Screening for human papillomavirus [HPV] in Egyptian females by the second-generation hybrid capture [HC II] test

Human Papillomavirus [HPV] infection is the main cause of cervical cancers and cervical intraepithelial neoplasias [CIN] worldwide. Consequently, it would be useful to evaluate HPV testing to screen for cervical cancer. Recently developed, the second-generation Hybrid Capture [HC II] test is a non-radioactive, relatively rapid, liquid hybridization assay designed to detect 18 HPV types, divided into high and low-risk groups. This test has an additional advantage, as it is also designed to provide quantitative estimates of the viral load .The aim of the present work, is to detect the rate of HPV infection and its various genotypes among the attendants of Kasr El Aini out patient gynecology clinic, using a non-invasive approach and to provide quantitative estimates of viral load. We evaluated 166 Egyptian females for HPV infection with the HC II test. The mean age of the participants was 37.28 +/- 9.16 years. According to cytology, the females were classified into normal cytology, chronic nonspecific cervicitis and squamous intraepithelial lesions [SILs]. The overall prevalence of HPV DNA in the studied groups was 15.06% [25/166], ranging from 6.6% [7/106] in normal cytology to 18% [9/50] in chronic nonspecific cervicitis to 90% [9/10] in squamous intraepithelial lesions. Among the 25 HPV- positive women, 16 [64%] were infected with high-risk HPV types, 4[16%] were infected with low risk HPV types, while 5[20%] had both types. Twenty-one [84%] of the infected woman harbored at least one high risk HPV type while 9[36%] harbored at least one low risk HPV type. Values of HPV viral load for low risk HPV infecton showed no significant difference for normal and chronic nonspecific cervicitis. But when HPV viral load of high risk HPV infecton was compared in normal, chronic nonspecific cervicitis and SIL a significant difference was found between normal and chronic nonspecific cervicitis, and between chronic nonspecific cervicitis and SIL and between normal and SIL, suggesting an association between viral load and risk of SIL and accordingly risk of cancer. Mixed HPV infection gave high viral load values even in normal smears. The viral load was apparently higher in SIL. From this study we may conclude that HPV testing using HC II assay is a useful tool when combined with cytology in diagnosing high-risk HPV viral types in apparently normal tissues. This may decrease greatly the increasing referral rate for colposcopy. This will reduce the cost services and could contribute to cancer prevention. Thus, this test may facilitate the detection of silent carriers of HPV by a sensitive noninvasive technique; leading to the identification of Egyptian women at risk of cervical neoplasia

Angiogenic versus antiangiogenic factors in cancer bladder patients

Angiogenesis is essential for tumor growth and progression and is mediated by positive and negative regulators of vessel growth. Since angiogenic mediators found in patient serum have been postulated to reflect the angiogenic potential of a malignant tumor, we investigated the angiogenic stimulators activity such as [vascular endothelial growth factor [VEGF], matrix metalloproteinases [MMPs]] and angiogenesis inhibitor such as endostatin in the serum of patients with primary transitional cell carcinoma of the bladder and to evaluate their clinical prognostic application. The present work was conducted on twenty four male patients pathologically proved carcinoma of the urinary bladder; 2 patients had superficial bladder cancer, 14 patients had localized invasive bladder cancer and 8 patients had distant metastasis. The pathologic grade was grade I in 8 patients, grade II in 9 patients, and grade III in 7 patients. In addition twelve normal healthy male subjects of matched age and sex were included as control group. The serum VEGF, MMP-9 and endostatin levels were significantly greater in all patients with bladder cancer than in the healthy controls [p<0.001]. When compared according to tumor stage, the distant metastatic group had significantly greater levels of serum VEGF, MMP-9 and endostatin than the localized invasive group [without distant metastasis]. The levels of the three parameters were significantly greater in patients with high-grade tumors [G3] than in patients with low-grade tumors [Gl and G2] [p<0.001], but no statistically significant difference was found between Gl and G2. A significant positive correlation between endostatin and each of VEGF and MMP-9 [r= 0.63; p<0.01 and r = 0.65;p<0.01 respectively]. The previous results denote that serum levels of endostatin, MMP-9 and VEGF were elevated in patients with transitional cell carcinoma of the bladder. The elevation was associated with the stage and grade of bladder cancer. Thus, elevation of serum levels of endostatin, MMP-9 and VEGF might be considered as indicators of tumor invasion and metastasis in the future

Assessment of nitric oxide and prostaglandins levels in different pathological types of glomerular disease

The objective of this study was to evaluate plasma nitrite and nitrate as well as urinary nitrite levels in forty cases with different glomerular disorders. In addition, serum thromboxane A2 [TXA2] and prostacyclin 12 [PGI2] levels were evaluated in these cases in comparison to 20 healthy control subjects. The effect of steroid therapy on the above mentioned parameters was also evaluated. The results revealed that urinary nitrite level was significantly elevated among patients compared to control. The elevation was observed in diabetic nephropathy as well as proliferative forms of glomerular disease such as lupus nephritis and mesangioproliferative GN. However, plasma nitrite, nitrate and serum cGMP levels were similar in patients compared to the control levels. TXA2 level exhibited significant elevation in patients, whereas serum PGI2 showed significant decrease in its level among cases as compared to control subjects. Steroid therapy was demonstrated to have no effect on all of the studied parameters. The study concluded that the data indicated that NO might play a role in the pathogenesis of proliferative glomerular disease and diabetic nephropathy. The demonstration of normal level of urinary nitrite in non proliferative GN suggests that enhanced NO production is not the sole cause of proteinuria in these cases. Further studies are, therefore, needed to examine the exact role of NO in pathogenesis of glomerular injury. The significant elevation of TXA2 level together with the significant decrease in serum PGI2 should be thoroughly investigated regarding the renal hemodynamics, the extent of proteinuria and the thromboembolic tendency reported in these cases

Helicobacter pylori infection in cirrhotic patients with and without hepatic encephalopathy, correlation with ammonia level in blood

To determine the association between Helicobacter pylori infection, hepatic encephalopathy and blood ammonia level; 23 patients with liver cirrhosis and hepatic encephalopathy [HE] as well as 25 age and sex matched cirrhotics without encephalopathy were subjected to this study. They were c and idates for history taking, clinical examination and blood ammonia study. Endoscopy with urease test for biopsies from the gastric antrum was performed. Significantly more positive results for H. Pylori infection were obtained from cirrhotic subjects with HE than from cirrhotics without HE. H. Pylori positive patients with HE had a higher blood ammonia level than H. Pylori negative patients. Cirrhotics with H. pylori infection had a higher blood ammonia level than those negative for H. pylori. There was no significant difference between the prevalence of H. pylori in cirrhotics with and without endoscopic evidence of portal hypertensive gastropathy