Analyzing the "correct" endpoint

The choice of QOL endpoints for a study should be based on which score will most likely change if the treatment is favorable. How the QOL change is calculated should be based on the expected amount of missing data, how many time points data will be collected, and whether extreme outliers in the scores impact results. The study should have sufficient power to detect a meaningful difference between arms (typically 10 points on a 0-100 point scale) in the chosen QOL endpoint. At the conclusion of a study, several secondary endpoints can be analyzed which can provide additional information and confirm primary endpoint results.     

Contact ureterolithotripsy by the Ho laser "Medialis H" by the firm "Dornier"

The authors describe results of application of Ho laser "Medilas H" (Dornier) in patients with uroliths located in different parts of upper urinary tracts. The results of new approaches to uroliths fragmentation in different parts of the ureter are outlined.     

Inflammation joins the "niche"

Bone marrow-derived cells have an important role in tumor metastasis and have been reported to "prime" distant tissues for tumor engraftment, although the mechanisms for their recruitment have remained unclear. A new study by Hiratsuka et al. describes an inflammatory signaling pathway that mediates the chemoattraction of myeloid and tumor cells to organ-specific metastatic sites.     

Choosing the "correct" assessment tool

We present the family vacation analogy: Vacations are fun and exciting adventures for most families, often taken through unfamiliar cities and towns. Although the territory is unknown, there will undoubtedly be at least one convenient and well-known fast food restaurant. Although not a bad choice for dining, national fast food chains are often over-utilized as the main food source for vacationers. With a little advanced planning, a vacationer can easily find other restaurants to suit their needs. Utilizing a QOL instrument is not all that different from this light-hearted analogy. For many researchers, QOL is an unfamiliar subject and the most popular QOL instruments are chosen because of convenience. For example, the SF-36 is an excellent QOL instrument, yet it is over utilized because of its popularity when a disease-specific instrument might be more appropriate. Using the algorithm (Fig 1) during the planning phase of a study, an appropriate instrument tailored to the research study can be selected. It is important to allow the scientific process to determine the instrument selection, not availability or convenience. Experience has shown that a naïve selection of a QOL instrument for a research study will likely show an inability for the QOL assessment to detect a true difference or produce meaningful results.     

Preparing the "soil": the premetastatic niche

Current focus on cancer metastasis has centered on the intrinsic factors regulating the cell autonomous homing of the tumor cells to the metastatic site. Specific up-regulation of fibronectin and clustering of bone marrow-derived cellular infiltrates coexpressing matrix metalloproteinases in distant tissue sites before tumor cell arrival are proving to be indispensable for the initial stages of metastasis. These bone marrow-derived hematopoietic progenitors that express vascular endothelial growth factor receptor 1 mobilize in response to the unique array of growth factors produced by the primary tumor. Their arrival in distant sites represents early changes in the local microenvironment, termed the "premetastatic niche," which dictate the pattern of metastatic spread. Focus on the early cellular and molecular events in cancer dissemination and selectivity will likely lead to new approaches to detect and prevent metastasis at its earliest inception.     

How to obtain the "perfect" plug

In order to obtain the "perfect" plug, distortion of the skin produced by the punch must be eliminated by reducing the pressure exerted. This can be accomplished by using a power-driven, exquisitely sharp punch and by proper saline infiltration. Other factors are also reviewed.     

Transposition "banner" flaps of the torso

Several cases with serial photographs and commentary summarize experiences with well over 200 transposition "banner" flaps on the torso. The technique allows aesthetically acceptable reconstructions on the trunk by attention to detailed planning.     

Oncogenes and tumor angiogenesis: the question of vascular "supply" and vascular "demand"

Among novel promising approaches that have recently entered the scene of anti-cancer therapy angiogenesis inhibition and targeting cancer-causing genes (e.g. oncogenes) are of particular interest as potentially highly synergistic. One reason for this is that transforming genetic lesions driving cancer progression (e.g. mutations of ras and/or p53) are thought to be causative for the onset of tumor angiogenesis and thereby responsible for build up of vascular supply which is essential for cancer cell survival, malignant growth, invasion and metastasis. However, many of the same genetic alterations that emerge during disease progression and repeated rounds of mutagenic and/or apoptosis causing therapy could alter cellular hypoxia-, growth factor- and apoptotic pathways in such a manner, as to also render cancer cells (partially) refractory to the detrimental consequences of poor blood vessel accessibility (density), ischemia, hypoxia and growth factor deprivation. As recent experimental evidence suggests, such cancer cells could therefore display a reduced vascular demand and remain viable even in poorly perfused regions of the tumor as well as possess an overall growth/survival advantage. The latter circumstance may lead to (predict) diminished efficacy of anti-angiogenic agents in certain malignancies. Therefore, we propose that analysis of oncogenic pathways and gene expression profiling of cancer cells may lead to important clues as to potential efficacy of anti-angiogenic therapies, the direct target of which is the host vasculature, but which are ultimately aimed at (indirect) destruction/control of the cancer cells population. We also suggest that oncogene (tumor suppressor)-directed therapies may help reverse diminished vascular demand of highly transformed cancer cells and thereby facilitate (sensitize tumors to) therapies directed against vascular supply of cancers and their metastases.     

"Nano": the new nemesis of cancer

Materials at nano dimensions exhibit totally different properties compared to their bulk and atomic states. This feature has been harnessed by scientists from various disciplines, to develop functional nanomaterials for cancer diagnosis and therapeutics. The success stories range from delivering chemotherapeutic molecules in nano-sized formulations to functional nanomaterials, which deliver thermal and radiotherapy at specific targeted sites. This brief review summarizes the recent developments of various nanotechnologies in cancer therapy and diagnostics, both from the research sector and the upcoming products in pipeline on its route to commercialization. Supportive engineering innovations and frontiers in nanomolecular research, with a potential to revolutionize cancer therapy, have been discussed in brief.     

"Pinch modification" of the linear advancement flap

Pinch modification of linear advancement flap is a hybrid of advancement and bilateral rotation flaps. This modification, which shortens and widens the flap, shows an increase in flap survival rate over the traditional advancement technique.     

运用EXCEL科学化管理病人信息资料

目的探讨病人资料的科学管理方法。方法建立病人资料信息目录表格,利用Excel编辑菜单及命令迅速查找、统计病人信息。结果成功建立病人资料信息目录。结论利用Excel查找、统计病人信息快捷、准确、方便。     

Intravascular lymphoma: the oncologist's "great imitator"

Intravascular lymphoma (IVL) is a rare subtype of extranodal diffuse large B-cell lymphoma with a distinct presentation. Anatomically the disease is characterized by the proliferation of clonal lymphocytes within small vessels with relative sparing of the surrounding tissue. The clinical symptoms of the disease are dependent on the specific organ involvement, which most often includes the central nervous system and skin. Because of the various modes of presentation and the rarity of IVL, the diagnosis is often made postmortem. The diagnosis is almost exclusively made by surgical biopsy of a suspected site of involvement. Advances in imaging and immunohistochemistry have led to increasing antemortem diagnosis of this lymphoma. Although some patients with this disease may be curable with aggressive therapy, further research into novel treatment strategies is needed to improve outcome. Some potential insights into future therapies may be drawn from the small amount of basic science literature relevant to this entity. This review provides a concise, up-to-date summary of IVL.