Gene therapy, science fiction or science fact?

The term gene therapy is commonly understood to be the use of DNA as a pharmaceutical agent to treat diseases. This may be done by replacing defective or absent genes or to counteract those that are overexpressed. This would have been a science fiction story only a few years ago. Currently, gene therapy has attracted considerable attention and has become a hot topic for investigation. Gene therapy aims to repair the cause of the problem and not merely suppress symptoms, provides long-term cure, and does not require repeated applications or clinic visits

Bone marrow stem cells as a potential treatment of experimentally induced cartilage defects in the knee joint of adult male albino rats

Spontaneous proper healing of articular cartilage trauma in adults is rare and osteoarthritis might develop as a result. Cultured bone marrow mesenchymal stem cells [BM-MSCs] could differentiate into chondrocytes, and might thus be a good choice for treating such trauma. To assess the efficacy of an intraarticular injection of BM-MSCs derived from young albino rats in the repair of an induced chondral defect in the knee joints of adult albino rats. Six young male albino rats were used as a source of BM-MSCs. In addition, 30 adult male albino rats were divided into four groups. Group I served as a control. Group II served as a model of a chondral defect. Group III was subdivided into subgroups IIIa and IIIb, in which a cartilage defect was induced and sacrificed after 4 and 8 weeks, respectively. Group IV was subdivided into subgroups IVa and IVb, in which a cartilage defect was induced and injected intraarticularly by BM-MSCs suspended in hyaluronic acid [HA] in the right knees and HA alone into their left knees and then sacrificed after 4 and 8 weeks, respectively. Histological, immunohistochemical, and statistical studies were performed. Group III showed healing of the defect by fibrous tissue. However, BM-MSCs- injected knees healed by hyaline-like cartilage, whereas the HA injection induced healing by fibrocartilage. Intraarticular injections of BM-MSCs suspended in HA promoted healing of an articular cartilage defect by hyaline cartilage. Thus, it is recommended to treat a traumatic articular cartilage injury by BM-MSCs

Gene therapy in glaucoma-part I: basic mechanisms and molecular genetics

Glaucoma is the second most common cause of blindness in the world as determined by the World Health Organization [WHO]. Glaucoma diagnosis, identification of people at risk, initiation of treatment and timing of surgical intervention remains a problem. Despite new and improving diagnostic and therapeutic options for glaucoma, blindness from glaucoma remains a major public health problem. The role of heredity in ocular disease is attracting greater attention as knowledge and recent advances of Human Genome Project and the HapMap Project have made genetic analysis of many human disorders possible. Glaucoma offers a variety of potential targets for gene therapy. All risk factors for glaucoma and their underlying causes are potentially susceptible to modulation by gene transfer. The discovery of genes responsible for glaucoma has led to the development of new methods of Deoxyribonucleic acid [DNA]-based diagnosis and treatment. As genetic defects responsible for glaucoma are identified and the biochemical mechanisms underlying the disease are recognized, new methods of therapy can be developed. It is of utmost importance for ophthalmologists and glaucoma specialists to be familiar with and understand the basic molecular mechanisms, genes responsible for glaucoma and the ways of genetic treatment. The literature was searched on the Medline database using the Pubmed interface

Effect of omega-3 versus omega-6 fatty acids on induced ulcerative colitis in male albino rat. Light and electron microscopic study

Ulcerative colitis [UC] is an inflammatory bowel disease [IBD] well known by its exacerbated immune response. At present, a specific causal treatment for IBD is not available. The drugs currently used for management of IBD unfortunately are not devoid of potentially serious side effects. Polyunsaturated fatty acids [PUFAS] as omega-3 and omega-6 were reported to have immunomodulatory activities. Hence, may be of benefit in treating UC. The goal of this study was to illustrate the effect of omega-3 and omega-6 fatty acids on ulcerative colitis induced in male albino rat. Thirty adult male albino rats were used in the study. They were divided into four groups; Group I served as a control group. Group II was used as a model of ulcerative colitis. Rats of this group were subjected to intracolonic enema injection of 1 ml of 2% acetic acid for three consecutive days. Group III and group IV were subjected to colitis induction and on the fourth day, daily oral administration of omega-3 and omega-6 was done respectively for 14 days. All rats were sacrificed on day 17 from the beginning of the experiment. Colon specimens were collected and processed for light microscopic, scanning and transmission electron microscopic examination. Ulcerative colitis induction showed mucosal injury. There were patchy areas with loss of crypt architecture, inflammatory cell infiltrate and ulcerated mucosa. Scanning electron microscopic study revealed areas of ulceration, whereas other areas showed alteration of the columnar absorptive cells. Transmission electron microscopic study revealed loss of apical microvilli of enterocytes with signs of degeneration. Administration of omega-3 completely treated the colonic structure, while omega-6 was by far less efficient in treating induced ulcerative colitis. Omega-6 fatty acids partially improved the colon against ulcer induction. Meanwhile, omega-3 fatty acid proved to be a more effective dietary management of ulcerative colitis without the adverse effects of either surgery or medications

Evaluation of time dependent changes of the rat's lung in experimentally induced diabetes mellitus: light and electron microscopic study

Diabetes mellitus is a chronic metabolic disease characterized by persistent hyperglycemia. This a major health problem that is associated with a number of serious, sometimes life-threatening complications. There has been increasing evidence that the respiratory functions of patients with diabetes are impaired in the course of their disease. This work aimed to study structural changes of the rat's lung in experimentally induced diabetes and evaluation of these changes in relation to duration of diabetes. Thirty adult male albino rats were divided into three groups, Group I served as control group. Group II consisted of two equal subgroups of rats [lb and lib], which received citrate buffer. Group Ill included two equal subgroups [IIIa and IIIb], which were subjected to induction of diabetes by using streptozotocin [STZ]. Subgroups IIa and IIIa were sacrificed after four weeks from the experiment while subgroups Jib and Tub were sacrificed after eight weeks. Blood samples were collected three times during the experiment to measure the blood glucose level. At the end of the experiment, the lungs were dissected out and the specimens were prepared for light and electron microscopic study. Morphometric analysis was also done to confirm the results. After 4 weeks of induction of diabetes, there was significant increase in the thickness of interalveolar sepia which showed cellular infiltration. Some bronchioles showed patchy areas of hyperplasia of theft lining epithelium. After 8 weeks of induction of diabetes, the lung revealed accumulation of large number of alveolar inacrophages and inflammatory cells in the pulmonary interstitium leading to highly significant increase in the thickness of interalveolar sepia and collapse of many alveoli with loss of normal architecture of the lung parenchyma. Congestion of the blood vessels and thickening of their walls could be seen with exiravasation of RBCs and fluid exudates in the interstitium. There was increased deposition of collagen fibres by increasing duration of diabetes. Electron microscopy revealed significant increase in the mean number of type II pneumocytes which showed progressive degenerative changes with increasing duration of diabetes.It could be concluded that, diabetes induced structural changes of the lung which increased progressively and became much worse with increasing duration of diabetes. So much attention should be directed to early diagnosis and treatment of diabetes to avoid or postpone onset of complications

Nosocomial infections and fever of unknown origin in pediatric hematology/oncology unit: a retrospective annual study

Pediatric hematology / oncology patients are faced with an increased risk of nosocomial infections [NIs] that vary in different populations and different institutes with considerable morbidity and mortality. Our aims were to assess the frequency and patterns of NIs in this group of patients relation to the risk of neutropenia and to determine the prevalence of causative organisms and their antimicrobial sensitivities. A retrospective analysis of the data for all children admitted to pediatric hematoloy/oncology unit of Mansoura University, Egypt, was done over one year from January, 2007 to January, 2008. A total of 1564 patients were included [173 children with leukemia, 39 with lymphoma, 49 with other solid tumors, 1293 with thalassemia and 10 withaplastic anemia] corresponding to 2084 admissions and 27092 inpatient days. The Centers for Disease Control and Prevention criteria were used as standard definition for NI. The overall incidence density rates of NIs in all patients and neutropenic patients were 8.6 and 25.3 per 1000 patient-days respectively. The most frequent sites of microbiologically and or clinically documented NIs were blood stream [42.7%], respiratory [25.3%], Urinary [22.2%] and CNS infections [9.8%] whereas nosocomial fever of unknown origin [nFUO] constituted 52.9% of defined cases with incidence density rates of 9.7 and 15.4 per 1000 patient-days in, all patients and neutropenic patients respectively. The frequency of NIs and nFUO were significantly higher during neutropenic days [p<0.001]. Gram-positive organisms represented 64.5% of isolated pathogens [Staphylococci 71.5%, Streptococci 16%, Pneamococci 7% and Enterococci 5.5%], gram-negative organisms represented 30% [E coli 48.6%, Klebsiella 15.7%, and Pseudomonas 35.7%], and Candida 5.5%. Positive cultures were more frequent in summer months [July to September]. The antimicrobial susceptibilities of the isolated organisms were relatively low [cefoperazone/sulbactam 49.9%, amikacin 35.9%, imipenem/cilastatin 34.4%, cefoperazone 33.6% and vancomycin 36.5%]. Blood stream infection and fever of unknown origin are the most common nosocomial infections in pediatric hematology / oncology patients with a higher risk during neutropenic days. Isolated organisms are multi-drug resistant, predominantly gram-positive pathogens

Glucosidase acid beta mutations in children with gaucher and relation to disease phenotype

More than 200 mutations have been described in patients with Gaucher disease [GD] and usually more than one mutation achieves a high population frequency. Genotype I phenotype correlation in patients with GD are not established. This study was designed to determine the underlying mutations in Egyptian children with GD and to assess their relation to disease phenotype. The study comprised 17 children with GD, 13 males and 4 females with mean age 6,09 +/- 441 years in addition to 10 healthy controls with matched age and sex. Patients included 13 children with type 1, 2 children with type 2 and 2 with type 3 GD. DNA was extracted from peripheral blood leukocytes; exon 9 and 10 were amplified by PCR using specific primers and DNA sequences were determined by ABI 310 genetic analyzer. Wild type allele was detected in 95%of controls [19/20] and a normal variant in 1/20 [5%]. L444P allele was encountered in 50%of the alleles in type 1 patients [13/26], H451 P in 2/26 [7.7%] and recombinant alleles [RecNcil, RecNcil+M450L RecFs, RecFs+M450L] in 9/26 [34.6%]. L444P and Rec alleles each occurs in 214 [50%] of type 2 and 3. A new mutation has been described in this study [g.7336A>C, [M450L]] and 2 mutant alleles have not been determined. Genotypes in type 1 patients comprised; L444P/L444P [23,1%], Rec alleles/L444P [53.8%]. Type 2 and 3. patients had Rec alleles/L444P genotypes in all patients [100%]. There was no significant association between mutant alleles frequency [p=0.63] or genotype frequency [p=0.41] and disease phenotypes. L444P is the most frequent mutant allele followed by Rec alleles in studied patients. Novel mutations are continuosly detected adding more to this expanding panel of GD mutations. No significant genotype-phenotype association was observed in studied patients

Evaluation of the possible protective role of folic acid on the liver toxicity induced experimentally by methotrexate in adult male albino rats

Methotrexate [MTX] is a chemotherapeutic drug that is widely used in the treatment of malignant tumors and rheumatic disorders. However, the clinical success is limited by the hepatotoxic effect which is a major adverse reaction that can occur during [MTX] treatment. The present study was designed to throw the light on the histological changes in the rat liver following treatment with [MTX] with evaluation of the possible protective effect of folic acid. Thirty two adult male albino rats were utilized in the present work. They were classified into four groups [8 animals each]. Group I: Served as control group. Group II: The rats received folic acid in a daily oral dose of [250ug/kg b.w] for four weeks. Group III: Included rats which received an I.P injection of MTX [20mg/kg b.w] once weekly for four weeks. Group IV: The animals were concomitantly treated with MTX and FA as the same previous doses, period and routes of administration for four weeks. Blood samples were collected from retroorbital venous plexus for biochemical measurements of liver enzymes [transaminases] in the serum, then the animals were sacrificed by decapitation. Specimens from the liver were processed for light and electron microscopic studies. The present work showed severe damage of the rat liver following [MTX] treatment as denoted by increased levels of aspartate transaminase [AST] and alanine transaminase [ALT] enzymes in the serum. Examination of the liver sections revealed severe dilatation and congestion of the central and portal veins with marked mononuclear cellular infiltration. Hepatocellular vacuolation with areas of fatty degeneration could be clearly seen. Increased collagen deposition especially around the portal areas was observed in addition to depletion of glycogen content. The activity of succinic dehydrogenase enzyme was apparently decreased while that of acid phosphatase was greatly increased. Severe damage of the cell organdies was obviously seen. On the other hand, rats received folic acid [FA] following treatmeIlt with MTX revealed more or less apparent normal architecture. FA proved to have remarkable protective effect against toxicity of MTX by minimizing the previous degenerative changes, so it is advisable for patients routinely treated with [MTX]

Impact of parvovirus B19 infection in pediatric oncology patients

Oncology patients are at particular risk for parvovirus B19 infection that may cause severe, persistent usually non specific illness in this group. This study was designed to assess the prevalence and impact of parvovirus B19 in pediatric oncology patients receiving chemotherapy and to define the optimal diagnostic tests in such patients. Fifty nine children under chemotherapy [39 with ALL, 20 with solid tumors] with mean ages of 4.96 +/- 1.94 years, in addition to 30 healthy children of matched age and sex, were enrolled in this study. Clinical and laboratory data were collected by examination and from patients' records. Specific parvovirus IgM, and IgG B19 antibodies were assessed by Elisa and parvovirus DNA was detected by nested PCR for all patients and controls. Parvovirus DNA was detected in 16 [27.1%], IgM in 3 [5.1%] and IgG in 36 [61%] patients. IgM had sensitivity, specificity and accuracy of 18.75%, 100% and 77.9% respectively, while those of IgG were 81.25, 53.4%, 61% respectively. PCR positive patients had significantly higher frequency of unexplained anaemia, blood transfusions and longer hospital stay than PCR negative patients [P<0.001]. Multiple linear regression analysis showed that both unexplained anaemia and multiple blood transfusions were the most important variables that can predict PCR positivity. Parvovirus B19 is not uncommon problem in pediatric oncology patients that exhibited weak antibody response and non specific clinical features. Screening of these patients with PCR rather than serology is recommended when infection is suspected

Present situation of house dust mites in Dakahlia governorate, Egypt

House dust mites are common inhalant allergens, which can precipitate atopic disease episodes. The present study revealed presence of four mites. These are Dermatophagoides farinae, D. pteronyssinus, Acheles gracilis and Ornithonyssus bacoti. Population densities of different live adult mites were investigated in different house habitats. In urban houses, pyroglyphid mites were the predominant in bedrooms and D. farinae was the most abundant. A. gracilis was more abundant in living rooms followed by D. farinae then D. pteronyssinus. A. gracilis was the most prevalent in kitchens. While in rural houses, O. bacoti was the most abundant species followed by pyroglyphid mites. Since Dermatophagoides species and A. gracilis were present in numbers high enough to allow their ecological consideration, their seasonal abundance in urban bed-rooms was investigated and revealed that both D. farinae and D. pteronyssinus have two peaks of abundance, one slightly higher in spring and the second in autumn. A. gracilis has two peaks but the higher occurred in autumn and the second in spring

Cholestasis in human fascioliasis in Dakahlia governorate, Egypt

This study was conducted to assess cholestasis in human fascioliasis. Twenty five patients, passing Fasciola eggs, were compared to twenty age- and sex-matched healthy controls. All were subjected to thorough clinical examination, stool analysis, complete blood picture, liver function tests [AST, ALT, SAP, GGT and total serum bilirubin]. Autoimmune and viral hepatitis [HCV and HBV] were excluded. All cases were subjected to radiological examinations [chest X-ray and abdominal ultrasonography]. The study revealed significant elevation of liver enzymes in the patients compared to the controls. Calcular and non-calcular cholecystitis were common findings among patients [32% and 24%, respectively]. Ascites [4%] and dilated intrahepatic biliary radicals [32%] were encountered; pleural effusion was detected by chest X-ray in 20% of cases. So, fascioliasis should be considered in the diagnosis of cholestasis in Fasciola endemic areas

Synthesis of novel tetrahydronaphthalen-2-yl thiazoles of expected anticancer activity

In the present investigation. a variety of tetrahydronaphthyl thiazole derivatives were prepared. The parent compound 4-[5,6,7,8-tetrahydro-2-naphthyl]-2-aminothiazole [l] was allowed to react with isocyanates and isothiocyanates to give substituted ureas or thioureas Ila-f with acid anhydrides to give thiazolyl-pyrrolidinedione IIIa-c. with alkylhalides or aryl sulphonyl chlorides to give the N-substituted derivatives lVa-d with urethane to give N-substituted urea V. with carbon disulphide to give isothiocyanate derivatives VI, with alpha-halocarbonyl compounds to give Vlla-d and with malononitrile to give VIII. Moreover, compound VIId was allowed to react with potassium thiocymatc to give thiamlidinone derivatives X, with semicarbazidc and thiosemicarhztzidc to give Xla,b. with thioglycolic acid to give thiomorpholincdione derivative XII. with malononitrilc to give pyrrole carbonitrilc XIII and with different secondary amines to give acetamido derivatives XlVa-d. Also compound llc reacted with chloroacetic acid. malonic acid and or phenacyl bromide to give the corresponding derivatives XV, XVI and XVII respectivly. Compounds lVa, Vllb and X are effective on both liver carcinoma cell line HePG2 and brain carcinoma cell line U25I while compounds llc, Vlld and VIII are effective on HePG2 only

Comparative study about some salmonella isolation techniques from cases of enterica

Typhoid fever remains an important public health problem in many parts of the world. Rapid and sensitive laboratory methods for Salmonella isolation in diagnosis of typhoid fever are essential for prompt and effective antibiotic therapy. This study was designed to compare Some techniques for Salmonella isolation from blood and stool to find the most rapid, sensitive and specific one to detect their antibiotic sensitivity pattern suitable for antibiotic therapy and epidemiological surveillance. For this purpose 312 patients [262 typhoid study cases - 50 none typhoid control cases] admitted to Abbassia Fever Hospital from April 1996 to April 1999 were examined 191 cases out of 312 cases proved to be enterica by conventional techniques like [WBCs count, ESR, Widal test, ordinary stool and blood isolation culture,]. Yielded 104 Salmonella Strains by conventional techniques but when bi-examined in 5 groups for isolation of salmonella by one of the following culture techniques in comparison to ordinary B. C: [1- Isoslate culture, 2- Monocyte culture, 3- Clot culture, 4- Stool culture, and 5- Bone marrow culture.] they yielded [127,] salmonella isolates. The results of conventional and non conventional isolation techniques were evaluated and compared as regards specificity, sensitivity, rate of isolation, performance and costs. From this study it was found that [1-The mononuclear culture was the most sensitive blood culture technique in isolating Salmonella strains with 63% sensitivity and average time 1.1 days if compared to conventional blood culture [2.8 days]. It was found that the indirect mononuclear technique took the same time as conventional blood culture [2. 7 days- 2.8 days]. The test was easy but hazardous to laboratory workers, 2- The lysis isoslate culture was the most rapid blood culture technique by direct method [one day] but it was less sensitive than conventional one [43% - 55%]. The test showed also simple and no difference between direct and indirect technique as regard average isolation time, 3- The clot culture technique was the simplest one and showed the same sensitivity as conventional blood culture [58- 55%] with average time 2.6 days nearly equal to conventional techniques [2.8 days]. the test was selective for salmonella species and inhibited the growth of skin contaminants. The separated serum could be used for serological diagnosis of typhoid fever. 4- The stool culture technique had a limited value in diagnosis of acute typhoid fever with very low sensitivity 13% compared to ordinary blood culture technique which is less sensitive and takes more average time [2.8 days] 5- The bone marrow culture although highly specific and sensitive; it can not be used as a routine technique except in case of [F. U. O] to exclude the infection in some typhoid cases finder specific therapy. 6- The highest isolation rate of salmonella strains from, blood [47%] was obtained by using both ordinary blood culture and isostate blood culture together. It has the chance of isolation when there is low number of bacteria

Effect of ciprofloxacin on the submadibular salivary gland of adult male albino rat: a light and electron microscopic study

Ciprofloxacin is a synthetic antimicrobial agent with a wide spectrum of antibacterial activity. This work was done to evaluate the histological and histochemical changes induced by ciprofloxacin administration on the structure of submandibular gland of rats. It also aimed to predict the possibility of recovery after drug withdrawal. Twenty-four adult male albino rats were used in this study. They were divided into three equal groups: 8 rats each. Group I was the control group. Group II included animals, which received the therapeutic dose of ciprofloxacin [90 mg/kg/day] for 10 days. Group III consisted of animals, which received the therapeutic dose of ciprofloxacin for 10 days and left to recover for 4 weeks. At the end of the experiment, the animals were decapitated and the submandibular glands were dissected out. They were prepared for light and electron microscopic examination. In Group II there were focal areas in the submandibular gland where the acini were almost disorganized. The acinar cells showed variable degrees of degeneration. The striated and convoluted ducts as well were affected. Some of their lining epithelium showed cytoplasmic vacuolations. There was a noticeable diminution in both the mucopolysaccharides and protein contents in the gland. However, these changes were seen to be reversible and the submandibular gland of rats in group III appeared more or less similar to the control

Evaluation of myrrh [Mirazid] therapy in fascioliasis and intestinal schistosomiasis in children: Immuno - logical and parasitological study

This study was done on 21 children with fascioliasis and 8 children with schistosomiasis mansoni treated with myrrh [mirazid], which is an oleo-gum resin from the stem of Commiphora molmol tree [family Burseraceae]. Also, ten healthy cross matched children were utilized as controls. The diagnosis was based on the detection of Fasciola hepatica or Schistosoma mansoni eggs in stool by Kato-Katz technique. Mirazid was given as 10 mg/kg/d an hour before breakfast for three consecutive days in schistosomiasis and for six days in fascioliasis. Clinical evaluation and stool analysis were done initially and at 2, 4 and 12 weeks post treatment to evaluate the cure rate. Rectal snip was done for responding schistosomiasis cases to confirm recovery. Automated complete blood count with manual assessment of eosinophils, serum total IgE [enzyme immunoassay] and in vitro cytokines assay [IL-1 beta, IL- 4 and IL-5] by ELISA were performed for all subjects before treatment and repeated at 12 weeks only for patients after therapy. It was concluded that mirazid is an effective fasciolicidal and schistosomicidal drug. IL-1 beta and IL-5 were high in fascioliasis and schistosomiasis, but decreased with therapy denoting immunopathogenesis. The depressed IL-4 production may be a parasite immune evasion or host regulatory mechanism and the cytokines levels may be the criteria of cure

Decreased Helicobacter pylori-associated gastric epithelial proliferation by concurrent Schistosomal infection

Helicobacter pylori [H. pylori] injection is associated with increased gastric epithelial proliferation, the enhanced epithelial proliferation is important in developing gastric carcinoma. Some developing countries with a high prevalence of H. pylori infection have high gastric cancer rates, whereas in others, these rates are low. The progression of helicobacter-induced gastritis and gastric atrophy mediated by T-helper cell, type 1 [Th1] response may be modulated by concurrent parasitic infection. Pathogenic helminths of the genus Schistosoma cause T-helper cell, type 2 [Th2] response to parasite eggs. The Th2 response is usually associated with down regulation of Th1 cytokine synthesis. The aim of the present study was to assess whether concurrent Schistosoma mansoni infection with H. pylori has an effect on gastric mucosal injury in view of cell proliferation, apoptosis, pathological changes, nitric oxide and oxyradicals status. Between April 2001 and March 2002, 73 patients [13 child and 60 adults] were subjected to upper gastrointestinal endoscopy for dyspepsia and liver cirrhosis in the National Liver Institute, Menoufiya University. Four biopsy specimens were taken, two from the greater curvature of the antrum and two from the upper body of the stomach, biopsies were obtained from any lesion as well as from apparently healthy mucosa. One snap from each site was preserved in RNA later solution, then kept at -80°C till utilized for estimation of DNA-flow cytometric assay, reduced glutathion [GSH], catalase [CAT], superoxide dismutase [SOD], Nitric oxide [NO], and lipid peroxidation product- malondialdehyde [MDA]-. Diagnosis of bilharziasis was done by stool analysis, or by sigmoidoscopy and rectal snip. OF the 73 patients, 60 patients were cirrhotic [20 Child A, 34 B, 6 C], 48 were H. pylori-positive and 25 H. pylori negative. The mean age in H. pylori positive patients [46.31 +/- 10.7 years] was significantly less than in H. pylori - negative patients [52.8 +/- 7.2 years]. Infection with H. pylori alone correlated with increased DNA s-phase, proliferation activity and apoptosis [sub-G phase] [p 0.04, 0.03 and 0.04] respectively. Concurrent infection with schistosomiasis occurred in 34 patients and it significantly suppressed DNA 5-phase [P=0.001], proliferation activity [p<0.004], and apoptosis [sub-G phase], [p>0.05]. On contrast, concurrent infection had an adverse effect on liver cirrhosis with increased incidence of upper gastrointestinal bleeding. Schistosomal concurrent infection with H. pylori is associated with higher incidence of superficial gastritis, and may complicate liver cirrhosis with increased upper gastrointestinal bleeding. On the other hand, concurrent schistosomal infection may have a protective effect against the possible progression of H. pylori induced gastritis towards gastric carcinoma, by modulating the cytokine profile of the gastric mucosa with suppression of the proliferation activity. A detailed study of the cytokine expression in similar cases is recommended for unraveling the mystery of this phenomenon

Bone turnover markers and bone mineral status in protein-energy malnourished infants

This study aimed to evaluate bone turnover in malnourished infants and to assess their bone mineral status by dual energy x-ray absorptiometry [DXA]. We studied 18 marasmic patients aged 10.55 +/- 7.01 mo [mean +/- SD], 5 kwashiorkor patients aged 18 +/- 6 mo in addition to 7 healthy infants with matched age and sex. For all subjects, serum levels of osteocalcin, parathormone and bone specific alkaline phosphatase were assessed by Elisa and 25 [OH] D3 level by RIA. Urinary excretion of deoxypyridinoline was assessed by Elisa and expressed as nmol/mmol creatinine. Bone mineral content [BMC] and bone mineral density [BMD] were measured by DXA. Osteocalcin was significantly lower in marasmus and kwashiorkor group than control [P=0.02, 0.002]. Marasmus group had a significantly higher osteocalcin level than kwashiorkor [P=0.037]. Compared with control, deoxypyridinoline was significantly lower in marasmus than control [P=0.014] but was insignificantly lower in kwashiorkor with no significant difference between both patient groups. Alkaline phosphatase and parathormone were significantly lower in marasmus than control but not in kwashiorkor. There were no significant differences between the studied groups regarding 25[OH] D3. Bone mineral content was significantly lower in all of the studied regions of both patient groups than control and kwashiorkor patients had a significantly decreased arm and total BMC than marasmus [P=0.07, 0.02 respectively]. Only leg BMD was significantly lower in malnourished patients. There was no significant correlation between biochemical markers and total BMC or BMD. Protein-energy malnourished infants have decreased bone turnover which was more pronounced in marasmus with decreased BMC and non generalized decrease in BMD

Study of peripheral lymphocytes apoptosis in childhood tuberculosis

In a trial to understand some aspects of immunopathogenesis of active tuberculous infection in children, we studied the spontaneous and Mycobacterium tuberculosis [MTR]-induced apoptosis of lymphocytes in children with tuberculous infection. This study included 18 newly diagnosed tuberculous patients [11 pulmonary and 7 lymphadenopathy] with age range of 4-15 years [mean 10.7 +/- 3.1 y] in addition to 9 contacts with positive tuberculin test and 9 healthy tuberculin non-reactors with matched age and sex. Diagnosis of tuberculosis was confirmed by smear positivity, Bactec culture for T.B or biopsy. From each patient and control peripheral blood mononuclear cells [PBMC] were obtained and subjected to study of apoptosis both spontaneously and after stimulation with atypical mycobacterial culture by TUNEL Method. The mean percentages of spontaneous apoptosis were 7.83 +/- 3.29, 1.22 +/- 0.44 and 1.0 +/- 0 in tuberculous patients, tuberculin positive contacts and healthy negative control respectively. After culture, the mean percentages of apoptosis increased to 16 +/- 7.15, 4.77 +/- 1.85 and 2.33 +/- 0.71 in patients, tuberculin reactor contacts and healthy non- reactor groups respectively. Spontaneous apoptosis was significantly higher in patients than contact tuberculin-reactors and healthy non reactors [P<0.001] without significant difference between the latter 2 groups. After culture, apoptosis in patients was significantly higher than control groups [P < 0.001] and tuberculin reactor contacts had significantly more apoptosis than healthy non reactors [P=0.002]. There was no significant difference in apoptosis increment between pulmonary or tuberculous lymphadenopathy patients. There was highly significant correlation between tuberculin diameter and incremement of apoptosis [P=0.006]. It could be concluded that apoptosis is directly involved in the immunopathogenesis of tuberculosis in children. It affects both primed and non primed lymphocytes and is related to the state of hypersensitivity

effects of orchiectomy, antiandrogen and testosterone on the parotid gland of albino rats

The relationship between the testis and the parotid gland has been poorly investigated. This study deals with the structure of the parotid gland and its changes after orchiectomy, antiandrogen [flutamide] and testosterone substitution. The rat parotid glands of controt and experimental animals [orchimectomized, orchiectomized with testosterone substitution and antiandrogen] were analyzed by light and electron microscopy. Orchiectomy and antiandrogen have more or less similar effects on the parotid gland. Both reduced secretory activity of the gland which was manifested by decreasing the secretory granules, vacuolations of the cytoplasm and degeneration of mitochondria. Exogenously given testosterone can prevent the mentioned effects of orchiectomy on the parotid gland. It is concluded that orchiectomy and antiandrogens affect the rat parotid gland, demonstrating the existence of an interaction between the testis and parotid gland

Treatment of chronic anal fissure with isosorbide dinitrate and its cost versus open lateral sphincterotomy

Internal anal sphincterotomy for treating chronic anal fissure can irreversibly damage anal continence. Reversible chemical sphincterotomy may be achieved by topical application of nitric oxide donors [isosorbide dinitrate]. This study was undertaken to compare local application of isosorbide dinitrate with lateral internal sphincterotomy. A sample of 153 patients with chronic anal fissure was allocated to treatment with sphincterotomy [69 patients] or local isosorbide dinitrate tablets [84 patients]. Patients were followed-up for one year. Common age group was 30-40 years. The healing rate was 97% in surgical group and 47.8% in medical group. The recurrence after healing in last group was 44.4%. The cost of treatment by sphincterotomy under local anesthesia is nearly equal to treatment by topical application of isosorbide dinitrate tablet. Lateral internal sphincterotomy under local anesthesia is considered the operation of choice in surgically fit patients in treatment of chronic anal fissure. Topical application of isosorbide dinitrate can be used for those who are surgically unfit or refuse operation