ž˙'D.D'J' The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 261- 270
Endothelial Progenitor Cells in Peripheral Blood of Cardiac
Catheterization Personnel
Soheir Korraa1, Tawfik M.S.1, Mohamed Maher 2 and Amr Zaher 3
1. Radiation Health research department, National center for radiation research and technology
(NCRRT). 2. Zoology department, Science College, Suez Canal University. 3. National Heart
Institute, Imbaba.

Abstract
Background:
The aim of the present study was to evaluate the rejuvenation capacity among cardiac
catheterization technicians occupationally exposed to ionizing radiation.
Subjects and methods: The individual annual collective dose information was measured by
thermoluminscent personal dosimeters (TLD) for those technicians and found to be ranging between
2.16 and 8.44 mSv/y. Venous blood samples were obtained from 30 cardiac catheterization
technicians exposed to X-ray during fluoroscopy procedures at the National Heart Institute in
Embaba. The control group involved 25 persons not exposed to ionizing radiation and not working in
hospitals in addition to 20 persons not exposed to ionizing radiation and working in hospitals. Blood
samples were assayed for total and differential blood counts, micronucleus formation (FMN) plasma
stromal derived growth factor-1 (SDF-1 ) and cell phenotype of circulating endothelial progenitor
cells (EPCs), whose surface markers were identified as the CD34, CD133 and kinase domain
receptors (KDR).
Results: SDF-1 (2650± 270 vs. 2170 ± 430 pg/ml) and FMN (19.9 ± 5.5 vs. 2.8 ± 1.4/1000 cells)
were significantly higher among cardiac catheterization staff compared to those of the controls
respectively. Similarly, EPCs: CD34 (53 ± 3.9 vs. 48 ± 8.5/105 mononuclear cells), CD133 (62.4 ±
4.8 vs. 54.2 ± 10.6 /105 mononuclear cells) KDR (52.7 ± 10.6 vs.43.5± 8.2 /105 mononuclear cells)
were also significantly higher among cardiac catheterization staff compared to the values of controls
respectively. Smoking seemed to have a positive effect on the FMN and SDF-1 but had a negative
effect on EPCs. It was found that among cardiac catheterization staff, the numbers of circulating
progenitor cells had increased and accordingly there was an increased capacity for tissue repair.
Conclusion: In conclusion, the present work shows that occupational exposure to radiation, well
within permissible levels, leaves a genetic mark on the somatic DNA of the cardiac catheterization
technician. On the other hand, exposure of workers to ionizing radiation stimulates regenerative
processes as indicated by the increase in EPCs numbers and SDF-1 levels. This regenerative process
is decreased by smoking as evidenced by increased levels of SDF-1 and decreased numbers of EPCs.
The technicians who work in cardiac catheterization laboratories should therefore carefully follow
radiation protection procedures and should minimize radiation exposure to avoid possible genotoxic
effects.
Key words: Cardiac catheterization personnel, Ionizing radiation, Smoking, Endothelial progenitor
cells, Stromal Derived Factor-1 .

Introduction


The advent of complex and prolonged
(7, 8) and in various occupationally-exposed
coronary interventional procedures has
groups (9-13).
increased levels of radiation exposure among
Atherosclerosis is the most common
cardiac catheterization working staff (1, 2), who
pathological process that leads to coronary
due to close contact with patients, have the
heart disease and stroke. It is a disease of large
highest potential risk of receiving a long-term
and medium-sized arteries that is characterized
exposure to low levels of ionizing radiation
by the formation of atherosclerotic plaques
that greatly increase the risk of health hazards
consisting of necrotic cores, calcified regions,
(3, 4). Although a causative link has long been
accumulated modified lipids, and inflamed
established between exposure to ionizing
smooth muscle cells (SMCs), endothelial cells
radiation and the risk of mortality from many
(ECs), leukocytes, and foam cells (14). Though
forms of cancer (5), recently there is emerging
previously initiation of atherosclerosis was
evidence of excess risk of cardiovascular
attributed mainly to lipid accumulation within
disease at much lower radiation doses (6) and
the arterial walls, it is now widely accepted
occurring a long time after radiation exposure
that inflammation plays a vital role in the
261
DOI: 10.12816/0005573


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ž˙'D.D'J' The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 271-279

Apoptosis, Cytogenetic and Endothelial Progenitor Cells in the Peripheral
Blood of Industrial Radiographers
Tawfik M.S.*, Mona Yousri** and Soheir Korraa*
*Department of Health Radiation Research, National Center for Radiation Research and Technology
­ Atomic Energy Authority of Egypt
**Department of Clinical Pathology ­ Faculty of Medicine ­ Al Azhar University.
Correspondence: mstewfik@yahoo.com


Abstract


Background: Radioactive sources and fixed or mobile X-ray equipment are used for both process
and quality control in the metallurgical and fertilizer industries. Workers in the nuclear industry are a
suitable sector of the populace for the direct estimation of radiation effects at low doses as they are
typically monitored and restricted to effective doses of 100 mSv every 5 years. A dose-related
increased mortality from circulatory diseases has been observed in some studies of nuclear industry
workers, but it is unclear whether this reflects a real effect of radiation exposure or a spurious one.
The aim of the present study was to detect the circulating endothelial progenitor cells (EPCs) in the
peripheral blood and the frequency of micronuclei (FMN) among industrial radiographers
occupationally exposed to ionizing radiation at the Steamer's Welding Company and EL Nasr
Company for the manufacture of Fertilizers and Chemicals in Suez and Talkha, Egypt.
Material and Methods: Venous blood samples were obtained from 30 industrial radiographers
exposed to x-rays during industrial procedures vs. 20 persons not exposed to ionizing radiation as
control subjects. Blood samples were assayed for total and differential blood counts and cell
phenotype of circulating EPCs, whose surface markers were identified as CD34, CD133 and kinase
domain receptor (KDR), frequency of chromosomal aberrations (FCA), apoptosis percentage in
circulating lymphocytes together with plasma stromal cell derived factor-1 (SDF-1) and vascular
endothelial growth factor (VEGF).
Results: The results of this study revealed a significant increase in FCA with respect to total number
of dicentrics (0.09 ± 0.03 vs. 0.0005 ± 0.0001) and rings (0.01 ± 0.0012 vs. 0) together with apoptosis
percentage (7.3 ± 2.8 % vs. 2.4 ± 1.5 %) among industrial radiographers compared to control subjects
respectively, indicating radiation exposure among such workers. Also a significant increase was
observed in plasma SDF-1 (2750 ± 370 vs. 2270 ± 430 pg/ml), VEGF (157.9 ± 16.9 vs. 137.5 ± 12.6
pg/ml) among industrial radiographers compared to control subjects. Percentage of circulating
mononuclear cells expressing CD34 (53 ± 3.9 vs. 54.2 ± 10.6/ 105 mononuclear cells), CD133 (82.4 ±
4.8 vs. 54.2 ± 10.6/ 105 mononuclear cells) and KDR (48.7 ± 12.5 vs. 43.5 ± 8.2/ 105 mononuclear
cells) was significantly higher among industrial radiographers compared to control subjects.
Conclusion: It is concluded that the industrial radiographers have increased numbers of circulating
EPCs and increased levels of SDF-1 and VEGF, which denotes an increased capacity for tissue repair.
Keywords: Endothelial progenitor cells, apoptosis, stromal derived factor-1, Industrial
Radiographers, Ionizing radiation.

Introduction


Industrial radiography is the process
year (3, 4). Although a causative link has long
of using either gamma-emitting radionuclide
been established between exposure to ionizing
sources or X-ray machines to examine the
radiation and the risk of mortality from many
safety of industrial materials. Industrial
forms of cancer (5), there has been emerging
radiographers are among the radiation workers
evidence of excess risk of cardiovascular
who
receive
the
highest
individual
disease at much lower radiation doses (6) that
occupational radiation doses (1, 2). Those
occur a long time after radiation exposure (7, 8)
workers who are at risk for repeated radiation
and in various occupationally-exposed groups
exposure, are typically monitored and
(9-11), although not in all (12).
restricted to effective doses of 100 mSv every

5 years (i.e., 20 mSv per year), with a
Atherosclerosis is the most common
maximum of 50 mSv allowed in any given
pathological process that leads to coronary

heart disease and stroke. It is a disease of large
271
DOI: 10.12816/0005574


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c:\work\Jor\vol56_3 The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 280-288

Occult Hepatitis C Virus Infection in Haemodialysis Unit: A Single-center Experience
Abdel Hamid A. Serwah1, Waleed S. Mohamed1, Mohamed Serwah1, Awateif Edreis2, Ahmad El
Zaydi3
Internal Medicine Department, College of Medicine, Taif University, KSA, 1 Tropical medicine
Department, College of Medicine, Taif University, KSA, 2 and Consultant of Nephrology, KAASH,
KSA3
Author of Correspondence: Abdelhamid Serwah. Internal Medicine Department, College of Medicine,
TaifUniversity.E-mail: abdelhamidserwah@yahoo.com. Mobile: 00966/557849852

Abstract
Background & Aims:
Detection of hepatitis C virus RNA in peripheral blood mononuclear
cells (PBMC) and/or hepatocytes in the absence of HCV RNA in serum, designated as `occult HCV
infection', has been a matter of controversy in the recent years. Occult hepatitis C virus (HCV) infection
has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of
occult HCV infection in large cohorts of chronic hemodialysis (CHD) patients in a single heamodialysis
center at Al-Taif, KSA.
Methods: We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was
tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to
test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients.
For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a
control group.
Results: In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in
peripheral blood mononuclear cells (PBMNCs), was found in 13.4 % of the patients; 83 % of these
patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV
infection had spent a significantly longer time on heamodialysis and had significantly higher mean
alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients,
those with occult HCV have less elevated bilirubin, AST and ALT.
Conclusions: The prevalence of occult HCV infection was moderate in our CHD patients, and it did not
appear to be clinically relevant. Further studies in other geographic populations with high HCV
endemicity are required to clarify the significance of occult HCV infection in these patient groups.
Abbreviations
HCV, Hepatitis C Virus ; antibody against HCV; PBMC, peripheral blood mononuclear cells; rRT-PCR,
real time reverse transcriptase polymerase chain reaction; CHD, chronic hemodialysis.

Keywords
Occult hepatitis C; HCV; PBMCs; Peripheral blood mononuclear cells; Prevalence; Hemodialysis; HCV
RNA; Anti-HCV.



Introduction

Hepatitis C virus (HCV) infection is a
infection is still a major problem in
worldwide infection associated with an
heamodialysis (HD) units.5,6 Chronic infection
increased disease burden due to liver cirrhosis
with hepatitis C virus (HCV) is a serious public
and considerable mortality. It is estimated that
health problem associated with increased
about 170 million people, 3% of the world's
morbidity and mortality. It can lead to the
population, are infected with HCV.1,2 So far, six
development
of
cirrhosis
and
even
major genotypes (HCV-1 to HCV-6) have been
hepatocellular carcinoma.7,8 The prevalence of
described, each containing multiple subtypes,3
HCV is high among Saudi patients, 9 and the
with significant differences in their global
prevalence in patients with chronic renal failure
distribution and prevalence.4 Despite screening
maintained on heamodialysis ranged from
of blood products for anti-HCV and
52.5% to 72.3.10-13
implementation of precaution measures, HCV

DOI: 10.12816/0005575


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c:\work\Jor\vol56_4 The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 289-299

Role of Percutaneous Microwave Ablation in Treatment of Hepatocellular
Carcinoma
Ahmed Tharwat Sayed, MSc *, Sahar M El Fiky, MD*,
Osama M Hetta, MD, Osama A Khallaf, MD
Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University


Abstract
Introduction:
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide with
an annual occurrence of one million new cases. An etiologic association between HBV infection and the
development of HCC has been established. Hepatitis C virus is also proving an important predisposing
factor for this malignancy, the use of minimally invasive Percutaneous ablative technique (e.g.
Radiofrequency (RF) and Microwave ablation (MW) has gained great momentum and because of the
drawbacks of RF ablation, several groups have successfully proved the efficacious nature of Microwave
ablation in the treatment of hepatocellular carcinoma.
Aim of the Work: The aim of this work is to highlight the role, the principles and the applications of
percutaneous Microwave Ablation in Hepatocellular carcinoma.
Methods: The studied group included 30 patients (25 men and 5 women) with hepatocellular carcinoma.
All patients underwent microwave ablation for the hepatocellular carcinoma.
Results: The results of the procedures will be assessed as regarding sizeand enhancement of the lesion (s)
on triphasic CT abdomen before the procedure and at the follow up at one month as well as the Alpha
fetoprotein levels.
Conclusion: MWA technique represents a safe, fast and efficacious way to perform hepatic ablation in
patients with HCC. Initial results are encouraging; however, longer follow-up is needed for further
classification of our results.

INTRODUCTION


Hepatocellular carcinoma (HCC) is one of
Recently newly developed antennas and
the most common malignancies worldwide with
techniques are used to increase efficiency of the
an annual occurrence of one million new cases.
microwave ablation as cooled-shaft microwave
An etiologic association between HBV infection
ablation antenna which enabled delivery of
and the development of HCC has been
greater energy without concern about skin
established. Hepatitis C virus is also proving an
burns.(3)
important
predisposing
factor
for
this

malignancy.(1)
THE AIM OF THE WORK

Given that most patients present initially
The aim of this work is to highlight the
with unresectable tumors, the use of minimally
role, the principles and the applications of
invasive Percutaneous ablative technique (e.g.
percutaneous
Microwave
Ablation
in
Radiofrequency (RF) and Microwave ablation
Hepatocellular carcinoma.
(MW) has gained great momentum and because

of the drawbacks of RF ablation, several groups
METHODS
have successfully proved the efficacious nature
This study will be conducted over a
of Microwave ablation in the treatment of
period of 3 years on 30 patients (25 men and 5
hepatocellular carcinoma.(2)
women)
presenting
with
hepatocellular
The main advantages of microwave
carcinomas. All patients should undergo
technology, when compared with existing
triphasic CT scan before the procedure for better
thermo-ablative
technologies,
include
diagnosis and for follow up.
consistently higher intra-tumoral temperatures,
Patients included in our study will have
larger tumor ablation volumes, faster ablation
one of the following criteria: Single nodular
times, and an improved convection profile.(2)
HCC lesions of 8 cm or smaller, Five or fewer
289
DOI: 10.12816/0005576


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Protective and Therapeutic Efficacy of Aloe vera Against Malathion Induced Haematological Changes in rabbits The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 300-310

The Potential Protective and Therapeutic Effects of Aloe Vera Juice
Against Malathion Induced Haematological Changes in Rabbits
Ahmed R. Hassan, Mohamed S. Al-Shinnawy, Dalia N. Ismail and Mohamed A. Shahin
Biological and Geological Sciences Department - Faculty of Education ­ Ain Shams University


Abstract

Background: the potential protective and therapeutic effects of Aloe vera juice against malathion
induced haematological changes in young rabbits (Oryctolagus cuniculus) were evaluated in this study.
Material and methods: Rabbits were allocated into two sets of experiments short (7 days) and
long (21 days) periods. Animals of each set were divided into eight groups; four treated groups and each
treated group had its own control. The animals of the first group were orally dosed with Aloe vera juice
(0.84 ml/kg b. wt.). Rabbits of the second group were orally dosed with malathion (5 mg/kg b. wt.). In
the third group (the protective group) animals were dosed orally with malathion concomitant with Aloe
vera juice. Animals of the fourth group (the therapeutic group) were dosed orally with malathion; for 7
days followed by Aloe vera juice for the same period. All the animals were sacrificed, blood samples
were collected and used to determine the levels of hematological indices: red blood cells (RBCs), white
blood cells (WBCs), haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean
corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC).
Results: rabbits treated with Aloe vera juice (group 1) showed insignificant change in WBCs
count, MCH and MCHC after treatment for both periods. On the other hand, other parameters exhibited
significant (RBCs count) and highly significant (Hb and Hct values) change in rabbits treated for the
short period. The rabbits of the second group (treated with malathion) exhibited a marked increase in
WBCs count, MCV and MCH values, while, the values of RBCs, Haemoglobin and Hct were decreased.
The protective group (Group3) showed that the values of all the tested haematological parameters
(except MCHC, in both periods of treatment, and WBCs count in the short period of treatment) recorded
a significant change in rabbits treated for short (7 days) or long (21 days) periods. A marked recovery in
RBCs count and MCH value was observed in rabbits treated for 21 days. Regarding to group 4 (the
therapeutic group
), it was found that in both terms the rabbits exhibited insignificant changes in the
values of all the tested haematological parameters compared to their corresponding controls, except three
parameters in which they recorded significant (WBCs count, MCHC) and highly significant (Hct)
increase compared to their control values after the long period only. These observations indicated the
ability of Aloe vera juice to improve the deleterious effects caused by malathion administration.
Keywords: Haematology; Aloe vera juice; malathion; rabbits.

INTRODUCTION

assessment of potential dietary exposures
The international use of pesticides has
addresses the residues that may occur as a result
increased food production in associated with
of agricultural uses of malathion. Several studies
population growth in many parts of the world.
have shown that malathion induced various
Many insect-borne diseases have also been
health effects on the haematological parameters
eliminated or controlled by the use of
of experimental animals (5-8).
insecticides. (1) The widespread use of these
Aloe Vera barbedinesis Miller (Aloe vera)
insecticides has led to some serious problems
is a perennial succulent plant belonging to
including toxic residues on grass and toxicity to
Liliaceae family and is called the "silent healer".
non-target organisms such as mammals, birds
Aloe vera contains 75 potentially active

biological constituents. (9) Administration of
and fish. (2,3) Malathion is an organophosphate
Aloe vera extract has been demonstrated to
insecticide which is registered for agricultural
increase the phagocytic and proliferative activity
uses and for landscape maintenance, vector
of the reticuloendothelial system. (10&11) Aloe
control, and structural pest control. (4) This
vera extracts possess immunological effects;
300

DOI: 10.12816/0005577


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Role of PET/CT in Management of Chest Tumors The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 311-320
Diagnostic Accuracy of Multi-detector CT Angiography in Evaluation of Lower
Limb Arterial Diseases: Comparative Study with Conventional Angiography
Kareman M. Ahmed**, Sahar N. Mohamed **, Sherif H. Abo Gamra **, Nivine A. Chalabi,
**Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract
Purpose:
To assess the diagnostic accuracy of multi-detector CT angiography in the assessment of lower
extremity arterial diseases by comparing the results with the standard of reference, conventional
angiography.
Patients and Methods: The studied group included 140 patients with suspected diagnosis of lower limb
arterial disease on the basis of clinical examination or Doppler study with no age or sex predilection
between March 2011 and November 2013. All patients were evaluated with lower limb angiography by
multi-detector computed tomography and conventional angiography. The data obtained was statistically
analysed to assess the accuracy of diagnosis of lower limb arterial diseases by MDCT angiography
compared to conventional angiography that described in terms of count and percentage.
Results: MDCT angiography findings showed 90.3% overall agreement with CA findings regarding the
degree of stenosis while regarding the stenosis length MDCT angiography results showed 87.5% overall
agreement with CA results. The overall sensitivity of MDCT angiography was 94.5%, specificity was
92.2%, and accuracy was 95.3%.
Conclusion: Multi­detector row CT angiography can be used as an alternative to conventional
angiography in the evaluation of aortoiliac and lower extremity arteries in patients with peripheral arterial
disease.
Key words: Computed Tomography (CT), Conventional Angiography (CA), Multi-detector computed
tomography (MDCT).

Introduction
the whole vascular tree in a limited period with a
Initial diagnosis of peripheral arterial disease
decreasing amount of contrast medium (3).
(PAD) typically relies on patient history and
Patients & Methods: The study was done in
physical examination of the patient. If PAD is
Nasr City Health Insurance Hospital and
suspected, a number of tests needed to be
specialized private center in Cairo during the
performed
to
detect
the
presence
of
period from March 2011 till November 2013.
atherosclerosis, as well as to localize areas of
One hundred and forty patients with suspected
stenosis and to estimate the degree of the stenosis
diagnosis of lower limb arterial disease on the
(1). Selecting the appropriate treatment option for
basis of clinical examination or Doppler study
symptomatic patients relies heavily upon
were included in this study with no age or sex
accurate visualization of the peripheral vascular
predilections. Thirty patients were excluded from
anatomy. While conventional angiography (CA)
the study population because of allergic reactions
is considered as the gold standard for imaging of
to contrast materials, renal impairment or some
peripheral vessels, its invasive nature and
patients had done CT angiography without
inherent risks of vascular complications limits
complementary CA. The study was performed
use. Therefore, there remains a significant need
after approval of the Ethical Committee of
for an accurate non-invasive imaging method in
Scientific Research, Faculty of Medicine, Ain
patients with peripheral arterial diseases (2).
Shams University and after taking consent from
Computed
tomography
angiography
is
all patients. All patients were subjected to full
increasingly attractive due to rapid technical
history taking, clinical examination and
developments. Shorter acquisition times, thinner
laboratory investigation (serum creatinine).
slices,
higher
spatial
resolution,
and
Multi-detector row CT scanning: The study was
improvement
of
multi-detector computed
performed using 16­detector row scanner
tomographic (CT) scanners enable scanning of
(Asteion, Toshiba, Tokyo, Japan). After
obtaining an initial scout image (120 kV, 100
311

DOI: 10.12816/0005578


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STUDY OF SERUM MONOCYTE CHEMOATTRACTANT PROTEIN-1 AS A MARKER IN RHEUMATOID ARTHRITIS The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 321-332
Study of Serum Monocyte Chemoattractant Protein-1AS A Marker in
Rheumatoid Arthritis
Wafaa Mohie El deen Abdel Fatah, Laila Atef Ahmed , Nareman Youniss Mohamed* Mona Abd
El-Raof Abd El-Kader and Fawkia Eissa Zahran**
*Department of medical biochemistry, faculty of medicine for girls Al-Azhar University.**
Department of internal medicine faculty of medicine for girls Al-Azhar University

Abstract: Rheumatoid arthritis (RA) is a chronic, multisystem autoimmune disease which manifests
itself in multiple joints of the body. It is characterized by infiltration of inflammatory cel s such as
monocytes and it is believed to be the result of a faulty immune response.
Chemokines play a major role in selectively recruiting monocytes, neutrophils, and lymphocytes,
as wel as in inducing chemotaxis through the activation of G-protein-coupled receptors. Monocyte
chemoattractant protein-1 (MCP-1/CCL2) is one of the key chemokines that regulates migration and
infiltration of monocytes/macrophages.
Aim of The Work: was to study the role of serum Monocyte chemotactic protein-1 (MCP-1) in
patients with rheumatoid arthritis as a diagnostic and prognostic marker and the possible association with
disease activity.
Subjects and methods: Forty rheumatoid arthritis diseased patients were selected , they were 3
males and 37 females. The patients were categorized into two groups according to activity of the disease
regarding DAS score . Another 20 healthy subjects, 2 males and 18 females, with no history of
rheumatoid disease were recruited as controls .Results: this study showed a highly significant increase in
MCP-1 and ESR in all rheumatoid arthritis patients groups , active rheumatoid arthritis patients group
and inactive rheumatoid arthritis patients group compared to control group.
Correlation study of serum MCP-1 revealed a significant positive correlation between serum MCP-
1 and ESR and DAS score in al patients versus the healthy group and a significant positive correlation
between serum MCP-1 and ESR in the active group. ROC curve analysis was showing the diagnostic
performance of serum MCP-1 in rheumatoid arthritis patients(active and inactive) versus the healthy
control group, at a cut-off level of 52.5 ng/ml., the diagnostic sensitivity, specificity, negative predictive
value and positive predictive value were 98%, 93%, 93% and 98% respectively
Also, it shows the diagnostic performance of serum MCP-1 in discriminating active rheumatoid
arthritis patients from the inactive group, at a cut-off level of 61ng/ml Conclusion: - Serum MCP-1 is one
of the best indicator of clinical arthritic activity in RA patients. It represents a novel, independent
indicator of clinical arthritic activity that also provides a good reflection of effect of treatment in
rheumatoid arthritis patients.
Key words: Rheumatoid arthritis (RA), serum Monocyte chemotactic protein-1 (MCP-1)

Introduction

Rheumatoid arthritis (RA) is an autoimmune
a regulated multi-step process, involving
disease that results in a chronic, systemic
interactions between leukocytes and endothelial
inflammatory disorder that may affect many
cel s, cel ular adhesion molecules. [1]Many data
tissues and organs, but principal y attacks flexible
suggest that the disease involves abnormal B
(synovial) jointsThe inflammatory process is
cel ­T cel interaction, once the abnormal
characterized by infiltration of inflammatory cel s
immune response has become established
into the joints, leading to proliferation of
(which may take several years before any
synoviocytes and destruction of cartilage and
symptoms occur), plasma cel s derived from B
bone. In RA synovial tissue, the infiltrating cel s
lymphocytes produce rheumatoid factors and
such as macrophages, T cel s, B cel s and dendritic
Anti-citrul inated protein antibodies (ACPA) of
cel s play important role in the pathogenesis of
the IgG and IgM classes in large quantities.
RA. Migration of leukocytes into the synovium is
They appear to b of al groups the consent was
321

DOI: 10.12816/0005579


Document Outline


Full Paper (vol.56 paper# 7)


c:\work\Jor\vol56_8 The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 333-344

Effect of Noise and Crowding Stresses on Hypothalamic­Pituitary­Gonadal Axis
and Protective Effect of Sulpiride Drug in Adult Female Albino Rats
Eman G. E. Helal 1*,Noran Ahmed Abou- Aouf1**, Nareman Y. Mohamed 2
and Neama M.Taha3
1Zoology Department, Faculty of Science for Girls Al-Azhar University
2Medical Biochemistry Department , Faculty of Medicine for Girls Al-Azhar University, Egypt,
3Physiology Department, College of Medicine, Umm Al-Qura University KSA.


Abstract
Background:
Noise and crowding are the most stressful factors which cause depressant effects on
human beings, especially females.Therfore this study was aimed at clarifying their effects on
hypothalamus pituitary gonadal axis hormones (luteinizing hormone (LH) and follicle-stimulating
hormone (FSH), estrogen (E2)and progesterone as well as prolactin (PRL)and the possible protective
effect of antidepressant drug;sulpiride.
Material and Methods: Sixty adult female rats were divided into six groups (10/each):
1- Rats served as control, 2- Rats treated with sulpiride drug only, 3- Rats exposed to noise (90db,
3hr. per day) for 45 days, 4- Rats exposed to noise and treated with sulpiride drug, 5- Rats exposed to
crowding and 6- Rats exposed to crowding and treated with sulpiride drug.
Results: Noise and crowding stresses caused a significant decrease of estrogen (E2), progesterone
(P), LH and FSH levels and high significant increase in PRL level. Sulpiride drug ameliorated these
parameters changes except PRL level which showed a high significant level compared to control
group.
Conclusion: it is useful to use antidepressant drug (e.g. sulpiride) with people who are exposing to
noise and crowding stress.
Keywords: Noise, Crowding, Sulpiride drug, hypothalamic­pituitary­gonadal axis FSH, LH, PL
estrogen, and progesterone.

Introduction

The hypothalamic­pituitary­gonadal (HPG)
allopregnanolone has been associated with
axis refers to the effects of the hypothalamus,
impaired fear extinction in rodent models (2).
pituitary gland, and gonads as if these separate

endocrine glands were a single entity acting as
However, Milad et al. (3) investigated fear
a whole. Since the glands often function in
extinction with respect to both progesterone
cooperation, endocrinologists and physiologists
and estrogen levels and found that deficits in
find it more simple and descriptive to refer to
extinction recall seemed to be more highly
them as a single system. The HPG axis controls
associated with estrogen(5).
reproduction, development, and aging. The

hypothalamus produces gonadotropin-releasing
Prolactin (PRL) develops the mammary
hormone (GnRH). The anterior portion of the
glands and stimulates lactation. Recent
pituitary gland produces luteinizing hormone
evidence shows that PRL plays an important
(LH) and follicle-stimulating hormone (FSH),
role in the regulatory mechanism of biological
and the gonads produce estrogen (E2) and
responses to several stressors. The increase in
progesterone(1).
peripheral concentrations of PRL is a typical

response to physiological and psychological
Estrogen (E2) is only one of the hormones
stressors and the response is sometimes used as
in the complex milieu that changes across the
an index of stress intensity (4). The
menstrual cycle; progesterone levels, as well as
physiological meaning of PRL response to
the ratio of estrogen to progesterone, may have
stressors remains to be clarified (5). Many
strong influences on fear and anxiety. For
studies have demonstrated that PRL secretion
example, progesterone has been implicated in
from the anterior pituitary, which is the
neuroimaging studies using emotionally
principal origin of the hormone in circulation,
arousing images (1); additionally, its metabolite
is under regulation by both stimulatory PRL-

releasing factors (PRFs) and inhibitory factors,
333

DOI: 10.12816/0005580


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Compartive study on the effect of Factor V Leiden and Prothrombin gene polymorphism in preeclampsic cases The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 345-354
Comparative Study on the Effect of Factor V Leiden and Prothrombin
Gene Polymorphism in Preeclampsic Cases
Rizk Mohammed EL Baz**, Manal Mohamed Ramadan*, Eman Fayad***, Ali Ali
Shaltot**, andEffat Mahmoud EL Shershaby *
* Faculty of Science, Zoology department at Mansoura University.
** Faculty of Medicine, Genetic department at MansouraUniversity.
*** Faculty of Science, Zoology department at Mansoura University, assistant professor at
Biotechnology department, Faculty of science at Taif University


Abstract:

Objective: To identify polymorphism of Factor V Leiden and Prothrombin gene in women
suffering from preeclampsia.
Study design: From 142 pregnant women we identified 92 women suffering from preeclampsia
and 50 healthy controls with normal pregnancy matched for age and socioeconomic status,
preeclampsic patient classified as mild preeclampsia 42(45.7%) and severe preeclampsia
50(54.3%). Blood samples were tested for DNA polymorphism affecting thrombophilia Factor V
Leiden and Prothrombin gene polymorphism.
Results: Heterozygous AG genotype showed a significant high frequency among preeclampsic
patients (20.7%) compared to controls (4.0%), (OR 6.2, P= 0.006) regarding to Prothrombin gene
but: Factor V Leiden, AG genotype showed (8.7%) of preeclampsic patients which was absent in
any of the controls.
Key words: Factor V Leiden, Prothrombin gene, preeclampsia.

Introduction:


Preeclampsia defined as pregnancy-
science, and informed consent was obtained
induced protein uric hypertension with onset
from all the studygroups.
of clinical symptoms beyond 20 weeks

gestation, it is a serious pregnancy
Study groups:
complication and a leading cause of maternal

mortality and fetal perinatal morbidity .(1,2)
Group I (Patients):
Clinical disease may also be associated with


This group comprised 92 cases
abnormalities of the central nervous system,
selected randomly from those attending
the liver, the kidneys, and intra-vascular
Obstetricsand Gynecology Department at
disseminated coagulation.(3,4,5)
Mansoura University Hospitals, complaining
Factor V Leiden (FVL) and the
of preeclampsia. They were collected
prothrombin gene mutations are the first and
through one year from August 2008. Age of
second most common genetic abnormalities
the patients ranged from 20-28 years (mean
associated with increased risk of deep venous
age 23.91 ± 2.1 years). They were classified
thrombosis.(6)
into mild preeclampsia, 42 cases (45.7%) and
Prothrombin gene mutation is one of the
severe preeclampsia, 50 cases (54.3%).
most common genetic alterations associated

with venous thrombosis .(7) Thrombotic
Group II (control group):
events frequently appear to result from a

This group included 50 healthy
multifactorial process, in which acquired risk
females, with normal pregnancy, matched for
factors, such as surgery, pregnancy, trauma,
age, residency and socioeconomic status.
immobilization, and malignancy, interact

with inherited abnormalities of coagulation.(8)
Methods:


Materials and Methods:
DNA extraction:
This study was reviewed and
The Generation DNA Purification
approved by the Mansoura University of
Capture Column Kit is based on a proprietary

system that uses two reagents, a DNA
345
DOI: 10.12816/0005581


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c:\work\Jor\vol56_10 The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 355-367

Comparative Study on the Effect of C667T and A1298C Polymorphism in
Preeclampsic Cases
Rizk Mohammed EL Baz**, Manal Mohamed Ramadan*, Eman Fayad***, Ali Ali Shaltot**, and
Effat Mahmoud EL Shershaby *
* Faculty of Science, Zoology department at Mansoura University.
** Faculty of Medicine, Genetic department at Mansoura University.
*** Faculty of Science, Zoology department at Mansoura University, assistant professor at
Biotechnology department, Faculty of science at Taif University.

Abstract:

Objective: To identify polymorphism of methylenetetrahydrofolate reductase gene in women
suffering from preeclampsia.
Study design: From 142 pregnant women we identify 92 women suffer from preeclampsia and 50
healthy controls with normal pregnancy matched for age and socioeconomic status, preeclampsic patient
classified as mild preeclampsia 42(45.7%) and severe preeclampsia 50(54.3%). Blood samples were
tested for DNA polymorphism affecting thrombophilia methylenetetrahydrofolate reductase C677T and
A1298C.
Results: Homozygous TT genotype, T allele of C677T polymorphism has a significantly higher
frequency among preeclampsic cases compared to healthy controls (OR=21.7, 1.46, respectively). Thus
TT genotype and T allele may be considered as genetic risk factors for preeclampsic cases. on the other
hand, non significant association in either genotype among preeclampsic cases compared to controls
regarding to A1298C.
Key words: C667T gene, A1298C , preeclampsia.

Introduction:



Preeclampsia defined as pregnancy-induced
Hyperhomocystinemia can induce vascular
protein uric hypertension with onset of clinical
injury, increase platelet consumption, and can
symptoms beyond 20 weeks gestation, It is a
result in thrombosis caused by increased
serious pregnancy complication and a leading
oxidative
stress.
Clinically,
cause of maternal mortality and fetal perinatal
hyperhomocystinemia caused by the C677T and
morbidity.(1,2)
A1298C mutation has been implicated in

premature cardiovascular disease (13), Venous
Clinically, disease may also be associated with
thrombosis .(14) and more recently in adverse
abnormalities of the central nervous system, the
pregnancy
outcome,
especially
liver,
the
kidneys,
and
intra-vascular
preeclampsia.(15,6,16)
disseminated coagulation .(3,4,5)


Material and Methods:-
The
human
methylenetetrahydrofolate
This study was reviewed and approved
reductase [MTHFR] gene, which is located on
by the Mansoura University of science, and
chromosome 1p36, belongs to the proposed
informed consent was obtained from all the
candidate loci for preclampsia .(6)
study groups.
The MTHFR gene is critical in the

metabolism of homocysteine because the
Study groups:
reaction catalyzed by MTHFR is a rate-limiting
Group I (Patients):
step in the folate cycle and can be affected by


This group comprised 92 cases
individual's folate status. .(7,8)
selected randomly from those attending
Polymorphisms have been identified in the
Obstetrics and Gynecology Department at
gene encoding MTHFR.(9,10,11) The two most
Mansoura University Hospitals, complaining of
common variants of the MTHFR gene are
preeclampsia. They were collected through one
located at nucleotides 677 (C677T) and 1298
year from August 2008. Age of the patients
(A1298C) .(9,12)
ranged from 20-28 years (mean age 23.91 ± 2.1

years). They were classified into mild

preeclampsia, 42 cases (45.7%) and severe

preeclampsia, 50 cases (54.3%).
355


Full Paper (vol.56 paper# 10)


Full Paper (vol.56 paper# 11)


c:\work\Jor\vol56_12 The Egyptian Journal of Hospital Medicine (July 2014) Vol. 56, Page 376-383

Ultrasonographic Assessment Predicts Adverse Perinatal Outcomes
Mourad Mohey El-Din El-Said1, Wessam Magdi Abuelgar1, Haitham Abdel Mohsin Sabba1,
Ahmed Ramy1, Sahar Ahmed Nour EL Deen2, and Radwa Rashidy Ali 1.
1Obstetric & Gynecology Department; Faculty of Medicine, Ain Shams University, Cairo,
Egypt.2Pediatric Department; Faculty of Medicine, Ain Shams University, Cairo, Egypt
Correspondence:Radwa Rashidy Ali Msc Obstetric & Gynecology department, Faculty of Medicine, Ain Shams
University, Abbasia, Cairo, Egypt..E-mail: doharasheedy@yahoo.com Tel: 02-01283492979

Abstract

Background:
Objective:The aim of this work was to evaluate accuracy of the ultrasonographic assessment at the first
or the second trimester of gestation as a predictor of adverse outcome in high risk pregnancies.
Patients and methods:A cross sectional study was conducted on 85 consecutive high risk pregnancies
attending the Antenatal Clinic and Medical Genetics Center of Ain Shams University. Nuchal
translucency thickness was obtained for all cases recruited during 1st trimester. Nuchal fold thickness was
obtained for all cases recruited during 2nd trimester.We prospectively evaluated the outcome of each
pregnancy.
Results:The mean age of participants, mean marriage duration, and gestational age were 32.5 ± 6 years,
7.1±3.3 years and 14.5±2.1weeks respectively.Increased NT thickness and NF thickness were present
in5%, and 8.89% respectively.Down syndrome was found in 1.2% of current pregnancy outcome, while,
cystic hygroma was found in 1.2%, cystic hygroma with hydrops was found in 1.2%, skeletal dysplasia
and renal agenesis was found in1.2% missed abortion was found in 3.53%.There is a highly significant
difference between normal outcome pregnancy and abnormal outcome pregnancy regarding mean NF
thickness while no significant differences regarding NT thickness.
Conclusion:The findings of our prospective study demonstrate the feasibility of using NF thickness to
screen for aneuploidies, adverse perinatal outcome in high risk pregnancies.
Keywords:
Nuchal fold thickness, Nuchal translucency, perinatal outcome, high risk pregnancy.

Introduction:


For decades, early pregnancy ultrasound was
The 15-20 weeks of pregnancy is the optimum
used only for the assessment of gestational age,
gestational age for nuchal fold measurement
detection of fetal viability, diagnosis of twins
when the normal skin thickness tends to be
and the determination of their chorionicity. (1)
relatively constant. (5)
Recently, ultrasound screening in first trimester
Thickened nuchal fold 6 mm was found in 40%
of pregnancy provides the most effective way of
of fetuses with Down syndrome with a positive
chromosomal abnormalities screening. The
predictive value of 69% in the high-risk
ultrasound assessment of nuchal translucency
pregnancies. A thickened nuchal fold is
(NT) is used as non-invasive method for fetal
associated with other euploid syndromes, such
abnormalities. (2)
as Noonan syndrome, and heart defects. (5)
The appearance of a thickened NT during 11-14

weeks of gestation is strongly associated with
Subjects and Methods
fetal structural defects, genetic syndromes, and
A cross sectional study was conducted on 85
poor perinatal outcomes. (3)
consecutive high risk pregnancies attending
Increased NT can be caused by different
the Antenatal Clinic and Medical Genetics
mechanisms, such as disturbance in lymphatic
Center of Ain Shams University.
development, altered extracellular matrix, and
The high risk pregnancy included those with
cardiac failure. (3)
advanced maternal age (maternal age above 35
A thickened nuchal fold is considered to
years).those
with
previous
child
with
be one of the most sensitive and specific of the
chromosomal abnormality, history of parental
minor markers for fetal Down syndrome. (4)
376

DOI: 10.12816/0005584


Full Paper (vol.56 paper# 12)