[A rare case of metastatic tumor of heart from bladder cancer].

The article presents a case report of metastatic heart damage which developed in association with urothelial bladder carcinoma in a 79-year old female patient. Various masses may be found in the heart. In tumors, a secondary damage to the heart is observed much more frequently than a primary damage; however, metastasis of bladder carcinoma to the heart is extremely rare. Of interest is the fact of metastatic damage to all layers of the heart, including the endocardium, pericardium, and myocardium.

[The histological changes in the stomach associated with death from overcooling at the site of discovery of the corpse and at the stage of hospitalization]. / Gistologicheskie izmeneniya zheludka pri smerti ot pereokhlazhdeniya na meste obnaruzheniya trupa i na gospital'nom etape.

The objective of the present publication was the description of the histological changes in the gastric structures revealed after the death of the victims of overcooling at the site of discovery of the corpse and at the stage of hospitalization. The stomachs of the subjects found at the place of death from overcooling in the absence of concomitant pathological findings were characterized by a diagnostic complex of pathomorphological changes peculiar to this form of death. The expression of separate signs forming the diagnostic complex decreased in the subjects with chronic atrophic gastritis and the concurrent structural reorganization of the organ. The high concentration of ethyl alcohol in the blood is associated with enhanced permeability of the vessels. The analysis of the relevant literature publications and the results of original morphological studies of the cases of death from overcooling at the stage of hospitalization after cessation of the influence of cold made it possible to elucidate dynamics of histological changes in the stomach. These data taken together with information from other sources allow to evaluate the lifetime effects of cold and the duration of its action under extreme conditions as well as to prognosticate the development of pathological processes.

[The compensatory and adaptive e reactions of the respiratory system as the diagnostic criteria for histological studies in forensic medicine].

The objective of the present study was to characterize the structural changes in the respiratory system equivalent to its compensatory and adaptive reactions in response to the action of various factors under the normal and extreme conditions for the assessment of the possibility of their further use for the purpose of diagnostics. The action of various factors on the tissues obtained from the human respiratory system for forensic medical examination was shown to cause combined histomorphological alterations that refelect a wide spectrum of protective, compensatory, and adaptive reactions. The range of potential morphological and functional changes in the respiratory system depends on the characteristics of endogenous and exogenous factors influencing the organism of the affected subjects. It is concluded that the use of the proposed approach to morphological diagnostics may be useful for the development of criteria for the evaluation of various variants of tanatogenesis with their objective confirmation by mathematical models.

Bilateral symmetry of breast tissue composition by magnetic resonance in young women and adults.

BACKGROUND: Some reports suggest that there is a slightly higher frequency of breast cancer in the left breast compared with the right in middle-aged women. The reasons for this association are unknown. The water and fat content of both breasts was compared using magnetic resonance (MR). Breast water by MR reflects fibro-glandular tissue and is strongly positively correlated with percent mammographic density, a strong risk factor for breast cancer. METHODS: Magnetic resonance was used to measure fat and water content of the breast in 400 young women aged 15-30 years and a random sample of 100 of their mothers. All MR examinations were carried out using a 1.5T MR system, and 45 contiguous slices were obtained in the sagittal plane. One reader identified the breast tissue in the image, and subsequently, fat and water content was calculated using a three-point Dixon technique. Left- and right-sided images were read independently in random order. RESULTS: In young women, mean percent water was on average 0.84 % higher in the right compared with the left breast (p < 0.001) and total breast water was on average 6.42 cm(3) greater on the right side (p < 0.001). In mothers, there were no significant differences in any breast measure between right and left sides. CONCLUSION: The small differences in breast tissue composition in young women are unlikely to be associated with large differences in breast cancer risk between sides. The reported excess of left-sided breast cancer in older women is unlikely to be explained by differences in breast tissue composition.

Diminished pheromone-induced sexual behavior in neurokinin-1 receptor deficient (TACR1(-/-)) mice.

Studies in mice with targeted deletions of tachykinin genes suggest that tachykinins and their receptors influence emotional behaviors such as aggression, depression and anxiety. Here, we investigated whether TAC1- and TAC4-encoded peptides (substance P and hemokinin-1, respectively) and the neurokinin-1 receptor (NK-1R) are involved in the modulation of sexual behaviors. Male mice deficient for the NK-1R (TACR1 (-/-)) exhibited decreased exploration of female urine in contrast to C57BL/6 control mice and mice deficient for NK-1R ligands such as TAC1 (-/-), TAC4 (-/-) and the newly generated TAC1 (-/-) /TAC4 (-/-) mice. In comparison to C57BL/6 mice, mounting frequency and duration were decreased in male TACR1 (-/-) mice, while mounting latency was increased. Decreased preference for sexual pheromones was also seen in female TACR1 (-/-) mice. Furthermore, administration of the NK-1R-antagonist L-703,606 decreased investigation of female urine by male C57BL/6 mice, suggesting an involvement of NK-1R in urine sniffing behavior. Our results provide evidence for the NK-1R in facilitating sexual approach behavior, as male TACR1 (-/-) mice exhibited blunted approach behavior toward females following the initial interaction compared with C57BL/6 mice. NK-1R signaling may therefore play an important role in pheromone-induced sexual behavior.

Transient Silencing of a Type IV P-Type ATPase, Atp10c, Results in Decreased Glucose Uptake in C2C12 Myotubes.

Atp10c is a strong candidate gene for diet-induced obesity and type 2 diabetes. To identify molecular and cellular targets of ATP10C, Atp10c expression was altered in vitro in C2C12 skeletal muscle myotubes by transient transfection with an Atp10c-specific siRNA. Glucose uptake assays revealed that insulin stimulation caused a significant 2.54-fold decrease in 2-deoxyglucose uptake in transfected cells coupled with a significant upregulation of native mitogen-activated protein kinases (MAPKs), p38, and p44/42. Additionally, glucose transporter-1 (GLUT1) was significantly upregulated; no changes in glucose transporter-4 (GLUT4) expression were observed. The involvement of MAPKs was confirmed using the specific inhibitor SB203580, which downregulated the expression of native and phosphorylated MAPK proteins in transfected cells without any changes in insulin-stimulated glucose uptake. Results indicate that Atp10c regulates glucose metabolism, at least in part via the MAPK pathway, and, thus, plays a significant role in the development of insulin resistance and type 2 diabetes.

[Evaluation of D-dimer in outpatients: clinical value and specific features].

D-dimer as an activation marker of coagulation and fibrinolysis is a recognized diagnostic criterion of deep vein thrombosis, pulmonary thromboembolism, and disseminated intravascular coagulation. In recent years, this laboratory test has been most frequently used for other purposes: to detect the activation of coagulation, to predict the course of diseases, and to determine the duration of anticoagulant therapy. Our investigation examined 1514 D-dimer measurements in 1370 outpatients without acute abnormalities, including 72 patients receiving warfarin and 32 patients after myocardial revascularization. 36.1% of cases were found to have values of more than 0.5 mkg/ml. Adequate anticoagulant therapy (INR 2-3) caused a reduction in the level of D-dimer that is an important additional laboratory test for the evaluation of antithrombotic defense. Further investigations are needed to determine cutoff values for various clinical situations.

A pilot randomised controlled trial to reduce colorectal cancer risk markers associated with B-vitamin deficiency, insulin resistance and colonic inflammation.

Colorectal cancer risk is associated with biochemical markers for B-vitamin deficiency, insulin resistance and colonic inflammation, suggesting that these three conditions are each involved in colon carcinogenesis. We expected that dietary supplements of folic acid, n-3 fatty acids and calcium would reduce the markers and thus possibly cancer risk. We therefore randomised 98 participants, with previous colonic polyps or intramucosal carcinomas, to a combined treatment of supplementary folic acid, fish oil and calcium carbonate, or placebos for 28 days. Blood and faecal samples were obtained prior to and at the conclusion of the intervention and analysed for plasma folate, homocysteine, insulin, free fatty acids, triglycerides and faecal calprotectin. In addition, plasma vitamin B12, thiamin, glucose and C-reactive protein were assessed. Our supplemental strategy modestly affected some of the biomarkers associated with folate metabolism and insulin resistance, but had no effect on those associated with colonic inflammation. This pilot study demonstrates the feasibility and practicality of clinical trials aimed at reducing diet-related biochemical risk markers for colon cancer. We suggest that long-term intervention studies with tumour-related end points should be undertaken when the intervention agents used are found effective in short-term biochemical risk marker trials.

Dietary fat and breast cancer risk revisited: a meta-analysis of the published literature.

Animal experiments and human ecological studies suggest that dietary fat intake is associated with a risk of breast cancer, but individual-based studies have given contradictory results. We have carried out a meta-analysis of this association to include all papers published up to July 2003. Case-control and cohort studies that examined the association of dietary fat, or fat-containing foods, with risk of breast cancer were identified. A total of 45 risk estimates for total fat intake were obtained. Descriptive data from each study were extracted with an estimate of relative risk and its associated 95% confidence interval (CI), and were analysed using the random effects model of DerSimonian and Laird. The summary relative risk, comparing the highest and lowest levels of intake of total fat, was 1.13 (95% CI: 1.03-1.25). Cohort studies (N=14) had a summary relative risk of 1.11 (95% CI: 0.99-1.25) and case-control studies (N=31) had a relative risk of 1.14 (95% CI 0.99-1.32). Significant summary relative risks were also found for saturated fat (RR, 1.19; 95% CI: 1.06-1.35) and meat intake (RR, 1.17; 95% CI 1.06-1.29). Combined estimates of risk for total and saturated fat intake, and for meat intake, all indicate an association between higher intakes and an increased risk of breast cancer. Case-control and cohort studies gave similar results.

The detection of change in mammographic density.

Mammographic density is associated with risk of breast cancer, and factors that change density may also change risk. There has, however, been little research into how change in serial mammograms is best detected. The purpose of the work described here was to examine the effects of different reading conditions on the detection of change in mammographic features. Mammograms were selected from women who had participated in a randomized controlled trial of screening for breast cancer. We selected two age-matched groups of subjects, one had undergone menopause after entry (n = 202) and another who had not (n = 202). Serial mammograms from these subjects were then measured four times using a computer-assisted method under different conditions: (a) films were randomized; (b) subjects were randomized (i.e., pairs of films from individuals were read one after the other), but the order of films was random and unknown to the reader; (c) subjects were randomized, and the order of films was sequential and known to the reader; and (d) subjects were randomized, and the order of films was random and unknown to the reader, but both films in each pair were read simultaneously on separate computer screens. The mean effect of the menopause on change in the mammographic measures of total, dense and nondense areas, percent density, and the associated variances were then compared. With one exception, all of the randomization and viewing methods confirmed a change in all mammographic measures at menopause and produced very similar overall results, suggesting that mammographic density is a robust measure. Compared with randomization of all films, the method in which subjects were randomized and paired films read one after the other in random and unknown order was associated with a slightly smaller mean difference and achieved a substantial reduction in variability, suggesting that it is the most sensitive method of randomization and viewing for the detection of change.

Quantitative PCR identifies a minimal deleted region of 120 kb extending from the Philadelphia chromosome ABL translocation breakpoint in chronic myeloid leukemia with poor outcome.

Fluorescence in situ hybridization (FISH) analysis has shown previously that 10-15% of chronic myeloid leukemias (CML) have hemizygous deletions of variable sizes affecting regions that flank the ABL and BCR translocation breakpoints on the derivative chromosome 9, and these patients have a poor outcome. FISH studies using large commercial genomic probes have previously suggested that haploinsufficiency of sequences flanking either ABL or BCR modify the disease process of CML and lead to an unfavorable prognosis. In this present study, real-time quantitative PCR (Q-PCR) analysis was used to identify and map much smaller hemizygous microdeletions in a subset of CML patients that were not deleted using large genomic FISH probes. Microdeletions were identified by Q-PCR in 25 of 71 patients selected based on less favorable outcome (chronic phase duration of less than 96 months and a survival time of less than 84 months). In contrast, no microdeletion was detected in any of 18 CML samples selected from a group with a more favorable outcome. Detailed mapping of the 25 Q-PCR microdeletions showed that the minimal deleted region extended approximately 120 kb from the 5' end of the ABL gene in the centromeric direction on the derivative chromosome 9, and the region 3' to BCR on chromosome 22 was excluded. Of the four ESTs and/or genes that map to the 120 kb region, the putative tumor suppressor PRDM12 is the strongest candidate gene. The potential role for each sequence in modifying the clinical behavior of CML is presented.

The association of breast mitogens with mammographic densities.

Radiologically dense breast tissue (mammographic density) is strongly associated with risk of breast cancer, but the biological basis for this association is unknown. In this study we have examined the association of circulating levels of hormones and growth factors with mammographic density. A total of 382 subjects, 193 premenopausal and 189 postmenopausal, without previous breast cancer or current hormone use, were selected in each of five categories of breast density from mammography units. Risk factor information, anthropometric measures, and blood samples were obtained, and oestradiol, progesterone, sex hormone binding globulin, growth hormone, insulin-like growth factor-I and its principal binding protein, and prolactin measured. Mammograms were digitised and measured using a computer-assisted method. After adjustment for other risk factors, we found in premenopausal women that serum insulin-like growth factor-I levels, and in postmenopausal women, serum levels of prolactin, were both significantly and positively associated with per cent density. Total oestradiol and progesterone levels were unrelated to per cent density in both groups. In postmenopausal women, free oestradiol (negatively), and sex hormone binding globulin (positively), were significantly related to per cent density. These data show an association between blood levels of breast mitogens and mammographic density, and suggest a biological basis for the associated risk of breast cancer.

Mammographic densities as a marker of human breast cancer risk and their use in chemoprevention.

Differences in the parenchymal pattern of the breast on mammography reflect differences in the amounts of stromal, epithelial, and fat tissue present in the breast. Stroma and epithelium are radiologically dense, whereas fat is lucent. Extensive areas of mammographically dense breast tissue are strongly associated with an increased risk of breast cancer. A variety of interventions, including gonadotropin-releasing hormone inhibitor, tamoxifen, stopping hormone replacement therapy (HRT), and adopting a low-fat, high-carbohydrate diet, all influence the tissue composition of the breast and reduce mammographic densities. Of the interventions examined to date, only tamoxifen has been shown to reduce the incidence of breast cancer, at least in the short term. Conversely, HRT, which increases density, also increases risk of breast cancer. These results suggest that mammographic density may be a short-term marker of the effect on the breast of potential preventive interventions for breast cancer.

Primary chromosomal rearrangements of leukemia are frequently accompanied by extensive submicroscopic deletions and may lead to altered prognosis.

BCR/ABL fluorescent in situ hybridization study of chronic myeloid leukemia (CML) and Philadelphia(+) (Ph(+)) acute lymphoid leukemia (ALL) indicated that approximately 9% of patients exhibited an atypical hybridization pattern consistent with a submicroscopic deletion of the 5' region of ABL and the 3' region of the BCR genes on the 9q(+) chromosome. The CML patients with deletions had a shorter survival time and a high relapse rate following bone marrow transplant. Since deletions are associated with both Ph(+) CML and ALL, it seemed probable that other leukemia-associated genomic rearrangements may also have submicroscopic deletions. This hypothesis was confirmed by the detection of deletions of the 3' regions of the CBFB and the MLL genes in AML M4 patients with inv(16) and in patients with ALL and AML associated with MLL gene translocations, respectively. In contrast, analysis of the AML M3 group of patients and AML M2 showed that similar large deletions were not frequently associated with the t(15;17) or t(8;21) translocations. Analysis of sequence data from each of the breakpoint regions suggested that large submicroscopic deletions occur in regions with a high overall density of Alu sequence repeats. These findings are the first to show that the process of deletion formation is not disease specific in leukemia and also implicate that the presence of repetitive DNA in the vicinity of breakpoint regions may facilitate the generation of submicroscopic deletions. Such deletions could lead to the loss of one or more genes, and the associated haploinsufficiency may result in the observed differences in clinical behavior. (Blood. 2001;97:3581-3588)

A comparison in individual murine tumors of techniques for measuring oxygen levels.

PURPOSE: To investigate the relationship between different techniques for measuring oxygen levels in a murine tumor model. METHODS AND MATERIALS: Using the murine fibrosarcoma line KHT-C, five techniques of measuring oxygen levels-the Eppendorf pO2 Histograph, EF5 binding, the comet assay, a paired survival assay, and an in vivo growth delay assay-were assessed. In these experiments, three or more techniques were applied in different combinations to measure the oxygen levels in individual tumors. RESULTS: Statistically significant correlations were observed between the hypoxic proportions calculated from the paired survival assay with those from EF5 binding. The comet assay was found to have a statistically significant correlation with the paired survival analysis and the growth delay analysis. No statistically significant correlation was found between the Eppendorf pO2 Histograph measurements and those from the other techniques, although there were weak correlations with the paired survival assay and EF5 binding. For technical reasons, a comparison was not made between EF5 binding and the growth delay assay. CONCLUSIONS: The correlations found between EF5 binding and the comet assay with the radiobiological assays suggest that these techniques have potential for predicting outcome following radiation treatment. The lack of correlation seen between the pO2 Histograph data and the radiobiological assays is in contrast to results from early clinical trials.

The use of needle biopsies for radiobiological assessment of oxygen levels in KHT-C tumors.

Hypoxia affects the sensitivity of cells to radiation. Hence there is considerable interest in the development and assessment of techniques for measuring oxygen levels. In the work described here, we explore the use of tumor needle biopsies (fine needle aspirates) in an assay that is standard in the field of radiation biology: the paired survival assay. We found that needle biopsies are a feasible option for estimating cell survival when conducting this assay, and that the variability in cell survival between tumors was greater than that between different biopsies from the same tumor. Using this technique, we then compared measurements of tumor hypoxia using the paired survival assay and the growth delay assay in the same individual tumors. We found a significant correlation between these two techniques.

Likelihood-based experimental design for estimation of ED50.

In selecting the best dosage choice for the estimation of ED50, it is natural to try to minimize the length of the confidence intervals. In this presentation, the dose allocation that minimizes the length of the likelihood-based confidence intervals is presented and compared with alternative allocations that have been proposed based on the length of different types of confidence intervals, such as those based on the asymptotic variance or on Fieller's Theorem. Effective strategies to deal with the parameter dependence of these allocations are explored. A series of experiments to evaluate the effect of small doses per fraction on the radiation tolerance of the rat cervical spinal cord provide the motivation and an illustration for the proposed procedures.

Aberrant crypt focus promotion and glucose intolerance: correlation in the rat across diets differing in fat, n-3 fatty acids and energy.

McKeown-Eyssen (Cancer Epidemiol. Biomarkers Prevent., 3, 687-695, 1994) and Giovannucci (Cancer Causes Control, 6, 164-179, 1995), noting the striking similarity in lifestyle risk factors for colorectal cancer and insulin resistance, proposed that the hyperinsulinemia, glycemia and hypertriglyceridemia associated with insulin resistance promotes colon cancer. To compare the effect of diet on colon cancer promotion and insulin resistance in the F344 rat, we assessed the effect of fat, n-3 fatty acids and energy in pairwise comparisons on average size of aberrant crypt foci (ACF) and on glucose intolerance in the same animals in a single experiment. Diets high in fat and energy increased and diets with increased n-3 fatty acids and calorie restriction decreased both ACF growth and glucose intolerance compared with control diets. The measures of promotion of colon cancer and insulin resistance were strongly correlated (n = 98, r = 0.67, P < 0.001). In addition, both were highly correlated with daily energy intake (r = 0.62 and 0.66) and were also correlated with basal (post-prandial) insulin, glucose and triglycerides (r = 0.31-0.53, P < 0.01). We concluded that ACF growth and glucose intolerance are correlated for a wide range of diets and that increased circulating energy (glucose and triglycerides) may lead to both colon cancer promotion and insulin resistance.