Combined blood and pleural levels of mesothelin and osteopontin for the diagnosis of malignant pleural mesothelioma

Malignant pleural mesothelioma [MPM] is a highly aggressive tumor with poor survival rate. It is difficult to diagnose MPM at an early stage. Soluble mesothelin remains the best available biomarker for MPM, however the lack of sensitivity for early stage disease provides a motivation for the search of an additional marker that could be combined with mesothelin for early malignancy detection. The aim was to evaluate the diagnostic value of soluble mesothelin and osteopontin both in blood and pleural fluid of MPM patients and to assess whether combination of these markers could improve the diagnostic accuracy of mesothelin. In this study mesothelin and osteopontin were measured by ELISA method in 197 samples [123 blood and 74 pleural] obtained from 123 participants, divided into 4 groups: 38 MPM patients, 24 patients with metastatic pleural effusion [Mets] of various carcinomas, 29 patients with hydrothorax and 32 healthy asbestos exposed subjects. Receiver operating characteristic [ROC] curves were generated to compare the diagnostic capability of these biomarkers. Combination of markers was done through logistic regression analysis. The median blood and pleural levels of the two markers were significantly higher in MPM patients than in hydrothorax or asbestos exposure groups [P < 0.0001], however the difference between MPM and Mets group was not significant. Combining the data from blood mesothelin and osteopontin using logistic regression model raised the area under the ROC curve [AUC] from 0.774 for serum mesothelin and 0.828 for plasma osteopontin to 0.867 to differentiate MPM from hydrothorax and asbestos exposed subjects. Combining the diagnostic capability of both pleural markers raised the AUC from 0.871 for pleural mesothelin and 0.847 for pleural osteopontin to 0.905 to differentiate MPM from hydrothorax patients. The performance of serum and pleural mesothelin in diagnosing MPM was improved when combined with plasma and pleural osteopontin [respectively] through logistic regression analysis model. This will be a great advance in screening and management of MPM

effect of ochratoxin on antimicrobial polypeptide expression in channel catfish [Ictalurus punctatus]

Mycotoxins contamination of agricultural commodities poses a serious risk to animal health, including aquaculture species. While chronic effects of mycotoxins, including immunosupression, are much more important than acute toxicities, they are much less evident. Ochratoxin A [OA] is the most immunotoxic ochratoxin, yet little is known about its effect on immune function in fish. Antimicrobial polypeptides [AMPPs] are one of the most potent, innate, host defense factors, yet very little is known about what types of chronic stressors affect their expression. Among the most prevalent and potent AMPPs in fish are histone-like proteins [HLP]. In this study, fish were fed 2, 4, or 8 ppm OA. Skin antibacterial activity was measured on Days 0, 28 and 56. Feeding 2, 4 or 8 ppm OA resulted in no changes in AMPP expression in any treatment group. Our data suggests that the immunosuppression of OA is probably due to impaired cell-mediated immune mechanisms other than a direct effect on antimicrobial polypeptide expression

Carbon monoxide poisoning: Role of brain diagnostic imaging [computed tomography and magnetic resonance imaging]

This study was conducted on thirty patients diagnosed as acute carbon monoxide [CO] poisoning who were admitted to Alexandria Poison Center, Alexandria, Egypt. They represented 4.4% of the total admission [n=9196] to the center during the year 2000. Their carboxyhemoglobin percentage [COHb%] level ranged from 15-42% with a mean of 27.38 +/- 7.73%. This level was significantly increased with deterioration of the level of consciousness, while insignificant relation was found between COHb% level and various clinical presentations, blood gases and acid-base status. Computerized tomography [CT] brain scan was done to all patients and revealed the following: Norma CT scan in 70.0% of patients, 26.7% had brain edema and one patient [3.3%] had internal capsular infarction, which delineated by magnetic resonance imaging [MRI] as bilateral lesions in the internal capsule and cerebellar peduncles. The vast majority of patients [96.7%] recovered completely, only one patient developed permanent sequelae manifested by paraparesis, dysarthria, and incoordination of movement

impact of simultaneous nursing staff training and unit reorganization on nursing empowerment

This study intended to empower the nursing staff through training and reorganization of neurosurgical unit. The subjects were all the unit staff [20 physicians, 18 nurses, 4 auxiliary personnel and 34 patients]. The study was done in 3 phases: An assessment phase, to inspect the physical set up, equipment used, facilities, unit's staff opinions, suggestions, patient's condition, nurses knowledge, performance and level of anxiety using Taylor anxiety scale and Phaneuf scale to measure the quality of care that patient receives; the experimental phase, that was based on the input from the assessment phase, a program for reconstruction of the unit and upgrading knowledge and performance of the staff was developed and implemented for 10-month period; the evaluation phase in which correlation was done between results of the assessment phase and post program implementation. There was improvement regarding staff knowledge and performance as well as patients condition with an interesting finding which showed marked increase of the nurses' anxiety level post the implementation of the program which can be attributed to increase level of responsibility. This paper showed that through empowerment of the nurses productivity increased, functions improved and the patients received higher quality care

Knowledge and skill performance of wound infection prevention among nurses working in surgical wards

The study calls for the attention of the health care agencies to update the knowledge and train for better level of performance of those nurses working in surgical wards. Infection control units in well developed health agencies should expand their horizon to involve educating nurses working in smaller and remote health agencies through educational programs, specially for the newly employed nurses. Manuals and guides dealing with wound infection control measures should be available for nurses

Serum lipid profile in patients with chronic renal failure before and after renal transplantation

Serum lipid profile was investigated in 15 patients with chronic renal failure who were on regular hemodialysis. Serum samples were taken before and 1, 3 and 6 months after renal transplantation to find any changes in the lipid profile which may occur in these patients. The results of the study showed significant progressive elevation in serum triglycerides, cholesterol, LDL, and apo-B lipoprotein giving their highest level at the 6th month after renal transplantation. On the other hand, HDL and apo-A lipoprotein serum levels were significantly increased giving their highest level one month after transplantation. These findings point to the important role of lipid abnormalities in the pathogenesis of post transplantation atherosclerosis which may allow to identify patients at risk earlier

Peak expiratory flow [PEF] and serum levels of cortisol as well as IgE in bronchial asthma

Patients with cryptogenic asthma treated for long periods with corticosteroids had low plasma cortisol levels during the attack and during the remission. Such a low cortisol level indicates a state of adrenal insufficiency which could result from long term and irregular therapy with corticosteroids. These patients are usually in continuous need for corticosteroid therapy. Low doses and alternate day steroid administration are the most desirable modalities of therapy long as there are no contraindications to its administration. Cases of extrinsic asthma on corticosteroid therapy did not show better improvement than those on bronchodilators alone. On the other hand, those on bronchodilators had the benefit that their serum cortisol level was steady during the attack and during the remission and within normal levels. Concerning IgE and PEF [Peak Expiratory Flow] the improvement was nearly the same in both groups [cryptogenic and extrinsic], whether on corticosteroids or on bronchodilators

Surface disintegration [solubility] of four calcium hydroxide-based cements following acid etching

The surface disintegration [solubility] of four br and s of calcium hydroxide based cements in 37.5% phosphoric acid in the form of solution or gel was studied. It was found that one br and [Life] showed the least acid solubility in comparison with the remaining three br and s. Also, the results of this study revealed that phosphoric acid solution produced greater solubility for Ca[OH]2 than phosphoric acid gel

Effect of reheating rubber base impressions on the accuracy of poured dies

The axial discrepancy [Um] of stone dies, which were poured in three different types of rubber impressions, was measured using the dial gauge. Dies were poured from impressions under the following conditions: Cooling to room temperature for 15 minutes, cooling to room temperature for 15 minutes and preheating water and stone to 37C, and cooling to room temperature for 15 minutes and reheating to 37C for 30 minutes and preheating water and stone to 37C. Results showed that the least axial discrepancy was measured in case of dies poured from impressions which were cooled at room temperature for 15 minutes and then reheated to 37C for 30 minutes and the water and stone preheated to 37C

Stress attenuating function of split shaft post system

The aim of this study was to compare the reduction in the insertion stress factor by using solid and split shaft post systems in an experimental determination of the stress level. From the results of this study, it was detected that the undesirable stress concentration at solid post-model interface have been reduced 50%, by using split shaft one. This is due to collapsing ability of split shaft during the insertion into the post space. It can be concluded that split shaft post have provided a stress breaking function, so it is recommended for restoration of endodontically treated teeth

Associating urinary tract anomalies in ano-rectal malformations

Detailed study of the urinary tract had been done in our last twenty consecutive children born with anorectal malformations [A.R.M.] of both sexes. Associated urologic anomalies other than those anomalies which are part of the syndrome [e.g. rectourinary fistula] were found in sixteen out of the twenty children. This high incidence of associated urinary tract anomalies in patients with A.R.M. reflects the importance of a thorough urologic study irrespective of the sex or the type of the anorectal anomaly

Evaluation of computed tomography and hormonal profile in empty sella syndrome

Hormonal assay was done in 20 patients diagnosed as having empty sella syndrome using CT scan. 10 patients had the galactorrhea amenorrhea syndrome. There was significant increase in prolactin level and non significant decrease in gonadotrophic hormones. Both thyroid and adrenal hormones were normal. The role of CT scan as an important tool for diagnosis was reassessed and evaluated

Wear of anterior and posterior composites under accelerated aging

The two-body abrasion, compressive strength, and single-pass sliding parameters of three anterior and four posterior composites were determined. Single-pass samples were aged for 900 hours in a weathering chamber. Compressive strength was not correlated with either two-body abrasion or single-pass sliding parameters. The quarters-filled composites had the lowest values of two-body abrasion. The light-cured composites were among the composites with high values of two-body abrasion and track width before aging

Effect of setting expansion of some dental stones upon the accuracy of poured dies

This investigation has shown that the setting expansion of three dental stones when measured according to the ADA Specification No.25, was lower than that expansion when determined by a dial gauge method. The values of setting expansion from this test and percentage deviation of the diameter of extra coronal stone dies from the base diameter of the st and ard preparation were identical

Effect of cross head speed on the tensile strength of some composite resins

Diametral tensile strength was measured for four composite resins under different tensile load speed. The results showed that crushing speed have a statistically significant effect on the tensile strength. A constant slow speed is very important in determining the tensile strength and it should not be more than 0.05 cm/minute. The four materials tested have different values depending on the type and content of filler

study of the characteristic retentive behaviour of the cements

Cement film thickness, mechanical properties, retention and adhesive properties of some cements were evaluated. The cement film thickness has a high correlation with the effective maximum grain size of the cements used. There was no correlation between the strength properties tested and the retention of the cements. Glass ionomer and polycarboxylate cements showed a greater increase in retention after one month

Thyroid hormonal profile and a new strategy for thyroid function testing in bilharzial patients

The aim of this work is to study the thyroid hormonal profile in early and advanced bilharziasis whether pure or combined with other chronic liver diseases and to evaluate the thyroid function tests in bilharzial patients. Seventy-six human subjects [56 males and 20 females] were the subject of this study. The subjects were classified into the following groups: Group 1- Normal control subjects, Group 2- Simple bilharziasis, Group 3- Pure bilharzial hepatosplenomegaly and Group 4- Combined bilharzial hepatosplenomegaly. The following thyroid function tests were performed by radioimmunoassay techniques for both patients and normal controls: Serum total [T4] and free thyroxine [FT4], total [T3] and free tri-iodothyronine [FT3] reverse tri-iodothyronine [rT3], thyroid stimulating hormone [TSH] and thyroxine binding globulin, [TBG]. The results of the present study showed that simple bilharzial infestation without liver involvement had no effect on thyroid hormone secretions, regulation or peripheral tissue metabolism, since no significant change in serum thyroid hormones, TSH or TBG levels was detected in these patients compared to controls Patients with bilharzial hepatosplenomegaly [pure or combined with other chronic liver diseases] show tendency for hypothyroidism, as indicated by low serum levels of FT4, T3 and FT3 the pituitary and hypothalamic responses to the low thyroid hormones levels are normal as indicated

Surgical reconstruction in benign strictures of bile duct

Reconstructive biliary surgery is mandatory in obstructive jaundice due to benign causes. Twenty five patients operated upon due to stricture in the common bile duct and/or common hepatic duct after cholycystectomy operation during the period from 1982-1988. Operations performed were choledchoduodenostomy for stricture of the common bile duct and hepaticojejunostomy using a Roux-en- Y loop of the jejunum for stricture of the common hepatic duct. The results were good with minimal complications and one mortality. In severely ill patients, percutaneous transhepatic biliary drainage improved the condition preoperatively