The role of vascular endothelial growth factor in ossification / 国际口腔科学杂志·英文版

Osteogenesis and angiogenesis are two closely correlated processes during bone growth, development, remodelling and repair.Vascular endothelial growth factor (VEGF) is an essential mediator during the process of angiogenesis. Based on an extensive literature search, which was carried out using the PubMed database and the keywords of osteogenesis, VEGF, endochondral ossification and intramembranous ossification, this manuscript reviews the role of VEGF in ossification, with emphasis on its effect in endochondral and intramembranous ossification. Osteogenesis and angiogenesis are closely correlated processes. VEGF acts as an essential mediator during these processes. It not only functions in bone angiogenesis but also in various aspects of bone development.

Synthesis, surface active properties of some amphoteric and anionic surfactants derived from long-chain mono alkyl malonate

A series of N.N-dimethyl-1-aminoethyl-2-amido-alkyl malonate and N, N-bis-carboxymethyl-1-aminoethyl-2-amido alkyl malonate surfactants based on fatly alcohol have been synthesized. The structure of these compounds was confirmed by elemental and spectroscopic analysis. The critical micelle concentration, efficiency, effectiveness, surface tension reduction at the air/water interface, CmC/C20 ratios. standard free energy of micellization, wetting and foam stability of the surfactants were determined. The results suggested that the minimum area/surfactants molecule [Amin] for the investigated compounds decreased with increasing the incorporated anionic group in the molecule of surfactant. It was shown that wetting and foaming characteristics of amphoteric surfactants were significantly better than those observed for anionic ones

Steroid and azathioprine versus steroid, cyclosporine, and azathioprine therapies in primary haplo-identical living donor kidney transplantation Twenty-year experience

Achievements in short-term graft survival since the introduction of cyclosporine has not been matched by improvement in long-term graft function, and chronic allograft nephropathy remains the second commonest cause of graft attrition over time. We aimed to evaluate the long-term results of conventional immunosuppression by steroid and azathioprine in comparison with cyclosporine-based triple therapy in living donor kidney transplants. We evaluated the long-term follow-up data of 369 living related kidney transplant recipients that were on prednisolone-azathioprine immunosuppressive therapy [group 1] or triple therapy by prednisolone, cyclosporine, and azathioprine [group 2]. All recipients were followed-up for more than 10 years [mean, 240 +/- 12 months]. Comparative analyses included patient and graft survival rates, condition at last follow-up, graft rejection, and graft function. There were 130 patients in group 1 and 239 in group 2. The overall frequency of acute rejection episodes was not significantly different between the two groups. However, the proportion of patients with chronic allograft nephropathy was significantly higher in group 2 [21% versus 35%, P = .001]. Graft survival rates were 85.3% versus 92.4% at 1 year, 69.9% versus 71.9% at 5 years, and 52.5% versus 50.8% at 10 years in groups 1 and 2, respectively [P = .03]. The two groups were comparable regarding posttransplant malignancies, diabetes mellitus, serious bacterial infections, and hepatic diseases. However, hypertensive patients were significantly more frequent in group 2. Chronic allograft nephropathy was significantly higher in patients receiving cyclosporine, possibly due to the risk of drug-induced nephrotoxicity, glomerular disease recurrence, and hypertension. Nowadays, it is possible to achieve excellent calcineurin inhibitors-free regimen using newer maintenance immunosuppressive agents

Effect of P-glycoprotien blockers on the bioavailability of paclitaxel in swiss albino mice

In this study, we have investigated the influence of P-glycoprotein blockers, namely verapamil and cyclosporine on the oral bioavailability of anticancer paclitaxel, aiming for increasing the oral bioavailability of paclitaxel with possibly reducing its side effect resulting from its parentral administration. The oral bioavailability of paclitaxel [10 mg/kg] in Swiss albino mice pretreated with either verapamil [20 mg/kg] and/or cyclosporine [50 mg/kg] was enhanced by 2.7 and 5.7 fold, respectively. This result may show that both drugs effectively inhibited the P-glycoprotein effhix pump activity in the intestinal tract, allowing for better absorption of paclitaxel. In this context art indirect index of P-glycoprotein efflux activity was used where a certain dye Rh-123 is transported by the membrane efflux P-glycoprotein pump in the same way as paclitaxel. The dye has a certain fluorescence which can be measured spectroflurometrically and its content in the intestinal tissue would reflect the amount absorbed as a result of P-glycoprotein inhibition. This study showed that Rh-123 was alike in the groups of control, i.p., and p.o. of paclitaxel. Pretreatment of oral paclitaxel with either cyclosporine an/or verapamil showed 2 and 1.4 times increase in Rh-123 level, respectively, indicating that cyclosporine was more effective than verapamil in inhibiting P-glycoprotein efflux pump activity. Paclitaxel itself had no effect on the leukocyte count but prior administration of either cyclosporine or verapamil significantly decreased the total number of white blood cells. Cyclosporine seemed to have a greater deleterious effect than verapamil. Both verapamil and cyclosporine given with oral paclitaxel also induced marked rise in the cardiac enzyme CK-MB but the effect was only transient and subsided after 48 hours, this has also been histopathologically confirmed. On the other hand, survival data of Ehrlich carcinoma bearing mice treated with pacliaiel indicated that both P-glycoprotein blockers did not adversely affect the antitumor activity of paclitaxel. Further work would certainly be needed for setting the benefit/risk ratio before the use of Pglycoprotein blockers can be advocated clinically

Domestic violence among women attending out-patient clinics in Ain Shams University Hospitals, Cairo, Egypt

Violence affects millions of women worldwide and it cuts across cultural and religious barriers, impeding the women's right to participate fully in the society. A descriptive cross sectional study was conducted to determine the prevalence of domestic violence among ever married females presenting to out patient clinics in Am Shams university hospitals and to identify factors affecting it. Out of a total number of 509 women, 89.8% had experienced one or more episodes of violent behavior by their husbands of which 56%, 88.4% and 47.9% suffered physical, control and threat violence. Both univariate and multivariate analysis was done. The most common form of violence among the study group was husband's shouting followed by being kept short of money. About 34.2% had been beaten by their husbands and 17.1% were forced to do sex. Using multiple logistic regression it was found that smoking husband and economic problems were independent significant factors associated with all forms of violence. Suffering violence was significantly associated with different forms of health complaints and only 9.1% had been asked by their doctors on domestic violence exposure. This proposes the importance of effective screening, diagnosis and management of domestic violence victims

Pulmonary effects of thoracic epidural analgesia for cardiac valve replacement surgery

The study was performed on forty patients [ASA physical status II: III] with symptomatic mitral valve disease underwent mitral valve replacement surgery. The patients where criteria were randomly allocated into two equal groups [20 patients each] 1- General anesthesia group [GA] ['control group]. 2- General anesthesia with thoracic epidural analgesia group [TEA group]. Anesthetic technique and management of cardiopulmonary bypass were standardized for all patients. Spirometric data: [FVC, FEV1, FEV1/FVC% and PEFR,], and respiratory rate were measured at the night before surgery, after extubation by 1h, 12h, 24h, 48h, 72h and [6th postoperative day Arterial Blood Gases: PaO2, PaCO2 and pH were measured after induction of GA by 15 min., after extubation by 48h, 72h and 6th postoperative day. Visual analogue scale [VAS] score for assessment of pain was measured after extubation by 1h, 6h, 12h, 18h, 24h, 48h, 72h and 6th postoperative day. Total dose of fentanyl analgesia was calculated in each group. There were some improvement in respiratory function [FVC, FEV 1 and PEFR.] started at the 3rd to the 6th post operative days.There were insignificant changes in FEV1/FVC all over the study period RR decreased significantly in the epidural group than control group in all readings. There was a significant decrease in VAS in TEA group than the control group throughout the study period. PaO 2 was significantly decreased in both groups at all readings. 1. Intensive Care Unit [ICU] stay: There was insignificant difference between the two groups. 2. Time to first awake /hour was significantly decreased in thoracic epidural group than general anesthesia group [1.3 +/- 0.3 vercus 2.5 +/- 0.6]. 3. Time to extubation /hour was significantly decreased in thoracic epidural group than general anesthesia group [3.5 + 0.2 versus 7.3 +/- 0.3]. 4. Total postoperative fentanyl consumption in 1st 24h was a significant decrease in TEA than GA group [p<0. 00] [677.9 +/- 26 in TEA group versus 1203.4 +/- 44 in general anesthesia group] perioperative epidural infusion of 0.125% bupivacaine and fentanyl, started before induction of anesthesia in valve replacement surgery reduces the total requirements of intraoperative narcotics, without cm appreciable delay in extubation. There was slight improvement in pulmonary function, but not to expected values and far less than control reading indicating multifactorial bases of pulmonary dysfunction in cardiac surgery using CBP

Deterioration of glucose tolerance in non-diabetic non-IGT elderly population: potential role of Beta cell dysfunction and insulin insensitivity

Aim: As the human community develops, the group of aged individuals constitutes a larger percent of the total population. This particular group of people is characterized by increased incidence of macrovascular complications that are similar to those described in the metabolic syndrome or type 2 diabetes. Moreover, it is well known that the incidence as well as the prevalence of type 2 diabetes and impaired glucose tolerance is more common in old age people. The mechanism of age-related glucose intolerance is not yet completely clear. Subjects and A clinicobiochemical study was carried out comprising 20 apparently healthy non-diabetic nonobese old individuals [mean age 65 +/- 4.8 years] and 20 type 2 diabetic patients compared to 10 healthy young subjects. The senile group had no family history of diabetes. Cases with renal, hepatic, gastrointestinal, or endocrine abnormalities were excluded from the study. Intravenous glucose tolerance test [ivGTT] was done with sampling at 0, 5, 10, 15, 30, 45, and 60 min after glucose load and the following estimations were undertaken: glucose decay constant [kG], glucose and insulin areas under the curve, insulnogenic index, first phase insulin response, insulin resistance index and fractional insulin clearance. The senile and diabetic groups, when compared to the controls, had a ronsignificantly different fasting plasma glucose, but it was higher in diabetic patients. Fasting serum insulin was significantly higher in the studied groups than in the healthy control group. The senile group showed a significant reduction in glucose tolerance [KG 1.36 +/- 0.3%/min], decreased insulin sensitivity index [5.19 +/- 1.4 10-4 min-1 /[micro U/ml] and a marked reduction of first phase insulin response [2.45 +/- 0.78 micro U/ml per mg/dl], when compared with the control group. However, the degree of glucose intolerance and insulin insensitivity of the senile group was still significantly lower than that of type 2 diabetic patients. This study revealed that the insulin resistance seems to be a characteristic feature of the normal aging process and senility could be considered as an inevitable risk factor for glucose intolerance and metabolic syndrome with its accompanying health hazards. Conclusions: Insulin secretion, insulin clearance and interaction between insulin and target tissues are defective in elderly subjects. These functions are intermediate between healthy controls and NIDDM patients and may predispose the elderly population to the risk of impaired glucose tolerance or diabetes mellitus with its attendant macrovascular and microvascular complications

Naloxone versus nalbuphine for treatment of intrathecal morphine-induced side effects

This study included 200 adult male and female patients undergoing lower abdominal and anorectal surgeries under spinal anesthesia. All patients received [3 ml bupivacaine 0.5% + 1 mg morphine] intrathecally. Patients were observed for 24 hours postoperatively. One hundred patients requested treatment for moderate to severe symptoms [pruritus, nausea and/or vomiting]. According to the drug used to treat intrathecal morphine-induced side effects, patients were divided randomly into two equal [each of 50] groups: Group I, received nalbuphine in a dose of 2 mg for a maximum of 6 doses [12 mg] and group II, received naloxone in a dose of 0.08 mg for a maximum of 6 doses [0.48 mg]. The remaining 100 patients developed no or mild symptoms requiring no treatment. Those patients constituted group III. Intrathecal morphine in a dose of 1 mg produced moderate to severe side effects [pruritus, nausea and/or vomiting and urinary retention] in a 50% of patients. No incidence of respiratory depression was observed at this dose. Both naloxone and nalbuphine were effective and safe in treating the side effects of intrathecal morphine. However, there was an evidence that nalbuphine may be superior than naloxone as regards the possibility to reverse intrathecal morphine-induced analgesia

Severity of dentofacial deformity, the motivations and the outcome of surgery in skeletal Class III patients / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the relationship between severity of skeletal Class III malocclusion and the patient's emotional status, as well as motivation for seeking surgical correction and satisfaction with the outcome of the surgery.</p><p><b>METHODS</b>One hundred and forty consecutive Chinese patients with skeletal Class III malocclusion who had been treated with a combined orthodontic and surgical approach were studied. Sixty-seven percent (40 males and 54 females) responded to a questionnaire. Fifty-four percent had two jaw deformities, 32% mandibular hyperplasia and 14% maxillary hypoplasia. Surgical procedures: 77% received two jaw surgeries, 15% maxillary advancement and 8% mandibular setback. This was a retrospective study based on questionnaires with numerical scale ranked answers (0: not at all; 1: a little; 2: moderately; 3: quite a bit; and 4: extremely).</p><p><b>RESULTS</b>ANB angle was significantly negatively correlated with feelings about the nickname related to their facial problems (embarrassment: gamma =-0.30, P < 0.01; worn out gamma =-0.32, P < 0.01; angry gamma =-0.24, P < 0.05). ANB angle also had a significant negative correlation with the reasons for having the surgery (pressure from their friends: gamma =-0.21, P < 0.05, and referred by physician: gamma =-0.24, P < 0.05). Changes in life style as a result of surgery were significantly negatively correlated with the ANB angle before treatment, positive influence on relationships with the opposite sex (gamma =-0.25, P < 0.05), positive influence in social activities (gamma =-0.22, P < 0.05).</p><p><b>CONCLUSION</b>The psychological status before surgery and the outcome following orthognathic surgery in patients with skeletal Class III malocclusion were closely related to severity of the malocclusion.</p>

Mansoura ATG and steroid resistant rejection

ATG is one of the most effective therapeutic agents in the treatment of acute renal allogrqft rejection, especially when the episode is resistant to steroids. Anti thymocyte globulin [ATG] is a hyperirnmune serum produced in rabbits against purified human thymus cells. Fifteen patches of ATG were prepared locally in our lab. Antibody production was done by injection of purified human thymus cells into about 10-12 rabbits/patch. Adsorption, fractionation and purification of rabbit serum, antibody assays, and quality control tests were done. Our ATG was utilized in 20 patients suffering from sterioid resistant rejection [SRR]. Monitoring of the drug by T cell subsets analysis and Anti ATG antibodies revealed depletion of the total T lymphocytes especially in the early doses beside absence of anti ATG antibodies without any side effects of the preparation on the other haematologic series. Regarding the clinical efficacy of our ATG in reversing SRR, 80% of cases respond completely while partial response was noted in 10% and another 10% showed failure. In conclusion our ATG is as effective as other ATG in saving renal transplantation otherwise the graft will be lost

Hepatitis C virus infection among haemodialysis patients: risk factors and predominant gentype

This study was conducted on 100 haemodialysis [HD] patients [69 females and 31 males], from 8 to 67 years [mean 30.9 + 11.9 SD] and 50 apparently healthy controls with matched age and sex. All subjects were investigated for serum bilirubin, albumin, alanine transaminase [ALT] and aspartate transaminase [AST]. Serum hepatitis C virus [HCV] antibodies were detected by 2nd generation ELISA [ElAll] and 2nd generation RIB A test [RIBAII]. Serum HCV-RNA was assessed by reverse transcriptase -polymerase chain reaction [RT-PCR]. Haemodialysis patients were also subjected to Hepatitis B surface antigen [HbsAg] detection and histopathological examination of rectal snip to diagnose Schistosoma infection. Genotyping of [19] positive HCV RNA patients was performed using the INNO-LiPA [line probe assay] HCVII Kit [Innogenetics, N. V., Belgium]. Seventy seven [77%] of HD patients were found to be positive for HCV by EIAII, 68 of them were also positive by RIBA II and 8 were intermediate. HCV RNA was detected in 38% of patients by RT- PCR. A significant correlation between HCV infection in these patients versus length of time and frequency of dialysis as well as number of previous blood transfusion [P=0.009, P= 0.03, p=0.001 respectively] was detected suggesting nosocomial spread of HCV infection within the HD units. No significant correlation between HBsAg positivity and HCV infection was detected by EIAII, RIBAII, or PCR. Schistosoma infection was not significantly associated with anti-HCV status by using RIBAII or RT-PCR [p=0.9]. Genotyping of 19 HCV RNA positive patients on chronic HD revealed that genotype 4 was the predominant one [68.4%, 52.6% type 4 perse and 15.8% type 4 subtype h], type 1 was detected in 10.6% [5.3% for each of type 1a and 1b], while the remaining 21% were untypable strains. Further epidemiological and molecular studies to identify the routes by which HCV could be transmitted in HD units are needed

Eosinophil cationic protein [ECP] and skin prick tests in children with steroid-responsive nephritic syndrome [SRNS]

To assess the atopic state in patients with SRNS, serum ECP levels were measured by chemiluminescent enzyme immunornetric assay and skin prick tests were done in 32 children with SRNS and 10 age- and sex-matched healthy children without evidence of atopy. Out of the nephrotic patients, 19 children had active disease [Group I] and 13 were in remission [Group II]. Among group I, 7 children were frequent relapsers [FR] while 12 were infrequent relapsers [IR] or non-relapsers [NR]. We found that 37.5% of our patients had positive skin prick tests. Serum ECP levels were elevated in group I patients [= 25.3 and Interquartile range [IQR] = 13.8-33.6 ng /ml] and group II patients [median = 14.2 and IQR = 12.0-20.2 ng/ml] compared to controls [median = 9.1 and IQR = 7.2-13.5 ng/ml, P < 0.0001 and 0.006 respectively]. Similarly, patients with negative skin prick tests in group land group II had higher ECP levels compared to controls [P = 0.007 and 0.07 respectively]. Among group I, ECP levels were higher in patients with positive skin prick tests to those with negative tests [P < 0.0001] and in FR compared to IR and NR [P = 0.05]. Moreover, there was an association between the development of frequent relapses and positivity of skin prick tests [Fishers Exact = 0.07 relative risk = 6.4 and confidence interval = 1.0-41.2]. In conclusion, serum ECP levels are elevated in children with active SRNS. ECP could be considered as one of the neutralizing cations involved in the pathogenesis of proteinuria in these patients. Atopy could be assumed as a risk factor for the development of frequent relapses, so the value of a course of non-steroidal anti-inflammatory drug [as ketotifen] infrequently relapsing nephrotic children should be evaluated

Phytochemical and biological study of certain Terminalia species growing in Egypt

A comparative study of the lipid, fatty acids, protein and amino acid content of the fruits of four Terminalia species, viz., T.bellerica Roxb., T.arjuna W. and A., T.muelleri Benth. and T.myriocarpa Heurck and Muell. is carried out. Determination of the tannin content of the different organs; bark, stem, leaf and fruit, isolation and identification of ethyl gallate and gallic acid from the fruits of T. bellerica as well as apigenin-7 -O-glucoside and quercetin-3-O-glucoside from the leaves of the same plant is achieved. A toxicological study, pharmacological and antimicrobial screening of the alcohol and aqueous extracts of the fruits and bark of T. bellerica is also carried out

Haemolytic anaemia after ABO-mismatched living-donor kidney transplantation

ABO.mismatched transplants are used frequently. Acquired haemolytic anaemia have been reported after ABO mismatched transplantation. Among 214 ABO.unmatched living-donor kidney transplants tS, 10 cases with cyclosporine based therapy developed haemolysis All studied patients had pre-transplant non specific blood transfusion and received kidneys from one haplotype HLA mismatched living donors. There were 164 males and 50 females. while the mean age was 30.41 years. CsA was stopped in patients treated with triple Immunosuppression while the patients received Pred-CsA were switched to conventional immunosuppression 6 patients were transfused with washed O cells and no plasma exchange was required. The prognosis was excellent in 9 patient, and one died from severe haemolysis. The haemolytic anaemia was more frequent among blood group A recipients [60% of our cases] and more severe among recipients with blood group B. Univariate analysis demonstrated significant impact for recipient age. donor sex, number of pretransplant blood transfusions. primary immunosuppression, time to onset of diuresis, recipient and donor blood groups. On the other hand, multivariate analysis restricted the significance to blood group of donor and recipient. time to onset of diuresis and primary immunosuppression. ABO unmatched kindray transplantation had no impact on patient survival, mean while the graft survival appeared to be better among unmatched ABO group in comparison to the same blood group recipients

Nutritional assessment of failure to thrive

Failure to thrive is a common problem that is met by pediatricians all over the world. 40 cases of children with FTT aged 1-5 years and 10 normal children of the same age as a conttrol group were studied. All were subjected to comperhensive history taking, through physical examination including anthroprometric assessment [weight, height, head and mid-arm circumferences] and laboratory investigations with particular to estimation of nutritional markers [plasma prealbumin, fibronectin and retinal binding protein]. Our results showed a statistically, significant difference with [P<0.001] in the weight and mid-arm circumference between cases of FTT and control group.Statistical non significan't difference between control group and cases in respect to supine length or height and head circumference [All parameters as a percentage of 50[th] percentile of normal Egyptian growth curves] there was statistical difference in the control levels and our cases of FTT in all nutritional markers. The mean prealbumin level in the control group was 25.4 +/- 9.2 mg/dL compared to the organic group 9.57 mg/dL with P value <0.0001 and in non-organic cases was 12.1 mg/dL with P -value [< 0.005] which is highly significant. The mean plasma fibronectin level in the control group was 21.5 +/- 6.8 mg/dL compared to the mean level in FTT cases 11.7 +/- 4.18 mg/dL with P-value [<0.05]. In the organic group mean level was 10. 15 +/- 3.2 mg/dL with P value [< 0.0005] and in non-organic group the mean fibronectin level was 12.68 +/- 2.3 mg/dL with P-value [< 0.05] compared to control group. Retinol binding protein mean level in control group was 3.82 +/- 1.1 mg/dL while in FTT cases was 1.81 +/- 0.69 mg/dL with statstically non-stignificant difference P-value [< 0.25]. We concluded that the incidence of non-organic failure to thrive cases was higher than the organic causes, most likely in children < 5 years. Ignorance, poverty, frequent infections, cultural customs or unstable families are the main causes in our developing countries

DRB1 alleles in Egyptian children with idiopathic Nephrotic Syndrome

Idiopathic nephrotic syndrome [INS] of children has been reported to be associated with serologically detected HLA-DR antigens. To investigate the association of INS and genes, 22 patients with INS and 20 control subjects were typed for HLA DRB1 during reverse hybridization technique. The study have found that the frequency of children positive for DRB1*03 alleles was significantly increased among patients with INS. The frequency of DRB1 01* alleles was also increased; however it was not significant. The frequency of DRB1*11 alleles was low in INS patients, but it was not significant when corrected to the number of antigens tested. These findings suggested that DRB1*03 genes, or closely associated unknown genes confer susceptibility to INS. The DEB1*03 genes are not involved in the response of INS patients to steroid therapy. The protective effect of DRB1*11 genes remains to be elucidated due small number of patients

Cervical canal stenosis: relative merits of the diagnostic imaging modalities

Twenty seven patients with cervical myeloradiculopathic symptoms were examined by MRI. Myelography was done to 21 patients and is followed by CTM in 20 cases. Twenty patients were operated upon. Magnetic resonance imaging and CT myelography provided comparable information about the degree of narrowing of the spinal canal, cord compression and encroachment on lateral foramina. CT myelography is slightly more sensitive in the detection of osseous component of a disc lesion and MRI is superior in detecting intrinsic cord lesions [gliosis and cavitation]. Because MRI is not invasive and has several practical advantages, it is recommended as the primary imaging modality in patients with myeloradiculopathic symptoms