bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimating the Velocity and Transport of Western Boundary Current Systems: A Case Study of the East Australian Current near Brisbane
Authors: Zilberman N. V. , Roemmich D. H. , Gille S. T. , Gilson J. 
Published: April 2018

AbstractWestern boundary currents (WBCs) are highly variable narrow meandering jets, making assessment of their volume transports a complex task. The required high-resolution temporal and spatial measurements are available only at a limited number of sites. In this study a method is developed for improving estimates of the East Australian Current (EAC) mean transport and its low-frequency variability, using complementary modern datasets. The present calculation is a case study that will be extended to other subtropical WBCs. The method developed in this work will reduce uncertainties in estimates of the WBC volume transport and in the interannual mass and heat budgets of the meridional overturning circulations, improving our understanding of the response of WBCs to local and remote forcing on long time scales. High-resolution expendable bathythermograph (HR-XBT) profiles collected along a transect crossing the EAC system near Brisbane, Australia, are merged with coexisting profiles and parking-depth trajectories from Argo floats, and with altimetric sea surface height data. Using HR-XBT/Argo/altimetry data combined with Argo trajectory-based velocities at 1000 m, the 2004–15 mean poleward alongshore transport of the EAC is 19.5 ± 2.0 Sv (1 Sv ≡ 106 m3 s−1) of which 2.5 ± 0.5 Sv recirculate equatorward just offshore of the EAC. These transport estimates are consistent in their mean and variability with concurrent and nearly collocated moored observations at 27°S, and with earlier moored observations along 30°S. Geostrophic transport anomalies in the EAC system, including the EAC recirculation, show a standard deviation of ±3.1 Sv at interannual time scales between 2004 and 2015.
Sergio De Santis, un naufrago della scrittura
Authors: Perrella Silvio 
Published: April 2018

Quelle di Sergio De Santis (Napoli, 1953) sono storie naufraghe e salmastre; storie di malussìa che raccontano di uno “smarrimento fra gli stretti sentieri di una vita troppo diversa da come l’avevamo immaginata”. E la malussìa è la dimensione di un io metamorfico e dai nomi cangianti – a volte professore, altre velista, altre ancora giocatore di carte… – che attraversa il suo mondo narrativo, legando tra loro echi, temi e movenze di scrittura. Nel gruzzolo di opere sinora pubblicate – una raccolta di racconti e tre romanzi – De Santis si dimostra un naufrago della scrittura che ama giocare con la reticenza, non solo perché è consapevole della forza dell’allusività e del rapporto tra i vuoti e i pieni, ma anche perché vuole che il suo paesaggio fisico e morale sia un correlativo di una condizione umana generale. Per De Santis il Sud è soprattutto la specola attraverso la quale guardare malinconicamente al disastro del mondo, senza però lasciarsi sfuggire ogni possibilità residua e imprevista di bellezza.
Toxicological hair analysis: Pre-analytical, analytical and interpretive aspects
Authors: Khajuria Himanshu , Nayak Biswa Prakash , Badiye Ashish 
Published: April 2018

Background and aims Hair analysis for drug detection is one of the widely accepted imperative techniques in the field of forensic toxicology. The current study was designed to investigate the efficacy of chromatography for detection of drugs of abuse in hair. Method A comprehensive review of articles from last two decades on hair analyses via PubMed and similar resources was performed. Issues concerning collection, decontamination and analytical techniques are summarised. Physiochemical nature of hair, mechanism of drug incorporation and its stability in hair are briefly discussed. Furthermore, various factors affecting results and interpretation are elucidated. Result A hair sample is chosen over traditional biological samples such blood, urine, saliva or tissues due to its inimitable ability to provide a longer time frame for drug detection. Its collection is almost non-invasive, less cumbersome and does not involve any specialised training/expertise. Recent advances in analytical technology have resulted in better sensitivity, reproducibility and accuracy, thus providing a new arena of scientific understanding and test interpretation. Conclusion Though recent studies have yielded many insights into drug binding and drug incorporation in hair, the major challenge in hair analysis lies in the interpretation of results, which may be affected by external contamination and thus lead to false-positives. Therefore, there is a need for more sensitive and selective analysis methods to be developed in order to minimise factors that induce the effect of melanin, age and so on, and this would certainly provide a new dimension to hair analysis and its applications.
Salvage Treatment with Epirubicin and/or Paclitaxel in Metastatic Breast Cancer Patients Relapsed after High-dose Chemotherapy with Peripheral Blood Progenitor Cells
Authors: Tartarone Alfredo , Sirotovà Zuzana , Aieta Michele , Lelli Giorgio 
Published: April 2018

Aims and Background To evaluate feasibility and efficacy of paclitaxel as a single agent or in combination with epirubicin in breast cancer taxane-naive patients who have failed previous high-dose chemotherapy. Methods Since February 1995, we have treated 32 patients in first relapse or progression after high-dose chemotherapy. Nineteen patients had metastatic breast cancer, 12 more than 3 involved axillary lymph nodes, and 1 inflammatory breast cancer at inclusion to the program. The median time to relapse after high-dose chemotherapy was 12 months (range, 2-43). At relapse, 12 patients were treated with epirubicin (90 mg/m2) plus paclitaxel (175 mg/m2) administered on day 1 every 21 days. In 20 patients who had previously received more than 350 mg/m2 of a cumulative dose of epirubicin and in one patient pretreated with chemotherapy containing mitoxantrone, we employed paclitaxel (175 mg/m2) alone. A median number of five courses was administered (range, 2-10). Results The overall response rate after 3 courses (29 of 32 patients were assessable) was 55% and after 6 courses (21 of 32 patients were assessable) was 57%. The median time to progression was 7 months (95% CI, 5.7-9.2), and median survival was 27.5 months (95% CI, 17.8-37.0). Toxicity was recorded for 180 cycles (epirubicin + paclitaxel for 62 cycles and paclitaxel alone for 118 cycles). The main toxicity in both regimens was hematologic. We observed WHO grade 3-4 neutropenia (in 8 patients, 25%), for which G-CSF (5 μg/kg/day sc) was employed. WHO grade 3-4 thrombocytopenia occurred in 2 patients (6%) and WHO grade 3 anemia in 1 patient (3%). Conclusions Our study showed that paclitaxel (alone or in combination with epirubicin) is feasible as salvage treatment in heavily pretreated patients.
Results of a Prospective Study with High-dose Etoposide, Thiotepa and Carboplatin and Peripheral Blood Stem Cell Rescue for High-risk Stage II-IIIA and Selected Stage IV Breast Cancer Patients
Authors: Gori Stefania , Mosconi Anna Maria , Tabilio Antonio , Falzetti Franca , Aristei Cynthia , Basurto Carlo , Cherubini Roberta , Latini Paolo , Martelli Massimo Fabrizio , Tonato Maurizio , Colozza Mariantonietta 
Published: April 2018

Aims and Background To investigate the safety and efficacy of a high-dose chemotherapy regimen with etoposide, carboplatin and thiotepa in high-risk stage II-IIIA breast cancer and in responsive metastatic patients. Study Design From April 1992 to December 1998, 24 patients with high-risk stage II-IIIA breast cancer (≥9 positive nodes) and 9 responsive metastatic patients were enrolled in the trial. After induction chemotherapy with an anthracycline-based regimen, peripheral blood stem cells were mobilized with cyclophosphamide (7 g/m2) and G-CSF (5-16 μg/kg/sc/day). The high-dose chemotherapy regimen consisted of etoposide (1000 mg/m2), carboplatin (800 mg/m2) and thiotepa (500 mg/m2). At the end of the high-dose chemotherapy, all stage II-IIIA patients received radiotherapy to the breast or chest wall and draining nodes; stage IV patients were irradiated to sites of disease, if feasible. All ER+ and/or PgR+ patients were treated with hormone therapy. Results For stage II-IIIA high-risk patients, the median follow-up was 4.36 years (range, 1.93-6.94), and the Kaplan-Meier estimate at 5 years of disease-free survival and overall survival was 54.8 ± 11% SE and 76.73 ± 9.4% SE, respectively. For metastatic patients, the median follow-up was 4.93 years (range, 4.15-7.95), and the Kaplan-Meier estimate at 5 years of progression-free survival and overall survival was 22.2 ± 13.9% SE and 76.2 ± 14.8% SE, respectively. No treatment-related deaths were observed. Conclusions Our results are comparable to those obtained in other high-dose chemotherapy trials but do not seem to be superior to conventional-dose therapy given to similar patients.
Radioimmunoguided Breast Surgery Using Radiolabeled Antibody NR-LU-10 FAB: A Pilot Study
Authors: Burak William E , De Palatis Louis , Mosic Jennifer L , Soble Denise , Hinkle George , Hitchcock Charles L 
Published: April 2018

Aim and Background Radioimmunoguided surgery using radiolabeled NR-LU-10 Fab was evaluated as a method of intraoperative breast cancer detection. Methods Breast cancer patients were injected intravenously with 125I (74 MBq) labeled NR-LU-10 Fab (5 mg) and then underwent tumor excision 2, 4 or 7 days later, during which time the gamma detector probe was used to evaluate the primary tumor for evidence of radioactive uptake. Results Intraoperative probing revealed tumor localization in 7 of 10 patients (70%). Gamma probe counts of the excised tumor were elevated in all patients, although high counts in surrounding nonmalignant tissue obscured the ability to detect the tumor in vivo in 3 patients. One patient with bilateral breast cancer was found to have a separate focus of occult tumor in each breast using the gamma detector probe. Conclusions Radiolabeled NR-LU-10 Fab possesses favorable pharmokinetics and tumor-binding ability as a targeting agent. However, binding to nonmalignant tissue limits its role in the intraoperative evaluation of tumor margins in breast cancer patients. Its role in other malignancies should be explored.
Immunohistochemical Study of 49 Cutaneous Melanomas: P53, PCNA, Bcl-2 Expression and Multidrug Resistance
Authors: Loggini Barbara , Rinaldi Isabella , Pingitore Raffaele , Cristofani Renza , Castagna Maura , Barachini Paolo 
Published: April 2018

Aims and Background Thickness and level of invasion are the main morphological elements for an approximate but not sufficiently sensitive prognostic evaluation of cutaneous melanomas. By using immunohistochemical methods it is possible to detect biological markers related to prognosis. We have studied p53, PCNA, Bcl-2 and P-gp expression in 49 primary cutaneous melanomas. Materials We used the immunophosphatase APAAP immunohistochemical method. The percentage of labeled cells (according to four classes of positivity: <5%; 5-25%; 25-50%; >50%) and the localization of immunoreactivity were expressed for each marker. Statistical analysis was performed to determine the correlations between markers and level or thickness of melanomas. Results We found a good correlation between p53 expression and melanoma thickness (P <0.005), PCNA and P-gp expression. No relationship was observed between Bcl-2 expression and the different variables considered or other markers. Conclusions Our data seem to indicate an unfavorable prognostic role of higher nuclear p53 expression. However, we believe that our results need to be integrated with patients’ clinical follow-up and with the study of the expression of these markers in benign melanocytic lesions to gain more accurate information about their prognostic significance.
Breast Cancer and Pregnancy
Authors: Crivellari Diana , Lombardi Davide , Scuderi Cristina , Spazzapan Simon , Magri Maria Donatella , Giorda Giorgio , Berretta Massimiliano , Veronesi Andrea 
Published: April 2018

The diagnosis of breast cancer during pregnancy is a rare event, but the young age of the patient together with the emotional impact for both the family and the doctors make therapeutic choices usually very difficult. Until recently, the occurrence of pregnancy associated breast cancer was thought to hold a grave prognosis and therapeutic abortion was very often advised in common practice. The hormonal environment with the increase in estrogens and progesterone was the main factor for the fear of tumor stimulation. The course of breast cancer, however, does not appear to be adversely affected by continuation of pregnancy. In the last years it was realized that potentially curative therapies can be administered even when pregnancy is continued. Of course in the medical literature there is no randomized clinical trial helping in taking decision in this setting; however, a significant experience already exists in some institutions and can guide management in these difficult cases. The aim of our review is to give an answer to questions usually coming from various specialists who collaborate with the oncologists in treating these patients and furthermore to try and find some basic guidelines which can be used in the information of the patients regarding previous experience in this field. The problem of a pregnancy after treatment for breast cancer is also analyzed, as this aspect is an emerging issue in clinical oncology. The decision should be evaluated for each single patient, taking into account the prognosis of the patient and her desire of pregnancy.
Breast Microcalcifications Studied with 3d Contrast-enhanced High-field Magnetic Resonance Imaging: More Accuracy in the Diagnosis of Breast Cancer
Authors: Trecate Giovanna , Tesoro Tess John David , Vergnaghi Daniele , Bergonzi Silvana , De Simone Tiziana , Mariani Gabriella , Musumeci Renato 
Published: April 2018

Aims To evaluate the reliability of magnetic resonance imaging (MRI) performed with three-dimensional (3D) sequences in mammographically detected breast microcalcifications. Methods During an 8-month period, a group of 28 patients with mammographically detected microcalcifications suspicious for malignancy underwent MRI. Their ages ranged from 33 to 65 years. Examinations were performed with a 1.5 Tesla MR unit and a 3D T1 weighted sequence. Images were interpreted on the basis of morphologic parameters and dynamic behavior in the uptake of contrast medium (Gd-DTPA). Histologic findings were considered as the gold reference. Results Histologic analysis revealed invasive carcinoma in 7 patients, 3 of which were associated with foci of lobular carcinoma in situ. Intraductal carcinoma was diagnosed in 8 patients, 1 of which was associated with a tubular carcinoma. Benign lesions accounted for 13 patients. All the neoplastic conditions showed enhancement on MR images (sensitivity, 100%), whereas early and intense enhancement was noted in 5 of 13 benign lesions (specificity, 61%). The positive predictive value was 75% and negative predictive value, 100%. Conclusions Although an overlap in the enhancement behavior of malignant and some benign lesions is clearly evident, a careful interpretation of MR images is helpful in detecting and mainly ruling out breast cancer combined with mammographically suspicious microcalcifications.
Interobserver Agreement of the Dermoscopic Diagnosis of 129 Small Melanocytic Skin Lesions
Authors: Pizzichetta Maria Antonietta , Talamini Renato , Piccolo Domenico , Trevisan Giusto , Veronesi Andrea , Carbone Antonino , Soyer H Peter 
Published: April 2018

Aim and background Dermoscopic diagnosis of pigmented skin lesions is based on the evaluation of dermoscopic criteria (classical pattern analysis) and on alternative diagnostic methods, such as the ABCD (A, asymmetry; B, border; C, color; D, differential structures) rule based on the total dermatoscopic score. The aim of the study was to investigate the interobserver agreement of standard dermoscopic criteria between two observers and the diagnostic validity of dermoscopic diagnosis by pattern analysis and by the ABCD rule. Study design The study included a total of 129 small (≤5 mm) melanocytic skin lesions selected from all lesions observed in consecutive patients between April 1996 and September 1998. Before surgery, each lesion was photographed with a Dermaphot. Dermoscopic images were examined independently by two observers to evaluate the presence or absence of standard dermoscopic criteria and to establish the dermoscopic diagnosis by pattern analysis and by the ABCD rule. Results Interobserver agreement for dermoscopic criteria varied from moderately good to good, with the highest agreement for radial streaks (k = 0.96) and the lowest for pseudopods (k = 0.49). Interobserver agreement was moderately good in dermoscopic diagnosis by pattern analysis (k = 0.48) and by the total dermatoscopic score (k = 0.44). The sensitivity and specificity of dermoscopic diagnosis by pattern analysis were 40% and 99%, respectively, for both observers. As regards the total dermatoscopic score (a cutoff score of ≤5.45 vs >5.45), sensitivity ranged from 80% to 100% and specificity from 48% to 59%. Conclusions The study showed that the pattern analyses as well as the ABCD rule give a poor discrimination between benign and malignant lesions and do not add relevant information for management decision in small melanocytic lesions. However, close follow-up examinations of small equivocal melanocytic lesions using digital equipment allow evaluation of their dermoscopic features during progression and whether their rather commonly found atypical dermoscopic features are lost during their natural course of growth.
Pain Mechanisms Involved and Outcome in Advanced Cancer Patients with Possible Indications for Celiac Plexus Block and Superior Hypogastric Plexus Block
Authors: Mercadante Sebastiano , Fulfaro Fabio , Casuccio Alessandra 
Published: April 2018

Aims and Background There is controversy about the role of neurolytic sympathetic blocks in advanced cancer, when pain syndromes may assume other characteristics, with a possible involvement of structures other than visceral. The aim of the present study was to assess the pain characteristics and the analgesic response of a consecutive sample of home care patients with pancreatic and pelvic pain, which would have possible indications for a celiac plexus block and a superior hypogastric block, respectively. Methods From January 1999 to December 1999, 400 consecutive advanced cancer patients were surveyed for a prospective longitudinal survey. We considered only patients who had pancreatic cancer or pelvic cancer with pain. Results Thirty-six patients were surveyed: 22 patients had pelvic cancers and 14 had pancreatic cancer. Patients with pelvic cancers showed a longer survival than those with pancreatic cancer (P = 0.019). Patients with pelvic cancers more frequently showed a neuropathic component associated with a visceral or somatic mechanism than patients with pain due to pancreatic cancer (P = 0.019). When the pain mechanism was taken into consideration, patients with pelvic cancers with a neuropathic component showed worse pain relief than patients with pain due to pancreatic cancer (P = 0.040). Conclusions Sympathetic procedures for pain conditions due to pancreatic and pelvic cancers should be intended as adjuvant techniques to reduce the analgesic consumption, and not as a panacea, given that multiple pain mechanisms are often involved because progression of disease is able to change the underlying pain mechanisms. Pancreatic pain seems to maintain visceral characteristics amenable to sympathetic block more than pain due to pelvic cancer.
Prognostic and Therapeutic Impact of Sentinel Node Micrometastasis in Patients with Invasive Breast Cancer
Authors: Carcoforo P , Bergossi L , Basaglia E , Soliani G , Querzoli P , Zambrini E , Pozza E , Feggi L 
Published: April 2018

Aims and Background Locoregional lymph node status is one of the most important prognostic factors determining the need for adjuvant chemotherapy in patients with breast cancer. Many authors have reported that micrometastases were not detected by routine sectioning of lymph nodes but were identified by multiple sectioning and additional staining. Among lymph node-negative patients 15-20% had an unfavorable outcome at five years from primary surgery. Sentinel lymph node (SLN) biopsy is an accurate technique for identifying axillary metastases because the pathologist utilizes hematoxylin-eosin (H-E) staining together with immunohistochemistry (IH) to examine all lymph node sections. Sentinel node micrometastasis has therefore become an important tumor-related prognostic factor. Methods and Study Design From November 1997 to October 2001 we examined in 210 patients the pathological features of primary breast lesions and SLN metastases and we correlated these with the tumor status of non-SLNs in the same axillary basin. We applied IH examination to both SLNs and non-SLNs of patients who were negative for metastasis by standard H-E examination. Results In this study lymph node staging was based on SLN findings, primary tumor size, and the presence of peritumoral lymphovascular invasion (LVI). We found 18 SLN micrometastases (9%) in 210 patients and one of these (5.5% of patients with SLN micrometastasis) also had one non-SLN metastasis: this patient had LVI and a larger primary tumor than patients with SLN micrometastasis without non-SLN metastasis. We also found 24 SLN macrometastases (11.5%) in 210 patients and 13 of these (54.2% of patients with SLN macrometastases) had one or more non-SLN metastases. Conclusions According to the results reported in the literature, tumor cells are unlikely to be found in non-SLNs when the primary lesion is small and SLN involvement micrometastatic (5.5% in our experience, 7% in Giuliano's). Our findings suggest that axillary lymph node dissection may not be necessary in patients with SLN micrometastasis from T1 lesions.
Radiolabeled Localization of the Sentinel Lymph Node: Dosimetric Evaluation in Personnel Involved in the Procedure
Authors: Pelosi E , Arena V , Bellò M , Cesana P , Lamberti L , Spandonari T , Ropolo R , Sandrucci S , Bisi G 
Published: April 2018

Aims and Background Peritumoral injection of 99mTc-labeled colloids for lymphoscintigraphy and radioguided surgery does not entail any relevant radiation burden to the patients. The real issue about radiation protection concerns the personnel involved in the procedure besides the nuclear medicine personnel. The aim of our study was to evaluate the cumulative doses to personnel involved during the injection of radiolabeled compounds under ultrasound or stereotactic guidance and the radiation burden to the personnel involved in the surgical incision of the tumor 24 hours after the administration of 99mTc-labeled colloids. Methods and Study Design We performed environmental contamination tests (SMEAR TEST) and exposure evaluation in the operating room. Results In the operating room the removed activity in the analyzed samples was less than 0.5Bq/g and exposure to the personnel was less than 6μSv/h. The evaluations made during ultrasound guidance demonstrated an equivalent and effective dose less than 20μSv. Conclusions Our results show that during ultrasound or stereotactic administration of radiolabeled compounds the radiation burden to the personnel involved in the procedure is virtually negligible. The surgeons too are exposed to a negligible radiation dose.