Angiosarcoma remains a difficult management problem with poor loco-regional and distal control. In our study, an overall incidence rate of secondary breast angiosarcoma is 0.065%. Although the prognosis for this disease is poor (typical survival period is 14.5-34 months with a 5-year survival rate of approximately 15%), all the three patients treated at our institute are alive and disease-free at the end of reported period. Finally, it is assumed that the use of breast conserving therapy will increase the incidence of post-irradiation angiosarcoma but the small difference in risk of subsequent sarcoma of the breast cancer patients receiving radiotherapy does not suppress its benefit.

Complexing of polynueleotides to polycationic substances enhances their uptake by mouse peritoneal cells. DEAE dextran and protamine sulfate when complexed with poly(rI) 9 poly(rC) lost their ability to release histamine while the complexes become very active in their interferon inducing capacity. Increased concentrations of poly(rI) 9 poly(rC) in the complex with protamine sulfate resulted in increase of interferon production but in decrease of histamine liberation. As the cationic character of histamine liberators is not necessary for this process, results presented here suggest, that the cell membrane may play an important role in the interferon production triggered by polynucleotides.Arch. ges. Virusforsch. 44]4 21

60 patients with 60 viridans streptococcal bacteraemic episodes (42 due to penicillin-sensitive and 18 due to penicillin-resistant viridans streptococci) were analysed in a population of 12,185 admissions and 1,380 bacteraemic episodes during a 7-year period in a National Cancer Institute. The incidence of viridans streptococci among bacteraemias decreased from 11.5% in 1989 to 2.5% in 1995 after penicillin was introduced for prophylaxis of febrile neutropenia in acute leukaemia in 1993. However, the proportion of penicillin-resistant viridans streptococcal bacteraemias increased from 0 in 1989 and 1990 before any prophylaxis was given, to 12.9-16.7% after quinolones were used for prophylaxis in 1991 and 1992, and to 44.4-81.8% in 1993-1995 after penicillin was added to the quinolones. Mortality rate was higher in the subgroup of penicillin-resistant viridans streptococcal bacteraemias (p < 0.05). Statistically significant risk factors in patients with penicillin-resistant (compared with penicillin-sensitive) viridans streptococcal bacteraemia were: acute leukaemia (p < 0.03), high doses of cytarabine (p < 0.05), mucocutaneous lesions (p < 0.004), breakthrough bacteraemia during prophylaxis with ofloxacine plus penicillin (p < 0.001). Multiple logistic regression analysis showed that only acute leukaemia (OR 2.05, CI 0.85-1.85, p < 0.00452) and penicillin-resistance (OR 0.71, CI 0.103-4.887, p < 0.0209) were significant independent predictors of inferior outcome. Breakthrough bacteraemia during empiric therapy with vancomycine occurred in 5 of 116 patients treated with vancomycine, and during therapy with ampicillin plus gentamicin in 6 patients of 18 treated.

Hormonal regulation of mouse mammary tumor virus (MMTV) synthesis was studied in the CCL-51-SF cell subline derived from the Sykes' mammary tumor cell line CCL-51 and adapted to grow in semi-synthetic in vitro conditions. The virus was quantitated by measuring the supernatant reverse transcriptase activity in exogenous reaction using poly (rA)-oligo (dT) and poly (rC)-oligo (dG) as template/primers. The cells produced a low but significant amount of virus in the absence of any hormones and serum proteins. The synthetic glucocorticoid dexamethasone increased production considerably, up to 100-fold. Pretreatment of CCL-51-SF cells with serum or 5-bromodeoxyuridine, BrdUrd, partly reduced the stimulation by dexamethasone of MMTV production. Insulin and prolactin alone or in combination had no stimulating effect on spontaneous MMTV synthesis and cell growth. Prolactin, and more efficiently the prolactin-insulin combination, enhanced the MMTV production stumulated with dexamethasone. Insulin alone remained without effect. The polyamine spermidine, but not spermine, increased the MMTV production over the control by a factor of 2. Polyamines did not influence cell replication at the concentrations used.

Breast angiosarcoma may occur de novo, or as a complication of radiation therapy, or chronic lymphedema secondary to axillary lymph node dissection for mammary carcinoma. Both primary and secondary angiosarcomas may present with bruise like skin discoloration, which may delay the diagnosis. Imaging fi ndings are nonspecifi c. In case of high-grade tumours, MRI may be used effectively to determine lesion extent by showing rapid enhancement, nevertheless earliest possible diagnostics is crucial therefore any symptoms of angiosarcoma have to be carefully analysed. The case analysed here reports on results of 44-year old premenopausal woman who was treated for a T1N1M0 invasive ductal carcinoma. After a biopsy diagnosis of carcinoma, the patient underwent quadrantectomy with axillary lymph node dissection. She received partial 4 cycles of chemotherapy with adriamycin and cyclophosphamide, followed by radiation treatment. Thereafter, a standard postoperative radiotherapy was applied at our institution four months after chemotherapy (TD 46Gy in 23 fractions followed by a 10Gy electron boost to the tumour bed). Adjuvant chemotherapy was fi nished six months after operation, followed by tamoxifen. Follow up: no further complications were detected during regular check-ups. However, 12-years later, patient reported signifi cant changes at breast region which was exposed to radiation during treatment of original tumour. In this article, we describe the clinical presentation, imaging and pathological fi ndings of secondary angiosarcoma of the breast after radiotherapy (Fig. 2, Ref. 26). Text in PDF www.elis.sk.