[Evaluation of bcl-2 and Bax in Invasive-DuctaI breast carcinoma and its correlation with steroidal receptors and cellular proliferative markers using Immunohistochernistry]

Background: breast carcinoma has been regarded as the most common malignant tumors and the leading cause of death due to cancer in women. Apoptosis plays a central role in both normal cell cycle and tumor biology; it is controlled by family of related proteins including Bax and bcl-2. This study was designed to evaluate the expression of Bax and bcl-2 proteins in 46 cases of Invasive-Ductal carcinoma of breast and their correlation to the expression of ki-67, estrogen and progesterone receptors immunohistochemically

Materials and methods: formalin fixed paraffin embedded-tissue from 46 cases of invasive ductal carcinoma of breast were analyzed by immunohistochimistry [IHC] method. We performed a statistical analysis to investigate the relationship between clinicopathological parameters and Bax, bcl-2, KI-67, ER. PR expressions

Results: forty-six cases of invasive ductal carcinoma of breast with mean age 45 were studied. According to Bloom-Richardson score system of 46 cases. 8.7% were grade 1 1.80% were grade 2 and 11% were grade 3. Eighty-seven percent of cases had 4 or more lymph node metastasis. According to IHC results, 43% were bcl 2 positive, 28% were ER positive, 39% were PR positive , and 95% were Bax positive ,mean KI-67 index was 40% . There was significant correlation between bcl-2 expression and ER, PR and size of tumor. There wasn't any correlation between Bax and PR and ER status .there was statistically correlation between KI-67 index and ER and PR status, grade and metastasis to lymph nodes .There was statically correlation between ER and PR status and size of tumor, grade and metastasis to lymph nodes

Conclusion: Bcl-2, as an anti-apoptotic factor, plays an important role in biology of breast cancer. It may be a mediator in the action of ER and PR or it may have independent role. KI-67 as a proliferative maker. doesn't have any correlation with apoptotic factors, but have prognostic valve through its relation to ER, PR. grade and LN status. Because of high rate of Bax positively, we guess IHC isn't a good way for evaluation of Bax and it is better to use molecular methods

Accuracy of pipelle endometrial sampler in evaluation of endometrium

The purpose of this study was to compare the use of pipelle endometrial sampling device based on the quality of material obtained and diagnostic accuracy with conventional dilation and curettage [Dand C] or hysterectomy specimens. This cross sectional study was done on 50 patients who referred to gynecology ward of Imam Reza hospital with abnormal uterine bleeding [AUB] or infertility for endometrial dating. Thirty-eight patients underwent two endometrial samplings [pipelle and conventional D and C] on the same occasion while 12 cases underwent hysterectomy. The procedure of sampling by pipelle was done by one person and the specimens were submitted to a pathologist. The adequacy of the specimen and histoiogical diagnosis were compared. Pipelle obtained adequate sample in 47 of 50 cases [94%]. The histoiogical diagnosis was the same in 85% of cases [40 out of 47]. The sensitivity for endometrial dating and endometrial polyp was 100% and 40%, respectively. Among 7 cases of inconsistent diagnosis, there was one missed malignancy [squamous cell carcinoma of cervix with extension to isthmus and lower segment]. In this case the histoiogical diagnosis of pipelle was inactive endometrium surrounded by pieces of clot. Pipelle endometrial sampling is an easy method for diagnosis of endometrial pathology. Its diagnostic accuracy for endometrial dating is very high, but in management of AUB, replacing conventional D and C with pipelle should be done with caution and preferably completed by other diagnostic techniques

[ effect of loose tightening of drains on the infection rate]

Background: Infection has always been one of the major complications of surgical procedures and drains have been used to reduce the rate of post operative infections in spite of the fact that their efficacy is under question. In this study, we tried to investigate the role of a loose tightened drain to reduce the infection rate in comparison with an ordinary used drain and no use of drain

Materials and methods: In this experimental study, the role of loose tightening of drain on infection was investigated trough usage of blood agar plates, prospectively. Firstly, blood agar plates were prepared according to strict methods to guaranty sterility. Then, the plates were randomized into three groups in operating room and the drains were inserted into the plates while another surgical operation was being performed in the same place. The plates then were incubated for 3-5 days and the subsequent results were gathered and being analyzed using SPSS-10

Results: Among total of 585 cases being investigated, 4 positive cultures were -out of 197-in tightened drain group and 4 positive ones-out of 194-cases in ordinary placed drain group, while 10 positive ones in no-drain group were found. There was no significant difference between both two control groups [P=0.102]. Also, no significant difference was found between drain groups and no-drain group [P=O.122]. Among cases tested after 72 hour incubation, the rate of infection was zero but this ratio was 2 out of 88, and 4 out of 88 in ordinary drain group and in tightened drain group respectively. There were no significant differences among groups of 72 hour incubation. Among cases incubated for 5 days, in tightened drain group [109 cases] no growth was found and in ordinary drain group [106 cases] 2 positive cultures were reported, while no growth was found in no-drain group. There was significant difference among all 3 groups [P=0.001], while no significant difference was found among ordinary drain group and tightened drain group [P=0.242]

Conclusions: According to increased rate of infection in no-drain group incubated for 5 days, the role of incubation time in occurrence of clony growth is clearly proven. It also seems that statistically significant reduction in the growth of microorganisms in the groups with drain recommends the usage of drains in the surgical sites that hematoma formation is probable. According to researchers' idea, the reduction in the rate of infection to zero in tightened drains incubated for 5 days although not significant, it can state the role of tightening of drains in decreasing the rate of infection