Diagnostic Value of Glypican-3 for Hepatocellular Carcinomas

Background: Hepatocellular carcinoma (HCC) is a common and dangerous malignancy in many parts of the world,and especially in Egypt. Early diagnosis is the most important step in successful HCC management. However mostcases are detected at late stage making effective intervention impossible. Aim: The aim of this study was to evaluatethe potential of Glypican-3 (GPC-3) to aid in diagnosis of HCC, especially in patients with low serum alpha-fetoprotein(AFP). Subjects and methods: Serum GPC-3 was assessed by flow-cytometry and serum AFP by enzyme-linkedimmunosorbent assay (ELISA) in 40 HCC patients with AFP< 400ug\l. (GI), 40 HCC patients with AFP> 400ug\l.(GII) and 20 healthy controls (GIII). Results: GPC-3 was found to be significantly elevated in HCC as compared tohealthy subjects (GI 38.2±22. 5, GII 50.2±22.6, and GIII 2.24±1.19), with sensitivities of 85% for GI and 84% for GIIand specificities of 95% for GI and 92% for GII. AFP showed respective sensitivities of 50% and 79%, and specificitiesof 80% and 90%, for HCC diagnosis. The combination of GPC-3 with AFP achieved the highest sensitivity (98.5%) andspecificity (97.8%). Conclusion: Serum GPC-3 has a better sensitivity than AFP for the diagnosis of HCC. Combinationof two markers appears warranted for greatest accuracy     

Differentiation of adrenal incidentalomas by qualitative and quantitative analytical data obtained by 18F-FDG positron emission tomography/computed tomography in cancer patients

Aim of the work

To evaluate the diagnostic reliability of qualitative and quantitative data of 18F-FDG PET/CT scanning in the identification and differentiation of adrenal incidentalomas discovered in cancer patients.

One-Stage Anterior Urethroplasty

Purpose

A deficient urethral segment was replaced with penile skin during a 1-stage procedure in patients with a long, tight urethral stricture, multiple attempts at hypospadias repair or severe hypospadias and circumcision.

Materials and Methods

In 29 patients a pedicled circumferential strip of distal penile skin was used to construct a neourethral floor. The roof was formed by regeneration of the epithelium from the edges of the floor over Buck's fascia. In our series the urethra was reconstructed because of an anterior urethral stricture in 11 patients, multiple failed hypospadias repairs in 6 and severe hypospadias with circumcision in 12.

Results

A neourethra of sufficient caliber and length was constructed with minimal postoperative complications in all patients. There were 2 cases of urethrocutaneous fistula at the subcoronal region, 1 meatal stenosis, 1 persistent chordee and 1 small distal penile skin patch slough that required only prolonged dressings. Mean followup was 19 months.

Conclusion

Our urethroplasty technique can be used to correct various types of anterior urethral stricture or hypospadias associated with insufficient penile or preputial skin.     

Intestinal intussusception associated with adenovirus infection in Mexican children

Formalin-fixed intestinal tissue specimens from 12 Mexican pediatric patients with intussusception were examined for the presence of adenovirus. Four patients (33%) had detectable adenovirus antigen in epithelial cells as determined by using immunohistochemical analysis. Two of the patients with positive immunohistochemical results had antigens in dendritic and mononuclear inflammatory cells, and 3 patients had positive results for species C adenovirus by in situ hybridization using adenovirus species-specific probes (A-F). A real-time polymerase chain reaction assay specific for species C (nonenteric) adenoviruses was used to confirm immunohistochemical results and to amplify adenovirus DNA for sequencing. A sequence similar to that for adenovirus serotype 1 was found in 1 patient, serotype 2 in another, and serotype 6 in a third; in the fourth patient, the sequence was indeterminate between serotypes 2 and 6. The assays used in this study proved useful for the identification of species C adenoviruses in formalin-fixed specimens from Mexican pediatric patients with intussusception.     

A novel nasal co-loaded loratadine and sulpiride nanoemulsion with improved downregulation of TNF-α, TGF-β and IL-1 in rabbit models of ovalbumin-induced allergic rhinitis

PurposeThe work aimed to develop a co-loaded loratadine and sulpiride nasal nanoemulsion for allergic rhinitis management.MethodsCompatibility studies were conducted adopting differential scanning calorimetry and Fourier transform infrared spectroscopy. Nanoemulsion formulations were prepared using soybean lecithin, olive oil and tween 80. Sodium cholate and glycerol were employed as co-surfactants. Nanoemulsions were assessed for viscosity, pH, droplet size, polydispersity index, zeta potential, electrical conductivity, entrapment, In vitro drug release and corresponding kinetics. Stability of the selected formulation was investigated. The biological effectiveness was evaluated in rabbit models of ovalbumin-induced allergic rhinitis by measuring TNF-α, TGF-β and IL-1.ResultsCompatibility studies revealed absence of drug/drug interactions. Nanoemulsions exhibited > 90% entrapment efficiency. The selected nanoemulsion demonstrated small droplet size (85.2 ± 0.2 nm), low PDI (0.35 ± 0.0) and appropriate Zeta Potential (−23.3 ± 0.2) and stability. It also displayed enhanced in vitro drug release following the Higuashi Diffusion and Baker–Lonsdale models. The mean relative mRNA expression of TNF-α, IL-1 and TGF-β significantly decreased from 9.59 ± 1.06, 4.15 ± 0.02 and 4.15 ± 0.02 to 1.28 ± 0.02, 1.93 ± 0.06 and 1.56 ± 0.02 respectively after treatment with the selected nanoemulsion formulation.ConclusionThe results reflected a promising potent effect of the combined loratadine and sulpiride nasal nanoemulsion in managing the symptoms of allergic rhinitis.     

Dynamics of epithelial cells in the corpus of the mouse stomach. IV. Bidirectional migration of parietal cells ending in their gradual degeneration and loss

The life story of parietal cells has been investigated in the corpus of the mouse stomach using electron microscopy and ³H-thymidine radioautography. Parietal cells are scattered in the four regions of the unit. On the average 3.6 cells are in the pit, 6.2 in the isthmus, 5.6 in the neck, and 10.6 in the base. Parietal cells do not divide. They arise from partially differentiated pre-parietal cells, which are believed to be derived in the isthmus from the three subtypes of granule-free cells: undifferentiated cells, pre-pit cell precursors, and pre-neck cell precursors. Radioautography indicates that the transformation of granule-free cells into pre-parietal cells takes at least one day. The pre-parietal cells, of which there are 0.6 per unit on the average, develop into parietal cells through three successive stages. Stage 1 is characterized by small immature cells that are identified by long apical microvilli. Stage 2 is characterized by larger cells, about one-third the size of parietal cells, and by an incipient canaliculus and a few apical tubulovesicles. Stage 3 is characterized by the expansion of the canalicular and tubulovesicular systems as well as mitochondrial enlargement, which cause the pre-parietal cell to gradually approach the size of, and eventually become, a parietal cell. This cell sequence mainly takes place in the isthmus, but may extend to the neck region. Continuous infusion of ³H-thymidine confirms that parietal cells originate in the isthmus and that they migrate in two directions: some go outward to the pit and the others migrate inward to the neck and eventually to the base. It has been estimated that for every six parietal cells produced per month in the isthmus, three migrate to the pit and three migrate to the neck to eventually reach the base. While almost all parietal cells in the isthmus and neck appear normal, a large proportion of those reaching the pit (21%) and base (23%) undergo gradual alteration and degeneration. After the ensuing death, parietal cells are eliminated in one of two major ways: (1) extrusion into the gastric lumen, if they appear necrotic, or (2) phagocytosis by a neighboring cell or even by an invading connective tissue macrophage, if they are apoptotic. The overall turnover time of parietal cells averages 54 days. Briefly, a sequence of cells—the parietal cell lineage—is initiated in the isthmus, where the three subtypes of granule-free cells are presumed to give rise to pre-parietal cells, which then differentiate into parietal cells. Half of the parietal cells migrate away in the direction of the gastric lumen and gradually degenerate as they approach the free surface, while the other half migrate in the other direction toward the unit's blind end, where they degenerate and are eliminated. © 1993 Wiley-Liss, Inc.