Relationship between hyperprolactinemia and bone metabolic markers in breast cancer patients

The understanding of the pathophysiology and the monitoring of metastatic bone disease remain unsatisfactory. Therefore, this study aimed at identification of the relationship between serum prolactin [PRL] levels and some bone metabolic markers [osteocalcin [OC] serum alkaline phosphatase [SAP], calcium [Ca], and inorganic phosphorus [Pi]] in early stages of breast cancer. Thirteen breast cancer patients in whom serum prolactin [PRL] levels had been determined were stratified into 2 groups according to their serum prolactin levels. Breast cancer I [BCI] included those with hyperprolactinemia and breast cancer II [BCII] included those with normal levels. Also a control group matched for age was taken. The bone markers of these groups were analyzed and compared. The study demonstrated that 6 patients [46%] "BCI" had a hyperprolactinemia and 7 patients [54%] "BCII" had a normal level of PRL. One way ANOVA test revealed significant differences in PRL, OC, SAP, Ca, and Pi between the three groups. OC is significantly reduced in the hyperprolactinemic patients reflecting diminished bone formation. SAP and Pi were significantly higher in all patients of breast cancer than that of the controls. The level of Ca tended to be higher in hyperprolactinemic patients than that of the controls. In the breast cancer patients, negative correlation between PRL and OC [R=-0.56, p<0.05] was found. On the contrary, positive correlation between PRL and SAP [r=0.60, p<0.05]was detected. It was concluded that the role of PRL in bone metabolism must be taken into consideration. Further wide scale studies are needed in a trial to uncover the exact role of hyperprolactinemia in patients with bone metastasis. This study could help in understanding bone disorders that may occur in breast cancer patients specially those with hyperprolactinemia

Mast cell in colorectal polyps

This work was undertaken to quantify mast cells in order to investigate their role in determining the likelihood of malignant changes in colorectal polyps. The mean number of mast cells showed significant differences in various colonic disorders studied. On ultrastructure background, there was difference in mast cell character between non neolplastic and neoplastic polyps such as the degree of maturity and the intensity of chymase staining reaction. From this study we might speculate that mast cells may play a role in triggering the early phase of malignant changes in colonic polyps. Mast cells may be useful as marker of colorectal neoplasia. The mechanism of action of mast cells has not been yet elucidated

prognostic value of congestion index in patients with portal hypertension due to schistosomal hepatic fibrosis with and without chronic hepatitis C: a clinico-pathological and hemodynamic study

We intended to assess the value of congestion index of portal vein [Cl PV] [derived from the ratio between the cross-sectional area of the portal vein and the mean velocity of portal flow] in assessing the severity of portal hypertension and its correlation with North Italian Endoscopic Club [NIEC] index and risk of bleeding in patients with schistosomal hepatic fibrosis with and without chronic hepatitis C. We studied 64 patients with portal hypertension who were categorized into three groups based on histological diagnosis: group I [19 with pure schistosomal hepatic fibrosis], group II [22 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C] and group III [23 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C with cirrhosis]. All patients were of the Child class A.They were subjected to; clinical examination, stool and serological examinations for schistosoma infection, serum transaminases and alkaline phosphatase, serum albumin, prothrombin activity and virological markers. Upper endoscopy, abdominal Ultrasonography with duplex as well as liver biopsies were performed to all patients. The results showed that the mean value of Cl PV was found to be higher in groups II [0.155 +/- 0.05] and III [0.179 +/- 0.04] than in group I [0.134 +/- 0.04], which reached a significant level only between groups III and I [P<0.05]. The mean values of NIEC index and NIEC risk of bleeding were found to be significantly higher in group III [28.5 +/- 4, 18.3 +/- 6.3] respectively than in groups I [23.6 +/- 5, 10.6 +/- 7.8] and II [23.5+4, 11+6.5] [P<0.05] with no significant difference between groups I and II. The Cl PV was found to have a significant positive correlation with the degree of fibrosis as assessed by both the sonographic and the histopathologic examinations. It was also significantly correlated with NIEC risk of bleeding. We concluded that the congestion index of portal vein is a valuable non invasive parameter in assessing the severity of portal hypertension and in predicting bleeding in schistosomal patients with and without chronic hepatitis C

Relationship between aminopyrine breath test score and post-operative morbidity in schistosomal patients

The aminopyrine breath [ABT] was done in 25 patients with hepatosplenic schistosomiasis scheduled for splenectomy and left gastric artery ligation and in 15 patients with normal livers and spleens requiring upper abdominal surgical intervention. The relevant radiological and laboratory investigations indicate significant liver involvement in the schistosomal patients. The mean ABT score correlated well with the Child's class where the mean score for class A> class B> class C. However, in this group the mean score for patients with pure schistosomal fibrosis was very close to normal while that for patients with mixed cirrhosis was 40% lower. The incidence of post-operative complications was much higher in schistosomal patients who had lower ABT scores. For determining the probability of postoperative morbidity, the ABT may be of value in the framework of an overall clinico laboratory regime for diagnosis

Adjuvant systemic treatment after resection of colorectal carcinoma utilizing 5-fluorouracil versus 5-fluorouracil plus levamisole

The study included 90 patients with resected stages B2-C colorectal carcinoma. All patients received localized postoperative radiotherapy to a dose of 5000-5500 cGy. Patients were divided into three treatment groups. Group A: receiving no adjuvant systemic treatment [Controls], group B: receiving 5-fluorouracil [5FU] alone [450 mg/m[2] IV bolus for 5 consecutive days] repeated every 28 days; and group C: receiving 5FU as in group B/ and levamizole [Lev] [50 mg, 3 times daily for 3 days and repeated every 2 weeks]. Adjuvant treatment in groups B and C was given for one year. The follow up ranged between 25-62 months [median 3.5 years]. Patients of 5FU/Lev group showed significantly lower recurrence rates than controls [P<0.025], but no difference in rate of recurrence between 5FU group and controls. The advantage of 5FU /Lev group over controls in reduction of recurrences was significant only in patients with stage C disease [P<0.01]. Also patients treated by 5FU/Lev combination showed significantly better overall survival compared to controls [P<0.05]. Toxicity of 5FU/Lev combination was mild and consistent with what might be expected with 5FU alone. 5FU /Lev is tolerable adjuvant therapy to patients with colorectal carcinoma with significant reduction of recurrence rate and significant improvement of overall survival