Valor pronóstico de los receptores hormonales,receptor del factor de crecimiento epidérmico humano,ciclinas D1 y D2, B-Cell Lymphoma2 y ciclooxigenasa-2 en pacientes jóvenes con cáncer de mama

Objetive

To investigate the value of hormone receptor (HR) status, HER-2, cyclins D1 and D2, bcl-2 and cyclooxygenase-2 (COX-2) in predicting the outcome of very young breast cancer patients (below 35 years).

Subjects and method

In this study HR, HER-2, cyclins D1 and D2, bcl-2 and COX-2 were determined for a second time by immunohistochemistry and tissue arrays in a cohort of 71 patients aged less than 35 years with known outcome. The prognostic influence of these factors was evaluated by the chi-square test and Kaplan Meier method.

Results

Expression of HR was detected in 67% of the patients, HER-2 in 48.6%, cyclins D1 and D2 in 59.1% and 59.7%, respectively, bcl-2 in 62.5% and COX-2 in 63.4% of breast tumors. HR and COX-2 overexpression were significantly correlated with a major risk of local relapse (OR: 4.6, P=.03 for HR and OR: 3.7, P=.02 for COX-2).

Conclusions

Increased expression of HR and COX-2 may play a role in the progression of primary breast carcinoma in very young patients. Overexpression of cyclins D1 and D2 and bcl-2 had no prognostic value.     

A simple assay to detect endothelial cell injury; measurement of released thrombomodulin from cells.

A simple assay to determine the degree of endothelial cell injury has been developed using released thrombomodulin as the index. Thrombomodulin is a cell surface protein on endothelial cells which is released from the cell upon injury. In this assay, bovine arterial endothelial cells were cultured in serum free medium with the test substances and the amount of thrombomodulin released into the culture medium was measured by enzyme immunoassay. Substances which are known to injure cells such as H2O2, prostaglandin A2, lipopolysaccharide, and elastase released significant amounts of thrombomodulin. The sensitivity of this assay for mild injury was superior or at least equal to the traditional 51Cr release method. Since this method does not require the use of radioisotopes, it seems to be advantageous and suitable for the detection of endothelial cell injury during routine examination.     

Growth dynamics of the heart from perinatal period to childhood

In order to obtain information useful for the diagnosis of fetus and newborn heart disease, we established a theoretical model of perinatal cardiac growth. We measured with the use of ultrasonic cross-section imaging system the mitral valve ring dimension, tricuspid valve ring dimension, and total cardiac dimension as morphological parameters of the heart in 45 cases composed of fetuses and children. The obtained data were entered into a computer. With the use of these data, simulation was made on the basis of the general theory of biological development. The present simulation showed that from the fetal stage to childhood the growth rates of the foregoing three morphological parameters mutually differ, but during the period of growth to the age of 12 years of the present study, they all demonstrated continuous growth up to 3 1/2 years after birth when they reached a growth saturation level.     

Immunoglobulin genes encoding antibodies directed to oncodevelopmental carbohydrate antigens

We investigated the immunoglobulin genes which encode the variable region of the monoclonal antibodies directed to the onco-developmental carbohydrate antigens such SSEA-1, fucosyl SSEA-1, SSEA-3 and SSEA-4. The VH region of these antibodies was preferentially encoded by the gene members of the X24, VH7183 and Q52 families, the families which are known to be located at the 3'-end region of the murine germ line VH gene. This result is interesting particularly when considering that the members of the 3'-end VH families are known to be preferentially expressed in embryonic B lymphocytes by an intrinsic genetic program. The comparative study of the nucleic acid sequences of mRNAs encoding these antibodies and the sequences of the corresponding germ line VH genes disclosed that the sequences encoding the antibodies contain no mutation from the germ line VH genes, or contain only a few somatic mutations, which are thought to be insignificant for the reactivity of the antibodies to the nominal antigens. These results imply that some of the embryonic B lymphocytes that express the unmutated germ line VH genes of the 3'-end families can be reactive with embryonic carbohydrate antigens, albeit rearranged with appropriate D-JH gene segments, and coupled with proper light chains. The VH region of the syngenic monoclonal anti-idiotypic antibodies directed to these anti-carbohydrate antibodies were also encoded preferentially by the members of the 3'-end VH families. We propose here that a part of the virgin embryonic B lymphocytes, which express the antibody encoded by the gene members of the 3'-end VH families at the cell surface, will be stimulated by the embryonic carbohydrate antigens which are abundantly present in the internal milieu of the embryo. The clonally expanded B lymphocytes, in turn, will facilitate the proliferation of other populations of embryonic B lymphocytes expressing the corresponding anti-idiotypic antibodies, which are also encoded by the gene members of the 3'-end VH families. This process will lead to the formation of the primitive immune idiotype network system directed to the embryonic carbohydrate auto-antigens in the embryo, which is rarely exposed to the external antigens.     

Hitting a Moving Target: Successful Management of Diffuse Large B-cell Lymphoma Involving the Mesentery With Volumetric Image-guided Intensity Modulated Radiation Therapy

Introduction

We report successful treatment of mesenteric diffuse large B-cell lymphoma (DLBCL) using localized involved site radiation therapy (ISRT), intensity modulated radiation therapy (IMRT), and daily computed tomography (CT)-image guidance.

Study on pruritus in hemodialysis patients and the antipruritic effect of neurotropin: plasma levels of substance P, somatostatin, IgE, PTH and histamine.

It has been reported that Neurotropin can markedly improve pruritus in patients undergoing hemodialysis (HD). In order to elucidate the probable causes of pruritus and the antipruritic effect of Neurotropin, various biochemical parameters in the plasma of patients before and during HD were investigated. Forty-three patients undergoing HD were divided into three groups. Eighteen patients had suffered no episode of pruritus (group A), 17 patients had on-going pruritus (group B) and the remaining 8 patients had experienced improvement of pruritus following Neurotropin treatment (group C). The mean concentration of substance P was in only B group significantly increased with HD only in B group, indicating that substance P could be one of the causes of pruritus in patients undergoing HD. Neurotropin appears to exert its antipruritic effect by lowering the level of substance P. The change in parathyroid hormone (PTH) level during HD was not significant in any of the groups, but the mean concentration of PTH in group B was higher than that of group A, indicating that PTH may also be one of the causes of pruritus.     

Assessing the macroeconomic impact of a healthcare problem: the application of computable general equilibrium analysis to antimicrobial resistance

There is a positive relationship between the health of a nation and its economic prosperity. However, in evaluating health care, economists typically concentrate on the economic impact only to the health (care) sector, which may mis-specify the social costs and benefits of a disease or intervention. This paper demonstrates the value of using a macroeconomic approach to modelling a major health problem, using the context of antimicrobial resistance and the application of the computable general equilibrium technique. This approach is described in detail and its 'added value' demonstrated in the case of AMR.