Breast metastases from lung carcinomas: a report of three cases.

Tumours metastasising to the breast are very infrequent, with an incidence of 0.4-6.6% of all breast tumours. Occasionally a breast mass is the first indicator of a tumour arising elsewhere. Development of metastases to the breast from a lung cancer is very rare and the prognosis for such patients is poor. We present three patients who had metastases to the breast presenting clinically as the primary origin. It is important to distinguish a primary breast cancer from a metastasis, as different therapies are offered with considerably different outcomes.

Guidewire assisted cephalic vein cutdown for insertion of totally implantable access ports.

BACKGROUND: Totally implantable access ports (TIAP) placed by the cephalic vein cutdown technique have high failure rates. METHODS: We describe a guidewire assisted technique of the cephalic vein cutdown for TIAP placement that can be easily introduced catheter when difficulties in insertion of the catheter. The key point of the presented technique is the use of J guidewire to go beyond the stenosis and advancement of catheter through the guidewire into the superior vena cava. RESULTS: We used this technique for introducing the catheter in six patients without failure or complication. CONCLUSION: The presented technique is easy and simple. It can be used where there are difficulties in insertion of the catheter by cephalic vein cutdown method.

Intra- and extracellular reactive oxygen species generated by blue light.

Blue light from dental photopolymerization devices has significant biological effects on cells. These effects may alter normal cell function of tissues exposed during placement of oral restorations, but recent data suggest that some light-induced effects may also be therapeutically useful, for example in the treatment of epithelial cancers. Reactive oxygen species (ROS) appear to mediate blue light effects in cells, but the sources of ROS (intra- versus extracellular) and their respective roles in the cellular response to blue light are not known. In the current study, we tested the hypothesis that intra- and extracellular sources of blue light-generated ROS synergize to depress mitochondrial function. Normal human epidermal keratinocytes (NHEK) and oral squamous cell carcinoma (OSC2) cells were exposed to blue light (380-500 nm; 5-60 J/cm(2)) from a dental photopolymerization source (quartz-tungsten-halogen, 550 mW/cm(2)). Light was applied in cell-culture media or balanced salt solutions with or without cells present. Intracellular ROS levels were estimated using the dihydrofluorescein diacetate (DFDA) assay; extracellular ROS levels were estimated using the leucocrystal violet assay. Cell response was estimated using the MTT mitochondrial activity assay. Blue light increased intracellular ROS equally in both NHEK and OSC2. Blue light also increased ROS levels in cell-free MEM or salt solutions, and riboflavin supplements increased ROS formation. Extracellularly applied ROS rapidly (50-400 muM, <1 min) increased intracellular ROS levels, which were higher and longer-lived in NHEK than OSC2. The type of cell-culture medium significantly affected the ability of blue light to suppress cellular mitochondrial activity; the greatest suppression was observed in DMEM-containing or NHEK media. Collectively, the data support our hypothesis that intra- and extracellularly generated ROS synergize to affect cellular mitochondrial suppression of tumor cells in response to blue light. However, the identity of blue light targets that mediate these changes remain unclear. These data support additional investigations into the risks of coincident exposure of tissues to blue light during material polymerization of restorative materials, and possible therapeutic benefits.

Case report of vasopressin-responsive diabetes insipidus associated with chronic myelogenous leukemia.

A sixth case in the world literature is reported of a 59-year-old male with diabetes insipidus (DI) associated with chronic myelogenous leukemia (CML). The patient is unique in that his CML was diagnosed 10 years before he presented with vasopressin-responsive DI. Radiation to the central nervous system failed to reduce the daily requirement of his need for vasopressin.

Chemotherapy of hormone-refractory carcinoma of prostate with 5-fluorouracil, adriamycin, and mitomycin C.

A modification of the DMF protocol was used to treat 14 patients with hormone-refractory adenocarcinoma of the prostate. A subjective response of pain relief occurred in 71 per cent (10/14) of the patients. The median duration of the response in these patients was 4.2 months, and their median survival was 248 days. No patient experienced either an objective complete or partial response based on the criteria of the NPCP. However, an objective stable response was produced in 36 per cent (5/14) of the patients, and their median survival was 330 days. Patients entering the study with a performance status of less than or equal to 2 exhibited a longer median survival than patients with a performance status greater than 2. This regimen of 5-fluorouracil, doxorubicin (Adriamycin), and mitomycin C is reasonably well tolerated and appears to warrant consideration as a palliative therapeutic alternative in hormone-resistant prostate cancer.

Eosinophilic granulocytes as a possible source of vitamin B12-binding protein.

Leucocyte B12 and B12-binding capacity were measured by Simultrac radioassay in eosinophilic granulocytes, neutrophilic granulocytes and leucocytes obtained from patients with chronic granulocytic and lymphocytic leukaemia. It is shown that (a) eosinophils are a possible source of B12-binding protein similar to neutrophils and (b) granulocytes in myeloproliferative disorders and normal neutrophils have similar B12 and B12-binding capacity indicating that increased B12 and B12-binding capacity in myeloproliferative disorders arise from an increase in myeloid cell turnover.

Acute leukemia following combination chemotherapy for cancer of the lung.

A 64-year-old male with recurrent metastatic squamous cell carcinoma was successfully treated with intensive combination chemotherapy. His complete remission was maintained with a nitrosourea, nitrogen mustard and methotrexate for 3 years. While in remission the patient developed acute leukemia. It appears that this secondary malignancy was due to his prolonged chemotherapy.

Peutz-Jeghers syndrome with intestinal carcinoma: report of the association in one family.

The Peutz-Jeghers Syndrome is a rare, genectically inherited disorder. There are insufficient data to establish this syndrome as a precancerous condition, but documented cases of gastrointestinal cancer arising in this syndrome have been reported with an incidence of 2--3%. Since the syndrome is transmitted as an autosomal dominant and is associated with cancer, family members so afflicted may show an increased cancer risk. This is the first reported case of a father and son with both Peutz-Jeghers Syndrome and colonic carcinoma.

T cell chronic lymphocytic leukemia: presence in bone marrow and peripheral blood of cells that suppress erythropoiesis in vitro.

The pathogenesis of the anemia associated with malignancy was investigated in a patient with T cell chronic lymphocytic leukemia. The plasma clot culture system was used as a measure in vitro of erythropoiesis. The patient's peripheral blood and marrow T lymphocytes obtained both before and after transfusion therapy suppressed erythroid colony formation by normal human bone marrow cells. Pretreatment of the patient's bone marrow T cells by antithymocyte globulin (ATG) and complement reversed this suppression. In addition, pretreatment of the patient's marrow cells with ATG and complement markedly augmented erythropoiesis in vitro. The expression of erythroid activity caused by the selective destruction of the suppressor T lymphocytes in the patient's bone marrow with ATG and the suppression of normal erythropoiesis by the patient's bone marrow and peripheral blood lymphocytes suggest that interaction between the malignant T cell and the erythropoietin-responsive stem cell is important in production of anemia in this patient.