Abeer Refaiy

Camellia sinensis (green tea) extract attenuate acrylamide induced testicular damage in albino rats

Acrylamide is a proved toxin for testicular function, found in food when heated for long period of time. Green tea (Camellia sinensis) is a potent antioxidant; the aim of this study was to investigate the protective effect of green tea extract against the toxic effects of acrylamide in rat testes. Methods: acrylamide was administered orally to rats in different doses and also the extract of green tea was administered orally to different groups of animals in combination with the acrylamide. The weight of animals, testosterone hormone level and histopathological effect upon testicles were evaluated. Results: Testosterone hormone level in serum, and histopathological findings were significantly improved with the co‐administration of green tea extract with the acrylamide. Green tea extract reversed all the toxic effects of acrylamide even in high dose for long period (90 days). Conclusion: Green tea extract is a potent antioxidant antidote for the acrylamide toxic effects upon testicular function.

Intralesional vs. contact cryosurgery in treatment of keloids: a clinical and immunohistochemical study

Cryosurgery is a safe and effective treatment of keloids. Intralesional cryosurgery has been shown to bring about significant improvement in keloids. The histopathological and immunohistochemical changes in keloids following cryosurgery are not well‐assessed.

Cardiac histopathological and immunohistochemical changes due to electric injury in rats

It has been a puzzling forensic task to determine the cause of death as a result of electric shock in the absence of recognizable skin marks or definite postmortem morphological findings. In forensic pathology, while classical macroscopic and microscopic morphology remain core procedures to investigate deaths, a variety of subsidiary measures has been developed and incorporated to detail that pathology. C-fos, one of a small group of genes called primary response genes and its protein product, fos, are crucial elements of complex signaling mechanisms believed to be responsible for cell response to stimulation. It has been found that c-fos plays a significant role in myocardial lesions, and has close relation to injury repair of the molecule. The aim of this study was to detect the histopathological findings in the myocardium after fatal and non-fatal electrical injury in rats and to investigate the potential role of c-fos expression using immunohistochemistry to distinguish antemortem from postmortem electrocution. Forty adult female rats were implemented and randomly divided into four groups (A, B, C and D). Group (A) rats were subjected to instantaneous antemortem electricity and their hearts were collected either immediately (A₁) or after an hour (A₂) before being subjected to cervical dislocation. Group (B) rats were electrically injured instantaneously postmortem, hearts were collected immediately (B₁) or an hour later (B₂) while Group (C) rats were electrified up to death, and their hearts were also gathered either immediately (C₁) or after an hour (C₂) from electrocution. Lastly, another group of rats served as a control group (Group D). Subgroup (D₁): rats were clamped but not electrified, before death and another group of rats were clamped but not electrified, after being killed by cervical dislocation. Sections from the hearts of all groups were fixed in formalin and routinely processed. The c-fos oncogene expression was evaluated in all groups by immunohistochemistry. Significant histopathological findings were detected in groups A and C. Few c-fos oncogene protein positive cardiomyocyte nuclei were seen in rats of groups (A₁) and (B₁). Additionally, increased expression in rats of groups C₁, C₂ and A₂ were observed. On the other hand, no c-fos protein expression was seen either in the control (groups D₁ and D₂) or in group B₂. Significant differences (p < 0.001) in c-fos expression were observed among rats of groups with antemortem electric injury (A₁, A₂) and those of postmortem injury (B₁ and B₂). Thus, in addition to classical histopathological methods, c-fos can be regarded as a target in identifying electrical injury, and can be used as an indicator to distinguish antemortem from postmortem electric shock.

IL-10 and TGF-β: Roles in chondroprotective effects of Glucosamine in experimental Osteoarthritis?

OBJECTIVE Osteoarthritis (OA) is a complex disease of the whole joint. Glucosamine (GlcN) treatment may have a chondroprotective effect on OA. We investigated the mechanism of action of glucosamine treatment through interleukin-10 (Il-10) and transforming growth factor β-1 (TGF β-1). METHODS Thirty male albino rats were used. A single intraarticular (i.a.) injection of 2mg of Monosodium Iodoacetate (MIA) was injected into the knee joint of anesthetized rats. GlcN (50 or 100mg/kg/day, p.o. for 2 month) was administered orally. Serum levels of Il-10 and TGF-β1 were determined by ELISA. Histopathological changes in treated and control joints were examined using hematoxylin-eosin (H & E) staining. RESULTS The mean serum level of IL-10 significantly decreased in the OA group compared to control group (P value<0.0001). On the other hand, mean serum level of IL-10 significantly increased in GlcN treated groups when compared to the OA group (P value<0.0001). Serum level of TGF β-1 was significantly elevated in OA group compared to control group (P value<0.0001). On the other hand, the mean serum level of TGF β-1 was significantly decreased in the GlcN treated groups when compared to the OA group (P value<0.0001). Histopathological evaluation of GlcN treated groups showed different grades of healing, according to Osteoarthritis Research Society International (OARSI) grading system. CONCLUSION Our results showed that IL-10 and TGF-β1 possibly mediate GlcN chondroprotective effects in OA. Both serum biomarkers can be useful in the follow-up of articular cartilage damage in clinical settings.

Cytomegalo virus as a possible risk factor for neonatal gastrointestinal surgical conditions.

The present work aims to evaluate the possible causal relationship between CMV infection and gastrointestinal surgical conditions in the neonates. 33 neonate operated on because of gastrointestinal surgical conditions in Assiut University Children Hospital. Detection of CMV IgG and IgM from both mother and newborn was done. Surgical specimen was taken for pathologic examination. Positive serological tests (CMV IgM) were found only in four neonates (3 males and one female). Maternal CMV IgM were positive only in two cases. All surgical specimens showed characteristic CMV nuclear inclusion bodies.

Expression of survivin in squamous cell carcinoma and transitional cell carcinoma of the urinary bladder: A comparative immunohistochemical study

Purpose To compare the expression of survivin and its association with clinicopathological criteria in major types of urinary bladder carcinoma, specifically, transitional cell carcinoma with and without squamous differentiation and squamous cell carcinoma. Materials and Methods Immunohistochemical staining for survivin and Ki67 was performed on paraffin-embedded sections of 104 carcinomas: 52 transitional cell carcinoma, 20 transitional cell carcinoma with squamous differentiation, and 32 squamous cell carcinoma. Expression of survivin in >10% of tumor cells was described as altered survivin status. Ki67 staining in >20% of tumor cells was described as a high proliferation index. Results Altered survivin expression was detected in 60/104 specimens (58%) and was significantly more frequent in transitional cell carcinoma (78%) than in squamous cell carcinoma (38%) or transitional cell carcinoma with squamous differentiation (40%) (p<0.0001). In transitional cell carcinoma but not in squamous cell carcinoma, altered survivin status was associated with higher tumor grade, higher proliferation index, and recurrence. In the whole specimens, altered survivin expression was significantly associated with advanced stage (p<0.001), recurrence (p=0.005), distant metastasis (p<0.001), and death (p=0.001). In the multivariate analysis, altered survivin was an independent poor prognostic factor for recurrence. Conclusions Unlike in transitional cell carcinoma, alteration of survivin expression in squamous cell carcinoma occurs less frequently and is not associated with features of tumor aggression or patient outcome. These findings raise a question: are urinary bladder carcinoma patients with squamous cell carcinoma type suitable candidates for survivin vaccine? This is an important question to be answered before approving the vaccine in management.

Demographic features and prevalence of myocarditis in patients undergoing transarterial endomyocardial biopsy for unexplained cardiomyopathy

Background The diagnosis of myocarditis is still a challenge. The true incidence of the disease is unknown due to great variation in clinical manifestations. Objective The aim of this study was to identify the demographic features and in-hospital prevalence of myocarditis in patients undergoing transarterial endomyocardial biopsy (EMB) for unexplained cardiomyopathy. Patients and methods This was a prospective observational study. We recruited all patients with unexplained cardiomyopathy presented at Assiut University Hospital from January 2014 till December 2014. The inclusion criteria were namely acute symptoms of heart failure, worsening of ejection fraction (EF) despite optimized therapy, hemodynamically significant arrhythmias, heart failure with concurrent rash, fever, or peripheral eosinophilia and new-onset cardiomyopathy in the presence of known amyloidosis. We excluded patients with uncontrolled hypertension, diabetes mellitus, ischemic, congenital, rheumatic heart disease, peripartum cardiomyopathy, cardiotoxic exposure, alcoholic and familial cardiomyopathies. All patients were subjected to full examination with ECG, echocardiography and coronary angiography, and then 3 EMB samples via femoral artery were taken from the LV. The histopathological examination of all biopsies was done. Results Out of the 1100 patients admitted to our department, 15 patients (1.4%), who had unexplained cardiomyopathy were included in our study. Seventy-three percent were males with mean age 37.8 ± 17 y. 87% were from rural areas, and 73.3% presented with dyspnea grade III to IV for a duration period that varied from 2 to 8 weeks. 33% had an EF > 40%. 33 EMB samples from 11 patients were examined. 7 out of 11 patients (63.6%) proved to have myocarditis on pathological examination, 5 of them had active myocarditis, 1 had chronic myocarditis and 1 had borderline myocarditis. Three patients (27.3%) had no pathological evidence of inflammation and one patient (9.1%) had cardiac amyloidosis. Four out of 15 patients (26.7%) did not undergo EMB because of LV thrombus or bleeding tendency. None of our patients had any complication from EMB. Conclusion The in-hospital prevalence of myocarditis is high among patients with unexplained cardiomyopathy. EMB via femoral artery is safe and essential in confirming the diagnosis.

Increased density of CD1a+ Langerhans cells and CD86+ cells in perilesional and lesional psoriatic skin: an immunohistochemical study

Background Psoriasis is a long-lasting autoimmune disease mediated by T-lymphocytes and dendritic cells (DC). CD1a+ is a DC marker. CD86+ is a well-known activation marker of the DC (costimulatory molecule). It is hypothesized that the development of chronic plaque psoriasis is associated with alterations of DC. Objective To characterize CD1a+ and CD86+ cells in chronic plaque psoriasis. Patients and methods Monoclonal antibodies against CD1a+ and CD86+ were used for immunohistochemical evaluation of these molecules in the lesional and perilesional skin obtained from 30 psoriatic cases. Five cases represented the control group (healthy skin). Results We found significant variations in the density of CD1a+ and CD86+ cells among the control skin compared with the perilesional and lesional psoriatic skin. There was an increased density of CD1a+ Langerhans and CD86+ DC in the perilesional and lesional psoriatic skin compared with healthy skin. Higher counts of CD1a+ Langerhans cells in the epidermis and CD86+ cells in both epidermis and dermis of the perilesional psoriatic skin were observed compared with lesional ones. Conclusion The prominent density of CD1a+ and CD86+ DC in the perilesional skin compared with the lesional psoriatic skin suggests the pathogenetic role of these cells in the initiation of plaque psoriasis. The simultaneous presence and close localization of CD1a+ and CD86+ cells in the psoriatic dermal and epidermal compartments suggests that their interaction potentially contributes to the development of psoriasis.

Association of Hirschsprung's disease with anorectal malformations: the early alarming signs for diagnosis and comorbidity related to this association.

BACKGROUND AND AIM The association of Hirschsprungs disease (HD) and anorectal malformation (ARM) is rare. The aim of this study is to highlight the frequency of this rare association and comorbidity that may be related to this association. PATIENTS AND METHODS Eleven cases out of four hundred forty six cases (2.5%) with ARM found to have HD association presented to Assiut University Children Hospital. All cases were diagnosed by complete clinical, radiological assessment and histopathological examination before correction. The evaluating parameters for those patients were the early warning signs for diagnosis, any unnecessary procedures done and any associated morbidity related to misdiagnosis of this association. RESULTS Age at presentation of these eleven cases ranged from 2 days to 10 years. The diagnosis started early during neonatal period only in four cases either by change of bowel caliber or nonfunctioning stoma. In the remaining seven cases the diagnosis was delayed because of unsuspected association. Fecal fistula after closure of stoma and wound dehiscence followed by incisional hernia is evident associated comorbidity. CONCLUSIONS The incidence of HD in ARM population seems to be more common than its incidence in the general pediatric population. Caliber change of the bowel during the first operation or nonfunctioning stoma is early alarming sign for diagnoses of such association and should direct the attention for stomal biopsy.