Evaluation of HLA-DR antigen expression and CD4 T helper cells in normal respiratory nasal epithelium and nasal polyp

The objective of this study was to evaluate human leucocyte antigen-DR [HLA-DR] expression in nasalpolyp epithelium compared with their surrounding normal nasal mucosa as well as activated T helper cells [CD4 positive] in order to obtain a clue concerning the immunological mechanisms that are possibly relevant to the nasal polyp pathogenesis. By means of immunohistochemical methods, samples from 16 patients with nasal polyps were investigated. The histomorphologic analysis revealed nonallergic nasal in 12 cases, while allergic polyps in only 4 cases. Epithelial changes were observed in 10 of both allergic and nonallergic polyp types. They included epithelial hyperplasia [four cases], goblet metaplasia [two cases] and squamous metaplasia [four cases]. Nasal polyps with average normal epithelial thickness were present in six cases. HLA-DR antigen molecules were significantly highly expressed in the normal respiratory nasal epithelial cells as well as in nasal polyps with an average normal epithelial thickness. However, they significantly reduced in nasal polyps associated with epithelial hyperplasia, goblet cell metaplasia and squamous cell metaplasia. On the other hand, submucosal inflammatory cells exhibited a high expression of HLA-DR in nasal polyps versus normal submucosa. The activated T helper cells [CD4 positive] were increased in nasal polyps versus normal nasal mucosa, with no significant difference between allergic and nonallergic polyps

Plasma thrombomodulin levels in patients with chronic renal failure

To evaluate the plasma soluble thrombomodulin T M levels in patients with chronic renal failure on conservative treatment and in those on hemodialysis as a new marker which reflect the extent of endothelial dysfunction with possible relation to cardiovascular complications Forty two patients with chronic renal failure together with twenty normal control subjects were allocated to this study. Patients were divided into two groups: group I of twenty patients on conservative treatment and group II of twenty two patients on hemodialysis treatment. Patients with diabetes mellitus, collagen vascular diseases, haemorrhagic diathesis and with malignancies were excluded from this study. There was significant increase in mean plasma TM levels in each group compared with normal subjects [p<0.05, p < 0.01 respecitvely]. Throm-tenodulin level was positively correlated with duration of chronic renal failure [p < 0.05]. Also, there was a positive correlation between plasma TM levels and duration of hypertension in both groups [p < 0.05; p<0.01]. Also these results may suggest that TM level can be considered as a marker for extent of endothelial damage and can reflect cardiovascular morbidity in patients with chronic renal failure

Comparative study between: systemic stress response after laparoscopic and open cholecystectomy

This study compared neuro-endocrine and metabolic stress responses in a group of 20 patients undergoing laparoscopic cholecystectomy and another group of 20 patients undergoing open cholecystectomy. Serum levels of cortisol, glucose, interleukin-6 [IL-6] and C-reactive protein [CRP] were measured before, during and after operation. Serum levels of cortisol and glucose increased during and after both laparoscopic and open cholecystectomy, however their postoperative responses were significantly higher after open cholecystectomy. IL-6 and CRP levels also increased after operation and were significantly higher in open cholecystectomy group. These results indicated that neuro-endocrine stress and inflammatory responses following laparoscopic cholecystectomy were significantly reduced compared with those after open cholecystectomy