IRAQI JOURNAL OF MEDICAL SCIENCES

Back ground: The failure of current treatment strategies to control many cases of IBD makes a strong stimulus to find out new modalities of treatment.
Aims: to study the effects of zinc sulfate on induced colitis in rabbits.
Materials and Methods: Colitis was induced in rabbits by rectal acetic acidethanol (model 1), or acetic acid (model 2).
The effects of zinc sulfate were compared to distilled water (control), and prednisolone regarding changes in body weight, colon segment weight, and gross and microscopical scores. Plasma zinc and copper concentrations were measured in control and zinc sulfate groups in both
models.
Results: In model 1, severe gross and microscopical damage observed in colon. Gross and microscopical scores of zinc sulfate group were not significantly different from that of control and of prednisolone groups.
In model 2, a less severe inflammation occurred; yet, an evident gross and microscopical damage were observed. Zinc sulfate and prednisolone
treatment reduced the loss of body weight of rabbits in comparison to the control. The gross and microscopical damages were significantly lowered in zinc sulfate and prednisolone groups.
In both models (1 and 2), a significant decrement in post induction mean plasma zinc level was detected (p < 0.05); however, such decrement could be corrected by zinc sulfate therapy.
Conclusions: Acetic acid -induced colitis in rabbits (model II) is preferred for testing the anti-inflammatory effectiveness of new therapeutic modalities. Zinc sulfate has a valid prophylactic activity in this model.

Background: Several investigators reported an excess of cardiovascular morbidity and mortality among RA patients. The majority of cardiovascular deaths results from accelerated atherosclerosis.
Elevated plasma total cholesterol (TC)and low –density lipoprotein cholesterol (LDLC),decreased high – density lipoprotein cholesterol (HDL-C) are strong factors for atherosclerotic events.
Objectives: This study was done to:
1- Show the changes of serum lipid profile in patients with ERA.
2- Explain the pathological role of changing lipid profile in ERA and to demonstrate the changes of atherogenic ratio in ERA patients.
3- Presenting the correlation between lipid profile and different inflammatory markers especially ESR and CRP.
Method: Twenty five patients with ERA who met the American college of rheumatology (ACR) 1987 criteria for rheumatoid arthritis (RA) had early disease with disease duration of less than one year without prior use of disease modifying antirheumatic drugs (DMARDS)and or systemic steroids were examined for their lipid profile level and the relation of the atheroganic ratio to their disease were investigated during the period between March –December 2006 in the department of rheumatology at Al –Kadhimiya teaching hospital .Lipid profil (TC,LDL-C,HDL –C and TG)ESR and C-reactive protein were determined for both the patients and control
groups.
Results: The results of the study revealed that ERA patients exhibited higher serum levels of total cholesterol (TC) low- density lipoprotein cholesterol (LDL) and triglycerides (TG).Where as their serum high –density lipoprotein cholesterol (HDL –C) levels were significantly lower compared to control .As a consequence the atherogenic ratio of TC /HDL –C as well as that of LDL-C/HDL –C was significantly higher in ERA patients compared to controls and these changes were correlated with laboratory changes especially GRP and ESR .
Conclusion: ERA patients are characterized by an atherogenic profile in comparision with the healthy control subject .Recognition and treatment of early rheumatoid arthritis and reduction of these and other cardiac risk factor has greater impact on the course of the diseases.

Background: Melatonin is a neuro-hormone of the pineal gland. It increases and enhances immunity, whether in animals or human. The mononuclear – phagocyte system; is a single functional immune unit. The pulmonary alveolar macrophages are one of the most important members included within this immune unit.
Objective: This work tried to study the effect of different doses of dietary melatonin on adult rat\'s pulmonary alveolar macrophages.
Methods: Melatonin was supplied to adult rats, for successive 30 days. Rats were divided into 6 groups. Group I was the control. Group II, III, IV, V and VI were given a daily dose of melatonin as 125, 250, 500, 750 and 1000 µg / kg body weight, respectively. After the last day of treatment, the left lung of the rat was removed under anesthesia for histological study.
Results: The results showed significant beneficial effects on pulmonary alveolar macrophages by normal therapeutic dosages, whereas with further stepping up doses, significant damaging effects were seen.
Conclusion: Dietary melatonin had good effects on the rat\'s pulmonary alveolar macrophages within therapeutic doses, whereas it had highly damaging changes in overabundance.

Background: The spermatozoa are provided with the needed capacity for normal motility, in the epididymidis, so the function of epididymidis is very important for the normal fertility. Melatonin is the basic neuro-hormone of the pineal gland, regulates the sexual and reproductive activities in all mammals including man.
Objective: To study the effect of different doses of dietary melatonin on the histology of adult rat\'s epididymidis.
Methods: Melatonin was supplied to adult Wister albino rats with their diet, for successive 30 days. Rats were divided into 6 groups. Group I was the control. Group II, III, IV, V and VI were given a daily dose of 125, 250, 500, 750 and 1000 µg / kg body weight, respectively. After the last day of treatment, animals were killed under effect of anesthesia; epididymidis was removed, fixed in Bouin’s solution and processed routinely for histological study.
Results: The results showed significant positive effects on epididymidis, since it increased the epididymal wall thickness, epididymal, as well as spermatozoal clump within epididymal tubules, with normal therapeutic dosages, whereas significant damaging effects were seen with raising dosages.
Conclusion: Dietary melatonin has clear positive effects on the rat\'s epididymidis within therapeutic doses, since it increased the epididymal wall thickness, epididymal, as well as spermatozoal clump within epididymal tubules, whereas it had highly damaging changes in surplus doses.

Background: As a result of hypoxia, acidosis and effect of drugs used in chronic obstructive pulmonary disease arrhythmia can develop in many patients. Improvement in pulmonary function will result in decreasing the incidence of arrhythmia.
Aim of study: To describe the frequency of cardiac arrhythmia in patient with COPD recorded by 24 hour holter monitoring and their relationship to clinical and homodynamic factors.
Patients and methods: Fifty patient with COPD and fifty patients with normal people monitored by pulmonary function test, 12 lead standards ECG and 24 hour holter monitor.
Result: Different types of arrhythmia were seen in patients with COPD and there is increase incidence of arrhythmia with the development of cor-pulmonal.

Background: Thymoma is a rare tumor, it represent 0.09% of all tumors in Iraq still it’s the most frequent anterosuperior mediastinal tumor.
Aim of the study: Study the clinicopathological features of thymoma in Iraqi patients.
Materials and Methods: A retrospective study on Fifty-one cases of thymoma, randomly selected from three specialized cardiothoracic centers in Baghdad for the period from Jan.1991 to Oct.2004. Paraffin blocks were collected, and 4 micrometers sections were stained with Hematoxyline & Eosin stain. Thymoma was classified according to the most recent WHO histopathological classification (1999). And staged according to Masaoka`s staging system (1981), TNM staging system (1991) and GETT staging system (1991.
Results: The fifty one cases included 19 females (37.25%) and 32 males (62.75%) their age ranged from 11-67 years with a mean of (39 +13.6) years. About half of the patients (54.9%) were found to have myasthenia gravis. WHO sub typing revealed that B2 was the most frequent subtype (35.3%). A significant correlation was found between WHO classification system &, Masaoka`s &TNM staging system, and with the sex of the patients.
Conclusion: MG was the only paraneoplastic syndrome diagnosed in this study. A significant correlation was found between WHO classification system & Masaoka`s & TNM staging system, and with the sex of the patients.

Human cytomegalovirus (HCMV) has been implicated to transform many mammalian cells, so we tried to investigate whether HCMV participates in human colorectal carcinogenesis.
Methods: Immunohistochemistry analysis using monoclonal antibody of HCMV early protein was conducted on tissues of 32 colorectal adenocarcinomas and eight colorectal hyperplastic polyps, tissues of normal tumor margin were considered as control.
Results: HCMV early protein was detected in five out of 32 (15.6%) colorectal adenocarcinomas, while none of the eight colorectal hyperplastic polyps and tissues of normal tumor margins was positive for the virus early protein.
Conclusion: the data of this study suggests that HCMV may participate in the process of colorectal carcinogenesis as it is evidenced that HCMV was detected in colorectal cancer tissues only.

Background: Th1-type cytokines secretion such as IFN-γ, and Th2 cytokines such as IL-10, have been shown to exert deleterious effects on pregnancy, inhibiting fetal growth and development
Objective: Estimation of Interleukin-10 (IL-10), IL-8 and IFN-γ levels in sera of patients with recurrent spontaneous abortion (RSA) using ELISA method.
Method: A total of one hundred and nineteen women, ranged from the mean age (23.9 – 28.5)years, were enrolled in the current study and were further classified into three categories: Group A- Recurrent spontaneous abortion (RSA): n= 62 women, with a mean age of (28.5 + 0.68);Group B- non- recurrent spontaneous abortion (non-RSA): n= 34 women, with a mean age of (26.4 ± 0.85)and group C- Control (successful pregnancy): n= 23 women, with a mean age of (23.9 ± 0.88). From each patient and control blood sample was collected and serum was eparated. Estimation of Interleukin-10 (IL-10), IL-8 IFN-γ levels in sera of patients was done using ELISA method.
Result: the current study failed to demonstrate a significant difference in circulating levels of IL-8 between RSA and control group (p> 0.05) and no significant different between non-RSA and control (p>0.05) . IFN-γ expression is significantly increased (p<0.001) in women with RSA and non-RSA compared with successful pregnancy. Defective IL-10 expression in women with RSA and non-RSA .The ratio of IFN-γ: IL-10 was found to be highly significant (p<0.001) in aborted women. IL-8 was expressed in high levels in aborted women (RSA and non-RSA) and those with successful pregnancy, but no significant difference (p>0.05) was found when compared between successful pregnancy and RSA or non-RSA, whereas highly significant difference (p<0.001) was found between RSA and non-RSA.
Conclusions: IFN-γ expression is highly significant increased (p<0.001) in women with RSA and non-RSA compared with successful pregnancy, indicating that Thl cytokines might well be implicated in adversely affecting pregnancy. And defective IL-10 expression in women with RSA and non-RSA might be documentary to the previous studies on the possible defect in Th2 cytokines production in these patients.

Background: Colorectal cancer is a major cause of morbidity and mortality worldwide. Prognostic assessment influences the treatment of patients with colorectal cancer, including decisions about adjuvant therapy. Bcl2 over-expression is a genetic event associated with tumor progression and is a prognostic marker of this disease.
Objective: Colorectal carcinoma is a major cause of morbidity and mortality worldwide. Bcl2 overexpression is a genetic event associated with tumor progression and is a prognostic marker for this disease. The aim of this study is to assess the expression of bcl2 in colorectal carcinoma and its correlation with other clinicopathological parameters.
Methods: From January 2004- January 2005, thirty –five formalin fixed paraffin embedded tissue samples from patients with colorectal carcinoma were included in this study. Four-micrometer tissue sections were obtained for each case, two of them were stained by H&E and the diagnosis had been revised, and the other two were stained immunohistochemically by using avidin biotin alkaline phosphatase method for evaluating bcl2 expression. The presence of red cytoplasmic staining in less than 25% of tumor cells was considered a positive expression of bcl2.
Statistical analysis of all the results were performed using Chi square test at level of significance alpha = 0.05 (P<0.05) regarded as statistically significant.
Results: Bcl2 expression was significantly higher in low grade and early stage colorectal carcinoma .Non mucinous colorectal cancer showed more bcl2 expression than the mucinous type. An inverse correlation was found between bcl2 expression with the greatest diameter of the tumor and the lymph node status. Bcl2 expression was correlated neither with the age nor with the sex of the patient and the tumor location.
Conclusion: Bcl2 over-expression correlates with many variables as low grade colorectal tumor, early stage, non mucinous type, small tumor size and negative lymph node status.

Background: Carcinoma of the stomach is on of the most prevalent cancer types in the world today. P53 is the most notable tumor suppressor gene mutated in human cancers, including gastric cancer. The practical implication of this phenomenon in gastric cancer prognosis or even treatment by restoration of mutated p53 function are yet to be fully exploited.
Objective: To assess the immunohistochemical expression of p53 protein in gastric carcinoma and to study the correlation between p53 protein expression and different clinicopathological variables like: age, gender, site, gross pattern, histological type, grade, and stage of the tumor in gastric carcinoma cases.
Materials and methods: Forty formalin fixed paraffin embedded gastric carcinoma tissue blocks (partial or total gastrectomy specimens) from the archived materials of the Department of Pathology of Baghdad Teaching Hospital and the Center of Gastrointestinal and Hepatic Diseases , and other private laboratories were included in this study. A four micrometer –thick tissue sections were obtained and three slides had been prepared for each case, one was stained with Hematoxylin and eosin (H&E) and then reviewed, while two sections were stained immunohistochemically for p53. Statistical analysis was done using chi-square test for tables with frequencies, percentages, range, mean and standard deviation. Values were considered statistically significant when P<0.05.
Results: A clinico-pathological assessment revealed that 28 patients were males and 12 patients were females. Male to female ratio was 2.3 /1. The age of patients ranged between 30-80 years with a mean ± standard error of (55.77±1.88 year). The majority of the gastric carcinoma cases, in this study (70%) were above 50 years of age. Large proportions of gastric carcinoma cases (80%) were located in the antral region while the remaining cases were located in the cardia region. The ulcerative gross pattern was the most predominant gross pattern type(72.5%). Whereas the commonest histological type was the intestinal type (75%). The majority of the gastric carcinoma cases (62%) were moderately differentiated. Most of the gastric carcinoma cases (92.5%) fall in stage lll disease. The overall expression of p53 in gastric carcinoma cases in the present study was (44%). No statistically significant difference was found between p53 overexpression with age and sex of patients (P>0.05).Although there was no significant correlation in the relation ship between p53 overexpression with tumor site and gross pattern type, p53 positivity rate was higher in gastric carcinoma cases located in the antrum and in those cases of ulcerative gross pattern type. P53 overexpression was more commonly seen in gastric carcinoma case of intestinal type compared to diffuse type, However, the results were statistically not significant (P>0.05). P53 overexpression was more common in gastric carcinoma cases of moderately differentiated type compared to poorly differentiated type, with no statistically significant difference (P>0.05) . Although the majority of gastric carcinoma cases which showed positive p53 expression were in stage lll disease, these results were not significant (P>0.05).
Conclusion: The overall expression of p53 protein in gastric carcinoma cases in this immunohistochemical study was 44%. There was no significant correlation between p53 overexpression and different clinicopathological variables like: age, gender, gross pattern, histological type, tumor grade and stage.

Background: Cervical cancer is one of the most frequent diseases in women; it comprises approximately 12% of all cancers in women worldwide. P53 is a tumor suppressor gene, functional inactivation of the P53 gene is a key event in tumorigenesis of many human malignancies, in cervical carcinoma this functional inactivation could occur either due to mutations or causes other than mutations like binding and inactivation or degradation by viral proteins.
Objective: To assess the immunohistochemical expression of P53 in invasive cervical carcinoma (squamous cells carcinoma and adenocarcinoma) and to study the correlation between P53 over-expression with clinico-pathological variants (age, grade of tumor and histological type).
Materials and methods: A total of 42 tissue samples of invasive cervical carcinoma (30 cases of squamous cell carcinoma and 12 cases of adenocarcinoma) were included in this retrospective study.
The samples were obtained from archival paraffin embedded blocks covering the years 1998 to 2005 from the histopathology files of al-Kadhimiya Teaching Hospital, Al-Ulwiya Teaching Hospital and from private laboratories. All the clinico-pathological data had been obtained from the files of these patients.
Out of 12 cases of adenocarcinoma, 8 had punch biopsy, and 4 had hysterectomies .For the 30 cases of squamous cell carcinomas, 16 patients had punch biopsy and 14 had hysterectomy.
All cases were analyzed by immunohistochemical staining with P53 tumor marker.
Results: The percentage of P53 over-expression in cervical adenocarcinoma (58.3%) was significantly higher than P53 over-expression in cervical squamous cell carcinoma (16.66%), (P<0.05).
P53 nuclear positivity in poorly, moderate and well-differentiated invasive cervical cancers was (50%, 18.18%, and 16.16% respectively), with no significant difference between P53 over-expression in different grades (P>0.05).
The percentage of P53 over-expression for the patients below the age of 50 was (32.14%) and for those equal and above 50 was (17.64%), no significant difference was found in P53 over-expression between the two age groups.
From the clinico-pathological assessment, the mean age of cervical adenocarcinoma (38.5 ±1.11 S.D. years) was significantly lower than the mean age of cervical squamous cell carcinoma (47.5±1.94 S.D. years).
No significant difference was found between the grade of the invasive cervical carcinoma and the two histological types.
Conclusion: In this study, a significant correlation has been found between P53 over-expression and the histological type of the invasive cervical carcinoma.
-Although there was no statistical correlation between P53 over-expression and the three grades of the invasive cervical carcinoma, poorly differentiated tumors showed the higher percentage of P53 over-expression.
-No significant difference was found between P53 over-expression and the age of the patient.

Recurrent pregnancy loss (RPL) has been found to be associated with increase in the pro-inflammatory cytokines which cause up-regulation of inflammatory mediators including cell adhesion molecules (CAMs) that might act in aggravation of this pathological process.
Objective: To find out whether there is a relation between the pathology of RPL and the expression of intracellular adhesion molecule-1 (ICAM-1) and ICAM-3 at the feto-maternal interface in these patients.
Methods: Immunohistochemistry technique was performed to detect and determine the expression of ICAM-1 and ICAM-3 using paraffin embedded sections of curate samples obtained from 40 women, who where divided into three groups: 24 women with RPL, 10 women with abortion for the first time, and 6 women with induced abortion.
Results: The levels of the expression of both endothelial ICAM-1 and leukocytes ICAM-3 at the feto-maternal interface were found to be significantly up-regulated in the first group as compared with the second and the third groups (p=0.001), with a highly significant positive correlation between these two parameters (r=0.927, p<0.01).
Conclusion: ICAM-1 and ICAM-3 might play an important role in the pathology of RPL by increase adherence and recruitment of inflammatory cells at the feto-maternal interface ending with a pregnancy failure

Background: Shoulder pain is one of the complications that happened in patient suffered from hemiplegia. There are many pathological processes have been postulated as causes of painful hemiplegics shoulder after stroke. One of the causes is Rotator cuff syndrome. Other causes of shoulder pain are biceptal tendonitis; Subacromial and sub-deltoid Bursitis, Adhesive capsulitis (frozen shoulder) is a common painful condition associated with loss of active movement in the direction of external rotation and abduction.
Objective: The aim of this study is to analyze shoulder pain and its correlation with the different clinical aspects of cerebral dysfunction.
Patients and method: 56 patients affected by different types of stroke were enrolled in this study , each patient was examined by neurologist, CT scan then done and referred to a consultant rheumatologist at Al-Kindi hospital for assessment of his shoulder area, the patient then investigated thoroughly for his or her shoulder pain.
Results and conclusion: The study showed high correlation between shoulder pain and older age patients, aphasia, cortical sensory defects. The shoulder pain development is more common in older age group. Patients with cortical involvement are at high risk to develop shoulder pain. The shoulder pain development is not related to the side of hemiplagia, sex and grading of muscle weakness.

Background: The major histocompatiblity complex (MHC) refers to as human leukocyte antigen (HLA). The loss of HLA antigens by neoplastic cells is considerably important for tumor growth and metastasis and expression of certain certain HLA allels may predispose to have certain types of tumors.
Objective: To investigate the genetic susceptibility of HLA-DRB1, DRB3, DRB4 and. DRB5 alleles to brain astrocytomas in Iraqi patients.
Methods: HLA-DRB1, DRB3, DRB4 and, DRB5 allele polymorphisms were typed by polymerase chain- reaction with sequence-specific primers (PCR-SSP) in 30 unrelated patients astrocytomas and 17 unrelated normal control subjects. The association was measured by appropriate statistical tests.
Results: Allele frequency (AF) of HLA-DRB1*10011 and DRB1*10012 was significantly decreased in brain astrocytomas patients than that in normal controls (0.53 vs 0.93) the odds ratio 8.76). There was no association between patients and controls in the rested HLA-DRB1 alleles.
Conclusion: HLA-DRB1*10011 and DRB1*10012 alleles were less common in the patients with brain astrocytomas than in the healthy controls. Individuals carrying HLA-DRB1* 10011 and DRB1*10012 alleles might be considered as protective markers. These protective alleles; might have a role in the degree of malignancy of the tumors and its histological type.

Ulcerative Colitis is one type of the inflammatory bowel diseases that affect the rectum and the colon. The usual age of presentation is at adolescence and adulthood. It is rarely seen during infancy and in young children. Our case, Mohammed, was presented at the age of 18 months with persistent bloody diarrhea that did not respond to the usual antibiotic and anti-parasitic drugs. All the investigations that were done during the period of the illness (more than 9 months) were non conclusive. Then colonoscopy were done which revealed the picture of ulcerative colitis. The patient then was put on oral steroid and salazopyrine with dramatic improvement in the general condition and disappearance of bloody diarrhea. Now the patient is on salazopyrine orally with steroid only in exacerbations.