Palliative-radiotherapy in lumbosacral carcinomatous neuropathy.

The authors report their own experience in obtaining pain relief in 13 recurrent or disseminated cancer patients affected by lumbosacral carcinomatous neuropathy (LCN). The site, where the disease involved the lumbosacral plexus or its branches, was palliatively irradiated with a few large fractions. The average duration of response was 196 days. Median survival (uncensored) was 185 days (range 47-636 days).

Ultrastructural study of the vascular response in small early gastric cancer.

The microvasculature of the stroma of four cases of small early gastric cancer (EGC) was investigated by conventional electron microscopy. Severe damage to small and large fenestrated capillaries was observed around endothelium-adherent, partially degranulated neutrophils. The findings suggest the existence of neutrophil-mediated injury of endothelial cells during the development of inflammatory responses in small EGC. The severely injured microvessels exhibited increase in vasopermeability, microhaemorrhage, and platelet aggregates. Other microvascular changes included endothelial cell and pericyte activation as well as basal lamina replications, indicative of repeated episodes of endothelial injury, necrosis and regeneration. This new capillary growth within the old basal laminas shared morphological features with a peculiar angiogenic process described in man and animals.

Steroid patterns of benign breast disease.

We briefly review some biochemical aspects of benign breast disease (BBD), mainly focusing on free and conjugate estrogen content of breast cyst fluid (BCF), also in relation to cyst type. Evidence is reported that high K(+)-type I-cysts clearly associate with low Cl- levels and accumulate significantly higher quantities of dehydroepiandrosterone sulfate (DHAS) and estrone-3-sulfate (E1S). In spite of the limited number of cases, both increasing DHAS and E1S levels correlate with the increment of K+ to Na+ ratio. A positive correlation was also found between DHAS and E1S. Using electrochemical detection (ECD) on-line to high performance liquid chromatography (HPLC) in the reverse phase mode, we also studied the free estrogen profile. We observed that in type I BCF there are significantly increased amounts of free estrone (E1). The E1S to E1 ratio was significantly different in the two cyst subpopulations; again, a positive correlation was found between free and sulfated E1 (r = 0.820, p less than 10(-6). This last, together with other experimental observations, allows us to hypothesize that in BCF a main pathway of steroids should be E1S----E1. Besides, high specific activity of sulfatase, as well as beta-glucuronidase enzymes, has been demonstrated for BBD. Preliminary information is also reported concerning the BCF pattern of free estrogens, including the highly polar ones, i.e., catecholestrogens (CCE) and the parent methoxy (MeO) conjugates, which represent, in BCF, a predominant portion of all free estrogens. Both CCE levels and ratios appear unevenly distributed in the two different cyst types. In addition, some BCFs show very high concentrations of 16 alpha-OH-E1. Further studies are needed to answer the main question: whether estrogen patterns could represent additive parameters to further categorize breast cystic disease (BCD) or whether they are of minor interest to determine patients' risk of developing breast cancer.

Effect of whole brain radiation on local cerebral glucose utilization in the rat.

We assessed, by means of the [14C]-2-deoxy-D-glucose autoradiography method, the effect of whole-brain x-radiation on local cerebral glucose utilization in the rat brain. Animals were exposed to conventional fractionation (200 +/- 4 cGy/day, 5 days/week; total dose, 4000 cGy). Metabolic experiments were made 2 to 3 weeks after completion of the radiation exposure. In comparison with control and sham-irradiated animals, cerebral metabolic activity was diffusely decreased after irradiation. Statistically significant decreases in metabolic activity were observed in 13 of 27 brain regions studied. In general, the brain areas with the highest basal metabolic rates showed the greatest percentage of decrease in glucose utilization. The concept that radiation suppresses glucose utilization before any morphological change takes place in the cell structures was the basis of this study. Metabolic alterations after irradiation may explain the syndrome of early delayed deterioration observed in humans after whole-brain radiotherapy. These studies have applications to observations made with the [18F]-fluorodeoxyglucose method in conjunction with positron emission tomographic scans in patients receiving radiation therapy for intracranial malignancies. The data reported here also have potential clinical implications for the evaluation of a risk/benefit ratio for radiotherapy in patients with benign neurosurgical diseases or children undergoing prophylactic treatment of the central nervous system.

Quantitative study of blood-brain barrier permeability changes after experimental whole-brain radiation.

Basic mechanisms underlying the tolerance and reaction of the central nervous system to ionizing radiation are not known precisely. We investigated the possibility of a change in blood-brain barrier (BBB) function as a causative factor for early delayed whole-brain radiation-induced cerebral dysfunction. Rats were exposed to conventional fractionation (200 cGy/d, 5 d/wk; total dose, 4000 cGy). BBB changes were assessed by means of the quantitative 14C-alpha-aminoisobutyric acid technique and electron microscopy. Studies of the passage of horseradish peroxidase across the BBB permitted comparative quantitative isotopical and qualitative morphological data. Experiments were carried out 2 to 3 weeks after the completion of the radiation exposure. The transport of 14C-alpha-aminoisobutyric acid across the BBB increased significantly in cerebral cortex and cerebellar gray matter, averaging 1.3 to 1.5 times over the normal values. Electron microscopy disclosed an intense vesicular response of the cortical microvascular endothelium that occurred without the opening of the tight junctions and resulted in an intense transport of HRP across the intact endothelium. The present data indicate that moderate doses of whole-brain radiation induce well-defined changes in BBB function, which possibly are involved in the pathogenesis of radiation-induced cerebral dysfunction in humans.

Time-related ultrastructural changes in an experimental model of whole brain irradiation.

To stimulate therapeutic irradiation, we exposed rats to conventional fractionation (200 +/- 4 cGy/d, 5 d/wk; total dose, 4000 cGy). The effects of this regimen were assessed by electron microscopic examinations of brain microvascular and parenchymal cells 15 and 90 days after irradiation. Studies of the transendothelial passage of horseradish peroxidase provided information about the functional status of the blood-brain barrier. At 15 days after irradiation, there was an increased vesicular transport of horseradish peroxidase across the intact endothelium without opening of the tight junctions, and without evidence of structural alterations of neuropil, neuronal bodies, and astrocytes. Ninety days after irradiation, well-defined ultrastructural alterations were observed, involving the microvasculature, the neuropil, the neuronal bodies, and astrocytes. The main ultrastructural feature of cortical microvessels was their collapsed aspect, associated with perivascular edema containing cell debris. Altered neurons and reactive activated astrocytes were also noticeable. These data suggest a possible association, not necessarily causal, between damage of the microvascular/glial unit of tissue injury and development of radiation-induced brain toxicity.

Progressive perturbations in cerebral energy metabolism after experimental whole-brain radiation in the therapeutic range.

Basic mechanisms underlying the tolerance and reaction of the central nervous system to ionizing radiation have not been fully elucidated in the literature. The authors employed the [14C]-2-deoxy-D-glucose autoradiography method to investigate the effect of whole-brain x-irradiation on local cerebral glucose utilization in the rat brain. The animals were exposed to conventional fractionation (200 +/- 4 cGy/day, 5 days/week for a total dose of 4000 cGy), and the effects of this regimen were assessed at 2 weeks and 3 months postirradiation. In rats evaluated 2 weeks after treatment, statistically significant decreases in cerebral metabolic activity were found in 13 of the 27 regions studied, compared to control animals. In rats studied 3 months after treatment, additional metabolic suppression and statistically significant decreases in cerebral metabolic activity were found in 11 of the 27 regions, compared to rats studied 2 weeks after treatment. A weighted-average rate for the brain as a whole was approximately 15% and approximately 25% below that of control animals 2 weeks and 3 months after exposure, respectively. Although the difference in species is significant enough so that direct extrapolation to humans may not be appropriate, the data reported here may have potential clinical implications for the evaluation of the risk-benefit ratio for radiotherapy. This model can be used reproducibly for further investigations, including evaluation of therapies that may reduce irradiation-induced brain injury.

Morphometry of in vitro systems. An image analysis of two human prostate cancer cell lines (PC3 and DU-145).

Morphometric analysis on two human prostate cancer cell lines (PC3 and DU-145) was carried out to better characterize these cells and to approach some problems concerning their polymorphism. In our hands, these cells appear to differ either in their ability to oxidize testosterone or in their androgen receptor content. Morphometric evaluation was performed by means of an Interactive Image Analysis System (IBAS 1), which computes several parameters related to the whole cell and to the nucleus. Our results clearly indicate that nuclear parameters alone may discriminate PC3 from DU-145 cells. Particularly, the Nuclear Roundness Factor appeared important, since it quantifies changes in nuclear shape. Nevertheless, the value of this parameter for "in vitro" morphometry may be overshadowed by the polymorphism common to the cultured cells. However, morphometric evaluation of PC3 and DU-145 cells is relevant to a better understanding and definition of the biologic nature of these cells, even if polymorphism, heterogeneity and genetic instability, specially of PC3, require further investigations.

Effect of x-radiation to brain on cerebral glucose utilization in the rat.

We assessed, by means of the [14C]-2-deoxy-D-glucose autoradiography method, the effect of whole-brain x-radiation on local cerebral glucose utilization in the rat brain. Animals were exposed to conventional fractionation (200 +/- cGy/day given 5 days a week) to a total dose of 4000 cGy. Metabolic experiments were made 2 weeks after completion of the radiation exposure. In comparison with control and sham-irradiated animals, cerebral metabolic activity was diffusely decreased following irradiation. Statistically significant decreases in metabolic activity were observed in 13 of 27 brain regions studied. In general, brain areas with the highest basal metabolic rates showed the greatest percentage drop of glucose utilization. Post-irradiation metabolic alterations possibly provide an explanation for the syndrome of early delayed deterioration observed in humans after whole-brain radiotherapy.

Antiulcer activity of Opuntia ficus indica (L.) Mill. (Cactaceae): ultrastructural study.

In Sicily folk medicine, Opuntia ficus indica (L.) Mill. cladodes are used for the treatment of gastric ulcer. We studied the effect of administration of lyophilized cladodes on experimental ethanol-induced ulcer in rat. In this paper, we report the ultrastructural observations of gastric mucosa. The ultrastructural changes were observed by trasmission electronic microscopy (TEM) confirming the protective effect exercised by administration of lyophilized cladodes. Pre-treatment test in rats revealed a protective action against ethanol-induced ulcer. Probably, the mucilage of Opuntia ficus indica is involved.

Effects of Teucrium divaricatum Heldr. ssp. divaricatum decoction on experimental ulcer in rats.

The effects of chronic intragastric administration of the aerial parts decoction of Teucrium divaricatum Heldr. ssp. divaricatum (Labiateae) on experimental acetylsalicylic acid (ASA)-induced ulcer were studied in rats. The ulcer index and histological mucosa regeneration were evaluated. The ulcer index significantly decreased (U.I. 1.7+/-1.5; P<0.05) after treatment with a lyophilized decoction of T. divaricatum (500 mg/kg os), once daily for 7 days, compared to the control (U.I. 11.4+/-2.3). The ultrastructure modifications of gastric mucosa were observed by transmission electronic microscopy (TEM) confirming the antisecretory effect exercised by administration of the T. divaricatum decoction. Treatment with T. divaricatum seems to block up parietal cell acid secretion and to stimulate in the chief cells the formation of zymogen granules.

Helicobacter pylori in gastroduodenal diseases: rapid identification by endoscopic brush cytology.

Previous reports showed Helicobacter pylori (H. pylori) in type B gastritis-affected stomachs. This study was carried out to compare H. pylori staining effectiveness on biopsy to brush cytology. Tissue and brush parallel samples of gastric mucosa with abnormal or normal appearances were examined: 57.6% H. pylori-positive pieces from the antrum and 19.2% from the body were found, versus 65.3% and 25% H. pylori-positive brush smears, respectively. H. pylori resembling organisms were mainly related to chronic and acute antral inflammations and were often associated with higher amounts of round-shaped cocco-bacteria. In addition, H. pylori direct stain on brushing is proposed as the most rapid and reliable method for the routine diagnosis of Helicobacter pylori infection, in both ulcer or nonulcer gastritis.

Coherence measure in hamiltonian systems with many degrees of freedom

We study the phase space region of two- and three-dimensional lattices where a transition from chaotic to ordered dynamics takes place when the energy is lowered. In this region we find coexistence of degrees of freedom (DOF's), endowed with different levels of chaos. The analysis of this complex dynamical pattern requires the introduction of diagnostic tools suitable for a characterization of single DOF's: coherence angles and coherence times. We find that the coherence times-which give a measure of the time each DOF needs to relax to equilibrium-are roughly proportional to the inverse of the specific energy. This may be useful to evaluate the reliability of statistical results obtained in computer experiments performed on condensed matter systems at low energy.

[Prognosis of colorectal tumors in patients with synchronous polyps]. / Prognosi dei tumori del colon-retto in soggetti con polipi sincroni.

A retrospective study was carried out in 110 patients who underwent colon resection for cancer of the colon-rectum. Polypoid formation reappeared in 10 (21.5%) patients in whom synchronous polyps were found around carcinoma during initial staging; during the follow-up polyps were only found in 3% of patients in whom synchronous polyps had not been documented. A similar ratio was found in the incidence of neoplastic recurrences which was greater (14%) in patients with synchronous polyps. This incidence was higher in cases with multiple polyps and/or polyps larger than 2 cm in size, and in relation to their histological type. The authors suggest that a more comprehensive operation, for example subtotal colectomy, should be performed in patients at greater risk to develop a second primary carcinoma, and/or that a particularly careful post-operative follow-up should be carried out in these patients.

Anticonvulsant and sedative effects of Salvadora persica L. stem extracts.

The effect of Salvadora persica L. stem extracts on the potentiation of sodium pentobarbital activity and on generalized tonic-clonic seizure produced by pentylenetetrazol (PTZ) on the rat is reported. The extracts of Salvadora persica L. extended sleeping-time and decreased induction-time induced by sodium pentobarbital; in addition it showed protection against pentylenetetrazol-induced convulsion by increasing the latency period and diminishing the death rate.

[Conservative treatment of early breast carcinoma. Localization of the booster field]. / Trattamento conservativo del carcinoma mammario iniziale. Localizzazione del volume bersaglio da sovradosare.

The definition of the methods for localizing the booster field used in the conservative treatment of early breast cancer is often blurred in several studies in the current literature. This paper is aimed at reporting a surgical-radiological method more objective than the clinico-anamnestic one used, so far, for planning the booster field. To this purpose 33 patients underwent conservative surgery in healthy tissue and radiopaque clips were inserted at the margins of the excision cavity. The booster field as defined with clinico-anamnestic standards was then simulated and later verified by a radiation therapy simulator. The clinical fields thus set up were correct in 15/33 cases. The authors discuss their results and compare them with literature data. The importance of the use of the surgical-radiological method to localize the booster field is stressed.

Unusual relapse of hepatocellular carcinoma.

The authors report a patient with iatrogenic dissemination of hepatocellular carcinoma (HCC). A 65-year-old Caucasian man was found to have a moderately well-differentiated HCC diagnosed by laparoscopy and biopsy; the patient had atypical left liver lobe resection. Thirty-three months after definitive surgery a double relapse was found at the site of the previous laparoscopy and at the surgical scar; no other metastases were found. Surgical procedure for removal of these lesions was performed, and the patient received complementary radiation therapy. At 30 months of follow-up, the patient is alive and disease free. The risk of neoplastic seeding through biopsy and improved safety in surgical techniques justify the omission of diagnostic biopsy in patients who have surgical procedures.

Hypoglycemic effects of Salvadora persica L. in the rat.

The stem decoction of Salvadora persica L., a drug widely used as a tooth cleaning stick in Arabian countries, shows, in normal rats, hypoglycemic effects, an increase in plasma immunoreactive insulin (IRI) and an incremented oral-glucose tolerance. The decoction also causes a significant decrease in mean body weight without drastic reduction in food consumption.

Effects of naringin on experimental ulcer in rats.

The effects of chronic intragastric administration of naringin (200 mg/kg) on experimental acetylsalicylic acid (ASA)-induced ulcer were studied in rat. The ulcer index and histological mucosa regeneration were evaluated. The ulcer index significantly decreased after treatment with naringin (200 mg/kg) once daily for seven days. Microscopic observations confirm these results.

[Clodronate and radiotherapy for the treatment of osteolysis caused by metastasis of breast carcinoma and non-small cell lung carcinoma. A retrospective study]. / Clodronato più radioterapia nel trattamento delle osteolisi metastatiche da carcinoma mammario e polmonare non microcitoma. Studio retrospettivo.

We have retrospectively examined 94 evaluable patients with metastatic osteolysis from breast cancer (BC) and non-small cell lung (NSCLC) cancer, who received RT from Nov. 88 to Nov. 89.27 (15 BC and 12 NSCLC) were in treatment with Clodronate for at least 3 days from the beginning of RT; of the remaining 67 treated with RT alone, 31 had NSCLC and 36 BC. We have evaluated: increase in pain (IP) occurring on the first days of RT, percentages of complete pain relief (CPR) at the end of RT and 4-6 weeks after. A decreased occurrence of IP was observed more in NSCLC patients receiving RT + Clodronate compared to those treated with RT alone (33.3% vs 41.9%). Both at the end of RT and 4-6 weeks after, we registered a significant difference in the percentages of CPR in the RT + Clodronate group (40.7 vs 20.9 and 70.3% vs 53.7%). We believe the points of interest focused in this paper-greater precision in centering and defining the target volume, decreased occurrence of IP during the first days of RT, increase in percentage of CPR--need a prospective confirmation.