The effect of endogenous and exogenously administered oestrogens, androgens and progesterone on plasma and urinary uric acid and uric acid clearance was studied in a total of 65 healthy volunteers, including normal menstruating and post-menopausal women, girls with primary amenorrhoea and adult male subjects. A serial study throughout a full cycle in 3 women showed an inverse relationship between plasma uric acid levels and endogenous oestrogens. Administration of conjugated and synthetic oestrogens produced a fall in plasma uric acid concentration through a uricosuric effect in most subjects of both sexes. Testosterone propionate caused a definite increase in plasma uric acid levels in post-menopausal women while endogenous testosterone changes due to Leydig cell stimulation produced no definite effect in male subjects. Administration of a progesterone preparation produced an effect similar to that of oestrogens in post-menopausal women. The evidence presented here supports the view that sex steroids play a significant part in uric acid regulation in biological fluids of both sexes.It has been well established that uric acid (UA) concentration in the plasma of healthy subjects is related to age and sex and that in women of reproductive age plasma uric acid (PUA) levels are markedly lower than those of adult men of comparable age (Mikkelsen et al. 1965). The underlying cause for these
A case of a successfully treated solitary fibrous tumor (SFT) of the liver is reported. An 82-year-old female presented with left upper abdominal discomfort, a firm mass on palpation, and imaging studies revealed a large tumor, 15 cm in diameter, arising from the left lobe of the liver. A formal left hepatectomy was performed. Microscopic evaluation showed spindle and fibroblast-like cells within the collagenous stroma. Immunohistochemistry disclosed diffuse CD34 and positive vimentin, supporting the diagnosis of a benign SFT. The patient remained well 21 months after surgery. SFT of the liver is a very rare neoplasm of mesenchymal origin. In most cases it is a benign lesion, although some may have malignant histological features and recur locally or metastasize. With less than 30 reported cases in the literature, little can be said regarding its natural history or the benefits of adjuvant radiochemotherapy. Complete surgical resection remains the cornerstone of its treatment.
We conclude that the FEC2 regimen, in which epirubicin replaced the methotrexate in CMF, is the preferable adjuvant chemotherapy regimen for premenopausal patients with operable axillary node-positive breast cancer.
The data show that combined chemohormonal treatment reduces the risk of relapse in postmenopausal patients with node-positive breast cancer. No evidence was found, however, for an improvement in overall survival. The size of benefit observed for both outcomes was consistent with that reported in the Early Breast Cancer Trialists' Collaborative Group overview. The trial presented here, however, provides the first report of an improvement in RFS associated with the provision of a single cytotoxic drug in addition to prolonged TAM.
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