Bone scan in initial staging of prostate cancer

Bone scans of 64 patients with newly diagnosed prostate cancer were retrospectively analysed. Metastases were present in 29 patients (45%). In 75% of these cases, the pattern was manifeastly metastatic. The third threshold has high negative and positive predictive values. The topography of metastatic lesions is in favour of a systemic spread. There were no metastatic cases with a PSA level under 10 ng/ml. Multiple IAU and intense IAU are the most specific patterns of metastatic lesions. Also, focal lesions on sacroiliacs are also in favour of metastatic origin. The distribution of metastases is globally similar to that of the bone marrow in adult and systemic spread is the most probable. Staging bone scan must be reserved to patients with PSA level greater than 10 ng/ml, poorly degree of differentiation and advanced clinical stage.     

Growth charts of heights and weights of male children and adolescents of Isfahan, Iran

Measurements of height and weight are important data source relating to growth and development, puberty, and nutritional status of children and adolescents. In clinical setting, the charts of the National Center for Health Statistics (NCHS), USA, are used in Iran. A survey identified significant differences in weight- and height-for-age across provinces, between urban and rural children. Although the percentiles derived from data of the national health survey, in 1990-1992, were substantially below the NCHS charts, the growth patterns were parallel to the NCHS percentiles. In 1997, an anthropometric assessment of male students aged 6-18 years was conducted in Isfahan, a centrally-located city in Iran. The goal of the study was to establish the normograms of heights and weights in Isfahan for use in clinical settings. By a random cluster sample survey, 4,364 of 200,000 male students aged 6-18 years were selected from all areas of the city. Trained health staff measured their heights (cm) and weights (kg), and all the percentiles were calculated. A comparison was made with weight and height data collected from other parts of the country on several occasions. Findings showed that the growth percentiles of 6-18-year male students of Isfahan in 1997 were comparable to the NCHS charts. These students were taller and heavier than their fellow-citizens 22 years earlier, their compatriots in rural areas of Isfahan (1997) and Rasht (1989). They were also taller than those who were living in Tehran (1994). A similar study was conducted at the same time on urban Isfahani female students aged 6-18 years. All the percentiles of their height and weight curves were comparable with those of the NCHS charts. Thus, it is appropriate to use the NCHS charts for school-age children and adolescents in Isfahan city. The cause of improvement in growth parameters in Isfahan should be evaluated in future studies.     

The association of lipid levels with mortality in patients on chronic peritoneal dialysis.

BACKGROUND: The role of traditional risk factors, including plasma lipids, in the pathogenesis of cardiovascular (CV) disease in chronic dialysis patients is unclear. Previous studies have suggested that lower serum total cholesterol (TC) is associated with higher mortality in patients on chronic haemodialysis (HD). Whether this relationship is specific to the HD population or is common to the uraemic state is unclear. The present study evaluated the association of serum TC and triglycerides with clinical outcomes in chronic peritoneal dialysis (PD) patients. METHODS: Data of 1053 PD patients from the United States Renal Data System (USRDS) prospective Dialysis Morbidity and Mortality Study Wave 2 were examined. Cox regression was used to evaluate the relationship between lipid levels and mortality. RESULTS: Patients with TC levels < or =125 mg/dl (3.24 mmol/l) had a statistically significant increased risk of an all-cause mortality, including those taking or not taking lipid-modifying medications, compared with the reference of 176-225 mg/dl (4.54-5.83 mmol/l). In stratified analysis, this association was demonstrated in patients with serum albumin >3.0 g/dl (30 g/l), but not with albumin < or =3.0 g/dl. Compared with patients with triglyceride levels of 201-300 mg/dl (2.27-3.39 mmol/l), a statistically significant reduction of all-cause, but not CV, mortality was observed in patients with triglyceride levels of 101-200 mg/dl (1.14-2.26 mmol/l), as well as in the subgroup with serum albumin levels <3.0 g/dl (30 g/l) and triglycerides of < or =100 mg/dl (1.13 mmol/l) and 101-200 mg/dl (1.14-2.26 mmol/l). CONCLUSIONS: While confounding factors and causal pathways have not been clearly identified, aggressive lowering of plasma cholesterol in PD patients is not supported by this study, however, treatment of hypertriglyceridaemia may be warranted with triglyceride levels >200 mg/dl (2.26 mmol/l).     

Polycystic kidney disease in children

Polycystic renal diseases in children include 2 pathologically and genetically distinct diseases: autosomal recessive polycystic kidney disease (ARPKD), incorrectly called the "infantile form", characterized by a constant hepato-renal involvement, and autosomal dominant polycystic kidney disease, often termed the "adult form", which is more and more frequently detected in children as a result of advances in renal imaging techniques. The differential diagnosis is not based on age at discovery, clinical symptoms or renal imaging, which may all be similar in the 2 diseases, but on the presence, detected by either pathology or ultrasonography, of the biliary dysgenesis specific to ARPKD, and mainly on the mode of inheritance, confirmed by the results of ultrasonography in parents and grandparents.     

Evaluation of androgen metabolism studies in human prostate cancer--correlation with zinc levels

Standard radioimmunoassay and enzymatic techniques were used for the measurement of endogenous steroid levels and the evaluation of three specific enzymatic activities in prostate tissue from patients with benign prostatic hypertrophy (BPH) and carcinoma of the prostate (CaP). In order to develop new methods for the characterization of prostatic cancer, these parameters were also correlated to the zinc concentration found in the tissues. Our studies suggest that the malignant tissue was very distinct in all parameters examined and significant differences between the benign and cancerous prostate were observed: (a) differences in the enzymatic profiles—5α-reductase and 3α(β)-hydroxysteroid dehydrogenase decreased in cancer whereas 17β-hydroxyteroid dehydrogenase increased, (b) the excessively high levels of testosterone found in the malignant tissue, and (c) the inability of CaP to retain the zinc. Our studies also suggest that the endocrine activity of the gland is dependent upon the zinc concentration in the tissue and that these metallohormonal studies could be selectively used to discriminate between BPH and CaP.