bluuebunny/crossref_metadata_2025 huggingface dataset:
Iris Diaphragm Implantation in Post-Traumatic Aniridia and Tractional Retinal Detachment
Authors: Marullo M. , Scupola A. , Pasqua R. , Agostini N. , Balestrazzi E.
Published: April 2018

The implantation of an artificial iris diaphragm is described in a case of aniridia and traumatic aphakia with a relapsed, tractional retinal detachment. The addition of heparin and dexamethasone to the infusion liquid is useful to reduce the fibrinous exudation which seems to be the main cause of diaphragm obliteration.
A Case of Duane's Retraction Syndrome with Multiple Congenital Malformations
Authors: Kadayifçilar S. , Aydin P. , Oto S.
Published: April 2018

Duane's retraction syndrome is associated with various ocular and systemic abnormalities. We report a case with bilateral Duane's retraction syndrome type I accompanied by renal agenesis, vesico-ureteral reflux, patent ductus arteriosus, and external ear malpositioning. Because of disabling consequences, we recommend a thorough physical examination and screening for renal and cardiac abnormalities in all patients presenting with Duane's reaction syndrome.
Oct Images and Surgery of Juvenile Macular Retinoschisis
Authors: Azzolini C. , Pierro L. , Codenotti M. , Brancato R.
Published: April 2018

We describe three cases of X-linked juvenile retinoschisis confined to the posterior pole of the eye, one of which surgically treated. In the first two cases, in vivo optical coherence tomography (OCT) had revealed a cleavage plane in both nerve fiber and outer retinal layers. In the two similar operated eyes of the third case, postoperative OCT had revealed the disappearance of macular schisis in the eye with good recovery of visual function after surgery. On the contrary, it had revealed a persistent splitting of the retina in the other eye, not clinically visible, which explained the poor recovery of visual function after surgery. In cases with progressive worsening of macular involvement in X-linked juvenile retinoschisis, highly accurate surgery may be considered, and the pre- and postsurgical OCT monitor of these patients is indicated.
Medial Canthus Tumor Surgery: A Prospective Study of Microscopically Controlled Excision
Authors: Aliseda D. , Vazquez J. , Munuera J.M.
Published: April 2018

Objectives.

We set out to demonstrate that medial canthus tumors are malignancies requiring microscopically-controlled excision for a high cure rate. We also aim to show that reconstruction can have good esthetic results with a few simple techniques.

Methods.

During 1992, we treated 38 basal cell carcinomas of the medial canthus, employing our own two-step Mohs’ surgery. All cases were reconstructed with five simple techniques: “laissez faire”, full thickness graft, nasoglabellar flap, mild-line forehead flap or combination of flaps.

Results.

No recurrent basal cell carcinomas have been observed in our patients during the last four years. All the medial canthus tumours were basal cell carcinomas, eight involving morpheiform infiltration. Perineural infiltration was observed in two cases.

Conclusions.

Micrographic surgery for medial canthus malignant tumors is the best resection technique. Infiltrating, basal cell carcinomas, are the most common tumors of medial canthus, but also have an excellent cure rate. Reconstruction with a small number of flaps and skin graft is generally an easy process, producing highly satisfactory results.
Optic Nerve Hypoplasia in Fetal Alcohol Syndrome: An Update
Authors: Pinazo-Duran M.D. , Renau-Piqueras J. , Guerri C. , Strömland K.
Published: April 2018

Optic nerve hypoplasia was detected in up to one half of a group of Swedish children born to alcoholic mothers. Using an experimental model of pre- and postnatal alcohol exposure in rats fed a liquid diet, reduced optic nerve size from gestational day 21 (294 ± 26×102 μm2 vs 502 ± 16×102 μm2; n=6; p≤0.001) to later in development was observed as a result of the daily mean blood alcohol levels achieved in dams and their offspring. Altered glial cells and degenerating and atrophic optic axons, myelin sheaths and ganglion cells were frequent in the alcohol-exposed optic nerves.

Smaller optic nerve (1,918 ± 61×102 μm2 vs 2.195 ± 40×102 μm2; n=4; p≤0.001), reduced gaglion cell and axonal densities, and ultrastructural damage to the macroglial cells and myelin sheaths were also detected in the treated group. All these changes remained in the retina and optic nerve of the oldest rats, as a consequence of the long-lasting effects of prenatal alcohol exposure. In summary, alcohol as a major teratogenic agent may induce dysmorphogenesis and irremediable damage to the retina and optic nerve, which frequently manifests itself as hypoplastic optic nerve.
Necrotizing Choroiditis-Retinitis as Presenting Symptom of Disseminated Aspergillosis after Lung Transplantation
Authors: Anteby I. , Kramer M. , Rahav G. , Benezra D.
Published: April 2018

Background.

Endogenous endophthalmitis due to Aspergillus is rare affecting the severely immunosuppressed population, in particular recipients of heart and lung transplants. Ocular involvement of aspergillosis has always been observed late in the course of the disease.

Subject.

A young woman noted blurred vision in one eye three weeks after lung transplantation. At this stage, no systemic manifestations of fungal infection were detected and the ocular findings were attributed to viral infection.

Results.

Twenty-four hours after the original ocular complaint, an aggressive endophthalmitis developed in the left eye. The possibility of fungal endophthalmitis was raised. Within 48 hours of her first ocular complaint the patient died. Cultures from a vitreous tap and from autopsy ocular specimens were positive for Aspergillus fumigatus.

Conclusions.

Aspergillus endophthalmitis may occur in patients undergoing lung transplantation despite antifungal therapy. Increased awareness of this unusual entity may be life and vision saving in these patients.
Central Serous Chorioretinopathy Complicating Systemic Corticosteroid Therapy
Authors: El-Asrar A.M. Abu
Published: April 2018

Purpose.

To present evidence that systemic corticosteroid therapy may cause central serous chorioretinopathy.

Methods.

A 20-year-old male with idiopathic thrombocytopenic purpura was examined during systemic treatment with corticosteroids (100 mg daily).

Results.

The patient had central serous chorioretinopathy. Spontaneous recovery accompanied discontinuation of the steroid treatment.

Conclusions.

This case provides further evidence that Cortisol may play a role in the development of central serous chorioretinopathy.
Multisubstance Analysis of Reflection Spectra before and after Laser Photocoagulation for Proliferative Diabetic Retinopathy
Authors: Augsten R. , Königsdörffer E. , Schweitzer D. , Strobel J.
Published: April 2018

Purpose

The aim of the study was to provide new data that add to the understanding of diabetic retinopathy and its treatment by photocoagulation.

Patients and Methods.

Using a spectrometric method, the reflection spectra of the macula in six type II diabetics with proliferative diabetic retinopathy were measured before and after laser photocoagulation and compared with normals. The investigations were done one day before laser photocoagulation and again the day after. Further measurements were made 14 days, 6 weeks and 4 months after coagulation. The reflection spectra were assessed by multisubstance analysis.

Results and Conclusions.

The contents of xanthophyll, melanin and choroidal oxyhemoglobin and the intensity of scattered light were significantly altered after laser coagulation. For example, in patients with proliferative diabetic retinopathy the content of oxyhemoglobin in the choroid was lower than normal, but it rose after laser treatment. This suggests an improved oxygen supply of the choroid after laser coagulation, implying reduced retinal hypoxia.
Primary Vitrectomy for Bullous Rhegmatogenous Retinal Detachments Due to Complex Breaks
Authors: El-Asrar A.M. Abu
Published: April 2018

Introduction

The role of vitrectomy for the treatment of uncomplicated retinal detachments has not been clearly defined. This study reports the results of a series of eyes with bullous rhegmatogenous retinal detachment (RRD) due to complex breaks that were managed by primary vitrectomy.

Methods

The study consisted of a consecutive series of 22 eyes (22 patients) with a bullous RRD not complicated by proliferative vitreoretinopathy (PVR) associated with large, multiple, or posterior breaks. All eyes underwent vitrectomy, injection of perfluorocarbon liquid (PFCL), cryopexy and gas tamponade as the primary procedure. Encircling scleral bands were placed in all cases. Follow-up ranged from 6 to 24 months (mean 10.9 ± 6.5 months).

Results

Anatomical retinal re-attachment was achieved in all eyes after one operation. Best-corrected final visual acuity was improved in all cases. Complications included progressive posterior subcapsular and nucleosclerotic cataract in four (22%) of the 18 phakic eyes and epiretinal membrane in one patient.

Conclusions

These results, together with the relatively low incidence of complications, lead us to conclude that this technique is an effective method for treatment of bullous RRD not complicated by PVR associated with technically difficult breaks. A controlled, prospective, randomized study would be necessary to thoroughly assess the advantages of vitrectomy over scleral buckling alone in these cases.
A Comparative Study of the Duration and Efficacy of Tetracaine 1% and Bupivacaine 0.75% in Controlling Pain following Photorefractive Keratectomy (PRK)
Authors: Verma S. , Corbett M.C. , Patmore A. , Heacock G. , Marshall J.
Published: April 2018

Objective

To evaluate if topical bupivacaine 0.75% provides better pain control after excimer laser over topical tetracaine 1% without affecting corneal wound healing, refractive outcome of visual function.

Design

A prospective, double-masked trial was conducted in which 38 patients were randomized to receive either tetracaine or bupivacaine every 30 minutes for 24 hours post-operatively. Pain was recorded over a four day period using a Visual Analogue Pain Scale. The rate of epithelial healing was assessed during digitized retro-illumination photography. Visual performance was recorded using best corrected Snellen acuity, objective measurements of haze, halo and glare over a six month period.

Results

Tetracaine afforded better pain control (p=0.05). Full epithelial closure occurred in all patients within 72 hours and no statistically significant difference was recorded in any of the parameters measured.

Conclusions

Contrary to our expectation, the longer acting anaesthetic, bupivacaine, was inferior to tetracaine. Limited and supervised use of topical anaesthetics is recommended in controlling pain following photorefractive keratectomy.
Long-Term Effects of Postoperative Subconjunctival Injections of Mitomycin-C in the Rabbit Eye
Authors: Pablo L.E. , Ramirez T. , Pueyo M. , Larrosa J.M. , Polo V. , Honrubia F.M.
Published: April 2018

Aim

Single or multiple subconjunctival injections of mitomycin-C (MMC) may offer one way of establishing the total dosage of MMC more accurately. The method also allows re-applications later postoperatively. In this experimental, randomized prospective study we compared the effects of a single intraoperative application of MMC at the filtering site and a single postoperative subconjunctival injection of the drug.

Methods

The left eyes of 32 pigmented rabbits were divided into two groups. In the first group we applied MMC intraoperatively (10) with a 4×1 mm surgical sponge soaked in a MMC solution (0.5 mg/ml). In the second group we injected 0.4 ml of the same solution subconjunctivally (SC) immediately after (conjunctival) suture. Post-operative evaluation was carried out every day during the first week, then every three days until day 58. Survival analyses were done for intraocular pressure (IOP) and bleb failure. Log-rank tests were used to compare survival differences between the groups.

Results

The IO group showed longer survival parameters than the SC group (p<0.05), both in the control of IOP and as regards blebs. The histological persistence of fistulas was similar. The IO group, however, had a higher incidence of undesirable side effects.

Conclusions

Our findings suggest IO application of MMC is more effective in reducing fibroblast ingrowth. However, subconjunctival application offers certain advantages such as the possibility of repeating the treatment postoperatively and, therefore, using a smaller initial dose.
Coexistence of Optic Nerve Head Drusen and Pseudotumor Cerebri: A Clinical Dilemma
Authors: Krasnitz I. , Beiran I. , Mezer E. , Miller B.
Published: April 2018

The coexistence of optic nerve head drusen and pseudotumor cerebri is a potential clinical problem since diagnosing only one of two clinical abormalities in a patient may delay or prevent the appropriate treatment. To the best of our knowledge, only four cases of such coexistence have been described. We report three cases diagnosed as having both optic nerve head drusen and pseudotumor cerebri and propose possible explanations. The report draws attention to the need for awareness of this potential coexistence in order to assure proper treatment.
Is the Blind Spot Enlarged in Early Glaucoma?
Authors: Meyer J.H. , Guhlmann M. , Funk J.
Published: April 2018

Purpose

We investigated whether the blind spot is larger in early “preperimetric” glaucoma with already deeply excavated optic discs than in normal persons.

Methods

We examined eight eyes of five patients with definite glaucomatous optic disc cupping but normal visual fields. Ten eyes of five normal healthy volunteers, with normal central excavation, served as controls. With SLO-perimetry we measured the differential light sensitivity 0.5-1.0° outside the disc margins, “within” the center (Goldmann V stimulus) and along the horizontal meridian of the optic discs. Optic disc topography was documented with the Heidelberg Retina Tomograph (HRT).

Results

Differential light sensitivities adjacent to the optic discs did not differ in the two groups (normal 8.3dB, early glaucoma 8.4dB). Goldmann IV stimuli presented on the horizontal meridian of optic discs with glaucomatous cupping were seen up to 0.7° centrally (i.e., towards the center) of the disc margin. In the control group this distance was significantly greater (1.3°). The light differential thresholds with stimulus presentation in the disc center (Goldmann V) were significantly higher in the glaucoma group (0±2.8dB) than in the normal controls (6.6±1.3dB), though disc size was the same in both groups.

Conclusions

Blind spots of normal discs seem to be smaller than those of deeply excavated discs in eyes with early glaucoma, possibly because there is more light scattering by the normal disc surface towards the adjacent functioning retina.
HIF-2α-ILK Is Involved in Mesenchymal Stromal Cell Angiogenesis in Multiple Myeloma Under Hypoxic Conditions
Authors: Zhang Xiaoying , Xu Yinhui , Liu Hongbo , Zhao Pan , Chen Yafang , Yue Zhijie , Zhang Zhiqing , Wang Xiaofang
Published: April 2018

Mesenchymal stromal cells are proven to be likely induce the angiogenic response in multiple myeloma and thus represent an enticing target for antiangiogenesis therapies for multiple myeloma. Substantial evidence indicates that angiogenesis in multiple myeloma is complex and involves direct production of angiogenic cytokines by abnormal plasma cells and these B-cell neoplasia generated pathophysiology change within the microenvironment. In this study, we demonstrated that mesenchymal stromal cells cultured with U266/Lp-1 under hypoxic conditions resulted in an increased α-smooth muscle actin expression and high productive levels of both hypoxia-inducible factor-2α and integrin-linked kinase proteins. Moreover, inhibition of hypoxia-inducible factor-2α by Small interfering RNA (siRNA) in mesenchymal stromal cells decreased the protein levels of both α-smooth muscle actin and integrin-linked kinase after mesenchymal stromal cells cultured with U266 under hypoxic conditions. We further demonstrated that transfection of integrin-linked kinase-siRNA reduced the protein level of α-smooth muscle actin and attenuated angiogenesis in vitro by decreasing the attachment of Q-dot labeled cells and secretion of angiogenic factors. In conclusion, our research showed that mesenchymal stromal cells cultured with myeloma cells under hypoxia participated in the angiogenesis of multiple myeloma, which is regulated by the hypoxia-inducible factor-2α-integrin-linked kinase pathway. Thus, targeting integrin-linked kinase may represent an effective strategy to block hypoxia-inducible factor-2α-induced angiogenesis in the treatment of multiple myeloma.
LNDIR: A lightweight non-increasing delivery-latency interval-based routing for duty-cycled sensor networks
Authors: Shahzad Muhammad K , Nguyen Dang Tu , Zalyubovskiy Vyacheslav , Choo Hyunseung
Published: April 2018

Wireless sensor networks are composed of low-energy, small-size, and low-range unattended sensor nodes. Recently, it has been observed that by periodically turning on and off the sensing and communication capabilities of sensor nodes, we can significantly reduce the active time and thus prolong network lifetime. However, this duty cycling may result in high network latency, routing overhead, and neighbor discovery delays due to asynchronous sleep and wake-up scheduling. These limitations call for a countermeasure for duty-cycled wireless sensor networks which should minimize routing information, routing traffic load, and energy consumption. In this article, we propose a lightweight non-increasing delivery-latency interval routing referred as LNDIR. This scheme can discover minimum latency routes at each non-increasing delivery-latency interval instead of each time slot. Simulation experiments demonstrated the validity of this novel approach in minimizing routing information stored at each sensor. Furthermore, this novel routing can also guarantee the minimum delivery latency from each source to the sink. Performance improvements of up to 12-fold and 11-fold are observed in terms of routing traffic load reduction and energy efficiency, respectively, as compared to existing schemes.
The Obama Administration American Recovery and Reinvestment Act and Local School Board Politics
Authors: Okhremtchouk Irina S. , Jimenez-Castellanos Oscar
Published: April 2018

The American Recovery and Reinvestment Act (ARRA) 2009 funds were established by the Obama administration to stabilize the U.S. economy and support public education. This case examines how the district leadership in one rural unified school district in California decided to allocate the State Fiscal Stabilization Funds and Title I Part A/ARRA funds provided within ARRA. The case explores how local school board politics and local bureaucracies contribute to the district leadership’s allocation of these funds.
Estrogen and Progesterone Measurement and its Quality Control in Breast Cancer: A Reappraisal
Authors: Piffanelli Adriano , Giovannini Gloria , Pelizzola Dario , De Bortoli Michele
Published: April 2018

This article illustrates the two main methods for routine measurement of cytoplasmic estrogen receptor status in neoplastic biopsy. The first is the Dextran Coated Charcoal Technique (D.C.C. Assay) which is still the method of choice in the majority of clinical laboratories for its simplicity, reproducibility and low cost. The second is a more advanced technique based on the specific binding, enzimatically displayed, of commercially available antiestrogen monoclonal antibodies (Enzyme Immuno Assay - ABBOTT).

The sui generis characteristics of endocrine sensitivity assessment on tumor tissues and the importance of decision-making connected with the assay justify rigorous quality assurance schemes. The quality control design proposed by the Italian Committee concerned the evaluation of several lyophilized preparations with scalar receptor content; this permits the identification through linear regression analysis of systematic and non-systematic errors. The Italian Committee has currently connected 50 labs from most regions of the country.
Neuron-Specific Enolase in the Diagnosis and Therapy Monitoring of Lung Cancer: A Comparison with Cea, Tpa, Ferritin and Calcitonin
Authors: Fischbach Wolfgang , Jany Berthold
Published: April 2018

The significance of neuron-specific enolase (NSE) in the diagnosis and treatment monitoring of lung cancer was investigated in comparison with such established tumour markers as carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), ferritin and calcitonin. We determined the serum concentrations of these tumour markers in 25 patients with small cell lung cancer (SCLC), 30 patients with non small cell lung cancer (NSCLC), and 38 patients with benign pulmonary diseases (BPD). In 14 patients with lung cancer, it was possible to follow up the behaviour of the tumour markers under treatment for up to 16 months. Calcitonin proved to have a surprisingly low sensitivity for SCLC. The utility of TPA and of ferritin was restricted, although the sensitivity was comparably high, by the high rate of false positive results. For NSCLC, CEA proved to be the best tumour marker. At present, NSE appears to be the tumour marker with the greatest specificity and sensitivity for SCLC. Its determination in the diagnosis, treatment and follow-up of SCLC makes good sense.
A Double Determinant Radioimmunoassay Mov2-Mov8* for Monitoring Ovarian Carcinomas: Definition of the Methodology
Authors: Diotti Alessandro , Santoro Olivia , Mantovani Liliana , Regazzoni Mario , Fontanelli Rosanna , Ravagnani Ferdinando , Miotti Silvia , Ménard Sylvie , Colnaghi Maria Ines
Published: April 2018

A double-determinant radioimmunoassay for the detection of circulating antigens associated with human ovarian carcinoma was developed using two monoclonal antibodies: MOv2 and MOv8 employed respectively as catcher and tracer. The development of the method through three different procedures enabled us to detect the presence of CaMOv2-CaMOv8 carrying molecules in 14 out of 15 ascitic fluids from ovarian carcinoma patients whose tumors were found to be positive with MOv2 and MOv8 monoclonal antibodies by immunofluorescence. Moreover, 13 out of 15 ovarian carcinoma patients presented high levels of antigen in their serum (60-170 Ua/ml). Low levels of antigen were observed in the normal population, the values ranging from 30-40 Ua/ml. However, in 13 out of 100 apparently healthy women high levels of antigen were found in the serum
Serum ß2-Microglobulin lin Patients with Monoclonal Gammopathies
Authors: Di Giovanni Samuele , Valentini Gaetano , Ravazzolo Emma , Carducci Paolo , Giallonardo Paolo , Maschio Camillo
Published: April 2018

Beta-2-microglobulin concentrations were determined in serum samples from 45 patients with benign and malignant monoclonal gammopathies. In the group of patients suffering from multiple myeloma or Waldenström macroglobulinemia the mean β2-microglobulin level was significantly higher than in the group with monoclonal gammopathy of undetermined significance. Values above 3 mg/L were highly indicative of a neoplastic process and were observed in all the Waldenström patients and in > 90% of myeloma patients. No significant correlation was noticed between β2-microglobulin and monoclonal protein levels in any of the groups examined.
Tissue Polypeptide Antigen (Tpa) Modifications in Hepatic Cirrhosis, Aggressive Chronic Hepatitis, Persistent Chronic Hepatitis, and in Minimal Pathology
Authors: Sabbatani S. , Monti M. , Fini A.
Published: April 2018

A total of 104 patients with various liver diseases were studied. Hepatic biopsy was performed and the AST, ALT and TPA in serum were measured.

Higher levels of TPA, AST and ALT were found in CAH and LC, lower in CPH and MHP. High serum TPA values, usually suggesting the possibility of neoplasm, should be considered with attention. A follow-up with periodic TPA assays (in addition to AST and ALT) is suggested in patients with acute hepatitis, in order to predict further possible complications such as CAH and LC.
CA 15.3 and CEA Plasma Level Monitoring in Patients with Breast Cancer
Authors: Martoni A. , Ercolino L. , Bellanova B. , Zanichelli L. , Canova N. , Pannuti F.
Published: April 2018

CA 15.3 and CEA were determined in the serum of 217 patients with early and advanced breast carcinoma.

CA 15.3 was high (> 30 U/ml) in 1/6 (17%) patients with stage III primary tumor, in 4/77 (5%) patients without clinical signs of disease after mastectomy, in 67/102 (65%) patients with advanced disease in progression, and in 13/32 (41%) patients with advanced disease not in progression and undergoing therapy. The corresponding incidences of pathological CEA values (> 2.5 ng/ml) were 33, 8, 55 and 14%>. The combination of the two markers brings about a certain improvement in the sensitivity for recognising patients with advanced disease in progression (79/102 = 77%). The presence of high values of CA 15.3 is statistically correlated to the prevalent site of metastases (bone and viscera > soft tissues). Monitoring the two markers during antitumor therapy in 36 patients showed good accordance (56%) between CA 15.3 changes and response to therapy. The decrease of the marker in patients who achieved partial remission was statistically significant.

In conclusion, CA 15.3 is more sensitive than CEA in recognising patients with advanced disease in progression and gives better accordance with the response to therapy. The simultaneous use of the two markers may be useful in the follow-up of operated patients and in monitoring the disease during treatment.
Antiferritin Antibodies in Immunoscintigraphic Detection of Human Tumor Xenografts
Authors: Kopřivová H. , Novák F. , Poučková P. , Dvořák P. , Šeblová J. , Švihovcová P. , Dušková J. , Pospíšil J. , Dienstbier Z.
Published: April 2018

Affinity-purified antibodies against human placental ferritin and their F(ab) 2 fragments labeled with 131I were examined for suitability for radioimmunodetection of ferritin-containing tumors. The nude mouse model (BALB/c, nu/nu) with xenografts of HeLa cell tumors and human adenocarcinoma of the rectum (with proven ferritin content) was used. Gamma-camera imaging and tissue distribution studies revealed that both kinds of tumor selectively accumulate antiferritin antibodies and their fragments. In large necrotic tumors nonspecific uptake of radiolabeled normal IgG occurred, but otherwise there was no tumor localisation. This study, in accordance with the literature, confirms the utility of antiferritin antibodies for the detection of human tumors in an animal model.
Pattern Analysis of Serum alpha-fetoprotein in the Early Diagnosis of Hepatocellular Carcinoma in Liver Cirrhosis
Authors: Arrigoni A. , Andriulli A. , Gindro T. , Piantino P. , Capussotti L. , Rizzetto M.
Published: April 2018

In a surveillance program for hepatocellular carcinoma (HCC), serum alpha-fetoprotein (AFP) was determined every 4 months in 164 patients with liver cirrhosis. Ultrasonography (US) was performed yearly or as dictated by abnormal AFP levels.

During a follow-up of 32.5 ± 20.8 months HCC was identified by US in 16 patients. In 9 of them the AFP levels rose steadily over 4 months, increasing 7, 8 and 12 months in 3 cases before the lesion became detectable by US. In 4 patients tumors developed despite persistently normal AFP levels. Nine more patients showed abnormal fluctuations of AFP but HCC was not detected.

AFP sensitivity was higher at a low cutoff point (40 ng/ml) while specificity of the test appeared higher at the 200 ng/ml cutoff point. An AFP value rising steeply over a few months appeared more reliable than a fixed preset threshold in indicating carcinomatous transformation.

Screening for AFP can be expected to uncover about 3/4 of HCC developing in cirrhotics with few false-positive reactions. The test may have a unique role in identifying a subset of liver tumors whose early expression is AFP production.
Molecular Profile, Tissue Distribution and Prognostic Evaluation of a Human Melanoma-Carcinoma Antigen Recognized by the Murine Monoclonal Antibody B1.1
Authors: Natali P.G. , Nicotra M.R. , Nuti M. , Bigotti G. , Calabrò A. , Schlom J. , Giacomini P.
Published: April 2018

Using the murine monoclonal antibody (MoAb) B1.1 we have analyzed the immunochemical profile and the tissue distribution of a human melanoma associated antigen (MAA) carrying an epitope shared by the 180 kd CEA. Results of this study have demonstrated that the epitope expressed by the MAA is carried by a distinct set of molecules of 110-140 kd. Similarly to the 180 kd CEA molecules synthesized by carcinomas, the expression of the melanoma associated CEA like components (MA-CEA) is upregulated by IFN-α. The tissue distribution of MA-CEA is not restricted to malignant primary and metastatic melanocytic lesions but is found also at low levels in 64% of benign nevi. No circulating CEA was found in patients bearing widespread metastatic disease of MA-CEA positive lesions.

Preliminary clinical evaluation of stage I melanoma patients bearing MoAb Bl. l positive lesions has not shown a significative prognostic association of this phenotypic marker with clinical course of the disease.
Changes in Receptor Status after Treatment with Tamoxifen in Endometrial Cancer
Authors: Oriana S. , Raspagliesi F. , Duca P.G. , Coradini D. , Di Re E.M. , Ragazzi D. , Grillo T. , Luciani L.
Published: April 2018

Estrogen (ER) and progesterone receptor (PgR) status was determined in 41 women with operable endometrial cancer before and after administration of tamoxifen (TAM). The first sample was obtained by hysteroscopy to ensure a precise biopsy of neoplastic tissue; the second was done on the surgical specimen. PgR content was significantly increased after TAM treatment and this data was compared with the degree of tumor differentiation.
Immunohistochemical Detection of Carcinoembryonic Antigen (CEA) in Non-Cancerous and Cancerous Gastric Mucosa
Authors: Nasierowska-Guttmejer A. , Szawlowski A.W.
Published: April 2018

Carcinoembryonic antigen (CEA) was stained by the PAP immunoperoxidase method in cancerous and non-cancerous gastric mucosa of 40 patients (25 non-cancerous dyspeptic patients and 15 patients with gastric carcinoma). The pattern of CEA localization was apical or membranous-cytoplasmic and immuno-reactivity was mild (+), moderate (++) or intensive (+++). No CEA immunoreactivity was detected in normal gastric mucosa whereas it was marked in gastric mucosa of non-cancerous dyspeptic patients with chronic atrophic gastritis and dysplasia (intense). In patients with superficial gastritis and epithelial hyperplasia it was mild or absent. The CEA localization pattern was also apical in non-cancerous dyspeptic patients with microscopic changes, e.g. superficial or chronic atrophic gastritis, epithelial hyperplasia and dysplasia, and in non-cancerous mucosa and cancerous tissue of patients with well (G1) and moderately (G2) differentiated adenocarcinoma.
The Pineal Gland and Breast Cancer: Serum Levels of Melatonin in Patients with Mammary Tumors and Their Relation to Clinical Characteristics
Authors: Barni S. , Lissoni P. , Sormani A. , Pelizzoni F. , Brivio F. , Crispino S. , Tancini G.
Published: April 2018

Several studies have suggested that the pineal gland hormone melatonin may influence the growth of breast cancer. The importance of melatonin blood concentrations in the clinical history of human breast cancer, however, has still to be defined. To further investigate this problem, we used a RIA method to assay serum levels of the pineal hormone in 74 untreated breast cancer patients, clinical stage T1–3 NO-2 MO, and in 46 age-matched healthy women as controls. Mean serum melatonin levels were significantly higher inpatients than in controls. Melatonin concentrations were highest in breast cancer patients with the best prognosis (i.e. estrogen receptor-positive/node-negative cases). Mean levels of melatonin were significantly higher in estrogen receptor-positive patients than in the negative ones. They were also higher in node-negative than in node-positive cases, and in progesterone receptor-positive patients than negative ones, but none of these differences was statistically significant. No difference was observed in relation to menopausal status and to tumor histotype. These results suggest that melatonin plays a role in the hormone-dependency of human breast cancer.
CA 15-3 in Human Breast Cancer.: Comparison with Tissue Polypeptide Antigen (TPA) and Carcinoembryonic Antigen (CEA)
Authors: Caponigro F. , Iaffaioli R.V. , Pagliarulo C. , De Placido S. , Frasci G. , Ungaro B. , Matano E. , Bianco A.R.
Published: April 2018

CEA, TPA, CA 15-3 were assayed in 238 patients in follow-up for breast cancer after surgery. CA 15-3 showed the best sensitivity and specificity; the predictive value of a positive CA 15-3 test was three times higher than CEA and TPA. No association was found between marker positivity and the number of organs involved by metastases. CA 15-3 positivity was significantly associated with visceral rather than soft tissue recurrences; no significant similar association was observed for CEA and TPA. CA 15-3 serum levels were early predictors of relapse in four out of nine patients within a 6-12 month follow-up period.
PNA: A Marker of Neoplastic Progression and Differentiation in the Gastrointestinal Tract
Authors: Grigolato P. , Benetti A. , Berenzi A. , Villanacci V. , Tardanico R.
Published: April 2018

We examined 35 cases of stomach carcinoma and 40 cases of colonic carcinoma with PNA associated with peroxidase (peanut agglutinin, lectin which binds to the terminal disaccharide galactose β (1, 3)-N-acetil-galacto-samine).

In this way evaluation of the functional aspects of the normal-neoplastic sequence was undertaken. This method was carried out for histological and ultrastructural investigations. The results obtained in both cases showed a different reactivity in the evolution of neoplastic disease: in fact, positivity in dysplasia is finely granular intracytoplasmic, whereas in well-differentiated neoplastic transformation such a reactivity is preferentially localized along the cellular membranes, with restoration of gross positivity in the cytoplasm for the poorly-differentiated neoplasm. We therefore believe PNA to be a marker not only of neoplastic progression but of differentiation as well: we also hypothesize it to reveal glycoprotein groups with possible antigenic power, involved in immunologic interactions between tumor and host.
Squamous Cell Carcinoma Antigen (SCC), Carcinoembryonic Antigen (CEA), and Tumour-Associated Trypsin Inhibitor (TATI) for Monitoring Head and Neck Cancer
Authors: Pectasides D. , Bourazanis J. , Economides N. , Pozadzidou P. , Gogou L. , Koutsiouba P. , Athanassiou A.
Published: April 2018

Eighty-eight patients with head and neck cancer were prospectively monitored, before and after treatment, by means of simultaneous serum SCC, CEA and TATI measurements. Thirty-two (36.6%) patients had early stages (I, II, III) and 56 (63.4%) advanced (stage IV) or recurrent disease. Pre-treatment serum SCC levels were elevated in 20.4% of patients, CEA in 27.2% and TATI in 4.5%. There was no correlation between the incidence of TATI elevation and tumour burden; this marker did not increase with progressing disease stages. CEA and SCC had low sensitivity in the early stages of head and neck cancer and reached 35.7% (20/56 patients) and 25% (14/56 patients) in stage IV or recurrent disease. Despite the low sensitivity of these tumour markers, there was a correlation between tumour marker levels and the course of the disease. This study indicates that the routine assessment of SCC, CEA and TATI serum levels is of no value. However, it can be used as a potential tool for monitoring the efficacy of individual therapy in both early and advanced stages of head and neck cancer.
Intraoperative Radioimmunolocalization of Colorectal Cancer: A Review
Authors: Aprile C.
Published: April 2018

Although intraoperative radioimmunolocalization (IORIL) is gaining wider acceptance, several limits inhibit a more extensive clinical use.

In this paper the following topics will be discussed: 1) the clinical approach, that is, the combined use of immunoscintigraphy and IORIL after a single MAb administration or the use of non-imaging 125 I MAb; 2) the detector type and its collimation and shielding; 3) the nuclides employed, and 4) the background problem.

The clinical results of our and other groups show a sensitivity that is generally higher than 0.75 with a high positive predictive value. The detection rate of occult lesions is in the order of 20% of all explored sites. However, the current state of detector and MAb technology do not allow to achieve better results; probably the results can be improved by the use of bispecific MAb or the avidin-biotin system.
Radioimmunotherapy of Ovarian Cancer
Authors: Crippa F.
Published: April 2018

Radioimmunotherapy (RIT) is a new therapeutical approach where radiolabeled monoclonal antibodies (MAb) against tumor-associated antigens are administered to treat tumor lesions. Ovarian cancer is one of the most promising fields for RIT. This paper gives an overview of some biodistribution studies in animal models and in patients with radiolabeled anti-ovarian cancer MAbs, and defines the main criteria which should be considered to plan a clinical trial of RIT in ovarian cancer. As regards the clinical results, the published outcome of various trials and the experience of the National Cancer Institute of Milan are summarized. Even if the number of patients involved in these clinical studies of RIT is too small to provide conclusive indications about its role in the management of ovarian cancer, the preliminary results from qualified groups show its potential in this disease despite the current problems that limit clinical application (above all, the instability of the radiolabeled linkage, the immunogenicity of murine antibodies, the poor absolute tumor radiolabel uptake and the bone marrow toxicity).
Immunohistochemical Detection of c-erbB-2 Expression by Neoplastic Human Tissue using Monospecific and Bispecific Monoclonal Antibodies
Authors: Garcia De Palazzo I. , Klein-Szanto A. , Weiner L. M.
Published: April 2018

Selected murine monoclonal antibodies (MAb) have been shown to inhibit relevant tumor growth in vitro and in animal models. Recently, bispecific antibodies (BsMAb) have been developed which target cytolytic effector cells via one antibody binding site and tumor antigen by the other specificity. For example, the BsMAb 2B1 possesses specificity for c-erbB-2 and Fcγ RIII, the low affinity Fcγ receptor expressed by polymorphonuclear leukocytes (PMN), macrophages and large granular lymphocytes (LGL). The human homologue of the rat neu oncogene, c-erbB-2, has been demonstrated to be amplified in breast, gastrointestinal, lung and ovarian carcinomas. Tumor expression of c-erbB-2 has been shown to be an important prognostic indicator in breast and ovarian carcinomas. The restricted expression of the c-erbB-2 protooncogene product in normal human tissues and the wide distribution of c-erbB-2 expression in such tumors may justify attempts to use an appropriately constructed BsM Ab in clinical trials. In this report we have addressed this issue by immunohistochemically evaluating the expression of c-erbB-2 oncogene product in a variety of malignant tumors utilizing 2B1 and the anti-c-erbB-2 monovalent parent of 2B1, 520C9. Among the studied neoplasms, c-erbB-2 expression was detected in 49% of primary carcinomas stained with 520C9 and in 39% of those stained with 2B1. In the group of metastatic tumors, c-erbB-2 oncoprotein was detected in 52% of cases by 520C9 and in 41% by 2B1. Our results indicate that immunocytochemistry using bispecific monoclonal 2B1 is a reliable method for the detection of c-erbB-2 expression, and that this BsMAb detects c-erbB-2 expression in tumors nearly as well as its anti-c-erbB-2 monovalent parent antibody.
Disappearance Rate of Serum Calcitonin after Total Thyroidectomy for Medullary Thyroid Carcinoma
Authors: Fugazzola L. , Pinchera A. , Luchetti F. , Iacconi P. , Miccoli P. , Romei C. , Puccini M. , Pacini F.
Published: April 2018

We studied the half-life of serum calcitonin (CT) in patients subjected to total thyroidectomy for medullary thyroid carcinoma (MTC). One patient showed a rapid serum CT component with a half-life of 3 hours and a slow component with a half-life of 30 hours; in another case only the 30-hour component was found. By chromatography of tumor extracts, we found that all the immunoreactive CT had a molecular weight of 3,600. After surgery, normalization of serum CT was achieved within 15 days in 4 patients, at 3 months and at 6 months in 2 other patients, while 1 patient never normalized. Normalization of serum CT after surgery is not an index of definitive cure in MTC, as demonstrated by one patient who relapsed 3 months after normalization of serum CT. However, as a general rule, patients who reach undetectable serum CT levels soon after surgery, are those having the best prognosis.
Serum Tumor Marker Half-Life during Chemotherapy in Patients with Germ Cell Tumors
Authors: Bosl G.J. , Head M.D.
Published: April 2018

Approximately 80% of previously untreated men with metastatic germ cell tumors will be cured with cisplatin-based chemotherapy. Serum levels of alpha fetoprotein (AFP) or human chorionic gonadotropin (HCG) or both are increased in most of these patients. Pre-treatment clinical characteristics can be used to distinguish between “good” and “poor” risk patients who are either highly likely or unlikely to achieve a complete remission, respectively. A slow rate of decline of either AFP or HCG or both has been associated with an inferior survival in both good and poor risk patients. In multivariate analysis, the pre-treatment risk status and the post-treatment clearance of markers were independent and equal prognostic variables. Similarly, in patients receiving cisplatin + ifosfamide-based salvage chemotherapy, the rate of decline of HCG was an independent predictor variable in addition to the primary site and pre-treatment HCG levels for both overall and event-free survival. Prolonged half-life clearance of serum tumor markers is an important prognostic variable in both previously untreated as well as previously treated germ cel tumor patients. Treatment strategies can be based on marker clearance and prospective clinical trials are warranted.
Evaluation of Cytokeratin 19 Serum Fragments (Cyfra 21–1) in Patients with Lung Cancer: Results of a Multicenter Trial
Authors: Bombardieri E. , Seregni E. , Bogni A. , Ardit S. , Belloli S. , Busetto A. , Caniello B. , Castelli M. , Cianetti A. , Correale M. , De Angelis G. , Gandolfo G.M. , Gion M. , Macchia V. , Mione R. , Navaglia F. , Onetto M. , Paganuzzi M. , Pecchio F. , Plebani M. , Rapellino M. , Ruggeri G. , Vannini P. , Vitelli G. , Zamperlin A.
Published: April 2018

Recently, a new immunometric assay (Cyfra 21–1) was developed to measure serum concentrations of a soluble fragment of cytokeratin subunit 19. With this method, supplied by Boehringer Mannheim (EIA Test Cyfra 21–1), an Italian multicenter trial was performed in patients with lung cancer. Cyfra 21–1 serum levels were determined in 568 normal subjects (blood donors), 607 patients with non-malignant diseases (491 respiratory diseases) and 730 patients with malignancies. In the latter group 584 had lung cancer. All these 584 patients had pathologically confirmed disease; 314 were epidermoid tumors, 166 adenocarcinomas, 88 small cell cancers and 16 large cell cancers.

In the 568 healthy blood donors the mean Cyfra 21–1 value was 0.91 ng/ml (SD 0.47 ng/ml; range 0.05–2.90 ng/ml). A threshold of 1.9 ng/ml was chosen as the upper limit of normality. High levels of Cyfra21–1 were observed in patients with chronic hepatitis (positivity rate: 17/51–33.3%) and with pancreatitis (positivity rate 5/16 - 31.3%). In 114 out of 491 (23.2%) patients with respiratory diseases Cyfra 21–1 showed values greater than 1.9 ng/ml. The overall sensitivity (all stages) of Cyfra 21–1 in lung cancer was 65.6% (383/584). When the histology was considered the highest positivity rates were found in patients with squamous cell tumors (226/314; 72%) followed by adenocarcinomas (105/166; 63%). In patients with SCLC the global sensitivity was 52.3% (46/88). Higher sensitivity of Cyfra 21–1 was observed from stage I to stage IV (53.9% vs 85.7%; Chisquare: p < 0.01). When comparing patients in whom curative resections were possible (up to stage IIIa) with patients suffering from inoperable tumors, a significant difference in Cyfra 21–1 positivies was found (59% vs 81.5%; Chi square p < 0.01).
A Preliminary Study on the Functional Analysis of Peripheral Blood Lymphocytes from Ovarian Cancer Patients Developing Hama after Immunoscintigraphy
Authors: Donnerstag B. , Baum R.P. , Oltrogge J.B. , Hertel A. , Hör G.
Published: April 2018

In the follow-up of ovarian cancer patients, rising levels of the tumor-associated antigen CA 125 are an indication for immunoscintigraphy. Human anti-mouse antibodies (HAMA) are frequently found after immunoscintigraphy with murine MAb directed against CA 125. Since we observed that patients developing high HAMA-levels in serum remained free of tumor or had stable disease, we examined the cytotoxic activity of peripheral blood lymphocytes (PBL) by a fluorescence-based assay. Our results demonstrate that PBLs of patients with high anti-idiotypic antibodies show an increased cytotoxic activity (by a factor of 4) compared to those of patients with low HAMA levels. The clinical course of the patients after the first injection of murine monoclonal antibody was observed over a period of 1 to 3 years. Improvement or deterioration of patients ‘ clinical condition corresponded with the results obtained by functional analysis. Further investigations concerning the course of cytotoxic activity in HAMA-positive patients will have to clarify HAMA's role in the immune response.
Correlation between Lipid-Associated Sialic Acid and Tumor Burden in Melanoma
Authors: Buzaid A.C. , Sandler A.B. , Hayden C.L. , Scinto J. , Poo W.-J. , Clark M.B. , Hotchkiss S.
Published: April 2018

Recent studies have suggested that lipid-associated sialic acid (LSA) may be a useful tumor marker for monitoring patients with melanoma, but the relationship between LSA and tumor burden has not been previously studied. We therefore examined LSA levels in 240 patients of whom 169 had no clinical evidence of disease (NED) and 71 had metastatic disease. There was a statistically significant difference in LSA levels in patients with NED compared with metastatic disease as well as those with high tumor burden compared with low or intermediate tumor burden. There was no difference between the groups with low and intermediate tumor burden. An LSA level of 25 mg/dl provided a positive predictive value of 70% and a negative value of approximately 80%. Our data show that LSA levels correlate with tumor burden in patients with melanoma.