Cryptococcal pneumonia: the great mimicker

Cryptococcal pneumonia is a fungal infection caused by Cryptococcus neoformans predominantly in immunosuppressed individuals and rarely in the immunocompetent population. In this study, we describe the varied radiological presentations in three patients, both immunosuppressed and immunocompetent individuals. The varied imaging presentations pose a great challenge for the radiologist and the clinician. The imaging findings mimic other diseases and it might make the diagnosis difficult purely on radiological features alone. Hence, image-guided biopsies and further evaluation are essential for confirmation of diagnosis.

The salubrious effect of tamoxifen [correction of Tamaxifen] on serum marker enzymes, glycoproteins, and lysosomal enzymes level in breast cancer woman

Tumour markers correlate strongly with prognosis based on tumour burden and surgical resectability. If chemotherapy is extremely effective in certain stage of the disease, the sensitive marker may be of great use in monitoring disease response and drug treatment. Hence, this study was launched to evaluate the changes in tumour marker enzymes like lactate dehydrogenase (LDH), glutamate oxaloacetate transaminase (SGOT), glutamate pyruvate transaminase (SGPT), alkaline phosphatase, and acid phosphatase in before and after 3 and 6 months tamoxifen treated breast cancer patients. In addition, the changes in serum glycoproteins viz., hexose, hexosamine, and sialic acid and lysosomal enzymes such as N-acetyl-beta-D-glucosaminidase, beta-D-galactosidase, and beta-D-glucuronidase were analysed in these patients. These values were compared with their age matched healthy control subjects. At 6 months evaluation, the tamoxifen treated postmenopausal breast cancer women showed a statistically significant decreased (p < 0.001, 0.05 respectively) levels of LDH, SGOT, SGPT, alkaline and acid phosphatases than their baseline values. Similarly, the levels of hexose, hexosamine, and sialic acid and N-acetyl-beta-D-glucosaminidase, beta-D-galactosidase, and beta-D-glucuronidase were decreased significantly (p < 0.001) in tamoxifen received postmenopausal women. The result of this study suggested that tamoxifen potentially retard the metastasis of breast cancer as well as the bone demineralisation in postmenopausal breast cancer women. Thus, tamoxifen may also have its antitumour activity through its beneficial effects on tumour marker enzymes and serum proteins in breast cancer women.

Alpha-tocopherol ameliorates cyclophosphamide-induced hyperlipidemia in fibrosarcoma-bearing rats

Cyclophosphamide, an alkylating agent, is currently being used for the treatment of various types of cancer, either alone or in combination with other cytostatic drugs. However, cyclophosphamide has a detrimental effect on lipid metabolism and causes hyperlipidemia in patients. Since alpha-tocopherol is known to reduce hyperlipidemia, we have investigated the effects of adding alpha-tocopherol to the cyclophosphamide treatment. Our study, carried out on fibrosarcoma-bearing rats, shows that alpha-tocopherol markedly reduces cyclophosphamide-induced hyperlipidemia and brings lipid metabolism down to values observed in untreated controls.

Plasma lipids and lipoprotein alterations in tamoxifen-treated breast cancer women in relation to the menopausal status

Plasma lipids and lipoprotein profiles were monitored in 72 postmenopausal and 29 premenopausal breast cancer women who were treated with tamoxifen (20 mg twice a day) for 6 months. The levels of total and free cholesterol and LDL cholesterol were markedly (P < 0.001 for each) decreased in 3 and 6 month tamoxifen-treated postmenopausal women than the baseline values of untreated breast cancer patients. On the contrary, plasma ester cholesterol, triglycerides, VLDL and HDL cholesterol levels were increased significantly in these patients. In the case of premenopausal women the lipid lowering potential of tamoxifen was markedly retarded. These results indicated that tamoxifen - treatment was more beneficial and estrogenic in postmenopausal women's lipids. In premenopausal breast cancer women, tamoxifen was antiestrogenic and less beneficial. Hence, the difference in plasma lipids and lipoprotein content was no greater among those receiving tamoxifen and baseline values of premeno - pausal women. These results indicate that tamoxifen-treatment has a more beneficial effect in postmenopausal women, with a likely reduction in cardiovascular disease, than in premenopausal subjects.