Relation between hypercholesterolaemia and vascular endothelial microinflammation

We investigated the correlation between hypercholesterolaemia and oxidative stress and P-selectin and interleukin-6 [IL-6] as markers for endothelial status. We studied 40 Egyptian adults with asymptomatic hypercholesterolaemia and 20 age- and sex-matched controls. Lipid peroxidation was significantly higher [P < 0.001] in the study group and positively correlated with cholesterol [P < 0.001] and low-density lipoprotein [LDL] [P < 0.002]. Glutathione peroxidase activity was also significantly higher [P < 0.001] with positive correlation with cholesterol [P < 0.001] and LDL [P < 0.001]. Markers for endothelial cell function were significantly higher in the study group [P < 0.001] with a positive correlation with cholesterol [P < 0.001] and LDL [P < 0.001]. Hypercholesterolaemia causes endothelial microinflammation, and P-selectin and IL-6 may also be risk factors for cardiovascular disease

Regulation of cell adhesion by heparan sulfate proteoglycan in adenomatoid odontogenic tumour

During recent years, attention was drawn to the role of cell adhesion in tumour development and progression. Cell-cell and cell-extracellular matrix interaction is crucial with regard to tumorous transformation and tumour spreading. There are numerous data indicating that the expression of syndecan-1 an important transmembrane proteoglycan undergoes changes during the development of several tumours. CD 138 antibody reacts with the core protein of syndecan-1, cell surface integral membrane heparin sulfate and chondroitin sulfate containing proteoglycan that binds to interstitial extracellular matrix molecules, thereby regulating cell adhesion. The predominant location of syndecan-1 is on epithelial cells where its expression correlates with normal epithelial organization. Previous studies have demonstrated that decreased expression of CD 138 is linked to malignant progression. Hitherto, few studies on the expression of CD138 in odontogenic tumours have been published and no studies have been found regarding the expression of this marker in adenomatoid odontogenic tumour [AOT]. Therefore, this study was carried out to highlight the recent concepts of cell adhesion in tumour development and progression in AOT using CD 138 monoclonal antibody. In respect to this, formalin-fixed, paraffinembedded tissue sections of 7 cases of AOT were selected in an attempt to clarify the peculiar histopathological features of this lesion. All studied cases showed positive reaction to the marker used, however differences were observed among the studied cases regarding areas of immunoreactivity and optical density of the positive areas. Overexpressions of CD138 were observed as cytoplasmic immunoreactivity especially in the spindle cells bordering the sheets and masses of the polyhedral cells and in the scanty stromal cells. The duct like structures and masses of polyhedral cells showed negative reactions. The results of the present study explain why AOT is a benign non-aggressive lesion

Correlations of cell proliferation and transformation with histopathological features of adenomatoid odontogenic tumour

Recently, 2 highly related and widely expressed molecules, CREB- binding protein [CBP] and p300, have emerged as important cofactors for a broad number of transcription factors. The p300 gene is a potential tumour suppressor and its expression increases during progression from late Gl into M phase of the cell cycle. p300 transcriptional coactivators are also targeted by oncogenic viruses. p300 is involved in cell growth, transformation and development and has an important role in regulation of cell proliferation. However, many questions regarding its role in transcriptional regulation remain unanswered and no study until now was found describing the immunoreactivity of this novel marker in adenomatoid odontogenic tumour [AOT]. Therefore, this study was carried out to highlight the recent concepts of cell transformation and proliferation in AOT using p300 monoclonal antibody. In respect to this, 7 cases of AOT were selected in an attempt to clarify the peculiar his-topathological features of this lesion. All studied cases showed positive reaction to the marker used, however differences were observed regarding areas of immunoreactivity and optical density of the positive areas among studied cases. Overexpression of p300 was observed as nuclear immunoreactivity especially in the rounded or polyhedral cells forming the masses and sheets of odontogenic epithelial cells, also in the columnar cells lining the duct like structures. Conversely, the flat or spindle cells showed negative immunoreactivity. Invasion of the connective tissue capsule by slender of tumor cells was observed in some cases. The results of the present study suggest that the neoplastic cells in AOT may be represented by the population of rounded or polyhedral cells and the cells forming the duct like structures. Therefore, AOT should be regarded as a true neoplasm and not hamartomatous in nature as sometimes previously thought

Male slings for postprostatectomy urinary incontinence

Incontinence after prostatectomy for benign or malignant disease is a well-known and often feared outcome. The objective of this study was to evaluate the role of bulbourethral slings in the treatment of post prostatectomy incontinence, as being a fast, less expensive and reliable method in comparison to other modalities. This study was conducted on 40 patients in the period from May 2003 till October 2005 [median 12 months], who have underwent prostatectomy, and have established total or severe stress incontinence after a period of at least 6 months postoperatively. All patients included in the study were subjected to full history taking, physical examination, laboratory preoperative investigations, radiological study in the form of ascending urethrocystography, micturating films, and Urodynamic study including uroflowmetry, filling cystometry and pressure flow study, urethral pressure profile and estimation of the abdominal leak point pressure. EMG was done for all patients. Uretherocystoscopy was used to exclude anastomotic or urethral stricture. All patients underwent sling operation and were divided into two groups. In Group 1 Slings were applied by a perineal approach and in Group 2 Slings were applied by a combined abdomino-perineal approach using synthetic material or rectus sheath: Exclusion criteria included; urethral strictures, vesical causes including atonic bladder causing urinary retention with overflow, or overactive bladder due to either a neurogenic cause or infection leading to bladder irritability and uninhibited bladder contractions. A total of 40 patients 50 to 78 years old [median 68 years] underwent male sling placement. The mean operative time was 45 minutes without confrontation with intraoperative complications. Postoperative complication rate was 42.5%. This rate can be further divided according to the fate of complications into permanent [irreversible] being about 5% of the total complications and 37.5% of the total complication being temporary [reversible]. The total cure rate in the study was an average of 67.5.% and the total improvement rate was an average of 12.5%, giving a mean cure/ improvement value of 80%. The overall failure rate was 20% of patients involved. The male bulbourethral sling is a quick, safe, simple and effective option in the treatment of postprostatectomy incontinence, and considered to be an alternative to other methods such as artificial urinary sphincter, periurethral injection. Yet longer follow up and further experience will be needed to establish its long-term efficacy

Reamed intramedullary interlocking nail for open tibial shaft fractures: friend or foe

Thirty seven open fractures of the tibial shaft were treated with reamed intramedullary Interlocking nailing in 37 patients. All patients had a minimum of one year follow-up. The Internal ftxation was indicated because of a factor related either to the patient or to the fracture. There were 29 male patients and 8 female patients. Their mean age was 34 years [range, 18-55 years]. All cases were unilateral, 14 on left and 23 on right side. Most of the fractures were the result of high-energy trauma. There were 22 fractures [59.45%] Grade I and 15 fractures [40.55%] Grade II open fractures. Non were Grade III open fracture. There was no associated neurovascular injury. Mean time for fractures union was 25.2 weeks. It was 21.4 weeks for Grade I fractures and 29.5 weeks for Grade II fractures. Satisfactory results were gained in 32 fractures [86.4%]. Non union complicated 3 fractures and mal-union complicated 2 fractures. Infection occurred in 3 fractures, one superficial and 2 deep. Compartment syndrome was recorded in 2 fractures. No implant failure was recorded. From this study, it was observed that reamed locking intramedullary nailing could be safe and effective method for management of open tibial shaft fractures Grade I and II. It provided adequate stabilization of the fractures through bone-nail surface contact with low complication rate

proinflammatory cytokines in pneumonic children

Pneumonia continues to be a major cause of morbidity and mortality among infants and children. Aspects of the host response to infection such as the release of cytokines may be contributing to the high morbidity and mortality of the disease. Serum levels of the pro-inflammatory cytokines: Tumor necrosis factor [TNF alpha and Interleukin-beta [IL-I beta] were measured in 63 infants and children with pneumonia; out of them 31 patients had severe pneumonia necessitating ICU admission [18 non ventilated and 13 ventilated patients]. Twenty healthy infants and children with comparable age and sex were taken as a control group A significantly high mean serum levels of both cytokines were found in all studied patients compared to control [p< 0.001]. A highly significant positive correlation was detected between serum and bronchoalveolar lavage [BAL] fluid levels of both TNF alpha and IL-1 beta among ICU ventilated patients [r = 0.81, P<0.01 and 0.67, P< 0.01 consecutively] .A significant correlation was found between IL-l beta and body temperature on admission [r =0.74, p< 0.01] Serum TNF alpha levels correlated with both severity of pneumonia and the outcome [p < 0.001]. A significantly higher serum TNF alpha levels were detected in ICU pneumonia patients, compared to the non ICU patients group [p < 0.001] .Also the mean serum levels of TNF alpha of non survivors were significantly higher than that of survivors [P < 0.001] .No correlation was found between IL-1 beta and the severity or the outcome of pneumonia [p > 0.05]. In conclusion, IL-1 beta appeared to be associated with the severity of fever, while TNF alpha may be a marker of severity and out come of pneumonia

Diagnostic modalities of childhood urinary tract infection: clinical versus imaging

Seventy six infants and children with febrile urinary tract infection [UTI] were studied aiming at investigating the most reliable imaging approach for febrile UTI and to evaluate the reliability of clinical and laboratory diagnosis of acute pyelonephritis [APN] versus imaging diagnosis using renal scan with dimercaptosuccinic acid labeled with technetium 99m [99mTc-DMSA] as standard reference. Positive radiological findings were documented in 36 out of the 76 studied patients [47.37%]. Out of the 76 studied patients APN was confirmed in 28 patients [36.84%] by 99mTc-DMSA scanning. Renal ulrasonography [US] detected upper urinary tract abnormalities in 19.74% [15/76] of patients, all of them had DMSA positive scan for APN. Micturating cystourethrography [MCUG] demonstrated vesicoureteral reflux [VUR] in 23.68% [18/76] patients. Positive DMSA scan for APN was documented in 61.11% [11/18] of patients with VUR. The sensitivity of US compared to 99mTc-DMSA scan for detection of acute renal pa-renchymal changes was 53.57%, the specificity was 100% and the accuracy was 76.79%. Compared to 99mTc-DMSA scan, clinical and laboratory diagnosis of APN had a sensitivity of 67.85%, specificity of 72.92% and accuracy of 70.39%. In conclusion: the diagnosis of APN among infants and children with febrile UTI based on clinical and laboratory observations is insufficient and requires imaging studies. The three imaging modalities chosen are complementary and are needed for establishing a diagnostic approach for childhood UTI. The results of this study also emphasize the value of 99mTc-DMSA scintigraphy in the initial evaluation of febrile UTI

Posterior arthrodesis with short segment transpedicular fixation for thoracolumbar burst fractures

12 patients who had a burst fracture of thoracolumber spine were managed with the use of short segment transpedicular fixation. The patients were followed up for an average period of 24 months. 12 months after the operation, the rods were removed and the fusion mass was inspected. All 12 patients had a solid fusion at all levels of the arthrodesis at the latest follow-up examination, with good range of spinal movement for segments in which fusion had not been intended. Before operation the average anterior height of the fractured vertebra was 59.5% of the estimated height before injury, this improved after the operation to 82.7%. At the latest follow-up examination, the anterior height was average 75.75% of the estimated height before the injury. Kyphosis of the injured segment before the operation was measured for the 12 patients averaged 24 degrees, as a result of the operation, this improved an average of 7 degrees of kyphosis. At the latest evaluation the average kyphosis of the injured segment was 15 degrees. Although, the anatomical results as seen on the recent radiographs were superior, at the latest follow up evaluation some loss of spinal alignment was noted

Profiles of platelet volume distributions in normal and in sickle cell disease children

Profiles of platelet volume distributions and platelet count were evaluated in 171 normal infants and children, 37 patients with sickle cell disease [SCD] and 44 patients with sickle cell trait [SCT] . SCD group of patients showed significant increase in MPV and PDW, while no significant changes were detected in PC and PCT when compared with the control group. Patients with SCT showed only significant increase in MPV when compared with the control group. Yet, there was no significant difference between SCT and SCD groups of patients except for the increased PDW in SCD patients. It was also noticed that SCD patients during the vaso-occlusive crisis had a significant increase in MPV when compared with those during the hemolytic crisis [P < 0.05]. ..[MPV: mean platelet volume, PC: platelet count, PCT: plateletcrit and PDW: platelet distribution width]

Growth pattern in cardiac patients in relation to somatomedin and growth hormone levels

General patterns of growth as well as serum levels of Growth hormone[GH] and Somatomedin-C [Sm-C] were assessed in 25 healthy infants and children and in 58 patients with heart diseases [25 with rheumatic heart disease, 18 with congenital acyanotic heart disease and 15 with congenital cyanotic heart disease]. Obvious growth retardation of variable degrees was present in cardiac patients being more pronounced in congenital heart disease patients, mostly the cyanotic types. A highly significant lower serum levels of both GH and Sm were detected in cardiac patients compared to control. There was no significant difference between the serum levels of GH in the three studied groups of patients, while a highly significant difference in the serum levels of Sm existed between them. A significant lower serum levels of GH and Sm were encountered in patients below the 10th percentile, compared to those above the 10th percentile. The results of this work point to the endocrinal contribution in the development of growth retardation in cardiac patients, as suggested by the low levels of GH and Sm found in cardiac patients