Correlation between c-erbB2 expression, lymphovascular invasion and other biological and clinical prognostic factors and preoperative tumor markers in patients with early-stage and locally advanced breast cancer

PURPOSE

To evaluate the correlation between c-erbB2 expression, lymphovascular invasion and other biological and clinical prognostic variables and preoperative CA 15-3 and CEA levels in patients with early-stage and locally advanced breast cancer.

METHODS

Preoperative serum concentrations of CA 15- 3 and CEA were measured in 123 patients undergoing surgical treatment for stage I-III breast cancer and the association between these markers and clinical and biological variables were evaluated.

RESULTS

With cut-off values of 45 U/ml (CA 15-3) and 2.5 ng/ml (CEA), the sensitivity for CA 15-3 and CEA was 10% and 24% and their mean values were 23 U/ml and 2.32 ng/ml, respectively. A significant correlation between preoperative levels of CA 15-3 and CEA was noticed (p=0.023). Preoperative CA 15-3 levels were significantly higher in patients with tumors > 5 cm (p<0.0001), with positive axillary lymph nodes (p=0.04), with increasing nodal burden (p= 0.025) and in patients with stage III disease (p=0.003). Tumor size >5 cm (p=0.002), increasing axillary nodal burden (p=0.02) and stage III disease (p<0.0001) were also significantly correlated with CEA values above the cut-off level. There were no correlations between CA 15-3 and CEA levels and other variables including c-erbB2 expression, age, grade, hormone receptor status, and lymphovascular invasion.

CONCLUSION

Preoperative CA 15-3 and CEA levels are significantly correlated with tumor size, axillary nodal status and stage in patients with non-metastatic breast carcinoma. No correlation between preoperative values of CA15-3/CEA and c-erbB2 status, lymphovascular invasion and other prognostic factors was detected.

Primary Cranial Vault Lymphoma Presenting As a Traumatic Subdural Hematoma

OBJECTIVE AND IMPORTANCE

The authors present a rare case of a primary cranial vault lymphoma, mimicking a subacute subdural hematoma after head trauma.

CLINICAL PRESENTATION

A 78-year-old woman was admitted to the hospital with progressive left hemiparesis, headache and a gradually increasing soft lump over the right parietal region 1 week after head trauma due to falling from a high place. A computed tomography (CT) scan demonstrated a hyperdense parieto-occipital subdural and subgaleal lesion together with marked midline shift and white matter edema.

INTERVENTION

Considering her trauma story and clinical progression, the patient underwent an emergency operation with the diagnosis of subdural hematoma. However, the lesion was found to be of a tumors nature and the histopathological diagnosis was high-grade malignant non-Hodgkin's lymphoma.

CONCLUSION

The authors emphasize the rarity of primary cranial vault lymphoma and its importance in the differential diagnosis of cranial vault mass lesions extending either intra- or extracranially. This case may be considered as another example where magnetic resonance imaging (MRI) is the ultimate definitive test in the emergency ward whenever CT demonstrates any findings which are unclear.

Tc-99m MIBI imaging in malignant fibrous histiocytoma

The authors report a case of malignant fibrous histiocytoma of the left forearm demonstrated by Tc-99m MIBI imaging. The tumor originated in the soft tissue of the forearm; no obvious bone invasion or metastasis was detected scintigraphically or radiologically.

Prevalence and comparisons of five different diagnostic methods for Helicobacter pylori in diabetic patients

Helicobacter pylori is now regarded as a major gastroduodenal pathogen that is etiologically linked with duodenal and gastric disease. It has been suggested recently as an important factor for nongastroenterologic conditions such as coronary heart disease and diabetes mellitus. In this study, we planned to investigate the prevalence of H. pylori in diabetic patients and to evaluate five different diagnostic tests. Group I consisted of 67 patients with type II diabetes mellitus and seventy-three aged-matched health people served as control in group II. Group I was divided in two subgroups with good (Group IA) and poor (Group IB) glycemic control. H. pylori was diagnosed by five different tests: 1) biopsy, 2) culture, 3) gram staining, 4) imprint cytology and 5) brushing cytology. The usefulness of each test for each group was statistically compared. There was a higher prevalence for H. pylori in diabetic patients. This study showed that two positive out of five tests was most reliable for predicting the H. pylori in diabetic and nondiabetic patients. In conclusion, the prevalence of H. pylori is high in diabetic patients. Peristaltic activity, and impaired nonspecific immunity must be evaluated as risk factors in diabetics. We recommend that the 'gold standard' should be regarded as two positive out of these five different tests.

Effect of G-CSF on ethanol-induced hemorrhagic gastritis model in diabetes mellitus-induced rats

Diabetes mellitus can affect every organ system, including large and small vessels, eyes, nerves, kidneys and gastrointestinal system. Acid peptic disease is an inflammatory condition involving the upper gastrointestinal tract. The elevated serum glucose levels of diabetics affect traditional host defenses such as neutrophil counts and functions. We aimed to investigate changes of gastric mucosa and the role of impaired neutrophil functions in a diabetes-induced experimental model and whether G-CSF, which modulates neutrophil counts and function, has protective effects against gastric mucosal injury in diabetic rats. Fifty rats were divided into three groups. Diabetes mellitus was induced by a single dose of streptozotocin in 40 of 50 rats. Controls had a sham injection. The gastric mucosal lesions were produced by intragastric administration of 1 ml of 95% ethanol in all three groups. Granulocyte colony-stimulating factor (G-CSF) was subcutaneously injected to twenty of diabetes-induced rats. Stomach histology and tissue malondialdehyde and glutathione levels were determined. White blood cell count, neutrophil counts and functions were determined. Peripheral blood cell counts, neutrophil phagocytosis index were decreased but neutrophil adhesivity index was not different in diabetes-induced groups. G-CSF administration improved netrophil counts and function. Macroscopic and microscopic gastric mucosal injury were significantly greater in control and only diabetes group compared with G-CSF pretreated group (p < 0.05). The tissue malondialdehyde and glutathione levels were significantly decreased in G-CSF-administrated diabetic group compared to untreated diabetics (p < 0.001). Finally, G-CSF has been shown to cause neutrophilia and improve neutrophil phagocytosis in diabetic. G-CSF may be cytoprotective for gastric mucosa in diabetes mellitus-induced rats.

MR imaging of renal vein occlusion in dogs

RATIONALE AND OBJECTIVES

MR findings of renal vein thrombosis are not consistent in the literature. Our goal was to evaluate MR findings of kidneys after renal vein occlusion in dogs.

METHODS

Surgical ligation of renal veins was performed in seven dogs. Of these, five dogs were examined with MRI before surgery, on the day of the renal vein ligation, and on the 1st, 4th, 8th, 15th, and 30th days. The other two dogs underwent nephrectomy on the 4th and 8th days for histopathologic correlation.

RESULTS

On T1-weighted images, corticomedullary differentiation was lost in all dogs by the 15th day. On T2-weighted images, the signal intensity of the renal cortex was significantly decreased beginning on the first day. The kidneys showed no medullary enhancement in the postcontrast period. The volume of the kidney began increasing at the time of renal vein ligation, started to decrease after the 4th day, and developed significant atrophy by the 30th day.

CONCLUSIONS

After renal vein ligation, the renal cortex appears hypointense on T2-weighted images, corticomedullary differentiation is lost within 2 weeks on T1-weighted images, and the kidney becomes atrophic by 1 month.

Comparison of the effects of surgical and autologous fascial suture materials on testicular histology in rats subjected to orchiopexy

In this study orchiopexy was performed in 30 Sprague-Dawley rats in order to compare traumatic effects of surgical and autologous fascial suture materials on testicular histology. Abscess formation was observed in 72.7% of the chromic, in 36.3% of the nylon, and in 18.1% of the vicryl fixed groups. There were no abscess formations in the dartos and autologous fascial fixed group. Examination of the testes revealed complete absence of spermatogenesis in the chromic fixed group. Spermatogenesis was normal, 72% in the vicryl, 18.1% in the nylon, 90.9% in the dartos and autologous fascial suture fixed groups. Antisperm antibody was not observed in any rat sera. We consider that it is preferred to use dartos pouch fixation. If necessary, it is advisable to use autologous fascial suture materials.