Correlation between serum osteoprotegerin and atherosclerotic vascular disorders in rheumatoid arthritis patients

The aim of the present study was to investigate the association of serum osteoprotegerin [OPG] level with the presence of angiographically documented asymptomatic coronary artery disease [CAD] in patients with rheumatoid arthritis [RA] and to evaluate its relationship with plasma thrombomodulin [TM], as a marker of endothelial dysfunction and with carotid artery intima media thickness [IMT], as a marker of atherosclerosis. The study included 20 rheumatoid patients without CAD [negative results on exercise ECG stress test] and other 20 rheumatoid patients with CAD [positive results on exercise ECG stress test and confirmed by coronary angiography]. In addition, 20 age and sex matched normal control subjects were studied. Serum OPG and plasma TM levels were measured and carotid artery IMT was determined. The study revealed that serum OPG levels were significantly higher in rheumatoid patients with and without CAD than in controls [P < 0.001,P < 0.01; respectively] and were positively correlated with age, duration of disease, Disease active score 28[DAS28], Erythrocyte sedimentation rate [ESR], C-reactive protein [CRP] and carotid IMT in rheumatoid patients with and without CAD. Serum OPG level was correlated significantly with plasma TM only in rheumatoid patients with CAD [P < 0.001]. Osteoprotegerin is a clinically important molecule independently associated with the presence of coronary artery disease and may be a good indicator of atherosclerotic vascular damage and macroangiopathy in asymptomatic rheumatoid patients. Hence, measurement of serum OPG merits further investigation as a simple test for improving early diagnosis of asymptomatic CAD in rheumatoid patients

Surgical, radiological and histopathological studies of cases of superficial glioma in children

The clinical, Radiological findings and the Surgical results of 20 patients with superficial glioma in children who were operated in the period from March 2004 to September 2006, 12 boys and 8 girls aged from 8 months to sixteen years old [mean age 12 years]. The patients were presented to neurosurgery, neurology, and pediatric outpatients clinics at Al-Azhar University Hospitals and Al-Sahel teaching Hospital, with repeated attacks of partial complex seizures of different time of onset and progressive course as increase of frequency and prolonged duration of fits. The disease duration expressed between seven months and two years since time of onset. The most common presentation was epileptic fits in all cases, and focal manifestations and increased intracranial pressure were 16 cases. Papilledema was found in the 8 cases, hemiparesis and hemianesthesia of the contra lateral side of the tumor in 11 cases. The most common site of the tumors were temporal lobe 14 cases. Complete tumor removal was accomplished in 18 cases. The most common radiological and histopathological diagnosis among these group of patients of this study were Gangliogliomas 6 cases, and Gangliocytoma 5 cases. Comparative radiological studies between CT [Computerized tomography], MRI [Magnetic resonance imaging] and histopathology were evaluated. Sensitivity, Specificity and accuracy were 83%, 87% and 89% in CT and for MRI were 87.8%, 91.5%, 93.3% respectively. Transcortical approach were done in most cases, post operative radiation therapy was used in one patient. The choice of the radiological modalities, surgical approach, and result will be discussed