Increased angiogenesis is related to boosted growth and malignancy in carcinomas. "Chronic Persistent Low-Dose Ionizing Radiation" (CPLDIR) exposure increases incidence and aggressive behavior of clear-cell renal-cell carcinoma (CCRCC). The aim was to study the biology of angiogenesis, including microvessel density (MVD), in human clear-cell renal-cell carcinomas (CCRCC) originating from a radio-contaminated geographical area (Ukraine) and to compare with similar tumors diagnosed in non-contaminated regions of Europe (Spain, Valencia) and Latin America (Colombia, Barranquilla). MVD was comparatively examined in 124 patients diagnosed with CCRCC from three geographical areas by means of digital micro-imaging and computerized analysis. Additionally, 50 adult normal kidneys were used for controls (autopsy kidneys from Valencia and Barranquilla). Furthermore, an immunohistochemical study of several vascular related growth factors was undertaken using a similar methodology. MVD as well as VEFG are the most discriminating factors associated with an aggressive behavior of CCRCC. Their expression increased in proportion to the level of exposure to chronic low-dose ionizing radiation in Ukrainian patients in the 25 years since the Chernobyl accident substantiated by comparison with the two control groups of renal carcinomas present in non-irradiated areas (Spain and Colombia). No major biological differences relating to angiogenesis appear to exist between the CCRCC diagnosed in two distant geographical areas of the world. HIF-1α expression was similar in all groups, with no statistical significance. Present findings demonstrate the existence of a significant relationship between MVD and VEGF in CCRCC: an increased expression of VEGF is associated with a high level of angiogenesis.
Introducción: el carcinoma metaplásico de la mama tipo células escamosas es una neoplasia maligna poco frecuente que representa un 0,04% de los carcinomas mamarios. Su diagnóstico clínico e imagenológico es complejo dado la similitud con lesiones benignas; sin embargo, su rápido crecimiento alerta sobre su comportamiento agresivo. Debido a los pocos casos en la literatura, no hay un consenso general sobre su diagnóstico y tratamiento. Se presenta un caso con el objetivo de hacer una revisión sobre el tema respecto al diagnóstico histopatológico y factores pronósticos.Caso clínico: se presenta el caso clínico de una paciente de 51 años, con una de masa de 6 cm en mama derecha, cuyos estudios ecográficos reportaron una probable lesión benigna (Breast Imaging Reporting and Data System - BIRADS III). El estudio histopatológico revela una lesión tumoral maligna constituida por células escamosas que tapizan espacios quísticos.Materiales y métodos: para la revisión de la literatura se exploró la base de datos PubMed, con el fin de buscar revisiones sistemáticas, presentación de casos clínicos, estudios clínicos y epidemiológicos con las palabras clave metaplastic breast carcinoma, metaplastic carcinoma, durante el período comprendido entre el 2000-2011.Conclusiones: histopatológicamente, el carcinoma metaplásico de células escamosas puede presentarse como una mezcla de adenocarcinoma con áreas dominantes de diferenciación escamosa, e incluso, en formas escamosas puras, representando plasticidad fenotípica del tumor. El sistema modificado de Scarf-Bloom-Richardson no es aplicable en esta lesión. Los factores pronósticos más importantes son la edad y el tamaño tumoral; sin embargo, algunos estudios consideran las metástasis nodales y el estado de los receptores.
Duazomycin A a glutamine analogue, chemically similar to DON, was studied in 143 patients. An intravenous dose of 3 mg. per kilogram daily for 14 days appeared to be the tolerated dose in humans. Undesirable effects were nausea, vomiting, diarrhea, stomatitis, leukopenia, and thrombopenia. These effects cleared rapidly when the drug was discontinued. Tumor regression was noted in 6 patients but was evanescent and clinically beneficial to only 2.
Introduction In patients with ischemic stroke, the levels of circulating Endothelial Progenitor Cells (EPCs) have been infrequently studied. Our study was focused on investigating the EPC counts in patients with acute, subacute and chronic ischemic stroke and analyzing the associated variables. Methods We prospectively studied consecutive patients with ischemic stroke within the first 48 hours from symptoms onset. We evaluated demographic data (age, sex); classical vascular risk factors (high blood pressure, diabetes mellitus, hypercholesterolemia, coronary artery disease, peripheral vascular disease, previous ischemic stroke, smoking, alcohol abuse, obesity, number or risk factors); thrombolysis; treatment with statins before and after stroke; etiology (sss-TOAST criteria); severity of the neurological deficit (NIHSS score). Blood samples were collected at baseline (n=146), day 7 (n=121) and day 90 (n=92) after stroke onset. EPCs were measured by flow cytometry within 30 minutes after blood collection. We considered that a cell was an EPC when it was labeled for the following 3 markers: CD34, AC133 and KDR. EPC counts were adjusted for the lymphomonocytic population in each sample and expressed as %. Statistics: Non-parametric bivariate analyses, logistic regression analysis. Results We included 146 patients (mean age 70.8±12.2 y, 63% men). In the baseline sample, the following variables were associated with the EPCs count: alcohol abuse (p=0.08), hipercolesterolemia (p=0.029), pre-treatment with statins (p=0.015) and etiology (p=0.037). There were no variables associated with the EPCs count at 7 days. Variables associated with the EPCs count at 3 months were: treatment with statins after stroke (p=0.017), old cerebral infarction (p=0.059) and obesity (p=0.029). The multivariate analysis showed that pre-treatment with statins (OD 3.11, 95%CI 1.34-7.19, p=0.008) and stroke of unknown etiology (p=0.032) independently predicted higher EPC counts at baseline. No variables were independently associated with EPCs counts at 7 days. Finally, at day 90, treatment with statins after stroke was the only variable independently associated with higher EPC counts (OR 11.7, 95%CI 1.5-86, p=0.016). Conclusion In conclusion, prior treatment with statins and stroke etiology are predictors of EPC counts in patients with acute ischemic stroke, while treatment with statins after stroke is independently associated with EPC count at 3 months. The increase in EPCs may be one of the pleiotropic effects of statins that improve the outcome of patients with ischemic stroke.
We describe 2 cases of proximal tubular defects induced by the administration of ifosfamide at a dosage of 6 g/m2/course over 2 days in children with a diagnosis of malignant mesenchymal tumors. This adverse effect could be minimized dividing dosage of the drug. However at present it is not clear if divided doses are completely safe.
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