bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual Mobility Cups: An Effective Prosthesis in Revision Total Hip Arthroplasties for Preventing Dislocations
Authors: Jauregui Julio J. , Pierce Todd P. , Elmallah Randa K. , Cherian Jeffrey J. , Delanois Ronald E. , Mont Michael A.
Published: October 2015

Purpose

Postoperative dislocation is one of the most common complications following total hip arthroplasty (THA), and dual mobility articulations have been designed to provide greater hip stability. However, there are few studies that have assessed outcomes of these designs in revision THAs. Our purpose was to evaluate differences in dislocation rates, aseptic survivorship, and patient outcomes between dual mobility articulations and conventional arthroplasties in the revision setting.

Methods

Patients who underwent revision THA with dual mobility articulations (n = 60) were matched (1:2) to patients who had conventional single articulation prostheses (n = 120). They were matched for body mass index, age, gender, and Paprosky acetabular defect classification, and were followed up for a mean of 30 months (range, 18 to 52 months). The outcomes were evaluated preoperatively and at final follow-up using Harris Hip Scores, the University of California Los Angeles activity scale, and the Short Form-36 questionnaires.

Results

The dual mobility group had lower dislocation (1.7% (1 out of 60) versus 5.8% (7 out of 120)) and aseptic loosening rates (1.7% (1 out of 60) versus 4.2% (5 out of 120)) compared to the control group. There were no significant differences in functional outcomes, activity level, or overall physical and mental health status between the 2 cohorts.

Conclusions

When used in the revision setting, dual mobility bearings had fewer dislocations. We believe that these designs may lead to clinically significant improvements in complications while also improving patient reported and functional outcomes, but larger cohort studies are necessary for evaluation.
Slipped Capital Femoral Epiphysis: Long-Term Outcome and Remodelling after in Situ Fixation
Authors: Reinhardt Max , Stauner Kerstin , Schuh Alexander , Steger Wolfgang , Schraml Annemarie
Published: October 2015

Purpose

In primary treatment of slipped capital femoral epiphysis (SCFE) in situ fixation reliably prevents slip progression. The aim of this study was to examine the long-term outcome of SCFE-patients treated by transfixation with Kirschner wires with a special focus on the remodelling process of the hips under this fixation method.

Methods

30 patients with stable SCFE (mean initial slip angle: 29°, mean follow-up: 10 years), who were treated with bilateral transfixation by Kirschner wires, were recruited for this study. At most recent follow-up patients were clinically and radiologically (X-ray and MRI) examined. Medical records were reviewed for previous follow-up time points.

Results

Range of motion: At most recent follow-up the mean range of motion was: extension/flexion: 0/0/121, abduction/adduction: 44/0/31, external rotation/internal rotation: 39/0/24. Nearly all dimensions of motion significantly improved during the postoperative course. Head-shaft angle: We saw a significant reduction of the mean head-shaft angle from 29° preoperatively to 11° at most recent follow-up (p<0.0001). Harris Hip Score (HHS): 24 patients had an excellent, 3 a good, 2 a fair and 1 a poor outcome defined by HHS. Remodelling: At most recent follow-up 25 patients achieved complete remodelling. The remodelling process took place especially during the first postoperative year. Angle alpha: The mean angle alpha of the affected hips at most recent follow-up was 62°.

Conclusions

Transfixation with Kirschner wires leads to very good clinical, functional and radiologic results with a low complication rate. Furthermore the femoral head-neck junction retains enough plasticity for an active remodelling process.
Hip Arthroscopy in Osteoarthritis: A Systematic Review of the Literature
Authors: Piuzzi Nicolas S. , Slullitel Pablo A.I. , Bertona Agustin , Oñativia Ignacio J. , Albergo Ignacio , Zanotti Gerardo , Buttaro Martin A. , Piccaluga Francisco , Comba Fernando M.
Published: October 2015

Background

Hip arthroscopy treatment in patients with osteoarthritis is controversial.

Hypothesis/Purpose

To systematically review the clinical outcome of patients with hip osteoarthritis (OA) treated with arthroscopy and what proportion of these patients subsequently underwent total hip arthroplasty (THA).

Study design

Systematic review.

Methods

PubMed, Cochrane library and LILACS were searched from January 1990 through December 2013 for eligible studies. The methodological quality of the collected data (applied to each study) was performed with a modified version of the Coleman methodology score (mCMS).

Results

11 studies were included in this review. Most of the studies included reported clinical improvements. The overall conversion rate to THA ranged from 9.5% to 50%. Mean time between arthroscopy and THA was 13.5 months.

Conclusions

The quality of studies is low. We have found inconclusive evidence to make categorical indications for hip arthroscopy in the treatment of OA, although we have found that there is some postoperative clinical outcome improvement of pain and function in a short-term evaluation. Increasingly worse outcomes were seen as the severity of OA increased.
Emergency Percutaneous, Bicaval Double-Lumen, ECMO Cannulation in Neonates and Infants: Insights from Three Consecutive Cases
Authors: Moscatelli Andrea , Buratti Silvia , Gregoretti Cesare , Lampugnani Elisabetta , Salvati Pietro , Marasini Maurizio , Ribera Elena , Fulcheri Ezio , Tuo Pietro
Published: October 2015

Background

Veno-venous extracorporeal membrane oxygenation (ECMO) is probably the preferable configuration to assist children with respiratory failure who do not respond to maximized conventional therapies. The single-vessel, double-lumen approach through the internal jugular vein is extremely advantageous, especially in infants, where femoral access presents limitations related to the small dimensions of the veins. In case of emergencies, ECMO might need to be started at the bedside, without the availability of fluoroscopic guidance. To our knowledge, a completely percutaneous approach has not been reported before in children younger than 1 year and weighing less than 5 kg.

Methods

We describe 3 cases of emergency bedside, percutaneous, bicaval double-lumen cannulation under real-time transthoracic ultrasound control in 2 neonates and 1 infant.

Results

In our experience, this approach proved to be safe, effective and time saving, while minimizing bleeding from the cannula insertion site. Cannulation times, from decision making to the beginning of ECMO flow, were 30, 28, 25 minutes respectively, from patient 1 to 3. We do not report any cannula-related injury to vessels and heart structures.

Conclusions

Our preliminary data suggest that, with the described precautions, percutaneous, echo-guided, bicaval double-lumen cannulation in neonates and infants could be effective and free from major complications. Further evaluation should be warranted in the neonatal population.
Effect of Air-Abrasion Regimens and Fine Diamond Bur Grinding on Flexural Strength, Weibull Modulus and Phase Transformation of Zirconium Dioxide
Authors: Michida Silvia Masae de Araújo , Kimpara Estevão Tomomitsu , dos Santos Claudinei , Souza Rodrigo Othavio Assunção , Bottino Marco Antonio , Özcan Mutlu
Published: October 2015

Purpose

This study evaluated the effect of air abrasion and polishing regimens on the flexural strength of yttrium stabilized polycrystalline tetragonal zirconia (Y-TZP).

Methods

From Y-TZP blocks (InCeram 2000 YZ Cubes; Vita Zahnfabrik, Bad Säckingen, Germany) 120 bars (25 mm × 4 mm × 1.2 mm) were obtained according to ISO 6872:2008 and randomly divided into 4 groups: Group C: (control) without surface treatment (n = 30); Group APA: Air abrasion with aluminum oxide (44 µm) (n = 30); Group SC: Silica-coating (CoJet, 30 µm) (n = 30); Group FD: Fine diamond bur (n = 30). Subsequently, all specimens were subjected to 4-point bending test (in distilled water at 37°C) in a universal testing machine (EMIC DL 1000; São José dos Pinhais, Paraná, Brazil); cross-head speed: 0.5 mm/min). The characteristic strength (σ0) of each specimen was obtained from the flexural strength test and evaluated using Weibull analysis. X-ray diffraction analysis was utilized to quantity the monoclinic phase. The surface topography of specimens was analyzed using 3D optical profilometer and scanning electron microscopy (SEM) after surface conditioning methods. The flexural strength data (σ4p) were statistically analyzed by 1-way ANOVA, Tukey test (α = 0.05) and Weibull (m = modulus, σ0 = characteristic strength) were calculated.

Results

The mean ± standard deviations (MPa) of the groups were as follows: C: 1196.2 ± 284.2a; APA: 1369.7 ± 272.3a; SC: 1207.1 ± 229.7a and FD: 874.4 ± 365.4b. The values (m) and (σ0) were as follows: C: 4.5 and 1308.12; APA: 5.9 and 1477.88; SC: 6.0 and 1300.28; and FD: 2.6 and 985.901, respectively.

Conclusions

Air particle abrasion with neither silica nor alumina showed significant difference compared to the control group but grinding with fine diamond bur impaired the flexural strength of the zirconia tested.
Effects of Thermal Cycling on Surface Roughness, Hardness and Flexural Strength of Polymethylmethacrylate and Polyamide Denture Base Resins
Authors: Ayaz Elif Aydoğan , Bağış Bora , Turgut Sedanur
Published: October 2015

Background

The purpose of this study was to evaluate the effects of thermal cycling on the surface roughness, hardness and flexural strength of denture resins.

Methods

Polyamide (PA; Deflex and Valplast) and polymethylmethacrylate (PMMA; QC-20 and Acron MC) denture materials were selected. A total of 180 specimens were fabricated and then divided into 3 groups. The first group (group 1) acted as a control and was not thermocycled. The second group (group 2) was subjected to thermocycling for 10,000 cycles in artificial saliva and 5,000 cycles in distilled water. The last group (group 3) was thermocycled for 20,000 cycles in artificial saliva and 10,000 cycles in distilled water. The surface roughness were measured with a profilometer. The hardness of the resins were measured with a Vickers Hardness Tester using a 100-gf load. The flexural strength test was performed using the universal test machine with a crosshead speed of 5 mm/min. Data were analyzed using statistical software. The results of the measurements in the 3 different tests were analyzed by Kruskal-Wallis test with Bonferroni correction. Multiple comparisons were made by Conover and Wilcoxon tests.

Results and conclusions

There was a significant difference between the PMMA and PA groups in terms of surface roughness, hardness and transverse strength before and after thermal cycling (p<0.001). Thermal cycling did not change the surface roughness, hardness and flexural strength values of either the PMMA or PA group (p>0.001).
Cytotoxicity and Gelatinolytic Activity of a New Silicon-Based Endodontic Sealer
Authors: Silva Emmanuel J.N.L. , Neves Aline A. , De-Deus Gustavo , Accorsi-Mendonça Thais , Moraes Ana Paula , Valentim Rodrigo M. , Moreira Edson J.
Published: October 2015

Purpose

To compare the cytotoxicity, gelatinolytic activity, and protein levels (MMP-2 and MMP-9) produced by 3T3 fibroblasts cells after stimulation with GuttaFlow 2 and AH Plus.

Methods

3T3 fibroblasts were incubated with elutes of GuttaFlow 2 and AH Plus for 24 h. The cytotoxicity of tested materials was determined using the MTT and the LDH assay. Supernatants of cell cultures incubated with sealers were collected to determine the levels of MMP-2 and MMP-9 gelatinolytic activity by gelatin zymography. Cell lysates were used to determine MMP-2 and MMP-9 protein levels by Western Blot. Data were analyzed using ANOVA and Tukey test (P<0.05).

Results

AH Plus showed significantly less cell viability (mitochondrial activity of cells) than GuttaFlow 2 (P<0.01). Moreover, GuttaFlow 2 was noncytotoxic, showing no statistically significant difference in LDH leakage levels compared to the control group (p>0.05). Specific characterization of MMPs demonstrated that GuttaFlow 2 seemed not to affect MMP-2 levels compared with the control group, while AH Plus had elevated gelatinolytic activity and protein levels of MMP-2 as confirmed by quantitative measurements. No detectable gelatinolytic activity or protein levels of MMP-9 (92 kDa) was observed in any tested group.

Conclusions

GuttaFlow 2 did not showed cytotoxic effects and did not induce MMP-2 or MMP-9 expression.
Compatibility Study of Alginate/Keratin Blend for Biopolymer Development
Authors: Gupta Pratima , Nayak Kush Kumar
Published: October 2015

The ultimate characteristics of blend film depend on the properties of its polymeric components, composition, and on the compatibility of the polymers. Binary polymer blend films of alginate (ALG) and keratin (KER) fibers (obtained from chicken feathers) were prepared by simple solution casting techniques and their compatibility properties were studied by X-ray diffraction and scanning electron microscopy. The tensile strength and percent of elongation were measured by a tensile strength tester. The results of the present studies elucidate that ALG and KER are compatible and suitable for the development of a blend film. It was found that the ALG/KER blend ratios of 90:10 and 80:20 possess characteristics to make a blend film with a high tensile strength value. The blend with composition 90:10 of ALG/KER is the one of the strongest candidates in the preparation of blending films, because it has the highest tensile strength (0.38 MPa) and percentage of elongation (59.5%) among all tested blend compositions. The blend ratio of 80:20 of ALG/KER achieves maximum compatibility, since its intensity pattern changes drastically as recorded in an X-ray diffraction study. The fabricated blend film can be a suitable candidate for a range of biomaterials such as for a drug delivery vesicle, hydrogel, and scaffolding, etc.
Evaluation of HER2 by Automated FISH and IHC in Gastric Carcinoma Biopsies
Authors: Silva Maria R. , Alarcão Ana , Ferreira Teresa , d'Aguiar Maria , Ladeirinha Ana , Balseiro Sandra , Carvalho Lina
Published: October 2015

Purpose

The use of trastuzumab (Herceptin) to target HER2 has been applied in breast carcinoma and gastric carcinoma (GC). Previous studies have tested trastuzumab's effectiveness by assessing HER2 expression or HER2 amplification by means of immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH). In this work we aimed to evaluate automated FISH and IHC technologies for HER2 detection in GC biopsies to be used in routine pathology practice.

Methods

The study used an Oracle HER2 IHC System and an LSI HER2/CEP17 Dual Probe on an automated Bond™ system (Leica Microsystems). One hundred GC biopsies were evaluated including 44 intestinal type, 38 diffuse type and 18 indeterminate type according to Lauren's classification.

Results

The overall concordance rate between the automated FISH and IHC methods was 94% ( κ = 0.87), as 6 samples were scored as equivocal (4 in IHC and 2 in FISH). Moreover, HER2 positivity was significantly different between the 3 types of GC (p<0.05), being more frequent in intestinal-type GC (23%) than in the other 2 histological types (5% and 0%). Finally, the HER2/CEP17 FISH ratio was significantly different (p<0.01) between disomic and polysomic samples, being higher in polysomic samples (mean 1.633 ± 0.509) than in disomic samples (mean 1.231 ± 0.675).

Conclusions

Automated HER2 testing of GC biopsies using the Leica Bond system was useful and efficient. This method allowed us to improve normal routine procedures, minimizing time and costs as well as handling and observation errors.
Concordance Rate between HER2 Immunohistochemistry and in Situ Hybridization in Gastric Carcinoma: Systematic Review and Meta-Analysis
Authors: Pyo Jung-Soo , Sohn Jin Hee , Kim Woo Ho
Published: October 2015

Purpose

The aim of this study was to investigate the diagnostic accuracy of HER2 immunohistochemistry (IHC) in gastric carcinoma (GC) through a systematic review, meta-analysis and diagnostic test accuracy review.

Method

The current study included 12,679 GC cases and 181 subsets in 45 eligible studies. We performed concordance analysis between HER2 IHC and in situ hybridization (ISH) in GC. Diagnostic test accuracy was analyzed and the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve was calculated.

Results

HER2 amplification rates were 3.0%, 31.8%, and 93.0% in the IHC score 0/1+, 2+, and 3+ groups, respectively. The concordance rates between IHC and ISH were 0.969 (95% confidence interval [CI] 0.962-0.975), 0.393 (95% CI 0.331-0.458) and 0.915 (95% CI 0.882-0.939) in the HER2 IHC score 0/1+, 2+, and 3+ groups, respectively. For all the HER2 IHC score groups, the positive rates were higher in the silver ISH (SISH) subgroup than in the fluorescence ISH (FISH) and chromogenic ISH (CISH) subgroups. In diagnostic test accuracy review, the pooled sensitivity and specificity were 0.86 (95% CI 0.84-0.87) and 0.91 (95% CI 0.90-0.91). The AUC on SROC curve was 0.958. However, there was no significant difference in the values of AUC between the ISH methods.

Conclusions

Our results showed that HER2 IHC was well concordant with ISH in HER2 IHC score 0/1+ or 3+. Although this meta-analysis showed higher diagnostic accuracy of HER2 IHC, more detailed criteria for HER2 IHC score 2+ cases will be required to predict HER2 status.
An Efficacy of Intensive Vitamin D Delivery to Neointimal Hyperplasia in Recurrent Vascular Access Stenosis
Authors: Sato Tetsuhiko , Iwasaki Yoshiko , Kikkawa Yamato , Fukagawa Masafumi
Published: October 2015

Purpose

Neointimal hyperplasia (NH) causes vascular access (VA) stenosis, which results in serious under-dialytic morbidity in hemodialysis patients. We sought to assess whether a vitamin D intervention to NH lesions leads to better VA patency and examined clinical and in vitro studies.

Methods

A pilot clinical study of six hemodialysis patients was conducted to elucidate whether 0.5 μg calcitriol injection to stenotic lesion after balloon angioplasty (PTA) maintains better vessel patency until the next follow-up angiography. Localized vitamin D exposure was utilized by delivering and fixing calcitriol intensively at the stenotic lesion through a side-hole catheter with balloon clamping. We also performed vascular smooth muscle cell (VSMC) culture to detect both apoptosis (cell death detection assay) and cell viability (5-Bromo-2′-deoxy-uridine incorporation), and explored the efficacy of vitamin D to inhibit VSMC proliferation. Additionally, immunohistochemistry (IHC) was conducted to examine vitamin D receptor (VDR) expression at NH lesion, obtained from VA surgery.

Results

Percent patency, the proportion between stenotic and non-stenotic vessel diameters, increased significantly (p = 0.03) after directly catheter-delivered 0.5 μg calcitriol administration. In vitro VSMC studies, 0.1 nM calcitriol significantly (p<0.05) enhanced apoptosis and cell-cycle inhibition for two different calcitriol exposure times (15 minutes and 24 hours). IHC staining revealed that VDR-positive hyperplastic cells were observed at NH lesion.

Conclusions

Intensive vitamin D exposure at NH lesion has an ability to inhibit further VSMC proliferation, and presumably leads to greater patency rate for recurrent VA stenosis. Further studies are needed to clarify whether its unique property is exhibited through VDR-mediated mechanism.
Ischemic Colitis Diagnosed by Magnetic Resonance Imaging during Lenalidomide Treatment in a Patient with Relapsed Multiple Myeloma
Authors: Guerrini Susanna , Bucalossi Alessandro , Cioffi Squitieri Nevada , Mazzei Francesco G. , Volterrani Luca , Mazzei Maria Antonietta
Published: October 2015

Introduction

Multiple myeloma is the second most common hematological neoplasm that also affects young patients. The progression-free survival after autologous stem cell transplant has improved with the introduction of several novel agents such as lenalidomide, which may, however, increase the risk of adverse events.

Methods

We describe the case of a 54-year-old woman with relapse of multiple myeloma 3 years after myeloablative allogeneic stem cell transplant who developed abdominal pain and bloody diarrhea following 7 months of lenalidomide therapy.

Results

Abdominal plain x-ray and magnetic resonance imaging (MRI) without intravenous contrast material showed left-sided and splenic flexure acute ischemic colitis with reperfusion phenomena. Continuous intravenous infusion of unfractionated heparin was given with metronidazole and meropenem and the patient improved within a few days. MRI performed 15 days later confirmed complete recovery of ischemic colitis.

Conclusions

To our knowledge there have been no previously reported cases of ischemic colitis during lenalidomide therapy as a single agent in relapsed or refractory multiple myeloma, in particular promptly diagnosed by MRI.
Trastuzumab Cardiac Toxicity: A Problem we Put our Heart Into
Authors: Bregni Giacomo , Galli Giulia , Gevorgyan Arpine , de Braud Filippo , Di Cosimo Serena
Published: October 2015

Trastuzumab has gained a central role in the treatment of HER2-positive breast cancer, revolutionizing care in this setting. However, since the beginning of its use there have been concerns about its cardiac safety. Trastuzumab can give rise to cardiac toxicity, in some cases leading to discontinuation of treatment. Growing evidence shows that trastuzumab toxicity can be detected early or averted by means of new chemotherapy regimens using different anthracycline formulations or avoiding anthracyclines altogether. Moreover, patients in whom cardiac toxicity develops can be treated effectively and full cardiac function can be restored thanks to progress in drug management. Knowing the characteristics and proper management of trastuzumab toxicity is of paramount importance to grant patients in this setting the best available treatment.
Extramammary Paget Disease of the Vulva: Minimal Excision with Adjuvant Radiation Treatment for Optimal Aesthetic Results
Authors: Jeon Myeong Su , Jung Gyu Yong , Lee Joon Ho , Kang Kyung Won , No Kwang Won
Published: October 2015

Aims and background

Extramammary Paget disease (EMPD) is an uncommon malignant neoplasm that occurs in areas containing apocrine glands, and the vulva is the most commonly involved site. Wide surgical excision with subsequent defect reconstruction is widely accepted as the first-line treatment for EMPD. More recently, radiation treatment has been considered an appropriate primary or adjuvant treatment. In an effort to replace wide excision and avoid unfavorable aesthetic results and sexual dysfunction, we decided to excise the tumor minimally and to add adjuvant radiation treatment.

Methods

A 71-year-old woman had EMPD at the right labium majus. The patient was treated by minimal excision with a 1-cm safety margin and by adjuvant radiation treatment weekly from 1 month to 3 months after surgery to a total dose of 70.2 Gy. Four months after completing the radiation treatment, a 10-point surgical biopsy around the site of previous resection was performed. Radiation treatment caused hypertrophy of the left labium minus, which was treated by additional labiaplasty (labium minus reduction) to obtain optimal aesthetic results.

Results

Surgical biopsy revealed no definite evidence of recurrence. Currently, the patient had no EMPD symptoms, is satisfied with a symmetrical vagina, and experiences no discomfort during ordinary activities or intercourse.

Conclusions

Minimal tumor excision (with a 1-cm safety margin), adjuvant radiotherapy, and additional labiaplasty were performed to treat EMPD. Complete tumor removal without recurrence, an aesthetically satisfactory result, and normal sexual function were achieved in this patient.
FDG-PET/CT to Predict Optimal Primary Cytoreductive Surgery in Patients with Advanced Ovarian Cancer: Preliminary Results
Authors: Alessi Alessandra , Martinelli Fabio , Padovano Barbara , Serafini Gianluca , Lorusso Domenica , Lorenzoni Alice , Ditto Antonino , Lecce Francesca , Mira Marta , Donfrancesco Cristina , Raspagliesi Francesco , Crippa Flavio
Published: October 2015

Aims and background

Primary cytoreductive surgery (CRS) has a significant impact on prognosis in epithelial ovarian cancer (EOC). Patient selection is important to recognize factors limiting optimal CRS and to avoid unnecessary aggressive surgical procedures. We evaluated the contribution of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the presurgical identification of disease sites that may preclude EOC cytoreducibility.

Methods

Patients with suspected EOC underwent 18F-FDG-PET/CT within 20 days before debulking surgery. The PET/CT results were compared with surgical findings and postsurgery histopathology in order to assess the diagnostic value.

Results

Between August 2013 and January 2014, 29 patients were evaluated. The histopathology showed 23 EOC and 6 benign tumors. The FDG-PET/CT was positive (maximum standardized uptake value [SUVmax] 11.3 ± 5.4) in 21/23 (91%) patients with EOC and provided 2 false-negatives (1 mucinous and 1 clear cell carcinoma; SUVmax ≤2.8). The FDG-PET/CT was true-negative (SUVmax 2.2 ± 1.6) in 4 out of 6 patients (67%). False-positive FDG-PET results were obtained in 2 cellular fibromas (SUVmax 4.8 and 5.6). The sensitivity, specificity, and accuracy of PET/CT to characterize ovarian masses were 91%, 67%, and 86%, respectively. Among the 21 FDG-PET/CT-positive EOC, we detected factors limiting optimal CRS in 6 cases (29%): 4 hepatic hilum infiltration and 2 root mesentery involvement, confirmed at surgical exploration. The FDG-PET did not find limiting factors in the remaining 15 patients (71%) in whom optimal CRS was obtained.

Conclusions

Fluorodeoxyglucose-PET/CT shows high sensitivity but suboptimal specificity in the characterization of ovarian masses. However, PET/CT may play a role in noninvasively selecting patients with EOC who can benefit from primary CRS.
Medical Conditions, Family History of Cancer, and the Risk of Biliary Tract Cancers
Authors: Rosato Valentina , Bosetti Cristina , Maso Dal Luigino , Montella Maurizio , Serraino Diego , Negri Eva , La Vecchia Carlo
Published: October 2015

Background

Scanty data exist on the role of personal medical conditions, except for gallstones, and family history of cancer on the risk of biliary tract cancers (BTC).

Methods

We analyzed this issue using data from two Italian case-control studies, including 159 cases of BTC and 795 matched hospital controls. Odds ratios (ORs) of BTC and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression models.

Results

Gallstones were associated with a 2-fold excess risk of BTC (95% CI 1.24-3.45). No significant associations were observed with other conditions investigated, including diabetes (OR 1.15, 95% CI 0.63-2.11), hypertension (OR 0.65, 95% CI 0.39-1.11), hyperlipidemia (OR 0.61, 95% CI 0.31-1.21), allergy (OR 0.64, 95% CI 0.29-1.40), gastroduodenal ulcer (OR 0.52, 95% CI 0.24-1.12), hepatitis (OR 2.02, 95% CI 0.35-11.67), benign thyroid diseases (OR 1.16, 95% CI 0.56-2.40), hysterectomy (OR 1.19, 95% CI 0.53-2.68), unilateral oophorectomy (OR 1.75, 95% CI 0.44-6.93), and bilateral oophorectomy (OR 2.48, 95% CI 0.79-7.82). We found an excess risk of BTC in relation to family history of any cancer (OR 1.52, 95% CI 1.03-2.24) and family history of gallbladder cancer (OR 3.83, 95% CI 0.59-24.75).

Conclusions

The present study confirms a strong association between BTC and history of gallstones, and provides further evidence of a positive association with family history of cancer.
Mitogen-activated Protein Kinase 7 Promotes Cell Proliferation, Migration and Invasion in SOSP-M Human Osteosarcoma Cell Line
Authors: Huang Yan , Yao Jianhua , Zhu Bing , Zhang Jianzheng , Sun Tiansheng
Published: October 2015

Purpose

Osteosarcoma (OS) is the most common primary bone tumor and has low cure rates. Our study aimed to evaluate the roles of mitogen-activated protein kinase 7 (MAPK7) in cell proliferation, migration and invasion using the SOSP-M human OS cell line as an in vitro model.

Methods

SOSP-M cells were transfected with PCDNA3.1-MAPK7 and siRNA-MAPK7 plasmids using Lipofectamine 2000. Quantitative real-time polymerase chain reaction (RT-PCR) was performed to determine the relative expression level of MAPK7 and Western blot analysis was carried out to determine the expression level of ERK5 protein. Then MTT, scratch wound healing and Matrigel transwell assays were used to investigate the roles of MAPK7 expression in the proliferation, migration and invasion, respectively, of SOSP-M cells in vitro.

Results

RT-PCR analysis showed that the expression level of MAPK7 increased significantly after transfection with PCDNA3.1-MAPK7 plasmid compared with the blank group, while it decreased significantly after transfection with siRNA-MAPK7 plasmid. Similar results for ERK5 expression were obtained by Western blot analysis. In addition, the cell proliferation rate, cell migration rate and invasive cell number in the PCDNA3.1-MAPK7 transfection group increased significantly compared with the blank group, while they decreased significantly in the siRNA-MAPK7 transfection group.

Conclusions

Our results indicate that overexpression of MAPK7 in human OS cells could promote cell proliferation, migration and invasion, whereas knockdown of MAPK7 expression had the opposite effect. All the results suggest that MAPK7 may serve as a potent target for drug development.
Absence of GNAS Mutation in Colorectal Carcinogenesis
Authors: Lee Hyunsu , La Boo-Mi , Hwang IlSeon , Kang Yu-Na , Choi In-Jang , Lee Jae-Ho
Published: October 2015

Aims and background

The incidence rate of colorectal cancer (CRC) increases every year in Korean populations. However, association between the GNAS mutation and colorectal precancerous lesions has not been studied in in Korean populations. To contribute to better understanding of colorectal carcinogenesis, we analyzed GNAS mutation in 100 cancerous and 96 precancerous colorectal lesions.

Methods

The records of colonoscopic polypectomy performed at Dongsan Medical Center between 1999 and 2003 were reviewed retrospectively. Precancerous lesions included 7 villous adenomas, 59 tubular adenomas, and 18 sessile serrated adenomas, and 12 hyperplastic polyps. Keimyung Human Bio-Resource Bank at Dongsan Medical Center provided 100 CRC samples.

Results

GNAS mutation was not found in any colorectal cancer or any precancerous colorectal lesions, including villous adenoma, which is thought to harbor the mutation.

Conclusions

The role of GNAS mutation might be limited in colorectal neoplasms of the Korean population.
Molecular Detection of Human Papillomavirus and Viral DNA Load after Radiotherapy for Cervical Carcinomas
Authors: Kahla Saloua , Kochbati Lotfi , Sarraj Sana , Ben Daya Imen , Maalej Mongi , Oueslati Ridha
Published: October 2015

Aims and background

Infection with high-risk types of human papillomavirus (HPV) is a necessary cause for cervical carcinoma. Radiation therapy together with surgery is the most effective treatment. The purpose of this study was to investigate the molecular basis of the response to radiotherapy in cervical cancer cells.

Methods and study design

Tumor cells were obtained from biopsies of 44 cervical cancers, collected before and after radiotherapy. The presence of HPV was analyzed by polymerase chain reaction (PCR) using primers specific for the L1 region.

Results

The prevalence of HPV was 70.4%, with HPV16 being the most common (54.5%) and HPV18 the second (15.9%). Our analyses show that ionizing radiation does not influence HPV detection, as the percentage of HPV-positive biopsies was similar in patients before and after radiotherapy (HPV16 60% vs. 51.7% and HPV18 20% vs. 13.7%, respectively). However, the detection of HPV did vary by tumor stage, with the highest proportion observed in late-stage tumors (HPV16 and HPV18 in 80% and 60% of stage III tumors, respectively). We also found that HPV viral load is influenced by radiotherapy and tumor stage, with the highest viral loads in late-stage tumors (stage III) after 1 day since radiotherapy (p<0.05). According to Kaplan-Meier curves, higher HPV viral load was associated with significantly shortened progression-free survival (p = 0.04).

Conclusions

Our data provide prospective evidence that ionizing radiation can affect the HPV viral load and this might offer the best strategies for assessment of therapeutic efficacy.
Jaw Osteonecrosis associated with Aflibercept, Irinotecan and Fluorouracil: Attention to Oral District
Authors: Ponzetti Agostino , Pinta Francesco , Spadi Rosella , Mecca Caterina , Fanchini Laura , Zanini Marcello , Ciuffreda Libero , Racca Patrizia
Published: October 2015

Introduction

The antiangiogenic monoclonal antibody aflibercept in association with fluorouracil and irinotecan improves the survival of patients with metastatic colorectal cancer (mCRC) treated previously with oxaliplatin-based therapy. Multiple reports raised the hypothesis that the concomitant use of antiresorptive drugs and antiangiogenic drugs may increase the risk of osteonecrosis of the jaw (ONJ). Some reports have been published regarding cases of ONJ during treatment with bevacizumab for mCRC.

Case description

Here we describe the first reported case of ONJ occurring in a 64-year-old woman with untreated periodontitis and episodic previous pyorrhea occurring during treatment with aflibercept plus FOLFIRI during the expanded-access program.

Conclusions

This case report warrants further investigation into the potential association between the use of anti-VEGF agents and ONJ. Given the serious nature of ONJ, we recommend that particular attention be paid to the oral district prior to treating patients and during treatment with chemotherapy and targeted agents, especially anti-VEGF agents. Such measures could also be useful in reducing the incidence of stomatitis.
Challenges and Differences in External Radiation Therapy for Retinoblastoma: From Standard Techniques to New Developments
Authors: Hiçsönmez Ayşe , Güney Yıldız , Dizman Ayşen , Dirican Bahar , Arslan Yakup , Atakul Tugba , Uysal Hasan , Gündüz Kaan , Taçyıldız Nurdan , Ünal Emel , Dinçaslan Handan , Andrieu Meltem Nalça
Published: October 2015

Aims

The purpose of this study is to calculate the treatment plans and to compare the dose distributions and dose-volume histograms (DVH) for 6 external radiotherapy techniques for the treatment of retinoblastoma as well as intensity-modulated radiotherapy (IMRT) and fractionated stereotactic radiotherapy (Cyberknife).

Methods

Treatment plans were developed using 6 techniques, including an en face electron technique (ET), an anterior and lateral wedge photon technique (LFT), a 3D conformal (6 fields) technique (CRT), an inverse plan IMRT, tomotherapy, and conventional focal stereotactic external beam radiotherapy with Cyberknife (SBRT). Dose volume analyses were carried out for each technique.

Results

All techniques except electron provided similar target coverage. When comparing conformal plan with IMRT and SBRT, there was no significant difference in planning target volume dose distribution. The mean volume of ipsilateral bony orbit received more than 20 Gy, a suggested threshold for bone growth inhibition. The V20 Gy was 73% for the ET, 57% for the LFT, 87% for the CRT, 65% for the IMRT, 66% for the tomotherapy, and 2.7% for the SBRT.

Conclusions

This work supports the potential use of IMRT and SBRT to spare normal tissues in these patients.
Exclusion Criteria vs Reality: Dual BRAF/MEK Inhibition and Radiotherapy in a Patient with Melanoma Metastatic to the Brain and ECOG 3
Authors: Márquez-Rodas Iván , Avilés-Izquierdo Jose-Antonio , Parra Verónica , Álvarez-González Ana , Borrego Pedro , Fernández-García Pilar , Guzmán-de-Villoria Juan-Adan , Jerez Yolanda , Martin Miguel
Published: October 2015

Background

Prognosis of metastatic melanoma is changing due to advances in immunotherapy and targeted therapy. However, management of patients with brain metastases in day-to-day practice continues to be a challenge.

Case Report

We describe a 40-year-old woman diagnosed with symptomatic brain metastases from cutaneous melanoma and Eastern Cooperative Oncology Group 3. She was treated, off label, with BRAF inhibitor (dabrafenib) + MEK inhibitor (trametinib) and radiotherapy. There was significant, long-lasting, response (17 months), no clinically relevant toxicity, and clear improvement in quality of life.

Conclusions

This case is an example of real-life application of advances in targeted therapy.
Tumor-Associated Trypsin Inhibitor in Patients with Endometrial Cancer
Authors: Kozakiewicz Barbara , Chądzyńska Małgorzata , Dmoch-Gajzlerska Ewa , Stefaniak Małgorzata
Published: October 2015

Aim

The aim of the study was to look for prognostic factors of metastasis or recurrence in patients with endometrial cancer.

Methods

Tumor-associated trypsin inhibitor (TATI) concentrations were measured in serum of 317 patients with endometrial cancer. The assay was done 7 times in each patient, from the moment of diagnosis until the start of follow-up after the completion of treatment. Observation of patients after treatment lasted from 0 to 16 years.

Results

The TATI levels in patients with adverse prognostic factors accumulated in the first 3 assays and then decreased to zero. Mean TATI concentrations were significantly higher in patients with clinically advanced disease (stage IIIB) than patients at stage I (Kruskal-Wallis p = 0.0446). An increase in the concentration by more than 10.6% in the first 3 assays was significantly correlated with disease relapse (Mann-Whitney Z = −6.06653, p = 0.00000) and local or distant recurrence (Mann-Whitney Z = −4.97475, p = 0.000001). A significant increase in the TATI level in the first 3 tests also occurred in patients who died during the study period (Kruskal Wallis p<0.001). In our series of patients with endometrial cancer, TATI proved to be a sensitive indicator of disease recurrence and distant metastasis, with a sensitivity of 84.4% and 75.7%, respectively.

Conclusions

TATI seems to behave as a prognostic factor in certain subgroups of patients with endometrial cancer.
Reducing Heart dose during Left Breast Cancer Radiotherapy: Comparison among 3 Radiation Techniques
Authors: D’Agostino Giuseppe R. , Diletto Barbara , Mantini Giovanna , Nardone Luigia , Mattiucci Gian Carlo , Catucci Francesco , Canna Roberta , Martino Antonella , Azario Luigi , Valentini Vincenzo
Published: October 2015

Purpose

Breast cancer survivors have a high risk of cardiac death as a consequence of heart irradiation during left breast tangential radiotherapy (RT). This study compares the cardiac dose delivered by standard 3D conformal tangential RT (CRT) to that delivered by prospective-gating RT (PGRT) or 5-field intensity-modulated RT (IMRT).

Methods

Patients with early left breast cancer, referred for adjuvant RT to our institution, were enrolled in this study. For each patient, 2 simulation computed tomography scans were acquired: the first during free breathing, and the second on prospective gating during deep inspiration breath-hold. The scans were monitored by the Varian RPM™ respiratory gating system. For each patient, 3 treatment plans were performed: a 3D-CRT and an IMRT plan, each based on the free-breathing scan, and a PGRT plan, based on the deep inspiration breath-hold scan. Dose-volume histograms were compared by means of the Friedman test.

Results

The median mean heart dose was 3 Gy (range 0.9-7.3 Gy) in the CRT plans, 1.9 Gy (range 0.5-3.6 Gy) in the PGRT plans, and 4.5 Gy (range 1.1-10.5 Gy) in the IMRT plans (p = 0.001). The mean heart V25 was 1.2% (range 0%-9.7%), 0% (range 0%-2.0%), and 0.2% (range 0%-7.3%) for CRT, PGRT, and IMRT plans, respectively (p<0.001).

Conclusions

Prospective-gating RT to the left breast offered the best protection of heart and lung, as well as a lower irradiation of the contralateral breast, compared to CRT or IMRT.
Surgical Approach to Primary Tumors of the Chest Wall in Children and Adolescents: 30 Years of Mono-Institutional Experience
Authors: Girelli Lara , Luksch Roberto , Podda Marta G. , Meazza Cristina , Puma Nadia , Scanagatta Paolo , Pecori Emilia , Diletto Barbara , Galeone Carlotta , Massimino Maura , Pastorino Ugo
Published: October 2015

Aims and background

Chest wall reconstruction after surgical resection for malignancies in children is a challenge for surgeons because of growth-related complications. The aim of this study is to analyze the surgical treatment and outcomes of 30 pediatric and adolescent patients treated at Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, over a 30-year period.

Methods

Pediatric patients undergoing chest wall resection were retrospectively reviewed and selected for malignant primary tumor. Endpoints were survival, recurrences, and long-term results. We also reported the use of the innovative rib-like technique in 2 young patients.

Results

Twenty-one patients were male. Median age was 13.7 years. Eleven patients (37%) presented with a chest wall mass. Twenty-six (87%) had Ewing sarcoma family tumors. Twenty-eight (94%) received neoadjuvant chemotherapy after histologic diagnosis. One rib was resected in 13 cases; 2 or 3 contiguous ribs in 8 cases. No postoperative mortality was observed and the complication rate was 40%. Overall survival was 85.2% (95% confidence interval [CI] 65.2%-94.2%) at 5 and 10 years. Relapse occurred in 7 patients. The 5-year disease-free survival rate was 82% (95% CI 62%-92%).

Conclusions

Long-term survival is achievable for chest wall tumors in a high-volume referral center where a multimodal treatment should be set to reach the best result. As advances in medical treatment have increased survival, surgical techniques must ensure a lasting functional result. When refining the reconstruction techniques, such as the rib-like approach, it is necessary to expand the options of curative surgery for young patients.
Osteoblastic Progression during EGFR Tyrosine Kinase Inhibitor Therapy in Mutated Non-small Cell Lung Cancer: A Potential Blunder
Authors: Bersanelli Melissa , Bini Paola , Rabaiotti Enrico , Facchinetti Francesco , De Filippo Massimo , Bortesi Beatrice , Buti Sebastiano , Tiseo Marcello
Published: October 2015

Aims and background

Bone flare reaction as a sign of response to antineoplastic treatment has been redefined, including the onset of new osteoblastic lesions. If misunderstood as skeletal progression, this finding could lead to erroneous therapy discontinuation, changing the disease clinical course. We aim to describe this clinical phenomenon in patients with advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor ( EGFR) gene-activating mutations treated with tyrosine kinase inhibitor (TKI).

Methods

We retrospectively reviewed the computed tomography scans of 43 EGFR-mutated patients with NSCLC treated with EGFR-TKI, analyzing the bone response in terms of increase in the quantity and/or density of lesions, and assessing objective tumor response to treatment.

Results

Osteoblastic reaction was detected in 10 cases (23%), showing different patterns: dimensional or density increase of known osteosclerotic metastases (pattern A, n = 4); response of previously lytic lesions (pattern B, n = 2); onset of new osteosclerotic lesions (pattern C, n = 4). Seven patients had partial response to TKI treatment, with response rate of 70%, vs 50% of patients with bone metastases without this reaction. No difference in terms of median overall survival or progression-free survival emerged between patients with or without osteoblastic reaction.

Conclusions

The correct clinico-radiologic interpretation of osteoblastic reaction is crucial to avoid waste of therapeutic lines when TKI treatment has not yet exhausted its potential effectiveness. Clinical implications of ambiguous radiologic findings as described in this study deserve further discussion.
Impact of Aspirin on Clinical Outcomes for African American Men with Prostate Cancer Undergoing Radiation
Authors: Osborn Virginia Wedell , Chen Shan-Chin , Weiner Joseph , Schwartz David , Schreiber David
Published: October 2015

Aims and background

Preclinical and clinical studies have suggested that aspirin (ASA) may exhibit antineoplastic activity. Particularly in prostate cancer, several reports have suggested that ASA plays a role in improved outcomes. Therefore, we studied the role of ASA in a uniquely African American population, which is known to harbor more aggressive and biologically different disease compared to the general population.

Methods

We identified 289 African American men with prostate cancer who were treated with definitive radiation therapy to a dose of ≥7560 cGy. The median follow-up was 76 months. Kaplan-Meier analysis was used to analyze biochemical failure-free survival (bFFS), distant progression-free survival (DMPFS), and prostate cancer-specific survival (PCSS). Multivariate Cox regression was used to analyze the impact of covariates on all endpoints.

Results

There were 147 men who were ASA+ and 142 who were ASA-. The 7-year bFFS was 80.9% for ASA+ men and 70.3% for ASA− men (p = 0.03). On multivariate analysis, ASA use was associated with a significant reduction in biochemical recurrences (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.34-0.93, p = 0.03). The 7-year DMPFS was 98.4% for ASA+ and 91.8% for ASA− men (p = 0.04). On multivariate analysis, ASA use was associated with a decreased risk of distant metastases (HR 0.23, 95% CI 0.06-0.91, p = 0.04). The 7-year PCSS was 99.3% for ASA+ and 96.9% for ASA− men (p = 0.07).

Conclusions

In this study, ASA use was associated with improved biochemical outcomes and reduced distant metastases. This indicates that ASA appears to play an important antineoplastic role in African American men.
Misregulation of the Dependence Receptor DCC and its Upstream lincRNA, LOC100287225, in Colorectal Cancer
Authors: Kazemzadeh Mina , Safaralizadeh Reza , feizi Mohammad Ali HosseinPour , Somi Mohammad Hossein , Shokoohi Behrooz
Published: October 2015

Background

Long non-coding RNAs (lncRNAs), a class of regulatory RNAs, play a major role in various cellular processes. Long intergenic non-coding RNAs (lincRNAs), a subclass of lncRNAs, are involved in the trans- and cis-regulation of gene expression. In the case of cis-regulation, by recruiting chromatin-modifying complexes, lincRNAs influence adjacent gene expression.

Methods

We used quantitative real-time reverse-transcription polymerase chain reaction (qRT-PCR) to evaluate the coexpression of LOC100287225, a lincRNA, and DCC, one of its adjacent genes that is often decreased in colorectal cancer, in pairs of tumor and adjacent tumor-free tissues of 30 colorectal cancer patients.

Results

The qRT-PCR results revealed the misregulation of these genes during tumorigenesis. Their relative expression levels were significantly lower in tumor tissues than adjacent tumor-free tissues. However, the analysis found no significant correlation between reduced expression of these genes.

Conclusions

Our study demonstrated the concurrent misregulation of DCC and LOC100287225 in colorectal cancer.