bluuebunny/crossref_metadata_2025 huggingface dataset:
Root Coverage Using Acellular Dermal Matrix and Comparing a Coronally Positioned Tunnel With and Without Platelet‐Rich Plasma: A Pilot Study in Humans
Authors: Shepherd Neal , Greenwell Henry , Hill Margaret , Vidal Ricardo , Scheetz James P.
Published: March 2009

Background: The primary aim of this randomized, controlled, blinded clinical pilot study was to compare the percentage of recession defect coverage obtained with a coronally positioned tunnel (CPT) plus an acellular dermal matrix allograft (ADM) to that of a CPT plus ADM and platelet‐rich plasma (CPT/PRP) 4 months post‐surgically.

Methods: Eighteen patients with Miller Class I or II recession ≥3 mm at one site were treated and followed for 4 months. Nine patients received a CPT plus ADM and were considered the positive control group. The test group consisted of nine patients treated with a CPT plus ADM and PRP. Patients were randomly selected by a coin toss to receive the test or positive control treatment.

Results: The mean recession at the initial examination for the CPT group was 3.6 ± 1.0 mm, which was reduced to 1.0 ± 1.0 mm at the 4‐month examination for a gain of 2.6 ± 1.5 mm or 70% defect coverage (P <0.05). The mean recession at the initial examination for the CPT/PRP group was 3.3 ± 0.7 mm, which was reduced to 0.4 ± 0.7 mm at the 4‐month examination for a gain of 2.9 ± 0.5 mm or 90% defect coverage (P <0.05). There were no statistically significant differences between the groups (P >0.05).

Conclusions: The CPT plus ADM and PRP produced defect coverage of 90%, whereas the CPT with ADM produced only 70% defect coverage. This difference was not statistically significant, but it may be clinically significant.
Application of the Checkerboard Immunoblotting Technique to the Quantification of Host Biomarkers in Gingival Crevicular Fluid
Authors: Teles Ricardo P. , Sakellari Dimitra , Konstantinidis Antonis , Socransky Sigmund S. , Haffajee Anne D.
Published: March 2009

Background: The aim of this study was to describe the development and validation of the checkerboard immunoblotting (CBIB) technique for the high‐throughput quantification of multiple inflammatory mediators in gingival crevicular fluid (GCF) samples.

Methods: Monoclonal antibodies were used to bind GCF interleukin (IL)‐1β and −8 and matrix metalloproteinase (MMP)‐8 to the surface of membranes. Biotinylated antibodies were used to detect bound antigens in a checkerboard format. Signals were developed using chemiluminescence, captured on film, and quantified using software for array analysis. The assay was tested for potential cross‐reactions among the three pairs of antibodies. Eleven CBIBs were processed to determine the analytical sensitivity of the assay. Forty GCF samples were analyzed using CBIB and enzyme‐linked immunosorbent assay (ELISA) in parallel, and the significance of the correlations among the results was tested using the Pearson correlation coefficient. Nine hundred thirty‐one GCF samples were collected from 20 periodontally healthy subjects and 20 periodontitis subjects and analyzed using CBIB to test the assay's sensitivity and dynamic ranges using clinical samples.

Results: The CBIB was capable of distinguishing among the three analytes. The sensitivity and dynamic ranges of the assay were suitable for the detection of the three targets in the majority of GCF samples. There were highly statistically significant (P <0.0001) positive correlations between CBIB and ELISA data for all three biomarkers. The periodontitis subjects had statistically significantly higher mean levels of IL‐1β and −8 compared to healthy subjects.

Conclusion: The CBIB technique is a sensitive and specific assay for the high‐throughput quantification of MMP‐8 and IL‐8 and −1β in GCF.
Identification of Pathogen and Host‐Response Markers Correlated With Periodontal Disease
Authors: Ramseier Christoph A. , Kinney Janet S. , Herr Amy E. , Braun Thomas , Sugai James V. , Shelburne Charlie A. , Rayburn Lindsay A. , Tran Huu M. , Singh Anup K. , Giannobile William V.
Published: March 2009

Background: Periodontitis is the major cause of tooth loss in adults and is linked to systemic illnesses, such as cardiovascular disease and stroke. The development of rapid point‐of‐care (POC) chairside diagnostics has the potential for the early detection of periodontal infection and progression to identify incipient disease and reduce health care costs. However, validation of effective diagnostics requires the identification and verification of biomarkers correlated with disease progression. This clinical study sought to determine the ability of putative host‐ and microbially derived biomarkers to identify periodontal disease status from whole saliva and plaque biofilm.

Methods: One hundred human subjects were equally recruited into a healthy/gingivitis group or a periodontitis population. Whole saliva was collected from all subjects and analyzed using antibody arrays to measure the levels of multiple proinflammatory cytokines and bone resorptive/turnover markers.

Results: Salivary biomarker data were correlated to comprehensive clinical, radiographic, and microbial plaque biofilm levels measured by quantitative polymerase chain reaction (qPCR) for the generation of models for periodontal disease identification. Significantly elevated levels of matrix metalloproteinase (MMP)‐8 and −9 were found in subjects with advanced periodontitis with Random Forest importance scores of 7.1 and 5.1, respectively. The generation of receiver operating characteristic curves demonstrated that permutations of salivary biomarkers and pathogen biofilm values augmented the prediction of disease category. Multiple combinations of salivary biomarkers (especially MMP‐8 and −9 and osteoprotegerin) combined with red‐complex anaerobic periodontal pathogens (such as Porphyromonas gingivalis or Treponema denticola) provided highly accurate predictions of periodontal disease category. Elevated salivary MMP‐8 and T. denticola biofilm levels displayed robust combinatorial characteristics in predicting periodontal disease severity (area under the curve = 0.88; odds ratio = 24.6; 95% confidence interval: 5.2 to 116.5).

Conclusions: Using qPCR and sensitive immunoassays, we identified host‐ and bacterially derived biomarkers correlated with periodontal disease. This approach offers significant potential for the discovery of biomarker signatures useful in the development of rapid POC chairside diagnostics for oral and systemic diseases. Studies are ongoing to apply this approach to the longitudinal predictions of disease activity.
Prevention of Mandibular Third Molar Extraction‐Associated Periodontal Defects: A Comparative Study
Authors: Sammartino Gilberto , Tia Mariano , Bucci Tommaso , Wang Hom‐Lay
Published: March 2009

Background: Extraction of deep‐impacted mandibular third molars may lead to periodontal defects at the distal surface of the adjacent second molar. The purpose of this study was to compare the ability of three regenerative approaches to prevent third molar extraction‐related periodontal defects.

Methods: Forty‐five patients with bilateral osseous or soft tissue–impacted lower third molars were selected to participate in the study. Inclusion criteria were the presence of a pocket that was located distally to the mandibular second molar with a probing depth (PD) ≥7 mm and with a probing clinical attachment level (CAL) ≥6 mm. Ninety third molar impactions were used and were randomly assigned to three equal treatment groups (30 each): bovine porous bone mineral (BPBM) alone, BPBM plus collagen membrane (CM), and an untreated control group. Clinical and radiographic measurements were recorded at 3, 6, 9, 12, 18, 24, 36, 48, 60, and 72 months after the surgery.

Results: BPBM or BPBM + CM resulted in a significant reduction in PD and gain in CAL compared to the control group at all time points. BPBM + CM had the best outcome for the prevention of a second‐molar periodontal defect.

Conclusion: The application of BPBM, with or without a collagen membrane, can be a viable and stable treatment to alleviate the periodontal defects that are often associated with impacted mandibular third molar extractions.
Relationship Between Intake of Green Tea and Periodontal Disease
Authors: Kushiyama Mitoshi , Shimazaki Yoshihiro , Murakami Masatoshi , Yamashita Yoshihisa
Published: March 2009

Background: Green tea is a very popular beverage, and in vitro studies have shown that green tea polyphenols inhibit the growth and cellular adherence of periodontal pathogens and their production of virulence factors. We investigated the epidemiologic relationship between the intake of green tea and periodontal disease.

Methods: We analyzed 940 Japanese men aged 49 to 59 years as part of a comprehensive health examination. Probing depth (PD), clinical attachment loss (AL), and bleeding on probing (BOP) were used as the periodontal parameters. We examined the relationship between the intake of green tea and periodontal parameters. The intake of green tea was defined as the number of cups per day in a self‐administered questionnaire.

Results: The intake of green tea was inversely correlated with the mean PD, mean clinical AL, and BOP. In multivariate linear regression models, every one cup/day increment in green tea intake was associated with a 0.023‐mm decrease in the mean PD (P <0.05), a 0.028‐mm decrease in the mean clinical AL (P <0.05), and a 0.63% decrease in BOP (P <0.05), after adjusting for other confounding variables.

Conclusion: There was a modest inverse association between the intake of green tea and periodontal disease.
Bone Perforation and Placement of Collagen Sponge Facilitate Bone Augmentation
Authors: Shimoji Shinji , Miyaji Hirofumi , Sugaya Tsutomu , Tsuji Hifumi , Hongo Tetsunari , Nakatsuka Megumi , Uz Zaman Khurshid , Kawanami Masamitsu
Published: March 2009

Background: Bone perforation may induce bone marrow cell migration into a collagen sponge onlay implant. This study investigated the efficacy of bone perforation and collagen sponge onlay placement with regard to new bone formation.

Methods: One hundred sixty femurs of 80 Wistar male rats were used in four groups: bone perforation and sponge (PS) group: after perforating the femur, fibrillar and heat‐denatured collagen (FC‐HAC) sponges were placed on the femur; sponge (S) group: a FC‐HAC sponge was placed directly on the femur without bone perforation; perforation (P) group: femur perforation without collagen sponge placement; and control (C) group: neither bone perforation nor sponge placement was used. Histologic and histomorphometric analyses were performed after the surgery.

Results: Numerous osteoblastic and fibroblastic cells were seen during the early repopulation in and at the periphery of the sponge in the PS group. These cells were seen only at the periphery of the sponge in the S group. In the PS group, angiogenesis was noted frequently, and it exhibited significantly greater new bone area compared to the other groups at days 14 and 28.

Conclusion: The use of the FC‐HAC sponge on the bone perforation area seemed to promote bone augmentation by possibly acting as a scaffold for the bone marrow cells as well as maintaining the space that is necessary for bone growth to occur.
TGF-beta1 in breast cancer-estrogen regulation
Authors: Todorovic-Rakovic Natasa , Ivanovic Vesna , Demajo Miroslav , Neskovic Borka , Neskovic-Konstantinovic Zora , Kanjer Ksenija , Markicevic Milan , Nikolic-Vukosavljevic Dragica
Published: March 2009

TGF-beta1 is a pluripotent cytokine with diverse effects in the normal development of mammary glands, and in the development of malignant tumors of the breast. The aim of the study was to determine the levels of TGF-beta1 in the group of advanced breast cancer, in which increased TGF-beta1 levels were most likely to be expected. TGF-beta1 levels were also compared with estradiol levels. Our results suggested that TGF-beta1 synthesis may be regulated by estrogen or anti-estrogen through ER. Finding of increased TGF-beta1 levels, due to its possible role in predicting invasive phenotype in later phases of tumor progression, may indicate the tendency of tumor tissue towards autonomy.
Review of the World Health Organization classification of tumors of the nervous system
Authors: Dozic Slobodan , Cvetkovic-Dozic Dubravka , Skender-Gazibara Milica , Dozic Branko
Published: March 2009

(Conclusion) Classifications of the nervous system tumors should be neither static nor definitive. The most recent, third, current WHO classification of nervous system tumors was published in 2000. Many substantial changes were introduced. New entities include the chordoid glioma of the third ventricle, the atypical teratoid/rhabdoid tumor, cerebellar liponeurocytoma (the former lipomatous medulloblstoma of the cerebellum), solitary fibrous tumor and perineurioma. The new tumor variants include the large cell medulloblastoma, tanacytic ependymoma and rhabdoid meningioma. Several essential changes were introduced in the meningiomas regarding histological subtypes, grading and proliferation index. In addition to new entities described in the 2000 WHO classification there are newly brain tumor entities and tumor variants, which are not included in the current classification due to the insufficient number of reporeted cases, for example papillary glioneuronal tumor, rosetted glioneuronal tumor, lipoastrocytoma and lipomatous meningioma. They will be probably accepted in the next WHO classificaton. In the current WHO classification the importance of cytogenetic and molecular biologic investigation in the understanding and further classifications of these tumors has been emphasized.
Quality control in radiotherapy of brain tumors
Authors: Golubicic Ivana , Nikitovic Marina , Gligorijevic Gordana
Published: March 2009

(Conclusion) Radiotherapy techniques for brain tumors are complex and require precision in planning and giving radiotherapy programs. Continual application of quality control should enable achieving better treatment results with minimizing risk for late treatment-related complications. Introduction of uniform and precise parameters for the therapy planning, dose determining and patient's control, makes possible for optimal follow-up and comparison of treatment results between different therapeutic centers.
Sentinel node biopsy in the breast cancer: Possibility of the avoidance of axillary node dissection
Authors: Golubovic Andrija , Stojiljkovic Bratislav , Plzak Aleksandar , Radovanovic Zoran , Patrnogic Aleksandar
Published: March 2009

(Conclusion) This researching, and many others, indicates that in certain patients (especially T1a and T1b), under precise criteria, when SN metastases are not present, axillary dissection in the breast cancer (10, 22) and all its consequences (lymphoedeama, numbness, pain, limited movement in the shoulder joint) could be avoided. We should remember that nowadays at least 50% of women undergo axillary nodes dissection within the breast cancer operative treatment because of histopathologically negative nodes.
Clinical efficacy of neoadjuvant FAC chemotherapy in locally advanced breast cancer patients
Authors: Zdrale Zdravko , Susnjar Snezana , Stamatovic Ljiljana , Matijasevic Miodrag , Neskovic-Konstantinovic Zora
Published: March 2009

Background: FAC chemotherapy (CT) regimen is a well-established standard in the neo-adjuvant or primary chemotherapy for locally advanced breast cancer (LABC) treatment. Its main goal is to achieve locoregional tumor shrinkage allowing for the radical surgical treatment with curative intent. Concerning that prognosis of these patients depends on the response to initial neo-adjuvant therapy, we have analyzed clinical response to standard FAC CT in a group of routinely treated unrespectable LABC patients. Methods: During the three-year period, 50 pre- and postmenopausal patients without any cardiac risk factors, aged from 38-61 years, were treated with 3 to 4 cycles of neo-adjuvant FAC CT (500-50-500 mg/m 2 /21d). The initial diagnosis of LABC was based on tumor, nodal and/or skin characteristics: in 25 patients tumor was classified as T3-T4, N2 category was registered in 28 patients while skin lymphagiosis was found in 22 patients. Pathological diagnosis was confirmed either by skin, tumor and/or lymph node biopsy, or by tumorectomy (in 45 and 5 patients, respectively). Steroid receptor status was determined by biochemical DCC method in 35, or by immunohistochemistry in 7 patients. Results: Axillary lymph node status was evaluable in 47/50, and T status in 48/50 patients. Objective nodal response was achieved in 41/47 patients (12 CR and 29 PR, respectively), inflammatory skin features responded in 17/22 patients (2CR and 15PR, respectively). Overall objective response was achieved in 41/48 (82%) patients (9 CR, 32 PR), while 5 patients were classified as SD, and 2 consecutive patients as PD, with 2 non-evaluable patients. As far as toxicity was concerned, no acute cardiac damage was noted, emesis was successfully prevented with standard anti-emetics, and grade 3 to 4 alopecia developed in most of patients. Hematological tolerance was also good. Conclusion: Our results confirmed the high response rate to standard neoadjuvant FAC CT in unresectable LABC patients, in whom downstaging was achieved in majority, allowing for radical surgical treatment.
Sequential dose-dense single agent chemotherapy for locally advanced breast cancer
Authors: Vrbic Svetislav , Pejcic Ivica , Filipovic Sladjana , Radic Stojan
Published: March 2009

Chemotherapy of breast cancer is still the area of intensive research. Based on mathematical model of tumor cell growth kinetics, articulated by Larry Norton, novel concept of chemotherapy in breast cancer was launched and it implies dose-densification of chemotherapy trough the use of sequential non cross-resistant single agents or regimens. The introduction of primary systemic chemotherapy (PST) improved the outcome of patients with locally advanced breast cancer (LABC). Simultaneous PST is the standard approach to patients with LABC nowadays. On the other hand, many studies using two most active cytotoxic drugs in primary breast cancer, anthracyclines and taxanes showed that sequential dose-dense single agent PST could be superior in terms of enhancing the rates of patients suitable for conservative surgery. In the light of this data, based on the results of the new clinical trials we will discuss merits and demerits of using sequential dose-dense single agent chemotherapy in LABC.
Factors influencing successful radioiodine therapy of thyroid
Authors: Popadic Silvija , Vojicic Jelena , Peter Andrea , Malesevic Milica , Mihailovic Jasna , Kermeci Katarina
Published: March 2009

Background: Well-known fact is that the good surgical treatment, leaving only small residuals of thyroid tissue, is the outmost valid predictive factor of successful ablative radioiodine treatment. Assuming that all patients had state of the art surgical treatment, with this study we tried to evaluate other possible predictive factors of successful radioiodine therapy after total thyroidectomy. Methods: Total of 56 patients (15 males and 41 females mean age 43.37?13), operated during the year 2001 was evaluated. Due to differentiated carcinoma of the thyroid total thyreoidectomy was done in 7 with follicular and in 49 patients with papillary cancer. Forty-one patients received ablative 131 I dose (3.7GBq) and fifteen patients received therapeutic dose (5.55GBq) of radioiodine therapy. As possible predictive factors the TNM classification (T1, 6; T2, 17; T3, 4; T4, 28 and 24 with N0 and 32 with N1), the number of foci on whole body scan (WBS), and the serum level of thyroglobulin were statistically evaluated. One year after radioiodine therapy control WBS was done and successful outcome of the therapy was considered to be the WBS without visible accumulation of radioiodine and with low serum level of thyroglobulin. Results: Outcome of ablative radioiodine therapy was considered as successful in 55.4% patients and 44.6% of patients needed additional radioiodine therapies. Only the number of foci and the level of thyroglobulin showed statistically significant (p(0.05) influence on the outcome of applied radioiodine therapy. Conclusion: Significant influence of the thyroglobulin level and number of foci on the WBS in patients with total thyroidectomy could be explained by the fact that there were the signs of minimum thyroid residual tissue, and that there were no microscopic spread of disease.
Surgical treatment for anaplastic thyroid cancer
Authors: Zivaljevic Vladan , Diklic Aleksandar , Krgovic Ksenija , Kazic Milena , Kalezic Nevena , Paunovic Ivan
Published: March 2009

Background: Anaplastic thyroid cancer is relatively rare but extremely aggressive neoplasm. The aim of the present paper was to study the possibility of surgery for anaplastic thyroid cancer. Methods: During 5-year period (from 1998 to 2002) in the Center for endocrine surgery, we found anaplastic thyroid cancer in 65 patients (44 female and 21 male patients) of median age 63 years (range: 37-88 years). Diagnosis was determined on the basis of histological analysis in operated patients or on cytology findings in case of patients who were not operated. Histological analysis confirmed anaplastic transformation of papillary thyroid cancer in 18 cases. Results In 50% patients we performed only fine needle biopsy, and in 37% patients operative biopsy or tumor reduction. We performed radical surgery hemithyroidectomy or total thyroidectomy, in 13% patients with anaplastic thyroid cancer. Thyroid goiter was present in 35% patients longer than a year before diagnosis of anaplastic cancer was made. Conclusion: Possibility of surgery for anaplastic thyroid cancer is very limited. In about one third of patients there were longstanding goiter or histological verified dedifferentiation of papillary thyroid cancer. These patients should have been operated before anaplastic transformation.
Incidence of difficult intubation in thyroid gland surgery
Authors: Kalezic Nevena , Kazic Milena , Paunovic Ivan , Diklic Aleksandar , Zivaljevic Vladimir , Krgovic Ksenija
Published: March 2009

Background: Difficult intubation (DI) occurs in 1% to 3% in general population, and unsuccessful intubation in 0.04%. DI may cause a lot of undesirable effects during prolonged intubation period, including lethal outcome. The aim of the study was to establish the incidence of DI in thyroid gland surgery and to compare the incidence of DI to predicted DI due to different DI screening testes. Methods: Prospective study included 2000 patients, which underwent thyroid gland surgery in Center for endocrine gland surgery, Clinical Center of Serbia, Belgrade, during 1999-2001. 436 of them were thyroid carcinomas 525 were nodal goiter, 671 polynodal goiter and 368 hyperthyreosis; 1705 female, 295 men, average age 48.1 year. According to ASA classification (American Society of Anesthesiologist's classification for correlation between co-existing diseases and perioperative complications) there were 886 ASA I, 901 ASA II and 213 ASA III. We used Mallampathi classes, Wilson criteria and Cormack-Lehane (CL) criteria to predict DI, and CL criteria to define DI. The complications during DI were analyzed and the ratio of DI to predicted DI was established. Results: There were 110 DI- 84 women, 26 men. Considering diagnosis there were T 24, PS 42 H 22. ASA III were 9.38%, ASAII 5.77, ASAI 4.28%. There were 3 unsuccessful intubations. Complications during DI were noted in 32 patients. Ratio between expected DI and DI, and unexpected DI and DI were: 12.77% failed positive and 0.45% failed negative results. Conclusion: Incidence of DI in thyroid gland surgery is twice more in men than in women. Screening tests for prediction DI showed higher specify than sensitivity.
Combined chemotherapy and irradiation in anaplastic thyroid carcinoma
Authors: Pejcic Ivica , Vrbic Svetislav , Scekic Mirjana
Published: March 2009

Background: Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive cancer; patient's death usually occurs rapidly after diagnosis with a mean survival of six months in the majority of individual research series. Treatment of ATC ranges from surgery, radiotherapy, chemotherapy, or a combination of these regimes. Yet, the optimal sequence of treatment modalities has not been established. Methods: From 1997 to 2002 six consecutive patients with a histological diagnosis of ATC were treated with combined chemotherapy and irradiation at our Clinic for Oncology, Clinical Center Ni?. Five of these patients were females and 1 male, aged between 28 and 71 years (mean age: 57 years). None of them had distant metastases at the time of diagnosis. Extrathyroidal extension was present in 3 patients with invasion into skin and hypoderm. Treatment consisted of doxorubicin 60 mg/m 2 plus cisplatin 60 mg/m 2 every three weeks. Total doses ranged between 158-375 mg/m 2 for doxorubicin and 183-380 mg/m 2 for cisplatin. External beam radiation to the neck was administered, at a daily dose of 1.2 Gy, up to total doses ranging between 45-60 Gy. Results: One patient achieved a complete response (CR) and one patient achieved a partial response (PR). Three patients had stable disease. One patient with CR progressed during follow-up and died 18 months from bone and brain metastases. The treatment was moderately well tolerated, although all patients experienced some mild form of toxicity; neutropenia occurred in all patients, but none of them required hospital admission. Median survival was 8 months (range: 4-18 months). Conclusion: We concluded that the present regimen produces meaningful responses for patients with localized ATC. A randomized study is needed to determine the effect on survival.
Evaluation of quality of life in patients with locally advanced non-small cell lung cancer treated with combined radiochemotherapy
Authors: Isakovic-Vidovic Suzana , Borojevic Nenad , Radosevic-Jelic Ljiljana , Pekmezovic Tatjana
Published: March 2009

Background: The aim was to investigate the application of radiopotentiation which was initiated by the fact that in patients with locally advanced non-small cell lung cancer there is a high risk of relapse due to failure in local control of the disease and the risk of systemic micrometastases. The other aim was the evaluation of quality of life. Methods: A study group consisted of 67 patients. Patients were first treated with TD30 Gy in 10 fractions during 2 weeks (5 fractions per week) with a potentiation by 20 mg/m 2 of carboplatinol intravenous bolus infusion just prior to each radiotherapy fraction. After a 2-week pause, additional radiation of 25 Gy in 10 fractions was applied during 2 weeks (5 fractions/week) with a potentiation by 20 mg/m 2 of carboplatinol. Total tumor dose (TTD) was 55 Gy (30+25 Gy) in 20 fractions, total duration of the therapy was 6 weeks, and total dose of carboplatinol was 600 mg. A control group consisted of 70 patients and they were treated with a radical radiotherapy with a conventional fractionation (60 Gy in 30 fractions, 2 Gy per day, 5 fractions per week). Quality of life was evaluated by Karnofsky performance scale (KI), at the beginning of the treatment, after the completion of the whole course of treatment, and during follow-up at regular check-ups. Results After the completion of the whole course of treatment most of patients had KI 80%. Analysis made during the last check-up showed statistically significant low KI. In both study and control groups KI was significantly higher at the beginning of the treatment than KI after the completion of the whole course of treatment (p=0.001). However, the analysis of KI at the time of the completion of the whole course of treatment showed significantly better KI in study group (p=0.036) than in control group. Conclusion: These results showed that the combined radiochemotherapy treatment is well tolerated.
Data of colorectal cancer in the Hospital cancer registry, Clinic of oncology in Nis, in the period 1998-2002
Authors: Lukic Natasa , Radic Stojan , Stanojevic Zorica , Markovic Milan , Cirkovic Slavica
Published: March 2009

Background: Colon and rectal cancers (CRC) accounted for 783.000 new disease cases (9.7% of the world total), and was a cause of 437 000 deaths (8.4% of the world total). Unlike the situation with most disease sites, incidence and mortality were not much different between men and women (ratio 1.05:1.00). In terms of incidence, CRC rank thirds in frequency in men (after prostate and lung) and third in women (after breast and lung). Methods: In the Hospital Cancer Registry of the Clinic of oncology Nis, for the period 1998-2002 there were 7873 registered new cancer cases. The authors searched the registry with aim to establish the number of patients affected with colorectal cancer for the observed 5-year period, to establish the most frequent cancer site, histopathologic diagnosis, age distribution of the disease, and tumor burden in the registered cases. Results: CRC participates with 10.24% of all cancers cases. There were 1329 gastrointestinal cancer cases, out of which 806 (61%) colorectal cancer cases. CRC ranks first in frequency in men (18% at all cancers in men), and fifth in women (5.96% at all cancers in women). The disease was predominant in male population (504/806 men and 302/806 women; ratio 1.67:1.00). The youngest two cases were in the group of patients aged from 20 to 24 years. The number of CRC increases with age for both genders (68 men and 39 women aged 50-54 years), and the highest number of patients were observed among persons aged from 65-69 years (95 men and 52 women). Colorectal cancers most frequently arise in the rectosigmoid colon portion (89 cases; 22%), then in the colon transversum (72 cases; 18%), colon ascendens (73 cases; 18%) cecum (48 cases; 12%), sigmoid colon (31 cases; 7.7%), hepatic flexura (26 cases; 6.5%), lineal flexura (12 cases; 3%) and colon descendens (8 cases 2%). The most common histopathologic diagnoses are: Adenocarcinoma 685 (85%), Ca papillare 69 (8.6%), Ca mucinosum 43 (5.3%), Ca planocellulare 8 (1%), Ca lucidocellulare 4 (0.5%), and sarcoma 2 (0.2%). Conclusion: The analysis of the period showed the increase of the number of cases (133 patients in 1999 and 241 cases in 2002). CRC makes up 61 % of all gastrointestinal cancers. The most frequent localization was rectum (393/806; 49 %) These tumors most commonly occur in rectum and sigmoid colon (89/401). Colon descendens is rarely affected (8/401). The most predominant type was adenocarcinoma (685/806). CRC was 1.67 times more frequent among men then among women.
Ductal in situ cancer in non-palpable breast lesions
Authors: Stojiljkovic Dejan , Prekajski Milan , Inic Momcilo , Miletic Nebojsa , Dzodic Radan , Celebic Aleksandar
Published: March 2009

Background: Great importance in detecting in situ cancer is in the fact that epithelial layer is deprived of the blood and lymph vessels, so metastases can develop only when basal membrane has been broken. Methods: The paper included 40 operated women in whom preoperatively suspect non-palpable lesion had been verified. Preoperative diagnostics included use of high-resolution mammography, aimed mammography, palpatory examination of surgeon-oncologist, as well as fine-needle aspiration (FNA) biopsy and cytology analysis of the sample. Methodology of the work implied the use of stereotaxic marking, specimen mammography and extempore histopathology analysis. Results: From 40 investigated patients, the breast malignant tissue lesion was diagnosed in 18 patients (45%). Two of these lesions (11.1%) were histopathologically verified as ductal in situ cancer (DCIS) seven (38.9%) as DCIS with present invasive component, and in the remaining nine patients (50%) other cancer types were found. Conclusion: Comparing our results with data from the hospital registry of the Institute of Oncology and Radiology of Serbia (IORS) for 2001, where 1173 patients with the malignant lesions were registered of whom 13 (1.1%) patients with DCIS, we may conclude that there is statistically significant difference in number of detected cancers in this early stage. This further limits surgical intervention to tumorectomy in DCIS, and in DCIS with present invasive component it enables conserving operation in majority of cases. In both cases, disease prognosis is good, what speaks in favor of screening examination and routine application of the most contemporary procedures.
Our experience in education of patients within the first session "Human body and cancer" of European education program "Learning to live with cancer"
Authors: Pavlovic Danica , Djurdjevic Ana
Published: March 2009

Background: As a part of educational team within the European Educational Program (EEP), senior nurse should give clear and understandable information to the patients about the functioning of the human body, tissues and cells and increase their knowledge about the cancer. Senior nurse also has to get them acquainted with the medical terminology. The aim of this research was to assess how participants was satisfied with the information they had been given either orally, or in written form within the first session of the EEP. Methodology: Thirty-seven patients and their family members were entered in this research. They were divided in two groups, which were investigated separately, on December 2002, and on May 2003 at the Department for Educational Activities. For the purpose of this investigation an anonymous questionnaire and the original evaluation list from the EEP as an assessment instrument, were used. Results: Seventy percent of the participants assessed the first session as very good, while the remaining 30% scored the session as excellent. All participants understand information they had been given and 97% of them claimed they had learned something they had not used to know. As far as printed material was concerned, 73% of the participants evaluated this material as being very good, and 24% of all included persons as being excellent. Conclusion: Our results confirmed that the first session "Human body and cancer" of EEP Learning to live with cancer meet the patients' and their family members' expectation concerning getting clear information on this subject.
Nursing interventions in prevention of the complication in locoregional administration of chemotherapy through port-a-cath system
Authors: Boskovic Snezana , Todorovic Biljana , Mitov Nevenka , Debelnogic Biljana
Published: March 2009

Background: Port-a-cath is an implantable system, which can be inserted into the arterial or venous blood vessel. It enables more comfortable administration of drugs. Intraarterial chemotherapy has the greatest effect in the region downstream of the place of insertion, without major systemic side effects. The aim of the study was to evaluate complications during the administration of cytotoxic drugs through port-a-cath system. Patients and methods: Twenty colorectal cancer patients with liver metastases were entered into this investigation, and they were prospectively followed up. All of them had the intraarterial implantable device for intrahepatic drug delivery, and they were treated during six-month period. Nursing interventions serving to prevent complications of drug administration are as follows: preparing of the patient, check for the system, preparing cytotoxic drugs for the administration, control the patients and the drug flow during the administration of chemotherapy. Results: During this prospective follow up of our patients we noticed several problems related to the administration of chemotherapy through intraarterial port-a-cath systems. These difficulties include: difficulties in drug flow at the insertion point difficulties in blood aspiration (n=6), redness above the puncture, painful and moist skin lesions around the puncture (n=1). Conclusion: We did not notice frequent adverse effects of intrahepatic therapy because nursing interventions had been carefully planned in order to prevent the complications. Nurses should make an adequate health care plan based on the real and potential problems, with possible reasons and potential resolution of complications.
Attitudes of patients with cancer toward the diagnosis, treatment and prognosis of the disease and their influence on the process of adaptation
Authors: Boskovic Snezana
Published: March 2009

Background: For majority of people cancer means a serious suffering and concern about their own life. Within the cognitive model, which includes assessment, interpretation and evaluation related to cancer, the style of adaptation is developed according to what cancer means to patients, and its significance defines their emotional and behavioral response. The aim of this research was to established patients' reactions and emotional responses to cancer and influence of its presence on the development of adaptation process. Patients and methods: Thirty-six patients with gynecological and lung cancers and Hodgkin's lymphomas were asked to answer the questionnaire that had been previously developed for the purpose of this research. Results: Our results showed that the considerable percent of patients do not accept the term "cancer" as their diagnoses (50% of patients accepted the term "tumor" and 8% of them did not even know which disease they were suffering from). All patients clearly recognized which therapy belongs to an antineoplastic treatment. Emotional distress, defined as anxiety (irritation, tension, trouble, nervousness) was present in 23% of patients. Thirty nine percent were depressive, 38.8% of them experienced significant weakness, while 12.9% suffered from insomnia. Fear for future was present in 45% of patients, mostly women. Fatigue was the dominant symptom (47% of patients) and alopecia was the most frequently observed therapy adverse effect. Conclusion: Since the oncologists in our country usually do not communicate the real diagnosis of cancer with patients, rejection is a common psychological defense mechanism especially among males. The majority of patients were not depressed, but the depression was more frequently expressed than anxiety, especially at transitional points during the disease (at diagnosis, waiting for operation, check ups, etc). Our results indicated that our cancer patients accomplished positive process of adaptation.
Health care during administration of combined docetaxel-Mitomycin C-Vinblastin therapy in treatment of metastatic breast cancer patients
Authors: Mitrovic Jasmina , Popovic Branka , Jelecanin Dusanka
Published: March 2009

Background: New chemotherapy combinations are extensively investigated in metastatic breast cancer, especially in anthracycline resistant patients. However, the higher the treatment efficacy, usually the greater therapy side effects are reported. We present our health care experience in treating advanced breast cancer patients with three-drug combinations consisting of Taxotere, Mitomycin C and Vinblastin. Aim of the work was to evaluate the toxicity profile and the effectiveness of health care measures in prevention of chemotherapy side effects. Nurses interventions in prevention of complications due to therapy related toxicity were as follows: Regular check-ups of patients, monitoring for signs and symptoms of infection in severely neutropenic patients, monitoring for hemorrhagic syndrome in patients with severe thrombocytopenia, monitoring for the signs and symptoms of stomatitis and aseptic care of oral cavity in order to prevent oral mucosal damage. Methodology: From December 1998 to April 2000, 27 patients were included into the phase II study of metastatic breast cancer patients. The following therapy regime was used: Taxotere 80 mg/m 2 every 3 weeks Vinblastin 6mg/m 2 every 3 weeks, and Mitomycin C 12 mg/m 2 in 6-week intervals. Presented data are obtained from interviews, analysis of health care lists and patients' diaries, which they filled in at home. Results During the study, a total of 133 chemotherapy cycles were applied. Neutropenia of grade 3-4 was registered in 25/27 patients (93%), and only 12 patients (48%) had at least one episode of febrile neutropenia, which was manageable. Other toxicities were as follows: Thrombocytopenia of grade 3 in 1 out of 27 patients, without development of hemorrhagic syndrome, anemia of grade 3 in 3 women, neurosensory toxicity in 4 patients, and liquid retention in 6 patients. However, mucositis of grade 4 occurred in 1 patients, and grade 3 in 2 of them despite the rigorous health care interventions. Fatigue of grade 2 developed in 7 patients. Other toxicities were mild or moderate, the most frequent of which was diarrhea in 3 women. Conclusion: Our results confirm that a TXTR-MTC-VLB combination has considerable acute and cumulative side effects that are expected. However regular monitoring and in time nursing interventions may spare patients from suffering the severe complications due to chemotherapy side effects.
Development and analytic validation of a gas chromatography–mass spectrometry method for the measurement of sugar probes in canine serum
Authors: Rodriguez Heriberto , Suchodolski Jan S. , Berghoff Nora , Steiner Jörg M.
Published: March 2009

Objective—To develop and analytically validate a gas chromatography–mass spectrometry (GC-MS) method for the quantification of lactulose, rhamnose, xylose, 3-O-methylglucose, and sucrose in canine serum.

Sample Population—Pooled serum samples from 200 dogs.

Procedures—Serum samples spiked with various sugars were analyzed by use of GC-MS. The method was analytically validated by determination of dilutional parallelism, spiking recovery, intra-assay variability, and interassay variability.

Results—Standard curves ranging from 0.5 to 500 mg/L for each sugar revealed a mean r2 of 0.997. The lower detection limit was 0.03 mg/L for lactulose, rhamnose, xylose, and methylglucose and 0.12 mg/L for sucrose. The observed-to-expected ratios for dilutional parallelism had a mean ± SD of 105.6 ± 25.4% at dilutions of 1:2, 1:4, and 1:8. Analytic recoveries for the GC-MS assays of sugars ranged from 92.1% to 124.7% (mean ± SD, 106.2 ± 13.0%). Intra-assay coefficients of variation ranged from 6.8% to 12.9% for lactulose, 7.1% to 12.8% for rhamnose, 7.2% to 11.2% for xylose, 8.9% to 11.5% for methylglucose, and 8.9% to 12.0% for sucrose. Interassay coefficients of variation ranged from 7.0% to 11.5% for lactulose, 6.4% to 9.4% for rhamnose, 6.8% to 13.2% for xylose, 7.0% to 15.9% for methylglucose, and 5.5% to 9.4% for sucrose.

Conclusions and Clinical Relevance—The GC-MS method described here was accurate, precise, and reproducible for the simultaneous measurement of sugar probes in canine serum.
Characterization of systolic intervals in healthy, conscious sheep
Authors: Kharin Sergey N. , Shmakov Dmitry N. , Vityazev Vladimir A.
Published: March 2009

Objective—To characterize systolic intervals of the left ventricle and their relationship with heart rate in conscious sheep.

Animals—11 healthy Romanov sheep (age range, 3 months to 10 years).

Procedures—Systolic intervals and indices of myocardial contractility of the left ventricle were measured in conscious sheep by use of polycardiography.

Results—The mean ± SD pre-ejection period was 59 ± 12 milliseconds, and the mean left ventricular ejection time was 194 ± 34 milliseconds. The mean myocardial tension index was 0.22 ± 0.05, and the mean ratio of the pre-ejection period to ejection time was 0.30 ± 0.09. Total electromechanical systole, mechanical systole, and ejection time varied inversely with heart rate. The electromechanical delay and pre-ejection period were not correlated with heart rate, nor were the myocardial tension index and the ratio of the pre-ejection period to ejection time. The isovolumetric contraction index and isovolumetric contraction time were not significantly correlated with heart rate, although the values for the correlation coefficient were moderate (r = −0.561 and r = −0.482, respectively).

Conclusions and Clinical Relevance—Although a larger study would be needed to provide reference intervals for healthy sheep, the results of the study reported here provided useful information for the cardiac evaluation of sheep.
Determination of cardiac output in anesthetized neonatal foals by use of two pulse wave analysis methods
Authors: Shih Andre C. , Giguère Steeve , Sanchez Linda C. , Valverde Alexander , Jankunas Hope J. , Robertson Sheilah A.
Published: March 2009

Objective—To compare cardiac output (CO) measured by lithium arterial pressure waveform analysis (PULSECO) and CO measured by transpulmonary pulse contour analysis (PICCO) in anesthetized foals, with CO measured by use of lithium dilution (LIDCO) considered the criterion-referenced standard.

Sample Population—6 neonatal (1- to 4-day-old) foals that weighed 38 to 45 kg.

Procedures—Foals were anesthetized and instrumented to measure direct blood pressure, heart rate, arterial blood gases, and CO. The CO was measured by use of PULSECO, PICCO, and LIDCO techniques. Measurements were converted to specific CO (sCO) values for statistical analysis. Measurements were obtained during low, intermediate, and high CO states.

Results—sCO ranged from 75.5 to 310 mL/kg/min. Mean ± SD PICCO bias varied significantly among CO states and was −51.9 ± 23.1 mL/kg/min, 20.0 ± 19.5 mL/kg/min, and 87.2 ± 19.5 mL/kg/min at low, intermediate, and high CO states, respectively. Mean PULSECO bias (11.0 ± 37.5 mL/kg/min) was significantly lower than that of PICCO and did not vary among CO states. Concordance correlation coefficient between LIDCO and PULSECO was significantly greater than that between LIDCO and PICCO. The proportion of observations with a relative bias < ± 30% was significantly lower with the PULSECO method than with the PICCO method.

Conclusions and Clinical Relevance—Values for the PULSECO method were more reproducible and agreed better with values for the LIDCO method than did values for the PICCO method and were able to more accurately monitor changes in CO in anesthetized newborn foals.
Effects of dietary soy isoflavones on health, steroidogenesis, and thyroid gland function in dogs
Authors: Cerundolo Rosario , Michel Kathy E. , Court Michael H. , Shrestha Binu , Refsal Kent R. , Oliver Jack W. , Biourge Vincent , Shofer Frances S.
Published: March 2009

Objective—To evaluate the effect of a soy-based diet on general health and adrenocortical and thyroid gland function in dogs.

Animals—20 healthy privately owned adult dogs.

Procedures—In a randomized controlled clinical trial, dogs were fed a soy-based diet with high (HID; n = 10) or low (LID; 10) isoflavones content. General health of dogs, clinicopathologic variables, and serum concentrations of adrenal gland and thyroid gland hormones were assessed before treatment was initiated and up to 1 year later. Differences between groups with respect to changes in the values of variables after treatment were assessed by means of a Student t test (2 time points) and repeated-measures ANOVA (3 time points).

Results—No differences were detected between the 2 groups with respect to body condition and results of hematologic, serum biochemical, and urine analyses. Most serum concentrations of hormones did not change significantly after treatment, nor were they affected by diet. However, the mean change in serum concentration of total thyroxine was higher in the HID group (15.7 pmol/L) than that in the LID group (–1.9 pmol/L). The mean change in estradiol concentration after ACTH stimulation at 1 year after diets began was also higher in the HID group (19.0 pg/mL) than that in the LID group (–5.6 pg/mL).

Conclusions and Clinical Relevance—Phytoestrogens may influence endocrine function in dogs. Feeding soy to dogs on a long-term basis may influence results of studies in which endocrine function is evaluated, although larger studies are needed to confirm this supposition.