Effect of some antihypertensive drugs on serum creatinine and tubulointerstitial index in adenine induced nephropathy in rats

The progression of chronic kidney disease [CKD] is more than just a simple, creeping loss of kidney function finally resulting in end-stage renal disease [ESRD]. The present study was intended to study the potential renoprotective effect of ramipril [angiotensin-converting enzyme inhibitors -ACEI] and valsartan [angiotensin receptor-1 blocker- ATI blacker] on adenine-induced nephropathy in rats. Also, to study the possible effect of combination of above mentioned drugs. Seventy- six male albino rats were used through out the study in Clinical Pharmacology Department, Mansoara University. Twelve rats were taken as negative control without any manipulation. Sixty four male albino rats were given adenine diet [I50mg] in 0.5 ml saline by gavage feeding once daily for 10 days to confirm induction of adenine-induced nephrotoxicity. Sixteen rats died during induction. Rats that survived, started treatment and divided into two main groups: animals in each group were classified into 4 subgroups [each contain 6 rats], each of them took the test drugs once daily by stomach tube for 4 weeks Group I: started treatment after 2 weeks from administration of adenine and Group II: started treatment after 4 weeks from administration of adenine. The sera were taken for measurement of creatinine. The kidneys are rapidly dissected and put in formalin containing bottles and taken for pathological examination by H and E and special stains that included PAS and trichrome stains. Administration of each of -amipril, ualsartan and combination of both ramipril and valsartan showed that they produced highly significant reduction of the mean serum creatinine level [p<0.01, p<0.001, p<0.001] respectively as compared with the positive control. There was non-significant decrease of tubulointerstitial index when comparing ramipril treated group, valsartan treated group, and ramipril plus vaisartafi treated group, versus positive control group. We concluded that adenine induced nephropathy is important model in elucidating tubulointerstitial injury and coincident with chronic renal insufficiency. Drugs under the study play some degree of renoprotectin

Diagnostic approach of primary salivary clear cell tumors: histopathological and immunohistochemical study

It is becoming increasingly evident that primary clear cell tumors [not variants of other known salivary tumors] represent a heterogeneous group of neoplasms. This group had been referred to clear cell carcinoma, clear cell epithelialmyoepithelial carcinoma and clear cell myoepithelial carcinoma. This work aims to study the histopathological criteria for diagnosis of primary salivary clear cell tumors and to investigate immunohistochemically their interrelationship with regard to myoepithelial differentiation 110 cases of salivary tumors were identified in the files at pathology department, Mansoura faculty of medicine through the period from 2000 to 2006. These cases were reviewed, and sixteen cases with clear cell features were rulled and evaluated further. Seven out of the sixteen cases were clear cell variants of oncocytoma, mucoepidermioid carcinoma, acinic cell carcinoma and were rulled out. The remaining nine cases could be classified as primary salivary clear cell tumors including 5 clear cell carcinomas, 3 epithelial-myoepithelial carcinomas, and 1 clear cell myoepithelial carcinoma. Histochemical [periodic acid-Schiff, with and without diastase treatment] and immunohistochemical studies were performed on formalin-fixed, paraffin-embedded sections using the labeled streptavidin-biotin-peroxidase complex to asses reactivity for S100, alpha smooth muscle actin, and broad spectrum cytokeratin. Six men and three women aged 30 to 62 years with mean age 46 yrs were participated in the study, and most presented with a painless mass. The parotid gland was the most common site [n = 7]. Clear cell carcinoma show positive staining for cytokeratin in all the studied cases [100%] and none of the cases show reactivity for smooth muscle actin confirming the epithelial origin of these tumors. Two out of five cases of CCC showed positive staining for S-100. Epithellal-myoepithelial carcinomas express S-100 and smooth muscle actin in the clear cell and the bimodal cell population with a ductal pattern was confirmed by cytokeratin cocktail immunohistochemistry thus confirming the myoepithelial nature of the tumors. Clear cell myoepithelial carcinoma show reactivity to cytokeratin, alpha smooth muscle actin and S-100. We concluded that there is no definitive immunohistochemical evidence of myoepithelial differentiation in clear cell carcinoma, indicating that it is probably morphogenetically distinct from epithelialmyoepithelial carcinomas and clear cell myoepithelial carcinoma, both tumors with diagnostically requisite myoepithelial differentiation

Histopathological study of precancerous epithelial lesions of esophagus

Barrett's esophagus is premalignant for adenocarcinoma of the esophagus and esophagogastric junction. In 1998, the American College of Gastroenterology defined Barrett's esophagus as a change in the esophageal epithelium of any length that can be recognized at endoscopy and is confirmed to have intestinal metaplasia by biopsy of the esophagus. Metaplasia is followed by a series of histopathological changes, namely dysplasia, carcinoma in situ and finally leading to the development of adenocarcinoma. Dysplastic squamous epithelium is frequently found adjacent to the cancer and prospective follow up studies, particularly in areas of high incidence, have documented the progression of dysplasia to carcinoma. The aim of this work is to study histological types and grades of esophageal precancerous epithelial lesions. The study included seventy [70] cases of precancerous esophageal lesions diagnosed by endoscopic biopsy, at the pathology department of Gasroenterolgy Center, Mansoura University, in the period between January 1996 and December 2005. Sixty seven [67] cases of esophageal carcinoma, diagnosed by surgical resected specimens, were also studied during the same period to assess the presence or absence of associated precancerous lesions namely Barrett esophagus, squamous or glandular dysplasia. The paraffin blocks were sectioned at 4-5 microns and stained by Haematoxyline and Eosin for diagnosis of Barrett's esophagus, detection of dysplasia and its grades. Alcian blue stain at PH 2.5 was employed for staining of cases of Barrett's esophagus to confirm the diagnosis by staining acid mucins in the Goblet cells. Periodic acid Schiff was used to stain neutral mucins and the brush border of intestinal absorptive cells. Cases with squamous dysplasia were diagnosed and its grades were assessed. In cases of esophageal carcinoma, diagnosis of tumor type using the WHO classification [2000] was done. The presence or absence of associated Barrett esophagus, squamous or glandular dysplasia was evaluated. Results of the endoscopic biopsies: This study included seventy [70] cases of precancerous esophageal lesions. Forty six cases were Barrett's esophagus and twenty four cases were squamous dysplasia. In the 46 cases of Barrett's esophagus, Seven cases [15.23%] showed complete intestinal metaplasia in the form of goblet cells and non secretory absorptive cells and thirty five cases [76.08%] showed incomplete intestinal metaplasia diagnosed by PAS positive mucin in the columner cells. Four cases [8.69%] showed mixture of complete and incomplete intestinal metaplsia. Both Barrett's esophagus and squamous dysplasia showed male predilection as male to female ratio was 1.9:1 and 1.4:1 respectively. The age range for Barrett's esophagus was 23-63 years with a mean age of 45.41 +/- 8.94 For squamous dysplasia, the age ranged from 32 to 65 years with a mean age of 48.88 +/- 12.88. 21 cases of Barrett's esophagus were negative for dysplasia with a percentage of 45.65% while 6 cases were indefinite for dysplasia [13.04%]. Low grade dysplasia was diagnosed in 10 cases [21.73%], high grade dysplasia in 7 cases [15.23%] and intramucosal carcinoma in 2 cases [4.35%]. Nine cases of squamous dysplasia wore of moderate grade [37.50%] while eight cases [33.33%] were of severe grade. Five cases [20.83%] were of mild grade. Carcinoma in situ was diagnosed in two cases. Results of the resected specimens: Squamous cell carcinoma had the highest incidence with a percentage of 53.73% [36 cases], while adenocarcioma represented 38.82% [26 cases] of the total number of cases. 53.85% [14 cases] of the adenocarcinomas in the study were associated with Barrett's esophagus and 46.15% [12 cases] were not. Squamous dysplasia was found in 61.11% [22 cases] of the squamous cell carcinoma cases, while 38.89% [14 cases] of squamous cell carcinoma was not associated with squamous dysplasia. The diagnosis of precancerous Lesions of the esophagus is of utmost importance as cancer esophagus is characterized by poor prognosis but it is curable in its earliest stages. Successful early detection strategies require identification of precancerous lesions that can be targets for screening and treatment