Role of transvaginal contrast enhanced MRI in early detection and staging of cervical cancer: a review

Cervical cancer is the second most common gynecologic malignancy. It usually takes years for pre-cancerous changes to turn into cervical cancer. This pre-cancerous change when detected is 100% treatable. Accurate cervical cancer staging is crucial for appropriate treatment selection and treatment planning. The greatest difficulties in the clinical staging are the estimation of tumor size, especially if the tumor is primarily endocervical in location. MRI has excellent soft-tissue contrast resolution, which exceeds that of CT and US. Consequently, MRI is significantly more valuable in the assessment of the size of the tumor, the depth of cervical invasion, and the local-regional extent of the disease

Aim of the Study: to highlight the role of transvaginal contrast enhanced MRI in the early detectionand staging of cervical cancer to guide for accurate management

Conclusion: high-resolution MRI is accepted as optimal for evaluation of the main prognostic factors and selection of therapeutic strategy for cervical cancer

Value of transvaginal ultrasonography in the diagnosis of endometrium abnormalities in patients treated with tamoxifen

This study was conducted to investigate the value of endovaginal ultrasound in the assessment of tamoxifen associated changes of the endometrium in patients with breast cancer and to correlate sonographic and pathologic findings to symptoms and duration of tamoxifen therapy. Medical records and sonograms of 80 post-menopausal women treated for cancer breast with adjuvant tamoxifen therapy were reviewed retrospectively. Endometrial thickness was recorded as a single layer thickness and considered abnormal when greater than 2.5 mm for post-menopausal women. Sonographic endometrial thickness was correlated to histologic findings, symptoms and duration of tamoxifen therapy. Fifty seven of 80 post-menopausal women had single layer endometria1 thickness of 2.5 mm or greater measured by TVS and 55 of 57 had endometrial biopsies or dilatation and curettage. Biopsies detected 24 cases of abnormal endometrial including endometrial carcinoma [2], breast carcinoma metastatic to the endometrium [one], endometrial polyps [13], tuba1 metaplasia [3] and benign endometrial hyperplasia [5]. Using a single- layer endometrial thickness greater than 2.5 mm by TVS, 21 of 24 women with abnormal endometrial were detected. Women with abnormal pathologic findings had a significantly thicker mean single layer endometrial thickness than those with normal findings [7 mm versus 4 mm]. Twelve women had post-menopausal bleeding all of whom had a single layer endometrial thickness greater than 2.5 mm on TVS

GAD, IA-2 and insulin autoantibodies in relation to some risk factors in siblings of Egyptian children with type 1 diabetes

The aim of the present work has been to screen siblings of children with type 1 diabetes for some immunological markers of the disease, namely GAD, IA-2 and insulin autoantibodies and to study their possible relation with other risk factors. Siblings of 151 child with type 1 diabetes [287 healthy siblings] besides 100 healthy control subjects matched for age and sex. Subjects were subjected to estimation of GAD antibodies using radiolig and binding assay developed by Peterson et al, in 1994, IA-2 antibodies by radiolig and assay and insulin autoantibodies [IAA] using ELISA technique. Subjects with positive immunological markers were screened for HLA-DR3 and DR4 and first phase insulin release [FPIR] arter IV glucose infusion. revealed that 39.7% of healthy siblings were positive for one or more autoantibodies, 22.8% for 2 antibodies and 4.38% for 3 antibodies. GAD antibodies were present in 27.9%, IA-2 antibodies in 9% and IAA in 15.3% of healthy siblings. These prevalences were statistically significantly higher than those found in control subjects: 7%, 2%, 1.5% respectively No relation could be elicited between positivity of immunological markers in siblings and their age, sex, duration of breast feeding, age at cow's milk feeding nor with parents consanguinity. On the other h and, HLA-DR3, HLA-DR4 and DR3/DR4 were found in 29.4%, 64.7% and 88.2% respectively in seropositive subjects while in 27.5% 32.5% and 45% in seronegative healthy siblings. Conclusion the high prevalence of positivity of autoantibodies among siblings of type 1 diabetic children suggests the importance of an environmental factor, perhaps via a mechanism of antigenic mimicry. Also the results in relation to other risk factors may help to a better underst and ing of the immuno-genetic susceptibility and /or pathogenesis of type 1 diabetes in a particular population