Evaluation of an automatized AMBU ESSI-1 INC designed at the Instituto Nacional de Cardiología Ignacio Chávez / Evaluación del AMBU automatizado ESSI-1 INC diseñado en el Instituto Nacional de Cardiología Ignacio Chávez

Abstract Objective: The objectives of this study were to evaluate an automated device for ventilatory support based on AMBU manufactured in March 2020. Methods: The ESSI-1 INC was evaluated through pulmonary mechanics and physiology parameters through compensatory spirometer tests (TISSOTs), and an artificial lung Model5600i Dual Adult PNEU VIEW SYSTEM; it was also compared to the anesthetic ventilatory support equipment (AEONMED 7500) in porcine models, measuring ventilatory, hemodynamic and gasometric parameters. Results: This equipment (ESSI-1 INC) was successfully tested by mechanical and biological models, such as pigs in which its performance was evaluated in terms of variability of tidal volume, ventilation frequency, and I/E relationship versus the manual performance of two medical interns. All the results turned out as expected and were satisfactory. Conclusions: It is safe and effective equipment and should be tested and used in diverse clinical conditions to standardize the ventilatory safety and care of patients who require it.

Resumen Objetivo: Evaluar un dispositivo automatizado para la asistencia ventilatoria basado en un AMBU manufacturado en Marzo del 2020. Métodos: El ESSI-1 INC fue evaluado por medio de parámetros fisiológicos y mecánica pulmonar a través de pruebas de espirómetro compensatorios (TISSOT); pulmón artificial (Modelo 5600i Dual Adult PNEU VIEW SYSTEM); así como su desempeño comparado a la máquina de anestesia (AEONMED 7500) en modelos porcinos, midiendo criterios ventilatorios, hemodinámicos y gasométricos. Resultados: Este equipo (ESSI-1 INC) fue exitosamente probado por modelos mecánicos y biológicos, tales como cerdos donde su desempeño fue evaluado en términos de la variabilidad del volumen tidal, frecuencia ventilatoria, y relación I/E versus el desempeño manual de dos médicos. Todos los resultados finalizaron como se esperaba de forma satisfactoria. Conclusiones: Es un equipo seguro y efectivo, el cual debería ser probado y usado en distintas condiciones clínicas para estandarizar la seguridad ventilatoria y cuidado de pacientes que lo requieran.

Seguridad y eficacia de la bioprótesis de válvula cardiaca INC en humanos / Safety and efficacy of the INC bioprosthetic heart valve in humans

Resumen Introducción: Las bioprótesis de válvulas cardiacas son el estándar de oro para el reemplazo quirúrgico de la válvula aórtica en pacientes seleccionados. Objetivo: Evaluar la seguridad y eficacia de la válvula cardiaca bioprotésica del Instituto Nacional de Cardiología (INC) en humanos. Métodos: Estudio unicéntrico que incluyó 341 pacientes que se sometieron a reemplazo valvular quirúrgico único de válvula aórtica con válvula INC. Resultados: Se realizaron 318 implantes de novo (93 %) y 23 como segunda cirugía (7 %); las puntuaciones STS fueron de 1.4 y 1.8 % y el seguimiento de 42 y 46 meses, respectivamente. No existieron diferencias en las complicaciones ni en la tasa de implantación de marcapasos. Ambos grupos mantuvieron una FEVI normal. Se observó mejoría global en la clase funcional con empeoramiento solo en dos pacientes del grupo de novo. La disfunción de la prótesis INC que ameritó reintervención quirúrgica se observó en ocho pacientes (4.65 %) del grupo de novo versus un paciente (7.69 %) con segunda cirugía. Conclusiones: La válvula cardiaca INC es eficaz y segura, se asocia a baja tasa de complicaciones y mejoría de la clase funcional durante el seguimiento a largo plazo. Se necesitan estudios prospectivos comparativos de esta válvula.

Abstract Introduction: Heart valve bioprostheses are the gold standard for aortic valve surgical replacement in selected patients. Objective: To evaluate the safety and efficacy of the of the National Institute of Cardiology (INC) bioprosthetic heart alve of the National Institute of Cardiology (INC) bioprosthetic heart valve in humans. Methods: Single-center study that ncluded 341 patients who underwent single surgical aortic valve replacement with INC heart valve. Results: 318 implants were performed de novo (93%) and 23 as redo surgery (7%); STS scores were 1.4 and 1.8%, and follow-up was for 42 and 46 months, respectively. There were no differences in clinical complications or pacemaker implantation rate. Both groups maintained a normal LVEF. Overall improvement in functional class was observed, with worsening only in two patients of the de novo group. INC prosthesis dysfunction requiring surgical reintervention was observed in eight patients (4.65%) of the de novo group vs. one patient in the redo group. Conclusions: The INC heart valve is efficacious and safe, and is associated with a The INC heart valve is efficacious and safe, and is associated with a low rate of complications and functional class improvement during long-term follow-up. Prospective, comparative studies of this valve are required.

Bio-guided Isolation of Natural Iron Chelators from Mangifera indica Leaves and their Comparative Study to Desferal®

Through bio-guided isolation, two natural iron chelators were isolated from Mangifera indica L. leaves, identified as mangiferin (1) and iriflophenone-3-C-β-D-glucoside (2). Their iron-chelating activity was compared to that of Desferal® using bipyridyl assay and EDTA as a standard. Mangiferin showed the highest activity with IC50 value of 0.385 mM (162.85 μg/mL). Furthermore, two combinations of mangiferin with Desferal® (M-D) and iriflophenone-3-C-β-D-glucoside (M-I) were evaluated. The results showed that mangiferin potentiated the iron chelation activity of Desferal® about 46%, also that M-I combination is a promising candidate formula for iron chelation therapy. In addition, mangiferin and Desferal-iron complexes were prepared and characterized by IR, UV, and Mass spectra to compare their mode of chelation to iron. Their structural stability was studied by DFT calculations. Furthermore, they displayed increased ABTS antioxidant activity when bound to iron as compared to their free form, which enhances their pharmacological importance.

Bio-guided Isolation of Natural Iron Chelators from Mangifera indica Leaves and their Comparative Study to Desferal®

Through bio-guided isolation, two natural iron chelators were isolated from Mangifera indica L. leaves, identified as mangiferin (1) and iriflophenone-3-C-β-D-glucoside (2). Their iron-chelating activity was compared to that of Desferal® using bipyridyl assay and EDTA as a standard. Mangiferin showed the highest activity with IC50 value of 0.385 mM (162.85 μg/mL). Furthermore, two combinations of mangiferin with Desferal® (M-D) and iriflophenone-3-C-β-D-glucoside (M-I) were evaluated. The results showed that mangiferin potentiated the iron chelation activity of Desferal® about 46%, also that M-I combination is a promising candidate formula for iron chelation therapy. In addition, mangiferin and Desferal-iron complexes were prepared and characterized by IR, UV, and Mass spectra to compare their mode of chelation to iron. Their structural stability was studied by DFT calculations. Furthermore, they displayed increased ABTS antioxidant activity when bound to iron as compared to their free form, which enhances their pharmacological importance.

Étude comparée des gels hydroalcooliques importés et ceux produits au Bénin, vendus dans les supermarchés de la ville de Cotonou / NA

Depuis le début de la crise épidémique liée au virus Covid-19, pour de nombreux citoyens, se laver les mains est devenu un rituel nécessaire. Le gel hydroalcoolique constitue une solution alternative qui a été popularisée par les recommandations des autorités sanitaires dans le cas d'indisponibilité du lavage des mains. Que cela soit en pharmacie, en supermarché, ou sur internet, de nombreux sites de commerce proposent ces produits à la vente. Toutefois l'appellation ne garantit pas l'efficacité de chaque produit vendu. C'est ainsi que la présente étude s'est attelée à l'évaluation de la qualité des gels hydroalcooliques (GHA) utilisés pour la désinfection des mains au cours de la crise sanitaire liée au Coronavirus. Au total, 28 échantillons dont 23 importés et 5 locaux ont été collectés dans 16 supermarchés de la ville de Cotonou. Ils ont été soumis au test d'inspection visuelle, aux tests organoleptiques ainsi qu'aux analyses physico-chimiques et microbiologiques. Au terme de l'étude, 17,86% des GHA ont été déclarés non-conformes par rapport aux inspections visuelles, 39,28% par rapport aux tests organoleptiques, 21% par rapport au pH et à la densité et enfin 21% de non-conformité aux tests microbiologiques. Le taux de non-conformité est plus important dans le camp des gels importés ce qui atteste l'effort des producteurs locaux pour le respect des normes promulguées par les autorités sanitaires

Since the start of the epidemic crisis linked to the Covid-19 virus, for many citizens, washing their hands has become a necessary ritual. Hydroalcoholic gel constitutes an alternative solution which has been popularized by the recommendations of the health authorities in the case of hand washing unavailable. Whether in pharmacies, supermarkets, or on the internet, many shopping sites offered these products for sale. However, this name does not guarantee the effectiveness of each product sold. The present study has been set out to assess the quality of hydroalcoholic gels (GHA) used for hand disinfection during the health crisis linked to the Coronavirus. In total, 28 samples, of which 23 were imported and 5 locals, were collected in 16 supermarkets in the city of Cotonou. They were subjected to visual inspection test, organoleptic tests as well as physico-chemical and microbiological analyzes. At the end of the study, 17.86% of GHAs were declared non-compliant with respect to visual inspections, 39.28% with respect to organoleptic tests, 21% with respect to pH and density and finally 21% of noncompliance with microbiological testing. The rate of non-compliance is higher in the imported gel camp, which attests to the efforts of local producers to comply with the standards promulgated by the health authorities

NUTRIENT MANAGEMENT PRACTICES FOR ENHANCING SOYBEAN (Glycine max L.) PRODUCTION / Prácticas de gestión de nutrientes para mejoramiento en la producción de soja (Glycine max L.)

Soybean (Glycine max L.), is the most important pulse crop in the world. Soybean is a very energy-rich grain legume containing 40 percent protein and 19 percent oil in the seeds. The magnitude of soybean yield losses due to nutrient deficiency also varies among the nutrients. Deficiencies of N, P, Fe, B and S nutrients may cause yield losses up to 10 %, 29-45 %, 22-90 %, 100 % and 16-30 %, respectively, in soybean depending on soil fertility, climate and plant factors. Soil salinity is one of the major limiting factors of soybean production in semiarid regions, and chloride salinity has a more depressive effect on yield than sulphate salinity. The goal of nutrient management is to maximize soybean productivity while minimizing environmental consequences. Balanced and timely nutrient management practices applied for soybean contributes to sustainable growth of yield and quality, influences plant health and reduces environmental risks. Balanced nutrition with mineral fertilizers can assist in integrated pest management to reduce damage from infestations of pests and diseases and save inputs required to control them. Balanced fertilization generates higher profits for the farmers, not necessarily through reduced inputs. The role of education and extension in delivering the up-to-date knowledge on nutrient management is crucial, challenging, and continuous.

La soya (Glycine max L.), es el cultivo de legumbres más importante en el mundo. La magnitud de las pérdidas en el rendimiento de la soya debido a deficiencias varía dependiendo de los nutrientes. Las deficiencias de N, P, Fe, B y S pueden causar pérdidas en rendimiento de hasta 10 %, 29-45 %, 22-90 %, 100 % y 16-30 %, respectivamente, en la soya dependiendo de la fertilidad del suelo, clima y factores intrínsecos a las plantas. La textura de los suelos utilizados en el cultivo de soya varía entre arenosa y arcillosa. La salinidad del suelo es uno de los mayores factores limitantes en la producción del cultivo en regiones semiáridas, y la salinidad por cloro tiene un mayor efecto en la disminución del rendimiento que la salinidad por sulfatos. Los granos de soya son una gran fuente de energía que contienen 40 % de proteína y 19 % de aceite. El éxito del manejo de nutrientes es maximizar la productividad del cultivo mientras se minimizan los impactos ambientales. Las prácticas de manejo de nutrientes balanceadas y reguladas en el tiempo contribuyen a un crecimiento sostenido del rendimiento y la calidad, influencian la salud de las plantas y reducen los riesgos ambientales. Una nutrición balanceada con fertilizantes minerales puede ayudar en el manejo integrado de plagas para reducir los daños causados por las infestaciones de pestes y enfermedades y reducir los insumos requeridos para su control. Una fertilización balanceada genera mayores ganancias para los agricultores, no necesariamente por reducción de los insumos. El papel de la educación y la extensión en la difusión del conocimiento actual sobre manejo de nutrientes es crucial, desafiante y continuo.

Paraspinal Extraosseous Ewing's Sarcoma With Disseminated Metastases Masquerading As Pott's Spine.

A 16 years old girl presented with low back pain, fever and weakness in both lower limbs for 3 months. Plain radiograph shows lytic lesion in first sacral vertebra and multiple lung nodules. In suspicion of tuberculosis, antitubercular drugs were advised. But magnetic resonance imaging revealed right paraspinal soft tissue mass with multiple lesions in several vertebrae causing spinal canal compression alongwith lesions in iliac bones, sacrum, lung parenchyma and scalp tissue. Fine needle aspiration cytology and biopsy revealed Ewing’s sarcoma. Patient was referred to higher centre for chemotherapy/radiotherapy. Herein we report this rare case of extraosseous Ewing’s sarcoma with disseminated metastases masquerading as Pott’s spine.

Ultrasonography measurement of inferior vena cava diameter of blood donors as predictors for early blood loss in tertiary hospital northeastern, malaysia

According to the class of hypovolaemic shock, a blood loss less than 750 ml is not associated with the physiological changes. As a result it may cause a delay in fluid resuscitation. We postulate inferior vena cava (IVC) diameter reduction in inspiration and expiration may resemble the significant volume of blood loss in a healthy adult. We conducted a study to examine the changes of the IVC diameter pre and post blood donation.The inferior vena cava diameter during inspiration (IVCi) and expiration (IVCe) were measured using ultrasound (GE HEALTH) in supine position before and after blood donation of 450 ml. Paired t-test and Wilcoxin rank test were used to analyse the data. Forty two blood donors enrolled during the study period. The mean age of blood donors was 32.3 +/- 8.9 and mainly male blood donors. The mean IVCe of pre and post blood donation was 18.5 +/- 6.2 mm (95%CI 18.23, 18.74) and 16.6 +/- 6.6 mm (95%CI 16.35, 16.76) respectively. Meanwhile, the mean IVCi of pre and post blood donation was 17.1 +/- 8.6 mm (95%CI 16.89,17.30) and 15.6 +/- 6.6 mm (95%CI 15.43,15.81) respectively. The mean difference of IVCe pre and post blood donation was 1.9 +/- 0.5 mm (95%CI 1.75, 2.13) (p<0.001). In contrast, the mean difference of IVCi pre and post blood donation was 1.5 +/- 0.5 mm (95%CI 1.34, 1.68) (p<0.001). As a conclusion, the measurement of IVC diameter by ultrasound can predict the volume of blood loss in simulated type 1 hypovolaemia patient.

Improving the probability of pregnancy in endometriosis cases: a study in patients undergoing in vitro fertilization.

Background: Endometriosis is the most common condition underlying infertility in women. To increase the rate of pregnancy in women with endometriosis, embryo selection is performed during in vitro fertilization. This study aims to prove the effectiveness of embryo selection on the rate of pregnancy in a hospital in Jakarta. Methods: This is a cross sectional clinical epidemiology study, performed on endometriosis patients who visited the hospital between 2007 – 2009. Patients were diagnosed with endometriosis using the laparoscopy technique. Embryo selection was performed by assessing the morphology and cell count. Results: We were able to collect data from 72 subjects who underwent IVF during this research period. One subject was dropped out of the program due to immaturity of the oocyte. Successful fertilization was achieved for 65 subjects, but two of them did not undergo embryo transfer. Out of all the subjects undergoing embryo transfer, 26 subjects successfully became pregnant (36.1%). In severe endometriosis cases, pregnancy was achieved with excellent quality embryos (50%) and good-moderate quality embryos (16.7%); but the probability of failure to become pregnant was found to be the same (50%). In mild-moderate endometriosis cases, the probability of pregnancy with excellent quality embryos was 39% compared to 25% chance with good-moderate quality embryos. Regarding the number of embryos that were transferred, we have found that the probability of pregnancy was 50% higher when 3 embryos were transferred, compared to 1 or 2 transferred embryos. Conclusion: This study shows that embryo quality and the number of transferred embryos are relevant to increase the probability of pregnancy in patients undergoing IVF. But because the probability of not achieving pregnancy is not significantly different, we need to find another marker that is more sensitive to assess the quality of embryo transfer.

Role of some mycotoxins in inducing kidney diseases in upper Egypt

Egypt has a climate that favors the growth of fungi specially those producing mycotoxins. Mycotoxins are found all over the world in human food and blood as well as in animal blood and tissues. The most threatening effects are their nephrotoxicity and carcinogenicity. The aim of this study was to identify the role of some mycotoxins namely; ochraloxin A [OTA] and fumonisin B[1] [FB1] in the occurrence of chronic renal disease of unknown aetiology in Upper Egypt. This study was carried out on 134 subjects who were classified as: 47 patients suffered from chronic renal failure of unknown aetiology before dialysis treatment [group A], 35 subjects who were relatives of patients in group A considering that they share them in the same environmental conditions [group B], 28 subjects working in the Middle Egypt Company [MEC] for grinding of cereals as an occupational risk group for exposure to inhalation of mycotoxins [group C] and 24 subjects with normal kidney functions as a control group. They exposed to a detailed history, their occupation, family history and kidney function tests. Indices of early kidney affection and levels of OTA and FB[1] in urine and serum for all subjects in all groups were also done. As regard group A, OTA was significantly increased while FBI was non-significantly increased in both serum and urine of patients compared to control group. There was positive correlation between the levels of OTA in both serum and urine versus the level of blood urea. It was found also that the patients with positive ochratoxicity had mild proteinuria. As regard group B, OTA and FB[1] were detected in urine and plasma, although with levels lower than that in group A but significantly higher than that of controls. As regard group C, OTA was found to be nearly equal to that in controls both in serum and urine which may indicate the low contamination levels of cereals in MEC due to good storage conditions. However, FB[1] was found in serum to be insignificantly higher than that in groups A and controls. Also FB[1] was detected in urine insignificantly lower than that in group A and insignificantly higher than that in controls. Although the results were statistically non significant but may indicate the increased risk of exposure to FB[1] in this group. We concluded that the presence of OTA and FB[1] in serum and urine of our control group may indicate the presence of these two mycotoxins as contaminants in the food in our locality. Also, these toxins may play a role in inducing chronic renal diseases in our locality. We advise a continuous follow up for all subjects exposed to these toxins, giving instructions about ways for protection and treatment as well as good storage for cereals and foods

Explotación de la pesquería de arrastre de camarón durante el período 1991-1999 en el Golfo de Nicoya, Costa Rica / Exploitation of the shrimp trawl fishery in the period 1991-1999 at the Gulf of Nicoya, Costa Rica

In Costa Rica, the Gulf of Nicoya shrimp fishery originated in 1952 and represented one of the most important economic activities in the region. Nevertheless, overfishery reduced the captured volumes to levels that prevent this commercial activity. I analyzed official fishery statistics between 1991 and 1999. These species involved are: two species of white shrimp, (Litopenaeus occidentalis and L. stylirostris), the "titi" shrimp (Xiphopenaeus riveti), the brown shrimp (Farfantepenaeus californiensis), the "pinki" shrimp (F. brevirostris) and the "fidel" shrimp (Solenocera agassizi). All the species reached the Maximum Sustainable Yield in the decades of 1970 and 1980 and are now found at over-exploitation levels. I recommend that this shrimp trawl fishery be completely closed down.

Un modelo biogeoquímico para el Golfo de Nicoya, Costa Rica / A biogeochemical model for the Gulf of Nicoya, Costa Rica

In agreement with the Broecker and Penn two-boxes model, I generated a biogeochemical balance model for the Gulf of Nicoya (Guanacaste, Costa Rica) using two nutrient reservoirs: surface water and deep water. The mixing zone was located at a depth of 20 m. There is a balance between surface waters descending to the bottom and upwelling waters that carry nutrients and other chemical elements to the surface. The main source of nitrogen (nitrate), was the outlet of the Tempisque and Tárcoles rivers. The Gulf of Nicoya is a net source of Dissolved Inorganic Nitrogen (DIN) with an availability rate of 87 x 10(3) mol day(-1) in the dry season and 3044 x 10(3) mol day(-1)in the rainy season. Dissolved Inorganic Phosphate (DIP) was estimated in 27 mol day(-1) in the dry season and 207 mol day(-1) in the rainy season. The dynamics of these biolimited nutrients, in relation to runoff seasonal variations, fits the biological processes reported for the gulf, for example, for variations in primary productivity levels, and maturity and reproduction seasons for species with short and long life cycles.

Biological evaluation and study of polysaccharides of Dalbergia sissoo Roxb growing in Egypt

The extracts of Dalbergia sissoo Roxb growing in Egypt, the polysaccharides prepared from leaves, stem and bark and the major constituent in the plant [biochanin A] were subjected to screening of anti-inflammatory, anti-pyretic and analgesic activities adopting new methodology. The anti-tumor, anti-oxidant, and antimicrobial activities of these substances were also examined. Since the polysaccharides prepared from different organs [leaves 2.5%, stem 2.2%, bark 1.2%] possessed anti-inflammatory activities, they were subjected to further phytochemical studies, using paper chromato-graphy and GC/MS analysis. The polysaccharides were heterogeneous in nature and lacked uronic acids. The use of GC/MS to study the monomeric composition of polysaccharides in the acid hydrolysate indicated that the leaf polysaccharides consist mainly of rhamnose [77%] in addition to glucose [23%]. The stem polysaccharide consists of rhamnose [47%], glycerol [46%] and galactose [7%]. The bark polysaccharide consists of rhamnose [18%], fructose [2.5%], glucose [74.5%] and galactose [6%]

Effect of selected natural products, thioproline and pegasys on hepatic platelet activating factor [PAF] in CCl[4]-induced hepatic fibrosis in rats

This study aimed to estimate hepatic levels of platelet activating factor [PAF] in liver fibrosis induced by CC1[4] in rats. A group of selected natural products; boswellic acids, curcumin and glycyrrhizin [preparation named OMNI[R]; a drug under clinical trials for treatment of hepatitis C virus], Mirazid[R] [a commercially available schistomicidal drug], Thioproline [a commercially available hepatoprotective agent] and Pegasys[R] [peg interferon alpha-2a; a commercially available therapy for treatment of hepatitis C virus] were examined for their effect on hepatic PAF after CC1[4] intoxication. For this purpose, 54 rats were used in the study. Rats were divided into 6 groups each comprised 9 rats. Group 1 was treated only with CC1[4], groups 2 to 5 were treated with OMNI[R], Mirazid[R], Thioproline and Pegasys[R], respectively, whereas the sixth group was the normal control group [with no treatment, except an injection of the vehicle]. Liver damage was induced in all groups except normal control group [groups 1 to 5] by i.p. injection of 40% CC1[4] in corn oil [0.375 ml/kg] 3 times a week for 3 weeks. One week after CC1[4] intoxication, all tested drugs were injected i.p. daily for 3 weeks. Hepatic PAF concentration was estimated by HPTLC [high performance thin layer chromatography], while, levels of serum transaminases [ALT, AST], hepatic hydroxyproline [as markers of liver fibrosis], serum malondialdehyde and catalase [as markers of oxidative stress] were estimated spectrophotometrically. The hepatic PAF levels were significantly higher in CC1[4] group [24.24 +/- 2.01 pmol equiv./mg] as compared to normal control [8.81 +/- 1.09 pmol equiv./mg] [p<0.001]. Treatment with OMNI[R], Mirazid[R], Thioproline and Pegasys[R] reduced hepatic PAF significantly to be 11.84 +/- 0.22, 14.5 +/- 1.00, 13.17 +/- 0.54 and 14.26 +/- 1.09 pmol equiv./mg, respectively. This study may add further rational to the anti-fibrotic activity of the tested drugs via reduction of hepatic PAF

Isolation of aeromonas species from diarrheal patients in Ismailia Governorate

In order to know the prevalence of Aeromonas species as a causative agent of diarrhea in Ismailia, three hundred and fifty stool samples and rectal swabs were collected from infants and children under the age of 5 years visiting El Kilo 11 Clinic suffering from acute diarrhea in the period from May 2004 to September 2004. Stool samples were collected from control group of fifty healthy infants and children of matched age and sex. It was found that 29 diarrheal samples were positive for Aeromonas species with prevalence of 8.28%. None of control samples were positive for Aeromonas. In most cases it was found that the infection is water or food borne. Aeromonas strains show high degree of antibiotic susceptibility

study on the role of epstein barr virus infection in the pathogenesis of nasopharyngeal carcinoma

Oral herpes virus infections are thought to be a responsible predisposing cause of nasopharyngeal cancer. Of the herpes viruses, Epstein-Barr virus [EBV] has classically been associated with nasopharyngeal carcinoma [NPC] and Burkitt's lymphoma. Recently, multiple studies have been published linking EBV with oral squamous cell carcinoma and, to a lesser extent, hypopharyngeal and laryngeal tumors. Using a sensitive method of detection, this study was conducted to analyze the presence of EBV DNA in 40 NPC cases and 35 cases with benign nasal polyps as control in serum and tissue and compared it with serological markers. Three EBV serological markers were performed by enzyme linked immunosorbant assay including EBV VCA IgM, EBV IgG and EBNA IgG. Herpes simplex virus antibodies HSV I and II IgG were examined in serum. Forty serum and tissue samples exclusive of nasopharyngeal carcinoma were examined for the presence of EBV DNA and HSV II DNA using qualitative polymerase chain reaction. Thirty-five serum and tissue samples of benign nasal polyps were submitted to all the tests as control. Serological tests for EBV: revealed that EBV VCA IgG was positive in 57.5%, EBNA IgG was positive in total of 47.5% NPC. EBV DNA was positive in serum in all EBV VCA IgG and EBNA IgG positive cases. EBV DNA by PCR in tissue was positive in 72.5% of NPC in which 70% were EBV-DNA serum positive. In the benign group 17.1% EBV-DNA tissue positive cases, only 2.9% were EBV-DNA serum positive by PCR. HSV DNA in tissue was positive in 20% of NPC and 11.4% of benign group. In NPC HSV-DNA tissue positive cases, 2.5% were HSV-DNA serum positive by PCR and 17.5% were negative. The results indicate that HSV and EBV have a role in the etiology of nasopharyngeal carcinoma. Detection of EBNA1 and HSV in the serum and corresponding tissue of nasopharyngeal carcinoma indicates the role of circulating viral DNA as an early marker for pathogenesis of nasopharyngeal carcinoma and that it could serve as good supplement to pathological diagnosis of nasopharyngeal carcinoma

Early detection of malignant showers in blood of colorectal cancer patients using carcinoembryonic antigen mRNA Reverse Transcriptase-polymerase Chain Reaction

Serum CEA is among the most widely accepted marker for diagnosing and monitoring colorectal cancer [CRC] yet it has many limitations. The objective of the present study was to evaluate the utility of plasma CEA-mRNA as a marker for early detection of micrometastasis and assess its usefulness versus that of serum CEA in CRC patients. This study included 36 patients with CRC who were staged according to Dukes' staging system into stage A [n = 4], B [n = 8] C [n = 14] and stage D [n = 10]. Patients included in Dukes' stages A and B [n = 12] had non-metastatic lesion and were considered as one group [group I] while those having stages C and D [n = 24] had metastatic lesions. Patients with metastatic lesions who weren't receiving chemotherapy were included in one group [group II, n = 20] while those on chemotherapy [5 fluorouracil and leukovorin] were considered as group III [n = 4]. Six patients suffering from benign colorectal disease [ulcerative colitis n = 2, diverticulitis n = 1 and polyps n=3] and six healthy age and gender matched and with normal serum CEA concentration were included in the study and were considered as the control group [group IVa, group IVb respectively]. All CRC patients were subjected to clinical, radiological, endoscopic, histopathological and laboratory assessment. Control subjects were assessed both clinically and laboratory wise. Serum CEA was assayed by chemiluminescent sequential immunometric assay while plasma CEA-mRNA was determined by semi nested reverse transcription RT-PCR. The median and inter-quartile values for serum CEA in groups I, II and III were 2.5 [1.5-3.4], 4.6 [2.8-9.9] and 4.2 [2.9-5.3] ng/mL respectively. As for the control groups, it was 2 [0.9-2.2] ng/mL in group IVa and 3.3 [2.1-4.0] ng/mL in group IVb. When compared to controls, serum CEA was significantly higher only in metastatic patients [group II and III], however, when compared to non-metastatic CRC, serum CEA was significantly higher only in patients not on chemotherapy [group II]. The degree of tumor differentiation had no significant impact on serum CEA concentration. Our results also demonstrated that the percent positivity for CEA-mRNA increase with advancing CRC stage where a highly significant increase was observed in metastatic patients [65%] when compared to non metastatic ones [8.3%]. Our results also showed that CEA- mRNA may be positive in subjects with benign colorectal diseases [8.3%] and that chemotherapy may result in negative results for m-RNA. Again, the degree of differentiation had no impact on percent positivity of CEA- mRNA. Finally, our results showed that serum CEA and percent positivity of CEA- mRNA do not correlate and that the recurrence rate in patients with positive CEA-mRNA is significantly high [70%]. Reverse-trancriptase polymerase chain reaction for CEA-mRNA is a sensitive method for detection of circulating cancer cells in CRC patients. Colorectal cancer patients with postoperative CEA-mRNA positive cells in peripheral blood have less disease free survival than patients who demonstrate absence of these cells. Studies involving a larger group of patients with a longer follow-up period should be done to implement the clinical relevance of this phenomenon. Patients receiving chemotherapy should not be tested for CEA-mRNA during the treatment course. They should be tested repeatedly thereafter at longer time intervals following the last dose of chemotherapy