Levels of 5-hydroxyindoleacetic acid, Gamma-aminobutyric acid and Nitric oxide metabolites in cerebrospinal fluid of Egyptian women suffering of Fibromyalgia

Fibromyalgia [FM] is a complex chronic disorder predominately affects women. The lack of objective analytical image for diagnosis and prognosis of FM attract many investigators to evaluate the neuroendocrine changes in body fluids that may be related to the pathophysiology of FM. To compare the levels of 5-hydroxyindoleacetic acid [5-HIAA, serotonin metabolite], gamma-aminobutyric acid [GABA] and nitric oxide [NO] metabolites in cerebrospinal fluid [CSF] of normoglycemic women suffering of FM with those of control group. In addition, levels of insulin, insulin like growth factor-1 [IGF-1], cortisol, 5-hydroxytryptamine [5-HT, serotonin], GABA, and NO metabolites were determined in serum of FM patients compared to control group. Moreover, the correlations between all the studied parameters were performed. The present study showed altered serum levels of insulin and cortisol in normoglycemic women suffering of FM [n=15] compared to those of control group [n=15]. However, the data did not find significant differences between serum levels of IGF-1 in women suffering of FM and those in healthy women. Cortisol levels in FM sera were inversely correlated with the number of tender points [r=-0.76, p<0.001]. Also, negative correlation was observed between serum IGF-1 levels and age of FM patients [r=-0.63, p< 0.05]. Low levels of serum 5-HT and CSF 5-HIAA were also noticed among women suffering of FM. A decrement of both serum and CSF levels of GABA in those patients compared to controls was detected. Furthermore, there was a positive correlation between serum GABA levels and serum cortisol levels [r=0.61, p< 0.05], and between CSF GABA and 5-HT [r=0.56, p< 0.05]. However, CSF GABA levels were negatively correlated with age of women suffering of FM. These findings may clarify the significant role of GABA in the pathogenesis of FM. A higher serum and CSF levels of NO metabolites were detected in FM patients than in control group. In addition, serum levels of NO metabolites were correlated with those levels in CSF [r=0.63, p< 0.05]. The involvement of NO in pain process was revealed by a strong correlation between serum and CSF levels of NO metabolites with the number of tender points [r=0.91, p< 0.001; r=0.73, p< 0.01 respectively]. Also, by a negative correlation between serum levels of NO metabolites and serum cortisol levels [r=0.70, p< 0.01] in FM patients. The changes in the levels of studied hormones and neurotransmitters in women suffering of FM support the hypothesis of neuroendocrine involvement in FM pathogenesis. The current study suggested that GABA and NO may play a role in modulating FM. Alterations of their levels in serum and CSF of women suffering of FM and their correlations with age, number of tender points and/ or cortisol may confirm this suggestion. Accordingly, this investigation recommended the examination of GABAergic agents, NO synthase [NOS] inhibitors, or antioxidants for therapy of various symptoms in women suffering of FM. Furthermore, our study may find utility of these neurotransmitters as possible markers of FM, but this study warrant more investigations to confirm these findings

Electrovapourization of the prostate: Five years follow-up

This study was carried out to determine the long-term outcome of electrovaporization. Fifty patients with symptomatic benign prostatic hyperplasia were evaluated by international prostate symptoms score [IPSS], quality of life score [QLS], physical examination, urinalysis, total prostate specific antigen [PSA], uroflowmetry, measurement of postvoid residual urine [PVRU] and transrectal ultrasonography [TRUS]. All patients underwent electrovaporization of the prostate and follow up for five years. No serious complications were discovered during or after the procedure. All efficacy parameters were significantly improved. IPSS dropped from 26.2 to 6.3 at 6- and 60-month visits. The mean Qmax increased from 7.8 ml/s to 18.9 ml/s and 19 ml/s at 6- and 60-month follow up. The study concluded that electrovaporization of the prostate is a safe, effective and durable treatment modality of BPH

Concordance of relapse and stage progression with angiogenesis, P53, PCNA and DNA ploidy in low-grade superficial transitional cell carcinoma of urinary bladder: a clinicopathological study

The present study was undertaken to evaluate some molecular pathologic parameters as prognostic factors in low-grade superficial urinary bladder carcinoma. Twenty cases of low-grade [G1/G2] and superficial [T1] transitional cell carcinoma were included in this study with a follow up period of 30 months. A recurrence was noticed in 14 cases, while 6 cases showed no recurrences. Among the recurrent tumors, six patients developed subsequent muscle invasion and subjected to radical cystectomy. A total of 71 paraffin blocks were available for the study from the initial as well as the recurrences. They were submitted to microvessel count, using factor VIII related antigen, p53 expression, PCNA immunoreactivity and DNA ploidy, using CAS 200-image cytometer

Neodymium: yag laser coagulation of the prostate in surgical risk patients

Transurethral Neodymium:YAG laser coagulation of the prostate gland was used to treat benign prostatic hyperplasia in 36 surgical risk patients, who had either significant lower urinary tract symptoms or urinary retention. The mean International Prostate Symptom Score [IPSS] decreased from 26.8 to 9.6, then increased to 14.2. The mean maximum flow rate [Qmax] increased from 8.3 to 15.1 ml/s and then decreased to 10.6 ml/s. The average residual urine volume [PVR] decreased from 139.3 to 65 ml, then increased to 87.5 ml at 12th and 60th months, respectively. Catheters were removed after seven days. Seven out of the 36 patients required re-catheterization within the first visit. Repeated interference was needed in 12 of the 36 patients. From the results obtained it was concluded that, aggressive Nd:YAG laser prostatectomy is safe and effective for high surgical risk patients with obstructive prostates and produces good results that are sustained for up to two years. On the contrary, the durability of this procedure is significantly decreased after three years with high incidence of re-treatment rate