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Valizadeh N.,Section of Hematology and Medical Oncology | Musavi J.,Infectious Diseases Specialist | Nateghi S.H.,Urmia University of Medical Sciences
Shiraz E Medical Journal | Year: 2011

Hemophagocytic syndrome (HPS) is a disorder characterized by benign proliferation of hys-tiocytes and marked hemophagocytosis in bone marrow. Hemaphagocytic syndrome (HPS) is a rare manifestation of brucellosis. Genitiurinary complications of brucellosis are very diverse and include hydrocele, urinary tract infection, pyonephrosis, epididymo-orchitis, infertility and prostatitis. Acute prostatitis is rarely reported as the first manifestation of. This article is introducing a case of brucellosis presented with acute prostatitis and concurrent hemophagocytic syndrome. Source


Tang S.T.,Chang Gung University | Liu T.-W.,National Health Research Institute | Chow J.-M.,Section of Hematology and Medical Oncology | Chiu C.-F.,China Medical University at Taichung | And 3 more authors.
Psycho-Oncology | Year: 2014

Objective Adequate knowledge of prognosis is a prerequisite for planning appropriate end-of-life (EOL) care. However, questions remain about whether the association between prognostic understanding and EOL-care intensity reflects terminally ill cancer patients' preferences for EOL care. This study investigated the associations between accurate prognostic understanding and EOL-care preferences, and identified correlates of accurate prognostic understanding. Methods A cross-sectional survey of 2452 terminally ill cancer patients from 23 hospitals throughout Taiwan. Results Nearly half the participants (49.80%) accurately understood their prognosis. These patients were significantly more likely to prefer comfort-oriented care as their goal for EOL care, but less likely to prefer life-prolonging treatments. Accurately understanding prognosis decreased the likelihood of preferring intensive care unit care, cardiac pulmonary resuscitation, cardiac massage, intubation, and mechanical ventilation support, but increased preference for hospice care. Participants were significantly more likely to accurately understand their prognosis if they were male, younger, better educated, with a stronger preference for physicians to disclose their prognosis to them, and receiving care at a hospital accredited as a medical center and in northwest Taiwan. The likelihood of accurate prognostic understanding was lower for patients recently (≤12 months) diagnosed with cancers with better prognosis and hematologic malignancies than for lung cancer patients. Conclusions Accurately understanding prognosis is associated with fewer preferences for life-sustaining treatments and is correlated with both patient and institutional characteristics. Interventions should be developed to improve accurate prognostic understanding, thus facilitating informed EOL-care decisions that may limit the use of aggressive interventions. Copyright © 2014 John Wiley & Sons, Ltd. Source


Verbeek H.H.G.,University of Groningen | Plukker J.T.M.,University of Groningen | Koopmans K.P.,Martini Hospital Groningen | De Groot J.W.B.,Section of Hematology and Medical Oncology | And 6 more authors.
Journal of Nuclear Medicine | Year: 2012

The transition from stable to progressive disease is unpredictable in patients with biochemical evidence of medullary thyroid carcinoma (MTC). Calcitonin and carcinoembryonic antigen (CEA) doubling times are currently the most reliable markers for progression, but for accurate determination, serial measurements, which need time, are required. We compared 18F-FDG PET and 18F-dihydroxyphenylanaline (18F-DOPA) PET with biochemical parameters and survival to assess whether these imaging modalities could be of value in detecting progressive disease. Methods: We evaluated the outcome of 18F-FDG PET or 18F-DOPA PET with calcitonin and CEA doubling times in 47 MTC patients. A subgroup of patients was included in the whole metabolic burden (WBMTB) analysis, with determination of standardized uptake values and number of lesions. WBMTB of 18F-DOPA PET and 18F-FDG PET was compared with biochemical parameters. Furthermore, survival was compared with 18F-DOPA PET or 18F-FDG PET positivity. Results: Doubling times were available for 38 of 40 patients undergoing 18F-FDG PET. There was a significant correlation with 18F-FDG PET positivity. Doubling times were less than 24 mo in 77% (n = 10/13) of 18F-FDG PET-positive patients, whereas 88% (n = 22/25) of 18F-FDG PET-negative patients had doubling times greater than 24 mo (P < 0.001). Between doubling times and 18F-DOPA PET positivity, no significant correlation existed. 18F-DOPA PET detected significantly more lesions (75%, 56/75) than did 18F-FDG PET (47%, 35/75) in the 21 patients included in WBMTB analysis (P = 0.009). Calcitonin and CEA levels correlated significantly with WBMTB on 18F-DOPA PET, but doubling times did not. 18F-FDG PET positivity was a more important indicator for poor survival in patients for whom both scans were obtained. Conclusion: 18F-FDG PET is superior in detecting patients with biochemical progressive disease and identifying patients with poor survival. Although 18F-DOPA PET has less prognostic value, it can more accurately assess the extent of the disease in patients with residual MTC. Hence, both scans are informative about tumor localization and behavior. On the basis of these results, we designed a clinical flow diagram for general practice in detecting recurrent MTC. COPYRIGHT © 2012 by the Society of Nuclear Medicine and Molecular Imaging, Inc. Source


Saba N.S.,Section of Hematology and Medical Oncology | Saba N.S.,Tulane Cancer Center | Levy L.S.,Tulane Cancer Center | Levy L.S.,Tulane University
Journal of Investigative Medicine | Year: 2012

Introduction: Acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin lymphoma (NHL) constitutes an aggressive variety of lymphomas characterized by increased extranodal involvement, relapse rate, and resistance to chemotherapy. Protein kinase C-beta (PKCA) targeting showed promising results in preclinical and clinical studies involving a wide variety of cancers, but studies describing the role of PKCA in AIDS-NHL are primitive if not lacking. Methods: In the present study, 3 AIDS-NHL cell lines were examined: 2F7 (AIDSYBurkitt lymphoma), BCBL-1 (AIDSYprimary effusion lymphoma), and UMCL01-101 (AIDSYdiffuse large B-cell lymphoma). Results: Immunoblot analysis demonstrated expression of PKCA1 and PKCA2 in 2F7 and UMCL01-101 cells, and PKCA1 alone in BCBL-1 cells. The viability of 2F7 and BCBL-1 cells decreased significantly in the presence of PKCA-selective inhibitor at half-maximal inhibitory concentration of 14 and 15 Kmol/L, respectively, as measured by tetrazolium dye reduction assay. In contrast, UMCL01-101 cells were relatively resistant. As determined using flow cytometric deoxynucleotidyl transferase dUTP nick-end labeling assay with propidium iodide staining, the responsiveness of sensitive cells was associated with apoptotic induction and cell cycle inhibition. Protein kinase C-betaYselective inhibition was observed not to affect AKT phosphorylation but to induce a rapid and sustained reduction in the phosphorylation of glycogen synthase kinase-3 beta, ribosomal protein S6, and mammalian target of rapamycin in sensitive cell lines. Conclusions: The results indicate that PKCA plays an important role in AIDS-related NHL survival and suggest that PKCA targeting should be considered in a broader spectrum of NHL. The observations in BCBL-1 were unexpected in the absence of PKCA2 expression and implicate PKCA1 as a regulator in those cells. © 2012 by The American Federation for Medical Research. Source


Rhodes L.V.,Section of Hematology and Medical Oncology | Short S.P.,Vanderbilt University | Neel N.F.,Vanderbilt University | Salvo V.A.,Section of Hematology and Medical Oncology | And 26 more authors.
Cancer Research | Year: 2011

Estrogen independence and progression to a metastatic phenotype are hallmarks of therapeutic resistance and mortality in breast cancer patients. Metastasis has been associated with chemokine signaling through the SDF-1-CXCR4 axis. Thus, the development of estrogen independence and endocrine therapy resistance in breast cancer patients may be driven by SDF-1-CXCR4 signaling. Here we report that CXCR4 overexpression is indeed correlated with worse prognosis and decreased patient survival irrespective of the status of the estrogen receptor (ER). Constitutive activation of CXCR4 in poorly metastatic MCF-7 cells led to enhanced tumor growth and metastases that could be reversed by CXCR4 inhibition. CXCR4 overexpression in MCF-7 cells promoted estrogen independence in vivo, whereas exogenous SDF-1 treatment negated the inhibitory effects of treatment with the anti-estrogen ICI 182,780 on CXCR4-mediated tumor growth. The effects of CXCR4 overexpression were correlated with SDF-1-mediated activation of downstream signaling via ERK1/2 and p38 MAPK (mitogen activated protein kinase) and with an enhancement of ER-mediated gene expression. Together, these results show that enhanced CXCR4 signaling is sufficient to drive ER-positive breast cancers to a metastatic and endocrine therapy-resistant phenotype via increased MAPK signaling. Our findings highlight CXCR4 signaling as a rational therapeutic target for the treatment of ER-positive, estrogen-independent breast carcinomas needing improved clinical management. © 2010 American Association for Cancer Research. Source

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