Sex determination by radiographic localization of the inferior alveolar canal using cone-beam computed tomography in an Egyptian population

Purpose@#The purpose of this study was to evaluate possible differences in the location of the inferior alveolar canal in male and female Egyptians. @*Materials and Methods@#This cross-sectional retrospective study involved the evaluation of 210 CBCT scans of Egyptian individuals (18–70 years old). The inferior alveolar canal was localized by measuring 8 linear dimensions: 2 for the vertical localization of the mental foramen (superior and inferior to the mental foramen), 4 at the first molar bifurcation for the vertical and horizontal localization of the inferior alveolar canal (superior, inferior, buccal, and lingual to the inferior alveolar canal), and 2 for the horizontal localization of the mandibular foramen (anterior and posterior to the mandibular foramen). The measurements were statistically analyzed via comparative analysis, stepwise logistic regression, and receiver operating characteristic (ROC) curve analysis. @*Results@#Six of the 8 measured distances differed to a statistically significant extent between the sexes. Regression analysis suggested a logistic function with a concordance index of 84%. The diagnostic accuracy capabilities of the linear measurements as sex predictors were calculated using ROC analysis, and the 6 best predictors for sex determination were selected and ranked from highest to lowest predictive power. Moreover, combining these 6 predictors increased the predictive power to 84%. @*Conclusion@#The location of the inferior alveolar canal in the Egyptian population varies significantly by sex; accordingly, this anatomic landmark could be used as a reliable indicator of sexual dimorphism.

Impact of HCV Genome Structure on Responder to Pegylated Interferon Therapy in Egyptian Patients

This study aimed to investigate relationship of the HCV genome structure and treatment with Pegylated Interferonα/Ribavirin (peg-IFNα/RBV) Egyptian patient. Mutations in two sites of HCV genome; the internal ribosome entry site(IRES) and the interferon sensitivity determining region (ISDR) of HCV genotype 4a were studied in details including DNAsequences and mutations detection in response to treatment. Ninety patients, responders and non-responders, to treatmentwith peg-IFN α /RBV were included in this study. IRES and ISDR regions were amplified by RT-PCR using specific designedprimers, and amplified regions were sequenced. The data obtained were aligned with published sequences in GenBank usingBLAST program. Results of this study have revealed that there are different mutations in the studied sequences in both ISDRand IRES regions. The predicted amino acids sequences in the ISDR region showed significant differences ranging from oneup to more than eight mutations in the HCV Genome sequences. Although there was a significant difference betweensequences of HCV RNA isolated from responders and non-responders, these data were not able to give an absolute answerwhether response to interferon therapy is directly/relates to the structure of the HCV genome

role of fibroscan as a non-invasive predictor for oesophageal varices in post hcv cirrhotic egyptian patients with or without bilhariziasis

Background: Development of oesophageal varices is a major complication that may occur in up to 90% of cirrhotic patients. The endoscopic screening is an invasive procedure. This is why the selection of patients with large oesophageal varices at high risk for bleeding has become an issue of growing importance. In this respect, several clinical, biochemical, ultrasonographic and elastrogarphic [transient elastography-TE] methods have been proposed [and some of them validated] as noninvasive alternatives to endoscopy

Objectives: It was to evaluate transient elastography by fibroscan in the prediction and determination of the grade of esophageal varices in cirrhotic patients due to chronic hepatitis c virus [HCV] infection with or without bilharziasis

Patients and Methods: Sixty Egyptian patients with body mass index [BMI] <35, no history of: upper gastro-intestinal tract [GIT] bleeding, hepatocellular carcinoma, moderate and tense ascites or any other cause of liver cirrhosis. The patients were divided into two groups: Group I included thirty patients with liver cirrhosis due to HCV infection only. Group II included thirty patients with liver cirrhosis due to HCV infection associated with bilharziasis. The patients were subjected to: 1] Thorough history taking. 2] Detailed clinical examination. 3] Laboratory tests. 4] Abdominal ultrasound. 5] Rectal snip for diagnosis of bilharziasis. 6] Upper gastrointestinal endoscopy. 7] fibroscan

Results: Regarding fibroscan in both groups, the mean values of fibroscan were lower in patients without esophageal varices than patients with esophageal varices or with large esophageal varices with statistically high significant differences [p<0.01]. Regarding fibroscan in group I, the mean values of fibroscan were lower in patients without esophageal varices than patients with small esophageal varices with statistically high significant differences [p<0.01]. But in group II, the mean values of fibroscan were lower in patients without esophageal varices than patients with small esophageal varices with statistically non significant differences [p > 0.05]. In both groups, the mean values of fibroscan were lower in patients with small esophageal varices than patients with large esophageal varices with statistically non significant differences [p > 0.05]

Conclusion: fibroscan is valuable in predicting the presence of esophageal varices and large esophageal varices in patients with post HCV liver cirrhosis with or without bilharziasis but couldnot predict the grade of esophageal varices

Neurophysiological assessment of peripheral nerve functions in a sample of egyptian patients with liver cirrhosis

Background: peripheral neuropathy is damage to or disease affecting nerves which may impair sensation, movement, gland or organs function or other aspects of health depending on the type of nerve affected. Peripheral neuropathy is a common complication of liver cirrhosis either due to viral [mostly HCV], NASH, Alcoholic or mixed

Objectives: the aim of this study was to define the prevalence of peripheral neuropathy in a sample of Egyptian patients with liver cirrhosis and to determine any etiologic correlation

Patients and Methods: this descriptive study was conducted on 47 Egyptian liver cirrhotic patients. Patients were subjected to history taking, detailed neurological examination and clinical and neurophysiological assessment

Results: viral hepatitis was the commonest cause of liver cirrhosis 59.6% while non viral causes 25.5% e.g. NASH, the main duration of liver cirrhosis was 10 +/+ 3.98 yrs ranging from 3-23 yrs. The majority of patients were asymptomatic, 48.9%, while the most presenting symptoms were sensory symptoms 25.5%, the prevalence of PN among a sample of Egyptian patients with liver cirrhosis according to neurophysiological assessment was 72.3% mostly of mixed sensory and motor polyneuropathic pattern, not related to the cause of liver cirrhosis but affected by the duration and severity of liver cirrhosis determined by Child Pugh classification

Conclusion: peripheral neuropathy is a common complication of liver cirrhosis related mainly to the duration and severity of liver cirrhosis, but not affected by the causes of liver cirrhosis

Expression of FAS protein [CD95] and fas ligand in liver tissue of patients with HCV-induced chronic liver disease and its correlation with the disease progression

This study evaluated hepatic expression of both Fas and Fas ligand [FasL] in patients with hepatitis c virus [HCV]-induced chronic liver disease and its correlation with the histopathological activity and laboratory parameters as an early predictor of advancement of the disease. The selected patients were [39] males and [21] females, their ages ranged from [20-67years] with a mean of 43.5 +/- 4.5 years, as well as [10] subjects [normal individuals] serving as a control group. They were [7] males and [3] females, their age ranged from [26-53 years] with a mean of 39.5 +/- 7.3 years. Patients were grouped as [1] Chronic hepatitis [CH] group including [30] patients with chronic viral hepatitis C. [2] Liver cirrhosis [LC] group including [30] patients with post hepatitis C cirrhosis. Liver biopsy was done for all subjects using an automated 18-gauge true cut needle. Sections were stained with Haematoxylin and Eosin for histopathological diagnosis and with Maisson and Trichrome for assessment of fibrosis. Unstained paraffin sections from each case were subjected for immuno-histochemical procedures using indirect immunoflourescence technique for detection of apoptotic hepatic and lymphocytic cells using monoclonal antibodies. Semiquantitative analysis of the pattern and distribution of the Fas antigen and Fas Ligand as indicators for hepatic apoptosis was studied and assessed

Multifocal electroretinogram in retinal vein occlusion

To determine the effects of retinal vein occlusion [RVO] on multifocal electroretinogram [MF-ERG] parameters, to correlate MF-ERG and standard electroretinogram [ERG] and to correlate MF-ERG with findings of optical coherence tomography [OCT] in cases of RVO. Both eyes of 50 patients with RVO and 50 eyes of 25 normal subjects were examined using MF-ERG, standard ERG, fluorescein angiography and OCT. The latency in millisecond [ms] and response density in nanovolt [nv/degenerations] were measured for each of four quadrant areas and central area. OCT was used to measure the foveal retinal thickness. Fluorescein angiography was used to measure retinal ischemia. Central retinal vein occlusion [CRVO] markedly affected all parameters of MF-ERG. In pathological quadrants in branch retinal vein occlusion, the response densities of MF-ERG were decreased and latencies of p-wave were prolonged. The MF-ERG responses obtained from eyes with RVO were significantly different [P>0.05] from derived from the fellow eyes. The amplitude of MF-ERG were abnormal in 40 eyes and implicit times were delayed in 48 eyes compared with normal subjects. While 30 Hz flicker implicit were abnormal only 24 eyes with RVO. Implicit times were prolonged in eyes with macular ischemia than in eyes without ischemia. There were significant correlation between foveal retinal thickness measured by OCT and P response density MF-ERG in cases of retinal vein occlusion. MR-ERG is more susceptible than standard ERG to eye changes of RVO due to the multiple frequencies of stimulation used to record MF-ERG response. MR-ERG could be sensitive indicator of underlying disease affecting the retinal vein in eyes with RVO. MR-ERG is useful for detecting local retinal dysfunction in patients with RVO and sensitive to morphological changes and functional disorders induced by RVO

correlation of cyclin A with dtug resistance in adult acute non lymphoblastic leukemia

Acute Non Lymphoblastic Leukemia is one of the most common malignant tumors of haematology. With the recent progress in chemotherapy and supportive therapy, the remission and survival rate have been markedly improved. In this study, cyclin A2 and multidrug resistance expression was measured by flow cytometry and RT-PCR in 52 de novo AML patients with acute myeloid leukemia. Their expression was correlated with other prognostic criteria, response to treatment and to overall survival. The rate of CR and PR was significantly higher in the group of positive expression of cyclin A2, compared to that with negative expression. However a statistically significant difference was only reached by PCR [p=0.02]. By flow cytometry, the overall Survival [OS] in the group with positive cyclin A2 expression is significantly higher than that in the group of negative cyclin A2 expression, p=0.03. Regarding MDRI, it was expressed in 39% of our patients and the level of expression was slightly higher by RT-PCR. The rate of CR and PR in the group of negative MDR expression was significantly higher as compared to the group of positive MDR expression, by both flow cytometry and RTPCR [p= 0.005, 0.004, respectively]. The OS in the group with negative MDR1 expression was significantly higher than that in the group of positive MDR1 expression, p=O.04. There was a significant inverse relationship between Cyclin A2 and MDR expression in our AML cases by RTPCR technique [p= 0.005], while it showed no significance by Flow cytometry [p=0.12]. There was no agreement [Kappa=0.25] between Flow cytometry and RT-PCR in detection of cyclin A2. On the contrary, there was an agreement between Flow cytometry and RT-PCR in detection of MDR. In conclusion, the low expression of cyclin A2 and high expression of MDR1 are indicators for unfavorable prognosis for individuals with AML. The detection of cyclin A2 level would predict drug resistance. However, it is one of many other factors

comparative study between the effect of conventional articulation drill therapy and phonological awareness-based therapy on improving multiple phonological defects and phonological awareness in Arabic-speaking children

Arabic-speaking children with multiple phonological defects have been under-investigated when it comes to assessing their phonological awareness abilities and when providing them with a phonological awareness oriented therapy. This study included a comparison of the improvement achieved by using Metaphonological therapy program and the improvement achieved by applying conventional Articulation Drill therapy in these children with multiple phonological defects

Acoustic analysis of female voices from childhood to menopause

The female human larynx is affected by various factors, some of which are age, development, diseases and medications. Also her life cycle is strongly related to hormonal changes. Varying dynamics of the three sex hormones [progesterone, estrogen and androgen] unfold at different life phases, starting at puberty fluctuating during reproductive years and dramatically declining at menopause. The aim of this work was to study objectively the physiological voice changes that occur throughout the female lifespan using acoustic analysis. Hundred healthy females were randomly selected from the outpatient clinic of the Phoniatric Unit in Kasr El-Aini Hospital. All females were healthy family members of children paying regular visits to the outpatient clinic. The females were then divided into four major groups according to age. Results showed that children had the highest mean fundamental frequency levels, while adolescents had the highest degree of voice instability. Finally postmenopausal females showed a significant drop in their mean fundamental frequency

Narrative abilities in children with attention deficit hyperactivity disorder [ADHD]

Attention deficit hyperactivity disorder [ADHD] is a common disorder in children. Children with ADHD are at risk for language and speech disorders and evidence a variety of pragmatic deficits particularly discourse and narrative deficits. The aim of this study was to assess the narrative comprehension and retelling abilities in children with ADHD, in order to come up with a better understanding of the nature of the deficits that require intervention. 45 subjects were included in this study. They were divided into 2 groups, Group 1 [Study group], included 23 boys who had previously been diagnosed as ADHD. Their age ranged from 8.7 +/- 1.2 years. Group 2 [control group], included 22 age and sex matched children. Each subject was assessed for the comprehension and retelling narrative skills. A score was formulated for the variables measured and the mean values of both groups were calculated and statistically compared for significance. Children with ADHD exhibited statistically significant deficits compared to the control group in most of the variables measured to assess comprehension and retelling narrative skills. Further studies with a larger number and different age groups would be informative

Expression of toll-like receptors 2 and 4 in periodontal diseases

Background: Periodontitis is an inflammatory disease affecting the connective tissue surrounding the teeth leading to tooth loss. Pathogens associated with periodontitis interact with Toll-like receptors [TLRs] to induce cytokines causing and aggravating disease. Members of TLR family recognize conserved microbial structures, such as bacterial lipopolysaccharides[LPS], and activate signaling pathways that result in immune responses against microbial infections

The aim of the present study was to determine the level of tissue expression of TLR-2 and TLR-4 in healthy gingiva, chronic gingivitis and chronic periodontitis and find out their role in these different infections

Subjects and Methods: 28 subjects between the ages of 25-45 were recruited. All subjects were able and willing to participate in the study and gave their informed consent to study participation 28 Gingival tissue specimens were obtained from 28 subjects during periodontal surgical therapy who were divided into three groups: Group 1: Ten patients suffering from chronic gingivitis. Group 2: Ten patients suffering from chronic periodontitis. Group 3: Eight control samples from healthy individuals who haveundergone orthodontic treatment. Gingival tissues were collected on phosphate buffered saline. Total RNA isolation was done, then cDNA synthesis and PCR were done in a single step using Prime RT- PCR Premix. Data are presented as mean +/- standard deviation. Comparison between groups was done using students [t] test

Results: The present study showed that both TLR 2 and 4 were expressed in controls, and that the expression of TLR-2 and TLR-4 were statistically significantly elevated in tissue samples from patients with chronic gingivitis and chronic periodontitis compared to controls. TLR-2 expression in controls and chronic gingivitis patients was increased compared to TLR-4 but the increase was not statistically significant. Whereas, TLR-4 was statistically significantly increased in chronic periodontitis compared to TLR-2. Also, TLR-4 was statistically significantly increased in chronic periodontitis compared to chronic gingivitis

Conclusion: It could be concluded that TLR 2 and 4 have a role in the pathogenesis of periodontal diseases however the present study is only a step that needs further studies to fully understand the expression of TLRs in different stages of gingivitis and periodontitis

Effect of platelet rich plasma on osseointegration of endosseous implants in induced diabetic experimental models

The oral rehabilitation by dental implants in patients with diabetes remains a controversial issue. The aim of this study was to investigate the role of platelet rich plasma [PRP] in osseointegration of endossous implants in induced diabetic experimental models. A total of 16 New Zealand Albino male rabbits were used in this study. The animals were randomly divided into 2 groups with 8 animals each; Control group [CG] Group I, and insulin treated induced diabetic group [ITIDG] Group II. Where diabetes was induced by a single dose of Sterptozotocin. 32 implants were used in this study. In each group, each animal received two endossous implants inserted bilaterally in the tibiae shafts, one implant was inserted in the right tibia, while the other implant was inserted in the left tibia after application of PRP into the prepared surgical site. At the 4th and 12 th weeks the animals were subjected to Scintigraphy. Animals were sacrificed at the 12 th week following implants insertion and PRP application, specimens were examined under scanning electron microscope [SEM] where it was possible to observe the bone implant interface. In our results a statistically significant difference was observed in all groups regarding bone density around the implants which is represented as PV overtime. The osteoblastic activity was measured according to the degree of photon emission, the count of photons [ROI]. The mean percentage change of ROI count overtime was statistically significant in all groups. Under SEM it was possible to observe the bone implant interface after 12 weeks, SEM results revealed intimate contact between bone and implants surface in case of group Ib, although bone formation differs at several regions of the implant yet more bone formation and less gap distance was observed around implants in both groups la and IIb, larger gaps were detected in group Ila. Finally, SPECT and SEM both offer an elegant model for evaluation of implant osseointegration. Radio-nuclide imaging is much more sensitive to early or small changes in bone than other imaging systems. Growth factors are a realistic method to improve and expedite both soft and hard tissue healing

Studies on some bacterial causes and blood serum biochemical changes of respiratory affections in lambs [with 6 tables]

This study was carried out on 36 lambs in private farm at Dakahlia governorate, 7 of them apparently healthy, 11 clinically diseased suffering from respiratory affections and 18 slaughtered lambs. Bacteriological examination of the samples revealed that 35 samples were positive for bacterial isolates, distributed as 6 [85.71%], 11 [100.00%] and 18 [100.00%] of apparently healthy, clinically diseased and slaughtered lambs respectively. 66 bacterial isolates identified biochemically into P. multocida 19 [28.79%], P. heamolytica 5 [7.58%], E. coli 15 [22.73%], Klebsiella pneumonia 8 [12.12%], Pseudomonas aeruginosa 7 [10.61%] and staph. aureus 12 [18.18%]. Pathogenicity test for P. multocida isolates indicated that all isolates were pathogenic. Blood samples were collected from the clinically healthy and diseased groups of lambs. Two blood samples were obtained from each animal, one as a whole blood and the other in the form of blood for obtaining clear non-haemolysed serum. Haematological studies revealed that presence of high significant decrease in the total erythrocytic count, haemoglobin concentration, packed cell volume and blood lymphocytes [per mm[3] blood] in diseased animals when compared with clinically healthy ones. Also high significant increase in total leucocytic count, significant increase in neutrophil, oesinophil and monocyte cells were recorded in diseased cases. The studied biochemical parameters revealed high significant elevation in the values of AST, ALT, GGT and blood urea in diseased animals. Also creatinine showed marked elevation. Presence of high significant decrease in the level of albumin, while total protein, sodium chlorides and calcium levels were significantly decreased. On contrary, presence of significant increase in the glucose and potassium levels. From previously mentioned data, it was cleared that respiratory affections in lambs especially those of bacterial origin cause significant changes in blood picture, liver and kidney functions and the level of both sodium, potassium, chloride and calcium

Rotary chair findings in patients with peripheral vestibular lesions

Imbalance and vertigo are among the most common symptoms causing patients to visit a physician. The rotational chair is one test modality used in the diagnosis of peripheral vestibular lesions through its ability to test higher, more physiologic frequencies and provides an adjunct to caloric and other ENG tests. The aim of this study was to assess the role of low frequency rotary chair testing in the evaluation and diagnosis of peripheral vestibular lesions. Forty subjects suffering from unilateral peripheral vestibular lesions, documented by the caloric test participated in this study. Twenty healthy adults served as control. They were subjected to: history taking, audiological evaluation, ENG and rotational chair testing in the form of Rotational Sinusoidal Harmonic Acceleration [SHA] test and Rotational Velocity Step Test [VST]. Results of the SHA test showed phase lead and reduced gain at low and mid frequencies [p<0.001] that improved at higher frequencies, together with reduced time constant [TC] in the velocity step test [p<0.001] between the study and control groups. TC was reduced in the study group in response to rotation towards the side of the lesion. Results of the VOR phase and gain between study groups according to different etiologies revealed that acoustic neuroma had the highest mean in the gain parameter [p<0.01]. In patients with unilateral peripheral vestibular lesions: gain reduction and phase lead are the main abnormalities seen with SHA test and are more pronounced at low frequencies of the test range. Rotational VST demonstrated response asymmetries in the form of reduced TC in response to rotation towards the side of the lesion. The onset and course of the peripheral vestibular lesion have an important effect on the degree of compensation mechanism

Neonatal one stage pull-through operation for hirschsprung's disease: transanal versus conventional soave pull-through technique

The aim of this study is to compare between the transanal pull-through and the open Soave technique in the surgical correction of neonatal Hirschsprung's disease as regards the results, feasibility, operative and immediate postoperative details. A prospective analysis of twenty neonates with Hirschsprung's disease admitted to the Pediatric Surgery Unit, Alexandria University from August 2002, till August 2003, was carried out. The twenty cases were classified randomly into two groups, ten in each. Group A underwent transanal pull-through, while group B underwent open Soave operation. The results showed that, in-group A, the mean operative time was 40 minutes [30-60], compared to 80 minutes in-group B. The mean length of hospital of stay was three days [2-5] in-group A, while in-group B it was 9 days [8-11]. Babies in-group A started oral feeding after a mean period of 1.5 day [1-2 days], whereas in-group B, it was 4 days [3-5]. Both groups recorded no bowel motion disturbance. Two cases required anal dilatation in-group B, in comparison to only one case in-group A. Neither major complications, nor mortality was observed

Conclusion: in selected cases, one stage pull-through operation can be safely done in neonatal Hirschsprung's disease. Transanal technique is superior to open Soave due to its simplicity, cost effectiveness, and less surgical morbidity

Casein derivatives complexed with calcium phosphate efficacy as a mouth moistener in young patients with severe xerostomia secondary to radiotherapy

The purpose of this study was to evaluate casein derivatives coupled with calcium phosphate [CD-CP] as a mouth moistener and its effect on the oral hygiene status in a group of young patients with severe xerostomia. A randomized control trial design was used. Participants had had radiotherapy for head and neck cancer. Baseline data collection was followed by re-examination one month later. A total of 60 patients. 30 in the CD-CP group and 30 used their usual moistening strategies. The baseline characteristics of the two groups did not differ. Patients used Topacal C-5 [CD-CP] and the responses to here compared with the responses to their other mouth moistening strategies. The outcome indicated that Topacal C-5, when used as a mouth moistening and lubricant provided satisfactory results moreover, it has enhanced the oral hygiene status as well as the gingival health status through reduction of plaque, papillary bleeding, and gingival indices

effect of operative delay on the postoperative complications in older patients with hip fractures

This study was carried postoperatively on 125 patients who had fractures around the hip to determine the effect of the operative delay on the postoperative complications. All patients were above the age of 60 years with a mean age of 66.3 years and were generally fit before surgery. The average follow-up period was at least one year. The operative delay was defined as an interval of three calendar days or more between the time of admission to the hospital and the operation. The pre-existing medical conditions were mainly grouped in diabetes mellitus, hypertension, cardiac diseases and chest diseases. The operative procedures that were done for the patients were the standard operations for neck femur fracture [56 cases], trochanteric femoral fractures [59 cases] and sub-trochanteric fractures [10 cases]. No specific preoperative medications were given other than those used to control the pre-existing medical conditions. It was concluded that operative delay of more than five calendar days after admission is an important predictor of mortality within one year for elderly patients who have hip fractures and who are able to walk and live at home before fracture. Optimally, such patients should have the operation within five calendar days after admission to the hospital

Arthroscopic release in the management of frozen shoulder

A prospective study was performed on 18 patients who developed frozen shoulders with variable degrees of complaint and severity. They all failed to respond to conservative treatment. Intraarticular corticosteroids were administrated as a part of the conservative treatment. Approximately half of the patients who responded initially to the latter regimen still their symptoms recurred. Postoperative physiotherapy was carried to maintain the range of movement. They were ten males and eight females, their ages ranged from 34 to 56 years. The follow up period varied from 1 to 5 years. In all patients, an arthroscopic release was done in one shoulder that had the severer symptoms in bilateral affection. The patients were assessed using the American Shoulder Society Score both preoperatively and postoperatively on five criteria, i.e. pain, motion, strength, stability and function

Power assisted adenoidectomy in palatal abnormalities.

The aim of this work was to study the short-term effects of power- assisted complete and superior adenoidectomy on velopharyngeal closure in patients with palatal abnormalities in order to detect which procedure is more able to avoid the post-adenoidectomy velopharyngeal insufficiency. Thirty patients with different palatal abnormalities participated in this study. The patients were divided into two groups: Group 1 [16 patients] was treated with power-assisted complete adenoidectomy, while group 2 [14 patients] was treated with endoscopic power-assisted superior adenoidectomy. All patients experienced a complete resolution of their nasal obstruction and/or otitis media. Four patients of group 1 developed permanent velopharyngeal insufficiency as evidenced by fiberoptic examination and nasometric studies. The other 10 patients and the whole of group 2 did not develop velopharyngeal insufficiency

Increased tissue factor pathway inhibitor activity: a marker for vascular endothelial damage in diabetes mellitus with microangiopathy

Tissue factor pathway inhibitor [TFPI] is produced and bound to the vascular endothelium that plays an essential role in the regulation of local haemostatic process is to study TFPI activity in diabetes mellitus with microangiopathy. We studied 12 healthy controls [group I] and 36 type 1 diabetics: 20 without microangiopathy [group II], 9 with retinopathy [group III] and 7 with mixed retinopathy and nephropathy [group IV]. We determined TFPI activity by chromogenic assay, albumin excretion rate [AER] by turbidimetric assay for 24 hour microalbuminurea, glycosylated hemoglobin [HbA[1c]] by quantitative colorimetric method, fasting and postprandial blood glucose [FBG and PPBG] by enzymatic method.TFPI activity was significantly higher in group III and IV than in controls [P<0.01], in group III and IV than in group II [P<0.01] and in group IV; than in group III [P<0.01], while there was no significant difference between group II and controls. TFPI activity was positively correlated to duration of diabetes and HbA[1c] in all diabetic groups and to systolic blood pressure and AER in only group IV. TFPI bound to the endothelial cells is released into plasma with the advance of diabetic microangiopathy. An increase in TFPI activity in diabetes probably reflects vascular endothelial damage