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Results for “Stage shift”

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PubMed1979

[Dynamics of the total proteolytic activity and kinin system components of the blood in acute cholecystitis].

Under study was the dynamics of changes of the activity of components of the kinin system and proteolytic activity of blood in 32 patients with acute cholecystitis. The results have shown that cholecystic patients and patients with the diseases of biliary ducts, especially in the exacerbation stage, have pronounced shifts in the kinin system components and in the proteolytic activity of blood as a whole. In clinical conditions the proteolytic activity data can be used for determining the severity and development of acute cholecystitis. The use of protease inhibitors in the inflammation of the gallbladder and biliary ducts results in a decreased blood proteolytic activity and thereby contributes to more rapid recovery of patients with such disorders.

Acute Disease↗

PubMed1978

Effects of high ambient temperature on sleep in young men.

Each of 10 normal subjects had 4 nights of laboratory-monitored sleep, consisting of adjustment, baseline, high blanket temperature (HBT), and recovery nights. EEG-EOG recordings were made on each night; rectal temperature, heart rate, body weight, and ambient temperatures were monitored throughout the last 2 nights. On the HBT night, subjects had less total sleep time, more frequent and longer awakenings, greater shifting among sleep stages, decreased amounts of stage 1 REM and stages 3 + 4, and delayed onset of deep sleep (stages 3 and 4). Body temperature was elevated to a relatively constant level of 37 degrees C on the HBT night, but gradually decreased from 36 degrees C to 34.5 degrees C across the recovery night. Heart rate decreased at a linear rate on both the HBT and recovery nights, but was 15 beats/min faster on the former. Subjects experienced liquid loss of 1.25 kg on the HBT night, but had a full recovery by the following evening.

Adult↗

PubMed1982

[Noradrenaline and plasticity of the visual cortex of the kitten: a reexamination].

We have undertaken a study of the role of the noradrenergic system in the functional modifications, observed in the primary visual cortex of the Kitten, following monocular deprivation. The lids of one eye were sutured in 5 week old Kittens for a period of 1 or 2 weeks. Noradrenergic depletion was obtained by 6-OHDA injection, either intraventricular or localized in the coeruleus complex. Our results indicate that disappearance of noradrenaline in area 17 does not prevent the loss of binocularity of cortical cells, but appears to limit ocular dominance shifts at a stage equivalent to that observed in the intact Kitten after 6 days of monocular deprivation.

Animals↗

PubMed1996

[Colorectal cancer: has its diagnosis improved in the last decade?].

OBJECTIVE: To assess whether any shift in pathologic stage, tumor resectability and need of emergency surgery has been observed in colorectal carcinoma patients over the last ten years. EXPERIMENTAL DESIGN: Retrospective study. PATIENTS: We compare 201 patients treated in our Service from January 1981 to December 1983 (Group I) with 306 patients operated from January 1991 to December 1993 (Group II). RESULTS: No change has been noticed in any of the parameters analyzed. CONCLUSIONS: We think that the efforts in earlier detection of CCR should be increased to improve the prognosis of the disease.

Age Factors↗

PubMed1997

The early detection of prostate carcinoma with prostate specific antigen: the Washington University experience.

BACKGROUND: It is not yet known whether screening for the detection of early prostate carcinoma will reduce mortality rates. However, data are available to assess intermediate outcomes from screening, including the performance characteristics of the screening tests and shifts in disease stage. METHODS: Approximately 30,000 community volunteers (mean age 60 years; <5% nonwhite) were enrolled in 1 of 3 screening studies. Volunteers were screened with PSA or PSA in combination with digital rectal examination at 6-month intervals, and prostatic biopsy was recommended for those with results suspicious for cancer. Based on a first-time screen, the current study reports screening test results, the proportion of men recommended to undergo biopsy, the proportion who actually underwent biopsy, and the carcinoma detection rates for each study, stratified by initial PSA level. The authors also report the pathologic features of screen-detected carcinomas for a subset of men who underwent radical prostatectomy and for whom complete embedding and microscopic examination of the surgical specimen was performed. RESULTS: Approximately 10% of the volunteers had PSA levels >4.0 ng/mL and 3-10% had digital rectal examination results suspicious for cancer. Overall, 9-20% of volunteers were recommended to undergo biopsy and 8-13% actually underwent the procedure. The positive predictive value for carcinoma detection ranged from 25-33% across studies. In the subset of men for whom surgical specimens were completely embedded, the majority of tumors detected had the clinicopathologic features of significant carcinoma (<10% possibly harmless). CONCLUSIONS: The intermediate outcomes for screening with PSA and/or PSA in combination with digital rectal examination are encouraging. In community volunteers these screening tests demonstrated reasonable positive predictive value and detected carcinomas at an earlier stage. The majority of screen-detected tumors had the pathologic characteristics of medically significant carcinoma.

Biopsy↗

PubMedDate not supplied

Race and the Will Rogers phenomenon in prostate cancer.

PURPOSE: With the introduction of prostate-specific antigen testing, the "Will Rogers phenomenon"--stage migration associated with more sensitive diagnostic and staging procedures--seemed likely to occur. MATERIALS AND METHODS: Yearly values of prostate-specific antigen from 1988 to 1995 were determined for whites (n = 34) and African-Americans (n = 321). Pretreatment levels were used as objective surrogates of tumor cell burden. Changes in clinical stage and pathological grade by calendar year also were determined. RESULTS: There was a statistically significant yearly decline in levels of prostate-specific antigen for African-Americans (12.2% per year). There was no significant decline among whites. Similar trends were seen on multivariate analysis that adjusted for stage and grade. There was clinical stage migration for whites and African-Americans. There was also a shift in tumor grade for both whites and African-Americans. DISCUSSION: Over the past decade, African-Americans have shown a decline in tumor cell burden at the time of diagnosis as reflected by a decline in mean levels of prostate-specific antigen. For whites and African-Americans, there has been a shift to early clinical stages. The Will Rogers phenomenon, as demonstrated in African-Americans by decline in prostate-specific antigen and in whites and African-Americans by clinical stage migration, indicates lead-time and length biases, resulting in a more favorable disease profile at diagnosis for both groups. The decline in prostate-specific antigen among African-Americans indicates that the initial higher tumor cell burden seen in the past was caused by socioeconomic factors rather than inherited differences, and is likely to be ameliorated with widespread prostate-specific-antigen screening.

Black or African American↗

PubMed2000

Fluorine-18 fluorodeoxyglucose positron emission tomography in the staging and follow-up of lymphoma: is it time to shift gears?

Positron emission tomography (PET) imaging has become a very useful technique for staging and monitoring therapy response in lymphoma, providing unique information about the biological behavior of disease. Increased fluorine-18 fluorodeoxyglucose (FDG) uptake in lymphoma is based on elevated glycolysis and longer residence time of FDG in malignant cells compared with most normal tissues. The metabolic information provided by this technique suggests that FDG-PET may be more sensitive than the anatomical imaging modalities. Computed tomography (CT) is the principal imaging modality for the staging and restaging of lymphoma. Nonetheless, this technique has significant shortcomings, particularly in the post-therapy setting. Gallium-67 scintigraphy has played an important role in monitoring response to therapy and follow-up of patients; however, the sensitivity of 67Ga depends on the subtype of lymphoma and the size and location of disease. Published results strongly indicate that FDG-PET is superior to 67Ga imaging and may be equal or superior to CT for the detection of nodal as well as extranodal involvement in lymphoma.

Fluorodeoxyglucose F18↗

PubMedDate not supplied

Evaluation of a polymorphism in intron 2 of the p53 gene in ovarian cancer patients. From the Danish "Malova" Ovarian Cancer Study.

BACKGROUND: The p53 gene is frequently mutated in various human tumours. In addition, single nucleotide polymorphisms are often observed in exons and introns of the p53 gene in normal tissues and tumours. MATERIALS AND METHODS: A total of 210 blood and tissue samples from 182 ovarian cancers (OC) and 28 ovarian borderline tumours, in addition to blood samples from 72 healthy women, were analysed. The used analyses were PCR and SSCP. The distinguishable SSCP patterns were confirmed by DNA sequencing. RESULTS: A polymorphism located at position 38 in intron 2 of the p53 gene was studied in blood and tumour tissues from Danish ovarian tumour patients and in blood from controls. Significant differences were found between the distributions of the genotypes in blood samples compared to the corresponding tissue samples (p = 0.0002). A tendency towards a significant difference in survival was observed between OC stage II patients with a shift from one genotype in the blood to another genotype in the tissue and patients with no shift (p = 0.05). In multivariate COX regression analysis restricted to stage III OC patients, the only independent factors found were shift, serum-tetranectin and age. CONCLUSION: A shift from one p53 intron 2 genotype in the blood to another genotype in the tissue may be a prognostic factor in ovarian cancer patients.

Adult↗

PubMed2006

Estimates of stage-specific survival are altered by changes in the 2002 American Joint Committee on Cancer staging system for melanoma.

BACKGROUND: The objectives of the current study were to examine how the estimated stage-specific survival is altered in the 2002 American Joint Committee on Cancer (AJCC) melanoma staging system compared with the 1997 AJCC staging system and to contrast the predictive accuracy of the 2 staging systems. METHODS: There were 5847 consecutive melanoma patients who presented to Memorial Sloan-Kettering Cancer Center from 1996 to 2004 and who were entered prospectively into a data base. These patients were staged according to both the 1997 and 2002 AJCC staging criteria. Overall survival estimates were determined using the Kaplan-Meier method. The overall predictive accuracy of the two staging systems was compared using concordance estimation. RESULTS: In total, 1035 patients were shifted to a lower stage in the 2002 staging system, whereas only 15 patients were upstaged. The number of patients with Stage I melanoma increased by 697 under the 2002 system (n = 2166 patients) compared with the 1997 system (n = 1463 patients). Because of the changes in 2002, the estimated 5-year overall survival for patients with Stage II melanoma decreased considerably, from 79% (1997) to 64% (2002). With the initiation of subgroups in 2002, it became apparent that patients with Stage III melanoma were very heterogeneous in terms of their survival probabilities (5-yr overall survival ranged from 70% in patients with Stage IIIA disease to 24% in patients with Stage IIIC disease). Furthermore, in the 2002 system, there was substantial prognostic overlap between Stage II and Stage III. Despite the increased complexity of the 2002 system, the 2 staging systems had similar concordance estimates: 58% for the 1997 staging system compared with 58% (ignoring the subgroups) and 59% (with subgroups) for the 2002 system. CONCLUSIONS: Estimates of stage-specific survival were altered substantially by the changes made in the 2002 AJCC staging system for melanoma, particularly for Stage II. Stage subgroups that were added in the 2002 system resulted in a large diversity of risk within Stage III. This must be taken into account to stratify patients properly for clinical trials. The increased complexity of the 2002 system did not improve its predictive ability over the simpler 1997 system, highlighting the importance of developing individualized risk-prediction models.

Databases, Factual↗

PubMed1998

pH is a potent modulator of erythroid differentiation.

Physiological parameters such as pH and oxygen tension probably play significant roles in the regulation of haemopoiesis in the bone marrow microenvironment, but these roles have yet to be characterized in detail. We have found that changes in culture pH (0.2 units) can cause significant changes in the culture composition of mature cells and colony-forming cells (CFCs), especially in the presence of erythropoietin (Epo). Peripheral blood (PB) CD34+ cells cultured at different pH values (7.15-7.6) were characterized using total cell counts, colony assays, morphological analysis. haemoglobin staining, flow cytometry, immunocytochemical staining, and Western blots. Cultures performed at high (7.6) pH contained greater numbers of haemoglobin-positive and band-3-positive cells. and acquired these erythroid differentiation markers sooner than standard (7.35) and low (7.1) pH cultures. Flow cytometry using CD71 and CD45RA antigens also indicated that erythroid differentiation proceeds faster at high pH and is blocked at an intermediate stage by low pH. Morphological data confirmed that high pH cultures had been shifted towards late-stage erythroid compartments as compared to low and standard pH cultures. These findings have important implications both in elucidating the regulatory role of pH in the bone marrow microenvironment and for the design of in vitro systems to study the development of erythroid cells.

Anion Exchange Protein 1, Erythrocyte↗

PubMedDate not supplied

Comparison of the UICC/AJCC 1992 and 1997 pN categories for gastric cancer patients after surgery.

BACKGROUND/AIMS: UICC/AJCC 1997 classification changes pN category. We evaluated its prognostic impact. METHODOLOGY: A total of 710 patients who underwent a > or = D2 gastrectomy were recruited. Among them, the data of 319 patients who had involved regional lymph nodes and no evidence of distant metastases were used for comparing the 1992 and 1997 pN categories. RESULTS: For 1997 category, 201 patients (64%) were pN1, 75 (23.5%) pN2, and 43 (13.5%) pN3. For 1992 category, 143 patients (44.8%) were pN1, and 147(46.1%) pN2. 29 patients (9.1%) with lymph node metastasis to the hepatoduodenal ligament were distant metastasis. The 1997 pN category was a more powerful prognostic discriminant (relative risk: 2.086) than the 1992 category. Compared to the 1992 stage classification, the 1997 one had a skewed distribution of patients with marked shift of patients of stage IIIA (105-126 patients), IIIB (116-58 patients), and IV (100-122 patients). The survival difference between stage IIIA and IIIB for the 1997 stage classification is narrower than for 1992. CONCLUSIONS: The 1997 pN category allows for estimation of prognosis superior to the 1992 category.

Adenocarcinoma↗

PubMed1985

Ontogeny of the visual system in the cuttlefish, Sepiella japonica. II. Intramembrane particles, histofluorescence, and electrical responses in the developing retina.

To study molecular and functional differentiation of photoreceptive membranes, the development of the retina in embryos of the cuttlefish, Sepiella japonica, was examined by the freeze-fracture technique, by histo-fluorescence of retinal-related protein, and by electrical responses to photic stimulation. P-face particles in the microvillar plasma membrane of the receptor cell increased in density from about 2,000/micron2 to about 6,000/micron2 during the early stages of rhabdomere formation (from stage 31 to stage 36). The size distribution of P-face particles in the microvillar and the cell body plasma membranes showed a similar monomodal pattern with a peak at 8 nm in diameter from stage 31 to 33. In the cell body plasma membrane, the size distribution pattern hardly changed throughout later stages, but in the microvillar membrane, the peak shifted progressively to 9 nm (stages 35 and 36) and then to 10 nm (stage 37). The histofluorescence of reduced rhodopsin was first visible at stage 36 in the layer of growing apical processes. The fluorescence of reduced retinochrome first appeared faintly at stage 40 on both sides of the basal lamina. Electroretinograms (ERGs) were first obtained at stage 34 when many microvilli appeared from the apical processes, increasing rapidly in amplitude with increase in regularity of the microvillar arrangement from stage 35 to 36. Early receptor potentials (ERPs) elicited by a bright light flash were first recorded at the earliest stage of the apical process formation (stage 30), increasing gradually in amplitude during development. The increase was correlated with an increase in the total number of P-face particles in the microvillar membrane within the retina. These findings suggest that the P-face particles in the microvillar membrane are associated with rhodopsin, that the receptor cells have a small amount of rhodopsin before rhabdomere formation, and that differentiation of the apical plasma membrane of the receptor cells into the functional photoreceptive membrane occurs in conjunction with its morphological differentiation into rhabdomeres.

Animals↗

PubMed2004

Monitoring stage-specific trends in melanoma incidence across Europe reveals the need for more complete information on diagnostic characteristics.

Cutaneous malignant melanoma has been characterized by rapid and steady increases in incidence and mortality in white populations. Some reports mentioned declining trends in the mean thickness of these tumours, but other studies suggested a stable incidence of thick melanomas. The aim of this study was to describe the stage distribution of melanomas across Europe, with particular reference to temporal trends. Twenty-three cancer registries provided data sets containing information on stage and histology, 21 of which were used for a general description and nine for trends analyses. Despite a preponderance of missing data, interesting patterns emerged: a less favourable stage distribution in populations with relatively low incidence, but high case-fatality rates, and a favourable trend in stage and histology distribution over time, including a shift from later to earlier stages in recent years. Early detection campaigns raising awareness for thin lesions can potentially improve melanoma survival rates. Monitoring of stage-specific trends in melanoma incidence can assess the impact of such interventions. This paper demonstrates the potential utility of high-quality, timely cancer registry data in pursuing such public health objectives and addresses the need for more complete information on diagnostic features of melanoma patients. This will allow more informative evaluations of preventive strategies.

Adult↗

PubMed1983

Nuclear magnetic resonance imaging of experimentally induced liver disease.

Experimental animal models of hepatitis, fatty liver, and hepatic iron overload were evaluated using a 3.5-kGauss nuclear magnetic resonance (NMR) imaging system. Increases in image intensity measurements and in T2 relaxation times equalled the sensitivity of histologic findings for the detection of early stages of hepatitis. A significant shift in T1 relaxation times characterized the early stages of hepatic necrosis. Liver triglyceride content correlated significantly with increases in NMR intensity measurements (p less than 0.01); however, changes in liver water content had a much greater influence on intensity, T1, and T2. Thus, it may be possible to distinguish hepatitis from benign fatty liver. Liver iron content correlated with decreases in NMR intensity measurements (p less than 0.001), and iron levels as low as 1.2 mg/g were detected. NMR may more specifically identify hepatocellular iron overload than do other techniques that do not distinguish hepatocellular from reticuloendothelial iron.

Animals↗

PubMed1998

Impact of work site health promotion on stages of dietary change: the Working Well Trial.

The stages of change construct has been applied to healthful dietary behavior in cross-sectional studies. This report examines associations of stages of change with diet prospectively and addresses whether (1) baseline stage of change predicts participation, (2) forward changes in stage movement were greater in treatment work sites, and (3) change in stage was associated with adoption of healthful diets, using data from a cohort of 11,237 employees. Findings indicate that persons in later stages of change reported higher participation levels. Employees from intervention work sites who were in preaction stages at baseline were much more likely to shift into action and maintenance stages than controls. Changes in dietary stage of change were associated with decreases in fat intake and increases in fiber, fruit and vegetable intake. Net change in diet due to the intervention was modest. Stage of change appears to be useful for understanding mediators of health promotion intervention effectiveness.

Adult↗

PubMed1998

Results after surgery in stage-I bronchogenic carcinoma.

BACKGROUND: The aim of this retrospective study was to evaluate prognostic factors for recurrence-free survival in stage-I non-small-cell bronchogenic carcinoma. METHODS: During 9 years, 338 consecutive patients were operated on for stage-I bronchogenic carcinoma. Patients with small-cell carcinoma (n = 14), prior malignancies in locations other than pulmonary (n = 41), and patients with incomplete data on prognostic factors (n = 11) were excluded. Of the remaining 272 patients 226 were men. Mean age was 63 years (40 to 81 years). The resections performed comprised 215 lobectomies and bilobectomies, 36 segmentectomies and wedge resections, and 21 pneumonectomies. According to the number of sites of dissected lymph nodes 3 subgroups were formed: group A with 0 to 4 (n = 71), B with 5 to 6 (n = 118), and C with 7 to 10 sites (n = 83). Median follow-up was 46 months. RESULTS: Three patients (1.1 %) died within 30 days of operation. In 3 patients the resection was revealed to be not radical (R1). At the end of follow-up, 191 patients were alive, 174 of these without recurrence. Eighty-one patients had died, 53 associated with tumor recurrence. Four patients had died of non-pulmonary malignancies. Twenty-two patients died of causes not related to tumor disease. In 2 patients the cause of death could not be determined retrospectively. Overall 5-year survival was 65% (95% confidence interval [CI] 58-72%), recurrence-free survival 59% (CI 51-66%). Significant prognostic factors for recurrence-free survival were T stage (relative risk [RR] 1.7 for T2 vs. T1, CI 1.0-3.0), age (RR 1.9 for >70 years vs. < or =70 years, CI 1.1-3.1), adeno cell type (RR 2.3 vs. squamous cell, CI 1.4-4.0), as well as lymphangiosis carcinomatosa (RR 2.3, CI 1.2-4.4). Extent of operative resection, extent of lymphadenectomy, and sex did not influence survival. CONCLUSION: 5-year survival of our patients was in the range reported in literature. Most patients died of distant metastases. Our retrospective study probably underestimated the occurrence of second primary cancers of the lung. Limited resection in poor-risk patients showed equivalent results to lobectomy. The extent of lymph-node resections had no influence on survival of stage-I patients, however, it must be remembered that positive results in lymph nodes shift patients to higher stages.

Carcinoma, Bronchogenic↗

PubMed2006

Intra-dimensional/extra-dimensional set-shifting performance in schizophrenia: impact of distractors.

BACKGROUND: We sought to determine if a representative group of young chronic patients with schizophrenia would demonstrate selective impairments in set shifting processes of the CANTAB Intra-dimensional/extra-dimensional (IDED) task. We predicted that patients would have prominent difficulties with Compound Discrimination (C_D) (stage of the task in which irrelevant stimuli are introduced) and Extra-Dimensional Shifting (EDS) (stage of the task in which a new stimulus dimension must be attended) on the basis of the results of cortical hypodopaminergic states in subhuman primates (for C_D) and effects of dorsolateral prefrontal cortical lesions on set shifting and prior results in schizophrenia (for EDS). METHODS: We administered the IDED to 36 patients and 26 healthy controls. Additionally, we administered the Wisconsin Card Sorting Test (WCST), another test of set shifting, and a Continuous Performance Test (CPT) type task of attention to patients with schizophrenia in order to investigate which cognitive components accounted for performance difficulties at different stages of the IDED task. RESULTS: Patients had selective difficulties on C_D and EDS stages of the task. In schizophrenic patients early stages of the task involving the introduction and establishment of attentional set were correlated to CPT performance, while later set shifting stages were correlated with WCST categories attained. CONCLUSION: We found evidence that patients with schizophrenia were susceptible to introduction of unreinforced irrelevant stimuli at the C_D stage, such that the previously rewarded target stimuli no longer held hegemony as a representation. This type of processing failure may reflect difficulties in stabilizing a representation and is consistent with effects of prefrontal hypodopaminergia in primates. Secondly, "survivors" of this stage experienced marked difficulties on EDS-stage, suggestive of classic prefrontal failures.

Adult↗

PubMed1999

Stage-specific homeotic vertebral transformations in mouse fetuses induced by maternal hyperthermia during somitogenesis.

To investigate the heat shock effects upon somitogenesis and specification of the vertebral identity, pregnant ICR mice were briefly exposed to 42 degrees C or 43 degrees C at E7.5, E8.5, or E9.5 (noon of the plug day = E0.5). Heat treatment induced embryonic day-specific vertebral transformations whose frequency and severity were dependent on the temperature elevation. Following a heat treatment at E8.5, the vertebral identity of T6 through S1 was shifted anteriorly by one or two segments (posterior transformations). Such shifts were found in more than one-third of the fetuses heat-stressed at 42 degrees C, and in over 90% of those exposed to 43 degrees C. When heated at E7.5, the anterior boundary of vertebral transformations was shifted cranially to cervical levels (C1-C7), and when heated at E9.5, it was shifted caudally to the lower thoracic and lumbar levels (T13-L4). Examination of Hox gene expression domains by in situ hybridization showed that the anterior boundaries of Hoxa-5, Hoxa-7, Hoxc-8, and Hoxc-9 expression domains in the paraxial mesoderm were shifted cranially by one somite segment in embryos heated at E7.5, as compared with the corresponding levels of their expression in control embryos. Such cranial shifts were found for Hoxa-7, Hoxc-8 and Hoxc-9, but not for Hoxa-5, in embryos heated at E8.0. In embryos heated at E8.5, only the expression domains for Hoxc-8 and Hoxc-9 were found to be shifted. The observed stage-specific vertebral transformations and shifts of the Hox gene expression domains were consistent with the temporal colinearity and posterior predominance of Hox gene expression during development. Further histological and cytochemical analyses revealed that heat-induced vertebral transformations may not be a result of induced cell death, but heat-induced transient arrest of cell proliferation and somitogenesis could result in altered expression of Hox genes and subsequently produce vertebral transformations.

Animals↗