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Potential Cure (potential + cure)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Primary Pulmonary Artery Sarcoma: Surgical Management and Differential Diagnosis with Pulmonary Embolism and Pulmonary Valve Stenosis

JOURNAL OF CARDIAC SURGERY, Issue 6 2009
Xiao-Peng Hu M.D.
We present six cases of primary pulmonary artery sarcomas and discuss clinical features, differential diagnosis, surgical treatment, and outcome of the tumors. Methods: Between January 1994 and July 2008, six patients were identified with the disease during operation. Three patients were initially diagnosed with pulmonary valve stenosis, and two patients had a presumptive diagnosis of chronic pulmonary embolism. Two patients had simple or partial tumor resection. Four patients had radical tumor resection and homograft reconstruction of the pulmonary arteries. Results: Histological examinations showed five malignant mesenchymomas and one fibrosarcoma. One patient died of refractory pulmonary hypertension during operation. Two patients died 4 months postoperatively because of brain metastases. Two patients were alive for 3 and 9 months, respectively after the operation with recurrent tumor. One patient is alive even 2 years after resection with no signs of recurrence or metastasis. Conclusions: Because of similar clinical features, pulmonary artery sarcomas are often confused with other pulmonary vascular obstructive diseases. Computed tomography scanning and gadolinium-enhanced magnetic resonance imaging could be useful methods for differential diagnosis. The prognosis is very poor. The survival time after resection varies from several months to several years depending on the presence of recurrence or metastasis. Early diagnosis and radical surgical resection presents the only opportunity for a potential cure. [source]

Single-dose lentiviral gene transfer for lifetime airway gene expression

THE JOURNAL OF GENE MEDICINE, Issue 10 2009
Alice G. Stocker
Abstract Background Cystic fibrosis (CF) is caused by a defect in cystic fibrosis transmembrane conductance regulator (CFTR) activity, often resulting in an incurable airway disease. Gene therapy into the conducting airway epithelium is a potential cure for CF; however, most gene vectors do not result in long-lived expression, and require re-dosing. Perversely, intrinsic host immune responses can then block renewed gene transfer. Methods To investigate whether persistent gene expression could be achieved after a single dosing event, thus avoiding the issue of blocking host responses, we used a gene transfer protocol that combined an airway pretreatment using lysophosphatidylcholine with a human immunodeficiency virus type-1 (vesicular stomatitis virus G pseudotype) derived lentiviral vector to test whether an integrating vector could produce gene expression able to last for a substantial part of the lifetime of the laboratory mouse. Results We found that a single dose of LV-LacZ produced immediate as well as lifetime mouse airway expression, confirming our hypothesis that use of an integrating vector extends transgene expression. Importantly, LV-CFTR dosing achieved at least 12 months of CFTR expression, representing partial functional correction of the CFTR defect in CF-null mice. Conclusions These findings validate the potential of this methodology for developing a gene transfer treatment for CF airway disease. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Quality of life during potentially curative treatment for locally advanced oesophageal cancer,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2007
K. N. L. Avery
Background: Combination chemoradiotherapy with or without surgery are internationally applied alternative strategies for potential cure of oesophageal cancer. This study compared health-related quality of life (HRQL) between patients selected for chemoradiation and those who had combination treatment including oesophagectomy. Methods: Patients with stage II or III oesophageal cancer completed HRQL assessments at baseline, at the worst expected HRQL time point and at expected recovery. HRQL was compared between groups using linear regression, adjusting for age, sex, performance status, tumour stage and type, and baseline HRQL. Results: Some 132 patients began treatment, of whom 51 had chemoradiotherapy and 81 combination treatment including surgery. Patients selected for chemoradiotherapy were older, more likely to have squamous cell cancer and reported poorer HRQL than those selected for surgery. At the worst expected time point after treatment, both groups reported multiple symptoms and poor function, but surgery was associated with a greater reduction in HRQL from baseline than chemoradiotherapy. Recovery of HRQL was achieved within 6 months after chemoradiotherapy, but complete recovery had not occurred 6 months after surgery and there was persistent significant deterioration in some aspects. Conclusion: The negative treatment-related impact of chemoradiation on short-term HRQL is less than that experienced with combination treatment including surgery. Patients preferring early recovery should consider definitive chemoradiation. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Six of the Best, Colorectal 20

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue S1 2002
D.L. Francis
Aims: Surgical resection is the only potential cure for patients with colorectal liver metastases (CLM), but patient selection relies on accurate preoperative staging. The aim of this study was to assess the accuracy of routinely using whole-body FDG-PET (WBPET) for preoperative staging of patients being considered for resection of CLM. Methods: A prospective study of patients referred for possible hepatic resection was undertaken. Patients were initially staged by spiral CT and subsequently underwent WBPET. These modalities were considered independently before findings were compared and a decision regarding patient management was made. Accuracy of each modality was compared with histology, clinical/radiological follow-up or operative findings if appropriate. Results: Twenty-nine patients were recruited. Ten solitary CLM were correctly identified by both WBPET and CT. Nineteen patients had multiple CLM or extrahepatic disease, of these CT correctly staged seven patients (36 per cent), understaged 10 patients (53 per cent) and overstaged two (11 per cent). WBPET correctly staged 18 patients (95 per cent) and overstaged just one (5 per cent). WBPET was more sensitive and specific (100 and 92 per cent, respectively) for detecting multiple CLM and extrahepatic disease compared to CT (41 and 83 per cent). As a result of routine WBPET, patient management was altered in 10 patients (34 per cent), of whom four (14 per cent) avoided inappropriate surgery. Conclusions: WBPET is both more sensitive and specific in the preoperative staging of CLM, and we recommend its inclusion in the management algorithm of all patients being considered for hepatic resection. Altered patient management such as avoiding inappropriate laparotomy may also ultimately lead to financial savings. [source]