Estrogen receptors in adult Egyptians with gynecomastia with or without schistosomiasis

Idiopathic gynecomastia occurs with persistence of low T/E1 and T/E2 ratios after puberty. Men with liver disease have gynecomastia, as a consequence of impaired hepatic steroid metabolism. In Egyptian patients with schistosomal hepatic fibrosis, gynecomastia is not an uncommon condition. To study the estrogen receptors in breast tissue in gynecomastia associated with schistosomal hepatic fibro sis compared to idiopathic gynecomastia. The study included 10 males with gynecomastia associated with schistosomal hepatic fibrosis [group A] and 8 patients with idiopathic gynecomastia free of liver disease. Mammary tissue, obtained via surgical excision was submitted to histopathological examination. The mean values of the plasma testosterone in the groups A and B, were 8 +/- 2.6 ng/ml and 5.7 +/- 2 ng/ml respectively. The difference was statistically insignificant [p = 0.058]. The mean values of serum estradiol were 45 +/- 24 pg/ml for group A and 24 +/- 9 pg/ml for group B. In group A there was characteristic lymphocytic and histocytic infiltration, with less fibrous reaction in the stromal tissue than it was in group B. ER status showed positivity in 67% of cases including 5/10 [50%] in group A and 7/8 [88%] in group B. It appeared in the form of reddish nuclear staining in 10 patients and cytoplasmic in two patients who were both in group B. The ER positivity was found to be significantly lower in patients of group A than it is in those of group B

Factors affecting the functional results after surgical repair of ectopic vestibular anus

It has reported that 1/5000 newborn will have an anorectal malformation. Some 65 to 80% of anorectal anomalies in girls are in the form of imperforate anus with vestibular fistula, a condition commonly known as [ectopic] or [vestibular] anus. are to study the important clinical and technical variables that influence the long-term results of surgical reconstruction for vestibular ectopic anus. This study included 25 females with vestibular ectopic anus. Perineal deformity was found in [20%]. It showed high incidence in relation to rerouting operation [38%], to post operative complications [25%] and to the non use of colostomy. Anal deformity was found in [20%]. It showed higher incidence in patients operated upon before 2years, in relation to re-routing operation, to post operative as well as the absence of colostomy. Anal stenosis showed the same relations but with higher incidence with cutback procedure and with the use of colostomy. Persistence of ano-vestibular communication [20%] and occurrence of anal incontinence [25%], showed higher incidence in relation to re-routing operation, and the occurrence of post operative complications and anal deformity. Anal manometry including RAP, SAP, VSI, and FACL, were performed for 22/25 patients. There was no statistical differences of all the manometric results in relation to various variables except with VSI that showed lower values with post-operative complications and with the non use of colostomy beforehand. The long-term results of treatment of vestibular ectopic anus, especially anal incontinence, deformity and stenosis as well as persistent fistulas are important parameters to be used for assessment of various surgical techniques. Manometric changes are not typically coinciding with the clinical and anatomical appearance. Delaying the surgery to old age did not give significant reduction in the success of surgery in such low anomalies