Analysing cause of death during follow-up for non-muscle-invasive bladder cancer: is there a role for watchful waiting?

Introduction: Non-muscle-invasive bladder cancer (NMIBC) patients often require multiple invasive procedures during follow-up. Surveillance guidelines do not adjust for increasing frailty or competing comorbidity. We aim to evaluate the influence of these factors on the natural history of NMIBC and whether this may have implications for appropriate follow-up schedules.

Unilateral Giant Bullae: Pulmonary Placental Transmogrification Should Be Kept in Mind: Case Reports.

Placental transmogrification is a peculiar clinical entity of the lung of uncertain etiology. We report 2 cases of pulmonary placental transmogrification in 2 patients of different nationalities. Both of them had no history of smoking or chronic lung disease.

Combined Unilateral Posteroventral Pallidotomy and Ventral Intermediate Nucleus Thalamotomy in Tremor-Dominant Parkinson's Disease versus Posteroventral Pallidotomy Alone: A Prospective Comparative Study.

Background: The optimum target in surgery for Parkinson's disease (PD) is still controversial, especially in patients with tremor-dominant PD. We aim to compare results in tremor-dominant patients undergoing pallidotomy vs. those undergoing simultaneous posteroventral pallidotomy (PVP) and ventral intermediate nucleus (VIM) thalamotomy.

Pure spinal epidural cavernous hemangioma: A case series of seven cases.

Introduction: Pure spinal epidural cavernous hemangiomas (PSECHs) are rare vascular lesions with about 100 cases reported. Herein, we present a case series of 7 PSECHs discussing their clinical presentation, radiological characteristics, surgical technique and intraoperative findings, pathological features, and functional outcome.

Materials And Methods: We retrieved from the retrolective databases of the senior authors, patients with pathologically confirmed PSECH operated between January 2002 and November 2015.

Evaluation of Interspinous Spacer Outcomes in Degenerative Lumbar Canal Stenosis: Clinical Study.

Background: Lumbar spinal stenosis is a common diagnosis in elderly individuals, and the rates of surgery have risen all over the world. The optimal approach to provide satisfactory decompression and minimize complications for lumbar spinal stenosis remains controversial.

Objective: The purpose of this study was to evaluate the surgical outcome of interspinous spacers versus decompressive laminectomy in the management of degenerative lumbar canal stenosis.

Spotlight on the three main hepatic fibrogenic cells in HCV-infected patients: Multiple immunofluorescence and ultrastructure study.

The present work deals with the simultaneous ultrastructure and triple immunofluorescence study of the three main hepatic fibrogenic cells, hepatic stellate cell, myofibroblast (MF), and fibroblast, in a group of hepatitis C virus (HCV) RNA positive patients, as their exact interrelation behavior in vivo with the progress of hepatic fibrosis is still inadequate. In this study, for the first time, cells having the morphological characteristic of MF and not bone marrow fibrocytes were revealed in liver portal vessels. This necessitates the reevaluation of the available knowledge concerning bone marrow fibrocyte.

Circulating miRNAs as Predictor Markers for Activation of Hepatic Stellate Cells and Progression of HCV-Induced Liver Fibrosis.

Introduction: Liver fibrosis is the excessive accumulation of extracellular matrix that occurs by activation of hepatic stellate cells (HSCs), which has been identified as the major driver of liver fibrosis. Several studies confirmed that miRNAs have regulatory effects on the activation of HSCs by affecting the signaling pathways. The aim of this study was to develop non-invasive diagnostic markers by measuring different circulating miRNAs in serum as predictor markers for early diagnosis of liver fibrosis and its progression.

Serum Markers of Epithelial Mesenchymal Transition as Predictors of HCV-induced Liver Fibrosis, Cirrhosis and Hepatocellular Carcinoma.

Introduction: Hepatitis C virus (HCV) is a major cause of chronic liver disease in Egypt, leading to hepatic fibrosis, liver cirrhosis (LC), and hepatocellular carcinoma (HCC). Liver fibrosis is characterized by excessive deposition of extracellular matrix (ECM). Newly-recognized pathogenic mechanisms point to the epithelial-mesenchymal transition (EMT) of hepatocytes to matrix synthesizing (myo-) fibroblasts.

Value of reelin for assessing hepatic fibrogenesis in a group of Egyptian HCV infected patients.

Background: Development of non-invasive markers that can predict the stages of hepatic fibrosis without resorting to repeated liver biopsies is still an important goal to evaluate the effectiveness of antifibrotic treatment. The present work investigates the value of the assessment of peripheral circulating reelin, in which the liver represents its prime source, as a marker for monitoring hepatic fibrogenesis.

Methods: Seventy-four cases with chronic hepatitis positive for serum HCV RNA and 15 healthy volunteers were enrolled in this study.

Perioperative acute phase response and outcome of hepatic resection, an experimental study.

Identification of patients at risk of postoperative complications could have an impact on the indications for a procedure as well as permitting modifications of treatment to reduce the surgical risk. This experimental study evaluated the correlation between peri-operative acute phase response and outcome of hepatic resection. The study was conducted on sixty healthy golden hamsters, which underwent partial hepatectomy.

Hematopoietic stem cell mobilization into the peripheral circulation in patients with chronic liver diseases.

Objective: The present study was aimed to investigate and compare the kinetics of bone marrow-derived hematopoietic stem cells (BMHSC) migration in the peripheral blood and liver in response to liver injury in patients with chronic liver disease (CLD).

Methods: In all, 45 CLD patients staged with Child-Pugh A, B and C and 15 healthy participants were evaluated for the concentration of circulating BMHSC by a flow cytometric analysis of CD133(+) /CD34(+) cells. In addition, homing BMHSC and hepatic progenitors were assessed by the immunohistochemical detection of CD133(+) and OV6(+) cells in liver biopsy specimens from Child-Pugh A and B patients.

Effect of splenectomy on liver regeneration and function following partial hepatectomy: experimental study.

The presence of enough remaining functioning liver parenchyma to avoid life-threatening post-operative liver failure is a major prerequisite for hepatic resection in patients with hepato-biliary carcinoma. There are clinical reports which confirm the beneficial clinical effects of splenectomy on integrity of the residual liver following liver resection for hepatocellular carcinoma in cirrhotic patients with hypersplenism and portal hypertension. This experimental study was designed on hamsters to evaluate the proliferative capacity and function of the remaining liver lobes; in which splenectomy was done simultaneously with partial hepatectomy compared with those in which splenectomy was not done.

Role of fibrogenic markers in chronic hepatitis C and associated hepatocellular carcinoma.

Detection and follow up of fibrogenesis in chronic hepatitis C (CHC) is mandatory for early treatment and risk stratification. The current study included 120 patients with CHC, of whom 30 had liver cirrhosis (LC) and 30 had hepatocellular carcinoma (HCC). 15 wedge liver biopsies, taken during laparoscopic cholecystectomy, were included as normal controls.

Robotic-assisted, laparoscopic, and abdominal myomectomy: a comparison of surgical outcomes.

Objective: To compare the surgical outcomes of robot-assisted laparoscopic myomectomy (robot-assisted), standard laparoscopic myomectomy (laparoscopic), and open myomectomy (abdominal).

Methods: Myomectomy patients were identified from the case records of the Cleveland Clinic and stratified into three groups. Operative and immediate postoperative outcomes were compared.

Does granulocyte-colony stimulating factor administration induce damage or repair response in schistosomiasis?

Aim: To introduce Granulocyte-colony stimulating factor (G-CSF) as a new therapeutic modality for schistosomiasis through stem cell mobilization, immunomodulation or fibrosis remodeling.

Methods: In this study, a 5 d course of human recombinant G-CSF (100 μg/kg sc) was applied to Schistosoma mansoni-infected mice at different stages of disease (5 d before infection as well as 3, 5 and 7 wk post-infection). The animals were sacrificed at 10 d as well as 4, 6 and 8 wk post infection.

Differential expression of cell cycle regulators in HCV-infection and related hepatocellular carcinoma.

Aim: To investigate cell cycle proteins in chronic hepatitis C virus infection in order to analyze their role in the process of hepatocyte transformation and to characterize their prognostic properties.

Methods: Subjects of the current study included 50 cases of chronic hepatitis C (CHC) without cirrhosis, 30 cases of CHC with liver cirrhosis (LC), and 30 cases of hepatitis C-related hepatocellular carcinoma (HCC) admitted to the Department of Hepato-Gastroenterology, Theodor Bilharz Research Institute (TBRI), Giza, Egypt. Fifteen wedge liver biopsies, taken during laparoscopic cholecystectomy, were also included as normal controls.

Immunological and parasitological parameters after treatment with dexamethasone in murine Schistosoma mansoni.

This work aimed to evaluate the effect of diphenyl dimethyl bicarboxylate (DDB) and dexamethasone alone and in combination with praziquantel on various parasitological, immunological and pathological parameters reflecting disease severity and morbidity in murine schistosomiasis. DDB and dexamethasone had no effect on worm burden but altered tissue egg distribution. This indicates that, under the schedule used, neither drug interfered with the development of adult worms or oviposition, but both can modulate liver pathology.

Portal hypertensive enteropathy before and after variceal obliteration: an endoscopic, histopathologic and immunohistochemical study.

Aim: To study portal hypertensive enteropathy (PHE) before and after the obliteration of esophageal varices.

Methods: 30 patients with portal hypertension and esophageal varices were included. Band ligation was performed for every patient until the obliteration of esophageal varices.

Cyclooxygenase-2 expression on urothelial and inflammatory cells of cystoscopic biopsies and urine cytology as a possible predictive marker for bladder carcinoma.

Cyclooxygenase-2 (COX-2) is a key inducible enzyme involved in the production of prostaglandins. It contributes to human carcinogenesis by various mechanisms. The aim of the current study was to elucidate the possible involvement of COX-2 in human bladder carcinoma by examining its expression on both urothelial and inflammatory cells in tissue biopsies and urine cytology samples of different urinary bladder lesions.

Circulating and hepatic Fas expression in HCV-induced chronic liver disease and hepatocellular carcinoma.

Apoptosis is central for control and elimination of viral infections. In chronic hepatitis C virus (HCV) infection, enhanced hepatocyte apoptosis and upregulation of the death-inducing ligands CD95/Fas occur. This study aimed to study the role of serum soluble Fas and hepatic Fas expression as early predictors of advancement of chronic hepatitis C disease.

Assessement of peritoneal adhesions due to starch granules of surgical glove powder an experimental study.

Introduction of foreign material into abdominal cavity during surgery causes irritation of peritoneum leading to postoperative (PO) adhesions. To assess and prevent PO adhesions, an experimental study was done to assess the caused by starch granules of the surgical glove powder and to avoid complications using the effect of normal saline and low molecular weight heparin (LMWH). Thirty Wister Albino male rats were subjected to laparotomy and ileocaecal abrasions were done mechanically to induce postoperative peritoneal adhesions.

Expression of cyclooxygenase-2 and transforming growth factor-beta1 in HCV-induced chronic liver disease and hepatocellular carcinoma.

Unlabelled: Cyclooxygenase-2 (COX-2) and transforming growth factor-beta1 (TGF-beta1) were modulated in a variety of viral infections, but there is a paucity of data about their role in the pathologic process of cirrhosis and/or hepatocellular carcinoma (HCC) following chronic hepatitis C virus (HCV) infection. The material of the current study included 50 cases of chronic hepatitis C (CHC) without cirrhosis, 30 cases of CHC with cirrhosis, and 30 cases of HCC with HCV admitted to the Gastroenterology and Hepatology Department of Theodor Bilharz Research Institute, Giza, Egypt. Fifteen wedge liver biopsies, taken during laparoscopic cholecystectomy, were included in the study as normal controls.

Immunohistopathological and biochemical changes in Schistosoma mansoni-infected mice treated with artemether.

Objective: To investigate immune mechanisms possibly involved in the amelioration of histopathological changes in livers of Schistosoma mansoni-infected mice treated with artemether (ART), including liver functions and apoptotic changes.

Methods: Male CD-1 Swiss albino mice were infected with Schistosoma mansoni and treated with praziquantel (PZQ) 6 weeks post-infection (PI) (500 mg/kg/day x2) and/or ART in double dose (each of 400 mg/kg) 4 and 6 weeks PI. Parasitological parameters, liver functions and histopathological changes including T-lymphocyte profile and apoptotic changes were assessed.

Pharmacodynamics of pentoxifylline and/or praziquantel in murine schistosomiasis mansoni.

Pentoxifylline (PTX) was proved to exert both anti-inflammatory and anti-fibrotic effects, and was used therapeutically in this experimental model to investigate its role alone or with praziquantel (PZQ) in Schistosoma mansoni-infected mice, and to explore its impact on the tissue expression of transforming growth factor-beta1 (TGF-beta1). S. mansoni-infected mice were divided into seven groups: Control untreated (I), treated with curative dose of PZQ, 500 mg/kg/day for 2 consecutive days (II), or subcurative dose, 100 mg/kg/day for 2 consecutive days (III), treated with PTX (10 mg/kg/day for 5 days/wk) alone for 4 weeks (IV) or in addition to subcurative dose of PZQ (V), and treated with PTX alone for 8 weeks (VI) or in addition to subcurative dose of PZQ (VII).