bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic Conditions in the Emergency Eye Clinic
Authors: Tabandeh H. , Kon C. , Rostron C. , Luke I.
Published: April 2018

Purpose

A systemic disease may be diagnosed for the first time in patients who present to the eye department with ophthalmological manifestations. This study documents the pattern of systemic disorders which were encountered in an emergency eye clinic for the first time.

Subjects and method.

Over a period of six months details of all patients who had a previously unknown systemic condition diagnosed in the Emergency Eye Clinic were recorded. Patients were seen in this clinic upon referral from other practitioners. All patients, with the exception of those with minor ophthalmic problems, were screened for hypertension and glycosuria. The patients were subsequently referred to their general practitioner or the appropriate hospital specialist for further management.

Results

During this period 1025 new patients visited the emergency eye clinic. Previously undiagnosed systemic disease was present in 86 patients (8.4%). The commonest disorders were neurological 35 (41%), cardiovascular 17 (20%), glycosuria 13 (15%) and respiratory 5 (6%). Visual disturbance and pain were the most frequent ocular presentation. In 54 patients (62.8%) the ocular condition was a direct manifestation of the systemic condition and in 32 patients (37.2%) the systemic disease was a coincidental finding.

Conclusions

Awareness of ophthalmological manifestations of systemic disorders helps in the early diagnosis of these conditions and reduces the resulting morbidity and possibly mortality. This study illustrates the hidden role of the emergency eye clinic in identifying patients with an underlying systemic condition.
Predictors of Survival in Malignant Melanoma of the Conjunctiva: A Clinico-Pathological and Follow-Up Study
Authors: Bobić-Radovanović A. , Latković Z. , Marinković J. , Radovanović Z.
Published: April 2018

The study comprised 61 patients with histologically diagnosed malignant melanoma of the conjunctiva (MMC) who were treated and followed up in the Department of Ophthalmology, Clinical Center of Serbia, Belgrade, over a period of 24 years (1970-1993). Data on 15 clinical and 10 histopathological characteristics of MMC were related to the outcome of the disease. Tumour thickness on the histological section was the most important single predictor of survival in MMC. Other predictors of survival in MMC were the number of mitoses, the histologically assessed degree of tumour pigmentation and the intensity of inflammation at the tumour site. The variables entered into the model comprised as much as 85.3% of all predictors of survival in MMC.
Eyelid Malpositions after Cataract Surgery
Authors: Hosal B.M. , Tekeli O. , Gürsel E.
Published: April 2018

Purpose.

To estimate the incidence and the factors that may play a role in the etiology of eyelid malpositions after cataract extraction.

Methods.

We followed up 124 patients for six months after cataract extraction. Palpebral aperture, levator function, height of the upper lid crease, lower eyelid laxity and position of the punctums were recorded preoperatively and postoperatively. Post-cataract ptosis was defined as a 2 mm or greater drop in the lid margin after correcting for any change in the fellow eye.

Results.

None of the patients developed ectropion or entropion, but five (4%) developed punctal ectropion after surgery. The incidence of post-cataract ptosis was 7.3% at six months. Age, sex, preoperative measurements of levator function, lid crease and dermatochalasis were not predictive for the development of ptosis at six months. However, there was a significant difference in the preoperative palpebral fissure width between the patients with ptosis and those without (p<0.05). There was a positive correlation between the mean volume of local anesthetic and the degree of ptosis on the first postoperative day (p<0.05, r: 0.1873). The presence and amount of ptosis on the first postoperative day was the best predictor of post-cataract ptosis at six months (p<0.001).

Conclusions.

Several factors are involved in the development of post-cataract ptosis. Temporary ptosis may be related to the myotoxicity of the local anesthetic. The presence of ptosis on the first postoperative day is the best predictor for the development of ptosis at six months.
The Effects of Rimexolone 1% in Postoperative Inflammation after Cataract Extraction. A Double-Masked Placebo-Controlled Study
Authors: Bron A. , Denis P. , Hoang-Xuan T. C. , Boureau-Andrieux C. , Crozafon P. , Hachet E. , Medhorn E. , Akingbehin A.
Published: April 2018

Aim

A multicentre, randomized, placebo-controlled double-masked study was conducted to assess the efficacy and safety of Rimexolone 1% eye drops in reducing inflammation after cataract surgery and intra-ocular lens implantation.

Methods

Rimexolone 1% (124 patients) or placebo (58 patients) was given, four times a day for 14 days starting 22-34 hours after surgery. All patients also received tobramycin 0.3% four times a day for 7 days. The clinical signs of ocular inflammation were recorded on days 1, 3, 8, 15 and 17 or 18.

Results

Rimexolone 1% markedly decreased the mean inflammation severity scores, and the sum of clinical assessments of cells and flare in the anterior chamber compared with placebo at each assessment. In addition, the percentage of patients with no anterior chamber inflammation was significantly higher with Rimexolone 1% than with the placebo at each assessment. All these results were statistically significant. Intra-ocular pressure did not rise after treatment with Rimexolone 1%.

Conclusions

The results suggest that Rimexolone 1% ophthalmic solution is an effective and safe steroidal anti-inflammatory agent for topical use following cataract surgery and intraocular lens implantation.
Deconstructing the ‘older worker’: Exploring the complexities of subject positioning at the intersection of multiple discourses
Authors: Spedale Simona
Published: April 2018

This study adopts an intersectional approach to explore the complexities and contingencies of subject positioning in the case of an individual older worker. Five deconstruction strategies are applied to an older worker’s account of his experience of the workplace to unveil the variety of discourses and taken-for-granted assumptions that regulate individual identity formation and contribute to perpetuating the marginalization of the aging organizational subject. Deconstruction analysis shows how the unique positioning of the research subject emerges at the intersection of complex discourses of age, enterprise, family, death, and mental and physical health, casting him as both victim and perpetrator of inequality across a kaleidoscope of interacting categories of oppression. The analysis contributes to the critique of the binary dualism implicit in the victim–perpetrator paradigm dominating mainstream research and policy making on age discrimination in the workplace. It also advocates for new conceptualizations of aging at work that recognize the systemic nature of inequality as the product of intersecting systems of power relations.
Theory-based evaluations: Framing the existence of a new theory in evaluation and the rise of the 5th generation
Authors: Brousselle Astrid , Buregeya Jean-Marie
Published: April 2018

In this article we defend the idea that theory-based evaluations—contribution analysis, logic analysis, and realist evaluation—are complementary components of a new theory in evaluation. We also posit that we are currently observing the emergence of a fifth generation in evaluation: the explanation generation. Theory-based evaluations have featured prominently in the discourse of evaluators since the mid-1980s. They have developed mainly in response to the need for evaluation of complex interventions. In this article we analyze certain approaches that have matured in their design and application. We use the framework of Shadish et al. to analyze the ontological, epistemological, and methodological foundations of various theory-based approaches in evaluation to appraise their similarities and differences. We observe that all these approaches are grounded in critical realism. Similarities seen in their ontological, epistemological, and methodological positionings, as well as their complementarity in terms of the evaluative questions they address, suggest we may be observing the consolidation of a new theory in evaluation and the emergence of a fifth generation.
Methodological individualism as anti-reductionism
Authors: Bulle Nathalie
Published: April 2018

The demarcation criterion of methodological individualism is not defined in relation to entities ultimately involved in explanation – individuals to the exclusion of structures – as supposed by its reductionist interpretations. It introduces an epistemological approach that distinguishes between causal powers representing driving forces – they arise from individual (trans-situational) rational capacities – and structural properties which do not exert a causal power but have nevertheless a crucial causal role – they define the situational properties on the basis of which individuals’ rational capacities are developed. Whereas the forces in action in society are governed by the subjective meaning of/the reasons for individual actions, social structures have an explanatory or causal role insofar as they affect the subjective meaning of/the reasons for individual actions.
‘There is no sincerer love than the love of food’ (George Bernard Shaw, 1903): The meaning of food and its uses in prison subculture
Authors: Einat Tomer , Davidian Moran
Published: April 2018

This study examines the ways in which the prison service handles food and analyses the uses and meanings of food in prison subculture. Using semi-structured interviews and content analysis, data were collected and analysed from 20 ex-prisoners who were incarcerated in maximum-security prison facilities for a period of three years or more. Our main findings are that, according to the interviewees’ testimonies, (a) the Israel Prison Service (IPS) makes manipulative and abusive use of food in order to perpetuate its power; and (b) food serves as a means to determine the relationship between prisoners and staff, govern social status or rejection in the prison subculture, or pass the time. We have four main conclusions. First, the IPS nutrition policy differentiates and discriminates among prisoners and clearly violates the basic human rights of prisoners, thus suggesting an abuse of power. Second, the IPS’s use of food as a tool for punishing or rewarding introduces and perpetuates inequalities and encourages the illegal prison trade in food and food products. Third, cooking in prison, especially in light of its illegality, constitutes a symbolic expression of resistance to the institution and a meaningful way of coping with boredom. Lastly, food and its possession in prison serve as very powerful tools for constructing and perpetuating exploitation and unequal power relations among prisoners.

Although the study suffers from two limitations – the validity of the adolescents’ responses and the small sample size – its findings lead us to propose that an improvement in the food products that are accessible to prisoners and permission to cook in their cells are inexpensive and legitimate means of bettering both the prisoners’ quality of life and the social atmosphere in prison.
Pain and Hardship Among Older Men: Examining the Buffering Effect of Medicare Insurance Coverage
Authors: Marshall Gillian L. , Baker Tamara A. , Song Chiho , Miller David B.
Published: April 2018

To better understand the health status of men in the United States, this study aimed to assess the association of hardship on the presence of and pain severity among men 50 years of age and older. Cross-sectional multivariate logistic regression analyses were conducted using the 2010 wave of the Health and Retirement Study ( N = 3,174) to assess the association between four hardship indicators and the presence of pain and pain severity among this sample of older men.

Results suggest that the association between the presence of pain and hardship was statistically significant across all four indicators: ongoing financial hardship (CI [1.05, 1.63], p < .05), difficulty paying bills (CI [1.42, 3.02], p < .001), food insecurity (CI [1.46, 3.15], p < .001), and not taking medication due to cost (CI [1.06, 1.66], p < .05), even after adjusting for all demographic factors.

The associations between pain severity and ongoing financial strain (CI [1.23, 2.83], p < .01) and difficulty paying bills (CI [1.02, 3.18], p < .05) were statistically significant. Results also indicate that education was a buffer at all levels. In addition, the interactive effect of hardship and Medicare insurance coverage on pain severity was significant only for ongoing financial strain (CI [1.74, 14.33], p > .001) and difficulty paying bills (CI [1.26, 7.05], p < .05). The evidence is clear that each hardship indicators is associated with the presence of pain and across some of the indicators in pain severity among men aged 50 and older. In addition, these findings stress the importance that Medicare insurance plays in acting as a buffer to alleviate some of the hardships experienced by older men. These findings also highlight the association between the presence of pain and pain severity for the overall quality of life, health outcomes, and financial position of men in later life.
A Qualitative Study to Assess Barber Perceptions of the Feasibility of the Employer as a Health Advisor for Obesity Prevention
Authors: Roy Siddhartha , Hansen Andrew R. , Ross Levi , Larson Rebecca
Published: April 2018

Obesity has become a serious issue affecting millions of Americans, especially in the southern United States. One avenue for addressing obesity is the workplace setting. This formative research study examined the feasibility of an obesity prevention worksite intervention in the barbershop for African American barbershop owners (employers) and barbers (employees). The study proposes an intervention where the owner of the barbershop would be trained to educate his barbers about obesity prevention. Twenty in-depth interviews were conducted with the owners ( n = 5) and barbers ( n = 15) of five barbershops in Statesboro, Georgia, to determine the feasibility of the intervention. The results of this study indicated that the owners and barbers all felt that the intervention was feasible and could be implemented in the barbershop. The owners and barbers felt that obesity was an important issue in their community. Additional themes identified include program benefits, empowerment of owners and barbers, and motivational components to help produce healthy habits. The owners felt comfortable educating their barbers about obesity prevention, and the barbers were receptive toward the idea of being educated by their employer. In order for this intervention to be implemented and effective, it must be tailored to fit within the barbershop environment. This intervention addresses known health disparities that exist in the African American community and underscores the need for additional worksite health promotion programs in medically underserved communities.
Detrimental Effects of Paraquat on Astrocytes-Regulating Synaptic Functions
Authors: Li Zheng , Zheng Jing , Zhang Xiao-Feng
Published: April 2018

Paraquat (PQ) exposure is known as a risk factor for developing neurodegenerative diseases. Astrocytes are implicated and affected in neurodegenerative diseases and brain injuries, so it is suspected that PQ may impose detrimental effects on astrocytes function. Here, we present a study of the effects of PQ on synaptic function of astrocytes. Human astrocytes (HA1800) were separately treated with PQ at 200, 400, and 800 µmol/L for 12, 24, and 48 hours, respectively. The concentrations of membrane cholesterol, intracellular glutamate, and adenosine triphosphate (ATP) were assessed by measuring changes with Kits after PQ treatment. Expression levels of glial fibrillary acidic protein (GFAP) and apolipoprotein E (ApoE) were detected using Western blot method. The results indicated that astrocytes were highly susceptible to PQ showing astrogliosis characterized by enhanced GFAP expression ( P < .05). The decreased cholesterol level and ApoE expression were observed in PQ-treated astrocytes and so were the decreased levels of glutamates and ATP in PQ-treated astrocytes. These results suggested that PQ exerted the detrimental effects on synaptic function of astrocytes, which may be involved in the progressive process of neurodegenerative disorders.
Usefulness and Potential Pitfalls of Sialic Acid Determination in Sera of Patients with Ovarian Tumors
Authors: Berra Bruno , Rapelli Silvana , Monticelli Gianluigi , Fighetti Maria Albertina , Mea Ines Della , Raspagliesi Francesco , Di Re Emanuela , Ringhini Roberto , Bombardieri Emilio
Published: April 2018

Increasing evidence in the literature indicates that serum sialic acid is increased in cancer patients suggesting a possible usefulness of its determination as a tumor marker. However there are many discrepancies in the data reported, probably due to methodological errors, mainly in lipid bound sialic measurement.

In this paper we illustrate the results obtained when we applied a method worked out in our laboratory for the determination of total and fractionated sialic acid (lipid and protein bound) to the analysis of sera from patients with ovarian tumors and the preliminary data on the follow up of selected cases. The potential pitfalls in using this relatively new tumor marker will be critically evaluated.
Circulating Levels of Immunoreactive Peptides and Steroid Hormones in Bronchogenic Carcinoma
Authors: Francini Guido , Inaudi Pieraldo , Gotti Giuseppe , Gonnelli Stefano , Lucani Barbara , Perrone Anna Filomena , Gennari Carlo
Published: April 2018

Plasma levels of immunoreactive parathormone (iPTH), immunoreactive calcitonin (iCT) and prostaglandins (PGE2) were measured by RIA in 115 patients with bronchogenic carcinoma. In 37 of these cases the following hormones were also assayed: adrenocorticotropic hormone (ACTH), cortisol, plasma renin activity (PRA), aldosterone, prolactin, human growth hormone (HGH), thyroid stimulating hormone (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH) human chorionic gonadotropin (HCG), progesterone (P), an-drostenedoone (A), testosterone (T), estradiol (E2) and dehydropiandrosterone sulphate (DHAS). High serum levels of many hormone-like substances and hormones were found and the levels of certain hormones varied in some cases according to the clinical evolution of the disease and the response to therapy.
Terminal Deoxynucleotidyl Transferase, Tdt, as a Marker for Leukemia and Lymphoma Cells
Authors: Campagnari Francesco , Bombardieri Emilio , de Braud Filippo , Baldini Luca , Maiolo Anna Teresa
Published: April 2018

Terminal deoxynucleotidyl transferase, TdT, was assayed in the mononucleate cells of blood and bone marrow from 121 patients with leukemias at the onset of disease and from 95 subjects with malignant lymphomas at diagnosis. This intracellular marker was also investigated by cytoimmunofluorescent tests in 17 other cases of initial leukemias and in 3 diagnosed lymphoblastic lymphomas. Generally, the TdT levels were significantly enhanced in the blasts of the following: acute undifferentiated leukemias; the more immature types of acute lymphoblastic leukemias i.e., the null, non-T non-B, common, early T and pre-B subgroups; a fraction of blastic crises in chronic myelogenous leukemias; and many lymphoblastic lymphomas. TdT might also be slightly increased in the mononucleate blood cells obtained from the most immature forms of acute myelogenous leukemias.

Relapses with changes in cell phenotypes were occasionally observed in previously TdT-positive leukemias as a result of clonal evolution of the disease. The leukemias with blasts containing high levels of TdT were usually responsive to treatment with corticosteroids and vincristine.

TdT is an oligoclonal marker characterizing several populations of undifferentiated or poorly differentiated blasts that tend to develop towards or along the lymphoid pathway. Together with specific immunological markers, this enzyme is useful to define the particular type of leukemic cells. It also serves to identify the quasi-lymphoblastic nature of the malignant clone, a helpful indication for the choice of therapy.
Treatment of a Patient with b Cell Lymphoma by 1-131 Lym-1 Monoclonal Antibodies
Authors: DeNardo Sally J. , DeNardo Gerald L. , O'Grady Lois F. , Macey Daniel J. , Mills Stanley L. , Epstein Alan L. , Peng Jo-Sen , McGahan John P.
Published: April 2018

A patient with Richter's syndrome, a malignant lymphomatous transformation of chronic lymphocytic leukemia, had become moribund with rapidly enlarging masses, granulocytopenia and thrombocytopenia despite the use of conventional chemotherapy and radiotherapy. Greater than ten percent of a test dose of I-131 Lym-1, a murine monoclonal antibody produced against Burkitt's African B cell lymphoma, was accumulated by her tumor. The patient was subsequently treated with a series of injections of I-131 Lym-1 with dramatic clinical response, reduction of tumor volume by x-ray computerized tomography and progression of circulating cellular elements toward normality. Her course over the next ten months was not like that to be expected for Richter's syndrome, which has an average survival of four months. This mode of treatment appears promising.
Serum Prostate-Specific Antigen Determination in Prostatic Carcinoma
Authors: Tizzani Alessandro , Casetta Giovanni , Piana Paolo , Bellina Maurizio , Pecchio Ferdinando , Aimo Giuseppe , Adamo Rita
Published: April 2018

Prostate-specific antigen (PSA) is a tissue-specific glycoprotein identified by Wang in 1979. It is synthesized in the prostate independently of prostatic acid phosphatase (PAP). A total of 199 subjects were divided into four groups: controls aged less than 50 years, controls aged more than 50 years, patients with benign prostatic hyperplasia (BPH) and patients with prostatic carcinoma.

PSA cut-off value was set at 10 ng/ml (mean for the BPH group plus 2 SD). With this cut-off value PSA could not be used as an early predictor of prostatic carcinoma. The association of PSA and PAP in prostatic cancer increases the number of patients with positive biological markers.
Immunosuppressive Acidic Protein (Iap) and Ca 125 Assays in Detection of Human Ovarian Cancer: Preliminary Results
Authors: Castelli Mauro , Romano Patrizio , Atlante Giuseppe , Pozzi Maurizio , Ferrini Umberto
Published: April 2018

Serum levels of the immunosuppressive acidic protein (IAP) and CA-125 were measured in 45 patients with ovarian tumors (30 malignant and 15 benign) before surgery. Concentrations of both markers were slightly increased in benign forms but still within the upper limit for controls.

The sensitivity of IAP in detecting ovarian cancer was higher than CA-125 (83.4% versus 76.7%). Five false negatives were observed in IAP assay and seven for CA-125. Parallel determination of both markers, however, improved the diagnostic accuracy up to 90.0% of the total malignant cases. Combined measurements of circulating IAP and CA-125 are therefore recommended in the detection of ovarian cancers.
Value of Ca 19-9 Assay in Serum and Duodenal Juice in the Differential Diagnosis of Pancreatic Disease
Authors: Tappero Gianfranco , Piantino Paolo
Published: April 2018

Levels of CA 19-9 in the serum and duodenal juice of nine patients with pancreatic adenocarcinoma (PC), ten patients with chronic calcifying pancreatitis (CCP) and ten healthy volunteers (C) were determined by immunoassay. Duodenal juice was obtained by duodenal intubation during the secretin caerulein test. Elevated CA 19-9 levels in the serum were significantly more frequent in PC than in CCP patients, but two PC patients gave levels only slightly above the cut off value of 37 U/ml. CA 19-9 levels in duodenal juice were significantly higher in PC than in CCP patients, but there was some overlap between them; no overlapping was seen between PC or CCP group and controls. Two PC patients with duodenal juice CA 19-9 levels overlapping those of CCP were the same who showed only a slight rise in serum CA 19-9 levels. The CA 19-9 to total protein ratio in duodenal juice did not permit better discrimination between PC and CCP. We conclude that CA 19-9 assay in duodenal juice can differentiate healthy subjects from patients with pancreatic diseases, but it cannot improve the differential diagnosis between CCP and PC patients with a slight rise of CA 19-9 levels in serum.
Carcinoembryonic Antigen and Breast Carcinoma Antigen (CA 15.3) in Preoperative Staging and Postoperative Monitoring of Patients with Carcinoma of the Breast
Authors: Omar Y.T. , Behbehani A.E. , Al-Naqeeb N. , Motawy M.M. , Folldi M.O. , Awwad A.H. , Nasralla M. Y. , Szymendera J.J.
Published: April 2018

Serum levels of carcinoembryonic antigen (CEA) and breast carcinoma antigen (CA 15.3) were determined in patients with breast carcinoma: in 129 before initial surgical or nonsurgical treatment and in 134 afterwards. Before any initial treatment, CEA was elevated in 15% of patients with Stage IV disease and CA 15.3 was high in 11% with Stage III and 48% with Stage IV. While monitoring management active disease was associated with elevated serum CEA in 66% of the patients, with elevated CA 15.3 in 73% and with at least one of the markers elevated in 86%. Both tests had high specificity (93% and 98%). The rise in serum CEA and, even more so, of serum CA 15.3 roughly paralleled the increase in bulk of the tumor: from locoregional disease through metastases to the lungs, bones, lungs with bones, and liver. Decreases in the levels of serum CEA and CA 15.3 reflected response to therapy, increases in the level of at least one marker - treatment failure, and levels fluctuating above the normal range indicated stationary disease.

During follow-up, the predictive value of a negative test (levels within the normal range), suggesting that the patient might be free of disease, was 61% for CEA alone, 67% for CA 15.3 alone, and 80% for the two tests combined. We conclude that an elevated serum level of only one of the markers was useful for staging, implying advanced disease. Determination of both markers jointly was useful for monitoring the effectiveness of the therapy and for follow-up aimed at detection of relapse.
Sialic Acid, Ferritin and CEA Levels in Peripheral Blood and Blood Draining from the Tumor in Breast Cancer
Authors: Monti M. , Catania S. , Locatelli E. , Scazzoso A. , Calzaferri G. , Cunietti E.
Published: April 2018

Concentrations of total serum N-acetyl-neuraminic acid, carcinoembryonic antigen, ferritin, lactate dehydrogenase, creatine phosphokinase and total proteins were measured in both tumor drainage blood (axillary vein) and in peripheral blood taken during surgery from 44 breast cancer patients.

There were no significant differences in any of the markers between mean values in peripheral and tumor drainage blood, between cancer patients and healthy controls, between patients with or without axillary lymph node metastases, or according to the site of breast mass.
A Preliminary Study of Brain Gliomas with H17E2 Monoclonal Antibody: Immunoscintigraphy and Pharmacokinetics
Authors: Skarlos DV. , Malamitsi J. , Sivolapenko G B. , Demakopoulos N. , Avgoustatos G. , Koutoulidis C. , Epenetos Aa.
Published: April 2018

Ten patients with relapsing high grade brain gliomas and one patient with low grade glioma were studied with a monoclonal antibody (H17E2) against placental alkaline phosphatase. In addition 2 patients with relapsing high grade glioma were studied with a non specific antibody (4D513/2118). 1 mCi of Iodine-131-labelled H17E2 was administered intracarotidly (i.c.) in two, and intravenously (i.v.) in 9 patients. Immunoscintigrams were taken at 0, 2, 24, 48 and 72 hours. Radioactivity was monitored in blood and urine. Tumour/non-tumour ratios were estimated (max. 2.45). All high grade gliomas receiving specific antibody irrespective of the route of administration, gave a positive immunoscintigraphic pattern, increasing in intensity with time.

Disappearance of radioactivity in blood was biexpontential with a long component over 30 hours. Urinary excretion of radioactivity ranged from 3.7–21.7% of administered dose/day. The patient with low grade glioma and the patients receiving non specific monoclonal antibody showed a negative pattern, a fast blood clearance and a high urinary excretion. We conclude that a) Iodine-131 labelled H17E2 proved to be stable in vivo and produced satisfactory tumour localisation and b) i.v. route was as good as i.c.
Interleukin-2 Receptor Positive Cells and Circulating Soluble Interleukin-2 Receptors in Patients with Solid Tumors are not Correlated
Authors: Lissoni P. , Rizzo V. , Barni S. , Rescaldani R. , Rovelli F. , Biondi A. , Archili C. , Frigerio F. , Tancini G.
Published: April 2018

Activated lymphocytes can release a soluble form of IL-2 receptor (sIL-2R), which retains the capacity to bind IL-2. Abnormally high values of sIL-2R have been observed in patients with advanced solid tumors. In an attempt to further understand the biological significance of sIL-2R in solid tumors, this study investigated the relation between sIL-2R and Tac-positive cells. sIL-2R serum levels and Tac-positive cells were determinedin 18 patients with solid tumors metastatic, 108 non-metastatic. Tumor types were: breast 7; lung 6; colon 2; stomach 1; testis 1; larynx 1. No correlation was found between circulating sIL-2R values and Tac-positive cells, and there was no difference between Tac-positive cell mean number in patients with high and normal sIL-2R levels. These preliminary results suggest that different mechanisms are responsible for sIL-2R release in the blood and IL-2 receptor expression on the immune cell surface.
Tumor Markers in Patients with Chronic Renal Failure
Authors: Filella X. , Cases A. , Molina R. , Jo J. , Bedini J.L. , Revert L. , Ballesta A.M.
Published: April 2018

In order to evaluate the specificity of tumor markers in chronic renal failure, we have determined serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19.9 (CA 19.9), carbohydrate antigen 50 (CA 50), alfafetoprotein (AFP), neuron-specific enolase (NSE), prostatic acid phosphatase (PAP), prostatic specific antigen (PSA), squamous cell carcinoma antigen (SCC), carbohydrate antigen 15.3 (CA 15.3) and carbohydrate antigen 125 (CA 125) in 30 patients with cronic renal failure and in 36 hemodialyzed patients without clinical evidence of neoplasia. CEA, CA 50, NSE and SCC frequently show increased serum levels, suggesting a renal metabolism, while others remain, generally, within the normal levels.
Serum SCC-Ag in Head and Neck Squamous Cell Carcinoma
Authors: Palermo F. , Carniato A. , Fede A. , Boccaletto F. , Marchiori C.
Published: April 2018

We estimated the serum levels of SCC-Ag, CEA and TPA in 69 patients with head or neck neoplasia and 31 healthy patients using a radioimmunometric method (double antibody). SCC-Ag concentrations were significantly increased in 43.4% cancer patients with respect to the cut-off point value (1.7 ng/ml) of the control group, and the specificity was 96.7%. The data varied according to the evolutive phase of disease. Since the combined evaluation of SCC-Ag, TPA and CEA serum levels increased the sensitivity, that was 71.0%, we thought it opportune to use all these markers in the tumoral pahtology taken into consideration.
Radioimmunotherapy Trials in Germ Testicular Carcinoma: A Phase I Study
Authors: Riva P. , Marangolo M. , Tison V. , Moscatelli G. , Franceschi G. , Spinelli A. , Rosti G. , Morigi P. , Riva N. , Tirindelli D.
Published: April 2018

Two patients with germ cell testicular cancer were submitted to radioimmunotherapy (RIT) by using the monoclonal antibody 131I-radiolabelled (MoAb) H17E2, raised against placental alkaline phosphatase (PLAP).

Both patients had been previously treated with repeated chemotherapy regimens assisted by autologous bone marrow transplant (ABMT), that, in the end were unsuccessful, thus necessitating further experimental treatment.

RIT was well tolerated and the targeting of multiple neoplastic lesions was satisfactory. Nevertheless, the clinical results of treatment were minimal owing to the extension of the tumour.

The data obtained suggest the possibility of applying this form of treatment in patients with minimal residual disease after previous traditional chemotherapy regimens.
Carcinoembryonic Antigen (CEA), α-fetoprotein, CA 19.9 and CA 125 in Advanced Colorectal Cancer (ACC)
Authors: Tsavaris N. , Vonorta K. , Tsoutsos H. , Kozatsani-Halividi D. , Mylonakis N. , Papagrigoriou D. , Koutsiouba-Kazakou P. , Kosmidis P.
Published: April 2018

In 111 patients with ACC we studied CEA, FP, CA-125 and CA 19.9 during therapy and follow-up. Marker determination was performed every two months. CEA was elevated (> 5 ng/ml) in 82%, αFP(> 15 ng/ml) in 0%, CA-125 (>38 U/ml) in 37%, CA 19.9 (> 30 U/ml) in 64% of the patients. We did not find significant differences between the sensititivity of CEA alone and that of the combination of CEA + CA-125 (86%), CEA + CA 19.9 (87%), CA-125 + CA-19.9 (71%) and CEA + CA-125 + CA 19.9 (88%). We did not find any correlation between the level of positivity of the markers and the clinical parameters we examined. When serial determinations were carried out, CEA showed the best indication of response to treatment, followed by CA 19.9. In the evaluation of the response to chemotherapy we found that CA 125 presented significant percentages of false-positive (9%) (P < 0.008) and false-negative (8.1%) (P < 0.008) results, compared to CEA and CA 19.9. CA 125 did not demonstrate any utility for the follow-up of patients with colorectal cancer although increased values were found in 37%. We conclude that CEA is currently the best marker for the follow-up of patients with colorectal cancer. The combination of CEA and CA 19.9 had some utility in follow-up, without significantly improving CEA results
Clinical Significance of the New Tumor Marker MCA in the follow-up of Patients with Mammary Carcinoma
Authors: Müller-Brand J. , Mäcke H.
Published: April 2018

MCA is a mucin-like carcinoma-associated antigen which has been found in all breast cancer independent of histological type and degree of differentiation. A two-step solid-phase EIA was developed and the serum concentration of MCA was measured in 176 breast cancer patiens after surgery. Using a cutoff of 11.0 U/ml the test showed a sensitivity of 77% and a specifity of 82% when compared to clinical status. The predictive value of this tumor marker was 72% for a positive diagnosis and 93% for a negative diagnosis. Based on these observations it is recommended that determination of MCA values take place 2 to 3 times in the first postoperative week in all women with surgically treated mammary carcinoma. These MCA values should then serve as reference for further determinations, which should be performed at each check-up. A subsequent increase in the MCA value should be considered as a first sign of metastasis.
Conventional Antibodies: Requirements and Methods for their Optimization
Authors: Ménard S. , Bottero F. , Bottini C. , Campiglio M.
Published: April 2018

Eighteen years after the discovery of monoclonal antibodies (MAbs), the debate as to whether these reagents have fulfilled their promise must now be addressed. When MAbs were studied as tools for diagnosis and therapy, problems arose regarding the reagents themselves and the recognized target antigens. Because most MAbs are of murine origin, they usually evoke an immune response in human patients, which reduces their effectiveness. Moreover, their bulky size and dispersal via the blood prevent most of the injected antibodies from substantially penetrating solid, poorly vascularized tumors. However, MAbs that are adequately selected and manipulated to circumvent these problems have been found to successfully image tumors and to be therapeutically active.
Serum and Tissue Levels of CEA, TPA, CA 125 and CA 15.3 in Patients with Lung Cancer
Authors: Macchia V. , Paduano D. , Di Carlo A. , Mariano A. , Cecere C. , Ferrante G.
Published: April 2018

Forty-nine healthy subjects (Group I), 24 patients with benign lung diseases (Group II) and 48 patients surgically treated for lung cancer (Group III): 28 with squamous cell carcinoma (SCC) and 20 with adenocarcinoma (adenoca), were tested for the presence of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), cancer antigen CA 125 and antigen CA 15.3. The four markers were measured in the serum of the patients of the three groups and in the cytosol extract of tumoral and peritumoral tissues of Group III subjects. The mean levels of serum CEA and TPA were significantly higher in squamous cell carcinoma and in adenocarcinoma patients than in normal subjects. In benign lung disease serum CEA was equal and TPA slightly higher than in normal subjects. CA 125 was higher in the serum of patients with malignant diseases compared to normal or benign lung diseases but this difference was not statistically significant. Serum CA 15.3 levels were similar in all subjects studied. CA 125 in squamous cell carcinoma cytosol was much higher than in peritumoral cytosol whereas the other three markers were not significantly different in tumor cytosol or peritumoral cytosol. A direct correlation between serum and cytosol values was observed for CEA, but not for the other markers. The levels of the four markers in serum and cytosol did not correlate with the stage or grade of the tumors.
Elimination Kinetics of Prostate-Specific Antigen Serum and Urine
Authors: Semjonow A. , Hamm M. , Rathert P.
Published: April 2018

The serum half-life of prostate-specific antigen (PSA) was calculated in 66 patients subsequent to radical prostatectomy. Comparing serum half-life to disease outcome in 37 patients after a minimum follow-up of two years, it was found that PSA serum half-life identifies patients with residual disease earlier and more reliably than the presence or absence of detectable PSA levels postoperatively. It is suggested that residual tumor affects the half-life by contributing to the serum level of PSA. When PSA serum half-life was calculated solely in potentially cured patients, we found a half-life of 1.6 days, which is considerably shorter than in previous reports based on patient populations regardless of the outcome of disease in the follow-up.

To elucidate the route of PSA elimination, serial urine PSA levels were determined before and after radical prostatectomy, revealing strong evidence for the assumption that PSA is not eliminated by the kidneys in its unchanged form.
Afp and Hcg in Germ Cell Tumors
Authors: Bassetto M.A. , Franceschi T. , Lenotti M. , Parise G. , Pancheri F. , Sabbioni R. , Zaninelli M. , Cetto G.L.
Published: April 2018

The high specificity and sensitivity of testicular tumor markers make them particularly useful in the management of these neoplasms. Basal value represents an independent prognostic variable, influencing the choice of therapy. An increase in marker level before chemotherapy could also acquire a powerful prognostic significance. The decay curve pattern is indicative of the radicality of surgery. Also during chemotherapy the behavior of markers conditions further therapeutic strategies.
Disappearance Curves of Tumor Markers after Radical Surgery
Authors: Rapellino M. , Piantino P. , Pecchio F. , Ruffini E. , Cavallo A. , Scappaticci E. , Baldi S. , Ciocia E. , Pivetti S.
Published: April 2018

CEA serum levels were sampled from 15 patients with lung carcinoma, 12 patients with colon carcinoma, and 5 patients with gastric carcinoma before and after radical excision of the malignancy. In addition, TPA serum levels were measured in 7 patients with lung carcinoma and CA 19.9 serum levels in 9 patients with colon carcinoma, before and after curative surgery. Irrespective of the primary malignancy, a CEA half-life of approximately 3 days was calculated. The normalization time was related to the preoperative level of the marker, being longer when the preoperative CEA level was > 20 ng/ml. The TPA half-life was slightly longer than 1 day, ranging from less than 1 day to more than 3 days, with a normalization time of about 20 days. The CA 19.9 half-life was slightly longer than 1 day with variations from less than 1 day to about 3 days. Many factors, especially associated inflammatory processes and hepatic clearance imbalances, may influence marker kinetics in the postoperative period. A correct evaluation of the clinical significance of tumor marker half-life after radical surgery will require a larger number of patients as well as careful and prolonged follow-up.
Comparison of Cyfra 21–1, Tpa and Tps in Lung Cancer, Urinary Bladder Cancer and Benign Diseases
Authors: Stieber P. , Dienemann H. , Hasholzner U. , Fabricius P.G. , Schambeck C. , Weinzierl M. , Poley S. , Samtleben W. , Hofmann K. , Meier W. , Untch M. , Fateh-Moghadam A.
Published: April 2018

Recently CYFRA 21–1, a new tumor marker measuring a fragment of cytokeratin 19, was introduced and proved to be suitable for therapy monitoring and follow-up of non-small cell lung carcinomas (NSCLC), in particular squamous cell carcinomas. Besides CYFRA 21–1 there are two other tumor markers, tissue polypeptide antigen (TPA) and tissue polypeptide-specific antigen (TPS), which also measure various cytokeratins in serum. In a retrospective study we investigated the clinical significance of these three cytokeratin markers in lung cancer and in carcinoma of the urinary bladder. For this purpose we investigated the sera of 50 healthy persons, 273 patients with various benign diseases, 218 patients with histologically proven lung cancer and 88 patients with carcinoma of the urinary bladder.

In a first step the specificity was established for the different reference groups and the cutoff values were fixed at a specificity of 95%. In lung cancer the single and combined sensitivities were calculated versus benign lung diseases (n = 58) as reference group. With single determinations CYFRA 21–1 proved to have the highest sensitivity in lung cancer in general (61%), in non-small cell lung carcinomas (64%), in squamous cell carcinomas (79%), in adenocarcinomas (54%) and in large cell carcinomas (65%). In small cell lung carcinomas (SCLC) NSE was confirmed to be the marker of choice (55%). With combined determinations a clear increase in sensitivity could only be reached in large cell carcinomas (CYFRA 21–1 + TPA: 77%) and in small cell carcinomas (CYFRA 21–1 + NSE: 62%). In cancer of the urinary bladder the sensitivities were established versus benign urological diseases (n = 73). CYFRA 21–1 showed with 38% true positive test results the highest sensitivity compared to TPA (27%) and TPS (23%).

From our investigations it was evident that TPA detects at least partially the same substance as CYFRA 21–1 (the sensitivities compared to the markers TPS, CEA, SCC and NSE were rather high, but not as high as for CYFRA 21–1) whereas TPS represents a completely different parameter of clinical chemistry (lowest number of true positive test results over the whole investigation), which apparently measures something completely different. These findings cleary correspond with the very recent results of immunoblotting comparing CYFRA 21–1, TPA and TPS.
Evaluation of the Expression of Tissue DF-3 and MCA and the Corresponding Serum Values in Patients with Breast Carcinoma
Authors: Giovagnoli M.R. , Reale G. , Cosentino L. , Manna A. , Midulla C. , Marchei G. , Vecchione A.
Published: April 2018

Two specific monoclonal antibodies for breast tissue (DF3 and MCAb-12) and the corresponding tumor markers CA15-3 and MCA in serum have been evaluated in 50 patients with breast cancer and in 15 controls. The expression of these antigens in tissue was poorly correlated with the common prognostic parameters. Their presence in serum was associated with an altered distribution of the antigens in the cell. The expression of these antigens in tissue enables us to select patients for serological follow-up and to evaluate tumor differentiation from a functional point of view.
Neuron-Specific Enolase
Authors: Cooper E.H.
Published: April 2018

The clinical value of neuron-specific enolase as a marker in small cell lung cancer, neuroblastoma, melanoma and seminoma has been reviewed The role of serum and cerebrospinal NSE in benign and malignant disease of the central nervous sytem is discussed.
Serum Levels of Carboxyterminal Propeptide of Type I Procollagen in Cancer Patients with Osteoblastic and Osteolytic Bone Metastases
Authors: Piovesan A. , Berruti A. , Osella G. , Raucci C.A. , Torta M. , Dogliotti L. , Angeli A.
Published: April 2018

Serial monitoring of serum and urinary markers of bone regeneration may provide an indirect assessment of the activity of bone metastases. We measured serum levels of carboxyterminal propeptide of type I procollagen (PICP), a new marker of bone formation, in 236 control subjects, stratified according to age and sex, and in 122 cancer patients: 80 with breast cancer (BC) (42 with osteolytic bone metastases) and 42 with prostate cancer (PC) (31 with osteoblastic bone metastases). An inverse correlation between age and serum PICP levels was found in healthy men (r = -0.30), but not in women. PICP levels were significantly higher in patients with osteoblastic metastases compared to age-matched control subjects and patients with advanced disease not involving the skeleton. The sensitivity of PICP was 64% for detecting osteoblastic metastases, and 12% for detecting osteolytic metastases. Serum PICP determination may have a diagnostic role for osteoblastic activity.
Soluble Interleukin-2 Receptors in Patients with Advanced Colorectal Carcinoma
Authors: Pavlidis N. , Nicolaides C. , Bairaktari E. , Kalef-Ezra J. , Athanassiadis A. , Seferiadis C. , Fountzilas G.
Published: April 2018

The levels of soluble interleukin-2 receptors (sIL-2R) were measured in the serum of 52 patients with advanced colorectal carcinoma and compared to CEA and CA 19-9 levels. Twenty-five normal, age and sex-matched individuals served as controls. Seventy-five per cent of the patients had increased mean serum levels of sIL-2R (1539 ± 155 U/ml), while normal controls had mean levels of 555 ± 31 U/ml (p < 0.001). The relationship with hepatic or lymph nodal metastases showed no statistically significant difference (p=0.34 and p=0.47, respectively). Serum sIL-2R levels showed a linear correlation with CEA (p < 0.05). Patients with lower pretreatment sIL-2R levels (less than 1.200 U/ml) had a longer survival than patients with higher initial levels (more than 1.200 U/ml) (p=0.0049).

In conclusion, the present work shows that the serum levels of sIL-2R: a) are elevated in patients with advanced colorectal cancer, b) have no relationship with the type of metastases, c) correlate with serum CEA and d) have a prognostic value for survival.
CA 19.9, CA 242 and CEA in the Diagnosis and Follow-up of Pancreatic Cancer
Authors: Banfi G. , Bravi S. , Ardemagni A. , Zerbi A.
Published: April 2018

The diagnosis of pancreatic cancer is usually made in the advanced stages of the disease when the prognosis is poor. We compared the behavior of CA19.9, CEA and the newly proposed mucin CA242 in a consecutive series of 42 pancreatic carcinomas. A control group was recruited of 21 patients with benign pancreatic diseases. With the recommended cutoffs (37 U/ml for CA19.9, 20 U/ml for CA242 and 8 ng/ml for CEA) we obtained a specificity of 90% for CA19.9 and of 85% for CA242 and CEA. The sensitivity was 85.7% for CA19.9, 73.8% for CA242 and 26.2% for CEA. CA19.9 and CA242 showed identical behavior in various TNM stages of cancer and in stages HI and TV of the Hermreck classification. Moreover, CA19.9 and CA242 showed identical behavior in 10 patients monitored during the survival period who developed recurrence of disease. ROC curve evaluation demonstrated that CA242 and CA19.9 were very similar. The results of CA242 were better than those of CA19.9 in the false positive range under 10%, whereas CA19.9 had a better performance in the true positive range over 70%. CA242 could be used instead of CA19.9 for diagnosing pancreatic carcinoma.