Curative Group Research Articles

Ameliorative effect of the sea cucumber Holothuria arenicola extract against gastric ulcer in rats

Holothuria arenicola is the most important and abundant sea cucumber species in the Mediterranean Sea on the Egyptian coast. This work aimed to investigate the prophylactic and the curative effects of H. arenicola extract HaE (200mg/kg) on gastric mucosal damage following indomethacin and cold stress in healthy rats. Sixty-four rats were randomly divided into four main groups. Rats of the first group (8 rats/group) were administered distilled water orally (control group), rats of the second group (8 rats/group) were administered single oral dose of indomethacin (150mg/kg) and exposed to cold stress (4±1°C) for 30min to induce gastric ulcer (GU) model (ulcer group), rats of the third group, prophylactic group (24 rats/group) were treated with HaE and/or ranitidine (RAN) and then exposed to GU and rats of the fourth group, curative group (24 rats/group) were exposed firstly to GU and then treated with HaE and/or RAN. The results clearly indicate that pre-treatment with HaE and/or ranitidine significantly decreases the ulcer index, showing 72.50%, 53.11% and 80.56% ulceration inhibition, respectively. However, post-treatment with HaE and/or ranitidine significantly decreases the ulcer index, showing 51.66%, 62.41% and 67.78% ulceration inhibition, respectively. The results also showed that pre and post-treatment with HaE and/or RAN significantly decreased gastric malondialdehyde (MDA) level and enhanced reduced glutathione (GSH), catalase (CAT), glutathione-S-transferase (GST) and superoxide dismutase (SOD) levels. The results clearly indicate that pre-treatment with HaE is preferable.

Proton beam therapy for unresectable intrahepatic cholangiocarcinoma.

Treatment for unresectable intrahepatic cholangiocarcinoma (ICC) has not been established. The aim of the study was to evaluate the outcome of proton beam therapy (PBT) for patients with unresectable ICC. Up to 2010, 20 patients (11 males, 9 females, median age 63 years old) with unresectable ICC (two, seven, seven, and four in stages II, IIIA, IIIC, and IV, respectively) were treated with PBT. The largest dimensions of the tumors ranged from 15 to 140 mm (median: 50 mm). The intrahepatic region and lymph nodes received median total proton doses of 72.6 GyE in 22 fractions and 56.1 GyE in 17 fractions, respectively. Four patients received concurrent chemotherapy (tegafur, gimeracil, and oteracil; TS-1) during PBT. Twelve patients were treated curatively, and eight were treated palliatively because tumors were present outside the irradiation field. In the curative group, nine tumors within the irradiated field were controlled in follow-up of 8.6-62.6 months (median: 20.8 months). Median survival rates in the curative and palliative groups were 27.5 and 9.6 months, respectively, and overall 1- and 3-year survival rates were 82% and 38%, and 50% and 0%, respectively. Eight patients survived for > 2 years, and there was no distant metastasis in five of these patients after 2 years. No severe side-effects occurred. The results suggest that long-term survival can be achieved using PBT for patients with unresectable ICC without distant metastasis. Further studies are required to determine the optimal treatment schedule and best combination of PBT and chemotherapy.

Expression of CCRK in small cell lung cancer and its clinical significance

Objective To investigate the pathogenesis of small cell lung cancer (SCLC) and to explore the expression of cell cycle related kinase (CCRK) in SCLC and its clinical significance. Methods Reverse transcription polymerase chain reaction (RT-PCR) and Western blot were performed to examine expression of CCRK in SCLC and normal tissues. Results The expressions of gene [(0.51±0.11)IU/L] and protein [(0.61±0.13)IU/L] of CCRK in SCLC tissues were significantly higher than normal tissues [(0.30±0.08)IU/L, (0.34±0.09)IU/L] (P 0.05). Conclusions The expressions of gene and protein of CCRK in SCLC tissues were significantly higher than normal tissues. CCRK promoted the occurrence and progress of SCLC. Chem can restrain effectually the excessive expression of CCRK. The expressions of gene and protein of CCRK in the different clinical curative effect group had significant difference. Key words: Lung neoplasms/ME; Cyclin-dependent kinases/ME

Multiple b value diffusion-weighted MRI based on intravoxel incoherent motion model applied to lymphoma-pilot study

Objective To evaluate treatment effect of nodal lymphoma by using multiple b value diffusion-weighted MRI based on intravoxel incoherent motion (IVIM) model. Methods From November 2012 to November 2013, 22 patients with pathology confirmed lymphoma in Guangdong General Hospital were chosen. Patients were examined on a 1.5 T MR scanner with plain MRI scan and multiple b value diffusion-weighted MRI scan before and after cycle two of chemotherapy. According to chemotherapy response which evaluated after cycle 2 of chemotherapy, lymphoma nodes were divided into four groups: complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD). Kruskal-Wallis H test was used to compare prechemotherapy D value, f value among CR, PR, SD groups. Nemenyi test was used to compare prechemotherapy D value between the two of CR, PR, SD groups. One-way ANOVA was used to compare D* value among CR, PR, SD groups. Paired-sample t test was used to compare D, f, D* value between before and after chemotherapy in PR group. CR and PR group were ascribed to curative group, and SD group ascribed to poor response group. ROC curve was used to evaluate the predictive efficiency of parameters derived from IVIM. Results Twenty-two lymphoma patients were scanned before chemotherapy and 21 patients were scanned after cycle 2 of chemotherapy. There were 49 lesions in CR group, 17 lesions in PR group, 8 lesions in SD group and no lesions in PD group. Prechemotherapy D value of CR, PR, SD group were (0.63±0.26)×10-3, (0.57±0.10)×10-3, (0.42±0.04)×10-3 mm2/s, respectively. There was significant difference among the three groups (H=12.944, P=0.002). There was no statistically difference of prechemotherapy D value between CR and PR group (χ2=0.072, P=0.965). Prechemotherapy D value was lower in SD group than that in CR group (χ2=12.090, P=0.002) and PR group (χ2=10.684, P=0.005). There was no statistically difference of prechemotherapy f value among CR, PR, SD groups (χ2=2.312, P=0.315) or D* value (F=0.535, P=0.588). D value significantly increased after chemotherapy in PR group [(1.03±0.37)× 10-3 vs.(0.63±0.26)×10-3 mm2/s, t=-4.781, P=0.001]. f value significantly increased after chemotherapy in PR group [(9.39±4.52)% vs. (6.44±3.25)%, t=2.294, P=0.036]. D* value slightly increased after chemotherapy but with no statistical difference in PR group [(99.72±42.12)×10-3 vs. (90.37±45.33)× 10-3 mm2/s, t=-0.579, P=0.570]. When a D value of 0.48 × 10-3 mm2/s was used as the threshold value for predicting chemotherapy response, the best results were obtained with sensitivity of 100.00% and specificity of 75.76%. Conclusions Prechemotherapy D value can predict chemotherapy response and D value can monitor chemotherapy response in lymphoma. Key words: Magnetic resonance imaging; Lymphoma; Comparative effectiveness research

1:27 PM, Abstract No. 269 - Safety and efficacy of renal cryoablation for small renal masses: midterm follow-up

database, all patients with stage T1aN0M0 RCC (r4cm) diagnosed in 2004 to 2011 were identified. Sociodemographic trends in use of surgery vs. TA were evaluated by chi-square and logistic regression. Overall survival (OS) was estimated using Kaplan-Meier from the time of diagnosis. Difference in utilization rate of TA in 2004-2007 vs. 2008-2011 was observed. Results: Of 28351 patients with T1a lesion, 2133 (7.5%) did not receive curative therapy. Of 26218 patients who received curative therapy, the majority underwent surgical resection: 24992 (95.3%) surgical resection, 671(2.6%) CRA, 553(2.1%) (po0.001). While mean overall survival was similar between the surgery (81.1 months) and TA (81.0 months) group (p1⁄40.612). Those who did not receive curative therapy had a significantly shorter mean OS (70.4 mo; po0.001) when compared to curative group as a whole. Furthermore, mean OS for TA group was also significantly prolonged compared to no curative therapy group (po0.001). Being unmarried, Z65 years of age, being insured, living in metropolitan areas, in Pacific Coast region, and residing in areas with higher median family income demonstrated higher likelihoods of receiving TA when compared to surgery (po0.001). There was a significant increase in the rate of use of TA compared to surgery in more recent years (3.2% in 2004-2007 vs. 5.3% in 2008-2011 (po0.001)). Older age, being unmarried, living in rural areas with lower median family income and lower educational status were found to be predictor of not receiving therapy. Conclusion: There was significant disparity in the management of T1a RCC lesions, in part affected by patient’s sociodemographic determinants. In addition, there was significant underutilization of less invasive thermal ablation which demonstrated similar survivorship compared to surgery and significantly prolonged survival compared to no therapy.

The effect of curative surgery in Borrmann type IV advanced gastric cancer.

176 Background: The aims of the present study are to know the significance of curative surgery in Borrmann type IV and prove the causes related with poor prognosis by analyzing the recurrence patterns and unique diagnostic characteristics. Methods: We analyzed 168 patients with Borrmann type IV undergoing surgery at Seoul St. Mary Hospital from 1989 to 2010. We categorized the patients into curative (R0) and non-curative (R1, R2 and no-resection) group. Results: The numbers of curative and non-curative group were 91 and 77. The 3- and 5-yr OSRs of patients in curative group were significantly higher than those in non-curative group (curative: 52.4% and 33.0%, non-curative: 18.6% and 7.0%; p<0.001). In multivariate analysis, the curability was not a significant prognostic factor for survival (p=0.527). The most frequent recurrence site was peritoneum (64.7%). Most of recurrences were presented within early 2 years. The preoperative diagnostic rate of Borrmann type IV was only 50.5%. The reasons for non-curative surgery were unexpected peritoneal seeding (28.4%) and resection margin involvement (6.4%). Conclusions: The role of surgery for Borrmann type IV is quite limited. It has poor prognosis even after curative surgery, because it is very difficult to diagnose preoperatively and make curative surgery. [Table: see text]

Clinical characteristics and outcomes for gastric cancer patients over age 80: A retrospective case-control study.

30 Background: The average human life expectancy is increasing worldwide, thus proportion of elderly gastric cancer patients are also increasing. In this study, we investigated the clinical and oncologic outcomes of gastric cancer in patients over 80 years old through a case-control study. Methods: From January 2004 to December 2010, 291 patients aged over 81 years old (case group) were diagnosed and treated with gastric cancer at the Asan Medical Center. During the same period, 291 patients aged 18 to 80 years old were selected as control group. The clinical findings, histopathological parameters, and clinical outcomes of gastric cancer were reviewed retrospectively and compared between the two groups. Results: There were significant differences in overall 5-year survival rate between the two groups (30.9% vs 73.8%, P< 0.001). When analysis was confined to resectable elderly patients with favorable performance of American Society of Anesthesiologists (ASA) score 1 or 2, curative resection group showed significantly better overall 3- and 5-year survival rate than the conservative treatment group (73.7% and 58.8% vs 29.8% and 0%, respectively). In multivariate analysis, lower BMI and advanced TNM stage were found to be independent prognostic predictors for poorer survival. ASA score showed borderline significance for predictors for poorer survival (P=0.087). Conclusions: Although elderly patients showed advanced stage at diagnosis and poor prognosis compared to non-elderly patients, elderly patients with good performance could benefit from curative resection of gastric cancer, thus the clinical decision whether to undergo curative resection or conservative management should be made on individualized approach.

Toxicological Evaluation of Bee Sting in Plasmodium berghei Infected Mice

Aim: Based on the traditional and scientific claims of intra-dermal antiplasmodial activity of bee stings, its effect on liver and serum enzymes in Plasmodium berghei-infected mice were investigated. Methodology: Twenty albino mice were intra-peritoneally infected with P. berghei and divided into four animals per group. Group I was set up as negative control (parasitized untreated), group II as parasitized treated with 5 mg chloroquine/kg body weight, group III as suppressive treated, group IV as curative treated and group five as not parasitized not treated. Results: The results of serum alanine transaminase (ALT) and aspartate transaminase (AST) of the infected treated with chloroquine shows significant increase when compared to other experimental groups (p˂ 0.05). Whereas, there was increase in liver AST in group II, group III and group IV when compared to not parasitized not treated (p˂ 0.05). Also, there was significant decrease in liver ALT activity in all the experimental groups. The serum and liver gamma glutamyl transferase (GGT) showed no significant difference (p<0.05) in the curative and suppressive groups when compared to the standard drug (chloroquine). Whereas, parasitized not treated group shows significant increase (p<0.05) in the liver GGT and ALP when compared with other experimental groups. Therefore, Original Research Article Shittu and Ibrahim; IJBcRR, 6(4): 170-177, 2015; Article no.IJBcRR.2015.049 171 these increases in specific activity of the parasitized untreated group might be due to infection. Conclusion: It can be concluded that bee sting have ameliorative effect against changes caused by P. berghei.

Anti-plasmodial Activity of Bee Sting in Plasmodium berghei Infected Mice

Aim: Based on traditional claims and practice, the antiplasmodial activity of bee stings and its effect on haematological indices was investigated in P. berghei infected mice. Methodology: Sixteen albino mice were intraperitoneally infected with chloroquine sensitive P. berghei strain and divided into four groups each consisted of four animals. Group I was set up as negative control of 0.2 ml normal Saline/kg body weight, group II as 5 mg chloroquine/kg body weight, group III had suppressive treatment and group IV was administered curative treatment. The thin blood smear was used to determine the parasiteamia counts and the haematological parameters were estimated on day 7. Results: The result of percentage chemosuppression shows that bee stings suppress the parasitaemia to 56.6%. Also, the suppressive and curative groups show longer mean survival period of 15.0 and 20.0 respectively. The haematological studies show that the level of packed cell volume (PCV) and haemoglobin concentration (HB) of infected untreated group was significantly (p<0.05) lower when compare with all other experimental groups, where as chloroquine treated Original Research Article Shittu and Eyihuri; IJTDH, 6(3): 80-85, 2015; Article no.IJTDH.2015.042 81 group shows significant increase compared to the bee treated groups. The Red blood cell (R.B.C.) counts was significantly (p<0.05) lowered in infected untreated group when compare with suppressive and chloroquine treated groups. However the white blood cell (WBC) counts was significantly (p<0.05) higher in infected bee sting treated when compare to the infected untreated and infected chloroquine treated groups. Conclusion: Based on the result obtained, this study confirms the antiplasmodial activity of bee stings and suggests its potential as drug agent or lead against malaria.

Taurine accelerates alcohol and fat metabolism of rats with alcoholic Fatty liver disease.

Liver is considered to be the main organ capable of oxidizing alcohol and fat. Chronic consumption of alcohol is the major cause of liver injury and the development of alcoholic fatty liver disease (AFLD). Liver is also the main organ capable of synthesizing taurine, and the effects of taurine on liver disease have aroused great attention. In the present study, alcohol and pyrazole were administered to male Wistar rats by way of intragastric administration and combined with a high fat diet in order to establish the AFLD model. Taurine was administered in the drinking water during and after the establishment of the AFLD model. The preventive experiment lasted for 12 weeks. The curative experiment was divided into 4 and 8 weeks. Hepatic activities of ADH, ALDH, serum ALT, AST, TC, TG, HDL-C, LDL-C, NEFA and hepatic NEFA were measured. The results showed that hepatic ADH and ALDH in AFLD rats were significantly lower while serum ALT, AST, TC, TG, LDL-C, NEFA and hepatic NEFA in model group were significantly higher than normal rats (P < 0.05), and serum HDL-C was obviously lower. Serum ALT, AST, TC, TG, LDL-C, NEFA, and hepatic NEFA were decreased in taurine preventive and curative groups (P < 0.05), while hepatic activities of ADH and ALDH, serum HDL-C were significantly increased in taurine groups (P < 0.05). Observation of the pathological sections showed that taurine can significantly attenuate fatty degeneration and the deposition of the liver caused by alcohol. The results indicated that taurine presumably accelerates the metabolism of alcohol and fat in the liver, thereby inhibiting and reversing hepatic fatty degeneration in AFLD rats.

단일 기관에서 경험한 원발성 간세포암의 10년간의 변화 양상

Background/Aims: Hepatocellular carcinoma (HCC) is common cause of liver related death in Korea, and the importance of alcohol as an etiology of chronic liver disease including cirrhosis is emphasized recently. We investigated the epidemiologic changes of HCC during last 10 years in single tertiary center in Gangneung, Korea. MethodsWe retrospectively reviewed the medical records of admitted patients diagnosed as HCC in year 2002 and 2012 respectively, and their clinical characteristics were compared. ResultsA total of 214 patients were enrolled. Mean age was 60.1 years and 179 (83.6%) was male. Number of patient with cirrhosis was 160 (74.8%) and with viral hepatitis was 164 (74.8%). Chronic hepatitis B (CHB) was the most common cause of HCC patients with liver cirrhosis (61.9%), and alcohol was 14.4%. The possible curative group (by BCLC stage 0 or A) was only 36.4% (n=78), and had not decreased during the study periods (36.3 % vs. 36.6%, P=0.144), and other clinical variables also had no statistical differences. ConclusionsThe clinical characteristics of HCC including clinical stage at the time of diagnosis were not changed over the last 10 year period, and CHB was still the most common etiology of HCC in Gangneung, Korea.

Positive Psychology and Curative Community Groups: Life Satisfaction, Depression, and Group Therapeutic Factors

Yalom’s therapeutic factors are examined in the context of small quilt-making groups, revealing the presence of predominant curative factors. Additional results reveal positive well-being reported among group participants through higher life levels of satisfaction and lower levels of depression. Results of this preliminary research provide initial support for encouraging participation in community-based groups for individuals suffering from depression or among those seeking to improve life satisfaction, given the demonstrated presence of therapeutic factors and the potential to advance specific therapeutic goals.

Prophylactic and Curative Assessment of Essentiale Forte® On Carbon Tetrachloride-Induced Liver Damage in Wistar Rats

AIM: This study was to assess the prophylactic and curative effects of Essentiale forte (ESF) on carbon tetrachloride (CCl4) induced liver damage in Wistar rats.MATERIALS AND METHODS: Twenty-four adult Wistar rats were randomly divided into four groups of six rats each. Group I (control group) received 0.3 ml/kg/day of propylene glycol for one month; group II (toxic control) was given 0.7 ml/kg/day of CCl4 dissolved in olive oil (1:1,v/v) orally for 7 days; group III (prophylactic group) received 4.3 mg/kg/day of ESF for one month followed by CCl4 for one week; group IV (curative group) was treated with CCl4 for one week and subsequently received ESF (4.3 mg/kg/day) for one month. Half of the rats were sacrificed at active period, the other half after a 2-week recovery period.RESULTS: The activities of serum AST, ALT, ALP, total bilirubin level were significantly higher, total protein and GSH levels were significantly reduced in the toxic control group compared to the control group. Group III had significantly higher AST and ALT activities compared to the control rats at active period, whereas after the recovery period no significant differences were observed in almost all the parameters. Moreover, no significant differences in the parameters mentioned above were observed in group IV compared to the control rats at active and recovery period.CONCLUSION: The results of this study showed that Essential forte was better as a curative agent rather than a prophylactic agent in rats.

Clinical characteristics and adequate treatment of familial adenomatous polyposis combined with desmoid tumors.

PurposeThe objective of this study was to examine the clincopathologic characteristics and outcomes of familial adenomatous polyposis (FAP) patients with and without desmoid tumors (DTs), including the risk factors for progression of FAP-related DTs.Materials and MethodsWe reviewed the medical records and database of all patients with FAP who were treated between January 1993 and December 2011.ResultsOf 75 FAP patients, 18 (24%) were FAP with DTs. Seventeen of these had intra-abdominal DTs and one had intra- and extra-abdominal DTs. We divided the patients into two groups according to type of resection; the R0 or R1 resection group, referred to as the curative resection group (eight patients), and the R2 resection/palliative operation/medical treatment group, referred to as the palliative resection group (10 patients). Two patients in the curative resection group and two patients in the palliative group had progressed to tumor growth by the follow-up (p=0.800). In univariate analysis, DT diagnosis before or simultaneously with FAP diagnosis (DTs unrelated to surgical trauma) was a significant risk factor for tumor progression at final follow-up.ConclusionA multidisciplinary approach to DT treatment is needed, including nonsteroidal antiinflammatory drugs, anti-estrogens, cytotoxic agents, and surgery. However, the role of surgery in resectable and complicated tumors may be limited. DT unrelated to surgical trauma has a relatively poor prognosis.

Surgical resection after down-staging of locally advanced hepatocellular carcinoma by localized concurrent chemoradiotherapy.

This study evaluated the down-staging efficacy and impact on resectability of concurrent chemoradiotherapy (CCRT) followed by hepatic arterial infusion chemotherapy (HAIC) in locally advanced hepatocellular carcinoma, and identified prognostic factors of disease-free survival (DFS) and overall survival (OS) after curative resection. DFS and OS were investigated using clinicopathologic variables. Functional residual liver volume (FRLV) was assessed before CCRT and again before surgery in patients with major hepatectomy. Tumor marker response was defined as elevated tumor marker levels at diagnosis but levels below cutoff values before surgery (α-fetoprotein<20ng/mL, protein induced by vitamin K absence or antagonist-II<40mAU/mL). Of 243 patients who received CCRT followed by HAIC between 2005 and 2011, 41 (16.9%) underwent curative resection. Tumor down-staging was demonstrated in 32 (78%) of the resected patients. FRLV significantly increased from 47.5 to 69.9% before surgery in patients who underwent major hepatectomy. In addition, the OS of the curative resection group was significantly higher than the OS of the CCRT followed by HAIC alone group (49.6 vs. 9.8% at 5-year survival; p<0.001). By multivariate analysis, the poor prognostic factors for DFS after curative resection were tumor marker non-response and the presence of a satellite nodule; however, tumor marker non-response was the only independent poor prognostic factor of OS. CCRT followed by HAIC increased resectability by down-staging tumors and increasing FRLV. Curative resection may provide good long-term survival in tumor marker responders who undergo CCRT followed by HAIC.

Hepatoprotective effect of Ecballium Elaterium fruit juice against paracetamol induced hepatotoxicity in male albino rats

This study was designed to investigate the antioxidant and hepatoprotective activity of Ecballium elaterium "Fruit juice" extract against paracetamol induced hepatotoxicity in male albino rats. The hepatotoxicity was induced by acetaminophen (PCM) at dose of 400 mg/kg in male albino rats. It was administered orally once a day, every 48 h at the same time for twenty two days. The biochemical liver functional tests ALT, AST, ALP, total bilirubin, total protein, antioxidant enzymes (GR, GPx, CAT, SOD), and histopathological changes were examined. Our results showed that Levels of liver enzymes ALT, AST, ALP, G-GT and total bilirubin and MDA level were significantly enhanced by administration of acetaminophen and level of total protein while antioxidant enzymes "GR, GPx, CAT, SOD" were decreased. However, the pretreatment with The E. elaterium "fruit juice" at 1 ml/kg orally revealed attenuation of serum ALT, AST, ALP. The histopathological studies also supported the protective properties of E. elaterium "fruit juice". The area of necrosis and degeneration of hepatocytes were observed in the toxic group. The prophylactic and curative groups showed a marked protective effect with decreased necrotic zones and hepatocellular degeneration. The present results clearly demonstrate the marked antihepatotoxic effects of E. elaterium "fruit juice" extract through its antioxidant activity on acetaminophen induced hepatotoxicity in rats.DOI: http://dx.doi.org/10.3329/icpj.v3i5.18535 International Current Pharmaceutical Journal, April 2014, 3(5): 270-274

Survival results and prognostic factors in T4 N0-3 non-small cell lung cancer patients according to the AJCC 7th edition staging system.

The American Joint Committee on Cancer (AJCC) published a new staging system (7th edition) in 2009. In our study, we evaluated the survival results and prognostic factors among T4 local advanced non-small cell lung cancer (LA-NSCLC) patients in a large heterogeneous group, in accordance with this new system. We retrospectively evaluated the files of 122 T4 N0-3 M0 LA-NSCLC patients, identified according to the new staging system, treated at two centers between November 2003 and June 2012. Variables correlating with univariate survival at p<0.20 were later included in multivariate Cox regression analysis. Here, selection of relevant predictors of survival was carried out in accordance with the likelihood ratio formula with p<0.05 regarded as significant. The median age was 60 and the median follow-up period was 17.4 months. Median overall survival (OS) was 18.3 months, the 1 year overall survival (OS) rate was 72%, and the 5 year OS rate was 28%. Statistically significant predictors of survival were (p<0.20) ECOG-PS (Eastern Cooperative Oncology Group Performance Status), age, T4 factor subgroup, stage and primary treatment in OS univariate analysis. On multivariate analysis for OS ECOG-PS (p=0.001), diagnostic stage (p=0.021), and primary treatment (p=0.004) were significant. In the group receiving non-curative treatment, the median OS was 11.0 months, while it was 19.0 months in the definitive RT group and 26.6 months in the curative treatment group. There was a significant difference between the non-curative group and the groups which had definitive RT and curative operations (respectively p<0.001 and p=0.001) in terms of OS, but not between the groups which had definitive RT and curative operations. The median event free survival (EFS) rate was 9.9 months, with rates of 46% and 19% at 3 and 5 years, respectively. On univariate analysis of EFS rate with ECOG-PS, weight loss and staging, statistical significance was found only for thorax computerized tomography (CT)+18F-fluorodeoxy-glucose positron emission tomography-CT (PET-CT) use, stage and primary treatment (p<0.20). In multivariate analysis with EFS, only the primary treatment was statistically significant (p=0.001). In the group receiving non-curative treatment, the median EFS was 10.5 months while in the curative operation group it was 14.7 months. When all the primary treatment groups were taken into consideration, grade III/IV side effect was observed in 57 patients (46.6%). Esophagitis was most prominent among those that received definitive radiotherapy. Independent prognostic factors among these 122 heterogeneous LA-NSCLC T4 N0-3 M0 patients were age at diagnosis, ECOG-PS, stage and primary treatment, the last also being a significant prognostic indicator of EFS. Our findings point to the importance of appropriate staging and a multidisciplinary approach with modern imaging methods in this patient group. In those with T4 lesions, treatment selection and the effective use of curative potential should be the most important goal of clinical care.

Psychometric analysis of a Persian version of the European Organization for Research and Treatment of Cancer OG25 Quality of Life Questionnaire in oesophagogastric cancer patients.

Health-related quality of life (HRQL) is a fundamental outcome in oncology patients and quality of life (QOL) assessment requires clinically relevant questionnaires. The purpose of this study was translation and definition of measurement properties and the clinical validity of Quality of Life Questionnaire (QLQ) -OG25 module in Persian patients with oesophagus, oesophagogastric junction (OGJ) or gastric cancers. The translation procedure followed European Organization for Research and Treatment of Cancer (EORTC) guidelines. Both EORTC QLQ-OG25 and a core questionnaire (EORTC QLQ-C30) were administered to patients with oesophagus (150), OG junction (93) and gastric (32) cancer undergoing multi-modal treatments. Convergent and discriminant validity, Cronbach's alpha coefficient and known-groups comparisons were used to examine reliability and validity. In all, 275 patients (mean age 62 years) completed both questionnaires. Compliance rate was high and the questionnaire module was well accepted. We found good reliability for multi-item subscales of QLQ-OG25 (Cronbach's alpha coefficients 0.76-0.89). About 73% had TNM staging and scales distinguished between clinically distinct groups of patients. However, patients in palliative group experienced compromised functional status and worse treatment-associated symptoms than those in the potentially curative group. Test-retest scores were consistent. Multi-trait scaling analysis demonstrated good convergent and discriminant validity. Overall, the Persian version of QLQ-OG25 demonstrated psychometric and clinical validity that supports its application as a supplement to the original tool (EORTC QLQ-C30) when assessing HRQL in patients with upper-gastrointestinal (GI) cancer both in curative and palliative phases.

Retrospective Analysis of 119 Small Bowel Adenocarcinoma in Chinese Patients

Background: Small bowel adenocarcinoma (SBA) is a rare occurrence and few studies have addressed it adequately, especially in China. Methods: Clinicopathological features, survival and prognostic analysis were retrospectively done in SBA patients admitted between 2001 and 2011 in the People's Liberation Army General Hospital. Results: The study included 68 men and 51 women with a median age of 56.5 year. Tumors mainly occurred in duodenum (93.3%). Abdominal pain was the most frequent symptom (36.8%). Patients (30.3%) who received postoperative adjuvant chemotherapy had an increased, but not significant, median overall survival (MOS) rate compared to those who did not receive chemotherapy (37 vs 35 months, p = .324). One year disease free survival rate was higher in patients receiving postoperative chemotherapy (83.3% vs 71.1%). Patients survived longer in the curative surgery group (median survival time of 49.0 months) than those in the palliative group (7.0 months) (p < .001). Node-negative patients survived longer than node-positive patients (median OS: 49.0 vs 21.0 months, p = .004). Depth (95% CI: 1.013–1.517, p = .037), node involvement (95% CI: 1.234–3.890, p = .007), palliative surgery (95% CI, 2.998–10.555, p = .0005), and the site of tumor (95% CI: 0.052–0.970, p = .045) were independent predictors of OS in a multivariate analysis. Conclusions: SBA is rare and there is lack of obvious clinical manifestations. Depth, node involvement, palliative surgery, and the site of tumor are associated with a poor prognosis. Our analysis highlights the need for further studies to find out the exact role of postoperative adjuvant chemotherapy in these patients.

Antioxidant therapy prevents ethylene glycol-induced renal calcium oxalate crystal deposition in Wistar rats

Renal epithelial cell injury by reactive oxygen species is a prerequisite step in the pathogenesis of urolithiasis, and there is increasing evidence that reactive oxygen species is produced and oxidative stress (OS) is developed during idiopathic calcium oxalate nephrolithiasis. It appears that the administration of natural antioxidants has been used to protect against nephrolithiasis in human and experimental animals. Calcium oxalate urolithiasis was induced experimentally by administration of 0.75 % v/v ethylene glycol in drinking water of male Wistar rats weighing 150-200 g. Study was conducted in 4- and 8-week periods. In the 4-week period, Group 1 (control) was fed a standard commercial diet. Group 2 received the same diet with the addition of 0.75 % of ethylene glycol (EG). Group 3 received EG plus the diet, and water with additional antioxidant nutrients, and lemon juice as the dietary source of citrate (EG + AX). Group 4 was the same as Group 3, but with no EG in water. In the 8-week study protocol, Group 5 was fed the standard diet with EG in water for the first 28 days, followed with no EG. Group 6 (curative group) received the diet with EG for the first 28 days, followed by discontinuation of EG plus the addition of antioxidant nutrients. Group 7 was provided the diet with antioxidant nutrients for 8 weeks. Group 8 (preventive group) received the diet with antioxidant nutrients for 4 weeks, followed by antioxidant nutrients with EG for the next 4 weeks. Lime juice was given along the antioxidants. After treatment period, kidneys were removed and used for histopathological examination. In the 4-week study, the mean number of crystal deposits in Group 2 was significantly higher than that of animals in Group 3. After 8 weeks, animals given curative antioxidant supplementation within the second 4-week period developed fewer deposits in Group 6 as compared to Group 5 animals. In the other preventive AX loading Group 8, the number of crystal deposits was substantially less than that of either Group 2 or Group 5 animals (EG-treated rats). Results showed a beneficial effect on treating and superior renal protection for preventing stone deposition in the rat kidney. These results provide a scientific rationale for preventive and treatment roles of antioxidant nutrient complex in human kidney stone disease.