bluuebunny/crossref_metadata_2025 huggingface dataset:
Neoplastic and Non-Neoplastic Thyroid Lesions in Surgical Material: Historical Review of Five Decades in São Paulo, Brazil
Authors: Bisi Helio , Fernandes Vilma S.O. , Rosalinda Y. , De Camargo Asato , Filho Adhemar Longatto , Ruggeri Glaucia Berreta , Abdo Anete H.
Published: April 2018

Aims and background

The goal of the study was to report and discuss the neoplastic and non-neoplastic diseases of the thyroid gland present in a historical series of surgical material examined during the period 1945 to 1989 at the Pathology Department of the Sao Paulo University Medical School.

Methods

Records of 281,175 cases were reviewed to select those which affected the thyroid gland. The slides of these selected cases were analyzed and classified according to current terminology.

Results

Non-neoplastic lesions comprised 86.68% of the cases (n = 7024), and most of them were nodular goiter (n = 6458). Neoplastic lesions were divided into two groups: primary and metastatic. Of 1072 primary neoplasms, 530 were benign and 542 were malignant. Of the malignant neoplasms, papillary and follicular were the most frequent types (n = 201 and 187, respectively), followed by undifferentiated (n = 86), Hürthle (n = 46), medullary (n = 16) and others (n = 6). Of 8 metastatic neoplasms, 4 were from and undetermined primary epidermoid carcinoma.

Conclusions

We concluded that owing to the high incidence of neoplastic lesions (13.32%), half of which were malignant, examination of the thyroid gland should be done with strict criteria in view of the therapeutic and prognostic implications.
Distribution of the Carbohydrate Antigens, Du-Pan-2 and Ca19-9, in Tumors of the Lung
Authors: Ohshio Gakuji , Yamaki Kenichirou , Imamura Takaashi , Suwa Hirofumi , Chang Chien Yih , Wada Hiromi , Sueno Yurika , Imamura Masayuki
Published: April 2018

Aims and background

The carbohydrate chains of malignant cells appear to be related to oncofetal differentiation. The serum levels of CA19-9 have been reported to be evaluated in some patients with lung carcinomas, however, the distribution of carbohydrate antigens were not precisely described. We have investigated in this study the distribution of DU-PAN-2 and CA19-9 antigens in lung tumors.

Methods

Ninety five specimens of lung tumors were selected from surgical specimens. The expression of DU-PAN-2 and CA19-9 were studied by immunohystochemical techniques. The relationship between the expression of these antigens and the classification or the differentiation degree of the tumors were examined.

Results

DU-PAN-2 or CA19-9 antigens were detected in 41 (54%) and 45 (59%) cases of the 76 malignant epithelial tumors investigated. These antigens were detected in all types of malignant epithelial tumors, including squamous cell carcinomas, where they were mainly localized to the entire cell surface of malignant cells. In adenocarcinomas, large cell carcinomas and small cell carcinomas, however, these antigens were commonly detected both on the cell membrane and in the cytoplasm. There was positive correlation between the degree of differentiation and DU-PAN-2, but not CA19-9 expression. Among the non-epithelial tumors investigated, those antigens were detected in pulmonary blastomas but not in mesotheliomas.

Conclusions

Immunohistochemical studies for DU-PAN-2 and CA19-9 are useful for defining characteristics of the lung tumors. DU-PAN-2 could be a marker for differentiating between malignant epithelial tumors and mesotheliomas.
Quality of Life among Mastectomy Patients Using External Breast Prostheses
Authors: Hart Stacey , Meyerowitz Beth E. , Apolone Giovanni , Mosconi Paola , Liberati Alessandro
Published: April 2018

Background

Most women who undergo mastectomy for breast cancer use external breast prostheses. Yet, little is known about patterns of use, satisfaction levels, and quality of life associated with their use as compared to other options.

Patients and Methods

We report longitudinal, self-report questionnaire data regarding prosthetic use from 592 Italian mastectomy patients. Women who report satisfaction with their prostheses are compared on medical, demographic, and quality of life variables to a matched sample of women who report dissatisfaction. We also compare matched samples of women who do not use prostheses and women who had reconstruction to prosthetic users.

Results

Most women used and were satisfied with their prostheses. However, there was a small group of women who were dissatisfied. These women reported greater disruption to their sense of feminility and worse quality of life in some areas. We found few differences between prosthetic users and women who used either of the other two options available following mastectomy - taking no action to restore the appearance of the amputated breast or having reconstructive surgery.

Conclusions

No one technique for restoring the appearance of the mastectomized breast is necessary to optimize quality of life for all women. Physicians should describe the options to women, along with the average satisfaction rates for women choosing those options, and help women to make the best personal decisions.
Ovca (CA125) Second Generation: Technical Aspects and Serum Levels in Controls, Patients with Liver Disease, Pregnant Women and Patients with Ovarian Disease
Authors: Cioffi Michele , Fratta Mario , Gazzerro Patrizia , Di Finizio Bruno , Tucci Aniello , Molinari Anna Maria
Published: April 2018

An immunoradiometric method of the second generation (IRMA II) is widely used to determine CA125 serum levels. In this study we have evaluated the performance characteristics of a commercially available IRMA CA125 II (Byk-Gulden, Sangtec Diagnostics). The CA125 serum levels were determined in several groups of patients (healthy women, pregnant women, subjects affected by benign and malignant ovarian cancer, patients with liver diseases) with two IRMAs CA125 II (Byk-Gulden, Sangtec Diagnostica and Centocor, Diagnostic Division) and IRMA CA125 I (Byk-Gulden, Sangtec Diagnostica). Our results show a good analytic performance of IRMA CA125 II (Byk-Gulden, Sangtec Diagnostica), a good correlation between IRMAs CA125 II (Byk-Gulden, Sangtec Diagnostica and Centocor, Diagnostic Division), but an unacceptable correlation between IRMAs CA125 II (Byk-Gulden, Sangtec Diagnostica and Centocor, Diagnostic Division) and IRMA CA125 I. A statistically significant difference was observed comparing the values obtained with both IRMAs CA125 II and IRMA CA125 I in the groups of patients. In contrast no statistically significant difference was observed when we compared the values obtained with IRMA CA125 II (Byk-Gulden, Sangtec Diagnostica) and IRMA CA125 II (Centocor, Diagnostic Division). CA125 serum values obtained with the second-generation kits were different from those obtained with the first-generation one; consequently, it is important, especially in the follow-up of cancer patients, that CA125 serum values be obtained with kits of the same generation. Our data seem to suggest the use of second-generation kits to determine CA125 serum levels.
Postoperative Adjuvant Chemoradiotherapy for Rectal Cancer: Analysis of Acute and Chronic Toxicity
Authors: Bertuccelli Maurizio , Cartei Francesco , Falcone Alfredo , Campoccia Salvatrice , Sainato Aldo , Ducci Francesco , Moda Stefano , Pfanner Elisabetta , Lencioni Monica , Brunetti Isa , Giulianotti Pier Cristoforo , Mosca Franco , Laddaga Michele , Conte Pier Franco
Published: April 2018

Aims and background

The aim of the study was to evaluate acute and chronic toxicity of combined postoperative standard radiation therapy to the pelvis and 5-fluorouracil plus levamisole in resectable rectal cancer.

Methods

Between July 1990 and September 1993, 58 patients with histologically confirmed adenocarcinoma of the rectum entered the prospective study. The schedule consisted of 5-fluorouracil, 450 mg/m2 i.v. for 5 days, and from day 28 5-fluorouracil, 450 mg/m2 i.v. weekly for 24 weeks, plus levamisole given orally at the dose of 150 mg every day for 3 days every 2 weeks for 6 months; radiotherapy (180 cGy/day) 5 days a week for a total dose of 45 Gy was administered from day 28.

Results

After the first cycle of chemotherapy (before radiotherapy), overall toxicity was mild. During chemoradiotherapy, dose-limiting toxicity was grade 3 diarrhea and proctitis, for which the combined treatment was interrupted for more than 7 cumulative days in 28 patients. During the 24 weeks of weekly 5-fluorouracil (after radiotherapy), no severe toxicity was reported. Three-year survival and progression-free survival were 65% and 50–55%, respectively.

Conclusions

Although adjuvant chemoradiotherapy is usually feasible, in our study toxicity was severe in a substantial proportion of patients, probably due to the schedule applied. We are evaluating the feasibility and toxicity of a combined treatment which includes 5-fluorouracil in continuous chronomodulated infusion during radiotherapy.
Tuberculous Skeletal Muscle Involvement in Acute Leukemia: Report on Two Cases
Authors: del Giglio Auro , Pinczowski Hélio , Portugal Gileno , Feher Olavo
Published: April 2018

Bacterial infection of skeletal muscle (pyomyositis) is usually followed by abscess formation. The most commonly isolated pathogen is Staphylococcus aureus. Tuberculosis rarely affects patients with acute leukemia. The authors report on 2 patients, one with acute myelogenous leukemia and the other with acute lymphoblastic leukemia whose clinical course was complicated by tuberculous skeletal muscle abscesses. In both instances, musculoskeletal pain was accompanied by evidence of muscle abscesses by imaging studies of the painful areas. Therefore, in patients with acute leukemia and evidence of muscle abscesses with initial cultures negative for bacteria and fungi, one should include tuberculosis in the differential diagnosis.
Structure, Function and Gene Expression of Epithelial Mucins
Authors: Seregni Ettore , Botti Carlo , Massaron Simonetta , Lombardo Claudia , Capobianco Alba , Bogni Anna , Bombardieri Emilio
Published: April 2018

In this review the main characteristics, i.e., structure, function and gene expression, of the different mucins are discussed. Mucin-type molecules consist of a core protein moiety (apomucin) where a number of carbohydrate chains are attached to serines and threonines by glycosidic bonds. O-linked carbohydrates form up to 80% of the molecule and the length of the glucidic side chains varies from one to more than 20 residues. At least eight mucin-like genes have been isolated so far, and the main characteristic is the presence of a central domain composed of a variable number of “tandem repeats”. The sequence homology of the central domain among the different members of the mucin-type family is limited, indicating that this internal domain is unique for each mucin. Thanks to the integrated results of genetic, immunological and biochemical studies, it is now possible to identify eight apomucin genes, namely MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC5B, MUC6 and MUC7. MUC1 is the best characterized mucin and it is expressed on the apical surface of most polarized epithelial cells. The MUC1 gene has been cloned and sequenced. The MUC2 gene encodes a typical secretory gel-forming mucin which represents the predominant form in human intestinal and colon tissues. Another intestinal mucin is MUC3. The MUC4, MUC5AC and MUC5B genes have been isolated from a bronchial tissue cDNA library. The MUC4 and MUC5AC genes are mainly expressed in the respiratory tract, in gastric and reproductive mucosa, while MUC5B is highly detectable only in the bronchial glands. The MUC6 gene is expressed by gastric tissue and, recently, MUC7 has been cloned and sequenced using a salivary cDNA library.
Nonstandard Fractionation Schedules in Radiation Therapy of Head and Neck Cancer: A Review
Authors: Olmi Patrizia , Fallai Carlo
Published: April 2018

The authors present an updated review of the clinical trials on hyperfractionated and accelerated fractionation schedules in radiotherapy of head and neck cancer. The available results in terms of survival and local control, and acute and late toxicity data are summarized in order to show the current status of this research field. The new breed of fractionation schedules that are on study, designed on the ground of new rationales, are presented as well. Finally, an introductory overview of combination therapy including non standard fractionation radiotherapy associated with chemotherapy is reported70.
Training in Colposcopy: Experience with a Videocolposcopy Test
Authors: Cecchini Silvia , Bonardi Rita , Grazzini Grazia , lossa Anna , Cianferoni Luciano , Scuderi Angelo , Rossi Riccardo , Spaggiari Gianna , Pane Angela , Ciatto Stefano
Published: April 2018

The authors evaluate the results of a videocolposcopy test (330 total cases, 12 cases of histologically confirmed CIN2 or more severe lesions) taken by 9 accredited and 17 unaccredited colposcopists during 1995. Seven of 9 accredited and 4 of 13 unaccredited colposcopists reached the requested standard (sensitivity >90%, biopsy rate «60%). Performance was definitely better when the test was not blind to the cytologic report (4 of 13 reached the requested standard) with respect to blind reading (none of 17). The study confirmed that colposcopy at unaccredited practices is poorly accurate. Colposcopy assessment of patients with abnormal smears should be centralized in accredited practices, which should undergo periodic quality control to guarantee screening efficacy. Tape-recorded videocolposcopy tests are a good, simple, practical and inexpensive method for interobserver quality control of colposcopic performance.
High-Dose Epirubicin in Locally Advanced Operable Noninflammatory Breast Cancer: A Feasibility Trial
Authors: Crivellari Diana , Buonadonna Angela , Sacco Cosimo , Bidoli Ettore , Candiani Ezio , Massarut Samuele , Roncadin Mario , Rossi Carlo , Galligioni Enzo
Published: April 2018

Aims and background

Anthracyclines are among the most active agents for the treatment of patients with locally advanced breast cancer. The aim of our study was to evaluate the feasibility and activity of a relatively high-dose regimen with 4-epirubicin plus normal doses of cyclophosphamide over a short period of time without the use of hematologic growth factors as adjuvant in resected locally advanced breast cancer.

Methods.

Between January 1990 and June 1992, 43 consecutive patients, premenopausal or postmenopausal «60 yrs, were surgically resected and then treated with epirubicin plus cyclophosphamide for at least 4 cycles (maximum 6). Electron beam (6–10 MeV energy) radiotherapy was delivered on the chest wall in patients with pathological skin infiltration (pT4b).

Results

Median age was 46 years (range, 27–59); 37 were premenopausal and 6 postmenopausal. The total number of administered cycles was 202 (6 in 15 patients and 4 in 28 patients); 195/202 (96.5%) were administered at full dose, and 7 (3.5%) were reduced to 75% of the planned dosage. The three-year disease-free survival was 67% for stage IlIa and 61% for stage IIIb patients. The three-year overall survival was 88% and 79%, respectively. Local relapse only was reported in one patient (2%), distant relapse in 11 patients (25%), and local and distant relapse in four patients (9%). Toxicity was acceptable and mainly hematologic.

Conclusions.

Our trial showed that the regimen is feasible without the use of hematologic growth factors. In this era of cost containment, the use of this short-term, high-dose induction course instead of repetitive courses of conventional dose regimens merits further evaluation, possibly in a large randomized trial.
Intermittent Continuous Infusion of Fluorouracil and Low-Dose Oral Leucovorin in Pretreated Breast Cancer: A Pilot Study
Authors: Colleoni Marco , Vicario Giovanni , Nelli Patrizia , Sgarbossa Gigliola , Pancheri Francesca , Manente Paolo
Published: April 2018

Aims and background

There is evidence that fluorouracil (FU), when administered by protracted venous infusion, has antitumor activity in pretreated breast cancer. The aims of the study were to assess, in a population of heavily pretreated breast cancer patients (≥2 lines of chemotherapy previously administered), the feasibility and activity of a new combination of oral L-leucovorin and continuous FU infusion.

Methods

Patients were treated with the following combination: oral L-leucovorin, 5 mg/m2 days 1 through 14, plus FU, 250 mg/m2 days 1 through 14, with cycles repeated every 21 days.

Results

Since November 1994, 22 patients have entered the study and 20 are assessable for response and side effects. Major patient characteristics were: ECOG performance status, 0-2; median age, 56 years (range, 41–70); sites of metastasis, bone 9, lung 8, liver 2, pleura 7; 2 or more metastatic sites, 18. A total of 74 cycles has been administered (median/patient, 3 cycles). Five partial remissions (25%), 4 disease stabilizations and 11 disease progressions have been observed. Median time to progression was 3 months (range 1–6+). Grade I–II mucositis was observed in 8 patients and grade III–IV in 6 patients. Other side effects have included diarrhea and thrombocytopenia.

Conclusions

The schedule has demonstrated moderate activity in heavily pretreated breast cancer, with mucositis as the dose-limiting toxicity.
The Role of Fluorine-18-Deoxyglucose (Fdg) Positron Emission Tomography (Pet) Whole Body Scan (Wbs) in the Staging and Follow-Up of Cancer Patients: Our First Experience
Authors: Ferlin Giorgio , Rubello Domenico , Chierichetti Franca , Zanco Pierluigi , Bergamin Roberta , Trento Paolo , Fini Alberto , Cargnel Serena
Published: April 2018

We report the results of FDG PET whole body scan in 75 cancer patients in whom tumor extent was defined by surgical, histological or cytological findings and clinical follow-up. Twenty-five had malignant lymphomas, 24 lung carcinomas, and 26 other types of solid tumors. Twenty-three patients were evaluated at disease onset, before therapy, and 37 at the moment of tumor recurrence; the remaining 15 patients were in complete remission after treatment and were taken as controls. Visual and quantitative PET results were compared with conventional imaging (US, CT scan and/or MRI, and Tc99m MDP bone scan).

In the 60 patients with active disease, PET as well as conventional imaging were able to locate the primary tumor in all 23 patients studied at disease onset. However, with regard to lymph node and distant metastases, PET provided the same information as conventional imaging in 31 cases (51.6%), but revealed further neoplastic foci in 29 cases (48.4%), 21 in lymph nodes and 8 at distant sites. The sensitivity of PET, in comparison with conventional imaging, was 100% versus 100% for the detection of the primary tumor, 97.6% versus 55.8% for the localization of node metastases, and 100% versus 55.5% for the visualization of distant metastases. The specificity, calculated in the group of 15 disease-free patients, was 100% for PET and 86.6% for conventional imaging. The therapeutic approach was modified in 12 patients (20%) on the basis of the PET results. Furthermore, in 14 cases (23.3%) with advanced disease, PET provided complete information on tumor spread, otherwise obtainable only by taking together the results of all other diagnostic procedures. Our data indicate a higher accuracy of FDG PET whole body scan compared to conventional imaging techniques in the evaluation of metastatic spread both at initial diagnosis and during follow-up, with an important impact on therapeutic decision-making. Moreover, by providing complete information on tumor spread in some cases, PET can become a profitable tool in terms of cost reduction.
Granular Cell Basal Cell Carcinoma of the Skin. Report of a Case with Immunocytochemical Positivity for Lysozyme
Authors: Boscaino Amedeo , Tornillo Luigi , Orabona Pasquale , Staibano Stefania , Gentile Raffaella , De Rosa Gaetano
Published: April 2018

Granular cell tumors have been described in many sites throughout the body. To our knowledge, few cases have been described in the literature. We report here the sixth case, in which positivity for lysozyme was also observed for the first time. The problems of the histogenesis and differential diagnosis of this rare variant of basal cell carcinoma are also discussed.
Surgery or Radiotherapy for Early Stages Carcinomas of the Glottic Larynx
Authors: Magnano Mauro , Cavalot Andrea L. , Gervasio Carmine F. , Lerda Walter , Gabriele Pietro , Orecchia Roberto , Ruo-Redda Maria Grazia , Beltramo Guido , Ragona Riccardo , Cortesina Giorgio
Published: April 2018

Aims and Background

The choice of treatment in limited squamous cell carcinoma of the glottic larynx often depends on individual and tumor factors. Data of the literature clearly show that surgery and radiotherapy tend to give identical results in terms of survival. We examined 196 cases of T1-T2/N0 cancers of the glottic larynx. We review the literature and discuss the indications and the efficacy of the various available treatments.

Methods and Study Design

196 consecutive cases of T1-T2/N0 cancers of the glottic larynx were examined. In 54.5% the tumor was confined to the vocal cord; in 38.2% it extended to the anterior commissure, in 4.6% to the arytenoid cartilage and in 2.5% to the floor of the ventricle. We performed partial laryngeal surgery in 41.3% (81 cases). Radiotherapy alone was employed in 58.6% (115 cases).

Results

In T1a and T1b cases there was no statistically significant difference in 5-year disease-free survival. In T2 cases the NED survival of patients who underwent partial laryngectomies (90% of cases) was significantly better (P <0.05) than among patients given radiotherapy (73%). NED survival at 5 years in patients with the primary tumor on a vocal cord, ventricle or anterior commissure was 78%, 80% and 81%, respectively, with no statistically significant difference among the various sites. It is possible that involvement of the anterior commissure exposes patients to greater risk of recurrence when radiotherapy alone is used (5 out of 23 cases, 21.7%, compared to 3 out of 52 cases, 5.7%, among our surgically treated patients).

Conclusions

When the tumor is confined to the vocal cord and mobility is not impaired (T1a), surgery and radiotherapy give comparable results, and the latter yields a better functional outcome. When the anterior commissure is involved, recurrences appear to be less likely after surgery. In T2 glottic carcinoma, surgery gives better results than radiotherapy alone. In any event, the choice of treatment should be patient-specific and based on a careful analysis of the factors involved in each case.
Intrathoracic Benign Metastasizing Leiomyoma with Extrapulmonary Growth Pattern. A Case Report
Authors: Tavecchio Luca , Bedini Amedeo Vittorio , Di Palma Silvana , Andreani Stefano Michele
Published: April 2018

The authors report a case of a woman in whom complete resection of an extrapulmonary differentiated leiomyomatous tumor of uterine origin was performed 39 years after hysterectomy for uterine leiomyomas.
Locally Advanced Breast Cancer Treated with Primary Chemotherapy: Comparison between Magnetic Resonance Imaging and Pathologic Evaluation of Residual Disease
Authors: Trecate Giovanna , Ceglia Errico , Stabile Fernando , Tesoro-Tess John David , Mariani Gabriella , Zambetti Milvia , Musumeci Renato
Published: April 2018

Aims and Background

We evaluated the response of locally advanced breast cancer to induction chemotherapy using MRI techniques. The size and vitality of any residual pathologic tissue was quantified by means of morphologic and dynamic analysis. A curve derived from the dynamic parameters shows the uptake intensity with respect to the time elapsed since administration, which is related to vascularization and therefore indirectly reflects the angiogenesis of malignant tissue.

Methods and Study Design

A group of 30 patients were examined with MRI for staging purposes before undergoing treatment and subsequently to assess the response to treatment. Alterations in size and dynamic parameters were closely monitored.

Results

The overall accuracy was 90%, the sensitivity 96%, the specificity 75%, the positive predictive value 92.5% and the negative predictive value 66%. Interestingly, analysis of the dynamic curves made it possible to obtain additional information regarding the angiogenetic activity of the residual tumor.

Conclusions

Evaluation of the response to treatment by means of conventional imaging and clinical examination can be particularly difficult because of the fibrosis induced by cytotoxic drugs or the small volume of residual disease. The additional information supplied by MRI could therefore allow a more conservative surgical approach in selected cases of optimal response to treatment, as well as a much more accurate follow-up. Furthermore, the variation in dynamic parameters according to the vitality of residual disease could in the future become a useful tool for monitoring the effectiveness of anti-angiogenetic drugs.
High Doses of 5-Fluorouracil and Epirubicin with or without Cisplatin in Advanced Gastric Cancer: A Randomized Study
Authors: Roth Anton , Kolaric Krsto , Zupanc Darko , Oresic Vladimir , Roth Andrej , Ebling Zdravko
Published: April 2018

Background

A prospective randomized clinical study was performed in patients with locally advanced or metastatic gastric cancer. The purpose of the study was to determine the activity of high doses of 5-fluorouracil and epirubicin (FE) vs the same combination + cisplatin (FEP), and particularly the value of cisplatin in the combination.

Patients and Methods

A total of 122 patients was included in the study; 110 of them were assessable. In the FE arm, the treatment involved 1000 mg/m2 in a 6-hr infusion of 5-fluorouracil on days 1, 2, 3, 4 and 5 and 120 mg/m2 of epirubicin iv on day 1. In the FEP arm, the same combination of cytostatics + cisplatin (30 mg/m2) was administered on days 2 and 4. The cycles were repeated after 4 weeks. Altogether, 468 cycles of chemotherapy were given (FE, 240; FEP, 228).

Results

In the FE arm, 56 patients were assessable, with 2 complete and 14 partial remissions (28.6%); in the FEP arm, 4 complete and 19 partial remissions (42.6%) were observed in 54 assessable patients. Median survival in the FE group was 7.1 months and in the FEP group 9.6 months. The survival difference was statistically significant (Cox's test, P<0.05). The most frequent side effects included grade 2 and 3 alopecia (FE, 93%; FEP, 94%) and grade 2 and 3 vomiting (FE, 20%; FEP, 35%). Grade 3 and 4 leukopenia was observed in 9% of patients in the FE group and in 13% of patients in the FEP group, with 6 cases of febrile neutropenia (FE, 4%; FEP, 7%). Stenocardia was registered in 1 patient in the FE group and in 2 patients in the FEP group. No treatment-related death was registered.

Conclusions

The addition of cisplatin to high doses of 5-fluorouracil and epirubicin resulted in a statistically significant better survival of treated patients.
Cold Knife Conization and Loop Excision for Cervical Intraepithelial Neoplasia
Authors: Takač Iztok , Gorišek Borut
Published: April 2018

Aims and Background

Our aim was to investigate whether loop excision is an acceptable alternative to traditional cold knife conization of the cervix.

Patients and Methods

240 with cervical intraepithelial neoplasia (CIN) were randomly assigned to loop excision (n = 120) or cold knife conization (n = 120). Success and complication rates of both methods were analysed.

Results

100% of cold knife conization and 98% of loop excision surgical specimens were positive for dysplasia. The rate of complete resection was 91% in the cold knife and 82% in the loop excision group, but histologic confirmation of residual CIN was obtained in only 2 (1.7%) women after cold knife conization and in 5 (4.2%) after loop excision. Loop excision cones were significantly shallower than those obtained by a cold knife. Secondary surgical procedures due to early hemorrhage were performed in 9 (7.5%) patients treated with cold knife conization and in 8 (6.7%) treated with loop excision. Elevated temperature postoperatively was observed in 16.4% of patients after cold knife conization and in 13.9% after loop excision. There were no other postoperative complications.

Conclusions

The results suggest that cold knife conization and loop excision are comparable and equally effective diagnostic and therapeutic procedures for CIN.
Retroperitoneal Soft Tissue Sarcoma: Effect of Hyperthermic Total Abdominal Perfusion
Authors: Eroğlu Aydan , Kocaoğlu Hilmi , Demirci Salim , Akgül Hikmet
Published: April 2018

Aims and Background

Soft tissue sarcomas (STS) of the retroperitoneum are rare tumors. Surgery remains the principal modality of therapy in the management of primary and recurrent retroperitoneal STS. However, little is known about the effect of regional chemotherapy using hyperthermic total abdominal perfusion (HTAP). We analyzed independent prognostic variables in 33 patients with STS in the retroperitoneum admitted from November 1990 through December 1996.

Methods and Study Design

Data regarding patients’ age, gender, tumor size, histological tumor type, tumor location, type of operation (primary or secondary surgery), extent of surgical management (marginal or extended), use of HTAP, tumor grade, and tumor stage according to the TNM classification were examined by univariate and multivariate analyses.

Results

All 33 patients underwent complete resections (marginal or extended). Eleven of them received locoregional chemotherapy by HTAP. The overall cumulative 5-year survival rates in patients with stage IIA and advanced disease were 82% and 22%, respectively (log-rank test, P <0.01). Using Cox's proportional hazard model, tumor stage, use of HTAP and type of operation were found to have significant influence on overall survival (P <0.05).

Conclusions

Our results showed that complete resection along with HTAP chemotherapy may improve survival in patients with retroperitoneal STS. These phase II data could be used to support the initiation of a phase III trial to test HTAP in patients submitted to complete resection of retroperitoneal STS.
Improving the Quality of Life for Children with Cancer
Authors: Jankovic Momcilo , Van Dongen-Melman Jeanette E.W.M. , Vasilatou-Kosmidis Helen , Jenney Meriel E.M.
Published: April 2018

There are now more than one million new cases of cancer every year in the European Community (EC) including the children to whom particular needs should be addressed. Besides the disease-free survival other outcomes reflecting the impact of treatment on the patient and their families must also be assessed and include their physical, psychological and social functioning throughout their care: during therapy, after completion of treatment or, for some, in the terminal phase of their illness. To provide optimal care and thus improve the quality of life for these children needs:

a) an appropriately structured Paediatric Cancer Unit;

b) well trained and permanent staff members: comprising doctors, nurses, psychologists, social workers and other health care professionals;

c) facilities such as a specific out-patient clinic, a hospital school, a residence for parents;

d) a well defined programme for the terminally ill children;

e) a well defined programme for controlling the late effects of therapy.
Hypersensitivity Reaction to Carboplatin during Treatment for Ovarian Cancer: Successful Resolution by Replacement with Cisplatin
Authors: Shukunami Ken-ichi , Kurokawa Tetsuji , Kubo Makoto , Kaneshima Mitsuo , Kamitani Naoyuki , Kotsuji Fumikazu
Published: April 2018

Development of hypersensitivity reactions to carboplatin (CP) during cancer treatment makes optimal chemotherapy difficult to achieve. Many approaches have previously been used following the development of reactions to CP. We report on a patient with ovarian cancer who developed a hypersensitivity reaction to CP. The patient was successfully treated following replacement of carboplatin with cisplatin.
Accrual Issues for Chemoprevention Trials: The Example of the 4-HPR Study for the Prevention of Contralateral Breast Cancer
Authors: Camerini Tiziana , De Palo Giuseppe , Mariani Luigi , Marubini Ettore , Costa Alberto , Veronesi Umberto
Published: April 2018

This paper describes the accrual of the controlled clinical trial with fenretinide for the prevention of contraiateral breast cancer. Accrual screened 4,030 potentially eligible patients of whom 1,815 were randomized. Two strategies of recruitment were used, i.e. retrospective and prospective. In the retrospective accrual, the medical staff reviewed the records of breast cancer patients who had received curative surgery to select those who fulfilled the eligibility criteria of the study. For the prospective recruitment operated, patients were contacted after the beginning of the trial. The study started in March 1987 and accrual closed on July 31,1993. The planned accrual period was extended by 19 months. The yearly accrual tended to decrease with time. This was mainly due to the end of the retrospective recruitment and to the introduction of adjuvant chemotherapy, a reason for exclusion from the trial, also for patients with negative axillary nodes. The known accrual difficulties of chemoprevention studies proved also to be true for the high-risk population of this trial.
Cancer Prevalence in the Elderly
Authors: Vercelli Marina , Quaglia Alberto , Parodi Stefano , Crosignani Paolo ,   Itapreval Working Group:, Micheli A. , Gatta G. , Sant M. , Rossi A. Giorgi , Francisci S. , Saltarelli S. , Dell'Era L. , Gasparre N. , Verdecchia A. , Capocaccia R. , Mariotto A. , Dally A. , Corazziari I. , Crosignani P. , Tagliabue G. , Falcini F. , Milandri C. , Vattiato R. , Conti E. , Ramazzotti V. , Caperle M. , Zanetti R. , Rosso S. , Patriarca S. , Federico M. , Mangone L. , Santacroce M. , Barchielli A. , Balzi D. , Crocetti E. , Paci E. , De Lisi V. , Serventi L. , Barili A. , Vercelli M. , Casella C. , Parodi S. , De Leon M. Ponz , Roncucci L. , Benatti P. , Gafà L. , Tumino R. , La Rosa E. , Guzzinati S. , Simonato L. , Bovo E.
Published: April 2018

Aims and Background

To describe the cancer prevalence in elderly Italian people and analyze the differences, if any, with the prevalence among younger subjects.

Methods & Study Design

The cancer prevalence among elderly patients (65 years and over), the three age classes encompassing elderly age (65-74 years, 75-84 years, 85 years and over) and younger patients (0-64 years) was computed using the PREVAL method on the basis of the incident cases over the period 1976-1992 followed up to 31 December 1992 (prevalence reference date). Data were collected by 11 Italian cancer registries.

Results

The observed prevalence figures for all cancers (except skin epitheliomas), both sexes combined and considering the whole elderly group, were 1,090 and 3,601 cases per 100,000 one and five years since diagnosis, respectively; the prevalence increased up to the 75-84 age group and showed a slight decrease after age 85. With regard to specific cancer sites, in men bladder and prostate had the highest prevalence 5 years from diagnosis (more than 800 cases per 100,000), followed by colon and lung (about 500 cases per 100,000) stomach and rectum (about 300 cases per 100,000); in women breast cancer ranked first (more than 1,000 cases per 100,000), followed by colon (about 350 cases per 100,000), corpus uteri, stomach and rectum cancers (between 150 and 200 cases per 100,000). For all malignancies and the two sexes combined the prevalence figures were about six times higher in the older than in the younger age group.

Conclusions

These figures confirm the important role of aging in determining the increase in cancer prevalence. The resulting prevalence figures clearly indicate the cancer burden placed on health care services; moreover, the figures will probably increase in the next decades due to a possible improvement in survival and to the dramatic aging of the population, assuming a stable trend for incidence rates. This picture will represent a major challenge for politicians and those dealing with health care planning and social policies in general, especially in the light of the reduction of the available financial resources and the specific features of medical and social needs in the elderly.
Transpectoral Anterior Approach to the Axilla for Lymph Node Dissection in Association with Mastectomy Preserving Both Pectoral Muscles and Their Neurovascular Bundles
Authors: Dasgupta Satyabrata , Sanyal Sabitri , Sengupta Shankar Prasad
Published: April 2018

In Patey's mastectomy, which is still the most common operation for breast cancer, axillary node dissection (AND) is performed through the base of the axilla after retracting the pectoralis major muscle and excising the pectoralis minor muscle (some surgeons preserve the latter). This has the disadvantage of inadequate exposure of the axilla and the risk of damage to the neurovascular bundles supplying the pectoral muscles, which in the long run may lead to atrophy of these muscles. A transpectoral anterior approach to the axilla for AND in association with mastectomy was attempted in 115 cases to obviate the above-mentioned disadvantages. The approach included: 1) splitting of the pectoralis major between the clavicular and sternal fibers; 2) mobilization and swinging of the pectoralis minor into different directions by means of a sling to facilitate AND at selected levels. The major advantages of this approach were: 1) total preservation of both pectoral muscles with their neurovascular bundles maintained the normal anatomy and function of the shoulder; 2) the axilla was directly approached through the anterior wall instead of through the base; in this way the axillary contents were exposed almost at surface level; 3) the dissection plane could be limited to anterior to and below the axillary vein and the risk of postoperative lymphedema could thus be minimized; 4) change of position of the ipsilateral arm was not necessary; 5) the duration of surgery was reduced. Monoblock ablation of significant and suspected tissues, maintaining the normal anatomy and function of the shoulder, could be easily accomplished with this approach.
Effects of Gemcitabine in Normaland Transformed Human Lung Cell Cultures: Cytotoxicity and Increase in Radiation Sensitivity
Authors: Pacini Stefania , Milano Franco , Pinzani Pamela , Pazzagli Mario , Gulisano Massimo , Ruggiero Marco , Casamassima Franco
Published: April 2018

Aims and Background

Several anticancer drugs increase cell sensitivity to irradiation. Gemcitabine (2′, 2′ difluorodeoxycytidine) decreases the cellular dNTP pools and thus significantly increases the sensitivity to the DNA damaging effects of low-dose radiation. In this study we have investigated whether gemcitabine may play a role as radiosensitizer also in lung adenocarcinoma treatment.

Methods & Study Design

We studied this nucleoside analogue in normal and transformed human cell lines (fetal lung and lung adenocarcinoma). After drug treatment, cell lines were irradiated with different doses. Cell damage following drug treatment and/or irradiation was assessed by measuring intracellular ATP level and by the colony forming assay.

Results

The two cell lines significantly differed in their sensitivity to the toxic effects of the drug; the normal cell line was much more resistant than its transformed counterpart. This difference was observed in both assays, although it was more evident in the colony forming assay. A low radiation dose (50-100 cGy) did not cause any significant damage to transformed cells; normal cells were more resistant and doses up to 500 cGy caused little damage. However, when transformed cells were pretreated for three hours with gemcitabine, even a nontoxic concentration of the drug (1-10 nM) caused a marked sensitization of the cells to irradiation (50-100 cGy). The radiosensitizing effect of gemcitabine could be observed also in normal cells, although these cells were more resistant to the damaging effects of both anticancer treatments.

Conclusions

This study demonstrates that gemcitabine, a chemotherapeutic agent already used in the clinic, could be proposed as a radiosensitizer for radiation therapy of lung adenocarcinoma, having a clearly potentiating effect on low-dose radiation.
Epithelioid Hemangioendothelioma of the Larynx
Authors: Boscaino Amedeo , Errico Maria Elena , Orabona Pasquale , Tornillo Luigi , Staibano Stefania , Donofrio Vittoria , De Rosa Gaetano
Published: April 2018

Epithelioid hemangioendothelioma is an uncommon vascular tumor of the soft tissues. Several reports have described this tumor in visceral locations such as liver, lung, and brain. To the best of our knowledge this is the first report of an immunohistochemical and ultrastructural study of a primary epithelioid hemangioendothelioma occurring in the larynx.

Difficulties concerning the differential diagnosis and clinical problems arising from surgical therapy in the laryngeal area are also discussed.
Pathological and Microbiological Study of Mortality in a Captive Breeding Colony of the Endangered Lord Howe Island Stick Insect (Dryococelus australis)
Authors: Bayley Christine , Cheng Christina , Lynch Michael
Published: April 2018

The authors describe pathological and microbiological features of mortalities in a captive breeding colony of Lord Howe Island stick insects ( Dryococelus australis) over a period of 18 months. There were 2 peaks of mortality in this period. In the first, insects presented dead with minimal premonitory signs of illness. In the second, affected insects were ataxic with contracted limbs and inability to climb or right themselves. Gross lesions were uncommon but included pigmented plaques on the gut and cloacal prolapse. Histological lesions in both outbreaks indicated a cellular innate immune response including nodulation characterized by Gram-negative bacterial bacilli entrapped within nodules of pigmented hemocytes, and melanization characterized by melanin within hemocyte nodules and around bacteria. Hemolymph culture findings varied and often yielded a mixed growth. Pure growth of Serratia marcescens was cultured in 44% of animals in Outbreak 1, while pure growth of Pseudomonas aeruginosa was cultured in 30% of animals in Outbreak 2. Cases with S. marcescens-positive culture often showed inflammation at the foregut-midgut junction. The frequency of mixed bacterial culture results did not allow firm conclusions about causality to be made, and may indicate primary bacterial infection or increased susceptibility to hemolymph colonization with an opportunistic pathogen. These findings highlight the utility of histopathology combined with ancillary testing when investigating mortality in captive insect colonies.
Urothelial Carcinomas of the Urinary Bladder With Plasmacytoid or Rhabdoid Features and Tendency of Epithelial-Mesenchymal Transition in 3 Dogs
Authors: Lin Susanne Je-Han , Kao Chi-Fei , Wang Fun-In , Jeng Chian-Ren , Lee Jih-Jong , Wang Lei-Ya , Chang Hui-Wen , Chen Yi-Jiun , Liu Chen-Hsuan , Pang Victor Fei
Published: April 2018

Plasmacytoid and rhabdoid variants of urothelial carcinomas (UCs) of the urinary bladder have been described in humans with plasma cell–like or rhabdoid cellular appearance and aggressive clinical outcome. Canine UC of the bladder is generally classified as papillary/nonpapillary and infiltrating/noninfiltrating with limited information regarding other histological patterns. We report 3 cases of UC of the urinary bladder showing a unique discohesive cellular morphology with malignant behavior resembling the human plasmacytoid and rhabdoid variants of UC, which may raise some difficulties in diagnosis. Epithelial-mesenchymal transition and reduced E-cadherin expression were revealed by immunohistochemistry in 2 cases, possibly explaining the discohesive and invasive behavior of the tumor cells. The findings broaden the morphological spectrum as well as the distinct clinical features of canine UC of the urinary bladder.
Performance Evaluation of Cement and Slag Stabilized Expansive Soils
Authors: Mahedi Masrur , Cetin Bora , White David J.
Published: April 2018

Swelling, shrinking, and subsequent low strength of expansive soil poses significant damage to structures if it is considered as foundation or fill material. Recently, the use of cement has become very prevalent in stabilizing these problematic soils owing to its effectiveness. However, the swelling potential of expansive soil is not always adequately resolved by cement. The presence of sulfate salts aggravates the situation impairing the effectiveness of cement, leading to the need to reassess its performance. In this study, the effectiveness of different stabilizers was investigated in stabilizing high-plasticity soil. Two types of soil with variable sulfate content were treated with slag, Type I/II, and Type V Portland cement, and their performances were evaluated based on Atterberg limits, pH, unconfined compression, and volumetric swell tests. A total of 312 samples were prepared for 18 different soil–stabilizer blends tested after 7, 28, and 90 days of curing period. Laboratory test results indicated that strength gain performance was attenuated and swelling potential increased due to the presence of sulfate salts. Adding stabilizers improved the strength of soils by a factor of 4–10 and decreased the swelling potential to < 1%. Atterberg limits decreased initially and then slightly increased with the increase of additive dosages. Additives increased the pH up to a maximum value of 11–12, which could be used as an indicator of target stabilizer addition rate. Finally, slag improved the performance of cement significantly and has proven to be a better option for treating high sulfate expansive soils.
Leaching Assessment of Eco-Friendly Rubberized Chip Seal Pavement
Authors: Gheni Ahmed , Liu Xuesong , ElGawady Mohamed A. , Shi Honglan , Wang Jianmin
Published: April 2018

Companies in the United States need to mine billions of tons of raw natural aggregate each year. At the same time, billions of scrap tires are stockpiled every year. As a result, replacing the natural aggregate with recycled aggregate is beneficial to the construction industry and the environment. This paper is part of a comprehensive project that developed, and field implemented, a new eco-friendly rubberized chip seal where the mineral aggregate in chip seal is partially or totally replaced with crumb rubber made of recycled tires. This paper presents an extensive study of the environmental impact of using rubber aggregate in chip seal pavement in terms of leaching under different pH conditions, including simulated acid rain. The results are compared with those of conventional chip seal. Leaching from the constituents of chip seal, that is, rubber aggregate and emulsion, was investigated. Two types of rubber and two types of asphalt emulsions were studied. The leaching performance of rubberized chip seal was also investigated. This study revealed that the toxic heavy metals leached from the rubberized chip seal, for pH ranging from 4 to 10, were below that of the EPA drinking water standards. In addition, a significant reduction of heavy metal leaching was recorded when rubber was used with emulsion in the form of chip seal pavement under different pH conditions. Finally, the metal leaching in all types of samples (including rubber, asphalt emulsion, and chip seal) decreased with the increase in pH value.