Clinical presentation, treatment options and outcome in patients with bronchioloalveolar carcinoma.

PURPOSE: To determine the characteristics of bronchioloalveolar carcinoma (BAC) as a special clinical and pathological entity and to evaluate the effects of treatment options on survival of BAC patients. PATIENTS AND METHODS: The study was partially retrospective and partially prospective, non randomized. We evaluated the clinical presentation, smoking habits, radiographic findings, treatment and survival of 21 patients with BAC treated at our Institute from 2000-2004. RESULTS: Registered were 16 (76.2%) male and 5 (23.8%) female patients, most of them in the 6th and 7th decade of life. Among younger patients females prevailed. Most common symptoms were dyspnoea 15 (71.4%), cough 14 (66.6%) and bronchial hypersecretion 9 (42.8%). There were 5 (23.8%) smokers, 6 (28.6%) ex-smokers and 10 (47.6%) nonsmokers. Main radiographic findings were lung consolidation (9; 42.8%), diffuse interstitial infiltrates (6; 28.6%), solitary (4; 19.0%) and multiple pulmonary lesions (2; 9.5%). Surgery was performed in 8 (38.0%) patients and 5 of them received adjuvant radio- and chemotherapy, while the remaining received chemotherapy alone (9; 42.8%) and symptomatic treatment (4; 19.0%). The median survival was 25 months and 1-year survival 70%, regardless of stage. In the group of patients treated surgically 1- and 2-year survival rate was 100% and the median survival 33 months. In non-operated patients the median survival was 18 months and 1- and 2-year survival 55% and 25%, respectively. CONCLUSION: BAC is a special clinical and pathological form of adenocarcinoma of the lung. Surgical treatment is the best option for selected BAC patients. Survival is associated with the treatment modality. Larger scale studies are necessary to confirm these findings.

The influence of chemical sympathectomy on oxygen uptake during development of rat brain cortical tissue.

In this study the influence of 6-hydroxydopamine (6-OHDA), in vitro and in vivo, on the oxygen consumption in the rat brain cortical slices was examined. The treatment with 6-OHDA increased the oxygen uptake of brain cortical tissue of young rats. The maximum increase was observed 7 and 14 days after treatment with 6-OHDA. On the contrary, 6-OHDA added in vitro produced very marked depression of oxygen uptake in slices of brain cortical tissue of the tested animals. The addition of isoprenaline in vitro stimulated the respiratory activity in the cerebral tissue of control young rats in all the periods of examination. Thus, 18 days after the birth, the isoprenaline-stimulation of oxygen uptake in brain tissue was 44.3% as compared to the control values. The same degree of stimulation was noted in the cerebral tissue of older animals (25, 32 and 45 days after birth). However, addition of isoprenaline did not influence the respiration of cerebral tissue stimulated by 6-OHDA.

The effects of physostigmine on the oxygen uptake in rat brain tissue.

Physostigmine in a dose of 0.1 mg/kg i.v. expressly stimulated the oxygen uptake in the rat cerebral cortex. This effect was blocked by propranolol and seems be mediated by catecholamines. Since atropine also antagonized the stimulant effect of physostigmine, it appears that the action of physostigmine is primarily cholinergic and that the adrenergic effect is a secondary phenomenon. The higher dose of physostigmine (0.4 mg/kg i.v.) caused a depression of rat brain oxygen uptake.

Chronic diseases in the rubber industry.

An overview is presented of epidemiologic studies of chronic diseases in the rubber industry. Analyses of the mortality experience during the period 1964-1972 of workers age 40-64 and retirees age 65-84 of two large rubber and tire manufacturing companies consistently disclosed excesses of deaths attributed to leukemia and lymphosarcoma, and for cancers of the stomach, large intestine, and prostate. The relation of site-specific malignancies to work histories and grouped occupational titles as surrogate measures of work-related exposures to possible carcinogens is described. There was no evidence of company-wide, sizable, consistent excess for the other major chronic diseases causes of death. Although a total cohort deficit in the mortality rate for lung cancer was found, there was a history of increased frequency of exposure to certain work areas among lung cancer decedents. Morbidity studies, including analysis of disability retirements, and ad hoc questionnaire and health testing surveys, disclosed excesses of chronic pulmonary diseases. There was evidence of an interactive effect in the association of work and smoking histories with pulmonary disability retirement.

Cancer mortality among rubber workers: an epidemiologic study.

Several previous epidemiologic studies of the rubber industry--an industry that uses many chemicals--have identified excess mortality from certain specific cancers. In this study, four cohorts of active and retired workers, at four major rubber-tire plants, were identified historically and followed for the ten-year period from 1964 to 1973. The cancer mortality of these four population was compared, separately and combined, with that of the general community. For all cancers combined, there was a slight excess above the expected number of deaths, whereas for some specific cancers (stomach, colon, prostate, and neoplasms of the lymphatic and hematopoietic system) there was a marked excess of deaths. Proportional mortality analysis at other small plants revealed similar excesses for these cancers, and some excess for lung, bladder, and CNS cancers. Analysis of detailed individual work histories reveals an association of certain cancers with specific job exposures; in particular, lymphatic leukemia and solvent exposure, and lung cancer and curing-room exposure. For both bladder cancer and stomach cancer, preliminary analyses indicate an association with groups of jobs in adjacent production stages (handling and mixing raw ingredients, and processing the "green" precured rubber, respectively). Further analytic studies are currently under way to identify groups of rubber workers at increased risk of other specific cancers.