The incidence of occult cancer in patients with deep venous thrombosis: A prospective study

{Objective. This study was undertaken to assess a potential relationship between idiopathic deep venous thrombosis (DVT) and occult cancer. Design. Prospective study with a 2-year follow-up. Setting. The Angiology Unit of the First Department of Surgery, University of Athens, Greece, a tertiary referral centre. Subjects. Two hundred and ninety-three patients with a first episode of venographically or Doppler-proved DVT were included in the study, of whom 264 were followed up for 2 years. \textbackslash{} Interventions. After an initial extensive diagnostic workup, including routine blood counts and chemistries, erythrocyte sedimentation rate, CEA levels, chest X-ray and abdominopelvic CT scan, all patients were closely followed up and periodically examined. Main outcome measures. The incidence of cancer amongst patients with idiopathic and secondary DVT, and the validity of our screening programme. Results. Cancer was diagnosed in 21 out of 84 patients with idiopathic DVT (25\%) as compared with eight out of 202 patients with secondary DVT (4\%). In 22 out of the 29 cases, cancer was detected during the initial admission, and the remaining seven cases were detected during follow-up. Cancer was diagnosed in 15 asymptomatic, healthy individuals, but only in seven of them was the diagnosis made by CT scan. Conclusion. Occult cancer is fairly common in patients with idiopathic DVT, but the routine use of extensive diagnostic studies for its detection remains to be validated by further prospective studies.

Sex hormone changes in morbidly obese patients after vertical banded gastroplasty

Serum sex hormone levels were measured preoperatively in 57 morbidly obese patients (19 men and 38 premenopausal women) and 12 months after vertical banded gastroplasty. In the male group, there was a significant decrease in estradiol and an increase in follicle-stimulating hormone (FSH), total testosterone and sex-hormone-binding globulin (SHBG). Among female patients, a significant decrease in estradiol, total and free testosterone and an increase in FSH and SHBG was found. Irregular menses present preoperatively in 5 women were corrected after successful weight loss. In conclusion, altered sex hormonal levels and gynecologic abnormalities associated with morbid obesity are corrected with adequate weight loss following vertical banded gastroplasty

Immunohistochemical detection of oestrogen receptors in ductal carcinoma in situ of the breast

The expression of oestrogen receptor (ER) protein in invasive carcinoma of the breast and its clinical significance has been extensively evaluated, Little information is available regarding ER expression in ductal carcinoma in situ (DCIS), In this study, 46 formalin-fixed, paraffin-embedded tissue specimens of mammographically detected DCIS were evaluated immunohistochemically for the presence of ER using specific monoclonal antibodies against ER (ER-ICA Abbott Lab), The associations between ER expression and histological type, degree of differentiation and patient menopausal status were evaluated, Positive ER staining was present in 72% of cases, Non-comedo types of DCIS were more frequently ER-positive than comedocarcinoma, ER-positive tumours were inversely correlated with the presence of nuclear pleomorphism, The incidence of ER in pre-menopausal and post-menopausal women was similar, In conclusion, ER expression is present in a considerable percentage of DCIS, and ER-positivity is associated with the degree of differentiation and non-comedo carcinoma variants

Serum beta-endorphin levels in morbidly obese patients: The effect of vertical banded gastroplasty

The associations between serum beta-endorphin levels and clinical and metabolic variables as well as beta-endorphin changes after surgically induced weight loss were investigated in 13 morbidly obese patients. A significant positive correlation between beta-endorphin and body weight, degree of body weight increase and ACTH was found preoperatively. Only body weight was independently associated with beta-endorphin levels, Twelve months following vertical banded gastroplasty, there was an extensive weight loss in all patients and improvement in their metabolic profile. A significant reduction in P-endorphin levels which was proportional to the extent of weight loss was also observed

The effect of vertical banded gastroplasty on glucose-induced beta-endorphin response

Background. beta-Endorphin is an endogenous opioid involved in the regulation of food intake and obesity as well as in insulin metabolism, In this study, we investigated glucose-induced beta-endorphin, insulin, and glucose responsiveness in morbidly obese patients and the effect of surgically induced weight loss, Methods. Thirty-two healthy, nondiabetic, morbidly obese patients (body mass index over 40 kg/m(2)) and 32 normal-weight controls were studied. Serum levels of P-endorphin, insulin, and glucose were measured under basal conditions and during an oral glucose tolerance test (OGTT) before and 12 months following vertical banded gastroplasty. Results. Preoperative basal levels of beta-endorphin, insulin, and glucose and their responses during OGTT in obese patients were significantly higher compared with those of controls. After surgery, basal beta-endorphin, insulin, and glucose levels decreased significantly compared with preoperative values. Postoperative basal insulin and glucose levels were similar to those in controls, while beta-endorphin levels remained significantly higher than those of controls. A significant reduction in total responses of beta-endorphin, insulin, and glucose during OGTT was also observed; however, postoperative beta-endorphin and insulin responses remained significantly higher than in controls. Conclusion. Morbidly obese patients have an increased glucose-stimulated response of beta-endorphin, insulin, and glucose which is partially corrected with weight loss following vertical banded gastroplasty. (C) 1998 Academic Press