Differential expression of metallothionein and p21 in gastric cancer and some precursor lesions.

OBJECTIVE: Gastric cancer (GC) is a heterogeneous disease with molecular diversity between and within tumors; therefore, searching for altered genes within this cancer is mandatory to reach the proper individualized targeted therapy. Expressions of Metallothionein (MT) and p21 are not uniform in various types of cancers and their predictive value in GC is controversial. This study aimed to assess the role of MT and p21 in intestinal-type GC and some of its precursor lesions. MATERIALS AND METHODS: Immunohistochemical staining for MT and p21 was applied on paraffin blocks belonging to 30 GCs and 51 benign gastric lesions/precancerous lesions [33 chronic gastritis and 18 chronic gastritis with gastric intestinal metaplasia (GIM)]; 27 of them were associated with H. pylori infection. RESULTS: MT expression was dramatically increased while p21 expression was dramatically decreased from chronic gastritis to GIM to GC. In precancerous lesions, H. pylori-positive cases had significantly higher MT expression and lower p21 expression compared to H. pylori-negative cases. In GCs, decreased expression of both MT and p21 was associated with high-grade and advanced-stage cancers. CONCLUSIONS: Both MT and p21 may have a role in the development and progression of GC, and both proteins may be useful for selecting targeted therapy for GC patients.

Bioresorbable versus titanium space-maintaining mesh in maxillary sinus floor elevation: a split-mouth study.

Maxillary sinus pneumatization limits implant placement in the edentulous posterior maxilla. Grafted sinus floor augmentation through Schneiderian membrane elevation and space obliteration with autogenous bone grafts, bone substitutes, or a combination of the two has often been used to resolve this problem. More recently, non-grafted sinus floor elevation has been established. This is based on the concept of membrane elevation and support either by tenting technique or using space-maintaining mesh. The aim of this study was to evaluate the predictability of new bone formation after sinus floor elevation using space-maintaining mesh without graft material and to illustrate the difference between the use of bioresorbable and titanium meshes. Eight patients with bilateral sinus pneumatization were selected for implant placement in the edentulous posterior maxilla. Pneumatized sinuses were approached through the lateral window technique; these were elevated and maintained with resorbable or titanium meshes. All patients were evaluated clinically and radiographically immediately and at 6 months postoperative. At 6 months, a core bone biopsy was obtained from the planned implant position using a trephine drill, and the bone formed was examined histologically. Healing was uneventful in all patients, and radiographic, clinical, and histological evidence of new bone formation was seen in both groups. Titanium and resorbable meshes were found to be reliable and predictable as space-maintaining devices.

Effect of grapefruit juice on amiodarone induced nephrotoxicity in albino rats.

Amiodarone is a potent antiarrhythmic drug that is used to treat ventricular and supraventricular tachyarrhythmias. The present work studied the effect of amiodarone on the kidney of albino rats and the possible ameliorative role of grapefruit juice. Administration of amiodarone by gastric intubation (18 mg/kg body weight (b.w.), daily for 5 weeks) caused many histological alterations including intertubular leucocytic infiltrations, degeneration of the renal tubules, and atrophy of the glomeruli. Amiodarone caused marked elevation in serum creatinine and blood urea nitrogen. Histochemical examination of the renal tubules revealed depletion of glycogen and total proteins. Besides, animals administered with amiodarone showed an increase of apoptotic bands as detected by gel electrophoresis. Treating animals with amiodarone and grapefruit juice (27 ml/kg b.w.) caused an improvement in histological and histochemical appearance of the kidney together with decrease of serum creatinine and blood urea nitrogen. Moreover, the apoptosis was decreased. It is concluded from the obtained results that grapefruit juice ameliorates the nephrotoxicity of amiodarone in albino rats and this may be due to the potent antioxidant effects of its components.

Proanthocyanidin and fish oil potent activity against cisplatin-induced renal cell cycle arrest and apoptosis in rats.

Cisplatin is an effective chemotherapeutic agent that displays dose-limiting nephrotoxicity. In the present study, the efficacy of grape seed proanthocyanidin extract (GSPE: 100 mg/kg/day) and fish oil (FO: 5 mL/kg/day) against cisplatin-induced nephrotoxicity was evaluated in terms of DNA damage, histopathological changes and expression levels of molecular markers of apoptosis. The administration of cisplatin (CP) (7 mg/kg) results in an increasing percentage of S-phase, G2/M and apoptosis. Furthermore, CP induces apoptosis as indicated by an elevation of renal caspase-3 and reduction in the expression of BCL-2. In addition to occurred renal histopathological changes as manifested by tubular degeneration, degenerative glomerulus, necrotic tubular cells, and cell debris. On the other hand, the administration of GSPE or FO pre-cisplatin treatment can be ameliorated the current DNA cell cycle alterations by the restoration of expression of proteins related to apoptosis and reduced the undesirable renal histopathological changes. So, it can be concluded that the consumption of GSPE or FO might be useful for minimizing nephrotoxicity caused by cisplatin chemotherapy through their anti-apoptotic and antioxidant properties.

Flow cytometric study of cell cycle and DNA ploidy in bilharzial bladder cancer.

BACKGROUND: Tumor grade and stage are currently the most important prognostic variables in bladder cancer but establishing additional criteria is still needed for effective treatment. In this study, we analyzed DNA ploidy and the cell cycle: gap one stage (GO/1), synthesis stage (S-phase%), and gap two stage (G2/M) in urine and blood cells of bilharzial bladder cancer patients. METHODS: The cell cycle and DNA ploidy were investigated using a flow cytometric technique for 150 bilharzial bladder cancer patients and 60 healthy normal controls. RESULTS: This study demonstrated that GO/1 levels were significantly decreased in urine and blood cells of bladder cancer patients compared to controls and these decreases were significant in urine cells compared to blood cells and at high grade and stage. In contrast, S-phase%, G2/M, coefficient variation (CV), and DNA index (DI) levels were increased in urine and blood cells of patients compared to those of controls. These levels were significantly increased in urine patients compared to their blood. Finally, the undetectable DNA aneuploidy in control cells was significantly increased in urine cells of patients compared to their blood cells at higher grade and stage. CONCLUSIONS: Taken together, the cell cycle and DNA aneuploidy analysis especially in urine cells of bilharzial bladder cancer patients may help in diagnosis, prognosis, and clinical treatment and can be considered as an additional marker for bladder cancer.

Subclinical sacroiliitis in brucellosis. Clinical presentation and MRI findings.

PURPOSE: The aim of this work was to detect subclinical sacroiliac joint involvement in patients with brucellosis and study their clinical and laboratory features. PATIENTS AND METHODS: The study included 100 brucellosis patients being followed-up in the Gastroenterology and Hepatology Unit, Theodor Bilharz Research Institute and Cairo University outpatient clinics. A thorough history, physical examination, routine laboratory tests, and abdominal ultrasound were obtained for all patients. Extended rheumatological examination was performed including clinical testing for sacroiliitis and enthesitis. None of the patients reported a history of back pain or any symptoms suggestive of sacroiliitis during the course of the infection. Plain x-ray and MRI scan of the sacroiliac joints were performed for all patients. RESULTS: Asymptomatic sacroiliitis was present in 24 % of the brucellosis patients; none of the patients had tenderness over their spine with preserved lumbar spine mobility. Sacroiliitis was mainly unilateral being bilateral in 20.83 %. There was an obvious relationship with animal contact and occupation of the patients. Osteoarticular involvement was common (67 %) including arthralgias, arthritis, myalgias, spondylitis, enthesitis and bursitis, being clearly higher in those with sacroiliitis. The MRI scan showed blurring of the margins in 66.67 %, widening in 25 %, narrowing in 54.17 %, erosions in 20.83 %, and sclerosis in 12.5 %. CONCLUSION: Osteoarticular manifestations of brucellosis are prevalent and subclinical sacroiliitis is evident, a finding that may classify these patients as having brucellar spondyloarthropathy (BSA). Referring brucellosis patients for rheumatological assessment has the advantage of early assessment of asymptomatic cases with sacroiliitis which is commonly overlooked.

Amelioration of cisplatin-induced nephrotoxicity by grape seed extract and fish oil is mediated by lowering oxidative stress and DNA damage.

Cisplatin (CP) is a chemotherapeutic drug used in treatment of malignancies. However, its clinical utility is limited by nephrotoxicity. The purpose of the present study was to investigate the protective role of grape seed proanthocyanidin extract (GSPE) (100 mg/kg/day) or fish oil (FO) (5 ml/kg/day) against cisplatin induced nephrotoxicity in terms of biochemical parameters, oxidative stress and DNA damage. CP nephrotoxiciy is manifested by increased levels of serum creatinine, urea and uric acid, accompanied by their decrease in urine. Na, K and Ca levels were altered in both serum and urine. In addition, cisplatin caused a decrease in renal GSH, SH-group, SOD, GST, and Na-K-ATPase levels. However the levels of MDA, H2O2 and NO were increased. Also, we assessed the renal genotoxic potential of cisplatin as manifested by an increase in the tail length of DNA, tail intensity (DNA %) and tail moment. On the other hand, administration of GSPE or FO pre-cisplatin treatment ameliorated the current changes in most of the above tested parameters, particularly oxidative stress, endogenous antioxidant defense system and DNA damage indicating their curative effect. Thus, it can be concluded that the consumption of GSPE or FO might be useful for preventing nephrotoxicity caused by cisplatin treatment.

Quantitative changes in p53, Bcl-2 and apoptosis in blood and urine of bladder cancer patients.

BACKGROUND: While current pathological and clinical parameters provide important prognostic information, they still have a limited ability to predict the true malignant potential of most bladder tumors. Therefore, the present study was carried out to investigate the levels of anti-apoptotic proteins such as p53 and Bcl-2, and of apoptosis itself as reflected by the increase in sub-G1 peak staining, in the blood and urine of bladder cancer patients, and to thus determine the usefulness of these parameters as tools for early and accurate prediction of tumor growth and development of metastases, in order to assess treatment benefit potential. METHODS: A total of 80 bladder cancer patients and 50 healthy controls without malignancies were enrolled in this study. The levels of p53, Bcl-2 and apoptosis (sub-G1 peak) were evaluated by flow cytometry in the urine and blood of patients and controls. RESULTS: Levels of p53, Bcl-2 and apoptosis were significantly higher in the urine sediment than in the blood. Moreover, p53 levels in the blood and urine of bladder cancer patients were significantly higher than in controls, and were significantly increased during the development of tumor grades and in association with positive parameters of urine analysis. In contrast, Bcl-2 and apoptosis levels in the blood and urine of bladder cancer patients were significantly lower than in samples from controls, and were significantly decreased during the development of tumor grades and in association with positive parameters of urine analysis. Apoptosis levels were positively correlated with Bcl-2 levels but negatively correlated with p53 levels. CONCLUSIONS: These findings suggest that quantitative analysis of p53, Bcl-2 and apoptosis, especially in the urine sediment, may be a useful tool in the diagnosis of bladder cancer.

Diagnostic validity of cervicovaginal human chorionic gonadotrophin at 26-36 weeks of gestation as a biochemical predictor of preterm birth.

AIM: The aim of this study was to assess the diagnostic accuracy of qualitative and quantitative assay of human chorionic gonadotrophin (hCG) in cervicovaginal secretion as a biochemical predictor of preterm birth. MATERIAL AND METHODS: A prospective study was conducted at Ain-Shams University Maternity Hospital, Cairo, Egypt. A total of 390 pregnant women were included in the statistical analysis: 90 women who presented with threatened preterm labor and 300 asymptomatic pregnant women with matched age, gestational age, bodyweight, parity and obstetric history. Qualitative and quantitative measurements of cervicovaginal fluid hCG at 26-36 weeks of gestation were performed to assess the risk for preterm birth. RESULTS: In women with threatened preterm labor (group 1) and asymptomatic pregnant women (group 2), preterm birth occurred in 35.6% and 9.3%, respectively. We analyzed predictive performances of qualitative and quantitative assay of hCG in cervicovaginal secretion, while combining group 1 and group 2. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of qualitative test, by the cut-off level of 25 mIU/mL, to predict preterm birth were 68.3%, 96.1%, 76.9%, 94.3% and 91.8%, respectively; those of quantitative test, by the cut-off level of 34.5 mIU/mL, were 100%, 98.5%, 92.3%, 100% and 98.7%, respectively. CONCLUSIONS: Both the qualitative and quantitative assessment of cervicovaginal fluid hCG at 26-36 weeks of gestation were valuable in the prediction of occurrence of preterm birth in the women who presented with threatened preterm labor as well as in the asymptomatic pregnant population.

Surgical management of patients receiving haemodialysis for chronic renal failure.

This study was carried out on 22 patients seeking dental extractions of one molar tooth. The first group consisted of 12 patients suffering from chronic renal failure undergoing haemodialysis, while the other group consisted of 10 apparently healthy dental patients acting as a control group. The scope of this work is based on the proper handling and management of chronic renal failure patients receiving haemodialysis and undergoing an oral surgical procedure. Complete blood picture, screening of bleeding and coagulation and postextraction complications were monitored for the two groups.

The predictive value of circulating immune complexes (CIC) in patients with malignant salivary gland tumors.

The present study included nine patients suffering from various types of malignant salivary gland neoplasms. The patients were monitored both pre and post operatively utilizing the circulating immune complex assay. The (CIC) levels decreased significantly after the surgical eradication of the neoplasms. This diagnostic parameter proved to be of great value in monitoring therapy in patients with various types of malignancies.

Prognostic value of tissue polypeptide antigen (TPA) plasma levels in patients with malignant salivary gland tumors.

Nine subject with various malignant salivary gland tumors were monitored with tissue polypeptide antigen (TPA) pre and post operatively utilizing TA radio-immunoassay kit. The TPA radioimmunoassay proved to be a specific and sensitive method aiding in diagnoses monitoring and a post operative follow up in malignancies.