Introgression of bacterial leaf blight (BLB) resistant gene, Xa7 into MARDI elite variety, MR219 by marker assisted backcrossing (MABC) approach

Abstract Bacterial leaf blight (BLB) is one of the major rice diseases in Malaysia. This disease causes substantial yield loss as high as 70%. Development of rice varieties which inherited BLB resistant traits is a crucial approach to promote and sustain rice industry in Malaysia. Hence, this study aims were to enhance BLB disease resistant characters of high yielding commercial variety MR219 through backcross breeding approach with supporting tool of marker-assisted selection (MAS). Broad spectrum BLB resistance gene, Xa7 from donor parent IRBB7 were introgressed into the susceptible MR219 (recurrent parent) using two flanking markers ID7 and ID15. At BC3F4, we managed to generate 19 introgressed lines with homozygous Xa7 gene and showed resistant characteristics as donor parent when it was challenged with Xanthomonas oryzae pv. oryzae through artificial inoculation. Recurrent parent MR219 and control variety, MR263 were found to be severely infected by the disease. The improved lines exhibited similar morphological and yield performance characters as to the elite variety, MR219. Two lines, PB-2-107 and PB-2-34 were chosen to be potential lines because of their outstanding performances compared to parent, MR219. This study demonstrates a success story of MAS application in development of improved disease resistance lines of rice against BLB disease.

Resumo A mancha bacteriana das folhas (BLB) é uma das principais doenças do arroz na Malásia. Essa doença causa perdas substanciais de rendimento de até 70%. O desenvolvimento de variedades de arroz que herdaram características de resistência ao BLB é uma abordagem crucial para promover e sustentar a indústria do arroz na Malásia. Portanto, o objetivo deste estudo foi aumentar os caracteres BLB resistentes a doenças da variedade comercial MR219 de alto rendimento por meio de uma abordagem de cruzamento retrocruzamento com ferramenta de apoio de seleção assistida por marcador (MAS). O gene de resistência a BLB de amplo espectro, Xa7 do pai doador IRBB7, foi introgressado no MR219 suscetível (pai recorrente) usando dois marcadores flanqueadores ID7 e ID15. No BC3F4, conseguimos gerar 19 linhagens introgressadas com o gene Xa7 homozigoto e apresentamos características de resistência como genitor doador quando desafiado com Xanthomonas oryzae pv. oryzae por inoculação artificial. O pai recorrente MR219 e a variedade controle, MR263, estavam gravemente infectados pela doença. As linhas melhoradas exibiram características morfológicas e de desempenho de rendimento semelhantes às da variedade elite, MR219. Duas linhas, PB-2-107 e PB-2-34, foram escolhidas como linhas potenciais por causa de seus desempenhos excelentes em comparação com a mãe, MR219. Este estudo demonstra uma história de sucesso de aplicação de MAS no desenvolvimento de linhas de arroz melhoradas com resistência a doenças contra a doença BLB.

Introgression of bacterial leaf blight (BLB) resistant gene, Xa7 into MARDI elite variety, MR219 by marker assisted backcrossing (MABC) approach / Introdução do gene resistente à ferragem da folha bacteriana (BLB), xa7 na variedade MARDI elite, MR219 por abordagem de backcrossing assistida por marcador (MABC)

Abstract Bacterial leaf blight (BLB) is one of the major rice diseases in Malaysia. This disease causes substantial yield loss as high as 70%. Development of rice varieties which inherited BLB resistant traits is a crucial approach to promote and sustain rice industry in Malaysia. Hence, this study aims were to enhance BLB disease resistant characters of high yielding commercial variety MR219 through backcross breeding approach with supporting tool of marker-assisted selection (MAS). Broad spectrum BLB resistance gene, Xa7 from donor parent IRBB7 were introgressed into the susceptible MR219 (recurrent parent) using two flanking markers ID7 and ID15. At BC3F4, we managed to generate 19 introgressed lines with homozygous Xa7 gene and showed resistant characteristics as donor parent when it was challenged with Xanthomonas oryzae pv. oryzae through artificial inoculation. Recurrent parent MR219 and control variety, MR263 were found to be severely infected by the disease. The improved lines exhibited similar morphological and yield performance characters as to the elite variety, MR219. Two lines, PB-2-107 and PB-2-34 were chosen to be potential lines because of their outstanding performances compared to parent, MR219. This study demonstrates a success story of MAS application in development of improved disease resistance lines of rice against BLB disease.

Resumo A mancha bacteriana das folhas (BLB) é uma das principais doenças do arroz na Malásia. Essa doença causa perdas substanciais de rendimento de até 70%. O desenvolvimento de variedades de arroz que herdaram características de resistência ao BLB é uma abordagem crucial para promover e sustentar a indústria do arroz na Malásia. Portanto, o objetivo deste estudo foi aumentar os caracteres BLB resistentes a doenças da variedade comercial MR219 de alto rendimento por meio de uma abordagem de cruzamento retrocruzamento com ferramenta de apoio de seleção assistida por marcador (MAS). O gene de resistência a BLB de amplo espectro, Xa7 do pai doador IRBB7, foi introgressado no MR219 suscetível (pai recorrente) usando dois marcadores flanqueadores ID7 e ID15. No BC3F4, conseguimos gerar 19 linhagens introgressadas com o gene Xa7 homozigoto e apresentamos características de resistência como genitor doador quando desafiado com Xanthomonas oryzae pv. oryzae por inoculação artificial. O pai recorrente MR219 e a variedade controle, MR263, estavam gravemente infectados pela doença. As linhas melhoradas exibiram características morfológicas e de desempenho de rendimento semelhantes às da variedade elite, MR219. Duas linhas, PB-2-107 e PB-2-34, foram escolhidas como linhas potenciais por causa de seus desempenhos excelentes em comparação com a mãe, MR219. Este estudo demonstra uma história de sucesso de aplicação de MAS no desenvolvimento de linhas de arroz melhoradas com resistência a doenças contra a doença BLB.

Synthesis, characterization, anti-mycobacterial activity and in silico study of new 2,5-disubstituted-1,3,4-oxadiazole derivatives

@#A series of new 2,5-disubstituted-1,3,4-oxadiazole derivatives (5a-j and 6a-j) have been designed and synthesized in four-steps. Sixteen compounds among the twenty compounds are reported for the first time. The compounds were characterized and confirmed by the FTIR, 1D- and 2D-NMR and HRMS analyses, and were tested against Mycobacterium smegmatis and Mycobacterium tuberculosis H37Ra. Compound 5d was the most active against M. smegmatis with MIC value of 25 µM, and exhibited cidal activity with MBC of 68 µM, respectively. The time-kill assay showed the good killing rate at 77% with the combination of isoniazid (INH). In addition, checkboard assay confirmed the interaction of compound 5d was categorised as additive. Docking simulation has been performed to position 5d into the pantothenate synthetase active site with binding free energy value –8.6 kcal mol-1. It also occupied the same active site as that of standard native ligand with similar interactions, which clearly indicate their potential as pantothenate synthetase inhibitor.

Seroprevalence of Toxoplasmosis among Hemato-oncology patients in Kelantan

@# Toxoplasmosis is a zoonotic disease caused by Toxoplasma gondii that is prevalent in humans and animals. This study was aimed to determine the seroprevalence of T. gondii infection among hemato-oncology patients and its association with sociodemographic and behavioural characteristics. This cross-sectional study was conducted at the Hospital Universiti Sains Malaysia (USM) involving 56 blood samples from hemato-oncology patients. Anti-T. gondii IgG and IgM antibodies and IgG avidity were determined using enzyme-linked immunosorbent assays (ELISA). The association of T. gondii exposure, sociodemographic, and behavioural characteristics were assessed by a questionnaire and face-to-face interviews. Twenty-eight (50%) patients were seropositive for T. gondii antibodies, where 27 (48.21%) patients were IgG+/IgM- and one patient (1.79%) was IgG+/IgM+ with high avidity index, indicating infection of more than 20 weeks. A univariate analysis showed that age, gender, ethnicity, marital status, educational level, employment status, stem cell transplant, blood transfusion, close contact with cats, water supply, and consumption of undercooked meat were not significantly associated with Toxoplasma seropositivity (p > 0.05). Our study has demonstrated, for the first time, the serological evidence of T. gondii exposure among hemato-oncology patients in Hospital USM. Our findings indicated that latent toxoplasmosis was relatively prevalence among our patients. Therefore, serological screening tests should be considered for immunocompromised patients as well as the implementation of health education programmes to encourage a healthy lifestyle and the consumption of healthy food among them.

Diabetes and oral therapies. A review of oral therapies for diabetes mellitus

For decades, antihyperglycaemic agents have been used for the treatment of type 2 diabetes mellitus given their effectiveness and convenience. Metformin [MET] and sulphonylureas [SU] are time-tested antihyperglycaemic agents that have been administered for more than 50 years. These agents were followed by the introduction of other antihyperglycaemic agents such as glinides [GLN], thiazolidinediones [TZD], alpha-glucosidase inhibitors [AGI], dipeptidyl peptidase-4 inhibitors [DPP-4I], and sodiumeglucose cotransporter-2 inhibitors [SGLT2I]. MET is recognized as the drug of choice for monotherapy unless contraindicated or unwanted side effects occur. SU-induced hypoglycaemia is losing ground to various new agents, but the generic formulae of SU together with MET are cheap and effective. The cardiovascular hazards of several agents are a major concern to physicians and legislating bodies. In choosing antihyperglycaemic agents for dual or triple therapy, the treating physician must keep in mind the health status of the patient, medication side effects, cost, and patient preference. This review addresses the advantages and disadvantages of a range of antihyperglycaemic agents and their applications in monotherapy or combination therapy

Late-presenting complete heart block after pediatric cardiac surgery

Late presenting complete heart block after pediatric cardiac surgery is a rare complication and its management is well defined once the initial diagnosis in made timely and appropriately. In this report we described a child who underwent atrioventricular septal defect repair with a normal sinus rhythm during the postoperative period, as well as during the first 2 years of follow up. She subsequently developed complete heart block with bradycardia that required insertion of a pacemaker. Here we discuss this unusual late-presenting complication, possible risk factors, and management

Middle East Consensus Statement on the Prevention, Diagnosis, and Management of Cow's Milk Protein Allergy / 대한소아소화기영양학회지

Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers.

Correction: Middle East Consensus Statement on the Prevention, Diagnosis, and Management of Cow's Milk Protein Allergy / 대한소아소화기영양학회지

Table 2 contains a typographical error.

Differences in perioperative outcomes after laparoscopic management of benign and malignant adnexal masses / 부인종양

OBJECTIVE: To compare the feasibility and safety of the laparoscopic management of adnexal masses appearing preoperatively benign with those suspicious for malignancy. METHODS: Retrospective study of 694 women that underwent laparoscopic management of an adnexal mass. RESULTS: Laparoscopic management of an adnexal mass was completed in 678 patients. Six hundred and thirty five patients had benign pathology (91.5%) and 53 (7.6%) had primary ovarian cancers. Sixteen patients (2.3%) were converted to laparotomy; there were 13 intraoperative (1.9%) and 16 postoperative complications (2.3%). Patients divided in 2 groups: benign and borderline/malignant tumors. Patients in the benign group had a higher incidence of ovarian cyst rupture (26% vs. 8.7%, p<0.05). Patients in the borderline/malignant group had a statistically significant higher conversion rate to laparotomy (0.9% vs. 16.9%, p<0.001), postoperative complications (1.9% vs. 12.2%, p<0.05), blood loss, operative time, and duration of hospital stay. The incidence of intraoperative complications was similar between the 2 groups. CONCLUSION: Laparoscopic management of masses that are suspicious for malignancy or borderline pathology is associated with an increased risk in specific intra-operative and post-operative morbidities in comparison to benign masses. Surgeons should tailor the operative risks with their patients according to the preoperative likelihood of the mass being carcinoma or borderline malignancy.

bibliometric analysis of pubmed-published Jordanian literature in the twentieth century

To identify the quantitative and qualitative characteristics of research published by Jordanian institutions in the medical and paramedical fields in the twentieth century. PubMed database was searched to identify relevant articles. Abstracts, full text, and or the 2003 Journal Citation Report were used to retrieve investigated characteristics. Jordanian medical institutions published 833 Pubmed-indexed articles in the twentieth century. Most of these articles [81%] were published in the last decade of the twentieth century. Articles published in Pharmacology Journals represented the largest proportion among other disciplines [12%], followed by dental, general medicine, infectious diseases, and obstetric journals, respectively. 72% of the articles were published in journals with assigned impact factors. However, the bulk of these articles [60%] were published in journals with impact factors of only 2 or less. It is worth nothing that only 16% of the published articles reflected experimental trials and only 3% were randomized and controlled, while 55% of the articles reflected observational studies. Jordan University of Science and Technology [JUST] researchers produced 44% of the total while Jordan University researchers produced 34%. Inter-institutional collaborative research was minimal and was dominated by JUST and the Ministry of Health. It is very clear that the Jordanian medical sciences research production has increased significantly in the last decade of the twentieth century. However, the quality of this research continues to be of low value. Efforts and resources are better directed toward multi-center, interventional, and more controlled research

role of prophylactic laser iridotomy on the fellow eye in primary angle closure glaucoma

To evaluate the long-term efficacy of laser peripheral iridotomy [LPI] of fellow eye of patients with acute primary angle-closure glaucoma [APACG]. Retrospective non comparative case series. Forty six patients [46 eyes] with APACG at presentation to Assiut University Hospital from January, 2005 to December 2008 were included. All fellow eyes were initially treated with prophylactic pilocarpine 2% eye drops four times daily before LPI which was done within 2 weeks. All patients were followed to detect development of acute angle-closure and rise of IOP. No cases developed APAC after LPI during the follow-up of 37.3 +/- 7.1 months. Thirty eight eyes [82.8%] did not develop rise of lOP during the follow-up period, while the remaining eight eyes [17.2%] developed chronic rise of lOP and required additional treatment. LPI is effective in preventing angle-closure in fellow eyes. Long-term follow-up is recommended to detect any rise of lOP that may occur and required additional treatment

Infantile cataract surgery and intraocular lens implantation

To assess the long term results of cataract extraction and intraocular lens [IOL] implantation for congenital cataract. Prospective hospital based study of 39 children [age 6-13 months] underwent cataract extraction and lOLs implantation for congenital cataract in Assiut University Hospital and followed-up for 21 months [range 16-33 months]. Posterior capsulotomy and generous anterior vitrectomy was performed in all eyes. Forty nine eyes of 39 patients were included. At surgery, the mean age was 8.3 months [range 6 to 13 months]. The mean follow-up was 21 months [range 16 to 33 months]. At the last follow-up, 82.1% of children had central steady vision. Postoperative complications included anterior pupillary membrane [n=8], deposition on the anterior surface of the IOL [n=4], posterior pupillary membrane [n=3], pupil capture [n = 6], pseudophakic glaucoma [n=2], posterior synechia [n=3] and squint [n=13]. Implantation of lOLs in infants with congenital cataract is safe and effective and without serious postoperative complications

Squamous cell carcinoma antigen as a tumor marker in patients with hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is considered the fifth most common cancer in the world. Owing to its increased incidence in the last decade and the expected further increase in the next 2 decades, HCC is arousing great interest. HCC commonly develops on cirrhotic livers and therefore, surveillance programs have been suggested to identify early HCC, at a stage suitable for surgical or interventional therapy and has a better clinical outcome. The only serologic marker used in clinical practice is alpha-fetoprotein [alpha-FP], but its sensitivity is poor. Hence, the investigation of new markers is required. To assess the clinical utility of squamous cell carcinoma antigen [SCCA] as a non invasive marker in the early diagnosis of HCC and whether the association of alpha-FP and SCCA could improves the diagnostic power. This study is conducted on 65 newly diagnosed hepatic focal lesion cases from those attending the Tropical Medicine Department, Cairo University Hospitals [Group I] as well as 20 age and sex matched healthy control subjects [Group II]. Group I was further subdivided into la [49 HCC proved untreated patients] and Ib [16 patients with Cirrhosis only] according to their histopathological findings. All patients were subjected to full history taking, clinical examination, laboratory investigations [including liver function test, hepatitis markers, alpha-FP and SCCA serum levels], triphasic abdominal CT and pathological examination. Group I included 42 males [64.7%] and 23 females [35.3%] with ages ranging between 42-70 years [60.7111.28], of them 16 patients had HBV [24.6%], 37 patients had HCV [56.9%] and 12 patients [18.4%] had mixed HBV and HCV infection. Group I was further subdivided into group la which included 49 HCC proved patients and group Ib which included 16 patients with regeneration nodules [cirrhosis only] according to their histopathologic findings. Group II [control] included 20 age and sex matched healthy subjects. Mean levels of serum alpha-FP and SCCA in group Ia was significantly higher when compared with group Ib [p<0.0005 for both of them]. At a cutoff of serum alpha-FP 200 ng/mL, the sensitivity was 35% and the specificity was 100% while at a cutoff >400ng/mL, the sensitivity decreased to 7.6%. On using the receiver operator curve [ROC], to improve the specificity and sensitivity of alpha-FP and SCCA, the cutoff value of 40ng/ml and 0.55ug/L yielded a sensitivity of 67.2% and 61.2% respectively and specificity of 100% [best cutoff]. When combined sensitivity of them was calculated at the best-chosen cutoff values, sensitivity improved to 87.7% with specificity of 100%.Combined use of alpha-FP and SCCA in the screening of patients with hepatic focal lesions may increase the chance of diagnosis of HCC patients

Evaluation of transforming growth factor alpha [TGFn] and tumor necrosis factor alpha [TGFn] in children with acute hepatitis

The present study included 60 children who were recruited from Pediatric Department of National Liver Institute [NLI], Menoufiya University and 20 apparently healthy children from the relatives of patients as a control group. Their ages ranged from 2 to 15 years, they were 49 males and 31 females. The studied children were divided according to their diagnosis into groups each of 20; Group [I] acute hepatitis, Group [II] acute fulminant hepatitis [F. H], Group [III] chronic hepatitis and Group [IV] control group. The mean level of both transforming growth factor alpha [TGF I] and tumor necrosis factor alpha [TNF I] were higher in group II [32.74 +/- 9.98 pg/mL and 116.41 +/- 49.70 pg/ml, respectively] more than the other groups and the difference was statistically highly significant [[P<0.001] and [<0.05], respectively]. The mean of level of [TGFD in FH survivors was [29.23 +/- 5.51pg/mL] compared to deceased ones [20.93 +/- 4.60 pg/mL] but the difference was statistically insignificant [p>0.05]. On the other hand the mean of [TNFI] in the deceased cases was 132.76 +/- 48.81pg/mL compared to 117.93 +/- 19.15pg/mL in survivors but the difference was statistically insignificant [P > 0.05]. Case fatality rate for all FH cases was 80%. In conclusion, the levels of both TGFI and TNFI are significantly higher in fulminant hepatitis more than acute hepatitis cases but with no significance in the progress of the disease. Further studies is recommended to uncover predictors that can differentiate between acute hepatitis and fulminant hepatitis and the progress of the disease

Left ventricular functions in patients with thyroid disorders

Cardiac functions in patients with different thyroid disorders are not well studied. The study was addressed to study cardiac dysfunctions especially in subclinical thyroid disorders by a new specific and sensitive imaging, pulsed wave tissue Doppler imaging [PWTDI], which is able to precisely assess the ventricular wall motion. In addition to N-terminal pro-brain natriuretic peptide [N-terminal proBNP]. A new neurohormone, which is a specific and sensitive marker for early detection of left ventricular dysfunctions. We studied 40 patients [29 females and 11 males] with hypothyroidism, 20 of them with overt hypothyroidism [group I], the other 20 patients with subclinical hypothyroidism [group II]. Forty patients [27 females and 13 males] with thyrotoxicosis, 20 of them with overt hyperthyroidism [group III], the other 20 patients with subclinical hyperthyroidism [group IV]. In addition to 20 euthyroid, subjects with age and sex matched [14 females and 6 male] as controls [group V]. The study was performed at Al-Azhar University Hospitals from January 2006 to March 2007. All partners were subjected to full clinical examinations to assess thyroid and left ventricular function, measurements of thyroid profile [FT3, FT4 and TSH] and N-terminal proBNP. All subjects underwent to PWTDI to accurately quantify the global and regional left ventricular function at the posterior septal wall. Left ventricular diastolic dysfunction in the form of impairment of both diastolic relaxation [decreased Ea] and compliance to ventricular filling [decrease Ea / Aa ratio]. LV systolic dysfunction in the form of impaired systolic ejection [decrease Sa]. PWTDI indices show a significant impairment of systolic ejection in all studied groups [P < 0.01] for overt and P< 0.05 for subclinical hypo and hyperfunction] and a delay in diastolic relaxation in overt hypothyroidism [P < 0.01], even those with subclinical hypothyroidism, [P < 0.05] but not impaired in hyperthyroid groups. PWTDI indices showed LV impairment early and significantly than when we used standard 2-D echocardiograms [EF% impaired only in patients with overt thyroid disorders] especially in subclinical groups. In subclinical hypothyroidism LV dysfunction was detected in two patients [10%], using standard 2-D echocardiograms vs. 14 patients [70%], using PWTDI, Sa [P < 0.01] and in 16 patients [80%], using Ea / Aa ratio [P < 0.01] and significantly correlated with FT3, FT4, TSH and N-terminal proBNP. In subclinical hyperthyroidism LV dysfunction was detected in two patients [10%], using standard 2-D echocardiograms vs. 8 patients [40%], using PWTDI, Sa [P < 0.01] and no patients [0%], using Ea / Aa ratio. N-terminal proBNP is highly sensitive and specific with a good positive and negative predicted value for early detection and diagnosis of LV dysfunction especially in subclinical groups and significantly correlated with thyroid profile and PWTDI indices. Left ventricular dysfunction is common in patients with different thyroid disorders even in patients with subclinical thyroid disorders. PWTDI and measurement of N-terminal proBNP are sensitive techniques that allow detection of LV dysfunction, not only in patients with overt thyroid disorders, but also in patients with subclinical thyroid disorders

Value of urinary free cortisol/cortisone in assessing the activity of 11-beta-hydroxysteroid dehydrogenase in obese children: optimization of high performance liquid chromatography

Increased secretion of glucocorticoids is associated with obesity and cortisol secretion is increased in subjects with idiopathic obesity, especially of central distribution. Intercon-version of active cortisol with inactive cortisone is catalysed by the isozymes of 11 beta -HSD activities in different tissues can be assessed by ratio of urinary free cort isol to cortisone. The present study was carried out to evaluate the free cortisol/cortisone ratio in urine of obese children and adolescents to clarify the role of 11 beta-HSD in the pathogenesis of exogenous obesity. Thirty obese children were included in the present study; they were recruited from those attending Diabetic Endocrine Metabolic Pediatric Unit [DEMPU], Children Hospital, Cairo University, for assessment of obesity. Ten apparently healthy, non obese children matched in age and sex, were also included as controls. Urinary free cortisol [UFF] was measured by radio immune assay [RIA] and High performance liquid chromatography [HPLC] while urinary free cortisone [UFE] was measured by HPLC. The obtained results showed higher ratio of UFF/UFE in obese children suggesting that cortisol metabolism may be enhanced in children with higher body fat. This finding is supported by the positive correlation encountered between UFF and both BMI and fat%, which can be attributed to a higher activity of 11 beta-HSD-1 expressed in both subcutaneous and visceral fat with increased reactivation of cortisone to cortisol. This highlights the value of the UFF/UFE in demonstrating 11 beta-HSD activity more than measuring UFF or UFE alone. Finally, HPLC method under adopted conditions was found to be rapid, reliable and specific for measurement of both UFF and UFE

Hormone-receptor negative status and outcome of sequential adjuvant docetaxel for node-positive breast cancer patients

This trial compared six cycles of fluorouracil, doxorubicin, and cyclophosphamide [FAC] with a sequential regimen of three cycles of FAC followed by three cycles of docetaxel [FAC-D] as adjuvant treatment for women with node-positive, hormone-receptor negative breast cancer. Eighty-five patients with node-positive, hormone receptor negative breast cancer women were randomly assigned to either FAC every 21 days for six cycles, or three cycles of FAC followed by three cycles of docetaxel [FAC-D], both given every 21 days. Radiotherapy was performed after the 6 cycles of chemotherapy. The primary end-point was disease-free survival. Median follow-up was 44 months, disease-free survival was 60.5% with FAC, and 78.5% with FAC-D, demonstrating 47% reduction in the risk of relapse. The high risk of an event was found during the first 2 years. Overall-survival rates were 69.8% with FAC and 81% for FAC-D, demonstrating 33% reduction in the risk of death. The incidence of neutropenia and parasethia, were higher in the sequential arm of the study [p- 0.03, 0.017, respectively]. Though non-significant difference, incidence of amenorrhea was higher in the FAC group [p=0.06]. Sequential adjuvant chemotherapy with FAC followed by docetaxel resulted in significant improvement in disease-free survival but no significant improvement in overall-survival in node-positive, hormone-receptor negative breast cancer patients and has an acceptable toxicity

Expression of some apoptosis-controlling proteins in children with acute lymphoblastic leukemia

The aim of this study was to determine the serum levels of some apoptosis-controlling proteins [Bcl-2 and soluble Fas] in children with acute lymphoblastic leukemia [ALL], and to find out the relation between their expression and the clinico-laboratory parameters as well as outcome of the disease. The study included 20 children with ALL [13 males and 7 females], their age ranged from 0.5-13 years. Twelve apparently healthy children were included as a control group. Cases and controls were subjected to full history taking, thorough clinical examination, and determination of serum levels of Bcl-2 and soluble Fas proteins [sFas], and complete blood picture [CBC]. Bone marrow examination, CSF examination, immunophenotyping, and radiological evaluation were done for cases only. One-year follow-up of cases was performed for evaluation of the prognosis and the outcome of the disease. The results showed that serum levels of Fas and Bcl-2 were significantly elevated in patients with ALL when compared to control [P: 0.007 and P: 0.003 respectively]. Serum levels of sFas were significantly elevated in cases with CNS involvement compared to those without CNS involvement [p <0.01], in cases with white blood cell count >50.000/mm[3] in peripheral blood compared to those having lower cell counts [p<0.05], and in patients with T cell lineage compared to those with B lineage [p<0.01]. Serum levels of Bcl-2 were not significantly different as regard these parameters. Serum levels of Bcl-2 were significantly lowered after treatment [P<0.001], while serum sFas didn't differ significantly before and after treatment. Levels of sFas and Bcl-2 were higher in ALL patients resistant to induction chemotherapy compared to those showing complete remission, but the difference did not reach the level of significance. Our study shows that 1] increased serum expression of Bcl-2 and soluble Fas [sFas] can be demonstrated in children with ALL. 2] increased expression of sFas [but not Bcl-2] has been found to be associated with certain unfavorable prognostic features such as T-lineage ALL, CNS involvement, and higher WBCs count and 3] the higher levels of sFas and Bcl-2 in these cases were not associated with poor response to therapy

Angiogenic modulators in chronic obstructive pulmonary diseases

Angiogenesis or formation of new blood vessels out of pre-existing capillaries is a sequence of events that is fundamental to many physiologic and pathologic processes such as COPD. With the identification of several proangiogenic molecules such as VEGF and bFGF and the recent description of specific inhibitors of angiogenesis such as angiostatin and endostatin. The current study included 76 COPD patients of 5 grades according to postbronchodilator FEV1: -Grade zero: Included 14 male patients who were already diagnosed as COPD grade zero. - Grade 1: Included 10 male patients who were already diagnosed as COPD grade 1. -Grade II a: Include 4 male patients who were already diagnosed as COPD grade II a. -Grade II b: Included 12 male patients who were diagnosed as COPD grade II b. Grade III: Included 36 male patients, who were already diagnosed as COPD grade III. The patients were recruited before treatment administration among the attendants of chest and internal medicine departments, Assiut University Hospital. The study also included 20 healthy male subjects as a control group who were matched in age to the patients [mean age was 63 years old]. For each of the patients and control group the following items were done 1- History 2- Clinical examination 3- Spirometry: to measure the following pulmonary function test. 4- Arterial blood samples for blood gases [PO@, PCO2] analysis. 5- Venous blood sample, the sera were removed for estimation bFGF, VEGF, NO, Lipid peroxide, Copper, Zinc and total iron. The result reveal that serum bFGF, VEGF, serum NO, Lipid peroxide and Serum copper levels were significantly higher in patients with COPD compared to healthy controls [p. value

Audiological, cognitive and communicative assessment of patients with Down syndrome

Outline the hearing and cognitive profile of children with Down syndrome in relation to speech and language aptitudes in order to recognize other underlying etiological factors of communicative disability beside mental handicap that would improve the rehabilitation of those children. Twenty children with Down syndrome and 20 age and sex-matched normal subjects were subjected to comprehensive audiological evaluation including pure tone audiometry, tympanometry, Auditory brainstem response [ABR], and Event-related potentials [ERPs] in addition to vocal tract examination, and communicative and psychometric evaluation. Conductive hearing loss was detected in 5 [25%] as a complication of recurrent otitis media and repeated insertion of ventilation tubes. ABR wave V detection thresholds were compatible with behavioural pure tone audiometry. Shortened absolute latency of waves I, III and V as well as interpeak latency of I-III, III-V and I-V was observed in 10 patients [50%]. In 8 patients [40%] ERPs showed delay in latency of N[1], P[2], N[2] and P[3] components. In comparison to normal subjects, all patients showed variable degrees of subnormal mentality and social immaturity [p<0.001] as well as delayed language [language age] development [p<0.001]. Auditory dysfunction in patients with Down syndrome can occur at many levels either middle ear, brainstem and higher cortical cognitive progressing. Such findings may contribute to lower functioning of those patients in cognitive, linguistic and social aptitudes. Early audiological screening specific management and well-tailored rehabilitation strategy may allow improved prognosis and good quality of life in patients with Down syndrome