bluuebunny/crossref_metadata_2025 huggingface dataset:
Pseudoxanthoma Elasticum Associated With Vitelliform Macular Lesion
Authors: Parodi Maurizio Battaglia , Iacono Pierlugi , Bandello Francesco
Published: February 2015

The authors describe an uncommon association between pseudoxanthoma elasticum with typical fundus lesions and positive testing for mutation in the ABCC6 gene and the concomitant presence of a large subfoveal vitelliform lesion.

[
Ophthalmic Surg Lasers Imaging Retina.
2015;46:287–288.]
Imaging Areas of Retinal Nonperfusion in Ischemic Branch Retinal Vein Occlusion With Swept-Source OCT Microangiography
Authors: Kuehlewein Laura , An Lin , Durbin Mary K. , Sadda SriniVas R.
Published: February 2015

The authors present the case of a patient with a history of ischemic branch vein occlusion and multimodal imaging of the retinal vasculature by fluorescein angiography (FA) and ultrahigh-speed swept-source optical coherence tomography (SS-OCT) microangiography (SS-OCT laser prototype; 1,050 nm, 100,000 A-scans/second). Multiple images across the macula were acquired (3 × 3 mm cubes in clusters of four repeated B-scans). En face images of the vasculature were generated by implementing an intensity differentiation algorithm. The retinal vasculature as well areas of nonperfusion could be identified precisely at multiple retinal levels. Ultrahigh-speed SS-OCT microangiography provides noninvasive, three-dimensional, high-resolution images of the retinal vasculature including the capillaries.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:249–252.]
Bilateral Central Retinal Artery Occlusion Associated With Herpes Simplex Virus–Associated Acute Retinal Necrosis and Meningitis: Case Report and Literature Review
Authors: Weissman Heather M. , Biousse Valerie , Schechter Marcos Coutinho , Rio Carlos Del , Yeh Steven
Published: February 2015

A 60-year-old woman with a history of recurrent headaches and blurred vision presented with bilateral optic disc edema. Optic neuritis was suspected, and intravenous methylprednisonlone was administered. Her vision declined to hand motions in both eyes, and subsequent evaluation revealed bilateral acute retinal necrosis with bilateral central retinal artery occlusions (CRAO). Aqueous humor polymerase chain reaction analysis was positive for herpes simplex virus (HSV), establishing a diagnosis of HSV-associated bilateral acute retinal necrosis (ARN) and meningitis. CRAO has rarely been reported in association with ARN, and a fulminant course with bilateral CRAO in association with ARN has not been previously reported. This case emphasizes the importance of careful peripheral examination in patients with presumptive optic neuritis, judicious use of systemic corticosteroid in this context, and the retinal vaso-obliterative findings that may be observed in the pathogenesis of ARN.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:279–283.]
Whole Eye Segment Imaging and Measurement With Dual-Channel Spectral-Domain OCT
Authors: Fan Shanhui , Sun Yong , Yang Xuan , Dai Cuixia , Ren Qiushi , Zheng Haihua , Zhou Chuanqing
Published: February 2015

BACKGROUND AND OBJECTIVES:

To image and measure whole eye segments using dual-channel spectral-domain optical coherence tomography (SD-OCT) and to compare the results with those from the IOLMaster (Carl Zeiss Meditec, Dublin, CA).

PATIENTS AND METHODS:

Twenty eyes of 20 volunteers were recruited. Ocular dimensions, including cornea thickness, anterior chamber depth (ACD), lens thickness, anterior lens surface curvature, and axial length (AL), were calculated. The reproducibility of SD-OCT measurements, statistical significance of inter-instrument difference, correlation, and agreement were evaluated.

RESULTS:

No significant differences were found between independent SD-OCT measurements (
P
> .05). The ACD and AL measured with IOLMaster were significantly shorter than those from SD-OCT (
P
< .001). There were high correlations and agreements in ACD (r = 0.994; 95% limits of agreement [LOA], 0.131–0.223 mm) and AL (r = 0.998; 95% LOA, 0.678–0.853 mm) between the two methods.

CONCLUSION:

Dual-channel SD-OCT was demonstrated to have good repeatability in imaging and measuring whole eye segments. The results had high correlations and agreements with those from the IOLMaster.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:186–194.]
Validation of Annulus Formation in Spotted Sucker Otoliths
Authors: Strickland P. Andrew , Middaugh Christopher R.
Published: February 2015

Spotted suckers Minytrema melanops are found in many river systems from the Midwest to the Southeast United States. Though they are a relatively abundant species, otolith age validation methods have not been reported. The objective of this study was to validate annulus formation on the lapillar otolith for spotted suckers. We collected spotted suckers monthly from December 2005 to November 2006 in the Apalachicola River, Florida. Using marginal incremental analysis on whole browned lapillar otoliths, we validated that spotted suckers form one annulus per year between May and June. We also report population characteristics including a length–weight regression. This study validates otolith aging to provide an avenue for accurately assessing the age composition of spotted sucker populations, which will facilitate a better understanding of growth, recruitment, and mortality of the species.
The Use of Carbon-Fiber-Reinforced (CFR) PEEK Material in Orthopedic Implants: A Systematic Review
Authors: Li Chuan Silvia , Vannabouathong Christopher , Sprague Sheila , Bhandari Mohit
Published: February 2015

Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) has been successfully used in orthopedic implants. The aim of this systematic review is to investigate the properties, technical data, and safety of CFR-PEEK biomaterial and to evaluate its potential for new innovation in the design of articulating medical devices. A comprehensive search in PubMed and EMBASE was conducted to identify articles relevant to the outcomes of CFR-PEEK orthopedic implants. The search was also expanded by reviewing the reference sections of selected papers and references and benchmark reports provided by content experts. A total of 23 articles were included in this review. There is limited literature available assessing the performance of CFR-PEEK, specifically as an implant material for arthroplasty systems. Nevertheless, available studies strongly support CFR-PEEK as a promising and suitable material for orthopedic implants because of its biocompatibility, material characteristics, and mechanical durability. Future studies should continue to investigate CFR-PEEK's potential benefits.
Echocardiographic Manifestation of Esophagitis Mimicking a Posterior Mediastinal Mass
Authors: Swarup Supreeya , Kantamneni Sowmya , Kabir Sarah , Zeltser Roman , Makaryus Amgad N.
Published: February 2015

Incidental extracardiac findings (ECFs) are commonly noted on cardiac imaging. The majority of the ECFs are noticed on computed tomography (CT), cardiac magnetic resonance scanning, and myocardial perfusion imaging. Although transthoracic echocardiography (TTE) is a widely used cardiac modality, there is scarcity of data describing ECF on TTE. ECFs have the potential to alter patient management. We present a rare case of a cystic mass seen in the posterior mediastinum on TTE, which led to further evaluation and diagnosis of esophagitis with ulceration.
A Novel Approach to Identify Candidate Prognostic Factors for Hepatitis C Treatment Response Integrating Clinical and Viral Genetic Data
Authors: Amadoz Alicia , Gonzáez-Candelas Fernando
Published: February 2015

The combined therapy of pegylated interferon (IFN) plus ribavirin (RBV) has been for a long time the standard treatment for patients infected with hepatitis C virus (HCV). In the case of genotype 1, only 38%–48% of patients have a positive response to the combined treatment. In previous studies, viral genetic information has been occasionally included as a predictor. Here, we consider viral genetic variation in addition to 11 clinical and 19 viral populations and evolutionary parameters to identify candidate baseline prognostic factors that could be involved in the treatment outcome. We obtained potential prognostic models for HCV subtypes la and lb in combination as well as separately. We also found that viral genetic information is relevant for the combined treatment assessment of patients, as the potential prognostic model of joint subtypes includes 9 viral­related variables out of 11. Our proposed methodology fully characterizes viral genetic information and finds a combination of positions that modulate inter­patient variability.
Use of radio occultation to probe the high latitude ionosphere
Authors: Mannucci A. J. , Tsurutani B. T. , Verkhoglyadova O. , Komjathy A. , Pi X.
Published: February 2015

Abstract. We have explored the use of COSMIC data to provide valuable scientific information on the ionospheric impacts of energetic particle precipitation during geomagnetic storms. Ionospheric electron density in the E region, and hence ionospheric conductivity, is significantly altered by precipitating particles from the magnetosphere. This has global impacts on the thermosphere-ionosphere because of the important role of conductivity on high latitude Joule heating. Two high-speed stream (HSS) and two coronal mass ejection (CME) storms are examined with the COSMIC data. We find clear correlation between geomagnetic activity and electron density retrievals from COSMIC. At nighttime local times, the number of profiles with maximum electron densities in the E layer (below 200 km altitude) is well correlated with geomagnetic activity. We interpret this to mean that electron density increases due to precipitation are captured by the COSMIC profiles. These "E layer dominant ionosphere" (ELDI) profiles have geomagnetic latitudes that are consistent with climatological models of the auroral location. For the two HSS storms, that occurred in May of 2011 and 2012, a strong hemispheric asymmetry is observed, with nearly all the ELDI profiles found in the southern, less sunlit, hemisphere. Stronger aurora and precipitation have been observed before in winter hemispheres, but the degree of asymmetry deserves further study. For the two CME storms, occurring in July and November of 2012, large increases in the number of ELDI profiles are found starting in the storm's main phase but continuing for several days into the recovery phase. Analysis of the COSMIC profiles was extended to all local times for the July 2012 CME storm by relaxing the ELDI criterion and instead visually inspecting all profiles above 50° magnetic latitude for signatures of precipitation in the E region. For nine days during the July 2012 period, we find a signature of precipitation occurs nearly uniformly in local time, although the magnitude of electron density increase may vary with local time. The latitudinal extent of the precipitation layers is generally consistent with auroral climatology. However, after the storm main phase on 14 July 2012, the precipitation tended to be somewhat more equatorward than predicted by the climatology (by about 5–10° latitude). We conclude that, if analyzed appropriately, high latitude COSMIC profiles have the potential to contribute to our understanding of MI coupling processes and extend and improve existing models of the auroral region.
The Hiccup: a dynamical coupling process during the autumn transition in the Northern Hemisphere – similarities and differences to sudden stratospheric warmings
Authors: Matthias V. , Shepherd T. G. , Hoffmann P. , Rapp M.
Published: February 2015

Abstract. Sudden stratospheric warmings (SSWs) are the most prominent vertical coupling process in the middle atmosphere, which occur during winter and are caused by the interaction of planetary waves (PWs) with the zonal mean flow. Vertical coupling has also been identified during the equinox transitions, and is similarly associated with PWs. We argue that there is a characteristic aspect of the autumn transition in northern high latitudes, which we call the "hiccup", and which acts like a "mini SSW", i.e. like a small minor warming. We study the average characteristics of the hiccup based on a superimposed epoch analysis using a nudged version of the Canadian Middle Atmosphere Model, representing 30 years of historical data. Hiccups can be identified in about half the years studied. The mesospheric zonal wind results are compared to radar observations over Andenes (69° N, 16° E) for the years 2000–2013. A comparison of the average characteristics of hiccups and SSWs shows both similarities and differences between the two vertical coupling processes.
Ground temperature variations in a talus slope influenced by permafrost: a comparison of field observations and model simulations
Authors: Staub B. , Marmy A. , Hauck C. , Hilbich C. , Delaloye R.
Published: February 2015

Abstract. Variations in surface and near-surface ground temperatures (GST) dominate the evolution of the ground thermal regime over time and represent the upper boundary condition for the subsurface. Focusing on the Lapires talus slope in the south-western part of the Swiss Alps, which partly contains massive ground ice, and using a joint observational and modelling approach, this study compares and combines observed and simulated GST in the proximity of a borehole. The aim was to determine the applicability of the physically based subsurface model COUP to accurately reproduce spatially heterogeneous GST data and to enhance its reliability for long-term simulations. The reconstruction of GST variations revealed very promising results, even though two-dimensional processes like the convection within the coarse-blocky sediments close to the surface or ascending air circulation throughout the landform ("chimney effect") are not included in the model. For most simulations, the model bias revealed a distinct seasonal pattern mainly related to the simulation of the snow cover. The study shows that, by means of a detailed comparison of GST simulations with ground truth data, the calibration of the upper boundary conditions – which are crucial for modelling the subsurface – could be enhanced.
Nitrogen surface water retention in the Baltic Sea drainage basin
Authors: Stålnacke P. , Pengerud A. , Vassiljev A. , Smedberg E. , Mörth C.-M. , Hägg H. E. , Humborg C. , Andersen H. E.
Published: February 2015

Abstract. In this paper, we estimate the surface water retention of nitrogen (N) in all the 117 drainage basins to the Baltic Sea with the use of a statistical model (MESAW) for source apportionment of riverine loads of pollutants. Our results show that the MESAW model was able to estimate the N load at the river mouth of 88 Baltic Sea rivers, for which we had observed data, with a sufficient degree of precision and accuracy. The estimated retention parameters were also statistically significant. Our results show that around 380 000 t of N are annually retained in surface waters draining to the Baltic Sea. The total annual riverine load from the 117 basins to the Baltic Sea was estimated at 570 000 t of N, giving a total surface water N retention of around 40%. In terms of absolute retention values, three major river basins account for 50% of the total retention in the 117 basins; i.e. around 104 000 t of N are retained in Neva, 55 000 t in Vistula and 32 000 t in Oder. The largest retention was found in river basins with a high percentage of lakes as indicated by a strong relationship between N retention (%) and share of lake area in the river drainage areas. For example in Göta älv, we estimated a total N retention of 72%, whereof 67% of the retention occurred in the lakes of that drainage area (Lake Vänern primarily). The obtained results will hopefully enable the Helsinki Commission (HELCOM) to refine the nutrient load targets in the Baltic Sea Action Plan (BSAP), as well as to better identify cost-efficient measures to reduce nutrient loadings to the Baltic Sea.
Influence of the substrate on the overall sensor impedance of planar H2 sensors involving TiO2–SnO2 interfaces
Authors: Ebersberger L. , Fischerauer G.
Published: February 2015

Abstract. To date, very little has been written about the influence of the substrate layer on the overall sensor impedance of single- and multilayer planar sensors (e.g., metal-oxide sensors). However, the substrate is an elementary part of the sensor element. Through the selection of a substrate, the sensor performance can be manipulated. The current contribution reports on the substrate influence in multilayer metal-oxide chemical sensors. Measurements of the impedance are used to discuss the sensor performance with quartz substrates, (laboratory) glass substrates and substrates covered by silicon-dioxide insulating layers. Numerical experiments based on previous measurement results show that inexpensive glass substrates contribute up to 97% to the overall sensor responses. With an isolating layer of 200 nm SiO2, the glass substrate contribution is reduced to about 25%.
Thin film sensors for measuring small forces
Authors: Schmaljohann F. , Hagedorn D. , Löffler F.
Published: February 2015

Abstract. Especially in the case of measuring small forces, the use of conventional foil strain gauges is limited. The measurement uncertainty rises by force shunts and is due to the polymer foils used, as they are susceptible to moisture. Strain gauges in thin film technology present a potential solution to overcome these effects because of their direct and atomic contact with the measuring body, omitting an adhesive layer and the polymer foil. For force measurements up to 1 N, a suitable deformation element was developed by finite element (FE) analysis. This element is designed for an approximate strain of 1000 μm m−1 at the designated nominal load. The thin film system was applied by magnetron sputtering. The strain gauge structure is fabricated by distinct photolithographic steps. The developed sensors were tested with different load increments. The functional capability of the single resistance strain gauges could be proven. Moreover, a developed sensor in a full bridge circuit showed a linear characteristic with low deviation and good stability.
Assessing the economic impacts of drought from the perspective of profit loss rate: a case study of the sugar industry in China
Authors: Wang Y. , Lin L. , Chen H.
Published: February 2015

Abstract. Natural disasters have enormous impacts on human society, especially on the development of the economy. To support decision making in mitigation and adaption to natural disasters, assessment of economic impacts is fundamental and of great significance. Based on a review of the literature of economic impact evaluation, this paper proposes a new assessment model of economic impact from drought by using the sugar industry in China as a case study, which focuses on the generation and transfer of economic impacts along a simple value chain involving only sugarcane growers and a sugar producing company. A perspective of profit loss rate is applied to scale economic impact with a model based on cost-and-benefit analysis. By using analysis of "with-and-without", profit loss is defined as the difference in profits between disaster-hit and disaster-free scenarios. To calculate profit, analysis on a time series of sugar price is applied. With the support of a linear regression model, an endogenous trend in sugar price is identified, and the time series of sugar price "without" disaster is obtained using an autoregressive error model to separate impact by disasters from the internal trend in sugar price. Unlike the settings in other assessment models, representative sugar prices, which represent value level in disaster-free condition and disaster-hit condition, are integrated from a long time series that covers the whole period of drought. As a result, it is found that in a rigid farming contract, sugarcane growers suffer far more than the sugar company when impacted by severe drought, which may promote the reflections on economic equality among various economic bodies at the occurrence of natural disasters.
Litter decomposition rate and soil organic matter quality in a patchwork heathland of southern Norway
Authors: Certini G. , Vestgarden L. S. , Forte C. , Tau Strand L.
Published: February 2015

Abstract. Norwegian heathland soils, although scant and shallow, are major reservoirs of carbon (C). We aimed at assessing whether vegetation cover and, indirectly, its driving factor soil drainage are good proxies for soil organic matter (SOM) composition and dynamics in a typical heathland area of southern Norway consisting in a patchwork of three different types of vegetation, dominated by Calluna vulgaris (L.) Hull., Molinia caerulea (L.) Moench, or Sphagnum capillifolium (Ehrh.) Hedw. Such vegetation covers were clearly associated to microtopographic differences, which in turn dictated differences in soil moisture regime, Calluna growing in the driest sites, Sphagnum in the wettest, and Molinia in sites with intermediate moisture. Litter decomposition was followed over a period of 1 year by placing litterbags filled with biomass from each dominant species in each type of vegetation cover. The composition of the plant material and SOM was investigated using chemical methods and solid-state 13C nuclear magnetic resonance (NMR) spectroscopy. Litter decomposition was faster for Molinia and Calluna, irrespective of the vegetation cover of the site where they were placed. Sphagnum litter decomposed very slowly, especially under Calluna, where the soil environment is by far more oxidising than under itself. In terms of SOM quality, Calluna covered areas showed the greatest differences from the others, in particular a much higher contribution from lipids and aliphatic biopolymers, apparently related to biomass composition. Our findings showed that, in the studied environment, litter decomposition rate and SOM composition are actually dependent on vegetation cover and/or soil drainage. On this basis, monitoring changes in the patchwork of vegetation types in boreal heathlands could be a reliable cost-effective way to account for climate-change-induced modifications to SOM and its potential to last.
Moving from Discovery to Validation in Circulating microRNA Research
Authors: Verderio Paolo , Bottelli Stefano , Ciniselli Chiara M , Pierotti Marco A , Zanutto Susanna , Gariboldi Manuela , Pizzamiglio Sara
Published: February 2015

Background

MicroRNAs (miRNAs), small noncoding RNAs, are involved in tumorigenesis and in the development of various cancers. Quantitative real-time polymerase chain reaction (qPCR) is the most commonly used tool to investigate miRNA expression, and qPCR low-density arrays are increasingly being used as an experimental technique for both the identification of potentially relevant miRNAs and their subsequent validation. Due to the reduced number of microRNAs to be validated, this phase is generally performed on ad hoc customized cards for which a technical robustness is assumed similar to that of the high-throughput cards used during the identification phase.

Methods

With the aim of investigating the degree of reproducibility between the 2 types of cards, we analyzed plasma-circulating miRNAs evaluated in 60 subjects enrolled in a colorectal cancer screening program.

Results

Our results showed a reproducibility between the 2 methods that was not fully satisfactory, with a concordance correlation coefficient equal to 0.69 (95% confidence interval, 0.12-0.92).

Conclusions

This report highlights the need to add a technical validation step to the high-throughput-based miRNA identification workflow, after their discovery and before the validation step in an independent series.
SOX2 Expression in Gastrointestinal Cancers of Iranian Patients
Authors: Rassouli Fatemeh B , Matin Maryam M , Bahrami Ahmad Reza , Ghaffarzadegan Kamran , Sisakhtnezhad Sajjad , Cheshomi Hamid , Abbasi Fatemeh
Published: February 2015

Purpose

Gastrointestinal (GI) malignancies are among the 5 most common cancers in Iran, and their high associated mortality rates are attributable to late diagnosis and poor treatment options. SOX2, a transcription factor necessary for maintenance and induction of pluripotency and self-renewal, has been identified as a lineage-survival oncogene in several cancers. In the present study, we examined SOX2 expression in esophageal squamous cell carcinoma (ESCC), gastric adenocarcinoma and colon squamous cell carcinoma (SCC), as well as normal GI tissues, in Iranian patients.

Methods

To elucidate the role of SOX2 in GI carcinogenesis, formalin-fixed tissues were analyzed using immunohistochemistry (IHC), while frozen ESCC samples were studied by quantitative reverse transcription polymerase chain reaction (qRT-PCR).

Results

IHC studies indicated presence of SOX2+ cells in a subset of cancerous and normal tissues of stomach and colon, while no significant difference was observed between groups, and no correlation was found between SOX2 expression and tumors grades. Nevertheless, studying ESCC samples with IHC and qRT-PCR revealed overexpression of SOX2 in comparison with normal adjacent tissues.

Conclusions

The present results are in line with other studies and indicate SOX2 up-regulation in ESCC; however, due to our small sample size and contradictory reports, more research is needed to determine the importance of SOX2 in GI cancers.
CA 19-9 in Evaluation of adnexal mass: retrospective cohort analysis and review of the literature
Authors: Sagi-Dain Lena , Lavie Ofer , Auslander Ron , Sagi Shlomi
Published: February 2015

Objective

The aim of this study was to estimate the diagnostic accuracy of serum marker CA 19-9 levels in the triage of adnexal masses.

Methods

This retrospective cohort study was carried out in patients referred to the Gynecology Department at Carmel Medical Center due to adnexal masses. All patients underwent preoperative measurements of serum CA 125 and CA 19-9 and surgery with histopathologically confirmed diagnosis.

Results

Between January 2005 and December 2012, 503 patients with adnexal masses were evaluated with serum tumor markers. Combination of CA 19-9 with CA 125, compared with CA 125 levels alone, suggested a nonsignificant effect on sensitivity (86.9% vs. 88.9%, respectively, p = 0.54) or specificity (79.5% vs. 73.5%, p = 0.1) in differentiating malignant from benign adnexal masses. CA 19-9 was not helpful in detecting mucinous histological types or borderline tumors. Mean CA 19-9 levels were higher in metastatic cases compared with primary ovarian malignancy (488.7 ± 1,457 vs. 46.3 ± 149.8 U/mL, respectively, p = 0.001). In mature cystic teratomas, mean CA 19-9 levels were higher and CA 125 levels were lower than in ovarian carcinoma (p = 0.049 and p = 0.0012, respectively).

Conclusions

The combination of the tumor markers CA 19-9 and CA 125 did not contribute significantly to the detection of malignant adnexal masses compared with CA 125 alone. As our results suggest that higher CA 19-9 levels could be helpful in differentiating metastatic tumors from primary ovarian malignancy; this issue should be investigated in large well-designed prospective cohort trials.
Effect of Non-Cavity Distorting Intramural Fibroids on Assisted Reproduction Outcomes: A Cohort Study
Authors: Marqueta Belen , Barri Pedro N. , Coroleu Buenaventura , Barri Soldevila Pedro N. , Rodriguez Ignacio
Published: February 2015

Introduction

The impact of uterine fibroids on fertility and the beneficial role of surgery is controversial. Current data suggest that submucosal and intramural fibroids that distort the endometrial cavity decrease pregnancy and implantation rates. However, the impact of intramural fibroids without intracavitary component is unclear. The aim of this study is to clarify the impact of the uterine myomas and myomectomy in patients undergoing assisted reproductive techniques (ART).

Methods

Retrospective cohort study performed in Instituto Universitario Dexeus including 1072 cycles of IVF performed in infertile patients: 473 in patients with uterine myomas not treated before ART, 79 in patients undergoing ART after myomectomy and 520 in patients included as a control group.

Results

Our results show that there is a significant 64% reduction in the clinical pregnancy rate in women with cavity-distorting intramural fibroids, a 51% significant reduction in the clinical pregnancy rate and a 53% significant reduction in the delivery rate in patients with non-distorting intramural fibroids.

Conclusions

Our study supports the opinion that non-cavity distorting intramural fibroids have a detrimental effect on live births, clinical pregnancy, implantation and delivery rates in patients undergoing ART.
Role and Technique of Nerve-Sparing Surgery in Deep Endometriosis
Authors: Ceccaroni Marcello , Clarizia Roberto , Tebache Linda
Published: February 2015

Background

Nerve-sparing (NS) surgery reduces bowel, bladder and sexual dysfunction without decreasing surgical efficacy.

Objectives

This study aimed to summarize the anatomical and surgical data of NS technique and to review the post-operative outcomes after NS surgery for deeply infiltrating endometriosis (DIE).

Data Sources

Data were collected from published research articles from MEDLINE and the Cochrane Library databases.

Conclusions, implications of key findings

The NS technique approach for DIE seems to be feasible and reproductive. In comparison to the conventional surgery (CS), it seems to demonstrate better preservation of pelvic visceral function and an improvement in quality of life with same recurrence rates. The concept of preservation of autonomic nerves during surgical treatment of DIE should become standard in reference center.
Hepatocellular Carcinoma with Peritoneal Metastasis Treated with Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy
Authors: Bhagwandin Shanel B. , Salti George I.
Published: February 2015

Peritoneal carcinomatosis from hepatocellular carcinoma is well regarded as a poorly treatable malignant disease with rapid decline. Over the past decade, new modalities that combine cytoreductive surgery with perioperative hyperthermic intraperitoneal chemotherapy have been shown to be aggressive local-regional treatments with improved survival. We present a case of a 67-year-old non-cirrhotic woman with peritoneal metastases from hepatocellular caracinoma who was treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Consideration remains individualized, but it can be considered in patients with adequate preservation of liver function, management of their primary hepatocellular caracinoma as well as the localized nature of their peritoneal metastases.
Irinotecan and Capecitabine Combination Chemotherapy in a Patient with Triple-negative Breast Cancer Relapsed after Adjuvant Chemotherapy with Anthracycline and Taxane
Authors: Lee Anna , Go Se-Il , Lee Won Sup , Lee Un Seok , Kim Moon Jin , Kang Myoung Hee , Lee Gyeong-Won , Kim Hoon-Gu , Kang Jung Hun , Jeon Kyung-Nyeo , Cho Jae Min , Lee Jeong-Hee
Published: February 2015

The most effective regimen for taxane- and anthracycline-refractory triple-negative breast cancer (TNBC) has not yet been established. Capecitabine was approved by the US Food and Drug Administration for the treatment of advanced breast cancer and has shown efficacy in advanced breast cancer refractory to anthracyclines and taxanes. Irinotecan has synergism with 5-fluorouracil and shows efficacy in advanced breast cancer. Here we report on a patient with TNBC who relapsed with widespread bone and lung metastases shortly after adjuvant anthracycline followed by taxane chemotherapy. She achieved a metabolic complete response with irinotecan and capecitabine combination therapy and had 10 months' progression-free survival and 22 months' overall survival. She relapsed with and died of brain metastasis without any definite signs of progression of the lung and bone lesions she had had before the irinotecan and capecitabine combination therapy. To validate this favorable result, larger clinical trials are warranted in patients with metastatic or relapsed TNBC.
Thymoma of the Left Thymic Lobe with a Contralateral Small Pleural Implant Successfully Detected with Diffusion-weighted MRI
Authors: Priola Adriano Massimiliano , Priola Sandro Massimo
Published: February 2015

Thymoma is the most common primary neoplasm of the anterior mediastinum. At diagnosis, up to 40% of patients present with advanced disease. Because advanced thymomas receive neoadjuvant chemotherapy, diagnostic imaging is crucial to plan the correct treatment. For characterizing thymomas, CT is the first choice modality, whereas 18F-FDG/PET is reserved for questionable cases and MRI is not routinely employed. Hereby, we describe a case of thymoma with a single contralateral pleural implant in a 30-year-old woman. The small pleural thickening detected at CT was correctly interpreted as pleural seeding related to thymoma at diffusion-weighted (DW)-MRI after a negative 18F-FDG/PET scan, and was subsequently confirmed at surgery. Precise diagnosis and accurate preoperative staging are crucial in managing thymic epithelial tumours in order to design the appropriate treatment and improve prognosis. Indeed, when stage IVa for pleural seeding is diagnosed preoperatively, a multimodality approach including primary chemotherapy followed by surgery and postoperative radiotherapy/chemotherapy is recommended. This is the first report that used DW-MRI for the characterization of pleural seeding in thymoma and demonstrates that DW-MRI could be useful for the correct pre-operatory staging in thymoma patients, especially in cases with indeterminate pleural thickenings at CT, in order to define the correct management.
Lung cancer Presenting as a Metastasis to the Tibial Bones: A Case Report
Authors: Gurrieri Lorena , Longhi Alessandra , Braghetti Antonio
Published: February 2015

Aims and Background

Bone metastasis below the knee from primary lung cancer is rare. Discussion of such cases in a multidisciplinary team is important to establish the correct treatment approach.

Case report

We analyzed the diagnostic pathway of a 53-year-old female patient with a 5-month history of pain in the right foot. The patient underwent several radiological examinations for the pain. An initial diagnosis of osteoporotic syndrome was made, followed by a diagnosis of primary sarcoma. Only when the patient continued to have pain were other radiological examinations performed and a biopsy of the right ankle taken. This revealed a metastasis from undifferentiated pulmonary adenocarcinoma. A total-body computed tomography scan did not show any tumor locations apart from the primary lung cancer. The patient underwent chemotherapy and palliative therapies. This case has been reported for its rarity.
High-dose Chemotherapy Followed by Autologous and Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Follicular Non-Hodgkin's Lymphoma in the Rituximab Era
Authors: Escobar Ignacio García , de Ibargüen Blanca Cantos Sánchez , de Juan Virginia Calvo , Alonso C. Maximiano , García Miriam Méndez , Ruíz Antonio Carlos Sánchez , Pulla Mariano Provencio
Published: February 2015

High-dose chemotherapy in lymphomas, and mainly non-Hodgkin's lymphomas, has been advancing since the 1970s. This therapeutic strategy is based on the supposed existence of a dose-response curve for cytotoxic agents. However, the available data are contradictory, so high-dose chemotherapy cannot be guaranteed as consolidation treatment for first-remission follicular lymphoma or diffuse large cell lymphoma. The objective of this paper is to review the current knowledge about high-dose chemotherapy followed by hematopoietic stem cell transplantation in follicular non-Hodgkin's lymphoma. The published studies on follicular lymphoma after first remission, recurrent follicular lymphoma, and transformed follicular lymphoma were assessed together with the data available on diffuse large cell lymphoma. During analysis of the studies, difficulties were encountered in comparing studies due to the heterogeneous nature of the data. High-dose chemotherapy as consolidation treatment after first remission or in recurrent or refractory disease was also analyzed.
Incidence and Time Trends of Cancer in Cyprus over 11 Years (1998-2008)
Authors: Cooter Mary , Soliman Amr S. , Pavlou Pavlos , Demetriou Anna , Orphanides Chloe , Kritioti Evie , Banerjee Mousumi , Farazi Paraskevi A.
Published: February 2015

Cyprus maintains a population-based cancer registry that allows for in-depth study of cancer in a culturally and environmentally unique setting. Using 11 years of collected data (1998-2008), we present the first comprehensive analysis of cancer in Cyprus. We calculated gender-specific, world age-adjusted incidence rates and time trends for the 26 most incident cancers. This study revealed that overall world age-standardized rates among men increased from 195.4 cases per 100,000 in 1998-2002 to 239.0 cases per 100,000 in 2006-2008. For the entire 11-year period, prostate, lung, colorectal and bladder cancers were the most incident cancers among men. Among women, the overall world age-standardized rate increased from 180.6 cases per 100,000 in 1998-2002 to 217.1 cases per 100,000 in 2006-2008. Over the entire period, breast, colorectal, uterine and thyroid cancers were the most incident cancers in women. There were 16 sex-specific cancers showing statistically significantly increasing incidence trends over the study period and no types for which the rate was significantly decreasing. Thyroid cancer illustrated rapid increases in rates. Results were compared to other Mediterranean European registries using the Cancer Incidence in 5 Continents reports for 1997-2002. Overall cancer incidence in Cyprus is lower than that of many southern Mediterranean countries, and given the known environmental risk factors in Cyprus, the low rate of lung cancer is especially interesting. The epidemiologic patterns reported in this study open the door for future etiologic studies to elucidate the role of environmental and lifestyle factors in this population and highlight opportunities for cancer prevention and control.
On and off Metronomic Oral Vinorelbine in Elderly Women with Advanced Breast Cancer
Authors: De Iuliis Francesca , Salerno Gerardo , Taglieri Ludovica , Lanza Rosina , Scarpa Susanna
Published: February 2015

Background

Elderly patients with metastatic breast cancer (MBC) have more problems receiving chemotherapy than younger patients, especially with the presence of multiple comorbidities, adverse drug events and functional decline. Low-dose oral administration of cytotoxic agents such as vinorelbine, a semisynthetic vinca alkaloid that interferes with microtubule assembly, leading to arrest of cell division, is usually effective and well tolerated.

Methods

From February 2010 to February 2014, 32 patients with MBC, median age 76 years (range 69-83) were treated with oral vinorelbine 30 mg (total dose), one day on and one day off, until disease progression or unacceptable toxicity levels were reported. Toxicity, quality of life and clinical benefit were evaluated. Matched t-tests were conducted to discern whether quality-of-life indicator (p<0.05 was considered significant) differed before and 6 months after treatment. Statistical analysis was performed using Graph Pad Prism 5.0 (GraphPad Software Inc., San Diego, CA, USA).

Results

No grade 3 and 4 adverse events were reported. A clinical benefit of 50% was found in our cohort. On and off metronomic vinorelbine oral administration resulted in good tolerability and safe profile in our selected elderly population, and improved patient adherence to therapy.

Conclusions

The present study demonstrated that metronomic vinorelbine might be a potential treatment in elderly patients by reducing adverse effects and increasing quality of life, setting the stage for future extensive clinical trials.
Bleeding after Bevacizumab Treatment in Patients with Metastatic Colorectal Cancer
Authors: Cao Dan , Guo Chun-hong , Liu Jie-wei , Yang Xi , Li Qiu
Published: February 2015

Aims and Background

To evaluate the adverse events (AEs) of bleeding caused by bevacizumab/5-fluorouracil/ leucovorin (5-FU/LV) combination chemotherapy with addition of irinotecan or oxaliplatin in patients with metastatic colorectal cancer (mCRC).

Methods

A retrospective study was conducted to evaluate the bleeding AEs associated with bevacizumab and to explore potential associations between bleeding and baseline patient characteristics. The National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 were used to classify the severity of AEs. AEs were divided into five grades: grade 1, mild: intervention not indicated; grade 2, moderate: medical intervention or minor cauterization indicated; grade 3, severe: transfusion, radiological, endoscopic or elective surgical intervention indicated; grade 4, life threatening: urgent intervention indicated; and grade 5, death.

Results

Sixty-two patients were evaluated. Bleeding occurred in 26 (41%) patients; the incidence of grade 3 bleeding was 1.6% while no grade 4-5 bleeding occurred. Grade 1 epistaxis and grade 2 hemoptysis events were observed in 25.8% and 3.2% of patients, respectively. Hematochezia events occurred in 12 (19.4%) patients, one (1.6%) of whom required bevacizumab discontinuation. The incidence of hematochezia was higher in patients with unresected primary tumors, prior intestinal bleeding, and tumor response (p<0.05).

Conclusions

These data provide important information about the incidence of clinically significant bleeding AEs, including minor mucocutaneous hemorrhage and major tumor-related bleeding such as hemoptysis and hematochezia in bevacizumab-treated mCRC patients. In addition, unresected primary tumor, prior bleeding, and tumor response were significant risk factors for hematochezia.
Efficacy of Bronchoscopic Therapies for Bronchial Mucoepidermoid Carcinoma in Children: Results from Six Patients
Authors: Wang Hongwu , Zhang Jieli , Li Dongmei , Zhang Nan , Li Jing , Mao Jiangfeng
Published: February 2015

Aims and Background

Bronchial mucoepidermoid carcinoma is a rare disease in children, and lobectomy is traditionally considered as a first-line treatment. As the tumor is characterized by intraluminal growth, low malignancy and superficial infiltration of bronchial walls, bronchoscopic interventional therapy may provide an alternative treatment with favorable results. The aim of the study was to evaluate the efficacy and safety of bronchoscopic therapies for bronchial mucoepidermoid carcinoma in children.

Methods and Study design

Clinical manifestations, multiple bronchoscopic interventions and outcomes in 6 children with bronchial mucoepidermoid carcinoma were retrospectively analyzed.

Results

The median age was 8.7 years (range 4 to 12 years). All the tumors were located in the lobar bronchus and were detected by computerized tomography. Diagnoses of low-grade mucoepidermoid carcinoma were made based on biopsies obtained via bronchoscopy. Five tumors were classified as intraluminal type and successfully eradicated by carbon dioxide cryotherapy and argon plasma coagulation under bronchoscopy. The other tumor in patient 3 was classified as the mixture type and could not be removed by a bronchoscopic, so left upper lobectomy was performed. For each patient, interventional procedures were conducted on the average for 6 times. No recurrence was detected by bronchoscopic inspections or computed tomography scans during follow-ups for 16-72 months.

Conclusions

Multiple bronchoscopic procedures, as alternative treatments, are effective in removing bronchial mucoepidermoid carcinoma mucoepidermoid carcinoma in children without any major complications.
The Anal Canal as a Risk Organ in Cervical Cancer Patients with Hemorrhoids Undergoing Whole Pelvic Radiotherapy
Authors: Jang Hyunsoo , Baek Jong Geun , Jo Sunmi
Published: February 2015

Aims and Background

Tolerance of the anal canal tends to be ignored in patients with cervical cancer undergoing whole pelvic radiotherapy. However, patients with hemorrhoids may be troubled with low radiation dose. We tried to analyze the dose-volume statistics of the anal canal in patients undergoing whole pelvic radiotherapy.

Methods

The records of 31 patients with cervical cancer who received definite or postoperative radiotherapy at one institution were reviewed. Acute anal symptoms, such as anal pain and bleeding, were evaluated from radiotherapy start to 1 month after radiotherapy completion. Various clinical and dosimetric factors were analyzed to characterize relations with acute anal complications.

Results

The anal verge was located an average of 1.2 cm (range −0.6~3.9) below the lower border of the ischial tuberosity and an average of 2.7 cm (range −0.6~5.7) behind the sacral promontory level. The presence of hemorrhoids before radiotherapy was found to be significantly associated with acute radiation-induced anal symptoms (p = 0.001), and the mean induction dose for anal symptoms was 36.9 Gy. No patient without hemorrhoids developed an anal symptom during radiotherapy. Dosimetric analyses of V30 and V40 showed marginal correlations with anal symptoms (p = 0.07).

Conclusions

The present study suggests a relation between acute anal symptoms following radiotherapy and acute hemorrhoid aggravation. Furthermore, the location of the anal verge was found to be variable, and consequently doses administered to the anal canal also varied substantially. Our results caution careful radiation treatment planning for whole pelvic radiotherapy, and that proper clinical management be afforded patients with hemorrhoids during radiotherapy.
Predictive Factors for Additional Non-Sentinel Lymph Node Involvement in Breast Cancer Patients with One Positive Sentinel Node
Authors: Meattini Icro , Saieva Calogero , Bertocci Silvia , Francolini Giulio , Zei Giacomo , De Luca Cardillo Carla , Scotti Vieri , Greto Daniela , Bonomo Pierluigi , Orzalesi Lorenzo , Bianchi Simonetta , Livi Lorenzo
Published: February 2015

Aim

The aim of this study was to identify a subgroup of breast cancer patients in whom it is possible to avoid axillary lymph node dissection (ALND) when the sentinel lymph node (SLN) is positive.

Methods

A series of 292 patients treated with breast-conserving surgery or mastectomy underwent ALND after positive SLN detection. To correlate SLN metastasis with the chances of finding additional metastasis in non-SLNs we evaluated the main clinicopathological characteristics. No patients received adjuvant radiotherapy to the axillary region.

Results

Fifty-six patients (35.4%) with positive SLNs for macrometastases (n = 158) had additional metastases upon completion ALND compared with 7 patients (5.2%) with micrometastases in the SLN (n = 132). Cases with a higher number of positive axillary lymph nodes tended to have higher pT stage (p = 0.004). In multivariate analysis, pT was confirmed as an independent predictor of non-SLN metastases (OR = 2.40; 95% CI = 1.16-4.99). No patients with micrometastases in SLN and cancer <10 mm had additional positive non-SLNs.

Conclusions

Our results, in agreement with the major published studies, suggest that ALND can be avoided in selected patients without the need for additional treatment to the axillary region.