Does the severity of untreated dental caries of preschool children influence the oral health-related quality of life?

AIM

To assess the impact of untreated dental caries and its severity on the oral health-related quality of life (OHRQoL) of Kuwaiti preschool children and their caregivers.

METHODS

Participants were 4- and 5-year-old kindergarten children attending preselected public schools from one of the Governorates in Kuwait. Early childhood caries (ECC) was evaluated by clinical examinations and presented using decayed, missed, filled teeth/surface (dmft/dmfs). The clinical consequences of untreated dental caries were assessed using the pufa (pulp, ulcers, fistula, abscess) index for primary teeth. A structured questionnaire obtained demographic information of children and their caregivers. OHRQoL was assessed using the Arabic version of Early Childhood Oral Health Impact Scale (A-ECOHIS).

RESULTS

Among the 334 participants, 171 were kindergarten level-1 (KG1), and 163 were level-2 (KG2). The overall prevalence of dental caries was 78.9% for KG1 children and 67.4% for KG2 children. Decayed teeth were the main component for both dmft (84%) and dmfs (68%). The total mean (SD) pufa score was 0.54 (1.5), and about 19.2% of participants had at least one tooth with pufa > 0. A total of 207 A-ECOHIS were completed. Both family and child impact scores were significantly higher for children with a dmft score of 1 or more (p < 0.001) or with one or more pufa (p < 0.001). Child impact section scores were significantly higher with the increasing degrees of untreated caries (dt) (p = 0.004).

CONCLUSION

The severity of untreated dental caries and caries experience had a negative impact on the OHRQoL of Kuwaiti preschool children and their families. Using the pufa index had provided additional information about the effect of the caries severity on the OHRQoL than assessing the caries experience alone.

Role of meteorological parameters with the spread of Covid-19 in Pakistan: application of autoregressive distributed lag approach

This research focuses on the impacts of different meteorological parameters (temperature, humidity, rainfall, and evapotranspiration) on the transmission of Covid-19 in the administrative regions and provinces of Pakistan, i.e., Azad Jammu and Kashmir, Gilgit Baltistan, Khyber Pakhtunkhwa, Islamabad, Punjab, Sindh, and Balochistan from June 10, 2020, to August 31, 2021. This study analyzes the relation between Covid-19-confirmed cases and the meteorological parameters with the help of the autoregressive distributed lag model. In this research, additional tools (t-statistics, f-statistics, and time series analysis) are used for the motive of examining the linear relationship, the productivity of the model, and for the significant association between dependent and independent variables, lnccc and lnevp, lnhum, lnrain, lntemp, respectively. Values of t-statistics and f-statistics reveal that variables have a connection and individual significance for the model exist. Time series display that the Covid-19 spread increased from June 10, 2020, to August 31, 2021, in Pakistan. Temperature positively influenced the Covid-19-confirmed cases in all provinces of Pakistan in the long run. Evapotranspiration and rainfall influenced positively, while specific humidity influenced negatively on the confirmed Covid-19 cases in Azad Jammu Kashmir, Khyber Pakhtunkhwa, and Punjab. Specific humidity had a positive impact, while evapotranspiration and rainfall had the negative impact on the Covid-19-confirmed cases in Sindh and Balochistan. Evapotranspiration and specific humidity influenced positively, while rainfall influenced the Covid-19-confirmed cases negatively in Gilgit Baltistan. Evapotranspiration influenced positively, while specific humidity and rainfall influenced negatively on the Covid-19-confirmed cases in Islamabad.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13762-023-04997-4.

Abstract AP09: COPY-NUMBER SIGNATURES AND MUTATIONAL PROCESSES IN HIGH GRADE SEROUS OVARIAN CARCINOMA

BACKGROUND: The genomic complexity of profound copy-number aberration has prevented effective molecular stratification of high grade serous ovarian carcinoma (HGSOC). Recent algorithmic advances have enabled interpretation of complex genomic changes by identifying mutational signatures—genomic patterns that are the imprint of mutagenic processes accumulated over the lifetime of a cancer cell. We hypothesized that specific features of copy-number (CN) abnormalities could represent the imprints of distinct mutational processes, and developed methods to identify signatures from copy-number features in HGSOC.

METHODS: We derived copy-number signatures from absolute copy number profiles from 253 primary and relapsed HGSOC samples from 132 patients in the BriTROC-1 cohort using low-cost shallow whole-genome sequencing (sWGS; 0.1×). A subset of 56 of these cases had deep whole-genome sequencing (dWGS) performed for mutation analysis and comparison with sWGS data. Independent validation was performed using 112 dWGS HGSOC cases from PCAWG and 415 HGSOC cases with SNP array and whole exome sequence from TCGA. CN signature exposures were correlated with mutation data, SNV signatures, and other measures derived from deep WGS and exome sequencing to identify statistically significant genomic associations using a false discovery rate &lt;0.05.

RESULTS: We identified 7 CN signatures that provided a molecular framework to rederive the major defining elements of HGSOC genomes, including defective homologous recombination (HRD), tandem duplication, amplification of CCNE1 and amplification-associated fold-back inversions. Almost all patients with HGSOC demonstrated a mixture of signatures indicative of combinations of mutational processes, including those with early driver events such as BRCA2 mutation (in addition to HRD signatures). High exposure to CN signature 3, characterised by BRCA1/2-related HRD, was associated with improved overall survival. Conversely, high exposure to signature 1, which was characterised by oncogenic RAS signaling (including NF1, KRAS and NRAS mutation), predicted platinum-resistant relapse and poor survival.

CONCLUSIONS: HGSOC lacks clinically-relevant patient stratification, which is reflected in poor survival and is a significant barrier to precision medicine. Copy-number signature exposures at diagnosis predict both overall survival and the probability of platinum-resistant relapse. Our results suggest that early TP53 mutation, the ubiquitous initiating event in HGSOC, may permit multiple mutational processes to co-evolve, potentially simultaneously and that additional signature exposures may alter the risk of developing therapeutic resistance. Thus, our results suggest that HGSOC is a continuum of genomes.

We derived signatures using inexpensive sWGS of DNA from core biopsies. These approaches are rapid and cost effective, thus providing a clear path to clinical implementation. By dissecting the mutational forces shaping HGSOC genomes, our study paves the way to understanding extreme genomic complexity, as well as revealing the evolution of tumors as they relapse and acquire resistance to therapy.

Citation Format: Geoff Macintyre, Teodora E. Goranova, Dilrini De Silva, Darren Ennis, Anna M. Piskorz, Matthew Eldridge, Daoud Sie, Liz-Anne Lewsley, Aishah Hanif, Cheryl Wilson, Suzanne Dowson, Rosalind M. Glasspool, Michelle Lockley, Elly Brockbank, Ana Montes, Axel Walther, Sudha Sundar, Richard Edmondson, Geoff D. Hall, Andrew Clamp, Charlie Gourley, Marcia Hall, Christina Fotopoulou, Hani Gabra, James Paul, Anna Supernat, David Millan, Aoisha Hoyle, Gareth Bryson, Craig Nourse, Laura Mincarelli, Luis Navarro Sanchez, Bauke Ylstra, Mercedes Jimenez-Linan, Luiza Moore, Oliver Hofmann, Florian Markowetz, Iain A. McNeish, James D. Brenton. COPY-NUMBER SIGNATURES AND MUTATIONAL PROCESSES IN HIGH GRADE SEROUS OVARIAN CARCINOMA [abstract]. In: Proceedings of the 12th Biennial Ovarian Cancer Research Symposium; Sep 13-15, 2018; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2019;25(22 Suppl):Abstract nr AP09.

Copy number signatures and mutational processes in ovarian carcinoma

The genomic complexity of profound copy number aberrations has prevented effective molecular stratification of ovarian cancers. Here, to decode this complexity, we derived copy number signatures from shallow whole-genome sequencing of 117 high-grade serous ovarian cancer (HGSOC) cases, which were validated on 527 independent cases. We show that HGSOC comprises a continuum of genomes shaped by multiple mutational processes that result in known patterns of genomic aberration. Copy number signature exposures at diagnosis predict both overall survival and the probability of platinum-resistant relapse. Measurement of signature exposures provides a rational framework to choose combination treatments that target multiple mutational processes.

Copy number signatures and mutational processes in ovarian carcinoma

The genomic complexity of profound copy number aberrations has prevented effective molecular stratification of ovarian cancers. Here, to decode this complexity, we derived copy number signatures from shallow whole-genome sequencing of 117 high-grade serous ovarian cancer (HGSOC) cases, which were validated on 527 independent cases. We show that HGSOC comprises a continuum of genomes shaped by multiple mutational processes that result in known patterns of genomic aberration. Copy number signature exposures at diagnosis predict both overall survival and the probability of platinum-resistant relapse. Measurement of signature exposures provides a rational framework to choose combination treatments that target multiple mutational processes.

Cost-Utility Analysis of Three Iron Chelators Used in Monotherapy for the Treatment of Chronic Iron Overload in β-Thalassaemia Major Patients: An Italian Perspective

PURPOSE

Deferiprone (DFP), deferasirox (DFX) and deferoxamine (DFO) are used in thalassaemia major (TM) patients to treat chronic iron overload. We evaluated the cost-effectiveness of DFP, compared with DFX and DFO monotherapy, from an Italian healthcare system perspective.

METHODS

A Markov model was used over a time horizon of 5 years. Italian-specific cost data were combined with Italian efficacy data. Costs and quality-adjusted life years (QALYs) were calculated for each treatment, with cost-effectiveness expressed as cost per QALY.

RESULTS

In all scenarios modelled, DFP was the dominant treatment strategy. Sensitivity analyses showed that DFP dominated the other treatments with a >99% likelihood of being cost-effective against DFX and DFO at a willingness to pay threshold of €20,000 per QALY.

CONCLUSIONS

DFP was the dominant and most cost-effective treatment for managing chronic iron overload in TM patients. Its use can result in substantial cost savings for the Italian healthcare system.

A phase I trial of the oral hedgehog inhibitor taladegib (LY2940680) in combination with weekly paclitaxel in patients with advanced, solid tumours

2594

Background: Aberrant Hedgehog (Hh) signaling is implicated in carcinogenesis and is associated with poor prognosis in multiple tumours types. Hh inhibitors increase sensitivity to paclitaxel in taxane-resistant cell lines. Taladegib is an orally bioavailable, potent inhibitor of Smoothened, a key Hh pathway component, with activity in basal cell carcinoma. The single agent recommended dose is 400mg od. We present the dose escalation phase of a phase I study of weekly paclitaxel with oral taladegib. Methods: Primary objective: determine the dose limiting toxicity (DLT) and maximum tolerated dose (MTD) of taladegib on a continuous oral daily dosing regimen in combination with paclitaxel (80mg/m2, iv, day 1, 8 and 15 q 28) in patients with advanced solid cancers. Secondary objectives: assess the safety and tolerability, determine the recommended phase II dose (RP2D), and evaluate the pharmacokinetics of taladegib and paclitaxel. Exploratory objective: assess preliminary efficacy. A standard 3 + 3 dose escalation design was used. All patients received up to 6 cycles of paclitaxel. In addition, successive cohorts received continuous oral taladegib continued until progression or unacceptable toxicity as follows: dose level 1: 100mg od; 2: 200mg od; 3: 400mg od. Results: No DLTs were seen at dose level 1 or in the first 3 patients at dose level 2. 3 DLTs of grade 2 neuropathy were seen at dose level 3 (400mg taladegib); therefore, dose level 2 was expanded to 6 patients. No DLT was seen in the fourth patient and 2 additional patients have started treatment. After the DLT period 2 patients developed G2 and 4 developed G1 neuropathy. Other non DLT, drug-related G3 toxicities: uncomplicated neutropenia x2, muscle cramp x1 and fatigue x1. To date, 3 patients have had partial responses. Conclusions: The combination of daily oral taladegib and weekly paclitaxel is feasible. DLT of G2 neuropathy was seen at 400mg. Promising activity has been seen in solid tumours. A dose expansion cohort is due to commence in high grade ovarian carcinoma. ISRCTN No:ISRCTN15903698 Eudract Ref:2014-004695-37 Funded by Cancer Research UK C8361/A18775 and Ignyta. Sponsored by NHS Greater Glasgow and Clyde. Clinical trial information: ISRCTN15903698.

OCTOPUS: A randomised, multi-centre phase II umbrella trial of weekly paclitaxel+/- novel agents in platinum-resistant ovarian cancer—Vistusertib (AZD2014)

TPS5609

Background: There is an urgent need to improve outcomes for patients with platinum-resistant and refractory ovarian cancer (PROC). OCTOPUS is an umbrella phase II framework for testing whether the addition of novel targeted agents to weekly paclitaxel (wPxl) improves efficacy in PROC. The first agent to be evaluated is the dual mTORC1/mTORC2 inhibitor, vistusertib (AZD2014), as preclinical studies support targeting the PI3kinase/Akt/mTOR pathway in PROC and the combination of vistusertib and wPxl has shown promising preliminary activity in high grade serous ovarian cancer (HGS) patients in a phase I trial (Banerji et al poster discussion ESMO 2016). This is the first randomised trial of wPxl and a dual mTORC1/2 inhibitor in ovarian cancer. Methods: OCTOPUS is an investigator-initiated, randomised, double-blind, placebo-controlled, multicentre, phase II trial. 140 patients with PROC (histologically confirmed HGS) are randomised 1:1 to receive wPxl (80mg/m2 D1, D8, D15 of 28 day cycle) plus oral vistusertib (50mg BD) or placebo (D1-3, D8-10, D15-17). The primary endpoint is progression-free survival (PFS) based on combined RECIST v1.1/GCIG CA125 criteria. The study is designed to detect a 50% improvement in median PFS from 3.7 months on placebo to 5.55 months on the experimental arm with 90% power, at the 20% 1-sided level of statistical significance (or equivalently with 80% power at the 10% level of statistical significance) using a 3-outcome design. Secondary endpoints include response (based on RECIST 1.1 and GCIG CA125 criteria), overall survival, toxicity and quality of life. Patients whom received prior wPxl for PROC are not eligible. A mandatory pre-treatment biopsy (if technically feasible), archival tissue, and serial blood samples will be collected for translational research studies. 49 patients have been recruited. The study is part of the NIHR CRN Cancer/Astrazeneca Alliance, sponsored by NHS Greater Glasgow and Clyde/University of Glasgow and endorsed by Cancer Research UK (CRUKE/14/052). Clinical trial information: ISRCTN16426935.

Attitude and knowledge of family medicine practitioners towards the association between periodontal disease and obesity

OBJECTIVES

To assess the attitude and knowledge of family medicine practitioners (FMPs) towards the association between periodontal disease and obesity.

MATERIALS AND METHODS

A cross-sectional study was performed and a 13-item survey questionnaire was given to FMPs practicing in 12 different teaching hospitals in Karachi, Pakistan. The questions were aimed at exploring the knowledge of FMP's regarding the association of obesity and periodontal disease and their attitude towards the association of obesity and periodontal disease. Chi-square and Spearman co-efficient were conducted to compare subgroups and correlate factors with the knowledge score of FMPs.

RESULTS

A total of 314 questionnaires were completed (response rate = 92%). Median age of participants was 41 years and 57% were females. Almost 61% of FMPs answered all the knowledge questions correctly and 64% reported moderate understanding of the association between periodontal health and obesity. Nearly 73% FMPs inquired from obese patients regarding the periodontal disease and more than half (58%) refer patients to a dentist for evaluation. More than half of FMPs perform periodontal disease screening. Nearly all FMPs considered informing obese patients regarding periodontal disease as one of their roles.

CONCLUSIONS

FMP's play an important role in the early diagnosis, prevention and treatment of periodontal conditions in obese patients. More than two thirds of FMPs showed good knowledge of the association of obesity and periodontal disease. The attitudes of FMPs towards assessing and referring obese patients at a risk of having periodontal disease were reassuring.

Abstract P6-09-37: Ductal carcinoma in situ: Patient outcomes and association with hormone receptors

Background

Local recurrence is a major concern in patients (pts) diagnosed with ductal carcinoma in situ (DCIS). Therefore, the need to identify pts at risk for DCIS recurrence is a significant priority. In invasive breast cancers, ER+/PR- subtype is considered a more aggressive tumor phenotype with poorer prognosis as compared to ER+/PR+ tumors. It is unclear whether this molecular subtype holds the same significance in pts with DCIS.

Methods

We designed an analysis to determine if a significant difference exists in the recurrence rates in pts with ER+/PR- DCIS when compared to ER+/PR+ tumors. Six hundred and ninety three pts diagnosed and treated for DCIS at Froedtert & MCW Clinical Cancer Center from Feb 2002-March 2015 were included in our study. Recurrence was defined as either non-invasive or invasive ipsilateral, contralateral or distant disease. Probabilities of recurrences were calculated using Kaplan-Meier estimator. Cox proportional hazards model was used to evaluate the effect of prognostic factors on DCIS recurrence.

Results

Median follow up was 5.2 years. Five year recurrence free survival (RFS) was 91% (95% CI 88.2-93.3) while estimated 7 year RFS was 86% (95% CI 81.9-89.2). Patient characteristics are shown in table below. Seventy five pts were found to have a recurrence during their follow-up. Most of the grade 1 tumors were ER+/PR+ whereas almost all of the ER-/PR- subtype were high grade tumors. ER+/PR- tumors were mainly intermediate and high grade (p &lt;0.0001). Pts with ER-/PR- tumors had a significantly higher risk of recurrence (HR 3.7, 95% CI 1.9-7.2, p=0.0001) and those with ER+/PR- tumor subtype did not have a statistically significant difference in risk of recurrence when compared to ER+/PR+ tumors (HR 1.75, 95% CI 0.92-3.32, p=0.085). Pts who did not receive endocrine therapy for their ER+ DCIS had a significantly higher risk of recurrence as compared to those who received endocrine therapy (HR 2.2, 95% CI 1.23-3.92, p=0.0073). When compared to pts undergoing lumpectomy and radiation, pts undergoing lumpectomy alone had a significantly higher risk of recurrence (HR 2.5, 95% CI 1.32-4.93, p=0.005) whereas those who underwent mastectomy had a significantly lower risk of recurrence (HR 0.34, 95% CI 0.15-0.8, p=0.014).

Patient characteristicsCharacteristicsN (%)Total no. of patients693Median age53 (21-91)Median BMI27 (17-65)Post-menopausal480 (69)OCP use301 (43)HRT use201 (29)Tumor characteristics Median size0.8cm (0.2-6.5)Histology Solid349 (52)Cribriform290 (43)Papillary35 (5)Comedo necrosis423 (61)ER/PR status ER+/PR+482 (71.2)ER+/PR-77 (11.4)ER-/PR-118 (17.4)Tumor grade Low125 (18)Intermediate305 (45)High250 (37)Treatment Lumpectomy517 (75)Mastectomy169 (25)Radiation450 (66)Endocrine therapy286 (42)Patients with recurrence75 (11)Type of recurrence In-situ44 (6)Invasive31 (5)BMI=body mass index, OCP=oral contraceptive pills, HRT=hormone replacement therapy

Conclusion

ER+/PR- subtype was not a significant predictor of recurrence in DCIS patients. This finding is in contrast to the risk of recurrence and tumor aggressiveness seen in invasive breast cancers. Mastectomy and post lumpectomy radiation were associated with improved outcomes as was adjuvant endocrine therapy.

Citation Format: Chaudhary LN, Jawa Z, Hanif A, Szabo A, Chitambar CR. Ductal carcinoma in situ: Patient outcomes and association with hormone receptors [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-37.

A vapor phase adsorptive desulfurization process for producing ultra low sulphur diesel using NiY zeolite as a regenerable adsorbent

A NiY zeolite based vapor phase adsorptive desulfurization process has been described which can bring down sulphur concentration of a commercial BS IV grade (Euro IV equivalent) diesel from 50 ppm to a <5 ppm level.

Evaluation of existing curriculum (2002) of undergraduate medical education in Bangladesh

This study was conducted for evaluation of existing MBBS curriculum (2002) of undergraduate medical education in Bangladesh. The specific objectives of this study were: i) to assess the subject wise course content coverage in the new MBBS curriculum, ii) to assess different examination system for evaluation of MBBS students, iii) to evaluate the effectiveness of teaching and learning activities under the curriculum, iv) to explore students opinions regarding improvement of new curriculum. This was a descriptive cross-sectional study. The study was conducted among the students of Dhaka medical colleges of Bangladesh in 2008. Data was collected by self administered structured questioner adopting convenient sampling method. About ninety percent students opined that the coverage of course content of subjects in the curriculum in Phase I was enough. In case of the subjects in phase II except community medicine more than four fifth of the students expressed their opinion about coverage of course content in the curriculum as enough. In case of phase III it was mentioned by most of the students that coverage of course content was enough. Study revealed that teaching methods were perceived suitable by about three fourth of the respondents, to achieve learning objectives. Most of the students expressed their positive views regarding practice of block posting teaching. More than three fourth of the students perceived that formative assessment was encouraging for students to become time bound learner and Structured Oral Examination (SOE) was fair on an average. Only 31(8.6%) of the respondents had opinion that Objective Structured Practical Examination (OSPE)/Objective Structured Clinical Examination (OSCE) was not well organized. About half of the students opined that 20% marks in written test should be allocated for Multiple Choice Question (MCQ). Students' suggestions regarding teaching were: there should be smaller group sessions; more interactive sessions; more clinical and practical sessions; more problem oriented sessions; more sessions with senior and experienced teachers; teachers should follow the curriculum properly; and should be well prepared for class. Regarding assessment suggestions were: written script of the formative examination should be returned to students with feedback; teachers should not be biased. Study recommended that training of the teachers on teaching methodology and assessment system is needed; teachers should provide feedback to the students according to the performance of the formative assessment at the individual level; to maintain the standards of assessment proper planning, designing, conduction and evaluation of assessment should be taken into consideration; subject wise review and updating is essential to make the curriculum more need based, user friendly and applicable considering context of Bangladesh.

Plasma Renin in ipsilateral renal vein in patients with chronic unilateral pelvic ureteric junction obstruction

Acute experimental hydronephrosis induces increased output of renin from ipsilateral kidney. In most clinical presentation of unilateral hydronephrosis the patients are however, normotensive with normal circulating plasma renin activity. In consideration of this argument we undertook this prospective study of ipsilateral renal vein renin activity in children with congenital Pelvic Ureteric Junction Obstruction (PUJO) and compared with other wise normal children. In this prospective cross-sectional study, started from July 99 to June 2001, twenty patients, age upto 12 years, with unilateral hydronephrosis and in control group ten patients without hydronephrosis were taken. 2ml blood was taken from the renal vein in study group and from infrarenal portion of inferior vena cava during exploratory laparotomy from the control group. All the patients had advanced grade of hydronephrosis and two patients (13%) had mild hypertension. In this study the mean plasma renin activity (PRA) was 45.58 ng/ml/hr (range: 11.69-67.56 ng/ml/hr) in study group. The mean PRA in control group was 5.9ng/ml/hr. The result of study group was significantly higher than normal (P value 0.0003). In Bangladesh we are doing more conservative kidney preserving surgery for PUJO, but need long term follow up of the patients undergoing surgery for PUJO in childhood for potential of developing renin-angiotensin induced hypertension in later life.

The effect of sea bream (Sparus aurata) broodstock and larval vaccination on the susceptibility by Photobacterium damsela subsp. piscicida and on the humoral immune parameters

Sea bream broodstock were immunised 1 or 2 months before spawning with a novel photobacteriosis vaccine. Sixty-seven-day-old larvae (mean weight 22.3 mg) originating from immunised and non-immunised parents were experimentally infected with the Photobacterium damsela subsp. piscicida (Phdp). Larvae from immunised fish showed delayed onset and lower mortality (66.67%) compared with larvae from control fish (80%). Eighty-nine-day-old larvae (mean weight 162.2 mg) from both groups were bath vaccinated with Phdp and Escherichia coli lipopolysaccharides (LPS) and larval samples were collected for measurement of humoral parameters. Larvae vaccinated with Phdp and LPS showed significantly higher anti-protease activity, lysozyme activity and total immunoglobulin compared to the controls. One-hundred-and-twenty-day-old larvae (mean weight 297.85 mg) from both parental groups were challenged with (LD70) virulent Phdp bacterial cells. Vaccinated larvae from both groups showed significantly less mortality compared to the respective controls. The RPS values of larvae from immunised parents vaccinated with Phdp and LPS was 95.83% and 72.22%, respectively. The RPS values of larvae from non-immunised parents vaccinated with Phdp and LPS was 62.5% and 70.83%, respectively. Results are discussed with respect to the beneficial effect of broodstock immunisation prior to spawning and the immunisation of larvae on their survival against photobacteriosis.

Maternal transfer of humoral specific and non-specific immune parameters to sea bream (Sparus aurata) larvae

Immunisation of sea bream (Sparus aurata L.) broodstock with a novel vaccine mixture of Photobacterium damsela subsp. piscicida SK7 (Phdp) was performed during the period of egg development and the changes in specific and non-specific humoral immune parameters were measured. Total immunoglobulin level, specific antibody titre, anti-protease activity and lysozyme activity were significantly higher in immunised parents compared to the control. After spawning significantly higher anti-protease activity, lysozyme activity and total immunoglobulin level were detected in the eggs from immunised parents. Specific antibody titres against Phdp were only detected in the eggs from the immunised parents. The larvae from immunised parents also expressed significantly higher levels of specific and non-specific humoral immune parameters compared to the controls. A small amount of total immunoglobulin was detected in larvae decreasing gradually until day 8 post-hatching and then an increase was measured in larvae from immunised parents, whereas no immunoglobulin was detected at days 4, 6 and 8 in larvae from non-immunised parents. The specific antibody titre against Phdp was detected only in larvae from immunised broodstock until day 14 post-hatching. The higher humoral immune parameters in eggs and larvae from immunised parents in comparison to eggs and larvae from non-immunised parents, suggest transfer of maternal specific and non-specific immune factors.

The effect of in vivo growth on the cellular and extracellular components of the marine bacterial pathogen Photobacterium damsela subsp. piscicida

Photobacterium damsela subsp. piscicida, the causative agent of fish pasteurellosis, was grown in vivo. Bacterial cells and extracellular products (ECPs) were analysed via electrophoresis and immunoblot analysis, using specific sea bass antisera. Growth in vivo induced the synthesis of unique bacterial cell proteins at > 206, 206, 21.3, 18, 7.6 and < 7.6 kDa. Sea bass serum raised against live bacterial cells of the pathogen and especially a sea bass serum raised against formalin-inactivated bacterial cells grown in a specific novel medium recognized the novel antigens at > 206 (associated with iron sequestration), 21.3, 7.6 and < 7.6 kDa, suggesting that the latter medium conserves the synthesis of natural bacterial cell proteins in vitro. In vivo growth of the pathogen induced the synthesis of more toxic ECPs in comparison with in vitro growth and an inverse correlation between total protein concentration in the ECPs and toxicity per unit of protein was observed. Substrate-polyacrylamide electrophoresis revealed the presence of in vivo synthesized ECPs of the pathogen (proteases) at 175, 132, < 79 and 48.3 kDa. Histological examination of tissues isolated from fish injected with these ECPs revealed inflammatory and necrotic lesions in the spleen, liver, head kidney, intestine and heart as soon as 48 h post-introduction of the ECPs.

In hydronephrosis less than 10 % kidney function is not an indication for nephrectomy in children

PURPOSE

To reduce the incidence of nephrectomy or hydronephrosis in children.

MATERIALS AND METHODS

From September 1998 to October 2000, we treated 58 patients with hydronephrosis; their ages ranged from 35 days to 11 years (mean age 4 years 7 months). All patients were subjected to a DTPA renogram with split function. In 12 patients (study group), kidney function was less than 10 % (range 0 - 10 %). Initially, nephrostomy was carried out in all 12 patients followed by Anderson-Hyne's pyeloplasty after 4 - 6 weeks. Postoperatively renal USG, urine r/m/e & c/s (routine and microscopic examination and culture and sensitivity test), blood urea, serum creatinine were assessed and DMSA scan and DTPA renogram with split functions were carried out in all patients.

RESULTS

In the study group, all 12 patients showed improvement of renal function (more than 10 %) after nephrostomy and in all of them pyeloplasty was subsequently carried out within 4 - 6 weeks. There were no significant pre-, peri- or postoperative complications.

CONCLUSIONS

Contrary to common practice we do not recommend nephrectomy for hydronephrotic kidneys which show < 10 % of renal function on renogram. The renal functional status improves significantly after a preliminary nephrostomy, thus avoiding the need for a straightforward nephrectomy in children along with all the possible long-term effects of a single kidney.