Macrophage level is not affected by monocyte chemotactic protein-1 in invasive ductal breast carcinoma.

PURPOSE AND METHOD: Monocyte chemotactic protein-1 (MCP-1) is a chemokine involved in the macrophage infiltration of tumor tissue. Tumor-associated macrophages (TAMs) are a population of mononuclear phagocytic cells that can have a complex function in tumor biology. The aim of this study was to determine the possible correlation between parenchymal MCP-1 expression and TAM level by immunohistochemical analysis of 97 invasive ductal breast carcinomas, not otherwise specified (NOS), and to investigate their relation with tumor size, histological grade, mitotic activity index (MAI) and lymph node status. Secondly, the MCP-1 mRNA was determined by reverse transcriptase-polymerase chain reaction (RT-PCR) in eight samples of normal breast tissue and 27 samples of invasive breast carcinomas and compared with TAMs. RESULTS: MCP-1 immunoreactivity was present in tumor cells (17/97), but also in TAMs, fibroblasts and endothelial cells. The statistical analysis did not show a significant correlation between MCP-1 expression in tumoral epithelium and tumor size, histological grade, MAI, lymph node status or TAMs. The results of RT-PCR showed that, in all cases of breast carcinomas (27/27) and the majority of normal breast tissues (7/8), the number of detected MCP-1 cDNA copies was above the detection limit. However, carcinomas showed higher levels of MCP-1 mRNA than normal breast tissue. Nevertheless, the statistical analysis did not find a significant correlation between MCP-1 expression and macrophage infiltrations. CONCLUSION: These results indicate that MCP-1 is probably not the only and/or crucial factor involved in macrophage attraction to tumor locus in breast carcinoma.

[Lethal rupture of an echinococcal cyst of the liver]. / Perforation eines Leberechinokokkus mit Todesfolge.

A 50-year-old man is admitted to the hospital emergency service because of a 24-hour history of right abdominal pain. Ultrasound examination and laboratory tests suggest the perforation of an Echinococcal cyst situated in the subcapsular area of the right hepatic lobe. The patient and his family refuse the recommended hospitalisation and operation and leave the hospital on their own responsibility. 60 hours later the patient dies. Post-mortem examination confirms the diagnosis of a perforated hydatid cyst of the right hepatic lobe. The cause of death was a partly fibrino-purulent, partly nodular peritonitis including the area of liver rupture.

[Transthoracic truncal vagotomy as an operation necessary in peptic ulcer of the jejunum]. / Transtorakalna trunkalna vagotomija kao operacija iz nuzde kod peptickog ulkusa jejunuma

Peptic ulcers require radical surgery in most cases, typically involving resection of the gaster and a vagotomy. However, as post partial gastrectomy recidive peptic ulcers are usually recistant to internal treatment, and since often patients so afflicted are in poor physical condition, the surgeon must choose the least radical procedure. Because of this, the authors feel that in cases of perforative and/or bleeding peptic ulcers of the jejunum, the transthoracic truncal vagotomy in the procedure which is least taxing for both the patient and surgeon. The operation is short, easy to perform and does not considerably alter the condition of the patient. To date, at the Surgical Clinic of the "Braca Dr. Sobol" Hospital (Rijeka), on about 2000 gastric resection, only 11 transthoracic truncal vagotomies, as exclusiv operations, were performed. Postoperatively, these patients were supervised several months to ten years or longer. In all cases the pain and bleeding subsided. For these reasons, the authors recommend this minimal but necessary operation.