Telomerase activity, and tissue polypeptide specific antigen (TPS) in Egyptian breast cancer patients.

OBJECTIVES: Breast cancer is the most common malignancy among Egyptian women. The aim of this study is to evaluate the role of both telomerase and TPS estimation in assessment of breast cancer. METHODS: The study included 40 patients with breast cancer, and 20 patients with benign breast diseases. Telomerase activity in breast tissues was assessed using TRAP assay. TPS was measured in sera of the patients by ELISA. RESULTS: Telomerase positivity was 15% in benign group vs. 60% in malignant group (p = 0.0009). It was significantly correlated to stage, and lymph node status (p < 0.02). Telomerase positivity showed significant correlation to tumor recurrence (p = 0.0076) in a follow-up period of 36 months. Mean rank of TPS was significantly higher in malignant than benign groups (p < 0.001), and in telomerase positive than telomerase negative patients (p < 0.001). In malignant group, mean rank of TPS was significantly higher in late stages (p < 0.002), in higher grade (p < 0.05), in larger tumor size (p < 0.01), and in lymph node positive patients (p < 0.001). ROC curve was utilized to choose the best cutoff for serum TPS (88 U/L). At this cutoff, the sensitivity was 95%, and the specificity was 75%. At a higher cutoff (109 U/L), TPS positivity was significantly correlated to stage, grade, lymph node status, and telomerase positivity (p < 0.05). CONCLUSION: Telomerase positivity and serum TPS might be used as additional markers for assessment of breast cancer.     

The use of sulfasalazine and pentoxifylline (low-cost antitumour necrosis factor drugs) as adjuvant therapy for the treatment of pemphigus vulgaris: a comparative study

Background  Pemphigus vulgaris (PV) represents a potentially life-threatening autoimmune blistering disease in which IgG autoantibodies are directed against cell–cell adhesion molecules. Tumour necrosis factor (TNF)-α has been suggested to have a possible role in the mechanism underlying acantholysis.
Objectives  This comparative double-blinded study was carried out to estimate the use of both sulfasalazine (SSZ) and pentoxifylline (PTX) (low-cost anti-TNF drugs) as an adjuvant therapy for PV.
Methods  The study included 64 patients with PV: 42 patients received the full treatment regimen (with SSZ and PTX) and 22 patients followed the same regimen except they received placebo instead of PTX and SSZ. Five healthy subjects were included as controls. Serum samples were taken to measure TNF-α levels in the control group and before starting treatment in both the patient groups and this was repeated every 2 weeks for 8 weeks; a clinical assessment was made every week for all the patients.
Results  The serum level of TNF-α was statistically higher in both groups of patients than in the healthy individuals. There was a statistically significant decrease in the serum levels of TNF-α in patients in group 1 compared with those in group 2 at 6 and 8 weeks. There was also a significant clinical improvement in patients in group 1 compared with those in group 2.
Conclusion  The use of PTX and SSZ as adjuvant therapy in the treatment of PV induced a faster and more significant decrease in the serum level of TNF-α, and this decrease was associated with rapid clinical improvement.     

Does maintenance of Bevacizumab after treatment failure have a role in metastatic colon cancer？

Objective: To study the timing of Bevacizumab (BVC) in the overall treatment strategy of advanced metastatic colorectal cancer - early use (first-line) or later use. Methods: 41 patients with progressive metastatic colorectal carcinoma were included. Patients were randomized to receive chemotherapy with or without BVC. Primary end point was objective response. Secondary end points were median survival, time to tumor progression, and toxicity. Results: Partial response with second-line BVC group constituted 25% and 18.8% in patients with first-line chemotherapy and BVC-based regimen respectively, compared to 11.8% and 5.9% with second-line chemotherapy. Median time to progression was 3.1 vs. 2.3 months for cases with first-line chemotherapy and BVC-based regimens respectively. Median survival was 8.2 vs. 4 months in both groups respectively (P = 0.019). Conclusion: Second-line chemotherapy combined BVC had higher disease control rate (partial response and stable disease), median time to progression and median survival in BVC-naive patients compared to patients with first-line BVC-based therapy. BVC should be maintained in the second- and third-line settings, as cases with BVC discontinuation had significantly lower median time to disease progression and median survival. Selection of patients for use of BVC was recommended with taking into consideration the cost-benefit value and that the discontinuation of BVC would increase tumor progression.     

Anatomical exploration of a dicephalous goat kid using sheet plastination (E12)

A dicephalous, 1-day-old, female goat kid was presented for anatomical study. Epoxy plastination slices (E12) were used successfully to explore this condition. They provided excellent anatomic and bone detail, demonstrating organ position, shared structures, and vascular anatomy. Sheet plastination (E12) was used as an optimal method to clarify how the two heads were united, especially the neuroanatomy. The plastinated transparent slices allowed detailed study of the anatomical structures, in a non-collapsed and non-dislocated state. Thus, we anatomically explored this rare condition without traditional dissection. The advantages of plastination extended to the preservation at room temperature of this case for further topographical investigation. To the authors' best knowledge, this is the first published report of plastination of a dicephalous goat.