Detection of cyclooxygenase-2 [COX-2] expression in non-small cell lung carcinoma. An immunohistochemical and computerized image analysis study

Lung cancer is the leading cause of cancer death all over the world. Evidence is accumulating to suggest that cyclooxygenase-2 [COX-2] is involved the pathogenesis and progression of some types of lung cancer. COX-2 is one of the novel targets under evaluation for non-small cell lung carcinoma [NSCLC] therapy and chemoprevention. The aim of the present study was to detect COX-2 expression in non-small cell lung carcinoma [NSCLC] and to determine its correlation with various clinic pathological parameters. The expression of COX-2 was assessed in 30 patients with NSCLC using immunohistochemistry, followed by quantitative assessment of the immunostaining using computerized image analysis. The present work was conducted on 30 patients with NSCLC: squamous cell carcinoma [15 patients], adenocarcinoma [10 patients], and undifferentiated large cell carcinoma [5 patients]. Overall, 70% of studied NSCLC expressed COX-2. 60% of squamous cell carcinoma [SCC], 80% of adenocarcinoma [ADC] and 80% of undifferentiated large cell carcinoma [ULCC] showed positive immunostaining for COX-2. No significant correlation was found between tumor histological type and each of frequency and degree of COX-2 expression [p=0.569 and p=0.094 respectively]. Though the expression of COX-2 increased with tumor grade, the relation between COX2 expression [both the frequency and degree of expression] and tumor grade was not significant [p=0.778 and p=0.247 respectively for SCC, and p=0.641 and p=0.067 respectively for ADC]. A statistically significant difference was found between node positive and node negative cases as regards the degree of COX2 expression [p=0.05]. No significant relationship was found between COX-2 expression and age and sex of patients, smoking and tumor stage. COX-2 is frequently overexpressed in NSCLC especially in adenocarcinoma and undifferentiated large cell carcinoma. Expression was higher in node-positive tumors and tended to increase with tumor grade, suggesting that COX-2 might play a role in the pathogenesis and/or progression of these tumors. COX-2 appears to be a potentially promising target for therapy and chemoprevention of NSCLC

Sex hormones and endocrine abnormalities in patients with chronic respiratory hypoxia

Ten male patients with hypoxia associated with chronic obstructive air way disease and seven with hypoxic pulmonary fibrosis were studied. Serum testosterone concentrations were significantly reduced in both patient groups P< 0.05]. There was significant correlation between serum testosterone and PO2 [r= +0.68]. Basal levels of lutenising hormone and follicle stimulating hormones were significantly lower than in the groups of age matched control. Basal serum level of prolactin concentrations were moderately raised in 3 out of 17 patients with normal level in the others. Resting level of thyroid stimulating hormone, thyroxine and triiodothyronine were normal. Most of men suffered from reduced sexual function. which is considered to be due, at least in part, to endocrine disturbance

Alveolar macrophages function in cigarette smokers

Cigarette smokers are more susceptible to recurrent respiratory tract infection. Broncho-aveolar lavage [BAL] for these smokers demonstrated increased number of immune and inflammatory cells. Inspite of this, recurrent infection suggests that there may be functional defects concerning dealing with microorganisms by these cells. In order to throw more light on the functional activity of the most common cells in BAL i.e alveolar macrophages, one performed this study on twenty eight volunteers. Eighteen of them were moderate smokers and ten were non smokers. The two groups were matched in age and were clinically free. Transnasal fiberoptic bronchoscopy with pulmonary lavage of right middle lobe was performed in these 28 volunteers. The yielded fluids were collected and the cells after cenrifugation were subjected to total and differential count of cells/ml [XIO4 cells], estimation if phagocytic activity, phagocytic index and intracellular killing% of macrophage cells. In smoker's lavage, aveolar macrophages constitude mosy of the cells [91.23 +/- 4.31% of the total count]. Poltmorphnuclear cells were significantly increased in the smoker's lavage when compared to the non smokers [3.65 +/- 2.1% and 0.56 +/- 0.47%, respectively]. phagocytic activity was significantly diminished in smokers when compared to the non smokers [P < 0.001]. Phagocytic index was significantly decreased in the smokers when compared with the non smokers [P < 0.001]

Breathing pattern in chronic obstructive lung diseases and interstitial lung fibrosis

The pattern of breathing was studied in 27 patients with chronic obstructive lung diseases [COLD], 17 non-hypercapnic and 10 hypercapnic and 10 patients with diffuse interstitial lung fibrosis [DLF] using mouth piece, nose clip, respirometer. In COLD, the results showed similar pattern in non and hypercapnic patients with exaggeration in the absolute values in later group. They showed high respiratory frequency [f], normal tidal volume [VT] high minute ventilation [MV], short inspiratory time [Ti], very small Ti/T tot [T tot total inspiratory cycle time], high VT/Ti. This indicated that it is contrary to current theory, there is an increase in respiratory center drive in all patients with COLD with or without hypercapnia. So, stimulants to respiratory center are not indicated and may have hazardous effects. In DLF patients, [f] was higher than COLD groups, VT was low than normal. Ti and TE [expiratory time] were low. So, Ti/T tot was within normal in contrast to COLD, Vt/Ti is high. The abnormal breathing pattern in DLF attributed by physico-pathological mechanisms triggered by interstitial lung fibrosis. This work illustrated that pattern of breathing and its components can be studied as a routine test by simple noninvasive method using respirometer to assess respiratory center drive and respiratory timing in health and diseases

Antituberculous treatment as a therapeutic test in sputum negative pulmonary tuberculosis

The smear negative case of pulmonary tuberculosis [TB] are very commonly met with by the chest physicians and general practitioners. This work was done on two groups of smear negative patients: Group I [prospective group] consists of 50 patients and group II [retrospective group] consists of 30 patients. All patients had clinico-radiological possibilities of pulmonary TB therapeutic test with antituberculous treatment [ATT] on these patients using 4 drugs [rifadine + INH + ethambital + streptomycin] for 2 months in group I and 12 months in group II, revealed radiological improvement in 74% and 80% of TB patients in prospective and retrospective group, respectively. So, a soundly based policy to start treatment in these patients without delay can be recommended. The results showed that tuberculin negative test cannot rule out the possibility of TB even with sputum smear negative

Anion gap an illuminating point in acute respiratory failure of severe bronchial asthma

Calculation of anion gap [AG] is an important clinical criterion in establishing the nature of metabolic acidosis [MA]. This study showed that MA as shown by high AG is not uncommon in patients hospitalized with acute exacerbation of asthma. High anion gap was found in 11 out of 20 patients with severe bronchial asthma, whose PaO2 <50 mmHg. Their AG on admission ranged between 20.6 and 39 mEq/L with a mean of 29.50 mEq/L. Fifteen out of 20 patients had absolute and relative hypercapnea, nine of them had high AG. Five patients had hypocapnea, two of them had high AG. Patients with MA ran more aggressive downhill course than those without, six of them needed artificial ventilation. It was concluded that the calculation of AG to recognize MA was not only a kind of diagnosis and evaluating the acid base status, but also it gave a greater insight of the prospect of therapy and follow up of the patients in the quagmire of critical care medicine

Breathing patterns in normal persons

The breathing pattern at rest was studied in 37 young healthy human volunteers [24.76 +/- 4.15 years] and 25 old healthy persons [61.56 +/- 10.53 years] using Lode respirometer. The mean respiratory frequency [f] was 16.95/min. in young and 15.92/min, in old persons. Tidal volumes varied: 497 +/- 56, 453 +/- 39 ml. in the young and old respectively. Sighing occurred in elderly persons as well as in all females [young and old]. The rythmicity was more irregular in elderly. Minute ventilation is analyzed in terms of mean inspiratory flow [VT/Ti] which reflects respiratory center drive, and fractional inspiratory time [Ti/Ttot] which is a pure index of respiratory timing. In the young VT/Ti was 343 +/- 39 ml/sec. and Ti/Ttot 0.416 +/- 0.019. In the old VT/Ti was 291 +/- 28 ml/sec. and Ti/Ttot 0.414 +/- 0.02. Inspiratory duration was found approximately constant