Microsoft Word - Document1The Egyptian Journal of Hospital Medicine (2007) Vol., 26: 1 21
Inhibitory Effect of Dietary Curcumin on 1, 2-Dimethylhydrazine-Induced Colon Preneoplasia in Irradiated Rats Manar Nabih Hafez
National Centre for Radiation Research and Technology, Atomic Energy Authority Abstract
Introduction: Prevention of cancer remains a primary need and new chemopreventive agents must be developed for this purpose. It is well known that the radiotherapy is associated with severe side effects and offers no firm expectation for a cure. Thus, there is a constant need for the investigation of other potentially useful options. One of the widely sought approaches is cancer chemoprevention that uses natural agents. Curcumin, a natural plant product, has been shown to have anti-inflammatory and antioxidant properties and which, thus, may be a potential anticancer drug. Material and Methods: The inhibitory effects of dietary curcumin (0.6 % in diet) on colonic precancerous lesions in rats treated with 1,2-dimethylhydrazine, (DMH, 20 mg/kg, s.c. once weekly for 6 weeks) or exposed to -radiation (6.5 Gy) alone or in combination were evaluated histologically and histochemically. Results: The results showed clear features of colonic dysplasia with DMH treatment. The dysplastic crypts exhibited marked hyperchromatism, loss of polarity besides nuclear and cellular stratification. Whereas, -irradiation revealed marked crypt dilatation accompanied by disorganized crypt structure and alteration of surface epithelium. The results also demonstrate an apparent synergy between the radiation and the chemical carcinogen in the induction of augmentation of mucosal abnormalities accompanied with increased total DNA content and cell proliferation. Consistent with these observations, changes in the type of mucous secretion with predominance of sialomucins were observed in the areas of mild to moderate dysplasia whilst the surrounding normal epithelium produced sulphated material. Mucus depletion was a common feature in areas of severe dysplasia. Addition of curcumin to the diet remarkably reduced the amount and severity of dysplastic lesions with DMH-induced colon preneoplasia without appreciable toxicity. Moreover, curcumin could prevent or improve the disruption of colonic architecture caused by - irradiation. Such improvement was also investigated but to a lesser extent with the combined radiation and DMH. Conclusion: These results indicated that curcumin is potent in inhibiting the preneoplastic lesions and other cellular events relevant to colon and was, therefore, of value as a safe chemotherapeutic agent. Introduction
Colon cancer is one of the most
Dimethylhydrazine (DMH) has been shown
common cancer in developed countries and
to induce colonic carcinomas in rats and
is considered to be one of the major causes
mice with marked organ specificity (Sitohy
of cancer-related death (Manju et al., 2005).
and El-Salhy, 2001). Also, Maskens (1976)
Virtually every major form of human
reported that DMH treatment enhances
cancer can be reproduced in experimental
epithelial cell proliferation in the rat colon .
animals by exposure to specific chemical
Deschner and Long (1977) found that
carcinogens (Yuspa and Poirier, 1988).1, 2-
whatever alterations are induced by DMH
1
þÿThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 22 30
Effect of increase in Antioxidants Supplementation on Kidney Tissue of Mice Subjected to Fractionated Dose of -Irradiation.
*Hanafi N., **Abel Baset El Aaser,***Mohamed S. Gabry,***Amany A Tohamy and ***Manal El Saied Ebrahim
*Radiation Biology Department, National Centre for Radiation Research and Technology,
Atomic Energy Authority, Cairo, Egypt**Cancer Biology Depart. Cancer Institute, Cairo
University ***Zoology Dept. Faculty of Science, Helwan University. Abstract
Introduction: Although there is little doubt that antioxidants are a necessary component for good health, no one knows if supplements should be taken and, if so, how much. Materials and methods: To investigate the increase in antioxidants supplementation, a group of mice feeding on a diet containing 20% soybean was used as control group. The control group treated with 5% Nigella sativa and Antox drug (3 mg/mouse/day) either alone or in combination for 15 days. Another control group was treated with the same antioxidants and subjected to 1 Gy of - irradiation x 5 times day after day. In kidney tissue the levels of malonaldehyde (MDA) and reduced glutathione (GSH) were estimated. Also, the histopathological changes were recorded. Results: 5% Nigella sativa revealed a little decrease in MDA level and a highly significant decrease in GSH in kidney tissue while the exposure to fractionated dose of - irradiation predicted a highly significant decrease in MDA and a highly significant increase in GSH level. Gastric intubations of Antox drug showed a highly significant increase in MDA and GSH levels in kidney tissue either alone or in addition to fractionated radiation exposure. Combined treatments of Nigella sativa and Antox drug showed a highly significant decrease in MDA level and a highly significant increase in GSH level in kidney tissue in comparison to the control group. Histopathological changes showed that treatment with 5% Nigella sativa and Antox drug either alone or in combination revealed toxic effect on kidney tissue. However, their treatments prior to radiation exposure showed ameliorating effect. Conclusion: Our findings indicated that we must use the antioxidants under control or under oxidative stress.
Introduction
Antioxidant in a classification of
have suggested benefits for antioxidant
several organic substances, including
supplements in laboratory experiments,
vitamins C, E and vitamin A (which is
excess supplementation may be harmful. It
converted from beta-carotene), selenium (a
is logic to assume that one dimensional
mineral), and a group known as the
approach to dietary supplementation with
carotenoids. At the molecular and cellular
one specific antioxidant is not a panacea,
levels, antioxidants serve to deactivate
since a broad diet rich in phytonutrients will
certain particles called free radicals.
yield thousands of different polyphenol
Antioxidants are widely used as ingredients
antioxidants available for metabolism.
in dietary supplements that are used for
Also, clinicians should advise their patients
health purposes such as preventing cancer
against the use of antioxidant dietary
and heart disease. However, many studies
supplements during chemotherapy or
22
The protective effect of L-tryptophan versus alpha lipoic acid against L-arginine induced experimental acute pancreatitis in aThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 31 45
The protective effect of L-tryptophan versus alpha lipoic acid against L-arginine-induced experimental acute pancreatitis in albino rats Lamia M. Farghaly* , Nagwan A. Sabak ** and Naglaa A. El-sherbeny***
Departments of Histology*, Biochemistry**and Pharmacology.***
Faculty of Medicine, Suez Canal University.
Abstract
Aim of the study: This study was conducted to investigate the possible protective effects of L- treptophan "a precursor of melatonin" and alpha lipoic acid against L- arginine-induced experimental acute pancreatitis in albino rats. Methods: Fourty adult male albino rats (200- 250g) were randomized into 4 groups (n= 10). Group I, the control group was given 0.9% saline intraperitoneally (i.p). Group II, was given 500 mg/100g L-arginine (i.p) as a single dose to induce acute pancreatitis. Group III: was given 250mg/kg L-tryptophan (i.p) 30 min prior to L- arginine injection. Group IV: was given 50mg/kg alpha lipioc acid(i.p) 30 min prior to L-arginine. Before scarifice, blood samples were obtained from all groups to assay serum amylase and interleukin 6. Animals were sacrificed after 6 hours. For the histopathological study, pancreatic tissue was prepared for histological (H&E, PAS) histochemical ( Tween stain for lipases) and immunohistochemical ( Bax stain for apoptosis) techniques. Both qualitative and quantitative analyses were done to assess the degree of acinar cells affection Results: It was revealed that serum amylase and interleukin 6 in group II rose rapidly. Microscopically, severe acinar cells degeneration, interstitial edema, diffuse bleeding and inflammatory infiltration were demonstrated. These changes were markedly improved with the administration of both L- tryptophan and alpha lipoic acid. Conclusion: It was concluded that both L- tryptophan & alpha lipoic acid reduced the effects of L-arginine-induced acute pancreatitis with better protection achieved by L-tryptophan administration.
Introduction:
Acute pancreatitis ( AP ) is a clinical
amylase, lipase, immunoreactive trypsin or
entity that is believed to have intracellular
elastase) at animal models ( Smotkin and
activation of digestive enzymes and
Tenner, 2002).
autodigestion of the pancreas as its central
Therefore, it is advised to find good
patho-physiologic cause. This non-infec-
animal models to characterize the events of
tious destruction of pancreatic parenchyma
this severe disease. Mizinuma et al. (1984)
quickly induces an inflammatory reaction at
were the first who studied the type of
the site of injury ( Park et al ., 2005)
experimental necrotizing pancreatitis by
Despite
medical
treatment,
the
intraperitoneal administration of a high
lethality of severe acute pancreatitis is still
single dose (500mg/100g) of L-arginine in
high (20- 30%) ( Peter et al ., 2004) a l
bi n
o r a ts. They demonstrated that 70-80%
Histologically, acute pancreatitis is
of acinar cells were necrotized without any
characterized by interstitial edema, vacuo-
morphological change in the islets of
lization, inflammation and acinar cell
Langerhans ( Peter et al ., 2004).
necrosis ( Baron and Morgan, 1999).
It was shown in experimental models
The diagnosis of acute pancreatitis is
that
several
anti-inflammatory
and
usually based on pancreatic edema index
antioxidant compounds, inspite of their
(pancreatic weight/ body weight), pancr-
diverse structure, were all capable of
eatic
serum
enzymes
(e.g.pancreatic
reducing the severity of many substances
31
Cytogenetic study in couples with recurrent miscarriageThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 46 54 Cytogenetic Study in Couples with Recurrent Miscarriage *Tarek A. Atia, **Salah E. Mourad*** Salem H.
*Histology Dept., **Anatomy Dept., ***Gyn.& Obst. Dept.
Al-Azhar Faculty of Medicine, Cairo, Egypt. Abstract:
Introduction: Recurrent miscarriage (RM) is a mysterious reproductive problem affecting a proportion of couples trying to conceive. Although spontaneous abortion occurs in approximately 15 to 20% of clinically diagnosed pregnancies of reproductive-aged women, recurrent miscarriage occurs in approximately 1 to 2% of these women. Many syndromes are involved in the aetiology of RM, where genetic factors appear to be highly associated. Indeed, chromosomal anomaly constitutes the single most common cause. About 7% of couples with RM have one partner with balanced chromosomal rearrangement. Aim of the study: This study is a prospective study carried out to evaluate the incidence of chromosomal abnormalities in couples suffering recurrent miscarriage. Patient and methods: The present study included one hundred couples attending the antenatal clinic. They have been divided into two groups; the first, is a study group, included 50 couples with recurrent miscarriage. And the second, is a control group, included 50 couples with normal reproductive history. Conventional cytogenetic analysis was done for both groups. Result: We have found four cases (8%) carrying chromosomal rearrangements (two reciprocal translocations, one Robertsonian translocation, and one with duplicated chromosome segment) among RM group, and no cases of chromosomal rearrangement among those with normal reproductive history. Statistically, there was a significant association between recurrent miscarriage and chromosomal rearrangement. Conclusion: We have concluded that chromosome analysis is highly important to evaluate such cases with RM. Key Words: Recurrent miscarriage, cytogenetics, chromosome anomalies.
Introduction
Human reproduction is an inefficient
but the incidence may be higher by adding
process, as ~50% of all pregnancies were
the chemical detectable pregnancies (Ansari
lost before the expected menses, and
and Kirkpatrick, 1998). The actual preva-
another 30% was lost after or around the
lence of RM in all fertile couples of
time of a missed menses, i.e. before a
reproductive age is 12% (Kutteh, 2006),
woman realizes she is pregnant (Choudhury
and it is increased dramatically with mate-
and Knapp. 2000). Miscarriages are
rnal age 40 years (Bulletti et al., 1996).
considered any pregnancy loss before 20th
Many studies showed a positive correlation
gestational weeks. Some authors further
between the number of previous miscarr-
divide these into embryonic losses, which
iages and the miscarriage rate in the next
occur before the 9th gestational week; and
pregnancy, as up to 40% of women with
fetal losses, which occur at or after the 9th
three abortions and 50% of women with
gestational week to 20th weeks (Kutteh,
four abortions will expect foetal loss in
2006). Recurrent miscarriage (RM) refers
their coming pregnancy (Quenby and
to three or more consecutive spontaneous
Farquharson, 1993).
abortions before the 20th week of gestation.
Many syndromes are known to be
Spontaneous abortion represents 15-20%
associated with RM such as anatomical
among all clinically detectable pregnancies,
anomalies, genetic disorders, hormonal
46
Epistaxis ManagementThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 55 62
Epistaxis Management
Hesham A. Abdesallam, Ali K. Mahrous, & Abdelsalam H. Hashim
Otolaryngology/ Head and Neck Surgery Department,
Abstract:
Introduction: Epistaxis is common and has been reported to occur in up to 60 percent of the general population. The affected person usually does not seek medical attention, particularly if the bleeding is minor or self-limited. In rare cases, however, massive nasal bleeding can lead to death. The nose has an abundant blood supply. The arterial supply to the nose comes from carotid arteries. Nasal bleeding usually responds to first-aid measures. When epistaxis does not respond to simple measures, the source of the bleeding should be located and treated appropriately. There is no unanimity amongst Otorhinolaryngologists in terms of the sequence of different treatment methods in Epistaxis patients. We aimed in this study to examine our existing practice in terms of management of epistaxis, and to try to come up with suggestions of sequential treatment steps. This is a retrospective study conducted from November 2004 to January 2005 in the Otolaryngology Department in Midway Maritime Hospital. Subjects and Methods: The study group consisted of 100 case notes requested. The demographic data of the patients were collected and the history of epistaxis in each patient. Results: The study showed the peak of incidence of epistaxis (66%) was in adults (51 91 years old). No sex predilection. It was mostly spontaneous. 60% of the patients presented for the first time. 63% of the patients have co-morbid conditions. 60% of the patients needed hospital admission. The patients were treated with different measures. Conclusion: We concluded that the cases of epistaxis caused by trauma in our series is far less than expected. Co-morbidity plays a major role in the causation of epistaxis according to this study. We recommend the use of chemical cautery, merocele or both as the first line of local treatment of epistaxis. If it does not work, Rapid Rhino with or without anterior packing should be considered. If this does not work, then sphenopalatine artery ligation is the next step. Introduction
Epistaxis is defined as bleeding from
carotid, namely the branches of the anterior
the nostril, nasal cavity, or nasopharynx. It
and posterior ethmoid arteries from the
is a frequent Emergency Department (ED)
ophthalmic artery, and (2) branches from
complaint and often causes significant
the
external
carotid,
namely
the
anxiety in patients and clinicians.
sphenopalatine, greater palatine, superior
(Choudhury et al, 2004).
labial, and angular artery.
Epistaxis is common, particularly if
Internally, the lateral nasal wall is
the bleeding is minor or self-limited. In rare
supplied by the sphenopalatine artery
cases, however, massive nasal bleeding can
posteroinferiorly and by the anterior and
lead to death. (Tan and Calhoun,. 1999).
posterior ethmoid arteries superiorly. The
nasal septum also derives its blood supply Arterial supply of the nose, (Fig. 1)
from the sphenopalatine and the anterior
The nose, like the rest of the face, has
and posterior ethmoid arteries with the
an abundant blood supply. The arterial
added contribution of the superior labial
supply to the nose may be principally
artery (anteriorly) and the greater palatine
divided into (1) branches from the internal
artery (posteriorly). The Kiesselbach
55
Screenning for HypertensionThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 63 72 Assessing Knowledge, Attitude and Practices of Primary Health Care Physicians Towards Screening Patients for Hypertension in Cairo.
Ayman S. Abdelhady
Community Medicine Department , Faculty of Medicine , Al-Azhar University. Abstract
Introduction : Hypertension (HTN) is a common serious health problem associated with high morbidity and mortality rates .At the same time ,HTN is widely prevalent all over the world including Egypt. For many people, the primary care physician is their first point of contact with the health care system, as well as their main source of preventive and essential care. Objective: Assessing knowledge, attitude and practices of primary health care physicians towards screening patients for hypertension in Cairo. Methodology:A cross-sectional study , conducted in the primary health care centres (PHCC) in Nasr city, which was chosen randomly to represent Cairo city , where all doctors working in these centres were asked to complete a self administered structured and open ended questionnaire contained the relevant variables : Results: About 90% of the studied physicians were convinced with the importance of routine measuring blood pressure for risky patients and 79% stated that role of the PHC physician should be the early detection of HTN. As regards knowledge towards HTN items, only 23.5% knew the prevalence and 18.5% knew the most recent definition and grading. The practices of the doctors towards screening patients for HTN ,showed that only 63.9% of the doctors usually perform accurate and enough procedures to diagnose HTN patients and 46.2% routinely screen patients around forty years old while only 43.7% were regularly checking up the accuracy of the used sphygmomanometers . Conclusion: The participating physicians had poor knowledge towards some important items especially the prevalence and new classification of HTN. Their practices were not optimal as regards the accurate diagnosis of HTN and routine checkup and measuring blood pressure for people attending the PHC clinics. Recommendations to manage these defects were suggested.
Introduction
Hypertension (HTN) is a common
patient may have. This classification cons-
serious health problem associated with high
idered blood pressure of the person to be
morbidity and mortality rates (El-Khashab,
normal below 120 /80 mmHg , prehyp-
2002).
ertensive at BP:120-139/80-89 mm Hg,
One old and most prevailing defin-
hypertensive (stage 1) at BP: 140-159/90-
ition and classification of HTN recom-
99 and hypertensive (stage 2) with BP
mended a systolic blood pressure (SBP)
160/100. Treatment should be started to
>140 mmHg or diastolic blood pressure
BP<140/90 or BP <130/80 in patients with
(DBP) of 90 or more for the starting point
diabetes or chronic kidney disease
of HTN of mild degree, ( DBP) of 105-114
(National Heart, Lung & Blood Institute
mmHg for moderate HTN and (DBP) of
US, 2004).
115 mmHg for severe HTN (National
Evidence
from
the
Egyptian
Heart , Lung & Blood Institute US, 1993).
Hypertension National Project on a random
The most recent definition and
sample of 6733 subjects in six Egyptian
classification of HTN emphasized the
governorates, revealed that the overall
importance of assessing the risk factors, the
prevalence of hypertension is unusually
63
HISTOPATHOLOGICAL AND ULTRASTRUCTURAL ALTERATIONS INDUCED BY TWO AGROCHEMICALS POLLUTANT IN THE TESTICULAR TISSUES OF MICE AND PIGEONSThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 73 83
Effect Of Some Slimming Drugs On Haematological And Some Vital Signs Of Albino Rats Eman G.E. Helal* and Shadia, A. Radwan**
* Zoology Dept., Faculty of Science, Al-Azhar University **Biology & Geology Dept.,
Faculty of Education, Ain Shams University Abstract
Some of slimming drugs had been withdrawn from markets so, the present study was conducted to follow the effect of three different anorexic drugs; on the haematological and physical parameters of adults albino rats. The used drugs differ in their nature, where the first one i.e., apple-lite is a fully natural substance, the 2nd one i.e., mirapront-N. is a chemical substance and the 3rd one i.e., tenuate is a synthetic foamy filler substance.
Fourty adult male albino rats (130 20g) were randomly divided into four groups, ten
on each treated group and ten for the first group which conserved as control group. The 2nd group was treated daily with apple-lite (3.5mg/ 100g.b.wt), the 3rd group was treated daily with mirapro-N (0.14mg/100g.b.wt) and the 4th group was treated daily with tenuate (0.1 mg/100g.b.wt). Haematological parameters (RBCs, WBCs count, haemoglobin content (Hb), hematocrit value (Hct%), mean cell volume (MCV), mean cell heamoglobin (MCH) and mean cell heamoglobin concentration (MCHC) were detected after 30 days of treatment and also after 15 days of the last treatment as a recovery period. Also, body weight, percent of organs weight/body weight, skin-fold thickness and some vital measurements i.e. heart beats, respiratory rate and rectal temperature were recorded after the same periods of treatment and recovery. Haematological studies revealed that RBCs count, total WBCs count, Hb and Hct values were significantly decreased in the three groups treated daily with anorexic drugs for 30 days. These changes aere also recorded after the recovery period except in apple-lite treated group which showed insignificant change in RBCs and Hb after the recovery period. The calculated mean cell haemoglobin concentration (MCHC) recorded significant increase in apple-lite after treated and recovery periods, while non significant changes in MCHC were observed after mirapro-N and tenuate groups after treatment 30 daysfor 30 days but significant increase of MCHC was recorded after the recovery period of tenuate treated group. Skin-fold thickness of the three regions tested (gluteal, back and belly) revealed significant decrease in all the treated groups except the belly region in apple-lite treated group which showed insignificant decrease after treatment for 30 days. Significant decrease of skin-fold thickness of different regions still present after the recovery period of 15 days in the three treated groups except the back region of mirapro-N and the belly region of apple-lite- treated rats which showed insignificant decrease. Percent of organs weight/body weight were affected according the type of tested drug, while apple-lite- caused non significant changes, mirapro-N caused significant increase in hepatosomatic ratio and cardiosomatic ratio, and significant decrease in gonadosomatic ratio. On the other hand, tenuate resulted in a significant increase in percentage weight of kidneys and hepatosomatic ratio and significant decrease of gonadosomatic ratio after treatment for 30 days. After the recovery period, apple-lite revealed significant decrease in brain/b.wt. ratio, while mirapro-N still affected kidneys, gonadosomatic ratio and brain and tenuate still affected gonadosomatic ratio and brain; they recorded significant decrease. The physical measurement of vital signs, i.e. heart rate, respiratory rate and rectal temperature recorded insignificant change after treatment with apple-lite, mirapro-N and tenuate for 30 days, but significant increase of rectal temperature was recorded in the tenuate group of the treated rats. After recovery period insignificant changes in heart rate, respiratory rate and rectal temperature of the treated rats were observed in the three treated groups. Key words : Slimming drugs, Haematology, Vital signs, Albino rats.
73
PLATELET DERIVED GROWTH FACTOR AND THE EXTENT OF SKIN THICKENING AS POTENTIAL INDICATORS OF PULMONARY AFFECTION IN SYSTEMIC SCLEROSIS The Egyptian Journal of Hospital Medicine (2007) Vol., 26: 84 95
Platelet Derived Growth Factor And The Extent Of Skin Thickening As Potential Indicators Of Pulmonary Affection In Systemic Sclerosis Manal Mahmoud, Mona El Fangary*, Aya M Abdel Dayem**, Nesriene El Margoushy***, Mohamed Said****
Internal Medicine Ain Shams University, *Dermatology Department Misr University for
Science and Technology,**Chest Department Ain Shams University, ***Medical and
Radiation Research Department, Nuclear Material Authority, ****Biochemistry
Respiratory Intensive Care Unit Ain Shams University. Abstract
Background and objective: Systemic sclerosis is a multisystem disease that has considerable variability in its presentation, course, and prognosis. The aim of this study was to determine serum levels of platelet-derived growth factor (PDGF A/B) in patients with systemic sclerosis (SSc) and to correlate these levels with the extent of skin sclerosis and presence of pulmonary affection. Moreover, the efficiency of PDGF and skin score in early detection of pulmonary affection were assessed. Patients and methods:The study included 22 female patients with SSc (according to the American College of Rheumatology) (Masi et al., 1980) and 15 age-matched healthy control females. According to the classification by LeRoy et al. (1988), we divided our patients into limited SSc (10 patients-45.5%) and diffuse SSc (12 patients- 54.5%). The extent of skin sclerosis was assessed by the modified Rodnan total skin thickness scoring (TSS) system (Clementset al.,1995). In our study, patients with limited SSc had a skin score <25, while those with diffuse SSc had skin score >25. Five diffuse SSc patients had associated pulmonary affection, diagnosed by history taking, clinical examination, chest x-ray, arterial blood gases, spirometry and diffusing capacity of the lung for carbon monoxide (DLCO). Serum levels of PDGF were determined in SSc patients and healthy controls using quantitative sandwich ELISA technique. Results: Serum PDGF mean and standard deviation in healthy subjects was 5.2+2.466 ug/l. PDGF values showed continuous significant increment with progression of the disease. Mean PDGF serum levels in limited SSc, diffuse SSc without pulmonary affection and with pulmonary affection were 15.8+2.3, 20.86+2.41 and 32+3.08 ug/l, respectively. Furthermore, the results revealed that PDGF value <10 ug/l, tend to exclude the diagnosis of SSc with 100% sensitivity and specificity, respectively. Moreover, all patients with diffuse SSc and having pulmonary affection had PDGF values >25 ug/l. This value provided a diagnostic sensitivity and specificity of 100 %. As regards the total skin score, a statistical significance was found between limited and diffuse SSc but did not show a statistically significant difference between SSc patients with (32.2+4.49) and without (29.71+3.25) pulmonary affection (p>0.05). However, in patients with diffuse SSc, PDGF levels tended to correlate positively with the skin score (p=0.05). ROC plot showed that skin score at a value of 29 was the best cut-off level to diagnose pulmonary affection in patients with diffuse SSc with a diagnostic sensitivity of 80% and specificity of 71.4%. Conclusion: PDGF is a simple and easy laboratory test that tends to exclude the presence of SSc at a cut-off value of 10ng/ml with 100% sensitivity and specificity, respectively. PDGF correlates positively with extent of skin involvement and significantly with pulmonary affection. PDGF and skin scoring system are simple laboratory and physical measures for evaluating patients with systemic sclerosis with cut- off levels of 25 ug/l, and 29 respectively in detecting pulmonary affection. However,
84
Role of complement and superantigens in the pathogenecity of psoriasisThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 96 105 Role of Complements C5, C6 in the Pathogenecity of Psoriasis
Fayez Muhammad Shaldoum
Lecturer of Immunology and Parasitology, Department of Zoology, Faculty of Science,
University of El-Azhar, Cairo, Egypt
Abstract
Background: Psoriasis lesion/scale contains C5a des Arg and C5b-9 (Takematsu et al., 1992;Terui et al., 2000 and Uyemura et al., 1993). These activation products may have arisen from C5-C9 produced supposedly by keratinocytes (KC). In this work we have started with C5 and C6 to prove our hypothesis. Since psoriatic lesions contain several pro-inflammatory cytokines, it is important to find out which pro-inflammatory cytokines can differentially regulate the expected synthesis of C5 and C6 by keratinocytes. Methods: Human KC have been cultured in the absence and the presence of varying concentrations of pro-inflammatory cytokines and the synthesis of C components C5 and C6 have been measured by ELISA at the protein level and RT-PCR at the mRNA level. To test whether KC also secrete these C components, the same measurements have been performed to find out if these late components are present in the supernatant of the medium where these KC were cultured. The keratinocytes cell-line A431 was also used and the monocytes cultures were considered as the positive control. Results: The results showed that resting KC synthesize C5 mRNAs in detectable amounts. C5 mRNA which is synthesized by resting KC is not translated into detectable amount of protein. Although resting KC did not produce C6 mRNA in detectable amounts the levels of C6 protein were detectable. However, These C6 protein levels were minimally secreted by resting KC, into the culture medium. TCGF induced the secretion of C5 and C6 while TGF- induced only the secretion of C6. Conclusion : Normal KC synthesize their own C5 and C6. The synthesis of them is activated by TCGF. While TGF- ² activated the synthesis of C6 other factors might be responsible for activating the synthesis of C5. These factors could be secreted from other cell types than KC in human skin
Introduction
Psoriasis is a T-cell immune-mediated
Timar et al., 2006). It has also been
dermatitis (Tagami et al., 1997). Deposition
demonstrated that IFN- and tumour
of complement (C), has been seen in very
necrosis factor TNF- can augment the
early of psoriasis (Terui et al., 1987). This
production of C3 by human cultured
C system was found in an active state in
epidermal KC (Kaneko et al., 1980; Purwar
psoriasis skin since C fragments (C3a, C4a, et al., 2006 and Terui et al., 1997).
C5a and C4d), factors (Bb) and late
Therefore, it is postulated that an abnormal
complex (C5b-9) were present in high
production of C components in lesional
levels in the lesions (Takematsu et al.,
skin is involved in the acute inflammation
1992;Terui et al., 2000 and Uyemura et
occurring in the epidermis in psoriasis, al., 1993). It has been shown that C3, factor
under the influence of various cytokines
B and factor H are produced by interferon
including IFN- and TNF- (Kaneko et al.,
(IFN)--stimulated
cultured
human
1980; Miura et al., 1985; Purwar et al.,
epidermal keratinocytes (KC) (Basset-
2006 and Takematsu et al., 1986).
Seguin et al., 1990; Ozawa et al., 2005 and
However, while KC are known to produce
96
Circle of Willis, Variation sex linkedThe Egyptian Journal of Hospital Medicine (2007) Vol., 26: 106 121 Anatomical Variations of the Circle of Willis in Males and Females on 3D MR Angiograms Kawther A. Hafez, Nahla M. Afifi, Fardous Z. Saudi Anatomy department, Faculty of Medicine, Ain Shams University Abstract
Objective: The objective of the present work was to study the anatomical variations of the circle of Willis as regard its component vessels and their average diameters in a sample of adult Egyptians and to detect any sex-related differences in these variations. Material and Methods: One hundred and twenty adult patients were observed (60 males and 60 females). They all had problems unrelated to any ischemic or vascular diseases, so they were considered as healthy control, concerning the morphology of the circle of Willis. In addition, ten cadavers' brains were obtained from the Anatomy department, Faculty of Medicine Ain Shams University for examination of the circle of Willis and for detection of any variations. Results: The anatomical variations of the anterior part, posterior part and completeness of the circle were inspected. Also, the diameters of all component vessels were assessed.
The results indicated that, the anterior part of the circle was completed in 70% males and
75% females of the study sample. No statistically significant difference was detected between sexes. The most common variant of the anterior part was the single anterior communicating artery followed by the hypoplastic or absent anterior communicating artery.
The posterior part of the circle was completed in 44% males and 58% females. The most
common variant was the bilateral posterior communicating arteries, followed by the unilateral posterior communicating artery. An entirely complete circle was found only in 45% of the entire population; and it was higher in the females than the in males. The vessels diameters were smaller in the females than in the males, except for the diameter of the posterior communicating artery. Cadavers' examination revealed six cases with complete circle, 3 cases of unilateral fetal posterior communicating and one case of absent posterior communicating artery. Conclusion: The present study showed the amazing great variability of the anatomy of the circle of Willis in asymptomatic persons. Nevertheless, there were no marked differences between both sexes in most of the components and the mean diameters of the circle. Therefore, these anatomical variations have to be considered during radiological interpretation and would be reported in the current anatomy text to be aware of all these normal variations.
Introduction
Circle of Willis is located in the
proximal segment of the posterior cerebral
interpeduncular fossa and joins the two
artery with reversal flow through the
internal carotid arteries with the basilar
posterior communicating artery (Schomer
artery to ensure continued blood supply to et al., 1994). Ability of the circle of Willis
vital nervous tissues in cases of occluded
to redistribute blood flow depends on its
cerebral arteries (William et al., 1995; Ray
component vessels (Miralles et al., 1995). et al., 2007 ), (Fig.1). The proximal
Patients who suffered from occluded
segment of the anterior cerebral artery can
internal carotid artery (ICA) but their circle
provide hemispheric cerebral blood flow
of Willis with efficient collateral circulation
from the contralateral internal carotid if the
have a risk of strokes than those without
anterior communicating artery is patent and
such collaterals (Hoksbergen et al., 2003,
the basilar artery can supply collateral flow
Eftekhar et al., 2006). Vessels of the circle
to the anterior circulation through the
of Willis vary in caliber, being often
606