[Evaluation of effective clinicopathologic factors on patients outcome with well differentiated thyroid carcinoma]

Thyroid cancer is the most common cancer of endocrine system. Clinical, pathological and therapeutic factors affected patients' outcome with differentiated thyroid carcinoma. To evaluation the effective clinicopathologic factors on patients outcome with well differentiated thyroid carcinoma. In this retrospective analytic-descriptive study. Patients' files with thyroid carcinoma who referred to radiology and oncology ward in Omid and Ghaem hospital of Mashhad were assessed from 1996-2006. Cases with pathologic report of papillary and follicular carcinoma were considered and a specific questionnaire include age, sex, accepted time, pathologic subtype, tumor size and metastases, adjuvant treatment, last follow time, recurrence time, patient condition in the end refer and death time was recorded. The patients' mean age was 50.14 and median age was 52 years. 66 patients [85.7%] had papillary and 11 cases [14.3%] had follicular carcinoma. End condition in 43 cases [55.8%] was good and in 34 cases [44.2%] was bad. Mean survival time was 44.1 and median survival time was 36 months. There was a meaningful correlation between T stage with end condition [P=0.037] but there was no meaningful correlation between N stage with end condition [P=0.665]. Metastases in the first reference time had a clear correlation with patients' outcome. 41 patients [59.4%] from 69 cases with MO disease had a good end condition, against only one patient [16.7%] from 6 cases with Ml had a good outcome [P<0.001]. Also there was a meaningful correlation between patients' outcome and clinical stage [P=0.075]. None of the adjuvant treatment included iodine therapy [P=0.36], hormone therapy [P=0.378], chemotherapy and radiotherapy affected patients outcome. According to this study, factors with influence on patient's outcome with differentiated thyroid carcinoma were tumor stage, metastases in the first reference and clinical tumor stage. Lymph node involvement and adjuvant treatment had no effect on patients' prognosis

[Evaluation of bone marrow involvement in surgically resected patients with esophageal cancer]

Bone marrow samples obtained during rib resections in esophageal cancer patients evaluated by immunohistochemical and quantitative polymerase chain reaction techniques revealed disseminated tumor cells in up to 90% samples, but the clinical relevance of these findings is unclear. Evaluation of bone marrow involvement in these patients and its correlation with clinicopathological finding of tumor. 43 patients with esophageal cancer who referred to Omid and Ghaem hospitals from April 2008-2009 were selected to transthorasic surgery[without neoadjuvant treatment].Bone marrow samples from rib were evaluated by Hematoxylin-Eosin staining for tumoral involvement and cytokeratin immunohistochemistry to determine micrometastatic cells. The results were compared with primary tumor histopathologial characteristics; T stage, N stage, tumoral length and personal characteristics; age and sex. Patients mean age was 60.9 [51-70 years], the ratio of male to female was 2.9. 38 cases [88.4%] had squamous cell carcinoma and 5 [11.6%] adenocarsinoma. In 9 cases [20.9%] Hematoxylin-Eosin staining and 13 cases [30.2%] immunohistochemistry results were positive. There was no correlation between pathologic type and T stage with Hematoxylin-Eosin and cytokeratin results. [p=0.277, p=0.153] and [p=0.221, p=0.097]. There was a significant relation between bone marrow dissemination and mediastinal involvement and tumoral grade [p=0.008, p=0.001] and [p=0.002, p=0.001]. According to our study, there is a correlation between grade and N stage and bone marrow involvement in esophageal cancer patients and there is no statistically correlation with other clinicopathologial characteristic there is a low bone marrow involvement in our region patients, overally

Evaluation of prognostic factors in patients with Netastatic Breast Cancer

Metastatic breast cancer has remained as an incurable disease. The main objectives of treatments include alleviating of symptoms, delaying disease progression and increasing survival without any adverse effect on the quality of life. The main purpose of this study was to investigate the effects of some clinocopathological factors on the survival of patients with metastatic breast carcinoma in our institute. In this retrospective cohort study, we reviewed the files of patients who were metastatic at presentation or became metastatic during follow-up and were referred to oncology department of Omid Hospital affiliated to Mashhad University of Medical Sciences from 1997 to 2007. The information regarding clinicopathological characteristics were recorded. The first line chemotherapy regimen was as follows: 79 CAF [cyclophosphamide, doxurobicine, 5FU], 25 CMF [cyclophosphamide, methotrexate, 5FU] and 11 Taxene based; AT [doxorubicin, paclitaxol] or TAC [taxene, doxurobicine, cyclophosphamide]. 115 patients with a median age of 45 [range, 25-78] were investigated. The median follow-up time for all patients from diagnosis was 21 months [range, 5-74 months] and from metastatic manifestation was 12 months [5-36 months]. The sites of recurrence or metastasis were as follows: 18 [15.7%] local recurrence, 23[20%] bone and 74 [64.3%] visceral metastases. The median and 2- year overall survival for all patients with metastatic disease were 15 months and 44.6% +/- 6% respectively. Patients with bone metastasis had a significantly better overall survival compared to those with visceral metastasis. [74.2% vs.36.1%, P = 0.04] Among those patients who were non-metastatic at the time of referral, the time left to metastasis had a significant effect on the overall survival from metastasis manifestation. In comparison with premenopausal patients, the overall survival was relatively better in postmenopausal cases. [59.4% vs. 38.5%, P = 0.1]. In our study, disease free survival [DFS] was the most important factor for overall survival in patients with metastatic breast cancer. The patients with longer DFS [> 18month] had better overall survival. Overall the patients with bone metastasis had better survival than visceral metastasis

[ comparison between prednisolon and acyclovir regimen with prednisolone alone in treatment of Bell's palsy]

Introduction: the most common disease of the facial nerve is Bell's palsy. The recent finding of viral genome surrounding the seventh nerve suggests that antiviral agents may be useful in the management of Bell's palsy. The use of Acyclovir and Corticosteroid in combination was under study for treatment of this disease

Objective: the present study aim was to compare Prednisolon and Acyclovir regimen with Prednisolone alone in treatment of Bell's palsy

Materials and Methods: our study was double blind, and for comparison outcomes between two groups, we used the t-test, Fisher's exact test and Chi2 analysis. We compared the final outcome of 65 patients with Bell's palsy, in Rasht, treated with either acyclovir-prednisolone [33 patient] or prednisolone alone [32 patients]. For patients receiving Acyclovir, the dosage was 2000mg [400 mg 5 times daily] for five days. The dosage of Prednisolone in both groups of patients was 60 mg daily for the first week and then tapered. The time of complete improvement in all patients was recorded

Results: final Complete improvement did not differ between two groups, but in Acyclovir- Prednisolone group, improvement was earlier [mean duration of improvement in Acyclovir- Prednisolone group was 23.7 9.8 days but in Prednisolone group was 36.9 day's, P=0.0001]

Conclusion: we conclude that adding Acyclovir to Corticosteroids can reduce the time of improvement but does not alter final recovery