interplay between c-Myconcogene expression and circulating vascular endothelial growth factor, its antagonist receptor, funs-like tyrosine kinase 1 in diffuse large b cell lymphoma: relationship to patient outcome

Aim: is to assess the relation between c-Myc oncogene expression and angiogenic factors namely vascular endothelial growth factor [VEGF], funs-like tyrosine kinase 1[Flt-1] in patients with diffuse large B cell lymphoma [DLBCL] and their impact on the patient outcome

Methods: Forty Five DLBCL patients beside 10 normal controls were included. c-Myc oncoprotein was assessed by immunohistochemistry and sVEGF, and sFlt-1 were assessed by immunosorbent assay

Results: c-Myc over-expression was detected in 66.6% of DLBCL. The DLBCL patient group with positive c-Myc overexpression showed significantly higher sVEGF and significantly decreased sFlt-1 as compared to group with negative c-Myc over-expression [P=0.000, 0.009 respectively]. sVEGF was positively correlated to sLDH and .v./32 microglobulin [r =0.6, p;0.000, r =0.69, P= 0.000] respectively. The non-survived DLBCL group showed significantly higher expression of c-Myc, high concentration of sVEGF and lower concentration in sFlt-1 as compared to the living group [P=0.000 for all]

Conclusion: These findings confirm the in vitro based suggestion that c-Myc over-expression orchestrate the angiogenic mritch necessary for tumor progression. c-Myc over-expression, elevated sVEGF, and normal sFlt-1 at diagnosis are poor prognostic markers· in DLBCL patients

Study of nucleated red blood cells for evaluation of fetal asphyxia

Our purpose was to determine whether a relationship exists between the presence of nucleated red blood cells [NRBC], the timing of perinatal asphyxia and the severity of hypoxic insult. Nucleated red blood cells from 27 single full term asphyxiated neonates were compared with cord blood NRBC of 30 full term non-asphyxiated newborns. Our patients were classified into 3 groups according to the degree of neurological impairment suggestive of hypoxic ischemic encephalopathy [mild: group I, moderate: group II and severe: group III]. The first and highest nucleated red blood cells value and the time to NRBC disappearance were assessed. Asphyxiated neonates exhibited a significantly higher number of nucleated red blood cells per 100 white blood cells [median=120 and range: 5-835] than did the control group [median=1 and range: 0-8] [P=0.001]. Newborns with severe neurological impairment [group III] had significantly higher cord blood nucleated red blood cells than group II and I [P=0.001 for each]. The time of clearance of nucleated red blood cells from the peripheral blood was significantly longer among patients of group III than in group II and I [median value of nucleated red blood cells on the 7[th] day was 0.0/range 0-10 in group I, 11/range: 0-80 in group II and 122/range 0-500 in group III]. Meconium stained amniotic fluid was significantly present more in group III than groups II, I [P=0.001]. Correlation studies revealed highly significant positive correlations between cord blood nucleated red blood cells, cord blood pH, and degree of neurological impairment [P=0.001 in both]. In this limited study, counting of nucleated red cells appear to identify the presence of fetal asphyxia and correlated well with the severity of asphyxia. The peak value of nucleated red blood cells and the time of clearance together with the presence of meconium stained amniotic fluid can help in determining the time of fetal injury. In general, the closer the birth was to the asphyxial event, the lower the number of nucleated red blood cells

Relative frequency of glucose-6 phosphate dehydrogenase deficiency in icteric newborn infants

Quantitative erythrocyte G6PD enzyme activity was assessed in 100 mature jaundiced neonates in the first week after delivery, in order to estimate the frequency of G6PD deficiency in the icteric neonates as well as the severity of hyperbilirubinemia among G6PD deficient group. The G6PD deficiency was detected in 5 of the patients [equivalent to a frequency of 5%]. The total bilirubin level was significantly higher in G6PD deficient group compared to a jaundiced group with normal G6PD activity [P 0.02]. A strong positive significant correlation was found between the reticulocytic count and G6PD enzyme activity [r 0.87, P <0.05]. These findings suggest the necessity to establish this screening test as a routine for all icteric newborns, in order to have an opportunity detection and appropriate counseling