Circulating MiRNA-21 and programed cell death [PDCD] 4 gene expression in hepatocellular carcinoma [HCC] in Egyptian patients

Background: Circulating microRNAs [miRNAs] are endogenous, small [17-25 nucleo-tides] non-coding RNAs that are overexpressed in many human cancers including hepatocellular carcinoma [HCC]. Moreover, circulating miRNAs can reflect the level of tissue miRNAs, so could be potential tumor markers. miRNA-21 regulates post-transcriptional expression of tumor suppressor gene; programed cell death 4 [PDCD4] gene which implies that miRNA-21 might be a novel diagnostic and/or prognostic marker for cancer

Objective: To evaluate the diagnostic and prognostic potential of circulating miRNA-21 and study the expression of PDCD4 gene as a target of miRNA-21 in HCC in Egyptian patients

Subjects and methods: This study was conducted on 30 HCC patients, 20 chronic liver disease [CLD] patients due to HCV infection and 20 healthy subjects. Serum alpha fetoprotein [AFP] was measured for all participants. The relative plasma expression of each of miRNA-21 and PDCD4 gene was determined in whole blood samples using real-time polymerase chain reaction

Results: The results revealed over expression of miRNA-21 and under expression of PDCD4 gene in HCC group [p < 0.05] compared to both CLD and healthy subjects, while no significant change was detected between CLD and healthy subjects. miRNA-21 expression was negatively correlated with PDCD4 gene expression. miRNA-21 expression increased significantly with presence of cirrhosis, increased number of focal lesions, larger size of tumor, advanced tumor stage and presence of vascular invasion. Receiver Operator of Characteristics [ROC] curve analysis of plasma miRNA-21 revealed that, at a cut-off value of 3.93 [fold expression], the sensitivity and specificity for differentiation of HCC cases were 93% and 90%, respectively

Conclusion: Circulating miRNA-21 could be a novel early diagnostic and prognostic biomarker for detection of HCC. Approaches interfering with the miRNA-2 l/PDCD4-axis, or releasing PDCD4 expression, may have a strong basis for therapeutic uses in cancer in the future

Serum hepcidin level and disease course of acute leukemia in children

Acute leukemia [AL] is a heterogeneous group of hematopoietic neoplasms and it is the most common childhood malignancy. Many patients with AL develop severe anemia that requires multiple blood transfusions. Hepcidin expression may play a role in anemia which is often seen in these patients. The aim of this study is to evaluate the role of hepcidin in acute lymphoblastic leukemia in children in Egypt. 60 patients with acute lymphoblastic leukemia [ALL] and 20 age and gender matched healthy children, taken as control group, were included in the study. Complete blood count [CBC], Serum ALT and serum AST were measured by colorimetric methods. Serum hepcidin and ferritin were measured by ELISA. The study showed a significant difference between newly diagnosed ALL cases and other groups regarding all CBC parameters. There was a significant difference in serum levels of hepcidin and ferritin between studied groups. A significant negative correlation was found between serum level of hepcidin and ferritin and each of hemoglobin level and reticulocytic count%, while significant positive correlation was found between hepcidin and ferritin serum levels. From this study, it could be concluded that serum hepcidin level is elevated in ALL children patients at time of diagnosis and correlates with the disease extent. Hepcidin may be one of the serum markers that accounting for anemia associated with ALL in children

Percutaneous extraction of an infected permanent pacemaker in association with superior vena cava obstruction

The procedure of lead removal has recently matured into a definable, teachable art with its own specific tools and techniques. It is now time to recognize and formalize the practice of lead removal according to the current methods of medicine and the health care industry. In this article we report the first case in the United Arab Emirates of infected pacemaker extraction after 9 years of implantation of passive fixation lead for a VVI pacemaker using a locking stylet and countertraction technique with associated superior vena cava obstruction, which had been dilated using the balloon technique with deployment of a stent

study of thyroid hormones profile in breast cancer patients

Breast cancer is a hormone dependent neoplasm, estrogen involvement in breast cancer has been established, however the relationship between thyroid disorders and breast cancer is debated. The aim of this work is to study the changes of thyroid hormones profile in women with breast cancer and to find the relationship between thyroid hormones and E2 in the pathogenesis of breast cancer in premenopausal and postmenopausal women. The study was carried out on 60 subjects, 40 breast cancer patients with age range between 28 to 67 years and 20 healthy female subjects served as control with age range between 28 to 65 years. The studied subjects were subjected to full history taking, clinical and radiological examination, measurement of free triiodothyronine [FT3], free thyroxin [FT4], thyroid stimulating hormone [TSH], anti thyroid peroxidase antibodies [anti Tpo] and estradiol [E2]. The results of this study showed a significant decrease as regarding TSH level [p<0.05] and a high significant increase as regarding anti Tpo level [p<0.001] in patient group when compared to control group. Whereas there is no significant differences as regarding FT3, FT4, E2 and FT3/E2 index. High positive prevalence rate of sub-clinical hyperthyroidism and autoimmune thyroid diseases [p<0.01] in breast cancer patients when compared to controls. It could be concluded that there is a high prevalence of subclinical hyperthyroidism in postmenopausal breast cancer patients, while autoimmune thyroid disorders are more in premenopausal breast cancer patients suggesting the relationship between breast cancer and thyroid disorders

role of calcium channel blockers in the treatment of diabetic nephropathy

Diabetic nephropathy [DNP] is a chronic renal disease [CRD] and a major cause of illness and premature death in people with diabetes mellitus [DM]. It is the single most important cause of end-stage renal disease in the Western world and accounts for more than a quarter of all end-stage renal diseases. This article reviews the current development in DNP and the therapeutic challenge with particular reference to the role of calcium channel blockers. Moreover, renal ischaemia hastens the progression of DNP. Diltiazem and amlodipine have a tendency to reverse the changed parameters toward normal values but do not affect the biochemical parameters. Generally speaking, diltiazem is better than amlodipine in reversing biochemical and histopathological changes produced by DNP, and captopril reverses most of the changed parameters with the exception of the histopathological changes. These agents have nephroprotective properties and delay the progression of DNP

mechanism of action of calcium channel blockers in the treatment of diabetic nephropathy

Three types of calcium channels have been identified voltage-sensitive, receptor operated [cardiac muscle and vascular smooth muscle] and stretch operated [in some blood vessels] channels. Using electrophysiological and pharmacological techniques, three different types of voltage-gated calcium channels have been identified, namely, L-type [for long lasting, large channels], T-type [for transient, tiny channels] and N-type [for neuronal, neither L nor T]. Many compounds are known to have a calcium channel inhibitory effect. Calcium antagonists, based on the specificity of inhibition of the slow calcium current, can be classified into three groups: Group A: for 90 to 100 percent inhibition of calcium influx without change in the sodium current [verapamil, diltiazem and the dihydropyridines]; Group B: for 50 to 70 percent inhibition of calcium influx current without change in the sodium current [bepridil, cinnarizine and prenylamine] and Group C: for agents exhibiting some inhibition of calcium influx [phenytoin, indomethacin and propranolol]. There is now increasing evidence that, certain calcium channel blockers especially the dihydropyridines are more strongly associated with vasodilation of afferent arterioles than of efferent arterioles and also with increase intraglomerular pressure and albuminuria. Thus they have a beneficial effect in terms of reducing proteinuria and slowing the progression of diabetic renal failure

Circulating adhesion molecules as predictors of atherosclerosis and coronary heart disease

Adhesion of leukocytes to endothelial cells via cell adhesion molecules is thought to be pivotal in the initiation of atherosclerosis. This study was designed to determine the value of circulating cell adhesion molecules as a predictors of coronary heart disease and atherosclerosis. This study was conducted on 25 patients with coronary heart disease [CHD], 21 patients with carotid artery atherosclerosis [CAA] and 20 healthy individuals served as control group. The levels of serum soluble[s] adhesion molecules: E-selectin [sE-selectin], intracellular adhesion molecule-l [sICAM-1] and vascular cell adhesion molecule-l [sVCAM-1] were measured in addition to the serum lipids, total cholesterol and triglyceride, HDL-c and LDL-c. The concentration of sE-selectin was significantly higher in the patient groups when compared with the control subjects [CHD 34.9 +/- 19.2 ng/ml; CAA 43.0 +/- 16.7 ng/ml vs. control 18.5 +/- 7.4 ng/ml, p<0.05 and p< 0.001 respectivly]. While there were non significant statistical difference between CHD and CAA [p> 0.05]. The serum level of sICAM-1 was significantly higher in CHD than control [p< 0.05], while there were non significant changes in their values in CAA and control [CHD 318 +/- 85.1 ng/ml, CAA 292.3 +/- 64.2 ng/ml vs. control 240 +/- 68.1 ng/ml]. A significant increase was found in sVCAM-1 among the patient groups when compared with the control [CHD 535 + 227.1ng/ml, CAA 445 + 139.6 ng/ml, control 115+19.7 ng/ml p < 0.001 and p< 0.01 for CHD and CAA respectivly]. The levels of the studied serum lipids were significantly increased in the patient groups when compared with the control [p < 0.001]. When these serum lipids were correlated with the studied adhesion molecules, there were positive correlation between the sE-selectin and LDL-c [r = 0.5, p < 0.02], between sICAM-1 and both of LDL-c [r = 0.51, p< 0.02] and TG [r = 0.39, p<0.05] and between sVCAM-1 and TG [r = 0.62, p< 0.01]. In conclusion, the increase of sE-selectin, sICAM-1 and sVCAM-I levels in patients with CHD and CAA suggests that they would be of beneficial value as markers for preclinical prediction of atherosclerosis and CHD

Blood lead level in full-term and pre-term delivering women and their neonates

Lead toxicity causes hematological, gastrointestinal and neurological dysfunction in children and adults. This work aimed to determine whole blood lead level in full- and pre-term mothers and their neonates, to find the relation between maternal and neonatal blood lead level and to correlate it with some biochemical and hematological parameters. One hundred delivering women and their neonates were subjected to this study, fifty women were full-term and fifty were pre-term. In addition to whole blood lead level and complete blood picture which provides measurement of RBCs, Hb, Ht and MCV, determination of serum iron, total iron binding capacity [TIBC], ferritin and calcium was done for the mothers and their neonates. The blood lead level was> or= 200 micro g/L in 59% of mothers and 47% of neonates. The level was significantly higher in full-term mothers [273.5 +/- 112 micro g/L] and their neonates [215.5 +/- 90.2 micro g/L] than in pre-term ones [218 +/- 109.2 and 191.4 +/- 96.6 micro g/L]. There was non-significant differences between full- and pre-term mothers or their neonates regarding serum iron, TIBC, calcium, Hb, Ht and MCV [p > 0.05]. A significant statistical difference in serum iron, TIBC, Ferritin, Hb, Ht and MCV was found between mothers and their neonates in full- and pre-term groups [p < 0.05] whereas no significant differences were found as regards serum calcium and RBCs. There was significant correlation between blood lead level and each of serum iron, RBCs, Hb and MCV whereas no significant correlation was found between blood lead level and each of serum TIBC, ferritin, calcium and Ht in full-term mothers and their neonates. There was significant correlation between blood lead level and each of serum iron, TIBC, RBCs, Hb and MCV and non-significant correlation with serum ferritin, calcium and Ht in pre-term neonateSoThe blood lead level was higher in frequent Kohl users [338 micro g/L] than in infrequent users [209 micro g/L] and non-users [142 micro g/L]. The blood lead level was statistically higher in mothers having smoking husbands and their neonates [259 and 210 micro g/L respectively] than in those with non- smoking husbands [181 and 154 micro g/L respectively]. In conclusion, this study found high blood lead levels in delivering women and their neonates suggesting that lead exposure would be a major health problem which deserves special attention if possible future healthy pregnancy outcomes are to be considered