Inverse ratio ventilation versus conventional ratio ventilation during one lung ventilation in neonatal open repair of esophageal atresia/tracheoesophageal fistula: A randomized clinical trial

BACKGROUND

Maintaining oxygenation during neonatal open repair of esophageal atresia/tracheoesophageal fistula is difficult. Inverse ratio ventilation can be used during one lung ventilation to improve the oxygenation and lung mechanics.

OBJECTIVE

The aim of this study was to describe the impact of two different ventilatory strategies (inverse ratio ventilation vs. conventional ratio ventilation) during one lung ventilation in neonatal open repair of esophageal atresia/tracheoesophageal fistula on the incidence of oxygen desaturation episodes.

METHODS

We enrolled 40 term neonates undergoing open right thoracotomy for esophageal atresia/tracheoesophageal fistula repair and randomly assigned into two groups based on inspiratory to expiratory ratio of mechanical ventilation parameters (2:1 in inverse ratio ventilation "IRV" and 1:2 in conventional ratio ventilation "CRV"). The incidence of desaturation episodes that required stopping the procedure and reinflation of the lung were recorded as the primary outcome while hemodynamic parameters, incidence of complications, and length of surgical procedure were recorded as the secondary outcomes.

RESULTS

There was a trend toward a reduction in the incidence of severe desaturations (requiring stopping of surgery) with the use of inverse ratio ventilation (15% in IRV vs. 35% in CRV, RR [95% CI] 0.429 [0.129-1.426]). Incidence of all desaturations (including those requiring only an increase in ventilatory support or inspired oxygen saturation) was also reduced (40% in IRV vs. 75% in CRV, RR [95% CI] 0.533 [0.295-0.965]). This in turn affected the length of surgical procedure being significantly shorter in inverse ratio ventilation group (mean difference -16.3, 95% CI -31.64 to -0.958). The intraoperative fraction of inspired oxygen required to maintain adequate oxygen saturation was significantly lower in the inverse ratio ventilation group than in the conventional ratio ventilation group (mean difference -0.22, 95% CI -0.33 to -0.098), with no significant difference in hemodynamic stability or complications apart from higher blood loss in inverse ratio group.

CONCLUSION

There may be a role for inverse ratio ventilation with appropriate positive end-expiratory pressure to reduce the incidence of hypoxemia during open repair of esophageal atresia/tracheoesophageal fistula in neonates, further studies are required to establish the safety and efficacy of this technique.

Processing and characterization of antimicrobial bioplastic films based on green microalgae Scenedesmus obliquus extract-loaded polyurethane

The green microalga Scenedesmus obliquus, isolated from the Egyptian environment, was used for the synthesis of bio-based plastic materials. Polyurethane (PU) was blended with different proportions (0%, 10%, 20%, and 40%) of chloroform extract to form bioplastic films. The bioplastic films were characterized using water vapor transmission rate measurements and scanning electron microscopy (SEM). The WVTR of pure PU was 193.37 g/m2. day, while the values of algae/PU films were 129.74, 122.56, and 99.75 g/m2.day. S. obliquus reported having Palmitic, which possesses antimicrobial activity and acts as an effective antimicrobial agent in the synthesized bioplastic films. Antimicrobial activity of the algal extract and the synthesized bioplastic films were tested against two Gram-positive bacteria; Staphylococcus aureus, Enterococcus faecalis, two Gram-negative bacteria; Escherichia coli, Pseudomonas aeruginosa, and Candida albicans as a model for fungi. The results indicated that S. obliquus extract exhibited a clear antimicrobial activity against all tested microbes. The antimicrobial rate of bioplastic films containing 40% of the extract reached 100% after 2 h of contact with E. coli and E. faecalis. In conclusion, this study offers a promising future for the use of biodegradable antimicrobial bioplastic films as an affordable and environmentally friendly alternative to plastics in many applications.

Validation of the autism behavior checklist in Egyptian children with autism spectrum disorder

This study was designed to validate the Arabic version of the Autism Behavior Checklist (ABC) for the Egyptian population. A total of 500 mothers of children aged 4-14 years, of whom 150 had a diagnosis of ASD, 100 with intellectual disability, and 250 typically developing children completed the ABC. The factor analysis showed that 48 of 57 ABC items yielded a five-dimensional factor structure. The ABC-Arabic version indicated acceptable internal consistency (α = 0.85) and test - retest reliability (0.82). Also, the ABC exhibited good concurrent validity and discriminative validity. A cutoff score of 58 obtained a sensitivity of 94.7% and a specificity of 92.14% for detecting children with ASD. Our findings support the use of the ABC as a valid screening measure for ASD cases, and it may promote the use of the ABC for clinical and research purposes among Arabic-speaking communities.

Synthesis and characterization of bio-nanocomposite based on chitosan and CaCO3 nanoparticles for heavy metals removal

Water is a vital component of life; therefore, it is critical to have access to pure water for various life-sustaining activities including agriculture and human consumption. An eco-friendly nanocomposite based on chitosan (Cs) and nanomaterials (CaCO3-NPs) were combined to amalgamate the advantages of biopolymers and nanomaterials to overcome the problems of instability, poor mechanical properties, and low removal percentage of biopolymers. The as-prepared samples were characterized and were used for the removal of heavy metal from wastewater. X-ray diffractometer, Fourier transform infrared spectroscopy, and transmission electron microscope were used to distinguish the prepared absorbents. The absorption of the heavy metals by as-prepared samples was examined at different conditions. The kinetic and isotherm models of the adsorption process were also studied. The data showed that the removal percentages of Cd, Cu, Pb, Zn, Cr and Ni by the composite were 98.0, 94.8, 99.0, 97.9, 97.4 and 98.3 %, respectively. The kinetic and isothermal studies showed that the absorption of these metal ions by the samples obeyed a pseudo-second-order mechanism and Langmuir isotherm model, respectively. In addition, the maximum adsorption capacities of Cd, Cu, Pb, Zn, Cr, and Ni ions by as-prepared nanocomposite were 83.33, 47.84, 98.03, 89.28, 62.11, and 63.69 mg/g, respectively.

Measurement of Cumulative Preterm Neonatal and Maternal Stressors During Neonatal Intensive Care Unit Admission

OBJECTIVES

By nature, the neonatal intensive care unit (NICU) environment is stressful for both infants and mothers. This study aimed to explore and quantify the severity of early life stressors in premature infants admitted to the NICU and evaluate the effect of cumulative neonatal stressors on maternal mental health.

METHODS

This cross-sectional study included 100 preterm infants admitted to the NICU for at least 10 days. Daily experiences with painful/stressful procedures for 10 days were determined using the Neonatal Infant Stressor Scale. The included mothers were assessed for their psychological well-being 1 week after NICU admission using the Parental Stressor Scale: NICU and Edinburgh Postnatal Depression Scale.

RESULTS

During the first 10 days of NICU admission, preterm infants experienced an average of 350.76 ± 84.43 acute procedures and an average of 44.84 ± 11.12 cumulative hours of chronic events, with the highest scores recorded on first 3 days of admission. Although intravenous flushing for patency was the most frequent acute procedure, blood gas sampling was the most painful. Forty-five percent of the mothers showed significant depressive symptoms, with the maternal role alteration reported as the most stressful experience, especially for young and new mothers (p < .001). The cumulative stressors experienced by infants were significantly associated with elevated maternal perception of psychological maladjustment (p < .001).

CONCLUSION

This study confirmed that the NICU environment is stressful for both infants and mothers, with the total cumulative stressors experienced by preemies in the NICU having an negative impact on maternal mental health.

[Propofol-ketamine versus dexmedetomidine-ketamine for sedation during upper gastrointestinal endoscopy in pediatric patients: a randomized clinical trial]

BACKGROUND AND OBJECTIVES

Day-case pediatric sedation is challenging. Dexmedetomidine is a sedative analgesic that does not induce respiratory depression. We compared dexmedetomidine to propofol when it was added to ketamine for sedation during pediatric endoscopy, regarding recovery time and hemodynamic changes.

METHODS

We enrolled 120 patients (2-7 years in age) and randomly assigned them into two groups. Each patient received intravenous (IV) ketamine at a dose of 1 mg.kg^-1 in addition to either propofol (1 mg.kg^-1) or dexmedetomidine (0.5 μg.kg^-1). The recovery time was compared. Hemodynamics, oxygen saturation, need for additional doses, postoperative complications and endoscopist satisfaction were monitored.

RESULTS

There was no significant difference in hemodynamics between the groups. The Propofol-Ketamine (P-K) group showed significantly shorter recovery times than the Dexmedetomidine-Ketamine (D-K) group (21.25 and 29.75 minutes respectively, p <0.001). The P-K group showed more oxygen desaturation. Eleven and six patients experienced SpO₂ <92% in groups P-K and D-K, respectively. A significant difference was noted regarding the need for additional doses; 10% of patients in the D-K group needed one extra dose, and 5% needed two extra doses, compared to 25% and 20% in the P-K group, respectively (p=0.001). The P-K group showed less post-procedure nausea and vomiting. No statistically significant difference between both groups regarding endoscopist satisfaction.

CONCLUSIONS

The P-K combination was associated with a shorter recovery time in pediatric upper gastrointestinal endoscopy, while the D-K combination showed less need for additional doses.

REGISTRATION NUMBER

Clinical trials.gov (NCT02863861).

Conducting chitosan/hydroxylethyl cellulose/polyaniline bionanocomposites hydrogel based on graphene oxide doped with Ag-NPs

The current work focuses on a cheap and simple preparation of highly conducting chitosan/hydroxyl ethylcellulose/polyaniline loaded with graphene oxide doped by silver nanoparticles (CS/HEC/PAni/GO@Ag) bionanocomposite as a biodegradable and biocompatible hydrogel for energy storage technology. Scanning electron microscopy (SEM) displays the compatibility of chitosan, hydroxyl ethyl cellulose, and polyaniline and a good distribution of GO@Ag-NPs in bionanocomposite hydrogels. X-ray diffraction (XRD) displayed the structure and existence of GO@Ag-NPs in the matrix. The swelling percentage and the antibacterial activities slightly increased with raising the content of GO@Ag-NPs. Also, the presence of both chitosan and cellulose improves the biodegradation of the fabricated bionanocomposites, which is increased by adding GO. Moreover, the incorporation of 5% GO@Ag-NPs in hydrogels enhances dc-conductivity by about 25 times from 3.37 × 10^-3 to 8.53 × 10^-2 S/cm. The fabricated hydrogels are inexpensive, eco-friendly, and have high capacitance and permittivity, and so they can store electrical energy.

Association between circulating zinc/ferritin levels and parent Conner's scores in children with attention deficit hyperactivity disorder

ADHD is one of the most common neurobehavioral disorders among children and adolescents. In this prospective study, we aimed to measure circulating zinc and ferritin levels in children with ADHD, pick up the deficient ones to give zinc and iron supplements then compare before and after treatment according to their Conner's scores and Wecsler IQ test. Current study included fifty children diagnosed as having ADHD by DSMV criteria, their zinc and ferritin levels were measured by Colorimetric method and enzyme-linked immunosorbent assay (ELISA) respectively. They were divided into: group I (zinc only deficient),group II (zinc and ferritin deficient),group III (non-deficient), cases with mineral deficiency received zinc (55 mg/day) and/or iron (6 mg/kg/day) for 6 months then reassessed by parent Conner's rating scale. In group 1, there was no significant difference between the Wecsler verbal and non-verbal IQ scores and oppositional and cognitive problems in Conner's scores before and after zinc supplements, although there was significant improvement in attention, hyperactivity, emotional liability and impulsivity. In group II, there was significant improvement in verbal and total IQ but not in performance IQ, also there was significant improvement in hyperactivity, emotional liability and impulsivity with no significant difference in oppositional, cognitive problems and inattention before and after zinc/ iron supplements. In Conclusion, Zinc supplements in adjuvant to the main treatment significantly improved symptoms of ADHD children. However, a combined zinc and iron supplements was superior to zinc alone in alleviating ADHD symptoms as well as IQ improvement.

Green, economic, and partially biodegradable wood plastic composites via enzymatic surface modification of lignocellulosic fibers

Lignocellulosic fibers, which obtained from Citrus trees trimmings, were modified with Aspergillus flavus (EGYPTA5) enzymes. The non-modified and the modified lignocellulosic fibers were used with low density polyethylene (LDPE) by melt blending brabender method at 170 °C with different ratio (5, 10 and 20 wt%) to obtain wood plastic composites (WPC). The prepared samples were characterized using Fourier-transformed infrared (FT-IR), Scan Electron Microscope (SEM), and Water vapor transmission rate (WVTR) as well as, the mechanical, thermal, biodegradability and swelling properties were examined. The fabricated WPC displayed good mechanical and thermal properties compare with pure LDPE. Also, the WVTR was enhanced by the addition of modified lignocellulosic fibers over the unmodified one. Moreover, the enzymes assay such as cellulase and lignin peroxidase enzymes were estimated and confirming the growing of fungi on the lignocellulosic fiber in solid state fermentation condition to improve lignin peroxidase production and eliminate cellulose enzymes. The fabricated WPC can be used in different environmental application such as packaging system, that it will be green, economic, and partially biodegradable.

Thalamic activity and biochemical changes in individuals with neuropathic pain after spinal cord injury

There is increasing evidence relating thalamic changes to the generation and/or maintenance of neuropathic pain. We have recently reported that neuropathic orofacial pain is associated with altered thalamic anatomy, biochemistry, and activity, which may result in disturbed thalamocortical oscillatory circuits. Despite this evidence, it is possible that these thalamic changes are not responsible for the presence of pain per se, but result as a consequence of the injury. To clarify this subject, we compared brain activity and biochemistry in 12 people with below-level neuropathic pain after complete thoracic spinal cord injury with 11 people with similar injuries and no neuropathic pain and 21 age- and gender-matched healthy control subjects. Quantitative arterial spinal labelling was used to measure thalamic activity, and magnetic resonance spectroscopy was used to determine changes in neuronal variability quantifying N-acetylaspartate and alterations in inhibitory function quantifying gamma amino butyric acid. This study revealed that the presence of neuropathic pain is associated with significant changes in thalamic biochemistry and neuronal activity. More specifically, the presence of neuropathic pain after spinal cord injury is associated with significant reductions in thalamic N-acetylaspartate, gamma amino butyric acid content, and blood flow in the region of the thalamic reticular nucleus. Spinal cord injury on its own did not account for these changes. These findings support the hypothesis that neuropathic pain is associated with altered thalamic structure and function, which may disturb central processing and play a key role in the experience of neuropathic pain.

Design, synthesis and evaluation of novel benzimidazoles, benzothiazoles and benzofurans incorporating pyrazole moiety as antiangiogenic agents

Novel benzimidazoles, benzothiazoles and benzofurans incorporating pyrazole moiety have been synthesized and screened for their antiangogenic activities, by testing their ability to inhibit human umbilical vein endothelial cell (HUVEC) proliferation, cord formation and migration in response to chemoattractant. 3 compounds 19, 23 and 26 showed antiangiogenic activities at non-cytotoxic concentrations. Compound 19 was the most active with chemotaxis activity data nearly comparable to that of the positive control, TNP-470. Compound 42 showed a significant cytotoxic effect on the tested cancer cell lines and less antiangiogenesis activity compared to compounds 19, 23 and 26. All the tested compounds, in contrary to TNP-470, interfered with the migratory function of HUVECs in response to vascular endothelial growth factor rather than the endothelial cells proliferation or cord formation. Moreover, a docked pose of compounds 19 and 26 was obtained bound to kinase insert domain receptor using Molecular Operating Environment module.

Study of nonstandard auto-antibodies as prognostic markers in auto immune hepatitis in children

Background

Antibodies to chromatin and soluble liver antigen have been associated with severe form of autoimmune hepatitis and/or poor treatment response and may provide guidance in defining subsets of patients with different disease behaviors. The major clinical limitation of these antibodies is their lower individual occurrence in patients with autoimmune hepatitis.

Aim

To estimate the value of detection of these non-standard antibodies in autoimmune hepatitis as prognostic markers.

Methods

Both antibodies were tested by enzyme immunoassay in 20 patients with autoimmune hepatitis.

Results

Antibodies to soluble liver antigen were not detected in any of our patients. On the other hand anti chromatin antibodies were present in 50% (10/20). Antibodies to chromatin occurred more commonly in females than males (8/14 versus 2/6). Of the 14 patients who relapsed 8(57%) had antichromatin antibodies while they were present in only 2 out of 6(33.3%) non relapsers. Antichromatin antibodies were found more in patients with antinuclear (3/4) and anti smooth muscle antibodies (9/13) more than in those with liver kidney microsomal antibodies (1/4) and those seronegative (1/4) i.e. they were +ve in patients with type I (8/12(66.6%)) more than those with type II (1/4(25%)) and those seronegative (1/4(25%)). Antibodies to chromatin are associated with high levels of γ globulin but yet with no statistical difference between seropositive and seronegative counterparts (p = 0.65).

Conclusion

Antibodies to chromatin may be superior than those to soluble liver antigen in predicting relapse and may be useful as prognostic marker. Further studies with larger number of patients and combined testing of more than one antibody will improve the performance parameters of these antibodies and define optimal testing conditions for them before they can be incorporated into management algorithms that project prognosis.

Automated polyp detection at CT colonography: feasibility assessment in a human population

PURPOSE

To test the feasibility of and improve a computer algorithm to automatically detect colonic polyps in real human computed tomographic (CT) colonographic data sets.

MATERIALS AND METHODS

Twenty patients with known polyps underwent CT colonography in the supine position. CT colonographic data were processed by using a shape-based algorithm that depicts masses that protrude into the lumen. We studied nine shape criteria and three isosurface threshold settings. Results were compared with those of conventional colonoscopy performed the same day.

RESULTS

There were 50 polyps (28 were > or =10 mm in size; 12, 5-9 mm; 10, <5 mm). The sensitivity with optimal settings for detecting polyps 10 mm or greater was 64% (18 of 28). Sensitivity improved to 71% (10 of 14) for polyps 10 mm or greater in well-distended colonic segments. Performance decreased for polyps less than 10 mm, poorly distended colonic segments, and other shape algorithms. There was a mean of six false-positive lesion sites per colon. These sites were reduced 39% to 3.5 per colon by sampling CT attenuation at the lesion site and discarding sites having attenuation less than a threshold.

CONCLUSION

Automated detection of colonic polyps, especially clinically important large polyps, is feasible. Colonic distention is an important determinant of sensitivity. Further increases in sensitivity may be achieved by adding prone CT colonography.

Fate of postharvest-applied dichlorvos in stored and processed dates

The fate of dichlorvos (DDVP) on dates after storage and processing of postharvest-treated fruits has been investigated. Residues were determined using GC-ECD after extraction of the fruits. A postharvest application was made to fruits at different stages of maturity: khalal fruits (mature full colored stage), rutab fruits (soft brown stage), and the mature tamer fruits (hard raisin-like stage). The fate of the residues was followed during the storage at refrigerated, room, and summer average temperatures (3, 22, and 43 degrees C). The amount of residues absorbed varied with the level of maturity. The rate of the loss of the residues was found to follow first-order kinetics. First-order rate constants were calculated for the different levels of maturity. The rate of the loss of DDVP increased as the temperature of storage increased. Also, it decreased with increasing maturation of the dates, which was characterized by a decrease in moisture content as well as water activity and an increase in sugar content. The period of storage study was limited by the time of maturation to the next stage. Most common home-cooking methods, including dehydration, jam-making, and syrup-making, resulted in significant decreases in residue levels. Only 0-13% of initial DDVP residues was detected in final products.

Fuzzy logic algorithm for quantitative tissue characterization of diffuse liver diseases from ultrasound images

Computerized ultrasound tissue characterization has become an objective means for diagnosis of liver diseases. It is difficult to differentiate diffuse liver diseases, namely cirrhotic and fatty liver by visual inspection from the ultrasound images. The visual criteria for differentiating diffused diseases are rather confusing and highly dependent upon the sonographer's experience. This often causes a bias effects in the diagnostic procedure and limits its objectivity and reproducibility. Computerized tissue characterization to assist quantitatively the sonographer for the accurate differentiation and to minimize the degree of risk is thus justified. Fuzzy logic has emerged as one of the most active area in classification. In this paper, we present an approach that employs Fuzzy reasoning techniques to automatically differentiate diffuse liver diseases using numerical quantitative features measured from the ultrasound images. Fuzzy rules were generated from over 140 cases consisting of normal, fatty, and cirrhotic livers. The input to the fuzzy system is an eight dimensional vector of feature values: the mean gray level (MGL), the percentile 10%, the contrast (CON), the angular second moment (ASM), the entropy (ENT), the correlation (COR), the attenuation (ATTEN) and the speckle separation. The output of the fuzzy system is one of the three categories: cirrhosis, fatty or normal. The steps done for differentiating the pathologies are data acquisition and feature extraction, dividing the input spaces of the measured quantitative data into fuzzy sets. Based on the expert knowledge, the fuzzy rules are generated and applied using the fuzzy inference procedures to determine the pathology. Different membership functions are developed for the input spaces. This approach has resulted in very good sensitivities and specificity for classifying diffused liver pathologies. This classification technique can be used in the diagnostic process, together with the history information, laboratory, clinical and pathological examinations.

Classification algorithms for quantitative tissue characterization of diffuse liver disease from ultrasound images

Visual criteria for diagnosing diffused liver diseases from ultrasound images can be assisted by computerized tissue classification. Feature extraction algorithms are proposed in this paper to extract the tissue characterization parameters from liver images. The resulting parameter set is further processed to obtain the minimum number of parameters which represent the most discriminating pattern space for classification. This preprocessing step has been applied to over 120 distinct pathology-investigated cases to obtain the learning data for classification. The extracted features are divided into independent training and test sets, and are used to develop and compare both statistical and neural classifiers. The optimal criteria for these classifiers are set to have minimum classification error, ease of implementation and learning, and the flexibility for future modifications. Various algorithms of classification based on statistical and neural network methods are presented and tested. The authors show that very good diagnostic rates can be obtained using unconventional classifiers trained on actual patient data.

Iatrogenic urogenital fistulae

Nineteen patients with iatrogenic urogenital fistulae were treated between 1985 and 1989. All resulted from obstetric and gynaecological surgery. Major symptoms were leakage of urine through the vagina, menouria and perineal dermatitis. The fistulae formed after treatment for benign conditions in 18 patients. Fistulae complicating cancer surgery were uncommon. All patients with uretero-vaginal fistulae underwent preliminary percutaneous nephrostomy. Twelve patients underwent reconstruction using either the Boari-Ockerblad flap (5), uretero-neocystostomy (4) or other techniques (3), all with excellent results. Most of the remaining patients had treatment elsewhere. We consider that preliminary diversion, followed by delayed reconstruction, is a valuable option in the management of uretero-vaginal fistulae.

Edible products from pelagic bissaria (Atherina mochon) fish

The study was concerned with the utilization of small pelagic bissaria (Atherina mochon) fish in preparing edible, cheap, acceptable and nutritive products. The results confirmed the successful use of the mince of both the whole and beheaded gutted fish either alone or after mixing with different levels of plant sources (e.g. rice, wheat, potato, sesame butter, spices) in producing fresh fish ball, fish flour and spiced salted fish paste. Generally, the panelists preferred the products made from beheaded gutted fish mince above that prepared from whole one. The utilization of plant sources improved the technological properties of the products. The influence of processing on the chemical composition of these products was studied and tabulated.

Blood pressure responses to care procedures in ventilated preterm infants

Responses of mean aortic blood pressure to sequences of routine care procedures in 22 ventilated, preterm infants were studied daily for the first 3 days of life. In the first 11 infants standard care procedures were used, whereas the next 11 infants were preoxygenated by a preceding 10% increase in inspired oxygen concentration; in these infants, chest physiotherapy was entirely omitted while the frequency of endotracheal suctioning was reduced. A total of 259 blood pressure responses were recorded. In general, responses were biphasic, consisting of an initial blood pressure drop followed by a greater blood pressure rise of longer duration. Baseline blood pressure, as well as the minimum and maximum blood pressure during the care procedures, increased with gestational age and with postnatal age. The blood pressure drop was most pronounced in the infants requiring the most intensive ventilatory support and was reduced by modifying the care procedures. The blood pressure rise was the least in the infants receiving pancuronium and phenobarbitone. Eight infants, 4 in each group, had intraventricular haemorrhage; in these infants, the care procedures induced more pronounced blood pressure drops in the first day of life when compared to the infants without haemorrhage.

Effects of certain antibilharzial and contraceptive drugs on liver functions in rats

Effects of single and combined administration of contraceptive drug (microvlar-30) and anti-urinary bilharzial drug (metriphonate) as well as anti-intestinal bilharzial drug (oxamniquine) on the liver functions of female albino rats were studied. Metriphonate increased serum globulin content and caused no change in the hepatic cells. Oxamniquine significantly increased the activities of serum transaminases and alkaline phosphatase and caused necrosis in some liver cells. Microvlar-30 exhibited no change on the serum enzymes, while marked increase was found in serum triglyceride and protein levels. The combined administration of metriphonate or oxamniquine with microvlar-30 prevented the increase in the levels of serum triglycerides and proteins. Histopathological examination confirmed the results obtained by chemical analysis.

The characterization of lipoprotein lipase isolated from the post-heparin plasma of the rainbow trout, Salmo gairdneri Richardson

1. Intravenous injection of heparin into the trout resulted in the appearance in the plasma of a lipase with the properties of lipoprotein lipase. 2. The enzyme was purified to apparent electrophoretic homogeneity by means of heparin-Sepharose affinity chromatography. The enzyme was eluted with 1.5 M-NaCl and had a specific activity approx. 450-fold that of the post-heparin plasma. 3. The activity of the purified enzyme was inhibited by 1.0 M-NaCl and protamine sulphate and was stimulated between 3- and 8.8-fold by the addition of trout plasma. 4. The activity was strongly stimulated by trout very low density lipoproteins and to a lesser extent by high density lipoproteins. 5. The isolated enzyme fraction gave a single band on sodium dodecyl sulphate/polyacrylamide-gel electrophoresis and had an apparent subunit M4 of 63 000. 6. These results suggest that the uptake of lipid by the tissues in the trout can occur by a process similar to that in mammals.

The surgical management of bilharzial strictures of the ureter

Twenty-one ureteric strictures due to bilharzia have been treated surgically in 13 patients. Two required nephrectomy; 19 had direct ureteric reimplantation into the dome of the bladder after excision of the strictured segment of ureter. A simple technique of reimplantation into the dome of the bladder is described and early results have justified its further use.

Internal urethrotomy using Sachse knife for managing urethral strictures

Urethral strictures secondary to trauma have been a frequent cause of obstruction in the male population residing in Saudi Arabia. This study of 59 patients presenting with urethral strictures covers a two-year period. Patients were asked to return for the initial follow-up one month after treatment and were asked about the force of their urine stream. They returned again after six months for a urethrogram; finally yearly follow-ups were commenced.

Intrarenal and in situ kidney workbench surgery under hypothermia

Two methods are described to cool the kidney. The surgact type of device can cover the entire kidney or a single pole. The second method for cooling the kidney is use of an intracellular hypothermic solution with methylprednisolone; the kidney is flushed via the renal artery to achieve cooling. Two interesting cases are presented which illustrate the methods used to achieve hypothermia.

The use of pedicled grafts of omentum in the repair of transplant-related urinary tract problems

Urologic complications related to renal transplantation may be difficult to treat and can be serious threats to life or to function of the transplanted kidney. Successful experience with omentrum for non-transplant and transplant-related reconstructive procedures recommends its further use. Herein are reported 4 patients in whom pedicled flaps of omentum were used to treat transplant-related urologic problems.

Constituents of Egyptian euphorbiaceae. I. Triterpenoids and related substances of Euphorbia paralias

The study of the triterpenoids and their related substances of Euphorbia paralias resulted in isolation of ursolic acid, cycloartenol, 24-methylenecycloartenol, uvaol, a hydrocarbon fraction (n-C29 n-C35), alcohol fraction (hexacosanol and octacosanol) and a sterol fraction (β-sitosterol, stigmasterol, campesterol and cholesterol)