Prolactin receptor expression in gynaecomastia and male breast carcinoma

AIMS

Despite the well-established function of prolactin (PRL) in normal breast development, its role in breast cancer pathogenesis is still controversial. PRL activity is dependent on the activation of a transmembrane protein, the PRL receptor (PRLR). The aim was to evaluate and compare PRLR expression in gynaecomastia and male breast carcinoma (MBC).

METHODS AND RESULTS

PRLR expression was detected immunohistochemically in 30 cases of gynaecomastia and 30 cases of MBC. The whole series was also assessed for oestrogen receptors (ER), progesterone receptors (PR) and androgen receptors (AR). A cut-off of 10% was used as the criterion for positivity. Histological type and tumour differentiation were evaluated. Pathological stage was assessed [Tumour Node Metastasis (TNM)-International Union Against Cancer system]. Statistical analysis was performed with Fisher's exact test. PRLR positivity was seen in 20% of gynaecomastia cases and in 60% of MBC cases (P = 0.003). In gynaecomastia immunoreactivity was predominantly observed in luminal cell borders, whereas in MBC the reactivity was heterogeneous and mainly cytoplasmic. There was no statistically significant correlation between PRLR expression and ER, PR, AR, pTNM, or histological grade.

CONCLUSIONS

PRLR is significantly more expressed in MBC than in gynaecomastia, and with different patterns of reactivity, suggesting a role for PRL in male breast carcinogenesis.

Oxidative stress response in gill and liver of Liza saliens, from the Esmoriz-Paramos coastal lagoon, Portugal

Tissue-specific responses against oxidative stress and lipid peroxidation were analyzed in wild adult mullet (Liza saliens) caught in the Portuguese coastal lagoon Esmoriz-Paramos. Parameters measured were catalase (CAT), superoxide dismutase (SOD), and glutathione-S-transferase (GST) activities in liver and gill tissues and lipid peroxidation. The enzyme activities were related to gill histopathological alterations, as well as to heavy metals (Cu and Zn) concentrations in these tissues. Gill epithelium of L. saliens showed histological alterations, such as epithelial hyperplasia resulting in lamellar fusion, epithelial lifting, vasodilatation, and lamellar aneurisms, with a prevalence ranging from 62% to 92%. The highest Cu content was found in liver (379 mg x kg(-1)), while the highest Zn content was observed in gill (119 mg x kg(-1)). SOD and CAT activities showed differences between gill and liver. The highest activities found were SOD in gill (10.1 U/mg protein) and CAT in liver (39.2 mmol/min/mg protein). In gill, CAT activity was negatively related to both Cu levels and gill lifting, while a positive relationship was found between SOD activity and fish age. The positive relationship between Cu and CAT activity in liver suggests that an increase in metabolic level is related to Cu-induced oxidative stress. The decrease in gill CAT activity can be due to osmotic stress caused by damaged gill epithelium. CAT activity in liver is an appropriate biomarker of oxidative stress in the Esmoriz-Paramos lagoon.

The effect of long-term depuration on levels of oxidative stress biomarkers in mullets (Mugil cephalus) chronically exposed to contaminants

The present study aimed to obtain additional data on the effect of long-term depuration on the levels of oxidative stress biomarkers, and to clarify the role of mullets for monitoring pollution in River Douro estuary. Mullets chronically exposed to a mixture of contaminants in Douro estuary were captured in Spring of 2001, 2002 and 2003. The activities of antioxidant enzymes catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPX); and oxidative damages in lipids (lipid peroxidation) and in proteins (protein carbonyl content) were assessed at capture day and after transfer to unpolluted seawater for 1, 4 and 8 months. An overall decrease in the activities of the antioxidant enzymes was detected, except for the GPX after 4 months depuration. CAT activity exhibited the more significant decrease at the end of the long-term depuration. The decrease in SOD activity after 1 month of depuration was then maintained during the remaining depuration period. Regarding oxidative damages, a decrease in lipid peroxidation as well as the content of oxidised proteins was observed during depuration. Indeed, at capture the activities of antioxidant defences were higher as a result of the formation of reactive oxygen species (ROS) from the metabolism of pollutants. The oxidative damaged molecules were repaired or degraded during the depuration period, supporting the use of such damages as indicators of exposure to pro-oxidant pollutants.

AVALIAÇÃO DA REGIÃO ESPAÇADORA 16S-23S DNAR COMO MARCADOR MOLECULAR PARA DIFERENCIAÇÃO DE ACIDOVORAX AVENAE SUBSP. CATTLEYAE E BURKHOLDERIA GLADIOLI PV. GLADIOLI PATOGÊNICAS A ORQUÍDEAS

RESUMO A região espaçadora 16S-23S DNAr foi avaliada como marcador molecular para a diferenciação dos patógenos de orquídeas, Acidovorax avenae subsp. cattleyae e Burkholderia gladioli pv. gladioli. Outras espécies pertencentes a esses dois gêneros como B. gladioli pv. alliicola, A. avenae subsp. avenae, A. avenae subsp. citrulli, A. anthurii, A. facilis, A. delafieldii e A. konjaci também foram analisadas. A amplificação por PCR dessa região produziu um fragmento de aproximadamente 1.100 pares de bases para todas as linhagens testadas. Os produtos obtidos foram submetidos a digestões com as enzimas Afa I, Alu I, Hae III e Hpa II e os resultados mostraram perfis distintos de RFLP para A. avenae subsp. cattleyae de B. gladioli pv. gladioli com todas as endonucleases testadas. As seqüências da região espaçadora 16S-23S DNAr foram alinhadas e a análise filogenética confirmou as diferenças entre A. avenae subsp. cattleyae e B. gladioli pv. gladioli. A técnica de PCR-RFLP mostrouse eficiente e muito útil para a identificação desses patógenos, uma vez que eles causam sintomas muito semelhantes em orquídeas.

Patterns of care among veterans with colon cancer: Insights from California SEER, Medicare and VA-linked data

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Background: U.S. veterans have been shown to be a vulnerable population with high cancer rates, yet practice pattern information is lacking. Linkage of cancer registry, Medicare, and VA data provides a more complete view of health status and healthcare received among veterans with cancer. Methods: As part of a national study, a retrospective cohort of incident colon cancer patients from the California Cancer Registry data, who were = 66 years old and eligible to use VA and Medicare between 1999 and 2001, were followed for three years through 2004. We examined practice patterns for stages I-IV colon cancer, specifically, surgery and use of chemotherapy, and trends in one-year mortality using descriptive and multivariate regression models. Results: Among 633 veterans with colon cancer, 93% were male; 16% were African American; 28% were diagnosed at a VA facility compared to 72% at a Medicare facility, and 553 (87%) had colectomy. One year mortality rate was 29%. Among the 553 colectomy patients, prevalence of chemotherapy use, according to stage was 8%, 27%, 61% and 52% for stages I-IV, respectively (p-value <0.0001). Regression analyses of factors affecting whether chemotherapy was received revealed that Stage III patients were most likely to receive adjuvant chemotherapy (Odds Ratio (OR) 19.80, 95% Confidence Interval (CI): 9.68–40.50). However stage II and stage IV patients were also highly likely to receive chemotherapy following surgery (OR: 4.41 CI: 2.18–8.91 and OR: 13.21; CI: 6.01–29, respectively). Patients =76 years and those =86 years were less likely to receive chemotherapy following surgery (OR: 0.61, CI: 0.40–0.94 and OR: 0.25, CI: 0.094–0.64, respectively) compared to patients 66–75 years. Patients with Charlson Comorbidity Score of 2 or greater were less likely to receive chemotherapy (OR: 0.49; CI: 0.29–0.84). Treating facility (VA or Medicare), did not affect chemotherapy use. Conclusions: Among veterans with colon cancer in California, older patients were less likely to receive chemotherapy even when stage and comorbidity status were considered. Efforts focused on improving guideline consistent adjuvant chemotherapy use among older veterans with stage III colon cancer across treating facilities may yield the greatest benefit.

No significant financial relationships to disclose.

Lignin from sugar cane bagasse: extraction, fabrication of nanostructured films, and application

Four lignin samples were extracted from sugar cane bagasse using four different alcohols (methanol, ethanol, n-propanol, and 1-butanol) via the organosolv-CO2 supercritical pulping process. Langmuir films were characterized by surface pressure vs mean molecular area (Pi-A) isotherms to exploit information at the molecular level carrying out stability tests, cycles of compression/expansion (hysteresis), subphase temperature variations, and metallic ions dissolved into the water subphase at different concentrations. Briefly, it was observed that these lignins are relatively stable on the water surface when compared to those obtained via different extraction processes. Besides, the Pi-A isotherms are shifted to smaller molecular areas at higher subphase temperatures and to larger molecular areas when the metallic ions are dissolved into the subphase. The results are related to the formation of stable aggregates (domains) onto the water subphase by these lignins, as shown in the Pi-A isotherms. It was found as well that the most stable lignin monolayer onto the water subphase is that extracted with 1-butanol. Homogeneous Langmuir-Blodgett (LB) films of this lignin could be produced as confirmed by UV-vis absorption spectroscopy and the cumulative transfer parameter. In addition, FTIR analysis showed that this lignin LB film is structured in a way that the phenyl groups are organized preferentially parallel to the substrate surface. Further, these LB films were deposited onto gold interdigitated electrodes and ITO and applied in studies involving the detection of Cd+2 ions in aqueous solutions at low concentration levels through impedance spectroscopy and electrochemical measurements. FTIR spectroscopy was carried out before and after soaking the thin films into Cd+2 aqueous solutions, revealing a possible physical interaction between the lignin phenyl groups and the heavy metal ions. The importance of using nanostructured systems is demonstrated as well by comparing both LB and cast films.

Deliberate Subclavian Artery Occlusion during Aortic Endovascular Repair: Is it Really that Safe?

PURPOSE

To report a series of cases in which deliberate occlusion of the left Subclavian Artery (SA) caused the Subclavian Steal Syndrome (SSS).

METHODS

Between January 2001 and August 2006, we performed 81 endovascular repairs of the Thoracic Aorta. 21 patients required left SA occlusion for an adequate proximal landing zone. 17 of these patients were treated by deliberate SA occlusion. Four patients (23.5%) developed a SSS, of which three were treated by a secondary Subclavian-to-carotid transposition, with complete remission of the SSS.

RESULTS

The subclavian-to-carotid transposition was successful in the treatment of the 3 patients selected. One patient refused to be operated, and had only partial remission of the SSS symptoms. Mean follow-up was 28 months (range 2-48).

CONCLUSION

In this series deliberate occlusion of the SA led to SSS in a significant number of patients. Consideration should be given to primary subclavian transposition in some patients requiring subclavian occlusion.

Depuration of PCBs and DDTs in mullet under captivity clean conditions

Contaminated mullet (Mugil cephalus) from Douro estuary was allowed to depurate in clean water and fed with uncontaminated food. Levels of PCBs and DDTs in muscle and liver, and ethoxyresorufin O-deethylase (EROD) activity were measured at day 0, 21, 120 and 270. In specimens captured in the estuary total PCB and total DDT concentrations were 311 and 65 ng g(-1) in muscle and 686 and 115 ng g(-1) in liver, respectively. At day 21, after an initial 10-15 days period of starvation, organochlorines levels increased in both analyzed tissues. Thereafter levels of all PCB congeners and DDT compounds decreased in muscle, and at the end of the 270 days were 49 ng g(-1) and 13 ng g(-1), respectively. These decreases were correlated to the lipids consumption. In liver no relationship between those variables was observed, suggesting different elimination processes and eventual exchange of contaminants between muscle and liver. EROD activities decreased in the first days of depuration experiment, but showed no relations with analysed organochlorines.

"Downhill" varices. A rare cause of esophageal hemorrhage

"Downhill" varices or upper esophageal varices are a rare cause of proximal digestive tract hemorrhage with only 16 cases described in the literature. In our series, hemorrhage due to "downhill" varices represents 0.1% of all acute esophageal variceal bleeding. Their etiology differs from that of the usual "uphill" varices secondary to portal hypertension, and the clinical management should be directed to vascular obstruction if present. We report a case of an 89-year-old male with hemorrhagic "downhill" varices not associated, as usually, with superior vena cava obstruction or compression, but with severe pulmonary hypertension and drug-related hemorrhagic risk factors, whose removal proved sufficient to prevent rebleeding.

Treatment for acute lymphoblastic leukemia in children is associated with papillary carcinoma of thyroid, but not with thyroid disfunction

AIM

The treatment of acute lymphoblastic leukemia (ALL) in children may cause sequelae, some appearing only at long-term follow-up. We investigated the thyroid gland morphology and the function of the pituitary-thyroid axis in a group of patients treated for ALL in childhood.

METHODS

A cohort study was conducted at a tertiary medical center. Thirty-three children (22 males and 11 females; age: 11.9+/-3 years; range: 6 to 18 years) were studied. The mean age at the time of chemotherapy and prophylactic cranial irradiation (12-24 Gy) was 5.5+/-2.6 years (range: 1 to 14 years). The average length of the follow-up was 6.1+/-3 years (range: 2 to 12 years). Thyroid morphology (n=33) was evaluated by palpation and ultrasonography. Thyroid function (n=30) was evaluated measuring total T3 and T4, and by the thyrotrophin-releasing hormone (TRH) test. Prolactin secretion was assessed before and after injection of TRH to evaluate the diagnostic test accuracy.

RESULTS

One out of the 33 children (3%) was found to have a papillary carcinoma of thyroid four years after ALL treatment. Thyroid function was normal in all the patients, however one case (3%) showed high TSH (9.2 microU/mL) and prolactin (37.5 ng/mL) basal levels, but normal responses to TRH (TSH = 17.8 microU/mL; prolactin = 82.3 ng/mL). These hormonal alteration were not confirmed at follow-up: TSH = 1.6 microU/mL and prolactin = 13.7 ng/mL.

CONCLUSIONS

In this cohort of patients, the treatment of ALL was associated with one case of thyroid carcinoma, but it did not produce adverse effect on the thyroid function, at least after a follow-up lasted on average 6 years.

Esophageal perforation--associated risk with balloon tamponade after endoscopic therapy. Myth or reality?

BACKGROUND/AIMS

Variceal bleeding is still associated with high mortality and balloon tamponade may be a lifesaving measure when endoscopic therapy is not available or feasible. The risk of esophageal perforation with balloon tamponade after endoscopic therapy is still uncertain. The aims of the study were to investigate balloon tamponade effectiveness and safety after endoscopic therapy.

METHODOLOGY

Retrospective analysis of 100 consecutive episodes of acute variceal bleeding treated with the Sengstaken-Blakemore tube.

RESULTS

Balloon tamponade had an overall effectiveness of 61%. The Child-Pugh score was significantly higher in patients who failed balloon tamponade. In 48 cases balloon tamponade was preceded by failure of endoscopic therapy. Balloon tamponade was more effective if a previous attempt to perform endoscopic therapy happened (75% vs. 48%; p = 0.006). Aspiration was the most frequent complication. No cases of esophageal perforation were registered.

CONCLUSIONS

Currently balloon tamponade is only used as a temporary bridge to other strategies, when other forms of hemostatic therapies do not succeed. Balloon tamponade was more effective in patients with less severe hepatic dysfunction. Previous attempts to perform endoscopic therapy may augment tamponade effectiveness without increasing the risk of esophageal perforation.

The effect of long-term depuration on phase I and phase II biotransformation in mullets (Mugil cephalus) chronically exposed to pollutants in River Douro Estuary, Portugal

Pollutants such polycyclic aromatic hydrocarbons (PAHs) are released into the environment by urban communities and industries and the enzymes that catalyse the biotransformation of pollutants play a key role regarding the accumulation of these compounds in fish species inhabiting these areas. In this study the relationship between phase I (EROD activity) and phase II (GST activity) and PAH metabolites was measured in grey mullet (Mugil cephalus) after capture in the Douro estuary, and after long-term depuration in an unpolluted laboratory environment. The results showed a significant decrease in EROD activity after 1 month and in bile metabolites after 4 months in captivity, with both maintaining reduced levels at 4 and 8 months depuration. Liver GST activity did not showed significant changes. This study provides evidence that Douro estuary waters contain bioavailable PAHs that can be associated with the induction of cytochrome P450, and that mullets have the ability to metabolise and eliminate PAHs.

Chronic diseases and health inequalities in older persons in Botswana (southern Africa): a national survey

OBJECTIVES

To evaluate the health status of older persons in Botswana, to report on the prevalence of common health conditions--typically chronic diseases, to assess the socio-demographic correlates of morbidity in this population, and to assess the associations between physical functioning and self-reported health and the common health problems presented.

DESIGN

National, cross-sectional survey (12 rural areas, 3 urban centres), inclusive of clinical examinations.

SAMPLE

372 individuals (183 females, 189 males) aged 60-109 years.

RESULTS

68% of respondents reported musculoskeletal pain in two or more locations; 42% were found to be hypertensive; 36% reported dental problems; 32% had dermatological problems; 11% were blind (as defined); 9% had cognitive impairment; 7% were depressed. Multinomial regression analyses showed poor self reported health to be significantly associated with musculoskeletal pain (OR = 15.5), depression (OR = 9.7), incontinence (OR = 3.9), dermatological problems (OR = 3.0) and dental problems (OR = 2.3); hypertension, blindness and cognitive impairment did not show significant associations.

CONCLUSION

A large number of older persons in Botswana suffer from one or more age-associated chronic diseases that may impair function and quality of life. Several of the conditions may be diagnosed and treated to optimise the individuals' functioning. Poor self reported health was associated with "painful conditions" which are commonly poorly managed or untreated.

Oxidative stress biomarkers in two resident species, mullet (Mugil cephalus) and flounder (Platichthys flesus), from a polluted site in River Douro Estuary, Portugal

Exposure of marine animals to certain pollutants can enhance reactive oxygen species (ROS) production with subsequent damage to macromolecules and alterations in oxidant defences levels. Aimed at correlating the tissue concentration of certain contaminants (PCBs, DDT) with antioxidant defence levels and oxidative damages, two fish species with different life strategies (mullet, Mugil cephalus, and flounder, Platichthys flesus) were collected in the Douro Estuary (NW Portugal). After capture, the fish were left to depurate for 1 month in clean seawater. The levels of the two antioxidant enzyme activities revealed that they are species-dependent with mullet's livers showing higher superoxide dismutase (SOD) (13.2+/-0.5 U/mg protein) and catalase (CAT) (15.5+/-1.0 mmol/min/mg protein) activities than flounder (SOD: 7.9+/-0.9 U/mg protein; CAT: 11.1+/-0.8 mmol/min/mg protein). After 1 month in captivity the antioxidant enzymes activities in liver decreased in mullets, while for flounders the responses were not consistent because during the experimental period flounders did not ate and responses of antioxidant enzymes and oxidative damages were dependent on the fasting condition. The liver oxidative damages were evaluated by estimating oxidised lipids and proteins. Both species showed similar levels for these two parameters. The hepatic lipid peroxidation in flounder increased after 1 month in captivity, while in mullet an increase was observed only in summer and autumn. The oxidised protein content increased for both species after the depuration period. This study reveals differences between species under oxidative stress when exposed to pollutants. In a clean environment, the mullet's primary antioxidant defences decreased indicating that the animals living in Douro estuary were facing an oxidative stress. The data indicate that, namely in mullet, the presence of pollutants induce oxidative stress responses.