bluuebunny/crossref_metadata_2025 huggingface dataset:
A Cost Analysis of Single-Stage Bilateral versus Two-Stage Direct Anterior Total Hip Arthroplasty
Authors: Martin Glynn R. , Marsh Jacquelyn D. , Vasarhelyi Edward M. , Howard Jamie L. , Lanting Brent A.
Published: October 2015

Purpose

The potential cost savings of single-stage bilateral total hip arthroplasty (THA) are unclear, and the risks associated with it are not well defined. We sought to compare the costs and perioperative complications of single-stage bilateral THA via the direct anterior approach (DAA) to a two-stage bilateral protocol.

Methods

We retrospectively reviewed patients who underwent a single- stage bilateral DAA THA and compared them to a two-stage THA group. We conducted a cost analysis from both the hospital perspective and the Ministry of Health (MOH) perspective.

Results

24 patients were included in this study. The 2 groups were similar in age (58.9 vs 63.9 yrs), height (169.2 vs 170.9 cm), weight (80.2 vs 78.6 kg), BMI (27.9 vs 26.3 kg/m2), ASA score (2.2 vs 2.2), and CCI score (2.3 vs 2.9). The mean cost per patient from the hospital perspective for the single-stage group was $10,728.13 (SD = 621.46) compared to $12,670.63 (SD = 519.72) for the two-stage group (Mean Difference = $1,942.50, 95% CI = $1,457.49 to $2,427.51, p<0.001). Similarly, from the MOH perspective, the cost for the single-stage group was $12,552.34 (SD = 644.93) compared to $14,740.58 (SD = 598.07) for the two-stage group (Mean Difference = $2,188.24, 95% CI = $1,661.67 to $2,714.81, p<0.001). There were no significant differences in complication rate between groups. The largest percent of total cost savings from a hospital perspective was attributed to cost of operating room staff and OR set-up (55%).

Conclusions

Our results suggest that single-stage bilateral DAA THA results in significant cost savings compared to two-stage DAA THA.
Impact of Left Ventricular Assist Device Speed Adjustment on Exercise Tolerance and Markers of Wall Stress
Authors: Hayward Christopher S. , Salamonsen Robert , Keogh Anne M. , Woodard John , Ayre Peter , Prichard Roslyn , Kotlyar Eugene , Macdonald Peter S. , Jansz Paul , Spratt Phillip
Published: October 2015

Introduction

Left ventricular assist devices are crucial in rehabilitation of patients with end-stage heart failure. Whether cardiopulmonary function is enhanced with higher pump output is unknown.

Methods

10 patients (aged 39 ± 16 years, mean ± SD) underwent monitored adjustment of pump speed to determine minimum safe low speed and maximum safe high speed at rest. Patients were then randomized to these speed settings and underwent three 6-minute walk tests (6MWT) and symptom-limited cardiopulmonary stress tests (CPX) on separate days.

Results

Pump speed settings (low, normal and high) resulted in significantly different resting pump flows of 4.43 ± 0.6, 5.03 ± 0.94, and 5.72 ± 1.2 l/min ( P<.001). There was a significant enhancement of pump flows (greater at higher speed settings) with exercise ( P<0.05). Increased pump speed was associated with a trend to increased 6MWT distance ( P = .10); and CPX exercise time (p = .27). Maximum workload achieved and peak oxygen consumption were significantly different comparing low to high pump speed settings only ( P<.05). N-terminal-pro-B-type natriuretic peptide release was significantly reduced at higher pump speed with exercise ( P<.01).

Conclusions

We have found that alteration of pump speed setting resulted in significant variation in estimated pump flow. The high-speed setting was associated with lower natriuretic hormone release consistent with lower myocardial wall stress. This did not, however, improve exercise tolerance.
Synthesis, Characterization of Dextran Hydrogels and Their in Vitro Release of Gentamycin Sulphate
Authors: Guo Rui , Chen Peizhe , Mo Yunfei , Lan Yong , Xue Wei , Zhang Yuanming
Published: October 2015

Purpose

This study reports on the synthesis and characterization of biodegradable dextran–allyl isocyanate–ethylamine (Dex-AE)/polyethylene glycol–diacrylate (PEGDA) hydrogels for the controlled release of gentamycin sulphate (GS) and in vitro inhibition of organisms.

Methods

The Dex-AE precursor was prepared through a 2-step chemical modification and characterized by Fourier transform infrared spectroscopy (FTIR).

Results

Scanning electron microscopy (SEM) results revealed that an increase in Dex-AE content led to an initial decrease in pore size of the Dex-AE/PEGDA hydrogels, but a further increase in Dex-AE content resulted in a slightly increase of pore size. The swelling data indicated that the swelling ratio depended on the precursor feed ratio. GS was incorporated into the hydrogels through 2 different methods, i.e., immersed and crosslinked. The crosslinked GS-Dex-AE/PEGDA hydorgels exhibited stronger antimicrobial activities against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Finally, the viscoelastic properties of crosslinked GS-Dex-AE/PEGDA hydorgels were investigated.
Evaluation of Bond Strength of Self-Etching Adhesives Having Different pH on Primary and Permanent Teeth Dentin
Authors: Ozmen Bilal , Koyuturk Alp Erdin , Tokay Ugur , Cortcu Murat , Sari Mustafa Erhan
Published: October 2015

Purpose

The purpose of this in vitro study was to evaluate the dentin shear bond strength of 4 self-etching adhesives having a different pH on primary and permanent teeth dentin.

Methods

The occlusal enamel was removed from 60 freshly extracted third molar and 60 primary second molar human teeth, which were randomly separated into 4 groups (n = 15). Four adhesive systems were applied: G-Bond (GC Corporation, Tokyo, Japan, pH: 1.5), Futura Bond M (Voco, Cuxhaver, Germany, pH: 1.4), Adper Prompt L-Pop (3M/ESPE, St Paul, MN, USA, pH: 0.8), and Clearfil S3 Bond (Kuraray Medical, Tokyo, Japan, pH: 2.7) according to the manufacturer's instructions. After the application of dentin bonding agents, a composite resin material (Z250 Restorative A2, 3M ESPE, St. Paul, MN, USA) for permanent teeth and a compomer resin material (Dyract Extra A2, Dentsply, Konstanz, Germany) for primary teeth was applied onto the prepared dentin surfaces. The data were obtained by using a universal test machine at a crosshead speed of 1 mm/min.

Results

The mean values were compared using Tukey's multiple comparison test. Although there was no difference between adhesives on the permanent teeth, Clearfil S3 adhesive showed higher bond (18.07 ± 0.58 MPa) ( P>0.05). Lower bond strength values were obtained from primary teeth and especially G-Bond adhesive (9.36 ± 0.48 MPa) ( P<0.05).

Conclusions

Self-etching adhesives with different pH and solvent types can be used successfully for permanent teeth dentin but adhesives with low pH did not provide greater shear bond strength values.
Effect of Glucose on Fatigue-Induced Changes in the Microstructure and Mechanical Properties of Demineralized Bovine Cortical Bone
Authors: Trębacz Hanna , Zdunek Artur , Wlizło-Dyś Ewa , Cybulska Justyna , Pieczywek Piotr
Published: October 2015

Purpose

The aim of this study was to test a hypothesis that fatigue-induced weakening of cortical bone was intensified in bone incubated in glucose and that this weakening is revealed in the microstructure and mechanical competence of the bone matrix.

Methods

Cubic specimens of bovine femoral shaft were incubated in glucose solution (G) or in buffer (NG). One half of G samples and one half of NG were axially loaded in 300 cycles (30 mm/min) at constant deformation (F); the other half was a control (C). Samples from each group (GF, NGF, GC, NGC) were completely demineralized. Slices from demineralized samples were used for microscopic image analysis. A combined effect of glycation and fatigue on demineralized bone was tested in compression (10 mm/min). Damage of samples during the test was examined in terms of acoustic emission analysis (AE).

Results

During the fatigue procedure, resistance to loading in glycated samples decreased by 14.5% but only by 8.1% in nonglycated samples. In glycated samples fatigue resulted in increased porosity with pores significantly larger than in the other groups. Under compression, strain at failure in demineralized bone was significantly affected by glucose and fatigue. AE from demineralized bone matrix was considerably related to the largest pores in the tissue.

Conclusions

The results confirm the hypothesis that the effect of fatigue on cortical bone tissue was intensified after incubation in glucose, both in the terms of the mechanical competence of bone tissue and the structural changes in the collagenous matrix of bone.
Effect of Propolis as a Root Canal Irrigant on Bond Strength to Dentin
Authors: Kalyoncuoğlu Elif , Gönülol Nihan , Özsezer Demiryürek Ebru , Bodrumlu Emre
Published: October 2015

Purpose

The purpose of this in vitro study was to evaluate the effect of propolis on bond strength to dentin of a self-etch adhesive when used as a final irrigant.

Methods

126 human third molars were sectioned 3 mm below the occlusal level and then randomly divided into 7 groups (n = 18). The exposed dentin surfaces were treated with irrigation solutions as follows: Group 1: 5.25% NaOCl; Group 2: 5.25% NaOCl followed by 17% EDTA; Group 3: 5.25% NaOCl followed by Tubulicid Plus (Temrex, Freeport, NY, USA); Group 4: 5.25% NaOCl followed by MTAD; Group 5: 5.25% NaOCl followed by 20% propolis; Group 6: 5.25% NaOCl followed by 2% CHX; Group 7: distilled water (control). Irrigated specimens were bonded using Clearfil SE Bond (Kuraray, Osaka, Japan) with Tygon (Saint-Gobain, Saint-Gobain Performance Plastics, France), tubes for microshear bond strength testing. Data was analyzed using a one-way ANOVA and Tukey test.

Results

Among the tested groups, although the lowest bond strength values were detected in Group 1 (11.25 ± 1.97), a significant statistical difference was detected only between this group and Group 4 (18.70 ± 1.82) and Group 5 (16.75 ± 3.70) (p = 0.0012).

Conclusions

20% propolis solution as a final irrigant was found to have a favorable effect on the dentin bond strength of the tested self-etch adhesive to coronal dentin when compared with other irrigation solutions.
New Acrylate Terpolymer-Based Nanoparticles for the Release of Nucleic Acid: A Preliminary Study
Authors: Bellotti Elena , Barbani Niccoletta , Cascone Maria G. , Cristallini Caterina
Published: October 2015

Purpose

Nano-drug delivery systems based on polymeric biomaterials have received considerable interest as drug delivery vehicles. In this work, radical polymerization was carried out in order to obtain nanoparticles based on a new acrylate terpolymer (PBMA-(PEG)MEMA-PDMAEMA).

Methods

Nanoparticles were developed in the form both of nanospheres and nanocapsules, an innovative kind of hollow nanoparticles with a great potential because of their low effective density and high specific surface area. The ability of the nanoparticles to load and then release a nucleic acid (DNA) to be used in cancer treatment was also investigated.

Results

Scanning electron microscopy analysis showed a spherical shape, nanometric dimensions, and a homogeneous distribution of the nanoparticles, also confirmed by dynamic light scattering measurements. Fourier-transform infrared spectroscopy chemical imaging analysis carried out on the nanocapsules before and after removal of the core demonstrated the presence of the cavity. High-performance liquid chromatography analysis confirmed good encapsulation efficiency of DNA both for nanospheres and nanocapsules. Drug release tests showed controlled release kinetics for both the systems with a high release of DNA in the first hours. In vitro MTT assay showed that the particles do not have cytotoxic effects on the cells.

Conclusions

The preliminary investigation showed that the terpolymer-based nanoparticles developed in this study could be good candidates to be used as innovative and versatile gene delivery systems.
High Expression Levels of miR-21 and miR-210 Predict Unfavorable Survival in Breast Cancer: A Systemic Review and Meta-Analysis
Authors: Tang Yiting , Zhou Xifa , Ji Jianfeng , Chen Ling , Cao Jianping , Luo Judong , Zhang Shuyu
Published: October 2015

Background

MicroRNAs (miRNAs) have been emerging as valuable prognostic biomarkers of breast cancer. We therefore summarized recent research into miRNAs involved in human breast cancer and, further, completed a meta-analysis to predict the role of specific miRNAs in the survival of breast cancer patients.

Methods

Studies were identified by searching PubMed, Embase and Web of Science. Descriptive characteristics for studies were described, and an additional meta-analysis for specific miRNAs was performed. Pooled hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated.

Results

A total of 41 articles including 27 types of miRNAs were found regarding prognostic biomarkers for breast cancer survival, of which, micRNA-21 (miR-21) was the most-studied specific miRNA that appeared repeatedly among the selected classifiers. For the studies evaluating miR-21's association with clinical outcomes, the median HR in the studies was 2.32 (interquartile range [IQR] = 1.04-3.40), and the pooled HR suggested that high expression of miR-21 has a negative impact on overall survival (OS; HR = 1.46, 95% CI, 1.25-1.70; p<0.05) and disease/recurrence-free survival in breast cancer (HR = 1.49, 95% CI, 1.17-1.90; p<0.01). We also found that higher expression levels of miR-210 significantly predicted poorer outcome, with median HR in the reported studies of 4.07 (IQR = 1.54-4.43) and a pooled HR of 2.94 (95% CI, 2.08-4.17; p<0.05).

Conclusions

These results indicate that miRNAs show promising associations with prognosis in breast cancer. Moreover, specific miRNAs such as miR-21 and miR-210 can predict poor survival rates in breast cancer patients.
Combined use of Epithelial Membrane Antigen and Nuclear Matrix Protein 52 as Sensitive Biomarkers for Detection of Bladder Cancer
Authors: Attallah Abdelfattah M. , El-Far Mohamed , Abdallah Sanaa O. , El-Waseef Ahmed M. , Omran Mohamed M. , Abdelrazek Mohamed A. , Attallah Ahmed A. , Saadh Mohamed J. , Radwan Mohamed , El-waffaey Kholoud A. , Abol-Enei Hassan
Published: October 2015

Background

The advent of noninvasive urine-based markers as well as other novel modalities has yielded improved diagnostic accuracy. However, the new markers failed to reach higher sensitivity and specificity. We therefore evaluated the potential role of epithelial membrane antigen (EMA) and nuclear matrix protein 52 (NMP-52) singly and combined as noninvasive biomarkers for the detection of bladder cancer (BC).

Methods

A total of 160 individuals including 66 patients with BC, 54 patients with benign urologic disorders and 40 healthy volunteers were investigated. Urinary EMA at 130 kDa and NMP at 52 kDa were identified, purified and quantified by Western blot, electroelution and enzyme-linked immunosorbent assay (ELISA). The diagnostic performance of each biomarker and their combination were compared using area under receiver operating characteristic curves (AUC).

Results

Mean urinary EMA, 2.42 µg/mL, and NMP-52, 17.85 µg/mL, were significantly elevated in patients with BC compared to controls, 1.18 and 3.44 µg/mL, respectively (p<0.0001). The combined use of these markers yielded values which were increased 4.4- and 13.7-fold in the benign and malignant disease groups, respectively, with respect to the normal group. The values of EMA and NMP-52 were significantly higher in patients with higher-grade tumors than those with lower-grade tumors (p<0.0001). Moreover, this combination could predict all BC stages and grades with 0.91 AUC, 94% sensitivity and 80% specificity.

Conclusions

EMA and NMP-52 in combination could be promising noninvasive biomarkers for BC detection.
Major Contributions towards Finding a Cure for Cancer through Chemotherapy: A Historical Review
Authors: Masood Imran , Kiani Maria H. , Ahmad Mahmood , Masood Muhammed I. , Sadaquat Hadia
Published: October 2015

The history of cancer chemotherapy is as old as cancer itself. With the increase in the complexities of cancer and the development of resistance towards existing anticancer agents, increased attention is now being paid to the advancement of chemotherapy. Some chemotherapeutic agents were discovered by accident or trial-and-error methods while others were found to be useful for neoplasia when they were being evaluated for some other purpose. Broadly, these agents have been classified as alkylating agents, antimetabolites, platinum compounds, antitumor antibiotics and natural products. Hormones and compounds interfering with hormone metabolism are widely used in cancer treatment, besides monoclonal antibodies and small molecules targeting angiogenesis. In this review an attempt is made to discuss the major breakthroughs that have shaped the course of cancer chemotherapy, helping to decrease the mortality as well as lessen the suffering of patients.
Is Duodenojejunal Anastomosis to the Left of the Superior Mesenteric Vessels a Feasible Option for Tumors of the Angle of Treitz?
Authors: Caruso Francesco , Nencioni Marco , Zefelippo Arianna , Rossi Giorgio , Caccamo Lucio
Published: October 2015

Tumors of the angle of Treitz are a rare entity. Only 3%-5% of gastrointestinal stromal tumors (GISTs) occur at the level of the duodenum, and their location at the duodenojejunal junction is very uncommon. Surgery is the treatment of choice, while adjuvant medical therapy is used on the basis of the degree of radicality of the excision and the tumor's proliferative profile. These factors primarily influence the prognosis. Due to the frailty of the vascular viability of the left duodenum, which can be injured during surgery, it is generally recommended to perform digestive reconstruction at the level of the right portion of the duodenum. We here report the case of a patient with a large GIST located at the duodenojejunal junction behind the ligament of Treitz. We found reconstructive digestive anastomosis at the level of the third part of the duodenum to be a safe procedure.
Role of Breast Imaging in Predicting Outcome of Lesions of Uncertain Malignant Potential (B3) Diagnosed at Core Needle Biopsy
Authors: Petrovecki Marko , Alduk Ana Marija , Jakic-Razumovic Jasminka , Stern-Padovan Ranka , Bubic Vinko , Prutki Maja
Published: October 2015

Aims

To elucidate whether breast imaging can predict final histologic diagnosis of lesions of uncertain malignant potential diagnosed at ultrasound core needle biopsy (CNB).

Methods

The imaging characteristics (mammography, ultrasound, and magnetic resonance imaging [MRI]) of lesions of uncertain malignant potential in the breast that were obtained by ultrasound CNB were retrospectively analyzed in 87 women. Radiologic characteristics of lesions were compared to definitive histopathologic findings.

Results

Out of 87 breast lesions of uncertain malignant potential, 27 (31%) were diagnosed as papillary lesions, 24 (28%) atypical ductal hyperplasia, 19 (22%) lobular intraepithelial neoplasia, 9 (10%) phyllodes tumors, 3 (3%) radial sclerosing lesions, and 5 (6%) unspecified lesions of uncertain malignant potential. The underestimation rate of malignancy at CNB based on the total number of lesions on final follow-up was 22%. Using multivariate logistic regression, Breast Imaging-Reporting and Data System (BI-RADS) score (odds ratio [OR] = 12.29, p = 0.027) and Göttingen MRI scoring system (OR = 8.1, p = 0.008) were found to be independent predictors of malignancy. Receiver operating characteristic analysis showed that Göttingen MRI score >3 provides a plausibly good cutoff value with sensitivity of 100 (95% confidence interval [CI] 74%-100%) and specificity of 76% (95% CI 61%-88%).

Conclusions

Lesions of uncertain malignant potential classified as BI-RADS 5 and Göttingen score 4 or higher are at significantly higher risk of harboring malignancy and therefore should be recommended for surgical excision.
Peritoneal Cytology in Endometrial Cancer
Authors: Cetinkaya Kadir , Atalay Funda
Published: October 2015

Aims

To investigate whether positive peritoneal cytology (PPC) has an effect on expected survival in endometrial cancer and to present factors that affect PPC occurrence.

Methods

Patient chart information of 224 patients who had been treated at the Ankara Oncology Education and Research Hospital due to endometrial cancer between 1996 and 2006 were retrospectively reviewed. Factors that were likely to have an effect on peritoneal fluid cytology in all patients, such as age, histologic type, grade, myometrial invasion, cervical invasion, tumor size, and lymphatic metastasis, were analyzed.

Results

We observed peritoneal cytology, grade, myometrial invasion, cervical stromal invasion, tumor size, and lymphatic metastasis to have a significant effect on survival. Cytology was positive in 20 of 224 patients (8.9%). Statistical analysis revealed a significant effect on PPC occurrence of myometrial invasion, cervical stromal invasion, tumor size, histologic type, and lymphatic metastasis.

Conclusions

Positive peritoneal cytology has a significant effect on survival in endometrial cancer. Positive peritoneal cytology occurrence is influenced by myometrial invasion, cervical stromal invasion, tumor size, histologic type, and lymphatic metastasis.
Evaluation of Unusual and Highly Aggressive Variant of Endometrium Cancer: Nonendometrioid Endometrium Carcinoma of the Uterus
Authors: Sert Fatma , Yılmaz Ugur , Alanyalı Senem , Aras Arif , Ozsaran Zeynep
Published: October 2015

Aims

To evaluate the survival and treatment outcomes of patients with nonendometrioid endometrium carcinoma after postoperative radiotherapy.

Methods

The records of 94 patients treated with postoperative radiotherapy (RT) between January 2005 and December 2011 were retrospectively reviewed. Postoperative RT was delivered with a dose of 45-50.4 Gy with 1.8 Gy daily fractions and brachytherapy was added to external RT for 62 patients with a dose of 3 × 6 Gy. Median follow-up time was 35 months (range 6-95 months).

Results

Median age was 63 years (range 43-83 years) and lymph node metastasis (LNM) was positive in 15 (16.0%) patients. The stage distribution of the patients was as follows: stage I, 58 (61.7%); stage II, 16 (17.0%); stage III, 18 (19.1%); stage IV, 2 (2.2%). Five-year locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) rates were 92.3%, 68.2%, and 78.6%, respectively. In univariable analysis, it was determined that the factors affecting OS rates were stage (p = 0.003), presence of LNM (p = 0.003), and presence of lymphovascular space invasion (LVSI) (p = 0.007); factors affecting DFS rates were stage (p = 0.019), presence of LVSI (p = 0.002), and having LNM (p = 0.049); and the factor affecting LRC rates was tumor size (>5 cm) (p = 0.011). In subgroup analyses, among all stage I patients, the DFS rates were lower for those with histologic grade 3 tumors and more than ½ myometrial invasion.

Conclusions

Due to its rarity, the prognostic factors and outcomes of nonendometioid endometrium carcinoma are not fully understood. In our analysis, stage, LNM, and presence of LVSI were found to be the most important prognostic factors. In order to tailor the optimal treatment strategy, prospective studies are needed.
The Natural Compound Gambogic Acid Radiosensitizes Nasopharyngeal Carcinoma Cells under Hypoxic Conditions
Authors: Yang Meilin , Yang Yuehua , Cui Heqing , Guan Zhifeng , Yang Yan , Zhang Hao , Chen Xiaochen , Zhu Hongchen , Yang Xi , Cai Jing , Cheng Hongyan , Sun Xinchen
Published: October 2015

Aims

Hypoxia is an important factor that causes decreased local disease control as well as increased distant metastases and resistance to radiotherapy in patients with advanced nasopharyngeal carcinoma (NPC). Gambogic acid (GA), the major active ingredient of gamboge, exerts antitumor effects in vitro and in vivo. However, the molecular mechanism by which GA inhibits tumor radioresistance remains unclear. The present study aimed to investigate the radiosensitizing effects of GA on NPC and explore the underlying mechanisms.

Materials and methods

CNE-1 and CNE-2 cells exposed to hypoxia and radiation were treated with GA at different concentrations. CCK-8 assay, clonogenic assay, and flow cytometry were performed to analyze cell proliferation, colony formation, apoptosis, and cell cycle. The expression levels of hypoxia-inducible factor-1α (HIF-1α), Bcl-2, Bax, caspase-3, cyclin B1/p-cdc2 and γ-H2AX were assessed using Western blot and/or immunofluorescence analysis.

Results

Results of the CCK-8 assay, clonogenic assay, and flow cytometry showed that treatment of NPC cells with growth-suppressive concentrations of GA resulted in G2/M phase arrest and apoptosis. Western blot analysis demonstrated that GA-induced cell cycle arrest and apoptosis in CNE-2 cells was associated with upregulated expression of caspase-3 and Bax and downregulated expression of Bcl-2 and cyclin B1/p-cdc2 in hypoxia. Treatment with GA markedly decreased the expression of HIF-1α under hypoxic conditions.

Conclusions

The results of this study suggest that GA efficiently radiosensitizes NPC cells and the effect may be significant in hypoxic conditions.
Early Changes of Volume and Spatial Location in Target and Normal Tissues Caused by IMRT for Cervical Cancer
Authors: Chen Jianwu , Liu Ping , Chen Wenjuan , Bai Penggang , Li Jiangshan , Ni Xiaolei , Chen Kaiqiang , Li Qixin
Published: October 2015

Aims

To investigate the early changes of volume and spatial location in target and normal tissues caused by intensity-modulated radiotherapy (IMRT) for cervical cancer.

Methods

Forty patients with cervical cancer were included in this study and treated by IMRT. Computed tomography (CT) was performed before radiotherapy and when the patient had received 27 Gy in 15 fractions. After image registration, the volume of interest (VOI) for the targets and organs at risk was delineated by clinicians on the CT images. Changes of volume, spatial location and Dice similarity were calculated for all VOIs.

Results

There were significant changes in gross tumor volume (GTV) in the primary tumor (GTV-T) with t = 8.304 (p<0.01) and visible pelvic lymph nodes (GTV-N) with t = 4.996 (p<0.01) caused by IMRT. The mean volume differences for GTV-T and GTV-N were 38.64% ± 19.50% (range 3.16%–86.49%) and 42.49% ± 25.68% (range 2.79%–87.42%), respectively. Among the organs at risk, the bladder had the greatest volume change with 55.13% ± 33.40% (range 3.25%–116.01%). The Dice similarity for GTV-T and GTV-N was 0.50 ± 0.18 (range 0.10–0.85) and 0.31 ± 0.20 (range 0.00–0.71), respectively. The rectum had the least Dice similarity among the normal tissues, with a mean value of 0.57 ± 0.14 (range 0.18–0.76).

Conclusions

There were significant changes in volume and spatial location of the target and normal tissues after 27 Gy IMRT. In order to maintain the radiation dose to the targets and minimize the radiation to normal tissues, it is necessary to modify the radiotherapy planning.
Beyond the Beyond: First Case of 9 Cytoreductive Surgeries in a Long-Surviving Ovarian Cancer Patient: Case Report
Authors: Salerno Laura , Marchetti Claudia , Bevilacqua Elisa , Musella Angela , Riganelli Lucia , Ruscito Ilary , Perniola Giorgia , Muzii Ludovico , Benedetti Panici Pierluigi
Published: October 2015

Background

The role of surgery in recurrent ovarian cancer (ROC) is debated. Multiple prospective and retrospective series reported improved survival with optimal secondary surgical cytoreduction, but definitive results from randomized trials are needed. Up to the fourth cytoreductive surgery for recurrent disease in an attempt to improve patients’ prognosis has been reported.

Case Report

We report the first case of multiple ROC in an Italian woman, 50 years old at diagnosis, who underwent 9 cytoreductive surgeries during her 17 years of disease with no serious postoperative complications.

Conclusions

Multiple surgeries should not be considered as the standard treatment for ROC. In carefully selected patients, optimal cytoreductive surgery performed by highly specialized gynecologic oncologists might represent a useful tool in adjunction to chemotherapy for the management of ROC.
Outcomes of Thymoma Treated with Multimodality Approach: A Tertiary Cancer Center Experience of 71 Patients
Authors: Julka Pramod K. , Sharma Daya N. , Mallick Supriya , Gandhi Ajeet K. , Joshi Nikhil P. , Haresh Kunhi P. , Gupta Subhash , Rath Goura K.
Published: October 2015

Aims

To explore the demographics and clinical outcome of patients with thymoma treated with a multimodality approach at our institute.

Methods

A total of 71 patients with thymoma (Masaoka stage II-IV and WHO subtype AB-B3) treated from 1999-2013 were included in this retrospective analysis. Age, stage, WHO subtypes, details of surgery, radiotherapy, and chemotherapy were noted. Progression-free survival (PFS) was estimated using Kaplan-Meier method and SPSS (version 21.0) was used for statistical analysis.

Results

Male:female ratio was 56:15 with median age at presentation of 41 years. Stage-wise distribution was 6:46:19 for stage II, stage III, and stage IV, respectively. A total of 31 patients (44%) had associated myasthenia gravis and 3 had pure red cell aplasia. A total of 57 patients (80%) underwent radical thymectomy and all of these patients received adjuvant radiotherapy. A total of 15 patients and 7 patients received adjuvant chemotherapy and neoadjuvant chemotherapy, respectively. At median follow-up of 19.3 months (range 7.9-72.3 months), 2-year and 3-year PFS rate for the entire cohort was 78.3% and 57.1%, respectively. On univariate analysis, surgery (hazard ratio [HR] 3.881; 95% confidence interval [CI] 1.784-19.220; p = 0.006) and stage (HR 5.457; 95% CI 1.567-18.996; p = 0.0001) were significant prognostic factors and association with myasthenia gravis (HR 0.404; 95% CI 0.151-1.078; p = 0.078) trended towards better PFS. Stage retained its prognostic significance (HR 5.501; 95% CI 2.076-14.573; p = 0.0006) on multivariate analysis.

Conclusions

Multimodality management of locally advanced thymoma yields decent survival outcomes. Masaoka stage is an independent prognostic factor for survival and radical surgery should be contemplated in all cases of locoregionally limited thymoma.
Outcome of Definitive and Postoperative Radiotherapy in Patients with Sinonasal Squamous Cell Carcinomas
Authors: Park Shin-Hyung , Lee Jeong Eun , Ahn Dongbin
Published: October 2015

Aims

To evaluate outcomes in patients with sinonasal squamous cell carcinoma (SCC) treated with definitive radiotherapy (DRT) and postoperative radiotherapy (PORT).

Methods

Between 1990 and 2013, 73 patients with sinonasal SCC were treated with radiotherapy. Fifty-two patients (71.2%) were treated with DRT and 21 (28.8%) were treated with PORT. The primary tumor sites were the maxillary sinus in 47 patients (64.4%), the nasal cavity in 18 (24.7%), the ethmoid sinus in 7 (9.6%), and the frontal sinus in 1 (1.4%). Four (5.4%), 11 (15.1%), 24 (32.9%), 17 (23.3%), and 17 (23.3%) patients had T1, T2, T3, T4a, and T4b tumors, respectively. N stage was N0, N1, N2a, N2b, N2c, and N3 in 60 (82.2%), 6 (8.2%), 2 (2.7%), 2 (2.7%), and 3 (4.1%) patients, respectively. The median follow-up period was 23 months (range 3-196).

Results

The 5-year local progression-free survival (LPFS), regional progression-free survival (RPFS), distant metastasis-free survival (DMFS), and overall survival (OS) in the DRT and PORT groups were 50.6%, 82.1%, 91.1%, and 84.4% and 85.7%, 72.1%, 76.1%, and 83.5%, respectively, without any statistically significant differences.

Conclusions

The LPFS, RPFS, DMFS, and OS were not significantly different between the DRT and PORT groups. Given the possibility of functional disability and cosmetic disfigurement with facial surgery, DRT might be considered as a surrogate to surgery followed by PORT for patients with locally advanced sinonasal SCC.
Synergistic Cytotoxicity against Human Tumor Cell Lines by Oncolytic Adenovirus dl1520 (ONYX-015) and Melphalan
Authors: Ferguson Peter J. , Sykelyk Alexander , Figueredo Rene , Koropatnick James
Published: October 2015

Aims and background

In light of the need for more selective anticancer therapy, much work has been directed at developing compounds or biological agents that target functions specific to cancer cells. To this end, numerous viruses have been engineered to exploit the dependence of cancer cells on particular anomalies that contribute to their rogue proliferative activity, such as dysfunctional p53, overactive mitogenic signaling, or a defective interferon response. The oncolytic human adenovirus dl1520 (ONYX-015) was engineered to propagate specifically in p53-deficient tumors, which comprise over half of all tumors. Based on successes in clinical trials, the full potential of dl1520 and other oncolytic viruses may be even better realized by using them in combination with conventional chemotherapy drugs.

Methods

As a model system in which to test this potential, representative cell lines from 2 common cancer types, oral squamous cell carcinoma (HN-5a) and colon adenocarcinoma (HT-29), were chosen, as well as platinum-drug-resistant variants of each.

Results

Following preliminary screening of virus and drug combinations, dl1520 and melphalan were found to synergistically inhibit proliferation of all the cancer cell lines. Melphalan pretreatment or cotreatment with dl1520 enhanced inhibition of proliferation by dl1520 by up to 60% and increased apoptosis by up to 25%. The tight-junction protein CAR (coxsackie and adenovirus receptor), via which adenovirus enters cells, was not upregulated by treatment with melphalan, suggesting that other mechanisms contribute to synergy.

Conclusions

The synergy between melphalan and dl1520 suggests that tumor-selective cell killing by oncolytic viruses may be augmented by combining with cytotoxic drugs.
Positive Surgical Margin Status after Minimally Invasive Radical Prostatectomy: a Multicenter Study
Authors: Tafa Ardit , Grasso Angelica , Antonelli Alessandro , Bove Pierluigi , Celia Antonio , Ceruti Carlo , Crivellaro Simone , Falsaperla Mario , Minervini Andrea , Parma Paolo , Porreca Angelo , Zaramella Stefano , De Lorenzis Elisa , Cozzi Gabriele , Rocco Bernardo
Published: October 2015

Aim

The aim of our study is to evaluate the status of positive margins (PSMs) comparing their incidence between aparoscopic radical prostatectomy (LRP) and robot assisted radical prostatectomy (RARP) in centers with medium case-load (50–150 cases/year). We also analyzed the correlations between surgical technique, nerve-sparing approach (NS), and incidence of PSMs, stratifying our results by pathological stage.

Materials and methods

We analyzed 1992 patients who underwent RP in various urologic centers. We evaluated the incidence of PSMs, and then we compared the stage-related incidence of PSMs, for both the techniques.

Results

We did not find a statistically significant difference between the two surgical modalities in the study regarding the overall incidence of PSMs.

Conclusions

In our retrospective study, we did not find any difference in terms of PSMs in RARP versus LRP. Our PSMs were not negligible, particularly in pT3 stages, compared with high-volume centers; surgical experience and patients' selection can be a possible explanation.
Urological Consequences following Renal Transplantation: A Review of the Literature
Authors: Palazzetti Anna , Oderda Marco , Dalmasso Ettore , Falcone Marco , Bosio Andrea , Sedigh Omid , Frea Bruno , Gontero Paolo
Published: October 2015

Renal transplant (RT) represents the treatment of choice for end-stage renal disease (ESRD) but harbours a wide range of possible complications and therapeutic challenges of urological competence. Dialysis years and clinical medical background of these patients are risk factors for sexual dysfunction and lower urinary tract symptoms (LUTS). On the contrary, RT itself may have a number of possible surgical complications such as ureteral stenosis and urinary leakage, while immunosuppressive treatment is a known risk factor for de-novo malignancies.

The present review describes the main urologic problems of RT patients and their up-to-date treatment options according to the most recently available literature evidences.
Current Status of Robotic Urologic Surgery in Italy
Authors: Sacco Emilio , Bientinesi Riccardo , Bassi Pier Francesco
Published: October 2015

The introduction of robot-assisted surgery represents a milestone in the history of surgery. Today, many surgical disciplines make use of the DaVinci robotic system in performing surgery, even complex ones. Italy stands as one of the countries with a greater diffusion of robotics in surgery, particularly in urological surgery. In Italy, every year, numerous urological surgeries are performed with the DaVinci robot; however, costs of this technology are high and, although likely to decrease, constitute a limit to the spread of the same and restricting its use to shared areas.
Results of a Single Blind Study Placebo vs Diallil-Tiosulphinate, Nucipherine and Diosgenin in Patients Reponders to Tadalafil 5 mg
Authors: Scaduto Giovanna , Daricello Giuseppe , Pavone Carlo
Published: October 2015

The aim of the study is to evaluate the efficacy of Diallil-Tiosulphinate, Nuciepherine and Diosgenin in the treatment of erectile dysfunction. In our study were selected 120 men affected by erectile dysfunction. They were filled in a self-administered questionnaire International Index of Sexual Medicine. 74 of them reported a moderate erectile dysfunction and 46 reported a severe ED. All patients were treated with Tadalafil 5 mg once a day for 90 days. They were re-evaluated with the same questionnaire after three months of therapy. In 75% of the patients there was an improvement of IIEF-5 score. Only the 90 patients responders to Tadalafil once a day were randomized and divided into two groups, each formed by 45 subjects. The group A was treated with the association of Diallil-Tiosulfinate, Nucipherine and Diosgenin on alternate days. The patients of group B were treated with placebo. After three months, there was a new evaluation with IIEF-5 score. In group A we reported a maintenance of improvement post-Tadalafil in 36 patients;in group B, only 18 patients have maintained the previous improvement, according to IIEF-5 score. The χ2 test is 13,38, with a p-value of about 0,00013. The maintenance's odds ratio, confronting the two groups, is 6 with a confidence's interval of 95%. The study shows that the utilization of the association therapy in patients with erectile dysfunction responders to Tadalafil once a day is able to duplicate the odds of maintenance's improvement compared to placebo.
On the Relationship between Iranian L2 Teachers’ Pedagogical Beliefs and L2 Learners’ Attitudes
Authors: Sharajabian Maryam , Hashemian Mahmood
Published: October 2015

The present study employed a descriptive survey design to investigate L2 learners’ attitudes towards language learning, and the possible effects of teachers’ beliefs on learners’ attitudes. Participants were chosen from among 2 groups: Twenty EFL teachers were asked to take part in this study and 80 from a pool of 213 learners at 2 language schools who were chosen to fill out the learners’ attitude questionnaire. The teachers were subsequently placed at/in 3 groups of high-opinion group (HOG), moderate group (MG), and low-opinion group (LG), and the attitudes of the learners of these 3 groups of teachers were compared to uncover the possible impact of teacher beliefs on learner attitudes. The relationship between the teachers’ beliefs and the learners’ attitudes was analyzed, and it that showed there was a statistically significant difference in the learners’ attitude scores for HOG, MG, and LOG. Analysis of the data showed that the learners of the HOG teachers gained significantly higher attitude scores than the learners of the MG teachers. Simply put, it was found that EFL teachers’ beliefs can influence their learners’ attitudes about language learning. Language teachers should learn about the effect of their beliefs and experience it and become more aware of practicing them.
A Study of Effect of Dramatic Activities on Improving English Communicative Speaking Skill of Grade 11th Students
Authors: Iamsaard Prisana , Kerdpol Sakon
Published: October 2015

This paper aimed to reexamine the current EFL communicative speaking skill in high school level in Thailand due to the coming of the entry to ASEAN at the end of the year 2015. Thai students need to be wellprepared for workforce in the future since English is used as the working language in ASEAN. The purposes of this paper were to study the effect of dramatic activities on improving English communicative skills of grade 11th participants and to examine students’ opinions towards the use of dramatic activities in their speaking class. The duration of experiment was 21 hours within 7 weeks. The research instruments were lesson plans using dramatic activities, English communicative speaking test and a questionnaire measuring students’ opinions towards the teaching based on dramatic activities. The findings were that the English communicative speaking skill on grade 11th students after attending the teaching class using dramatic activities was significantly higher than before attending the teaching and the students’ opinions towards dramatic activities on speaking were highly positive.
Testamenten voor mensen met een beperking, in het bijzonder een verstandelijke handicap
Authors: Bauduin N.V.C.E.
Published: October 2015

Testamenten voor mensen met een beperking, in het bijzonder een verstandelijke handicap

Het nalaten aan een verstandelijk gehandicapt kind vereist bijzondere aandacht. Enerzijds willen ouders van een verstandelijk gehandicapt kind dat dit kind verzorgd achterblijft. Anderzijds willen zij doorgaans niet dat het na te laten vermogen ten goede komt aan een zorginstelling, of ‘geparkeerd’ wordt bij hun gehandicapte kind dat reeds een aanzienlijk vermogen heeft. In deze bijdrage wordt nader ingegaan op de mogelijkheden om te testeren in het kader van een verstandelijk gehandicapt kind.
Remote Internet Voting and Increase of Voter Turnout: Happy Coincidence or Fact? The Case of Estonia
Authors: Sál Karel
Published: October 2015

This article aims to explain a new and recent phenomenon from the scope of political science: How does the implementation of remote internet voting (RIV) affect voter turnout in one chosen European state (Estonia) after employing e-voting on the supranational, national and local level of elections. From some point of view, Remote internet voting can have a positive effect on lowering the barriers for voting, because traditional elections using paper ballots do not meet today’s standards for many citizens. The question seems simple: Does the application of RIV create new possibilities for Estonian citizens to vote outside the polling stations thus bringing new voters to the polls in a number, that we can recognize as a significant change in the total turnout in the first and the second level elections?
Open Data and Competition Law Some Issues Regarding Access and Pricing of Raw Data
Authors: Lundqvist Bjorn , Forsberg Ylva , De Vries Marc , Maggiolino Mariateresa
Published: October 2015

Public sector information (PSI) is a very valuable resource that, back in 2003, the EU parliament and council decided to appraise by incentivizing its re-use via a dedicated Directive. In 2013, the directive was revised to further promote the development of a single European market for information goods and services. On the bases of the European and national case law, this article investigates the main competitive issues that this EU law about PSI triggers.
From the Philosophy of Science to the Philosophy of the Sciences
Authors: Galavotti Maria Carla ,   Philosophy Documentation Center
Published: October 2015

The philosophy of science took shape as an autonomous discipline in the first decades of the Twentieth Century in connection with the movement known as logical positivism or logical empiricism. According to logical empiricists philosophy of science ought to perform a “rational reconstruction” aimed at exhibiting the logical structure of scientific theories and inferential processes involved in the acquisition of scientific knowledge. While focusing on the syntactical and semantical aspects of scientific language, logical empiricists left out of the realm of the philosophy of science the sociological and psychological aspects of theory formation, as well as all methodological aspects belonging to experimentation. Starting from the early Sixties this conception gradually changed, and philosophy of science underwent a radical transformation, leading to a significant broadening of its scope. New issues and problems were addressed, belonging to fields neglected by the traditional approach. This paper sketches the main features of the discipline as it is understood today as opposed to its traditional outlook, and suggests that the term “philosophy of the sciences” is better suited than “philosophy of science” to describe its present state.
Aspectos artísticos del fondo antiguo digital de la Universidad de Sevilla: los frontispicios del siglo XVI
Authors: Herrera José Luis
Published: October 2015

Se recopilan y estudian los frontispicios de la colección del fondo antiguo digital (siglo XVI) de la Universidad de Sevilla. Se propone un modelo de clasificación y análisis. El total de los frontispicios analizados es de 84, que forman parte de las 833 obras de la colección digital del siglo XVI de la Universidad de Sevilla.
Arte/Educación/Historia, una dialéctica del proceso de enseñanza/aprendizaje en museos de Historia
Authors: Alencar Valéria Peixoto de
Published: October 2015

La propuesta de este artículo es presentar una reflexión que relacione conocimientos históricos para el arte/educador  y conocimientos de educación artística para el historiador/educador. Utilizando algunos ejemplos del trabajo educativo realizado en el Museo Paulista/USP, São Paulo/SP, Brasil, busco tejer consideraciones acerca de los diferentes contextos que implican en el trabajo de educación en museos históricos, compartiendo y relacionando las ideas de educación emancipadora de Jacques Rancière y de la pedagogía del evento de Dennis Atkinson, como una acción contra la retórica de las certezas de la Historia del Arte partiendo de algunas consideraciones de Didi-Huberman.http://dx.doi.org/10.7203/eari.6.3510
Museos y modelos de comunicación
Authors: Vinent Cárdenas Maria , Martín Piñol Carolina , Gustems Carnicer Josep
Published: October 2015

La comunicación es uno de los elementos clave en un museo y que se relaciona con su capacidad educativa y de presencia e impacto en un territorio. la comunicación es previa a la visita y ejerce un importante reclamo y fundamenta el interés de los visitantes al museo. Este artículo pretende analizar los elementos principales destinados a establecer vínculos comunicativos con el píublico. Para ello se hace un repaso a dos modelos comunicativos, uno centrado en la información y otro a la emoción y ritualización. Se afronta la problemática de la indústria cultural frente a la obligada misión de los museos y de su distancia con los fines lucrativos de otras instituciones, que los pone en cierta situación de riesgo respecto a su futuro. Por otra parte se analizan canales habituales de la publicidad y el márquetin aplicados a los museos, para establecer los estudios de mercado y la marca imagen como técnica de identidad y valorización de cada museo. A continuación se analizan los componentes de las coleccciones mediante un esquema clásico comunicativo derivado de Saussure. también se señalan las principales caracterñísticas, evolución histórica y diferencias entre las exhibiciones y las exposiciones. Para finalizar se describen algunos elementos de la comunicación por internet como herramienta de presente y de futuro para asegurar la pervivencia de los museos y sus colecciones.http://dx.doi.org/10.7203/eari.6.4529