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Chromium and manganese levels in the scalp hair of normals and patients with breast cancer

The adverse health effects linked with chromium and manganese and the diverse cellular and molecular effects of chromium and manganese make the study of chromium and manganese carcinogenesis and toxicology very interesting and complex. Quantitative elemental analysis of scalp hair of breast cancer patients (stage III) (n=26) and controls (n=27) were used to study to find correlation and possible changes between breast cancer and healthy controls. The graphite furnace atomic absorption analysis of quantitative method was used for the determination of chromium and manganese element levels. Comparison of mean elemental contents of the breast cancer patients with controls shows a significant enhancement of chromium (p<0.05) but declining trends for manganase (p<0.05) in breast cancer patients. Changes in element content in hair can serve as a guide to opening up new vistas in the treatment of breast cancer on the basis of an overall analysis of symptoms and signs.

Use of Olive Oil Based Emulsions as an Alternative to Soybean Oil Based Emulsions in Total Parenteral Nutrition and Their Effects on Liver Regeneration following Hepatic Resection in Rats

Background/Aim: The main objective of this study was to compare the effects of olive oil to those of soybean oil on liver tissue regeneration following hepatic resection in rats. Methods: Seventy albino Wistar rats were randomly assigned to seven groups which contained 10 rats each. Group 1 was the sham-treated group; groups 2 and 3 received total parenteral nutrition (TPN) containing soybean oil lipid emulsions (20% Lipofundin MCT/LCT) for 48 or 72 h; groups 4 and 5 received TPN containing olive oil (80%)/soybean oil (20%) lipid emulsions (ClinOleic 20%) for 48 or 72 h; group 6 was the control group for 48 h, and group 7 was the control group for 72 h. TPN was given via internal jugular vein, and 70% hepatic resection was performed in the study groups. In addition, hepatic resections with no TPN were performed in the control groups, except the sham group. Relative liver weight, mitotic index, proliferating cell nuclear antigen labeling index, and carnitine levels in liver tissue samples were used to assess hepatic regeneration. Thiobarbituric acid reactive substances were measured as an index of lipid peroxidation and oxidative tissue damage. Alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase were parameters for the liver function. Results: The relative liver weight increased significantly with minimal hepatosteatosis in the olive oil treated groups. Lipid peroxidation significantly decreased with near-normal serum levels of the liver function parameters in the olive oil/soybean oil treated groups, and mitotic index and proliferating cell nuclear antigen labeling index reached their maximum level in rats receiving TPN containing any kind of lipid emulsions for 48 h following resection. Conclusions: The use of olive oil/soybean oil lipid emulsions in TPN has important beneficial effects on the liver regeneration, and the antioxidant properties of olive oil originating from its natural components indirectly contribute to the liver regeneration in rats.

Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies

Background: One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients. Methods: A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression. Results: The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon. Conclusion: TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres.

Methylation status of CpG islands at sites -59 to +96 in exon 1 of the BRCA2 gene varies in mammary tissue among women with sporadic breast cancer.

Germline mutations of the BRCA2 gene on chromosome 13q12-13 predispose humans to the development of earlyonset breast cancer and ovary cancer (Wooster et al. 1995). Most germline mutations in BRCA2 are predicted to result in truncation (Wooster et al. 1995; Tavtigian et al. 1996) and hence, inactivates the critical functions of the encoded protein (Shamoo 2003). Tumours arising in carriers of BRCA2 germline mutations usually exhibit loss of heterozygosity (LOH) of chromosome 13q polymorphic markers flanking BRCA2. The allele lost is the wild-type allele inherited from the nonmutation-carrying parent (Collins et al. 1995), a pattern that is characteristic of a tumour-suppressor gene and that is predicted to result in the absence of the functional protein in the tumour cell. In addition to germline mutations, many cancer predisposition genes including RB1, p53, NF-2, APC, WT1 (Fearon 1997), VHL (Shuin et al. 1994) NF-1 (Li et al. 1992) and MTS1 (Caldas et al. 1995) are somatically mutated in sporadic cancers. These somatic mutations are usually associated with a high frequency of LOH near the susceptibility gene, relevant to the sporadic cancers. Loss of heterozygosity at the BRCA2 locus has been observed in 30%–40% of sporadic primary breast cancers (Callens et al. 2003) and approximately 50% of sporadic primary ovarian cancers (Takahashi et al. 1996). However, exhaustive analyses of many sporadic breast, ovarian and other cancers have indicated that somatic mutations in BRCA2 gene are very rare (Collins et al. 1997).

Thyroid Metastasis from Gastric Carcinoma: Report of a Case

Abstract Thyroid metastasis from gastric carcinoma is rare. In this report, we describe the case of a patient in whom a rapidly growing thyroid metastasis was found 3 months after an operation for gastric carcinoma.

Intra-Abdominal Gallstone Spillage Detected During Umbilical Trocar Site Hernia Repair After Laparoscopic Cholecystectomy: Report of a Case

Abstract It is well known that spilled gallstones may occur as a complication during laparoscopic cholecystectomy. We present herein the case of a patient in whom intra-abdominal gallstone spillage was found during repair of an incisional hernia at the umbilical trocar port site 3 months after a laparoscopic cholecystectomy. We describe this case and present a review of the recent literature to stress the importance of preventing stone spillage and retrieving any stones that are spilled into the abdomen.

The Effects of Dimethylsulfoxide in Experimental Obstructive Jaundice

Abstract Material and methods: Thirty rats were divided into three groups, as sham, control and DMSO groups. Laparatomy was performed on each animal in the control and DMSO groups and common bile ducts were ligated. Common bile duct was observed but was not ligated for the rats in the sham group. Saline solution injection (1.5 mg/kg/intraperitoneally (ip)) was begun on the first day of surgical procedure and repeated once a day for the next 5 days. The same procedure was performed with DMSO (1.5 mg/kg/ip) instead of saline in the DMSO group. The rats were sacrificed on the postoperative seventh day, at which time venous blood and liver tissue specimens were taken. Main outcome measurements: On the 7th postoperative day, the bilirubin, AST, ALT, ALP and GGT levels of the control and DMSO groups were significantly higher in comparison with the sham group (p < 0.01). On the 7th postoperative day, the erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels of the control and DMSO groups were significantly lower than those of the sham group (p < 0.01), but there was no statistical difference between the two groups (p > 0.05). Erythrocyte and liver malondialdehyde (MDA) levels in the control and DMSO groups were significantly higher compared with the sham group (p < 0.01). However, the MDA levels were significantly lower in the DMSO group compared to the control group (p < 0.01). Conclusion: It is stated that free oxygen radicals seem to play a role in the liver tissue injury, secondary to obstructive jaundice. In our experimental study, exogenic DMSO seems to have decreased lipid peroxidation and to have improved some of the parameters of liver tissue injury due to the obstructive jaundice in rats.

Development of Collaterals in Intermittent and Permanent Ischemia of the Liver

The ischemia caused by hepatic dearterialization as therapy for hepatic malignancies is transient because of the rapid formation of collaterals. In order to prevent this transient repeated ischemia has been suggested. An experimental study was planned to compare the collateral occurrence in persistent ischemia and transient repeated ischeamia of the liver. Fourteen dogs (seven persistent ischemia, seven transient repeated ischemia) were used in this study. Hepatic dearterialization were performed in both groups. In the first group (persistent ischemia), the hepatic artery was ligated proximal to the gastroduodenal artery. In the second group (transient repeated ischemia), the hepatic artery was occluded externally in the same region as the first group by means of a device modified from 8 guage Foley catheter and after occlusion for one hour it was reopened. Occlusions were repeated twice in a day. Five dogs in the first group and six dogs in the second group completed a three weeks ischemia period and angiography were then performed in all. The dogs were sacrificed after the angiography and examined for possible abscess formation, arterial thrombosis, peritoneal adhesions and liver necrosis. After angiography, the two groups were also examined for collateral occurrence. Only one collateral occurred in the transient repeated ischemia group, but in the persistent ischemia group, collaterals occurred in all dogs. This difference between two groups is statistically significant (Fischer Absolute Chi Square Test, p=0.013). Transient repeated ischemia is superior to persistent ischemia because of fewer collaterals, but in practise, total dearterialization of the liver is impossible.

Prediction of nonsentinel lymph node metastasis in breast cancer patients with one or two positive sentinel lymph nodes

OBJECTIVE The aim of the present study was to investigate the association between non sentinel lymph node metastasis (NSLNM) and clinicopathological factors, particularly in the case of sentinel lymph node (SLN) metastasis in one or two, in clinically node negative patients with breast cancer. METHODS Between 10/2010 and 10/2014, 350 sentinel lymph node biopsy (SLNB) were performed in patients with histologically proven primary breast cancer in our clinic. The data collection includes the following characteristics: age, pathological tumor size, histological type, histological grade, lymphovascular invasion (LVI), number of positive SLN, size of the SLN metastasis (macrometastasis, micrometastasis, isolated tumor cells), multifocality (MF), extracapsuler invasion (ECI) of the SLN, the estrogen receptor (ER) status, the progesterone receptor (PR) status and the Her 2 receptor status, Ki 67 reseptor status. Data were collected retrospectively and then analyzed. RESULTS A successful SLN biopsy were performed in 345 (98.5%) cases. SLN metastases were detected in 110 (31.8%) cases. These patients then underwent axillary dissection; among these patients, 101 (91.8%) had only one to two positive SLNs. Of the 101 patients with positive SLN biopsies, 32 (31.6%) had metastases in the NSLNs. Univariate and multivariate analysis showed that lymphovascular invasion, extracapsular invasion (ECI), Her-2 receptor positive, and Ki-67 > 14% were related to NSLNM (p<.0.05). CONCLUSION The predicting factors of NSLNM were LVI, ECI, Ki-67 level, Her-2 reseptor positive and but should be further validated in our institutions, different institutions and different patient groups prospectively.

Correlations Between Oncotype DX Recurrence Score and Classic Risk Factors in Early Breast Cancer: Results of A Prospective Multicenter Study in Turkey

OBJECTIVE Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the correlations between Recurrence Score (RS) and routine risk factors. MATERIALS AND METHODS Ten academic centers across Turkey participated in this prospective trial. Consecutive patients with breast cancer who had pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at tumor conferences. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classic risk factors were evaluated using univariate and multivariate analyses. RESULTS Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of the 165 patients, 57% had low RS, 35% had intermediate RS, and 8% had high RS, respectively. Multivariate analysis indicated that progesterone receptor (PR) and Ki67 scores were significantly related to RS. CONCLUSION Oncotype DX Recurrence Score does not seem to have a significant correlation with the majority of classic risk factors, but it may have a correlation with PR score and Ki67 score.