Cyclooxygenase‐2 expression on urothelial and inflammatory cells of cystoscopic biopsies and urine cytology as a possible predictive marker for bladder carcinoma

Cyclooxygenase‐2 (COX‐2) is a key inducible enzyme involved in the production of prostaglandins. It contributes to human carcinogenesis by various mechanisms. The aim of the current study was to elucidate the possible involvement of COX‐2 in human bladder carcinoma by examining its expression on both urothelial and inflammatory cells in tissue biopsies and urine cytology samples of different urinary bladder lesions. A total of 65 patients were included in the study and were selected from cases admitted to Urology Department, Theodor Bilharz Research Institute (TBRI), Giza, Egypt. They represented seven control cases with almost normal‐looking bladder tissue; pure chronic cystitis (n=12); premalignant lesions (18) in the form of squamous metaplasia (n=8) or urothelial dysplasia (n=10) as well as transitional cell carcinoma (TCC) (n=18), and squamous cell carcinoma (SqCC) (n=10). Immunohistochemistry of formalin‐fixed, paraffin‐embedded tissue sections and urine cytology samples was performed for all cases using COX‐2 (H‐62): sc‐7951, a rabbit polyclonal antibody. The study revealed positive COX‐2 expression on the urothelial and inflammatory cells of cystoscopic biopsies from all cases of pure chronic cystitis, squamous metaplasia and SqCC compared with 42.8% and 71.4% of normal controls, respectively. The score of urothelial COX‐2 expression was sequentially up‐regulated from normal to chronic cystitis (either pure or associated with premalignant changes) (p<0.05) to malignant changes (p<0.05). However, the inflammatory cellular expression was down‐regulated with malignant transformation compared with chronic cystitis (p<0.05). In TCC, COX‐2 was over‐expressed on both urothelial and inflammatory cells in advanced tumors. Urine cytology samples were positive for COX‐2 in a comparable manner to that observed in cystoscopic biopsies. Accordingly, the results of the current study have provided new information in two aspects: First, is the possibility of using the differential COX‐2 expression on both inflammatory and urothelial cells as markers for premalignant or malignant transformation; second, besides cystoscopy, urine cytology was found to have a high sensitivity for COX‐2 expression and hence proved to be valuable in malignancy as a non‐invasive substitute for cystoscopy.     

TESTICULAR AND EPIDIDYMAL INVOLVEMENT IN LEPROSY PATIENTS, WITH SPECIAL REFERENCE TO GYNECOMASTIA

Sixty-six male patients with leprosy were studied. Only those with the lepromatous type developed testicular and epididymal changes. Nine of the 38 patients showed decreased sexual function, and 7 developed gynecomastia. These changes were believed to be due to the altered gonadal state.     

Psychiatric occupational therapists' verbal interaction with their clients

This study reports from a survey investigating psychiatric occupational therapists' (n=292) use of verbal interaction on a regular basis with their clients. Among predefined areas of verbal interaction, routine occupations, self-image and ego-strengthening interventions were among the most frequently given alternatives. Verbal interaction with clients was more common among occupational therapists in outpatient care than among those in inpatient care. Verbal interaction with clients was also more common among occupational therapists with advanced education in psychodynamically oriented psychotherapy. The respondents' use of theoretical frames of reference was related to the focus of their verbal interaction with clients. Interventions to reach certain goals emerged as the most common category of verbal interactions. It was concluded that verbal interaction with clients is essential to the occupational therapy process. Future research needs to investigate the interplay between verbal and non-verbal components of interaction in occupational therapy and how patients benefit from these elements.     

ANEMIA AND INFECTION IN SCHOOL-AGED EGYPTIAN CHILDREN

Iron-deficiency anemia and infection are deterrents to optimal child health in many developing countries. We investigated the prevalence of anemia and elevated erythrocyte sedimentation rate (ESR), which reflects chronic background infection, recent illness, and diet for 190 children aged 10 to 13 years in 1995 in a Nile Delta village. The children exhibited a high prevalence of anemia (61.6%) and elevated ESR (54.9%). One-third of the children reported a minor illness within the past week, and more than 75 per cent had one or more parasites evident in stool or urine samples. There was no relationship of socioeconomic or dietary indicators to anemia or elevated ESR. Mothers’ evaluation of the child’s health status had no relationship to anemia or elevated ESR, with 43.6 per cent of mothers reporting their child’s health status as excellent or good. Maternal report of the child’s health as poor was related to recent illness. We speculate that where anemia and chronic infection are hyperendemic, both children and mothers may become habituated to the associated symptoms and consider them normal.     

Studies on Agranulocytosis. II. The Effect of Chlorpromazine upon the Influx of S35 L-Cystine and L-Methionine into Human Leukocytes

1. When whole blood was incubated in vitro with S-35 L-cystine and L-methionine, the blood cells became radioactive.

2. Preincubation of whole blood from normals and from patients susceptibleto agranulocytosis with chlorpromazine showed no effect upon uptake of S-35L-cystine and L-methionine by leukocytes.

3. The in vivo administration of S-35 L-cystine was followed by the appearance of radioactive leukocytes. Peak radioactivity occurred in leukocytes in 5to 12 days.

4. Pretreatment of test subjects with large doses of chlorpromazine did notblock the uptake of S-35 L-cystine by leukocytes in vivo. Leukocytes of womenshowed an increase in the incorporation of S-35 L-cystine, in vivo. Studiesperformed in vivo on two persons during recovery from agranulocytosisshowed enhanced uptake of L-cystine in one and a normal uptake in the other.

Submitted on March 24, 1960 Accepted on July 13, 1960     

Biomarkers as non-invasive assessment of hepatic fibrosis in chronic hepatitis C

Abstract   Liver biopsy has been considered as the gold standard for assessing the stage and the grade of chronic liver diseases. Biopsy has a high sampling error (33% for fibrosis staging and 24% for necrosis staging), and intra- and interpathologist variability greater than 10%. Biochemical markers, particularly recent panels of markers (FibroTest-ActiTest) have good predictive values with a better benefit risk ratio and lower cost than liver biopsy. Discordances between biopsy and serological markers results can be either due to serological markers or to biopsy. Because of the improvement of biochemical markers, the limits and the risk of biopsy, liver biopsy should not be mandatory any longer in the management of patients with chronic liver hepatitis C.     

THE ROLE OE MAST CELLS IN TREATMENT OE SCABIES

Objective. The purpose of this study was to recognize the role of mast cells in the pathogenesis of scabies. Methods. One hundred and fifty patients and 10 controls were included in the study. Group 1 included 20 patients without previous treatment. In group 2, 80 patients were treated with antiscabietic drugs. Group 3 had 50 patients who received an antiscabietic drug followed by 3 days of crotamiton. Diurnal and nocturnal skin biopsies were taken from group 1. In groups 2 and 3, the biopsies were taken after 2 weeks of treatment. Sections were cut and stained by hematoxylin and eosin and Giemsa stains. Results. Mast cells were increased in diurnal and nocturnal biopsies. Evident degranulation of mast cells was detected in nocturnal biopsies. The mast cell number decreased to half its pretreatment number in patients treated with antiscabietic drugs and to its normal number in patients treated with antiscabietic drugs followed by 3 days with crotamiton. Conclusion. The number of mast cells are increased in scabietic lesions. This plays a role in the pathogenesis of the clinical and histologic picture of scabies. We recommend that an antiscabietic drug should be followed by 3 days of crotamiton in the treatment of scabies.     

Regression Equation Predicts Dietary Phosphorus Intake from Estimate of Dietary Protein Intake

Objective To develop a predictive equation for dietary phosphorus intake.

Design In this clinic-based, cross-sectional study, a dietitian-administered food frequency questionnaire provided dietary intake estimates for a population of patients with chronic renal failure. A prediction equation for dietary phosphorus intake was developed and was validated on another sample of patients with CRF from the same clinic.

Subjects Outpatients treated for chronic renal failure at the E. Wolfson Medical Center Institute of Nephrology in Holon, Israel, participated in the study (N=104, 73 men and 31 women, mean AGE=65.6 years). The validation sample consisted of 53 outpatients with chronic renal failure (38 men and 15 women, mean AGE=64.2 years) from the same clinic.

Main outcome measures Dietary variables (ie, energy, protein, carbohydrate, fat, phosphorus) were examined in terms of crude intake, as percentage of total energy intake, and per kilogram of body weight.

Statistical analyses performed Stepwise linear regression analysis and Student's t tests were used to examine relationships between dietary phosphorus and other variables. Results Dietary phosphorus (milligrams)=128+14 (protein intake [grams]) was the best-fitting equation and explained 84% of the variance in dietary phosphorus intake.

Applications The prediction equation for dietary phosphorus intake is especially useful for renal dietitians who calculate patient diets by hand. J Am Diet Assoc. 1996; 96:1268-1270.