الفهرس 
Types of muscle fibresOnly 14 pages are availabe for public view
 |  | from | 92 |  |  |
| | | from | 92 | | |
Abstract
study muscle changes i n d i f f e r e n t types of malignancies with s i g n s and symptoms of muscle a f f e c t i o n . Twenty cases of d i f f e r e n t malignancies were t h e s u b j e c t of t h i s s t u d y , they were diagnosed c l i n i c a l l y and v e r i f i e d p a t h o l o g i c a l l y . The c a s e s which showed any c l i n i c a l m e t a s t a s i s o r r e c e i v i n g r a d i o t h e r a p y or cytot o x i c drugs were excluded from t h i s study. I n t r a m u s c u l a r i n j e c t i o n s were p r o h i b i t e d f o r at l e a s t one week b e f o r e t a k i n g blood samples. Ten normal p e r s o n s se~veda s norma l c o n t r o l s i n t h i s study f o r l a b o r a t o r y i n v e s t i g a t i o n s . A l l cases were s u b j e c t e d t o complete medical and n e u r o l o g i c a l examination as well as l a b o r a t o r y i n v e s t igations i n c l u d i n g c r e a t i n e phosphokinase (CPK) , serum myoglobin and a l d o l a s e . Muscle b i o p s i e s were taken from t h e most a f f e c t e d p a r t of t h e muscle,(the muscles were selected as having weakness, wasting and/or p a i n , t e n d e r n e s s ) . These b i o p s i e s were s t a i n e d by Haemat o x y l i n and Eosin s t a i n s f o r h i s t o p a t h o l o g i c a l . exami.nation. It was concluded t h a t (90%) of c a s e s ranged i n age from 4 1-60 years with male predominance (65%).Most of t h e c a s e s (75%) were c l i n i c a l l y diagnosed a s myopathy while o t h e r s 25% were diagnosed as m y o s i t i s . The cases which were diagnosed as myositis had c r i t e r i a of muscle ;pain o r t e n d e r n e s s , a r t h r i t i s , rheumatic l i k e pain and neck muscle weakness, However no cutaneus f e a t u r e o r Raynaud Is phenomenon were observed. Most of t h e c a s e s (80%) showed a s u b a c u t e o n s e t with slowly p r o g r e s s i v e course, t h e weakness of the. muscle w a s more proximal i n t h e shoulder and p e l v i c g i r d l e . Most of t h e c a s e s which were diagnosed as myopathy showed a gradual onset (95%) and slowly p r o g r e s s i v e course, t h e weakness w a s more proximal and t h e limb g i r d l e muscles were p r i m a r i l y a f f e c t e d with diminished tendon r e f l e x e s . The case of bronchogenic carcinoma and t h a t of cancer ovary which were diagnosed c l i n i c a l l y as m y o s i t i s were t h e only two c a s e s which showed i n t e r s t i t i a l and p e r i v a s c u l a r c e l l u l a r i n f i l t e r a t e c o n s i s t i n g of monon u c l e a r inflammatory c e l l s . Most of t h e c a s e s (85%) showed nuclear changes (more observed i n cancer. ovary and cancer l a r y n x ) . Change i n diameter and l o s s of s t r i a t i o n was found i n a l l c a s e s and even were more observed i n cancer head of pancreas and bronchogenic carcinoma, Necrotic changes were seen i n 30% of cases and more observed i n cancer ovary and post c r i c o i d carcinoma and b a s o p h i l i c f i b r e s were seen i n 10% of cases and even more ,observed i n cancer colon and l a r y n x , The mean value of serum a l d o l a s e a c t i v i t y was ( 1 . 6 U/L -+ .1), i t d i d not show any s i g n i f i c a n t r i s e (P > .05). The mean val!le of CPK enzyme 21.85 U/L +- 2.63) , t h i s d i d not show any s i g n i f i c a n t rise (P) .05). The mean value of serum myoglobin a c t i v i t y was (102.5 U.~/L 2 11.74), denoting s i g n i f i c a n t r i s e b (P <.005). Thus it can be concluded t h a t serum myoglobin is t h e most sens$tive enzyme f o r muscular changes i n malignancies. 80% of t h e c a s e s which were diagnosed c l i n i c a l l y as m y o s i t i s , showed s i g n i f i c a n t r i s e i n serum myoglobin.The two cases which were v e r i f ied,pathologically t o have myosit is showed s i g n i f i c a n t r i s e i n serum myoglobin. T h i s denotes p o s i t i v e c o r r e l a t i o n between c l i n i c a l and p a t h o l o g i c a l s t a t u s with t h e r i s e i n t h e enzymatic a c t i v i t y of serum myoglobin.