Immunohistochemical study of epithelial-myofibroblast interaction in Barrett metaplasia.

Context: Sub-epithelial myofibroblasts are known to influence the biology (proliferation, differentiation and apoptosis) of overlying epithelia. In the intestine, myofibroblasts have been demonstrated to be essential for epithelial differentiation. It is therefore hypothesized that myofibroblasts may also be involved in intestinal metaplasia that is characteristic of Barrett esophagus. Objective: This study endeavors to immunohistologically evaluate epithelial-myofibroblast interaction in Barrett's metaplasia. Materials and Methods: Nineteen archival esophageal endoscopic biopsies of Barrett's metaplasia were immune-phenotyped for the following epithelial and myofibroblast antigens - cytokeratins (CK) 8, 13, 18, CDX2 (Caudal type homeobox 2), a-smooth muscle actin (SMA). Results: α-SMA immunostaining revealed close association between myofibroblasts and metaplastic Barrett's epithelium but not with normal esophageal squamous epithelium. Myofibroblasts were more prominent in dysplastic than in non-dysplastic Barrett metaplasia. CDX2 and CK 8/18, indicators of intestinal differentiation were expressed in Barrett metaplasia but not normal esophageal squamous epithelium, while the reverse was the case for CK 13, which only stained normal esophageal squamous epithelium. Conclusion: Although their precise role is yet to be clearly defined, sub-epithelial myofibroblasts are very likely involved in the pathogenesis of Barrett's metaplasia.

Thyroid Cancers in Nodular Goiters in Kano; Nigeria

Cancer is an occasional incidental finding in nodular goiter; but there has been no formal study on this disease in our locality. To determine the occurrence of histologically diagnosed malignancy in patients who presentwith nodular goiters. This is a 7- year (2000-2006) retrospective study of all histologically diagnosed malignancies within nodular goiters atAminuKanoTeachingHospital;Kano There were 160 multinodular goiters during the study period; out of which 24 (15.0) had histologically diagnosed cancer; and 1 out of the thirteen patients with solitary thyroid nodule (7.6) had carcinoma. The ages of the patients with carcinoma ranged from 16 to 65 years; with amean age of 38.8 years. Eighteen (72) were females; and 7(28) were males. Six out of the 25 cases of carcinoma were detected preoperatively by fine needle aspiration cytology. Well differentiated follicular carcinoma was the predominant histological type in 13(52) cases; followed by papillary in 10(40); medullary carcinoma in 1(4) and anaplastic carcinoma in 1(4) patient. One-seventh of nodular goiters in our center harbouredmalignancy; and follicular carcinomawas the prevalent histological type. This is consistent with the findings elsewhere in endemic goitrous regions. Ultrasound guided fine needle aspirationwould improve preoperative diagnosis and guide appropriate surgical management

Cancer in Nigeria: a 10-year analysis of the Kano Cancer registry

Background: Cancer is a major health problem in developed countries and epidemiological evidence shows the emergence of a similar tend in developing countries; particularly in sub-Saharan Africa where HIV/AIDS is predicted to augment the cancer burden. The present study analyses the profile of cancers recorded in the first decade (1995-2004) of establishment of the Kano cancer registry (KCR) a histology/ cytology-based registry in Kano; Nigeria. Methods: Records of cancer cases diagnosed based on histology or cytology and entered into the registry were retrieved and categorized by type/ organ sites affected according to International Classification of Diseases for Oncology.Results: There was a steady rise in frequency of cancer over the period where a total of 1990 cancer cases were recorded comprising of 1001 (50.3) males and 989 (49.7) females. Cancers of the cervix (22.9); Breast (18.9); Ovary (8.2); non-melanoma skin cancer (6.3); and Uterus (6.2) were the most frequent female cancers. In males; cancer of the prostate (16.5); bladder (10.2); non-melanoma skin (9.9); colorectum (9.3) and connective tissue (6.3) were most common.Burkits lymphoma (31.4); other lymphoreticular cancers (23.8) and retinoblastoma (20) predominated in children. Conclusion: The KCR supports existing predictions of an increase in incidence of cancers in developing countries. There is need for establishment of comprehensive cancer control programmes in developing countries for the common cancers of the cervix; breast; prostate; bladder; skin and colorectum which are amenable to prevention; early detection and cure

Radical Cystectomy for Locally Advanced Carcinoma of the Bladder in Kano; Nigeria

Objective: Bladder cancer is the second most common genito-urinary malignancy worldwide. The objective of this study was to assess the benefit of radical cystectomy on locally advanced bladder carcinoma in terms of improved quality of life and survival in our environment. Patients and Methods : The records of 58 patients with bladder carcinoma managed at Aminu Kano Teaching Hospital over a 5-year period (May 2000 to April 2005) were reviewed and analysed. Excluded were 28 patients with distant metastatic disease discovered during clinical investigation. Results: Thirty patients (25 males and 5 females) with a mean age of 50.5 years and variable symptoms underwent radical cystectomy for locally advanced carcinoma of the bladder. Urinary drainage was achieved by orthotopic ileal neobladder in 15 patients (50); continent cutaneous reservoir in 11 patients (36.7) and non-continent drainage in 4 patients (13.3). A 40survival was achieved at 6-60 months. Conclusion : Radical cystectomy is a worthwhile procedure in locally advanced carcinoma of the bladder and cure may be achieved in selected patients

Effect of environmental iodine deficiency (EID) on foetal growth in Nigeria.

BACKGROUND & OBJECTIVES: There is scarcity of information on impact of iodine deficiency on growth and development of newborns, both pre-term and term babies. The present study was carried out to see the impact of iodine deficiency (ID) on the intrauterine foetal growth and development in terms of birth weight (BW) in an African population living in an iodine deficient zone. METHODS: The maternal and cord serum thyroid parameters at term delivery (38-40 wk of gestation) were measured and correlated with the birth weights of the corresponding newborns, and the results compared between those assessed in an ID zone (Jengere region of Bassa district, Plateau State, Nigeria) and with that of non ID (Control) zone, Jos, the State capital. RESULTS: The level of maternal and neonatal thyroid function were significantly reduced in the group with low birth weights (<2.5 kg) as compared to the level seen in normal birth weights category in both control (Jos) and ID (Jengere) regions. Both in non ID and ID regions the maternal serum thyroxine (T4), thyroxine binding globulin (TBG) and free thyroxine index (FT4I) were positively correlated (P<0.005) with BW of term babies while thyroid stimulating hormone (TSH) (P<0.005) and thyroxine binding capacity (TBK) (P<0.05) showed negative correlation. Maternal T3 and T3/T4 ratio did not show any correlation with BW in Jos, while in the ID region of Bassa the BW showed a positive correlation (P<0.005) with the maternal serum T3 and T3/T4 ratio. Cord serum analysis of the term babies revealed that the BW was positively correlated with its T4, triiodothyronine (T3), TBG, FT4I and T4/TBG ratio (Jos only) (P<0.005) in both ID region of Bassa and non ID control zone of Jos. Cord serum TSH and TBK showed negative correlation (P<0.005) with BW. Thyrotrophin releasing hormone (TRH) stimulation test revealed that mothers with small for date (SFD) babies at term were more hypothyroid compared to the level of thyroid function seen in the women delivering normal babies. INTERPRETATION & CONCLUSION: Maternal thyroid hormone plays a significant role in the intrauterine foetal growth and development, and the smaller babies and their corresponding mothers, in an ID affected area are functionally sub-thyroid in greater proportion due to prevailing long standing environmental iodine deficiency (EID). Maternal T3 is an important factor in the defence of foetus in ID regions.

Hormonal abnormalities in azoospermic men in Kano, Northern Nigeria.

BACKGROUND & OBJECTIVES: We undertook this study to observe the pattern of hormonal abnormalities and testicular pathology in azoospermic male Africans in Kano, Northern Nigeria. METHODS: Eighty consecutive azoospermic infertile males attending fertility clinic in Aminu Kano Teaching Hospital, Kano, were selected for the study. Their semen were analyzed three times at eight weeks interval, after which serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and prolactin were assayed in serum samples, and histological examination of testicular biopsies done. RESULTS: Of the 80 subjects studied, 32 (40%) had abnormal hormonal levels, 48 (60%) had normal hormonal values and 36 (45%) had testicular pathology. INTERPRETATION & CONCLUSION: Endocrinopathies are common in azoospermia. Their contribution to male factor infertility cannot be overemphasized. The main reason for the endocrinopathies is not known but environmental factors, endocrine disruptors and genetic polymorphism have been suggested to be contributory.