bluuebunny/crossref_metadata_2025 huggingface dataset:
Chromogranin-A Expression in Neoplastic Neuroendocrine Cells and Prognosis in Colorectal Cancer
Authors: Secco Giovanni Battista , Campora Elisabetta , Fardelli Roberto , Lapertosa Gabriella , De Lucchi Francesca , Gianquinto Daniela , Bonfante Pierfrancesco
Published: April 2018

Aims

Chromogranin-A (CG), a cytoplasmic glycoprotein, is one of the markers most frequently used to identify the presence of neuroendocrine cells in the human gastrointestinal tract. Several authors have identified a subgroup of colorectal cancer patients with a severe prognosis whose tumors contained neuroendocrine CG-positive cells. In the present study, CG expression in 100 patients with colorectal adenocarcinoma treated from January 1983 to December 1988 with potentially curative surgery was analyzed and correlated with other prognostic factors and 5-year survival rate.

Methods

Samples tested immunohistochemically for CG were divided into three groups: I) negative; II) less than 1 CG-positive cell/mm2; III) more than 1 CG-positive cell/mm2.

Results

Of 100 patients with primary colorectal adenocarcinoma, 79% had tumors comprised of CG-negative cells, 17% had rare CG-positive cells, and 4% of cases could be classified in group III. No significant relation between CG expression and location of primary tumor, bowel wall infiltration, stage of disease or tumor grade according to Broders and Jass was observed. The 5-year survival was 53% and 52% for CG-positive and CG-negative lesions, respectively. Survival of patients with Dukes-Kirklin stage C and D was comparable in patients with CG-positive (33.3%) and CG-negative (30%) tumors.

Conclusions

CG expression cannot, at present, be recommended as a marker to identify prognostic subgroups in colorectal cancer patients.
Chemoprevention of Breast Cancer with Fenretinide (4-HPR): Study of Long-Term Visual and Ophthalmologic Tolerability
Authors: Mariani Luigi , Formelli Franca , De Palo Giuseppe , Manzari Antonia , Camerini Tiziana , Campa Tiziana , Di Mauro Maria Gaetana , Crippa Arnaldo , Grottaglie Maurizio Delle , Del Vecchio Marcella , Marubini Ettore , Costa Alberto , Veronesi Umberto
Published: April 2018

Background

Fenretinide (4-HPR) is a synthetic retinoid being clinically tested in the chemoprevention of different tumors and precancerous lesions. Though safer than many other retinoids in experimental models, in humans 4-HPR may induce adverse effects that mainly affect the eye and visual function. Such effects are thought to be caused by the reduction of plasma retinol levels, which occurs after administration of the retinoid.

Methods

A series of 826 women treated with 4-HPR was studied to quantify the incidence and temporal pattern of occurrence of visual (dark adaptation) and ophthalmologic complaints (ocular dryness, lacrimation, conjunctivitis or photophobia) and to investigate the possible association between their occurrence and plasma retinol levels.

Results

The cumulative incidence of visual complaints reached nearly 20% at 5 years. The occurrence of these symptoms was more frequent at the start of treatment. The probability of developing visual complaints was significantly higher in patients with lower plasma retinol concentrations following 4-HPR treatment. The cumulative incidence of ophthalmologic complaints was 8% at 5 years. The occurrence of these complaints was evenly distributed during treatment. Ophthalmologic complaints were not associated with a greater degree of reduction of plasma retinol concentrations, but rather with the patient's age, since symptomatic patients were generally older than asymptomatic patients.

Conclusions

Visual and ophthalmologic complaints are common during 4-HPR treatment: their estimated 5-year cumulative incidence is close to 20% and 8%, respectively. However, the pattern of occurrence over time and the underlying mechanisms of these two types of complaints seem different.
Soft Tissues Sarcoma with Acute Paraneoplastic Hepatic Dysfunction: Case Report
Authors: Bisagni Giancarlo , Boni Corrado , Fornaciari Giovanni , Gherlinzoni Franco
Published: April 2018

A case of malignant fibrous histiocytoma of soft tissues of the right scapula associated with transitory hepatic dysfunction in the absence of liver metastases is reported. After primary radiation therapy, the patient manifested fever, anemia, thrombocytosis and hepatic dysfunction. All the abnormalities disappeared immediately after complete removal of the tumor. The patient was well, with no evidence of distant metastases, at more than 12 months later. It is concluded that the abnormalities of laboratory data were indirectly induced by the tumor, although the exact mechanism of this paraneoplastic syndrome was not clarified.
Complementary Medicine and Oncologists’ Attitudes: A Survey in Italy
Authors: Crocetti Emanuele , Crotti Nadia , Montella Maurizio , Musso Marco
Published: April 2018

Aims and Background

There is growing interest in medical practices other than conventional medicine (complementary medicine, CM). CM is widely used by cancer patients. The purpose of the present study was to evaluate the knowledge of and the attitude towards CM in a sample of Italian allopathic oncologists.

Methods

Seventy-six oncologists of the Istituto Nazionale per la Ricerca sul Cancro of Genoa, 80 oncologists working at the Istituto Tumori Fondazione Pascale of Naples, and 100 hospital practitioners of the Province of Sondrio were asked to answer a self-administered structured questionnaire on CM. The level of their knowledge on CM, their opinion on CM and on CM therapists, the sources of information, the use of CM for themselves, the practice of CM and the attitude to refer patients to CM were investigated.

Results

Replies were received from 190 oncologists. The response rate was significantly lower for the oncologists of Naples. One-fifth of the physicians replied that they had no knowledge of CM. The main sources of information were newspapers and TV. One-fourth of the physicians had personally used CM. About one-fourth of the physicians had practiced a kind of CM. The percentage of oncologists from Genoa who would refer their cancer patients to CM was significantly higher than the others. The physicians thought that about 84% of their patients used CM. The variables considered were tested in a multivariate model. The oncologists from Genoa showed a significantly increased risk of referring their patients to CM. Oncologists who had personally used CM referred patients to CM 3 times more frequently than the others.

Conclusions

A large percentage of cancer patients used CM according to their physicians. The level and the quality of the knowledge of CM of the oncologists interviewed were low. The oncologists could hardly be helpful for their patients in dealing with therapies different from conventional medicine.
Hydroxyurea Did Not Enhance the Clinical Response to Vinblastine in Patients with Anthracycline-Resistant Metastatic Breast Cancer
Authors: Huan Susan D. , Yau Jonathan C. , Tomiak Eva , Goel Rakesh , Cripps Christine , Gertler Stan Z. , Prosser Isobel A. , Stewart David J.
Published: April 2018

Background

Vinblastine is commonly used in metastatic breast cancer after anthracycline failure. The response rate to vinblastine is approximately 20%, with short duration of response. In vitro studies have shown that the addition of hydroxyurea resulted in increased accumulation of vinblastine in tumor cells and in loss of double minutes. We evaluated the combination of vinblastine and hydroxyurea in patients with anthracycline-resistant metastatic breast cancer.

Patients and Methods

Fourteen assessable patients with metastatic breast cancer were entered in the study. All patients had progressed on anthracyclines or progressed within 8 months of stopping anthracyclines. Patients received hydroxyurea (500 mg orally) every Monday, Wednesday and Friday starting one week before the first course of chemotherapy and continuing throughout treatment until disease progression. Vinblastine (6 mg/m2) was given intravenously every 21 days.

Results

The median number of courses for vinblastine was 3.5 (range, 1-6). Three patients had partial responses in soft tissue metastases (21%). Four patients had stable disease. Four patients had > grade 2 neutropenia, and 1 patient had grade 4 thrombocytopenia. There were 2 cases of grade 3 constipation, 2 of grade 3 nausea, and 1 each of grade 2 neuropathy and myalgia. There was no treatment-related mortality.

Conclusions

Low-dose hydroxyurea in combination with vinblastine has a 21% response rate in metastatic breast cancer after anthracycline failure. Toxicity was mild and generally reversible. At the adopted dose schedule of hydroxyurea, the antitumor activity of vinblastine in anthracycline-resistant metastatic breast cancer did not appear to be enhanced.
Radiotherapy in the Maxillary Hemangioma
Authors: Rovirosa Angeles , Berenguer Joan , Sánchez-Reyes Alberto , Arias Carlos , Ferre Jordi , Farrús Blanca , Traserra Juan , Biete Albert
Published: April 2018

We present the case of a large maxillary hemangioma treated by radiotherapy. Only 4 cases managed by radiotherapy have been reported in the literature, and most authors negate the radiosensitivity of the tumor. In our patient, the outcome was excellent; by 6 months tumor reduction was more than 50%. This is the first case referred to in the literature whose radiotherapy response was evaluated by magnetic resonance imaging. We describe the clinical and imaging findings of this very rare tumor and its evolution. We also comment on the literature reviewed.
Intramedullary Teratoma: Case Report and Review of the Literature
Authors: Caruso Riccardo , Antonelli Mariano , Cervoni Luigi , Salvati Maurizio
Published: April 2018

Aims and Background

Intramedullary teratoma is an extremely exceptional tumor (5 cases), although a careful review of international literature has shown it to be more frequent (32 cases) than believed.

Methods

The authors present a personal case with some unusual aspects.

Results

Our case is unusual not only because it was diagnosed by MRI (only one case has been reported in the literature) but also because surgical removal of the tumor was apparently total (only 4 other cases have been described), with a long follow-up period (4.5 years) and excellent results, in clinical and neuroradiologic terms.
Cancer of the Appendix in Long-Standing Ulcerative Colitis: A Case Report
Authors: Zannoni Ursula , Masci Caterina , Bazzocchi Ruggero , Gandolfo Francesco , Pezzi Alberto , Alampi Giulia , Biasco Guido
Published: April 2018

Cancer of the appendix was found in a 69-year-old female patient affected by long-standing ulcerative colitis (UC). On histological examination the cancer was a typical cystadenocarcinoma of the appendix. The appendiceal mucosa not invaded by the neoplastic process was normal. Histological examination of the colorectal mucosa did not show dysplasia or cancer. These findings suggest that appendiceal cancer and UC may be unrelated diseases. A surveillance program for early detection of cancer of the appendix in patients with longstanding UC does not seem mandatory.
Postoperative Radiotherapy and Surgery in Stage I Endometrial Carcinoma: A 10-Year Experience
Authors: Boz Giovanni , De Paoli Antonino , Innocente Roberto , Talamini Renato , Scarabelli Carlo , Scozzari Giovanni , Trovò Mauro G.
Published: April 2018

Background

Data from the literature show that the incidence of pelvic recurrences in poor prognosis endometrial carcinoma is significantly reduced by combined surgery and radiotherapy compared to surgery alone.

Methods

In this paper we analyze the results of the combined treatment surgery plus adjuvant irradiation in patients with endometrial carcinoma with regard to survival, site of progression, and toxicity. The surgical treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pelvic and para-aortic node dissection was performed.

Results

The overall 5-year survival was 88%. Three patients had local failure. Ten patients with local control of disease had distant metastases and 2 had local and distant recurrences.

Conclusions

Our experience confirms the data of the literature. Postoperative irradiation is a safe and well tolerated treatment which can achieve good local control in high-risk stage I endometrial carcinoma. The control of distant metastases remains an open issue.
Adult Granulosa Cell Tumor of the Ovary: A Clinico Pathologic Study of 35 Cases
Authors: Fontanelli Rosanna , Stefanon Bernardina , Raspagliesi Francesco , Kenda Rado , Tomasic Gorana , Spatti Giovanbattista , Riboldi Gianluca , Di Donato Patrizia , Pilotti Silvana , De Palo Giuseppe
Published: April 2018

Aims and background

Adult granulosa cell tumor has a low malignant potential but requires an extensive follow-up of more than 5 years to accurately assess tumor activity. The aim of the present study was to evaluate the clinical characteristics, the treatment and the outcome of this rare ovarian tumor.

Study design

A retrospective review of 35 cases treated at primary onset of disease during a 23-year period from 1971 to 1993.

Results

The disease-free survival rate for stages IA-B-C at 5 and 10 years was 90% and 84%, respectively; for stages III-IV the 5-year freedom from progression rate was 16%.

Conclusions

The most important prognostic factor appears to be the extent of tumor involvement outside of the ovary.
A Phase II Study of 5-AZA-2'Deoxycytidine (Decitabine) in Hormone Independent Metastatic (D2) Prostate Cancer
Authors: Thibault Alain , Figg William D. , Bergan Raymond C. , Lush Richard M. , Myers Charles E. , Tompkins Anne , Reed Eddie , Samid Dvorit
Published: April 2018

Aims and Background

Decitabine (5-aza-2′-deoxycytidine) is an S-phase-specific pyrimidine analog with hypomethylation properties. In laboratory models of prostate cancer (PC-3 and DU-145), decitabine induces cellular differentiation and enhanced expression of genes involved in tumor suppression, immunogenicity, and programmed cell death.

Methods

We conducted a phase II study of decitabine in 14 men with progressive, metastatic prostate cancer recurrent after total androgen blockade and flutamide withdrawal. Decitabine was administered at a dose of 75 mg/m2/dose IV as a 1 hour infusion every 8 hours for three doses. Cycles of therapy were repeated every 5 to 8 weeks to allow for resolution of toxicity.

Results

Two of 12 patients evaluable for response had stable disease with a time to progression of more than 10 weeks. This activity was seen in 2 of 3 African-American patients. Toxicity was similar to previously reported experience. No significant changes in urinary concentrations of the angiogenic factor bFGF, a potential biomarker of tumor activity, were identified over time in 7 unselected patients with progressive disease.

Conclusions

We conclude that decitabine is a well tolerated regimen with modest clinical activity against hormone-independent prostate cancer. Further investigations in patients of African-American origin may be warranted.
Radiobiological Models of Tissue Response to Radiation in Treatment Planning Systems
Authors: Niemierko Andrzej
Published: April 2018

Aims

To present several biological concepts and models of tissue response to fractionated radiotherapy. To describe practical implementation of these models in three-dimensional treatment planning systems.

Methods

Models of cell survival, Equivalent Uniform Dose (EUD) and Tumor Control Probability (TCP) are discussed. These models are based on the target-cell hypothesis which assumes that response of organs and tissues to radiation therapy can be explained and mathematically described in terms of survival of the specific target-cells.

Results

Several formulae for deriving and calculating EUD and TCP for a given three-dimensional dose distribution are presented and discussed.

Conclusions

Biological models of tissue response to radiation, when used wisely, have a potential to be useful in radiation therapy treatment planning. The models can advance our understanding of the underlying biological mechanisms, and may help in designing new and better treatment strategies. They should be particularly useful in modern conformai radiotherapy where treatment strategy for each patient can be individualized and optimized according to patient characteristics and available technology of delivering sophisticated treatment plans.
Hadrontherapy in the World and the Programmes of the Tera Foundation
Authors: Arnaldi Ugo
Published: April 2018

Hadrontherapy was born in 1938, when neutron beams were used in cancer therapy, but it has become an accepted therapeutical modality only in the last five years. Fast neutrons are still in use, even if their limitations are now apparent. Charged hadron beams are more favorable, since the largest specific energy deposition occurs at the end of their range in matter. The most used hadrons are at present protons and carbon ions. Both allow a dose deposition which conforms to the tumour target. Radiobiological experiments and the results of the first clinical trials indicate that carbon ions have, on top of this macroscopic property, a different way of interacting with cells at the microscopic level. There are thus solid hopes to use carbon beams of about 4500 MeV to control tumours which are radioresistant both to X-rays and protons. After discussing these macroscopic and microscopic properties of hadrontherapy, the hospital-based facilities, running or under construction, are reviewed. The conclusion is that, while in USA and Japan twelve of these centres will be running around the year 2001, in Europe very little is foreseen to use hadrontherapy to treat deep-seated tumours. The most advanced programme is the Italian one, which is described in the last Sections of the report. The main activities concern the construction, near Milano, of a centre for protons and carbon ions called CNAO (National Centre for Oncological Hadrontherapy) and the development of new type of proton accelerators. The Istituto Superiore di Sanità in Rome obtained the initial financing for constructing, in collaboration with ENEA, a 3 GHz linac, which eventually will accelerate protons to 200 MeV, so as to allow deep protontherapy. These, and other hadrontherapy centres in Italy and Europe, will be connected with oncology centres, hospitals and clinics by a multimedial network called RITA, so that before referral each patient's case can be discussed directly by doctors, even located far away, with the experts sitting in the hadrontherapy centres.
Chemotherapy for Advanced Pancreatic Cancer: The History is Changing
Authors: Graziano Francesco , Catalano Giuseppina , Cascinu Stefano
Published: April 2018

Until recently, chemotherapy was considered ineffective in pancreatic cancer and these patients received best supportive care only. Now, there is evidence that chemotherapy may influence the natural history of the disease by prolonging survival and there are data on its role as an effective tool for the improvement of physical conditions in patients with advanced disease. The results are far from conclusive, and only partially satisfying but they represent a step forward.
Leukocyte Alkaline Phosphatase, CA15-3, CA125, and CEA in Cancer Patients
Authors: Walach Natalio , Gur Yigal
Published: April 2018

Peripheral blood leukocyte alkaline phosphatase (LAP) scores and CA15-3, CA125, and CEA levels in plasma were measured in 57 patients with metastatic breast, ovarian, and colorectal cancer, respectively, and in 79 patients with the same types of nonmetastatic cancer. The mean LAP scores of the metastatic cancer patients (261, 272 and 275 for breast, ovary and colon, respectively) were significantly higher than those of the nonmetastatic cancer group (70, 68 and 57, respectively). There was no overlap between the 95% confidence intervals of the two groups (i.e., metastatic versus nonmetastatic), and no patient known to be metastatic had a LAP score within the normal range. The mean levels of other markers in the metastatic patients (CA15-3, 63.4 μ/ml; CA125, 104.8 μ/ml; and CEA, 51.8 ng/ml for metastatic breast, ovarian, and colon cancer, respectively) were also higher than in the nonmetastatic patients (CA15-3, 24 μ/ml; CA125, 25.3 μ/ml; and CEA, 5.8 ng/ml for nonmetastatic breast, ovarian, and colon cancer, respectively). However, the 95% confidence intervals of the nonmetastatic and the metastatic patients overlapped so that there were false-negatives and/or false-positives when the other markers were used. We therefore conclude that the addition of the LAP score to conventional cancer markers could be helpful for the diagnosis of recurrence and follow-up of cancer patients and suggest that our results be confirmed by further studies on a larger series of patients.
Tamoxifen as Adjuvant after Surgery for Breast Cancer and Tamoxifen or Placebo as Chemoprevention in Healthy Women: Different Compliance with Treatment
Authors: Veronesi Andrea , Pizzichetta Maria Antonietta , Ferlante Maria Annunziata , Zottar Maura , Magri Maria Donatella , Crivellari Diana , Foladore Silva
Published: April 2018

Aim

The aim of this study was to investigate whether tamoxifen toxicity and treatment discontinuations differred in the adjuvant versus chemopreventive setting.

Methods

At our Institutions 119 postmenopausal breast cancer patients were randomized from August 1987 to March 1995 to tamoxifen only within adjuvant studies (International Breast Cancer Study Group studies VII and IX) and 202 healthy hysterectomized women aged 35-70 years were randomized from November 1993 to May 1996 in a multicenter, double-blind, placebo-controlled chemoprevention study (Italian Tamoxifen Prevention Study). The tamoxifen dose was 20 mg/day for 5 years in all studies. Median age was 66 years (54-85) in the adjuvant studies and 53 years (37-69) in the chemoprevention study. Median treatment duration was 238 and 120 weeks, respectively.

Results

Patients treated within adjuvant studies experienced more hot flashes, vaginal discharge and/or bleeding, bone marrow depression and weight gain than those treated in the chemoprevention study, consistent with the fact that a proportion of women in the latter study were receiving placebo. Temporary discontinuation occurred in 2.5% of patients in the adjuvant studies and in 5.4% of women in the chemoprevention study (difference not statistically significant). Permanent discontinuation was more frequent in the chemoprevention study than in the adjuvant ones (26.7% vs 15.1% - P < 0.05).

Conclusions

In summary, our data show that, although the toxicity of tamoxifen is superimposable in the two settings, a larger proportion of women treated as chemoprevention discontinue treatment spontaneously. Due to the double-blind nature of the chemoprevention study, the impact of the toxicity of tamoxifen upon compliance in the chemopreventive setting cannot be ascertained.
Complete Response to Chemotherapy in Intra-Abdominal Desmoplastic Small round Cell Carcinoma. A Case Report
Authors: De Lena Mario , Caruso Maria Lucia , Marzullo Franco , Mancarella Sergio , Armentano Raffaele , Ventrella Vincenzo , Guida Michele
Published: April 2018

Aims and background

The authors report the case of a 23-year-old woman affected by intra-abdominal desmoplastic small round cell tumor (DSRCT) who obtained a complete response to multiagent chemotherapy. DSRCT is a rare, highly aggressive neoplasm generally arising in young people and seldom in females (about 20 cases described in the literature).

Methods

The patient underwent surgical resection of a large 15 × 15 cm mass located in the right lower abdominal quadrant, but after only 2 months later, two liver metastasis were noted. Thus, she was subjected to an aggressive antineoplastic treatment consisting of three groups of alternating non-cross resistant multiagent regimens administered every 21 days (cis-platin-etoposide-adriamycin-bleomicin; gemcitabine-ifosfamide-dacarbazine; methotrexate-5-fluorouracilfolinic acid) for a total of 9 administrations.

Results

After one cycle of treatment including the administration of all the three alternated schemes of chemotherapy, a complete disappearance of liver disease was noted. The treatment was relatively well-tolerated and the toxicity was acceptable. At present, after 15 months from diagnosis and 12 months after starting chemotherapy, the patient is disease-free and in good health.

Conclusions

Even though this study regards only a single patient, it is noteworthy because of the rarity of this neoplasm and because of the infrequent complete responses reported in the literature. The efficacy and manageability of the treatment, suggests that both the timing and schedule used could constitute an important therapeutical option for this aggressive and poorly chemo-responsive tumor.
La Gastroprotezione Nel Paziente Oncologico: Approccio Razionale, Ruolo Dei Farmaci Antisecretori Ed Eventuali Ulteriori Prospettive in Oncologia
Authors: Mustacchi Giorgio , Ceccherini Rita
Published: April 2018

In view of the large number of cancer patients treated with FANS and/or corticosteroids for long periods of time, Authors discuss how the use of antisecretory drugs for gastroprotection has become common practice in spite of the lack of clear scientific evidence. The paper analyses the principal mechanisms of gastrotoxicity of FANS, essentially associated with the inhibition of prostaglandins and consequent reduction of the secretion of mucous and bicarbonate. It also discusses the numerous controlled trials evaluating the efficacy of ranitidine for gastroprotection versus placebo and versus the analogous synthetic substance, misoprostole, derived from prostaglandin E1. This analysis shows that misoprostole provides significant protection against both gastric and duodenal ulcers, whilst the antisecretory drug protects only against localised duodenal ulcer. The conclusion is that optimum protection against FANS is provided by misoprostole. In any case more than 30% of patients are destined to develop ulcerous or minor lesions for which treatment with antisecretory drugs is correct.

After analysis of the available literature on the gastrotoxicity of corticosteroids, it is clear that this risk is real only for a small sub-population of patients (treated in dual therapy with FANS, for long periods, with high doses or in presence of ulcer anamnesis). It is not known in these cases whether prophylactic treatment is suitable, nor which would be the best prophylactic treatment. In other cases the problem does not arise since the number of patients developing ulcers is similar with corticosteroids treatment or with placebo.

Some further interesting features of ranitidine compared to cimetidine (its better pharmacological profile due to the lack of side effects, lack of medullary depression, lack of interference with the immunological system, lack of antiandrogen effects) are also discussed.

Particularly interesting is the lack of interference with cyclophosphamide metabolism, such interference having shown for cimetidine.

Studies involving ranitidine treatment in association with Interleukin-2 for renal carcinoma and metastatic melanoma are also of interest although no statistically significant results are available as yet.
EPOETIN A ALFA IN RADIOTERAPIA
Authors: Trodella Lucio , Balducci Mario , Gambacorta Maria Antonietta , Mantini Giovanna
Published: April 2018

Sixty per cent of oncologic patients need radiation therapy for cure or palliation. In fact, in most neoplastic diseases, a better local control positively impacts on disease-free survival and overall survival. The efficacy of radiotherapy depends on several factors: while some are tumor-related, others are host-related.

Radiobiological phenomena are also important: ionizing radiation is responsible for cell damage (double rupture of DNA chains), mostly an indirect mechanism with the formation of free radicals. Their toxic action is enhanced by the oxygen partial pressure at the cellular level.

A number of studies have confirmed that good tissue oxygenation is a function of a high hemoglobin level in the peripheral blood (Hb≥13g/dL). Unfortunately, these values are rarely present in oncologic patients due to the disease-related toxicosis as well as to the therapy induced hematologic toxicity.

The treatment of anemia is free of risk for the recent developments in technology which with gene cloning and the technique of recombinant DNA has allowed the production of human recombinant erythropoietin.

Erythropoietin is produced by the interstitial cells of renal tubules in response to hypoxia. It prevents apoptosis and promotes erythroid proliferation and differentiation with consequent reticulocyte release and hemoglobin synthesis.

It is not completely understood whether the efficacy of radiotherapy depends on hemoglobin values present at the start of irradiation (often less than 12-13 g/dL) or on the higher ones observed during and at the end of radiotherapy.

Therefore, preventive systemic erythropoietin therapy in non anemic patients in terms of costs/benefits is at present non sustainable.

To the contrary, in patients undergoing radiotherapy to extended fields or aggressive multimodal treatments, for the higher risk of anemia, the early use of this treatment can be hypothesized in case of initial anemia to improve therapy compliance and prevent negative conditioning of results.

Keeping in mind that grade 1 minimum toxicity for red cells, according to the Radiation Therapy Oncology Group (RTOG) is equal to 11gHb/dL we think that this value can be considered as cutoff to start erythropoietin therapy.
Peritoneal Carcinomatosis: Feature of Dissemination a Review
Authors: Deraco Marcello , Santoro Nicola , Carraro Orlandina , Inglese Maria Grazia , Rebuffoni Giacomo , Guadagni Stefano , Somers Danielle Carlier , Vaglini Maurizio
Published: April 2018

Peritoneal carcinomatosis is a common event that develops in the natural history of many neoplastic diseases, representing a major problem encountered in cancer management. Peritoneal seedings are often associated with neoplastic ascites resulting in a source of significant discomfort to the patient. Considered in the past as a terminal condition, peritoneal carcinomatosis was approached during the last two decades as a curable disease. The introduction of cytoreductive surgery or peritonectomy in the treatment of peritoneal neoplastic diseases drastically changed the natural history of peritoneal carcinomatosis. Another technique that showed an important impact on disease control is intraperitoneal hyperthermic perfusion, one of the most fascinating treatments of peritoneal carcinomatosis that results in an impressive increase in overall survival and quality of life in treated patients with low morbidity. This review illustrates the modality of dissemination of peritoneal carcinomatosis in relation to the primary tumor site and grade of malignancy. Peritoneal carcinomatosis is a term used to define an advanced stage of many abdominal neoplastic diseases that differ in biologic aggressiveness and prognosis. The different presentation of peritoneal carcinomatosis in relation to a different primary tumor and different grade of malignancy strongly influences the potentially therapeutic radical approaches using new and advanced modalities like cytoreductive surgery and intraperitoneal hyperthermic perfusion.
Neural Correlates of Speed-Tuned Motion Perception in Healthy Adults
Authors: Meier Kimberly , Partanen Marita , Giaschi Deborah
Published: April 2018

It has been suggested that slow and medium-to-fast speeds of motion may be processed by at least partially separate mechanisms. The purpose of this study was to establish the cortical areas activated during motion-defined form and global motion tasks as a function of speed, using functional magnetic resonance imaging. Participants performed discrimination tasks with random dot stimuli at high coherence, at coherence near their own thresholds, and for random motion. Stimuli were moving at 0.1 or 5 deg/s. In the motion-defined form task, lateral occipital complex, V5/MT+ and intraparietal sulcus showed greater activation by high or near-threshold coherence than by random motion stimuli; V5/MT+ and intraparietal sulcus demonstrated greater activation for 5 than 0.1 deg/s dot motion. In the global motion task, only high coherence stimuli elicited significant activation over random motion; this activation was primarily in nonclassical motion areas. V5/MT+ was active for all motion conditions and showed similar activation for coherent and random motion. No regions demonstrated speed-tuning effects for global motion. These results suggest that similar cortical systems are activated by slow- and medium-speed stimuli during these tasks in healthy adults.
Music performance skills: A two-pronged approach – facilitating optimal music performance and reducing music performance anxiety
Authors: Cohen Susanna , Bodner Ehud
Published: April 2018

Classical performing musicians have command of a wide range of cognitive, physiological and musical skills. However, the literature on facilitating optimal music performance has tended to focus on treating the pathological aspects of performance: on reducing debilitating music performance anxiety (MPA). This study explores the suggestion from positive psychology that optimal functioning cannot be attained solely by the absence of pathology, but that methods for facilitating positive functioning need to be actively cultivated. Twenty-four music students participated in a semester Music Performance Skills course or wait-list control condition. The course comprised mental skills training, physiological awareness, enhancing musical communication and simulated performances. Significant pre-/post-test reductions in self-reported MPA, and significant improvements in performance quality, judge-rated MPA, positive and negative affect and state anxiety were reported in the intervention group. No significant changes in measures of flow were observed. The implications of the findings for musical educational establishments are discussed.
Timing and Outcomes of Tracheostomy Performed by Pulmonary and/or Critical Care Physicians
Authors: Nishi Shawn P. E. , Shah Shiwan K. , Zhang Wei , Kuo Yong-Fang , Sharma Gulshan
Published: April 2018

Background:

Although pulmonary and/or critical care (P/CC) physicians perform percutaneous tracheostomy in mechanically ventilated patients, the trends, timing, and outcomes of this procedure have not been well described. This study aims to describe the trends, timing, and outcomes of this procedure.

Methods:

Using 5% medicare data, we retrospectively examined a cohort who had tracheostomy performed after initiation of mechanical ventilation during acute hospitalization to describe the timing of tracheostomy placement by pulmonary and/or critical care (P/CC) physicians and associated outcomes.

Results:

There were 4864 participants in the study cohort from 2007 to 2014. We examined the timing of tracheostomy (in days from initiation of mechanical ventilation), length of hospital stay, in-hospital death, and death within 30 days after hospital discharge. The percentage of tracheostomies performed by P/CC physicians increased significantly, from 7.2% in 2007 to 14.1% in 2014 (Cochran-Armitage test for trend, P = .001). Tracheostomies performed by P/CC physicians were more common in larger hospitals and major academic medical centers. After adjustment for baseline characteristics, the following parameters did not differ by provider: time to tracheostomy, length of hospital stay (days), in-hospital death, and death within 30 days after discharge. A tracheostomy was more likely to be performed by a P/CC physician at a larger (≥500 beds) hospital (adjusted odds ratio: 1.85, 95% confidence interval: 1.47-2.34).

Conclusions:

Tracheostomies are increasingly performed by P/CC physicians with similar outcomes, likely related to patient selection.
Theoretical investigation into the formation mechanism and mitigation measures of short pitch rail corrugation in resilient tracks of metros
Authors: Fang Ge , Wang Yurong , Peng Zhike , Wu Tianxing
Published: April 2018

Severe rail corrugation occurs at both the curved and tangent tracks of the metro in Shanghai, where resilient rail fasteners are used to reduce ground-borne vibration by isolating the transmission of track vibration to the infrastructure. The wavelength of corrugation is about 25–30 mm. It could be assumed that this short pitch rail corrugation is caused by the pinned–pinned resonance. However, rail fasteners with low stiffness were believed to be able to suppress the pinned–pinned resonance thereby resulting in corrugation. To investigate the formation mechanism of this specific rail corrugation, a multiple wheel–rail interaction model is used to calculate the wheel–rail dynamic forces caused due to the multiple wheel–rail interactions, which are considered to play a major role in the formation of corrugation. Then the influences on wear and corrugation growth are analyzed in terms of both amplitude and phase of the wheel–rail dynamic forces. By combining the properties of multiple wheel–rail interactions with their influences on wear and corrugation, the growth rates of rail corrugation at different wavelengths (frequencies) are studied to obtain the characteristic wavelength (frequency), at which the highest corrugation growth rate appears. The obtained characteristic wavelength is in good agreement with observation in the practice of Shanghai metro. It is found that the wave reflection from the wheels on the rail is responsible for the short pitch rail corrugation in the resilient tracks. Finally, tuned rail dampers are applied in the multiple wheel–rail interaction models to investigate their effects on rail corrugation growth. The simulation results show that use of tuned rail dampers is effective in suppressing the short pitch rail corrugation occurring at resilient tracks.
Pathological evidence reveals cattle traction in North China by the early second millennium BC
Authors: Lin Minghao , Luan Fengshi , Fang Hui , Xu Hong , Zhao Haitao , Barker Graeme
Published: April 2018

The use of cattle labour in antiquity is a worldwide well-discussed topic among researchers as it can shed light on the possible development trajectories of our communities over the past several millennia. Zooarchaeology can play a vital role in illuminating the history of cattle traction through observed pathologies on cattle bones linked to traction activity. Systemic zooarchaeological investigation is still underdeveloped in China, one of the likely early beneficiaries of animal labour exploitation in the world. Here, we apply the pathological index (PI) method, first developed by Bartosiewicz et al. on European assemblages, to Chinese Bronze Age cattle bones. Our results first confirm the wide applicability of the PI method with the involvement of Chinese control samples, which holds the potential to be applied as an effective tool in a larger geographical region. Our results also confirm the importance of cattle traction for the Late Shang states ( c. 1300–1046 BC) as previously proposed on the basis of disputed interpretations of oracle bone inscriptions as showing cattle ploughing, but also show that light cattle traction practices likely developed in China in the Bronze Age Erlitou ( c. 1750–1530 BC) and Early Shang ( c. 1600–1300 BC) periods. Cattle traction use in the Chinese Bronze Age may have facilitated the introduction and subsequent cultivation in China of wheat, an exotic cereal.
Relations between socio-economic factors and nutritional diet in Vietnam from 2004 to 2014: New insights using compositional data analysis
Authors: Trinh Huong Thi , Morais Joanna , Thomas-Agnan Christine , Simioni Michel
Published: April 2018

This paper contributes to the analysis of the impact of socioeconomic factors, like food expenditure level and urbanization, on diet patterns in Vietnam, from 2004 to 2014. Contrary to the existing literature, we focus on the diet balance in terms of macronutrients consumption (protein, fat and carbohydrate) and we take into account the fact that the volumes of macronutrients are not independent. In other words, we are interested in the shares of each macronutrient in the total calorie intake. We use compositional data analysis (CODA), adapted to deal with the relative information contained in shares, to describe the evolution of diet patterns over time, and to model the impact of household characteristics on the macronutrient shares vector. We compute food expenditure elasticities of macronutrient shares, and we compare them to classical elasticities for macronutrient volumes and total calorie intake. The compositional model highlights the important role of many factors in the determination of diet choices and we will focus mainly on the role of food expenditure. Our results are consistent with the rest of the literature, but they have the advantage to highlight the substitution effects between macronutrients in the context of nutrition transition.
Macroscopic modeling of NiTiHf under different loading modes: A finite difference method
Authors: Farjam Nazanin , Mehrabi Reza , Karaca Haluk , Elahinia Mohammad
Published: April 2018

High-temperature shape memory alloys have remarkably solved the limitation of conventional shape memory alloys working at low levels of temperature and stress. The focus of this study is on a semi-analytical constitutive model for high-temperature shape memory alloys to predict their mechanical behavior. The model is based on Gibbs free energy, and the equations are simplified for NiTiHf at different loading conditions. A uniaxial compression case is used to validate the model with the experimental results. Superelastic behavior and also heating and cooling at different stress levels are compared to the experimental data reported in the literature. The nonlinear equations are solved using finite difference method, which is capable to calculate the distribution of strain and phase transformation along the cross section for various loading modes. Several more case studies on pure torsion and multiaxial loading are also investigated to show the capabilities of this approach.
Impact fracture behaviors of three-dimensional braided composite U-notch beam subjected to three-point bending
Authors: Shi Baohui , Liu Shengkai , Siddique Amna , Du Yongcan , Sun Baozhong , Gu Bohong
Published: April 2018

Impact fracture behaviors of three-dimensional braided composites are critical to designing the braided composite parts. Here we report the impact fracture behaviors of three-dimensional braided composite U-notch beam tested on a modified split Hopkinson pressure bar. Crack mouth opening displacement, deformation process, and crack evolutions were recorded with high-speed photography camera. The digital image correlation method was used to calculate deformation contours of the braided composite. A microstructure model of the three-dimensional braided composite U-notch beam was established for analyzing damage evolution and fracture mechanisms. The histories of deformation, the load, and the crack mouth opening displacement were obtained from the impact fracture test and finite element analysis. It was found that the impact fracture resistance and morphologies were influenced by the braided structure and braided yarn orientations. The crack generated at the notch tip and then propagated along the braided angle direction rather than the perpendicular direction that often occurred for isotropic materials, such as the epoxy resin solid. The combinations of different braided angle and yarns are recommended for high impact fracture behavior design.
Reactive Nodular Fibrous Pseudotumor Mimicking Metastatic Gastrointestinal Stromal Tumor to Perigastric Lymph Node: A Case Report and Review of the Literature
Authors: Moodley Jinesa , Cutz Jean-Claude , Schell Miranda
Published: April 2018

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal lesions of the gastrointestinal tract. Many are treated surgically with or without the use of adjuvant tyrosine kinase inhibitors. Metastases to lymph nodes are infrequent. In this article, we present a case of a perigastric nodule presenting 3 years postsurgical treatment for biopsy-proven GIST, clinically suspicious for a recurrent/metastatic GIST. The patient had also received adjuvant tyrosine kinase inhibitor therapy. Microscopic sections from the perigastric lesion showed a spindle cell nodule felt initially to represent a GIST with posttherapeutic changes. Together with morphology, immunohistochemical workup supported the myofibroblastic origin of the spindle cells, consistent with a reactive nodular fibrous pseudotumor, and definitively excluded metastatic GIST. This case highlights an important diagnostic pitfall and is the first known case of a GIST preceding a reactive nodular fibrous pseudotumor.
Inflammatory Biomarker Profiling in Total Joint Arthroplasty and Its Relevance to Circulating Levels of Lubricin, a Novel Proteoglycan
Authors: Galicia Kevin , Thorson Chase , Banos Andrew , Rondina Matthew , Hopkinson William , Hoppensteadt Debra , Fareed Jawed
Published: April 2018

Lubricin, also known as proteoglycan 4, acts as an antiadhesive and boundary lubricant to prevent cartilage damage in healthy joints. Following injury, a decrease in synovial fluid (SF) lubricin may lead to secondary osteoarthritis (OA). Inflammatory biomarkers, such as IL-1β and TNF-α, are also implicated in the pathophysiology of OA. Interestingly, they have been shown to suppress the expression and secretion of lubricin in SF. This study aims to compare circulating levels of inflammatory biomarkers and lubricin between total joint arthroplasty (TJA) patients and healthy individuals. Doing so may better elucidate their roles in OA and extend the understanding of inflammation as a regulator of lubricin. Deidentified plasma samples were obtained 1 day preoperatively and 1 day postoperatively from patients undergoing TJA. Utilizing biochip array technology, they were profiled for IL-2, IL-4, IL-6, IL-8, IL-10, VEGF, IFN-γ, IL-1α, IL-1β, MCP-1, EGF, and TNF-α. Circulating lubricin levels were also measured using enzyme-linked immunosorbent assay. Compared to healthy controls, IL-6, IL-8, VEGF, IL-1β, MCP-1, EGF, and TNF-α were significantly increased pre- and postoperatively. Lubricin was significantly decreased. This may indicate that elevations in inflammatory cytokines initiate a cascade of events, leading to decreased lubricin, which places the joint at increased risk of developing OA.
Pharmacological Differentiation of Thrombomodulin Alfa and Activated Protein C on Coagulation and Fibrinolysis In Vitro
Authors: Tanaka Kosuke , Tawara Shunsuke , Tsuruta Kazuhisa , Hoppensteadt Debra , Fareed Jawed
Published: April 2018

Although thrombomodulin alfa (TM alfa), recombinant human soluble thrombomodulin, exerts antithrombogenic effects through activated protein C (APC), clinical trials suggested that TM alfa has a lower bleeding risk than does recombinant human APC. To address the mechanism explaining this difference, effects of TM alfa and APC on thrombogenic, coagulation, and fibrinolytic processes were compared in vitro. TM alfa and APC inhibited generation of thrombogenic markers, thrombin, and prothrombin fragment F1+2 and prolonged coagulation parameters, activated clotting time (ACT), and activated partial thromboplastin time (APTT). Concentrations of TM alfa effective for thrombin and F1+2 generation inhibition were comparable to those of APC. However, effects of TM alfa on ACT and APTT were clearly weaker than those of APC. TM alfa significantly prolonged clot lysis time (CLT) and decreased LY30, a parameter of degree of fibrinolysis in thromboelastography, whereas APC significantly shortened CLT and increased LY30. These results suggested that while the antithrombogenic effects of TM alfa were similar to those of APC, its anticoagulant effects were lower. In addition, effects of TM alfa were antifibrinolytic, while those of APC were profibrinolytic.