Human myometrial interstitial cajal like cell [Telocyte] in preterm and full term labour: histological and immunohistochemical studies

Introduction: Preterm labour is a common obstetric problem. The human myometrium is formed of two types of cells namely smooth muscles and interstitial Cajal like cells or telocytes which express both estrogen and progesterone receptors

Aim of the work: This study aimed to know how many telocytes are present in the pregnant uteri at time of labour in the different gestational ages and the possible role of telocytes in preterm labour

Patients and methods: 10 pregnant women were included in the study planned to do cesarean section. They were divided into two groups: Group I: included 5 cases whose gestational age was less than 37 weeks [preterm]. Group II: included 5 cases whose gestational age was more than 37 weeks [full term]. Specimens were obtained from the myometrium at the time of the operation and processed for histological and immunohistochemical study

Results: H and E stained sections revealed hypertrophied smooth muscle fibers with different orientations. Methylene blue stain revealed telocytes between the smooth muscle fibers as a branched cell with small cell body and thin long processes. CD 117 [ckit] immunostaining revealed an apparent increase in the number of telocytes in preterm cases [Group I] compared to full term cases [Group II]. Morphometric study revealed a significant increase in the number of ckit positive telocytes in preterm cases compared to the full term one

Conclusion: Telocytes are present in the pregnant uteri at different gestational ages with a significant increase in their number in the preterm cases; they may have a possible role in preterm labour

relevance of Ki-67 and COX-2 immunoexpression in right-sided versus left-sided sporadic cancer colon in Egyptian patients

Cancer colon is one of the most common malignancies in Egypt. There are growing amount of data suggesting that carcinomas of the right and left colon should be considered as different tumor entities. Difference in tumor proliferation rates has been used as a prognostic tool. Ki-67 is a proliferation-associated nuclear and nucleolar protein antigen, which is expressed in all cycling cells, and it is an important marker to determine the degree of tumor malignance and invasion ability. Cyclooxygenase-2 [COX-2] is an important key enzyme required for the synthesis of prostaglandins, with high level seen in many cancers including colon cancer. A total of 167 colectomy specimens were reviewed during the period of 1 year. Fifty cases from the originally viewed 167 cases were chosen; 25 cases from the right-side colon and 25 from the left-side colon of comparable stages and grades. Each case was stained immunohistochemically for Ki-67 and COX-2 antibodies. The results of Ki-67 immunostaining showed that the difference between the right and left cases was significant [P < 0.05] in addition to the results of COX-2 immunostaining. We suggest that right and left cancer colon may be two different entities with possible different risk factors and different pathogenesis, and hence each may require different treatment polices as well. COX-2 expression in right-side tumors more than in left-side tumors may provide a chance for right-side cancers to benefit from COX-2 inhibitor therapy

Factors affecting the production of lactulose by Lactobacillus acidophilus NRRL 4495 β-galactosidase and its biological activity

Aim: Production of lactulose and other oligosaccharides by Lactobacillus acidophilus NRRL 4495 β-galactosidase and their biological activity. Methodology and Results: The transgalactosylation activity of Lactobacillus acidophilus NRRL 4495 β-galactosidase was investigated under different conditions for synthesis of lactulose and oligosaccharides. The synthesis was optimized with respect to pH; time; enzyme concentration and substrates ratio (lactose: fructose). Maximum production for lactulose was found to be 25 g/L at pH 6.6 with 40: 20% (w/v) lactose to fructose, respectively and enzyme concentration 4 IU/mL after 7 h. With respect to the other oligosaccharides the maximum yield (19 .68 g/L) was obtained under the same conditions but with enzyme concentration 2 IU/mL and after 10 h. As a new pharmaceutical application the produced lactulose and oligosaccharide and their sulfated derivative were found to have fibrinolytic activity, but they failed to act as anticoagulant. Conclusion significance and impact of study: the research leads to increase the production of lactulose and other oligosaccharides with a significant yield and discovered a new pharmaceutical application for all the products.

Isolated antral inverted L- shaped tube with vascularized pedicle for reconstruction of bismuth type iv bile duct injuries. A live animal experimental study

Surgical repair of hilar biliary injuries is difficult and remains a challenge which requires specific skills and experience. The aim of this study is to improve the outcome of surgical repair of type IV Bismuth BDI in situations in which there is extensive tissue loss by introducing the novel technique of isolated L-shaped tube of biliary reconstruction. This technique is tested in a live animal experimental study. Twenty mongrel dogs underwent biliary reconstruction using antral tube harvested and completely separated from the greater curvature of the stomach with its blood supply based upon right gastroepiploic vessels. The tube was anastmosed to LHD by end to end anastmosis then to RHD by end to side anastmosis then to duodenum. Postoperative mortality, morbidity, liver functions, gross and microscopic histologic pictures were assessed. One dog died from anaesthetic complication and another three dogs died due to abdominal sepsis. Sixteen dogs survived the procedure and showed uneventful course with no cholestasis. The mean internal diameter at the site of anastmosis with pedicled antral tube was 2.1 mm [range 2-3] for RHD, 3.2 mm [range 3-5] for LHD and 6.5 mm [range 5-7.5] for duodenum. Histologically, anastomotic sites showed good evidence of healing. In mongrel dogs surgical repair of Bismuth type IV bile duct injuries using isolated antral inverted L-shaped tube with a vzscularized pedicle is feasible and produces satisfactory results regarding biliary complications, anastomotic circumference and histological evidence of healing

Endobronchial ultrasonography for lung cancer staging in negative mediastinum on computed tomography

Lung cancer is the most common cause of cancer -related deaths. Chest CT scan is fre-quently unreliable in staging mediastinal lymph node metastases of lung cancer, since interpretation relies on lesion size. EBUS offers a unique way of imaging and parabronchial structures. The pro-cedure is safe, minimally invasive and does not require general anesthesia or hospitalization. The complication rate is extremely low. This study was conducted on eleven patients who were found without CT evidence of enlarged mediastinal lymph nodes. Bronchoscopy and EBUS were performed for the diagnosis of lung cancer. TBLB of detected mediastinal lymph nodes was performed. CT guided biopsies were done for non-diagnosed cases. In this study bronchogenic carcinoma was diagnosed by bronchoscopic biopsy in 6 cases [54.5%], by EBUS-TBNA in 2 cases [18.2%], and by CT guided biopsy in 3 cases [27.3%]. From the eleven patients with negative CT scan, EBUS of mediastinal L.N was positive in four cases [36.4%]. The first case showed 2 small subcarinal L.N station [7] and 2 right hilar lymph node stations[10R]. In the second case EBUS detected 2 subcarinal lymph node stations [7] and one left hilar station [10L] In the third case there was one subcarinal lymph node station [7]. The fourth case showed a left hilar lymph node station [10L]. EBUS is safe and minimally invasive technique in the detection of mediastinal lymph metastasis. EBUS in combination with conventional radiologic tools may contribute to improve diagnosis and staging of lung cancer

Effect of smoking on skin elastic fibers: a morphometric and immunohistochemical analysis

Tobacco smoking is one of the major health problems in the world. This study was conducted to investigate the morphological changes of the dermal elastic tissue of sun-protected skin induced by smoking. Punch biopsies were obtained from the nonexposed skin of 15 smokers and 15 nonsmokers to evaluate the dermal elastic fibers using morphometric analysis and immunohistochemical techniques. Elastic fibers of the reticular dermis were more numerous, thickened and fragmented in smokers than in nonsmokers. Correlations between the cumulative tobacco dose and the morphology of the elastic fibers were highly significant. Immunohistochemical analysis for alpha-1-antitrypsin showed negative cytoplasmic staining for all samples of both smokers and nonsmokers. This study indicates that smoking is one of the risk factors that lead to an increase in elastic fibers of the reticular dermis. This increase is due to elastic tissue degradation rather than by new synthesis, as in solar elastosis. Furthermore, smoking has multiplicative effects on facial ageing and could share, at least in part, a pathophysiological pathway

Clinical utility of interferon-gamma compared to ADA in tuberculous pleural effusion

Tuberculosis [TB], the single most frequent infectious cause of death worldwide, also is a major cause of pleural effusion, which in TB usually has lymphocytic and exudative characteristics. Differential diagnosis between TB and nontuberculous pleural effusion can be sometimes difficult, representing a critically important clinical problem. To evaluate the clinical utility of pleural IFN-gamma level in pleural fluid for diagnosing tuberculous pleuritis. The study was conducted in kasr El-Aini hospital, Cairo University in the period from January 2011 to January 2012. It was carried on 40 patients. The patients included in the study were classified into group I [included 20 cases with tuberculous pleural effusion] and group II [included 20 cases with non tuberculous pleural effusion]. All patients were subjected for complete history taking and clinical examination, chest X-rays PA and lateral views, pleural fluid aspiration and analysis. Our results demonstrate that the pleural fluid concentrations of ADA, INF-gamma in patients with tuberculous pleural effusions are significantly higher than in other effusions. Most importantly, ROC analysis clearly demonstrated ADA to be more sensitive and specific than INF-gamma for diagnosis of tuberculous pleuritis

Diagnostic value of adenosine deaminase in tuberculous and malignant pleural effusion

Tuberculous pleural effusion [TPE] is a common problem for differential diagnosis from malignant effusion [MPE] in epidemic areas of tuberculosis [TB]. Prediction based on adenosine deaminase [ADA] is dependent on age as well as the tuberculosis incidence. To estimate the value of cutoff point of ADA in MPE and TPE and to evaluate its role in differential diagnosis in Egypt a country with high incidence of TB. The study was conducted in Kaser El-Aini Hospital, Cairo University in the period from April 2011 to January 2012. It was carried on 30 patients. We retrospectively analyzed 30 patients with a definitive diagnosis of TPE [n= 19] and MPE [n= 11]. The optimal cutoff value of ADA was determined using the receiver operating characteristic [ROC] curve. There was a statistically significant difference according to the levels of pleural fluid ADA between TPE and MPE groups. Confirm that ADA is a very useful parameter for the differential diagnosis of TPE and MPE, specifically in younger with a higher incidence of tuberculosis

Protective effects and its relative mechanisms of low dose ionizing radiation on pancreatic cells of male diabetic rat's

Diabetes mellitus [DM] is a chronic metabolic disorder brings great danger to human health. Low-dose-rate radiation modulates various biological responses including carcinogenesis, immunological responses and diabetes. This study examined the effect of low doses of irradiation on the pathological and ultrastructural progression of type I diabetes in rats inducted by Streptozotocin. The present study was done on 80 healthy adult albino male rats 9 weeks age, in the weight range from [150-200 gm]. Rats were grouped to 4 groups they were cared according to the Guiding Principle in the Care and Use of Animals. Diabetes was induced by a single intraperitoneal injection of freshly prepared Streptozotocin [STZ- 45 mg/kg b.w.]. Whole body gamma irradiation was performed using Caesium -137. Animals were exposed to fractionated dose levels of 0.5 Gy/week of gamma-radiation for 3 and 6 weeks. The body weight, blood glucose and insulin levels were measured after 3 and 6 weeks. Small blocks of pancreatic tissues of different groups were removed and prepared for pathological and ultrastructure examination. An elevated level of glucose and decreased level of insulin in blood were first detected at 3 and 6 weeks of age in the STZ treated rats. There was significant and remarkable tendency of gaining normal levels of both blood glucose and blood insulin by irradiation exposure especially after 6 weeks of irradiation. Both suppression of cell death and cellular injury induced by STZ were also observed by EM examination in 3 week and 6 weeks. The present results indicated that treatment with 0.5 Gy gamma rays suppresses progression of type I diabetes in STZ rats

relevance of image analysis in differentiating computed tomography guided fine needle aspiration biopsy of lung adenocarcinoma versus pleural mesothelioma in Egypt

Mesothelioma is a very serious illness that can have dangerous, long-term health effects. Catching the disease early on is often the best way to combat it, knowing the signs and process for diagnosis of the disease can help make it easier. Mesothelioma can be difficult to diagnose. This is because there are many different types of cells that can make up a mesothelioma tumor. Sometimes it can be very difficult for a pathologist to diagnose pleural mesothelioma as it can look like other types of lung cancer. The differentiation of mesothelioma and lung adenocarcinoma can be challenging, as proper classification is essential for determination of treatment regimen for these diseases. The present work aim to clarify if the use of image analysis can replace the more expensive immunohistochemical technique in differentiating lung adenocarcinoma from malignant mesothelioma [epithelial type] of the pleura. In our study we investigated computed tomography guided fine needle biopsy [CT-guided FNA] from 20 cases of pleural mesothelioma and 20 cases of lung adenocarcinoma. The pleural mesothelioma cases were confirmed by specific immunohistochemical panel then were investigated by image analysis. These data showed insignificant variation [p value <0.05] in the nuclear area and cell area in pleural mesotheliomas and lung adenocarcinomas. From the cytological morphology, the malignant pleural mesothelioma in fine needle aspiration has somehow a special pattern for arrangement with nuclear crowding then those of the peripheral lung adenocarcinoma. The results were not significant enough for the substitution of immunohistochemistry technique by image analysis on cytological specimens yet it may give different results when applied on tissue specimen which need further investigation

Histopathological, morphometric and quantitative study on the effect of garlic against PCBs-induced hepatic toxicity in rats

Olychlorinated biphenyls [PCBs] are widespread persistent residual environmental contaminants, which have been widely used for various industrial applications. The present study was designed to investigate the potential protective effect of garlic against the hepatic toxicity of PCBs in rats. Four groups of animals were used in this study [control, garlic, PCBs and PCBs plus gartic] for 15 days. Histopathological and histochemical changes in the liver were investigated. In addition, nuclear area, nuclear volume, the ratio of nuclear volume/cellular volume and fibrotic areas were measured in the liver. Histopathological and histochemical observations showed severe damage in the liver. Garlic co-treatment to the PCBs-administered rats attenuated the increase of the mean values of nuclear area, nuclear volume, the ratio of nuclear volume/cellular volume and fibrotic area. Also, the morphological damage in the liver was reduced and the tissues appeared more or less normal. The present study suggests that garlic may be useful in combating damage due to PCBs toxicity

Transvaginal uterine artery ligation: a possible alternative treatment modality for the symptomatic fibroids

To determine the efficacy of Transvaginal Uterine Artery Ligationfor the management of symptomatic fibroids. 19 women, aged from 33 to 46 years, with symptomatic, single uterine fibroid, not exceeding 14 weeks, were recruited. Objective measurement of menstrual blood loss [MBL] by the alkaline hematin technique [Hallberg, et al, 1966], and ultrasonographic measurement of the fibroid volumes were determined preoperatively and at 3, 6 and 12 month post operative follow up. Improvement of the presenting symptoms -was observed during follow up. There was a significant decrease in the sonographic myoma volume at 3 month [P> 0.05], 6 months [P> 0.01], and 12 month [P> 0.01] postoperatively. The MBL was significantly lower in the postoperative follow up, when compared with the preoperative levels; at 3 month [P< 0.05], 6 month [P< 0.01], and 12 month [P< 0.01]. Rise in hemoglobin concentration was observed at 3 month postoperative [P>0.05]. Statistically significant higher hemoglobin concentrations were observed at 6 and 12 month postoperatively [P< 0.05]. There were no cases of ureteric injury, and none needed a second procedure. Transvaginal uterine artery ligation could be considered a possible, simple, alternative treatment modality for the symptomatic fibroids

Evaluation of non-mesh versus mesh repair of primary adult inguinal hernia

Inguinal hernia is the most frequently performed operation. Consequently, failure of inguinal hernia repair has a great impact on society and leads to increased patient discomfort, reoperations and considerable economic burden. The aim of this study was to compare the result of repair of primary inguinal hernia using mesh with the usually performed Bassini repair. Between April 2004 and November 2008, 200 patients with unilateral primary inguinal hernia were entered into the: study patients were distributed into 2 groups A and B. In group A patients, Bassini repair was preformed. In group B mesh repair was preformed. The patients were followed up during their hospital stay and every 6 month for 2 years. The main follow up variables were operating time, duration of hospital stay, postoperative pain, complications, return to normal activities and recurrence rate. Only 81 patient have received follow up examinations. In group B no recurrence occurred [0% versus 4.7%]. Although the mean operating time was longer in group B [56.5 versus 43.7 minutes], the mean duration of hospital stay was shorter [21.8 versus 25.6 hours], postoperative pain and complications were less and return to normal activities was earlier [12.3 versus 23.1 day] than in group A. Mesh inguinal hernia repair is superior to the usually preformed Bassini repair and should be adopted as standard treatment of all adult primary inguinal hernia

Diagnosis and management of small bowel and mesentery injury following blunt abdominal trauma in 12 cases

Over four years [April 2004 to December 2008] 12 patients with blunt small bowel and mesenteric injuries were treated at three hospitals dealing with trauma. Ten cases were victims of traffic accidents, of whom 70% wore seat belts. There were 11 small bowel injuries [4 full-thickness and 7 seromuscular] and 9 mesenteric injuries [3 with and 6 without a de-vascularized bowel segment]. All were managed initially following the Advanced Trauma Life Support [ATLS] guidelines. Emergency room ultrasound was positive for blood in 5/7 cases [71%] and CT scan in 2/4 [50%]. Diagnostic peritoneal lavage [DPL] was performed in one case and was positive for blood

Cardiovascular autonomic function tests in healthy and diabetic subjects

Diabetic autonomic neuropathy [DAN] is common chronic complications of diabetes mellitus [DM] that occur in nearly half of diabetic patients. DAN in patients with diabetes is an irreversible complication, but early detection is important because the condition can't be reversed. The present study was undertaken primarily to investigate cardiovascular autonomic functions in normal healthy individuals and patients with diabetes mellitus [type 1 and type 2 diabetes mellitus; T1DM and T2DM], and to determine the relationship between diabetes and extent of autonomic function impairment. Autonomic functions using five standard tests were examined in 40 diabetic patients and 40 age and sex matched controls. The extent of autonomic dysfunction was determined in the patients. All the patients and the controls were subjected to measurement of heart rate [HR] and P-R interval were monitored from lead II of the ECG and BP was measured by electrosphygmomanometry. Significant [p <0.001] increase in resting heart rate in T2DM [112 +/- 10 bpm] than T1DM [65 +/- 12 bpm] associated with significant decrease in HR variation daring deep breathing T2DM [8 +/- 3 bpm] compared to T1DM [18 +/- 5 bpm], significant decrease in HR response to standing in T2DM [0.7 +/- 0.2 bpm] compared to T1DM [1.06 +/- 0.2 bpm], significant decrease in postural changes in SBP in T2DM [-15 +/- 3 mmHg] compared to T1DM [-3 +/- 8 bpm] and significant decrease in DBP response to hand grip inT2DM [6 +/- l mmHg] compared to T1DM [20 +/- 7 mmHg] within 2-5 years of both types of DM. Moreover, no significant difference between T1DM and T2DM in cardiovascular autonomic function tests after 5 years of DM. Autonomic dysfunction was significantly more frequent in type 2 diabetes mellitus [T1DM] compared with type 1 diabetes mellitus [T2DM]. This study showed that autonomic neuropathy is common in diabetic patients, and that it increases in severity with increase in extent of T2DM, and starts after 5 years in T1DM suggesting that diabetes mellitus contributes to these neurological derangements

Age-related changes in carotid vascular responses to noradrenaline and nitric oxide synthase inhibitor

The aim of the present work was to study whether age alters the constrictor responses evoked by the sympathetic transmitter Noradrenaline in the carotid circulation in the rat. Another aim was to test whether age changes the influence of tonically synthetised nitric oxide [NO] on arterial blood pressure [ABP] and on carotid circulation. Further, to investigate the effect of NO synthesis inhibition on carotid vascular responses euoted by noradrenaline in three age groups of rats. In anaesthetised rats aged 4-5, 10-12 and 42-44 weeks [young, mature, middle-aged respectively], carotid blood flow [CBF] and carotid vascular conductance [CVC] were recorded during infusion of noradrenaline [2.5/micro g.kg[-1]], before and after a bolus dose of the nitric oxide synthase inhibitor L-NAME [10mg.kg[-1]]. In mature and middle-aged rats, noradrenaline infusion increased mean ABP to 180mmHg, but only to 150mmHg in young rats. Concomitantly, CVC decreased more in mature and middle-aged, than in young rats: CBF remained constant in young, but decreased in mature and middle-aged rats. NO synthase inhibition produced similar increases in baseline ABP in all groups, but decreased CVC and CBF more in mature and middle-aged rats. Following NO inhibition, noradrenaline infusion increased ABP to similar levels as before in young and mature rats, but to higher levels in middle-aged rats. Further, CVC fell in young and mature, but not in middle-aged rats, in whom CBF increased with ABP.Thus, in young rats there was a weak noradrenaline-evoked pressor response and decrease in CVC. By contrast, in mature and middle-aged rats, noradrenaline evoked a strong pressor response and decrease in CVC. In young and mature rats, NO seems not to limit the noradrenaline-evoked increases in ABP or decreases in CVC. However, by middle age NO limits noradrenaline-evoked pressor response and prevents breakthrough of CBF Autoregulation. The three age groups showed good autoregulatory response of carotid circulation during a pressor response induced by noradrenaline. However, the constrictor responses evoked by noradrenaline is weak in youngs before the age of sexual maturity. On the other hand, by middle-age and well before old age, the constrictor influences of noradrenaline in carotid circulation have begun to weaken. Moreover, by middle age, the dilator influence of NO helps to prevent breakthrough of Autoregulation of CBF at the upper end of the range

Use of endoglin [CD 105] as a marker for diagnosis and prognosis of prostatic cancer

To determine serum endoglin [CD 105] levels in cases of prostatic cancer and benign prostate hyperplasia Also, to evaluate its role in the diagnosis and prognosis of prostate cancer. This study included 70 patients and 12 normal control individuals. Measurement of serum PSA was performed for cases of prostate cancer and benign prostatic hyperplasia [BPH] while measurement of serum endoglin was performed for all patients and control individuals. These cases were classified into 3 groups. Group I included 42 patients with prostate cancer, the criteria for diagnosis were digital rectal examination [DRE] of irregular abnormal hard nodule/ nodules in the prostate or PSA > 4 ng /ml. The diagnosis wits confirmed by trans- rectal ultrasouand [TRUS] biopsy. According to Gleason's score, these patients were further classified into Grade II and III. Group II included 28 patients with benign prostatic hyperplasia [BPH].Group III included 12 healthy men as control group. Serum CD 105 concentration was estimated by using human endolin ELISA kit. There was a significant difference in PSA levels prostate cancer [mean 32.4 +/- 30.85 ng/ml] BPH [mean 2.84 +/- 1.67 ng/ml]. The mean values of CD 105 were 5.29, 2.12 and 0.15 ne/ml in group I, II and III [controls], respectively. The mean value of CD 105 in each group was significantly different from the other groups. In group I. the mean value of CD 105 of' grade III was 7.5 ng/ml and was significantly higher than that [4.89 ng/ml] of grade II prostate cancer. There was a significant correlation between CD 105 and PSA levels in prostate cancer. It was found that the cut of serum endoglin was 2.65 ng/ml for diagnosis of cancer prostate. Endoglin [CD105] has a critical role in the diagnosis and prognosis of cases of prostate cancer and it can be used as a marker for diagnosis of these cases

relationship between HLA-DR and prostate cancer

To determine the etiologie relationship between HLA class II [DR] and cancer prostate and its pattern on B lymphocytes of patients with prostate cancer patients and normal individuals by using INNO-LiPA technique. Thirty patients having cancer prostate were included whatever the age of patients, grade or stage of the disease and before any medical or surgical intervention and 60 normal persons. All the patients passed within the planned program such as complete history taking with clinical examination including digital rectal examination [DRE]. Laboratory investigations as complete blood picture, hepatic and renal function tests, serum prostatic specific antigen [PSA] and HLA typing for prostate cancer patients and healthy controls. Imaging tests as chest X-ray, abdomino-pelvic ultrasound and transrectal ultrasound [TRUS]. Histopathological examination of prostatic biopsy guided by TRUS. Our results revealed that the antigen of HLA-DRB4 was found in 10 patients [33.3%] with a relative risk of 1.4. X[2] of 0.16 and p value of 0.053 compared to [26.7%] of control group which is statistically significant. The antigen HLA-DRB-0406 was found in 4 patients [13.3%] with relative risk of 4.9, X[2] of 4.6 and p value of 0.044 compared to 3% of control group which is statistically significant. The antigen HLA-DRB1-0410 was found in I patients [6.7%] with a relative risk of 3.5, of 5.97 and p value of 0.043 compared to 2% of control group which is statistically significant. The antigen HLA-DRB 1405 was found in 2 patients [6.7%] with a relative risk of 2.7. X[2] of 5.03 and p value of 0.041 compared to 2.7% of control group which is statistically significant. HLA typing showed that HLA-DR alleles frequency in prostate cancer patients compared with normal persons is high. Beside its role as a risk factor for acquiring the disease, it could be used as a marker for early detection, to determine the biological behavior and activity of the tumor, prognostic marker and in choice of the appropriate line of treatment

Importance of inflammatory cytokines and endothelial peptides in predicting hypertensive left ventricular hypertrophy

Although it has been hypothesized that hypertension in part is an inflammatory disorder, the link between inflammation and endothelial disorders with hypertensive complications as left ventricle hypertrophy [LVH] is still marginal. This study was designed to investigate the role of inflammatory markers as interleukin-6 [IL-6], high sensitivity C reactive protein [Hs-CRP], endothelial peptides as endothelin-1 [EDN -1] and nitric oxide [NO] as well as serum lipid profile in predicting LVH. It also focused on the pathophysiological responsibility of inflammation and endothelial dysfunction in developing hypertensive LYH. To examine these hypotheses forty hypertensive patients were enrolled and divided by using echocardiography into hypertensive patients with normal left ventricular mass [Group I] and hypertensive patients with LVH [Group II]. Ten normotensive subjects were also included and considered as control group [C]. ELISA technique was used for measuring plasma concentrations of IL-6, Hs-CRP, EDN-1 by special kits, while serum NO and lipid profile were measured by spectrophotometer. Both hypertensive groups were relatively matched with each other regarding age, gender, body surface area and body mass index [BMI], however they were significantly greater than control. Serum levels of IL-6, Hs-CRP and END-1, were significantly higher and those of NO were significantly lower in both hypertensive groups compared to normotensives. Moreover, these changes were more obvious in hypertensive patients with LVK Additionally, estimation of serum lipid profile showed that levels of total cholesterol triglycerides, and low density lipoproteins [LDL-C] were significantly elevated and that of high density lipoproteins [HDL-C] were significantly reduced in group [II] compared to other groups. Among both hypertensive patients, LY mass index was significantly positively correlated with serum levels of IL-6, Hs-CRP, EDN-1, cholesterol, triglyceride, LDL-C and significantly negatively correlated with HDL-C hut not with age and NO levels. However, the slope of these relations was steeper in the hypertensive group with LVH. Besides, levels of IL-6 and EDN-1 were the most predictors [r= 0.849, P<0.0001, r= 0.889, P<0.0001 respectively] for LYH. The inflammatory markers are significantly increased in hypertensive patients with LVH. Increased EDN-l and lowered NO are also concerned to a greater extent in hypertensive LYH and this confirms a key pathophysiological role of inflammation and endothelium dysfunction in developing and progression of hypertension and LVH which is vital for recommending prophylactic and therapeutic strategies

Comparative study of different surgical modalities for treatment of sacrococcygeal pilonidal sinus

Pilonidal sinus disease of the natal cleft is a painful debilitating condition which often recurs despite different surgical procedures. In this thesis, the outcome of different methods for treatment of this disease are described and compared. A review of sixty patients were randomized into three groups. Group A were operated upon by sinus excision and leaving the resultant cavity to heal by granulation tissue. Group B were operated by excision with primary closure in natal cleft. Group C were operated by excision with oblique closure by z-plasty. Recurrence was highest in group B [25%] followed by group A [15%] and no recurrence occurred in group C. The mean satisfaction grading was 5, 2 in group A, 7.1 in group B and 9.3 in group c. Excision of pilonidal sinus and oblique closure by z-plasty offers improved patient satisfaction and no recurrence rate