Novelty and Impact: This first study compares the survival of HCV-positive DLBCL treated with and without rituximab which showed in toxicity and the outcome. Background: The effect of hepatitis C virus (HCV) infection on prognosis and hepatic toxicity in patients with diffuse large B-cell lymphoma (DLBCL) in the rituximab era is unclear. The treatment and the outcome of patients with DLBCL and HCV infection are still a matter of debate. Methods: We analyzed 137 DLBCL patients positive to HCV, treated with chemotherapy regimens include cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) ± rituximab. Survival outcomes and hepatic toxicity were compared in DLBCL patients positive to HCV infection according to CHOP ± rituximab. Result: Our result showed that the group of patients treated with R-CHOP has significant high incidence of hepatic toxicity grade (3–4) (28 vs. 18%, P value 0.001) and worse progression-free survival (55 vs. 80%, P value 0.002) in comparison with the group treated with CHOP, and also there is significant difference between both groups in overall survival. This first study compares the survival of HCV-positive DLBCL treated with and without rituximab which showed significant differences. Conclusion:We conclude that HCV-positive patients with DLBCL treated with rituximab plus CHOP have high incidence in hepatic toxicity. Specific protocols evaluating antiviral therapy should be designed for these patients

Objectives: The study design aimed to examine the differences in the clinical and pathologic features after vascular anastomoses of a rat femoral artery using four different suture techniques. Methods: Sixty Sprage-Dawely rats were divided randomly into four groups. Fifteen bisected arteries (one from each animal) in groups I, II, III, and IV were sutured with the simple interrupted suture, continuous suture, sleeve suture, and cuff suture, respectively. Results: The anastomosis times in groups I, II, III and IV were 28.67, 14.67, 15.47, and 15.93 minutes, respectively. Immediate bleeding that stopped without intervention (grade I) was observed in 67%, 73%, and 60% of the anastomosed vessels in groups II, III, and IV, respectively, whereas 60% of the vessels in group I showed light bleeding that was inhibited by gentile pressure (grade II). All vessels examined appeared to be patent at 5 and 15 minutes after the anastomosis. On the seventh day postoperatively, the vessels of group I showed the highest patency rate (93%) compared with groups II (67%), III (73%), and IV (87%). Moreover, there were more pronounced pathologic changes in group I than in the other groups. These changes included endothelial loss, endothelial proliferation, degeneration, and necrosis of the tunica media. Suture materials surrounded by an inflammatory reaction were also observed. Conclusions: The simple interrupted suture is preferable for vascular anastomosis due to its highest patency rate. The other techniques investigated can be good alternatives because of their short anastomotic time and moderate pathological changes.

Background: Despite the advances in the cure rate for acute leukemia, approximately 25% of affected patients suffer from relapses. Expression of genes for the multiple drug resistance (MDR-1) and breast cancer related protein (BCRP) may confer the phenotype of resistance to the treatment of acute leukemia. Objective: To analyze the expression of the MDR-1 and BCRP genes in new cases of acute leukemia via the real time polymerase chain reaction (RT-PCR) and to determine the correlation between their expression and overall survival. Patients and methods: Total number of patients diagnosed as AML (n = 15), ALL (n = 35) and 20 blood donors as a control group included in this study. The expression of messenger RNA for the MDR-1and BCRP genes by RT-PCR were assessed. Myeloid surface markers as (CD34, CD33, CD13 and CD14) and lymphoid surface markers as (CD3,CD5, CD2, CD4 ,CD8 and CD19)were analyzed by flow cytometry (FACS can, Becton Dickinson, Mountain View, CA, USA). Results: The studied groups with MDR gene, BCRP gene show highly significant difference compared to the control (P0.000). The relation between MDR & BCRP in both AML and ALL groups shows no significant difference. There was a significant difference between BCRP expression in AML, ALL groups (P0.01). No significant difference as regards overall survival between MDR +ve cases and MDR negative cases in AML and ALL. In contrast Overall survival in BCRP +ve cases and BCRP negative cases shows a significant difference between AML and ALL groups (P0.01). No significant difference was detected between O.S in AML (MDR +ve , CD34 +ve) and AML (MDR +ve, CD34 negative). In contrast, O.S between AML (BCRP +ve ,CD34 +ve)and AML (BCRP +ve ,CD34 negative) shows a significant difference (P0.01). The difference between O.S in ALL (MDR +ve, CD34 +ve) and ALL (MDR +ve, CD34 negative) was not significant. In contrast a significant difference was detected between O.S in ALL (BCRP +ve, CD34 +ve) and ALL (BCRR +ve, CD34 negative) (P0.01). Overall survinal in AML group with BCRP +ve (CD13 +ve) shows a significant difference (P0.01). In ALL group the association between (MDR +ve and CD19 +ve) or (BCRP +ve and CD19 +ve) cannot significantly affect the survival. Conclusion: We concluded that the evaluation of the expression of genes for resistance to antineoplastic drugs in acute leukemia upon diagnosis, and particularly the expression of the BCRP gene, may be of clinical relevance.

Background: Despite the advances in the cure rate for acute leukemia, approximately 25% of affected patients suffer from relapses. Expression of genes for the multiple drug resistance (MDR-1) and breast cancer related protein (BCRP) may confer the phenotype of resistance to the treatment of acute leukemia. Objective: To analyze the expression of the MDR-1 and BCRP genes in new cases of acute leukemia via the real time polymerase chain reaction (RT-PCR) and to determine the correlation between their expression and overall survival. Patients and methods: Total number of patients diagnosed as AML (n = 15), ALL (n = 35) and 20 blood donors as a control group included in this study. The expression of messenger RNA for the MDR-1and BCRP genes by RT-PCR were assessed. Myeloid surface markers as (CD34, CD33, CD13 and CD14) and lymphoid surface markers as (CD3,CD5, CD2, CD4 ,CD8 and CD19)were analyzed by flow cytometry (FACS can, Becton Dickinson, Mountain View, CA, USA). Results: The studied groups with MDR gene, BCRP gene show highly significant difference compared to the control (P0.000). The relation between MDR & BCRP in both AML and ALL groups shows no significant difference. There was a significant difference between BCRP expression in AML, ALL groups (P0.01). No significant difference as regards overall survival between MDR +ve cases and MDR negative cases in AML and ALL. In contrast Overall survival in BCRP +ve cases and BCRP negative cases shows a significant difference between AML and ALL groups (P0.01). No significant difference was detected between O.S in AML (MDR +ve , CD34 +ve) and AML (MDR +ve, CD34 negative). In contrast, O.S between AML (BCRP +ve ,CD34 +ve)and AML (BCRP +ve ,CD34 negative) shows a significant difference (P0.01). The difference between O.S in ALL (MDR +ve, CD34 +ve) and ALL (MDR +ve, CD34 negative) was not significant. In contrast a significant difference was detected between O.S in ALL (BCRP +ve, CD34 +ve) and ALL (BCRR +ve, CD34 negative) (P0.01). Overall survinal in AML group with BCRP +ve (CD13 +ve) shows a significant difference (P0.01). In ALL group the association between (MDR +ve and CD19 +ve) or (BCRP +ve and CD19 +ve) cannot significantly affect the survival. Conclusion: We concluded that the evaluation of the expression of genes for resistance to antineoplastic drugs in acute leukemia upon diagnosis, and particularly the expression of the BCRP gene, may be of clinical relevance.

Background: Despite the advances in the cure rate for acute leukemia, approximately 25% of affected patients suffer from relapses. Expression of genes for the multiple drug resistance (MDR-1) and breast cancer related protein (BCRP) may confer the phenotype of resistance to the treatment of acute leukemia. Objective: To analyze the expression of the MDR-1 and BCRP genes in new cases of acute leukemia via the real time polymerase chain reaction (RT-PCR) and to determine the correlation between their expression and overall survival. Patients and methods: Total number of patients diagnosed as AML (n = 15), ALL (n = 35) and 20 blood donors as a control group included in this study. The expression of messenger RNA for the MDR-1and BCRP genes by RT-PCR were assessed. Myeloid surface markers as (CD34, CD33, CD13 and CD14) and lymphoid surface markers as (CD3,CD5, CD2, CD4 ,CD8 and CD19)were analyzed by flow cytometry (FACS can, Becton Dickinson, Mountain View, CA, USA). Results: The studied groups with MDR gene, BCRP gene show highly significant difference compared to the control (P0.000). The relation between MDR & BCRP in both AML and ALL groups shows no significant difference. There was a significant difference between BCRP expression in AML, ALL groups (P0.01). No significant difference as regards overall survival between MDR +ve cases and MDR negative cases in AML and ALL. In contrast Overall survival in BCRP +ve cases and BCRP negative cases shows a significant difference between AML and ALL groups (P0.01). No significant difference was detected between O.S in AML (MDR +ve , CD34 +ve) and AML (MDR +ve, CD34 negative). In contrast, O.S between AML (BCRP +ve ,CD34 +ve)and AML (BCRP +ve ,CD34 negative) shows a significant difference (P0.01). The difference between O.S in ALL (MDR +ve, CD34 +ve) and ALL (MDR +ve, CD34 negative) was not significant. In contrast a significant difference was detected between O.S in ALL (BCRP +ve, CD34 +ve) and ALL (BCRR +ve, CD34 negative) (P0.01). Overall survinal in AML group with BCRP +ve (CD13 +ve) shows a significant difference (P0.01). In ALL group the association between (MDR +ve and CD19 +ve) or (BCRP +ve and CD19 +ve) cannot significantly affect the survival. Conclusion: We concluded that the evaluation of the expression of genes for resistance to antineoplastic drugs in acute leukemia upon diagnosis, and particularly the expression of the BCRP gene, may be of clinical relevance.

Background: Despite the advances in the cure rate for acute leukemia, approximately 25% of affected patients suffer from relapses. Expression of genes for the multiple drug resistance (MDR-1) and breast cancer related protein (BCRP) may confer the phenotype of resistance to the treatment of acute leukemia. Objective: To analyze the expression of the MDR-1 and BCRP genes in new cases of acute leukemia via the real time polymerase chain reaction (RT-PCR) and to determine the correlation between their expression and overall survival. Patients and methods: Total number of patients diagnosed as AML (n = 15), ALL (n = 35) and 20 blood donors as a control group included in this study. The expression of messenger RNA for the MDR-1and BCRP genes by RT-PCR were assessed. Myeloid surface markers as (CD34, CD33, CD13 and CD14) and lymphoid surface markers as (CD3,CD5, CD2, CD4 ,CD8 and CD19)were analyzed by flow cytometry (FACS can, Becton Dickinson, Mountain View, CA, USA). Results: The studied groups with MDR gene, BCRP gene show highly significant difference compared to the control (P0.000). The relation between MDR & BCRP in both AML and ALL groups shows no significant difference. There was a significant difference between BCRP expression in AML, ALL groups (P0.01). No significant difference as regards overall survival between MDR +ve cases and MDR negative cases in AML and ALL. In contrast Overall survival in BCRP +ve cases and BCRP negative cases shows a significant difference between AML and ALL groups (P0.01). No significant difference was detected between O.S in AML (MDR +ve , CD34 +ve) and AML (MDR +ve, CD34 negative). In contrast, O.S between AML (BCRP +ve ,CD34 +ve)and AML (BCRP +ve ,CD34 negative) shows a significant difference (P0.01). The difference between O.S in ALL (MDR +ve, CD34 +ve) and ALL (MDR +ve, CD34 negative) was not significant. In contrast a significant difference was detected between O.S in ALL (BCRP +ve, CD34 +ve) and ALL (BCRR +ve, CD34 negative) (P0.01). Overall survinal in AML group with BCRP +ve (CD13 +ve) shows a significant difference (P0.01). In ALL group the association between (MDR +ve and CD19 +ve) or (BCRP +ve and CD19 +ve) cannot significantly affect the survival. Conclusion: We concluded that the evaluation of the expression of genes for resistance to antineoplastic drugs in acute leukemia upon diagnosis, and particularly the expression of the BCRP gene, may be of clinical relevance.

Background: Despite the advances in the cure rate for acute leukemia, approximately 25% of affected patients suffer from relapses. Expression of genes for the multiple drug resistance (MDR-1) and breast cancer related protein (BCRP) may confer the phenotype of resistance to the treatment of acute leukemia. Objective: To analyze the expression of the MDR-1 and BCRP genes in new cases of acute leukemia via the real time polymerase chain reaction (RT-PCR) and to determine the correlation between their expression and overall survival. Patients and methods: Total number of patients diagnosed as AML (n = 15), ALL (n = 35) and 20 blood donors as a control group included in this study. The expression of messenger RNA for the MDR-1and BCRP genes by RT-PCR were assessed. Myeloid surface markers as (CD34, CD33, CD13 and CD14) and lymphoid surface markers as (CD3,CD5, CD2, CD4 ,CD8 and CD19)were analyzed by flow cytometry (FACS can, Becton Dickinson, Mountain View, CA, USA). Results: The studied groups with MDR gene, BCRP gene show highly significant difference compared to the control (P0.000). The relation between MDR & BCRP in both AML and ALL groups shows no significant difference. There was a significant difference between BCRP expression in AML, ALL groups (P0.01). No significant difference as regards overall survival between MDR +ve cases and MDR negative cases in AML and ALL. In contrast Overall survival in BCRP +ve cases and BCRP negative cases shows a significant difference between AML and ALL groups (P0.01). No significant difference was detected between O.S in AML (MDR +ve , CD34 +ve) and AML (MDR +ve, CD34 negative). In contrast, O.S between AML (BCRP +ve ,CD34 +ve)and AML (BCRP +ve ,CD34 negative) shows a significant difference (P0.01). The difference between O.S in ALL (MDR +ve, CD34 +ve) and ALL (MDR +ve, CD34 negative) was not significant. In contrast a significant difference was detected between O.S in ALL (BCRP +ve, CD34 +ve) and ALL (BCRR +ve, CD34 negative) (P0.01). Overall survinal in AML group with BCRP +ve (CD13 +ve) shows a significant difference (P0.01). In ALL group the association between (MDR +ve and CD19 +ve) or (BCRP +ve and CD19 +ve) cannot significantly affect the survival. Conclusion: We concluded that the evaluation of the expression of genes for resistance to antineoplastic drugs in acute leukemia upon diagnosis, and particularly the expression of the BCRP gene, may be of clinical relevance.

It is known that lymphocytes immunophenotype is a reflection of the functional level of the immune system. The immunosuppressive effect of major burns is also known for many years. T lymphocytes of 50 major burn patients were analyzed in base line (BL) samples at 24 hours and at 1 week and 2 weeks after burn, using monoclonal antibodies of CD3, CD4, CD8, CD25 (IL2R) and HLA-DR by flow cytometry and β2-microglobulin (β2-m) by ELISA. Recorded values were compared with those of 50 healthy donors. There was statistically significant reduction in absolute number of CD3 positive cells (CD3+) (p0.000) and CD4/CD8 ratio (p=0.01) in the first 24 hours in comparison with controls. CD25 (IL-2R) shows insignificant upregulation on T lymphocytes after burn with significant upregulation of HLA-DR. The absolute number of CD3+ cells began to increase after 2 weeks (p=0.03) but remained less than controls (p=0.08). CD4/CD8 ratio was more or less same as healthy controls after 2 weeks. Upregulation of CD25 was insignificantly increased and that of HLA-DR was markedly increased after 2 weeks (p=0.001). Significant negative correlations were detected between mean values of β2-m and both absolute numbers of CD3 and CD4 positive cells in BL and one week samples. In addition there was significant correlation between mean values of β2-m and values of CD25 expression in the BL samples. The obtained data is suggestive of persistent activation of T lymphocytes two weeks after major burns whereas early shedding of β2-m is related to activation of lymphocytes increasing their susceptibility to apoptosis, both indicative of altered immune response. Burn intensivists and surgeons should be keen to support the patients’ immune system in the first hours following major burns. This support will ensure free-bacteremic blood with a consequent better prognosis.

It is known that lymphocytes immunophenotype is a reflection of the functional level of the immune system. The immunosuppressive effect of major burns is also known for many years. T lymphocytes of 50 major burn patients were analyzed in base line (BL) samples at 24 hours and at 1 week and 2 weeks after burn, using monoclonal antibodies of CD3, CD4, CD8, CD25 (IL2R) and HLA-DR by flow cytometry and β2-microglobulin (β2-m) by ELISA. Recorded values were compared with those of 50 healthy donors. There was statistically significant reduction in absolute number of CD3 positive cells (CD3+) (p0.000) and CD4/CD8 ratio (p=0.01) in the first 24 hours in comparison with controls. CD25 (IL-2R) shows insignificant upregulation on T lymphocytes after burn with significant upregulation of HLA-DR. The absolute number of CD3+ cells began to increase after 2 weeks (p=0.03) but remained less than controls (p=0.08). CD4/CD8 ratio was more or less same as healthy controls after 2 weeks. Upregulation of CD25 was insignificantly increased and that of HLA-DR was markedly increased after 2 weeks (p=0.001). Significant negative correlations were detected between mean values of β2-m and both absolute numbers of CD3 and CD4 positive cells in BL and one week samples. In addition there was significant correlation between mean values of β2-m and values of CD25 expression in the BL samples. The obtained data is suggestive of persistent activation of T lymphocytes two weeks after major burns whereas early shedding of β2-m is related to activation of lymphocytes increasing their susceptibility to apoptosis, both indicative of altered immune response. Burn intensivists and surgeons should be keen to support the patients’ immune system in the first hours following major burns. This support will ensure free-bacteremic blood with a consequent better prognosis.