Problem statement: Hepatocellular carcinoma will emerge as a major form of malignancy in the coming decades. The continuing high incidence of hepatocellular carcinoma, suggests that this disease will continue to represent a global health problem far into the future. Different genes encode for the various components of the human telomerase complex. These components include the human Telomerase RNA Component (hTERC) and the Telomerase Catalytic Subunit (hTERT). Correlation between Telomerase Reverse Transcriptase (hTERT) expression and telomerase activity has been reported in cancer patients. This work aimed to clarify the significance of human Telomerase Reverse Transcriptase (hTERT mRNA) as a potential molecular tumor marker for Hepatocellular Carcinoma (HCC). Approach: The current study included 25 patients of hepatocellular carcinoma (HCC), 30 patients with liver cirrhosis and 25 age and sex matched individuals with normal laboratory and Image findings as a control group. hTERT mRNA was measured in plasma by Real time PCR in all patients samples in comparison with normal healthy controls. Results: The expression of hTERT mRNA by relative unit was 129.10±27.6 with range (67.72-69.6) Vs 5245.87±2382.48 (2053-12232.90) Vs 92782.76±16158 (61783.25-118596.47) for control Vs cirrhosis Vs HCC group respectively. The hTERT expression was significantly with 699 and 33 fold increase in HCC and cirrhosis groups correspondingly when compared to that of controls p<0.05. Conclusion: It was suggested that this procedure was highly discriminating between healthy subjects and cancer patients and strongly support the idea that a valuable diagnostic test for cancer might be developed using this genetic marker in plasma. However it needs to be combined with other markers in future studies to be more specific for liver cancer.
Abstract. The present study aimed to examine the predictability of pre-treatment serum levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α for determining the outcome of patients with nasopharyngeal carcinoma (NPC) assigned for chemoradiotherapy. A total of 35 patients with NPC were subjected to clinical examination and evaluation of performance status using Karnofsky scoring. Nasopharyngoscopy was performed for evaluation and to obtain a biopsy. Blood samples were obtained pre-and post-treatment for polymerase chain reaction quantitative estimation of Epstein-Barr virus (EBV) DNA plasma load and enzyme-linked immunosorbent assay for estimation of serum cytokines. All patients received chemoradiotherapy and were followed-up for 2 years. Cervical lymphadenopathy and recurrent attacks of epistaxis are the most common presenting symptoms. Treatment significantly decreased pre-treatment plasma EBV DNA load and serum levels of IL-6 and TNF-α, and increased serum IL-1β levels. Clinical staging and EBV DNA plasma load revealed positively significant correlation with pre-treatment serum levels of both IL-6 and TNF-α, while revealed negative significant correlation with serum IL-1β levels. The 2-year survival rate was negatively significantly correlated with pre-treatment levels of IL-6 and TNF-α, and EBV DNA viral load, while it was positively significantly correlated with pre-treatment performance scores and serum IL-1β levels. Statistical analyses defined high pre-treatment serum IL-6 levels as a significant specific predictor for high mortality rate. It was demonstrated that NPC was associated with high pre-treatment plasma EBV DNA load and serum cytokines, and chemoradiotherapy significantly reduced these high levels. High pre-treatment serum IL-6 level was a significant specific predictor for high mortality rate. Increased post-treatment serum levels of IL-1β indicated good therapeutic response and most probably a high survival rate.
Objectives: To evaluate relations of asymmetric dimethylarginine (ADMA) and nitric oxide (NO) with estrogen (E 2) and progesterone (Pg) and its role in pathogenesis and severity of preeclampsia (PE). Patients & Methods: At 12 th week gestational age (GA) constitutional data, systolic and diastolic blood pressures (SBP and DBP), uterine artery pulsatility index (UAPI) and serum NO, ADMA, E 2 and Pg levels were determined for primigravida attending the antenatal care unit. During pregnancy, women who developed PE were categorized as early or late and mild or severe according to ACOG Practice Bulletin of PE guidelines. Studied parameters were evaluated statistically as early predictors for development and severity of PE. Results: Ninety pregnant women developed PE; 39 early and 51 late. Only 13 women had severe and 77 women had mild PE. At 12 th week GA, UAPI and serum ADMA levels were significantly higher with significantly lower E 2 and NO levels in PE women than women free of PE and in early than in late PE. High SBP at time of PE diagnosis showed positive significant correlation with body mass index (BMI) and serum ADMA levels but showed negative significant correlation with serum NO and E 2 levels. Serum ADMA levels showed positive significant correlation with BMI, but negative significant correlation with serum E 2 levels. High UAPI, serum ADMA and high BMI were significant early predictors for PE development and severity. Conclusion: Disturbed maternal serum ADMA/NO axis and low E 2 serum levels may underlie PE development. High BMI and low E 2 level may have a role in PE pathogenesis through induction of high serum ADMA levels. High UAPI and serum ADMA at 12 th week GA could be used as early predictors of PE especially early-onset and severe PE.
Objectives: To evaluate ability of estimation of tissue extract fluid (TEF) levels of interleukin (IL)-1β, tumor necrosis factor (TNF)-α and IL-6 for differentiation between antemortem (AM) and postmortem (PM) wounds and for rough determination of wound age. Materials & Methods: The study included 20 patients arrived to Surgical Emergency Department (ED) with severe trauma requiring surgical intervention and died after a known survival interval. Time elapsed since trauma inflection till arrival to ED was determined. Four skin biopsies were obtained from each patient: one AM and 3 PM specimens. Skin samples were homogenized and TEF was used for ELISA estimation of IL-1β, TNF-α and IL-6 levels. Results: AM TEF levels of IL-1β and TNF-α were significantly higher compared to PM levels with significantly higher levels in PM1 and PM3 specimens than PM2 specimens. TEF levels of IL-6 were significantly higher in PM2 compared to AM, PM1 and PM3 specimens with significantly higher levels in AM specimens compared to PM3 specimens. TEF levels of IL-1β and TNF-α showed positive significant correlation with wound vitality. TEF levels of IL-6 showed a positive significant correlation with time lapsed since wound inflection. Only elevated TEF level of IL-1β showed significantly high sensitivity for identification of wound inflected since ≤60 minutes AM Conclusion: TEF levels of IL-1β, TNF-α and IL-6 could differentiate between wounds inflected while victim was alive and PM wounds. TEF level of IL-1β works better for such differentiation and could determine wound inflected within 60 minutes with high sensitivity.
This multi-center study was designed as a trial to explore the frequency of silent hepatitis B infection among hepatitis C patients and to determine the prevalent genotype of hepatitis C virus (HCV) in these patients. The study comprised 45 patients with post-hepatitic liver cirrhosis. All patients gave blood samples for estimation of liver function tests and ELISA estimation of serum levels of hepatitis B surface antigen (HBsAg) and anti-HCV antibodies; patients with HBsAg positive were excluded off the study. Qualitative detection of HCV RNA and HBV DNA by PCR (home-made PCR) and quantitative PCR for estimation of HCV viremia and HCV genotyping by RFLP technique were performed. The HCV-Ab was detected in all samples irrespective of its clinical severity class with a mean viremia level of 792336.7±400074.8; range: 134985-1957632 viral copy/ml as determined by quantitative PCR with a non-significant difference between clinical severity classes as regards viremia level. The HBV DNA was detected using qualitative PCR in 20 samples (44.4%); 4 class A, 7 class B and 9 class C samples with a significant increase of the frequency of silent HB in patients with class B (X 2 =5.446, p<0.01) and C (X 2 =8.154, p<0.001) in comparison to class A patients. Genotyping of HCV reported 41 samples (91.1%) with genotype-4 and 4 samples ( 8.9%) with genotype-1 with a prevalence rate of HCV genotype-4 was 91.1%. There was positive nonsignificant correlation between both HCV genotype and the presence of silent hepatitis B infection and clinical severity, however, using the receiver operating characteristic (ROC) curve analysis judged by the area under the curve (AUC) to evaluate the sensitivity and specificity of detection of silent hepatitis B infection and identification of HCV genotype as predictors of severe hepatitis showed a nonspecific role for genotyping for prediction of severity with AUC=0.467, while the detection of HBV DNA using PCR in patients with HCV infection is a specific predictor of severity with AUC=0.617. It could be concluded that HCV genotype-4 is the most prevalent type in Egyptian Hepatitis C cirrhotic patients with an incidence of silent hepatitis B of 44.4% and its detection is a specific predictor of severe cirrhosis.
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