Cavitated tumor as a clinical subentity in squamous cell lung cancer patients

Cavity in lung cancer patients is usually attributed to worse prognosis, which could be caused by diagnostic difficulties and late surgery. The aim of this study is to identify cavity as clinical subentity in squamous cell lung cancer (SqCLC) patients. 1094 patients with I0 - III0 of SqCLC underwent surgery with the purpose of radical lobectomy or pneumonectomy. The patients were divided into two groups: 100 patients with cavity (cSqCLC) and 994 with solid tumor (sSqCLC). The clinical, histological and prognostic features were compared for the both groups. The Cox multivariate analysis of the prognostic factors was performed. The survival curves for both groups were compared. cSqCLC patients showed lower body mass and more frequent hemoptoe. They had larger tumors, located peripherically, rarer nodal involvement and atelectasis. Despite the similar cancer stage and the exploratory thoracotomies ratio, cSqCLC patients lived shorter. The survival curves for both groups were different: in all population, for patients after radical surgery and even after exploratory thoracotomy. We conclude that the cavitation in SqCLC patients can be regarded as a separate subentity related to worse prognosis.     

Correlations among prostatic-specific antigen, Gleason score, staging and grading in patients after radical prostatectomy

OBJECTIVES: To evaluate the correlation between Gleason grade, T stage, tumour grade and preoperative prostate-specific antigen (PSA) level (< or > 20 ng/mL) in patients after radical prostatectomy (RP). PATIENTS AND METHODS: The serum total PSA level was measured 3 months before surgery in 87 patients who then underwent RP between 1994 and 2000; the tumour specimens were staged and graded. RESULTS: There were 57 (66%) patients with a PSA level of < 20 ng/mL; in this group only four (7%) patients had a Gleason grade of > 7 and eight (14%) had G3 tumours. Thirty (34%) patients had a PSA level of > 20 ng/mL; in this group only two (7%) patients had a Gleason grade of > 7 and 26 (87%) had G1 and G2 tumours. CONCLUSIONS: These results confirm our previous observations that the PSA level cannot be use as the only factor to indicate RP in patients with prostate cancer, but further evaluation on more patients is needed.     

Stimulation of neutrophil activation during coronary artery bypass grafting: comparison of crystalloid and blood cardioplegia

BACKGROUND: During myocardial ischemia, activation of polymorphonuclear neutrophils (PMNs) results in the production of free oxygen radicals, which increase myocardial injury. It has been shown that PMNs also produce nitric oxide. It is not clear whether PMNs become activated as a result of their direct contact with ischemic/reperfused myocardium or if PMN activation and free oxygen radical production are effects of specific stimuli released during coronary artery bypass grafting (CABG). The aim of the current study was to evaluate plasma-mediated neutrophil stimulation and production of superoxide anion (O2) and nitric oxide in patients undergoing CABG, and to verify whether crystalloid and blood cardioplegia can modify such stimulation. METHODS: Coronary sinus, peripheral arterial, and venous plasma samples were collected from 50 patients who underwent CABG and were divided into 2 equal groups which received either crystalloid or blood cardioplegia: directly before myocardial ischemia and aortic cross-clamping; at the beginning of reperfusion after aortic clamp release; and 30 minutes after reperfusion. O2 and nitric oxide production by PMN was evaluated by standard methods. RESULTS: There was a significant (p < 0.05) increase in O2 production by PMN incubated with plasma obtained from the coronary sinus immediately after reperfusion in patients receiving crystalloid cardioplegia compared to blood cardioplegia. No difference was observed in plasma stimulation of nitric oxide production by PMN in the 2 groups of patients at different times during the procedure. CONCLUSIONS: Cardioplegia may affect release of neutrophil-oriented stimuli from ischemic myocardium and modify neutrophil activation during coronary artery bypass grafting.     

Biochemical Assessment of Fetal Lung Maturity

Summary: Three tests currently used in assessing fetal pulmonary maturity were carried out on 86 specimens of amniotic fluid. These were the foam test and determinations of lecithin concentration and lecithin/sphingomyelin (L/S) ratio. An excellent correlation was found between the foam test and both lecithin concentration and L/S ratio. Twenty amniotic fluid samples collected within a week of delivery were analysed, and results demonstrated that a negative foam test result was associated with fetal pulmonary immaturity. This foam test corresponded to a lecithin concentration of less than 2.5 mg./100 ml. of amniotic fluid and an L/S ratio of less than 6.