Detection of helicobacter pylori in hepatic tissue of patients with chronic hepatitis c and hepatocellular carcinoma: [immunohistochemical study]

Recent studies have suggested that bacterial coinfection with Helicobacter species in patients already infected with hepatitis C virus [HCV] could be involved in the development of cirrhosis and hepatocellular carcinoma [HCC]. A retrospective study was performed in order to explore the association between Helicobacter pylori and HCV in hepatic tissue of Egyptian patients with chronic hepatitis C and hepatocellular carcinoma. The presence of Helicobacter pylori was tested by immunohistochemistry on liver samples from two groups of patients; chronic hepatitis C [group I, n = 45] and hepatocellular carcinoma [group II, n = 15]. Group I [chronic hepatitis C] involved 31 males and 14 females [male/female, 2.2:1]. Their age ranged from 27 to 58 years with a mean of 45.8 +/- 7.0 years and HCC group involved 11 males and 4 females [male/female, 2.8:1]. Their age ranged from 48 to 78 years with a mean of 60.2 +/- 10.0 years. Immunostaining revealed H. pylori microorganisms in 33/45 biopsies [73.3%] of chronic hepatitis C group and 5/15 [33.3%] of HCC group [p = 0.005]. H. pylori organisms were present in liver tissues of HCV and HCC patients with significantly higher proportion in the former. Further studies are needed to ascertain its possible role, if ever, in the pathogenesis of cirrhosis and hepatic malignancy in Egyptian patients

correlation of cyclin A with dtug resistance in adult acute non lymphoblastic leukemia

Acute Non Lymphoblastic Leukemia is one of the most common malignant tumors of haematology. With the recent progress in chemotherapy and supportive therapy, the remission and survival rate have been markedly improved. In this study, cyclin A2 and multidrug resistance expression was measured by flow cytometry and RT-PCR in 52 de novo AML patients with acute myeloid leukemia. Their expression was correlated with other prognostic criteria, response to treatment and to overall survival. The rate of CR and PR was significantly higher in the group of positive expression of cyclin A2, compared to that with negative expression. However a statistically significant difference was only reached by PCR [p=0.02]. By flow cytometry, the overall Survival [OS] in the group with positive cyclin A2 expression is significantly higher than that in the group of negative cyclin A2 expression, p=0.03. Regarding MDRI, it was expressed in 39% of our patients and the level of expression was slightly higher by RT-PCR. The rate of CR and PR in the group of negative MDR expression was significantly higher as compared to the group of positive MDR expression, by both flow cytometry and RTPCR [p= 0.005, 0.004, respectively]. The OS in the group with negative MDR1 expression was significantly higher than that in the group of positive MDR1 expression, p=O.04. There was a significant inverse relationship between Cyclin A2 and MDR expression in our AML cases by RTPCR technique [p= 0.005], while it showed no significance by Flow cytometry [p=0.12]. There was no agreement [Kappa=0.25] between Flow cytometry and RT-PCR in detection of cyclin A2. On the contrary, there was an agreement between Flow cytometry and RT-PCR in detection of MDR. In conclusion, the low expression of cyclin A2 and high expression of MDR1 are indicators for unfavorable prognosis for individuals with AML. The detection of cyclin A2 level would predict drug resistance. However, it is one of many other factors

Histopathological features of chronic hepatitis C in Egyptian patients

Chronic liver disease including that caused by the hepatitis C virus progresses in stages. It can range from inflammation, to fibrosis to end stage liver disease or liver cancer. This work aimed to study the histopathological features of chronic hepatitis C infected Egyptian patients followed-up at National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt. The study included 4267 liver biopsies from patients with serological and virological diagnosis of chronic HCV with no other identifiable cause for liver disease, signs of hepatic decomposition, or other significant non-hepatic disease. All biopsies were fixed in formalin, embedded in paraffin, and sectioned by microtome with a thickness of 5 micro m. Routine specimen processing involved staining slides with hematoxylin and eosin [5 levels] and Masson's trichrome stain [5 levels], for a total of 10 levels per specimen. All levels were screened by two pathologists to ensure the histological abnormalities. Ishak scoring system was applied for assessment of fibrosis and necroinflammatory injury. The percentage of hepatocytes involved by fatty changes was used to score the grade of steatosis. The relations between the histopathological findings, age and sex of the patients were carried out. The studied group [n = 4267] involved 3268 males and 999 female, with age ranging from 21 to 60 years and a mean of 41.7 +/- 9.7 years. Necroinflammatory activity of the virus was minimal in 17.88%, mild in 56.41%, moderate in 22.24% and severe in 3.47%. No fibrous tissue deposition was seen in 21 patients [0.49%], 27.32% of the patients had portal and periportal fibrous expansion, 27.91% had fibrous extensions with occasional thin fibrous tissue bridge, 36.28% had frequent broad fibrous tissue septa, while 7.99% of the studied group of patients had cirrhosis. Steatosis was absent in 52.45% of cases, mild in 39.75%, moderate in 7.19% and severe in 0.61% of patients. Non-specific granulomatous reaction was detected in 11 liver biopsies [9 males and 2 females]. Fibrosis and necroinflammation were more frequent in older patients. No significant difference between males and females regarding fibrosis, but females were more exposed to higher grades of necroinflammation [p < 0.001]. Chronic hepatitis C infection is a common and serious health problem that progresses to fibrosis, cirrhosis, liver failure and hepatocelluar carcinoma. Portal lymphoid infiltrate and minor hepatocellular necrosis were present in almost all cases. Necroinflammatory activity was mild in nearly half of the cases. Steatosis was detected in 47.55% of the patients. Fibrosis and necroinflammation were more frequent in older patients. Non-specific granulomas were rarely encountered in association with hepatitis C

Pseudomonas bacteremia in pediatric cancer patients

Despite availability of potent antimicrobial agents, Pseudomonas aeruginosa [P aeruginosa] continues to be a serious cause of bacteremia, with high rates of morbidity and mortality; but no available data to elucidate if non-aeruginosa strains of Pseudomonas constitute a similar problem or just bystanders. The aim of this study was to identify the relative frequency of Pseudomonas bacteremia, and to define its clinical impact in pediatric cancer patients receiving chemotherapy. Medical charts of pediatric cancer patients with Pseudomonas bacteremia, at National Cancer Institute were retrospectively reviewed during the period from January 1999 to December 2002. Risk factors, manifestations of infection, pattern of antibiotic susceptibility and outcome of cases with P aeruginosa and non- aeruginosa bacteremia were evaluated. Over the period of the study, 72 cases of Pseudomonas bacteremia were recorded. P aeruginosa bacteremia represented 1.9% of the total number of positive blood cultures; whereas non-aeruginosa accounted for 4.5%. It was more common in patients with hematologic malignancies [80.6% versus 19.4% in solid tumors]. The most common concomitant site of infection was the lower respiratory tract. The overall cure rate was 72% with no significant difference in adverse outcome between P aeruginosa and non-aeruginosa cases. The variables that were significantly associated with an unfavorable outcome were related to peripheral blood counts. Only a reduced monocyte count at day one was significantly associated with a bad prognosis, whereas at days 4 and 7 reduced absolute neutrophil count [ANC], monocyte, lymphocyte and platelet counts were all related to an adverse outcome. Pseudomonas sp. bacteremia still poses a great health hazard as regards morbidity and mortality in pediatric cancer patients receiving chemotherapy. Factors that can manipulate prolonged reduced cytopenias during intake of chemotherapy may be helpful to reduce adverse outcome of serious Pseudomonas sp. bacteremia in this population of patients