prognostic significance of Her2-Neu over expression in gastric carcinomas

Her2/neu is one of the epidermal growth factor receptors families and seems to have prognostic significance of some solid tumors. The objective of this study is to evaluate the possibility of Her2 expression in gastric cancers and the possible relationship of Her2 with tumor's clinicopathologic parameters and also its prognostic role. This study was performed on 100 cases of gastric carcinoma with stage I b to III [according to TNM staging]. Survival, recurrence date of patients, grade and lymph nodes involvement were assessed. Her2/neu expression was determined by immunohistochemical method on received sample blocks. Survival of patients with or without Her2-neu expression were evaluated by Kaplan-Meier method and compared with the log-rank test followed by multivariate analysis using Cox regression. Seven cases were 3+ membranous Her2 reactivity, 5 cases were 2+ and 13 cases were 1+; also 75% of cases demonstrated no reactivity. Regarding relationship between tumor grade and membranous Her2, all patients with poorly differentiated tumors were Her2 negative but patients with moderate and well differentiated tumor had 18.1% and 19.6% Her2 reactivity respectively; there were no significant difference between groups statistically [P>0.05]. Median overall survival was 27.25 and 46 months in Her2 negative and her2 positive cases respectively; there were no significant difference between groups statistically as well [P>0.05]. Her2 reactivity has not relationship with tumor grade and lymph node involvement as well as tumor stage. From the other point of view no significant correlation is found between Her2 expression and disease free survival or overall survival of gastric cancer patients

[ effect of trinitroglycerine injection on angiographic complications]

Currently the ischemic heart disease [IHD] is common worldwide. Coronary angiography is gold standard for detecting coronary artery disease. Death, myocardial infarction, nausea, coronary vessels spasm, chest pain, bradyarrhythmia, hypotension, and hypertension are among the common complications occurring following angiography. The aim of this study was to investigate the effect of simultaneous administration of trinitroglycerine [TNG] and the contrast agent on early complications of angiography. This was a clinical trial carried out in Isfahan Shahid Chamran Hospital in 2005. Patients were randomly allocated to two intervention [n=111] and placebo [n=112] groups. Nausea, coronary vessels spasm, chest pain, bradyarhythmia, and systolic and diastolic blood pressure in both intervention [TNG plus contrast agent] and placebo [distilled water plus contrast agent] groups were investigated during and after angiography. The mean age in intervention and placebo groups were 59.93 +/- 9.14 and 59.37 +/- 10.12 years, respectively. Also, sex distribution showed no significant difference. Between TNG group and placebo group we had considering the nausea [4.5% vs 6.2%], coronary vessels spasm [0.9% vs 5.4%], chest pain [1.8% vs 6.3%], and bradyarrythmia [7.1% vs 7.1%] respectively, that had not any significant lower in TNG group compared to placebo group [p=0.001]. Based on data obtained in the present study, except for blood pressure no benefit in simultaneous administration of TNG and the contrast agent on early complication of angiography was demonstrated. Further investigations using different dose, time tables and also selection of high risk patients are recommended. Furthermore, the late complications and mortality as well as the cost-effectiveness are the subjects deserving more attention

[ evaluation of tubule formation in breast cancer using fraction of fileds showing tubular differentiation [FTD] method and compare it with conventional methods]

Histological grading is one of the most important prognostic factors in breast cancer. So far, there has not been any available method for quantitative estimation of tubular differentiation. Therefore, this study was aimed to evaluate the experimental and conventional method and compare the reproducibility of it with the other quantitative and semi-quantitative methods using 200 morphometric microscopic magnifications. In this descriptive-analytical study which, conducted in 2006, a total of 38 histological samples of breast invasive ductal carcinoma were selected of 38 histological samples of breast invasive ductal carcinoma were selected and tubular differentiation was assessed by two pathologists using three methods. The first method [conventional], the rate of tubular differentiation [a portion of tumor with malignant tubules] to the total sample calculated and shown in percentage. The second one, was the fraction of fields showing tubular differentiation [FTD], and the third one was the subjective evaluation of each field and then considering the mean of all fields. Using Friedman test, the difference between the 3 methods was compared and Kappa test was used to compare the reproducibility of each method between the two observers. The results showed that using the second method, the scoring of the samples by the two observers was almost the same. It means that Kappa indices in the first, second, and third method was 0.4, 0.832, and 0.558, respectively [p<0.001]. Also, Friedman test showed that there was statistically significant difference between the findings of each of the observers in any of the 3 methods used [p<0.001]. Base on the results, FTD has higher reproducibility than that of other two methods. Thus, it can be used as a simple method in assessment of tubular differentiation

[ correlation between MDM[2] protein and histologic grading of cerebral astrocytomas]

MDM[2] is a protein factor that plays an improtant role in inhibition of P[53] and P[73] related apoptosis. The aim of this study was to investigate the correlation between MDM[2] expression and histologic grading of cerebral astrocytomas in order to reduce misdiagnosis of this tumor in controversial cases. In this study, 104 cases of astrocytic tumors including 4 different grades were selected randomly. We prepared 4 micro m sections of paraffin blocks of tumors. Then the slides were stained by anti MDM[2] antibody. The intensity of nuclear staining for MDM[2] marker had a statistically significant correlation with histologic grading. There was no significant correlation between percentage of nuclear staining for MDM[2] and histologic grading. The positivity of MDM[2] marker, as well as the multiplication of intensity and percentage of nuclear staining in S.Score had a significant correlation with histologic grading. The S.Score correlation with grading of astrocytic tumors was analysed by ROC Cure analysis method and showed that at the cut off point of 6, this score can be indicative for differentiation of Glioblastom multiform from other grades with specificity of 95.3%. Our results confirm the role of the MDM[2] protein as a oncogenic factor in progression of astrocytic tumors. Evaluation the MDM[2] experession in astrocytic cerebral tumors can be specifically indicative for distinction of glioblastom multiform from other grades of astrocytic tumors

Which major atherosclerosis' risk factors represents the extent of coronary artery disease?

Although cardiovascular diseases get top position in burden of disease list, the role of risk factors in extent and severity of atherosclerosis in coronary artery disease [CAD] remain controversial. To study the determinants of severity and extent of coronary artery disease in consecutive patients with major risk factors of CAD undergoing clinically indicated coronary angiography. In this cross sectional study, coronary angiograms of 325 men and 235 women patients were analyzed quantitatively. Then systolic and diastolic blood pressure, body weight, height, fasting blood sugar, serum lipids and smoking habit were collected in a questionnaire. Relationship of angiographic scores, reflecting severity and extent of CAD were comparing with potential risk factors using logistic and multiple linear regression analysis. We found significant differences between age and fasting blood glucose in patients with positive coronary angiogram versus patients with negative coronary angiogram [P<0.05]. Diabetic patients have higher score compare to non diabetics in both sexes and same difference were found in obese men. Fasting Blood Sugar in both sexes [males 0.017, females 0.016], diastolic blood pressure [0.044] in males and body mass index [BMI] [0.005] and HDL cholesterol [- 0.081] in females were significantly predictive factors for severity and extent of CAD [regression coefficient]. This findings show that in patients with positive coronary angiogram, fasting blood sugar in both sexes, high diastolic blood pressure in males and HDL-C and BMI in females may be stronger predictors of extent of CAD. Prevention of these risk factors may be effective in controlling the progress of CAD

Comparison of histopathologic findings of non-tumoral gastric mucus of patients with gastric cancer and patients with chronic gastritis

Gastric cancer is the second cause of cancer death throughout the world. Identification of precancerous lesions is important for designing preventive measures. Therefore, the aim of this study was to evaluate the correlation between lesions and the cancer. Histological findings of 55 patients with gastric cancer including atrophy, intestinal metaplasia, dysplasia, gastric grade, lymphoid follicles, infiltration of eosinophil and presence of H. pylori were compared with those of the patients with chronic gastritis without any tumor or ulcer. The data was analyzed using Chi-square, Mann-Whitney and Odds ratio tests. There was no statistically significant difference between the two groups with respect to atrophy, infiltration of eosinophil and lymphoid follicle. The frequency of intestinal metaplasia [OR: 19/89], dysplasia [OR: 76/22] and lymphoid follicule [OR: 22/46] in the case and control groups was 47.3% and 10.9% [p<0.001], 14.5% and 1.8% [p<0.01], 81.8% and 32.7% [p<0.001], respectively. The frequency of severe and moderate chronic gastritis in control group was more than that in the case group [p<0.05, OR: 0.93]. There was strong correlation between gastric cancer and dysplasia, intestinal metaplasia and lymphoid follicles. Therefore, the presence of such lesions in the gastric biopsy is alerting and these patients should be checked up regularly

role of Helicobacter pylori infection in gastric carcinoma

Several studies have been performed about the association between Helicobacter pylori and gastric carcinoma some of which have confirmed while others have excluded this link. The aim of this study was to evaluate a possible connection of gastric carcinoma with Helicobacter pylori infection. We evaluated 70 gastric carcinoma and 70 age and sex matched control subjects [without any mass or ulcer] for H. pylori infection by Giemsa staining of the samples obtained from the subjects. The prevalence of H. pylori infection was 37.14% in control subjects, 44.44% in intestinal type and 40% in diffuse type of gastric carcinoma. Statistical analysis did not reveal any meaningful difference between the prevalence of H. pylori in case and control group in this study. Therefore, the relationship between H. pylori and gastric carcinoma was excluded in our study. Atrophy and metaplasia of intestine which result in reduction of colonization of bacteria and also bias in sampling might account for the findings of the present study

prevalence of migraine headaches in patients with myocardial infarction

There are several reports suggesting a relation between migraine headaches and heart diseases. However, there is not enough persuading evidence implying that migraine headache is a potential risk factor for cardiovascular diseases. This study was conducted to determine the prevalence of migraine headaches in patients with myocardial infarction, concerning the common vascular etiology of both conditions. This is a hospital-based case-control study carried out in the summer and fall of 2001, at Nour, Alzahra, and Chamran hospitals, Isfahan, Iran. The case group consisted of 78 patients with acute MI, and a control group with equal numbers of patients without acute MI who were hospitalized at non-cardiac units, such as orthopedics, infectious diseases and general surgery wards. All patients were evaluated for migraine headaches. The data were analyzed by Chi Square and the multiple logistic regression tests using SPSS software package. 37% of patients were women, and 63% were men. The mean age of patients was 57.6 +/- 12 years, ranging from 37 to 90 years. 36% of patients with migraine headache were men, and 64% were women. The prevalence of migraine headaches was 16.5% and 5% in the case and control groups, respectively. Mean age of patients was 57.7 +/- 10.4 years in the case group, and 57.5 +/- 13.4 years in the control group. The onset age of migraine headaches was 25.4 +/- 11.4 years in the case group, and 24.9 +/- 8.6 years in the control group. Analysis of results demonstrated a meaningful difference between the case and control groups, as regards the relative prevalence of migraine headaches [P<0.05]. Multiple logistic regression analysis yielded an odds ratio [OR] of about 3.7. Given the high prevalence of migraine headaches in patients with acute myocardial infarction in the present study, and conformity of our results with those of previous studies, the strict control of other risk factors for coronary artery atherosclerosis is recommended