The complementary role of insulin-like growth factor II mRNA-binding protein 3 (IMP3) in diagnosis of Hodgkin's lymphoma.

BACKGROUND: Hodgkin's Lymphoma (HL) is a peculiar subtype of lymphoid malignancies. The etiology of HL is still unknown. Insulin-like growth factor II mRNA-binding Protein 3 (IMP3) is a member of IMP family. In HL, IMP3 is expressed in the cytoplasmic compartment of the tumor cells (in both HRS cells & LP cells) against completely negative background of non-tumor cells except for residual germinal centers. MATERIALS & METHODS: Of 51 cases of Hodgkin's lymphoma (HL) referred to surgical pathology laboratory at oncology center, Mansoura University (OCMU), Egypt. All cases were stained for CD20, CD3, CD15, CD30 and IMP3. Regarding IMP3 antibody, The slides were then incubated with the Anti-IMP3, mouse monoclonal antibody (1:200, clone sc-365640, concentrated, California) that was used as primary antibody for IMP3 detection for 1 hour at room temperature, followed by incubation with the secondary antibody, poly HRP (horseradish peroxidase), conjugate for mouse/rabbit, for 20 minutes. RESULTS: IMP3 showed cytoplasmic immunoreactivity in 43 (83%) cases while 8 cases were negative. The sensitivity of combined CD30 & CD15, combined CD30 & IMP3, combined CD15 & IMP3 were 96%, 98% and 94% respectively. On the other hand, the sensitivity of CD30, CD15 and IMP3 alone were 92.2%, 68.6% and 84.3% respectively. All 23 studied cases of NSCHL, all the 17 cases of MCCHL, 7 out of 8 cases of LRCHL and the only case of LDCHL had predominant T-lymphocytes in their background. On the other hand, the 2 cases of NLPHL and only case of LRCHL had predominant B-lymphocytes in their background. CONCLUSION: IMP3 is a novel marker that is expressed in large proportion of both types of HL against nearly negative background. It has no significant increase in sensitivity in detection of the tumor cells when combined with CD30. There are insignificant relations between IMP3 expression and different clinicopathological parameters. Further studies about IMP3 on a large scale of cases are required to confirm its mechanistic role in generation of HL.

Rifampicin for Idiopathic Granulomatous Lobular Mastitis: A Promising Alternative for Treatment.

BACKGROUND: Idiopathic granulomatous lobular mastitis (IGLM) is a chronic, non-caseating, inflammatory breast disease of obscure aetiology characterized by multiple masses, abscesses and sinus formation. There is no standard treatment to date, but surgical procedures and systemic corticosteroids are effective in its treatment despite high recurrence rates. PATIENTS AND METHODS: This prospective study including 30 patients with IGLM between November 2012 and May 2016 aimed to investigate the possibility of administration of Rifampicin (300 mg twice daily for a period of 6-9 months) as an alternative therapy for both surgery and corticosteroids in patients with IGLM. All patients were diagnosed by core needle biopsy. RESULTS: All patients were of reproductive age and had a history of breast feeding, which is the most important predisposing factor for IGLM. The mean age was 31.6 ± 5.8 years (range 23-42 years). Eighteen patients (60%) were treated by Rifampicin for 6 months, whereas 12 patients (40%) were treated for 9 months. Twelve months after the beginning of therapy, all patients showed complete clinical and ultrasonographic responses. No serious side effects were reported to stop the treatment course. The median follow-up after finishing the course of treatment was 15.5 months (average 3-35 months) with no episodes of disease relapse. CONCLUSION: Rifampicin is effective in the treatment of patients with IGLM with complete clinical and ultrasonographic response after 6-9 months and could be used as a solo medical therapy alternative to both surgery and corticosteroids.

No association between BRCA1 immunohistochemical expression and tumor grade, stage or overall survival in platinum-treated epithelial ovarian cancer patients.

BACKGROUND: The aim of this work is to assess the frequency of BRCA1 protein immunohistochemical (IHC) expression in epithelial ovarian cancer (EOC) and to evaluate the association of BRCA1 expression with clinical and pathological characteristics and the overall survival (OS) of patients treated with postoperative platinum- based chemotherapeutic agents. MATERIALS AND METHODS: This retrospective study was conducted on 35 cases of epithelial ovarian cancer selected from the files of the Pathology Department, Faculty of Medicine, Mansoura University, Egypt. Immunohistochemistry (IHC) was performed for BRCA1 gene protein. BRCA1 expression was compared to patient's age, tumor histology, grade, stage and OS time. Statistical analysis was carried out with the SPSS version 16.0 to assess significant associations. RESULTS: BRCA1 nuclear expression was detected in 40% of EOC, in which a mild increase in the percentage of positive cases was observed with serous histology, stage IV, and grade 3 carcinomas. There was a significant statistical difference in BRCA1 expression with regard to histological subtypes of EOC (p=0.048), but not grade or stage. Mean OS and survival rate were slightly better for BRCA1 expressing group, but there was no statistically significant difference (p=0.528). CONCLUSIONS: No association between BRCA1 immunohistochemical expression and tumor grade, stage or overall survival was noted in platinum-treated epithelial ovarian cancer patients.

Diagnostic role of glypican 3 and CD34 for differentiating hepatocellular carcinoma from nonmalignant hepatocellular lesions.

Well-differentiated hepatocellular carcinoma (HCC) may be difficult to distinguish from a benign lesion. Glypican 3 (GPC-3) is an oncofetal protein, which has been demonstrated to be up-regulated in HCC. The aim of this study is to evaluate the diagnostic role of combined GPC-3 and CD34 immunoassaying in the distinction between HCC and benign hepatic mimickers. This study was performed on 100 cases of formalin-fixed, paraffin-embedded cases of hepatic focal lesions obtained from the files of pathology laboratory of our university from 2009 to 2012. The following groups were studied: group A (n = 60) (hepatocellular malignant lesions) and group B (n = 40) (Hepatocellular nonmalignant lesions). All cases were stained with GPC-3 and CD34. Sensitivity, specificity, and positive and negative predictive values were calculated for both antibodies. Glypican 3 and complete CD34 staining pattern expression in group A was significantly higher than in group B. The results of costaining showed that, in HCCs, almost all the GPC-3-positive cases had a complete CD34 staining pattern, whereas in the 40 hepatocellular nonmalignant lesions, none stained up with the 2 markers. Therefore, although the sensitivity declined (82%), the specificity and positive predictive value (PPV) of costaining reached 100% and were greater than that observed for single staining with GPC-3 (specificity, 92.5%; PPV, 94.3%) or CD34 (specificity, 97.5%; PPV, 98.3%). Our data demonstrate that GPC-3 and CD34 costaining has better diagnostic value for differentiating HCC from nonmalignant hepatocellular lesions than does single staining.

In vivo effect of single oral dose of artemether against early juvenile stages of Schistosoma mansoni Egyptian strain.

The current treatment and control of schistosomiasis, rely on a single drug, praziquantel, although, it has minor activity against juvenile stages of the parasite. Studies have shown that artemether (ART) exhibits effects against juveniles of Schistosoma mansoni Liberian and Puerto Rican strains, Schistosoma japonicum and Schistosoma haematobium. Aiming to assess the in vivo activity of single oral dose of ART against early juvenile stages of S. mansoni Egyptian strain, this study was established. Mice were treated with ART (400 mg/kg) at two time points evenly spaced over the period of larval development (7 and 21 days post-infection; pi), and a third treatment point (day 49 pi) was included to elucidate when susceptibility decreases. Administration of ART on day 7 pi reduced the total worm burden by 85.94%. The greatest reductions were seen when treatment was given on day 21 pi, with total and female worm burden reductions of 91.52% and 90.57%, respectively, and cessation of oviposition. Similar dose given on day 49 pi reduced total worm burden by 55.17% and female worm burden by 66.51%. Moreover, it induced significant reduction in the tissue egg load and significant alterations in the oogram pattern with decreased immature eggs and increased dead eggs. Antipathological activities were evident in significant reductions in granulomata count and diameter. In conclusion, ART exhibits major in vivo schistosomicidal effects against the early larval migratory stages of S. mansoni Egyptian strain, mainly the 21-day old schistosomula, hence preventing disease progression and morbidity.

First insight into the effect of single oral dose therapy with artemisinin-naphthoquine phosphate combination in a mouse model of Schistosoma mansoni infection.

Praziquantel is the current drug of choice against schistosomiasis. The dependency on praziquantel exclusively is problematic, given the spread of the disease and the threat of drug resistance. This study investigates an alternative antischistosomal drug using the compound naphthoquine phosphate tablet, which is a novel single oral dose antimalarial drug, containing a combination of naphthoquine phosphate and artemisinin. In the present study, the therapeutic efficacies of different artemisinin-naphthoquine phosphate combination-dosing protocols were evaluated in experimentally infected mice harbouring juvenile or adult stages of Schistosoma mansoni (Egyptian strain). The study shows that the oral administration of artemisinin-naphthoquine phosphate combination in a single dose of 400 mg/kg on day 7 p.i. resulted in a significant worm burden reduction of 95.07%. When used at a dose of 600 mg/kg on day 21 p.i., all female worms were killed before depositing eggs, resulting in complete absence of eggs in hepatic and intestinal tissues. The same dose given on day 42 p.i. reduced total and female worm burdens by 93.36% and 94.17%, respectively. In addition, artemisinin-naphthoquine phosphate combination induced significant reductions of 80.18% and 76.73% in the hepatic and intestinal tissue egg loads, respectively. Artemisinin-naphthoquine phosphate combination also induced significant alterations in the oogram pattern with elevated levels of dead eggs. Antipathological activities were evident in the amelioration of hepatic granulomata. Our findings hold promise for the development of a novel antischistosomal drug using an artemisinin-naphthoquine phosphate combination. Further in vitro and in vivo studies should be launched to elucidate the possible mechanism/s of action and to study the effect of artemisinin-naphthoquine phosphate combination on other human schistosomes.

Role of L-thyroxin in counteracting rotenone induced neurotoxicity in rats.

A key feature of Parkinson's disease is the dopaminergic neuronal cell loss in the substantia nigra pars compacta. Many triggering pathways have been incriminated in the pathogenesis of this disease including inflammation, oxidative stress, excitotoxicity and apoptosis. Thyroid hormone is an essential agent for the growth and maturation of neurons; moreover, it has variable mechanisms for neuroprotection. So, we tested the efficacy of (L)-thyroxin as a neuroprotectant in rotenone model of Parkinson's disease in rats. Thirty Sprague Dawley rats aged 3 months were divided into 3 equal groups. The first received daily intraperitoneal injections of 0.5% carboxymethyl cellulose (CMC) 3 mL/Kg. The second group received rotenone suspended in 0.5% CMC intraperitoneally at a dose of 3 mg/kg, daily. The third group received the same rotenone regimen subcutaneous l-thyroxine at a dose of 7.5 µg daily. All animals were evaluated regarding locomotor disturbance through blinded investigator who monitored akinesia, catalepsy, tremors and performance in open field test. After 35 days the animals were sacrificed and their brains were immunostained against anti-tyrosine hydroxylase and iba-1. Photomicrographs for coronal sections of the substantia nigra and striatum were taken and analyzed using image J software to evaluate cell count in SNpc and striatal fibers density and number of microglia in the nigrostriatal system. The results were then analyzed statistically. Results showed selective protective effects of thyroxin against rotenone induced neurotoxicity in striatum, however, failed to exert similar protection on SN. Moreover, microglial elevated number in nigrostriatal system that was induced by rotenone injections was diminished selectively in striatum only in the l-thyroxin treated group. One of the possible mechanisms deduced from this work was the selective regulation of microglia in striatal tissues. Thus, this study provides an insight into thyroxin neuroprotection warranting further investigation as therapeutic option for Parkinson's disease patients.

Colchicine protects dopaminergic neurons in a rat model of Parkinson's disease.

A key feature of Parkinson's disease is the dopaminergic neuronal cell loss in the substantia nigra pars compacta. Besides inflammation, oxidative stress and apoptosis, a recent hypothesis suggested that degeneration of dopaminergic neurons occurs secondary to abnormal mitosis in these 'postmitotic neurons', ending up in apoptosis. Hence, recent therapies tried to prevent this mitotic cycle in dopaminergic neurons. However, most of the advocated therapies e.g., siRNA-induced silencing of cell cycle regulators, seems far from clinical application. In consequence, the use of anti-mitotic drugs could be a more practical alternative. Colchicine is one clinically approved drug that beyond its anti-mitotic effects has anti-inflammatory, anti-oxidant and anti-apoptotic properties. Moreover, clinical surveys proved that patients receiving colchicine for treating musculoskeletal disorders have lower incidence of Parkinson's disease. In addition, the difficult penetration of colchicines to the blood brain barrier disappears in parkinsonian patients due to depression of the p-glycoprotein efflux system. Based on these clinical data we explored the neuroprotective effects of colchicine in the rat rotenone model of Parkinson's disease. Thirty Sprague Dawley rats aged 3 months were divided into 3 equal groups. The first group received daily intraperitoneal injections of 0.5% carboxymethyl cellulose 3 mL/kg. The second group received rotenone suspended in 0.5% carboxymethyl cellulose intraperitoneally at a dose of 3 mg/kg, daily. The third group received the same rotenone regimen plus daily oral colchicine at a dose of 20 µg/kg. All animals were evaluated regarding locomotor disturbance through a blinded investigator who monitored akinesia, tremors and performance on grid test. After 35 and 70 days the animals were sacrificed and their brains were immunostained against anti-tyrosine hydroxylase. Results showed protective effects of colchicine against rotenone induced neurotoxicity as evident by behavioral tests and immunostaining analysis. Thus, this study provides, for the first time, experimental evidence that colchicine protects against the neurotoxic effects of rotenone on dopaminergic neurons, warranting further investigation as a therapeutic option for Parkinson's disease patients.

Frequency of central nervous system tumors in delta region, Egypt.

UNLABELLED: INTRODUCTION AND AIM OF WORK: Central nervous system (CNS) tumors represent a major public health problem, and their epidemiological data in Egypt have been rather incomplete except for some regional reports. There are no available frequency-based data on CNS tumors in our locality. The objective of this study was to estimate the frequency of CNS tumors in east delta region, Egypt. MATERIALS AND METHODS: The data were collected during the 8-year period from January 1999 to December 2007 from Pathology Department, Mansoura University, and other referred pathology labs. Examination of HandE stained sections from retrieved paraffin blocks were done in all cases for histopathologic categorization of C.N.S. tumors. Immunohistochemical studies were applied to confirm final histopathologic diagnosis in problematic cases. RESULTS: Intracranial tumors represented 86.7% of cases in comparison to only 13.3% for spinal tumors. Gliomas were the CNS tumors of the highest frequency (35.2%), followed by meningioma (25.6%), pituitary adenoma (11.6%) and nerve sheath tumors (6.6%). 10.25% of tumors were of children <15 years. CONCLUSION: This study provides the largest series of the relative frequency of CNS tumors in Delta region in Egypt till now and may help to give insight into the epidemiology of CNS tumors in our locality.