Clinical and biological characteristics of breast cancer.

PURPOSE: in view of the crucial importance of early detection and diagnosis of breast cancer for subsequent treatment and prognosis, the aim of this study was to identify clinical and biological characteristics of breast cancer at the time of diagnosis. METHODS: the study enrolled 449 breast cancer patients in Clinical Centre Nis. Results were analyzed using Student's t-test for paired and unpaired samples, chi-square test, Mantel- Haenszel test and Fisher's test of exact probability. RESULTS: The average patient age was 56.2 ± 12 years (range 23-85). Seventyhorbar;three percent of the affected women were postmenopausal and 8.3% below 40 years of age. Operable disease was identified in 78% of the cases, and metastatic in 3.6%. TNM clinical stage IIA was identified in 27.6% of the patients, T2 in 49.2% and Tis in 0.9%. Almost 44% had negative axillary lymph nodes. Most common monolocalization of metastatic disease was the liver and the supraclavicular lymph nodes, and combined localization was the liver and bones. Histologic and nuclear grades 2 and ductal carcinoma were most common. Estrogen receptor positive (ER+) status was 3-fold higher than ER negative (ER-) status. Human epidermal growth factor receptor 2 (HER2) positive patients were most commonly ER-. The most common primary tumor site was the upper lateral quadrant. Left breast was more commonly involved. Radical surgery was the most common type of operation. CONCLUSION: in view of the unfavorable age of patients at the time of diagnosis and clinical and biological tumor characteristics, the results confirmed that it is of vital importance to provide breast cancer prevention, screening, and to organize breast cancer units according EUSOMA guidelines.

Effect of thyroxine on antioxidant defense system in the liver of different aged rats.

The effects of altered thyroid state on the antioxidant defense system in the liver of differently aged rats were examined. Male rats aged 15, 45 and 75 days were treated with L-thyroxine, T(4) (40 microg/100 g body mass, s.c., one dose per day) for 14 days (finally aged 30, 60 and 90 days, respectively). The following antioxidant defense enzymes were measured: superoxide dismutases (both copper zinc, CuZn-SOD and manganese containing, Mn-SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione-S-transferase (GST), glutathione reductase (GR), as well as the content of low molecular mass antioxidant glutathione (GSH). The effect of T(4) on antioxidant defense system in the liver differs with respect to age. T(4) treatment decreased CAT and GST activities, as well as the content of GSH in animals aged 60 and 90 days. The same treatment elevated GR activity in rats at 30 days of age, this phenomenon was not observed in older animals. The different response of immature rats to thyroxine compared to older animals could be attributed to the differences in thyroxine metabolism and the developmental pattern. Direct effect of T(4) on mature rats can be considered as a part of its overall catabolic action.

Elevated serum uric acid reduce heart damage in patients undergoing opern-heart surgery.

OBJECTIVES: Peroxynitrite is species claimed to propagate ischemia/reperfusion damage. In this report levels of serum uric acid (UA), a peroxynitrite scavenger, are compared with creatine phosphokinase (CPK) in male patients before and after open-heart surgery in order to asses if increased levels of UA may protect heart from biochemical damage induced by peroxynitrite during the coronary by-pass grafting (CABG) intervention. METHODS: 45 male patients (16 carvedilol pretreated (6.25 mg/ daily, during 6 weeks before surgery, mean age 55.3+/-1.7 years, range 50-71) and 29 patients without carvedilol pretreatment (mean age 58.3+/-1.4 years, range 47-73) underwent elective CABG were examined. Study inclusion criteria were CABG performed on two and more coronary-vessels with aortic cross-clamp during 30-40 minutes. For assessment of patients objective health status before operations EuroSCORE were used. Serum uric acid (UA) levels and creatine phosphokinase (CPK) were measured spectrophotometricaly by using a quantitative enzymatic assay. RESULTS: Carvedilol pretreated patients had higher amount of serum UA (p<0.05) comparing to non-treated patients. During the surgical procedure patients are subjected to temporary ischemia due to transfer from corporeal to extracorporeal circulation. In this period of time the amount of UA decreased in carvedilol pretreated group (406+/-46 (tl) vs. 300+/-22 mmol/L (t2)) to the level of non-treated patients (328+/-14 (t1) vs. 322+18 mmol/L. Carvedilol pretreated patients and non-treated patients had the same level of CPK at the beginning of the surgical procedure (tl) (78+/-6 vs. 83+13 U/L) but lower increase (p<0.05) in CPK activity in carvedilol pretreated patients in respect to non-treated patients (338+46 vs. 644+103 U/L) at the end of procedure (t2). Such results suggest that open heart surgery led to elevated CPK levels, but this effect was less pronounced in patients with higher level of UA. CONCLUSIONS: Our results suggest possible role of UA in the protection from reperfusion injury. Increase of UA before surgery may be beneficial factor during CABG procedure in patients treated with carvedilol by decreasing level of peroxynitrite as one of molecular causes of reperfusion injury. Our results showed influence of UA on CPK levels at the end of surgical procedure, indicating that increased levels of UA may protect heart from biochemical damage induced by peroxynitrite during the CABG intervention.

Antioxidative defense in human myocardial reperfusion injury.

The activity of glutathione peroxidase (GSH-Px) as well as the activities of other antioxidative enzymes such as CuZn superoxide dismutase (CuZn SOD), catalase (CAT), glutathione reductase (GR) in erythrocytes, the plasma activity of glutathione-S-transferase (GST), and the plasma levels of vitamin E and vitamin C were evaluated in nine patients with acute myocardial infarction (AMI). Blood samples were taken before and 1, 3, 6, and 24 hours after the institution of thrombolytic therapy. The results were compared with those in 30 healthy volunteers. A significant decrease in catalase (CAT) activity and vitamin E content in patients before and after thrombolytic therapy as compared with controls was recorded. Our results confirmed that a disturbed oxidative/antioxidative balance is present after AMI and after thrombolytic therapy.

[Subclinical disorders of left ventricular function in diabetics detected by echocardiography]. / Supklinicki poremecaj funkcije leve komore srca kod dijabeticara otkriven ehokardiografskim ispitivanjem.

In diabetic patients, without coronary heart disease and hypertension, left ventricular filing dysfunction exist, that is registered by echocardiography. It is manifested as greater peak flow velocity during atrial systole and as shorter time from the aortic second heart sound to the peak of the early diastolic flow velocity curve. The diastolic dysfunction indicates increased left ventricular stiffness and may be the first maker of diabetic cardiomyopathy.