Sex hormones and oxidant- antioxidant status in post-menopausal women with coronary artery disease

The strikingly lower prevalence of acute coronary syndromes in pre-menopausal women than in men of similar age, then the progressive narrowing of that difference with age after menopause, suggests an important role for sex hormones and probably oxidative stress in the development of coronary artery disease. The aim of this study is to evaluate the sex hormones and oxidant stress [malondialdehyde, which is a metabolite of lipid peroxidation] and anti-oxidants [vitamin C and E] status in postmenopausal women with stable coronary artery disease and in those with acute coronary syndromes. This study was conducted on 40 non-hormone user postmenopausal women with coronary artery disease. They were divided into 3 groups: the 1[st] group [17 patients] who had an acute myocardial infarction, the 2[nd] group [10 patients] had unstable angina and the 3[rd] one [13 patients] had stable angina. This is an addition to 20 apparently healthy postmenopausal women of similar age. All cases and control subjects were subjected to thorough history taking, full clinical examination, routine laboratory investigations, resting echocardiography and special laboratory investigations including detection of serum level of; total and free testosterone, total estradiol, morning and nocturnal serum cortisol, malondialdehyde and plasma levels of alpha-tocopherol and vitamin-C. We found a higher serum level of total and free testosterone in cases than control subjects [P-value 0.016 and 0.031 respectively] and the serum free testosterone was significantly higher in the group of acute myocardial infarction than the group of stable angina [P-value 0.008]. The serum level of total estradiol was significantly lower in cases than in control group [P value 0.0001]. Serum malondialdehyde was significantly higher in cases than control subjects [P<0.0001], and it was significantly higher in cases of acute myocardial infarction in comparison to stable angina cases [P-value 0.005]. Vitamin E [[alpha]-tocopherol] and vitamin C were significantly lower in cases than control group [P 0.0001 and 0.048 respectively]. The serum levels of free testosterone as well as malondi-aldehyde were higher in postmenopausal women with coronary artery disease. However, serum level of estradiol, vitamin E and C were lower in them in comparison to control subjects

Serum and biliary cytokeratin fragment CYFRA 21-1, as a marker of resectability for extrahepatic cholangiocarcinoma

Serum levels of CEA and CA 19.9 are occasionally elevated in cases of cholangiocarcinoma [CC]. They, however, have low sensitivity and specificity, which makes the diagnosis of CC difficult, and better tumor markers are needed. CYFRA 21-1, a cytokeratin fragment, is being evaluated as a tumor marker with diagnostic potential for small cell lung carcinoma. The resectability of CC is difficult to assess accurately pre-operatively using available laboratory and imaging techniques. The aim of the present study was to assess the diagnostic value of CYFRA 21-1, CA 19.9, and CEA in serum and bile of patients with extrahepatic CC. and to evaluate whether any of these markers can be used to assess resectabilily. Fifty patients with extrahepatic obstructive jaundice were included in this study. Group 1: 30 patients with histologically proven CC had serum and bile samples measured for CYFRA 21-1, CA 19.9; and CEA. Group II: 20 patients with calcular obstructive jaundice had serum and bile samples obtained during endoscopic removal of stones to control for the effect of biliary obstruction on CYFRA 21-1, CA 19.9, and CEA. Sixteen patients in whom imaging studies showed resectability were explored and operative findings were correlated to tumor markers. CEA and CA 19.9 were measured using enzyme immnunoassay [EIA,], and CYFRA 21-1 level was measured using electrochemiluminescence immunoassay [ECLIA] in serum and bile of the CC patients and the caicular obstructive jaundice controls. Patients with CC had significantly higher serum levels of CEA [24.5 +/- 6 vs 4 +/- 1.3 ng/ml. p<0.01] CA 19.9 [118.9 +/- 25.4 vs 31.2 +/- 8.4 U/ml, p< 0.01] and CYFRA 21-1 [8.3 +/- 2.7 vs 2.1 +/- 0.5 ng/ml, p<0.01] than patients with benign calcular cholestatic disorder, and bile concentration of the 3 markers was sign higher than serum concentrations. Among the 16 patients who underwent surgery, serum and biliary levels of CYFRA 21-1 were significantly higher with irresectable tumors. CYFRA 21-1 may be a useful marker for resectabilily saving many unnecessary operations. This, however, needs further larger studies to be documented

Relation of chlamydia pneumoniae IgG antibodies to serum interleukin-6 levels in patients with unstable angina and acute myocardial infarction

The aim of this study was to confirm the role of Chalmydia pneumoniae [C pneumoniae] infection in acute myocardial infarction [AMI] and unstable angina, to find possible relations between high levels of interleukin-6 [IL-6], C-reactive protein [CRP], lipid profile and C pneumoniae, and to interrelate these data with the pathogenesis of acute coronary syndromes. A group of 25 patients with AMI, a group of 25 patients with unstable angina, and 13 members of a healthy control group matched for age, sex, and main coronary risk factors were included in the study. In this study, sera were examined by an enzyme-linked immunosorbent assay [ELISA] for IgG antibodies to C pneumoniae. Also, we measured the levels of IL-6 by ELISA. Patients with AMI had highly significant increase in IL-6 levels and CRP levels compared with unstable angina patients [P < 0.001]. Patients seropositive to C pneumoniae had highly significant atherogenic changes in different parameters of lipid profile compared with patients seronegative to C pneumoniae [P < 0.001]. A very high significant linear correlation was found between IL-6 levels and CRP, high density lipoprotein-cholesterol [HDL-c], low density lipoprotein-cholesterol [LDL-C] levels in the AMI and unstable angina patients [tb = 0.649, - 0.466, 0.474 respectively]. A high significant linear correlation was found between IL-6 levels and triglyceride [TG] levels in AMI and unstable angina patients [tb = 0.326]. A good significant linear correlation was also found between IL-6 levels and total cholesterol in the AMI and unstable angina patients [tb = 0.269]. Patients seropositive to C pneumoniae had highly significant increase in CRP and IL-6 [P < 0.001] compared with patients seronegative to C pneumoniae. IL-6, a proinflammatory and prothrombotic cytokine, was significantly elevated in AMI and unstable angina particularly in patients with serological evidence of C pneumoniae. Also patients with C pneumoniae had an atherogenic lipid profiles with significantly elevated CRP levels as a part of acute phase response. These effects appear to be mediated by cytokines like IL-6, since a significant linear correlation was found between IL-6 and measured lipid parameters in this work

Biochemical bone specific markers in early rheumatoid arthritis

To assess the potential of biochemical markers of bone turnover in early rheumatoid arthritis to reflect disease processes and to help monitor the course of the disease. serum from twenty five patients with early rheumatoid arthritis [RA] and from ten healthy control subjects were studied with enzyme-linked immunosorbent assays for bone sialoprotein and osteocalcin. Rheumatoid arthritis patients had significantly increased serum bone sialoprotein [BSP] in comparison with control subjects [P<0.001] whereas no significant difference was found between the two groups in the levels of osteocalin [P>0.05]. Bone sialoprotein as a biochemical marker of bone turnover can be measured to provide an assessment of disease process in patients with early rheumatoid arthritis

Plasma Endothelin 1 [ET-1] in Type 2 [non-insulin-dependent] Diabetes Mellitus

To evaluate the level of plasma endothelin-1 in NIDDM with and without hypertension. Plasma ET-1 levels were evaluated [by enzyme immunoassay] in 50 subjects. Thirty patients with NIDDM [15 nor-motensive and 15 hypertensive] and twenty subjects serving as controls [10 hypertensive and 10 healthy normotensive]. Circulating ET-1 levels are significantly higher in normotensive NIDDM [2.41 +/- 0.36 ng/mL] and hypertensive NIDDM [2.63 +/- 0.44 ng/ml] when compared with healthy controls [0.73 +/- 0.14 ng/ml] and hypertensive controls [0.84 +/- 0.13 ng/ml] [P<0.001]. Also there are no significant correlations between plasma ET-1 levels and fasting blood glucose [r = 0.188. P>0.05], mean blood pressure [r = 0.129, P>0.05], duration of diabetes [r = 0.137, P>0.05] and age of subjects [r = 0.099. P>0.05] Significant plasma endothelin-1 elevation in diabetic subjects may relate to diabetic endothelial cell damage and in turn be an important background factor in diabetic vascular complications and endothelin-1 receptor antagonists may have a role in ameliorating this dysfunction

comparative study of n-acetylcysteine and two new antidotes [zinc and hepanox] on acetaminophen hepatotoxicity in rats

Sixty mature albino rats were divided equally into five test groups and one control group. Acetaminophen was given orally [100 mg/kg] to rats of the five test groups. N-acetylcysteine [150mg/kg], zinc sulphate [15mg/kg]; combined zinc sulphate and N-acetylcysteine with the same doses and hepanox [150 mg/kg] ere given orally one hour after the toxic acetaminophen dose to rats of the second; third; fourth and fifth groups respectively. Statistical analysis of values of serum Alt, ast, ldh AND g-6-P-D showed high signifidcant elevation in the first test group [acetaminoiphen], significant decrease in the second DD[N-acetylcysteine] and third [zinc sulphate] groups and dramatic significant improvement in the fourth [combined N-acetylcysteine and zinc sulphate] and fifth [hepanox] groups. All biochemical results coincided completely and confirmed by the histopathological findings in the livers of the studied rats