DNA analysis of hepatocytes: a novel method for estimating the value of liver tissue vaccine (LTV).

Because of the socio-economic condition of African countries, the traditional types of vaccines should be encouraged. LTV in a preliminary study, proved to be of value in reducing morbidity and mortality in Schistosoma mansoni infection. In the present study and because of the vaccine contains liver tissue homogonate, the present authors analyed the DNA content of the hepatocytes of the vaccinated and control groups of animals to know any effects of the vaccine on the hepatocytes ploidy. The DNA content of vaccinated animals was higher. The results were discussed. It was concluded that for testing S. mansoni vaccine, DNA analysis of heptocytes for detecting proliferative S-phase is an important as a positive immune reaction.

Studies on house dust mites in Great Cairo, Egypt.

Nowadays, house dust mites have showed themselves as one of the health problem worldwide. They have to be considered in the differential diagnosis of allergy particularly in children. House dust mites were collected from eight different areas in Great Cairo. Nine species of mites were recovered from indoors. In order of abundance, they were Dermatophagoides pteronyssinus, D. farinae, Tyrophagous putrescentiae, Acarus siro, Cheyletus malaccensis, Blomia kulagini, Acheles graciles, Ornithonyssus bacoti and Lepidoglyphus destructor. All these mites were collected mainly from Bolak Al Dakrour (28.8%) and Al Wayly (27.6%). The least number (1.8%) and species (only three) were collected from Madent Al Salam. Pet and stray dogs and cats, domestic birds and commensal rodents were more or less reported in the majority of the examined areas. Also, patients with history of allergy of unknown cause, were reported in ten out of 80 houses examined (12.5%). The role played by house dust mites in causing allergic manifestations was important environmental disease agents.

Parasitic infections presenting as prolonged fevers.

Over two successive years, out of 187 cases of fevers of undetermined origin (FUO) admitted to Abbassia and Embaba Fever Hospitals, 30 (16%) cases proved to be of parasitic origin. Ten within normal subjects were taken as controls. Complete blood picture, repeated stool examination, rectal snip by transparency technique, ELISA for specific IgM antibodies for S. mansoni, indirect haemagglutination test for S. mansoni, Fasciola, hydatid, amoebic liver abscess and toxoplasmosis, indirect fluorescent antibody test for toxoplasmosis and abdominal ultrasonography were performed whenever indicated. Cases comprised 8 (26%) acute S. mansoni, 7 (24%) acute fascioliasis, 3 (10%) hydatid cyst, 8 (26%) amoebic liver abscess, 2 (7%) toxoplasmoisis and 2 (7%) malaria cases. The clinical picture of acute S. mansoni and acute fascioliasis were similar in the form of prolonged fever, diarrhea, hepatomegaly and leucocytosis with high eosinophilia. Serology (ELISA and IHAT) was essential in differentiating them. Abdominal ultrasonography is an easy, sensitive, cheap, non-invasive technique aiding in the diagnosis of amoebic liver abscess, liver hydatid cysts and fascioliasis but again serology was essential in differenting them. Toxoplasmic lymphadenitis mimic the clinical picture of infectious mononucleosis. Serology (monospot test, IHAT, IFAT) clinched the diagnosis. Malaria cases presented atypically by gastrointestinal manifestations and hepatic affection. Diagnosis was by positive blood smears.

Histopathological evidences for the antifibrogenic effect of colchicine in schistosomiasis mansoni in mice.

Colchicine treated mice showed significant decrease in prevalence of fibrocellular and fibrocellular and fibrous granulomas in liver specimens compared to corresponding control groups. Percentage of spindle cell component and red fibrillar (RF) material showed significant reduction compared to control groups. These evidences of the antifibrogenic effect of colchicine were more prominent when treatment was given early after infection. Combined therapy with colchicine and praziquantel gave the same results. Mice treated with praziquantel alone showed no significant change compared to control groups. Colchicine showed also an immunomodulant effect evidenced by a significant decrease in the intensity of small and medium-sized to large cell components compared to control groups.

Detection of Schistosoma mansoni antigen in the liver and antibodies in serum of patients with hepatic schistosomiasis.

Liver biopsies were taken from 28 patients with chronic hepatitic schistosomiasis for histopathological study and S. mansoni antigen detection by indirect immunofluorescence test. Circulating antibodies were estimated by indirect haemagglutination test. Thirteen cases (46.4%) revealed diffuse S. mansoni antigen in the liver blood sinusoids and in the formed granulomata. Circulating antibodies were detected in 21 cases, 11 of them showed antigen in the liver. Five cases only revealed definite granulomatous reactions around bilharzial ova, while the remaining 23 cases showed periportal fibrosis. So, for proper diagnosis of chronic hepatic schistosomiasis, it is recommended to examine the liver for S. mansoni antigen together with circulating antibodies detection.

Helminthotoxic capacity of eosinophils in case of eosinophilia.

Helminthotoxic effect of eosinophils on schistosomula of S. mansoni was studied in thirty patients with peripheral eosinophilia of different causes. Ten cases presented with parasitic infections and twenty cases were parasite free. Twenty healthy persons with normal blood picture were tested as a control group. The adherence assay test of eosinophils and the assay of cell mediated damage of eosinophils to schistosomula were used. The percentages of the adherence and the toxic effect of eosinophils were the same for each group. They were 85.1% in the parasitic group, 85.45% in the non parasitic with other causes group and 13.9% in the control group. The difference was statistically highly significant (P less than 0.001).

Estimation of serum and tissue immunoglobulins level in some colonic disorders.

The immunoglobulins level, were estimated in the sera of 51 patients with different colonic disorders and 12 controls. In 27 of them, tissue immunoglobulin level were estimated. In bilharzial patients there was significant increase in the serum level of IgG, IgM and IgE. IgA and IgD showed no change. IgA containing cells were (87.5%), IgG (50%) and IgM (16.7%). In patients with amoebic colitis, there was significant increase in serum IgG and IgE. IgA and IgD showed significant decrease while IgM was within normal limits. Tissue IgA and IgG were detected in all acses. IgM containing cells were detected in 2 cases. In patients with irritable bowel syndrome (I.B.S.), there was significant high levels of IgM and IgE. IgG showed significant low level, while IgG and IgA showed no change. Tissue IgA were detected in (70%), IgG in (10%) and IgM in (20%). In patients with ulcerative colitis (U.C.), there was significant high levels of IgM and IgE. IgD showed significant low level, while IgG and IgA showed no change. Tissue IgA, IgG and IgM were detected in all cases. In patients with Crohn's disease, the 3 immunoglobulins were detected.

Long-term efficacy of repeat argon laser trabeculoplasty.

The role of repeat argon laser trabeculoplasty (RALT) in the management of open-angle glaucoma is controversial. To determine the long-term efficacy of RALT, the authors reviewed case records of 44 patients (50 eyes) who received RALT for uncontrolled glaucoma at the Wills Eye Hospital before 1986. Success was defined as a 3 mmHg or greater decrease in intraocular pressure (IOP) to less than 22 mmHg, and no further surgical intervention. By life table analysis, RALT was successful in 35% of eyes at 6 months, in 21% at 12 months, in 11% at 24 months, and in 5% at 48 months. Thirty-three percent of eyes in which primary ALT was successful for 1 year were successful 12 months after RALT. Complications included IOP spikes in 12%. In conclusion, RALT was generally not effective for long-term control of open-angle glaucoma, but may be useful as a temporizing measure. However, this use of RALT must be weighed against the risks of complications and the additional progression of disease before more definitive surgical intervention.

Relation between bilharzial arthropathy and histocompatibility leucocytic antigen B27.

Fifty cases of active schistosomiasis divided into group I test group consists of twenty-five patients with arthropathy and group II control group consists of twenty-five patients without arthropathy, were subjected to clinical examination, indirected haemagglutination test (IHAT) for bilharziasis and plain X-ray on lumbosacral, sacroiliac and knee joints. HLA-B27 antigen typing was also done as a trial to find association between this antigen and the Egyptian cases of bilharzial arthropathy. Clinical examination of patients with arthropathy showed that the frequency of joint affection was knee joint 76%, shoulder joint 12% and hip, elbow and sacroiliac joints were equally 4% affected. Although the affected joints were tender and with limited movement, there were no hotness, deformities and morning stiffness. There was no effusion nor swelling except in one case of knee joint arthropathy. The results of the IHAT showed hundred percent positivity in all the patients without significant statistical difference between the test and the control groups (P greater than 0.05). X-ray on the sacroiliac, lumbosacral and knee joints showed no abnormalities in all the cases. The results of the HLA-B27 antigen typing showed that the frequency of this antigen in the test group was 16% and in the control group was 4%. The relation risk was 4.57 and the aetiological fraction was very small 0.12. However there was insignificant statistical difference between the test and the control groups (P greater than 0.05).

Specificity of crude and purified Fasciola antigens in immunodiagnosis of human fascioliasis.

A study has been done to find the effect of purification of crude antigens extracted from adult F. gigantica and F. hepatica on the cross reactions encountered in C.I.E.P., I.H.A. and E.L.I.S.A. serological techniques with sera o other parasitic and non-parasitic diseases. It was performed on 75 patients and 20 healthy controls. It was found that sera of many diseases may cross-react with crude Fasciola antigen in serological diagnosis. These diseases include schistosomiasis, hydatidosis, amoebic liver abscess, heterophyiasis, trichinosis, non parasitic liver diseases (liver neoplasms, pyogenic liver abscess, viral hepatitis and acute leukaemic) and rheumatoid arthritis. Partial purification of crude Fasciola antigens is a suitable method to avoid cross reactivity when using C.I.E.P. or to diminish them when using E.L.I.S.A. No need for this purification when using I.H.A. So using partially purified adult Fasciola antigens C.I.E.P. was the most specific test (100%) of followed by C.L.I.S.A. then I.H.A.

Trabeculectomy for glaucoma associated with Sturge-Weber syndrome.

We reviewed the results of trabeculectomy performed in six patients (seven eyes) with glaucoma associated with the Sturge-Weber syndrome. After follow-up periods ranging from 9 months to 9 years, intraocular pressure control was adequate in two eyes without the use of antiglaucoma medication; control was good in four eyes with mild medication. One eye required three trabeculectomies and postoperative medication to achieve control. There was no further deterioration of visual acuity or of the optic nerve in any of the eyes.

Long-term follow up of clear cornea trabeculectomy.

We evaluated the long-term results of Cairns' clear cornea "trabeculectomy" performed on the Glaucoma Service of the Wills Eye Hospital in six patients with serious glaucoma. Although postoperative pressures initially were lower in all six, these lower pressures were not maintained. Pressure in three of the patients finally was controlled only after instituting medical treatment, including carbonic anhydrase inhibitors in two. The operation failed in the other three, two of whom underwent further surgeries. We conclude that Cairns' clear cornea trabeculectomy, in itself, is not adequate to control intraocular pressure in cases of serious glaucoma.

Sensitivity of crude and purified Fasciola antigens in immunological diagnosis of human fascioliasis.

A study has been done to find the effect of purification of crude antigens, extracted from adult Fasciola gigantica and Fasciola hepatica worms on the sensitivity of some serological techniques in diagnosis of fascioliasis. Using C.I.E.P. test, the partially purified antigens of both Fasciola species were less sensitive than their corresponding crude ones. Using I.H.A., the difference between results of crude and partially purified antigens for the two species were statistically insignificant, both (P greater than 0.05). So in applying this test, there is no need for the partially purification of antigen. On using E.L.I.S.A. the partially purified antigens showed higher sensitivities for detection of fascioliasis than their corresponding crude ones. Partially purified F. gigantica and F. hepatica antigens gave nearly the same results whether using C.I.E.P., I.H.A. or E.L.I.S.A. However, E.L.I.S.A. was the most sensitive technique followed by I.H.A. then C.I.E.P.