The presence of bone marrow cytokeratin-immunoreactive cells does not predict outcome in gastric cancer patients

The independent prognostic significance of isolated tumour cells in bone marrow is still a matter of debate. This study evaluated the possible association of bone marrow micrometastases with tumour progression and prognosis in patients affected by gastric cancer. Bone marrow aspirates from both iliac crests were obtained from 114 consecutive patients operated on for gastric cancer. The specimens were stained with monoclonal antibody CAM 5.2 which reacts predominantly with cytokeratin filaments 8 and 19. Among 114 cases analysed, 33 cases (29%) had cytokeratine-positive cells in the bone marrow. There was no significant relationship between the presence of bone marrow micrometastases and site, depth of tumour invasion, lymph node metastases, presence of metastases. Patients with cytokeratine-positive cells had a trend towards a diffuse type histology (P=0.06). Among the 88 curatively resected patients, median survivals were 40 months and 36 months for cytokeratine-negative and cytokeratine-positive subsets respectively (P=0.9). Recurrence of the disease was observed in 39 cases (44.3%); 11 of 24 (45.8%) in the cytokeratine-positive subset and 28 of 64 (43.7%) in the cytokeratine-negative subset. In conclusion in our experience the presence of cytokeratine-positive cells in the bone marrow of curatively resected gastric cancer patients did not affect outcome and its independent prognostic significance remains to be proven before its official acceptance in the TNM classification

Stainless steel weld metal designed to mitigate residual stresses

There have been considerable efforts to create welding consumables which on solid state phase transformation partly compensate for the stresses which develop when a constrained weld cools to ambient temperatures. All of these efforts have focused on structural steels which are ferritic. In the present work, alloy design methods have been used to create a stainless steel welding consumable which solidifies as δ ferrite, transforms almost entirely into austenite which then undergoes martensitic transformation at a low temperature of about 220◦C. At the same time, the carbon concentration has been kept to a minimum to avoid phenomena such as sensitisation. The measured mechanical properties, especially toughness, seem to be significantly better than commercially available martensitic stainless steel welding consumables, and it has been demonstrated that the use of the new alloy reduces distortion in the final joint

Emorragie digestive superiori

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La colecistite acuta nell'anziano.

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Heparin-induced thrombocytopenia - prevalence in 236 patients and evidence that complex pf4 - heparin is the main antigen for the antibodies

I.F. 4.45

La terapia chirurgica delle rotture di esofago.

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Specific alloantigen self-control by regulatory T cells in organ transplantation: a review.

Multidrug immunosuppressive protocols have increased short-term patient and graft survival rates from 50% to 90% in the past two decades. Unfortunately, chronic graft rejection still remains the main cause of long-term failure and patients must undergo lifelong immunosuppression. The severe side effects such as life-threatening infections, secondary malignancies, and cardiovascular dysfunction all together include roughly 50% of deaths among kidney transplant patients with functioning grafts. Therefore, it should be of crucial importance to reduce immunosuppression and seek induction of specific tolerance to donor alloantigens. Several investigations have suggested that the acquisition of tolerance to self and/or foreign antigens is dependent on the number and function of naturally occurring and acquired regulatory T cells, which can control all aggressive T cells. The regulatory T cells together with their receptors, costimulatory molecules, cytokines, chemokines, and growth factors all contribute to maintain an equilibrium between aggressive and suppressive effector immune responses. As a consequence of increased knowledge, new immunosuppressive approaches based on either alloantigen-specific regulatory T-cell expansion in vivo or in vitro have been proposed to achieve donor-specific transplantation tolerance in kidney allograft recipients. This contribution attempted to summarize knowledge about regulatory T cells and developing methods to induce specific tolerance in kidney transplantation

Le varici gastriche sanguinanti

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Neodjuvant treatment for squamous cell carcinoma of the thoracic esophagus: long-term results

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