No significant association between the promoter region polymorphisms of factor VII gene and risk of venous thrombosis in cancer patients.

UNLABELLED: Factor VII (FVII) plays an important role in blood coagulation. The role of common polymorphisms influencing the FVII plasma levels in thromboembolic disorders has been evaluated but there is no published data related to the effect of FVII gene polymorphisms on the venous thrombosis risk in cancer. AIM: To investigate the association of three common functional polymorphisms in the promoter region of FVII gene: a decanucleotide insertion at position-323 (-323ins10-bp), a G to T substitution at position-401 (-401GT), and a G to A substitution at position-402 (-401GT) with venous thrombosis in cancer patients. MATERIALS AND METHODS: The study included 60 cancer patients with venous thromboembolism (VTE) (group 1) and 130 cancer patients without VTE (group 2). Genotyping of -323ins10-bp, -401GT, and -402GA polymorphisms in the promoter region of FVII gene was performed by the method of single-strand conformation polymorphism analysis and sequencing. Factor V Leiden (FVL) was also determined in all cases. RESULTS: The frequency of FVL was significantly greater in cancer patients with VTE compared with group 2 patients (p FVII gene, the distributions of genotypes and allele frequencies were not significantly different between two groups of patients ( p > 0.05). The results did not change significantly after the exclusion of patients carrying the FVL (p > 0.05). CONCLUSIONS: The screening for the -323ins10-bp, -401GT, and -402GA olymorphisms of FVII gene did not contribute to a meaningful diagnostic nvestigation in cancer patients with venous thrombosis.

Plasminogen activator inhibitor -1 gene 4G/5G polymorphism in patients with breast cancer.

PURPOSE: The plasminogen activator inhibitor-1 (PAI-1) plays an important role in the development of tumor invasion and metastasis. The 4G allele of 4G/5G insertion / deletion polymorphism located in the promoter region 675 bp upstream from the transcription start sequence of PAI-1 gene is responsible for the higher plasma PAI-1 level. The aim of the present study was to evaluate the association between PAI-1 gene 4G / 5G polymorphism and breast cancer. MATERIALS AND METHODS: Two groups were investigated: the first group(group 1)was composed of 34 patients with breast cancer, the second group (group 2) consisted of 90 unrelated healthy women without history of malignancy. Genomic DNA isolation was performed from peripheral venous blood by standard phenol-chloroform extraction and polymerase chain reaction of the PAI-1 4G/5G polymorphism was performed. RESULTS: The prevalence of 4G/4G or 4G/5G genotype in group 1 and 2 was 97.1% and 78.8%, respectively. The distribution of the PAI-1 4G/5G genotypes was significantly different between the two groups (p<0.05). CONCLUSIONS: We suggest that this polymorphism may contribute to an inherited predisposition to the development of breast cancer, however further studies with larger series from diverse ethnic populations are needed to confirm our results.

Identification of sentinel lymph node in stage I-II breast cancer with lymphoscintigraphy and surgical gamma probe: comparison of Tc-99m MIBI and Tc-99m sulfur colloid.

AIM: To evaluate the efficacy of the surgical gamma probe (SGP) after peritumoral injection of Tc-99m MIBI and filtered Tc-99m sulfur colloid (SC) in sentinel lymph node (SLN) detection in stage I and II breast cancer for deciding on the need for axillary dissection. MATERIALS AND METHODS: Thirty patients with stage I-II breast cancer had peritumoral injection of Tc-99m MIBI (74 MBq/0.2 mL [2 mCi/0.2 mL] at 4 different locations) and 42 different patients had peritumoral injection of filtered Tc-99m sulfur colloid (50 MBq/0.2 mL [1.3 mCi/0.2 mL] at 4 different locations). Anterior, lateral, and anterolateral spot images were acquired at 10, 30, 45, 60, and 120 minutes and 24 hours are injection in 5 patients. During surgery, counts were obtained from the injection site, affected breast tissue, internal mammary, axillary, and supraclavicular regions and the contralateral side using the gamma probe. Peritumoral blue dye was also injected during surgery. The first lymph nodes with counts at least twice the background tissue and/or with blue dye uptake were surgically isolated. Modified radical mastectomy and axillary dissection were performed. RESULTS: Histopathologic evaluation was made on SLN and other excised tissues. In the Tc-99m sulfur colloid group, lymphatic drainage and lymph nodes were demonstrated with lymphoscintigraphy in 31 of 42 patients. SLN was detected by SGP in 35 of 42 patients. In the Tc-99m MIBI group, lymphatic drainage and lymph nodes were visualized with lymphoscintigraphy in 23 of 30 patients. SLN was detected in 25 of 30 patients with SGP in this group. CONCLUSION: In patients with stage I-II breast cancer, SLN could be successfully demonstrated with lymphoscintigraphy and SGP by the peritumoral injection of filtered Tc-99m sulfur colloid and Tc-99m MIBI.

Olympic medals or long life: what's the bottom line?

On a per capita basis, Australia spent more than seven times as much on its Sydney Olympic team as did Canada, to win four times as many medals. Compared with Australia, Canada spent an additional amount per capita (standardised to the purchasing power parity rate at year 2000) of US dollars 1605 per life-year gained on healthcare in 2000. Neither country is "right" or "wrong" in making these funding choices, but they highlight the need for more explicit discussion about what is being spent, what is obtained for the given expenditure and what society actually values.

Identification of sentinel lymph node in breast cancer by lymphoscintigraphy and surgical gamma probe with peritumoral injection of scintimammographic agent "99mTc MIbI".

UNLABELLED: The purpose of this study was to evaluate the efficacy of lymphoscintigraphy and the surgical gamma probe (SGP) with peritumoral injection of 99mTc MIBI in sentinel lymph node (SLN) detection in breast cancer regardless of whether metastatic or not. METHOD: Thirty patients with T1/ T2 breast cancer had peritumoral injections of 99mTc MIBI (74 MBq/0.2 ml at 4 different locations) at 2, 6 and 24 hours before surgery. Anterior, anterolateral, and lateral spot images were taken at 10, 30, 45, 60 and 120 minutes. Counts were collected from the injection site, affected breast tissue, internal mammaries, axillary and supraclavicular regions, and the contralateral side. Peritumoral blue dye was also injected at surgery. The first lymph nodes with counts twice the background tissue and/or with blue dye uptake were surgically isolated, and histopathological evaluations were made. Modified radical mastectomy was performed on all patients. RESULTS: 23/30 patients had lymph nodes in scintigrams and the sentinel lymph nodes were identified with SGP in 25/30 patients. CONCLUSION: Lymphoscintigraphy and subsequent SGP detection with peritumoral injection of 99mTc MIBI can be used for identifying SLN in breast cancer.

A randomized trial of four cycles of adjuvant AC (adriamycin + cyclophosphamide) +/- two cycles of EP (etoposide + cisplatin) in node positive patients with breast cancer.

BACKGROUND: Four cycles of AC have been accepted as the standard chemotherapy in breast cancer. In the present randomized study we aimed to assess the efficacy of adjuvant etoposide + cisplatin (EP) combination following four cycles of standard adriamycin + cyclophosphamide (AC) in premenopausal patients with operable breast cancer and axillary lymph node metastasis. PATIENTS AND METHODS: Premenopausal patients with positive axillary lymph nodes following curative modified radical mastectomy were randomized to either four cycles of AC (82 patients) or four cycles of AC + two cycles of EP (83 patients). RESULTS: Median follow-up is 72 months. All randomized and eligible patients are included in the analysis (AC: 80 patients, AC + EP: 78 patients). The five-year disease-free survival (DFS) for the AC + EP group was significantly better when compared to AC group (45.5% vs. 30.4%; P = 0.048). Again, the five-year overall survival (OS) of the whole group was in favor of AC + EP arm, though without statistical significance (68.6% vs. 59.1%; P = 0.247). CONCLUSION: Two cycles of EP following four cycles of AC decreased the relapse rate in operable breast cancer patients.

Rapid Detection of Salmonella enteritidis in Pooled Liquid Egg Samples Using a Magnetic Bead-ELISA System.

An assay was developed to shorten the time necessary to detect Salmonella enteritidis (SE) in contaminated egg pools. The immunomagnetic separation (IMS)-based assay used the DynabeadsTM Anti- Salmonella , a magnetic bead with mouse anti- Salmonella antibodies affixed to the surface, to bind the SE in the egg pools. The bound SE were concentrated by a magnet and were detected via an enzyme-linked immunosorbent assay (ELISA) (IMS-ELISA) employing a monoclonal anti-SE flagellar proteins (flagellins) antibody. Following the ELISA, the beads were plated onto differential media (IMS-direct).The efficacy of the assay for detecting SE was compared with that of the standard assay, direct plating, in pooled egg samples spiked with low concentrations of SE and incubated at 37°C for 24 to 96 h. Conventional direct plating of egg samples required a total of 48 h before SE could be identified in egg pools, compared with 24 h for the IMS-ELISA. Plating of the beads (IMS-direct) to confirm the presence of SE required a further 24 h. The IMS-ELISA could detect SE at concentrations of 105 to 106 SE cells per ml, comparable to that shown previously for direct plating. The IMS-direct could detect SE at 104 SE cells per ml of egg pool. In egg pools initially contaminated with 10 SE cells per ml, the organism grew to levels by 24 h at 37°C where 100% of the pools were positive for SE by all three detection methods. In egg pools initially contaminated with 1 SE cell per ml, 61% of pools were detected by direct plating and IMS-ELISA and 72% were detected by IMS-direct. Similar detection frequencies were observed for a second SE isolate. The IMS-ELISA provides an SE detection rate comparable to direct plating but achieves the result 24 h sooner. The IMS-direct was the most sensitive means of detecting the SE.

Lactate and catecholamine responses in male and female sprinters during a Wingate test.

A total of six male and six female sprinters at the same national competition level and aged 18-20 years performed a force/velocity test and a 30-s supramaximal exercise test (Wingate test) on 2 different days, separated by a maximal interval of 15 days. The maximal anaerobic power (Wmax) was determined from the force/velocity test, and the mean anaerobic power (W) from the Wingate test. Immediately after the Wingate test, a 5-ml venous blood sample was drawn via a heparinized catheter in an antebrachial vein for subsequent catecholamine (adrenaline and noradrenaline) analysis. After 5 min recovery a few microliters of capillary blood were also taken for an immediate lactate determination. Even expressed per kilogram lean body mass, Wmax and W were significantly lower in women. The lactate and adrenaline responses induced by the Wingate test were also less pronounced in this group whereas the noradrenaline levels were not significantly different in men and women. Above all, very different relationships appeared between lactate, adrenaline, noradrenaline and W according to sex. Thus, as reported by other authors, the adrenergic response to a supramaximal exercise seemed to be lower in women than in men. Nevertheless a different training status between the two groups, even at same national competition level, could not be excluded and might contribute, at least in part, to the gender differences observed in the present study.