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At least 649 records · Page 36Linked to original sources
PubMed2005

Impact of total lymph node count on staging and survival after gastrectomy for gastric cancer: data from a large US-population database.

BACKGROUND: Prognosis of potentially curable (M0), completely resected gastric cancer is primarily determined by pathologic T and N staging criteria. The optimal regional dissection extent during gastrectomy for gastric adenocarcinoma continues to be debated. METHODS: A gastric cancer data set was created through structured queries to the Surveillance, Epidemiology, and End Results database (1973 to 1999). Relationships between the number of lymph nodes (LNs) examined and survival were analyzed for the stage subgroups T1/2N0, T1/2N1, T3N0, and T3N1. RESULTS: In every stage subgroup, overall survival was highly dependent on the number of LNs examined. Multivariate prognostic variables in the T1/2N0M0 subgroup were number of LNs examined, age (for both, P < .0001), race (P = .0004), sex (P = .0006), and tumor size (P = .02). A linear trend for superior survival based on more LNs examined could be confirmed for all four stage subgroups. Baseline model-predicted 5-year survival with only one LN examined was 56% (T1/2N0), 35% (T1/2N1), 29% (T3N0), or 13% (T3N1). For every 10 extra LNs dissected, survival improved by 7.6% (T1/2N0), 5.7% (T1/2N1), 11% (T3N0), or 7% (T3N1). A cut-point analysis yielded the greatest survival difference at 10 LNs examined but continued to detect significantly superior survival differences for cut points at up to 40 LNs, always in favor of more LNs examined. CONCLUSION: Although the impact of stage migration versus improved regional disease control cannot be separated on basis of the available information, the data provide support in favor of extended lymphadenectomy during potentially curative gastrectomy for gastric cancer.

Adolescent↗
PubMed1999

Surgical possibilities for pancreatic cancer: extended resection.

DESIGN: It was the aim of this study to investigate the influence of extended retroperitoneal tissue clearance on long-term survival in patients with ductal adenocarcinoma of the head of the pancreas. PATIENTS AND METHODS: From 10/1988 to 3/1998 a prospective observation study was initiated in 108 patients with malignant growth in the head of the pancreas to compare patients with regional lymphadenectomy (RLA) versus extended retroperitoneal tissue clearance (ELA). In 36 patients other tumors than ductal adenocarcinomas were found, so that 72 patients with a partial pancreaticoduodenectomy and a histologically established diagnosis of ductal adenocarcinoma were included. Pancreaticoduodenectomy was combined with RLA in 26 cases and with ELA in 46 patients. RESULTS: Comparing only R0-resected patients (n = 58) no significant difference in long-term survival rates between the RLA and the ELA group was found. Hospital mortality was 3.8% in the RLA group and 6.5% in the ELA group. Significant or nearly significant results were shown for the following parameters: STAGE OF THE DISEASE: Patients after partial pancreaticoduodenectomy of a stage I/II cancer of the head of the pancreas showed a 63% 5-year survival rate compared to 15% in patients in stage III or IV (p = 0.0087). GRADING: No patient with a poorly differentiated ductal adenocarcinoma of the head of the pancreas survived the first year in comparison to 55% of patients with well or moderately differentiated tumors (p = 0.0022). N-STAGE: 5-year survival of patients in NO stage was 46.9% and 15% for N1 stage patients (p = 0.081). PORTAL VEIN INFILTRATION: No patient with a R0-resection and histologically proven tumor infiltration of the portal vein survived the first year whereas 63% of patients did so after curative resection without portal vein involvement (p = 0.0063). CONCLUSION: Our data indicate that extensive retroperitoneal tissue clearance does not improve long-term survival rates compared to regional lymphadenectomy restricted to the right side of the mesenteric artery.

Aged↗
PubMed2000

[The mechanisms of the curative action of systemic enzyme therapy].

Employment of the authors' highly sensitive biochemical method allowed the fact of resorption of proteolytic enzymes after their peroral ingestion to be confirmed, with a question having been raised as to further fate of proteinases and mechanisms of curative action of combined enzyme preparations. The analysis of relevant data from published literature and the results of the author's own studies permitted identifying the most important moments of realization of the systemic enzyme therapy effects, which are as follows: 1) activation of receptors on the surface of enterocytes; 2) formation of activated alpha 2-macroglobulin (alpha 2-M) under the action of proteinases from the intestines, and realization of catalytic activity of those enzymes involved in this restrictor of proteinases; 3) modulation of cell activity by complexes alpha 2-M-proteinase; 4) activation of the system of mononuclear phagocytes; 5) influence on the balance of bodily endogenous proteolytic systems.

Drug Combinations↗
PubMedDate not supplied

[Initial axonal lesion in multiple sclerosis. Reasons for early treatment].

INTRODUCTION AND METHOD: There is no curative treatment for multiple sclerosis (MS) nor are there precise data that enable us to ensure a patient is given an accurate prognosis of his or her illness. A small percentage of patients will have such a particularly benign course that they will not require preventative treatment for the attacks. Unfortunately, many of them, above all those that display high lesion loads in the magnetic resonance imaging (MRI), will develop a relapsing remitting illness that will leave permanent sequelae. The initial inflammatory phases of MS are essential since they establish an accumulation of axonal lesion that will mark the future of a possible, more or less serious, neurodegenerative phase and which will become manifest in the second progressive phase. Until now, useful treatment in MS has acted on the inflammation, and efficiency is low in the later stages. For this reason, some authors recommend that IFN b 1a IM must be initiated in patients after the first attack, now that its use has recently been approved in the European Union in these cases. CONCLUSION: We believe that each patient should be informed and treatment proposed following the first demyelinating attack, provided he or she meets the criteria needed to be considered as having a high risk of developing MS, such as having a high lesion load in MRI.

Axons↗
PubMed2002

[Endoscopic sinus surgery, clinical observation with 40 cases].

OBJECTIVE: To study the curative effect of endoscopic sinus surgery(ESS). METHOD: The clinical data of ESS on 40 cases(70 sides) of chronic sinusitis and nasal polyps were analyzed. RESULT: In 34 of the 40 cases followed up over six months, 25 cases(73.5%) were cured, 7 cases(20.6%) were improved, 2 cases(5.9%) were ineffective. The effective rate was 94.1%. The serious operation complication was absent. Bleeding after operation was found in 1 case, middle turbinate synechiae with nasal septum were found in 2 cases. CONCLUSION: ESS is effective in the treatment of chronic sinusitis and nasal polyps. The success of operation is directly related to the excellent surgical skills. A regularly follow up and cleaning to the operation cavity after operation are important elements for securing optimal long-term result.

Adolescent↗
PubMed1992

[Epidemiology and treatment of stomach cancer: news in 1992].

Four studies presented at the 1992 ASCO and AACR meetings are analysed. Wanebo compared treatment of gastric cancer in the USA and in Japan. Retrospective analysis of 18,365 patients showed an important delay in diagnosis and surgical treatment without radical lymph node dissection (less than 10%) in the North-American patients. In 1982, the overall 5-year survival in the USA was 17.5%, not different from that of thirty years ago. MacDonald undertook a prospective randomised study of adjuvant FAM chemotherapy in 221 patients operated on for gastric cancer. With a median follow-up of 7 years, the median overall and disease free survival were respectively 36 and 29 months in the FAM group and 28 and 22 months in the control group. These differences were not significant and the authors concluded that FAM is not an effective adjuvant chemotherapy in resected gastric cancer. Ajani studied the efficacy of pre and post-operative EAP (etoposide, adriamycin, platine) chemotherapy in fourty-eight patients with potentially resectable gastric carcinoma. The overall clinical response rate was 31%, fourty-one patients were operated on and thirty-seven had a curative resection (70%). There was one chemotherapy related death. These data indicate that pre and post-operative EAP chemotherapy is feasible and effective in patients with potentially resectable gastric carcinoma. Correa made a lecture on human gastric carcinogenesis. The "intestinal" type of gastric cancer appears to be the end result of a long series of cellular changes called "multifocal chronic atrophic gastritis". Alterations in the function of the gland neck cells appear to be responsible for the preneoplasic changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Diagnostic and therapeutic aspects of vesico-colonic fistulae. Review of our experience].

Analysis of 10 fistulae in 9 patients, all male. The etiology was diverse although there was a predominance of colovesical diverticulitis. Mictional urinary symptomatology was most frequent. In one case symptoms had been first referred 10 months earlier, while the others ranged between 24 hours and 15 days. Cystography was the radiological procedure which diagnosed more cases whereas cystoscopy was the endoscopic procedure which provides more data. Seven fistulae were treated surgically, in 5 instances with curative and 2 with palliative purposes. Three cases were subsidiary to surgery. 44.4% of patients died within one month from diagnosis.

Adolescent↗
PubMed2004

[A study of electric information monitoring in the treatment of bruxism with occlusal splint].

OBJECTIVE: An electric monitor of bruxism had been invented in order to evaluate the curative effect of cuspid occlusal upheaving splint and stabilization splint. METHODS: 20 patients with bruxism were randomly divided into two groups. A cuspid occlusal upheaving splint or a stabilization splint was fabricated respectively for patients. The vertical dimension for each splint was 0.5 mm lower than mandibular postural position. Sleeping time, bruxist time and times of bruxism were recorded with bruxism monitor that was invented for studying bruxing. RESULTS: The bruxist time and the times of bruxism were decreased obviously in patients with cuspid occlusal upheaving splint, while no significant difference was shown before and after using the stabilization splint. CONCLUSIONS: The bruxism monitor can automatically measure and record the data of bruxism with splint, which is valuable for clinic. The curative effect of cuspid occlusal upheaving splint is better than that of stabilization splint for treating bruxism.

Adult↗
PubMed2005

[Application of simultaneous surgeries in patients with extended pulmonary tuberculosis].

The treatment of extended pulmonary tuberculosis, resistant to antibacterial preparations, constitutes extremely complex problem. The author proposes to apply simultant pulmonary resection and intrapleural thoracoplasty, the simple one or extended, for the treatment of those patients. There were studied up the results of treatment of 401 patients, simultant interventions were used in 134. Analysis of the data obtained permits to consider the operation as the curative-prophylactic one. The indications for application of every variant of intervention were determined, what have had significantly increased the possibilities of treatment of extended pulmonary tuberculosis.

Adult↗
PubMed2005

[The study of the minimum number of examined lymph nodes for the TNM classification of gastric cancer].

OBJECTIVE: To determine the minimum number of lymph nodes that should be examined for the UICC/AJCC TNM classification of gastric cancer. METHODS: The clinical and pathological data of four hundred and thirty-six patients underwent curative resection for gastric cancer were analyzed by Chi-square and Student-Newman-Keuls test. RESULTS: The pN0 patients with 1 to 4, 5 to 9 examined nodes showed significantly lower survival rate than those with 10 to 14, 15 or more examined nodes (P < 0.05), and the patients with 10 to 14 examined nodes had as good a prognosis as those with 15 or more examined nodes. In the pN1, pN2 categories, the patients with 1 to 4, 5 to 9 and 10 to 14 examined nodes tended toward significantly lower survival rates than those with 15 or more examined nodes (P < 0.05). Among the patients who were classified as stage II, the survival rate of those with 10 to 19 examined nodes was significantly lower than that with 20 or more examined nodes. Among the patients classified as stage III, those with 5 to 9, 10 to 19 and 20 to 29 examined nodes had significantly lower survival rates than those with 30 or more examined nodes (P < 0.05). CONCLUSIONS: The number of lymph nodes examined has significant prognostic impact within each pN category of gastric carcinoma. The minimum number of lymph nodes to examine in order to determine pN0 classification can be reduced from 15 to 10. For tumor with lymph node metastasis, the minimum number should be 15. In stage II, 20 or more nodes should be examined, and in stage III and IV 30 or more.

Adult↗
PubMedDate not supplied

[Gastric carcinoma in the elderly (clinical findings and results)].

On the basis of a series of 643 patients operated on for gastric cancer, the Authors seek to establish whether this disease presents clinical differences with advancing age of such a nature as to have a significant effect on therapeutic management. The series is divided into two groups, the first consisting of patients aged below 70 and the second of patients aged over 70. The following aspects were evaluated: sex, tumour site, oncological stage, type of surgery performed, operative mortality, postoperative survival, as assessed in overall terms and also differentiated in relation to curative or palliative surgery and oncological stage. Analysis of the data confirms that, apart from certain particular aspects, carcinoma of the stomach in the elderly benefits from the same sort of indications and techniques as those proposed for younger patients, with comparable postoperative survival rates, but with a higher operative mortality. To achieve better operative results, what is needed, in addition to correction of metabolic and functional abnormalities, is thorough assessment of risk factors. In patients with tumours at advanced stages, usually characterized by very poor postoperative results, the presence of major risk factors may raise serious doubts as to the actual advisability of the surgical indication itself.

Actuarial Analysis↗
PubMed1989

[Acute left colonic obstruction of neoplastic origin. Study of a series of 128 cases].

A retrospective study of 112 patients with acute obstructive carcinoma of the colon (added to 16 prospective recent cases), whose mean age was 74 years, with metastasis or peritoneal carcinosis in 23% of the cases, shows a high operative mortality (38.4%), an average survival of 804 days and a five years survival actuarial rate of 17.5%. 80% of further deaths were due to cancer. These results and the data of literature encourage the authors to suggest, whenever a curative resection is to be considered, a decompressive proximal colostomy combined to a short investigating laparotomy, followed by a two-stage resection 2 or 3 weeks later.

Acute Disease↗
PubMed1984

A review of morbidity and mortality in elderly patients undergoing pulmonary resection.

The morbidity and 30-day operative mortality were reviewed in the 43 patients 70 years of age or older who underwent pulmonary resection between June 1976 and May 1981. In addition to their surgical illness, many of these patients had pre-existing medical conditions including: coronary artery disease (8), hypertension (14), diabetes (4), and congestive heart failure (5). The mean preoperative 1 second forced expiratory volume (FEV1) was 1.7 liters and 17 patients had an FEV1 of less than 1.5 liters. The operative mortality was 2.3% (one patient), the average duration of postoperative hospital confinement was 9 days, and 39 of 42 (93%) of the patients were discharged within 2 weeks of their operation. There were 38 postoperative complications in 25 of the 42 survivors, most of which were minor and all of which were resolved. Problems included: air leak (13), atrial fibrillation or flutter (3), myocardial infarction (1), respiratory difficulties (9), hemorrhage (2), mental confusion (3), hyperpyrexia (3), difficult-to-manage diabetes (1), and social problems (3). Only two patients required prolonged mechanical ventilation. The low operative mortality, the short postoperative stay, and the minimal number of serious complications is contrasted with other published reports describing a high-operative mortality in elderly patients. The improvement may be related to recent advances in postoperative management and anesthetic techniques. These data suggest that advanced age is not a contraindication to curative pulmonary resection.

Age Factors↗
PubMed1993

Doctor and patient characteristics as modifiers of the effect of a changing remuneration system in general practice.

The objectives of the study was to investigate the effects on general practitioners' activities of a change in their remuneration system from a capitation-based system to a mixed fee-per-item and capitation-based system. It was our hypothesis that the effect of the change in remuneration varied between subgroups of doctors and patients as a result of the modifying effect of the doctors' age, sex, practice facilities, assistance, side jobs, and size of practice as well as patients' age, sex, and diagnostic group. The study was carried out as a follow-up with data collected from contact sheets completed by general practitioners in one period before a change in remuneration and two periods after. These data were supplemented by a questionnaire on doctors' characteristics as well as by health insurance data on population characteristics. The general increases in diagnostic and curative activities and reductions in referrals by general practitioners as a result of the change were found to be quite similar across subgroups of doctors and patients. While, total contact rates changed little, the sex of doctors showed a modifying effect: male doctors tended to increase their contact rates compared to female doctors. This tendency was most prominent among female patients with non-infectious diseases.

Age Factors↗
PubMed2006

Web-based analysis of the mouse transcriptome using Genevestigator.

BACKGROUND: Gene function analysis often requires a complex and laborious sequence of laboratory and computer-based experiments. Choosing an effective experimental design generally results from hypotheses derived from prior knowledge or experimentation. Knowledge obtained from meta-analyzing compendia of expression data with annotation libraries can provide significant clues in understanding gene and network function, resulting in better hypotheses that can be tested in the laboratory. DESCRIPTION: Genevestigator is a microarray database and analysis system allowing context-driven queries. Simple but powerful tools allow biologists with little computational background to retrieve information about when, where and how genes are expressed. We manually curated and quality-controlled 3110 mouse Affymetrix arrays from public repositories. Data queries can be run against an annotation library comprising 160 anatomy categories, 12 developmental stage groups, 80 stimuli, and 182 genetic backgrounds or modifications. The quality of results obtained through Genevestigator is illustrated by a number of biological scenarios that are substantiated by other types of experimentation in the literature. CONCLUSION: The Genevestigator-Mouse database effectively provides biologically meaningful results and can be accessed at https://www.genevestigator.ethz.ch.

Animals↗
PubMed2005

Text-based analysis of genes, proteins, aging, and cancer.

The diverse nature of cancer- and aging-related genes presents a challenge for large-scale studies based on molecular sequence and profiling data. An underexplored source of data for modeling and analysis is the textual descriptions and annotations present in curated gene-centered biomedical corpora. Here, 450 genes designated by surveys of the scientific literature as being associated with cancer and aging were analyzed using two complementary approaches. The first, ensemble attribute profile clustering, is a recently formulated, text-based, semi-automated data interpretation strategy that exploits ideas from statistical information retrieval to discover and characterize groups of genes with common structural and functional properties. Groups of genes with shared and unique Gene Ontology terms and protein domains were defined and examined. Human homologs of a group of known Drosphila aging-related genes are candidates for genes that may influence lifespan (hep/MAPK2K7, bsk/MAPK8, puc/LOC285193). These JNK pathway-associated proteins may specify a molecular hub that coordinates and integrates multiple intra- and extracellular processes via space- and time-dependent interactions with proteins in other pathways. The second approach, a qualitative examination of the chromosomal locations of 311 human cancer- and aging-related genes, provides anecdotal evidence for a "phenotype position effect": genes that are proximal in the linear genome often encode proteins involved in the same phenomenon. Comparative genomics was employed to enhance understanding of several genes, including open reading frames, identified as new candidates for genes with roles in aging or cancer. Overall, the results highlight fundamental molecular and mechanistic connections between progenitor/stem cell lineage determination, embryonic morphogenesis, cancer, and aging. Despite diversity in the nature of the molecular and cellular processes associated with these phenomena, they seem related to the architectural hub of tissue polarity and a need to generate and control this property in a timely manner.

Aging↗
PubMed1994

Radiofrequency catheter ablation as a cure for idiopathic tachycardia of both left and right ventricular origin.

OBJECTIVES: The purpose of this study was 1) to investigate the efficacy and safety of radiofrequency energy catheter ablation as curative treatment for idiopathic tachycardia of both left and right ventricular origin, and 2) to compare the usefulness of different methods used to map the site of origin of idiopathic ventricular tachycardia. BACKGROUND: Percutaneous radiofrequency catheter ablation has been used with dramatic success in the treatment of patients with Wolff-Parkinson-White syndrome, atrioventricular node reentrant tachycardia and bundle branch reentrant tachycardia. Limited data are available on the use of radiofrequency energy catheter ablation as curative treatment for idiopathic tachycardia of both left and right ventricular origin. METHODS: Twenty-eight consecutive patients (13 to 71 years old) presenting with idiopathic ventricular tachycardia were enrolled in the study. The site of origin of both left and right ventricular tachycardia was mapped using earliest endocardial activation times during tachycardia and by pace mapping. These mapping techniques were compared. RESULTS: Radiofrequency ablation was successful in all eight patients (100%) with left ventricular tachycardia. Tachycardia recurred in one patient. The ablation procedure was complicated by mild aortic insufficiency in one patient. Right ventricular outflow tract tachycardia was successfully ablated in 17 (85%) of 20 patients. The success rate at follow-up was 85%. In one patient, the ablation procedure was complicated by acute ventricular perforation and death. Pace maps from successful ablation sites were better than pace maps from unsuccessful sites (p < 0.004). Endocardial activation times at successful ablation sites were not different from unsuccessful sites (p < 0.13). CONCLUSIONS: Radiofrequency catheter ablation is an effective treatment for idiopathic ventricular tachycardia. The site of origin of tachycardia is best identified using pace mapping. Significant complications can occur and should be considered in the risk/benefit analysis for each patient.

Adolescent↗
PubMedDate not supplied

Pediatric high-grade gliomas.

High-grade gliomas, including glioblastoma multiforme, anaplastic astrocytoma, and intrinsic pontine, are very difficult to treat in children. Despite aggressive treatment with multimodal therapy, most children with these diseases do not survive. Data from published series support aggressive surgical resection when clinically feasible. Patients who have had aggressive resections tend to have a longer survival than those who have undergone only biopsies or partial resections. Almost all patients with high-grade gliomas respond to radiation therapy, and it is the current mainstay of adjuvant therapy. Radiation therapy also tends to prolong survival, but it is rarely curative. Although responses to chemotherapy have been demonstrated, there are no compelling data indicating that it prolongs survival for this group of patients. Current and proposed studies are combining radiation therapy and/or chemotherapy with agents that have shown preclinical promise as radiosensitizers, anti-angiogenesis factors, growth factor receptor inhibitors, and free radical inducers. Other biologic therapies, including gene therapy, are also being investigated. Improved survival for these patients will likely require combined therapy that includes novel treatment.

Brain Neoplasms↗