Immunohistochemical Expression of P53; Ebv-Lmpi and Cyclin D1 Proteins in Oesophageal Carcinoma: A Pilot Retrospective Study of 26 Cases

Introduction: The development of oesophageal carcinoma has been attributed to various environmental factors and its incidence varies regionally. The development of this disease is known to occur in recognized histological stages from normal through dysplasia to the malignant stage. Like other cancers; the diagnosis of oesophageal cancer in its premalignant stage would improve the survival. The diagnosis of this cancer on cytomorphology alone is usually done in the late stage of the disease. To be able to diagnose this disease in its early stage; specific tumour markers must be found. The objective of this study was to evaluate p53 tumour suppressor gene protein expression; Epstein-Barr virus latent membrane protein expression and cyclin DI cell cyase protein expression in malignant and normal oesophageal tissues to see whether any variation in their expression in these tissues could be of diagnostic or prognostic value. Methods: 26 archival formalin-fixed paraffin wax embedded tissue blocks of oesphageal carcinoma and 6 of normal oesophagus obtained by endoscopy were studied. 5?m thick tissue sections were cut onto poly-L-Lysine coated microscope slides and dried at 600C for 60 minutes. p53 gene protein expression; EBV-LMPI protein expression and cyclin DI expression were studied immunohisto chemically in these tissue sections. Sections were dewaxed and hydrated to Tris-buffered saline; pH 7.6. Appropriately diluted primary antibodies to p53; EBV-LMPI and Cyclin DI were applied to different sections and incubated overnight at 40OC in a humidity chamber. Sequential applications of other reagents in a three-stage peroxidase antiperoxidase method were applied for chromogen immunoreaction for light microscope visualization. The sections from normal oesophageal tissues were processed with carcinomatous tissues.Results: p53 gene protein was overexpressed in 17 of 26 cases of carcinoma; EBV-LMPI was expressed in 12 of 26 cases of carcinoma; cyclin DI protein was expressed in 14 of the 26 cases of carcinoma; 10 cases of p53 expression were also associated with EBV-LMPI protein expression; 7 cases of p53 protein overexpression did not express EBV-LMPI; 2 cases of EBV-LMPI protein expression did not express p53 protein and 7 cases did not express both p53 and EBV-LMPI proteins. Conclusion: Overexpression of p53 tumour suppressor gene protein in tumour cells of 17 of 26 cases of oesophageal carcinoma while no such expression was demonstrated in normal oesophagus; may have diagnostic and prognostic value. EBV-LMPI expression in tumour cells of 10 of 26 cases of oesophageal carcinoma may also be of value in diagnosis and pathogenesis. Cyclin DI was overexpressed in 14 of the 26 cases and may have diagnostic and prognostic value

Diagnostic utility of fine-needle aspiration cytology in the management of liver disease in a district hospital.

BACKGROUND: Fine needle aspiration (FNA) cytology is a cost effective technique of obtaining cellular specimens for diagnoses. It has many advantages over large needle core biopsies that makes it quite suitable for outpatient department and institutions without facilities for histopathology diagnosis. Any site of the body can be sampled with FNA technique. OBJECTIVE: To assess the diagnostic utility of fine needle aspiration cytology technique in management of patients with liver disease in resource limited settings. DESIGN: Prospective cross sectional study. SETTING: Patient evaluation and FNA aspiration were done in Murang'a and Machakos district hospitals and specimen staining and microscopy were done in Centre for Clinical Research, Kenya Medical Research Institute. SUBJECTS: Patients who were suspected to have liver disease were referred to the medical outpatient clinics in Murang'a and Machakos district hospitals for evaluation. In addition those on the medical wards in the two hospitals who were suspected to have liver disease were also evaluated. INTERVENTIONS: The patients with liver disease were identified after physical and abdominal ultrasound examination. Those with hepatomegaly were selected for the study. Liver fine needle aspiration was done using 21 gauge fine needle attached to a 10 ml syringe. Focal lesions were targeted as much as possible. Thin smears of specimens obtained were spread onto microscope slides which were then dropped into 95% ethanol and left for 30 min in order to fix the material. The slides were then removed, dried and transported to KEMRI where they were stained with Papanicolaou stain then evaluated on the light microscope. RESULTS: One hundred and twenty patients with suspected liver disease were evaluated in the two hospitals; 70 in Machakos and 50 in Murang'a. Fifty patients were identified to have liver disease and fine needle aspiration done aseptically. Twenty one (42%) of the 50 patients had malignant cells; 15(30%) of the 50 patients had necrotic material aspirates 2 (4%) shoved fatty changes later showed to be liver cirrhosis; 11 (22%) showed normal hepatocytes. CONCLUSION: The results support the diagnostic utility of FNA cytology in the management of liver disease, especially in rural setting.

Profile of bacteria and fungi on money coins.

OBJECTIVES: To determine the quantity and quality of bacterial and fungi on money coins and to identify those that could pose a public health risk. DESIGN: Random sampling of coins from subjects within predetermined categories. SETTING: Westlands division of Nairobi Metropolitan province. SUBJECTS: Twenty-shilling coin samples were collected from matatu (a common commuter vehicle in Kenya) taxi conductors, greengrocers, shoe shiners, butchers, food kiosk/restaurant attendants, grocery shops attendants, roast maize vendors and school children. Forty coin samples were analysed for both the total viable content and the types of bacterial and fungal organisms. RESULTS: Average bacterial content on the coins ranged from 2.3 x 10(3) to 25.5 x 10(3) and fungi content from 11 to 377 colony forming units. The following potentially pathogenic bacteria were among those isolated: Escherichia coli, Klebsiella, Serratia, Enterobacter, Salmonella, Acinetobacter, Enterococci, Staphylococcus and Bacillus cereus. In addition, this is the first report of potentially pathogenic fungal isolation from money coins. Penicillium spp, Aspergillus niger, Fusarium, Rhizopus, Altenaria spp, Candida spp and Cryptococcus were isolated. CONCLUSION: Money coins harbour potentially pathogenic bacteria and fungi that may pose a public health risk. Hand hygiene is therefore strongly recommended, especially for those who simultaneously handle food and money.

Caseous lymphadenitis in goats: the pathogenesis, incubation period and serological response after experimental infection.

Twenty goats, in two groups of 10, were injected intradermally with Corynebacterium pseudotuberculosis. The doses of infection were 1 x 10(5) and 5 x 10(4) colony-forming units (cfu) for groups 1 and 2, respectively. Thereafter, a goat from each group was killed every 2-3 days and examined for gross and microscopic caseous lesions in the draining lymph nodes. Bands or zones of macrophages and polymorphonuclear granulocytes were observed microscopically on the second day of infection in both groups. Gross caseous lesions were observed from days 8 and 9 of infection, respectively. Positive bacterial agglutination test and haemolysis inhibition test titres were detected after 15-17 days and 20-25 days of infection, respectively. These results indicated that caseous lymphadenitis is a subacute disease with an incubation period of 8-9 days, but that it is not detectable serologically until after 15 days of infection.

Arteriosclerosis and related lesions in rabbits.

Eleven female rabbits, mainly of the NZW breed, aged between 1 and 3.5 years, were examined post mortem. All had originated over the years 1982 to 1987 from the same rabbitry where they had been fed on pellets from the same manufacturer. Apart from one rabbit, all had a history of progressive loss of bodily condition and six of them had also been infertile. Grossly, most of them were emaciated and their arteries were hardened. In some, hepatopathy, nephropathy and pulmonary emphysema were evident. In one case, mummified foetuses were recovered from the abdominal cavity. Microscopically, degenerative changes and calcification were found in the walls of arteries, kidneys, lungs, hearts and ovaries.