Functional and prognostic relevance of -173 G/C gene polymorphism of macrophage migration inhibitory factor in sepsis patients in Egyptian intensive care units

This study aimed to evaluate the association of plasma MIF level and -173 G/C single nucleotide polymorphism of the MIF gene with the occurrence, severity and mortality of sepsis patients. A study was conducted in adult surgical intensive care units of Zagazig University Hospitals, Egypt on 25 patients with sepsis, 27 with severe sepsis and 28 controls. Gram-negative bacilli were the most common isolates in both severe sepsis [63.0%] and sepsis [56.0%] patients. A highly statistically significant difference was found in MIF levels between sepsis cases and controls and a statistically significant difference as regards MIF level in different genotypes of the studied groups. MIF level was significantly associated with mortality in sepsis cases. High MIF levels and MIF -173G/C gene polymorphism are powerful predictors of the severity of sepsis and its outcome

Role of MRI in characterization of occult breast lesions in high risk population

To evaluate the diagnostic validity of breast MRI in discriminating benign from malignant lesions in women with occult breast lesions who are at a high risk of developing breast cancer, with histopathologic findings and/or follow up used as the reference standard. Contrast-enhanced bilateral breast MRI was performed on 100 women at high risk of developing breast cancer with indeterminate imaging findings by mammography and/or ultrasonography. Lesions detected by MRI that could represent potential malignancies in both breasts were evaluated. Morphologic assessment and kinetic analysis [contrast enhancement and time/intensity curves] were performed on each lesion using dedicated postprocessing and display software. Functional MR tools were used in about 60% of cases to help in the differential diagnosis between malignant and benign of suspicious lesions detected at conventional MRI. Among 100 patients included in the study12% of the patients were finally diagnosed as free of any pathology, 56% had benign findings, while 31% of the patients were malignant. [24 IDC, 4 Invasive Lobular Carcinoma, 1 Medullary carcinoma, 1 Mucinous carcinoma and 1 DCIS.] The sensitivity, specificity, positive and negative predictive values of CE-MRI, were 100%, 93%, 86%, and 100% respectively. Overall accuracy of MRI breast was 95%. Breast MRI is highly effective in detection and characterization of occult breast lesions in high risk population, with excellent sensitivity and high specificity. Development of functional MRI tools contributed to the improving validity of this modality

Neonatal hepatitis: clinico-pathologic study with an attempt to set a histologic activity prognostic index

Neonatal hepatitis encompasses a variety of cholestatic disorders having different underlying etiologies with varied prognoses. The aim of this work is to do a clinico-pathologic study of neonatal hepatitis cases with an attempt to set a histological activity index that might give an idea about the possible outcome of the disease irrespective of the underlying etiology. The study included 36 neonatal hepatitis patients who presented to Pediatric Hepatology unit Cairo University Children's Hospital. Analysis of data included thorough history, clinical examination, laboratory findings, liver biopsies and follow up. A scheme was proposed for grading the histological activity in liver biopsy done at presentation using lobular disarray, giant cell tans formation, cholestasis, portal tract mononuclear inflammatory cellular infiltrate, Kupffer cell hyperplasia, porto-portal necroinflammatory bridging and extramedullary hematopoiesis. Staging was based on the degree of fibrosis. Twenty cases showed complete cure by clinical and laboratory follow up findings; [Group with favorable outcome], whereas 16 cases either died or severely deteriorated during follow up; [Group with unfavorable outcome]. At the onset of the disease, there was no statistically significant difference in the clinical picture and laboratory findings between the group with favorable outcome and the group with the unfavorable outcome. Kupffer call hyperplasia was statistically significantly higher in the group with favorable outcome than in the group with unfavorable outcome. Other histologic parameters did not show statistically significant difference, between the two groups. Findings in this study revealed that Kupffer cell hyperplasia, by Logistic Regression Analysis; is the only predictor for improvement of neonatal hepatitis. Other parameters used in this study did not show statistically significant difference between the two groups. Further studies to determine the exact cytokines secreted by the Kupffer cells might provide more insight into the pathogenesis, prognosis and possible future therapeutic intervention

Relation between cytotoxin producing Helicobacter pylori and Helicobacter pylorielated upper gastrointestinal disease

Helicobacter pylori [H. pylori], a major aetiological agent in gastritis, peptic ulcer and gastric cancer, is estimated to infect more than 50% of the world's population. However, only about 10% will develop peptic ulcer disease and 1 - 2% gastric malignancy. Virulent strains carrying the cag A gene and vac A s1 genotype and capable of cytotoxin production have been proposed to be associating with the severer forms or disease, although this was not universal. We were interested in studying the relation between cytotoxin-producing H. pylori strains and the H. pylori-related upper gastrointestinal disease in our community. Sixty patients were allocated into 3 predefined groups according to their endoscopic picture: gastroesophageal reflux disease [GERD], peptic ulcer disease, and gastritis groups. Gastric biopsies from the patients were examined for the presence of H. pylori by urease test and culture. The isolated H. pylori strains were subjected to cytotoxic assay to detect cytotoxin-producing strains. Forty-one patients [68.3%] were H. pylori positive, of them 19 [46.3%] were positive for cytotoxin production. Cytotoxin-producing H. pylori strains significantly associated peptic ulcer disease where 73.3% of peptic ulcer patients were infected with cytotoxin-producing strains. GERD was significantly associated with absence of H. pylori infection [66.7% of GERD patients were free of H. pylori infection]. The presence of gastritis did not correlate with the H. pylori status, however, there was a significant association between cytotoxin-producing strains and atrophic gastritis. Cytotoxin-producing H. pylori strains are associated with severer H. pylori-related upper gastrointestinal diseases such as atrophic gastritis and peptic ulcer disease. Our findings support the hypothesis of cag A [+] H. pylori being protective against GERD. Determination of cag A status of H. pylori strains bears importance in clinical practice in detecting patients at increased risk for developing gastric cancer and in helping planning treatment strategies

relation between liver iron overload and hepatocellular carcinoma in patients with viral C cirrhosis

Fifty patients with histologically proven cirrhosis and positive antibodies for CV were included in this study and classified into two groups: The first group consisted of 18 patients with HCC on top of cirrhosis and the second one included 32 cirrhotic patients [HCC free] as controls. Hepatic iron was evaluated using a semiquantitative method in liver biopsies from all patients. Iron deposits were assessed using three different scores [hepatocytic iron score [0- 36], sinusoidal iron score [0-12] and portal iron score [0-12]]. The total iron score [0-60] was defined by the sum of these three scores

Assessment of antenatal care in an urban area

In this study, a full history of pregnancy was taken as well as any other complications during previous pregnancies if they were present. The condition of the newborn, cause or causes for incubation and the place where ANC had been run were recorded. A questionnaire was presented to all women for data collection. Medical records supplied information about gestation at delivery and causes for incubation. The results reflected the effect of certain parameters on delivery outcome stressing that the very basic routine of ANC was very important, but it was neglected by both service providers and patients. The lack of some laboratory investigations such as complete blood count [CBC] and Hb% was striking. The effect of the level of maternal and paternal education on the ANC attendance was obvious

Role of interferon gamma in pathogenesis of allergic nasal polyps in children

Nasal polyposis is a chronic inflammatory disease of the nasal mucosa with inflammatory cell, [especially neutrophil], infiltration and structural modifications of the epithelium [secretory hyperplasia and squamous metaplasia] and lamina propria [basement membrane thickening, extracellular matrix accumulation, and fibrosis]. The etiology of nasal polyosis in the pediatric population is unclear. The pathophysiological mechanisms of formation and growth of nasal polyps remain poorly understood. Nasal polyps were evaluated for distribution and levels of interferon gamma [IFN gamma] in specimens from 30 children with nasal polyposis and 10 controls. Immunohistochemical study revealed IFN gamma staining of eosinophils and epithelium [27 of 30 patients]. ELISA analysis showed elevated INF gamma levels in nasal polyp[NP] tissues 40.5 +/- 8.20 pg/mg total protein [TP] compared with controls [15.2 +/- 4.5 pg/mg TP]. Three groups were identified based on IFN gamma levels: low IFN g group [11.7 +/- 5.51 pg/mg TP]; medium IFN gamma group [30.76 +/- 4.90 pg/mg TP]; and high IFN gamma group [60.54 +/- 11.28 pg/mg TP]. The later levels were approximately 3.5 times the control levels [P<0.005]. Patients with pervious polypectomy showed higher levels of IFN gamma compared with controls [P<0.05]

Factors predicting the incidence of spontaneous bacterial peritonitis in cirrhotic patients with ascites

The aim of this study was to identify the factors which may predict the occurrence of spontaneous bacterial peritonitis [SBP] complication. Two groups of cirrhotic patients with ascites were included in the study: A group who had never developed SBP and a group who had been successfully treated from this complication. The liver profile, the immunological status and the local ascitic factors were assessed in both groups. The group who had suffered from SBP showed significantly higher levels of serum bilirubin; while the serum albumin, prothrombin activity, T-lymphocytic count, serum and ascitic C3 and ascitic fluid protein and IgC were significantly lower than in the group who had never suffered SBP

chemosystematics of Egyptian onopordum species [compositae]

From the leaves and stems of Onopordum alexandrinum, 11 flavonoid compounds were isolated and identified as apigenin, luteolin, chrysoeriol and their 7-galactosides and 7-glucosides together with the 7-diglucosides of apigenin and chrysoeriol

Study of pulmonary function tests in insulin dependent diabetes mellitus

Thirty patients complaining from insulin dependent diabetes mellitus were selected for the present study. A set of ventilatory lung function parameters was measured in each patient [N=30] and control subjects [N=10] using an electronic spirometer. The studied group showed a highly significant [p<0.001] reduction in SVC, FEV1, FEV1 / FVC, FEF 25-75% and PEFR when compared with control group. The present study showed insignificant difference in the spirometric parameters when diabetic group with duration of diabetes more than 5 years compared with diabetic group with duration of diabetes 5 years or less. Also, insignificant difference were observed in patients with blood glucose level above 200 mg/dl and those with blood glucose below 200 mg/dl. From the present study we concluded that both restrictive and obstructive ventilatory defect were observed in insulin dependent diabetes mellitus. These ventilatory disorders had no relation to both the duration and glycemic control of diabetes We recommend the periodic evaluation of pulmonary function using spirometer in insulin dependent diabetic patients even though not symptomatized and to remember that the base line is not the same as for healthy subjects

Role of some interleukins in atopic dermatitis

This study was done on 40 atopic dermatitis patients, 22 males and 18 females, positive family history was present in 42.5% of cases and personal history in 12.5% of them. Fifteen of the patients were of the infantile type [37.5%] while 9 were of the Besniers prurigo [22.5%] and 16 of the atypical childhood type [40%]. According to the clinical severity, they were classified into severe [n = 10], moderate [n = 25] and mild [n = 5] [following Rajka, 1990]. According to their IgE level, they were classified into two groups: Highly atopics [IgE >600 mu/ml] and atopics [IgE <600 mu/ml]. The patients were compared with 20 non atopic control, of the same age. From each person of the study group, a serum samples were taken and examined by ELISA technique for serum IgG level. A heparinized samples were taken, from which peripheral blood mononuclear cell [PBMNC] cultures were prepared and supernatant were examined for the level of inteleukin 4 [IL 4] and [IL 6] by ELISA technique. From the present study it was concluded that, IL 4 plays an important role in atopic dermatitis being produced in excess in PBMNc cultures in all groups of the disease, especially in the severe and highly atopic groups

Aflatoxins production by Aspergillus flavus on whey

Karesh cheese whey was used to investigate its suitability for aflatoxins production by local Aspergillus flavus isolate. The maximum amounts of mycelial dry weights of A. flavus and aflatoxins were produced on sodium chloride free whey [control] and whey plus sodium chloride after incubation for 6 and 9 days, respectively. Clear increases in the amounts of the mycelia of Aspergillus flavus were obtained on whey containing sodium chloride after all incubation periods, while aflatoxins amounts decreased after 3, 6 and 15 days. The lowest and highest amounts of aflatoxins were produced on galaclose and glucose after 3 and 12 days, respectively. In general, all tested carbon sources induced notable decreases in the mycelial dry weights of A. flavus after 3-9 days, compared with the respective values obtained on whey plus sodium chloride, while clear increases in the values of dry weights of A. flavus on all tested carbon sources, except glucose plus mannose, after incubation for 12 and 15 days

Effect of radiation on serum sodium level in pregnant rats submitted to mineral deficient dietary treatment

A total number of 150 female albino rats in addition to a number of males [for mating] were used to study the effect of two doses [2 and 4 Gy] whole- body gamma irradiation on serum level in pregnant rats submitted to minerals deficient dietary treatment. The following results were obtained: 1- In the non-pregnant rats, serum sodium showed a highly significant decrease from the 8[th] up to the 17[th] day post-irradiation with 2 Gy, while the 4 Gy dose induced a significant decrease from the 1[st] up to the 17[th] day post irradiation. 2- In the pregnant rats, serum sodium level showed a highly significant decrease post exposure to 2 and 4 Gy extended to post partum. 3- In the pregnant rats submitted to mineral deficiency, serum sodium level showed highly significant decrease post exposure to 2 and 4 Gy during pregnancy and post partum

Effect of radiation on serum potassium level in pregnant rats submitted of minerals deficient dietary treatment

A total number of 150 female albino rats in addition to a number of males [for mating] were used to study the effect of two doses [2 and 4 Gy] whole- body gamma irradiation on serum level in pregnant rats submitted to minerals deficient dietary treatment. The following results were obtained: 1- In the non-pregnant rats, serum sodium showed a highly significant decrease from the 8[th] up to the 17[th] day post-irradiation with 2 Gy, while the 4 Gy dose induced a significant decrease from the 1[st] up to the 17[th] day post irradiation. 2- In the pregnant rats, serum sodium level showed a highly significant decrease post exposure to 2 and 4 Gy extended to post partum. 3- In the pregnant rats submitted to mineral deficiency, serum sodium level showed highly significant decrease post exposure to 2 and 4 Gy during pregnancy and post partum

Effect of radiation on serum copper level in pregnant rats submitted to minerals deficient dietary treatment

A total number of 150 female albino rats in addition to a number of males [for mating] were used to study the effect of two doses [2 and 4 Gy] whole body gamma irradiation on serum potassium level in pregnant rats submitted to minerals deficient dietary treatment. The following results were obtained: 1- In the non pregnant rats, serum potassium significantly increased from the 8[th] up to the 17[th] day post exposure to 4 Gy. 2- In the pregnant rats, serum potassium levels were significantly increased during pregnancy and post partum after exposure to 2 Gy and 4 Gy. 3- In the pregnant rats submitted to mineral deficiency, serum potassium levels showed highly significant increase at both doses [2 and 4 Gy] during pregnancy and post partum

Histological changes in the liver of merluccius by anisakis larvae

Larval nematodes belonging to the genus Anisakis is redescribed from Merluccius merluccius from Egypt. The larvae are characterized by the presence of a lip mass surrounding the mouth opening and a tail spine at its post. end. The alimentary canal is simple without oesophageal appendix or intestinal caecum. The average length of the larva and that of the oesophagus with its two portions are also included. This parasite is reported here on account to record its new locality. Histological examination of normal fish liver demonstrated a diffused pancreatic tissue composed of pancreatic acini and islets of Langerhans. The hepatic parenchymal cells are arranged in strands enclosing a network of sinusoids in between. Histopathologic studies of liver infected with Anisakis larvae revealed a hypertrophy in parenchymal cells and necrosis in the nuclei. Some capsules enclosing larvae were also observed. Histochemically, a significant decrease in lipids and acid mucopolysaccharides was noted in infected hepatic cells in comparison with normal liver tissue