Модернізація стоматологічної установки УС- 30

Background: The novel chemokine CXCL17 acts as chemoattractant for monocytes, macrophages and dendritic cells. CXCL17 also has a role in angiogenesis of importance for tumour development. Methods: Expression of CXCL17, CXCL10, CXCL9 and CCL2 was assessed in primary colon cancer tumours, colon carcinoma cell lines and normal colon tissue at mRNA and protein levels by real-time qRT-PCR, immunohistochemistry, two-colour immunofluorescence and immunomorphometry. Results: CXCL17 mRNA was expressed at 8000 times higher levels in primary tumours than in normal colon (P<0.0001). CXCL17 protein was seen in 17.2% of cells in tumours as compared with 0.07% in normal colon (P = 0.0002). CXCL10, CXCL9 and CCL2 mRNAs were elevated in tumours but did not reach the levels of CXCL17. CXCL17 and CCL2 mRNA levels were significantly correlated in tumours. Concordant with the mRNA results, CXCL10-and CXCL9-positive cells were detected in tumour tissue, but at significantly lower numbers than CXCL17. Two-colour immunofluorescence and single-colour staining of consecutive sections for CXCL17 and the epithelial cell markers carcinoembryonic antigen and BerEP4 demonstrated that colon carcinoma tumour cells indeed expressed CXCL17. Conclusions: CXCL17 is ectopically expressed in primary colon cancer tumours. As CXCL17 enhances angiogenesis and attracts immune cells, its expression could be informative for prognosis in colon cancer patients

COL11A1 in FAP polyps and in sporadic colorectal tumors

BACKGROUND: We previously reported that the α-1 chain of type 11 collagen (COL11A1), not normally expressed in the colon, was up-regulated in stromal fibroblasts in most sporadic colorectal carcinomas. Patients with germline mutations in the APC gene show, besides colonic polyposis, symptoms of stromal fibroblast involvement, which could be related to COL11A1 expression. Most colorectal carcinomas are suggested to be a result of an activated Wnt- pathway, most often involving an inactivation of the APC gene or activation of β-catenin. METHODS: We used normal and polyp tissue samples from one FAP patient and a set of 37 sporadic colorectal carcinomas to find out if the up-regulation of COL11A1 was associated with an active APC/β-catenin pathway. RESULTS: In this study we found a statistically significant difference in COL11A1 expression between normal tissue and adenomas from one FAP patient, and all adenomas gave evidence for an active APC/β-catenin pathway. An active Wnt pathway has been suggested to involve stromal expression of WISP-1. We found a strong correlation between WISP-1 and COL11A1 expression in sporadic carcinomas. CONCLUSIONS: Our results suggest that expression of COL11A1 in colorectal tumors could be associated with the APC/β-catenin pathway in FAP and sporadic colorectal cancer

Let’s build prehistory : archaeologist’s opinions about experimental archaeology and possibilities to use it as mediating

This essay discusses different opinions about experimental archaeology. To start with literature was examined and a questionnaire was sent out to students and working archaeologists. The possibility for experiments to mediate archaeology to people without an education in archaeology is lifted and is also mentioned in the questionnaire. In the discussion part of the essay the results from the questionnaire and the literature are used to see what opinions are the strongest. The mediating is also discussed and the result is compiled in the conclusion. There are different opinions about experimental archaeology, but no prominent difference between what students and archaeologists answered. It is possible to see different opinions in the literature, but concerning the mediating most of the writers agree that the experimental archaeology is a good method to communicate with the laymen

Let’s build prehistory : archaeologist’s opinions about experimental archaeology and possibilities to use it as mediating

This essay discusses different opinions about experimental archaeology. To start with literature was examined and a questionnaire was sent out to students and working archaeologists. The possibility for experiments to mediate archaeology to people without an education in archaeology is lifted and is also mentioned in the questionnaire. In the discussion part of the essay the results from the questionnaire and the literature are used to see what opinions are the strongest. The mediating is also discussed and the result is compiled in the conclusion. There are different opinions about experimental archaeology, but no prominent difference between what students and archaeologists answered. It is possible to see different opinions in the literature, but concerning the mediating most of the writers agree that the experimental archaeology is a good method to communicate with the laymen

Let’s build prehistory : archaeologist’s opinions about experimental archaeology and possibilities to use it as mediating

This essay discusses different opinions about experimental archaeology. To start with literature was examined and a questionnaire was sent out to students and working archaeologists. The possibility for experiments to mediate archaeology to people without an education in archaeology is lifted and is also mentioned in the questionnaire. In the discussion part of the essay the results from the questionnaire and the literature are used to see what opinions are the strongest. The mediating is also discussed and the result is compiled in the conclusion. There are different opinions about experimental archaeology, but no prominent difference between what students and archaeologists answered. It is possible to see different opinions in the literature, but concerning the mediating most of the writers agree that the experimental archaeology is a good method to communicate with the laymen

Anastomotic leakage after surgery for rectal cancer: a risk factor of local recurrence, distant metastasis and reduced cancer-specific survival?

ABSTRACT Background We explored the impact of anastomotic leakage (AL) on the oncological outcome after anterior resection (AR) for rectal cancer which is still controversial.. Local recurrence (LR) and overall recurrenc(OAR) and cancer-specific survival were analysed. Method Patients undergoing AR for rectal cancer with a registered AL between 1995 and 1997 and a control group were identified in the Swedish Rectal Cancer Registry. The medical records were retrieved for additional data and validation. Differences in the oncological outcome at 5 year follow-up were analysed with multivariate methods. Results After validation, 114 patients with AL and 136 controls with locally radical surgery for tumours of TNM stages I-III were analysed. There was no difference detected between patients with AL and controls regarding rates of LR [8% (9/114) vs 9% (12/136); P=0.97], distant metastasis [18% (20/114) vs 23% (31/136); P=0.37] and OAR [19% (22/114) vs 28% (38/136); P=0.15]. The 5 year cancer specific survival was almost 80% in both groups. In multivariate analysis, AL was not a risk factor for LR, distant metastasis or OAR and had no impact on 5 year overall or 5 year cancer specific survival. Irrespective of the occurrence of AL, preoperative radiotherapy (P=0.055) and rectal washout (P=0.046) reduced the LR rate, but did not influence survival. Conclusion AL was not proven to be a risk factor for worse oncological outcome. Hence additional adjuvant treatment or extended follow-up on the basis of the occurrence of AL after AR might not be justified

Risk Factors of Rectal Cancer Local Recurrence: Population-based Survey and Validation of the Swedish Rectal Cancer Registry.

Aim Despite advances in rectal cancer treatment local recurrence (LR) remains a significant problem. To select high-risk patients for different treatment options aimed at reducing LR, it is essential to identify LR risk factors. Method LR and survival rates of 4157 patients registered 1995-1997 in the Swedish Rectal Cancer Registry were analysed. LR risk factors were analysed by multivariate methods. For LR patients the registry was validated and additional data retrieved. Results The five-year overall and cancer specific survival rates were 45% and 62%. LR was registered in 326 (8%) patients. After R0-resections for tumours in TNM-stages I-III, LR developed in 10% of tumours at 0-5 cm, 8% at 6-10 cm, and 6% at 11-15 cm above the anal verge. Preoperative radiotherapy (RT) reduced the LR rate irrespective of height [0-5 cm: OR 0.50 (0.30-0.83), 6-10 cm: OR 0.42 (0.25-0.71), and 11-15 cm: OR 0.29 (0.13-0.64)]. Patients without preoperative RT had significantly higher LR risk after rectal perforation [OR 2.50 (1.48-4.24)], and almost significantly decreased LR risk when rectal washout was performed [OR 0.65 (0.43-1.00)]. Preoperative RT prolonged time to LR but did not significantly influence survival among LR patients. LR was an isolated tumour manifestation in 103 (39%) patients with validated LR. Conclusions Preoperative RT should be considered for rectal cancer also in the upper third of the rectum. Intraoperative perforation should be avoided, and rectal washout is indicated as valuable. Follow-up for detection of isolated LR is important. Extended follow-up should be considered for patients treated with RT

Water soluble contrast enema examination of the integrity of the rectal anastomosis prior to loop ileostomy reversal may be superfluous

Defunctioning loop ileostomy in low anterior resection (LAR) is routinely used to reduce consequences of anastomotic leakage. The purpose of this study was to analyze which examination technique is optimal for evaluating the integrity of the anastomosis prior to loop ileostomy reversal. Retrospective analysis of 95 patients who had been subjected to LAR at Helsingborg Hospital and SkAyenne University Hospital, Sweden, was undertaken between January 2007 and June 2009. The examination techniques of the rectal anastomosis prior to reversal and the clinical outcome after reversal were studied. Radiologic anastomosis control using water soluble contrast enema, digital rectal examination (DRE), and rectoscopy were performed in 53 % (50/95), 98 % (93/95), and 69 % (66/95), respectively. In two patients, no control of the anastomosis was performed before reversal. Fifty-two percent (49/95) of the patients were examined using all techniques. Six patients demonstrated leakage detected before reversal of which two were only radiological leakages. These two patients underwent loop ileostomy reversal after delay without complications. They were the only ones where the three examination techniques did not prove coherence. Four patients had symptomatic leakage; these were detected with rectoscopy and DRE and verified with enema. Three patients developed anastomotic leakage after loop ileostomy reversal despite normal preoperative examinations. Two of these patients had rectovaginal fistulas (AVFs). This retrospective study indicates that contrast enema does not provide additional information if rectoscopy and DRE are normal. Despite negative examinations, three of nine leakages were diagnosed after loop ileostomy reversal. Especially, AVFs seem difficult to diagnose

Oncological outcome after incidental perforation in radical rectal cancer surgery.

PURPOSE: Identification of risk factors of poor oncological outcome in rectal cancer surgery is of utmost importance. This study examines the impact of incidental perforation on the oncological outcome. METHODS: Using the Swedish Rectal Cancer Registry, patients were selected who received major abdominal surgery for rectal cancer between 1995 and 1997 with registered incidental perforation. A control group was also selected for analysis of the oncological outcome after 5-year follow-up. Multivariate analysis was performed. Registry data were validated, and additional data were supplemented from medical records. RESULTS: After validation and exclusion of non-radically operated patients, 118 patients with incidental perforation and 155 controls in TNM stages I-III were included in the analysis. The rate of local recurrence (LR) [20% (23/118) vs. 8% (12/155) (p = 0.007)] was significantly higher among patients with perforation, whereas the rates of distant metastasis [27% (32/118) vs. 21% (33/155) (p = 0.33)] and overall recurrence (OAR) [35% (41/118) vs. 25% (38/155) (p = 0.087)] were not significantly different between the groups. Overall as well as cancer-specific 5-year survival rates were significantly reduced for the patients with perforation [44 vs. 64% (p = 0.002) and 66 vs. 80% (p = 0.026), respectively]. In the multivariate analysis, perforation was a significant risk factor of increased rates of LR and OAR as well as reduced 5-year overall and cancer-specific survival. CONCLUSIONS: Incidental perforation in rectal cancer surgery is an important risk factor of poor oncological outcome and should be considered in the discussion concerning postoperative adjuvant treatment as well as the follow-up regime

Validity of the Swedish Rectal Cancer Registry for patients treated with major abdominal surgery between 1995 and 1997.

Background. Founded in 1995, the Swedish Rectal Cancer Registry (SRCR) is frequently used for rectal cancer research. However, the validity of the registry has not been extensively studied. This study aims to validate a large amount of registry data to assess SRCR quality. Material and methods. The study comprises 906 patients treated with major abdominal surgery registered in the SRCR between 1995 and 1997. SRCR data for 14 variables were scrutinized for validity against the medical records. Kappa's and Kendall's correlation coefficients for agreement between SRCR data and medical records data were calculated for 13 variables. Results. For 11 variables, concerning the tumor, neoadjuvant therapy, the surgical procedure, local radicality and TNM stage, data were missing in 5% or less of the registrations; for the remaining three variables, anastomotic leakage, local and distant recurrence, data were missing in 13-38%. For the variables surgery performed or not and type of surgical procedure, no data were missing. Erroneous registrations were found in less than 10% of all variables; for the variables preoperative chemotherapy and surgery performed or not, all registrations were correct. For the variables concerning neoadjuvant therapy, local radicality according to the surgeon as well as the pathologist and distant metastasis, the false-positive or -negative registrations were equally distributed, and for the variables rectal washout, rectal perforation, anastomotic leakage and local recurrence there was a discrepancy in distribution. The correlation coefficient for 12 variables ranged from 0.82 to 1.00, and was 0.78 for the remaining variable. Conclusion. The validity of the SRCR was good for the initial three registry years. Thus, research based on SRCR data is reliable from the beginning of the registry's use