RESUMO
OBJECTIVES: The aim of the study was to evaluate the influence of dispositional mindfulness on suicidal ideation and its moderating effect on the relationships between depressive symptoms and borderline personality traits, and suicidal ideation. METHODS: A sample of 1034 students from France (818 women, mean age=20.1±2; 216 men, mean age=20.6±2.2) completed the Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), assessing dispositional mindfulness, the Patient Health Questionnaire-9 (PHQ-9) assessing depression symptoms; the borderline personality disorder scale of the Personality Disorder Questionnaire-4th Edition (PDQ-4), and the three-item scale measuring suicidal ideation proposed by Garrison et al. (1991). RESULTS: At least occasional wish to kill oneself was reported by 11% of men and 10% of women. Thirty-eight percent of men and 47% of women had moderate to severe depressive symptoms (P<.001). The mean borderline personality traits score for women was higher than for men (33.44±10.56 versus 31.48±10.35; P=.02), and the mean dispositional mindfulness score for men was higher than for women (77.99±12.3 versus 73.4±12.1; P<.001). In order to explore the role of mindfulness as a moderator between depressive symptoms/borderline traits and the wish to kill oneself, multiple regression analyses were performed separately by gender according to the method of Hayes (2013). To assess whether the presence of dispositional mindfulness decreased the risk for persons with depressive symptoms/borderline personality traits to have suicidal ideation, the effect of the interaction between these disorders and dispositional mindfulness was tested by introducing in a second regression the cross product of these two variables. To assert moderation we had to observe that the interaction explained an additional part of the variance of suicidal ideation. For men, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 32% of the variance of suicidal ideation (R2=.32, s.e.=1.42). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (ß=-.26; t=-4.48, P<.001), accounting for an additional 6% of the variance of suicidal ideation (R2=.38, s.e.=1.36). For women, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 25% of the variance of suicidal ideation (R2=.25, s.e.=1.29). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had slightly decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (ß=-.16; t=-5.34, P<.001), accounting for an additional 3% of the variance of suicidal ideation (R2=.28, s.e.=1.26). For men, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 23% of the variance of suicidal ideation (R2=.23, s.e.=1.51). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (ß=-.27; t=-4.68, P<.001), accounting for an additional 7% of the variance of suicidal ideation (R2=.30, s.e.=1.44). For women, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 24% of the variance of suicidal ideation (R2=.24, s.e.=1.30). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores remained the same. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (ß=-.19; t=-6.30, P<.001) accounting for an additional 3% of the variance of suicidal ideation (R2=.27, s.e.=1.27). CONCLUSIONS: Dispositional mindfulness appeared to be a moderator between depressive symptoms/borderline personality traits and the wish to kill oneself in both genders. This finding is relevant for prevention and therapy and suggests that mindfulness may be important and useful to reduce suicidal ideation and prevent suicidal attempts in young adults.
Assuntos
Transtorno da Personalidade Borderline/psicologia , Depressão/psicologia , Atenção Plena , Ideação Suicida , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Testes de Personalidade , Valor Preditivo dos Testes , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: Pilomatrix Carcinoma (PC) is a rare and malignant dermo-hypodermic tumor. Only 11 cases were reported in patients younger than 18 years old and only 13 cases were reported on the scalp. CASE REPORT: We report the case of a 15-year-old woman who underwent cyst excision on the vertex. Anatomopathology shed light trichilemmal cyst. Five months later, she presented a first local recurrence. The tumor was removed with wide margin. Anatomopathology shed light PC. No adjuvant therapy was performed. The patient presented a second recurrence 3 months later with a parietal bone and superior sagittal sinus invasion and a lung metastasis. She underwent a craniotomy and radiochemotherapy. A third local recurrence was detected 4 months later. Three more lines of chemotherapy were performed without success. DISCUSSION: PC is a locally aggressive tumour, with a high rate of local recurrences and metastases. PC arises de novo or through malignant transformation of a pilomatrixoma. PC were observed frequently in the white male over 50 years old. The histological diagnosis is difficult to prove. Treatment consists of a wide surgical excision. Peritumoral margins are not codified. Because of most cases are on the face and neck, Mohs Micrographic Surgery seems to be a good modality to limit margins. Radiation therapy is an adjuvant treatment. Chemotherapy can be used in metastasis case. CONCLUSION: PC is a rare malignant tumor with high rate of disease relapse. Histological diagnosis is difficult and treatment is not standardized. Surgical procedure with wide margins is recommended to avoid the large recurrence when the staging shows no metastasis.
Assuntos
Pilomatrixoma/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Adolescente , Feminino , Humanos , Metástase Neoplásica , Recidiva Local de Neoplasia , Pilomatrixoma/terapia , Couro Cabeludo/cirurgia , Neoplasias Cutâneas/terapiaRESUMO
BACKGROUND: Keloids and hypertrophic scars (HSc) affect 4.5-16% of the population. Thus far, the different approaches of keloid treatment are not very efficient, with a 50% relapse rate and many ongoing researches are looking for simple, safe and more efficient therapeutic methods. Tacrolimus is an immunomodulator that could be useful in treating keloid. OBJECTIVES: The objective of this study is to evaluate the effectiveness of Tacrolimus in inhibiting HSc formation on rabbits' ears model and to check optical skin spectroscopy in tissue characterization. METHODS: Our study was carried out on 20 New-Zealand female white rabbits. HSc were obtained by wounding rabbits' ear. These wounds were treated with intradermal injections of tacrolimus (0.2-0.5 mg/cm(2)) or a vehicule. The assessment of treatment efficacy was performed by clinical examinations, histological assay and skin spectrometry. RESULTS: Tacrolimus did not induce general or local side-effects. The scar elevation index in treated subjects was half less than that of the untreated ones. Furthermore, dermal thickness and inflammatory cellular density were both significantly smaller for treated scars than for the control ones. In vivo optical skin spectroscopy can characterize hypertrophic and normal skin with high sensibility and specificity. CONCLUSION: Intradermal injection of tacrolimus at 0.5 mg/cm(2) is an efficient way to prevent HSc in our experiment model and its tolerance is correct. Optical spectroscopy could be a good non-invasive tool to evaluate HSc treatment. These promising results might be proposed for patients suffering from keloid.
Assuntos
Cicatriz Hipertrófica/prevenção & controle , Imunossupressores/farmacologia , Queloide/prevenção & controle , Tacrolimo/farmacologia , Ferimentos e Lesões/tratamento farmacológico , Animais , Cicatriz Hipertrófica/patologia , Dermoscopia , Modelos Animais de Doenças , Orelha Externa , Feminino , Hipertrofia , Imunossupressores/toxicidade , Injeções Intradérmicas , Queloide/patologia , Coelhos , Análise Espectral , Tacrolimo/toxicidade , Ferimentos e Lesões/patologiaRESUMO
BACKGROUND: Post-excisional brachytherapy with Iridium 192 is a treatment of keloids scars (KS). Its indications and its parameters are not subject to any consensus. OBJECTIVE: We wanted to assess the effectiveness and satisfaction of patients treated in our centre. PATIENTS AND METHODS: This was a retrospective study conducted from November 2006 to November 2007. Patients with clinically and histologically proven KS treated between 1990 and 2005, were convened in consultation between September and October 2007. Clinical data and parameters of the brachytherapy have been collected. RESULTS: Eighty-seven patients (138 KS) were treated. Eighty-two KS (46 patients) met the criteria for inclusion. Thirty-two patients (55 KS) have been seen in consultation. The average time between the onset of KS and treatment was 63.5 months. The brachytherapy has begun after a maximum of 7 hours posterior to surgery for all KS. The average dose was 17.9 Gy calculated at 5 mm. We observed 23.6% of recurrence after treatment. Seventy-nine per cent of itching and 87.5% of pain have totally disappeared. The phototypes 5 and 6 had an increased risk of recurrence. DISCUSSION: This is the most important series of KS treated with Post-excisional brachytherapy presented so far. The technique is efficient in preventing keloid recurrence and in treating the functional signs, but at the expense of an unaesthetic result, of which patient must be warned about. A follow-up of at least two years after treatment is recommended.
Assuntos
Braquiterapia , Radioisótopos de Irídio/uso terapêutico , Queloide/radioterapia , Feminino , Humanos , Masculino , Cuidados Pós-Operatórios , Recidiva , Estudos RetrospectivosRESUMO
Bizarre parosteal osteochondromatous proliferation (BPOP) is a very rare benign lesion on face bones. The first line treatment is surgical exeresis. The frequency of recurrence after exeresis may suggest a malignancy.
Assuntos
Neoplasias Maxilomandibulares/diagnóstico , Osteocondromatose/diagnóstico , Condrossarcoma/diagnóstico , Diagnóstico Diferencial , Ossos Faciais/patologia , Humanos , Neoplasias Maxilomandibulares/patologia , Osteocondroma/diagnóstico , Osteocondromatose/patologia , Osteossarcoma Justacortical/diagnóstico , Neoplasias Cranianas/diagnósticoAssuntos
Carcinoma de Células Escamosas/diagnóstico , Guias de Prática Clínica como Assunto , Lesões Pré-Cancerosas/diagnóstico , Neoplasias Cutâneas/diagnóstico , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Humanos , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologiaRESUMO
Prolactin (PRL) increases of Ia antigen (Ia Ag) expression in female Sprague-Dawley rats with N-nitroso-N-methylurea [(NMU) CAS: 684-93-5]-induced mammary tumors were studied. The effectiveness of PRL was examined when cancers appeared about 2-3 months after the first NMU administration. Rats with NMU-induced mammary tumors were divided into 3 groups: Group 1 was treated with 30 micrograms ovine PRL (o-PRL) in daily sc injections for 5 days. Group 2 received 0.5 mg 2 alpha-bromoergocryptine (CB-154), a known inhibitor of pituitary gland secretion, daily in sc injections for 6 days. Group 3 was the control group. Ia Ags expressed by NMU-induced mammary tumor cells were then quantified successively by double labeling [protein membrane cells with iodine-131 and anti-Ia monoclonal antibody (MoAb) with iodine-125]; then isolation and quantification of the doubly labeled immune complex were performed by affinity chromatography and chromatofocusing successively. When the specific activity of glycoproteins is known, the amount of glycoproteins that bind specifically to the anti-Ia MoAb can be deduced. In NMU-induced rat mammary tumor controls, about 5% of the purified glycoproteins bound specifically to the MoAb, and the amount increased to 8% for NMU-induced rat mammary tumors treated with 30 micrograms o-PRL daily for 5 days and decreased to 2.5% in NMU-induced rat mammary tumors treated with 0.5 mg CB-154 daily for 6 days. Total PRL receptor levels were measured in all tumors tested. For control NMU-induced rat mammary tumors, total PRL receptor levels were 6.35 +/- 1.40 fmol/mg protein, 7.20 +/- 2.40 fmol/mg protein for NMU-induced rat mammary tumors treated with o-PRL, and 6.81 +/- 2.34 fmol/mg protein for NMU-induced rat mammary tumors treated with CB-154. Our results demonstrated that treatment of NMU-induced rat mammary tumors with PRL increased the amount of Ia Ag expression by tumor cells and should prove very useful to the understanding of the biology of PRL in the tumorogenesis of the mammary gland.
Assuntos
Antígenos de Histocompatibilidade Classe II/análise , Neoplasias Mamárias Experimentais/imunologia , Prolactina/fisiologia , Animais , Anticorpos Monoclonais/imunologia , Feminino , Antígenos de Histocompatibilidade Classe II/imunologia , Neoplasias Mamárias Experimentais/análise , Neoplasias Mamárias Experimentais/induzido quimicamente , Metilnitrosoureia , Prolactina/sangue , Prolactina/farmacologia , Ratos , Ratos Endogâmicos , Receptores de Superfície Celular/análise , Receptores da ProlactinaRESUMO
In 20 women with breast carcinoma, 17 of whom had locally advanced cancer and 3 of whom had confirmed metastases, the expression of P-glycoprotein was evaluated before the start of a chemotherapy regimen that included multidrug resistance-related drugs. With the use of the C494 monoclonal antibody in an avidin-biotin-immunoperoxidase technique, P-glycoprotein was detected in 17 of 20 tumor samples. Results were expressed in a semiquantitative manner, taking into account the number of positive tumor cells (N index) and the specific staining intensity (I index). The 17 patients with nonmetastatic cancer were followed from the first cycle of chemotherapy to cancer recurrence; subsequent to six cycles of chemotherapy, all of these patients except one were rendered clinically disease-free through surgery and/or radiation. The end point was defined as either local/regional recurrence or metastasis. Strong P-glycoprotein-positive staining in a majority of tumor cells (the N+/I+ phenotype) was significantly correlated with no initial response to chemotherapy (P less than .02) and with a shorter progression-free survival (P less than .02). Thus, the pretreatment evaluation of P-glycoprotein expression may be of prognostic value in patients with locally advanced breast cancer.
Assuntos
Neoplasias da Mama/química , Carcinoma/química , Resistência a Medicamentos , Glicoproteínas de Membrana/análise , Membro 1 da Subfamília B de Cassetes de Ligação de ATP , Adulto , Idoso , Anticorpos Monoclonais , Neoplasias da Mama/tratamento farmacológico , Carcinoma/tratamento farmacológico , Feminino , Humanos , Imuno-Histoquímica , Glicoproteínas de Membrana/imunologia , Pessoa de Meia-Idade , FenótipoRESUMO
Class II HLA antigen expression in breast carcinoma and normal breast gland cells was compared using a method more accurate than immunofluorescence. This new method involves labeling membrane proteins with 131I and the anti-Class II HLA monoclonal antibody with 125I. The isolation and purification of the doubly labeled (125I-131I) immune complex was performed by affinity chromatography and chromatofocusing successively. When the specific activity of glycoproteins is known, the amount of glycoproteins which bind specifically to the anti-Class II HLA monoclonal antibody can be deduced. In breast carcinoma cells, 1.5 to 2% of the purified glycoproteins bind specifically to the monoclonal antibody, whereas less than 0.3% of normal breast gland cells binds. In contrast, leukemic cells, of which 80 to 90% possess Class II HLA antigens, 2 to 3% of Class II HLA glycoproteins bind specifically with the anti-Class II HLA monoclonal antibody.
Assuntos
Neoplasias da Mama/imunologia , Mama/imunologia , Antígenos HLA/análise , Anticorpos Monoclonais/imunologia , Especificidade de Anticorpos , Complexo Antígeno-Anticorpo/isolamento & purificação , Cromatografia de Afinidade , Feminino , Humanos , Radioisótopos do Iodo , LectinasRESUMO
Cyclosporine A (an immunosuppressive agent) decreases Ia lymphoid differentiation marker in female Sprague-Dawley rats with N-nitroso-N-methylurea-induced mammary tumors. Presence of lymphoid differentiation antigens was determined on mammary tumor cells and lymphoid cells from bone marrow, spleen, and peripheral blood by flow cytometric analysis. Quantification of Ia antigen expression was also performed by affinity chromatography and chromatofocusing in mammary tumors. A significant decrease in Ia antigen expression by mammary tumors of animals treated with cyclosporine A was noted with the two different methods. Cyclosporine A acts as an antagonist to prolactin receptors in such hormone-dependent mammary cancer. Our results should prove very useful in understanding the mechanisms of prolactin regulation of Ia antigen in tumorigenesis of the mammary gland.
Assuntos
Antígenos de Diferenciação de Linfócitos T/metabolismo , Ciclosporinas/farmacologia , Neoplasias Mamárias Experimentais/imunologia , Animais , Anticorpos Monoclonais , Ligação Competitiva , Ciclosporinas/metabolismo , Feminino , Neoplasias Mamárias Experimentais/metabolismo , Metilnitrosoureia , Prolactina/metabolismo , RatosRESUMO
The antigen receptor genes studied (immunoglobulin gene for B-cells, and T-cell receptor -beta or -gamma gene for T-cells) represent the most powerful tools for diagnosing the clonality of a lymphoid lineage. We have clonotyped 23 cutaneous T-cell lymphomas and 5 were found to be clonotypically all heterogeneous. Analysis of each patient was performed either from serial skin biopsies taken several months apart or from different tumor samples. In these cases, T-cell lymphoma clonotypic heterogeneity was demonstrated and was especially evident when examining different tumor sites. Moreover, in one case, a biogenotypic population (immunoglobulin and T-cell receptor-rearranged) was found. This unexpected high frequency of T-cell clonal heterogeneity (22%) could be explained either by the evolution of subclones from a single undifferentiated malignant cell or by the independent transformation to cancer of 2 or more lymphocytes, though the latter seems less likely. Clonotypic heterogeneity seems to be as frequent in T-cell lymphomas with cutaneous lesions as in B-cell leukemias.
Assuntos
Linfoma de Células T/genética , Neoplasias Cutâneas/genética , Rearranjo Gênico , Genes de Imunoglobulinas , Genótipo , Humanos , Linfoma de Células T/imunologia , Receptores de Antígenos de Linfócitos T/genética , Neoplasias Cutâneas/imunologiaRESUMO
The present work compared the blood variations in some committed stem cells (CSC), and corresponding differentiated WBC during the first three courses of a 6-day sequential chemotherapy given to 16 breast cancer patients for 28 days each. The granulomonocytic and lymphocytic colony-forming unit levels in blood were significantly lowered in cancer patients before treatment. These CSC appeared to have cyclic variations following each course of chemotherapy. In granulomonocytic colony-forming units, a nadir was observed by Day 15, followed by a sharp rebound above the initial values by Days 22 to 24, which was not affected in magnitude by the continuation of treatment. In lymphocytic colony-forming units, the Day 1 level increased with the continuation of chemotherapy. The initial decrease was less marked, but by Day 15 a minimal level was also observed, followed by a progressive increase to reach a maximum by Day 28. Leukocytes and granulocytes reached a nadir by Days 16 to 17 and recovered by Day 25. The cyclic evolution of monocytes was less apparent as was that of lymphocytes; however, there was less restoration of monocytes and lymphocytes than of granulocytes at the end of the resting period. This study showed: (a) an apparent relationship between the level of CSC in blood, and subsequent variations in the corresponding mature cells of the same lineage; and (b) a weak interval of time between the nadir and peaks of CSC and the corresponding mature cells, which was more evident in the granulocytic lineage. These observations seemed to be of physiological importance, but the possible prediction value of peripheral granulomonocytic colony-forming unit peak magnitude following treatment remains to be established.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/fisiopatologia , Células-Tronco Hematopoéticas/fisiologia , Adulto , Idoso , Neoplasias da Mama/tratamento farmacológico , Diferenciação Celular , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Células-Tronco Hematopoéticas/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Vincristina/administração & dosagemRESUMO
PURPOSE: A series of 53 patients with poor-prognosis epithelial ovarian cancer treated with high-dose chemotherapy (HDC) followed by hematopoietic rescue was retrospectively studied from the day of diagnosis for toxicity and long-term survival analysis. PATIENTS AND METHODS: Patients were treated with surgery followed by cisplatin combination chemotherapy. After second-look operation (SLO), HDC was administered: 23 patients received melphalan (140 mg/m2 on day 1) and 30 patients received a combination of carboplatin (400 mg/m2 on days 1 to 4) and cyclophosphamide (1.6 g/m2 on days 1 to 4). After HDC, autologous stem-cell transplantation was performed for hematologic support. RESULTS: One patient died of cardiac failure after HDC, but the acute toxicity was acceptable for the other patients. With a median follow-up of 81.5 months, the 5-year overall survival rate for the 53 patients was 59.9% and the disease-free survival (DFS) rate at 5 years was 23.6%. Twenty-four patients (45.3%) were alive, 12 with no evidence of disease and 12 with recurrent disease. The best results were achieved in 19 patients with pathologic complete response at SLO (74.2% 5-year overall survival; 32.8% 5-year DFS). CONCLUSION: HDC followed by autologous stem-cell support is a well-tolerated therapeutic approach for patients with poor-prognosis ovarian carcinoma. In this report, the 59.9% survival of 53 patients at 5 years must be compared to the 20% to 30% 5-year survival observed after conventional therapy. These results should be confirmed by an ongoing prospective randomized trial.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas , Neoplasias Ovarianas/tratamento farmacológico , Adulto , Antineoplásicos Alquilantes/administração & dosagem , Carboplatina/administração & dosagem , Carcinoma/patologia , Ciclofosfamida/administração & dosagem , Feminino , Humanos , Melfalan/administração & dosagem , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/patologia , Prognóstico , Estudos Retrospectivos , Terapia de Salvação , Análise de Sobrevida , Resultado do TratamentoRESUMO
BACKGROUND: Undernutrition is a main cause of immunodeficiency. Many confounding factors limit the interpretation of immune function in hospitalized elderly patients. OBJECTIVE: We compared the effects of short-term fasting and refeeding on lymphocyte subset distribution and neutrophil function in healthy subjects. DESIGN: Seven young adult (x +/- SE age: 24 +/- 2 y) and 8 elderly (71 +/- 3 y) subjects were fed standardized diets (1.6 x predicted resting energy expenditure; 16% protein) for 7 d. They then fasted for 36 h and were refed for 4 h (42 kJ/kg). Lymphocyte subsets were quantified by using fluorochrome-conjugated monoclonal antibodies. Neutrophil chemotactic migration was evaluated by using a 2-compartment chamber. Neutrophil reactive oxygen species production was measured by using a luminol-amplified chemiluminescence assay and oxidation of 2'7'-dichlorofluorescein diacetate. RESULTS: Baseline total and cytotoxic T lymphocyte subpopulations were lower in elderly than in adult subjects (P < 0.01). Nutritional state had a significant effect (P < 0.05) on total, helper, and cytotoxic T and B lymphocyte counts in all subjects, and the response of lymphocyte subpopulations to nutritional fluctuations was significantly affected by age. The chemotactic index was lowered by fasting in both groups (P < 0.05 compared with basal values). After refeeding, neutrophil migration was restored in adult but not elderly subjects. The superoxide anion production rate increased with fasting and reverted to prefasting values with refeeding in both groups (P < 0.05). Fasting induced a significant decrease in hydrogen peroxide production in stimulated neutrophils that was reversed by refeeding in adult but not elderly subjects. CONCLUSION: The lack of response of lymphocyte subpopulation counts and neutrophil function to nutritional changes may help to explain the proneness of elderly persons to infection.
Assuntos
Envelhecimento/imunologia , Jejum/fisiologia , Sistema Imunitário/fisiopatologia , Subpopulações de Linfócitos/imunologia , Neutrófilos/imunologia , Desnutrição Proteico-Calórica/imunologia , Adulto , Fatores Etários , Idoso , Anticorpos Monoclonais/análise , Contagem de Células , Quimiotaxia de Leucócito/imunologia , Citometria de Fluxo , Humanos , Peróxido de Hidrogênio/metabolismo , Imunidade/fisiologia , Medições Luminescentes , Estado Nutricional , Oxirredução , Espécies Reativas de Oxigênio , Superóxidos/metabolismoRESUMO
BACKGROUND: Previous reports suggest that correcting the malnourished state is more difficult in elderly people than in younger ones and that protein requirements may be higher in elderly than in younger adults. OBJECTIVE: The aim of this study was to establish whether malnourished old rats respond to protein-supplemented nutritional repletion as do young adult rats. DESIGN: Adult (3 mo old) and old (22 mo old) rats were submitted to dietary restriction programs that induced similar metabolic and nutritional alterations. Malnourished adult and old rats were then killed (R groups) or refed for 1 wk with a high-protein diet (HPD; 23% protein) or a very-high-protein diet (VHPD; 27% protein). Control groups at both ages were fed ad libitum throughout the experiment. Effects of food repletion were evaluated in terms of protein metabolism, intestinal histomorphometry, and nonspecific immune status. RESULTS: In adult rats, HPD sufficed to increase body weight and restore basal values of liver weight and protein content (P: < 0.01 compared with the R adult group), nitrogen balance (P: < 0.01 compared with the R adult group), and hydrogen peroxide production by polymorphonuclear neutrophils and monocytes (P: < 0.01 compared with the R group); VHPD had no supplementary effect except on nitrogen balance. In old rats, HPD was less effective and greater benefit was observed with VHPD in terms of body weight gain (10%; P: < 0.01 compared with the old group fed HPD), albuminemia, muscle weight and protein content, plasma arginine concentration, and hydrogen peroxide production by stimulated polymorphonuclear neutrophils and monocytes compared with the old R group (P: < 0.01). CONCLUSION: Aging is a significant variable affecting the response to nutritional support.
Assuntos
Envelhecimento/fisiologia , Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Proteínas Alimentares/uso terapêutico , Distúrbios Nutricionais/terapia , Aminoácidos/sangue , Animais , Peso Corporal/efeitos dos fármacos , Proteínas Alimentares/administração & dosagem , Relação Dose-Resposta a Droga , Peróxido de Hidrogênio/metabolismo , Fígado/metabolismo , Fígado/patologia , Macrófagos Peritoneais/metabolismo , Masculino , Monócitos/metabolismo , Neutrófilos/metabolismo , Distúrbios Nutricionais/sangue , Distúrbios Nutricionais/patologia , Tamanho do Órgão/efeitos dos fármacos , Proteínas/metabolismo , Ratos , Ratos Sprague-Dawley , Albumina Sérica/análise , Fator de Necrose Tumoral alfa/biossínteseRESUMO
126 patients with non-inflammatory operable breast cancer, who otherwise would have undergone modified radical mastectomy (MRM), were treated by induction chemotherapy. Before treatment, every patient had a local and general assessment, and pathological or cytological evidence of malignancy. Patients received, every 3 weeks, the same treatment with doxorubicin, vincristine, cyclophosphamide, 5-fluorouracil (AVCF); methotrexate was added in 80 cases (AVCFM). Tumour shrinkage greater than 50% was documented in 105 (83%) of the 126 women. A higher objective response rate was obtained in aneuploid or high S phase tumours, especially in the patients treated with methotrexate. After chemotherapy, 41 patients were then treated by radiotherapy alone after complete or sub-complete response; 64 had a residual tumour that could be treated by conservative surgery and radiotherapy. Only 19 had MRM and radiotherapy. Histopathological complete remission was documented in 1 case; isolated residual tumour cells were found in 5 patients. Thus primary chemotherapy enhanced the possibility of breast conservation in up to 83% of the cases in a series in which most would have been otherwise subjected to a MRM because of tumour size.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Adjuvantes Farmacêuticos/administração & dosagem , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Terapia Combinada , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Vincristina/administração & dosagemRESUMO
Cell electrophoresis allows separation of normal human lymphocytes into two principal groups which are a function of their relative rates of migration. In 42 healthy adults, 19.9% of the lymphocytes have a slower migration rate, and 80.1%, a faster migration rate than the reference speed (1 mum - sec-1 - cm). Two methods are used for the selection of the lymphocytic populations: spontaneous rosetting with sheeps red blood cells, a property of T-lymphocytes, and adherence to nylon wool columns, which preferentially selects B-lymphocytes. The cells which do not form spontaneous rosettes, but adhere to nylon wool columns show mainly slow migration. Cells which do not adhere to nylon columns show a faster migration rate. These findings affirm the T-nature of the rapidly migrating lymphocytes, and the B-nature of the slow-migrating lymphocytes. Results by the immunofluorescence technique confirm this.
Assuntos
Imunofluorescência , Reação de Imunoaderência , Linfócitos/imunologia , Adolescente , Adulto , Animais , Adesão Celular , Movimento Celular , Separação Celular , Eletroforese , Agregação Eritrocítica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nylons , Ovinos/imunologia , Fatores de Tempo , LãRESUMO
PURPOSE: To evaluate the efficacy of postoperative brachytherapy alone (brachy) for Stage T1-2 squamous cell carcinomas (SCC) of the floor of mouth (FM) and the oral tongue (OT) with close or positive margins. METHODS AND MATERIALS: Between 1979 and 1993, 36 patients with T1-2 N0 (24 T1, 12 T2) OT (19), and FOM (17) SCC with close or positive margins following surgery underwent postoperative brachy. Mean patient age was 56 years (range 37-81) and sex ratio was 3.5:1 male:female. Mean surgery to brachy interval was 36 days (range 16-68). The technique used was interstitial Iridium-192 ((192)Ir) brachytherapy with plastic tubes and manual afterloading. Mean total dose was 60 Gy (range 50-67.4) at a mean dose rate of 0.64 Gy/h (range 0.32-0.94). Mean patient follow-up was 80 months. RESULTS: The 5-year actuarial overall and cause-specific survivals of the entire group were 75% and 85%, respectively. The local control was 88.5% at 2 years, with a plateau apparent after 23 months. Of the 4 local relapses, 2 were salvaged with surgery and external beam radiotherapy (EBR). No tumor or treatment factors, including tumor size, margin status, disease site, or radiation dose, were correlated with local control. The 2 head and neck second primaries underwent curative treatment on nonirradiated tissue. One patient developed a grade 3 sequelae (bone and soft tissue necrosis). Grade 2-3 chronic sequelae were seen in 7 of 17 and 3 of 19 FOM and OT tumors, respectively (p = 0.09). CONCLUSION: Postoperative brachy is a promising approach in T1-2 N0 OT and FOM SCC with close or positive margins. This approach is associated with high rate of locoregional control and low risk of chronic sequelae, obviates major surgery, avoids potential sequelae of EBR (xerostomia, dysgueusia, fibrosis), and avoids treatment of second head and neck primary on nonirradiated tissues.
Assuntos
Braquiterapia , Carcinoma de Células Escamosas/radioterapia , Neoplasias Bucais/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Terapia Combinada , Feminino , Humanos , Radioisótopos de Irídio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Soalho Bucal , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Estadiamento de Neoplasias , Neoplasia Residual , Período Pós-Operatório , Lesões por Radiação/etiologia , Lesões por Radiação/patologia , Neoplasias da Língua/patologia , Neoplasias da Língua/radioterapia , Neoplasias da Língua/cirurgiaRESUMO
A relationship has been sought between the classical marker, active E-rosette and the surface antigens of T-lymphocytes, defined by OKT 4 and 8 monoclonal antigens, in the peripheral blood of normal human people. It was found that no significant correlation existed in the case of OKT 4 antigen; conversely the OKT 8-positive cells were significantly enriched after E-rosette-forming cell isolation (about 2.5 times in comparison with the negatively selected cells). In this latter case, some partial correlation could exist between SRBC-high affinity of T-lymphocytes and the subsets defined by OKT 8 antigen.
Assuntos
Anticorpos Monoclonais/classificação , Formação de Roseta , Linfócitos T/imunologia , Reações Antígeno-Anticorpo , Soro Antilinfocitário/farmacologia , Separação Celular , Humanos , Linfócitos T/classificaçãoRESUMO
Using appropriate DNA probes, the configurations of the T-cell receptor beta-chain genes and immunoglobulin heavy-chain genes were studied in patients diagnosed as having the following malignancies: 7 chronic myeloid leukemia, 13 acute myeloblastic leukemia, 9 acute lymphocytic leukemia and 20 chronic lymphocytic leukemia. Rearrangements not corresponding to the immunotype were unexpectedly found in lineage neoplasias.