role of plasma homocysteine and lipoprotein [a] in coronary artery disease

Objective: to study the possible role of homocysteine and lipoprotein [a] as risk factors for premature coronary artery disease [CAD], and to assess their relationship to conventional risk factors

Subjects and Methods: 45 subjects were divided into 3 groups, 15 premature CAD patients without traditional cardiovascular risk factors, 15 premature CAD patients with one or more traditional cardiovascular risk factors [hypertension, diabetes mellitus, cigarette smoking, or dyslipidemia] and 15 healthy normal subjects matched for age and sex [controls]. All were subjected lo estimation of plasma homocysteine [Hcys], plasminogen activator inhibitor-1 [PAI-1] by ELISA, plasma folic acid by radioimmunoassay, plasma lipoproteine a [Lp[a]] by turbidimetry and plasma lipids by colorimetry

Results : this study showed a significant elevated Hcys and low folate levels in premature CAD patients. Significant correlations found between elevated level of PAI-1 and CAE in the two patient groups. There were significant positive correlations between plasma Hcys and that of PAI-I and LDL-C and significant negative correlations between plasma Hcys and that of folate and HDL-c in the patient groups. Plasma Lp[a] was only significantly elevated in premature CAD patients with traditional risk factors

Conclusion : Hcys, folic acid and PAI-1 might serve as independent risk factors for premature CAD in patients with and without traditional coronary risk factors. However. Lp[a] might confer an additional coronary risk factor only in the presence of traditional risk factors

Correlation between some angiogenic and apoptotic factors in acute leukemias

Objective: to evaluate matrix metalloproteinase-9 [MMP-9], inhibitor of metalloproteinase-1 [TIMP-I], sFas, hepatocyte growth factor [HGF] and myeloperoxidase [MPO] levels in newly diagnosed patients with acute leukemias and to correlate their levels with the patients' clinical data. We also tried to study the correlation between apoptosis and angiogenesis in acute leukemias

Patients and Methods: this study included 15 patients with acute lymphoblastic leukemia [ALL]. 15 patients with acute myeloblastic leukemia [AML] and 15 healthy persons of matched age and sex served as controls. The levels of serum human total matrix metailoproteinase-9 [MMP-9], human tissue inhibitor of metalloproteinase-1 [TIMP-I], human sFas and plasma concentration of hepatocyte growth factor [HGF] were determined by enzyme linked immunosorbent assay. The measurement of MPO was done in peripheral blood polymorphonuclear layer

Results: elevated levels of the angiogenic factors [MMP-9. its inhibitor TIMP-I, and HGF] as well as the apoptotic factor [sFas] were detected in both acute leukemic groups when compared with controls while MPO was significantly decreased in both groups as compared to controls. Significantly higher levels of MMP-9 and MPO were present in AML group than ALL group while sFas level was significantly higher in ALL than AML group. HGF level was insignificantly different between both groups. Higher values of MMP-9, HGF and sFas were observed in M4 and M5 than other FAB subtypes and in adult than child ALL. No correlation was present between angiogenesis and apoptosis in acute leukemic patients

Conclusion: angiogenesis and apoptosis are independent processes in acute leukemias

Concentration of some prophylactic antibiotic in blood, dentoalveolar blood and mandibular bone in impaction surgery

Surgical removal of impacted third molars might be followed by infection. To fight against such infection an adequate antibiotic concentration should be there at the local tissue before the operation. This study was conducted to identify the level of single oral dose of prophylactic antibiotic in antecuhital serum, dentoalveolar serum and mandibular bone in impaction surgery. This study included 200 patients. divided into five groups each comprised forty patients and each group received single oral dose of one antibiotic under investigation [azithromycin. clindamycin. doxycycline. erythromycin, and penicillin-V]. Each group was further subdivided into eight subgroups comprising 5 patients according to the proposed time intervals. Antibiotics were taken 30. 60, 90. 120. 150. 180. 210, and 240 minutes before the operation according to the tested subgroup. Samples of blood. dentoalveolar blood and mandibular bone were taken at the planed time intervals. The concentrations of antibiotic in these samples were assayed in vitro by the agar diffusion [cup plate] method. The result showed that penicillin-V showed the highest mean peak serum concentration followed by doxycycline and clindamycin. However. all antibiotics gave measurable level exceeding the NBC of the tested bacterial isolates. Doxycycline showed the highest concentration ratio [bone/serum]. followed by penicillin-V, clindamycin and erythromycin. Up to four hours [240 minutes] no measurable level of azithromycin concentration could be attained in bone, so a further study at a longer time period [more than 12 hours] may be indicated. The suggested time for prophylactic use of the tested antibiotic should he two hours before the operation for clindamycin [300 mg]. one and half hour before the operation for erythromycin [500 mg]. three hours before the operation for doxycycline [200mg.] and half an hour before the operation for penicillin [937.5m2]

role of von-wellbrand's factor; fibronectin and lipid profile as risk factors for vascular damage in rheumatoid arthritis and systemic sclerosis

This study was designed to determine the roles of Von-Willbrand's factor, fibronectin and lipid profile as risk factors in etiopathogensis of vascular lesions in 20 rheumatoid disease patients [RD] diagnosed according to American Rheumatism Association Criteria and 20 Systemic Sclerosis patients [SSc] diagnosed according to the preliminary criteria for SSc. 20 healthy subjects of matched age and sex were included as control group. Variable degrees of vascular lesions were detected: Raynouds phenomenon [RD 30%, SSc 50%] cutaneous telangiectasia and digital ulcers [RD 5%, SSc 40%], peripheral vascular insufficiency via Doppler study [RD 5%, SSc 40%], clinically evident systemic hypertension [SSc 15%], pulmonary vascular disease via Echo-Doppler study [RD 5%, SSc 20%], Coronary heart disease via E.C.G and Echo-Doppler study [20% in RD, 15% in SSc] and clinically evident cerebrovascular strokes [RD 10% SSc 10%]. The mean plasma levels of Von-Willebrand's factor and fibronectin were significantly higher in RD and SSc patients than in controls and the highest levels were observed in patients with vascular manifestations particularly with SSc., suggesting the presence of endothelial dysfunction and were considered as non invasive markers of vascular damage which are more prominant in SSc than in RD. The total serum lipids, Triglycerides, cholesterol, LDL-cholesterol, free fatty acids and Apoprotein B-were, significantly increased while HDL-cholesterol and apoprotein A, were significantly decreased, suggesting the presence of atherogenic dyslipidemic pattern in the etiopathogenesis of vascular manifestations in RD and SSc. The higher levels which observed in RD patients with vascular manifestations are most probably due to patients inactivity resulting from articular lesions or due to steroid therapy induced dyslipedemia. Circulating levels of endothelial cell products such as VWF and fibronectin may reflect the role of the immune mechanism in the pathogenesis of RD and SSc vascular disease and assist the clinician in monitoring response to therapy. Furthermore, monitoring of VWF and fibronectin as parameters of endothelial cell injury may help to define the vascular disease in an early and more measuringful fashion