Evaluation of selected markers of liver fibrosis in chronic hepatitis C virus patients

To evaluate the usefulness of serum hyaluronan [HA], matrix rnetalloproteinase-9 [MMP-9] and tissue inhibitor of metalloproteinase-1 TIMP-1 as well as AST/ALT ratio [whether as isolated or combined variables] in discrimination of stages of fibrosis in chronic hepatitis C [CHC] patients. Internal Medicine, Medical Biochemistry and Pathology Departments, Faculty of Medicine, Cairo University and Internal Medicine Department. Theodor Research Institute. Thirty six patients with CHC and twelve age and sex-matched healthy subjects as a control group. Histological staging of fibrosis [F0. F1, F2, F3 and F4] was performed in liver biopsy specimen according to the METAVIR Score. Serum levels of HA, MMP-9 and TIMP-l were determined by the Enzyme Linked Immunosorbent Assay [ELISA]. The AST/ALT ratio was calculated. Levels of serum HA and TIMP-I were significantly increased in all stages of fibrosis versus the control group. The AST/ALT ratio was significantly increased while the MMP-9 was significantly decreased in the F2, F3 and F4 stages only versus the controls. Using receiver operating characteristic analysis, the area under the curve [AUC] of the score to discriminate extensive fibrosis [F3] and cirrhosis [F4] stages of CHC from early stages of CHC [FO. Fl, F2] were 0.98 for TIMP-1. with a sensitivity of' 100% and specificity 72.9% . As for HA, the AUC was 0.93% with a sensitivity of' l00f and specificity 57.8% . By multivariate regression analysis, only HA followed by TIMP-1 wee independently associated with extensive fibrosis and/or cirrhosis and were accurate in discriminating F3/F4 stages from the early F0/F1/F2 stages. Furthermore, a combination of the our studied parameters increased the accuracy. The present results suggest that the serum fibrotic markers, especially HA and TIMP-1, may be clinically useful in discriminating early fibrotic stages from the late extensive fibrosis and cirrhosis stages in patients with CHC, especially if combined with other variables, as MMP-9 and AST/ALT ratio

identification of a novel Helicobacter species in cholecystitis specimens; a preliminary study

This work tried to verify the role if any of helicobacter species in the incidence of cholecystitis. This study was conducted in the General Surgery Department at Theodore Bilharzia Research Institute. 83 patients were included in this study. A full history was taken with emphasis on symptoms suggestive of cholecystitis. The 83 cholecystectomy specimens removed by both laparoscopic and conventional open surgical procedures and collected for histopathological examination. Most of the examined gall bladders contained stones [79 specimens], while the other 4 specimens contained gravel material [biliary mud]. All positive cases for helicobacter were cases of chronic calculus cholecystitis. The study detected histopathologically certain bacterial species similar in morphology, staining characters and cellular distribution to Helicobacter pylori in few cholecystectomy specimens. Six specimens were removed from patients with chronic cholecystitis. These few cases were associated with gastric type metaplasia of gall bladder mucosa. These microorganisms may contribute in the pathogenesis of chronic calcular cholecystitis and or the development of gall stones [lithiasis]. Further bacteriological and molecular studies are recommended to identify the exact nature of these microorganisms, the method of infection and the response to therapy

Clinical, sonographic, histopatholgical and DNA study of predictors for malignancy in chronic calcular cholecystitis

In 31 patients with dyspepsia sonographic examination showed thick wall gallbladder in 26 [83.9%], multiple stones in 21 [67.7%] and single stone in 10 cases [32.2%]. Mucosal chronic inflammatory infiltration and mucosal ulceration were the most common lesions [87.1% and 67.7% respectively]. Dysplasia was found in 3 gallbladders [9.7%], with DNA changes showing aneuploid histogram pattern and higher values of S phase percent of cellular population. Hyperplasia was associated with increased percentage of cells occupying the S phase and increased values of 2C-deviation index and 5C exceeding rate percentage. The DNA changes were more associated with multiple stones with significant differences in S phase percentage cellular population between multiple and single stones. Thus, it is concluded that multiple gallstones is an indicator for preference of cholecystectomy to avoid development difficulty predicting malignancy of gallbladder

Ultrasonic guided fine needle biopsy and menghini needle biopsy in endemic hepatosplenomegaly

This study was perfomed on 26 patients admitted to Theodor Bilharz Research Institute. Ultrasonography, thick and fine needle biopsies were performed. Hepatic histopathological diagnosis showed, schistosomiasis, chronic active hepatitis and mixed cirrhosis. Results obtained by the fine needle biopsies were compared to the blind thick Menghini needle technique. The former can have a useful role in the diagnosis of liver diseases

Some psychiatric aspects of anorexia nervosa and bulimia nervosa in arab adolescents and young adults

Eating disorders have become at the present time common diagnoses in the psychiatric clinics, and yet they are not studied properly in our culture. This may be explained by the fact that these disorders have many underlying psychopathological and biological implications. Also, their relation to depression still needs clarification. In this study, 30 adolescents and young adult patients [17 with anorexia nervosa and 13 with bulimia nervosa] and matched control groups were studied for many clinical characteristics concerning these disorders. The eating attitudes test [EAT], the bulimia test [BULIT] and the Hamilton depression scale were carried out, also. The results of the study showed the interactions of various individual, familial, and cultural factors in the etiology and psychopathology of these disorders. For instance, these patients showed special idealization for the thin body form, also their body image was disturbed as well as their type of thinking. Depression was found to be significant in these patients, and they have a tendency to exaggerate symptoms which may be cultural in origin. Eating habits of the family, Eastern familial relationships which discourage autonomy and a family history of depression, substance abuse or eating disorders may be risk factors. History of premorbid obesity, dieting and any chronic medical illness needing nutritional regulation were also found to be of importance