1.
In Vivo. 2019 Sep-Oct;33(5):1707-1712. doi: 10.21873/invivo.11660.
Outcomes of Triple-Combination Therapy for Chronic Tinnitus.
Juan YH1,2, Hsu CT3, Hwang JH4,5,6.
Author information
1
Department of Traditional Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, R.O.C.
2
Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan, R.O.C.
3
Department of Clinical Psychology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, R.O.C.
4
Department of Otolaryngology-Head and Neck Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, R.O.C. g120796@tzuchi.com.tw.
5
School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C.
6
Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, R.O.C.
Abstract
BACKGROUND/AIM:
Patients with tinnitus suffer not only from auditory dysfunction but also physical, mental, and social difficulties. Our aim was to investigate the outcomes of our triple-combination therapy for chronic tinnitus, which includes narrow-band noise masking, auricular acupuncture and cognitive behavioral therapy.

PATIENTS AND METHODS:
The tinnitus handicap inventory (THI) scores of 78 adults with chronic tinnitus who received triple-combination therapy for 12 weeks were analyzed retrospectively.

RESULTS:
There were 39 females and 39 males in this study. The mean age was 60.5 years [standard deviation (SD)=13.0, range=27-88 years] for all subjects. Mean pure tone average=39.5 decibel hearing level (SD=23.09). Pre-treatment mean THI score was 41.4 (SD=21.13), functional (F) subscore was 17.9 (SD=10.69), emotional (E) subscore was 10.6 (SD=6.87), and catastrophic (C) subscore was 12.9 (SD=4.85). Post-treatment THI total score was significantly lower compared to pre-treatment THI total score. Also, post-treatment subscores were significantly lower compared to pre-treatment subscores in F and C subsocres, but not in E subscore. In addition, multivariate logistic regression analysis showed that coffee and tea consumption was significantly positively associated with a reduction of THI total score.

CONCLUSION:
Triple-combination therapy could be helpful for chronic tinnitus patients. It seemed that coffee and tea consumption may elicit increased improvement in conjunction with combined therapy for chronic tinnitus.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Chronic tinnitus; acupuncture; coffee; cognitive behavioral therapy; combined therapy; narrow-band noise; tea

PMID: 31471428 DOI: 10.21873/invivo.11660
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2.
In Vivo. 2019 Sep-Oct;33(5):1703-1706. doi: 10.21873/invivo.11659.
Correlation of Cerebroplacental Ratio (CPR) With Adverse Perinatal Outcome in Singleton Pregnancies.
Grüttner B#1, Ratiu J#1, Ratiu D1, Gottschalk I1, Morgenstern B1, Abel JS1, Eichler C1, Pahmeyer C1, Ludwig S1, Mallmann P1, Thangarajah F2.
Author information
1
Department of Obstetrics and Gynecology, University Hospital Cologne and Medical Faculty, Cologne, Germany.
2
Department of Obstetrics and Gynecology, University Hospital Cologne and Medical Faculty, Cologne, Germany Fabinshy.Thangarajah@uk-koeln.de.
#
Contributed equally
Abstract
BACKGROUND/AIM:
For many years clinical research has been concerned with doppler sonography as a non-invasive tool for intrauterine fetal status assessment. A new focus is now placed on the measurement of cerebroplacental index (CPR) as a predictor of fetal outcome. Our aim was to investigate the relationship between the cerebroplacental ratio (CPR), the delivery mode and the fetal outcome in singleton pregnancies.

PATIENTS AND METHODS:
A retrospective cohort study of pregnancies in which doppler sonography of middle cerebral artery (MCA) and umbilical artery (UA) was conducted up to 9 weeks before delivery took place. Patients with pathological (CPR≤1.0) and normal CPR (>1.0) were compared by umbilical cord pH, APGAR scores, birth weight, delivery week and delivery mode.

RESULTS:
A total of 2,270 singleton pregnancies were included. The APGAR score for 1, 5 and 10 minutes and the gestational age at delivery were significantly lower in the group of patients with pathological CPR (p<0.001). Overall, 50% of the cohort had a cesarean section, the difference between the groups was statistically significant (p<0.001), with a higher amount of cesareans in the group of patients with pathological CPR. The multiple regression analysis showed a significantly improved pH of delivery when cesarean section (p<0.001), female sex of fetus (p=0.013) and higher CPR (p=0.035) were present.

CONCLUSION:
The measurement of CPR is an important, non-invasive predictive parameter and leads to the identification of a risk collective even in the non-selected patient population and thus probably to a reduction of perinatal morbidity.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
CPR; doppler sonography; fetal outcome

PMID: 31471427 DOI: 10.21873/invivo.11659
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3.
In Vivo. 2019 Sep-Oct;33(5):1697-1702. doi: 10.21873/invivo.11658.
Extrahepatic Portal Venous Obstruction With Hepatic Enzyme Elevation Resembling Hepatitis in Patients With Cancer.
Liao TY1, Liaw CC2, Hsu HC3, Hsieh CH1, Chang JW1, Juan YH4.
Author information
1
Division of Hemato-Oncology, Department of Internal Medicine, Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, R.O.C.
2
Division of Hemato-Oncology, Department of Internal Medicine, Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, R.O.C. e102309@adm.cgmh.org.tw.
3
Division of Chinese Acupuncture and Traumatology, Department of Traditional Chinese Medicine, Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, R.O.C.
4
Department of Medical Imaging and Intervention, Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, R.O.C.
Abstract
BACKGROUND/AIM:
Chemotherapy is often halted due to abnormal liver function resembling hepatitis. But the cause can be extrahepatic portal venous obstruction (EHPVO) with hepatic enzyme elevation rather than being an adverse effect of chemotherapy. We investigated EHPVO with hepatic enzyme elevation in patients with cancer.

PATIENTS AND METHODS:
Data of these hospitalized patients with solid tumors between January 2013 and September 2017 were collected. The criteria for study inclusion were: (i) Extrahepatic malignancy; (ii) computed tomographic scans showing a tumor with external compression of the extrahepatic portal vein; and (iii) serum aminotransferase (AST) or alanine transaminase (ALT) level three times above the normal value.

RESULTS:
Thirteen out of 377 (3%) patients developed EHPVO with hepatic enzyme elevation, as demonstrated from computed tomographic scan. Four cases (31%) also had vascular thrombosis (three portal vein and one inferior vena cava). Serum AST increased from 34±11 to 169±94 U/l. ALT increased from 9±38 to 177±104 U/l. There was no relationship of EHPVO with viral markers and cirrhosis. Six cases received chemotherapy with liver function improvement.

CONCLUSION:
EHPVO occurred in patients with metastatic cancer, leading to hepatic enzyme elevation resembling hepatitis without hepatitis risk factors and cirrhosis. Before withholding chemotherapy due to hepatic enzyme elevation, the possibility of EHPVO should firstly be excluded.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Extrahepatic portal vein obstruction; computed tomography; hepatic enzyme elevation; thromboembolic complications

PMID: 31471426 DOI: 10.21873/invivo.11658
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4.
In Vivo. 2019 Sep-Oct;33(5):1691-1696. doi: 10.21873/invivo.11657.
Increasing Age Hinders the Decline in B-Type Natriuretic Peptide Following Parathyroidectomy in Dialysis Patients.
Chu TP1, Yang PS1, Lee JJ1, Wu CJ2,3, Cheng SP4,3.
Author information
1
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan, R.O.C.
2
Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan, R.O.C.
3
Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
4
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan, R.O.C. surg.mmh@gmail.com.
Abstract
BACKGROUND/AIM:
Parathyroidectomy has beneficial effects on all-cause and cardiovascular mortality in patients with uncontrolled hyperparathyroidism. B-Type natriuretic peptide (BNP) correlates with the severity of heart failure. We aimed to investigate whether parathyroidectomy modulates the BNP levels in dialysis patients.

PATIENTS AND METHODS:
Patients who underwent surgical intervention for hyperparathyroidism were included. The serum BNP levels were determined before parathyroidectomy and during follow-up.

RESULTS:
The preoperative and postoperative BNP levels were 499±561 and 453±442 pg/ml, respectively (p=0.82). The baseline BNP level was positively correlated with weakness and headache, but not biochemical parameters. In multivariate analysis, age (odds ratio=0.837) and preoperative symptom score (odds ratio=0.935) were independent predictors for the postoperative decline in BNP levels Conclusion: The serum BNP levels may increase or decrease after parathyroidectomy. Younger age and lower symptom burden are associated with decline in BNP levels.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
B-Type natriuretic peptide; age; hyperparathyroidism; parathyroidectomy

PMID: 31471425 DOI: 10.21873/invivo.11657
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5.
In Vivo. 2019 Sep-Oct;33(5):1685-1690. doi: 10.21873/invivo.11656.
C-Reactive Protein Gene Variants and Their Serum Levels in Early Adult-onset Type 2 Diabetes Mellitus.
Huang YC1,2, Chen CC1,3, Wang TY3, Nguyen HTT4, Chen YH5, Wu CM2, Chang YW2, Liao WL6,7, Tsai FJ8,9.
Author information
1
School of Chinese Medicine, China Medical University, Taichung, Taiwan, R.O.C.
2
Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C.
3
Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.
4
International Master's Program of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C.
5
Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, R.O.C.
6
Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, R.O.C. d0704@www.cmuh.org.tw wl0129@mail.cmu.edu.tw.
7
Center for Personalized Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.
8
Department of Medical Research, Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan, R.O.C. d0704@www.cmuh.org.tw wl0129@mail.cmu.edu.tw.
9
Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan, R.O.C.
Abstract
BACKGROUND/AIM:
C-Reactive protein (CRP) is a common marker of inflammation. Elevated CRP levels have been associated with increased risk of development of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association of CRP gene polymorphisms with early-onset T2DM and the effect of genetic variants on CRP level.

MATERIALS AND METHODS:
In total, 948 individuals with early-onset (n=271) or late-onset (n=677) T2DM were enrolled in the study. Five single-nucleotide polymorphisms (SNPs) in the CRP gene, namely rs3093077, rs2808630, rs1800947, rs11265263, and rs11265265, were selected for genotyping, and CRP levels were measured.

RESULTS:
Genotypic, allelic, and haplotype frequencies of these five SNPs were not significantly different between patients with early- and those with late-onset. T2DM Higher serum CRP levels were independently associated with the C-allele of rs3093077 and T-allele of rs11265265 (p<0.001). Furthermore, the C-allele of rs3093077 was associated with higher CRP level in both early- (p=0.016) and late-onset (p<0.001) T2DM.

CONCLUSION:
CRP gene variants may contribute to the risk of early-onset T2DM by affecting the serum CRP level.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
C-Reactive protein; Taiwan; early-onset; polymorphism; type 2 diabetes

PMID: 31471424 DOI: 10.21873/invivo.11656
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6.
In Vivo. 2019 Sep-Oct;33(5):1677-1684. doi: 10.21873/invivo.11655.
Radiation Therapy for Uterine Cervical Cancer With Lung Metastases Including Oligometastases.
Mukai Y1, Koike I2, Matsunaga T3, Yokota NR3, Takano S2, Sugiura M2, Sato M2, Miyagi E3, Hata M2.
Author information
1
Department of Radiation Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan y_mukai@yokohama-cu.ac.jp.
2
Department of Radiation Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
3
Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Abstract
BACKGROUND/AIM:
To investigate the role and outcomes of radiation therapy (RT) for stage IVB uterine cervical cancer (UCC) patients with lung (oligo) metastases due to the lack of recent reports on the subject.

PATIENTS AND METHODS:
The cohort for this retrospective study comprised 23 consecutive patients with UCC (squamous cell carcinoma, n=13) and lung metastases who had received pelvic RT. Ten had lung metastases only, including 7 with oligometastases (≤4 lung metastases); the remaining 13 also had other distant metastases.

RESULTS:
Nine (39.1%) of the 22 patients (95.7%) completed RT without interruption. The 1-year primary progression-free rate was 95.2%. The 1-year overall survival rate was 47.2 % (estimated median survival: 9 months). Significant prognostic factors for survival included: i) ≤4 lung metastases (p=0.035), ii) unilateral lung metastases (p=0.039), iii) primary tumor diameter <100 mm (p<0.001), and iv) ECOG performance status <1 (p=0.015).

CONCLUSION:
RT is safe and effective for stage IVB UCC patients with lung metastases.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Uterine cervical cancer; gynecological malignancies; lung metastases; oligometastases; radiation therapy

PMID: 31471423 DOI: 10.21873/invivo.11655
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7.
In Vivo. 2019 Sep-Oct;33(5):1671-1675. doi: 10.21873/invivo.11654.
Integrated Treatment With Stapled Haemorrhoidopexy and Proctonorm® of Haemorrhoidal Disease.
Reboa G1, Gipponi M2, Fregatti P3,4, Depaoli F5.
Author information
1
Department of Surgery, Coloproctology Unit - Casa di Cura San Camillo, Forte dei Marmi (Lucca), Italy.
2
Breast Surgery Clinic, Osp. Policlinico San Martino, Genoa, Italy marco.gipponi@hsanmartino.it.
3
Breast Surgery Clinic, Osp. Policlinico San Martino, Genoa, Italy.
4
School of Medicine, University of Genoa, Genoa, Italy.
5
Breast Surgery Unit, Azienda Sanitaria Locale 3, Genoa, Italy.
Abstract
BACKGROUND/AIM:
This retrospective study was performed in patients undergoing Stapled Haemorrhoidopexy (SH) who were post-operatively treated with Proctonorm® with the aim of assessing its effect on early and late haemorrhoidal-related symptoms.

PATIENTS AND METHODS:
Forty-six males and 54 females received Proctonorm® (one tablet twice daily for 14 days) and Ketoprofene R (200 mg, one tablet twice daily, as requested).

RESULTS:
"Early Complication Score" (0-12) two days after surgery was 2.02±1.03; pain VAS (Visual Analogue Scale) (0-10) was 1.21±0.89, and the number of anti-inflammatory tablets was 4.24±1.06. At 40-day post-operative assessment, seven patients had post-operative complications with "Late Complication Score" (0-20) of 0.34±0.68. At six-month follow-up, a high index of patient satisfaction (VAS=9.39±0.24) was self-reported with 75% reduction in CSS (Constipation Scoring System) (1.95±2.58) compared to preoperative scores; "Late Complication Score" was 0.

CONCLUSION:
The specific target activity of Proctonorm® at the microcircular level may be effective in patients undergoing SH in order to reduce the inflammatory response of residual haemorrhoids while waiting for stable resolution of symptoms within one or two weeks.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Haemorrhoidal prolapse; stapled haemorrhoidopexy

PMID: 31471422 DOI: 10.21873/invivo.11654
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8.
In Vivo. 2019 Sep-Oct;33(5):1667-1669. doi: 10.21873/invivo.11653.
Aggressive Merkel Cell Carcinoma After Janus Kinase Inhibitor Ruxolitinib for Polycythemia Vera.
Rastrelli M#1, Ferrazzi B#2, Tropea S1, Costa A1, Finotto S3, Marino D3, Campana L1, Del Fiore P1, Rossi CR1, Alaibac M4.
Author information
1
Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
2
Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.
3
Medical Oncology 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
4
Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy mauro.alaibac@unipd.it.
#
Contributed equally
Abstract
Merkel cell carcinoma (MCC) is a rare neuroendocrine carcinoma of the skin. It is highly aggressive and represents the second most common cause of skin cancer-related death. Ruxolitinib is an orally administered selective inhibitor of Janus associated kinases1 and 2, which is used in the management of patients with symptomatic myelofibrosis and polycythemia vera who are non-responders or intolerant to hydroxyurea. Herein, we report the case of a 47-year-old woman with a 14-year history of chronic myeloproliferative syndrome initially treated with hydroxyurea for 4 years. She was then enrolled in the Response trial and treated for 7 years with ruxolitinib subsequently developing an MCC. This report shows the possibility of development of MCC in patients treated with ruxolitinib. Periodic skin examination is indicated in patients who undergo ruxolitinib therapy, especially if they have a history of skin cancer; dermatologists and oncohematologists should be aware of this possibility in order to introduce appropriate preventive strategies.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Merkel cell carcinoma; immunomodulatory drugs; myelofibrosis; polycythemia vera; response trial; ruxolitinib

PMID: 31471421 DOI: 10.21873/invivo.11653
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9.
In Vivo. 2019 Sep-Oct;33(5):1659-1665. doi: 10.21873/invivo.11652.
Local Radiotherapy or Chemotherapy for Oligo-recurrent Cervical Cancer in Patients With Prior Pelvic Irradiation.
Kobayashi K1,2,3, Murakami N4, Takahashi K4, Inaba K4, Hamamoto R5,2,3, Itami J4.
Author information
1
Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan kazumkob@ncc.go.jp.
2
Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan.
3
Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
4
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
5
Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan.
Abstract
BACKGROUND/AIM:
The aim of this study was to compare the clinical outcomes of patients treated by local radiotherapy or chemotherapy for oligo-recurrent cervical cancer with prior pelvic irradiation.

PATIENTS AND METHODS:
Forty-one patients who had received pelvic irradiation for cervical cancer developed oligo-recurrent (≤5 lesions) relapses and underwent local radiotherapy (n=22) or systemic chemotherapy (n=19). Overall survival (OS), local recurrence-free survival (LRFS) and distant-free survival (DFS) were estimated, and risk factors were identified.

RESULTS:
The median follow-up was 24.1 months. The group of local radiotherapy showed a significantly superior LRFS, but inferior DFS. There was no significant difference in OS. Multivariate analysis revealed that FIGO stage at initial diagnosis was associated with OS. For patients with early FIGO stages (IB-IIB), local radiotherapy provided a tendency toward longer OS than chemotherapy.

CONCLUSION:
Out-field oligo-recurrence in patients with initial early FIGO stages may be an indication of salvage radiotherapy.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Cervical cancer; oligo-recurrence; radiotherapy; salvage treatment

PMID: 31471420 DOI: 10.21873/invivo.11652
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10.
In Vivo. 2019 Sep-Oct;33(5):1653-1658. doi: 10.21873/invivo.11651.
Plasma Histone H4 and H4K20 Trimethylation Levels Differ Between Colon Cancer and Precancerous Polyps.
Özgür E1, Keskin M2, Yörüker EE1, Holdenrieder S3, Gezer U4.
Author information
1
Department of Basic Oncology at Oncology Institute, Istanbul University, Istanbul, Turkey.
2
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
3
Department of Laboratory Medicine, German Heart Center at Munich Technical University, Munich, Germany.
4
Department of Basic Oncology at Oncology Institute, Istanbul University, Istanbul, Turkey ugurd@istanbul.edu.tr.
Abstract
BACKGROUND/AIM:
No blood-based biomarkers are available to differentiate between colonic tumors and precancerous polyps. Previously we demonstrated levels of trimethylated H4K20 (H4K20me3) to be lower in blood plasma from patients with colon cancer than those from cancer-free individuals. Herein, we added individuals with precancerous polyps for the first time in order to analyze and investigate the usefulness of plasma H4K20me3 and histone H4 to discriminate colon tumors from precancerous polyps.

MATERIALS AND METHODS:
The study included a cohort of 185 individuals undergoing colonoscopy. H4K20me3 and histone H4, measured by an enzyme-linked immunosorbent assay-like assay in plasma, were analyzed according to colonoscopy findings.

RESULTS:
Levels of H4K20me3 were lower in patients with colon cancer than in individuals with normal colonoscopy and those with precancerous polyps (p=0.02 and p=0.01, respectively). In contrast, highest quantities of histone H4 were measured in those with colon cancer compared to other groups (all p<0.01).

CONCLUSION:
Beside H4K20me3, plasma histone H4 is a useful marker to discriminate colonic tumors from precancerous polyps and other conditions.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Colon cancer; blood plasma; histone methylation; histones; precancerous polyps

PMID: 31471419 DOI: 10.21873/invivo.11651
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11.
In Vivo. 2019 Sep-Oct;33(5):1645-1651. doi: 10.21873/invivo.11650.
Phase Angle as an Objective and Predictive Factor of Radiotherapy-induced Changes in Body Composition of Male Patients With Head and Neck Cancer.
Małecka-Massalska T1, Powrózek T1, Prendecka M2, Mlak R2, Sobieszek G3, Brzozowski W4, Brzozowska A5.
Author information
1
Department of Human Physiology, Medical University of Lublin, Lublin, Poland tomaszpowrozek@gmail.com t.malecka@gmail.com.
2
Department of Human Physiology, Medical University of Lublin, Lublin, Poland.
3
Department of Cardiology, 1st Military Clinical Hospital with the Outpatient Clinic, Lublin, Poland.
4
Department of Cardiology, Medical University Lublin, Lublin, Poland.
5
St. John of Dukla Lublin Region Cancer Center, Lublin, Poland.
Abstract
BACKGROUND:
Unfavorable changes in body composition are frequent among patients with head and neck cancer (HNC). Unfortunately, in daily clinical practice, there is a lack of reliable diagnostic tools for predicting changes in body composition in individuals following radiotherapy (RT). Among non-invasive tools, bioelectrical impedance analysis (BIA) seems to be most promising. One BIA parameter, the phase angle (PA), reflects condition of various body cells and their mass in detail.

MATERIALS AND METHODS:
Using BIA, the body composition was measured prior to and after RT in 52 male patients with HNC. PA derived from BIA prior to RT was tested as a predictor of body composition changes developing during RT.

RESULTS:
Patients with low PA had a greater than 9.3-fold higher chance of body mass index (BMI) reduction below 18.5 kg/m2 and over 5.9-fold and 4.2-fold higher chance of lean mass and fat mass reduction after therapy end compared with patients with a high PA value. PA values demonstrated significant diagnostic accuracy for detection of fat-free mass, lean mass and BMI reduction in the study group [area under the curve (AUC)=0.781, 0.774 and 0.786, respectively].

CONCLUSION:
PA prior to RT is a useful marker for selection of individuals with HNC who are at a high risk of unfavorable changes in body composition.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Head and neck cancer; bioimpedance; body composition; phase angle; radiotherapy

PMID: 31471418 DOI: 10.21873/invivo.11650
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12.
In Vivo. 2019 Sep-Oct;33(5):1641-1644. doi: 10.21873/invivo.11649.
An Open-label, Single-arm Study of CRYO2 for Debulking at the Site of Central Airway Obstruction or Stenosis.
Saka H1, Oki M2, Kada A3, Saito AM3.
Author information
1
Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Japan saka@med.nagoya-u.ac.jp.
2
Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
3
Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Abstract
BACKGROUND:
An open-label, single-arm study was conducted to assess the safety of a cryosurgery unit named CRYO2 for debulking at the site of obstruction or stenosis.

PATIENTS AND METHODS:
In order to treat central airway tumor-related stenosis, debulking at the stenotic site of the airway was performed using CRYO2 under general or local anesthesia. The primary endpoint was the incidence of moderate to massive hemorrhage.

RESULTS:
Incidence of moderate to massive hemorrhage during surgery was 3.8% (1/26) (95% confidence interval(CI)=0.1-19.6%). Technical success was 96.2% (25/26), with a 95% confidence interval of 80.4-99.9%.

CONCLUSION:
CRYO2 for debulking at the site of obstruction or stenosis can be performed safely.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Obstruction; cryosurgery unit; safety; stenosis

PMID: 31471417 DOI: 10.21873/invivo.11649
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13.
In Vivo. 2019 Sep-Oct;33(5):1635-1640. doi: 10.21873/invivo.11648.
Strain Ultrasound Elastography in the Achilles Tendon of Ankylosing Spondylitis Patients Treated With Anti-TNF-α: A Preliminary Study.
Zardi EM1, Pipita ME2, Giorgi C3, Afeltra A4, Maffulli N5,6,7, Franceschi F8.
Author information
1
Internistic Ultrasound Service "Campus Bio-Medico" University, Rome, Italy e.zardi@unicampus.it.
2
Internistic Ultrasound Service "Campus Bio-Medico" University, Rome, Italy.
3
Radiology Department, S. Maria della Misericordia Hospital, Urbino, Italy.
4
Immunorheumatology "Campus Bio-Medico" University, Rome, Italy.
5
Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy.
6
Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, U.K.
7
School of Medicine, Institute of Science and Technology in Medicine, Guy Hilton, Keele University, Newcastle, U.K.
8
Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Rome, Italy.
Abstract
BACKGROUND/AIM:
To compare patients affected by ankylosing spondylitis (AS) treated with anti-TNF-α for two years with controls in terms of Achilles tendon stiffness, ultrasound structure and thickness.

PATIENTS AND METHODS:
B-mode ultrasound evaluation and strain ultrasound elastography were performed in longitudinal and transverse planes on 22 Achilles tendons of 11 AS patients and 26 of 13 controls.

RESULTS:
There were no significant differences in thickness and stiffness of the Achilles tendon between AS patients and controls, except for an increased thickness in the middle third of the tendon in the AS patients (p=0.04). The Achilles tendon stiffness ratio of AS patients was 1.02±0.36 vs. 1.14±0.38 in the controls (p=0.2).

CONCLUSION:
AS patients had an Achilles tendon thickness greater than controls at the middle third, but no difference in the stiffness was found among them. Strain ultrasound elastography may be useful to exclude early changes in mechanical properties of tendons.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Achilles tendon; ankylosing spondylitis; anti-TNF-α therapy; elastography; ultrasound

PMID: 31471416 DOI: 10.21873/invivo.11648
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14.
In Vivo. 2019 Sep-Oct;33(5):1625-1633. doi: 10.21873/invivo.11647.
Integrated IT Platform for Coordination of Diagnosis, Treatment, and Aftercare of Prosthetic Joint Infections.
Suren C1, Feihl S2, Querbach C3, Rämer P2, Pohlig F4, Thurner J4, Bernard R3, Busch D2, VON Eisenhart-Rothe R#4, Mühlhofer HML#4.
Author information
1
Department for Orthopedics and Sports Orthopedics, Technical University Munich, Munich, Germany christian.suren@mri.tum.de.
2
Institute for Medical Microbiology, Immunology and Hygiene, Technical University Munich, Munich, Germany.
3
Apotheke, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
4
Department for Orthopedics and Sports Orthopedics, Technical University Munich, Munich, Germany.
#
Contributed equally
Abstract
BACKGROUND/AIM:
Prosthetic joint infections (PJI) are difficult to diagnose and treat. For a correct diagnosis, an array of information has to be processed and weighted. Successful treatment depends on the diagnosis, timing, and surgical strategy paired with treatment of the infectious agent. The complexity and interdisciplinarity needed cause difficulties concerning decision-making, the communication between disciplines, and the execution of a treatment strategy. The aim of this study was to develop a software platform to enhance the collection of information for the diagnosis of PJI, the interdisciplinary decision-making process, the communication between team members, and continuous evaluation of treatment.

PATIENTS AND METHODS:
In regular planning sessions with an information technology (IT) specialist, a concept for an IT solution was chosen and the tool was designed in an interdisciplinary approach.

RESULTS:
The tool has been used as a trial version since June 2017. It consists of 14 user interfaces with 431 items. A total of 117 patients with 118 infections have been entered and the strategy decided upon and communicated using 298 infection board documents outlining the treatment. The tool is now being used to organize the infections board agenda, schedule patient case discussions, document the relevant data and treatment plan, as well as communicate with the other teams involved in the treatment.

CONCLUSION:
Using the developed tool enables the infections team to work collaboratively and under division of labor on each case, rendering the work flow more efficient for each team member.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Infection board; PJI; antibiotic stewardship; interdisciplinary; prosthetic joint infections

PMID: 31471415 DOI: 10.21873/invivo.11647
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15.
In Vivo. 2019 Sep-Oct;33(5):1621-1624. doi: 10.21873/invivo.11646.
Hypofractionated Accelerated Chemo-radiotherapy (Chemo-HypoAR) With Cisplatin and Liposomal Doxorubicin for the Treatment of Patients With Uterine Sarcomas.
Domoxoudis S1, Koukourakis IM1, Giakzidis AG1, Koukourakis MI2.
Author information
1
Department of Radiotherapy - Oncology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
2
Department of Radiotherapy - Oncology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece targ@her.forthnet.gr.
Abstract
BACKGROUND/AIM:
Uterine sarcoma is an aggressive tumor associated with poor survival, compared to endometrioid carcinoma. Postoperative local radiotherapy and chemotherapy are controversial.

PATIENTS AND METHODS:
We report a retrospective analysis of 14 patients with uterine homologous type carcinosarcoma (9 patients) or leiomyosarcoma (5 patients), treated with postoperative 3D-conformal accelerated hypofractionated radiotherapy (2.7 Gy/fraction for 14 fractions followed by one fraction of 6-8 Gy dose to the vagina). Chemotherapy with cisplatin (50 mg/m2) and liposomal doxorubicin (20 mg/m2), was also administered bi-weekly for two cycles before and for three cycles during radiotherapy.

RESULTS:
Chemotherapy induced only grade 1 neutropenia or anemia in 4/14 (28.5%) and 5/14 (35.7%) of patients, respectively. Two patients (2/14, 14.2%) interrupted their radiotherapy for one and two weeks, respectively, due to grade II persistent diarrhea. Within a median of 58 months (range=8-137 months) of follow-up, none of the patients presented with loco-regional relapse. Two patients developed distant metastasis.

CONCLUSION:
Concurrent hypofractionated and accelerated chemo-radiotherapy (chemo-HypoAR) is feasible and provides excellent survival figures.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Uterine sarcoma; acceleration; cisplatin; hypofractionation; liposomal doxorubicin; radiotherapy

PMID: 31471414 DOI: 10.21873/invivo.11646
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16.
In Vivo. 2019 Sep-Oct;33(5):1615-1620. doi: 10.21873/invivo.11645.
Circulating Tumor Cell Counts in Patients With Localized Prostate Cancer Including Those Under Active Surveillance.
Choi SY1, Lim B2, Kyung YS2, Kim Y2, Kim BM2, Jeon BH3, Park JC3, Sohn YW3, Lee JH3, Uh JH3, Jang S4, Kim CS5.
Author information
1
Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
2
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
3
Cytogen, Seoul, Republic of Korea.
4
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
5
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea cskim@amc.seoul.kr.
Abstract
AIM:
To evaluate the clinical efficacy of a circulating tumor cell (CTC) test by comparison between healthy volunteers and patients with localized prostate cancer including those under active surveillance.

MATERIALS AND METHODS:
CTC counts in peripheral blood were compared between patients with prostate cancer (n=45) and healthy volunteers (n=17). CTCs were identified based on the expression of epithelial cell adhesion molecule (EpCAM) and counted using a SMART BIOPSY™ SYSTEM.

RESULTS:
The number of EpCAM+ cells was significantly higher in patients with cancer than in healthy volunteers. Among the low-risk patients (n=9), two had up-staging and six had up-grading. Among those up-staged, there was one case which was EpCAM+ Among those cases up-graded, three were EpCAM+ In those with stage T2 tumors, the presence of Gleason pattern 5 was positively correlated with EpCAM positivity (rho=0.59, p<0.001).

CONCLUSION:
CTC counts in localized prostate cancer were associated with Gleason pattern 5. Active treatment should be considered for patients with low-risk disease during active surveillance who are found to have EpCAM+ CTCs because of a risk of up-staging and up-grading.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
EpCAM; PSMA; Prostate biopsy; biomarker; prostatectomy

PMID: 31471413 DOI: 10.21873/invivo.11645
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17.
In Vivo. 2019 Sep-Oct;33(5):1609-1614. doi: 10.21873/invivo.11644.
Retrospective Analysis of Trabectedin Therapy for Soft Tissue Sarcoma.
Kawaguchi K1, Nakano K1, Urasaki T1, Fukuda N1, Taira S1, Ono M1, Tomomatsu J1, Nishizawa M1, Ae K2, Matsumoto S2, Takahashi S3.
Author information
1
Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
2
Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
3
Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan s.takahashi-chemotherapy@jfcr.or.jp.
Abstract
BACKGROUND/AIM:
Trabectedin is a synthetic antineoplastic agent approved for advanced soft tissue sarcoma (STS) in Japan. The aim of this study was to evaluate the efficacy and safety of the Japan-approved dose of trabectedin for advanced STS.

PATIENTS AND METHODS:
We retrospectively reviewed 38 patients with advanced STS who received salvage chemotherapy with trabectedin.

RESULTS:
The overall response and disease control rates were 16% (5 patients) and 67% (20 patients), respectively. The median progression-free and overall survival were 7.3 and 17.8 months, respectively. There were no significant differences between patients with liposarcoma or leiomyosarcoma and those without, or between patients with TRS and those without. The most common grade 3-4 AEs were elevated transaminases and neutropenia.

CONCLUSION:
Trabectedin 1.2 mg/m2, as the approved dose in Japan, showed similar efficacy to the dose of 1.5 mg/m2 used in Western countries. Trabectedin could be an option for advanced STS in Japan, regardless of histological subtype.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
L-sarcoma; Soft tissue sarcoma; overall survival; progression-free survival; translocation-related sarcoma

PMID: 31471412 DOI: 10.21873/invivo.11644
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18.
In Vivo. 2019 Sep-Oct;33(5):1605-1608. doi: 10.21873/invivo.11643.
Surgical Resection of Colorectal Cancer With Distant Metastases to Other than Liver or Lung.
Naito A1,2, Kagawa Y3, Kawai K3, Takeno A3, Takeda Y3, Ohtsuka M2, Suzuki Y2, Imasato M2, Fujie Y2, Nakaba H2, Akamatsu H2, Murata K3.
Author information
1
Department of Gastroenterological Surgery, Kansai Rosai Hospital, Amagasaki, Japan naito.atsu@gmail.com.
2
Department of Gastroenterological Surgery, Osaka Police Hospital, Osaka, Japan.
3
Department of Gastroenterological Surgery, Kansai Rosai Hospital, Amagasaki, Japan.
Abstract
BACKGROUND/AIM:
If both distant metastases and the primary tumour of colorectal cancer (CRC) are resectable, resection of the distant metastases is considered. The aim of this retrospective study was to determine the efficacy of curative resection of both primary and metastatic lesions in organs other than liver or lung in CRC patients.

PATIENTS AND METHODS:
The medical records of 23 CRC patients who received R0 resection for primary and metastatic regions between 2009 and 2018 were retrospectively analyzed.

RESULTS:
The 3-year overall survival (OS) in all 23 cases was 80.0%. There was no clinicopathological factor associated with OS on univariate analysis.

CONCLUSION:
Curative surgical resection appears to be useful for distant CRC metastases to organs other than liver or lung.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Colorectal cancer; R0 resection; metastases

PMID: 31471411 DOI: 10.21873/invivo.11643
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19.
In Vivo. 2019 Sep-Oct;33(5):1599-1604. doi: 10.21873/invivo.11642.
Methotrexate-associated Classical Hodgkin Lymphoma Shows Distinct Clinicopathological Features but Comparable Clinical Outcomes With Sporadic Cases.
Yoshifuji K1, Umezawa Y1, Ichikawa A1, Watanabe K1, Miura O1, Yamamoto M2.
Author information
1
Department of Hematology, Tokyo Medical and Dental University, Tokyo, Japan.
2
Department of Hematology, Tokyo Medical and Dental University, Tokyo, Japan hide.hema@tmd.ac.jp.
Abstract
BACKGROUND/AIM:
Methotrexate (MTX)-associated classical Hodgkin lymphoma (CHL) is a rare disease, and its prognosis remains unclear.

MATERIALS AND METHODS:
Our study retrospectively compared clinicopathological features and clinical outcomes of patients with MTX-CHL (n=6) and sporadic CHL (n=40).

RESULTS:
MTX-CHL was more frequently the mixed cellularity subtype and positive for Epstein-Barr virus, but less frequently positive for CD20 than sporadic CHL. Clinically, MTX-CHL was more frequent in advanced stage than sporadic CHL and often associated with extranodal disease. After the cessation of MTX, transient spontaneous regression was observed in two MTX-CHL cases. Eventually, all patients with MTX-CHL required chemotherapy, which gave similar complete remission rates at 2 years compared to sporadic CHL. Patients with MTX-CHL tended to have a higher incidence of grade 3 or more neutropenia.

CONCLUSION:
The present study revealed differences in clinicopathological features but similarities in clinical outcomes of MTX-CHL and sporadic CHL.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Methotrexate; absolute lymphocyte count; methotrexate-associated classical Hodgkin lymphoma; methotrexate-associated lymphoproliferative disorders; spontaneous remission

PMID: 31471410 DOI: 10.21873/invivo.11642
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20.
In Vivo. 2019 Sep-Oct;33(5):1593-1598. doi: 10.21873/invivo.11641.
Successful Management of a Pregnant Patient With Chronic Myeloid Leukemia Receiving Standard Dose Imatinib.
Stella S#1,2, Tirró E#3,2, Massimino M#3,2, Vitale SR3,2, Russo S4, Pennisi MS3,2, Puma A3,2, Romano C3,2, DI Gregorio S3,2, Innao V4, Stagno F5, DI Raimondo F5,6, Musolino C4, Manzella L3,2.
Author information
1
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy stefania.stel@gmail.com.
2
Center of Experimental Oncology and Hematology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.
3
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
4
Division of Hematology, University of Messina, Messina, Italy.
5
Division of Hematology and Bone Marrow Transplant, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.
6
Department of Surgery, Medical and Surgical Specialities, University of Catania, Catania, Italy.
#
Contributed equally
Abstract
BACKGROUND/AIM:
As approximately 10% of individuals developing chronic myeloid leukemia (CML) are females aged 20-44 years, a considerable number will consider a planned pregnancy if disease is well controlled by pharmacological treatment. The management of these young patients during pregnancy represents a therapeutic dilemma due to the potential teratogen effects of several tyrosine kinase inhibitors (TKIs) and is a matter of continuous debate. Indeed, despite the existence of several studies, there is currently no consensus on how to manage different pregnancy situations in subjects with CML.

PATIENTS AND METHODS:
We describe a female patient diagnosed with Ph-positive CML one month after her first delivery who achieved excellent hematological, cytogenetic and molecular responses while on imatinib mesylate (IM) treatment.

RESULTS:
The excellent responses allowed the patient to suspend TKI treatment in order to plan a second pregnancy. Despite IM discontinuation, stringent molecular monitoring of her BCR-ABL1/ABL1 levels allowed the safe delivery of the child and, while the patient eventually developed a molecular relapse after four years of treatment discontinuation, upon restarting IM she quickly regained a deep molecular response that is still ongoing.

CONCLUSION:
Our case report demonstrates that, if the pregnancy is properly planned in CML patients, it can result in excellent management of the clinical therapeutic option for the benefit of both mother and child.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
BCR-ABL1; Pregnancy; chronic myeloid leukemia; imatinib mesylate

PMID: 31471409 DOI: 10.21873/invivo.11641
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21.
In Vivo. 2019 Sep-Oct;33(5):1581-1592. doi: 10.21873/invivo.11640.
Predictive Value of Endoplasmic Reticulum Stress Markers in Low Ejection Fractional Heart Failure.
Sabirli R1, Koseler A2, Mansur N3, Zeytunluoglu A4, Sabirli GT5, Turkcuer I6, Kilic ID7.
Author information
1
Servergazi State Hospital, Department of Emergency Medicine, Denizli, Turkey ramazan_sabirli@hotmail.com.
2
Department of Biophysics, Pamukkale University Medical Faculty, Denizli, Turkey.
3
Department of Biotechnology, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
4
Department of Electronic and Automation, Denizli Vocational School of Technical Sciences, Pamukkale University, Denizli, Turkey.
5
Department of Pediatrics, Pamukkale University Medical Faculty, Denizli, Turkey.
6
Department of Emergency Medicine, Pamukkale University Medical Faculty, Denizli, Turkey.
7
Department of Cardiology, Pamukkale University Medical Faculty, Denizli, Turkey.
Abstract
BACKGROUND/AIM:
Endoplasmic reticulum (ER) stress plays a critical role in the development of cardiac hypertrophy and heart failure. Heart failure is a crucial health problem that affects 23 million people worldwide, causes approximately 2.4 million people to be hospitalized every year in the USA, and leads to the death of more than 300,000 people. In this study, we aimed to investigate the clinical significance of ER stress markers and the predictive value of acute decompensated heart failure in patients with low ejection fraction heart failure (ADHF).

PATIENTS AND METHODS:
This is a prospective case control study. The data included laboratory parameters pertaining to patients with ADHF in the emergency service and lipid parameters obtained during their admission to the hospital. In addition, the same parameters obtained from the control group patients with chronic heart failure (CHF) during their routine polyclinic control were recorded in the data set. Admission time to the hospital and length of hospital stay were included in the data. The levels of glucose regulated protein (GRP78), protein kinase RNA-like endoplasmic reticulum kinase (PERK), and C/EBP homologous protein (CHOP) in peripheral blood serum obtained from the patients and the control group were measured using the ELISA method.

RESULTS:
Serum GRP78 concentration was lower in the HF group (p=0.003) compared to the control. The median value of serum PERK concentration in the HF group was higher than that of the control group (573 pg/ml, IQR=477.5-650 vs. 495.5 pg/ml, IQR=294-648, respectively) (p=0.001). However, there were no statistically significant differences in GRP78 and PERK serum concentrations between ADHF and CHF subgroups. Receiver operating characteristic (ROC) curve analysis showed greater area under the curve (AUC) for the serum GRP78 levels of the healthy individuals (AUC=0.748, 95% CI=0.681-0.814, p=0.0003). The serum GRP78 level was found to be 80% sensitive and 70% specific at 147.5 pg/ml (p=0.0003) for distinguishing healthy individuals from HF patients. In the ADHF subgroup, there was a moderate correlation between hospitalization time and serum CHOP concentrations (Spearman rho=0.586 and p=0.001).

CONCLUSION:
High GRP78 serum concentration may protect the patient from ER stress. In addition, the serum PERK level is high in patients with HF, whereas it is insufficient in predicting acute decompensation. CHOP may be useful in predicting the length of hospital stay in patients with ADHF.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Endoplasmic reticulum stress; acute decompensated heart failure; heart failure

PMID: 31471408 DOI: 10.21873/invivo.11640
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22.
In Vivo. 2019 Sep-Oct;33(5):1573-1580. doi: 10.21873/invivo.11639.
Predictive Value of Osteoprotegerin and Neutrophil Gelatinase-associated Lipocalin on Multiple Organ Failure in Multiple Trauma.
Peters H1, Macke C1, Mommsen P1, Zeckey C1,2, Clausen JD1, Krettek C1, Neunaber C1, Winkelmann M3.
Author information
1
Trauma Department, Hannover Medical School, Hannover, Germany.
2
Department of General, Trauma and Reconstructive Surgery, Ludwig-Maximilians-Universität München, Munich, Germany.
3
Trauma Department, Hannover Medical School, Hannover, Germany winkelmann.marcel@mh-hannover.de.
Abstract
BACKGROUND/AIM:
Multiple organ dysfunction syndrome (MODS) is the leading cause of late posttraumatic mortality. This study analyzed the prognostic values of osteoprotegerin (OPG) and neutrophil gelatinase-associated lipocalin (NGAL/lipocalin 2) compared to interleukin-6 (IL-6) in multiply injured patients.

PATIENTS AND METHODS:
A retrospective observational cohort study on multiply injured patients with an injury severity score (ISS) of ≥16 was performed. OPG, NGAL and IL-6 blood concentrations were measured. Statistical analysis comprised receiver-operating-characteristic (ROC) analysis with the corresponding area under the curve (AUC).

RESULTS:
Thirty-nine patients with a mean ISS of 34±11 were included. Fourteen patients (36%) developed MODS and 8 patients (21%) died. Plasma levels of NGAL, OPG, and IL-6 were significantly elevated in the MODS+ group. Each biomarker positively correlated with MODS score and diagnosis of MODS.

CONCLUSION:
NGAL and OPG might be indicative of MODS and could have the potential to be biomarkers in the early detection of patients at risk of posttraumatic MODS.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Multiple organ failure; lipocalin; multiple injury; multiple organ dysfunction syndrome; multiple trauma

PMID: 31471407 DOI: 10.21873/invivo.11639
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23.
In Vivo. 2019 Sep-Oct;33(5):1565-1572. doi: 10.21873/invivo.11638.
Overview and Comparison of Infectious Endocarditis and Non-infectious Endocarditis: A Review of 814 Autoptic Cases.
Bussani R#1, DE-Giorgio F#2, Pesel G1, Zandonà L1, Sinagra G3, Grassi S4, Baldi A5, Abbate A6, Silvestri F1.
Author information
1
Institute of Pathological Anatomy, Riuniti Hospital and University of Trieste, Trieste, Italy.
2
Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy fabio.degiorgio@unicatt.it.
3
Cardiovascular Department, Riuniti Hospital and University of Trieste, Trieste, Italy.
4
Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
5
Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, L. Vanvitelli University of Campania, Caserta, Italy.
6
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, U.S.A.
#
Contributed equally
Abstract
AIM:
We examined evidence on infective and non-infective endocarditis obtained from a database of 50,403 clinical autopsies performed at an Italian general hospital between January 1983 and December 2006.

MATERIALS AND METHODS:
Out of 814 endocarditis cases, 409 were of infective endocarditis (IE) and 405 non-infective (NIE). The median age at the time of death was 78 years for those with IE and 83 for those with NIE. Data were collected on gender, clinical history, comorbidities, kind of affected valve (non-prosthetic/mechanical/biological), pathological features of endocarditis, endocarditis complications and microbiological agents.

RESULTS:
The diagnosis of IE was frequently missed and these conditions were often complicated by cardiovascular events. IE was more common among patients with prior valve infection or cardiovascular surgery, while malignancies were frequent comorbidities of NIE.

CONCLUSION:
In general, we found several data that differ from those generally present in the scientific literature, and this could be explained by the fact that data on IE and NIE are generally obtained from surgical and clinical databases, while we analysed only autoptic cases.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Infective endocarditis; autopsy; forensic science; non-bacterial thrombotic endocarditis; non-infective endocarditis; post mortem; sudden death

PMID: 31471406 DOI: 10.21873/invivo.11638
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24.
In Vivo. 2019 Sep-Oct;33(5):1559-1564. doi: 10.21873/invivo.11637.
First Reported Use of the Faxitron LOCalizer™ Radiofrequency Identification (RFID) System in Europe - A Feasibility Trial, Surgical Guide and Review for Non-palpable Breast Lesions.
Malter W1, Holtschmidt J1, Thangarajah F1, Mallmann P1, Krug B2, Warm M1,3, Eichler C4.
Author information
1
University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany.
2
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Radiology, Cologne, Germany.
3
Breast Cancer Center, Municipal Hospital Holweide, Cologne, Germany.
4
University of Cologne, Faculty of Faculty of Medicine and University Hospital Cologne, Department of Obstetrics and Gynecology, Cologne, Germany ceichler@gmail.com christian.eichler@uk-koeln.de.
Abstract
BACKGROUND/AIM:
The problem of adequately marking any given lesion within a breast surgical site is commonly solved by introducing a titanium clip. However, clip dislocation and/or stereotactic hook-wire dislocation are common problems. An ideal solution would be a clip that can be easily found without the use of stereotactic intervention. This work reviews the available data on radiofrequency identification devices (RFID) in breast surgery, reports initial experience data in Europe and discusses surgical pitfalls, advantages and disadvantages.

PATIENTS AND METHODS:
This study represents a single center, consecutively recruited, initiation trial with subsequent surgeon questionnaire for the first institution in Europe to report Faxitron LOCalizer™ chip data. Four patients with non-palpable tumors were marked with the system and were correlated via mammography, pre- and intra-operative ultrasound and pathology. Data were then compared to available literature and a literature review was added.

RESULTS:
The four patients marked with this RFID system, displayed a 100% success location rate at a 0% complication rate. Surgeons evaluated the new system as being safe to use and only slightly more difficult to place compared to a standard clip. A significant improvement in ultrasound localization and intraoperative localization was also reported for the LOCalizer™ system when compared to a standard titanium clip.

CONCLUSION:
This trial added a small number of consecutively recruited patients to an existing number of available data, resulting in a total of 121 evaluated and reviewed Faxitron LOCalizer™ marked non-palpable in-breast lesions worldwide.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Faxitron; LOCalizer™; Localizer; RFID; breast; lesion; marking; non-palpable; nonpalpable; radiofrequency identification device

PMID: 31471405 DOI: 10.21873/invivo.11637
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25.
In Vivo. 2019 Sep-Oct;33(5):1553-1557. doi: 10.21873/invivo.11636.
Impact of Bile Exposure Time on Organ/space Surgical Site Infections After Pancreaticoduodenectomy.
Kumagai YU1, Fujioka S2, Hata T1, Misawa T1, Kitamura H1, Furukawa K1, Ishida Y1, Yanaga K1.
Author information
1
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
2
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan sfujioka@jikei.ac.jp.
Abstract
BACKGROUND/AIM:
Organ/space surgical site infections (SSIs) are critical complications of pancreaticoduodenectomy. We investigated the impact of the time between division of the common hepatic duct and completion of biliary reconstruction [bile exposure (BE) time] on the occurrence of post-pancreaticoduodenectomy organ/space SSI.

PATIENTS AND METHODS:
Sixty-one patients who underwent pancreaticoduodenectomy were retrospectively studied. The impact of perioperative variables and BE time on organ/space SSI occurrence was analyzed.

RESULTS:
Organ/space SSIs occurred in 17 patients (28%). Patients were divided into two groups according to BE time. The incidence of organ/space SSIs was significantly higher in the long BE time group than in the short BE time group (42% versus 13%, p=0.0127). Multivariate analysis revealed that long BE times [odds ratio (OR)=4.8; p=0.0240] and soft pancreatic texture (OR=16.5; p=0.0106) were independent risk factors for organ/space SSIs.

CONCLUSION:
Long BE time is a risk factor for post-pancreaticoduodenectomy organ/space SSIs. Shortening BE time may reduce organ/space SSI occurrence.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Pancreaticoduodenectomy; bile; biliary reconstruction; organ/space SSI

PMID: 31471404 DOI: 10.21873/invivo.11636
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26.
In Vivo. 2019 Sep-Oct;33(5):1547-1551. doi: 10.21873/invivo.11635.
Artificial Intelligence in Obstetrics and Gynaecology: Is This the Way Forward?
Emin EI1, Emin E2, Papalois A3, Willmott F4, Clarke S#5, Sideris M#6.
Author information
1
Faculty of Life Sciences and Medicine, King's College London, London, U.K.
2
School of Biosciences, Kingston University London, London, U.K.
3
Experimental Educational and Research Centre ELPEN, Athens, Greece.
4
Whipps Cross University Hospital Barts Health NHS Trust, London, U.K.
5
Guys and St Thomas' Hospital, King's College London, London, U.K.
6
Women's Health Research Unit, Queen Mary University of London, London, U.K. m.sideris@qmul.ac.uk.
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Contributed equally
Abstract
An increasing trend in funding towards artificial intelligence (AI) research in medicine has re-animated huge expectations for future applications. Obstetrics and gynaecology remain highly litigious specialities, accounting for a large proportion of indemnity payments due to poor outcomes. Several challenges have to be faced in order to improve current clinical practice in both obstetrics and gynaecology. For instance, a complete understanding of fetal physiology and establishing accurately predictive antepartum and intrapartum monitoring are yet to be achieved. In gynaecology, the complexity of molecular biology results in a lack of understanding of gynaecological cancer, which also contributes to poor outcomes. In this review, we aim to describe some important applications of AI in obstetrics and gynaecology. We also discuss whether AI can lead to a deeper understanding of pathophysiological concepts in obstetrics and gynaecology, allowing delineation of some grey zones, leading to improved healthcare provision. We conclude that AI can be used as a promising tool in obstetrics and gynaecology, as an approach to resolve several longstanding challenges; AI may also be a means to augment knowledge and assist clinicians in decision-making in a variety of areas in obstetrics and gynaecology.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Artificial intelligence; IVF; fetal monitoring; gynaecological cancer; obstetrics and gynaecology; personalised medicine; review

PMID: 31471403 DOI: 10.21873/invivo.11635
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27.
In Vivo. 2019 Sep-Oct;33(5):1539-1545. doi: 10.21873/invivo.11634.
Impact of Accidental Hypothermia on Pulmonary Complications in Multiply Injured Patients With Blunt Chest Trauma - A Matched-pair Analysis.
Winkelmann M1, Clausen JD2, Graeff P2, Schröter C2,3, Zeckey C2,4, Weber-Spickschen S2, Mommsen P2.
Author information
1
Trauma Department, Hannover Medical School, Hannover, Germany winkelmann.marcel@mh-hannover.de.
2
Trauma Department, Hannover Medical School, Hannover, Germany.
3
Trauma Department, Wolfsburg Hospital, Wolfsburg, Germany.
4
Department of General, Trauma and Reconstructive Surgery, Ludwig Maximilian University Munich, Munich, Germany.
Abstract
BACKGROUND/AIM:
Blunt chest trauma is one of the major injuries in multiply injured patients and is associated with an increased risk of acute respiratory distress syndrome (ARDS) and ventilator-associated pneumonia (VAP). Accidental hypothermia is a common accompaniment of multiply injured patients. The objective of this study was to analyze the influence of accidental hypothermia on pulmonary complications in multiply injured patients with blunt chest trauma.

PATIENTS AND METHODS:
Multiply injured patients [injury severity score (ISS) ≥16] with severe blunt chest trauma [abbreviated injury scale of the chest (AISchest) ≥3] were analyzed. Hypothermia was defined as body core temperature <35°C. The primary endpoint was the development of ARDS and VAP. Propensity score matching was performed.

RESULTS:
Data were analyzed for 238 patients, with a median ISS of 26 (interquartile range=12). A total of 67 patients (28%) were hypothermic on admission. Hypothermic patients were injured more severely (median ISS 34 vs. 24, p<0.001) and had a higher transfusion requirement (p<0.001). Their mortality rate was consequently increased (10% vs. 1%, p=0.002); After propensity score matching, the mortality rate was still higher (10% vs. 2%, p=0.046). However, hypothermia was not an independent predictor of mortality. Hypothermic patients had to be ventilated longer (p=0.02). However, there were no differences in occurrence of ARDS and VAP. Hypothermia was not identified as an independent predictor of ARDS and VAP.

CONCLUSION:
Among multiply injured patients with severe blunt chest trauma, accidental hypothermia is not an independent predictor of ARDS and VAP and is more likely to be an accompaniment of injury severity and hemorrhage.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Blunt chest trauma; adult respiratory distress syndrome; hypothermia; multiple trauma; ventilator-associated pneumonia

PMID: 31471402 DOI: 10.21873/invivo.11634
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28.
In Vivo. 2019 Sep-Oct;33(5):1531-1538. doi: 10.21873/invivo.11633.
Pericardial Synovial Sarcoma: Case Report, Literature Review and Pooled Analysis.
Duran-Moreno J1, Kampoli K1, Kapetanakis EI2, Mademli M3, Koufopoulos N4, Foukas PG4, Kostopanagiotou K2, Tomos P2, Koumarianou A5.
Author information
1
Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
2
Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
3
Second Department of Radiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
4
Second Department of Pathology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
5
Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece akoumari@yahoo.com.
Abstract
BACKGROUND:
Pericardial synovial sarcomas (PSS) are very rare tumors, with dismal prognosis and limited data. We describe the clinical features and identify prognostic factors of primary PSS.

CASE REPORT:
We describe the case of a 56-year-old male patient with PSS managed by the multidisciplinary team of thoracic oncology. The therapeutic plan comprised surgery, chemotherapy, stereotactic radiosurgery and targeted therapy, with excellent results.

MATERIALS AND METHODS:
Data from 37 cases reported in English during the past 20 years were gathered and analyzed. PSS was found to occur at a mean age of 36±17.082 (range=13-67) years. Survival analysis was performed on 20 cases with follow-up of at least 6 months.

CONCLUSION:
Only complete resection of the tumor seems to be an independent prognostic factor. To our knowledge, this is the first report on the safety and effectivity of pazopanib in PSS and may provide guidance for similar cases in the future.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Pericardial synovial sarcoma; chemotherapy; pazopanib; stereotactic radiosurgery

PMID: 31471401 DOI: 10.21873/invivo.11633
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29.
In Vivo. 2019 Sep-Oct;33(5):1521-1530. doi: 10.21873/invivo.11632.
Quality Indicators and Survival Outcome in Stage IIIB-IVB Epithelial Ovarian Cancer Treated at a Single Institution.
Steinberga I1, Jansson K2, Sorbe B3.
Author information
1
Department of Obstetrics and Gynecology, Orebro University Hospital, Orebro, Sweden inga.steinberga@bredband.net inga.steinberga@regionorebrolan.se.
2
Department of Surgery, Orebro University Hospital, Orebro, Sweden.
3
Department of Oncology, Orebro University Hospital, Orebro, Sweden.
Abstract
BACKGROUND/AIM:
To investigate the overall survival rate, quality indicators and treatment outcome in FIGO stage IIIB-IVB epithelial ovarian cancer at a University Hospital in Sweden between 2006 and 2015.

MATERIALS AND METHODS:
A cohort of 110 patients was followed-up for 3-12 years after cancer diagnosis. Three main groups (primary surgery, neoadjuvant chemotherapy, palliative treatment), and six subgroups were defined according to treatment modality.

RESULTS:
The mean age was 65 years. Patients were observed for a mean of 50 months. The total resection frequency was 83%. Significant differences in overall survival at 5 years were observed between the groups varying from 60% to 12%.

CONCLUSION:
Patient age, tumor stage and complete tumor removal at surgery were significant, independent prognostic factors of overall survival. Complication rate was a significant adverse prognostic factor in univariate analysis. Data discrepancy was observed between public quality reports and locally obtained data.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Epithelial ovarian cancer; quality factors; surgical treatment; survival

PMID: 31471400 DOI: 10.21873/invivo.11632
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30.
In Vivo. 2019 Sep-Oct;33(5):1507-1519. doi: 10.21873/invivo.11631.
Acute and 28-Day Repeated Inhalation Toxicity Study of Glycolic Acid in Male Sprague-Dawley Rats.
Lim SK1, Yoo J1, Kim H1, Kim W1, Shim I1, Yoon BI2, Kim P1, DO Yu S1, Eom IC3.
Author information
1
Environmental Health Research Department, National Institute of Environmental Research, Incheon, Republic of Korea.
2
College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon, Republic of Korea.
3
Environmental Health Research Department, National Institute of Environmental Research, Incheon, Republic of Korea iceom@korea.kr.
Abstract
BACKGROUND/AIM:
The use of glycolic acid is present in a variety of consumer products, including medicines, cleaners, cosmetics, and paint strippers. It has recently led to concerns about toxicity from inhalation exposure. Herein, the pulmonary toxicity of glycolic acid was investigated in rats.

MATERIALS AND METHODS:
We conducted acute (~458 mg/m3) and sub-acute (~49.5 mg/m3) inhalation tests to identify the potential toxicities of glycolic acid.

RESULTS:
Inhalation exposure to glycolic acid in the acute and subacute inhalation tests did not cause any specific changes in clinical examinations, including body weight, organ weight, hematology, serum biochemistry, and histopathology. The polymorphonuclear neutrophils (PMNs) and inflammatory cytokines in Bronchoalveolar lavage fluid (BALF) increased in rats exposed to single and repeated inhalations. In the sub-acute test, the changes induced by glycolic acid were minor or returned to normal during the recovery period.

CONCLUSION:
The No Observed Adverse Effect Concentration (NOAEC) for the nasal and pulmonary toxicity of glycolic acid was determined to be over 50 mg/m3 at the end of a 28-day inhalation test in male rats.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

KEYWORDS:
Acute; glycolic acid; inhalation exposure; subacute; toxicity

PMID: 31471399 DOI: 10.21873/invivo.11631
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