The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)

Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. Of note, the early mortality rate was reduced to 7.5%. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries.

Characterization of the mechanisms underlying the crosstalk between galectins and notch in gastric cancer

Gastric cancer is the fourth most common cancer and the second leading cause of cancer-related deaths worldwide. Galectins form a family of β-galactosides binding proteins that recognize a variety of glycan-containing proteins at the cell surface and are overexpressed in various tumors, including gastric cancer. Galectins overexpression as well as changes in their subcellular distribution has been associated with gastric cancer progression and poor prognosis. It is not well understood, however, how the interaction between galectins and glycosylated receptors modulates tumor development and growth. Since Notch receptors and ligands contain glycan structures known to bind galectins, we aim to demonstrate that galectins expression in the tumor microenvironment may interfere with Notch signaling activation during tumor development and progression. Materials and methods Immunoprecipitation procedures with gastric cancer cell line AGS (ATCC CRL-1739) and MKN45 (ACC 409) were used to test for association between galectin-1/-3 and Notch-1 receptor. Furthermore, we transfected AGS cell line with siRNA against galectin-1/-3 or scramble using standard protocols (IDT DNA technologies), stimulate them with immobilized human recombinant delta-4 or Jagged-1 and assessed Notch-1 receptor activation. Results Galectin-1 and -3 interact with Notch-1 receptor and differentially modulate Notch signaling pathway upon activation by Delta/Jagged ligands. Galectin-1 knockdown alters Notch-1 activation induced by Delta-4 whereas galectin-3 knockdown alters jagged-1-mediated Notch-1 activation. Furthermore, we found that exogenously added galectin-3 can enhance Notch-1 activation by Jagged-1. Conclusion Our results suggest that galectin-1 and -3 interact with Notch-1 receptor and differentially modulate Notch signaling activation induced by Jagged-1 and Delta-4.

Effects of the administration of pentoxifylline and prednisolone on the evolution of portal fibrogenesis secondary to biliary obstruction in growing animals: immunohistochemical analysis of the expression of TGF-β and VEGF

OBJECTIVE: During the neonatal and infancy periods, some chronic liver diseases may lead to progressive hepatic fibrosis, which is a condition that can ultimately result in the loss of organ function and severe portal hypertension necessitating hepatic transplantation. In a previous report, pharmacological interventions were demonstrated to modulate hepatic fibrosis induced by bile duct ligation in young rats. The administration of pentoxifylline or prednisolone, or the combination of both, resulted in reduced fibrogenesis in portal spaces. The objectives of the present study were to evaluate the expression of transforming growth factor β and vascular endothelial growth factor after bile duct ligation in young rats and to assess the effect of those same drugs on cytokine expression. METHODS: In this experimental study, 80 young rats (21 or 22 days old) were submitted either to laparotomy and common bile duct ligation or to sham surgery. The animals were allocated into four groups according to surgical procedure, and the following treatments were administered: (1) common bile duct ligation + distilled water, (2) sham surgery + distilled water, (3) common bile duct ligation + pentoxifylline, or (4) common bile duct ligation + prednisolone. After 30 days, a hepatic fragment was collected from each animal for immunohistochemical analysis using monoclonal antibodies against transforming growth factor β and vascular endothelial growth factor. Digital morphometric and statistical analyses were performed. RESULTS: The administration of pentoxifylline reduced the transforming growth factor β-marked area and the amount of transforming growth factor β expressed in liver tissue. This effect was not observed after the administration of prednisolone. There was a significant reduction in vascular endothelial growth factor expression after the administration of either drug compared with the non-treatment group. CONCLUSIONS: The administration of pentoxifylline to cholestatic young rats resulted in the diminished expression of transforming growth factor β and vascular endothelial growth factor in liver tissue. The administration of steroids resulted in the diminished expression of vascular endothelial growth factor only. These pathways may be involved in hepatic fibrogenesis in young rats submitted to bile duct ligation and exposed to pentoxifylline or prednisolone.

Rangelia vitalii: changes in the enzymes ALT, CK and AST during the acute phase of experimental infection in dogs

Rangelia vitalii is a protozoon that causes diseases in dogs, and anemia is the most common laboratory finding. However, few studies on the biochemical changes in dogs infected with this protozoon exist. Thus, this study aimed to investigate the biochemical changes in dogs experimentally infected with R. vitalii, during the acute phase of the infection. For this study, 12 female dogs (aged 6-12 months and weighing between 4 and 7 kg) were used, divided in two groups. Group A was composed of healthy dogs (n = 5); and group B consisted of infected animals (n = 7). Blood samples were collected on days 0, 10, 20 and 30 after infection, using tubes without anticoagulant to obtain serum and analyze the biochemical parameters. An increase in alanine aminotransferase (ALT) on day 20 (P < 0.05) was observed. Also, increased creatine kinase (CK) and aspartate aminotransferase (AST) levels were observed throughout the experimental period (P < 0.05). No changes in the serum gamma-glutamyltransferase, urea and creatinine levels were observed. Thus, is possible to conclude that experimental infection with R. vitalii in dogs causes changes to the biochemical profile, with increased ALT, AST and CK enzyme levels.

The relationship between lymphatic vascular density and vascular endothelial growth factor A (VEGF-A) expression with clinical-pathological features and survival in pancreatic adenocarcinomas

Abstract: Background Pancreatic cancer is a rare tumor with an extremely low survival rate. Its known risk factors include the chronic use of tobacco and excessive alcohol consumption and the presence of chronic inflammatory diseases, such as pancreatitis and type 2 diabetes. Angiogenesis and lymphangiogenesis, which have been the focus of recent research, are considered prognostic factors for cancer development. Knowing the angiogenic and lymphangiogenic profiles of a tumor may provide new insights for designing treatments according to the different properties of the tumor. The aim of this study was to evaluate the density of blood and lymphatic vessels, and the expression of VEGF-A, in pancreatic adenocarcinomas, as well as the relationship between blood and lymphatic vascular density and the prognostically important clinical-pathological features of pancreatic tumors. Methods Paraffin blocks containing tumor samples from 100 patients who were diagnosed with pancreatic cancer between 1990 and 2010 were used to construct a tissue microarray. VEGF expression was assessed in these samples by immunohistochemistry. To assess the lymphatic and vascular properties of the tumors, 63 cases that contained sufficient material were sectioned routinely. The sections were then stained with the D2-40 antibody to identify the lymphatic vessels and with a CD34 antibody to identify the blood vessels. The vessels were counted individually with the Leica Application Suite v4 program. All statistical analyses were performed using SPSS 18.0 (Chicago, IL, USA) software, and p values ≤ 0.05 were considered significant. Results In the Cox regression analysis, advanced age (p=0.03) and a history of type 2 diabetes (p=0.014) or chronic pancreatitis (p=0.02) were shown to be prognostic factors for pancreatic cancer. Blood vessel density (BVD) had no relationship with clinical-pathological features or death. Lymphatic vessel density (LVD) was inversely correlated with death (p=0.002), and by Kaplan-Meyer survival analysis, we found a significant association between low LVD (p=0.021), VEGF expression (p=0.023) and low patient survival. Conclusions Pancreatic carcinogenesis is related to a history of chronic inflammatory processes, such as type 2 diabetes and chronic pancreatitis. In pancreatic cancer development, lymphangiogenesis can be considered an early event that enables the dissemination of metastases. VEGF expression and low LVD can be considered as poor prognostic factors as tumors with this profile are fast growing and highly aggressive. Virtual slides. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5113892881028514

Tools and methods for the quality assurance of force platforms in human movement analysis

The human movement analysis (HMA) aims to measure the abilities of a subject to stand or to walk. In the field of HMA, tests are daily performed in research laboratories, hospitals and clinics, aiming to diagnose a disease, distinguish between disease entities, monitor the progress of a treatment and predict the outcome of an intervention [Brand and Crowninshield, 1981; Brand, 1987; Baker, 2006]. To achieve these purposes, clinicians and researchers use measurement devices, like force platforms, stereophotogrammetric systems, accelerometers, baropodometric insoles, etc. This thesis focus on the force platform (FP) and in particular on the quality assessment of the FP data. The principal objective of our work was the design and the experimental validation of a portable system for the in situ calibration of FPs. The thesis is structured as follows: Chapter 1. Description of the physical principles used for the functioning of a FP: how these principles are used to create force transducers, such as strain gauges and piezoelectrics transducers. Then, description of the two category of FPs, three- and six-component, the signals acquisition (hardware structure), and the signals calibration. Finally, a brief description of the use of FPs in HMA, for balance or gait analysis. Chapter 2. Description of the inverse dynamics, the most common method used in the field of HMA. This method uses the signals measured by a FP to estimate kinetic quantities, such as joint forces and moments. The measures of these variables can not be taken directly, unless very invasive techniques; consequently these variables can only be estimated using indirect techniques, as the inverse dynamics. Finally, a brief description of the sources of error, present in the gait analysis. Chapter 3. State of the art in the FP calibration. The selected literature is divided in sections, each section describes: systems for the periodic control of the FP accuracy; systems for the error reduction in the FP signals; systems and procedures for the construction of a FP. In particular is detailed described a calibration system designed by our group, based on the theoretical method proposed by ?. This system was the “starting point” for the new system presented in this thesis. Chapter 4. Description of the new system, divided in its parts: 1) the algorithm; 2) the device; and 3) the calibration procedure, for the correct performing of the calibration process. The algorithm characteristics were optimized by a simulation approach, the results are here presented. In addiction, the different versions of the device are described. Chapter 5. Experimental validation of the new system, achieved by testing it on 4 commercial FPs. The effectiveness of the calibration was verified by measuring, before and after calibration, the accuracy of the FPs in measuring the center of pressure of an applied force. The new system can estimate local and global calibration matrices; by local and global calibration matrices, the non–linearity of the FPs was quantified and locally compensated. Further, a non–linear calibration is proposed. This calibration compensates the non– linear effect in the FP functioning, due to the bending of its upper plate. The experimental results are presented. Chapter 6. Influence of the FP calibration on the estimation of kinetic quantities, with the inverse dynamics approach. Chapter 7. The conclusions of this thesis are presented: need of a calibration of FPs and consequential enhancement in the kinetic data quality. Appendix: Calibration of the LC used in the presented system. Different calibration set–up of a 3D force transducer are presented, and is proposed the optimal set–up, with particular attention to the compensation of non–linearities. The optimal set–up is verified by experimental results.

Spatial and temporal variation in settlement, growth and condition of the rockfish species Sebastes caurinus and Sebastes carnatus in the Channel Islands region, Santa Barbara, CA

Survival during the early life stages of marine species, including nearshore temperate reef fishes, is typically very low, and small changes in mortality rates, due to physiological and environmental conditions, can have marked effects on survival of a cohort and, on a larger scale, on the success of a recruitment season. Moreover, trade offs between larval growth and accumulation of energetic resources prior to settlement are likely to influence growth and survival until this critical period and afterwards. Rockfish recruitment rates are notoriously variable between years and across geographic locations. Monitoring of rates of onshore delivery of pelagic juveniles (defined here as settlement) of two species of nearshore rockfishes, Sebastes caurinus and Sebastes carnatus, was done between 2003-2009 years using artificial collectors placed at San Miguel and Santa Cruz Island, off Southern California coast. I investigated spatiotemporal variation in settlement rate, lipid content, pelagic larval duration and larval growth of the newly settled fishes; I assessed relationships between birth date, larval growth, early life-history characteristics and lipid content at settlement, considering also interspecific differences; finally, I attempt to relate interannual patterns of settlement and of early life history traits to easily accessible, local and regional indices of ocean conditions including in situ ocean temperature and regional upwelling, sea surface temperature (SST) and Chlorophyll-a (Chl-a) concentration. Spatial variations appeared to be of low relevance, while significant interannual differences were detected in settlement rate, pelagic larval duration and larval growth. The amount of lipid content of the newly settled fishes was highly variable in space and time, but did not differ between the two species and did not show any relationships with early life history traits, indicating that no trade off involved these physiological processes or they were masked by high individual variability in different periods of larval life. Significant interspecific differences were found in the timing of parturition and settlement and in larval growth rates, with S. carnatus growing faster and breeding and settling later than S. caurinus. The two species exhibited also different patterns of correlations between larval growth rates and larval duration. S. carnatus larval duration was longer when the growth in the first two weeks post-hatch was faster, while S. caurinus had a shorter larval duration when grew fast in the middle and in the end of larval life, suggesting different larval strategies. Fishes with longer larval durations were longer in size at settlement and exhibited longer planktonic phase in periods of favourable environmental conditions. Ocean conditions had a low explanatory power for interannual variation in early life history traits, but a very high explanatory power for settlement fluctuations, with regional upwelling strength being the principal indicator. Nonetheless, interannual variability in larval duration and growth were related to great phenological changes in upwelling happened during the period of this study and that caused negative consequences at all trophic levels along the California coast. Despite the low explanatory power of the environmental variables used in this study on the variation of larval biological traits, environmental processes were differently related with early life history characteristics analyzed to species, indicating possible species-specific susceptibility to ocean conditions and local environmental adaptation, which should be further investigated. These results have implications for understanding the processes influencing larval and juvenile survival, and consequently recruitment variability, which may be dependent on biological characteristics and environmental conditions.

Physiology and Biotechnology of the Hydrogen Production with the Green Microalga Chlamydomonas reinhardtii

The hydrogen production in the green microalga Chlamydomonas reinhardtii was evaluated by means of a detailed physiological and biotechnological study. First, a wide screening of the hydrogen productivity was done on 22 strains of C. reinhardtii, most of which mutated at the level of the D1 protein. The screening revealed for the first time that mutations upon the D1 protein may result on an increased hydrogen production. Indeed, productions ranged between 0 and more than 500 mL hydrogen per liter of culture (Torzillo, Scoma et al., 2007a), the highest producer (L159I-N230Y) being up to 5 times more performant than the strain cc124 widely adopted in literature (Torzillo, Scoma, et al., 2007b). Improved productivities by D1 protein mutants were generally a result of high photosynthetic capabilities counteracted by high respiration rates. Optimization of culture conditions were addressed according to the results of the physiological study of selected strains. In a first step, the photobioreactor (PBR) was provided with a multiple-impeller stirring system designed, developed and tested by us, using the strain cc124. It was found that the impeller system was effectively able to induce regular and turbulent mixing, which led to improved photosynthetic yields by means of light/dark cycles. Moreover, improved mixing regime sustained higher respiration rates, compared to what obtained with the commonly used stir bar mixing system. As far as the results of the initial screening phase are considered, both these factors are relevant to the hydrogen production. Indeed, very high energy conversion efficiencies (light to hydrogen) were obtained with the impeller device, prooving that our PBR was a good tool to both improve and study photosynthetic processes (Giannelli, Scoma et al., 2009). In the second part of the optimization, an accurate analysis of all the positive features of the high performance strain L159I-N230Y pointed out, respect to the WT, it has: (1) a larger chlorophyll optical cross-section; (2) a higher electron transfer rate by PSII; (3) a higher respiration rate; (4) a higher efficiency of utilization of the hydrogenase; (5) a higher starch synthesis capability; (6) a higher per cell D1 protein amount; (7) a higher zeaxanthin synthesis capability (Torzillo, Scoma et al., 2009). These information were gathered with those obtained with the impeller mixing device to find out the best culture conditions to optimize productivity with strain L159I-N230Y. The main aim was to sustain as long as possible the direct PSII contribution, which leads to hydrogen production without net CO2 release. Finally, an outstanding maximum rate of 11.1 ± 1.0 mL/L/h was reached and maintained for 21.8 ± 7.7 hours, when the effective photochemical efficiency of PSII (ΔF/F'm) underwent a last drop to zero. If expressed in terms of chl (24.0 ± 2.2 µmoles/mg chl/h), these rates of production are 4 times higher than what reported in literature to date (Scoma et al., 2010a submitted). DCMU addition experiments confirmed the key role played by PSII in sustaining such rates. On the other hand, experiments carried out in similar conditions with the control strain cc124 showed an improved final productivity, but no constant PSII direct contribution. These results showed that, aside from fermentation processes, if proper conditions are supplied to selected strains, hydrogen production can be substantially enhanced by means of biophotolysis. A last study on the physiology of the process was carried out with the mutant IL. Although able to express and very efficiently utilize the hydrogenase enzyme, this strain was unable to produce hydrogen when sulfur deprived. However, in a specific set of experiments this goal was finally reached, pointing out that other than (1) a state 1-2 transition of the photosynthetic apparatus, (2) starch storage and (3) anaerobiosis establishment, a timely transition to the hydrogen production is also needed in sulfur deprivation to induce the process before energy reserves are driven towards other processes necessary for the survival of the cell. This information turned out to be crucial when moving outdoor for the hydrogen production in a tubular horizontal 50-liter PBR under sunlight radiation. First attempts with laboratory grown cultures showed that no hydrogen production under sulfur starvation can be induced if a previous adaptation of the culture is not pursued outdoor. Indeed, in these conditions the hydrogen production under direct sunlight radiation with C. reinhardtii was finally achieved for the first time in literature (Scoma et al., 2010b submitted). Experiments were also made to optimize productivity in outdoor conditions, with respect to the light dilution within the culture layers. Finally, a brief study of the anaerobic metabolism of C. reinhardtii during hydrogen oxidation has been carried out. This study represents a good integration to the understanding of the complex interplay of pathways that operate concomitantly in this microalga.

Comparative genomics and phylogenetics of the vertebrate CYP3 family

CYP3A verstoffwechselt mehr als 50% aller gegenwärtig in der Therapie eingesetzten Wirkstoffe, die häufig an klinisch relevanten Arzneimitttel-Wechselwirkungen beteiligt sind. Das Verständnis über die Bedeutung und die Regulation von einzelnen CYP3A Genen in der Pharmakologie und Physiologie ist unvollständig. Wir untersuchten die Evolution des CYP3 Genlokus über einen Zeitraum von 450 Millionen Jahre mittels genomischer Sequenzen von 16 Tierarten. Neue CYP3 Unterfamilien (CYP3B, C und D) entstanden über eine beschleunigte Evolution aus CYP3A Vorstufen von Clupeocephala Spezies. Ausgeprägte funktionelle Unterschiede traten zwischen CYP3A in Säugern und Clupeocephala CYP3 auf. Alle amnioten CYP3A Gene entwickelten sich aus zwei CYP3A Urgenen. Aufgrund der Entstehung von Säugern mit Plazenta ging eines von ihnen verloren während das andere eine neue genomische Umgebung infolge einer Translokation erlangte. In Primaten unterzog sich CYP3A mit mehreren Genduplikationen, Deletionen, Pseudogenisierung und Genkonversionen einer raschen evolutionären Veränderung. Die Entwicklung von CYP3A in Schmalnasenaffen (Alte Welt Affen, große Menschenaffen und Menschen) unterschieden sich wesentlich von Neue Welt Primaten (z.B. gewöhnlichen Krallenaffen) und Feuchtnasenaffen (z.B. Galago). Stellvertretend für die CYP3A Protein-codierende Sequenz entdeckten wir zwei frühe Episoden von besonders starker positiver Selektion: (1) auf CYP3A7 in der frühen hominoiden Evolution, welche im fetalen Zeitraum von einer Einschränkung der hepatischen Expression begleitet war, und (2) auf humanes CYP3A4 im Anschluss an die Teilung der Abstammungslinie in Schimpansen und Mensch. In Übereinstimmung mit diesen Befunden beeinflussen drei von vier positiv ausgewählten Aminosäuren, die in früheren biochemischen CYP3A Studien untersucht wurden, die Aktivität und Regioselektivität. Es ist somit naheliegend, dass CYP3A7 und CYP3A4 katalytische Funktionen erworben haben können, die besonders wichtig waren für die Evolution von Hominoiden und Menschen. Die Charakterisierung von CYP3A Promotoren in Primaten zeigte eine Anreicherung von ER6 Elementen in CYP3A Promotoren von Primaten und einen Trend in Richtung Erhöhung der ER6 Enstehung entlang den Abstammungslinien, die zu humanen und Schimpansen CYP3A4 führten. Die steigende Anzahl an ER6 Elementen kann durch die ausgeprägte CYP3A4 Induzierbarkeit und Expressionsvariabilität im Menschen verursacht sein.

Phylogeny and phylogeography of the family Hyalidae (Crustacea: Amphipoda) along the northeast Atlantic coasts

The family Hyalidae comprises more than one hundred species, distributed worldwide. They are common and abundant in the littoral and shallow sublittoral habitats and they play an important role in the coastal food chain. Most studies about this family were dealing with taxonomy and ecology, while very little is known about phylogenetic relationship among genera and species. In the present study we aim to achieve the first approach of the phylogenetic patterns of this family in NE Atlantic Ocean and Mediterranean Sea, and to perform the first insight into the phylogeography Apohyale prevostii along both the North Atlantic coasts. In order to do that, eight species belonging to the genera Apohyale, Hyale, Serejohyale and Protohyale were investigated using the mitochondrial COI-5P barcode region. Specimens were collected along European and Moroccan Atlantic rocky shores, including Iceland, the British Isles, Macaronesia and in the Mediterranean Sea. Sequences of A. prevostii, from the NW Atlantic Ocean, available in BOLD and GenBank, were retrieved. As expected, phylogenetic analyses showed highly-divergent clades, clearly discriminating among different species clusters, confirming their morphology-based identifications. Although, within A. perieri, A. media, A. stebbingi, P. (Protohyale) schmidtii and S. spinidactylus, high genetic diversity was found, revealing putative cryptic species. The clade of A. prevostii and A. stebbingi appears well supported and divided from the other two congeneric species, and P. (Protohyale) schmidtii shows a basal divergence. The north-western Atlantic coasts were recently colonized by A. prevostii after the last glacial maximum from the European populations showing also a common haplotype in every population analysed. The use of the COI-5P as DNA barcode provided a good tool to underline the necessity of a revision of this emblematic family, as well as to discern taxonomically the possible new species flagged with this molecular device.

Temperature effects on larval growth and survival in five species of Caribbean Echinoids

Under the global change scenario, the possible effects of ocean warming were investigated on the larvae of five species of Caribbean Echinoids: Echinometra lucunter, Echinometra viridis, Clypeaster rosaceus, Tripneustes ventricosus and Lytechinus williamsi. Their thermal tolerance was evaluated rearing them for six days under different temperature regimes (26, 28, 30, 32, 34, 36°C). The larval sensitivity to the treatments was evaluated on the base of survival and growth. The rearing at higher temperatures has revealed a great suffering state of the larvae by inducing both reduction of live larvae and abnormality in their development. The extent of impact of the treatments varied from species to species, evidencing different levels of thermal tolerance. Anyway, higher temperature treatments have shown a general lethal threshold at about 34°C for most of the species. As an exception, the lethal threshold of Echinometra species was 36°C, few larvae of which being still capable of survive at the temperature of 34°C. The studies have also analyzed the effect of water warming on the larvae growth in terms of size and symmetry. The results put in evidence the presence of a critical upper temperature (about 32°C) at which the larvae of all species reveal a great suffering state that translates in the reduction of size (i.e., of body, stomach and postero-dorsal arm) and abnormalities (i.e., strong difference in the lengths of the two postero-dorsal arms). As sea surface temperatures are predicted to increase of 4-5°C by 2100, the high percentage of abnormal larvae and their scarce survival observed at 32- 34°C treatments indicate that the early stages of these species could be affected by future global warming.

The role of exenterative surgery and urinary diversion in persistent or locally recurrent gynecological malignancy: complications and survival

Treatment options in patients with persistent or locally recurrent cervical cancer are limited. The aim of this study was to determine the chance of cure and associated morbidity following pelvic exenteration.

Endosonographic radial tumor thickness after neoadjuvant chemoradiation therapy to predict response and survival in patients with locally advanced esophageal cancer: a prospective multicenter phase ll study by the Swiss Group for Clinical Cancer Research (SAKK 75/02)

EUS response assessment in patients with locally advanced esophageal cancer undergoing neoadjuvant chemoradiation therapy (CRT) is limited by disintegration of the involved anatomic structures.

Mortality and loss to follow-up in the first year of ART: Malawi national ART programme

To analyse mortality, loss to follow-up (LTFU) and retention on antiretroviral treatment (ART) in the first year of ART across all age groups in the Malawi national ART programme.