effect of methotrexate on the fallopian tubes of adult albino rats: a histological and immunohistochemical study

Methotrexate [Mtx] [the anticancer drug] has been a prevalent drug in the conservative treatment for unruptured tubal pregnancy for many years. Unfortunately, current emphasis has been on its damaging effects on the ovaries and fallopian tubes. The aim of this study was to examine the acute and long-term toxic effects of different doses of Mtx on the fallopian tubes. The study was carried out on 60 female rats. The rats were divided into three groups: the control group [group I], comprising 20 rats; group II, comprising 20 rats given 2.5 mg/kg Mtx intraperitoneally for 10 days [acute study]; and group III, comprising 20 rats given 2.5 mg/kg Mtx for 2 months [long-term study]. Rats in each group were killed at each time point and the fallopian tubes were dissected and stained with H and E, following which estrogen receptor [ER] expression was detected by immunohistochemistry. Light microscopy [acute] study showed a decrease in the number of mucosal folds with fusions of some folds. Cellular infiltration was limited to the mucosa when Mtx was administered in small doses. With increasing dose of Mtx, cellular infiltration extended to the musculosa and serosal layer. In the chronic study some regions showed an improvement in epithelial folding and the muscle layer, together with a decrease in cellular infiltration, especially at low dose. The immunohistochemical study revealed a weak positive immunoreaction for ERs in all rats of the acute group and high-dose chronic group, whereas in the low-dose chronic study moderate positive reaction for ERs in epithelial cells was detected. These results prove that Mtx [>/=5 mg/kg] can induce long-term, irreversible damage to fallopian tubes and steroid hormone receptors [ER] in a dose-dependent manner. Therefore, Mtx should be used in a relatively small and safe range of dosage in order to avoid impairment and potential risk of subsequent tubal pregnancy or infertility

Acute heat stress and adrenal cortex: biochemical, histological and ultrastrureal study in albino rats

Stress can be defined as a state of threatened balance induced by external stressor and appear as the display of somatic, and psychic reaction, struggling to regain homeostasis. Among stressful stimuli, heat stress is an environmental factor capable of causing a wide range of physiological alteration chiefly at the level of the hopothalamic- pituitary-adrenocortical [HPA] axis. The objective of the present study was to evaluate the effect of acute heat exposure on the ACTH and cortisol levels as well as structurally and ultrastructurally changes of the adrenal cortical glands in rats. Twenty normal adult male albino rats, weighting 180-200 grams, were divided into two equal groups. Group A represented the control rats and group B acted as a heat stressed rats that were exposed to hear at 38-40[degree sign]C for sixty minutes. At the end of experiment, rats were anesthetized, blood sample withdrawn for hormonal study and suprarenal glands were dissected out and prepared for microscopical and ultrasctructural examinations. A significant increase in ACTH and cortisol levels were reported in heat stressed group when compared with control group. Light microscopic examination of suprarenal cortical layers of heat-stressed rats revealed foamy cytoplasm with pyknotic nuclear changes as compared to control rats. In addition, ultrastructure examination of group B showed mitochondrial changes in all zones especially zona reticularis, decreased number of lipid droplets in both zona fasciculate and reticularis, and prominent dilatation of smooth endoplasmic reticulum vesicles when compared with group A. In conclusion, acute heat exposure was a stressful condition affecting the suprarenal glands as evidenced by the altered biochemical hormonal levels along with both structural and ultra structural changes

Study of Interleukin-16 in Bronchoalveolar lavage of Smokers with and without chronic bronchitis

The study included 30 subjects [10 case of healthy smokers with no chest symptoms, 10 cases of smokers with chronic bronchitis and ten healthy non smokers as control group]. The result of this study showed highly significant statistical increase in the level of IL- 16 in BAL and serum of smokers with or without chronic bronchitis compared to control group [P < 0.001, P < 0.0001 respectively] but no significant statistical difference in its level in BAL and serum of smokers with and without chronic bronchitis [P < 0.05, P > 0.05 respectively]. Also, there was no significant correlation between serum and BAL IL- 16 level in non smokers and smokers without chronic bronchitis [P< 0.05] but there was a significant correlation between them in smokers with chronic bronchitis [P< 0.05]. We concluded that, BAL and serum IL- 16 levels are significantly higher in smokers, [even if they are asymptomatic] than in non smokers, this fact must make us to focus on the danger of smoking in the community

Complicated Crohn 's disease

Crohn's disease is a debilitating, Chronic inflammatory disease that is neither medically or surgically Curable. [1] Approximately 60-70 percent of all patients with Crohn's disease will eventually need to undergo surgery for the disease. [2] In 20:40 percent of patients, the disease is complicated by the development of a Fistula or a deep penetrating abscess. [3] Several studies with INFLIXIMAB have clinically demonstrated that the antitumour necrosis factor-alpha therapy rapidly reduces signs and symptoms in patients with moderate to-severe Crohn's disease. [4] The objective: To increase awareness by this uncommon disease process and through light on a newly therapeutic agent that can reduce and maintain remission in a patient population in this retrospective study, we analyze the clinical records of 17 patients [13 males, 4 Females] as regard presentation, history, Clinical examination, investigation and treatment regimens and operative details. Four patients presented as acute appendicitis, 2 patients with terminal ileal perferation, 2 patients with abdominal masses, 3 patients with acute abdowen, 2 patients with peria pendicular abscess, 2 patients with intestiol abslructionand 2 cases with malnutrition. In 4 cases inflexemab was added to the treatment regimm leading to rapid cure Crohn's disease, though considered uncommon, can account for 10:60 percent afacute abdominal disorders. Thus every physician or surgeon in deal with acute abomen should bear in mind a Crohn's possibility Infliximab, a therapeutic agent that can induce and maintain remission, while promoting the restoration of intestinal mucosa, would prove to be most beneficial in such a patient population

Auditory dysfunction among printing workers

The aim of this study is to explore the combined effect of occupational exposure to noise and lead on the hearing process of the exposed workers. Twenty-four exposed workers [48 ears] from two printing facilities at Cairo University and twenty controls [40 ears], not occupationally exposed to noise or lead, were included in this study. All studied personnel were subjected to medical and occupational history, clinical and ENT examination, blood lead level determination and audiological assessment including: pure tone hearing thresholds, otoacoustic emissions [OAE] and auditory brain-stem response [ABR]. The work environments were tested for noise levels which were found to be 88 and 92 dB A, respectively. Statistically significant differences were detected between the exposed group and the controls as regards the hearing thresholds at frequencies 4 and 8 KHz and the OAE, The ABR revealed significant prolongation of the absolute latencies of waves 1 and 3 with increased [1 -3] interpeak latency in the exposed group. The 5/ 1 amplitude ratio was also smaller in the exposed compared to the controls. The blood lead level was significantly higher in the exposed in comparison to the controls [p < 0.001]

Parathyroid injury during thyroidectomy

The present study included 50 patients with different thyroid pathology, subjected to thyroidectomies and evaluated for parathyroid function pre- and postoperatively. The study showed definite decrease in calcium level in the early and late postoperative periods mostly in all groups. The study showed also the relation between the experience of the surgeon to the incidence of parathyroid injury in risky and difficult cases. Finally, recommendations for protection of the parathyroid gland were added during thyroidectomy

genetic study of vitamin D deficiency rickets: 2-sex differences and ABO typing

In a further attempt to study the role of genetics in vitamin D deficiency rickets, 400 rachitic infants randomly chosen and aged from 6 months to 2 years [14.3 +/- 3.5 months] were investigated for sex differences and ABO typing. A significant [P < 0.001] predominance of the male sex was found, sex ratio being 1.43. Blood group A was significantly [P < 0.001] associated with rachitic patients whether males or females. Alkaline phosphatase values were significantly [P < 0.01] higher in male infants 91% of them had levels above 30 K.A. units, while the corresponding percentage of girls was 72%. This indicates that the disease is more severe among males. The study gives added support for the belief that there is a genetic factor in nutritional rickets

Beta-glucuronidase and hyperbilirubinemia in breast-fed versus formula-fed babies

Breast milk and formula milk and the corresponding serum samples from 20 breast-fed babies, 20 formula-fed babies, and their mothers were examined at 3 days of age for beta-glucuronidase enzyme. Serum indirect bilirubin levels were also examined for all the infants. Serum indirect bilirubin concentrations were significantly higher [p < 0.001] in breast-fed [4.87 +/- 2.4mg/dl] than in formula-fed infants [1.04 +/- 0.5 mg/dl]. beta-glucuronidase activity in formula milk was negligible, while that in human milk was considerable [468.26 +/- 220.8 Sigma units/ml] and was correlated [p < 0.05] with that in the serum of the breast-fed [66.13 +/- 18.1 Sigma units/ml] than in formula fed infants [52.08 +/- 11.9 Sigma units/ml] and a significant [p < 0.05] correlation was found between its serum level and serum indirect bilirubin in both breast and formula fed infants. Also in breast-fed infants serum bilirubin concentrations were related to beta-glucuronidase activity in breast milk [p < 0.05]: Breast milk beta-glucuronidase - by facilitating intestinal reabsorption of bilirubin - seems to be an important factor in the neonatal hyperbilirubinemia of breast-fed babies

Cardiac profile in primary hypothyroidism and effect of therapy

This study was undertaken to evaluate the cardiac function determined by echocardiography, heart and chest X-rays and electrocardiogram [ECG] in a group of 15 infants and children with congenital hypothyroidism prior to and after thyroxine therapy. Their ages varied from 1 to 30 months, 6 cases were males and 9 were females. Prior to therapy, the study revealed that 40% of these patients had murmurs, 80% had ECG abnormalities, 66% had radiological enlargement of the cardiac silhouette, 20% had evidence of myopathic changes, mainly of the obstructive type, and all the subjects had small to moderate pericardial effusion. After full replacement therapy, these abnormalities reversed to normal, except for one patient with a persistent mild posterior effusion and an associated pulmonary stenosis. No significant abnormality in cardiac chamber dimensions or indices of myocardial function was detected among the hypothyroid children, prior to therapy or after re-establishment of normal thyroxine concentrations with exogenous hormone. The study revealed that the cardiac abnormalities observed in this study did not compromise the cardiac function and reversed to normal after full replacement therapy

Zinc and copper status in children with bronchial asthma and atopic dermatitis

The study comprised 40 children of both sexes aged from 2 to 12 years, 22 suffering from bronchial asthma and 18 suffering from atopic dermatitis. Twenty healthy children of comparable age and sex to the patients were studied as controls. All the children were subjected to full history including dietetic questionnaire, thorough examination, and to estimation of serum IgE, serum ceruloplasmin, and zinc and copper levels in both serum and hairs. The mean concentrations of zinc in serum and hairs were respectively 70.3 +/- 13.2 micro g/100 ml and 167.5 +/- 23.0 micro g/gm in asthmatic cases and 65.9 +/- 11.7 micro g/100 ml and 164.8 +/- 23.6 micro g/gm in those with atopic dermatitis.These levels were significantly [p <0.001] decreased in comparison to the control values [88.4 +/- 11.0 micro g/100 ml and 194.5 +/- 18.6 micro g/gm] .On the other hand, a significant [p <0.001] increase in serum and hairs copper was demonstrated in both allergic groups compared to the controls. Mean copper values were respectively 79.5 +/- 8.06 micro g/100 ml and 18.7 +/- 1.9 micro g/gm in the asthmatic cases and 81.4 +/- 8.4 micro g/100 ml and 17.8 +/- 2.08 micro g/gm in cases with atopic dermatitis. The control mean concentrations were 67.95 +/- 6.37 micro g/100 ml and 14.5 +/- 2.53 micro g/pm respectively. Significant [p <0.001] higher levels of serum ceruloplasmin were observed in the allergic patients compared to the controls and were correlated with the hypercupremia. The results were discussed and a good dietetic intake of high biological value protein and zinc supplement was recommended to these patients in order to correct their disturbances especially the hypozincemia which could lead to exaggeration of their allergic conditions. The field of trace elements metabolism has grown rapidly over the past few years, particularly after the development of novel techniques as the atomic absorption spectrophotometry which had allowed the reliable measurements of several trace elements in tissues and so had opened a new field for many researches [Henkin, 1976]. Zinc and copper are involved in cell and tissue growth. Zinc plays an important role in DNA and protein synthesis and is intimately involved with copper as cofactors in several important enzyme systems. The effects of many pathological conditions as congestive heart failure, pneumonia, rheumatic heart diseases, bronchitis, recurrent infection, hemolytic anemia, psoriasis, and malnutrition on the levels of serum zinc, copper, and other trace elements have been of interest to investigators for a number of years [Sinha and Gabriel i, 1970; David et al .,1984]. Moreover, the importance of trace elements in general and zinc in particular in the development and maintenance of the immune system is now widely accepted [Fraker et al., 1986]. Accordingly, this work was designed to study the concentrations of zinc and copper in serum and hairs of Egyptian children suffering from bronchial asthma and atopic dermatitis, in order to explore and delineate their clinical and pathological significance in such disorders