Telocytes in Cutaneous Biology: A Reappraisal

The telocytes (TCs) are novel interstitial cells that have been overlooked for a long time due to their histologic similarity to other stromal cells. TCs can be separated from the stromal cells based on their distinct immunohistochemical, ultrastructural, and molecular features. Functionally, TCs are involved in the tissue renewal, mechanical support, and immune modulation. These cells are also involved in the signal transduction either through their direct interactions with the neighboring cells or through the paracrine signaling via extracellular vesicles. TCs are damaged in several inflammatory and fibrotic conditions such as ulcerative colitis, Crohn's disease, hepatic fibrosis, psoriasis, and systemic sclerosis. The transplantation of TCs in the damaged tissue can promote tissue regeneration. Therefore, enhancing tissue TCs either by their transplantation or by promoting their survival and growth using novel medications represents novel therapeutic strategy in the future. In this review, we addressed several aspects of TCs including their origin, distribution, morphologic features, and functions. We also discussed their involvement of the cutaneous TCs in the development various pathologic conditions.

Characterization of Antimicrobial Resistance Genes of Pasteurella multocida Isolated from Diseased Chickens in Egypt

 In this study, the prevalence of Pasteurella multocida in diseased chickens, capsular genotyping, antimicrobial resistance patterns and some resistance genes were determined. Lungs, liver and spleen samples were collected from 250 diseased chickens from layers and broiler flocks from El-Gharbia and Kafr El-Sheikh governorates in Egypt for isolation of P. multocida in the period from June 2018 to December 2019. Confirmatory identification was done by using PCR for capsular type A antigen. P. multocida was isolated from 3.6 % of the diseased chicken. Six isolates of P. multocida that examined for detection of capsular type A showed positive results. Antimicrobial resistance patterns were evaluated for all isolates against twenty antimicrobial agents and the results showed 100% resistance totrimethoprim/sulfamethazole, oxacillin and nitrofurantion. Also, strains expressed highly resistant to penicillin, chloramphenicol, rifampicin and ampicillin \sulbactam, while they were sensitive to norfloxacin, clindamycin, cephalexin and cefotaxime. The antimicrobial resistance genes were detected by using PCR and the results showed  that all isolates harbored  β-lactam-resistantgene BlaROB-1 (100%), followed by sulfonamide resistant gene  sul1 (50%), tetracycline-resistant gene tetH (33.3%) and trimethoprim-resistant dihydrofolate reductase dfrA (16.6%).

Outcomes Associated With Cardiac Arrest in Patients in the Cardiac Intensive Care Unit With Cardiogenic Shock

Cardiac arrest (CA) is common and has been associated with adverse outcomes in patients with cardiogenic shock (CS). We sought to determine the prevalence, patient characteristics, and outcomes of CA in cardiovascular intensive care unit patients with CS. We queried cardiovascular intensive care unit admissions from 2007 to 2018 with an admission diagnosis of CS and compared patients with and without CA. Temporal trends were assessed using linear regression. The primary and secondary outcomes of in-hospital and 1-year mortality were analyzed using logistic regression and Cox proportional-hazards analysis, respectively. We included 1,498 patients, and CA was present in 510 patients (34%), with 258 (50.6% of patients with CA) having ventricular fibrillation (VF). Mean age was 68 ± 14 years, and 37% were females. The prevalence of CA decreased over time (from 43% in 2007 to 24% in 2018, p <0.001). Hospital mortality was 33.3% and decreased over time in patients without CA (from 30% in 2007 to 22% in 2018, p = 0.05), but not in patients with CA (p = 0.71). CA was associated with a higher risk of hospital mortality (51.0% vs 24.2%, adjusted odds ratio 2.15, 95% confidence interval [CI] 1.52 to 3.05, p <0.001), with no difference between VF CA and non-VF CA (p = 0.64). CA was associated with higher 1-year mortality (adjusted hazard ratio 1.53, 95% CI 1.24 to 1.89, p <0.001). In conclusion, CA is present in 1 of 3 of CS hospitalizations and confers a substantially higher risk of hospital and 1-year mortality with no improvement during our 12-year study period contrary to prevailing trends.

Clinical and Haematological Findings in Dengue Fever

From 2000 onwards dengue fever has been occurring at regular intervals in Bangladesh. Ultrasonography is a useful diagnostic procedure. This study was done, keeping this background in mind. Objective of this study was to identify the role of ultrasonography as a useful tool in early diagnosis of dengue haemorrhagic fever. This was a cross-sectional descriptive type of observational study. Results of ultrasonography, haematogy an immunology were observed in 2004 and 2019 in 32 patients on each occasion. In 2004 out of 32 patients 29 had positive ultrsonographic findings supported by corresponding haematological and immunological findings. In 2019 ultrsonography was done in three out of thirty two patients, all three had had positive ultra sonographic findings which were supported by haematological and immunological findings. Dengue fever has serious complications like plasma leakage which manifest in the form of ascites, pleural effusion, thick gallbladder wall etc. If such complications can be detected at an early stage many lives can be saved.

Removal of iron, zinc, and nickel-ions using nano bentonite and its applications on power station wastewater

Removal of high concentrations of toxic heavy metals from wastewater is very important within the environmental field because heavy metals pollution a serious environmental problem due to them being nonbiodegradable. This study shed some light on the use of Nano bentonite as an adsorbent for the elimination of Iron, Zinc, and Nickel ions from wastewater, and the optimum conditions were evaluated to find out thermodynamic and kinetic parameters and equilibrium adsorption models have been applied. The results showed that adsorption percentage increases with increasing temperature, speed of rotation, and volume of solution, but decreases with adsorbent dose and initial concentration increase. The adsorption process has fit pseudo-second-order kinetic model Langmuir and Freundlich adsorption isotherm models were applied to analyze adsorption data and both were found to apply to these adsorption processes. Thermodynamic parameters e.g., ΔG^o, ΔS^o, and ΔH^o of the adsorption process were found to be endothermic. Finally, the Nano bentonite was observed to be more powerful for the removal of Fe (III), Zn (II), and Ni (II) at the same experimental conditions.

Shock in the cardiac intensive care unit: Changes in epidemiology and prognosis over time

There are few studies documenting the changing epidemiology and outcomes of shock in cardiac intensive care unit (CICU) patients. We sought to describe the changes in shock epidemiology and outcomes over time in a CICU population.

METHODS

We included 1859 unique patients admitted to the Mayo Clinic Rochester CICU from 2007 through 2018 with an admission diagnosis of shock. Temporal trends, including mortality, were assessed across 3-year periods.

RESULTS

Shock comprised 15.1% of CICU admissions during the study period, increasing from 8.8% of CICU admissions in 2007 to 21.6% in 2018 (P < .01 for trend). Mean age was 68 ± 14 years (38% females). Shock was cardiogenic in 65%, septic in 10% and mixed cardiogenic-septic in 15%. Concomitant diagnoses in patients with cardiogenic shock (CS) included acute coronary syndrome (ACS) in 17%, heart failure (HF) in 35% and both in 40%. There was no significant change in the prevalence of individual shock subtypes over time (P > .1). Among patients with CS, the prevalence of ACS decreased and the prevalence of HF increased over time (P < .01). Hospital mortality was highest among patients with mixed shock (39%; P = .05). Among patients with CS, hospital mortality was lower among those with HF compared to those without HF (31% vs. 40%, P < .01). Hospital mortality decreased over time among patients with shock (P < .01) and CS (P = .02).

CONCLUSIONS

The prevalence of shock in the CICU has increased over time, with a substantial prevalence of mixed CS. The etiology of CS has changed over the last decade with HF overtaking ACS as the most common cause of CS in the CICU.

Thymoquinone and curcumin modify inducible nitric oxide synthase, caspase 3, and thioredoxin immunohistochemical expression in acetaminophen hepatotoxicity

BACKGROUND

Acetaminophen (APAP) hepatotoxicity is characterised by an extensive oxidative stress due to depletion of glutathione (GSH), which results in massive lipid peroxidation and subsequent liver injury. The current paradigm suggests that mitochondria are the main source of reactive oxygen species (ROS), which impair mitochondrial function and are responsible for cell signalling resulting in cell death. This study was designed to compare the potential impact of thymoquinone (THQ), and/or curcumin (CURC) on liver injury induced by APAP toxicity in rats.

MATERIALS AND METHODS

Serum levels of alanine transaminase, aspartate transaminase, total bilirubin, and total protein were measured. In addition, liver nitric oxide (NO), malondialdehyde, reduced glutathione (GSH), and superoxide dismutase (SOD) were estimated. Moreover, these biochemical parameters were confirmed by histopathological and immunohistochemical investigations for the expression of thioredoxin, iNOS and caspase 3.

RESULTS

Acetaminophen toxicity elevated most of the above-mentioned parameters but decreased GSH, SOD, and total protein levels. Histologically, liver sections demonstrated liver injury characterised by hepatocellular necrosis with nuclear pyknosis, karyorrhexis and karyolysis. Immunohistochemical study revealed increased expression of iNOS and caspase 3 proteins, while the thioredoxin protein expression was decreased.

CONCLUSIONS

Treatment with the THQ and CURC regulated the biochemical and histopathological alterations induced by APAP toxicity. It was concluded that the combination strategy of THQ and CURC might be considered as a potential antidote in combating liver injury induced by APAP with minimal side effects.

Silver nanoparticles enhance the larvicidal toxicity of Photorhabdus and Xenorhabdus bacterial toxins: an approach to control the filarial vector, Culex pipiens

Mosquito-control is still based mostly on chemical insecticides which are toxic and cause environmental deprivation. This study investigates synthesizing silver bio-nanoparticles (AgNPs) from nematode-symbiotic bacterial toxin complexes as an alternative larvicidal bioinsecticide agent against Culex pipiens larvae. Five species/strains of nematode-symbiotic bacteria, Xenorhabdus indica, Xenorhabdus spp., Photorhabdus luminescens laumondii HP88, Photorhabdus luminescens akhurstii HRM1 and Photorhabdus luminescens akhurstii HS1 were used. AgNPs were characterized by scanning electron microscopy and x-ray diffraction analysis. Larvae were initially exposed to descending concentrations (300, 150, 75, 37.5 and 18.75 µg/ml) of each of the five bacterial toxins (as positive controls) or to the bio-AgNPs synthesized from the same bacterial toxins (200, 100, 50, 25, 12.5, 6.25, 3.12 and 1.5 µg/ml) for 48 hours. Results of toxicity bioassays showed that mortality of treated larvae was concentration-dependent, toxins from X. indica, P. luminescens laumondii HP88 and P. luminescens akhurstii HS1 showed LC₅₀ of 29, 28 and 2002 µg/ml, respectively. While, toxins from P. luminescens akhurstii HRM1 and Xenorhabdus sp. showed LC₅₀ of 199, 318 µg/ml, respectively. Bio-AgNPs synthesized from, X. indica or Xenorhabdus sp. toxins have significantly increased their larvicidal activities (LC₅₀ of 1.6, 3.7 µg/ml ) at 48h post-treatment. Moreover, bio-AgNPs synthesized from P. luminescens laumondii HP88, P. luminescens akhurstii HRM1 or P. luminescens akhurstii HS1 toxins significantly increased their larvicidal activities (LC₅₀ of 2.1, 1.5, 13.9 µg/ml, respectively) at 48h post treatment. In conclusion, the highest larval toxicity was observed when larvae were treated with bio-AgNPs synthesized from P. luminescens akhurstii HRM1 and X. indica, followed by P. luminescens laumondii HP88 and Xenorhabdus sp. Subsequently, data of the present study suggest these bio-AgNPs toxin complexes as potentially effective bio-control candidates in the battle against mosquito. However, testing other types of bio-synthesized nanomaterials, and their synergistic combinations against different mosquito species still under investigation.

Peste des petits ruminants infection in domestic ruminants in Sudan

The existence of peste des petits ruminants (PPR) in domestic ruminants and camels in Sudan during 2008-2012 was investigated. Lung tissues and serum samples were randomly collected from sheep, goats, cattle, and camels at different areas of Sudan. A total of 12,384 serum samples were collected from clinically healthy 7413 sheep, 1988 camels, 1501 cattle, 1459 goats, and 23 gazelles at different areas in the Sudan. They were examined for PPR antibodies using competitive ELISA (cELISA). The overall detected seroprevalence of PPR in tested sera was 49.4%; seroprevalence values within species were 67.1, 48.2, 25.8, 2.1, and 21.7% in sheep, goat, cattle, camels, and gazelles, respectively. The highest seroprevalence (68.1%) was observed in sera collected from Darfur states, then the central states (54.3%). A total of 1276 lung tissue samples (623 sheep, 324 cattle, 220 camels, and 109 goats) were collected. The majority of lung samples were collected from clinically healthy animals that showed lesions on PM in slaughterhouses (95%) and during PPR outbreaks; samples were tested for PPR antigen using immunocapture ELISA (IcELISA). PPR antigen was detected in 233 out of the 1276 tested samples (18.3%). Positive results were observed in samples collected from clinically healthy and diseased animals. The observed prevalence values in each species were 33.6, 21.1, 15.4, and 12.3% in camel, goat, sheep, and cattle, respectively. PPR antigen was detected in samples from different areas; however, the highest prevalence (63.9%) was found in samples collected from the eastern states, then Khartoum state (28%). Trials for virus isolation were done in different cell cultures. Out of 30 IcELISA-positive samples inoculated in primary bovine and ovine kidney cells, Vero cells, the PPR virus was successfully isolated from 15 (eight sheep, five camels, and two goats) samples in the three cell culture types. Using RT-PCR, PPRV nucleic acid was detected in all 25 IcELISA-positive tested samples.

Adrenal medulla of AS/AGU rats: a histological and immunohistochemical study

BACKGROUND

The outcome of the autograft therapy for Parkinson's disease including autologous cells from adrenal medulla was disappointing. This could be attributed to the pathological process in Parkinson's disease affecting cells of the adrenal medulla. This study was performed to investigate the histopathological changes in the adrenal medulla of AS/AGU rat, a model of Parkinson's disease, in comparison with Albino Swiss (AS) rats.

MATERIALS AND METHODS

A total of 24 male AS rats were divided into four groups, each of 6 animals: AS W1 - AS rats aged 1 week; AS adult - AS adult rats; AS/ /AGU W1 - AS/AGU rats aged 1 week; and AS/AGU adult - AS/AGU adult rats. The rats were sacrificed and the adrenal glands were dissected and processed for histological staining with haematoxylin and eosin and periodic acid Schiff and for immunohistochemical staining for S100 protein, ubiquitin and tyrosine hydroxylase.

RESULTS

The histological investigation of the adrenal medulla of AS/AGU rats showed vascular congestion, inflammatory cellular infiltration, pyknotic nuclei, necrotic chromaffin cells and medullary inclusion bodies. The immunohistochemical investigation of AS/AGU rats showed a statistically significant decrease in the expression of S100 protein, ubiquitin and tyrosine hydroxylase compared to AS rats.

CONCLUSIONS

The histological and immunohistological changes in the adrenal medulla could explain the failure of outcome of adrenal autograft therapy in Parkinson's disease.

Immunohistochemical study of sustentacular cells in adrenal medulla of neonatal and adult rats using an antibody against S-100 protein

BACKGROUND

This study was performed to investigate the light microscopic features of sustentacular cells in adrenal medulla in neonatal and adult male albino rats using an antibody against S-100 protein. S-100 expression in sustentacular cells is considered a reliable cell marker for this type of cells.

MATERIALS AND METHODS

Twenty-four male albino rats were allocated into two groups, neonatal group (1 week old, 12 rats) and adult group (3 months old, 12 rats). Paraffin sections of the adrenal glands were immunostained for the expression of S-100 protein.

RESULTS

The results demonstrated differences in distribution, arrangement and structure of sustentacular cells in adrenal medulla in neonatal and adult rats. All sustentacular cells of adrenal medulla in all animals showed intense immunoreactivity for S-100 protein in their nuclei, perikarya, and cytoplasmic processes. Most of S-100 immunopositive sustentacular cells in adrenal medulla of neonatal rats are few, dispersed, small in size, and oval in shape with thin short bipolar cytoplasmic processes. These cells in adult rats are more numerous, larger in size, and stellate in shape with numerous slender, longer branched cytoplasmic processes.

CONCLUSIONS

This study indicated that adrenal medullary sustentacular cells showed obvious morphological postnatal changes with aging suggesting structural and functional maturation.

[Rates of prostate-specific antigen testing for early detection of prostate cancer: a first comparison of German results with current international data]

OBJECTIVE

Measurement of prostate-specific antigen (PSA) is not only used as a screening instrument by urologists, but also by general practitioners and internal specialists (GP-IS). Until now, there are neither data on the approach of German GP-IS in practicing this nor have data been classified in the context of available international literature on this topic.

MATERIALS AND METHODS

Between May and December 2012, a questionnaire containing 16 items was sent to 600 GP-IS in Brandenburg and Berlin. The response rate was 65% (392/600). Six indicator questions (IQ1-6) were selected and results were set in the context of available international data. The quality of present studies was evaluated by the Harden criteria.

RESULTS

Of the 392 responding physicians, 317 (81%) declared that they would use PSA testing for early detection of PCA (IQ1) and, thus, formed the study group. Of these GP-IS, 38% consider an age between 41 and 50 years as suitable for testing begin (IQ2), while 53% and 14% of the GP-IS perform early detection until the age of 80 and 90 years, respectively (IQ3). A rigid PSA cut-off of 4 ng/ml is considered to be reasonable by 47% of the involved GP-IS, whereas 16% prefer an age-adjusted PSA cut-off (IQ4). Patients with pathological PSA levels were immediately referred to a board-certified urologist by 69% of the GP-IS. On the other hand, 10% first would independently control elevated PSA levels themselves after 3-12 months (IQ5). Furthermore, 14% of the interviewed physicians consider a decrease of PCA-specific mortality by PSA screening as being proven (IQ6). Knowledge regarding PCA diagnostics is mainly based on continuous medical education for GP-IS (33%), personal contact with urologists (6%), and guideline studies (4%). While 53% indicated more than one education source, 4% did not obtain any PCA-specific training. The results provided by this questionnaire evaluating response of German GP-IS to six selected indicator questions fit well into the international context; however, further studies with sufficient methodical quality are required.

CONCLUSIONS

Despite current findings and controversial recommendations of the two large PCA screening studies on this issue, German GP-IS still frequently use PCA screening by PSA measurement. Primary strategies of early detection as well as follow-up after assessment of pathologically elevated PSA levels poorly follow international recommendations. Thus, an intensification of specific education is justified.

Health-related quality of life and its determinants in HIV patients with post herpetic neuralgia

BACKGROUND

Postherpetic neuralgia is a neuralgia caused by the varicella zoster virus. Its natural history involves slow resolution of the pain syndrome. A subgroup of patients may develop severe, long-lasting pain that does not respond to medical therapy. It also accounts for 11-15% of all referrals to pain clinics but little is known about the quality of life of patients with this condition in our locality Nigeria.

METHOD

Fifty three Post herpetic Neuralgia patients aged between 25 and 56 years (mean = 37.47 +/- 8.29 years) receiving antiretroviral therapy/treatment at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria participated in this study. The short-form 36 (SF-36) generic health-related Quality of Life questionnaire was used to assess the QoL. Spearman rank correlation procedure was used to evaluate the relationship of HRQoL outcomes with medical and socio-demographic factor.

RESULT

Physical functioning), Role limitations due to physical health (LPH), Role limitations due to emotional problems (LEP), Social functioning (SF), General health perceptions (GH) scores were below average (35.59 +/- 19.85, 34.28 +/- 33.16, 33.70 +/- 23.26, 49.07 +/- 17.04, 44.09 +/- 9.72 respectively) while Emotional well being/Mental health (EM) was above average (50.13 +/- 11.56). An average (moderate) symptom scale score was Energy/Fatigue (EF) (51.32 +/- 12.87) while Bodily pain (BP) was severe (31.09 +/- 20.46). Age and sex had no significant influence on any of the functional and symptom scale scores as well as the overall QOL. Inverse relationship was observed between age and each of the LPH, LEP, SF, GH, overall QoL and the entire symptom scales. The overall QoL and each of the symptom scale scores were significantly related (P > 0.05). The functional scale score PF, RPH, REP EM and GH were significantly related to overall QoL while SF was not significantly related (P > 0.01).

CONCLUSION

This study has shown that the overall QoL of PHN in HIV positive patients undergoing adjuvant therapy is below average. The predictor factors of the overall QoL of this group of patients have been brought to light. These patients would require ways to improve the QoL, there is the need for health care provider to address the factors uncovered by this study. Four of the determinant factors (PF, LP, BP and EF) are issues that fall within the corridor of physical therapy. Physical therapist should arise to address these significant aspects of the management this group of patients.

Flock dynamics of desert Barki sheep in relation to age structure

Reproduction data of 8689 ewe records spread over 40 years (from 1960 to 2000) representing 2952 breeding Barki ewes were used in this study. The flock belonged to the Desert Research Center in Egypt. Flock dynamics of nine age groups (2-10 yrs) were assessed. Two parameters were used to evaluate flock dynamics, net reproduction rate (R(o)) (number of ewe- lambs reaching joining age and produced by each ewe during its lifetime in the flock) and intrinsic rate of increase (r(m)) (flock growth when no resource is limiting). Age of ewe had a highly significant (P < 0.01) effect on number of ewes lambing per ewe joined (E(PJ)), number of lambs born per ewe joined (L(BJ)), number of lambs weaned per ewe joined (L(WJ)) and number of ewe lambs reaching joining age per ewe joined (L(EJ.J)). All estimates tended to increase with dams age up to four years and decreased thereafter. The results of R(o) and r(m) showed that the studied flock must consist of 5 age groups to maintain its size and replace itself. It may be recommended to cull the breeding ewe at the age of 6 years to accelerate genetic improvement.

Staphylococcus aureus isolated from a horse in a sudden death condition in Kassala state, eastern Sudan

In this study, Staphylococcus aureus was isolated from a draught horse presented to Kassala Veterinary Research Laboratory (KVRL) for investigation and diagnosis. The affected animal was previously treated with Gentamycin and Tetracycline before submitted to this laboratory, but the animal was not cure. Thereafter, the animal was attended to the laboratory; it was suffering from inguinal abscess and some clinical signs. Clinical and laboratory examinations were carried out however, the animal was suddenly fallen and died immediately. Then post-mortem, bacteriological and histopathological examinations were done. S. aureus was isolated as pure culture from the lungs and peritoneum of the necropsied animal. This isolate showed highly sensitivity to Erythromycin and Clindamycin and it was resistant to Penicillin, Cloxacillin, Cefotaxime, Co-Trimoxazole, Cephalexin and Tetracycline. It was concluded from this study, the shock resulted from S. aureus was the causative agent of the death in this case.

Patterns of lipid changes among type 2 diabetes patients in Sudan

This study investigated the patterns and determinants of lipid disorders among a group of 250 type 2 adult diabetic patients and 60 age- and sex-matched healthy controls in Sudan. Demographic and clinical data, body mass index and waist circumference, and fasting blood samples were taken to estimate the glucose and lipid profile. The mean duration of diabetes was 9.4 years and 46.0% of patients had poor glycaemic control. Compared to controls we detected a statistically significant increase in triglycerides level and a decrease in HDL-C levels. Other lipid values showed a slight increase compared to controls. There was a statistically significant association of triglycerides and HDL-C with increasing age, female sex, obesity, physical inactivity and poor glycaemic control of diabetes.

Towards sustainable delivery of health services in Afghanistan: options for the future

Disruption caused by decades of war and civil strife in Afghanistan has led many international and national nongovernmental organizations (NGOs) to assume responsibility for the delivery of health services through contracts with donor agencies. Recently the Afghan Government has pursued the policy of contracting for a basic package of health services (BPHS) supported by funds from three major donors - the World Bank, the United States Agency for International Development (USAID) and the European Commission. With the gradual strengthening of the public health ministry, options for the future include pursuing the contracting option or increasing public provision of health services. Should contracting with NGOs be pursued, a clear strategy is required that includes developing accreditation instruments, better contracting mechanisms and a system for monitoring and evaluating the entire process. Should the government opt for an increasing role, problems to be solved include securing the transition to public provision, obtaining guarantees that appropriate financing will be provided and reconfiguration of the public health delivery system. Large-scale contracting with the private for-profit sector cannot be recommended at this stage, although this option could be explored via subcontracting by larger NGOs or small-scale trial contracts initiated by the public health ministry. Irrespective of the option chosen, an important challenge remaining is the recalcitrant problem of high out-of-pocket payments. Sustainable delivery of health services in Afghanistan can only be achieved with a clear national strategy in which all stakeholders have roles to play in the financing, regulation and delivery of services.

Use of the Internet by Sudanese doctors and medical students

Patterns of use of the Internet were investigated by a questionnaire survey of 102 hospital doctors and 123 medical students in Khartoum, Sudan, in January 2005. More doctors (84.3%) had used the Internet than had students (78.9%). Half of consultants (55.0%) used the Internet daily, compared with only 18.2% of junior doctors. Many consultants and junior doctors rated their abilities as poor (60.0% and53.1%). One-third of students (33.3%) used the Internet only for personal and not for academic purposes. Barriers to greater use of the Internet by doctors included: time constraints (80.2%), poor skills (54.6%), no access to full texts of journal articles (53.4%), difficulty in verifying the quality of information (47.6%) and high costs (41.8%). Students faced similar barriers but also listed poor knowledge of the English language.

Expression of cyclooxygenase-2 and 12-lipoxygenase in human breast cancer and their relationship with HER-2/neu and hormonal receptors: impact on prognosis and therapy

BACKGROUND

A number of studies have shown over-expression of cox-2 in breast cancer. Also it has been recorded that human breast cancer expresses high level of cox-2 and 12-lipoxygenase which may be beneficial in future therapy plan for those patients.

AIMS

The present study aims to examine the level of transcripts of cox-2 and 12-lipoxygenase in Egyptian breast cancer patients and to compare between the expressions of both enzymes and TNM staging, hormone receptors status (including estrogen and progesterone) and HER2/neu expression.

MATERIALS AND METHODS

Total cellular RNA was extracted from 64 frozen tissue samples of breast carcinoma and their corresponding normal adjacent tissues. Cox-2 and 12-lipooxygenase expressions were detected using RT-PCR. Hormonal receptors as well as HER2/neu were detected immuno-histochemically for each patient.

RESULTS

About 47 and 62.5% of carcinoma samples showed over-expression of cox-2 and 12-lipooxygenase respectively as compared to their corresponding normal tissues. The results revealed that cox-2 significantly associated with TNM staging (P = 0.0047) and hormonal receptors status (P = 0.0201). The relationship between cox-2 and HER2/neu expression was close to a significant value (P = 0.0747). 12-lipooxygenase showed only significant association with TNM staging (P = 0.0076). Neither hormonal receptors nor HER2/neu showed significant association with this enzyme.

CONCLUSION

Elevated levels of cox-2 and 12-lipoxygenase expression were detected in human breast cancer. Also, the results revealed that cox-2 and 12-lipooxygenase mRNA expressions are associated with TNM staging in human breast cancer. Furthermore, there is an inverse association between cox-2 expression and hormonal receptor status. This observation may drive us to the possible role of those two enzymes in determining the plan of therapy of breast cancer patients.