Potential Role for a Panel of Immunohistochemical Markers in the Management of Endometrial Carcinoma

BACKGROUND: In order to improve the efficacy of endometrial carcinoma (EC) treatment, identifying prognostic factors for high risk patients is a high research priority. This study aimed to assess the relationships among the expression of estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and the different histopathological prognostic parameters in EC and to assess the value of these in the management of EC. METHODS: We examined 109 cases of EC. Immunohistochemistry for ER, PR, HER2, and Ki-67 were evaluated in relation to age, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage and grade, depth of infiltration, cervical and ovarian involvement, lymphovascular space invasion (LVSI), and lymph node (LN) metastasis. RESULTS: The mean age of patients in this study was 59.8 ± 8.2 years. Low ER and PR expression scores and high Ki-67 expression showed highly significant associations with non-endometrioid histology (p = .007, p < .001, and p < .001, respectively) and poor differentiation (p = .007, p < .001, and p <. 001, respectively). Low PR score showed a significant association with advanced stage (p = .009). Low ER score was highly associated with LVSI (p = .006), and low PR scores were associated significantly with LN metastasis (p = .026). HER2 expression was significantly related to advanced stages (p = .04), increased depth of infiltration (p = .02), LVSI (p = .017), ovarian involvement (p = .038), and LN metastasis (p = .038). There was a close relationship between HER2 expression and uterine cervical involvement (p = .009). Higher Ki-67 values were associated with LN involvement (p = .012). CONCLUSIONS: The over-expression of HER2 and Ki-67 and low expression of ER and PR indicate a more malignant EC behavior. An immunohistochemical panel for the identification of high risk tumors can contribute significantly to prognostic assessments.

Study the effect of apocynin on some renal functions in ischemia/reperfusion injury in male albino rats

Background: Apocynin [4-hydroxy-3-methoxyacetophenone] which isolated from the traditional medicinal plant Picrorhiza kurroa, is a naturally occurring methoxy-substituted catechol, experimentally used as an inhibitor of NADPH oxidase and of the concomitant ROS production. Apocynin also proved to be a potent anti-inflammatory agent, based on the selective inhibition of the production of ROS by activated human PMNs

Aim of the Study: to explore the protective effect of Apocynin and the NADPH oxidase inhibitor on kidney damage induced by ischemia/reperfusion [I/R] in a rat model

Subjects and Methods: Fourty male albino rats were categorized into four equal groups of 10. Group 1: Sham operated control group, Group 2: Ischemia / reperfusion [I/R] group; which underwent bilateral renal ischemia for 1 hour followed by a 23 hour reperfusion, Group 3: 4-week Apocynin treated group in which rats received Apocynin with a dose o16 mg/kg /day for 4 weeks followed by bilateral renal ischemia for 1 hour then 23 hour reperfusion afterwards , and Group 4: 8- week Apocynin treated group in which rats received Apocynin with a dose of 16 mg/kg /day for 8 weeks then bilateral renal ischemia for 1 hour followed by 23 hour reperfusion. After reperfusion, the animals were sacrificed, the blood samples were collected for determination of blood urea nitrogen, serum creatinine, 24 hour urine were collected for determination of creatinine clearance. Kidneys of all animals were harvested and evaluated biochemically through determination of tissue MDA, MPO, GPX and catalase level

Results: Kidney tissue MDA, MPO, serum BUN and Creatinine levels were found to be significantly higher in the I/R group. GPx level showed a significant decrease, while there was a slight decrease in Catalase level when compared with Sham operated group. Creatinine clearance was impaired in renal I/R group. Renal I/R injury has also induced an extensive tubular necrosis, glomerular damage, and apoptosis. Apocynin significantly reduced MDA and MPO and increased GPX and catalase in both treatment groups when compared to the I/R group [p< 0.001]. The elevated BUN and creatinine levels were significantly reduced in treatment groups, also creatinine clearance was restored to around normal value

Conclusion: with accordance to the findings and outcome of the present study, Apocynin has exerted protective effects against ischemia/reperfusion injury by ameliorating the kidney damage induced by I/R injury to a significant extent. However, there was no significant difference in the outcome if the treatment was extended from 4 to 8 weeks

study of low achievement on third grade primary school failed students in Minoufiya

This study was conducted on 374 students who constituted about one fourth of third grade primary school failed students in whole Minoufiya governorate and 100 never failed students from the same classes as a control group. Semi structured psychiatric interview and thorough, neurological examination, beside sociodemographic data sheet and psychometric assessment using children depressive inventory children's phobia scale and Anxiety scale for children, child behavior checklist and IQ assessment. 45.9% of failed students were founded to have psychiatric disorders in comparison to 27% of the control group. 9.1% of the repeaters were founded to be mentally retarded. and 34.3% of them were of border line IQ compared to 2% and 20% of the control group respectively. Epilepsy was present among 2.1% of failed students compared to 1% of the control group. The failed group were founded to be significantly different from control group as regard parental education, family size, make truancy from school. Abnormal behavior problems were more prevalent among failed students than control group. Learning problems as reading, writing and mathematics problems were founded to be more prevalent among failed students. No difference of significant value was detected between failed males and females students regarding the studied items, except for conduct disorder and [Aggressive, Delinquent, Hyperactive disorders "ADHD"]

Attitude and role of health care workers toward anti-smoking measures and legislations at the Capital Governorate Health Region, Kuwait

Objectives: this study demonstrates the attitude of health care workers [HCWs] in capital region [including Amiri hospital and health centers working at ministry of health] towards antismoking legislations in Kuwait, and towards their professional responsibility role in smoking cessation program for their patients, and determine the attitude of non smokers towards those who smoke in different situations

Subjects and methods: a cross sectional study was conducted during August and September 2003. All HCWs at Ministry of Health facilities, Capital Region, including AL-Amiri hospital and the health centers propagated through the Capital Region, were invited to participate using an anonymous self -administered questionnaire. The survey collected information on soci-demographic characteristics, attitude of HCWs towards anti-smoking legislations, and towards their professional responsibility role in smoking cessation program for their patients, and to determine the attitude of non-smokers towards smoker in different situations

Results: a total of 1625 respondents [604 male, 1021 female] mere included in the study. The prevalence of smoking among the HCWs was 16.80%. More than 90% of HCWs support legislations to prohibit smoking in hospital and health care centers, to ban tobacco sales to children and advertisement of tobacco Product, and encourage clear print of health warning on cigarette packages. The attitude of nonsmokers towards someone smoke in different places is disappointly passive. About 87% of respondents agree to ask and advise the patients about his smoking status, and 75% agree that advice of physician to his patients to stop smoking increases the probability of their quite. Overall the attitude of respondents varied according to their smoking status and their occupation; current smoker were significantly. [p <0.0001] less in favor of antismoking legislations and less likely to ask patients about their smoking status than non and ex-smokers

Conclusion: HCWs realized that the use of tobacco products could have a detrimental effect on health. They support promotion of smoke free workplaces, restriction on youth access to tobacco products and on advertisement and promotions directed towards children. They have ample opportunity to assist patients to stop smoking and support antismoking legislations in Kuwait