Different ART outcomes at increasing peak estradiol levels with long and antagonist protocols: retrospective insights from ten years experience

Purpose  

To evaluate the impact of high estradiol (E2) levels on assisted reproductive technologies outcomes in high responders (≥12 oocytes retrieved) according to the controlled ovarian stimulation protocol (COS) used.     

Pancreatic Secondary Lesions from Renal Cell Carcinoma

Background

Metastatic lesions to the pancreas are uncommon. The most frequent metastases are from renal cell carcinoma (RCC). We analyzed the clinical features and survival of patients with pancreatic metastasis from renal cell carcinoma.

Methods

We retrospectively reviewed the clinical records of patients with pancreatic metastases from RCC, observed in our department from January 2004 to March 2010. Follow-up continued to September 2013.

Results

In the study period 13 patients with a diagnosis of metastasis from RCC were observed in our clinic, and among them 9 pancreatic resections were performed (2 pancreaticoduodenectomy, 1 duodenum-preserving pancreatic head resection, 1 central pancreatectomy, and 5 distal pancreatectomy). Four patients did not undergo a pancreatic resection: two refused surgery, one had an endoscopic biliary stent for jaundice placed and then underwent a surgical biliary bypass, and the fourth patient was too advanced and had only an endoscopic biliary stent. The mean follow-up was 56 months (range  5–115, median  53), with one nonresected patient lost in follow-up after 38 months. Among the other 12 patients, 4 died: two for progression of disease 5 and 20 months respectively after our observation. The mean (±SEM) disease-free survival of seven resected patients with curative intent was 40 ± 11 months (median  34).

Conclusions

Pancreatic metastases from RCC are often asymptomatic. They generally present slow growth and an indolent behavior. Surgery is the treatment of choice in those patients with only pancreatic involvement, achieving long-term survival and disease-free survival.     

On-Command Drug Release from Nanochains Inhibits Growth of Breast Tumors

Purpose

To evaluate the ability of radiofrequency (RF)-triggered drug release from a multicomponent chain-shaped nanoparticle to inhibit the growth of an aggressive breast tumor.

Methods

A two-step solid phase chemistry was employed to synthesize doxorubicin-loaded nanochains, which were composed of three iron oxide nanospheres and one doxorubicin-loaded liposome assembled in a 100-nm-long linear nanochain. The nanochains were tested in the 4T1-Luc-GFP orthotopic mouse model, which is a highly aggressive breast cancer model. The 4T1-Luc-GFP cell line stably expresses firefly luciferase, which allowed the non-invasive in vivo imaging of tumor response to the treatment using bioluminescence imaging (BLI).

Results

Longitudinal BLI imaging showed that a single nanochain treatment followed by application of RF resulted in an at least 100-fold lower BLI signal compared to the groups treated with nanochains (without RF) or free doxorubicin followed by RF. A statistically significant increase in survival time of the nanochain-treated animals followed by RF (64.3 days) was observed when compared to the nanochain-treated group without RF (35.7 days), free doxorubicin-treated group followed by RF (38.5 days), and the untreated group (30.5 days; n?=?5 animals per group).

Conclusions

These studies showed that the combination of RF and nanochains has the potential to effectively treat highly aggressive cancers and prolong survival.     

CD69 is independently prognostic in chronic lymphocytic leukemia: a comprehensive clinical and biological profiling study

Background

CD69 is expressed in several hemopoietic cells and is an early activation marker in chronic lymphocytic leukemia. Chronic lymphocytic leukemia is a clinically heterogeneous disease which needs novel prognostic parameters which can be easily and efficiently managed.

Design and Methods

We investigated CD69 by flow cytometry in a series of 417 patients affected by chronic lymphocytic leukemia and compared this to other biological and clinical prognosticators.

Results

CD69 was associated with Rai stages (P=0.00002), β₂-microglobulin (P=0.0005) and soluble CD23 (P<0.0001). CD69 and ZAP-70 (P=0.018) or CD38 (P=0.00015) or immunoglobulin variable heavy chain gene mutations (P=0.0005) were also significantly correlated. Clinically, CD69 positive chronic lymphocytic leukemias received chemotherapy more frequently (74%; P<0.0001), and presented a shorter duration of response after fludarabine plus rituximab (P=0.010) as well as shorter progression free survival and overall survival (P<0.0001). CD69 demonstrated true additive prognostic properties, since the CD69⁺ plus ZAP-70⁺ or CD38⁺ or immunoglobulin variable heavy chain gene unmutated patients had the worst progression free survival and overall survival (P<0.0001). Interestingly, low CD69 expression was necessary to correctly prognosticate the longer progression free survival of patients with a low tumor burden of β₂-microglobulin (P=0.002), of soluble CD23 (P=0.020), or of Rai stages 0-I (P=0.005). CD69 was confirmed to be an independent prognostic factor in multivariate analysis of progression free survival (P=0.017) and overall survival (P=0.039).

Conclusions

Our data indicate that CD69 is significantly correlated with poor clinical and biological prognostic factors and is confirmed to be an independent disease prognosticator. This supports its introduction in a routine laboratory assessment and, possibly, in a prognostic scoring system for chronic lymphocytic leukemia, after an adequate standardization process.     

Number of lymph nodes after neoadjuvant therapy for rectal cancer: How many are needed?

Neoadjuvant chemoradiation is the standard treatment for advanced rectal tumor,providing better local control of disease and potentially increasing sphincter preservation surgery.Neoadjuvant radiation may affect the number of lymph nodes harvested after resection or alter their prognostic value.Over the past 10 years,standards for lymph node harvests in colorectal cancer have been proposed.Several studies have recommend examination of at least 12 lymph nodes(LNs) in the specimen and this number is now used as a reflection of surgical quality.Nevertheless,recent reports have identified significantly decreased LN harvests in patients treated with neoadjuvant radiation.And preoperative chemoradiation has a significant effect on the number of nodes harvested in rectal specimens and this should be considered in staging of the tumor.In the near future,the total number of nodes will be less important than specific biologic markers in detecting high-risk patients and improving their prognosis with adjuvant therapy tailored.     

Experimental Investigation on Thermal Conductivity and Thermal Diffusivity of Ex-Vivo Bovine Liver from Room Temperature down to −60 °C

Ex vivo animal tissues (e.g., bovine liver) as well as water-agar gel are commonly used to simulate both experimentally and numerically the response of human tissues to cryoablation treatments. Data on the low temperature thermal properties of bovine liver are difficult to find in the literature and very often are not provided for the whole temperature range of interest. This article presents the thermal conductivity and thermal diffusivity measurements performed on ex-vivo bovine liver samples using the transient plane source method. Regression coefficients are provided to determine these properties in different temperature ranges except for the phase transition during which no results were obtained, which suggests an ad hoc calorimetric analysis. A quick procedure is also suggested to determine the water mass fraction in the tissue. Moreover, an attempt to estimate the liver density in the frozen state using measurements performed solely at room temperature is also presented. The measured thermal conductivity and thermal diffusivity values are compared with data reported in literature highlighting a spread up to 40%. Moreover, it emerges that water-agar gel usually made with 2% by weight of agar does not show the same thermal properties as the bovine liver.