bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of BCL-2, BAX and P53 Proteins in Pituitary Adenomas an Immunohistochemical Study
Authors: Ozer Erdener , Canda M Serefettin , Ulukus Cagnur , Guray Merih , Erbayraktar Serhat 
Published: April 2018

Aims and Background Although pituitary adenomas are usually benign lesions, their growth rate is highly variable and unpredictable. Apoptosis appears to be an important process in neoplastic lesions. The purpose of this study was to investigate the expression of apoptosis-related proteins including Bcl-2, bax and p53 in pituitary adenomas and its correlation with hormone function, tumor size, local control, and proliferative activity. Study Design The expression of Bcl-2, Bax and p53 proteins and hormonal function were determined in formalin-fixed, paraffin-embedded tissue from 41 untreated pituitary adenomas using immunohistochemistry. The patients were followed for a median of 60 months (range, 12 to 95). Patient charts were reviewed to record tumor recurrence and size. Tumor proliferative activity was assessed by immunohistochemistry using Ki-67 antibody. Results Of 41 pituitary adenomas, 26 (63%) were hormone-secreting and 15 (37%) non-functioning, 34 (83%) were macroadenoma and 7 (17%) microadenoma, and 15 (37%) showed local relapse. Six (14%) adenomas were of low proliferative activity, whereas the others (86%) were non-proliferative. Immunohistochemically, 31 adenomas (75%) showed bcl-2 positivity, 37 (90%) bax positivity, and 7 (17%) p53 positivity. Statistical analysis revealed that Bcl-2 protein expression significantly diminished in prolactin-secreting and non-functioning adenomas (P = 0.005 and P = 0.006, respectively), and increased in growth hormone-secreting adenomas (P = 0.003). In addition, expression of bax protein significantly decreased in recurrent tumors, in contrast to p53 protein, which showed a significant increase (P = 0.03 and P = 0.002, respectively). Conclusions We think that apoptosis-related proteins such as Bcl-2, Bax and p53 may be significantly related to hormone function and local control in pituitary adenomas.
Down-Staging after Two Different Preoperative Chemoradiation Schedules in Rectal Cancer
Authors: Grillo-Ruggieri Filippo , Mantello Giovanna , Cardinali Massimo , Fabbietti Letizia , Fenu Francesco , Montisci Maria , Bracci Raffaella , Delprete Stefano , Guerrieri Mario , Marmorale Cristina 
Published: April 2018

Aims To compare preoperative downstaging, toxicity and sphincter-saving procedures obtained with preoperative radiotherapy and two different concomitant chemotherapy schedules. Methods From February 1997 to August 2001, 68 consecutive patients were treated with external radiotherapy (5040 cGy in 28 fractions) and concomitant chemotherapy: group a) 36 patients (10T2, 19T3, 7T4, 25 adenocarcinoma and 11 mucinous histology) were treated with cis-diamminedichloroplatinum bolus + 5-fluorouracil continuous infusion; group b) 32 patients (14 T2, 18 T3, 27 adenocarcinoma and 5 mucinous histology) were treated with 5-fluorouracil bolus ± mitomycin C. The interval between the end of radiotherapy and surgery ranged from 4 to 9 weeks. Results Group a) Overall downstaging was 63.9%. Longitudinal shrinkage of the neoplasm allowed conservative surgery in 6 of 11 patients with a pre-chemoradiation tumor location ≤3 cm from the external anal ring. When patients with adenocarcinoma (25/36) were studied separately from patients with mucinous histology, 7/25 patients (28%) were found to have no microscopic evidence of residual tumor (pTO); 8/25 (32%) were found to have only rare isolated cancer cells (pTmic); only 7/25 patients (28%) were found to have no change. Overall, 72% patients had downstaging. In contrast, only 5/11 (45.5%) of mucinous tumors had partial downstaging and 6/11 (54.5%) no downstaging at all. Group b) Overall downstaging was 46.9%. When patients with adenocarcinoma (27/32) were studied separately, 7/27 (26%) were found to have pTO, 3/27 (11.1%) pTmic, and 13/27 (48.1%) no change. Only 1/5 (20%) of mucinous tumors had downstaging and 4/5 (80%) had no downstaging at all. Overall toxicity was comparable among groups a and b, except for lower hematologic and gastrointestinal G3-4 toxicity observed in group a. Conclusions The overall response allowed conservative surgery in 56 (82.3%) of the 68 patients. Continuous infusion of 5-fluorouracil and diamminedichloroplatinum as a radipsensitizer determined better results in group a than group b (63.9% downstaging vs 46.9% even with a higher incidence of mucinous histology). Mucinous histology, for a definitely lower response rate, could benefit from an even more aggressive approach.
Anxiety, Depression and Informed Consent in Patients Referred to a Radiotherapy Department
Authors: Cazzaniga Luigi Franco , Maroni Daniela , Bianchi Ernestina , Bossi Alberto , Cagna Emanuela , Cosentino Dorian , Palmieri Luigi , Scandolaro Luciano , Valli Maria Carla 
Published: April 2018

Aims and background Informing cancer patients is an ethical, legal and deontological aspect of patient management. Patients need clear instructions in order to be able to accept or refuse medical procedures. Many reports in the literature have shown differences among physicians in informing cancer patients. The aim of this study was to assess patients’ understanding of diagnosis, planned radiotherapy and risk of early and late effects, their satisfaction with the discussion with the doctor and correlation with anxiety and depression after the disclosure of a cancer diagnosis. Methods From April to July 2000 a physician with psychiatric training conducted interviews with patients after their consultation with the radiotherapist and asked them to fill in a questionnaire. Anxiety and depression were measured by means of a scoring system [HAD(A) and HAD(D)] such as the patient's satisfaction and the physician's belief in it. Eighty-two outpatients referred to our radiotherapy department were studied. Results We did not find any correlation between HAD(A) and HAD(D) scores and comprehension scores of disease, treatment schedule, side effects and patient satisfaction, or between any scores and presumed predictive variables such as diagnosis, gender, age, treatment aims, time from diagnosis, education, marital status, profession, life habits, and the role of the doctor obtaining the informed consent. Conclusions We may conclude that informed consent does not seem to increase reactive anxiety or depression. Its quality is high in our department but must be improved.
Detection of Matrix Metalloproteinases (MMP), Tissue Inhibitor of Metalloproteinase-2, Urokinase and Plasminogen Activator Inhibitor-1 within Matrigel and Growth Factor-Reduced Matrigel Basement Membrane
Authors: Gillette Karin M , Forbes Katie , Sehgal Inder 
Published: April 2018

Aims and background Matrigel (MG) basement membrane is commonly used for in vitro studies of cellular migration, invasion and angiogenesis. It contains structural molecules such as collagen IV and laminin plus several growth factors which are diminished in growth factor-reduced Matrigel (GFR-MG). A less appreciated but important aspect of MG is the presence of matrix enzymes and their inhibitors. For relevant interpretation of data using MG/GFR-MG models, it may be necessary to know the enzymes or inhibitors contributed by these basement membranes themselves. Methods Immunoblot and zymography were used to detect the presence or absence of MMP-1 and 7, tissue inhibitor of metalloproteinase 1 and 2 (TIMP-1, TIMP-2), plasminogen activator activity and plasminogen activator inhibitor-1 (PAI-1). Growth and invasion assays using prostate cancer cells were used to assess the effects of TIMP-2 presence or absence. Results We detected MMP-7, urokinase plasminogen activator (uPA) and PAI-1 in both Matrigels, TIMP-2 was detected only in regular Matrigel and no MMP-1 or TIMP-1 was detected in either matrix. Invasion assays comparing regular MG and GFR-MG indicated cell line variability with regard to invasion efficiency as two tested prostate cancer lines were unaffected by the MG type while one was significantly more invasive in regular MG. Growth experiments suggest that the presence of TIMP-2 in regular MG may retard growth but overall proliferation is still greater in regular MG than in GFR-MG. Conclusions These data provide a useful reference for interpretation of in vitro Matrigel assays.
Correlates of Age at Natural Menopause in the Cohorts of Epic-Italy
Authors: Celentano Egidio , Galasso Rocco , Berrino Franco , Fusconi Elisabetta , Giurdanella Maria Concetta , Tumino Rosario , Sacerdote Carlotta , Fiorini Laura , Ciardullo Anna Vittoria , Mattiello Amalia , Palli Domenico , Masala Giovanna , Panico Salvatore 
Published: April 2018

A large number of studies have investigated the factors correlated to age at natural menopause in several populations. However, information on genetics and life-style factors influencing the age of onset of menopause in different populations is of current scientific interest. Specifically, for Italian women there are no large population-based data. The EPIC-Italy collaboration is a source of data of this kind; moreover, the geographical distribution of the cohorts (recruited in northern, central and southern Italy) is an added value as regards the scientific interest of these data. A number of biological and life-style-related factors have been analyzed to evaluate their association to the age at natural menopause in 14,454 menopausal women of the EPIC-Italy collaboration. As regards life-style and environmental factors, the main results are: a) women living in different areas of the country have different ages of onset of natural menopause; b) educational level is significantly associated to this age and may explain part of the between-center difference; c) cigarette smoking appears as a major correlate and probably determinant of the age at natural menopause across all the Italian cohorts; d) alcohol consumption does not have any relationship with the age at natural menopause; e) the use of oral contraceptives may influence age at natural menopause. As regards biological factors, short cycles and low parity have been found associated with earlier menopause. Overall, the results concerning menstrual cycles, parity, and cigarette smoking are consistent with the hypothesis that the number of oocytes in the ovary is pre-determined and any acceleration or impairment of the ovarian function leads to reduce the duration of the reproductive life.
Determinants of Exposure to Environmental Tobacco Smoke in 21,588 Italian Non-Smokers
Authors: Veglia Fabrizio , Vineis Paolo , Berrino Franco , Del Sette Cerulli Daniela , Giurdanella Maria Concetta , Tumino Rosario , Fiorini Laura , Sacerdote Carlotta , Panico Salvatore , Mattiello Amalia , Palli Domenico , Saieva Calogero , Davico Laura 
Published: April 2018

Background Exposure to environmental tobacco smoke (ETS) is associated with an increased risk of lung cancer, ischemic heart disease and respiratory diseases in non-smokers. Exposure is likely to be uneven in the population. Knowledge of its distribution is important for a better planning of preventive activities. Methods In the context of the Italian branch of the EPIC prospective investigation, in which we enrolled 47,000 volunteers, we have surveyed exposure to ETS and its determinants (age, social class, occupation). The purpose of the present paper is to contribute to identify the main sources of exposure in Italy. Results We found, in a sample of 21,588 Italian non-smokers, a prevalence of 0.337 (95% confidence interval, 0.336-0.337) in women and 0.537 (0.529-0.544) in men. Exposure was defined as at least 1 hr/day for at least one year. Exposure at work is by far the commonest source of exposure to ETS, with a strong difference between full-time and part-time jobs. The distribution of exposure by social class was uneven, with statistically significant odds ratios for higher social groups in the order of 0.4-0.5. White-collar workers are the occupational category mostly exposed, suggesting that the implementation of anti-smoking legislation is still incomplete in Italian offices. Conclusions The uneven distribution of ETS in the population is a matter of concern, since it contributes to the unequal distribution of health in different social groups.
Fractionations in Radiotherapy of Brain Metastases
Authors: Portaluri Maurizio , Bambace Santa , Giuliano Giuseppe , Di Paola Lucia , Gianicolo Maria Elena , Distante Simona , Casciaro Sergio 
Published: April 2018

Aims and background The aim of this study was to evaluate different fractionations for radiotherapy of brain metastases. Methods One hundred and twenty-five patients treated with whole brain cobalt therapy (WBRT) were examined to evaluate the effect on survival and quality of life of three different dose fractionations (2 Gy × 25, 3 Gy × 10 and 4 Gy × 5). Fractionation was evaluated in relation to mean survival, single or multiple lesions, presence of extracranial metastases, primary tumor control and neurological status before and after treatment. Kaplan-Meier analysis of survival and univariate and multivariate analysis of these factors were performed. Twenty-six (21%) patients were treated with 2 Gy × 25, 48 patients (38%) with 3 Gy × 10 and 42 patients (33%) with 4 Gy × 5. The other 9 patients were treated with unusual fractionations. Results In 66% of patients an improvement in neurological status after radiotherapy was recorded. Patients with controlled primary tumors had a better mean survival, 8.6 months, if they had no extracranial metastases. The six-month survival was 21% in the 4 Gy × 5 group, 36% in the 3 Gy × 10 group, and 21% in the 2 Gy × 25 group; the results for one-year actuarial survival were highly similar in the three fractionation groups (5%, 11% and 6%, respectively). Conclusions The use of 5 × 4 Gy fractionation may be appropriate in lung cancer patients, where no significant difference in 6- and 12-month survival was observed with respect to the other fractionation groups despite the most unfavorable prognosis of these patients and the lower biological effectiveness of this fractionation with respect to the other schedules.
Cancer Patients Submitted to Innovative Chemotherapeutic Agents of Intermediate Emetogenic Potential: Antiemetic Prescriptions and Incidence of Emesis
Authors:   Italian Group for Antiemetic Research, De Angelis Verena 
Published: April 2018

Controversies exist regarding the classification of the emetogenic potential of chemotherapeutic agents such as taxanes, gemcitabine and irinotecan and the antiemetic prophylaxis for acute emesis to be administered. Instead, no prophylaxis for delayed emesis has been suggested. A prospective, observational study was carried out in 103 Italian oncological centers to evaluate the prescriptions of antiemetics and the incidence of nausea and vomiting in patients submitted to these chemotherapy agents. Two hundred and nine patients treated with taxanes, 300 with gemcitabine and 93 with irinotecan were evaluated. For the prophylaxis of acute emesis a 5-HT3 antagonist alone or in combination with a corticosteroid was administered to 86.6% of patients receiving taxanes, to 59.3% of those receiving gemcitabine and to 96.8% of those submitted to irinotecan. 20% to 40% of patients received antiemetic prophylaxis for delayed emesis. In taxane-treated patients the incidence of acute vomiting and nausea was 6.2% and 27.3%, respectively, while in gemcitabine- and irinotecan-treated patients it was 6.0/33.4% and 17.9/58.9%, respectively. In conclusion, the study showed that almost all patients received prophylaxis for acute emesis and that there is overprescription of 5-HT3 antagonists. The incidence of acute emesis is low; therefore, randomized clinical trials are necessary to verify the utility of prophylaxis and to find the best antiemetic treatment.
BCL2 Expression and its Correlation with Neuroendocrine Differentiation in Colon Carcinomas
Authors: Atasoy Pınar , Bozdoğan Önder , Öztürk Sibel , Ensari Arzu 
Published: April 2018

Aims and background In this study we investigated the association between BCL2 expression and neuroendocrine differentiation in tubular adenomas and colon carcinomas. We also evaluated the prognostic significance of BCL2 expression and neuroendocrine differentiation in the carcinoma group. Methods Forty-eight colon carcinomas and twelve tubular adenomas were stained immunohistochemically with BCL2 and chromogranin A (CgA). Staining patterns were scored semiquantitatively and correlated with tumor type, tumor grade, Dukes stage, and survival time. Results BCL2 expression was detected in 7 of 12 (58.3%) adenomas and 37 of 48 (77.0%) carcinomas. In normal mucosa we observed positive staining only in the basal portions of the crypts. However, diffuse positivity was observed in the adenomas and carcinomas. Carcinomas had significantly higher BCL2 scores than the normal group, but we did not observe any significant differences either between the adenoma and carcinoma group or between the adenoma and normal group. BCL2 scores were higher in stage B than in stage C tumors, and in adenocarcinomas than in mucinous carcinomas. CgA positivity was observed in 24 of 48 (50%) carcinomas. It was not detected in adenomas. We did not find a significant correlation between CgA expression and any of the clinicopathological parameters. Conclusion On consecutive sections BCL2 and CgA positivity closely paralleled each other and a significant positive correlation was observed between CgA and BCL2 expression. These findings suggest a close association between BCL2 expression and neuroendocrine differentiation and indicate that BCL2 may be involved in neuroendocrine differentiation in addition to its role in protecting cells from apoptosis.
Low Expression of P63 and P73 in Osteosarcoma
Authors: Park Hye-Rim , Kim Youn-Wha , Park Jae-Hoon , Maeng Young-Hee , Nojima Takayuki , Hashimoto Hiroshi , Park Yong-Koo 
Published: April 2018

Background The recent discovery of two p53-related genes, p63 and p73, has revealed an additional level of complexity to the study of p53 function. Both genes encode multiple proteins arising from alternative promoter usage and splicing, with transactivation, DNA-binding, and tetramerization domains. Recent data support a role for p63 in squamous and transitional cell carcinomas, as well as in certain lymphomas and thymomas. Methods To characterize the involvement of p63 and p73 in the development of osteosarcoma, we analyzed the expression and mutation of TAp63 and TAp73 in six osteosarcoma cell lines and twelve osteosarcoma specimens. Results Semiquantitative DNA/PCR analysis revealed that eight (67%) and six (50%) out of twelve osteosarcoma specimens showed significantly reduced levels of p63 and p73 transcription, respectively. Direct sequencing of the entire coding region detected no mutations in cell lines or osteosarcoma specimens. Conclusions Our data suggest that low expression of p63 and p73 is relatively common in osteosarcomas and might contribute to their molecular pathogenesis.
Decrease in Length of Hospitalization before Death of Cancer Patients in the Italian Province of Imperia
Authors: Campora Elisabetta , Colloca Giuseppe , Addamo Gianfranco , Venturino Antonella , Guarneri Domenico 
Published: April 2018

Although the overall cure rates for cancer in Italy are comparable to those of other developed countries, these results are the product of very heterogeneous facilities. In order to assess the possible impact of improved acute cancer care services on the last phase of life, a retrospective study was carried out which included 4238 patients registered at the Division of Medical Oncology of Imperia Province from January 1995 to December 2002. In 1998 the Province of Imperia, with a population of 217,000, had only two doctors and five day-hospital beds. During 1999 and 2000, resources increased to include five oncology specialists and 10 day-hospital beds. Compared to 1998, in 2002 the number of new patients registering at the Division of Medical Oncology and the number of day-hospital treatments increased by 76% and 67%, respectively. Since end-of-life care for advanced cancer patients is expensive, the length of hospitalization of cancer patients dying in acute hospital settings was analyzed for the years 1995-2002. Of the 4238 patients registered during the eight-year period, 1433 (33.8%) died before 31 December 2002. Among these 1433 patients, the records relative to hospitalization and death were available for 571 cancer patients, 324 males (56.7%) and 247 females (43.3%) with a median age of 70 years (range, 21-91). The average number of days of hospitalization declined from 14.6 (range, 1-76) in 1998 to 8.2 (range, 1-29) in 2002, a decrease of approximately 44%. The length of hospitalization prior to death has declined considerably for cancer patients in the Imperia Province and the costs of acute hospital facilities for end-of-life care in cancer patients have decreased. In addition, fewer days in hospital before death may have had an important impact on the quality of life of these cancer patients.
Primary Cerebral Lymphoma: A Retrospective Study in 22 Immunocompetent Patients
Authors: Caroli Emanuela , Acqui Michele , Ferrante Luigi 
Published: April 2018

Aims and background Primary CNS lymphomas are uncommon tumors in immunocompetent patients. We describe the radiological features that should orient towards performing a biopsy and analyze the results in our series of patients. Methods We reviewed 22 immunocompetent patients with primary central nervous system lymphoma admitted in our Institute between 1977 and 1997. The follow-up period ranged from 2 months (patient deceased) to 69 months. Fourteen patients underwent surgical removal of the tumor and the remainder a biopsy. All patients received radiotherapy and 8 patients radiotherapy plus chemotherapy. Results Two of the 14 patients treated by surgical removal of the tumor died. There was no mortality related to biopsy procedures. Patients treated with radiotherapy had 1-year, 2-year and 5-year survival rates of 66%, 41.6% and 16.6%, compared to 87.5%, 62.5% and 50%, respectively, for patients who received radiotherapy and chemotherapy. Conclusions At present, there is no definite treatment for these highly malignant brain tumors. The most favorable results seem related to biopsy followed by radiotherapy plus chemotherapy versus surgical removal, which is related to a high risk of severe postoperative deficit for both the deep location and infiltrating nature of these lesions.
Post-Traumatic Glioma. Report of Four Cases and Review of the Literature
Authors: Salvati Maurizio , Caroli Emanuela , Rocchi Giovanni , Frati Alessandro , Brogna Christian , Orlando Epimenio Ramundo 
Published: April 2018

Aims and background To add a further contribution to the literature supporting the relationship between previous head trauma and development of glioma. Methods We report on four patients who developed brain gliomas in the scar of an old brain injury. Results All cases fulfilled the widely established criteria for brain tumors of traumatic origin. In all of our cases there was radiological evidence of absence of tumor at the time of the injury. Conclusions We believe that in specific cases it is reasonable to acknowledge an etiological association between a severe head trauma and the development of a glioma. This assumption is further sustained if there is radiological and surgical documentation of the absence of neoplasia at the moment of the trauma.