Immunohistochemical expression of programmed death-ligand 1 and CD8 in glioblastomas

Background@#Glioblastoma is the most aggressive primary malignant brain tumor in adults and is characterized by poor prognosis. Immune evasion occurs via programmed death-ligand 1 (PD-L1)/programmed death receptor 1 (PD-1) interaction. Some malignant tumors have responded to PD-L1/PD-1 blockade treatment strategies, and PD-L1 has been described as a potential predictive biomarker. This study discussed the expression of PD-L1 and CD8 in glioblastomas. @*Methods@#Thirty cases of glioblastoma were stained immunohistochemically for PD-L1 and CD8, where PD-L1 expression in glioblastoma tumor tissue above 1% is considered positive and CD-8 is expressed in tumor infiltrating lymphocytes. The expression of each marker was correlated with clinicopathologic parameters. Survival analysis was conducted to correlate progression-free survival (PFS) and overall survival (OS) with PD-L1 and CD8 expression. @*Results@#Diffuse/fibrillary PD-L1 was expressed in all cases (mean expression, 57.6%), whereas membranous PD-L1 was expressed in six of 30 cases. CD8-positive tumor-infiltrating lymphocytes (CD8+ TILs) had a median expression of 10%. PD-L1 and CD8 were positively correlated (p = .001). High PD-L1 expression was associated with worse PFS and OS (p = .026 and p = .001, respectively). Correlation of CD8+ TILs percentage with age, sex, tumor site, laterality, and outcomes were statistically insignificant. Multivariate analysis revealed that PD-L1 was the only independent factor that affected prognosis. @*Conclusions@#PD-L1 expression in patients with glioblastoma is robust; higher PD-L1 expression is associated with lower CD8+ TIL expression and worse prognosis.

Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial

Objective@#To investigate the combined effect of extracorporeal shockwave therapy (ESWT) and integrated neuromuscular inhibition (INI) on myofascial trigger points in the upper trapezius. @*Methods@#Sixty subjects aged 18–24 years old with active myofascial trigger points in the upper trapezius were studied. Participants were assigned randomly to either group A who received ESWT one session/week, group B who received INI three sessions/week, or group C who received ESWT in addition to INI. All groups completed 4 weeks of intervention. The following main outcome measures were evaluated at baseline and after 4 weeks of intervention: pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR). @*Results@#Within-group analysis revealed a significant decline in visual analog scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention (p<0.001). Multiple comparison analysis showed a substantial difference between the groups, while the major changes favored group C (p<0.05). @*Conclusion@#Combined treatment with ESWT and INI for treating myofascial trigger points in the upper trapezius is more effective than using only one of the two approaches in terms of clinical, functional, and neurophysiological aspects.

Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial

Objective@#To investigate the combined effect of extracorporeal shockwave therapy (ESWT) and integrated neuromuscular inhibition (INI) on myofascial trigger points in the upper trapezius. @*Methods@#Sixty subjects aged 18–24 years old with active myofascial trigger points in the upper trapezius were studied. Participants were assigned randomly to either group A who received ESWT one session/week, group B who received INI three sessions/week, or group C who received ESWT in addition to INI. All groups completed 4 weeks of intervention. The following main outcome measures were evaluated at baseline and after 4 weeks of intervention: pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR). @*Results@#Within-group analysis revealed a significant decline in visual analog scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention (p<0.001). Multiple comparison analysis showed a substantial difference between the groups, while the major changes favored group C (p<0.05). @*Conclusion@#Combined treatment with ESWT and INI for treating myofascial trigger points in the upper trapezius is more effective than using only one of the two approaches in terms of clinical, functional, and neurophysiological aspects.

Histopathological findings in lesional and perilesional skin of vitiligo patients before and after narrow band ultraviolet B phototherapy

Background: Vitiligo is a skin disease with complex, multifactorial pathogenesis. Abnormalities in surrounding keratinocytes may cause melanocyte death due to deprivation of growth factors. Narrow band ultraviolet B (NB-UVB) is an effective therapeutic option especially in patients with generalized disease.Objective: The aim of this study was to identify histopathological changes in lesional and perilesional skin of vitiligo patients and the effect of NB-UVB therapy on them.Methods: Twenty patients were enrolled in this study. They received NB-UVB twice weekly on non-consecutive days for a total of 40 sessions. Skin biopsies from lesional and perilesional skin were obtained from each patient before and after therapy.Results: After therapy, 10% of patients showed excellent clinical response, 10% showed good response, 40% showed moderate response, 35% showed poor response and 5% showed progressive disease. Before therapy, 50% of patients showed a basal lymphocytic infiltrate with a perivascular lymphocytic infiltrate in both lesional and perilesional skin. 40% of them showed additional hydropic degeneration of lower epidermis with apoptotic keratinocytes in 20% of them. After therapy, these inflammatory changes were significantly reduced (p=0.04).Conclusion: NB-UVB is an effective method of treatment of vitiligo. This may be due to its immunosuppressive effects. Also, keratinocyte apoptosis may have a role in pathogenesis of vitiligo

Screening of growth impairment in juvenile rheumatoid arthritis, systemic lupus erythematosus and autoimmune chronic liver disorders

Introduction: Autoimmune disease are frequently associated with growth impairment

This may be a consequence of the inflammatory process associated with disease activity and it also caused by the high-dose corticosteroids that are often used for treatment

Aim: Screening of growth impairment in juvenile rheumatoid arthritis, systemic lupus erythematosus and autoimmune chronic liver disorders

Subject and methods: One thousand cases of school age children of both sexes of juvenile rheumatoid arthritis, systemic lupus erythematosus and autoimmune chronic liver disorders, the study will be conducted in the 4 main pediatric hospitals in Alexandria, to detect growth impairment in those children as indicated by auxological parameters from June 2010 to August 2015

Results: in the studied juvenile rheumatoid arthritis[No. 593] group of school male [No. 118] and female [No. 475] children <3[rd]-<10[th] height for age percentile category [short stature] the percentage in males and females were 51.7 and 46.5 respectively, which the highest percentages are statistically significant and in the studied autoimmune chronic liver disorders [ACLD] group of school age female [N. 69] children and adolescents in the short stature category [<3[rd]-<10[th] height for age percentile] a high percentage was observed which was 45.5 that is statistically significant

Pubertal assessment [Tanner staging] of the studied systemic lupus erythematosus[SLE] group of school age male children and adolescents [No. 69] shows that 48% of cases were in the Tanner stage 1 category is statistically significant which means delayed puberty was in a large number of this cases

Conclusion: Juvenile rheumatoid arthritis, systemic lupus eryth-ematosus and autoimmune chronic liver disorders are frequently associated with growth impairment and delayed puberty. It is important to regularly monitor physical development and control inflammation associated with disease activity

In vitro hepatotoxcity of Catha edulis Forsk. (khat) phenolic-rich extract on human hepatocytes.

In our previous research, Khat has been shown to be associated with hepatic hypertrophy and hepatotoxicity in male and female SD-rats. However, no in vitro studies have been previously done to test on hepatotoxicity of khat on human experimental models. In vitro toxicological evaluation system plays an important role in the early phase of pharmaceutical development and drug safety. Therefore, the current study was designed to examine the in vitro hepatotoxic effect of phenolic-rich extract of khat (Catha edulis Forsk.). Khat was randomly collected from different places in Yemen [Dhamar (DMR), Ibb (IB), Taiz (TZ) cities] and Ethiopia (HAR). Phenolic-rich extraction was performed using 60% methanol. The effects of khat on HepG2 human hepatocyte cell line were measured using the MTT assay. HepG2 cells are a suitable in vitro model system for the study of human hepatocytes. The potency of cell growth inhibition for khat was expressed as an IC50 value. Cellular proliferation following 24h of exposure to khat samples showed considerable inhibition in khat-treated cells compared to nontreated cells (controls). The IC50 values of DMR, IB, TZ and HAR were 5.1±0.03, 15.3±0.12, 10.2±0.20 and 8.7±0.47 μg/mL, following 24 h of treatment, respectively. The proliferation of khat-treated cells decreased as the khat concentration increased. The method used appears to be a useful and reproducible technique for the in vitro assessment of the khat-induced cytotoxicity in a human liver cell line. Further studies are recommended to understand the molecular mechanism of Khat induced HepG2 cytotoxicity.

Comparative study on the effect of factor V leiden and prothrombin gene polymorphism in preeclampsic cases

To identify polymorphism of Factor V Leiden and Prothrombin gene in women suffering from preeclampsia. From 142 pregnant women we identified 92 women suffering from preeclampsia and 50 healthy controls with normal pregnancy matched for age and socioeconomic status, preeclampsic patient classified as mild preeclampsia 42[45.7%] and severe preeclampsia 50[54.3%]. Blood samples were tested for DNA polymorphism affecting thrombophilia Factor V Leiden and Prothrombin gene polymorphism. Heterozygous AG genotype showed a significant high frequency among preeclampsic patients [20.7%] compared to controls [4.0%], [OR 6.2, P= 0.006] regarding to Prothrombin gene but: Factor V Leiden, AG genotype showed [8.7%] of preeclampsic patients which was absent in any of the controls

Comparative study on the effect of C667T and A1298C polymorphism in preeclampsic cases

To identify polymorphism of methylenetetrahydrofolate reductase gene in women suffering from preeclampsia. From 142 pregnant women we identify 92 women suffer from preeclampsia and 50 healthy controls with normal pregnancy matched for age and socioeconomic status, preeclampsic patient classified as mild preeclampsia 42[45.7%] and severe preeclampsia 50[54.3%]. Blood samples were tested for DNA polymorphism affecting thrombophilia methylenetetrahydrofolate reductase C677T and A1298C. Homozygous TT genotype, T allele of C677T polymorphism has a significantly higher frequency among preeclampsic cases compared to healthy controls [OR=21.7, 1.46, respectively]. Thus TT genotype and T allele may be considered as genetic risk factors for preeclampsic cases. On the other hand, non significant association in either genotype among preeclampsic cases compared to controls regarding to A1298C

Safety and outcome of treatment of metastatic melanoma using 3-bromopyruvate: a concise literature review and case study / 癌症

3-Bromopyruvate (3BP) is a new, promising anticancer alkylating agent with several notable functions. In addition to inhibiting key glycolysis enzymes including hexokinase II and lactate dehydrogenase (LDH), 3BP also selectively inhibits mitochondrial oxidative phosphorylation, angiogenesis, and energy production in cancer cells. Moreover, 3BP induces hydrogen peroxide generation in cancer cells (oxidative stress effect) and competes with the LDH substrates pyruvate and lactate. There is only one published human clinical study showing that 3BP was effective in treating fibrolamellar hepatocellular carcinoma. LDH is a good measure for tumor evaluation and predicts the outcome of treatment better than the presence of a residual tumor mass. According to the Warburg effect, LDH is responsible for lactate synthesis, which facilitates cancer cell survival, progression, aggressiveness, metastasis, and angiogenesis. Lactate produced through LDH activity fuels aerobic cell populations inside tumors via metabolic symbiosis. In melanoma, the most deadly skin cancer, 3BP induced necrotic cell death in sensitive cells, whereas high glutathione (GSH) content made other melanoma cells resistant to 3BP. Concurrent use of a GSH depletor with 3BP killed resistant melanoma cells. Survival of melanoma patients was inversely associated with high serum LDH levels, which was reported to be highly predictive of melanoma treatment in randomized clinical trials. Here, we report a 28-year-old man presented with stage IV metastatic melanoma affecting the back, left pleura, and lung. The disease caused total destruction of the left lung and a high serum LDH level (4,283 U/L). After ethics committee approval and written patient consent, the patient received 3BP intravenous infusions (1-2.2 mg/kg), but the anticancer effect was minimal as indicated by a high serum LDH level. This may have been due to high tumor GSH content. On combining oral paracetamol, which depletes tumor GSH, with 3BP treatment, serum LDH level dropped maximally. Although a slow intravenous infusion of 3BP appeared to have minimal cytotoxicity, its anticancer efficacy via this delivery method was low. This was possibly due to high tumor GSH content, which was increased after concurrent use of the GSH depletor paracetamol. If the anticancer effectiveness of 3BP is less than expected, the combination with paracetamol may be needed to sensitize cancer cells to 3BP-induced effects.

Development of a remediation program for Egyptian dyslexic children

The present study was designed to formulate a remediation program for Arabic speaking children suffering from dyslexia based on improving phonological awareness using materials appropriate for Arabic culture. The study was carried out at the unit of Phoniatrics, Faculty of Medicine, Alexandria main university hospital. The subjects were divided into two groups.Group I: 30 dyslexic children of both sexes in the age range of 6[1/2]-10[1/2] years on which the proposed remediation programme was applied. Group II: 30 dyslexic children age and sexmatched were included as a control group; they received no remediation programs during the time of conduction of the study. The formulated Arabic remediation program was based on improving the phonological awareness for dyslexic children, after the Phonological Awareness Training for Reading Program. Modifications and additions were made to suit the nature of the Arabic language, and face the differences between Arabic and English orthography. The program was divided into sound blending, sound segmenting, reading and spelling activities. The training program was applied twice weekly, with session duration lasting from 25 to 30 min. Each session had about 2 or 3 children. The studied groups were subjected to protocol for evaluation of dyslexia before and after therapy to document to evaluate the improvement and the stability in the condition of these children. The presented training program significantly improved reading, writing and phonological awareness of dyslexic cases. The present study highlighted the importance of phonological awareness skills as a prerequisite for emergence of literacy skills. The program was modified to suit Arabic speaking Egyptian children. The study found that the age of the child is the most important predictor factor, the younger the age of intervention the better the outcome of therapy program

Coping patterns of mothers of children with epilepsy

Epilepsy is the most common neurological disorder in childhood Mothers of children with a chronic condition such as epilepsy have to cope with the burden of daily related to the illness and the constant adjustment to the changing demands of the chronic condition. to assess coping patterns of mothers of children with epilepsy through: Assessing mother's awareness and practice regarding childhood epilepsy, and detecting mother's coping patterns toward their children with epilepsy. A descriptive research design was utilized in this study, the convenience sample consisted of 120 epileptic children and their accompanying mothers recruited from the epileptic outpatient Clinic and the neurological pediatric out patient clinic affiliated to Ain Shams University hospital. Data were collected using questionnaire regarding knowledge and practice about childhood epilepsy, and coping scale to assess maternal coping toward their epileptic children. The mean age of the mothers' was 34.341 +/- 5.850 years. 71.7% of them had poor knowledge, 59.2% not done practice related to epilepsy disease. A statistically significant correlation was found between problems-oriented coping used by mother of epileptic children and her knowledge [P= 0.000], and practice toward childhood epilepsy [P=. 0.005]. The majority of the studied mothers were having poor knowledge and practice related to their epileptic children, particularly in regard to types of epilepsy and first aid management of acute seizures. Three fifth of them tended to cope by always using emotional oriented coping. Further researches are needed to determine the barriers that affect negatively the mothers of epileptic children coping patterns with their affected children. Conduct Continuous various educational programs for the mothers of epileptic children, based on needs assessment to raise their awareness regarding epilepsy

Functional status among patients with spinal cord injuries: a proposed protocol of care

Spinal cord Injuries [SCI] can result in devastating the physical, psychological or social functional status due to prolonged immobility. Spinal cord injury is a catastrophic condition that may cause dramatic changes in the victim's life. The aim of this study was of two folds to 1-assess the functional status among patients with spinal cord injuries; 2-propose a protocol of care. A total of one hundred patients were recruited in the study from 4 orthopedic wards at El Manial University Hospital affiliated to Cairo University. Data were collected utilizing three designed tools; interviewing schedule, the Functional Status Rating System Scale in relation to self care, mobility, communication, psychosocial adjustment and cognitive function; physical complications assessment sheet including the most common physical complications among patients with SCI. The study findings revealed that, there are statistically significant differences between the items of self care, communication, psychosocial adjustment and severity of the disease, while there are no statistically significant difference between the items of cognitive function and the severity of illness. The most common physical complications among those patients are constipation, pressure ulcer, urinary tract infection, urine and stool incontinence, chest infection, and deep venous thrombosis. The study recommended that, the proposed protocol of care should be implemented and evaluated in relation to incidence of complications. Health education of patients and family should be provided to maximize the injured individual's potential for full participation in activities of daily living and prevent secondary complications

Use of silicone gel sheets in combination with pressure garments in prevention of hypertrophic scarring; is it effective?

Patients can have a wide range of problems related to scars, in terms of cosmesis, function, symptoms, psychological problems and overall quality of life issues. Hypertrophic scars can be reduced by the application of silicone dressing; however, the detailed mechanism of silicone action is still unknown. It is known that silicone gel sheets Cerederm[R] cause a hydration of the epidermal layer of the skin. An in vitro coculture experiment has shown that hydration of keratinocytes had a suppressive effect on the metabolism of the underlying fibroblasts resulting in reduced collagen deposition. This study was conducted on 80 linear scars, 40 patients with post abdominoplasty scars, and 20 patients [40 breasts] with reduction mammoplasty scars; they were divided into two groups with the use of pressure garment fixed in both groups. The first group used silicone gel sheet Cerederm [R] while the second did not. Both groups were followed up for a period of 6 months. Then the outcome was compared both on clinical and histopathological basis. On clinical assessment the two groups where compared according to the Vancouver Scar Scale [VSS.]: scar height, pigmentation .etc. While in histopathological examination, three biopsies were taken at day 0, 90, 180 respectively. Each specimen was stained by hematoxylin and eosin to show the normal pattern of collagen bundle formation, the amount of fibrosis and proliferation of the fibroblasts. Early restoration of the water barrier is essential for reducing the stimulus for epidermal proliferation, and secondary epidermal cross talk to stimulate collagen synthesis in the dermis. Adding the pressure garment to the silicon play a role in decreasing the height of the scar or prevent its formation with decrease the other unpleasant sequel of the scar

Oral health status of residents of elderly homes

Maintenance of oral health is fundamental to prevent any oral and systemic diseases, to achieve the highest level of physical, mental, and social well-being and to attain successful ageing, thereby significantly contributing to the better quality of life. The aim of this study was to assess the oral health status of residents of elderly homes in Alexandria. The subjects comprised 238 residents aged 60 years and above residing in all governmental elderly homes in Alexandria. Data was collected using three tools: Structured interview sheet to collect data about personal characteristics of the elders, Kayser-Jones Brief Oral Health Status Examination to assess the oral health status of the elders, and Geriatric Oral Health Assessment Index to assess the elders physical and psychosocial function accompanying oral health problems. The study revealed that the majority of the institutionalized elders had one or more oral health problems particularly tongue lesions, gingival lesions, and denture related lesions that need immediate referral to appropriate specialist. The poor oral health status is mostly the outcome of each of significant factors including age, sex, level of education, financial status, smoking, and follow-up pattern. Moreover, oral health problems have serious physical and psychological impact on the majority of the residents of elderly homes. Therefore, educational programs should be planned and offered on a regular basis for nurses and caregivers to conduct the oral screening at regular intervals for the institutionalized elders

Role of dietary supplementation of methionine and folic acid in early atherosclerotic changes in adult male mice

Homocysteine is an important intermediate product in normal metabolism of methionine. Elevation of homocysteine is known as an independent risk factor for atherosclerosis. On the other hand, several studies have reported beneficial effects of folates on endothelial dysfunction. However, the exact mechanism remains to be elucidated. Thus, the objectives of this study were to assess the relationship between total plasma homocysteine and early atherosclerosis, b] to determine whether homocysteine exerts its effects through the adhesion molecule VCAM-]1 or not, c] To estimate the role of folic acid as a prophylactic and or treatment of early atherosclerotic changes. Adult male mice [n=40,] were randomly divided into 4 groups. Group I received the control diet. Group II received control diet plus methionine dissolved in drinking water, adjusted to deliver a total of 4.4%methionine/L drinking water for 8 weeks and the doses were calculated assuming an average water intake of 3 to 4 mL/d and an average body weight of 25 g. Group III received methionine in the same previous dose and duration concomitant with folic acid in a dose of 1mg/kg. Group IV received methionine in the same previous dose and duration followed by folic acid in the same previous dose for another 8 weeks. Blood samples were taken for estimation of homocysteine, Cholesterol, triglycerides, LDL, HDL, nitric oxide, superoxide dismutase. Specimens from aorta were taken and processed for histopathological and immunohistochemical examination. The high expression of VC'AM4 in group II might be responsible for the observed histological changes; adherent inflammatory cells to the irregular endothelial lining in addition to increased intima-media thickness, formation of intimal foam cells, hyperplastic changes, migration of the smooth muscle cells of the media, increase collagen and disturbed elastic fibers architecture. The plasma homocysteine and cholesterol levels were significantly higher in group II than in group I. It was reduced in group III and IV. Although, there was no significant dfference between their levels in group I and III, there was significant difference between group I and IV LDL, HDL, and triglycerides plasma levels did not differ statistically between different groups. Nitric oxide and superoxide were markedly reduced in group II with improvement in groups III and IV. However, the nitric oxide level in group I was significantly higher than that in group Ill and IV While no significant differences between group I, III and IV in superoxide dismutase levels. As regard the endothelial 'VCAM-1 expression, marked increase in the expression in group II, low expression in group III [similar to control] and moderate expression in group IV were observed. Elevated plasma homocysteine is a risk factor for early atherosclerosis which was confirmed by the endothelial expression of VCAM-1. Prophylactic administration of folic acid has a beneficial effect more than its role as a treatment

Using of particle counter as a monitoring tool for giardia and cryptosporidium in a water purification plant

Drinking water plays a major role in the spread of intestinal protozoa pathogenic for human, namely Giardia Iamblia and Cryptosporidium parvum. Surface water is contaminated with Giardia or Cryptosporidium in two major ways: wastewater treatment plants may discharge effluent with cysts or by fecal pollution by various animals that live on the watersheds. So, they are of great concern to the water treatment industry because they are known to have caused a number of waterborne outbreaks of diseases. Since, -the identifying of Giardia cysts and Cryptosporidium oocysts require, special technique and lab personnel specially trained in microbiology. Particle counting is another physical technique for enumeration of Giardia cysts and Cryptosporidium oocysts by instrument depending on their size distribution. This study aims at evaluating the use of particle counter as a monitoring tool for particle removal in a conventional pilot water treatment plant. The results revealed that coagulation, sedimentation, and filtration removed the most percentage of both parasites. The average removals of both parasites by coagulation and sedimentation were 76% and 71%, while filtration process only removed about >/=99.5%. On the other hand, the average removal of turbidity was 90.7% by coagulation and sedimentation and 95.2% by filtration. The average over-all removals of turbidity, Giardia, and Cryptosporidium were 99.53%, 99.95%, and 99.89%, respectively. While, the average log removal of parasites and turbidity were 3.3 log for Giardia, 3.02 log for Cryptosporidium, and 2.38 log for turbidity. A significant strong correlation was found between total particle removal and cyst and oocyst sizes removals, while a significant correlation between turbidity and parasites removal were observed. So, particle counter and turbidimeter can be used as surrogate indicator of Giardia and Cryptosporidium removal. The study recommended reducing the risk of raw water infection by Giardia and Cryptosporidium through the multiple barrier approach to treatment, including watershed protection, optimization of chemical pretreatment, filtration, disinfection, and a properly operated and maintained distribution system. It should be installed on-line instruments - particle counting and turbiditimeter monitoring - at various stages of the water treatment process to evaluate water purification plant performance for Giardia and Cryptosporidium removal and enable the operator to develop optimal operations conditions to achieve maximum particulates removal

Preparation and evaluation of the protective efficacyof pseudomonas aeruginosa irradiated vaccine in chickens

A total of 75 P. aeruginosa isolates were secured out of 280 samples from diseased chickens suffering from different respiratory manifestations. The isolates were characterized and serotyped. The most prevalent serotypes were O3 and O4. An inactivated bivalent P. aeruginosa vaccine was prepared from these serotypes. The inactivation was achieved through irradiation with Cobalt 60. The quality control analysis of the prepared irradiated vaccine indicated that it was safe and its use was not associated with any clinical distress. Application of ELISA for evaluation of humoral immune response developed against P. aeruginosa in the vaccinated chicken groups showed significant increase in antibody titers, which was influenced by the route of immunization. The protection rates post challenge reached 100%, 96% and 90% among the intramuscularly, subcutaneously and orally vaccinated chicken groups, respectively. Also, vaccination of egg laying hens with the prepared vaccine stimulated formation and concentration of P. aeruginosa. specific IgY in the egg yolk

Anisakis and fish induced urticaria

Skin tests using prepared Anisakis antigen and commercially available fish antigen were done. Also, specific IgE detection for Anisakis was done by RAST method. Two patients out of 20 showed positive skin test and positive RAST to larval Anisakis antigen and negative skin test to fish antigen. These two patients were considered hypersensitive to Anisakis