Comparative evaluation of Nigella sativa (Kalonji) and simvastatin for the treatment of hyperlipidemia and in the induction of hepatotoxicity.

Hyperlipidemia is a major risk factor for incidence of coronary artery disease. Simvastatin is a synthetic lipid lowering drug and Nigella sativa seeds found helpful in controlling hyperlipidemia. The study performed to evaluate the efficacy of Nigella sativa in comparison to simvastatin to treat hyperlipidemia. Thirty Sprague Dawley rats fed on an ad libitum diet for 02 weeks, on cholesterol diet for 08 weeks. Then group II treated with simvastatin and group III with Nigella sativa for 06 weeks. Blood samples analyzed for serum cholesterol, serum triglycerides, HDL-C, LDL-C & serum ALT. The results evident that Nigella sativa (kalonji) and simvastatin showed significant improvement in the lipid profile of rats in respective groups after treatment. The p value <0.05 of group II and III documented that Nigella sativa (kalonji) affect the lipid profile in the same way as of simvastatin. However, ALT levels significantly raised in group II treated with simvastatin compared to group III. Nigella sativa and simvastatin showed comparable effects in the treatment of hyperlipidemia. Nigella sativa showed protective role in terms of hepatic dysfunction and can be used as a cholesterol lowering agent.

Neonatal haemochromatosis: report of a patient with favourable outcome.

UNLABELLED: A male newborn was referred on the 2nd day of life because of suspected sepsis. The child became comatose and ventilator dependent owing to progressive hepatic failure with hyperammonaemia. Diagnostic studies revealed an highly elevated ferritin level. The family history was remarkable in that an aunt and a great aunt on his mother's side have idiopathic haemochromatosis. Open liver biopsy showed advanced cirrhosis with cholestasis and excessive hepatocellular siderosis. Concentrations of iron in liver tissue were highly elevated. The child's status improved unexpectedly, and excretory and synthetic liver function gradually returned to normal. CONCLUSION: Neonatal haemochromatosis is not an irreversible disease of iron metabolism but rather a distinct outcome of fetal liver disease which predisposes by an yet unknown mechanism to a derangement of fetoplacental iron handling. If patients survive the initial phase of liver failure, prognosis is largely dependent upon liver cirrhosis and its sequels. The iron overload in this type of haemochromatosis is reversible and not progressive.

In vitro cytobiological effects of human herpesviruses 6 and 7: immunohistological monitoring of apoptosis, differentiation and cell proliferation.

Two human herpesviruses, HHV-6 and HHV-7, recently identified and closely related, were studied for their influence on cellular apoptosis and proliferation. Infection was monitored by viral DNA--and antigen expression. Apoptosis and cell proliferation were determined by immunocytological techniques and the markers p53, p21WAF/Cip, Bax, Bak, Bcl-2, cyclin D1 and PCNA, and also screened for signal transduction indicators such as c-H-ras, c-fos and raf-1. Cell differentiation and function was monitored by determining cell membrane receptors including Fas and CD specificities, and by ELISA tests for interleukin production. Both HHV-6 and HHV-7 readily infected their target cells, yet virus antigen expression and virus replication were less active in HHV-7 infection. Both viruses also induced GM-CFS production. Cell differentiation in terms of CD receptor expression was more pronounced in HHV-6 than in HHV-7 infection. No differences were found in the activity of signal transduction factors. There were quantitative differences in the activation of p53, Bax, p21WAF and Bcl-2 in HHV 6-infected CBC as compared to HHV-7 infection supporting the apoptosis cycle. CyclinD1 activity remained at lower levels in HHV-7 infected CBC, yet was high in similarly infected transformed SupT1 cells. In contrast, HHV-6 supported rather the p53/p21WAF apoptosis pathway in both untransformed CBC and transformed HSB1 cells. Both herpesviruses, HHV-6 and HHV-7, thus possessed similar biological activities in cultures of non-transformed susceptible cells, although with certain quantitative differences. The data reported here may further support the notion that HHV-7 is less active in inducing apoptosis thus favoring continued cell proliferation. The mechanism by which these viruses interfere with the network control of cell proliferation, differentiation and apoptosis appear more complicated than shown here and therefore afford a more detailed study, including a more sensitive technology than immunohistology.

Morphogenesis in chronic Pneumocystis carinii infection--discussion of three cases.

The clinical and histological features of three HIV1-positive patients are reported of whom two showed persistent focal lesions on serial chest X-rays without any demonstrable lesion on repeated bronchoscopies. The third patient presented with recurrent pneumothorax. By thoracoscopy peripheral lung tissue was obtained in all cases, showing localized histomorphological findings compatible with a prolonged interstitial reaction around Pneumocystis carinii (PC) organisms and their breakdown products. Based on the finding of foreign body granulomas and an increased number of alveolar macrophages, we propose a hypothetical pathway for the development of this unusual reaction to PC infection focusing on the possible secretion of tumor necrosis factor alpha by activated macrophages. By this model the unusual features of PC infection in our patients and in the literature could be explained. Furthermore, in these cases possibly an additional oral or intravenous treatment might be indicated.

Bone marrow hypoplasia and fibrosis following interferon treatment.

Interferon treatment is known to cause hematologic changes such as thrombocytopenia, anemia and granulocytopenia or combinations thereof. Patients previously treated with chemotherapeutic drugs followed by alpha interferon treatment developed even more severe pancytopenia and aplasia. Case reports of two patients who received treatment with alpha interferon 2a are reported here. Both patients were previously treated with chemotherapy, but with a long interval before starting IFN administration. Patient one developed life-threatening bone marrow hypoplasia and aplasia after interferon treatment and died. Patient two showed similar but less severe changes in bone marrow, i.e. thrombocytopenia, mild leukopenia and anemia. The clinical course of both patients was followed by routine peripheral blood tests and bone marrow biopsies and permit some reflection on the pathogenesis of marrow hypoplasia. Myelosuppressive effects of interferon treatment are discussed in the context of chemotherapy effects, cytokine actions and potential additional influences of herpesvirus infections.

Chronic Pneumocystis carinii pneumonia in AIDS.

The clinical and radiologic presentation as well as the macroscopic and histologic characteristics of lung parenchyma in three HIV-infected patients with Pneumocystis carinii pneumonia (PCP) are detailed. The distinguishing clinical feature in these patients was a prolonged stable clinical course of the disease over at least 4 to approximately 24 months. Serial chest radiographs in two patients demonstrated persistent focal radiographic lesions. In one patient blebs in both upper lobes were not recognized until thoracoscopy/thoracotomy was performed. Biopsy specimens of affected areas revealed extensive interstitial fibrosis, occasional giant cell reactions, and honeycombing. In view of the combined clinical, radiologic, macroscopic, and histologic patterns, it is suggested that these patients had a chronic productive form of PCP rather than the well-known acute presentation of the disease. Data from the literature confirm the impression that atypical histologic lesions of PCP, either of a productive or destructive nature, are frequently related to a prolonged clinical course. It is unlikely that prophylactic pentamidine contributes to this entity. Coinfection with other pathogens may have a role. Given the recent evidence on augmented release of tumor necrosis factor a (TNFa) in HIV-associated pulmonary complications, it is speculated that TNFa may be of importance in producing focal fibrosis in Pneumocystis infection of the lung.

Active human herpesvirus-6 (HHV-6) infection associated with Kikuchi-Fujimoto disease and systemic lupus erythematosus (SLE).

Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) is a well defined disorder primarily affecting young adults. The cause of this disease is still unknown. The authors report a case of a 37-yar old woman with Kikuchi-Fujimoto disease and systemic lupus erythematosus (SLE). Serologic testing for HHV-6 antibodies revealed an active infection. An excised cervical lymph node contained HHV-6 genome demonstrated by using in situ hybridization. Active HHV-6 infection should be considered in Kikuchi-Fujimoto disease.

[Acute pneumocystosis during polychemotherapy following the MACOP-B protocol]. / Akute Pneumozystosen unter Polychemotherapie nach dem MACOP-B-Protokoll.

Four out of eleven patients--none of them HIV positive--who received treatment for non-Hodgkin lymphoma by the MACOP-B protocol between June 1989 and February 1990 were taken ill during or shortly after the conclusion of the course with fulminant pneumonia necessitating artificial ventilation. In three cases Pneumocystis carinii was identified as the pathogen, and in one patient the diagnosis of pneumocystosis seemed probable. The mean cumulative doses given before the outbreak of pneumonia were as follows: cyclophosphamide 2753 +/- 1161 mg, methotrexate 1590 +/- 667 mg, bleomycin 36 +/- 16.8 mg and prednisone 4378 +/- 1734 mg. The mean haemoglobin concentration was 10.7 +/- 0.5 g/dl, leucocyte count 5250 +/- 2100/microliters, lymphocyte count 1300 +/- 300/microliters and lactate dehydrogenase 227 +/- 34 U/l. The cumulative doses and laboratory findings in the seven patients not affected by pneumocytosis were not significantly different. The patients with pneumonia were supported by mechanical ventilation for 6-26 days and treated with large doses of corticosteroids and co-trimoxazole. One patient died after 17 days' ventilation. Three patients were successfully weaned from the ventilator. Chemotherapy protocols such as MACOP-B predispose to acute Pneumocystis pneumonia. The risk of infection is independent of the cumulative doses of the drugs employed. For this reason, prophylaxis with co-trimoxazole is normally mandatory.

The reliability of functional gain.

This study examined the test-retest reliability of unaided and aided sound-field thresholds and the functional gain values derived from these measurements. Sound-field warble-tone thresholds were obtained at 250, 1000, and 4000 Hz from 24 hearing-impaired listeners with and without their hearing aids. Test-retest standard deviations were significantly larger for functional gain than for unaided thresholds, but only slightly and nonsignificantly larger than for aided thresholds. The variability of functional-gain measures is discussed in relation to measures of insertion gain obtained with probe-tube microphones.