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Anesthesia awareness has potential psychological consequences. Use of the bispectral index (BIS) developed from a processed electroencephalogram has been reported to decrease anesthesia awareness. In this randomized, controlled trial comparing a BIS-based protocol with a protocol based on measurement of end-tidal anesthetic gases, two cases of definite anesthesia awareness occurred in each group. This study did not show a benefit of BIS monitoring in reducing the rate of anesthesia awareness.
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Immediate hypersensitivity reactions to the monoclonal antibody cetuximab, used for the treatment of colorectal cancer and cancer of the head and neck, were found to be associated with IgE antibodies against cetuximab. These antibodies were present in pretreatment serum and were specific for galactose-α-1,3-galactose on the heavy chain of the cetuximab monoclonal antibody.
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Methylation of the promoter region of a gene is a mechanism that influences gene expression. In this study of patients with stage I non–small-cell lung cancer (NSCLC), methylation of seven genes — p16, CDH13, APC, RASSF1A, MGMT, ASC, and DAPK — from tumor and lymph-node specimens was studied. Four genes (p16, CDH13, RASSF1A, and APC), when methylated, were associated with recurrence after surgery with curative intent.
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In six patients who received bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor (VEGF), proteinuria subsequently developed, and thrombotic microangiopathy was shown on renal biopsy. In a murine model, the authors showed that using conditional gene targeting to ablate the VEGF gene from renal podocytes can trigger thrombotic microangiopathy. This finding suggests that glomerular injury from bevacizumab may be due to the direct targeting of VEGF.
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Gene transcription can be activated or inhibited by a reversible modification of the gene; this modification is termed an epigenetic change. This account of epigenetics in cancer reviews the mechanisms and consequences of epigenetic changes in cancer cells and concludes with the implications of these changes for the diagnosis, prognosis, and treatment of cancer.
Functional activation of growth factors and receptors of the epidermal growth factor receptor (EGFR) family occurs in most epithelial-cell cancers, rendering EGFR a target for cancer treatment. This article discusses the mechanisms of action of EGFR inhibitors, their anticancer activity, and clinical issues concerning their use in the treatment of patients with cancer.
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