Journal Issue: Vol.1, No.2 - June 2001

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Profile -- Prof. Andrew Wallace Boyd

Prof. Andrew Wallace Boyd Prof. Andrew Wallace Boyd BMedSc MBBS PhD FRACP is currently working as the Assistant Director of Queensland Institute of Medical Research. Dr. Andrew Boyd is one of the leading scientists of Australia. Dr. Boyd received his B.Med.Sc. degree from the Melbourne University in 1970 and his MBBS degree from the same University in 1973. Dr. Boyd did his PhD with Professors John Schrader and Sir Gus Nossal at the Walter and Eliza Hall Institute (WEH) from 1978-1981. In 1981 he finished his PhD from the Melbourne University. He became a Fellow of the Royal Australasian College of Physicians in 1983. During his professional career Prof. Boyd has successfully combined his work as a leading academic researcher with a strong commitment to his practitioner duties. His first post-doctoral studies were undertaken with Professor Don Metcalf at the Walter and Eliza Hall Institute. Further post-doctoral studies were undertaken from 1983 to 1985 in the Division of Tumor Immunology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. Following this from 1985 to 1996, Dr. Boyd was the Head of the Lions Caner Research Laboratory, Cellular Immunology Unit, Walter and Eliza Hall Institute. During this period from 1985-1996, he also maintained his practice as a physician with the Department of Medical Oncology, Royal Melbourne Hospital, as well as working as Assistant Haematologist in the Department of Diagnosis Haematology, Royal Melbourne Hospital from 1990-1996. Dr. Boyd has an impressive publication record. He has contributed articles to the scientific community in the following areas: Tumor models for immune function- mechanism of effector cell blockade, induction of cell death by anti-immunoglobulin, phenotype switch from B cell to macrophage; The role of membrane proteins in B lymphocyte differentiation ? altered expression in tumors, link between cell surface phenotype and tumor type, first demonstration of lineage switching within the hemopoietic compartment; Role of ICAM-1 and other adhesin molecules in immune function and in inflammation; Characterisation of human haemopioetic progenitor cells from umbilical cord blood; Bone marrow stromal cell activity in support of human haemopoiesis; Identification of a novel tyrosine kinase (HEK) as one of the first members of a unique class of receptor tyrosine kinase proteins, the Eph kinases, characterization of the EphA3 ligand and elucidation of receptor-ligand promiscuity; The role of Eph receptors in cell movement in early development; and, The role of Eph receptors in cancer. He has more than 152 publications in his credit. Dr. Boyd is currently the Assistant Director of Queensland Institute of Medical Research Head, Leukaemia Foundation Laboratory, Queensland Institute of Medical Research, Senior Principal Research Fellow, Queensland Institute of Medical Research, Professor of Experimental Haematology, University of Queensland, Chairman, Joint Program for Experimental Haematology, Queensland Institute of Medical Research & University of Queensland. Dr. Andrew Boyd is a well-reputed clinician and is a Consultant Haematologist in the Department of Haematology, Royal Brisbane Hospital.


Expresssion of Drug-Resistance Proteins in Human Breast:Taiwan Experience

Dr Chia-Hung Kao, Dr Tse-Jia Lin

  1. Dr Chia-Hung Kao
    Department of Nuclear Medicine, Taichung Veterans General Hospital,
  2. Dr Tse-Jia Lin
    Surgery & Nuclear Medicine,Taichung Veterans General Hospital,

The incidence rate of breast cancer has been increasing in recent years in Taiwan. Adjuvant therapy with chemotherapy is increasingly being used in the treatment of breast caner patients. Drug resistance plays an important role in chemotherapy failure in drug cancer. The aim of this project was to study the expression of drugs resistance proteins (p-glycoprotein (Pgp), Ki-67 and mutant p53) and relate the results to the follow-up data. Protein expression was investigated by immunohisto-chemistry. We studied the expression of drug resistance proteins in 87 breast cancer patients. Pgp staining was observed in 24% of specimens. Nuclear staining of Ki-67 and mutant p53 were observed in 44% and 25% of specimens respectively,. Pgp expression was associated with Ki-67 and mutant p53 expression, and was significant in its direct relationship to tumor grading. Statistically significant relations were detected between Ki-67 expression and nodal status and tumor grading. Mutant p53 positivity was associated with an older patient age. An inverse correlation was also seen between the mutant p53 expression and progesterone receptor content. The relationship between drug resistance proteins and survival time requires further investigation. We hope this study will allow clinicians to provide more appropriate treatment.

Pediatric Head and Neck Cancer: A Retrospective Study of 82 Cases

Dr M. Weyl Ben Arush, M Peretz Nahum, Dr J Rosenthal, Dr J Danino, Dr D Goldenberg

  1. Dr M. Weyl Ben Arush
    Pediatric Hematology/Oncology Department, Rambam Medical Centre
  2. M Peretz Nahum
    Department of Otolarygnology - Head and Neck Surgery, Rambam Medical Centre and Faculty of Medicine, Israel Institute of Technology
  3. Dr J Rosenthal
    Department of Otolarygnology - Head and Neck Surgery, Rambam Medical Centre and Faculty of Medicine, Israel Institute of Technology
  4. Dr J Danino
    Department of Otolarygnology - Head and Neck Surgery, Rambam Medical Centre and Faculty of Medicine, Israel Institute of Technology
  5. Dr D Goldenberg
    Department of Otolarygnology - Head and Neck Surgery, Rambam Medical Centre and Faculty of Medicine, Israel Institute of Technology

The head and neck are common sites of mass lesions in children. Most of these lesions are congenital or inflammatory in origin and malignancy is not the most common etiology; however, this possibility must be considered until otherwise proved. Not infrequently, the etiologies are combined and difficult. Differential diagnosis of inflammatory or neoplastic lesions affecting the cervical lymph tissue, such as lymphoma, occur in the evaluation of sub-acute or chronic cervical lymphadenopathy. We reviewed the epidemiology, clinical patterns, treatment, follow-up and outcome of 82 children with malignant head and neck solid tumors.

Febrile Neutropenia in Pediatric Oncology

Dr T Celkan, Dr H Apak, Prof L Yuskel, Prof I Yidiz

  1. Dr T Celkan
    Pediatric Haematologist, Department of Paediatric Haematology-Oncology, Cerraphasa Medical School, University of Istabul
  2. Dr H Apak
    Pediatric Oncologist, Istabul University, Cerraphasa Medical School, Department of Paediatric Haematology-Oncology
  3. Prof L Yuskel
    Professor of Paediatric Haematology-Oncology, Istabul University, Cerraphasa Medical School, Department of Paediatric Haematology-Oncology
  4. Prof I Yidiz
    Professor of Paediatric Haematology-Oncology, Istabul University, Cerraphasa Medical School, Department of Paediatric Haematology-Oncology

In a two years period, 40 children with leukemia/lymphoma and 18 children with solid tumors, 34 males and 24 females (ranging in age from 10 months to 14.5 years) had neutropenia on 115 occasions. The patients received one of three empirical occasions. The patients received one of three empirical antibiotic regimens: A: piperacillin + cefazolin + netilmicin; B: cefoperazone/sulbactam + netilmicin; C: imipenem/ cilastatin. Microbiologically documented infections occurred in 56 episodes (48.6%). Frequency of gram negative and positive bacteria isolated was identical (%50). S. viridans and S. epidermidis being the most frequent gram (+) and E. Coli and Klebsiella spp being the most frequent gram (-) pathogens. Blood cultures were positive in 24 episodes (20.8%) in 15 which (62.5%) the causative organism was gram (+), primarily S. epidermidis and S. aureus. There were 5 cases of infection-related deaths, three due to gram (-) bacteremia (P.aeruginosa and E.coli) and one due to systemic candida infection. There were no statistical difference between antibiotic regimens for duration of fever or neutropenia, response rate, necessity for modifications and failure.

Factors Related to Contience Preserving Surgery and Local Control in Patients with Curative Rectal Resection for Rectal Cancer: A Population-based Study

Pr Jean-Francois Bosset

  1. Pr Jean-Francois Bosset
    Radiotherapy Department, University Hospital

The aim of study was to determine the factors related to the choice of continence-preserving resection (CPR), and to local recurrence (LR) in patients with rectal cancer registered in the Tumour Registry of Doubs (France) during the period 1984 ? 1995. Some 566 patients were selected. Stage, postoperative mortality (1.8%) and survival did not change during the study period. CPR was performed in 372 patients (65.7%). Study period (p<.0001), tumor location within the rectum (p<.004) and its macroscopical appearance (circular or not) (p<.003) were significant factors associated with CPR. LR was observed in 106 patients (19.09%). The risk of LR significantly increased with more advanced stages or circular tumors, and decreased with preoperative radiotherapy. This population- based study demonstrates that improvements have been made in the management of rectal cancer patients. The benefits of preoperative radiotherapy indicate that multidisciplinary approach is efficient.

Colorectal Polyp Detection with Virtual Colonoscopy (Computed Tomographic Colonography): The Reliability of the Method

D Dimitroulopoulos, D Xynopoulos, K Tsamakides, E Arhavlis, M Stasinopoulou, M Kontou, A Tavernaraki, E Paraskevas

  1. D Dimitroulopoulos
  2. D Xynopoulos
  3. K Tsamakides
  4. E Arhavlis
  5. M Stasinopoulou
  6. M Kontou
  7. A Tavernaraki
  8. E Paraskevas

BACKGROUND/AIMS: The aim of this study was to compare the reliability of virtual colonoscopy (V.C.) with conentional conoloscopy in detection of colorectal polyps. MATERIAL AND METHODS: Since November 1997 to February 2000, 23 patients (14 males, 9 females) and 43-86 years (mean 63) with colo-rectal polyps who underwent colonoscopy in our endoscopy unit, were referred for V.C. The colon was distended with an enema tube for rectal insuflation and subsequently was scanned by helical Ct (Toshiba X-vision) using the following parameters: KV 120, mAs 200, table feed 5 mm/sec, slice thickness 5 mm and reconstruction intervals 2.5 mm. Using SPARC Station 20 V.C. was generated. RESULTS: A total of 30 polyps (19 with diameter 8-15 mm and 11 larger than 15mm) were detected with conventional colonoscopy V.C. visualized 27 polyps (17 with diameter 8-15mm and 10 with diameter >15mm). CONCLUSIONS: V.C. is a non invasive, well tolerated, safe technique and can be useful for detection of colorectal polyps. Weakness of the method are the inability to detect small lesions and to perform biopsies.

Angiogenin: Its Clinical Implications in Malignancy

Dr Shouji Shimoyama, Michio Kaminishi

  1. Dr Shouji Shimoyama
    Departmental of Gastrointestinal Surgery, University of Tokyo
  2. Michio Kaminishi

Angiogenin (ANG) is a 14kDa angiogenic protein which was originally isolated from a medium conditioned by the HT-29 human colon carcinoma cell line. It has been found in human nonmalignant cells as well as in plasma or sera from healthy humans. Also, ANG expression has been observed in malignant cell lines as well as in sera or in tissues from patients with various malignancies. Increased ANG expression in patients with malignancies correlating with tumor progression suggests the involvement of ANG in tumor aggressiveness. Proteolytic activities of ANG and the adhesion of ANG to endothelial cells and extracellular matrix molecules may enable ANG expressing tumor cells to degrade, penetrate through, and invade into the basement membrane and surrounding tumor stroma, thus resulting in increased tumor progression, metastasis, and aggressiveness. Inductions of ANG by hypoxic stress and some inflammatory cytokines suggest the participation of ANG in cytokine networks in tumor stroma. The inhibition of ANG action may thus represent a potential target for the treatment of malignant disease.

A Public Health Model for the Prevention of Cancer: The Australian Experience with Melanoma and Non-melanoma Skin Cancer

Rodney Sinclair, PA Curnow, R Marks

  1. Rodney Sinclair
  2. PA Curnow
  3. R Marks

Australia has he highest incidence and mortality rates due to skin cancer in the world. Sunlight is a major risk factor in the development of these cancers. In an attempt to address this problem both primary and secondary prevention using a public health approach have been implemented over the past two decades. This article outlines the steps involved as a model for the prevention of a common cancer.

Virtual Simulation in a Smaller Cancer Centre

Dr S. P Gulavita, P L McGhee

  1. Dr S. P Gulavita
    Northwestern Ontario, Regional Cancer Centre
  2. P L McGhee

The availability of CT data has now led to the new innovation of virtual simulation. Using CT data, the patient is of reconstructed inside a computer to create a ?virtual patient?. The entire simulation process is then performed on the virtual patient rather than the actual person. The advantages of virtual simulation are (a) shortens the time that the patient must dedicate to the stimulation process; (b) various treatment strategies can be simulated without additional inconvenience to the patient; (c) facilities remote real-time participation in the acquisition of CT images; (d) provides visual presentation of the patient?s anatomy that cannot be obtained through conventional means; (e) supports the implementation of more complex treatment techniques, eg. beam arrangements in 2D and 3D format; (f) completely compatible with current trends in medicine towards ?filmless? procedures. This article describes how virtual simulation has been implemented in a smaller Cancer Centre resulting in a more patient friendly approach that provides improved cost, time and labour efficiencies.

Haemorrhagic Cerebral Metastasis

N Geetha, M C Kalavathy, M Krishnan Nair, K Ramachandran, G Sreejith Nair

Truth Disclosure in Cancer with Special Reference to Ethical and Clinical Dilemmas

Dr Noritoshi Tanida, Noriyasu Yamamoto, Takashi Sakagami

  1. Dr Noritoshi Tanida
    MD, PhD.
    Department of Internal Medicine, Hyogo College of Medicine,
  2. Noriyasu Yamamoto
  3. Takashi Sakagami

Issues regarding truth disclosure are analyzed ethically with 4 elements including medical indications, patient preferences, quality of life (QOL) and contextual features. Results show that truth disclosure is rationalized in most occasions from a view of medical indications. Truth disclosure is unquestionable in the concept and procedure of informed consent or patient preferences. A concern regarding QOL is not an obstacle to truth disclosure, because truth disclosure does not have a negative influence on QOL. Cross-cultural issues in truth disclosure are not a matter of the appropriateness of truth disclosure, but a matter of the current clinical practice in a particular culture. There is no justifiable reason for concealing truth from patients except if the patient explicitly requests not to be told the truth. In addition, clinical dilemmas caused by incapability to deliver bad news and to take care of distressed patients are likely to be obstacles to practice truth disclosure among medical professionals. Thus, the issue of truth disclosure will be solved by improvement in understanding and capacity of medical professionals to deal with distressed patients who desperately need support from surrounding people.

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