Epidemiological and clinical features of rotavirus gastroenteritis in Oman

Two-hundred-and-seventeen children admitted with diarrhoea and 204 unmatched controls hospitalized during the 2-year period from November 1990 to October 1992 were included in this prospective study. Their stool samples were subjected to microscopy, cultures, ELISA for rotavirus and electron microscopy. Human rotavirus (HRV) was detected in 68 (31 per cent) of the stool samples in the study group and 12 (6 per cent) in the control group. There was an increased incidence in the cooler months of the year; typically, most of the affected infants and children presented with vomiting and respiratory symptoms, and had mild to moderate dehydration. Biochemical profile showed normal or hyponatraemia and normokalaemia. A more detailed community-based study of diarrhoeal diseases in Oman is to follow this pilot study.

Magnetic resonance imaging after frontal sinus surgery with fat obliteration

The obliteration of the frontal sinus via an osteoplastic approach is performed with the aim of achieving a permanent 'switching off' by final and conclusive clearing out. For this, freshly harvested abdominal fat has shown itself to be the best clinically. It is possible to demonstrate the vitality of fat transplanted into the frontal sinus without an operation, i.e. by a macroscopical and histological examination using magnetic resonance imaging (MRI). The magnetic resonance examinations were carried out on a supraconductive 0.5 T Magnet (Gyroscan T.S.II, Philips Medicine Systems, Eindhoven, Netherlands) with a quadrature (square) head spool. We produced T1-weighted spin echo images (TR: 450-550 ms; TE: 20-25 ms), T2-weighted fast spin echo images or in double-echo technique in transverse orientation (Turbo SE or TR: 2000-2500 ms; TE: 50-90 ms) and short tau inversion recovery (STIR) sequences for fat suppression (TJ: 140 ms; TR: 1400 ms; TE: 30 ms). The fat implanted into the frontal sinus of 11 patients aged 22-65 years, having undergone an osteoplastic frontal sinus operation with obliteration, was examined post-operatively by MRI. Objectives were the time-dependent distribution of portions of vital fatty or connective tissue, the eventual development of necroses or cysts as well as recurrences, inflammatory complications or re-epithelization of the frontal sinus four to 24 months post-operatively. In only six out of 11 cases was vital fatty tissue found. Fatty necrosis occurred five times, whereas in four cases a transformation into granulation tissue and in one case into connective tissue could be seen. All 11 patients were complaint-free. Long-term observations are needed to see if differences in the recurrence rate of frontal sinus disease are dependent on whether the implanted fat remains vital or necrosed and transformed.

Immunotherapy with natural interleukins and/or thymosin alpha 1 potently augments T-lymphocyte responses of hydrocortisone-treated aged mice

Cytokines and thymic hormones are thought to play critical roles in the regulation of T-lymphocyte development and function. In an effort to determine the effectiveness of such agents in an immunotherapeutic strategy, we employed aged mice in a hydrocortisone treatment model to generate an immunodeficient state and to study its reconstitution. Mice were given five daily injections of a natural cytokine mixture (NCM), recombinant interleukins (rIL-1, rIL-2) or their combination, thymosin alpha 1 or fraction 5 (T alpha 1, TF5), or the combinations of NCM plus T alpha 1 and of NCM plus TF5. Spleen and thymus weights were obtained and the cellular responses to stimulation in vitro with NCM, IL-1, IL-2 and mitogens (PHA and Con A) were assayed. Both NCM and T alpha 1 in vivo treatment augmented thymocyte and splenocyte in vitro responses to both interleukins and mitogens. Neither treatments with equivalent doses of rIL-1, rIL-2 nor their combination, nor TF5 achieved similar results. Of all the treatments, only NCM plus T alpha 1 augmented spleen weight; none augmented thymus weight. Surface marker analyses of T-lymphocytes and subsets indicate that treatment of mice with NCM plus T alpha 1 increased spleen T-cell numbers of both CD4 and CD8 positive cells significantly. These data indicate that NCM and T alpha 1 alone and in combination may be therapeutically useful to restore T-lymphocyte number or function in secondary immunodeficiency.

Radiation-induced inactivation of flavocytochrome b2 in dilute aqueous solution

Effect of gamma radiation on flavocytochrome b2 in dilute aqueous solution was studied. A study of the effect of the radiolytically produced inorganic free-radical anions such as I2.-, Br2.- and (SCN)2.- on the enzyme activity indicates the involvement of cysteine and tyrosine residues in the catalytic activity of flavocytochrome b2. The changes in kinetic parameters, i.e., Michaelis-Menten constant Km and maximal velocity Vmax, due to irradiation under different conditions suggest that radiation induced enzyme inactivation is the result of destruction of active-site residues as well as modification of the substrate binding site. Fluorescence studies of unirradiated and irradiated enzyme reveal that FMN (flavin mononucleotide) is inaccessible to water radicals.

The introduction of epidemiology in training future doctors: the oman experience

This paper highlights the emphasis put on epidemiology in the training of future doctors at Sultan Qaboos University. It describes the special features of the teaching of epidemiology making it needs-oriented with continuous practical application in the field throughout the preclinical period. The students take an active part in planning field studies using their knowledge of epidemiology. Integration of epidemiology with statistics enables the students to analyze and interpret their own data thus obtaining a quick feed-back of the epidemiological studies conducted by them. They apply their knowledge of epidemiology to evaluate the data and formulate intervention programmes.Close collaboration with the Ministry of Health provides an opportunity for the students to orient themselves with the important health problems of Oman and participate in the country's national programs. The scheduling of courses and continuation of application of epidemiology in the clinical years help to reinforce their knowledge of epidemiology and statistics for the clinical period and subsequent postgraduation.

Accumulation of antifungal compounds in tea leaf tissue infected with Bipolaris carbonum

Varietal resistance of tea towards Bipolaris carbonum was tested following detached leaf inoculation technique. Among the fourteen varieties tested, three were found to be highly susceptible, while other three were resistant. Leaf exudates and diffusates collected from the resistant varieties were more fungitoxic than those from the susceptible ones. Two antifungal compounds isolated from healthy and B. carbonum-infected tea leaves exhibited clear inhibition zones at RF 0.8 and 0.65, respectively, in a chromatographic bioassay. On the basis of their color reaction on TLC and UV-spectra these were identified to be catechin and pyrocatechol. Resistant and susceptible varieties accumulated 439-510 and 187-212 micrograms/g fresh mass tissue of pyrocatechol, respectively, 2 d after inoculation with B. carbonum, while a low concentration (45-58 micrograms/g) of this compound was detected in healthy leaf tissue.

Clinical profile and natural history of Ebstein's anomaly of tricuspid valve

There were 63 patients of Ebstein's anomaly of tricuspid valve encountered from 1976 to 1991; 28 (44.4%) were male and 35 (55.6%) female. Their age at presentation ranged from 3 months to 51 years. Five (7.9%) patients were asymptomatic, 48 (76.2%) had class II-III exertional dyspnoea, palpitation or both. Thirty patients (47.6%) had cyanosis. Electrocardiogram showed paroxysmal atrial fibrillation in two, chronic atrial fibrillation in four (6.3%), paroxysmal supraventricular tachycardia in seven, atrial or ventricular ectopic beats in five (7.9%), 2:1 atrioventricular block in one (1.6%), complete atrioventricular block in two (3.2%) and type B WPW syndrome in nine patients (14.3%). Chest X-ray showed diminished vascularity in 22 (34.9%). Diagnosis was established by cardiac catheterization and or echocardiography. Atrialized right ventricular chamber was demonstrated in 51 (80.9%) by angiography and in 40 (63.5%) by electrophysiology. Patients were followed up for 1-172 months. Seventeen patients (26.9%) required surgery. Three patients (4.8%) died during medical follow-up, and five (7.9%) died following surgery. Survival probability for 46 medical patients was 88.9% at 172 months. Factors affecting survival were pulmonary blood flow, cyanosis, clubbing and systemic arterial oxygen saturation.

Prognosis for patients with Eisenmenger syndrome of various aetiology

The objective of this study was to determine the long-term survival pattern and variables affecting long-term survival and complications occurring during follow-up of patients with Eisenmenger syndrome. A retrospective study of patients diagnosed with Eisenmenger syndrome were followed up. A tertiary care centre was used and it provided superspeciality services in various disciplines. The subjects included 201 patients with Eisenmenger syndrome--diagnosed by a combination of echocardiography and a peripheral arterial oxygen saturation study and/or cardiac catheterisation with or without angiocardiography--worked up and followed up for variable duration over a period of 16 years from 1976 to 1992. One hundred nine patients were females and 92 were males--age of presentation varied from 3 months to 62 years (mean +/- standard deviation 19.23 +/- 12.62 years). A total of 12 different anatomic lesions were seen--the most common three being ventricular septal defect (33.33%), aterial septal defect (29.85%), and patent ductus arteriosus (14.23%). History, physical examination, chest skiagram and electrocardiogram established only the presence of pulmonary arterial hypertension except where differential cyanosis indicating ductus was discernible or the degree of splitting of second heart sound provided some clue to the level of shunt. Contrast echocardiography, completed in 25.4% established the level of shunt in all patients. In others the diagnosis was confirmed by cardiac catheterisation. Twenty patients died during a mean follow-up period of 54.6 +/- 54.47 months. Sudden cardiac deaths (30%), congestive heart failure (25%) and haemoptysis (15%) were the most predominant causes of death. Only one patient died during puerperium.(ABSTRACT TRUNCATED AT 250 WORDS)

Malignant tumours in Omani children

In an effort to understand better the epidemiology of childhood cancer in Oman, a retrospective review of hospital-based biopsy-proven malignant tumours was undertaken. A total of 313 cases of malignant diseases in children between the ages of 0 and 12 years were diagnosed in Oman during the 5-year period from January 1988 to December 1992, inclusive. Leukaemias were the most commonly occurring malignancies (32.3%), followed by lymphomas (29%) and brain tumours (11.2%). The male:female ratio was 1.3:1. The commonest presenting age group was 2 years, the majority of which were leukaemias and lymphomas. Differences and similarities between Omani data and those from other countries are discussed.

Tyrosine residues in unirradiated and gamma-irradiated dihydroorotate dehydrogenase: fluorimetric and second-derivative absorption spectrophotometric studies

The effect of gamma-radiation on tyrosine residues of dihydroorotate dehydrogenase under different conditions was investigated by means of fluorescence spectroscopy and second-derivative spectrophotometry. No change in the fluorescence spectral distribution was observed when unirradiated and irradiated enzyme were denatured in guanidine hydrochloride. However, decreases in fluorescence intensity in irradiated samples indicates a radiation-induced modification of tyrosine residues. The fluorescence intensity at 340 nm decreased exponentially with radiation dose in aerated medium but non-exponentially under argon and nitrous oxide-saturated conditions. The percentage loss of tyrosine fluorescence under different conditions was determined. The number of tyrosine residues left intact following irradiation at a dose for 50% inactivation under different conditions was measured by second-derivative absorption spectrophotometry. The results obtained from both these methods show that the hydroxyl radical is less efficient in inducing radiation damage of tyrosine in aerated conditions compared with that under deoxygenated conditions. This lower efficiency of the hydroxyl radical in aerated medium has been attributed to the protective effect of oxygen and/or the superoxide radical anion.

Differential activation and survival of basal forebrain neurons following infusions of excitatory amino acids: studies with the immediate early gene c-fos

These experiments investigated, by studying patterns of c-fos expression, the distribution of neurons activated or destroyed by the infusion into the basal forebrain of various excitatory amino acids at toxic and subtoxic doses. The results of experiment 1 showed that N-methyl-D-aspartic acid (NMDA), quisqualic acid and alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) differentially increased the expression of c-fos in magnocellular cholinergic nucleus basalis, dorsal and ventral pallidal neurons. AMPA was the most, and NMDA the least, effective in inducing FOS in nucleus basalis magnocellularis (nbM) neurons, with quisqualic acid having an intermediate effect, whereas the reverse was true in terms of the induction of FOS in pallidal neurons. In experiment 2, it was demonstrated that, in animals with ibotenic acid-induced lesions of the basal forebrain that were targetted on the nbM, virtually no pallidal neurons could be visualized that expressed FOS following AMPA-induced excitation of the dorsal and ventral striatum. By contrast, in animals with AMPA-induced lesions of the nbM, excitation of the striatum was followed by the expression of FOS in many dorsal and ventral pallidal neurons. Thus, infusions of AMPA into the basal forebrain appears preferentially to activate or destroy, depending on the concentration infused, cholinergic nbM neurons, whereas ibotenic acid or NMDA preferentially destroys or activates neurons of the dorsal and ventral pallidum. These results provide novel and complementary information regarding the organization of the basal forebrain and allow a clearer understanding of the different behavioural consequences of NMDA agonist-induced and non-NMDA agonist-induced excito-toxic lesions of this area.

Radiation-induced inactivation of dihydroorotate dehydrogenase in dilute aqueous solution

The inactivation of dihydroorotate dehydrogenase by gamma irradiation in dilute aqueous solution has been investigated. The activity of the enzyme decreased exponentially as a function of the absorbed dose under aerated and nitrous oxide-saturated conditions. The contributions of the individual radical species derived from water radiolysis were estimated from the inactivation results observed under aerated, argon-saturated, and nitrous oxide-saturated conditions. The hydrogen atom and hydroxyl radical were found to be important in enzyme inactivation. The effect of selected inorganic radical anions such as Br.2-, I.2-, and (SCN).2- on the enzyme activity was also studied, and the results implicate the possible involvement of cysteine and tyrosine residues in the catalytic activity of dihydroorotate dehydrogenase. Changes in the kinetic parameters (Michaelis-Menten constant, Km, and maximal velocity, Vmax) due to irradiation under the conditions investigated suggest that radiation-induced inactivation is due to modification of the substrate binding sites and that of the active site residues in the enzyme. Evidence for the reduction of iron-sulfur centers in the enzyme during the inactivation process has been put forward from the difference spectrum of the irradiated dihydroorotate dehydrogenase. It has also been shown by electrophoretic studies that radiation-induced inactivation was not due to any fragmentation of the protein structure or the formation of any intermolecular crosslinking.

Radiation-induced changes in flavin fluorescence of dihydroorotate dehydrogenase

The effect of gamma-radiation on the flavin moiety of dihydroorotate dehydrogenase was studied by fluorescence spectroscopy. Irradiation of aerated solutions (0-7 Gy) led to a small increase in fluorescence intensity, but with higher doses a decrease in intensity was observed. The increase in fluorescence intensity after irradiation at low doses may be attributed to protein unfolding, leading to greater exposure of flavin groups and a concomitant increase in separation between the flavin moiety and the iron-sulphur centre. This was confirmed by fluorescence quenching studies using potassium iodide as quencher. The Stern-Volmer constant calculated for iodide quenching indicates a two-fold increase in the fraction of flavin moiety being accessible to the quencher after 6.6 Gy. No spectral change was observed when unirradiated or irradiated enzyme was denatured with guanidine hydrochloride. However, a decrease in fluorescence intensity in the case of irradiated samples indicated a radiation-induced decrease in the flavin fluorophore. The flavin fluorophore loss in dihydroorotate dehydrogenase was also determined using aerated, argon-saturated or nitrous oxide-saturated solutions. H and OH radicals were found to have nearly equal contributions in damaging the flavin moiety of dihydroorotate dehydrogenase.

Cysteinyl peptide labeled by 3-bromo-2-ketoglutarate in the active site of pig heart NAD+-dependent isocitrate dehydrogenase

The substrate affinity label 3-bromo-2-ketoglutarate (BrKG) reacts covalently with pig heart NAD+-specific isocitrate dehydrogenase with complete inactivation and incorporation of about 0.8 mol of reagent/mol of average enzyme subunit [Bednar, R.A., Hartman, F.C., & Colman, R.F. (1982) Biochemistry 21, 3681-3689]. Protection against inactivation is provided by isocitrate and Mn2+. We have now identified a critical modified peptide by comparison of the peptides labeled by BrKG at pH 6.1 in the absence and presence of isocitrate and Mn2+. Modified enzyme, isolated from unreacted BrKG, was incubated with [3H]NaBH4 to reduce the keto group of protein-bound 2-ketoglutarate and thereby introduce a radioactive tracer into the modified amino acid. Following carboxymethylation and digestion with trypsin, the specific modified peptide was isolated by reverse-phase HPLC, first in 0.1% trifluoroacetic acid with a gradient in acetonitrile and then in 20 mM ammonium acetate, pH 5.8, with an acetonitrile gradient. Gas-phase sequencing gave the modified peptide: Ser-Ala-X-Val-Pro-Val-Asp-Phe-Glu-Glu-Val-Val-Val-Ser-Ser-Asn-Ala-Asp-Gl u-Glu- Asp-Ile-Arg. The corresponding tryptic peptide that was isolated from unmodified enzyme yielded the same sequence except for (carboxymethyl)cysteine at position 3, suggesting that cysteine is the target of 3-bromo-2-ketoglutarate. Pig heart NAD+-dependent isocitrate dehydrogenase is composed of three distinct subunits (alpha, beta, and gamma) that can be separated by chromatofocusing in urea and identified by analytical gel isoelectric focusing. The peptide modified by 3-bromo-2-ketoglutarate, which is in or near the substrate site, is derived only from the separated gamma subunit.(ABSTRACT TRUNCATED AT 250 WORDS)

Socio-biological correlates of bacteriuria in Saudi pregnant women

Prevalence and socio-biological correlates of bacteriuria in Saudi pregnant women were investigated at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. Midstream sample specimens of urine were used for identification of significant bacteriuria (greater than or equal to 10.5 organisms of single species per milliliter of urine). The prevalence of bacteriuria was found to be 14.2%. It was more common in women below 20 years of age and among the parous as against the nullipara women. Bacteriuria was significantly associated with socio-economic conditions. It was higher in those with a low family income, of large family size (10+) and living in over-crowded conditions. Only one-fourth (25.8%) of bacteriuric women were symptomatic. Almost half (45.8%) had a past history of urinary tract infection. To identify the problem of urinary tract infection in a vulnerable group of women, as well as to reduce the load on laboratory facilities, it is suggested that routine antenatal screening for bacteriuria should be advocated on a selective basis, i.e. for the young teenage parous women, those coming from disadvantaged socio-economic conditions and in patients with a past history of urinary tract infection.

Modification of NAD-dependent isocitrate dehydrogenase by the 2',3'-dialdehyde derivatives of NAD, NADH, NADP, and NADPH

The 2',3'-dialdehyde nicotinamide ribose derivatives of NAD (oNAD) and NADH (oNADH) have been prepared enzymatically from the corresponding 2',3'-dialdehyde analogs of NADP and NADPH. Pig heart NAD-dependent isocitrate dehydrogenase requires NAD as coenzyme but binds NADPH, as well as NADH, ADP, and ATP, at regulatory sites. Incubation of 1-3 mM oNAD or oNADH with this isocitrate dehydrogenase causes a time-dependent decrease in activity to a limiting value 40% that of the initial enzyme, suggesting that reaction does not occur at the catalytic coenzyme site. Upon varying the concentration of oNAD or oNADH from 0.2 to 3 mM, the inactivation rate constants increase in a nonlinear manner, consistent with reversible binding of oNAD and oNADH to the enzyme prior to covalent reaction. Inactivation is accompanied by incorporation of radioactive reagent with extrapolation to 0.54 mol [14C]oNAD or 0.45 mol [14C]oNADH/mol average enzyme subunit (or about 2 mol reagent/mol enzyme tetramer) when the enzyme is maximally inactivated; this value corresponds to the number of reversible binding sites for each of the natural ligands of isocitrate dehydrogenase. The protection against oNAD or oNADH inactivation by NADH, NADPH, and ADP (but not by isocitrate, NAD, or NADP) indicates that reaction occurs in the region of a nucleotide regulatory site. In contrast to the effects of oNAD and oNADH, oNADP and oNADPH cause total inactivation of the NAD-dependent isocitrate dehydrogenase, concomitant with incorporation, respectively, of about 3.5 mol [14C]oNADP or 1.3 mol [14C]oNADPH/mol average subunit. Reaction rates exhibit a linear dependence on [oNADP] or [oNADPH] and protection by natural ligands against inactivation is not striking. These results imply that oNADP and oNADPH are acting in this case as general chemical modifiers and indicate the importance of the free adenosine 2'-OH of oNAD and oNADH for specific labeling of the NAD-dependent isocitrate dehydrogenase. The new availability of 2',3'-dialdehyde nicotinamide ribose derivatives of NAD, NADH, NADP, and NADPH may allow selection of the appropriate reactive coenzyme analog for affinity labeling of a variety of dehydrogenases.

Ruptured uterine sacculation. A rare presentation of ectopic implantation

Pregnancy growing in the uterine sacculation following medical termination of pregnancy is a rare occurrence. We present one such case in which rupture occurred on the ward while the patient was waiting for diagnostic laparotomy.

Attempts to detect by physicochemical methods plasmid DNA in mycoplasmas of human origin before and after transformation to tetracycline resistance

Physicochemical methods have been used to compare mycoplasma DNA capable of the genetic transformation of tetracycline resistance with DNA from tetracycline-sensitive mycoplasmas and their transformants. These mycoplasmas were isolated from human patients. The DNA extracted from Mycoplasma hominis tetr resistant to 100 microgram/mL tetracycline transforms tetracycline resistance to sensitive strains of Mycoplasma salivarium tets and Mycoplasma hominis tets but not Mycoplasma fermentans tets. Bulk DNA and DNA extracted by methods which increase the yield of circular DNA moieties were analyzed by cesium chloride and cesium chloride--ethidium bromide buoyant density ultracentrifugation and by horizontal and vertical agarose gel electrophoresis. Extrachromosomal DNA was not detected, which suggests that transformation was mediated by the recombination of chromosomal genes for tetracycline resistance and not by R factors. Moreover, no significant differences were detected in the DNA from the resistant and sensitive species or from their transformants and Mycoplasma fermentans tets which could not be transformed to resistance to 10 micrograms tetracycline/mL medium.