Raman Spectroscopic Measurements of Dermal Carotenoids in Breast Cancer Operated Patients Provide Evidence for the Positive Impact of a Dietary Regimen Rich in Fruit and Vegetables on Body Oxidative Stress and BC Prognostic Anthropometric Parameters: A Five-Year Study.

Dermal carotenoids are a feasible marker of the body antioxidative network and may reveal a moderate to severe imbalance of the redox status, thereby providing indication of individual oxidative stress. In this work noninvasive Resonance Raman Spectroscopy (RRS) measurements of skin carotenoids (skin carotenoid score (SCS)) were used to provide indications of individual oxidative stress, each year for five years, in 71 breast cancer (BC) patients at high risk of recurrence. Patients' SCS has been correlated with parameters relevant to BC risk, waist circumference (WC), and body mass index (BMI), in the aim of monitoring the effect of a dietary regimen intended to positively affect BC risk factors. The RRS methodological approach in BC patients appeared from positive correlation between patients' SCS and blood level of lycopene. The level of skin carotenoids was inversely correlated with the patients' WC and BMI. At the end of the 5 y observation BC patients exhibited a significant reduction of WC and BMI and increase of SCS, when strictly adhering to the dietary regimen. In conclusion, noninvasive measurements of skin carotenoids can (i) reveal an oxidative stress condition correlated with parameters of BC risk and (ii) monitor dietary-related variations in BC patients.

Trace element concentrations in red swamp crayfish (Procambarus clarkii) and surface sediments in Lake Preola and Gorghi Tondi natural reserve, SW Sicily.

Concentrations of trace elements (Cd, Pb, As, V, Cr, Ni, Cu and Zn) were determined in superficial sediments and in muscle and hepatopancreas tissues of the red swamp crayfish Procambarus clarkii from Lake Preola and Gorghi Tondi Natural Reserve (SW Sicily). In particular, hepatopancreas showed a decidedly higher content of all analysed trace elements with respect to muscles (two- to threefold higher for Cd, Cu, As, Zn and V; four- to fivefold higher for Pb and Cr and seven times higher for Ni). However, no statistically reliable differential accumulation pattern emerged with regard to length and weight for trace elements (except for Cd for which significant positive correlations with length were recorded). Trace element concentrations found in crayfish tissues were in the range considered harmful to human health (except for Cd and Cr). Moreover, the As and Pb concentrations, either in sediment or crayfish tissues, are clearly related to intense agricultural activities, with extensive use of fertilizers and pesticides, that significantly affect the levels of these toxic metals in the study area.

Metals content in otoliths of Dicentrarchus labrax from two fish farms of Sicily.

Otoliths of cultured sea bass (Dicentrarchus labrax) from two different fish farms of Sicily were collected and analyzed by using inductively coupled plasma optical emission spectroscopy. Metal content (Ba, Cd, Fe, Mg, Mn, Sr, and Zn) was measured in order to test the potential use of biogenic carbonates as proxies of dissimilar environmental conditions since the fish farms are implanted in opposite coastal marine areas (Gulf of Castellammare and Gulf of Gela) characterized by different oceanographic features and human activities. Cluster analysis discriminates samples as different groups on the basis of metal content. Results show that concentrations of Sr in the otoliths have a similar range of distribution and not significantly different between the two farms. Otherwise, Fe, Mg, Mn, and Cd show higher concentrations in otoliths collected from fish reared in the farm in the southern coast (Gulf of Gela), an area subject to a great anthropogenic pressure. Zn is the only element with higher values in the otoliths from the farm in the northern coast (Gulf of Trappeto) probably due to industrial effluent. In this work, obtained data confirm the high potential of trace elements measurements in these biogenic carbonates as proxies of different environmental conditions.

Mercury in fishes from Augusta Bay (southern Italy): risk assessment and health implication.

Our study reports on the total mercury (HgT) concentrations measured in the muscles and livers of several benthic, demersal and pelagic fish species caught inside and outside of Augusta Bay (southern Italy), a semi-enclosed marine area, highly contaminated by the uncontrolled (since the 1950s to 1978s) discharge of the largest European petrochemical plant. Mercury levels in fish tissues are discussed with regard to specific habitat, size and/or age of the specimens and HgT distribution in the bottom sediments. Results suggest a still active Hg release mechanism from the polluted sediments to the marine environment. Also, the high HgT concentrations measured in fishes caught in the external area of the bay imply a potential role of Augusta Bay as a pollutant source for the Mediterranean ecosystem. Finally, values of hazard target quotient (THQ) and estimated weekly intake (EWI) demonstrate that consumption of fishes caught inside the bay represents a serious risk for human health. Also, data indicate that intake of fishes caught from the external area of the bay, especially for that concern demersal and benthic species, could be represent a significant component of risk for the local population.

Mastectomy rates are decreasing in the era of service screening: a population-based study in Italy (1997-2001).

We enrolled all 2162 in situ and 21 148 invasive cases of breast cancer in 17 areas of Italy, diagnosed in 1997-2001. Rates of early cancer increased by 13.7% in the screening age group (50-69 years), and breast conserving surgery by 24.6%. Advanced cancer rates decreased by 19.4%, and mastectomy rates by 24.2%. Service screening did not increase mastectomy rates in the study population.

Breast cancer registry in Palermo and its Province: incidence in 1999.

The incidence of breast cancer in the city of Palermo and its Province was investigated. The cancer rate was higher in the city of Palermo (100.8/100,000/year), a great southern urban area, than in the 81 municipalities of the Province (79.2/100,000/year). Rates were also compared with those in other geographic areas of Italy, showing a smaller than expected negative north-south gradient in incidence, especially in the young age group, as shown by the cumulative risk observed in the 0-54-year-old group. These findings confirm the role of recent life style changes in the cancer risk distribution.

Ligand binding and cytochemical analysis of estrogen and progesterone receptors in relation to follow-up in patients with breast cancer.

Soluble and nuclear estrogen receptor (ER) content was measured by ligand binding assay, and estrogen and progesterone receptors by immunohistochemical assays (ER-ICA and PR-ICA) in 214 patients with breast cancer recruited at the "M. Ascoli" Cancer Hospital Centre in Palermo, Sicily, to assess the discriminant and predictive value of these parameters. On follow-up, data from both ER-ICA and PR-ICA showed a statistically significant difference, PR-positive patients having longer disease-free (DSF) and overall (OS) survival than PR-negative ones. Conversely, ER status did not correlate significantly with both DFS (P = 0.6) and OS (P = 0.2). In particular, PR-positive patients had 59 +/- 18 months DFS and 67 +/- 12 months OS, compared to 51 +/- 22 months DFS and 57 +/- 17 months OS of PR-negative cases. The present evidence implies that a PR-negative status identifies breast cancer patients with early relapse, as also suggested by previous studies. It also agrees with the results of ligand binding assay of ER, where ER status is a good discriminant and predictor of response to endocrine treatment, but is unable to anticipate early relapse in breast cancer patients. Evidence that PR status is a statistically significant prognostic indicator deserves further study to ascertain whether or not PR should be regarded as an ER-dependent parameter or be related to other biological variables such as growth factor (e.g., EGF), oncogene (e.g., Her2/Neu), or tumor suppressor gene (e.g., p53) products.

The Mediet Project.

Preliminary evidence from a case control study of healthy postmenopausal women living in Palermo, Sicily, is presented to investigate the potential impact of a traditional Mediterranean diet on the risk of developing breast cancer. Of the 230 women who fulfilled specific eligibility criteria, 115 were enrolled in the study based on serum testosterone values equal to or greater than the median population value (0.14 microg/ml). Women were then individually randomized into a diet intervention (n = 58) and a control (n = 55) group. Women in the intervention group attended a weekly "cooking course" for 1 year, being trained by professional chefs in the correct use of the natural ingredients of the traditional Mediterranean diet, including whole cereals, legumes, seeds, fish, cruciferous vegetables, and many others. The intervention group was subsequently instructed to follow the learned diet at home, while the control group was only advised to increase the consumption of fruits and vegetables, as recommended by WHO. The following measures were taken at the beginning, middle, and end of the study: (a) fasting blood and 12-hour urine samples to assay defined hormonal endpoints; (b) height, weight, and circumference of the waist and hip; and (c) a food frequency and computerized 24-hour dietary recall questionnaire. After 1 year, both the control and the intervention groups showed satisfactory compliance rates (81 and 85%, respectively). In addition, preliminary results so far obtained reveal an unequivocal trend towards weight loss, a strong reduction in cholesterol levels, and a psychophysical feeling of well-being by women adopting the Mediterranean diet. The study is currently ongoing to verify the association of changes in serum and urine hormone levels and breast cancer risk in the intervention group.

Androgen receptor status in nontumoral and malignant human colorectal tissues.

Data on androgen receptor (AR) status of nontumoral and malignant human colorectal tissues are compared using ligand binding assay in 22 patients who underwent surgery for colorectal cancer at the "M. Ascoli" Cancer Hospital Centre in Palermo, Sicily. In nontumoral tissues, ARs were predominantly (67%) positive, with 25% of cases having a 0/+ status. Conversely, malignant tissues showed only 32% of cases with a positive (+/+) AR status, with a proportional increase of 0/+ cases (from 25% to 55%); the extent of AR-negative (0/0) cases remained fairly constant (8-9%). Overall, our evidence indicates that nontumoral colorectal tissues have a predominantly positive (+/+) AR status and that this condition shifts towards a significant decrease of AR-positive cases in cancer tissues. Studies on the relation between status of sex steroid receptors and specific biomolecular markers in human colorectal tumors are currently being carried out in our laboratories.

Quantitative image analysis of estrogen and progesterone receptors as a prognostic tool for selecting breast cancer patients for therapy.

OBJECTIVE: To assess estrogen and progesterone receptor presence in human breast tumors using immunocytochemical analysis. STUDY DESIGN: For both estrogen (ER) and progesterone (PR) receptor assay, percent of stained cells and intensity of staining were estimated on a series of 251 consecutive breast cancer cases from the M. Ascoli Cancer Hospital Center in Palermo using the CAS 200 image analysis system. RESULTS: Cytochemical assay revealed a differential distribution of both ER and PR, by menopausal status of the patients; premenopause (PreM) was mostly ER negative (63%), and postmenopause (PostM) > 10 years was mostly ER and PR positive (64%). The percent of cells stained for ER was significantly different between PreM and PostM patients when they were considered as a whole. By contrast, no difference emerged for PR staining among menopausal groups. Overall, patients whose tumors were PR positive showed a significantly (P < .03) longer interval free of relapse. CONCLUSION: The present results suggest that PRs behave as better indicators than ERs of early relapse in breast cancer patients. Further studies, with longer follow-up, are needed, however, to validate this concept.

Expression of different 17beta-hydroxysteroid dehydrogenase types and their activities in human prostate cancer cells.

The 17beta-hydroxysteroid dehydrogenase (17betaHSD) enzyme system governs important redox reactions at the C17 position of steroid hormones. Different 17betaHSD types (no. 1-4) have been identified to date in peripheral human tissues, such as placenta, testis, and breast. However, there is little information on their expression and activity in either normal or malignant prostate. In the present work, we have inspected pathways of 17beta-oxidation of either androgen or estrogen in human prostate cancer cells (LNCaP, DU145, and PC3) in relation to the expression of messenger RNAs (mRNAs) for 17betaHSD types 1-4. These cell systems feature distinct steroid receptor status and response to hormones. We report here that high expression levels of 17betaHSD4 were consistently observed in all three cell lines, whereas even greater amounts of 17betaHSD2 mRNA were detected solely in PC3 cells. Neither 17betaHSD1 nor 17betaHSD3 mRNAs could be detected in any cell line. From a metabolic standpoint, intact cell analysis showed a much lower extent of 17beta-oxidation of both androgen [testosterone (T)] and estrogen [estradiol (E2)] in LNCaP and DU145 cells compared to PC3 cells, where a greater precursor degradation and higher formation rates of oxidized derivatives (respectively, androstenedione and estrone) were observed. Using subcellular fractionation, we have been able to differentiate among 17betaHSD types 1-4 on the basis of their distinct substrate specificities and subcellular localization. This latter approach gave rise to equivalent results. PC3 cells, in fact, displayed a high level of microsomal activity with a low E2/T activity ratio and approximately equal apparent Km values for E2 and T, suggesting the presence of 17betaHSD2. Dehydrogenase specific activity with both E2 and T was also detected, although at lower levels, in LNCaP and DU145 cells. No evidence for reductase activity could be obtained in either the soluble or microsomal fraction of any cell line. As comparable expression levels of 17betaHSD4 were seen in the three cell lines, 17betaHSD2 is a likely candidate to account for the predominant oxidative activity in PC3 cells, whereas 17betaHSD4 may account for the lower extent of E2 oxidation seen in both LNCaP and DU145 cells. This is the first report on the expression of four different 17betaHSD types in human prostate cancer cells. It ought to be emphasized that for the first time, analysis of different 17betaHSD activities in either intact or fractionated cells harmonizes with the expression of relevant mRNAs species.

A support system for content-based medical image retrieval in object oriented databases.

This work describes both the concepts used in an Object Manager for storage of medical images as one more data type associated to objects, and a support system developed to offer this kind of tool to medical application developers. The purpose of this work is to support the retrieval of images through queries based on the graphical contents of the stored images. The usual approach uses icons and textual attributes stored with the images to specify the queries. This work uses a novel modeling technique to define the "image data type," by means of which it is possible to decide, before the query itself, the key data of each image that must be extracted from the image when it is stored in the database, so the search can be accelerated when queries are issued. This approach enables building of expansible systems, where new image processing algorithms can be added easily, using its syntactic representation stored through an Image Meta-schema into the application database schema. This work shows how such a system has been implemented, and also provides a query language used to refer and execute these algorithms from inside the database management system.

3D reconstruction of tomographic images applied to largely spaced slices.

This paper presents a full reconstruction process of magnetic resonance images. The first step is to bring the acquired data from the frequency domain, using a Fast Fourier Transform algorithm. A Tomographic Image Interpolation is then used to transform a sequence of tomographic slices in an isotropic volume data set, a process also called 3D Reconstruction. This work describes an automatic method whose interpolation stage is based on a previous matching stage using Delaunay Triangulation. The reconstruction approach uses an extrapolation procedure that permits appropriate treatment of the boundaries of the object under analysis.

Description of integrated competency examination: tools to assess the chiropractic curriculum effectiveness and students' competency levels.

Los Angeles College of Chiropractic (LACC) has developed a variety of methods to monitor the effectiveness of its competency based/problem-centered curriculum. The College introduced two Integrative Competency Examination courses (ICE I and ICE II) to assess the chiropractic program's effectiveness and students' competency levels. The ICE courses are pass/fail examinations that use a multistation, objective structured clinical examination (OSCE) format that involves standardized patients along with cognitive assessment of basic science information as methods of evaluation. ICE I requires students to perform psychomotor skills and interpret clinical data; ICE II requires students to perform at a higher level. They are directed to select, perform and interpret clinical data appropriately and correlate this data with relevant basic science information. Through these two levels of evaluation, the educational program, the individual courses and the competency level of each student are assessed. This paper describes the format, content and evaluation tools used in the ICE courses as well as the potential benefits of the courses.