Multifocal

It is used by direct instillation into the bladder for multifocal local bladder carcinoma. Nausea and myelosuppression are the major toxicities of thiotepa. It is not a local vesicant and has been safely injected intramuscularly and even intra-thecally. 

Cidofovir (Fig. 2) has been formally approved for the treatment of CMV retinitis in AIDS patients, where it is administered intravenously at a dose not exceeding 5 mg/kg once weekly during the first two weeks (and every other week thereafter). Cidofovir is also used off label for the treatment of human papilloma virus (HPV) infections (i.e., cutaneous warts, anogenital warts, laryngeal and pharyngeal papilloma), polyomavirus [i.e., progressive (i.e., multifocal leukoencephalopathy (PML)], adenovirus, herpesvirus, and poxvirus (i.e., molluscum contagiosum) infections, where it can be administered intravenously (at a dose of < 5 mg/kg once weekly or every other week) or topically as a 1% gel or cream (De Clercq and Holy 2005). Especially in immunosuppressed patients (i.e., transplant recipients), local treatment of HPV-associated lesions has often yielded spectacular results (Bonatti etal.2007). 

Whereas in children internal organ involvement (systemic mastocytosis, SM) is unusual, MPCM in adults is associated with SM in the majority of cases [10]. WHO criteria for SM consist of the major criterion of multifocal mast cell infiltrates in the bone marrow or other extracutaneous organ(s) and four minor criteria (table 2) [21] 25% or more of mast cells in non-cutaneous biopsy sections with spindle-shaped or abnormal morphology, or... 

Multifocal dense infiltrates of mast cells in bone marrow and/or other extracutaneous organs... 

The clinical presentation of MM in HIV-infected patients is similar to that in other patients with vasculitic neuropathy (Hoke and Comblath 2004). It is characterized by symptoms and signs of sensory involvement, with numbness and tingling in the distribution of one peripheral nerve trunk. Sequential involvement of other noncontiguous peripheral or cranial nerves progresses over days to weeks. The initial multifocal and random neurologic features may evolve to symmetrical neuropathy (Ferrari et al. 2006). 

Fig. 4.1 Hypothetical model of pathogenesis of pain in DSP. (1) Injury of peripheral nerve fibers due to multifocal inflammation and secreted macrophage activation products results in abnormal spontaneous activity of neighboring uninjured nociceptive fibers ( peripheral sensitization ). (2) Furthermore, the aberrant inflammatory response in DRG leads to alterations in neuronal sodium and calcium channel expression and ectopic impulse generation. (3) This results in central remodeling within the dorsal horn due to A-fiber sprouting and synaptic formation with pain fibers in lamina 11, and maintenance of neuropathic pain ( central sensitization ). Reproduced with permission from (Keswani et al. 2002)...

Adelman B, Sandrock A, Panzara MA (2005) Natalizumab and progressive multifocal leukoen-cephalopathy. N Engl J Med 353 432-433... 

Radiation therapy is the treatment of choice for most patients with brain metastases. Most patients receive whole-brain radiation because the majority of brain metastases are multifocal. Another method known as stereotactic radiosurgery provides intense focal radiation, typically using a linear accelerator or gamma knife, in patients who cannot tolerate surgery or have lesions that are surgically inaccessible (e.g., in the brain stem). 

M (granulomatous peribroncholitis multifocal broncholar /alveolar pneumonia in 1 rat each)... 

Granulomatous perbroncholitis (lof4) and multifocal bronchiolar/alveolar pneumonia (1 of 4) were noted in rats orally exposed to 1,000 mg/kg/day MIL-H-5606 for 26 days (Mattie et al. 1993). It is uncertain if these effects were treatment related. 

Parisi, V., M. Tedeschi et al. (2008). Carotenoids and antioxidants in age-related maculopathy Italian study Multifocal electroretinogram modifications after 1 year. Ophthalmology 115(2) 324—333. 

Nielsen, T., Fricke, M., Hellweg, D. and Anderson, P. (2000). High efficiency beam splitter for multifocal multiphoton microscopy. J. Microsc. 201, 368-76. 

Straub, M. and Hell, S. W. (1998). Fluorescence lifetime three-dimensional microscopy with picosecond precision using a multifocal multiphoton microscope. Appl. Phys. Lett. 73, 1769-71. 

Peripheral neuropathies maybe widely disseminated or focal. Patients with disseminated polyneuropathy, whether demyelinative or axonal, usually demonstrate distal sensory and/or motor impairment. Multifocal neuropathy, also referred to as mononeuropathy multiplex, is often a consequence of lesions affecting the vasa nervorum, the blood vessels that supply peripheral nerves. The most common diseases to compromise the vasa nervorum and cause infarction of nerve fascicles are diabetes mellitus and periarteritis nodosa. Other frequent causes of mononeuropathy multiplex include infection (e.g. Lyme disease and leprosy) and multiple compression injury (e.g. bilateral carpal tunnel syndrome). When mononeuropathy... 

Vasculitic mononeuritis multiplex Multifocal motor neuropathy... 

Said, G., Lacroix, C., Lozeron, P., Ropert, A., Plante, V. and Adams, D. Inflammatory vasculopathy in multifocal diabetic neuropathy. Brain 126 376-385, 2003. 

Progressive multifocal leukoencephalopathy (PML) is historically a rare demyelinating disease that is usually associated with disorders of the reticuloendothelial system, neoplasias and immunosuppressive therapy [1, 2]. However, it has become more important in clinical medicine because it is frequently seen as an opportunistic secondary infection in immunocompromised persons with AIDS. PML is characterized by focal lesions that are noninflammatory and caused by infection of oligodendrocytes with the JC papovavirus. 

NRPE N-retinylidene phosphatidylethanolamine PML progressive multifocal leukoencephalopathy... 

Fed 50, 250, or 1250 mg/kg feed for 2 years Nonneoplastic pathological changes diagnosed as multifocal microganulomas in lymph nodes, liver, and spleen of males at all dose levels, and in females at the 250 and 1250 mg/kg diet level 20... 

Automatic atrial tachycardias such as multifocal atrial tachycardia appear to arise from supraventricular foci with enhanced automatic properties. Severe pulmonary disease is the underlying precipitating disorder in 60% to 80% of patients. 

Progressive multifocal leukoencephalopathy Salmonella septicemia, recurrent Toxoplasmosis of brain Wasting syndrome due to HIV... 

---