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Background: Stroke is the second most common cause of mortality worldwide and a major contributor to morbidity and chronic adult disability. To study the prognostic significance of serum cortisol and serum albumin in patients of ischemic stroke was the objective.Methods: This hospital based observational cohort prospective study was undertaken in the Department of Medicine in collaboration with the Departments of Radio diagnosis and Pathology, Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh from January 2017 to November 2018. By convenience method for sampling, 102 patients who were admitted with the diagnosis of acute ischemic stroke to IPD of JNMCH, Aligarh, on clinical as well as radiological grounds were taken into study.Results: Mean cortisol was 450.84±190.35 nmol/L. The (mean±SD) of serum cortisol was 258.10±77.91 ng/ml in patients with good outcome and 585.77±113.34ng/ml in patients with poor outcome. (p<0.05, r= 0.812). Mean serum albumin was 2.83±0.76 gm/dl. The (mean±SD) of serum albumin was 3.47±0.64mg/dl in patients with good outcome and it was comparatively lower in patients with poor outcome (2.38±0.45mg/dl). (p <0.01, r=-0.659).Conclusions: Serum albumin, serum cortisol are prognostic indicators of functional outcome at 3 months in patients of ischemic stroke.
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Introduction: Sepsis is today’s overwhelming and lifethreatning response to infection and recent studies reveal thatserum cholesterol may be a useful prognostic marker of sepsis.Aim: To study the serum cholesterol levels in the patients ofsepsis and its prognostic significance.Material and methods: This was an Prospective Observationalstudy done at CSS Hospital, SVSU Subharti Medical CollegeMeerut U.P. 100 Patients qualifying by fulfilling all inclusionand exclusion criteria and were enlisted in the study afterinformed consent. Serum cholesterol levels were done on theday of presentation and the 3rd day.Result: In the instant study, out of 100 subjects, 48 showedthe rise in the cholesterol with sepsis where as in 52 subjectsshowed decline of cholesterol level. During the study, 52subjects survived whereas 43 subjects expired during thecourse of treatment, 5 subjects left the study group.Conclusion: Monitoring the total cholesterol level can beused as prognostic tool in ICU patients. The level of totalcholesterol at the time of presentation and then the trendwhich is followed by the total cholesterol (increasing trendin total cholesterol level indicates better prognosis of diseaseoutcome and vice versa), is a better marker for prognosis ofthe patient with septicemia in ICU patients
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OBJECTIVE@#To explore the role of DNMT3B in regulating the proliferation and invasion of hepatocellular carcinoma (HCC) cells.@*METHODS@#We collected the tumor tissues and adjacent tissues from a total of 175 patients with HCC diagnosed in the Second Affiliated Hospital of Chongqing Medical University between May, 2008 and May, 2013 to prepare the tissue microarrays. The association of the expression of DNMT3B with the prognosis and the tumor-free survival and tumor-specific survival rates of the patients was analyzed. Univariate and multivariate Cox regression analyses were used to analyze the effect of DNMT3B expression on the prognosis of HCC. We used RNA interference technique to knock down the expression of DNMT3B in Huh-7 hepatoma cells and observed the changes in cell proliferation using CCK-8 assay and EDU staining and in cell migration and invasion ability using Transwell assay.@*RESULTS@#The positive rates of DNMT3B was significantly higher in HCC tissues than in paired adjacent tissues (67.4% 41.1%, =0.015). A high DNMT3B expression in HCC was significantly associated with the tumor size (=0.001), vascular invasion (=0.004), and intrahepatic metastasis (=0.018). The patients with high DNMT3B expressions had significantly lower tumor-free and tumor-specific survival rates than those with low DNMT3B expressions ( < 0.005). In Huh-7 cells, silencing DNMT3B significantly inhibited the cell proliferation and inhibited cell migration and invasion. Western blotting showed that silencing DNMT3B obviously increased LATS1 expression, decreased the expression of YAP1, and activated Hippo signaling pathway. Methylation-specific PCR showed that the methylation level of LATS1 was decreased in the cells with DNMT3B silencing.@*CONCLUSIONS@#The expression level of DNMT3B is significantly higher HCC tissues than in the adjacent tissues, and the high expression of DNMT3B is closely related to the low survival rate of the patients. Silencing DNMT3B inhibits the proliferation, migration and invasion of HCC cells. DNMT3B promotes the progression of HCC primarily by enhancing the expression of YAP1 through methylation of LATS1 and inhibition of its expression, which inhibits the anti-cancer effect of Hippo signaling pathway.
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Humans , Carcinoma, Hepatocellular , Cell Line, Tumor , Cell Proliferation , Liver Neoplasms , Protein Serine-Threonine Kinases , Signal TransductionABSTRACT
Patient-prosthesis mismatch (PPM) is a controversial issue in current clinical practice. PPM has been reported to have a negative impact on patients' prognosis after aortic valve replacement in several studies, showing increased all-cause and cardiac mortality. Moreover, a close relationship has recently been described between PPM and structural valve deterioration in biological prostheses. In patients at risk for PPM, several issues should be considered, and in the current era of cardiac surgery, preoperative planning should consider the different types of valves available and the various surgical techniques that can be used to prevent PPM. The present paper analyses the state of the art of the PPM issue.
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Humans , Aortic Valve , Mortality , Prognosis , Prostheses and Implants , Thoracic SurgeryABSTRACT
Abstract: We present the case of a 2-year-old male patient with a facial tumor partially treated with chemotherapy before his admission to our institution. The tumor involved from the frontal region to the maxillary floor, the orbit, and the maxillary and sphenoid sinuses. The histopathological diagnosis revealed a stage IV alveolar rhabdomyosarcoma with infiltration to bone marrow and cerebrospinal fluid. He was managed with four cycles of adriamycin, actinomycin, cyclophosphamide and vincristine; cisplatin and irinotecan were added to the last cycle. The tumor had a 50% size reduction, but the patient died after a neutropenia and fever episode. The aggressive behavior of alveolar rhabdomyosarcoma has been associated with the expression of oncogenic fusion proteins resulting from chromosomal translocations, particularly t(2;13) (q35;q14) PAX3/FOXO1, and t(1;13) (p36;q14) PAX7/FOXO1 which were present in this patient.
Resumen: Se presenta el caso de un niño de dos años de edad con un tumor facial tratado parcialmente con quimioterapia anterior a su admisión en este hospital. El tumor abarcaba desde la región frontal hasta el piso maxilar, la órbita y los senos esfenoidales y maxilares. El diagnóstico histopatológico reveló un rabdomiosarcoma alveolar estadio IV con infiltración a la médula ósea y fluido cerebroespinal. El paciente fue tratado con cuatro ciclos de adriamicina, actinomicina, ciclofosfamida y vincristina; al último ciclo se añadieron cisplatino e irinotecan. El tumor se redujo en 50% de su tamaño, pero el paciente murió tras un episodio febril y neutropénico. La agresividad del rabdomiosarcoma alveolar se ha asociado con la expresión de proteínas oncogénicas de fusión provenientes de translocaciones cromosomales, particularmente t(2;13) (q35;q14) PAX3/FOXO1 y t(1;13) (p36;q14) PAX7/FOXO1, presentes en este paciente.
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Aim This study aimed to observe the role of the p53 gene in ovarian carcinogenesis, and identify the prognostic significance of the expression of the p53 protein expression in ovarian cancer. Methods Fourty one ovarian cancer patients were examined in this study by analyzing the mutations of p53 gene from their blood samples, and by analyzing the p53 protein expression from ovarian cancer tissues. Results Mutational analysis in “hot spot” exons (exons 5-9) and in “non hot spot exon” (exon 11) was performed by PCR-sequencing methods and p53 expression analysis was performed by immunohistochemistry method. Mutations of p53 were found in all samples, and the mutations were mostly found in “hot spot” exons, though few mutations were also found in “non hot spot” exon. The expression levels of p53 protein were found higher in advanced stages of ovarian cancer. Six month to two year post surgery follow-up of patients showed that high expression of p53 protein was in line with high mortality rate. Conclusion This study showed that the p53 gene could be used as a prognostic indicator of ovarian cancer.
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Ovarian Neoplasms , Genes, p53 , MutationABSTRACT
BACKGROUND: Despite progress in surgical techniques and adjuvant treatments, the prognosis for advanced gastric cancer has not improved. Knowledge of the kinds of tumor markers that might indicate the postoperative prognosis for gastric cancer is important in detecting microscopic residual cancers but still needs to be developed. METHODS: The serum levels of carcinoembryonic antigen (sCEA) and carbohydrate antigen 19-9 (sCA19-9), as well as the CEA, the CA19-9, and the tissue-type plasminogen activator levels in peritoneal washings (pCEA, pCA19-9, pTPA) were measured in 57 patients with gastric cancer who had undergone laparotomies from Oct. 1996 to Mar. 1997. The relationships between the positivity of tumor markers and several clinicopathological factors were evaluated by using a univariate analysis. Also, the significance of tumor markers in predicting the survival and the recurrence of disease was analyzed. RESULTS: The positivity of pCEA and pCA19-9 increased according to the stage (p<0.01) and the presence of serosal invasion (P<0.01). When pCEA or pCA19-9 is positive, the rate of curative surgery in those patients was lower than it was in the patients with negative tumor markers (p<0.01 and p<0.05, respectively). The positivities of pCEA, sCA19-9, pCA19-9 were higher in recurring cases than in nonrecurring cases after curative surgery (p<0.01, p<0.01, and p<0.05, respectively). The positivities of the tumor markers pCEA and pCA19-9 in the 4 cases with peritoneal seeding at the laparotomy were significantly different from those in the 53 cases with no peritoneal seeding (p<0.01) and (p<0.01), respectively pCEA. The risk of peritoneal recurrence after curative surgery was higher in pCEA positive cases than in negative cases (p=0.016) and in serosal positive and pCEA positive cases than in the other cases (p=0.016). CONCLUSION: pCEA and pCA19-9 are useful prognostic factors and an adjuvant treatment to prevent peritoneal recurrence should be considered, especially, in patients presenting positive pCEA with positive serosal invasion.
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Humans , Biomarkers, Tumor , Carcinoembryonic Antigen , Laparotomy , Neoplasm, Residual , Prognosis , Recurrence , Stomach Neoplasms , Tissue Plasminogen ActivatorABSTRACT
PURPOSE: We evaluated the prognostic significance of p53 and proliferating cell nuclear antigen(PCNA) in stage III gastric carcinoma to determine the correlation between the p53 and PCNA expression and various clinicopathological parameters. MATERIALS AND METHODS: The expression of p53 and PCNA were studied immunohistochemically in 64 cases of stage III gastric carcinomas with paraffin-embedded tissue specimens which were obtained surgically at the department of surgery, Presbyterian Medical Center from 1991 to 1992. Both expression were compared with known factors of prognosis. Survival rate and other clinicopathological parameters were analysed. RESULTS: Expression rates of p53 and high PCNA group were 40.6% and 26.6%, respectively. There was no significant correlation between the p53 and PCNA expression and various clinicopathological variables such as age, sex, stage, histology, tumor depth, number of metastatic node, tumor size, site and method of operation. To analyse survival, we evaluated overall survival according to the extent of p53 and PCNA expression. No significant correlations between the p53 and PCNA expression and overall survival were found. CONCLUSION: These results suggest that the p53 and PCNA expression seems to be hard to use as a prognostic indicator in stage III gastric carcinoma.
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Prognosis , Proliferating Cell Nuclear Antigen , Protestantism , Survival RateABSTRACT
The purpose of this study is to evaluate the prognostic significance of argyrophilic nucleoalr organizer regions (AgNORs) and proliferating cell nuclear antigen (PCNA) by using DMBA hamster buccal pouch carcinogenesis which provides a good experimental model in reproducing steps from precancerous lesions to invasive squamous cell carcinomas. The buccal pouches of 50 Syrian hamsters were applied with 0.5% DMBA in mineral oil three times a week to reproduce various lesions from precancerous ones such as hyperkeratosis or epithelial dysplasia to invasive squamous cell carcinomas. Their sections were stained with H & E, and silver colloid, and processed immunohistochemically by being applied with monoclonal antibody to PCNA. The histopathologic examainations were done and the counts of AgNORs were evaluated. The PCNA labelling indices on each lesions were evaluated. The correlation between histopathological grades and counts of AgNORs or PCNA labelling indices were evaluated. The number of AgNORs was 2.22+/-0.22 in control group, 3.46+/-0.72 in carcinoma in situ (CIS), 3.78+/-0.63 in squamous cell carcinoma (SCC), respectively. AgNORs significantly increased in severe epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The PCNA Labeling Index (LI) was 39.47+/-6.68% in control group, 79.61+/-4.14% in CIS, and 85.43+/-6.25% in SCC, respectively. PCNA LI also significantly increased in epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The number of AgNORs, AgNOR area, and PCNA LI slightly increased in the advancing front than in the center of SCC, but, it was not statistically significant. It appeared that there were a good correlation between the number of AgNORs and PCNA LI (Pierson correlation coefficient : 0.649, P<0.001). These results suggested that the number of AgNORs and the PCNA LI could be useful markers for evaluating the risk of malignant transformation and prognosis of SCC. It was thought that the clinical usefulness of these markers should be verified by using human tissue specimens.
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Animals , Cricetinae , Humans , 9,10-Dimethyl-1,2-benzanthracene , Carcinogenesis , Carcinoma in Situ , Carcinoma, Squamous Cell , Colloids , Mesocricetus , Mineral Oil , Models, Theoretical , Prognosis , Proliferating Cell Nuclear Antigen , SilverABSTRACT
BACKGROUND: Inferior myocardial infarctions account for 40-50% of all acute myocardial infarctions and are generally viewed as having a more favorable prognosis than anterior wall infarctions. However, nearly 50% of patients suffering inferior infarction will have complications such as heart block, concomitant precordial ST-segment depression and right ventricular infarction or distinguishing features associated with an increased mortality that will substantially alter an otherwise favorable prognosis. METHODS: Clinical characteristics, electrocardiograms, and angiographic findings of coronary artery were viewed in 47 patients with inferior myocardial infarction. Significant ST-segment change was defined as > or =0.1mV horizontal or down sloping depression in acute inferior myocardial infarction patients with ST-segment elevation on leads II, III, aVF measured with reference to the TP segment, 80ms after J point. A group=no precordial ST-segment depression. B group=sum of ST-segment depression in leads V1 to V3 equal to or more than the sum of ST-segment depression in leads V4 to V6. C group=maximal precordial ST-segment depression in leads V4 to V6. RESULTS: 1) Incidence of multi-vessel disease in group A and in group B were 23% and 22%, respectively, compared with 60% for those of group C(p0.05). CONCLUSION: The patients with acute inferior myocardial infarction with the maximal ST-segment depression in leads V4 to V6 would be at high risk for congestive heart failure and multi-vessel disease.