Assessment of Deep Learning Models for Cutaneous Leishmania Parasite Diagnosis Using Microscopic Images

Cutaneous leishmaniasis (CL) is a common illness that causes skin lesions, principally ulcerations, on exposed regions of the body. Although neglected tropical diseases (NTDs) are typically found in tropical areas, they have recently become more common along Africa's northern coast, particularly in Libya. The devastation of healthcare infrastructure during the 2011 war and the following conflicts, as well as governmental apathy, may be causal factors associated with this catastrophic event. The main objective of this study is to evaluate alternative diagnostic strategies for recognizing amastigotes of cutaneous leishmaniasis parasites at various stages using Convolutional Neural Networks (CNNs). The research is additionally aimed at testing different classification models employing a dataset of ultra-thin skin smear images of Leishmania parasite-infected people with cutaneous leishmaniasis. The pre-trained deep learning models including EfficientNetB0, DenseNet201, ResNet101, MobileNetv2, and Xception are used for the cutaneous leishmania parasite diagnosis task. To assess the models' effectiveness, we employed a five-fold cross-validation approach to guarantee the consistency of the models' outputs when applied to different portions of the full dataset. Following a thorough assessment and contrast of the various models, DenseNet-201 proved to be the most suitable choice. It attained a mean accuracy of 0.9914 along with outstanding results for sensitivity, specificity, positive predictive value, negative predictive value, F1-score, Matthew's correlation coefficient, and Cohen's Kappa coefficient. The DenseNet-201 model surpassed the other models based on a comprehensive evaluation of these key classification performance metrics.

The Diversity in Grapes of Vitis labrusca Grown in Bolu (Türkiye) Assessed by Multivariate Approaches

The grape is one of the most produced and processed horticultural crops. This study evaluated the grape genetic resource belonging to the Vitis labrusca species. The diversity was assessed according to morphometric, antioxidant, physicochemical, and colorimetric characteristics. The diversity was evaluated using a variation index and multivariate analyses. The bunch weight of the vines exhibited a range from 21.05 g to 162.46 g, with a coefficient of variation (CV) of 38.97%. The average bunch weight was 64.74 g. In terms of the berry properties, the highest CV was observed for the berry weight (21.95%). The peel thickness displayed a CV of 36.40%, and an average of 0.23 mm. The CVs for the juice characteristics in the berries of the studied vines were 7.11%, 16.61%, 19.41%, and 28.10% for the pH, TSS, must yield, and TA, respectively. The TPC of the accessions exhibited a notably low variation (CV = 4.63%). The color properties of the accessions displayed an immense variation, except for the L* values. The hierarchical clustering analysis divided the accessions into two main clusters, which both had two subclusters. The multivariate approaches separated individuals into different groups, and they were considered useful tools for utilization in the genetic diversity assessments. Further studies on the cultivation technique and crossbreeding with Vitis vinifera will provide more insights into the population, and this study will be a source for upcoming studies on V. labrusca in the region.

The Effect of Altitude on Phenolic, Antioxidant and Fatty Acid Compositions of Some Turkish Hazelnut (Coryllus avellana L.) Cultivars

Turkey is the leading producer and exporter of hazelnuts, producing approximately 64% of global hazelnut production. This research investigated the effects of cultivars and altitude on the phenolic, antioxidant, and fatty acid compositions of five hazelnut cultivars grown at three different altitudes, 100 m, 350 m, and 800 m, in Ordu province, one of the territories that produce the most hazelnuts. The results showed that the cultivar and location significantly affected phenolic compounds, antioxidant activity, and fatty acid (FA) content. The lowest (2.30 mg/kg-Yağlı) and highest (21.11 mg/kg-Kara) gallic acids were obtained at 100 m. The highest total phenolic content and antioxidant activity were found in the nuts grown at 350 m in the Kara and Palaz cultivars, at 100 m in the Yağlı and Sivri cultivars, and at 800 m in the Çakıldak cultivar. Oleic acid was the predominant FA in the cultivars and possessed a diverse trend according to the altitude and cultivar, ranging from 76.04% to 84.80%, increasing with altitude in all cultivars except Çakıldak. Palmitic acid was the predominant saturated FA followed by stearic acid, which significantly varied according to the elevations. This study suggests that the responses of hazelnuts to altitude depend on the cultivar; hence, a proper approach to producing nuts containing more phenolic, fatty acids, and antioxidant activity includes choosing a suitable cultivar for a specific elevation.

Molecular and Technological Characterization of Saccharomyces cerevisiae from Sourdough

DNA markers help detect the intraspecific genetic diversity of yeast strains. Eight ISSR (Inter Simple Sequence Repeats) primers were used to assess the intraspecific diversity of Saccharomyces cerevisiae (n = 96) from different populations (n = 3), evaluate the technological characteristics, and investigate trait-loci associations. The primers amplified 154 reproducible and scorable bands, of which 79.87% were polymorphic. The UPGMA (unweighted pair group method with arithmetic mean) dendrogram clustered 96 isolates into two main clusters, supported by STRUCTURE HARVESTER results (ΔK = 2). Analysis of molecular variance (AMOVA) indicated significant genetic differences between (15%) and within the populations (85%) (p < 0.001). Twenty-nine genetically distinct strains were selected for the technological characterization. Principal component analysis (PCA) revealed that five strains with high fermentation capacity, leavening activity, high growth index at 37 °C, and harsh growth conditions were technologically relevant. Trait-loci association analyses indicated that the highest correlation (r = 0.60) was recorded for the fermentation capacity on the 8th and 113th loci, amplified by ISSR-1 and ISSR-6 primers, respectively (p < 0.05). The strains yielding high performances and the associated loci amplified by ISSR markers possess a high potential to generate locus-specific primers to target the strains with high fermentation capacity.

[Investigation of Leishmania infantum Seroprevalance and Leishmaniasis Knowledge Level in Northern Cyprus]

Leishmaniasis is an infectious disease caused by Leishmania parasites, transmitted by sand flies and common in the Mediterranean region. Cyprus is located in the east of Mediterranean Sea and is considered endemic for Leishmaniasis. In our study, it was aimed to investigate Leishmania infantum IgG seropositivity in healthy volunteers living in different regions of Northern Cyprus and to determine the risk factors for Leishmaniasis and measure the level of public knowledge about the disease. A total of 300 healthy volunteers (farmer/livestock: 100, hunter: 100, control group: 100) from five different regions of Northern Cyprus were included in the study, including Nicosia, Kyrenia, Famagusta, Morphou/Lefka, and Trikomo/Karpasia. The participants' blood was drawn and prepared questionnaire forms were filled out. Collected blood was centrifuged and the serum samples were separated and stored at -80ºC until the day of the test. All serum samples were tested for L.infantum IgG specific antibodies using the ELISA method (NovaTec, Immundiagnostica GmbH, Germany) in accordance with the manufacturer's recommendations. L.infantum IgG positivity was found to be 4.7% (14/300). The mean ages of L.infantum IgG positive and negative participants were 43.64 ± 11.74 and 42.17 ± 14.32 respectively. There was no statistically significant relationship between seropositivity and age (p= 0.706). The positivity rate was found to be significantly higher in hunters and farmers/livestocks compared with the control group (p= 0.020). In addition, it was determined that having a dog and the number of dogs owned were significantly associated with Leishmaniasis (p= 0.017, p= 0.020, respectively). On the other hand, 77% (231/300) of the volunteers included in our study had no prior knowledge about the disease. When compared to the other study groups, it was determined that hunters had the most knowledge of the Leishmaniasis infection (p= 0.001). Moreover, it was observed that as the education level of the participants increased, the level of knowledge about the disease also increased in parallel (p≤ 0.001). According to the results in our study, L.infantum IgG seropositivity was undeniably high in the healthy population living in Northern Cyprus. It is clear that outdoor activities such as hunting or dealing with farming/livestock are risk factors for the disease. In this context, it is apparent that more clear results will be obtained about the prevalence of the disease with the conduction of large-scale epidemiological studies. As a result, we concluded that especially risk groups should be informed about the current status of Leishmaniasis infection and necessary precautions should be taken.

Investigation of <i>Brucella canis and Brucella abortus</i> Seropositivity by In-House Rapid Slide Agglutination Test and In-House ELISA in Northern Cyprus

The incidence of Brucella canis (B. canis) in humans is unknown in Northern Cyprus. In this study, we investigated the prevalence of B. canis and Brucella abortus (B. abortus) infection in human sera and evaluated the results obtained by agglutination-based techniques using standardized antigens made from B. canis comparatively. All of the subjects were negative in terms of Rose-Bengal plate test. Undiluted serum samples were initially screened by rapid slide agglutination test (RSAT), and those which were found positive were retested in the dilution of 1/25-1/200. Confirmation of the positive results was performed by using 2-mercaptoethanol standard agglutination test (SAT). The test antigen was prepared from the less mucoid M (-) variant of B. canis, and 1/1,048 titered dog antiserum was used as positive control. In 225 serum samples, 3.6% (8/225) was positive by B. canis M (-) RSAT, 4.4 % (10/225) was positive by B. canis M (-) indirect enzyme-linked immunosorbent assay (iELISA). 5.3% (12/225) was positive by B. abortus S99 RSAT and 9.8% (22/225) was positive by B. abortus S99 iELISA. Nine samples were positive by both B. abortus S99 RSAT and B. abortus S99 iELISA. Seven samples were positive by both B. canis M (-) RSAT and B. canis M (-) iELISA. One patient was positive by all methods. It is important to evaluate patient samples with RSAT and iELISA. Until the notification system gives better results to the Ministry of Health, in order to reach the real data for Northern Cyprus, multicenter prevalence determination studies should be done for future.

Epidemiology of Intestinal Parasites in a University Hospital in Northern Cyprus: A 4-year Retrospective Experience

Objective

Intestinal parasitic infections (IPI) are considered as one of the most important public health problems that cause morbidity and mortality. For this reason, to determine their prevalence it is critical for prevention. This study aimed to determine the prevalence of intestinal parasites.

Methods

In our study, a total of 4.957 patients registered to our hospital with gastrointestinal symptoms between January 2016 and December 2019 were retrospectively analysed. Their stool samples were examined macroscopically and microscopically. In the microscopy, native-lugol and formol ethyl acetate concentration methods were used. Crypto-Giardia-Entamoeba antigen test was applied. All cases were evaluated in terms of age, gender, year and season.

Results

In our study group, 239 (4.8%) patients were detected as positive for intestinal parasites. Among these patients, 129 (54%) were male and 110 (46%) were female. No statistically significant difference was found between IPI and gender (p=0.228). Blastocystis hominis (76.2%) and Giardia intestinalis (12.1%) were the most common parasites. According to age groups, most intestinal parasites are found in 16-45 years old and least in 0-15-years-old (p=0.0001). A significant increase was found in positive intestinal parasite cases especially after 2018 (p=0.0001). Our study determined that intestinal parasites were observed most frequently in autumn (p=0.033).

Conclusion

The prevalence of IPI in our country is low. However, due to the increasing trend of IPI since 2018, necessary measures must be implemented to prevent further increase in the number of cases. In addition, reasons behind the rising cases of intestinal parasites during the autumn months in which rainfall begins require further investigation.

In vitro Anti-Leishmanial Activity of Essential Oils Extracted from Plants Growing in Northern Cyprus Against Leishmania tropica

OBJECTIVE

Natural plant products are considered as a source of novel and effective compounds for the treatment of leishmaniasis. In this study, the in vitro activities of essential oils obtained from Origanum dubium (OD), Origanum majorana (OM), Salvia fruticosa (SF) and Laurus nobilis (LN) plants in Northern Cyprus were investigated against Leishmania tropica.

METHODS

Leishmania tropica strain (MHOM/TR/2012/CBCL-LT) was obtained. RPMI-1640 was added to 96-well plates in 100 μL aliquots, 100 μg/mL essential oil was added to the first well of each row and serial 2-fold dilutions were performed. A promastigote suspension was pipetted into all wells, and the plates were incubated. The promastigotes were enumerated using a haemocytometer.

RESULTS

OD essential oil was effective at killing all promastigotes at a minimum inhibitor height (MIC)=0.2 μg/mL and had high activity at the lowest concentrations. Both SF and LN oils had MIC=1.56 μg/mL and LD₅₀=0.78 μg/mL. SF was observed to impair promastigote morphology at the lowest concentrations, while LN did not exert any effect at concentrations <0.2 μg/mL. OM essential oil was found to have a MIC=3.13 μg/mL and a LD₅₀=1.56 μg/mL.

CONCLUSION

All tested essential oils inhibited promastigotes of Leishmania tropica. OD essential oil demonstrated the highest anti-leishmanial activity.

AMAÇ

Bitkilerden elde edilen doğal ürünlerin leishmaniasis tedavisi için yeni ve etkili bileşiklerin üretilmesine öncülük edeceği düşünülmektedir. Çalışmamızda, Kuzey Kıbrıs’ta yetişen Origanum dubium (OD), Origanum majorana (OM), Salvia fruticosa (SF) ve Laurus nobilis (LN) bitkilerinden elde edilen uçucu yağların Leishmania tropica’ya karşı in vitro etkinlikleri araştırılmıştır.

YÖNTEMLER

Çalışmamızda, Leishmania tropica suşu (MHOM/TR/2012/CBCL-LT) kullanıldı. Düz tabanlı 96’lık plaklarda, tüm kuyucuklara 100 μL RPMI-1640 ve ilk kuyucuklara 100 μg/mL uçucu yağlar eklenerek, seri dilüsyonları yapıldı. Ardından tüm kuyucuklara Leishmania tropica promastigot süspansiyonundan pipetlendi ve inkübe edildi. Hemositometre yöntemiyle promastigotların sayısı incelendi.

BULGULAR

OD yağının minimum inhibitör konsantrasyonu (MİK)=0,2 μg/mL’de tüm promastigotları öldürürken, en düşük konsantrasyonlarda bile etkili olduğu görülmüştür. SF ve LN uçucu yağlarının ikisinde de MİK=1,56 μg/mL, LD₅₀=0,78 μg/mL olarak saptanmıştır. SF’nin en düşük konsantrasyonlarının bile promastigot morfolojisini bozduğu görülürken, Laurus nobilis’in ise 0,2 μg/mL’den sonraki konsantrasyonlarda etkisini kaybettiği belirlenmiştir. OM uçucu yağının MİK=3,13 μg/mL, LD₅₀=1,56 μg/mL olduğu görülmüştür.

SONUÇ

Kullanılan tüm uçucu yağların Leishmania tropica promastigotlarını inhibe ettiği görülürken, en yüksek anti-leishmanial etkinlik Origanum dubium uçucu yağında bulunmuştur.

Evaluation of Imported Malaria Cases in Northern Cyprus between 2016 and 2019: First Data Series

Objective

In present times, malaria remains an infectious disease with a high mortality rate in some regions of the world. It is predicted to preserve its importance as a disease in the future because of the traveling human populations from malaria-endemic African countries into the regions where malaria has been eradicated. The objective of this study is to evaluate the increasing imported malaria cases in the Turkish Republic of Northern Cyprus.

Methods

In this study, we investigated 13 patients who were diagnosed with malaria between 2016 and 2019. We clinically evaluated all the cases. More importantly, we made the diagnosis of these patients by Giemsa-stained thin and thick blood smears, rapid malaria antigen tests, and genotyping (only for five patients) by real-time polymerase chain reaction. Additionally, we evaluated patients with malaria in terms of age, gender, and seasons.

Results

In the diagnosed malaria cases, 11 (84.4%) of them were male and 2 (15.6%) were female. There was no significance between malaria infection and gender (p=0.358). Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale infection were detected in ten patients (76.9%), two (15.4%) patients, and one (7.7%) patient, respectively. There was a significant increase (p=0.003) in the malaria cases in 2019 (n=9). The seasonal comparison revealed that malaria infections are most common in autumn (8/13, 61.5%).

Conclusion

Despite the eradication of malaria in Turkish Republic of Northern Cyprus, the rising number of recently imported cases increases the risk of emerging local cases. Malaria infection should be immediately suspected, particularly, in foreign patients who travel from the malaria-endemic region and present with symptoms such as fever and shivering if the laboratory findings especially detect thrombocytopenia.

[An Endemic Plant of Cyprus, Origanum majorana: Is It A New Alternative Natural Product for Malaria Treatment?]

Malaria still remains to be a public health threat and one of the most important infectious diseases to get attention from World Health Organization. No domestic malaria cases have been reported on the island of Cyprus since 1948, as a result of successful elimination process. All of the malaria cases detected in recent years are imported cases. As known, hundreds of medicines are obtained from plants and traditional medicine are used in endemic places of malaria. The cause of malaria - Plasmodium parasites, are developing resistance to antimalarial drugs. Hence, research on plant extracts and essential oils have gained great interest in recent years to obtain new and safe agents/substances. In our study, it was aimed to investigate the in vivo antimalarial activities of essential oils obtained from Origanum dubium, Origanum majorana, Salvia fruticosa and Laurus nobilis plants which grows in Northern Cyprus against Plasmodium berghei - the rodent malaria agent. Plants were collected in appropriate seasons and were dried to obtain and analyze essential oils via Clevenger Apparatus system. L929 mouse fibroblast cell line and MTT [3-(4.5-dimethylthiazole-2-yl) -2.5-diphenyltetrazolium bromide] kit were used to determine the cytotoxic activities of the essential oils obtained. In our study, total of 36 mice (Balb/c) of 6 groups (6 mice in each group) were formed: chloroquine group (CG) (50 mg/kg) as malaria reference group, untreated control group (UTCG), O.dubium (OD) (20 mg/kg), O.majorana (OM) (20 mg/kg), S.fruticosa (SF) (20 mg/kg) and L.nobilis (LN) (20 mg/kg). The essential oils were given to mice infected with P.berghei strain orally on 0, 1, 2 and 3rd days (4 times in total). Blood was taken from the tail end of each mouse 24 hours after the last treatment and blood collection was continued every two days until the mice died. Withdrawn blood taken from the mice were prepared as a thin smear and stained with Giemsa. Then, parasitemia percentages in each smear were calculated. As a result of the cytotoxicity tests, cytotoxic activity was not found at 100 µg/ml (20 mg/kg) in all oils except OD essential oil. While the mice receiving chloroquine continued their lives with the disappearance of the parasite on the 6thday, the mice in the UTCG died on the 9th day. The parasitemia rate reached 35% in the OM group on the 23rd day, in the OD group on the 21st day and in the other groups (SF and LN) on the 14th day and the mice have died. In our study, the difference between the life span in all groups was found statistically significant (p≤ 0.001). As a result, the essential oils O.majorana (14 days increase according to UTCG) an endemic plant of Cyprus and O.dubium (12 days increase according to UTCG) which had an antimalarial effect, decreased parasitemia and increased the life span of mice more than two times, indicated that they could be a source for the acquisition of new antimalarial molecules.

Congenital Infantile Fibrosarcoma of the Thigh in a Newborn

Congenital/infantile fibrosarcoma occurs frequently in the first year of life and differs from fibrosarcoma in adulthood. The clinical course of congenital/infantile fibrosarcoma is more favorable and metastatic spread is rare. While adult fibrosarcomas are common in the thigh, congenital/infantile fibrosarcomas affect chiefly the distal portions of the extremities. Standard treatment is primarily wide surgical excision. Chemotherapy may be given as neoadjuvant or adjuvant treatment in order to avoid the morbidity associated with wide excision. In this case report we present our experience of a newborn affected by congenital/infantile fibrosarcoma of the left thigh.

Pleuropulmonary Blastoma in a Child Presenting with Pneumothorax

Pleuropulmonary blastoma is an uncommon primary malignant tumor of the lung. Surgery is the most important part of the treatment. Despite the use of chemotherapy with or without radiotherapy, the prognosis is poor. Here we report on the case of a 2.5 year-old boy presenting with pneumothorax who turned out to have a right hemithoracic mass. The patient underwent surgical resection of the mass. Pathologic diagnosis was type II pleuropulmonary blastoma. Postoperative thoracic CT showed nodular residual densities so the patient was given adjuvant combination chemotherapy with cisplatin and etoposide. He has been disease free for 12 months.

[Molecular epidemiology of hepatitis B virus in Northern Cyprus]

Identification of hepatitis B virus (HBV) strains and understanding of molecular epidemiological characteristics are important for the effective surveillance of HBV infections. Genotype D is dominant in studies performed in Turkey but it is known that cases infected with genotypes A, E, G and H also exists. In contrast, there are no data regarding the molecular epidemiologic characteristics of the HBV in Northern Cyprus. The aim of this study was to determine the distribution of genotypes and subgenotypes of HBV among the people living, educating and working in Northern Cyprus. A total of 160 cases (1.2%) who were HBsAg seropositive out of 13.892 subjects admitted to Nicosia, Near East University Hospital microbiology laboratory for the routine control and to blood center for donor screening tests between November 2011 to September 2014, were included in the study. HBV-DNA levels in the HBsAg positive cases were detected by real-time polymerase chain reaction and genotypes/subgenotypes were determined by sequence analysis of the viral pol gene (reverse transcriptase [rt] region, between 80-250. aminoacids). Sixty samples (60/160, 37.5%) were excluded from sequencing analysis due to negative and/or very low (< 30 IU/ml) HBV-DNA levels, so 100 samples were included in sequence analysis. Ninety-six of those cases (13 female, 87 male; mean age: 35.51 ± 12.88 years) were anti-HBc IgG, 95 were anti-HBe and five were HBeAg positive, with a mean HBV-DNA level of 5.36 x 10(6) ± 3.58 x 10(7) IU/ml. As 32 (32%) samples yielded HBV-DNA level below the threshold of 1000 IU/ml, sequence analyses were unsuccesful, eventually 68 (68/160, 42.5%) samples could be phylogenetically analyzed. The distribution of HBV genotypes/subgenotypes were found as follows: 48 were (70.6%) D/D1; four were (5.9%) D/D2; one was (1.5%) D/D3, five were (7.4%) A/A1, two were (2.9%) A/A2 and eight were (11.8%) genotype E. Among the most frequent D1 strains, 60.4% (29/48) cases were from Turkish; single D/D3 strain from Benguela (Angola) and all eight genotype E strains were from Nigerian national cases. According to the data of this first study performed in TRNC on this subject, genotype D is dominant (53/68, 78%) in Northern Cyprus and consistent with the subgenotype distribution that is similar to Turkey and mediterranean basin. The prevalences of genotype A (7/68, 10.3%) and E (8/68, 11.8%) were also remarkable. In conclusion, although Northern Cyprus is an island country the heterogeneous distribution of HBV genotype/subgenotype may be contributed to the cosmopolitan characteristics of various populations from different countries who have come here for education, work or touristic purposes.

Aspects of thermal martensite in a FeNiMnCo alloy

Thermal martensite characteristics in Fe-29%Ni-2%Mn-2%Co alloy were investigated with scanning electron microscopy (SEM) and Mössbauer spectroscopy characterization techniques. SEM observations obviously revealed the lath martensite morphology in the prior austenite phase of examined alloy. As well, the martensitic transformation kinetics was found to be as athermal type. On the other hand, Mössbauer spectroscopy offered the paramagnetic austenite phase and ferromagnetic martensite phase with their volume fractions. Also, the internal magnetic field of the martensite was measured as 32.9T from the Mössbauer spectrometer.

Influence of the relapse and remission periods on hearing status in children with minimal change nephrotic syndrome

OBJECTIVE

Minimal change nephrotic syndrome (MCNS) is characterized by the onset of NS (Nephrotic Syndrome) without systemic disease, hypocomplementemia, or other serious signs of renal disease. Hearing status is not very well known in MCNS. Our objective was to address this question and to find out remission and relapse periods of the syndrome would affect the hearing of the patients.

METHODS AND PATIENTS

Otologic status of 26 children with clinical MCNS was investigated in relapse and remission periods using audiometry and tympanometry. The pure tones that were obtained at the frequencies 250, 500, 1000, 2000, 4000 and 6000 Hz were noted. Pure tone averages (PTAs) were calculated at 500, 1000, 2000 and 4000 Hz frequencies.

RESULTS

In both remission and relapse periods, PTA of the patients did not change and was 13 dB. The frequency specific pure tone results were not significantly different between the right and left ears of the patients as well as between the remission and relapse periods (p > 0.05). In the relapsing and remission periods, type A tympanogram was encountered in 86.4% and 92.3% of the ears, respectively. Type B tympanogram was encountered in 11.5% and 3.8% of the ears in the relapsing and remission periods, respectively. Type C tympanogram was encountered in 3.8% of the ears both in the relapsing and remission periods. Differences between the tympanometry results were not significant (p > 0.05).

CONCLUSION

MCNS in childhood is not associated with an alteration in the hearing status, both in remission and relapse periods of the disease.

Extraneural metastasis in a child with atypical teratoid rhabdoid tumor of the central nervous system

Atypical teratoid rhabdoid tumor is a distinctive brain tumor appearing in infancy and early childhood. Leptomeningeal dissemination is common, both at presentation and relapse. Extracranial metastases of the central nervous system tumors are rarely seen. To our knowledge there is only one report with an atypical teratoid rhabdoid tumor metastasizing via a ventriculoperitoneal shunt. We describe the first case of atypical teratoid rhabdoid tumor of the central nervous system who developed lung metastasis without the presence of a shunt.

Urticaria pigmentosa associated with Wilms tumor

Urticaria pigmentosa is the most common manifestation of mastocytosis, with the majority of cases undergoing spontaneous resolution, especially in children. Several reports have documented hematologic malignancies developing in patients with urticaria pigmentosa. We present a 4.5-year-old boy with urticaria pigmentosa who developed Wilms tumor. To our knowledge, coexisting urticaria pigmentosa and Wilms tumor have not previously been described.

Studies on vaginal bioadhesive tablets of acyclovir

Bioadhesive vaginal tablets were prepared using poly(acrylic acid) (PAA); Methylcellulose (MC), carboxymethyl cellulose (CMC), hydroxypropyl cellulose (HPC) and hydroxypropylmethyl cellulose (HPMC) as bioadhesive polymers in different concentrations and acyclovir as drug by direct compression technique (DCT) and wet granulation technique (WGT). Physical tests were applied to the tablets. The swelling behavior of vaginal tablets in distilled water, lactic solution and cow vagina, acyclovir release rate in lactic solution and bioadhesion to vaginal mucosa in cow vagina, in situ, were investigated. Swelling of the tablets containing HPC, CMC and MC was very rapid and caused disintegration of the tablets. The swelling behaviour of the tablets containing HPMC lasted 6 h in lactic solution. The force (N) necessary to detach the tablets from the vaginal tissue was found to depend on concentration and type of the bioadhesive polymer. The tablets containing HPMC needed the most detachment force.

Studies on controlled release dimenhydrinate from matrix tablet formulations

In this study, controlled release dosage forms of dimenhydrinate were prepared with different polymers as MC, HEC, Carbopol 934, Eudragit RLPM and Eudragit NE 30 D at different concentrations (2.5-10%). Direct compression (DC) and wet granulation (WG) techniques were used to prepare the tablets. Magnesium stearate was the lubricant while starch gel was the binder. For the quality control of tablets prepared according to 11 different formulations, weight deviation, hardness, friability, diameter-height ratio, content uniformity of the active substance and in vitro dissolution techniques were performed. Dissolution rate of these tablets was controlled by USP XXII dissolution method and the profile of each tablet was plotted and only for F 5 was evaluated kinetically.

A comparison of the effect of high-dose methylprednisolone with conventional-dose prednisolone in acute lymphoblastic leukemia patients with randomization

In this preliminary study the efficacy of high-dose methylprednisolone (HDMP) during remission-induction chemotherapy was evaluated on 166 children with acute lymphoblastic leukemia (ALL). The St. Jude Total Therapy Study XI protocol with minor modifications was used in this trial. Patients were randomized into two groups. Group A received conventional-dose (2 mg/kg/day orally) prednisolone, and group B received high-dose methylprednisolone (HDMP, Prednol-L, 900-600 mg/m2 orally) during remission-induction chemotherapy. Complete remission was achieved in 97% of the children. For the 80 patients who were followed up for 3 years, median follow-up was 44 (range 5-60) months and the 3-year event-free survival (EFS) rate was 68.5%) overall, 58.6% in group A and 78.4% in group B. The EFS among patients in group B was significantly higher than in group A (p=0.05). When we compared the 3-year EFS of groups A and B in the high-risk groups and high-risk subgroups with white blood cell (WBC) counts > or = 50 x 10(9)/l and age > or = 10 years, the survival rates were 45% versus 77.2%, 33% versus 78% and 45% versus 89%, respectively. During the follow-up of 162 patients, relapses were significantly higher in group A. Bone marrow relapses in 162 patients, and also in a subgroup of patients > or = 10 years of age were significantly higher in group A. These results suggest that HDMP during remission-induction chemotherapy improves long-term EFS, particularly for high-risk patients.

Microencapsulation of ketorolac tromethamine by means of a coacervation-phase separation technique induced by the addition of non-solvent

Ketorolac tromethamine (KT) is a non-steroidal drug with potent analgesic and anti-inflammatory activity and is absorbed rapidly (Tmax < 1.0 h) with an efficiency > 87% following oral and intramuscular administration. The plasma half-life of ketorolac ranges from 1.1 to 6.0 h. Its oral bioavailability is estimated to be 80%. Ketorolac has been found 36 times more potent than phenylbutazone, approximately twice as potent as indomethacin, and three times more potent than naproxen in suppressing carrageenan-induced paw oedema in rat. In this study, microcapsules of KT were prepared by means of coacervation-phase separation technique induced by the addition of non-solvent, and release rates from microcapsules were studied. Eudragit S100 was used as the coating material. Coacervation was achieved by the addition of cyclohexane at 2 ml/min at 25 degrees C and 1:4 solvent: non-solvent ratio was used. The microcapsules were washed with cyclohexane to harden the wall and dried at room temperature. Microcapsules with core:wall ratio of 1:1 and 1:2 were prepared and the particles obtained by sieving with an average diameter of 177-500 microns were used. The yield was calculated and the release properties of KT were investigated by USP XXII paddle method and using UV spectrophotometry at 318 and 323 nm.

Spontaneous complete remission in a child with acute lymphoblastic leukemia

A five-year-old girl was admitted to the hospital with fever and tender lymphadenopathy. She was diagnosed with acute lymphoblastic leukemia (ALL-L3). Because of infection she was given antibiotics and a blood transfusion. Her bone marrow was in remission after 15 days without chemotherapy. This case emphases the role of transfusion and/ or infection in obtaining complete remission without chemotherapy.

Serum TNF-alpha, gamma-INF, G-CSF and GM-CSF levels in neutropenic children with acute leukemia treated with short-course, high-dose methylprednisolone

High-dose methylprednisolone (HDMP, 20-30 mg/kg/day po) treatment has been shown to increase the number of bone marrow and peripheral blood CD34 positive progenitors and serum granulocyte-macrophage colony-stimulating factor (GM-CSF) levels in patients with ALL and AML. To investigate the effect of HDMP on some other hematopoietic regulatory cytokines, tumor necrosis factor-alpha (TNF-alpha), gamma-interferon (gamma-INF), granulocyte colony-stimulating factor (G-CSF) and interleukin-6 (IL-6) were studied by microplate ELISA technique in 15 chemotherapy-induced neutropenic episodes of 14 children with acute leukemia (eight with ALL and six with AML) in whom HDMP was given alone (30 mg/kg/day po) for 4 days. The absolute neutrophil counts increased significantly in all neutropenic episodes on the fourth day of HDMP treatment. The TNF-alpha was 93.5 +/- 161 pg/ml in ALL and 78.3 +/- 61.4 pg/ml in AML before treatment and 76.1 +/- 160 pg/ml in ALL and 19.1 +/- 39.8 pg/ml in AML after treatment. The gamma-INF was 204.1 +/- 210.3 pg/ml in ALL and 130.8 +/- 138.3 pg/ml in AML before treatment and 28.6 +/- 50.5 pg/ml in ALL and 23.3 +/- 20.4 pg/ml in AML after treatment (P<0.05). Serum G-CSF and GM-CSF levels increased in all episodes (100%). The GM-CSF levels increased from 12.2 +/- 10.9 pg/ml to 36 +/- 24.7 pg/ml after treatment in ALL (P<0.05) and from 13.3 +/- 4 pg/ml to 45 +/- 48.1 pg/ml in AML (P<0.05). Serum G-CSF levels increased from 13.3 +/- 11.7 pg/ml to 83.3 +/- 86.8 pg/ml after treatment in ALL (P<0.05) and from 6.6 +/- 12.1 pg/ml to 28.3 +/- 11.3 pg/ml in AML (P<0.05). However, IL-6 levels were undetectable in all patients before and after therapy. These preliminary data suggest that short-course HDMP treatment could decrease serum TNF-alpha and gamma-INF and increase G-CSF and GM-CSF levels.

Preparation and in vitro dissolution of salbutamol sulphate microcapsules and tabletted microcapsules

Salbutamol sulphate is a sympathomimetic amine having a rather short plasma half-life. Aiming to achieve sustained release of this drug through microencapsulation, the coacervation method with a 1:1 core-shell ratio was used. In vitro release rate experiments were performed on the microcapsules prepared using ethyl cellulose as the coating agent and compared to the results of intact drug, the tabletted microcapsules and a commercial tablet. The release rate of salbutamol sulphate could be controlled through microencapsulation. The time for the 50% release of the drug was 15 and 90 min for the tabletted microcapsules and microcapsules respectively. The specific surface area of the intact drug was 0.35 m2/cc while it reduced to 0.06 m2/cc after encapsulation.