Tamoxifen (Tam) is effective for the treatment and prevention of breast cancer. However, it has toxic drawbacks and has limitedduration utility because, over time, human tumours become refractory to Tam. Recently, a new nontoxic peptide, a-fetoproteinderived peptide (AFPep) has been proposed for the treatment and prevention of breast cancer. The purpose of this paper is to determine whether combining AFPep with Tam would increase efficacy and reduce toxicity in experimental models of breast cancer. Low doses of AFPep and Tam were more effective in combination than either agent alone against breast cancer growth in cell culture, in tumour-xenografted mice, and in carcinogen-exposed rats. a-Fetoprotein-derived peptide interfered with Tam-induced uterine hyperplasia in immature mice, and showed no toxic effects. Unlike Tam, AFPep did not inhibit binding of oestradiol (E 2 ) to oestrogen receptor (ER). Thus, these two agents utilise different mechanisms to interfere with ER functionality, yet work cooperatively to reduce breast cancer growth and alleviate Tam's troubling toxicity of uterine hyperplasia and appear to be a rational combination for the treatment of ER-positive breast cancer.
Objectives To determine the usefulness of creatine kinase (CK) alone or in combination with lactic dehydrogenase (LDH) in identifying, those infants at risk of developing hypoxic ischaemic encephalopathy (HIE) or a major handicap following perinatal asphyxia. Design Prospective observational study. Method CK and LDH in serum were measured in 35 asphyxiated infants and in 30 controls within 6 hours of delivery. The asphyxiated newborns were monitored for evidence of HIE. Both groups were followed up in paediatric outpatients clinic and a developmental assessment was done at the end of one year. Results Both the CK and LDH levels were significantly raised in all asphyxiated newborns. 25.7% of asphyxiated babies developed HIE. The CK and LDH values of those who developed HIE were significantly higher than the rest of the asphyxiated newborns. Five babies had developmental delay and their CK values too were significantly higher. The same relationship was not seen with their LDH values. Conclusion Both the CK and LDH values are raised in birth asphyxia. The increase is more marked among those who developed HIE. However, only the raised CK levels correlated with long-term outcome. Babies with CK values above 2860 IU/ L should be closely monitored for both the immediate and longterm sequelae.
A prospective hospital-based study of dengue haemorrhagic fever Recently a retrospective study was done on sus pected cases of dengue haemorrhagic fever (DHF) admit ted to the Lady Ridgeway Hospital (LRH) during 1996 (1). To verify the findings of the above study a prospective study was carried out on suspected cases of DHF admit ted to a paediatric unit at LRH during 1999. The objective was to study the clinical, laboratory, radiological and se rological diagnosis of DHF.
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