Prognostic role of serum interleukin-18 in Egyptian patients with hepatitis c virus-related hepatocellular carcinoma treated by radiofrequency ablation.

Aim: The aim of this study is to identify the prognostic value of serum interleukin (IL)-18 level in hepatitis C virus (HCV) -related hepatocellular carcinoma (HCC) patients. Materials and Methods: This study was conducted in Tropical Medicine department and HCC unit in Ain Shams University Hospitals. It included 35 patients with HCV associated HCC fit for radio frequency ablation and 20 healthy control subjects. Serum IL-18 level was measured for all participants at the beginning of the study. Patients were followed-up for 1 year then serum IL-18 re-measured at the end of the follow-up period. Results: Pre-intervention serum IL-18 level was significantly higher in patients than healthy control subjects and was associated with bad clinical, laboratory or radiological prognosis. Post follow-up mean value of IL-18 level was significantly lower than pre-intervention level. Conclusion: Higher pre-intervention serum IL-18 level in HCV -related HCC patients level was associated with bad prognosis either clinically, laboratory or radiologically.

Identification and characterization of nuclear matrix protein[s] and assessment of its usefullness for early diagnosis of bladder cancer

The highest incidence rates of bladder cancer are generally found in industrially developed countries, particularly North America and Western Europe, and areas associated with endemic schistosomiasis, including parts of Africa and the Middle East. The appropriate treatment of patients with bladder cancer mandates early detection and regular follow up for recurrences. Currently, cystoscopy is the standard method for diagnosing and monitoring bladder cancer recurrence, but it is an invasive and relatively costly technique, and may sometimes be inconclusive, particularly in cases of cystitis. Western blot and specific immunoglobulin-G antibody were used to identify the urinary NMP marker. Urine samples from 123 patients with bladder cancer and 50 controls were evaluated using the developed SDS-PAGE, Western blot and ELISA. The NMP marker was identified in the urine of patients with bladder cancer at 52 kDa [NMP- 52] by SDS-PAGE, Western blot and ELISA. In addition, the NMP-52 tumor marker was not detected in the urine of patients. Detecting the urinary NMP-52 marker using SDS-PAGE, Western blot and ELISA, would be helpful in the rapid diagnosis of bladder cancer

Proximal row carpectomy for treatment of stage III ulna neutral variant of kienbock's disease

Kienbock's disease is a painful disorder of the wrist of unknown cause in which roentgenograms show a vascular necrosis of the carpal lunate. Treatment options depend widely on classification of the disease stage and are not standardized in literature. Proximal Row carpectomy [PRC] is a motion preservation option for patients with kienbock's disease in late stages where carpal collapse has already happened and when no arthritic changes has affected the lower radial articular cartilage nor proximal pole of capitate especially in ulna neutral variant when leveling procedures have no role. This prospective study was conducted in Am Shams University Hospitals and Hospitals of the Ministry of Health between April of 2001 and January of 2006. [Diagnosis, management and follow-ups were done during that period] Seven patients, stage III, ulna neutral variant, Kienbock's disease with no evidence of arthritis of neither the upper pole of capitate nor lunate fossa [lower radial articular cartilage] were treated by Proximal Row Carpectomy [PRC] by the two surgeon authors via dorsal approach. The study included four males and three females. Age ranged from 28-47 years with a mean age of 37.6 +/- 12.3 years. Range of time passed from the beginning of symptoms and diagnosis was 3-7 months with mean of 5.2 +/- 1.4 months. Patients were followed-up for a minimum of 30[Thirty] months postoperatively. Range of follow up was from 30-57 months with a mean of 43.29 +/- 12.3 months and we considered the follow up at 30 months postoperative as the end of follow up for the current work. Six of seven patients [86%] had complete pain relief' at the end of follow-up. Only one patient had mild pain on moderate exertion with intermittent use of NSAIDs. Range of motion improved for all patients at the end of follow-up: Flexion range improved from a median of 29 to79° Extension from 25 to 75°, radial deviation from 25 to 50°, ulnar deviation from 25 to 66.7° [% of normal side movement]. Improvement of each movement was found to be statistically significant [P value < 0.05]. DASH score decreased from a median of 82.5 to 44.2. This indicated that patients got less disabled at the end of follow-up and this improvement was found to be statistically significant [P value < 0.05]. Grip strength improved from a mean of 25 to 50 [As% of normal side] and this improvement was found to be statistically significant [P value < 0.05]. Patients' working ability improved as indicated by decrease of DASH optional work module score from 100 to 50 and this improvement was found to be statistically significant. [P value < 0.05]. Patient's satisfaction rate was 100%. Results of this study were comparable to results of PRC in other series in literature. Table [1] Lichtman and Degnan's classification: Stage I: Normal architecture with evidence of a linear or compression fracture. Stage II: Normal outline but definite density changes within the lunate. Stage III: Collapse or fragmentation of the lunate and proximal migration of the capitate [carpal height ratio is less than 0.54 +/- 0.03]. Stage IV: Generalized degenerative changes within the carpus. We found this procedure of PRC to be an effective motion preservation method for treatment of stage III Kienbock's disease in ulna neutral variant where leveling procedures are not indicated and when preservation of wrist motion is possible i.e. when there is no degenerative arthritis involving the Lunate fossa nor the proximal pole of capitate

Lymphocytes DNA content, p53, C-MYC and BCL-2 as predictive markers in childhood with acute lymphoblastic leukemia

Cell cycle parameters as well as apoptotic and tumor markers directly control cell growth. DNA ploidy and S phase fraction, apoptosis fraction in addition to apoptotic inducer [p53, c-myc] and antiapoptotic marker [Bcl-2] were investigated in childhood with acute lymphoblastic leukemia [ALL] leukemia as a predictive markers represented in survival data. This study included 70 children with [ALL]; 38 males and 32 females; of median age 5 years. Event free survival [EFS] and overall survival [OS] were estimated for all studied cases. Cell cycle and apoptotic parameters as well as p53, c-myc and Bcl-2 were analyzed using FACS caliber flow cytometer in the lymphocyte cells of peripheral blood. Aneuploidy constituted 33% of studied cases. The median overall survival [OS] showed higher significant values when S% was <4.5%, and DNA index was >/= 0.94 and p53 was < 70.87, whereas it showed no significant difference related to G0/G1%, G2/M% and aneuploidy%. The median event free survival [EFS] showed significant higher value at Bcl-2 >/= 81.5 but with no significance related to other cell cycle parameters as well as p53 and c-myc. These data suggest that DNA index, S phase fraction, p53 and BcI-2 may be useful as a predictive markers that help patients' stratification and adjusting protocols of ALL therapy

Schistosoma mansoni major egg antigen Smp40: molecular modeling and potential immunoreactivity for anti-pathology vaccine development

The pathogenesis of Schistosoma mansoni infection is largely determined by host T-cell mediated immune responses such as the granulomatous response to tissue deposited eggs and subsequent fibrosis. The major egg antigens have a valuable role in desensitizing the CD4+ Th cells that mediate granuloma formation, which may prevent or ameliorate clinical signs of schistosomiasis.S. mansoni major egg antigen Smp40 was expressed and completely purified. It was found that the expressed Smp40 reacts specifically with anti-Smp40 monoclonal antibody in Western blotting. Three-dimensional structure was elucidated based on the similarity of Smp40 with the small heat shock protein coded in the protein database as 1SHS as a template in the molecular modeling. It was figured out that the C-terminal of the Smp40 protein (residues 130 onward) contains two alpha crystallin domains. The fold consists of eight beta strands sandwiched in two sheets forming Greek key. The purified Smp40 was used for in vitro stimulation of peripheral blood mononuclear cells from patients infected with S. mansoni using phytohemagglutinin mitogen as a positive control. The obtained results showed that there is no statistical difference in interferon-g, interleukin (IL)-4 and IL-13 levels obtained with Smp40 stimulation compared with the control group (P > 0.05 for each). On the other hand, there were significant differences after Smp40 stimulation in IL-5 (P = 0.006) and IL-10 levels (P < 0.001) compared with the control group. Gaining the knowledge by reviewing the literature, it was found that the overall pattern of cytokine profile obtained with Smp40 stimulation is reported to be associated with reduced collagen deposition, decreased fibrosis, and granuloma formation inhibition. This may reflect its future prospect as a leading anti-pathology schistosomal vaccine candidate.