CD45RO+TILs: cellular biomarkers for larynx squamous cell carcinoma outcome

Abstract Objective: The prognostic importance of Tumor-Infiltrating Lymphocytes (TILs) in the tumor microenvironment of various cancers is increasingly recognized. In the present study, we aimed to investigate the prognostic value of CD3+, CD4+, CD8+, and CD45RO + TILs and their relation to histopathological features in larynx squamous cell carcinoma. Methods: Formalin-Fixed and Paraffin-Embedded (FFPE) samples from 63 primary larynx squamous cell carcinoma patients were immunostained for CD3, CD4, CD8, and CD45RO expression. Positive cells in micrographs from Invasive Margin (IM) and Tumor Center (CT) of tissue specimens counted by ImageJ software and their correlation with disease outcome were analyzed. Results: The expression level of TILs subpopulations was associated with clinicopathological markers as well as Overall Survival (OS) and Disease-Free Survival (DFS). In multivariate analysis, high frequency of CD45RO + cells in IM were confirmed as an independent prognostic marker for DFS (p = 0.007, HR = 4.968) and OS (p = 0.007, HR = 4.957). Similar findings were observed in the multivariate analysis of the combined frequency of CD45RO+cells in IM and CT. Conclusion: TILs are associated with patients clinicopathological features. Also, our findings indicate that CD45RO + TILs are a valuable marker for risk prediction in larynx SCC and could predict patients' outcomes.

Comparison of stereoacuity in patients of anisometropia, isometropia and emmetropia

Purpose: To compare the stereoacuity in patients with anisometropia, isometropia, and emmetropia. Methods: A cross?sectional study was conducted on 1403 subjects (range: 5–45 years) divided into anisometropes (n = 403), isometropes (n = 500), and emmetropes (n = 500). There were 258 amblyopic eyes among anisometropes and 156 amblyopic eyes among isometropes. Stereoacuity was measured using the Titmus stereo test consisting of a combination of contour targets. Results: There were 675 males and 728 females. A significant (P < 0.001) reduction in stereoacuity was found in anisometropes as compared to isometropes and emmetropes. The stereoacuity was even worse in amblyopes as compared to non?amblyopes. Most patients with anisometropia of <3.0 D had fair stereoacuity. However, as the degree of anisometropia increased to >3.0 D, stereoacuity deteriorated gradually. Marked reduction of stereoacuity was observed in severe degree of anisometropia (>6.0 D). Overall, an anisometropia of ?2.12 D was associated with reduced stereoacuity. Among the anisometropes, it was found to be the poorest in myopia, followed by myopia with astigmatism, hypermetropia with astigmatism, and hypermetropia. Conclusion: The level of stereoacuity was worse in anisometropes as compared to isometropes and emmetropes. Amblyopes had a greater reduction in stereoacuity than non?amblyopes. Stereoacuity decreased as the degree of anisometropia increased. Among the anisometropes, myopes had worst stereoacuity than hypermetropes.

Retinal nerve fiber layer and ganglion cell complex thickness analysis in patients having relative afferent pupillary defect

Purpose: To determine the retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness in patients having relative afferent pupillary defect (RAPD) measured by optical coherence tomography (OCT). Methods: This cross?sectional study was conducted on 30 patients with posterior segment disease and glaucoma presenting with RAPD. The control group comprised 30 patients with the aforementioned diseases without RAPD. RAPD was graded using neutral density filters placed over the unaffected eye. Peripapillary RNFL thickness and macular GCC were measured using the Cirrus HD?OCT machine. Results: There were 45 males and 15 females. There was a statistically significant (P < 0.05) difference in the mean of average RNFL thickness in patients having RAPD (64.73 ± 15.16 ?m in the affected eyes) as compared to sick control (82.73 ± 11.33 ?m in the affected eyes). It was further observed that there was a decrease in RNFL thickness with advancing grades of RAPD. There was a statistically significant (P < 0.05) difference in the mean of average GCC thickness in patients having RAPD (51.57 ± 14.96 ?m in the affected eyes) as compared to sick control (76.36 ± 8.06 ?m in the affected eyes). Conclusion: Our study suggests that there is a significant reduction in RNFL thickness and GCC thickness in RAPD patients as compared to the sick control group

Influence of combined mechanical-chemical versus mechanical bowel preparation on anastomotic leak and surgical site infections after elective resection of left colon cancer

Background: Mechanical bowel preparation (MBP) before elective resection of left colon cancer remains controversial. We propose that the protective effect of MBP is dependent on its combination with chemical preparation by oral antibiotics.Methods: Medical data of adult patients with left colon cancer who underwent elective resection at Sohag University Hospital (August 2016-March 2019) were reviewed. Anastomotic leak (AL), surgical site infections (SSI), postoperative morbidity and mortality were compared among patients who preoperatively received MBP followed by chemical preparation with oral antibiotics (MBP and OABx group) versus another group of preoperative MPB alone (MBP group).Results: Forty-two patients with left colon adenocarcinoma were enrolled, 21 per group. Overall, sigmoid colon was the most common site of left sided colon cancer (76%). Malignant lesions were found in proximal sigmoid in 19 (45%), rectosigmoid in 13 (31%), descending colon in 8 (19%) and splenic flexure in 2 (5%) patients. Dukes’ classification was A in 6 (14%), B in 19 (45%) and C in 17 (41%) patients. Compared with MBP, MBP and OABx group showed significantly lower rates of anastomotic leak (3 patients (14%) versus 1 (5%) respectively, p<0.05) and surgical site and intraabdominal infections (7 patients (33%) versus 2 (10%), p<0.05). MBP and OABx group exhibited lesser grades of postoperative complications (p<0.05) and shorter hospital stay (p<0.05). Postoperative mortality occurred only in the MBP group.Conclusions: Combined mechanical-chemical bowel preparation prior to elective resection of left colon cancer confers superior clinical outcome regarding anastomotic leak, surgical site infections and overall postoperative complications.

Combined liver-visceral resection for neoplastic lesions correlates with increased postoperative complications

Background: Combined liver-visceral resections (CLVRs) may impose increased risk of postoperative complications. The clinical outcome of CLVRs versus sole liver resection (SLR) has not been adequately reported from upper Egypt cancer surgery programs.Methods: Medical records of adult non-cirrhotic patients who electively underwent liver resection from February 2015 to April 2018 at Sohag University Hospital, Egypt, were retrospectively reviewed. Indications for liver resection comprised definitively malignant tumors and those with equivocal radiologic features. The severity of surgical complications, including mortality, was compared among patients who underwent CLVRs versus SLR control group with matching age, gender, number of resected liver segments, method of hepatic inflow occlusion and parenchyma transection techniques.Results: Twenty-six patients were enrolled, including 13 with CLVRs group and their 13 SLR control group. Histopathologic examination of resected specimens confirmed malignancy in 17 patients (10 in CLVR group and 7 in SLR group). Major liver resection (≥3 segments) was carried out in 14 (54%) patients, 7 per each group. The complication score was significantly higher in CLVRs (p<0.05). Similarly, the length of hospital and intensive care unit stays was significantly prolonged in CLVRs group (p<0.05). Overall, 2 patients died (8%), exclusively in the CLVRs. Elderly patients (>65 years) who underwent CLVRs exhibited increased complications compared with their matching controls.Conclusions: CLVR predisposes to increased morbidity rates and mortality. It should be carried out in carefully selected patients to avoid worse clinical outcome.

Overexpression of CDC7 in malignant salivary gland tumors correlates with tumor differentiation / Superexpressão de CDC7 em tumores malignos de glândulas salivares correlaciona-se com a diferenciação dos tumores

Abstract Introduction: Cell division cycle-7 protein is a serine/threonine kinase that has a basic role in cell cycle regulation and is a potential prognostic or therapeutic target in some human cancers. Objectives: This study investigated the expression of cell division cycle-7 protein in benign and malignant salivary gland tumors and also its correlation with clinicopathologic factors. Methods: Immunohistochemical expression of cell division cycle-7 was evaluated in 46 cases, including 15 adenoid cystic carcinoma, 12 mucoepidermoid carcinoma, 14 pleomorphic adenoma, and 5 normal salivary glands. Cell division cycle-7 expression rate and intensity were compared statistically. Results: The protein was expressed in almost all tumors. The intensity and mean of cell division cycle-7 expression were higher in malignant tumors in comparison with pleomorphic adenomas (p = 0.000). The protein expression was correlated with tumor grades (p = 0.000). Conclusions: The present study demonstrated cell division cycle-7 overexpression in malignant salivary gland tumors in comparison with pleomorphic adenomas, and also a correlation with tumor differentiation. Therefore, this protein might be a potential prognostic and therapeutic target for salivary gland tumors.

Resumo Introdução: A cell division cycle-7 é uma serina/treonina quinase que tem um papel básico na regulação do ciclo celular e é um potencial marcador prognóstico ou terapêutico em alguns tipos de câncer humano. Objetivos: Este estudo investigou a expressão de cell division cycle-7 em tumores de glândulas salivares benignos e malignos e também sua correlação com fatores clínico-patológicos. Método: A expressão imuno-histoquímica de cell division cycle-7 foi avaliada em 46 casos, incluindo 15 carcinomas adenoide císticos, 12 carcinomas mucoepidermoides, 14 adenomas pleomórficos e 5 glândulas salivares normais. A taxa de expressão e a intensidade da proteína cell division cycle-7 foram comparadas estatisticamente. Resultados: A proteína foi expressa em quase todos os tumores. A intensidade e a média da expressão de cell division cycle-7 foram maiores em tumores malignos em comparação com adenoma pleomórfico (p = 0,000). A expressão da proteína foi correlacionada com os graus do tumor (p = 0,000). Conclusões: O presente estudo demonstrou a superexpressão de cell division cycle-7 em tumores malignos de glândulas salivares quando comparada com o adenoma pleomórfico, além de uma correlação com a diferenciação de tumores. Portanto, essa proteína pode ser um potencial marcador prognóstico e terapêutico para tumores de glândulas salivares.

Is neutrophil/lymphocyte ratio a useful marker to predict the severity of pre-eclampsia?

Background: Preeclampsia refers to the new onset of hypertension and proteinuria or hypertension and end-organ dysfunction with or without proteinuria after 20 weeks of gestation in a previously normotensive woman

Objective: This study was aimed to evaluate the relationship between Neutrophil/Lymphocyte ratio [NLR] in patients with pre-eclampsia [PE] and severity of preeclampsia. Subjects and methods: This prospective study comprised a total of 150 pregnant females divided in 3 groups "50 healthy pregnant females [Group 1], 50 females with mild pre-eclampsia [Group 2] and 50 with severe pre-eclampsia [Group 3]". All the study participants were statistically compared in respect to Neutrophil/Lymphocyte Ratio [NLR] and the baseline data including age and BMI

Results: Maternal NLR was determined to be significantly high in the pre-eclamptic patients [Groups 2 and 3] compared to those with healthy pregnancies [Group 1] [p = 0.0003]. NLR was significantly higher in the severe pre-eclampsia group than in the mild pre-eclampsia group [p = 0.042]

Conclusion: It could be concluded that while NLR was determined as significantly high in patients with pre- eclampsia, to be able to use this in the classification of the severity of pre-eclampsia, there is a need for further studies on a more extensive population

Tonsillectomy - A Comparative Study of GA or LA

Background: Ethically it is our jurisdiction to decide upon the medical procedure we undertake after weighing the risk benefit ratio. Tonsillectomy is conventionally operated under general anesthesia but it has its own merits and demerits. The aim of the study was to analyse the better procedure. Methods: Hundred patients were operated in the medical college over period of two years in HIMS Barabanki and Govt medical college Kannauj. Seventy patients were operated under general anesthesia and another thirty under local anesthesia. Results: The total operation time, VAS, blood loss, complications, cost effectiveness, bed occupancy, patient turnover rate and patient satisfaction was better in surgical exercise done under local anesthesia when compared to general anesthesia. Conclusions: Tonsillectomy done under local anesthesia definitely has an edge over the general anesthesia.

Esthesioneuroblastoma - A Clinicopathological Study

Background: Esthesioneuroblastoma is a rare tumour accounting for only 3% of all intranasal tumors. Its proximity with important structures and aggressive behavior presents a diagnostic and therapeutic challenge. CT, MRI and histopathology forms the basic pillars of management. Methods: A prospective study was conducted between Feb 1998 to Feb 2004 in the Department of ENT, JNMC, AMU Aligarh. All the five patients taken up for study proved histopathologically to be cases of esthesioneuroblastoma. Results: Of the five patients, three presented with unilateral nasal obstruction (60%) and two with epistaxis (40%). Proptosis was present in one patient. Anosmia, headache and pain were other associated symptoms. Conclusions: hepatic and renal involvement occurs in patients suffering from dengue fever. Hence, multidisciplinary approach should be carried out while treating such patients.

Dentigerous Cyst – Its’ Prevalence and Presentation in a Tertiary Care Teaching Hospital

Background: Dentigerous cyst is although not uncommon but now is infrequently found in otolaryngological practice after the development of dental fraternity. Many times, they are encountered because of swelling in head neck area and facial disfigurement. NCCT and OPG play important role in its diagnosis. Removal can be both open or endoscopically. Methods: This prospective study was carried on n= 5 patients suspected of Dentigerous Cyst were included in our study on the basis of inclusion and exclusion criteria. Results: Here a series of five cases of Dentigerous cyst is presented with discussion regarding clinical and radiological features and treatment with a short review of literature. Conclusions: The Dentigerous cyst are usually encountered in ENT OPD and needs to be properly investigated. Advent of endoscopes and knowledge of anatomy of the area gives edge to the Otorhinolaryngologist over dentist in its management.

The efficacy of intravitreal interferon alpha‑2b for the treatment of experimental endotoxin‑induced uveitis

Purpose: To study the efficacy of intravitreal interferon alpha‑2b for endotoxin‑induced uveitis. Materials and Methods: A total of 36 rabbits were randomly allocated to one of the three groups: (1) received interferon plus balanced‑salt solution; (2) received lipopolysaccharide (LPS) plus interferon; and (3) received LPS plus balanced‑salt solution. Intraocular inflammation was evaluated by slit‑lamp biomicroscopy (standardization of uveitis nomenclature grading), binocular indirect ophthalmoscopy (BIO) score, and histopathology. Results: Group 2 showed significantly lower mean (±standard deviation) anterior chamber reaction than Group 3 (3.1 ± 0.9 vs. 3.8 ± 0.4) on day 1 postinjection, lower vitreous cells on days 1 through 7 (day 1: 3.1 ± 0.9 vs. 3.8 ± 0.4; day 3: 2.1 ± 1.6 vs. 3.8 ± 0.4; day 7: 1.9 ± 1.3 vs. 3.6 ± 0.7), and lower BIO score on days 1–7 (day 1: 3.3 ± 1.2 vs. 4.4 ± 0.7; day 3: 3.0 ± 1.4 vs. 4.3 ± 0.9; day 7: 2.4 ± 1.4 vs. 3.7 ± 1.2). The protein content of anterior and vitreous aspirates was lower in Group 2 than 3 (1618.5 ± 411.4 vs. 2567.3 ± 330.8 and 2157.0 ± 283.3 vs. 3204.6 ± 259.5, respectively). Conclusion: Intravitreal interferon alpha‑2b was effective in controlling endotoxin‑induced uveitis.

Tissue expression, serum and salivary levels of vascular endothelial growth factor in patients with HNSCC / Expressão tecidual, soro e níveis salivares de VEGF em pacientes com carcinoma de células escamosas de cabeça e pescoço

Introduction: Vascular endothelial growth factor is thought to be an important angiogenic factor involved in tumor growth, progression, and metastasis. Objective: The present study evaluated the relation between tissue expression, serum and salivary levels of vascular endothelial growth factor in head and neck squamous cell carcinomas, and their correlation with clinicopathologic features. Methods: Samples were collected from 30 patients with head and neck squamous cell carcinomas and 24 healthy volunteers. Immunohistochemical analysis was used for tissue expression and enzyme-linked immunosorbent assay was employed to measure serum and salivary levels. Results: No vascular endothelial growth factor staining was observed in normal tissues, whereas vascular endothelial growth factor expression was seen in 6 patients (20%). Mean serum level of VEGF was 83.7 ± 104.47 in patients and 50.04 ± 32.94 in controls. Mean salivary level of vascular endothelial growth factor was 174.41 ± 115.07 in patients and 149.58 ± 101.88 in controls. No significant difference was found by Mann-Whitney test between controls and patients (p = 0.411, p = 0.944, respectively). No correlation was found between vascular endothelial growth factor tissue expression and its serum and salivary level. Conclusion: Overexpression of vascular endothelial growth factor was found in head and neck squamous cell carcinoma patients, suggesting its role in the pathogenesis of head and neck squamous cell carcinoma, but no relation was found between tissue expression, serum levels, and salivary levels of this marker. .

Introdução: Acredita-se que o fator de crescimento vascular endotelial (FCEV) seja um importante fator angiogênico envolvido no crescimento, na progressão e na metástase tumoral. Objetivo: O presente estudo avalia a relacão entre a expressão tecidual e os níveis séricos e salivares do FCEV em carcinomas de células escamosas da cabeca e pescoco (CCECPs) e sua correlacão com aspectos clinicopatológicos. Método: Foram coletadas amostras de 30 pacientes com CCECP e de 24 voluntários saudáveis. Utilizamos análise imuno-histoquímica para a expressão tecidual e ELISA para determinação dos níveis séricos e salivares. Resultados: Não foi observada coloração para FCEV nos tecidos normais, enquanto que foi observada expressão de FCEV em seis pacientes (20%). O nível sérico médio de FCEV foi 83,7 ± 104,47 em pacientes e 50,04 ± 32,94 em controles. O nível salivar médio de FCEV foi de 174,41 ± 115,07 em pacientes e 149,58 ± 101,88 em controles. Não foi observada diferenca significativa pelo teste de Mann-Whitney entre controles e pacientes (respectivamente, p = 0,411, p = 0,944). Não foi observada relacão entre a expressão tecidual de FCEV e seus níveis séricos e salivares. Conclusão: A expressão elevada de FCEV foi observada em pacientes com CCECP, e isso sugere seu papel na patogênese de CCECP, mas não foi observada relacão entre a expressão tecidual e os níveis séricos e salivares desse marcador. .

Biochemical characterization and some biological properties of the phosphodiesterase I purified from Agistrodon bilineatus venom.

The venom phosphodiesterase I (PDE-I, EC 3.1.4.1) is useful in the elucidation of the structure and nucleotide sequence of nucleic acids. In the present study, PDE-I was purified from Agistrodon bilineatus venom by preparative native-PAGE. A single protein band was observed in analytical native-PAGE. The enzyme also gave a single band in SDS-PAGE with a molecular mass of 140 kDa. The position of the band was not altered in the presence of β-mercaptoethanol, suggesting the protein did not contain subunits. The enzyme was free from 5’-nucleotidase and alkaline phosphatase activities. It showed a broad optimum pH range (9.0-11.0), whereas the optimum temperature was found to be 600C, with activity decreasing at >650C. Energy of activation (Ea) was calculated to be 0.31. The PDE-I was a glycoprotein having 14% of carbohydrate content. The Vmax, Km, Kcat and Ksp values of the enzyme were 3.85 μM/min/mg, 8.3 × 10-3 M, 23s-1 and 46.4 M-1 Min-1 respectively. Cysteine caused a non-competitive inhibition with a Ki 6.3 × 10−3 M (IC50 of 1.6 mM), whereas ADP caused a competitive inhibition having Ki 0.8 × 10−3 M (IC50 5.4 mM). Glutathione, o-phenanthroline, zinc and EDTA inhibited the enzyme activity, whereas Mg2+ slightly potentiated the activity. The enzyme hydrolyzed thymidine 5’-monophosphate p-nitro-phenyl ester most readily (10-fold), while 3’-5’-cAMP was least readily hydrolyzed substrate. The enzyme up to 4.0 mg/Kg i.p was not lethal in mice. It exhibited an anticoagulant effect, and increased the normal clotting time of normal citrated human plasma, whereas the crude venom showed strong coagulant effect. The above results showed that the A. bilineatus PDE-I was very similar to that isolated from other snake venoms. The purification procedure described here is simple, rapid and reproducible and may prove useful to isolate pure protein for investigation into the contribution of this enzyme to the biological activities of A. bilineatus venom and PDE-I insight, in general.

Gains beyond cosmesis: Recovery of fusion and stereopsis in adults with longstanding strabismus following successful surgical realignment.

We evaluated recovery of binocularity in 15 chronically strabismic, non-fusing (with neutralizing prisms) adults following successful surgical alignment. We included > or =12-year-olds, with best corrected visual acuity (BCVA) > or =20/60, and excluded those with: anisoacuity> 2 lines-Snellen; failed realignment judged by> 10 prism diopters (PD) horizontal and> 4 PD vertical. Six-week outcomes were: fusion by Worth Four-Dots (WFDT) and Bagolini striated glasses (BSG) and stereopsis by Titmus test and the Netherlands organisation for applied scientific research (TNO) test. Baseline data in medians (range): age 18 (12-40) years, strabismus 45 (19-95) PD, duration 14 (0.5-24) years, 12 females; 12 exotropes, three esotropes; visual acuity was 20/20 in 10, while none had BCVA < 20/60. Postoperative strabismus measured 6 PD (range:0-10). By six weeks none suppressed: WFDT findings showed eight fused at distance and 13 at near; and on BSG figures were 10 and 13 respectively. Stereopsis was demonstrated by 13 on Titmus and by 10 on TNO tests. It is concluded that longstanding strabismic adults with good vision can recover fusion and stereopsis following successful squint surgery.