RESUMO
Background: the induction of apoptosis for the virus-infected cells is an important host defense mechanism against invading pathogens. Activated T cells express Fas receptor; virus-infected hepatocytes bear the receptor as well. Both immune mediated reaction and cytopathic effects of HCV may be involved in pathogenesis. The apoptosis in immune or non-immune tissue and the mechanism of liver damage in chronic HCV infection remains uncertain
Aim: to assess the relationship between serum concentrations of adhesion and apoptotic-related soluble structures in patients affected by Hepatitis C Virus [HCV]. Investigate serum levels of soluble Fas antigen [sFas], soluble intercellular adhesion molecules-1 [sICAM-1]; study their roles in pathogenesis and liver cell damage in chronic hepatitis C patients
Patients and methods: sixty chronic hepatitis C patients [78.33% male vs. 22.66% female] and twenty controls recruited, they were positive for anti-HCV, and HCV-RNA by quantitative PCR. Liver biopsies were fixed and examination. Patients were classified into Group A [n=23] Chronic Hepatitis C minimal activity [0-3], Group B [n=19] mild activity [4 -8], and Group C [n=13] moderate and severe activity [9-13, and >13] depending on Histological Activity Index [HAI] score, then, assessment of hepatic [periportal, intra-lobular and total] was done. Patients were categorized into cirrhotic group [n=18] and non-cirrhotic group [n=42]. Tissue Fas [tFas] was assessed using anti-Fas antibody. Serum Soluble Fas [sFas] and [sICAM-1] were measured using EIA kits
Result: sFas was significantly increased in patients subgroups compared to controls [p<0.001] and in comparing cirrhotic to no cirrhotic [p<0.01]. tFas showed rising significance with disease activity [p<0.01].Both studied parameters of Fas were not correlated with ALT level [r=0.04, 0.03]. sICAM-1 revealed significant correlation of albumin levels in Group B [mild activity], with sFas antigen in non-cirrhotic patients group correlation not yet reach significance. No correlation was found between viral load, Fas parameters and sICAM [r=0.19, 0.16 and 0.21] respectively, while correlated with HAI [r=0.91, 0.96] respectively, expect in patients group A of [minimal activity]. In addition, sFas correlated significantly with tFas expect group A
Conclusion: Fas studied parameters can reflect severity of liver inflammation and play a crucial role in HCV infection. Equally, Soluble Fas and sICAM-1may serve as serological indicator of active inflammation. Strategies to prevent Fas-mediated apoptosis during inflammation might offer exciting therapeutic potential
RESUMO
With advancing technology in ultrasound machines, examination of the fetal heart became available even at 14 weeks gestation. There are many reasons for referral for complete fetal echocardiographic assessment; the most common one is family history of congenital heart disease, while the most productive one is abnormal four chamber view. This study describes the value and accuracy of fetal echocardiographic screening for cardiac malformations in high-risk pregnancies. We studied 270 pregnant ladies who were referred for fetal echocardiography for several reasons e. g. family history of CHD, diabetes mellitus, inadequate or abnormal view of the heart [four chamber or great vessels], the presence of fetal abnormality on obstetric scanning and increased nuchal translucency thickness particularly in the first trimester. Antenatal fetal echocardiographic scanning of the heart was performed and compared with the postnatal one or compared with the histopathological finding of the specimen if termination of pregnancy took place. In cases where chromosomal abnormalities were detected, a chromosomal study was carried out. Our results showed a spectrum, of multiple cardiac abnormalities, both major and minor such as atrioventricular septal defect, hypoplastic left heart, aortic coarctation, large VSD, transposition of great vessels, cardiomyopathy and cardiac tumours. The most productive group of patients were those referred due to abnormal or inadequate four chamber view, the percentage of CHD in this group was 66.6% extended examination of the fetal heart [four chamber view and great vessel view] could detect about 75% of CHD. The percentage of chromosomal abnormalities in case with CHD was 20%. The accuracy of fetal echo is affected by the time during gestation when scanning is performed especially for valvular stenosis, coarctation of the aorta. Scanning in the first trimester is confined to the high risk patient