Genetic polymorphism of glutathione-S- transferase [GST-M1 and GST-T1] in schistosomiasis -associated bladder cancer in Egyptian patients

This work was carried out on three groups, 30 Egyptian patients with Schistosoma haematobium [S. haematobium] with bladder cancer [15], and without bladder cancer [15], as well as 15 normal individuals as a control. All the individuals were subjected to measurement of serum level of GST by using ELISA technique and genotyping for GST-M1 and GST-T1 using PCR technique. The results proved that GST serum level was significantly deceased in S. haematobium patients with bladder cancer as compared to the other groups. The PCR results for the GST-M1 and GST-T1 genotyping showed 4 categories, [M1+ve/T1+ve, M1+ve/T1-ve, M1-ve/T1+ve, M1-ve/T1/-ve]. There was a significant decrease in enzyme levels in patients with GST-M1-ve/T1-ve as compared to the other categories. Besides, there was a significant increased risk for bladder cancer development in patients with combined gene deletion [OR = 40] which represented mainly in S. haematobium patients with bladder cancer [53.3% = M1-ve/T1-ve]

HFE mutations, serum iron indices, and hepatic iron: impact on fibrosis severity and steatosis in patients with chronic hepatitis C genotype 4

Iron overload may cause or contribute to hepatic injuiy and fibrosis. Mutations in tbr HFE gene may influence development or progression of chronic liver disease by increasing iron stores or modulating immune responses. The aim of this work was to assess the influence of HFE mutations and serum and hepatic measures of iron status on fibrosis severity and steatosis in patients with chronic hepatitis C genotype 4. We studied 47 patients [33 males, 14 females, mean age 43.46 +/- 13.54 years] with chronic HCV infection. Serum iron indices were determined in all participants. Hepatitis C virus RMA was detected in patients' sera by reverse transcriptase-polymerase chain reaction [RT-PCR]. Liver biopsies were taken to evaluate steatosis, fibrosis, and hepatic iron depositions. We used the method of polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP] to analyze the HFE mutations. Twenty-three patients 23/47 [48.936%] had increased serum iron stores and only eleven patients 11/47 [23.40%] had positive hepatic iron stain. There was a significant difference between hepatic steatosis subgroups as regards inflammatory grading and fibrosis staging [p <0.001]. Ferritin level was significantly correlated with fibrosis severity and steatosis grading. Hepatic iron deposition was significantly correlated only with steatosis grading but not with fibrosis severity. Heterozyosity for H63D allele was noted to be five patients 5/47 [10.638%] in CHC patients. Our data demonstrated no significant difference in the prevalence of HFE mutations between the HCV patients with increased serum iron store and others without Also, the same results were noticed in patients with and without hepatic iron deposition. Ferritin level should be better considered as a surrogate marker of severe fibrosis in chronic hepatitis C. The prevalence of HFE mutations associated with hereditary hemochromatosis is not increased in the patients with CHC. The HFE mutations may not contribute to iron accumulation in the CHC patients even when serum iron overload is observed in these patients

Metallothionein [MTI and MT II] gene expression in hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is one of the most frequent human tumors worldwide, and commonly evolves from chronic hepatitis and liver cirrhosis. It is therefore very important to detect and evaluate the progressing state of chronic hepatic disorders. Recently, serum metal levels such as copper [Cu] and zinc [Zn] have been reported to be highly sensitive in the diagnosis of some diseases. Hypozincemia and marked hypercupremia have been reported in patients with digestive, hepatic, breast, and lung cancers. Also much attention was paid to the association between metallothioneins [MTs] and chronic liver diseases including HCC. Available informations suggested that MTs might play important roles in carcinogenic and apoptotic process of some tumors. The aim of the present study was to throw the light on the role of zinc, copper and metallothioneine in the diagnosis of chronic liver diseases and to clarify the role of metallothioneins [MTs] I and II mRNA expression in hepatocellular carcinoma. This study was carried out on 45 patients with liver diseases [15 patients with chronic hepatitis, 15 patients with liver cirrhosis and 15 patients with HCC] as well as 15 healthy individuals as a control group. All patients and controls were subjected to estimation of serum copper, zinc and metallothioneine levels also their tissue levels were estimated in all patient groups. Metallothioneins [MT I and MT II] mRNA expression by RT-PCR were done for all cases. The results of the present study documented a significant decrease in serum and tissue levels of zinc and metallothioneine with concomitant increase in copper levels in all patient groups. More changes were documented in HCC patients. Concerning the PCR results of MT genes expression, there was a significant decrease in MT I and MT II mRNA expression in HCC patients when compared to the other groups. They also decreased in patients with liver cirrhosis when compared to the control group and patients with chronic hepatitis. In contrast their expressions do not show significant decrease in chronic hepatitis when compared to the control group. On the basis of these results, it could be concluded that serum zinc, copper, and metallothioneines levels may be used as a non-invasive biochemical markers for early detection of the progression of chronic liver diseases. Moreover, the progressive decrease in MT I and MT II gene expression may play an important role in carcinogenesis of HCC

Genetic polymorphism of glutathione-s-transferase [GST-M1 and GST-T1] in Egyptian schistosomiasis -associated bladder cancer

Bladder cancer is a common neoplasm around the world. In Egypt, the majority of bladder cancer is associated with Schistosoma haematobium [S. haematobium]. Glutathione-s-transferase [GST] represents an important family of metabolizing enzymes that catalyzes the conjugation of large variety of endogenous and exogenous compounds including carcinogens and anti cancer drugs and their metabolites with reduced glutathione. Individuals with very low levels of GSTs are at increased risk for the development of carcinoma and inflammatory diseases. The potential role of GST gene polymorphism on bladder cancer susceptibility is less certain. So, the aim of this work was to study GST-M1 and GST-T1 genes polymorphism in Egyptian patients with S. haematobium to clarify its role on bladder cancer susceptibility in those patients. This was carried out on three groups, 15 Egyptian patients with S. haematobium with bladder cancer, 15 Egyptian patients with S. haematobium without bladder cancer and 10 normal individual as a control group. All individuals were subjected to measurement of serum level of GST using ELISA technique and genotyping for GST-M1 and GST-T1 using PCR technique. The results proved that GST serum level in Schistosoma patients without bladder cancer was decreased but not statistically significant if compared to control group, in contrast it was significantly deceased in Schistosoma patients with bladder cancer if compared to the other groups. PCR results for GST-M1 and GST-T1 genotyping had shown 4 categories, in control group [M1+ve/T1+ve [80%], M1+ve/T1-ve[10%], M1-ve/T1+ve[10%], M1-ve/T1/-ve[0%]], in Schistosoma without bladder cancer [M1+ve/T1+ve[66.7%], M1+ve /T1-ve[13.3%], M1-ve/T1+ve[13.3%], M1 -ve/T1-ve[6.7%]], while in Schistosoma patients with bladder cancer [M1+ve/T1+ve[13.3%], M1+ve/T1-ve[13.3%], M1-ve/T1+ve[20%] and M1-ve/T1-ve [53.3%]]. It was demonstrated a significant decrease in enzyme levels in patients with homozygous deletions of both GST-M1 and GST-T1 genes [GST-M1-ve/T1-ve] if compared to the other three categories of genotyping. Moreover, there was a significant increased risk for development of bladder cancer in patients with combined gene deletion [OR=40] which represented mainly in Schistosoma patients with bladder cancer [53.3% were M1-ve/T1-ve]. Bladder cancer is a common multifactorial disease, and genetic polymorphism especially in GST-M1 and GST-T1 could play an important role as a risk factors in development of urinary bladder cancer among Egyptian with Schistosoma haematobium. So, it could be used for early prediction of risk group in order to help them by follow up for early diagnosis or by cancer chemoprotection

Clinical and radiological outcomes of posterior lumbar interbody fusion with carbon fiber cage in comparison to posterior lumbar interbody fusion with iliac bone graft

This prospective, controlled, randomized clinical study critically compared the clinical and radiological outcomes in patients surgically treated by PLIF with carbon fiber cage versus those treated by PLIF with iliac bone graft. In the period between May 2004 and April 2006, sixty patients underwent posterior interbody fusion of the lumbar spine with transpedicular screw fixation for the treatment of their degenerative segmental instability. In half of then PLIF was done using carbon fiber cage and in the other half PLIF was done using iliac bone graft. Participants were evaluated pre-operatively and post-operatively at 3, 6, 9, and 12-month intervals. Pain was scored by a VAS for both lower limb and back pain both preoperatively and postoperatively. The clinical outcomes were compared using the Prolo economic and functional rating scale and the fusion status was compared using the radiological criteria of fusion proposed by Brantigan. By 12 months follow up period, 65% of the study group expressed clinical success. Prolo scale showed clinical outcomes of patients who were treated with PLIF with carbon cage are better than those treated with PLIF with iliac crest graft but this was not statistically significant. The radiographic evaluation for bone union showed that 43% of the iliac bone group had no fusion, but 80% of cases of the cage group revealed sound fusion. Complications were matched in the 2 groups except for collapse and iliac crest harvest complications that prevail in the iliac crest group. PLIF with Carbon cage gives better fusion on radiology than PLIF with iliac bone graft, but no statistical difference in the clinical outcome. Carbon cage use precludes complications associated with iliac bone harvesting

Experimental study of biochemical effects of insecticides in albino rats

To detect the acute toxicity of some insecticide rats were divided into ten treatments each one contained six rats. These rats administered a single oral dose of 1/10 LD[50], 1/4 LD[50] and the LD[50] of primiphos-methyl, Chlorpyriphos-methyl and fenitrothion. After 24 hr treated rats were sacrificed. The activity of some biochemical parameters glutamic oxaloacetic transaminase [GOT], glutamic pyruvic transaminase [GPT], alkaline phosphatase [Alk. Ph.], creatinine, urea, total protein and total cholesterol] were detected in blood serum. The results indicated that all treatments caused significant increase in the activity of GOT, GPT and [Alk. Ph.], as well as the level of creatinine, urea and total cholesterol as compared by control ones. While the results indicated that 1/4 LD[50] and 1/10 LD[50] of the three tested insecticides caused significant decrease in total protein concentration. These detected differences observed on values between enzymes tested of liver and kidney function by increase or decrease it is considered a sign and pronounced that treated animals affected by oral dose through 24 hr

Comparasion of three normovolaemic haemodilutions on pulmonary gas exchange and tissue oxygenation in cardiac surgery with extracorporeal circulation

Cardiopulmonaary bypass [CPB] with haemodilution is currently used as a common adjunctive measure in cardiac surgery. However, there is still much controversies as regards the effect of haemodilution on pulmonary gas exchange and tissue oxygenation after cardiac surgery with extracorporeal circulation. We have studied 60 adult patients, ASA II and III who were undergoing elective coronary artery bypass graft operation with CPB. Patients were allocated info three groups according to their final haematocrit after the end of extracorporeal circulation; group [I] haematocrit above 30%, group [2] haematocrit from 25%-30%, and group [3] with haematocrit between 21%-25%. Our study showed a significant impairment of pulmonary gas exchange after cardiopulmonary bypass as shown immediately after the end of bypass and continued all over the study period as shown by a decrease in the arterial oxygen partial pressure [PaO2] and arterial alveolar oxygen tension PaO2 /PAO2 and an increase in alveol-arterial oxygen tension gradient P [A-a] O2 and pulmonary shunt Qs /Qt. while no significant effect of the different haematocrit values was noted on the pulmonary gas exhange, in addition the tissue oxygenation parameters showed a stability in the oxygen consumption VO2 in spite of a marked decrease in the oxygen delivery DO2 this may be achieved through an increase in both oxygen extraction O2EX% and cardiac index CI

Surgical treatment of resistant cases of planter fasciitis

Subcalcaneal heel pain [plantar fasciitis] is a very common presenting complaint in orthopedic practice. The exact cause of pain is uncertain. It may be due to repetitive microtrauma and overload injury to the plantar fascia at its attachment to the calcaneal tuberosity, loss of heel pad elasticity or entrapment neuropathy of a branch of the lateral plantar nerve to the abductor digiti minimi muscle or medial calcaneal branches. Systemic disorders as rheumatoid arthritis, diabetes mellitus, SLE, gout, ankylosing spondylitis or Reiter's syndrome might also cause plantar fasciitis. Most patients respond to one form or another of conservative treatment. Twenty-four patients [30 feet] with refractory plantar fasciitis for whom surgical treatment was done were presented. Fasciotomy, stripping of the short muscles of the toes and excision of calcaneal spur, if present, were done for all patients. The minimum follow up period was one year and the results were 86.6% satisfactory and 13.4% unsatisfactory. The complications were two feet with superficial infection, six feet with a strip of hyposthesis below the incision and four feet with persistent pain and tenderness at the final examination