Satisfactory functional results and complication rates after anterior glenoid bone block reconstruction in recurrent shoulder dislocation: a mean 4-year follow-up comparative study.

BACKGROUND: Anterior recurrent instability of the glenohumeral joint is a common clinical problem among the young population. Glenoid reconstruction with bone graft has become the treatment of choice, particularly in significant deficiency (˃20%). This study aims to assess the functional results of glenoid reconstruction using Latarjet and iliac bone graft in the management of glenoid insufficiency associated with recurrent anterior dislocation of the glenohumeral joint. METHODS: Patients suffering from anterior shoulder instability with glenoid defect >20% were included in this study between 2016 and 2021. The university of California at Los Angeles (UCLA) shoulder scale and Constant score were used to assess the functional improvement. Preoperative and final postoperative continuous outcomes were compared with a one-tailed paired t-test and the outcomes across groups were compared using a two-tailed independent t-test. A P-value of <0.05 was considered statistically significant for both tests. RESULTS: This trial included 50 patients; twenty-five underwent mini-open Latarjet, and 25 underwent arthroscopic tricortical iliac crest bone grafting (ICBG). The mean follow-up durations were 50.1 ± 5.9 months for Laterjet and 51.6 ± 6.8 months for ICBG. Both techniques showed statistically significant improvement in the final UCLA (31.1 ± 2.1 in Laterjet and 30.2 ± 2.2 in ICBG) and Constant (90.2 ± 4.6 in Laterjet and 89 ± 5.01 in ICBG) scores. There was no statistically significant difference regarding mean age, sex, side of injury, mechanism of injury, follow-up period and clinical outcome between both surgical treatments. At the end of the study, both groups demonstrated statistically significant improvement in the range of motion (p Ë‚ 0.00001). Only one, non-adherent patient in Laterjet group had post-operative dislocation. In ICBG group, two patients had partial bone graft resorption, 3 graft site morbidities and 1 hardware prominence. CONCLUSION: Both Laterjet and iliac bone graft procedures had satisfactory functional results in reconstruction of glenoid defect >20% in unstable shoulders with a mean 4-year follow-up. No statistically significant difference was reported in the last postoperative Constant and UCLA scores between both techniques, but Latarjet procedure had fewer complications (4%) than ICBG (24%). LEVEL OF EVIDENCE: Prospective non-randomized comparative study; level II.

3-Dimensional fasciectomy: A highly efficacious common ground approach to Dupuytren's surgery.

BACKGROUND: Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. METHODS: We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3-5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue). The surgical outcomes between traditional limited fasciectomy (LF) and 3DF are compared. RESULTS: From the 786 operations included (n=585), postoperative recurrence rates were significantly lower for the 3DF group (2/145, 1.4%) than the LF group (72/641, 11.2%) (P=0.001), and the time to recurrence was significantly longer (5.0±0 years vs. 4.0±0.2 years; P<0.0001). With recurrence excluded, there were no differences between the postoperative complication rates for 3DF (5/145, 3.5%) and LF (41/641, 6.4%) (P=0.4). CONCLUSIONS: Our results suggest that 3DF leads to lower recurrence rates and a longer disease-free period for patients, without increasing complications. 3DF provides a safe, efficacious, common ground surgical approach in the treatment of Dupuytren's flexion deformity.

3-Dimensional fasciectomy: A highly efficacious common ground approach to Dupuytren's surgery

BACKGROUND: Numerous Dupuytren’s fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren’s disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren’s disease and unite current limited fasciectomy practice that varies considerably between surgeons. METHODS: We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3−5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue). The surgical outcomes between traditional limited fasciectomy (LF) and 3DF are compared. RESULTS: From the 786 operations included (n=585), postoperative recurrence rates were significantly lower for the 3DF group (2/145, 1.4%) than the LF group (72/641, 11.2%) (P=0.001), and the time to recurrence was significantly longer (5.0±0 years vs. 4.0±0.2 years; P < 0.0001). With recurrence excluded, there were no differences between the postoperative complication rates for 3DF (5/145, 3.5%) and LF (41/641, 6.4%) (P=0.4). CONCLUSIONS: Our results suggest that 3DF leads to lower recurrence rates and a longer disease-free period for patients, without increasing complications. 3DF provides a safe, efficacious, common ground surgical approach in the treatment of Dupuytren’s flexion deformity.

Postsurgical Pyoderma Gangrenosum Versus Necrotizing Fasciitis: Can We Spot the Difference?

BACKGROUND: Pyoderma gangrenosum is a rare noninfectious cutaneous disease characterized by expanding areas of skin ulceration around necrotic centers with purulent debris. Exceptionally, it can be precipitated by surgery alone, and this entity has been described as postsurgical pyoderma gangrenosum (PSPG). Cases of PSPG in the literature are rare. METHODS: We performed a retrospective review of the current literature on PSPG and highlight some observed differences between these conditions. We also present our experience of PSPG imitating an infectious process post reduction mammoplasty. RESULTS: Although PSPG can demonstrate fever, malaise, systemic signs, and serology that mimic the sepsis of necrotizing fasciitis, we identify some features that can aid diagnosis of pyoderma gangrenosum in the absence of pathergy (which is pathognomonic). These include premorbid inflammatory bowel disease, hematological malignancy, or inflammatory polyarthritis; the exquisite and disproportionate pain associated (in particular within surrounding normal skin); symmetrical changes on both breasts; specific histopathological changes with absence of microorganisms; cutaneous wounds demonstrating an ulcerated, violaceous, and undermined edge; and, in this case, bilaterally spared nipple-areola complexes suggesting progression within continuous skin up to but not across incision lines. CONCLUSIONS: We hope that, in encouraging a higher index of suspicion, prompt diagnosis, and accurate treatment, a better outcome for both patient and surgeon can be achieved in future cases.

Axillary skin malignancy: a rare breast cancer presentation.

A rise in incidence and decrease in mortality rates from breast cancer have lead to an increase in prevalence within developed countries. Presentation is classically with a palpable breast tissue mass that may metastasize to bone, lung, liver, brain, lymph nodes, and skin. We describe a delayed diagnosis, in an 80-year-old female patient, where, on 2 occasions, the primary initial presentation was with a cutaneous squamous cell carcinoma in the right axilla. It was not until the third referral, with an ipsilateral breast lump, that breast cancer was clinically diagnosed. This was histologically identified as the primary malignancy, most likely in-keeping with squamous cell carcinoma of the breast. This unique atypical presentation represents a diagnostic challenge and highlights a clinically relevant learning point that may avoid subsequent diagnostic delay. Cutaneous axillary lesions should be treated with a high index of suspicion, necessitating the requirement for chest examination because of the possible presence of an associated primary breast carcinoma.

Health-care professionals' perceptions and expectations of pharmacists' role in the emergency department, United Arab Emirates.

The objective of this study was to assess health-care professionals' attitudes and perceptions towards the value of certain pharmacist functions in the emergency department (ED). The study was conducted among 396 physicians, nurses and other professionals in 4 government hospitals and 10 private hospitals in Dubai. While 83.6% of respondents reported that pharmacy services were available in the ED only 30.7% had a permanent clinical pharmacist working there. A majority (75.7%) agreed that the availability of clinical pharmacists in the ED would improve quality of care. On the role of clinical pharmacists in the medication review process, 45.0% of respondents favoured the review of only high-risk medication orders in the ED. The study found favourable views towards a role for clinical pharmacists in the ED for assuring appropriate medicine prescribing and administration, monitoring patient adherence, providing drug information consultation and monitoring patient responses and treatment outcome.

Comparison between lumbar and thoracic epidural morphine for severe isolated blunt chest wall trauma: a randomized open-label trial.

PURPOSE: The aim of this randomized, parallel-arm, open-label trial was to compare lumbar versus thoracic epidural morphine for severe isolated blunt chest wall injury as regards the incidence of pulmonary complications and pain control. METHODS: Fifty-five patients who sustained severe isolated blunt chest wall trauma were randomized using a computer-generated list to receive epidural morphine injection every 24 h through an epidural catheter inserted into the lumbar (n = 28) or thoracic (n = 27) region. Need for mechanical ventilation, incidence of pneumonia, arterial blood gas values, and pulmonary function tests were compared in both groups. Pain scores, supplemental analgesic consumption, length of intensive care unit (ICU) stay, and occurrence of epidural morphine-related side effects were compared as well. Primary outcome measures were need for mechanical ventilation and incidence of pneumonia. RESULTS: Five (17.9 %) patients in the lumbar group were mechanically ventilated, compared with six (22.2 %) in the thoracic group (hazard ratio 1.35; 95 % CI 0.41-4.4; P = 0.611). Seven (25 %) patients in the lumbar group developed pneumonia versus six (22.2 %) in the thoracic group (hazard ratio 0.97; 95 % CI 0.33-2.9; P = 0.96). Both groups were comparable as regards the duration of mechanical ventilation (P = 0.141) and length of ICU stay (P = 0.227). Pain scores, supplemental analgesic consumption, pulmonary function, and occurrence of epidural morphine-related side effects were, likewise, comparable (P > 0.05). CONCLUSION: Lumbar and thoracic epidural morphine administered as once-daily injection to patients with severe isolated blunt chest wall trauma were comparable in terms of pain control, incidence of pulmonary complications, and occurrence of epidural morphine-related side effects.

Protective and curative effects of the 15 KD isolated protein from the Peganum harmala L. seeds against carbon tetrachloride induced oxidative stress in brain, tests and erythrocytes of rats.

BACKGROUND AND OBJECTIVES: The present study aimed to evaluate the protective and curative effects of the 15 KD protein isolated from the seeds of Peganum harmala L. against carbon tetrachloride (CCl4) induced oxidative stress in rats. MATERIALS AND METHODS: In the protective study, animals were pretreated intraperitoneally with 15 KD isolated protein at doses of 4 and 8 mg/kg body weight as well as vitamin C (250 mg/kg body weight p.o) for 7 days and then challenged with CCl4 orally (1 ml/kg body weight) in olive oil (50%) for 2 days. In the curative study, rats were administered CCl4 orally for 2 days, then treated intraperitoneally with 15 KD protein (4 and 8 mg/kg body weight) and orally with vitamin C. RESULTS: Administration of CCl4 induced induction in malondialdehyde (MDA) and decrease in reduced glutathione (GSH) levels as well as glutathione-S-transferase (GST) activity in brain, testes and erythrocytes. The activity of acetylcholinesterase (AchE) in brain was also inhibited by CCl4 administration. CONCLUSIONS: Treatment of rats either pre or post CCl4 intoxication successfully alleviated the oxidative stress in the brain, testes and erythrocytes of the experimental animals. Data also showed that the isolated protein possessed strong antioxidant activity comparable to that of vitamin C.

Curative effect of the Egyptian marine Erugosquilla massavensis extract on carbon tetrachloride-induced oxidative stress in rat liver and erythrocytes.

OBJECTIVES: The purpose of the present work was to investigate the effect of marine crustacean extract (MCE) from marine mantis shrimp Erugosquilla massavensis and silymarin on oxidative stress induced by carbon tetrachloride (CCl4) in rat liver and erythrocytes. MATERIALS AND METHODS: Male rats were randomly divided into 3 main groups, (1) control group which administered olive oil orally for 2 days, followed by distilled water for 7 consecutive days, (2) MCE group in which rats administered orally MCE, 250 mg/kg body weight for 9 consecutive days and (3) CCl4-treated group in which rats given CCl4 orally (2.5 ml/kg body weight) for 2 days. This group then subdivided into 5 subgroups. All subgroups treated orally for 7 consecutive days with distilled water (subgroup I), silymarin, 150 mg/kg body weight (subgroup II) and MCE at three tested doses 50, 100 and 250 mg/kg body weight (subgroups III, IV and V). RESULTS: The MCE and silymarin produced significant hepatoprotective effect by decreasing the activity of serum aminotransferases (ASAT and ALAT) and alkaline phosphatase (ALP) as well as malondialdehyde (MDA) level, and increasing the serum total protein, glutathione reduced (GSH) levels and the activities of glutathione-S-transferase (GST) and catalase (CAT). The MCE and silymarin also showed the same antioxidant effect on erythrocytes. CONCLUSIONS: The results of the present study, suggested that, the MCE could protect the liver and erythrocytes injuries perhaps, by its antioxidative effect, hence eliminating the deleterious effect of toxic metabolites from CCl4.

The effect of a 3 : 1 volume mixture of propofol 1% and thiopental 2.5% in reducing the pain on injection of propofol in children.

BACKGROUND: In this prospective, randomized, double-blind, controlled trial, our primary objective was to assess the effect of a 3 : 1 mixture of propofol and thiopental in reducing pain on injection in children. Our hypothesis was that a 3 : 1 mixture of propofol and thiopental (treatment) would reduce the incidence of pain on injection to 20% compared to the expected incidence of 40% in the control group of an 11 : 1 mixture of propofol and 2% lidocaine. METHODS: Study subjects were patients 12-17 years old who were scheduled to undergo surgery and general anesthesia. Pain was assessed by a single-blinded observer present in the operating room. The major statistical method used in the analysis was multiple logistic regression. RESULTS: Among the 164 children analyzed, 96 patients (58.5%) were male. The average age was 14.3 (sd = 1.65). The incidence of pain in the control group was 32.1% (26/81), compared to 25.3% (21/83) in the treatment group. The logistic regression analysis showed that there was not sufficient evidence that the treatment group was better than control group in reducing pain (P = 0.24). There were no significant differences in postoperative recovery time, nausea, vomiting, or blood pressure between the two groups (all P values >0.10). CONCLUSION: There was not sufficient evidence to show that a 3 : 1 mixture of propofol and thiopental was better than an 11 : 1 volume admixture of propofol and lidocaine in reducing the incidence of pain on injection to 20%.

Ultrasonographic fetometry and determination of fetal sex in buffaloes (Bubalus bubalis).

The aim of the current study was to establish ultrasonic biometric threshold of different fetal parts in buffaloes and to evaluate the feasibility and accuracy of ultrasonic fetal sex determination. Serial ultrasonographic examinations were carried out on twelve pregnant buffalo-cows, during which fetal parts were measured, and fetal sex and presentation were determined. The obtained results revealed that embryo and amniotic vesicle (AV) were detected by the forth and fifth week of pregnancy, respectively. Organization was observed by the seventh week, while ossification was indicated between the eighth and 10th week. High correlations were found between different studied parameters and gestational age, where the highest correlation was found with the crown-rump length (CRL) and amniotic vesicle diameter (AVD) at the early-gestation; the biparietal diameter (BPD) at the mid-gestation; and the eyeball diameter (EBD) at the mid- and late-gestation. The results also revealed that the best window for fetal sexing was found between the 10th and 18th week of gestations, with an overall accuracy of 97.1%. The final polarity with all fetuses in anterior presentation was adopted by the 30th week. In conclusion, the overall data indicated the feasibility and value of ultrasonographic fetometry in buffaloes for evaluation of fetal development, estimation of gestational age and determination of fetal sex.

Ovarian dynamics and milk progesterone concentrations in cycling and non-cycling buffalo-cows (Bubalus bubalis) during Ovsynch program.

The objective was to evaluate ovarian dynamics and progesterone concentrations in cyclic (CYC, n=10) and non-cyclic (NCY, n=8) buffalo-cows during Ovsynch program. All cows received GnRH on day 0, PGF2alpha on day 7, and GnRH on day 9, and AI 14 h later. Ovarian structures were monitored by ultrasound and milk samples were collected for progesterone (P4) analysis. The first GnRH resulted in ovulation in CYC (90%) and NCY (62.5%) cows. By day 7, almost all cows had large follicle and lutein tissue. Luteolytic responses to PGF2alpha were 80 and 87.5% for CYC and NCY cows, respectively. Following second GnRH, ovulation occurred in 80% of CYC and 100% of NCY cows. Ovulation began earlier (12 h following second GnRH) and extended for longer (36 h) in NCY cows, when compared to CYC cows (36 and 12 h, respectively). The mean P4 levels increased from days 0 through 7 in CYC and NCY cows and levels were higher in CYC group. Conception rates were 60 and 37.5% in CYC and NYC cows, respectively. Early and asynchronous ovulation and luteal sub-function seemed to be a problem in NCY cows. Inseminating NCY cows twice, at 0 and 24 h of the second GnRH is recommended.

Estrogen and progesterone receptors and telomerase enzyme immunohistochemical detection in gestational trophoblastic tumors.

The purpose of this study is to evaluate the immunohistochemical detection of telomerase enzyme and estrogen receptor (ER) and progesterone receptor (PGR) in gestational trophoblastic neoplasia (GTN) and its clinical significance. Formalin-fixed paraffin blocks for 30 patients (24 with molar pregnancy, 3 with choriocarcinoma, and 3 with placental site trophoblastic tumor) as cases and six products of conception samples from patients with incomplete abortion as controls were included in the study. Immunohistochemical detection of the telomerase catalytic protein and ER and PGR was carried out using streptavidin-biotin-peroxidase method. All control tissues were negative for telomerase and ER expression, while five of six were PGR positive. Significant positive telomerase expression was detected in all gestational trophoblastic tumors (three of six partial moles, 12 of 18 complete moles, three of three choriocarcinomas, and two of three placental site trophoblastic tumors). Nine of 24 molar pregnancies were followed by GTN. Molar pregnancies followed by GTN were associated with higher serum beta-hCG (human chorionic gonadotrophic hormone), larger uterine size for gestational age, negative ER expression, negative PGR expression, and positive telomerase expression. All patients with molar pregnancy with negative telomerase expression (9 of 24) showed spontaneous regression after evacuation. Positive telomerase expression and its immunohistochemical detection are associated with the development of GTN. Negative telomerase expression is highly predictive of postmolar spontaneous regression. Patients with molar pregnancies with negative telomerase expression can be saved the long-term follow-up. ER and PGR expression do not show a significantly different pattern in molar tissues, while negative expression is associated with developing GTN. Cautions on the use of postmolar hormonal contraception may be unjustified.

The sitting, oblique, and supine marking technique for reduction mammaplasty and mastopexy.

BACKGROUND: Reduction mammaplasty is one of the most common procedures in plastic surgery. It presents both artistic and technical challenges. Breast reduction surgery aims to reduce the vertical and horizontal planes, shape the parenchyma, reposition the nipple-areola complex, and resect redundant skin. The surgery on paired organs has the added challenge of symmetry. Much of the outcome of our work as plastic surgeons is determined by preoperative planning and designing. METHODS: A number of techniques have been described for the preoperative marking of breast reduction, with particular reference to the precision of the angle between the two vertical limbs. Few, if any, of the previous techniques have gained total popularity or acceptance by plastic surgeons. RESULTS: The freehand marking technique is probably the most widely used technique. Devices such as templates, shaped wires, and goniometers, and geometric techniques, have also been recommended. Some of these devices have stood the test of time; others have been modified or abandoned. CONCLUSIONS: The authors propose a new preoperative marking technique dependent on the natural breast fall. The patient is marked in three positions: sitting, oblique, and supine. This technique has been adopted for the past 10 years.

Pesticides and heavy metals levels in Egyptian leafy vegetables and some aromatic medicinal plants.

A total of 835 samples of leafy vegetables and some aromatic medicinal plants were collected from five different areas of Egypt during 1999. Ninety-seven per cent of the leafy vegetables were contaminated with heavy metals with 39% exceeding the maximum limits for each element. Cadmium was detected in 78 of 116 samples of leafy vegetable, although without any exceeding the maximum limits. However, lead was detected in 99 samples, of which 39 exceeded the maximum limits (0.3 mg kg(-1)) and 56 medicinal plant samples of 70 had lead levels above 0.5 mg kg(-1). Copper was detected in 69 medicinal plant samples, of which 58 samples contained levels higher than 10 mg kg(-1). However, cadmium was only found in 43% of samples with only two of 70 samples above the maximum limit. Seventy-three per cent of the samples of medicinal plants were contaminated with pesticide residues, of which 44% contained amounts that exceeded maximum residue limits. Malathion was the most frequently found pesticide residue, being detected in 203 of 391 (52%.) samples, followed by profenofos, which was detected in 131 of 391 (33%) samples.

In situ nasal absorption of midazolam in rats.

Intranasal (i.n.) midazolam (MDZ) administrations may be used successfully for preoperative sedation, especially in young patients. However, clinicians have to use the commercial parenteral formulation, the low pH of which (3.3), necessary to solubilize MDZ (pK(a) 6.1), is probably responsible for the signs of local irritation frequently reported. As a starting point to design a formulation suitable for the nasal route, MDZ nasal absorption was investigated in rats. The effects of the MDZ solution concentration (10--100 microg/ml), osmolality (from less than 10 mOsm/kg up to 450 mOsm/kg) and pH (3.3--7.4) were studied using an in situ perfusion technique. MDZ was determined by reversed-phase HPLC in the circulating solution and results were expressed in clearance terms. MDZ absorption was independent of its concentration. The pH of the solutions was the key-parameter and only a pH above 4 allowed significant absorption. These results were consistent with a passive diffusion absorption of MDZ and partly followed the pH partition theory. In conclusion, satisfactory MDZ absorption should be expected with a formulation at a pH suitable for the nasal route in human (5.5--6.5).

Novel thiazolinyl, thiazolidinonyl, thiadiazolyl and oxadiazolyl-benzotriazole derivatives with potential antiinflammatory activity and minimum ulcerogenic effect.

Four novel series of 1H-benzotriazole derivatives; containing thiazolin, thiazolidin, thiadiazole and oxadiazole moieties; namely 1-[(3,4-disubstituted thiazolin-2-ylidene)hydrazinocarbonyl]methyl-1H-benzotriazoles 3a-1; 1-[3-substituted 5-ethoxycarbonyl-4-methyl thiazolin-2-ylidene)hydrazinocarbonyl]methyl-1H-benzotriazoles 4a-c; 1-[(3-substituted-4-oxothiazolidin-2-ylidene)hydrazinocarbonyl]methyl-1H- benzotriazoles 5a-d; 1-[(5-substituted aminothiadiazol-2-yl)methyl]-1H-benzotriazoles 6a-c have been synthesized by cyclization of the key intermediates 1-[(substituted thiocarbamoylhydrazinocarbonyl)methyl]-1H-benzotriazoles 2a-d. Furthermore 1-[(5-substituted aminooxadiazol-2-yl)methyl]-1H-benzotriazoles 7a, b were obtained by one-pot synthesis starting from 1H-benzotriazol-1-acetic acid hydrazide. The antiinflammatory activity of representative compounds was evaluated in vivo against indomethacin as a standard using the sponge implantation model of inflammation in rats. Both non-immunological parameters such as exudate volume, total leucocyte count (TLC), and differential leucocyte count (DLC), and immunological parameters, for example neutrophil phagocytic function by reduced cytochrome C levels, and the assay of interleukin-1 beta (IL-1 beta) levels in drug-pre-treated rats, were determined. The ulcerogenic activity of compounds showing marked antiinflammatory activity was also studied. Compounds 3e, 5b and 5c showed antiinflammatory activity comparable to indomethacin, and they also demonstrated minimum ulcerogenic activity.

Enzyme/prodrug therapy for head and neck cancer using a catalytically superior cytosine deaminase.

The use of cytosine deaminase (CD) in conjunction with 5-fluorocytosine (5-FC) has been studied for cancer gene therapy as a means of achieving tumor-specific generation of the toxic metabolite 5-fluorouracil (5-FU). Since 5-FC is frequently used as an antifungal agent, and because it has little or no efficacy as an antibacterial agent, we hypothesized that yeast CD (YCD) might be more efficient at utilizing 5-FC as a substrate and hence be a better choice for a CD/5-FC gene therapy strategy than the typically utilized bacterial CD (BCD). To that end Saccharomyces cerevisiae CD was cloned from yeast genomic DNA and expressed in vitro. Functional analysis of BCD and YCD expressed in COS-1 cells indicated that BCD and YCD both utilized cytosine with equal efficacy; however, 5-FC was an extremely poor substrate for BCD, with an apparent catalytic efficiency 280-fold lower than that observed for YCD. Retroviral infection of tumor cell lines in vitro indicated that the IC50 of 5-FC was 30-fold lower in YCD-infected cultures as compared with cultures infected with BCD retrovirus. In addition, when SCCVII murine squamous cell carcinoma cells were infected in vitro at low rates of infection (< or =10%) there was no significant cytotoxicity toward BCD-expressing cells while there was potent cytotoxicity to both YCD-expressing cells and "bystander cells" even at this low level of expression. Finally, stable BCD- or YCD-expressing SCCVII clones were developed and used in an orthotopic immune-competent model of head and neck cancer. Subsequent treatment with 5-FC followed by monitoring of tumor growth by noninvasive magnetic resonance imaging (MRI) and survival of animals indicated a growth delay during the course of 5-FC treatment for BCD-expressing tumors, which quickly regrew at the end of treatment. In contrast, YCD-expressing tumors exhibited not only a growth delay, which was of longer duration, but also in some cases frank tumor regression and complete cures occurred.

Monitoring pesticide residues in Egyptian fruits and vegetables in 1995.

Organophosphorus, dithiocarbamates, and some synthetic pyrethroids pesticides, which are commonly used in Egypt for pest control, were monitored, as well as persistent organochlorines, which had been prohibited from use several years ago. Fruit and vegetable samples (397) were collected from 8 local markets and examined for 52 pesticides. Of all analyzed samples, 42.8% contained detectable residues, of which 1.76% exceeded their maximum residue limits (MRLs). The rates of contamination with the different pesticides were 0-86%. However, violation rates among contaminated products were very low, ranging from 0 to 4.6%. In general, organochlorine pesticide residues were not detected in most samples. Dithiocarbamate residues were found in 70.4% of 98 samples analyzed for dithiocarbamates, but only one grape sample had residues exceeding the MRL established by the Codex Committee on Pesticide Residues.

Health beliefs and preferences for medical treatment: a comparison between medical and social science students.

OBJECTIVE: This study looked at the relationship between beliefs in 'scientific medicine', personal health beliefs, attitudes to complementary medical practitioners and medical treatment preferences in two different groups: medical and non-medical (mainly social science) students. It extended the previous work of looking at patient groups. DESIGN: Once the psychometric properties of the four short questionnaires (53 items in all) were established as satisfactory in terms of their factor structure, the two groups were compared. RESULTS: By means of analysis of variance it was established that there were fewer differences between medical and non-medical students than might be expected by chance. A 'higher order' factor analysis revealed three clear factors underlying attitudes to complementary medicine: pro complementary medicine; pro orthodox medicine; and satisfaction with general practitioner. All the students appeared to have a sceptical but positive attitude to complementary medicine.