Study of complement C3 and C4 and phagocytic function of the neutrophils before and after splenectomy

The present study showed significant increases in the total leucocytic and neutrophilic counts and in the calculated absolute number of stimulated NBT positive cells after splenectomy in all studied groups [P <0.05]. By contrast, the serum complement C3c and C4 showed insignificant increases after splenectomy in all trial groups [P >0.05]. Nevertheless, the age was not important factor affecting the changes that have been observed in the present study. It can be concluded that the spleen does not share in the synthesis, consumption or catabolism of C3c and C4. Meanwhile, the phagocytic function of neutrophils will increase after removal of the spleen. This might be a part of the whole increase in the number of while cells and neutrophils or due to post-splenectomy infection or the increase in the function of macrophages mediated by the macrophageactivating factors secreted by T-cells since splenectomy induces and increase in T helper and decrease in T suppressor cells

Detection of HBV, HCV, Delta agent, cytomegalovirus, Epstein Bar virus and HIV in polytransfused patients with hemophilia and thalassemia

Fifty hemophilic and fifty thalassemic patients, who need multiple transfusions, as well as ten normal controls were studied for the presence of viral infection with hepatitis B virus [HBV], hepatitis C virus [HCV], the delta hepatitis virus [HDV], cytomegalovirus [CMV], the Ebstein Barr virus [EBV], and the Human Immune Defeciency virus[HIV]- using the ELISA method. The multi-transfused thalassemic and hemophilic patients in our study showed significantly higher prevalence of the HBV, HCV, HDV, EBV and the CMV, nonsignificant prevalence of HDV, while none of our patients was seropositive for HIV virus. The high prevalence of HCV reaching up to 86% of patients might be due to many factors which have participated in giving such a higher prevalence, the most important of which is the false positive results obtained by ELI-SA method, which can be eliminated by doing a confirmatory test using either the anti-HCV recombinant immunoblot assay [RIBA] test, or the polymerase chain reaction [PCR] test. Other factors include the prevalence of HCV in the total population and the possibility of acquiring the infection by using factor VIII concentrate which was prepared before the time when effective methods of concentrate sterilization were introduced. We suggested to include test for HCV in the screening program for the donating blood along with tests for HB[s] A[g] and HIV

Efficiency of red cells hexose monophosphate shunt in uraemic patients: its role in shortening red cell survival

This work was performed to study the hexose monophosphate [HMP] shunt especially G6PD level in uraemic patients' red cells and its role in haemolysis. Besides 10 healthy controls, this study was conducted on 30 chronic renal failure [CRF] cases divided into 3 groups. In group I, patients' serum creatinine was below 5 mg/dl, in group II it was 5-10 mg/dl and in group III, it was above 10 mg/dl. Following proper history taking and thorough clinical examination, all patients and controls were subjected to urine analysis, complete blood count as well as determination of their serum iron, total iron binding capacity, transferring saturation, bone marrow examination, iron stores in addition to blood urea, serum creatinine, sodium, potassium total calcium and inorganic phosphorus. Thereafter, G6PD activity was estimated. Our results confirmed occurrence of anaemia and haemolysis in CRF patients. G6PD levels were significantly reduced in 20, 40 and 60% of group I, II and III cases respectively. Therefore, HMP shunt activity was reduced in CRF due to decreased G6PD enzyme activity. This diminution became more prominent with rise of serum creatinine. Thus, decreased G6PD activity could be considered as a cause of haemolysis in CRE

Microalbuminuria as a predictor of diabetic nephropathy - Comparison between type I and type II diabetes mellitus

This study was done to determine the incidence of nephropathy in both types of diabetes, insulin dependent [IDDM] and non-insulin dependent diabetes mellitus [NIDDM] and its interrelation with arterial blood pressure, metabolic control as indicated by glycosylated hemoglobin and the renal functions as indicated by creatinine clearance. It mainly investigates microalbuminuria using radioimmunoassay as a predictor of early stages of nephropathy and correlate it with different vascular complications of diabetes as hypertension and retinopathy as well as to metabolic control. The study included 50 subjects classified as 10 normal healthy persons as controls, 20 IDDM patients divided into normotensive [10] and hypertensive [10] patients as well as 20 NIDDM patients who also were divided into 10 normotensive and 10 hypertensive patients. All patients showing microalbuminuria had duration of diabetes more than 5 years. Microalbuminuria was more evident in IDDM than NIDDM patients. It was also significantly higher in hypertensive than normotensive IDDM patients. A negative correlation between glycosylated hemoglobin and microalbuminuria in all diabetics was found, which may be due to other factors influencing the glycosylated Hb. Retinal changes were more related to the duration of diabetes than to the type of diabetes, hypertension or to the state of metabolic control. NIDDM patients with retinal changes showed significant increase in microalbuminuria. Every diabetic patient with microalbuminuria must be followed up for other vascular complications

Cytogenetic and immunologic study in chronic leukemia

Cytogenetic study of peripheral blood and bone marrow aspirate as well as HLA typing were done in 17 patients with chronic myeloid leukemia [CML] and 14 patients with chronic lymphocytic leukemia [CLL]. Chromosomal studies of phytohemagglutinin stimulated lymphocytes usually reveal normal karyotype. Clonal chromosomal aberrations are revealed in about half of the patients if lymphocyte cultures are stimulated by B-cell mitogen such as pokeweed mitogen and other polyclonal mitogens. In CML, the most common abnormality was the presence of Philadelphia chromosome [Ph1] which was found in 88% of the cases: Additional chromosomal abnormalities were found in 47% of the patients, including deletions, breaks, duplication of X- chromosome and monosomy 6. These aberrations were found in patients in the accelerated phase or in the blastic phase of the disease. Ph1 negative patients were found to have more aggressive course of the disease, while the presence of a single Ph1 carries a better prognosis. In patients with CLL, only one patient had monosomy 7 and another one had monosomy 8 and 10 patients showed normal karyotype, while the cytogenetic study failed in two patients. As regards HLA typing, CML patients have significantly high frequency of the specificities HLA- A9, CW3, and CW4, whereas the frequency of HLA-AW19 was decreased significantly as compared to the typing of 100 normal random individuals from the same population. In patients with CLL, there was a significantly high relative risk of the phenotypes HLA-B8, B14, and A9 as compared to those in controls. The present study revealed the importance of cytogenetic studies in the diagnosis, classification, course and prognosis of leukemic patients. The appearance of aneuploid metaphases in a previously diploid marrow may herald imminent relapse of the disease and may be used for diagnostic purposes in cases in which other parameters are confusing. The cytogenetic data when combined with clinical data can preferably predict an impending transformation in chronic leukemia patients. The appearance of additional chromosomal aberrations together with Ph1 denotes disease metamorphosis whether to accelerated phase or actual blastic crisis. The presence of chromosome aberrations in patients with CLL denotes advanced disease stage or resistance to therapy, while normal karyotype carries a better prognosis

liver in chronic renal failure: an ultrastructural study

The nature of the biochemical disturbances that cause the alteration in chronic renal failure with the consequent multi-system affection constitutes a major problem. The present study examined the hepatocytes in renal failure at the ultrastructural level. Liver samples were processed for electron microscopy and ultrathin sections were examined at a joel electron microscope. Several subcellular changes in the plasma membrane, mitochondria, rough endoplasmic reticulum and the nucleus were noticed. Such hepatocellular fine alteration might be responsible for certain laboratory and clinical features associated with the uremic syndrome

T-cell and B-cell identification combined with histologic classification in lymphoma

The study was carried out on 20 patients with lymphomas: 10 with Hodgkin's disease and 10 with non-Hodgkin's lymphoma. Comparison between histologic classification of lymphoma after surgical biopsies and cytologic examination of smears after lymph node puncture was done. This was also accompanied by identification of T and B cells in the lymph node aspirate and in the peripheral blood samples of these patients. The study showed that most patients with Hodgkin's lymphoma were of B cell origin. Matching the cytologic results of lymph node smear with lymph node biopsy reports was made in six out of eight cases [75%] with Hodgkin's disease and in five out of seven cases [71%] with non-Hodgkin's lymphoma

Histopathology and histochemistry of the jejunal mucosa in the elderly

Jejunal mucosal biopsy specimens, obtained by Watson's capsule from 20 senescent males aged above 60 and 5 control males aged below 50 years were examined histopathologically, and histochemically. There were progressive blunting and flattening of villi with ageing together with altered crypt-villus ratio up to 3:1. This together with the few mitotic figures seen at the neck of the crypts indicated a hypoplastic mitotic process. The histochemical findings showed reduced enzymatic activities with ageing concerning succinic dehydrogenase, simple esterases, alkaline phosphatase and acid phospbatase

Radiological study on the small intestine in the elderly

Intestinal follow through was done in 20 male individuals aged above 60. Mesenteric angiography was carried out in 6 old male individuals. The findings revealed intestinal hypotonicity as evidenced by increase in calibre and prolonged in transit time; as well as coarse mucosal pattern. Mesenteric angiography revealed atherosclerotic changes in the mesenteric blood vessels as evidenced by tortuosity, attenuation and irregularities in the wall of the main trunk. Amputation of the small tributaries was also noted. This atherosclerotic narrowing can be responsible in part for the diminished absorption in old age through reduction in regional blood flow and mucosal atrophy