Role of Krebs von den Lungen-6 (KL-6) in Assessing Hypersensitivity Pneumonitis / 결핵및호흡기질환

Background@#Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. @*Methods@#An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. @*Results@#The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. @*Conclusion@#The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.

Role of Krebs von den Lungen-6 (KL-6) in Assessing Hypersensitivity Pneumonitis / 결핵및호흡기질환

Background@#Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. @*Methods@#An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. @*Results@#The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. @*Conclusion@#The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.

Distribution of different metals in coastal waters of Alexandria, Egypt

Seasonal variation of some heavy metals [Fe, MN, Cu, Cd, Pb, Co, Ni, Cr, Sn and Al] are estimated at surface and bottom waters from 10 stations at near-shore, Alexandria coast during 2004. Salinity [16.20-39.10] and pH values [alkaline side] were also measured. The concentrations of heavy metals are at high levels in regions receiving different effluents from wastes of El-Mex region. A comparative study between the different stations was carried out to evaluate the effect of sewage, agricultural and industrial wastes discharged into some regions of Alexandria coast. Different statistical treatments were carried out to calculate the correlation coefficients between metals and the annual average variation

Some chemical and physical characteristics of Alexandria coastal water, Egypt

Seasonal collection of water samples were carried out at Alexandria coast from 18 selected stations during 2004 - 2005. The study area was divided into three sections A, B, and C. The study areas A and C are clearly affected by brackish polluted water discharge from El-Ammia, Rakta, Bughas, Umum, and Noubaria drains which were studied too. The hydrographic parameters [pH, DO, salinity, and OOM] were studied. This work aimed at evaluating some major ions level [average of 434.6 mg/l, 1.39 g/l, 3.11g/l, and 67.32 mg/l for Ca, Mg, SO[4], and Br in surface water and 449.12 mg/l, 1.48g/l, 3.42 g/l, and 75.68 mg/l in bottom water, respectively] in Alexandria coastal water and their chlorinity ratios relevant to the corresponding normal oceanic ones. The influence of dilution effect resulted from the discharge of different types and amount of land-based effluents was discussed. By all, the average chlorinity ratios of cations deviations from the respective oceanic values can detect as a resulting from the discharging of land -based effluents; [average of 0.074, 0.023, 0.004, and 0.172 for Mg/CI, Ca/CI, Br/CI and SO[4]/CI, respectively]. The correlation coefficients between the major cations and the hydrographic parameters were computed and discussed

Effect of the pattern of colonization of the maternal genital tract at the time of delivery on early onset neonatal sepsis

Early onset neonatal sepsis increases significantly in the presence of vaginal and cervical colonization with pathogenic organisms. The aim of this study was to study the effect of the pattern of colonization of the maternal genital tract at the time of delivery on early onset neonatal sepsis. A prospective clinical study was conducted in Cairo University Hospitals on 352 pregnant women coming for delivery and their newborns. Vaginal swabs were taken from the mothers before first vaginal examination [PV] and just before delivery. Surface swabs from the body of babies were taken. The neonates were clinically evaluated and prospectively followed up in the first week of their life for clinical evidence of sepsis and blood cultures were done for clinically septic neonates. Swabs were taken from different environmental sources in the Obstetric and Neonatology wards. Microbiological typing was conducted by biotyping and antibiogram to prove the similarity between microorganisms isolated from maternal or environmental sources and the corresponding neonates. Pulsed field gel electrophoresis was used for genotyping of phenotypically similar isolates. Microbiological similarity between culture results of mothers and their newborns was proven in 86% of cases. The correlation between clinical sepsis and microbiological agreement was also highly significant [p value=0.001]. Positive vaginal swab cultures were highly predictive of positive blood culture [p-value=0.09]. We found that, multiple vaginal examinations [more than 3 times] was the most frequent maternal risk factor of neonatal bacteremia [p-value=0.049]. Contamination of environment [gel and gloves] and equipment [suction sets] used for mothers and their babies during delivery was probably an important source of microorganisms. Maternal colonization and the contaminated environment were important risk factors for neonatal sepsis. Hence, limitation of PV and strict infection control measures should be followed in delivery room

Evaluation of nurses practices toward patients who undergo cardiac catheterization

To evaluate the nurse's practices and it's relationship between with thier demographic characteristic. A descriptive study was carried out, from January 15th 2002 to April 15th 2002, to evaluate the nurse's practices toward patients who undergo cardiac catheterization. A purposive sample of [65] nurse, was selected out of three teaching hospitals in Baghdad city. These nurses were worked at the catheterization units and catheterization labs. A questionnaire was constructed for the purpose of the study, which comprised of three major parts in which there were [45] items. Reliability and validity of the questionnaire were determined through the conduct of a pilot study. Data were collected through the use of the constructed questionnaire as an observational tool and the observation technique as means of data collection. Data were analyzed through the use of two statistical analysis approaches: 1 - Descriptive statistical analysis that included frequencies and percentages. 2 - Inferential statistical analysis that include mean of scores, Alpha correlation coefficient and Chi square. Findings of the study indicated that there were no significant associations between the nurse's practices toward patients who undergo cardiac catheterization and their educational level and the nurse's sex. The present study concluded that all staff nurse had performed almost an equal level of practices regardless to their sex and education and newly employed nurses had presented better practices that other. The study recommended that a well - formulated bill of standards should be created and presented to all sites in which such practices are performed. Special training programs should be designed and constructed for nurses in this area to reinforce their skills and promote their experience

protective effect of nigella sativa oil and the derived thymoquinone and nigellone against thioacetamide induced liver fibrosis in rats

The present study examined the effect of oral administration of Nigella saliva oil [NSO], thymoquinone [TQ], the main active principle of the volatile oil of NSO and nigellone [NG], the less toxic carbonyl polymer of TQ, on progress of thioacetamide [TAA] -induced liver fibrosis in rats. Sixty male albino rats weighing 150-200 g/rat were classified into 6 groups as follows: group I, [saline-control], group II [TAA-induced liver injury], group III [NSO-treated], group IV [TQ-treated], group V [NG-treated] and group VI [propylene glycol - treated]. NSO, TQ, NG and propylene glycol were given daily orally for 6 weeks starting with TAA administration. Propylene glycol was the vehicle of TQ and NG. TAA-injury [group II] caused a significant rise in the portal pressure and serum concentrations of tumor necrosis factor -alpha, transforming growth factor - beta[1] and malondialdehyde. Moreover, liver function tests [serum aspartate and alanine aminotransferases, alkaline phosphatase and gamma-glutamyl transferase activities and serum albumin concentration] were significantly impaired in group II as compared to group I. Liver tissues obtained from rats treated by TAA had higher hydroxyproline and lower reduced glutathione contents as compared to saline-control [group I]. Administration NSO, TQ or NG caused significant and similar protective effects against all TAA-induced haemodynamic and biochemical impairments. This study suggests that NSO, TQ and NG are significantly and probably equally effective against TAA-induced liver injury and fibrosis. Inhibition of synthesis and/or release of TNF-alpha and TGF-beta[1] as well as inhibition of tissue oxidative stress may be of particular importance

Distribution pattern of cancer and quality of data in Alexandria Cancer Registry

A Cancer Registry is an important informative source for cancer incidence. No population-based cancer registry is available in Egypt. Alexandria Cancer Registry [ACR] is a central hospital-based cancer registry located in the Department of Medical Statistics, Medical Research Institute, covering all the governorates. During 1972-2001, 76,028 cases were accessioned into the registry and stored on the computer using the [ICD-10] code. In males, there were 37,851 cancer cases; the urinary bladder accounted for 15.2% of all cancers, lymphatic and hematopoietic tissue were 19.3%, brain and nervous system were 9.2%, digestive system and peritoneum were 17.7%, respiratory system was 14.4%, oral cavity and pharynx were 5% skin was 2%, bones were 2.5%, soft tissue was 1.9%, and breast was 1.6%. In females there were 38,177 cancer cases; breast cancer accounted for 40.9%, urinary bladder was 3.4%, genital organs were 10% oral cavity and pharynx were 2.7%, lymphatic and hematopoietic tissues were 11.9%, brain and nervous system were 6.6%, digestive system and peritoneum were 10.3, skin was 1.1%, soft tissue was 1.6%, bones were 1.7%, and respiratory system was 3.3%. Incidence rates were calculated for total cancers and for each type of cancer separately in each year of the studied period

Predictors of microvascular complications in children and adolescents with type I diabetes mellitus

Diabetes mellitus is characterized by microangiopathy and increased angiogenic response. Several angiogenic factors are involved in vascular endothelial growth. This work was designed to study serum levels of angiogenic factors: vascular endothelial growth factor [VEGF], basic fibroblast growth factor [bFGF], angiogenin and transforming growth factor-beta 1 [TGF-beta1] and their relationship to metabolic control in children and adolescents with type I diabetes mellitus and to evaluate whether these angiogenic factors can predict and identify cases at greater risk to develop diabetic retinopathy or persistent microalbuminuria in a follow-up period of 12 months. The present study included 20 type I diabetic cases aged 6-18 years and 15 healthy controls. Diabetic cases were subjected to detailed history taking, clinical examination, fundus examination, electroretinography [ERG] and repeated estimation of glycosylated hemoglobin [HbA1C%] and fasting blood glucose in addition to urinary albumin excretion [UAE] ug/minute/1.73m[2] in repeated 24 hours collection of urine. These data were collected at the baseline [at the beginning of the study] and after 12 months follow-up period. Baseline investigations included the determination of blood urea, serum creatinine and assessment of serum angiogenic factors: VEGF, bFGF, angiogenin and TGF- beta1 by ELISA. At the beginning of the study, diabetic cases had significantly higher serum levels of VEGF, bFGF and angiogenin and significantly lower oscillatory potentials amplitude [Ops] than the control group. When diabetic cases were followed up for 12 months, 4/20 cases developed background retinopathy in fundus examination and 5/20 developed incipient nephropathy [persistent microalbuminuria] Development of microvascular complications was associated with significantly higher HbA1C%, serum VEGF, bFGF and angiogenin than uncomplicated cases. Furthermore, cases with diabetic retinopathy had significantly higher UAE and significantly lower baseline Ops than those without. Angiogenic factors as VEGF, bFGF and angiogenin and ERG examination could be used as predictors for identification of diabetic cases at high risk to develop diabetic retinopathy with a sensitivity of 75-100% and specificity of 81.25-93.75% and in prediction of incipient diabetic nephropathy with a sensitivity of 60-100% and a specificity of 86.67-93.33%. Angiogenic factors were correlated with HbA1C% and repeated blood glucose. The medical management of diabetes mellitus should be focused not only on metabolic control but also on measurement of angiogenic factors and ERG examination to predict cases at high risk of microvascular complications for early and more effective intervention that may include in the future antagonists to angiogenic factors

Antioxidant activity in hematological diseases in children

Several hematological diseases are accompanied by oxidant stress. The objective of this work was to study antioxidant status in children with some hematological diseases and to relate the results to metabolic alterations and complications of these diseases. Red blood cells glutathione content [GSH], glutathione-related enzymes, catalase, and superoxide dismutase [SOD], in addition to plasma total radical trapping antioxidant capacity [TRAP], and vitamins E and C in blood samples from 20 children with acute G-6-PD hemolytic anemia [favism] before transfusion, 20 with homozygous beta-thalassemia and 20 with acute lymphoblastic leukemia [ALL], in addition to 20 healthy children as controls. Children with favism as well as those with beta-thalassemia had significantly lower TRAP activity, GSH, catalase, vitamins E and C than the controls. Thalassemic cases had negative correlations between ferritin levels and vitamins E and C. On the other hand, leukemic cases showed TRAP activity that was not significantly different from the controls and increased activity of GSH peroxidase and reductase enzymes. It could be concluded that antioxidant defenses are not defective in ALL, however, a pronounced defect is present in cases with favism and beta-thalassemia major. Therefore, administration of antioxidants in addition to optimal iron chelation therapy may be warranted

Bond strength and candidal growth inhibition of the VLC soft liners in comparison to silicone and acrylic soft liners

The purpose of the present work was to compare bonding of the visible light-curved VLC soft liners to denture base resin with that of silicone and acrylic soft liners to denture base resin. Another purpose to study the effect of the studied soft lining materials on Candida albicans growth. Specimens were prepared from denture base resin bonded to the different denture soft liners. An Instron universal testing machine was used to measure the tensile failure of the different specimens. Other specimens from the different materials were prepared and were cultured with isolated Candida albicans. The percentage of growth inhibition of Candida albicans was compared. The results showed that the heat-cured silicone soft liner had the highest bonding values to denture base resin, followed by the two tested VLC soft liners. It was also shown that the self-cured acrylic soft liner had the highest inhibition values of Candida albicans growth while the silicone material had the lowest inhibition values of Candida albicans growth

Soluble vascular cell adhesion molecule - 1 [s. VCAM - 1] A marker of vascular dysfunction and progressive vascular diseases in diabetic patients

Advanced glycation endproducts [AGEs] which accumulate in diabetic vasculature results in enhanced expression of endothelial cell associated vascular cell adhesion molecule-1 [VCAM-1] as well as release of soluble form of VCAM-1 [s.VCAM-1] into culture supernatant. The present work was designed to study plasma s.VCAM-1 concentration in diabetic patients and its relation to microalbuminuria, to study the hypothesis that s.VCAM-1 in diabetic plasma might reflect early vascular perturbation in diabetic vasculopathy. Diabetic patients with microalbuminuria [patients at risk for vascular complication] had increased s.VCAM-1 when compared to diabetic patients without microalbuminuria [p < 0.05] and when compared to control [p < 0.05]. In conclusion, s.VCAM-1 can serve as a marker of ongoing vascular perturbation in diabetic patients and it may be of potential benefit in the assessment of success of therapeutic intervention intended to minimize vascular injury

Cytokeratin 20 [CK-20] a prognostic marker in TCC of the bladder

This immunohistochemical study has examined the degree and pattern of expression of a recently identified cytokeratin [CK-20] in 10 cases of normal bladder urothelium and 15 cases of TCC with well documented clinical course, using immunoperoxidase technique. In normal urothelium the expression of CK-20 was found to be differentiation related and confined to the superficial highly differentiated "umbrella" cells. Correlation of the expression of CK-20 with the clinical course in TCC of the bladder revealed that 85.71 of superficial bladder tumour with good outcome had retained a high degree of expression of CK-20: in the surface cell layer, whereas 80% of muscle invasive tumours, with aggressive clinical course, showed negative expression of the antigen. These observations suggest that the degree and pattern of expression of CK-20 is parallel to the outcome of the tunour. which may make CK-20 a useful prognositc marker in TCC of the bladder. There was another group which showed heterogenous pattern of expression of CK-20. This group was represented mainly by 3 cases of T1 tunours and who had one or more recurrences during the period of follow-up

Evaluation of prostate - related complaints by transrectal ultrasonography, digital rectal examination and prostatic specific antigen

120 male patients with mean age of 55.1 +/- 8.1 years [40 - 78 years] presented with symptoms of prostatism. Symptoms were quantified using the American Urological Association [A.U.A] symptom score. They were subjected to digital rectal examination [D. R. E], prostates specific antigen estimation [P. S. A] transrectal ultrasound [TRUS] and biopsy was obtained from suspicious lesions by the biopsy gun and examined for histopathology. The results were analysed statistically. The results showed three groups of echopattern, isoechoic [46.2%]: hyperechoic [6.7%] and hypoechoic [29.1]. DRE suspected 6 lesions to be malignant. All proved to be hypoechoic by TRUS and confirmed malignant histologically. Of all the hypoechoic lesions biopsy, 8 patients including the six patients suspected by DRE had prostatic carcinoma. Sensitivity of DRE in detection of prostatic carcinoma was 75%, PSA [100%] and TRUS [100%] Specificity reached 93.3% in DRE but decreased to 87.5% using PSA and 70.8% by TRUs

Independent evaluation of venogenic impotence by colour duplex sonography and dynamic cavernosometery cavernosography

In twenty four patients 30 to 59 years old [mean 44 years] with suspected vasculogenic erectile dysfunction diagnosed on the basis of repeated negative response to intracavernous papaverine [60 mg] injection. Colour duplex sonography [CDI] and dynamic cavernosometery / cavernosography [CVM] were performed to all patients. The results were analyzed and correlated. The maximum systolic velocity [V max] was 36.35 +/- 9.14 cm/sec, the end diastolic velocity [V min] was 8.47 +/- 5.33 cm/sec. and resistance index [R.I.] was 0.77 +/- 0.13. By colour duplex, three patients showed arterial insufficiency [A.I] the remaining 21 patients, 16 patients [66.6%] showed venous leakage and 5 patients [20.9] showed no leakage. By dynamic cavernosometery/cavernosography: 15 patients [62.5%] showed venous leakage and 9 patients [37.5%] no leakage. Complete agreement was reached between two modalities in 20 patients. Specificity of colour duplex is 83.3% and predictive value of positive test index was 93.7% but sensitivity of the test and predictive value of the negative test reached 100%. In conclusion, the end diastolic velocity [V min] can be used as screening procedure to exclude venous leakage

Endoscopic balloon dilatation of the prostate

28 patients who had symptoms of prostatism were treated by endoscopic balloon dilatation of the prostate [EBDP]. Their age ranges between 52 and 80 years [mean 66.5]. One month after dilatation 75% of patients demonstrated at least 25% improvement in subjective [symptom score] and 64.2% showed the same improvement in objective [Q max]. After 4 months the improvement in symptom score decreased to 71.4% and to 57.1% in Q max. Complications included mild bleeding, postoperative pain and urinary tract infection

Role of intravesical BCG for the treatment of superficial bladder cancer

A controlled trial was performed on 30 patients to evaluate the efficacy of intravesical Pasteur strain bacillus Calmetle-Guerin [BCG] administration as a prophylaxis against tumor recurrence after complete endoscopic resection of superficial bladder cancer. The treatment schedule consisting of 6 weeks course of BCG instillation 10 days after transurethral resection of bladder tumor [TURT]. Patients who were treated with BCG were significantly better as regards to tumor recurrence, the tumor free interval, stage and grade of the recurrent tumors is significantly better than the control group

Electrical conductance and ion pair formation of Co [III] complexes of acetylpyridinethiosemicarbazone halides in ethanol-water mixtures at 25C

The conductance of [III] complexes of acetylpyri-dinethiosemicarbazone halides were measured in ethanol-water mixtures covering a range of dielectric constant 24.33 < D < 78.54 at 25C. The conductance parameters derived from the Fuoss-Onsager conductance theory indicate that the solvation of these halides decreases with the decrease of the dielectric constant until a certain minimum and then increases again. The plots of log Ka vs. 1/D are not linear indicating that the solvent separated-ion pairs in these systems are characterized by strong hydrogen bonding

Aspergillus fumigatus a possible cause of nasal and frontal sinuses affections of dogs and man

A total of 53 stray dogs and 23 pet dogs as well as 17 owners were included in a study to find out the incidence of Aspergillus fumigatus in their nasal cavities. Aspergillus fumigatus was recovered from 40% and 61.11% of symptoms stray dogs and those showing nasal discharge respectively, while the respective values for pet dogs were 16.677% and 50%. Examination of the owners of pet dogs revealed an incidence of 16.67% for symptomless cases and 40% in those showing nasal discharges. It was concluded that the localization of Aspergillus fumigatus in the nasal cavities of a high percentage of both stray and pet dogs will definitely facilitate transmission of the mould to other dogs and man. Public health education is essential to give instruction on the hazardous nature of stray dogs. Also, periodical check-up of pet dogs is recommended

Occurrence of Microsporum gypseum in some Egyptian soil inhabited by animals

Ninety nine soil samples were collected from domestic as well as from zoo animals enclosures. M. gypseum was recovered from thirty three samples. The high rate of M. gypseum isolation was from yards inhabited by ponies, cattle and horses. The role of soil in playing a major part as reservoir of infection to animals was emphasized