prognostic significance of Her2-Neu over expression in gastric carcinomas

Her2/neu is one of the epidermal growth factor receptors families and seems to have prognostic significance of some solid tumors. The objective of this study is to evaluate the possibility of Her2 expression in gastric cancers and the possible relationship of Her2 with tumor's clinicopathologic parameters and also its prognostic role. This study was performed on 100 cases of gastric carcinoma with stage I b to III [according to TNM staging]. Survival, recurrence date of patients, grade and lymph nodes involvement were assessed. Her2/neu expression was determined by immunohistochemical method on received sample blocks. Survival of patients with or without Her2-neu expression were evaluated by Kaplan-Meier method and compared with the log-rank test followed by multivariate analysis using Cox regression. Seven cases were 3+ membranous Her2 reactivity, 5 cases were 2+ and 13 cases were 1+; also 75% of cases demonstrated no reactivity. Regarding relationship between tumor grade and membranous Her2, all patients with poorly differentiated tumors were Her2 negative but patients with moderate and well differentiated tumor had 18.1% and 19.6% Her2 reactivity respectively; there were no significant difference between groups statistically [P>0.05]. Median overall survival was 27.25 and 46 months in Her2 negative and her2 positive cases respectively; there were no significant difference between groups statistically as well [P>0.05]. Her2 reactivity has not relationship with tumor grade and lymph node involvement as well as tumor stage. From the other point of view no significant correlation is found between Her2 expression and disease free survival or overall survival of gastric cancer patients

Comparison of histopathologic findings of non-tumoral gastric mucus of patients with gastric cancer and patients with chronic gastritis

Gastric cancer is the second cause of cancer death throughout the world. Identification of precancerous lesions is important for designing preventive measures. Therefore, the aim of this study was to evaluate the correlation between lesions and the cancer. Histological findings of 55 patients with gastric cancer including atrophy, intestinal metaplasia, dysplasia, gastric grade, lymphoid follicles, infiltration of eosinophil and presence of H. pylori were compared with those of the patients with chronic gastritis without any tumor or ulcer. The data was analyzed using Chi-square, Mann-Whitney and Odds ratio tests. There was no statistically significant difference between the two groups with respect to atrophy, infiltration of eosinophil and lymphoid follicle. The frequency of intestinal metaplasia [OR: 19/89], dysplasia [OR: 76/22] and lymphoid follicule [OR: 22/46] in the case and control groups was 47.3% and 10.9% [p<0.001], 14.5% and 1.8% [p<0.01], 81.8% and 32.7% [p<0.001], respectively. The frequency of severe and moderate chronic gastritis in control group was more than that in the case group [p<0.05, OR: 0.93]. There was strong correlation between gastric cancer and dysplasia, intestinal metaplasia and lymphoid follicles. Therefore, the presence of such lesions in the gastric biopsy is alerting and these patients should be checked up regularly

Comparison of radiotherapy side effects on lung volumes and peripheral oxygen saturation in two methods of radiotherapy: two tangential and single anterior supraclavicular field with two tangential and two anterior and posterior opposed supraclavicular fields

Radiotherapy after breast cancer surgery will increase local control of the disease and also increase overall survival. Radiation have some side effects on lung function. In different radiotherapy techniques, these side effects are different. Pulmonary function tests and oxygen saturation are methods for evaluation of these complications. In this study we decide to campare pulmonary complications in two radiotherapy methods. In this clinical trial study fifty one patients with breast cancer hi stage II and III according to TNM staging system, which were under modified radical mastectomy in Imam Hosein hospital and refered for adjuvant radiotherapy, randomly divided in two groups. In one group patients were treated with three field technique and in others with four field technique. All patients received total dose of 48-50 Gy. For patients, pulmonary function test and pulse oxymetery were done once before initiation of radiotherapy and then one and three months after radiotherapy. Measurement of FEV[1], FVC and FEV, FVC show that no significant statistical difference was present between the two groups one month and three months after radiotherapy, also in each of the two groups the amount of FEV[1], FVC and FEV, FVC one month after radiotherapy had no significant statistical difference in comparison to baseline tests but FEVI and FVC after three months was decreased and had significant statistical difference respectively [p<0.001, p<0.006]. SO[2] had no significant defference between the two groups and also hi each group after one and three month of radiotherapy. Locoregional radiotherapy of breast and lymph nodes areas causes a decrease in some parameter of pulmonary function tests but no difference was present between three field and four field techniques

[ comparsion of nortriptiline and vit B12 effects on diabetic neuropathy]

Diabetes is one of the most prevalent disease in the world.Today there are 100 milion diabetics around the world and in Iran it is about 1.5 milion. The prevalence of symptomatic neuropathy is 15% but with NCV it will increase to 50%. Regarding the suffer produced by neuropathy and that there is no effective treatment for that, this is necessary to investigate new treatment options. This is a clinical trial study, done during a 3 months period in vali-e-asr hospital in year 2004. 100 diabetic patients were selected randomly and divided into two equal groups. A complete sensorimotor assessment was performed and a questionnaire consisting history and clinical symptoms including limb pain, murmur and paresthesia and examinations such as pin prink test, position and vibration assessment, was completed. NCV was also done and blood sugar and HbAlc was measured. In case group 2000 micrograms vit B12 was prescribed twice weekly and in control group 10mg nortiptiline every night was prescribed. After 3 months patients were assessed again. Data was analysed using mean and standard deviation and Chi square, K-S, Leven, T and Mann Whitney tests. Based on visual analage scale the difference between pain number before and after treatment was decreased 3.66 [3.66-4.25] in case and 0.48 [0.54-1.13] in control group [P< 0.0001]. Also the difference between paresthesia number before and after treatment was decreased 2.98 [2.51-3.44] in case and 1.06 [064-1.47] in control group [P< 0.001]. The differene between murmur number before and after treatment was decreased 3.48 [2.93-4.02] in case and 3.48 [2.93-4.02] in control group [P< 0.001]. There was no significant difference between NCV, vibration, position and pin prink test results. Changes in clinical symptoms in case group in comparison to those in control group was significant, but change in physical assessment findings [pin prink, Position, vibration and NCV] was not significant

[ case report of D-penicillamine induced focal segmental glomerulonephritis in a patient scleroderma]

Therapeutic use of D-penicillamine is associated with several side effects. Proteinuria is the most common side effect of it, often due to membranous glomerulopathy. In this article we have reported a case of D-penicillamine induced focal segmental glomerulonephritis with systemic sclerosis. In this article, we have presented a patient who had been under treatment with D-penicillamine and complicated by nephrotic range proteinuria resulting from focal segmental glomerulonephritis. Proteinuria was resolved one months after discontinuation of D-penicillamine without any additional treatment. She had no finding in favour of renal crisis of scleroderma. Such this pathologic form of renal involvement [FSGN] resulting from D-penicillamine has not been reported in the literature yet

[ effect of clinical research center, on clinical researches of Arak University of medical science]

Performing correct research in different aspects of community as well as medical sciences can be a way to resolve many problems. In order to create a systematic knowledge of research method in academic members of Arak University of medical science and enabling them in providing proposals and performing researches, a clinical research center was developed. This study is done to investigate the effect of this center on improving clinical researches in the University. This is a HSR, before and after, interventional study in which, clinical academic members of Arak University of medical science were evaluated. First the information of the pre intervention period was gathered [jan2002-jan2004]. Then the intervention was done in the form of development a research center in Vali-Asr hospital, performing serial research workshops, research conferences, research consultations and planning data bases during a 2 years period. Again data was gathered and then compared to those of pre intervention period. The comparison of pre and post intervention periods showed that in pre intervention period from 38 proposals 30 and in post intervention period from 89 proposals 76 were approved by research committee of the University. In the two pre and post intervention periods 14 [46.6%] and 50 [65.8%] of accepted proposals were clinical respectively. Also from the view point of quality, 11 and 15 proposals were HSR, 2 and 22 clinical trials and 8 and 8 descriptive, respectively. The number of published articles in first period was 45 and in second 84. Presented articles in internal and external congresses were 33 and 59 in the two periods overally, which 25 and 51 articles were presented in the country and 8 and 8 in abroad congresses, respectively. Regarding the results it seems developing research center in this University and other similar Universities can have a significant effect on the process of clinical researches

[ long term effects of occupational electromagnetic fields exposure on peripheral blood indexes in workers of aluminum processing factory of Arak]

The effect of electromagnetic fields on human health and especially the risk of carcinogenesis have been comprehensively studied. However, the vast majority of findings of these studies were controversial. Therefore, the aim of this study was to determine the effects of electromagnetic fields on the hematological determinants in individuals who exposed to these fields during long-term period. This was a prospective study carried out in an aluminum processing factory in Arak, Iran. First, the magnetic strength of the field was measured about 25-32 mTesla. Subsequently, 200 workers from the exposed group [case] and 200 workers from non-exposed group [control] were chosen from the same factory with age and sex match. Both groups were examined and followed up using physical exam, data gathering sheet and CBC during two consecutive years. Using SPSS, the data were analyzed and P values less than 0.05 were considered statistically significant. There was no difference between mean age or sex of the two groups studied. Means of hematological determinants in the exposed group were more than those of the non-exposed group in the cases of neutrophiles, red blood cells [RBC], haemoglobine and hematocrite during two consecutive years. Also, the means of monocytes, RBC, Hb and HCT were statistically different between the two groups during this period [p<0.05]. However, no case of malignancy, anemia, polycytemia or coagulopathy was detected in the two groups. Although there was statistically significant difference between the two groups, all the blood indices were in the normal range in both groups and no pathological abnormality was detected in their hemalopoietic system. Conclusively, to determine the hematological disorders in exposed workers, more comprehensive studies during long-term period may be required

Disseminated nocardiosis in an immunocompromised child with unknown cause

Disseminated nocardiosis [DN], is an infrequent and severe infection due to Nocardia species and defined as infection in two or more discontinuous organs. Most infections occur in the immunocompromised host or in persons with underlying disease. DN occurs rarely in children. In this report, we describe an 11-year-old immunecompromised child with nocardiosis involving the lung, skin, brain and bone. No predisposing factor nor any underlying disease was found to explain his immune deficiency. Diagnosis of nocardial infection is often cumbersome, resulting at times in wrong initial clinical diagnosis such as cancer and other bacterial infections [e.g. tuberculosis]. Therefore, it is important to consider nocardial infection in the differential diagnosis of children with combined brain and lung lesions