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Students in Nigerian English language classrooms encounter difficulty in writing. However, the utilisation of metacognitive strategies has the potential to aid students in organising their thoughts during writing for better achievement. Therefore, this study aims to examine the effect of digital graphic organisers on secondary school students' achievement in expository essay writing and the students' perceptions of writing challenges and the impact of the strategy. The study adopted a mixed-methods research design consisting of a within-group experimental design and focus group interview. Five research questions and one hypothesis are formulated to guide the study. An intact class size of 38 students is the subject of the study, while an expository essay writing achievement test and a focus group interview were used for data collection. Percentage, mean and standard deviation, and thematic analysis were used in answering the research questions, while a paired sample t-test was used to test the null hypothesis at 0.05 significance. The study found a statistically significant difference between students' mean achievement scores before and after exposure to digital graphic organiser charts when writing expository essays.
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AIM: This study investigated the haematinic, antihyperlipidaemic, hepato-renal protective effects of Terminalia catappa aqueous leaf extract on male Wistar rats exposed to phenylhydrazine toxicity. METHODS: Animals were exposed to phenylhydrazine (PHZ) 50 mg/kg intraperitoneal for two consecutive days thereafter, treated with T. catappa extract (100 mg/kg and 200 mg/kg) orally for 21 days. After the experimentation, animals were sedated with ketamine (70 mg/kg) and euthanized by cervical dislodgement. Blood and organs were collected for haematology and biochemical studies following standard laboratory methods. RESULTS: Our study showed that T. catappa significantly increased erythrocytes, haemoglobin, haematocrit and high density lipoprotein as well as down-regulating leukocytes, thrombocytes, ALP AST, ALT creatinine, urea, total cholesterol as well as low density lipoprotein. The liver, kidney and spleen antioxidant defence were also up-regulated against the adverse effect caused by phenylhydrazine exposure. CONCLUSION: Terminalia catappa attenuated Phenylhydrazine-induced anaemia and hepato-renal toxicity in male Wistar rat by boosting blood cells, modulation of lipoproteins and up-regulation of in vivo antioxidant armouries.
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Anemia , Terminalia , Ratos , Masculino , Animais , Antioxidantes/farmacologia , Ratos Wistar , Extratos Vegetais/farmacologia , Regulação para Cima , Fígado , Células Sanguíneas , Lipoproteínas/farmacologiaRESUMO
There is evidence that Nigeria is already experiencing environmental challenges attributed to climate change (CC) and its impacts. This has clearly highlighted the need for knowledge-based strategies to help plan adequate mitigation and adaptation measures for the country. One of the basic requirements to ensure such strategies is the development of a database of national CC research. This will aid in the assessment of past and present scientific publications from which directions for future study can be mapped. The present study used standard, systematic, and bibliographic literature reviews to analyse the trend, focus, spatial variability, and effectiveness of published research on CC impacts in Nigeria. Four thematic areas of CC impact research were defined: Agriculture, Environment, Human and Multi-disciplinary study. A total of 701 articles were found to be relevant and the review shows that CC impacts and adaptations in the literature vary across research categories and locations. The period between 2011 (68 studies) and 2015 (80 studies) showed a tremendous rise in CC impact research with a peak in 2014 (84 studies). Studies in the agriculture category had the highest publications in 23 States of Nigeria. The review revealed three research gaps: (1) lack of research that investigated the magnitude of present and potential future impacts in the aquatic environment (2) little attention on CC impacts and adaptation in the Northern regions of Nigeria (3) absence of study investigating the effects of multiple variables of CC at the same time. The findings suggest that it would be useful to advance CC research in Nigeria beyond perceptive approaches to more quantitative ones. This is particularly important for highly vulnerable animals, crops, locations, and for better planning of adaptation strategies.
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BACKGROUND: Stroke risk in sickle cell anaemia (SCA) can be detected by abnormalities of cerebral blood flow velocities (CBFV), measurable by Transcranial Doppler Imaging (TCDI) ultrasonography. This has become an important strategy in the routine care of children with SCA globally. OBJECTIVES: To determine the pattern of CBFV and document the proportion of children with SCA at risk of stroke at National Hospital Abuja (NHA), Nigeria using TCDI. METHODS: This was a cross-sectional study of 130 children aged 2-16 years with SCA attending the haematology clinic at NHA. Systematic random sampling method was used in recruiting the participants and CBFV over the middle cerebral artery (MCA) were measured by TCDI technique. The criteria from the stroke prevention (STOP) trial in SCA used to stratify stroke risk, as modified for TCDI was employed to evaluate CBFV from the study. Thus, CBFV (stroke risk) were normal (standard) < 155cm/sec, conditional 155-179cm/sec and abnormal (high) >180cm/sec. RESULTS: There were 130 children with SCA, aged 7.7 ± 4.1 (mean age ± SD) years; and 59.2% were males. This study documented CBFV (stroke risk) as: normal 106 (81.5%), conditional 15 (11.5%) and abnormal (high) 9 (6.9%) in the MCA. The highest CBFV was recorded in the right MCA and ICA with 272cm/sec and 262cm/sec, respectively. There were significant interhemispheric differences between the CBFV on the right and left of PCA and ICA. CONCLUSION: This study documented that a significant proportion of children with SCA in Nigeria were at risk of stroke. Hence, the need for routine monitoring for stroke risk in children with SCA.
CONTEXTE: Le risque d'accident vasculaire cérébral dans la drépanocytose (SCA) peut être détecté par des anomalies des vitesses du flux sanguin cérébral (CBFV), mesurables par échographie transcrânienne d'imagerie Doppler (TCDI). Ceci est devenu une stratégie importante dans la prise en charge de routine des enfants atteints de SCA dans le monde. OBJECTIFS: Déterminer le modèle de CBFV et documenter la proportion d'enfants atteints de SCA à risque d'accident vasculaire cérébral à l'hôpital national d'Abuja (NHA), Nigéria en utilisant TCDI. cm / s. MÉTHODES: Il s'agissait d'une étude transversale de 130 enfants âgés de 2 à 16 ans atteints de SCA fréquentant la clinique d'hématologie de la NHA. La méthode d'échantillonnage aléatoire systématique a été utilisée pour recruter les participants et le CBFV sur l'artère cérébrale moyenne (ACM) a été mesuré par la technique TCDI. Les critères de l'essai de prévention des AVC (STOP) dans SCA utilisés pour stratifier le risque d'AVC, tels que modifiés pour le TCDI, ont été utilisés pour évaluer le CBFV de l'étude. Ainsi, les CBFV (risque d'accident vasculaire cérébral) étaient normaux (standard) <155 cm/s, conditionnels 155-179 cm / s et anormaux (élevés) e "180. RÉSULTATS: Il y avait 130 enfants avec SCA, âgés de 7,7 ± 4,1 (âge moyen ± ET) ans; et 59,2% étaient des hommes. Cette étude a documenté le CBFV (risque d'AVC) comme: normal 106 (81,5%), conditionnel 15 (11,5%) et anormal (élevé) 9 (6,9%) dans le MCA. Le CBFV le plus élevé a été enregistré dans le droit MCA et ICA avec 272 cm / sec et 262 cm / sec, respectivement. Il y avait des différences interhémisphériques significatives entre le CBFV à droite et à gauche du PCA et de l'ICA. CONCLUSION: Cette étude a documenté qu'une proportion significative d'enfants atteints de SCA au Nigéria étaient à risque d'accident vasculaire cérébral. D'où la nécessité d'une surveillance de routine du risque d'AVC chez les enfants atteints de SCA.
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Anemia Falciforme , Ultrassonografia Doppler Transcraniana , Anemia Falciforme/complicações , Anemia Falciforme/diagnóstico por imagem , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria , Centros de Atenção TerciáriaRESUMO
Background: Digital rectal examination (DRE) is an indispensable tool for provisional diagnosis of prostate diseases. When abnormal prostate examination findings are elicited, a diagnosis of prostate cancer (Pca) is usually entertained and further tests to confirm or rule out the presence of Pca demands histological examination of biopsied tissue. A combination of DRE findings and serum PSA increases the predictive value for Pca diagnosis. In this study, we evaluated the degree of accuracy of DRE to diagnose Pca confirmed by histology reports of biopsy specimens.Materials and Methods: Two hundred and six (206) patients were studied over a period of three years. Information retrieved from their case notes were entered into a well-structured protocol for management of prostatic diseases. Analysis of variables collated was performed with the statistical package for the social sciences (SPSS) version 20.0. Frequency table was used to analyze categorical variables while descriptive statistics was used for continuous variables. Level of significance was set at P<.05.Results: 206 patients were studied with mean age of 68.23±8.71 years ranging from 48 to 91 years. Men in the Pca group were older than those in the BPH group. Abnormal DRE was associated with high grade tumours, and high level of aggressive tumour characteristics by WHO grade group standard.Conclusion: DRE has a high level of accuracy in predicting a diagnosis of Pca which was confirmed by histology reports especially in prostates with abnormal findings
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Biópsia , Exame Retal Digital , Sintomas do Trato Urinário Inferior , Nigéria , Neoplasias da Próstata/diagnósticoRESUMO
We have previously reported that administration of a CD11d monoclonal antibody (mAb) improves recovery in a clip-compression model of SCI. In this model the CD11d mAb reduces the infiltration of activated leukocytes into the injured spinal cord (as indicated by reduced intraspinal MPO). However not all anti-inflammatory strategies have reported beneficial results, suggesting that success of the CD11d mAb treatment may depend on the type or severity of the injury. We therefore tested the CD11d mAb treatment in a rat hemi-contusion model of cervical SCI. In contrast to its effects in the clip-compression model, the CD11d mAb treatment did not improve forelimb function nor did it significantly reduce MPO levels in the hemi-contused cord. To determine if the disparate results using the CD11d mAb were due to the biomechanical nature of the cord injury (compression SCI versus contusion SCI) or to the spinal level of the injury (12th thoracic level versus cervical) we further evaluated the CD11d mAb treatment after a T12 contusion SCI. In contrast to the T12 clip compression SCI, the CD11d mAb treatment did not improve locomotor recovery or significantly reduce MPO levels after T12 contusion SCI. Lesion analyses revealed increased levels of hemorrhage after contusion SCI compared to clip-compression SCI. SCI that is accompanied by increased intraspinal hemorrhage would be predicted to be refractory to the CD11d mAb therapy as this approach targets leukocyte diapedesis through the intact vasculature. These results suggest that the disparate results of the anti-CD11d treatment in contusion and clip-compression models of SCI are due to the different pathophysiological mechanisms that dominate these two types of spinal cord injuries.
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Antígenos CD11/efeitos dos fármacos , Hemorragia/complicações , Traumatismos da Medula Espinal/tratamento farmacológico , Animais , Anticorpos Bloqueadores/farmacologia , Anticorpos Monoclonais/farmacologia , Vértebras Cervicais/lesões , Membro Anterior , Locomoção , Masculino , Peroxidase/metabolismo , Ratos , Ratos Sprague-Dawley , Ratos Wistar , Recuperação de Função Fisiológica , Compressão da Medula Espinal/tratamento farmacológico , Compressão da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/complicações , Vértebras Torácicas/lesões , Migração Transendotelial e Transepitelial/efeitos dos fármacosRESUMO
Prostate carcinoma is the most frequently diagnosed malignancy and the second leading cause of death as a result of cancer in men in the US and other parts of the world. There are conflicting reports on the serum levels of testosterone and 17ß-estradiol (E2) in benign prostatic hyperplasia (BPH) and prostate cancer. This study was designed to evaluate the serum concentrations of these hormones in patients with these disorders. Serum levels of prostate specific antigen (PSA), total testosterone and estradiol were determined in 228 subjects comprising of 116 subjects with BPH, 62 subjects with prostate cancer (CaP) and 50 age-matched apparently healthy controls, using ELISA methods. PSA levels were significantly elevated (p < 0.05) in BPH subjects than controls, while there was no significant difference (p > 0.05) in testosterone and estradiol levels of these subjects. PSA and estradiol levels were significantly higher (p < 0.05) in CaP subjects than in controls, while there was no observed significant difference (p > 0.05) in testosterone levels. CaP subjects had significantly raised PSA, testosterone, and estradiol levels than BPH subjects. The mean molar ratio of testosterone: E2 was lowest among CaP patients (134:1) and highest among controls (166:1). Significant positive correlation between PSA and 17ß-estradiol was observed in prostate disorders (BPH and CaP patients: r = 0.347; p = 0.000). Significant negative correlations between testosterone and PSA were also observed among BPH patients (r = -0.221, p = 0.049) and control subjects (r = -0.490, p = 0.000). No significant correlation existed between testosterone and PSA in CaP patients (r = 0.051, p = 0.693). Correlations between age and estradiol in both BPH and CaP were not significant (p > 0.05). This study has shown that, there was a significant increase in serum estradiol in CaP subjects, while the testosterone levels in both BPH and CaP subjects were not different from those of controls.
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INTRODUCTION: The impact of obstetric vesicovaginal fistula (VVF), which continues to occur among women in developing countries, can severely affect the health of the women while the condition persists. This study was designed to discover the effect of successful VVF repair on affected women's quality of life. METHODS: A comparison of the quality of life of a cross-section of women who had VVF was carried out before and 6 months after successful repair. Quality of life was assessed using the WHO Quality of Life (WHOQOL)-BREF Questionnaire. RESULTS: Of the 150 women studied, only 20% felt satisfied with their general state of health and quality of life before the repair, while this increased to 90% following successful repair (highly statistically significant at p<0.000). In the physical health domain, the mean quality of life score was 67.9 ± 4.4 before and 69.3 ± 3.4 after successful repair (p<0.01). In the mental health domain, the mean quality of life score was 32.4 ± 8.7 before and 74.7 ± 3.2 after successful repair (p<0.005). In the social health domain, the mean score was 20.2 ± 2.7 before and 69.7 ± 2.3 after successful repair (p<0.001). In the environment domain, the mean score of quality of life was 60.3 ± 4.3 before repair and 59.7 ± 2.7 after successful repair (comparable at p<0.2). CONCLUSION: Successful repair of VVF is associated with significant improvement in the multidimensional quality of life among affected women.
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Qualidade de Vida/psicologia , Fístula Vesicovaginal/psicologia , Fístula Vesicovaginal/cirurgia , Adolescente , Adulto , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Relações Interpessoais , Saúde Mental , Nigéria , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento , Adulto JovemRESUMO
Augmented vasoconstriction contributes to arterial stiffness associated with diabetes. It has been shown that capacitative calcium entry induced by sarcoplasmic-endoplasmic reticulum calcium ATPase blocker cyclopiazonic acid (CPA) in endothelial cells stimulates production of constrictor prostaglandins, which causes contractions of vascular smooth muscle cells. The aim of the work was to study the effect of diabetes on the vasoconstrictor response induced by calcium entry into endothelial and smooth muscle cells. Force was measured in isolated aortae of diabetic ob/ob and control C57BL/6J mice under isometric conditions. Contractions caused by 10 micromol/l CPA in diabetic mouse aortae featured higher amplitudes and longer durations in comparison with nondiabetic aortae. These contractions were abolished by a COX inhibitor indomethacin (10 micromol/l) or a specific thromboxane A2 receptor blocker SQ 29548 (1 micromol/l) and were not observed in denuded aortae. The contractions were sensitive to extracellular Ca (2+) and store-operated channel blockers. All together this suggests that vasoconstriction was caused by thromboxane A2 synthesis in endothelial cells induced by Ca (2+) entry through store-operated channels. Higher concentrations of CPA (30 micromol/l) or thapsigargin (1 micromol/l) elicited indomethacin-resistant tonic contractions of aortae with 2-fold amplitude in diabetic mice compared to their nondiabetic littermates, which were sensitive to store-operated channel blockers, but not to indomethacin, SQ 29548, or denudation. In conclusions, increases in intracellular Ca (2+) cause augmented vasoconstriction in diabetic vasculature through endothelial synthesis of contractile prostaglandins. In addition capacitative Ca (2+) entry is enhanced in diabetic vascular smooth muscle. These mechanisms indicate possible targets for clinical applications.
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Sinalização do Cálcio , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/patologia , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Comunicação Parácrina , Tromboxanos/metabolismo , Animais , Aorta/efeitos dos fármacos , Aorta/fisiopatologia , Sinalização do Cálcio/efeitos dos fármacos , Modelos Animais de Doenças , Células Endoteliais/efeitos dos fármacos , Técnicas In Vitro , Indóis/farmacologia , Indometacina/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Obesos , Modelos Biológicos , NG-Nitroarginina Metil Éster/farmacologia , Comunicação Parácrina/efeitos dos fármacos , Vasoconstrição/efeitos dos fármacosRESUMO
Diurnal fluctuations of protein excretion into urine and the effect of urinary pH on the urinary protein concentrations were studied in patients with various kidney diseases. The diurnal kinetics of gamma-immunoglobulin, transferrin, albumin, alpha1-microglobulin, gamma-immunoglobulin light chains, and the retinol-binding protein proved to positively correlate with the diurnal fluctuations of proteinuria and to negatively correlate with urinary pH. Diurnal changes in urinary beta2-microglobulin content did not correlate with those of any other protein. Oral bicarbonate intake alkalinized the urine, increased the urinary beta2-microglobulin content, and led to a direct correlation between beta2-microglobulin excretion and excretion of other low-molecular proteins. Thus, proteinuria, single protein excretion, and urinary pH displayed diurnal rhythmicity in the patients; beta2-microglobulin was unstable in acid urine and its urinary level depended on the urinary pH.
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Ritmo Circadiano , Proteinúria/urina , Microglobulina beta-2/urina , Albuminúria/urina , Nefropatia dos Bálcãs/urina , Doença Crônica , Glomerulonefrite/urina , Humanos , Concentração de Íons de Hidrogênio , Nefrite/urina , Pielonefrite/urinaRESUMO
Pituitary metastases account for about 1% of operated pituitary lesions. Most derive from primaries in the breast or lung. Pituitary metastases from hepatocellular carcinoma (HCC) have rarely been reported. We describe a patient in whom headache and left external ophthalmoplegia were the only presenting signs of a clinically silent and radiographically undetectable HCC, that had metastasized to the pituitary and both adrenal glands. Pituitary histology and adrenal needle biopsy failed to establish the final diagnosis, which was reached only after surgical exploration of the abdomen. This case illustrates the difficulties encountered in the histopathological diagnosis of pituitary metastasis and the need for good clinical judgment when confronting pituitary tumors with atypical features.
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Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/secundário , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/secundário , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologia , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/secundário , Diagnóstico Diferencial , Cefaleia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmoplegia/etiologiaRESUMO
Liver pathology was studied in 3 patients with primary chemochromatosis. In two cases so-called iron free foci with signs of hepatocytes with feature of dysplasia were found. Many siderosomes were found ultrastructurally in the cytoplasma of hepatocytes. Histological markers of virus infection were absent in a patient with positive serum HbsAg and HCV-Ab. Alcohol did not produce typical histological changes. In this case grave liver reticuloendothelial hemosiderosis typical for secondary hemochromatosis and overloading with iron of spleen pulp according to MR imaging were observed.
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Hemocromatose/patologia , Antígenos de Histocompatibilidade Classe I/genética , Fígado/patologia , Proteínas de Membrana/genética , Mutação , Marcadores Genéticos/genética , Hemocromatose/genética , Proteína da Hemocromatose , Homozigoto , Humanos , Imuno-Histoquímica , Fígado/ultraestrutura , Imageamento por Ressonância Magnética , Microscopia Eletrônica , Pessoa de Meia-IdadeRESUMO
It is now clear that angiogenesis and angiogenesis factors are important in the pathogenesis of haematological malignancies. High pretreatment levels of serum basic fibroblast growth factor have been shown to be associated with poor prognosis in patients with non-Hodgkin's lymphoma. The aim of this study was to evaluate whether non-Hodgkin's lymphoma cells express basic fibroblast growth factor and/or its receptor (fibroblast growth factor receptor-1) and whether basic fibroblast growth factor expression correlates with basic fibroblast growth factor serum levels, intratumoral microvessel density, and patient outcome. We measured basic fibroblast growth factor by enzyme-linked immunosorbent assay in sera taken from 58 patients with non-Hodgkin's lymphoma before treatment and in 19 of them also after treatment. Pathological specimens at diagnosis were evaluated by immunohistochemistry staining using polyoclonal antibody against factor-VIII-related antigen, basic fibroblast growth factor and fibroblast growth factor receptor-1 to determine the expression of the microvessel count and basic fibroblast growth factor and fibroblast growth factor receptor-1. The lymphoma specimens demonstrated positive staining for basic fibroblast growth factor (in 23%) and fibroblast growth factor receptor-1 (in 58.5%). The patients who expressed basic fibroblast growth factor had a significantly worse progression-free and overall survival than those who did not (P=0.003 and P=0.03 respectively), while patients expressing fibroblast growth factor receptor-1 were less likely to achieve complete remission than those lacking the receptor (33% vs 65%, P=0.047). There was no correlation of basic fibroblast growth factor staining with either serum basic fibroblast growth factor levels or microvessel count. Basic fibroblast growth factor serum levels did not change significantly after treatment These results suggest that non-Hodgkin's lymphoma specimens express basic fibroblast growth factor and its receptor (fibroblast growth factor receptor-1) and this expression is associated with poor patient outcome.
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Fator 2 de Crescimento de Fibroblastos/análise , Linfoma não Hodgkin/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Fator VIII/análise , Feminino , Humanos , Linfoma não Hodgkin/mortalidade , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/patologia , Prognóstico , Análise de Sobrevida , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Two patients with primary Sjögren's syndrome and T cell large granular lymphocyte (LGL) leukemia are described. One patient had evidence of T cell LGL salivary gland infiltration, suggesting a possible common etiopathogenesis for these 2 conditions.
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Leucemia Linfoide/patologia , Leucemia de Células T/patologia , Síndrome de Sjogren/patologia , Idoso , Feminino , Humanos , Leucemia Linfoide/complicações , Leucemia de Células T/complicações , Infiltração Leucêmica/patologia , Glândulas Salivares Menores/patologia , Síndrome de Sjogren/complicações , Linfócitos T/patologiaRESUMO
We describe a girl who presented at the age of 11 years with short stature. She had female external genitalia and some clinical features of Turner syndrome. At laparotomy a uterus and Fallopian tubes and small gonad-like tissue masses in the region of the Fallopian fimbria were found. The tissue masses were removed and histological examination revealed no organized testicular or ovarian morphology. Remnants of Fallopian tubes, epididymis, and clusters of Leydig cells were seen but no Sertoli cells were found. Endocrine studies showed levels of sex hormones consistent with primary gonadal failure. G-banding analysis of 16 blood lymphocytes revealed the karyotype 46,X,dicY(q11.2) in all cells. Varying proportions of X and Y centromeres in blood lymphocytes, skin fibroblasts, and in the incompletely formed Wolffian and Müllerian duct derivatives were demonstrated by FISH. Molecular studies confirmed the absence of most of the long arm of the Y chromosome and an intact short arm. The SRY gene was shown to be present, but we presume that due to the mosaicism the dose was insufficient to allow normal testicular development.
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Cromossomos Humanos Par 11/genética , Mosaicismo/genética , Translocação Genética/genética , Cromossomo X/genética , Cromossomo Y/genética , Criança , Análise Citogenética/métodos , Feminino , Humanos , Hibridização in Situ Fluorescente/métodos , FenótipoRESUMO
Angiotropic large B cell lymphoma (angiotropic LCL) or intravascular large cell lymphoma (IVLCL) was diagnosed by liver and bone marrow biopsies and immunohistochemical studies in a 52 year old Caucasian male. IVLCL is a very rare disease characterized by widespread intravascular proliferation of lymphoma cells. Although it most commonly affects the central nervous system or skin and occasionally bone marrow, angiotropic LCL may be present without evidence of localized disease, as seen initially in our patient. To date, only a few cases of intravascular malignant lymphomatosis associated with parathyroid hormone related protein (PTH-rP) induced humoral hypercalcemia have been published. Our extraordinary case was diagnosed mainly by liver biopsy. The neoplastic lymphoid cells stained diffusely and strongly positive with CD-20 (Pan B) and were negative for CD-3 (Pan T) immunostain. The most significant, initial clinical finding was severe, unexplained hypercalcemia (until 18.6 mg/dl). Plasma PTH-rP showed a ten-fold increase at 8 pmol/L (normal value less than 0.8 pmol/L). Very unusual cytogenic abnormalities were found. The patient received the massive third generation combination chemotherapy comprising of Methotrexate, Doxorubicine, Cyclophosphamide, Vincristine, Prednisone and Bleomycin and developed, complete although temporary, clinical, humoral and cytogenetic remission.
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Hipercalcemia/diagnóstico , Linfoma de Células B/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Hormônio Paratireóideo/sangue , Proteínas/análise , Neoplasias Vasculares/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Hipercalcemia/complicações , Israel , Cariotipagem , Linfoma de Células B/complicações , Linfoma de Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Proteína Relacionada ao Hormônio Paratireóideo , Neoplasias Vasculares/complicações , Neoplasias Vasculares/tratamento farmacológico , População BrancaRESUMO
Twelve different genes for mucin have been described. MUC5AC and MUC6 encode the secreted apomucins of the stomach. A gradient from the surface epithelium (foveola) to the glands is typical for MUC5AC synthesis, whereas a gradient in the opposite direction was found for MUC6. Our goal was to determine the distribution of MUC5AC and MUC6 in the postoperative stomach, with relation to the H. pylori status. Gastric corpus biopsy specimens from patients who underwent partial gastrectomy were examined by immunohistochemistry for mucin gene (MUC5AC and MUC6) apoproteins. We used polyclonal antibodies for amino acid tandem repeats of both proteins. A scoring system (0-3) was used to assess staining intensity at four sites: the lumen, the foveola, the mucous neck cells, and the glands. Helicobacter pylori status was determined by histology and rapid urease test and was considered positive or negative when both tests were positive or negative, respectively. We studied 19 H. pylori-positive and 32 H. pylori-negative patients. No significant change in MUC5AC or MUC6 synthesis and secretion was demonstrated between H. pylori-positive or -negative patients. A gradient similar to that shown for the intact stomach (from the surface epithelium to the glands) for MUC5AC protein and an increase of MUC6 protein presentation from the mucous neck cell to the glands were demonstrated. The pattern of MUC5AC protein synthesis was not different between H. pylori-positive and -negative patients in the postoperative stomach. MUC6 expression was higher in the foveola in H. pylori-positive patients, whereas there was no difference in the other cell layers.
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Gastrectomia , Mucinas Gástricas/biossíntese , Mucosa Gástrica/metabolismo , Helicobacter pylori , Estômago/microbiologia , HumanosRESUMO
BACKGROUND/OBJECTIVE: Helicobacter pylori colonizes the gastric mucous gel layer, the surface epithelium and glands. It has been shown that H. pylori infection causes aberrant expression of gastric mucins MUC 5 and MUC 6. This study aimed to determine the distribution of MUC 5 and MUC 6 in the gastric antrum of dyspeptic patients, and to investigate changes in this pattern in the presence of H. pylori and after successful eradication. MATERIALS AND METHODS: Gastric antrum biopsy specimens were examined by immunohistochemistry for mucin gene (MUC 5 and MUC 6) expression. Polyclonal antibodies were used to detect amino acid tandem repeats of each protein. A scoring system (0-3) was used to assess staining intensity at three sites: foveola, mucous neck cells and glands. H. pylori status was determined by histology and rapid urease test, and considered positive or negative when both tests were positive or negative, respectively. The study included 49 patients positive for H. pylori, in 36 of whom successful eradication was performed, and 11 H. pylori-negative patients. RESULTS: There was a gradient of MUC 5 expression, higher to lower, from the surface to the glands, which was more pronounced before eradication. Increased MUC 5 synthesis in the mucous neck cells and in the glands was found after H. pylori eradication (P = 0.016). MUC 6 was synthesized in the glands more than in the mucous neck cells or foveola. MUC 6 was also secreted into the lumen and probably comprised the superficial part of the unstirred mucous layer. CONCLUSION: The change in MUC 5 synthesis may reflect H. pylori colonization.
Assuntos
Mucinas Gástricas/metabolismo , Expressão Gênica , Infecções por Helicobacter/metabolismo , Helicobacter pylori , Antro Pilórico/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Contagem de Colônia Microbiana , Feminino , Helicobacter pylori/crescimento & desenvolvimento , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To compare the development of fully and partially isolated human follicles by using various culture systems. DESIGN: Human ovarian material was incubated with collagenase and deoxyribonuclease. Fully and partially isolated follicles (30-50 microm) were dissected and studied under light and electron microscopy. The follicles were then cultured on and within various matrices. Fully isolated follicles were also cocultured with stromal cells. SETTING: Rabin Medical Center, a major care and referral center. PATIENT(S): Women undergoing laparoscopy. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Microscopy studies, follicular measurements. RESULT(S): Electron microscopy studies revealed an excess of lipid droplets in the granulosa cells of freshly isolated follicles. An increase in follicular size and granulosa cell number was observed only in the fully isolated follicles cultured within collagen gels for 24 hours. Most of the partially isolated follicles detached from the collagen gels. When cultured on collagen, extracellular matrix, and poly-L-lysine, both the fully and the partially isolated follicles deteriorated within the first 24 hours; coculture with stromal cells had no beneficial effect. CONCLUSION(S): The excess in lipid droplets in granulosa cells of isolated follicles might suggest that the isolation process does not yield completely healthy follicles. However, despite this finding, our studies show that fully isolated follicles, but not partially isolated follicles, can grow within, but not on, a culture matrix.