values were Cmax: 112±58 ng/mL, AUC: 1618±930 ng.h/mL, t1/2: 15±2.5 h. Day 1 and 21 AUC values were comparable. Tumor assessments (modified RECIST criteria) were made at baseline and at the end of alternate cycles (28 days/cycle). Two breast cancer pts had confirmed partial responses (PRs) and 2 had unconfirmed PRs. Conclusions: When HKI-272 was administered on a continuous, once-daily, oral treatment schedule, the MTD was 320 mg/day, with diarrhea as the most frequently occurring related AE. HKI-272 has antitumor activity in HER-2-positive breast cancer. [Table: see text]
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Lynch T. Cases of Meralgia Paraesthetica. IRISH MEDICAL JOURNAL 2006; 99:125. [PMID: 16977713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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79
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Healy DG, Abou-Sleiman PM, Gibson JM, Ross OA, Jain S, Gandhi S, Gosal D, Muqit MMK, Wood NW, Lynch T. PINK1 (PARK6) associated Parkinson disease in Ireland. Neurology 2006; 63:1486-8. [PMID: 15505171 DOI: 10.1212/01.wnl.0000142089.38301.8e] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Mutations in the PINK1 gene have recently been shown to cause autosomal recessive Parkinson disease (PD). The authors assessed the prevalence of PINK1 gene mutations in 290 well-characterized early- and late-onset PD patients from Ireland. In a 51-year-old PD patient with a family history of PD, the authors identified a novel heterozygous mutation (R147H) in exon 2 of the PINK1 gene. Overall, these data indicate that PINK1 mutations are a rare cause of PD in Ireland.
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Abstract
Developments in molecular neuropathology have led to protein-based classification systems for neurodegenerative disorders. Key proteins include alpha-synuclein, amyloid and tau. Alternative mRNA splicing and post-translational change, induced by a bewildering variety of protein modifying processes such as phosphorylation and ubiquitination, have generated insights into new mechanisms of selective neuronal degeneration. The task now is to bring these developments in protein chemistry to the clinic, to try to determine whether this biochemical diversity can help in explaining the phenotypic variability that is so typical of neurodegeneration in general. In this review, we will explore the clinicopathological diversity of the tau-related disorders with specific reference to three of the most common tauopathies, frontotemporal dementia (familial and sporadic), progressive supranuclear palsy and corticobasal degeneration.
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81
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O'Dwyer JP, O'Riordan S, Saunders-Pullman R, Bressman SB, Molloy F, Lynch T, Hutchinson M. Sensory abnormalities in unaffected relatives in familial adult-onset dystonia. Neurology 2005; 65:938-40. [PMID: 16186541 DOI: 10.1212/01.wnl.0000176068.23983.a8] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Somatosensory abnormalities are found in adult-onset primary torsion dystonia (PTD). Therefore we assessed spatial discrimination thresholds (SDT), a measure of spatial acuity, in four multiplex families with adult-onset PTD. In family members aged 20 to 45 years vs controls (mean + 2.5 SD), abnormal SDTs were found in four of five affected with adult-onset PTD and in 12 of 49 unaffected relatives. Sensory abnormalities may be an endophenotype, possibly expressed later as adult-onset PTD.
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82
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Hanna N, Bonomi P, Lynch T, Ansari R, Govindan R, Janne P, Lilenbaum R. O-106 A phase II trial of cetuximab as therapy for recurrent non-small cell lung cancer (NSCLC). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80240-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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83
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Rizvi N, Villalona-Calero M, Lynch T, Yee L, Gabrail N, Sandler A, Cropp G, Graham M, Palmer G. P-565 A Phase II study of KOS-862 (Epothilone D) as second-linetherapy in non-small cell lung cancer. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81058-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sequist L, Janne P, Joshi V, Fidias P, Verlander P, Meyerson M, Haber D, Johnson B, Kucherlapati R, Lynch T. PD-156 The Massachusetts General Hospital/Dana-Farber Cancer Institute/Harvard Medical School Partners HealthCare Center for genetics and genomics experience with clinical testing for somatic EGFR mutations in NSCLC patients. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80489-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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85
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Seguist L, Fidias P, Temel J, Kennedy E, Ostler P, Rabin M, Huberman M, Keck J, Brown G, Lynch T. P-572 Phase I–II trial of TLK286 (telcyta), carboplatin (C), and paclitaxel(P) as first-line treatment for advanced non-small cell lung cancer (NSCLC). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81065-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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86
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Janne P, Sequist L, Lindeman N, Bell D, Huberman M, Meyerson M, Haber D, Lynch T, Johnson B. PD-145 Long-term survival of NSCLC patients with EGFR mutationstreated with EGFR TKIs gefitinib or erlotinib. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80478-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jackman D, Lucca J, Fidias P, Rabin M, Lynch T, Ostler P, Skarin A, Temel J, Johnson B, Janne P. O-188 Phase II study of the EGFR tyrosine kinase inhibitor erlotinib (Tarceva) in patients >70 years of age with previously untreated advanced non-small cell lung carcinoma. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80322-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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88
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Temel J, Pirl W, Cashavelly B, Lynch T. P-846 Fatigue screening in a thoracic oncology clinic. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81339-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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89
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Temel J, Jackson V, Bilings A, Dahlin C, Fidias P, Buss M, Block S, Ostler P, Kornblith A, Lynch T. P-847 Early palliative care (EPC) in patients with advanced non-smallcell lung cancer (NSCLC) is feasible. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81340-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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90
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Yee L, Lynch T, Villalona-Calero M, Rizvi N, Gabrail N, Sandler A, Cropp G, Palmer G. A phase II study of KOS-862 (epothilone D) as second-line therapy in non-small cell lung cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7127] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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91
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Lilenbaum R, Bonomi P, Ansari R, Lynch T, Govindan R, Janne P, Hanna N. A phase II trial of cetuximab as therapy for recurrent non-small cell lung cancer (NSCLC): Final results. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7036] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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92
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Suk R, Park S, Liu G, Cogan-Drew T, Zhou W, Su L, Lynch T, Wain J, Christiani D. Polymorphisms in ERCC2 and overall survival (OS) in early stage non-small cell lung cancer (NSCLC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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93
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Costello DJ, Renganathan R, O'Hare A, Murray B, Lynch T. Audit of an inpatient neurology consultation service in a tertiary referral centre: value of the consulting neurologist. IRISH MEDICAL JOURNAL 2005; 98:134-7. [PMID: 16010778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The Mater Misericordiae Hospital is a 575-bed tertiary referral centre with busy medical and surgical subspecialty services (including the national cardiac, cardiothoracic, spinal cord injury and pulmonary hypertension units). An audit of in-patient referrals to a neurology service was carried out over the twelve-month period of January to December 2002 inclusively. Five hundred and seventy seven inpatients were evaluated and managed in conjunction with the referring services. Consultation by the neurological service led to a significant contribution in the management of clinical cases in one of three ways: establishing a de novo diagnosis in patients admitted with active neurological symptoms where no working diagnosis exists (40.7% of referrals), significant alteration in diagnosis where the referring service have already established a specific working diagnosis (11.1% of referrals), or offering advice in the ongoing management of active neurological symptoms when the diagnosis is historically established and secure (48.2% of referrals). In order of frequency the most common reason for referral was stroke (131 cases (22.7%)), seizures unrelated to alcohol (59 cases (10.2%)), alcohol-related neurological problems (55 cases (9.5%)), movement disorders (41 cases (7.1%)), neuromuscular (40 cases (6.9%)), coma (35 cases (6%)), disorders of cognition (31 cases (5.3%)), acute headache (28 case (4.8%)) and functional neurological syndromes (26 cases (4.5%)). This audit highlights the value of a consulting neurology service in a multidisciplinary tertiary referral setting.
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Cantwell C, Ryan M, O'Connell M, Cunningham P, Brennan D, Costigan D, Lynch T, Eustace S. A comparison of inflammatory myopathies at whole-body turbo STIR MRI. Clin Radiol 2005; 60:261-7. [PMID: 15664582 DOI: 10.1016/j.crad.2004.06.027] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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O'Riordan S, Raymond D, Lynch T, Saunders-Pullman R, Bressman SB, Daly L, Hutchinson M. Age at onset as a factor in determining the phenotype of primary torsion dystonia. Neurology 2004; 63:1423-6. [PMID: 15505159 DOI: 10.1212/01.wnl.0000142035.26034.c2] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The genetic basis of most forms of primary torsion dystonia (PTD) is unknown; multiplex families are uncommon due to low penetrance. Intrafamilial, age-related, phenotypic heterogeneity was noted in 14 PTD families. The authors hypothesized that the clinical presentation of PTD was modulated by the age at onset of the dystonia, irrespective of the genotype. METHODS This hypothesis was addressed in a study of 14 PTD families and a meta-analysis of 83 published series of PTD. RESULTS In 12 families with adult-onset PTD, the index cases presented with cervical dystonia (CD); of the 22 affected relatives, 17 had CD, 2 had writer's cramp, 1 had blepharospasm, and 2 had spasmodic dysphonia. In the two other PTD families, the probands and all 10 symptomatic relatives had limb-onset dystonia at <20 years of age. There were differences between the median ages at onset of the different phenotypes (p = 0.0037). Analysis of 83 published series including 5,057 patients indicated significant differences in the mean age at onset of five phenotypes of PTD (mean age at onset; 95% CI): DYT1 dystonia (11.3 years; 10.3 to 12.2), writer's cramp (38.4; 36.9 to 39.9), CD (40.8; 40.3 to 41.3), spasmodic dysphonia (43.0; 42.2 to 43.9), and blepharospasm-oromandibular dystonia (55.7; 55.1 to 56.4). CONCLUSION Phenotypic variation in PTD presentation is due to the effect of age at onset modulating the expression of a genetic disorder with a caudal-to-rostral change in the site of onset.
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Hutchinson M, Galvin R, Sweeney B, Lynch T, Murphy R, Redmond J. Effect of a multidisciplinary clinic on survival in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2004; 75:1208-9; author reply 1209. [PMID: 15258242 PMCID: PMC1739194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Lynch T. Does the Lateral Chest Radiograph Help Pediatric Emergency Physicians Diagnose Pneumonia? A Randomized Clinical Trial. Acad Emerg Med 2004. [DOI: 10.1197/j.aem.2003.12.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ouellette DW, Everson T, Bruder E, Lynch T, Lim R, Joubert GI. 112 The Additive Value of Nuclear Medicine Shuntograms to Computed Tomography for Suspected Cerebrospinal Fluid Shunt Obstruction in the Pediatric Emergency Department. Paediatr Child Health 2004. [DOI: 10.1093/pch/9.suppl_a.53aa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Baldwin M, Lynch T, Chousal L, Seraydarian R, Doerner R, Luckhardt S. An injector device for producing clean-surface liquid metal samples of Li, Ga and Sn–Li in vacuum. FUSION ENGINEERING AND DESIGN 2004. [DOI: 10.1016/s0920-3796(03)00415-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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100
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Breathnach CS, McHugh J, Lynch T, Breathnach CS. Book Reviews. Ir J Med Sci 2004. [DOI: 10.1007/bf02914530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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