bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishment and characterization of TSGH9201, a human gastric carcinoma cell line that is growth inhibited by epidermal growth factor
Authors: Shyu Rong‐Yaun , Jiang Shun‐Yuan , Yeh Ming‐Yang , Wang Chang‐Chung , Wu Ming‐Fang , Harn Horng‐Jyh , Chang Tzu‐Ming
Published: February 2007

A human signet ring gastric carcinoma cell line TSGH9201 was established in vitro. The cells grew in vitro as a monolayer with polygonal morphology and had a population doubling time of 34 hours. The cells secreted tumor markers CEA and CA 125. They were, however, not tumorigenic in athymic nude mice. Karyotypic analysis demonstrated a near tetraploidy with a modal chromosome number of 98. Northern blotting and immunocytochemical analysis revealed the expression of both transforming growth factor α and high levels of epidermal growth factor receptor. Cell growth was inhibited by the epidermal growth factor in vitro. The cell line may be a useful tool to study autocrine growth regulation through the epidermal growth factor receptor. © 1995 Wiley‐Liss, Inc.
Postoperative radiotherapy in gastric cancer
Authors: Guzel Zuzanna , Gajl Danuta , Grzegorzewski Jerzy
Published: February 2007

Surgeons in Poland are very skeptical about the positive role of adjuvant irradiation in patients with gastric cancer. A retrospective study of 21 patients with operable gastric cancer referred for irradiation to Cancer Centre in Warsaw between December 1984 and December 1991 was performed. Patients were qualified to receive adjuvant treatment because of bad prognostic factors—nonradical surgery (10 patients), infiltration of entire thickness of gastric wall (13 patients), and metastases in regional lymph nodes (9 patients). All patients were in good condition.

They were treated by either telecobalt 60 unit or linear accelerator using 9–15 MeV photons. The total dose to the gastric bed and lymphatic was 46–50 Gy in 25 to 28 fractions, 5 days a week. The tolerance of treatment was good. None of these patients received 5‐FU either during irradiation or as maintenance therapy.

We have obtained more than 50% overall survival rate at 3 years. Median survival was 27 months and median recurrent‐free interval 27 months. Local recurrence was found in four patients, distant metastases in five patients. In the group of 10 patients with nonradical surgery, 5 are alive without evidence of disease from 2 up to 7 years after treatment.

Our preliminary results and good tolerance of treatment seem to support the beneficial role of adjuvant radiotherapy after gastrectomy in patients with risk factors of locoregional cancer recurrence. © 1995 Wiley‐Liss, Inc.
Lymphokine‐activated killer cell function of lymphocytes from regional lymph nodes in patients with gastric carcinoma
Authors: Arinaga Shinya , Karimine Nobuya , Nanbara Shigeru , Inoue Hiroshi , Nakashima Hideaki , Ueo Hiroaki , Akiyoshi Tsuyoshi
Published: February 2007

Lymphokine‐activated killer (LAK) cells generated by culture of regional lymph node cells (LNC) with interleukin 2 (IL 2) for 4 and 11 days were examined for their functional capabilities in comparison with those of peripheral blood mononuclear cells (PBM) in 25 patients with gastric carcinoma. The cytotoxic activity of LAK cells induced from LNC for 4‐day culture with IL 2 was significantly lower than that from PBM. However, the LNC‐LAK cytotoxicity was markedly increased up to almost the same level as that of PBM after 11‐day culture. The production of interferon‐γ (INF‐γ) and tumor necrosis factor‐α (TNF‐α) from nonadherent LAK cells in LNC was also significantly reduced as compared to that from PBM 4 days after culture, when stimulated with or without tumor target, Raji cells. After 11‐day culture with IL 2, however, the levels of these cytokines produced by LNC‐LAK cells either with or without stimulation by tumor target were comparable to those by PBM‐LAK cells, although the release of these cytokines was markedly reduced when compared to that after 4‐day culture. Phenotypic analysis revealed decreased proportion of cells mediating NK activity in LNC before and 4 days after culture. CD56+ and CD57+ cells in LNC were increased after 11‐day culture, although the percentages of these cells were still low as compared to those in PBM. The proportions of OKIal+ and CD25+ cells were uniformly increased after 4 and 11‐day culture in both cell populations. Changes in subpopulations of CD4+ and CD8+ cells in LNC were not apparently different from PBM. These results indicated the differential LAK cell function of cells from regional lymph nodes from PBM in patients with gastric carcinoma. © 1995 Wiley‐Liss, Inc.
Cytokine‐mediated alterations in host metabolism prevent nutritional repletion in cachectic cancer patients
Authors: Espat N. Joseph , Moldawer Lyle L. , Copeland Edward M.
Published: February 2007

The clinical syndrome of cachexia is characterized by anorexia, continued losses of lean body mass, and altered carbohydrate and lipid metabolism. As early as the 1930s, this “chronic wasting” syndrome had been identified as the most frequent immediate cause of death in patients with cancer [Warren: Am J Med Sci 184:610–619, 1932]. At present, controversy remains as to the benefit of supplemental parenteral or enteral feedings in the nutritional repletion of cachectic cancer patients, since only selected patient groups have demonstrated clear benefit from their administration [Copeland et al.: Cancer 43:2108‐2116, 1979; Copeland et al.: Cancer Res 37:2451‐2456, 1977; Terepka and Waterhouse: Am J Med 20:225‐238, 1956]. Despite having these advanced nutritional modalities firmly in our therapeutic armamentarium, the progression of cachexia in the nutritionally depleted cancer patient often continues unabated, and our ability to intervene successfully remains limited. This review proposes that host: tumor interactions lead to a nonspecific inflammatory response mediated in part by the chronic production and release of proinflammatory cytokines, including interleukin‐1, tumor necrosis factor α, interleukin‐6 and interferon‐γ, which antagonize the anabolic signals associated with enteral and parenteral nutrition support. Cytokine‐mediated alterations can explain the inability of adequate dietary nitrogen and calories to result in lean tissue repletion. Based on this proposal, interrupting proinflammatory cytokine production or target organ action may be an appropriate therapeutic objective to improve nutrient utilization in patients with tumors. © 1995 Wiley‐Liss, Inc.
Immunohistochemical analysis of p53 in colorectal cancer regarding clinicopathological correlation and prognostic significance
Authors: Tomoda Hirotsugu , Kakeji Yoshihiro
Published: February 2007

The overexpression of the tumor suppressor gene p53 was investigated immunohistochemically in 144 cases of primary colorectal cancer and in 8 cases with cancer in the corresponding metastatic lymph nodes. Abnormalities in p53 expression were found in 36 cases (25%) of the 144 primary cancer cases. In addition, p53‐positive tumors were found to metastasize frequently to the lymph nodes, as compared to p53‐negative tumors (61.1% vs. 41.7%, P=0.0428). p53 staining was identical in 7 of 8 (87.5%) cases in primary and metastatic lesions. When the DNA content of the tumor was determined by flow cytometry, the DNA index (mean ± SD) was significantly higher in p53‐positive tumors than in p53‐negative tumors (1.57 ± 0.38 vs. 1.39 ± 0.37, P=0.012). Therefore, the immunohistochemical data of p53 in colorectal cancer may help in potentially predicting metastatic spread to the lymph nodes. © 1995 Wiley‐Liss, Inc.
Concomitant and isolated expression of TGF‐alpha and EGF‐R in human hepatoma cells supports the hypothesis of autocrine, paracrine, and endocrine growth of human hepatoma
Authors: Carr Brian I. , Yamaguchi Koji , Nalesnik Michael A.
Published: February 2007

Single and double immunohistochemical staining for transforming growth factor (TGF)‐alpha and epidermal growth factor‐receptor (EGF‐R) was done in order to identify the localization of TGF‐alpha and EGF‐R in human hepatocellular carcinoma (HCC). Single immunohistochemical staining for TGF‐alpha showed immunoreactivity in the cytoplasm of hepatoma cells in 22 of 30 cases of HCC. The localization of TGF‐alpha was heterogeneous from HCC cells to HCC cells. In the surrounding regenerative nodules, the hepatocytes were mildly to moderately positive for TGF‐alpha. The proliferating bile ductules and peripheral nerves were also immunopositive for TGF‐alpha. Single immunohistochemical staining for EGF‐R demonstrated a linear localization of EGF‐R along the cell membrane of the HCC cells in 21 of the 30 cases of HCC. In the regenerative nodules, the hepatocytes also showed linear staining along the cell membrane. Double staining for TGF‐alpha and EGF‐R in 12 cases of HCC showed a concurrent localization of TGF‐alpha and EGF‐R in some hepatoma cells and isolated localization of the two substances of other HCC cells. These combinations either abruptly moved around or intermingled with each other. These immonohistochemical results thus support the theory of an autocrine, paracrine, and endocrine mechanism of TGF‐alpha and EGF‐R on the proliferation of human hepatocellular carcinoma. © 1995 Wiley‐Liss, Inc.
Needle track seeding after percutaneous ethanol injection therapy for small hepatocellular carcinoma
Authors: Shimada Mitsuo , Kano Tadashi , Saitoh Atsushi , Maeda Takashi , Morotomi Ikuo
Published: February 2007

We present two cases of patients experiencing needle track seeding after undergoing percutaneous ethanol injection therapy (PEIT) for small hepatocellular carcinoma, who were treated by surgical resection of the metastases. One patient demonstrated metastatic tumors due to needle track seeding 6 months after the beginning of PEIT (a total of 7 injection sessions for 2 tumors measuring <20 mm in diameters), whereas the other developed a metastatic tumor 20 months after beginning PEIT (a total of 30 injection sessions for 3 tumors measuring <20 mm in diameter). In the two cases, both the primary and metastatic tumors histologically revealed moderately differentiated hepatocellular carcinoma. Moreover, the histological findings of the metastatic foci did not always appear to be more aggressive than those of the primary tumors. Therefore, in order to detect such metastasis as early as possible, more careful attention should be paid to the appearance of needle track seeding after performing PEIT for hepatocellular carcinoma, even if the target of such PEIT is small HCC. © 1995 Wiley‐Liss, Inc.
Long‐term impact of previous breast biopsy on breast cancer screening modalities
Authors: Goff James M. , Molloy Mark , Debbas Maureen T. , Hale Douglas A. , Jaques David P.
Published: February 2007

Approximately 80% of breast biopsies are performed for what proves to be a benign process. The patients who undergo these procedures should continue screening with breast physical examination and mammography. The long‐term impact of breast biopsy on these screening modalities has not been well studied. We performed a prospective, follow‐up evaluation in 63 patients who underwent needle localization biopsy with benign histology at our institution between 6 and 7 years ago. This evaluation consisted of a directed history, breast physical examination, and follow‐up mammogram. Two patients (3%) had undergone mastectomy for an interval breast cancer; 17 others (28%) had undergone subsequent biopsies. No patient had changes on physical examination of the biopsy site. All mammograms were evaluated as normal or as having benign abnormalities. Excisional breast biopsy does not generally produce long‐term changes affecting the interpretation of breast physical examination or mammography.
Prognostic indicators for neuroblastoma: Stage, grade, DNA ploidy, MIB‐1‐proliferation index, p53, HER‐2/neu and EGFr–a survival study
Authors: Layfield Lester J. , Keith Thompson J. , Dodge Richard K. , Kerns Billie‐Jo
Published: February 2007

Neuroblastoma, a tumor of the sympathetic nervous system, is one of the most common solid malignancies in infants and represents 7% of all cases of childhood cancer outside of the central nervous system. Thirty‐five samples of neuroblastoma from 31 patients were obtained from Duke University Medical Center between 1979 and 1991 and studied to determine the relative prognostic value of a number of clinical, histologic, nuclear, and oncogenic features. The features studied were: stage, Shimada classification, DNA ploidy, MIB‐1‐proliferation index and status for HER‐2/neu, p53 and epidermal growth factor receptor (EGFr). Only age (P = .03), HER‐2/neu (P = .01), and p53 (P = .02) reached statistical significance as prognostic indicators. The median survival for patients with no HER‐2/neu expression was 12 months; median survival for patients with no HER‐2/neu expression was 138 months. Similary, the median survival for patients with p53 expression was 12 months; patients with no p53 expression had a median survival was 144 months. The combination of either HER‐2/neu or p53 positivity was especially strong as a prognostic indicator (p = .002).
Prognostic factors of resectable intrahepatic cholangiocarcinoma
Authors: Chou Fong‐Fu , Sheen‐Chen Shyr‐Ming , Chen Chao‐Long , Chen Yaw‐Sen , Chen Mao‐Chan
Published: February 2007

Intrahepatic cholangiocarcinoma is a rare disease. The prognostic factors of resectable cholangiocarcinoma have not been previously reported. Nineteen patients (10M, 9F) with resectable cholangiocarcinoma were investigated to find factors that might influence prognosis. The cumulative survival rate was measured using the Kaplan‐Meier method. The log‐rank test was used to compare two survivals. Age, sex, tumor size, and positive tissue carcinoembryonic antigen were factors that had no influence on prognosis. Patients with a positive HLA‐DR, a well‐differentiated carcinoma, and a clear resective margin had better prognoses but were statistically undifferentiatable from the other patients. Patients with positive hilar lymph nodes had poor prognoses (p < 0.01), whereas patients with positive mucobilia had good prognoses (p < 0.05). Positive staining for HLA‐DR on tumor cells was observed in nine of 19 cases of intrahepatic cholangiocarcinoma. The positive HLA‐DR staining correlated with a better prognosis, but no significant difference was noted between the positive and negative HLA‐DR staining group. A positive hilar lymph node was a grave sign, as almost all patients of positive lymph node died within 9 months after operation. Positive mucobilia was a good prognostic sign that correlated with the long‐term survival.
Neoadjuvant chemotherapy of stage III‐A and B lung carcinoma using the pacco regimen
Authors: Takita Hiroshi , Blumenson Leslie E. , Raghavan Derek
Published: February 2007

Previously, we reported an effective chemotherapeutic combination regimen for non‐small cell lung carcinoma (NSCLC): cisplatinum, doxorubicin, cyclophosphamide, CCNU, and vincristine (PACCO).

Forty‐one patients with a diagnosis of NSCLC Stages III‐A and III‐B were entered into the protocol of neoadjuvant PACCO chemotherapy. Following two courses of chemotherapy, the patients were evaluated for surgical therapy. The overall response rate to the chemotherapy was 60%. Subsequently, 65% of the patients underwent surgical resection. The overall estimated median survival was 18 months. The survival of patients in III‐A was 36 months and that of III‐B was 18 months (95% confidence lower bounds for III‐A: 8 months and for III‐B: 13 months). There was one chemotherapy‐related mortality but no surgical mortality.

Neoadjuvant chemotherapy with PACCO regiment offers an alternative to chemoradiation therapy, without increasing the surgical mortality, and should be validated in a randomized clinical trial. For successful neoadjuvant chemotherapy of Stage III NSCLC, chemotherapy combination which would give a high response rate without significant side effects must be chosen.
Tumour excision plus continuous tamoxifen compared with modified radical mastectomy in patients over 70 years of age with operable breast cancer
Authors: Van Zyl Jacobus Alwyn , Muller Anna Gertruida S.
Published: February 2007

Between 1985 and 1991, we randomly assigned 77 women over the age of 70 years with stage I‐3a breast cancer to undergo a modified radical mastectomy or tumour excision followed by tamoxifen. Median follow‐up was 45 months.

Patients treated by tumour excision and tamoxifen had a significantly better survival (P = 0.04). The disease‐free survival of the tumour excision and tamoxifen group was close to significantly better (P = 0.10).

Only two patients in the tamoxifen group required an axillary dissection on follow‐up for progressive nodal enlargement. Two patients underwent a local mastectomy for locally recurrent disease.

We conclude that tumour excision followed by continous tamoxifen is an acceptable, safe alternative to a modified radical mastectomy in patients over 70 years of age.
Surgical management and follow‐up of medullary thyroid carcinoma
Authors: Marzano Luigi A. , Porcelli Alberto , Biondi Bernadette , Lupoli Glovanni , Delrio Paolo , Lombardi Gaetano , Zarrilli Lucio
Published: February 2007

Between 1977 and 1990 we operated on 33 patients with medullary thyroid carcinoma. We performed total thyroidectomy in 31 patients and central node dissection and/or lateral modified node dissection in 21 patients (63.3%). Two patients underwent radiotherapy after subtotal resection and tracheostomy. No perioperative death occurred. Twenty‐five patients were followed (mean follow‐up, 63.8 months) and 8 others were unavailable for follow‐up. Three patients (1 with multiple endocrine neoplasia type IIB, 2 sporadic with distant metastases) died of their disease at 12, 18 and 36 months after initial operation. Of the remaining 22 patients, 4 with stage II disease were normocalcitoninemic even with pentagastrin stimulation, following total thyroidectomy and bilateral modified neck dissection and central node dissection. Eighteen other patients continued to have elevated calcitonin levels postoperatively. Only 10 patients with known cervical metastatic disease were reoperated upon. We performed extensive node dissection in all. In addition we resected recurrent tumor from the thyroid bed in 4 patients. Despite these extensive reoperations no patient became normocalcitoninemic. At the completion of the study (December 1991), 22 of the 25 patients followed were alive: 4 patients with normal calcitonin levels, baseline and after pentagastrin stimulation, and 18 with persistent mildly elevated calcitonin levels but no other evidence of disease. Our experience supports a very aggressive surgical approach at the time of the first operation for patients with medullary thyroid carcinoma. A lesser operation usually resulted in residual medullary thyroid carcinoma in the neck. We demonstrate the difficulty of achieving a cure by reoperation once the tumor becomes demonstrable by localization studies.
Flow cytometric analysis of nuclear dna content in tissues of colon cancer using endoscopic biopsy specimens
Authors: Nishida Koichi , Takano Hirohisa , Yoneda Mitsuru , Ohtsuki Tsuneaki , Fujii Mitsuhiro , Terasawa Yoshimitsu , Yamane Etsuo , Nishioka Bunzo , Namura Kenji , Yoshikawa Toshikazu , Kondo Motoharu
Published: February 2007

Flow cytometric assay of nuclear DNA in endoscopic biopsy specimens was evaluated in colon cancer patients. When the cells were divided into diploid cells and aneuploid cells, aneuploidy was observed in 63% (58 of 92) of the colon cancer patients. However, no clear relation was observed between the frequency of aneuploidy and the invasive depth, size, or histological type of colon cancer. Noncancerous portions of the colon tissues including colon adenoma or normal mucosa were mostly (96%, 87 of 91) diploid. Nuclear DNA content could be analyzed in the fresh biopsy specimens of colon cancer tissues and such investigation might be possibly valuable for further biological characterization of colon cancer in the usual procedure of clinical diagnosis for colonic malignancy before surgical operation or other treatment.
Primary squamous cell carcinoma of the breast: Sensitivity to cisplatinum‐based chemotherapy
Authors: Dejager Dawn , Redlich Philip N. , Dayer Anne M. , Davis Hugh L. , Komorowski Richard A.
Published: February 2007

Primary squamous cell carcinoma (SCC) of the breast is a rare malignancy whose optimal treatment and prognosis anre unknown. A patient with SCC whose tumor responded dramatically to chemotherapy as part of multimodal treatment is presented. A 61‐year‐old woman had a palpable 5.5‐cm tender left breast mass with overlying skin edema and erythema and irregular margins by mammography. Fine needle aspiration revealed malignant squamous cells with keratinization; incisional biopsy confirmed SCC. Extensive evaluation for an extramammary primary site of disease was negative.

Neoadjuvant cisplatinum and 5‐fluorouracil (5‐FU) led to tumor shrinkage and complete resolution of pain and erythema. Modified radical mastectomy with post‐operative chest wall radiation were performed. Neither residual invasive carcinoma nor metastatic nodal disease was found, though intraductal carcinoma with marked squamous features was identified. The patient remains disease‐free 2.5 years after diagnosis. Cisplatinum‐based chemotherapy should be considered in the treatment regimen of this disease.
Surgical treatment of patients with gastric carcinoma and duodenal invasion
Authors: Kakeji Yoshihiro , Korenaga Daisuke , Baba Hideo , Watanabe Akihiro , Tsujitani Shunichi , Maehara Yoshihiko , Sugimachi Keizo
Published: February 2007

We retrospectively examined the extent of invasion of gastric cancer with duodenal involvement in order to design pertinent surgical procedures that may lead to a better prognosis. Examinations were made on excised tissues from 650 patients who underwent gastrectomy for adenocarcinoma in the gastric antrum. In 95 patients, the cancer cells extended to beyond the pyloric ring. Spread into the duodenum was limited to within 2 cm in 76% of the patients and to within 3 cm in 81%. In addition to high rates of metastasis in group 1 and 2 lymph nodes, some group 3 lymph nodes also were involved, and more frequently so in cases with duodenal invasion than in those without such invasion (P < 0.01). The 5‐year survival rate for patients with duodenal invasion was 35.4% when a curative resection was done. For patients with advanced adenocarcinoma with duodenal invasion, gastrectomy with resection of 3–4 cm of the duodenum and dissection of group 1, 2, and 3 lymph nodes were recommended.
Immunohistochemically demonstrated expression of HLA‐DR antigen in colorectal adenocarcinomas and its relation to clinicopathological features
Authors: Morita Mika , Tanaka Kanji , Kawanishi Hiroshi , Tsuji Masazumi , Ookusa Tokio , Takada Hideho , Okamura Akiharu , Hioki Koshiro
Published: February 2007

We studied 148 colorectal adenocarcinomas to clarify any correlation between HLA‐DR antigen expression on tumor cells and histopathological features. Paraffin sections of formalin‐fixed tissues were stained with HLA‐DR antigen using the indirect immunoperoxidase technique. All the tumor tissues were divided into two groups, depending on the incidence of HLA‐DR‐positive cells (greater and lesser than 50%). Carcinoma tissues with a higher incidence showed less mural invasion, lymphoductal invasion, venous invasion, lymphonodular metastasis, and peritoneal metastasis. Tissues with a high HLA‐DR reactivity were more often observed for Dukes' A and B stages, whereas those with a low HLA‐DR positivity were frequently Dukes' C and D stages. As for the cumulative survival rate, the group with high HLA‐DR expression demonstrated significantly better survival. We speculate that HLA‐DR expression by colorectal cancer cells exerts a favorable influence on clinical course.
Effect of exogenous testosterone replacement on prostate‐specific antigen and prostate‐specific membrane antigen levels in hypogonadal men
Authors: Douglas Thomas H. , Connelly Roger R. , McLeod David G. , Erickson Sheila J. , Iii Robert Barren , Murphy Gerald P.
Published: February 2007

Previous studies have suggested that serum prostate‐specific antigen (PSA) levels are under androgenic influence, especially in patients with adenocarcinoma of the prostate. PSMA (prostate‐specific membrane antigen) is thought to reflect hormonal or clonal resistance or an independence with respect to testosterone regulation. The influence of testosterone on serum PSA expression in normal men is not clear. We studied the effect of exogenous testosterone administration on the serum levels of PSA and PSMA in hypogonadal men. Serial serum PSA, serum PSMA by Western blot, and serum total testosterone levels were obtained at intervals of every 2–4 weeks in 10 hypogonadal men undergoing treatment with exogenous testosterone, delivered as testosterone enanthate injection or by testosterone patch. Linear and quadratic orthogonal polynomial scores were calculated for PSMA, PSA, and testosterone. A 2‐tailed, paired t‐test failed to demonstrate a significant correlation between serum PSA (linear P = 0.432, quadratic P = 0.290) or PSMA (linear P = 0.162, quadratic P = 0.973) and serum testosterone levels. This study suggests that in hypogonadal men, neither PSMA nor PSA expression is testosterone‐dependent.
Macroscopic intraoperative diagnosis of serosal invasion and clinical outcome of gastric cancer: Risk of underestimation
Authors: Ichiyoshi Yuji , Maehara Yoshihiko , Tomisaki Shin‐Ichi , Oiwa Hisao , Sakaguchi Yoshihisa , Ohno Shinji , Sugimachi Keizo
Published: February 2007

Data on 715 Japanese patients with gastric cancer were studied retrospectively with regard to the relationship between macroscopic and microscopic diagnoses of serosal invasion and clinicopathological factors affecting the accuracy of the macroscopic diagnosis. Although there was no macroscopic evidence of serosal invasion intraoperatively (SO or S1), there was histological evidence of cancer cells on the serosal surface in 69 patients (9.7%). In these serosal invasion‐positive cases, the tumors were larger; were located more commonly in the upper third, lesser and greater curvatures of the stomach; were Borrmann type 3 or type 4 tumors, and of an undifferentiated histologic type with an infiltrative growth pattern more commonly, and had more extensive lymphatic and vascular vessel invasion and lymph node metastasis (P < 0.01). Total gastrectomy was done more often for the serosal invasion‐positive group, but the extent of lymph node dissection was comparable. Cases of a noncurative resection because of a positive surgical margin were more frequent in the serosal invasion‐positive gorup (8/69 vs. 14/646, P < 0.01), and most had undifferentiated and infiltrative cancers. The 10‐year survival rates were 49.2% and 85.5% for patients with and without serosa invasion, respectively. These findings clearly show that the serosal surface, especially in cases of the undifferentiated or infiltrative type of gastric cancer, must be closely inspected intraoperatively.
Completion thyroidectomy for differentiated thyroid carcinoma
Authors: Eroǧlu Aydan , Berberoǧlu Uǧur , Buruk Fatma , Yildirim Emin
Published: February 2007

Completion thyroidectomy is defined as the surgical removal of the remnant thyroid tissue following procedures less than total or near‐total thyroidectomy. The extent of surgical management for differentiated thyroid carcinoma (DTC) is controversial. Although some authors advocate subtotal thyroidectomy with lower complication rates, total or near‐total thyroidectomy and completion thyroidectomy have been defended by others because of the improved survival and lower morbidity that is comparable with subtotal thyroidectomy. In this study, the incidence of residual tumor and surgical complication rates in patients who underwent completion thyroidectomy were investigated. The medical records of 165 patients undergoing completion thyroidectomy for DTC were reviewed. Seventyseven (46.6%) of these patients were found to have residual tumor in the remaining thyroid tissue. Anaplastic transformation developed in two of these patients. Permanent bilateral recurrent laryngeal nerve palsy occurred in three patients, and permanent hypoparathyroidism was seen in one patient. We recommend completion thyroidectomy as an efficient and safe method of surgical treatment with a low complication rate for DTC.
Esophageal squamous cell carcinoma occurring in the surface epithelium over a benign tumor
Authors: Kuwano Hiroyuki , Sadanaga Noriaki , Watanabe Masayuki , Yasuda Mitsuhiro , Nozoe Tadahiro , Sugimachi Keizo
Published: February 2007

The coexistence of a benign tumor and carcinoma in the same esophagus is uncommon, while the occurrence of carcinoma in the surface epithelium over a benign tumor is considered to be extremely rare. Among 587 patients with surgically resected esophageal cancer, the cases with carcinoma located over a benign tumor of the esophageal cancer, the cases with carcinoma located over a benign tumor of the esophagus were histopathologically investigated and the carcinogenesis of such cases was discussed. Only three cases were found to have esophageal squamous cell carcinoma located over benign tumors (two were leiomyomas and one was a lipoma). All three benign tumors protruded to the esophageal surface, and the carcinoma was located just over such tumors without coexisting epithelial dysplasia. Moreover, the epithelium, except for portions around these tumors, was intact in all three cases. From these findings it was suggested that chronic stimulation of the epithelium covering the benign tumors might have induced the carcinoma.
Fresh colorectal tumor cells isolated from individual patients differ in their susceptibility to monocyte mediated cytotoxicity
Authors: Schuurman Bart , Beelen Robert H. J. , Heuff Gijsbert , Scheper Rik J. , Claessen Anke M. E. , Meyer Sybren
Published: February 2007

Studies on monocyte/macrophage mediated cytotoxicity usually pertain to the use of cell lines that are liable to antigenic and structural changes. Therefore we compared monocyte mediated cytotoxicity against colorectal tumor cell lines (WiDR, HT29, SW620, and SW948) with fresh colorectal tumor cells from patients. Fresh tumor cells were isolated from surgical specimens by a short enzymatic treatment (Collagenase/DNAse). Monocytes were obtained from one healthy donor. Cytotoxicity was determined using the MTT‐assay. Fresh colorectal tumor cells displayed a similar differential susceptibility to cytotoxic monocytes as cell lines. Cytotoxicity against fresh tumor cells ranged from 4.9% to 50.4% at E/T ratio 5 (n = 9). Activation of monocytes with Interferon‐γ (100 U/ml) induced an increase of 6.2% ± 1.6 (n = 4, P = 0.06). In this study we demonstrate monocyte mediated cytotoxicity against colorectal tumor cells isolated from individual patients. This may be important in view of the development of adoptive immunotherapy and cell‐directed immunotherapy. © 1995 Wiley‐Liss, Inc.
Intraoperative peritoneal washing cytology with the rapid immunoperoxidase method using microwave irradiation
Authors: Nomoto Shuji , Nakao Akimasa , Takeuchi Yuuki , Nonami Toshiaki , Harada Akio , Ichihara Tohru , Takagi Hiroshi
Published: February 2007

The rapid immunocytochemical staining of gastrointestinal cancer‐associated antigens, carcinoembryonic antigen (CEA) and carbohydrate antigen 19‐9 (CA19–9), for intraoperative peritoneal washing cytology of pancreatic or biliary carcinoma can be completed in only 25 minutes by using microwave irradiation to accelerate incubation of the primary antibody. Only 3‐second irradiation at 500 W for fresh smears produced specific antigen staining of malignant cells similar to that obtained with longer incubation, and the sensitivity of intraoperative cytology was greater than by the conventional staining method. The rapid immunocytochemical staining method of peritoneal washings at laparotomy can provide sensitive information for determining more aggressive therapy for intraperitoneal spread of malignant cells before closing the abdominal wall. © 1995 Wiley‐Liss, Inc.
Adenoma‐carcinoma sequence: A reappraisal with immunohistochemical expression of ferritin
Authors: Yang Hsiao‐Bai , Hsu Ping‐I , Lee Jen‐Chang , Chan Shih‐Huang , Lin Xi‐Zhang , Chow Nan‐Haw
Published: February 2007

To examine the biological significance of ferritin (FRN) expression, a retrospective immunohistochemical study was performed in normal coIonic mucosae (n = 8), adenomas (n = 88), and colorectal carcinomas (n = 104). FRN was present in some epithelia in the crypt base of normal colonic mucosae. Significant cytoplasmic staining for FRN was revealed in 26 (29.5%) cases of adenoma and 54 cases (51.9%) of adenocarcinoma. The cancer cells had a higher proportion of FRN expression than those of adenomas or non‐neoplastic mucosae (P < 0.001). Expression of FRN showed a positive association with the degree of dysplasia (P = 0.039) and the distal location of adenoma (P = 0.013). FRN expression tended to be associated with the tumor size (P = 0.083), but no substantial difference was observed among the histologic types of adenoma (P = 0.754). The results suggest that cytoplasmic FRN expression is associated with cellular proliferation. The proliferative index shows a significant difference through the adenoma‐carcinoma sequence. Further investigation is necessary to clarify the clinical implication of FRN expression in tumor cells and normal‐appearing mucosae. © 1995 Wiley‐Liss, Inc.
Management of lymph node metastases in breast cancer and gastric cancer
Authors: Noguchi Masakuni , Miyazaki Itsuo
Published: February 2007

The management of regional lymph node metastases in breast cancer and gastric cancer is reviewed. Regional lymph node metastasis is a critical prognostic factor in these diseases, but there is an apparent discrepancy in the efficacy of regional lymph node dissection between them. A number of prospective randomized clinical trials have demonstrated that regional lymph node dissection improves the regional control of breast cancer, but does not improve the survival. On the other hand, only retrospective or prospective comparative studies have shown that extended lymph node dissection significantly improves the survival in gastric cancer. Although the discrepancy in the regional lymph node dissection between breast and gastric cancers has been explained by differences in their biological behaviors, caution must still be exercised in drawing conclusions from these nonrandomized studies. © 1995 Wiley‐Liss, Inc.
Effects of intraportal administration of chemoimmunotherapeutic agents on natural killer cell activity in the rat liver
Authors: Rafique Mohammad , Adachi Wataru
Published: February 2007

To evaluate the effects of continuous intraportal chemotherapy on tumor immunity of the liver, natural killer (NK) cell activity was estimated in the rat liver. In an in vitro study, NK‐enriched mononuclear cells collected from rat liver were incubated with 5‐fluorouracil (5‐FU) alone and with a 5‐fluorouracil/mitomycin C (5‐FU/MMC) combination at different concentrations. NK activity was measured after 24‐hour incubation. In an in vivo study, the continuous intraportal administration of chemotherapeutic (5‐FU/MMC) and chemo‐immunotherapeutic (5‐FU/MMC/lentinan) agents was carried out in rats for 5 days, and NK‐enriched mononuclear cells were then collected from the liver for the measurement of NK activity. Neither 5‐FU alone nor the 5‐FU/MMC combination affected NK activity in vitro. In the in vivo study, however, the 5‐FU/MMC combination significantly decreased NK activity, and the addition of lentinan recovered the activity to the control level. It can thus be concluded that the intraportal administration of chemotherapeutic agents reduces NK activity in the liver and the addition of an immunostimulator to such agents prevents this reduction. © 1995 Wiley‐Liss, Inc.
Mastectomy as the preferred treatment for breast cancer among new immigrants from the former USSR
Authors: Kaufman Zvi , Shpitz Baruch , Rozin Mona
Published: February 2007

Sixty‐four new immigrant patients with primary breast cancer who arrived in Israel since 1990 were compared to 322 Israeli women with primary breast cancer. New immigrant patients had a more advanced stage at diagnosis (stage III+IV 28% vs. 13% respectively, P = 0.00005); larger mean tumor size (3.08 ±1.7 cm vs. 2.25 ±1.4 cm respectively, P = 0.00002); and more involved lymph nodes (3.8 ± 5.3 vs. 1.8 ± 3.3 P = 0.0002). Forty‐seven percent of new immigrants had breast‐conserving surgery compared to 69% of the Israelis (P = 0.0004). In stage II 51% of the new immigrants had conservative surgery compared to 74% in the Israeli group (P = 0.03). Mastectomy was recommended to 39 Israeli patients and to six immigrants. Only 19% of the Israeli group requested mastectomy compared to 44% in the new immigrant group. Most of the new immigrant patients chose mastectomy although breast‐conserving surgery was an equal alternative. The reasons for choosing mastectomy as the preferred mode of treatment were related to economic problems, different life concepts, and other priorities. Constant surveillance and considerable enlightenment are needed in the new immigrant population, so that they will be able to separate the disease and its treatment from their paramedical problems. © 1995 Wiley‐Liss, Inc.
Long‐term follow‐up of patients with superficial transitional cell carcinoma of the urinary bladder treated by intravesical mitomycin C
Authors: Pavlotsky Abraham , Eidelman Abraham , Barak Frida , Walach Natalio , Horn Yoav
Published: February 2007

Prophylactic intravesical chemotherapy (IVC) reduces recurrence rates of superficial transitional cell carcinoma (TCC) of the urinary bladder. The patient cohort existed of 86 individuals (stage TaNOMO or T1N0M0) superficial carcinoma of various grades of malignancy. Following initial transuretheral resection or diagnostic cystoscopy, mitomycin C (MMC), 20 mg dissolved in 50 ml saline, was instilled intravesically by catheter over 1 hr at 2‐week intervals, initially and then four more times followed by diagnostic cystoscopy (one course = 12 weeks). Two similar courses were administered thereafter for a total period of 36 weeks. For patients in remission, installations continued in monthly fractionations for 9 more months (cystoscopy every 3 months) and then at 2‐month intervals for 12 more months (cystoscopy every 6 months). When cystoscopy revealed recurrence, IVC was repeated from the beginning. No symptoms of MMC‐related toxicity were observed. Cystoscopic follow‐up evaluations showed a complete response rate of 84% at 3 years and 81 % at 5 years after initial therapy. Twenty‐seven patients who had not responded to previous treatment with other drugs responded to MMC. © 1995 Wiley‐Liss, Inc.
Absorption cytometric dna analysis of sections of gastric carcinomas and a comparison with cytofluorometry of single‐cell suspensions and flow cytometry
Authors: Haraguchi Masaru , Kakeji Yoshihiro , Orita Hiroyuki , Korenaga Daisuke , Maehara Yoshihiko , Sugimachi Keizo
Published: February 2007

Measurements were made of cellular deoxyribonucleic acid (DNA) content in paraffin‐embedded materials from 44 gastric carcinomas, using three different methods; static cytometric light absorbance technique using tissue sections (SCM‐abs), static cytometric fluorescence technique using single‐cell suspensions (SCM‐flu), and flow cytometry (FCM). The DNA ploidy determined by SCM‐abs was grouped into low or high ploidy according to dispersion on the DNA histogram, and the DNA ploidy determined by SCM‐flu and FCM was grouped into diploidy or aneu‐ploidy, according to the peak DNA value. Accord between SCM‐abs and SCM‐flu or between SCM‐abs and FCM was confirmed when low ploidy by SCM‐abs showed diploidy by SCM‐flu or FCM and high ploidy by SCM‐abs showed aneuploidy by SCM‐flu or FCM. An incomplete but good accord of DNA ploidy was obtained with these methods. © 1995 Wiley‐Liss, Inc.
Benign salivary gland tumors: A cytogenetic study of 21 cases
Authors: Martins Carmo , Fonseca Isabel , Félix Ana , Roque Lúcia , Soares Jorge
Published: February 2007

Cytogenetic findings of 21 benign salivary gland tumors, including 14 pleomorphic adenomas, 5 Warthin's tumors, 1 myoepithelioma, and 1 cystadenoma, are reported. The present study confirms that pleomorphic adenomas characteristically have highly specific rearrangements involving only a few chromosome regions (3p21, 8q12 and 12q13–15) which suggests their specific role in the mixed tumors genesis. Warthin's tumors also show nonrandom numerical and structural alterations that were concurrent in one of the cases studied. To our knowledge no cytogenetic data are available in myoepitheliomas and cystadenomas. The former reveals a normal karyotype and the latter shows only clonal numerical alterations (gain of chromosomes 2 and 18). © 1995 Wiley‐Liss, Inc.
Surgical treatment of non‐small cell lung cancer in patients older than seventy years
Authors: Harvey James C. , Erdman Christopher , Pisch Julianna , Beattie Edward J.
Published: February 2007

Surgical treatment of non‐small cell lung cancer has been reported to be associated with increased mortality, especially when pneumonectomy has been employed. A 9‐year review of 81 patients treated surgically, with a policy of avoiding pneumonectomy and using internal radiation and wedge excisions rather than lobectomy among patients with impaired reserve, resulted in an operative mortality of 4.9% compared with an overall mortality of 2.1%. Three of the four deaths were among patients older than 80 3/17 (17.6%) years so that mortality of patients 70 < age < 80 was not significantly different from overall mortality. Two of the four deaths were related to pulmonary emboli but there have been no such deaths since routine use of mini‐heparin was initiated in 1990. Five‐year survival was 42% overall, 65% for stage I, and 24% for stages II‐IIIB. We conclude that surgical treatment of patients 70 < age < 80 may be accomplished with similar mortality and survival as the overall population. Heparin prophylaxis may be especially important among patients older than 80 years. © 1995 Wiley‐Liss, Inc.
Intrapleural chemotherapy for patients with incompletely resected malignant mesothelioma: The ucla experience
Authors: Lee Jeffrey D. , Perez Sol , Wang He‐Jing , Figlin Robert A. , Holmes E. Carmack
Published: February 2007

From 1986 to 1993, 15 patients with malignant pleural mesothelioma were treated by pleurectomy/decortication and intrapleural cisplatin (100 mg/ m2) and cytosine arabinoside (1,200 mg). All patients were without known extrathoracic disease and had a mean age of 63.5 ± 7.9 years (range 51–78); 13 were male. Histologic subtype of disease were epithelial (47%), sarcomatoid (27%), and mixed‐biphasic (27%). The major morbidity and mortality rates were 13% and 0%, respectively. The mean length of hospital stay was 6.5 ± 2.1 days. Postoperatively, adjuvant chemotherapy and radiation therapy were given to 46% and 73% of the patients respectively. Median survival from date of treatment was 11.5 months. Those patients with an epithelial histologic subtype experienced significantly improved survival compared to those of sarcomatoid subtype (P = 0.024). Whether adjuvant chemotherapy or radiation therapy were given had no significant effect on survival. These data suggest that although this treatment regimen can be administered with very limited morbidity and no mortality, the role of this approach in the treatment of malignant pleural mesothelioma appears limited and cannot currently be recommended. © 1995 Wiley‐Liss, Inc.
Single‐treatment skin tightening by radiofrequency and long‐pulsed, 1064‐nm Nd: YAg laser compared
Authors: Key Douglas J.
Published: February 2007

Background and Objective

To compare single‐treatment facial skin tightening achieved with the current radiofrequency (RF) protocol with single‐treatment tightening achieved with the long‐pulsed, 1064‐nm Nd:YAG laser.

Study Design/Materials and Methods

A total of 12 patients were treated with RF energy on one side of the face and laser energy on the other. Results were evaluated on a numerical scale (0–12 with 12 = greatest enhancement) from pre‐ and posttreatment photographs by a blinded panel.

Results

Upper face improvement (posttreatment score minus pretreatment score) was essentially the same on both sides (30.2 and 31.3% improvement for laser and RF, respectively, P = 0.89). Lower face improvement was greater in the laser‐treated side (35.7 and 23.8% improvement for laser and RF, respectively), but the difference was not significant (P = 0.074). Overall face improvement was significantly greater on the laser‐treated side (47.5 and 29.8% improvement for laser and RF, respectively, P = 0.028).

Conclusion

A single high‐fluence treatment with the long‐pulse 1064‐nm Nd:YAG laser may improve skin laxity more than a single treatment with the RF device. Further controlled split‐face or very large non‐self controlled studies are needed to conclusively determine the relative efficacies of the two technologies. Lasers Surg. Med. 39:169–175, 2007. © 2007 Wiley‐Liss, Inc.
Laser surgery of port wine stains using local vaccum pressure: Changes in calculated energy deposition (Part II)
Authors: Franco Walfre , Childers Michael , Stuart Nelson J. , Aguilar Guillermo
Published: February 2007

Background and Objectives

Application of local vacuum pressure to human skin during laser irradiation results in less absorption in the epidermis and more light delivered to targeted vessels with an increased blood volume. The objective of the present numerical study is to assess the effect of applying local vacuum pressure on the temperatures of the epidermis and small vessels during port wine stain (PWS) laser treatment.

Study Design/ Materials and Methods

Mathematical models of light deposition and heat diffusion are used to compute absorbed energy and temperature distributions of skin and blood vessels with different diameters (10–60 µm) at various depths (200–800 µm) exposed to laser irradiation under atmospheric and vacuum pressures.

Results

Under 50 kPa (15 in Hg) vacuum pressure, peak temperatures at the inner walls of small diameter vessels (10–30 µm) located 200–300 µm below the skin surface are ≈10°C higher than those under atmospheric pressure, and peak temperatures in the epidermis of patients with skin phototype II are ≈5°C lower. In patients with darker skin phototype (IV), the peak temperature at the inner wall of a 10 µm diameter vessel located 200 µm below the skin surface is ≈5°C higher than that under atmospheric pressure, and the peak temperature in the epidermis is ≈10°C lower.

Conclusions

Additional energy deposition in a larger blood volume permits higher temperatures to be achieved at vessel walls in response to laser irradiation. While more energy is deposited in every vessel, temperature gains in small diameter vessels (10–30 µm) are greater, increasing the likelihood of irreversible thermal damage to such vessels. In addition, temperatures in the epidermis decrease because less energy is absorbed therein due to reduced epidermal thickness and concentration of melanin per unit area. Lasers Surg. Med. 39:118–127, 2007. © 2007 Wiley‐Liss, Inc.