Due to its unique composition and the complex processing of nectar by the bees which changes its chemical properties, honey is suitable for long term preservation and is easily assimilated even after long conservation. History knows examples of honey preservation for decades, and even centuries. "...small residues of edible honey have even been found in the pharaoh's tombs…"
A number of special prerequisites are, however, necessary to achieve the conservation periods of this order. These might include sealing the product in vessels of chosen material, kept in a favorable environment of specific humidity, temperature etc. An example of natural sealing of the honey with wax by the bees in little separated honey comb cells could be taken for reference.When conventional preservation methods are applied, it is not recommended to preserve the honey for longer than 2 (maximum 3) years. As the honey has a strong tendency to absorb outside smells, it is advisable to keep it in clean, hermetically sealed vessels. It is also advisable to keep it in darkened (not lucid) vessels, or in dark store-places. When the honey remains in direct sunlight for about one day its lysozyme (antibacterial albuminous enzyme) is being destroyed. Honey should also be protected from oxygen inflow—the accelerated crystallization is brought about by it. Optimal preservation temperature is +4-10°C. The store-place should be dark and dry, preventing the honey from absorbing the moisture. When excessive moisture is soaked up by the honey, it might start fermenting. "Bee honey can absorb the moisture from the air, therefore it might ferment in a damp place"
"Exposure to fresh air brings about the soaking up of external smells, oxygen and moisture, which cause fundamental chemical change of the product—decay of valuable amino acids, vitamins, enzymes and "antibiotics". The light has a similar influence."
The acacia honey is known to be more resistant against crystallization. "The acacia honey would not crystallize (as quick as other types)…"
Due to the above reasons (high tendency to absorb outside smells and moisture) it is not advisable to preserve the honey in a fridge, especially together with other foods and products.
Honey is considered to gradually become toxic when preserved in metal containers. "Honey must not be preserved in metal containers, because the acids contained in its structure may cause oxidation. This leads to increased content of heavy metals in honey and decreases the amount of valuable healthy ingredients. Such a honey may cause obnoxious sensations in the stomach and even bring about a poisoning…"It used to be preserved in ceramic and wooden containers in ancient times. Glass bottles are recommended nowadays. "The wooden vessels of coniferous wood are not suitable for honey preservation (honey soaks up the coniferous smell in such vessels). In the oak wood vessels honey grows black."
Traditionally honey was preserved in deep cellars, but not together with wine or other products. It is considered even more sensitive to the store-place conditions than the best wines.
Honey should not be heated above 40°С (104°F).The best honey is in the uncut honey combs. After being pumped out from there it is very vulnerable, and the main losses of quality take place during preservation and distribution. Heating up to 37°С causes loss of nearly 200 components, part of which are antibacterial. Heating up to 40°С destroys the invertase—the main bee enzyme, thanks to which the nectar becomes honey; heating up to 50°С turns the honey into caramel (the most valuable honey sugars become analogous to synthetic sugar). Generally any larger temperature fluctuation (10°С is ideal for preservation of ripe honey) causes decay."
From : Wikipedia
17 Juni 2008
Description, Sign and Symptoms of Mesothelioma
Mesothelioma Description
Before recognizing furthermore of mesothelioma we better know the mesothelioma description and asbestosis. The Mesothelioma description is a cancer that develops within the mesothelium of the body. Or there are some expert says : Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).
The mesothelium is the protective covering in the body. It covers various organs, including the lungs. The mesothelium is made up of two thin layers. When cancer develops in the mesothelium it is between these layers. The narrow space makes it very difficult to diagnose mesothelioma in the early stages. Mesothelioma is a difficult cancer to treat. Once a diagnosis of mesothelioma is made, the majority of patients will not live longer than eighteen months. There are a variety of reasons for this, including the advanced nature of the disease once it is diagnosed and the lack of an effective
While most cases of mesothelioma occur around the lungs, it can also occur in the abdominal mesothelium, called the peritoneum, or the pericardium. While mesothelioma is most common in the lungs, it is important to differentiate between mesothelioma and lung cancer. They are two very different types of cancer and require different types of treatment.
Signs and symptoms
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
Chest wall pain, pleural effusion, or fluid surrounding the lung, shortness of breath, fatigue or anemia, wheezing, hoarseness, or cough, blood in the sputum (fluid) coughed up
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage.
Symptoms include:
Abdominal pain, ascites, or an abnormal buildup of fluid in the abdomen, a mass in the abdomen, problems with bowel function, weight loss
In severe cases of the disease, the following signs and symptoms may be present:
Blood clots in the veins, which may cause thrombophlebitis, disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs, jaundice, or yellowing of the eyes and skin, low blood sugar level, pleural effusion, pulmonary emboli, or blood clots in the arteries of the lungs and severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
14 Juni 2008
Clinical Cancer Centers in USA
Clinical Cancer Centers have support from the National Cancer Institute for programs that investigate new treatments or research programs. For information on a clinical cancer center in your area, call the National Cancer Institute's Cancer Information Service at 800-4-CANCER.
CALIFORNIA
City of Hope National Medical CenterLocated just northeast of Los Angeles in Duarte, California, City of Hope comprises more than 300 physicians and scientists and over 2,500 employees work to find the causes of and cures for cancer and other life-threatening diseases. The 2004 Patients Evaluation of Performance in California (PEP-C) survey, the largest patient satisfaction survey in the nation, named City of Hope as the only hospital in Southern California and one of only four hospitals in the state to receive the highest marks in all applicable categories from patients. City of Hope Medical Center1500 East Duarte Road, Duarte, CA 91010818-359-8111 or 818-301-8164
Salk Institute Cancer CenterThe Salk Institute consistently ranks among the leading research institutions in the world for its faculty’s contributions and the impact of their findings. The Institute has trained more than 2,000 scientists, many of whom have gone on to positions of leadership in other prominent research centers worldwide. Five scientists trained at the Institute have won Nobel prizes, and three current resident faculty members are Nobel Laureates.The major areas of study are: Molecular Biology and Genetics; Neurosciences; and Plant Biology. Knowledge acquired in Salk laboratories provides new understanding and potential new therapies and treatments for a range of diseases—from cancer, AIDS and Alzheimer’s disease, to cardiovascular disorders, anomalies of the brain and birth defects. Studies in plant biology at the Salk may one day help improve the quality and quantity of the world’s food supply.Salk Institute 10010 North Torrey Pines Road, La Jolla, California 92037Tel: (858) 453-4100 X 1386
The Burnham Institute for Medical Research Research at the Burnham is organized into 3 disease-focused research centers, bolstered by 3 technology centers. The Cancer Research Center constitutes approximately half the effort. The Burnham has been a member of the National Cancer Institute (NCI) designed Cancer Centers program since 1981 in the category of “basic science” cancer centers. The Cancer Research Center has also been designed by the NCI through special grants we receive as: (1) one of 13 centers for cancer drug discovery; (2) one of six centers for defining the molecular signatures of cancer for generating more powerful diagnostic test, in partnership with neighboring organizations including SKCC, and (4) one of eight centers for cancer bionanotechnology, also in partnership with neighboring organizations. Burnham Institute for Medical Research 10901 North Torrey Pines Road, La Jolla, California 92037Tel: (858) 646-3100
Stanford Cancer Center Opened in March 2004, the Stanford Cancer Center offers the latest advances in patient-focused treatment in a warm and supportive environment. Consolidating the medical center’s resources for diagnosing and treating cancer, the new cancer center enhances Stanford’s team approach to care while enabling patients to stay in one location for procedures and tests. The building supports the translational mission of the SCC, bringing together clinicians and researchers to collaborate on the behalf of patients. Housing a tumor registry, a clinical research suite and conference rooms, the center serves as the medical center’s hub for clinical trials of novel cancer therapies and enhances its ability to bring promising research discoveries into clinical practice.Stanford University Cancer Center800 Welch Road, Room 284, Stanford, CA 94305-5796Tel: (650) 736-1808
UC Davis Cancer Center, University of California, Davis UC Davis Cancer Center's research program is unique in the nation. It is a model partnership that unites physicians and scientists from throughout the university with biomedical researchers and engineers from Lawrence Livermore National Laboratory (home to the world's most powerful computer and a Human Genome Project center).Every day, our light physicists, biomedical engineers and oncologists partner with experts in dozens of other fields. All told, we have nearly 300 scientists working fulltime to make the breakthroughs that will offer cancer patients fresh hope. It's a collaborative, multidisciplinary approach that sets UC Davis apart. And it's good news for our many patients, who stand to be the first to benefit from our advances.UC Davis Cancer Center4501 X Street, Suite 3003, Sacramento, California 95817Tel: (916) 734-5800
University of California at Irvine Cancer CenterPeople seeking information, support and treatment at the UCI Chao Family Comprehensive Cancer Center have access to new kinds of therapies years before they are generally available to the public, as well as to the full spectrum of conventional approaches to the disease. In addition, patients are assured that a multidisciplinary team of highly trained cancer specialists will wage a concentrated attack on the disease, sensitive to the physical, emotional, and economic impact of the illness on patients and their families. As a university-based facility, the cancer center offers the expertise of a scientific community that has earned an international reputation for its work in the prevention, diagnosis, and treatment of cancer. University of California Irvine Chao Family Comprehensive Cancer Center 101 The City DriveOrange, CA 92668714-456-8200
University of California at San Diego Cancer CenterThe UCSD Cancer Center ranks among the top centers in the nation conducting basic and clinical cancer research, providing advanced patient care and serving the community through outreach and education programs. Loocated at the University of California, San Diego, the Cancer Center offers over 150 clinical trials at any given time. University of California San Diego Moores Cancer Center 200 West Arbor DriveSan Diego, CA 92130619-543-3325
COLORADO
University of Colorado Cancer CenterThe Rocky Mountain region's only National Cancer Institute, UCCC offers information and treatment options not available anywhere else in Colorado - providing a multidisciplinary team approach to care — the opportunity to meet with a variety of specialists, in one location, in one day; Physicians who are highly trained in the treatment of specific cancer types, using the latest technology and a commitment to world-class care and amazing service for patients.UCCC's cancer specialists are dedicated to treating nearly every form of cancer, including mesothelioma. University of Colorado Cancer Center 4200 East 9th AvenueDenver, CO 80262303-270-3007
HAWAII
Cancer Research Center of Hawaii , University of Hawaii at Manoa The Cancer Research Center of Hawaii is a research unit of the University of Hawaii (UH) that was established by the Board of Regents as a freestanding independent institute in 1981. On July 1, 1996, the Center became an NCI-designated center and was awarded the Cancer Center Support Grant. Today, the Cancer Research Center of Hawaii continues to bring together researchers who focus on understanding the etiology of cancer and on reducing its impact on the people of Hawaii.The CRCH conducts research on the causes, prevention and treatment of cancer across a broad array of disciplines. Research areas include epidemiology, molecular carcinogenesis, cancer treatment, prevention methods, quality of life in cancer survivors, new therapeutic approaches to cancer treatment, and community-based interventions to promote cancer preventive lifestyles in our multiethnic population.Cancer Research Center of Hawaii1236 Lauhala Street, Honolulu, Hawaii 96813Tel: (808) 586-3013
CALIFORNIA
City of Hope National Medical CenterLocated just northeast of Los Angeles in Duarte, California, City of Hope comprises more than 300 physicians and scientists and over 2,500 employees work to find the causes of and cures for cancer and other life-threatening diseases. The 2004 Patients Evaluation of Performance in California (PEP-C) survey, the largest patient satisfaction survey in the nation, named City of Hope as the only hospital in Southern California and one of only four hospitals in the state to receive the highest marks in all applicable categories from patients. City of Hope Medical Center1500 East Duarte Road, Duarte, CA 91010818-359-8111 or 818-301-8164
Salk Institute Cancer CenterThe Salk Institute consistently ranks among the leading research institutions in the world for its faculty’s contributions and the impact of their findings. The Institute has trained more than 2,000 scientists, many of whom have gone on to positions of leadership in other prominent research centers worldwide. Five scientists trained at the Institute have won Nobel prizes, and three current resident faculty members are Nobel Laureates.The major areas of study are: Molecular Biology and Genetics; Neurosciences; and Plant Biology. Knowledge acquired in Salk laboratories provides new understanding and potential new therapies and treatments for a range of diseases—from cancer, AIDS and Alzheimer’s disease, to cardiovascular disorders, anomalies of the brain and birth defects. Studies in plant biology at the Salk may one day help improve the quality and quantity of the world’s food supply.Salk Institute 10010 North Torrey Pines Road, La Jolla, California 92037Tel: (858) 453-4100 X 1386
The Burnham Institute for Medical Research Research at the Burnham is organized into 3 disease-focused research centers, bolstered by 3 technology centers. The Cancer Research Center constitutes approximately half the effort. The Burnham has been a member of the National Cancer Institute (NCI) designed Cancer Centers program since 1981 in the category of “basic science” cancer centers. The Cancer Research Center has also been designed by the NCI through special grants we receive as: (1) one of 13 centers for cancer drug discovery; (2) one of six centers for defining the molecular signatures of cancer for generating more powerful diagnostic test, in partnership with neighboring organizations including SKCC, and (4) one of eight centers for cancer bionanotechnology, also in partnership with neighboring organizations. Burnham Institute for Medical Research 10901 North Torrey Pines Road, La Jolla, California 92037Tel: (858) 646-3100
Stanford Cancer Center Opened in March 2004, the Stanford Cancer Center offers the latest advances in patient-focused treatment in a warm and supportive environment. Consolidating the medical center’s resources for diagnosing and treating cancer, the new cancer center enhances Stanford’s team approach to care while enabling patients to stay in one location for procedures and tests. The building supports the translational mission of the SCC, bringing together clinicians and researchers to collaborate on the behalf of patients. Housing a tumor registry, a clinical research suite and conference rooms, the center serves as the medical center’s hub for clinical trials of novel cancer therapies and enhances its ability to bring promising research discoveries into clinical practice.Stanford University Cancer Center800 Welch Road, Room 284, Stanford, CA 94305-5796Tel: (650) 736-1808
UC Davis Cancer Center, University of California, Davis UC Davis Cancer Center's research program is unique in the nation. It is a model partnership that unites physicians and scientists from throughout the university with biomedical researchers and engineers from Lawrence Livermore National Laboratory (home to the world's most powerful computer and a Human Genome Project center).Every day, our light physicists, biomedical engineers and oncologists partner with experts in dozens of other fields. All told, we have nearly 300 scientists working fulltime to make the breakthroughs that will offer cancer patients fresh hope. It's a collaborative, multidisciplinary approach that sets UC Davis apart. And it's good news for our many patients, who stand to be the first to benefit from our advances.UC Davis Cancer Center4501 X Street, Suite 3003, Sacramento, California 95817Tel: (916) 734-5800
University of California at Irvine Cancer CenterPeople seeking information, support and treatment at the UCI Chao Family Comprehensive Cancer Center have access to new kinds of therapies years before they are generally available to the public, as well as to the full spectrum of conventional approaches to the disease. In addition, patients are assured that a multidisciplinary team of highly trained cancer specialists will wage a concentrated attack on the disease, sensitive to the physical, emotional, and economic impact of the illness on patients and their families. As a university-based facility, the cancer center offers the expertise of a scientific community that has earned an international reputation for its work in the prevention, diagnosis, and treatment of cancer. University of California Irvine Chao Family Comprehensive Cancer Center 101 The City DriveOrange, CA 92668714-456-8200
University of California at San Diego Cancer CenterThe UCSD Cancer Center ranks among the top centers in the nation conducting basic and clinical cancer research, providing advanced patient care and serving the community through outreach and education programs. Loocated at the University of California, San Diego, the Cancer Center offers over 150 clinical trials at any given time. University of California San Diego Moores Cancer Center 200 West Arbor DriveSan Diego, CA 92130619-543-3325
COLORADO
University of Colorado Cancer CenterThe Rocky Mountain region's only National Cancer Institute, UCCC offers information and treatment options not available anywhere else in Colorado - providing a multidisciplinary team approach to care — the opportunity to meet with a variety of specialists, in one location, in one day; Physicians who are highly trained in the treatment of specific cancer types, using the latest technology and a commitment to world-class care and amazing service for patients.UCCC's cancer specialists are dedicated to treating nearly every form of cancer, including mesothelioma. University of Colorado Cancer Center 4200 East 9th AvenueDenver, CO 80262303-270-3007
HAWAII
Cancer Research Center of Hawaii , University of Hawaii at Manoa The Cancer Research Center of Hawaii is a research unit of the University of Hawaii (UH) that was established by the Board of Regents as a freestanding independent institute in 1981. On July 1, 1996, the Center became an NCI-designated center and was awarded the Cancer Center Support Grant. Today, the Cancer Research Center of Hawaii continues to bring together researchers who focus on understanding the etiology of cancer and on reducing its impact on the people of Hawaii.The CRCH conducts research on the causes, prevention and treatment of cancer across a broad array of disciplines. Research areas include epidemiology, molecular carcinogenesis, cancer treatment, prevention methods, quality of life in cancer survivors, new therapeutic approaches to cancer treatment, and community-based interventions to promote cancer preventive lifestyles in our multiethnic population.Cancer Research Center of Hawaii1236 Lauhala Street, Honolulu, Hawaii 96813Tel: (808) 586-3013
09 Juni 2008
Directory Clinical Cancer in New Mexico, Illinois, Indiana, Nebraska, Maine, and Massachusettes
University of ChicagoBen May Department for Cancer ResearchThe work done by the collection of laboratories within the Ben May Department for Cancer Research has advanced cancer treatment by providing answers to fundamental biological questions and by finding applications for groundbreaking scientific discoveries. UC Department for Cancer Research 929 East 57th Street, W421 Chicago, IL 60637312-702-6180
INDIANA
Indiana University Melvin and Bren Simon Cancer CenterIndiana University (IU) Melvin and Bren Simon Cancer Center advances the understanding, prevention and treatment of cancer throughout Indiana and the world with patient-centered care, acceleration of promising science and collaborative educational programs. Over 200 investigators conduct research in the areas of experimental and development therapeutics, breast cancer, cancer control, as well as hematopoiesis, microenvironment and immunology. The IU Simon Cancer Center’s Translational Research Acceleration Collaboration (ITRAC) is the internal planning and funding process which has recently been implemented to speed the development of new cancer diagnostics and therapies from the laboratory to the bedside. Molecular and environmental carcinogenesis is one research area currently in development at the center.Indiana University Melvin and Bren Simon Cancer CenterIndiana Cancer Pavilion535 Barnhill Drive, Room 455, Indianapolis, Indiana 46202-5289Tel: (317) 278-0070
The Purdue Cancer Center The Purdue Cancer Center is an interdisciplinary basic cancer research Center. Its mission is to promote and support multidisciplinary cancer research at Purdue University. The scientific mission of the Center is to promote interdisciplinary cancer research at Purdue University. To accomplish its mission, the Center is organized into three scientific programs: Experimental Therapeutics and Diagnostics; Structural Biology; and Cell Growth and Differentiation. These programs form the scientific core of the Center. Our scientists collaborate across many departments to focus the most advanced biological, chemical, engineering and veterinary technologies on fighting cancer. Such collaborations generate knowledge, concentrate efforts on the most promising diagnostics and therapeutics, create additional research and funding opportunities, and help train future leaders in cancer researchPurdue University Cancer CenterHansen Life Sciences Research BuildingSouth University Street, West Lafayette, Indiana 47907-1524Tel: (765) 494-9129
MAINE
The Jackson Laboratory Cancer CenterScience at The Jackson Laboratory Cancer Center gains its strength and focus from multidisciplinary approaches to cancer, grounded in the genomics and basic biology of the mouse. Accurate preclinical models for human cancers are a foundation for translational research, a proving ground for target identification and validation. Among the best are modern mouse models, in which sophisticated genetic manipulation in the context of defined genetic backgrounds reproduces molecular aberrations associated with human tumors. The Jackson Laboratory Cancer Center has a single research program, modeling cancer: stem cells to therapy. Several members work on stem/progenitor cells, focusing on aspects of genome organization, nuclear architecture, and nuclear reprogramming, genome instability and programmed cell death in normal and transitional cells. Others investigate mechanisms involved in disease progression and host response, such as angiogenesis, immune recognition, metabolic regulators, and processes of aging. Prevention and therapy research involves targeting signal transduction pathways; bone marrow transplantation; and complications of cancer and therapy that become health issues for survivors, such as bone loss, reproductive failure and anemia. The sophisticated scientific services and resources supported by the Cancer Center enable this research.The Jackson Laboratory Cancer Center600 Main Street, Bar Harbor, Maine 04609-0800Tel: (207) 288-6041
MASSACHUSETTES
MIT Center for Cancer Research Massachusetts Institute of TechnologyThe MIT Center for Cancer Research (CCR) was founded in 1974, and is one of eight National Cancer Institute-designated basic research centers. Our mission is to apply the tools of basic science and technology to determine how cancer is caused, progresses and responds to treatment. Through this effort we have developed an increasingly complete understanding of the nature of cancer cells, which as led directly to improved treatments for the disease. Molecules identified by CCR research teams were used as targets for two of the first few FDA-approved cancer-fighting drugs produced by molecular medicine (approved by the FDA in 1998 and 2001). Today, the Center for Cancer Research continues to generate critical new insights into the basic mechanisms of cancer that are essential for advancing the diagnosis and treatment of cancer. We remain committed to our founding vision that we can conquer cancer through research and technology. MIT Center for Cancer Research77 Massachusetts Avenue, Room E17-110, Cambridge, Massachusetts 02139-4307Tel: (617) 253-8511
NEBRASKA
University of Nebraska Medical Center/ Eppley Cancer CenterThe UNMC Eppley Cancer Center is renowned for its basic research programs in chemical carcinogenesis, molecular, cellular and structural biology, and translational research in new therapies. Promising areas of clinical research include investigating antibodies for diagnosing and treating lymphomas and solid tumors, and developing tumor vaccines for colon and breast cancer, to name a few. In the multidisciplinary Peggy D. Cowdery Patient Care Center, part of the Lied Transplant Center, cancer patients are treated by surgical, medical, and radiation oncologists, as well as by supportive care specialists such as genetic counselors, nutritionists, and social workers. At the Lied Transplant Center, patients with cancer and other diseases requiring transplantation benefit from revolutionary treatment strategies in a comfortable, home-like setting. Cooperative Care, a new model of care delivery, enables family members to stay and participate as partners in a patient’s care. University of Nebraska Medical Center/ Eppley Cancer Center600 South 42nd Street, Omaha, Nebraska 68198-6805 Tel: (402) 559-4238
NEW MEXICO
University of New Mexico Cancer Research & Treatment Center Located in a region of rich multicultural and multiethnic diversity, tremendous scientific and technological capability, and challenging health and socioeconomic disparity, The University of New Mexico Cancer Research & Treatment Center (UNM CRTC) is the nation’s newest NCI-Designated Cancer Center. The special characteristics of the UNM CRTC are the multiethnic populations that it serves with their strikingly different patterns of cancer incidence and mortality; the integration of regional scientific strengths in engineering, nanotechnology, microsystems, and high performance computing at UNM, New Mexico State University, and Sandia and Los Alamos National Laboratories into its Research Programs; and the extensive networks that it has developed for community-based participatory research and cancer clinical trials. With significant support from UNM, The State of New Mexico, its formal consortium partners (Lovelace Respiratory Research Institute, Sandia and Los Alamos National Laboratories), and the community, the UNM CRTC members and programs have grown tremendously over the past five years. Over 45 new clinical and research faculty have been recruited since 2001. University of New MexicoMSC 08 4630, 1 University of New Mexico, 2325 Camino de SaludAlbuquerque, New Mexico 87131Tel: (505) 272-5622
INDIANA
Indiana University Melvin and Bren Simon Cancer CenterIndiana University (IU) Melvin and Bren Simon Cancer Center advances the understanding, prevention and treatment of cancer throughout Indiana and the world with patient-centered care, acceleration of promising science and collaborative educational programs. Over 200 investigators conduct research in the areas of experimental and development therapeutics, breast cancer, cancer control, as well as hematopoiesis, microenvironment and immunology. The IU Simon Cancer Center’s Translational Research Acceleration Collaboration (ITRAC) is the internal planning and funding process which has recently been implemented to speed the development of new cancer diagnostics and therapies from the laboratory to the bedside. Molecular and environmental carcinogenesis is one research area currently in development at the center.Indiana University Melvin and Bren Simon Cancer CenterIndiana Cancer Pavilion535 Barnhill Drive, Room 455, Indianapolis, Indiana 46202-5289Tel: (317) 278-0070
The Purdue Cancer Center The Purdue Cancer Center is an interdisciplinary basic cancer research Center. Its mission is to promote and support multidisciplinary cancer research at Purdue University. The scientific mission of the Center is to promote interdisciplinary cancer research at Purdue University. To accomplish its mission, the Center is organized into three scientific programs: Experimental Therapeutics and Diagnostics; Structural Biology; and Cell Growth and Differentiation. These programs form the scientific core of the Center. Our scientists collaborate across many departments to focus the most advanced biological, chemical, engineering and veterinary technologies on fighting cancer. Such collaborations generate knowledge, concentrate efforts on the most promising diagnostics and therapeutics, create additional research and funding opportunities, and help train future leaders in cancer researchPurdue University Cancer CenterHansen Life Sciences Research BuildingSouth University Street, West Lafayette, Indiana 47907-1524Tel: (765) 494-9129
MAINE
The Jackson Laboratory Cancer CenterScience at The Jackson Laboratory Cancer Center gains its strength and focus from multidisciplinary approaches to cancer, grounded in the genomics and basic biology of the mouse. Accurate preclinical models for human cancers are a foundation for translational research, a proving ground for target identification and validation. Among the best are modern mouse models, in which sophisticated genetic manipulation in the context of defined genetic backgrounds reproduces molecular aberrations associated with human tumors. The Jackson Laboratory Cancer Center has a single research program, modeling cancer: stem cells to therapy. Several members work on stem/progenitor cells, focusing on aspects of genome organization, nuclear architecture, and nuclear reprogramming, genome instability and programmed cell death in normal and transitional cells. Others investigate mechanisms involved in disease progression and host response, such as angiogenesis, immune recognition, metabolic regulators, and processes of aging. Prevention and therapy research involves targeting signal transduction pathways; bone marrow transplantation; and complications of cancer and therapy that become health issues for survivors, such as bone loss, reproductive failure and anemia. The sophisticated scientific services and resources supported by the Cancer Center enable this research.The Jackson Laboratory Cancer Center600 Main Street, Bar Harbor, Maine 04609-0800Tel: (207) 288-6041
MASSACHUSETTES
MIT Center for Cancer Research Massachusetts Institute of TechnologyThe MIT Center for Cancer Research (CCR) was founded in 1974, and is one of eight National Cancer Institute-designated basic research centers. Our mission is to apply the tools of basic science and technology to determine how cancer is caused, progresses and responds to treatment. Through this effort we have developed an increasingly complete understanding of the nature of cancer cells, which as led directly to improved treatments for the disease. Molecules identified by CCR research teams were used as targets for two of the first few FDA-approved cancer-fighting drugs produced by molecular medicine (approved by the FDA in 1998 and 2001). Today, the Center for Cancer Research continues to generate critical new insights into the basic mechanisms of cancer that are essential for advancing the diagnosis and treatment of cancer. We remain committed to our founding vision that we can conquer cancer through research and technology. MIT Center for Cancer Research77 Massachusetts Avenue, Room E17-110, Cambridge, Massachusetts 02139-4307Tel: (617) 253-8511
NEBRASKA
University of Nebraska Medical Center/ Eppley Cancer CenterThe UNMC Eppley Cancer Center is renowned for its basic research programs in chemical carcinogenesis, molecular, cellular and structural biology, and translational research in new therapies. Promising areas of clinical research include investigating antibodies for diagnosing and treating lymphomas and solid tumors, and developing tumor vaccines for colon and breast cancer, to name a few. In the multidisciplinary Peggy D. Cowdery Patient Care Center, part of the Lied Transplant Center, cancer patients are treated by surgical, medical, and radiation oncologists, as well as by supportive care specialists such as genetic counselors, nutritionists, and social workers. At the Lied Transplant Center, patients with cancer and other diseases requiring transplantation benefit from revolutionary treatment strategies in a comfortable, home-like setting. Cooperative Care, a new model of care delivery, enables family members to stay and participate as partners in a patient’s care. University of Nebraska Medical Center/ Eppley Cancer Center600 South 42nd Street, Omaha, Nebraska 68198-6805 Tel: (402) 559-4238
NEW MEXICO
University of New Mexico Cancer Research & Treatment Center Located in a region of rich multicultural and multiethnic diversity, tremendous scientific and technological capability, and challenging health and socioeconomic disparity, The University of New Mexico Cancer Research & Treatment Center (UNM CRTC) is the nation’s newest NCI-Designated Cancer Center. The special characteristics of the UNM CRTC are the multiethnic populations that it serves with their strikingly different patterns of cancer incidence and mortality; the integration of regional scientific strengths in engineering, nanotechnology, microsystems, and high performance computing at UNM, New Mexico State University, and Sandia and Los Alamos National Laboratories into its Research Programs; and the extensive networks that it has developed for community-based participatory research and cancer clinical trials. With significant support from UNM, The State of New Mexico, its formal consortium partners (Lovelace Respiratory Research Institute, Sandia and Los Alamos National Laboratories), and the community, the UNM CRTC members and programs have grown tremendously over the past five years. Over 45 new clinical and research faculty have been recruited since 2001. University of New MexicoMSC 08 4630, 1 University of New Mexico, 2325 Camino de SaludAlbuquerque, New Mexico 87131Tel: (505) 272-5622
Comprehensive Cancer Centers
Comprehensive Cancer Centers have been designated as such by the National Cancer Institute. They are required to have basic laboratory research in several fields; to be able to transfer research findings into clinical practice; to conduct clinical studies and trial; to research cancer prevention and control; to offer information about cancer to patients, the public, and health care professionals; and to provide community service related to cancer control. At any given time, most if not all comprehensive cancer centers are working on or facilitate research or clinical trials related to mesothelioma treatment.
NorthCarolina
Duke Comprehensive Cancer Center
North Carolina based Duke CCC provides comprehensive compassionate care, cutting edge research, and ongoing support for victims of mesothelioma and other forms of cancer. Duke University Medical Center Comprehensive Cancer CenterDurham, NC 27710919-684-5613
OHIO
The Case Comprehensive Cancer Center (Case CCC) The Case Comprehensive Cancer Center (Case CCC) based at Case Western Reserve University (Case) is a partnership organization supporting all cancer related research efforts at Case, University Hospitals of Cleveland (UHC), and the Cleveland Clinic. Located in Cleveland, Ohio, the Case CCC serves the cancer research and clinical needs of an urban manufacturing and rural agricultural region containing 3.8 million people in Northern Ohio. Case Comprehensive Care Center 11100 Euclid AvenueCleveland, OH 44106
Ohio State University Comprehensive Cancer CenterOSUCCC's mission is to save lives through innovative research designed to improve detection, treatment and prevention of cancer in its many forms. The OSUCCC is home to the Arthur G. James Cancer Hospital and Solove Research Institute - a 160+ bed hospital dedicated solely to cancer care. Ohio State Universrity Comprehensive Care CenterArthur G. James Cancer Hospital300 West 10th Avenue Columbus, OH 4321800-638-6996 or 614-293-4878
PENNSYLVANIA
Fox Chase Cancer CenterThe mission of Fox Chase Cancer Center is to reduce the burden of human cancer through the pursuit of new knowledge in basic biological research; to conduct research specifically related to cancer causes, prevention, and treatment; to apply this knowledge to the prevention of cancer; and to render compassionate care and treatment to cancer patients. Fox Chase Cancer Center 7701 Burholme Avenue Philadelphia, PA 19111215-728-2781
University of PennsylvaniaThe Abramson Cancer Center is dedicated to innovative and compassionate cancer care. The clinical program, comprised of a dedicated staff of physicians, nurse practitioners, nurses, social workers, physical therapists, nutritionists and patient care coordinators, currently sees over 50,000 outpatient visits, 3400 inpatient admissions, and provides over 24,000 chemotherapy treatments, and more than 65,000 radiation treatments. Abramson Cancer Center of the University of Pennsylvania 3400 Spruce StreetPhiladelphia, PA 19104215-662-6334
University of Pittsburgh Cancer InstituteSince 1985, the UPCI has been committed to improving the understanding of how cancer develops; to characterizing new lifesaving approaches for cancer prevention, detection, diagnosis and treatment; and to educating future generations of scientists and clinicians. University of Pittsburgh Cancer Institute200 Meyran AvenuePittsburgh, PA 15213-2592800-537-4063 or 412-692-4670
TENNESSEE
Vanderbilt Cancer CenterA Leading Center for Cancer Care, The Vanderbilt-Ingram Cancer Center is the only National Cancer Institute-designated Comprehensive Cancer Center in Tennessee. The Vanderbilt-Ingram Cancer Center is committed to bringing together the best and brightest scientists, clinicians and caregivers to lead the worldwide effort to alleviate suffering from cancer through pioneering research, compassionate care, prevention, outreach and education. Vanderbilt Cancer Center Vanderbilt University649 Medical Research Building II Nashville, TN 37232615-936-1782
TEXAS
The University of Texas M.D. Anderson Cancer CenterM. D. Anderson Cancer Center offers integrated programs in cancer treatment, clinical trials, education programs and cancer prevention. The mission of The University of Texas M. D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public. Comprehensive services and treatment geared toward surviving mesothelioma provided through the ACC thoracic center. M.D. Anderson Cancer Center 1515 Holcolmbe Boulevard Houston, TX 77030800-392-1611 option 3
VERMONT
Vermont Cancer CenterUniversity of VermontVCC is dedicated to improving the human condition as it is affected by cancer, through fostering and sustaining innovative research in the laboratory and in the clinic, cancer information, prevention and control research and programs, state-of-the art cancer diagnosis and treatment, compassionate care that respects the individual patient, education, and community outreach. Vermont Cancer Center University of Vermont, E-213 Given Building 89 Beaumont Avenue Burlington, VT 05405 802-656-4414
WASHINGTHON
Fred Hutchinson Cancer Research CenterThe mission of Fred Hutchinson Cancer Research Center is the elimination of cancer as a cause of human suffering and death. The center conducts research of the highest standards to improve prevention and treatment of cancer and related diseases. Fred Hutchinson Cancer Research Center 1124 Columbia StreetSeattle, WA 98104206-667-5000 or 206-667-4302
WISCONSIN
University of Wisconsin Comprehensive Cancer CenterThe University of Wisconsin Paul P. Carbone Comprehensive Cancer Center is the only comprehensive cancer center in Wisconsin, as designated by the National Cancer Institute. An integral part of the UW School of Medicine and Public Health, the UWCCC unites more than 250 physicians and scientists who work together in translating discoveries from research laboratories into new treatments that benefit cancer patients. University of Wisconsin Comprehensive Cancer Center 600 Highland AvenueMadison, WI 53792608-263-8610
NorthCarolina
Duke Comprehensive Cancer Center
North Carolina based Duke CCC provides comprehensive compassionate care, cutting edge research, and ongoing support for victims of mesothelioma and other forms of cancer. Duke University Medical Center Comprehensive Cancer CenterDurham, NC 27710919-684-5613
OHIO
The Case Comprehensive Cancer Center (Case CCC) The Case Comprehensive Cancer Center (Case CCC) based at Case Western Reserve University (Case) is a partnership organization supporting all cancer related research efforts at Case, University Hospitals of Cleveland (UHC), and the Cleveland Clinic. Located in Cleveland, Ohio, the Case CCC serves the cancer research and clinical needs of an urban manufacturing and rural agricultural region containing 3.8 million people in Northern Ohio. Case Comprehensive Care Center 11100 Euclid AvenueCleveland, OH 44106
Ohio State University Comprehensive Cancer CenterOSUCCC's mission is to save lives through innovative research designed to improve detection, treatment and prevention of cancer in its many forms. The OSUCCC is home to the Arthur G. James Cancer Hospital and Solove Research Institute - a 160+ bed hospital dedicated solely to cancer care. Ohio State Universrity Comprehensive Care CenterArthur G. James Cancer Hospital300 West 10th Avenue Columbus, OH 4321800-638-6996 or 614-293-4878
PENNSYLVANIA
Fox Chase Cancer CenterThe mission of Fox Chase Cancer Center is to reduce the burden of human cancer through the pursuit of new knowledge in basic biological research; to conduct research specifically related to cancer causes, prevention, and treatment; to apply this knowledge to the prevention of cancer; and to render compassionate care and treatment to cancer patients. Fox Chase Cancer Center 7701 Burholme Avenue Philadelphia, PA 19111215-728-2781
University of PennsylvaniaThe Abramson Cancer Center is dedicated to innovative and compassionate cancer care. The clinical program, comprised of a dedicated staff of physicians, nurse practitioners, nurses, social workers, physical therapists, nutritionists and patient care coordinators, currently sees over 50,000 outpatient visits, 3400 inpatient admissions, and provides over 24,000 chemotherapy treatments, and more than 65,000 radiation treatments. Abramson Cancer Center of the University of Pennsylvania 3400 Spruce StreetPhiladelphia, PA 19104215-662-6334
University of Pittsburgh Cancer InstituteSince 1985, the UPCI has been committed to improving the understanding of how cancer develops; to characterizing new lifesaving approaches for cancer prevention, detection, diagnosis and treatment; and to educating future generations of scientists and clinicians. University of Pittsburgh Cancer Institute200 Meyran AvenuePittsburgh, PA 15213-2592800-537-4063 or 412-692-4670
TENNESSEE
Vanderbilt Cancer CenterA Leading Center for Cancer Care, The Vanderbilt-Ingram Cancer Center is the only National Cancer Institute-designated Comprehensive Cancer Center in Tennessee. The Vanderbilt-Ingram Cancer Center is committed to bringing together the best and brightest scientists, clinicians and caregivers to lead the worldwide effort to alleviate suffering from cancer through pioneering research, compassionate care, prevention, outreach and education. Vanderbilt Cancer Center Vanderbilt University649 Medical Research Building II Nashville, TN 37232615-936-1782
TEXAS
The University of Texas M.D. Anderson Cancer CenterM. D. Anderson Cancer Center offers integrated programs in cancer treatment, clinical trials, education programs and cancer prevention. The mission of The University of Texas M. D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public. Comprehensive services and treatment geared toward surviving mesothelioma provided through the ACC thoracic center. M.D. Anderson Cancer Center 1515 Holcolmbe Boulevard Houston, TX 77030800-392-1611 option 3
VERMONT
Vermont Cancer CenterUniversity of VermontVCC is dedicated to improving the human condition as it is affected by cancer, through fostering and sustaining innovative research in the laboratory and in the clinic, cancer information, prevention and control research and programs, state-of-the art cancer diagnosis and treatment, compassionate care that respects the individual patient, education, and community outreach. Vermont Cancer Center University of Vermont, E-213 Given Building 89 Beaumont Avenue Burlington, VT 05405 802-656-4414
WASHINGTHON
Fred Hutchinson Cancer Research CenterThe mission of Fred Hutchinson Cancer Research Center is the elimination of cancer as a cause of human suffering and death. The center conducts research of the highest standards to improve prevention and treatment of cancer and related diseases. Fred Hutchinson Cancer Research Center 1124 Columbia StreetSeattle, WA 98104206-667-5000 or 206-667-4302
WISCONSIN
University of Wisconsin Comprehensive Cancer CenterThe University of Wisconsin Paul P. Carbone Comprehensive Cancer Center is the only comprehensive cancer center in Wisconsin, as designated by the National Cancer Institute. An integral part of the UW School of Medicine and Public Health, the UWCCC unites more than 250 physicians and scientists who work together in translating discoveries from research laboratories into new treatments that benefit cancer patients. University of Wisconsin Comprehensive Cancer Center 600 Highland AvenueMadison, WI 53792608-263-8610
03 Juni 2008
Examination of Aspergillosis
Laboratory
Direct examinationClinical material, such as fluids, sputa, or tissue, is mounted in 10% KOH. Long, branching, hyaline, septate hyphae approximately 3.0 µm in diameter typify aspergillosis. The demonstration of hyphae in the clinical specimen and the repeated recovery of the same species of Aspergillus in culture is critical in supporting the diagnosis of aspergillosis. It must always be remembered that a number of other fungi can be morphologically identical to Aspergillus in tissue. On rare occasions, the hyphae of an Aspergillus sp. may have lateral conidia in tissue.IsolationInoculate the clinical material onto Sabouraud glucose agar, Inhibitory Mould Agar (IMA) or other proper medium with antibiotics (gentamicin or chlorampenicol) and incubate at 30°C. The aspergilli are sensitive to cycloheximide, hence they will not grow on media containing this antimicrobial agent.
Discard negative cultures after 4 weeks.Mycology (principal fungi) : Aspergillus flavus, Aspergillus fumigatus, Aspergillus glaucus group, Aspergillus nidulans, Aspergillus niger, Aspergillus terreus groupDetection of galactomannan antigen in serumThe mortality rate of invasive aspergillosis is as high as 50-100% and definitive diagnosis by culture may take as long as 4 weeks. Thus, early diagnosis is of remarkable significance for earlier initiation of antifungal therapy and reduction of mortality rates. Detection of galactomannan antigen, an exoantigen of Aspergillus, has recently been shown to be a useful screening test for early diagnosis of invasive aspergillosis. Platelia Aspergillus EIA (Bio-Rad Laboratories) is a commercially available kit used to detect galactomannan antigen in body fluids. This method can detect as little as 1 ng/ml of galactomannan in the tested sample. Serum is the most frequently tested specimen and appears to provide highest sensitivity. Use of other samples such as bronchoalveolar lavage and cerebrospinal fluid also appears to provide promising results.
Galactomannan antigen positivity is among the microbiological diagnostic criteria proposed by European Organization for Research and Treatment of Cancer (EUORTC) and Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) for diagnosis of invasive aspergillosis This tool continues to gain acceptance: the US Food & Drug Administration approved the marketing of Platelia Aspergillus EIA kit in USA on 16 May 2003. Galactomannan antigen positivity can be detected 5-8 days (average) before clinical signs develop (in 65.2% of patients), findings on chest X-ray are visible (in 71.5% of patients) and culture results become positive (in 100% of patient). The test should be used as a screening test for patients at high risk of developing invasive aspergillosis.
Detection of positive results particularly in two consecutive serum samples provides strong support for the diagnosis of invasive aspergillosis. Platelia Aspergillus EIA can also be used for follow-up of clinical response to antifungal therapy. The titer of the antigen tends to decrease in case of clinical response, except for patients who are treated with an echinocandin compound.The overall sensitivity and specificity of the method were 80.7% and 89.2%, respectively, in the dataset submitted to the US FDA. False positive reactions have been observed in 1-18% of the tested samples and may be due to cross reactivity or false positive antigenemia. Cross reactivity may be due to the existence of other fungi, such as Penicillium chrysogenum, Penicillium digitatum, Rhodotorula rubra, and Paecilomyces variotii in the tested sample [2208]. The mechanism of false positive antigenemia, on the other hand, has not been fully clarified. It appears to be more frequent in children and may develop after translocation of galactomannan antigen found in various food stuff (bread, pasta, corn flakes, rice, cake, turkey, sausage, etc.) through the damaged intestinal mucosa. In addition to these, very recent data have shown that the serum samples of patients receiving piperacillin/tazobactam (Zosyn®), an injectable antibacterial combination product from Wyeth Pharmaceuticals, may also yield false positive galactomannan antigen test results. Detection of galactomannan antigen in certain batches of Zosyn® strengthened this finding. Thus, Bio-Rad, the manufacturer of the Platelia Aspergillus EIA kit, now states that positive galactomannan antigen test results in patients treated with Zosyn® should be interpreted cautiously. Since the existence of invasive aspergillosis cannot be ruled out in these patients, other methods should be used for confirmation of the diagnosis.
Direct examinationClinical material, such as fluids, sputa, or tissue, is mounted in 10% KOH. Long, branching, hyaline, septate hyphae approximately 3.0 µm in diameter typify aspergillosis. The demonstration of hyphae in the clinical specimen and the repeated recovery of the same species of Aspergillus in culture is critical in supporting the diagnosis of aspergillosis. It must always be remembered that a number of other fungi can be morphologically identical to Aspergillus in tissue. On rare occasions, the hyphae of an Aspergillus sp. may have lateral conidia in tissue.IsolationInoculate the clinical material onto Sabouraud glucose agar, Inhibitory Mould Agar (IMA) or other proper medium with antibiotics (gentamicin or chlorampenicol) and incubate at 30°C. The aspergilli are sensitive to cycloheximide, hence they will not grow on media containing this antimicrobial agent.
Discard negative cultures after 4 weeks.Mycology (principal fungi) : Aspergillus flavus, Aspergillus fumigatus, Aspergillus glaucus group, Aspergillus nidulans, Aspergillus niger, Aspergillus terreus groupDetection of galactomannan antigen in serumThe mortality rate of invasive aspergillosis is as high as 50-100% and definitive diagnosis by culture may take as long as 4 weeks. Thus, early diagnosis is of remarkable significance for earlier initiation of antifungal therapy and reduction of mortality rates. Detection of galactomannan antigen, an exoantigen of Aspergillus, has recently been shown to be a useful screening test for early diagnosis of invasive aspergillosis. Platelia Aspergillus EIA (Bio-Rad Laboratories) is a commercially available kit used to detect galactomannan antigen in body fluids. This method can detect as little as 1 ng/ml of galactomannan in the tested sample. Serum is the most frequently tested specimen and appears to provide highest sensitivity. Use of other samples such as bronchoalveolar lavage and cerebrospinal fluid also appears to provide promising results.
Galactomannan antigen positivity is among the microbiological diagnostic criteria proposed by European Organization for Research and Treatment of Cancer (EUORTC) and Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) for diagnosis of invasive aspergillosis This tool continues to gain acceptance: the US Food & Drug Administration approved the marketing of Platelia Aspergillus EIA kit in USA on 16 May 2003. Galactomannan antigen positivity can be detected 5-8 days (average) before clinical signs develop (in 65.2% of patients), findings on chest X-ray are visible (in 71.5% of patients) and culture results become positive (in 100% of patient). The test should be used as a screening test for patients at high risk of developing invasive aspergillosis.
Detection of positive results particularly in two consecutive serum samples provides strong support for the diagnosis of invasive aspergillosis. Platelia Aspergillus EIA can also be used for follow-up of clinical response to antifungal therapy. The titer of the antigen tends to decrease in case of clinical response, except for patients who are treated with an echinocandin compound.The overall sensitivity and specificity of the method were 80.7% and 89.2%, respectively, in the dataset submitted to the US FDA. False positive reactions have been observed in 1-18% of the tested samples and may be due to cross reactivity or false positive antigenemia. Cross reactivity may be due to the existence of other fungi, such as Penicillium chrysogenum, Penicillium digitatum, Rhodotorula rubra, and Paecilomyces variotii in the tested sample [2208]. The mechanism of false positive antigenemia, on the other hand, has not been fully clarified. It appears to be more frequent in children and may develop after translocation of galactomannan antigen found in various food stuff (bread, pasta, corn flakes, rice, cake, turkey, sausage, etc.) through the damaged intestinal mucosa. In addition to these, very recent data have shown that the serum samples of patients receiving piperacillin/tazobactam (Zosyn®), an injectable antibacterial combination product from Wyeth Pharmaceuticals, may also yield false positive galactomannan antigen test results. Detection of galactomannan antigen in certain batches of Zosyn® strengthened this finding. Thus, Bio-Rad, the manufacturer of the Platelia Aspergillus EIA kit, now states that positive galactomannan antigen test results in patients treated with Zosyn® should be interpreted cautiously. Since the existence of invasive aspergillosis cannot be ruled out in these patients, other methods should be used for confirmation of the diagnosis.
29 Mei 2008
Diabetes
Diabetes means that your blood sugar is too high. Your blood always has some sugar in it because the body uses sugar for energy; it's the fuel that keeps you going. But too much sugar in the blood is not good for your health. Your body changes most of the food you eat into sugar. Your blood takes the sugar to the cells throughout your body. The sugar needs insulin to get into the body's cells. Insulin is a hormone made in the pancreas, an organ near the stomach. The pancreas releases insulin into the blood. Insulin helps the sugar from food get into body cells. If your body does not make enough insulin or the insulin does not work right, the sugar can't get into the cells, so it stays in the blood. This makes your blood sugar level high, causing you to have diabetes.
Diabetes can lead to blindness, heart disease, stroke, kidney failure, amputations (having a toe or foot removed, for example), and nerve damage. In women, diabetes can cause problems during pregnancy and make it more likely that your baby will be born with birth defects.
Pre-diabetes means your blood sugar is higher than normal but lower than the diabetes range. It also means you are at risk of getting type 2 diabetes and heart disease. The good news is: You can reduce the risk of getting diabetes and even return to normal blood sugar levels with modest weight loss and moderate physical activity. If you are told you have pre-diabetes, have your blood glucose (sugar) checked again in 1 to 2 years.
The three main types of diabetes are:
Type 1 diabetes is commonly diagnosed in children and young adults, but it's a lifelong condition. If you have this type of diabetes, your body does not make insulin, so you must take insulin every day. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, eating healthy, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol.
Type 2 diabetes is the most common type of diabetes — about 9 out of 10 people with diabetes have type 2 diabetes. You can get type 2 diabetes at any age, even during childhood. In type 2 diabetes, your body makes insulin, but the insulin can't do its job, so sugar is not getting into the cells. Treatment includes taking medicine, eating healthy, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol.
Gestational (jess-TAY-shun-ul) diabetes occurs during pregnancy. This type of diabetes occurs in about 1 in 20 pregnancies. During pregnancy your body makes hormones that keep insulin from doing its job. To make up for this, your body makes extra insulin. But in some women this extra insulin is not enough, so they get gestational diabetes. Gestational diabetes usually goes away when the pregnancy is over. Women who have had gestational diabetes are more likely to develop type 2 diabetes later in life.
About 20 million Americans have diabetes, about half of whom are women. As many as one third do not know they have diabetes.
Type 1 diabetes occurs at about the same rate in men and women, but it is more common in Whites than in minorities.
Type 2 diabetes is more common in older people, mainly in people who are overweight. It is more common in African Americans, Hispanic Americans/Latinos, and American Indians.
Causes diabetes
Type 1 and type 2 diabetes — The exact causes of both types of diabetes are still not known. Type 1 diabetes tends to show up after a person is exposed to a trigger, such as a virus, which can start an attack on the cells in the pancreas that make insulin. There is no one cause for type 2 diabetes, but it seems to run in families, and most people who get type 2 diabetes are overweight.
Gestational diabetes — Changing hormones and weight gain are part of a healthy pregnancy, but these changes make it hard for your body to keep up with its need for insulin. When that happens, your body doesn't get the energy it needs from the foods you eat.
Things that can put you at risk for diabetes include:
Age (being older than 45); Overweight or obesity; Family history (having a mother, father, brother, or sister with diabetes)
Race/ethnicity — your family background is African American, American Indian/Alaska Native, Hispanic American/Latino, Asian American/Pacific Islander and Native Hawaiian
Having a baby with a birth weight more than 9 pounds
Having diabetes during pregnancy (gestational diabetes)
High blood pressure — 140/90 mm HG or higher. Both numbers are important. If one or both numbers are usually high, you have high blood pressure.
High cholesterol — total cholesterol over 240 mg/dL
Inactivity — exercising less than 3 times a week
Abnormal results in a prior diabetes test
Having other health conditions that are linked to problems using insulin, like Polycystic Ovarian Syndrome (PCOS)
Having a history of heart disease or stroke
Should I be tested for diabetes?
If you're at least 45-years-old, you should get tested for diabetes, and then you should be tested again every 3 years. If you're 45 or older and overweight (Calculate your Body Mass Index (BMI) you may want to get tested more often. If you're younger than 45, overweight, and have one or more of the risk factors listed in "Am I at Risk for Diabetes?" you should get tested now. Ask your doctor for a fasting blood glucose test or an oral glucose tolerance test. Your doctor will tell you if you have normal blood glucose (blood sugar), pre-diabetes, or diabetes.
Being very thirsty, urinating a lot, feeling very hungry, feeling very tired, losing weight without trying, having sores that are slow to heal, having dry and itchy skin, losing feeling in or having tingling in the hands or feet, having blurry vision and having more infections than usual
If you have one or more of these signs, contact your doctor
More information :
Contacting the National Women's Health Information Center at 1-800-994-9662 or the following organizations:
National Diabetes Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney DiseasesPhone Number(s): (800) 860-8747Internet Address: http://www.niddk.nih.gov/health/diabetes/diabetes.htm
National Diabetes Education ProgramPhone Number(s): (800) 438-5383 (publications ordering)Internet Address: http://ndep.nih.gov/
Centers for Disease Control and PreventionPhone Number(s): (800) 232-4636Internet Address: http://www.cdc.gov/diabetes/
INFECTION ADENOVIRUS
A group of viruses that infect the membranes (tissue linings) of the respiratory tract, the eyes, the intestines, the urinary tract, and are a frequent cause of diarrhea. Adenoviral infections affect infants and young children much more frequently than adults. Although these infections can occur at any time of the year, respiratory tract disease caused by adenovirus is more common in late winter, spring, and early summer.
However, conjunctivitis and pharyngoconjunctival fever caused by adenovirus tend to affect older children mostly in the summer.
Signs and Symptoms
1) Febrile respiratory disease, which is an infection of the respiratory tract that includes a fever, is the most common result of adenoviral infection in children. The illness often appears flu-like and can include symptoms of pharyngitis (inflammation of the pharynx, or sore throat), rhinitis (inflammation of nasal membranes, or a congested, runny nose), cough, and swollen lymph nodes (glands). Sometimes the respiratory infection leads to acute otitis media, an infection of the middle ear. Adenovirus often affects the lower respiratory tract as well, causing bronchiolitis, croup, or viral pneumonia, which is less common but can cause serious illness in infants. Adenovirus can also produce a dry, harsh cough that can resemble whooping cough (pertussis). 2) Gastroenteritis is an inflammation of the stomach and the small and large intestines. Symptoms include watery diarrhea, vomiting, headache, fever, and abdominal cramps.
4) Conjunctivitis (or pinkeye) is a mild inflammation of the conjunctiva (membranes that cover the eye and inner surfaces of the eyelids.
5) Pharyngoconjunctival fever, often seen in small outbreaks among school-age children, occurs when adenovirus affects both the lining of the eye and the respiratory tract. Symptoms include very red eyes and a severe sore throat, sometimes accompanied by low-grade fever, rhinitis, and swollen lymph nodes.
6) Keratoconjunctivitis is a more severe infection that involves both the conjunctiva and cornea (the transparent front part of the eye). This type of adenoviral infection is extremely contagious, and occurs most often in older children and young adults, who complain of red eyes, photophobia (discomfort of the eyes upon exposure to light), tearing, and pain.
ContagiousnessThe types of adenovirus that cause respiratory and intestinal infections spread from person to person through respiratory secretions (coughs or sneezes) or fecal contamination. Fecal material can be ingested through contamination of water supplies, poor hand washing between the bathroom and the kitchen, eating food contaminated by houseflies, or poor hygiene after handling diapers. Indirect transmission can occur through exposure to the contaminated surfaces of furniture and other objects. IncubationOnce a child is exposed to adenovirus, symptoms can develop from 2 days to 2 weeks later.TreatmentAdenoviral illnesses often resemble certain bacterial infections, which can be treated with antibiotics. But antibiotics don't work against viruses. To diagnose the true cause of the symptoms so that proper treatment can be prescribed, your child's doctor may want to test a sample of respiratory or conjunctival secretions, a stool specimen, or blood or urine sample - depending on what condition is being considered. The doctor will decide on a course of action based on your child's condition.
Adenoviral infections usually don't require hospitalization. However, infants and young children may not be able to drink enough fluids to replace what they lose during vomiting or diarrhea and may therefore need to be hospitalized to correct or prevent dehydration. Also, young - especially premature - infants with pneumonia usually need to be hospitalized.If your child has a respiratory infection or fever, getting plenty of rest and taking in extra fluids is essential. A cool-mist humidifier (vaporizer) may help loosen congestion and make your child more comfortable. Be sure to clean and dry the humidifier thoroughly each day to prevent bacterial or mold contamination. If your child is under 6 months old, you may need to clear his or her nose with a bulb syringe. Don't give any over-the-counter (OTC) cold remedies or cough medicines without checking with your child's doctor.
You can use acetaminophen to treat a fever; however, do not give aspirin because of the risk of Reye syndrome, a life-threatening illness.If your child has diarrhea or is vomiting, increase fluid intake and check with the doctor about giving an oral rehydration solution to prevent dehydration. To relieve the symptoms of conjunctivitis, use warm compresses and a topical eye ointment or drops if your child's doctor recommends them.DurationMost adenoviral infections last from a few days to a week. Severe respiratory infections may last longer and cause lingering symptoms, such as a cough. Pneumonia can last anywhere from 2 to 4 weeks. In cases of pharyngoconjunctival fever, sore throat and fever may disappear within a week, but conjunctivitis can persist for another several days to a week.
The more severe keratoconjunctivitis can even last for several weeks. Adenovirus can also cause diarrhea that lasts up to 2 weeks, which is longer than other viral diarrheas.PreventionThere's no way to completely prevent adenoviral infections in children. To reduce the risk of transmission, parents and other caregivers should encourage frequent hand washing, keep shared surfaces such as countertops and toys clean, and remove children with infections from group settings until symptoms subside.
When to Call Your Child's Doctor
1) A fever continues more than a few days 2) A symptoms seem to get worse after a week 3) Your child has breathing problems 4) Your child is under 3 months old 5) Any swelling and redness around the eye becomes more severe or painful 6) Your child shows signs of dehydration, such as appearing tired or lacking energy, producing less urine or tears, or having a dry mouth or sunken eyesRemember that you know your child best. If he or she appears to be severely ill, don't hesitate to call your child's doctor right away.From : Nemours Foundation Kids health
27 Mei 2008
Pharmacology of Coccaine
Cocaine in its purest form is a white, pearly product. Cocaine appearing in powder form is a salt, typically cocaine hydrochloride (CAS 53-21-4). Street market cocaine is frequently adulterated or “cut” with various powdery fillers to increase its weight; the substances most commonly used in this process are baking soda; sugars, such as lactose, dextrose, inositol, and mannitol; and local anesthetics, such as lidocaine or benzocaine, which mimic or add to cocaine's numbing effect on mucous membranes. Cocaine may also be "cut" with other stimulants such as methamphetamine.Adulterated cocaine is often a white, off-white or pinkish powder.
The color of “crack” cocaine depends upon several factors including the origin of the cocaine used, the method of preparation – with ammonia or baking soda – and the presence of impurities, but will generally range from white to a yellowish cream to a light brown. Its texture will also depend on the adulterants, origin and processing of the powdered cocaine, and the method of converting the base. It ranges from a crumbly texture, sometimes extremely oily, to a hard, almost crystalline nature.
From : Wikipedia
24 Mei 2008
Aspergillosis
Aspergillosis is a large spectrum of fungi infection diseases caused by members of the genus Aspergillus. The three principal entities are: allergic bronchopulmonary aspergillosis, pulmonary aspergilloma and invasive aspergillosis. Colonization of the respiratory tract is also common. The clinical manifestation and severity of the disease depends upon the immunologic state of the patient. Lowered host resistance due to such factors as underlying debilitating disease, neutropenia chemotherapy, disruption of normal flora, and an inflammatory response due to the use of antimicrobial agents and steroids can predispose the patient to colonization, invasive disease, or both. Aspergillus spp. are frequently secondary opportunistic pathogens in patients with bronchiectasis, carcinoma, other mycoses, sarcoid, and tuberculosis.
Aspergillosis also dangerous for our livestock. At 1960 in England happened the epidemic which caused big loss at turkey ranch over there. With study known the the epidemic caused of existence of mikotoksin at feed livestock yielded by mushroom of Aspergillus flavus. Start the moment that's emerging various research of concerning the micotoxin. At 1972 Wookey find in New Guinea of feed substance which is a lot of contaminated by aflatoxin are peanut, sorgum,dan maize with the rate until 500 ppb.In Thailand in the year 1982 found the fact that peanut and maize over there a lot of impure of aflatoxin that is each 77% and 60% with the rate 12,5 - 20 ppb Shotwell and Hasseltine 1983 in Virginia there are 25% impure maize of aflatoxin with the rate 21 - 137 ppb. Culvenor 1974 said expressing peaceful aflatoxin for chicken with the maximal rate 200 ppb, for human being maximal peaceful rate 30 ppb. Pursuant to various research of other;dissimilar contamination rate very depend on climate and weather; in moment of rain season contaminat rate can 2-3 times in drought season.
Forms of the disease Sites
Colonization, allergic bronchopulmonary aspergillosis and toxicoses involved sinuses, lungs
Pulmonary aspergilloma involved Pre-existing lung cavity
Invasive aspergillosis
Pulmonary aspergillosis, CNS aspergillosis, Sinonasal aspergillosis, Osteomyelitis Endophthalmitis, Endocarditis, Renal abscesses, Cutaneous (burns, post surgical wounds, IV insertion sites, etc).
Others : Otomycosis, Exogenous endophthalmitis, Allergic fungal sinusitis and Urinary tract fungus balls
Change of patologis organ for example hiperplasia bile tract, vacuoliszation of hepar cell, megalositosis, fibrosis at hepar tissue
Prognosis
Prognosis depends upon the type and severity of disease as well as the immunological status of the patient. Allergic aspergillosis is typically a chronic entity, but evolves from episodes of acute corticosteroid-responsive asthma to fibrotic end-stage lung disease. Allergic aspergillosis has been successfully treated with corticosteroids, and intraconazole. The prolonged use of steroids in cases of chronic aspergillosis should be approached with caution.
Treatment TheraphyAspergillomas may be treated by surgical resection. However, this approach may cause significant morbidity and mortality, therefore it should be reserved for patients at high risk to develop severe hemoptysis.Invasive aspergillosis may be treated with voriconazole, amphotericin B (deoxycholate and lipid preparations), and itraconazole. The ability of voriconazole to effectively treat invasive aspergillosis and to reduce associated mortality was recently demonstrated by a large well-conducted randomized trial and is particulary noteworthy. A large number of new investigational drugs (posaconazole, ravuconazole, caspofungin, FK463, and anidulafungin (LY303366)) have activity against Aspergillus spp. and are being extensively evaluated. Caspofungin was also recently licensed in the United States for treatment of invasive aspergillosis in patients who are refractory to, or intolerant of other therapies (i.e., amphotericin B, lipid formulations of amphotericin B, and/or itraconazole). However, despite these advances in therapy, the invasive forms of aspergillosis are often associated with significant morbidity and mortality.Selection of therapy also needs to consider the certainty of the diagnosis. Voriconazole, itraconazole, the investigational azoles with anti-mould activity, and amphotericin B all possess a reasonably broad-spectrum of activity against Aspergillus and the related hyaline moulds. Their activity does, however, vary for the agents of zygomycosis, with posaconazole being the azole with the most reliable activity against this class of fungi. The echinocandin glucan synthesis inhibitors (caspofungin, FK463, and anidulafungin) possess a narrower spectrum of activity and should only be used if the infection is known to be due to Aspergillus spp. Usage of hydrated of sodium of calcium alumunium silicate can prevent the absorbtion aflatoxin in digestion and degrade negativity effect.
Diagnosis of Mesothelioma
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking.
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells. The procedure could diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients.
Typical immunohistochemistry results Positive
EMA (epithelial membrane antigen) in a membranous distribution, WT1 (Wilms' tumour 1), Calretinin, Mesothelin-1, Cytokeratin 5/6, HBME-1 (human mesothelial cell 1)
Typical immunohistochemistry results Negative
CEA (carcinoembryonic antigen), B72.3, MOC-3 1, CD15, Ber-EP4, TTF-1 (thyroid transcription factor-1)
Screening
There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that the serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.
Staging
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
Pathophysiology
The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fibre can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibres may be deposited in the gut after ingestion of sputum contaminated with asbestos fibres.
Pleural contamination with asbestos or other mineral fibres has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).However, there is now evidence that smaller particles may be more dangerous than the larger fibers. They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.
Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibres. It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localised lesions of accumulated asbestos fibres in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibres remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibres has not yet been achieved. In general, asbestos fibres are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.
Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to make contact with chromosomes, often adhering to the chromatin fibres or becoming entangled within the chromosome. This contact between the asbestos fibre and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:
- Neurofibromatosis type 2 at 22q12
- P16INK4A
- P14ARF
Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:
- Inactivation of tumor suppressor genes
- Activation of oncogenes
- Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
- Activation of DNA repair enzymes, which may be prone to error
- Activation of telomerase
- Prevention of apoptosis
Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.
Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.
From Wikipedia
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells. The procedure could diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients.
Typical immunohistochemistry results Positive
EMA (epithelial membrane antigen) in a membranous distribution, WT1 (Wilms' tumour 1), Calretinin, Mesothelin-1, Cytokeratin 5/6, HBME-1 (human mesothelial cell 1)
Typical immunohistochemistry results Negative
CEA (carcinoembryonic antigen), B72.3, MOC-3 1, CD15, Ber-EP4, TTF-1 (thyroid transcription factor-1)
Screening
There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that the serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.
Staging
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
Pathophysiology
The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fibre can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibres may be deposited in the gut after ingestion of sputum contaminated with asbestos fibres.
Pleural contamination with asbestos or other mineral fibres has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).However, there is now evidence that smaller particles may be more dangerous than the larger fibers. They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.
Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibres. It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localised lesions of accumulated asbestos fibres in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibres remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibres has not yet been achieved. In general, asbestos fibres are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.
Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to make contact with chromosomes, often adhering to the chromatin fibres or becoming entangled within the chromosome. This contact between the asbestos fibre and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:
- Neurofibromatosis type 2 at 22q12
- P16INK4A
- P14ARF
Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:
- Inactivation of tumor suppressor genes
- Activation of oncogenes
- Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
- Activation of DNA repair enzymes, which may be prone to error
- Activation of telomerase
- Prevention of apoptosis
Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.
Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.
From Wikipedia
19 Mei 2008
Androgen Insensitivity Syndrome
What is androgen insensitivity syndrome?
Androgen insensitivity syndrome is a condition that affects sexual development before birth and during puberty. People with this condition are genetically male, with one X and one Y chromosome. Because their bodies are unable to respond to certain hormones (called androgens), they may have mostly female sexual characteristics or signs of both male and female sexual development (hermaphroditism).
Complete androgen insensitivity syndrome occurs when the body cannot use androgens at all. Partial or mild androgen insensitivity syndrome results when tissues are partially sensitive to the effects of androgens. People with partial androgen insensitivity (also called Reifenstein syndrome) can have normal female sexual characteristics, both male and female sexual characteristics, or normal male sexual characteristics. People with mild androgen insensitivity appear male, but are often infertile and tend to develop female breasts at puberty.
How common is androgen insensitivity syndrome?
Complete androgen insensitivity syndrome affects 2 to 5 per 100,000 live male births. Partial androgen insensitivity is at least as common as complete androgen insensitivity. Mild androgen insensitivity is much less common.
What genes are related to androgen insensitivity syndrome?
Mutations in the AR gene cause androgen insensitivity syndrome.
The AR gene provides instructions to make a protein called an androgen receptor. This protein allows cells to respond to androgens, which are hormones (such as testosterone) that direct male sexual development. Androgens and androgen receptors also have other important functions in both males and females, such as regulating hair growth and sex drive. Mutations in the AR gene prevent the androgen receptor from working properly, which makes cells less responsive to androgens or prevents cells from using these hormones at all. Depending on the level of androgen insensitivity, an affected person's sexual characteristics can vary from mostly female to mostly male.
Read more about the AR gene.
How do people inherit androgen insensitivity syndrome?
This condition is inherited in an X-linked recessive pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. In males (who have only one X chromosome) one altered copy of the gene in each cell is sufficient to cause the condition. Males are affected by X-linked recessive disorders much more frequently than females. A striking characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons.
About two-thirds of cases are inherited from mothers who carry an altered copy of the AR gene on one of their two X chromosomes. The remaining cases result from a new mutation in a mother's egg cell before the child is conceived.
17 Mei 2008
Cancer Center Research Mesothelioma
ILLINOIS
Robert H. Lurie Cancer CenterNorthwestern UniversityThe Robert H. Lurie Comprehensive Cancer Center of Northwestern University in conjunction with the Northwestern Medical Faculty Foundation recently opened a modern, outpatient clinical cancer center. The facility offers a full range of oncology services and provides access to specialized research, clinical trials and diagnostic services. RHL Cancer Center, Northwestern University 303 East Chicago AvenueOlson Pavilion, Room 8250 Chicago, IL 60611312-908-5250
MARYLAND
Sidney Kimmel Comprehensive Cancer CenterThe Johns Hopkins Comprehensive Care CenterThe Comprehensive Cancer Center at Johns Hopkins is dedicated to better understanding human cancers and finding more effective treatments. The center has active programs in clinical research, laboratory research, education, community outreach, and prevention, treatment and control. Sidney Kimmel Comprehensive Cancer Center is the only such NCI Comprehensive Cancer Center in the state of Maryland. The Center also offers complete family and patient services that include a Cancer Counseling Center, survivors and palliative care programs, and two residences for patients traveling from out-of-town to receive treatment. Sidney Kimmel Comprehensive Cancer Center Johns Hopkins University 600 North Wolfe StreetBaltimore, MD 21287-8943410-955-8822
MASSACHUSETTS
Dana-Farber Cancer Institute, BostonThe mission of Dana-Farber Cancer Institute is to provide expert, compassionate care to children and adults with cancer while advancing the understanding, diagnosis, treatment, cure, and prevention of cancer and related diseases. Dana-Farber Cancer Institute44 Binney StreetBoston, MA 02115617-632-2233
MICHIGAN
University of MichiganComprehensive Cancer CenterThe University of Michigan Comprehensive Cancer Center provides its patients comprehensive diagnostic, treatment and support services in an environment that reflects their mission: the conquest of cancer through innovation and collaboration. Drawing on the strengths of the U-M faculty, the Cancer Center has assembled a team of specialists who are leaders in their fields to unravel the threat of cancer and to provide care and comfort to those it afflicts. UMCCC102 ObservatoryAnn Arbor, MI 48109-0724313-936-1831
Barbara Ann Karmanos Cancer InstituteThe Barbara Ann Karmanos Cancer Institute, backed state-of-the-science cancer research, is the only cancer center in southeast Michigan where teams of cancer experts diagnose patients with world-class precision and compassionate care. Working with hundreds of doctors statewide, the Institute arranges for care convenient for patients and families. Cancer teams and doctors can recommend the best treatment options with the Institute’s immediate access to the latest cancer-fighting drugs and therapies. Karmanos Cancer Institute, Michigan 110 East Warren AvenueDetroit, MI 48201313-833-1146
MINNESOTA
Mayo Cancer CenterMayo FoundationMayo Clinic Cancer Center is the only NCI-designated cancer center with a national presence. It is located in three sites: Scottsdale, Ariz.; Jacksonville, Fla.; and Rochester, Minn. The three locations give Mayo Clinic Cancer Center a broad geographic reach to serve diverse patient populations and bring diverse perspectives to its research. Offers Clinical trials for the treatment of advanced lung cancer and malignant pleural mesothelioma, as just one of the center's many services. Mayo Clinic Cancer Center 200 First Street SWRoghester, MN 55905507-284-3753
NEW HAMPSHIRE
Norris Cotton Cancer CenterProvides a positive environment for treatment, cure, and recovery for patients with all forms of cancer. Patients receive technologically advanced cancer treatments and access to clinical trials of new treatments. Each patient is seen as an individual, and a specific treatment plan is developed by specialists who work directly with the patient, family, and referring physician. The Cancer Center is also a leader in improving the comfort and quality of life of patients. Norris Cotton Cancer Center Dartmouth-Hitchock Medical CenterOne Medical Center Drive Lebanon, NH 03756603-650-4141
NEW YORK
Roswell Park Cancer InstituteRoswell Park Cancer Institute is dedicated to providing total care to the cancer patient; to conducting research into the causes, treatment and prevention of cancer; and to educating the public and the next generation of those who study and treat cancer. Specializing in the diagnosis and treatment of mesothelioma and other forms of cancer. Roswell Park Cancer Institute Elm and Carlton Streets Buffalo, NY 14263800-767-9355213-845-5770
Columbia-Presbyterian Comprehensive Cancer CenterOngoing clinical trials for mesothelioma treatment among a full range of research, care, after-care and support in helping patients set on the goal of surviving cancer. Herbert Irving Comprehensive Cancer CenterCollege of Physicians and Surgeons701 West 168th Street New York, NY 10032212-305-6921
Memorial Sloan-Kettering Cancer CenterOne of the world's premier cancer centers, Memorial Sloan-Kettering Cancer Center is committed to exceptional patient care, leading-edge research, and superb educational programs. Provides comprehensive services in the field of mesothelioma treatment, as well as extensive support for those surviving from asbestos caused and other forms of cancer. Memorial Sloan-Kettering Cancer Center1275 York Avenue New York, NY 10021Physician Referral Service: 800-525-2225General Information & Appointment Scheduling: 212-639-2000
Robert H. Lurie Cancer CenterNorthwestern UniversityThe Robert H. Lurie Comprehensive Cancer Center of Northwestern University in conjunction with the Northwestern Medical Faculty Foundation recently opened a modern, outpatient clinical cancer center. The facility offers a full range of oncology services and provides access to specialized research, clinical trials and diagnostic services. RHL Cancer Center, Northwestern University 303 East Chicago AvenueOlson Pavilion, Room 8250 Chicago, IL 60611312-908-5250
MARYLAND
Sidney Kimmel Comprehensive Cancer CenterThe Johns Hopkins Comprehensive Care CenterThe Comprehensive Cancer Center at Johns Hopkins is dedicated to better understanding human cancers and finding more effective treatments. The center has active programs in clinical research, laboratory research, education, community outreach, and prevention, treatment and control. Sidney Kimmel Comprehensive Cancer Center is the only such NCI Comprehensive Cancer Center in the state of Maryland. The Center also offers complete family and patient services that include a Cancer Counseling Center, survivors and palliative care programs, and two residences for patients traveling from out-of-town to receive treatment. Sidney Kimmel Comprehensive Cancer Center Johns Hopkins University 600 North Wolfe StreetBaltimore, MD 21287-8943410-955-8822
MASSACHUSETTS
Dana-Farber Cancer Institute, BostonThe mission of Dana-Farber Cancer Institute is to provide expert, compassionate care to children and adults with cancer while advancing the understanding, diagnosis, treatment, cure, and prevention of cancer and related diseases. Dana-Farber Cancer Institute44 Binney StreetBoston, MA 02115617-632-2233
MICHIGAN
University of MichiganComprehensive Cancer CenterThe University of Michigan Comprehensive Cancer Center provides its patients comprehensive diagnostic, treatment and support services in an environment that reflects their mission: the conquest of cancer through innovation and collaboration. Drawing on the strengths of the U-M faculty, the Cancer Center has assembled a team of specialists who are leaders in their fields to unravel the threat of cancer and to provide care and comfort to those it afflicts. UMCCC102 ObservatoryAnn Arbor, MI 48109-0724313-936-1831
Barbara Ann Karmanos Cancer InstituteThe Barbara Ann Karmanos Cancer Institute, backed state-of-the-science cancer research, is the only cancer center in southeast Michigan where teams of cancer experts diagnose patients with world-class precision and compassionate care. Working with hundreds of doctors statewide, the Institute arranges for care convenient for patients and families. Cancer teams and doctors can recommend the best treatment options with the Institute’s immediate access to the latest cancer-fighting drugs and therapies. Karmanos Cancer Institute, Michigan 110 East Warren AvenueDetroit, MI 48201313-833-1146
MINNESOTA
Mayo Cancer CenterMayo FoundationMayo Clinic Cancer Center is the only NCI-designated cancer center with a national presence. It is located in three sites: Scottsdale, Ariz.; Jacksonville, Fla.; and Rochester, Minn. The three locations give Mayo Clinic Cancer Center a broad geographic reach to serve diverse patient populations and bring diverse perspectives to its research. Offers Clinical trials for the treatment of advanced lung cancer and malignant pleural mesothelioma, as just one of the center's many services. Mayo Clinic Cancer Center 200 First Street SWRoghester, MN 55905507-284-3753
NEW HAMPSHIRE
Norris Cotton Cancer CenterProvides a positive environment for treatment, cure, and recovery for patients with all forms of cancer. Patients receive technologically advanced cancer treatments and access to clinical trials of new treatments. Each patient is seen as an individual, and a specific treatment plan is developed by specialists who work directly with the patient, family, and referring physician. The Cancer Center is also a leader in improving the comfort and quality of life of patients. Norris Cotton Cancer Center Dartmouth-Hitchock Medical CenterOne Medical Center Drive Lebanon, NH 03756603-650-4141
NEW YORK
Roswell Park Cancer InstituteRoswell Park Cancer Institute is dedicated to providing total care to the cancer patient; to conducting research into the causes, treatment and prevention of cancer; and to educating the public and the next generation of those who study and treat cancer. Specializing in the diagnosis and treatment of mesothelioma and other forms of cancer. Roswell Park Cancer Institute Elm and Carlton Streets Buffalo, NY 14263800-767-9355213-845-5770
Columbia-Presbyterian Comprehensive Cancer CenterOngoing clinical trials for mesothelioma treatment among a full range of research, care, after-care and support in helping patients set on the goal of surviving cancer. Herbert Irving Comprehensive Cancer CenterCollege of Physicians and Surgeons701 West 168th Street New York, NY 10032212-305-6921
Memorial Sloan-Kettering Cancer CenterOne of the world's premier cancer centers, Memorial Sloan-Kettering Cancer Center is committed to exceptional patient care, leading-edge research, and superb educational programs. Provides comprehensive services in the field of mesothelioma treatment, as well as extensive support for those surviving from asbestos caused and other forms of cancer. Memorial Sloan-Kettering Cancer Center1275 York Avenue New York, NY 10021Physician Referral Service: 800-525-2225General Information & Appointment Scheduling: 212-639-2000
Cancer Center Research Mesothelioma (Alabama, Arizona, California, Connecticut, Washington and Florida)
ALABAMA
University of Alabama at BirminghamIt is the mission of the UAB Comprehensive Cancer Center to provide the most up-to-date and effective care to cancer patients; to advance the nation's scientific understanding of cancer; and to translate this new knowledge into improved diagnosis, treatment, and prevention for all types of cancer including mesothelioma. UAB Comprehensive Cancer CenterBasic Health Sciences Building1824 Sixth Avenue SouthBirmingham, AL 35294-3300205-934-5077
ARIZONA
University of Arizona Cancer CenterArizona's first comprehensive cancer center provides care for and treatment of those who have encountered all forms of cancer including mesothelioma (asbestos related cancer), as well as research into new techniques for prevention and cure, and through educational outreach programs that help people reduce their cancer risk. University of Arizona Cancer Center 1501 North Campbell Ave.Tucson, AZ 85724602-626-7925
CALIFORNIA
Jonsson Comprehensive Cancer Center
UCLA´s Jonsson Comprehensive Cancer Center (JCCC) has established an international reputation for developing new cancer therapies, providing the best in experimental and traditional treatments, and expertly guiding and training the next generation of medical researchers. With a membership of more than 230 physicians and scientists, the Jonsson Cancer Center handles more than 20,000 patient visits per year and conducts hundreds of clinical trials, providing the latest in experimental cancer treatments. Patients at the JCCC benefit from care provided by experts from different specialties who work together to help them contend with the immediate and long-term challenges of cancer. University of California at Los Angeles10833 Le Conte AvenueLos Angeles, CA 90095-1781800-825-2631310-825-5268
USC/Norris Comprehensive Cancer Center
The USC/Norris Comprehensive Cancer Center, located in Los Angeles, is a major regional and national resource for cancer research, treatment, prevention and education. More than 190 basic scientists, physicians and other Keck School of Medicine of USC faculty members who are members of the USC/Norris Cancer Center investigate the complex origins and progression of cancer, develop prevention strategies and search for cures. University of Southern California1441 Eastlake Avenue Los Angeles, CA 90033-0800213-764-0816
University of California San Francisco Comprehensive Cancer Center Housed within one of the nation's top biomedical research universities, the UCSF Comprehensive Cancer Center consolidates the work of researchers and clinicians who are dedicated to four fundamental pursuits: Laboratory research into the causes and events of cancer's progression; clinical research to translate new knowledge into viable treatments; sensitive, state-of-the-art patient care; and population research that can lead to effective prevention, early detection, and quality-of-life improvement for those living with cancer. Several physiciaans, oncologists, doctors and specialists providing mesothelioma treatment resources / information and research are affiliated with or work directly at the UCSF Comprehensive Cancer Center. University of California San Francisco 1600 Divisadero Street, San Francisco, CA 94115 1-800-888-8664
City Of Hope Comprehensive Cancer Center
Throughout its history, City of Hope has been committed to excellence in all areas of biomedical research, patient-centered medical care, and community outreach. StethIn recognition of our excellence in a broad range of new approaches to cancer research and treatment—and our outreach to the community—the
National Cancer Institute (NCI) has designated City of Hope a Comprehensive Cancer Center—one of just a handful of elite institutions nationwide. As a division of the National Institutes of Health, the NCI is the Federal Government's principal agency for cancer research and training. BB The NCI's Cancer Center program acknowledges institutions for their scientific excellence, and their ability to bring diverse research approaches to the problem of cancer. The "Comprehensive Cancer Center" designation indicates that City of Hope has undergone a rigorous peer review process, and has been found to be worthy of this highest level of recognition. City of Hope Comprehensive Cancer Center1500 East Duarte Road Duarte, CA 91010 626-256-HOPE (4673) 310-825-5268
CONNECTICUT
Yale Comprehensive Cancer Center
Yale Cancer Center combines innovative cancer treatment and quality care for patients. YCCC is the only comprehensive cancer center in Southern New England. Cancer treatment is available through multidisciplinary teams who work together to make sure that every aspect of a patient’s treatment plan is well managed. Among other cancer disciplines, YCCC has a team of doctors specializing in and dedicated to mesothelioma diagnosis and treatment. Yale University School of Medicine333 Cedar StreetNew Haven, CT 06520-8028203-785-4095
District of Columbia, WASHINGTON DC
Lombardi Cancer Research Center
Lombardi is the only NCI-designated Comprehensive Cancer Center in the Washington, DC area. LCRC's clinical team offers the latest treatments for virtually every type of cancer. LCRC also provides the Lombardi CancerLine - a free, confidential information and referral resource for questions about cancer prevention, symptoms, screenings, support services, and treatment, or to access any of LCRC's doctors. The CancerLine can be reached at (202) 444-4000 from 9 a.m. to 5 p.m. LCRC at Georgetown University Medical Center3800 Reservoir Road NW Washington, DC 20007202-687-2110
FLORIDA
Sylvester Comprehensive Cancer Center
SCCC is Southern Florida's univserity based cancer center, providing cancer-related research, diagnosis, and treatment at the University of Miami Leonard M. Miller School of Medicine. UM/Sylvester handles more than 1,400 inpatient admissions annually, performs 3,000 surgical procedures, and treats 3,000 new cancer patients each year. In addition, UM/Sylvester physicians and scientists are engaged in 200 clinical trials and receive more than $31 million annually in research grants. University of Miami Medical School1475 Northwest 12th Avenue Miami, FL 33136305-548-4918
University of Alabama at BirminghamIt is the mission of the UAB Comprehensive Cancer Center to provide the most up-to-date and effective care to cancer patients; to advance the nation's scientific understanding of cancer; and to translate this new knowledge into improved diagnosis, treatment, and prevention for all types of cancer including mesothelioma. UAB Comprehensive Cancer CenterBasic Health Sciences Building1824 Sixth Avenue SouthBirmingham, AL 35294-3300205-934-5077
ARIZONA
University of Arizona Cancer CenterArizona's first comprehensive cancer center provides care for and treatment of those who have encountered all forms of cancer including mesothelioma (asbestos related cancer), as well as research into new techniques for prevention and cure, and through educational outreach programs that help people reduce their cancer risk. University of Arizona Cancer Center 1501 North Campbell Ave.Tucson, AZ 85724602-626-7925
CALIFORNIA
Jonsson Comprehensive Cancer Center
UCLA´s Jonsson Comprehensive Cancer Center (JCCC) has established an international reputation for developing new cancer therapies, providing the best in experimental and traditional treatments, and expertly guiding and training the next generation of medical researchers. With a membership of more than 230 physicians and scientists, the Jonsson Cancer Center handles more than 20,000 patient visits per year and conducts hundreds of clinical trials, providing the latest in experimental cancer treatments. Patients at the JCCC benefit from care provided by experts from different specialties who work together to help them contend with the immediate and long-term challenges of cancer. University of California at Los Angeles10833 Le Conte AvenueLos Angeles, CA 90095-1781800-825-2631310-825-5268
USC/Norris Comprehensive Cancer Center
The USC/Norris Comprehensive Cancer Center, located in Los Angeles, is a major regional and national resource for cancer research, treatment, prevention and education. More than 190 basic scientists, physicians and other Keck School of Medicine of USC faculty members who are members of the USC/Norris Cancer Center investigate the complex origins and progression of cancer, develop prevention strategies and search for cures. University of Southern California1441 Eastlake Avenue Los Angeles, CA 90033-0800213-764-0816
University of California San Francisco Comprehensive Cancer Center Housed within one of the nation's top biomedical research universities, the UCSF Comprehensive Cancer Center consolidates the work of researchers and clinicians who are dedicated to four fundamental pursuits: Laboratory research into the causes and events of cancer's progression; clinical research to translate new knowledge into viable treatments; sensitive, state-of-the-art patient care; and population research that can lead to effective prevention, early detection, and quality-of-life improvement for those living with cancer. Several physiciaans, oncologists, doctors and specialists providing mesothelioma treatment resources / information and research are affiliated with or work directly at the UCSF Comprehensive Cancer Center. University of California San Francisco 1600 Divisadero Street, San Francisco, CA 94115 1-800-888-8664
City Of Hope Comprehensive Cancer Center
Throughout its history, City of Hope has been committed to excellence in all areas of biomedical research, patient-centered medical care, and community outreach. StethIn recognition of our excellence in a broad range of new approaches to cancer research and treatment—and our outreach to the community—the
National Cancer Institute (NCI) has designated City of Hope a Comprehensive Cancer Center—one of just a handful of elite institutions nationwide. As a division of the National Institutes of Health, the NCI is the Federal Government's principal agency for cancer research and training. BB The NCI's Cancer Center program acknowledges institutions for their scientific excellence, and their ability to bring diverse research approaches to the problem of cancer. The "Comprehensive Cancer Center" designation indicates that City of Hope has undergone a rigorous peer review process, and has been found to be worthy of this highest level of recognition. City of Hope Comprehensive Cancer Center1500 East Duarte Road Duarte, CA 91010 626-256-HOPE (4673) 310-825-5268
CONNECTICUT
Yale Comprehensive Cancer Center
Yale Cancer Center combines innovative cancer treatment and quality care for patients. YCCC is the only comprehensive cancer center in Southern New England. Cancer treatment is available through multidisciplinary teams who work together to make sure that every aspect of a patient’s treatment plan is well managed. Among other cancer disciplines, YCCC has a team of doctors specializing in and dedicated to mesothelioma diagnosis and treatment. Yale University School of Medicine333 Cedar StreetNew Haven, CT 06520-8028203-785-4095
District of Columbia, WASHINGTON DC
Lombardi Cancer Research Center
Lombardi is the only NCI-designated Comprehensive Cancer Center in the Washington, DC area. LCRC's clinical team offers the latest treatments for virtually every type of cancer. LCRC also provides the Lombardi CancerLine - a free, confidential information and referral resource for questions about cancer prevention, symptoms, screenings, support services, and treatment, or to access any of LCRC's doctors. The CancerLine can be reached at (202) 444-4000 from 9 a.m. to 5 p.m. LCRC at Georgetown University Medical Center3800 Reservoir Road NW Washington, DC 20007202-687-2110
FLORIDA
Sylvester Comprehensive Cancer Center
SCCC is Southern Florida's univserity based cancer center, providing cancer-related research, diagnosis, and treatment at the University of Miami Leonard M. Miller School of Medicine. UM/Sylvester handles more than 1,400 inpatient admissions annually, performs 3,000 surgical procedures, and treats 3,000 new cancer patients each year. In addition, UM/Sylvester physicians and scientists are engaged in 200 clinical trials and receive more than $31 million annually in research grants. University of Miami Medical School1475 Northwest 12th Avenue Miami, FL 33136305-548-4918
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