BACKGROUND: The melanocyte and keratinocyte transplantation procedure (MKTP) is a safe and effective procedure in treatment of vitiligo. Major advantage of this technique is that a small area of donor skin is needed to cover a large recipient area. To date, there is no consensus on the optimal donor-to-recipient ratio (D/R) required to achieve acceptable repigmentation following melanocyte and keratinocyte transplantation procedure (MKTP) in generalized vitiligo. It has been postulated that the addition of post-transplantation phototherapy may enhance the results. This is first study to assess two different (D/R) ratios with or without adjuvant phototherapy. OBJECTIVE:To compare the repigmentation after MKTP using two different D/R ratios (1/3 and 1/10) with and without adjuvant phototherapy (NB-UVB)..METHODS AND MATERIALS: In this non randomized prospective clinical trial, 42 patients with stable generalized vitiligo bilateral and symmetrical in distribution were included. Patients were divided into two groups, 21 patients with a total of 50 lesions were treated with MKTP using a D/R ratio of 1/3 (Group I; 3000 ± 500 cell/mm2 ) and the other 21 patients with a total of 52 lesions were treated by MKTP using a D/R ratio of 1/10 (Group II; 1000 ± 200 cell/mm2 ). To study the role of adjuvant phototherapy on repigmentation, lesions in each patient were divided into two subgroups (a and b): lesions in subgroups Ia and IIa (did not receive NB-UVB) and lesions in subgroups Ib and IIb (received adjuvant phototherapy NB-UVB, two sessions per week for 6 months). The overall grading of repigmentation used was excellent (90%-100% repigmentation), good (75%-89%), fair (50%-74%), and poor (50%). Also, the percentage of VASI change and color matching were used to assess the results. The study design was approved by the ethical committee of the Faculty of Medicine, Assiut University (IRB attached).RESULTS:The mean percentage of repigmentation was significantly better in group I than group II cases in both areas with or without adjuvant NB-UVB. It was 86.00 ± 16.21 and 87.62 ± 11.66 in subgroups Ia and Ib, respectively, vs 24.14 ± 18.08 and 29.98 ± 16.34 in subgroups IIa and IIb, respectively (P value was 0.000). The percent of excellent response was significantly better in group I than group II. It was 60% and 64% in subgroups Ia and Ib, respectively, and 7.6 and 11.5 in subgroups IIa and IIb, respectively (P value was 0.000). The mean percentage of VASI change was significantly better in group I than group II cases in both areas. It was -90.74 ± 15.84 and -92.06 ± 11.86 in subgroups Ia and Ib, respectively, vs -23.10 ± 32.85 and -26.03 ± 35.15 in subgroups IIa and IIb, respectively (P value was 0.000). The percent of excellent color match was better in group I than group II. It was 84% and 88% in subgroups Ia and Ib, respectively, vs 34.6 in both subgroups IIa and IIb (P 0.05). A higher density of epidermal cells was transplanted in the recipient area in group I (3000 ± 500 cell/mm2 ) compared to group II (1000 ± 200 cell/mm2 ). There were no statistically significant differences between subgroups (Ia vs Ib and IIa vs IIb) although percentage of repigmentation was slightly better in NB-UVB subgroups.CONCLUSIONS:The higher density of epidermal cells used in the suspension, the higher the percentage of repigmentation obtained. The usage of adjuvant phototherapy following NKMT can enhance the repigmentation response.

BACKGROUND: Although gene expression profiling provided a comprehensive molecular characterization of different subtypes of bladder urothelial carcinoma (UC), which are distinct in their biological features and prognosis, such a system is not yet applicable for routine clinical practice. This study aimed to examine the expression of these molecular classes of UC using simple panel of immunohistochemical markers. MATERIALS AND METHODS: Tissue sections from 192 specimens of UC were stained with FGFR3, CK5, CCNB1, HER-2, and P53. The molecular classes identified were correlated with clinicopathologic characteristics and patient survival. RESULTS: The most frequent class in our cohort was urobasal B (UroB) (44.1%), followed by squamous cell carcinoma-like (SCCL) (22%), genomically unstable (GU) (20.3%), and urobasal A (UroA) (13.6%). Patients with SCCL were significantly younger (P .0001). Both the SCCL and GU types were of significantly higher histopathologic grade (P .0001). UroA tumors were mainly of the T1 stage (75%), whereas 61.5% of the SCCL and 58.3% of the GU types were of stage T2 (P .001). Prognosis was significantly different among groups. The SCCL class showed the lowest overall survival (38.5%; P = .030) and metastasis-free survival (69.2%; P = .017). The best prognosis was for UroA, with an overall survival of 75% and no metastatic events. CONCLUSION: The distribution of UC subtypes in our study was uniquely different from other studies. This simple immunohistochemical panel could be suggested as a clinically applicable tool that has the potential to be used routinely in guiding individualized treatment of UC.

BACKGROUND: Although gene expression profiling provided a comprehensive molecular characterization of different subtypes of bladder urothelial carcinoma (UC), which are distinct in their biological features and prognosis, such a system is not yet applicable for routine clinical practice. This study aimed to examine the expression of these molecular classes of UC using simple panel of immunohistochemical markers. MATERIALS AND METHODS: Tissue sections from 192 specimens of UC were stained with FGFR3, CK5, CCNB1, HER-2, and P53. The molecular classes identified were correlated with clinicopathologic characteristics and patient survival. RESULTS: The most frequent class in our cohort was urobasal B (UroB) (44.1%), followed by squamous cell carcinoma-like (SCCL) (22%), genomically unstable (GU) (20.3%), and urobasal A (UroA) (13.6%). Patients with SCCL were significantly younger (P .0001). Both the SCCL and GU types were of significantly higher histopathologic grade (P .0001). UroA tumors were mainly of the T1 stage (75%), whereas 61.5% of the SCCL and 58.3% of the GU types were of stage T2 (P .001). Prognosis was significantly different among groups. The SCCL class showed the lowest overall survival (38.5%; P = .030) and metastasis-free survival (69.2%; P = .017). The best prognosis was for UroA, with an overall survival of 75% and no metastatic events. CONCLUSION: The distribution of UC subtypes in our study was uniquely different from other studies. This simple immunohistochemical panel could be suggested as a clinically applicable tool that has the potential to be used routinely in guiding individualized treatment of UC.

BACKGROUND: Although gene expression profiling provided a comprehensive molecular characterization of different subtypes of bladder urothelial carcinoma (UC), which are distinct in their biological features and prognosis, such a system is not yet applicable for routine clinical practice. This study aimed to examine the expression of these molecular classes of UC using simple panel of immunohistochemical markers. MATERIALS AND METHODS: Tissue sections from 192 specimens of UC were stained with FGFR3, CK5, CCNB1, HER-2, and P53. The molecular classes identified were correlated with clinicopathologic characteristics and patient survival. RESULTS: The most frequent class in our cohort was urobasal B (UroB) (44.1%), followed by squamous cell carcinoma-like (SCCL) (22%), genomically unstable (GU) (20.3%), and urobasal A (UroA) (13.6%). Patients with SCCL were significantly younger (P .0001). Both the SCCL and GU types were of significantly higher histopathologic grade (P .0001). UroA tumors were mainly of the T1 stage (75%), whereas 61.5% of the SCCL and 58.3% of the GU types were of stage T2 (P .001). Prognosis was significantly different among groups. The SCCL class showed the lowest overall survival (38.5%; P = .030) and metastasis-free survival (69.2%; P = .017). The best prognosis was for UroA, with an overall survival of 75% and no metastatic events. CONCLUSION: The distribution of UC subtypes in our study was uniquely different from other studies. This simple immunohistochemical panel could be suggested as a clinically applicable tool that has the potential to be used routinely in guiding individualized treatment of UC.

Background and aims: Clinicopathological features of Basal-like Breast Cancer (BLBC) in African American women have been extensively studied. Comparatively, less is known about these tumors in patients from countries in the North African region. The aim of this study was to assess the frequency and clinicopathological characteristics of BLBC in Egyptian patients with comparison to British patients. Material and methods: Tissue microarray blocks were constructed from primary invasive breast cancer from 321 Egyptian and 527 British BC patients. Sections were stained immunohistochemically with oestrogen receptor (ER), progesterone receptor (PR), HER2, CK19, CK14, EGFR, CK5/6, P53 and Ki67. BLBC phenotype was identified by lacking of staining of ER, PR, HER2 and positive staining for any of the CK14, CK5/6 and/or EGFR. Results: The rate of BLBC phenotype was higher in Egyptian cohort (21%) than the British cohort (13%). BLBC tumors from both Egyptian and British patients were significantly associated with tumors of higher histopathological grade (P0.001& P0.001), higher proliferation rate (P0.001& P=0.001), and higher rate of P53 expression (P0.001& P0.001) respectively. Compared with the British tumors, BLBC in Egyptian women were significantly of larger tumor size (P0.001) and were associated with more advanced lymph node (LN) stage (P0.001). Conclusion: BLBC occurred more frequently in Egyptian patients compared with British women and are characterized by unfavorable biological features akin to BLBC in African American women. These warrant further studies to unravel the genetic background of BLBC and whether their aggressive features are related to ethnic origin or other multi-factorial and environmental variables.

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Aging is a complex process and many factors in the elderly, especially multiple diseases and related unnecessary drug use, support a deprescription approach to this age group to save money and health cost. In this review, we have searched for studies related to the pharmacoeconomic aspect of this deprescription approach in the elderly. Few studies are available, but they are promising and effective in paving the way for prospective longitudinal studies to assess the role of deprescription in optimizing the drugs prescribed to aged patients in a way that reduces the costs of both drug adverse effects and/or hospitalization. Awareness of deprescription is important not only to society, but also to hospital stuff and individual patients.

Squamous cell carcinoma of the conjunctiva (SCC) is considered as one of the ocular surface squamous neoplasia (OSSN). It is the most common conjunctival malignancy. In this report, we describe the short term success of surgical excision, followed by topical chemotherapy, with 5-fluorouracil (5-FU) and mitomycin C (MMC) eye drops, in a 43-year old Egyptian woman.