Evaluation of the response of fractional carbon dioxide [CO2] laser and punch elevation technique in treatment of acne scars: a split-face comparative clinical, histopathological, and immune histochemical study

Background: Acne is the most common skin disease affecting adolescents and young adults, with associated scarring and its sequelae. Treatment options are either lifting procedures raising scar base closer to normal skin surface, or resurfacing ones injuring epidermis and superficial dermis with neocollagenesis and epidermal repair. Punch elevation [PE] method is better for improving deep atrophic acne scars, that can be combined with depth resurfacing. CO2 laser stimulates new collagen formation, tightens skin and raises scar to surface

Aim of the Work: to assess efficacy and safety of combination of PE technique and fractional co2 laser [Fr co2 L] compared to fr co2 L alone

Subjects and Methods: 20 atrophic post acne scars patients were subjected to history taking, general and dermatological examinations, identifying scars types and grades. Treatment response at start, before each fr. co2 L session and 4 weeks after last laser session was clinically evaluated by Goodman and Baron scale, and recording patients' photographs, satisfaction, and complications. Histopathological examination of scar skin biopsies before and 4 weeks after the last fr. co2 L session was done using H and E, Mallory trichome, sliver stain and immunohistochemical VEGF

Results: combined treatment with fr co2 L and PE was more effective in improving post acne scars than fr. co2 L resurfacing alone. Histopathological examination before combined fr. co2 L and PE treatment and 1 month after the last fr. co2 L session showed high significant increase in epidermal thickness [H and E], increase in collagen fiber type III [Mallory trichrome stain], decrease in collagen fiber type I [sliver stain] and increase in fibroblasts' activity [VEGF]

Conclusion: both PE technique and fr. co2 L resurfacing show promising efficacy and safety in treating atrophic post acne scars, complementing each other to improve skin texture and appearance, with excellent cosmetic outcomes

Expired breath hydrogen peroxide as a marker of acute airway inflammation in children with asthma

Airway inflammation is an important factor in the development and progression of asthma. Activation of inflammatory cells induces a respiratory burst resulting in the production of reactive oxygen species, such as hydrogen peroxide [H[2]O[2]]. The aim of this study was to measure the levels of H[2]O[2] in expired breath condensate in asthmatic children, compared with levels in age-matched controls and to outline its relation to asthmatic triggers, asthma severity, treatment modalities, pulmonary function tests, and total and differential white cell count. Forty asthmatic and 20 healthy children were studied. Their ages ranged from 6-18 years. Expired H[2]O[2] was measured using a colorimetric assay. In asthmatic children, there was a significant elevation of the mean H[2]O[2], level compared to values in controls [p=0.003]. Asthmatic triggers [e.g.: bad housing1 passive smoking, upper respiratory tract infection] showed non significant relation to the mean value of H[2]O[2] level in expired air of asthmatic children. Bad housing showed significant relation to number of acute asthmatic attacks [p=0.03]. There was no significant difference between moderate and severe asthma regarding H[2]O[2] levels [p=0.424] Similarly, there was no significant difference between asthmatic patients whether they received inhaled steroids or not regarding H[2]O[2] levels [p=0.875]. Basal spirometric pulmonary function tests, showed no significant correlation to the level of H[2]O[2]. Correlations of H[2]O[2] level in expired air of asthmatic children with total leukocytic counts [r=0.024; p=0.899], eosinophilic counts [r=0.092; p=0.630] and neutrophilic counts [r=0.021; p=0.910] were all non significant. We conclude that expired H[2]O[2] is significantly elevated in asthmatic patients. Measurement of expired H[2]O[2], may be useful to assess airway inflammation and oxidative stress in asthmatic patients

Eyolution of living doner liver transplantation in Egypt

To date, cadaveric organ donation is illegal in Egypt. Therefore, Egypt recently introduced living donor liver transplantation [LDLT], aiming to save those who are suffering from end stage liver disease. Herein, we study the evolution of LDLT in Egypt. In Egypt, between August 2001 and February 2004, we approached all centers performing LDLT through personal communication and sent a questionnaire to each center asking for limited information regarding their LDLT experience. We identified and approached 7 LDLT centers, which collectively performed a total of 130 LDLT procedures, however, 3 major centers performed most of the cases [91%]. Overseas surgical teams, mainly from Japan, France, Korea, and Germany, either performed or supervised almost all procedures. Out of those 7 LDLT centers, 5 centers agreed to provide complete data on their patients including a total of 73 LDLT procedures. Out of those 73 recipients, 50 [68.5%] survived after a median follow-up period of 305 days [range 15-826 days]. They reported single donor mortality. Hepatitis C virus cirrhosis, whether alone or mixed with schistosomiasis, was the main indication for LDLT. Egypt recently introduced LDLT with reasonable outcomes; yet, it carries considerable risks to healthy donors, it lacks cadaveric back up, and is not feasible for all patients. We hope that the initial success in LDLT will not deter the efforts to legalize cadaveric organ donation in Egypt

Long-term follow-up after liver transplantation in Egyptians transplanted abroad

To study the long-term outcome after liver transplantation [LT] in Egyptian patients who underwent LT outside Egypt. Between May 1993 and February 2004, over 150 Egyptians underwent LT outside Egypt. Data of 67 recipients were collected in Egypt through personal communications with the Overseas Liver Transplant Centers and through the records of the Egyptian Liver Transplant Association. Most patients underwent LT in Europe [73.1%], few in the United State of America [17.9%] and in Japan [9%]. Sixty-one patients underwent cadaveric LT and the remaining 6 patients underwent living related liver transplantation [LDLT]. The male to female ratio was 58:9. Median age was 45 [3-63 years]. Hepatitis C virus [HCV] cirrhosis whether alone or mixed with schistosomiasis was the main indication for LT. Out of those 67 recipients, 52 [77.6%] survived after a median follow-up period of 4.6 years [rang 1-10.5 years]. Deaths were due to primary non-function in 3 patients, postoperative bleeding in one patient, recurrent hepatitis C virus [HCV] in 10 patients, and chronic rejection in one patient. Egyptians underwent LT abroad showed a good long-term outcome. Due to the high prevalence of HCV, we expect a growing need for LT in Egypt. Although LDLT has been introduced recently in Egypt, cadaveric liver donation is still not legalized by the government. Efforts should be directed to expanding LDLT, legalizing cadaveric LT and also to the prevention and control of HCV infection in Egypt in order to avoid its devastating effect on the society as well as its enormous negative impact on Egypt's economy and future development

Microwave adverse exposure changes of blood and brain levels of some elements in rats

In this work, four groups of adult male albino rats were used; the first as control, the second was exposed to microwave radiation 11/2 hr/day for seven consecutive days at a dose of 15 mW/cm2 and frequency 10.525 CHz. The third was exposed like the second but for 24 consecutive days, while the fourth was treated as the third and then left for two weeks as a rest period. Then animals were sacrificed and the blood and brain levels of some major and trace elements [calcium. iron, manganese, copper, nickel, zinc, selenium and molybdenum] were estimated by the Energy Dispersive X-ray Fluorescence technique [EDXF]; an easy, rapid, multi-elemental and need low weight of samples. Calcium, iron and manganese showed a significant increase in the exposed groups, while zinc, copper and molybdenum showed a significant decrease in both blood and brain when compared to control. Nickel of blood exposed groups showed a significant drop in the acute and chronic exposure groups and restored its normal figure in the chronic exposure then rest group, but it gave no readings in the brain sample for all groups. As for selenium it showed a significant drop in both acute and chronic exposure groups and a significant rise in the chronic then rest group in the blood; but in brain it gave no readings for the control and chronic exposure groups and a significant rise in the other two. These changes were explained by the microwave variant effects on ion fluxes via the effect on the ion channel properties of cell membrane, interaction between the cellular membrane molecules containing these ions, voltage changes across the cell membrane. etc

study of the possible hazards of acute and chronic exposure to microwaves on hepatorenal function and some blood trace elements in albino rats

Microwave exposure possess some degree of health hazards, the objective of the present study was the investigation of the possible effects of acute and chronic exposure to radiation on some liver, kidney, tissue antioxidants enzymes as superoxide dismutase, glutathione peroxidases, glutathione and toxic free radical lipid peroxide that results from stress oxidative tissues damage as well as the effect of microwaves on some trace elements that acts as metalloenzyme as zinc, selenium, copper and manganese. The result of the present study showed that exposure to microwaves [acute and chronic] produced significant reduction of antioxidant enzymes as superoxide dismutase, glutathione peroxidase and glutathione content. It also produced significant increase in toxic free radical malondialdehyde. These changes are more manifested with acute exposure [7 days]. The parameters of this study were improved with concomitant administration of DDB [well known antioxidant and tissue protective]. Also, the results showed that there was significant impairment of liver and kidney parameters with acute exposure and still there were changes in chronic which were insignificant. The parameters of liver and kidney were improved by the administration of DDB concomitantly

Evaluation of the possible effects of microwaves on some vasoactive substances serotonin [Part I] and some metabolite [part II] steptozotocin induced diabetic rats

The objective of this study was the evaluation of the possible adverse effects of microwaves [e.g. mobile, microwave ovens, etc.] on some vasoactive substances as catecholamine [norepinephrine and epinephrine], 5 hydroxy tryptamine [serotonin] and histamine as well as histaminase enzyme activity and the possible role of Nigella sativa oil [NSO] administration in albino rats. Male adult albino rats were divided into control group [n=10], group II [n=10] received microwaves for 7 days consecutively at a dose of 170 mW/Cm2 and frequency of 2.06 GHz for 3 hours [acute group], the third group [group III] [n=10] received the same dose as group II but for 28 consecutive days [chronic group], the fourth group [group IV] was treated as group II with concomitant administration of Nigella sativa oil [NSO] 100 mg/kg/day/orally by gastric tube. The fifth group [n=10] was treated as group III with concomitant oral administration of Nigella sativa oil in the same dose as group IV for 28 days. At the end of experiments, the animals were sacrificed and blood examined for norepinephrine, epinephrine, serotonin, histamine and histaminase enzyme activity. The result of the present study showed that microwaves produced significant reduction of histaminase activity significant increase in histamine, serotonin, norepinephrine and epinephrine, all were highly significantly changed in acute group of irradiation