Introduction: There are many factors that determine the survival of patients with VSD. Among these include size of VSD, position, pulmonary hypertension, bacterial sepsis, valvular involvement, associated anomalies with VSD, associated syndromes and age at first diagnosis. There has been no published local data as far as we know and this information will be useful especially for consultation with parents. Even though VSD in general has a good prognosis, whenever they have added risks for example pulmonary hypertension then they are at risk of further morbidity and mortality. Objective: To determine the factors that are associated with survival of patients with VSD. Design: Retrospective cohort. Materials and methods: All cases of isolated VSDs admitted to HUSM from 1996 to 2003 were reviewed. Results: Univariate Cox regression of survival time of patients with VSDs revealed that 4 factors had prognostic significance namely bacterial sepsis (HR= 287.7, 95% CI 51.1, 1618.5, P < 0.001), Down syndrome (HR = 14.89, 95% CI 3.00, 73.92, P = 0.001), pulmonary hypertension (HR=14.58, 95% CI 1.69, 125.7, P=0.015) and large VSDs (HR=8.23, 95% CI 1.5, 45, P=0.015). Bacterial sepsis was the only significant prognostic factors for the survival of patients with VSDs using the multivariate Cox proportional hazard model. Conclusion: Bacterial sepsis, pulmonary hypertension, large VSD and Down syndrome were the significant prognostic factors from Univariate Cox analysis, however bacterial sepsis was the only significant prognostic factor from Multivariate Cox analysis.
Background: Astrocytic gliomas are the most common primary brain tumors that developed from glial origin.
The angiogenic cell population from brain tumor enhances the recruitment of circulating cancer stem cells
homing towards tumor site.
Objectives: This study aimed to investigate the tumor angiogenic cell population that stained with CD133+
and VEGFA+ markers and its association with circulating cancer stem cell (CD133+/VEGFR2-) population in the
peripheral blood mononuclear cells (PBMCs) of astrocytic glioma patients.
Methods: A total of 22 astrocytic glioma patients from Hospital Universiti Sains Malaysia who consented to
the study were included. Tumors (n=22) were sliced and stained with CD133+ and VEGFA+ angiogenic markers
and counter stained with DAPI. The circulating cancer stem cells (CD133+/VEGFR2-) in PBMCs (n=22) were
quantified using FACS based on the expression of CD133 and VEGFR2 markers. The paired t-test and Pearson
correlation were used for the data analysis.
Results: The percentage of angiogenic cell population was significantly higher in brain tumor compared to
adjacent normal brain tissue (1.25 ± 0.96% vs. 0.74 ± 0.68%; paired t-test=2.855; df=21, p = 0.009). Positive
correlation was found between the angiogenic cells of brain tumor tissue and adjacent normal brain tissue
(Pearson correlation, r = 0.53, p = 0.011). Significant positive correlation was found between angiogenic cells
in glioma tumor and cancer stem cells in peripheral circulating systems of astrocytic glioma patients (Pearson
correlation, r = 0.42, p = 0.049).
Conclusion: Angiogenic cells in the brain tumor resident promote the recruitment of circulating cancer stem cells
homing to the tumor site and induce the proliferation and growth of the tumor in astrocytic glioma patients.