Stress protein Hsp27 expression predicts the outcome in operated small cell lung carcinoma and large cell neuroendocrine carcinoma patients.

PURPOSE: Heat shock protein (Hsp)27 is overexpressed in a range of human cancers and is implicated in tumor cell proliferation, differentiation, invasion, metastasis, and survival. The aim of the present study was to determine the prognostic significance of Hsp27 expression in small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). METHODS: Surgically resected SCLCs (N=51) and LCNECs (N=15) were studied. The Hsp27 expression was detected immunohistochemically. RESULTS: Hsp27 positive immunoreaction in the cytoplasm was observed in 45 (88%) SCLCs and 14 (93%) LCNECs. A combination of cytoplasmic with nuclear Hsp27 expression was observed in 28 (62%) SCLCs and 14 (100%) LCNECs. There was a correlation between Hsp27 cytoplasmic overexpression and Hsp27 nuclear expression with patient survival confirmed by Cox multivariate analysis. CONCLUSION: We conclude that the higher Hsp27 cytoplasmic expression and nuclear expression may represent favorable prognostic factors in SCLC and LCNEC.

[Major respiratory tract traumas]. / Travmi na magistralnite vuzdukhonosni putishta.

Between 1988 and 2000 a total of 33 patients with traumatic tracheobronchial lesions were diagnosed and treated. The trauma was penetrating in 7 (stab and gun-shot), blunt in 10 (car accidents, compression and falling from heights) and iatrogenic in 16 of them (postintubational--15, after foreign body extraction--1). The main clinical and radiological features were subcutaneous emphysema, hemoptysis, respiratory insufficiency, pneumomediastinum and pneumothorax. The diagnosis was confirmed in all patients by early fiberoptic bronchoscopy. "Watch and see" tactics with massive antibiotics therapy was followed in 4 (12%) patients. A surgical treatment was carried out in 29 (88%) patients as follows: simple repair--19 (58%), left pneumonectomy--2 (6%), tracheal resection and anastomosis "end to end"--2 (6%), tracheostomy--1 (3%), thoracocenthesis and drainage--3 (9%) and cervical mediastinotomy--2 (6%). The operative mortality was 9%. The cause of death in these 3 patients were associated brain and spinal cord injuries. In the rest of patients the early and long-term postoperative results were considered very good.

Transbronchial needle aspiration in the staging of bronchogenic carcinoma.

To evaluate the usefulness of transbronchial needle aspiration biopsy (TBNA) for the diagnosis of mediastinal involvement, we have prospectively examined 316 patients with morphologically verified bronchogenic carcinoma. The percentage of positive aspirations (149 of 316) from the three basic lymph node groups in the mediastinum was not significantly different. Tumor cells were aspirated from the mediastinum in 75 of 112 patients with radiologically positive findings and in patients with 74 of 204 radiologically negative findings. Mediastinal involvement was verified even in 61 of 196 patients with a normal endoscopic picture. Metastases were proved in 14 of 39 patients with peripheral versus 135 of 277 patients with central carcinoma. Tumor cells were aspirated in 47 of 76 patients with undifferentiated small cell carcinoma, 92 of 227 patients with squamous cell carcinoma, and 10 of 13 patients with adenocarcinoma. Our results suggest that TBNA being a highly diagnostic and less invasive method, will prove its clinical importance.

Photodynamic therapy in lung and gastrointestinal cancers.

Twelve central bronchial carcinoma patients and two gastrointestinal (GI) tract (oesophageal and colonic) early-stage cancer patients were treated with photodynamic therapy (PDT). Haematoporphyrin (HP/5, Jacopo Monico, Italy) at a dose of 5 mg kg-1 body weight was used as photosensitizer. Laser light at 628.2-630 nm generated by two different laser systems (gold vapour laser (I.P. Optics, Sofia, Bulgaria) in lung cancer cases and an argon dye laser system (Spectra Physics, Mountain View, U.S.A.) in GI tract cancers) was used. Lung cancers were irradiated 48 h after drug administration and GI tract cancers were irradiated 72 h after infusion of the photosensitizer. Both tumour sites were treated with a total energy dose in the range 350-600 J cm-2. Efficiency of PDT in lung cancer was evaluated by X-rays and endoscopic and functional respiratory tests for bronchial de-obstruction. Complete remission after PDT of GI tract cancers was considered to be tumour eradication (histologically and cytologically proved) and a tumour-free interval of at least 12 months.

[The somatotype and fatty body weight of medical students]. / Somatip i mastna telesna masa pri studenti meditsi.

The somatotype was determined of 247 healthy students of medicine, male Bulgarians, average age 22, according to the method of Heath and Carter. More than half of the examined subjects (55,9%) was established to belong to the group of mesomorphy with a predomination of the subgroup of endomorphic mesomorphy. The other morphological structures are presented in comparatively identical shares. The fatty body mass, being 16,29 per cent of the total body mass of the subjects studied was determined to the same subjects according to the method of Möhr and Milev. It was established that the fatty body mass was within the physiological limits among the students from the group of ectomorphy and from the group with balanced mesomorphy, non-manifested obesity had the subjects with ectomorphic endomorphy, endomorphic mesomorphy and with central somatotype and with manifested obesity--the students with balanced and mesomorphic endomorphy.

[Clinical biochemical changes in ischemic heart disease: hyperuricemia as a risk factor]. / Kliniko-biokhimichni promeni pri bolni s IBS: khiperurikemiiata kato riskov faktor.

One hundred and sixty patients with IHD were examined--73 males and 87 females, average age for males--58.58 +/- 12.69 and for females--59.65 +/- 7.76. Elevated levels of uric acid were found in 51.5 per cent. The correlation analysis showed a positive correlation dependence between total fats and uric acid, between cholesterol and uric acid as well as between total protein and uric acid and reverse dependence between uric acid and alpha 2-globulines, beta and gamma globuline fractions. The results from the investigations carried out provided grounds to admit hyperuricemia to be one of the risk factors of IHD.

Effect of a sarcolysin-containing polymer on the the lymphatic tissues and immune response to sheep red blood cells.

The influence on the size of lymphoid organs and immune response to sheep erythrocytes in BALB/c mice of an effective antitumor polymer preparation, a compound of sarcolysin with a copolymer of vinylpyrrolidone and maleic anhydride (SVPMA) was studied. A significant reduction in the weights of the thymus and spleen, and in the serum hemagglutinin titers as well as a slight decrease in the number of spleen rosette-forming cells were observed on animals receiving sarcolysin rather than on animals receiving SVPMA when compared with each other as well as with a control group of mice. Moreover a significant stimulating effect on the size of the lymph nodes and partly on the spleen was seen in the mice treated with SVPMA. These results, therefore, provide additional evidence on the possibility to obtain, on the basis of synthetic polymers, effective antitumor preparations with minimal or no immunodepressive properties.

Spontaneous rosette formation in patients with oral cancer.

The percentage of "total" E-rosettes was studied in the peripheral blood of 38 untreated patients with squamous cell carcinoma of the oral cavity, performing the test at 4 degrees C and at 20 degrees C. At 4 degrees C the quantity of the E-rosettes was higher than at 20 degrees C. The mean value of E-rosettes was strongly reduced only in 17 of these patients with metastases in the regional lymph nodes when compared with a group of 40 normal individuals as well as with the group of remaining 21 patients with localized cancer (P less than 0.001), whatever the temperature of testing. The mean percentage of 20 degrees C E-rosettes was significantly higher in patients with localized disease than in the 22 normal donors (50.2 +/- 3.0% vs 41.8 +/- 2.0%, P less than 0.01) but in favour of 4 degrees C E-rosettes the difference was not significant (57.3 +/- 2.8% vs 54.2 +/- 2.9%). Thus there was a clear correlation between changes of the T cell level and the clinical stage of the disease.

Comparative study of the effects of treatment with diethyleneiminebenzoquinone and its polymer complex with polyvinylpyrrolidone on the primary response of mice to sheep red blood cells.

The primary response of BALB/c mice to sheep red blood cells was used to study comparatively the time-dependent effects of a 5-day course of treatment with equivalent doses (0.8 mg/kg of body weight every day) of the cytotoxic agent diethyleneiminebenzoquinone (DEiBq) and its polymer complex with polyvinylpyrrolidone (DEiBqPVP). The experimental results show that in contrast to treatment with DEiBq, the ability of treated mice to establish a specific immune response was not markedly impaired during the treatment with DEiBqPVP. The possible significance of these results is considered with reference to the use of the synthetic polymer PVP as a carrier of cytotoxic groups in experimental cancer chemotherapy.

[Immunodepressive properties of diethyleneimine benzoquinone-containing polyvinylpyrrolidone complexes]. / Imunodepresivni svoistva na dietileniminbenzokhinon-sudurzhashti kompleksi na polivinilpirolidona.

The authors examined the changes, which occurred in the weight of lymphoid organs (thymus, spleen, and lymph nodes) and titre of serum hemagglutinines against sheep erythrocytes in mice BAIB/c under the influence of treatment with diethyleniminbenzochinon and some of its complexes with polyvinylpirolidon (PVP). The ratio of the substances composing the complexes (in mg per 1000 mg of complex) was as followed: DEiBx- PVP complex NoI-340:660; DEiBx-PVP complex No2-200:800; DEiBx-PVP-Uracyl complex No3-250:500:250. There was a sharp reduction of the weight of lymphoid organs in mice, treated with DEiBx, singly or in the form of complexes NoI and No2 in comparison with the control nontreated mice or treated with complex No3. This effect was more manifested after treatment with DEiBx during the same regimen (0.8 mg/kg of body weight daily for 5 days). The ability of the treated animals to react to immunization with sheep erythrocytes practicaly was not impaired during the treatment with complexes No2 and No3 or the damage was slight (complex NoI) in contrast to the treatment with DEiBx.

[Immune response to sheep erythrocytes fixed in formaldehyde]. / Imunen otgovor kum ovneshki eritrotsiti, fiksirani s formaldekhid.

Treatment of sheep erythrocytes with 1.5% of formaldehyde alter their immunogenic properties. On the background of immune response to nonfixed erythrocytes, the performed studies showed the following peculiarities in the reaction of mice to fixed erythrocytes: 1) the primary response of animals, in ected with fixed erythrocytes, was rather weak after its determination by the number of rosette forming cells (RFC), antibody forming cells (AFC) in the spleen and by the of hemagglutinins (HA) in serum; 2) in contrast to the primary response the fixed erythrocytes induced a good secondary response, which was considerably higher/according to the number of RFC and titre of HA/in mice sensibilized by nonfixed erytrocytes in advance than in those presensibilized by fixed cells. Therefore the fixed erythrocytes were weaker inducers of immunologic memory than the nonfixed under equal other conditions. 3) In contrast to the nonfixed the fixed erythrocytes did not induce the formation of large amounts of direct AFC during the secondary response as well even then when the animals were presensibilized by nonfixed form of the antigen.

[Use of an immunofluorescence method and a flocculation test with DNA-sensitized bentonite particles in the serodiagnosis of disseminated lupus erythematosus (SLE)]. / Prilozhenie na imunofluorestsentniia metod i flokulatsionniia test s DNK-sensibilizirani chastitsi bentonit v serodiagnostikata na diseminiraniia lupus eritematodes (LED).

The determination of antibodies against native DNA is of great importance in the solution of the diagnostic and therapeutic problems of dissiminated lupus erythematodes. The practical results are in a direct dependence on the laboratory methods for their determination. The diagnostic significance of two methods was studied with the present investigation: indirect immunofluorescent test and flocculation test with DNA-sensibilized bentonite particles. Under the conditions of the investigation, with the aid of the first method, antibodies against native DNA were found in 86.1 per cent of the sera of lupus nephropathy patients as well as in 13.3 per cent of the sera of patients with renal diseases not associated with LED. High serum titres including up to 1/128, were observed only in LED cases. The continuous persistence of antibodies against LED is also characteristic for the latter. The flocculation test was positive in 60.7 per cent of the sera investigated only with LED cases. The conclusion is that both methods could more wisely be used in LED immunodiagnostic because they combine high sensitivity with specificity of reaction, are easy to perform and no expensive material and apparatuses are required.