To evaluate the cosmetic results in patients with breast implants treated with radiation therapy (RT) for BC, and analyze factors associated with low cosmetic results considering the assessment of the physicians and patient. We selected patients with breast implants and diagnosed BC who received RT. Capsular contracture was evaluated by Baker scale before and after RT and at 3, 6, 12, and 24 months. To objectify the cosmesis, patient and two radiation oncologists were asked to classify results by Harvard scale. To investigate factors that may influence the capsular contracture and cosmetics, T test, chi-square, and Wilcoxon signed-rank were analyzed. Forty patients with BC who had surgery for cosmetic breast implant were analyzed. The mean time from that cosmetic surgery to oncologic surgery was 11 years (2-42 years). Before RT 28 patients had one aesthetic surgery, but 11 patients had 2 previous surgeries and 1 patient up to 3. The implant material was: silicone 60% and 40% saline. The location was 30 retro glandular implants, and 7 retro pectoral, and 3 unknown. The mean follow-up was 35 months (24-102), the mean age of BC diagnosis was 54 years (35-76), Left side 23, 3DCRT 37, Stages 0: 12.5% I: 67.5% II: 20%.8 smokers and alcoholic 2, no diabetic patients. Acute radiation toxicity RTOG scale was I = 29, II = 10, III = 1. The local recurrence rate was 5%. A replacement of implant after RT was required in 5 patients. Prosthetic contracture before RT was analyzed with Baker classification I = 23; II = 11; III = 6. Baker III and IV were tested to identify their influence on aesthetics. Age, time since cosmetic surgery, smoking, drinking, prosthetic material, location, RT technique, hormone- therapy, and acute toxicity were not significant; however, in patients who had more than one previous cosmetic surgery a difference was obtained P = 0.034 assigning RR 4.67 of worst result according to the number of previous surgeries. The results of Harvard reported by patients and the physicians were: Excellent 19 and 21; Good 12, 9; tolerable 3, 7; Poor 6, 3; respectively. 12 patients reported changing results after RT according to Harvard scale; for the physicians just 9, of them, initially had poor or tolerable results in 8 and 6 respectively. The difference between the observers was not significant P = 0.3 We found a group of patients 27.5% who had a tendency to capsular contracture previous to RT related to the number of surgeries before treatment. The lower result in Harvard scale after RT reported by patient and physicians was 30% and 22.5% respectively, but this change was 20% and 15% for tolerable and poor results. There was an agreement related to cosmetic outcomes according the physicians and patient. It is important to point out; that only 12.5% of the patients needed an implant replacement for disagreement related to esthetic, most of them are satisfied.

Radiation and chemotherapy have defined roles in the multidisciplinary management of breast cancer, the optimal sequence is controversial. We evaluate the acute radiation dermatitis in patients with different paclitaxel regimens and radiation therapy. A prospective analysis of acute skin toxicity according to RTOG criteria in 41 patients with operable breast cancer stage IA-IIIC, that received adjuvant chemotherapy with doxorubicin/cyclophosphamide (AC) and subsequent radiation therapy with concurrent paclitaxel regimen (CP) (n = 22, 53.66%) administrated weekly (Qw) or every 3 weeks (Q3w) vs sequential paclitaxel (SP) (n = 19, 46.34%). The irradiation fields were determined by surgery and pathology reports. The mean age was 50.92 years, the 90.24% performed conservative surgery vs. 9.76% mastectomy. Stage IA: 7 (17.07%), IIA: 18 (43.90%), IIB: 10 (24.39%), IIIA: 2 (4.88%), IIIC: 4 (9.76%). The 95.12% had invasive ductal histology. Three-dimensional Conformal treatment was performed in 26 (63.41%) and conventional radiation therapy in 15 (36.58%). An increase in G2 skin toxicity incidence was evidenced in the CP group 12/22 (54.55%) vs SP 2/19 (10.53%), and G3 toxicity CP 2/22 (9.09%) vs. SP 0% (p = 0.002). The relative risk of acute G2/3 skin toxicity in patients with CP scheme was 2.73, (p = 0.0005). Moist dermatitis occurred in 10/41 patients (24.39%): CP arm 8/10 (80%) vs SP arm 2/10 (20%). The need for temporary interruption of treatment (split) in CP arm was 11/22 (50%): Qw 7/11 (63.64%), Q3w 4/11 (36.36%) p = 0.279, the mean dose at split was 36 Gy (27-45 Gy), the mean time of split was 1.5 weeks. In an attempt to reduce treatment interruptions due to severe dermatitis, the boost was intercalated in 10/22 patients of CP arm (45.5%) vs 1/19 SP arm (5.26%) (p = 0.004). We observed in the CP arm a tendency to greater skin toxicity with Qw regimen 63.64% vs. Q3w regimen 36.36%, p = 0.279. The different breast diameters did not act as a modifier of toxicities between the regimens. There was no evidence of symptomatic pulmonary toxicity during the follow up. Treatment of concurrent paclitaxel and radiation therapy for breast cancer significantly increases the acute G2/3 skin toxicity (RR 2.67) and treatment time despite strict monitoring; therefore, we discourage weekly concomitant paclitaxel and radiation therapy, and the Q3W concomitant regimen must be carefully assessed before administration.

BACKGROUND/AIMS:The ideal treatment for patients with advanced rectal cancer and who cannot undergo a radical therapy is still undefined. The association between lasertherapy (LT) and internal radiotherapy (IRT) could affect both technical results and quality of life. This study was aimed at evaluating the association of LT and IRT in the palliative treatment of rectal cancer.MATERIAL AND METHODS:Between January and April 1994, 9 patients (2 males, 7 females) with rectal cancer underwent a combined treatment modality in order to control their symptoms. All patients were unfit for surgery and EUS showed an invasion of the whole muscular layer. After laser recanalization, brachytherapy was applied at a one week interval from last laser session. Two fractions of 10 Gy were administered at one week intervals.RESULTS:The mean number of laser sessions to obtain a complete recanalization was 3 (range:2-5) and no complications occurred. After IRT, we obtained a good result in 7/9 patients (79%) and 2 patients required further LT. The mean follow-up was 146 days (range:74-240): during this period no laser treatment was performed. Four patients complained of acute perineal pain and tenesmus after brachytherapy: in one patient, a colostomy was performed.CONCLUSION:We deem that the administration of two fractions of 10 Gy is not advisable, particularly for the treatment of non-circumferential lesions, due to the severe side effects we observed.

A number of free fatty acids (FFA) and their corresponding monoglycerol esters (MG) are known to have bactericidal properties.We evaluated several medium-chain MG and FFA (C8 to C12) for bactericidal activity in vitro for H. pylori and H. felis and ability to clear H. felis infection in mice.One hour incubation of H. pylori with

Familial aggregation of colorectal cancer occurs even among sporadic cases that are not part of defined genetic syndromes. First-degree relatives of patients with "sporadic" colorectal cancer have a three- to fourfold increased risk of the same cancer. The aim of the present study is to investigate the relationship between a first-degree family history of colorectal cancer and the pathological and clinical features of the tumor (site, Dukes' stage, age at diagnosis, sex, and patient survival). Four hundred and sixty-one patients with colorectal cancer were evaluated (250 males and 211 females) and information obtained on their family history of cancer. Sex, age, and stage of disease were the only parameters that correlated significantly with survival. No relationship between family history of colorectal cancer and the prognostic variables was observed.

Fifty-nine colonic adenomas and 6 hyperplastic colonic polyps were analyzed by single-strand conformation polymorphism analysis for mutations in the adenomatous polyposis coli gene (APC). Frameshifts and premature stop codons in at least one copy of APC were detected in 25 of these adenomas. Five adenomas carried 2 APC mutations. No mutations in APC were found in any of the 6 hyperplastic polyps. The detection of APC mutations increased with size and degree of dysplasia and in rectal as compared to colonic adenomas, although the association was not statistically significant. The frequency of detectable APC mutations was higher in tubulovillous and villous adenomas (10 of 13) than in tubular adenomas (15 of 45) (odds ratio, 6.67; 95% confidence limits, 1.39-41.83; P = 0.005). The significance of the association between the detection of APC mutations and a villous architecture was confirmed in multivariate analysis (relative risk, 6.67; 95% confidence limits, 1.54-28.8; P = 0.005). In conclusion, APC mutation plays a role in adenoma progression; its frequency is significantly higher in lesions with a more villous morphology.

Tenascin is a glycoprotein found mainly in the extracellular matrix of developing and malignant tissues. The distribution of this molecule in normal and pathological synovia from patients with osteoarthritis (OA) and rheumatoid arthritis (RA) was investigated by indirect immunofluorescence utilizing specific monoclonal antibodies. The same technique was used to study total fibronectin (tFn) in synovial tissues as well as ED-A and ED-B containing fibronectin (Fn) isoforms (A-Fn, B-Fn), generated by alternative splicing of pre-mRNA. Tenascin was found in normal synovium just beneath the whole lining cell layer. However, a higher density and spreading pattern of distribution was observed in OA and RA sections. A-Fn and B-Fn isoforms were prominent and widespread throughout the normal synovial lining; in hypercellular synovial lining (in RA and OA samples), A-Fn and B-Fn were also observed spreading in the sublining, as well as tFn.

Les auteurs rapportent un cas associant une maladie de Crohn, une fistule péri-anale persistante et un adénocarcinome mucineux de la jonction ano-rectale.

Familial aggregation of colorectal cancer occurs also among sporadic cases that are not part of defined genetic syndromes. First degree relatives of patients with "sporadic" colorectal cancer have a 3-4 fold increased risk of the same cancer. The aim of the present study is to investigate the relationship between a first degree family history of colorectal cancer and pathological and clinical features of the tumor (site, Dukes' stage, age at diagnosis, sex and survival of patients). 461 patients with colorectal cancer were evaluated (250 males and 211 females) after obtaining informations about their family history of cancer. 52 (11.25%) of them reported to have at least one close relative affected by intestinal cancer. Sex, age and stage of the disease are the only parameters that significantly affect survival. No relationship between family history of colorectal cancer and prognostic variables was observed.