Stage IV (stage + iv)

Distribution by Scientific Domains
Distribution within Medical Sciences

Terms modified by Stage IV

  • stage iv disease
  • stage iv melanoma
  • stage iv tumor

  • Selected Abstracts


    Shortened intensified multi-agent chemotherapy and non-cross resistant maintenance therapy for advanced lymphoblastic lymphoma in children and adolescents: report from the Children's Oncology Group

    BRITISH JOURNAL OF HAEMATOLOGY, Issue 2 2008
    Minnie Abromowitch
    Summary Pediatric lymphoblastic lymphoma (LL) has utilized treatment strategies similar to childhood acute lymphoblastic leukaemia (ALL) with prolonged maintenance chemotherapy. We report the results of a pilot study to estimate the feasibility, toxicity and efficacy of a 12-month aggressive multi-agent chemotherapy regimen in children and adolescents with advanced LL. Between July 1994 and June 1997, 85 eligible children and adolescents with advanced LL (Stage III/IV) were enrolled on this pilot study. Patients achieving a complete response following induction and consolidation received six cycles of maintenance chemotherapy for a total duration of 12 months. Grade III/IV toxicities included: hematological (80%), infections (20%), stomatitis and elevated transaminases, (29%). There were a total of 19 events, 13 relapses, two secondary acute myeloid leukaemia and four toxic deaths (5%). The 5-year event-free survival (EFS) and overall survival (OS) was 78 45% and 85 39%, respectively. Relapsed patients had a 5-year OS of only 33 14%. Multivariate analysis failed to demonstrate age, gender, lactate dehydrogenase level, presence of marrow and/or central nervous system disease to have independent prognostic value. These results suggest that this experimental approach is safe and results in similar outcomes as more prolonged childhood ALL regimens. [source]


    Effects of Qi therapy (external Qigong) on symptoms of advanced cancer: a single case study

    EUROPEAN JOURNAL OF CANCER CARE, Issue 5 2005
    M.S. LEE phd
    The aim of this study was to examine the effectiveness of Qi therapy (external Qigong) in the management of symptoms of advanced cancer in a man. We used a single case study design to evaluate the effectiveness of Qi therapy (external Qigong) in a 35-year-old man with advanced cancer (Stage IV) involving metastases in the stomach, lung and bone (Karnofsky performance scale: KPS, 40: requires special care and assistance, disabled). Treatment involved six days of pre-assessment, eight treatment sessions on alternate days over 16 days, and a two-week follow-up phase. A visual analogue scale (VAS) was used to assess the patient's self-reported symptoms of cancer over the intervention and follow-up periods. Following treatment, VAS scores' analysis revealed beneficial effects on pain, vomiting, dyspnoea, fatigue, anorexia, insomnia, daily activity and psychological calmness. These improvements were maintained over the two-week follow-up phase. After the first Qi therapy session, the patient discontinued medication and could sit by himself; after the fourth session, the patient was able to walk and use the toilet without assistance (improvement in KPS: 70: care for self, unable to perform normal activity or to do active work). Although limited by the single case study approach, our results support previous studies on this topic and provide reasons to conduct controlled clinical trials. [source]


    Vertical distribution and behaviour of shrimp Pandalus borealis larval stages in thermally stratified water columns: laboratory experiment and field observations

    FISHERIES OCEANOGRAPHY, Issue 5 2006
    PATRICK OUELLET
    Abstract By combining field data and laboratory observations of larvae in a simulated thermal gradient, we described the ontogenetic changes in vertical distribution and behaviour of early stages of shrimp Pandalus borealis in thermally stratified water columns. Both in the laboratory and at stations in the north-western Gulf of St Lawrence, the first two larval stages appear to actively select and maintain a position in the upper layer of warmer temperatures, within the thermocline and above the cold (<1C) intermediate layer. Stage III larvae were distributed deeper in the water column and in colder waters than the previous two stages. Stage IV and V larvae showed the highest degree of swimming activity in the laboratory and a much wider range (from surface to ,200 m) in vertical distribution in the field. The shift to deeper waters and settlement to the bottom habitat appears to happen after the fifth moult, at stage VI. We propose that the pattern of vertical distribution in the field reflects the adjustment of the different developmental stages to the distribution of preferred prey. The description of the ontogenetic change in the vertical distributions and movements of early stages of P. borealis should be valuable information for future attempts to model larval transport and dispersion, and for detecting settlement/recruitment areas using 3D ocean circulation models. The identification of the thermal habitat of the different larval stages and the timing for settlement at the bottom also provides important information for the development of temperature-dependent growth models up to the first juvenile stages. [source]


    Eclogites from the Chinese continental scientific drilling borehole, their petrology and different P-T evolutions

    ISLAND ARC, Issue 4 2007
    Yong-Feng Zhu
    Abstract Four phengite-bearing eclogites, taken from different depths of the Chinese continental scientific drilling (CCSD) borehole in the Sulu ultrahigh pressure terrane, eastern China, were studied with the electron microprobe. The compositional zonations of garnet and omphacite are moderate, whereas phengite compositions generally vary significantly in a single sample from core to rim by decrease of the Si content. Various geothermobarometric methods were applied to constrain the P-T conditions of these eclogites on the basis of the compositional variability of the above minerals. The constrained P-T path for sample B218 is characterized by pressure decrease from ca 3.0 GPa (ca 600C) to 1.3 GPa (ca 550C). Eclogite B310 yielded P-T conditions of 3.0 GPa and 750C. The path for eclogite B1008 starts at about 650C and 3.6,3.9 GPa (stage I) followed by a pressure decrease to 2.8,3.0 GPa and a significant temperature rise (stages II and IIIa, 750,810C). Afterwards, this rock cooled down to 620,660C at still high pressures (2.5,2.7 GPa, stage IIIb). Retrograde conditions were about 670C and 1.3 GPa (stage IV). Eclogite B1039 yielded a P-T path starting at ca 600C and 3.3,3.9 GPa (stage I). A pressure decrease to about 3.0 GPa (stage II, 590,610C) and then a moderate isobaric temperature increase to ca 630C (stage III) followed. Stage IV is characterized by temperatures of 650C at pressures close to 1.3 GPa. During and after this stage (hydrous) fluids partially rich in potassium penetrated the rocks causing minor changes. Relatively high oxygen fugacities led to andradite and magnetite among the newly formed minerals. We think that the above findings can be best explained by mass flow in a subduction channel. Thus, we conclude that the assembly of UHP rocks of the CCSD site, eclogites, quartzofeldspathic rocks, and peridotites, cannot represent a crustal section that was already coherent at UHP conditions as it is the common belief currently. The coherency was attained after significant exhumation of these UHP rocks. [source]


    ,-trace protein, a new marker of GFR, may predict the early prognostic stages of patients with type 2 diabetic nephropathy

    JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 4 2004
    Mami Kobata
    Abstract The relationship between serum levels of ,-trace protein (BTP) or serum creatinine (s-Cr) and the prognostic stages of type 2 diabetic nephropathy was determined. Serum samples from 174 patients with type 2 diabetes were obtained from Juntendo University Hospital, Tokyo, and Juntendo Urayasu Hospital, Chiba, Japan. They were classified into four groups according to the Report of the Ministry of Health and Welfare of Japan (1991, p 251,256) as follows: Stage I (normoalbuminuric stage), Stage II (microalbuminuric stage), Stage IIIA (macroalbuminuric stage without renal dysfunction), Stage IIIB (macroalbuminuric stage with renal dysfunction), and Stage IV (renal failure stage). Among these patients, 68 were Stage I, 29 Stage II, 32 Stage IIIA, 17 Stage IIIB, and 28 Stage IV. Levels of serum BTP were measured using the nephelometric assay on a BNA II analyzer (Dade Behring Diagnostics, Marburg, Germany). The mean levels of serum BTP in Stage IIIA were significantly higher than those in Stage I or II (P<0.00001, P<0.002, respectively). However, the mean levels of s-Cr in Stage IIIA were not significantly higher than that in Stage I or II. In conclusion, serum BTP was a good marker for the identification of early renal impairment in type 2 diabetes. J. Clin. Lab. Anal. 18:237,239, 2004. 2004 Wiley-Liss, Inc. [source]


    Serum cystatin C may predict the early prognostic stages of patients with type 2 diabetic nephropathy

    JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 5 2003
    Ayumi Shimizu
    Abstract We determined the relationship between levels of serum cystatin C or serum creatinine (s-Cr) and prognostic stages of type 2 diabetic nephropathy. Serum samples from 174 patients with type 2 diabetes were obtained from Juntendo University Hospital, Tokyo and Juntendo Urayasu Hospital, Chiba, Japan. They were classified into four groups according to the Report of the Ministry of Health and Welfare of Japan as follows: Stage I (normoalbuminuric stage), Stage II (microalbuminuric stage), Stage IIIA (macroalbuminuric stage without renal dysfunction), Stage IIIB (macroalbuminuric stage with renal dysfunction), and Stage IV (renal failure stage). Among these patients, 68 were Stage I, 29 Stage II, 32 Stage IIIA, 17 Stage IIIB, and 28 Stage IV. The levels of serum cystatin C were measured using the Dade Behring Cystatin C assay with automated Dade Behring Nephelometer II (BNII) (Dade Behring Marburg GmbH, Germany). The mean levels of serum cystatin C in Stage IIIA were significantly higher than those in Stage I or II (P<0.00001, P<0.0005, respectively). The mean levels of serum cystatin C in Stage IIIB and Stage IV were also significantly higher than those in Stage I (P<0.00001). However, the mean levels of serum creatinine (s-Cr) in Stage IIIA were not significantly higher than those in Stage I or II. The levels of s-Cr in Stage IIIB and Stage IV were significantly higher than those in Stage I (P<0.00001). Receiver operating characteristic (ROC) plots demonstrated that the area under the curve (AUC) of cystatin C (0.76) was greater than that of s-Cr (0.66). As an early prognostic marker of type 2 diabetic nephropathy, serum cystatin C was better than s-Cr in terms of sensitivity and specificity. It appears that the levels of serum cystatin C may predict early prognostic stages of patients with type 2 diabetic nephropathy. J. Clin. Lab. Anal. 17:164,167, 2003. 2003 Wiley-Liss, Inc. [source]


    Ultrahigh-pressure metamorphism and exhumation of garnet peridotite in Pohorje, Eastern Alps

    JOURNAL OF METAMORPHIC GEOLOGY, Issue 1 2006
    M. JANK
    Abstract New evidence for ultrahigh-pressure metamorphism (UHPM) in the Eastern Alps is reported from garnet-bearing ultramafic rocks from the Pohorje Mountains in Slovenia. The garnet peridotites are closely associated with UHP kyanite eclogites. These rocks belong to the Lower Central Austroalpine basement unit of the Eastern Alps, exposed in the proximity of the Periadriatic fault. Ultramafic rocks have experienced a complex metamorphic history. On the basis of petrochemical data, garnet peridotites could have been derived from depleted mantle rocks that were subsequently metasomatized by melts and/or fluids either in the plagioclase-peridotite or the spinel-peridotite field. At least four stages of recrystallization have been identified in the garnet peridotites based on an analysis of reaction textures and mineral compositions. Stage I was most probably a spinel peridotite stage, as inferred from the presence of chromian spinel and aluminous pyroxenes. Stage II is a UHPM stage defined by the assemblage garnet + olivine + low-Al orthopyroxene + clinopyroxene + Cr-spinel. Garnet formed as exsolutions from clinopyroxene, coronas around Cr-spinel, and porphyroblasts. Stage III is a decompression stage, manifested by the formation of kelyphitic rims of high-Al orthopyroxene, aluminous spinel, diopside and pargasitic hornblende replacing garnet. Stage IV is represented by the formation of tremolitic amphibole, chlorite, serpentine and talc. Geothermobarometric calculations using (i) garnet-olivine and garnet-orthopyroxene Fe-Mg exchange thermometers and (ii) the Al-in-orthopyroxene barometer indicate that the peak of metamorphism (stage II) occurred at conditions of around 900 C and 4 GPa. These results suggest that garnet peridotites in the Pohorje Mountains experienced UHPM during the Cretaceous orogeny. We propose that UHPM resulted from deep subduction of continental crust, which incorporated mantle peridotites from the upper plate, in an intracontinental subduction zone. Sinking of the overlying mantle and lower crustal wedge into the asthenosphere (slab extraction) caused the main stage of unroofing of the UHP rocks during the Upper Cretaceous. Final exhumation was achieved by Miocene extensional core complex formation. [source]


    Pancreatic adenocarcinoma in a young patient population,12-year experience at Memorial Sloan Kettering Cancer Center

    JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2009
    A. Duffy MD
    Abstract Background There is a dearth of data in a younger population of patients with pancreatic ductal adenocarcinoma (PAC) regarding epidemiology, genetics, prognosis, and outcome. This report examines a large cohort of patients with PAC ,45 years of age evaluated at MSKCC over a 12-year period. Methods A retrospective analysis of patients referred to MSKCC with PAC identified from the institutional tumor registry, who were ,45 years on the date of the diagnostic biopsy, between January 1995 and February 2008, was performed. Information reviewed included demographics, clinical and pathological staging, surgical management, therapy, date of relapse, death or last follow-up. Survival curves were estimated using the Kaplan,Meier method and compared using the log-rank test. Results One hundred thirty-six cases of PAC, age ,45 years at diagnosis, were identified. Seventy-four (54%) females, 62 (46%) males. Age range: 24,45; 4, 38, and 94 patients in age groups 20,29, 30,39, 40,45 years, respectively. Fifty (37%) had a smoking history. Fourteen (10.3%) had a positive family history of PAC. Thirty-five (25.7%) underwent a curative resection for localized disease. Twenty-eight (20.1%) presented with locally advanced, inoperable disease. Sixty-eight (50%) presented as AJCC Stage IV. Twenty-three (37%) of those resected underwent adjuvant chemoradiation. Thirteen received adjuvant gemcitabine. The median overall survival for the entire cohort was 12.3 months (95% CI 10.2,14.0 months). The median overall survival for the patients with locally resectable disease was 41.8 months (95% CI 20.3,47 months). The median overall survival for the patients who presented with locally advanced, unresectable disease was 15.3 months (95% CI 12,19.3 months). The median overall survival for those who presented with metastatic disease was 7.2 months (95% CI 5.2,9.5 months). Conclusions This is the largest reported cohort of young patients with PAC ,45 years of age. The data suggest that patients with stages I,II disease may have an improved prognosis, however the prognosis for stages III,IV patients appears to be similar to the typical (older) patient population with PAC. J. Surg. Oncol. 2009;100:8,12. 2009 Wiley-Liss, Inc. [source]


    Epithermal Gold-Silver Mineralization of the Asachinskoe Deposit in South Kamchatka, Russia

    RESOURCE GEOLOGY, Issue 4 2007
    Ryohei Takahashi
    Abstract The Asachinskoe epithermal Au-Ag deposit is a representative low-sulfidation type of deposit in Kamchatka, Russia. In the Asachinskoe deposit there are approximately 40 mineralized veins mainly hosted by dacite,andesite stock intrusions of Miocene,Pliocene age. The veins are emplaced in tensional cracks with a north orientation. Wall-rock alteration at the bonanza level (170,200 m a.s.l.) consists of the mineral assemblage of quartz, pyrite, albite, illite and trace amounts of smectite. Mineralized veins are well banded with quartz, adularia and minor illite. Mineralization stages in the main zone are divided into stages I,IV. Stage I is relatively barren quartz,adularia association formed at 4.7 0.2 Ma (K-Ar age). Stage II consists of abundant illite, Cu-bearing cryptomelane and other manganese oxides and hydroxides, electrum, argentite, quartz, adularia and minor rhodochrosite and calcite. Stage III, the main stage of gold mineralization (4.5,4.4 0.1,3.1 0.1 Ma, K-Ar age), consists of a large amount of electrum, naumannite and Se-bearing polybasite with quartz,adularia association. Stage IV is characterized by hydrothermal breccia, where electrum, tetrahedrite and secondary covellite occur with quartz, adularia and illite. The concentration of Au+Ag in ores has a positive correlation with the content of K2O + Al2O3, which is controlled by the presence of adularia and minor illite, and both Hg and Au also have positive correlations with the light rare-earth elements. Fluid inclusion studies indicate a salinity of 1.0,2.6 wt% NaCl equivalent for the whole deposit, and ore-forming temperatures are estimated as approximately 160,190C in stage III of the present 218 m a.s.l. and 170,180C in stage IV of 200 m a.s.l. The depth of ore formation is estimated to be 90,400 m from the paleo-water table for stage IV of 200 m a.s.l., if a hydrostatic condition is assumed. An increase of salinity (>CNaCl, 0.2 wt%) and decrease of temperature (>T , 30C) within a 115-m vertical interval for the ascending hydrothermal solution is calculated, which is interpreted as due to steam loss during fluid boiling. Ranges of selenium and sulfur fugacities are estimated to be logfSe2 = ,17 to ,14.5 and logfS2 = ,15 to ,12 for the ore-forming solution that was responsible for Au-Ag-Se precipitation in stage III of 200 m a.s.l. Separation of Se from S-Se complex in the solution and its partition into selenides could be due to a relatively oxidizing condition. The precipitation of Au-Ag-Se was caused by boiling in stage III, and the precipitation of Au-Ag-Cu was caused by sudden decompression and boiling in stage IV. [source]


    Fatty acid profiles of spiny lobster (Panulirus homarus) phyllosoma fed enriched Artemia

    AQUACULTURE RESEARCH, Issue 10 2010
    Kajal Chakraborty
    Abstract Three different life stages of spiny lobster larvae (phyllosoma) of Panulirus homarus were fed A1-Selco-enriched Artemia in two culture treatments, one with the microalgae Nannochloropsis salina (green water) and the other without the microalgae (clear water) to assess the ability to manipulate their fatty acid composition. Phyllosoma fed with 3-h A1-Selco-enriched Artemia salina attained Stage VIII (5.3 mm) and Stage V (3.4 mm) in 42 days in the green and clear water treatments respectively. The higher content of the essential fatty acids in N. salina (eicosapentaenoic acid, 25.8%; arachidonic acid, 9.5%; and docosahexaenoic acid, 4.2%) in the green water system increased the fatty acid content of the live food Artemia, and ultimately the phyllosoma. In spite of phyllosoma being fed with enriched Artemia in the clear water system, the total polyunsaturated fatty acid content of the early (Stages I,III) and mid stage (Stages IV,V) phyllosoma were significantly smaller (18.8% and 14.6% respectively) (P<0.05) than in the green water system (25.3% and 21.2% respectively). These results indicate the positive role of the microalgae in boosting the essential fatty acid content of lobster larvae. [source]


    Improved treatment outcome in Chinese children and adolescents with Burkitt's lymphoma and large cell lymphoma by using the modified B-non-Hodgkin's lymphoma-Berlin-Frankfurt-Mnster-90 protocol

    EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2006
    Xiao-Fei Sun
    Abstract:,Objectives:,This study was designed to evaluate the efficacy and toxicity of the modified B-Non-Hodgkin's Lymphoma (NHL)-Berlin-Frankfurt-Mnster (BFM)-90-based protocol in Chinese children and adolescents with Burkitt's lymphoma and large cell lymphoma. Methods:,From September 1997 to August 2005, 55 untreated patients (age less than 20 yr) from a single institution were enrolled. The patients were stratified by risk factors (stage, LDH level and chemotherapy response). All patients were treated with a modified B-NHL-BFM 90 protocol. Results:,The median age of the patients was 8 yr (range 1.5,20 yr). Of these patients, 22 (40%) had Burkitt's lymphoma (BKL), 22 (40%) had diffuse large B-cell lymphoma (DLBL) and 11 (20%) had anaplastic large T-cell lymphoma (ALCL). Complete remission (CR) occurred in 45 patients (83%), partial remission (PR) in eight patients (14.5%), and progressive disease (PD) in one patient (1.8%). At a median follow up of 24 months, the event free survival (EFS) for all patients was 85% 5% with 100% for group R1, 84% 7% for group R2 and 72% 13% for group R3, and most notably, 80% 6% for stage III/IV at diagnosis. There was no statistically significant difference (P = 0.96) in EFS among BKL and DLBL and ALCL. The major toxicity complications were myelosuppression and mucositis, but these conditions were tolerated and manageable. Conclusions:,This modified NHL-BFM-90 protocol is very effective for Chinese children and adolescents with BKL and large cell lymphomas, and represented an increase in the cure rates in childhood NHL in China. [source]


    Neoadjuvant chemotherapy for squamous cell carcinoma of the oral tongue in young adults: A case series

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2005
    Erich M. Sturgis MD
    Abstract Background. Squamous cell carcinoma of the oral tongue (SCCOT) in the young population has emerged as a growing worldwide health problem. Standard therapies, consisting primarily of surgery with possible adjuvant radiotherapy, have resulted in only modest improvements in survival in recent decades, whereas the treatments for SCCOT continue to impair oral function. With the increased use and improved functional results of neoadjuvant chemotherapy in the treatment of squamous cell carcinoma of other upper aerodigestive tract sites, we have reviewed our experience with neoadjuvant chemotherapy in young patients with SCCOT. Methods. A retrospective review was conducted of all patients younger than 45 years (N = 49) with previously untreated SCCOT evaluated at a comprehensive cancer center from July 1995 to August 2001. Charts were reviewed to obtain demographic data, comorbidities, nutritional status, tumor status, treatment and response information, and follow-up data. Results. Fifteen patients were identified who received neoadjuvant chemotherapy with taxane-based regimens before undergoing glossectomy and neck dissection. Thirteen of these patients (87%) exhibited stage III or IV disease at presentation, and all exhibited at least a partial response at the primary site. Pathologically positive nodes were identified in only six patients (40%), although 13 (87%) had clinically or radiographically suspicious nodes at presentation. Adjuvant radiation therapy was administered to seven patients (47%). With a median follow-up of 39 months, no patient has had local or regional recurrence, although three patients (20%) have had distant metastases develop; one patient with an isolated distant metastasis was successfully salvaged with radiation. By comparison during the same period, 34 young adult patients with SCCOT were treated with surgery with or without postoperative radiotherapy but without the use of chemotherapy. Although these patients had lower T classifications (18% vs 67% T3/T4; p = .0007), incidence of nodal metastases (15% vs 87% N+; p < .0001), and overall disease stage (24% vs 87% stage III/IV; p < .0001) than the neoadjuvant chemotherapy group, the overall survival (82%), disease-specific survival (88%), and recurrence-free survival (82%) of the surgery-first group was similar to that of the neoadjuvant chemotherapy group (87%, 87%, and 80%, respectively). Conclusions. This retrospective investigation demonstrates that neoadjuvant chemotherapy with taxane-based regimens may play a role in the successful treatment of SCCOT in young adult patients. Ultimately, this treatment plan may lead to improved functional outcomes in young patients with SCCOT by allowing function-sparing surgery and avoiding postoperative radiotherapy, without sacrificing disease control and survival, but a prospective trial is needed. We have initiated a prospective clinical trial to further investigate the impact of neoadjuvant chemotherapy in patients younger than 50 with SCCOT. 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]


    Tumor necrosis factor- , and transforming growth factor- , reflect severity of liver damage in primary biliary cirrhosis

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2002
    MANUELA NEUMAN
    Abstract Background and Aims The pathogenesis of primary biliary cirrhosis (PBC) is unknown. The role of cytokines such as tumor necrosis factor-, (TNF-,) and transforming growth factor-, (,GF-,), and the effect of ursodeoxycholic acid (UDCA) in modifying the cytokine environment in patients with PBC has remained largely unstudied. Our aims were to determine: (i) the relationship between serum levels of TNF-, and TGF-, and the severity of PBC; and (ii) the effects of UDCA therapy on TNF-, and TGF-, levels in patients with PBC. Methods We studied 90 patients who had been treated with UDCA (53 patients) or placebo (37 patients) for 2 years as part of a randomized, double-blind, controlled trial. Patients were divided into histological stage I/II or stage III/IV disease. Serum TNF-, and TGF-, levels were quantified by enzyme-linked immunoabsorbent assay. Results Baseline levels of TNF-, were significantly greater in patients with stage III/IV compared to stage I/II disease. After 2 years of treatment with UDCA, patients showed a significantly greater decrease in TNF-, levels and progression risk score compared to placebo-treated patients. TNF-, and TGF-, levels were significantly reduced compared to baseline levels in the UDCA-treated group after 2 years, while there was no significant change in the levels of placebo-treated patients. Conclusions Serum TNF-, and TGF-, levels may reflect severity of disease in patients with PBC. The beneficial effects of UDCA therapy may be explained by lowering serum levels of these two cytokines. [source]


    Expression of the stem cell marker nestin in peripheral blood of patients with melanoma

    BRITISH JOURNAL OF DERMATOLOGY, Issue 1 2010
    A. Fusi
    Summary Background, There is continued interest in markers indicative of circulating melanoma cells. Nestin is a neuroepithelial intermediate filament protein that was found to be expressed in melanoma and in various cancer stem cells. Objectives, We investigated expression of nestin in peripheral blood of patients with melanoma. Methods, We analysed nestin expression by flow cytometry and by quantitative reverse transcription,polymerase chain reaction both in tissues (n = 23) and in blood samples (n = 102) from patients with American Joint Committee on Cancer stage III,IV melanoma. Forty-six negative controls were also added. Results, Flow cytometry did not reveal nestin-expressing cells in peripheral blood of healthy volunteers. In patients with melanoma, however, nestin protein was expressed in a proportion of melanoma cells enriched from peripheral blood by immunomagnetic sorting. In melanoma tissue samples a significant correlation was found between mRNAs coding for nestin and tyrosinase (P = 0001) and melan-A (P = 0002), whereas in blood a significant correlation was observed only for tyrosinase (P = 0015), but not for melan-A (P = 053). Nestin expression was higher in stage IV patients compared with stage III/IV with no evidence of disease, in patients with high tumour burden, and was positively correlated to expression of tyrosinase and melan-A. Conclusions, Nestin was found to be an additional marker of interest for circulating melanoma cells. Prospective studies should investigate its potential added informative value in comparison with markers already in use for melanoma cell detection. [source]


    Mantle Cell Lymphoma in the Ocular Region

    ACTA OPHTHALMOLOGICA, Issue 2008
    S HEEGAARD
    Purpose To characterize the clinicopathological features of mantle cell lymphoma (MCL) in the ocular region. Methods All lymphoid lesions were retrieved searching the Danish Ocular Lymphoma Database 1980-2007. Specimens were collected from Danish pathology departments and re-evaluated with a panel of monoclonal antibodies. For all patients with confirmed MCL the complete clinical files were collected and reviewed. Results Twenty-one patients with MCL were identified comprising nine percent (21/230) of all lymphomas in the ocular region. There were 18 male and three female patients with an age range from 60 to 90 years (median 75 years). Ocular region MCL as first presenting symptom included 67% of the patients. Of these, 71% had bilateral involvement and all had lymphoma in more than one site within the ocular region. The orbit (71%) and eyelids (64%) were the most commonly affected sites. At the time of diagnosis 93% of the patients were in Ann Arbor stage III/IV, with bone marrow involvement (79%) and B-symptoms (50%). Median overall survival (OS) was 30 months and the five-year OS rate was 21%. Patients receiving anti-CD20 (Rituximab)-containing chemotherapy had a significant better 5-year OS rate (80 %) (p < 0,027) than patients in treatment regimes without Rituximab (5-year OS rate, 29%). Conclusion MCL presenting in the ocular region has a male predominance and affects elderly patients. The orbit and eyelids were frequently involved. Patients with ocular region MCL as first presenting symptom had a high proportion of bilateral affection. Patients had advanced stage disease at diagnosis, multiple relapses and a low 5-year OS rate similar to systemic MCL. Treatment with Rituximab-containing chemotherapy improved survival significantly. [source]


    NON-GYNAECOLOGICAL CYTOLOGY: THE CLINICIAN'S VIEW

    CYTOPATHOLOGY, Issue 2006
    I. Penman
    There is increased recognition of the importance of accurate staging of malignancies of the GI tract and lung, greater use of neoadjuvant therapies and more protocol-driven management. This is particularly important where regional lymph node involvement significantly impacts on curability. Multidetector CT and PET scanning have resulted in greater detection of potential abnormalities which, if positive for malignancy, would change management. There is also a greater recognition that many enlarged nodes may be inflammatory and that size criteria alone are unreliable in determining involvement. In other situations, especially pancreatic masses, not all represent carcinoma as focal chronic pancreatitis, autoimmune pancreatitis etc can catch out the unwary. A preoperative tissue diagnosis is essential and even if unresectable, oncologists are increasingly reluctant to initiate chemotherapy or enroll patients into trials without this. The approach to obtaining tissue is often hampered by the small size or relative inaccessibility of lesions by percutaneous approaches. As such novel techniques such as endoscopic ultrasound (EUS) guided FNA have been developed. A 120cm needle is passed through the instrument and, under real-time visualisation, through the gastrointestinal wall to sample adjacent lymph nodes or masses. Multiple studies have demonstrated the safety and performance of this technique. In oesophageal cancer, confirmation of node positivity by has a major negative influence on curative resection rates and will often lead to a decision to use neoadjuvant chemotherapy or a non-operative approach. Sampling of lymph nodes at the true coeliac axis upstages the patient to M1a status (stage IV) disease and makes the patient incurable. In NSCLC, subcarinal lymph nodes are frequently present but may be inflammatory. If positive these represent N2 (stage IIIA) disease and in most centres again makes the patient inoperable. Access to these lymph nodes would otherwise require mediastinosocopy whereas this can be done simply, safely and quickly by EUS. Overall the sensitivity for EUS , FNA of mediastinal or upper abdominal lymph nodes is 83,90% with an accuracy of 80,90%. In pancreatic cancer performance is less good but pooled analysis of published studies indicates a sensitivity of 85% and accuracy of 88%. In a recent spin-off from EUS, endobronchial ultrasound (EBUS) instruments have been developed and the ability to sample anterior mediastinal nodes has been demonstrated. It is likely that this EBUS , FNA technique will become increasingly utilised and may replace mediastinoscopy. The development of techniques such as EUS and EBUS to allow FNA sampling of lesions has increased the role of non-gynaecological cytology significantly in recent years. Cytology therefore remains important for a broad range of specialties and there is ongoing need for careful and close co-operation between cytologists and clinicians in these specialties. References:, 1. Williams DB, Sahai AV, Aabakken L, Penman ID, van Velse A, Webb J et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut. 1999; 44: 720,6. 2. Silvestri GA, Hoffman BJ, Bhutani MS et al. Endoscopic ultrasound with fine-needle aspiration in the diagnosis and staging of lung cancer. Ann Thorac Surg 1996; 61: 1441,6. 3. Rintoul RC, Skwarski KM, Murchison JT, Wallace WA, Walker WS, Penman ID. Endobronchial and endoscopic ultrasound real-time fine-needle aspiration staging of the mediastinum ). Eur Resp J 2005; 25: 1,6. [source]


    Lung cancer with metastases to the stomach and duodenum. report of three cases

    DIGESTIVE ENDOSCOPY, Issue 3 2003
    Hiroshi Nakamura
    Over a period of about 1.5 years between September 1999 and April 2000, three cases of lung cancer that metastasized to the stomach and duodenum were encountered. Case 1 was a 74-year-old man with lung cancer at stage IV. During chemotherapy, he passed tarry feces, which led to an endoscopic examination. Subsequently, submucosal tumorous nodules were recognized in the stomach and descending portion of the duodenum, which were diagnosed as metastases. Case 2, a 59-year-old man, underwent radiotherapy for treatment of lung cancer at stage IV. He developed obstructive jaundice 15 months later and, following percutaneous drainage to correct the icteric condition, endoscopic examination was conducted. A 5-cm submucosal tumor was found at the descending portion of the duodenum and a diagnosis of obstructive jaundice caused by a duodenal metastasis was given. Case 3, an 81-year-old male with stage IIIb lung cancer had been receiving oral Tegafur uracil. Because of hypochondriac pain that had lasted for 2 weeks, an endoscopic examination was conducted. A tumorous lesion was discovered in the horizontal part of the duodenum, which proved to be a metastasis. Metastasis of a lung cancer to the digestive system is rare: gastric metastasis is only 4.5% and metastasis to the small intestine, 5.8%. However, our experience suggests that metastases to the digestive system occur more frequently than reports would indicate. Endoscopic screening should be aggressively used, not only for those cases that develop subjective symptoms, but also for the asymptomatic cases to assess accuracy in staging, which may contribute to choosing the most appropriate therapeutic plan. [source]


    Concurrent chemoradiotherapy with weekly paclitaxel and carboplatin for locally advanced head and neck cancer: Long-term follow-up of a Brown University Oncology Group Phase II Study (HN-53)

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 3 2008
    Prakash B. Chougule MD
    Abstract Background. A phase II study was conducted using concurrent paclitaxel, carboplatin, and external beam radiotherapy (RT) in patients with advanced head and neck cancer. Methods. Forty-three patients (stage III, n = 12; stage IV, n = 31) were treated with 8 cycles of weekly paclitaxel (60 mg/m2), carboplatin (area under the curve [AUC] = 1), and RT (1.8 Gy daily; total dose, 66,72 Gy). Patients with initially palpable lymph nodes underwent neck dissection. Results. The overall clinical response rate was 91% (65% complete, 26% partial). Severe mucositis occurred in 37 (90%) patients, necessitating hospitalization in 13 (31%) patients. With a median follow-up of 49 months, the locoregional and distant failure rates were 26% and 21%, respectively. Conclusions. Concurrent paclitaxel, carboplatin, and RT for advanced head and neck cancer results in high complete response rates. Long-term follow-up has revealed the curative potential of this regimen, though the doses used resulted in unacceptable toxicity. 2007 Wiley Periodicals, Inc. Head Neck 2008 [source]


    Long-term survival in locally advanced oral cavity cancer: An analysis of patients treated with neoadjuvant cisplatin-based chemotherapy followed by surgery,

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2005
    Enzo Maria Ruggeri MD
    Abstract Background. Neoadjuvant chemotherapy has been reported to be extremely active in head and neck cancer but has failed to give a statistically significant improvement in survival. Methods. From 1981 to 1994, 33 operable patients with locally advanced oral cavity cancer received cisplatin-based chemotherapy before surgery. Postoperative radiotherapy was performed in high-risk patients. Results. The overall clinical and pathologic complete response rates to neoadjuvant chemotherapy were 48% and 30%, respectively. At a median follow-up of 7.0 years (range, 0.3,15.3+ years), the 5-year and 10-year overall survival rates were 54.5% and 39.5%, and the disease-specific median survival was 6.6 years for all patients (8.3 and 2.3 years for stages III and IV, respectively). The univariate analysis showed a positive relationship between survival and male sex (p = .05), pathologic (p = .02), and clinical (p = .03) complete response. The Cox proportional hazard regression model confirmed the independent prognostic value of the clinical response with a 4.67 (95% CI, 1.70,12.86) hazard ratio. A second primary tumor occurred in six patients (18%), with a median of occurrence of 9 years (range, 7,11 years). Conclusions. This study confirms the prolonged survival expectancy largely exceeding 5 years for selected patients with stage IV and for most with stage III locally advanced oral cavity cancer achieving a clinical and/or pathologic complete response to chemotherapy. 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]


    Long-term survival with stage IV poorly differentiated pancreatic adenocarcinoma

    HPB, Issue 2 2004
    BF Levy
    Background Metastatic poorly differentiated adenocarcinoma of the pancreas has a poor outcome despite the use of various chemotherapy regimes. Case outline A 57-year-old woman presented with a 3-month history of generalised abdominal pain associated with weight loss. Computed tomography (CT) showed a large tumour in the head and body of pancreas, and needle biopsy confirmed a poorly differentiated adenocarcinoma. Laparoscopy revealed liver metastases in both lobes, again histologically shown to be poorly differentiated adenocarcinoma. Six cycles of cisplatin, epirubicin and infusional 5-fluorouracil were given. Five years later the patient remains completely well. Repeat CT scans show a complete radiological response. Discussion Previous studies using numerous chemotherapy regimes have not significantly altered the outcome of pancreatic cancer. To the best of our knowledge this is the longest surviving case of a patient with advanced metastatic adenocarcinoma (stage IV) of the pancreas treated with chemotherapy. [source]


    Estimation of rainfall from infrared-microwave satellite data for basin-scale hydrologic modelling

    HYDROLOGICAL PROCESSES, Issue 15 2010
    Oscar Anthony Kalinga
    Abstract The infrared-microwave rainfall algorithm (IMRA) was developed for retrieving spatial rainfall from infrared (IR) brightness temperatures (TBs) of satellite sensors to provide supplementary information to the rainfall field, and to decrease the traditional dependency on limited rain gauge data that are point measurements. In IMRA, a SLOPE technique (ST) was developed for discriminating rain/no-rain pixels through IR image cloud-top temperature gradient, and 243K as the IR threshold temperature for minimum detectable rainfall rate. IMRA also allows for the adjustment of rainfall derived from IR-TB using microwave (MW) TBs. In this study, IMRA rainfall estimates were assessed on hourly and daily basis for different spatial scales (4, 12, 20, and 100 km) using NCEP stage IV gauge-adjusted radar rainfall data, and daily rain gauge data. IMRA was assessed in terms of the accuracy of the rainfall estimates and the basin streamflow simulated by the hydrologic model, Sacramento soil moisture accounting (SAC-SMA), driven by the rainfall data. The results show that the ST option of IMRA gave accurate satellite rainfall estimates for both light and heavy rainfall systems while the Hessian technique only gave accurate estimates for the convective systems. At daily time step, there was no improvement in IR-satellite rainfall estimates adjusted with MW TBs. The basin-scale streamflow simulated by SAC-SMA driven by satellite rainfall data was marginally better than when SAC-SMA was driven by rain gauge data, and was similar to the case using radar data, reflecting the potential applications of satellite rainfall in basin-scale hydrologic modelling. Copyright 2010 John Wiley & Sons, Ltd. [source]


    Beta2-microglobulin mutations in microsatellite unstable colorectal tumors

    INTERNATIONAL JOURNAL OF CANCER, Issue 2 2007
    Matthias Kloor
    Abstract Defects of DNA mismatch repair (MMR) cause the high level microsatellite instability (MSI-H) phenotype. MSI-H cancers may develop either sporadically or in the context of the hereditary nonpolyposis colorectal cancer (HNPCC) syndrome that is caused by germline mutations of MMR genes. In colorectal cancer (CRC), MSI-H is characterized by a dense lymphocytic infiltration, reflecting a high immunogenicity of these cancers. As a consequence of immunoselection, MSI-H CRCs frequently display a loss of human leukocyte antigen (HLA) class I antigen presentation caused by mutations of the ,2 -microglobulin (,2m) gene. To examine the implications of ,2m mutations during MSI-H colorectal tumor development, we analyzed the prevalence of ,2m mutations in MSI-H colorectal adenomas (n = 38) and carcinomas (n = 104) of different stages. Mutations were observed in 6/38 (15.8%) MSI-H adenomas and 29/104 (27.9%) MSI-H CRCs. A higher frequency of ,2m mutations was observed in MSI-H CRC patients with germline mutations of MMR genes MLH1 or MSH2 (36.4%) compared with patients without germline mutations (15.4%). The high frequency of ,2m mutations in HNPCC-associated MSI-H CRCs is in line with the hypothesis that immunoselection may be particularly pronounced in HNPCC patients with inherited predisposition to develop MSI-H cancers. ,2m mutations were positively related to stage in tumors without distant metastases (UICC I-III), suggesting that loss of ,2m expression may promote local progression of colorectal MSI-H tumors. However, no ,2m mutations were observed in metastasized CRCs (UICC stage IV, p = 0.04). These results suggest that functional ,2m may be necessary for distant metastasis formation in CRC patients. 2007 Wiley-Liss, Inc. [source]


    Cytoplasmic melanoma-associated antigen (CYT-MAA) serum level in patients with melanoma: A potential marker of response to immunotherapy?

    INTERNATIONAL JOURNAL OF CANCER, Issue 1 2006
    Sandra R. Reynolds
    Abstract Simple, noninvasive methods are needed to follow effectiveness of new treatments in patients with melanoma. In our study, we examined cytoplasmic melanoma-associated antigen (CYT-MAA) serum level in melanoma patients during immunotherapy. Sera of 117 patients were assayed for CYT-MAA by double-sandwich ELISA before and during treatment with a polyvalent, shed antigen, melanoma vaccine. Vaccine-treated patients included 30 with American Joint Committee on Cancer (AJCC) stage IIb or IIIa, 30 with stage IIc, IIIb or IIIc, 30 with resected stage IV and 27 with measurable stage IV disease. Prior to vaccine therapy, 63% of patients had elevated serum CYT-MAA with high levels of antigen in all disease stages. After initiation of therapy, the level declined in more than 90% of the positive patients and fell below the positive cut-off in 56% of these patients within 5 months. By contrast, there was no decline in CYT-MAA serum level in 11 patients who served as untreated controls with melanoma. Multivariate analysis of the treated patients using accelerated failure time Weibull models adjusted for stage and age showed that patients whose CYT-MAA serum level remained elevated during treatment were ,3 times more likely to recur or progress than patients who were consistently below the positive cut-off (hazard ratio = 3.42, 95% CI [1.38, 8.47], p = 0.0079). Measurement of CYT-MAA serum level appears to show potential as an early marker of prognosis in patients with stages IIb to IV melanoma. Measurement of CYT-MAA serum level during therapy could provide an intermediate marker of response in these patients. 2006 Wiley-Liss, Inc. [source]


    Highly sensitive detection of the MGB1 transcript (mammaglobin) in the peripheral blood of breast cancer patients

    INTERNATIONAL JOURNAL OF CANCER, Issue 4 2004
    Nuno Cerveira
    Abstract We describe a new one-step RT-PCR assay for the detection of the mammaglobin (MGB1) gene transcript in the peripheral blood of breast cancer patients. With this approach, the MGB1 transcript could be detected in the peripheral blood of 22 of 54 (41%) breast cancer patients prior to any therapy. This method, using specific primers for cDNA synthesis, proved to be more sensitive (10,6 to 10,11, usually 10,7) than previously reported methodologies. This increased sensitivity was achieved without compromising specificity, as the MGB1 transcript was not detected in 38 blood samples of healthy donors and in only 1 of 18 blood samples of patients presenting with hematologic malignancies. A positive correlation was seen between MGB1 positivity and breast cancer stage: 0/3 (0%) in stage 0, 3/13 (23%) in stage I, 6/17 (35%) in stage II, 5/10 (50%) in stage III, 8/11 (73%) in stage IV (p = 0.003). The prognostic and therapeutic implications of MGB1 positivity by one-step RT-PCR in the peripheral blood of breast cancer patients, especially in clinically localized disease (stages I and II), should be evaluated after long-term clinical follow-up of these patients. 2003 Wiley-Liss, Inc. [source]


    Progressive macular hypomelanosis in Singapore: a clinico-pathological study

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006
    Sujith Prasad W. Kumarasinghe MBBS
    Introduction, Progressive macular hypomelanosis (PMH), a condition of uncertain etiology, is characterized by asymptomatic hypopigmented macules predominantly located on the trunk. To date, there are no reports from South-East Asia concerning this condition. We sought to record the clinical features of PMH in Asian patients, identify etiologic factors, and study the structural and ultrastructural features of melanocytes in this disorder. Methods, Patients who presented to the National Skin Center with acquired, hypopigmented macules on the trunk, without a history of inflammation or infection, were recruited. Erythrocyte sedimentation rate (ESR), complete blood count, fasting blood glucose, liver function tests, skin scrapings for fungi, and skin biopsy specimens (from lesional and normal skin) were obtained. Biopsies were stained with hematoxylin and eosin (H&E), Fontana Masson, an immunohistochemical panel for identification of melanocyte differentiation antibodies (HMB 45, Melan A, and S100) and CD 68. Electron microscopy (EM) was also performed. The patients were evaluated every 3 months. Results, During a 9 month period, eight patients (all Chinese) presented with hypopigmented, ill-defined, confluent macules involving the lower aspect of the trunk. There were four men and four women, and the mean age was 25.9 years (range 19,45 years). Skin scrapings were negative for fungi and laboratory tests were normal. Microscopic evaluation of skin biopsy speciments showed reduced pigmentation of lesional as compared with normal appearing skin, but H&E-stained sections revealed only minimal histologic differences between lesional and normal skin. EM demonstrated a statistically significant (P = 0.047, Wilcoxon Signed Rank Test, Wilcoxon 95% CI 0.02,0.62) higher ratio of stage IV and late stage III (dark) melanosomes in normal vs. lesional skin. Conclusions, PMH may occur among young adults in Singapore. Its etiology is uncertain. The melanin content of lesional skin appears to be less than that in normal sites. EM shows a higher ratio of immature melanosomes in lesional vs. normal skin. [source]


    Adrenocortical carcinoma: Retrospective study of 14 patients experienced at a single institution over 34 years

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2007
    Sachiyo Nishida
    Objective: To review clinical outcome of patients with adrenocortical carcinoma experienced at a single institute over 34 years. Methods: The study included 14 patients who were diagnosed as having the disease and were treated at the Department of Urology, Sapporo Medical University Hospital between 1973 and 2006. Their clinical features and outcomes were reviewed. Results: Of the 14 patients, there were nine men and five women. The median follow-up period was 13.0 months (range, 1,213). Two patients were classified as having stage II disease, seven as stage III and five as stage IV. The disease was completely removed in eight patients and incompletely in three. Two other patients received exploratory laparotomy only. The remaining one patient had no indication for surgery. The median survival periods were 2 months in patients with stage IV and 108 months in those with stages II and III (P = 0.136). Mitotane treatment in the adjuvant setting did not clearly affect the clinical courses of patients without metastasis. However, the treatment was effective for metastasis that was repeatedly developed as late recurrence in one patient. Three patients with metastasis at diagnosis received combination chemotherapy with etoposide, doxorubicin and cisplatin (EDP) with or without mitotane treatment, to which lung metastasis completely responded in one patient. Conclusions: Adrenocortical carcinoma is a rare disease but frequently recurs. The best chance of survival may be achieved by early detection and complete surgical removal. There may be patients who possibly benefit from mitotane treatment with or without EDP, although this remains to be conclusively determined. [source]


    Clinical features of testicular tumors in children

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2004
    SATORU KANTO
    Abstract Aim:, Testicular tumors are not common pediatric solid tumors, especially in Asian children. There have been few reviews of cases in Japan to date. We present the clinical features of 14 pediatric testicular tumor patients. Methods:, Clinical features of 14 testicular tumor patients, such as chief complaints, age at diagnosis, pathology, stages, treatments and prognosis, were examined from medical records. Two patients had their semen tested at adolescence. Results:, Of the 14 prepubescent patients, 12 (85.7%) patients were diagnosed before 3 years of age. Ten cases (71.4%) were diagnosed as yolk sac tumors, three (21.4%) as mature teratomas and one case as an epidermoid cyst. Nine cases (90.0%) among the 10 cases of yolk sac tumor were diagnosed as stage I and one case was stage IV. One stage I yolk sac tumor patient developed lung metastasis later. Eventually, two yolk sac tumor patients died, despite chemotherapy. While all the cases with a diagnosis before 2 years of age survived, 67% (2/3) of cases with a diagnosis after the age of 2 died of tumors. Semen analysis in two patients showed normospermia. Conclusion:, In the present study, the most common testicular tumors were yolk sac tumors and the patients diagnosed before 2 years of age showed favorable results. Age could be a relapse risk factor in yolk sac tumors. Guidelines for handling testicular tumors in children is not yet well established in Japan. An organized system seems necessary to gather and accumulate the results of the cases in Japan in order to develop better guidelines for treatment. [source]


    Eclogites from the Chinese continental scientific drilling borehole, their petrology and different P-T evolutions

    ISLAND ARC, Issue 4 2007
    Yong-Feng Zhu
    Abstract Four phengite-bearing eclogites, taken from different depths of the Chinese continental scientific drilling (CCSD) borehole in the Sulu ultrahigh pressure terrane, eastern China, were studied with the electron microprobe. The compositional zonations of garnet and omphacite are moderate, whereas phengite compositions generally vary significantly in a single sample from core to rim by decrease of the Si content. Various geothermobarometric methods were applied to constrain the P-T conditions of these eclogites on the basis of the compositional variability of the above minerals. The constrained P-T path for sample B218 is characterized by pressure decrease from ca 3.0 GPa (ca 600C) to 1.3 GPa (ca 550C). Eclogite B310 yielded P-T conditions of 3.0 GPa and 750C. The path for eclogite B1008 starts at about 650C and 3.6,3.9 GPa (stage I) followed by a pressure decrease to 2.8,3.0 GPa and a significant temperature rise (stages II and IIIa, 750,810C). Afterwards, this rock cooled down to 620,660C at still high pressures (2.5,2.7 GPa, stage IIIb). Retrograde conditions were about 670C and 1.3 GPa (stage IV). Eclogite B1039 yielded a P-T path starting at ca 600C and 3.3,3.9 GPa (stage I). A pressure decrease to about 3.0 GPa (stage II, 590,610C) and then a moderate isobaric temperature increase to ca 630C (stage III) followed. Stage IV is characterized by temperatures of 650C at pressures close to 1.3 GPa. During and after this stage (hydrous) fluids partially rich in potassium penetrated the rocks causing minor changes. Relatively high oxygen fugacities led to andradite and magnetite among the newly formed minerals. We think that the above findings can be best explained by mass flow in a subduction channel. Thus, we conclude that the assembly of UHP rocks of the CCSD site, eclogites, quartzofeldspathic rocks, and peridotites, cannot represent a crustal section that was already coherent at UHP conditions as it is the common belief currently. The coherency was attained after significant exhumation of these UHP rocks. [source]


    Tenascin expression in actinic keratosis

    JOURNAL OF CUTANEOUS PATHOLOGY, Issue 11 2006
    Maria Lentini
    Background:, Tenascin is an extracellular matrix protein frequently expressed around neoplastic and non-neoplastic lesions of the skin. Actinic keratoses (AKs) are intraepidermal neoplastic lesions of the sun-exposed skin. They are classified according to the extension of dysplasia in four stages; they also present different histological varieties. Methods:, We performed an immunohistochemical study using tenascin monoclonal antibody diluted 1 : 50 on 150 cases of AKs classified, respectively, in histotypes (38 hypertrophic, 18 atrophic, 21 bowenoid, 19 acantolytic, and 40 mixed) and in stages (27 stage I, 46 stage II, 42 stage III, and 35 stage IV; 14 in tumoral progression). Results:, Tenascin positivity was observed in all cases at the dermal level close to the epithelial lesion. The intensity of reaction increased from stage I to stage IV and, of course, also in tumoral progression. Its expression was not related to the histotypes. In very few cases, the atypical keratinocytes were positive. Conclusions:, Tenascin expression in AKs is related to the stages of dysplasia. In fact, the immunostaining intensity corresponds to the degree of the dysplasia rather than the thickness of the involved epidermis. Tenascin plays a role in neoplastic progression working as an anti-adhesive factor. [source]


    Retinoblastoma: Review of 30 years' experience with external beam radiotherapy

    JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2003
    Claire Phillips
    Summary A review of the experience at the Peter MacCallum Cancer Centre (Peter Mac), Melbourne, Australia in treating retinoblastoma with external beam radiotherapy was conducted. Outcomes of particular interest were tumour control, vision preservation and treatment late effects. The review was restricted to patients that had intact eyes treated at Peter Mac from 1965 until 1997 with at least 2 years of follow up. Histories were reviewed regarding patient and tumour characteristics and treatment details. Thirty-five patients were identified in whom 47 eyes were treated. Of the tumours, 47% were Reese,Ellsworth stage IV or V and the majority of others were at high risk for vision loss because of tumour location. The radiation treatment technique became increasingly sophisticated during the study period. Radiation dose and fraction size have similarly evolved but most patients received 30,50 Gy. Since 1989, a highly accurate contact lens immobilization technique has been used to deliver 40 Gy in 20 fractions. Thirteen eyes required additional local therapy. Of the treated eyes, 34 (72%) remain intact and 74% of these have useful vision. One patient died from retinoblastoma and three from second malignant neoplasms. With modern radiotherapy, late toxicities other than growth arrest and non-progressive cataract did not occur during the study period. Tumour control was high and a very acceptable rate of organ and vision preservation was achieved in a relatively high-risk population. Modern radiotherapy continues to develop in an attempt to improve treatment accuracy and minimize late radiation toxicity. [source]