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  • 2005-2009
  • 1995-1999  (616)
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  • 1920-1924
  • 1998  (249)
  • 1996  (367)
  • 1982  (18)
  • Magnetic resonance imaging
  • breast cancer
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Erscheinungszeitraum
  • 2005-2009
  • 1995-1999  (616)
  • 1980-1984  (18)
  • 1920-1924
Jahr
  • 101
    ISSN: 1432-1920
    Schlagwort(e): Key words Brain ; blood flow ; Cerebral blood volume ; Magnetic resonance imaging ; Acetazolamide
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstracts The acetazolamide (ACZ) test is performed to evaluate the decrease in cerebral perfusion pressure (CPP) by investigation of vasomotor reactivity (VMR). Our aim was to study cerebral blood flow and blood volume changes induced by the ACZ test in healthy control subjects using dynamic susceptibility contrast-enhanced gradient-echo MRI (DSC-MRI). A FLASH sequence was used to produce susceptibility-weighted images during an intravenous injection of 0.1 mmol/kg gadopentetate dimeglumine (Gd-DTPA). After the first dynamic study, 1 g acetazolamide was given intravenously and 10 min later a second bolus of Gd-DTPA was injected. Using the indicator-dilution theory, relative cerebral blood volume and relative cerebral blood flow were estimated. In healthy subjects the ACZ test induced a significant increase in relative blood volume (from 80.5 ± 10.7 to 113.4 ± 11.9) and relative blood flow (from 5.73 ± 0.96 to 7.5 ± 0.97), symmetrically in the cerebral hemispheres. This approach might be promising in the understanding of cerebral haemodynamics in patients with vascular disorders.
    Materialart: Digitale Medien
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  • 102
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 40 (1998), S. 27-31 
    ISSN: 1432-1920
    Schlagwort(e): Key words Brain ; anatomy ; Magnetic resonance imaging ; threedimensional ; Virchow-Robin spaces
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We performed a histopathological study of two human brains to look at dilated Virchow-Robin (V-R) spaces in the anterior perforated substance and putamen. We measured the diameter of 74 arteries in 54 dilated V-R spaces. In 28 patients without neurological deficits we ascertained the characteristic location of dilated V-R spaces in the anterior perforated substance and basal ganglia on MRI, measuring the distance from 64 foci of cerebrospinal fluid signal intensity to the centre of the mamillary body on 1 mm thick images. In the histopathological study, the mean diameter of the arteries was 39.0 ± 36.0 μm. Dilatation of the V-R space was observed from the end of the indentation of the pial membrane towards the brain surface along the perforating artery. In the MR images, the mean distance from the dilated V-R space to the mamillary body was 10.0 ± 4.5 mm. The V-R space was confined to a fixed level in the lower part of the basal ganglia, and not found near the brain surface.
    Materialart: Digitale Medien
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  • 103
    ISSN: 1432-1920
    Schlagwort(e): Key words Schwannoma Malignant ; Leptomeningeal metastasis ; Magnetic resonance imaging ; Computed tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A malignant retroperitoneal schwannoma in a patient without von Recklinghausen's disease is reported. Ossification in the tumour, shown on CT and MRI in this previously untreated patient is exceptional. MRI demonstration of spinal leptomeningeal metastases supports the hypothesis of haematogenous metastatic spread of systemic malignant tumours to the leptomeningeal spaces.
    Materialart: Digitale Medien
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  • 104
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 40 (1998), S. 651-655 
    ISSN: 1432-1920
    Schlagwort(e): Key words Pituitary adenoma ; Suprasellar tumour ; Magnetic resonance imaging ; Computed tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We present five proven giant pituitary adenomas studied by CT and MRI, and review the clinical and imaging findings. Our aim was to examine the radiologic appearances and to search for criteria useful in distinguishing these tumors from other sellar and suprasellar tumours, mainly craniopharyngioma. The main differences from small adenomas were high prevalence of macrocysts, a more invasive behaviour and a clinical picture dominated by mass effect rather than endocrine disturbance. Factors supporting the diagnosis of pituitary adenoma in a giant intra- and suprasellar mass include: infrasellar extension, absence of calcification and presence of low-signal cysts on T1-weighted images.
    Materialart: Digitale Medien
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  • 105
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 40 (1998), S. 771-777 
    ISSN: 1432-1920
    Schlagwort(e): Key words Brain infarction ; Contrast enhancement ; Cortical laminar necrosis ; FLAIR images ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract To examine the chronological changes characteristic of cortical laminar necrosis caused by brain infarction, 16 patients were repeatedly examined using T1-, T2-weighted spin-echo, T2*-weighted gradient echo, fluid attenuated inversion recovery (FLAIR) images, and contrast enhanced T1-weighted images at 1.0 or 1.5 T. High intensity cortical lesions were visible on the T1-weighted images from 2 weeks after ictus and became prominent at 1 to 3 months, then became less apparent, but occasionally remained at high intensity for 2 years. High intensity cortical lesions on FLAIR images became prominent from 1 month, and then became less prominent from 1 year, but occasionally remained at high intensity for 2 years. Subcortical lesions did not display high intensity on T1-weighted images at any stage. On FLAIR images, subcortical lesions initially showed slightly high intensity and then low intensity from 6 months due to encephalomalacia. Cortical lesions showed prominent contrast enhancement from 2 weeks to 3 months, but subcortical lesions were prominent from 2 weeks only up to 1 month. T2*-weighted images disclosed haemosiderin in 3 of 7 patients, but there was no correlation with cortical short T1 lesions. Cortical laminar necrosis showed characteristic chronological signal changes on T1-weighted images and FLAIR images. Cortical short T1 lesions were found not to be caused by haemorrhagic infarction.
    Materialart: Digitale Medien
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  • 106
    ISSN: 1432-1920
    Schlagwort(e): Key words Paraganglioma ; Intrasellar neoplasm ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A 76-year-old woman presented with an intrasellar and suprasellar mass which caused deterioration of visual acuity and bitemporal visual field defects. Trans-sphenoidal and transcranial partial resection revealed a primary chemodectoma. This tumour is very rare in the sellar area, where there are normally no paraganglionic cells. We review the literature and discuss possible mechanisms for the development of this tumour.
    Materialart: Digitale Medien
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  • 107
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 40 (1998), S. 516-518 
    ISSN: 1432-1920
    Schlagwort(e): Key words Agammaglobulinaemia ; congenital ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract MRI in a 17-year-old boy with known congenital agammaglobulinaemia (CA) demonstrated signs of chronic leptomeningeal inflammation with thickened, enhancing meninges. Furthermore, high signal was found symmetrically on T2-weighted images in the frontal and parietal white matter. The patient presented with severe general brain dysfunction and recent cerebellar ataxia. Extensive investigation did not reveal a causal agent. This case shows that MRI can be helpful in establishing the presence of pathological changes in cases where laboratory results are negative.
    Materialart: Digitale Medien
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  • 108
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 40 (1998), S. 577-579 
    ISSN: 1432-1920
    Schlagwort(e): Key words Fibroma ; chondromyxoid ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Only a smal proportion of cases of this rare neoplasm occur in the skull. We present an unusually extensive tumour in a young man.
    Materialart: Digitale Medien
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  • 109
    ISSN: 1432-198X
    Schlagwort(e): Key words: Pyelonephritis ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. The diagnosis of acute pyelonephritis in children remains a clinical challenge. We assessed the feasibility of magnetic resonance imaging (MRI) detection of pyelonephritis in four pediatric patients and compared the results with renal cortical scintigraphy. MRI revealed areas of high signal intensity in the kidney that coincided with photon-deficient regions in the radionuclide scans in two children with acute pyelonephritis. These findings confirm work in experimental animals and indicate that MRI can accurately detect acute pyelonephritis in children.
    Materialart: Digitale Medien
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  • 110
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 38 (1998), S. 824-831 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Koloskopie ; Spiral-CT ; Elektronenstrahltomographie ; MRT ; virtuelle Realität ; Key words Spiral computed tomography ; Electron beam tomography ; EBT ; Magnetic resonance imaging ; MRI ; Colonoscopy ; Virtual reality
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Purpose: To evaluate experimentally and in patients the sensitivity and effective dose of virtual electron-beam tomography (EBT) colonoscopy for detecting small colon tumors and to compare the methods and results with virtual colonoscopy using spiral CT and MR imaging in a review of the literature. Materials and methods: Six polyps with diameters between 3 and 12 mm were created and randomly placed in resected pig colon. After distension with air, the pig colon was scanned with continous volume scanning (CVS, 3 mm collimation) and a pitch of 0.4, 0.8 and 1.5. Twenty patients positive for the fecal blood test were examined after rectal CO2 insufflation and i. v. administration of 1 mg glucagon. A 13 s CVS scan was used to cover the entire colon within one breathhold. 3D volume-rendered fly-throughs were evaluated by two independent radiologists. Effective dose equivalent was estimated using an Alderson phantom equipped with thermoluminescence dosimeters. Results: In the tumor model, all polyps were detectable at a pitch of 1.5. A further reduction of the pitch ratio did not improve the conspicuity of the polyps. In patient studies, all tumors (n = 4) and polyps (n = 3) were correctly identified on 3D fly-throughs. Two false positive results were obtained. Effective dose equivalent was calculated at 3.2 mSv per scan. Conclusions: Our preliminary results indicate that virtual EBT colonoscopy holds promise for fast screening for colon polyps. The best technique for virtual colonoscopy (Spiral CT, EBT, MRI) has not yet been determined and the future role of virtual colonoscopy must still be defined.
    Notizen: Zusammenfassung Ziel: Als virtuelle Koloskopie bezeichnet man eine neue Methode, die aus Bilddaten der radiologischen Schnittbildverfahren, CT, Elektronenstrahl-CT (EBT) und MRT mittels computerunterstützter Bildnachverarbeitung simulierte dreidimensionale (3D-), endoskopieähnliche Bilder des Kolons erzeugt. Ziel unserer Untersuchung war die Bestimmung der Wertigkeit der virtuellen EBT-Koloskopie zum Nachweis von kolorektalen Polypen und Tumoren in vitro am Tumormodell und in Patientenstudien. Anhand publizierter Studien der virtuellen Koloskopie mit Spiral-CT und MRT sollen die verschiedenen Untersuchungstechniken dargestellt und verglichen werden. Material und Methode: 6 Polypen mit einem Durchmesser von 3–12 mm wurden nach Abheben und Umstechen der Mukosa in Schweinekolon gebildet. Nach Distension mit Raumluft wurde dieses Tumormodell mit EBT im „continuous volume scanning (CVS)-Mode” mit 3-mm-Kollimation und 3 verschiedenen Pitchverhältnissen (0,4; 0,8; 1,5) gescannt; 20 Patienten mit positivem Hämocculttest wurden nach rektaler CO2-Insufflation und i. v.-Gabe von 1 mg Glucagon in Atemanhaltetechnik mit einem den ganzen Kolonrahmen abdeckenden CVS-Scan (13 s Untersuchungsdauer) untersucht. Endoskopische 3D-Durchflugsrekonstruktionen wurden von 2 unabhängigen Radiologen hinsichtlich des Vorliegens von Polypen oder Tumoren beurteilt. Die zu erwartende effektive Dosis für die EBT-Koloskopie wurde über Messungen mit einem Alderson-Phantom, welches mit Thermolumineszenzdosimetern bestückt war, berechnet. Ergebnisse: Schon bei einem Pitch von 1,5 wurden alle Polypen im Tumormodell erkannt. Die Reduzierung des Pitch auf 0,8 oder 0,4 verbesserte nicht die Erkennbarkeit der Polypen auf den endoskopischen 3D-Rekonstruktionen. Alle Tumoren (n = 4) und Polypen (n = 3) der Patientenuntersuchungen wurden korrekt identifiziert. 2 falsch-positive Befunde wurden erhoben. Die effektive Dosis pro Scan errechnete sich zu maximal 3,2 mSv. Schlußfolgerungen: Unsere vorläufigen Ergebnisse deuten darauf hin, daß die virtuelle EBT-Koloskopie eine vielversprechende Methode zum Nachweis von kolorektalen Tumoren ist. Der Stellenwert der verschiedenen Techniken der virtuellen Koloskopie (Spiral-CT, EBT, MRT) muß erst noch bestimmt werden.
    Materialart: Digitale Medien
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  • 111
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Angiographie ; Koronare Bypässe ; Myokardszintigraphie ; Echokardiographie ; Elektronenstrahl-Tomographie ; Spiral-Computertomographie ; Magnetresonanztomographie ; Key words Angiography ; Coronary artery bypass grafts ; Myocardial scintigraphy ; Echocardiography ; Electron beam tomography ; Spiral computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Purpose: Electron beam tomography (EBT) permits acquisition of images with high spatial and temporal resolution. The value of EBT and other imaging modalities for the depiction of patent coronary artery bypass grafts (ACVB, IMA) are compared to coronary angiography and an overview of current results is given. Material and methods: Graft patency can be evaluated with indirect methods stress, such as echocardiography, radionuclide ventriculography, myocardial scintigraphy, positron-emission tomography (PET) and direct imaging modalities, such as Doppler/2D echocardiography, EBT, spiral computed tomography (SCT) and magnetic resonance angiography (MRA). Results: With indirect methods graft patency can be evaluated with sensitivity of 64–100% and specificity of 73–100%. EBT and SCT are equivalent in sensitivity (=94%) in the assessment of open venous grafts and specificity is up to 100%, but EBT is superior in the diagnosis of patent IMA grafts (sensitivity 100% vs 89%). Visualization of high-grade venous bypass stenosis seems possible with EBT. MRA with gradient echo technique is highly accurate in the assessment of patent venous grafts (sensitivity 77–93%) but has limited value in the evaluation of IMAs (sensitivity=53%). Promising are ultrafast 3D-MRA methods which permit high accuracy (sensitivity=94–96%) in assessing venous and arterial grafts. Discussion: Indirect imaging methods cannot differentiate between an occluded bypass, progression of coronary artery disease and myocardial infarction. EBT and SCT are equivalent in the diagnosis of open and occluded venous grafts, but EBT is superior in the assessment of patent IMA grafts. Visualization of high-grade venous bypass stenosis seems possible with EBT. MRA techniques, especially ultrafast 3D-MR methods, are highyly accurate in the assessment of patent venous and arterial grafts but are still limited to scientific research.
    Notizen: Zusammenfassung Zielsetzung: Die Elektronenstrahl-Tomographie (EBT) erlaubt es, Einzelschichtbilder mit hoher räumlicher und zeitlicher Auflösung zu erzeugen. Der Stellenwert der EBT in der Diagnostik venöser und arterieller Bypässe soll anderen bildgebenden Verfahren gegenübergestellt werden. Material und Methoden: Die Beurteilung der Durchgängigkeit von Bypässen erfolgt mit indirekten und direkten Methoden. Indirekte Methoden umfassen die Streßechokardiographie sowie nuklearmedizinische Techniken wie die Radionuklidventrikulographie, Myokardszintigraphie und Positronen- Emissions-Tomographie (PET). Zu den direkten Verfahren zählen die Doppler-/2D-Echokardiographie, die Spiral-Computertomographie (SCT), Magnetresonanz-Angiographie (MRA) und die EBT. Ergebnisse: Mit nuklearmedizinischen Methoden gelingt die Beurteilung der Bypassdurchgängigkeit mit einer Sensitivität von 64%–100% bei einer Spezifität von 73%– 100%. Bei der Echokardiographie liegt die Sensitivität bei 83%–93%. EBT und Spiral-CT weisen vergleichbare Sensitivitäten (bis 94%) in der Beurteilung venöser Bypässe auf, die Spezifität wird mit bis zu 100% angegeben. In der Diagnostik arterieller Bypässe zeigt die EBT dagegen eindeutige Vorteile (Sensitivität bis 100%) gegenüber der SCT (Sensitivität bis 89%). Die morphologische Beurteilung hochgradiger venöser Bypass-Stenosen scheint nur mit der EBT möglich zu sein. Mit Gradienten-Echo-Techniken der MRA können angiographisch offene venöse Bypässe mit einer Sensitivität von 77%–93% als durchgängig bewertet werden, für die Diagnostik arterieller Grafts sind sie nicht geeignet (Sensitivität=53%). Vielversprechend sind moderne kontrastverstärkte 3D-MRA Methoden, die auch eine genaue Beurteilung von arteriellen Bypässen gestatten (Sensitivität=96%). Ob eine morphologische Beurteilung von Bypass-Stenosen mit Navigator-Echo-Technik möglich ist, muß noch untersucht werden. Zusammenfassung: Mit indirekten bildgebenden Verfahren ist eine Differenzierung zwischen Bypassverschluß, Progression der koronaren Herzerkrankung oder stattgehabten Myokardinfarkt nicht möglich. EBT und Spiral-CT sind gleichwertig in der Beurteilung der Durchgängigkeit venöser Bypässe. Die EBT besitzt Vorteile in der Diagnostik arterieller Bypässe und der morphologischen Beurteilung hochgradiger venöser Bypass-Stenosen. Die MRA, vor allem ultraschnelle kontrastverstärkte 3D-Methoden, weisen eine hohe diagnostische Aussagekraft in der Beurteilung der Durchgängigkeit venöser und arterieller Grafts auf, ihr Einsatz bleibt aber vorerst wissenschaftlichen Fragestellungen vorbehalten.
    Materialart: Digitale Medien
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  • 112
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 38 (1998), S. 913-923 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Zerebrale Lymphome ; Hirntumoren ; Computertomographie ; Kernspintomographie ; Key words Cerebral lymphomas ; Brain tumours ; Computer tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary The incidence of primary cerebral lymphomas has risen continuously during the past years. The neuroradiological signs, which are decisive for the differential diagnosis of cerebral lymphomas, are worked up and discussed in this study. Thirty CT and 27 MR investigations of a total of 32 patients (14 males, 18 females, age 60±15 years) with histopathologically proven cerebral lymphomas were analysed retrospectively. Multiple cerebral lymphomas were detected in 10/32 patients (31%). The cerebral lymphomas appeared on CT scans as hyperdense masses in 28/30 cases (93%). On T2-weighted MR scans 14/27 (52%) lymphomas were slightly hyperintense compared to white matter and 9/27 (33%) inhomogeneously isointense to poorly hyperintense. These were clearly T2-hypointense compared to T2-hyperintense perifocal oedema. In these cases CT density and T2-weighted signal intensity looked like grey matter. All cerebral lymphomas except one case took up contrast medium. An ependymal infiltration or a contact to the ventricle’s wall were found in 24/32 cases and an infiltration or a contact to the leptomeningeal space in 15/32 cases. One should consider a cerebral lymphoma as a possible differential diagnosis when a cerebral mass shows the following signs: (1) in CT scans as a hyperdense mass, and on T2-weighted MR images hyperintense compared to white matter and hypointense compared to perifocal edema; (2) clear contrast enhancement and (3) infiltration or broad contact with the ependyma and/or the leptomeningeal space.
    Notizen: Zusammenfassung Die Inzidenz der primär zerebralen Lymphome hat in den vergangenen Jahren kontinuierlich zugenommen. In der vorliegenden Arbeit werden die neuroradiologischen Kriterien, die für die Differentialdiagnose zerebraler Lymphome entscheidend sind, erarbeitet. Hierzu wurden 30 CT- und 27 MRT-Untersuchungen von 32 Patienten (14 Männer, 18 Frauen, mittleres Alter 60± 15 Jahre) mit einem neuropathologisch verifiziertem zerebralem Lymphom retrospektiv ausgewertet. Bei 10/32 (31%) Patienten wurden multiple zerebrale Lymphomherde diagnostiziert. In der CT stellten sich nativ bei 28/30 Patienten (93%) die Lymphome mäßig hyperdens dar. Auf T2-gewichteten Spin-Echo-Aufnahmen waren in 14/27 Fällen (52%) die Lymphome im Vergleich zur weißen Substanz mäßig hyperintens und in 9/27 (33%) inhomogen iso- bis hyperintens. Im Vergleich zum T2-hyperintensen perifokalen Ödem kamen sie hypointens zur Darstellung. CT-Dichte und T2-Signalintensität entsprach in diesen Fällen der der Hirnrinde. Bis auf einen Fall nahmen alle zerebralen Lymphommanifestationen deutlich Korntrastmittel auf. In 24/32 Fällen fand sich eine Infiltration des Ependyms oder ein Kontakt zu den Ventrikelwänden. Eine Infiltration oder Kontakt zum leptomeningealen Raum lag in 15/32 Fällen vor. Bei einer intrakraniellen Raumforderung sollte differentialdiagnostisch an ein zerebrales Lymphom gedacht werden, wenn diese 1. im CT hyperdens und auf T2-gewichteten Aufnahmen im Vergleich zum perifokalen Ödem hypointens ist, 2. ein deutliches Kontrastmittelenhancement besteht und 3. eine Infiltration oder ein breiter Kontakt zum Ependym und/oder zum leptomeningealen Raum vorliegt.
    Materialart: Digitale Medien
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  • 113
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Samenblasenzysten ; Nierenagenesie ; Langzeitverlauf ; Computertomographie ; Magnetresonanztomographie ; Key words Seminal vesicle cysts ; Renal agenesis ; Long-term results ; Magnetic resonance imaging ; Computed tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Congenital seminal vesicle cysts associated with ipsilateral renal agenesis or dysplasia are rare malformations. Even though they are more often diagnosed today due to the introduction of advanced, sectional imaging techniques as CT and MRI, no reliable data about the prevalence of this malformation are available. This study reports seven consecutive cases, with long-term follow-up in five cases (26–119 months, mean 52 months). All patients underwent sonography, excretory urography, CT and MRI. Only two of seven patients presented nonspecific symptoms of the lower urinary tract; five were asymptomatic. In all cases sonography revealed the cystic character of the retrovesical enlargement. The anatomy of the lower pelvis was most accurately shown on MRI, which depicted the ectopic insertion of the ureter into the seminal vesicle in five cases. Cysts demonstrated high signal intensities in T1- and T2-weighted spin-echo images. In five cases the CT density was over 40 HU. Whereas one patient (15 years) presented significant enlargement of the cysts 10 years after primary diagnosis with compression of the urinary bladder, four patients showed no changes of their malformation in the follow-up examinations. The present data therefore support the concept of treating only symptomatic patients.
    Notizen: Zusammenfassung Kongenitale Samenblasenzysten mit ipsilateraler Nierenagenesie oder -dyplasie sind seltene angeborene Mißbildungen. Seit Einführung moderner Schnittbildverfahren werden sie jedoch zunehmend häufiger diagnostiziert. Dennoch fehlen bislang genaue Angaben über die Prävalenz dieses Mißbildungsmusters. Diese Studie berichtet über 7 konsekutive Fälle und dokumentiert in 5 Fällen Langzeitbeobachtungen (26–119 Monate, Mittel 52 Monate). Von allen Patienten liegen Ultraschalluntersuchungen, Ausscheidungsurographien sowie Computer- und Kernspintomographien vor. Nur 2 von 7 Patienten wiesen unspezifische Symptome des unteren Harntraktes auf, alle anderen waren asymptomatisch. Von allen bildgebenden Verfahren zeigte die Kernspintomographie am genausten die Veränderungen im kleinen Becken und ihre Beziehungen zum Urogenitalsystem. Die Zysten wiesen eine hohe Signalintensität in T1- und T2-gewichteten Spin-Echo-Sequenzen auf. Computertomographisch fanden sich in 5 Fällen Dichtewerte über 40 HE. Während ein Patient (15 Jahre alt) 10 Jahre nach Erstdiagnose eine erhebliche Vergrößerung der Zysten mit Verdrängung der Harnblase aufwies, zeigten 4 Patienten bei der Nachuntersuchung keine Veränderung der Fehlbildung. Die vorliegenden Daten stützen somit das Konzept, nur symptomatische Patienten zu therapieren.
    Materialart: Digitale Medien
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  • 114
    ISSN: 1432-1084
    Schlagwort(e): Key words: Cholesteatoma ; Meningitis ; Granuloma ; Foreign bodies ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. A case of chronic chemical meningitis occurring after a radical mastoidectomy is reported. Imaging and surgical findings were suggestive of a dissemination of cholesteatoma debris within the subarachnoid spaces. Chemical meningitis has been described in epidermoid and dermoid cyst rupture. This report illustrates that clinicians should be aware of this possible complication. Skull base imaging is mandatory before considering the diagnosis of idiopathic meningitis. Only treatment of the abnormal communication between cerebrospinal fluid and middle ear may eradicate the origin of this rare meningitis.
    Materialart: Digitale Medien
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  • 115
    ISSN: 1432-1084
    Schlagwort(e): Key words: Hematology ; Bone marrow ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Despite its lack of specificity, magnetic resonance imaging (MRI) of the bone marrow has the potential to play a role in the management of patients with primary neoplastic disorders of the hematopoietic system, including lymphomas, leukemias and multiple myeloma. In addition to its use in the assessment of suspected spinal cord compression, bone marrow MRI could be used as a prognostic method or as a technique to assess the response to treatment. The current review addresses the common patterns of bone marrow involvement observed in primary neoplasms of the bone marrow, basic technical principles of bone marrow MRI, and several applications of MRI in selected clinical situations.
    Materialart: Digitale Medien
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  • 116
    ISSN: 1432-1084
    Schlagwort(e): Key words: Bone neoplasms ; Soft tissue neoplasms ; Magnetic resonance imaging ; Osteoblastoma ; Schwannoma ; Neurilemmoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. One case of malignant schwannoma of the sacrum and another of occipital osteoblastoma were evaluated by MR imaging. Both tumors showed fluid-fluid levels with different signal intensities in the sequences performed. Pathologic examination revealed hemmorhagic fluid in both tumors. Malignant schwannoma and osteoblastoma should be included in the list of bone and soft-tissue with fluid-fluid levels. Our data confirm the non-specificity of this finding, which only suggests the presence of previous intratumoral hemorrhage.
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  • 117
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 8 (1998), S. 3-8 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Rectum ; Diagnosis ; Magnetic resonance imaging ; Congenital disorders ; Inflammatory diseases ; Vascular
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. The rectum has become the most successful area of the gastrointestinal tract to be studied with MRI. Its anatomical location, fixed in the pelvic fat, and its lack of peristalsis, make it an ideal organ to be scanned with MRI. In addition, MRI allows a direct sagittal and coronal display, of key importance to colorectal surgeons whose terminology and approach are based on the coronal plane. The sagittal plane allows the depiction of the relation of the rectum to the sacrum, uterus and prostate, with detail not available by other imaging techniques, and the use of endorectal coils allows excellent demonstration of the rectal wall. Although MRI has been used primarily to study rectal carcinoma, other diseases, congenital, inflammatory and vascular in origin, can be studied using the correct technique.
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  • 118
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 8 (1998), S. 116-122 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Spine ; Magnetic resonance imaging ; Nerves ; spinal ; Radiculitis ; Contrast media ; paramagnetic
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Disc prolapse presenting with sciatica may be associated with enhancement of the symptomatic nerve root following magnetic resonance imaging (MRI) with intravenous gadolinium (Gd)-DTPA. Previous studies have shown, however, that this does not occur in all cases. The aim of this study was to assess the incidence of nerve root enhancement in patients with sciatica and disc prolapse and to try to identify any specific features that might be associated with the phenomenon. A total of 227 patients presenting with low back pain and/or sciatica underwent a MRI study of the lumbar spine with intravenous contrast enhancement. Nineteen of 81 (23.5 %) patients with disc prolapse demonstrated nerve root enhancement. Nerve root enhancement had a highly significant association with sequestrated disc lesions (13/19, 68 %; P 〈 0.0005), and was primarily seen in the symptomatic ipsilateral nerve root (16/19, 84 %). The sensitivity of nerve root enhancement associated with disc prolapse was 23.5 % with a specificity of 95.9 %, a positive predictive value of 76 % and a negative predictive value of 69.3 %. Nerve root enhancement may be indicative of the symptomatic level but its poor sensitivity negates the routine use of Gd-DTPA in MRI for sciatica.
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  • 119
    ISSN: 1432-1084
    Schlagwort(e): Key words: Rhabdomyosarcoma ; Magnetic resonance imaging ; Larynx
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. We report a rare case of a young girl with an embryonal rhabdomyosarcoma of the right aryepiglottic fold. Local disease recurrence, occurring 7 years after subtotal resection and adjuvant chemotherapy, was studied with plain radiography, CT and MRI. To the best of our knowledge, this is the first report illustrating the MRI characteristics of a laryngeal embryonal rhabdomyosarcoma in a child.
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  • 120
    Digitale Medien
    Digitale Medien
    Springer
    European spine journal 7 (1998), S. 344-347 
    ISSN: 1432-0932
    Schlagwort(e): Key words Lipoma ; Computed tomography ; Magnetic resonance imaging ; Radiography ; Vertebral
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Osseous lipomata of vertebral bodies are rare. We present a very unusual case where adjacent vertebrae are involved and the plain radiographic and scintigraphic appearances gave cause for some concern. The findings on plain films, scintigraphy, computed tomography and magnetic resonance imaging are discussed.
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  • 121
    ISSN: 1432-1459
    Schlagwort(e): Key words Vascular dementia ; Dominant inheritance ; Cognition ; Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report a 2-year prospective neuropsychological study of five asymptomatic subjects with magnetic resonance imaging (MRI) abnormalities from an Italian kindred affected by cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). These subjects completed tests for attention capacities, processing speed, abstract thinking, short-term memory, learning and constructional praxis. Seven normal subjects matched for age and education, belonging to the same pedigree and not having MRI hyperintensities were examined as controls. The results did not show significant differences between asymptomatic subjects and normal controls. Cognitive performance of asymptomatic subjects did not deteriorate during a 2-year follow-up. Our findings suggest that, at this stage of the disease process, the presence of diffuse leukoencephalopathy does not imply subtle cognitive defects.
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  • 122
    ISSN: 1432-1459
    Schlagwort(e): Key words Alzheimer dementia ; Magnetic resonance imaging ; Temporal lobe ; Amygdala ; High ; signal lesions
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The aim of the present study was to assess selective atrophy of the temporal lobe and amygdala in the early stages of Alzheimer dementia (AD). Magnetic resonance imaging (MRI) measurements and the presence of highsignal lesions (HSL) were analysed in 31 patients with mild to moderate probable AD and 22 controls. In the AD group, MRI findings were compared with cognitive variables and specific features of memory functions. Alzheimer patients showed a significant reduction in volumetric measurement compared with controls in the total volume (P 〈 0.01), temporal lobe (P 〈 0.01) and amygdala (P 〈 0.05). The temporal lobe/brain volume ratio was also significantly reduced in AD subjects (P 〈 0.05). Atrophy of temporal structures was significantly related to the degree of episodic and semantic memory impairment according to a material-specific effect. No significant correlations between amygdala and cognitive variables were found. The results of our study confirm the usefulness of measures of temporal lobe atrophy assessed with MRI in the diagnosis of AD. In contrast, HSL are relatively common in AD patients (12/31 cases) and were not related to volumetric findings, severity of dementia or functional disability.
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  • 123
    Digitale Medien
    Digitale Medien
    Springer
    Archives of gynecology and obstetrics 262 (1998), S. 91-94 
    ISSN: 1432-0711
    Schlagwort(e): Key words: Placenta accreta ; Uterine abscess ; Magnetic resonance imaging ; CT scan ; Ultrasound
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. The postpartum magnetic resonance imaging (MRI) appearance of a patient with placenta accreta and abscess formation is presented here and compared to the ultrasound and CT findings. The diagnosis was confirmed on histopathologic examination and cultures of the hysterectomy specimen. On MRI, the T1-weighted acquisitions showed an enlarged uterus of mildly heterogeneous but predominantly low signal intensity. The T2-weighted images demonstrated a heterogenous area of predominantly bright signal within the uterine body and fundus. In this case, MRI was more informative than ultrasound and non-contrast CT scan in the postpartum diagnosis of placenta accreta with abscess formation.
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  • 124
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 14 (1998), S. 537-546 
    ISSN: 1433-0350
    Schlagwort(e): Key words Fourth ventricle ; Brain stem ; Cerebellum ; Astrocytoma ; Brain neoplasms ; Craniotomy ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The authors conducted a study of 21 children with benign astrocytomas in the IV ventricle treated with radical tumor resection from 1982 through 1991. The purposes of this study were to identify the tumor origin and neural involvement, and to determine the natural history following surgical resection. Pathological studies showed that 18 were pilocytic astrocytomas (pure pilocytic in 12, mixed in 6), 2 fibrillary, and 1 gemistocytic. In the IV ventricle, 12 patients had a transependymal involvement of the floor (brain stem), 6 had an involvement of the wall (cerebellar peduncle), and 3 had involvement of both floor and wall. A gross total resection was performed in 9 patients, and the remaining 12 patients underwent a subtotal resection. All patients were followed without radiation therapy (RT) or chemotherapy. During a follow-up period of 6.5–15 years, all patients were alive. Eight patients suffered recurrence between five months and 66 months after diagnosis. Of these, five received RT for recurrence and had a complete response in all cases. The remaining 13 patients showed no evidence of disease and one had a stable residual tumor. The recurrence-free 5-year and 10-year survival rates were 62.5% and 57% respectively. Patients without brainstem involvement, with total resection, or with pure pilocytic astrocytoma had a better outcome than those with brain stem involvement, with subtotal resection, or with nonpilocytic or mixed histology. In summary, a great majority of benign IV ventricle astrocytomas involve the floor of the IV ventricle. It is often difficult to determine the origin of these tumors in most cases. Benign IV ventricle astrocytomas may not recur even after incomplete resection, and close observation without RT is recommended, although RT appears to be effective for these tumors when they recur.
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  • 125
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 14 (1998), S. 135-138 
    ISSN: 1433-0350
    Schlagwort(e): Key words Hallervorden-Spatz syndrome ; Optic atrophy ; Basal ganglia ; Iron deposits ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A 16-year-old boy with the classic or postinfantile type of Hallervorden-Spatz syndrome is described. Bilateral optic atrophy with visual loss but without retinal changes was the only presenting symptom. Mild cognitive impairment, behavioural disturbances and insidious extrapyramidal involvement appeared later. MRI showed marked symmetrical hypointensity of the globi pallidi and substantia nigra. This new observation suggests that the occurrence of optic atrophy in a patient with Hallervorden-Spatz syndrome should be regarded as noncoincidental and stresses the importance of an accurate neurological work-up in all adolescents with any unusual form of progressive optic atrophy.
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  • 126
    ISSN: 1432-2161
    Schlagwort(e): Key words Slipped capital femoral epiphysis ; Physis ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Objective. To define and compare early lesions associated with slipped capital femoral epiphysis (SCFE) on magnetic resonance imaging (MRI), computed tomography (CT) and radiography. Design and patients. Thirteen patients with 15 symptomatic hips due to SCFE underwent radiography and MRI; CT was performed in 12 patients. SCFE was graded on radiographs, head/neck angles and qualitative changes were evaluated on CT, and morphologic/signal abnormalities were determined on MRI. Results. Physeal widening, apparent on T1-weighted MRI, was evident in every case of SCFE, including one presumed “pre-slip.” T2-weighted images demonstrated synovitis and marrow edema but obscured physeal abnormalities. CT head/neck angles ranged from 4–57° for symptomatic to 0–14° for asymptomatic hips. Physeal and metaphyseal changes were variably identified on both radiographs and CT in all cases of SCFE, but not in the pre-slip. Conclusion. MRI clearly delineates physeal changes of both pre-slip and SCFE, and demonstrates very early changes at a time when radiographs and CT may appear normal.
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  • 127
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 27 (1998), S. 161-163 
    ISSN: 1432-2161
    Schlagwort(e): Key words Parosteal osteoma ; Iliac bone ; Computed tomography ; Magnetic resonance imaging ; Partial regression
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  A 33-year-old patient with a 2-year history of intermittent pain in the right gluteal region and thigh presented with a large sclerotic lesion of the iliac bone. From the findings on radiography, scintigraphy, CT and MRI, a giant parosteal osteoma was suspected. The histological examination confirmed the diagnosis. Since the lesion was extensive it was observed with periodic follow-up examinations. At present, 5 years after the diagnosis, the patient is asymptomatic and imaging studies show that the lesion persists with reduction of sclerosis and size. The tumor was on the surface as well as intramedullary – only one other case with such a distribution is known to us – and it was also in the iliac bone.
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  • 128
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 27 (1998), S. 266-270 
    ISSN: 1432-2161
    Schlagwort(e): Key words Granuloma annulare ; Magnetic resonance imaging ; Soft-tissue tumors ; Rheumatoid nodule ; Pseudo-rheumatoid nodule
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Objective. Granuloma annulare is an uncommon benign inflammatory dermatosis characterized by the formation of dermal papules with a tendency to form rings. There are several clinically distinct forms. The subcutaneous form is the most frequently encountered by radiologists, with the lesion presenting as a superficial mass. There are only a few scattered reports of the imaging appearance of this entity in the literature. We report the radiologic appearance of five cases of subcutaneous granuloma annulare. Design and patients. The radiologic images of five patients (three male, two female) with subcutaneous granuloma annulare were retrospectively studied. Mean patient age was 6.4 years (range, 2–13 years). The lesions occurred in the lower leg (two), foot, forearm, and hand. MR images were available for all lesions, gadolinium-enhanced imaging in three cases, radiographs in four, and bone scintigraphy in one. Results. Radiographs showed unmineralized nodular masses localized to the subcutaneous adipose tissue. The size range, in greatest dimension on imaging studies, was 1–4 cm. MR images show a mass with relatively decreased signal intensity on all pulse sequences, with variable but generally relatively well defined margins. There was extensive diffuse enhancement following gadolinium administration. Conclusion. The radiologic appearance of subcutaneous granuloma annulare is characteristic, typically demonstrating a nodular soft-tissue mass involving the subcutaneous adipose tissue. MR images show a mass with relatively decreased signal intensity on all pulse sequences and variable but generally well defined margins. There is extensive diffuse enhancement following gadolinium administration. Radiographs show a soft-tissue mass or soft-tissue swelling without evidence of bone involvement or mineralization. This radiologic appearance in a young individual is highly suggestive of subcutaneous granuloma annulare.
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  • 129
    ISSN: 1432-2161
    Schlagwort(e): Key words Joints ; Knee joints ; Cartilage ; Magnetic resonance imaging ; Susceptibility effects
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Objective: To study magnetic resonance (MR) imaging pattern of normal hyaline articular cartilage in the knee joint with regard to the contribution of the “magic angle” effect to the MR signal. Design. Thirty-two healthy volunteers were imaged in a standard supine position in a 1.5-T unit using spin echo and gradient echo sequences. Nine volunteers were reimaged with the knee flexed. The signal behavior of the hyaline cartilage of the femoral condyles was evaluated qualitatively and quantitatively. The extended and flexed positions of the nine volunteers were compared. Results. A superficial and a deep hyperintense layer and a hypointense middle cartilage layer were observed. Segments of increased signal intensity were visible along the condyles; a magic angle effect on signal intensity was evident in the hypointense middle layer with both gradient echo and spin echo images. Conclusion. The MR signal behavior of hyaline cartilage is influenced by the alignment of the collagen fibers within the cartilage in relation to the magnetic field. Failure to recognize this effect may lead to inaccurate diagnosis.
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  • 130
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 14 (1998), S. 139-141 
    ISSN: 1433-0350
    Schlagwort(e): Key words Cerebellitis ; Hydrocephalus ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A 14-year-old boy presented acutely with occipital headache, nausea and vomiting. MRI showed obstructive hydrocephalus and marked bilateral cerebellar swelling with increased signal on T2-weighted imaging. Following treatment with oral corticosteroids, the clinical and radiological signs resolved. The clinical course and radiological appearances were consistent with cerebellitis associated with a significant mass effect and hydrocephalus.
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  • 131
    ISSN: 1433-0350
    Schlagwort(e): Key words Diffuse astrocytoma ; Bilateral thalamic astrocytomas ; Computed tomography ; Magnetic resonance imaging ; Hyperfractionated radiotherapy ; Chemotherapy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report the case of a 13-year-old girl with diffuse bilateral thalamic astrocytomas. Incoordination was observed at the onset. Cranial computed tomography (CT) showed enlarged thalami, and magnetic resonance imaging (MRI) revealed these lesions to be symmetrically enlarged with high intensity on the T2-weighted image. Owing to these atypical findings in the neuroimaging studies, we had difficulty in making the correct diagnosis of a brain tumor. After the diagnosis of diffuse bilateral thalamic astrocytomas was obtained, we performed hyperfractionated radiotherapy followed by chemotherapy. Radiation therapy was effective for a while, but the girl's condition deteriorated again and she died 8 months after admission. Although diffuse bilateral thalamic astrocytomas are difficult to diagnose because they do not resemble most other neoplasms on neuroimaging studies, pediatricians should keep this entity in mind in order to arrive at a precise and prompt diagnosis.
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  • 132
    ISSN: 1433-0350
    Schlagwort(e): Key words Choroid plexus cyst ; Lateral ventricle ; Intraventricular cyst ; Magnetic resonance imaging ; CT-stereoendoscopy ; Diomed 25 laser
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A cyst of the choroid plexus of the left lateral ventricle with intermittent blockage of the foramen of Monro and initially with invagination of the III ventricle in a child is described. In a 6-week-old boy a ventriculoatrial shunt was implanted for correction of an active asymmetrical hydrocephalus of unknown origin. When he was 3 months of age a water-soluble contrast CT ventriculography revealed a noncolloid cyst localised predominantly in the upper portion of the III ventricle. At that time the ventricular catheter obstructed with choroid plexus was removed; new bilateral catheters in a parieto-occipital region were implanted. In the course of the next 4 years, first the atrial catheter had to be extracted and then the peritoneal catheter was changed, in both cases because of obstruction. Periods of normal life alternated with periods of transient and intermittent symptoms of increased intracranial pressure, papilloedema, and myoclonic jerks. Repeated computed tomography (CT) and magnetic resonance imaging (MRI) showed stabilised hydrocephalus with an enlarged left lateral ventricle. When the boy was 16 years old MRI revealed a choroid plexus cyst in the left lateral ventricle 2 cm in diameter, with a ball-valve type of obstruction of the foramen of Monro. CT stereoendoscopic resection of the wall of a large cyst filled with cerebrospinal fluid was performed, and two additional adnexal small cysts were coagulated using the bipolar coagulator, Diomed 25 laser and scissors; the symptoms then regressed, except for superior bilateral altitudinal anopsia. Light and electron microscopy of the cyst wall is reported. The cyst was composed of collagenic connective tissue lined with a basal lamina lacking in epithelial cells. The preoperative and postoperative MRI are presented. Choroid plexus cysts localised in the anterior part of lateral ventricles are very rare, and all reported cases have been in male patients. According to the literature our case is only the third ever described in a child.
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  • 133
    Digitale Medien
    Digitale Medien
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    Child's nervous system 14 (1998), S. 747-750 
    ISSN: 1433-0350
    Schlagwort(e): Key wordsListeria monocytogenes ; Magnetic resonance imaging ; Intracerebral cyst ; Neonatal ; Pregnancy complications
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We present the rare case of a girl surviving intrauterine listeria brain stem meningoencephalitis, who subsequently developed hydrocephalus, a trapped IV ventricle and an intramedullary cyst. Such cases have been reported only infrequently, and in earlier cases modern imaging studies were not available. Magnetic resonance imaging has been helpful in our patient to delineate the lesions and plan further treatment.
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  • 134
    Digitale Medien
    Digitale Medien
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    Der Radiologe 38 (1998), S. 948-953 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Maligne Gliome ; Hirnödem ; Rezidiv ; Magnetresonanztomographie ; Key words Malignant glioma ; Brain edema ; Tumor recurrence ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Purpose: To assess the influence of initial preoperative brain edema in malignant gliomas on regrowth patterns. Subjects and methods: 79 patients with histologically verified supratentorial malignant glioma were prospectively studied by magnetic resonance imaging (MRI) before and every 2–3 months after surgery. The median follow-up time was 11 months. We correlated the configuration of the initial vasogenic edema on T2-weighted images with tumor regrowth patterns on contrast-enhanced T1-weighted images. Results: 35/47 tumor regrowths (75%) imitated the initial edema configuration, while 11/47 occurred within the initial tumor bed; in one case tumor recurrence was multilocal. Conclusion: In glioblastoma, tumor regrowth patterns correlate positively with the configuration of the initial vasogenic brain edema. The initial, „presurgical” peritumoral edema should thus be considered when planning further treatment.
    Notizen: Zusammenfassung Fragestellung: Beeinflussen Form und Größe des präoperativen peritumoralen Hirnödems die Rezidiventwicklung bei malignen supratentoriellen Gliomen? Methodik: Prospektiv wurden 79 Patienten mit einem malignen supratentoriellen Gliom mit einem standardisierten MRT-Protokoll untersucht. MRT-Untersuchungen erfolgten vor der neurochirurgischen Operation, möglichst innerhalb der ersten 3 Tage nach Operation und während der Nachbeobachtungszeit in Abständen von 2–3 Monaten. Die mediane Nachbeobachtungszeit betrug 11 Monate. Die initiale präoperative Ödemkonfiguration auf den T2-gewichteten MRT-Aufnahmen wurde mit der Rezidivtumorkonfiguration auf den Kontrastmittel verstärkten T1-gewichteten Aufnahmen verglichen. Ergebnisse: 47 Patienten entwickelten während der Nachbeobachtungszeit ein Rezidiv. Die Konfiguration des Rezidivtumors imitierte in 35/47 Patienten (75%) die initiale präoperative Ödemkonfiguration. Bei 11/47 Patienten entwickelte sich ein lokales und bei einem Patienten ein multilokales Rezidiv. Schlußfolgerungen: Die präoperative Tumorödemkonfiguration im T2-gewichteten MRT-Bild korreliert mit der Rezidivtumorausdehnung. Zukünftige Therapiestudien sollten daher die Ausdehnung des initalen präoperativen Ödems als zusätzlichen prognostischen Faktor mitberücksichigen.
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  • 135
    ISSN: 1433-8491
    Schlagwort(e): Key words. Bipolar affective disorder ; Phosphorus-31 magnetic resonance spectroscopy ; Magnetic resonance imaging ; Mood disorder
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The authors have previously reported decreased intracellular pH (pHi) in the frontal lobes in euthymic bipolar patients treated with lithium using 31P-MRS. White matter hyperintensity (WMHI) is frequently seen in bipolar disorder. To examine a possible effect of lithium on pHi and the relationship between pHi and WMHI, seven drug-free euthymic bipolar patients were examined, and T2-weighted MRI were examined in 14 previously reported bipolar patients. Drug-free patients showed significantly lower pHi than controls. WMHI was associated with low pHi and increased phosphodiester peak. These results suggest that decrease of pHi is not an effect of lithium but is instead related to the pathophysiology of illness. Decrease of pHi and increase of the PDE peak may be the biochemical basis of WMHI in bipolar disorder.
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  • 136
    Digitale Medien
    Digitale Medien
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    Annals of oncology 9 (1998), S. 133-138 
    ISSN: 1569-8041
    Schlagwort(e): breast cancer ; clinical research ; molecular biology
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Clinical research for breast cancer is moving in three new directions following: 1) a critical analysis of three decades of randomized clinical trials for early disease; 2) increasing awareness of this lethal disease among women, generating women's associations which are pressing for improved breast cancer education, screening and treatment; 3) an exponential growth in our understanding of breast cancer molecular biology, leading to a number of innovative therapies with new targets in the cancer cell or its environment. It is the remarkable work of the Oxford Group which has finally vindicated the use of our three main weapons against breast cancer micro-metastases, namely tamoxifen, chemotherapy and ovarian ablation. There is now consensus that clinical research in the adjuvant setting may gain speed and efficiency through intergroup collaboration. Such an 'Intergroup' has been recently created in Europe and will collaborate with the American–Canadian Intergroup. Women's associations have only recently stepped forward to demand better care, and more effective therapies: they are becoming new partners in identifying critical issues in breast cancer research. Medical oncologists involved in breast cancer research are facing a new challenge: the optimal integration of traditional breast cancer therapies, namely endocrine treatments and chemotherapy, and entirely new strategies targeting signal transduction, apoptosis or angiogenesis. In view of the above, there is no doubt that we are entering a new and exciting era in breast cancer clinical research.
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  • 137
    ISSN: 1569-8041
    Schlagwort(e): bone scan ; breast cancer ; chest radiography ; liver ultrasonography ; risk groups ; staging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Bone scan (BS), chest X-rays (CXR), liver ultrasonography (LUS) and laboratory parameters (LP) are frequently used as routine staging procedures for breast cancer patients. These procedures are not always appropriate in either clinical or research settings, regardless of the stage. The aim of this study was to identify groups of patients with differing risks for metastases in order to select more precise standard staging procedures. Patients and methods: The staging data relating to 406 breast cancer patients consecutively referred to our institution between November 1989 and October 1996 were analysed including pathological TNN grading and biological parameters. All of the cases with a positive or suspicious pre-operatory staging and who proved to have metastatic disease before surgery or during the first six months of follow-up were considered true- positive; all of the other cases with a positive or suspicious initial staging but with no evidence of distant metastasis before surgery and with a disease-free survival longer then six months were considered false-positive. In the same way all cases with negative initial staging who relapsed during the first six months of follow-up were considered false-negative and those with negative initial staging and with a disease-free survival longer then six months were considered true-negative. Statistical analysis was performed using Fisher's exact test. Results: BS, CXR and LUS, 388, 399 and 398 examinations respectively, were considered available, and 17 (4.38%), six (1.5%) and four (1%), respectively, proved to be true-positive. A statistically significant difference was observed when our cases were grouped according to T status (T4 vs. T1–T2–T3, P 〈 0.01) and nodal status (N0–N1 cases with less than three involved nodes and N1 with more than three positive lymph nodes N2 patients, P 〈 0.01). Conclusions: The present study suggests that breast cancer patients can be divided into three subgroups with different detection rates for distant metastases at staging (0.59%, 2.94% and 15.53%), and that the standard practice should be changed. In the first (T1N0 and T1N1 patients with ≤3 positive lymph nodes – 41.13% of the patients) and the second group (T2N0, T2N1 with ≤3 positive lymph nodes, T3N0 and T3N1 patients with ≤3 positive lymph nodes – 33.49% of the patients) there is no need for a complete set of staging procedures, whereas full procedural staging is needed in the third group of patients (T4, N1 with 〉3 lymph nodes and N2, 25.37% of the patients).
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  • 138
    Digitale Medien
    Digitale Medien
    Springer
    Molecular and cellular biochemistry 188 (1998), S. 5-12 
    ISSN: 1573-4919
    Schlagwort(e): breast cancer ; estrogen ; dietary fat ; polyunsaturated fatty acid ; estradiol ; pregnancy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Chemie und Pharmazie , Medizin
    Notizen: Abstract The possible association between a high fat diet and increased breast cancer risk has remained controversial. This largely reflects the conflicting data obtained from migrant, case control and animal studies, which generally support this association, and cohort studies which often fail to show a link between fat and breast cancer. The mammary gland is particularly sensitive to estrogens during the fetal development, leading us to hypothesize that dietary fat levels during this period may significantly influence breast cancer risk. Using chemically-induced mammary tumors in rats as our experimental model, we have demonstrated the ability of a maternal diet, high in the polyunsaturated fatty acid (PUFA) linoleic acid, to alter mammary gland differentiation, accelerate the onset of sexual maturation, and increase breast cancer risk. The mammary glands of female rats exposed to a highfat diet in utero have more of the undifferentiated structures (terminal end buds) and fewer of the differentiated structures (alveolar buds) than the glands of rats exposed to a low-fat diet in utero. Furthermore, these mammary glands contain lower levels of total estrogen receptors and have reduced total protein kinase C activity. These effects appear to be mediated by an increase in tne serum estradiol levels of pregnancy, which are elevated at least 30% in pregnant dams fed a high fat diet. Furthermore, the administration of estradiol to pregnant dams produce effects on mammary gland development, onset of puberty and sensitivity to chemical carcinogenesis comparable to those seen in the offspring of rats fed a high fat diet during pregnancy. Our results, thus, support the hypothesis based on epidemiological data that high maternal estrogen levels increase daughters' breast cancer risk. The results also suggest that a high-fat diet may be an important factor in increasing pregnancy estrogenic activity.
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  • 139
    ISSN: 1573-4919
    Schlagwort(e): tamoxifen ; breast cancer ; marker enzymes ; glycoproteins ; lysosomal enzymes
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Chemie und Pharmazie , Medizin
    Notizen: Abstract Tumour markers correlate strongly with prognosis based on tumour burden and surgical resectability. If chemotherapy is extremely effective in certain stage of the disease, the sensitive marker may be of great use in monitoring disease response and drug treatment. Hence, this study was launched to evaluate the changes in tumour marker enzymes like lactate dehydrogenase (LDH), glumate oxaloacetate transaminase (SGOT), glutamate pyruvate transaminase (SGPT), alkaline phosphatase, and acid phosphatase in before and after 3 and 6 months tamoxifen treated breast cancer patients. In addition, the changes in serum glycoproteins viz., hexose, hexosamine, and sialic acid and lysosomal enzymes such as N-acetyl-beta-D-glucosaminidase, beta-D-galactosidase, and beta-D-glucuronidase were analysed in these patients. These values were compared with their age matched healthy control subjects. At 6 months evaluation, the tamoxifen treated postmenopausal breast cancer women showed a statistically significant decreased (p 〈 0.001, 0.05 respectively) levels of LDH, SGOT, SGPT, alkaline and acid phosphatases than their baseline values. Similarly, the levels of hexose, hexosamine, and sialic acid and N-acetyl-beta-D-glucosaminidase, beta-D-galactosidase, and beta-D-glucuronidase were decreased significantly (p 〈 0.001 ) in tamoxifen received postmenopausal women. The result of this study suggested that tamoxifen potentially retard the metastasis of breast cancer as well as the bone demineralisation in postmenopausal breast cancer women. Thus, tamoxifen may also have its antitumour activity through its beneficial effects on tumour marker enzymes and serum proteins in breast cancer women.
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  • 140
    Digitale Medien
    Digitale Medien
    Springer
    Molecular and cellular biochemistry 189 (1998), S. 119-125 
    ISSN: 1573-4919
    Schlagwort(e): estrogen ; breast cancer ; raf-1 kinase ; early growth response gene-1
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Chemie und Pharmazie , Medizin
    Notizen: Abstract We have investigated whether the raf-1 kinase, a downstream mediator of both receptor tyrosine kinase and protein kinase C signalling, is activated by estrogen (E2) in an estrogen receptor positive human breast cancer cell line. Autophosphorylation of raf-1 kinase was studied after treatment of MCF-7 cells with E2. E2-deprived cells contained low levels of raf-1 kinase activity. Treatment of cells for 1 min with E2 resulted in raf-1 autophosphorylation which was maximal within 5 min. Western blot analysis showed that raf-1 undergoes an electrophoretic mobility shift following E2 treatment. Egr-1 is a zinc finger-containing transcription factor which is expressed in association with raf-1 activation. Untreated MCF-7 cells expressed low levels of Egr-1 while E2 treatment resulted in an induction of egr-1 mRNA expression. These kinetics followed closely behind the E2 induction of c-myc mRNA. Egr-1 protein was similarly low in E2-deprived MCF-7 cells and was transiently increased following E2 treatment. Several studies have suggested that kinase activity may play a role in estrogen receptor (ER) activation. While activated v-raf failed to augment ER activation of transcription in transient transfection assays, a dominant negative mutant of raf-1 inhibited E2-induced transcription by 50% primarily as a result of increased baseline levels of E2 independent transcription. The results show that E2 can induce raf-1 kinase activity in MCF-7 breast cancer cells associated with the expression of an early growth response gene and modulation of ER signalling.
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  • 141
    ISSN: 1615-3146
    Schlagwort(e): Epiphysenlösung ; Epiphysiolysis capitis femoris ; Hüftkopf ; Kernspintomographie ; Hüfte ; Röntgendiagnostik ; Slipped epiphysis ; Femur head ; Magnetic resonance imaging ; Hip radiography ; Technology
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Abstract Diagnosis and determination of severity of chronic slipped capital femoral epiphysis (SCFE) is usually made from clinical history, physical examination and radiographic measurement of the degree of slippage. Aim of the present study is to evaluate the diagnostic impact of magnetic resonance imaging in early detection of SCFE. We evaluated magnetic resonance imaging of the hips of 5 healthy children in comparison to the findings in conventional radiographs and magnetic resonance imaging of 9 patients with suspected SCFE. The growth plate of healthy objects shows homogenous low signal intensity, constant width up to 3 mm, and is clearly defined against the surrounding osseous structures. The adjacent surface appears homogenous. Patients with suspected SCFE showed widened growth plate (〉 3 mm) in 6 of 9 cases. Articular effusion was seen in all cases of clinical suspected disease. Incongruence of the ondulate surfaces was seen. Here we found flattening of denticulation of the growth plate in addition. Growth plate showed increase of signal intensity in 2 cases.
    Notizen: Zusammenfassung Die Diagnose der im Jugendalter spontan auftretenden Epiphysiolysis capitis femoris wurde bislang anhand der klinischen Beschwerden sowie der Bestimmung des Abrutschwinkels in konventionellen Aufnahmen (Beckenübersicht, Aufnahme nach Rippstein) gestellt. Für die Diagnose der Frühformen der Epiphysiolysis capitis femoris exsistiert kein allseits akzeptierter Goldstandard. Ziel der vorliegenden Arbeit war es herauszuarbeiten, inwieweit die Epiphysiolysis capitis femoris charakteristische Zeichen in der Kernspintomographie bietet und ob die MRT in der Lage ist, früher Veränderungen als die konventionellen Methoden zu erkennen. Die Kernspintomographien (1,5-T-, T1- und T2-SE-Sequenzen koronar, sagittal, paraaxial, fakultativ STIR-, TIRM-, FLASH-2D-Sequenzen) von fünf gesunden Kindern wurden standardisiert analysiert und mit den magnetresonanztomographischen Untersuchungen von neun Patienten mit vermuteter Epiphysiolysis capitis femoris verglichen. Bei den neun Patienten lagen zusätzlich konventionelle Röntgenaufnahmen nach Rippstein vor. Im Normalkollektiv stellte sich die Epiphysenfuge homogen signalarm bzw. signalfrei dar. Sie wies eine konstante Weite bis zu 3 mm auf und war gegenüber den angrenzenden knöchernen Strukturen scharf abgegrenzt. Das Grenzflächensignal erschien homogen und gezähnelt. Patienten mit vermuteter Epiphysiolysis capitis femoris zeigten eine Erweiterung der Epiphysenfuge auf mehr als 3 mm in sechs von neun Fällen. Bei allen klinisch verdächtigen Fällen konnte ein Gelenkerguß abgegrenzt werden. Es fand sich zusätzlich eine Verschiebung oder Abflachung der Verzähnelung. Ein Signalanstieg im Bereich des Knorpels fand sich kernspintomographisch in nur zwei Fällen.
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  • 142
    ISSN: 1619-7089
    Schlagwort(e): Key words: Absorbed Dose ; S-value ; MIRD phantom ; Whole-body positron emission tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. The purpose of this study was to measure the cumulated activity and absorbed dose in organs after intravenous administration of 2-[F-18]fluoro-2-deoxy-d-glucose (18F-FDG) using whole-body positron emission tomography (PET) and magnetic resonance imaging (MRI). Whole-body dynamic emission scans for 18F-FDG were performed in six normal volunteers after transmission scans. The total activity of a source organ was obtained from the activity concentration of the organ measured by whole-body PET and the volume of that organ measured by whole-body T1-weighted MRI. The cumulated activity of each source organ was calculated from the time-activity curve. Absorbed doses to the individuals were estimated by the MIRD (medical internal radiation dosimetry) method using S-values adjusted to the individuals. Another calculation of cumulated activities and absorbed doses was performed using the organ volumes from the MIRD phantom and the ”Japanese reference man” to investigate the discrepancy of actual individual results against the phantom results. The cumulated activities of 18 source organs were calculated, and absorbed doses of 27 target organs estimated. Among the target organs, bladder wall, brain and kidney received the highest doses for the above three sets of organ volumes. Using measured individual organ volumes, the average absorbed doses for those organs were found to be 3.1×10–1, 3.7×10–2 and 2.8×10–2 mGy/MBq, respectively. The mean effective doses in this study for individuals of average body weight (64.5 kg) and the MIRD phantom of 70 kg were the same, i.e. 2.9×10–2 mSv/MBq, while for the Japanese reference man of 60 kg the effective dose was 2.1×10–2 mSv/MBq. The results for measured organ volumes derived from MRI were comparable to those obtained for organ volumes from the MIRD phantom. Although this study considered 18F-FDG, combined use of whole-body PET and MRI might be quite effective for improving the accuracy of estimations of the cumulated activity and absorbed dose of positron-labelled radiopharmaceuticals.
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  • 143
    ISSN: 1619-7089
    Schlagwort(e): Key words: Ictal single-photon emission tomography ; Positron emission tomography ; Magnetic resonance imaging ; EEG-video monitoring ; Epilepsy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Although ictal single-photon emission tomography (SPET) with technetium-99m ethyl cysteinate dimer (ECD) has a well-established role in the diagnostic evaluation of patients with temporal lobe epilepsy who are being considered for epilepsy surgery, its use in cases of extratemporal epilepsy is still limited. We investigated the influence of the propagation of extratemporal epileptic seizure activity on the regional increase in cerebral blood flow, which is usually associated with epileptic seizure activity. Forty-two consecutive patients with extratemporal epilepsies were prospectively evaluated. All patients underwent ictal SPET studies with simultaneous electroencephalography (EEG) and video recordings of habitual seizures and imaging studies including cranial magnetic resonance imaging and positron emission tomography with 2-[18F]-fluoro-2 deoxy-d-glucose. Propagation of epilptic seizure activity (PESA) was defined as the absence of hyperperfusion on ictal ECD SPET in the lobe of seizure onset, but its presence in another ipsilateral or contralateral lobe. Observers analysing the SPET images were not informed of the other results. PESA was observed in 8 of the 42 patients (19%) and was ipsilateral to the seizure onset in five (63%) of these eight patients. The time between clinical seizure onset and injection of the ECD tracer ranged from 14 to 61 s (mean 34 s). Seven patients (88%) with PESA had parieto-occipital epilepsy and one patient had a frontal epilepsy. PESA was statistically more frequent in patients with parieto-occipital lobe epilepsies (58%) than in the remaining extratemporal epilepsy syndromes (3%) (P〈0.0002). These findings indicate that ictal SPET studies require simultaneous EEG-video recordings in patients with extratemporal epilepsies. PESA should be considered when interpreting ictal SPET studies in these patients. Patients with PESA are more likely to have parieto-occipital lobe epilepsy than seizure onset in other extratemporal regions.
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  • 144
    Digitale Medien
    Digitale Medien
    Springer
    Cytotechnology 26 (1998), S. 207-218 
    ISSN: 1573-0778
    Schlagwort(e): breast cancer ; breast cell lines ; drugscreen target ; immortalized cell lines ; serum-free medium
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin , Werkstoffwissenschaften, Fertigungsverfahren, Fertigung
    Notizen: Abstract New human breast cell lines were developed from metastatic breast cancer tissues and normal breast tissues. Primary cultures were initiated from cellular outgrowths of explanted tissues or from mechanically isolated cells in two serum-free media. Cell cultures derived from both cancer and normal tissues were immortalized with pRSV-T plasmid to generate permanent breast cell lines that exhibited an epithelial morphology. Cell lines generated in this study were characterized with respect to morphology, growth rate, karyotype, presence of specific genes, and the expression of epithelial and breast markers. The cell lines expressed the epithelial cell markers, cytokeratins 8 and 18, and retained the capacity to produce human milk fat globulin. They also express the BRCA-1, erbB2, and EGF receptor genes and possess the H-ras, K-ras, and p53 genes. Preliminary data showed that one of the new cancer cell lines was highly sensitive to the cytotoxic action of taxol. It is envisioned that the new breast cell lines will be useful as targets for identification of therapeutic agents against breast cancer and as models for carcinogenesis studies.
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  • 145
    ISSN: 1573-7276
    Schlagwort(e): breast cancer ; differential gene expression ; new mitochondrial transcript ; new receptor ; tumor progression
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract As a model system for the identification of genes involved in the progression of human breast cancer, differential gene expression in cell lines MCF-7 and MCF-7ADR was investigated. The latter cell line is derived from the former. Cell line MCF-7 is estrogen receptor-positive, vimentin-negative and uninvasive in the Matrigel outgrowth assay and in the nude mouse, while MCF-7ADR is estrogen receptor-negative, hormone-resistant, vimentin-positive, invasive in the Matrigel outgrowth assay and in the nude mouse and resistant to adriamycin due to overexpression of glycoprotein gp170. We have shown that tumor progression in this model system is mediated by transcriptional regulation of mitochondria-related genes, proteases, transmembrane receptors and cell cycle-related gene proteins. Among the genes differentially regulated at the transcriptional level in the cell lines MCF-7 and MCP-7ADR are a new mitochondrial transcript, mitochondrial creatine kinase, matrix metalloproteinase-1, stromelysin-3, urokinase and its receptor, tissue factor, E-cadherin, epidermal growth factor receptor, transmembrane proteins Mat-8 and progression associated protein (PAP), cyclin E, cyclin-dependent kinase-2 and cell cycle inhibitory proteins p16, p21 and p27.
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  • 146
    ISSN: 1573-7276
    Schlagwort(e): breast cancer ; in vitro invasiveness ; metalloproteinase system ; urokinase system
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Hormone-independent growth and invasiveness represent phenotypic properties acquired during early progression of breast cancer. We compared human mammary adenocarcinoma cells, MCF-7, which are estrogen-dependent and poorly metastatic, with the estrogen-independent and highly metastatic subline, MCF7/LCC1, with regard to expression of tissue-degrading factors of the matrix metalloproteinase (MMP)-and urokinase (uPA)-dependent degradative pathways, as well as for their in vitro invasive properties. Both cell lines showed low constitutive mRNA expression of the MMP inhibitor TIMP-1. Baseline expression of TIMP-2 mRNA was also very low in MCF-7 cells, whereas the MCF7/LCC1 level was much higher (~10- fold). Furthermore, both cell lines revealed low constitutive capacity to migrate in an in vitro invasion assay. Treatment with 12-O-tetradecanoylphorbol-13-acetate (TPA; 100 nM) induced the mRNAs for TIMP-1 as well as for MMP-1, MMP-9, the uPA receptor, and the uPA inhibitor PAI-1, am ongst which only the responses of MMP-9 and PAI-1 were cell-specific. The mRNA levels of MMP-9 and PAI-1 were ~10-fold and ~15-fold higher in MCF7/LCC1 cells compared to MCF-7 cells. The secretion of immuno-reactive PAI-1 was considerably elevated (. 20-fold) in TPA-treated MCF7/LCC1 cells, whereas the TPA-dependent level of 92-kDa MMP-9 was only ~2-fold higher in MCF7/LCC1 cells than in MCF-7 cells. In both cell lines treatment with TPA was associated with an increase (~10-fold) in in vitro migration, which in the MCF7/LCC1 cells was significantly attenuated by a reconstituted basement membrane extract (Matrigel). These data suggest that TPA-responsive in vitro invasive properties that are probably associ-ated with PAI-1 expression may co-vary with progression from hormone-dependent to -independent breast cancer. © Rapid Science 1998
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  • 147
    Digitale Medien
    Digitale Medien
    Springer
    Cancer causes & control 9 (1998), S. 189-198 
    ISSN: 1573-7225
    Schlagwort(e): Age of onset ; Australia ; breast cancer ; family history ; height ; oral contraceptives ; parity ; weight
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives: A case-control-family study of breast cancer in women under the age of 40 was carried out in Melbourne and Sydney, Australia, from 1992 to 1995 to determine the risk factors for these women. Subjects included 467 incident cases identified by state cancer registries and 408 population-based controls. Methods: All participants completed a structured risk-factor questionnaire and family pedigree during an in-person interview. Where possible, cancers in first- and second-degree relatives were verified. Results: Multiple logistic regression analysis showed that the strongest risk factor for breast cancer was a family history of the disease - having at least one affected first-degree relative trebled the risk (relative risk [RR] = 3.3, 95 percent confidence interval [CI] = 1.9-5.8). Risk increased with height by three percent (standard error [SE] of one percent) per cm, and after adjusting for height, there was evidence for a decreased risk in women weighing 73 kg or more. There was an increased risk of breast cancer after the first full-term birth (RR = 1.8, CI = 1.0-3.5) but this risk fell by 30 percent (SE = 11 percent) with each subsequent livebirth. Conclusions: The effects of other reproductive factors and oral contraceptive use, although not nominally significant, were in accord with published findings from similar studies in young women. This study of Australian women has indicated that some risk factors for breast cancer in women under age 40 differ from those reported for older women either in direction (e.g., weight) or relative importance (e.g., family history).
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  • 148
    Digitale Medien
    Digitale Medien
    Springer
    Cancer causes & control 9 (1998), S. 433-439 
    ISSN: 1573-7225
    Schlagwort(e): Body mass ; breast cancer ; menopause ; physical activity ; United States ; women
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objectives: It is unclear whether physical activity is associated with a reduced risk of breast cancer. Some studies also suggest different effects between pre- and postmenopausal women, and lean and heavy women. Methods: We followed 1,566 University of Pennsylvania alumnae (mean age, 45.5 years), initially free of breast cancer, from 1962 until 1993. Physical activity at baseline was assessed by asking women about stairs climbed, blocks walked, and sports played. We estimated energy expenditure and categorized women into approximate thirds (〈 500, 500-999, 1,000+ kcal/wk). We identified 109 breast cancer cases during 35,365 person-years from follow-up questionnaires or from death certificates. Results: After adjustment for age and body mass index (BMI) (kg/m2), the relative risk (RR) of breast cancer was 0.92 (95 percent confidence interval [CI]=0.58-1.45) among women expending 500-999 kcal/wk and 0.73 (CI=0.46-1.14) for those expending 1,000+ kcal/wk, compared with women expending 〈 500 kcal/wk (P trend=0.17). This association was modified by menopausal status, but not BMI. For postmenopausal women, corresponding RRs were 0.95 (CI=0.58-1.57) and 0.49 (CI=0.28-0.86), respectively (P trend=0.015). Increased physical activity in premenopausal women was not significantly associated with decreased risk of breast cancer. Conclusions: These data support an inverse association between physical activity and breast cancer among postmenopausal women. Cancer Causes and Control 1998, 9, 433–439
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  • 149
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; CD44 transmembrane receptor variants ; soluble CD44 v5 and v6 ; CD44 v5 and v6 expression ; metastatic disease
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Primary breast cancers were shown to overexpress CD44 v5 and v6 at the plasma membrane. However, the clinical significance of this overexpression remains unclear. Overexpression of CD44 v5 and v6 in primary breast cancers was found to correlate with metastasis and poor prognosis by some investigators, yet this correlation could not be confirmed by others using different antibodies. In this study the influence of metastatic disease, the site of metastasis, and the amount of CD44 v5 and v6 expression in the primary tumor on serum levels of the soluble forms of CD44 v5 and v6 (sCD44 v5 and v6) in breast cancer patients was investigated. Soluble CD44 v5 and v6 serum levels were measured by enzyme linked immuno sorbent assay in a group of breast cancer patients who developed metastases in various organs and in another group of patients with single organ metastasis. For control, sCD44 v5 and v6 levels were measured in breast cancer patients who remained free of metastasis and in healthy blood donors. Expression of plasma membrane bound CD44 v5 and v6 in the primary tumors of the patients with metastasis in various organs was correlated to sCD44 v5 and v6 levels in serum. Furthermore the size of sCD44 v6 was analyzed by immunoblot using a monoclonal antibody directed against CD44 v6. When metastases were detected, sCD44 v5 and v6 serum levels were increased as compared to levels measured one month after tumor surgery in patients free of metastases (p = 0.0025 and p = 0.0004). Six of 19 and 6 of 20 patients had sCD44 v5 and v6 serum levels above a cut-off level of 85 and 275 ng/mL, respectively. In these cases expression of CD44 v5 and v6 in the primary cancers was also elevated. Low sCD44 v5 and v6 serum levels were associated with weak expression of CD44 v5 and v6 in the respective primary cancers. As shown by statistical analysis of sCD44 v5 and v6 levels in 57 patients with single organ metastases, elevated sCD44 v6 levels but not sCD44 v5 levels were associated with metastases in liver or bone (p = 0.0025). Immunoblot analysis of soluble CD44 proteins in serum revealed two CD44 v6 specific signals of approximately 120 and 170 kDa. Increased sCD44 v5 and v6 serum levels in patients with breast cancer were influenced by the amount of CD44 v5 and v6 expression in the primary tumor by the site of metastasis. Elevated sCD44 v6 serum levels were preferentially found in patients with metastases in liver or bone.
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  • 150
    ISSN: 1573-7217
    Schlagwort(e): mammary adenocarcinoma cell line ; MG 1361 ; MMTV-neu transgenic mice ; breast cancer ; hormone responsiveness ; apoptosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A new murine cell line, named MG1361, was established from mammary adenocarcinomas arising in a MMTV-neu transgenic mouse lineage where breast tumors develop in 100% of females, due to the over-expression of the activated rat neu oncogene in the mammary gland. The MG1361 cell line shows an epithelial-like morphology, has a poor plating efficiency, low clonogenic capacity, and a doubling time of 23.8 hours. Karyotype and flow cytometry analysis revealed a hypotetraploid number of chromosomes, whereas cell cycle analysis showed 31.2% of cells to be in the G1 phase, 21.4% in S and 47.4% in G2 + M. This cell line maintains a high level of neu expression in vitro. The MG1361 cell line was tumorigenic when inoculated in immunodeficient (nude) mice and the derived tumors showed the same histological features as the primary tumors from which they were isolated. MG1361 cells were positive for specific ER and PgR binding which was competed by tamoxifen, making this cell line useful for the evaluation of endocrine therapy. Moreover, they were sensitive to etoposide treatment, suggesting that they could be a model for the study of chemotherapy-induced apoptosis. As the tumors arising in MMTV-neu transgenic mice have many features in common with human mammary adenocarcinomas (Sacco et al., Gene Therapy 1995; 2: 493–497), this cell line can be utilized to perform basic studies on the role of the neu oncogene in the maintenance of the transformed phenotype, and to test novel protocols of therapeutic strategies.
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  • 151
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 47 (1998), S. 197-199 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; insulin-like growth factor system ; IGF-I receptor ; IGF-II receptor ; binding proteins ; prognosis ; transformation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In 1992, a special issue of Breast Cancer Research and Treatment was devoted to the insulin-like growth factors and breast cancer. In that issue, identification of the key components of the IGF system was reviewed and their potential role in breast cancer growth was described. In this issue, we revisit the IGF system with particular attention to data that further supports their role in the growth regulation of breast cancer. Several new facets of the IGF system are described, and several laboratories have more clearly defined how each individual component of the IGF system may influence breast cancer biology.
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  • 152
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; tamoxifen ; estrogen receptor ; progesterone receptor ; Ki67 ; S-phase fraction
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Aim: To determine the effects of tamoxifen on the levels of hormone receptors and proliferation markers in the early phase of treatment and the relationship of the changes with tumor response in patients with primary breast cancer. Methods: Twenty-one women with primary, operable breast carcinomas were treated with tamoxifen 20 mg daily. Fine needle aspiration (FNA) was used to obtain samples prior to the start and at 14 days and 8-weeks post-treatment. From these samples estrogen receptor (ER), progesterone receptor (PgR), and Ki67 levels were determined using immunocytochemistry and ploidy and S-phase fraction (SPF) using flow cytometry. Tumor response was measured clinically according to UICC criteria. Results: There were 12 responders (2 CR, 10 PR) and 9 non-responders (2 NC, 7 PD). Responders were more likely to be ER + (p=0.002), PgR + (p=0.006), and low SPF (p=0.06). At 14 days post-tamoxifen, the median decrease in Ki67 (% cells staining) for responders was − 4.8 and for non-responders − 0.15 (p=0.005). This decrease was seen predominantly in ER + tumours. The difference in SPF was not significant. A decrease in ER was seen in 3/15 patients all of whom were responders. A rise in PgR was seen in 7/17 patients and all but one were responders. Similar changes for ER and PgR were seen at 8-weeks post-tamoxifen, although the reductions in Ki67 and SPF at that time point were not related to response. Conclusion: We have observed a decrease in Ki67 and ER and a rise in PgR after 14 days of treatment with tamoxifen that was related to subsequent response. This is the first study in which an early decrease in a proliferation marker has been shown to relate to subsequent clinical response.
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  • 153
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; LNCaP ; PSA ; SCID mice ; steroid hormones ; T47D
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Previous studies revealed that prostate-specific antigen (PSA) is present in 〉 30% of human breast tumor cytosols. Survival analysis showed that patients with PSA-producing tumors have a reduced risk for relapse, suggesting PSA to be an independent favorable prognostic marker for a large subset of breast cancer patients. The present investigation established an in vivo model for the induction of PSA in human breast cancer tumors growing as xenografts in severe combined immunodeficient (SCID) mice. The human mammary cancer cell-line T47D was grown i.m. in female mice. When the tumor and leg diameter reached 10 mm, the mice were stimulated daily with norgestrel for either 5 or 7 days to produce PSA, and sacrificed on day 8. The prostate cancer cell-line LNCaP was grown in male mice and functioned as a positive control for PSA production. After T47D and LNCaP mice were sacrificed, a highly sensitive immunofluorometric assay was used to analyze the PSA concentration in the tumor, muscle, liver, and kidney cytosols. Norgestrel-stimulated T47D mice showed significantly more PSA in the tumors compared to tumors of the control mice. However, PSA levels in tumors of the stimulated mice were significantly lower than those in the LNCaP xenografts. No PSA levels above background were present in the blood and normal tissue of the norgestrel-stimulated or control T47D xenografts. This mouse model will be a valuable tool for investigating and screening new therapies for a subgroup of breast cancer patients who have significant PSA concentrations in their tumors.
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  • 154
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 48 (1998), S. 97-106 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; oxygen partial pressure ; molecular markers ; prognostic factors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Hypoxic tumor cells may represent a fraction of cells that are not susceptible to radiation or chemotherapy. Intratumoral oxygen partial pressure (pO2) is the result of oxygen delivery and consumption. Cell proliferation is one factor to effect oxygen consumption and we therefore studied the correlation between tumor pO2 and histological parameters. Patients and methods: In 36 women and one man (age range 29–80 years) with suspected breast cancer. Before tumor resection, intralesional pO2 was determined with a polarographic needle electrode. Under ultrasound control, 200 tumor measurements were obtained; Hb levels, Hk, arterial blood gas parameters, and tissue temperature were determined. The median of pO2 values and the percentage of hypoxic areas (pO2 〈 10 mmHg) were calculated and correlated with the histological type, grading, ER, PR, and the expression of Ki-67, p53, EGFR, pS2, and c-erb-B2. Results: The overall median pO2 was 44 mmHg, and 1024 measurements (13.8%) represented hypoxic areas. Ductal and lobular invasive cancers showed median pO2 of 41 mmHg. The mean pO2 of G1 tumors was 59 mmHg and the hypoxic fraction 8%, in contrast to G2 tumors with 43 mmHg and 17%, and G3 tumors with 36 mmHg and 20.4% (p 〈 0.01). We observed a correlation with tumor size and an increased rate of hypoxic areas in T3–4 lesions (p 〈 0.02). Also tumors with negative nodes or positive ER had significantly higher pO2 values, as did tumors with an overexpression of c-erb-B2, p53, and cathepsin D. Conclusion: Oxygenation of human breast cancers can safely be measured in patients prior to surgical therapy. pO2 values correlate both with prognostic markers examined histologically and with molecular growth factors. As the efficacy of preoperative or adjuvant treatment in individuals may depend on oxygen partial pressure, efforts to manipulate tumor pO2 for therapeutic purpose could be promising.
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  • 155
    ISSN: 1573-7217
    Schlagwort(e): aneuploidy ; breast cancer ; FISH ; interphase cytogenetics ; metastasis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Previous work from our laboratory demonstrated aneuploidy for several chromosomes by interphase fluorescence in situ hybridization (FISH) in a high proportion of breast cancer specimens. In the literature, only limited data are available concerning chromosome 8 anomalies in breast cancer. To determine chromosome 8 ploidy status in primary and metastatic specimens from 81 breast cancer patients, FISH analysis with a DNA probe recognizing chromosome 8 centromeres was performed. In all primary tumor specimens (n=30), significant proportions of cells were aneuploid exhibiting gain of chromosome 8 copy numbers; in 75% of effusion specimens previously classified as malignant by cytology and/or FISH for various chromosomes (n=40), cell populations aneuploid for chromosome 8 were detected; effusions previously classified non-malignant (n=11) were diploid in 10 cases, whereas one specimen contained rare hyperdiploid cells. Among these cells complex chromosomal aneuploidy could be demonstrated by two-color FISH, suggesting malignancy. Trisomic and tetrasomic clones were predominant in the majority of samples, but a marked intratumor cytogenetic heterogeneity was observed in most cases. Primary tumors and corresponding positive axillary lymph nodes revealed similar distributions of chromosome 8 copy numbers, analogous to previous findings with other chromosomes. This implies that, by using suitable FISH probes after examination of the respective primary tumor, an efficient search for (micro)metastasis might be feasible.
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  • 156
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; antiestrogen ; estrogen-sensitive ; bone mineral density ; lipids ; BMD ; cholesterol ; triglycerides
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The effect of EM-800, a new non-steroidal antiestrogen having pure antiestrogenic activity, was studied on chemical carcinogenesis induced by dimethylbenz(a)anthracene (DMBA) as well as on serum lipids and bone mass in the rat. Treatment with EM-800 orally, once daily, for 282 days (9 months), starting 3 days before DMBA administration, decreased the incidence of tumors from 95% in control animals to 60% (p 〈 0.01), 38% (p 〈 0.01), and 28% (p 〈 0.01) at the daily doses of 25 μg, 75 μg, and 250 μg, respectively. The average number of tumors per animal decreased from 4.5 ± 0.5 tumors in the control group to 0.9 ± 0.2 (p 〈 0.01), 0.5 ± 0.2 (p 〈 0.01), and 0.3 ± 0.1 (p 〈 0.01) tumors in the rats treated with the above-indicated doses of the antiestrogen. In addition, treatment with the increasing doses of EM-800 reduced serum cholesterol levels to 64%, 56%, and 48% of control, while serum triglycerides decreased to 31%, 28%, and 30% of control. Bone mineral content (BMC) and bone mineral density (BMD) of total skeleton, femur, and lumbar spine were not significantly affected following 282 days of treatment with EM-800. However, treatment with EM-800 inhibited the urinary ratio of hydroxyproline to creatinine (HP/Cr) from 14.0 ± 3.90 μmol/mmol in controls to 7.6 ± 0.8 (p 〈 0.05), 6.8 ± 0.8 (p 〈 0.01), and 6.8 ± 1.1 (p 〈 0.01) μmol/mmol, respectively, while the same treatment had no effect on serum total alkaline phosphatase (tALP) activity or urinary calcium and phosphorus excretion. The 25 μg, 75 μg, and 250 μg daily doses of EM-800 inhibited uterine weight by 35% (p 〈 0.01), 62% (p 〈 0.01), and 66% (p 〈 0.01), while vaginal weight was reduced by 8% (p 〈 0.05), 30% (p 〈 0.01), and 38% (p 〈 0.01), respectively. In agreement with the 27% increment (p 〈 0.05) in ovarian weight at the highest antiestrogen dose used, serum androstenedione (p 〈 0.05), androst-5-ene-3β,17β-diol (p 〈 0.01), testosterone (p 〈 0.05), and estradiol (p 〈 0.01) levels were increased. The present data show that EM-800 prevents the development of DMBA-induced mammary tumors while simultaneously inhibiting uterine and vaginal weight, reducing serum cholesterol and triglyceride levels, and having no adverse effect on bone mass following 9 months of treatment in the rat.
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  • 157
    ISSN: 1573-7217
    Schlagwort(e): doxorubicin ; breast cancer ; potentiation ; DPPE
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract N,N-diethyl-2-[4-(phenylmethyl)phenoxy] ethanamine.HCl (DPPE) is a diphenylmethane analog of tamoxifen that antagonizes the intracellular binding of histamine to growth-regulatory sites, a proportion of which represents P450 enzymes, in microsomes and nuclei. We previously reported increased response rates and decreased myelotoxicity in patients with prostate and other cancers who received an intensive dose/schedule of DPPE plus single-agent chemotherapy. We now report the results of a study of DPPE combined with a standard dose/schedule of doxorubicin in twenty-three patients with metastatic breast cancer, sixteen of whom had received prior non-anthracycline chemotherapy. DPPE (6 mg/kg) was infused intravenously (IV) over 80 minutes. Doxorubicin (60 mg/m2) was administered IV over the last 20 minutes of the DPPE infusion. Treatment was repeated every 3 weeks (maximum, 7 cycles). Patients achieving complete response (CR) were followed off treatment until relapse. All patients were evaluable for toxicities and efficacy. Sixteen patients (69%; 95% C.I. = 47–87%) responded (7 CR and 9 PR). Eleven responders, including 6 with CR, had prior chemotherapy. Five responders (2CR, 3PR) had a poor (ECOG 3/4) performance status pre-treatment. Median CR duration was 11 (range 5–18) months. Hematological toxicity was low; GI toxicity (nausea/vomiting/dyspepsia) appeared somewhat higher than historical experience, but responded well to anti-emetics, ranitidine, and/or dexamethasone in most patients; a mean absolute drop in left ventricular ejection fraction of 8% occurred in 17 patients who received ⩾ 300 mg/m2 doxorubicin. The observed response rate in DPPE/doxorubicin-treated patients appeared to be higher than historically reported for doxorubicin alone in this setting, suggesting a chemopotentiating effect of DPPE. A multi-centre trial of this regimen in an additional 32 patients with early metastatic breast cancer has been conducted by the Clinical Trials Group, National Cancer Institute of Canada, and a phase 3 study is planned.
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  • 158
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. 69-78 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; ipsilateral breast tumor recurrence ; prognosis ; uncontrolled local disease
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Introduction: The aims of the study were to assess the outcome among patients with early breast cancer operated on with wide local excision who developed a subsequent ipsilateral breast tumor recurrence, and to identify risk factors for uncontrolled local disease. Uncontrolled local disease (ULD) was defined as the appearance of clinically manifest invasive adenocarcinoma in the remaining breast or on the ipsilateral chest wall which could not be eradicated with salvage treatment during the period of follow-up (2–18 years). Patients and methods: Eighty-five patients in a cohort of 759 patients, treated for invasive Stage I–II breast cancer with breast-conserving surgery 1976–1985 in Stockholm, with a subsequent ipsilateral breast tumor recurrence (IBTR) were reviewed retrospectively. The majority of the patients were premenopausal (58%), node negative (72%), and had received postoperative radiotherapy (79%). Median follow-up time following breast-conserving surgery was 13 (9–19) years. Multivariate Cox's hazard regression was used in the statistical analysis to identify prognostic factors for ULD. Results: The majority (n = 61) of the IBTR's were located in the original tumor quadrant and showed the same histopathological features as the primary tumor. Salvage mastectomy (n = 65) or reexcision (n = 14) were performed in 79 (93%) of the patients. Twenty-one patients developed ULD. Five years following the diagnosis of IBTR the disease-free survival was 59%, the cumulative incidence for ULD was 24%, and for death in breast cancer 34%. In the cohort of 759 patients, patients who received radiotherapy following the primary breast-conserving surgery had 1% cumulative incidence of ULD following the diagnosis of IBTR compared to 4% among patients that received no postoperative radiotherapy. The cumulative incidence at 5 years of ULD following salvage mastectomy was 12% compared to 33% after salvage reexcision. Patients operated on with breast-conserving surgery with an original tumor size 〈 15 mm, who were treated with salvage mastectomy for IBTR, had in multivariate analysis the lowest relative risk for ULD. Adjuvant chemotherapy following IBTR treatment did not seem to improve local tumor control. Following the diagnosis of IBTR, 78% (n = 21) of the patients with ULD and/or regional recurrence (n = 27), died of a disseminated breast cancer in contrast to 10% (n = 6) among the remaining 58 patients. Conclusion: Uncontrolled local disease is an important outcome measure following breast-conserving surgery. In this cohort, salvage mastectomy provided a superior local control rate compared to salvage reexcision. A higher although not statistically significant rate of ULD was also seen in patients who had not received postoperative radiotherapy as part of their primary treatment.
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  • 159
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. 165-169 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; fibroadenoma ; loss of heterozygosity ; microsatellite instability
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A majority of studies have shown an increase in the risk of breast cancer among women previously diagnosed with fibroadenoma (FA). At present there is conflicting evidence whether some of the chromosome abnormalities frequently found in breast carcinoma, such as loss of heterozygosity (LOH), are already present in FAs and other types of benign breast disease and, if present, whether such abnormalities are associated with the observed increase in risk. Microsatellite instability (MSI) is also recognised as a marker of genetic damage and is thought to occur when there has been damage to the cell's mismatch repair (MMR) system. We have analysed 39 cases of FA obtained from paraffin-embedded tissue for the presence of MSI and LOH at 11 loci to determine if these types of genetic alterations occur in FA. The incidence of MSI and LOH found were 4 of 395 (1.0%) and 5 of 271 (1.8%) informative loci tested respectively. Approximately 8% of cases were positive for MSI and 10% were positive for LOH, with one specimen having multiple occurences of both MSI and LOH. We conclude that these forms of genetic alteration do occur in FAs but that the incidence is low.
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  • 160
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. 171-183 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; galectin-3 ; Line 1 retrotransposon
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Galectin-3 is a galactoside binding protein found at elevated levels in a wide variety of neoplastic cells and thought to be involved in cognitive cellular interactions during transformation and metastasis. Previously, we have shown that introduction of human galectin-3 (Mr 31,000) cDNA into the human breast cancer cells BT-549 which are galectin-3 null and non-tumorigenic in nude mice resulted in the establishment of four galectin-3 expressing clones. Three of them acquired tumorigenicity when inoculated in the mammary fat pad of nude mice. Here, we questioned what is the molecular difference between the nude mouse tumorigenic and non-tumorigenic galectin-3 expressing BT-549 cell clones. Differential display analysis and Northern blotting revealed that, unlike the tumorigenic clones, neither the parental cells nor the non-tumorigenic clone expressed a 6.5 Kb transcript. A 607 bp PCR (polymerase chain reaction) product from the differentially displayed mRNA revealed a 93% sequence homology with the human L1 retrotransposon previously suggested to play a role in the pathobiology of some breast cancers. In addition, we show that the two gene products, i.e., galectin-3 and L1, are co-expressed in breast carcinoma specimens and in other nude mouse tumorigenic cell lines.
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  • 161
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. 245-249 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; fibroadenoma ; fibrocystic disease ; fractal analysis ; mammography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Mammography has become the mainstay of breast cancer screening. However, widespread mammography has led to an increase of the number of breast biopsies done for benign disease. Therefore, a method to better discriminate benign from malignant lesions is needed. Fractal analysis is a mathematical method which can quantify complex shapes. It has been previously shown retrospectively that the composite fractal dimensions, D, of malignant mammographic masses is higher than for benign lesions. A prospective study of 75 patients who were recommended to undergo needle localized breast biopsy by independent radiologists had the composite D calculated. Fractal analysis was done without knowledge of the biopsy results. The mean composite D of malignant lesions was higher than benign lesions, 2.545 ± 0.067 vs. 1.936 ± 0.144 (p=0.00004). Calculation of a receiver-operating characteristic curve showed that a cutoff value of 2.067 had a 100% sensitivity and 63% specificity (i.e., false positive rate of 37%). Mean D for fibroadenomas was 2.087 ± 0.054, fibrocystic disease was 1.877 ± 0.167, DCIS was 2.261 ± 0.069, and invasive cancer was 2.634 ± 0.039 (1-way ANOVA, p=0.00007). These data imply that fractal analysis may be beneficial in discriminating between benign and malignant lesions. However, further study in a larger number of patients with a variety of lesions is needed.
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  • 162
    ISSN: 1573-7217
    Schlagwort(e): infiltrating ductal carcinoma ; breast cancer ; histology ; fibrotic focus ; prognosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The presence of fibratic fows (FF) in infiltrating ductal carcinoma (IDC) has been shown to be an important histological factor associated with high tumor aggressiveness, or early tumor recurrence or death. However, the clinicopathological significance of FF for predicting the long-term survival of the patients with IDC has not been fully investigated. In order to elucidate this aspect, we divided 140 IDCs with at least 10 years of follow up into tumors with FF and those without. IDC with FF showed significantly higher histologic grade (P=0.02), higher frequency of tumor necrosis (P=0.02), higher frequency of cases with more than three positive lymph node metastases (P=0.04), higher T classification (P=0.009), and higher pathological stage (P=0.0002) than those without FF. Relative risk (RR) of tumor recurrence and death was significantly higher in tumors with FF than in those without (RR=4.5, P 〈 0.00001 and RR=5.6, P 〈 0.00001, respectively). In cases of early stage cancer (stages I, IIA, and IIB), or in those with less than four lymph node metastases, IDCs with FF demonstrated a significantly higher risk than those without. Multivariate adjustments for other pathological factors did not change the RRs significantly. These results indicate that in long-term follow up the presence of FF is a significant prognostic parameter for IDC, and therefore strongly suggest that IDCs must be divided into those with and without FF.
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  • 163
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 48 (1998), S. 87-92 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; SRC-1 ; RT-PCR ; response ; tamoxifen
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Tamoxifen causes an objective response in about one-third of metastatic breast cancer and in only half of the breast cancer patients with estrogen receptor (ER) positive tumors. Steroid-receptor coactivator-1 (SRC-1) appears to be a general coactivator for steroid receptors and rate limiting factor necessary for efficient ER transactivation. We aimed to evaluate whether SRC-1 expression is an additional factor for prediction of response to first-line tamoxifen therapy in patients who developed recurrent disease. Here for the first time, we report on SRC-1 expression using a semi-quantitative RT-PCR in 21 primary breast tumors, seven mammary tumor cell-lines, 12 fibroblast cultures, and six normal breast tissues. The highest levels of SRC-1 were observed in normal tissues, intermediate levels in tumor tissues, and the lowest levels in breast tumor cell-lines. There was no relationship between the levels of SRC-1 in these primary tumors and the proportion of tumor cells within the surgical samples, nor with ER status. The median SRC-1 level was, however, lower in tumors from patients that did not respond to tamoxifen. Our findings suggest that high levels of SRC-1 indicate a favorable response to tamoxifen of patients with recurrent breast cancer. Abbreviations: PgR, progesterone receptor; ER, estrogen receptor; GR, glucocorticoid receptor; TR, thyroid hormone receptor; RXR, retinoid X receptor; SRC-1, steroid-receptor coactivator-1; EGF, epidermal growth factor; TGF, transforming growth factor; IGF, insulin like growth factor; UPA, urokinase-type plasminogen activator
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  • 164
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 48 (1998), S. 265-271 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; c-neu transgenic mice ; N-(4-hydroxyphenyl) retinamide ; arotinoid Ro 40-8757 ; retinoid analogues
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Breast cancer is one of the most common cancers and is a leading cause of mortality in women. The TG.NK transgenic mouse line expresses the c-neu breast cancer oncogene under the control of an MMTV promoter and appears to be a useful animal model for evaluation of intervention strategies to delay/prevent breast cancer. Fiber-rich nonpurified diet (NTP-2000), as compared to a purified diet (AIN-76A), has previously been shown to significantly delay the development of mammary cancer in the TG.NK model. Four-week old hemizygous TG.NK female mice with MMTV/c-neu oncogene were fed NTP-2000 diet containing the retinoid analogue 4-hydroxyphenyl retinamide (4-HPR) at 5 mM/kg or an arotinoid Ro 40-8757 at 2 and 3 mmol/kg for 26 weeks. The 4-HPR at 5 mmol/kg diet delayed the development of palpable tumors up to 24 weeks, but by 26 weeks, the incidence was not significantly different from the NTP-2000 diet control group. However, the 4-HPR diet markedly decreased the average weight of the tumors at 26 weeks. The 4-HPR diet also caused a significant increase in body weight without an increase in food consumption. Arotinoid Ro-40-8757 at both doses inhibited the development of mammary tumors for the duration of the study. However, the Ro 40-8757 at 3 mmol/kg appeared to be toxic as indicated by a significant depression of the average body weight with alopecia and skin scaling in some mice. Our observations with TG.NK transgenic mouse and fiber-rich diet (NTP-2000) indicate that the arotinoid Ro 40-8757 has a markedly higher inhibitory effect on the development of mammary cancer than 4-HPR. Studies to evaluate genetic changes and expression of hormonal receptors and growth factors associated with the inhibition of mammary cancer development by the retinoid analogues are in progress.
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  • 165
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 48 (1998), S. 273-286 
    ISSN: 1573-7217
    Schlagwort(e): adenoviral vectors ; apoptosis ; breast cancer ; gene therapy ; p53
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Reconstitution of the p53-dependent apoptotic pathway by gene transfer of a recombinant wild-type p53 minigene leads to rapid apoptotic cell death in breast and other cancer cell types expressing null or mutant p53. Tumour cells expressing wild-type p53 have been reported to be more resistant to this treatment strategy, presumably as a result of mutations in downstream regulators of p53-dependent apoptotic signalling. The MCF-7 breast cancer cell line is representative of this class of tumour cell. Our recent observation of a p53-dependent apoptotic response following adenovirus-mediated HSV thymidine kinase gene transfer and gancyclovir treatment led us to reexamine recombinant p53 cytotoxicity in MCF-7 cells. Infection with a recombinant adenovirus expressing wild-type p53 resulted in a dramatic increase in p53 protein levels and was accompanied by an increase in p21WAF 1/CIP1 protein levels and G1 arrest within 24 hours post-infection. A significant decrease in MCF-7 cell viability was first observed at 5 days post-infection and coincided with the appearance of morphological and biochemical changes consistent with apoptotic cell death. By day 7 post-treatment, cell viability decreased to 45% and clonogenic survival was reduced to 12% of controls. The results demonstrate that persistent, high level expression of recombinant p53 can induce programmed cell death in MCF-7 cells. While the mechanism by which p53 overexpression overcomes the defect in downstream apoptotic signalling is not clear, our data suggests that this treatment strategy may be beneficial for the class of tumour cells represented by the MCF-7 cell line.
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  • 166
    ISSN: 1573-7217
    Schlagwort(e): uPA ; PAI-1 ; uPAR ; plasma ; menstruation ; breast cancer
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The plasma urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1), and urokinase-type plasminogen activator receptor (uPAR) levels were measured in healthy volunteers and breast cancer patients. In pre-menopause healthy females, blood was sampled weekly during one menstruation cycle and menstruation phases (follicular, ovulatory, luteal) were determined by FSH/LH levels. uPA, PAI-1, and uPAR levels were at the nadir during ovulatory phase. uPA level was highest at follicular phase while PAI-1 level was highest at luteal phase. In comparison between pre- and post-menopause states, uPA and uPAR levels were higher in post-menopause state while PAI-1 level was higher in pre-menopause state. In breast cancer patients, uPA, PAI-1, and uPAR positive rates were low when we use the menopause-state-unmatched cut-off points. As we adjusted the cut-off points by menopause states, the PAI-1 positivity increased mainly in post-menopause cancer patients. These findings suggest that there is a minor but possible sequential change of these molecules during menstruation cycle which might blur the pathological positivity in pre-menopause cancer patients. The pathological elevation of PAI-1 was well detected in post-menopause cancer patients, but this elevation did not correlate with tumor burden such as number of metastatic sites or metastatic location. In conclusion, adjustment of physiological changes of uPA, PAI-1, and uPAR is required in determining pathological elevation of the plasma levels in cancer patients, especially in females.
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  • 167
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; adjuvant therapy ; endocrine therapy ; chemotherapy ; chemoendocrine therapy ; randomized trial ; estrogen receptors ; menopause
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Based on estrogen receptor (ER) and menopausal status, operable breast cancer (UICC stage I, II, III-a) patients were randomized for adjuvant endocrine therapy, chemotherapy, and chemoendocrine therapy, and the effects on the relapse-free survival (RFS) and overall survival (OS) were compared. Tamoxifen (TAM) 20 mg/day was administered orally for 2 years after mastectomy as an adjuvant endocrine therapy in postmenopausal patients. In premenopausal patients, oophorectomy (OVEX) was performed before TAM administration. In the chemotherapy arm (CHEM), patients were given 0.06 mg/kg of body weight of mitomycin C (MMC) intravenously, followed by an oral administration of cyclophosphamide (CPA) 100 mg/day in an administration of a 3-month period and a 3-month intermission. This 6-month schedule was repeated 4 times in 2 years. The chemoendocrine arm (CHEM + TAM) was composed of TAM with MMC + CPA chemotherapy. The patients were randomized according to ER and menopausal status. ER-positive patients were randomized to three arms: OVEX ± TAM, CHEM, and CHEM + TAM. For ER-negative patients there were two arms: CHEM and CHEM + TAM. 1579 patients entered the trial between September 1978 and December 1991, with median follow-up of 8.2 years. In ER-positive, premenopausal patients, there were no significant differences in RFS or OS among OVEX ± TAM, MMC + CPA, TAM + MMC + CPA arms. On the contrary, in ER-positive, postmenopausal patients, the chemoendocrine therapy showed a significantly higher RFS (p = 0.0400) and OS (p=0.0187) as compared with TAM to chemotherapy alone. There were no significant differences in RFS or OS by addition of TAM on the chemotherapy, in both pre- and post-menopausal ER-negative patients. It was concluded that in ER-positive premenopausal breast cancer, endocrine therapy alone may be equivalent in prolonging RFS and OS to chemotherapy or chemoendocrine therapy, and that ER-positive postmenopausal breast cancer may be better controlled with the combination of TAM and chemotherapy, as compared to TAM or chemotherapy alone. The importance of stratification of operable breast cancer by ER and menopausal status, as well as the direct comparisons of different treatments, were stressed.
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  • 168
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; estrogen receptors ; progesterone receptor ; pS2 ; cathepsin-D ; native receptor ; tamoxifen aziridine
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract [3H]Tamoxifen Aziridine ([3H]TAZ) is a derivative of the antiestrogen tamoxifen that covalently labels the Estrogen Receptor (ER), and perhaps other uncharacterized proteins. In a previous article we described that [3H]TAZ binds to a cytosolic protein from human uterine tissues that shares some, but not all, the ER properties. Here we have extended these studies to [3H]TAZ binding to cytosol proteins from human breast cancer specimens, and studied its quantitative association with other molecular markers and clinico-pathological variables. Cytosols were obtained in hypotonic buffer containing 20 mM molybdate and protease inhibitors, incubated with [3H]TAZ, and subjected to Sucrose Gradient Analysis (SGA). A [3H]TAZ labeled peak that consistently migrated with the 4S fractions was found in most of the assayed cytosols (range of 0 to 1278 fmol/mg p.). The 4S peak of [3H]TAZ was partially inhibited by both estrogens and antiestrogens. When [3H]E2 was used instead of [3H]TAZ, only an 8S peak was detected. [3H]TAZ was covalently bound to a protein with an apparent MW of 65 kDa, as determined by SDS-PAGE and fluorography. The mean of [3H]TAZ binding was significantly higher in the subgroups of samples classified as ER-, PR-, pS2- or cathepsin D-, than in the respective positive subgroups (P 〈 0.01 in all the cases). [3H]TAZ binding was not associated with clinico-pathological variables, except that its mean was significantly larger in tumors larger than 5 cm than in smaller tumors. These results, and those previously reported, suggest that: 1) [3H]TAZ labels a cytosolic protein present in human breast cancers and uterine tissues that does not share all the ER properties, and 2) the [3H]TAZ binding by breast cancer cytosols is negatively associated with markers of estrogenic dependency, and its quantification may provide valuable information on antiestrogen responsiveness of a given tumor.
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  • 169
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; metastases ; models ; retrospective studies ; risk ; spinal cord compression
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Breast cancer is the most common cause of metastatic epidural spinal cord compression (SCC) in women, and this condition results in significant neurologic dysfunction and morbidity. Prior studies of patients with suspected SCC did not employ multivariate analysis techniques, often included persons with a wide variety of malignancies, and generally focused on identifying associated neurologic and radiologic features. We therefore conducted a study examining a more comprehensive set of potential clinical risk factors in breast cancer patients with suspected SCC. We retrospectively analysed 123 episodes of suspected SCC among 93 breast cancer patients evaluated by spine computed tomography (CT) scanning. Multiple logistic regression analysis was employed to identify independent predictors of SCC. Clinically significant metastatic epidural cancer was defined as thecal sac compression (TSC), which occurred in 33 episodes (27%). Four independent predictors of TSC were identified and included oncologic features (known bone metastases ≥ 2 years, metastatic disease at initial diagnosis) in addition to neurologic and radiologic features (objective weakness, vertebral compression fracture on spine radiograph). These four predictors stratified episodes into subgroups with widely varying risks of TSC, ranging from 12% (0 risk factors) to 85% (≥ 3 risk factors). These results suggest that the evaluation of breast cancer patients with suspected SCC should include clinical information about their disease course in addition to neurologic examination and prior imaging studies. If confirmed, these predictors may help clinicians assess risk in this patient population.
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  • 170
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 51 (1998), S. 209-225 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; prognosis ; tumor size
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The widespread use of mammography has resulted in the detection of an increasing number of small invasive breast cancers,i.e. those that are 1cm and smaller. Patients with these small cancers generally have a low incidence of axillary lymph node metastases, and this has led to some to question the routine use of axillary dissection in these patients. In addition, the prognosis of these patients is generally favorable, and the routine use of adjuvant systemic therapy is difficult to justify. Nonetheless, some patients with these small invasive cancers will have axillary nodal involvement and/or develop metastatic disease. The identification of this prognostically unfavorable subset of patients within this otherwise favorable group is an important goal of clinical research. In this article, we review the available literature on prognostic factors for patients with breast cancers 1cm and smaller to help determine which of these features might be of value in the identification of patients at risk for axillary lymph node involvement and/or metastatic disease.
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  • 171
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. S85 
    ISSN: 1573-7217
    Schlagwort(e): aromatase ; breast cancer ; normal breast immunocytochemistry
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The plasma levels of free estradiol are very low in postmenopausal women. However, concentrations of estrogens within breast tissue have been reported to be higher than in plasma and similar to plasma concentrations in premenopausal women. One mechanism by which this may occur is for breast cells to synthesize estrogens themselves and produce high concentrations locally. Thus, tumor aromatase may be a significant source of estrogen which stimulates tumor growth. To address the question of the importance of this pathway, we have investigated the expression of aromatase within the normal breast and breast cancers. Because conventional biochemical assays for measuring aromatase activity require relatively large amounts of tissue, we developed an immunocytochemical method using a monoclonal antibody to determine the expression of aromatase. The method can be applied to sections of tumors embedded in paraffin blocks as routinely prepared for pathology. Since we have previously shown that mRNA for aromatase (P450 arom) and the protein are expressed in the same cells of the human placenta, we used in situ hybridization of sequence specific probes to P450 arom mRNA in breast tissue as one method to verify the specificity of the immunocytochemical detection of the enzyme. Both immunocytochemistry and in situ hybridization identified aromatase enzyme and mRNA expression in the epithelial cells of the terminal ductal lobula units (TDLU) and surrounding stromal cells of the normal human breast, and in the tumor epithelial cells and stromal cells of breast cancers. In addition, evidence for the functional significance of tumor aromatase was indicated by a correlation between aromatase activity and expression of proliferating cell nuclear antigen (PCNA) in the tumor, and by increased thymidine incorporation into DNA in response to testosterone in tumors in histoculture which had high aromatase activity but not in those with low activity. The findings suggests that estrogen produced locally is important in enhancing proliferation of the tumor.
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  • 172
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 113-124 
    ISSN: 1573-7217
    Schlagwort(e): MMP ; TIMP ; breast cancer ; angiogenesis ; prognosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Because the proteolytic degradation of extracellular matrix is required for invasion and metastasis, it would appear that the important family of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) might be prognostic indicators of the invasive potential of a breast tumor. Nevertheless, there are few data demonstrating an independent prognostic value of any individual MMPs or TIMPs in primary breast cancer patients. It is possible, however, that the balance among levels of certain MMPs and their inhibitors will be more informative, since MMPs are clearly involved in paracrine tumor-stromal interactions and are associated with angiogenesis, which does appear to be prognostic.
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  • 173
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; cell death ; gamma radiation ; pimozide ; sigma sites
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Neuroleptic drugs that bind sigma sites were tested for their ability to inhibit growth and radiosensitize MCF-7 human breast cancer cells. Inhibition of growth by ∼ 50% occurred in cells exposed to pimozide (0.6 μM), haloperidol (10 μM), and the sigma ligand DTG (1,3-di(2-tolyl)guanidine, 20 μM), but no growth inhibition occurred in cells exposed to clozapine, a neuroleptic drug lacking sigma binding activity, or dextromethorphan, a selective sigma 1 binding ligand. Pimozide (2.5 μM), but not haloperidol (3.6 μM), enhanced the sensitivity of MCF-7 cells to γ radiation in clonogenic survival assays. Pimozide significantly decreased MCF-7 clonogenic survival following a 5 or 8 Gy dose of γ radiation, and the dose of radiation required for 1% survival (survival enhancement ratio, SER) was decreased by a factor of 2. Exposure of normal WI-38 human embryonic lung cells to pimozide did not increase their sensitivity to γ radiation. Pimozide (2.5 μM) activated early apoptotic changes in MCF-7 cells that were detected by the uptake of Hoechst 33342 dye, and 10 μM pimozide activated a complete apoptotic pathway resulting in the death of 〉 90% of the cells within 24 hours. MCF-7 cells exposed to γ radiation alone (8 Gy) showed giant cell formation, mitotic arrest, and a limited degree of apoptosis and necrosis. Within 50 hours of treatment with a combination of radiation and pimozide, cell numbers were sharply reduced compared with cultures exposed to either radiation or pimozide alone. We conclude that pimozide augmented the sensitivity of MCF-7 cells to radiation-induced cell killing through a mechanism not shared by haloperidol, but suggest that concentration of pimozide in MCF-7 cells as a result of an enrichment of sigma 2 sites might target the radiosensitization.
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  • 174
    ISSN: 1573-7217
    Schlagwort(e): tumor markers ; c-erbB-2 ; CEA ; CA 15.3 ; breast cancer ; tumor-associated antigens ; prognosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The diagnostic value of a new tumor marker, c-erbB-2, was studied in the sera of 50 healthy subjects, 58 patients with benign breast diseases, and 413 patients with breast cancer (186 locoregional, 185 with advanced disease, and 42 with no evidence of disease). Using 15 U/ml as the cut-off, no healthy subjects or patients with benign diseases and only 2.4% of no evidence of disease patients had elevated serum levels. Abnormal c-erbB-2 levels were found in 29% (101/370) of the patients with breast carcinoma (locoregional 9%, metastases 45.4%). CEA (cut-off 5 U/ml) and CA 15.3 (cut-off 35 U/ml) sensitivity was 18% and 16% in patients with locoregional disease and 61% and 70% in those patients with advanced disease, respectively. A trend toward higher serum levels of all three tumor markers in patients with nodal involvement or greater tumor size was found, but was statistically significant only with CEA (p 〈 0.01). By contrast, c-erbB-2 was related to steroid receptors, in both locoregional and metastatic tumors. When the prognostic value of these markers was evaluated, patients with abnormally high presurgical CEA and c-erbB-2 had a worse prognosis than those patients with normal values, in both node-negative (p 〈 0.05 and p 〈 0.001, respectively) and node-positive patients (p 〈 0.556 and p 〈 0.001, respectively). By contrast, no relationship was found between CA 15.3 values and prognosis. Multivariate analysis showed that CEA and c-erbB-2 were also prognostic factors. The correlation between serum and tissue levels of c-erbB-2 was studied in the tumors of 161 patients. Significantly higher c-erbB-2 serum levels were found in patients with overexpression in tissue by immunohistochemistry, in both locoregional and advanced disease (p=0.0001). Serum concentrations in patients with advanced disease were related to the site of recurrence, with significantly higher values in patients with metastases (mainly in those with liver metastases) than in those with locoregional recurrence. In summary, c-erbB-2 serum levels seem to be a useful tumor marker in the prognosis of patients with breast cancer. Using all three tumor markers, sensitivity was 35% in patients with locoregional breast cancer and 88% in patients with recurrence.
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  • 175
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; estrogenic recruitment ; doxorubicin uptake
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Kinetic resistance to cytotoxic drugs may account for the moderate responsiveness of breast cancer to chemotherapy. In the present study the in vitro effects of estradiol-mediated DNA stimulation on the cellular uptake of the DNA intercalating drug doxorubicin (DOX) were examined in MCF-7 human breast cancer cells. Methods: Using the fluorescent properties of the drug, the cellular uptake was investigated by high performance liquid chromatography (HPLC), and by flow cytometry. Results: The uptake of DOX (0.01–2 μg/ml) by MCF-7 cells in suspension, incubated for 1 and 6 h, showed a strong correlation between the incubation concentration of DOX and the cellular uptake of the drug as measured by HPLC and flow cytometry. Simultaneous exposure of MCF-7 cells, in monolayer culture, to DOX (0.04–0.2 μg/ml) and estradiol (1 nM) for 1–24 h showed no significant difference in uptake of the drug compared to control cultures exposed to DOX in the absence of estradiol. Neither was there a significant difference in uptake of DOX when MCF-7 cells were pretreated with estradiol (1 nM) for 16–24 h followed by a 0.5, 1, 6, and 21/23 h incubation with DOX (0.01–2 μg/ml). Pretreatment with estradiol did not affect the retention of DOX as measured 24 h after a 0.5 h incubation with DOX (2 μg/ml). Furthermore, fluorescence microscopy revealed no difference in the cellular DOX distribution pattern of estradiol-stimulated MCF-7 cultures compared to unstimulated cultures. Conclusion: From this study we can conclude that, for the human MCF-7 breast cancer cells in vitro, the uptake, retention, and cellular distribution of DOX are not influenced by estrogenic manipulation.
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  • 176
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 51 (1998), S. 195-208 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; prognosis ; histology ; tumor type ; tumor grade ; pathology
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Diagnosis coupled with prognostication is the challenge for and charge of the pathologist. In this time of rapidly developing basic knowledge and increasing sophistication in the evaluation of prognostic information, there has also been an important re- evaluation of the validity, reliability, and relevance of classic histopathology. Also, the precision of and criteria for evaluating tumor size and status of regional lymph nodes is under study. Our emphasis in this review is tissue pathology and further, its practical relevance to patient management. Histopathology remains the basis of diagnosis universally; the addition of other elements will increase precision of prediction, particularly of responsiveness to individual therapies. Histologic grade may be integrated to substratify high and low stage cases into prognostically more useful subsets. Histologic types also interact with size and nodal status to predict patients with excellent prognosis. Further refinement of these parameters may occur by analysis within clinical, pathologic, or therapeutic subsets.
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  • 177
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 1-15 
    ISSN: 1573-7217
    Schlagwort(e): cyclin D1 ; estrogen receptor ; p27 ; breast cancer ; prognosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Cyclin D1 protein plays an important part in regulating the progress of the cell during the G1 phase of the cell cycle. The cyclin D1 gene, CCND1, is amplified in approximately 20% of mammary carcinomas, and the protein is over- expressed in approximately 50% of cases. This has led to intensive study to ascertain whether cyclin D1 is a biological marker in breast cancer; however, the clinical work has produced unexpected results. Work in cell lines and in transgenic mice indicate that CCND1 is a weak oncogene and it was expected that, like c- erbB-2, over-expression of cyclin D1 protein would be associated with a poor prognosis. Early immunohistochemical prognostic studies produced equivocal results but we, and others, have recently shown that strong staining for cyclin D1 is more likely to be seen in well differentiated, estrogen receptor positive carcinomas. Furthermore, we have found that over-expression of cyclin D1 is actually associated with a good outcome, both in terms of prognosis and response to endocrine treatment. Cyclin D1 is frequently over- expressed in ductal carcinoma in situ but not in benign breast disease, including atypical ductal hyperplasia; hence its expression appears to be closely linked with carcinogenesis. In order to help explain the apparent beneficial effects of cyclin D1 over- expression, a number of closely associated cell cycle proteins have also been evaluated, including the cyclin dependent kinase inhibitor p27, which blocks the activating effects of cyclin D1. Initial reports show that high levels of p27 are associated with a good prognosis and we have shown a positive association between p27 and cyclin D1 expression. These clinical results of cyclin D1 are an example of how information obtained from basic cell biology studies needs to be complemented by clinical studies to ascertain the true worth of a prognostic marker.
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  • 178
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 147-158 
    ISSN: 1573-7217
    Schlagwort(e): angiogenesis ; age ; breast cancer ; immunohistochemistry ; neovascularization ; prognostic factors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The search for prognostic markers is important both to identify those patients with occult metastases and also to spare chemotherapy in those patients whose tumors have not developed the capacity for distant spread. Angiogenesis, the formation of new blood vessels, is necessary for breast cancer growth and metastasis. Good correlation has been demonstrated between intratumoral vascularization and outcome in patients with breast cancer. Intratumoral vascularization in human breast cancer can be measured by using standard immunohistochemical methods. Strict guidelines for scoring need to be followed. Although attempts are being made to automate the reading, visual scoring remains superior. We studied a population of women with small node-negative breast cancer who received no adjuvant therapy and have a median follow-up of 15 years. We have found intratumoral vascularization, as measured by microvessel count, to be an independent prognostic factor for disease-free survival. Low microvessel count identifies a group of patients with a 20 year disease free survival of 93%. The proportion of women with low microvessel count decreases with increase in tumor size and increases with patient age. But even in mammographically detected nonpalpable breast cancer, that is, the smallest breast cancer we currently detect, the majority already have high microvessel count. Intratumoral vascularization appears to be an early event that is necessary but not sufficient for metastatic progression. Microvessel count seems to be an excellent marker to identify patients with good prognosis because those with low microvessel count have a 93% disease-free survival irrespective of size, grade, or estrogen receptor status, but is less good at predicting those at high risk since the 20-year disease-free survival is still 67-70% in those with high microvessel count. Thus, the higher risk group needs to be further stratified using additional prognostic factors.
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  • 179
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 239-259 
    ISSN: 1573-7217
    Schlagwort(e): tumor markers ; tumor-associated antigens ; serum markers ; breast cancer ; metastatic disease
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Detecting and/or monitoring changes in circulating tumor markers might assist in evaluating cancer risk, diagnosis, prognosis, or response to treatment. Several categories of circulating tumor markers have been investigated in breast cancer. These categories include classical tumor-associated antigens, such as CEA and CA 15-3, markers of tumor biology, including markers of angiogenesis, adhesion, and invasion, and antibody response to tumor-associated antigens such as HER2/neu and p53. We used a recently proposed Tumor Marker Utility Grading System to evaluate the use of several circulating tumor markers for different clinical utilities in breast cancer. While there are no tumor markers with established clinical utilities for most uses, tumor-associated antigens can be used for monitoring patients with metastatic disease. In addition, markers of tumor biology such as the circulating extracellular domain of HER2/neu might be useful in determining not only prognosis, but also response to specific treatments. However, further investigations are required to further assess the utility of individual tumor markers for specific clinical uses.
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  • 180
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 321-331 
    ISSN: 1573-7217
    Schlagwort(e): predictive factors ; prognostic factors ; serum markers ; breast cancer
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
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  • 181
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 305-319 
    ISSN: 1573-7217
    Schlagwort(e): tumor markers ; prognostic factors ; predictive factors ; breast cancer ; patient management ; treatment decisions
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Very few tumor markers have been recommended for routine clinical care of patients with breast cancer [1]. A framework to determine the clinical utility of tumor markers is required. In a previous publication, a "Tumor Marker Utility Grading System" (TMUGS) was proposed [2]. TMUGS included a semi-quantitative grading scale (0-3+) which can be used to assign a score to a given tumor marker for a given outcome. Only those markers that are felt to be sufficiently strong to influence a therapeutic decision that results in improved clinical outcome for the patient are recommended. The studies from which data are used to assign a TMUGS grade can be placed into one of five Levels of Evidence (LOE). An extension of TMUGS ("TMUGS-Plus") is now proposed in which the relative strength of a prognostic or predictive factor can be estimated and expressed in terms of a risk ratio (RR) for prognostic factors or benefit ratio (BR) for predictive factors. Three categories of prognostic factors and three categories of predictive factors are proposed (strong, moderate, and weak). It is recommended that only LOE type I studies (prospective, highly powered studies of the tumor marker, or meta-analysis of LOE II or III datasets), be used to estimate the RR or BR of a given factor. Finally, a matrix, based on assumptions of acceptable absolute benefits relative to risks, is proposed in which any given tumor marker can be assessed for its clinical utility. TMUGS-Plus should aid in the assessment of published data regarding clinical utility of tumor markers. Perhaps more important, clinical investigators can use TMUGS-Plus to design tumor marker studies that will fulfill criteria for clinical utility, resulting in more rapid acceptance of tumor markers for routine clinical use.
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  • 182
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 79-98 
    ISSN: 1573-7217
    Schlagwort(e): p53 gene ; p53 protein ; breast cancer ; prognosis ; p21 ; WAF-1
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The prognostic and predictive value of p53 has been extensively studied in breast cancer. p53 serves a multifunctional role as a transcriptional regulator, genomic stabilizer, inhibitor of cell cycle progression, facilitator of apoptosis, and also perhaps an inhibitor of angiogenesis. Abrogation of its function should therefore lead to a more aggressive breast cancer phenotype and a worse clinical outcome, and indeed the preponderance of studies confirm this, with the risk of recurrence and death increasing by 50% or more if p53 is abnormal. Lack of unanimity of results may be due to differences in technique, study design, or population, as well as the subjectivity inherent in some approaches; however, the complexity and random nature of genomic change present in cancer cells may well also contribute to the lack of unanimity. Because many anticancer agents may exert a therapeutic effect through genomic damage and subsequent triggering of apoptosis, and because p53 can respond to genomic damage and facilitate apoptosis, it can be hypothesized that an intact p53 would predict sensitivity to therapy. Present data in breast cancer, however, does not clearly indicate that this is the case. There are several potential explanations. Study designs to accurately test the predictive value of a molecular marker are more exacting and difficult to achieve than prognostic studies. There may also be multiple alternative pathways, not involving p53, that play a part in determining the therapeutic effect of a treatment. The prognostic value of a downstream effector of p53 has also been assessed, though less extensively. p21 is transcriptionally upregulated by p53 and is an inhibitor of cyclin-dependent kinases and thus of cell cycle progression. Higher levels of p21 might indicate a more indolent type of breast cancer. However, data from a number of clinical studies is very conflicting, and at present p21 is not a promising prognostic factor in breast cancer.
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  • 183
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 52 (1998), S. 159-173 
    ISSN: 1573-7217
    Schlagwort(e): angiogenesis ; angiogenic factors ; breast cancer ; prediction ; prognosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Growth, progression, and metastasis of breast cancer, as well as of most of the other tumors, are angiogenesis-dependent processes. Several pro-angiogenic growth factors and endogenous inhibitors of angiogenesis have been identified and sequenced, and experimental studies suggest that angiogenic activity of a tumor may result from down-regulation of inhibitors of angiogenesis or up-regulation of endothelial growth factors. The mechanisms leading to the alteration of the balance between positive and negative modulators of angiogenesis are only partially known. We are at the beginning of research to identify the more active angiogenic factors in human breast cancer, and little information is presently available on their clinical significance. Preliminary results suggest that among the known angiogenic peptides, both vascular endothelial growth factor (VEGF) and platelet-derived endothelial cell growth factor / thymidine phosphorylase (PD-ECGF/TP) have promising prognostic and, perhaps, predictive value. No data are available on the clinical value of co-determination of positive and negative regulators of angiogenesis to look at the angiogenic balance of each single tumor. Only a few studies have assessed the role of endogenous inhibitors of angiogenesis in human breast cancer, with results available only on thrombospondin-1 and -2 (TSP-1, -2). Finally, the determination of some integrins such as α6 and αvβ3 and of some other endothelial-adhesion molecules seems to be of potential prognostic value. Recognizing which are the more biologically active positive and negative angiogenic factors is the key for the identification not only of new prognostic markers but also of targets for antiangiogenic therapy in human breast cancer.
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  • 184
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; Cox models ; nonproportional hazards ; prognostic factors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Some prognostic factors, such as steroid receptors, appear strongly related to outcome in early studies with short follow-up, but as follow-up matures the relationships appear to weaken. We investigated this phenomenon for several factors (tumor size, axillary lymph nodes, S-phase fraction, estrogen receptor (ER) status, and adjuvant therapy) in a large sample of breast cancer cases (N=2,873) with up to 17 years of follow-up for disease-free survival (DFS). Subjects in the study were identified from patients who had hormone receptor assays performed in our laboratory. Analysis of DFS included fitting a multivariate Cox proportional hazards model, testing for nonproportionality, and examining diagnostic plots. The assumption of proportional hazards was violated for several factors including ER, tumor size, and S-phase fraction. For ER, the hazard ratio was initially less than 1.0, indicating a good effect on prognosis, but increased at later times to values greater than 1.0, indicating a bad effect on prognosis. In contrast, the hazard ratios for tumor size and S-phase were initially high and decreased asymptotically toward 1.0 over time. Analysis of p53 expression in a subset of cases yielded qualitatively similar results. We conclude that several standard prognostic factors (ER, tumor size, S-phase fraction) and possibly other investigational factors have important but nonproportional effects on hazard. It is likely that violation of proportional hazards is common and not limited to breast cancer. Failure to recognize violations of proportional hazards can lead to both over- and under-estimation of the effects of important prognostic factors.
    Materialart: Digitale Medien
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  • 185
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; conservative therapy ; radiation therapy ; angiosarcoma ; surgery
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Purpose. In the past 15 years breast conserving therapy (BCT) has become an important treatment option for primary breast cancer. Thirty three angiosarcomas (AS) after BCT have been described in a total of 20 published reports. Limited follow-up data and the lack of information on incidence of AS prompted the authors to review the comprehensive experience in the Netherlands. Methods. Between 1987 and 1995 twenty-one patients with BCT-associated AS were diagnosed in the Netherlands. Follow-up after diagnosis of AS ranged from 6 to 82 months with a median of 24 months. Information on the total number of patients treated with BCT and on the numbers of angiosarcoma in the breast was obtained. Results. The median interval between BCT and AS was 74 months (range: 29–106) and appeared to decrease with higher age. Detection of skin changes followed by incisional biopsy provided the diagnosis. Two year overall (OS) and disease free survivals were 72% (s.e. 10.9) and 35% (s.e. 10.7), respectively. Two year OS after initial complete surgical resection was 86% (s.e. 9.3) compared to 0% after incomplete resection of the AS (P=0.04). The estimated incidence of AS after BCT is 0.16%. Conclusions. BCT-associated AS arises after a relatively short interval. Although the incidence of AS is low, the absolute number of patients at risk is increasing. This calls for vigilance concerning skin changes occurring after BCT. An incisional biopsy provides the only reliable diagnosis. The prognosis appears to be related to the completeness of surgical resection.
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  • 186
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 47 (1998), S. 255-267 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; IGF-I receptor ; IRS-1 ; SHC ; adhesion ; apoptosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Experimental evidence suggests an important role of the type I IGF receptor (IGF-IR) in breast cancer development. Breast tumors and breast cancer cell lines express the IGF-IR. IGF-IR levels are higher in cancer cells than in normal breast tissue or in benign mammary tumors. The ligands of the IGF-IR are potent mitogens promoting monolayer and anchorage-independent growth of breast cancer cells. Interference with IGF-IR activation, expression, or signaling inhibits growth and induces apoptosis in breast cancer cells. In addition, recent studies established the involvement of the IGF-IR in the regulation of breast cancer cell motility and adhesion. We have demonstrated that in MCF-7 cells, overexpression of the IGF-IR promotes E-cadherin-dependent cell aggregation, which is associated with enhanced cell proliferation and prolonged survival in three-dimensional culture. The expression or function of the IGF-IR in breast cancer cells is modulated by different humoral factors, such as estrogen, progesterone, IGF-II, and interleukin-1. The IGF-IR and the estrogen receptor (ER) are usually co-expressed and the two signaling systems are engaged in a complex functional cross-talk controlling cell proliferation. Despite the convincing experimental evidence, the role of the IGF-IR in breast cancer etiology, especially in metastatic progression, is still not clear. The view emerging from cellular and animal studies is that abnormally high levels of IGF-IRs may contribute to the increase of tumor mass and/or aid tumor recurrence, by promoting proliferation, cell survival, and cell-cell interactions. However, in breast cancer, except for the well established correlation with ER status, the associations of the IGF-IR with other prognostic parameters are still insufficiently documented.
    Materialart: Digitale Medien
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  • 187
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 48 (1998), S. 1-9 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; estrogen receptor status ; interaction effects ; progesterone receptor status ; prognostic index ; time-dependency
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The aim of this study was to test the prognostic contribution of estrogen (ER) and progesterone (PgR) receptor status to an index consisting of the number of positive lymph nodes, the mean nuclear area of the breast cancer cells (MNA), and tumour diameter. This index is compared with a Danish index, which includes the same factors but uses histological grade instead of MNA. The Danish index has been developed from the Nottingham Prognostic Index (NPI). In the present study of 1629 breast cancer patients the Cox proportional hazard method is used to examine the time-dependency of the index, and to test for interaction between the index and the hormone receptors. The index sorts the patients into groups with low, intermediate, and high risk of dying. Logistic regression analysis is used to report the sensitivity and specificity of the index with and without ER and PgR. Our index gave information comparable to that of the Danish group. However, the information given by our index is time-dependent, its strength being weaker after 5-year of follow-up. PgR and ER add information to high risk patients, but only in the first 5-year period. High risk patients with positive hormone receptors have a prognosis similar to intermediate risk ones. PgR increases the ability of the index to predict breast cancer deaths correctly by 5 percent in high risk patients. In conclusion, PgR and ER act differently in groups of patients with different risk levels when time-dependency is considered. This indicates biological differences in subgroups as defined by the index.
    Materialart: Digitale Medien
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  • 188
    ISSN: 1573-7217
    Schlagwort(e): angiogenesis ; breast cancer ; blood flow ; Doppler
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The phenomenon of tumor angiogenesis is an important aspect of understanding tumor biology. Studies in breast carcinoma have shown microvessel density (MVD) assessed by immunohistochemistry to be of prognostic importance in primary breast cancer. On the other hand, recently developed highly sensitive color-coded Doppler techniques offer a noninvasive method to examine neovascularisation in breast tumors. The purpose of this study was to determine the relationship between Doppler flow parameters and microvessel count assessed by immunohistochemistry. Fifty-three patients with primary breast cancer were examined preoperatively with color-coded Doppler ultrasound. The obtained Doppler frequency spectra were analyzed for peak systolic flow velocity (Vmax). Following surgery, paraffin-embedded microsections were immunohistochemically stained for factor VIII-related antigen. Tumor angiogenesis was assessed by microvessel count under light microscopy. Undifferentiated tumors correlated with high MVD (p=0.009) whereas other clinicopathological parameters were not associated with MVD. Color Doppler signals were detected in 50 out of 53 breast tumors. Evaluation of tumor flow velocity with various clinicopathological parameters showed a significant correlation with tumor size (p=0.0001) and lymph node metastasis (p=0.02). However, there was no significant correlation between MVD and intratumoral blood flow velocity assessed by color-coded Doppler. Our findings showed that Doppler flow measurement did not correlate with the extent of tumor angiogenesis of breast cancer. The present data give circumstantial evidence that microvessel count assessed by immunohistochemistry reflects the microvascular network, whereas tumor vasculature documented by Doppler ultrasound supplies information on the macrovasculature.
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  • 189
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 47 (1998), S. 141-151 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; posttraumatic distress ; predictors ; psychosocial function ; surgery
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract One hundred and six patients with operable breast cancer were studied at intervals one day before surgery, and at six weeks and one year post-operatively by means of taped clinical interviews and self-report questionnaires (Impact of Event Scale (IES) and General Health Questionnaire (GHQ-28)). A year after surgery, 9%reported a high level of intrusive symptoms and 10% of avoidance symptoms compared to 18% and 14% after six weeks, respectively. Based on questionnaire data, a year after surgery, thirteen patients (12%) were estimated to have a posttraumatic stress disorder (PTSD) compared to fifteen patients (14%) after six weeks. Severity of posttraumatic stress symptoms (PTSS) after one year was significantly associated with impaired psychosocial functioning over the last year previous to surgery (p 〈 0.05), negative life events during the year before surgery (p 〈 0.05), health problems during the previous ten years (p 〈 0.01), and a personality trait characterized by high emotional reactivity (p 〈 0.001). Crisis support in the acute situation, type of surgery, axillary-node metastases, and postoperative adjuvant chemotherapy did not predict subsequent PTSS. Premorbid health variables, personality, and level of distress six weeks after surgery were most important risk factors for persistent PTSS in our patients with operable breast cancer stage I and II.
    Materialart: Digitale Medien
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  • 190
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 47 (1998), S. 219-233 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; estrogen ; insulin-like growth factors ; mannose 6-phosphate/IGF2 receptor ; paracrine factors ; stromal cells
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Local environmental signals regulate the growth and development of both normal and malignant breast epithelium. Members of the insulin-like growth factor (IGF) family likely influence both of these processes. The localization of IGF2 to stroma specifically surrounding malignant breast epithelium indicates that this growth factor may play a critical role in the genesis or maintenance of this transformed phenotype. Recent studies have sought to understand the mechanism by which IGF2 expressing fibroblasts are localized to the periphery of malignant breast cancer cells. In addition, the consequences of the expression of IGF-signaling components likely expand beyond their direct effects on mitogenesis. Indirect effects predominantly associated with the IGF2 receptor could also influence the invasive potential of breast tumor cells.
    Materialart: Digitale Medien
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  • 191
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 47 (1998), S. 295-302 
    ISSN: 1573-7217
    Schlagwort(e): IGF ; breast cancer ; prognosis ; IGFBP ; treatment
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The insulin-like growth factor (IGF) family of ligands, receptors, and binding proteins can regulate breast cancer cell proliferation in vitro, and interruption of these pathways inhibits IGF-mediated cell proliferation. If the IGF family members are key regulators of breast cancer growth and progression in vivo, we would expect their expression to be an indicator of the prognosis of the disease. Thus, measurement of IGF expression may provide an indicator of the growth effect within a tumor, and provide new targets for treatment of the disease. In this review we will summarize the data generated thus far indicating that IGF family members are indicators of prognosis of breast cancer, and that measurement of the whole IGF family in concert may provide useful information for treatment strategies of breast cancer.
    Materialart: Digitale Medien
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  • 192
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; estrogens ; uptake ; hypersensitivity ; in situ synthesis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Estradiol stimulates the growth of breast tumor cells in both pre- and post menopausal women. Following the menopause, the levels of estradiol in breast tumor tissues are similar to those from tumors obtained prior to cessation of ovarian function, even though plasma estrogen levels are 10–50 fold lower in post- than in premenopausal women. These observations suggested the possibility of enhanced estradiol uptake from plasma or in situ synthesis in post-menopausal women. We systematically studied these possibilities in a series of model systems. Initially we demonstrated a very high affinity estradiol binding site in tissues from castrated rats. Enhanced uptake occurred under conditions of low plasma estrogen levels when compared to animals with higher estradiol levels. In situ synthesis also occurred both through the sulfatase and aromatase pathways. In further studies, we compared uptake from plasma with in situ synthesis via aromatase in a nude mouse model. Under the conditions utilized, in situ synthesis resulted in much higher tissue estradiol levels and tumor growth rates than did uptake from plasma. During these studies we demonstrated that tumors deprived of estradiol developed mechanisms rendering them more sensitive to estrogen. This involved the ability of cells to adapt to estradiol deprivation to allow them to be responsive to four log lower amounts of estrogen than when studied under wild type conditions. In addition, cells adapted by increasing their level of aromatase and thus developing the capability to become more sensitive to estrogen precursors. Taken together, these studies demonstrate that breast cancer tissue is highly plastic and can adapt to conditions of estrogen deprivation via a variety of mechanisms.
    Materialart: Digitale Medien
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  • 193
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. S45 
    ISSN: 1573-7217
    Schlagwort(e): aromatase ; estrogens ; hormones ; exemestane ; breast cancer ; therapy ; pharmacology ; formestane
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Steroidal aromatase inhibitors like formestane and exemestane are useful drugs for endocrine treatment of postmenopausal breast cancer. In addition, these drugs should be considered valuable probes to explore the biology of breast cancer with particular emphasis on possible relations between the degree of estrogen suppression and clinical efficacy and the possible role of intratumor estrogen synthesis. The fact that steroidal and non-steroidal aromatase inhibitors bind to different parts of the aromatase enzyme suggests these drugs may act in concert aggravating plasma estrogen suppression. Thus, use of a steroidal and a non-steroidal aromatase inhibitors in concert may be one way to improve breast cancer treatment and may also provide important information to a better understanding of the dose-response relationship between estrogen suppression and clinical effects. Further, the finding that patients progressing on non-steroidal aromatase inhibitors may respond to formestane as well as exemestane suggests these drugs may have differential effects, probably on the aromatization in the tumor tissue. Further studies are warranted to explore the influence of steroidal and non-steroidal aromatase inhibitors on intratumor aromatase activity and intratumor estrogen concentrations and to correlate these findings to intratumor drug concentrations. The findings that steroidal aromatase inhibitors may have clinical effects in patients progressing on treatment with the non-steroidal aromatase inhibitor aminoglutethimide is challenging, and suggest further studies to evaluate possible benefits of using different novel aromatase inhibitors in concert or sequence.
    Materialart: Digitale Medien
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  • 194
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. S59 
    ISSN: 1573-7217
    Schlagwort(e): vorozole ; aromatase inhibitor ; review ; breast cancer
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Vorozole (RivizorTM), is a triazole derivative and one of the new, third generation aromatase inhibitors. Vorozole causes reversible inhibition of cytochrome P450 aromatase with the majority of the aromatase inhibition activity attributable to the dextro-isomer. In vitro the IC50 against human placental aromatase and in cultured rat ovarian granulosa cells is 1.38 and 0.44 nM, respectively. Vorozole is selective and does not effect other cytochrome P450-dependent reactions at concentrations up to at least 500-fold the aromatase inhibiting concentration. In vitro vorozole, at concentrations of up to 10 μM, does not exhibit agonistic or antagonistic effects on steroid receptors including the estrogen, progestin, androgen and glucocorticoid receptors. In vivo vorozole produces dose-dependent inhibition of aromatase and reduces circulating estrogen levels. Vorozole has been shown to inhibit intratumoral aromatase activity in postmenopausal breast cancer patients pretreated for 7 days prior to undergoing mastectomy. Tissue estrone and estradiol levels were also shown to be decreased by 64% and 80%, respectively. In four phase II clinical trials, vorozole produced response rates of 18–33% corresponding to selective inhibition of estradiol. Vorozole has been examined in large, randomized multi-centre, controlled trials against both megestrol acetate (MA) and aminoglutethimide (AG) plus hydrocortisone. Against MA, response rates were comparable (10.5% vorozole; 7.6% MA) however, a trend towards improvement in median duration of response for vorozole (18.2 versus 12.5 months; p=0.07) was shown. No differences in time to progression or survival were noted. Significant and persistent weight gain associated with MA administration was the most notable difference in tolerability between the two agents. Against AG, vorozole showed a higher response rate (23% versus 18%) however this did not reach statistical significance (p=0.085). No differences in duration of response, time to progression and survival were noted. A significantly better Functional Living Index-Cancer (FLIC) quality of life score was associated with vorozole compared to AG. Vorozole is a specific, selective and potent aromatase inhibitor and useful for postmenopausal patients with advanced breast cancer.
    Materialart: Digitale Medien
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  • 195
    ISSN: 1573-7217
    Schlagwort(e): tumour cell detection ; cathepsin D ; breast cancer ; micrometastasis ; prognostic factor
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Patients with an elevated level of cathepsin D in breast cancer tissue have an adverse prognosis. This study evaluated the prognostic relevance of cathepsin D detection in disseminated tumour cells in bone marrow. Bone marrow was sampled intraoperatively from both anterior iliac crests in 290 patients with primary breast cancer. Interphase cells were enhanced and stained immunocytologically with two antibodies: BM2, which detects tumour-associated glycoprotein TAG 12, which is typically expressed by almost all breast cancer cells, and the anti-cathepsin D antibody. 67 of 149 BM2-positive women (45%) developed metastatic disease (median follow-up time: 69 months). Of these, 15 were cathepsin D-positive (22%). Patients with cathepsin D-positive cells in bone marrow (n = 26; 9%) had a significantly shorter metastasis-free interval (38 months) compared with women who were cathepsin D-negative (64.5 months). The worst prognosis was seen in patients positive for both markers (30.5 months), followed by those who were cathepsin D-negative and BM2-positive (48 months). The detection of cathepsin D on disseminated tumour cells characterises a subgroup of patients with a poorer prognosis who should undergo more aggressive adjuvant systemic therapy.
    Materialart: Digitale Medien
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  • 196
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. 109-117 
    ISSN: 1573-7217
    Schlagwort(e): antiestrogens (tamoxifen) ; antiprogestins (mifepristone, onapristone ; breast cancer ; MCF-7 cells ; nude mice
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract This is the first report demonstrating an in vivo antitumor activity of antiprogestins (mifepristone, onapristone) alone and in combination with tamoxifen in the MCF-7 human breast cancer model. The MCF-7 cells produced progressive growing tumors in female nude mice supplemented with 17β-estradiol. Tumor regression was observed following either estrogen ablation alone or estrogen ablation in combination with tamoxifen. Monotherapy with tamoxifen or antiprogestins caused a retardation of estrogen-induced tumor progression. Complete inhibition or prevention of tumor growth occurred as a result of simultaneous administration of mifepristone and tamoxifen. The addition of mifepristone in this combination treatment was also effective in delaying or preventing tumor escape (relapse) from the antiestrogenic (antitumor) effect of tamoxifen. These results suggest a potential clinical benefit of adding an antiprogestin to antiestrogen therapy of breast cancer patients.
    Materialart: Digitale Medien
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  • 197
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. 187-193 
    ISSN: 1573-7217
    Schlagwort(e): breast cancer ; diet ; fatty acids ; growth hormone ; hyperinsulinaemia ; IGF-I ; insulin resistance ; menarche
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The typical high fat, low fibre diet of the industrialised West, particularly when associated with inadequate exercise, is likely to advance the onset of puberty. This will manifest in girls as an earlier menarche, earlier onset of breast development, and an earlier growth spurt. Both earlier menarche and adult tallness are markers of increased risk to breast cancer. Earlier menarche in the West is usually associated with earlier onset of hyperinsulinaemia, and multiple case-control studies report that hyperinsulinaemia too is a marker of increased breast cancer risk. Although the Western diet is linked both to earlier menarche and also to earlier hyperinsulinaemia, the mechanism involved is not necessarily the same. While menarche is likely to be triggered by a threshold level of fatness, manifestation of insulin resistance is genetically-determined and strongly influenced by the fatty acid profile of the diet. The putative mechanisms by which they influence mammary carcinogenesis also differ. Early menarche is reported to be associated with a raised oestradiol level persisting into early adult life. On the other hand, hyperinsulinaemia is commonly associated with abnormal aromatase activity in the ovaries. In addition, the concomitant increase in bioactive levels of insulin-like growth factor-I may synergise with oestrogen in stimulating proliferative activity in mammary epithelium. Dietary modification and exercise regimens are proposed in families at high risk to breast cancer. The measures have been shown to reduce insulin levels in both children and adults, and serial monitoring of insulin and sex steroid levels could be used to detect a metabolic-endocrine effect.
    Materialart: Digitale Medien
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  • 198
    ISSN: 1573-7217
    Schlagwort(e): high-dose therapy ; PBSC support ; mobilization regimen ; breast cancer
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract High-dose therapy followed by peripheral blood stem cell (PBSC) support was performed in 29 patients with primary high-risk (Group I) or chemoresponsive metastatic (Group II) breast cancer patients. Group I patients had received PBSC mobilization within 4 weeks of modified radical mastectomy. Group II patients had to achieve minimal residual disease (MRD) by induction chemotherapy before being considered eligible for PBSC mobilization and high-dose therapy. An innovative FE120C regimen (5-FU 600 mg/m2, i.v., day 1; epirubicin 120 mg/m2, i.v., day 1; cyclophosphamide 600 mg/m2, i.v., day 1) plus G-CSF (300 μg/day, subcutaneous injection for 9 days, from day 4 post-FE120 C) was used to mobilize PBSCs. After high-dose CTCb (cyclophosphamide 6,000 mg/m2, thiothepa 500 mg/m2, carboplatin 800 mg/m2, in 4 days), patients received PBSC infusion and daily C-CSF 300 μg sub cutaneous injection. There were 19 and 16 patients enrolled into Group I and Group II, respectively. Ten of the Group II patients had achieved minimal residual disease (MRD) after induction chemotherapy. The median numbers of mobilized total CD34 + cells for Group I and Group II patients were 27.3 (9.2 to 114.1) × 106/kg and 17.1 (5.9 to 69.1) × 106/kg respectively. The median time to neutrophil recovery (ANC ≥ 500/μL) was 8 and 9 days in Group I and II, respectively. The median time to platelet recovery (≥ 50,000/μL) was 10 and 15 days in Group I and II, respectively. No major treatment-related toxicities were noted. In Group I, 13 out of 19 patients (68.4%; 43–87%, 95% C.I.) remained recurrence-free with a median follow-up of 31 months (6 + to 55 + months). In Group II, 3 out of 10 patients (30%; 7–65%, 95% C.I.) remained progression-free at 33 +, 35 +, 39 + months from induction therapy. We suggest that the FE120C plus G-CSF is an effective and innovative regimen for PBSC mobilization in breast cancer patients, and high-dose CTCb therapy with PBSC support is a safe and well-tolerated treatment modality.
    Materialart: Digitale Medien
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  • 199
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. S9 
    ISSN: 1573-7217
    Schlagwort(e): aromatase ; breast cancer ; estrogens ; cytokines ; prostaglandins
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Aromatase activity is increased in breast tumors and it is possible that this results from stimulation by cytokines and/or prostaglandin E2 (PGE2) which regulate the activity of this enzyme. As different promoters can be used to control aromatase gene expression in normal and malignant breast tissues, which are regulated by different factors, we are currently investigating the relative roles of cytokines and PGE2 in controlling breast tumor aromatase activity. No significant effect of PGE2 on aromatase activity in MCF-7 breast cancer cells has so far been detected. However, preliminary evidence was obtained, from co-cultures of MCF-7 cells and breast tumor-derived fibroblasts, that MCF-7 cells secrete a factor, possibly a cytokine, which can act in a paracrine manner to enhance aromatase activity in stromal cells. Understanding the complex regulation of aromatase activity in breast tumors could lead to novel therapies for specifically inhibiting tumor estrogen synthesis.
    Materialart: Digitale Medien
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  • 200
    Digitale Medien
    Digitale Medien
    Springer
    Breast cancer research and treatment 49 (1998), S. S27 
    ISSN: 1573-7217
    Schlagwort(e): aromatase ; estrogens ; mammary tissue ; breast cancer ; inhibitors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Evidence to support the contention that estrogen biosynthesis in breast cancers is of clinical significance has been sought by relating activity to (i) clinical response to aromatase inhibitors and (ii) tumor concentrations of estrogens. Significant correlations have been reported between the presence/high levels of tumor aromatase in vitro and likelihood of response to aminoglutethimide in patients with advanced breast cancer, but the association is not absolute and it has been more difficult to demonstrate similar relationships in patients with earlier stages of cancers treated with other more potent inhibitors. There are however data to suggest that in vitro measurements of aromatase may not reflect in situ estrogen synthesis. For example mammary adipose tissue fibroblasts preincubated with reversible aromatase inhibitors may paradoxically display elevated in vitro aromatase activity. Similar enhanced in vitro activity may be observed in breast material taken from patients treated neo-adjuvantly with aromatase inhibitors such as aminoglutethamide and letrozole. That this is an artifact of in vitro systems can be demonstrated by performing in situ assessments of aromatase activity in patients before and after treatment with aromatase inhibitors. Thus it can be shown that letrozole markedly inhibits in situ aromatase and reduces tumor levels of estrogens.
    Materialart: Digitale Medien
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