Immunolocalization of relaxin in the corpus luteum of the dromedary camel. (Camelus dromedarius)

The objective of this study was to determine the distribution of the peptide hormone relaxin in ovarian tissues of the pregnant and non-pregnant dromedary (Camelus dromedarius). Using light and electron microscopy we here describe the presence of relaxin in cells of the corpus luteum at various stages of the reproductive cycle of this important species.

Synthesis and antifungal activity of some new quinazoline and benzoxazinone derivatives

The hitherto unknown 2-isopropyl-6,8-dibromo-4H-3,1-benzoxazin-4-one (2) was subjected to condensation with either primary or secondary amines affording the benzamide derivatives (3-7), while with alcohols in presence of the base, corresponding esters were obtained (8 and 9). Acylation of the hydrazide (12) or its cyclized form (13) gave (14-17). The quinazolinone derivative (18) was obtained either when (12) was reacted with nitrous acid or via fusion of (2) with ammonium acetate. The thione (20) which was obtained via reaction of (18) with Lawesson's reagent, was subjected to either alkylation yielding (21-25) or desulphurization with primary amines affording (26 and 27). Treatment of (18) as well as (20) with a chlorinating agent provided (29, 30) and (28, 29) mixtures, respectively. Ten of our compounds were examined against Sclerotium cepivorum as well as Botrytis allii on PDA media. These compounds showed a significant reduction of mycelial growth and scleratia number of these fungi which cause the white rot and neck rot diseases of onion.

Antimicrobial agent resistance in bacterial isolates from patients with diarrhea and urinary tract infection in the Sudan

Antimicrobial sensitivity tests were performed on four-hundred and ninety-seven bacterial isolates from Sudanese patients with diarrhea or urinary tract infections. Shigella dysenteriae type I and enteropathogenic Escherichia coli showed high resistance rates (percentage of isolates showing antibiotic resistance) against the commonly-used antimicrobial agents: ampicillin, amoxicillin, chloramphenicol, tetracycline, cotrimoxazole, nalidixic acid, sulfonamide, and neomycin, and were completely sensitive to ciprofloxacin. Eighteen resistance patterns against nine antimicrobial agents tested were observed in enteric pathogens. Resistance to ampicillin, amoxicillin, tetracycline, cotrimoxazole, and sulfonamide was the most frequent pattern. The common urinary pathogens, E. coli, Klebsiella pneumoniae, and Proteus mirabilis showed high rates of resistance to ampicillin, amoxicillin, cotrimoxazole, tetracycline, sulfonamide, trimethoprim, streptomycin, and carbenicillin. We recommend that physicians seek updated knowledge of the common antibiotic-sensitivity patterns when starting empirical antibiotic therapy in Sudanese patients with diarrhea or urinary tract infection.

Highly oxygenated monoterpenes from Chenopodium ambrosioides

Three new monoterpenes (3-5) were isolated from an organic extract of the aerial parts of Chenopodium ambrosioides. Structures were established on the basis of MS and NMR spectroscopic ((1)H, (13)C, (1)H-(1)H COSY, HMQC and HMBC) data.

The surgical management and outcome of oesophageal cancer in Addis Ababa

One hundred and forty two patients with oesophageal cancer seen from 1992-1996 at a surgical unit of Tikur Anbessa Hospital (TAH), Department of Surgery, Faculty of Medicine were studied retrospectively. It represented 13.8% of all malignant tumours that were seen in the department during the study period. Seventy four patients (52%) were explored and thirty four (46%) of them had resection, 27 (80%) had locally invasive tumours). Of the thirty four patients that were explored, thirty had an Ivor-Lewis type of resection, using stomach tube through the right side of the chest, and four had partial gastero-oesophagectomy with gastero-oesophagostomy in the left side of the chest. The post operative mortality was 21 (28%). The commonest causes of death were sepsis secondary to anastomotic leak and pneumonia. Follow up was possible for eighteen patients, eleven of them for seven months and the rest for seventeen months, all were doing well. Sixteen patients could not be traced.

Malignant adenomyoepithelioma of the breast with malignant proliferation of epithelial and myoepithelial elements: a case report and review of the literature

Malignant adenomyoepithelioma of the breast is a rare lesion characterized by malignant proliferation of epithelial and myoepithelial cells that show characteristic histologic and immunohistochemical features. Eleven cases have been reported, 4 of which showed evidence of distant metastasis. The authors report a case of malignant adenomyoepithelioma in the axillary tail of a 71-year-old woman, one of the oldest patients described so far, and review the literature. Malignancy in the current case was evidenced by the presence of local invasion, high mitotic rate, and severe cytologic atypia. The tumor was associated with adenosis and lobular adenomyoepithelial hyperplasia. Malignant adenomyoepithelioma is a rare neoplasm, diagnosable by light microscopy and immunohistochemistry. To date, it has only been reported in women, who ranged in age from 26 to 76 years. Metastases have only been documented in tumors 2.0 cm in diameter or larger.

Diterpenoid acids from Grindelia nana

Two new norditerpenoid acids of the labdane-type (norgrindelic acids), 4,5-dehydro-6-oxo-18-norgrindelic acid (1) and 4beta-hydroxy-6-oxo-19-norgrindelic acid (2), as well as a new grindelic acid derivative, 18-hydroxy-6-oxogrindelic acid (3), were isolated from the aerial parts of Grindelia nana. In addition, the known compounds, 6-oxogrindelic acid, grindelic acid, methyl grindeloate, 7alpha,8alpha-epoxygrindelic acid, and 4alpha-carboxygrindelic acid were also isolated. The structures of the new compounds were characterized on the basis of spectroscopic analysis.

Demand and supply of doctors and dentists in Bahrain, 1998-2005

We examined the supply and demand of medical doctors and dentists in Bahrain. Demand for physicians and dentists was based on the objective of having a physician-to-population ratio of 1:650, and a dentist-to-population ratio of 1:5000. Analysis of the current workforce and projected graduates in the period 1998-2005 indicated that the supply of Bahraini medical doctors and dentists until the year 2005 will not be sufficient to meet the projected demand in these categories. By the year 2005, Bahraini doctors and dentists will provide 82.5% and 75.9% of medical and dental demands respectively. The remaining 17.2% of physicians and 24.1% of dentists will have to be recruited from abroad. Thus, the prospect of oversupply of Bahrainis among these categories until the year 2005 is highly unlikely.

Modulating effects of sensory and autonomic neuropeptides on murine splenocyte proliferation and cytokine secretion induced by Leishmania major

The intimate, bidirectional link between neuroendocrine and immune systems is now accepted. A modulating effect of the nervous system on immune and inflammatory responses has been corroborated by identification of neuropeptide receptors on immunocompetent cells and the finding that neuropeptides can regulate leukocyte functions. The present study was undertaken to investigate the possible immunomodulatory role of sensory (SOM, CGRP and SP) and autonomic (VIP and NPY) neuropeptides in a murine model of cutaneous leishmaniasis, using two genetically different inbred mouse strains, BALB/c and C57BL/6, respectively susceptible and resistant to Leishmania (L.) major infection. The parameters studied were extent of splenocyte proliferation, as measured by thymidine uptake, and the ability of these cells to secrete IFN-gamma and IL-4 by using a two-site ELISA, upon in vitro challenge with L. major parasites and addition of the neuropeptides. The resistant mouse splenocyte proliferation was enhanced by SOM, CGRP, and VIP at 10(-5), 10(-6) and 10(-9) M concentration, respectively, but was inhibited by NPY at 10(-5) M. Proliferation of the splenocytes from the susceptible strain was inhibited by SOM (10(-11) M) and CGRP(10(-5) M). Somatostatin, at various concentrations, stimulated IFN-gamma secretion in both mouse strain splenocytes, and IL-4 production in the susceptible mouse. Calcitonin gene-related peptide enhanced IFN-gamma secretion in susceptible mouse splenocytes at 10(-6), 10(-7) and 10(-9) M, as did VIP at 10(-10) M and NPY at 10(-7) M. Vasoactive intestinal peptide also stimulated IL-4 production in BALB/c splenocytes at all concentrations used. Substance P had no effect on either cell proliferation or cytokine secretion in either of the two mouse strains. These findings indicate that the nervous system, represented by sensory and autonomic nerve terminals and their content of neuromediators, may be involved in the pathophysiology of cutaneous leishmaniasis.

A xanthanolide diol and a dimeric xanthanolide from Xanthium species

Extracts of the aerial parts of Xanthium strumarium and fruit of X. pungens afforded a new Xanthanolide diol derivative, 11alpha,13-dihydroxyxanthatin and a new dimeric xanthanolide sesquiterpene lactone, pungiolide C, in addition to some known compounds. The structures of the new compounds were determined by spectroscopic methods particularly high resolution (1)H-, (13)C-NMR and 2D (1)H- (1)H and (1)H- (13)C COSY NMR analysis.

Highly oxygenated bisabolenes and an acetylene from Matricaria aurea

Reinvestigation of the aerial parts of Matricaria aurea led to the isolation of three new bisabolenes and a new acetylene. The structures of the four compounds, namely (1R*,2R*,3R*,6R*,7R*)1,2,3,6,7- pentahydroxy-bisabol-10(11)-ene, (1R*,2R*,3R*,6R*,7R*)1,2,3,6,7-pentahydroxy-1-acetoxy-bisabol-10(1 1)-ene, (1R*,2R*,3R*,6R*,7R*)1,2,3,6,7-pentahydroxy-2-acetoxy-bisabol-10(1 1)-ene and (3S*,4S*,5R*)-(E)-3,4-dihydroxy-2-(hexa-2,4-diynyliden)-1,6- dioxaspiro-(4,5)decane, were deduced from the high field NMR studies.

Sevoflurane exposure time and the neuromuscular blocking effect of vecuronium

PURPOSE

To determine the effect of sevoflurane exposure time on the duration of vecuronium neuromuscular blockade.

METHODS

In 40 adult patients anesthesia was induced with 1.5-2 mg x kg(-1) propofol and 3-5 microg x kg(-1) fentanyl and the trachea was intubated without the aid of muscle relaxant. Patients were randomized into four groups of 10. In group 1, 0.05 mg x kg(-1) vecuronium was administered with N2O and anesthesia was maintained by propofol infusion and fentanyl. Vecuronium was administered with sevoflurane 2% in 30 patients, commencing at the same time (group 2) and at 30, and 60 min after sevoflurane (groups 3, 4). Adductor pollicis force of contraction to train-of-four ulnar nerve stimulation was recorded. Times from vecuronium injection to 95%, maximal block, and recovery times to 25% recovery were recorded.

RESULTS

There were no differences in times to 95% and maximal block in the four groups. Recovery times were longer in groups 3 and 4 than in groups 2 and 1 (P < 0.01). Times to 5% recovery were 15.0 +/- 3.7, 17.8 +/- 4.8, 28.2 +/- 9.9, and 29.5 +/- 9.5, and to 25% recovery were 22.3 +/- 5.2, 27.2 +/- 6.4, 42.3 +/- 16.3, and 50.5 +/- 16.4 in groups 1, 2, 3, and 4 respectively. No differences were found between group 1 and group 2 nor between group 3 and group 4.

CONCLUSION

Sevoflurane produced time-dependent potentiation of vecuronium. After 30 min exposure, 25% recovery was prolonged by 89% and after 60 min by more than 100% compared with the control group.

Fatal pulmonary tumor embolism caused by chondroblastic osteosarcoma: report of a case and review of the literature

Fatal pulmonary tumor embolism is an unusual phenomenon that has only rarely been reported with osteosarcoma. It usually presents with typical symptoms and signs of pulmonary thromboembolism. The authors report the case of a 65-year-old woman with chondroblastic osteosarcoma of the distal femur who suffered a fatal tumor embolism 30 hours after surgery and review the literature.

A new chromene glucoside from Ageratum conyzoides

The aerial parts of AGERATUM CONYZOIDES afforded a new chromene glucoside, 2,2-dimethylchromene 7- O-beta-glucopyranoside, together with a known benzofuran derivative. The structures were elucidated by high-field NMR spectroscopy.

Natural rubber base matrix containing Calendula officinalis plant as a source of molluscicdal saponin

Natural rubber (NR) has been used as a binding matrix for Calendula officinalis, where it is used as a vulcanizate. Various doses of the plant covering the range from 100 up to 200 parts per 100 of rubber (phr) were found suitable for processing conditions using conventional rubber mixing equipment. The release rate of saponin was extended to over 4 months. Incorporation of fillers, such as HAF and Hisil, in the compounded rubber decreased the release of saponin; especially in the first period of immersion. The amount of saponin released was affected by the environmental temperature and the type of fillers present in the formulations. The scanning electron micrographs illustrate the presence of a tortuous pass and pore structure that formed after soaking in water and leaching process occurred.

Neuropeptide Y concentrations in experimental Leishmania major cutaneous leishmaniasis

Neuropeptide Y (NPY) concentrations were investigated by radioimmunoassay and immunohistochemistry in a murine model of cutaneous leishmaniasis, using a susceptible (BALB/c) and a resistant (C57BL/6) mouse strain. The analyses were performed on the skin, secondary lymphoid organs and dorsal root ganglia (DRG) at 1, 3, 6 and 9 weeks postinfection. An overall reduction in the NPY concentrations in the studied organs was observed in both mouse strains; the reduction in the skin and draining lymph nodes was more evident and progressive in the susceptible strain. Using immunohistochemistry there seemed to be a reduction in NPY immunoreactivity in all inflamed tissues analysed compared to the controls. These observations might indicate a possible pathophysiological role for NPY in murine cutaneous leishmaniasis.

In vitro Leishmania major promastigote-induced macrophage migration is modulated by sensory and autonomic neuropeptides

Recruitment, migration and adherence of macrophages and their interaction with inoculated promastigotes are key steps in the initiation of the inflammatory process in cutaneous leishmaniasis. Parasite- and nervous system-derived factors might be involved in this process. In the present study the chemotactic activities of live, killed and sonicated Leishmania major promastigotes and of the promastigote culture supernatant as well as the L. major surface protease gp63 towards a murine macrophage cell line, Raw 264.7, were investigated, using the Boyden technique. The sensory neuropeptides SOM, CGRP and SP, and the autonomic neuropeptides VIP and NPY, were also investigated for possible modulatory effects on this chemotaxis, using the living promastigotes. Living promastigotes were the most efficient attractants for macrophages compared with other forms of the parasites. Prior incubation of the macrophages with the parasites completely abolished the chemotactic activity. This might indicate that the living promastigote chemotaxis is a receptor-mediated process. On the other hand, paraformaldehyde-killed promastigotes not only failed to induce macrophage chemotaxis but also inhibited it in comparison with the control. The surface protease gp63 tended to inhibit the macrophage chemotactic activity and the sonicate tended to stimulate it compared with controls. The culture supernatant had no effect, indicating that the chemoattractive factors putatively synthesized by the living promastigotes are not released to the surrounding medium. Somatostatin inhibited L. major promastigote-induced macrophage migration at a high concentration, 10(-6) M, while substance P inhibited it at both low concentrations, 10(-10) and 10(-9) M, and a high one, 10(-6) M, the last-mentioned having the greatest inhibitory effect. A stimulatory effect of calcitonin gene-related peptide was found at high concentrations, 10(-5) and 10(-6) M. Vasoactive intestinal peptide stimulated macrophage chemotactic activity at both a high, 10(-5) M, and at a low, 10(-9) M, concentration, the same concentration at which neuropeptide Y exerted its maximum inhibitory effect.

Radiation dose to the human respiratory tract from inhalation of radon-222 and its progeny

In this article the regional dose equivalent for exposure to 1 working level month (WLM), the annual effective dose equivalent and the dose equivalent conversion factor due to the inhalation of short-lived radon progeny (218Po, 214Pb and 214Bi/214Po) are calculated with a dosimetric model. Experimental results of aerosol size characteristics, unattached activity fractions, equilibrium factors, and activity size distributions of the short-lived radon progeny in indoor and outdoor atmosphere are summarized. Dose calculations based on these results show that the changes in dose rate values are influenced by the different model assumptions concerning deposition probabilities of aerosol particles in the respiratory system during inhalation, the sensitivity of different cells (epithelial, basal) to radiation and assuming nose or mouth breathing. The inverse relationship between the unattached fraction of potential alpha-particle energy in room air and the radioactive equilibrium between radon gas and its progeny indicates that dose equivalent is closely related to the concentration of radon gas averaged over a period of exposure.

Decreased concentrations of CGRP in Leishmania major murine cutaneous leishmaniasis

The expression of the sensory neuropeptide calcitonin gene-related peptide (CGRP) in the skin, secondary lymphoid organs and dorsal root ganglia (L4-L6) in Leishmania major-induced inflammation was evaluated by radioimmunoassay. The investigation was conducted on two mouse strains, the susceptible BALB/c and the resistant C57BL/6. The CGRP concentration in the inflamed skin of both mouse strains was decreased as early as 1 week postinfection, compared to controls. A further reduction was observed in both mouse strains throughout the 9-week study period, but was more evident in the susceptible strain. The CGRP concentration was increased in the ipsilateral dorsal root ganglia (L4-L6) of mice of the resistant strain 1 week postinfection, while no change was observed in the susceptible strain. In the remaining part of the study period there was a reduction in CGRP in the ipsilateral dorsal root ganglia of both mouse strains. In the spleen, a reduction was noted in the infected BALB/c at all measurement times (significant at 6 and 9 weeks), while no change was observed in C57BL/6 strain. These findings may indicate a regulatory function of CGRP in the pathophysiology of murine cutaneous leishmaniasis and hence in the disease outcome. The reduction in CGRP might also explain the defective nociception observed in patients with cutaneous leishmaniasis.

Effect of forty-eight-hour glucose infusion into rats on islet ion fluxes, ATP/ADP ratio and redox ratios of pyridine nucleotides

Glucose infusion into rats has been shown to sensitize/desensitize insulin secretion in response to glucose. In pancreatic islets from glucose-infused rats (GIR) (48 h, 50%, 2 ml/h) basal insulin release (2.8 mmol/l glucose) was more than fourfold compared with islets from saline-infused controls and the concentration-response curve for glucose was shifted to the left with a maximum at 11.1 mmol/l. The concentration-response curve for 45Ca2+ uptake was also shifted to the left in islets from GIR with a maximum at 11.1 mmol/l glucose. Starting from a high basal level at 2.8 mmol/l glucose KCl produced no insulin release or 45Ca2+ uptake in islets from GIR. Islets from GIR exhibited a higher ATP/ADP ratio in the presence of 2.8 mmol/l glucose and marked inhibition of 86Rb+ efflux occurred even at 3 mmol/l glucose. Moreover, in islets from GIR the redox ratios of pyridine nucleotides were increased. On the other hand insulin content was reduced to about 20%. The data suggest that a 48-h glucose infusion sensitizes glucose-induced insulin release in vitro in concentrations below 11.1 mmol/l. This may, at least in part, be due to enhanced glucose metabolism providing increased availability of critical metabolic factors including ATP which, in turn, decrease the threshold for depolarization and therefore calcium uptake. Calcium uptake may then be further augmented by elevation of the redox state of pyridine nucleotides.

Differential expression of nerve growth factor in Leishmania major murine cutaneous leishmaniasis

The cross-talk between the immune and nervous systems is becoming an interesting field of research and there is accumulating evidence supporting this notion. In the present study we investigated the levels of nerve growth factor in a murine model of cutaneous leishmaniasis, using a two-site ELISA. Two strains of inbred mice were used for this purpose, namely BALB/c and C57BL/6, genetically susceptible and resistant, respectively, to infection with Leishmania major. This work demonstrates a difference in expression of nerve growth factor in the skin and secondary lymphoid organ microenvironment, as well as in the serum, between these mouse strains. The high nerve growth factor levels in the microenvironment seem to be important and possibly critical for the outcome of the disease. Compared with controls, the resistant strain, C57BL/6, expressed significantly increased nerve growth factor levels in the skin, secondary lymphoid organs and serum at 1 week post-infection, whereas the susceptible strain, BALB/c, showed no change in the skin and a slight increase in the lymphoid organs and serum at this time-point. These high nerve growth factor levels in the early stage of the disease, whether produced directly by the inflammatory cells or indirectly through its induction by other cytokines or both, might indicate a contribution of this neurotrophic factor to differentiation of naive T lymphocytes into either Th1 or Th2 subsets that fundamentally govern the disease outcome. The expression of significantly elevated nerve growth factor levels in the skin and lymphoid organs of C57BL/6 at the late studied time points might suggest a role for nerve growth factor in the resolution of the disease process, which is usually evident from 6 weeks post-infection in this model. The high nerve growth factor levels expressed in the skin, lymph nodes and serum of BALB/c at late stages of the disease may be explained as an attempt to counteract the progression and dissemination of the disease. This investigation adds further experimental evidence for an anti-inflammatory effect of nerve growth factor, possibly through its action as a link between the nervous and immune systems.

Eudesmane derivatives from Iva frutescens

Re-investigation of the aerial parts of Iva frutescens resulted in the isolation of three sesquiterpenes, two of which are new natural products, and their structures were established by spectral data.

Functional analysis of a 38 kilobase region on chromosome XVI in Saccharomyces cerevisiae

In this report we assess the functional importance of 16 open reading frames (ORFs) contained within a 38 780 base-pair region immediately adjacent to the centromere on the right arm of chromosome XVI in Saccharomyces cerevisiae. This analysis involved replacing one copy of each ORF in a diploid strain with a cassette encoding the green fluorescent protein from the jellyfish Aequorea victoria and HIS3. Each replacement cassette was generated by PCR using oligonucleotide pairs with 45-base extensions complementary to sequences immediately upstream and downstream of the target gene's coding region. After replacement of the targeted genes, each gene-replacement strain was subjected to a series of genetic and phenotypic tests to assess the functional importance of the deleted gene. This analysis showed that two ORFs were essential, one for spores to germinate and another for vegetative growth. A third gene encoded a copper-fist-like transcription factor that was required for proper bud-site selection. One of the 16 ORFs was duplicated, a situation not observed in the strain used to sequence the yeast genome (S288C). RNA analysis showed 11 of the 16 ORFs in this region expressed steady-state poly(A+) RNA levels that were greater than or equal to 2% of the level expressed from the yeast actin gene, ACT1.

Spontaneous ovarian hyperstimulation syndrome with pregnancy

Only two cases of severe spontaneous ovarian hyperstimulation syndrome with pregnancy have been reported. We report the third one and the only one that was successfully managed conservatively throughout pregnancy.

Uterus-like mass arising in the broad ligament: a metaplasia or mullerian duct anomaly?

A 46-year-old woman presented with a large abdominopelvic mass. Exploration revealed a large cystic mass that arose from the posterior leaf of the right broad ligament. The mass was lined by endometrial-like tissue and had an outer layer of smooth muscle that resembled myometrium. The inner wall was focally composed of a thick layer of intermixed smooth muscle and endometrial glands comparable to adenomyosis. This is the fourth reported case of "a uterus-like mass" and the first that is clearly extraneous to the ovary. We hypothesize that these masses may arise from subperitoneal mesenchymal cells that retain the ability to duplicate mullerian duct structures; other cases may represent mullerian duct fusion defects.

Clerodane diterpenoids, long chain esters of coumaric acid and other compounds from Baccharis myrsinites

A new clerodane diterpenoid and two new long chain esters of trans- and cis-coumaric acid, in addition to known triterpenoids and one known clerodane diterpenoid, have been isolated and characterized from Baccharis myrsinites. The structures were determined by spectroscopic techniques.

Histone H1 in Saccharomyces cerevisiae

The existence of histone H1 in the yeast, Saccharomyces cerevisiae, has long been debated. In this report we describe the presence of histone H1 in yeast. YPL127c, a gene encoding a protein with a high degree of similarity to histone H1 from other species was sequenced as part of the contribution of the Montreal Yeast Genome Sequencing Group to chromosome XVI. To reflect this similarity, the gene designation has been changed HHO1 (Histone H One). The HHO1 gene is highly expressed as poly A+ RNA in yeast. Although deletion of this gene had no detectable effect on cell growth, viability or mating, it significantly altered the expression of beta-galactosidase from a CYC1-lacZ reporter. Fluorescence observed in cells expressing a histone H1-GFP protein fusion indicated that histone H1 is localized to the nucleus.

Management in the Ministry of Health: what are the vital signs?

Effective and efficient management of health services is becoming more and more important in all countries and in all organizations whether profit or non-profit. Management practices and attitudes which may have been accepted in previous years are no longer appropriate. A study was conducted in the Ministry of Health, State of Bahrain to determine the current status of management skills and attitudes. Participants were asked to identify the best and the worst practices of managers. Eight key areas of concern were identified: participative vs. non-participative style, communication, motivation, delegation, human relations skills, style of supervision, goal-oriented behavior, and use of supervisory power. In each of these management-related skill areas, examples of best and worst practices are provided in order to aid the manager/leader in self-assessing his/her abilities as a first step toward improving management.

A new derivative of glucose and 2-C-methyl-D-erythritol from Ferula sinaica

A new glucose derivative (1) and 2-C-methyl-D-erythritol (2) were isolated from the leaves of Ferula sinaica. The two structures were elucidated by highfield NMR spectroscopy, and that of 1 was confirmed by X-ray diffraction analysis.

Comparison of the acute effects on gas exchange of nasal ventilation and doxapram in exacerbations of chronic obstructive pulmonary disease

BACKGROUND

Nasal intermittent positive pressure ventilation (NIPPV) is useful in exacerbations of chronic obstructive pulmonary disease (COPD) complicated by ventilatory failure. The effects of NIPPV were compared with those of the respiratory stimulant doxapram on gas exchange in patients with COPD and acute ventilatory failure.

METHODS

Patients admitted with acute exacerbations of COPD and type 2 respiratory failure (Pao2 < 8 kPa and PaCO2 > 6.7 kPa) who did not improve with conventional treatment were randomised to receive either NIPPV or intravenous doxapram. Blood gas tensions were monitored for four hours.

RESULTS

In nine patients who received NIPPV the arterial PaO2 improved from a mean (SE) of 5.9 (0.4) kPa to a maximum of 8.1 (0.6) kPa which was maintained at four hours. Eight patients who received doxapram had a similar baseline Pao2 of 5.6 (0.4) kPa which rose to a maximum of 7.3 (0.5) kPa but this was not maintained at four hours. The improvement in Pao2 in patients on NIPPV was accompanied by a fall in Paco2 but, in contrast, in those who received doxapram there was no improvement in Paco2.

CONCLUSIONS

NIPPV may be more effective than doxapram in the management of acute ventilatory failure complicating COPD.

Immunohistochemical studies of proinflammatory cytokines and their receptors in hair follicles of normal human skin

Immunoreactivity to interleukin-1 alpha, interleukin-1 beta, interleukin-6 and tumour necrosis factor-alpha and their receptors, as well as the endogenous interleukin-1 receptor antagonist, was investigated in hair follicles in paraffin-embedded normal human skin. Interleukin-1 beta- and tumour necrosis factor-alpha-like immunoreactivities were found in the inner root sheath layer of hair follicles, at the suprapapillary level. Interleukin-1 receptor-like immunoreactivity was also found in this layer, while there was a variable immunoreactivity to the interleukin-1 receptor antagonist. In the outer root sheath there was a weak to moderate staining for the four cytokines, in addition to intense staining for their receptors and a weak staining for the antagonist. The fibrous root sheath had a moderate immunoreactivity for interleukin-1 alpha and interleukin-6. The distribution patterns suggest that these cytokines, particularly interleukin-1 beta and tumour necrosis factor-alpha, may have a protective role in hair formation, while all the investigated proinflammatory cytokines may have a role in the differentiation process.

Post-endemic acute bacterial meningitis in Sudanese children

The study describes an 18-month surveillance of the epidemiological, clinical and microbiological features of childhood acute bacterial meningitis (ABM) seven months after the end of a major epidemic of Neisseria meningitidis (MC) in Khartoum. A total of 125 children, aged one month to 14 years, who were admitted with a provisional diagnosis of meningitis/meningoencephalitis to the Children's Emergency Hospital (CEH) in Khartoum, Sudan, were prospectively enrolled in the study. Bacterial meningitis was diagnosed by direct microscopy (DM), culture or a recently introduced ELISA assay (EIA-test) in 56 children. Haemophilus influenzae (HI) and MC were the commonest causative bacteria (each accounting for 38%) and were followed by Streptococcus pneumoniae (PNC, 23%). There was a relative decrease in the proportion of HI which was found to be the leading causative bacteria in a previous study done in the same hospital during endemic situations. This was accounted for by a relative excess of MC during the post-epidemic period. Molecular analysis of two MC strains revealed that clone III-I of serogroup A (that caused an intercontinental wave of MC disease between 1983 and 1990) was still prevalent. The case fatality rate was 28.6% which is higher than that reported in Sudan (18.6%) during endemic situations; but comparable to the mortality in other African countries. Of the prognostic factors on admission, low systolic blood pressure (< 70 mmHg), hyperpyrexia (temperature > 40 degrees C) and light to deep coma correlated significantly with a fatal outcome.

Proinflammatory cytokines and their corresponding receptor proteins in eccrine sweat glands in normal and cutaneous leishmaniasis human skin. An immunohistochemical study

Paraformaldehyde-fixed biopsy specimens of normal and chronic cutaneous leishmaniasis human skin were investigated for the presence and cellular distribution of interleukin-1 alpha, interleukin-1 beta, interleukin-6 and tumour necrosis factor-alpha and the corresponding receptors in eccrine sweat glands, using an indirect immunoperoxidase technique. There was cytoplasmic staining for all 4 cytokines as well as their receptor proteins in the clear cells of the eccrine sweat glands of both normal and inflamed skin specimens. No staining could be seen in the dark cells or the myoepithelial cells, neither in normal nor in inflamed skin. However, a difference between normal and inflamed skin was observed in the ductal system. Thus, cell layers of the dermal ducts in leishmaniasis skin were stained for all 4 cytokines, with more intense labelling in the basal cell layer of the coiled ducts, while in the normal skin, an intense staining was more evident in the inner luminal layer, with variable and less intense labelling of the basal layer. The immunolabelling for the cytokine receptors within the dermal ducts exhibited similar staining intensity in both luminal and basal cell layers, except in the case of the IL-6 receptor, which showed a moderate to intense signal in the basal cell layer but a weak staining of the luminal cell layer. Infiltrating inflammatory cells around the sweat gland apparatus in leishmaniasis skin exhibited immunoreactivities for all cytokines and their corresponding receptors.

Immunohistochemical localization of interleukin-6-like immunoreactivity to peripheral nerve-like structures in normal and inflamed human skin

Interleukin-6-like (IL-6-like) immunoreactivity was sought in inflamed and normal human skin using the same immunohistochemical technique as for detection of neuropeptides. Such immunoreactivity was found in dermal and in a few intraepidermal nerve-like fibres in biopsy specimens from inflamed skin from patients with positive epicutaneous patch-test reactions to nickel sulphate, and in skin specimens from patients with atopic dermatitis and prurigo nodularis. However, IL-6-like immunoreactivity was also found in nerve-like fibres in specimens from nonlesional skin. In skin from patients with positive epicutaneous patch-test reactions there was a statistically significantly (P < 0.01) higher number of IL-6-positive nerve fibres in the epidermis than in normal skin, in contrast to the papillary dermis, in which no difference was found. Moreover, there were clusters of nerve-like fibres with IL-6-like immunoreactivity in the dermis of prurigo nodularis lesions. In these nerve-like fibres, the colocalization of the immunoreactivities for IL-6 and calcitonin gene-related peptide was indicated. Localization of immunoreactivity to nerve-like structures surrounding the eccrine sweat glands indicates that IL-6 is present in autonomic as well as in sensory nerve fibres.

Bronchoscopic extraction of aspirated foreign bodies in children in Harare

Fifty eight children underwent rigid bronchoscopy under general anaesthesia for suspected aspirated foreign bodies. There were 36 boys and 22 girls with a median age of thirty three months. Physical examination showed decreased breath sounds and wheezing over the affected site in forty seven cases. Chest x-rays were diagnostic in eleven cases showing definite radiopaque shadow and suggestive of aspirated foreign body in thirty five (60%). Three patients had negative results of bronchoscopy (5.2%). Extraction of foreign bodies was performed by forceps under direct vision at bronchoscopy in fifty five patients. Two children had an intraoperative hypoxic arrest. Post endoscopic complications included mild to moderate croup in fifteen patients (26%), fever in four and pneumothorax in one. Rigid bronchoscopy of aspirated foreign bodies in children is a safe, effective and often life saving procedure. Morbidity is low and although mortality was 1.8% in this series zero mortality should be achievable.

Gamma irradiation of Egyptian Cobra (Naja haje) Venom

The aim of the present study was to prepare an effective and safe toxoid for the Egyptian Cobra (Naja haje) Venom by gamma irradiation. The effects of gamma irradiation (0.1-10 M rad) on the toxicity, as well as the antigen antibody complex formation reactivity was described. It appears from the results that the lethality of Naja haje venom irradiated in the dry form was not affected up to a dose of 10 M rad (100 KGy). On the other hand, the venom irradiated in the aqueous solution form showed a decrease in its lethality, and this was proportionately related to the dose of irradiation, while the ability of the venom antigens to react with its corresponding antibodies was retained up to irradiation dose of 5 M rad. The results of double immunodiffusion of non irradiated and the different dose levels of gamma irradiated venom (0.1-5 M rad) against a commercial Egyptian polyvalent antivenin, all showed similar patterns, the four visible lines obtained in the immunodiffusion reactions were identical and joined smoothly at the corners, indicating that there was no change in antigenic reactivity with antibodies determinants.

An ELISA assay for the rapid diagnosis of acute bacterial meningitis

A recently introduced ELISA test (EIA-Test) was used for the detection of the common organisms that cause acute bacterial meningitis (ABM). The test--which detects antigens of Haemophilus influenzae type b, Neisseria meningitidis (serogroups A, B, C) and Streptococcus pneumoniae (25 selected types)--is performed in less than 1 hour and read by the naked eye. Cerebrospinal fluid (CSF) specimens of 125 Sudanese children (1 month-14 years) admitted with a provisional diagnosis of meningitis/meningoencephalitis were prospectively examined with the EIA-Test, direct microscopy (DM) using Gram stain and culture. Of the 56 positive CSF specimens, the EIA-Test had the highest yield (100%), followed by culture (33.9%) and DM (30.4%). Nineteen (33.9%) of the positive samples came from children who had been treated with antibiotics prior to admission, and all were positive in the EIA-Test. EIA-Test was also the only positive test in 31 (55.4%) cases. From the present study, and similar to previous observations, the EIA-Test seems to have valuable potential for the rapid diagnosis of ABM and is of particular help in patients who have been pre-treated with antibiotics.

Sesquiterpene lactones and other constituents from Hymenoxys richardsonii and H. subintegra

Two Hymenoxys species afforded, in addition to known compounds, three new pseudoguaianoloides, a new sesquiterpene glucoside and a new butyrolactone. This is the first report of an eudesmane from the genus Hymenoxys. The structures were elucidated by high-field NMR and chemical transformations.

Interleukin (IL)-1 alpha- and -1 beta-, IL-6-, and tumor necrosis factor-alpha-like immunoreactivities in human common and dysplastic nevocellular nevi and malignant melanoma

Interleukin-1 alpha and -1 beta, interleukin-6, and tumor necrosis factor-alpha may have a protective effect against malignant transformation of melanocytes. By using monoclonal and polyclonal antisera we investigated, in paraformaldehyde-fixed tissue, the cellular distribution of these cytokines in human common and dysplastic nevocellular nevi and in malignant melanoma. Generally, the immunolabeling for all of these cytokines was both cytoplasmic and perinuclear as well as present in the basement membrane, which surrounds the individual cells or cellular nests of some of the nevi. In compound and intradermal nevi the immunolabeling was abundant, although there was a variation in the staining intensity between individual cells and even inside a single nevus cell, ranging from weak to strong. There was a strong labeling of the basement membrane around the cellular nests and around individual cells inside or outside the nests in the papillary and reticular dermis. With regard to the common junctional and dysplastic nevi and malignant melanoma, occasional immunolabeling could be seen in some cells within the cellular nests in the junctional area or papillary dermis, ranging from faint to moderate in intensity, but in this case the basement membrane around individual cells or cellular nests was not stained. The staining of nevocellular nevi and malignant melanoma indicates the possibility of these cytokines being synthesized by the nevi and melanoma cells. The labeling of the basement membrane in compound and intradermal nevi suggests that cytokines produced by nevocellular cells may be stored in the basement membrane, from which they could be released upon environmental or mechanical challenge. This distribution pattern would support the hypothesis that these cytokines may protect the common nevi from malignant transformation.

Abietane diterpenes from Lepechinia urbaniana

Lepechinia urbaniana was investigated with respect to abietane diterpenes. In addition to four widespread diterpenes, two rare compounds were isolated and characterized.

Interleukin-1 alpha- and beta-, interleukin-6- and tumour necrosis factor-alpha-like immunoreactivities in chronic granulomatous skin conditions

Paraformaldehyde-fixed tissue of chronic granulomatous skin conditions, such as cutaneous leishmaniasis, granuloma annulare, leprosy and hidroadenitis, was investigated for the presence of interleukin-1 alpha-, interleukin-1 beta-, interleukin-6- and tumour necrosis factor-alpha-like immunoreactivities among the cellular infiltrates. There was a weak to strong cytoplasmic labelling of plasma cells for interleukin-6 and tumour necrosis factor-alpha at the periphery of the granulomatous mass and around the skin appendages. The interleukin-6-like immunoreactivity seemed to be correlated with the coarseness of the chromatin material of the cells, being more intense with coarse chromatin. The cytoplasmic labelling for interleukin-1 alpha and interleukin-1 beta in the plasma cells was less intense. Epitheloid, Langhans' giant cells and small round cells exhibited a weak to moderate cytoplasmic labelling for interleukin-1 alpha and interleukin-1 beta, whereas the staining intensity for interleukin-6 and tumour necrosis factor-alpha was weak to strong. In addition, there was staining of the stroma in the centre of granuloma with antisera against interleukin-1 alpha, interleukin-1 beta, interleukin-6 and tumour necrosis factor-alpha. This area contained few cells, suggesting that the granuloma was in a resolution process. A contribution of interleukin-6 and tumour necrosis factor-alpha to the granulomatous reaction, at least during the maintenance period, is suggested by the occurrence of these cytokines in the skin conditions studied. The findings are also consistent with a suggested role of B cells in the late stages of the granulomatous reaction. In addition, they are in line with the reported declining role of interleukin-1 in the maintenance of granuloma.

Bronchoscopic extraction of aspirated foreign bodies in children in Harare Central Hospital, Harare, Zimbabwe

Fifty eight children underwent rigid bronchoscopy under general anaesthesia for suspected aspirated foreign bodies. There were 36 boys and 22 girls with a mean age of 18 months. Physical examination showed decreased breath sounds and wheezing over the affected site in 47 cases. CXR's were diagnostic in 11 cases showing a definite radio opaque shadow suggestive of aspirated foreign body in 35 (60 pc). Three patients had negative results at bronchoscopy (5.4 pc). Extraction of foreign bodies was performed by forceps under direct vision at bronchoscopy in 55 patients. Two children had an intra-operative hypoxic arrest. Post endoscopic complications included mild to moderate croup in 15 patients, fever in four and pneumothorax in one. Rigid bronchoscopy of aspirated foreign bodies in children is a safe, effective and often life saving procedure. Morbidity is low and although mortality was 1.8 pc in this series zero mortality should be achievable.

Soda-lime-silica glass for radiation dosimetry

The color developed in a commercially available soda-lime-silica glass when subjected to gamma-irradiation and the stability of such radiation-induced color were studied to test its sensitivity to small doses of gamma-rays (0.0-27 kGy). After irradiation, two absorption bands developed at 400 and 620 nm. The former band exhibited a stronger absorption than the later one. The intensity of both bands showed a gradual increase with increasing irradiation dose and a gradual decrease with increasing fading time after irradiation. The development of these bands is associated with the generation of defects at nonbridging oxygen atoms in the glass lattice and hole centers. The results obtained suggest that this glass simulated the Z of compact bone in terms of gamma rays absorption properties over broad radiation spectra (0.1 to 10 MeV).