Tissue polypeptide antigen in bronchogenic carcinoma.

Serum concentrations of tissue polypeptide antigen (TPA) were examined by an immunoradiometric technique in 114 patients with bronchogenic carcinoma and in 55 patients with noncancerous lung diseases. The sensitivity of TPA examination in bronchogenic carcinoma was 67.5% and was increased in advanced stages of the disease. No statistically significant differences were observed between histologic types of bronchogenic carcinoma. In nonmalignant lung diseases, elevated levels of TPA were observed in 21.8% of patients. TPA is of little value in the diagnosis of bronchogenic carcinoma; however, it may be useful as an auxiliary criterion for staging.

Usefulness of a multiple biomarker assay in bronchoalveolar lavage (BAL) and serum for the diagnosis of small cell lung cancer.

To evaluate the diagnostic usefulness of simultaneous determinations of carcinoembryonic antigen (CEA), neuron specific enolase (NSE), chorionic gonadotrophin (HCG) and carbohydrate antigenic determinant 19-9 (CA 19-9), we studied 48 patients with small cell lung carcinoma (SCLC) and 15 with nonmalignant lung disease. The combination of CEA-BAL, NSE-BAL, and NSE-serum taken together with results of bronchoscopy (histologic and cytologic) showed the highest discriminating power between malignant (SCLC) and nonmalignant lung disease. The sensitivity of bronchoscopy alone was 35%. However, when bronchoscopy results were combined with 3 positive markers, the sensitivity increased to 71%, with at least 2 positive markers to 94%, and with at least 1 positive marker to 100%. When both bronchoscopy and all 3 markers were negative, the results showed a negative predictive value of 100%.

Gastric mucosal antioxidant activity in patients at increased risk of gastric cancer.

In 68 subjects the activities of Cu/Zn-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) were investigated in gastric mucosa. The patients were classified according to the histological finding into following groups: 12 with normal finding (N), 16 with superficial gastritis (SG), 13 with mild atrophic gastritis (MAG), 19 with severe atrophic gastritis (SAG) and 8 with gastritis after partial gastrectomy (PGG). The comparison of groups SG, MAG, SAG and PGG with the group N revealed the following changes: in SG increased SOD and GSH-Px, in MAG and SAG no significant changes, and in PGG increase in SOD, CAT and GSH-Px were observed. It was supposed that increased enzymatic activities were caused by higher concentration of active oxygen species produced by phagocytizing leukocytes in inflamed gastric mucosa. Administration of vitamin E resulted in significant reduction of SOD and CAT activities, on the other hand GSH-Px activity significantly increased. The explanation of this effect of vitamin E requires further studies. A prolonged interaction of active oxygen species with chemical carcinogens (N-nitroso- or diazonium compounds, PAH) can exhibit a significant promoting effect on the development of intestinal type of gastric cancer from its precancerous conditions, above all after partial gastrectomy.

Comparability of results of postnatal and long-term tests for carcinogenicity.

A method of testing postnatal carcinogenicity in rats was elaborated. The substances to be tested were administered from the 1st day after birth to the 5th, 10th and 20th days of age. The subsequent supply of a substance in diet from weaning (28th day of age) up to the end of the first year of survival was an optimal combination. A total of 12 substances were tested by this method. For all substances it was possible to provide a comparison with the results of long-term studies. For nine substances carcinogenicity was demonstrated in both tests, out of them in eight cases in identical organ systems. In three cases no carcinogenicity was ascertained in the postnatal study, in two compounds identical negative results were obtained by the two approaches. In one case (the cytostatic TS-160) development of sarcomas was found at the site of subcutaneous administration in the long-term study, and this effect was not observed in the postnatal study. Results identical for the two methods (carcinogenic or noncarcinogenic) were achieved in 11 substances, i.e. 91.7%. In addition, in 10 compounds, for which carcinogenicity was demonstrated either in the postnatal study or in the long-term study, the occurrence of tumors was found in identical organ systems after 8 compounds which is an 80% agreement. In mice, this identity of organs was demonstrated only in 62.5% of the compounds tested. The present results demonstrated that the use of postnatal carcinogenicity test in rats offers the determination of possible carcinogenic effect of the compound tested with a high probability, under economically more advantageous conditions, and with almost the same qualitative results as with the use of the long-term tests for carcinogenicity.

Bilateral germ cell tumors of the testis.

In a retrospective study of 530 patients with testicular germ cell tumors treated between 1977 and 1993, a group of 12 patients (2.26%) with bilateral testicular tumors was analyzed. While bilateral tumors were simultaneously present in two cases (both with different histologic types), consecutive development of a tumor in the contralateral testis was observed in 10 patients 5.25 years (range, 3-13.5 years) after orchiectomy for the first tumor. The authors highlight the variability of histologic types in both testes, the need for an individual therapeutic approach with a view to previous therapy for the first tumor, the need for hormonal replacement as well as the possibility of testicular prosthesis implantation following bilateral orchiectomy.

Soft tissue sarcomas: thirteen years experience in the service of medical oncology of a general hospital.

Thirty-seven patients with soft tissue sarcomas were treated between 1981 and 1990. All of them were operated. Thirteen patients with marginal resection received adjuvant radiotherapy. Radiotherapy decreased the rate of local relapses. Sixteen patients received adjuvant chemotherapy with ifosfamide-epirubicin and four of them had a recurrence. Twenty-one patients did not receive chemotherapy and 13 of them relapsed. Adjuvant chemotherapy improved the disease-free survival during the first year, but not benefit appeared in long-term disease-free survival and overall survival.

Acute myeloid leukemia: correlation between purine metabolism enzyme activities and membrane immunophenotype.

A total of 34 AML patients with heterogenous age distribution (from 2 years up to 82 years) were observed. Purine metabolism enzyme activities were compared and correlated with membrane immunophenotype. Analysis of bone marrow and peripheral blood samples based on FAB criteria and immunologic phenotyping of acute myeloid leukemia (AML) provided useful--either confirmatory or contradictory-information on the distribution of M1-M6 patients demonstrating a predominance of M1+M2 and M4 groups (44% and 32.4%, respectively). In contrast, it was demonstrated that less frequent subtypes were M3 and M6 (5.9% and 2.9%, respectively). AML subtypes were correlated with expression of surface antigens detected by the following monoclonal antibodies: CD13, CD33, CDw65, CD11b, CD15, CD14, HLA-DR and CD34. On the basis of immunophenotyping we found the following characteristic markers: M1, M2-CD34, HLA-DR, CD13, CD33, CDw65; M3-CD13, CD33, HLA-DR (negative); M4, M5-CDw65, CD14, CD13, CD33 and HLA-DR. CD14 was confirmed to be a typical marker for discriminating myeloid from monocytoid FAB AML subtypes. Analysis of purine metabolism enzyme activities showed that there is a correlation between the values of adenosine deaminase and purine nucleoside phosphorylase and various immunotypes of AML. High ADA/PNP ratio (> 1.0) was found in M1, M2, M3 subtypes. It was due to the increased level of ADA activity (> 100 pkat.10(-6) cells), though these activities overlapped to a certain extent. It was shown that PNP activity simultaneously decreased. With maturation of cells within AML lineage ADA activity decreased and PNP activity increased. This corresponded with ADA/PNP ratio that was < 1.0 in cells of more mature AML subtypes. We found that the enzymatic values were characteristic mainly in cells of M5 (monocytic) AML subtype and were characterized by decreased values of ADA activity with a simultaneous increase in PNP activity. It follows from our results that ADA/PNP ratio enables to discriminate between myeloid and monocytoid subtypes of AML.

Immunoglobulin levels in children treated for malignant tumors.

IgG, IgA and IgM levels were examined in children treated for different malignant tumors. Chemotherapy decreased IgG and mainly IgM. There was increased incidence of infectious complications in IgG deficiency.

Prognostic value of plasma-cell immunophenotype in patients with multiple myeloma.

A review is given of the prognostic significance of immunophenotyping of blood lymphoplasmocytic cells. From a group of 250 patients followed from 1981 through 1991 a subgroup of 70 patients (followed 1986 through 1991) were phenotyped at 6-month intervals by immunofluorescence tests with monoclonal antibodies for cytoplasmic immunoglobulin, kappa-lambda index, CD71, CD10, CD20, CD38, and HLA-DR receptors. In course of a longitudinal study it was found that prognostic significance for shortened survival can be derived from the presence of circulating CD10, CD71, and CD20 positive undifferentiated cells in peripheral blood. There was a correlation between increase of CALLA positive and CD71 positive cells. Further, an increase of undifferentiated clone occurred during transition of the disease to an aggressive phase. The median survival of the total group of 250 patients treated by the VMCP/MOCCA protocol, according to statistical analysis, was 90 months, the median survival of the aggressive stage with plasmoblastic and lymphoplasmocytic cell type, respectively, was only 12 months. The significance of phenotypization in the prognostic evaluation of variant heterogenous myeloma types is stressed.

Immunophenotypic significance of the "lymphoid" CD38 antigen in myeloid blood malignancies.

In 72 patients with blood malignancies (leukemias), the expression and distribution of the "B-lineage" antigen CD38, was analyzed, individually and in combination with CD19, CD10, HLA-DR, CD13, CD14, CD33, CDw65, CD2 and CD7. The expression of CD38 on the surface of leukemic cells was totally different from its expression on normal hematopoietic cells. Its positivity in myeloid malignancies was as follows: In patients with acute myeloid leukemia in 21/28 cases-75% (probability of expression 0.68 +/- 0.2, p < 0.05) and in patients with chronic myeloid leukemia in 4/6 cases-66%. In lymphoproliferative malignancies the CD38 antigen was expressed as follows: In patients with acute non-T lymphoblastic leukemia in 12/16 cases-75% (probability of expression 0.7 +/- 0.2, p < 0.05) and in patients with chronic B lymphocytic leukemia in 6/8 cases-75%. CD38 was also found positive in patients with acute mixed lineage leukemia.

Multiple fractions of gamma rays do not induce overexpression of c-myc or c-Ki-ras oncogenes in human cervical carcinoma cells.

Multiple fractions of gamma rays (0.5 Gy daily, 30 fractions) had previously been found to change the sensitivity of human cervical carcinoma HeLa cells to anticancer drugs. Preirradiated cells became resistant to cisplatin, methotrexate and vincristine, but retained the same sensitivity to gamma rays and ultraviolet light. Some mechanisms involved in resistance of preirradiated cells to cisplatin and vincristine were determined, i.e. the increased levels of metallothioneins and increased expression of plasma membrane P glycoprotein. As recent reports indicated that the resistance to cisplatin and ionizing radiation may involve expression of oncogenes, we examined whether multiple fractions of gamma rays can change the expression of c-myc and c-Ki-ras oncogenes in HeLa cells and determined whether there is a correlation between expression of these oncogenes and sensitivity of preirradiated cells to cisplatin and gamma rays. The expression of c-myc and c-Ki-ras oncogenes were examined by the use of DNA dot blot, RNA dot blot and Northern blot analyses. The results show that preirradiation did not induce either amplification or elevated expression of c-myc or c-Ki-ras oncogenes. Further, there is no correlation between expression of c-myc and c-Ki-ras oncogenes and the acquired resistance to cisplatin.

Polarographic study of cytosine nucleosides.

The conditions for polarographic reduction of several nucleic acid components were determined. These components were the pyrimidine base cytosine and nucleoside cytidine, and its synthetic analogs arabinosylcytosine and cyclocytidine hydrochloride which are cytotoxic and antileukemic agents. Polarographic reduction, its character and mechanism were studied in aqueous conditions of Britton Robinson buffer at different pH and in nonaqueous conditions of dry dimethylformamide. It was found that the polarographic wave of all compounds had a diffuse character and that the whole process was a two-electron event which in dependence on pH may consist of two one-electron steps. It was demonstrated on the hydrolysis reaction of cyclocytidine hydrochloride to arabinosylcytosine at alkaline pH that the polarographic method may be used for the documentation of structural changes of pyrimidine nucleoside going on in the polarographic chamber.

The effect of purine phosphonomethoxyalkyl derivatives on DNA synthesis in CHO Chinese hamster cells.

The inhibition of incorporation of 3H-thymidine and the changes of the rate of nascent DNA chain elongation were investigated in CHO Chinese hamster cells treated with (S)-(3-hydroxy-2-phosphonomethoxypropyl) (HPMP) and N-(2-phosphonomethoxyethyl) (PME) derivatives of adenine (A), guanine (G) and 2,6-diaminopurine (DAP). No direct correlation was observed in PME and HPMP derivatives between cytotoxicity, inhibition of 3H-thymidine incorporation and inhibition of nascent DNA chain elongation. The highest cytotoxicity and inhibition of DNA synthesis were caused by PMEG. The limited extent of inhibition of DNA elongation was encountered in the case of HPMPG and HPMPA. With PMEA, weak inhibition of elongation of DNA was observed only after a prolonged exposure (6 h). None of the investigated drugs induced DNA breaks.

Pre- and postirradiation hemopoietic effects of liposomal muramyl tripeptide phosphatidylethanolamine (MTP-PE) administered to C57Bl/6 mice before irradiation.

The effect of muramyl tripeptide (MTP-PE) encapsulated in liposomes (multilamellar vesicles, MLV) on hemopoiesis and hemopoietic recovery after sublethal single irradiation with a dose of 6 Gy was investigated. MTP-PE/MLV during 24 h after administration stimulated the monocyte/macrophage system and accelerated recovery from radiation-induced damage of hemopoiesis. The above reparative processes were accompanied by hyperplasia of granulocytes in the bone marrow on days 6-8 after irradiation, acceleration of erythropoiesis in the spleen and recovery of granulocyte count in the peripheral blood. The repair of thymic and splenic lymphoid tissues as well as recovery of the number of mononuclear cells in peripheral blood was not influenced by MTP-PE/MLV application.

Selective cervical cytology screening: discriminant analysis approach.

Cervical cancer is one of the leading malignancies seen in Indian women. It has been well established that organized cervical cytology screening program is the mainstay for control of cervical cancer. It is not possible to carry out cervical cytology screening for masses in India due to paucity of human and financial resources. Hence there is a need for development of an alternate strategy to concentrate on women with high risk. In the present communication attempt was made to define a high risk group based on sociodemographic factors, viz. age, parity, education and clinical features. A total of 67,000 women were screened of which in 250 malignancy was detected. The rate of malignancy was observed to be high in women above 40 years (10.5/1000) with more than two children (6.1/1000) and in illiterate group (4.9/1000) as compared to women below 40 years, more than 3 children and illiterate group. Similarly, the rates were higher in women with clinical diagnosis of cervical erosion which bled on touch, unhealthy cervix and suspicious looking cervix, malignancy rates were 17.1, 24.7, 263.2 (per 1000), respectively. An attempt was made to study the combined effect of all the six factors (sociodemographic and clinical) by employing the technique of linear discriminant analysis to find out the discrimination power between the normal and malignant women. Discriminant score thus obtained would help to classify the case for subjecting to cervical cytology. It was observed that the model containing sociodemographic and clinical variables was able to classify 69% of malignant cases correctly. When the clinical variables were dropped from the model, the sensitivity dropped to 65%. The above exercise indicated that based on the discriminant score even in the absence of facilities for clinical examination of women, it may be possible to identify women of high risk group for subjecting them to cervical cytology screening.

Characterization of lymphokine-activated killer cells from peripheral blood and lymph nodes of non-Hodgkin's lymphoma patients.

Peripheral blood lymphocytes (PBL) and lymph node lymphocytes (LNL) from non-Hodgkin's lymphoma patients were tested for LAK cell cytotoxicity using appropriate targets in a short-term 51chromium-release assay. The results showed a significant depression in LNL-LAK activity suggesting the reduced capacity of LNL to generate LAK cells. LNL-LAK cells demonstrated significantly low percentages of cells expressing CD16, CD56 and CD25 as compared to PBL-LAK of patients and healthy donors. The reduced capacity to generate LAK cells in lymph nodes could be due to the presence of low numbers of NK cells which are thought to be the main precursors of LAK cells. The IL-2 producing ability of lymph node mononuclear cells was found to be significantly higher than that of peripheral blood mononuclear cells from both healthy donors and NHL patients.

Protective role of vanadium in the survival of hosts during the growth of a transplantable murine lymphoma and its profound effects on the rates and patterns of biotransformation.

Vanadium, as ammonium mononium monovanadate, has been found to have anticarcinogenic effect in host mice bearing a transplantable ascitic lymphoma. The potentiating effect of vanadium was supported by biochemical analysis of autopsies relating to markers like microsomal cytochrome P-450, UDP glucuronyl transferase (UDPGT) and cytosolic glutathione-S-transferase (GSHT) in the hepatic tissue of the hosts, which showed substantial alterations in the extent of tumor regression as compared to their lymphoma and normal counterparts, prolonging the survival of the hosts.

Interleukin-2 production by human leukemia cell lines of pre-B cell origin.

Cells of 7 tested human leukemia cell lines of pre-B cell origin (as characterized by immunophenotyping and by the expression of cytoplasmic mu chains, but not by surface immunoglobulins) produced after stimulation with bacterial lipopolysaccharide (LPS) or phorbol myristate acetate (PMA) a lymphokine activity which supported the growth of the interleukin-2 (IL-2)-dependent CTLL-2 cell line. Three pieces of evidence indicate that the secreted lymphokine was functionally and antigenically very similar, if not identical, to human IL-2: (1) The lymphokine supported the growth of murine IL-2-dependent CTLL-2 cells, which did not respond to human lymphokines other than IL-2, but it did not stimulate the growth of murine IL-3-dependent FDC-P2 cells, (2) the biological activity of the lymphokine was inhibited by monoclonal antibody (mAb) anti-human-IL-2, and (3) the proliferation of IL-2-dependent cells in the presence of the active material was completely inhibited by the inclusion of the anti-mouse-IL-2 receptor (IL-2R) mAb. Since leukemia cells of immature B-cell origin also synthesize IL-2R, the human pre-B cell leukemias could represent another type of hematological malignancy where the autocrine processes of IL-2 production and utilization are involved in the expansion of the disease.

Characterization of ferritin from spleens of patients with Hodgkin's disease (HD).

Ferritin, an iron-storing protein, was isolated from disease-involved and -uninvolved regions of spleen biopsies obtained from patients with Hodgkin's disease (HD). Ferritin from all human spleen biopsies showed a major band of polypeptide of M(r) around 20 kDa in 1D-SDS-PAGE analysis. The corresponding bands for horse spleen ferritin and apoferritin (Sigma) were at a slightly lower M(r) level. In isoelectrofocusing (IEF) studies, the pI values of human spleen ferritin from the uninvolved and involved regions were 4.55 and 4.14, respectively. These were more acidic than that of horse spleen ferritin (4.79). Human spleen ferritin from the involved region also differed from that of the uninvolved region in the pattern of CNBr-generated peptide maps in 1D-SDS-PAGE. These results suggest that the presence of Hodgkin's disease in human spleen is associated with some physiochemical changes in the tissue ferritin.

Teratogenicity of cyclophosphamide in New Zealand white rabbits.

Pregnant rabbit does received daily oral doses of 6.2 or 18.6 mg/kg cyclophosphamide (CP) on days 6-20 of gestation. On day 29, shortly before term, the uterine content was removed by Caesarean section. At the dose of 6.2 mg/kg CP maternal mortality was 2/9 does and at 18.6 mg/kg CP one abortion was recorded. Body weight gain of pregnant females was essentially unaffected by CP treatment. Both doses of CP elicited significant dose-dependent decrease of fetal body, organ (heart, lung, liver, kidney) as well as placental weight. After treatment with 18.6 mg/kg CP, gross examination of fetuses revealed significantly increased incidence of exophthalmos, cleft palate/lip, syndactyly, and brachycardia. Skeletal anomalies and malformations, significantly increased after the higher CP dose, included sternebrae, back-bone and limb defects. Oral administration of CP to rabbits in the dose of 18.6 mg/kg during organogenesis resulted in pronounced embryotoxic and teratogenic changes.

Importance of tumor size and repopulation for radiocurability of skin cancer.

Data on 946 skin cancers treated by radiation were used to estimate the importance of repopulation. Six different treatment regimes were used from a single dose to 74 Gy given in 47 fractions. High local control of the small skin cancers (L 1 cm) was independent of dose fractionation. For large tumors, only 74 Gy in 47 fractions was the optimal treatment. Time factor analysis showed a steep increase in the NTD50 values between day 28 and 65 of treatment. This implies that tumor clonogen repopulation starts around 4 weeks of treatment. The present results showed a three-component dose response curve instead of the two-component curves which were found for head and neck and bladder cancer.

Estradiol receptor and prognosis in human breast cancer and its metastases.

Follow-up of 86 patients for at least 40 months confirmed age dependency of receptor binding capacity in primary breast tumors but not in lymph node metastases. In most cases receptor binding capacity was higher in lymph node metastases than in primary tumors. Prognosis of the disease expressed as percentage of patients who survived and had a disease-free interval is related to receptor binding capacity of the primary tumors investigated. In our investigation, a value of 60 fmol/mg protein seems to be a suitable cut-off value to distinguish between breast cancer patients with good and bad prognosis. Receptor levels of lymph node metastases showed a similar behaviour as those of primary tumors related to percentage of patients who survived, but not to disease-free interval.

IgD paraproteinemias.

In a series of 2038 paraproteinemic sera, 9 IgD paraproteins (0.44%) were found. Clinical diagnosis of all the 9 was multiple myeloma. One patient had an IgD-lambda plasmacytoma which developed into plasmocellular leukemia. Our series of IgD paraproteins consisted of 6 females and 3 males with a mean age of 58.5 years. The mean concentrations of IgD paraproteins were 6.7 +/- 4.26 g/l and the mean proteinuria was 5.1 +/- 4.76 g/24 h. Eight IgD paraproteins had light chains lambda and one had light chains kappa.

Geographic variation of secular trends of breast cancer mortality in Spain.

Breast cancer mortality information contained in the available statistics derived from the Spanish death certificates has been reviewed. Mortality from breast neoplasms was grouped into three five-year periods: 1903-1907, 1931-1935 and 1975-1979. Age-adjusted rates were estimated for every province (n = 49) in each period, and confidence intervals for the standardized mortality ratios and adjusted rates were calculated. Results are presented with maps of Spain that illustrate provincial contrasts in each period. Secular breast cancer mortality trends in the provinces are discussed in comparison with those of other countries. Furthermore, values are compared with the geographical distribution of risk factors, the aim being to formulate hypothesis explaining the observed contrasts and suggesting some future research lines.

Modulation of leukosialin (sialophorin, CD43 antigen) on the cell surface of human hematopoietic cell lines induced by cytokins, retinoic acid and 1,25(OH)2-vitamin D3.

Cell surface expression of leukosialin (sialophorin, CD43 antigen) on human neoplastic hematopoietic cell lines K-562, U-937, HL-60 and REH was determined with the aid of a new CD43 monoclonal antibody (Bra7G) by the immunochemical (radioimmunoprecipitation, immunoblotting) and immunocytofluorometric techniques. Interferon-gamma and TNF-alpha were utilized as the "physiological" inducers of differentiation-associated markers. The "non-physiological" inducer phorbol ester PMA induced down-regulation of leukosialin cell surface expression on immature erythroid-myeloid leukemia cell line K-562, but up-regulation of CD43 antigen on the promyelocyte leukemia cell line HL-60 and, to a lesser extent on the monocyte-like U-937 and CALLA+ ALL cell line REH. Retinoic acid down-regulated leukosialin on both U-937 monocyte-like cells and the CALLA+ ALL cell line REH. In contrast to these data, interferon-gamma, TNF-alpha, retinoic acid and 1,25(OH)2-vitamin D3 induced the up-regulation of leukosialin in a promyelocytic leukemia cell line HL-60.

Ceftriaxone versus ceftazidime plus aminoglycoside therapy for infections in patients with neutropenia after cytotoxic chemotherapy. Short communication.

One hundred and one patients undergoing anticancer chemotherapy due to hematologic malignancy were retrospectively divided into two groups: 67 patients were treated with ceftriaxone plus amikacin, receiving once daily (od) 2-4 g ceftriaxone, 1-1.5 g amikacin (those without a peripheral or central venous catheter) and 34 patients with central or peripheral venous catheter (CPVC) receiving ceftizidime 2 g three times daily (tid) plus amikacin 0.5 g tid i.v. Both groups were similar as to their isolated pathogens, localization of infection, and basic diagnoses of hematologic malignancies. There was no significant difference in efficacy between ceftriaxone plus amikacin versus ceftazidime plus amikacin, but the toxicity was lower in once daily ceftriaxone plus amikacin group.

Erythrocyte glutathione peroxidase in patients with colon cancer.

Erythrocyte activity of glutathione peroxidase (GSH-Px) was measured in 26 patients with colon cancer and in 26 sex, age, height and weight matched controls. The patient group had a lower mean GSH-Px activity than the control group (p < 0.001). No correlation was found between glutathione peroxidase activity and sex, age, height, or weight, or between glutathione peroxidase activity and duration of the disease. The inverse correlation between the activity of this enzyme and the extent of the disease may be caused by a decreased absorption of selenium from the diseased colon. The significance of decreased GSH-Px in patients with this disease is unknown, but the possibility exists that this may further increase their risk of developing colonic cancer.

Blood transfusion and survival after surgery for stage I and II breast cancer.

The records of 690 Stage I and II breast cancer patients (31% of them with transfusions), who underwent mastectomy with axillary dissection were examined whether perioperative blood transfusion might be detrimental to survival. The overall 5- and 10-year survival rates for 477 patients who had not received transfusions were 75% and 63% respectively, compared with 66% and 49% for those who had transfusions (p = 0.005). There was no significant difference between the groups in any other of the most important prognostic factors. An analysis of the subpopulation of patients with favorable prognostic factors yielded similar results. A multivariate analysis indicated that blood transfusion was one of the four variables significantly related to survival.

Estrogen and progesterone receptor status in breast cancer in Kuwait female population.

The levels cytosol estrogen (ERc) and progesterone (PRc) receptors were determined in 315 primary breast cancers of female Arab patients aged 23-80 years. Most of breast cancers (78%) occurred in women aged 21-50 years, and only 22% were in women aged 51-80 years. Breast cancers containing ERc and PRc concentrations in the range 5-50 fmol/mg of cytosol protein (mg c.p.) were found with similar frequency in women aged under or over 50 years (53% for ERc and 43% for PRc, respectively). On the other hand, breast cancers with ERc values of > 50 and > 100 fmol/mg c.p. were twice as frequent in women aged over 50 years as in women aged under 50 years. The frequency of breast cancers with PRc level of over 50 fmol/mg c.p. in women aged over 50 years was only half that in those aged under 50 years. In breast cancers of Kuwait Arab women the higher values of ERc (> 100 fmol/mg c.p.) and PRc (> 50 fmol/mg c.p.) were less frequent than in other populations reported in literature. The low frequency of breast cancer in postmenopausal Kuwait women is associated with low proportions of tumors with higher ERc and PRc contents. In contrast to this, data from literature indicate that in the North Western European and American populations the postmenopausal incidence rise of breast cancers is associated with increased proportions of tumors with higher ERc and PRc levels.

Long-term results in hairy cell leukemia treated by splenectomy.

Splenectomy as a therapeutic modality has been evaluated in a group of 24 consecutive patients. Before and after splenectomy only supportive therapy was applied with the exception of two patients in whom corticosteroids were administered because of vasculitis. Radiation therapy was applied in one patient because of massive retroperitoneal lymphadenopathy. One patient received Leukeran shortly before the fatal outcome because his response to splenectomy was poor. Out of 24 patients 14 patients died. The median survival for the partial responders and non-responders was 6 months only. Patients with a complete response did not reach median survival yet and 8 of them (33% of the whole group) have been alive for more than 9 years, one patient for more than 20 years. Two distinct groups of patients with respect to the outcome of splenectomy can be distinguished: The first group is characterized by a rapid fatal outcome mostly within two years after splenectomy, the second group has a more favorable course with a plateau and only occasional deaths after the fourth year.