association of helicobacter pylori infection with the development of gastroesophageal reflux disease GERD

The objective of this study was to prove the causal association of Helicobacter pylori infection and the development of GERD in order to be able to plan a program for intervention. The work was conducted on 30 patients suffering from symptoms suggestive of gastroesophageal reflux disease diagnosed by upper endoscopic examination and 20 matched controls were chosen complaining from dyspeptic symptoms, but were completely normal by upper endoscopic examination. The patients and controls were selected from Mataria Teaching Hospital and Ain Shams Specialized Hospital in Cairo and subjected to complete history taking, clinical examination, endoscopic examination and biopsy from the lower end of esophagus for the examination of the presence of Helicobacter pylori. No causal association between infection with Helicobacter pylon and the development of [GERD] could be demonstrated

Polyerga in advanced cancer patients

Thirty patients with a variety of locally advanced and metastatic malignant diseases which were refractory to conventional therapy were introduced into a prospective randomized clinical trial of the glycopeptide polyerga. The drug was given in the form of both oral tablets and subcutaneous injection over 12 weeks period. Evaluation of patients response included changes in their general state of health, total lymphocytic count and body weight together with resolution of symptoms; tumor response and occurrence of any adverse effects during the follow-up period. Response to polyerga was limited. A negative effect was noticed for polyerga over the performance status [PS] and pain severity with a steady effect on the total lymphocytic count level, alleviation of nausea and vomiting. On the other hand, increased body weight was noticed in the 8th week of follow-up period, but cannot be maintained till the end of the 12th week. Worsening of the studied parameters were more noticed in locally advanced stages rather than in metastatic stage, whereas, the primary site of malignancy appeared to have no influential effect on the parameters. Males experienced more increase in pain severity with stationary performances status, while the reverse was noticed in the females. These results can be explained by the facts of advanced and diverse disease presentation, exhaustion of the patients' immune system by previous antineoplastic therapy, the small cohort of patients as well as the short period of follow-up, therefore, a suggestion for further prospective trials with better selection with a less advanced stages, a larger number of studied patients with dose and duration modification over a longer follow-up period, is recommended for better evaluation of response to polyerga

Congenital dislocation of the knee

Two sisters [siblings] were treated in Al-Razi Orthopaedic Hospital between July 1986 and November 1989 for bilateral congenital dislocation of their knees. The occurrence of the deformity in two sisters supports the familial aetiology of the condition. No other associated deformities or neurological deficits were found. We advocate early surgical treatment when manipulation fails to reduce the deformity

Evaluation and management of glomus tumors in NEMROCK

Forty patients with glomus tumors attended NEMROCK [Kasr El Aini Center of Radiation Oncology and Nuclear Medicine], in the period from 1965 till 1993. An epidemiological survey, clinical, radiological and pathological data were analyzed for all patients. The treatment was biopsy and subtotal surgery, followed by pot operative radiotherapy in 30 patients. Radiotherapy regimen as 5000 cGy/5 weeks/25 treatments, was done by a Cobalt teletherapy machine. Assessment of the treatment results as disease control and total survival proved that radiation therapy following surgery, is an effective treatment for glomus tumors, with least late progression of the disease

Role of intraarterial infusion chemotherapy in the management of malignant liver neoplasms

This study included 46 patients with histologically confirmed liver malignancies who were randomly assigned to one of three treatment modality group intravenous chemotherapy, intravenous chemotherapy with hepatic irradiation or intraarterial infusion chemotherapy with hepatic irradiation. The overall one-year survival rate for patients treated by either intraarterial infusion chemotherapy or intravenous chemotherapy only was 6.7% and 6.2% respectively, while none of the patients treated by intravenous chemotherapy and hepatic irradiation survived for more than one year. The highest objective and subjective response rates were obtained in patients treated by intraarterial infusion chemotherapy [74%] with eighty percent of patients reporting improvement of their pretreatment symptoms by more than 50%

Evaluation of chemoembolization in the treatment of patients with hepatocellular carcinoma

This study is a pilot study of 15 patients with histologically confirmed hepatocellular carcinoma who were treated by chemoemboliza-tion. Most patients were in the 50-70 year age bracket with a male to female ratio of 2 1. The commonest presentation was right hypochondrial pain with or without gastrointestinal disturbances. Chemoembolization was carried out in two steps peripheral with injection of mixture of Adriamycin and lipiodol, followed by central embolization where spongel microcubes were injected. Although only one patient survived 1 year [6.7%], but 50% of patients showed reduction of alpha-fetoprotein level to half its pretreatment level with more than 80% of patients reporting subjective improvement. No life threatening complications were encounterd

Alpha-2B-interferon in head and neck cancer

Alpha-2b-interferon had demonstrated a different activity in advanced refractory of relapsing solid tumors and in particular tumors of head and neck. Because of the reported synergism between interferon and different treatment modalities [including cytotoxic agents], a trial of 31 patients with advanced head and neck cancer was conducted utilizing alpha-2b-interferon [interon A]. Interon A was given as a single [in 7 patients] or in combination with other treatment modalities [in 24 patients]. Administration of interon A was either perilesionally [in 17 patients] or intravenously [in 14 patients] in a dose of one million IU. daily for a planned minimum 4 weeks, then 3 times weekly for 3 weeks. The overall remission [partial and complete] was seen in 13/24 [54%] of patients in the combined treatment group and in 2/7 [28.6%] of patients treated with interferon alone. Response duration was 7 and 44 months, respectively. The most common side effects were flu-like symptoms; fatigue and pyrexia which could be ameliorated by acetaminophen. Statistically, there was no significant difference observed between patients treated by interferon alone or in combination with other treatment modalities, as regard response rate; duration of response or effect of prior therapy, yet, considering the high risk characteristics of this group of patients [61% relapse or refractory after prior therapy, and 39% had advanced disease], in addition to the small-sized sample of this group; these preliminary results suggest that interferon may have an active role in treatment of head and neck cancer patients with an acceptable degree of toxicity

Role of induction chemotherapy in locally advanced head and neck cancer prior to radical radiotherapy and/or surgery

This prospective randomized study included 57 previously untreated, stage III and IV head and neck cancer patients seen at Kasr El Aini Center of Oncology. Patients were randomly assigned to two arms; Arm [1] included 28 patients who received 2 courses of combination chemotherapy [Methotrexate, bleomycin and cisplatinum] followed by locoregional treatment, while arm [2] included 29 patients who received standard radiation treatment to the primary as well as regional nodes. The follow up period for all evaluable cases was 30 months with a mean duration of 18 months. The disease-free survival was 5.5 and 4 months for arm [1] and [2] respectively. The overall median actuarial survival of all evaluable cases was 10.5 months

prognostic value of the immune status in breast cancer patients

This work has been carried out at Kasr El Aini of Radiation Oncology and Nuclear Medicine [NEMROCK] from the 15th of September 1982 to the 15th of June 1983, studying the prognostic value of the immune status in breast cancer. All patients [98 females] were referred after modified radical mastectomy to receive adjuvant radiotherapy and or chemotherapy or no treatment. Patients were subjected to clinical examination, laboratory studies, radiological examinations, radionuclide scanning, histopathological evaluation. Sixty eight patients were subjected to immunological studies. Suppressed cell-mediated immunity [CMI] was diagnosed if one or both of the skin tests were negative and/or if low absolute count or low stimulation index were obtained compared to normal controls. At sit months post-treatment, disease free survival was significantly higher among patients who were postmenopausal with early disease, round cell infiltration in tumour bed, sinus histiocytosis in axillary lymph nodes and normal cell mediated immune status

Prediction of relapse in breast cancer

The clinicopathologic and immunologic features of 54 breast cancer patients together with the type of post-operative treatment had been analyzed. The results were compared with the incidence of relapse and the percentage of disease-free survival. Nine variables were studied; age; menstrual status; clinical stage; pathologic behaviors of tumor; number of involved lymph nodes; immune reaction in primary tumor. And in its draining lymph nodes; immune competence and type of treatment given to the patients. A stepwise multivariate regression using the cox regression model was carried out to identify the variable related to the incidence of relapse. The regression analysis showed that the number of involved lymph nodes; the immune reaction in them; the type of treatment given post-operatively, the menstrual status and the pathological behavior of tumor were the most significant five variables for predicting relapse. The effect of the general immune competence of patients in predicting relapse was negative. Using the lefe table method the disease free survival was calculated and was found to be 74% at 3 years and 53% at 5 years. A simple mathematical formula was developed to predict the outcome of cancer breast patients

effect of different adjuvant treatment modalities on immune status in breast cancer patients

Fifty seven females with breast carcinoma were referred to Kasr El Aini Center of Radiation Oncology and Nuclear Medicine [NEMROCK] after mastectomy for adjuvant radiotherapy [30 patients] or radio-chemotherapy [27 patients] using the CMF regimen. All patients were subjected to pre-treatment clinical examination, laboratory studies, radiological examinations, isotopic scanning, histopathological evaluation and immunological studies. There were marked depression in total leucocytic, absolute lymphocytic and T-lymphocytic counts at one 6 months from the end of treatment in both groups. Serum immunoglobulins demonstrated significant decrease in IgM in the group treated by radiotherapy alone, depressed IgM and IgA level in the group treated by radio-chemotherapy. Significant decrease in the concentration of IgG, IgA and IgM were observed at the end of 6 cycles of chemotherapy compared to their levels before rediotherapy. In the present study, the maintained lymphocytic counts and functions could be explained by the additive immunodepression of both radiation and chemotherapy in addition to the pretreatment depressed levels

Management of pituitary tumors

Fiftypatients of pituitary tumors were subjected to thorough clinical,radiological and hormonal studiesbeforeandafter treatment. Surgery was done for all of them and postoperative radiotherapy was performed for 32 cases out of the total cases.Mass releafing effect was observed in all cases after surgery,while hormonal cure was noticed in 25% and visual improvement in 8% of cases. The results of postoperative radiotherapy were good in 93.8% of the cases and only43.7% of them were in need of further medical treatment

Combination chemotherapy in advanced breast cancer

In a retrospective analysis of 216 patients with advanced breast cancer at NEMROCK over seven consequetive years to whom modified Cooper's regimen was applied, the response rate of the fully evaluated, 174 cases was 33.9%. the response to chemotherapy was shown to be influenced by the site of metastatic deposis as the highest response was seen in soft tissue deposits followed by skeletal and visceral deposits and the least response was in mixed deposits. Also, the highest response to chemotherapy treatment was in recurrent cases associated with residual disease [47.8%]. The best response to chemotherapy treatment was seen in the age group 40-45 years and over 70 years of age. It is concluded that further trials with other combination chemotherapy regimens should be performed to reach a higher response rate, longer duration of remission and a better quality of survival with least toxic manifestations to this type of therapy