Survival after percutaneous endoscopic gastrostomy: the role of dementia.

Background: Percutaneous Endoscopic Gastrostomy (PEG) is a widely used technique for enteral feeding in nursing home patients. Several factors including malnutrition, hypoalbuminemia, older age, number of co-morbidities and cognitive impairment adversely affect survival.

Objective: This study evaluated the relative impact of age, serum albumin, number of co-morbid illnesses and dementia on survival in male nursing home patients who had undergone percutaneous endoscopic gastrostomy (PEG).

Primary malignant melanoma of the small bowel: a case report and review of the literature.

Although small bowel involvement by malignant melanoma is most frequently metastatic, a primary origin at this site has been reported in rare cases. The biological and clinical features of these cases have not yet been summarized. Here, another case of small bowel melanoma is described, and a review of the existing literature is given.

Protein expression and gene copy number analysis of topoisomerase 2alpha, HER2 and P53 in minimally invasive urothelial carcinoma of the urinary bladder--a multitissue array study with prognostic implications.

Background: Due to their variable clinical course, there is a need for new prognostic parameters in minimally invasive (stage T1) bladder carcinomas.

Materials And Methods: Using multitissue arrays, protein expression and gene copy numbers of topoisomerase (TOP2alpha), HER2 and p53 were investigated by immunohistochemistry and by fluorescence in situ hybridization (FISH) in 73 T1 tumors. The results were compared with tumor recurrence and progression.

P16 immunoreactivity is an independent predictor of tumor progression in minimally invasive urothelial bladder carcinoma.

Objective: To evaluate the prognostic impact of p16 immunoreactivity in minimally invasive transitional cell bladder carcinomas (stage T1).

Methods: Multi-tissue-arrays containing 73 samples of T1 bladder carcinomas were stained immunohistochemically for p16. Additionally, p53 and Ki-67 antigen expression were examined.

Chondrolipoma of the hand: a case report.

The authors present the case of a chondrolipoma which was excised from the left hand's palm of an 83-year old woman. Chondrolipomas are rare neoplasms; their terminology and pathogenesis have been controversial in the past. Chondrolipoma in the hand does not seem to have been reported so far.

Different mechanisms participate in the R-dependent activity of the R2R3 MYB transcription factor C1.

The R2R3 MYB transcription factor C1 requires the basic helix-loop-helix factor R as an essential co-activator for the transcription of maize anthocyanin genes. In contrast, the R2R3 MYB protein P1 activates a subset of the C1-regulated genes independently of R. Substitution of six amino acids in P1 with the C1 amino acids results in P1(*), whose activity on C1-regulated and P1-regulated genes is R-dependent or R-enhanced, respectively.

Histologic tumor growth pattern is significantly associated with disease-related survival in muscle-invasive transitional cell carcinoma of the urinary bladder.

Tumor stage and lymph node status are currently the most established prognostic factors in muscle-invasive bladder cancer. However, there is still a need for new parameters allowing to assess the prognosis more accurately. A recently introduced morphologic classification of tumor growth, which distinguishes three growth patterns (nodular, trabecular, and infiltrative type), was retrospectively applied to a collective of 153 muscle-invasive bladder carcinomas in order to examine its prognostic relevance.

Significant damage of the conduction system during cardioplegic arrest is due to necrosis not apoptosis.

Objectives: Ventricular conduction disturbances following cardioplegic arrest remains a serious, yet unsolved problem. In the present study we examined whether myocardial conduction cells (MCC, Purkinje fibers) are more vulnerable to ischemia/reperfusion injury than working myocardial cells and whether the damage is due to necrosis or apoptosis.

Methods: Mini-pigs were subjected to 60 min of crystalloid (St Thomas; n = 15 group I) or blood (Buckberg; n = 6 group II) cardioplegic arrest followed by 3 h of reperfusion.

Prognostic significance of a grading system considering tumor heterogeneity in muscle-invasive urothelial carcinoma of the urinary bladder.

The fact that urothelial carcinomas (UC) often contain areas with different histologic grades has been recently shown to bear some prognostic relevance. Here we examined the prognostic significance of a grading system considering tumor heterogeneity in muscle-invasive bladder carcinomas. 151 UC treated by radical cystectomy were included.

Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL.

Cyclophosphamide, doxorubicin, vincristine, and prednisone, given every 3 weeks (CHOP-21), is standard chemotherapy for aggressive lymphomas. To determine whether biweekly CHOP (CHOP-14) with or without etoposide is more effective than CHOP-21, 689 patients ages 61 to 75 years were randomized to 6 cycles of CHOP-21, CHOP-14, CHOEP-21 (CHOP plus etoposide 100 mg/m2 days 1-3), or CHOEP-14. Patients in the 2-weekly regimens received granulocyte colony-stimulating factor (G-CSF) starting from day 4.

[Dysfunction of a kidney allograft with life-threatening results].

Post-transplant lymphoproliferative disease (PTLD) is a serious complication after organ transplantation. We describe the case of a 45-year old patient who developed an EBV associated B-cell lymphoma in a cadaveric renal allograft. This case underscores the importance of considering PTLD as possible differential diagnosis for allograft dysfunction.

Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL.

The combination of cyclophosphamide, doxorubicin, vincristine, and prednisone, given every 3 weeks (CHOP-21) is standard chemotherapy for aggressive lymphomas. To determine whether CHOP given every 2 weeks (CHOP-14) or the addition of etoposide (CHOEP-21, CHOEP-14) can improve results in patients ages 18 to 60 years with good prognosis (normal lactic dehydrogenase [LDH] level), 710 patients were randomized to 6 cycles of CHOP-21, CHOP-14, CHOEP-21 (CHOP plus etoposide 100 mg/m2 days 1-3), or CHOEP-14 in a 2 x 2 factorial study design. Patients in the biweekly regimens received granulocyte colony-stimulating factor (G-CSF) starting from day 4.

Immune phenomena in localized and generalized Wegener's granulomatosis.

Wegener's granulomatosis (WG) is characterized by granulomatous inflammation and systemic vasculitis with a predilection for the lungs and kidneys. In most patients WG begins with a localized organ involvement of the upper respiratory tract that progresses to systemic disease (generalized WG) (1). Because of the life-threatening nature of systemic vasculitis, much effort has concentrated on elucidating the pathogenesis of the vasculitis.

Primitive neuroectodermal tumor (PNET) of the urinary bladder.

We report on the clinical, morphologic, immunohistochemical, ultrastructural, and molecular cytogenetic features of a primitive neuroectodermal tumor (PNET) primarily arising in the urinary bladder. An 81-year-old man presented with lymphedema of the lower extremities, fatigue, and urge incontinence. Radiographically, a tumor filling the entire cavity of the urinary bladder and extending into the pelvic and retroperitoneal tissue was noted.

Application of Newly Developed Tissue-arrays to Study EMMPRIN (CD147) Expression in Malignant Non-Hodgkin Lymphoma.

Background: Matrix-metalloproteinases (MMP) are involved in a broad spectrum of physiological processes. Moreover, they also play a key role in tumour invasion and metastatic spread. The induction of MMPs is mediated via the extracellular matrix-metalloproteinase inducer (EMMPRIN).

The "Gent" consensus on perforator flap terminology: preliminary definitions.

Due to its increasing popularity, more and more articles on the use of perforator flaps have been reported in the literature during the past few years. Because the area of perforator flaps is new and rapidly evolving, there are no definitions and standard rules on terminology and nomenclature, which creates confusion when surgeons try to communicate and compare surgical techniques. This article attempts to represent the opinion of a group of pioneers in the field of perforator flap surgery.

Meckel diverticulum: a geriatric disease masquerading as common gastrointestinal tract disorders.

Background: Meckel diverticulum (MD) is traditionally considered a pediatric disease that is associated with intestinal hemorrhage or perforation. Symptomatic MD is rarely a consideration in the geriatric population.

Objective: To notify clinicians of the clinical variety and diagnostic uncertainty of MD in the elderly, we report 7 cases of complicated MD that presented as common disorders of the gastrointestinal (GI) tract in patients older than 65 years.

Whole cell ELISA for measuring anti-tumour effects of immunotherapies in a mouse tumour model of ALCL.

The use of whole cell vaccines to augment anti-tumour immunity has been explored throughout the last century. Using the recently established TS1G6 ALCL mouse model, we compared the ability of whole cell vaccines with different combinations of CpG oligodeoxynucleotides, Diphteria-, Pertussis- and Tetanus-vaccine (DPT) to enhance the immunogenicity of tumour cells. We have therefore developed a whole cell ELISA that detects the systemic anti-tumor-cell antibody response.

Seventy-five years' survival in partial atrioventricular septal defect.

Long-term survival of patients with partial atrioventricular septal defect (PAVSD) without operative therapy is very rare. The case is reported of a 75-year-old man who presented with dyspnea and decline of general condition. A heart defect was known but not investigated as the patient refused to undergo invasive cardiologic diagnosis.

Differences in CCR5 expression on peripheral blood CD4+CD28- T-cells and in granulomatous lesions between localized and generalized Wegener's granulomatosis.

Wegener's granulomatosis (WG) is an autoimmune disease characterized by granulomatous lesions and a necrotizing vasculitis. Th1-type-cells lacking CD28 are expanded independent of age and immunosuppressive therapy in WG. To address their migratory properties of CD4(+)CD28(-) T-cells we studied the expression of the inducible inflammatory Th1-type chemokine receptor CCR5 in localized WG and generalized WG.

VEGF-, KIT protein- and neutral endopeptidase (NEP/CD10)-positive myofibroblasts-precursors of angiogenesis in chorioangiomas?

Chorioangiomas are benign angiomatous tumours of the placenta occurring with a frequency of approximately one per cent of all examined placentae. Hypoxia and genetic factors are discussed to be predisposing factors for chorioangiomas. However, not much is known about the tumorigenesis of these benign tumours.

Matrix-metalloproteinases in Hodgkin lymphoma.

Background: Classical Hodgkin lymphomas are characterized by relatively few tumour cells and prominent proliferation of plasma cells, histiocytes, lymphocytes and eosinophils. In addition there is a varying degree of sclerosis, which is especially prominent in nodular sclerosis. These morphological peculiarities led to the idea that the interaction between tumour cells and bystander cells as well as the extracellular matrix may be important in Hodgkin lymphomas.

Numerical aberrations of chromosome 17 and the 9p21 locus are independent predictors of tumor recurrence in non-invasive transitional cell carcinoma of the urinary bladder.

Since the majority of patients with non-invasive (stage pTa) bladder carcinoma experience tumor recurrence, the identification of prognostic markers for assessing the biologic behavior of tumors is of high clinical interest. In this retrospective study, we investigated the prognostic value of numerical aberrations of chromosomes 3, 7, 17 and of the 9p21 gene locus in 71 pTa bladder carcinomas using the UroVysion test. This recently developed multi-probe fluorescence in situ hybridization (FISH) test, which simultaneously stains the 9p21 locus and the centromer regions of chromosomes 3, 7 and 17, was applied on paraffin sections from formalin-fixed tumor specimens.

[Mycosis fungoides in childhood and adolescence with clonal T-cell receptor gamma gene rearrangement. Two cases].

Mycosis fungoides (MF) is a cutaneous T-cell lymphoma (CTCL) characterized by its typical progress in three stages: the patch-, the plaque- and the tumour-stage. The incidence of mycosis fungoides rises with age and the average age at presentation is about 50. Children and adolescents are rarely affected and there are only few reports in the literature.