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[Inhibition of elastase activity in human gingival extracts by elastin peptides].

Effects of elastin peptides on elastase activity of gingival biopsy specimen extracts were studied in vitro and in vivo. All the extracts from biopsy specimens from 15 patients with a variety of periodontal diseases demonstrated fairly marked elastase activity. In vitro, addition of elastin peptides produced a mean inhibition of 54% +/- 14% with a concentration of 0.25 mg/ml and a mean inhibition of 90% +/- 6% with 2.5 mg/ml. In vivo treatment of gums with a paste containing 1% elastin peptides reduced elastase activity by 47% in 7 of 8 patients. These data suggest that elastin peptides are effective inhibitors of periodontal elastase activity and may be useful in preparations used for the preventive or curative treatment of periodontal diseases with tissue lysis.

Adolescent↗

Neural invasion in pancreatic carcinoma.

BACKGROUND: Neural invasion is a special metastatic route in pancreatic cancer and responsible for the high recurrence in curatively resected cases. OBJECTIVE: To summarize the characteristics and mechanisms of neural invasion in pancreatic carcinoma for the better treatment of this disease. DATA SOURCES: The international literatures were reviewed about the definition, incidence and mechanisms of neural invasion and its clinicopathology, diagnosis and treatment. DATA SYNTHESIS: Neural invasion is defined when the medial perineurium is involved by cancer cells, accounting for 45%-100% of all cases. It can be divided into different kinds or stages according to its locations and the number of nerve fascicles involved. Invasion along vascularity, lymphatic vessels, perineural space and neurotropism is considered as its primary mechanisms. No clinicopathologic factors are correlated with neural invasion. Intravascular ultrasound, CT scan and immunostaining K-ras gene analysis can be used to diagnose neural invasion pre-, intra- or postoperatively. CONCLUSION: Neural invasion is an important prognostic factor for the recurrence of pancreatic carcinoma after pancreatectomy. Because of its high incidence, pancreatectomy with extended radical retroperitoneal dissection should be considered as a basic procedure in the treatment of pancreatic carcinoma.

Carcinoma↗

[Recurrence after radiotherapy and/or surgery of carcinoma of the oropharynx and the pharynx. Possibilities of salvage surgery].

Forty-seven laryngeal and 21 oropharyngeal recurrences were treated with salvage surgery alone or combined with radiotherapy at the ENT Clinic and Radiotherapy Division of the University of Turin, Italy. Primary tumors had been treated with surgery alone in 10 cases (larynx) and in 21 cases (oropharynx), with combined surgery and radiotherapy in 2 and 8 patients, and with radiotherapy alone in 9 and 18 cases. We observed 26/47 (larynx) and 12/21 (oropharynx) recurrences at the site of primary tumor, 20/47 and 9/21 in loco-regional nodes, and 9/47 and 3/21 in locations adjacent to the primary tumor. Salvage treatment employed surgery alone in 12 (oropharynx) and 16 (larynx) cases; radiotherapy was combined in 9 and 31 cases. Five-year actuarial NED survival was 45.5% for laryngeal and 24% for oropharyngeal cancer patients. After salvage surgery, 50% of laryngeal lesions and only 25% of oropharyngeal recurrences were completely cured. In our series, in 2 cases only the complications caused the patient's death, while in the extant cases a prolonged postoperative hospitalization was necessary. Our study was aimed at investigating the curative potentials of secondary therapy for recurrent carcinomas. A review of the literature on the subject is reported. The small amount of published data prevents "universal" treatment protocol from being assessed. The authors suggest the opportunity of employing a multimodal treatment policy for recurrences of head and neck cancers.

Adult↗

Cutaneous melanoma of the head and neck.

Seventy patients surgically treated in The Netherlands Cancer Institute between 1969 and 1984 for cutaneous melanoma of the head and neck were reviewed with regard to patient data, tumor site, stage, histological criteria, treatment, disease-control and survival. The objectives of the study were to analyse the results of curative treatment of cutaneous melanoma of the head and neck, the value of prognostic factors and the treatment policy for the N0 and N+ neck. Tumor thickness (Breslow Index) was by far the most important prognostic factor in cutaneous melanoma of the head and neck. Other known important factors like level of invasion, tumor subsite, stage, tumor type and ulceration provided additional information. Elective node dissection is advised in lesions thicker than 1.5 mm since N0-N+ transformation is seen in 37% of these patients. Partial neck dissection which includes removal of the nodes adjacent to the primary provides proper regional control except for primary lesions in the neck that require at least a modified neck dissection.

Adult↗

[Geography of major parasitosis in Tunisia].

Basing on their personal investigations, literature data and statistic archives, the authors have tried to establish the geographical distribution of the main parasitic diseases in Tunisia which require a curative action together with an action on the environment for their eradication. Three of these disease are transmitted by vectors: Malaria, Leishmaniasis, Schistosomiasis; and three others are transmitted by soil: Hydatidosis, Ancylostomiasis and Strongyloidiasis.

Ancylostomiasis↗

[Progress and controversy in treatment of Hodgkin's disease].

Hodgkin's disease (HD) is a malignant disease originating from hematopoietic tissue which is characterized by the presence of Hodgkin and Reed-Sternberg cells. The vast majority of HD patients are cured with current standard therapy. Both megavoltage radiotherapy and combination chemotherapy are effective treatment modalities. Radiotherapy is curative for localized Hodgkin's disease, and it is now generally agreed that advanced Hodgkin's disease can be cured by combination chemotherapy. Data from uncontrolled trials suggest that in patients with advanced disease the addition of low-dose radiation to sites of previous disease involvement is associated with better long term and relapse free survival. Patients who relapse after initial treatment with chemotherapy are considered suitable candidates for systemic salvage programs. These programs may include treatment with the same drugs, the use of non-cross resistant chemotherapy programs or investigational programs such as high dose chemotherapy with autologous or allogenic bone marrow rescue. An appropriate management decision depends upon assessment of the disease and also on the impact of treatment side effects on the individual patients.

Antineoplastic Combined Chemotherapy Protocols↗

[Quality assurance in tumor surgery--the effect of tumor surgery interventions on the quality of life of patients with urologic tumors].

During the last 20 years important improvements in diagnosis, staging and indications as well as in operative and conservative treatments of urological malignancies have been achieved. In consequence the prognoses of patients with these cancers have been improved. One remaining question concerns the impact of curative radical surgery on the individual's quality of life and life perspective. The purpose of this prospective study was to obtain relevant data upon which to develop tumor-specific modules according to the guidelines of the EORTC, so that this question can be studied. Between July, 1993 and July, 1994 data from 106 cancer patients with non metastatic urological malignancies (prostate, kidney and bladder) were gathered for analysis. Patients include 37 with prostatic cancer, who were treated by a radical prostatovesicalectomy. Fourty-two patients with renal cell carcinoma underwent radical nephrectomy. In 30 bladder cancer patients radical cystoprostatovesicalectomy with an ileum conduit was carried out. The first step was to describe the symptomatology in these patients by means of open interviews. In addition, one day postoperatively, the day before discharge and one year after surgery the patients completed self-administered symptomatic and psychological questionnaires. The symptomatic questionnaire contained 20 items, each with six response choices. For evaluating subjective well-being, we selected the "Basler Befindlichkeitsbogen" (Basler Psychological Balance), which has four dimensions: Vitality, vigilance, social extrovertivity and psychological balance. Descriptive and comparative analyses were performed with an SPSS programme. Comparing the preoperative and one year postoperative values, all patients groups showed a significant deterioration in the four dimensions of the psychological parameters. The data from the present study were the basis for the development of EORTC-specific tumor modules for urological cancer according to the guidelines of the EORTC.

Adaptation, Psychological↗

The unrewarding results of curative therapy in esophageal cancer.

The mortality from carcinoma of the esophagus in the non-white male population of the metropolitan Washington, DC, area is probably the highest in the United States. Data from the National Center for Health Statistics indicates a mortality figure of 27.9/100,000 for the period 1969-1971.(1) Between 1971 and 1976, 114 patients were seen at Howard University Hospital with the diagnosis of carcinoma of the esophagus, of which only 48 were suitable for definitive therapy. All patients were black. The male/female ratio was 4 to 1. Postoperative irradiation appeared to confer benefit on surgically respected patients. In this selected group of patients, treatment had little influence on the natural history of the disease and the adjusted direct five-year survival was 2.1 percent.(*)

Adult↗

Local recurrence in patients with rectal cancer diagnosed between 1988 and 1992: a population-based study in the west Netherlands.

AIMS: We carried out a population-based study of local recurrence rates in curatively resected patients with rectal cancer, diagnosed between 1988 and 1992. The first objective was to make an inventory of the overall local recurrence rate after non-standardized conventional surgery, inter-institutional recurrence rate variability, and correlations between patient- and tumour-related factors and recurrence rate. A second objective was to investigate the compliance to guidelines for post-operative radiotherapy. METHODS: Data were obtained from the Comprehensive Cancer Centre West. The study comprised 1105 patients from 12 hospitals. Of these patients, 437 were ineligible because of missing medical records, no carcinoma, incorrect registration, no laparotomy, non-curative resection, or loss to follow-up. RESULTS: The overall local recurrence rate was 22.5% with a range of 9-36% between the hospitals. These differences were not significant. Dukes' Astler-Coller stage, tumour location, and residual tumour were significant independent prognostic factors for the risk of local recurrence. Indications for post-operative radiotherapy were Dukes' Astler-Coller B2 and C tumours, positive surgical margins, and tumour spill. Compliance to the guidelines for radiotherapy was only 50%. However, no significant difference in recurrence rate was found between patients treated according to the guidelines and those not treated according to the guidelines. CONCLUSION: This study shows a large variability in local recurrence rate between the participating hospitals and confirms that the risk of recurrence in primary rectal cancer is dependent on Dukes' Astler-Coller stage, tumour location and residual tumour. Furthermore, this study contributes to the discussion about the feasibility of guidelines for post-operative radiotherapy.

Adult↗

ABS: a database of Annotated regulatory Binding Sites from orthologous promoters.

Information about the genomic coordinates and the sequence of experimentally identified transcription factor binding sites is found scattered under a variety of diverse formats. The availability of standard collections of such high-quality data is important to design, evaluate and improve novel computational approaches to identify binding motifs on promoter sequences from related genes. ABS (http://genome.imim.es/datasets/abs2005/index.html) is a public database of known binding sites identified in promoters of orthologous vertebrate genes that have been manually curated from bibliography. We have annotated 650 experimental binding sites from 68 transcription factors and 100 orthologous target genes in human, mouse, rat or chicken genome sequences. Computational predictions and promoter alignment information are also provided for each entry. A simple and easy-to-use web interface facilitates data retrieval allowing different views of the information. In addition, the release 1.0 of ABS includes a customizable generator of artificial datasets based on the known sites contained in the collection and an evaluation tool to aid during the training and the assessment of motif-finding programs.

Animals↗

[Laparoscopic resection of colorectal malignancy--an oncological risk?].

Oncological risks associated with laparoscopic colorectal surgery in curative intention include inadequate radicality, seeding of tumour cells through unprotected recovery of the surgical specimen, faulty surgical technique, and failure to observe the technical and/or oncological limitations applicable to certain tumour sites. Results of laparoscopic colorectal surgery may be defined by pathohistologic findings (number of removed lymph nodes, count of tumor tears, clearance of margins) and long-term results (port-site metastases, local recurrence rate, number of distnant metastase, 5-year-survival). Current published results and first data from the Multicenter Study Group will be compared with the data of open surgery. Merely a few reports on the number of lymph nodes removed during such operations have been published. First data of the Multicenter Study Group Laparoscopis Colorectal Surgery seem to report comparable data to open surgery. There are no certain data the occurrence rate of portsite metastases as on long-term results, local recurrence rates and the 5-year-survival. So the sense and the quality of laparoscopic colorectal surgery in curative intention can't be judged nowadays. The many potential mistakes and hazards of oncological laparoscopic surgery make it mandatory that such interventions should be done only within the framework of prospective clinical studies covering limited indications.

Colectomy↗

Carcinoid tumors of the lung: immuno- and ligandohistochemistry, analysis of integrated optical density, syntactic structure analysis, clinical data, and prognosis of patients treated surgically.

BACKGROUND: Analysis of potentially prognostic relevant factors of carcinoid tumors of the lung. METHODS: Clinical features, tumor size, and features derived from immuno- and ligandohistochemistry, cytometry and histometry, and survival have been analyzed in 82 potentially curatively resected carcinoid tumors of the lung. RESULTS: Patients with typical carcinoid tumors had a longer history of symptoms (13 vs. 8 months), fewer smoked (30% vs. 80%), and developed less frequently lymph node metastases (20% vs. 65%) compared to patients with atypical carcinoids. Statistically significant differences between both cell types have been observed in cytometric and histometric features, and binding of Lewis A trisaccharide (Lea). Prognosis is associated with the cell type, presence of lymph node metastases and heparin-binding lectin (HBL), certain cytometric and structural features, and binding of macrophage migration inhibitory factor (MIF) and beta-N-acetyl-D-galactosamine (beta-GalNAc). CONCLUSIONS: Complete lymph node dissection is necessary, data of cytometry, histometry, and ligandohistochemistry might eventually predict the course of the disease.

Adolescent↗

Opposing kinase signaling may underlie the inverse relationship between cancer and Alzheimer's disease.

Cancer and Alzheimer's disease (AD) are leading causes of mortality and exhibit an inverse relationship, where AD patients have reduced cancer risk and vice versa. However, the molecular basis of this relationship remains poorly understood. We reanalyzed published proteomic and phosphoproteomic datasets to investigate this relationship. Differentially abundant proteins were identified in lung adenocarcinoma and glioblastoma samples relative to controls and compared with proteins altered in AD brains, revealing 37 proteins with opposing abundance patterns. Protein-protein interaction and pathway analyses revealed enrichment in kinase signaling and phosphorylation pathways. Phosphoproteomic analysis identified 52 differentially phosphorylated sites with opposing patterns, while kinase-substrate enrichment analysis identified 44 kinases with opposing inferred activity profiles. Integration of kinase activity and phosphosite data identified 29 kinase-phosphosite pairs, including 4 prioritized pairs with opposing patterns relevant to both diseases. Across seven independent cancer cohorts, 17 of 20 statistically significant phosphosite-cohort comparisons (85%) were concordant with the discovery findings, supporting reproducibility of the prioritized phosphosites. Together, these findings highlight opposing kinase signaling as a prominent feature of the inverse relationship and suggest potential biomarkers and therapeutic targets. This study provides a novel systems-level framework for investigating inverse relationships, supported by an R Shiny application for data exploration (https://advscancer.shinyapps.io/advscancer/). SIGNIFICANCE: This study presents an integrated proteomic and phosphoproteomic framework for investigating the inverse relationship between cancer and Alzheimer's disease (AD). By integrating differential protein abundance, phosphosite phosphorylation, inferred kinase activity, and curated kinase-substrate relationships, we identified opposing signaling patterns and prioritized four kinase-phosphosite pairs. Independent evaluation across seven CPTAC cancer cohorts supported the reproducibility of the prioritized phosphosite patterns. These findings provide insight into molecular processes potentially associated with the inverse relationship between cancer and AD, identify candidate biomarkers and therapeutic targets, and demonstrate the value of systems-level, data-driven approaches for investigating shared and opposing disease processes.

Humans↗

Surgical treatment of Borrmann type IV gastric carcinoma: relevance of lymphadenectomy in improving survival.

BACKGROUND: Borrmann type IV gastric carcinoma carries a poor prognosis, even if curatively resected. The benefit of a lymphadenectomy is unknown. STUDY DESIGN: A retrospective study was designed to evaluate whether improvements have been made in the treatment of type IV gastric carcinoma over the past decade. The 345 patients with type IV carcinoma who underwent laparotomy within a recent 16-year period were split into two groups: one group of patients who underwent laparotomy between 1977 and 1985, and the other between 1986 and 1992. Survival data were compared between these two groups and prognostic factors for type IV gastric carcinoma were assessed by multivariate analysis. RESULTS: A significant difference in survival was observed between the groups, both of which underwent curative resection, despite a lack of difference in background factors. The improvement was more prominent among patients with nodal metastases and insignificant among patients without nodal metastases. Multivariate analysis identified nodal metastasis as a major independent prognostic factor. CONCLUSIONS: An improvement in outcome was presumably achieved through extended lymphadenectomy. However, the survival rate remains unsatisfactory, and further advances in the treatment of this disease are needed.

Adenocarcinoma↗

Automated methods of predicting the function of biological sequences using GO and BLAST.

BACKGROUND: With the exponential increase in genomic sequence data there is a need to develop automated approaches to deducing the biological functions of novel sequences with high accuracy. Our aim is to demonstrate how accuracy benchmarking can be used in a decision-making process evaluating competing designs of biological function predictors. We utilise the Gene Ontology, GO, a directed acyclic graph of functional terms, to annotate sequences with functional information describing their biological context. Initially we examine the effect on accuracy scores of increasing the allowed distance between predicted and a test set of curator assigned terms. Next we evaluate several annotator methods using accuracy benchmarking. Given an unannotated sequence we use the Basic Local Alignment Search Tool, BLAST, to find similar sequences that have already been assigned GO terms by curators. A number of methods were developed that utilise terms associated with the best five matching sequences. These methods were compared against a benchmark method of simply using terms associated with the best BLAST-matched sequence (best BLAST approach). RESULTS: The precision and recall of estimates increases rapidly as the amount of distance permitted between a predicted term and a correct term assignment increases. Accuracy benchmarking allows a comparison of annotation methods. A covering graph approach performs poorly, except where the term assignment rate is high. A term distance concordance approach has a similar accuracy to the best BLAST approach, demonstrating lower precision but higher recall. However, a discriminant function method has higher precision and recall than the best BLAST approach and other methods shown here. CONCLUSION: Allowing term predictions to be counted correct if closely related to a correct term decreases the reliability of the accuracy score. As such we recommend using accuracy measures that require exact matching of predicted terms with curator assigned terms. Furthermore, we conclude that competing designs of BLAST-based GO term annotators can be effectively compared using an accuracy benchmarking approach. The most accurate annotation method was developed using data mining techniques. As such we recommend that designers of term annotators utilise accuracy benchmarking and data mining to ensure newly developed annotators are of high quality.

Benchmarking↗

[The biology of myelodysplastic syndromes].

In the past 10 years a large amount of data has been published with respect to myelodysplasia. However, this newly emerged data, to date, has not been integrated into an all encompassing cohesive concept. The more knowledge we have about this illness to more precise diagnostic classifications, prognostications and eventually curative treatment modalities are possible. The ineffective haemopoiesis that is a hallmark of the disease may be explained by the apoptosis, hence antiapoptotic therapy, it appears, in some cases results in improvement. It is known that the malfunction of the mitochondria is responsible for accumulating the iron in sideroblastic anemia. The same mitochondrial malfunction may also be a factor in the development and progression of the non-sideroblastic forms of myelodysplasia as well. Promising research is on the way in examining the interaction between stroma cells of the bone marrow and the stem cells. Several publications study the hypothesis that the stroma also plays a significant role in the development of myelodysplasia clone. This role may be a causative one or perhaps a more passive/permissive one. This paper attempts to provide an overview of the newly emerged data, published in the most recent years, concerning myelodysplasia.

Apoptosis↗

Prognostic factors for patients with colon or rectal carcinoma treated with resection only. Five-year follow-up report.

BACKGROUND: The prognostic factors and natural history of recurrence in patients with colorectal carcinoma who underwent curative resection and no other therapy were analyzed. METHODS: The object of analysis was the potentially curative resection only subgroup in the randomized clinical trial (RCT) that we performed. Cox's proportional hazards model was used mainly to analyze recurrence rates during the first 5 years after surgery. RESULTS: The analysis was performed on a subgroup of the RCT (279 patients with colon carcinoma and 293 patients with rectal carcinoma). Five-year disease free survival rates were 76.3% and 56.5% for colon and rectal carcinomas, respectively. The prognostic factors for recurrence for colon carcinoma patients were different from those with rectal carcinoma. For colon carcinoma, only Dukes stage was significant, whereas for rectal carcinoma, Dukes stage, age, location of the tumor, and serosal and venous invasion by cancer cells were prognostic factors. Log-transformed disease free survival rates were linear in Dukes Stage B and biphasic in Dukes Stage C for both colon and rectal carcinoma. The two phases in Dukes Stage C intersected at 2.85 and 3.04 years, respectively. The annual hazard value was high for the first 3 years in both colon and rectal carcinoma. CONCLUSIONS: We conclude that follow-up of patients with colorectal carcinoma who undergo potentially curative resection is of particular importance in the first 3 years after surgery. Furthermore, the usefulness of adjuvant chemotherapy can be adequately evaluated from data yielded during this postoperative period.

Chemotherapy, Adjuvant↗

Neoadjuvant chemoradiation for advanced primary vulvar cancer.

BACKGROUND: In advanced stage primary vulvar cancer, treatment is tailored to individual patient needs. Combined treatment modalities have been developed, using chemotherapy, radiotherapy and surgery. OBJECTIVES: To determine whether the combined treatment strategy using concurrent neoadjuvant chemoradiation therapy followed by surgery is effective and safe in vulvar cancer patients with advanced primary disease. Main outcomes of interest were: types of surgical intervention following chemoradiation and survival, recurrence and complication rates. SEARCH STRATEGY: We searched the Cochrane Gynaecological Cancer Review Group Specialised Register. The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE (PubMed), EMBASE, CANCERLIT, other databases and reference lists of articles. The latest search was conducted on 12 March 2005. SELECTION CRITERIA: Studies of curative treatment of patients with advanced, primary squamous cell carcinoma of the vulva were included. Treatment included concurrent radiotherapy and chemotherapy, followed by surgery. DATA COLLECTION AND ANALYSIS: Twenty-eight abstracts and papers were selected either by the search strategy or by checking the cross references. Randomised controlled trials (RCTs) were not available. Five studies met the inclusion criteria. (Eifel 1995; Landoni 1996; Montana 2000; Moore 1998; Scheistroen 1993). Two authors (HCvD, MV-L) independently assessed trial quality and extracted data. Study authors were contacted for additional information. Adverse effects information was collected from the trials. MAIN RESULTS: Chemotherapy was given uniformly within each of the five selected studies. However, four different chemoradiation schedules were applied. Radiotherapy dose fractionation techniques, fields and target definitions varied. Skin toxicity was observed in nearly all patients. Wound breakdown, infection, lymphedema, lymphorrhea and lymphoceles were also common. Operability was achieved in 63 to 92% of cases in the four studies using 5FU and CDDP or 5FU and MMC. In contrast, only 20% of the patients who received Bleomycin were operable after chemoradiation. After a follow up of 5 to 125 months, 26 to 63% of participants were alive and well. A total of 27 to 85% of participants died due to treatment related causes or disease. The five studies included in this review show that preoperative chemoradiotherapy reduces tumour size and improves operability. However, complications of treatment are considerable and information on the effects of quality of life (QOL) is not available. Furthermore, treatment results of the respective studies diverge considerably. AUTHORS' CONCLUSIONS: Patients with inoperable primary tumours or lymph nodes benefit from chemoradiation if an operation can be performed. In patients with large tumours that can only be treated with anterior and/or posterior exenteration complications of neoadjuvant therapy might outweigh complications of exenterative surgery. With the current knowledge neoadjuvant therapy is not justified in patients with tumours that can be adequately treated with radical vulvectomy and bilateral groin node dissection alone.

Carcinoma, Squamous Cell↗