Frequency of central nervous system tumors in delta region, Egypt.

Introduction and Aim of Work: Central nervous system (CNS) tumors represent a major public health problem, and their epidemiological data in Egypt have been rather incomplete except for some regional reports. There are no available frequency-based data on CNS tumors in our locality. The objective of this study was to estimate the frequency of CNS tumors in east delta region, Egypt. Materials and Methods: The data were collected during the 8-year period from January 1999 to December 2007 from Pathology Department, Mansoura University, and other referred pathology labs. Examination of HandE stained sections from retrieved paraffin blocks were done in all cases for histopathologic categorization of C.N.S. tumors. Immunohistochemical studies were applied to confirm final histopathologic diagnosis in problematic cases. Results: Intracranial tumors represented 86.7% of cases in comparison to only 13.3% for spinal tumors. Gliomas were the CNS tumors of the highest frequency (35.2%), followed by meningioma (25.6%), pituitary adenoma (11.6%) and nerve sheath tumors (6.6%). 10.25% of tumors were of children <15 years. Conclusion: This study provides the largest series of the relative frequency of CNS tumors in Delta region in Egypt till now and may help to give insight into the epidemiology of CNS tumors in our locality.

Experience with peripheral nerve injury in upper extremities

This study reports the results of 87 operations performed on nerves of the upper extremities of 87 patients during the period of 5 years from 2000-2005 in Mansoura University hospital and Emergency Hospital. Among them there were 84 males and 3 females, age ranged from 5 - 53 years. There were 27 patients with isolated median nerve injury, 33 with isolated ulnar nerve injury, 12 with isolated radial nerve injury and 15 patients with combined median and ulnar nerve injury. All patients were treated with nerve exploration within 1 hour, 7 months after combined injury and were followed-up for 3 months - 2 years. There were 77 nerve lesions not in continuity [74 needed suture repair and 3 needed sural nerve graft repair], while 25 nerve lesions where in continuity [9 partial lesions needed neurolysis and 16 complete lesions needed neuroma excision and suture repair]. Analysis of the outcome of surgical treatment was performed with respect to the following parameters: period between the injury and operation, patient age, type of injured nerve, level of injury and type of surgical intervention. Overall significant outcome [>/= 3 Lousiana State University Health Science [LSUHS] grade] was obtained in 67.5% [radial nerve 75%, ulnar nerve 64% and median nerve 71%]. Significant outcome according to the level of the injury were 51% arm, 69% forearm and elbow and 82% wrist. According to the type of intervention and lesion categories, lesions not in continuity had a significant outcome 61% [primary suture repair 75%, secondary suture repair 61%, while graft repair was 0%]. Lesions in continuity had a significant outcome 88% [partial lesions underwent neurolysis 100%, while complete lesions underwent surture repair 81%, cut injuries 79% and crushed injuries 59%]. The most favourable outcome was obtained with lesions that result in partial lesion in continuity

High resolution computed tomography assessment of airway wall thickness in patients with bronchial asthma

HRCT scanning increasingly used in bronchial asthma. This work was planned to assess the thickness of airway wall in chronic bronchial asthma by using HRCT scanning and its relation to pulmonary function and asthma severity. The study was carried out on 25 chronic asthmatic patients 14 females and 11 males and 10 normal healthy subjects as a control group they were matching as regard age, gender, and height All cases were subjected to the following: complete history taking complete clinical examination, plain chest radiography, pulmonary function tests and HRCT chest scanning at 5 levels; top of aortic arch, at the main carina, 1 cm below main carina, at the level of pulmonary veins, and 2 cm above right hemidiaphragm. Asthmatic patients were classified into severe asthma II cases, moderate asthma 10 cases, and 4 cases as mild asthma, the following data were found: There were no statistically significant difference between cases and control groups -in age, sex or height. There were highly significant increases in FVC, FEV[1], and FEF25-75% and low significance increase in FEV[1]/FVC among cases after use of bronchodilator than before it There was no significant difference in pulmonary function before and after BD among control group There were significant difference between cases and control groups in all pulmonary function results. There were high significant difference between cases and control groups in FEV[1], FVC, FEF 25-75% after use of bronchodilator. There were statistically significant negative association between wall thickness and FEV[1]/FVC and FEF25 75%. There were statistically negative significant correlation between wall area and FEF25-75%, and FEV[1]/FVC- There were significant negative correlation between [thickness/diameter] T/D ratio and FEF 25-75% and FEV[1]/FVC. There were significant correlation between airway wall area and severity of bronchial asthma. No significant correlation between airway wall thickness and FEV[1] but there is negative association between wall thickness and FEF25-75% and FEV[1]/FVC ratio. This study showed strong positive correlation between wall thickness, wall area and asthma severity and duration of asthma There were significant correlation between asthma severity, duration, and thickness of the airway wall and wall area%. Many changes as bronchiectasis, mucoid impaction, emphysema and bronchial dilatation were found in chronic asthmatics

Adenosine deaminase enzyme activity as a diagnostic marker in rheumatoid arthritis

This study has been conducted to evaluate the diagnostic value of estimating adenosine deaminase [ADA] enzyme activity in the differential diagnosis of RA especially those cases with seronegative RA [those with negative latex test]. The study involved two main groups of patients, 20 osteoarthritis [OA] patients constitute the reference group and 30 rheumatoid arthritis [RA] patients [20 patients were latex positive and 10 patients were latex negative] constitute the test group. ADA activity was studied in sera, peripheral blood lymphocytes and synovial fluids of knee joints of all groups. Serum ADA activity showed significantly higher values in both groups of RA than OA [88.95 +/- 11 .69 IU/L in latex positive and 86.40 + 11.92 lt1/L in latex negative vs 30.2 + 8.05 IU/L, in OA]. In synovial fluids ADA activity showed a similar pattern [183.1 + 14.81 IU/L in latex positive RA and 181.9 +/- 17.31 IU/L in latex negative RA vs 33.9 +/- 5.3 IU/L in OA]. Both latex positive and latex negative RA patients showed significantly higher values of ADA activity in peripheral blood lymphocytes than those with OA [841.55 + 6.1 micromolNH[3] / [10][6] cell/hour in Latex +ve RA and 839 +/- 50.93 /micromolNH[3] / [10][6] cell/hour in Latex negative RA vs 362.6 micromoINH[3] / [10][6] cell/hour in OA. There was no significant difference in ADA activity between both subgroups of RA in all materials studied indicating a reliable sensitivity of ADA in seronegative patients and pointing to the possible use of ADA activity as a diagnostic marker in RA especially seronegative cases