Isolation and characterization of marine-derived actinomycetes with cytotoxic activity from the Red Sea coast

Objective: To isolate and evaluate the cytotoxic activity of different actinomycetes species isolated from the Red Sea coast in Sharm el-Sheikh, Egypt. Methods: Forty actinomycetes strains were isolated from different sediments and seawater samples collected from the Red Sea coast in Egypt. Actinomycetes were recognized by morphological and microscopic examinations. Cell viability and cytotoxicity induced by the crude extracts on breast cancer cell lines MDA-MB-231 were assessed using methylene blue assay. The strains with promising cytotoxic activity were identified by sequencing and amplifying the 16S rRNA genes. The antibacterial activities of the crude extracts were performed using Kirby-Bauer disc diffusion method. Results: The results indicated that five ethyl acetate extracts exhibited cytotoxicity towards breast cancer cell lines MDA-MB-231. The highest cytotoxic activity was found for the ethyl acetate extracts of EGY2 and EGY39. The isolate EGY3 was identified as a new Streptomyces species, while the actinomycete EGY22 was found to be a member of the genus Nocardiopsis sp. The crude extract of the isolate EGY8 showed slightly high antimicrobial activity against different test microorganisms. Conclusions: The results of the present study reveal that marine sediments of the Red Sea are a potent source of novel species of actinomycetes. The isolates may be useful in discovery of novel bioactive compounds and an important step in the development of microbial natural product research.

Maternal and fetal prolactin levels in relation to maternal smoking during pregnancy

In this study, the maternal and serum cord prolactin and nicotine metabolite levels were measured at birth using the IMMULITE immunoassay method in 40 apparently healthy mother-neonate pairs. In 20 of them, the mothers were smokers during pregnancy and the remaining 20 were nonsmokers and not exposed to passive smoking from a household smoker and with no chronic disease prior to pregnancy, drug- induced pregnancy, ingestion of drugs known to alter prolactin secretion, twin gestations, prematurity, malformations, complications during pregnancy or labor. The findings indicated that maternal smoking during pregnancy lower the serum prolactin level in mothers at delivery with the expected short period of breast feeding, which makes their infants susceptible to the drawbacks of artificial feeding, in addition to the disturbance of the endocrine status of the fetus as shown by the lower fetal prolactin level

Survival impact of surgical cytoreduction in advanced ovarian cancer

Background: Neoadjuvant chemotherapy and interval debulking surgery [NCT/ID] in advanced ovarian cancer has been proposed as an alternative to conventional surgery for patients with bulky diseases aiming at improving quality of life and achieving a survival benefit that may be equivalent to that achieved with the standard line of management

Aim of the Study: This prospective study was undertaken to compare the outcome of treatment of advanced stage III and IV epithelial ovarian cancer between patients treated by NCT/ID and those treated by primary surgical debulking [P.S.]

Patients and Methods: Forty-three patients with advanced ovarian ccancer were treated in Menufia between January 1998 and January 2001, the results of their treatment were correlated on view that there were two groups of patients treated in two different ways. The first group, were those patients treated by primary surgical debulking [P.S] followed with 6 cycles of adjuvant chemotherapy [Cisplatinum and Cyclophosphamide]. The second group, were those patients found to have irresectable tumors during staginglaparotomy and only performed partial excision. Those patients were treated by 3 cycles of combination chemotherapy [Cisplatinum and Cyclophosphamide] followed by interval debulking surgery and 4-6 cycles of same adjuvant chemotherapy. Second line chemotherapy was used in both groups in case of relapse. Correlation between both groups for progression free duration [PFD], overall survival [OAS], and 4-year survival rate, in addition to comparison of the morbidity of treatment in both groups were evaluated

Results: There were 22 patients in NCT/ID group versus 221 patients' in P.S group. The median age was similar in both groups [56 and 55 years]. Papillary serous cyst adenocarcinorna was the main pathological subtype in both groups, but high grade tumours predominate in NCT/ ID group [77.3%] versus P.S group [4.7%]. Analysis of surgical outcome revealed that in P.S group 61.9% of patients could perform maximal surgical debulking and in 38.1% suboptimal debulking was performed; while in NCT/ID group staging laparotomy was the only primary intervention in 68.2% and in 31.8% partial excision was done. After neoadjuvant chemotherapy, maximal surgical dehulking was achieved in 15 patients [68.2%], and in another 5 patients [22.7%] completeremission was achieved as evaluated by second look operation. There were 44 surgical procedures performed for patients in NCT/ID group versus 24 procedures in P.S group. Morbidity reported in 10 instances in NCT/ID group [22.72%] and 8 instances in P.S group [33.33%]. There was high response rate to neoadjuvant chemotherapy recorded in NCT/ID group of patients [90.9%] with complete remission in 5 patients [22.7%]. Response to adjuvant chemotherapy as measured by the incidence of relapse for patients who were in remission and necessitated second line chemotherapy in both groups was found to be similar in both groups [23.7% and 23.5%] for P.S and NCT/ID groups respectively. Progression free duration [PFD] was relatively but not significantly higher for P.S group versus NCT/ID group [20 and 15 months respectively][P=0.615]. On the other hand the overall survival [OAS] was also relatively and not significantly higher in NCT/ID group compared to P.S group' [29 and 23 months respectively][P= 0.493]. A similar 4-year survival rates were recorded for NCT/ID group and P.S group [27% and 29% respectively]

Conclusion: Neoadjuvant chemotherapy and interval debulking surgery resulted in survival figures that are comparable with patients who performed primary surgical cytoreduction. Further trials are needed to validate this strategy with the introduction of more potent chemotherapeutic agents in order to minimize the risk of tumour progression during neoadjuvant chemotherapy treatment and possibly improving survival//

Diagnosis and management of failed ovum pickup, a postulated cause of unexplained infertility

To study the ovum pickup mechanism and the fimbrio-ovarian relation in fertile and cases of unexplained infertility and to design a method for investigation and anticipation of the state of ovum pickup. Prospective clinical study. Department of Obstetrics and Gynecology Kasr El Aini Hospital, Cairo University, Egypt. Fifty fertile and twenty five cases of unexplained infertility. In all cases the fimbrio-ovarian relation is studied by determining the length of the ovulation border, the site of ovulation on that border and the length of the firnbria ovarica. It is also determined by a simple test [The fimbrio-ovarian accessibility test]. The fimbrio are held by non-traumatizing grasper and their ability to reach and/or to cover the ovulation site are taken as prove for successful ovum pickup. In addition, cases having suspected failed ovum picking are treated by controlled superovulatton, drilling of the ovary at an accessible site to the fimbrio ovarica and also by freeing short fimbrio ovarica, or partial bisection of the ovarian ligament using bipolar diathermy to allow for more ovarian accessibility to the fallopian tube and hence improving the fimbrio -ovarian juxtaposition. The ovulation site is found to be usually accessible to the fimbrio end of the tube [94%] in the fertile cases and not accessible [92%] in the infertile cases. Correction of the fimbrio-ovarian relation in the infertile cases was associated with a cumulative ongoing pregnancy rate of 68%. Failed ovum pickup should be considered as one of the important causes of unexplained infertility. The suggested "firnbrio - ovarian inaccessibility" should be considered in these cases. Correction of the fimbrio-ovarian relation, to make ovum pickup possible, should be considered as a method for treating such cases