Long-term clinical and manometric comparison between surgical and chemical sphincterotomy for treatment of chronic anal fissure

Comparison between surgical and chemical sphincterotomy for treatment of chronic anal fissure. 160 patients were equally randomly divided into 4 groups treated by: lateral internal sphincterotomy [Group], local Diltiazem ointment [Group[22]], local Glyceryl trinitrate ointment [Group[222]], or injection of Botulinum toxin into the internal anal sphincter [Group 2V]. Anal manometry was measured before and 3 months after treatment. Patients were followed up for 5 years. Mean time for complete pain relief was 5.68 +/- 7.77 days [Group I], 15.7 +/- 5.87 days [Group II], 15.6 +/- 5.90 days [Group III] and 2.67 +/- 3.60 days [Group IV]. Mean healing time was 4.48 +/- 1.20 weeks [Group I], 5.12 +/- 1.13 weeks [Group II], 5.00 +/- 1.12 weeks [Group III] and 5.06 +/- 1.31 weeks [Group IV]. Mean resting and squeeze anal pressures decreased significantly after sphincterotomy. Recurrence rate was 10% in Group I, 65% in Group II, 57.5% in Group III and 52.5% in Group IV. Lateral internal sphincterotomy is easy and satisfactory, with minimal complications and recurrence. Medical sphincterotomy is safe, and easy, with mild complications. Its effect is reversible. Relapse after it is common. It is worth trial before surgery or in patients that cannot or unwilling to undergo surgery

Assessment of stanniocalcin-1 mRNA as a molecular marker for micrometastases of breast cancer

Very few tumor molecular markers have been identified that are highly specific for breast cancer cells when applied to blood. Stanniocalcin [STC]-1 is a recently discovered human gene that has been implicated in cellular calcium homeostasis and is located on chromosome 8p in a region associated with amplification of breast cancer. We investigated STC-1 mRNA as a molecular marker for detecting occult breast cancer cells in blood. Using real time PCR detection assay to assess for STC-1 mRNA expression, we evaluated the blood of 25 breast cancer patients with different stages [I-IV] according to American Joint Committee on Cancer, 7 patients with benign breast lumps as fibroadenomas and fibrocystic swelling, and 8 healthy women as control subjects. In this study there was blood STC-1 gene expression of the malignant group; the mean value of the STC-1 positive blood specimen [copies number] was 8103.1+491.0, without blood expression in the other two groups. Also, the results of this work showed that, 19 [76%] patients of 25 patients of cancer breast had detectable STC-1 mRNA [copies] in their blood, without detectable expression in the other 6 [24%], p<0.001 with significant increase of STC-1 copy numbers with progression of AJCC stages, P<0.001. Finally in this study, the presence of STC-1 mRNA in the blood significantly correlated with primary tumor size [P<0.001], the involved lymph nodes characteristics [P<0.001], the presence of distant metastasis [P<0.001] and the overall AJCC stage [P<0.001]. STC-1 mRNA assay may be a useful and sensitive molecular marker for breast cancer cases with different stages without expression in the normal blood cells. Also, the presence of breast cancer associated STC-1 mRNA in the blood cells correlated significantly with the primary clinico-pathological determinants of disease outcome