Surgical outcomes in patients with cutaneous malignant melanoma in Europe - a systematic literature review.

There is limited comparative evidence of the outcomes of different types of surgical management in patients with malignant melanoma in Europe. To address that gap we conducted a systematic literature review to summarize studies reporting outcomes of surgical procedures in patients with malignant melanoma in Europe. Medline was searched for European studies published in English, between 2004 and 2014 reporting surgical outcomes in adults with cutaneous malignant melanoma. We identified 23 studies that evaluated 18 332 patients treated surgically between 1979 and 2009 from 11 European countries. Most of the studies (21/23) were observational; the two remaining studies were randomized controlled trials (RCTs). Studies compared the effect of a range of surgical interventions on a range of clinical outcomes, more commonly overall survival (OS) and disease-free survival (DFS)/recurrence-free survival (RFS). Wider excisions were not associated with improved survival in patients with melanoma thickness ≥2 mm in both studies (RCTs), however, recent results based on long-term follow-up data associate 3 cm excision margins (vs. 1 cm) with favourable survival outcomes. There was some evidence that complete lymph node dissection after positive sentinel lymph node offers survival benefits over therapeutic lymph node dissection. Sentinel lymph node biopsy was not shown to be associated with significant OS benefits, however, it was overly related with higher rates of DFS/RFS. This review highlights the difficulties of making comparisons between different types of surgical procedures for malignant melanoma. As surgery remains the main treatment, this is an important field, and further evidence, particularly from RCTs, is needed.

Inhibition of return and attentional control settings.

In the present study, we used a spatial cuing paradigm in conjunction with a choice identification task to investigate whether exogenous attentional orienting and inhibition of return are affected by attentional control settings. As in previous studies (e.g., Folk, Remington, & Johnston, 1992), onset- and color-defined targets were crossed with uninformative onset- and color-defined cues. As expected, when the cue-target stimulus onset asynchrony (SOA) was short (i.e., 100 msec), the results showed that exogenous attentional orienting was contingent on attentional set; attentional capture occurred in response to a particular cue only when the feature that defined the cue also defined the target (Folk et al., 1992). More importantly, when the cue-target SOA was long (i.e., 1,000 msec), the results showed that the occurrence of inhibition of return was also contingent on attentional set, at least partially so; inhibition of return occurred in response to onset cues only when they preceded onset targets. In contrast, inhibition of return never occurred in response to color cues (at a variety of long SOAs). The associations and dissociations that were observed between exogenous attentional orienting and inhibition of return are discussed in terms of posterior and anterior attention networks in the brain (Posner & Petersen, 1990).

Quantitative determination of high-density lipoprotein cholesterol by agarose gel electrophoresis.

We have developed a procedure for the determination of high-density lipoprotein cholesterol by agarose gel electrophoresis. Only 2 micro L of sample was applied to the gel. After electrophoresis at 90 V for 35 min, an enzymatic cholesterol reagent was applied. After a 30-min incubation, the high-density lipoprotein cholesterol was quantified by densitometry. Precision for this measurment approaches that reported for the heparin-manganese/Abell-Kendall method (Clin. Chem, 25: 596--609, 1979). We evaluated accuracy by comparing high-density lipoprotein cholesterol concentration measured by electrophoresis to that determined in the Framingham Heart Study procedure (J. Biol. Chem. 195: 357, 1952). The resulting correlation was excellent. By the paired Student's t-test, there was no significant difference between the two methods. The proposed method gives a linear standard curve when the concentration of total cholesterol is between 1.0 and 3.5 g/L. By accurate quantitation of high-density lipoprotein cholesterol, agarose gel electrophoresis can aid in assessment of coronary heart disease risk for a large segment of the population.