Patterns of drug resistance in case of smear positive pulmonary tuberculosis in Giza and Cairo governorate

Pulmonary tuberculosis is a major cause of morbidity and mortality World Wide, resulting in the greatest number of deaths due to any other single infectious agent. Drug resistance threatens global tuberculosis control efforts. Multi drug resistance means drug resistance to at least rifampicin and isoniazid. One hundred and nineteen sputum and culture positive patients underwent drug susceptibility to the first line drugs [Isoniazid, Rifampicin, Streptomycin and Ethambutol]. 79/119 patients in addition underwent drug susceptibility to Pyrizinamide, Ofloxacin, Amikacin and Levofloxacin. The susceptibility test shows that 35/119 patients [29.4%] were sensitive to all the tested drugs. 84/119 of the included patients [70.6%] showed drug resistance to at least one of the first line drugs by different patterns. 29/119 patients were diagnosed as MDR cases with a percent of 31% [resistant to both INH and Rifampcin]. This study shows increase incidence of resistance to first line drugs as well as increase incidence of MDR

Factors affecting quality of life for patients with rectal cancer undergoing radiotherapy

Rectal cancer is a significant health problem for patient and results in bowel and sexual function problems. Quality of life is an important outcome measure that has to be considered when deciding treatment strategy for rectal cancer. It has become an integral part of the modern assessment of cancer treatment. This study has been conducted to assess the factors affecting quality of life for patients with rectal cancer undergoing radiotherapy. A descriptive exploratory study was conducted at the surgical outpatient's clinics and Radiotherapy and Nuclear Medicine Department in Ain Shams University Hospitals. A purposive sample of 50 adult patients from both sexes with rectal cancer undergoing radiotherapy were recruited for the conduction of this study, from the above mentioned setting. [1] Patients' interview questionnaire sheet were used to assess factors affecting quality of life [pre treatment course, during radiotherapy and pre surgery], [2] Quality of Life Scale that was used to assess the impact of rectal cancer on the quality of life dimension [physical, psychological, social and spiritual] for the patients during and after radiotherapy and [3] A self-report 5 day diary to identify patients' complications during radiotherapy sessions. The prominent factors affecting on quality of life were patients' age and education, disease stage, side-effects, physical condition and nature of the surgery. There were statistically significant differences between the side-effects during and after radiotherapy, added to the improvement in physical and psychological domains of quality of life post radiotherapy by one month later. There were many factors affecting on quality of life for patients with rectal cancer undergoing radiotherapy [pre treatment course, during radiotherapy and pre surgery]. In addition strong positive correlation was found regarding to these factors and quality of life domains. Further studies are needed to focus on other factors affecting on quality of life for patients with rectal cancer undergoing chemotherapy

Synthesis, biological evaluation and molecular modeling investigation of some new benzimidazole analogs as antiviral agents

A set of heterocyclic benzimidazole derivatives bearing 1,3,5-triazine group with different substituents at C-2 and C-5 of the benzimidazole ring have been synthesized and evaluated for their antiviral activities against HSV-1. The structures of these compounds have been established by analytical data, IR spectra, [1]H NMR, and mass spectra. Compounds 8a and 8b proved to be the most active antiherpetic agents in this study, at EC[50]% concentrations of 2.9, 3.4 mg/ml, respectively. Computational evaluation of the quantum chemical descriptors such as hydrophobicity [log P], HOMO and LUMO, and the gap energy, were calculated and correlated with the antiviral activity. The tested compounds showed proper degree of hydrophobicity [<0.5 - >5]. The HOMO-LUMO gap energy values of the tested compounds are comparable with the observed values for the antiviral drug, Acyclovir

Virtual versus fiberoptic bronchoscopy in the evaluation of tracheobronchial neoplasms

Lung tumours represent a true epidemic of the twentieth century. Patients with suspected tracheobronchial lesions typically undergo diagnostic evaluation consisting of CT scanning and fiberoptic bronchoscopy. Multislice CT is more than upgrade of single detector CT. Virtual bronchoscopy is the descriptive term given to representations of the bronchial tree and surrounding structures created from spatial information derived from imaging sources other than the bronchoscope itself. The present work aimed to assess accuracy of virtual bronchoscopy compared to fiberoptic bronchoscopy in evaluating tracheobronchial neoplasms. The studied group included 20 patients who were subjected to full history taking, clinical examination, routine laboratory investigations, radiologic evaluation using plain X-ray chest and Multidetector CT virtual bronchoscopy then fiberoptic bronchoscopy examination under local anesthesia. The mean age of the patients was 54.6 +/- 15.79 years. There were 14 male and 6 female patients. All patients were symptomatic at the time of presentation. Thirty-four airways were found by endoscopy to be obstructed. The mucosal descriptions of these lesions were described only by fiberoptic bronchoscopy. There were no significant differences between both bronchoscopes regarding the type of the lesion [endoluminal or extrinsic compression], the degree of obstruction [partial, near total or total], the origin of the masses and its extent. Exploration distal to the obstructing mass was possible in 61.8% of the airways by virtual bronchoscopy and only in 32.4% by fiberoptic bronchoscopy. Virtual bronchoscopy reported sensitivity of 82% and specificity of 87% in detecting extrinsic compression while in endoluminal masses, it reported sensitivity of 86% and specificity of 79%. However, regarding the degree of obstruction, virtual bronchoscopy reported in partial obstruction sensitivity of 85% and specificity of 75.9%. The sensitivity of virtual bronchoscopy in near-total obstruction was 80.5% and specificity was 78.9%, and for total obstruction, the sensitivity was 82.3% and the specificity was 80.2%. Virtual bronchoscopy using multislice CT is an accurate mean of estimating airway lesions. It is an easy complementary tool to fibroptic bronchoscopy

Safety and experience with awake video-assisted thoracoscopic surgery [VATS] in compromized patients

Background: Video-assisted thoracoscopic surgery [VATS] was implemented as a minimally-invasive technique to reduce tissue trauma. Thoracic epidural anesthesia furtherly-reduces intra-operative metabolic stress, postoperative pain, in addition to supporting awake VATS, by which then completely avoiding the drawbacks of mechanical ventilation and general anesthesia in high-risk patients. In this study we report the safety and experience with using VATS in patients where general anesthesia was deemed unsafe or not suitable. The VATS procedure was done in awake patients utilizing thoracic epidural analgesia and I.V sedation

Methods: In this prospective study twenty five patients underwent VAT surgery for different thoracic pathologies at New Kasr El Aini Teaching Hospital, Cairo University between February 2005 and December 2006. There were 19 male and 6 females ranging in age from 55 to 79 years and their body mass index ranging from 25 to 31. All patients had various co-morbid conditions [hepatic, cardiac, renal and/or respiratory compromise] hence general anesthesia was deemed a hazardous option

Results: Twenty five patients underwent 28 VAT procedures which included pleural biopsy and talc poudrage in 7 patients; bullectomy in 7 patients; pleuropericardial window in 4 patients; lung biopsy in 4 patients; evacuation of clotted hemothorax in 2 patients; and wedge resection of pulmonary nodule in 1 patient. There were no morbidity or mortality related to the procedure. However there were 2 late mortalities which were attributed to the primary disease

Conclusion: Awake video-assisted thoracoscopic procedure was carried out in various thoracic pathologies with technical ease and minimal morbidity and mortality complications. In our experience this procedure is considered soundly-safe particularly in patients athigh risk for general anesthesia

Computational characteristics of valproic acid binding to histone deacetylase

Recently, the antiepileptic drug valproic acid [VPA] has also demonstrated efficacy in the management of cancer and bipolar disorders. These actions are largely mediated by inhibition of the HDAC enzyme/induction of certain genes. Relative to other HDAC inhibitors such as trichostatin-A [TSA], VPA offers higher selectivity on cancer cells with virtually no detrimental effects on normal cells. The molecular underpinnings of these biological profiles for VPA remain undefined. We currently propose for and attempt to identify differences in the binding of VPA and TSA to HDAC. In this paper, conformational changes and energy calculations have been derived. VPA had to accomplish conformational changes in its structure for best accommodation at the HDAC binding site. Energy computations showed that VPA has a lower binding affinity than TSA [-53.80 vs. -66.30 Kcal/mol]. These findings demonstrate that VPA binding to HDAC confers catalytic, conformational, and computational characteristics that are distinct from those of TSA. These findings for VPA are consistent with a moderate inhibition of HDAC, a low toxicity on normal cells, and a higher selectivity on cancer cells than TSA. Accordingly, these newly identified binding properties of VPA can state a framework strategy for the rational design of VPA-related anticancer drugs with superior cytodifferentiating- and/or safety-profiles

Mechanism of butyrate binding to histone deacetylase[HDAC] correlation with chemopreventive effects and ligand selectivity

Sodium butyrate [SB] is a natural cytodifferentiating and cancer preventive agent. These actions are largely triggered by inhibition of the HDAC enzyme, thereby inducing hyperacetylation/ transcription of certain genes. Unlike the prototype HDAC inhibitor, trichostatin-A [TSA], SB offers higher selectivity on cancer cells, with a lower affinity to HDAC. The mechanisms underlying these distinct biological profiles for SB remain undefined. We currently propose for, and attempt to identify differences in the binding of SB and TSA to the HDAC binding pocket. The lowest energy conformer of SB was prepositioned on TSA binding site of HDAC. Following minimization of the best-docked S8-HDAC complex, binding profiles, conformational changes and energy calculations have been derived. TSA elicited 4 hydrogen bonds with 3 key enzyme pocket residues [His131, His132 and Tyr297; bidentated]. SB missed a hydrogen bond with Tyr297 and caused more disruption of the pocket amino acid residues His131, His132 [RMS deviation value difference of up to 0.40 A]. Besides, a looser binding to the pivotal zinc atom of HDAC was evident with SB [1 vs. 2 bonds in case of TSA]. Likewise, SB was far loosely packed in the HDAC's binding tunnel as compared to TSA. Moreover, energy computations indicated that SB had a lower binding affinity than that of TSA [-27.8 vs. -66.3 Kcal/mol]. Detailed binding differences for both ligands are described. These studies demonstrate that SB binding to HDAC confers unique catalytic, conformational and computational characteristics consistent with a lower binding affinity to HDAC and a higher selectivity on cancer cells than TSA. These newly defined binding properties of SB can further state a framework strategy for the rational development of SB-like anticancer drugs with enhanced biological and safety profiles

Resveratrol activates the kinase-G system in human coronary smooth muscle cells via a nongenomic, estrogen-independant mechanism

Resveratrol [RSVL], a polyphenolic phytoestrogen in grapes, confers multifaceted cardiovascular benefits. The cellular and molecular basis of RSVL actions has been largely undefined. Currently, in human coronary smooth muscle cells [HCSMCs], RSVL markedly [3.2 fold] enhanced cGMP formation [t1/2: 6.3 min, EC 50: 1.8 microM] and stimulated kinase-G activity [4 fold]. By contrast, RSVL had no effect on cAMP or PKA activity in these cells. The RSVL-enhanced cGMP/kinase-G activity was not abrogated by either of the phosphodiesterase-inhibitors [zaprinast, 10 microM, IBMX, 0.5mM], the nitric oxide synthase-inhibitor [L-NMMA, 10 microM], or the soluble guanylyl cyclase [sGC]-inhibitor [ODQ, 10 microM].In membrane preparations from HCSMCs, RSVL activated GC in the particulate-, but not in the soluble- membrane fraction. Similar effects were due to the specific particulate-GC [pGC] agonist atrial natriuretic peptide [ANP, 0.1-1 microM]. By contrast, the nitric oxide donor, SNAP [1-10 microM] stimulated GC only in the soluble fraction. Responses to RSVL were insensitive to the estrogen receptor blockers, tamoxifen and ICI-182,780. Conversely, pretreatment with the PKC activator, PMA [0.1 microM], a known desensitizer of pGC, markedly blunted the RSVL-enhanced GC-activity. These findings demonstrate that RSVL triggers a pGC-mediated stimulation of protein kinase-G in human coronary smooth muscle cells. This pathway appears to be independent of the conventional estrogen machinery and supports both vasodilatory and anti-atherogenic actions for RSVL

Plasma interleukin-8 level changes in acute renal failure patients treated with different therapeutic modalities

Acute renal failure is defined as rapid deterioration [hours to weeks] of kidney function. Introduction of continuous renal replacement therapy, with its advantages as regards hemodynamic stability, is expected to improve the outcome in patients with multi-organ failure MOF. It's also claimed to help in removal of IL-8, a pro-inflammatory chemokine that shares in leukocyte trafficking towards the kidney, where its removal could help in attenuating acute renal injury. The aim of our study was to test the effect of dialytic treatment opposed to non-dialytic treatment on the outcome of ARF. We also tested the difference between dialytic modalities on patients' outcome and on the ability to remove IL-8 from circulation. This study included 30 patients who suffered form acute renal failure [ARF] divided into two groups: Group A [15 patients] who received dialytic treatment and group B [15 patients] who did not receive dialysis. Group A was further subdivided into 3 groups according to the mode of dialysis used: Group A 1 [n=5]: Received continuous renal replacement therapies [CRRT], Group A 2 [n=5]: Received intermittent hemodialysis [IHD] and Group A 3 [n=5]: Received peritoneal dialysis [PD]. Plasma IL-8 level was determined pre and post dialysis. There is no significant difference in IL-8 pre in group A patients versus group B patients [p>0.05]. No significant difference was found between the outcome in group A versus group B [p>0.05]. There was no significant correlation between IL-8 pre and outcome in the whole population [p>0.05]. IL-8 is significantly higher in patients with septicemia [2233.5 +/- 1606.6] than that in patients without septicemia [202.4 +/- 256.7] [p<0.001]. Death was significantly higher in PD group compared with IHD [p<0.05], while there was no significant difference between IHD and CRRT, CRRT and IPD [p>0.05]. Death among patients with isolated ARF was significantly lower [16.6%] than death in patients with ARF as part of MOF [75%] [p<0.001]. Our results have shown that different dialytic modalities could remove the pro-inflammatory chemokine IL-8, from the plasma. Further studies aiming to evaluate the impact of variable dialytic modalities on ARF, need to be conducted using larger number of patients and more homogenous population as regard illness severity

Airway management of a rare huge-size supraglottic mass

Laser excision of a huge-sized supraglottic mass nearly obstructing the airway passage is a real challenge to anesthesiologists. Upper airway obstruction due to neoplasm in supraglottic region, is traditionally managed by preoperative tracheostomy, however, such a common procedure can potentially have an impact on long-term outcome. A 26-year-old patient presented with dysphagia caused by left cystic vallecular synovial sarcoma. The airway was successfully secured via fiberoptic bronchoscopy, followed by excision of the supraglottic tumor with CO2 laser surgery. Tracheostomy was not required. The patient was discharged from the hospital on the 4th day of surgery. This case, highlights the possibility to secure the airway passage without performing preoperative tracheostomy resulting in good outcome and short hospital stay

Spinal anaesthesia versus combined sciatic femoral nerve block for knee arthroscopy

This study was designed to evaluate the duration required to perform anaesthesia, achieve surgical block and fulfill standardized discharge criteria for knee surgery with spinal anaesthesia versus combined sciatic femoral nerve block. fifty patients ASA 1-11 scheduled for knee hrartoscopy were randomized to receive either spinal anaesthesia with 4 mg of 0.5% hyperbaric bupivacaine [spinal group], or combined sciatic -femoral nerve block with 0.75% ropivacaine and a multiple injection technique [12 ml for femoral nerve block and 18 ml for sciatic nerve block]. Time lasting from skin disinfection to the end of local anaesthetic injection [performance time] and then to achieve surgical anaesthesia [readiness for surgery], time required for block resolution, as well as time for discharge were recorded. Occurrence of adverse events was also recorded. Performance time was longer with sciatic femoral block than spinal block while no differences were observed in the time required to achieve anaesthesia [mean time for sensory block was 6.2 +/- 1.5 min and 8.8 +/- 1.7 min in the spinal and sciatic femoral block respectively and that for motor block was 9.7 +/- 3.6 min and 10.5 +/- 3.5 min]. No differences in haemodynamic parameter or in the visual analogue scale. Patients in the spinal group showed faster resolution of nerve block however no significant differences were observed in the discharge time. Sciatic femoral nerve block with multiple injection technique using ropivacaine 0.75% provided adequate anaesthesia for knee arthroscopy as spinal anaesthesia with no differences in home discharge and less side effects

Chronic diseases detection and follow-up: a primary health care perspective "1[st] stage"

Introduction: In Egypt the Primary health care perspective of chronic diseases remains poorly defined and the distribution as well as the natural histories of many chronic illnesses remains obscure. While progress has been made, in identifying some specific treatment strategies, preventive strategies still lacking behind. Study hypothesis: The prevalence of chronic diseases is under estimated and underserved in rural areas

Aim of the study: Foundation of a Primary Health Care [PHC] model, for detecting, recording and follow-up of chronic diseases in their served communities

Specific Objectives: 1. To determine the prevalence of target chronic diseases [diabetes mellitus I and II, hypertension, end stage renal disease and chronic liver disease in the served rural community. 2. Foundation a database model of chronic disease in PHC setting for further epidemiological studies

Study Design: Intervention operational research

Subject and Methods: Twenty-four Primary Health Care [PHC] units assigned randomly, six representing each of the four studied districts representing the four Governorates assigned for the Health System Upgrading Project II to work in. The principal nurse, Al Raeda Refias within the unit's catchments area and PHC physician were the responsible local personnel. Nurses were subjected for orientation, completing forms and conducting screening test at PHC or home settings for all family members, when an index case is there [previously or newly diagnosed]. Same procedure to be done for suspected or referred cases by El Raedas whom were subjected for more detailed orientation about target diseases, their signs and symptoms. Training concerning how to prepare family lists [suspected cases recorded in different color], referral of suspected member to PHC nurse for screening and to validate the diagnosis by the PHC physician. A simple computerized data base [using Excel] was designed in each PHC and PHC team was trained to implement

Results: The total population surveyed in this study assumed to be 227, 335 individuals. The total number of identified patients with the four assigned diseases was 2135; of which 387 were affected by 2 diseases, and 53 were found to have 3 conditions. The total count of the four target diseases were 2575 conditions [910 diabetes mellitus of both types with a prevalence of 4/1000], 1208 hypertension [5.3/1000], 126 renal failure [0.6/1000] and 331 liver cell failure [1.5/1000]. With the exception of liver disease, female predominated and 70% of patients were illiterate

Conclusion: chronic diseases in rural communities were underestimated; more attention should be given to different aspect of care, regular active screening to trace disease clustering and identification of risk factors, epidemiological features, monitoring and follow-up with suitable curative services

Volatiles, phenolics and biological activities of salix babylonica L. leaves and stem bark

The volatile constituents of both the leaves and stem bark of Salix babylonica were analyzed by GC/MS. 50 and 45 compounds were identified representing 88.04 % and 87.38 % of the total volatiles, respectively. Alpha-Pinene, salicylaldehyde, 1,2-cyclohexanedione, linalool, cis-4-hexen-l-ol and beta-cedrene were the major compounds of the leaves, while, those of the bark were alpha-terpineol, trans- linalool oxide and cis -Linalool oxide. The total oxygenated compounds constituted 53.25 % and 85.49% of the volatiles of leaves and stem bark, respectively. Two flavonoids, luteolin, luteolin-6-C-beta-D-glucopyranoside [iso-orientin] and two phenolic glycosides, trichocarpin and tremuloidin were isolated from the leaves and identified by, physical, chemical and spectroscopic methods. The LD[50], anti-inflammatory, analgesic, antipyretic, antioxidant and antimicrobial activities of leaves and bark extracts were investigated. It is worth to mention that the volatile constituents, the isolated compounds and the biological activities of the leaves and stem bark of the plant were investigated for the first time in the current study

Body magnesium status in critically Ill patients

A wide variation in the prevalence of total serum hypomagnesemia in intensive care unit patients has been reported. This work aims to assess body magnesium deficiency in critically ill patients using different approaches and to evaluate its relationship to other electrolyte disturbances and clinical outcome. The study included 43 adult critically ill patients and 20 healthy controls. Laboratory parameters carried out on admission and every 24 hours for 3 days included: serum electrolytes, serum and erythrocyte total magnesium [RBCMg]. Twenty four hour urinary magnesium was determined before and after IV magnesium loading. Mg retention was defined as excretion of < 70% of the magnesium load. At admission, RBCMg was significantly lower in patients than controls [p = 0.008] whereas serum magnesium was not significantly different. Twenty one patients were magnesium retainers, only 9 of whom were hypomagnesemic. All non-retainers were normomagnesemic. Magnesium retainers had significantly lower RBCMg, serum potassium and calcium than non-retainers [p = 0.0007, 0.004 and 0.007 respectively]. In retainers, retention% negatively correlated to RBCMg and serum potassium. In both retainers and non-retainers, RBCMg positively correlated to serum potassium whereas serum magnesium did not correlate to any of the other parameters of magnesium status. Magnesium retainers had significantly longer ICU stay and a higher mortality rate. Magnesium deficiency is common in critically ill patients and is associated with hypocalcemia, hypokalemia and a poor clinical outcome

Adrenal cystic masses: report of ten cases and suggested algorithm for therapy

Purpose: To report our experience in diagnosis and treatment of adrenal cysts in 10 cases. Patients and Over 7 years period adrenal cysts have been diagnosed in 10 patients [7 males and 3 females]. Their ages ranged between 25 n 68 years. Eight cases were between 50 and 68 years. Six cysts were detected incidentally during imaging work-up performed for extra-adrenal complaints. Three cases presented by flank pain and only one had severe hypertension. Diagnosis was made by ultrasound [US] in all cases and confirmed by computed tomography [CT] in six cases. The longest diameter of the cysts ranged from 3 to 12 centimeters. The right side was affected in 8 cases and the left side in 2 cases. All cases had unilateral cysts. Biochemical work up included determinations of serum electrolytes, lipids and hormonal study. Adrenal ultrasound-guided FNAB was performed in all cases. Six cases had simple non-functioning adrenal cysts, two had infected adrenal cysts one had cystic pheochromocytoma and one had adrenal carcinoma. Surgical adrenalectomy was performed in three patients [30%]. The indications for operation were pheochromocytoma in one patient, symptomatic adrenal cyst with diameter greater than 5 cm in another one, and adrenal carcinoma in a third patient. Imaging characteristics suggestive of malignancy were found in only one proved to have adrenal carcinoma. Cysts recurred in five cases after FNAB. Small, asymptomatic, non-functional cysts with benign characteristics may be treated conservatively with regular follow-up by US or CT. Symptomatic benign nonfunctioning adrenal cyst may be managed by aspiration alone. If the cyst recurs and is asymptomatic, it may observed. If a symptomatic cyst recurs, it may be reaspirated or excised. Malignant adrenal cysts should be treated by adrenalectomy

Computerized morphometric analysis of muscular structure in pelviureteric junction obstruction [PUJO] based on aetiology and duration of obstruction

The pathophysiology of pelviureteric junction obstruction [PUJO] is unknown. Abnormalities of smooth muscle and/or collagen fibers in PUJ were reported by light and electron microscopes. Computerized image analysis was used to objectively quantify the percentage of smooth muscle fibers in surgical specimens of PUJ obtained from 45 patients [28 male and 17 female], aged 1- 53 years mean age 27.48 +/- 12.27, after surgical repair using dismembered technique of pyeloplasty. Control materials were obtained from 10 patients [aged 40-70 years] in whom nephrectomy was done for other pathology than PUJO. Twenty different fields were examined for each tissue section, which were stained by Masson trichrome stain for smooth muscle fibers. In patients with PUJO the percentage of smooth Muscle fibers [SMFs] ranged between 16 and 44% with a mean 26.08 +/- 5.68 while in control group, the Percentage of SMFs was ranging between 41 and 89%with amean 64.22 +/- 13.13 In 34 patients with intrinsic PUJO the percentage of SMFs ranged from 15 to 49% with a mean 24.71 +/- 4.74 while in 11 patients with extrinsic PUJO it ranged between 15 and 49% with a mean 30.31 +/- 6.47. Out of 34 patients with intrinsic PUJO, in patients below I6 years [n=10] the percentage of SMF ranged between 17 and 44% with a mean 27.83 +/- 4.3 and while in patients above 16 years [n=24] the percentage of SMF ranged between 15 and 49% with a mean 23.41 +/- 4.33. The significant difference between mean percentage of smooth muscle fibers in PUJO group 26.08% and control group 64.22% indicate the role of SMF in pathogenesis of PUJO. The difference between percentage of SMF in intrinsic PUJO 24.71% and those of extrinsic causes 30.3 1%, confirm this finding. The difference in percentage of SMFs in patients with intrinsic PUJO below 16 years 27.83% and those above 16 years 23.41% indicate that the duration of obstruction may affect the muscular structure

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

Renal ultrastucture changes with experimentally induced microliths in rats

This work aimed to study the ultrastructure changes that occur in rat kidney with microlith formation and detecting the feature of formation and mechanism of retention and development of renal tubular crystal deposits. Calcium oxalate stone formation was induced in rats by oral application of stone forming diet containing ammonium oxalate [5.3%] and ammonium chloride [2%] mixed with semisynthetic diet for 6 weeks. Periorbital blood samples were taken for determination of blood urea, serum creatinine, cholesterol and total serum triglycerides at the start of experiment and just before scarification. Plain X-ray was done for three rats at the end of six weeks feeding to detect any abnormal calcification. The rats were anaesthetized and perfusion of kidneys with saline, followed by Karnovsky's fixative. The kidneys were excised and processed for diagnosis by light and electron microscopic [E/M] studies. Microliths were present in kidneys of all rats in this study. Light microscopic study revealed protrusion of apical cells in proximal and distal tubules and presence of cellular debris and crystal ghosts in lumen of proximal and distal convoluted tubules. Transmission E/M study revealed swollen cytoplasm and mitochondria of renal tubular cells. Cellular debris and crystal ghosts were present in lumen of both proximal and distal convoluted tubules. Scanning E/M study revealed that renal tubules appeared swollen and lost their brush borders. Tubules were crowded with red blood corpuscles, cellular debris and crystal nucleations

Protein G ELISA for detection of antibodies against toxoplasma SAG1 in dromedaries

In this study, ELISA was used for the detection of antibodies against the immunodominant surface antigen 1 [SAG 1, synonymous P30] of Toxoplasma gondii and peroxidase-conjugated protein G was used instead of commercially unavailable enzyme-conjugated anti-dromedary antibody. A latex agglutination test was employed to select 20 seronegative control animals and peroxidase-conjugated protein A was used for comparison with protein G. The overall seroprevalence rate was 31.4%, males had, to some extent, a higher seropositive rate than females. Seropositive camels sampled in winter had significantly higher antibody levels than those sampled in summer. ELISA values using protein G and protein A conjugates were significantly correlated. The results were discussed