Sentinel node biopsy in cutaneous melanoma patients — early results

Wstęp. Chirurgia jest główną metodą leczenia czerniaka skóry. Skuteczność leczenia zależy od zaawansowania nowotworu. Większość czerniaków w Polsce wykrywana jest w stopniu > pT1a, dlatego u tych chorych należy wykonać biopsję węzła wartowniczego (sentinel node biopsy — SNB). Metoda ta w sposób precyzyjny określa zaawansowanie regionalne (węzłowe). Celem pracy była ocena wczesnych wyników leczenia u chorych na czerniaka skóry poddanych SNB.Materiał i metody. W latach 2010–2012 w Klinice Chirurgii Onkologicznej Centrum Onkologii w Krakowie wykonano SNB u 115 chorych na czerniaka skóry (72 kobiety i 43 mężczyzn). Przeprowadzono analizę statystyczną wybranych parametrów wpływających na czas przeżycia bezobjawowego.Wyniki. U 15 (13%) chorych stwierdzono przerzuty w SN. Większą grubość czerniaków stwierdzono w grupie, w której SN zawierał przerzut (5,16 vs 3,87 mm, p = 0,08). W okresie obserwacji u 23 chorych wystąpił nawrót choroby w postaci odległych przerzutów (17 chorych) lub wznowy lokoregionalnej (6 chorych). W grupie, w której stwierdzono przerzut w SN, do nawrotu doszło u 8 chorych (53%); w grupie, w której SN nie zawierał przerzutu, nawrót stwierdzono u 15 chorych (15%). Stwierdzono, że chorzy z nawrotem choroby mieli grubsze czerniaki (7,1 vs 3,53 mm, p = 0,03). Stwierdzono też znamienną różnicę pod względem przebiegu krzywych przeżycia bez objawów nowotworu (metoda Kaplana-Meiera) dla grupy z przerzutem oraz bez przerzutu w SN. Przeprowadzono analizę niezależnych czynników prognostycznych metodą Coxa. Stan SN oraz aktywność mitotyczna guza były niezależnymi czynnikami istotnie wpływającymi na przeżycia bezobjawowe (p = 0,001).Wnioski. SNB jest efektywną metodą identyfikacji chorych na czerniaka z subklinicznymi przerzutami w regionalnych węzłach chłonnych. Grubość czerniaka określana wg Breslowa jest istotnym czynnikiem ryzyka przerzutów w regionalnych węzłach chłonnych. Obecność przerzutu w SN oraz duża aktywność mitotyczna znamiennie zwiększają ryzyko nawrotu choroby.Introduction. Surgery is the main treatment option for skin melanoma and the treatment results depend on stage. Most melanomas diagnosed in Poland are > pT1a and therefore sentinel node biopsy (SNB) is needed for accurate allows for accurate regional (nodal) staging. The aim of this work was to assess early treatment results in skin melanomapatients undergoing SNB.Material and methods. From 2010 to 2012 in the Department of Surgical Oncology, Cancer Center in Kraków,115 skin melanoma patients underwent SNB (72 females and 43 males). Selected parameters potentially influencing survival were analyzed.Results. In 15 (13%) patients SN was positive. In patients with positive SN melanomas were thicker compared to SN negative patients (5.16 versus 3.87 mm, p = 0.08). In 23 patients the disease relapsed: distant metastases (n = 17) or locoregional recurrence (n = 6). In the group with positive SN, recurrence was noted in 8 cases (53%); in the group with negative SN, recurrence was seen in 15 patients (15%). Recurrent patients were characterised by thicker melanomas (7.1 versus 3.53 mm, p = 0.03). No evidence of disease survival (Kaplan-Meier) curves were significantly separated for positive and negative SN groups. Cox analysis was used for prognostic parameters. SN status and mitotic index were shown to independently influence survival time with no evidence of disease (p = 0.001).Conclusions. SNB effectively identifies melanoma patients with microscopic regional node metastases. Melanoma thickness (Breslow) significantly influences the risk for nodal metastases. Presence of nodal metastasis in SN and high mitotic activity significantly increased the risk of relapse

Empirical Investigation on Agile Methods Usage: Issues Identified from Early Adopters in Malaysia

Agile Methods are a set of software practices that can help to produce products faster and at the same time deliver what customers want. Despite the benefits that Agile methods can deliver, however, we found few studies from the Southeast Asia region, particularly Malaysia. As a result, less empirical evidence can be obtained in the country making its implementation harder. To use a new method, experience from other practitioners is critical, which describes what is important, what is possible and what is not possible concerning Agile. We conducted a qualitative study to understand the issues faced by early adopters in Malaysia where Agile methods are still relatively new. The initial study involves 13 participants including project managers, CEOs, founders and software developers from seven organisations. Our study has shown that social and human aspects are important when using Agile methods. While technical aspects have always been considered to exist in software development, we found these factors to be less important when using Agile methods. The results obtained can serve as guidelines to practitioners in the country and the neighbouring regions

Recurrent mutations of BRCA1, BRCA2 and PALB2 in the population of breast and ovarian cancer patients in Southern Poland

Background Mutations in the BRCA1, BRCA2 and PALB2 genes are well-established risk factors for the development of breast and/or ovarian cancer. The frequency and spectrum of mutations in these genes has not yet been examined in the population of Southern Poland. Methods We examined the entire coding sequences of the BRCA1 and BRCA2 genes and genotyped a recurrent mutation of the PALB2 gene (c.509_510delGA) in 121 women with familial and/or early-onset breast or ovarian cancer from Southern Poland. Results A BRCA1 mutation was identified in 11 of 121 patients (9.1 %) and a BRCA2 mutation was identified in 10 of 121 patients (8.3 %). Two founder mutations of BRCA1 accounted for 91 % of all BRCA1 mutation carriers (c.5266dupC was identified in six patients and c.181 T > G was identified in four patients). Three of the seven different BRCA2 mutations were detected in two patients each (c.9371A > T, c.9403delC and c.1310_1313delAAGA). Three mutations have not been previously reported in the Polish population (BRCA1 c.3531delT, BRCA2 c.1310_1313delAAGA and BRCA2 c.9027delT). The recurrent PALB2 mutation c.509_510delGA was identified in two patients (1.7 %). Conclusions The standard panel of BRCA1 founder mutations is sufficiently sensitive for the identification of BRCA1 mutation carriers in Southern Poland. The BRCA2 mutations c.9371A > T and c.9403delC as well as the PALB2 mutation c.509_510delGA should be included in the testing panel for this population

Archival data on wild food plants used in Poland in 1948

<p>Abstract</p> <p>Background</p> <p>In 1948, Professor Józef Gajek initiated a detailed census of the wild edible plants used in Poland. The questionnaires were collected by correspondents of the Polish Folklore Society in 95 localities throughout Poland. A major part of these archival materials, including a substantial collection of herbarium specimens, had not undergone thorough analysis prior to this study, which presents a quantitative analysis of this archival set of data.</p> <p>Methods</p> <p>Herbarium specimens were identified and a database was created.</p> <p>Results</p> <p>Ninety-eight taxa identified to genus or species level, including 71 botanical species, identified using herbarium specimens, were found. On average only 11 edible plant species per locality were listed, the longest list included 39 species. No correlation between latitude and the number of edible species was found, whereas there was small but significant correlation with the longitude. Fruits were the most frequently collected part of plants. Most plants were primarily collected by women and children. Children both helped parents to collect wild fruits and also ate many species raw, which were not consumed by adults, but had often been eaten in the past. Eighteen of the taxa had not been reported in a recent comprehensive review of edible plants of Poland. <it>Stratiotes aloides</it>, used as a famine vegetable in the Łódź region, has never been reported as edible in any ethnobotanical literature.</p> <p>Conclusion</p> <p>The results undermine the conclusions of a recent comprehensive review of edible plants of Poland, which stated that many more wild edible plants have been collected in the Carpathians than in lowland Poland. However such results were shown to be caused by the substantially larger number of ethnographic studies undertaken in the Carpathians. In fact, large numbers of edible plant species were collected in the mid-20^thcentury in a few regions, particularly along the eastern border, in the Carpathians and in communities originating from the expanded Soviet Union, which had been resettled to the north-west of Poland in 1945.</p

Porphyromonas gingivalis in Alzheimer's disease brains : evidence for disease causation and treatment with small-molecule inhibitors

Porphyromonas gingivalis, the keystone pathogen in chronic periodontitis, was identified in the brain of Alzheimer's disease patients. Toxic proteases from the bacterium called gingipains were also identified in the brain of Alzheimer's patients, and levels correlated with tau and ubiquitin pathology. Oral P. gingivalis infection in mice resulted in brain colonization and increased production of Aβ1-42, a component of amyloid plaques. Further, gingipains were neurotoxic in vivo and in vitro, exerting detrimental effects on tau, a protein needed for normal neuronal function. To block this neurotoxicity, we designed and synthesized small-molecule inhibitors targeting gingipains. Gingipain inhibition reduced the bacterial load of an established P. gingivalis brain infection, blocked Aβ1-42 production, reduced neuroinflammation, and rescued neurons in the hippocampus. These data suggest that gingipain inhibitors could be valuable for treating P. gingivalis brain colonization and neurodegeneration in Alzheimer's disease