Long-term stability of anterior segmental maxillary osteotomy

The long-term stability of anterior segmental maxillary osteotomy was evaluated in 11 patients. Both the Wunderer and down-fracture procedures were used. The patients were examined periodically until 18 months after surgery. Operative and postoperative cephalograms were compared; a more reliable method was utilized to assess the displacement of the osteotomy segment. Linear and angular measurements were used for evaluation of relapse. No major complications were recorded, and no correlation was found between the magnitude of segment repositioning and degree of relapse. Positional changes at the end of the study, though statistically significant, were clinically acceptable and subjectively undetectable. Results emphasized the merits and potential of the surgical osteotomy. Satisfactory correction of anterior maxillary excess was achieved, with absolute improvement in esthetics and occlusion.

Characterization of a newly established human pancreatic carcinoma cell line, UK Pan-1

BACKGROUND

A highly tumorigenic cell line designated as UK Pan-1 was established in a surgically removed human pancreatic adenocarcinoma and characterized as having many of the genotypic and phenotypic alterations commonly found in pancreatic tumors.

METHODS

The cell line was characterized by its morphology, growth rate in monolayer culture and soft agar, tumorigenicity in nude mice, and chromosomal analysis. Furthermore, the status of p53, Ki-ras mutation and transforming growth factor (TGF)-/receptor expression were determined. The characteristics of UK Pan-1 were compared with those of other commonly used pancreatic carcinoma cell lines.

RESULTS

Quiescent UK Pan-1 cells could be stimulated to proliferate in growth factor free nutrient media, indicating a growth factor independent phenotype. UK Pan- 1 cells grew in soft agar and rapidly formed tumors in nude mice. This cell line possesses a mutation at codon 12 of the c-Ki-ras-2 gene that is commonly found in pancreatic carcinoma. Fluorescence in situ hybridization showed that two alleles of p53 tumor suppressor gene were present in UK Pan-1. However, sequencing analysis revealed a mutation in one allele at exon 8, codon 273 (G to A; Arg to His). Additional growth assays indicated that the cell line was insensitive to negative growth regulation induced by exogenous TGF-beta. Molecular analysis of the TGF-beta signaling pathway showed that UK Pan-1 did not express appreciable levels of the TGF-beta receptor type I, II, or III mRNAs, but did express DPC4 mRNA. Karyotype analysis revealed an 18q21 deletion indicating a possible loss of heterozygosity for DPC4, as well as other chromosomal deletions and rearrangements.

CONCLUSIONS

This study indicates that UK Pan-1 is a highly tumorigenic cell line possessing a molecularly complex pattern of mutations that may be used as a model to further the understanding of the mechanisms responsible for the development of pancreatic carcinoma.

Differential expression of transforming growth factor beta receptors in human pancreatic adenocarcinoma

BACKGROUND

Many cancer cells show resistance to transforming growth factor beta (TGF-beta)-mediated growth inhibition. This resistance to TGF-beta is associated with an increased tumorigenic phenotype.

OBJECTIVE

In this study, we determined whether a loss in expression of TGF-beta receptors or DPC4, an important down stream target of TGF-beta signaling, might account for this lack of TGF-beta sensitivity in pancreatic adenocarcinoma.

MATERIALS AND METHODS

To accomplish this, six established pancreatic cancer cell lines, twenty-six surgically resected tumor specimens of pancreatic adenocarcinoma and ten non-tumor pancreas tissues were analyzed for the mRNA expression of the three TGF-beta receptors (RI, RII, and RIII) and DPC4.

RESULTS

We report here that five of six pancreatic cancer cell lines were not sensitive to TGF-beta. All the ten non-tumor specimens of pancreas showed expression of RI, and DPC4; while nine of ten showed expression of RIII and eight of ten showed expression of RII. Five of six pancreatic cancer cell lines and 23 of 26 tumor specimens showed expression of RI. Two cell lines and about half (46%) of the tumor specimens did not express RII. Only two cell lines showed appreciable levels of RIII expression; while ten of 26 (38%) tumor specimens did not show expression of RIII. DPC4 expression was observed in three of the six (50%) cell lines and 19 of 24 (79%) tumor specimens.

CONCLUSION

This study indicates that apart from the functional loss of DPC4 due to mutations or homozygous deletion, a lack of the TGF-beta receptors, particularly RII and RIII, may contribute to a loss of TGF-beta signaling in a population of pancreatic cancers.

High-dose spatially-fractionated radiation (GRID): a new paradigm in the management of advanced cancers

PURPOSE

With the advent of megavoltage radiation, the concept of spatially-fractionated (SFR) radiation has been abandoned for the last several decades; yet, historically, it has been proven to be safe and effective in delivering large cumulative doses (> 100 Gy) of radiation in the treatment of cancer. SFR radiation has been adapted to megavoltage beams using a specially constructed grid. This study evaluates the toxicity and effectiveness of this approach in treatment of advanced and bulky cancers.

METHODS AND MATERIALS

From January 1995 through March 1998, 71 patients with advanced bulky tumors (tumor sizes > 8 cm) were treated with SFR high-dose external beam megavoltage radiation using a GRID technique. Sixteen patients received GRID treatments to multiple sites and a total of 87 sites were irradiated. A 50:50 GRID (open to closed area) was utilized, and a single dose of 1,000-2,000 cGy (median 1,500 cGy) to Dmax was delivered utilizing 6 MV photons. Sixty-three patients received high-dose GRID therapy for palliation (pain, mass, bleeding, or dyspnea). In 8 patients, GRID therapy was given as part of a definitive treatment combined with conventionally-fractionated external beam irradiation (dose range 5,000-7,000 cGy) followed by subsequent surgery. Forty-seven patients were treated with GRID radiation followed by additional fractionated external beam irradiation, and 14 patients were treated with GRID alone. Thirty-one treatments were delivered to the abdomen and pelvis, 30 to the head and neck region, 15 to the thorax, and 11 to the extremities.

RESULTS

For palliative treatments, a 78% response rate was observed for pain, including a complete response (CR) of 19.5%, and a partial response (PR) of 58.5% in these large bulky tumors. A 72.5% response rate was observed for mass effect (CR 14.6%, PR 52.9%). The response rate observed for bleeding was 100% (50% CR, 50% PR) and for dyspnea, a 60% PR rate only. A relatively higher response rate (CR 23.3%, PR 60%) was observed in patients who received GRID treatment in the head and neck area. No grade 3 late skin, subcutaneous, mucosal, GI, or CNS complications were observed in any patient in spite of these high doses. In the 8 patients who received GRID treatment for definitive treatment, a clinical CR was observed in 5 patients (62.5%) and a pathological complete response was confirmed in the operative specimen in 4 patients (50%).

CONCLUSION

The efficacy and safety of using a large fraction of SFR radiation was confirmed by this study and substantiates our earlier results. In selected patients with bulky tumors (> 8 cm), SFR radiation can be combined with fractionated external beam irradiation to yield improved local control of disease, both for palliation and selective definitive treatment, especially where conventional treatment alone has a limited chance of success.

Hepatitis C viral load, genotype and histological severity in patients with bleeding disorders

We report the relationship between hepatitis C virus (HCV) titre, liver histology and HCV genotype in patients with bleeding disorders. One hundred and thirty-two RIBA-2-positive patients, including 56 who were also HIV positive, were identified at our centre. Fifty of these patients, including nine who were HIV infected, underwent percutaneous liver biopsy. Liver histology was assessed using a modified histological activity index (HAI). Qualitative serum HCV PCR was positive in 87 (87%) of the 101 patients tested including 43 of 50 biopsied patients. HCV RNA titres, measured by quantitative PCR, were significantly higher in HIV-positive patients compared with HIV-negative patients (P < 0.05) but were not related to HAI, mean factor concentrate usage, duration of HCV infection or HCV genotype. There was no relationship between HCV genotype and HAI. Qualitative HCV PCR was positive in 30 of 43 liver biopsies tested. Biopsy PCR-positive and -negative cohorts were not distinguished by HAI or serum HCV titre. We conclude that although serum HCV PCR is useful in confirming the presence of HCV infection in patients with bleeding disorders, little meaningful information concerning the severity of the disease can be obtained from serum HCV quantification.

Novel mutations in the polyadenine tract of the transforming growth factor beta type II receptor gene are found in a subpopulation of human pancreatic adenocarcinomas

In this study, we determined the incidence of microsatellite instability (MIN) in pancreatic adenocarcinoma and determined whether MIN might target, for mutations, the simple nucleotide repeats of the transforming growth factor beta type II receptor (TGFBR2) gene. Forty-eight surgically resected pancreatic tumor tissue samples and two normal pancreas tissue samples were analyzed in this study. Microsatellite analysis was performed for six loci in 14 of the 48 tumor specimens for which we had matching normal genomic DNA. Only four of the 14 tumors (29%) were MIN-positive as determined by the presence of microsatellite variations in more than one locus. Interestingly, eight of the 14 specimens (57%) showed microsatellite variations or loss of heterozygosity at D18S34, suggesting that this locus may be a critical region of genetic instability in pancreatic tumorigenesis. Of the 48 tumors, only two (4%) showed mutations in the polyA region, one of the MIN-targeted sites of the TGFBR2 gene. DNA sequence analysis of these two specimens showed the presence of a two-base deletion in one tumor specimen and the other tumor specimen showed a base substitution in the polyA tract at codon 128 of the TGFBR2 gene. The fact that these mutations occurred in the polyA tract of some pancreatic tumors suggests that a subpopulation of these tumors may be susceptible to MIN-targeted mutations. The incidence of these mutations are low and similar to that reported for nonhereditary, sporadic colon cancers.

Ionizing radiation-inducible apoptosis in the absence of p53 linked to transcription factor EGR-1

The tumor suppressor protein p53 is a pivotal regulator of apoptosis, and prostate cancer cells that lack p53 protein are moderately resistant to apoptotic death by ionizing radiation. Genes encoding the transcription factor early growth response-1 (EGR-1) and cytokine tumor necrosis factor-alpha (TNF-alpha) were induced upon irradiation of prostate cancer cells, and inhibition of EGR-1 function resulted in abrogation of both TNF-alpha induction and apoptosis. Induction of the TNF-alpha gene by ionizing radiation and EGR-1 was mediated via a GC-rich EGR-1-binding motif in the TNF-alpha promoter. Because TNF-alpha induces apoptosis in prostate cancer cells, these findings suggest that, in the absence of p53, ionizing radiation-inducible apoptosis is mediated by EGR-1 via TNF-alpha transactivation.

Detection of respiratory events during NPSG: nasal cannula/pressure sensor versus thermistor

Recording of respiratory airflow is an integral part of polysomnography (NPSG). It is conventionally monitored with a thermistor that measures temperature as a surrogate of flow. The subjectivity of interpreting hypopnea from this signal has prompted us to measure nasal airflow directly with a simple pneumotachograph consisting of a standard nasal cannula connected to a 2-cm H2O pressure transducer. We manually analyzed respiratory events using simultaneous thermistor and nasal cannula in 11 patients with obstructive sleep apnea syndrome (OSAS) and 9 with upper airway resistance syndrome (UARS). Definite events were scored separately for each signal when amplitude was <50% for >10 seconds. Events were also scored on the nasal cannula signal when the flattened shape of the signal suggested flow limitation, and these were tabulated separately. Definite events in one signal were tabulated by whether the other signal showed a definite event or not. In addition, nasal cannula events were compared to a more liberal thermistor criterion (any change in the signal for > or = 2 breaths). Visually, events were more easily recognized on the nasal cannula signal than on the thermistor signal. In OSAS, 1,873 definite thermistor events were detected. Of these, 99.1% were detected by nasal cannula, and 0.9% were missed. Of 3,541 definite nasal cannula events, 51.9% were detected by definite thermistor criteria; 75.0% were detected by liberal thermistor criteria; 25.0% were missed. In UARS, 123 definite thermistor events were detected. Of these, 89.4% were detected by nasal cannula and 10.6% were missed. Nine hundred and three nasal cannula events were detected. However, only 17.2% of these were detected by definite thermistor criteria; 38.6% were detected by liberal thermistor criteria; 61.4% were completely undetected by thermistor. When events identified on the nasal cannula by flow limitation alone were excluded, the thermistor detected 30.1% of events by definite criteria and 78.6% by liberal criteria, still leaving 21.4% completely undetected by the thermistor. We conclude that the nasal cannula reliably detects respiratory events seen by thermistor. Additional events (including some characterized only by flow limitation) that help define the UARS, were recognized by nasal cannula but often completely missed by thermistor. We propose that respiratory monitoring during NPSG with nasal cannula significantly improves event detection and classification over that with thermistor.

Critical issues in the evolving management of rectal cancer

Evolving trends in the management of rectal cancer have focused on organ preservation, improved quality of life, and survival of patients. A significant shift is underway in our thinking about what constitutes the true rectum and defining the "proximal" and "distal" segments of the rectum. Tumor mobility remains a dominant prognostic factor in patient selection and choice of surgery. A clinical staging with tumor location in the rectum provides a logical algorithm for treatment decision making with either chemoradiation therapy or surgery as initial treatment of choice. Current rectal cancer management has largely focused on postoperative adjuvant radiation strategies with improvement reported for T3 and N+ cases. Recent data from Europe suggests that preoperative radiation has a significant advantage over surgery alone or postoperative treatment. This appears to be borne out by institutional studies of high-dose preoperative radiation (>45 Gy) in the United States. Aggressive preoperative combined chemoradiation has also led to significant downstaging of cancer with pathological complete response rates of 20% to 30%. This offers new options for surgical management of residual disease with endocavitary radiation or local excision. The development of new agents Gemcitabine, paclitaxel, and CPT-11 may also prove beneficial. New treatment strategies need to be coordinated with evolving knowledge of the biological behavior of the tumor based on its genetic fingerprints. c-Ki-ras and C-myc mutations have been implicated in tumor initiation and progression. A number of other tumor suppressor genes, APC gene, p53, and DCC have also been implicated in colorectal tumor carcigenesis. The modification of biological behavior by mutations in these genes is currently under study. This may guide new treatment strategies significantly reducing the death rates from rectal cancer and improving functional results of treatment.

Role of O6-methylguanine-DNA methyltransferase in the resistance of pancreatic tumors to DNA alkylating agents

Pancreatic adenocarcinomas rarely respond to radiation or chemotherapy, indicating that a large percentage of these tumors possess complex mechanisms of resistance. The failure of alkylating agents, such as carmustine [1,3-bis(2-chloroethyl)-1-nitrosourea; BCNU], lomustine [1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea; CCNU], and streptozotocin, to yield consistent therapeutic results further suggests that one of these mechanisms may be the high expression of O6-methylguanine-DNA methyltransferase (MGMT). All 12 human pancreatic ductal adenocarcinomas assayed for MGMT activity showed unusually high levels, implying that these malignancies are efficient in repairing genotoxic O6-alkylguanine lesions induced by methylating (streptozotocin) and 2-chloroethylating (BCNU and CCNU) chemotherapeutic genotoxic agents. Immunohistochemical analysis of an additional 15 pancreatic tumors showed that high levels of MGMT protein reside in the nucleus and the cytoplasm of malignant cells. Both nuclear and cytoplasmic staining were absent in hyperplastic duct epithelium, but staining was invariably present in moderate to highly dysplastic foci and especially strong in invasive components of the tumor. With the exception of lymphocytes that were MGMT positive, acinar, ductal, and islet cells did not stain for MGMT in histologically normal pancreata. These data indicate that MGMT activity is up-regulated in dysplastic epithelium, and its expression increases during tumor progression, reaching the highest levels in the invasive components of the tumor. Resistance of pancreatic tumor cells to alkylating agents was verified with four pancreatic tumor cell lines. CAPAN-2, CFPAC-1, PANC-1, and MIAPaCa-2, having MGMT levels of 1800, 987, 700, and 880 fmol/mg protein, respectively, were resistant to BCNU, but their resistance declined sharply following pretreatment with the MGMT inhibitor O6-benzylguanine (O6-BG). On the other hand, PANC-1 and MIAPaCa-2 could not be eradicated with N-methylnitrosourea (MNU) at concentrations as high as 2 mM, even when pretreated with O6-BG. These two lines were shown to be modified genetically in microsatellite sequences by MNU and are believed to have a defective mismatch repair system, which may explain their resistance to methylating agents. Failure of pancreatic tumors to respond to nitrosoureas is related to high levels of MGMT expression and in some cases to genomic instability. However, these tumors can be sensitized to chloroethylating drugs and eradicated following the elimination of MGMT activity by O6-BG or homologous MGMT inhibitors.

Hepatitis G virus infection in patients with bleeding disorders

Eighty-two patients with bleeding, disorders registered with our centre were screened for infection with hepatitis G virus (HGV). 80 patients were positive for hepatitis C (HCV) antibodies, 66 of whom (83%) were HCV PCR positive. 11 patients (13%) were HGV RNA-positive, a similar prevalence rate to that of other studies of patients with bleeding disorders who received factor concentrates prior to the introduction of viral inactivation procedures. There was no significant difference in histological activity index (HAI) between the 10 HGV RNA-positive and the 31 HGV RNA-negative patients who underwent liver biopsy for assessment of HCV infection (median HAI scores 5.5, range 2-10 and four, range 0-10 respectively, P = 0.07). One patient in each group had established cirrhosis. In patients who underwent HCV quantitation there was no significant difference in HCV viral titre between HGV RNA-positive and negative patients (median HCV titre in HGV RNA-positive patients 2.10 x 10(5) DNA copies/ml (n = 8) range 4.17 x 10(2) to 4.17 x 10(6), median HCV titre in HGV RNA-negative patients 3.33 x 10(5) (n = 31) range 1.00 x 10(3) to 6.67 x 10(6), P = 0.68). In this study there was no evidence that individuals co-infected with HGV and HCV have more severe liver disease than those infected with HCV alone.

Effect of tannin-rich plant (Acacia nilotica) on some nutritional and bacteriological parameters in goats

The effects of A. nilotica (tannin-rich plants) on the digestion coefficient of nutrients and its antibacterial properties were "in-vivo" investigated in this study. Twenty five male baladi goats aged 3-4 years and weighing 19-21 kg were randomly classified into five groups (5 per each). Each animal group was fed on one of the experimental diets containing different levels of A. nilotica leaves (0%, 5%, 10%, 15% & 20%). Chemical analysis of A. nilotica leaves revealed that its content of crude protein, crude fiber, ash were 12.1%, 30.5%, 13.2%, respectively, while the total soluble tannins were 34%. The digestion coefficient of dry matter (DM), crude protein, crude fiber and nitrogen free-extract (NFE) in the control group were better than those of the experimental diets. However, digestion coefficient of most nutrients were significantly decreased (P < 0.01) with increasing levels of A. nilotica in the goat's diets. Absorbed and retained nitrogen (g/day) were decreased with increasing levels of A. nilotica. Concerning nitrogen balance, all animals of the experimental groups showed positive nitrogen balance. Colony forming units (CFU) were drastically reduced in both faecal und ruminal juice samples. This reduction was directly proportional to levels of A. nilotica in the ingested feed. The CFU were reduced in the faecal samples from 5.9 x 10(8)/g (control group) to 2.8 x 10(4) (fifth group) (that received 20% Acacia nilotica). On the other hand, the CFU/ml of ruminal juice samples were reduced from 5.8 x 10(6) (control group) to 1.8 x 10(3) (fifth group). On the other hand, Cl. perfringens count was reduced from 1.0 x 10(4) to 6.3 x 10/g in the faecal samples while their count was reduced from 6.2 x 10(2) to 4.4 x 10/ml in case of ruminal samples. The reduction of total bacterial and Cl. perfringens counts were directly proportional to the levels of A. nilotica in the diets of goats.

Phytochemical analysis of Geigeria alata and Francoeuria crispa essential oils

Phytochemical analyses of Geigeria alata (Benth. & Hook.) and Francoeuria crispa (Forssk., Cas.) (Asteraceae) essential oils were performed. G. alata oil showed moderate in vitro cytotoxicity (IC50, micrograms/ml against tumor cells; P388: 2.0, A-549: 2.5 and HT-29: 5.0), and also showed weak anti-HIV activity. S-Carvotanacetone, the major component of F. crispa oil (93.0%), was isolated and its structure was elucidated by 2D-NMR analysis.

Contemporary diagnosis and treatment of fibroepithelial ureteral polyp

Fibroepithelial polyps of the ureter are rare, benign tumors often not easily distinguished from malignant transitional-cell carcinomas by radiologic means. Historically, many patients have undergone unnecessary nephroureterectomy for these lesions. With recent advancement in endourologic instrumentation, a biopsy-proven diagnosis of suspect upper-tract lesions can be made prior to definitive therapy. We describe a typical case of fibroepithelial ureteral polyp wherein the diagnosis and surgical treatment was accomplished entirely by endoscopic means.

Evaluation of culture, histological examination, serology and the rapid urease test for diagnosis of Helicobacter pylori in patients with dyspepsia in Bangladesh

Helicobacter pylori, a gram-negative, microaerophilic bacterium, has been established to have a causal association with chronic gastritis, peptic ulcer, gastric adenocarcinoma, and low-grade lymphoma. The present study was undertaken to evaluate the efficacy of culture, histological examination, the rapid urease test, and serology for the diagnosis of H. pylori infection. A total of 45 consecutive subjects with various upper gastrointestinal symptoms were included in this study. The rates of diagnosis of H. pylori infection were 51.1%, 55.6%, 82.2%, and 93.3%, by culture, rapid urease test (RUT), histological examination, and serology, respectively. The sensitivity, specificity, and positive and negative predictive values were 95.5%, 82.6%, 84.0%, and 95.0%, respectively for RUT; 95.5%, 30.4%, 56.8%, and 87.5% for histological examination; 100%, 13.6%, 54.8% and 100% for serology.

Gastric antiulcer and cytoprotective effect of Commiphora molmol in rats

The aqueous suspension of Commiphora molmol (oleo-gum resin) has been screened for its potential to protect gastric mucosa against the ulcers caused by 80% ethanol, 25% NaCl, 0.2 M NaOH, indomethacin and combined indomethacin-ethanol treatment. C. molmol pretreatment at doses of 250, 500 and 1000 mg/kg provided dose-dependent protection against the ulcerogenic effects of different necrotizing agents used. The effects caused by ethanol were further investigated. Treatment of rats with 1 ml of 80% ethanol was found to cause depletion of stomach wall mucus, reduction in the concentration of protein, nucleic acids and NP-SH groups in the stomach wall. Ethanol treatment also caused histopathological lesions including necrosis, erosion, congestion and haemorrhage of the stomach wall. Pretreatment with C. molmol offered a dose-dependent protection against all these effects. In the same manner it affected the malondialdehyde concentration altered by ethanol treatment. C. molmol also offered protection against mucosal damage caused by indomethacin and its combination with ethanol. The protective effect of C. molmol observed in the present study is attributed to its effect on mucus production, increase in nucleic acid and non-protein sulfhydryl concentration, which appears to be mediated through its free radical-scavenging, thyroid-stimulating and prostaglandin-inducing properties.

EGR-1 induction is required for maximal radiosensitivity in A375-C6 melanoma cells

Exposure to ionizing radiation leads to induction of the immediate-early gene, early growth response-1 (Egr-1). Previous studies have suggested distinct cell type- and inducer-specific roles for EGR-1 protein in cellular growth inhibition. The present study was undertaken to determine the functional role of EGR-1 in growth inhibition caused by exposure of tumor cells to ionizing radiation. Exposure to ionizing radiation caused induction of EGR-1 protein in human melanoma cells A375-C6. Inhibition of either the function of EGR-1 protein by stable transfection with a dominant-negative mutant or the expression of EGR-1 by transient transfection with an antisense oligomer resulted in a diminished growth-inhibitory response to ionizing radiation. Because previous studies have suggested that mutations in the tumor-suppressor gene p53 confer radio-resistance, we examined the p53 status of A375-C6 cells. Interestingly, both the parental and the transfected A375-C6 cells showed trisomy for wild-type p53 alleles. Exposure to ionizing radiation resulted in induction of p53 protein that localized to the nucleus in A375-C6 cells. These data suggest that inhibition of EGR-1 function confers radio resistance despite the induction of wild-type nuclear p53. Thus, EGR-1 is required for the growth-inhibitory response to ionizing radiation in A375-C6 cells.

A combined management protocol for patients with coagulation disorders infected with hepatitis C virus

The case notes of 394 adults with bleeding disorders registered at our centre together with those of the 72 patients who had died since 1971 were reviewed. 36/72 deceased patients had evidence of HCV infection. Liver decompensation was present at time of death in six. 274 (70%) of the currently registered patients had received factor concentrate or cryoprecipitate and 174 of these were screened for HCV infection. 76% of tested patients were RIBA positive. 87% of RIBA-positive patients were RT-PCR positive. 50 RIBA-positive patients, including nine who were HIV infected, have undergone percutaneous liver biopsy following appropriate factor infusion with no complication. The biopsy was assessed using a Histological Activity Index (HAI) ranging from 0 to 13. Patients with HAI > or = 6 were offered treatment with interferon. Patients with HAI < 6 were followed up with a view to re-biopsy in 2-3 years to assess progression. The median HAI was 4.5 (range 0-10) with HAI > or = 6 in 13 cases (27%). HAI was not correlated with duration of infection. haemophilia severity. RT-PCR status. HIV status or HCV genotype. Liver biopsy, a safe procedure in our hands, is an important investigation in HCV-infected patients to assess suitability for interferon therapy.

Effect of camel urine on the cytological and biochemical changes induced by cyclophosphamide in mice

Camel urine treatment was found to cause a significant cytotoxic effect in the bone marrow cells of mice. This cytotoxicity at higher doses was comparable with that of standard drug cyclophosphamide (CP). However, unlike CP, the camel urine treatment failed to induce any clastogenicity. The cytotoxicity induced by camel urine treatment was substantiated by the reduction of liver nucleic acids and glutathione levels and increased malondialdehyde (MDA) contents in the same animals. CP treatment was found to be highly clastogenic, cytotoxic and it reduced the levels of nucleic acids, proteins, glutathione and increased malondialdehyde concentration due to its prooxidant nature. The non-clastogenic nature of camel urine was attributed to the antioxidant and antimutagenic compounds present in camel urine. Pretreatment with camel urine increased the cytotoxicity of CP and intensified the CP induced reduction of liver nucleic acids, glutathione and increased the MDA concentration. The increase of CP induced cytotoxicity appears to be partly due to the additive effect of the two treatments on cellular lipid peroxidation.

Expression and mutation of H-ras in uterine cervical cancer

In cervical cancer, abnormalities of ras genes have not been fully investigated. We studied the expression and mutation of H-ras oncogene in cervical cancer to investigate their relationship and usefulness as an independent prognostic indicator. Twenty-seven paraffin-embedded resection specimens of cervical cancer (21 squamous, 3 adeno, 2 adenosquamous, and 1 small cell) were examined by immunohistochemistry using a mAb H-ras p21 and by PCR and allele-specific oligonucleotide hybridization using H-ras codon 12 and 61 amplimers and oligonucleotide probes. A strong immunoreaction was noted in 10 cases (37%) and weak immunoreaction in an additional 6 cases (22%). H-ras codon 12 mutations were detected in 6 of 27 cases (22%) and all of the mutations were guanine to adenine transitions. There was no mutation in codon 61. Cases with codon 12 mutations included all 3 squamous, 2 adeno, and I adenosquamous carcinoma. Only 3 of 16 (19%) cases with positive staining and 3 of 11 (27%) cases with negative staining showed mutations. No correlation was found between ras gene alterations and patient survival time. Our findings indicate that expression and mutation of H-ras oncogene occur in cervical cancer but their determination adds no useful prognostic information.

Unexplained hepatitis C virus antibody seroconversion in established blood donors

BACKGROUND

Understanding of the epidemiology and natural history of hepatitis C virus (HCV) infection is incomplete without reference to the early phase of infection. The prevalence of HCV infection is well documented in numerous reports. The seroconversion pattern in previously antibody-negative blood donors provides a model for the study of the incidence and transmission of HCV infection.

STUDY DESIGN AND METHODS

Records of HCV antibody tests at the West Midlands Blood Transfusion Centre were reviewed to determine the seroconversion rate in 1994 among previously anti-HCV-negative blood donors. Seroconverting donors were counseled to investigate the possible routes of infection.

RESULTS

In 1994, blood donations (n = 256,935) were collected from 149,370 donors; 24 donors (0.016%; 1/6224) were positive in the screening enzyme-linked immunosorbent assay (ELISA) and the third-generation recombinant immunoblot assay (RIBA-3). Two donors previously negative for HCV antibody in ELISA were positive in both tests in 1994. Four donors positive in ELISA and indeterminate in RIBA-3 in 1993 reacted positively in both tests in 1994. One donor negative for HCV antibody on previous screening reacted positively in ELISA and was indeterminate in RIBA-3 in 1994 and has become positive in both tests in 1995. A further 43 donors negative for HCV antibody on previous screening reacted positively in ELISA and were indeterminate in RIBA-3 in 1994.

CONCLUSION

Documented seroconversion can take place in the absence of exposure to recognizable risk factors for the infection. The index donation or the donation immediately preceding seroconversion may be positive for HCV RNA in the polymerase chain reaction.

Hepatitis C virus seroconversion by a third generation ELISA screening test in blood donors

The significance of seroconversion as detected by an ELISA screening test for hepatitis C virus (HCV) antibody with a negative supplemental/confirmatory recombinant immunoblot assay (RIBA) result was investigated. Of 118,220 established West Midlands blood donors with at least one negative HCV antibody screen, 43 had seroconverted in 1994 according to the ELISA but had negative RIBA-3 results. The paired archive serum samples of the pre- and postseroconversion donations of 29 seroconverting donors were tested by nested polymerase chain reaction (PCR) for the detection of HCV RNA. All 58 samples were negative by PCR. The absence of detectable viraemia in all tested seroconverting donors suggests that HCV infection was not responsible for seroconversion by ELISA.

C-Ki-ras mutations in peripheral blood of pancreatic cancer patients: a marker for early tumor metastasis

PURPOSE

To determine the incidence of circulating minimal malignant clone (CMMC) (harboring c-Ki-ras-2 mutation) in peripheral blood (PB) samples of untreated pancreatic cancer using polymerase chain reaction (PCR) analysis of c-Ki-ras-2 oncogene.

METHODS AND MATERIALS

Experiments were carried out in fresh tumor, peritoneal washings (PW), and PB samples of untreated pancreatic adenocarcinoma patients (both resectable and unresectable). Samples were taken from 16 patients diagnosed with pancreatic adenocarcinoma for the PCR analysis of mutated c-Ki-ras oncogene. Five tumor samples, 15 PB samples, and 3 PW samples were analyzed for point mutation of the c-Ki-ras gene at codon 12.

RESULTS

Out of five tumor samples analyzed for c-Ki-ras mutation, four were positive at the 12th codon. Out of total 15 PB samples, nine were positive for the c-Ki-ras point mutation at the 12th codon. All the positive PB samples showed a base substitution from GGT to GAT in the second position of the 12th codon. Out of three PW samples, two showed mutation at the second position from GGT to GAT similar to their PB and tumor samples.

CONCLUSION

Our study indicated the presence of the tumor cells (CMMC) in PB of pancreatic adenocarcinoma that can be identified by PCR analysis of c-Ki-ras oncogene. Patients with presence of CMMC in PB and mutation in PW had aggressive tumors that responded poorly to treatment.

Energy and nitrogen balance and changes in midupper-arm circumference with multiple organ failure

Energy intake and energy expenditure, nitrogen intake, and urinary nitrogen excretion (or urea production rates) were measured in 35 intravenously fed patients with multiple organ failure over the course of their illness to determine to what extent nutrient requirements were met despite fluid retention. Energy and nitrogen balance were related to serial measurements of midupper-arm circumference (MAC). The target feeding regimen of 176 kJ (42 kcal)/kg fat-free mass (FFM) was achieved in only three patients and the target of 0.24 g N/kg FFM in only four. Two patterns of change in MAC were noted: a steady decrease with time and no change with time. Serial muscle biopsy data indicated that all the patients were wasting away; the maintenance of MAC in the group with no change over time was due to fluid retention. Abnormal losses were not measured, but energy and nitrogen balance in the group in which arm circumference decreased had no apparent effect on the rate of wasting.

Influence of anethole treatment on the tumour induced by Ehrlich ascites carcinoma cells in paw of Swiss albino mice

The anticarcinogenic potential of anethole was studied in Ehrlich ascites tumour (EAT) in the paw of Swiss albino mice. The antitumour activity was evaluated from the cytotoxicity of EAT-cells in the paw and their biochemical changes were determined from nucleic acids, protein, malondialdehyde (MDA) and glutathione (NP-SH) concentrations. Furthermore, the observations on survival rate, tumour weight, its volume and body weight of EAT-bearing mice were made. The EAT-bearing paws were also evaluated for histopathological changes. Additional studies were undertaken on the cytological effects of anethole in order to establish its clastogenic and mitodepressive activity in normal mice. The results obtained in the present study revealed anethole to increase the survival time, reduce the tumour weight and volume and body weight of the EAT-bearing mice. It caused a significant cytotoxic effect in EAT cells in the paw, reduced the levels of nucleic acids and MDA, and increased NP-SH concentrations. The histopathological changes observed after treatment with anethole were comparable to the standard cytotoxic drug cyclophosphamide. The results on the frequency of micronuclei and the ratio of polychromatic erythrocytes to normochromatic erythrocytes showed anethole to be mitodepressive and non-clastogenic in the femoral cells of mice. Our results indicate the anticarcinogenic, cytotoxic and non=clastogenic nature of anethole. Further studies are warranted to explore the mode of action and safety of anethole for its possible use in cancer therapy.

Hepatitis C virus seroconversion rate in established blood donors

The results of hepatitis C virus (HCV) antibody test of 237,813 blood donations collected from 143,815 donors by the West Midlands Blood Transfusion Centre in 1993 were analyzed retrospectively in order to determine the seroconversion rate among established previously anti-HCV negative donors. Three hundred sixteen (0.22%; 1 in 455) donors were positive by the enzyme linked immunosorbent assay (ELISA) screening test and 34 (0.024%; 1 in 4,230) donors were positive by ELISA and the Recombinant Immuno Blot Assay (RIBA). Three donors previously negative for HCV antibody reacted positively by both tests. The annual seroconversion rate was calculated as one in 35,937 donors. This figure argues against limitation of HCV antibody screening to new blood donors. A further 45 donors negative on previous screening reacted positively by ELISA and were indeterminate by RIBA. Unexpectedly, lapsed blood donors first tested for HCV antibody in 1993 had high positive reaction rates by ELISA and RIBA, which was significantly (P < 0.001) higher than those of new donors. RIBA-positive reaction rate among ELISA-positive donors was significantly higher amongst males than females (P < 0.001).

Enhanced efficacy of praziquantel treatment in mice vaccinated with radiation attenuated cercariae of Schistosoma mansoni

Normal, and vaccinated mice four weeks previously with radiation attenuated cercariae of S. mansoni (500/mouse) were challenged with normal cercariae (150/mouse), then treated one week later with praziquantel (400 mg/kg body weight, orally). Worm burden was determined to calculate the % immunity in all groups under study. Histopathological examination of liver, small and large intestine, spleen and lung was done. Serum IgE level was estimated using the immunoradiometric assay. (IRMA). The % immunity was highest among vaccinated, infected and treated group with minimal pathological changes recorded and highest IgE level. From the data collected, it was found that, the efficacy of praziquantel treatment was enhanced in vaccinated mice and that there was synergistic effect between drug treatment and vaccination when praziquantel was given seven days post-infection (challenge).

Time factor and eosinophil count in relation to experimental Schistosoma mansoni infection

The effects of diurnal variations of eosinophils on hostparasite relationship was studied in mice primarily exposed to S. mansoni infection. The eosinophil counts of 20 control normal mice showed different variations at different hours of the day with maximum level at midday and the minimum level at midnight. At these times, 2 groups of mice, each consists of 30 mice, were infected by about 100 S. mansoni cercariae. The infected mice in both groups showed more or less the same results as regards the worm burden, egg counts in tissues and histopathological changes in livers. Both infected groups showed marked eosinophil elevation versus normal control group yet the difference in-between them was insignificant. This means that the normal physiological variation in eosinophils in normal mice is useless in protection against infection. Complete ablation of eosinophils from animal using antieosinophilic sera, is essential for any study on eosinophils in relation to infection.

Evaluation of Caralluma tuberculata pretreatment for the protection of rat gastric mucosa against toxic damage

The ethanolic extract of Caralluma tuberculata N. E. Brown has been screened for its potential to protect gastric mucosa against the injuries caused by 80% ethanol, 0.2 M NaOH, hypertonic saline, and indomethacin. C. tuberculata at doses of 250, 500, and 1000 mg/kg body wt given 30 min before the necrotizing agents provided dose-dependent protection against the damage caused by all tested agents. The effects caused by ethanol were further investigated. Treatment of rats with 1 ml of 80% ethanol (gavage) was found to cause depletion of stomach-wall mucus, to lower the concentrations of proteins, nucleic acids, and nonprotein sulfhydryl groups in the stomach wall, and to cause histopathological lesions, including necrosis, erosions, congestion, and hemorrhage, of the stomach wall. C. tuberculata treatment caused a dose-dependent protection against all these effects. In the same manner it affected malondialdehyde concentrations altered by ethanol treatment. C. tuberculata also offered protection against mucosal damage caused by indomethacin. The protective effects of C. tuberculata in addition to its effects on mucus production and nonprotein sulfhydryl concentration may be mediated through its free radical scavenging and prostaglandin inducing properties.

Anticarcinogenic effect of Commiphora molmol on solid tumors induced by Ehrlich carcinoma cells in mice

The anticarcinogenic potential of Commiphora molmol (oleoresin) was studied in Ehrlich-solid-tumor-bearing mice. The antitumor activity of C. molmol was evaluated from the total count and viability of Ehrlich solid tumor cells and their nucleic acid, protein, malondialdehyde and glutathione levels at the end of 25 and 50 days of treatment. Furthermore, observations of animal survival rate and measurements of the tumor and body weight were made. The Ehrlich solid tumors were also evaluated for histopathological changes. Treatment with C. molmol (250 and 500 mg/kg/day) was found to be cytotoxic in Ehrlich solid tumors cells. The antitumor potential of C. molmol was comparable to the standard cytotoxic drug cyclophosphamide. This effect of C. molmol was less pronounced after 50 days of treatment. The present study confirmed the cytotoxic and anticarcinogenic potential of C. molmol. Further studies are warranted to explore its mode of action and safety for medicinal use in cancer therapy.

Human scabies acquired from a pet puppy

Scabies is a very old contagious skin disease caused by itch mite, Sarcoptes scabiei which burrows into the stratum corneum. Nowadays, human scabies is one of the health problems among the school children. This paper dealt with a case of scabies in a preschool aged child who acquired the infestation from his pet puppy.

The helminthic parasites of rodents in Dakahlia Governorate, with reference to their Egyptian helminth fauna

No doubt, rodents are among the most important reservoirs of zoonotic diseases. This paper aimed to survey the helminth fauna of the different species of rodents in Dakahlia Governorate. Eight species of rodents were encountered in the different centers examined. A total of fifteen species of helminthic parasites were found. They belong to four classes: Trematoda five species: H. heterophyes, H. pumilio, H. yokogawai, S. tridactyla and E. callawayensis, Cestoidea three species: H diminuta, H. nana and T. taeniaeformis, Nematoda six species: A. cantonensis, T. muris, C. hepatica, S. obvelata, S. muris, S. ratti, and Archiacanthocephala one species: M. moniliformis. The medical and/or veterinary importance of these parasites were discussed. It was concluded that rodents are the most serious source of zoonotic parasites.

Laboratory study on the molluscicidal effect of Earth Tec: an environmentally responsible copper sulfate product

Studies were carried out, under laboratory conditions to evaluate the molluscicidal activity of Earth Tec on Biomphalaria alexandrina snails, the intermediate host of Schistosoma mansoni. Earth Tec is an environmentally responsible copper sulfate product manufactured and marketed as an algicide/bactericide with an active ingredient form of copper ion (Cu++). A single application, of 1 ppm of copper equivalent, for 24 hours caused 100% mortality rate of the snails. Exposure for 48 hours to 1 ppm and 2 weeks to 0.25 ppm caused mortality rates of 84% and 100% respectively. It was concluded that this chemical compound is a promising molluscicide. Field studies are ongoing and will be published in due time.

Investigation on the presence of Leishmania natural infection and antibodies among rodents in Riyadh, Saudi Arabia

Leishmaniases whether cutaneous and/or visceral are one of the public health problems in nearly all countries of the Eastern Mediterranean Region. The prevalence and the incidence are increasing. Control of the animal reservoir hosts in zoonotic forms is one of the best means of measures against leishmaniasis. This paper aimed to screen rodents for their role as reservoir for leishmaniasis. Natural Leishmania infection was detected in one Meriones crassus out of 3 which had cutaneous lesions. The lesion present on Gerbillus cheesmani was negative for amastigotes. Anti-leishmanial antibodies as detected by indirect haemagglutination tests (I.H.A.T.) showed reaction among the seven species of the trapped rodents. However, by interpretation of the diagnostic value of I.H.A. only three M. crassus (3/512) and one Gerbillus cheesmani (1/256) gave seropositive reactions. The whole results were discussed.

Studies on the antiinflammatory, antipyretic and analgesic activities of santonin

Santonin, a sesquiterpene lactone, commonly found in the plants of the family Compositae was found to show significant antiinflammatory activity on acute inflammatory processes. The activity profile of santonin closely resembled that of a standard non-steroidal antiinflammatory drug, diclofenac sodium. It also showed a significant inhibitory effect on granuloma formation; however, this effect of santonin was less pronounced as compared to diclofenac sodium. Santonin caused a significant antipyretic effect in mice, which was found to be independent of the route of administration of the drug. It also increased the hot plate reaction time of treated mice, similar to morphine.

Effect of Commiphora molmol (oleo-gum-resin) on the cytological and biochemical changes induced by cyclophosphamide in mice

The anticlastogenic and biochemical potentials of Commiphora molmol were studied in Swiss albino mice treated with cyclophosphamide (CP). The C.molmol treatment (125-500 mg/kg) showed no mutagenicity. It caused a highly significant and dose-dependent mitodepressant effect in the femoral cells and reduction of RNA levels in hepatic cells as compared with the control. CP treatment showed significant increase in the frequency of micronuclei, cytotoxicity and reduction in the contents of nucleic acids and proteins. Pretreatment with C. molmol could neither alter the biochemical and cytological effects of CP nor show any additive effect of both treatments.

Factors affecting C3 in intestinal schistosomiasis

Complement component C3 was investigated in sera of a group of schistosomal patients free from obvious nephritis. C3 was studied in relation to S. mansoni egg count, presence of HBsAg, and liver functions. C3 level was low in schistosomal patients than normal individuals. Levels were low in both HBsAg --ve and HBsAG +ve schistosomal patients. No significant difference was found between HBsAg --ve and HBsAg +ve in one hand, and between patients with egg counts more than 400 and those with egg counts less than 400 eggs/1 gr as regards level of C3 on the other hand. Presence of ascites did not affect C3 concentration. Positive correlation was found with Serum albumin, but not with prothrombin concentration serum alkaline phosphatase or serum transaminases.

Evaluation of direct and indirect methods in diagnosis of chronic intestinal schistosomiasis in Menoufia Governorate

A comparative study of Kato thick smear method, modified Ritchie concentration technique (MRCT), rectal snip biopsy and indirect haemagglutination (IHA) test were done on fifty patients with chronic intestinal schistosomiasis from Menoufia governorate, an area of Nile Delta endemic for schistosomiasis. Study revealed that a single kato-preparation was not sufficient to determine correctly the prevalence of Schistosoma mansoni infection particularly in chronic cases (22%), the accuracy was maximized by examining stool samples obtained from the same patient by MRCT (46%). Rectal snip biopsy and IHA test showed high positivity rate of 80% and 74% respectively. It is recommended to combine stool examination by MRCT with either rectal snip or IHA test according to the condition of patient as the former can not be performed on routine basis.

Evaluation of cercarien hullen reaction (CHR) as a diagnostic test in chronic schistosomiasis and as a parameter for reinfection in acute cases

CHR was evaluated as a serodiagnostic test in relation to stool analysis, rectal snip and indirect haemagglutination test (IHA) in 25 cases with chronic active mansonian schistosomiasis. Sensitivities of CHR, IHA, rectal snip and stool analysis, respectively, proved to be 68%, 48%, 84% and 52%. Rectal ship showed higher diagnostic efficacy 90% followed by CHR (77.5%), while IHA showed 67.5% diagnostic efficacy. To study CHR as parameter for pattern of reaction after treatment, 120 school children with acute mansonian schistosomiasis were examined CHR was done before and one month after treatment. These children were followed up for one year by stool examination. Results of CHR test after treatment showed that the children who were not reinfected gave the highest degree of reaction, while those of high reinfection showed decrease in reaction. This denotes that anticercarial antibodies may play a role in resistance to reinfection and CHR test could be used as parameter for reinfection in such cases.

Evaluation of the genotoxic, cytotoxic, and antitumor properties of Commiphora molmol using normal and Ehrlich ascites carcinoma cell-bearing Swiss albino mice

The genotoxic, cytotoxic and antitumor properties of Commiphora molmol (oleo gum resin) were studied in normal and Ehrlich ascites carcinoma cell-bearing mice. In normal mice, the genotoxic and cytotoxic activity was evaluated on the bases of the frequency of micronuclei and the ratio of polychromatic to normochromatic cells in bone marrow, which was substantiated by the biochemical changes in hepatic cells. The antitumor activity of C. molmol was evaluated from the total count and viability of Ehrlich ascites carcinoma cells and their nucleic acid, protein, malondialdehyde, and elemental concentrations in addition to observations on survival and the trend of changes in body weight. The tumors at the site of injection were evaluated for histopathological changes. Treatment with C. molmol (125-500 mg/kg) showed no clastogenicity but was found to be highly cytotoxic in normal mice. The results obtained in the Ehrlich ascites carcinoma cell-bearing mice revealed the cytotoxic and antitumor activity of C. molmol which was found to be equivalent to those of the standard cytotoxic drug cyclophosphamide. On the basis of the nonmutagenic, antioxidative, and cytotoxic potential of C. molmol as observed in the present study, its use in cancer therapy seems to be appropriate and further investigations are suggested.

Effect of Caralluma tuberculata on the cytological and biochemical changes induced by cyclophosphamide in mice

Treatment with Caralluma tuberculata extract induced complex biochemical and cytological changes in mice. Its cytotoxicity in the bone marrow cells of mice was comparable with that of the standard drug cyclophosphamide (CP); however, unlike CP, C. tuberculata was not clastogenic (as shown by the micronucleus assay). A dose-dependent decrease in the RNA content of liver and testes was produced by C. tuberculata treatment whereas there was no effect on the content of nucleic acid and protein in the brain. In the extract-treated animals there was a significant and dose-dependent increase in the DNA content of the liver, with a negligible effect on the protein content. Combined treatment with C. tuberculata and CP showed that C. tuberculata diminished the effect of CP on DNA levels; however, RNA levels were further suppressed, resulting in increased cytotoxicity. Pretreatment with C. tuberculata extract significantly reduced the clastogenicity of CP. These results indicated the involvement of different phytoconstituents acting by different routes.

Seroepidemiology of Toxoplasma infection in Riyadh, Saudi Arabia

A total of 362 apparently healthy Saudis of both sexes living in Riyadh and aged 4-60 years, were investigated for Toxoplasma antibodies using the indirect haemagglutination test (IHT). Eighty one (22.4%) were positive with titres of 1/64 or greater. A significantly higher prevalence of Toxoplasma antibodies was correlated with age and association with cats. Economic status showed an apparent, but not significant, negative correlation with antibody prevalence rates. No significant association was found between Toxoplasma infection and sex, consumption of raw or undercooked meat, and urban or rural residence. The results provide an evidence that cats may be the main source of human infection with Toxoplasma in Riyadh.

A study of uric acid pretreatment for the protection of rat gastric mucosa against toxic damage

Uric acid was evaluated for its potential to protect the gastric mucosa against the injuries caused by 80% ethanol, 0.6 m-HCl and 0.2 M-NaOH in rats. Uric acid at doses of 50, 100 or 300 mg/kg body weight provided dose-dependent protection against the ulcerogenic effects of all three agents. Other effects caused by ethanol only were studied. Serum uric acid concentrations were statistically significantly increased by both uric acid and ethanol treatments. Treatments of rats by gavage with 1 ml 80% ethanol was found to cause depletion of stomach-wall mucus, to lower the concentrations of protein, nucleic acids and non-protein sulphydryl groups in the stomach wall, and to cause histopathological lesions, including necrosis, erosions, congestion and haemorrhage, of the stomach wall. Treatment with uric acid, at doses of 50, 100 or 300 mg/kg body weight, by gavage, provided some measure of protection against all of these effects, and the protection was generally dose dependent. The protective effects of uric acid against damage to the gastric-wall mucosa may be mediated through its effects on mucus production and non-protein sulphydryl concentrations, and/or its free-radical scavenging properties.

Haematological values and parasitic infections in school children in Riyadh, Saudi Arabia

A total of 1426 apparently healthy Saudi children, were subjected to clinical and laboratory investigations of blood, urine and stools. Lower means were observed for Hb concentration, Hot ratio, RBC and WBC counts. The MCV was in the range of Western levels. Of 1343 stool specimens 156 (11.6%) were positive for intestinal parasites (5.4% pathogenic and 6.3% commensals). The higher infection rate of commensals strongly suggests the presence of potentially infectious environmental sources and a public health problem. Giardia lamblia was the most common pathogenic parasite 3.6% and its high infection rate seemed to be associated with lower Hb level. So screening for parasitic infections especially among anaemic children is necessary as a part of the general health care programme.

Parasitic infections and haemoglobin level among school children of different socioeconomic classes in Abha, Saudi Arabia

A total of 717 school children from Abha region, from upper, middle and lower social classes (182, 405 & 130 respectively), were examined for parasitic infections and haemoglobin level. Giardia lamblia was found to be the most common intestinal parasite among children of all classes, Entamoeba histolytica followed among children of middle class, and Hymenolepis nana among those of lower one. Anaemia was more prevalent among parasitically infected children particularly the multi-infected ones of the lower social class.

Mosquitoes of the genus Culex in the Suez Canal Governorates

Mosquitoes are among the most annoying and important vectors of human and animal diseases as malaria, filariasis, yellow fever, rift valley fever...etc. In this paper, it was aimed to study the present status of species of genus Culex in the Suez Canal Governorates after the reconstruction and developmental projects. Five species of Culex were identified: C. pipiens, C. univittatus, C. antennatus, C. poicilipes and C. pusillus. The latter species was represented by two specimens. C. pipiens was the commonest species both indoors and outdoors. C. antennatus and C. poicilipes were found only outdoors. C. pipiens was found all the year round particularly in Spring. Other species were found in Spring and Autumn, except C. antennatus which was found in Summer as well. The results were discussed on the light of work done before.

On the specificity of the indirect haemagglutination in diagnosis of visceral leishmaniasis

Human sera were collected from parasitologically proven cases of filariasis, strongyloidiasis, hymenolepiasis and ascariasis. Antibodies against these parasites cross react in the indirect haemagglutination for the antileishmanial antibodies at dilution up to 1:128. The diagnostic titer should be raised to 256 in order to increase the specificity of the test in areas where such parasites occur.

Treatment of cutaneous leishmaniasis with Pentostam or cryosurgery

Cutaneous leishmaniasis (CL.) caused by L. major or L. tropica is endemic in many countries in the Middle East particularly Saudi Arabia. The disease is characterized by spontaneous healing and sterilizing immunity. However, medical treatment is always indicated particularly those due to L. tropica to reduce the reservoir of infection. In this study parasitologically proven patients with CL. were treated with Pentostam (57) or Cryosurgery (38). Both gave satisfactory results. However, the disadvantages of each line were discussed. There is a need for a drug which is cheaper, less toxic, safe, more effective and more easily administered than those currently available.

A preliminary survey of parasitic infections and nutritional status among school children in Riyadh, Saudi Arabia

A total of 320 school children in the Model Institute of the Capital in Riyadh, were clinically and parasitologically examined. Thirty-five (10.94%) had intestinal parasites. Entamoeba coli (61.91%) was found more frequently among the commensals, while Giardia lamblia (28.57%) was the most common pathogenic parasite. All urines were parasite free. The low infection rate with Gardia could be explained by the good physical and nutritional status and better sanitary and living conditions.

Studies on biting midges of the genus Culicoides in the Suez Canal Zone

The importance of the biting midges of the genus Culicoides being in their role as vector of non periodic filarial worms of the genus Mansonella and Dipetalonema to man and pathogenic virus to livestock. Besides, their painful bite may disappear within an hour or cause an appreciable systemic reaction. In this paper, the four species recorded in the Suez Canal Zone (C. schultzei, C. puncticollis, C. pallidipennis & C. distinctipennis) were redescribed. Also, the hours of activity of the most common and abundant species, C. schultzei was studied. C. neavei Austin, 1912, representing a new record in Egypt.