[Metastatic breast cancer in 28 years old man]. / Diseminovaný karcinóm prsníka u 28-rocného muza.

BACKGROUNDS: Male breast cancer only makes up about 1% of all malignancies in the male population; the median age at time of diagnosis is 68 years. The treatment procedures used in clinical practice are those confirmed by studies on women. CASE: Presented is a case of a 28-year-old man with breast cancer in the fourth clinical stage. RESULTS: The patient was treated with the addition of trastuzumab to chemotherapy, radiotherapy, hormone treatment, with disease progression with lapatinib added to chemotherapy. 18 months after initiation of therapy, the patient died. CONCLUSION: Despite the increase in incidence, male breast cancer remains a rare diagnosis and treatment data are not confirmed in prospective randomized studies.

Sequential intermediate high-dose therapy with etoposide, ifosfamide and cisplatin for patients with germ cell tumors.

Intermediate high dose VIP (etoposide, ifosfamide, cisplatin) achieved comparable efficacy and improved tolerance in comparison with high-dose chemotherapy plus PBSC in poor risk germ cell tumors. The aim of this study was to confirm the effectivity and tolerance of this regimen in clinical practice. Twenty-five consecutive patients, 9 previously untreated with poor prognosis and 16 relapsed, were treated with 1.6 VIP or 1.9 VIP+PBSC. A relative dose intensity of 1.6 VIP was used in 14 patients and 11 patients received the intensity of 1.9 VIP. Clinical response was achieved in 56% of patients. Fifty-eight percent of patients have survived more than 1 year and 44% more than 2 years. No significant difference was noted between previously treated and untreated patients, as well as between the patients on 1.6 VIP and 1.9 VIP, with the exception of improved 1-year survival of patients on 1.9 VIP. One of four cisplatin-refractory patients achieved durable partial remission with a normal level of tumor markers. Serious non-hematological toxicity was rare. Myelotoxicity of 1.9 VIP was less serious in comparison with 1.6 VIP regimen, but the difference was not significant. Sequential intermediate high-dose therapy is an effective and tolerable regimen for patients with poor risk germ cell tumor as well as for relapsed patients.

Biomarkers for predicting response to regional chemo-immunotherapy in liver metastases from colorectal carcinoma.

Differences in therapeutic outcomes after regional chemotherapy or chemo-immunotherapy in liver metastases from colorectal carcinoma cannot be explained only by variations in the regimens of treatment. This study was undertaken to assess the potential of several tumor-associated markers of biological behavior (biomarkers) to predict therapeutic response in order to pre-select the best candidates for this demanding treatment. In a group of 21 patients, flow cytometric DNA ploidy provided the most accurate prediction, with a response rate of 88% in 8 DNA diploid tumors compared to 31% in 13 DNA aneuploid cases (P = 0.017) and a difference in overall survival of nine months (20.4 vs 11.3, P = 0.041). Only a slight trend towards improved response rate was observed when we immunohistochemically detected p53 anti-oncoprotein expression in 11 (52%) p53-positive tumors (P = 0.063). Other immunohistochemical biomarkers as P-glycoprotein (p170), p21/WAF, mdm2, c-erbB-2, and proliferative activity of tumor (detected either by anti-PCNA and anti-Ki67 monoclonal antibodies or as a flow cytometric proliferation index) were unrelated to the outcome of treatment. DNA ploidy and expression of p53 protein are potential biomarkers for predicting the response to regional chemotherapy of liver metastases from colorectal carcinoma.

Adenotomy under general anesthesia.

Experience obtained from adenotomy (AT) under general anesthesia using Ketamin hydrochloride (Ketalar, Narkamon) in children are presented in this paper. The authors had used intramuscular premedication with Prothazin, Dolsin and Atropin at the first stage, then they shifted to oral administration of a combination of Diazepam, Theadryl and Atropin. Ketamin may be applied intravenously in the dosage of 1.0 to 1.5 mg/kg of body weight in most children. Where it is not possible, a triple dose into the muscle is used. A total of 2,266 AT were performed. About 70% of patients were calm during the operation, once a suspected aspiration was considered but it was not confirmed. The main contribution of the method is 100% amnesia of the surgery made. The procedure is a compromise between a requirement for minimal traumatization of the child's psyche by the intervention and the resources available, particularly the need of personnel at the majority of otorhinolaryngo-logical departments nowadays.