bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Type of Graphical Passwords Based on Odd-Elegant Labelled Graphs
Authors: Wang Hongyu , Xu Jin , Ma Mingyuan , Zhang Hongyan
Published: April 2018

Graphical password (GPW) is one of various passwords used in information communication. The QR code, which is widely used in the current world, is one of GPWs. Topsnut-GPWs are new-type GPWs made by topological structures (also, called graphs) and number theory, but the existing GPWs use pictures/images almost. We design new Topsnut-GPWs by means of a graph labelling, called odd-elegant labelling. The new Topsnut-GPWs will be constructed by Topsnut-GPWs having smaller vertex numbers; in other words, they are compound Topsnut-GPWs such that they are more robust to deciphering attacks. Furthermore, the new Topsnut-GPWs can induce some mathematical problems and conjectures.
Seepage Flow Model and Deformation Properties of Coastal Deep Foundation Pit under Tidal Influence
Authors: Li Shu-chen , Xie Can , Liang Yan-hong , Yan Qin
Published: April 2018

As the coastal region is the most developed region in China, an increasing number of engineering projects are under construction in it in recent years. However, the quality of these projects is significantly affected by groundwater, which is influenced by tidal variations. Therefore, the regional groundwater dynamic characteristics under tidal impact and the spatiotemporal evolution of the seepage field must be considered in the construction of the projects. Then, Boussinesq function was introduced into the research to deduce the seepage equation under tidal influence for the coastal area. To determine the spatiotemporal evolution of the deep foundation pit seepage field and the coastal seepage field evolution model, numerical calculations based on changes in the tidal water level and seepage equation were performed using MATLAB. According to the developed model, the influence of the seepage field on the foundation pit supporting structure in the excavation process was analyzed through numerical simulations. The results of this research could be considered in design and engineering practice.
Targeting Toll-like Receptors in Cancer Prevention
Authors: Sfanos Karen S.
Published: April 2018

There is a pressing need for the development of new prevention strategies for the most common worldwide malignancy, nonmelanoma skin cancer (NMSC), as sun protection efforts have not proven to be completely effective. Interestingly, despite the known circumstance that individuals undergoing chronic immunosuppression are at a substantially increased risk for developing NMSC, in this issue of Cancer Prevention Research, Blohm-Mangone and colleagues provide new evidence that topical application of the Toll-like receptor 4 (TLR4) antagonist resatorvid may be efficacious as a chemopreventive agent in NMSC specifically via blocking UV-induced inflammatory signaling. These new findings highlight a potentially delicate dichotomy between the role of innate immune receptors in the normal, protective immunosurveillance of damaged cells in the skin and the pathogenic UV-induced overstimulation of cutaneous inflammation that promotes photocarcinogenesis. Given the tremendous cancer burden incurred by NMSC, further exploration of the use of TLR4 antagonists in NMSC chemoprevention strategies is certainly warranted. Cancer Prev Res; 11(5); 251–4. ©2018 AACR.

See related article by Blohm-Mangone et al., p. 265
O bunker e o kubo branko
Authors: Buti Marco Francesco
Published: April 2018

Uma curta reflexão em texto e imagem sobre espaços expositivos contemporâneos.
Tough love
Authors: Bois Yve-Alain
Published: April 2018

O texto a seguir apresenta a contribuição de Yve-Alain Bois ao colóquio “Hubert Damisch, l’art au travail”, organizado em homenagem ao autor de Théorie du nuage, em Paris, pelo Institut National d’Histoire de l’Art, nos dias 8 e 9 de novembro de 2013. O relato rememora o convívio de Bois com Hubert Damisch e Roland Barthes, autores cujos seminários ele frequentou no início dos anos 1970.
Editorial
Authors: Jaremtchuk Dária , Benetti Liliane , Laurentiz Silvia , Salzstein Sônia
Published: April 2018

Editorial
The Commitment to Go on Theorizing “Religion”
Authors: Taira Teemu
Published: April 2018

There are two kinds of scholars in the world, those who do theory and those who do not. This is one of the main organizing binaries inTheory in a Time of Excess(edited by Aaron W. Hughes). All contributors of the volume agree that theory is something that is valuable. In this essay I explore what theory means in this book and how contributors to the volume highlight different aspects of theorizing. This opens up the question of who are the most fruitful conversation partners that potentially maintain and extend a commitment to theorizing.
The Madness of Cambyses: Herodotus and the Problem of Inquiry
Authors: Rathnam Lindsay Mahon
Published: April 2018

In his evaluation of the mad despot Cambyses, Herodotus proclaims that preference for one’s own culture persists after examination. This paper examines how Herodotus’ treatment of Cambyses reveals the insidious ways that thought is bounded by cultural attachments. Blindness to one’s attachments spurs the drive to empire by covering and justifying expansionist appetites. Herodotus’ treatment of Cambyses’ imperialist inquiries will thus not only implicate the Persians, but raise unsettling questions about the Hellenes’ own appetites. Herodotus offers his own methods of inquiry as an alternative. Rather than denying appetite and rendering it subterranean, Herodotus suggests that inquiry must be motivated by the quest for self-knowledge – understanding the diversity of the world helps reveal the fuller contours of human nature. Herodotus’ storytelling engages affect by provoking the intellectual curiosity of his audience. It promises that expansionist appetites can be rehabilitated into genuine curiosity and openness to difference.
The Law in Plato’s Laws: A Reading of the ‘Classical Thesis’
Authors: Hunt Luke William
Published: April 2018

Plato’s Laws include what H.L.A. Hart called the ‘classical thesis’ about the nature and role of law: the law exists to see that one leads a morally good life. This paper develops Hart’s brief remarks by providing a panorama of the classical thesis in Laws. This is done by considering two themes: (1) the extent to which Laws is paternalistic, and (2) the extent to which Laws is naturalistic. These themes are significant for a number of reasons, including because they show how Laws might be viewed as a sophisticated forerunner of natural law theory. The upshot is that Plato’s metaphysical commitments about legal ontology allow him to base the truth of legal propositions on the way they relate to the truth of corresponding moral propositions.
Philosophical Genesis: The Three Waves and the City-Soul Analogy in Republic v
Authors: Thomas Charlotte C.S. , Honeycutt Kevin S.
Published: April 2018

It is conventional to argue that the city-soul analogy of Plato’s Republic dominates Books ii through iv and viii through x but is absent in Books v through vii. We argue that the analogy remains operative in Books v through vii and that its role there, especially as it is played out in the motif of the three waves, illuminates its function in the dialogue as a whole, particularly with respect to the questions: What are the natural dispositions of soul necessary for philosophy? What are the necessary and sufficient conditions for philosophical education?
Hermetic Influences on the Evolutionary System of Helena Blavatsky’s Theosophy
Authors: Prophet Erin
Published: April 2018

Helena Blavatsky (1831–1891) developed a program of salvation that she called “double evolution,” which was elaborated in a system known as root race theory. Human souls were seen as traversing through progressive reincarnation a series of seven “races,” or body types, ranging from gigantic amorphous and ethereal bodies and transitioning through hermaphroditic into gigantic gendered ape-like humans, modern humans, and thereafter adepts and divine beings. Although root race theory drew from the scientific racism of its day, it did not equate root races with human races, but to stages of human emanation from and return to divinity. The sources of root race theory have been sought in Eastern contexts due to its use of Hindu and Buddhist terminology, though scholars have noted its Western esoteric influences. This article argues that the primary structure of root race theory is based in the Corpus Hermeticum. It identifies some of Blavatsky’s Hermetic sources, showing that she referred not only generally to a perennialist “Hermetic philosophy” that incorporated Western esoteric tropes, but also to specific Hermetic texts. These texts provided the organizing matrix of root race theory, specifically its creation mythology, support for prior androgyne human existence, a “fall into matter,” and the initial ensoulment of humans with mind, ornous. It also provided a template for the future transformation of humans into divine beings. The article builds on the suggestions of Nicholas Goodrick-Clarke (2013) and Brendan French (2001) to elaborate on the role of Hermetic influence in Blavatsky’s reconfiguring of evolution as a novel form of salvation for an empirically-oriented nineteenth century audience.
The Exoskeletons in our Closets: A synthesis of research from the ‘Arthropods of our Homes’ project in Raleigh, NC

Authors: LEONG MISHA , BERTONE MATTHEW A. , BAYLESS KEITH M. , DUNN ROBERT R. , TRAUTWEIN MICHELLE D.
Published: April 2018

The history of people living with insects, spiders and their relatives is long, probably as long as humans have been using fixed domiciles (e.g., caves). Studies of caves inhabited by prehistoric people 26,000 years ago suggest arthropod pests already lived alongside our ancestors in those caves (Araújo et al. 2009). Arthropods are also both abundant and diverse in domestic archaeological sites from agricultural civilizations in Egypt, Israel and Europe (Switzerland and Greenland). Arthropods are especially common in association with stored food products and livestock (Panagiotakopulu 2001; Overgaard Nielsen, Mahler, and Rasmussen 2000; Kislev, Hartmann, and Galili 2004).
A new species of Hypopygus Hoedeman (Gymnotiformes: Rhamphichthyidae) from the rio Trombetas system, Amazon basin, Brazil
Authors: CAMPOS-DA-PAZ RICARDO
Published: April 2018

A new Hypopygus species is described from the igarapé Saracá, a stream in the lower rio Trombetas system, Pará State, Brazil. It differs from congeners by a unique combination of characters (either primitive or of uncertain polarity) which includes mouth position, interocular width, snout length, postorbital length, pectoral-fin length, snout-to-occiput length, caudal-filament length, counts of pectoral-fin rays and anal-fin rays, distribution of anal-fin chomatophores, as well as a set of osteological features. A phylogenetic analysis indicates that the new species, belongs to a monophyletic subgroup in Hypopygus that includes all congeners, except H. neblinae; its relationships within that clade, however, are currently uncertain, and a brief discussion is provided. Corrections are made concerning some morphometric and meristic information furnished in recent contributions regarding Hypopygus species.
New records of the family Chalcididae (Hymenoptera: Chalcidoidea) from Egypt
Authors: ABUL-SOOD MEDHAT I. , GADALLAH NEVEEN S.
Published: April 2018

In the present study, a checklist of new records of the family Chalcididae of Egypt is presented based on a total of 180 specimens collected from 24 different Egyptian localities between June 2011 and October 2016, mostly by sweeping and Malaise traps. Nineteen species as well as the subfamily Epitraninae and the genera Bucekia Steffan, Epitranus Walker, Proconura Dodd, and Tanycoryphus Cameron, are newly recorded from Egypt. A single species previously placed in the genus Hockeria is transferred to Euchalcis Dufour as E. rufula (Nikol’skaya, 1960) comb. nov.
Onychostoma brevibarba, a new cyprinine fish (Pisces: Teleostei) from the middle Chang Jiang basin in Hunan Province, South China
Authors: SONG XUE-LING , CAO LIANG , ZHANG E.
Published: April 2018

Onychostoma brevibarba, a new cyprinid species, is described from two tributaries flowing into the Xiang Jiang (= River) of the middle Chang Jiang basin in Hunan Province, South China. The new species is morphologically similar to two Chinese congeners, O. minnanense and O. barbatulum, but differs from them in the anteromedian extension of the postlabial groove. It further differs from O. minnanense in the maxillary-barbel length, shape and body coloration, and from O. barbatulum in the number of lateral-line perforated scales and the width of the mouth opening. The validity of the new species and its close relationship with these two species were affirmed by a molecular phylogenetic analysis based on the mitochondrial cyt b and CO1 genes.
Determining agricultural impact on environment
Authors: Zekić Stanislav , Kleut Žana , Matkovski Bojan , Đokić Danilo
Published: April 2018

As part of Serbia’s strategic goal of accession to the European Union (EU), harmonization with the agro-environmental policy is an important issue for the creators of Serbia’s agricultural and rural policy. The main goal of this study was to define a model of agro-environmental performance in Serbia and the countries of the EU to determine Serbia’s position in relation to other countries (EU-28). In this article, factor analysis was applied, with four factors extracted within the model: the degree of agricultural modernization that indirectly affects the environment, the degree of intensification of agricultural production with a direct effect on the environment, air pollution from agriculture, and energy use. The factor scores were used as variables within the Preference Ranking Organization Method for Enrichment Evaluation method to rank countries according to the impact of agriculture on the environment.
Estimated Cost to a Restaurant of a Foodborne Illness Outbreak
Authors: Bartsch Sarah M. , Asti Lindsey , Nyathi Sindiso , Spiker Marie L. , Lee Bruce Y.
Published: April 2018

Objectives:

Although outbreaks of restaurant-associated foodborne illness occur periodically and make the news, a restaurant may not be aware of the cost of an outbreak. We estimated this cost under varying circumstances.

Methods:

We developed a computational simulation model; scenarios varied outbreak size (5 to 250 people affected), pathogen (n = 15), type of dining establishment (fast food, fast casual, casual dining, and fine dining), lost revenue (ie, meals lost per illness), cost of lawsuits and legal fees, fines, and insurance premium increases.

Results:

We estimated that the cost of a single foodborne illness outbreak ranged from $3968 to $1.9 million for a fast-food restaurant, $6330 to $2.1 million for a fast-casual restaurant, $8030 to $2.2 million for a casual-dining restaurant, and $8273 to $2.6 million for a fine-dining restaurant, varying from a 5-person outbreak, with no lost revenue, lawsuits, legal fees, or fines, to a 250-person outbreak, with high lost revenue (100 meals lost per illness), and a high amount of lawsuits and legal fees ($1 656 569) and fines ($100 000). This cost amounts to 10% to 5790% of a restaurant’s annual marketing costs and 0.3% to 101% of annual profits and revenue. The biggest cost drivers were lawsuits and legal fees, outbreak size, and lost revenue. Pathogen type affected the cost by a maximum of $337 000, the difference between a Bacillus cereus outbreak (least costly) and a listeria outbreak (most costly).

Conclusions:

The cost of a single foodborne illness outbreak to a restaurant can be substantial and outweigh the typical costs of prevention and control measures. Our study can help decision makers determine investment and motivate research for infection-control measures in restaurant settings.
The Tune of Christian Apocalyptic: Paul and John in Concert
Authors: Moses Robert
Published: April 2018

This article puts John and Paul in conversation concerning two issues: believers’ partaking of food sacrificed to idols and the question of who were the primary actors in Jesus’ death. While many modern interpreters see discord between John’s treatment of food offered to idols and Paul’s, this article argues that both John and Paul were informed by an apocalyptic worldview that sees demonic forces behind idolatry. As such, they are in harmony in their arguments that all foods explicitly identified as idol food must be rejected by believers. Furthermore, both John and Paul share an apocalyptic worldview that saw demonic forces as the primary actors in Jesus’ crucifixion.
Do Supply Chain Auditors Compromise? Evidence From the Association of Supplier Aggressive Revenue Management and Major Customer Dependence
Authors: Chang Hsihui , Chen Hsin-Chi , Chen Jengfang , Reichelt Kenneth J.
Published: April 2018

Our study examines whether aggressive revenue management by a supplier is greater when the supplier and their major customer engage the same office-level auditor and when significant purchases are made by the major customer from the supplier. We posit that the auditor is more accommodating to clients who are jointly audited by the same office-level auditor because of the implicit threat of losing not just the supplier client but also the major customer client. The threat arises from the potential loss of synergies of a jointly planned audit engagement when significant purchases are made by the major customer. We find that income-increasing discretionary revenue is positively associated with the major customer’s percentage of purchases from the supplier when the same office-level auditor is engaged by the supplier and their major customer. We fail to find a statistically significant association when they engage a different office-level auditor or a different audit firm. Our findings provide evidence that office-level auditors tolerate greater aggressive revenue management when they have clients who are partners in the same supply chain and when greater audit synergies are at stake. In addition, our results are partly explained by supplier clients who have interlocking directors with major customers and significant influence.
Immanence, transindividuality and the free multitude
Authors: Voss Daniela
Published: April 2018

Since the late 1960s there has been a resurgence of interest in Spinozism in France: Gilles Deleuze was among the first who gave life to a ‘new Spinoza’ with his seminal book Expressionism in Philosophy: Spinoza (1968). While Deleuze was primarily interested in Spinoza’s ontology and ethics, the contemporary French philosopher Étienne Balibar focuses on the political writings. Despite their common fascination for Spinoza’s relational definition of the individual, both thinkers have drawn very different consequences from the Spinozist inspiration regarding the relevance of his philosophy for a contemporary ethical and political thought. Deleuze draws from Spinoza an ethics of the encounter, an ‘ethology’ that is concerned with the composition of bodies on a plane of immanence. Balibar, on the contrary, deals with the modes of communication that we institute between one another and that are always effectuations on two levels at once: the real and the imaginary. Whereas Deleuze emphasizes the conception of a univocal plane of immanence, Balibar insists on a double expression of the real and the imaginary in any transindividual practice. The aim of this paper is to compare and finally assess their respective contributions to a conception of collective political action: the question of constitution of the ‘free multitude’.
Association of MTHFR C677T gene polymorphism with metabolic syndrome in a Chinese population: a case–control study
Authors: Wang Jin , Xu Lijuan , Xia Hongmiao , Li Ying , Tang Shiqi
Published: April 2018

Objective

To investigate the association of the MTHFR C677T gene polymorphism with metabolic syndrome (MetS) in people in Hubei Province, China.

Methods

A case–control study was conducted with 651 subjects with MetS (MetS group) and 727 healthy controls (control group) at Renmin Hospital of Wuhan University between January and December 2016. The MTHFR C677T genotype was detected by the gene chip technique and clinical data were collected.

Results

Body mass index, waist circumference, the waist-hip-ratio, systolic and diastolic blood pressure, fasting blood glucose, fasting insulin, triglyceride, total cholesterol, low-density lipoprotein-cholesterol, and homocysteine levels, and the homeostasis model assessment of insulin resistance were higher in the MetS group than in controls. The risk of MetS was higher for the TT genotype and T allele carriers than for the CC genotype and C allele carriers. With MetS, the TT genotype increased the risk of elevated blood pressure, fasting glucose levels, and triglyceride levels. Patients with MetS and the TT genotype showed more severe abdominal obesity, dyslipidaemia, insulin resistance, elevated blood pressure, elevated fasting glucose levels, and hyperhomocysteinaemia compared with those with the CC genotype.

Conclusions

In this population, MTHFR C677T gene polymorphism may be a risk factor for MetS.
Factors of Risk for Breast Cancer Influencing Post-Menopausal Long-Term Hormone Replacement Therapy
Authors: Chiechi Luigi Mario , Secreto Giorgio
Published: April 2018

The advantages of hormone replacement therapy (HRT) are well documented in contrasting the symptomatology of climacterium and in reducing morbidity and mortality associated with coronary heart disease and osteoporotic fractures of postmenopausal age. However, growing evidence points to increased breast cancer risk in HRT long-term users, and the adverse effect would, obviously, overwhelm any other benefit. At present, the risk/benefit ratio of HRT is an object of hot debate, and we feel it necessary and urgent to select women who can safely benefit from HRT and women whose risk of breast cancer can be perilously increased by the raised hormonal levels related to HRT. We have reviewed studies on the breast cancer risk in HRT users and data on the interaction between steroid hormones and breast cancer. Reasoning that the outcome of mammary cancer can be increased by hormonal overstimulation of the breast, we have focused on those factors of risk that could be further enhanced by the exogenous hormonal stimulus of HRT, so as to cause a further significant increase in the risk of breast cancer. We conclude that some biologic and clinical markers, namely android obesity, bone density, mammographic density, androgen and estrogen circulating levels, alcohol consumption, benign breast disease, and familiarity, should be carefully considered before prescribing long-term HRT. Our analysis suggests that HRT could increase the risk of breast cancer and useless in preventing coronary heart disease and osteoporotic fractures when administered in women with positivity for one or more of these markers.
Breast Metastases from Cutaneous Melanoma a Report of Three Cases
Authors: Plesničar Andrej , Kovač Viljem
Published: April 2018

In this report we describe three female patients with breast metastases from cutaneous melanoma (CM) who were treated in Slovenia in the period from 1988 to 1991. We found that in 476 Slovenian patients with this disease diagnosed in the given period CM disseminated to the breast less frequently than in other series. In one pregnant and one perimenopausal patient breast involvement by CM was confirmed at the time of widespread dissemination of the disease. Treatment was not effective and the survival of these patients was four months and two weeks and six months, respectively. A slightly better outcome was observed in a normally menstruating patient referred from another country with an isolated solitary breast metastasis from CM. In this patient quadrantectomy seemed to have been sufficient to achieve a disease-free interval of more than eight months. Special attention should therefore be given to a small subset of patients with isolated solitary breast metastases from CM, since their prognosis may be less dismal than in patients with massively infiltrated breasts and disseminated disease.
Adrenocorticotropic Hormone Secreting Pituitary Adenomas: Analysis of Growth Fraction Using the MIB-1 Antibody
Authors: Mastronardi Luciano , Guiducci Antonio , Spera Cristina , Puzzilli Fabrizio , Liberati Fabrizio , Ruggeri Andrea , Peciarolo Antonella
Published: April 2018

Aims and background

Pituitary adenomas are usually considered well differentiated tumors, even if in about one third of cases they invade surrounding tissues, with the possibility of postoperative relapse after complete surgical removal. Adrenocorticotropic hormone (ACTH) secreting adenomas seem to be the most infiltrating subtype, with a higher incidence of recurrence. Ki-67 is a nuclear antigen which is easily detectable by means of the MIB-1 monoclonal antibody, and the labeling index (LI) obtained can be considered a marker of tumor proliferation.

Methods

In order to identify the growth fraction of these tumors we used the MIB-1 antibody to evaluate the expression of Ki-67 antibody in 11 ACTH secreting pituitary adenomas and to compare it with the LI obtained in 98 other hormone secreting or non-functioning pituitary adenomas consecutively operated on during a 40-month period.

Results

In relation to surgically verified infiltration of the sellar floor dura and bone, we identified eight non-invasive and three invasive ACTH secreting pituitary adenomas. All invasive tumors infiltrated the wall of the cavernous sinus (CS). The mean Ki-67 LI was 5.88 ± 9.13% versus 2.33 ± 2.40% in non-ACTH secreting adenomas (P = 0.0025). It was 13.27 ± 15.42% in invasive and 3.11 ± 4.37% in non-invasive ACTH adenomas, and 18.40 ± 17.82% in patients over 50 years versus 3.10 ± 4.09% in younger subjects (P = 0.02).

Conclusions

Ki-67 LI is a useful marker in the determination of proliferative activity and invasiveness of anterior pituitary adenomas. Our data seem to confirm that ACTH secreting adenomas have a higher growth fraction than other pituitary adenomas and this observation presumably explains the higher incidence of relapse of these tumors even after macroscopically total removal.
The Sentinel Lymph Node in T1N0 Breast Cancer
Authors: de Rubeis Gian Paolo , Bafile Alberto , Resta Valter , Vicentini Roberto
Published: April 2018

The authors report their experience gathered from December 1998 to December 1999 in the use of the sentinel lymph node (SN) method in breast cancer treatment. In 20 out of 21 cases (95%) localization of the SN was obtained by scintigraphy while in 19 cases (90.5%) the SN was found during surgery. Histological examination of the axillary lymph nodes gave a 95% accuracy with only one negative SN associated with positive axillary lymph nodes out of a total of 19. However, the authors have subjected all patients to a complete three-level axillary dissection since they believe the method applied has not yet been fully validated.
Detection of Melanoma Cells in Peripheral Blood and Sentinel Lymph Nodes by RT-PCR Analysis: A Comparative Study with Immunohistochemistry
Authors: Pellegrino Daniela , Bellina Calogero Riccardo , Manca Gianpiero , Boni Giuseppe , Grosso Mariano , Volterrani Duccio , Desideri lelizza , Bianchi Francesca , Bottoni Antonio , Ciliberti Vincenzo , Salimbeni Grazia , Gandini Daniele , Castagna Maura , Zucchi Vanna , Romanini Antonella , Bianchi Romano
Published: April 2018

The presence of lymph node metastases is the best prognostic factor for predicting relapse or survival in melanoma patients. It has been demonstrated that melanoma metastases spread through the first lymph node(s) draining the tumor (sentinel lymph node, SN) to the lymphatic system and that detection of melanoma cells in peripheral blood directly correlates with prognosis in melanoma.

To identify lymph node metastases and circulating melanocytes, we developed a single-step reverse transcriptase-polymerase chain reaction assay (RT-PCR) for detection of two melanoma-specific markers: the tyrosinase gene, which encodes an enzyme associated with melanin synthesis, and melanoma antigen-related T-cells, which are present in tumor infiltrating T-lymphocytes. This method detects two tumor cells in a background of 107 lymphocytes.

Thirty patients with stage I–IV cutaneous melanoma entered the study. Blood samples were taken preoperatively, one month after excision of the primary melanoma lesion and the SN or total lymphadenectomy, and before the start of chemotherapy and every three months thereafter in metastatic patients. SNs were collected from 22 patients, bisected and analyzed by RT-PCR and routine pathological and immunohistochemical tests. The preliminary results indicate that RT-PCR for melanoma markers is a sensitive and valuable method for the detection of micrometastases and for early diagnosis and staging of melanoma.
Sentinel Node Mapping for Malignant Melanoma
Authors: Landra Marino , Acchiardi Franco , Pugno Francesco , Forte Giuseppe , Granetto Cristina , Camuzzini Gian Franco
Published: April 2018

Sixty-seven patients with malignant melanomas were seen in our institute since 1998. We looked for a sentinel node in 26 (38%) patients with lesions thicker than 1 mm, employing a double technique: staining with methylene blue and gamma probe mapping after injection of 99mTc. Forty-six nodes were retrieved, 25% of them containing tumor cells. This approach enabled us to choose between a wait-and-see policy and radical surgery.
Detection of Sentinel Nodes by Lymphoscintigraphy and Gamma Probe Guided Surgery in Vulvar Neoplasia
Authors: Sideri Mario , De Cicco Concetta , Maggioni Angelo , Colombo Nicoletta , Bocciolone Luca , Trifirò Giuseppe , De Nuzzo Maria , Mangioni Costantino , Paganelli Giovanni
Published: April 2018

Background

Pathologic lymph node status is the most important prognostic factor in vulvar cancer; however, complete inguinofemoral node dissection is associated with significant morbidity. Intraoperative lymphoscintigraphy associated with gamma detecting probe-guided surgery has proved to be reliable in the detection of sentinel node (SN) involvement in melanoma and breast cancer patients. The present study evaluates the feasibility of the surgical identification of inguinal sentinel nodes using lymphoscintigraphy and a gamma detecting probe in patients with early vulvar cancer.

Methods

Technetium-99-labeled colloid human albumin was administered perilesionally in 44 patients. Twenty patients had T1 and 23 had T2 invasive epidermoid vulvar cancer; one patient had a lower-third vaginal cancer. An intraoperative gamma detecting probe was used to identify SNs during surgery. Complete inguinofemoral node dissection was subsequently performed. SNs underwent separate pathologic evaluation.

Results

A total of 77 groins were dissected in 44 patients. SNs were identified in all the studied groins. Thirteen cases had positive nodes: the SN was positive in all of them; in 10 cases the SN was the only positive node. Thirty-one patients showed negative SNs: all of them were negative for lymph node metastasis.

Conclusions

Lymphoscintigraphy and SN biopsy under gamma detecting probe guidance proved to be an easy and reliable method for detection of SNs in early vulvar cancer. If these preliminary data will be confirmed, the technique would represent a real progress towards less aggressive treatment in patients with vulvar cancer.
Use of Surgical Gamma Probe for the Detection of Lymph Node Metastases in Differentiated Thyroid Cancer
Authors: Lippi Francesco , Capezzone Marco , Miccoli Paolo , Traino Claudio , Di Martino Francesco , Angelini Fabrizio , Spinelli Claudio , Iacconi Pietro , Pinchera Aldo , Pacini Furio
Published: April 2018

Background

Patients with differentiated thyroid cancer (DTC) after total or near-total thyroidectomy require 131l therapy. After surgery the persistence of lymph node metastases in our series of patients was frequent (30%). Such patients are preferentially treated with radioiodine and shifted to surgical re-intervention when the nodal lesions persist after two 131I treatments.

Aim

Use of an intraoperative radioactive probe (C-TraK) to allow a more radical surgical approach in thyroid cancer patients submitted to surgery for lymph node metastases.

Methods and results

After adequate withdrawal of L-thyroxine suppressive therapy six patients were given high 131l doses followed by post-therapy WBS which demonstrated cervical activity in 5 patients and peri-jugular activity in 1. Surgery with the help of a gamma probe allowed to detect and remove all metastatic nodes. After excision all surgical specimens showed higher radioactive counts with respect to the background. The post-surgical scan showed the disappearance of all areas of 131I uptake. Histology confirmed the presence of metastatic lesions from papillary thyroid cancer.

Conclusions

We conclude that the use of a gamma probe can be successful in patients with metastatic neck lesions resistant to 131I treatment, particularly in patients with nonpalpable lesions.
Radioguided Surgery of Breast Cancer: Radiation Protection Survey
Authors: Motta Cinzia , Turra Alessandro , Farina Bruno , Ostan Antonella , Ramella Sergio , Cartia Gian Luca
Published: April 2018

The aim of this study was to estimate the radioactive risk for surgical staff performing radioguided sentinel lymph node (SN) biopsy and to calculate the contamination level in the operating room for assessment of the possible need for specific radiation protection procedures. We studied 20 patients who were selected for quadrantectomy and SN biopsy. The day before surgery a volume of 0.15 mL of 99mTc-nanocoll was injected: the activity was 3.11 ± 0.85 MBq in group A (15 pts) and 11.6 ± 0.6 MBq in group B (5 pts). External radiation to staff was evaluated by measuring the exposure rate in air one hour after radiopharmaceutical administration. The air KERMA rate during surgery was estimated considering the physical decay of 99mTc. Contamination of disposable materials and surgical instruments in the operating room was measured using a contamination monitor, whereas the residual activity in the SN and the injection site was measured with a gamma probe. The exposure rate at 20 cm from the injection site was 0.75 μSv/h when the most radioactive patients (group B) were treated. Contamination in the operating room proved to be negligible. Considering the number of radioguided treatments carried out by a surgeon in one year, an equivalent effective dose of 0.075 mSv was estimated; the recommended dose limit according to the relevant Italian law, DL 230/95, is 1 mSv/yr. Surgical staff therefore do not require a classification of “exposed workers'’ and there is no need to supply the operating room with special containers for radioactive waste.
Fulminant Hepatic Failure Caused by Diffuse Intrasinusoidal Metastatic Liver Disease: A Case Report
Authors: Martelli Olga , Coppola Luigi , De Quarto Angelo Luca , Palma Marzia , Sarmiento Roberta , Foggi Carlo Maria
Published: April 2018

A 53-year-old woman experienced rapidly progressing liver failure four years after a quadrantectomy for a breast carcinoma. She had received adjuvant chemotherapy and radiotherapy, and second-line chemotherapy for bone metastasis one year earlier. The hepatic failure manifested with ascites, jaundice, elevation of serum bilirubin and hepatic enzyme levels and hypoalbuminemia. Imaging studies showed an enlarged liver without metastatic lesions. The patient died of hepatic decompensation within two weeks. Liver examination at autopsy revealed massive neoplastic infiltration consistent with a primary breast carcinoma. It is important to realize that this unusual pattern of liver metastasis cannot be demonstrated even with the most advanced techniques of instrumental diagnosis (CT scan, ultrasonography and magnetic resonance imaging), and should be taken into account in the differential diagnosis of rapidly progressing liver failure.
Peritoneal Carcinomatosis from an Unknown Primary Site. Management of 15 Patients
Authors: Sebbag Gilbert , Shmookler Barry M , Chang David , Sugarbaker Paul H
Published: April 2018

Aims and background

Peritoneal carcinomatosis from an unknown primary site is a rare and ill-defined entity. This work attempts to identify clinical and pathological features of patients with this disease and report the results of an aggressive combined treatment modality.

Methods

Retrospective analysis was performed of medical records of 15 patients with peritoneal carcinomatosis with no primary site identified at a single institution between 1989 and 2000. A primary gastrointestinal cancer was ruled out after a thorough endoscopic and radiologic work-up and complete exploratory surgery.

Results

Four women and 11 men were identified; the average age was 49 years. All patients had cytoreductive surgery with peritonectomies; 4 patients underwent a second-look operation. Perioperative intraperitoneal chemotherapy was given to 10 of the 15 patients, and 9 patients received post-cytoreduction chemotherapy given intraperitoneally (1), systemically (7) or both intraperitoneally and systemically (1). Overall median survival from diagnosis was 19.0 months; 1 patient is alive with disease at 21 months; and 3 patients are disease-free at 17, 38, and 60 months from diagnosis. Significant positive predictive factors for survival were a small volume of ascites (P = 0.02), a large number of peritonectomies performed (P = 0.001), second-look cytoreduction (P = 0.003), perioperative intraperitoneal chemotherapy (P = 0.008) and postoperative chemotherapy (P = 0.01), either intraperitoneal or systemic.

Conclusions

Peritoneal carcinomatosis from an unknown primary site is a rare subset of primary peritoneal malignancy. Aggressive treatment may provide prolonged palliation with occasional long-term survival.
Tumor in Tumor: Metastasis of Breast Carcinoma to Intracranial Meningioma
Authors: Elmaci Ilham , Ekinci Gazanfer , Kurtkaya Ozlem , Sav Aydin , Pamir M Necmettin
Published: April 2018

This report presents magnetic resonance imaging (MRI) findings of a breast carcinoma metastasis in an intracranial meningioma with correlated pathological findings. MRI showed multiple foci of intense enhancement with hypointense surrounding areas. The described foci appeared to be metastatic disease from the patient's known breast carcinoma. In addition, this is the first study reported in the literature to have investigated the expression of a possibly common carcinogenic molecule in breast carcinoma metastatic to a coexisting meningioma: overexpressed c-myc oncogene was found both in the breast carcinoma compartment and in the meningioma component of the tumor.
Role of Double-contrast Barium Enema in Colorectal Cancer Screening Based on Fecal Occult Blood
Authors: Ciatto Stefano , Castiglione Guido
Published: April 2018

Aims and Background

Screening for colorectal cancer by fecal occult-blood testing has been shown to be effective in reducing colorectal cancer mortality. Total colonoscopy is the test of choice for the assessment of fecal occult blood-positive subjects. Double-contrast barium enema is commonly employed to study the rest of the colon when colonoscopy is incomplete. The present study evaluated the contribution of double-contrast barium enema in detecting neoplastic lesions of the colon in fecal occult-blood-positive subjects with incomplete colonoscopy.

Methods

In the frame of a screening program for colorectal cancer in the Florence District, a new immunochemical fecal occult-blood test replaced the classic guaiac fecal occult-blood test in 1993. Subjects with a positive fecal occult-blood test were invited to undergo total colonoscopy. Incomplete colonoscopy prompted double-contrast barium enema. Type and rate of neoplastic lesions detected by endoscopy or double-contrast barium enema as single methods or combined were evaluated.

Results

A total of 38,829 subjects underwent fecal occult-blood testing in the period 1993-2000. Overall, 1,542 were positive. Assessment was refused by 235 subjects. Out of 1,307 subjects accepting assessment, total colonoscopy was attempted in 1,294: of these, it was not possible in 343 cases, and double-contrast barium enema was advised and performed in 261 subjects. Colorectal cancer was detected in 115 subjects, single or multiple adenomas in 323, hyperplastic polyps in 58, inflammatory, hamartomatous or not histologically confirmed polyps in 38, and other benign non-polypoid findings or no abnormality in 773. There were significant differences between the rates of detected colorectal cancers or adenomas of total and incomplete colonoscopy. There were also significant differences between incomplete colonoscopy and the combination of incomplete colonoscopy and double-contrast barium enema as regards rates of detected colorectal cancer, and between total colonoscopy and the combination of incomplete colonoscopy with double-contrast barium enema as regards rates of detected adenomas. Double-contrast barium enema associated to incomplete colonoscopy was responsible for an increase in detection rates of cancer or adenoma of 2.3‰ or 3.8‰, respectively.

Conclusions

Double-contrast barium enema was useful in detecting colorectal cancer beyond the range reached by incomplete colonoscopy, whereas our data confirmed a lower sensitivity of double-contrast barium enema for polyps. The diagnostic contribution observed in the present survey confirms the opportunity of performing double-contrast barium enema as a routine adjunct to incomplete colonoscopy. Nevertheless, in order to maximize the detection rate of adenomas, the rate of total colonoscopy should be kept as high as possible.
Long-term Survival after Regional Chemotherapy for Liver Metastases from Breast Cancer. A Case Report
Authors: Tekin Koray , Kocaoglu Hilmi , Bayar Sancar
Published: April 2018

The prognosis of patients with liver metastases from breast cancer has to be regarded as rather unfavorable. A 45-year-old woman with cancer of the left breast and multiple simultaneous liver metastases was initially treated with cyclophosphamide, methotrexate, and 5-fluorouracil. After two treatment cycles a sonogram of the left breast revealed reduction of the tumor size and she underwent a modified radical mastectomy and hepatic artery catheterization. There was no change in the multiple lesions of the liver on abdominal ultrasonography. One week later a regional chemotherapy regimen was given through a hepatic arterial catheter with subcutaneous implanted reservoir. After completion of the seventh course of chemotherapy, ultrasonography revealed that the multiple liver metastases had regressed completely. To date (July 2001) there has been no relapse during the seven-year follow-up period. In conclusion, we suggest that intra-arterial regional chemotherapy may have an important role to play in the management of breast cancer patients with isolated liver metastases.
Pulmonary Blastoma after Liver Transplant: A Case Report
Authors: Tartarone Alfredo , Romano Giampiero , Galasso Rocco , Coccaro Mariarosa , Cammarota Aldo , Sgambato Alessandro , Bochicchio Annamaria
Published: April 2018

There is an increased risk of cancer after organ transplantation mainly due to the immunosuppressive therapy required in these patients. We report a case of biphasic pulmonary blastoma in an adult male who underwent liver transplant for hepatocellular carcinoma in March 1999, followed by immunosuppressive treatment and adjuvant chemotherapy with epirubicin. Disease-free survival lasted 18 months, then a diagnosis of biphasic pulmonary blastoma was made and the patient underwent a lung lobectomy. Five months after surgical resection a recurrence of this rare tumor was recorded and two cycles of cisplatin + etoposide and ifosfamide + etoposide and one cycle of second-line chemotherapy with vinorelbine were administered. The tolerability and the efficacy of this treatment were poor. The patient died less than one year after diagnosis. To our knowledge this is the first reported case of pulmonary blastoma in a transplant patient. Our findings confirm that organ transplant recipients deserve long-term medical surveillance also in the absence of graft complications, and that pulmonary blastoma is an aggressive tumor with a poor prognosis.
Levels of Ve-Cadherin Increase Independently of Vegf in Preoperative Sera of Patients with Colorectal Cancer
Authors: Sulkowska Mariola , Famulski Waldemar , Wincewicz Andrzej , Moniuszko Tadeusz , Kȩdra Bogusłtaw , Koda Mariusz , Zalewski Bogdan , Baltaziak Marek , Sulkowski Stanislaw
Published: April 2018

Aims and Background

Vascular endothelial cadherin (VE-cad-herin) preserves the tightness of the mature vascular network as a component of endothelial adherens junctions. Vascular endothelial growth factor (VEGF) makes VE-cadherin dissociate from complexes with β-catenin, so that endothelial cells can loosely proliferate and migrate. We searched for relationships between VEGF and VE-cadherin levels in preoperative sera of patients with colorectal cancer (CRC). We also compared VE-cadherin levels of control and preoperative CRC sera in relation to clinicopathological features.

Methods

We measured with an ELISA kit the serum levels of the proteins in preoperative samples from 125 CRC patients and in samples from 16 healthy volunteers.

Results

Serum VE-cadherin was about fourfold higher in CRC patients than in controls (P <0.00001), with similar results being found in subgroups with different clinicopathological features versus controls. VE-cadherin was not correlated with VEGF in the entire group of CRC patients nor in the subgroups of node-positive and node-negative patients, different grades of histological differentiation (G2 or G3), extent of tumor growth (pT1+pT2 or pT3+pT4), histopathological type (adenocarcinoma or mucinous carcinoma), sex, age, and tumor site (colon or rectum). However, the serum levels of VE-cadherin and VEGF in CRC patients, which were higher than the mean values of controls, tended towards a negative correlation in node-positive patients (P = 0.078, r = -0.279).

Conclusions

VEGF and VE-cadherin seem to be independent markers of angiogenesis in CRC with no significant correlation between their serum levels.
Ileal Carcinoid with Liver Metastasis Presenting after Ten Years with Abdominal Mass and Right Heart Failure: Report of a Case
Authors: Stella Mattia , Decian Franco , Mithieux François , Meeus Pierre , Rivoire Michel
Published: April 2018

A case of ileal carcinoid metastatic to the liver is reported. The diagnosis was made and treatment given ten years after the detection of a left hypervascular liver mass, which was first confounded with a hemangioma. The onset of right heart failure led to surgical replacement of the tricuspid and pulmonary valves. After cardiac surgery the patient underwent an ileal resection and left hepatectomy for a cystic left liver metastasis.

Isolated right heart failure and cystic degeneration of a liver metastasis are uncommon features of metastatic carcinoid tumors; only a few cases have been described in the literature. Cardiac surgery is recommended before liver surgery to reduce venous pressure and consequent bleeding during hepatectomy. Surgical treatment of liver metastases may relieve endocrine symptoms and result in an overall five-year survival rate of 47%.