bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Disease Management Profiles. The Mammographic Screening Program of Lazio
Authors: Rossi Paolo Giorgi , Chini Francesco , Barca Alessandra , Baiocchi Diego , Federici Antonio , Farchi Sara , Borgia Piero 
Published: February 2018

Background Screening programs are considered disease management profiles. The aim of the present study was to evaluate the efficacy of screening programs compared to regularly offered health care services, using early outcomes and process indicators. Method In the study period (1/7/99-30/6/01), six breast cancer screening programs were active in 12 health districts in the Lazio region of Italy. Screening histories of all the incident cases of women surgically treated for a breast neoplasm were reconstructed (not contacted, contacted, non-participants, participants). The subpopulations were then compared for the appropriateness of treatments received. Results We identified 3251 women who were treated for malignant neoplasms of the breast and 1562 treated for benign neoplasms. The incidence of malignant neoplasms was higher in the women contacted for screening (incidence rate ratio, 1.45; 95% CI, 1.32–1.60), and the incidence of treatment for non-malignancies was similar in the two populations (incidence rate ratio, 1.00: 95% CI, 0.86–1.16). The percentage of surgery for non-malignancies detected by screening was 16.7%, whereas among the cases diagnosed outside a screening program it was 33.8%. Of malignancies detected outside of screening, 16.6% had a surgical treatment that was too invasive, among the screen-detected malignancies the percentage fell to 11% (prevalence rate ratio, 0.66; 95% CI, 0.48–0.91). Women contacted for screening showed a higher incidence of localized and in situ tumors, whereas the incidence of non-localized and metastatic tumors was basically the same in the two groups. Conclusions The first round of screening programs led to more surgical interventions, a similar incidence of mastectomy and of interventions for benign neoplasm, but a lower incidence of unnecessary treatment.
Incidence and Radiographic Findings of Primary Central Nervous System Lymphoma in Immunocompetent Patients in Southern Thailand
Authors: Rujirojindakul Pairaya , Rohitoprakarn Montanan , Kongkabpan Daolada , Viboonjantra Pongthep , Lekhakula Arnuparp 
Published: February 2018

Aims and Background In the last two decades there have been conflicting reports concerninga rising incidence of primary central nervous system lymphoma (PCNSL) in immunocompetent patients. This study is being conducted to review the incidence and radiographic findings of PCNSL in a large tertiary care institution in southern Thailand. Patients A review was carried out in Songklanagarind University Hospital of the clinical records, CT and MRI images of immunocompetent patients who had histologically proven PCNSL diagnosed between January 1993 and December 2004. Results A total of 25 PCNSL patients were diagnosed over a 12-year period. The incidence trend was rising but not to a statistically significant extent. The median age at diagnosis was 57.4 years. Based on the Working Formulation classification, diffuse large cell was the most common subtype. All of the 20 patients with available immunohistochemical results had B-cell lymphomas. The radiographic findings in our series show that the majority of patients had a single lesion (60%) at a supratentorial location (50%). Most of the lesions were well circumscribed. Based on the density of the lesions before administration of a contrast medium, 56% of the lesions on CT images appeared hyperdense. On T1-weighted MRI images, the lesions of our patients were most frequently hypointense (67%) while the T2-weighted images were more commonly hyperintense (60%) and contrast enhancement was found in all lesions. There were 21 patients who received whole brain radiotherapy with doses ranging between 4.2 and 6.0 Gy. The median survival time was 14.4 months. Conclusions This study indicates that there has been no significant increase in PCNSL cases over the last 12 years. The recognition of characteristic imaging features of PCNSL may facilitate a stereotactic procedure before steroid administration. In addition, we provide evidence that radiotherapy alone is insufficient in PCNSL.
Increased Expression of Endonuclease G in Gastric and Colorectal Carcinomas
Authors: Yoo Nam Jin , Jeong Eun Goo , Kim Min Sung , Ahn Chang Hyeok , Kim Sung Soo , Lee Sug Hyung 
Published: February 2018

Aims Endonuclease G (EndoG) is a mitochondrial protein that plays a role in DNA fragmentation during apoptosis. In addition, EndoG plays a role in cell proliferation and survival. It may be important to identify EndoG protein expression to predict its function in human cancers. The aim of this study was to explore whether alteration of EndoG expression might be a characteristic of colorectal or gastric carcinoma. Methods We investigated EndoG protein expression in 103 colorectal and 60 gastric carcinoma tissues by immunohistochemistry using a tissue microarray approach. Results Expression of EndoG was detected in 72 (70%) of the colorectal carcinomas and 41 (68%) of the gastric carcinomas in cytoplasm. By contrast, normal mucosal cells of both stomach and colon tissues showed no or very weak expression of EndoG. There was no significant association of EndoG expression with clinocopathological characteristics, including invasion, metastasis and stage. Conclusion Our data indicate that EndoG inactivation by loss of expression may not occur in colorectal and gastric cancers. Rather, increased expression of EndoG in colorectal and gastric cancer cells compared to their normal mucosal epithelial counterparts suggests that neo-expression of EndoG may play a role in both colorectal and gastric tumorigenesis.
Lung Cancer Stage is an Independent Risk Factor for Surgical Mortality
Authors: Pastorino Ugo , Borasio Piero , Francese Massimo , Miceli Rosalba , Calabrò Elisa , Solli Piergiorgio , Leo Francesco , Novello Silvia , Scagliotti Giorgio , Mariani Luigi 
Published: February 2018

Aims and Background To study surgical mortality and evaluate major risk factors, with specific focus on the role of pathological stage in patients undergoing lung cancer resection. Methods and Study Design Age, gender, comorbidity, resection volume, experience of the hospital and surgical team have been reported as variables related to postoperative morbidity and mortality in lung cancer. The role of pathological tumor stage on postoperative mortality has never been fully evaluated. The study included 1418 consecutive lung cancer resections performed from 1998 to 2002 in two institutions. The effect of age, gender, comorbidity, resection volume, pathological stage and induction therapies on postoperative mortality was assessed by univariable and multivariable logistic regression analysis. Results Postoperative mortality was 1.8% overall, 3.7% (9/243) for pneumonectomy, 1.7% (17/1016) for lobectomy, and null (0/159) for sublobar resections (P = 0.020). At multivariable analysis, cardiovascular comorbidity (P = 0.008), resection volume (P = 0.036) and pathological stage (P = 0.027) emerged as significant predictors of surgical mortality. Conclusions Early stage lung cancer resection has a favorable effect on surgical mortality, not only by preventing the need for pneumonectomy, but also by reducing mortality after lobectomy.
Trastuzumab and Vinorelbine as Highly Effective and Safe Therapy for HER-2-Overexpressing Metastatic Breast Cancer. A Single Institution Experience
Authors: Di Lauro Vincenzo , Murrone Antonio , Bidoli Ettore , Magri Maria D , Crivellari Diana , Veronesi Andrea 
Published: February 2018

Aims and Background Trastuzumab-based therapy has improved survival of women with human epidermal growth factor receptor 2 (HER2)-overexpressing metastatic breast cancer. Study Design From September 2002 to July 2006, 45 women with metastatic breast cancer HER2 3+, or 2+ and positive for HER2 gene amplification, were enrolled in the study and received a combination therapy with vinorelbine, 25 mg/m2 weeks 1 and 2, plus trastuzumab, 4 mg/kg loading dose and then 2 mg/kg weekly, in a three weeks cycle. Eligibility criteria included measurable disease and a baseline ejection fraction ≥50%. Forty-two percent of the patients were not pretreated, whereas 58% had received a previous chemotherapy regimen for metastatic disease, including anthracy-clines and/or taxanes (47%), and trastuzumab plus taxol (11%). Results We observed 14 (31%) complete responses and 21 (47%) partial responses, with an overall response rate of 78%. Stable disease >6 months was assessed for 5 (11%) patients with a clinical benefit of 89%. Five (11%) patients progressed. With a median follow-up of 11 months, median time to progression was 9 months and median duration of response was 7.6 months for complete remissions and 4 months for partial remissions. Median survival was 29 months. Conclusions In spite of a smaller dose intensity of vinorelbine than previously reported, the regimen evaluated was notably effective in terms of response rate, time to progression and survival, with very mild toxicity.
Cellular Mechanisms of Hepatocyte Growth Factor-Mediated Urokinase Plasminogen Activator Secretion by MAPK Signaling in Hepatocellular Carcinoma
Authors: Lee Kyung Hee , Choi Eun Young , Hyun Myung Soo , Eun Jong Ryul , Jang Byung Ik , Kim Tae Nyeun , Lee Heon Ju , Lee Dong Shik , Yun Sung Su , Kim Hong Jīn , Kim Jung Hye , Kim Jae-Ryong 
Published: February 2018

Aims and Background The hepatocyte growth factor, its receptor c-Met, and urokinase-type plasminogen mediate various cellular responses on activation, including proliferation, survival, invasion, and metastasis. The regulatory mechanisms for the proliferation and the particular invasive phenotypes of hepatocellular carcinoma are not yet fully understood. In order to clarify the intracellular downstream signal for hepatocyte growth factor/c-Met signaling in tumor progression and metastasis in hepatoma, we determined the effects of a specific MEK1 inhibitor (PD 098059) and a p38 kinase inhibitor (SB 203580) on hepatocyte growth factor-mediated cell proliferation and urokinase-type plasminogen expression in hepatoma cell lines (HepG2 and Hep3B). Results Hepatocyte growth factor treatment induced the phosphorylation of ERK and p38 kinase in a dose-dependent manner, resulting in an early peak of phosphorylation at 3 to 10 min, which then rapidly decreased to a near basal level. Pretreatment with PD 098059 reduced hepatocyte growth factor-mediated cell proliferation and urokinase-type plasminogen secretion. In contrast, SB 203580 pretreatment enhanced cell proliferation and urokinase-type plasminogen secretion due to induction of ERK phosphorylation. Treatment with PD 098059 and SB 203580 resulted in a decrease in phospho-ERK activity. Stable expression of dominant negative-MEK1 in HepG2 cells showed a decrease in hepatocyte growth factor-mediated urokinase-type plasminogen secretion. Conclusions Such results suggest that interaction of an MEK/ERK and a p38 kinase might be critical in intrahepatic invasion and metastasis of human hepatoma cells.
Psychological Assessment of Women on an Early Breast Screening Program after Radiotherapy to the Chest Wall for Childhood Cancer
Authors: Clerici Carlo Alfredo , Fossati-Bellani Franca , Lepera Paolo , Gennaro Massimiliano , Bergonzi Silvana , Meazza Cristina , Podda Marta , Gandola Lorenza , Veneroni Laura , Casanova Michela , Cefalo Graziella , Ferrari Andrea , Luksch Roberto , Massimino Maura , Polastri Daniela , Spreafico Filippo , Terenziani Monica 
Published: February 2018

Aims and Background This study investigates the psychological status in a population of female patients who received chest irradiation for a childhood cancer and were screened for second primary breast cancer. Methods Sixty-eight consecutive such young women were included. Compilation of the Crown-Crisp Index questionnaire was requested and 49/68 patients accepted to fill it in; 14 women in the sample had children (28%). Results Twenty-seven of 49 patients achieved a normal score, whereas in 22 the score was slightly above the normal range in at least one scale. Pathological scores were more frequent among the women without children. Conclusions Quality of life in this series of long-term survivors does not seem to be severely affected by previous treatment for cancer nor by the concern for the onset of a second primary malignancy.
Multiple Bowel Stenosis and Perforation as Long-Term Complications of Chemoradiotherapy for Advanced Cervical Cancer in a Young Woman: Case Report
Authors: Bifulco Giuseppe , Mandato Vincenzo Dario , Piccoli Roberto , Bucci Luigi , Giampaolino Pierluigi , Nappi Carmine 
Published: February 2018

Background Although combined treatment (chemoradiotherapy) appears to improve the overall and progression-free survival of patients wih locally advanced cervical cancer, some acute toxicity is increased (hematological toxicity, nausea, vomiting) while the long-term side effects are unclear. Case A35-year-old Caucasian woman with a diagnosis of advanced cervical cancer (FIGO stage IIIB) was treated with neoadjuvant chemoradiotherapy not followed by radical surgery. She underwent whole pelvic radiation therapy for a total of 40 Gy in fractions of 2.5 Gy given 4 times per week for 4 consecutive weeks followed by 2 sessions of intracavitary brachytherapy starting within 7 days of completion of external beam radiotherapy (3500 mg/h and 2500–3000 mg/h). Cis-DDP IV was administered at a dose of 25 mg/m2 on day 1 and then weekly until completion of the radiotherapeutic protocol. After several months the patient presented persistent gastrointestinal symptoms and an X-ray showed findings consistent with bowel occlusion. The patient underwent emergency surgery and multiple bowel stenosis with perforation was diagnosed. Discussion This is the first report in which neoadjuvant chemoradiotherapy is associated with the late complication of multiple stenosis and bowel perforation in a young woman with advanced cervical cancer. Considering that despite the large number of studies about noncisplatin agents there is not enough evidence to justify treatment with alternative agents, this case report might provide new important data regarding the late morbidity of cisplatin-based concurrent chemoradiation.
Congenital Tumors of the Retrorectal Space in the Adult: Report of Two Cases and Review of the Literature
Authors: Coco Claudio , Manno Alberto , Mattana Claudio , Verbo Alessandro , Sermoneta Daniel , Franceschini Gianluca , De Gaetano Annamaria , Larocca Luigi Maria , Petito Luigi , Pedretti Giorgio , Rizzo Gianluca , Lodoli Claudio , D'Ugo Domenico 
Published: February 2018

Aims and Background To describe and discuss, on the basis of the authors’ experience and a review of the literature, the main aspects regarding the etiology, diagnosis, treatment and prognosis of congenital tumors of the retrorectal space. Methods We present 2 cases of congenital retrorectal tumors, a sacrococcygeal teratoma and a dermoid cyst, which represent, from the pathogenetic point of view, the most frequent presentation of the rare tumors of the retrorectal space. Results The reported cases are typical. The teratoma presented as an encapsulated, mixed mass located in the pelvic cavity behind the rectum and the vaginal canal, without signs of sacral involvement. The dermoid cyst appeared as a unilocular lesion filled with sebum and hair, which extended laterally to the iliopubic branch, medially to the urethra and anal canal, and posteriorly to the adipose tissue of the right buttock. Pelvic MRI produced a precise picture of the extension of the lesion and of the relationship between the mass and the pelvic organs and surrounding bony structures. Both lesions were completely removed via the perineal approach without coccygectomy. No recurrences were observed at 2 years of follow-up. Conclusions Congenital retrorectal tumors are rare. MRI is crucial for diagnosis and preoperative planning. Complete surgical removal is the treatment of choice. Resection of the coccyx is necessary only in case of its involvement by the neoplastic mass or suspected malignant transformation.
Smoking in Italy 2007, with a Focus on the Young
Authors: Ferketich Amy K , Gallus Silvano , Iacobelli Nicholas , Zuccaro Piergiorgio , Colombo Paolo , La Vecchia Carlo 
Published: February 2018

Aims and Background Although smoking has been on the decline in Italy, its prevalence is still high among younger individuals. We analyzed data from the 2007 tobacco survey and present the findings on smoking prevalence by selected characteristics, with a particular focus on the young. Methods The data were collected from 3,057 Italians aged 15 years and older in March and April 2007 who were randomly selected to be representative of the general Italian population. The prevalence of self-reported current smoking was estimated overall and by age group, education, geographic region, and gender. Additionally, intentions to quit and trends in smoking in the total population and among individuals aged 15–24 years were estimated. Results The smoking prevalence overall was 23.5% (27.9% among males and 19.3% among females), with higher estimates among adults living in central regions and among men with a lower educational level. Among individuals aged 15–24 years, since 2001 the male prevalence has fluctuated between 30% and 35% and the female prevalence between 20% and 25%. Overall, the prevalence decreased by approximately 40% in this age group. A small percentage (3.3%) reported having intention to quit smoking in the next 6 months. Conclusions The smoking prevalence is the lowest estimate reported since 1957, and the gap between men and women has diminished. Compared to earlier birth cohorts, the lower current estimate among younger adults suggests that the rates will decrease in the future.
Serum Cytokine in Response to Chemo-Radiotherapy for Hodgkin's Disease
Authors: Villani Fabrizio , Busia Alessandra , Villani Massimiliano , Vismara Chiara , Viviani Simonetta , Bonfante Valeria 
Published: February 2018

Aims and Background Mediastinal radiotherapy and multiple-drug chemotherapy, including bleomycin employed in the treatment of Hodgkin's disease, can produce lung toxicity leading to fibrosis. There is increasing evidence of the involvement in the fibrosing process of different cytokines and growth factors such as TNF-alfa, IL-1 beta, TGF-beta and PDGF. Material and Methods In a pilot study, we evaluated lung function in 20 patients suffering from Hodgkin's disease, mainly in stage II A, submitted to multiple-drug chemotherapy including bleomycin (ABVD) and mediastinal radiotherapy and correlated its modifications with serum concentration of the cytokines determined by immunoenzymatic assay. Spirometry and transfer lung function for carbon monoxide (DLCO) were performed before, at the end of chemotherapy, at the end of radiotherapy and after a follow-up of 6 and 12 months. Results DLCO decreased at the end of the combined treatment and then remained constantly decreased. TNF-alfa, TGF-beta and PDGF-alfa concentrations did not change, whereas IL-1 beta significantly increased after the completion of the combined treatment and after a follow-up of 6–months and then declined to normal values after 12 months. The serum concentration of the cytokine was significantly higher in patients who had a DLCO <75% of predicted after 1 year than in patients with a DLCO >75%. Conclusions The results indicate a potential role of IL-1 beta in the pathogenesis of chemoradiotherapy-induced lung toxicity, which needs to be confirmed in a larger patient population.
An Evaluation of Half-Body Irradiation in the Treatment of Widespread, Painful Metastatic Bone Disease
Authors: Miszczyk Leszek , Tukiendorf Andrzej , Gaborek Aleksandra , Wydmański Jerzy 
Published: February 2018

Aims Evaluation of analgesic uptake, pain intensity, and quality-of-life changes after half-body irradiation of patients with bone metastases. Material and Methods Ninety-five patients (97 irradiations) were treated with single half-body irradiation fraction (3–8 Gy). Thirty-three patients had upper-half-body irradiation, 55 lower-half-body irradiation and 9 middle-half-body irradiation. The patients were examined on the day of irradiation, 2 and 4 weeks later, and then once a month. The intake of analgesics, pain level (from 0 to 10), and the quality of life (EORTC QLQ-C30) were evaluated. The fluctuations of pain levels and the particular scaling values of QLQ-C30 during a one-year period were analyzed (Kendall t correlation). Results Over the course of 5 months, the incidence of patients using strong opioids decreased from 43.8% to 33.3%, and the incidence of patients who did not need to resort to analgesics increased from 6.7% to 25%. The mean pain level decreased from 6.1 points (half-body irradiation) to 3.1 points 2 weeks later. An inverse correlation between pain level readings and time was statistically significant. An increase was observed in the values of the five functional scales as reflected on the EORTC QLQ-C30 questionnaire (four of which correlated significantly with the observation time). A similar situation prevailed with respect to global health status. A decrease was observed in most of the values on the symptoms scales; 6 saw a significant decrease, in correlation with the follow-up. Correlations were also found between pain intensity and functionality, and between symptoms scales readings and global health status. Conclusions Half-body irradiation of cancer patients suffering from painful multiple bone dissemination is an effective and simple treatment modality that affords significant quality-of-life improvement and pain relief, thus allowing for a reduction in the use of strong analgesics.
Exposure to Benzene and Risk of Breast Cancer among Shoe Factory Workers in Italy
Authors: Costantini Adele Seniori , Gorini Giuseppe , Consonni Dario , Miligi Lucia , Giovannetti Lucia , Quinn Margaret 
Published: February 2018

Aims and background Evidence of the association between leukemia and benzene exposure has been provided by several epidemiological studies. An increased risk of breast cancer among women exposed to benzene has also been suggested. The aim of this study was to analyze breast cancer risk in a cohort of 1,002 women exposed to benzene in a shoe factory in Florence, Italy, where an excess of leukemia in men was reported. Methods The cohort of women at work on January 1st, 1950, was followed from 1950 to 2003 for mortality and from 1985 to 2000 for incidence of breast cancer. For a sub-cohort of 797 women, cumulative exposure to benzene was available. Results Standardized mortality ratios were obtained for the 797 women for whom information on cumulative exposure was available. For those with <30 years of latency the standardized mortality ratio was 58.5 (95% CI, 18.9–181.2, based on 3 deaths) and 151.1 (95% CI, 78.6–290.3, based on 9 deaths) for ≥30 years of latency. In the >40 ppm-year and ≥30 year latency period category, the standardized mortality ratio was 166.0 (95% CI, 62.3–442.2, based on 4 deaths). The standardized incidence ratio for women with a latency period <30 years was 140.9 (95% CI, 75.8–261.9, based on 10 cases) and 108.2 (95% CI, 64.1–182.7) for a latency period ≥30 years. For cumulative exposure >40 ppm-years and a latency period <30 years, the standardized incidence ratio was 211.9 (95% CI, 29.9–1504.1, based on 1 case). Conclusions The study moderately supports the hypothesis that benzene represents a risk factor for breast cancer.