Detection of 14q32 rearrangements in multiple myeloma, using simultaneous FISH analysis combined with immunofluorescence

14q32 rearrangement has been identified as a recurrent hotspot of translocations in multiple myeloma [MM]. The Fluorescence Immunophenotyping and Interphase Cytogenetics as a tool for the Investigation of Neoplasms [known as FICTION technique] for evaluation of chromosomal changes in MM. The aim of this work is to detect 14q32 rearrangement, using FICTION technique, on archival bone marrow [BM] slides of MM patients, and to study its prognostic value. This study was conducted at Ain Shams University Hospital. The FICTION technique, which uses CD138 and dual color, and the break-apart 14q32 rearrangement probe, was performed on archived smears of BM slides for 50 MM patients at the time of diagnosis. A significantly higher percentage of cases were positive for 14q32 rearrangement by FICTION [32%] compared to fluorescence in situ hybridization [FISH] [12%] [p = 0.04]. Cases positive by FICTION for the rearrangement were designated as Group A, while negative cases were designated as Group B. Significantly lower Hb and CRP levels were found among Group B when compared to Group A patients [p = 0.001 and 0.01, respectively]. Serum albumin level and Bence Jones protein [BJP] significantly affect overall survival [OS] [p = 0.01, 0.007, respectively]. However, a statistically non-significant shorter mean survival time was found in positive cases through FICTION versus negative cases. FICTION technique provides a sensitive tool for establishing clonal plasma cells [PC] infiltration of BM aspirates, and is amenable for use on archived as well as fresh smears

Ultrasonographic and portal hemodynamic changes in hepatic schistosomiasis patients after treatment with praziquantel

The study included 40 schistosomal cases that divided into 2 groups: Group I [with early schistosomal hepatic fibrosis], and group II [with late schistosomal hepatic fibrosis]. Abdominal and duplex-Doppler ultrasound changes were studied for every case before and 6 months after PZQ therapy in a single dose of 60 mg/kg. In group I, portal vein diameter was significantly reduced after therapy, while group II showed insignificant change. Patients with periportal fibrosis grade 1 and grade 2 showed significant decrease in the degree of fibrosis in group I and no significant difference was recorded in group II. Hepatic fibrosis grade 3 showed no significant change. Duplex-Doppler study showed significant increase in maximum and mean velocity of blood flow in portal vein after praziquantel in group I but no significant change in group II. Accordingly, it was concluded that praziquantel may result in reversal of periportal fibrosis especially in early stage after schistosomal infection

Portal vein Duplex study before and after operation of portal hypertension

Portal hypertension is an increase in the hydrostatic pressure within the portal vein or one of its tributaries. The aim of this work was duplex assessment of portal hypertension and duplex evaluation of haemodynamic changes before and after splenectomy and devascularization. The study included 30 persons divided into two groups: 10 normal subjects as controls and 20 patients with portal hypertension. To both groups duplex Doppler was done to assess the portal vein diameter, portal vein caliber variation during respiration, splenic vein diameter, presence of collaterals, measuring portal vein velocity and the cross sectional area and then calculation of portal blood flow using the equation: portal blood flow=velocity x cross sectional area. Of the present work showed that, in the control group, the mean portal vein diameter was 1.1 +/- 0.08 cm and the portal blood flow was 1.5 +/- 0.4 L/M. The pre-operative duplex study showed a mean velocity of 26.4 +/- 8.82 cm/sec. The mean portal blood flow was 1.2 +/- 0.6 L/M. The portal vein diameter ranged between 1.2 and 2.1 cm with mean 1.83 +/- 0.34 cm. The post -operative duplex study showed that the portal vein diameter ranged between 1 and 2 cm with a mean of 1.57 +/- 0.24 cm, the mean velocity ranged from 9 to 35.4 cm/sec with a mean 24.17 +/- 7.81 cm/sec. The portal blood flow ranged from 0.36 to 1.5 L/M with a mean of 0.78 +/- 0.34 L/M. The study of splenectomy and devasculariziation was done on 20 patients and portal blood flow was measured before and after surgery. Of the present work showed decrease in the portal blood flow in 18 patients out of 20 [90%]. This study showed decreased in portal vein diameter in 17 patients [85%] and no change in 3 cases [15%]. This was explained by drop of portal pressure that occurred after operation

Cardiac performance in typhoid fever

The cardiac performance was studied in 19 patients with typhoid fever within 10 days from the onset of fever, 15 of them were restudied in the convalescent period [4 weeks] together with 8 feverish subjects with common cold as controls. There were ECG changes in 46% of cases in the form of prolongation of the P-R interval, Q-Tc interval, S-T and T wave changes. In echo doppler study there was no significant changes in left ventricular systolic function. There was significant change in left ventricular diastolic function during the acute phase of the disease in the form of decrease in velocity of E relative to A and reversal of E/A ratio. The results conclude that the echo doppler change had a direct relation to the clinical severity of the disease and was corrected during the convalescent period of typhoid fever

Thoracic duct lymphocyte study in schistosomal hepatic fibrosis

Schistosomal hepatic fibrosis is associated with important lymphodynamic changes. In this work, thoracic duct lymphocytes' function and subsets were studied in 20 males with hepatic achistosomiasis and 10 controls to evaluate the role of thoracic duct lymph in cellular immunity in schistosomal patients. Beside routine laboratory investigations, both serum and thoracic duct lymph were subjected to E-rosette testing, counting T-helper and suppressor cells using monoclonal antibodies and migration inhibition test to evaluate lymphocyte function. In schistosomal cases, peripheral blood testing revealed the presence of a reduction in T-cell number and function with increase in their suppressive action. Moreover, thoracic duct lymph studies showed reduction in E-rosette percentage T-helper cells and T h/s ratio with a slight increase in T suppressor cells. These findings may suggest preferencial passage of specific cells to lymph and/or presence of a specific factor that produces immunosuppression or abolishes the helper action of T lymphocytes

Symptomatic giardiasis and intestinal bacterial overgrowth

The clinical spectrum of giardiasis varies from symptomatic cases to patients with malabsorption. Whether or not bacterial colonization of the duodenum affects the outcome of giardial infection was investigated in this work. Duodenal aspirates, obtained from fifty Egyptian males suffering from giardiasis, were studied microscopically and bacteriologically. The results revealed the occurrence of bacterial overgrowth [mostly aerobic] in 62% of cases. A directly proportional relation could be detected between the presence and number of bacteria on one hand and the severity and duration of the disease on the other hand. It could be postulated that intestinal microbial overgrowth favours mucosal invasion by the parasite and aggravates its pathogenicity

Cerebral CT changes and pituitary-gonadal dysfunction in schistosomal hepatic fibrosis

Brain CT and estimation of basal serum luteinizing hormone, testosterone and prolactin were performed in thirty male patients with confirmed schistosomal hepatic fibrosis [SHF], aged 20-40 years and 15 matched controls. Brain scans showed overt mild cortical atrophy in 5 patients, internal hydrocephalus in one and normal brain scan in 24 cases. CT measures in the latter patients revealed significantly wider sulcal score than that of controls though still within normal ranges. Hormonal assays showed significant lowering of basal serum LH and testosterone in schistosonnal cases with and without cerebral atrophy while the basal serum prolactin level in these patients was not significantly increased. There were no significant differences in the studied hormones' levels in cases with and without cerebral atrophy. The present findings showed measurable cerebral neuroanatomical disturbances in patients with SHF without clinical neurological manifestations. Pathogenesis of these changes is still unknown. Moreover, the mechanism of hypogonadism in SHF may be a defect at the level of the hypothalamus and/or pituitary rather than primary gonadal failure

Hepatitis' antigen in hepatitis B positive hepatocellular carcinoma

The relationship between hepatitis B infection and primary hepatocellular carcinoma [HCC] was observed years ago, yet much more investigations are still needed to clarify it. This study was, accordingly, conducted to determine the HBeAg profile among hepatitis B positive hepatocellular carcinoma patients. Other HBV markers were also investigated. Ten patients were included in this work, five of them were also investigated. Ten patients were included in this work, five of them were found to have only HBsAg in their sera. The other five had in addition to the surface antigen, one or more of the other HBV sero-markers. These latter patients seem to have either an acute HBV infection not related to the state of malignancy, an active exacerbation of a chronic HBV infection or a superinfection with a NANB or a delta agent

Schistosoma mansoni ova output and some immunogenic parameters in hepatic schistosomiasis: a possible relation

The present work was designed to study the relations between S. mansoni ova output the HLA system and the immune responsiveness in patent patients with hepatic schistosomiasis. The work included 20 unrelated male patients with active intestinal schistosomiasis and in a state of early schistosomal hepatic affection, as well as 20 normal controls. The incidence of HLA-A28 and HLA-B5 was found to be significantly higher in the patients than in controls. No relation could be detected between S. mansoni egg excretion and the HLA system, the humoral or the cellular immune parameters in the studied patients. The present work suggested that though the major histocompatibility complex may not influence the susceptibility to S. mansoni infection, it has an effect on the outcome of this infection

T-lymphocytes in giardiasis

The cell mediated immunity is poorly understood in giardiasis, however T-cells were claimed to have a role. This study included 30 children with symptomatic giardiasis and 10 healthy parasite free children of the same age and socio-economic standard. The immune response was assessed by performing T-cell count using Rosette formation and T-cell function using Blast transformation technique. In the present work although both T-lymphocyte count and function were significantly reduced in patients with giardiasis as compared with the control group, there was no correlation between both parameters and the parasite load

Secretory IgA level in schistosomal colonic polyposis

This study was carried out on 20 patients with early intestinal schistosomiasis and 20 cases of schistosomal intestinal polyposis. A group of 10 healthy subjects was also included as control. This work aimed at evaluating colonic tissue secretory IgA levels for patients in both groups. Serum IgA level in schistosomal patients showed no significant difference compared with the control group. Also, no significant difference in secretory IgA could be obtained in the intestinal schistosomal patients compared with the control subjects. On the other hand, polyploid tissue contained higher levels of secretory IgA than normal mucosal tissue. The excess secretory IgA in polyploid tissue support the suggestion that it can mediate cellular immune response and share in the formation of antigen antibody complexes. Secretory IgA accordingly may play a role in the pathogenesis of schistosomal colonic polyposis

Hydatidosis in Alexandria

Hydatid disease is becoming more frequently discovered among citizens of Alexandria. The most striking clinical feature is its nature of presentation; a multiple organ involvement with multicystic affection. Selected cases from patients records of the last year were presented in this work

Human basophil degranulation test and total IgE in schistosoma haematobium patients before and after chemotherapy with oltipraz and metrifonate

Thirty male adult patients infected with schistosomiasis were included in the study. They were arranged into two equal groups. The first received Metrifonate while the second was given Oltipraz. A third group of 15 healthy individuals was also included as control. The calculated parameters were : total and differential leucocytic count, urine analysis, total IgE level and human basophil degranulation test [HBDT]. The results showed a non significant change in the total leucocytic count except after treatment with oltipraz where a significant decrease was noticed. Measurements of the percent of eosinophilia and basophil degranulation and total IgE level demonstrated, significant increase in patients of both groups. Treatment with Metrifonate and Oltipraz induced significant decrease in both eosinophil percentage and basophil degranulation percentage. Oltipraz demonstrated a significant decrease in IgE level while Metrifonate did not. The observed cure rate was 86% with Metrifonate and 93% with Oltipraz

Immunofluorescent study of the spleen in hepatic schistosomiasis

Estimation of immunoglobulins in splenic tissue homogenates [using Tri-partigen immunodiffusion plates] and direct immunofluorescent examination of spleen sections were performed for specimens obtained from 22 cases of schistosomal hepatic fibrosis and 6 control spleens after accidental traumatic rupture. The splenic immunoglobulins G and M were significantly higher in the schistosomal cases, while IgA was significantly lower than that of the controls. Immunofluorescent examination revealed intense fluorescence all over the splenic tissue in almost all schistosomal cases. Our study confirmed the immunological role of the spleen in the pathogenesis of schistosomal hepatic fibrosis

prevalence of parasitic infections in basin twelve, Alexandria

The prevalence of schistomiasis and intestinal parasitic infections has been estimated among 498 individuals living in Basin Twelve, a village situated 15 miles east to Alexandria. Results showed that nearly all persons examined had parasitic infections. About one third of the cases harboured three parasites, more than 20% had four parasites while 14% had more than four parasites. The over-all prevalence rate of S. mansoni infection was 60%, S. haematobium 50%, Ascaris lumbricoides 58%, Ancylostoma duodenale 37%, Strongyloides stercoralis 2% and Hymenolepis nana 7%