Begell House Inc.
Journal of Environmental Pathology, Toxicology and Oncology
JEP(T)
0731-8898
27
1
2008
Implementation of Revolutionary Legislation for Informed Consent for Dental Patients Receiving Amalgam Restorations
1-3
10.1615/JEnvironPatholToxicolOncol.v27.i1.10
Richard
Edlich
Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, USA
Catherine L.
Cross
Legacy Emanuel Hospital, Portland, OR, USA
Jill J.
Dahlstrom
Legacy Verified Level I Shock Trauma Center, Legacy Emanuel Hospital, Portland, OR, USA
William B.
Long III
Trauma Specialists LLP, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emmanuel Hospital, Portland, OR, USA
Anthony T.
Newkirk
Synergy Dental, Portland, OR, USA
Mercury is one of the most dangerous environmental toxins. Realizing the environmental dangers of mercury, the Norwegian Minister of the Environment and International Development, Erik Solheim, has therefore prohibited the use of mercury in products in Norway. This ban will include dental filling materials (amalgam) and measuring instruments, as well as other products. This ban is valid from January 1, 2008. Sweden announced a similar ban, and dentists in Denmark will no longer be able to use mercury in fillings after April 1, 2008. It is indeed unfortunate that the United States has not taken a leadership role in enacting Informed Consent Legislations for patients receiving dental amalgam restorations. Informed Consent Legislations have been enacted by Maine, California, Connecticut, and Vermont.
The Use of Photodynamic Therapy for Diseases of the Esophagus
5-21
10.1615/JEnvironPatholToxicolOncol.v27.i1.20
Seth A.
Gross
Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA
Herbert C.
Wolfsen
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
This is a review of the uses, history, and current status of photodynamic therapy for diseases of the esophagus, specifically Barrett's dysplasia and early esophageal carcinoma. This paper describes the clinical experience of photodynamic therapy and compares the use of various photosensitizer drugs. Finally, important biophotonics developments are discussed, including their anticipated impact for improved endoscopic detection of dysplasia and carcinoma. In addition, methods for real-time photodynamic therapy and light dosimetry are provided in order to optimize ablation treatment outcomes while minimizing the risk of complications.
Potentiation of the Photodynamic Action of Hypericin
23-33
10.1615/JEnvironPatholToxicolOncol.v27.i1.30
Constance Lay Lay
Saw
Department of Pharmacy, National University of Singapore, Singapore 117543
Paul Wan Sia
Heng
Department of Pharmacy, National University of Singapore, Singapore 117543
Malini
Olivo
Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, National Cancer Centre, 169610 Singapore
Hypericin (HY) is an interesting photosensitizer with dark activity and photodynamic therapy (PDT) effects via p53-independent pathway. In photodynamic diagnosis (PDD) of bladder cancer using HY, very high sensitivity and specificity were reported, in comparison with its counterpart, 5-aminolevulinic acid (5-ALA). HY was tested for the detection of human gastric cancer. It was also studied for treating some cancers and age-related macular degeneration and showed some promising findings. Several strategies to enhance the efficacy of HY-PDD and HY-PDT are reviewed. Using fractionated light dosing, fractionated drug dosing, hyperthermia, adjuvants such as oxygen carrier/antiangiogenesis, chemical modifications, and formulation approaches to enhance the PDT effects of HY are topics of this review. Despite cutting-edge technology approach such as preparing transferring-mediated targeting HY liposomes and nanoparticles of HY, such preparations did not always offer the desired enhanced treatment effects. It turns out that simple solutions of HY, especially those prepared without using plasma protein, were more successful in enhancing the delivery of HY for in vitro and in vivo systems. Thus, the HY-PDT with these formulations performed better. It is anticipated that HY-PDD and HY-PDT can be enhanced and optimized with the right combination of light dosimetry and drug dose in an effective formulation containing a suitable adjuvant. Hyperoxygenation and hyperthermia can also be used to further enhance the efficacy of HY-PDT.
Immune Response Against Angiosarcoma Following Lower Fluence Rate Clinical Photodynamic Therapy
35-42
10.1615/JEnvironPatholToxicolOncol.v27.i1.40
Patricia S.P.
Thong
Division of Medical Sciences, National Cancer Centre, Singapore
Malini
Olivo
Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, National Cancer Centre, 169610 Singapore
Kiang-Wei
Kho
Division of Medical Sciences, National Cancer Centre, Singapore
Ramaswamy
Bhuvaneswari
Division of Medical Sciences, National Cancer Centre, Singapore
William W. L.
Chin
Division of Medical Sciences, National Cancer Centre; and Department of Urology, Singapore General Hospital, Outram Road, 169608 Singapore
Kong-Wee
Ong
Division of Medical Sciences, National Cancer Centre, Singapore
Khee-Chee
Soo
Division of Medical Sciences, National Cancer Centre; and Department of Surgery, Singapore General Hospital, Singapore
Tumor response to photodynamic therapy (PDT) is dependent on treatment parameters used. In particular, the light fluence rate may be an important determinant of the treatment outcome. In this clinical case report, we describe the response of angiosarcoma to PDT carried out using different fluence rates and drug and light doses. A patient with recurrent multifocal angiosarcoma of the head and neck was recruited for PDT. A new generation chlorin-based photosensitizer, Fotolon, was administered at a dose of 2.0 to 5.7 mg/kg. The lesions were irradiated with 665 nm laser light for a light dose of 65 to 200 J/cm2 delivered at a fluence rate of 80 or 150 mW/cm2. High dose PDT carried out at a high fluence rate resulted in local control of the disease for up to a year; however, the disease recurred and PDT had to be repeated. PDT of new lesions carried out at a lower fluence rate resulted in tumor eradication. More significantly, it also resulted in spontaneous remission of neighboring and distant untreated lesions. Repeat PDT carried out on a recurrent lesion at a lower fluence rate resulted in eradication of both treated and untreated lesions despite the lower total light dose delivered. Immunohistochemical examination of biopsy samples implies that PDT could have activated a cell-mediated immune response against untreated lesions. Subsequent histopatho-logical examination of the lesion sites showed negative for disease. Our clinical observations show that lower fluence rate PDT results in better outcome and also indicate that the fluence rate, rather than the total light dose, is a more crucial determinant of the treatment outcome. Specifically, lower fluence rate PDT appears to activate the body's immune response against untreated lesions.
Tissue Levels of Arsenicals and Skin Tumor Response Following Administration of Monomethylarsonous Acid and Arsenite to K6/ODC Mice
43-52
10.1615/JEnvironPatholToxicolOncol.v27.i1.50
Yan
Chen
ODC Mouse Group Inc., 1209 Childs Ave, Drexel Hill, PA 19026, USA
Tom
O'Brien
ODC Mouse Group Inc., 1209 Childs Ave, Drexel Hill, PA 19026, USA
Luz Maria
Del Razo
Toxicology Department, CINVESTAV-IPN, Mexico City, Mexico
David J.
Thomas
Environmental Toxicology Division, National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC 27711
Kirk T.
Kitchin
Environmental Carcinogenesis Division, National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC 27711
The effects of monomethylarsonous acid (MMA[III]) and arsenite, administered in drinking water on tissue levels of arsenicals, cytogenetics, and mouse skin tumorigenicity were determined. A low-methionine diet modified the pattern of arsenical tissue concentrations and decreased the tissue arsenical concentrations, particularly in kidney and urinary bladder, less so in liver, and had little effect in the lungs. In mice given 75 ppm arsenite and a low-methionine diet, the urinary bladder tissue levels were only 29%, 26%, and 38% of the inorganic arsenic (iAs), MMA, and dimethylarsinic acid (DMA) concentrations found in mice eating the control diet. In K6/ODC transgenic mice that consumed a normal diet (Purina 5002), a 26-week drinking water exposure to 10 ppm arsenite resulted in 5% of the treated animals having squamous skin tumors. Exposure to 10, 50, 75, or 150 ppm MMA(III) caused 5%, 6.7%, 5%, or 0% tumor-bearing animals. A low-methionine diet did not markedly change the incidence of skin tumors—10 ppm arsenite led to 10% tumors. With a low-methionine diet, 10 and 50 ppm, MMA(III) caused 5% and 6.7% tumor-bearing animals. In comparing the frequency of tumors in the concurrent control groups (1/70, 1.4%) with the frequency of tumors in the pooled arsenical-treated responsive groups (8/122, 6.6%), there is an excess of 6 mouse skin tumors observed in the pooled arsenical-responsive treatment groups compared to the expected number of tumors based on frequency of tumors observed in concurrent control mice. In summary, studies with MMA(III) and arsenite-treated K6/ODC transgenic mice showed (1) a low-methionine diet substantially altered mouse tissue arsenical levels and (2) numerically elevated incidence of mouse skin tumors following arsenical exposures.
Increased Frequency of Chromosomal Aberrations in Industrial Painters Exposed to Lead-Based Paints
53-59
10.1615/JEnvironPatholToxicolOncol.v27.i1.60
Dokku
Madhavi
Department of Zoology, Osmania University, Hyderabad — 500 007, Andhra Pradesh, India
Kanapuram Rudrama
Devi
Department of Zoology, Osmania University, Hyderabad — 500 007, Andhra Pradesh, India
Bammidi Lakshmi
Sowjanya
Department of Zoology, Osmania University, Hyderabad — 500 007, Andhra Pradesh, India
The investigation was carried out in the peripheral lymphocytes of industrial painters who were exposed to dust and fumes of lead-based paints. Samples of peripheral blood were collected from 102 workers out of which 40 were smokers and 62 were nonsmokers. The painters in both the categories were divided in to 3 groups based on duration of exposure. Control data of 30 nonsmokers and 20 smokers belonging to the same socioeconomic group but not exposed to either radiation or toxic chemicals were studied. There was a significant increase in the frequency of chromosomal aberrations in the workers when compared to the controls. Further, smoking had an added effect on the frequency of aberrant metaphases.
The First Pilot Study on Characteristics and Practice Patterns of Kuwaiti Breast Cancer Patients
61-75
10.1615/JEnvironPatholToxicolOncol.v27.i1.70
Farid
Saleh
Kuwait University
Waleed
Reno
Department of Anatomy, Faculty of Medicine, Health Science Centre, Kuwait University, P.O. Box 24923 Safat 13110, Kuwait
Ghada
Ibrahim
Department of Surgery at Mubarak Al-Kabeer Hospital, Ministry of Health, P.O. Box 24923 Safat 13110, Kuwait
Abdullah
Behbehani
Department of Surgery, Faculty of Medicine, Health Science Centre, Kuwait University, P.O. Box 24923 Safat 13110, Kuwait
Hussein
Dashti
Department of Anatomy, and Department of Surgery, Faculty of Medicine, Health Science Centre, Kuwait University, P.O. Box 24923 Safat 13110, Kuwait
Sami
Asfar
Department of Surgery, Faculty of Medicine, Health Science Centre, Kuwait University, P.O. Box 24923 Safat 13110, Kuwait
Nongenetic breast cancer risk factors have never been evaluated in Kuwait. Accordingly, we aimed at examining these factors as well as the immune profile of the patients. Fifty stage I breast cancer patients and 50 age group-matched normal controls were assessed for the level of their peripheral blood lymphocyte subsets and for risk factors associated with their demographic and reproductive characteristics and with diet. The percentages of CD4+ T lymphocytes, CD4+:CD8+ ratio, and CD19+ B lymphocytes were significantly higher in the patients as compared to controls, while the percentages of CD8+ T lymphocytes and natural killer (CD56+) cells were significantly reduced. Risk factors associated with the disease included higher BMI, lack of regular exercise and physical activity in the past 5 years, early age at menarche, late age at first pregnancy, lack of previous information about breast cancer, hormonal therapy, and presence in Kuwait during the invasion/liberation. Other parameters included significantly more frequent consumption of carbohydrate, sweets, animal fat, and vegetable oil (margarine) and less frequent consumption of fresh vegetables and olive oil. This is the first study to highlight the environmental risk factors associated with breast cancer among the Kuwaiti women. We recommend introducing a nationwide campaign to further investigate these factors and to address them accordingly.