SEROEPIDEMIOLOGY OF HBV ANTIGEN AND ANTI-HCV AMONG GENERAL POPULATION IN A RURAL LOCAL IN BAUCHI STATE, NIGERIA.

Background: HBV and HCV infections are a significant public health issue in developing countries with weak healthcare systems, high poverty rates, illiteracy, low HBV immunization coverage, and low public health education. A study assessed the sero epidemiology of HBV antigen, anti- HCV markers, biochemical and heamatological indices of 559 participants in Dambam local government during hepatitis day. A structured questionnaire was administered to assess demographic information and risk factors. Rapid latex immunochromtographic kits were used for HBV, HCV, and HBV Combo serological markers, with positive and negative control included in each batch analysis. Descriptive statistics analysis was conducted on the data. Results: The 559 study participants, had a mean age of 35.5+10.9years, majority within the age- group, 18-39years 279(49.04%), female accounted for 291(52.1%) compared to male 268(47.9), educational background, tertiary 244(43.6%), married, 356(68.7%) and student were 254(45.4%). Seroprevalence of HBsAg was 10.7%, serological markers as follows, HbsAb 1.7%, HbeAg 13.3%, HbeAb 60.0% HbcAb 95.0% and Anti-HCV of 3.4%. Gender breakdown(M vs F) of HBV(13.4% vs 8.2%) and HCV(3.0% vs 3.8%). Significant association was observed in the seroprevalence of HBV and HCV with age-group, gender, marital status and occupation(<0.05). No significant difference was observed with the risk factors of HBV and HCV. Biochemical and heamatological indices showed a significant difference between seropositive and negative study participants(<0.05). Conclusion: The study's findings affirmed the endemicity of HBV infection and the increasing trend of HCV infection in Bauchi state, posing serious public health concerns. HBV serological markers suggest a low HBV immunization coverage rate and exposure of participants to the viral etiology in the community. Strengthening immunization coverage and population-based surveillance is strategic in the prevention and control of viral hepatitis in Bauchi state.

Expression pattern of ISL-1, TTF-1 and PAX5 in olfactory neuroblastoma.

Olfactory neuroblastoma (ONB) is a rare neoplasm of the sinonasal area with neuroendocrine differentiation. ISL-1, TTF-1 and PAX5 are transcription factors that are frequently upregulated in tumors showing neuroendocrine differentiation. The aim of our study was to evaluate these markers in a group of ONBs. We included 11 ONBs from 4 large university hospitals. Immunohistochemical expression of TTF-1, PAX5 and ISL-1 was evaluated. TTF-1, ISL-1 and PAX5 were expressed in 3/11 cases (27.27%, h-score: 3-45), 7/11 cases (63.64%, h-score: 23-200), and in 3/11 cases (27.77%, h-score 3-85), respectively. The patient with the strongest PAX5 reactivity exhibited an aggressive clinical course with rapid dissemination to the spine and death shortly after the diagnosis. No significant correlation in the expression of PAX5 and TTF-1 ( = 0.43; p = 0.18) was observed. ISL-1 is widely expressed in tumors with neuroendocrine differentiation and therefore of limited value in their differential diagnosis. TTF-1 positivity does not exclude the diagnosis of primary ONB, although usually only a small percentage of cells are positive. PAX5 expression is infrequent (27.27%) in ONB; however, if present it can be associated with a very aggressive clinical course.

Tumour thrombus consistency has no impact on survival in patients with renal cell carcinoma.

The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not always possible to predict. The prognostic impact and independence of tumour thrombus-related factors including the recently introduced tumour thrombus consistency (TTC) on overall survival remain controversial. The aim of this study was to investigate the prognostic role of TTC in patients' survival. We determined the tumour thrombus consistency (solid vs. friable) in a cohort of 84 patients with RCC and VTT who underwent nephrectomy with thrombectomy, and performed a retrospective evaluation of the patients' data from the prospectively maintained database. A total of 45% of patients had solid thrombus (sTT) and 55% had friable thrombus (fTT). The venous tumour thrombus consistency was not predictive of overall survival. Further studies, preferably prospective and with a larger number of patients, are needed to validate the obtained results, as well as to evaluate the usefulness of tumour thrombus consistency in clinical practice for stratifying the risk of recurrence and planning further follow-up.

Population dynamics of Staphylococcus aureus from Northeastern Nigeria in 2007 and 2012.

The population structure of Staphylococcus aureus is changing globally but the situation regarding dominant clones in sub-Saharan Africa is not clear. We therefore assessed changes in the population structure of clinical S. aureus isolates obtained in 2007 (n = 75) and 2012 (n = 75) from Northeastern Nigeria. A reduction in resistance to penicillin, gentamicin, erythromycin and clindamycin was observed in 2012. A decrease of methicillin resistance rates (13·3% to 8·0%) was associated with the decline of the ST241 MRSA clone. The proportion of Panton-Valentine leukocidin (PVL)-positive isolates also decreased from 65·3% to 44%, and was linked with the emergence of PVL-negative ST601 clone in 2012. The significant decline in antibiotic resistance in the study area is in contrast to the worldwide trend of increasing resistance rates.

Selected immunohistochemical features of conventional renal cell carcinomas coexpressing P53 and MDM2.

Renal clear cell carcinoma (CCRCC) is an aggressive tumor for which new prognostic factors are needed. It has been suggested that CCRCCs co-expressing P53 and MDM2 could represent a special subgroup; therefore the aim of this study was to explore their immunohistochemical features. The material studied consisted of 470 cases of CCRCC. Immunohistochemistry for MDM2, P53, Ki-67, VEGF-A, VEGF-C, VEGF-D, GLUT1, CA9, and CK 7 was performed on tissue microarrays and assessed semi-quantitatively. On average, 6.6% or 5.3% of cases were P53+/MDM2+, depending on the P53 antibody used. The mean percentage of Ki-67 positive cells was 0.6% and p53-positive MDM2-positive cases showed significantly higher expression of Ki-67. The other immunohistochemical parameters studied did not differ between p53-positive MDM2-positive cases and the rest of the subtypes studied. Expression of almost all immunohistochemical markers differed with respect to pT stage; only for CA9 was the difference not significant. Furthermore, almost all immunohistochemical markers studied differed with respect to differences in grade; only for GLUT1 was the difference not significant. Our results suggest that with the exception of Ki-67, there are no significant associations between analyzed markers and the double P53+/MDM2+ phenotype.

Neuroendocrine markers and sustentacular cell count in benign and malignant pheochromocytomas - a comparative study.

Pheochromocytomas are rare tumours with uncertain clinical behaviour. Histological separation between benign and malignant pheochromocytomas is usually difficult. The utilization of PASS criteria (Pheochromocytoma of the Adrenal Gland Scaled Score) has not provided a solid basis for separating benign from malignant tumours. The aim of this study was to investigate immunohistochemical markers (chromogranin, synaptophysin, S-100 and Ki-67) to find out if they could provide useful diagnostic and/or prognostic data in a series of 62 pheochromocytomas (5 cases followed an aggressive clinical course). Chromogranin and synaptophysin immunoreactivity proved to be diagnostically useful, allowing, together with the absence of immunoreactivity for inhibin and melan A, an unequivocal diagnosis of pheochromocytoma. The pattern of staining did not provide, however, significant prognostic information. The mean count of sustentacular S-100 positive cells was lower in malignant than in benign pheochromocytomas but the frequent architectural variability and the haemorrhagic and cystic changes make it very difficult to achieve a precise and reproducible count in the majority of tumours. Without questioning that the occurrence of metastases and/or recurrent disease still remains the only unquestionable criterion for diagnosing a malignant pheochromocytoma, we think that the combined use of the PASS score and Ki-67 index provides useful information for diagnosing malignancy.

Short- and medium-chain fatty acids as a feed supplement for weaning and nursery pigs.

The effect of supplementing piglet diets with acidifiers containing the short-chain fatty acids - SCFA (propionic C3 and formic) together with medium-chain fatty acids -- MCFA (caprylic C8 and capric C10) on performance, nutrient apparent digestibility, intestinal microflora and small intestine structure was investigated. The study was performed on 326 piglets allocated to 5 experimental groups. They were fed a standard diet (Group I - control) or a standard diet supplemented with 0.5% propionic and formic acids (Group II - PF). Group III (PF + C8), group IV (PF + C10) and group V (PF + C8 + C10) received the same mixture as group II with a supplement of 0.2% of caprylic and/or capric acids, respectively. Apparent digestibility of nutrients and microbiological analyses were performed. The structure of jejunum mucosa was also examined. Piglets receiving capric acid (groups IV and V) had the highest body weight gains. Piglets receiving MCFA digested protein and fiber better (P < or = 0.05) than piglets receiving SCFA as acidifier. There was no difference in intestinal microflora except for Clostridium perfringens, the population of which was reduced by SCFA (group II). Villi of the mucosal epithelium were the highest (P < or = 0.05) in piglets receiving SCFA with capric acid (group IV). Under the conditions of this study a mixture of SCFA (propionic and formic) with capric acid significantly improves performance of piglets.

Laparoscopic embryo transfer in pigs - comparison of different variants and efficiencies of the method.

The aim of the study was to develop a method of laparoscopic embryo transfer in pigs and to compare different variants of this method. Two catheter diameters (1.6 mm and 1.0 mm), the method and site of embryo deposition (oviduct or uterus), the embryo development stage (2 - 4 cell or blastocyst), the method for oviduct or uterus stabilization, the potential for cryopreserved embryo transfer, the developmental potential of the embryos after transfer to the oviduct, patomorphology of the oviduct after transfer and possible clinical complications were taken into consideration. Two studies compared two variants of transfer to the uterus, and five variants of transfer to the fallopian tube. The transfer of embryos by the infundibulum may be of limited use due to handling problems and very low efficiency (pregnancy was not achieved). Very low efficiency was shown after transfer of vitrified embryos. Transfer to the fallopian tube by puncture of the fallopian tube, regardless of the developmental stage of the embryo, is the recommended method of embryo transfer. The histopathological examination of the fallopian tube revealed possible changes within the puncture site. The numerous clinical complications observed did not affect the effectiveness of the method.

Two consecutive cases of renal oncocytomatosis in a single-center experience.

Renal oncocytoma is a rare finding and represents the small percentage of all kidney tumors. This kind of tumor is benign and diagnosed accidentally (on autopsy or during nephrectomy performed for other reasons). On rare occasions, truly multiple tumors are seen, affecting the entire renal parenchyma; this condition is called oncocytosis or oncocytomatosis. Here we present two cases of this condition, diagnosed consecutively in a single internal medicine department.

Primary adrenal tumors--a 16-year experience in a single institution.

The incidence of primary adrenal gland tumors observed at the Pathology Department, Cracow, in the period of 16 years was examined. The frequency of adrenal lesion in males and females was studied and compared. The mean age of the patients was calculated. The results were shown in tables and diagrams and compared with data given in the WHO Classification of Tumors and the literature on the subject.

The unique case of adrenocortical malignant and functioning oncocytic tumour.

UNLABELLED: Adrenocortical oncocytoma is extremely rarely found. Only a little more than thirty cases of adrenal oncocytoma, mainly nonfunctioning and benign, have been reported in the literature. Adrenal mass 150 x 160 x 172 mm in size and enlarged periarterial lymph nodes were found in CT examination performed in 51-year-old male. Main complaints: weight loss, general asthenia and abdominal pain. PHYSICAL EXAMINATION: elevated blood pressure (180/120 mmHg), no features typical of Cushing's syndrome. Abnormal laboratory findings: oral glucose tolerance test revealed diabetes, elevated serum dehydroepiandrosterone-sulfate (1101.9 microg/dl; normal, 59-452), elevated serum cortisol following overnight 1 mg dexamethasone test (5.1 microg/dl; normal, <1.8), increased urinary excretion of 17- hydroxycorticosteroids (18.1 mg/24 h; normal, 2.0-7.0) with pathological response to high-dose dexamethason test (16.6 mg/24). On laparotomy, the lesion was considered unresectable because of evident - confirmed by intraoperative ultrasound - tumour infiltration of the inferior caval vein. The large biopsy specimen was obtained for histological examination in which tumour fulfilled criteria proposed by Bisceglia et al. for adrenocortical oncocytic borderline tumour. On immunohistochemistry, the lesion showed cytoplasmic reaction for cytokeratin, vimentin and synaptophysin. The presented case appears to be the first malignant and functioning adrenocortical oncocytic tumour reported and confirms the complexity of its biology.

Association of the immunohistochemical detection of gamma-glutamyl transferase expression with clinicopathological findings in postmenopausal women with endometrioid adenocarcinoma of the uterus.

Gamma-glutamyl transferase (GGT) is a membrane enzyme present not only in the liver but also in healthy endometrial epithelium. Its overexpression has been demonstrated in numerous malignancies, where it exerts an anti-apoptotic effect and causes drug resistance in response to oxidation stress. Aim of the study was investigation of GGT expression in postmenopausal patients with endometrioid adenocarcinoma of the uterus (EAC). The material comprised 98 paraffin-embedded post-operative tumour samples of EAC from postmenopausal patients and a control group of 60 normal human postmenopausal endometrium samples. For immunohistochemical specimen staining, polyclonal IgG anti-GGT was used; for GGT expression measurement, a semi-quantitative method was applied. In EAC patients, 16 (16.33%) were diagnosed as stage IA, 46 (46.93%) as stage IB, 14 (14.29%) as stage II, and 22 (22.45%) as stage IIIA-C, according to the International Federation of Gynaecology and Obstetrics (FIGO) classification. Fifty-six (57.14%) patients were diagnosed with low- or moderate-grade (G1-2) disease, and 42 (42.86%) were diagnosed with high-grade (G3) disease. Cytoplasmic GGT staining was confirmed in all samples, while apical membrane GGT staining was observed only in G1-2 EAC specimens and the control group. In G3 EAC specimens, GGT cytoplasmic staining and high nuclear polymorphism areas were predominantly shown. Comparable high GGT median apical expression was confirmed in healthy endometrium (2.0, S.E.M. = 0.28) and in G1-2 EAC (2.0, S.E.M. = 0.27); however, in G3 tumours, GGT expression was significantly lower (0.0, S.E.M. = 0.07) than in healthy endometrium (P < 0.001 and P < 0.001, respectively). After stratification of the cancer cases according to FIGO staging, the lowest median apical GGT expression levels were in II EAC (0.0, S.E.M. = 0.64) tumours compared with IA (4.0, S.E.M. = 0.47) tumours, specimen and normal endometrium (2.0, S.E.M. = 2.8) (P < 0001). Stage IB EAC and IIIA-C EAC (1.0, S.E.M. = 0.16) cases showed only moderate median apical expression of GGT (1.0, S.E.M. = 0.24). We concluded that impaired GGT expression has the potential to become a valuable tool for stratifying EEC patients' prognosis and treatment planning.

Karyometric features differentiate early invasive cervical squamous cell carcinoma from preinvasive carcinoma.

The aim of the study was to investigate whether karyometric features reflect phenotypic change from preinvasive to early invasive squamous cell carcinoma of the cervix uteri. The material for the study was obtained from 12 patients diagnosed in the Chair of Pathomorphology. Each specimen contained both preinvasive and microinvasive lesions. The system of image acquisition and analysis consisted of a microscope coupled with a CCD camera and a PC computer. The software based on AnalySIS 3.0 system (Soft Imaging Systems GmbH) automatically detected cell nuclei and measured the preselected parameters. In each case 250 cell nuceli from both preinvasive and invasive components were analyzed. Significant differences in basic karyometric parameters were found both within individual cases and especially between groups studied. The present findings confirm the presence of early cytological changes at the onset of invasion. From the practical viewpoint the results suggest that karyometric features measured by image analysis might be used as a diagnostic tool, especially in cases where the diagnosis of microinvasion is difficult.

Proliferation and apoptosis within the oral mucosa "hemangiomas".

In the study the expression of Ki-67, p53, bcl-2 and apoptotic index in ten cases of lobular capillary hemangioma (LCH), ten of capillary hemangioma (CH), and five of epithelioid hemangioma (EH) was examined. The expression of Ki-67, p53 and bcl-2 did not differ significantly between each group of lesions. Instead, significant differences in apoptotic index between LCH and CH were found. The expression of bcl-2 was positively correlated with that of Ki-67 in LCH and CH group, but negatively correlated in the EH group. Our results confirm that LCH, EH and CH, which are histologically similar, are different in terms of proliferation/apoptosis balance. This reflects their different biology, and presumably pathogenesis.

Morphometry separates squamous cell carcinoma of the vulva into two distinct groups.

The aim of the study was to investigate quantitatively the heterogeneity of vulvar squamous cell carcinoma. The material consisted of archive material from 36 patients with squamous cell carcinoma of the vulva treated at Department of Gynaecology and Oncology. Selected slides were stained with iodidium propide and immunostained for p53 and Ki-67 (MIB-1 clone). Percent of immunopositive nuclei, number of mitotic figures, DNA-ploidy, and geometric nuclear parameters such as area, perimeter, minimum, mean and maximum diameter, shape factor and folding factor were measured with applications running on AnalySIS pro 2.11 (Soft Imaging System GmbH, Germany) image analysis system. Cluster analysis disclosed 2 groups significantly different in respect to patient age, nuclear area, p53 expression and DNA-ploidy. No significant difference in proliferation markers nor clinical stage was found. In other studies also 2 distinct group of squamous cell carcinoma of the vulva are postulated; that groups differ in pathogenesis and epidemiology. Our study confirms this heterogeneity by an independent method. In the present study usefulness of image analysis for separating squamous cell carcinoma of the vulva into distinct groups was explored and proved.

Hyalinizing clear cell carcinoma of salivary gland. A case report.

Authors describe a case of hyalinizing clear cell carcinoma of the parotid gland in a 65-year-old female. Morphological characteristics of clear cell tumors of salivary glands are then discussed.

HER-2/Neu expression as a progression marker in pancreatic intraepithelial neoplasia.

Pancreatic intraepithelial neoplasia is only partially defined. Any attempt to establish the diagnostic criteria of early pancreatic carcinoma has been unsuccessful so far. In the present study we investigate expression of HER-2/neu in hyperplastic pancreatic duct epithelium. Material included resected pancreatic tissue obtained from 13 patients with pancreatic carcinoma, 11 with chronic pancreatitis, and 11 patients operated on for other reasons (gastric cancer, carcinoma of papilla Vateri). Hyperplasia of pancreatic duct epithelium was scored as: 1. flat mucosal hyperplasia FH, 2. papillary hyperplasia PH, 3. atypical papillary hyperplasia APH, 4. carcinoma in situ CIS. Immunohistochemical expression of HER-2/neu was studied with the biotin-streptavidin method. Results were scored as: 1+ barely perceptible light membranous rimming, 2+ light to moderate rimming, 3+ moderate to strong rimming. Expression of HER-2/neu paralleled with the hyperplasia grading, in most cases being negative in normal duct epithelium, weak in flat hyperplasia, and moderate to strong in atypical papillary hyperplasia and carcinoma in situ. In conclusion, HER-2/neu expression could be used as an additional marker of hyperplasia, dysplasia and atypia of pancreatic ductal and ductular epithelium in the process of pancreatic epithelial neoplasia. This could be especially useful in the cytological diagnosis of pancreatic intraepithelial neoplasia.

Cardioprotective properties of hydrophilic pollen extract (HPE).

Pharmacological effects of hydrophilic pollen extract (HPE) are unknown. The results of our previous studies suggest their cardioprotective influence. The purpose of the present study was to evaluate biochemical and morphological effects of HPE in adrenaline-induced myocardial damage. The study was carried out in 40 Wistar rats. Group A was intoxicated with adrenaline in a dose of 100 micrograms/kg i.p. Group A + HPE was given simultaneously HPE and adrenaline. Group K consisted of control animals. Analysis of blood enzymes and histological examination of myocardial tissue were performed 24 hours after the onset of the experiment. The activity of SGOT, CPK and AP was measured using an automatic analyzer. Whole transversal myocardial sections were obtained for histology. We evaluated cellular infiltration of the endocardium, microfocal myocyte damage, wavy myofibers, cellularity of the stroma and perivascular infiltrates. The results were compared using statistical methods. In group A the levels of SGOT and CPK were significantly higher than in groups A + HPE and K. Histological examination also revealed marked differences among these groups. The present study despite confirming cardioprotection by HPE does not provide grounds for unequivocally defining its mechanism. This problem and a possible use of HPE in cardiology require further studies.

Fabry's disease. Report of the case diagnosed on the basis of routine ultrastructural examination of the renal biopsy.

A 45-year-old man who developed proteinuria was diagnosed as having Fabry's disease on the basis of renal histological findings and prominent decreases in alpha-galactosidase A activity in blood leukocytes.

Ambiguity of morphological criteria of myocarditis in cardiac biopsy specimens.

Myocarditis is diagnosed when leukocytic infiltrate is accompanied by myocyte degeneration or necrosis. Endomyocardial biopsy is evaluated as the main diagnostic method. The purpose of the present study was to examine the individual elements of a histological picture and specify morphological criteria of diagnosing myocarditis in cardiac biopsy. The Dallas criteria were the point of reference. In the cardiobiopsies from 70 patients with clinically suspected myocarditis or congestive cardiomyopathy an active myocarditis was found in 19 cases, significantly more frequently in the group clinically classified as having myocarditis. Contraction bands, endocardial changes and vasculopathy were more frequent in cases histologically classified as active myocarditis than in borderline myocarditis. In our opinion the Dallas criteria include certain ambiguities concerning mainly differences of individual types and phases of myocarditis as well as their relations to congestive cardiomyopathy. The sensitivity and specificity of the diagnosis are related both to methodological limitations (material selection) and difficulties occurring mainly at the level of perception, evaluation and interpretation of changes. It is possible to improve the efficacy of cardiac biopsy in diagnosing myocarditis if a new techniques better revealing myocyte damage and more unequivocally determining the cellular composition of the stroma have been developed.