[ case of hydroa vacciniforme with ear mutilation]

Hydroa vacciniforme is a rare acquired photodermatosis which usually presents in childhood. It is characterized by vesicle, crust and scar formation following exposure to sunlight. Vacciniform scars of face and dorsa of the hands are common features but oral ulcers and eye complications also occur rarely. Another rare manifestation of the disease is ear mutilation which is presented in this report

Heterocycles from 2-Amino-4-[3,4,5-trimethoxy-phenyl]-Naphtho[2,1-b]-4H-pyran-3-carbonitrile

The TITLE compound 1 was prepared and subjected to react with different electrophilic reagents such as phenyl isothiocyanate, benzoyl chloride, 2-cyanocinnamonitrile, ethoxymethylenediethyl- malonate, formamide and carbon disulphide to give the naphtha-pyranopyrimidine derivative 3, naphtha [2,1-b]-4H-pyran derivative 7-9, naphtha [2,1-b]-4H-pyranopyrimidine 10 and naphtha [2,1-b]-4H-pyrano-1,3-thiazine derivative 11, respectively. Treatment of 3 with ethyl bromoacetate and hydrazine hydrate afforded 4 and 5. The hydrazine derivative 5 reacted with benzoylacetone and yielded the pyrazole derivative 6. The IR, [1]H-NMR and Mass spectra of the synthesized compounds were discussed

serological gastric biopsy: a non-endoscopical/histopathologic diagnostic approach in management of the dyspeptic patients

Objective: To assess the sensitivity, specificity and the predictive value of a 'gastropanel' blood test, including serum pepsinogen I [S-PGI] and amidated gastrin-17 [S-G-17] in the diagnosis of atrophic gastritis most probably due to helicobacter pylon [Hp] and to compare the results of serology with the endoscopic/histopathologic findings as a gold standard diagnostic tool

Subjects and Methods: This study comprised 86 dyspeptic outpatients who underwent a diagnostic gastroscopy with multiple biopsies from the antrum and corpus for histopathologic examination. Histopathologically, the series of cases included 46 patients diagnosed as having atrophic gastritis. Twenty five had an antral atrophy, 6 had corpus atrophy and 15 patients had an atrophic gastritis in both the antrum and corpus [multi local atrophic gastritis] MAG. The remaining 40 cases were considered as controls, 32 had a non-atrophic gastritis [NAG] and both the antrum and corpus were normal and healthy in 8 subjects. The fasting levels of S-PGI and antibodies to Hp lgG-antibodies [S-UpAb] and postprandial amidated S-G-17 [S-G-17prand] were measured 20 min after a protein-rich drink and were determined using enzyme immunoassay [EIA] methods. The serologic and morphologic results were compared with estimating the sensitivity, specificity, positive and negative predictive [PPV and NPV] and accuracy values of the tests [S-G-17 and S-PGI]

Results: Mean values of both S-G-17prand and S-PGI decreased with increasing grade of antral and corpus atrophy, respectively. A low S-PGI [<25 microg/I] was found in 4 of 6 patients with corpus atrophy [66.70%] and in 5 of 32 [15.62%] patients with NAG in the biopsy specimens. A low S-G-17prand [<5 pmol/l] was found in 13 patients with Hp-associated antral atrophy and in 5 of 32 [15.62%] patients with NAG. The diagnosis of gastritis obtained with the blood test panel is in good agreement with the endoscopic and biopsy findings: 92% of the patients went into same gastritis categories with both the panel and endoscopic/histopathologic findings. The sensitivity, specificity, PPV, NPV and accuracy values of the blood test panel [S-G-17prand and S-PGI] in delineation of patients with atrophic gastritis [either in the antrum or the corpus, or both] versus NAG and normal stomach were 87.5%, 82.60%, 8 1.40%, 88.40% and 85%, respectively

Conclusion: Low levels of S-G-17prand and S-PGI are conceivable biomarkers of atrophic gastritis. The serologic method gave a reasonable sensitivity, specificity, PPV. NPV and accuracy values in the diagnosis of atrophic gastritis. So, it may be offered as the screening tool for atrophic gastritis

Plasma levels of adrenomedullin and atrial natriuretic peptide in patients with congestive heart failure of various etiologies

Objective: The aim of this study was to evaluate the plasma levels of the adrenomedullin [ADM] and atrial natriuretic peptide [ANP] in adult and pediatric patients with congestive heart failure [CHF] of various etiologies and to investigate their relations with haemodynamic variables e.g. echocardiographic left ventricular ejection fraction [LVEF] and fractional shortening [FS]

Subjects and Methods: Thirty eight adult and 21 pediatric patients with CHF of various etiologies in addition to 15 adult and 10 pediatric normal healthy controls participated in this study. Patients with CHF were classified according to the New York Heart Association [NYHA] functional classification into grades II to IV in adult patients and into grade IV in all pediatric patients. ADM and ANP plasma levels were determined prior to treatment with enzyme immunoassay

Results: A statistically significant difference in plasma levels of ADM and ANP were found between pediatric and adult patients and corresponding healthy controls. Their levels were progressively increased with severity of NYHA class in adult patients. Significant positive correlations were found between plasma levels of each of ADM and ANP and pulse rate, systolic and diastolic blood pressure. There were significant negative correlations between their plasma levels and echocardiographic LVEF and FS. Significant positive correlations existed between plasma levels of ADM and ANP in both pediatric and adult patients

Conclusion: Plasma levels of ADM and ANP being non-invasive reliable tests may be used to identify high-risk subjects for HF for more invasive procedures

Optimising liposome-encapsulated praziquantel formulations for treating and overcoming resistant isolates of schistosoma mansoni

Praziquantel [pzq.] liposomes of [DPPC: Cholesterol] molar ratio 7:2, neutral [N] and negatively [-ve] charged, were prepared by the vortex dispersion method yielding multilamellar vesicles [MLV]. Some MLV were sonicated yielding unilamellar vesicles [ULV]. Entrapped pzq. was measured using UV spectrophotometric analysis at 265 nm. [N] UL and ML liposomes exhibited higher percentage entrapment over the [-ve] liposomes. Swelling at 52° for 24 hours, led to increased percentage entrapment of UL pzq. liposomes. Transmission electron micrographing was employed to characterize ML liposomes. [N] pzq. liposomes, of higher percentage entrapment, were used in curative and prophylactic experiments against susceptible [S] and resistant [R] isolates of S. mansoni, in mice. Pzq. liposomes were injected subcutaneously [s.c.] to effect efficient targeting to the site of infection viz., the liver. The effect of pzq. liposomes, in half dose, was compared to the same dose of free pzq, administered orally and as s.c. injection, in addition to full oral free pzq. [1000 mg/kg]. The curative experiment showed best efficacy for full oral free pzq. On the other hand, [N] pzq. ML liposomes imparted the highest 7-days chemoprophylactic effect against both [S] and [R] isolates of S. mansoni, emphasizing the significant success of such a pharmaceutical formulation in conquering the [R] S. mansoni isolate [EE2] responsible for evolving resistance to pzq. curative effect, in the Egyptian population

Increased serum levels of interleukin-18 in patients with diabetic nephropathy

Objective: to investigate the role of interleukin-18 [IL-18] and tumor necrosis factor-a [TNF-alpha] in the pathogenesis of diabetic complications especially diabetic nephropathy

Patients and Methods: serum concentrations of IL-18 and TNF-alpha were measured in sera from 65 diabetic [30 with type 1 insulin dependent diabetes mellitus [IDDM] and 35 with type 2 noninsulin dependent diabetes mellitus [NIDDM]] patients and 15 healthy volunteers by enzyme linked immunosorbent assay [ELISA]

Results: serum IL-18 and TNF-alpha levels were significantly higher in both IDDM and NIDDM as compared to the control group. Their levels in patients with diabetic nephropathy increased gradually according to the clinical stage of the disease, being highest in macroalbuminuric stage. Serum IL-18 and TNF-alpha concentrations were positively correlated with each other and positively correlated with fasting plasma glucose [FPC], 2h postprandial glucose, glycosylated hemoglobin [HbA1c], triglycerides, and urinary albumin levels. There were negative correlation between TNF-alpha and high density lipoprotein cholesterol [HDL-C] in diabetic patients

Conclusion: high serum levels of IL-18 and TNF-alpha suggested that they might play a role in the pathogenesis of DM and in the development of nephropathy in diabetic patients whether of type 1 or 2

Sugar beet pulp protein isolate as a partial meat-substitute in beef burger and sausage

Sugar beet pulp protein isolate [SBPPI] which prepared from sugar beet pulp as a by-product of the sugar industries contained higher level of protein being 92%, however, the color tends to light yellow. Therefore, it was considered to substitute 5, 10, 15, 20, 25% of meat in beef burger and sausage. Substitution with the isolate increased the protein content of meat products from 15.4% to 26.4% with raising the SBPPI level up to 25%. The SBPPI improved the water retention of meat products. Little effects of SBPPI replacements on the amino acid contents and calculated nutritional parameters of fried burger and sausage samples were observed. A negative relationship between cooking yield and either cooling loss or shrinkage percentages was observed. The organoleptic scores indicated that it is enough to replace about 20% of SBPPI to obtain burger or sausage with maximum good quality

Effect of varying the pharmaceutical formulation on the biochemical a vailability and immunological behaviour of schistosomicidal drug, Oxamniquine

Oxamniquine [OXQ] is one of schistosomicide specific for Schistosoma mansoni [S. mansoni] infection. The aim of this work was to encapsulate OXQ into a liposome. These liposomal formulations in order to exhibit long term prophylactic effect against S. mansoni. It was found that OXQ exhibited marked chemoprophylaxis effect when encapsulated in negatively charged liposomes. Pharmacokinetically, OXQ liposomes are perfectly targeted to the liver whereby they release oxamniquine in minute amounts over extended periods in the proximate of schistosomules, maturing in liver sinusoids. All animal groups were injected with either free oxamniquine, OXQ free liposomes or OXQ liposomes encapsulated, one, two or three months before infection by S. mansoni cercariae and were sacrificed 6 weeks post infection. It was found that OXQ liposomes had moderate normalization effect on liver enzymes, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma glutamyl transferase in serum. Oxamniquine liposomes normalized A/G ratio and decreased the liver granuloma diameters. Infection increased the IgE and IgGl level, treatment with OXQ liposomes increased the level of IgG1 when given one or two months before infection, while free OXQ reduced IgG1 when given one month before infection and no significant change when given two months before infection. Treatment with different formulations to S. mansoni infected mice produced a significant decrease in IgE level after one and two months protection, while in normal animals there was an increase in IgG1 level after one month and no significant change after two months protection. So, it was concluded that OXQ in liposomal formulations is more efficient and safe than free drug in the protection against S. mansoni infection

Effect of perindopril alone and combined with praziquantel in murine Schistosoma mansoni

Murine schistosomiasis is a granulomatous disease associated with high serum and granulomatous angiotensin-1-converting enzyme [ACE] activity. Perindopril, a specific competitive inhibitor of ACE, was administered to mice infected with Schistosoma mansoni [S. mansoni] to determine whether this compound could inhibit granuloma ACE activity and modify the size of the granulomatous response to schistosoma eggs. Per-oral administration of perindopril for 4 weeks to 6th weeks old infected mice with peak granulomatous responses was carried out. Treated mice demonstrated a reduction in hepatic granuloma diameter by about 31% associated with a decrease in serum, spleen and hepatic granuloma ACE activity by about 36%, 64% and 65%, respectively, 12 weeks post infection. Also, there was an improvement of liver function tests. Mean diameters of synchronous pulmonary granulomas induced by pulmonary embolization of schistosome eggs into normal [115.4 Um +/- 2.4] or sensitized mice [129.4 Um +/- 5.3] were decreased [28% and 26%, respectively] by a similar dose of perindopril when administered 16 days post egg injection. It was concluded that perindopril may partially inhibit the granulomatous response to schistosome eggs and improve the pathological manifestations of schistosomiasis possibly through inhibition of the inflammatory mediator [ACE]. It is possible that ACE has an inflammatory role in granulomatous inflammation. Combined treatment with praziquantel enhanced the reduction recorded in the previous parameters examined

Effect of Eclipta alba alone and in addition to praziquantel in murine Schistosomiasis mansoni

Eclipta alba has been used in traditional medicine for treatment of liver cirrhosis and hepatitis. In this study, Eclipta alba was used alone and in combination with praziquantel. Four groups of Schistosoma mansoni [S. mansoni] infected mice were used and treatment was started 8 weeks post infection. The first was control untreated group, the second praziquantel in a dose of 500 mg/kg orally for 2 consecutive days, the third group treated with Eclipta alba [200 mg/kg for two weeks] and the last group received combined therapy. The results confirmed that Eclipta alba does not have curative properties against S. mansoni in infected mice. However, both alone and in combination with praziquantel, it decreased the level of alanine aminotransaminase [ALT] and leukotrein B4 [LTB4] in serum and the level of reduced glutathione [GSH] and malonaldehyde [MDA] in liver homogenate. It also reduced the hepatic granuloma diameter [37% and 40%, respectively, after 10 and 13 weeks post infection] and reduced the number of eosinophils in these granulomas. On the other hand, praziquantel [PZQ] produced 99% worm reduction and improved the level of ALT,GSH and MDA. The results suggested that Eclipta alba had anti-inflammatory and anti-hepatoprotective effect in Schistosoma mansoni infection and would be a useful treatment after praziquantel treatment

Hepatic disorders among workers exposed to cotton dust containing pesticide residues

One hundred exposed and fifty control workers in a cotton ginning factory were chosen for this study. All were subjected to a special questionnaire including personal data together with clinical examination. The investigations involved detrmination of liver function parameters, detection of hepatitis markers [B and C], haemagglutination test for schistosomiasis, urine and stool analysis and liver sonography. Environmental study was done for estimation of concentration and pesticide residue contents of cotton dust collected from the factory atmosphere. This study was carried out twice; before and after [1991 - 1992] and before [1992 - 1993] ginning seasons. Subgrouping of studied workers was done according to the presence or absence of schistosomiasis and / or hepatitis markers, or according to sonographic pattern of the liver. The results of environmental study showed a concentration of respirable cotton dust in the atmosphere of different departments higher than the recommended threshold limit value in this industry. In cotton dust, the median measurements of different pesticide residues [organochlorine, organophosphorus, and carbamate] were below their threshold limit values. The study demonstrated a significant increase in SGPT, SGOT, SAP and gamma-GT among exposed than control groups at the end of the ginning season. Other liver functions including total and direct bilirubin, serum albumin and total serum protein showed no significant abnormal changes. Significant increase in SGPT, SGOT, SAP and gamma-GT were found among exposed subgroups when the comparison was done between pre and post seasons in each, or between different subgroups. Subgroup IV [free from schistosomiasis and / or hepatitis] and subgroup A [free from cirrhosis and periportal fibrosis] showed the significantly lowest mean values. The seasonal rest was associated with return to basic pre seasonal values of liver parameters. Moreover, there was a trend of increase in mean values of SGPT, SGOT, SAP and gamma-GT in exposed workers as the duration of exposure or the concentration of pesticide residues increased

Serum cholinesterase changes in workers exposed to organophosphorus and carbamate residues in cotton dust

One hundred exposed and fifty control workers in a cotton ginning factory were chosen for this study. All were subjected to a special questionnaire. The investigations involved determination of serum cholinesterase activity, detection of hepatitis markers [B and C], haemagglutination test for schistosomiasis, urine and stool analysis and liver sonography. Environmental study was done for estimation of pesticide [or-ganophosphorus and carbamate] residue contents of cotton dust collected from the factory atmosphere. This study was carried out twice: before and after [1991-1992] and before [1992-1993] ginning seasons. The results of environmental study showed that the median measurements of or-ganophosphorus and carbamate pesticide residues in the atmospheric dust were below their threshold limit values. The study demonstrated a non-significant lower level of serum cholinesterase activity in exposed workers before the beginning of work season than controls. A significantly lower level of serum cholinesterase activity was observed at the end of the ginning season among the exposed workers than controls, in subgroups of exposed workers with schistosomiasis, hepatitis markers and liver cirrhosis than other subgroups free from these diseases and in subgroups exposed to higher level of or-ganophospborus and carbamate residues. There was a trend of decrease in serum cholinesterase activity with the increase in duration of exposure

role of prolactin in the etiology of feminization in schistosomal hepatic fibrosis

Basal levels of Estradiol, Testosterone, and Prolactin were measured in 20 schistosomal patients and 10 normal controls. Prolactin response to provocation by Chlorpromazine [50 mg 1.M.] was also studied in the 20 schistosomal patients. Patients were divided into two groups. Group 1 included 10 patients with signs of feminization in the form of one or more of the following: Gynaccomastia, female escutcheon, female body habitus, and cutaneous arterial spider naevi. Group II included 10 patients without feminine manifestations. The basal levels of estradiol were not different in the three groups. Testosterone levels were significantly lower in schistosomal patients of both groups. Basal prolactin was significantly higher in schistosomal patients of both groups. The level was higher in patients without feminine manifestations than in patients with such manifestations. Prolactin response to stimulation was also higher in patients without feminine manifestations although the difference did not reach statistical significance. The results suggest that prolactin has no significant role in the pathogencsis of feminine manifestations in schistosomal patients