Circulating cell free DNA as a predictor of systemic lupus erythematosus severity and monitoring of therapy

Background: Systemic lupus erythematosus [SLE] is the most heterogeneous chronic autoimmune disease; it is characterized by the presence of auto reactive B and T cells, responsible for the aberrant production of a broad and heterogeneous group of autoantibodies. Recent studies using various detection methods have demonstrated the elevations of circulating DNA in SLE patients

Aim of the study: The current study aimed to measure cell-free DNA [cf-DNA] in SLE patients as a potential tool to predict disease activity and treatment follow up

Subjects and methods: 52 of SLE patients with age ranging from 10 to 48 years were randomly selected and 25 healthy subjects with age and gender matched with the patients were included as a control group. Thorough clinical examination stressing on the central nervous system, vascular, renal, rash, musculoskeletal, mucocutaneous manifestations, and fever was done for patients. The following investigations were done: Complete blood count [CBC], kidney function tests, C-reactive protein [CRP], routine autoantibodies for autoimmune diseases, complements [C3 and C4], anti-nucleosome antibodies and cf-DNA by real time PCR [RT-PCR]

Results: The levels of anti-double stranded DNA [anti-dsDNA], anti-nucleosome Ab, and cf-DNA were significantly increased in SLE patients compared to controls. The cf-DNA level was correlated to markers of disease severity namely CRP and anti-nucleosome. A significant reduction in levels of cf-DNA, anti-nucleosome Ab and anti-dsDNA was noticed after therapy

Conclusion: Our findings support that the measurement of cf-DNA appears to be a useful marker in addition to laboratory tests used in SLE diagnosis. High correlation with markers of disease severity suggesting its role in disease pathogenesis and decreasing its level after therapy makes it to be a marker of treatment follow-up

Radionuclide-assisted sentinel lymph node localization and biopsy in management of early invasive breast cancer

The value of sentinel lymph node[s] [SLN[s]] biopsy rests on the concept that a single lymph node [sentinel node] is the first of a group of lymph nodes that receives drainage of a specific body segment. In theory, by surveying this single node, tumor movement from the primary site can be predicted for the remainder of the lymph node basin. Should the sentinel node be free of tumor, the remaining lymph nodes of the basin are presumed to be negative, and the patient may be spared unnecessary axillary lymph node dissection. This study was conducted at 3 different centers during the period from December 2002 till May 2006. The study involved 60 females with early invasive breast cancer [T[1]-T[2], Clinically N[0] M[0]]. Localization of SLN[s] was performed by the combination of 3 techniques; operative lymphoscintigraphy, and intraoperative isosulfan blue dye mapping and hand-held gamma probe. After localization and excision of sentinel lymph nodes, axillary dissection, as well as, surgical management of the primary tumor was done. The specimens of SLN[s], non-SLN[s], and the primary tumor were examined separately for histopathology. Correlation between SLNs involvement and non-SLN[s] involvement was done. Among the 60 patients with early invasive breast cancer, the overall SLN[s] localization was successful in 90% cases. The sensitivity, the specificity, the predictive value positive test, the predictive value of negative test, as well as the accuracy of the histopathological yield of the SLN[s] biopsy were found to be 91.3%, 100%, 100%, 93.9% and 96.3% respectively. SLN[s] localization and biopsy is a good predictor of the histopathological status of axillary lymph nodes and can prevent unnecessary axillary dissection in early stages with node negative invasive breast cancer. The use of lymphoscintigraphy and gamma probe facilitates localization of SLN [s] and increases its accuracy

Grafting on high alpha-cellulose pulp extracted from sunflower stalks for removal of Hg [II] from aqueous solution

Dissolving pulp containing 95.5% a-cellulose was extracted from sunflower stalks. The pulped sunflower stalks [PSFS] were used as starting material for grafting with acrylamide [Aam]. All factors affecting the grafting reaction were examined. These factors include, liquor ratio [L.R], ceric ammonium nitrate [CAN] concentration as a catalyst, Aam concentration as well as reaction time and temperature. The grafted PSFS [GPSFS] samples were chracterized by estimation of nitrogen%. The optimum conditions for grafting are, PSFS, Ig; L.R, 1:15; CAN, 20mmole/l; Aam, Ig; Temp., 60°C and time 3hr. The GPSFS was utilized as adsorbent material to remove Hg [II] ions from aqueous solutions. All. factors affecting adsorption process were examined. These factors include, pH, adsobent concentation, temperature and agitation time. The adsorption data show that, the maximum adsorption capacity, q,, of Hg [II] onto GPSFS is 625mg/g. The adsorption data also showed that the adsorption of Hg [II] onto GPSFS obeys Langmuir and Freundlish isotherms

Evaluation of some conventional staining techniques and a monoclonal antibody based method for coccidian oocyst detection in human faecal samples

In the present study, different concentrations and staining techniques were used for the identification of coccidian oocysts in fecal samples from 230 immunocompetent patients complaining from persistent diarrhea. Also, fecal samples were obtained from 20 apparently healthy individuals [control group]. Formal ether sedimentation and Sheather's sugar flotation were used as concentration techniques. The concentrated stools were examined and stained by modified Ziehl- Neelsen [MZN] acid fast stain, rapid Diff stain, phenol-auramine stain and the monoclonal antibody [MAb] based reagent for direct immunofluorescence. It was concluded that for detection of coccidian oocysts, Sheather's sugar flotation can be used as a concentration method, while MZN is sufficient for clinical purposes. The immunofluorescence test is a useful tool in suspected cases with negative samples or in cases where the number of oocysts is suspected to be low

Clinical, hematological, and chemical correlates in convulsions of newborns

25 neonates aging from 1 to 28 days post-natal and presenting with convulsions or prematurity were the subject of the present study, in addition to 15 healthy full-term neonates as a control group. Full history was taken, clinical and neurological examination as well as hematological and chemical investigations were done aiming at correlating their results in order to diagnose causes of neonatal convulsions which is indeed a difficult task. Results showed that 11 patients [44%] were preterm. Ischemic encephalopathy was suspected in 6 cases [24%] who presented within 3 or 4 days after labor. Positive blood culture was obtained in 12 patients [48%] while CSF culture was positive in only 2 cases [8%]. Hypocalcemia was present in 6 patients, hyponatremia was fonud in 6 patients, hypomagnesemia alone in 3 cases and in association with hypocalcemia in other 2 cases and hypoglycemia in 3 cases. Congenital abnormalities were reported in 3 cases. Congenital abnormalities were reported in 3 cases. Toxoplasmin test [IgG immunoglobulin determination against toxoplasma gondii] was negative in all cases

Renal function and size in normal healthy infants and relation of kidney size to body measurements

90 normal healthy infants and children [39 females and 51 males] representing various age groups from birth to 30 months were studied as regards both kidney function and size. In addition, 10 healthy adults of both sexes were included in the study as a control group. All patients were subjected to full history taking and clinical examination was done to exclude any abnormality. Laboratory investigations included blood urea, serum creatinine and creatinine clearance as a measure of glomerular filtration rate [GFR]. Sonographic examination for both right and left kidneys was done in all groups, as well as the adults. Results showed that creatinine clearance was about one third that of the adult in the neonates, especially the preterm ones and its value increases gradually with age to reach the adult level at about 2.5 years. Sonographic examination of both kidneys in all groups showed that all renal measurements [longitudinal, transverse and thickness] correlate better with weight, length and surface area than age

Blood glucose level in newborn infants of high risk pregnancy

Under normal circumstances, the fetus receives a constant supply of nutrients and oxygen from his mother across the placenta. After delivery the newborn infant must rely on his endogenous source to maintain glucose homeostasis until an adequate food supply become available. A normal fasting blood glucose level depends on sufficient hepatic enzyme pathways for gluconeogenesis and glycogenolysis and normal hormonal activities for regulation of these processes. This study aimed at estimating the blood glucose level in newborn infants of high risk pregnancies as well as in high risk newborns. The study was carried out on 138 newborn infants at high risk, pregnant mothers, and high risk newborns, in addition to 20 healthy newborn infants of normal pregnancy. The groups included in the study were: Group [1] Diabetic Mothers: their number were 15. Group [2] Primiparous mothers over 35 Y: their number were 15. Group [3] Underweight mothers [under 60 kg]: their number were 5. Group [4] Mothers with Rheumatic heart disease: their number were 8. Group [5] Mothers with chronic hypertension; their number were 6. Group [6] Pre-eclamptic mothers: their number were 12. Group [7] Eclamptic mothers: their number were 6. Group [8] Multiparous mothers over 5 deliveries: their number were 8. Group [9] Premature newborns: their number were 25. Group [10] Small for date newborns: their number were 38. The blood glucose level in the newborns was done by the reflectometer method at birth, at 1 hour and at 4 hours after delivery. The results obtained, showed that in all infants, blood glucose level at 4 hours was significantly lower than its level at birth in all groups. Significant lower blood glucose level than that of the control groups was seen in infants of mothers suffering from diabetes, chronic hypertension and eclampsia. The same observation was seen in prematures and SGA newborns. On the other hand, no significant difference was seen in the rest of the groups

Sex-hormone binding globulin and total testosterone levels in androgenetic alopecia in women

Thirty-one female patients with androgenetic alopecia, which is considered to be an androgen dependent condition, were examined and total serum testosterone [T] and sex hormone binding globulin [SHBG] were determined. Twenty age-matched female control subjects were included. In spite of detection of very mild increase of the mean serum testosterone and mild decrease of the mean SHBG levels in patients in comparison with control values, no significant differences were found between both group. So, the serum total testosterone and SHBG levels did not correlate with androgenetic alopecia in women