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PubMed1989

[The in vitro effect of silica fibers on macrophage-mediated cytotoxic activities in mice].

The in vitro effects of silica fibers on macrophage-mediated cytotoxic activities in mice were studied, including 1) macrophage-mediated tumor cytolysis (MTC), 2) macrophage-mediated tumor cytostasis (MTCS) and 3) antibody-dependent cell-mediated cytolysis (ADCC), we found that silica fibers markedly inhibited both MTC and ADCC but slightly promoted MTCS. Silica fibers were active during the activation phase mediated by macrophage-activating factor as well as in the effector phases of MTC and MTCS. In ADCC, increasing the antibody titer could not abrogate the inhibitory effect of silica fibers.

Animals↗
PubMed1989

[A familial case of multiple endocrine neoplasia (MEN IIb). Diagnosis of medullary thyroid cancer].

The familial observations of multiple endocrine neoplasia are rare such that there are only four known cases in France. In our family, two children and their mother are affected. Their mother, at the age of 16, was operated on a medullary thyroid cancer (MTC) and now presents with a phaeochromocytoma. Vanessa also presents with a MTC but without either phaeochromocytoma nor hyperparathyroidism. Her sister was then systematically screened and the only positive test was Pentagastrin. This allowed us to practice a thyroidectomy which will confirm the presence of a medullary thyroid cancer. In all three cases, the Marfan-like features, the abnormal facies and lingual neuromas are all features of the disease. These observations are of interest for the systemic familial screening of MTC by tumour markers (calcitonin, ACE) and by the Pentagastrin test, while awaiting for the use of specific probes on chromosome 10.

Calcitonin↗
PubMed1989

Experience in imaging medullary thyroid carcinoma using 99mTc (V) dimercaptosuccinic acid (DMSA).

99mTc (V) dimercaptosuccinic acid (DMSA) is a new tumor imaging agent that has been successfully used to image patients with medullary thyroid carcinoma (MTC). Since 1986, studies have been performed in 32 patients with histologically proven MTC at Guy's Hospital, London, England. Five patients with primary tumor were studied prior to surgery, four patients were studied after successful removal of the primary tumor, and 26 patients with biochemical evidence of recurrence were studied. Eight patients were studied serially to assess progression of disease, and four patients were studied before and after surgery. Twenty-one of the 26 patients with disease had positive scans with four false-negative scans and three true negative scans. One patient had a false-positive scan (sensitivity 80%, specificity 75%). Two of the false-negative scans were obtained in patients with moderate but stable elevations of calcitonin but no other evidence of recurrence. One false-negative scan was obtained in a patient who was discovered on screening to have an abnormal pentagastrin response, and a small 1 cm tumor was subsequently removed. Uptake in local neck recurrence was frequently intense, but uptake at sites of bone metastases was less marked. 99mTc (V) DMSA is an inexpensive radiopharmaceutical which produces good quality images and has been shown to have an acceptable sensitivity and specificity in the follow-up of patients with MTC and thereby contributes significantly to the management of these patients.

Adolescent↗
PubMed1989

Diagnostic and therapeutic potential of new radiopharmaceutical agents in medullary thyroid carcinoma.

Recently developed radiopharmaceuticals have been proposed for imaging medullary thyroid carcinoma (MTC) with some having therapeutic potential. This study compares the imaging results obtained with radioiodinated meta-iodo-benzylguanidine (MIBG), 99mTc (V) DMSA, and 131I F(ab')2 anti-carcinoembryonic antigen (anti-CEA) in a group of MTC patients. In 23 patients 131I MIBG imaging showed a high specificity (no false-positive results) but a less satisfactory sensitivity (50%). In 12 patients 99mTc (V) DMSA revealed a better sensitivity (77%) but a lower specificity (three false-positive results). Positive results were obtained in two of three patients studied with 131I F(ab')2 anti-CEA. These data suggest that the highly sensitive 99mTc (V) DMSA should be considered as a first choice procedure followed by the highly specific radioiodinated MIBG to confirm the initial results. Since radioiodinated MIBG imaging may have therapeutic usefulness, 131I MIBG was evaluated in an integrated treatment protocol in four cases of proven MTC. The preliminary results obtained were encouraging.

3-Iodobenzylguanidine↗
PubMed1989

Peritoneal functional parameters after five years on continuous ambulatory peritoneal dialysis (CAPD): the effect of late peritonitis.

Functional stability of the peritoneum is essential for patients on long-term continuous ambulatory peritoneal dialysis (CAPD) treatment. Sixteen patients on CAPD treatment for at least 4 years were studied. Their mean age was 47 +/- 15 years, 5 were males, and none were diabetic. Residual creatinine clearance at the beginning was 2.1 +/- 2.6 mL/min. Once yearly since starting CAPD, we have evaluated their peritoneal ultrafiltration (UF) and diffusion capacities by calculating the peritoneal mass transfer coefficient (MTC, mL/min) for urea and creatinine. Patients were categorized so that we could distinguish the effect of peritonitis, betablockers, and hypertension. For all patients the average initial and final MTCs and UF values were not different. Early episodes of peritonitis (those occurring less than 36 months after starting CAPD) did not influence long-term function. However, late peritonitis (occurring greater than 36 months since initiation) induced a decrease in urea-MTC (22.3 +/- 6 to 15.8 +/- 3.9, p less than 0.05), creatinine-MTC (9.4 +/- 3.1 to 7.4 +/- 2.5, p less than 0.05), and a corresponding increase in UF (1.25 +/- 0.4 to 1.4 +/- 0.3, mL/min, p less than 0.05). Age, sex, betablockers and hypertension did not influence the peritoneal parameters followed. After 5 years on CAPD, functional stability of the peritoneum is evident, except for patients who suffer late episodes of peritonitis. We speculate that the peritoneum in patients who have been on long-term CAPD are more susceptible to injuries, such as peritonitis, and that this results in functional deterioration.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

[The importance of clinical and histologic variables in the prognosis of medullary carcinoma of the thyroid gland].

Patients with medullary thyroid carcinoma (MTC) have aroused considerable interest ever since Horn (1951), Hazarde et al. (1959) and Williams (1966) described MTC as a separate clinicopathologic entity, because this tumor occurs both in families and in association with neural and endocrine abnormalities. This interest also underlines our clinicohistologic study of 31 patients with a histologically demonstrated MTC. The patients have been analyzed at the Central Institute for Tumors and Allied Diseases in Zagreb from 1969 to 1988. The youngest patient was 17, and the oldest one 85 (average 45 years). None of the patients had thyroid carcinoma in his/her family history, or any association with pheochromocytoma or multiple skin and mucosal neurinoma. The men to women ratio was 1:0.94. The prognostic significance of some clinical and histologic variables in patients affected by medullary thyroid carcinoma have been studied. Treatment involved total thyroidectomy with or without neck dissection. Some of the patients were subsequently irradiated or administered chemotherapeutic agents. The data obtained in the study were statistically processed and the statistical differences between the survival rates of the various patient groups were determined by the logrank-test. Of the studied variables (sex, age, tumor size, cervical metastases, tumor structure, cell type, stroma, calcification, number of mitoses, necrosis, bleeding, amyloid content), the following were found to have a prognostic significance: age, tumor size and regional lymph node metastases.

Adolescent↗
PubMed1989

[Effects of subcutaneous administration of sandostatine (SMS 201.995) in 18 cases of thyroid medullary cancer].

Recent studies have suggested that somatostatin could reduce calcitonin plasma levels (CT) in normal subjects and in medullary thyroid carcinoma (MTC). The aim of this study was to examine the usefulness of the somatostatin analog, sandostatine (SMS 201.995) in MTC with elevated residual CT levels post-thyroidectomy with or without metastases. 18 patients (17-64 years, 12 men and 8 women) with CT greater than 850 pg/ml (N less than 150 pg/ml) and with metastases in 12 cases, were studied. MTC was sporadic in 11 cases, familial in 4 cases and of undefined form in 3. Initial posology was 300 micrograms/d of sandostatin (3 injections/day). It was then increased by 300 micrograms/d every 9 day till a maximum of 1500 micrograms/d. Treatment duration was 37 days in 11 cases and 60 days in 7 cases. Plasma CT and carcinoembryonic antigen levels (CEA) were measured before treatment and at the end of each dosage plateau. Morphologic evaluation of metastases was done at 0, 30, 60 days. 7/18 patients were reevaluated 2 to 8 months after with drawal of sandostatine. Treatment was well tolerated. Flushes improved in 4 out of 5 cases but diarrhea in only 2 out of 9 patients. Sandostatine was without any effect on plasma CEA. Heterogenous responses were observed for plasma CT levels (CT decreases greater than 20% in 8/18 patients when 900 to 1500 micrograms/day were administered). Patients were subdivised into 3 groups according to CEA levels and presence or absence of metastases. Group A (n = 9) had elevated CEA levels (greater than 10 mg/ml) and metastases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Medullary thyroid carcinoma: prognosis of familial versus nonfamilial disease and the role of radiotherapy.

A retrospective study of 202 patients with medullary thyroid carcinoma (MTC) diagnosed between 1943 and 1987 was done to compare the prognosis of patients with sporadic disease and those with the familial form of multiple endocrine neoplasia type II (MEN-II) and to study the effect of radiotherapy. The relationship between serum calcitonin (iCT), carcinoembryonic antigen (CEA), and calcitonin gene-related peptide (CGRP) to the extent of disease and prognosis was also studied. Patients with MEN-II had significantly longer survival rates than did patients with the sporadic variety (P less than 0.005), but most patients with sporadic disease were older and had more advanced disease. No differences in survival rates were found when patients from these two groups were matched for age and extent of disease (P greater than 0.7). When patients who received radiotherapy were matched for age, extent of disease, and surgery with patients who had had no radiotherapy, the latter group was found to live significantly longer (P less than 0.05). Our studies suggested (1) that the apparently poor prognosis of patients with sporadic MTC may be related to the patients' older age at detection rather than to inherent differences in the two forms of disease, (2) radiotherapy has little effect on MTC, (3) calcitonin gene-related peptide measurement was not helpful in determining the extent of disease or prognosis, (4) patients with liver metastasis had the highest iCT levels, (5) patients with bone metastasis had the highest CEA levels, and (6) patients with diarrhea had poor prognosis and had high iCT levels.

Adolescent↗
PubMed1989

Diagnostic procedure before reoperation in patients with medullary thyroid carcinoma.

Elevated calcitonin (CT) levels after primary operation of the medullary thyroid carcinoma (MTC) are a reliable marker for persistence or recurrence of MTC, which first metastasizes in the neck or mediastinal region. The reliability of different localisation methods before reoperation in 28 patients with elevated CT levels was tested by comparing their diagnostic results with the actual finding at reoperation. The diagnostic procedures comprised ultrasonography of the neck, CAT-scan of the neck and mediastinum, selective venous catheterization with CT determinations, and fine needle biopsy. Due to the results of these tests 28 patients were reoperated 48 times. Histological evidence confirmed the presence of suspected tumor that had been diagnosed by: palpation 52%, ultrasonography 78%, CAT-scan 70%, selective venous catheterization 75%, fine needle biopsy 81%. Despite the fact that only 2 out of the 28 patients had normal CT levels postoperatively, the 5 year survival rate in reoperated patients (86%) improved compared to patients without reintervention (69%). For precise preoperative staging ultrasonography seems to be the most predictable and reliable method. The prognosis of MTC patients with elevated CT-levels in the follow-up period could be improved by frequent reoperations.

Adult↗
PubMed1985

Effect of vector on infectivity of Trypanosoma cruzi.

A comparative study was carried out on the interaction between Triatoma infestans and bloodstream forms (BSF) of Trypanosoma cruzi isolates RA and UP, both lethal for mouse, and CA-I nonlethal for this host. Parasite duplication was readily detected in triatomes fed with CA-I, metacyclic (Mtc) differentiation reaching a maximum at an optimum ingestion level of 250 BSF/insect. Progress and differentiation proved much lower for RA, but reached intermediate values for the UP isolate. Assays for infectivity for each isolate after bug passage revealed a drop for the RA and UP, whereas for CA-I an increase was observed indicating that virulence of BSF and Mtc differs. Our results suggest that parasite selection by insect passage modulates infectivity of a given parasite population; however, virulence was independent of the absolute number of Mtc in the insect's feces.

Animals↗
PubMed1986

[Digestive manifestations in a patient with type-IIB multiple endocrine neoplasms].

The IIB or third type of multiple endocrine neoplasia is a very uncommon hereditary disease. It includes a digestive ganglioneuromatosis, a typical dysmorphia, a medullary thyroid cancer (MTC) sometimes a pheochromocytoma and seldom a hyperparathyroidism. We report a Men IIB case in a 19 years old patient who had been suffering from severe constipation and afflicted with a megacolon, known since early infancy. Diagnosis was documented by discovering a colonic ganglioneuromatosis and a MTC. A complete thyroidectomy was performed but cervical node metastasis were already present. The ganglioneuromatosis usually affects the whole alimentary tract, but megacolon although not regularly found occurs most frequently. Awareness of the diagnosis is easier when patients have big lips, eyelids, tongue (due to mucosal neuromas) and marfanoid habitus. The prognosis depends upon the MTC. It occurs early in the life, is often bilateral and has a trend to become uncontrollable in the young adult. The pheochromocytoma is often latent and affects only half of patients. The etiopathogeny of this disease still remains unknown. Family inquiry may help to an earlier diagnosis and therefore to a better prognosis.

Adult↗
PubMed1987

[Immuno-histochemical study of medullary thyroid carcinoma].

Five peptide hormones including calcitonin (CT) and gastrin-releasing peptide (GRP), serotonin (5HT), CEA, nervous tissue specific proteins and monoclonal antibody Leu-7 were immuno-histochemically studied on 60 cases of medullary thyroid carcinoma (MTC). In addition, localization of varied products in the tumor cells and its relations with the clinical features in some cases were evaluated. MTC contains a variety of products in many cases, and CT and CEA were positive in all cases. In 50 of the 57 cases (87.7%), GRP was positive, which suggested that GRP could be a novel tumor marker for this tumor. Furthermore, in tumor cells and C-cell hyperplastic foci, identical cells were sometimes revealed to possess both CT and GRP. Existence of somatostatin (SS), substance-P (SP), beta-MSH, 5 HT, Leu-7 and NSE in the tumor cells were confirmed. NSE was positive in 32 of the 47 cases (61.8%) which could confirm that MTC possesses neuroendocrine nature. In two cases of autopsy in which the tumors were highly malignant in clinical course and undifferentiated in histology, most tumor cells showed poor stainability for peptide hormones, suggesting that specific qualities as neuroendocrine tumor had been lost. In familial cases, the tumor tended to contain multiple substances.

Adult↗
PubMed1987

[An operated case of multiple endocrine neoplasia type IIb and review of the Japanese literature].

Multiple endocrine neoplasia, type IIb (MEN IIb) is a rare syndrome characterized by the occurrence of medullary thyroid carcinoma (MTC), pheochromocytoma and mucosal neuroma. A 35-year-old male patient with MEM IIb having megacolon, marfanoid habitus and no family history of the disease underwent surgery. Because MTC was present in both lobes, total thyroidectomy and modified neck dissection were performed. Pheochromocytoma was found bilaterally and bilateral adrenalectomy with adrenal autotransplantation in the rectus abdominis muscle was carried out. Postoperative course was satisfactory except for transient hypocalcemia and mild ileus. After the slow corticosteroid weaning process, his adrenocortical function was at the lower level within a normal range. In August 1986 (24 postoperative months), he was maintained by the administration of 10mg of hydrocortisone every three days, and calcitonin and CEA levels in sera were normal. We collected 15 cases reported in Japanese literatures. MTC and mucosal neuroma were found in all cases, whereas pheochromocytoma was present in 9 cases. Bilateral and multicentric occurrences were usual, and total thyroidectomy and bilateral adrenalectomy were, warranted. We believe that autotransplantation following bilateral adrenalectomy is a worthy alternative.

Adrenal Gland Neoplasms↗
PubMed1987

Direct effects of the pyrimido-pyrimidine derivative RA 233 (Rapenton) on rat 13762NF mammary tumor cell clones in vitro.

Studies with the pyrimido-pyrimidine analogue RA 233 (Rapenton) suggest that its antimetastatic action may not be mediated entirely by inhibition of platelet function. Little is known about its direct effects on tumor cells. We investigated the in vitro effects of RA 233 on clones MTLn3 and MTC of differing metastatic potentials, isolated from the 13762NF rat mammary adenocarcinoma. The results indicated that RA 233 is cytostatic (EC50 of approximately 140 microM and approximately 180 microM for MTLn3 and MTC cells, respectively) rather than cytotoxic by determining changes in viable cell number, thymidine uptake, and incorporation of thymidine and methionine. In both clones RA 233 inhibited cAMP-dependent phosphodiesterase activity and affected cAMP accumulation in intact cells. In contrast, clonal heterogeneity in drug-induced morphological changes, such as vacuole formation and altered organization of cytoskeletal structures, as well as increased tumor cell growth at 50 microM RA 233 was observed between clones MTLn3 and MTC. These data could explain the conflicting results obtained with RA 233 when evaluated as an antimetastatic agent.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1986

Prolonged dopamine receptor blockade in normoprolactinemic amenorrhea: a double-blind placebo study.

Patients with functional amenorrhea may have a raised central dopaminergic activity, leading to inhibition of pituitary-ovarian function. In a double-blind placebo trial, ten patients with amenorrhea received metoclopramide (MTC) orally in daily doses from 20 to 7.5 mg in a sequential form for 10 weeks. Six patients received placebo. Serum levels for luteinizing hormone (P less than 0.02), follicle-stimulating hormone (P less than 0.05), and prolactin (P less than 0.001) increased significantly during MTC administration, and no (P greater than 0.05) hormonal changes occurred in the placebo group. Six patients observed vaginal bleedings during MTC administration but without postovulatory progesterone levels. Dopamine receptor blockade may activate the hypothalamic-pituitary axis of amenorrheic patients, although an ovulatory response is not achieved.

Adult↗
PubMed1987

Calcitonin gene-related peptide: possible tumor marker for medullary thyroid cancer.

We have sought to determine whether medullary thyroid carcinoma (MTC) released calcitonin gene-related peptide (CGRP) in vivo. MTC cells were inoculated from tissue culture into eight Wag-Rij rats. One month later blood was drawn before and after the intravenous injection of calcium, and plasma levels of CGRP and calcitonin (CT) levels in that blood were determined by radioimmunoassay. The tumor was examined for content of CGRP and of CT by means of radioimmunoassay and immunocytochemistry. The tumor was divided and portions were passed to another eight rats. One month later, the studies were repeated. The tumor was passed two additional times (four passages in all). Controls consisted of non-tumor-bearing Wag-Rij rats. Basal levels of plasma CGRP in control rats (7 +/- 1 ng/ml) were unaffected by calcium stimulation. In tumor-bearing rats, the plasma CGRP level, which was initially slightly elevated (15 +/- 7 ng/ml), rose progressively with passages to 279 +/- 79 ng/ml in the third passage and fell to normal values at the end of passage four. Hypercalcemia had no effect on plasma CGRP levels in tumor-bearing rats but did stimulate the release of CT in both control and tumor-bearing rats, although it is not clear whether this release was from the tumor or from normal thyroid parafollicular cells in these tumor-bearing rats. We conclude that rat MTC synthesizes and releases CGRP but, unlike CT, CGRP appears unresponsive to calcium stimulation.

Animals↗
PubMed1987

Medullary carcinoma of the thyroid gland.

Nine cases of medullary carcinoma of the thyroid gland (MTC) are reported. Four of the carcinomas were of the familial type. Five of the patients were men and four were women. Patient age ranged from 23 to 66 years, with a mean age of 40 years. The median age of the four patients with the familial MTC was 32 years. A total or a subtotal thyroidectomy was performed in four and five patients, respectively, associated with a modified neck dissection in six patients with involved cervical lymph nodules. An underlying pheochromocytoma of the left adrenal was excised in one patient prior to thyroidectomy. In all cases the parathyroid glands were identified, and in two cases of familial MTC, in which they were grossly enlarged, the parathyroid glands were removed. Four patients died as a result of their disease within 3 years, whereas patients are well 4 to 12 years after surgery. The best chance of cure lies in early diagnosis and an aggressive surgical removal of the primary tumor and any cervical metastases.

Adult↗
PubMed1987

Systems of membranes involved in peritoneal dialysis.

To evaluate whether the viscera contribute to the system of membranes used in peritoneal dialysis, dialysis rate studies were performed comparing control rats (n = 9, mean peritoneal area 509 +/- 38 cm2) with eviscerated rats (n = 12, mean peritoneal area 200 +/- 123 cm2). The mass transfer coefficient (MTC) and absorption from the peritoneal cavity were calculated for urea, creatinine, and inulin, which had been added to commercially available 1.5% hydrous dextrose dialysate. Rates of peritoneal blood flow to the peritoneal membranes remaining after evisceration were similar for both groups. Urea, creatinine, glucose, and inulin were used as markers to compare control and eviscerated animals. The MTC results were (in milliliters per minute, mean +/- SEM): urea 3.0 +/- 0.3, 4.1 +/- 0.5 (P less than 0.01); creatinine 1.4 +/- 0.2, 2.0 +/- 0.2 (P less than 0.05); glucose 1.2 +/- 0.3, 1.7 +/- 0.2 (P less than 0.09); inulin 0.3 +/- 0.02, 0.6 +/- 0.1 (P less than 0.01); and MTC inulin/MTC urea 0.16 +/- 0.01, 0.14 +/- 0.01. Absorption of urea, creatinine, glucose, and inulin from the peritoneal cavity was only 10% to 23% greater among control animals. Whether the results were caused by nonparticipation of the intestinal viscera or other mechanisms, such as improved contact between dialysate and membrane, awaits further study.

Animals↗