A clinico-pathological analysis of breast cancer patients with a family history

Abstract #6090

Background: It has been said that the high incidence of breast cancer within family lines could be investigated efficiently from genetic and environmental aspects. There could be a strong enough relationship between various carcinogenic factors and these family members. In this study, we examined the clinical and pathological characteristics of breast cancer among patients with a family history.
 Patients and Methods: We put the definition of 'Positive for a family history (FH+)' for patients who had one or more members within three generations apart from the proband. Patients with family history of breast cancer were selected out of 10506 patients who were treated in our hospital between 1962 and 2007.
 Results: There were 1272 cases in FH+ and 9234 cases in 'Negative for a family history (FH-)' group. Distribution within the family line showed the highest percentage for sisters at 37%, aunts at 25% and a mother at 25%. The family history positive breast cancer patients were around 5% in 1960-1970 although the number increased up to 18% in 2007. There was similar increasing pattern in Europe and America. The survival rate had no significant difference between FH+ and FH- statistically, but the trend was toward a better prognosis in FH+ cases. There was no relationship between family history and body mass index (BMI). The outbreak of contralateral breast cancer of FH+ was significantly higher than FH-. FH+ patients had significantly higher prevalence of a mastopathy compare to FH- patients. As for the history of other cancer species, the FH+ breast cancer patients within first generation apart from the proband had significantly higher chances compared to FH- patients.Conclusion: The breast cancer patients with family history require more detail examinations especially for the development of contralateral breast cancer. Also carcinomatous examinations are important other than breast cancer to those patients who are in the first generation apart from the proband.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6090.

Hypofluorescent spots in indocyanine green angiography of peau d'orange and fundus

PURPOSE

Hypofluorescent spots were seen in indocyanine green (ICG) angiography of peau d'orange fundus in eyes with angioid streaks. Origin of the hypofluorescent spots were examined with attention to their correlation with a peau d'orange appearance of the central fundus using a computer-assisted image comparison system.

METHODS

ICG angiography was performed in 5 patients having peau d'orange appearance of fundus using a scanning laser ophthalmoscope (SLO) and a digital video-fundus camera. The same central fundus areas corresponding to hypofluorescent spots in an ICG angiogram were then digitally identified in a fluorescein angiogram and in a red-free picture in all 10 eyes of the 5 patients. Monochromatic light observation was also performed with a dark field observation using an SLO to see subretinal or intrachoroidal pigment clumping.

RESULTS

In no patient, the areas identified with hypofluorescent spots did show relevant changes in fluorescein angiogram or red-free picture. SLO examination revealed no perfusion defect at the same areas. The dark field observation showed no pigment clumping at the peripapillary and papillomacular bundle regions where hypofluorescent spots were seen.

CONCLUSIONS

Hypofluorescent spots seen in ICG angiograms did not show exact consistency with peau d'orange changes in their location and shape. Perfusion defects or blocking by pigments were not a cause of hypofluorescent spots. The scattered hypofluorescent spots were considered to be relevant with irregular affinity of the fundus to ICG dye.

[Classification of patterns of nocturnal penile tumescence with continuous monitoring of penile rigidity: analysis of various factors affecting erection]

In 43 men who required further examination of erectile function, we analyzed the relationship between the various factors including hormone levels, penile blood pressure index (PBPI), shape of the arterial wave, erection period after prostaglandin E1 injection and dynamic cavernosography/metry, as well as the patterns of nocturnal penile tumescence (NPT) with rigidity. Normal, dissociation, short episode, low amplitude and flat trace patterns, which were classified by Kaneko, were observed in 11, 8, 11, 2 and 11 men, respectively. Uncoupling was not observed in any men. There were no differences in the levels of prolactin and LH among the 6 patterns. A high FSH level was seen in men with a flat trace pattern; a low level of free testosterone ( < 12.2 pg/ml) was seen in men with dissociation, low amplitude and flat trace patterns, and low PBPI ( < 0.75) in men with flat trace pattern; and an arteriosclerotic shape of the arterial wave was seen in men with short episode and flat trace patterns. Each erection period immediately after prostaglandin E1 injection in men with dissociation, short episode, low amplitude and flat trace was shorter compared with cases with a normal pattern. Venoocclusive dysfunction was observed in 5 men with a dissociation pattern and 6 men with a flat trace pattern. In conclusion, an integral analysis of pattern of NPT with rigidity and other examinations are useful for differentiating organic impotence from psychogenic impotence and for accurately diagnosing pathophysiological disorders of organic impotence and underlying diseases.

[Scanning electron microscopic observation on altered fenestration of the choriocapillaris in sodium iodate-treated rats]

Fenestration of the choriocapillaris may be lost and regained in various pathologic conditions. The purpose of this study was to observe the gradual disappearance of fenestrae with the scanning electron microscope. Pigmented rats were treated with an intravenous injection of sodium iodate. Changes in the choriocapillaris were produced by damaging retinal pigment epithelium. The eyes were processed for styrene embedded cracking on the third, fifth, and seventh days. Dense clusters of fenestrae were seen at the luminal surface facing retina on the third day. These clusters were surrounded by protrusion of cellular surface. The clusters of fenestrae were smaller with some variation in size on the fifth and seventh days. The protrusion between the clusters became flatter and wider. Some endothelial cells had a flat surface with tiny clusters of fenestrae. Although there was loss of fenestrae with smaller clusters and some variation in size, the tendency of the fenestrae to cluster was sustained in the same way as during the reformation of fenestrae in the choriocapillaris after laser photocoagulation.

[Investigation of Chlamydia trachomatis pneumonia in children]

A neonatal pneumonia caused by Chlamydia trachomatis (C. trachomatis) is well-known. But it is uncertain whether C. trachomatis causes pneumonia in a patient over 1 year of age. Therefore, a search for serologic and cultural evidence of C. trachomatis infection in patients suffering from acute pneumonia over 1 year of age was made. We studied 183 children ages 1 to 5 year-old suffering from acute pneumonia admitted to Kousei General Hospital to assess the relation between acute pneumonia and C. trachomatis. We investigated the serologic evidence of acute C. trachomatis infections in 73 children with a persistent cough and wheezing, detecting specific IgG antibodies and IgM antibodies by microimmunofluorescence test. Serologic results signifying acute infection were observed in 4 cases (2.2%). Then we tried to isolate C. trachomatis from the cultures of nasopharyngeal swabs, specific inclusion bodies of C. trachomatis in 2 cases (1.1%) were found. Our study suggests that C. trachomatis might cause pneumonia in children over 1 year of age.

[Interferon-alpha for the treatment of retinal vasculitis associated with human T-lymphotropic virus type I myelopathy (HAM)]

Interferon-alpha was effective for the treatment of retinal vasculitis and vitreous opacity in a patient with human T-lymphotropic virus type I associated myelopathy (HAM). The patient was a 40-year-old male with retinal vasculitis, vitreous opacity and Koeppe's iris nodules. Systemic administration of corticosteroid hormone was not fully effective for the treatment of ocular involvements except for iris nodules. After Interferon-alpha treatment, given 3 million IU/day as the intramuscular injection for 4 weeks, the retinal vasculitis subsided and vitreous opacity disappeared.