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PubMed2005

A prospective analysis of immunohistochemically determined estrogen receptor alpha and progesterone receptor expression and host and tumor factors as predictors of disease-free period in mammary tumors of the dog.

The immunohistochemically determined estrogen receptor (ER) alpha (ERalpha) and progesterone receptor (PR) status, as well as recognized, well-accepted prognostic indicators and host factors were prospectively analyzed in 84 cases of primary canine mammary carcinoma for their effect on disease-free period (recurrence free, metastasis free, or combined) (DFP) after an observation period of 18 months. The presence of one or both receptors, as well as tumor size, lymph node status, histologic grading, intravascular growth, and necrosis, were of prognostic value for DFP. In multivariate analysis, only tumor size and histologic grading proved to be independent prognosticators. None of the host factors analyzed were of prognostic value for DFP. ERalpha, PR, or both were detected in 173 out of 228 tumors: 70 ERalpha and PR; 5 ERalpha only; 98 PR only. Statistically significant differences regarding the presence of one or both receptors were observed between benign and malignant tumors and between complex, mixed, and simple histologic subtypes of benign and malignant tumors. In the group of malignant tumors (n=155), the presence of one or both receptors was more frequent in tumors smaller than 3 cm, without lymph node metastasis, with tubulopapillary rather than solid patterns of growth among simple carcinomas, of histologic grades I and II, without both intravascular growth and necrosis, and with lymphocyte cell infiltrates. The most frequent groups of hormone receptors-positive tumors were the ERalpha-positive and PR-positive group among benign and the ERalpha-negative and PR-positive group among malignant tumors.

Animals↗
PubMed1991

[Clinical course of amyotrophic lateral sclerosis during life support care].

The authors provide the data on lateral amyotrophic sclerosis (LAS) in 11 patients whose life was extended during respiratory failure by respiratory resuscitation and intensive care. The disease was established to run a cyclic course. The following clinical disease periods were distinguished: period of precursors, local motor disorders period, and period of initial and marked generalization. De-efferentation was the final period. The latter one was characterized by the arrest of all motor functions, namely by total paralysis with the exception of the function of oculomotor nerves. Motoneurons of the truncus cerebri nuclei disintegrated much more slowly than those of the spinal cord. The phase of de-efferentation lasted 8 years whereas the total disease period reached 23 years. Intellectual functions were preserved whatever the disease periods. Slow progress of motoneuronal disintegration enables using the respiratory systems both inpatiently and at home. Respiratory resuscitation and intensive care can be employed, if the patient and his relatives give their consent.

Adolescent↗
PubMed2006

The EGF A61G polymorphism is associated with disease-free period and survival in malignant melanoma.

An earlier study reported that a common polymorphism in the 5' untranslated region of the epidermal growth factor (EGF) gene is associated with increased risk for cutaneous malignant melanoma (MM) and Breslow thickness. Since then, several independent studies have reported conflicting results that have challenged this hypothesis. However, none of the previous studies examined survival as the primary outcome. We therefore sought to study the association between this polymorphism and survival. One hundred and thirty patients diagnosed with MM with a Breslow thickness of >1.5 mm were included in this study. In our collective, the G/G genotype represented a significant risk factor for both shorter disease-free period (hazard ratio of 2.246, 95% CI: 1.06-4.78, P=0.036) and overall MM-specific survival (hazard ratio of 3.8, 95% CI: 1.5-9.5, P=0.004) compared with the A/A genotype, while the heterozygous A/G genotype showed an intermediate risk. In the present study, we demonstrate for the first time that the EGF A61G polymorphism is associated with survival. Our data suggest that this polymorphism is a potential marker for disease severity that predicts earlier progression of MM.

5' Untranslated Regions↗
PubMed2004

"Late" regressions of metastases from renal cancer after a period of disease progression continuing the same intermittent low dose immunotherapy regimen.

We here describe two patients with metastatic renal cell cancer (mRCC) treated with immunotherapy in whom the metastases completely regressed after a period of progressive disease. The treatment schedule was based on repeated cycles of low-dose recombinant interleukin-2 and recombinant interferon-alpha, and was never changed during the course of the disease. The first patient received immunotherapy because of multiple bilateral lung metastases. Progressive disease, with mediastinal lymph node involvement and an increased number of lung metastases, was observed after 30 months of regularly repeated therapy; complete regression was achieved after 60 months of immunotherapy (after 16 immunotherapy cycles). The second patient began immunotherapy because of three small lung metastases. Disease progression was observed after three cycles, but complete regression was obtained about 16 months after the start of immunotherapy (after 5 immunotherapy cycles). Long-term low-dose immunotherapy may bring about an effective anti-tumour response even late in the course of the disease and after an initial disease progression.

Adenocarcinoma, Clear Cell↗
PubMed2001

Identification of multiple quantitative trait loci linked to prion disease incubation period in mice.

Polymorphisms in the prion protein gene are known to affect prion disease incubation times and susceptibility in humans and mice. However, studies with inbred lines of mice show that large differences in incubation times occur even with the same amino acid sequence of the prion protein, suggesting that other genes may contribute to the observed variation. To identify these loci we analyzed 1,009 animals from an F2 intercross between two strains of mice, CAST/Ei and NZW/OlaHSd, with significantly different incubation periods when challenged with RML scrapie prions. Interval mapping identified three highly significantly linked regions on chromosomes 2, 11, and 12; composite interval mapping suggests that each of these regions includes multiple linked quantitative trait loci. Suggestive evidence for linkage was obtained on chromosomes 6 and 7. The sequence conservation between the mouse and human genome suggests that identification of mouse prion susceptibility alleles may have direct relevance to understanding human susceptibility to bovine spongiform encephalopathy (BSE) infection, as well as identifying key factors in the molecular pathways of prion pathogenesis. However, the demonstration of other major genetic effects on incubation period suggests the need for extreme caution in interpreting estimates of variant Creutzfeldt-Jakob disease epidemic size utilizing existing epidemiological models.

Animals↗
PubMed1989

[Ecologic dynamics of infectious diseases. II. Periodic recurrence of epidemics].

The incidence of hepatitis, mumps, poliomyelitis, scarlet fever, pertussis and measles from 1954 to 1984 was studied from the annual records of infectious diseases. Fluctuations were evaluated by Fourier analysis. Periodic recurrency was detected for poliomyelitis, scarlet fever, pertussis and measles and was likely for mumps. The asynchronic fluctuation of the proportion of cases and susceptible individuals is considered to be the origin of this phenomenon. Observed fluctuations corresponded to those predicted by the models.

Chile↗
PubMed1991

[Content of free and bound water fractions and adhesion properties of sputum in patients with acute focal pneumonia].

Dilatometry was used to measure the sputum content of free and bound water in 28 patients with acute focal pneumonias during the acute period of the disease and in the phase of remission. The adhesion properties of the sputum were studied in parallel. The status of the mucociliary defense system was assessed in terms of the time of excretion with the sputum of inhaled own hemoglobin. During the acute disease period, changes in tracheobronchial secretion were identified. They were manifested by high adhesion of the sputum, an increase in it of bound and a reduction of free water fractions. The rate of mucociliary transport was appreciably lowered. During remission, water fractions were found to be redistributed at the expense of the rise of free and decrease of bound ones. That was associated with a decrease of the adhesion properties of the sputum and normalization of mucociliary transport. Therefore, the measurement of water fractions in the sputum is an important diagnostic criterion for evaluation of the status of the mucociliary defense system.

Acute Disease↗
PubMed1994

[Diagnosis of peripheral joint involvement in children].

The diagnosis is assessed by a meticulous anamnesis, the research of associated clinical signs and the duration of the follow-up. If the clinical onset is recent (< 15 days), bacterial osteo-arthritis is to be treated in emergency; traumatic causes are easily advocated; reactive arthritis is infrequent. If the articular disease has been persistent or recurrent for 15 days to 3 months, and because of the urgency of the treatment, it should be unacceptable not to recognize a leukaemia or a metastatic neuroblastoma; the same is true for bacterial origins and some of the vascular alterations of growth cartilage. Reactive arthritis, frequently due to a digestive infection, has also to be considered. The localised articular lesions of traumatic or malformative origin, may be diagnosed by magnetic resonance imaging and arthroscopy. When the duration of the articular disease exceeds 3 months, the diagnosis of juvenile chronic arthritis, spondylarthropathy and connectivitis (disseminated lupus, panarteritis, dermatomyositis) or of some rare systemic diseases (Behçet, sarcoidosis, periodic disease) has to be considered. The non somatic and/or psychogenic causes must be accepted only if any organic disease has been excluded. The diagnosis of the so-called "growth pains" remains too often a medical error.

Acute Disease↗
PubMed1988

Creutzfeldt-Jakob disease without periodic sharp wave complexes: a clinical, electroencephalographic, and pathologic study.

A comparison of clinical, EEG, and pathologic features was carried out on all cases of autopsy-proven Creutzfeldt-Jakob disease (CJD) studied over the last 10 years. Periodic sharp wave complexes (PSWCs) were present in three but absent in seven patients. Myoclonus was documented in two of the three with and in only one of the seven without PSWCs. The three with PSWCs had severe neocortical and at least mild thalamic involvement; those without PSWCs had more variable disease topography. The diagnosis of CJD should not be rejected if PSWCs are absent.

Aged↗
PubMed2006

Dependence of heart rate variability on heart period in disease and aging.

The aim of this study was to compare the dependence of heart rate variability (HRV) on heart period (RR interval length) under different physiological and pathological states in order to detect changes in HR modulation. The dependence of HRV on the RR interval length in healthy elderly subjects, congestive heart failure (CHF) patients and one patient with a transplanted heart (T) was compared with healthy young subjects. Spectral powers, sample entropy (SampEn) and short-term fractal scaling exponent (alpha1) were determined from 24 h free-running recordings. For the same HR, HRV measures were different in different groups. In healthy subjects HRV measures depended on RR interval length and all spectral powers were highly correlated, although reduced in elderly subjects. SampEn at high HR was the most sensitive quantity to changes induced by aging. In disease, CHF and T, an achievable HR range was decreased, all spectral powers were reduced, but correlated, and the dependence of HRV measures on RR was lost. There was an evident difference in the dependence of nonlinear on linear measures between young subjects and all the other studied groups. In disease the reduction in autonomic control was associated with the decrease in short-range correlation and regularity in RR series. We have concluded that the analysis of HRV measures as functions of RR interval length can reveal important aspects of HR control that might be lost in averaging.

Adult↗
PubMed1992

[Significance of the so-called symptomless periods of disease].

Considerable change has occurred to nosology due to the advent of electron microscopy and its use in investigations of pathological processes. These investigations have shown that morphological alterations under the impact of pathogenic factors may persist for extended periods of time without any clinical manifestation due to soon effectiveness of mechanisms of compensation in the form of regeneration and hyperplasia of cells and intracellular ultrastructures (intracellular regeneration). Clinical symptoms will not grow manifest until regeneration and hyperplasia are not capable any more of compensation for tissue lesions that have resulted from dystrophy and necrosis. This is likely to offer an explanation for delay of treatment, when a patient will not see a physician until the disease has become incurable. It is the established purpose of early diagnosis to detect structural alterations in organs during the asymptomatic preclinical period, that is before the disease has reached an advanced stage. The idea of "primary existent functional and secondarily added morphological alterations" is just as erroneous as that of the existence of "purely functional diseases". Such outdated concepts used to be based on underestimation of compensatory reactions of the organism and the enormous role played by them in the development and outcome of pathological processes.

Disease↗
PubMed1990

[Vascular permeability, microcirculation and biologically active substances in patients with hemorrhagic fever with renal syndrome].

As many as 56 patients with associated hemorrhagic fever and the renal syndrome were examined for vascular permeability, microcirculation and blood plasma histamine, serotonin, kallikrein and prekallikrein. In all the disease periods, the majority of the patients (n-52) demonstrated a rise of vascular permeability for protein and liquid part of the plasma, with this being marked in particular in the oligoanuric period. Besides, significant perivascular and intravascular changes in microcirculation were noted in the oligoanuric and polyuric disease periods. It was established during examination of biologically active substances that the greatest shifts were experienced by the kinin system. Sometimes the content of kallikrein surpassed the control values more than 7-fold. Less pronounced changes were seen in blood plasma serotonin and histamine. A direct correlation was established between vascular permeability, microcirculation and the content of all biologically active substances explored by the authors. The strongest correlation was found to exist between the above parameters and the kinin system of blood plasma.

Acute Disease↗
PubMed1991

[The functional status of the endocrine pancreas in patients with acute intestinal infections].

RIA was used to measure the content of insulin, C-peptide and glucagon in blood plasma of 84 patients with acute dysentery and food toxicoinfections. The studies were carried out in the acute disease period and before the discharge from hospital. The data obtained indicate that despite the appreciable differences in the disease pathogenesis, the pathophysiological mechanisms influencing pancreatic function are similar in many respects. The changes are characterized by an increase in plasma insulin and a reduction in C-peptide and glucagon. The content of hormones in the peripheral blood is dependent on the disease period. In the authors' opinion, despite the high insulin content, the reduced level of C-peptide attests to hypofunction of beta-cells in acute intestinal infection, since it reflects their function more precisely. The reduced content of plasma glucagon points to hypofunction of alpha-cells.

Acute Disease↗
PubMedDate not supplied

[Effect of PSA nadir and the time to nadir in the disease-free period in localized prostatic carcinoma treated with radical radiation].

OBJECTIVE: To evaluate the prognostic significance of PSA nadir (nPSA) and the time to nadir in disease free of recurrence (DFR) in localized carcinoma of prostate treated with radical radiotherapy (RTR). MATERIAL AND METHODS: From October 1984 to December 1998, 86 patients have been treated with prostate carcinoma. It was considered of Low risk those patients with PSA < or = 10 ng/ml, Gleason = 6 or stage T1-T2. Moderate risk: those with one elevated of the three parameters. High risk: two or more parameters. The treatment was carried out in a lineal accelerator using photons of 15 MV, with standard technique and frationation, administering a median dose of 66 Gy (58-75 Gy). It was defined disease free of recurrence (DFR), the time to clinical PSA or biochemical failure. This one was defined as the time starting from the date of nadir PSA to the second consecutive increase of PSA value after three separate serial measurements separated for at least one month. RESULTS: The median of initial PSA value was of 16 ng/ml (1-270), initial clinical stage T1-T2 (70p), stages T3-T4 (14p), and unknown in 2p. The median of Gleason score was 6 (2-10). According to the group of risk they were classified as: low risk in 16 patients (19%), moderated risk in 22 patients (26%), high risk in 21 patients (24%), and unknown in 27 patients (31%). Median nPSA value was 0.8 ng/ml (limits: 0-139) and the median time elapsed between the initial PSA and nPSA has been of 11 months (limits: 0-72 months). The actuarial DFR projected to five years in those patients with nPSA = 1 ng/ml was of 67% vs. 47% in patient with nPSA figures > 1 ng/ml (p = 0.0018). The PFD in patients with time to nadir (t nadir) < 12 months it was of 20% vs. 80% in patients with t nadir > 12 months (p < 0.0001). Multivariate analysis demonstrated that time to nadir (H.R: 0.11 p = 0.001), group of risk (H.R: 28.72 p = 0.020), and grade of differentiation (HR: 28.72 p = 0.010), were determinant to DFR. CONCLUSIONS: nPSA is an important factor to determine the objective response to radiotherapy. nPSA and time to nadir are prognostic factors that influences significantly on the DFR. The indication of adjuvant treatment in those patients with unfavorable prognostic factors such us those who do not reach nadir PSA < or = 1 ng/ml and time to nadir < or = 12 months, deserves the realization of a prospective study.

Aged↗