Phenotypical characterization of the peripheral blood T cells in patients with celiac disease: does it differentiate suspicious celiac disease cases?

The present study aimed to study the immunological changes seen in the intestinal epithelium of the celiac patients could also be detected in the peripheral blood lymphocyte populations. Celiac disease [CD] is a small bowel enteropathy caused by permanent wheat gluten intolerance. One of the earliest signs of CD is an increase in the numbers of the intestinal intraepithelial lymphocytes [iIEL]. In this case-control study, totally 13 untreated subjects with acceptable criteria for CD without any complication and 16 healthy subjects without any positive criteria for CD were selected. Peripheral blood T cells were analyzed by two-color flow cytometry in both groups. The mean age of patients was 33.6 +/- 3.4 years and two patients had Marsh IIIB, five patients had Marsh IIIA and six patients had Marsh II histology class. The mean percentages of the gamma delta]TCR[+] T cells in the patients were significantly higher than the controls [p=0.015]. However, the mean percentages of the [alpha beta]TCR[+] T cells were significantly lower in the untreated patients than the controls [p=0.025]. There were no significant difference between the mean percentages of lymphocytes expressing the CD3, CD4 and CD8 molecules in the patients and the controls. The change in the percentages of the peripheral blood T cells expressing the [gamma delta]TCR and [alpha beta]TCR in the celiac patients could be used in conjunction with the other serological markers to identify new CD cases

[Painless labor with patient-controlled epidural pumps of bupivacaine and fentanyl]

Epidural anesthesia is an appropriate technique for managing labour pain, which is a common problem in acute pain management. Intact motor function, less hemodynamic changes and decreased maternal catecholamines are the other pearls in epidural anesthesia. Patient Control Epidural Analgesia [PCEA] is a safe and effective technique with minimal motor block, with more patients' satisfaction and stability and least drug requirement for analgesia. Epidural analgesia is the most effective technique among routine methods for labour pain control. In volunteers with vertex position of single fetus which were in active phase of pregnancy epidural catheter was implicated. After loading the first injection doseage; catheters were attached to the disposable silicone balloon pumps, which delivered maximum of 2ml of solution contained 0.1% marcaine plus 4 microgram per milliliter fentanyl every 15 minutes with patient control button. The patients were monitored for pain severity and vital signs. Subsidiary methods and drugs used for pain were also recorded during the labour. 45 parturient entered the study. Mean VAS in 96% was less than 4 during all times. 23 of the mothers [51%] had the score of 5 to 8 in MEPAS scale and were able to walk either with or without any help just 30 minutes after receiving the loading epidural dose. PCEA is a safe and effective method which showed effective pain reduction in 96% of cases

Role of E-cadherin in differentiation between squamous and basal cell carcinoma

Some type of basal cell carcinoma [ex Keratotic variant] is often misdiagnosed as squamous cell carcinoma and basal cell carinoma. The objective of this study was to determine the role of E-cadherin in differentiation between Squamous and basal cell carcinoma. The sampling was performed by simple method. Entry criteria to the study included 2 groups of 34 primary, untreated BCCs and SCCs each from a different patient. They were surgically removed and the diagnosis was confirmed by histopathology. The stained sections were scored by levels of expression and intensity of E-cadherin. Distribution of E-cadherin staining was more in BCC than SCCs [P=0.006] but the decreased staining intensity of E-cadherin in SCC compared with BCC was not statistically significant [P=0.056]. When the results [score of distribution and intensity of E-cadherin] were added together, the acquired E-cadherin index in a statistical analysis was meaningful to differ between SCC and BCC [P=0.002]. Our study showed that E-cadherin distribution and index but not intensity is lower in SCC cells than BCC cells and it can justify the cause of metastasis in SCC. However, this is ambiguous to use it for differentiating of aggressive forms of BCCs from SCCs, practically

Cervicovaginal microbial flora in methenamine silver staining method

Vagina like all other mucosal organs owns its especial bacterial/microbial flora. Though may be pathogen in other circumstances, members of vaginal normal flora do not cause disease on healthy vaginal mucosa. In this study, we tried to determine the relationship between microscopic findings on Methenamine silver stained cervicovaginal smears and clinical symptoms. A total of 389 cervicovaginal smears were examined cytologically from April to August 2005, among which 103 satisfactory smears of patients who were normally enstruating were subsequently selected. The originally Papanicolaou-stained smears were stained with Methenamine silver method. The cervicovaginal flora in symptomatic and asymptomatic patients was classified into four groups. The relationship between the type of genital flora and the presence of Candida or Actinomyces spp was also determined. Data were analyzed with SPSS software using Chi-square test. In 103 evaluated patients, 46 [44.7%] were symptomatic and the rest were asymptomatic. The most prevalent genital microbial flora in both symptomatic [21.7%] and asymptomatic [37.9%] patients was type II [Lactobacilli]. Microbial frequency differences were significant for types II [P = 0.034] and III [P = 0.039] in both groups. Coexistence of microbial flora of type I [P = 0.02] and type IV [P = 0.033] with Candida was statistically significant. Coexistence of all types of microbial flora with Actinomyces was not proved significant. Symptomatic women, except those with potential pathogens, tend to have Lactobacillus flora. Therefore, it is advisable that all Lactobacilli types be investigated through microbiological methods in symptomatic patients. In silver stained slides, there was a clear relationship between the type of vaginal microbial flora and the presence of Candida spp