- Email: [email protected]
Hormones and breast cancer
eral density and various biochemical biopsies were taken under local anest subjects. Results: Forearm bone mine lous bone areas were significantlylower in the alcoholicpatientscomparedwith c~ntt3 0.01 fnr all measurements),but !hcse %ahaes did not differ betwan the drinkerst?d TLCdrinkers, however, had significantly less osteoblastic activity than the abstainers, dynamic bone histomorphomary (f < 0.001). Serum bone Gla-protein concentrations the abstainers than in the drinkers (P < 0.001). No differences were seen rcl mctcr; of bone resorption. although the alcoholic patients who had lower serum free testosterooe concentrations than th- control subjects also had higher urinary lrydroxyproline excretion rates. Conclusion: These data suggest that ethanol may be responsible for o&oblastic dysfunction resuhiqz in diminished bone formation and reduced bone mineralization.
Diet and plasma oodrogens in ?ostme~opau~l pnusal women witb breast cancer
vegetarian
and omnivorous
women
8rsd post?le~l~-
Adlercreutz H; Hamalainen E; Gorbach SL; Goldin BR; Woods MN; Dwyer JT Department of ClitGcncol Chemistry. University of Helsinki, SF-00280 Helsinki: Fin/and Am. J. Clin. ?hctr.; 49/3 (433-442)/1989/ We
studied 27 postmenopausal women, 9 vegetarians, 10 omnivores, and 8 apparently healthy women with breast cancer (BC), four times during 1 year. Dietary intakes were recorded and plasma androgens and sex-hormone-binding globulin (SHBG) bindilg capacity were determined. Androstenedione (A), testosterone (T), free T (Fr). and SHBG were higher in omnivores ti’an in vegetarians. In multiple correlation analysis. intakes of protein and fat were positively correlated with A. T. and FT. whereas the intakes of carbohydrate, grain, total fiber, and grain fiber showed the opposite correlations. Protein intahe was positively correlated with percentage FT (@IoPT) and negativeti with SHBG. BC patients bad a ,irnilar paitern to omnivores with even higher levels of A and T (sit&cant compared with vegetar sns) and they showed !ignificantl, higher FT and lower SHBG than both control groups. We conclulle that a Western-type :iei in postmenopausal women is associated with high A, T, %FT. and low SHBG and this pattern was apparent in the BC patients.
Serum nod bile lipid levels in postmenopnusid woman after percntukeotu and oral nahral D’Amato G; C&ve!lini A: Me;>a C; Manyini V; Mkciagna G Deportment 7’ Obstetrrcs and Gynecologv, Istituto di Ricovero e Cura a Carattere Scientifico, 7GiJl3 Castellana. .Wy
Am. 1. Obstet. Gyneco!.: !KV? (6OO-&Il)/lrgL/ 17 betaBstradio1 was administered for 4 weeks percutaneously (5 me/day) and. after a 6--e& period to allow the drug to wash cut, orally (2 mg/day) to a postmenopausal woman in whom a Kerr tube had been paced because of an iarrogenic lesion of the cOlumon bile duct. After both methods of administration, there was an increase in the biliary cholesterol coaretrtration, but after oral dministration, bile flow also increased and cholesterol crystals appeared in the bile. The percutaneous metnui of -*r.idiol administrtion in postmcnqaus~l women seems to be less dangerous for the biliar) ‘-32.
Wormoaes rod breast cancer Wile AG; DiSaia PJ Divirion of SurgW sexology, University of Ctilifornig Irvine Cancer Center. Orange, CA MM; U.S.A. Am. J. Sure.; 157/4 (438--442)/1989/ Patients with successfully managed breast cancer have generaily ken denied subsequent exposure increased leveis of estrogen (endogenous or exogenous) based on the belief ihat exacerbation of
to
the
252 cancer would occur. The advent of oral contraceptives. the trend toward childbearing later in life, and the dpmonstration of the protectire va!ae of menopausal estrogen replacement therapy against osteoporosis and czrdiovascuiar disease requires that this issue be reexamined. New information bearing on this subject includes the recognition of estrogen receptors, the isolation of youth rather than pregnancy as the factor resulting in poor prognosis, epidemiologic studies showing no increased risk of breast cancer in women using oral contraceptives or taking hormonal replacement therapy, the benefi--d breast cancer, and the absence of an cial effect of pregnancy subsequent to successfuiiy man+.. adverse effect of oral con+Jaceptives upon estabiisbd breast camzer. !r. view of the lack of evidence relating estrogen to exacerbation of existing breast cancer, it may he in the best interest of our patients to liberalize our &t!itude to renewed hormonal exposure in patients with successfully n,anaged breast cancer.
Biophysicnl study of bone mineral in biopsies of ~steoporutic patknts
befote
and after long-term
treatment with fluoride
Baud CA; Very JM; Courvoisier B Institut de Morphologie, Centre Medical U+ersitaire, 1211 Geneve 4: Switzerland Bone; 916 (361-365)/1988/ Crystallographic characteristics of bone mineral were examined in a group of 60 Jsteoporotic patients before and after 3 to 6 years of fluoride therapy. The age of the mineral was evaluated by means of X-ray absorption, as degree of mineralization of bone tissue (MDBT). Crystallinity was evaluated by measuring both X-ray diffraction line broadening, beta (31.0) and beta (00.2). and the crystaliinity index (CI) by infrared spectrometry. The a arId c unit-cell parameters were determined by powder Xray diffraction. Bone fluoride contem was measured by specific electrode. Patients were divided in two groups according to MDBT before treatment: one group with MDBT values less thsn or equal tu mean value; another group with MDBT value. greater than mean value. in The first group, trabecuiar bone volume (TBV) did not change sigmficantiy during therapy. In the second group, an increase of TBV was observed. Osteoporoses can then be distinguished, on MDBT criterion, between osteoporosis with hypermaturated mineral an9 osteoporosis with hypomaturated mineral. The MDBT before treaunent permits one to predict the effect of fluoride therapy on TBV. In the two groups there was a significant increase in bone fluoride content between the onset and the end of treatment. Bone fluoride content increased linearly during therapy without any plateau effect. Crystallographic modifications iuduced by fluoride explain mechanical and chemical improvement of bone.
A model tor e~:!n~~i~?gthe poteotiat costs aod savfogs of osteopurosis
prevention
strategies
Ross PD, ‘Yasnich RD, Maciean CJ; Hagino P: Vogel JM Kuakini Gs:etipmxk Study, Kuakini Medical Center, Honolulu, HI; U.S.A. Bone; 916 (337-347)/1988/ A model was developed which estimates thL cost of osteoporosis ,isk evaluation and treatment, arid the resulting savings in terms of reduced fracture frequency, for the adult female population of the United States. In the absence of treatment, tk e model predicts 1.44 million fractures will occur annually from non-violent causes. Treatmerit of all women beginning at age 50 with an agent that slows hone 1~s by 50% would reduce the number of these fractures by 0.59 million. Selective treatment of the 47% of women at the greutcbt fracture -isk would reduce the number of fractures by 0.45 million. but would only cost 47010as much ah treating all women. Additional data are required before 6.emodel can be used to evaluate specific treatment regime;;. H~=.v;vcr, ‘t ++tars that selective treatment uf those at high& risk w&d yieid the gr:?cest benefit to cost ratio, if OII!~benefits related to reduced fracture frequency are considered.
Diet and plasma oodrogens in ?ostme~opau~l pnusal women witb breast cancer
vegetarian
and omnivorous
women
8rsd post?le~l~-
Adlercreutz H; Hamalainen E; Gorbach SL; Goldin BR; Woods MN; Dwyer JT Department of ClitGcncol Chemistry. University of Helsinki, SF-00280 Helsinki: Fin/and Am. J. Clin. ?hctr.; 49/3 (433-442)/1989/ We
studied 27 postmenopausal women, 9 vegetarians, 10 omnivores, and 8 apparently healthy women with breast cancer (BC), four times during 1 year. Dietary intakes were recorded and plasma androgens and sex-hormone-binding globulin (SHBG) bindilg capacity were determined. Androstenedione (A), testosterone (T), free T (Fr). and SHBG were higher in omnivores ti’an in vegetarians. In multiple correlation analysis. intakes of protein and fat were positively correlated with A. T. and FT. whereas the intakes of carbohydrate, grain, total fiber, and grain fiber showed the opposite correlations. Protein intahe was positively correlated with percentage FT (@IoPT) and negativeti with SHBG. BC patients bad a ,irnilar paitern to omnivores with even higher levels of A and T (sit&cant compared with vegetar sns) and they showed !ignificantl, higher FT and lower SHBG than both control groups. We conclulle that a Western-type :iei in postmenopausal women is associated with high A, T, %FT. and low SHBG and this pattern was apparent in the BC patients.
Serum nod bile lipid levels in postmenopnusid woman after percntukeotu and oral nahral D’Amato G; C&ve!lini A: Me;>a C; Manyini V; Mkciagna G Deportment 7’ Obstetrrcs and Gynecologv, Istituto di Ricovero e Cura a Carattere Scientifico, 7GiJl3 Castellana. .Wy
Am. 1. Obstet. Gyneco!.: !KV? (6OO-&Il)/lrgL/ 17 betaBstradio1 was administered for 4 weeks percutaneously (5 me/day) and. after a 6--e& period to allow the drug to wash cut, orally (2 mg/day) to a postmenopausal woman in whom a Kerr tube had been paced because of an iarrogenic lesion of the cOlumon bile duct. After both methods of administration, there was an increase in the biliary cholesterol coaretrtration, but after oral dministration, bile flow also increased and cholesterol crystals appeared in the bile. The percutaneous metnui of -*r.idiol administrtion in postmcnqaus~l women seems to be less dangerous for the biliar) ‘-32.
Wormoaes rod breast cancer Wile AG; DiSaia PJ Divirion of SurgW sexology, University of Ctilifornig Irvine Cancer Center. Orange, CA MM; U.S.A. Am. J. Sure.; 157/4 (438--442)/1989/ Patients with successfully managed breast cancer have generaily ken denied subsequent exposure increased leveis of estrogen (endogenous or exogenous) based on the belief ihat exacerbation of
to
the
252 cancer would occur. The advent of oral contraceptives. the trend toward childbearing later in life, and the dpmonstration of the protectire va!ae of menopausal estrogen replacement therapy against osteoporosis and czrdiovascuiar disease requires that this issue be reexamined. New information bearing on this subject includes the recognition of estrogen receptors, the isolation of youth rather than pregnancy as the factor resulting in poor prognosis, epidemiologic studies showing no increased risk of breast cancer in women using oral contraceptives or taking hormonal replacement therapy, the benefi--d breast cancer, and the absence of an cial effect of pregnancy subsequent to successfuiiy man+.. adverse effect of oral con+Jaceptives upon estabiisbd breast camzer. !r. view of the lack of evidence relating estrogen to exacerbation of existing breast cancer, it may he in the best interest of our patients to liberalize our &t!itude to renewed hormonal exposure in patients with successfully n,anaged breast cancer.
Biophysicnl study of bone mineral in biopsies of ~steoporutic patknts
befote
and after long-term
treatment with fluoride
Baud CA; Very JM; Courvoisier B Institut de Morphologie, Centre Medical U+ersitaire, 1211 Geneve 4: Switzerland Bone; 916 (361-365)/1988/ Crystallographic characteristics of bone mineral were examined in a group of 60 Jsteoporotic patients before and after 3 to 6 years of fluoride therapy. The age of the mineral was evaluated by means of X-ray absorption, as degree of mineralization of bone tissue (MDBT). Crystallinity was evaluated by measuring both X-ray diffraction line broadening, beta (31.0) and beta (00.2). and the crystaliinity index (CI) by infrared spectrometry. The a arId c unit-cell parameters were determined by powder Xray diffraction. Bone fluoride contem was measured by specific electrode. Patients were divided in two groups according to MDBT before treatment: one group with MDBT values less thsn or equal tu mean value; another group with MDBT value. greater than mean value. in The first group, trabecuiar bone volume (TBV) did not change sigmficantiy during therapy. In the second group, an increase of TBV was observed. Osteoporoses can then be distinguished, on MDBT criterion, between osteoporosis with hypermaturated mineral an9 osteoporosis with hypomaturated mineral. The MDBT before treaunent permits one to predict the effect of fluoride therapy on TBV. In the two groups there was a significant increase in bone fluoride content between the onset and the end of treatment. Bone fluoride content increased linearly during therapy without any plateau effect. Crystallographic modifications iuduced by fluoride explain mechanical and chemical improvement of bone.
A model tor e~:!n~~i~?gthe poteotiat costs aod savfogs of osteopurosis
prevention
strategies
Ross PD, ‘Yasnich RD, Maciean CJ; Hagino P: Vogel JM Kuakini Gs:etipmxk Study, Kuakini Medical Center, Honolulu, HI; U.S.A. Bone; 916 (337-347)/1988/ A model was developed which estimates thL cost of osteoporosis ,isk evaluation and treatment, arid the resulting savings in terms of reduced fracture frequency, for the adult female population of the United States. In the absence of treatment, tk e model predicts 1.44 million fractures will occur annually from non-violent causes. Treatmerit of all women beginning at age 50 with an agent that slows hone 1~s by 50% would reduce the number of these fractures by 0.59 million. Selective treatment of the 47% of women at the greutcbt fracture -isk would reduce the number of fractures by 0.45 million. but would only cost 47010as much ah treating all women. Additional data are required before 6.emodel can be used to evaluate specific treatment regime;;. H~=.v;vcr, ‘t ++tars that selective treatment uf those at high& risk w&d yieid the gr:?cest benefit to cost ratio, if OII!~benefits related to reduced fracture frequency are considered.