bluuebunny/crossref_metadata_2025 huggingface dataset:
A Phase I Study of Recombinant Interleukin 2 in Melanoma Patients. Toxicity and Clinical Effects
Authors: Marolda Raffaele , Belli Filiberto , Prada Augusto , Villani Fabrizio , Gambacorti-Passerini Carlo , Galazka Andrew , Parmiani Giorgio , Cascinelli Natale
Published: April 2018

Toxicity and clinical effects of a new brand of recombinant interleukin 2 (rIL2, Bioleukin™, Biogen, Geneva) were evaluated by a phase I study in 12 patients with stage III melanoma. Escalating doses from 100 μg/m2 to 800 μg/m2 were administered thrice a day with bolus injections given via a peripheral venous catheter for up to a maximum of 7 days. All patients showed malaise, fever and chills and mild gastrointestinal side effects. A modest electrolyte imbalance (hypocalcemia and hypokalemia) was detected in all 12 patients. Renal toxicity as judged by serum creatinine was not observed, and hepatic toxicity was moderate with the possible exception of one patient who had an unclear previous history of liver dysfunction. Mild, transient leukopenia was found in several patients, whereas thrombocytopenia developed in 4 patients; no anemia was observed. Cutaneous rash was seen in half of the patients treated. Fluid retention was minimal, with a weight gain associated to treatment that never exceeded 10% of pretreatment body weight. Electrocardiographic alterations developed in 2 patients in the form of ventricular and supraventricular extrasystoles. In 2 patients given the highest dose of rIL2, a significant reduction in transfer lung factor for carbon monoxide was seen, indicating alterations in pulmonary functions. Other dose-related toxicities were thrombocytopenia and malaise. All side effects disappeared 2-3 days after the end of rIL2 administration. No major responses were seen in association with the 4-8 days of treatment given in this study.
High-Dose Medroxyprogesterone in Disseminated Breast Cancer. Correlation between Bioavailability and Clinical Response
Authors: Fornasiero Adriano , Morandi Paolo , Daniele Otello , Ghiotto Cristina , Aversa Savina M.L. , Battaglia Angelo , Fosser Vincenzo , Fiorentino Mario V.
Published: April 2018

Clinical response to high-dose medroxyprogesterone (MPA), administered following three different routes of administration (i.m., p.o.+i.m., p.o.) and monitoring drug plasma levels, was evaluated in pretreated advanced breast cancer patients. Fifty-eight of 68 eligible patients were considered evaluable for response. Age ranged between 36 years and 82 years. Fifty-six of 58 evaluable patients were postmenopausal. An overall remission rate of 48% was achieved with i.m. MPA, 50% with combined (i.m. + p.o.) modalities; only a 19% remission rate was recorded in the p.o. group Response rate and MPA plasma concentrations were correlated, and a drug level of 80 ng/ml, by means of a GLC method, seems to identify a subset of patients with high probability of response. Only mild toxic effects were recorded.
Changes in Chemosensitivity of K 562 Leukemia Cells after Induction of Erythroid Differentiation by Hemin
Authors: Toffoli Giuseppe , Lorico Aurelio , Boiocchi Mauro
Published: April 2018

The human leukemia cell line K 562, when treated with subcytotoxic doses of hemin, undergoes reversible erythroid commitment, as shown by the increased synthesis of hemoglobin. Hemin-treated cells maintain replicative capabilities, although perturbations in cell cycle kinetics are induced. K 562 cells were used to investigate changes in antitumor drug sensitivity as a consequence of cell differentiation induced by hemin treatment. K 562 leukemia cells, cultured in the presence of 20 μM hemin for 12 days, were treated with non-phase-specific (adriamycin, 4-OOH-cyclophosphamide, mitomycin C, bleomycin, cis-diamminedichloro platinum) and phase-specific (vincristine, methotrexate and 5-fluorouracil) antitumor drugs. The results obtained by chemosensitivity tests showed a generalized decrease in chemosensitivity of the K 562 cells to all the drugs tested as a consequence of the hemin-induced differentiation.
Parafollicular C-Cell Hyperplasia. Report of Three Cases in Primary Thyroid Lymphomas
Authors: Montesco Maria Cristina , Pinarello Antonella , Ninfo Vito
Published: April 2018

Three cases of C-cell hyperplasia were observed in a series of 21 cases of primary thyroid lymphoma (PTL). The association is not well understood, since PTL is not included in the group of thyroid diseases which are known to cause C-cell hyperplasia. It may be interpreted as a compensatory reaction to diffuse and rapid destruction of most of the gland, or a « stimulation » related to the production of « bio-humoral » factors by neoplastic cells.
Radioligand-Labeled Binding Assay and Immunochemical Assay for Estrogen Receptor in 115 Human Breast Cancers
Authors: Riccobon Angela , Zoli Wainer , Capucci Antonella , Volpi Annalisa , Vasini Mara , Bonaguri Chiara , Flamini Emanuela , Ravaioli Alberto , Amadori Dino
Published: April 2018

The aim of this study was to evaluate the results obtained from a new enzyme immunoassay (Abbott-ER-EIA) for the determination of estrogen receptor levels in tumor cytosols in comparison with the currently used DCC method. One hundred and fifteen consecutive primary breast cancer specimens were examined; 66 of the women were postmenopausal and 49 were premenopausal. A good correlation (r = 0.88, p < 0.001 and a slope of 1.3) was found between ER-EIA and the steroid binding assay (DCC). When these data were analyzed according to menopausal status, no differences were observed for the slopes and correlation coefficients in pre’ and postmenopausal groups. The ER-EIA appears to produce results comparable to those obtained with the conventional DCC method for the determination of ER in breast tumor cytosols.
Paget's Disease in Gynecomastia: Immunohistochemical Study of a Case
Authors: Muretto Pietro , Polizzi Vincenzo , Staccioli M. Pia
Published: April 2018

A case of Paget's disease and gynecomastia in a 70-year-old man is reported. Paget's disease was connected to an intraductal carcinoma, and the immunohistochemical study revealed similar positivity for cytokeratin A, carcinoembryonic antigen and epithelial membrane antigen in Paget cells and intraductal neoplastic cells whereas Paget cells resulted negative for cytokeratin B and C. The study using monoclonal anti-cytokeratin A (35 βH11), B (34 βE12) and C (34 βB4) could represent a good tool, supporting the theory of a ductal origin of Paget cells. A review of the literature has shown the rarity of Paget's disease in the male breast and revealed only two previous reports with an associated gynecomastia, in 2 patients with Klinefelter's syndrome and infiltrating breast carcinoma.
Results of a Combined Chemo-Radiotherapeutic Program in 61 Patients Affected by Small Cell Lung Cancer
Authors: Tummarello Diego , Guidi Francesco , Porfiri Emilio , Isidor Pierpaolo , Raspugli Marzio , Cellerino Riccardo
Published: April 2018

Sixty-one patients affected by small cell lung cancer (SCLC) entered in the study. Eighteen had limited disease and 43 extensive disease. Treatment consisted of: induction chemotherapy with 3 courses of CAV (cyclophosphamide, adriamycin, vincristine) in limited disease patients or 2 courses of CAV plus 2 courses of DDP-VP16 (cisplatin, etoposide) in extensive disease patients, followed by chest radiotherapy and CNS prophylaxis in responsive patients. Subsequently, responders and stable patients received maintenance chemotherapy by the alternation of cycles of CAV, DDP-VP16 and C'MP (CCNU, methotrexate, procarbazine), which lasted 1 year or until relapse. Four of 17 limited disease patients (23%) obtained a CR and 11 (65%) a PR; their median survival was 11 months (range, 2 + - 36 +). One of the 7 extensive disease patients (3%) achieved a CR and 19 (51%) a PR; their median survival was 6 months (range, 1-22). Median duration of response was 12 months for CR and 5 months for PR. Responders (CR and PR) survived 11.5 months versus 3.5 months for failures (P < 0.05); 3/61 (5%) showed long-term survival, in the absence of disease. The overall median survival was 7 months (range, 1-36 +). The main toxic effects were myelosuppression and vomiting (WHO grade 3). From our results, this program does not offer further substantial gains in patients with SCLC.
Selection Criteria in Colorectal Cancer Screening
Authors: Castiglione Guido , Ciatto Stefano
Published: April 2018

The authors report the results of a risk questionnaire (RQ) used in a population-based screening program for colorectal cancer. The positive predictive value (PPV) for cancer or adenoma was evaluated for the Hemoccult test (HO) and for all RQ items (symptoms, personal and familial risk) in 8,114 cases, by univariate and multivariate analysis. A significant correlation with the presence of cancer or adenoma was observed for HO-positive tests, whereas a significant correlation was absent for most RQ variables. The use of an RQ in screening practice is disregarded since it does not improve the rate of cancer detection. Moreover, the increase in the detection rate of HO-negative adenomas does not justify the high rate (0.18) of screening responders selected for endoscopic diagnostic workup, a figure which influences negatively the overall compliance to screening.
Absence of Acquired Thermotolerance in Murine Tumors Unable to Increase the Expression of Heat Shock Proteins following Stress Stimuli
Authors: Mattei Elisabetta , Delpino Andrea , Mileo Anna Maria , Ferrini Umberto
Published: April 2018

The induction of thermotolerance was studied in two groups of murine tumors, one able to produce heat shock proteins (HSP) and the other entirely lacking HSP expression in response to various stress inducers. Heat treatments were performed in vitro and the development of thermotolerance was then evaluated in vivo. The data obtained on the of death rate of mice inoculated with tumor cells previously conditioned at 42 °C for 1 h and then challenged at 45 °C for 30 min following 2 h of reincubation at 37 °C, show that the rate of survival is far higher in mice inoculated with HSP negative tumor cells. This indicates that a large number of cells able to increase HSP synthesis following stress escape heat killing, whereas cells unable to express HSP after adequate stimuli are less tolerant against heat challenge.
Cutaneous Metastases from Carcinoma of the Cervix
Authors: Franciolini Gino , Momoli Giovanni , Minelli Luca , Mutolo Franco , Franchini Maria Andreina , Chiodini Stefano , Zorzi Fausto
Published: April 2018

Skin metastases from internal malignancies are rare, particularly those originating from carcinoma of the cervix: only 11 cases have been reported in the medical literature since 1940. We describe the case of a cutaneous metastases from a squamous-cell carcinoma of the cervix that was solitary, unusual for its location, and with the longest survival reported so far.
Evaluation of the Effect of Medroxyprogesterone Acetate on Bone Marrow Progenitor Cells
Authors: Pedrazzoli Paolo , Bacciocchi Giovanna , Da Prada Gian Antonio , Preti Pietro , Pavesi Lorenzo , Poggi Guido , Locatelli Franco , Rosti Vittorio , Robustelli della Cuna Gioacchino
Published: April 2018

Various clinical studies have demonstrated that high-dose medroxyprogesterone acetate (HD-MPA) can reduce hematologic toxicity in patients receiving chemotherapy for advanced solid tumors. The underlying mechanism(s) of this action is still unknown. A direct effect of MPA on hemopoietic cells has been postulated, but in vitro studies have given contradictory results. To clarify the biologic activity of MPA on hemopoiesis we have evaluated in vitro growth of pluripotent and committed progenitor cells from bone marrow cells which were preincubated in vitro with various doses of MPA and subsequently treated with or without the S-phase-specific drug arabinoside-cytosine (Ara-C). Four healthy subjects and 8 patients with advanced stage solid tumors with no bone marrow involvement were studied. In our experimental model we did not observe any effect of MPA on Ara-C killing of progenitor cells from either bone marrow mononuclear cells or bone marrow mononuclear cells depleted of T-lymphocytes and adherent cells. These results suggest that MPA does not act directly (or indirectly through the production of cytokines by T-lymphocytes and/or monocytes and macrophages) on bone marrow progenitors. In addition, the supposed mechanism of rendering stem cells less susceptible to the insult of cytotoxic drugs by lowering the number of progenitors in the S-phase has been ruled out by ceil kinetic studies.
Estimating Relative Survival of Italian Cancer Patients from Sparse Cancer Registries Data
Authors: De Angelis Roberta , Capocaccia Riccardo , Verdecchia Arduino
Published: April 2018

Purpose

A method is presented for estimating relative survival of cancer patients at the national level from survival data provided by cancer registries covering only a subset of the general population and referring to different, and not necessarily overlapping, incidence periods.

Methods

Relative survival rates are estimated as a function of the covariates sex, age, epoch of diagnosis, and registry area by means of a multiple regression model. National estimates are then computed by appropriate weighting of the sex-, age-, time- and registry-specific expected relative survival values.

Results

The method is illustrated by a sample application to survival data of female breast cancer patients in Italy. The national estimates of breast cancer survival pattern show a mild decrease of survival with age and a marked increase with period of diagnosis.
Sustaining Oncology Studies - SOS: Information and Support for Training, Research and Exploitation in Cancer and Related Biomedical Disciplines
Authors: Lombardo Claudio , Alloro Giovanna , Wiley Thomas , Sacile Roberto , Ugolini Donatella
Published: April 2018

This paper outlines the development of the Sustaining Oncology Studies Information Resources (SOS Europe), a multimedia World Wide Web (WWW) prototype providing support to experimental and clinical cancer researchers, general practitioners, industry personnel, and university students in the field of oncology in Europe and Italy. The system utilizes applications developed for the WWW and is designed in the most easily understandable approaches possible. The prototype now structures oncology-related information available on the Internet and also places resources maintained locally at users’ disposal. The system utilizes a WWW browser as a design platform and HTML to build its Home and subpages and to create hyperlinks to internal and external resources.
Radiation Therapy for Stage I Primary Orbital Non-Hodgkin's Lymphomas
Authors: Erkal Haldun Şükrü , Serin Meltem , Sak Serpil Dizbay , Çakmak Ahmet
Published: April 2018

Aims and Background

The orbit is an uncommon primary site for non-Hodgkin's lymphomas (NHL), and it accounts for less than 1% of all sites of primary presentations. We report the experience of the Department of Radiation Oncology at Ankara University Faculty of Medicine with radiation therapy in treatment of patients with stage I primary orbital NHL.

Methods

From February 1978 through August 1993, 14 patients with stage I primary orbital NHL were treated with radiation therapy. According to the Working Formulation classification, 8 patients had low-grade and 6 had intermediate-grade lymphomas. The most commonly used radiation therapy technique was a single anterior field with a Cobalt-60 unit, delivering 40 Gy in 2 Gy daily fractions. Two patients with intermediate-grade lymphomas received the CHOP regimen following radiation therapy.

Results

Follow-up ranged from 0.8 to 18.3 years (median, 10.3 years). Local control was achieved in all patients. Two patients with low-grade lymphomas relapsed locally and were successfully salvaged with radiation therapy. Three patients with intermediate-grade lymphomas failed systemically. Salvage therapy consisted of combination chemotherapy for 2 of them but was unsuccessful. Overall survival probabilities at 2, 5 and 10 years were 78.6%, 61.1% and 52.4%, respectively, for the entire group of 14 patients. Overall, cause-specific and disease-free survival probabilities were higher for patients with low-grade lymphomas than for those with intermediate-grade lymphomas (P = 0.03, P = 0.03 and P = 0.06, respectively). Cataracts were observed in 9 and lacrimal disorders in 4 patients.

Conclusions

The study suggests that among stage I primary orbital NHL, low-grade lymphomas could be treated with radiation therapy alone, whereas combination chemotherapy could accompany radiation therapy for intermediate-grade lymphomas.
Giant Cell Tumor of Tendon Sheath: Immunohistochemical Study of 20 Cases
Authors: Cavaliere Antonio , Sidoni Angelo , Bucciarelli Emilio
Published: April 2018

Aims and background

Giant cell tumor of tendon sheath (GCTTS) is a common tumor occurring on the tendon sheaths of the fingers. The nature of this lesion is still controversial: some researchers consider it a reactive process arising from chronic inflammation while others regard it as a tumor of presumed synovial cell or monocytic macrophage system origin. In an effort to clarify the histogenesis we decided to further investigate the immunophenotypic profile of this tumor.

Study design

We studied 20 GCTTS of the fingers using a panel of 18 antibodies, 13 monoclonal and 5 polyclonal.

Results

The immunohistochemical investigation revealed that the mononuclear cells of this lesion can be divided into two groups. The cells of the first and more numerous group were positive for vimentin, PG-M1 and KP1 but also for muscle actin (HHF35 monoclonal antibody) and neuron-specific enolase. A second population of mononuclear cells, usually arranged around the giant cells, were positive for PG-M1, KP1, LCA and occasionally for alpha-1-antitrypsin and alpha-1-antichymotrypsin. Multinucleated giant cells were also positive for KP1, PG-M1 and LCA monoclonal antibodies. A variable but usually weak positivity for al-pha-1-antitrypsin, alpha-1-antichymotrypsin and lysozyme was also observed.

Conclusions

Our results suggest a synovial cell origin for GCTTS and do not support the hypothesis that it could be a neoplasm with a true histiocytic origin. The positivity of some cells for the HHF35 antibody, together with electron microscopic evidence of filament bundles with focal dense bodies, suggests that at least part of the mononuclear cells may have a myofibroblastic differentiation.
Recent Experience in the Management of Meningeal Hemangiopericytomas
Authors: Brunori Andrea , Delitala Alberto , Oddi Giuseppina , Chiappetta Francesco
Published: April 2018

Although the histogenesis of meningeal hemangiopericytomas (HMP) remains controversial, both biological and clinical evidence seems to identify these neoplasms as a separate entity with respect to meningiomas. In order to assess the current prognosis of HMP we reviewed our personal experience limited to the last decade (1986-1995): during this period 7 patients (4M, 3F) were treated by surgery alone or surgery combined with postoperative radiotherapy. In spite of meticulous attempts at radical resection, the tumors recurred in all but two cases with a mean interval of 85 months, and a total of 18 operations were performed (2.57/patient; range 1-4). Massive intratumoral hemorrhage determined acute deterioration and required emergency surgery in two cases while in one patient diffuse visceral metastases were discovered at autopsy. Five patients are still alive at follow-up but only 2 of them are in good neurological conditions and without evidence of disease. These results are similar to those reported in other series. In view of our results we conclude that intracranial hemangiopericytomas still have a dismal prognosis. Advances in neuroimaging, neuroanesthesia, microneurosurgery and adjuvant therapy do not seem to have significantly affected the recurrence rate, quality of life and mortality.
Comparison of two Different Radiotherapy Schedules for Spinal Cord Compression in Prostate Cancer
Authors: Maranzano Ernesto , Latini Paolo , Beneventi Sara , Marafioti Luigi , Piro Fabrizio , Perrucci Elisabetta , Lupattelli Marco
Published: April 2018

Aims and background

To assess the clinical outcome and toxicity of two different radiotherapy (RT) schedules for the management of metastatic spinal cord compression from prostate cancer, we performed a prospective analysis of 44 patients with the complication.

Methods

Two different RT schedules were adopted, a split-course regimen of 5 Gy x 3, 4 days rest, and then 3 Gy x 5, and a short-course regimen of 8 Gy, 7 days rest, and then 8 Gy. The split-course RT was adopted for all prostate cancer patients referred to our center between 1986 and 1992. Starting in 1993, the short-course RT was added for patients with a poor prognosis (i.e., paresis or paraplegia, low performance status, and/or short life expectation), whereas others still underwent the split-course regimen. So, 27 (61%) patients were treated with the split-course and the other 17 (39%) with the short-course regimen. Medium follow-up was 48 months (range, 6 to 123).

Results

Back pain total response rate was 82%. Effectiveness of RT on motor and bladder capacity was conditioned by pretreatment status of patients. All 20 (100%) walking cases maintained the function, whereas 11 of 24 (46%) with motor impairment regained the ability. The difference in response rate was statistically significant (P<0.001). All 36 (100%) patients, able to void at presentation preserved the capacity, whereas 3 of 8 (38%) with sphincter dysfunction no longer needed an indwelling catheter. Posttreatment neurologic status was the only factor found to affect survival. Median survival, 9 months for the whole group, was 10 and 2 months for posttreatment walking and nonwalking patients, respectively (10 vs 2 months, P<0.001). Neither presence of other metastases nor RT regimen used (split vs short-course) conditioned response rate, duration of response or survival. Acute or late, severe toxicity was never recorded. No patient complained of spinal cord morbidity.

Conclusions

Both split-course and short-course RT schedules were effective and without complications. Early diagnosis was the most important prognostic factor, but there was also recovery of function in about half of the patients unable to walk, and about one-third of patients with bladder dysfunction before treatment. Since length of the course of therapy is a factor with an important impact on the patient's quality of life, the short-course RT regimen adopted in the trial merits further investigation.
Thyroid Cancer in Uremic Patients
Authors: Hatada Takuya , Okada Kaoru , Ishii Hiromitsu , Ichii Shigetoshi , Utsunomiya Joji
Published: April 2018

Background

The combination of thyroid cancer and secondary uremic hyperparathyroidism has thus far been reported in only 25 cases.

Methods

Here we report our experience of 19 patients with secondary hyperparathyroidism who underwent parathyroidectomy.

Results

Thyroid nodules were present in five patients (26.3%), including one with a benign nodule and four with papillary thyroid cancer (21.1%).

Conclusion

Our experience suggests that, in order to make a correct diagnosis, clinicians should consider the possibility of thyroid cancer in uremic patients with secondary hyperparathyroidism.
A Rare Presentation of Trilateral Retinoblastoma
Authors: Varan Ali , Akyüz Canan , Büyükpamukçu Münevver
Published: April 2018

Retinoblastoma and intracranial tumors are rarely found together. Here we report on a case with unilateral retinoblastoma and pineal tumor without symptoms of an intracranial mass at the time of diagnosis. The patient was found to have a retinoblastoma of the other eye at the 10th month of follow-up.
Endometrioid Carcinoma of the Ovary: A Retrospective Analysis of 106 Cases
Authors: Grosso Giuseppe , Raspagliesi Francesco , Baiocchi Gabriela , Di Re Emanuela , Colavita Maria , Cobellis Luigi
Published: April 2018

Aims and background

This report retrospectively analyzes 106 cases of endometrioid carcinoma of the ovary treated at the National Cancer Institute of Milan from 1974 through December 1993. In 12 of the 106 cases (11.3%) a synchronous carcinoma of the uterine body was observed.

Methods and study design

Only patients who had previously untreated disease were included in the study. Patients with synchronous tumors were staged according to their ovarian cancer and treated according to the stage of that disease.

Results

Thirty-nine patients (36.8%) had stage I, 17 (16.0%) stage II, 43 (40.6%) stage III, and 7 (6.6%) stage IV disease. Moderately plus poorly differentiated tumors were present in 76 of the 106 cases (71.7%). Considering the 67 patients with advanced disease, residual tumor was absent in 27 cases (40.3%), ≤ 2 cm in 17 (25.4%), and > 2 cm in 23 (34.3%) cases. Systematic pelvic and para-aortic lymphadenectomy was performed in 60 patients (56.6%); selective sampling was carried out in 23 cases (21.7%). After surgery, 77 patients underwent various chemotherapy regimens.

Conclusion

Using univariate analysis, FIGO stage, tumor grade, residual disease after surgery, lymph node status, and platinum in the chemotherapy regimen significantly influenced 5-year survival. However, when all these variables were included in a multivariate analysis only FIGO stage still had a significant impact on survival. Survival analysis also showed a trend towards longer survival in patients with synchronous tumors.
Treatment of Advanced Colorectal Cancer (CRC) in Daily Practice: Results of a Survey in two Italian Regions, Piemonte and Valle D'aosta
Authors: Comandone Alessandro , Berardo Roberto , Faggiuolo Roberto , Boglione Antonella , Bergnolo Paola , Dal Canton Orietta , Di Napoli Angelo , Oliva Cristiano , Bumma Cesare
Published: April 2018

Aims and background

Colorectal cancer (CRC) is one of the most important health problems in Western countries: it is the fourth cancer in terms of incidence and the second cause of cancer death. Surgery is the main therapeutic choice and there is broad consensus on the role of adjuvant chemotherapy (CT) after resection. Unfortunately, 50% of the patients will relapse and die of the disease. Palliative CT based on 5-fluorouracil (5FU) may induce a 9-48% response rate with a median survival of 11.5 months. At present there is no gold standard for CT in advanced CRC and the situation has become more complicated since the advent of new drugs (Raltitrexed, Irinotecan, Oxaliplatin). The aim of this study was the identification of the different approaches to treatment of advanced CRC among the clinicians (oncologists, radiologists, internal medicine specialists, surgeons) who practice CT.

Methods and study design

Forty-six clinicians from two Italian Regions (Piemonte and Valle d'Aosta) were interviewed by telephone.

Results

5FU modulated with Lederfolin according to the classic Machover scheme is the main option in daily practice. More sophisticated therapies are reserved to patients with a good performance status (PS) and are prescribed only in the larger centers. The planned therapies usually consist of six courses. Restaging may be performed after three or six courses. A marked difference has been recorded in the evaluation of a situation of no change (NC): 25.5% of the clinicians evaluate stable disease as a positive result. In the event of disease progression or relapse, 35% of the clinicians do not prescribe second-line CT. In case of further treatment, the options are totally subjective.

Conclusions

A national survey on this issue is necessary under the auspices of AIOM (Associazione Italiana Oncologia Medica) and involving oncologists, epidemiologists and statisticians, in order to define the reasons for variations in therapy in advanced CRC and determine the differences between clinicians of different age, specialization and location. This survey could lead to a definition of guidelines for the treatment of advanced CRC.
End-Stage Acute Hepatic Failure as Clinical Presentation of Liver Metastases from Breast Cancer
Authors: Nieto Yago , Alonso José Luis , Ayala Francisco , Ortega Luis , Casado Antonio , Martín Miguel , Díaz-Rubio Eduardo
Published: April 2018

A most unusual case of fatal acute hepatic failure as clinical presentation of liver metastases from breast cancer is described. The patient had a four-year history of indolent breast neoplasm and no previously known liver disease.
pS2 in Breast Carcinoma: Association with Steroid Hormone Receptor Status
Authors: Nikolić-Vukosavljević Dragica , Grujić-Adanja Gordana , Janković Radmila , Branković-Magić Mirjana , Polić Đoka , Jovanović Danica , Mitrović Labuda
Published: April 2018

Aims and background

Knowledge of the steroid hormone receptors has proved to be of significant value in breast cancer. In the present study the possible importance of estrogen-regulated pS2 protein was investigated. Our direct purpose was to answer the question whether the expression of pS2 may be a marker of functional heterogeneity with respect to the steroid hormone receptor status.

Methods and study design

The study included 152 patients with primary, operable, histologically confirmed breast carcinomas. Histology specimens were reviewed and classified according to type, nodal status, tumor size and grade. Steroid hormone receptors were assayed by biochemical methods according to the procedures recommended by the EORTC. pS2 protein measurement was performed in breast carcinoma cytosols using an immunoradio-metric assay. The results were analyzed by non-parametric statistical methods.

Results

A statistically significant inverse correlation between pS2 protein expression and histological tumor grade was found. The expression of pS2 protein was confirmed to be correlated with steroid hormone receptor status. However, it is important to point out that in spite of these statistically significant findings there were no significant biological associations due to overlapping individual pS2 protein values. The baseline level of expression of pS2 protein was obtained in histological grade III carcinomas with a negative steroid hormone receptor status. It was shown that the distribution of carcinomas according to the baseline level of pS2 protein expression was heterogeneous among estrogen receptor-positive carcinomas, and strikingly homogeneous among estrogen and progesterone-negative carcinoma.

Conclusion

Our study suggested that PR and pS2 protein may identify distinct subsets of estrogen receptor-positive breast carcinomas.
CD30 Differential Staining is Useful in Classifying Lymphomas Intermediate between Hodgkin's Disease and Anaplastic Large Cell (Ki1) Lymphoma
Authors: Schmidt Ulrich , Metz Klaus Alfred , Möser Ute
Published: April 2018

Aims and background

The authors analyzed the BerH2 reactivity patterns of the tumor cells in 23 Hodgkin's lymphomas (HD), in 13 CD30+ anaplastic large cell (Ki1) lymphomas (ALCL), in two HD with transition to secondary CD30+ ALCL, and in six additional lymphomas intermediate between HD and ALCL.

Methods

Paraffin blocks of formalin-fixed biopsies were im-munostained. Immunostaining was modified by pronase digestion and by microwave assistance.

Results

Hodgkin-Reed-Sternberg (HRS) cells of all 23 Hodgkin's lymphomas were reactive for BerH2, but the reactivity patterns differed: after pronase digestion, HRS cells of 17/23 Hodgkin's lymphomas showed exclusively or at least predominantly cytoplasmic BerH2 reactivity, whereas only four Hodgkin's lymphomas presented with prominent membrane-bound positivity. Microwave processing in 16/23 Hodgkin's lymphomas induced membrane-bound BerH2 positivity in the HRS cells; a minority of five cases retained the distinct cytoplasmic pattern. In contrast, 10/13 ALCLs were characterized by membranous reactions, independent of whether pronase or microwave pretreatment had been applied. The CD30+ ALCLs secondary to HD also showed a tendency towards membranous positivity more than did the antecedent Hodgkin's lymphomas. In the HD/AL-CL borderline group, 3/6 cases revealed cytoplasmic BerH2 patterns after pronase digestion and thus were more closely related to HD, whereas 2/6 cases reacted with membranous positivity as did the genuine ALCLs of our series.

Conclusions

We conclude from these findings that the above modifications in CD30 immunostaining can be helpful in the characterization of lymphomas that constitute a continuous histomorphologi-cal as well as phenotypical spectrum between HD and ALCL.
Solitary Eosinophilic Granuloma of the Calvaria
Authors: Puzzilli Fabrizio , Mastronardi Luciano , Farah Jibril Osman , Ruggeri Andrea , Lunardi Pierpaolo
Published: April 2018

Aims and background

Histiocytosis X is a condition characterized by an abnormal proliferation of histiocytes with a variable granulomatous and inflammatory component; bone involvement is almost always present. The aim of this study was to define the management of solitary eosinophilic granuloma (EG) of the calvaria in adult patients, in relation to the size and site of the lesion.

Methods

Fourteen patients, ranging in age from 7 to 45 years, with solitary eosinophilic granuloma of the calvaria were surgically treated by craniectomy or curettage and cranioplasty. We subgrouped the lesions into two types: A) lesions localized inside the diploë and/or compressing the cerebral parenchyma below but without dural infiltration; B) lesions with mainly intracranial growth, compressing the cerebral parenchyma and infiltrating the dura. The infiltrated dura mater in type B lesions was replaced with a dural patch. Cranioplasty was performed in lesions with a diameter of 4 cm or more and/or located in aesthetically exposed areas of the skull.

Results

None of the patients died during the study and no local or systemic recurrences were observed during follow-up (min. 3 yrs, max. 8 yrs).

Conclusions

Surgical treatment of patients with isolated EG of the calvaria not only is simple and quick but also allows histological diagnosis of the osteolytic lesion. These patients do not require further adjuvant treatment. Cranioplasty should be performed when the lesion has a diameter of 4 cm or more, when it is located in aesthetically exposed areas of the skull such as the frontal or temporal bones, or when it produces alterations of the normal skull morphology.
Villoglandular Papillary Adenocarcinoma of the Uterine Cervix: Report of a Case
Authors: Borgo Gianpiero , Feyles Elda , Gaglio Agostino , Tagliani Luigi , Andrion Alberto
Published: April 2018

Villoglandular papillary adenocarcinoma is a recently described form of adenocarcinoma of the uterine cervix, which apparently affects young women and seems to have a favorable course with an excellent prognosis. We report on a case of villoglandular papillary adenocarcinoma in a 26-year-old woman. The patient was treated by conization alone and is disease free after a 40-month follow-up.
Constellations of Power and Authority in the Political Economy of Illegal Timber Extraction in BTAD, Assam
Authors: Dutta Anwesha , Suykens Bert
Published: April 2018

This article seeks to comprehend the way the illegal timber economy in the Bodoland Territorial Autonomous Council (BTAD) in Assam is integrated within a constellation of power and authority. Based on over ten months of ethnographic field research, our analysis shows that the timber trade is indeed characterized by what can be conceptualized as an excess of sovereignty. However, a burdened agency is still exercised by those in the timber trade. Moreover, the authority structure consisting of state, rebel and non-armed actors do not directly engage violently in the trade, but are more interested in taxation, governance, or indeed wildlife protection, showing the other side of this multiple authoruty structure. As the article shows, different ethnic groups, which are often thought to be diametrically opposed to each other, collaborate in the local timber commodity chain. However, these collaborations are characterized by highly unequal relations of exchange. As we argue, those that have preferential access to the authority structure can use this to dictate the terms of interaction. Finally, while the timber economy is usually characterized by the operation of the constellation of power and authority, there are interstitial moments where the (violent) interactions among the actors embeded in the structure weaken the direct territorial control by them. As a result, times of violence are often also those in which the trade can flourish.
A mythical place: A conversation on the earthly aspects of myth
Authors: Essebo Maja
Published: April 2018

The concept of myth is far from foreign to geographical research, yet its definition and use has been both varied and assumed, leaving much of its potential geographically unexplored. Myths – naturalised stories which reflect ideology, alleviate anxiety, and guide everyday practices – instil place with meaning. Following the tradition within human geography of engaging with issues intersecting perception and place, this paper suggests that to further develop the concept of myth in and through human geography may help advance central disciplinary themes centring on issues of naturalisation and transformation of societal beliefs and, by extension, place.
Haemoperfusion over Ion Exchange Resins and Polymeric Adsorbents
Authors: Maini R.
Published: April 2018

A review of the development and application of haemoperfusion over ion exchange resins and polymeric adsorbents is presented. Aspects of biocompatibility and ion balance are discussed.
Artificial Gut for Total Parenteral Nutrition through the Peritoneal Cavity
Authors: Giordano C. , Capodicasa G. , De Santo N.G.
Published: April 2018

Total parenteral nutrition was attempted by using the peritoneal route. In this way it was possible to convey to the patients all elemental nutrients used in hyperalimentation. Three patients were studied while treated for an episode of catabolic stress in the course of acute or chronic uremia. Adequacy of treatment was controlled by measuring urea generation rates, plasma concentrations of 3-methyl-histidine, glucose disappearance from dialysate and kinetics of lipid particles removal from plasma. The data collected demonstrate that peritoneal hyperalimentation is feasible and adequate for clinical purposes.
A New Implantable Sphincter Prothesis for Artificial Anus
Authors: Szinicz G.
Published: April 2018

A new totally implantable hydraulic sphincter prothesis which differs from other systems by a very simple function is presented. The construction and the performance are described and the results of animal experiments are reported. The clinical application of this device in 3 female and 4 male patients has been successful. Indications and contraindications are discussed.
Erythrocytapheresis with Red Blood Cell Replacement by DFC as an Emergency Therapy
Authors: Garelli S. , Valbonesi M. , Veneziano S. , Stroppi F.
Published: April 2018

Erythroapheresis with RBC replacement was used as an emergency therapy in a patient with anilin poisoning. The same therapy was also performed in a pregnant woman with beta+/HbS anemia at her 40th week of pregnancy, as a prophylactic measure for preventing possible complications from cesarean section. This therapeutic modality was clinically effective confirming that the removal of pathological RBC is a safe procedure of essential value in emergency situations.
The PTFE Y-graft: One Year Experience in 21 Patients.
Authors: Polterauer P. , Wagner O. , Kretschmer G. , Piza F.
Published: April 2018

21 patients had aortoiliac reconstructions for aortic aneurysms or occlusive disease with the new PTFE Y-graft during the past 12 months. 2 patients in the aneurysm group with additional renal artery reconstruction suffered postoperative myocardial infarction and subsequently died. 2 patients older than 80 years died after aneurysm repair in cause of graft infection, respectively respiratory insufficiency. All grafts (n = 17) are functioning well or did so until death of the patient (n=4). The obvious advantage of the PTFE Y-graft is the fact, that there is no need of preclotting. Suture line — even using 4-0 material at the proximal anastomosis — and graft body is absolutely tight and no blood loss has to be expected from this site. However positioning of the left limb of the y-graft can be difficult in patients with right sided extraperitoneal approach and proximal side end anastomosis. Performing an end-end anastomosis can overcome this problem. For occlusion of the prosthesis limbs two vascular clamps on each side are needed to control blood flow within the rather stiff graft. Immediate and short term function is excellent. There was no material specific complication noted until now. Further longterm experience is necessary to evaluate the definitive quality of this new prosthetic material after some years.
A Comparative Flow Study of the Omniscience and the Björk-Shiley Cardiac Valve Prostheses
Authors: Reif T.H. , Huffstutler M.C.
Published: April 2018

The pressure-flow rate characteristics of two new convex-concave pivoting disc prosthetic heart valves are evaluated in vitro. The Omniscience and Björk-Shiley prostheses are chosen since both use curved occluders with similar dynamic function, but with different occluder curvature and eccentricity. The Omniscience prosthesis is shown to have consistently less pressure loss, and therefore less energy loss, over a range of steady state and pulsatile flow rates. The enhanced flow characteristics of the Omniscience valve are attributed to the larger opening angle of the occluder, the method of retaining the occluder, in the valve frame, the smaller curvature of the occluder, the smaller pivot-axis eccentricity, and the smaller profile thickness of the occluder. The valves are also tested in the closed position, with steady state pressure gradients causing leakage or backflow. This data is compared with the pulsatile pressure-flow rate data to gain insight into the nature of regurgitation. The total regurgitation of the pivoting disc valves are thought to be strongly dependent upon both the maximal opening angle of the occluder and the radial clearance between the disc and the valve orifice. Both the Omniscience valve and the Björk-Shiley valve are found to have nearly equal volumes of total regurgitation.
Removal of Protein-Bound Substance in Hepatic Failure: Polyetherurethane Sheet Embedded with Powdered Charcoal (UPC)
Authors: Kawanishi H. , Tsuchiya T. , Nishiki M. , Sugiyama M. , Ezaki H.
Published: April 2018

For the purpose of applying an artificial liver support system to a direct hemoperfusion (DHP), a new type of adsorbent, “polyetherurethane sheet embedded with powdered charcoal (UPC)” has been developed and clinically used.

A polypropylene container was used to prepare a column containing 70 g of powdered charcoal by filling it with a 35 m x 15 cm roll of the 150 μm thick UPC. The powdered charcoal with an optimum pore size was selected for the purpose of adsorbing protein-bound substances and middle molecular substances. The result of a 3-hour DHP performed on a jaundiced dog showed the removal amounts of about 70% of bilirubin and 90% of bile acid.

DHP was also performed on jaundiced patients. A 3-hour hemoperfusion using one UPC column obtained the maximum removal amounts of 23% of total bilirubin and 31% of bile acid. When 3 columns in all were used, one at a time, by replacing it with time, the removal amounts of 43% of total bilirubin and 55% of bile acid resulted. The hemoperfusion was safely completed with transient effects, if any, on the blood elements.
Plasma-exchange in Idiopathic Radiculopolyneuropathies: A Study in 62 Patients
Authors: Marconi G. , Taiuti R. , Avanzi G. , Paoletti P.
Published: April 2018

The effectiveness of plasma exchange (PE) in the treatment of acute and chronic idiopathic radiculopolyneuropathies (IR) is discussed on the basis of the literature and personal data. Results of controlled trials by Swedish, French and North American groups are favourable to the use of PE in acute forms, whereas one English group found no significant differences between treated patients and controls. Dick et al. (1986) reported significant improvement also in patients with chronic forms after PE.

Personal data from a non-controlled series of 62 acute and chronic IR and from a trial group of 12 acute patients and 12 controls indicated that PE — though helpful in Guillain-Barré syndrome — was not so useful in chronic forms.
Hemodynamic Tolerance and Plasma Volume Variations during Plasma Exchange
Authors: Guidet B. , Luquel L. , De Labriolle Vaylet C. , Offenstadt G.
Published: April 2018

Little is known about mechanisms of systemic hypotension frequently reported during plasma exchange (PE). Type of substitution fluids may interfere with hemodynamic tolerance. In a prospective study, right heart catheterization was performed during 18 PE by filtration with isovolumic substitution. Blood volume was measured with 51Cr tagged erythrocytes and plasma volume (PV) calculated from hematocrit. Substitution fluids were either albumin (A; n = 9) or A + gelatin (A + G; n = 9). In both groups, PE induces significant (p < 0.01) decreases of mean arterial pressure: group A: - 21 ± 14%; group A + G: - 23 ± 15%; of pulmonary wedge pressure: group A: - 41 ± 33%; group A + G: - 36 ± 22%; of cardiac index: group A: - 38 ± 18%; group A + G: - 25 ± 15%. Plasma volume also decreases after PE: group A: - 13.5 ± 4%; group A + G: - 18.5 + 4%. None of the variations are significantly different between the two groups. So we think that substitution with albumin alone has no advantage for hemodynamic tolerance.
Sieving Characteristics of a new Polysulfone Hemofilter for use with Continuous Arterio-venous Hemofiltration
Authors: Kaplan A.A. , Golper T.A.
Published: April 2018

Sieving coefficients (SC) for middle molecular weight (MMW) substances have been found to decrease markedly as filtration rates (Qf) are increased. To best evaluate the newly available Renaflo hemofilter, we studied the effect of increasing filtration rates on the SC of a sample MMW substance (inulin). An in-vi-tro filtration system was designed to deliver varying Qf from 4.1 to 17.7 ml/min. Serum and filtrate chemistries (urea, creatinine, total protein) were determined. The results revealed no change in sieving for urea or creatinine and a universally low sieving for protein. The sieving coefficient for inulin, however, decreased significantly; from 0.93 at a Qf of 4.1 ml/min to 0.79 at a Qf of 17.7 ml/min (p < 0.03).

These results confirm that the SC of MMW substances do decrease as Qf increase. Despite the decrease found, when compared to previously published data, the Renaflo hemofilter seems to offer a greater degree of middle molecular weight sieving under conditions encountered during CAVH.
Per-operative Uncontrollable Bleeding at Polyester (DacronR) Arterial Prosthesis Implantation
Authors: Guidoin R. , Downs A. , Verhaeghe J.L. , Roy P.E. , Marceau D. , Fiévé G. , Frisch R.
Published: April 2018

An aortobifemoral knitted polyester graft was placed in a 58-year-old woman with aorto-iliac occlusive disease. Although the prosthesis was preclotted in the usual manner, it never became impervious to blood under normal intra-arterial pressure. Examination of the graft showed lipid infiltration not ordinarily seen. We recommend that when a knitted prosthesis fails to preclot a woven graft should be used instead.