Possible protective effect of vitamin E on the joined cardio-renal effects of lead toxicity and noise stress in rats

Pollution is a worldwide problem and its potential to influence the physiological systems of human population is great. Many studies found that some pollutants have detrimental effects on human growth, particularly prenatal growth. Lead is one of the heavy metals commonly found in human populations. Lead toxicity was reported to be related to haemopoietic, hepatic, renal, nervous, gastrointestinal and reproductive disorders in man and animals. Recent studies have reported lead's potential for inducing oxidative stress which plays a role in the pathophysiology of lead toxicity. Noise stress from transportation sources also is related to different physiological effects on human, as well as impairment of auditory function and growth. Studies showed that combined exposure to noise and different pollutants affects heart and other organs. On the other hand, antioxidants were reported to reduce incidence to various physiological alterations accompanied by oxidative stress. Previous studies suggested that antioxidants may play an important role in abating some hazards of lead. The aim of the present work was to evaluate the possible ameliorating effect of vitamin E, as an antioxidant, on some alterations caused by lead or noise alone or in combination on kidney and heart biomarkers in adult male rats. Vitamin E was administered orally in a dose of 200 mg/kg two hours before lead dosage [15 mg/kg, i.p]. Animals were exposed to horn noise of about 110 dB for 30 minutes after administration of lead and/or vitamin E. The experiment was conducted for 14 consecutive days. The evaluated parameters included assessment of serum levels of urea, creatinine, Aspartate aminotransferase [AST], creatine kinase [CK] and lactate dehydrogenase [LDH] and levels of reduced glutathione [GSH] and malondialdehyde [MDA] in kidney and heart tissues. The histolopathological changes in both kidney and heart were reported. The obtained results revealed that lead and noise either alone or in combination caused statistically changes in the examined parameters with a good potential for vitamin E to protect against these changes

Mangifera indica leaves extract modulates serum leptin, asymmetric dimethylarginine and endothelin-1 levels in experimental diabetes mellitus

Diabetes is a chronic disease that is relatively common throughout the world. The present study was carried out in an attempt to investigate the possible antidiabetic activity of Mangifera indica [mango] leaves extract in streptozotocin [STZ]-diabetic rats. In addition, the effect of extract on diabetes complications as cardio, vascular and.endothelial dysfunction was also studied. 30 male adult albino rats were divided to three groups [10 rats each] and were studied as following scheme for 42 days, group [1] normal control, group [2] diabetic control rats were given distilled water daily by gastric incubation, and group [3] diabetic rats were treated orally with Mangifera indica leaves aqueous extract. Blood samples were collected at 21[st] and 42[nd] day for different biochemical parameters estimations. The Mangifera indica extract administration to diabetic rats significantly decreased the level of blood glucose, leptin, asymmetric dimethylarginine and endothelin-1 as well as lactate dehydrogenase, creatine kinase and aspartate aminotransferase activities. The levels of insulin, C-peptide and nitric oxide were significantly increased. Further, the extract showed significant antihyperlipidemic activity. These findings demonstrated that Mangifera indica leaves extract possess antidiabetic and antihyperlipidemic properties thus suggesting its beneficial effect in the treatment of diabetes mellitus associated with hyperlipidemia and related cardiovascular complications

effects of dietary Egyptian propolis and bee pollen supplementation against toxicity of sodium fluoride in rats

Propolis and bee pollen are substances produced by honey bees. Its components are strong antioxidants and free radical scavengers. The present study aimed to study the protective effects of propolis and bee pollen supplementation against toxicity of sodium fluoride [F] in rats. Rats were divided into six groups each 10 rats and treated for 6 weeks: group 1 as control group; group 2 fed on standard diet with F; groups [3-6] fed on standard diet with F and supplemented with different concentration of propolis or bee pollen at 0.1%, 0.2% and 1%, 2% respectively. After the end of experimental period, the rats were sacrified and biochemical analyses were carried out. The results showed that the administration of fluoride alone caused a significant increase of malondialdehyde [MDA] level and a significant decrease of antioxidant system as measured by erythrocyte superoxide dismutase [SOD] activity and reduced glutathione [GSH] levels in blood and brain. Also F caused a significant increase in alkaline phosphatase [ALP] activity, urea, creatinine, sodium and potassium levels.Moreover, a significant decrease in total protein, calcium, magnesium and phosphorus levels as compared to control group [P < 0.05] was recorded. The administration of propolis or bee pollen with F led to a significant decrease in MDA level and a significant increase in SOD activity, GSH levels in blood and brain.As well as significant decrease in ALP activity, urea, creatinine, sodium and potassium levels in serum was also observed. The propolis or bee pollen supplementation enhanced total protein, calcium, magnesium and phosphorus levels in serum as compared to F group alone. supplementation of natural antioxidants [propolis or beepollen] during Fluoride administration, facilitates reduction of the toxic effects and enhanced both the antioxidant system, as well as the levels of minerals in the serum

Hypoxemic episodes in mechnically ventilated newborn

To study hypoxemic episodes in newborn undergoing mechanical ventilation. Tidal volume, respiratory rate, oxygen saturation, heart rate, and body movement were continuously recorded in 10 low birth weight infants [LBWI] who exhibited episodes of hypoxemia during mechanical ventilation [birth weight, 829 +/- 139 gm; postconceptional age at study, 2.5 +/- 1 week]. Frequency of hypoxemic episodes was compared in both prone and supine positions. Seventy-six percent of hypoxemic episodes began in association with body movement as well as heart rate acceleration. Thereafter the spontaneous and delivered minute ventilation both decreased during the first 15 seconds of hypoxemia. The former decrease was due to a significant decrease in frequency of spontaneous respiration, whereas the latter was associated with a significant decrease in delivered tidal volume. Minute ventilation returned to normal before recovery of oxygenation. A change in body position from supine to prone significantly decreased the frequency of hypoxemic episodes. Hypoxemic episodes in infants who are on ventilatory support are characterized by: movement and cardioacceleration at initiation; adecrease in both spontaneous and delivered minute ventilation, and a lower incidence in the prone position. We speculate that spontaneous movement during sleep can trigger cardiopulmonary reflex responses that initiate and propagate these episodes

Apo-1 as a marker of programmed cell death in patients with acute lymphoblastic leukaemia

We have planned this work to evaluate the significance and prognostic values of both membrane and soluble APO-1 as markers of apoptosis in patients with acme leukaemia before and alter chemotherapy. For that, 30 patients suffering from acute leukaemia [15 patients with ALL and 15 patients with AMD and 10 apparently healthy individuals serving as control group, were selected and subjected to the following: thorough history and clinical examination, routine investigations including: complete blood picture, bone marrow examination, cytochemistry, immunopheno typing of the blast cells and specific investigations including: detection of mAPO1 [CD95] on surface of blast cells by flow cytometry, detection of DNA fragmentation by agarose gel electrophoresis and measurement of soluble APO-1 by ELISA technique before and after chemotherapy. Surface membrane CD9S was found to be expressed on the majority of ALL blast cells [86.6%] and in only 60% of AML blast cells. The degree of surface membrane expression was variable ranging from 23-86% in ALL and from 43-89%; in AML. In both ALL and AML patients, a significant relationship was detected between surface CD95 expression and response to initial induction chemotherapy. Ninety-one percent of ALL patients and 84% of AML patients who had surface CD95 expression>20% on their blast cells showed complete hematological remission after initial induction chemotherapy. This was confirmed by finding that DNA extracted from patients under chemotherapy, whose blast cells CD95 expression was>20%, showed DNA fragmentation [DNA laddering] by agarose gel electrophoresis [characteristic of apoptosis]. As regards soluble CD9S [SCD95] before starting chemotherapy, no statistically significant difference was observed between the level of soluble CD9S in both ALL and AML patients and the control group [P>0.05]. But, in AML patients, the level of soluble CD95 tended to be etevated [not significantly] in comparison with normal control. After initial induction chemotherapy, the level of soluble CD95 was found to be significantly decreased in both ALL and AML patients in comparison to its level before therapy [P<0.001 and<0.01, respectively]. By following up patients who were resistant to chemotherapy, it was observed that patients who did not achieve complete remission after induction chemotherapy had relatively higher levels of sAPO-1. From these results we can conclude that, since there is a significant relationship between surface CD95 expression in both ALL and AML patients and response to chemotherapy, the expression of surface CD95 could serve as a new prognostic marker as it is helpful in predicting the outcome of therapy. In addition, because soluble APO-1 was found to be relatively high in patients resistant to anti-leukaemic therapy, so measurement of s-APO-1 in sera of acute leukaemia patients could serve as a putative marker for an active persisting leukaemia

Influence of malt extract and marjoram oil on the neurobehavioral changes of scopolamine -induced demented rats

Dementia can result from Neurodegenerative diseases: Alzheimer's disease, multiple sclerosis, toxic insults and sleep disorder. Alzheimer's disease [AD] is a progresstve degenerative condition that represents the most common cause of dementia. Scopolamine is a reference substance for inducing Alzheimer-like cognitive deficits in both man and animals Donepezil hydrochloride is highly selective for the CNS and is used for the symptomatic treatment of mild to moderately severe dementia in Alzheimer's disease. Malt extract and marjoram oil are natural products used in folk medicine for the treatment of some psychiatric disorders. The present work aims to study the influence of malt extract and marjoram oil on the behavioral responses, cholinesterase activity, brain monoamines, malondialdehyde and reduced glutathione of scopolamine induced demented rats. The results show that scopolamine decreased the ambulation and rearing frequencies in the open field test. Norepinephrine, dopamine and reduced glutathione contents were also decreased. However, cholinesterase activity and malondialdehyde content were increased significantly. Treatment of demented rats with donepezil, malt extract or marjoram oil individually could normalize the effect of scopolamine on these measured parameters. Data revealed that malt extract and marjoram oil could play an important role in treatment of demented rats by improving the changed behavioral parameters, altered brain neurotransmitters, cholinesterase activity and oxidative biomarkers

Biochemical and biological studies on the interaction of some food colorants and preservatives

This study aims to investigate the effect of some food colorants and preservatives on Sprague-Dawley albino rats. The study was conducted on six equal groups fed on either basal control diet [group 1] or experimental diets [groups 2-6] as following: groups 2, 3 and 4 received a standard diet containing beta-carotene, tartrazine or benzoic acid, respectively at a dose of 200 mg/kg diet, while groups Sand 6 received a standard diet containing benzoic acid [200mg/ kg diet] incorporated with beta-carotene or tartrazine [200mg/ kg diet], respectively. Animals were fed ad libitum for 45 days. Body weight, food intake, feed efficiency and some biochemical analyses were measured, also histopathological examination of liver was performed. Our results showed a significant increase in blood urea, serum creatinine, ALT, AST, ALP and bilirubin in all groups except that received beta-carotene. Liver glycogen showed a significant decrease in rats fed on tartrazine alone or in combination with beuzoic acid. The histopathological results showed no significant toxic effects of beta-carotene alone while when combined with benzoic acid, moderate congestion and necrotic degeneration occurred. Tartrazine also induced slight mononuclear infiltration and benzoic alone showed marked vaculation, while in combination showed marked congestion, vascular infiltration and vaculation. In conclusion, the present study showed that even the permitted doses of colorants [e.g. beta-carotene and tartrazine] and food preservatives [e.g. benzoic acid] when taken together or if taken in excessive quantity may be harmful

protective effect of soybean and thyme on iron deficiency anemia in rats

The present study is carried out to investigate the protective effect and antioxidant activity of soybean and thyme on iron deficiency anemia. Thirty five male albino rats were divided into five groups [rats each]. The first group fed on basal diet, iron sufficient [35 mg Fe / kg], and served as control. Rats of other groups [second - fifth] were induced anemic by placing them on diet containing 3mg Fe / kg for 21 days, then divided to four dietary groups. The second group [anemic] stayed on basal diet with Fe-deficiency. The third group fed on basal diet with sufficient iron in the form of ferrous sulphate. The fourth group fed modified basal diet free from iron and supplemented with soybean. The fifth group fed basal diet free from iron and supplemented with thyme. All three iron sources provide 35 mg iron/kg diet. At the end of experiment [49 days], rats were anesthetized,' whole blood was used for determination of hemoglobin [Hb], hematocrit [HCt] and reduced glutathione [GSH] levels. Serum was used for determination of iron and lipid profile as well as lipid peroxidation as malondialdehyde [MDA]. The liver was used for determination of iron and copper concentrations. The present results indicated that Fe-deficiency caused many adverse effects reflected the significant decrease of Hb, HCt, serum iron, liver iron, GSH and high density lipoprotein-cholesterol [HDL-C]. Fe-deficiency also caused significant increase in total iron binding capacity [TIBC], liver copper, MDA, triacylglycerols [TG] and total cholesterol [TC]. In contrary, administration of ferrous sulphate [FeSO[4]], soybean or thyme induced a significant increase of serum and liver iron profile. Soybean and thyme could able to provide iron to correct dietary iron-deficiency anemia and powerful antioxidant effect of soybean or thyme was reflected on marked decrease of MDA and increase of GSH and HDL-C

Sleep apnea and its effect on ascitic patients

Obstructive sleep apnea syndrome has been recently described as a complication of ascites. This occurs due to elevated mechanical loads on the upper airway and defects in compensatory neuromuscular responses. Sleep disturbances, daytime hypersomnolence and neurocognitive dysfunction are common complications of cirrhosis and sleep apnea syndrome. The severity of these complications increases with the presence of both pathologies and improve markedly with the improvement of apnea after tapping of ascites. The aim of this study was to determine the type of apnea associated with ascites. The effect of apnea on the condition and the level of improvement in sleep disturbances and neurocognitive complications after tapping of ascites. The study was conducted on 40 patients with chronic liver disease, divided into 3 groups according to the extent of ascites. Group I with tense ascites [n=20], Group II with mild to moderate ascites [n=10], Group III without ascites [n=10]. Assessment was done through clinical examination, minimental state examination [MMSE], laboratory investigations, abdominal ultrasound and polysomnography. Sleep efficiency and neurocognitive functions as measured by MMSE were significantly affected with the increased degree of ascites. Apnea was found to be of the obstructive type. Apnea hypopnea index [AHI] was clearly higher in group I than groups II and III. MMSE and sleep efficiency showed a statistically significant correlation with the presence of significant apnea. AHI, sleep efficiency and MMSE improved markedly after tapping of ascites. Obstructive sleep apnea syndrome [OSAS] can be a complication of tense ascites. OSAS causes more deterioration of sleep efficiency and neurocognitive functions and these findings improved after tapping of ascites

Protective effect of vitamin C and beta-carotene against nickel-induced hepatotoxicity in rats

The present study was designed to investigate the effect of nickel sulphate [25 mg/kg diet] and to evaluate the protective effect of vitamin C and beta-carotene [200mg/kg diet] on the liver of male albino rats. Serum alanine aminotransferase [ALT] and aspartate aminotransferase [AST], superoxide dismutase [SOD] activities, lipids peroxidation as malondialdehyde [MDA] and hemoglobin concentration [Hb] were determined. The results showed that nickel sulphate administration for eight weeks induced highly significant [P<0.01] increase of ALT, AST activities and MDA level, highly significant decrease in the activity of SOD and significant [P<0.05] decrease in Hb concentration in rats. The supplementation of vitamin C simultaneously with nickel sulphate showed insignificant reduction in ALT and AST activities, highly significant increase in SOD activity and significant decrease in MDA level, while supplementation of [Beta-carotene with nickel sulphate induced a significant reduction in ALT, AST activities and MDA level with highly significant increase in SOD activity as compared with nickel sulphate treated rats. Supplementation of vitamin C or beta-carotene induced an insignificant increase in Hb concentration in rats comparing with nickel sulphate treated group

Influence of dietary omega-3 and omega-6 containing oils on the neurobehavioral responses in male rats

Omega-3 and Omega-6 fatty acids affect growth vitality and mental state. They favorably affect atheroscieorosis, coronary heart diseases, inflammatory diseases and perhaps even behavioral disorders. The aim of the present study was to elucidate the possible effect of feeding rats a diet enriched with 5% of each flaxseed oil or sun flower oil [for 10 weeks]on the levels of brain monoamines and on the parameters of two behavioral tests[open field and swimming tests].90 male rats pups after weaning[21 days of age]were divided into 3 groups: group[1]control untreated, group [2] and [3] subjected to a diet containing [5% flaxseed oil or sun flower oil] respectively for 10 weeks. The results showed that both Omega-3 and 6 produced a significant increase in the levels of serotonin and dopamine. In the open field test omega-3 and omega-6 oils induced a significant increase in the grooming number whereas, induced a significant decrease in the rearing number. Application of swimming test to tested groups revealed that both Omega-3 and Omega-6 induced a significant decrease in latency time, The data showed that both Omega-3 and Omega-6 containing oils cause alterations In the brain functions and behavior in rats

Effects of sevoflurane and isoflurane on coagulation system a comparative study

Several studies of the effects of inhalational anesthetic agents on platelet function have been reported since Ueda demonstrated in 1971 that clinical concentrations of halothane inhibited ADP-induced platelet aggregation. Sevoflurane in particular has recently been the subject of several investigations; however, the results remain contradictory. Platelets play an important role in hemostasis during and after surgery. Among multiple factors, interactions of drugs used in anesthesia with platelet function have been implicated to aggravate the risk of perioperative bleeding. In this study, the aim was to assess the effects of sevoflurane and isoflurane on the coagulation system. Patients were randomly divided into two groups [30 patients each]: isoflurane group [group I] and sevoflurane group [group S] according to the inhalational anesthetic used for maintenance of anesthesia. Blood samples were withdrawn before induction, 1 hour after induction and 1 hour postoperatively to measure red blood cells count, hemoglobin level, platelets count, bleeding time, prothrombin time and activity, activated partial thromboplastin time, pH, body temperature and platelet aggregation tests. The results of this study showed that red blood cells count, hemoglobin level, blood pH values and vital signs measurements were insignificantly changed during the predetermined times of measurements. Sevoflurane had a significant inhibitory effect on intraoperative platelet aggregation. Also, it had a residual suppressive effect 1 hour postoperatively, whereas it had no significant effect on other coagulation parameters including platelet count, bleeding time, prothrombin time and activity and activated partial thromboplastin time. As regards isoflurane, it had no significant effect neither on platelet aggregation nor other coagulation parameters during the intraoperative and postoperative periods. The conclusion of this study is that sevoflurane has a significant inhibitory effect on intraoperative platelet aggregation, whereas isoflurane has no effect. There is also a residual suppressive effect 1 hour postoperatively with sevoflurane. Therefore, in patients at increased risk of intraoperative and postoperative bleeding, isoflurane may be preferred as an inhalational agent for maintenance of general anesthesia.

Causes of denture fracture: a survey

Fracture of acrylic resin removable dentures occurs frequently during service through heavy occlusal force or accidental damage. The purpose of this survey was to determine the number and type of damaged removable dentures at Dammam Dental Center, Dammam, Saudi Arabia and to ascertain the statistical relationship between certain variables and damage to dentures. Three operators were instructed to complete the questionnaires for each denture received for repairs at the center over a period of 6 months. Eleven variables were examined for each damaged denture. Results obtained showed that the type of dentures most commonly needing repair was the lower partial denture [46.4%]. Results also showed that 53.6% of the damaged dentures had been in use more than 1 year and less than 3 years. Impact failure [80.4%] was the most common cause of damage. The most frequent type of damage was breakdown of the acrylic base [71.4%]. The Chi-square test showed a statistical dependence [P<0.05] between damaged dentures and some of tested variables namely, Kennedy classification of partial denture, age of the denture, causes of fracture, type of fracture, retention of the denture, type of antagonist and strengthener of the denture. It could be concluded that damage to removable dentures is quite frequent and provides much distress and cost for patients. These difficulties can best be prevented by regular examinations of the mouth and dentures. A new, more suitable method of reinforcing the base of dentures during preparation is also needed

Clinical and radiographic assessment of implant retained removable partial denture

The use of dental implant-supported restorations has given an expanded ability to provide predictable replacements for missing teeth. New designs will expand the use of this treatment modality further, especially in the areas of poor bone quality. Implant retained prostheses have become a well-established option to treat the partially edentulous patients and often represent an improvement over traditional removable partial dentures. This article describes implant alternatives and prosthesis design for a group of patients with mandibular unilateral -free end edentulous ridge with one modification on the opposite side. Each patient received removable partial denture retained by telescopic crowns on osseointegrated implants inserted in the edentulous spaces. Implants were used as supporting and retentive elements for mandibular distal extension prostheses. In these cases, sufficient retention gained from telescopic crowns on the implant abutments. A clinical and radiographic evaluation is performed for each patient. Results indicated consistent increased satisfaction in all patients, no radiographic evidence of excessive bone loss, and stable peri-implant soft tissues

Role of c-ERB-B2 in benign and malignant ameloblastomas of the jaws

The present work was undertaken to examine c-erb-B2 oncogene expression in benign and malignant ameloblastomas. The study included 16 cases of benign [9] and malignant[7] amel-oblastomas. Benign ameloblastoma included 6 cases of follicular type and 3 cases of plexiform type. Five cases were found to be malignant ameloblastoma while 2 were ameloblastic carcinoma. The imrnunohistochemical study on the expression of c-erb-B2 using labelled strept- avidin- biotin complex method revealed expression and/or amplification in most cases. 3 cases of follicular type and 2 cases of plexiform type showed mild immune reaction The positive c-erb-B2 expression was more severe in malignant ameloblastoma and ameloblastic carcinoma cases. Thus, it was concluded that amplification and overexpression of c-erb-B2 was found to be a valuable prognostic marker as it was associated with aggressive tumor growth and malignant potential of epithelial odontogenic tumors

Effect of supplementation with zinc and iron on growth, development and morbidity in infants in an urban neighborhood in Cairo, Egypt

Iron and zinc are trace minerals that are of critical importance to the young infant for normal growth and development.To investigate the effect of zinc and iron supplementation on growth and mental performance in infants. This study is a r and omized controlled trial conducted in an old crowded district in Cairo, Egypt. At baseline 119 infants aged 4 months [ +/- 15 days] randomly assigned to receive 5ml per day of either supplement A [multivitamins with zinc and iron added] or supplement B [multivitamins without zinc and iron]. Infants were examined clinically and anthropometric measures [weight, length and knee-heel] were taken. They were followed up for history taking [diet and morbidity], clinical examination and anthropometric measurements every 15 days till the age of 10 months +/- 2 weeks. Mental and Motor development were assessed at baseline [4 months] and at the end of the study [10 month +/- 2 weeks] using the Bayley Scale of Infant Development [BSID II]. The study was single blinded for clinical and growth assessment, while it was double blinded for developmental evaluation.Infants included in the study were those who had at least 3 recordings of anthropometric measurements [n=69 infants]. Repeated measures ANOVA test was used to compare differences between the groups, change with time, and group and time interaction. At the end of the study the zinc and iron supplemented group showed a slight but insignificant rise in anthropometric measurements. Developmental performance [MDI and PDI] also showed an insignificant rise at the end of the study in the supplemented group. Change with time is the same in both groups, differences between groups is the same at each time period. Comparison of growth rate between the two groups showed a trend towards increased velocity of all growth parameters in the zinc and iron supplemented group, however the difference between the two groups is not significant. Comparison of number of episodes of fever, upper respiratory tract infection [URTI] lower respiratory tract infection [LRTI] and diarrhea between the two groups showed no statistical differences, though we could see an increase in the percent number of infants with morbidity [except for URTI] in the group not supplemented with iron and zinc.Infants in both groups gained weight and length similar to reference data. In spite of this, we see a trend towards increased velocity of weight in the zinc and iron supplemented group as compared to the non-supplemented group. This is also associated with an apparent decrease in morbidity in the supplemented group

Corpus callosum MRI study in multiple sclerosis and small vessel ischemic stroke

Damage to corpus callosum visible by MRI in multiple sclerosis may be simulated by other CNS diseases [e.g. ischemia, SLE, Behcet's disease, other vasculitides, sarcoidosis]. Ischemic lesions, in particular, make MRI criteria much less reliable for the diagnosis of MS pateints over the age of 50. To study the difference between MRI abnormalities of the corpus callosum in patients with MS versus small vessel ischemic stroke. 76 patients were divided into 2 groups: group 1, comprising 26 patients with clinically definite, relapsing remitting, MS; and group 2, including 50 hypertensive and /or diabetic patients with history and clinical evidence of ischemic stroke proved by MRI to be of small vessel ischemic type. They were all subjected to minimental state examination [MMSE] and MRI brain study for corpus callosum lesions and atrophy. The mean MMSE score in the stroke group was 27.75 +/- 3.21 while in the MS group it was 23.62 +/- 3.76 with a significant difference between them [P < 0.05]. In both groups, the score inversely correlated with corpus callosum atrophy. The latter was significantly more in MS group [X[2] = 47.045, P <0.05]. The mean number of corpus callosum lesions was 2.3 +/- 2.4 in the stroke group and 8.1 +/- 2.6 in MS group with significant difference [P<0.05]. The predilection of location of corpus callosum lesions was significantly different in the 2 groups [P<0.05], being more inner callosal [42%] and ventriculocallosal [49%] in MS group while the outer callosal was more common in the stroke group [35%]. Corpus callosum atrophy would be used as a relatively morphological marker for cognitive decline in MS and small vessel ischemic stroke, being significantly more in MS. The more atrophic the corpus callosum is, the more weighing down of MS versus small vessel ischemic stroke in clinically and radiologically overlapping cases

Matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, parathyroid hormone related protein and tissue expression of CD44v6 in metastatic breast cancer

Matrix metalloproteinases [MMPs] and their inhibitors [TIMPs] modulate ECM composition and may affect breast cancer invasion and metastases. Bone metastases are a frequent complication of advanced breast cancer. This work investigated the relationship between plasma levels of MMP-9, TIMP1, PTHrP, tissue expression of CD44v6 and the development of nodal and bone metastases in 40 female patients with different stages of breast cancer. The control group comprised 10 females with benign breast lesions. All studied parameters were significantly higher in patients than in controls. Patients with lymph node involvement has significantly higher plasma MMP-9, MMP9/TIMP-1 ratio and CD44c6 expression than those without nodal affection, [p= 0.018, 0.006 and 0.02 respectively]. Higher MMP-9 MMP9/TIMP-1 ratio and PTHrP were found in patients with than those without bone metastases [p = 0.013, 0.01 and 0.0002 respectively]. CD44v6 expression was associated with increased MMP-9 and TIMP-1 levels as well as higher tumour grade. Post-operative MMP-9 was significantly lower than pre-operatively. Our data indicate that increased plasma MMP-9 and MMP-9 / TIMP-1 imbalance may be useful markers for development of nodal and bone meatstases in breast cancer patients and in predicting post-operative recurrence. While CD44v6 is involved in nodal metastases, PTHrP seems to be an important determinant of development of bone secondaries

Role of sentinel lymph node biopsy in the management of patients with breast cancer

The status of the axillary lymph node basin remains the most powerful predictor of survival in patients with invasive breast cancer. Lymphatic mapping concept entails that lymphatic drainage from primary tumors can be mapped to the regional lymph nodes. The first node[s] of these nodes, i.e., the SLN, can then be identified and removed. This node is supposed to be the initial site of metastatic disease, and the histologic characteristics of the SLN reflect the state of the remaining nodes in the lymphatic basin. The preliminary reports of lymphatic mapping and SLN biopsy in breast cancer have shown this technique to be an accurate axillary staging procedure. It is a less invasive procedure and therefore is associated with a lower rate of complications, such as postoperative lymphoedema, seroma formation, and neuropathy of the arm, than complete ALND. It also allows more detailed examination of the lymph node at greatest risk for metastatic disease. This can be performed by serially sectioning the SLN and applying immunohistochemical [IHC] stains to the specimens, thereby enhancing the detection of nodal metastatic disease. The present study aimed at: comparing peritumoural injection with subareolar injection of dye in identifying SLN/s. Also, identifying the presence of micrometastases in the SLN/s by serial sectioning of the SLN/s and H and E staining or cytokeratin stains. The study was performed on 94 patients with stages I and II breast cancer equally divided into two groups according to method of injection of dye each of 47 patients. SLN were successfully mapped in 84 patients. Fifty three of them harbored metastases. In 45 patients metastases was discovered by ordinary H and E technique. Micrometastases were discovered in eight more patients [5 by serial sectioning of lymph nodes and H and E examination and 3 by immunohistochemical staining. The use of SLN alone would have led to understaging in two patients. It can be concluded that SLN biopsy is an accurate and useful technique. A thorough knowledge of its different methods, its indications as well as limitations maximize the value of this techniques to the oncologic surgeon. The use of modern staining techniques helps also in detecting minimal disease and allows for appropriate treatment decisions

Epstein-Barr virus in head and neck squamous cell carcinoma

We compared 50 patients with head and neck squamous cell carcinomas [cases] and 45 matched healthy controls. Biopsy specimens were taken from tumours and normal tissue of the cases and controls respectively and serial paraffin embedded sections were processed to detect Epstein-Barr [EB] viral antigen. We found EB viral proteins in 38% of cases and none in controls, which suggests a positive correlation. Serum samples were also tested for the presence of EB virus IgG by ELISA for comparison with immunohistochemical findings. Patients with positive immunohistochemical staining results had significantly higher mean antibody titres compared with those with negative results. ELISA may be useful in determining the etiology of head and neck cancers, but the results are not unequivocally reliable