Inhibition of methylnitrosourea (MNU) induced oxidative stress and carcinogenesis by orally administered bee honey and Nigella grains in Sprague Dawely rats.

We studied the protective effect of bee honey and Nigella grains as nutraceuticals on the oxidative stress and carcinogenesis induced by methylnitrosourea (MNU) in Sprague Dawely rats. Four groups of animals were used and fed ad-libitum. The first group was a control (n=8), the second (n=8), the third (n=15) and the fourth groups (n=12) were injected MNU (single i.v. dose 50 mg/kg body weight). After one week the third and fourth groups were given orally 0.2 g ground Nigella grains and 0.2 g Nigella with 5 g honey/rat/day, respectively. After six months all animals were sacrificed except two from the second group (MNU-injected rats) that died one-week before the end of the experiment. We observed that MNU injected in the second group produced a variety of oxidative stresses ranging from severe inflammatory reaction in lung and skin to colon adenocarcinoma in four out of six animals. There was an associated elevation of malondialdehyde (MDA) and nitric oxide (NO) in sera obtained from animals of this group compared to the control one. Nigella sativa grains given orally protected against MNU-induced oxidative stress and carcinogenesis by 80% (12/15) and combated this effect by lowering MDA and NO. Whereas honey from bees and Nigella sativa together protected 100% (12/12) against MNU-induced oxidative stress, carcinogenesis and abolished the NO and MDA elevations shown in sera of animals who did not receive these nutrients. These results showed that supplementation of diet with honey and Nigella sativa has a protective effect against MNU-induced oxidative stress, inflammatory response and carcinogenesis.

Kikuchi histiocytic necrotizing lymphadenitis: clinicopathological and immunohistochemical study.

Clinical, morphological and immunohistochemical features of 10 cases having the lymphnodal histological pattern of Kikuchi disease were examined. Two of these were diagnosed as systemic lupus erythematosus (SLE). Morphologically, Kikuchi disease and SLE were nearly indistinguishable. Plasma cells, neutrophilic infiltration, haematoxyphilic bodies and vasculitis were not useful in differentiating the conditions. Kikuchi lymphadenitis and malignant lymphoma however could be differentiated histologically. Morphological features that exclude malignancy included: polymorphous nature of cellular infiltrate, absence of abnormal mitosis, preservation of sinusoidal pattern on intervening areas and presence of extracellular and intracellular karyorrhectic debris.

Kikuchi histiocytic necrotizing lymphadenitis: clinicopathological and immunohistochemical study

Clinical, morphological and immunohistochemical features of 10 cases having the lymphnodal histological pattern of Kikuchi disease were examined. Two of these were diagnosed as systemic lupus erythematosus [SLE]. Morphologically, Kikuchi disease and SLE were nearly indistinguishable. Plasma cells, neutrophilic infiltration, haematoxyphilic bodies and vasculitis were not useful in differentiating the conditions. Kikuchi lymphadenitis and malignant lymphoma however could be differentiated histologically. Morphological features that exclude malignancy included: polymorphous nature of cellular infiltrate, absence of abnormal mitosis, preservation of sinusoidal pattern on intervening areas and presence of extracellular and intracellular karyorrhectic debris

Immunohistochemical expression of p53 and c-erbB2 proteins in breast cancer in Egypt.

The purpose of the present study was to estimate p53 and c-erbB2 expression in an Egyptian cohort and assess their relationships with other indicators of aggressive disease. Additionally, the frequency of both oncogenes was compared to that reported in other breast cancer populations. Paraffin-embedded tissue sections obtained from 210 invasive ductal carcinomas were evaluated immunohistochemically for p53 and c-erbB2 oncoproteins using CM-1 polyclonal antibody and mAb1 monoclonal antibody, respectively. Tumor proliferation was also assessed using PC10 anti-PCNA (proliferation cell nuclear antigen) monoclonal antibody. Chi square test was used to assess the relationship between p53 and c-erbB2 and their associations with other prognostic factors. The results revealed that p53 and c-erbB2 were equally expressed, each accounting for 40% of the total cases (84 out of 210) Immunoreaction for p53 and/or c-erbB2 was demonstrated in 65% (136 out of 210) and 15% (32 out of 210) were positive for both oncogenes. Poor histologic grade was more significantly associated with p53 expression (P = 0.0001) than c-erbB2 expression (P = 0.01). The latter was also significantly associated with premenopausal status (P = 0.01) and large tumor size (P = 0.003). Both p53 and c-erbB2 oncoproteins were found to be unrelated to each other, nodal status or PCNA immunostaining. These data suggest that p53 and c-erbB2 oncogenes correlate with poor prognostic features of breast cancer. The differences between the frequency of p53 and c-erbB2 expression observed in this study and in the reports of Western authors will hopefully stimulate investigation of these oncogenes using molecular biologic techniques and matched comparative Egyptian and European breast cancer groups.

The outcome of a 2-week treatment of Helicobacter pylori-positive duodenal ulcer with omeprazole-based antibiotic regimen in a region with high metronidazole resistance rate.

BACKGROUND/OBJECTIVE: Metronidazole resistance is a major problem in many developing countries. Our main objective was to study the outcome of a non-metronidazole and omeprazole-based antibiotic regimen in eradicating Helicobacter pylori in patients with duodenal ulcer. DESIGN: A prospective study of 50 consecutive patients with proven peptic ulcer (mean age 36.6 +/- 10.5 years, range 17-60, male:female = 2), referred from the primary health centres. MAIN OUTCOME MEASURE: The primary outcome of the study was H. pylori eradication, at least 4 weeks after stopping antibiotic treatment. METHODS: Patients were considered eligible for the study if they had endoscopic evidence or a past medical history of peptic ulcer and had not received any antibiotics for at least 4 weeks prior to admission into the study. H. pylori infection was confirmed by serology, histology, a rapid urease test (RUT) and culture. After an initial oesophago-gastroduodenoscopy (OGD), each patient received a 2-week course of omeprazole (20 mg twice daily), and each of amoxycillin capsules (500 mg) and clarithromycin tablets (250 mg) thrice daily after food. The follow-up OGDs were performed after a mean period of 10.04 weeks (range 4-48) and at 10.4 +/- 2.5 months (range 6-14 months) after stopping treatment. RESULTS: All 50 patients completed the study. The sensitivity values for serology, RUT and histopathology were 98, 96 and 100%, respectively. H. pylori culture was positive in only 15 of 50 patients (30% sensitivity). H. pylori was eradicated in 47 (94%) patients. There was no evidence of H. pylori infection in the 27 of 35 (77%) patients, who returned for a third OGD. At the time of the second OGD, there was a significant reduction of pain-days (from 5.47 to 1.16), and antral (from 1.95 to 0.78) and corpus (from 1.8 to 0.6) mucosal cellular infiltrate scores, when compared with the first OGD (P < 0.001 in each case). CONCLUSION: Exclusion of metronidazole from the treatment regimen of patients with H. pylori-positive duodenal ulcer in a region with metronidazole resistance yielded an excellent H. pylori eradication rate of 94%, when omeprazole, amoxicillin and clarithromycin were used.

Non-evidence of estrogen receptors in the rectal mucosa.

The aim of the study was to investigate whether estrogen receptors are present in the rectal mucosa of premenopausal women compared to postmenopausal women and men. Thirty biopsies obtained from the rectal mucosa at colonoscopy, performed to investigate inflammatory bowel disease in 23 patients and neoplasia in 7, were examined by the avidin-biotin-peroxidase immunohistochemical technique for the presence of estrogen receptors. The study group (n = 10) were non-pregnant premenopausal women and the control group (n = 20) were postmenopausal women (n = 10) and men (n = 10). None of the subjects had fecal incontinence or was taking medication with hormones. In no case did the primary lesion involve the specimen used for laboratory analysis. All samples showed negative immunostaining for estrogen receptors. It was concluded that in continent women and men, a direct estrogenic effect on the rectal mucosa seems unlikely.

The relationship between hepatitis C virus and schistosomiasis: histopathologic evaluation of liver biopsy specimens.

The reported high incidence of anti-HCV seropositivity in the Egyptian population seems surprising. Some suggest that schistosomiasis is the responsible factor, either by producing false positivity for HCV antibodies or by predisposing to actual HCV infection in some way. In an attempt to investigate this unclear relationship on a histological level, we performed a thorough semiquantitative morphological study of liver biopsy specimens from 44 anti-HCV-positive Egyptian patients with chronic liver disease. More than half of these patients (23) had serological evidence of schistosomiasis. The results have shown that all 44 liver biopsy specimens demonstrated the histopathological features known to be characteristic of chronic HCV hepatitis. Statistical analysis showed no significant difference between the schistosomal and nonschistosomal groups regarding the semiquantitative histological scores of these features. This study confirms the presence of definite HCV-induced hepatic pathology in all anti-HCV seropositive cases. More importantly, it shows the lack of enhancement of this pathology in the schistosomal patients.

Immunohistochemical markers of tumor prognosis in breast cancer in Egypt.

Although the relationship among different biologic markers of breast cancer has been shown to be important in predicting cancer behavior, expression of these markers can be an attribute of the population under study. Breast cancer is the most common malignancy among Egyptian women. We have studied a number of prognostic tumor markers in infiltrating ductal carcinoma in a group of Egyptian women and have correlated our results with traditional histologic parameters of behavior such as tumor nuclear grade and lymph node status. Seventy-five cases of infiltrating ductal breast cancer were evaluated from pathology archives. Formalin-fixed paraffin-embedded sections were immunohistochemically stained for PCNA, p53, c-erB-2, metallothionein, cathepsin-D, and GST-pi using specific antibodies and a standard avidin-biotin method. Most high-grade tumors were associated with higher PCNA expression and p53 abnormality. There was a significant difference between node-negative and node-positive tumors with regard to their metallothionein content; other markers, however, did not differ significantly between node-negative and node-positive tumors. PCNA expression, metallothionein expression, and p53 mutation appear to be markers of aggressive tumor behavior in Egyptian women with breast cancer.

Pattern of cancer in the United Arab Emirates referred to Al-Ain Hospital.

To determine the safety, complication rate and cost saving of outpatient percutaneous blind needle liver biopsy in a single tertiary care center, we retrospectively reviewed the records of all 117 patients who had had outpatient percutaneous blind needle liver biopsy from March 1994 to September 1995. We reviewed data including demography, ChildA centAAs classification, histopathology report and complications, and attempted to compare the cost involved with inpatient liver biopsy. Of the 117 records studied, two were incomplete. Of the 115 patients who had complete records, 43 (37.4%) had minor complications, 2 (1.7%) required overnight hospitalization for pain and hypotension, and the procedure failed in one patient (0.9%). There was no correlation between complications and ChildA centAAs classification, or concomitant chronic renal failure. In comparison to inpatient liver biopsy, we calculated that the saving made is about 1800 Saudi Riyals ($478.70) per operation, if performed on an outpatient basis. We conclude that outpatient percutaneous blind needle liver biopsy is safe, successful in more than 99% of cases, associated with no mortality, has negligible major complications requiring hospital admission, and results in considerable savings per biopsy. We therefore strongly recommend performing most liver biopsies on an outpatient basis, in the appropriate hospital setting, unless hospital admission is otherwise indicated.

The value of the lysosomal protease cathepsin-d in egyptian bladder-cancer.

Cathepsin D was measured in cytosols of 60 malignant bladder specimens and normal tissue from the same bladder at safety margin 5 cm of the tumor. Significant elevation in cathepsin D level (50 +/- 3.5 pmol/mg protein) in bladder carcinoma compared to normal tissue (12.7 +/- 1.58 pmol/mg protein) was found. At 100% specificity, cathepsin D sensitivity was 78%. The positivity rate of cathepsin D increased in the presence of lymph node metastasis. The higher concentration of cathepsin D in malignant bladder tissue vs. normal tissue and its correlation with lymph node metastasis could reflect its importance as a marker of metastatic potentiality of primary bladder cancer.