bluuebunny/crossref_metadata_2025 huggingface dataset:
FURTHER EVALUATION OF LEISURE ITEMS IN THE ATTENTION CONDITION OF FUNCTIONAL ANALYSES
Authors: Roscoe Eileen M. , Carreau Abbey , MacDonald Jackie , Pence Sacha T.
Published: March 2009

Research suggests that including leisure items in the attention condition of a functional analysis may produce engagement that masks sensitivity to attention. In this study, 4 individuals' initial functional analyses indicated that behavior was maintained by nonsocial variables (n = 3) or by attention (n = 1). A preference assessment was used to identify items for subsequent functional analyses. Four conditions were compared, attention with and without leisure items and control with and without leisure items. Following this, either high‐ or low‐preference items were included in the attention condition. Problem behavior was more probable during the attention condition when no leisure items or low‐preference items were included, and lower levels of problem behavior were observed during the attention condition when high‐preference leisure items were included. These findings suggest how preferred items may hinder detection of behavioral function.
USING REAL‐TIME VISUAL FEEDBACK TO IMPROVE POSTURE AT COMPUTER WORKSTATIONS
Authors: Sigurdsson Sigurdur O. , Austin John
Published: March 2009

The purpose of the current study was to examine the effects of a multicomponent intervention that included discrimination training, real‐time visual feedback, and self‐monitoring on postural behavior at a computer workstation in a simulated office environment. Using a nonconcurrent multiple baseline design across 8 participants, the study assessed the effects of the intervention across three postural variables. Following an information phase, the intervention started for the lowest stable postural variable. The intervention led to substantial improvements in safety behavior for most targeted postural variables. A reversal to the information phase for 2 participants did not lead to decreases in safety. Postures self‐monitored with high accuracy improved to a greater degree than postures self‐monitored with low accuracy.
THE EFFECTS OF TACT AND LISTENER TRAINING ON THE EMERGENCE OF BIDIRECTIONAL INTRAVERBAL RELATIONS
Authors: Petursdottir Anna Ingeborg , ÓLafsdóttir Alma Rún , Aradóttir Berglind
Published: March 2009

We evaluated the effects of 2 types of training on the emergence of bidirectional intraverbal relations with 4 typically developing children. Tact training involved reinforcing foreign‐language vocalizations in the presence of visual stimuli, and listener training involved reinforcing selections of visual stimuli following vocal presentations of foreign‐language words. Intraverbal relations were tested by instructing participants to vocalize native‐language equivalents of foreign‐language words or vice versa. Both types of training produced increases in intraverbal responding, but the emergent relations were not always bidirectional.
USING PERFORMANCE FEEDBACK TO IMPROVE TREATMENT INTEGRITY OF CLASSWIDE BEHAVIOR PLANS: AN INVESTIGATION OF OBSERVER REACTIVITY
Authors: Codding Robin S. , Livanis Andrew , Pace Gary M. , Vaca Leslie
Published: March 2009

The current study replicated the positive effects of performance feedback on treatment integrity and extended previous work by examining reactivity using a multiple baseline design with alternating treatments for observer‐present and observer‐absent conditions on teachers' implementation of a classwide behavior plan. No differences were found between conditions, and treatment integrity improved across all teachers, suggesting that performance feedback, rather than observer reactivity, was responsible for reported behavior changes.
A PRELIMINARY ANALYSIS OF INSTRUCTIONAL CONTROL IN THE MAINTENANCE OF APPROPRIATE BEHAVIOR
Authors: Falcomata Terry S. , Northup John A. , Dutt Anuradha , Stricker Jason M. , Vinquist Kelly M. , Engebretson Brenda J.
Published: March 2009

This bridge study evaluated the effects of contingency‐specifying instructions (CSIs) and incomplete instructions (IIs) in terms of establishing instructional control of appropriate behavior. Results suggested that instructional control and maintenance were achieved with CSIs but not with IIs. Results are discussed in terms of the potential use of instructional control in the maintenance of appropriate behavior for children with attention deficit hyperactivity disorder.
AN EVALUATION OF THE HIGH‐PROBABILITY INSTRUCTION SEQUENCE WITH AND WITHOUT PROGRAMMED REINFORCEMENT FOR COMPLIANCE WITH HIGH‐PROBABILITY INSTRUCTIONS
Authors: Zuluaga Carlos A. , Normand Matthew P.
Published: March 2009

We assessed the effects of reinforcement and no reinforcement for compliance to high‐probability (high‐p) instructions on compliance to low‐probability (low‐p) instructions using a reversal design. For both participants, compliance with the low‐p instruction increased only when compliance with high‐p instructions was followed by reinforcement. These results suggest that providing reinforcement for high‐p instructions may result in increased compliance to low‐p instructions.
Total Antioxidant Capacity and Superoxide Dismutase Activity Levels in Serum and Gingival Crevicular Fluid in Pregnant Women With Chronic Periodontitis
Authors: Akalın Ferda Alev , Baltacıoğlu Esra , Alver Ahmet , Karabulut Erdem
Published: March 2009

Background: There is evidence of reduced antioxidant (AO) defense in periodontitis and pregnancy and adverse interactions between periodontitis and pregnancy.

Methods: In this study, serum and gingival crevicular fluid (GCF) total AO capacity (TAOC) and superoxide dismutase (SOD) enzyme concentrations in pregnant patients with chronic periodontitis (CP) were compared to those in non‐pregnant patients. Periodontal examinations were performed and GCF/serum samples were obtained from 33 pregnant patients with CP (PCP), 18 pregnant patients with gingivitis (PG), and 21 periodontally healthy pregnant controls (P‐controls), monitored in the first and third trimesters; 27 non‐pregnant women with CP; and 25 non‐pregnant control women. The concentrations of TAOC (automated measurement method) and SOD (spectrophotometric method) were determined.

Results: Periodontal parameters were higher in pregnant patients versus non‐pregnant patients and in the CP group compared to controls, whereas TAOC and SOD concentrations were lower (P <0.05). All parameters, except plaque index, increased in pregnant subjects in the third trimester compared to the first trimester, whereas TAOC and SOD levels decreased (P <0.05). Periodontal parameters were highest and TAOC and SOD levels were lowest in the PCP group in the third trimester (P <0.05).

Conclusions: Systemic and local GCF AO levels decreased in pregnancy and periodontitis, and AO defense reached the lowest levels in the last phase of pregnancy, whereas periodontal status deteriorated. These results suggest that reduced AO capacity may be associated with adverse periodontitis–pregnancy interactions, and each situation can be a provocative risk factor for the other.
Neutrophil Formylpeptide Receptor Single Nucleotide Polymorphism 348T>C in Aggressive Periodontitis
Authors: Maney Pooja , Emecen Pinar , Mills John S. , Walters John D.
Published: March 2009

Background: Neutrophil formylpeptide receptors (FPRs) play an important role in bacterial recognition and chemotaxis. Defective FPR1 expression and impaired polymorphonuclear leukocyte chemotaxis toward bacterial formylpeptides are associated with aggressive periodontitis (AgP). The objective of this study was to determine whether single nucleotide polymorphisms (SNPs) in FPR1 are associated with AgP.

Methods: Genomic DNA was isolated from blood samples obtained from African Americans (30 subjects with AgP and 33 healthy controls) and Turks (75 subjects with AgP and 63 healthy controls). A highly polymorphic fragment of the FPR1 gene was amplified by polymerase chain reaction and sequenced for analysis of SNPs.

Results: Five previously identified SNPs were detected in African Americans, whereas six were detected in Turkish subjects. The frequency of synonymous SNP c.348T>C was significantly higher in African Americans with AgP than in controls (P = 0.029). The 348T allele was significantly associated with AgP (P = 0.010). Seven of the subjects with AgP, but none of the controls, were homozygous for 348T. FPR1 haplotypes 348T.568A, 348T.576T, and 348T.568A.576T were significantly increased in African Americans with AgP (P <0.02). The Turkish population did not exhibit significant differences in FPR1 SNP frequencies between subjects with AgP and controls.

Conclusions: FPR1 SNP c.348T>C is associated with AgP in African Americans. Individuals who are homozygous for 348T may have an increased risk for developing this disorder.
Ability of Supragingival Plaque to Induce Toll‐Like Receptor 4–Mediated Stimulation Is Associated With Cytokine Production by Peripheral Blood Mononuclear Cells
Authors: Yamaguchi Ryusuke , Yoshimura Atsutoshi , Yoshioka Hidenobu , Kaneko Takashi , Hara Yoshitaka
Published: March 2009

Background: In our previous study, we found that the ability of supragingival plaque to induce Toll‐like receptor (TLR)4‐mediated stimulation was positively associated with plaque score and bleeding on probing (BOP) at the sampled sites and that the ability to induce TLR2‐mediated stimulation was negatively associated with probing depth (PD) and clinical attachment level (CAL). Because signaling from TLR leads to the induction of pro‐ and anti‐inflammatory cytokines, we further analyzed the influence of the ability of supragingival plaque to induce TLR2‐/TLR4‐mediated stimulation of cytokine production by peripheral blood mononuclear cells (PBMCs).

Methods: The abilities of 125 plaque samples to induce TLR2‐ or TLR4‐mediated stimulation were determined using genetically engineered Chinese hamster ovary reporter cells that express a reporter molecule upon activation of nuclear factor‐kappa B through TLR2 or TLR4. PBMCs were stimulated with each plaque sample, and the production of proinflammatory cytokines (tumor necrosis factor‐alpha and interleukin [IL]‐6 and −8) and an anti‐inflammatory cytokine (IL‐10) was analyzed by enzyme‐linked immunosorbent assay.

Results: The levels of the cytokines produced by PBMCs all correlated with the ability of supragingival plaque to induce TLR4‐mediated stimulation but not with its ability to induce TLR2‐mediated stimulation. Cytokine production was inhibited by an anti‐TLR4 monoclonal antibody and a TLR4 antagonist, compound 406. The levels of cytokines were associated with plaque index, BOP, PD, and CAL at the sampled sites.

Conclusions: The production of pro‐/anti‐inflammatory cytokines by PBMCs was associated with the ability of supragingival plaque to induce TLR4‐mediated stimulation. The cytokines induced by supragingival plaque via TLR4 might modulate periodontal status.
Immediate Occlusal Loading of Immediately Placed Implants Supporting Fixed Restorations in Completely Edentulous Arches: A 1‐Year Prospective Pilot Study
Authors: Pieri Francesco , Aldini Nicolò Nicoli , Fini Milena , Corinaldesi Giuseppe
Published: March 2009

Background: The aims of this pilot study were to evaluate the efficacy of treatment consisting of the immediate loading of implants placed immediately after tooth extraction in full‐arch restorations and to compare the clinical and radiographic outcomes of implants placed in healed versus postextraction sites in the same group of patients.

Methods: Twenty‐three patients who needed full‐arch restorations were treated. One hundred forty‐four implants were placed: 59 after tooth extraction (test group) and 85 in healed sites (control group). Within 48 to 72 hours of implant placement, nine maxillary and 15 mandibular arches received screw‐retained fixed prostheses, consisting of a titanium framework fabricated with a computer‐aided design and manufacturing techniques and composite resin teeth. The insertion torque for implants was ≥30 Ncm. Implant stability measurements (ISQ) and radiographs of the marginal bone level (MBL) change were performed at prosthesis delivery and after 1 year.

Results: One implant in the test group and one implant in the control group failed, giving a cumulative success rate of 98.6%; the prosthesis survival rate was 100%. At the 1‐year follow‐up, no statistically significant difference was found between the control and test sites with respect to MBL change (0.47 ± 0.18 mm versus 0.57 ± 0.27 mm) or mean ISQ values (62.24 ± 1.92 versus 61.34 ± 2.15).

Conclusion: These preliminary data suggest that immediate loading of implants placed immediately after extraction may be a viable treatment option for edentulous arches when implants are stable at insertion and are rigidly splinted with screw‐retained titanium‐resin prostheses.
The Use of Cancellous Block Allograft for Sinus Floor Augmentation With Simultaneous Implant Placement in the Posterior Atrophic Maxilla
Authors: Chaushu Gavriel , Mardinger Ofer , Calderon Shlomo , Moses Ofer , Nissan Joseph
Published: March 2009

Background: The simultaneous placement of dental implants during sinus augmentation is advocated in cases in which ≥4 to 5 mm of alveolar bone exists coronally to the sinus floor. The aim of the present study was to assess the survival rate of dental implants placed during sinus augmentation and stabilized by the use of cancellous freeze‐dried block allograft. Residual alveolar ridge height ≤4 mm was an inclusion criteria.

Methods: Twenty‐eight consecutive patients (13 females and 15 males) aged between 25 and 65 years (mean, 54 ± 9 years) were referred for implant‐supported reconstruction of the posterior atrophic maxillae. Seventy‐two implants (two to four per patient) were placed. No case presented difficulty in achieving initial stabilization. Relatively small membrane tears (5 to 10 mm) were observed in 21.4% of the sinuses. There were no other clinically evident complications of the sinuses. Sixty‐eight implants were clinically osseointegrated, yielding a 94.4% success rate, whereas four implants were noted to be failed at the second stage. Three months later, implants were inserted at the previously failed implant sites; after 3 additional months, at the second stage, they were diagnosed as osseointegrated. All patients received a fixed implant‐supported prosthesis.

Results: The mean follow‐up was 27 months (range, 11 to 46 months). Radiographs taken at the last follow‐up demonstrated that the vertical augmented bone within the sinus ranged from 11 to 14 mm (mean, 12.3 mm). The histologic evaluation showed newly formed bone containing viable osteocytes merged with residual grafted bone, characterized by empty lacunae devoid of osteocytes.

Conclusion: The cancellous block allograft seems to possess potential as a grafting material for sinus floor augmentation with simultaneous implant placement.
Osteocyte Density in the Peri‐Implant Bone of Immediately Loaded and Submerged Dental Implants
Authors: Barros Raquel R.M. , Degidi Marco , Novaes Arthur B. , Piattelli Adriano , Shibli Jamil A. , Iezzi Giovanna
Published: March 2009

Background: The role of osteocytes in bone structure and function remains partially unresolved. Their participation in mechanotransduction, i.e., the conversion of a physical stimulus into a cellular response, has been hypothesized. The present study was an evaluation of the osteocyte density in the peri‐implant bone of immediately loaded and submerged dental implants.

Methods: Fourteen male patients were included in the study; all of them were partially edentulous and needed a posterior mandibular restoration. Implants were inserted in these areas; half of the sample was loaded immediately (included in a fixed provisional prosthesis on the same day as implant surgery), whereas the other half was left to heal submerged. Fourteen implants (seven immediately loaded and seven unloaded) were retrieved with a trephine after a healing period of 8 weeks. The specimens were treated to obtain thin ground sections, and histomorphometry was used to evaluate the osteocyte index in the peri‐implant bone.

Results: A higher and statistically significant number of osteocytes was found in the peri‐implant bone around immediately loaded implants (P = 0.0081). A correlation between the percentage of bone–implant contact and osteocyte density was found for immediately loaded implants (P = 0.0480) but not for submerged implants (P = 0.2667).

Conclusion: The higher number of osteocytes in the peri‐implant bone around immediately loaded implants could be related to the functional adaptation required by the loading stimulus, which also explains the hypothesized involvement of the osteocytes in the maintenance of the bone matrix.
Multifocal Melanoacanthoma of the Gingiva and Hard Palate
Authors: Brooks John K. , Sindler Arnold J. , Papadimitriou John C. , Francis Laurie A.P. , Scheper Mark A.
Published: March 2009

Background: Gingival melanoacanthoma is an uncommon reactive lesion, typically appearing as a solitary pigmented macule. This article reports a previously undescribed case of multifocal melanoacanthoma affecting the maxillary and mandibular gingiva and the hard palate. A literature review of melanoacanthoma of the gingiva is also provided.

Methods: An otherwise healthy 60‐year‐old white female sought care for a periodic dental prophylaxis. The intraoral examination was remarkable for numerous painless, brown macular lesions in all four gingival quadrants and on the hard palate (eight on the gingiva and six on the palate). The lesions ranged in size from 2 to 4 mm. The patient had only been aware of one of these lesions, estimating its existence to be <1‐year duration. The unusual and widespread presentation of these lesions warranted biopsy.

Results: On microscopy, all surgical specimens revealed an acanthotic population of epithelium, with dendritic melanocytes distributed throughout, and numerous melanophages contained in the connective tissue. The dendritic melanocytes were immunoreactive for HMB‐45 and S‐100. Ultrastructural studies confirmed the presence of keratinocytes and dendritic melanocytes containing melanosomes. A 5.5‐month follow‐up recall disclosed six new pigmented lesions (four on the gingiva and two on the hard palate), clinically identical to the previously discerned melanoacanthomas. There has been no recurrence of any of the biopsied lesions.

Conclusions: Gingival melanoacanthomas may present as a solitary lesion or involve multiple sites. Pigmented gingival lesions of recent origin and without etiologic factors should undergo histopathologic review. A conservative biopsy for gingival melanoacanthoma may be sufficient for lesion identity and definitive treatment.
Amoxicillin and Metronidazole as an Adjunct to Full‐Mouth Scaling and Root Planing of Chronic Periodontitis
Authors: Cionca Norbert , Giannopoulou Catherine , Ugolotti Giovanni , Mombelli Andrea
Published: March 2009

Background: It has been suggested that scaling and root planing of all pockets within a few hours and chlorhexidine treatments (full‐mouth disinfection) may reduce the need for supplementary therapies. The aim of this study was to evaluate the clinical benefit of amoxicillin and metronidazole administered immediately after completion of full‐mouth periodontal debridement in patients with chronic periodontitis.

Methods: This was a single‐center, double‐masked, placebo‐controlled, randomized longitudinal study of 6 months' duration. Fifty‐one patients received full‐mouth periodontal debridement, performed within 48 hours. Twenty‐five subjects received metronidazole, 500 mg, and amoxicillin, 375 mg, three times a day for 7 days; 26 subjects received a placebo.

Results: Forty‐seven patients could be followed up to month 6. No differences in clinical parameters were noted before treatment. The overall mean probing depth decreased from 4.3 ± 0.4 mm to 3.0 ± 0.2 mm in the test group and from 4.4 ± 0.4 mm to 3.1 ± 0.3 mm in the control group (P = 0.05, difference between groups). More importantly, test subjects had a significantly lower mean number of persisting pockets >4 mm and bleeding on probing that required further treatment (P = 0.005): 6 months after full‐mouth debridement plus antibiotics, only 0.4 ± 0.8 persisting pockets were still present, whereas 3.0 ± 4.3 persisting pockets were still present in the control group. The protective risk of the antibiotics for having more than one pocket deeper than 4 mm and bleeding on probing per subject after 6 months was 8.85.

Conclusion: Systemic metronidazole and amoxicillin significantly improved the 6‐month clinical outcomes of full‐mouth non‐surgical periodontal debridement, thus significantly reducing the need for additional therapy.
The importance of antibody dependent cell-mediated cytotoxicity (ADCC) for breast cancer response to trastuzumab - Herceptin
Authors: Juranic Zorica , Stanojevic-Bakic Nevenka , Neskovic-Konstantinovic Zora , Zizak Zeljko , Stanojkovic Tatjana , Radulovic Sinisa , Milosevic Dusanka
Published: March 2009

In this work we investigated the direct or indirect (through ADCC) cytotoxic action of Herceptin, to two breast carcinoma cell lines: to MDA-MB 361, for HER-2, IHC score (3+) and to MDA-MB 453, IHC score (<2+). Cytotoxic action of Herceptin, of PBMC and of their combination (ADCC) was determined 48h later, indirectly, through the determination of target cell survival by MTT test. Preliminary results indicate that direct cytotoxicity of Herceptin against investigated breast carcinoma cells was very low, probably due to their high duplication time. However, the cytotoxic action of PBMC mediated through Herceptin as ADCC, was noted in investigation of cytotoxicity of some persons' PBMC.
The importance of simultaneous determination of breast cancer biomarkers
Authors: Markicevic Milan , Todorovic-Rakovic Natasa , Kanjer Ksenija , Nikolic-Vukosavljevic Dragica
Published: March 2009

It is shown that steroid hormone receptors by themselves are not sufficiently strong prognostic factors in management of breast cancer. For that reason, simultaneous consideration of different biomarkers seems to be more appropriate for clinical use, i.e. selections of patients with high/inter-mediate/low risk of disease outcome. However, the amount of tumor material available from breast carcinoma can preclude determination of estrogen- regulated biomarkers together with estrogen receptor and progesterone receptor. The aim of this study was to assess the possibility of estrogen receptor and progesterone receptor determination by a single-point instead of five-point biochemical method. Our results demonstrated that the correlation between measurements of estrogen and progesterone receptor contents obtained by the five-point and single-point assay in the total population was very high. Consequently, we could use the single-point assay instead of five-point assay for estrogen receptor and progesterone receptor determination, thus making possible determination of other molecular biomarkers from the same breast carcinoma.
Significance of histopathological and molecular genetics investigations on the diagnosis and prognosis of astrocytic and oligodendroglial glioma
Authors: Cvetkovic-Dozic Dubravka , Dozic Slobodan , Skender-Gazibara Milica
Published: March 2009

Histopathological evaluation should remain the chief support of brain tumor classification. Nevertheless, molecular genetic studies can play an important part in standardizing tumor categorization and resolving difficult diagnostic problems. These studies can be used to subdivide GBM into biologically distinct subsets and are currently being used to predict therapeutic response and survival in patients with anaplastic oligodendroglioma.
Value of the proliferative and hormonal markers in estimation of biological behaviour of meningioma
Authors: Skender-Gazibara Milica , Cvetkovic-Dozic Dubravka , Dozic Slobodan , Govedarovic Vitomir
Published: March 2009

(Conclusion) Although the proliferative markers and hormonal (progesterone) receptor status of meningiomas seem to provide useful, convenient, and predictive criterions for the subsequent evolution of the tumor, they should be used only in combination with other established histopatological features of tumor malignancy (cellular density, nuclear pleomorphism, nucleolar prominence, mitosis and necrosis - especially multifocal micronecrosis). A simple, reproducible clear set of criteria for the tendency of a meningioma to recur is yet to be determined. In the last few years there are some new data concerning genetic characterization of meningiomas (9) and some cellular proteins (p53, p21, p27) (10) in meningioma cells which may be valuable in precisely discriminating atypical meningiomas from benign or anaplastic meningiomas, at least in histologically borderline cases.
Fluid-attenuated inversion-recovery MR sequence in the evaluation of low-grade astrocytomas
Authors: Stosic-Opincal Tatjana , Peric Vesna , Gavrilov Mihail , Gavrilovic Svetlana
Published: March 2009

(Conclusion) Flair was found to be better for detection of the lesion and for definition of its margins in comparison with T2W se and PD sequences (6). Comparing with surrounding white matter, tumors on FLAIR images are isointense or hyperintense. Because of the suppression of CSF signal, contrast between FLAIR is currently used for supplementing basic MRI protocols. FLAIR technique may be used as an adjunct to T2W or PD SE imaging and may even replace PD imaging. FLAIR is superior for appreciation of the lesion and for demonstration of its margin. However, peritumoral edema is clearly demonstrated, and the FLAIR images often delineate edema from tumor, and distinguish CSF from a cystic or necrotic component, better than T2W and PD images. In cases when tumor has a cystic or necrotic component, the signal intensities of such areas are different from that of CSF on FLAIR images. FLAIR demonstrates better local spread of the tumor than T2W and PD images.
Contemporary management of low grade intracerebral gliomas
Authors: Grujicic Danica , Jeremic Branislav , Samardzic Miroslav
Published: March 2009

(Conclusion) Total or subtotal surgical resection is the therapy of choice for most intracerebral LGgls. It should be performed whenever possible. After postoperative MRI and PET, it should be decided about immediate postoperativne radiotherapy. If there are the signs of the tumor rest, radiotherapy is essential. Patients in poor clinical grade, or deep seated tumors should undergo stereotactic biopsy followed by stereotactic radiosurgery, or conventional radiation therapy. In recurrent diseases any kind of surgery should be followed by radiation therapy, or/and chemotherapy for chemosensitive oligodendrogliomas. Accurate histopathological diagnosis is essential for treatment choice and prognosis.
The role of radiotherapy in combined treatment for locally advanced breast cancer with ipsilateral supraclavicular metastases
Authors: Mladenovic Jasmina , Zoranovic Slavica , Sasic Jelena , Dozic Marko , Inic Ivana , Neskovic-Konstantinovic Zora , Borojevic Nenad
Published: March 2009

Background: Locally advanced breast cancer (LABC) includes a heterogeneous group of breast neoplasms classified from stage IIB, IIIA to IIIB. LABC with ipsilateral supraclavicular adenopathy without evidence of distant disease is included in the stage IV (but regional stage IV). Purpose of this study was to assess the role of radiotherapy (RT) in combined treatment with systemic therapy (chemotherapy and hormonotherapy) in LABC with ipsilateral supraclavicular adenopathy. Methods: In 5-year period 45 patients with LABC and ipsilateral supraclavicular metastases were treated with radiotherapy and chemo- or hormonotherapy depending on the physical condition, age and steroid receptors (ER, PGR) content. Twenty patients received TD 30 Gy in 10 fractions on breast and regional lymph nodes and 25 patients received TD 51 Gy in 15 fractions on the breast and TD 45 Gy in 15 fractions on regional lymph nodes. Twenty-three patients received chemotherapy (CMF or FAC), 10 received hormonotherapy, and 12 received both chemo- and hormonotherapy. Results: After finishing complete treatment the overall response rate was 93.3%. Complete response was 20% and partial response was 73.3%. Locoregional relapse occurred in 5 patients and distant metastases occurred in 10 patients. Conclusion: Treatment of LABC with ipsilateral supraclavicular lymph node involvement should be aggressive, what means combined radiotherapy and systemic chemo-hormonotherapy. Such treatment provides for these patients maximum chance of long-term disease - free and overall survival.
Locally advanced breast cancer in younger women
Authors: Lakicevic Jadranka , Lakic Dinka , Sorat Milan
Published: March 2009

Background: Standard treatment of locally advanced breast cancer is not yet established. In most institutions treatment is multimodal and consists of primary chemotherapy, surgical treatment with or without radiotherapy (RT) and hormonal therapy. To find out whether the age influences the kind of surgical treatment in a group of locally advanced breast cancer patients (LABC patients) responding to neo-adjuvant chemotherapy. Methods: Analysis included 39 LABC patients treated from January 2000 till January 2003 with neo-adjuvant chemotherapy and surgical treatment in Clinical Center of Montenegro, Podgorica. All patients had locally advanced disease (T2, T3 or T4b and/or N1-2 M1 sc). Patients with T4d tumors were excluded. The treatment consisted of neo-adjuvant chemotherapy, mostly anthracycline based, and surgical treatment - radical mastectomy or breast conserving surgery. Additional procedures after surgical treatment included 3-4 cycles of the same chemotherapy, hormonal treatment and/or RT. Results: Median age of patients was 47 years (range: 24-67 years). Thirty patients were initially in stage IIIA (14 post- and 16 premenopausal patients respectively), 6 patients in stage IIIB (2 post- and 4 premenopausal respectively), and 3 patients in stage IV, with supraclavicular node involvement (M1+sc, 2 post- and 1 premenopausal, respectively). Applied preoperative chemotherapy was anthracycline-based regimen (FAC, 3-6 cycles) except in one patient in premenopausal group and 2 patients in postmenopausal group, who had been treated with CMF chemotherapy due to anthracycline contraindications. All analyzed patients responded to neo-adjuvant chemotherapy, mostly with partial or minimal remission of their tumors. In a whole group 15/39 (38%) patients had breast conserving surgery (8 pre-, 7 postmenopausal, respectively), 24/39 (61%) patients radical mastectomy (13 pre-, 11 postmenopausal, respectively). In a group of patients old 40 years and younger only 2 partial resections were performed (2/9, 22%), and 7 radical mastectomies. Conclusion: Although in a small group of patients, our results confirmed that effective neo-adjuvant chemotherapy enabled breast surgery of LABC, even breast conservative procedure in some patients. However, breast conservation was not possible in majority of young patients. This suggests the investigation of more aggressive neo-adjuvant treatments, especially in patients old 40 years or younger.
Cu/Zn superoxide dismutase in blood cells of patients with locally advanced breast cancer
Authors: Niciforovic Ana , Filipovic Dragana , Neskovic-Konstantinovic Zora , Radojcic Marija
Published: March 2009

Background: The clinical treatment of breast cancer frequently includes highly cytotoxic agents such as, radiation or cytostatic drugs, aiming to inhibit tumor cell proliferation and/or induce tumor cell death. The cytotoxic effects of those agents are partly achieved by the increase in concentration of oxygen free radicals (ROS), which cause massive oxidative damage of tissue DNA, proteins and lipids above the limits of cell repair capacity. Radiotherapy is of great value in the treatment of a number of malignant tumors, but its potential utilization and efficacy is limited by the necessity of avoiding the excessive late damage to normal tissues. The incidence of radiogenic damage to soft tissue has been reported as being up to 40%. To protect against toxic effects of ROS, and to modulate its physiological effects, cells have evolved the antioxidant defense system. Superoxide dismutase is an enzyme that plays an important role in biological defense against activated oxygen and/or free radicals. SOD is highly efficient in scavenging superoxide (O 2*-) radical by catalyzing the dismutation of super-oxide radicals into hydrogen peroxide (H 2 O 2) and molecular oxygen (O 2). The aim of this study was to test Cu/Zn SOD as potential biomarker of individual sensitivity to cytotoxic treatment. Methods: The intracellular Cu/Zn SOD concentration was determined in peripheral blood of patients with locally advanced breast cancer prior to any clinical treatment. The assay was performed in two groups of patients with locally advanced breast cancer, the age group 30-45 (normal cycle, n=7 stage II or III), and 45-60 (perimenopausal women, n=12, stage III or IV). The respective healthy women: age group 30-45 (n=12) and age group 45-60 (n=12) were used as controls. The concentration of Cu/Zn SOD was also assayed after in vitro radiation challenge. Results: The results showed that the intracellular Cu/Zn SOD concentration in 30-45 age and 45-60 age control groups, were cca. 12.89?0.87 arbitrary mass units/ml (AmU/ml), and cca. 10.46?0.72 AmU/ml of blood, respectively. In the two groups of patients with locally advanced breast cancer, Cu/Zn SOD concentrations were cca. 18.90?1.54 AmU/ml, and cca. 22.48?1.40 AmU/ml of blood. Thus the intracellular Cu/Zn SOD concentration did not vary significantly within the control groups or within the patient groups. However, the Cu/Zn SOD concentration was significantly different between patient groups and the respective controls. The in vitro 2Gy and 9Gy 60 Co g-radiation challenge of blood cells did not lead to significant changes in Cu/Zn SOD concentrations within the age groups of either control or patients. Conclusion: It is concluded that the Cu/Zn SOD concentration is not a relevant biomarker for prediction of radiotherapy induced changes in healthy tissue antioxidative defense. However, the enzyme concentration in blood cells correlated well with the presence of locally advanced breast cancer.
Can thyroidectomy be performed in secondary thyroid cancer?
Authors: Diklic Aleksandar , Zivaljevic Vladan , Paunovic Ivan , Krgovic Ksenija , Tatic Svetislav , Bozic Vesna
Published: March 2009

Background: Secondary thyroid cancer is much less frequent than primary and in the majority of cases represents disseminated disease where operation on thyroid is useless or thyroid tumor is not operable, infiltrating surrounding structures. Methods: Five case reports of patients operated for secondary thyroid cancer. Results: Case 1: In male patient aged 64 years thyroidectomy was done for thyroid solid tumor 5 years after lung lobectomy for bronchogenic planocellular cancer. FNB suspected nonthyroid cancer histological analysis revealed planocellular cancer (Grimelius staining excluded medullar cancer) and multinodular goiter. Case 2: In female patient aged 65 years, thyroidectomy was done 4 years after left mastectomy with the history of long standing multinodular toxic goiter. Infiltrate remained in trachea and esophagus, histology revealed breast cancer metastasis in thyroid, confirmed with special mucin I, and estrogen receptor staining with negative thyroglobulin staining. Case 3: In female patient aged 76 years thyroidectomy was performed for metastatic lucidocellular kidney cancer in recurrent goiter (with Vimentin staining), a year after nephrectomy and 50 years after first goiter operation. Case 4: In female patient aged 58 years thyroidectomy was performed for planocellular infiltration of esophagus into the left thyroid lobe. Case 5: In female patient aged 77 years thyroidectomy was done for hemorrhage into thyrotoxic goiter, histology revealed metastasis of planocellular cancer of unknown origin into thyroid. Case 6: In male patient aged 54 years, thyroidectomy was done for thyroid metastatic lucidocellular cancer of kidney, 2 years after nephrectomy. Conclusion: Although prognosis of secondary thyroid cancer is poor, in rare cases aggressive surgery with adjuvant therapy may be successful.
Glutathione S-transferase T1 and M1 polymorphisms and risk of thyroid neoplasms
Authors: Stankov Karmen , Landi Stefano , Volante Marco , Papotti Mauro
Published: March 2009

Background: In order to test the possibility of association between GSTT1 and M1 (glutathione S-transferase) null allele variant, in which the entire gene is absent, and the risk of TCO (thyroid carcinoma with cell oxyphilia), the case-control study was carried out. Methods: Genotypes for GSTT1 and GSTM1 were determined by multiplex PCR in the DNA from 108 healthy individuals and in DNA from samples of thyroid tumors from 130 patients of the same race and origin as the control group (Caucasian, Italian). The following types of NMTC were analyzed: oxyphilic adenoma (OA), oxyphilic carcinoma (OC) papillary thyroid carcinoma with oxyphilic features (PTCof), follicular adenoma (FA), follicular carcinoma (FC), follicular variant of PTC (fvPTC) and classical PTC. Associations between prevalence of particular genotypes and the occurrence of TCO (versus controls) and other subtypes of NMTC were tested. Associations were quantified by calculating OR (odds ratio) with 95% confidence interval. StatGraphics Plus v. 5 software (Manugistics) was used for statistical analysis. Results: In this study of the association between the GSTT1 and M1 null genotype and the increased risk of TCO, the frequency of GSTT1 null genotype of 19.2% in cases and 15.7% in controls was found with an adjusted odds ratio (OR) of 1.4 (95% confidence interval (CI) 0.70-2.81), and the frequency of GSTM1 null genotype of 59% in cases with oxyphilic tumors and of 55.6% in controls (OR 1.24; 95% CI, 0.62-2.48). Conclusion: These results indicate that the GSTT1 and M1 null genotypes do not increase the risk of development of oxyphilic tumors, as well as other types of NMTC that have been included in this study.
Differentiated thyroid carcinomas and regional metastases
Authors: Stefanovic Ljubomir , Kermeci Katarina , Malesevic Milica , Mihailovic Jasna , Popadic Silvija , Srbovan Dolores
Published: March 2009

Background: Aim of the study was to determine the frequency of regional nodal metastases (N1) of differentiated thyroid carcinomas (DTC), to analyze the modes of treatment, course of disease, and outcome. Methods: In Department of Nuclear Medicine in Sremska Kamenica, 363 DTC patients were treated from 1977 to the end of 2000. Nodal metastases had 182 patients most of them were followed to the end of 2000. Methods: All patients with N1 were treated surgically (operation of thyroid gland was done in all patients, surgical treatment of lymph nodes in 80.2% of them), afterwards by radioiodine and long-life by hormonal therapy; external beam therapy was applied in 9.9% of patients, chemotherapy in 1.6% of patients. The range of follow-up was from 2 months to 24.2 years, the mean 4.7 years. Results Nodal metastases were detected first, before primary tumor, in 21.9% patients, and simultaneously in 63.2% patients. They appeared subsequently after detection and initial treatment of primary tumor in 14.8% patients the incomplete initial therapy in this subgroup of patients was more frequent than complete therapy (p<0.01). Regional metastases N1b were present more frequently than N1a (p<0.001). Distant metastases (M1) in N1 group were discovered in 27.5% of patients; they were more frequent than in N0 group of patients (p<0.001). Nodal metastases were found more frequently in the group of papillary than in the group of follicular carcinoma (p<0.001), and in the men than in the women with DTC (p<0.001). Remission was achieved in 67.7% of patients with N1. Disease related deaths occurred in 15.8% of patients with N1; M1 was cause of deaths in 10.2% of patients locoregional disease (T4 and/or N1) in 5.9% of patients, and M1+extended T4 and/or N1 in 0.7% of patients. Late complications of treatment caused the death in 2.1% of patients with N1. The relapses of disease occurred in 31.9% of patients. The survival probability after onset of the nodal disease in N1M0 subgroup was 0.88+/-0.05 after 10 years, and 0.64+/-0.16 after 20 years; the probability of survival was very significantly shorter when M1 were present (p<0.001). Conclusion: Regional metastases were detected in the half of DTC patients. The detection of N1 was the first indicator of thyroid tumor in about 20% of them. Nodal metastases grew later on after detection and initial treatment of primary tumor in about 15% of patients, mostly as a result of inadequate treatment. The frequency of N1 was greater in patients with papillary type of tumor and in males. The presence of M1 had significant influence on survival of patients with N1.
Galectin-3: A promising marker of thyroid malignancy
Authors: Cvejic Dubravka , Savin-Zegarac Svetlana , Paunovic Ivan , Tatic Svetislav , Havelka Marija
Published: March 2009

Background: Galectin-3 is an endogenous beta-galactoside binding lectin implicated in neoplastic transformation and tumor progression. High levels of this lectin have recently been found in malignant thyroid tumors, but not in normal or benign thyroid tissue, suggesting galectin-3 as a promising presurgical marker of thyroid malignancy. Methods: We analyzed immunohistochemically galectin-3 expression in thyroid tissue using a monoclonal antibody. The total of 108 tissue specimens included 55 cases of thyroid carcinoma (30 papillary, 15 follicular, and 10 anaplastic type), 15 samples of follicular adenoma, 15 samples of normal thyroid tissue, and 23 thyroid tissue specimens from human fetuses (16 to 37 weeks of intrauterine life). Results: The results showed galectin-3 expression in 20/30 papillary carcinomas, 11/15 follicular carcinomas, 10/10 anaplastic carcinomas, and 4/15 follicular adenomas. Thyroid follicular cells in normal adult and fetal tissue were negative. Conclusions: These results further confirm that galectin-3 expression is a feature of malignant thyroid cells, and that immunohistochemical detection of galectin-3 could be useful in thyroid carcinoma diagnostics. The absence of galectin-3 in thyroid cells during fetal development suggests that galectin-3 is expressed de novo during malignant transformation of thyroid epithelium, thus it should not be considered an oncofetal antigen.
Locally advanced cervical cancer: Preliminary results of the prospective randomized study
Authors: Stankovic Vesna , Marjanov Ivanka , Cikaric Slobodan , Grzetic Ljubomir , Colakovic Slobodanka , Rakovic Brankica
Published: March 2009

Background: The aim of this study is to show preliminary results of the randomized study that has been conducted among patients with advanced cervical cancer managed by loco-regional radiotherapy alone or combined treatment (radiotherapy with chemotherapy as radiosensitiser). Methods: From the beginning of 2002 till today 182 patients with locally advanced cervical cancer have been enrolled in the study (FIGO IIb-IVa). They have been treated by combined external beam irradiation (46Gy/22fr) and HDR brachyterapy (5x7Gy/A). Eighty-nine of them underwent the same radiotherapy regime with concomitant chemotherapy cisplatin (CDDP) 40mg per week). Median age for both groups were 52 years. Pathological examination showed: Squamous cell carcinoma in most cases 175, adeno Ca 6 and others 1. Effect of the therapy and early irradiation complications have been estimated by the tumor regression and toxicity grade. Results: Tumor regression have been occurred as complete response in 10.1% for RT group and for RT-HT group in 16.86%. Partial regression was for RT group 86% and for RT-HT group 87%. Early complications (haematological, urological and intestinal) in RT group were noted in 34% and in RT-HT group in 43% of patients. Conclusion: There was no benefit of RT-HT comparing to RT alone in the tumor regression of locally advanced cervical cancer. Early complications of combined therapy are more experienced than in RT group.
Treatment of metastatic breast cancer with anastrozole in patients previously treated with aminoglutethimide - case report
Authors: Boskov Nedeljka
Published: March 2009

Anastrozole represents new, strong and selective nonsteroid aromatase inhibitor. The purpose of this report was to show the effect of anastrozole in two patients with breast cancer who were previously treated with aminoglutethimide. A female patient aged 55 years (menopausal, unknown status of steroid receptors) has been living 246 months with breast cancer (63 months with metastatic disease), and treated with tamoxifen aminoglutethmide, and anastrozole. Therapeutic effect lasting 45 months was achieved with aromatase inhibitors. Female patient aged 56 years (menopausal, unknown status of steroid receptors) has been living 163 months with breast cancer (130 months with metastatic disease). There were 124 months response to hormonotherapy - tamoxifen (66 months), aminoglutethimide (54 months), and anastrozole (4 months). Therapeutic effect lasting 45 months was achieved with aromatase inhibitors. Anastrozole was selected in both patients because of metastatic involvement of the pleura with bilateral effusion. No disease progression was maintained for 4 and 5 months with no toxic effects and with good quality of life. Anastrozole has a marked role as a secondary hormone therapy medication in breast cancer, in the treatment of receptor positive patients in menopause.
Pancreatic carcinoma: The contribution of CA 19-9 to the enhancement of diagnostic precision of imaging techniques
Authors: Trifunovic Jasna , Muzikravic Ljubomir , Prvulovic Mladen , Salma Svetlana , Nikolin Borislava , Kukic Biljana
Published: March 2009

Background: Ultrasonography (US) and magnetic resonance (MR) are the most important imaging techniques in the diagnostics of pancreatic carcinoma and disease staging; they are also very useful in monitoring and follow-up of treatment efficacy. The problems with imaging diagnostics arise in certain cases of pancreatic focal lesions - for example in the differentiation of focal chronic pancreatitis and pancreatic carcinoma. Our objectives were the evaluation of US and MR reliability and determination of the importance of oncomarker CA 19-9 in the diagnostics of pancreatic carcinoma. Methods: Our investigation included patients with pancreatic focal mass suspected of malignancy. All patients were examined by ultrasonography, MR, and ultrasound-guided needle biopsy. Cytopathologic examination of the bioptic samples was used to diagnose the disease. Oncomarker CA 19-9 was done in all patients. Results: MR imaging and US examination made possible the correct diagnosis of carcinoma in case of 17 patients; in three patients with focal chronic pancreatitis the diagnosis was false positive. No case of false negative diagnosis was found. The value of oncomarker CA 19-9 was determined and it was clearly positive (over 150 U/ml) in all patients. Conclusion Imaging techniques gave good results in the evaluation of pancreatic pathology. However, when using imaging techniques differential diagnosis between focal chronic pancreatitis and pancreatic carcinoma seems to be major problem. Correlation of imaging technique and identification of CA 19-9 has an important role in the diagnostics of pancreatic carcinoma. Imaging techniques and identification of oncomarker CA 19-9 are complementary methods in the examination and diagnostics of pancreatic carcinoma and they allow better precision of diagnosis of pancreatic focal lesions.