Immunohistochemical expression of matrix metalloproteinase-7 in human colorectal adenomas using specified automated cellular image analysis system: a clinicopathological study

To evaluate the immunohistochemical expression of matrix metalloproteinase-7 [MMP-7] in colorectal adenomas, and to correlate this expression with different clinicopathological parameters. The study was retrospectively designed. Thirty three paraffin blocks from patients with colorectal adenoma and 20 samples of non-tumerous colonic tissue taken as control group were included in the study. MMP-7 expression was assessed by immunohistochemistry method. The scoring of immunohistochemical staining was conducted utilizing a specified automated cellular image analysis system [Digimizer]. The frequency of positive immunohistochemical expression of MMP-7 was significantly higher in adenoma than control group [45.45% versus 10%] [P value < 0.001]. Strong MMP-7 staining was mainly seen in adenoma cases [30.30%] in comparison with control [0%] the difference is significant [P < 0.001]. The three digital parameters of MMP-7 immunohistochemical expression [Area [A], Number of objects [N], and intensity [I]] were significantly higher in adenoma than control. Mean [A and I] of MMP-7 showed a significant correlation with large sized adenoma [>/= 1cm] [P < 0.05], also a significant positive correlation of the three digital parameters [A, N, and I] of MMP-7 expression with villous configuration and severe dysplasia in colorectal adenoma had been identified [P < 0.05]. MMP-7 plays an important role in the growth and malignant conversion of colorectal adenomas as it is more likely to be expressed in advanced colorectal adenomatous polyps with large size, severe dysplasia and villous histology. The use of automated cellular image analysis system [Digmizer] to quantify immunohistochemical staining yields more consistent assay results, converts semi-quantitative assay to a truly quantitative assay, and improves assay objectivity and reproducibility

Immunohistochemical expression of PCNA and CD34 in colorectal adenomas and carcinomas using specified automated cellular image analysis system: a clinicopathologic study

To evaluate the immunohistochemical expression of proliferating cell nuclear antigen [PCNA] and CD34 in colorectal adenomas and carcinomas, and to correlate this expression with different clinicopathologic parameters. The study was retrospectively designed. A total of 86 tissue samples, including 33 paraffin blocks from patients with colorectal adenomas, 33 paraffin blocks from patients with colorectal adenocarcinomas, and a control group of 20 samples of nontumerous colonic tissue, were included in the study. From each block, 3 sections of 5 micro m thickness were taken, 1 section was stained with hematoxylin and eosin [H and E] and the other 2 sections were stained immunohistochemically for PCNA and CD34. Scoring of the immunohistochemical staining was performed using a specified automated cellular image analysis system [Digimizer]. PCNA expression was significantly increased in a sequence of normal mucosa-adenoma-carcinoma. It was significantly higher in adenomas >/= 1 cm and those with severe dysplasia, and it showed a significant positive correlation with grade and lymph node involvement in colorectal carcinoma. CD34 showed significantly higher expression in carcinoma than adenoma and in adenoma than in the control group. CD34 expression showed a significant correlation with adenomas carrying severe dysplasia and large-sized adenomas [>/= 1cm]. It was significantly correlated with tumor grade, lymphovascular invasion, and lymph node involvement in colorectal carcinoma. PCNA plays an important role in colorectal neoplastic progression and can be utilized as ancillary marker for the risk of malignant transformation in colorectal adenomas as it correlates with high grade dysplasia and size. Intratumoral quantification of the mean [A and N] of CD34 in colorectal carcinoma reflects the grade of tumors and can predict lymph node involvement and lymphovascular invasion, to make a useful additional prognostic factor

Effect of moderate exercise on the level of melatonin hormone and lymphocyte apoptosis in healthy subjects

Physical exercise is important for promotion of the immune system. The immune responses to exercise are dependent on the intensity and duration of the exercise performed. During exercise, metabolic and hormonal changes occurred that can induce lymphocyte apoptosis. Melatonin is one of the hormones that are affected by exercise, it is a pineal gland hormone, its production and secretion followed a circadian pattern, onset of darkness stimulate its secretion, while day light suppress its production. Melatonin is regarded as an anti-aging hormone; it has a role in the elimination of harmful lymphocytes which may give rise to chronic inflammation and possibly to autoimmunity. This prospective study aimed to elucidate the effect of moderate endurance exercise on melatonin hormone and the percentage of peripheral blood lymphocyte apoptosis in healthy subjects. Sixty healthy subjects with a mean age of [37.05 +/- 13.02] year, participated in the study. They were subjected to moderate exercise session which lasted for 60 min and repeated 3 times per week for 3 months. The exercise intensity was 50-60% of heart rate reserve [according to Karvonen formula]. Two exercise stages were performed; the first stage include 30 minute of physical activity program and the second stage include 30 minute of treadmill exercise. Blood sample were collected before and after exercise to examine its effect on the level of melatonin hormone and apoptosis of peripheral blood lymphocyte. This study showed significant increment in the level of melatonin hormone and the percentage of lymphocyte apoptosis after exercise in comparison to pre exercise values for each week along the period of the test [P < 0.05]. Three months exercise showed a significant correlation with the levels of melatonin hormone [P= 0.008, r= 0.44], and with percentage of lymphocyte apoptosis [P = 0.001, r= 0.701]. It can be concluded that moderate exercise for three months was associated with increased percentage of periphral blood lymphocyte apoptosis and increased level of melatonin hormone in the first two months while in the third month this anti aging hormone had reached a steady state after the subjects get trained to exercise

Haematologic parameters in acute promyelocytic leukemia patients treated with ALL trans- retinoic acid

Acute Promyelocytic Leukemia [APL] is commonly associated with disseminated intravascular coagulation [DIC] and early correction of coagulopathy is of vital importance. All Trans-Retinoic Acid [ATRA] is considered to be the drug of choice in the treatment of APL. The work was conducted to: 1- Identify patients with APL who show laboratory evidence of DIC. 2- Study the serial changes in haemostatic parameters in APL patients treated with ATRA and to compare their results with those treated with conventional chemotherapy without ATRA. In this prospective study [from October 2003 to October 2005], 44 newly diagnosed, untreated APL patients were included. ATRA plus chemotherapy - treated patients were 24 while 17 patients were treated with chemotherapy other than ATRA. For each patient, a full clinical evaluation was done and hematological investigations were accomplished at time of diagnosis and repeated on day 3 and 7 of therapy. Diagnosis of DIC was based on finding a positive D- dimer test with hypofibrinogenaemia with or without pathologically prolonged [PT and/or APTT]. In 44 newly diagnosed, untreated APL patients studied, the age ranged between 6-81 years with a median of 27 years. Male to female ratio was 1.3:1. Before treatment all patients had anemia, thrombocytopenia, and elevated level of D - dimer. DIC was present in all patients at time of diagnosis. All parameters that showed abnormal level at time of diagnosis had returned to normality within one week in ATRA treated group, indicating that DIC has essentially resolved. By contrast, those parameters remained abnormal even on day 7 in the chemotherapy treated group, indicating that DIC was ongoing. ATRA therapy in APL patients is associated with rapid improvement of coagulopathy therefore, it is justified to be used from day one of the treatment

An appraisal of urine cytology in the diagnosis of transitional cell carcinoma of the urinary bladder

Urine cytology has an acceptable sensitivity, and specificity that justifies its use in the current diagnostic protocol. In Iraq transitional cell carcinoma [TCC] constitute about 62.1% of bladder cancer [which ranks the third according to the results of Iraqi Cancer Registry 1995-1997]. Urine cytology used in the primary diagnosis, follow up, and in the screening programs of asymptomatic but high-risk patients. This study was conducted on 93 patients, diagnosed or clinically suspected to have TCC of the urinary bladder attending to the Urological department in AL-Kadhimiya Teaching Hospital, AL-Yarmouk Teaching Hospital, and Baghdad Medical City. During the period from July 2004 to July 2005. 76 were males and 17 were females. Urine cytological examination was done to those patients using two types of stain hematoxylin and eosin, and papanicoloau stain] to detect malignant cells with the identification of the degree of differentiation, if possible, the cytological findings were correlated with the hisiopathological findings. And the cytological findings compared regarding each type of stain. Mean age of the patients was 59 year. Male.female ratio was 4.4:1. Main clinical presentation was hematuria [45.8%] of the total. Urine cytological examination has a sensitivity of 87.7%, specificity of 100% with an overall accuracy of 78% in the detection of TCC of urinary bladder. The main chief complaint of patients with TCC was haematuriawitch constitute 45.8% of the total. The percentage of highgrade cases in urine cytology was higher than that in histopathology.the percentage of cases of TCC diagnosed by papanicoloau stain was more than that diagnosed by II and E [73.24% by pap stain versus 70.42% by H and E]. Urine cytology has an acceptable sensitivity, specificity and an overall accuracy in the diagnosis of TCC of urinary bladder, and it offers a good chance for determination of the grade of the tumor especially in high grade tumor. Pap stain was better in the diagnosis of TCC

Cytological and immunocytochemical study of bronchial wash in bronchogenic carcinoma

Carcinoma of the lung has became the most common type of cancer since 1985 and the most common cause of cancer death in both males and females. To assess the diagnostic accuracy of bronchial wash cytology and application of immunocytochemical methods, using two tumor markers [low molecular weight cytokeratin and epithelial membrane antigen] for more accurate and precise diagnosis of lung tumors. Fifty fifes suspected lung cancer cases according to their clinicoradiological examinations were included in this study. Bronchial wash cytology was performed for all the 55 patients. Smears were stained by conventional cytological stain inaddition to immunocytochemial staining using low molecular weight cytokeratin and epithelial membrane antigen. The final results of bronchial wash were compared to histopathological results and final clinical diagnosis as. Cytological smears of bronchial wash revealed the presence of malignant cells in 33 cases [60%]. The sensitivity of bronchial wash cytology was 82.5%; the specificity was 100.0%, with overall accuracy of 87.3%. Using cytokeratin staining, 26 cases [47%] were positive for malignant cells, and 29 were negative. The sensitivity, specificity and overall accuracy were 65%, 100%, and 74.5% respectively. With EMA staining, 19 cases [27%] were positive for malignant cells and 36 were negative. The sensitivity, specificity and overall accuracy were 47.5%, 100%, and 61.8% respectively. Combined use of CK and EMA raised the sensitivity to 72.5%, specificity of 100% and overall accuracy of 80%. Combined use of monoclonal antibodies and conventional cytology raised the sensitivity to 95%, specificity 100%, with overall accuracy of 96.3%. Using more than one monoclonal antibody, or using combined conventional cytology and immunocytochemistry increase the sensitivity for detection of malignant cells in bronchial wash smears

Per cutaneous ultrasonic guided fine needle aspiration in the diagnosis and management of intra-abdominal abscesses

Ultrasonic guided per-cutaneous fine needle aspiration drainage technique of intra-abdominal fluid collection and/or abscess has become the treatment of choice for the majority of the cases, regardless of etiology. To evaluate the role of fine needle aspiration drainage technique with intra-cavitory broad spectrum antibiotic instillation as a diagnostic and therapeutic procedure for intra-abdominal abscesses and/or fluid collection. From September 1999 to April 2000 thirty two patients presented with intra-abdominal abscesses and fluid collection was treated by ultrasonic guided per-cutaneous fine needle aspiration drainage. Complete recovery and resolution was achieved in [93.7%] of the cases with two failure cases which needed another surgical intervention. Gram etiological microorganism, and [56.3%] of cases gave a history of previous intra-abdominal surgical intervention before symptoms started. This technique was proved to be negative bacilli were found to be the most common cause of intra-abdominal abscesses cases as an a desirable approach to diagnose and treat patients with intra-abdominal abscesses and/or fluid collection