Mortalidad y frecuencia hospitalaria de tumor maligno de mama en Extremadura (2002-2004) / Mortality and hospital utilization due to breast cancer in Extremadura, Spain (2002-2004)

Objetivo. Obtener información actualizada acerca de la mortalidad por cáncer de mama y frecuentación hospitalaria en la Comunidad Autónoma de Extremadura. Método. Estudio transversal, retrospectivo, de la situación del cáncer de mama en Extremadura. Se utilizaron como fuentes de información del estudio, el registro de mortalidad y el conjunto mínimo básico de datos al alta hospitalaria. Se presentan medias y desviaciones estándar (DE). Se calcularon las tasas crudas, específicas por edad, y estandarizadas de mortalidad y frecuencia hospitalaria por 100.000 mujeres. También se calcularon los añospotenciales de vida perdidos. Resultados. En el período de estudio se han producido 413 defunciones, 1.233 historias hospitalarias y 1.809 altas en mujeres por tumor maligno de mama. La edad media de defunción y alta hospitalaria han sido 70 (DE = 14,9) y 59,9 (DE = 14,3) años, respectivamente, y la estancia media en el hospital ha sido 8,9 días (DE = 6,3). Se han perdido 3.423 años potenciales de vida. El área de salud de Llerena es la que presenta mayores tasas de mortalidad, mientras que las menores las presenta el área de Coria. Conclusiones. El patrón de mortalidad por cáncer de mama en Extremadura es típico de los países desarrollados con una mayor mortalidad en los grupos de edad mayores. La tasa ajustada por edad es inferior a la de España en el período 1996-2000 (AU)

Objective. To provide an update on breast cancer mortality and hospital utilization in the autonomous region of Extremadura (Spain). Method. We performed a retrospective, cross-sectional study of breast cancer in Extremadura, using the minimum data set and the death register as data sources. The means and standard deviation (SD) are presented. Crude, age specific, and standardized mortality rates were calculated and expressed as rates per 100,000 women. The potential years of life lost were also calculated. Results. In the period studied, there were 413 deaths, 1,233 hospital admissions, and 1,809 discharges due to malignant breast disease. The mean age at the time of death and hospital discharge was 70.0 years (SD 14.9) and 59.9 years (SD 14.3), respectively. The mean length of hospital stay was 8.9 days (SD 6.3). A total of 3,423 potential years of life were lost. The highest mortality rates of breast cancer were observed in the health area of Llerena and the lowest in the health area of Coria. Conclusions. The pattern of breast cancer mortality in Extremadura is typical of developed countries with highermortality among older age groups. The aged-adjusted rate in Extremadura is lower than that in Spain for the period 1996-2000 (AU)

Atomic force microscopy study of living diatoms in ambient conditions.

We present the first in vivo study of diatoms using atomic force microscopy (AFM). Three chain-forming, benthic freshwater species -Eunotia sudetica, Navicula seminulum and a yet unidentified species - are directly imaged while growing on glass slides. Using the AFM, we imaged the topography of the diatom frustules at the nanometre range scale and we determined the thickness of the organic case enveloping the siliceous skeleton of the cell (10 nm). Imaging proved to be stable for several hours, thereby offering the possibility to study long-term dynamic changes, such as biomineralization or cell movement, as they occur. We also focused on the natural adhesives produced by these unicellular organisms to adhere to other cells or the substratum. Most man-made adhesives fail in wet conditions, owing to chemical modification of the adhesive or its substrate. Diatoms produce adhesives that are extremely strong and robust both in fresh- and in seawater environments. Our phase-imaging and force-pulling experiments reveal the characteristics of these natural adhesives that might be of use in designing man-made analogues that function in wet environments. Engineering stable underwater adhesives currently poses a major technical challenge.

A novel fluorescent silica tracer for biological silicification studies.

BACKGROUND: Biological silica production has drawn intense attention and several molecules involved in biosilicification have been identified. Cellular mechanisms, however, remain unknown mainly due to the lack of probes required for obtaining information on live specimens. RESULTS: The fluorescence spectra of the compound 2-(4-pyridyl)-5-((4-(2-dimethylaminoethylaminocarbamoyl)methoxy)phenyl)oxazole (PDMPO) are affected by the presence of >3.2 mM silicic acid. Increase in intensity and shift in the fluorescence coincide with the polymerization of Si. The unique PDMPO-silica fluorescence is explored here to visualize Si deposition in living diatoms. The fluorophore is selectively incorporated and co-deposited with Si into the newly synthesized frustules (the outer silica shells) showing an intense green fluorescence. CONCLUSIONS: We suggest that a fluorescence shift is due to an interaction between PDMPO and polymeric silicic acid. PDMPO is an excellent probe for imaging newly deposited silica in living cells and has also a potential for a wide range of applications in various Si-related disciplines, including biology of living organisms as diatoms, sponges, and higher plants, clinical research (e.g. lung fibrosis and cancer, bone development, artificial bone implantation), and chemistry and physics of materials research.

Expression of vascular endothelial growth factor in a human hemangiosarcoma cell line (ISO-HAS).

Vascular endothelial growth factor (VEGF), in addition to being a specific mitogen of endothelial cells in vitro, is also known to induce angiogenesis in vivo. These functions suggest that VEGF may play an important role in the growth of hemangiosarcomas. Previous studies have demonstrated the expression of VEGF and its receptors, flt-1 or KDR/flk-1, in hemangiosarcomas by immunohistochemical staining and in situ hybridization. In the present study, however, we demonstrated that tumor cells of the hemangiosarcoma cell line ISO-HAS express mRNA of VEGF and its two receptors, flt-1 and KDR, and secrete VEGF protein. VEGF mRNA expression and protein secretion were found to be enhanced by phorbol 12-myristate 13-acetate. In addition, we demonstrated that ISO-HAS cells respond to recombinant human VEGF165 with a dose-dependent up-regulation of cell proliferation and growth. These results suggest that the VEGF-VEGF receptor system plays a role in proliferation and growth of hemangiosarcoma cells.

Clinical significance of enzyme-linked immunosorbent assay for the detection of circulating anti-BP180 autoantibodies in patients with bullous pemphigoid.

The NC16A domain of the 180-kDa bullous pemphigoid antigen (BP180) is the most immunogenic and, probably, pathogenic region in bullous pemphigoid (BP). In the present study, in order to determine whether serum level of circulating anti-BP180 autoantibodies is a valuable serum marker in BP, the immunoreactivity of sera against the NC16A domain of BP180 was measured using enzyme-linked immunosorbent assay (ELISA) in ten patients with BP. Serum levels of anti-BP180 autoantibodies correlated with the clinical course in BP patients, who received various therapeutic agents. The result suggests that this NC16A-ELISA is a useful method for evaluating the clinical course and efficacy of the therapy in patients with BP.

CD56-Positive cutaneous lymphoma with multicentric Castleman's disease-like systemic manifestations.

We report a 55-year-old Japanese male with CD56+ cutaneous lymphoma. The patient had multiple cervical lymphadenopathy, a red nodule on his neck, and parotid gland nodularity. Histologic features of the biopsied cervical lymph node showed follicular hyperplasia with numerous plasma cells. A biopsied skin specimen of the nodule on his neck demonstrated dense infiltration of atypical large lymphocytes into the dermis. Immunohistochemical study of this specimen revealed CD3+, CD4+, and CD56+ expression in the majority of neoplastic cells. Polymerase chain reaction assays for the detection of Epstein-Barr virus sequences were positive for lymph node and skin DNA. Laboratory examinations showed polyclonal gammopathy, pancytopenia, and high serum interleukin-6 levels. These clinical and histological findings resembled those of multicentric Castleman's disease.

Dermatitis herpetiformis in a Japanese patient with anaplastic large cell lymphoma.

We report a 73-year-old Japanese man with dermatitis herpetiformis which developed after diagnosis of anaplastic large cell lymphoma. The patient suffered fever, sweating, shivering, and multiple enlarged cervical lymph nodes. The diagnosis of anaplastic large cell lymphoma was confirmed by the histologic features of a biopsied cervical lymph node. The patient underwent combination chemotherapy. However, one month after the initial therapy, pruritic erythematous skin lesions with peripheral vesicles appeared on his buttocks. A skin biopsy showed subepidermal blister formation associated with polymorphonuclear and mononuclear cell infiltrates. Direct immunofluorescence examination of the area adjacent to the lesion showed granular deposits of IgA at the dermoepidermal junction. While it is well-known that dermatitis herpetiformis can develop into lymphoma, there have been only a few reports of its appearance after a diagnosis of lymphoma. This case suggests that dermatitis herpetiformis may be induced by anaplastic large cell lymphoma.

Expression of CD40 and CD40 ligand in Bowen's disease and squamous cell carcinoma.

CD40 is a member of the tumor necrosis factor receptor super-family expressed by B cells, monocytes, dendritic cells, epithelial cells and hematopoietic progenitor cells. CD40 has recently been reported to be expressed on several epidermal tumors as well. CD40 on epidermal tumor cells interacts with lymphocytes expressing ligand for CD40 (CD40L) or monoclonal antibodies against CD40 with a significant decrease in proliferation. In this study, we examined the expression of CD40 and CD40L in Bowen's disease and squamous cell carcinoma (SCC). CD40 immunoreactivity was observed in a significantly lower proportion of tumor cells from SCC than from Bowen's disease. CD40L mRNA expression was detected in Bowen's disease and SCC by reverse transcriptase polymerase chain reaction (RT-PCR). CD40-CD40L interactions in epidermal tumors may play a role in the proliferation, and the lack of CD40 in tumor cells from SCC might be involved in the mechanisms of escape from the growth inhibitory effect.

Diffuse large B-cell lymphoma associated with skin, muscle and cranial nerve involvement.

The present case, a 75-year-old man with extranodal B-cell lymphoma showed facial hemiplegia, paresthesia and cutaneous manifestations. He was initially diagnosed as having a facial paralysis of unknown etiology. One month after the original diagnosis, erythematous indurated plaques developed on his left cheek and nose. A skin biopsy from the plaque on his cheek showed dense infiltrates of large lymphocytes with irregularly shaped nuclei and prominent nucleoli in the dermis and subcutaneous tissue. The lymphocytes were positive for L26 and CD79a. A diagnosis of diffuse large B-cell lymphoma was made. A muscle biopsy from facial muscle in the area of the erythematous plaque showed massive destruction of the muscle tissues by the lymphomatous infiltrates. Furthermore, electrodiagnostic study showed peripheral cranial nerve palsies, involving the left facial and trigeminal nerves. We conclude that diffuse large B-cell lymphoma may develop symptoms such as facial hemiplegia and paresthesia prior to cutaneous manifestations. Diffuse large B-cell lymphoma must be considered as one of the important causes of palsies of cranial nerves at the peripheral level.

CD40 ligation inhibits trichilemmoma cell proliferation and induces IL-6 production.

CD40 is a member of the tumor necrosis factor receptor superfamily expressed by B cells, monocytes, dendritic cells, epithelial cells, and hematopoietic progenitor cells. Recently, CD40 has been reported to also be expressed on human epidermal cells. We have elucidated the function of CD40 on epidermal tumor cells and have found that trichilemmoma (KTL-1) cells constitutively express CD40 and respond to CD40 ligation by anti-CD40 mAb (EA-5) with a significant decrease in proliferation. We were also able to demonstrate that KTL-1 cells respond to CD40 ligation by EA-5 with the up-regulation of interleukin-6 (IL-6) mRNA expression. Together, the results suggest that CD40 on KTL-1 cells may function to regulate their proliferation associated with the induction of IL-6 production.

Possibility of breakdown of overdamped and narrowing limits in low-frequency Raman spectra: phenomenological band-shape analysis using the multiple-random-telegraph model.

Depolarized low-frequency Raman spectra of liquid water and heavy water are investigated from 266 K to 356 K. The reduced Raman spectra below 250 cm(-1) are reproduced by a superposition of one relaxation mode and two damped harmonic oscillator modes. The multiple-random-telegraph (MRT) model, which takes into account inertia and memory effects, is applied to analyze the relaxation component. Two damped harmonic oscillators around 50 cm(-1) and 180 cm(-1) are known as a bendinglike mode and a stretchinglike mode, respectively. It is found that the intensity of the bendinglike mode in water (heavy water) gradually decreases with increasing temperature, and finally vanishes above about 296 K (306 K). The relaxation time of the MRT model is interpreted as representing the averaged lifetime of the vibrating unit. At high temperature, the relaxation time becomes short, that is to say, the vibrating unit is quickly destroyed before the 50 cm(-1) mode is oscillating sufficiently. In the present analysis, the strongly disrupted oscillation cannot be distinguished from the relaxation mode which includes the inertia and memory effects. It is found that the low-frequency Raman spectrum of liquid water at high temperature is a good example demonstrating an application of the MRT model.

A Fourier rebinning algorithm incorporating spectral transfer efficiency for 3D PET.

This paper presents a Fourier rebinning algorithm for three-dimensional image reconstruction in PET that incorporates the concept of spectral transfer function. It suggests the need for discarding low-frequency components in the rebinning. It also includes the correction for rebinning efficiency which was evaluated by simulations as a function of oblique angle of projections. The performance was optimized by high-pass filters and axial smoothing. The algorithm yields satisfactory images with negligible axial cross-talk for a maximum oblique angle up to 26.6 degrees. The statistical noise was evaluated in terms of 'noise equivalent number of oblique angles', and reasonable results were obtained in view of the theoretical expectation. Ring artefacts due to noise are negligibly small.

Dielectric measurements of lysozyme and tri-N-acetyl-D-glucosamine association at radio and microwave frequencies.

Time domain dielectric measurements were applied to the monitoring of molecular recognition by proteins. Lysozyme and tri-N-acetyl-D-glucosamine((NAG)3) were selected as a typical lock and key type recognition system. After association of (NAG)3, relaxation related to lysozyme itself was increased and depended on the pH of the solution. No change was detected in hydration of the enzyme before and after association.