Non small cell lung cancer molecular biomarkers in blood

Several studies have reported significant correlations between individual telomerase activity and apoptosis in malignant tumours including lung cancer. Such studies were carried out on tissue biopsies from the malignant tissue. The aim of the present study was to determine molecular biological parameters that can he used for early biological predisposition for lung cancer. Telomerase activity and Bcl-2 anti-apoptotic protein in circulating lymphocytes, plasma nitric oxide. epidermal growth factor and epidermal growth 'actor receptor were measured in the blood of 25 non small cell lung cancer [NSCLC] patients amid in 20 normal age and socio-economic matching controls, Results revealed significant increase in telomerase activity [53 +/- 8.2 vs. 19.5 +/- 4.8. p<0.0001] between cancer patients and normal controls, significant lower levels of Bcl-2 [7 2 +/- 1,5 vs. 10.4 +/- 1.4 micro g/ml, t 7.3. p<0.0000001] among cancer patients compared to normal controls, However, there were significantly higher levels of epidermal growth factors [6.2 +/- 2 05 vs 0.2 +/- 0.01 pg/ml], epidermal growth factor receptor EGFR [134 +/- 4.7 vs. 102 +/- 2.2 fmol/ml] and plasma nitrate/nitrite [18.8 +/- 4.7 vs. 12.5 +/- 5 micro g/ml. 1=-5.25. p<0.0001] in lung cancer patients compared to controls. This study reveals that Bcl-2 levels in circulating peripheral blood are weak biomarkers for lung cancer, while increase in plasma telomerase activity, NO and EGF levels can he used as reliable biomarkers for cancer prognosis

effect of intrauterine levonorgestrel on blood glucose, serum lipid profiles and sex Hormones binding globulin

Metabolic changes with hormonal contraception had been known several decades ago. The concentration of sex hormone binding globulin [SHBG] has been shown to decrease during the use of levonorgestrel [LNG] containing contraception. This decrease has been thought to be due to the andro genie action of LNG. Also, serum lipidse are known to be affected by hormonal treatment. To examine whether SHBG, blood sugar and serum lipids are affected by LNG intrauterine medicated device [LNG-IUS]. Forty women were divided into two groups. A copper releasing intrauterine device [IUD] was used in the control group [n = 20] and LNG-IUS in the study group [n = 20]. Fasting blood sugar [FBS], SHBG and serum lipids levels at base line and after 6 months use of contraception were measured. SHBG concentration decreased slightly with LNG-IUS. There was no change in the blood glucose level. Also, there were slight decrease in serum total cholesterol [TC], triglycerides [TG], low-density lipoprotein [LDL-C] and high-density lipoprotein [HDL-C] but LDL-C/HDL-C Ratio slightly increased. The data in this study showed that alterations in the levels of SHBG, FBS, TC, TG, HDL-C, LDL-C and LDL-C/HDL-C ratio are minimal 6 month after insertion of LNG-IUS

Prediction of preterm labor; a prospective study of the role of cervico-vaginal fibronectin and transvaginal sonography and their possible impact on the results of cervical cerclage

To determine the value of cervico-vaginal fetal fibronectin detection and transvaginal sonographic measurement of endocervical canal length as predictors of preterm labor in asymptomatic patients. Also, to evaluate the results of cervical cerclage in a group of patients with short cervix with and without positive fibronectin results in the cervicovaginal fluid. Longitudinal prospective study in which samples from cervico-vaginal secretions for fetal fibronectin were obtained biweekly from 24 to 34 weeks gestation. The length of endocervical canal was measured by an endo-vaginal sonography at 24 weeks. McDoneld cervical cerclage was done for some cases with short cervix. The study included 3 groups of patients; a group with high risk for preterm labor, another group with low risk and the third group included patients who undenvent cervical cerclage. Thirty four patients delivered before 37 weeks out of 273 patients [12.5%], 21 patients were positive for fibronectin in cervico-vaginal fluid and 23 patients had cervical shortening. The sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] were in the low risk group 40%, 87%, 22.2%, 44% respectively and in the high risk group 70.8%, 86.3%, 48.5%, 94.2% respectively. The positive predictive value of 2 positive fibronectin samples was 89.5% while PPV of any one positive sample was 11.8%. Most positive predictive tests were between 24-28 weeks [71.4%]. Trans-vaginal sonography of endocervical canal length with the chosen cut-off limit as a predictive test for preterm labor achieved sensitivity, specificity, PPV and NPV of 60%, 96.3%, 60% and 96.3% respectively in the low risk group and 70.8%, 90.1%, 56.7% and 94.4% in the high risk group. Examination at 24 weeks, detected 65.2% of the cases predicted by ultrasound. Eighteen patients underwent cervical cerclage, delivered prematurely. Fibronectin was positive in 4 cases that delivered prematurely and in 6 patients who delivered at term and the comparison was not significant. The incidence of preterm labor in cases that had cervical cerclage was 38.9% while in 14 cases with short cervix that had not cervical cerclage was 57.5%. Fibronectin is a predictor of preterm labor. As a negative test, it is reliable and the reliability as a positive test increases if two positive samples are obtained. The most important period for screening is between 24 and 28 weeks biweekly. Endocervical canal measurement by ultrasound is also, a predictor of preterm labor as good as fibronectin even more effective in low risk population or primigravidae. Positive fibronectin results had no impact on the outcome of cervical cerclage. Cervical cerclage decrease incidence of preterm delivery in cases with short cervix but not to a significant degree

comparative study of step-down dose, low-dose step-up and sequential step-up and step down regimens of human menopausal gonadotrophin for patients with polycystic ovary syndrome

To compare the efficacy and safety of the step-down dose, low-dose step up and sequential step-up and step-down regimens of human menopausal gonadotrophins [hMG] for women with poly cystic ovary syndrome [PCOS]. A prospective randomized study involved 68 stimulation cycles in 61 patients with PCOS divided as 24 cycles with step-down dose regimen, 25 cycles with low-dose step-up regimen and 19 cycles with sequential step-up and step-down protocol. The step-down regimen consisted of 225 IU/day of the hMG for the first 2 days, followed by 150 IU/day until the follicular diameter reached 9 mm after which the dose was decreased to 75 IU/day for the next 7 days. The low-dose step-up protocol consisted of 75 IU/dayof hMG for the first 7 days and if the follicular diameter did not increase to 9 mm. The dose was increased by 37.5 IU every 7 days. The sequential regimen was the same as the step up protocol but when follicular diameter reached 14 mm the daily dose was halved. Main outcome measures included the number of growing follicles and serum hormone levels. The number of intermediate sized follicles was significantly lower in the sequential regimen group and the low dose step up protocol compared with step-down dose regimen. Also, the maximum diameter of the ovaries was smaller in the same two groups. The luteal phase progesterone was significantly lower in the low dose step-up protocol and the sequential regimen. A pregnancy rate per cycle of 20%-21% was achieved in the 3 groups. The sequential step-up and step down regimen of hMG and low-dose step-up regimen may be the safest to avoid ovarian hyper stimulation syndrome and to ensure more rate of monofollicidar growth. However, they may be associated with higher risk of miscarriage

Study of pancreatic functions and ultrasonography in insulin-dependent diabetes mellitus

Thirty insulin-dependent diabetic patients and 20 normal control subjects of the same age and sex group were investigated to study some pancreatic functions and to assess the ultrasonographic picture of the pancreas and surrounding blood vessels .Statistical analysis of the results revealed that: Serum amylase, lipase and insulin values were significantly reduced, while, on the other hand, serum glucagon value was significantly elevated. Pancreatic sonography revealed an increase of its echogenicity, most probably due to fibrosis, with a significant reduction of its size that was positively correlated with insulin value but not with glucagon or enzyme values. There was a significant increase in portal vein diameter that showed positive correlation with blood sugar level indicating susceptibility of insulin-dependent diabetic patients to portal hypertension