bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility‐adjusted analysis of the cost of palliative radiotherapy for bone metastases
Authors: Barton Michael B , Jacob Susannah A , Gebsky Val 
Published: August 2003

SummaryPalliative radiotherapy is effective in the treatment of bone metastases but is under‐utilized, possibly because it is perceived to be expensive. We performed a cost‐utility analysis of palliative radiotherapy for bone metastases, evaluating both the actual cost of radiotherapy as well as its impact on quality of life by adjusting for the variation in response to treatment. Hospital records between July 1991 and July 1996 were reviewed to ascertain the number of patients treated with palliative radiotherapy for bone metastases, the average number of fields of radiation delivered to each patient and the average duration of survival. Partial and complete response rates to palliative radiotherapy were obtained from a review of all published randomized controlled trials of radiation treatment of bone metastases. Utility values were assigned to the response rates, and an overall adjusted response rate to radiotherapy was derived. The cost of delivering a field of radiation was calculated. The total cost was divided by the total number of response months to give a utility‐adjusted cost per month of palliative radiotherapy. The utility‐adjusted cost per month of palliative radiotherapy of bone metastases was found to be AUS$ 100 per month or AUS$ 1200 per utility‐adjusted life‐year. This study demonstrates that, contrary to popular perception, palliative radiotherapy is a cost‐effective treatment modality for bone metastases.
Early cervical cancer treated with definitive or adjuvant radiotherapy: Improved survival with adjuvant radiotherapy attributable to patient selection
Authors: MacLeod Craig A , Vinod Shalini K 
Published: August 2003

SummaryThe optimum management of patients with early cervical cancer (Federation Internationale de Gynécologie Stages IB and IIA) remains controversial. We reviewed our radiotherapy practise and compared patients with early stage cervical cancer who had surgery and adjuvant radiotherapy (ART) to those that had definitive radiotherapy (DRT). One hundred and twenty‐seven patients were identified, 81 of these underwent ART and 46 underwent DRT. Patients who underwent DRT were significantly older and of poorer performance status than those who underwent ART. The 5‐year relapse‐free survival in the ART and DRT groups were 79 and 72%, respectively (P = 0.70). The corresponding 5‐year overall survival figures were 86 and 58% (P = 0.006). The difference was due to increased deaths from other causes in the DRT arm, 37 versus 7% (P = 0.0007.) The poorer overall survival of DRT patients was due to patient selection.
A prospective trial of short‐fractionation radiotherapy for the palliation of liver metastases
Authors: Bydder S , Spry NA , Christie DRH , Roos D , Burmeister BH , Krawitz H , Davis S , Joseph DJ , Poulsen M , Berry M 
Published: August 2003

SummaryThe purpose of this study was to prospectively examine the effectiveness and tolerability of a simple radiotherapy technique for the palliation of symptomatic liver metastases. Twenty‐eight patients with symptomatic liver metastases were enrolled from seven centres, and received targeted (partial or whole) liver irradiation consisting of 10 Gy in two fractions over 2 days. Symptoms at baseline were hepatic pain (27 patients), abdominal distension (19), night sweats (12), nausea (18) and vomiting (eight). Twenty‐two patients (76%) had failed previous treatment with chemotherapy, hormonal therapy and/or high‐dose steroids. Symptoms and potential toxicities were prospectively assessed at the time of treatment, then 2, 6 and 10 weeks later. Individual symptom response rates were 53−66% at 2 weeks. Partial or complete global symptomatic responses were noted in 15 patients (54%) overall. The treatment was well tolerated with two patients (7%) experiencing grade 3 toxicity (one vomiting and one diarrhoea); however, four patients reported temporary worsening of pain shortly after treatment. This simple and well‐tolerated treatment achieves useful palliation.
Multicentre dosimetric comparison of photon‐junctioning techniques in head and neck radiotherapy
Authors: Kron Tomas , Barnes Kara , O'Brien Peter 
Published: August 2003

SummaryBecause many head and neck radiotherapy treatment techniques rely on a junction between X‐ray fields, it was the aim of the present study to investigate the use of different junctioning techniques and the affect on the dose across the junction. Techniques in use at nine radiotherapy centres in Australia were investigated using thermoluminescence dosimetry (TLD). The techniques could broadly be divided into two groups: (i) use of the light field to match the fields after moving the patient; and (ii) use of asymmetric collimation to create a single isocentre located in the junction. The mean dose at the junction and its reproducibility was studied in five consecutive treatments in each centre using 25 TLD chips placed throughout the junction in an anthropomorphic phantom. There was a tendency for the mono‐isocentric technique to deliver a lower, more accurate mean dose at the junction (Group I: 1.22 Gy (n = 8) vs Group II: 0.96 Gy (n = 5) for 1 Gy planned, some centres contributed to both technique) with greater reproducibility (Group I: 9.6%, Group II: 5.1% of the mean dose). We conclude that a mono‐isocentric treatment technique has the potential to deliver a more accurate and reproducible dose distribution at the field junction of photon beams in head and neck treatment.
Are radiologists meeting the needs of Australian medical oncologists? Results of a national survey
Authors: Koczwara B , Tie M , Esterman A 
Published: August 2003

SummaryAlthough radiological evaluation plays an integral role in the management of oncology patients, little is known about which elements of such evaluation are most important or about how satisfied clinicians are with the quality of radiology services in cancer patients. We have developed a 36‐item anonymous survey evaluating availability of and satisfaction with radiology services to medical oncologists. The survey was distributed to members of the Medical Oncology Group of Australia resident in Australia. We received 124 responses (51%). Most respondents (76.9%) were satisfied with their radiology services. Satisfaction correlated closely with the availability of standardized reporting and promptness of reporting (P < 0.001). Oncologists in private practise were more likely to receive prompt reports (P < 0.0001). Oncologists in public practice were more concerned about availability of CT scanning (P = 0.02). Services that were reported as less frequently available, despite being ranked as very important, included measurements of key lesions and comparison to previous studies. Standardized reporting was considered helpful by 91% of respondents. Only 32.5% of respondents reported receiving such a summary in more than 50% of cases and 21% never received such a summary. Our findings highlight the need for closer collaboration between oncologists and radiologists in order to address specific needs and develop optimal patterns of practise. Consideration should be given to standardization of reporting of radiology studies in oncology.
Neurosarcoidosis of the conus medullaris and cauda equina
Authors: Prelog Kristina , Blome Steven , Dennis Christopher 
Published: August 2003

SummaryAn uncommon case of neurosarcoidosis of the conus medullaris and cauda equina is described in a 24‐year‐old man with a 4‐year history of urological symptoms and rash. Chest X‐ray and biopsy confirmed sarcoidosis and MRI diagnosed conus medullaris involvement.
Pelvic chondrosarcoma in an 18‐year‐old man masquerading as tuberculous ilipsoas abscess
Authors: Zacharia Titty Thomas , Lakhar Bhushan , Perumpallichira James Joseph , Chavhan Govind 
Published: August 2003

SummaryChondrosarcoma is distinctly uncommon in the younger age group. We report an unusual presentation of pelvic bone chondrosarcoma in an 18‐year‐old man clinically creating an impression of tuberculous abscess, and we discuss the CT and MRI appearances.
Chondrosarcoma of bone complicating Ollier's disease: Report of a favourable response to radiotherapy
Authors: Le Anhchuong , Ball David , Pitman Alex , Fox Richard , King Kevin 
Published: August 2003

SummaryBecause chondrosarcoma of bone is traditionally thought to be a radioresistant malignancy, it is usually managed surgically. We report a case of multifocal chondrosarcoma arising in Ollier's disease for which the patient declined surgery. He was given a course of radical radiotherapy that resulted in symptom palliation and a radiologically confirmed response before he died of disseminated disease. In patients with inoperable chondrosarcoma, radiotherapy can provide palliative benefit.
Leptomeningeal carcinomatosis from squamous cell carcinoma of the supraglottic larynx
Authors: Thompson Stephen R , Veness Michael J , Morgan Gary J , Shannon Jeniffer , Kench James G 
Published: August 2003

SummaryLeptomeningeal carcinomatosis is an uncommon but devastating form of metastatic spread. To our knowledge, only 16 cases originating from a head and neck cancer have been reported. We describe the first case of a patient with leptomeningeal carcinomatosis arising from a laryngeal squamous cell carcinoma. Shortly after completing treatment for an advanced supraglottic laryngeal cancer, this 63‐year‐old man presented with lower limb neurological symptoms and signs. Radiological and cytological evidence of leptomeningeal carcinomatosis of the distal spinal canal was identified. He was treated with intrathecal methotrexate and palliative radiotherapy. Although his pain improved, his lower limb weakness worsened. He died 3 weeks after completing radiotherapy. Presumed mode of spread was via the haematogenous route. The natural history and management of leptomeningeal carcinomatosis are discussed. Clinicians should be aware of the uncommon possibility of leptomeningeal carcinomatosis in a patient presenting with an appropriate constellation of symptoms and signs, and a past history of cancer.
Stereotactic breast biopsy: An audit of 18 months at BreastScreen Auckland
Authors: Greenberg Darrilyn , Johnston Jane , Hart Rosemary , Weston Margaret , Benson‐Cooper David 
Published: August 2003

SummaryStereotactic biopsy has become a widely used technique for marnmographically detected lesions that are clinically and sonographically occult. Vacuum‐assisted (mammotome) biopsy on a dedicated prone stereotactic unit has further increased ease of biopsy and utility of the technique. Results of an 18‐month audit in the national breast screening programme (BreastScreen Auckland and North) in the Auckland region demonstrates results comparable with those achieved elsewhere. Of a total of 399 stereotactic biopsies, 23 were excluded as they were 14‐G core biopsies rather than 11‐G mammotome biopsies. Of 376 mammotome biopsies, 10 (2%) failed, 266 (70.7%) were benign, 39 (10.3%) were atypical ductal hyperplasia (ADH) and 70 (18.6%) were malignant. Of these, 14.6% were ductal carcinoma in situ (DCIS) and 4% were invasive carcinomas. All cases diagnosed as ADH underwent formal excision biopsy. Of the 39 cases, 33 demonstrated benign disease or residual ADH only on excision (84.6%) and six (15.4%) patients were upgraded: five to DCIS and one to invasive carcinoma. The significant complication rate was 0.5%. Indications for biopsy were calcification in 89% of cases, mass lesions in 10.6% of cases and architectural distortion in 0.2% of cases. The failure rate of 2% compares with hookwire biopsy series. Practical issues and protocols have been presented.
Imaging features of primary pulmonary liposarcoma
Authors: Said Mourad , Migaw Hayet , Hafsa Chiraz , Braham Radhia , Golli Mondher , Moussa Adnene , Zakhama Abdelfateh , Elkamel Ali , Gannouni Amor 
Published: August 2003

SummaryPrimary liposarcoma of the lung is extremely rare. We report a 28‐year‐old pregnant woman who complained of dyspnoea during the third trimester. Chest radiography, thoracic ultrasound, CT and MRI showed a huge heterogeneous tumour involving all the left lung and the mediastinum. The tumour was composed of soft tissue, and fatty and cystic components with calcifications. Diagnosis was made on core biopsy under CT guidance. Surgical excision was performed but unfortunately the patient died during the operation.
Differential expression of CCR5 and CRTH2 on infiltrated cells in colonic mucosa of patients with ulcerative colitis
Authors: MATSUZAKI KOJI , HOKARI RYOTA , KATO SHINGO , TSUZUKI YOSHIKAZU , TANAKA HIROFUMI , KURIHARA CHIE , IWAI ATSUHIRO , KAWAGUCHI ATSUSHI , NAGAO SHIGEAKI , ITOH KAZURO , NAGATA KINYA , MIURA SOICHIRO 
Published: August 2003

AbstractBackground and Aim:  The pathogenesis of ulcerative colitis (UC) is unclear, but abnormal infiltration of T lymphocytes in the colonic mucosa has been implicated in the mucosal tissue damage. The abnormal cytokine production because of a T helper (h)1/Th2 imbalance may play an important role in continuing inflammation in the colonic mucosa. In the present study, the expression of chemokine receptor 5 (CCR5) as a Th1 marker and a chemoattractant receptor‐homologs molecule expressed on Th2 cells (CRTH2) were investigated in order to analyze impaired Th1/Th2 responses in the colonic mucosa of UC patients.Methods:  Tissue samples were obtained by colonic biopsies from patients with UC or colonic polyps, with informed consent. Immunohistochemical analysis was performed on periodate, lysine‐paraformaldehyde‐fixed serial cryostat sections using the labeled streptavidin biotin method. Monoclonal antibodies against CD4, CCR5 or CRTH2 were used as primary antibodies. The number of cells expressing CD4, CCR5 or CRTH2 per unit area was calculated by using an image analyzer.Results:  In the patients with UC, the numbers of CD4‐ and CCR5‐positive cells were significantly increased in inflamed mucosa, and appeared to be correlated with the disease activity. The infiltration of CRTH2‐positive cells was predominantly observed in the mildly inflamed or the margin of inflamed mucosa of UC patients.Conclusion:  There is a possibility that Th1 responses significantly occur in colonic mucosa with severe inflammation, while Th2 responses mainly occur with mild inflammation in UC patients. The Th1/Th2 imbalance in colonic mucosa may be related to the disease progression of UC.
Effect of Helicobacter pylori infection and low‐dose aspirin use on iron stores in the elderly
Authors: KAFFES ARTHUR , CULLEN JOHN , MITCHELL HAZEL , KATELARIS PETER H 
Published: August 2003

AbstractBackground and Aims:  Helicobacter pylori infection has been associated with lower ferritin levels in some adult populations, but subsets of potentially higher risk subjects, such as the elderly have not been examined. The aim of the present study was to determine the impact of H. pylori infection and low‐dose aspirin use on iron stores in a well elderly population.Methods:  Consecutive subjects aged 65 years or older attending day care facilities were studied. Each subject was assisted in completing a medical questionnaire. Serum ferritin, hemoglobin, mean corpuscular volumes (MCV) and IgG antibodies (ELISA) against H. pylori were measured.Results:  In 220 subjects (age 75 ± 8 years), 42% were H. pylori seropositive (male 41%, female 44%). The median (IQR) ferritin level (ug/L) was higher in men 149 (89–280) than women 94 (54–161), p < 0.002. The ferritin levels were not different in H. pylori positive males 151 (105–283) compared with H. pylori negative males 145 (72–249), or H. pylori positive females 93 (60–142) compared with H. pylori negative females 97 (45–149). This relationship was not altered when controlled for non‐steroidal anti‐inflammatory agents (NSAID) use (9% of subjects), alcohol or dietary iron intake. Low‐dose aspirin use was common (28%), but did not have an independent impact on iron stores: male users 181 (95–248), non‐users 145 (86–284); female users 92 (43–162), non‐users 95 (62–163). However, in female aspirin users, H. pylori infection was associated with significantly lower ferritin levels: 65 (43–112) compared with uninfected subjects 103 (41–180), p < 0.04.Conclusions:  In this well elderly population, the combination of H. pylori infection and low‐dose aspirin use was associated with significantly lower serum ferritin concentrations in females. This difference supports the observation that H. pylori, even in asymptomatic subjects, may be a stressor of iron stores.
p53 expression, K‐ras gene mutation and microsatellite instability in gastric B‐cell lymphomas
Authors: HIYAMA TORU , TANAKA SHINJI , MASUDA HIROSHI , SHIMA HIDEYUKI , KOSE KAZUHIRO , TUNCEL HANDAN , ITO MASANORI , KITADAI YASUHIKO , SUMII MASAHARU , UEMURA NAOMI , YOSHIHARA MASAHARU , SHIMAMOTO FUMIO , HARUMA KEN , CHAYAMA KAZUAKI 
Published: August 2003

AbstractBackground and Aims:  Genetic mechanisms involved in the development of gastric B‐cell lymphomas remain unclear. The aim of the present study was to clarify the roles of mutations of the p53 and K‐ras genes, and microsatellite instability (MSI) in the development of gastric B‐cell lymphomas.Methods:  We investigated p53 immunoreactivity, mutations of the K‐ras gene, and MSI in 27 gastric marginal zone B‐cell lymphomas of mucosa‐associated lymphoid tissue type (MZBCL) and 24 diffuse large B‐cell lymphomas (DLBCL). p53 immunoreactivity was examined using a monoclonal antibody, DO‐7. Mutation of the K‐ras gene was detected by polymerase chain reaction‐single strand conformation polymorphism (PCR‐SSCP) analysis. MSI was examined at five microsatellite loci with a microsatellite assay. Cases were classified as having high‐frequency MSI (MSI‐H) (≥ 2 loci showing instability), low‐frequency MSI (MSI‐L) (only one locus showing instability), or as microsatellite stable.Results:  p53 immunoreactivity was detected in 1 of 16 (6%) MZBCL and 8 of 19 (42%) DLBCL. Frequency of p53 immunoreactivity in DLBCL was significantly higher than that in MZBCL (P = 0.018). MSI‐H was detected only in 1 of 20 (5%) DLBCL. None of the cases examined showed mutation of the K‐ras gene.Conclusions:  These data suggest that mutations of the p53 gene may play an important role in the development of gastric DLBCL, and that mutations of the K‐ras gene and MSI may be involved in little part of the development of gastric B‐cell lymphomas.
Experimental studies on morphological changes of microcirculation of DMN‐induced liver cirrhosis after normothermic ischemia with charge‐coupled device microscope
Authors: SHIMAMOTO TSUYOSHI , MORI YOSHIO , TAKAGI HISATO , YAMADA TAKUYA , SAKAMOTO KENICHI , MATSUO HIROSHI , NITTA TOYOO , MIZUTANI TOMOHIRO , IWATA HISASHI , HIROSE HAJIME 
Published: August 2003

AbstractAim:  The purpose of the present experiment was to find indices for intraoperative ischemic‐reperfusion injury in the cirrhotic liver.Methods:  One percent dimethylnitrosamine (DMN) was administered intraperitoneally to liver cirrhosis (LC) groups of Wister rats on three consecutive days of each week for a period of four weeks. The rats were divided into a N60 group with 60 minute ischemia in normal livers, a LC60 group with 60 minute ischemia in cirrhotic livers, and a LC30 group with 30 minute ischemia in cirrhotic livers. Digital videotapes recorded with a pencil lens‐probe charge‐coupled device (CCD) microscope were analyzed with NIH Image software. In zone 3, the sinusoid diameter (SD) was measured and the volume fraction (Vv) of zone 3 was calculated in preischemia and after 10, 20, 30, and 60 min of reperfusion. At the same time, bile flow was measured.Results:  The SD was significantly shorter in the cirrhotic liver groups than in the normal liver group at each point. The Vv after 60 min of reperfusion was significantly smaller in the LC60 group, with a survival rate of 0%, than in the LC30 group which had a survival rate of 67%. However, there was no significant difference in bile flow after 60 min of reperfusion in the LC30 and LC60 groups. Therefore, the Vv is suggested to be the better index for viability after ischemic‐reperfusion.Conclusion:  SD and Vv indicate microcirculatory differences and indices in the normal and cirrhotic livers in preischemia during reperfusion.
Concurrent pancreatic ductal changes in alcoholic liver disease
Authors: KOCHHAR RAKESH , KUMAR SETHY PRADEEPTA , SOOD AJIT , NAGI BIRINDER , SINGH KARTAR 
Published: August 2003

AbstractBackground:  Alcohol is a common etiological factor in both liver disease and chronic pancreatitis, but in a single individual it does not usually produce clinically significant disease in both organs. We assessed the prevalence of pancreatic ductal changes in patients presenting with alcoholic liver disease of different stages.Methods:  Forty‐six patients with alcoholic liver disease were included in the present study. Liver biopsy was performed in patients with normal coagulogram. Endoscopic retrograde pancreatogram was performed in all patients and changes in chronic pancreatitis were noted.Results:  Of the 46 patients with alcoholic liver disease, 31 had cirrhosis of the liver, nine had fatty liver and two patients had alcoholic hepatitis. Twenty (43.47%) patients had features of chronic pancreatitis on endoscopic retrograde pancreatogram and these consisted of minimal pancreatitis changes in 10 patients, moderate changes in nine patients and advanced changes in one patient. There was no difference in the prevalence of pancreatitis changes in cirrhotics in comparison to non‐cirrhotics. There was no correlation between the amount and length of alcohol intake and changes in pancreatitis.Conclusion:  Pancreatic ductal changes on endoscopic retrograde pancreatogram are common in patients with alcoholic liver disease.
Comparison of the effect on intragastric pH of a single dose of omeprazole or rabeprazole: Which is suitable for on‐demand therapy?
Authors: INAMORI MASAHIKO , TOGAWA JUN‐ICHI , TAKAHASHI HIROKAZU , YONEDA MASATO , FUJISAWA NOBUTAKA , IWASAKI TOMOYUKI , OZAWA YUTAKA , KIKUCHI TAISUKE , MURAMATSU KENICHI , CHIGUCHI GAKU , MATSUMOTO SHUHEI , KAWAMURA HARUNOBU , ABE YASUNOBU , KIRIKOSHI HIROYUKI , KOBAYASHI NORITOSHI , SAKAGUCHI TAKASHI , TAKAMURA TOMOO , NAKAJIMA ATSUSHI , UENO NORIO , SEKIHARA HISAHIKO 
Published: August 2003

AbstractBackground and Aims:  An ideal medication for heartburn should have the rapid onset of action needed for on‐demand treatment. However, assessment of the onset of action of proton pump inhibitors has been largely subjective. We compared the inhibitory effect on gastric acid secretion of a single oral dose of omeprazole with that of rabeprazole.Methods:  Fourteen Helicobacter pylori‐negative men participated in this randomized, double‐masked, two‐way cross‐over study. Intragastric pH was monitored continuously for 6 h after a single, randomly assigned 20 mg oral dose of either omeprazole or rabeprazole. After a 7‐day washout period, the other drug was administered. Each patient's S‐mephenytoin 4′‐hydroxylase (CYP2C19) genotype was determined by polymerase chain reaction‐restriction fragment length polymorphism.Results:  Intragastric pH and pH holding time did not differ between treatments when the data were analyzed for the whole group without stratifying for CYP2C19 status. In CYP2C19 homozygous and heterozygous extensive metabolizers (10 subjects), rabeprazole maintained the intragastric at pH > 3 and> 4 for longer than omeprazole during both the 5 and 6 h study periods, and the average pH during the 6 h study period was higher with rabeprazole than with omeprazole. In these extensive metabolizers, rabeprazole maintained the pH > 2,> 3,> 3.5 and> 4 for longer during the 6 h study period than did omeprazole.Conclusions:  In H. pylori‐negative men who are CYP2C19 homozygous or heterozygous extensive metabolizers, the intragastric pH after a single dose of 20 mg rabeprazole is higher during first 5–6 h than that after a single dose of 20 mg omeprazole.