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At least 361 records · Page 20Linked to original sources
PubMed1999

Safety and efficacy of low anterior resection for rectal cancer: 681 consecutive cases from a specialty service.

OBJECTIVE: To determine perioperative morbidity, survival, and local failure rates in a large group of consecutive patients with rectal cancer undergoing low anterior resection by multiple surgeons on a specialty service. The primary objective was to assess the surgical complications associated with preoperative radiation sequencing. SUMMARY BACKGROUND DATA: The goals in the treatment of rectal cancer are cure, local control, and preservation of sphincter, sexual, and bladder function. Surgical resection using sharp perimesorectal dissection is important for achieving these goals. The complications and mortality rate of this surgical strategy, particularly in the setting of preoperative chemoradiation, have not been well defined. METHODS: There were 1233 patients with primary rectal cancer treated at the authors' cancer center from 1987 to 1995. Of these, 681 underwent low anterior resection and/or coloanal anastomosis for primary rectal cancer. The surgical technique used the principles of sharp perimesorectal excision. Morbidity and mortality rates were compared between patients receiving preoperative chemoradiation (Preop RT, n = 150) and those not receiving preoperative chemoradiation (No Preop RT, n = 531). Recurrence and survival data were determined in patients undergoing curative resection (n = 583, 86%) among three groups of patients: those receiving Preop RT (n = 131), those receiving postoperative chemoradiation (Postop RT, n = 110), and those receiving no radiation therapy (No RT, n = 342). RESULTS: The perioperative mortality rate was 0.6% (4/681). Postoperative complications occurred in 22% (153/681). The operative time, estimated blood loss, and rate of pelvic abscess formation without associated leak were higher in the Preop RT group than the No Preop RT group. However, the overall complication rate, rate of wound infection, anastomotic leak, and length of hospital stay were no different between Preop RT and No Preop RT patients. With a median follow-up of 45.6 months, the overall actuarial 5-year recurrence rate for patients undergoing curative resection (n = 583) was 19%, with 4% having local recurrence only, 12% having distant recurrence, and 3% having both local and distant recurrence, for an overall local recurrence rate of 7%. The actuarial 5-year overall survival rate was 81%; the disease-free survival rate was 75% and the local recurrence rate was 10%. The overall survival rate was similar between Preop RT (85%), Postop RT (72%), and No RT (83%) patients (p = 0.10), whereas the disease-free survival rate was significantly worse for Postop RT (65%) patients compared with Preop RT (79%) and No RT (77%) patients (p = 0.04). CONCLUSION: The use of preoperative chemoradiation results in increased operative time, blood loss, and pelvic abscess formation but does not increase the rate of anastomotic leaks or the length of hospital stay after low anterior resection for rectal cancer. The 5-year actuarial overall survival rate for patients undergoing curative resection exceeded 80%, with a local recurrence rate of 10%.

Adult↗
PubMedDate not supplied

The prognostic value of invariant chain (Ii) and Her-2/neu expression in curatively resected colorectal cancer.

BACKGROUND: Current methods to predict outcome for patients with curatively resected colorectal cancer are not ideal. The combined use of molecular markers and clinicopathologic features may better identify patients who are at risk for recurrence. The Her-2/neu and invariant chain molecules may be important in cancer development and progression, but their usefulness as clinical predictors of outcome in colorectal cancer has not been well studied. METHODS: We used immunohistochemistry to determine the expression of Her-2/neu, invariant chain, p27, and p53 in primary tumor samples from 156 patients with curatively resected stage I-III colorectal cancer. The association between expression and clinical outcomes was assessed by univariate and multivariate analysis. RESULTS: Her-2/neu expression was detected in only 24% of cases, and high levels of invariant chain were detected in only 15%. Although patients whose tumors overexpressed Her-2/neu survived longer than those with non-overexpressing tumors, neither Her-2/neu nor invariant chain were independently associated with survival. Consistent with previous reports, high p27 expression was associated with improved outcome, whereas overexpression of p53 was associated with worse outcome. CONCLUSIONS: Our study did not reveal a statistically significant association between Her-2/neu or invariant chain expression and clinical outcomes in patients with curatively resected colorectal cancer. However, the data suggest that Her-2/neu could be a favorable prognostic variable. Because of the low frequency of Her-2/neu expression, larger numbers of patients need to be studied for this question to be adequately answered.

Adenocarcinoma↗
PubMed2005

Genomics in C. elegans: so many genes, such a little worm.

The Caenorhabditis elegans genome sequence is now complete, fully contiguous telomere to telomere and totaling 100,291,840 bp. The sequence has catalyzed the collection of systematic data sets and analyses, including a curated set of 19,735 protein-coding genes--with >90% directly supported by experimental evidence--and >1300 noncoding RNA genes. High-throughput efforts are under way to complete the gene sets, along with studies to characterize gene expression, function, and regulation on a genome-wide scale. The success of the worm project has had a profound effect on genome sequencing and on genomics more broadly. We now have a solid platform on which to build toward the lofty goal of a true molecular understanding of worm biology with all its implications including those for human health.

Animals↗
PubMed2026

Evaluating the need for late angiography for complete obliteration of AVMs after endovascular treatment: collaborative AVM center experience and a systematic review.

Brain arteriovenous malformations (bAVMs) can be treated curatively by endovascular embolization. However, limited data exist on late recanalization rates. We investigated the rate of late bAVM recanalization following complete endovascular obliteration, confirmed by primary control angiography.We performed a single-center retrospective cohort study on late recurrences in adult patients with bAVMs after complete endovascular obliteration at a Radboud - Isala - MUMC+ (RIM) collaborative AVM center in the Netherlands between 2014 and 2022.Additionally, we conducted a systematic review to evaluate the rate of late recanalization following complete endovascular obliteration, confirmed on primary control angiography, in adults with bAVMs. The protocol for this review was registered in PROSPERO (CRD42024546875).Our retrospective study revealed 42 adult patients treated by endovascular means only; 90.5% (38 patients with mean age of 48.1 years) had confirmed complete obliteration. Both primary (6 months post-treatment) and secondary (more than 1 year post-treatment) angiographic control confirmed complete obliteration in 21 of 23 patients with complete follow-up. Mean follow-up was 47.8 months. Two late recurrences (9.5%) were detected at 5- and 6-years' follow-up imaging.Our systematic review included two studies encompassing a total of 19 patients with mean angiographical follow-up of 20.8 months. There were no late recurrences.Late bAVM recurrence after endovascular treatment with proven complete obliteration may be underestimated owing to limited long-term follow-up. Our findings suggest that after a 6-month angiographic confirmed obliteration, a 5-year angiographic imaging control is justified.

Humans↗
PubMed2006

Current approaches to the management of hemochromatosis.

The term hemochromatosis encompasses at least four types of genetic iron overload conditions, most of them recently distinguished from one another as a result of the identification of a series of genes related to iron metabolism. At least three of these entities (HFE hemochromatosis, juvenile hemochromatosis and transferrin receptor 2 hemochromatosis) involve systemic hepcidin deficiency as a key pathogenetic factor. Major advances in the management of hemochromatosis influence the diagnostic approach to the disease, with the development of an overall non invasive strategy, mainly based on clinical, biological (iron parameters and genetic testing), and imaging (especially magnetic resonance imaging) data. Therapeutic management remains, on the curative side, dominated by phlebotomy (venesection), practical aspects of which have been recently revisited by the Guidelines Department of the French "Haute Autorité de Santé." However, innovative treatment approaches, based on the improved pathophysiological understanding of these diseases and the progress in iron chelation therapy, are emerging. Preventive therapy, focused on family screening, remains a key part of the management of hemochromatosis.

Antimicrobial Cationic Peptides↗
PubMed1992

Self-psychological approach to posttraumatic stress disorder: neurobiological aspects of transmuting internalization.

This essay presents the case of a young man with severe posttraumatic stress disorder (PTSD) in order to demonstrate how a self-psychological orientation and psychotherapeutic approach enables acute symptoms to be relieved, while concomitantly addressing vulnerability in character structure. The self-psychological conceptualization of the psychodynamics of PTSD is discussed, along with a recently proposed neuropsychological theory of PTSD. After viewing the pertinent neurobiological research, an integration of the self-psychological concepts of transmuting internalization (a purported curative factor in psychotherapy) with neurobiological data and behavioral observations is presented.

Adult↗
PubMed2004

Massive hepatocellular carcinoma in dogs: 48 cases (1992-2002).

OBJECTIVE: To determine clinical signs, diagnostic findings, outcome, and prognostic factors in dogs treated surgically for massive hepatocellular carcinoma (HCC) and compare survival times of surgically and conservatively treated dogs. DESIGN: Retrospective study. ANIMALS: 48 dogs. PROCEDURE: Medical records were examined for clinical signs, diagnostic and surgical findings, and postoperative outcome. Dogs were allocated into surgery and nonsurgery groups depending on whether curative-intent liver lobectomy was performed. Data from the surgical and nonsurgical groups were analyzed to identify prognostic factors and determine and compare rates of tumor control and survival time. RESULTS: 42 dogs were treated surgically, and 6 were managed conservatively. In the surgery group, intraoperative mortality rate was 4.8% with no local recurrence, metastatic rate was 4.8%, and median survival time was > 1,460 days (range, 1 to 1,460 days). High alanine aminotransferase and aspartate aminotransferase activities were associated with poor prognosis. Median survival time for the nonsurgery group was 270 days (range, 0 to 415 days), which was significantly less than that of surgically treated dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Liver lobectomy is recommended for dogs with massive HCC because tumor-related mortality rate was 15.4 times higher in dogs in the nonsurgery group, compared with the surgery group. Tumor control was excellent after surgical resection with no local recurrence and a low metastatic rate. Prognostic factors were identified, but their clinical relevance was uncertain because only 9.5% of dogs in the surgery group died as a result of their disease.

Alanine Transaminase↗
PubMed2004

Clinical significance of preoperative regional intra-arterial infusion chemotherapy for advanced gastric cancer.

AIM: Preoperative intra-arterial infusion chemotherapy could increase the radical resection rate of advanced gastric cancer, but its effect on the long-term survival has not been assessed. This study was designed to evaluate the clinical significance of preoperative intra-arterial infusion chemotherapy for advanced gastric cancer. METHODS: Clinicopathological data of 91 patients who underwent curative resection for advanced gastric cancer were collected. Among them, 37 patients undertaken preoperative intra-arterial infusion chemotherapy were used as the interventional chemotherapy group, and the remaining 54 patients as the control group. Eleven factors including clinicopathological variables, treatment procedures and molecular biological makers that might contribute to the long-term survival rate were analyzed using Cox multivariate regression analysis. RESULTS: The 5-year survival rate was 52.5% and 39.8%, respectively, for the interventional group and the control group (P<0.05). Cox multivariate regression analysis revealed that the TNM stage (P<0.001), preoperative intra-arterial infusion chemotherapy (P = 0.029) and growth pattern (P = 0.042) were the independent factors for the long-term survival of patients with advanced gastric cancer. CONCLUSION: Preoperative intra-arterial infusion chemotherapy plays an important role in improving the prognosis of advanced gastric cancer.

Adenocarcinoma↗
PubMed2000

[Biochemical control after external radiotherapy in localized prostatic cancer: results of a modern cohort].

PURPOSE: The present study reports biochemical outcomes of a modern series of patients with localised prostate cancer treated with external beam radiation therapy, and analyses the implications of the nadir PSA levels in monitoring outcome after treatment. METHODS: From March 1993 to March 1997, eighty three patients with clinical stages T1-T3 NxM0 prostate cancer received definitive external radiation therapy, median dose 66 Gy (range 60 to 68 Gy). Adjuvant androgen deprivation was associated in 53 high risk patients. Initial response to treatment was defined as a decrease of serum PSA to levels of < or = 1.5 ng/ml, and biochemical failure as three consecutive PSA rises over post-treatment nadir PSA value. RESULTS: The 3-year actuarial BDFS was 78% +/- 7 for the whole series, 74% +/- 12 for patients treated with radiotherapy alone, and 71% +/- 10 for high risk patients treated with combination therapy (p = 0.27). Only nPSA emerged as a potential indicator of biochemical control. The probability of BDFS at 3 years was 82%, 83% and 40% for nPSA of < or = 1 ng/ml, 1-2 ng/ml and > 2 ng/ml respectively (p = 0.0409). In multivariate analysis, this correlation was independent on the effect of other variables and persisted after adjusting for the effect of hormonal therapy (p = 0.0540). CONCLUSION: Radiation therapy is a potentially curative treatment for prostate carcinoma. Our data indicate that the nadir PSA value after radiation can be an excellent early determinant of outcome.

Adenocarcinoma↗
PubMedDate not supplied

Lymphatic spread differs according to tumor location in extrahepatic bile duct cancer.

BACKGROUND/AIMS: Identification of nodal involvement according to primary tumor location in extrahepatic bile duct carcinoma may guide surgical therapy. METHODOLOGY: Pathologic data of 81 patients who underwent curative operation for bile duct carcinoma were studied to clarify the differences in lymphatic spread from distal bile duct carcinoma, middle bile duct carcinoma, and proximal bile duct carcinoma. RESULTS: Lymph node metastases were present in 25 of 41 patients (61%) with distal bile duct carcinoma, 9 of 19 (47%) with middle bile duct carcinoma, and 11 of 21 (52%) with proximal bile duct carcinoma. The number of positive nodes per node-positive patient was greater in patients with middle bile duct carcinoma than in those with distal- or proximal bile duct carcinoma (mean 5.33 vs. 3.56 or 2.64, p < 0.05). Lymph nodes in the hepatoduodenal ligament were most frequently involved regardless of the primary tumor location. The frequency of distal- and middle bile duct carcinoma patients with metastasis to the superior mesenteric or para-aortic nodes was significantly higher than that of proximal bile duct carcinoma patients (p < 0.05 and p < 0.05). CONCLUSIONS: Patterns of lymphatic spread were different according to primary tumor location in bile duct carcinoma. Metastatic nodes were spread widely, from the hepatoduodenal ligament or posterior pancreaticoduodenal region to the nodes around the superior mesenteric artery and abdominal aorta, in distal- and middle bile duct carcinoma.

Adult↗
PubMed1992

Flow cytometric DNA analysis in Japanese colorectal cancer. A multivariate analysis.

Using Cox's proportional hazard model, we performed a multivariate analysis of survival data from 126 patients who underwent curative resection for colorectal cancer from 1971 to 1985. Flow cytometric DNA measurements were carried out using paraffin wax-embedded tissue blocks. Fifty-four per cent of the cases were found to be aneuploid and 46% were diploid. The depth of invasion of the tumor, nodal status, liver metastasis, peritoneal dissemination, DNA ploidy pattern, histology, macroscopic classification of the tumor, age, sex and site were tested in a survival analysis. The initial seven factors were found to be the significant prognostic variables in a univariate analysis. A multivariate analysis shows liver metastasis, DNA ploidy pattern and peritoneal dissemination as being the significant discriminants of survival (P = 0.0001, 0.0022, 0.0119, in this order). Therefore, nuclear DNA ploidy pattern in colorectal cancer is considered to be an independent prognostic factor.

Adult↗
PubMed2004

[Hematological abnormality and clinical characteristics in systemic lupus erythematosus].

To investigate the hematological abnormality and clinical characteristics in systemic lupus erythematosus (SLE), the hematological data of 58 SLE and the curative effects of corticosteroid and immunosuppressive agents on SLE were retrospectively analysed by using SPSS/PC software. The results showed that the incidence of hematological abnormalities in 58 cases was as follows: 50 cases of hemogram abnormality (86.2%), 41 of anemia (70.7%), 34 of thrombocytopenia (58.7%), 37 of leukopenia (63.8%). Peripheral cytopenia of every cell lineage was common in SLE. The cell abnormalities of two or three lineages were seen in 41 cases (70.7%). The initial symptoms with hematological abnormality were found in 12 cases (20.7%), 7 out of 12 cases were erroneously diagnosed as hematology diseases (12.1%). In 30 out of 58 patients, the results of bone marrow examination showed that 23 had hyperplasia (76.7%) and 7 were hypoplasia. In 25 out of 38 cases, splenomegaly (65.8%) was found by B ultrasonography. In 25 patients with SLE receiving Coombs test, 3 were positive (12.0%). PAIg increased in 16 out of 22 cases of thrombocytopenia (72.7%). 26 cases of SLE with two or three lineage cytopenia in peripheral blood were treated by corticosteroid and immunosuppressive agent. The hemogram improved in all patients including 6 cases of bone marrow hypoplasia. It is concluded that the hematological abnormalities are frequent in SLE patients, which are short of specialty. The cytopenia of two or more lineage in peripheral blood is most common when bone marrow shows hyperplastic. The therapy with corticosteroid and immunosuppressive agents is efficacious.

Adolescent↗
PubMed2005

Gotrees: predicting go associations from protein domain composition using decision trees.

The Gene Ontology (GO) offers a comprehensive and standardized way to describe a protein's biological role. Proteins are annotated with GO terms based on direct or indirect experimental evidence. Term assignments are also inferred from homology and literature mining. Regardless of the type of evidence used, GO assignments are manually curated or electronic. Unfortunately, manual curation cannot keep pace with the data, available from publications and various large experimental datasets. Automated literature-based annotation methods have been developed in order to speed up the annotation. However, they only apply to proteins that have been experimentally investigated or have close homologs with sufficient and consistent annotation. One of the homology-based electronic methods for GO annotation is provided by the InterPro database. The InterPro2GO/PFAM2GO associates individual protein domains with GO terms and thus can be used to annotate the less studied proteins. However, protein classification via a single functional domain demands stringency to avoid large number of false positives. This work broadens the basic approach. We model proteins via their entire functional domain content and train individual decision tree classifiers for each GO term using known protein assignments. We demonstrate that our approach is sensitive, specific and precise, as well as fairly robust to sparse data. We have found that our method is more sensitive when compared to the InterPro2GO performance and suffers only some precision decrease. In comparison to the InterPro2GO we have improved the sensitivity by 22%, 27% and 50% for Molecular Function, Biological Process and Cellular GO terms respectively.

Algorithms↗
PubMed2006

[Pulmonary hypertension and right ventricular failure. Part III. Patients with congenital heart disease].

In a series of articles the authors discuss literature data concerning epidemiology of pulmonary hypertension, its modern classification, peculiarities of its pathogenesis and treatment in various diseases and conditions. In the third lecture they consider peculiarities of pathogenesis of pulmonary hypertension and right ventricular failure in patients with congenital heart defects, and present literature data on drug treatment and other curative interventions in pulmonary hypertension in patients with Eisenmenger syndrome.

Heart Defects, Congenital↗
PubMedDate not supplied

[Impact of new lymph node staging on lymphadenectomy and on the prognosis of patients undergoing surgery for gastric cancer].

The TNM system has become the principal method for assessing the extent of disease, determining prognosis in gastric cancer patients, and influencing therapeutic strategies. The extent of lymph node metastases is the most important prognostic factor. The aim of the study was to compare the 4th and 6th TNM edition N-classifications and to retrospectively evaluate the prognostic value of the 2002 TNM edition. We evaluated 344 patients who underwent curative total or subtotal gastrectomy. Our data confirm the simplicity and easy application of the new staging and the better prognostic stratification of the N-stage. In multivariate analysis the difference between the old and new TNM staging is minimal. We therefore suggest comparing lymph node location and number in larger series. For the purposes of correct N-staging, 10 lymph nodes in early gastric cancer and at least 16 in the other pT stages seem sufficient to achieve effective pNO staging.

Adult↗
PubMed1990

[Risk factors in chronic noncommunicable diseases].

As a result of an epidemiological survey of able-bodied population aged 20-64, serviced by the territorial polyclinic of Minsk with the help of standard methods and standardized procedures, the data on the prevalence of some chronic non-communicable diseases and their risk factors were obtained. The high incidence of ischemic heart disease, arterial hypertension, such risk factors as hypercholesteremia, excess body weight, smoking and lack of exercise, and also their increase with age, suggested the necessity to intensify preventive activities among population. A study was made of the able-bodied population awareness regarding healthy lifestyle and also of the extent to which outpatient physicians fulfil the non-drug therapy recommendations. The data obtained were needed for planning curative and preventive activities with due regard for age-and-sex peculiarities in the distribution of characteristics studied.

Adult↗
PubMedDate not supplied

Clinicopathological features of patients who died with second primary cancer after curative resection for gastric cancer.

The appearance of a second cancer in patients who had undergone curative operation for the first gastric cancer is one of the crucial problems for the clinician. We analysed data on 910 patients with gastric cancer treated with curative resection, with respect to the risk factors for second primary cancer and the prognosis. Of 910 patients, 69 (7.6%) died with a second primary cancer. In patients with a second primary cancer, there were more men and age was more advanced, compared to the survivors. The gastric tumor was larger, the serosal invasion was more prominent and lymphatic involvement was more frequent. The postoperative 5-year survival for patients with a second primary cancer was 60.9%, the 10-year rate was 31.9% and the 15-year was 19.6%. Multivariate analysis revealed that risk factors for a second primary cancer was advanced age, male sex and a larger tumor. Our findings suggest that during the follow-up of patients with gastric cancer treated by curative resection and risk factors, a second primary cancer may occur in other organs, in addition to a recurrence of the first cancer.

Age Factors↗