Molecular hepatoprotective effects of lipoic acid against carbon tetrachloride-induced liver fibrosis in rats: Hepatoprotection at molecular level.

BACKGROUND: Liver fibrosis is a noteworthy well-being issue that can prompt the progression of liver cirrhosis and hepatocellular carcinoma. Prominently, many antioxidants have been shown to have defensive impacts against liver fibrosis. AIM: Subsequently, in the present study, the viability of alpha-lipoic acid (α-LA) in ensuring against carbon tetrachloride (CCl4)-actuated liver fibrosis and the mechanism(s) involved in this defensive impact were considered in rats. RESULTS: The present results uncovered that in the CCl4-treated group, the expression of antioxidant enzymes and matrix metalloproteinase-13 (MMP-13) messenger RNA (mRNA) was downregulated ( p < 0.05), and the levels of lipid peroxide and nitric oxide were increased ( p < 0.05) in the treated rat livers along with increased collagen deposition compared to that of the control group. Also, the gene expression levels of the proinflammatory factors interleukin-6 and tumor necrosis factor-alpha, nuclear factor-kappa B (NF-κB) p65, transforming growth factor-alpha, and inducible nitric oxide synthase (iNOS) were upregulated significantly ( p < 0.05) in the CCl4 group. These negative impacts were all restrained by α-LA. CONCLUSIONS: These outcomes show that α-LA might be compelling at forestalling collagen deposition and hepatic oxidative stress as well as downregulating the expression of hepatic proinflammatory cytokines, iNOS, and NF-κB and upregulating MMP-13 expression.

Measles virus-specific antibody levels in Sudanese infants: a prospective study using filter-paper blood samples.

We conducted a prospective birth cohort study in rural Sudan to assess measles virus (MV)-specific antibody levels at different time points in infancy. Dried blood spots were collected on filter paper at birth (cord blood) and at ages 6, 12 and 24 months (heel-prick). Maternally derived MV-specific antibody levels were high in cord blood samples, but at the age of 6 months had dropped below cut-off values in half of the infants. By extrapolation it was concluded that the current Expanded Programme of Immunization (EPI) target age for measles vaccination of 9 months was an appropriate choice for this area. At the age of 24 months acquired MV-specific antibodies were detected in 65-85% of the cohort, which corresponded well with the 79% of infants reported to be vaccinated by this age. This study demonstrates the usefulness of filter paper blood samples for seroepidemiological studies in developing countries.

Birthweight percentiles by gestational age in Kuwait.

Our aim is develop a curve for singleton birthweight based on accurately calculated gestational age. A retrospective analysis of all singleton live births from 22-44 completed weeks of gestation during the period from September 1998 to December 2000 in the two largest birth birth centers in Kuwait was conducted. Neonates with major congenital anomalies and those with unrecorded gestational age were excluded from the study population. Total population and gender-specific birthweight percentiles according to gestational age were developed after smoothening of growth curves. A total of 35768 births were included in the development of the birthweight curve. Percentiles of birthweight for all population and by gender are presented. There was significant difference in birthweight among different ethnic groups in this population. At term, 9.8% of births are smaller than the 10th percentile and 10.0% are larger than the 90th percentile. Plotting birthweight in our population on percentile curves derived from the United States or United Kingdom would generally overestimate small for gestational age newborns and underestimate large for gestational age newborns. We conclude that the diagnosis of clinically significant birthweight abnormalities depends on the fetal growth curve used. A population specific curve of fetal growth dated by ultrasonography would provide a reliable reference for birthweight distribution.

Ethnic variations in birthweight percentiles in Kuwait.

The objectives of this retrospective study were to assess the effect of ethnicity on birthweight percentiles and to compare ethnic-specific percentiles with other references. Analysis was made of 35 768 singleton live births from 22 to 44 completed weeks of gestation at two major obstetric hospitals in Kuwait, after exclusion of data with inaccurate gestational age, major congenital abnormalities, stillbirths, and outlying birthweights. The population included four major ethnic groups: Gulf Arabs, Mediterranean Arabs, Egyptians, and a group combining Indians and Southeast Asians. Total population and ethnic-specific smoothed birthweight percentiles according to gestational age were developed. Indians-Asians had the smallest birthweights, the highest prevalence of small-for-gestational-age (SGA) birthweights and the lowest prevalence of large-for-gestational-age (LGA) birthweights. On the contrary, Egyptians had the largest birthweights, the lowest prevalence of SGA birthweights and the highest prevalence of LGA birthweights. Plotting our birthweights on a reference from Canada resulted in a low prediction rate for SGA and a low sensitivity in identifying LGA of all ethnic groups. We conclude that interpretation of fetal growth and birthweight should involve locally derived and ethnically specific percentiles based on accurately calculated gestational age.

Prediction of fetal anemia by middle cerebral artery peak systolic velocity in pregnancies complicated by rhesus isoimmunization.

OBJECTIVES: To study the correlation of peak systolic velocity in the middle cerebral artery with hemoglobin concentration in fetuses at risk of anemia due to Rhesus isoimmunization. DESIGN: Peak systolic velocity of middle cerebral artery (MCA-PSV) was measured before 66 cordocentesis procedures in 20 isoimmunized fetuses. Reference values were derived from a study of 300 control fetuses. MCA-PSV values and hemoglobin concentrations were expressed as multiples of the median (MoM) for gestational age. The following hemoglobin concentration MoM thresholds defined degrees of anemia: mild, between 0.83 and 0.65; moderate, between 0.64 and 0.55; and severe, less than 0.55. Regression analysis was performed and receiver-operator-characteristic curves were constructed to determine the diagnostic accuracy of different thresholds of MCA-PSV for the prediction of moderate to severe anemia, either at the initial or repeat cordocentesis procedures. RESULTS: The mean (+/-SD) gestational age at cordocentesis was 28.5+/-4.6 weeks. Moderate to severe anemia was observed on 29 (44%) and hydrops on 27 (41%) occasions. MCA-PSV correlated weakly with hemoglobin concentrations. At threshold values 1.50 MoM, the sensitivity, specificity, and negative predictive value for moderate to severe anemia were 9.0, 100, and 48.0% at the initial cordocentesis procedures, and 44.0, 96.0, and 73.0% at repeat cordocentesis procedures, respectively. CONCLUSIONS: Although MCA-PSV is highly specific, negative values do not rule out fetal anemia. Further research is required before it can be recommended in clinical practice.

Treatment of ectopic pregnancy with a single intramuscular dose of methotrexate.

This study evaluates the outcome of unruptured ectopic pregnancies treated with single-dose intramuscular methotrexate injection. There were 77 women with unruptured non-laparoscopically diagnosed ectopic pregnancies who were prospectively followed after receiving a single dose of 50 mg/m2 intramuscular methotrexate. Diagnosis required transvaginal ultrasound and serial quantification of beta subunit of human chorionic gonadotropin (betahCG). A repeat dose was given if the weekly drop of betahCG was less than 30%. Therapy was considered successful if complete resolution of betahCG to a level below 25 IU/L was achieved without surgical intervention. Treatment in 73 (95%) cases was successful. The mean pre-treatment level of betahCG was 2592 +/- 3771 IU/L (177-15000 IU/L), the mean diameter of ectopic mass was 2.4 +/- 1.0 cm (1.7-3.5 cm). The average resolution period was 3.2 +/- 1.0 weeks (1-6 weeks) and this significantly correlated with the pre-treatment betahCG level. With strict criteria of inclusion and follow-up, single-dose intramuscular methotrexate is a successful method for the treatment of selected cases of ectopic pregnancy.

Measles in suburban Khartoum: an epidemiological and clinical study.

Clinical and epidemiological data were collected from 187 clinically diagnosed measles patients in Haj Yousif area, suburban Khartoum. Laboratory tests confirmed the diagnosis in 141 (75%) of the cases, but demonstrated that in 46 (25%) patients the clinical symptoms were not caused by an acute measles virus (MV) infection. According to their vaccination card, 59% of the laboratory-confirmed measles cases had been vaccinated for measles. Compared with non-measles rash disease cases, confirmed measles cases more often had severe illness (P < 0.0001), were dehydrated (P=0.01) at presentation and less likely to recover without complications [OR 0.19 (95% CI 0.09, 0.39)]. There was no difference in death rate (P=0.20). Underweight [weight-for-age Z score (WAZ)

Nonphytate phosphorus requirement and phosphorus excretion of broiler chicks fed diets composed of normal or high available phosphate corn with and without microbial phytase.

A study was conducted to evaluate the ability of the young (0 to 3 wk) broiler chicken to utilize the P provided by a high available P corn [HAPC; 0.27% total P and 0.17% nonphytate P] in comparison with yellow dent corn (YDC; 0.23% total P and 0.03% nonphytate P), and to determine the extent to which supplementation with exogenous phytase enzyme could reduce the demands for dietary P and subsequently reduce P excretion. Diets prepared using the two types of corn differed in the amount of phytate-bound P, with the HAPC diets containing approximately 50% less phytate-bound P. Treatment diets were prepared by varying the amount of dicalcium phosphate, and ranged from 0.10 to 0.50% nonphytate P for YDC diets, and from 0.18 to 0.50% nonphytate P for HAPC diets. Sublots of each diet were supplemented with 800 units/kg phytase. Each diet was fed to six pens of five male chicks of a commercial broiler strain from 1 to 21 d of age. Regression analysis was used to estimate nonphytate P requirements for each corn type with and without phytase supplementation. The greatest need for nonphytate P was for maximum tibia ash, with requirements of 0.39, 0.29, 0.37, and 0.32% in diets with YDC, YDC plus phytase, HAPC, and HAPC plus phytase, respectively. Addition of phytase liberated approximately 50% of the phytate-bound P from each diet. These levels were sufficient to support body weight, feed conversion, and livability. Fecal P content of broilers fed diets with YDC at the NRC (1994) recommended level of 0.45% nonphytate P was 1.21%, whereas at the respective requirement points indicated above, the P content was 1.09, 0.87, 0.78, and 0.64% in feces from broilers fed diets with YDC, YDC plus phytase, HAPC, and HAPC plus phytase, respectively. Thus, fecal P output could be reduced while maintaining optimum performance by the use of reduced dietary nonphytate P, introduction of HAPC, and phytase supplementation. One of the greatest benefits of phytase supplementation appeared to be maintaining livability at lower dietary levels of nonphytate P.

Hypertension and its determinants among primary-school children in Kuwait: an epidemiological study.

A multistage, stratified random sample of 1312 students (aged 6-10 years) was selected from the five regions in Kuwait. Parents were interviewed and weight, height and urine analysis of the children were taken. Blood pressure was measured on at least three separate occasions. The overall prevalence of hypertension (average systolic and/or diastolic blood pressure > 95th percentile for age and sex) was 5.1%. In multivariate logistic regression analysis, certain groups of Kuwaiti schoolchildren were much more likely to develop hypertension. They included children whose parents were consanguineous, children with a family history of hypertension and obese children.

Hypertension and its determinants among primary-school children in Kuwait: an epidemiological study

A multistage, stratified random sample of 1312 students [aged 6-10 years] was selected from the five regions in Kuwait. Parents were interviewed and weight, height and urine analysis of the children were taken. Blood pressure was measured on at least three separate occasions. The overall prevalence of hypertension [average systolic and/or diastolic blood pressure > 95th percentile for age and sex] was 5.1%. In multivariate logistic regression analysis, certain groups of Kuwaiti schoolchildren were much more likely to develop hypertension. They included children whose parents were consanguineous, children with a family history of hypertension and obese children

Successful term pregnancy following conservative debulking surgery for a stage IIIA serous low-malignant-potential tumor of the ovary: a case report.

Low-malignant-potential tumors of the ovary can occur in young women of childbearing age. Often these tumors are early stage and confined to the ovary at diagnosis allowing for fertility-preserving surgery. This case report describes a 25-year-old woman who presented with an advanced-stage metastatic LMP tumor and who underwent successful tumor debulking while preserving normal ovarian function. A successful spontaneous pregnancy occurred subsequently and the patient has remained well with 2 years of follow-up.

Influence of dietary lysine levels and arginine:lysine ratios on performance of broilers exposed to heat or cold stress during the period of three to six weeks of age.

Four trials of identical experimental design were conducted to determine the effects of temperature, dietary Lys level, and dietary Arg:Lys ratios on performance and carcass yield of male broilers. Birds of a commercial strain were grown from 21 to 42 d of age in wire-floored finishing batteries placed in environmental chambers. The chambers were programmed to provide either a constant thermoneutral temperature (21.1 C), a constant cold temperature (15.5 C), or a cycling hot diurnal temperature (25.5 to 33.3 C). Within each environment there was a factorial arrangement of three Lys levels (1.0, 1.1, and 1.2%) with four Arg:Lys ratios (1.1:1, 1.2:1, 1.3:1, and 1.4:1). Environmental temperature significantly influenced virtually every characteristic examined. Hot cyclic temperatures reduced weight gain, feed intake, and breast meat yield, and increased feed conversion, dressing percentage, leg quarter yield, and abdominal fat content. The cold environment promoted increased feed intake and mortality. Ascites and cardiomyopathy were the leading causes of death under cold exposure and thermoneutral conditions, whereas complications arising from heat exposure were the main cause of death under hot cyclic conditions. Levels of Lys affected leg quarter yield and abdominal fat content over all environments but increased breast meat yield only under cold conditions. Increasing Arg:Lys ratios improved feed conversion and dressing percentage and reduced abdominal fat content; it could not be determined whether these responses were consistent with Arg per se or were due to a nonspecific N response. As increasing Lys levels or Arg:Lys ratios did not improve weight gain, increase breast meat yield, or attenuate adverse effects due to heat or cold exposure, it is concluded that the levels of Lys and Arg suggested for 21 to 42 d by the NRC are adequate for birds of this age under the environmental conditions encountered.

Normal hearing in acoustic neuroma patients: a critical evaluation.

A series of 128 acoustic neuromas (ANs) managed in our center in the last 6 years were evaluated. Sixteen cases (12.5%) were found to have normal pure tone audiograms. A comparatively younger age was an important characteristic of these patients. Tinnitus, dysequilibrium, and subjective hearing loss or distortion were their most common complaints. Pure tone audiometry showed a mean pure tone average of 14.5 dB. Speech discrimination score and performance intensity phonetically balanced index were very insensitive and showed very high false-negative results. Auditory brainstem responses proved to be a reliable test, being positive in 93.8% of cases. The mean tumor size did not show any significant difference when compared with acoustic neuroma cases with abnormal hearing. The combination of otologic and neurotologic symptoms in a young patient should prompt the clinician to investigation further even if hearing is within normal limits. A high index of suspicion is a prerequisite for the early diagnosis of such subtle lesions.

Lateral approaches to the median skull base through the petrous bone: the system of the modified transcochlear approach.

Twenty-three patients with intradural lesions of the petroclival region and prepontine cistern were managed in our centres by the modified transcochlear approach. Total tumour removal was accomplished in 17 patients, while a second stage was planned for the remaining six patients. Two cases died in the immediate post-operative period. All the remaining cases showed a good outcome and returned to work. The basic approach type A is further classified according to its anterior, superior and inferior extension into types B, C and D respectively. The surgical procedure, classification, illustrative case reports and patients' summaries are presented.

Giant cell tumor of the lateral skull base: a case report.

Giant cell tumors of the temporal bone are very rare lesions. They should be differentiated from other giant cell lesions of bone, mainly reparative granulomas. A case with a very huge giant cell tumor of the temporal bone extending to the infratemporal fossa, temporomandibular joint, and greater wing of the sphenoid has been presented. Because of their tendency for recurrence, total removal is the treatment of choice for these tumors and was accomplished through the infratemporal fossa approach type B. A follow-up of 2 years and 9 months revealed no evidence of tumor recurrence.

Management of the high jugular bulb in the translabyrinthine approach.

A high jugular bulb is a frequent problem in the translabyrinthine approach. This article described a safe technique for effective inferior displacement of the high bulb.

Posterior fossa meningioma: surgical strategy.

Posterior fossa meningioma is the second most common tumor in the cerebellopontine angle. It has a higher rate of postoperative morbidity and mortality compared to acoustic neuroma. Forty posterior fossa meningioma patients managed in our centers were reviewed. Thirty-nine patients were managed surgically with 42 surgical procedures. The approaches used were the translabyrinthine approach in 18 patients (43%), the modified transcochlear in 11 cases (26%), the petro-occipital transsigmoid in 5 cases (12%), the suboccipital in 4 cases (10%), the petro-occipital trassigmoid transcervical in 2 cases (5%), the petro-occipital transsigmoid transtentorial in 1 case (2%), and a subtemporal transtentorial for another case (2%). Facial nerve anatomical integrity was preserved in 87% of procedures but was interrupted in 5 cases, with 4 of the latter subsequently repaired. Total tumor removal was accomplished in 38 cases. A second-stage total tumor removal is planned for the remaining case. There was only one case of perioperative death and no cases of radiological recurrence so far.

Dynamic of antibiotic accumulation by Streptomyces aureofaciens in a laboratory fermentor.

In a laboratory fermentor, the growth of Streptomyces aureofaciens on corn meal extract and its production of antibiotic was investigated. Weak biosynthesis of the antibiotic started after 12 hours of incubation, when phosphorus depletion in the medium occurred. During the third and fourth day of fermentation about 80.4% of the antibiotic was produced. The relationship between growth, antibiotic formation, and the uptake of both sugar and nitrogen was also studied. A chromatogram, showing the types of sugar present during fermentation period is given. Improvement of antibiotic accumulation either by adding sugar at the end of the logarithmic phase of growth or by determining the rate of aeration is also discussed.

Purification and identification of Streptomyces aureofaciens lD13 antibiotic.

Complete extraction of S. aureofaciens lD13 antibiotic was achieved by adding n-butanol to the clarified culture filtrate (v/2v) at pH 8.0. Using the column chromatography technique, 85.7% of the initial amount of the antibiotic was obtained in a purified form. Data of the Rf values of the antibiotic in different organic solvents revealed that it belongs to the tetracycline group. The antibiotic was chromatographically analyzed, using the thin-layer technique. UV and IR spectra, optical rotation, melting point as well as 15 colour reactions were also determined.