Epithelial and Stromal Syndecan-1 roles on the biological behavior of Dentigerous cyst, Ameloblastoma and Ameloblastic Carcinoma

Background: Dentigerous cyst diagnosis is simple but several case reports have documented neoplastic changes arising from them. Ameloblastoma is a common benign Odontogenic tumor with an aggressive manner and a high rate of recurrence. Ameloblastic Carcinoma is the malignant counterpart of Ameloblastoma but usually difficult to be distinguished from each other’s. Hence, need for Immunohistochemical markers may help achievement of accurate diagnosis. Objectives: Evaluation of Epithelial and Stromal Syn1 expressions and their roles in tumorigenesis and biological behavior of Dentigerous cyst, Ameloblastoma and Ameloblastic Carcinoma. Methods: Tissue samples comprising of 54 archived histopathologically confirmed cases of (10 Dentigerous cysts, 29 Ameloblastomas and 15 Ameloblastic Carcinoma). The sections were subjected to Immunohistochemical staining according to a standard protocol using antibody to Syn1. Results: Stromal Syn1 expression was higher in Desmolpastic Ameloblastoma than other Conventional Ameloblastoma subtypes. Unicystic Ameloblastoma showed higher Stromal Syn1 than Dentigerous cyst. Ameloblastic Carcinoma showed the highest immune-reactivity to Stromal Syn1 than Conventional Ameloblastoma. While, Epithelial Syn1 immune-reactivity was weak. Conclusions: Desmoplastic Ameloblastoma behaves in a more aggressive manner than other subtypes.Stromal Syn1 are highly expressed in aggressive and malignant odontogenic tumors and could be used together as prognostic predictor tool for odontogenic tumors

Screening of non-asthmatic chronic chest troubles in the outpatient chest clinic in a six months period

This study was carried out on 120 children suffering from chronic pulmonary symptoms such as cough, expectoration, anorexia, fever, dyspnoea, chest pain, wheezing, etc. and lasting>3 weeks in a 6 months period starting from 1st of January 2007. Asthmatic patients were excluded. Diagnosis of patients was based upon full medical history, thorough clinical examination, specific laboratory and radiological examinations. Leading causes were tuberculosis [TB], suppurative lung syndromes, interstitial lung diseases, gastro-oesophageal reflux disease [GERD], foreign body aspiration, cystic fibrosis, immune and congenital defects. Early and proper diagnosis is crucial in preventing morbidity and chronicity

microscopic observation drug susceptibility assay [MODS] for diagnosis of tuberculosis and detection of multi-drug resistance

Tuberculosis is a growing international health concern. It is the biggest killer among the infectious diseases in the world today. Early detection of drug resistance allows starting of an appropriate treatment. We evaluated the MODS assay for diagnosis of TB and detection of multidrug- resistance, 95 consecutive sputum samples collected from patients with suspected T8, were tested by smear, proportion method of susceptibility test using Lowenstein Jensen media and MODS. The results of MODS against proportion method of susceptibility test using Lowenstein Jensen media as the gold standard was evaluated. Out of 48 acid fast positive specimens, 14 [29.1%] isolates were resistant to one or the two of the tested anti-tuberculous drugs. Seven isolates [14.6%] had single drug resistance, including one isolate with rifampcin [RIF] monoresistance. Seven isolates [14.6%] were multidrug-resistant [resistant to both drugs]. 13 [27.1%] isolates were resistant to isoniazid [lNH], 8 [16.7%] isolates were resistant to RIF, thirty four test isolates [70.8%] and the control strain were susceptible. There was 97.9- 100% agreement between both reference method and MODS. The turnaround times from specimen processing to reporting of susceptibility results ranged between 6 and 11 [mean, 8 +/- 2.14] days by the MODS method, 41 and 63 [mean, 53.3 +/- 11.58] days by the reference proportion method. The detection rates were significantly faster for MODS than for proportion susceptibility test [P<0.001]. In conclusion, MODS appears to be a reliable, rapid, and convenient method for early diagnosis of tuberculosis [TB] and performing direct drug susceptibility tests in low-resource settings

Major airway obstruction as a cause of chest wheezes

Asthma is a disorder characterized by narrowing of airways which is reversible with time either spontaneously or as a result of treatment. Asthma presents mainly with dyspnea wheezes and or cough which are mainly nocturnal. Many diseases can either mimic or worsen asthma. Patients are often subjected to full anti-asthma therapy without improvement. The aim of our study was to investigate the possible causes of chest wheezes rather than bronchospasm. Our study included 50 patients [25 in pediatric age group and 25 in adult age group]. They were all having longstanding wheezy chest with failure to respond to the usual anti-asthma medications. All the patients were subjected to thorough history taking with special emphasis on foreign body inhalation especially in the children's group; complete general as well as local examination; chest radiology; routine laboratory investigations and fiberoptic bronchoscopy. Our results showed that the commonest cause among all patients was laryngotracheomalacia present in 13 patients. The second most common cause was inhaled neglected foreign body in 9 cases, 8 children and one adult with history of foreign body inhalation at age of 10. The third common cause was malignant neoplasm in 6 adult cases. In conclusion when a patient presents with persistent or recurrent wheezing and the typical features of asthma are lacking, other causes for noisy breathing should be considered and one must be very careful in order not to miss another etiology. In childhood laryngotracheomalacia and foreign body inhalation are the commonest while in adults we should think in malignant obstruction. Fiberoptic bronchoscopy and laryngoscopy are essential tools for investigating these patients

Pulmonary function tests in patients with systemic lupus erythematosus [SLE]

Systemic lupus erythematosus [SLE] is and autoimmune disorder which primarily affects females. It may affect virtually any organ. Abnormalities of pulmonary function have been found in children with SLE even in absence of clinical or radiological evidence of pulmonary involvement. It is unknown whether these abnormalities represent an early sign of progressive lung disease or whether they associated with disease activity. The aim of our study was to investigate the frequency of pulmonary involvement in childhood SLE and to find the relationship between pulmonary function tests and other parameters of the disease. Our study included 70 patients with SLE; pulmonary manifestations were present in 36 patients with a percentage of 51.4%. All patients with pulmonary affection whether clinical or radiological were subjected to pulmonary function tests [PFT]. These included forced vital capacity and forced expiratory volume during first second. Among those 36 patients, restrictive pulmonary function was present in 22 patients [31.4%]. A significant statistical relation was detected between pulmonary function and C3 only [p value 0.4%]. Abnormalities of pulmonary function may be found in children with SLE even in absence of radiological evidence of pulmonary involvement and it is not related to other parameters of disease activity. So, it is recommended to perform pulmonary function tests even in absence of radiological evidence of pulmonary involvement to establish a diagnosis and aid long term follow up of SLE patients with acute lupus pneumonitis and diffuse interstitial lung disease which has a major impact on the mortality and morbidity of SLE patients. Studies to demonstrate the efficacy of PFT in diagnosing pulmonary involvement in SLE patients even in absence of clinical pulmonary manifestations are needed