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PubMed1990

Sexually transmitted diseases in the elderly--issues and recommendations.

The incidence of sexually transmitted disease (STD) in the elderly population is significant for both newly acquired disease and for residual complications from preceding infections. Every health-care practitioner needs to assume responsibility for the primary prevention of STDs, which focuses on avoiding infection. Primary health education is imperative in the presence of an escalation of sexually transmitted infection for which there is no known curative therapy. The sexual history is an integral component of the routine data base for all geriatric patients. Diagnosis of AIDS in the generally low risk elderly population may be unexpected. Health-care practitioners must be aware of its many forms of presentation.

Aged↗

PubMedDate not supplied

Radical surgical treatment for cystic neoplasms of the pancreas: personal experience.

BACKGROUND: Cystic neoplasms comprise 1-10% of all pancreatic neoplasms. Most authors recommend resection due to the difficulties in differentiating benign from malignant tumors prior to operation. We performed an analysis on the radical surgical handling of patients with cystic neoplasms of the pancreas. PATIENTS AND METHODS: We analyzed data of all patients with pancreatic neoplasms who were treated by potentially curative surgical treatment by a single surgeon (A.D.C.). Postoperative survival and complications were recorded. RESULTS: Between August 1983 and November 2003, the aforementioned surgeon performed 77 pancreatic resections for pancreatic tumors. Nine of those operations were performed for cystic neoplasms of the pancreas. All patients submitted to partial pancreatic resections were discharged in good health. The patient that underwent a total pancreatectomy died nine days after the procedure. At a mean follow up of 44 months, there has been one local recurrence with death. CONCLUSIONS: Cystic tumors of the pancreas accounted for 11.7 % of the neoplasms studied in our series. Resection of those neoplasms attained by distal pancreatectomy is a safe procedure. PD is a risky procedure and should be viewed cautiously. Total pancreatectomy remains as a high-risk procedure and should be avoided.

Adolescent↗

PubMedDate not supplied

Immunohistochemical expression of Bcl2 is an independent predictor of time-to-biochemical failure in patients with clinically localized prostate cancer following radical prostatectomy.

BACKGROUND: Whether the immunohistochemical expression (IHCE) of the bcl2, the p53 and of the prostate apoptosis response-4 (PAR4) proteins is associated with pre-operative PSA levels, post-operative parameters of prostate cancer (PC) pathology, surgical staging or biochemical failure (BF) of patients with clinically localized PC who underwent radical prostatectomy (RP) of curative intent, was investigated. PATIENTS AND METHODS: A retrospective analysis of clinical data evaluating surgical specimens of 131 patients with PC, consecutively treated with RP for clinically localized disease, was performed. The IHC method of streptavidin biotin peroxidase on paraffin tissue sections was used to detect bcl2 and p53 oncoproteins and PAR4 pro-apoptotic protein expression in surgical specimens. RESULTS: Statistically significant relationships were detected between: (i) p53 IHC expression and infiltration of periprostatic tissue (IPT; p = 0.011); (ii) tumor volume (TV; p = 0.027); and (iii) bcl2 IHCE and absence of prostatic intraepithelial neoplasia (PIN) (p = 0.004). Biochemical failure (BF) was documented in 37% of these patients. Kaplan-Meier survival curves showed that the IHCE of bcl2 and p53 was significantly related to BF. Taking the hazard ratio (HR) estimated from the Cox proportional hazard regression model to be 1.00 for patients with negative bcl2 IHCE, a value of 2.82 was found for patients with positive bcl2 IHCE (p = 0.015, 95% CI = 1.22-6.47). The HR for patients with positive p53 IHCE was 2.05 (p = 0.048, 95% CI = 1.00-4.19). Multivariate analysis showed that only seminal vesicle invasion (SVI), pelvic lymph node metastasis (PLNM) and bcl2 IHCE were independent predictors for BF (HR = 3.06, 3.31 and 3.15; p = 0.048, p = 0.031 and p = 0.031 for SVI, PLNM and bcl2 IHCE, respectively). CONCLUSION: Bcl2 immunohistochemical overexpression in specimens of RP suggests high risk for BF in clinically localized PC.

Biomarkers, Tumor↗

PubMedDate not supplied

[Role of oxygen in the vital activity of aerobic organisms].

New experimental data that underlie construction of an adaptive-metabolic conception as to curative effect of hyperbaric oxygenation are systematized in the aspect of evolution. Oxygen under high pressure (300 kPa, 60 min) exerts a specific effect on functions of redox and antiredox systems and nonspecific effect determining adaptation mechanisms of functional (regulatory, effector), metabolic (bioenergy, detoxication, biosynthetic) and morphogenetic (cellular and intracellular regeneration) types at different (hyper-, normo- and hypobiotic) levels of vital activity as dependent on the metabolic activity of the functional structures under pathology conditions.

Adaptation, Physiological↗

PubMed1990

Carcinoma of the rectum: factors influencing the prognosis.

Three hundred and thirty one patients with cancer of the rectum and rectosigmoid junction, operated on during the period 1968-1985 are here examined. The study shows the prognostic value and the impact that stage, histopathological grade, number and location of nodal metastases, morphology of the primary tumour, occurrence of obstruction, perforation, and haemorrhage have on the natural history of the tumour. Stage and histopathologic grading resulted as the most outstanding prognostic parameters also because they are correlated to the presence, number, and location of nodal metastases as well as occurrence of obstruction, perforation and haemorrhage. The study concludes that: a) stage according to the Dukes-Gabriel classification still has a reliable prognostic predictivity, since it faithfully reflects major anatomic situations observed in rectal cancer; b) Dukes' stage C cases should be considered as a non-homogeneous group with a distinct biological behaviour depending on the number and site of the lymph nodes involved; c) intraoperative staging of the tumour, if possible, should guide the excision extent on a curative aim, where the term means a prospective evaluation based on statistical data correlating stage and survival.

Adult↗

PubMed1989

[Blood reinfusion in injuries of the chest and abdomen].

Reinfusion of blood used in 78 patients with injuries of the chest and abdomen has shown the method to be clinically effective and expedient including treatment of injuries of hollow organs of the abdominal cavity. The technique of blood reinfusion for different injuries is described. Data are presented which allow to suspect that the reinfused blood has curative properties in treatment of injuries of the chest and abdomen.

Abdominal Injuries↗

PubMed1987

Immunisation in a rural setting. The EPI as a vital arm of primary health care.

Immunisation forms an integral part of any health care system. In certain areas in the western Cape the immunisation cover has been analysed over several years. This data indicates an effective immunisation programme in these areas. Promotive, preventive and curative services are effectively provided within the limitations of the conditions pertaining in the areas.

BCG Vaccine↗

PubMed1977

[Analysis of the quality of clinical diagnosis from generalized findings of the pathologoanatomic service].

A statistical analysis of generalized data of the pathoanatomical service on quality of clinical diagnosis in curative-prophylactic institutions in 54 administrative territories of the RSFSR was carried out. The structure (extensive indices) and frequency (intensive indices)of erroneous clinical diagnoses referring to the most important classes of diseases were identified. As to the structure of indices and frequency of clinico-anatomic disparities the first place was occupied by oncological diseases (20.1+/-0.11 and 14.2+/-0.22%), the second--by infectious diseases (16.5+/-0.1 and 13.0+/-0.34%), the third--by diseases of the digestive system (14.6+/-0.09 and 13.0+/-0.33%), the forth--by diseases of the urogenital system (14.0+/-0.09 and 12.2+/-0.49%), the fifth--by disease of the respiratory system (12.7+/-0.09 and 10.6+/-0.24%), the sixth--by diseases of the cardiovascular system (11.1+/-0.08 and 8.0+/-0.14%). The recommendation is put forward to carry on annually a complex satistical analysis of extensive and intensive indices of erroneous clinical diagnoses demonstrating the quality of clinical diagnosis in therapeutic institutions of a given administrative territory.

Diagnostic Errors↗

PubMed1998

[The contribution of experimental models to the physiopathology and treatment of infectious endocarditis].

The model of experimental endocarditis can be used for the investigation of the different steps in the physiopathologic process leading to the formation of the infected cardiac vegetation. It has also greatly contributed to the knowledge of the characteristics of the infected vegetation. These data allow a better understanding of the therapeutic consequences (both preventive and curative) of the physiopathologic process.

Animals↗

PubMed1998

[Pathology of the ureterovesical junction in neurogenic bladders in children and adolescents. A retrospective study of 119 patients].

Ureterovesical junction dysfunction in congenital or acquired neurogenic bladders represents a threat for the renal parenchyma. In order to evaluate the incidence, mechanisms of development and preventive and curative treatments proposed in diseases of the ureterovesical junction associated with neurogenic bladders, the files of 119 children were retrospectively evaluated. 68 patients suffered from congenital neurogenic bladder and 51 had an acquired neurogenic bladder. In the congenital neurogenic bladder group, vesico-ureteric reflux was observed in 22 cases (32%) and dilatation was observed in 18 cases (26.5%), while 21 patients had both dilatation and reflux. In the acquired neurogenic bladder group, reflux was observed in 8 cases (16%) and dilatation was observed in 3 cases (10%), one of whom had both reflux and dilatation. The predominant mechanism of decompensation of the ureterovesical junction in the two groups was a combination of low compliance and high peripheral resistance. In patients with abnormalities of the ureterovesical junction, the incidence of associated parenchymal lesions was similar (30%) whether neurogenic bladder was congenital or acquired. The disparities between these two comparable patient groups, the preventive and curative treatments proposed and their results are analysed in comparison with the data reported in the literature.

Adolescent↗

PubMed2005

Neoadjuvant chemoradiation increases the risk of pelvic sepsis after radical excision of rectal cancer.

PURPOSE: This study was designed to examine the effect of neoadjuvant chemoradiation on pelvic sepsis after mesorectal excision for rectal cancer. METHODS: A retrospective chart review was conducted for all patients who underwent curative mesorectal excision for rectal cancer during an eight-year period. Demographic, preoperative, perioperative data were collected. Pelvic sepsis was defined as clinical or radiographically demonstrable leak or a pelvic abscess. Neoadjuvant chemoradiation included 5,040 Gy in conjunction with three cycles of 5-fluorouracil-based chemotherapy, followed by a one-month waiting period. RESULTS: From January 1994 to December 2002, 246 patients (151 males; mean age 68 (range, 36-97) years) underwent curative resection for rectal cancer. Procedures included 186 anterior resections, 52 abdominoperineal resections, and 8 Hartmann's. Of 60 patients (24.4 percent) who had neoadjuvant chemoradiation, 9 (15 percent) developed pelvic sepsis (3 leaks, 6 abscesses) compared with 9 of 186 (4.8 percent) after primary surgery (6 leaks, 3 abscesses; P < 0.01). Ninety-three patients had an anastomosis or=7 cm developed pelvic sepsis (5 leaks and 1 abscess), of whom 1 had preoperative radiation. Pelvic abscess developed in 3 of 24 patients after neoadjuvant chemotherapy and abdominoperineal resection. After primary abdominoperineal resection, none of the remaining 28 patients developed pelvic sepsis. A multivariable logistic regression model was constructed to determine predictors of sepsis. Neoadjuvant chemotherapy was the only variable that was predictive (odds ratio, 3.4; 95 percent confidence interval, 1.3-9). CONCLUSIONS: The addition of neoadjuvant chemoradiation to mesorectal excision significantly increased the rate of pelvic sepsis. This was particularly true for anastomoses in the lower third of the rectum. Fecal diversion should be considered in these patients.

Abscess↗

PubMed2005

The European Bioinformatics Institute's data resources: towards systems biology.

Genomic and post-genomic biological research has provided fine-grain insights into the molecular processes of life, but also threatens to drown biomedical researchers in data. Moreover, as new high-throughput technologies are developed, the types of data that are gathered en masse are diversifying. The need to collect, store and curate all this information in ways that allow its efficient retrieval and exploitation is greater than ever. The European Bioinformatics Institute's (EBI's) databases and tools have evolved to meet the changing needs of molecular biologists: since we last wrote about our services in the 2003 issue of Nucleic Acids Research, we have launched new databases covering protein-protein interactions (IntAct), pathways (Reactome) and small molecules (ChEBI). Our existing core databases have continued to evolve to meet the changing needs of biomedical researchers, and we have developed new data-access tools that help biologists to move intuitively through the different data types, thereby helping them to put the parts together to understand biology at the systems level. The EBI's data resources are all available on our website at http://www.ebi.ac.uk.

Computational Biology↗

PubMed2005

Systems-ADME/Tox: resources and network approaches.

The increasing cost of drug development is partially due to our failure to identify undesirable compounds at an early enough stage of development. The application of higher throughput screening methods have resulted in the generation of very large datasets from cells in vitro or from in vivo experiments following the treatment with drugs or known toxins. In recent years the development of systems biology, databases and pathway software has enabled the analysis of the high-throughput data in the context of the whole cell. One of the latest technology paradigms to be applied alongside the existing in vitro and computational models for absorption, distribution, metabolism, excretion and toxicology (ADME/Tox) involves the integration of complex multidimensional datasets, termed toxicogenomics. The goal is to provide a more complete understanding of the effects a molecule might have on the entire biological system. However, due to the sheer complexity of this data it may be necessary to apply one or more different types of computational approaches that have as yet not been fully utilized in this field. The present review describes the data generated currently and introduces computational approaches as a component of ADME/Tox. These methods include network algorithms and manually curated databases of interactions that have been separately classified under systems biology methods. The integration of these disparate tools will result in systems-ADME/Tox and it is important to understand exactly what data resources and technologies are available and applicable. Examples of networks derived with important drug transporters and drug metabolizing enzymes are provided to demonstrate the network technologies.

ATP Binding Cassette Transporter 1↗

PubMed2001

[Indications and outcome of liver metastases resection].

Liver resection with curative intent for metastastic disease can be performed at low operative morbidity and mortality (< 3%). Most data relate to colorectal metastases. Five year survival following primary and repeat liver resection is consistently reported as 25-30% and has not been improved by adjuvant chemotherapy. Options for improvement of prognosis by purely technical means appear limited. Instead, future strategies should aim at increasing the number of patients amenable to potentially curative liver resection. This could be achieved by earlier diagnosis, by combination of surgical resection with neoadjuvant treatment or thermoablation, by selective portal embolisation as well as further surgical specialisation. The search for effective adjuvant therapy should continue.

Colorectal Neoplasms↗

PubMed1994

Is the long-term survival rate improved by preoperative irradiation prior to Whipple's procedure for adenocarcinoma of the pancreatic head?

OBJECTIVE: To determine whether or not both regional control and long-term survival rate were improved by preoperative irradiation prior to curative pancreatectomy for adenocarcinoma of the pancreatic head. DESIGN: Retrospective study of recorded medical data from 1985 to 1989. SETTING: The Center for Adult Diseases, Osaka, one of the major cancer centers in Japan. PATIENTS AND INTERVENTION: Fifty-four consecutive patients in whom pancreatic head cancer had been judged to be resectable by preoperative diagnostic techniques. A total of 50 Gy per 10 MeV of x-ray was irradiated preoperatively to the wide field, including the pancreatic head area, in 23 patients (group A) but not in the 31 remaining patients (group B). The background factors before treatment did not differ between these two groups. OUTCOME MEASURES: Resectability, postoperative survival, and modes of cancer recurrence. RESULTS: At laparotomy, curative pancreatectomy was possible in 17 patients (74%) in group A and 19 (61%) in group B (not significant). In patients undergoing resection, the 1-year survival rate was 75% in group A and 43% in group B (P < .05). However, 3- and 5-year survival rates were almost the same in both groups (28% vs 32% and 22% vs 26%, respectively). With regard to the cause of death after pancreatectomy, group A had a significantly lower incidence of deaths due to regional recurrence within 1.5 postoperative years compared with group B, whereas deaths due to hepatic metastasis were markedly higher after 1 postoperative year in group A compared with group B. CONCLUSIONS: Preoperative irradiation prior to pancreatectomy succeeded in reducing the incidence of early deaths due to regional recurrence. However, owing to the next barrier--death due to hepatic metastasis after 1 postoperative year--long-term (3- and 5-year) survival rate was not improved at all.

Adenocarcinoma↗

PubMed2003

The mammalian protein-protein interaction database and its viewing system that is linked to the main FANTOM2 viewer.

Here, we describe the development of a mammalian protein-protein interaction (PPI) database and of a PPI Viewer application to display protein interaction networks (http://fantom21.gsc.riken.go.jp/PPI/). In the database, we stored the mammalian PPIs identified through our PPI assays (internal PPIs), as well as those we extracted and processed (external PPIs) from publicly available data sources, the DIP and BIND databases and MEDLINE abstracts by using FACTS, a new functional inference and curation system. We integrated the internal and external PPIs into the PPI database, which is linked to the main FANTOM2 viewer. In addition, we incorporated into the PPI Viewer information regarding the luciferase reporter activity of internal PPIs and the data confidence of external PPIs; these data enable visualization and evaluation of the reliability of each interaction. Using the described system, we successfully identified several interactions of biological significance. Therefore, the PPI Viewer is a useful tool for exploring FANTOM2 clone-related protein interactions and their potential effects on signaling and cellular communication.

Animals↗

PubMed2006

The LIFEdb database in 2006.

LIFEdb (http://www.LIFEdb.de) integrates data from large-scale functional genomics assays and manual cDNA annotation with bioinformatics gene expression and protein analysis. New features of LIFEdb include (i) an updated user interface with enhanced query capabilities, (ii) a configurable output table and the option to download search results in XML, (iii) the integration of data from cell-based screening assays addressing the influence of protein-overexpression on cell proliferation and (iv) the display of the relative expression ('Electronic Northern') of the genes under investigation using curated gene expression ontology information. LIFEdb enables researchers to systematically select and characterize genes and proteins of interest, and presents data and information via its user-friendly web-based interface.

Cell Proliferation↗

PubMed1982

Does local tumour heating im mice influence metastatic spread?

Experimental studies are reported on the effect of local tumour hyperthermia, combined with radiation, on the incidence of distant metastases. Two types of study were performed: a retrospective analysis of data obtained incidentally from regrowth delay experiments, and prospective studies designed specifically to investigate the effect of heat on the spread of disease. In the first case, tumours were treated with a range of palliative doses of X rays given either alone or in combination with heat (42.8 degrees C/h). Only one tumour out of 5 showed a significantly increased incidence of metastases, and then only when heated immediately before radiation. The prospective studies were designed so that primary tumours were locally controlled. Neither heat applied immediately before nor after irradiation resulted in a significant change in incidence of metastases. However, whole body heating did produce a marginally significant increase. Fractionated hyperthermia (4 heat doses plus curative radiation) did not result in any significant change in frequency of metastasis. These data suggest that local heating combined with radiation does not result in an increased risk of metastatic spread.

Animals↗