Pancreatic cyst fluid DNA analysis in evaluating pancreatic cysts: a report of the PANDA study.

Background: The role of pancreatic cyst fluid DNA analysis in evaluating pancreatic cysts remains unclear.

Objective: Our purpose was to evaluate the utility of a detailed DNA analysis of pancreatic cyst fluid to diagnose mucinous and malignant cysts.

Design: Prospective, multicenter study.

Adherence to home-monitoring and its impact on survival in post-lung transplantation patients.

A home-monitoring program can be an important part of the follow-up care after lung transplantation surgery. We report mortality data from the home-monitoring program at University of Minnesota. The data from 246 lung recipients who participated in the home-monitoring program from 1992 to 2002 were analyzed.

Unique site- and time-specific patterns of recurrence following resection of colorectal carcinoma hepatic metastases in patients staged by FDG-PET.

Background/purpose: We recently reported that patients staged by positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) prior to liver resection for metastatic colorectal cancer had an excellent 5-year survival. In this study, the site- and time-specific patterns of recurrence were examined in patients staged by FDG-PET and the results compared to historical literature control data.

Methods: From March 1995 to June 2002, all patients having hepatic resection for colorectal cancer metastases had preoperative FDG-PET.

Depression and end-stage renal disease: a therapeutic challenge.

Hedayati et al. document a 26.5% incidence of clinical depression and a strong association between depression and hospitalizations and mortality in hemodialysis patients.

Design and evaluation of a web-based interactive visualization system for lung transplant home monitoring data.

We describe the implementation and evaluation of an interactive system for displaying patient pulmonary information from a lung transplant home monitoring program. Software was designed to take case information and render it as Scalable Vector Graphics (SVG) in a web browser. Twelve clinician readers reviewed twenty randomly-ordered, retrospective cases in each of three display formats (graphical, graphical interactive, and tabular) and determined whether they showed signs of infection or graft rejection.

Molecular analysis of multifocal papillary thyroid carcinoma.

Papillary thyroid carcinoma (PTC) frequently presents as a multifocal process. To study the importance of separating independent primary (IP) from intrathyroid metastatic (ITM) PTC, we examined 19 molecular markers on 42 separate tumors from 18 multifocal PTC cases. In 12 of 18 (66.

Electronic feedback messages for home spirometry lung transplant recipients.

Background: Lung transplant recipients use a telemedicine device known as the electronic home spirometer to gauge the function of their lungs when they are away from the hospital or clinic setting. Health care providers review transmitted spirometry tests and user's symptom responses to detect early signs of infection and or rejection. Current home spirometry users have questions, concerns, and preferences about spirometry that may influence their daily adherence.

Liver transplantation for hepatocellular carcinoma: extension of indications based on molecular markers.

Background/aims: Liver transplantation usually cures hepatocellular carcinoma when the Milan selection criteria are applied, whereas there is substantial risk of posttransplant recurrence with tumors beyond these criteria. This study uses molecular data to identify a subgroup of patients who, despite having hepatocellular carcinoma beyond Milan criteria, have favorable outcomes.

Methods: Allelic imbalance of 18 microsatellites was analyzed in 70 consecutive patients (35 within Milan, 35 beyond Milan criteria) transplanted for hepatocellular carcinoma of whom 24 had recurrence and 46 survived at least 5 years recurrence-free.

Home telehealth for children with special health-care needs.

The U Special Kids (USK) programme at the University of Minnesota provides intensive care coordination and case management services to children with complex special health-care needs. We conducted a one-year pilot study to evaluate the feasibility of videoconferencing between the USK office and family homes. To ensure easy installation, families were provided with prepackaged equipment and software.

Effective tumor treatment targeting a melanoma/melanocyte-associated antigen triggers severe ocular autoimmunity.

Nonmutated tissue differentiation antigens expressed by tumors are attractive targets for cancer immunotherapy, but the consequences of a highly effective antitumor immune response on self-tissue have not been fully characterized. We found that the infusion of ex vivo expanded adoptively transferred melanoma/melanocyte-specific CD8+ T cells that mediated robust tumor killing also induced autoimmune destruction of melanocytes in the eye. This severe autoimmunity was associated with the up-regulation of MHC class I molecules in the eye and high levels of IFN-gamma derived from both adoptively transferred CD8+ T cells and host cells.

Diagnostic and prognostic utility of molecular markers in synchronous bilateral breast carcinoma.

Histologic criteria have a limited role in determining whether the synchronous bilateral breast carcinomas represent two primaries or a metastasis to the contralateral breast. We studied the molecular analysis of synchronous bilateral breast carcinoma and whether they are originating from a single or different clone. We examined 17 patients with breast carcinoma, including 12 patients with synchronous bilateral carcinomas and control group of 5 infiltrating ductal carcinomas with regional lymph node metastases.

Transducin gamma-subunit sets expression levels of alpha- and beta-subunits and is crucial for rod viability.

Transducin is a prototypic heterotrimeric G-protein mediating visual signaling in vertebrate photoreceptor cells. Despite its central role in phototransduction, little is known about the mechanisms that regulate its expression and maintain approximately stoichiometric levels of the alpha- and betagamma-subunits. Here we demonstrate that the knock-out of transducin gamma-subunit leads to a major downregulation of both alpha- and beta-subunit proteins, despite nearly normal levels of the corresponding transcripts, and fairly rapid photoreceptor degeneration.

Fractional allelic imbalance could allow for the development of an equitable transplant selection policy for patients with hepatocellular carcinoma.

Liver transplantation (LT) in the presence of hepatocellular carcinoma (HCC) remains a controversial issue because the current staging systems are not sufficiently predictive of outcomes. Paraffin blocks from 183 patients that underwent LT in the presence of HCC were collected. Molecular analysis was carried out blindly on the native liver specimens in all cases with respect to recurrence outcomes.

Trends in the use and role of biomarkers in phase I oncology trials.

Purpose: There has been interest in using biomarkers that aid the evaluation of new anticancer agents. We evaluated trends in the use of biomarkers and their contribution to the main goals of phase I trials.

Experimental Design: We did a systematic review of abstracts submitted to the American Society of Clinical Oncology annual meeting from 1991 to 2002 and the publications related to these abstracts.

VALUE: Virtual Assisted Living Umbrella for the Elderly -- user patterns.

VALUE is a randomized controlled trial to evaluate the impact of a home telehealth program on the ability of frail elderly individuals to remain living independently in their own home as their self-care abilities decline. VALUE uses broadband access to provide virtual visits with a home care nurse, a Web portal for ordering assisted living services, physiological monitoring, and access to the Internet. Subjects were able to use the VALUE program technology without difficulty after a brief instruction session with the nurse.

Psychosocial assessment of the patient on chronic peritoneal dialysis: an overview.

The psychosocial assessment of the patient with end-stage renal disease is critically important because (1) there is growing evidence that the psychosocial status of the patient impacts medical outcomes and (2) the objective of therapy is to maximize a patient's sense of well-being and quality of life. This is particularly true for patients receiving a home-based therapy such as chronic peritoneal dialysis. The present review outlines a possible structure and format for performing psychosocial evaluations for patients maintained on chronic peritoneal dialysis.

Economic evaluation of a Bayesian model to predict late-phase success of new chemical entities.

Objective: To evaluate the economic impact of a Bayesian network model designed to predict clinical success of a new chemical entity (NCE) based on pre-phase III data.

Methods: We trained our Bayesian network model on publicly accessible data on 503 NCEs, stratified by therapeutic class. We evaluated the sensitivity, specificity and accuracy of our model on an independent data set of 18 NCE-indication pairs, using prior probability data for the antineoplastic NCEs within the training set.

Combined [18F]Fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) for detection of recurrent, 131I-negative thyroid cancer.

Background: Whole-body (131)I scintigraphy (WBS) and serial thyroglobulin measurement (Tg) are standard methods for detecting thyroid cancer recurrence after total/near total thyroidectomy and (131)I ablation. Some patients develop elevated Tg (Tg-positive) or there is clinical suspicion of recurrence, but WBS are negative (WBS-negative). This may reflect non-iodine-avid recurrence or metastasis.

Hemodialysis and peritoneal dialysis: patients' assessment of their satisfaction with therapy and the impact of the therapy on their lives.

This study was undertaken to examine patient satisfaction with peritoneal dialysis (PD) and hemodialysis (HD) therapies, focusing attention on the positive and negative impact of the therapies on patients' lives. Patients were recruited from a free-standing PD unit and two free-standing HD units. A total of 94% (n = 62) of eligible PD and 84% (n = 84) of eligible HD patients participated.

Effects of home hemodialysis on health-related quality of life measures.

In recent years, there has been an increased interest in performing hemodialysis (HD) more frequently than thrice weekly, particularly in the home setting. This interest has been stimulated by some studies that have indicated significant benefits to performing more frequent HD on various medical and quality of life outcome measures. However, only a few studies using varying quality of life instruments have critically examined the impact of frequent HD on the quality of life of patients.

Prognostic models in hepatocellular carcinoma (HCC) and statistical methodologies behind them.

Hepatocellular carcinoma (HCC) is estimated to be responsible for 250,000 deaths worldwide yearly. Aggressive surgical resection or liver transplantation still remain the only viable curative options for patients suffering the disease despite the multitude of emerging therapies for HCC. However, even with the most aggressive surgical intervention, survival varies widely within each particular stage of HCC.