Purification and partial characterization of dermatophyte keratinases: application in the treatment of tinea in a guinea pig model

Dermatophyte infection of the skin continues to be a prevalent disease. However, the factors causing the divergent clinical presentation seen with dermatophytosis remain unknown. Seven different dermatophytes [Microsporum canis, M. gypseum, M. nanum, Trichophyton violaceum, T. rubrum, T. soudanense and T simii] were isolated from patients having different clinical types of tinea and their protein profiles were differentiated. Over a period of 28 days the seven dermatophytic species were examined for their ability to secrete keratinolytic enzymes. The duration and intensity of keratinase production differed among the seven dermatophytic species. Seven different proteins were isolated with molecular weights ranging from 22 kDa up to 80kDa. M canis was found to possess the highest keratinolytic activity. Guinea pig animals were experimentally infected with M. canis. The infection of the animals was determined by the presence of hair loss, scales and pustules in the lesions. The isolated keratinases of M canis were incorporated in Syzygium aromaticum methyl cellulose gel ointment and applied on the infected lesion until a complete cure of Guinea pig was achieved after 8 weeks of daily application, keratinases were found to have a role in treatment

Ureteroscopic Holmium lasertripsy for treatment of impacted ureteral calculi

To evaluate the efficacy and safety of Holmium: YAG laser lithotripsy for the treatment of impacted ureteral stones. From January 2000 to January 2007, 150 patients [105 males and 45 females] with impacted ureteral stones were treated at the Urology Department of the Assiut University Hospital, Assiut, Egypt. Their mean age was 36 years [range 20 to 66 years]. The mean duration of stone impaction was 4.6 months. The patients were managed via the retrograde endoscopic approach using small caliber [6.9 F rigid and 7.5 F flexible] ureteroscopes and the Holmium:YAG laser lithotriptor. Out of 150 ureteral stones, 144 [96%] were completely fragmented with a single endoscopic procedure. Proximal stone migration occurred in two cases, and the stones were treated by extracorporeal shock wave lithotripsy [ESWL]. Intra-operative ureteral perforation occurred in 4 cases and was managed by open surgical treatment. Endoscopic observation revealed inflammatory polyps at the site of impaction in 75 patients and a stricture adjacent to the stone in 20 cases. Holmium: YAG laser lithotripsy may be considered an effective first-line therapy for chronically impacted ureteral stones, which are frequently associated with chronic inflammation, polyps and strictures. It is quite safe and it avoids the futile repetition of ESWL and problems caused by a prolonged passage of stone fragments

Treatment of postoperative external duodenal fistula using roux-en-y jejunal loop

postoperative external duodenal fistulae are associated with significant mortality and morbidity. Although medical management is followed by closure of fistulae in up to 90% of patients, mortality and mortality rates are sill high among those who would not respond to this treatment. In addition, there is no technical recommendation as regards the surgical intervention as each operative procedure has its own limitations, mortality and morbidity. to evaluate the outcome of using Roux-en-Y jejunal loop for closure and drainage of postoperative external high-output duodenal fistulae. a series of prospective cases from March 1993 to February 1998. Department of Surgery, Faculty of Medicine, Zagazig University. seventeen patients with postoperative external duodenal fistulae, in whom surgical intervention was indicated, were treated using Roux-en-Y jejunal loop anastomosed to the fistula stoma. four patients [23.5%] died in the early postoperative period [30 days]. Morbidity was related to chest infections, intraabdominal infections, multiorgan failure and burst abdomen with a total major complications rate of 58.8%. the Roux-en-Y operation is recommended for difficult fistulae that do not heal with medical management. It is a safe one-stage procedure that is suitable for high-risk patients

Management of haemangioma in different sites

78 cases of haemangioma in different sites were treated in the last five years in surgery and Radiotherapy departments in Mansuora University Hospital. They were 68 cases of skin and 10 cases were vertibral haemangioma. In the last complete neurologincal examination and radiological invistigation were done. Treatment method advocated was ethanolamin injection [46 cases], surgical excision with or without grafting [8 cases] and radiotherapy [24 cases]. The latter treatment was given either primarily or after lamenectomy and biopsy of the vertibral haemangioma. Most of the leases were followed up for two years and showed good response denoting the value of radiotherapy in the treatment of vertibral haemangioma in particular. Surgery and intralesional injection of sclerosing agent were also mentioned as lines of treatment of choisce in haemangioma affecting the skin

Effect of saline and dextran infusion on blood albumin after slight and moderate blood loss

The effect of saline or dextran 70 infusion on the serum albumin level was studied after mild and moderate blood loss. From this experimental study in was shown that infusion of normal saline resulted in a decrease in the albumin level early after infusion than rapid recovery was noticed. Infusion of dextran 70 produced more manifest reduction than normal saline and took longer time to reach to the original value. Decreased albumin concentration caused by dextran infusion could be due to Shifting of albumin into the extravascular compartements [Mornison, 1956] or to the inhibition of synthesis [Craigic et al., 1969] or to the retention of addition fluid within the circulation [Gruber, 1965] or due to failure of Dextran 70 to increase rate of lymph flow [Table III]. The prolonged reduction in the circulating albumin after dextran 70 infusion could be explained by the delayed excretion of dextran 70. Only half the dose given is eliminated by excretion via the kidney within the first 24 hours. The whole given dose takes about 14 days to be elimenated [Artursson et al., 1964]