Bimetallic bis-Aroyldihydrazone-Isatin Complexes of High O=V(IV) and Low Cu(II) Valent Ions as Effective Biological Reagents for Antimicrobial and Anticancer Assays.

Due to the versatile bioreactivity of aroyldihydrazone complexes as cost-effective alternatives with different transition metals, two novel bimetallic homo-complexes (VOLph and CuLph) were prepared via the coordination of a terephthalic dihydrazone diisatin ligand (H2Lph) with VO2+ and Cu2+ ions, respectively. The structure elucidation was confirmed by alternative spectral methods. Biologically, the H2Lph ligand and its MLph complexes (M2+ = VO2+ or Cu2+) were investigated as antimicrobial and anticancer agents. Their biochemical activities towards ctDNA (calf thymus DNA) were estimated using measurable titration viscometrically and spectrophotometrically, as well as the gel electrophoresis technique. The growth inhibition of both VOLph and CuLph complexes against microbial and cancer cells was measured, and the inhibition action, MIC, and IC50 were compared to the inhibition action of the free H2Lph ligand. Both VOLph and CuLph showed remarkable interactive binding with ctDNA compared to the free ligand H2Lph, based on Kb = 16.31, 16.04 and 12.41 × 107 mol-1 dm3 and ΔGb≠ = 47.11, -46.89, and -44.05 kJ mol-1 for VOLph, CuLph, and H2Lph, respectively, due to the central metal ion (VIVO and CuII ions). VOLph (with a higher oxidation state of the V4+ ion and oxo-ligand) exhibited enhanced interaction with the ctDNA molecule compared to CuLph, demonstrating the role and type of the central metal ion within the performed electronegative and electrophilic characters.

Nucleoside Scaffolds and Carborane Clusters for Boron Neutron Capture Therapy: Developments and Future Perspective.

Nucleosides containing carboranes are one of the most important boron delivery agents for boron neutron capture therapy, BNCT, which are good substrates of hTK1. The development of several nucleosides containing carboranes at early stages led to the discovery of the first generation of 3CTAs by incorporating a hydrocarbon spacer between the thymidine scaffold and carborane cluster and attaching dihydroxylpropyl group on the second carbon (C2) atom of the carborane cluster (e.g., N5 and N5-2OH). Phosphorylation rate, tumor cellular uptake, and retention have been evaluated in parallel to change the length of the tether arm of spacers in these compounds. Many attempts were reported and discussed to overcome the disadvantage of the first generation of 3CTAs by a) incorporating modified spacers between thymidine and carborane clusters, such as ethyleneoxide, polyhydroxyl, triazole, and tetrazole units, b) attaching hydrophilic groups at C2 of the carborane cluster, c) transforming lipophilic closo-carboranes to hydrophilic nidocarborane. The previous modifications represented the second generation of 3CTAs to improve the hydrogen bond formation with the hTK1 active site. Moreover, amino acid prodrugs were developed to enhance biological and physicochemical properties. The structure-activity relationship (SAR) of carboranyl thymidine analogues led to the roadmap for the development of the 3rd generation of the 3CTAs for BNCT.

Bioreactivity of divalent bimetallic vanadyl and zinc complexes bis-oxalyldihydrazone ligand against microbial and human cancer series. ctDNA interaction mode.

Two novel divalent bimetallic complexes were constructed from the complexation of O=V4+ and Zn2+ ions (VOL and ZnL), respectively, with diisatin oxalyldihydrazone ligand (H2L). Various spectroscopic tools were used to confirm their chemical structures (FT-IR, NMR, EI-Mass, and electronic spectra), besides, elemental analyses and conductivity features. To estimate the role of divalent metal ions in their coordination compound for developing their bio-reactivity, the free ligand H2Lox, and its complexes (VOL and ZnL) were employed spectroscopic investigations against the growth of some microbial series (fungi and bacteria) and also against three human cancer/normal cells. Furthermore, their interaction behavior against calf thymus DNA (ctDNA) was studied through viscometric and spectrophotometric studies to discover the role of O=V4+ and Zn2+ ions to determine the mode of binding with ctDNA. The inhibiting effect of H2L, VOL, and ZnL versus the titled microbial (bacterial and fungal) was built upon their inhibited zone areas in mm and the MIC concentrations in µM. Their action against the three human cancer cells' growth was evaluated by IC50 values in µM and the selectivity index in percentage. Both VOL and ZnL complexes exhibited an amazing series with three human cancer cell growth (according to the zone values in mm of inhibition, MIC in µM, and IC50 values in µM) compared to those of their uncoordinated H2L ligand. VOL demonstrated a distinguished interacting behavior with ctDNA more than that interaction of ZnL depending on the variation of the central metal ion chemical features. Within the covalent and non-covalent interaction modes, the interaction binding between H2L, VOL, and ZnL with ctDNA was discussed based on the electronic spectroscopic observation.

Anticorrosion Evaluation of Novel Water-Soluble Schiff Base Molecules for C1018 Steel in CO2-Saturated Brine by Computational and Experimental Methodologies.

In this work, three different derivatives of Schiff base, as mono- and di-Schiff bases, were successfully synthesized by the facile condensation of 2-aminopyridine, o-phenylenediamine, or 4-chloro-o-phenylenediamine with sodium salicylaldehyde-5-sulfonate (H1, H2, and H3, respectively). A combination of theoretical and practical studies was accomplished on the corrosion mitigation effect of the prepared Schiff base derivatives on C1018 steel in CO2-saturated 3.5% NaCl solution. The corrosion inhibition effect of the synthesized Schiff base molecules was studied by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PDP) methods. The outcomes exhibited that Schiff base derivatives have an outstanding corrosion inhibition effect on carbon steel at particularly low concentrations in sweet conditions. The outcomes showed that Schiff base derivatives exhibited a satisfactory inhibition efficiency of 96.5% (H1), 97.7% (H2), and 98.1% (H3) with a dosage of 0.5 mM at 323 K. SEM/EDX analysis confirms the adsorbed inhibitor film's formation on the metal surface. The polarization plots indicate that the studied compounds behaved as inhibitors of the mixed type according to the isotherm model of Langmuir. The computational inspections (MD simulations and DFT calculations) display a good correlation with the investigational findings. The outcomes could be applied to assess the efficiency of the inhibiting agents in the gas and oil industry.

Photocatalytic removal of imidacloprid containing frequently applied insecticide in agriculture industry using Co3O4 modified MoO3 composites.

Water pollution caused by the frequent utilization of pesticides in the agriculture industry is one of the major environmental concerns that require proper attention. In this context, the photocatalytic removal of pesticides from contaminated water in the presence of metallic oxide photocatalysts is quite in approach. In the present study, Orthorhombic MoO3 has been modified with varying amount of cobalt oxide through wet impregnation for the removal of imidacloprid and imidacloprid-containing commercially available insecticide. The solid-state absorption response and band gap evaluation of synthesized composites revealed a significant extension of absorption cross-section and absorption edge in the visible region of the light spectrum than pristine MoO3. The indirect band gap energy varied from ∼2.88 eV (MoO3) to ∼2.15 eV (10% Co3O4-MoO3). The role of Co3O4 in minimizing the photo-excitons' recombination in MoO3 was studied using photoluminescence spectroscopy. The orthorhombic shape of MoO3 was confirmed through X-ray diffraction analysis and scanning electron microscopy. Moreover, the presence of distinct absorption edges and diffraction peaks corresponding to Co3O4 and MoO3 in absorption spectra and XRD patterns, respectively verified the composite nature of 10% Co3O4-MoO3. The photocatalytic study under natural sunlight irradiation showed higher photocatalytic removal (∼98%) of imidacloprid with relatively higher rate by 10% Co3O4-MoO3 composite among all contestants. Furthermore, the photocatalytic removal (∼93%) of commercially applied insecticide, i.e., Greeda was also explored.

The diagnostic trajectories of Danish patients with autoimmune rheumatologic disease associated interstitial lung disease: an interview-based study.

Background: Autoimmune rheumatologic disease associated interstitial lung diseases (ARD-ILD) are rare conditions and the association between ARDs and respiratory symptoms often goes unrecognised by ARD patients and general practitioners (GPs). The diagnostic trajectory from the first respiratory symptoms to an ARD-ILD diagnosis is often delayed and may increase the burden of symptoms and allow further disease progression.The aim of this study was to 1) characterise the diagnostic trajectories of ARD-ILD patients and to 2) identify barriers for obtaining a timely ILD diagnosis based on the experiences and perceptions of both patients and healthcare professionals. Method: Semi-structured qualitative interviews were conducted with Danish ARD-ILD patients, rheumatologists, pulmonologists and ILD nurses. Results: Sixteen patients, six rheumatologists, three ILD nurses and three pulmonologists participated. Five characteristics of diagnostic trajectories were identified in the patient interviews: 1) early referral to lung specialists; 2) early delay; 3) delay or shortcut depending on specific circumstances; 4) parallel diagnostic trajectories connected late in the process; 5) early identification of lung involvement without proper interpretation. With the exception of early referral to lung specialists, all of the diagnostic trajectory characteristics identified led to delayed diagnosis. Delayed diagnostic trajectories resulted in patients experiencing increased uncertainty. Inconsistent disease terminology, insufficient knowledge and lack of awareness of ARD-ILD among central healthcare professionals and delayed referral to ILD specialists were main contributors to the diagnostic delay identified by the informants. Conclusion: Five characteristics of the diagnostic trajectories were identified, four of which led to diagnostic delay of ARD-ILD. Improved diagnostic trajectories can shorten the diagnostic trajectory and increase early access to appropriate specialist medical care. Improved awareness and expertise in ARD-ILD across different medical specialties, especially among GPs, may contribute to more efficient and timely diagnostic trajectories and improved patient experiences.

Levels of trace elements and rare earth elements in honey from Jordan.

Honey is a common sweetener in the Jordanian diet with an annual consumption of approximately one thousand tons, two-thirds of which are imported. It is believed that the elemental profile of honey is an indicator of safety and botanical and geographic origin. In the literature, there are a lack of studies concerning the levels of major and trace elements in honey in Jordan. A total of 46 elements, including 15 rare earth elements (REEs), were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) in 18 monofloral and multifloral imported honey samples and 12 multifloral local samples. Regarding monofloral samples, Black Forest samples had the highest total metal content, while acacia samples had the lowest total metal content. Local multifloral honey had the largest Sr and total REE levels, while it had the lowest Mn levels. Very low levels of toxic elements were found in all samples, indicating the safety of honey in Jordan for human consumption. The results of this study showed that a large number of samples (> 100) and the application of advanced statistical models are required to discriminate between multifloral imported and local honey.

Turnover of type I and III collagen predicts progression of idiopathic pulmonary fibrosis.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is characterized by the accumulation of fibrillar collagens in the alveolar space resulting in reduced pulmonary function and a high mortality rate. Biomarkers measuring the turnover of type I and III collagen could provide valuable information for prognosis and treatment decisions in IPF. METHODS: Serological biomarkers reflecting the formation of type III collagen (PRO-C3) and degradation of type I (C1M) and III collagen (C3M) were evaluated in a real-world cohort of 178 newly diagnosed IPF patients. Blood samples and clinical data were collected at baseline, six, and 12 months. Baseline and longitudinal biomarker levels were related to disease progression of IPF (defined as ≥ 5% decline in forced vital capacity (FVC) and/or ≥ 10% decline in diffusing capacity for carbon monoxide (DLco) and/or all-cause mortality at 12 months). Furthermore, we analysed differences in percentage change of biomarker levels from baseline between patients receiving antifibrotic treatment or not. RESULTS: Increased baseline levels of type I and III collagen turnover biomarkers were associated with a greater risk of disease progression within 12 months compared to patients with a low baseline type I and III collagen turnover. Patients with progressive disease had higher serum levels of C1M (P = 0.038) and PRO-C3 (P = 0.0022) compared to those with stable disease over one year. There were no differences in biomarker levels between patients receiving pirfenidone, nintedanib, or no antifibrotics. CONCLUSION: Baseline levels of type I and III collagen turnover were associated with disease progression within 12 months in a real-world cohort of IPF patients. Longitudinal biomarker levels of type I and III collagen turnover were related to progressive disease. Moreover, antifibrotic therapy did not affect type I and III collagen turnover biomarkers in these patients. PRO-C3 and C1M may be potential biomarkers for a progressive disease behavior in IPF.

Synthesis, spectral characterization, DFT calculations, pharmacological studies, CT-DNA binding and molecular docking of potential N, O-multidentate chelating ligand and its VO(II), Zn(II) and ZrO(II) chelates.

The pharmacological efficacy of the variety tetradentate ligands encouraged us to design attractive compounds through effective synthetic procedure. The prepared Schiff base ligand 6,6'-((1E,1'E)-((4-chloro-1,2-phenylene)bis(azaneylylidene))bis(methaneylylidene))bis(2-ethoxy phenol (H2L), which derived from 4-chloro-o-phenylenediamine and 3-ethoxy-salicylaldehyde and its VO(II), Zn(II) and ZrO(II) metal chelates, have been synthesized and characterized with aim of that it may struggle the invasion of drug resistance. The chemical structural of studied compounds were discussed by TGA, elemental analysis, UV-Vis., 1H NMR, 13C NMR, FTIR, mass spectral, PXRD, molar conductance, magnetic susceptibility measurements and density functional theory. The results assigned square pyramid geometries for [VOL] and [ZrOL].2H2O chelates and an octahedral geometry for [ZnL(H2O)2].2H2O chelate. Powder XRD data showed that the complexes are monoclinic with polycrystalline nature. The results of CT-DNA interaction with the titled chelates showed that the binding between CT-DNA and the metal complexes occurs through intercalation mode. Their CT-DNA binding efficiency estimated in terms of their binding constants (Kb), which gave the order: VOL (6.9 × 105) > ZrOL (6.3 × 105) > ZnL(H2O)2 (5.5 × 105). The antimicrobial activities of the synthesized compounds were tested against selected fungal and bacterial strains using well diffusion technique. The obtained chelates showed higher antifungal and antibacterial activities than their corresponding ligand. Furthermore, the M-complexes showed higher potent cytotoxic effect toward HEK-293, human colorectal HepG-2, HCT-116 and MCF-7 adenocarcinoma cell lines compared to the free H2L ligand. Investigation of antioxidant property represented that all the prepared complexes have better radical scavenging potencies against DPPH radicals than the free H2L ligand. To study the molecular docking of proposed compounds versus Tyrosine kinases receptor (TKR), we used AutoDock1.5.6rc3® suite. The current compounds (H2L, VOL, ZrOL and ZnL(H2O)2) and STI were found to bind with C-kit of TKR with HBs at ILE789.A, ILE808.A, ASP810.A, GLU640.A and TYR846 amino acid residue and the binding energies were - 8.9, -8.93, -8.83, -1.48 and -10.39 kcal/mol respectively.

The First Egyptian Report Showing the Co-Existence of bla NDM-25, bla OXA-23, bla OXA-181, and bla GES-1 Among Carbapenem-Resistant K. pneumoniae Clinical Isolates Genotyped by BOX-PCR.

BACKGROUND AND OBJECTIVE: The emergence of carbapenem-resistant K. pneumoniae (CRKP) continues to escalate and is alarming because of the emergence of pan drug-resistant strains. The objective of this study was to investigate the existence of 12 carbapenemase genes among CRKP clinical isolates. METHODS: Ninety-six Klebsiella spp. clinical isolates were collected. The isolates were identified phenotypically and genotypically. These isolates were screened for susceptibility to 24 different antibiotics. The modified Hodge test (MHT) and the Carba Nordmann/Poirel (NP) test were used to phenotypically screen carbapenem-resistant strains for carbapenemase production. Phenotypic characterization of carbapenemases was performed using the combined disk synergy test (CDST). Additionally, the presence of 12 carbapenemase genes in CRKP isolates was investigated. The DNA sequence of bla NDM and bla GES genes was determined. The BOX-PCR technique was used to determine the clonal relationship between CRKP isolates. RESULTS: All carbapenem-resistant isolates were related to K. pneumoniae. Susceptibility testing showed that 19.79% (19/96) of the collected isolates were carbapenem-resistant. Of the CRKP isolates, 68.42% (13/19) tested positive for the MHT and Carba NP test. CDST showed that 42.11% (8/19), 63.16% (12/19), 47.37% (9/19), and 73.68% (14/19) of the CRKP isolates tested positive for the inhibitory effect of clavulanic acid, sulbactam, phenylboronic acid, and tazobactam, respectively, while 84.21% (16/19) and 68.42% (13/16) tested positive for the inhibitory effect of EDTA and mercaptopropionic acid, respectively. It was found that 10.53% (2/19) of the isolates tested positive for the inhibitory effect of sodium chloride. Molecular investigation of carbapenemases showed that 26.32% (5/19), 73.68% (14/19), 21.05% (4/19), 10.53% (2/19), and 5.26% (1/19) of the isolates tested positive for bla NDM, bla OXA-48, bla OXA-181, bla OXA-51, and bla OXA-23, respectively. None of the isolates tested positive for bla OXA-40 and bla OXA-58. Two allelic variants of bla NDM (bla NDM-1 and bla NDM-25) were detected. BOX-PCR revealed high clonal relatedness between CRKP isolates. CONCLUSION: MHT was more sensitive than Carba NP test for evaluating carbapenemase production and class D carbapenemase genes were the most prevalent of the 12 carbapenemase genes that were evaluated.

Biological and catalytic potential of sustainable low and high valent metal-Schiff base sulfonate salicylidene pincer complexes.

ONO-Pincer Schiff base salicylidene (HSaln ligand) complexes with VO2+, UO2 2+, MoO2 2+ and Mn2+ ions (MSaln complexes = VOSaln, UO2Saln, MoO2Saln and MnSaln, respectively) were synthesized and fully characterized by different physico-chemical tools. The VOSaln complex was further treated with 1,10-phenanthroline which afforded a new VO-complex (VOSaln-Ph). All complexes and their ligands, as eco-friendly reagents, were explored for their biological potential as antibacterial and antifungal agents. Reactivity of MSaln complexes against the tested pathogen strains exhibited a remarkable inhibitory effect compared to the coordinated ligand (HSaln) and applicable standard drugs. Moreover, the MSaln complex-DNA interaction was investigated by ultraviolet-visible spectroscopy, viscosity and gel electrophoresis techniques affording binding strengths in the order: UO2Saln > MnSaln > MoO2Saln > VOSaln-Ph > VOSaln. Additionally, the biological potential of the investigated compounds was further explored by molecular docking to illustrate the nature of the drug-DNA interactions. All MSaln complexes show respectable anti-proliferative potential as anticancer agents against selected human carcinoma cell lines. Aside from the biological activities these complexes (MSaln complexes) were also investigated for catalytic efficiency in the Suzuki-Miyaura cross-coupling system of phenylboronic acid with 2-bromopyridine in water, sustainably. The results indicated that the MnSaln catalyst performed well with high yield. The catalytic potential of MnSaln was compared in water, water-ionic liquid mixtures and ionic liquids.

Biological potential of oxo-vanadium salicylediene amino-acid complexes as cytotoxic, antimicrobial, antioxidant and DNA interaction.

New series of oxo-vanadium N-salicyledieneamino acid Schiff base complexes are synthesized and characterized. They are synthesized from the reaction of sodium salicylaldehyde-5-sulfonate, some amino acids, alanine (VOHL1), leucine (VOHL2) or glycine (VOHL3) in an aqueous media, and leucine (VOHLpy1) or tryptophan (VOHLpy2) in pyridine with vanadyl acetylacetonate. The complexes are characterized by EA, TGA, IR, UV-Visible and mass spectra, conductivity and magnetic measurements. The biological activity of the VO-complexes shows that VOHL1, VOHL2 and VOHL3 exhibit anti-proliferative effect and may be used as anticancer drugs. VO-complexes manifest high toxicity, except VOHL2 is less toxic, and could be applied for the human being. VOHL1, VOHL2 and VOHL3 display remarkable SOD like potential and act as high inhibiting reagents. VOHLpy1 and VOHLpy2 show low inhibiting potentials. VO-complexes have good anti-oxidant effect, in which VOHL3 affords the best antioxidant activity. The interaction between VO-complexes and DNA is studied spectrophotometrically and by gel electrophoresis. Binding constants and spectrophotometric parameters indicate a strong interaction between VO-complexes and DNA. VO-complexes have respectable anti-bacterial and antifungal activities, where VOHL3 shows the maximum potential. DFT calculations of VOHL1 and VOHL3 were discussed in the light of their biological activity, which are convenient with the obtained results.

3H-1,3-Azaphospholo[4,5-b]pyridines--novel heterocyclic P,N-bridging or hybrid ligands: synthesis and first d(8)-transition metal complexes.

The first 3H-1,3-azaphospholo-pyridines 2a-c were synthesized as racemic mixtures in modest to medium yield by the reaction of N-(2-chloropyrid-3-yl)-trimethylacetimidoyl chloride 1 with RPLi2 (R = Ph, n-Bu, i-Bu), generated from RPH2 and BuLi in THF at -70 °C, and studied with respect to their suitability as ligands (L) in transition metal complexes. Reactions of 2a with group 6 metal(0) pentacarbonyls led to P-coordinated LM(CO)5 complexes 3a-5a (Cr, Mo, W) and the reaction of 2c with (norbornadiene)Mo(CO)4 surprisingly to 4c. [Rh(1,5-COD)Cl]2 and 2a,b, in metal/ligand ratio 1 : 1, furnished LRh(1,5-COD)Cl complexes 6a,b with P-coordination, 6b accompanied by a minor contamination by the bis-coordinated L[Rh(COD)Cl]2 complex 7b. Reactions of 2a,b with [(allyl)PdCl]2 proceeded in THF with dismutation of N-coordinated (allyl)PdCl and formed with 2a a labile crude product [(2a){(allyl)PdCl}1.2(PdCl2)0.8]·C4H8O, with the composition close to L[Pd(allyl)Cl]PdCl2 THF (8a·THF), which converted during crystallization to 9a, whereas 2b directly formed the N,N'-PdCl2-bridged bis[LPd(allyl)chloride] complex 9b. Conversion of 2b with equimolar amounts of Pd(CH3CN)2Cl2 in THF, or Na2PdCl4 in methanol, gave rise to the dimeric P,N-bridging complex 10b. Crystal structure analyses of 6a (rac), 9b·2CDCl3 (meso), 10b·4.5THF and 10b·2D6-acetone (rac) provided detailed structural information. 10b, but more efficiently complexes formed in situ from 2a,b and Pd2(DBA)3 or Pd(OAc)2, catalysed the arylamination of 2-bromopyridine with 2,4,6-trimethylaniline.

Lung nodule volumetry: segmentation algorithms within the same software package cannot be used interchangeably.

OBJECTIVE: We examined the reproducibility of lung nodule volumetry software that offers three different volumetry algorithms. METHODS: In a lung cancer screening trial, 188 baseline nodules >5 mm were identified. Including follow-ups, these nodules formed a study-set of 545 nodules. Nodules were independently double read by two readers using commercially available volumetry software. The software offers readers three different analysing algorithms. We compared the inter-observer variability of nodule volumetry when the readers used the same and different algorithms. RESULTS: Both readers were able to correctly segment and measure 72% of nodules. In 80% of these cases, the readers chose the same algorithm. When readers used the same algorithm, exactly the same volume was measured in 50% of readings and a difference of >25% was observed in 4%. When the readers used different algorithms, 83% of measurements showed a difference of >25%. CONCLUSION: Modern volumetric software failed to correctly segment a high number of screen detected nodules. While choosing a different algorithm can yield better segmentation of a lung nodule, reproducibility of volumetric measurements deteriorates substantially when different algorithms were used. It is crucial even in the same software package to choose identical parameters for follow-up.

Exploring the role of CT densitometry: a randomised study of augmentation therapy in alpha1-antitrypsin deficiency.

Assessment of emphysema-modifying therapy is difficult, but newer outcome measures offer advantages over traditional methods. The EXAcerbations and Computed Tomography scan as Lung End-points (EXACTLE) trial explored the use of computed tomography (CT) densitometry and exacerbations for the assessment of the therapeutic effect of augmentation therapy in subjects with alpha(1)-antitrypsin (alpha(1)-AT) deficiency. In total, 77 subjects (protease inhibitor type Z) were randomised to weekly infusions of 60 mg x kg(-1) human alpha(1)-AT (Prolastin) or placebo for 2-2.5 yrs. The primary end-point was change in CT lung density, and an exploratory approach was adopted to identify optimal methodology, including two methods of adjustment for lung volume variability and two statistical approaches. Other end-points were exacerbations, health status and physiological indices. CT was more sensitive than other measures of emphysema progression, and the changes in CT and forced expiratory volume in 1 s were correlated. All methods of densitometric analysis concordantly showed a trend suggestive of treatment benefit (p-values for Prolastin versus placebo ranged 0.049-0.084). Exacerbation frequency was unaltered by treatment, but a reduction in exacerbation severity was observed. In patients with alpha(1)-AT deficiency, CT is a more sensitive outcome measure of emphysema-modifying therapy than physiology and health status, and demonstrates a trend of treatment benefit from alpha(1)-AT augmentation.

Quantitative assessment of regional emphysema distribution in patients with chronic obstructive pulmonary disease (COPD).

PURPOSE: To compare objective and subjective assessment of the distribution of emphysema in unselected patients with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: 167 patients were computed tomography (CT) scanned, and the relative area (RA-910) of emphysema in each CT slice was plotted against table position. The craniocaudal distribution was calculated as the slope of the regression line, and grouped as upper-lung-zone predominance (ULP), lower-lung-zone predominance (LLP), or mild/homogeneous distribution (MHE). CT scans were also classified as ULP, LLP, and MHE based on visual assessment of three high-resolution CT (HRCT) slices, and the leading pattern of emphysema was classified as centrilobular (CLE), paraseptal (PSE), panlobular (PLE), or no emphysema (NE). RESULTS: By objective classification, scans were divided into almost equal numbers of ULP, LLP, and MHE, whereas visual evaluation classified more scans as ULP (P<0.001) and very few as LLP (P<0.0001). In patients with CLE, 49% had ULP by objective classification, whereas LLP was the commonest leading pattern in PSE, PLE, and NE. CONCLUSION: We found significant discrepancies between the objective and subjective distributions of emphysema in various morphological patterns, which may be of clinical importance in, for instance, lung-volume-reduction surgery.

Blood transfusion and resuscitation using penile corpora: an experimental study.

OBJECTIVES: To test the feasibility of using the penile corpora cavernosa for blood transfusion and resuscitation purposes. METHODS: Three male donkeys were used for autologous blood transfusion into the corpus cavernosum during three sessions with a 1-week interval between each. Two blood units (450 mL each) were transfused per session to each donkey. Moreover, three dogs were bled up until a state of shock was produced. The mean arterial blood pressure decreased to 60 mm Hg. The withdrawn blood (mean volume 396.3 mL) was transfused back into their corpora cavernosa under 150 mm Hg pressure. Different transfusion parameters were assessed. The Assiut faculty of medicine ethical committee approved the study before its initiation. RESULTS: For the donkey model, the mean time of blood collection was 12 minutes. The mean time needed to establish corporal access was 22 seconds. The mean time of blood transfusion was 14.2 minutes. The mean rate of blood transfusion was 31.7 mL/min. Mild penile elongation with or without mild penile tumescence was observed on four occasions. All penile shafts returned spontaneously to their pretransfusion state at a maximum of 5 minutes after cessation of blood transfusion. No extravasation, hematoma formation, or color changes occurred. Regarding the dog model, the mean rate of transfusion was 35.2 mL/min. All dogs were resuscitated at the end of the transfusion. CONCLUSIONS: The corpus cavernosum is a feasible, simple, rapid, and effective alternative route for blood transfusion and venous access. It can be resorted to whenever necessary. It is a reliable means for volume replacement and resuscitation in males.

Quantitative computed tomography and aerosol morphometry in COPD and alpha1-antitrypsin deficiency.

Relative area of emphysema below -910 Hounsfield units (RA-910) and 15th percentile density (PD15) are quantitative computed tomography (CT) parameters used in the diagnosis of emphysema. New concepts for noninvasive diagnosis of emphysema are aerosol-derived airway morphometry, which measures effective airspace dimensions (EAD) and aerosol bolus dispersion (ABD). Quantitative CT, ABD and EAD were compared in 20 smokers with chronic obstructive pulmonary disease (COPD) and 22 patients with alpha1-antitrypsin deficiency (AAD) with a similar degree of airway obstruction and reduced diffusion capacity. In both groups, there was a significant correlation between RA-910 and PD15 and pulmonary function tests (PFTs). A significant correlation was also found between EAD, RA-910 and PD15 in the study population as a whole. Upon separation into two groups, the significance disappeared for the smokers with COPD and strengthened for those with AAD, where EAD correlated significantly with RA-910 and PD15. ABD was similar in the two groups and did not correlate with PFT and quantitative CT in either group. In conclusion, based on quantitative computed tomography and aerosol-derived airway morphometry, emphysema was significantly more severe in patients with alpha1-antitrypsin deficiency compared with patients with usual emphysema, despite similar measures of pulmonary function tests.

Alpha1-antitrypsin deficiency. 7: Computed tomographic imaging in alpha1-antitrypsin deficiency.

Computed tomographic scanning may replace lung function tests as the golden standard for assessing the response to known and novel treatments for alpha1-antitrypsin deficiency.