Influence of Hormone Receptor Status on Spinal Metastatic Lesions in Patients with Breast Cancer.

Objective: Bony metastasis predominantly affects the spinal column and has been commonly associated in patients with breast cancer. There are two types of lesions that can occur with spine cancer-osteolytic or osteoblastic. Some patients may have mixed lesions, which include lytic and blastic in one vertebra or lytic and blastic in different vertebrae.

Results of an intervention study to improve communication about randomised clinical trials of cancer therapy.

We report results from an intervention study to improve communication during consultations about randomised clinical trials of cancer therapy. Patients, eligible for a trial, completed questionnaires about information preferences and attitudes to trials prior to seeing their doctors, who were either shown these questionnaires (intervention) or not (control). Fifteen doctors participated and invited 265 patients to join one of 40 different randomised clinical trials.

The psychosocial impact of bilateral prophylactic mastectomy: prospective study using questionnaires and semistructured interviews.

Objectives: To investigate the psychosocial impact of bilateral prophylactic mastectomy for women with increased risk of breast cancer and to identify, preoperatively, risk factors for postoperative distress.

Design: Prospective study using interviews and questionnaire assessments.

Setting: Participants' homes throughout the United Kingdom.

The Medical Interaction Process System (MIPS): an instrument for analysing interviews of oncologists and patients with cancer.

The increase in communication skills training for doctors has led to the need for more effective means of evaluation. Analysis of video and audiotaped consultations using systems of interaction analysis can provide the trainee with in-depth feedback about their communication skills. Most interaction process systems were designed for use in primary care and recent research has questioned the applicability of these systems in medical specialties such as oncology.

How do doctors explain randomised clinical trials to their patients?

As part of a larger study designed to improve doctor-patient communication in randomised clinical trials (RCT), we audiotaped the discussions between doctor and patient in which consent was being obtained for a RCT. This paper reports on 82 discussions conducted by 5 clinical oncologists in both District General and University Hospital outpatient departments. When introducing the subject of trials, uncertainty about treatment decisions was expressed by the doctors in the majority of cases (79, 96.

Are we using appropriate self-report questionnaires for detecting anxiety and depression in women with early breast cancer?

The aim of this prospective study was to identify the psychiatric morbidity associated with the diagnosis and treatment of early breast cancer. At each of five time points, 269 women were interviewed using a shortened version of the Present State Examination (PSE) and 266 completed self-assessment questionnaires, the Hospital and Anxiety Depression Scale (HADS) and the Rotterdam Symptom Checklist (RSCL). This paper compares the ability of the questionnaires to detect psychiatric morbidity with that of the PSE.

Offering choice of surgical treatment to women with breast cancer.

Much has been written about the psychosocial and sexual dysfunction associated with the diagnosis and treatment of breast cancer. Hopes that breast conserving techniques would lead to a reduction in some of the psychosocial morbidity experienced, have not materialised. Most of the methodologically sound studies reported to date demonstrate few differences in quality of life domains between women whatever their primary surgical treatment.

Retinoic acid induces changes in c-fgr proto-oncogene mRNA levels in Burkitt's lymphoma cells.

The c-fgr proto-oncogene is expressed in Burkitt's lymphoma (BL) cell and cell lines derived from them. When Epstein-Barr virus (EBV)-negative BL cell lines that contain low levels of c-fgr mRNA are infected with EBV, transcription of the c-fgr gene is further induced. In this paper we show that treatment of EBV-negative and EBV-positive BL cell lines with all-trans retinoic acid also stimulates an increase in c-fgr mRNA levels, varying between 2- and 13-fold depending on the cell line.

Effect of cigarette smoking on cultured human endothelial cells.

Objective: The aim was to investigate whether the morphological changes previously described in endothelium exposed to cigarette smoke are linked with the oxidative burden imposed on the cells.

Methods: Cultured human umbilical vein endothelial cells (HUVEC) were exposed to samples of plasma taken from volunteer smokers and to samples of plasma to which small doses of fresh cigarette smoke derived from a smoking machine had been added. Measurements of the pentose phosphate pathway and the extruded total glutathione (GSSG) were performed to assess the presence and degree of oxidative stress on cells.

Reaction of nitric oxide with hydrogen peroxide to produce potentially cytotoxic singlet oxygen as a model for nitric oxide-mediated killing.

Nitric oxide, as well as being a major regulator of vascular reactivity, has been shown to be one of the mediators of cytotoxicity in macrophages. This cytotoxic effect seems to be due to the interaction between nitric oxide and oxygen-related free radicals. This study shows that, in vitro, nitric oxide reacts with hydrogen peroxide to release large amounts of chemiluminescence with the characteristics of the highly cytotoxic species, singlet oxygen.

Regulation of c-fgr messenger RNA levels in U937 cells treated with different modulating agents.

The U937 cell line was used to investigate the induction of messenger RNA (mRNA) for the c-fgr mRNA tyrosine kinase proto-oncogene in cells of the monocyte-macrophage lineage. U937 cells were exposed to tumour necrosis factor-alpha (TNF-alpha), TNF-beta and transforming growth factor-alpha (TGF-alpha), alone and in combination with PMA and 1,25-dihydroxycholecalciferol (1,25-DHCC). TNF-alpha and TNF-beta, but not TGF-alpha, decreased the proliferation of U937 cells in a time- and dose-dependent manner, and both TNF-alpha and TNF-beta enhanced the response of U937 cells to PMA during the first 24 hr of treatment and to 1,25-DHCC over 72 hr.

Gamma/delta T cells and the diagnosis of coeliac disease.

Gamma/delta T cells are increased in the gut epithelium of patients with coeliac disease compared with normal controls. The aim of this study was to determine whether the increase in gamma delta intraepithelial lymphocytes (IEL) is specific for coeliac disease, in which case it could be of diagnostic importance. Biopsies were obtained from children with no intestinal disease, coeliac disease, cow-milk-sensitive enteropathy/post-enteritis syndrome (CMSE PES) and miscellaneous other enteropathies (n = 67).

The c-fgr proto-oncogene: expression in Epstein-Barr-virus-infected B lymphocytes and in cells of the myelomonocytic and granulocytic lineages.

The c-fgr proto-oncogene, which is a member of the c-src gene family, encodes the cytoplasmic tyrosine kinase p55c-fgr. Expression of the c-fgr gene is activated in human B lymphocytes following infection with Epstein-Barr virus, and the viral protein EBNA-2 is involved in mediating this effect. The only normal cells in which the c-fgr gene is known to be expressed are peripheral-blood granulocytes and monocytes, and tissue macrophages.

Mechanisms of dendritic cell function.

There is now considerable evidence, from in vivo and in vitro studies, supporting the claim that dendritic cells are the principal accessory cells of the vertebrate immune system. Until recently, however, the biology of the dendritic cell accessory mechanism has remained obscure. Here, Philip King and David Katz review recent findings that have clarified several aspects of this mechanism, providing a possible basis for the potent T-cell stimulating capacity of the dendritic cell, and yielding clues to the ontogenetic relationships of these cells and to their role in immunopathology.

The role of CD44, CD45, CD45RO, CD46 and CD55 as potential anti-adhesion molecules involved in the binding of human tonsillar T cells to phorbol 12-myristate 13-acetate-differentiated U-937 cells.

In this study, we have shown that human tonsillar T cells adhere to phorbol 12-myristate 13-acetate(PMA)-differentiated U-937 cells. To examine the molecular mechanisms involved, the effect of a panel of monoclonal antibodies upon this adhesion was assessed in a quantitative binding assay. Antibodies against LFA-1 and ICAM-1 inhibited binding, directly implicated these molecules in T cell-PMA-induced U-937 adhesion.

Histological analysis and the pathogenesis of mucocutaneous leishmaniasis.

A series of over 400 well-documented biopsies of mucocutaneous leishmaniasis was evaluated to elucidate the histological processes associated with the elimination of parasites, and their correlation with the course of the disease. Non-specific inflammation was the most frequent and least effective response; its onset might be delayed, and in this event particularly the incidence of metastasis from skin to mucosa was high. Lysis of parasite-laden macrophages appeared to be the basic mechanism of parasite reduction, even when it was not overt.

Autocrine regulation of 1,25-dihydroxycholecalciferol metabolism in myelomonocytic cells.

In this study the effects of vitamin D metabolites on the myelomonocytic precursor cell line U937 have been compared with those of phorbol myristate acetate (PMA). PMA was used as a cell modulating agent in order to avoid effects of binding of the exogenous vitamin D metabolites receptors within the cell, which would interfere with subsequent measurement of these receptors in studies of the vitamin D3 metabolic pathway. Both the active 1,25 DHCC form of vitamin D3 and the inactive 24,25 DHCC metabolite inhibit cell proliferation and induce 24-hydroxylase activity, but not 1 alpha-hydroxylase activity.

Human tonsillar dendritic cell-induced T cell responses: analysis of molecular mechanisms using monoclonal antibodies.

Dendritic cells, isolated from human tonsillar tissue, were found to be potent stimulators of the sodium periodate T cell oxidative mitogenesis reaction. Monoclonal antibodies against CD2, CD4, CD11a, CD18, LFA-3, ICAM-1, class I and class II major histocompatibility complex (MHC) inhibited T cell proliferation in this response, whereas antibodies against CD8, CD11b, CD11c and CD16 had no effect. Further, antibodies against CD2, CD11a, CD18, LFA-3 and ICAM-1 inhibited the early dendritic cell-T cell clustering event which occurs in this cell interaction.

Epinephrine-induced cytotoxicity of rat plasma. Its effects on isolated cardiac myocytes.

The plasma from rats injected with epinephrine (5 mg/kg) (epinephrine plasma) was found to be cytotoxic when incubated with isolated heart cells. This cytotoxicity was apparent 60 minutes after the start of the incubation due to the appearance at this time of membrane microblebs and microvilli as seen by scanning electron microscopy and the start of a fall in intracellular concentrations of ATP. The membrane blebs increased in size with time and the cells became contracted.