bluuebunny/crossref_metadata_2025 huggingface dataset:
Vacutainer® filling time through subcutaneous venous access devices
Authors: Goossens G.A. , Vrebos M. , De Wever I. , Stas M.
Published: January 2018

Introduction

The functionality of subcutaneous venous access devices is evaluated at least every time the device is accessed. This evaluation is subjective and actions are only undertaken when blood withdrawal and/or fluid injection become problematic. The function of these devices has rarely been evaluated objectively. The present study tried to find an objective and standardized way to evaluate the withdrawal speed of a newly inserted port.

Methods

Between October 2001 and December 2002, a prospective randomized study of 3 types of ports was carried out. The ability to infuse heparinized normal saline and to withdraw blood was evaluated by recording the filling time of a 10 ml Vacutainer® tube in 876 newly inserted central venous ports at the end of the surgical procedure.

Results

The patient groups were comparable in age, gender and insertion procedure characteristics (vein used, position of the port on the body and length of the catheter). The median time needed to fill a 10 ml Vacutainer® tube in all ports was 17.00 sec (range 11.43–63.62 sec). The median filling time for BardPort™ was 16.36 sec (range 13.48–39.00 sec), for Celsite® 18.35 sec (range 12.03–40.00 sec) and for Port-a-cath® 16.43 sec (range 11.43–63–62 sec). A significant difference in filling time was found between the large bore catheters (BardPort™, Port-a-cath®) and the small bore catheter (Celsite®) of 2 seconds median value.

Conclusion

Measurement of withdrawal speed provides an objective criterion for the quality description of blood withdrawal immediately after insertion. A value of more than 20 seconds for filling a 10 ml Vacutainer® tube could therefore be suggested a useful trigger for further investigation.
Safety of Percutaneous Internal Jugular Catheterization in Cancer Patients: Prospective Observational Study
Authors: Gambotti L. , Pérol D. , Frering B. , Kaemmerlen P. , Coronel B. , Sebban H. , Bulso V. , Bachelot V. , Chauvin F. , Bachmann P.
Published: January 2018

Purpose

To determine predictors for failure and early complications of percutaneous internal jugular catheterization (IJC) in cancer patients.

Methods

Six hundred and thirty consecutive cancer patients who required central venous catheterization were included in a prospective observational study. The rates of failure (defined as the intervention of a second physician and/or failure at initial insertion site) and of early complications were prospectively ascertained. Logistic regression analysis estimated odds ratio (OR) and 95% confidence intervals (95% CI) for independent predictors for failure and early complications of percutaneous IJC.

Results

The failure rate was 6.7%, and the early complication rate was 6.7%. In multivariate analysis, left-side initial catheterization (p<0.01), prior catheterization at the same site (p=0.001) and physician inexperience (p<0.0001) were independently associated with failure. Placement requiring more than one needle pass (p<0.01 for two and p<0.0001 for three and more) and absence of fluoroscopy (p<0.0001) were independently associated with early complications.

Conclusions

Percutaneous IJC is a valid option in the central venous catheterization of cancer patients due to its reliability and safety. Skilled physicians must manage difficult placements. If placement requires more than one needle pass or is made without fluoroscopy, patients must be carefully followed for potential complications.
Temporary Vascular access via the External Iliac Vein as a Salvage Procedure: A Report of Two Cases
Authors: TokgöZ H. , Onaran M. , Senocak C. , Polat F. , Sert S.
Published: January 2018

Central venous catheters (CVCs) provide easy, immediate and rapid vascular access (VA) for hemodialysis (HD) in patients with acute renal failure (ARF), and in an increasing number of patients with end-stage renal disease (ESRD) as well. For this purpose, the vessels mainly used are the cephalic, jugular, subclavian and femoral veins. In some patients, vascular catheter insertion via these routes can become impossible. We report two hopeless cases, in which the external iliac veins (EIVs) were used as a temporary VA insertion site as a last resort.
A new technique for autogenous brachiobasilic upper arm transposition for vascular access for hemodialysis
Authors: Weyde W. , Krajewska M. , Letachowicz W. , Kusztal M. , Penar J. , Klinger M.
Published: January 2018

Purpose

Conventional brachiobasilic fistula creation consists of the mobilization and preparation of the brachial part of the basilic vein along its whole length, the vein transposition on the anterior surface of the arm and anastomosis using the brachial artery. In case of late thrombosis, the reparation of such a fistula is almost impossible.

Methods

To avoid total vein clotting in the case of thrombosis we decided to prepare only a short part of the vein in our method and not to mobilize the other part of the vein. The brachiobasilic fistula with our modification was performed as a two-stage procedure in 18 patients (8 females and 10 males), aged from 37–78 yrs (60 ± 13.6 yrs).

Results

In two patients early thrombosis occurred. The reparation procedure was not performed in two patients (the first patient died due to pneumonia; the second patient did not give his permission for further intervention). In 16 patients brachiobasilic fistula creation was successful. Late thrombotic complications occurred in three patients (in the 3rd, 8th and 12th months). A new successful fistula, a few centimeters proximally to the original one, was performed in 2 patients 24hr and in 1 patient 48hr after fistula clotting. On the following day after the procedure the fistula was ready to be used. The primary, assisted primary and cumulative secondary patency rates after 12 months of follow-up were 74, 89 and 100%, respectively.

Conclusion

In comparison with standard brachiobasilic techniques our method offers the possibility of a reparation procedure in the case of late thrombosis, which could improve the long-term patency of brachiobasilic fistulas. However, a prospective controlled study is necessary to establish if this new technique is superior to the traditional surgical procedure.
The role of mineral metabolism and inflammation on dialysis vascular access failure
Authors: Morena M. , Bosc J.Y. , Jaussent I. , Dupuy A.M. , Terrier N. , Leray-Moragues H. , Flavier J.L. , Maurice F. , Delcourt C. , Cristol J.P. , Canaud B.
Published: January 2018

Thrombosis of arteriovenous fistula (AVF) is the leading cause of vascular access (VA) loss usually due to silent stenosis. Therefore, assessment of relevant risk factors of VA monitoring may provide insight into potential therapeutic targets for stenosis and thrombosis. The aim of this study was to evaluate the influence of cardiovascular risk factors (including inflammation and mineral metabolism dysfunctions) on the failure of internal AVF in HD patients.

128 HD patients with internal AVF were included in the study and followed up for two years. At baseline, VA morphology and function were followed by Doppler ultrasonography and serum albumin, prealbumine, C-reactive protein, orosomucoid, calcium, phosphorus, parathyroid hormone, bone-type alkaline phosphatase, osteoprotegerin and receptor activator of nuclear factor κB ligand were measured.

At baseline, 50 stenoses were detected but none of them required any intervention. Age and biological parameters did not significantly differ between patients with or without VA stenosis. Over the two year- follow up, VA thrombosis occurred in 19 patients. Preexisting stenosis of VA was present in 9/19 patients (47.3% of cases) (chi-square = 3.708, p = 0.0538). Despite the low rate of events, phosphorus [1.75 (0.95–2.77) vs 1.42 (0.47–3.22) mmol/L, p = 0.0416], Calcium x Phosphorus product [4.00 (2.00–5.90) vs 3.40 (1.10–6.80) mmol2/L2, p = 0.0676] and parathyroid hormone [165.00 (1.00–944.00) vs 79.50 (1.00–846.60) ng/L, p = 0.0814) levels were higher in the 19 thrombotic patients whereas all other biological parameters did not significantly differ.

These results, which confirm that VA thrombosis occurs more frequently upon preexisting stenosis, also demonstrate that mineral metabolism disorders, compared to inflammation, may contribute to VA dysfunction leading to thrombosis.
Long-term outcomes of a fistula initiative: Sustaining “Fistula Culture”
Authors: Mcgill R.L. , Marcus R.J. , Healy D.A. , Nye S. , Brouwer D.J. , Smith B.C. , Sandroni S.E.
Published: January 2018

From 1998 to 2003, a low cost fistula initiative at Allegheny General Hospital increased the rate of AV fistulas from 32% to 72%. We present an additional 25 months of vascular access data, with stratification of results by gender and long-term patient survival data. These data show the self-sustaining nature of ‘fistula culture’ in an urban hemodialysis unit, and the survival benefits that result from increased fistula rates.
Superior Vena Cava Thrombosis after Intravascular AICD Lead Extraction: A Case Report
Authors: Santangelo L. , Russo V. , Ammendola E. , De Crescenzo I. , Pagano C. , Savarese C. , Caruso A. , Utili R. , Calabrò R.
Published: January 2018

Pacemaker lead extraction has been shown to be an effective and safe treatment in the case of infected permanent pacemaker leads. However, it can lead to potentially serious complications, usually occurring during the extraction procedure. This report describes a case of a 74-year-old male with a persistent superior vena cava thrombosis related to an infected permanent pacemaker lead transvenous extraction. Clinical and surgical management are discussed.
Delivery of intravenous treprostinil at low infusion rates using a miniaturized infusion pump in patients with pulmonary arterial hypertension
Authors: Tapson V.F. , Mclaughlin V.V. , Gomberg-Maitland M. , Widlitz A.C. , Krichman A.D. , Laliberte K.J. , Zaccardelli D.S. , Barst R.J.
Published: January 2018

Purpose

Treprostinil is approved for the treatment of pulmonary arterial hypertension (PAH) via continuous intravenous (IV) infusion. Treprostinil's anti-platelet aggregation characteristics and stability at room temperature may allow for low infusion rates (0.1–0.2 mL/hr) using a miniaturized infusion pump.

Methods

A 12-week, multi-center, open-label study in 12 adult PAH patients, evaluated the feasibility and safety of low-flow IV treprostinil administration via the 407C miniaturized pump. Patients receiving IV treprostinil at a stable dose were transitioned from their current CADD-Legacy pump to the 407C and were assessed for adverse events including catheter occlusions, pump alarms, and efficacy (six minute walk distance (6MWD), Borg Dyspnea Score (BDS), NYHA functional class, and PAH signs/symptoms). All patients were also maintained on therapeutic doses of warfarin, heparin or low molecular weight heparin throughout the study.

Results

Baseline mean (±SD) 6MWD was 477 ± 76 m (n = 9) with mean BDS of 2.1 ± 1.2 (n = 9). Week 12 mean 6MWD and BDS were 500 ± 92 m and 2.3 ± 1.7, respectively (n = 9). Four patients discontinued the study prematurely (3 AEs and 1 consent withdrawn). Adverse events included headache, flushing, and nausea. Pump complications occurred in 5 of 12 patients, and although no catheter occlusions occurred in any patient during the 12-week study, further study is needed regarding pump complications.

Conclusion

This study demonstrates that treprostinil can be administered intravenously at infusion rates as low as 0.1 mL/hr for 12 weeks without catheter occlusions. Further studies are warranted because the potential for adverse events is of some concern.
Dislocation of central venous catheters in pediatric patients
Authors: Giretti R. , Caruselli M. , Zannini R. , De Vivo E. , Piattellini G. , Bechi P. , Catani F. , Amici M. , Santelli F. , Pagni R.
Published: January 2018

Children have limited venous access possibilities; therefore, when long-term therapy is necessary, it is better to place a catheter in a central vein. The Port catheter, totally implanted, is less exposed to the risk of infection and permits a normal life. However, there is the possibility of the displacement or fragmentation of the catheter that can be diagnosed initially only by clinical symptoms and later by a chest X-ray. We report a case of disconnection between the Port catheter and the reservoir resulting in catheter migration to the left pulmonary artery.
Pulmonary atheroembolism via an AV shunt
Authors: Kono Y. , Takizawa H. , Yamaji I. , Takada T. , Shinohara T. , Tanaka S. , Mcgill R.L.
Published: January 2018

Although cholesterol crystal embolism can present with diffuse visceral involvement, lung lesions do not occur unless there is left to right circulatory shunting. Pulmonary atheroembolism was confirmed by histology in an elderly male with recent end-stage renal failure (ESRF) due to atheroembolic renal disease, who presented with massive hemoptysis and intractable respiratory failure. At autopsy, atheromatous degeneration of the aorta was observed and acute cholesterol emboli found in the kidneys, spleen, liver, stomach and lung. Cholesterol clefts were seen in pulmonary arterioles, and ischemic alveolar damage was present. The pulmonary arteries had no atheromatous changes. Intrapulmonary, intracardiac, and aorto-caval shunting were not present. Pulmonary atheroembolism arising from a dialysis fistula has not been previously reported.
YouTube, ageing and PJ Harvey: An ‘everyday’ story of the erasure of age
Authors: Gardner Abigail Sara
Published: January 2018

Ageing is starting to matter in popular cultural studies but the matter of ageing within YouTube is, at present, unwritten. This article is an attempt to start that process. YouTube hosts the music video for PJ Harvey’s single release The Community of Hope (2016) . Shot by Seamus Murphy, it shares screen space with official music videos from Harvey’s 23-year career. Raising questions about the relationship between her past and present, this article examines the link between YouTube and ageing through two concepts, repetitive circularity and the flat archive. These rely and inform each other in a process that prioritizes the presence of youthfulness through the absenting of age, whereby the ageing body is erased from a popular cultural forum. YouTube’s ‘wallpaper of the past’ has a nagging impact on how we might read the body’s progress through time, in particular, how it ages. Tackling the paucity of work on ageing as it surfaces within the changing topographies of popular music encounters, the article considers how ageing is presented within a digital environment such as YouTube and concludes that the story is one of age erasure.
Make, share, review, remix: Unpacking the impact of the internet on contemporary creativity
Authors: Literat Ioana
Published: January 2018

This article advances a holistic framework that aims to facilitate a better understanding of the nuanced impact of the internet on contemporary creative participation. Functioning simultaneously as the context, locus, and medium for creative activity, the internet affects each stage in the life cycle of a creative product – creation, distribution, interpretation, and remix. In addition, this influence is felt in a wide range of creative products: off-line and online, professional and vernacular. Previous research has not examined these different processes and types of creative output in conversation with each other; by advancing an integrative analytical approach and synthesizing research from multiple domains, this work attempts to address this gap. As a way to illuminate this impact and demonstrate the value of the proposed framework, the article applies this framework to three case studies: a work of off-line art ( The Artist Is Present), online art ( Moon), and online nonart or vernacular online creativity (Pepe the Frog memes). This analysis facilitates a deeper understanding of these interrelated processes, attends to the complex ways in which new media blurs the borders between those categorizations, and discusses the potential implications of these complex contemporary dynamics.
Mothers’ opinions on being asked about exposure to intimate partner violence in child healthcare centres in Sweden
Authors: Almqvist Kjerstin , Källström Åsa , Appell Petra , Anderzen-Carlsson Agneta
Published: January 2018

Intimate partner violence (IPV) constitutes a hidden health risk for exposed mothers and children. In Sweden, screening for IPV in healthcare has only been routine during pregnancy, despite an increase in IPV following childbirth. The arguments against routine questions postpartum have concerned a lack of evidence of beneficial effects as well as fear of stigmatizing women or placing abused women at further risk. Increased understanding of women’s attitudes to routine questions may allay these fears. In this study, 198 mothers in 12 child healthcare centres (CHCs) filled in a short questionnaire about their exposure and received information on IPV at a regular baby check-up visit. The mothers’ lifetime prevalence of exposure to IPV was 16%. One hundred and twenty-eight mothers participated in a telephone interview, giving their opinion on the screening experience. The intervention was well-received by most of the mothers who reported that questions and information on IPV are essential for parents, considering the health risks for children, and that the CHC is a natural arena for this. Necessary prerequisites were that questioning be routine to avoid stigmatizing and be offered in privacy without the partner being present.
Methodologies for the airbrush application of MALDI matrices
Authors: Warren Alexander D , Mitchell David J , Gates Paul J
Published: January 2018

There is still a need to develop reliable and robust matrix deposition methods for matrix-assisted laser desorption/ionisation mass spectrometry that are applicable to a range of matrices, solvents and analyte types. This paper presents a robust methodology for the airbrush application of matrices along with the implications of varying the set-up and airbrush parameters. A small number of organic analytes and metal salts are analysed in both positive and negative ion modes to exemplify this methodology. In the analyses with the airbrush deposited matrices, performance was enhanced when compared to standard pipette deposition with the need for a search for sweat spots greatly diminished due to the increase homogeneity of the matrix surface and resultant analyte spots. As expected, the graphite matrices were shown to specifically outperform the organic matrices in negative ion mode.
Riddle Me This: Using Riddles That Violate Gender Stereotypes To Demonstrate The Pervasiveness Of Stereotypes
Authors: Skorinko Jeanine Lee McHugh
Published: January 2018

This paper describes a classroom demonstration that showcases how pre-existing beliefs (e.g., stereotypes) influence problem-solving. Across four studies, participants solved riddles with gender stereotype-consistent (e.g. doctor is male) or gender stereotype-inconsistent (e.g., doctor is female; barber is female) solutions. Solve time, perceived difficulty, and perceptions of the demonstration and how it influenced learning were measured. Studies 3 and 4 extended Studies 1 and 2 by measuring objective learning through a quiz on gender stereotypes and bias. Results indicate that students solved the stereotype-inconsistent riddles slower than stereotype-consistent riddles. Stereotype-inconsistent riddles were rated as more difficult to solve than stereotype-consistent riddles. Subjectively, participants perceived the demonstration to be an effective tool, enhancing their knowledge about gender stereotypes. Objectively, participants performed better on the quiz when they solved stereotype-inconsistent riddles than stereotype-consistent riddles. These findings suggest that using stereotype-inconsistent riddles in class can help understanding about gender stereotypes and bias.
Abrasive jet drilling of glass sheets: Effect and optimisation of process parameters on kerf taper
Authors: Nassef Ahmed , Elkaseer Ahmed , Abdelnasser El Shimaa , Negm Mohamed , Qudeiri Jaber Abu
Published: January 2018

This article reports an investigation of the influence of process parameters on the obtainable dimensional accuracy when drilling glass using abrasive jet machining. In particular, holes were drilled out of glass sheets, and the effects of standoff distance, nozzle diameter, particle grain size and applied pressure on the kerf taper were examined. An artificial neural network technique was used to establish a precise model of kerf taper as a function of the process parameters. The proposed model was then optimised, and the conditions to minimise the kerf taper were identified using a genetic algorithm. The results revealed that standoff distance has a major effect on kerf taper, and it proved possible to substantially reduce the kerf taper by applying an axial feed to the nozzle so that the standoff distance is kept constant during the machining process.
Experimental investigation of the heat and mass transfer phenomena in a counterflow wet cooling tower with foam ceramic packing
Authors: Kong Qing Jie , Zhao Xue Yi , Xie De Qiang , Zhang Ben , Wang Pei
Published: January 2018

This article deals with an experimental investigation of coinstantaneous heat and mass transfer phenomena between water and air in a counterflow wet cooling tower filled with a new type packing named “FCP-08.” The packing consisted of foamed ceramic corrugated board with sine waves, surface retention groove is 1.0 m high, and it has a cross-sectional test area of 0.68 m × 0.68 m. This investigation is focused mainly on the effect of the water–air mass flow ratio on the heat and mass transfer characteristics of the cooling tower, for different inlet water temperatures. The results show that the cooling water range, [Formula: see text], and the cooling tower efficiency, [Formula: see text], decrease with the increase in water–air mass flow ratio, [Formula: see text]. Meanwhile, the heat rejected by the cooling tower, [Formula: see text], increases with the increase in the water mass flow rate. The cooling characteristic coefficient, [Formula: see text], slightly decreases with the increase in water–air mass flow ratio and the value is obviously higher than that of other packing investigated before. The relationship between the cooling characteristic coefficient and water–air mass flow ratio is obtained by linear fitting. The comparison between the obtained results and those found in the literature for other types of packing indicates that cooling performance of the tower with foam ceramic packing is better.
Serum HER-2 Extracellular Domain: Relationship with Clinicobiological Presentation and Prognostic Value before and after Primary Treatment in 701 Breast Cancer Patients
Authors: Saghatchian M. , Guepratte S. , Hacene K. , Neumann R. , Floiras J.-L. , Pichon M.-F.
Published: January 2018

Purpose

To determine the clinical correlations and prognostic value of serum HER-2 (sHER-2) before and after primary breast cancer treatment.

Methods

sHER-2 from 701 consecutive patients with stage I-III tumors (median follow-up 7.7 years) was assayed by an enzyme-linked immunosorbent assay (Immuno 1, Bayer Diagnostics).

Results

The median pretreatment sHER-2 concentration was 8.30 ng/mL (range 3.15–82.00 ng/mL). Forty-seven patients (6.7%) had sHER-2 concentrations >12 ng/mL (cutoff level). Pretreatment sHER-2 correlated positively with CA 15.3 (p=0.0169), pathological tumor size (p=0.0082), number of invaded lymph nodes (pN, p=0.0160) and histological grading (p=0.0086). Kaplan-Meier analyses indicated that pretreatment sHER-2 was of prognostic value for contralateral breast cancer (p=0.0018), metastasis-free survival (MFS) (p=0.0008) – particularly lung (p=0.0082) and liver metastases (p=0.0035) – and overall disease-specific survival (DSS) (p=0.0020). According to pN status, pretreatment sHER-2 was of prognostic value only for pN-positive patients (p=0.0017). When combined with estradiol or progesterone receptor status, patients with elevated sHER-2 and receptor-negative tumors had a significantly shorter DSS (p<0.0001 for both receptors). Post-treatment sHER-2 also had individual prognostic value for MFS (p=0.0144) and DSS (p=0.0212). In multivariate analysis, only sHER-2 after primary treatment was an independent prognostic variable for MFS and DSS (p=0.0078 and p=0.0058, respectively).

Conclusion

sHER-2 elevation in early breast cancer correlates with the principal criteria of tumor aggressiveness, thus permitting selection of patients with a high risk of visceral metastases and contralateral breast tumors. Post-treatment sHER-2 is an independent prognostic factor enabling to identify patients likely to benefit from aggressive adjuvant treatments.
Gene Transcript Assay by Real-Time Rt-PCR in Epithelial Breast Cancer Cells Selected by Laser Microdissection
Authors: Becette V. , Vignaud S. , Régnier C. , Labroquère M. , Fourme E. , Menet E. , Bièche I. , Spyratos F.
Published: January 2018

The cell type heterogeneity within clinical cancer tissue samples may affect the accuracy of gene expression analysis. In order to validate our laser microdissection (LMD) method using the Leica AS LMD system (LEICA Microsystems), we compared the mRNA levels of three major genes involved in breast cancer (ERα, PR, HER2), measured by means of real-time quantitative RT-PCR, in 5000 microdissected malignant epithelial cells and in corresponding bulk tumor ho-mogenates from 14 patients. We also compared the mRNA level results to protein expression measured by immunohistochemistry (IHC) on the same tumors. For the three genes, significant correlations were found between mRNA results obtained on microdissected cells and IHC. Comparison between IHC and mRNA results obtained on microdissected cells and bulk tumors showed that in all cases microdissection enhanced the sensitivity of assessing target gene transcript levels and was essential for their accurate evaluation in heterogeneous tumors.
Improvement of Liver Cancer Detection with Simultaneous Assessment of Circulating Levels of Free Alpha-Fetoprotein (AFP) and Afp-Igm Complexes
Authors: Beneduce L. , Castaldi F. , Marino M. , Tono N. , Gatta A. , Pontisso P. , Fassina G.
Published: January 2018

We assessed the presence of alpha-fetoprotein (AFP) complexed with IgM (AFP-IgM IC) in serum of patients affected by hepatocellular carcinoma (HCC), cirrhosis and chronic hepatitis as well as in healthy subjects by means of a dedicated ELISA assay. The amount of AFP-IgM IC was expressed in arbitrary units (AU) on a reference standard curve. Free AFP (FAFP) levels were determined in parallel in each sample by means of an automated immunoassay system. The mean serum concentration of AFP-IgM IC was significantly higher in HCC patients (mean ± SD: 1378.3 ± 2935.7 AU/mL) than in cirrhotic patients (129.8 ± 261.4 AU/mL) and in patients with chronic hepatitis (80.9 ± 168.9 AU/mL) (p<0.01). HCC patients had FAFP values above the 20 ng/mL cutoff in 44% of cases (22/50) and AFP-IgM IC values above the 120 AU/mL cutoff in 60% of cases (30/50). The occurrence of the free and IgM-complexed form of circulating AFP did not overlap, and 82% of patients (41/50) were positive for at least one marker. The results indicate that AFP-IgM IC is a complementary serological marker to FAFP and that the combination of these biomarkers may be useful in the diagnosis of liver cancer.
Are plasma Insulin-Like Growth Factor I (IGF-I) and Igf-Binding Protein 3 (Igfbp-3) Useful Markers of Prostate Cancer?
Authors: Lopez J.B. , Sahabudin R.M. , Chin L.P.
Published: January 2018

Increased concentrations of insulin-like growth factor I (IGF-I) and decreased insulin-like growth factor binding protein 3 (IGFBP-3) in serum have been proposed as markers of prostate cancer (CaP). The evidence for this, however, is contradictory. We assayed serum for IGF-I, IGFBP-3 and prostate-specific antigen (PSA) in patients with CaP and benign prostatic hyperplasia (BPH) and in healthy controls (HC). The mean ± SD concentration of IGF-I in CaP (98.3 ± 39.3 ng/mL; n=15) was lower than in BPH (119 ± 31.1 ng/mL; n=24) and HC (119 ± 36.1 ng/mL; n=46), but the differences between the three groups were not statistically significant (p>0.05). The mean IGFBP-3 concentrations in CaP (2691 ± 1105 ng/mL; n=16; p=0.029) and BPH (2618 ± 816 ng/mL; n= 26; p=0.006) patients were significantly lower than that of the HC (3119 ± 618 ng/mL; n=59), but the difference between the two groups of patients was not significant (p>0.05). PSA concentrations in CaP (median=80.8 ng/mL; n=25) were significantly higher than those in BPH (median=8.6 ng/mL; n=39) (p<0.001). Ninety-six percent of CaP and 72% of BPH patients had PSA concentrations >4.0 ng/mL; the proportions of patients with concentrations exceeding 20 ng/mL were 76% and 10%, respectively. We conclude that IGF-I and IGFBP-3 are inferior to PSA for CaP detection.
Can IL-2R Alpha be a Valuable Marker along with Ca 19–9 in the Diagnosis of Chronic Pancreatitis and Pancreatic Cancer?
Authors: Kayhan B. , Kayhan B. , Akdoğ;an M.
Published: January 2018

Background

Pancreatic cancer is characterized initially by non-specific abdominal symptoms followed by rapid tumor progression. Although chronic pancreatitis is a benign disorder, it can be one of the causative factors of pancreatic cancer. The level of the tumor marker carbohydrate antigen 19–9 (CA 19–9) in pancreatic cancer does not correlate with the stage of the neoplasm. Soluble interleukin 2 receptor (sIL-2R) is a cytokine that shows increased levels during some inflammatory processes and malignant disorders.

Aim

Our aim in this study was to investigate whether sIL-2Rα levels can be used in association with CA 19–9 in the early diagnosis of pancreatic cancer and chronic pancreatitis.

Patients

Serum samples were obtained from the blood of 21 pancreatic cancer patients without distant metastasis who were deemed inoperable, 16 chronic pancreatitis patients and 20 normal volunteers.

Results

We did not find any significant differences in CA 19–9 levels between normal controls and patients with chronic pancreatitis. There was a significant difference in the levels between the control group and the pancreatic cancer group (p=0.003) and between patients with chronic pancreatitis and those with pancreatic cancer (p=0.004). Although there was no significant difference in sIL-2Rα levels between the control group and the patient groups, we found a slight correlation between sIL-2Rα and CA 19–9 levels in the pancreatic cancer group (p=0.003, r=0.623) and a more marked correlation in the chronic pancreatitis group (p<0.01, r=0.751).

Conclusion

According to our results, sIL-2Rα alone is not a good candidate marker in the diagnosis of pancreatic cancer; it can, however, be used in association with CA 19–9 for this purpose.
Circulating Levels of Vegf-A, VEGF-D and soluble VEGF-A Receptor (sFlt-1) in Human Breast Cancer
Authors: Hoar F.J. , Lip G.Y.H. , Belgore F. , Stonelake P.S.
Published: January 2018

As circulating levels of vascular endothelial growth factor (VEGF-A) are raised in malignancy, the aim of this study was to investigate whether similar changes occur in two related factors, VEGF-D and the soluble VEGF-A receptor Flt-1 (sFlt-1). Circulating levels of VEGF-A, VEGF-D and sFlt-1 were determined by ELISA in 51 patients with primary breast cancer and matched healthy controls. Results were correlated with clinicopathological data.

Whilst there was a difference in VEGF-A levels between patient and control groups (p=0.03), no such difference was observed for sFlt-1 or VEGF-D levels and there was no association between individual factors and the clinicopathological variables examined. However, there was a positive correlation between VEGF-A and sFlt-1 levels in both patient and control groups (p<0.0001). In addition, the ratio of sFlt-1 to VEGF-A was significantly different between patients and controls (p<0.0001) and was also associated with tumour size (p=0.01) within the patient group.

During tumour progression there is a change in the relative amounts of sFlt-1 and VEGF-A in the circulation. Measuring the sFlt-1:VEGF-A ratio may have more significance than VEGF-A alone and further studies are needed to determine whether the ratio is of use as a prognostic marker or as a means of monitoring response to anti-angiogenic therapy in cancer.
Evaluation of Reactive oxygen Metabolites in Frozen Serum Samples. Effect of Storage and Repeated Thawing
Authors: Cavalleri A. , Colombo C. , Venturelli E. , Miceli R. , Mariani L. , Cornelli U. , Pala V. , Berrino F. , Secreto G.
Published: January 2018

Measuring the free radical activity in serum samples from prospective studies is the best way to investigate the association between oxidative stress and human diseases. Prospective studies require the analysis of serum samples that have often been stored for a long time. Our study was designed to determine the effect of storage at –30°C and –80°C for two years on free radical activity. We analyzed the free radical activity by measuring circulating hydroperoxides in a pool of sera at baseline and after one day, one week, one month and 25 months of storage, using a photometric method (d-ROMs test). Measurements were performed in aliquots thawed only once at each time point and in aliquots frozen and thawed repeatedly over the study period. After two years we observed a small but statistically significant 4% decrease in the hydroperoxide concentration, which was substantially unaffected by storage temperatures and repeated freeze-thaw cycles. We also carried out the d-ROMs test in sera from ten apparently healthy volunteers at 2, 8, 24, and 48 hours after collection and storage at 4°C and did not observe any significant variation. In conclusion, the d-ROMs test is a simple method suitable to evaluate the free radical activity in frozen serum samples after long-term storage.
Membranous Levels of C-Erbb-2 Oncoprotein in Gastric Cancer: Their Relationship with Clinicopathological Parameters and Their Prognostic Significance
Authors: Vizoso F.J. , Corte M.D. , Alvarez A. , García I. , del Casar J.M. , Bongera M. , Gonzílez L.O. , García-Muñiz J.L. , Allende M.T.
Published: January 2018

Background

The protein encoded by the c-erbB-2 gene is a membrane receptor expressed in a variety of solid human cancers and directly related to poor prognosis. The objective of this work was to evaluate the clinical value of the quantification of membranous oncoprotein levels in gastric cancer.

Materials and methods

Membranous c-erbB-2 levels were examined by means of a sandwich immunoenzymatic assay in 82 patients with gastric cancer. The median follow-up period for these patients was 16 months. In addition, c-erbB-2 expression was analyzed by immunohistochemistry in 57 gastric carcinomas.

Results

Membranous c-erbB-2 levels ranged widely in the studied tumors (44–112,000 NHU/mg protein). Median c-erbB-2 content was significantly higher in intestinal-type tumors than in diffuse-type tumors (p=0.01). In addition, high levels of c-erbB-2 were significantly associated with shorter relapse-free survival and overall survival in patients with resectable gastric carcinomas (p=0.01 and p=0.04, respectively). However, the correlation between immunohistochemistry and ELISA determinations did not reach statistical significance.

Conclusion

Our results suggest a potential prognostic value of membranous c-erbB-2 quantification by immunoenzymatic assay in gastric cancer. However, its possible role in the selection of patients with a view to the possible introduction of Herceptin as a novel drug against gastric cancer is at present uncertain.
Trimodal GSTT1 and GSTM1 Genotyping Assay by Real-Time PCR
Authors: Girault I. , Lidereau R. , Bièche I.
Published: January 2018

The GSTT1 and GSTM1 genes are characterized by the existence of a GST*0 null allele responsible for a lack of enzyme activity, with the respective null genotypes GSTT1*0/0 and GSTM1*0/0. The three resulting genotypes (GSTs*1/1, *1/0 and *0/0) are associated with a trimodal distribution of glutathione-conjugator activity. Previous epidemiological studies have only evaluated the cancer risk associated with the GST null genotype relative to the two GST carrier geno-® types (GSTs1*1/1 and *1/0). We developed GSTT1 and GSTM1 TaqMan real-time quantitative PCR assays to discriminate each of the three genotypes, with the albumin gene (ALB) as reference. The mean NGSTT1*1/1 value was 1.0 (95% confidence interval 0.80–1.20). The mean NGSTT1*1/0 value was 0.48 (95% CI 0.36–0.60). One (3.4%) of the 29 DNA samples yielded the GSTM1*1/1 genotype (NGSTM1*1/1 = 1), a frequency in keeping with the Hardy-Weinberg distribution. The mean NGSTM1*1/0 value was 0.50 (95% CI 0.42–0.58). All GSTT1*0/0 and GSTM1*0/0 samples yielded NGST values of 0 (Ct = 40); the frequencies of these genotypes (27.6% and 55.2%, respectively) were in keeping with published data. The GSTT1 and GSTM1 real-time PCR assays described here unambiguously discriminate each of the three existing genotypes which should be valuable for assessing the relative risk of cancer associated with each of the three GST genotypes.
Cytofluorimetric Evaluation of DNA Ploidy in Lung Cancer: A Bronchoscopic Study
Authors: Oliani C. , Barana D. , Cazzadori A. , Zanolin E. , Santo A. , Pasini F. , Padovani M. , Mazzini G. , Cetto G.L.
Published: January 2018

The study of the biological characteristics of lung cancer is gaining more and more interest both because of their potential role as prognostic indicators and for therapeutic reasons. The DNA content estimated by flow cytometry in surgical samples of non-small cell lung cancer (NSCLC) has already been demonstrated to be correlated with survival in these patients. From July 1990 to February 1992 we analyzed the DNA distribution of bronchoscopic biopsies from 88 patients with lung cancer (18 small cell lung cancer, SCLC, and 68 NSCLC, two unspecified histology). Twenty-eight tumors (34.6%) had a diploid DNA distribution, while 53 were aneuploid (65.4%). A correlation was found between DNA ploidy and survival. Evaluation of the DNA content in bronchoscopic samples in a large series of patients could determine the role of this analysis prior to surgery in NSCLC and its value as a marker with respect to prognosis and response to therapy in SCLC.
Is it Possible to Provide a Prognosis after Radical Prostatectomy for Prostate Cancer by Means of a Psa Regression Model?
Authors: May M. , Gunia S. , Helke C. , Braun K.P. , Pickenhain S. , Hoschke B.
Published: January 2018

Background

For over 15 years, studies have been done to evaluate the elimination kinetics of the prostate-specific antigen (PSA) after radical prostatectomy. Even though evaluation of PSA regression in the two-compartment model has become established, no clear data are currently available as to whether a statement can be made with regard to tumor prognosis from a computation of the PSA half-life (PSA-HL). This study focuses on the determination of the PSA-HL in the two-compartment model and on its correlation with the biochemical recurrence-free survival. In addition, a computer program is being developed to simplify the determination of PSA-HL.

Material and methods

Seventy-seven prospective patients were examined who subsequently had a radical prostatectomy at our facility without neoadjuvant or adjuvant hormone deprivation. In addition to preoperative measurement of the PSA value (d0), PSA determinations were carried out postoperatively on days 5, 10 and 60, and at four-monthly intervals thereafter (mean follow-up: 16 months). By means of the computer program developed for this purpose, CTK. TumW, the PSA half-lives for the first (d0–d5, PSA-HL1) and second (d5–d10, PSA-HL2) compartments were subsequently determined and their effect on biochemical recurrence-free survival was assessed.

Results

PSA-HL1 and PSA-HL2 were 1.89 (± 0.03) and 3.39 (± 0.14) days, respectively. Whilst PSA-HL1 did not permit any prognostic statement, the median PSA-HL in the second compartment between patients with and without disease progression differed significantly (4.44 versus 3.12 days; p<0.001). Discrimination analysis produced a cutoff of 3.8 days for the second compartment; patients with a PSA-HL2 ≥3.8 days had a significantly worse biochemical recurrence-free survival after 18 months than the other patients (27% versus 93%; p<0.001).

Conclusion

The PSA regression kinetics after radical prostatectomy follows a two-compartment model in which the prognostic value of the PSA-HL1 is limited. When a cutoff of 3.8 days is used, evaluation of the PSA-HL in compartment 2 (d5–10) appears to permit a prognostic statement. Due to the limited postsurgical follow-up, the disease process was only assessed as biochemical recurrence-free survival, and a longer follow-up will be necessary to generate data on progression-free survival.
Phenotype of Peripheral Blood Leukocytes and Survival of Patients with Metastatic Colorectal Cancer
Authors: Veselý P. , Touškoví M. , Melichar B.
Published: January 2018

Immune dysfunction is prevalent in metastatic cancer. Few patients with colorectal cancer metastases are cured, and among the strategies aimed at improving the therapeutic results in patients with metastatic colorectal cancer, immunotherapy is being increasingly investigated. We evaluated retrospectively the prognostic significance of peripheral blood leukocytes in 59 patients with metastatic colorectal cancer. The relative numbers of CD3+, CD3+CD4+, CD3+CD8+, NK (CD3-CD16+CD56+), CD3+DR+, CD3+CD25+, CD3+CD69+, CD19+, CD19+CD23+, CD8+CD28+, CD8-CD28+, CD8+CD57+, CD14+DR+ and CD14+CD16+ leukocytes were analyzed by two-color flow cytometry. A three-step approach was adopted to identify predictors of prognosis using regression analysis. Based on the results of univariate survival analysis, the absolute number of white blood cells, NK/CD3+CD69+ and NK/white cell count ratios were significant indicators of prognosis. In the multivariate regression analysis a model was obtained using a single parameter, the NK/CD3+CD69+ ratio, predicting the survival with 10–15% power of regression. The present results indicate that the NK/CD3+CD69+ ratio in peripheral blood may be an independent variable in a regression model predicting the overall survival of patients with colorectal cancer metastases to be tested in prospective studies.
Comparison between Two Methods in the Determination of Circulating Chromogranin A in Neuroendocrine Tumors (NETs): Results of a Prospective Multicenter Observational Study
Authors: Leon A. , Torta M. , Dittadi R. , Uberti E. degli , Ambrosio M.R. , Fave G. Delle , De Braud F. , Tomassetti P. , Gion M. , Dogliotti L.
Published: January 2018

Several methods for analyzing CgA using either monoclonal or polyclonal antibodies have been developed, which differ in their diagnostic performance. The present paper describes the results of a prospective multicenter study aimed at comparing the clinical value of the two most widely used commercially available CgA assay kits in patients affected by neuroendocrine tumors (NETs). Two hundred sixty-one patients from 40 different centers and 99 healthy subjects were evaluated. CgA levels were measured with two different methods, a two-step immunoradiometric assay (IRMA) and an enzyme-linked immunosorbent assay (ELISA). CgA was measured centrally by two reference laboratories, one of which used IRMA and the other ELISA, and it was measured by the participating institutions with the method routinely used by each of them. The major findings of the present study were: (i) the two assays for the determination of CgA present good diagnostic performance; (ii) both assays are robust and guarantee comparable results when applied in different settings (central vs local laboratory); (iii) the negative/positive cutoff points (87 ng/mL for IRMA and 21.3 U/L for ELISA) were established according to standardized criteria; (iv) the results obtained with the two assays in basal clinical samples of patients affected by NETs show an apparently satisfactory correlation (rs=0.843, p<0.0001). However, a possibly clinically meaningful 36% discordance rate was found. These findings support the hypothesis that the two CgA kits might provide partially different information.
Chemokines as Markers for Parasite-Induced Inflammation and Tumors
Authors: Trakatelli C. , Frydas S. , Hatzistilianou M. , Papadopoulos E. , Simeonidou I. , Founta A. , Paludi D. , Petrarca C. , Castellani M.L. , Papaioannou N. , Salini V. , Conti P. , Kempuraj D. , Vecchiet J.
Published: January 2018

Chemokines are a group of small secreted proteins (8–10 kDa) produced and released by a wide variety of cell types. They were originally described as mediators of leukocyte recruitment, which is essential in acute and chronic inflammation. They also play a critical role in many pathophysiological processes such as allergic responses, infections and autoimmune diseases, tumor growth and hematopoietic development. This review introduces the three supergene families of chemokines (CXC, CC and C) with emphasis on their important role in different states in humans and in animal models with parasitic diseases. The concentration of transcription and translation of the cytokines and chemokines in the parasitic diseases may be an important marker for evaluation of the inflammatory state.
Human Papillomavirus (Hpv) Typing in Relation to ras Oncogene mRNA Expression in HPV-Associated Human Squamous Cervical Neoplasia
Authors: Mammas I.N. , Zafiropoulos A. , Sifakis S. , Sourvinos G. , Spandidos D.A.
Published: January 2018

Objective

Human papillomavirus (HPV) has been identified as the principal etiologic agent for cervical cancer and its precursors. Different HPV types have been associated with different oncogenic potential. The purpose of this study was to evaluate the relationship between specific HPV type infection and expression pattern of the ras family oncogenes in different grades of HPV-associated human cervical neoplasia.

Methods

HPV typing was performed using polymerase chain reaction (PCR) in 31 HPV-positive human cervical specimens from patients with squamous intraepithelial lesions (SIL) or squamous cervical carcinoma (SCC). The mRNA expression levels of H-, K- and N-ras oncogenes were examined using the reverse transcriptase polymerase chain reaction (RT-PCR) technique. Statistical analyses were performed using SPSS software.

Results

Among patients with SCC, H-, K- and N-ras expression levels were higher in HPV 16/18-associated cases compared to HPV 16/18-unassociated samples (p=0.003, p=0.004 and p=0.0001, respectively). The expression levels for H-, K-and N-ras were significantly higher in SCC patients with multiple HPV infection compared with SCC patients with single HPV infection (p=0.009, p=0.01 and p=0.021, respectively). Among patients with SIL, no statistically significant relationship was found between ras expression and HPV status.

Conclusion

Our findings indicate the possible role of ras signaling interaction with “high-risk” HPV 16/18 and multiple HPV infection in cervical cancer development.