Background and aims: Conflicting results exist about the presence of Mycobacterium avium subspecies paratuberculosis (MAP) specific IS900 DNA in Crohn’s disease (CD) tissues. Therefore, we examined IS900 in a large n...Background and aims: Conflicting results exist about the presence of Mycobacterium avium subspecies paratuberculosis (MAP) specific IS900 DNA in Crohn’s disease (CD) tissues. Therefore, we examined IS900 in a large number of gut samples from patients with CD (n = 100) and ulcerative colitis (UC, n = 100), and in non-inflamed control tissues (nIBD, n = 100). We hypothesised that IS900 DNA detection might be associated with distinct clinical phenotypic characteristics in CD. Methods: The prevalence of MAP DNA in surgically resected tissues was examined using a mechanical-enzymatic disruption technique and nested IS900 specific polymerase chain reaction (PCR). CD patients were stratified according to the criteria of the Vienna classification and other clinical characteristics. Results: IS900 PCR detection rate was significantly higher in CD tissue samples (52%) than in UC (2%) or nIBD (5%) specimens (p < 0.0001 ). In CD patients, IS900 DNA was detected in samples from both diseased small bowel (47%) as well as from the colon (61%). No firm association between MAP specific IS900 detection rates and clinical phenotypic characteristics in CD could be established. However, corticosteroid medication constituted a factor which tended to have a negative influence on IS900 DNA detection rates in CD(p < 0.01). Conclusions: The presence of MAP specific IS900 DNA is a predominant feature of CD. Therapeutic intervention against MAP might represent a potential target for disease mitigation in Crohn’s disease.展开更多
To determine patients’quality of life (QOL) after macular translocation with 360°peripheral retinectomy (MT360) for age-related macular degeneration. Prosp ective, interventional, consecutive, noncomparative cas...To determine patients’quality of life (QOL) after macular translocation with 360°peripheral retinectomy (MT360) for age-related macular degeneration. Prosp ective, interventional, consecutive, noncomparative case series. A prospective s tudy assessed QOL 1 year after MT360 and its relation to postoperative visual fu nction. The 25-item National Eye Institute Visual Function Questionnaire (NEIVF Q-25) and the Medical Outcomes Study 12-item short form (SF-12) health survey were used to assess vision-related QOL and general health, respectively. Surve ys were administered preoperatively and postoperatively. Postoperative NEIVFQ-2 5 QOL and SF-12 subscale scores for all patients were compared with the preoper ative scores. Preoperative and postoperative distance and near visual acuities ( VAs) and reading speed were assessed. Changes in NEIVFQ-25 QOL subscale scores were compared in patients with and without improved visual function. Postoperati ve NEI VFQ-25 QOL subscale scores in patients with distance VA of ≥69 Early Tr eatment Diabetic Retinopathy Study letters, near VA of ≥20/70, and reading spee d of ≥90 words per minute were compared with subscale scores in patients with w orse postoperative visual function. National Eye Institute VFQ-25 and SF-12 QO L scores and their association with distance VA, near VA, and reading speed. In total, 50 patients with a mean age of 76.9 years were studied. Postoperative mea n NEIVFQ25 QOL scores were higher than the preoperative mean scores, and this di fference was significant for important vision-specific subscales. Patients with improved visual function had greater mean changes in NEIVFQ-25 QOL scores than those with no improvement. Patients with the outlined higher levels of visual f unction had greater mean NEIVFQ-25 QOL scores than those who had worse visual f unction. Preoperative and postoperative mean SF-12 QOL scores were similar. Mac ular translocation with 360°peripheral retinectomy was associated with improvem ent in vision-related QOL. The amount of improvement was greatest in patients w ith postoperative improvement in visual function, and the best postoperative vis ion-related QOL was seen in patients with better postoperative visual function. This was not associated with a change in patients’general health.展开更多
AIM:To determine whether serum levels of carcinoembryonic antigen(CEA) correlate with the presence of primary colorectal cancer(CRC),and/or recurrent CRC following radical resection.METHODS:A total of 413 patients wit...AIM:To determine whether serum levels of carcinoembryonic antigen(CEA) correlate with the presence of primary colorectal cancer(CRC),and/or recurrent CRC following radical resection.METHODS:A total of 413 patients with CRC underwent radical surgery between January 1998 and December 2002 in our department and were enrolled in this study.The median follow-up period was 69 mo(range,3-118 mo),and CRC recurrence was experienced by 90/413(21.8%) patients.Serum levels of CEA were assayed preoperatively,and using a cutoff value of 5 ng/mL,patients were divided into two groups,those with normal serum CEA levels(e.g.,≤ 5 ng/mL) and those with elevated CEA levels(> 5 ng/mL).RESULTS:The overall sensitivity of CEA for the detection of primary CRC was 37.0%.The sensitivity of CEA according to stage,was 21.4%,38.9%,and 41.7% for stagesⅠ-Ⅲ,respectively.Moreover,for stageⅡandstageⅢcases,the 5-year disease-free survival rates were reduced for patients with elevated preoperative serum CEA levels(P < 0.05).The overall sensitivity of CEA for detecting recurrent CRC was 54.4%,and sensitivity rates of 36.6%,66.7%,and 75.0% were associated with cases of local recurrence,single metastasis,and multiple metastases,respectively.In patients with normal serum levels of CEA preoperatively,the sensitivity of CEA for detecting recurrence was reduced compared with patients having a history of elevated CEA prior to radical resection(32.6% vs 77.3%,respectively,P < 0.05).CONCLUSION:CRC patients with normal serum CEA levels prior to resection maintained these levels during CRC recurrence,especially in cases of local recurrence vs cases of metastasis.展开更多
AIM:To determine the incidence of human epidermal growth factor receptor 2(HER2) over expression in oesophageal cancers.METHODS:A retrospective study,of one hundred consecutive cases of endoscopic histological samples...AIM:To determine the incidence of human epidermal growth factor receptor 2(HER2) over expression in oesophageal cancers.METHODS:A retrospective study,of one hundred consecutive cases of endoscopic histological samples of oesophageal cancers from a single British cancer network were included.Cancer cases were diagnosed between April 2007 and June 2010.HER2 over expression was assessed using immunohistochemistry,those that scored "0" and "+1" were considered "negative" for HER2;those that scored "+3" were considered "Positive".Cases that were scored "+2" on immunohistochemistry further went on to have HER2 gene analysis using the Ventana HER brightfield dual-colourin situ hybridisations(HER B DISH) assay and either came back to be positive or negative for HER2 over expression.Overall survival was measured from date of histological diagnosis until date of death.93% of the cases were followed up till five years or death,and all were followed up till two years.Cases of gastro-oesophageal junctional tumours were excluded.RESULTS:The median age of our sample was 66 years(range:38-91 years).Eighty one were male and 19 female.Ninety-one of the cases were adenocarcinoma of the oesophagus and the rest were cases of squamous cell carcinoma.The anatomical distribution of the tumours was;upper oesophagus 2,middle oesophagus 11,and 87 were in the lower oesophagus.Operative resection was completed in 15 cases;seven cases had attempted surgical resections,i.e.,open and close,33 patients received definitive chemo-radiation and 52 had palliative treatment.Twenty-five of the cancers showed evidence of HER2 over expression,all were adenocarcinomas.Of the 25 cases that showed evidence of HER2 over expression,21(84%) were located in the lower third of the oesophagus.On staging,24 out of the 25 HER2 positive cases were at stage 3 or more(13 at stage 3 and 11 at stage 4),For HER2 negative cases 37 were at stage 3 and 32 were staged as stage 4.Seventeen out of twenty five cases(68%) with HER2 over expression received palliative therapy,in comparison to thirty five out of seventy five(46.7%) in tumours not expressing HER2.No significant difference in overall survival was demonstrated between patients whose cancers showed evidence of HER2 over expression and those who did not;median overall survival for HER2 positive tumours was 15 mo(95%CI,11-19 mo) compared to 13 mo(95%CI,9-17 mo) for HER2 negative ones.Two years cumulative survival for cases with HER2 over expression was 33.7% compared to 31.6% in cases without HER2 over expression(P = 0.576).Only cancer's stage significantly affected overall survival on both univariant and multivariable analysis(P = 0.034 and P = 0.009 respectively).None of the patients included in this study received Trastuzumab.CONCLUSION:Twenty-seven point five percent of oesophageal adenocarcinomas showed evidence of HER2 over expression.Routine testing for human HER2 in oesophageal adenocarcinomas can have significant implication on treatments offered to patients that may potentially affect their prognosis.展开更多
文摘Background and aims: Conflicting results exist about the presence of Mycobacterium avium subspecies paratuberculosis (MAP) specific IS900 DNA in Crohn’s disease (CD) tissues. Therefore, we examined IS900 in a large number of gut samples from patients with CD (n = 100) and ulcerative colitis (UC, n = 100), and in non-inflamed control tissues (nIBD, n = 100). We hypothesised that IS900 DNA detection might be associated with distinct clinical phenotypic characteristics in CD. Methods: The prevalence of MAP DNA in surgically resected tissues was examined using a mechanical-enzymatic disruption technique and nested IS900 specific polymerase chain reaction (PCR). CD patients were stratified according to the criteria of the Vienna classification and other clinical characteristics. Results: IS900 PCR detection rate was significantly higher in CD tissue samples (52%) than in UC (2%) or nIBD (5%) specimens (p < 0.0001 ). In CD patients, IS900 DNA was detected in samples from both diseased small bowel (47%) as well as from the colon (61%). No firm association between MAP specific IS900 detection rates and clinical phenotypic characteristics in CD could be established. However, corticosteroid medication constituted a factor which tended to have a negative influence on IS900 DNA detection rates in CD(p < 0.01). Conclusions: The presence of MAP specific IS900 DNA is a predominant feature of CD. Therapeutic intervention against MAP might represent a potential target for disease mitigation in Crohn’s disease.
文摘To determine patients’quality of life (QOL) after macular translocation with 360°peripheral retinectomy (MT360) for age-related macular degeneration. Prosp ective, interventional, consecutive, noncomparative case series. A prospective s tudy assessed QOL 1 year after MT360 and its relation to postoperative visual fu nction. The 25-item National Eye Institute Visual Function Questionnaire (NEIVF Q-25) and the Medical Outcomes Study 12-item short form (SF-12) health survey were used to assess vision-related QOL and general health, respectively. Surve ys were administered preoperatively and postoperatively. Postoperative NEIVFQ-2 5 QOL and SF-12 subscale scores for all patients were compared with the preoper ative scores. Preoperative and postoperative distance and near visual acuities ( VAs) and reading speed were assessed. Changes in NEIVFQ-25 QOL subscale scores were compared in patients with and without improved visual function. Postoperati ve NEI VFQ-25 QOL subscale scores in patients with distance VA of ≥69 Early Tr eatment Diabetic Retinopathy Study letters, near VA of ≥20/70, and reading spee d of ≥90 words per minute were compared with subscale scores in patients with w orse postoperative visual function. National Eye Institute VFQ-25 and SF-12 QO L scores and their association with distance VA, near VA, and reading speed. In total, 50 patients with a mean age of 76.9 years were studied. Postoperative mea n NEIVFQ25 QOL scores were higher than the preoperative mean scores, and this di fference was significant for important vision-specific subscales. Patients with improved visual function had greater mean changes in NEIVFQ-25 QOL scores than those with no improvement. Patients with the outlined higher levels of visual f unction had greater mean NEIVFQ-25 QOL scores than those who had worse visual f unction. Preoperative and postoperative mean SF-12 QOL scores were similar. Mac ular translocation with 360°peripheral retinectomy was associated with improvem ent in vision-related QOL. The amount of improvement was greatest in patients w ith postoperative improvement in visual function, and the best postoperative vis ion-related QOL was seen in patients with better postoperative visual function. This was not associated with a change in patients’general health.
文摘AIM:To determine whether serum levels of carcinoembryonic antigen(CEA) correlate with the presence of primary colorectal cancer(CRC),and/or recurrent CRC following radical resection.METHODS:A total of 413 patients with CRC underwent radical surgery between January 1998 and December 2002 in our department and were enrolled in this study.The median follow-up period was 69 mo(range,3-118 mo),and CRC recurrence was experienced by 90/413(21.8%) patients.Serum levels of CEA were assayed preoperatively,and using a cutoff value of 5 ng/mL,patients were divided into two groups,those with normal serum CEA levels(e.g.,≤ 5 ng/mL) and those with elevated CEA levels(> 5 ng/mL).RESULTS:The overall sensitivity of CEA for the detection of primary CRC was 37.0%.The sensitivity of CEA according to stage,was 21.4%,38.9%,and 41.7% for stagesⅠ-Ⅲ,respectively.Moreover,for stageⅡandstageⅢcases,the 5-year disease-free survival rates were reduced for patients with elevated preoperative serum CEA levels(P < 0.05).The overall sensitivity of CEA for detecting recurrent CRC was 54.4%,and sensitivity rates of 36.6%,66.7%,and 75.0% were associated with cases of local recurrence,single metastasis,and multiple metastases,respectively.In patients with normal serum levels of CEA preoperatively,the sensitivity of CEA for detecting recurrence was reduced compared with patients having a history of elevated CEA prior to radical resection(32.6% vs 77.3%,respectively,P < 0.05).CONCLUSION:CRC patients with normal serum CEA levels prior to resection maintained these levels during CRC recurrence,especially in cases of local recurrence vs cases of metastasis.
文摘AIM:To determine the incidence of human epidermal growth factor receptor 2(HER2) over expression in oesophageal cancers.METHODS:A retrospective study,of one hundred consecutive cases of endoscopic histological samples of oesophageal cancers from a single British cancer network were included.Cancer cases were diagnosed between April 2007 and June 2010.HER2 over expression was assessed using immunohistochemistry,those that scored "0" and "+1" were considered "negative" for HER2;those that scored "+3" were considered "Positive".Cases that were scored "+2" on immunohistochemistry further went on to have HER2 gene analysis using the Ventana HER brightfield dual-colourin situ hybridisations(HER B DISH) assay and either came back to be positive or negative for HER2 over expression.Overall survival was measured from date of histological diagnosis until date of death.93% of the cases were followed up till five years or death,and all were followed up till two years.Cases of gastro-oesophageal junctional tumours were excluded.RESULTS:The median age of our sample was 66 years(range:38-91 years).Eighty one were male and 19 female.Ninety-one of the cases were adenocarcinoma of the oesophagus and the rest were cases of squamous cell carcinoma.The anatomical distribution of the tumours was;upper oesophagus 2,middle oesophagus 11,and 87 were in the lower oesophagus.Operative resection was completed in 15 cases;seven cases had attempted surgical resections,i.e.,open and close,33 patients received definitive chemo-radiation and 52 had palliative treatment.Twenty-five of the cancers showed evidence of HER2 over expression,all were adenocarcinomas.Of the 25 cases that showed evidence of HER2 over expression,21(84%) were located in the lower third of the oesophagus.On staging,24 out of the 25 HER2 positive cases were at stage 3 or more(13 at stage 3 and 11 at stage 4),For HER2 negative cases 37 were at stage 3 and 32 were staged as stage 4.Seventeen out of twenty five cases(68%) with HER2 over expression received palliative therapy,in comparison to thirty five out of seventy five(46.7%) in tumours not expressing HER2.No significant difference in overall survival was demonstrated between patients whose cancers showed evidence of HER2 over expression and those who did not;median overall survival for HER2 positive tumours was 15 mo(95%CI,11-19 mo) compared to 13 mo(95%CI,9-17 mo) for HER2 negative ones.Two years cumulative survival for cases with HER2 over expression was 33.7% compared to 31.6% in cases without HER2 over expression(P = 0.576).Only cancer's stage significantly affected overall survival on both univariant and multivariable analysis(P = 0.034 and P = 0.009 respectively).None of the patients included in this study received Trastuzumab.CONCLUSION:Twenty-seven point five percent of oesophageal adenocarcinomas showed evidence of HER2 over expression.Routine testing for human HER2 in oesophageal adenocarcinomas can have significant implication on treatments offered to patients that may potentially affect their prognosis.
