bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishing a Disciplining Financial Disposition in the City of London: Resilience, Speed and Intelligence
Authors: Simpson Alex
Published: July 2019

Examining the strategies, investments and values employed by finance workers in the City of London, this article draws on interview and ethnographic data to develop a culturally dominant ‘financial disposition’. Manifesting as an overarching strategy of discipline, and identifying the interlocking performative values of resilience, speed and intelligence, the findings articulate how finance workers invest in a system of practical and cognitive social relations to uphold an ideologically coherent system of ‘frictionless’ financial exchange. In doing so, the article allows us to see how an ideologically dominant market order, which is overwhelmingly subject to structural levels of analysis, establishes a set of durable yet adaptable social relations that contribute to the production of a coherent market system. It is a development that gives new meaning to the ways individuals adapt and contribute to the reproduction of material and structural relations and come to characterise the financial experience.
Unsupervised fabric defect detection based on a deep convolutional generative adversarial network
Authors: Hu Guanghua , Huang Junfeng , Wang Qinghui , Li Jingrong , Xu Zhijia , Huang Xingbiao
Published: July 2019

Detecting and locating surface defects in textured materials is a crucial but challenging problem due to factors such as texture variations and lack of adequate defective samples prior to testing. In this paper we present a novel unsupervised method for automatically detecting defects in fabrics based on a deep convolutional generative adversarial network (DCGAN). The proposed method extends the standard DCGAN, which consists of a discriminator and a generator, by introducing a new encoder component. With the assistance of this encoder, our model can reconstruct a given query image such that no defects but only normal textures will be preserved in the reconstruction. Therefore, when subtracting the reconstruction from the original image, a residual map can be created to highlight potential defective regions. Besides, our model generates a likelihood map for the image under inspection where each pixel value indicates the probability of occurrence of defects at that location. The residual map and the likelihood map are then synthesized together to form an enhanced fusion map. Typically, the fusion map exhibits uniform gray levels over defect-free regions but distinct deviations over defective areas, which can be further thresholded to produce a binarized segmentation result. Our model can be unsupervisedly trained by feeding with a set of small-sized image patches picked from a few defect-free examples. The training is divided into several successively performed stages, each under an individual training strategy. The performance of the proposed method has been extensively evaluated by a variety of real fabric samples. The experimental results in comparison with other methods demonstrate its effectiveness in fabric defect detection.
A Case Study of iPad Implementation in One Rural Elementary School
Authors: Corey Lesley
Published: July 2019

The study explored the implementation of a 1:1 iPad initiative with a focus on leadership. The distributed leadership model provided the framework using semistructured interviews as the primary source of data collection. Using the distributed leadership model, the researcher examined the role of school leaders. Four emerging themes were identified: time, access, technical support, and professional development. Results showed that successful implementation of a 1:1 iPad program requires advanced planning including time to obtain new skills and to research and explore the vast potential of the iPad in an environment where technical assistance is available within reasonable time constraints.
The Social Integration of American Cities: Network Measures of Connectedness Based on Everyday Mobility Across Neighborhoods
Authors: Phillips Nolan E. , Levy Brian L. , Sampson Robert J. , Small Mario L. , Wang Ryan Q.
Published: July 2019

The social integration of a city depends on the extent to which people from different neighborhoods have the opportunity to interact with one another, but most prior work has not developed formal ways of conceptualizing and measuring this kind of connectedness. In this article, we develop original, network-based measures of what we call “structural connectedness” based on the everyday travel of people across neighborhoods. Our principal index captures the extent to which residents in each neighborhood of a city travel to all other neighborhoods in equal proportion. Our secondary index captures the extent to which travels within a city are concentrated in a handful of receiving neighborhoods. We illustrate the value of our indices for the 50 largest American cities based on hundreds of millions of geotagged tweets over 18 months. We uncover important features of major American cities, including the extent to which their connectedness depends on a few neighborhood hubs, and the fact that in several cities, contact between some neighborhoods is all but nonexistent. We also show that cities with greater population densities, more cosmopolitanism, and less racial segregation have higher levels of structural connectedness. Our indices can be applied to data at any spatial scale, and our measures pave the way for more powerful and precise analyses of structural connectedness and its effects across a broad array of social phenomena.
Preparation of polyurethanes with broad damping temperature range and self-healing properties
Authors: Lu Xun , Xu Min , Sheng Ye-ming , Li Zhi-peng , Li Han-mo
Published: July 2019

It is urgent for polyurethane (PU) damping materials to broaden the effective damping range. Based on the designability of PU, this study is focused on the role of long dangling chain, wherein prepared by the reaction of polyethylene glycol monomethyl ether with toluene-2,4-diisocyanate. Notably, the introduction of long dangling chain not only makes the dangling chain longer and enhances the intermolecular interaction but also equips the dangling chain with strong polar carbamate group, bringing about more excellent compatibility of the soft and hard segments and lower degree of microphase separation under the condition of hydrogen bonding. The results show that the damping performance increases with the synergistic effect of significant hydrogen bonding and decreased degree of microphase separation, and the effective damping temperature range (tan δ ≥ 0.3) can exceed 150°C (−50°C to 100°C). Simultaneously, the addition of long dangling chains endows PU with self-healing property, the self-healing rate of system reaches maximum 70% with shore A hardness of 15 because of the synergistic effect above with the addition of 60% dangling chain, which extends the service life of PU damping materials.
Wind turbines power regulation using a low-complexity linear parameter varying-model predictive control approach
Authors: Bahmani Hamidreza , Bayat Farhad , Golchin Mohamadjavad
Published: July 2019

In this paper, the model predictive control (MPC) approach is utilized to stabilize the output power of the wind turbines at the region above the rated wind speed. The controller is designed based on two different approaches and results have been compared. First, by putting the advantages of the MPC approach into practice, the optimal output power regulation of the wind turbine is obtained using a control oriented linear parameter varying (LPV) model of the wind turbine. However, this method inherently requires high computational cost and thus powerful hardware and processors. To cope with this limitation, an efficient suboptimal approach is proposed that significantly reduces the online computational complexity of the controller. In this approach, the main part of the controller design procedure is done off-line prior to the closed-loop wind turbine power generation and a set of optimal controllers were designed using the MPC scheme. Then, a convex combination of the calculated controllers is used for online power regulation of the wind turbine. It is noted that the selected wind turbine is a horizontal axis wind turbine operating at various speeds ranging from 10-25 m/s. Finally, using a set of simulation results we investigate the performance of the proposed approach.
Mothers’ parenting knowledge and its sources in five societies: Specificity in and across Argentina, Belgium, Italy, South Korea, and the United States
Authors: Bornstein Marc H. , Yu Jing , Putnick Diane L.
Published: July 2019

In a cross-society comparison, we assessed the state of mothers’ knowledge of child-rearing and child development. The study included 1,077 mothers from five countries on four continents: Argentina, Belgium, Italy, South Korea, and the United States (U.S.) A criteria-referenced instrument, the Knowledge of Infant Development Inventory, was used to assess parenting knowledge after being adapted for cross-society comparison using item response theory and the alignment optimization approach for testing between-sample measurement invariance. Levels of mothers’ parenting knowledge varied across the five societies and were associated with different sociodemographic factors and personal and nonpersonal supports.
Democratizing dictators? Non-democratic regime conditions and the allocation of US democracy assistance, 1975–2010
Authors: Scott James M , Carter Ralph G
Published: July 2019

As the USA initiated strategies of democracy promotion to support the spread of democracy, a key element involved democracy assistance. However, some states receive substantial commitments of US democracy aid while other states receive little or none, and the mix of democracy assistance varies in allocation between civil society and institutional channels. This study examines democracy aid allocation, focusing on the role of regime conditions on the targeting and composition of the aid. We disaggregate regime type to differentiate among non-democratic governments and argue that such differences affect both the amount of democracy aid and whether aid packages target government institutions or civil society channels. We theorize how these regime conditions shape allocations, controlling for donor interests and recipient features, and test our argument against US democracy aid allocations by the US Agency for International Development (USAID) from 1975 to 2010. We conclude with discussion of the implications of these findings.
The Pluralistic Problematic: William James and the Pragmatics of the Pluriverse
Authors: Savransky Martin
Published: July 2019

In his lectures on pragmatism, William James famously proposed that the question of ‘the one and the many’ constitutes the most central of all philosophic problems, and that it is ‘central because so pregnant’. Prompted by James’ proposition, this article explores the intimately political connection in James’ thought between his pluralistic metaphysics and the nature of the problematic as a generative force that impregnates worlds and thoughts with differences: what I here call ‘the pluralistic problematic’. Exploring the generative significance of the problematic in James’ philosophy, I propose that, where James is concerned, the pluriverse has a thoroughly problematic mode of existence. And pluralism, rather than a celebration of the many, rather than a philosophical exposition on multiple worlds and ontologies, or a theory of the organisation of a diverse polis, is first and foremost a pragmatics of the pluriverse – a political, experimental and pragmatic response to the ongoing insistence of the pluralistic problematic.
Correlation between adverse events after drug treatment and the MDR1 C3435T polymorphism in advanced non-small cell lung cancer patients in an Asian population: a meta-analysis
Authors: Luo Hua , Qin Guangmei , Yao Caoyuan
Published: July 2019

Objective

To determine the association between the multidrug resistance 1 gene ( MDR1) C3435T polymorphism and adverse drug reactions in advanced non-small cell lung cancer (NSCLC) patients in Asia.

Methods

Literature about the relationship between the MDR1 C3435T polymorphism and adverse drug reactions in advanced NSCLC patients were collected from three English language databases (PubMed, Cochrane, and Embase) as well as three Chinese databases (Wanfang, China Knowledge Network, and the Chinese Biomedical Literature Database), and summarized by a meta-analysis.

Results

NSCLC patients with the T allele or TT genotype were significantly more likely to experience diarrhea than those with other genotypes under the allele model (odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.04–2.61), homozygous model (OR = 3.87, 95% CI: 1.49–10.07), and recessive model (OR = 4.48, 95% CI: 1.88–10.68). Similarly, these patients were significantly more likely to experience skin rash under the allele model (OR = 2.41, 95% CI: 1.24–4.66), homozygous model (OR = 4.77, 95% CI: 1.13–20.15), and dominant model (OR = 1.77, 95% CI: 1.03–3.05).

Conclusions

Asian NSCLC patients with the MDR1 C3435T T allele or TT genotype are significantly more likely to develop diarrhea and rash after drug treatment.
Association between osteopontin expression and asthma: a meta-analysis
Authors: Xu Hangdi , Lou Wei , Fu Fangfang
Published: July 2019

Objective

Osteopontin (OPN) plays an important role in chronic airway remodeling and bronchial hyperresponsiveness. The association between OPN protein expression and asthma has been investigated extensively, but the results of these studies are inconsistent. The aim of this meta-analysis was to determine the relationship between OPN protein expression and asthma.

Methods

A systematic search was performed to identify published studies regarding the association between OPN protein expression and asthma. Studies with quantitative data were analyzed, and standardized mean differences were determined with 95% confidence intervals.

Results

Nine studies were included in this analysis, involving 706 patients with asthma and 332 healthy controls. The pooled data from these studies demonstrated that OPN protein expression was significantly higher in patients with asthma than in controls. There was no significant difference in OPN protein between allergic asthma and nonallergic asthma. Moreover, there was no obvious relationship between OPN protein expression and the severity of asthma.

Conclusion

The results of this meta-analysis suggested that OPN protein expression is significantly upregulated in patients with asthma, but that it does not correlate with the type or severity of asthma.
Progressive diffuse idiopathic spinal hyperostosis: a case report
Authors: Matsumoto Koji , Uei Hiroshi , Tokuhashi Yasuaki
Published: July 2019

Diffuse idiopathic spinal hyperostosis (DISH) causes various problems, such as adjacent disc dysfunction, pseudarthrosis, or reossification, when spinal surgery is performed or spinal fracture occurs. The authors herein describe a patient with DISH in whom ossification of the anterior longitudinal ligament progressively advanced from the thoracic to sacral vertebrae during a 14-year period. Surgery was performed three times to treat the characteristic problems associated with DISH: abnormal sagittal alignment of the spine, ossification of the posterior longitudinal ligament, reossification of the laminectomy-treated regions and accompanying spinal canal stenosis, pseudarthrosis after spinal fracture, and delayed palsy. DISH-associated problems after spinal fusion are not rare, but this patient developed a particularly large number of problems often seen in the long term after spinal fusion in patients with DISH. Clinicians must be aware of problems being likely to occur in ossification-discontinuous and fragile regions during the postoperative follow-up.
Epirubicin and Gemcitabine as First-Line Treatment in Malignant Pleural Mesothelioma
Authors: Portalone Luigi , Antilli Antonio , Nunziati Francesco , Crispino Carlo , DeMarinis Filippo , Friggeri Luigi , Lombardi Alessandra , LoRusso Vito , Pranzato Paolo , Sambiasi Domenico , Signora Mauro
Published: July 2019

Malignant pleural mesothelioma represents a rare disease, for which chemotherapy actually remains unsatisfactory. From August 1998 to November 2001, 28 chemo-radio-immunonaive patients were consecutively enrolled in the trial: 22/6 males/females; median age 63 years (range, 45-79); median ECOG PS 1 (range, 0-2). They were treated with epirubicin (100 mg/m2 iv on day 1) plus gemcitabine (1000 mg/m2 iv on days 1 and 8) every 4 weeks for 6 cycles. Patients who responded to chemotherapy (n = 6) were subsequently treated with interleukin-2 (4,500,000 IU) subcutaneously every other day, until progression. A total of 124 epirubicin-gemcitabine cycles were administered (median, 6/patient; range, 2-6). Twenty-six patients were evaluated for toxicity. According to WHO criteria, we observed grade III-IV hematological and gastrointestinal toxicity respectively in 3 patients (11%) and 1 patient (3%). No red cell transfusions were required and no toxic deaths occurred. Two patients (8%) could not be evaluated for response (no therapy performed). According to WHO criteria, the final responses were: partial in 4 patients (14%), stable disease in 19 patients (69%), and progression in 3 patients (10%). In 26 patients, the median survival was 55 weeks (range, 7-222) and median time to progression 30 weeks (range, 4-156). At the time of this writing, no patient is alive. The 1-year survival was 32%, 2-year survival 11%, and 4% at 3 and 4 years. All patients were at stage III, and time to progression was 58 weeks and survival 63.5 weeks, without any toxicity. This multi-center phase II clinical trial showed that epirubicin plus gemcitabine, as a first-line treatment in malignant pleural mesothelioma, has promising activity with a good tolerability profile and symptom palliation. The role of interleukin-2 in maintenance therapy for malignant pleural mesothelioma is encouraging and requires further study.
Altered Fractionation Radiotherapy in Head and Neck Cancer: Clinical Issues and Pitfalls of “Evidence-Based Medicine”
Authors: Antognoni Paolo , Corvò Renzo , Zerini Dario , Orecchia Roberto
Published: July 2019

The authors present a critical appraisal of the biological bases of altered fractionation and a brief overview of published randomized trials with conventional fractionation as the control arm, reviews and meta-analysis on altered fractionation radiotherapy in head and neck cancer. The major controversial issues emerging from these studies are reviewed and the limiting factors which so far have prevented the widespread use of altered fractionation regimens in current clinical practice are analyzed. Future perspectives regarding predictive biological assays for patient selection and the integration of altered fractionation regimens with radiochemotherapy protocols, biomodulators and novel radiotherapy techniques are also reviewed and summarized.
Hemoglobin Levels and Acute Radiotherapy-Induced Toxicity
Authors: Barón Ricardo Escó , Julve Javier Valencia , Jaime Sonia Polo , Santaló Natividad Bascón , Millán Carmen Velilla , Mata Miriam López
Published: July 2019

Aims and background

To analyze the possible correlation between hemoglobin concentration and the appearance of acute radiotherapy-induced toxicity.

Methods

We prospectively studied hemoglobin levels and acute radiotherapy-induced toxicity in 86 patients treated for 3 months. Both sexes were considered to have anemia if their hemoglobin level was ≤12 g/dL. No patient received corrective treatment for hemoglobin levels. Acute toxicity was analyzed weekly during radiotherapy and 45 days after therapy ended. The possible relationship between anemia and toxicity was analyzed, as was the correlation between hemoglobin values and the degree of toxicity.

Results

The findings were similar for all prognostic factors in patients with and without anemia. Hemoglobin concentration was ≤12 g/dL in 24 patients (27.9%; mean, 10.93 ± 0.78 g/dL). At the end of radiotherapy, hemoglobin levels were ≤12 g/dL in 18 patients (20.9%; mean, 11.26 ± 1.06 g/dL). The correlation between pretherapy and posttherapy hemoglobin concentration was significant at r = 0.729 (P = 0.01). The correlation between absolute hemoglobin values and the degree of toxicity, and the possible relationship between hemoglobin concentration and the appearance or the degree of toxicity after radiotherapy, was not significant.

Conclusions

The relationship between hemoglobin concentration and oxygenation of the tumor and healthy tissues was not linear. This may account for the influence of hemoglobin levels on control of the disease as reported in earlier studies, but it does not account for their influence on acute toxicity after radiotherapy.
High Plasma Levels of Human Chromogranin a and Adrenomedullin in Patients with Pheochromocytoma
Authors: Cotesta Dario , Caliumi Chiara , Alò Piero , Petramala Luigi , Reale Maria Gabriella , Masciangelo Raffaele , Signore Alberto , Cianci Rosario , D'Erasmo Emilio , Letizia Claudio
Published: July 2019

Aims and background

The aim of our study was to investigate the plasma chromogranin A (CgA) and adrenomedullin (AM) levels in patients with pheochromocytomas.

Methods and study design

We collected blood samples for measurement of plasma CgA and AM in 21 patients with pheochromocytomas, 43 healthy subjects and 26 patients with solid non-functioning adrenocortical adenomas. In 11 patients with pheochromocytomas plasma CgA and AM were measured again four weeks after tumor removal. CgA and AM were measured by means of a novel solid-phase two-site immunoradiometric assay based on monoclonal antibodies (CgA-RIA CT, CIS bio international) and by a specific radioimmunoassay (RIA, Phoenix Pharm. Inc.), respectively.

Results

The mean plasma CgA level (±SD) in patients with pheochromocytomas (204 ± 147.9 ng/mL) was significantly higher (P <0.001) than that in healthy subjects (41.6 ± 10.7 ng/mL) and in patients with non-functioning adrenocortical adenomas (47.3 ± 17.6 ng/mL). The mean plasma AM concentration (±SD) in patients with pheochromocytomas (27.5 ± 10.4 pg/mL) was significantly higher (P <0.001) than that in HS (13.8 ± 4.5 pg/mL) and in patients with non-functioning adrenocortical adenomas (16.6 ± 7.3 pg/mL). Plasma CgA levels correlated with plasma AM levels (r = 0.501; P <0.02) and with plasma metanephrine levels (r = 0.738; P <0.0001) in patients with pheochromocytomas. In 11 patients with pheochromocytomas plasma CgA and AM concentrations significantly decreased after tumor removal (P <0.001 for both). Circulating CgA and AM had a sensitivity of 76.2% and 81%, a specificity of 97.7% and 90.7%, and an accuracy of 91% and 88%, respectively.

Conclusion

This study demonstrates that circulating CgA and AM levels are increased in pheochromocytoma patients compared with healthy subjects and patients with non-functioning adrenocortical adenomas. Moreover, at the time of diagnosis plasma CgA levels correlated with plasma AM levels and with plasma metanephrine levels in all patients with pheochromocytomas. In conclusion, plasma CgA and AM concentrations may represent additional biochemical parameters for clinical monitoring of patients with pheochromocytomas.
The Role of Quantitative Polymerase Chain Reaction in the Management of Follicular Lymphoma Patients
Authors: Perego Roberto A , Cairoli Roberto , Cornacchini Giorgia , Bianchi Cristina , Corizzato Matteo , Tresoldi Elisabetta , Morra Enrica
Published: July 2019

Aims and background

In order to increase the prognostic significance of polymerase chain reaction (PCR) data it has been suggested that quantitative PCR can be used to measure tumor burden. However, this option has not yet been definitely supported or refuted in patients with follicular lymphoma (FL). We decided to evaluate whether knowledge of the quantitative level of minimal residual disease and its variations can be of use in the management of FL patients.

Methods

We used qualitative and competitive PCR to study 11 patients with refractory or relapsed FL harboring the t(14;18) translocation who underwent autologous (nine patients) or allogeneic (two patients) stem cell transplantation (SCT). Competitive PCR was performed with a multiple competitor carrying specific sequences including Bcl2/lgH MBR and mcr, and the β-globin gene.

Results

After a median post-SCT follow-up of 44 months (range, 12-62), overall survival was 91% and disease-free survival 82%. The quantitative PCR data showed that: 1) effective chemotherapy before SCT substantially (1-2 log) reduced the tumor burden in the bone marrow (BM); 2) the increase in rearranged DNA detected in BM was associated with disease progression and relapse; 3) a PCR-negative autograft seemed to lead to lasting molecular remission even when it was performed in patients with a low level of BM infiltration before transplant; and 4) allo-SCT made and maintained the BM PCR negative even in the presence of a greater tumor burden before SCT. Six of the nine patients having CR after SCT (four auto and two allo) are in continuous molecular remission.

Conclusions

In FL patients qualitative and quantitative PCR may provide data that can be helpful for the prognostic evaluation of tumor progression and the early detection of impending relapse by highlighting biological features such as the quality of the infused material, the tumor burden at transplant, and the behavior of tumor cells after transplant.
Efficacy of Imatinib Mesylate in a Patient with Idiopathic Hypereosinophilic Syndrome and Severe Heart Involvement
Authors: Anghel Gabriel , De Rosa Luca , Ruscio Carla , Petti Nicola , Riccardi Massimo , Severino Alessandro , Majolino Ignazio
Published: July 2019

Idiopathic hypereosinophilic syndrome (HES) is a rare, chronic hematological disease mainly characterized by unexplained prolonged eosinophilia, with frequent evidence of secondary organ damage. Treatment with steroids, chemotherapy, interferon-alpha (IFN-α), or imatinib-mesylate may improve the prognosis.

Here we describe the case of a young male patient with a six-year history of HES and severe heart involvement who, after unsuccessful treatment attempts with steroids, hydroxyurea and IFN-α, had a prompt, clinical and hematological complete remission following administration of imatinib. As his cardiac function also markedly improved, he was considered for heart transplant. However, seven years after the onset of the disease and four months after the termination of imatinib treatment the patient died of a cerebral hemorrhage that occurred during an episode of acute respiratory sepsis. Imatinib has been previously reported to be effective in some hematological conditions with no evidence of the BCR/ABL transcript. The mechanisms that are probably involved in the response to imatinib in HES are also discussed.
Complete Remission of Poorly Differentiated Squamous Liver Carcinoma after Systemic Chemotherapy and Surgery a Case Report
Authors: Boscolo Giorgia , Jirillo Antonio , Da Pian Pierpaolo
Published: July 2019

We report the case of a 64-year-old male patient diagnosed as having inoperable poorly differentiated liver carcinoma that could be completely resected after systemic chemotherapy with cisplatin and 5-fluorouracil.
Primary Malignant Melanoma of the Small Bowel a Case Report and Review of the Literature
Authors: Krüger Stefan , Noack Frank , Blöchle Christian , Feller Alfred C
Published: July 2019

Although small bowel involvement by malignant melanoma is most frequently metastatic, a primary origin at this site has been reported in rare cases. The biological and clinical features of these cases have not yet been summarized. Here, another case of small bowel melanoma is described, and a review of the existing literature is given. An 81-year-old man presented with anemia and gastrointestinal bleeding. A tumor of the ileum was detected by video capsule endoscopy and removed by segment resection. Histological examination revealed a malignant melanoma of the ileum. Another primary site could be excluded by clinical and radiographic examination. The patient felt well five months after surgery.

Only 18 cases of primary small bowel melanoma (including the present one) have been reported to date. A literature review reveals that this rare neoplasm is associated with a slight predilection for the male gender, a predilection for the ileum and a poor prognosis.
Development of Squamous Cell Carcinoma of the Tongue during Induction Chemotherapy for Acute Myeloid Leukemia
Authors: Ural Ali Ugur , Avcu Ferit , Yilmaz Mahmut Ilker , Guden Metin , Ozturk Bekir , Ozcan Ayhan , Guran Sefik , Bahce Muhterem , Yalcin Atilla
Published: July 2019

Immunosuppression is a well-recognized cause of skin tumors, in particular squamous cell carcinomas (SCC). In patients with hematological malignancies undergoing chemotherapy, SCC has been reported late in the course of the disease or many years after completion of treatment. Here we report a patient with acute myeloid leukemia who developed a SCC of the tongue while receiving the third course of induction chemotherapy. This is the second such case in the medical literature. The role of immunosuppression, chemotherapy, the malignancy itself and possible genetic predisposition is discussed and the literature on this topic is reviewed.
Primary Orbital Liposarcoma in Li-Fraumeni Cancer Family Syndrome: A Case Report
Authors: Poli Tito , Laganà Francesco , Caradonna Luigi , Gobbi Roberta , Corradi Domenico , Sesenna Enrico
Published: July 2019

Aims and background

The aim of this study was to describe a case of primary orbital liposarcoma in Li-Fraumeni syndrome.

Methods and study design

In July 1998 a 20-year-old woman with a histological diagnosis of orbital myxoid liposarcoma underwent surgical treatment in our department. Since the patient's family pedigree met the clinical criteria for the diagnosis of LFS, molecular analysis was performed, which resulted in a molecular profile consistent with Li-Fraumeni syndrome.

Results

The patient underwent orbital exenteration extended to the upper eyelid; surgical reconstructive steps were performed to permit placement of an orbital prosthesis. Two years after primary surgery the patient underwent a quadrantectomy with lymphadenectomy of the right axilla because of the presence of a nodule of 1.5 cm in diameter in the upper-lateral quadrant of the right breast. One year after the last surgery, the patient is disease free.

Conclusion

The diagnosis of an orbital malignancy in a young patient with a family history of cancer should suggest the presence of an underlying genetic disorder like LFS; with molecular analysis we can now determine the genetic disorder and the exact location of the mutation, and also obtain important prognostic data using specific cellular markers. More prognostic information increases the chances of adequate personalized treatment.
Pericardial Metastases in a Long-Surviving Patient with Sigmoid Carcinoma
Authors: Lattuada Sara , Saggia Chiara , Biaggi Gabriele , Santagostino Alberto , Forti Giorgio , Manachino Domenico , Beilan Luciano , Pollo Maria Cristina , Alabiso Oscar
Published: July 2019

Cardiac metastases are rare in patients affected by colorectal cancer. This is the case of a woman who underwent a colon resection because of a metastatic sigmoid carcinoma, that survived for more than 6 years and died for malignant pericardial effusion.
Study of Sunbathing in Children: The Preliminary Evaluation of a Prevention Program
Authors: Manganoni Ausilia Maria , Cainelli Tullio , Zumiani Giuseppe , Bufalino Rosaria , Calzavara-Pinton Piergiacomo , Camerini Tiziana , Tucci Giovanna , Baldi Marzia , Venturini Marina , Marini Giovanni , Cascinelli Natale
Published: July 2019

Aims and background

Sunburn during childhood is associated with an increased risk for developing melanoma in an adult age. The aim of the present study was to define the validity of our educational program in order to teach the positive effects and risks of sun exposure during childhood.

Patients and methods

We conducted a population-based, case-control study in primary schools of three towns in Northern Italy (Brescia, Bergamo and Trento) between 2001 and 2002. The study was carried out on 1945 pupils (aged 8-9 years) and included 1309 case children who received an educational program before the summer to increase awareness towards sun exposure and 636 control children who did not. Parents of case and control children were interviewed using a questionnaire about their children's skin characteristics, sun protective behavior and sunburns. The questionnaire was completed twice, before and after the summer, to verify the changes of sun exposure habits.

Results

A significant decrease in sunburns was demonstrated in the group of subjects who received the educational program, indicating the validity of our operative procedure (from 14.6% to 10%, P = 4 × 10−4).

Conclusions

Our educational melanoma program may be important to disseminate in a wider range of children a correct education on sun exposure during childhood.
Cisplatin and Weekly Docetaxel as First-Line Therapy in Patients with Advanced Non-Small Cell Lung Cancer a Phase II Study
Authors: Tartarone Alfredo , Romano Gianpiero , lodice Giovanni , Capobianco Alba , Coccaro Mariarosa , Bochicchio Annamaria , Di Leo Pasquale , Ardito Raffaele , Di Renzo Nicola
Published: July 2019

Background

Based on the results of previous phase I studies, in the current phase II trial we evaluated the efficacy and toxicity of cisplatin plus weekly docetaxel in the treatment of advanced non-small cell lung cancer (NSCLC).

Patients and methods

The eligibility criteria for the study included newly diagnosed stage IIIB/IV NSCLC, age ≤75 years, Eastern Cooperative Oncology Group performance status of 0-2, adequate organ functions, and signed informed consent. The chemotherapy regimen consisted of cisplatin, 80 mg/m2 on day 1, and docetaxel, 25 mg/m2 on days 1, 8 and 15 every 4 weeks.

Results

Between January 2002 and December 2003, 31 patients with NSCLC were enrolled in the study. An objective response rate of 40% (95% CI, 21-60) was obtained in 27 assessable patients. The median time to progression was 6.4 months (range, 2.5-26.3) and median overall survival was 10.01 months (range, 5-28.3). The regimen was well tolerated with no grade 4 toxicity.

Conclusions

Cisplatin plus weekly docetaxel is an effective and well-tolerated regimen in chemo-naive patients with advanced NSCLC. A phase III study of weekly versus the conventional regimen of every three weeks should be conducted to compare the survival benefits, toxicity profile and quality of life.
A Pilot Study on the Effect of Acetyl-L-Carnitine in Paclitaxel-And Cisplatin-Induced Peripheral Neuropathy
Authors: Maestri Antonio , De Pasquale Ceratti Adolfo , Cundari Sante , Zanna Claudio , Cortesi Enrico , Crinò Lucio
Published: July 2019

Aims and background

In addition to bone marrow suppression and renal toxicity, neurotoxicity is a commonly occurring side effect of widely used chemotherapeutic agents like taxanes, cisplatin and vinca alkaloids. Neurotoxicity can cause antitumor therapy discontinuation or dose regimen modification. The aim of the present exploratory study was to investigate the activity of acetyl-L-carnitine in reversing peripheral neuropathy in patients with chemotherapy-induced peripheral neuropathy.

Methods and study design

Twenty-seven patients (16 males and 11 females) with paclitaxel and/or cisplatin-induced neuropathy (according to WHO recommendations for the grading of acute and subacute toxic effects) were enrolled. Patients received at least one cisplatin- (n = 5) or one paclitaxel- (n = 11) based regimen, or a combination of both (n = 11). Patients with chemotherapy-induced peripheral neuropathy were treated with acetyl-L-carnitine 1 g/die iv infusion over 1-2 h for at least 10 days.

Results

Twenty-six patients were evaluated for response having completed at least 10 days of acetyl-L-carnitine therapy (median, 14 days; range, 10-20). At least one WHO grade improvement in the peripheral neuropathy severity was shown in 73% of the patients. A case of insomnia related to ALC treatment was reported in one patient. Acetyl-L-carnitine seems to be an effective and well-tolerated agent for the treatment of chemotherapy-induced peripheral neuropathy.

Conclusions

Our preliminary results should be confirmed in double-blind, placebo controlled studies.
Treatment of Uterine Sarcoma at the University of Florence from 1980-2001
Authors: Livi Lorenzo , Paiar Fabiola , Meldolesi Elisa , Simontacchi Gabriele , Amunni Gianni , Barca Raffaella , Villanucci Alessandro , Scoccianti Silvia , Piperno Gaia , Biti Gianpaolo
Published: July 2019

Purpose

To correlate the treatment used in uterine sarcoma with outcome. The prognostic importance of pathology, clinical parameters and treatment are analyzed.

Patients and methods

Forty patients (median age, 59 years; range, 37-85) with histologically verified uterine sarcoma were identified from a database compiled at the University of Florence from 1980 to 2001. Patients were followed for a median of 54 months (range, 3 months to 10 years). Twenty-four patients had leiomyosarcoma, 12 patients had mixed mullerian tumors, and 3 patients had endometrial stromal sarcoma. Stage I, II, III and IV tumors were identified in 22, 2, 9 and 7 patients, respectively. High, intermediate, low and unspecified grade sarcoma occurred in 9, 4, 5 and 22 patients, respectively.

Results

At the time of analysis, 58% of patients had died and 42% were alive, with a median survival of 2 years from the initial diagnosis. Cause-specific survival for the entire group was 81%, 41% and 25% at 1, 3 and 5 years, respectively. In our series, univariate analysis for cause-specific survival did not demonstrate statistical significance for histology, grade, stage or age. There appeared to be a significant impact for postoperative radiotherapy in reducing local recurrence with a total dose higher than 50 Gy.

Conclusions

Our data favor treatment for uterine sarcoma with radical surgery plus irradiation, even in elderly patients.
Intraoperative Gamma Probe Detection of Head and Neck Paragangliomas with 111In-Pentetreotide: A Pilot Study
Authors: Filippi Luca , Valentina Fabrizio Benedetti , Gossetti Bruno , Gossetti Francesco , De Vincentis Giuseppe , Scopinaro Francesco , Massa Rita
Published: July 2019

Aims and background

The aim of this study was to assess whether intraoperative radiolocalization of head and neck paragangliomas with 111In-pentetreotide may increase surgical effectiveness, reducing the risk of recurrence.

Methods

Our study included eight patients with untreated, recently diagnosed paragangliomas (four unilateral and four bilateral tumors of the carotid body). After iv injection of −150 MBq 111In-pentetreotide, preoperative somatostatin receptor scintigraphy (SRS) was performed. SPECT of the neck was performed at four hours and planar Images of the head and neck were also obtained at four and 24 hours post injection. Scintigraphy was always compared with the results of conventional imaging methods (MRI, angiography and sonography). Intraoperative detection was performed on 11 lesions 24 hours after radiopharmaceutical administration using a handheld gamma probe.

Results

Preoperative SRS showed high radiotracer uptake in all patients. All the intraoperatively detected lesions were radically resected and histologically confirmed to be involved by tumor. No false positive results were recorded. Gamma probe detection revealed a small intracranial extension not detected by other imaging methods in a patient with a paraganglioma of the right carotid, and partial involvement of the carotid artery in another patient. During follow-up (median 3.5 years; range, 4 months-7 years) all patients remained disease free according to all parameters.

Conclusions

To our knowledge, this is the first experience of radioguided surgery in paraganglioma. Although our study included a relatively small number of patients, we suggest that intraoperative gamma probe detection may be a powerful tool to improve surgical effectiveness.
Localized Hand-Foot Syndrome after Intra-Arterial Hepatic Chemotherapy with Floxuridine: A Clinical Case
Authors: Bareggi Claudia , Paleari Daniela , Garassino Marina Chiara , Mora Monica , Salamina Silvia , Senecione Monica , Ghidini Antonio , Pancera Gianfranco
Published: July 2019

Hand-foot syndrome is a toxic effect of some chemotherapy agents such as 5-fluorouracil (5-FU), capecitabine and liposomal doxorubicin. The symptoms and signs are localized erythema and paresthesia. Floxuridine (FUDR) is an analogue of 5-FU, used for arterial hepatic infusion in patients affected by liver metastases from colorectal cancer. A patient who was treated for colorectal cancer with liver metastases underwent locoregional chemotherapy with FUDR and systemic chemotherapy with FOLFOX4. After three cycles he developed severe painful dermatitis of the right leg. Abdominal X-ray showed displacement of the catheter to the right common iliac artery. Treatment was discontinued and the patient had a rapid recovery.
Primary Malignant Melanoma of the Stomach
Authors: Jelincic Zeljko , Jakic-Razumovic Jasminka , Petrovic Igor , Cavcic Ana Marija , Unušic Josip , Trotic Robert
Published: July 2019

We report a 54-year-old patient with a complaint of weakness, abdominal pain and weight loss. During the clinical examination a palpable tumor resistance in the abdomen was found as well as iron deficiency anemia. Gastroscopy showed an exulcerated, dark brown, fungiform tumor about 4 cm in diameter at the great curve of stomach. Endoscopic biopsy revealed the diagnosis of malignant melanoma by demonstrating the presence of melanin containing tumor cells in gastric mucosa. The patient underwent subtotal gastrectomy, appendectomy and splenectomy. The diagnosis of gastric melanoma with regional lymph node metastases, as well as metastases in appendix adjacent tissue was confirmed by histology and immunohistochemistry. In three years follow up period patient developed cerebral and retroauricular subcutaneous metastases that were treated by surgery, adjuvant chemotherapy and radiotherapy. Finally, an explorative laparotomy was revealed advanced intraabdominal tumor dissemination with dark pigmented ascites. Concerning that all available diagnostic procedures failed to prove other site of melanoma, presented case was considered as primary gastric melanoma as a possible rare site of tumor.
Concurrent 5-Fluorouracil, Mitomycin C and Radiation with or without Brachytherapy in Recurrent Cervical Cancer: A Scoring System to Predict Clinical Response and Outcome
Authors: Smaniotto Daniela , D'Agostino Giuseppe , Luzi Stefano , Valentini Vincenzo , Macchia Gabriella , Mantini Giovanna , Margariti Pasquale Alessandro , Ferrandina Gabriella , Scambia Giovanni
Published: July 2019

Aims and purpose

This is a prospective, phase II study aimed to evaluate the effect of concurrent 5-fluorouracil, mitomycin C, and radiation with or without brachytherapy on the clinical outcome of a series of recurrent cervical cancer patients and to determine the prognostic impact of a subset of factors.

Methods

Thirty-three patients with locally recurrent, non-metastatic cervical cancer received external beam radiation (4-week split course: 23.4 + 23.4 Gy) plus two courses of concomitant chemotherapy (5-fluorouracil, 96-h continuous infusion, days 1–4, 1 g/m2/day; mitomycin C, 10 mg/m2, bolus iv, day 1). Twelve patients with vaginal recurrence (36.4%) underwent endocavitary low-dose rate brachytherapy boost (20–25 Gy); 11 patients with lateral pelvic recurrence (33.3%) received external beam radiation boost (14–20 Gy).

Results

Fourteen complete responses (42.4%), 7 partial responses (21.2%), 5 disease stabilizations (15.1%) and 7 progressions (21.2%) were obtained. After a median follow-up of 34 months (range, 6–127), overall actuarial 3-year survival, progression-free survival and local progression-free survival were 59.7%, 48.1% and 51.7%, respectively. Patients with vaginal recurrence of less than 4 cm and negative lymph nodes proved to respond best to the treatment. Two patients (6.1%) experienced hematologic grade 3 toxicity. One patient had grade 3 intestinal toxicity (3.0%). No patient had major skin or urological acute toxicity. Severe late toxicity was infrequent Three patients had prolonged leukopenia (9.0%). Four patients showed severe vaginal stenosis (12.1%). A clinical score of 0 to 1 was assigned to each patient on the basis of the absence (score = 0) or presence (score = 1) of any of the following prognostic factors: time between surgery and recurrence shorter than 12 months, pelvic wall site of recurrence, positive lymph nodes, hemoglobin <11 g/dL. Using this system, it was clear that patients with a low total score had a significantly better outcome (clinical remission, 51% of patients with a score ≤2 vs 12% of patients with a score >2, P = 0.06), local control of the disease (65% vs 20% after 3 years, P = 0.001,) and overall survival (75% vs 30% after 3 years, P = 0.032).

Conclusions

Our data suggest that this combined modality therapy was relatively well tolerated and resulted in reasonable local control and survival. The scoring system proved to be helpful to identify patients with the greatest chance of benefiting from the treatment Further studies are probably needed to salvage the other patients, whose prognosis remains severe.
Irinotecan and Oxaliplatin Combination, As Second-Line Treatment, In Fluoropyrimidine-Pretreated Advanced Colorectal Cancer. A Phase Ii Study by the Hellenic Cooperative Oncology Group (Hecog)
Authors: Timotheadou Eleni , Papakostas Pavlos , Tsavdaridis Dimitrios , Basdanis George , Kalofonos Haralambos , Aravantinos Gerasimos , Bafaloukos Dimitrios , Fountzilas George
Published: July 2019

Background

The management of patients with fluoropyrimidine-resistant advanced colorectal cancer remains investigational. Irinotecan and oxaliplatin have proved effective in first-line treatment in combination with 5-fluorouracil.

Study design

From February 1998 to September 2002, 34 patients with 5-fluorouracil-pretreated advanced colorectal cancer were enrolled in the study. Median age was 67 years (range, 32–76) and median performance status was 1. Twenty-one patients had multiple liver metastases. Other sites of disease included lungs, abdomen, pelvis, lymph nodes, bones and skin. They received six 28-day cycles of oxaliplatin (85 mg/m2 in a 2-h infusion on days 1 and 15) and irinotecan (80 mg/m2 in a 30-minute infusion on days 1,8 and 15 immediately following oxaliplatin).

Results

Thirteen patients (39%) completed treatment. The most common grade III-IV toxicities were diarrhea (27%), anemia (6%), neutropenia (18%), alopecia (6%) and peripheral neuropathy (6%). Thirteen patients (39%) received G-CSF support, and there were 2 episodes of febrile neutropenia. There were no treatment-related deaths. Six patients (18%) had a partial remission and another 11 (33%), disease stabilization. There were no complete remissions. Median time to progression was 6.6 months (range, 0.8–20.1) and median survival 10.6 months (range, 0.8–52.9).

Conclusions

Irinotecan and oxaliplatin combination has modest activity as second line treatment of 5-fluorouracil-resistant advanced colorectal cancer. Further research is warranted for the development of more effective and less toxic regimens in this setting.