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PubMedDate not supplied

[Locoregional recurrences of rectal cancers. Disappointments and hopes apropos of 54 cases].

From January 1985 to December 1993, 54 locoregional recurrences (LRR) of rectal cancer (RC) led to 30 surgical procedures, including 20 resections, of which 10 were palliative. There were 10 abdominoperineal resections (APR), 4 anastomotic resections, 4 Hartmann procedures, 2 tumoral excisions (eight of these operations were extended to other organs, locally or not). Median survival was 22.5 months after excision, 10.2 months after colostomy alone and 16.6 m in inoperable cases. Six patients are alive with recurrence and 7 without (median 31.5 months) of whom one 74 months after receiving extended APR with Bricker-type total cystectomy. Our review of the literature has shown how difficult and disappointing the treatment of LRR of RC is, and the need for early detection. Immunoscintigraphy with monoclonal antibodies (IS), which is only rarely mentioned in other published surgical studies, was used for 7 patients when diagnosis could not be made after usual explorations. IS confirmed the diagnosis of LRR in 5 cases and excluded it in the other two. IS (sensitivity: 90-100%, specificity: 79-97%), which is more accurate than CT scan or dynamic MRI, should be used at the slightest doubt during follow-up and contribute with echo-endoscopy to detect LRR early. Among the new techniques which could improve the prevention and treatment of LRR, we have used intraoperative radiotherapy (IOR) for the past year in 32 patients (including 15 invasive RC and 3 LRR of RC). In a study of LRR topography to find an eventual association with IOR, we found the following: on the one hand, no significant difference in distribution of the 54 LRR according to the anatomic quadrant of the pelvic-peritoneal cavity; on the other, an LRR site which differed 8 times from that of the primary tumour in the 31 cases in whom the latter was not circumferential.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1995

[Disappointing results of postanal repair in the treatment of fecal incontinence].

OBJECTIVE: To evaluate the long-term results after postanal repair in patients with faecal incontinence. DESIGN: Retrospective study. LOCATION: Rotterdam. METHODS: Thirty-seven patients, who underwent postanal repair during the period 1984-1992, were approached by telephone to determine the current functional status. RESULTS: The median duration of follow-up was 38 months (range: 4-94). One year after the operation 24 patients (65%) were continent. In 22 patients this successful outcome was observed within the first half year. In seven patients (29%) incontinence recurred. In 13 patients (35%) the functional results were disappointing from the very beginning. The final outcome, which was good in 46% of the patients, was not influenced by the underlying aetiology. CONCLUSION: Postanal repair is not beneficial for the majority of patients with faecal incontinence. Therefore, it should be considered if other treatment modalities, such as biofeedback and the electrically stimulated M. gracilis neosphincter might not be preferable.

Anal Canal↗
PubMed1997

[Disappointing response of chronic C hepatitis to interferon].

From February 1990 to August 1995 we treated 58 patients with chronic hepatitis C alfa-interferon, 3 million units 3 times weekly for 6 months. Of the 48 patients with adequate follow-up, 34 did not respond to treatment at all. 10 patients responded, but within a few months hepatic enzymes again increased. These 2 groups can be considered failures of interferon treatment. In 4 patients enzymes remained normal for the duration of follow-up, (10-34 months). Even in this small group, 1 patient had a positive test for HCV RNA after completion of treatment. A partial explanation of our disappointing results may be the high prevalence of a subtype of C hepatitis-subtype 1b, which has recently been reported in Israel. This strain is particularly resistant to interferon. The means to define subtypes were not, and as far as we know are not yet available in Israel. Various groups have attempted to improve the outcome of treatment of hepatitis C, which in other hands too was still far from satisfactory. Thus, regimens of interferon utilizing higher doses and longer periods of treatment are being evaluated, as well as the addition of Ribavirin, which hopefully will improve results.

Antiviral Agents↗
PubMed1992

Immunodiagnosis of neurocysticercosis. Disappointing performance of serology (enzyme-linked immunosorbent assay) in an unbiased sample of neurological patients.

To ascertain the reliability of serological diagnosis of neurocysticercosis in the everyday a priori situation of neurological consultation, the enzyme-linked immunosorbent assay test was used to predict the eventual diagnosis of neurocysticercosis in an unselected sample of 1064 consecutive neurological cases. Results showed 69% sensitivity and 71% specificity of the enzyme-linked immunosorbent assay test for the diagnosis of neurocysticercosis. In sharp contrast with publications that have proclaimed the excellent diagnostic performance of immunodiagnostic tests, our results suggest that identification of serum antibodies with standard enzyme-linked immunosorbent assay techniques is of little value when applied to a large and heterogeneous group of neurological patients in an endemic area of cysticercosis, and our results urge a reevaluation of currently used immunodiagnostic tests that are practiced in the serum of suspected cases.

Central Nervous System Diseases↗
PubMed1987

Disappointing follow-up findings for indigent high-risk newborns.

Indigent populations have received little attention in neonatal follow-up studies. We conducted "blinded" evaluations one year past term for 204 indigent high-risk infants who were ventilator treated or had a very low birth weight (VLBW) (less than or equal to 1500 g) and 85 healthy term controls from families similar to those of the high-risk infants. Marked developmental delay (Bayley Mental Developmental Index, less than 70) or gross motor abnormality occurred in 2% of controls, 27% of VLBW infants, 33% of ventilator-treated infants, and 39% of ventilator-treated VLBW infants. Despite considerable effort to prevent attrition, 43% of high-risk survivors were unavailable for follow-up at the one-year visit. Even if all of these infants were assumed to be normal, the incidence of developmental delay exceeded that in 11 of 12 recent studies. Indigent high-risk infants deserve considerable follow-up attention because of their high rate of attrition and developmental delay.

Anthropometry↗
PubMed2005

Correction of the CF defect by curcumin: hypes and disappointments.

Cystic fibrosis (CF), the most-common lethal hereditary disease in the white population, is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The mutation that is most frequently responsible for the disease, DeltaF508, causes misfolding and retention of the CFTR protein in the endoplasmic reticulum. This leads to a series of cellular dysfunctions and results in a multi-organ disease. In a recent report, Egan et al.(1) demonstrated that curcumin, a non-toxic natural product and major constituent of turmeric spice, corrected the CF defects in DeltaF508 CF mice. This paper aroused a lot of attention and hopes were raised that curcumin might produce similar effects in human, giving an efficient treatment for most CF patients. However, skepticism is growing since subsequent studies fail to reproduce these initial exciting results. Thus, although herbal medicines and dietary supplements can be desirable alternatives to classical pharmacological compounds, their efficacy needs careful evaluation both in vivo and ex vivo.

Animals↗
PubMed2001

Past expectations, present disappointments, future hopes or psychopathology as the rate-limiting step of progress in psychopharmacology.

In 1974 I published a paper in which we predicted that biological depression research would lead to new, innovative antidepressants, to more sophisticated prescription of antidepressants and ultimately to 'functional psychopharmacology'. These expectations have not materialized. The reasons why are discussed and the conclusion is reached that there are reasons to believe that, belated, they will come true. I consider it no bold venture to uphold them. Copyright 2001 John Wiley & sons, Ltd.

Journal Article↗
PubMed1979

Advances and disappointments, indications and restrictions regarding HLA-matched corneal grafts in high risk cases.

54 corneas, 49 high risk cases and 5 low risk cases, were grafted with HLA-matched donor material. The importance of antigen compatibility especially in high risk cases is demonstrated. The percentage of irreversible rejections and reversible rejections in this group is markedly smaller as compared with our own "at random" material and the "at random" material of other authors. The follow-up period is 3--21 months.

ABO Blood-Group System↗
PubMed1987

Toxicology, disappointments and promise.

The development of toxicology during the past 50 years is traced, with particular reference to chronic testing and carcinogenesis. The increasing dichotomy between the study of human disease and the accumulation of routine experimental data is examined. It is suggested that a drastic change is needed in toxicological approaches that replaces rote testing with more thoughtful scientific research. The relationship between toxicology and human disease needs to be re-emphasized and the medical profession encouraged to take a more active role in this field.

Animals↗