Background/aim Gastroesophageal reflux disease (GERD) is a major public health problem that may cause erosive or nonerosive esophagitis in symptomatic patients. The severity of esophagitis in GERD seems to be correlated not only to the amount of reflux and altered motor activity but also to the ability of the mucosa to resist injury and repair the damage. This study aimed to evaluate the cell proliferation status of esophageal epithelium in both normal individuals and patients with GERD with or without erosions and its correlation with the degree of inflammation of the esophagus. Participants and methods This study was carried out on 33 individuals; their ages ranged between 17 and 74 years. All participants were subjected to a clinical assessment and an endoscopic evaluation. Four biopsies were taken using an endoscope at 5 cm from the Z-line; histological esophagitis was identified and graded. Cell proliferation was evaluated by Ki-67 immunostaining. Results The prevalence of GERD was the highest in the 15-29 years age group (46.43%) and decreased with age. Cell proliferation [estimated by the Ki-67-labeling index (Ki-67 LI)] was reduced in esophageal epithelium in erosive (13.44%) and nonerosive (36.83%) reflux disease in relation to normal individuals (68%). There was a statistically significant positive correlation between cell proliferation (Ki-67 LI) and the endoscopic grade of esophagitis among patients with erosive disease. However, there was no significant correlation between cell proliferation (Ki-67 LI) and the histological grade of esophagitis in both erosive and nonerosive reflux disease. Conclusion The ability of the mucosa to resist injury and to repair the damage should be considered a key factor in the development of GERD. Esophageal mucosa exposed to chronic acid insult show reduced cell replication, estimated by the Ki-67 LI. Erosive esophagitis in GERD seems to be related to a low cell proliferation rate of esophageal epithelium rather than the amount of reflux.

Background/aim Liver fibrosis results from chronic inflammation of the hepatic parenchyma. Progressive accumulation of fibrous tissue eventually leads to cirrhosis and its complications. The severity of liver fibrosis defines the stage of chronic hepatitis and carries with it important clinical implications. Histological scoring systems such as Ishak provide descriptive evaluation of the liver tissue mainly in terms of architectural changes without measuring the amount of fibrosis. This study aimed to assess the theoretical advantage of image analysis morphometry for providing truly quantitative data with respect to the amount of fibrous tissue. Materials and methods A Lieca Qwin 500 image analyzer with a damaged area morphometry software was used applying the interactive method to measure the fibrous tissue area on the basis of different colors of hepatocytes and fibers following staining with Masson's trichrome stain. Forty-three patients (38 men and five women) were recruited into the study with a mean age of 45.5 years (range 15-58 years). Of them, 40 had chronic viral hepatitis and three had chronic nonviral hepatitis. Results Morphometric measurements of fibrosis obtained with the image analyzer were highly correlated with results obtained using the Ishak method. The correlation was found to be statistically significant using the w2-test (Po0.0001). Conclusion Quantitative image analysis for estimation of the percentage area of liver fibrosis is a simple and accurate method for evaluating fibrous tissue in patients with chronic hepatitis, aiding therapeutic approaches.

Background/aim The discovery of genetic alterations in oncogenes and tumor suppressor genes that accompany tumor formation has encouraged the search for genes that may promote or suppress tumor metastasis. This study aimed to investigate, by immunohistochemical analysis, protein expression of the metastasis-related genes metalloproteinase-2 (MMP-2) and nm-23 in human bladder carcinoma. Their role as prognostic factors against established clinicopathological variables in bladder carcinoma was evaluated. Materials and methods A total of 60 specimens of bladder carcinoma were obtained by radical cystectomy with pelvic lymphadenectomy. In addition, 10 tissue samples from normal mucosa adjacent to tumors were examined and served as controls. Immunohistochemical expression of MMP-2 and nm-23 was correlated with histological grade, tumor stage, lymph node metastases, and the presence or absence of bilharziasis. Results MMP-2 was expressed in 63% of patients with human bladder carcinoma and was shown to be positively correlated with histological grade, lymph node metastasis, and tumor stage. In contrast, nm-23 was expressed in 61% of patients with carcinoma but with insignificant correlation between its expression and the previous variables. Both proteins showed insignificant correlation with the presence or absence of bilharziasis. The study revealed that nm-23 expression was nonsignificantly correlated with MMP-2 expression and that nm-23 does not behave as a metastasis suppressor gene in bladder carcinoma. Conclusion MMP-2 overexpression seems to be related to more aggressive tumors with advanced stages and grades; therefore, it may be used not only as a promoting prognostic marker for bladder carcinoma but also as a novel target for clinical therapy.

Background Video-assisted thoracic sympathectomy (VATs) is the most frequently used procedure in the treatment of primary hyperhidrosis. The objective of the present study was to assess the life quality of patients before and after VATs clipping using a specific questionnaire. Methods Between February 2009 and September 2012, 45 patients with primary palmar hyperhidrosis admitted to King Abdulaziz University Hospital were administered a disease-specific questionnaire preoperatively and 6 months after VATs clipping of the third and fourth sympathetic chain thoracic segment (T3, 4) under general anesthesia. Results The mean age of the patients was 27.8 years (range 19-35). Thirty (66.67%) patients were female, with a mean age of 27 years (range 19-35). Fifteen (33.33%) patients were male, with a mean age of 29.3 years (range 25-34). Six (13.33%) patients were obese and consisted of one (2.22%) male and five (11.11%) female patients. All patients were discharged on the second day, except for one who had pneumothorax (fifth day). There was another patient with pneumothorax (2.22%), two patients with VATs port infection (4.44%), and 17 patients with compensatory hyperhidrosis (37.78%). All domains of the specific questionnaire reported a statistically significant improvement in each domain separately (Po0.001) and in the total test score (Po0.001). Preoperatively, 15 (33.33%) patients were in very poor (VP) health and 30 (66.67%) were in poor (P) health. Postoperatively, the condition of 17 (37.8%) patients improved considerably (of whom 12 were VP and five were P) and that of 28 (62.2%) improved but to a less extent (three were VP and 25 were P). Conclusion VATs is a straightforward, effectual, safe, and sound method for relieving the symptoms of primary palmar hyperhidrosis and improving the quality of life.

Background/aim Hydrocele is a common chronic condition in men that causes physical, psychological, social, and economic distress. This study aimed to evaluate the outcome of hydrocelectomy through the inguinal approach as compared with the scrotal approach in adults. Subjects and methods This prospective study was conducted on 40 patients who presented to the El-Hussein University Hospital with idiopathic hydrocele and underwent hydrocelectomy. These patients were divided into two groups: group I (inguinal approach group) included 20 patients with a mean age of 30.75 ± 10.76 years and who underwent hydrocelectomy through the inguinal approach, group II (scrotal approach group) included 20 patients with a mean age of 29.35 ± 8.93 years and who underwent hydrocelectomy through the scrotal approach. A comparison was made between the two groups as regards the volume of the hydrocele sac, operative time, postoperative morbidity, length of hospital stay, and time of return to daily life. Results The mean volume of hydroceles was 196.00±30.28ml in the inguinal approach group and 197.75±26.72ml in the scrotal approach group. The mean operative time was 25.50±4.60min in the inguinal approach group and 24.40±4.08min in the scrotal approach group. The mean length of hospital stay was 1.35±0.48 days in the inguinal approach group and 2.50±0.68 days in the scrotal approach group. Postoperative complications in the scrotal approach group included one wound sepsis, one partial wound dehiscence, two persistent scrotal edemas, and adherence of the testis to the scrotum in one patient. No postoperative complications or discomfort were observed in the inguinal approach group. The mean time to return to normal activity was 12.10±1.33 days in the inguinal approach group and 17.70±4.13 days in the scrotal approach group. Conclusion Hydrocelectomy through the inguinal approach in adults is associated with low or no postoperative morbidity and discomfort. It is easily applied and facilitates dealing with any associated lesions in the inguinal canal.

Background/aim Reports on the effect of oxytocin on intestinal motility have shown controversial results in human and animal studies. The aim of the study was to investigate the effect of oxytocin on duodenal motility in normal female Wistar rats in vivo and in vitro. Materials and methods A total of 30 adult femaleWistar albino rats were divided into three groups: the control group; the oxytocin-treated group (5 mg/kg body weight injected intraperitoneally for 7 days); and the in-vitro oxytocin group, in which the effect of four doses of oxytocin (0.022, 0.11, 0.22, and 1.1 mg/bath) added to the organ bath was studied. The isometric contractile response of isolated segments of duodenum was recorded with respect to the frequency of contraction, the average duration of contraction, the average force of contraction, and the motility index. Results Oxytocin-treated rats showed a significant increase in the duodenum average force of contraction (Po0.05) and motility index (Po0.01) and a decrease in the frequency of contraction (Po0.05) as compared with the control group. Low doses of oxytocin administered in vitro (0.022 and 0.11 mg/bath) resulted in a significant increase in the duodenum average force of contraction (Po0.05) and motility index (Po0.05) when compared with their respective baseline values, whereas higher doses caused either insignificant changes in the motility parameters at a dose of 0.22 mg/bath or a significant decrease in the duodenum average force of contraction (Po0.01) and motility index (Po0.01) at a dose of 1.1 mg/bath when compared with their baseline values. Conclusion Oxytocin treatment enhanced duodenal motility in adult female Wistar rats. Higher doses of oxytocin inhibit duodenal motility, which may be explained by an indirect mechanism.

Background/aims Heat stress was shown to cause impairments in hepatocytes and result in oxidative damage, which can lead to cytotoxicity; thus, we carried out this study to investigate the age tolerance to oxidative stress caused by heat stress in young and old female Wistar rats and whether this effect varied with different postexposure periods. Materials and methods Heat stress-induced injury in hepatic cells was evaluated in young (6 months) and old (24 months) female Wistar rats by exposing them at an ambient temperature of 421C for 1 h. Livers were harvested at several time points (6, 24, and 72 h) after application of the heat stress protocol. The level of DNA damage assessed using the comet assay, percentage of fragmented DNA, quantitative changes in nucleic acid and protein contents, activity of liver enzyme marker, level of superoxide dismutase, and lipid peroxidation were determined. Results The results showed that exposure to heat stress significantly increased the oxidative DNA damage, percentage of DNA fragmentation, and activities of liver enzyme marker and stimulated the process of lipid peroxidation in liver cells of young and old rats. Further, it decreased total nucleic acid and protein contents and superoxide dismutase activities. In addition, it was observed that the damage from heat stress was more serious in old animals than in young ones and they needed more time to return to control values. Conclusion It was concluded that aging and heat exposure instigate oxidative stress, which can contribute to cellular dysfunction and age-related reductions in stress tolerance.

Background/aim Social isolation is a type of stress that might adversely affect sex cycles in both animals and humans. The present study was planned to investigate the pituitary-gonadal axis in the proestrus phase of estrous cycle in adult female rats subjected to social isolation stress for 8 weeks. Materials and methods Twenty Sprague-Dawley adult female rats were divided into two experimental groups: a control group (n = 10) and a socially isolated group (SI, n = 10). Throughout the study, all rats were monitored for body weight and food intake. After 8 weeks, rats were sacrificed in the proestrus phase of estrous cycle. All rats were examined for final body weight, rectal temperature, hematocrit value, and serum levels of follicle stimulating hormone, luteinizing hormones, prolactin hormone, 17-b estradiol, and progesterone in addition to histological examination of the ovaries. Results The results of the present study showed that the SI group had significant decrease in their final body weights and their serum levels of 17-b estradiol and progesterone, whereas the serum level of prolactin was significantly increased. Histological examination of SI rat ovaries showed fewer growing ovarian follicles and numerous atretic ones compared to control rat ovaries. Conclusion These findings indicate that social isolation might result in depressed ovarian function in adult female rats.

Background/aim Deltamethrin (DLM) is a synthetic pyrethroid insecticide known for its wide toxic manifestations. The present experiment pertains to the protective role of vitamin E (vit E) against biochemical toxicity following pesticide exposure during 30 days. Materials and methods Male albino rats were divided into four groups of six each: Group I served as control rats (0 mg (vit E) and 0 mg DLM/kg body weight), Group II received deltamethrin (7.5mg/kg body weight). Group III received vit E (100 mg/kg body weight). Group IV received both deltamethrin (7.5mg/kg body weight) plus vit E (100mg/kg body weight). Results Exposure of rats to DLM induced significant increase in the levels of hepatic markers enzymes, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP); while acetylcholinesterase (AChE) was inhibited. Significant decrease in catalase (CAT) and glutathione S-transferase (GST) enzyme activities were observed in treated rats. Furthermore, renal markers such as urea and creatinine were increased in deltamethrin treated rats. Additionally, serum cholesterol, triglycerides, low-density lipoprotein (LDL) and the level of high-density lipoprotein (HDL) were significantly increased and decreased, respectively. Co-administration of vit E restored all the parameters cited above to near-normal values. Conclusion Our investigation showed that vit E acts as an effective antioxidant for DLM pesticide toxicity in reducing oxidative stress burden.