Circulating tumor cells in breast cancer: methodology and clinical repercussions.

Breast cancer is the most common type of cancer among women, and clinicians have long recognized its heterogeneity. Its detection and treatment in early stages allow for reduction of mortality. Despite the advances and new strategies for combining surgical, radiotherapy, and chemotherapy options, however, the percentage of patients developing metastases and advanced stages remains high. Even though serum tumor markers have been used for the early diagnosis of metastases, their systematic determination has not had an effect on survival. Methods that are more reliable are needed to detect metastases earlier than with the common clinical methods and thus start treatment before overt relapse. Early indicators of response or resistance to treatment are also an issue in clinical practice. Imaging techniques are time consuming, and it is difficult to detect changes that indicate response limited to therapy, and approaches to defining changes in tumor mass are time and resource consuming. In contrast, detection of circulating tumor cells (CTC) could be a useful tool in early detection of relapse and response to systemic chemotherapy. Extremely sensitive techniques are available that are easily applied to peripheral blood samples, which might provide enormous research possibilities in this area.

Circulating tumor cells in breast cancer: methodology and clinical repercussions

Breast cancer is the most common type of cancer among women, and clinicians have long recognized its heterogeneity. Its detection and treatment in early stages allow for reduction of mortality. Despite the advances and new strategies for combining surgical, radiotherapy, and chemotherapy options, however, the percentage of patients developing metastases and advanced stages remains high. Even though serum tumor markers have been used for the early diagnosis of metastases, their systematic determination has not had an effect on survival. Methods that are more reliable are needed to detect metastases earlier than with the common clinical methods and thus start treatment before overt relapse. Early indicators of response or resistance to treatment are also an issue in clinical practice. Imaging techniques are time consuming, and it is difficult to detect changes that indicate response limited to therapy, and approaches to defining changes in tumor mass are time and resource consuming. In contrast, detection of circulating tumor cells (CTC) could be a useful tool in early detection of relapse and response to systemic chemotherapy. Extremely sensitive techniques are available that are easily applied to peripheral blood samples, which might provide enormous research possibilities in this area (AU)

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Regional reference values for some quantities measured with the ADVIA Centaur analyser. A model of co-operation between the in vitro diagnostic industry and clinical laboratories.

This work is a model of co-operation between the in vitro diagnostic industry and clinical laboratories for the production of reference values. Thirteen clinical laboratories having an ADVIA Centaur analyser and representing the majority of the geographical regions of Spain have shared the search for reference individuals and the production of reference values for thyrotropin, free thyroxine, free triiodothyronine, cobalamine and folate concentrations in serum. All the logistic work has been done in co-operation with the Spanish supplier of the ADVIA Centaur analyser. The reference limits produced in the virtual laboratory are derived from the blend of reference values obtained by each laboratory. The multicentre reference limits were estimated according to the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).

[Commentary on the decision of the Constitutional Court of June 17, 1999 resolving the Recourse of Inconstitutionality no. 376/89 against the 35/1988 law of November on assisted reproduction techniques]. / Comentario a la Sentencia del Tribunal Constitucional de 17 de Junio de 1999 resolviendo el Recurso de Inconstitucionalidad no 376/89 contra la Ley 35/1988 de 22 de Noviembre sobre Técnicas de Reproducción Asistida.

The author discusses the ruling by the Spanish Constitutional Court (116/99, 17 June) in the matter of the challenge on grounds of alleged inconstitutionality lodged against the Law on Assisted Reproduction Techniques back in 1989. Other circumstances concerning the application and development of said law are examined also and a detailed critical study is made of the legal points used in the Ruling. The article concludes with some thoughts on the main issues arising therefrom.

Endoscopic enhancement of the healing of high-risk colon anastomoses by low-power helium-neon laser. An experimental study.

Recent studies suggest that helium-neon (He-Ne) lasers at low energy can enhance wound healing in intestinal anastomoses. In this experimental study, we tested the strength and collagen concentration of high-risk anastomoses of the rat colon after endoscopic irradiation by helium-neon laser. Our results show that repeated helium-neon laser irradiation (1.9 J/cm2) increases the bursting strength of the anastomoses by almost 100% on the fourth postoperative day. This effect is not observed by increasing the radiation dose (6.4 J/cm2). Differences in collagen (hydroxyproline) concentration did not reach statistical significance.

[4 families with silent cholinesterase variant]. / Estudio de cuatro familias con variante colinesterásica silente.

We report 4 patients who had apnea of variable duration after succinylcholine administration to facilitate orotracheal intubation during anesthesia. After ruling out other causes of apnea unrelated to succinylcholine, we genotyped the cholinesterase variants of these patients and their relatives measuring total plasmatic cholinesterase activity and using the inhibitors dibucaine and fluoride. We found the silent gene (Es1) both in homozygosis (2 cases) and heterozygosis, with the atypical gene (Ea11) (2 cases). The relevance of preoperative screening to prevent anesthetic accidents is emphasized.