A novel CNN architecture for accurate early detection and classification of Alzheimer's disease using MRI data

Alzheimer's disease (AD) is a debilitating neurodegenerative disorder that requires accurate diagnosis for effective management and treatment. In this article, we propose an architecture for a convolutional neural network (CNN) that utilizes magnetic resonance imaging (MRI) data from the Alzheimer's disease Neuroimaging Initiative (ADNI) dataset to categorize AD. The network employs two separate CNN models, each with distinct filter sizes and pooling layers, which are concatenated in a classification layer. The multi-class problem is addressed across three, four, and five categories. The proposed CNN architecture achieves exceptional accuracies of 99.43%, 99.57%, and 99.13%, respectively. These high accuracies demonstrate the efficacy of the network in capturing and discerning relevant features from MRI images, enabling precise classification of AD subtypes and stages. The network architecture leverages the hierarchical nature of convolutional layers, pooling layers, and fully connected layers to extract both local and global patterns from the data, facilitating accurate discrimination between different AD categories. Accurate classification of AD carries significant clinical implications, including early detection, personalized treatment planning, disease monitoring, and prognostic assessment. The reported accuracy underscores the potential of the proposed CNN architecture to assist medical professionals and researchers in making precise and informed judgments regarding AD patients.

Turning down PI3K/AKT/mTOR signalling pathway by natural products: an in silico multi-target approach

The PI3K/AKT/mTOR pathway is a significant target for cancer drug discovery. Many efforts have focused on discovering new inhibitors against key kinase proteins involved in this pathway for cancer treatment. PI3K/mTOR dual inhibitors, such as PKI-179, have been reported to be more effective than agents that act only on a single protein target. The present computational study aimed to discover triple target inhibitors against PI3K, AKT, and mTOR proteins. Accordingly, the PI3K protein bound with the ligand was used as input for e-pharmacophore modelling to generate the pharmacophore hypothesis and then screened for a library of 270,540 natural products from the Zinc database resulting in 57,220 compounds that matched the hypothesis. These compounds were then docked into the active site of PI3K, resulting in 292 compounds with better docking scores than the co-crystallized ligand. These compounds were re-docked into AKT and mTOR proteins. Besides, MM-GBSA binding free energy calculations, MD simulations, and ADMET prediction were carried out, leading to 5 potential triple-target inhibitors namely, ZINC000014644152, ZINC000014760695, ZINC000014644839, ZINC000095099451, and ZINC000005998557. In conclusion, these inhibitors may be possible leads for inhibiting PI3K/AKT/mTOR pathway, and they may be further evaluated in vitro and clinically as anticancer agents.

Sterile water moisturizer of the skin of extremely low birth weight infants

OBJECTIVE

To assess the feasibility of sterile water application to the skin of the extremely low birth weight (ELBW) newborns in the first week of life and examine its effects on their skin integrity and outcomes.

DESIGN

Pilot randomized controlled trial.

SETTING

Open-bay, 18 bed Level III NICU in the Eastern United States.

PARTICIPANTS

Twenty-eight ELBW neonates. Two newborns expired, sixteen newborns remained in the intervention group and twelve newborns in the control group.

METHODS

ELBW neonates were either assigned to receive frequent sterile water wash to skin or not during care for the first week of life. Using the Neonatal Skin Condition Scale (NSCS), assessments were performed twice a day during the first week. Fluid intake, serum electrolytes, culture proven sepsis and other morbidities, and length of stay (LOS) were compared while controlling for confounding variables using multiple regression analysis.

RESULTS

There was no difference in the demographic or clinical characteristics between both groups. Sterile water wash application to skin was not associated with differences in skin health indices or fluid intake. However, it was associated with higher median sodium level and with early regression of bilirubin level when compared to controls.

CONCLUSION

Frequent skin washes with sterile water are feasible and safe. However, they may not be associated with improved skin integrity or fluid intake.

Is it feasible to avoid suction before spontaneous breathing is established?

BACKGROUND

Suctioning of the posterior pharynx immediately after birth during neonatal resuscitation can produce a vagal response resulting in bradycardia or apnea. The feasibility of delaying any airway suctioning and avoiding deep suctioning has not been studied.

OBJECTIVES

To test the hypothesis that newborn resuscitation is feasible with the following two guidelines: 1) avoiding any suctioning until the infant establishes spontaneous respiration, and 2) avoiding the use of deep suction with catheters.

STUDY DESIGN

A quality improvement project was implemented using these two guidelines. Infants' mouth was cleaned with a dry cloth. No suction was started until infants establish spontaneous breathing. Then, bulb suction was used to clear secretions from the sides of the mouth and the nose without reaching the back of the pharynx. Deep suction using catheters was not used. Neonatal staff and physicians received biweekly training to support these changes. Resuscitation data before and after the practice change were compared.

RESULTS

A total of 999 sequential cases were compared; of them 501 and 498 infants were resuscitated before and after the implementation of the new practice, respectively. Suction before spontaneous breathing occurred in 12.4% in the first cohort. There were no differences between groups except for less use of oxygen with the new guidelines (12.4% vs 4.4%, P < 0.001).

CONCLUSION

Avoidance of any suction prior to spontaneous breathing and not applying deep suction with catheters are feasible during newborn resuscitation. These practices are associated with decreased exposure to oxygen in the delivery room.

Role of umbilical cord C-peptide levels in early prediction of hypoglycemia in infants of diabetic mothers

BACKGROUND

Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia.

MATERIAL AND METHODS

UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected.

RESULTS

In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value = 0.43). The hypoglycemia peak occurred within the first 3 h of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96%) compared to normoglycemic babies (HbA1C 6.11 ± 0.38%), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005).

CONCLUSION

Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.

Anti-aging effect of DL-β-hydroxybutyrate against hepatic cellular senescence induced by D-galactose or γ-irradiation via autophagic flux stimulation in male rats

The present study aims to shed new light on anti-aging effect of DL-β-hydroxybutyrate (βOHB) against hepatic cellular senescence induced by d-galactose or γ-irradiation. The rats divided into 6 groups. Group 1, control, group 2, exposed to γ-ray (5 GY), group 3, injected by d-galactose (150 mg/kg) daily for consecutive 6 weeks, which regarded to induce the aging, group 4, injected intraperitoneal by β-hydroxybutyrate (βOHB) (72.8 mg/kg) daily for consecutive 14 days, group 5, exposed to γ-ray then treated with βOHB daily for consecutive 14 days, group 6, injected daily with d-galactose for consecutive 6 weeks, then treated with βOHB daily at the last two weeks of d-galactose. Aspartate amino transferase (AST), alanine amino transferase (ALT), Insulin, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were estimated in serum. Moreover, protein expression of Microtubule-associated proteins 1A/1B light chain 3B (LC3-II/LC3-I) ratio, mechanistic target of rapamycin (mTOR), pAMPK, mRNA gene expression of 5' AMP-activated protein kinase (AMPK), Nucleoporin p62 (p62), cyclin-dependent kinase inhibitor 1(P21^CIP1), cyclin-dependent kinase inhibitor 2A (p16^INK4a) and DNA fragmentation percentage were measured in liver tissue as a biomarker of cellular senescence. The results confirmed that βOHB modulated serum level of AST, ALT, insulin, IL-6 and TNF-α, protein expression of mTOR and LC3-II/LC3-I ratio, pAMPK and p62 in liver aging model induced by d-galactose or γ-irradiation. Histopathological examination results of liver tissue indicated coincidence with those recorded by molecular biochemical inspection. Taken together, these findings suggest that βOHB may be useful in combating hepatic cellular senescence induced by d-galactose or γ-irradiation via autophagy dependent mechanisms.

Simultaneous Quantification of Cephalexin and Sodium Benzoate in their Dosage forms by high analytical technique. Application of Lean Six Sigma and In-Vitro Dissolution studies

OBJECTIVES

The aim of the present work is to develop and validate a novel and simple Chromatographic and MCR methods for simultaneous quantification of cephalexin (CPH) and sodium benzoate (SDM) in their dosage form and application of Lean Six Sigma (LSS) to reduce variation and improve quality.

METHODS

Isocratic separation is performed using Agilent XDB-C8 (4.6mm×250mm) 5μm, with a mobile phase consisting of acetonitrile: water (30: 70, v/v) containing 0.1% orthophosphoric acid (OPA) at flow rate of 1.5mL/min and wavelength 254nm with injection volume of 20μL for HPLC and Agilent ZORBAX SB-C18 column (50mm×2.1mm, 1.8μm particle size) at flow rate 0.25mL/min, injection volume 0.8μL for UPLC. MCR spectrophotometric method is successfully applied for resolving spectral overlap of drugs at 240nm and 250nm for CPH and SDM, respectively. Comparative invitro dissolution studies are established on Generic product; Rivalexin and Lexin 250mg/5mL, consequently it had been considered equivalent and like the innovator product; Cephalexin USP 250mg/5mL using different USP media.

RESULTS

Good Linearity and recovery are achieved over the concentration range of 10-300, and 5-50μg/mL for the studied drugs. Process Capability Index (Cpk) is >1.33 and still capable during all stages of the product release.

CONCLUSION

The proposed method is accurate and could be applied to dosage form and LSS to interpret the data of quality attributes.

Lower segment folding as novel technique to control bleeding in cases of morbidly adherent placenta

AIM

To evaluate the effectiveness of lower segment folding in controlling lower segment bleeding and conserving uterus in cases with morbidly adherent placenta.

METHODS

This study was conducted on OB/GYN emergency unit of Sohag University hospital. The upper edge of lower segment was sutured to the internal os in continuous purse-string manner using delayed absorbable sutures "N0 2 vicryl (polyglactin 910)." The sutures incude both anterior and lateral aspects of lower uterine segment. Care was taken to maintain patency of endocervix. The folded lower segment was sutured to upper segment as ordinary closure of hysterectomy.

RESULTS

Thirty-two cases were included. The procedure was successful in all studied group to achieve good hemostasis and preservation of uterus. The estimated intraoperative blood loss was (1645 ± 318), there was no need for massive blood transfusion in all cases as number of blood units transfused ranged from 1 to 4 with mean (2.1 ± 0.53). Time required to perform lower segment folding was ranged from 3 to 8 min with mean (4.9 ± 1.1).

CONCLUSION

Lower segment folding is a good option for saving the uterus in cases of morbidly adherent placenta. The technique is rapid, easy to be performed without a need of special expertise nor special equipment's.

Frequency and types of uterine anomalies during caesarean section

In this study all women undergoing caesarean section were included regardless of the indication. After the foetus and placenta were delivered, the uterus was examined for the presence or absence of congenital malformation through digital palpation of uterine cavity and direct inspection of the fundus. Of the 653 caesarean sections included, uterine anomalies were diagnosed in 31 women (4.75%). Most of the anomalies were septate and sub-septate uterus (71%) followed by bicornuate uterus (19.4%), while the frequency of unicornuate uterus was 6.4% and uterine didelphys represented only 3.2%. In conclusion, an examination of the uterus internally and externally should be performed as a routine step during caesarean section. Impact statement What is already known on this subject? Most of the data of uterine anomalies has been derived from studies of patients with reproductive problems and not from those with a normal reproductive outcome. What do the results of this study add? Approximately 5% of women were found to have uterine anomalies when examined during caesarean section. If any were detected, we feel that the patient should be informed, as they may affect future reproductive performance and the choice of contraception. What are the implications of these findings for clinical practice and/or further research? An examination of the uterus internally and externally should be considered as a routine step during a caesarean section.

Patent ductus arteriosus in premature infants: to treat or not to treat?

OBJECTIVE

Closing patent ductus arteriosus (PDA) is a widely accepted approach in the management of very low birth weight (VLBW) infants. Our objective is to test the hypothesis that conservative management (no treatment) of PDA will not affect survival without chronic lung diseases (CLD).

STUDY DESIGN

This retrospective study utilizes a prospectively collected database to compare two cohorts of VLBW infants. Infants in the first group (2001 to 2009) had their PDA treated with pharmacological and if necessary with surgical ligation. PDA in the second group (2010 to 2014) was not treated with medical or surgical intervention. The primary outcome was survival without oxygen requirement at 36 weeks. Pulmonary and non-pulmonary morbidities were also compared. Logistic regression analyses were performed to control for confounders.

RESULTS

This study included 643 VLBW infants, of them 415 infants in the Treat group and 228 in the No-Treat group. The rate of survival without CLD did not differ between Treat and No-Treat groups (78.4% vs 83.9%, respectively; adjusted odds ratio (aOR)=1.72, confidence interval (CI): 0.92 to 3.23, P=0.09). Mortality declined in No-Treat group (15.2% vs 10.5%, aOR=0.51, CI: 0.25 to 0.99, P=0.049), but the two groups did not differ in the incidence of CLD among survivors (5.8% vs 5.0%,=P0.47). Pulmonary complications and non-pulmonary morbidities did not differ between groups.

CONCLUSIONS

Conservative management (no treatment) of PDA may not compromise survival without CLD and is not associated with increased morbidities in VLBW infants. Prospective physiological studies are needed to determine the sector of VLBW infants, if any, who could benefit from PDA treatment.

Lipid peroxides in the serum of asphyxiated neonates

OBJECTIVE

Lipid peroxides (LPOs) are released when free radicals react with unsaturated fatty acids in cell membranes during hypoxic ischemic insult in neonates. We aimed to assess LPO concentrations in the serum of asphyxiated and non-asphyxiated neonates and examine their correlation with the severity of asphyxia.

STUDY DESIGN

This prospective cross-sectional study was conducted on a group of asphyxiated neonates and controls. Serum LPO concentrations was measured by enzyme-linked immunosorbent assay at 4-6 h of life in all subjects. Encephalopathy was classified according to Sarnat's stages into mild, moderate and severe at 12-24 h of life. LPO was compared between groups and was correlated with severity of encephalopathy and mortality.

RESULTS

A total of 90 infants were enrolled; of them 45 had asphyxia. Serum LPO (nmol ml(-1)) was significantly greater in the asphyxia group (6.9±3.01 vs 1.78±1.09, P<0.001). It correlated positively with severity of encephalopathy (P<0.001) and negatively with Apgar score at 5 min (r=-0.532, P<0.001) and with initial blood gases pH (r=-0.664, P<0.001). LPO measured greater concentrations in infants who died compared with asphyxiated survivors (11.64±1.31 vs 6.18±2.48, P=0.0004).

CONCLUSION

LPO was increased and correlated with severity of asphyxia as well as with mortality. Further studies are warranted to examine whether it is only a marker for outcome or a contributor in the pathogenesis of hypoxic-ischemic brain injury.

Maternal juvenile rheumatoid arthritis may be associated with preterm birth but not poor fetal growth

OBJECTIVE

Adverse pregnancy outcomes in mothers with juvenile rheumatoid arthritis (JRA) are not known. The objective of this study was to examine the risk of preterm birth and restricted fetal growth in pregnant mothers diagnosed with JRA, and to examine the impact of race/ethnicity and maternal age on this association.

STUDY DESIGN

Hospital discharge records for mothers who gave birth in 2011 and 2012 were examined in the National Inpatient Sample (NIS) database. JRA, preterm birth (<37 weeks of gestation), birth weight that is small for gestational age (SGA) and other demographic and clinical variables were identified using ICD-9 (International Classification of Disease--9th revision) diagnostic codes. The associations of JRA with preterm birth and restricted fetal growth were examined controlling for confounding variables.

RESULT

The sample included 8,273,987 birthing mothers, of these 1236 (0.01%) had JRA. The prevalence of preterm birth and SGA was 6.08% and 2.34%, respectively. Preterm birth in mothers with JRA was 12.9% compared with 6.1% in mothers without JRA with an adjusted odds ratio (OR) of 2.1 (confidence interval (CI): 1.74 to 2.42, P<0.001). The incidence of SGA in infants born to mothers with JRA was 3.34% compared with 2.34% in non-JRA mothers, which was not statistically significant. Adjusted OR for preterm birth in association with JRA among White mothers was 1.78 (CI: 1.41 to 2.24, P<0.001). However, Hispanic mothers with JRA (12%) were the ethnicity to suffer the most from preterm birth with an adjusted OR of 4.43 (CI: 2.97 to 6.62, P<0.001). Preterm birth among advanced maternal age (AMA) mothers with JRA was 25% compared with 7% in those without JRA with an adjusted OR of 5.42 (CI: 3.51 to 8.35, P<0.001).

CONCLUSION

JRA is associated with preterm birth but not with SGA. This association is significantly influenced by race/ethnicity and maternal age. More studies are needed to examine these findings in relation to medications used, severity of the disease and exacerbation during pregnancy to understand the genetic/socioeconomic factors behind these racial/ethnic differences.

Impact of race on male predisposition to birth asphyxia

OBJECTIVE

To examine the associations of: (a) neonatal sex with mild-to-moderate and severe birth asphyxia, (b) fetal sex with mortality due to birth asphyxia and (c) neonatal race with severe birth asphyxia.

STUDY DESIGN

We used the Nationwide Inpatient Sample (NIS) Database including the years 1993 to 2008 or its pediatric sub portion Kid's Inpatient Database (KID) for the years 1997, 2000, 2003 and 2006. NIS database is collected annually from more than 1000 hospitals across the United States for millions of inpatient discharge summaries. We included newborns older than 36 weeks gestational age or more than 2500 g at birth. We excluded newborns with congenital heart disease, major congenital anomalies and chromosomal disorders. We compared birth asphyxia in males to females, and in each race compared with whites, and examined effect of sex in association with birth asphyxia within each race/ethnicity.

RESULT

There were 9 708 251 term infants (51.8% males) included in the study. There were 15 569 newborns diagnosed with severe birth asphyxia (1.6 in 1000); of them 56.1% were males. Odds ratio (OR)to have severe birth asphyxia in male newborns was 1.16 (confidence interval (CI): 1.12 to 1.20, P<0.001). Compared with Whites, African-American newborns had more birth asphyxia, OR 1.23 (CI: 1.16 to 1.31, P<0001), whereas Hispanics and Asians had less birth asphyxia. Native American newborns did not differ from their white counterparts. On comparing males to females within each race, male sex was associated with increased birth asphyxia in all races but Native American.

CONCLUSION

Male sex and African-American race were associated with increased prevalence of birth asphyxia.

Identification of ant repellent allomone produced by social waspPolistes fuscatus (Hymenoptera: Vespidae)

Two active components were isolated from the ant repellent secretion produced by glandular cells on the sixth (terminal) gastral sternite ofPolistes fuscatus (F.) females. One of the components was identified as methyl palmitate. Field bioassays with synthetic methyl palmitate showed it had repellent activity againstSolenopsis geminata (F.)Forelius pruinosus (Roger), andPheidole sp. The effectiveness of the repellent was greater againstF. pruinosus andPheidole sp. than againstS. geminata. Four methyl ester homologs of methyl palmitate also were field tested for repellent activity: methyl myristate had repellent activity against all three ant species, whereas methyl stearate, methyl linoleate, and methyl linolenate exhibited no repellency.

Birth region, race and sex may affect the prevalence of congenital diaphragmatic hernia, abdominal wall and neural tube defects among US newborns

OBJECTIVE

Birth defects are number one cause of death among infants below 1 year of age. The objective is to examine the interaction of sex, race/ethnicity and place of birth on the prevalence of major congenital birth anomalies.

STUDY DESIGN

We analyzed the data sets produced by the Healthcare Cost and Utilization Project (HCUP) for the years 1997-2004. We identified the malformations: congenital diaphragmatic hernia (CDH), abdominal wall defects (AWD) and neural tube defects (NTD) using their respective International Classification of Disease 9 diagnostic codes. Newborns were classified according to their birth region into four groups; Northeast, South, Midwest and West. We calculated prevalence of each disease for the overall sample then for every sex, race and birth region. Using stratified analysis and χ(2) test, we calculated the odds ratio (OR) risk for each disease comparing females with males, different races/ethnicity to Caucasians and different US regions to Northeast.

RESULT

There were 1291 newborns with CDH representing 0.031% of the sample. (AWD: 2184 (0.052%) and NTD: 979 (0.024%)). West region had the highest prevalence of CDH (OR=1.62 (confidence intervals (CI): 1.4-1.9, P<0.001)). Female-to-male risk disparities were most observed among Caucasians in the South (OR=1.44 (CI: 1.1-1.8, P=0.003)). African Americans had the least prevalence of CDH but only in the South (OR=0.67 (CI: 0.5-0.8, P=0.001)). Native Americans had higher risk for AWD in the Midwest and West regions compared with Caucasians.

CONCLUSION

This study links the birth region as a detrimental factor like sex and race in the prevalence of CDH, AWD and NTD. These findings implicate a possible role for environmental factors in the pathogenesis of these diseases.

Permeation of human plasma lipoproteins in human carotid endarterectomy tissues: measurement by optical coherence tomography

Atherosclerosis is an inflammatory process occurring in arterial tissue, involving the subintimal accumulation of LDL. Measurement of the rate at which LDL and other lipoproteins, such as HDL and VLDL, enter and exit the tissue can provide insight into the mechanisms involved in the development of atherosclerotic lesions. Permeation of VLDL, LDL, HDL, and glucose was measured for both normal and atherosclerotic human carotid endarterectomy tissues (CEA) at 20°C and 37°C using optical coherence tomography (OCT). The rates for LDL permeation through normal CEA tissue were (3.16 ± 0.37) × 10(-5) cm/s at 20°C and (4.77 ± 0.48) × 10(-5) cm/s at 37°C, significantly greater (P < 0.05) than the rates for atherosclerotic CEA tissue at these temperatures [(1.97 ± 0.34) × 10(-5) cm/s at 20°C and (2.01 ± 0.23) × 10(-5) cm/s at 37°C]. This study effectively used OCT to measure the rates at which naturally occurring lipoproteins enter both normal and diseased carotid intimal tissue.

Mortality in infants with congenital diaphragmatic hernia: a study of the United States National Database

OBJECTIVE

To examine the effect of regionalization of care on outcomes of neonates with congenital diaphragmatic hernia (CDH).

STUDY DESIGN

We analyzed the National Inpatient Sample and the 'Kids' database for the years 1997 to 2004. Infants with CDH were grouped based on whether they underwent surgical repair at the hospital of birth, or at another facility. Groups were compared using chi-square, t-test and logistic regression.

RESULT

A total of 2140 infants were included: 41% were females, 42% were Caucasians, 48% were transported, 20% reported the use of extracorporeal membrane oxygenation (ECMO)and 33% died. Only 79% underwent operative repair, in which 85% survived after surgery. Survival among operated patients who used ECMO was 40%. Transported infants used more ECMO than non-transported ones (25 vs 15%; adjusted odds ratio (OR) 1.46; confidence interval 1.1 to 1.9, P=0.007), and had higher mortality after surgery (16 vs 13%; adjusted OR 1.46; confidence interval 1.1 to 2, P=0.02).

CONCLUSION

The utilization of neonatal transport of CDH patients is associated with increased mortality and increased need for ECMO. This study supports the need for regionalization of care, and favors maternal transport before delivery of CDH newborns.

Isolation and structure elucidation of antioxidant compounds from leaves of Laurus nobilis and Emex spinosus

In recent years, there has been increasing interest in finding naturally occurring antioxidants from plants for use in food and medicinal materials to replace synthetic antioxidants since such antioxidants are being restricted due to their side effects like carcinogenicity. The aim of this work was to examine the in vitro antioxidant activity of Laurus nobilis and Emex spinosus leaves and to isolate and structurally elucidate the active compounds in those leaves. The aqueous ethanolic extracts (70%) of Laurus nobilis and Emex spinosus leaves exhibited free radical scavenging action against 1,1-diphenyl-2-picrylhydrazyl (DPPH). Their concentrations of 50% inhibition (IC(50)) were 25.3 and 20.73 μg/mL, respectively. Activity-guided separation of these extracts using a combination of different chromatographic methods (TLC and column chromatography) resulted in the isolation of five chromatographically pure compounds (three from Laurus nobilis and two from Emex spinosus leaves). Spectroscopic methods ((1)H, (13)C-NMR, UV and MS) and chemical methods (detection tests and acidic hydrolysis) revealed the isolated antioxidant compounds to be flavonoid substances that were identified as kaempferol, kaempferol-3-rhamnopyranoside, and kaempferol-3,7-dirhamnopyranoside from Laurus nobilis extract and luteolin and rutin from Emex spinosus extract. The five flavonoids had varying ability to inhibit DPPH radicals (IC(50) from 4 to 35.8 μg/mL). Luteolin and rutin had strong scavenging action with an IC(50) of 4 and 4.6 μg/mL, respectively, and this action was stronger than that of synthetic antioxidant BHA, i.e., butylated hydroxyanisole (IC50 = 5.6 μg/mL).

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

Depression and hypogonadism are associated with erectile dysfunction (ED). We evaluated the prevalence of both conditions in men presenting to an ED specialty clinic, and tested whether hypogonadism correlated with the presence of depressive symptoms using a validated questionnaire. From July 2001 to June 2003, 157 men referred to an ED specialty clinic prospectively filled the Center for Epidemiologic Studies Depression Scale (CES-D), the abbreviated International Index of Erectile Function (IIEF-5) and had testosterone serum levels drawn. Median age was 53 (range=21-85 years). Hypogonadism, defined as serum T (testosterone)<300 mg/dl, was present in 36% of patients. This proportion was higher in men over the median age compared to younger patients (45 and 26%, respectively, P=0.002). Overt depression symptoms, defined as a CES-D> or =22, were found in 24% of men. Mean age of men with overt depression was 49.9+/-10.1 years vs 55.1+/-15.8 years for those with CES-D<22 (P=0.02). Hypogonadal men were more likely to have overt depression scores compared to eugonadal counterparts (35 vs 18%, P=0.02). This association was statistically stronger after correcting for age in a multivariate linear model (P=0.005). The relative risk of having overt depression was 1.94 times higher in men with hypogonadal testosterone level (95% confidence interval: 1.13 to 3.7). We conclude that in an ED referral population, symptoms of hypogonadism and depression symptoms are fairly prevalent, and that overt depression symptoms are strongly associated with hypogonadism. Clinicians should consider testosterone measurements in all men with high depression symptom scores.

Automatic segmentation and plaque characterization in atherosclerotic carotid artery MR images

In vivo MRI provides a means to non-invasively image and assess the morphological features of atherosclerotic carotid arteries. To assess quantitatively the degree of vulnerability and the type of plaque, the contours of the lumen, outer boundary of the vessel wall and plaque components, need to be traced. Currently this is done manually, which is time-consuming and sensitive to inter- and intra-observer variability. The goal of this work was to develop an automated contour detection technique for tracing the lumen, outer boundary and plaque contours in carotid MR short-axis black-blood images. Seventeen patients with carotid atherosclerosis were imaged using high-resolution in vivo MRI, generating a total of 50 PD- and T1-weighted MR images. These images were automatically segmented using the algorithm presented in this work, which combines model-based segmentation and fuzzy clustering to detect the vessel wall, lumen and lipid core boundaries. The results demonstrate excellent correspondence between automatic and manual area measurements for lumen (r = 0.92) and outer (r = 0.91), and acceptable correspondence for fibrous cap thickness (r = 0.71). Though further optimization is required, our algorithm is a powerful tool for automatic detection of lumen and outer boundaries, and characterization of plaque in atherosclerotic vessels.

Effect of enzyme preparation containing xylanase and beta-glucanase on performance of laying hens fed wheat/barley- or maize/soybean meal-based diets

1. A commercial enzyme preparation (Quatrazyme HP) containing xylanase and beta-glucanase was examined in two laying hen experiments with wheat/barley- or maize-based diets. The activities of other enzymes were measured also. Starch, cell wall contents and effects of Quatrazyme HP on in vitro viscosity of wheat, barley, maize and soybean meal were determined. 2. In the first experiment, 90 ISA Brown laying hens at 28 weeks of age were given a wheat/barley basal diet with or without 20mg of Quatrazyme HP, which provided 560 and 2,800 IU of xylanase and beta-glucanase/kg diet. In the second experiment, 66 ISA Brown laying hens at 45 weeks of age were given a maize/soybean meal basal diet with or without 20 mg of Quatrazyme HP/kg diet for 9 weeks. Egg production, egg weight, egg mass, feed conversion ratio and change in body weight were recorded as response criteria. 3. There was a significant improvement in feed conversion ratio with enzyme supplementation. Birds given an enzyme-supplemented diet gained 86 g while those fed on the unsupplemented diet lost 103 g of their body weight by the end of the experiment. 4. The enzyme preparation did not affect either egg production, egg weight or egg mass of birds fed on the maize/soybean meal diet. However, a significant improvement in feed conversion ratio was detected. Birds on either the supplemented or unsupplemented diet exhibited an increase in their body weight at the end of the experiment. 5. Addition of xylanase and beta-glucanase decreased in vitro viscosity of wheat, barley, maize and soybean meal. This effect was greater for wheat and barley than for maize and soybean meal. 6. It was concluded that the beneficial effect of using an enzyme preparation containing xylanase and beta-glucanase is not limited to wheat/barley-based diets but also occurs with maize/soybean meal-based diets.

The impact of cytomegalovirus serology for 7-year graft survival in cadaveric kidney transplantation--the Newcastle experience

To analyse the contribution of cytomegalovirus (CMV) serology to long-term graft survival in cadaveric kidney transplantation, 404 transplants from a single centre were divided into four subgroups with respect to the combination of donor and recipient CMV antibody status. Graft survival was estimated according to Kaplan-Meier for 1, 3, 5 and 7 years post-transplantation. The single-centre results confirm a negative impact of CMV-positive donor organs for initial graft survival in CMV-negative recipients within the first 3 years after transplantation. However, when 5- and 7-year long-term graft survival was studied, Donor +/Recipient - pairs showed a favourable long-term result, whilst D +/R - pairs had surprisingly a poorer outcome. Therefore, the concept of avoiding transplantation in the D +/R + CMV serology group should be ignored whereas attempts could be made to improve the poor long-term outcome of D +/R + pairs or to reduce its size by organ allocation.

Active TGF-beta1 expression in kidney transplantation: a comparative study of cyclosporin-A (CyA) and tacrolimus (FK506)

Chronic rejection is a major cause of graft dysfunction following kidney transplantation. This fibroproliferative disease may be promoted by overproduction of transforming growth factor beta (TGF-beta). Previous studies have suggested that cyclosporin-A (CyA) might increase production of this growth factor. The current study was designed to measure the expression of TGF-beta in renal transplant biopsies from patients immunosuppressed with either CyA or tacrolimus. Paraffin-embedded renal biopsies were sectioned, dewaxed and incubated with primary antibody against active TGF-beta1 antibody. After washing, the sections were treated with secondary antibody conjugated with fluorescein isothiocyanate (FITC). In each case the sections were assessed by semi-quantitative scanning laser confocal microscopy. Biopsies from patients receiving CyA expressed significantly more active TGF-beta1 than biopsies from patients receiving tacrolimus (P < 0.0001, Mann-Whitney test). The increased level of active TGF-beta1 expression in renal biopsies of patients receiving CyA may indicate a mechanism of chronic rejection.

In vitro selection and characterisation of a drought tolerant clone of Tagetes minuta

Aromatic Tagetes plants produce secondary products which have a biological activity against a wide range of micro-organisms, insects and nematodes. Tagetes oils are also used as pharmaceuticals and as flavour components in the food industry. This study aimed to use somaclonal variation to select drought tolerant plants of Tagetes. Cotyledons cultured on MS medium containing 3 mg l(-1) IAA and 10 mg l(-1) BA (callus growth medium; CGM) with 60 mM mannitol died. Shoot clumps developed on CGM for 6 months and then subcultured onto CGM containing 80 mM mannitol also died. Four shoots were regenerated from 72 shoot clumps on 12 MS medium containing 0.5 mg l(-1) IAA (shoot growth medium; SGM) after culturing on CGM without mannitol for 6 months and then on CGM with 60 mM mannitol for 3 months. Twelve shoots developed from 72 shoot clumps on SGM after culture for 9 months on CGM. Significant variations were observed in biomass amongst regenerated clones when cultured on medium containing mannitol. After growth in greenhouse conditions for 2 months, one clone developed from shoot clumps selected on medium with mannitol exhibited a significant tolerance in vitro in medium containing 90 mM mannitol; this medium completely inhibited growth of control plants. This clone had significantly higher proline content and soluble sugars than the non-stress-selected clone when cultured on medium containing 0 or 30 mM mannitol. When tested for drought tolerance (growth at 40% soil field capacity) in the greenhouse for 2 months, this clone showed a significant tolerance compared with other regenerated and control plants and revealed lower water potential, greater accumulated biomass and a higher relative growth rate.

Detection of cytomegalovirus (CMV) antigens in kidney biopsies and transplant nephrectomies as a marker for renal graft dysfunction

Chronic rejection accounts for the greatest loss of renal allografts. HLA mismatching has been minimised by organ allocation and new immunosuppressive drugs have been employed, but the average cadaveric graft survival still does not exceed 12 years. Though the aetiology is multifactorial, one contributory factor for this condition is cytomegalovirus (CMV). Detection of CMV in kidney biopsies and sera can diagnose and monitor this inflammatory event and define its role in chronic nephropathy. Twenty five biopsies taken at the time of transplantation, 10 biopsies for graft dysfunction and tissue blocks from 20 explanted kidney grafts were collected and investigated for CMV antigens by immunohistochemistry. Tissue samples were snap frozen and cryostat sections were incubated with monoclonal antibodies for CMV antigens followed by immunoperoxidase staining. In 12 out of 20 transplant nephrectomies CMV antigens were found. Only two of these patients had clinical CMV disease. Time 0 biopsies from CMV seronegative donors (n = 11) and CMV seropositive donors (n = 14) were negative for CMV antigens. The prevalence of CMV antigens in grafts lost due to chronic rejection was 60%. These antigens were not found within the time 0 biopsies, but were detected in 30% of biopsies taken at the time of clinical graft dysfunction. CMV appears to contribute to chronic rejection even without clinical disease.

TGF-beta expression in renal transplant biopsies: a comparative study between cyclosporin-A and tacrolimus

BACKGROUND

Chronic rejection is a major cause of graft dysfunction after kidney transplantation. This fibroproliferative disease may be promoted by overproduction of transforming growth factor beta (TGF-beta). Previous studies have suggested that CsA might increase production of this growth factor. The current study was designed to measure the expression of TGF-beta(b) in renal transplant biopsy specimens from patients undergoing immunosuppressive therapy with either CsA or tacrolimus (FK506).

METHOD

Paraffin-embedded renal biopsy specimens were sectioned, dewaxed, and incubated with primary antibody against TGF-beta(b)1 latency-associated protein and active TGF-beta(b1). After washing, the sections were treated with secondary antibody conjugated with FITC. In each case, the sections were assessed by semi-quantitative scanning laser confocal microscopic method.

RESULTS

There was no significant difference in latent TGF-beta(b) expression between biopsy specimens from patients receiving CsA and patients receiving FK506. However, biopsy specimens from patients receiving CsA expressed significantly more active TGF-beta(b1) than biopsy specimens from patients receiving FK506 (P<0.0001, Mann-Whitney test).

DISCUSSION

The increased level of active TGF-beta1 expression in renal biopsy specimens of patients receiving CsA may indicate a mechanism of chronic rejection. However, these biopsies were performed to assess deranged renal function; therefore, the specimens may reflect events rather than differences in medication.

Experimental induction of renal lesions in chickens

The present work was conducted to investigate the possibility of inducing renal lesions in chickens subcutaneously or orally inoculated with E. coli [E. coli O1K67(B12)], Staphylococcus aureus and Actinomyces pyogenes. The strains were previously isolated from the kidneys of broilers showing different pathological lesions. The gross lesions observed in the kidneys included enlargement, congestion, haemorrhagic spots in addition to dilatation and distension of the ureters. The microscopic lesions were mainly interstitial nephritis. The lesions were acute and changed gradually to subacute or chronic nephritis. The glomerular lesions were not common. The wall of the primary branches of the ureter and the ureters was heavily infiltrated with inflammatory cells, also granular and albuminous casts were seen in the renal tubules. The lesions were not related to the inoculated pathogen, although they were more severe in chickens inoculated with E. coli and Staph. aureus more than in Actinomyces pyogenes. Reisolation of the inoculated pathogens was more successful from the birds inoculated subcutaneously than from those infected orally.

Disposition of intravenous theophylline in asthmatic children: Bayesian approach vs direct pharmacokinetic calculations

Fifteen children (mean age +/- SD: 6.4 +/- 3.4, range: 2-12 years) with an acute asthma attack were treated by an intravenous dosage regimen of theophylline (30 min loading infusion of 6 mg/kg body weight followed by a constant infusion of 1 mg/kg, twice for 6 hr each). Three blood samples were drawn (each 15 min after the bolus infusion and after the two infusion periods of 6 hr). Plasma clearance (CL), apparent volume of distribution (Vd) and elimination half-life (t1/2) were estimated by the Bayesian approach using either only the first peak level (Bay 1) or all three monitored concentrations (Bay 3). These values were compared to the parameters calculated by a standard pharmacokinetic procedure (SC). Therapeutic steady state plasma levels around 12 micrograms/ml were rapidly achieved, and the pharmacokinetic parameters (CL = 1.1-1.5 ml/min/kg, Vd = 0.44-0.50 l/kg, t1/2 = 3.5-5.4 hr) differed slightly between the 3 methods applied. There was a significant linear correlation between the Bayesian-derived and SC-derived pharmacokinetic parameters. However the method Bay 1 seems to overestimate the elimination rate of theophylline more than Bay 3 does. In conclusion, Bayesian-based therapeutic plasma level monitoring (Bay 3 are better than Bay 1) can be utilized for individualized pharmacokinetic calculations and proper dosage predictions of theophylline in pediatric patients.

Role of cytomegalovirus in inducing congenital anomalies

Sixty eight infants and newborns were included in the present study being consisted of 55 cases with congenital anomalies and 13 cases of apparently healthy infants acting as controls. Three types of congenital anomaly cases were studied; 17 cases of microcephaly, 17 cases of cerebral palsy and 21 cases with jaundice. All serum samples were tested for cytomegalovirus IgM antibodies (CMV IgM) by microassay ELISA technique to explore the role of CMV infection in inducing congenital anomalies. Six out of the 68 serum samples were found to be positive for CMV IgM. Four of them were detected among the congenital cases (5 our to 55; 7.3%), while 2 cases were among the controls (2 out of 13; 15.4%). The microcephalic group showed 5.9% positivity (one out of 17). The jaundiced infants showed 14.3% positivity (3 out of 21), while all the cerebral palsy cases were negative for CMV IgM. Such a high percentage of CMV IgM in the control group may be attributed to asymptomatic infection, with liability for long term sequelae, particularly hearing loss or ocular abnormalities by 2 years of age. So, continuous follow-up of such asymptomatic cases is essential to control any possible congenital abnormality as early as possible.

Purification and characterization of purine nucleoside phosphorylase from developing embryos of Hyalomma dromedarii

Purine nucleoside phosphorylase from Hyalomma dromedarii, the camel tick, was purified to apparent homogeneity. A molecular weight of 56,000 - 58,000 was estimated for both the native and denatured enzyme, suggesting that the enzyme is monomeric. Unlike purine nucleoside phosphorylase preparations from other tissues, the H. dromedarii enzyme was unstable in the presence of beta-mercaptoethanol. The enzyme had a sharp pH optimum at pH 6.5. It catalyzed the phosphorolysis and arsenolysis of ribo- and deoxyribo-nucleosides of hypoxanthine and guanine, but not of adenine or pyrimidine nucleosides. The Km values of the enzyme at the optimal pH for inosine, deoxyinosine, guanosine, and deoxyguanosine were 0.31, 0.67, 0.55, and 0.33 mM, respectively. Inactivation and kinetic studies suggested that histidine and cysteine residues were essential for activity. The pKa values determined for catalytic ionizable groups were 6-7 and 8-9. The enzyme was completely inactivated by thiol reagents and reactivated by excess beta-mercaptoethanol. The enzyme was also susceptible to pH-dependent photooxidation in the presence of methylene blue, implicating histidine. Initial velocity studies showed an intersecting pattern of double-reciprocal plots of the data, consistent with a sequential mechanism.

Effect of some arsenic antagonists on the toxicity, distribution and excretion of arsenite and arsenate in rats

1. Arsenite and arsenate poisoned rats were treated with either BAL (2,3-dimercapto-1-propanol), penicillamine (PA) (beta-beta dimethyl cystein) or selenium (Se) (as sodium selenite). 2. The minimal dose of each antagonist that treated arsenic-induced lethality (causing 100% survival) was the same for both arsenite and arsenate. 3. Arsenic mobilization from the tissues (blood, kidney, liver, lungs, spleen, muscles, brain, heart) and its excretion in urine and feces were higher in arsenite-intoxicated animals than in arsenate-intoxicated ones. 4. The effect of each antagonist, when injected alone, on the urinary and fecal excretion of endogenous metals (Cu, Zn, Fe, Ca and Mg) was also examined. 5. The results indicated marked differences in the relative ability of BAL, PA and Se to increase the excretion of the metals.

Pathogenicity of recent isolates of infectious bursal disease virus in specific-pathogen-free chickens: protection conferred by an intermediate vaccine strain

The pathogenicity of recent isolates of infectious bursal disease virus and the protection conferred against them by a commercial vaccine strain of intermediate virulence were examined in specific-pathogen-free chickens. Based on clinical signs, mortality, and macroscopic lesions in susceptible chickens, the isolates designated as A-Delmarva and U-28 were distinct from a previously known serotype I virulent isolate (Edgar). Histopathological analysis of the bursa of Fabricius did not establish differences between the field isolates. Although the vaccine strain produced some degree of bursal damage in antibody-free chickens, it was significantly less severe than the damage caused by the field isolates. The active immune response induced by vaccination was cross-protective against the pathological effects produced by the different isolates used in this study.