Evaluation of the antiparasitic and antifibrotic effects of gallic acid on experimental hepatic schistosomiasis mansoni

Schistosomiasis afflicts approximately 120 million individuals globally. The hepatic pathology that occurs due to egg-induced granuloma and fibrosis is commonly attributed to this condition. However, there is currently no efficacious treatment available for either of these conditions.Our study aimed to investigate the potential antifibrotic and antiparasitic properties of different doses of gallic acid (GA) in experimental schistosomiasis mansoni. In addition, we investigated the outcomes of co-administering it with the standard anti-schistosomiasis treatment, praziquantel (PZQ).In experiment I, Schistosoma mansoni-infected mice were administered GA at doses of 10, 20, or 40 mg/kg. Their effectiveness was evaluated through parasitological (worm and egg loads, granuloma number and diameter), pathological (fibrosis percentage and H-score of hepatic stellate cells (HSCs)), and functional (liver enzymes) tests. In experiment II, we investigated the optimal dosage that yielded the best outcomes. This dosage was administered in conjunction with PZQ and was evaluated regarding the parasitological, pathological, functional, and immunological (fibrosis-regulating cytokines) activities.Our findings indicate that the administration of 40 mg/kg GA exhibited the highest level of effectiveness in experiment I. In experiment II, it exhibited lower antiparasitic efficacy in comparison to PZQ. However, it surpassed PZQ in other tests. It showed enhanced outcomes when combined with PZQ.In conclusion, our findings reveal that GA only slightly increased the antischistosomal activity of PZQ. However, it was linked to decreased fibrosis, particularly when administrated with PZQ. Our pilot study identifies GA as a natural antifibrotic agent, which could be administered with PZQ to mitigate the development of fibrosis.

Influence of the Scalpel Finishing Technique on Marginal Gap Formation in Class II Resin Composite Restorations

OBJECTIVES

Modern adhesives and composites allow the restoration of deep defects. In such cases, the matrix technique is particularly challenging, and excess composite is a common problem. Removing such overhangs with a scalpel has already been described as a substance preserving or selective finishing technique. Clinically, restoration margins may appear as a white line after scalpel finishing, and it is unclear whether this line represents a marginal gap and/or whether scalpel finishing promotes marginal gap formation. Therefore, the aim of this study was to investigate the influence of scalpel finishing of deep Class II composite restorations on marginal gap formation.

METHODS AND MATERIALS

Standardized mesioocclusal-distal (MOD) cavities were prepared and restored in 60 human molars randomly divided into six finishing protocol groups: G1, scalpels (SC); G2, oscillating files (OF); G3, finishing strips (FS); G4, scalpels and finishing strips (SC+FS); G5, scalpels and polishing discs (SC+PD); G6, polishing discs alone (PD, controls). The groups were additionally assigned to finishing and polishing in a phantom head (groups 1-4) or hand-held setting (groups 5-6) to simulate clinical and in-vitro research conditions, respectively. After restoration, artificial aging was performed by thermocycling (5-55°C, 2500 cycles) and mechanical loading (50 newtons (N) with 500,000 cycles) prior to scanning electron microscopy analysis of proximal restoration margin quality on the mesial and distal surfaces (n=120) of each tooth. Outcomes (perfect margin, marginal gap, overhang, marginal fracture) were statistically analyzed by t-test, Mann-Whitney U test, single-factor analysis of variance, post-hoc t-test, Kruskal-Wallis test and Dunn-Bonferroni correction for multiple group comparisons. Cohen's effect size d(Cohen) was calculated to show the strength of the relationship between variables.

RESULTS

Overall, marginal quality was significantly better in the hand-held setting (SC+PD and PD) than the phantom head setting (SC, OF, FS, SC+FS). The best marginal quality was achieved with oscillating files in the phantom head setting and with scalpels plus polishing discs in the hand-held setting. Marginal gaps occurred significantly more often with scalpels, but the proportion of gaps was very low and clinically insignificant. Finishing strips were the least effective instruments for removing overhangs but performed better in combination with scalpels.

CONCLUSIONS

Scalpel finishing can effectively and gently remove overhangs from enamel. However, blades should be used with caution as they can cut the dentin and cementum. Scalpel finishing does not lead to a clinically relevant increase in marginal gaps, but should be followed by polishing, whenever possible, to eliminate any marginal fractures that might be present.

Tooth discoloration induced by apical plugs with hydraulic calcium silicate-based cements in teeth with open apices-a 2-year in vitro study

Objectives

To assess tooth discoloration induced by different hydraulic calcium silicate-based cements (HCSCs), including effects of blood and placement method.

Materials and methods

Eighty bovine teeth cut to a length of 18 mm (crown 8 mm, root 10 mm) were randomly assigned to 10 groups (n = 8), receiving orthograde apical plug treatment (APT). Apical plugs were 4 mm in length and made of ProRoot MTA (Dentsply), Medcem MTA (Medcem), TotalFill BC RRM Fast Set Putty (Brasseler), or Medcem Medical Portland Cement (Medcem) plus bismuth oxide (Bi2O3) with and without bovine blood. Further, orthograde (with or without preoperative adhesive coronal dentin sealing) and retrograde APT were compared. Teeth were obturated with gutta-percha and sealer, sealed with composite and stored in distilled water. Tooth color was measured on apical plug, gutta-percha/sealer, and crown surface before treatment versus 24 h, 1, 3, 6, 12, and 24 months after treatment by spectrophotometry. Color difference (ΔE) values were calculated and analyzed by Shapiro–Wilk test, ANOVA with post hoc tests, Friedman test, t test, and post hoc tests with Bonferroni correction (α = .05).

Results

Tooth discoloration occurred in all groups with no significant differences between HCSCs (p > .05). After 24 months, color changes were prominent on roots but insignificant on crowns. Blood contamination induced a significantly decreased luminescence (p < .05). Blood had a stronger impact on tooth color than Bi₂O₃. No relevant effects of retrograde placement (p > .05) or preoperative dentin sealing (p > .05) were detected.

Conclusions

Apical plugs of the tested HCSCs cause discoloration of bovine roots, but not discoloration of bovine tooth crowns within a 24-month period.

Clinical relevance

APT should be performed carefully while avoiding direct contact with the coronal dentin, and in that case no aesthetic impairments occur.

FRI0078 SERUM IRISIN LEVEL IN RHEUMATOID ARTHRITIS PATIENTS: ITS RELATIONSHIP TO DISEASE ACTIVITY AND CARDIOVASCULAR MANIFESTATIONS

Background:

Active Rheumatoid Arthritis (RA) is associated with considerable changes in body composition, lipids, adipokines and insulin sensitivity. RA is an independent risk factor for CVD. The mechanisms leading to synovial inflammation are similar to those found in unstable atherosclerotic plaque. Irisin is a metabolic hormone and a novel adipomyokine related to insulin resistance and endothelial functions (1).

Objectives:

To investigate the relationship between serum irisin levels, disease activity and cardiovascular risk in RA patients, and to test its performance in predicting subclinical atherosclerosis in RA patients.

Methods:

60 RA patients fulfilling the 2010 ACR/EULAR RA Classification Criteria and 30 healthy controls were recruited for serological testing of irisin levels. BMI was calculated. Waist/hip ratio was measured. RA disease activity was assessed by DAS28-ESR. Disability was assessed by HAQ-DI in its Arabic version. Serum ESR, CRP, glycated hemoglobin (HbA1c), lipid profile (serum level of cholesterol, triglyceride, HDL, LDL and cholesterol/ LDL ratio), insulin levels were measured in all patients and controls. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to calculate insulin resistance. Carotid intimal medial thickness (C-IMT), an indicator of atherosclerosis, was measured by carotid doppler ultrasonography. Echocardiography was performed to assess cardiac abnormalities. Our RA patients were classified twice; first, according to cardiovascular abnormalities and second, according to cut-off values of DAS28.

Results:

Serum irisin levels were significantly lower in RA patients (9.84 ± 10.56)ng/ml compared to controls (20.48±13.82)ng/ml (p<0.001). BMI values were significantly higher in all patients than controls (P= 0.035), while waist/hip ratio in female patients only were significantly higher (P= 0.007).We found a negative correlation between serum irisin and DAS28-ESR (r = -0.455, P-value 0.005)& HAQ-DI (r = -0.309, P-value 0.016). There was a negative correlation between serum irisin level and parameters of cardiovascular risk including anthropometric measurements (BMI and waist/hip ratio), HOMA-IR (r=−0.371, p=0.009) and C-IMT (r=−0.511, p<0.001). No correlation could be detected between irisin and lipid profile. The frequency of cardiovascular (CV) involvement in RA patients was 45% (27 patients) (11.6 % with echocardiographic abnormalities and 40% having increased C-IMT). Patients with CV involvement showed lower serum irisin level, increased disease activity assessed by DAS28 and increased disease disability assessed by HAQ-DI with statistically significant difference (P < 0.001, P < 0.05 and P < 0.001 respectively). Classifying the patients based on cut-off values of DAS28 into 3 groups (low disease activity, moderate and high disease activity), we found a statistically significant difference between the irisin levels of the 3 groups, being lowest among highly active patients (P= 0.014). c-IMT values were significantly higher in highly active patients (P= 0.04). Assessing the biomarker’s performance as an independent indicator of subclinical atherosclerosis in RA patients using ROC curve, it showed an excellent ability (AUC 0.8, P <0.001). As regarding its ability to differentiate patients with high disease activity, it showed a very good performance (AUC 0.73, P <0.001).

Conclusion:

In RA patients, serum irisin level was significantly lower and perform better than traditional yardsticks in identifying disease activity. It may act as an independent indicator of subclinical atherosclerosis in RA patients. Serum irisin level may be responsible for increased cardiovascular risk in those patients.

References:

[1]Chen JQ, Huang YY, Gusdon AM, Qu S.Irisin: a new molecular marker and target in metabolic disorder. Lipids Health Dis. 2015 Jan 14; 14:2.

Disclosure of Interests:

None declared

FRI0185 DIAGNOSTIC SIGNIFICANCES OF BOTH MICRORNA-146A AND KALLIKREIN-1 IN PATIENTS WITH LUPUS NEPHRITIS

Background:

Lupus nephritis (LN) is one of the most critical complications of systemic lupus erythematosus (SLE). Approximately 30–50% of SLE patients develop LN with 5-year survival rate of about 70-80%. Thus, finding reliable non-invasive biomarkers at the early stages of SLE is of great interest (1). Many studies focused on the association between microRNAs and the risk of LN. miRNA-146a (miR-146a) was one of the most promising circulating markers which was suggested recently for early diagnosis of SLE but its diagnostic relevancies regarding LN have not been extensively investigated.

Objectives:

This study aims to test the expression of miR-146a in patients with LN in relation to Kallikrein-1 as another widely investigated diagnostic marker for LN along with other conventional measures.

Methods:

One hundred and thirty subjects were enrolled in this study. They were divided into forty six patients with LN, forty four patients with SLE but without nephritis and forty healthy controls. The expression levels of miR-146a in peripheral blood mononuclear cells (PBMCs) were detected via RT-qPCR analysis. Besides, serum Kallikrein-1 levels were determined by ELISA. The diagnostic role of miR-146a and Kallikrein-1 in LN was evaluated by Receiver operating curve (ROC). The impact of miR-146a and Kallikrein-1 on renal disease was compared to albumin creatinine ratio, renal biopsy findings as well as renal SLEDAI.

Results:

Levels of miR-146a were significantly lower in the plasma of LN patients than both patients of SLE without LN and normal controls (p < 0.05). However, serum levels of Kallikrein-1 were significantly higher in LN patients when compared to SLE patients and normal population (p < 0.05). ROCs were conducted to assess the diagnostic values of both miR-146a and kallikrein-1. They revealed good diagnostic values with AUC of 0.888 and 0.913 respectively. Also, plasma miR-146a was observed to be negatively associated with serum creatinine, proteinuria as well as SLEDAI score (p < 0.01) while serum Kallikrein-1 was positively correlated with them (p < 0.05) and inversely correlated with miR-146a (p < 0.01).

Conclusion:

The expression levels of miR-146a are reduced in SLE patients with more reduction with LN. Therefore, miR-146a could be considered as potential biomarker for detecting LN either alone or in combination with Kallikrein-1. However, more studies are required.

References:

[1]Soliman S. And Mohan C. Lupus nephritis Biomarkers.Clin Immunol.2017 Dec; 185: 10-20.

Disclosure of Interests:

None declared

SAT0234 SERUM AXL, FERRITIN, IGFBP4 AND STNFR2 AS BIOMARKERS OF PEDIATRIC SLE

Background:

Proteomic screening is an efficient approach for identifying protein biomarkers in various inflammatory diseases. Our preliminary proteomic analysis revealed elevated levels of serum Axl, Ferritin, IGFBP4 and sTNFR2 in adult patients with active lupus nephritis (LN) (1). However, the role of these serum biomarkers in pediatric systemic lupus erythematosus (SLE) patients has not been examined.

Objectives:

To evaluate the performance of 4 serum protein markers for detecting disease activity in pediatric patients with SLE.

Methods:

83 pediatric patients who fulfilled ≥4 ACR criteria for SLE and 25 healthy controls were recruited for serological testing of 4 protein markers identified by antibody-coated microarray screen, namely Axl, ferritin, IGFBP4 and sTNFR2. SLE disease activity was assessed using the SLEDAI-2k score, renal disease activity was assessed by the renal SLEDAI (range 0-16; 0= inactive LN, ≥ 8= active renal). 57 patients had clinically active SLE (SLEDAI score ≥ 4 or having a flare) (28 active renal and 29 active non-renal SLE patients). In active renal patients, concurrent renal biopsy was performed, unless contraindicated. The ISN/RPS criteria were used to assess the histopathologic features of LN. Those Patients were further subcategorized into 2 groups; active proliferative (ISN/RPS classes III/IV) and non-proliferative (classes I/II/V).

Results:

The serum concentrations of Axl and ferritin were significantly higher in patients with active SLE than inactive SLE (3765±235 vs. 2513±130 pg/ml,P= 0.001) and (111±26 vs. 18±4 ng/ml,P =0.0001) respectively. Serum Axl levels were significantly higher in active renal versus active non-renal SLE patients (3765±235.3 vs. 2825±200.7 pg/ml,P= 0.04). In the active renal patients with paired kidney tissue and blood samples, none of the biomarkers tested discriminated classes of LN, although serum Axl, ferritin and IGBPB4 levels were higher in the proliferative subgroup. The levels of Axl, ferritin and IGFBP4 correlated significantly with SLEDAI scores (Axl, r= 0.58,P<0.0001; ferritin, r= 0.53,P<0.0001; IGFBP4, r= 0.229,P= 0.03). However, only serum Axl levels correlated significantly with the renal SLEDAI (r= 0.46,P= 0.01). The levels of Axl, IFGBP4 and sTNFR2 correlated with decreased C3 levels (r= - 0.54,P<0.0001; r= - 0.29,P= 0.007; r= - 0.29,P= 0.007) respectively. Only serum Axl and ferritin correlated with urinary PCR (r= 0.42,P<0.0001; r= 0.22,P=0.04) respectively. These markers were more specific, but less sensitive, in detecting concurrent SLE activity than elevated anti-dsDNA or decreased C3. The specificity values of serum ferritin and IGFBP4 for concurrent active lupus nephritis were higher than anti-dsDNA or C3. Serum ferritin was the best predictor of global SLE activity (AUC 0.81,P<0.0001), followed by C3 (AUC 0.79,P<0.0001) then Axl (AUC 0.71,P= 0.002), while both Axl and C3 were the best predictors of lupus nephritis activity (AUC 0.72, both).

Conclusion:

In pediatric SLE patients, serum ferritin and Axl perform better than traditional yardsticks in identifying disease activity, either global or renal. The performance of these serum markers should be explored further in a longitudinal cohort of pediatric SLE patients.

References:

[1]Wu T, Ding H, Han J, et al. Antibody-Array-Based Proteomic Screening of Serum Markers in Systemic Lupus Erythematosus: A Discovery Study. J Proteome Res. 2016 Jul 1;15 (7): 2102-14.

Disclosure of Interests:

None declared

Computer-guided contouring of craniofacial fibrous dysplasia involving the zygoma using a patient-specific surgical depth guide

The aim of this study was to introduce a new computer-guided technique for contouring and shaving of craniofacial fibrous dysplasia involving the zygoma. Computer-guided contouring was performed for five patients with unilateral craniofacial fibrous dysplasia involving the zygoma, using a patient-specific surgical depth guide. This patient-specific guide with depth holes was virtually designed for each patient based on mirroring of the unaffected side. The guide was printed using rapid prototyping. In the surgical theatre, the guide was seated in place and implant drills were inserted through the guide holes, creating depth holes according to the preoperative planning. Bone removal was then continued using surgical burs and/or bone chisels, connecting the guiding depth holes. Satisfaction with facial aesthetics was evaluated by the patients using a Likert scale, and by the surgeons using the Whitaker rating scale. All patients were satisfied with the postoperative facial aesthetics. Four patients were rated category I on the Whitaker rating scale, and one patient as category II. In conclusion, this patient-specific surgical depth guide appears to offer a solution for the unpredictability of conventional bone removal in unilateral craniofacial fibrous dysplasia, especially in three-dimensional multiplanar areas such as the zygoma. Further investigations are required.

Effect of maturation conditions on light and temperature requirements during seed germination of Citrullus colocynthis from the Arabian Desert

Seed germination of Citrullus colocynthis, as in many other species of Cucurbitaceae, is inhibited by light, particularly at low temperatures. Germination response to light and temperature has been attributed to day length and temperature during seed maturation. This study assessed the effects of these factors on the germination response of C. colocynthis to temperature and light quality. Ripe fruits were collected from natural habitats during December and February and germinated at three temperatures (15/25, 20/30 and 25/35 °C) in five light treatments (dark, white light and Red:Far Red (R:FR) ratios of 0.30, 0.87 and 1.19). Additionally, unripe fruits were also collected from natural habitats and completed their maturation in growth chambers under different day lengths (6, 16 and 24 h of darkness) at 10/20 °C, and in darkness at both 10/20 °C and 25/35 °C. Mature seeds of the different treatments were germinated in the same five light treatments at 15/25 °C. Germination was significantly higher in the dark than that in any light treatment. Seeds matured at higher temperatures (i.e. seeds from the December collection and those matured at 25/35 °C) had significantly higher germination than those matured at lower temperatures (i.e. seeds from the February collection and those matured at 10/20 °C). Dark germination was significantly higher for the December collection than for the February collection. Seeds of the two collections germinated in the dark only at 15/25 °C. However, seeds matured in a growth chamber at 10/20 °C in darkness germinated at 15/25 °C in all light treatments, except for the R:FR ratio 0.30. Seeds of the different treatments failed to germinate in FR-rich light. This study demonstrates that both temperature and day length during seed maturation play significant roles in the germination response of C. colocynthis. Additionally, the dark requirement for germination is likely beneficial for species with the larger seeds, such as C. colocynthis, which produce bigger seedlings that are able to emerge from deep soils and are competitively superior under dense vegetation and resource-limited conditions.

Performance of Monolithic and Veneered Zirconia Crowns After Endodontic Treatment and Different Repair Strategies

Objectives:

To investigate failure loads of monolithic and veneered all-ceramic crowns after root canal treatment and to analyze marginal integrity of repair fillings.

Methods and Materials:

Seventy-two human molars were restored with monolithic (Zr-All) or veneered (Zr-Ven) zirconia crowns. Molars were assigned to six groups (n=12 per group) depending on restoration material, access type (no access cavity [control] or endodontic treatment [test]), and type of filling (one-step [1-st] or two-step [2-st]). For type of filling, molars were treated using a self-etch universal adhesive and cavities were either filled with layered composite (1-st) or filled until the crown material was reached, which was additionally conditioned and then filled (2-st). Scanning electron microscopic analysis of the restoration margins was performed before and after thermomechanical loading (TML), and the percentage of continuous margins was assessed. Crowns were then loaded to failure.

Results:

Preparation of the access cavity required more time in monolithic (445 s) than in veneered crowns (342 s). Loads to failure were higher in control groups (Zr-All: 5814 N; Zr-Ven: 2133 N) and higher in monolithic test (2985 N) than in veneered test crowns (889 N). In monolithic crowns, 1-st had lower fracture loads than 2-st fillings (2149 N vs 3821 N). Continuous margins of 66% to 71% were achieved, which deteriorated after TML by 39% to 40% in Zr-All, by 34% in Zr-Ven-1-st, and by 24% in Zr-Ven-2-st.

Conclusions:

Endodontic access and adhesive restorations resulted in reduced fracture load in monolithic and veneered zirconia crowns. Two-step fillings provided higher fracture loads in Zr-All and better marginal quality in Zr-Ven crowns.

First-line tracheal resection and primary anastomosis for postintubation tracheal stenosis

Introduction Tracheal stenosis following intubation is the most common indication for tracheal resection and reconstruction. Endoscopic dilation is almost always associated with recurrence. This study investigated first-line surgical resection and anastomosis performed in fit patients presenting with postintubation tracheal stenosis. Methods Between February 2011 and November 2014, a prospective study was performed involving patients who underwent first-line tracheal resection and primary anastomosis after presenting with postintubation tracheal stenosis. Results A total of 30 patients (20 male) were operated on. The median age was 23.5 years (range: 13-77 years). Seventeen patients (56.7%) had had previous endoscopic tracheal dilation, four (13.3%) had had tracheal stents inserted prior to surgery and one (3.3%) had undergone previous tracheal resection. Nineteen patients (63.3%) had had a tracheostomy. Eight patients (26.7%) had had no previous tracheal interventions. The median time of intubation in those developing tracheal stenosis was 20.5 days (range: 0-45 days). The median length of hospital stay was 10.5 days (range: 7-21 days). The success rate for anastomoses was 96.7% (29/30). One patient needed a permanent tracheostomy. The in-hospital mortality rate was 3.3%: 1 patient died from a chest infection 21 days after surgery. There was no mortality or morbidity in the group undergoing first-line surgery for de novo tracheal lesions. Conclusions First-line tracheal resection with primary anastomosis is a safe option for the treatment of tracheal stenosis following intubation and obviates the need for repeated dilations. Endoscopic dilation should be reserved for those patients with significant co-morbidities or as a temporary measure in non-equipped centres.

Safety of formoterol by Turbuhaler as reliever medication compared with terbutaline in moderate asthma

The present study compared the safety of 4.5 microg formoterol with 0.5 mg terbutaline, both by Turbuhaler and used as needed, in addition to regular formoterol in moderate asthma. In this double-blind parallel-group study, 357 patients taking a moderate-to-high dose of inhaled corticosteroids and additional terbutaline (2-5 inhalations x day(-1) during run-in) were randomised to either formoterol or terbutaline as needed in addition to formoterol 9 microg b.i.d. over 12 weeks. Adverse events, serum potassium levels, electrocardiogram, vital signs and lung function were assessed monthly; peak expiratory flow and severe asthma exacerbations were recorded daily. Patients used 2.16 (range 0.0-6.3) formoterol and 2.34 (range 0.1-7.5) terbutaline relief inhalations x day(-1). No clinically significant differences in safety variables were found between treatments. Statistically greater increases in cardiac frequency (2.6 beats x min(-1), p=0.03) were found on terbutaline. There were 44 and 52 severe asthma exacerbations with formoterol and terbutaline, respectively, with no significant difference in time to first exacerbation. There was also no difference between treatments for other efficacy measures (peak expiratory flow, forced expiratory volume in one second and morning/evening symptom scores). Formoterol 4.5 microg as needed was at least as safe, well tolerated and effective as terbutaline 0.5 mg in stable patients (requiring up to 6 relief inhalations x day(-1)) taking formoterol plus inhaled corticosteroids regularly over 12 weeks.

Effect of sex, size, and age of commensal rat hosts on the infestation parameters of their ectoparasites in a rural area of Egypt

The present study was carried out in the Bilbeis area, Sharqiya Governorate, Egypt. A total of 127 male and 115 female black rats Rattus rattus and 124 male and 153 female Norway rats R. norvegicus was collected during the study period. A total of 20,643 and 40,997 ectoparasites was recovered from R. rattus and R. norvegicus, respectively. Three common mite species were recovered from both rat hosts: Ornithonyssus bacoti, Radfordia ensifera, and Laelaps nuttalli. Three common flea species were also recovered from both rat hosts: Echidnophaga gallinacea, Leptopsylla segnis, and Xenopsylla cheopis. Polyplax spinulosa was the only louse species that infested both rat hosts. Rats that lived more than 12 mo formed about 24 and 14% of the populations of the black and Norway rats, respectively. The prevalences and general indices of many ectoparasites were significantly higher on males than on females of both rat hosts. Seasonal differences in prevalences and general indices of many ectoparasites were recorded between the 2 sexes of both rat species. Prevalences and general indices of most ectoparasites on both rat species showed a tendency to increase with increasing size and age of rat hosts. The type and degree of correlation between prevalences and general indices on the one hand and each of body size and age on the other hand differed among the species of ectoparasites.

Seasonal studies on commensal rats and their ectoparasites in a rural area of Egypt: the relationship of ectoparasites to the species, locality, and relative abundance of the host

The present study was carried out in 3 villages, namely Kafr Ayoub Soliman, Kafr Ibrahim El-Aidi, and El-Sa'adat, Sharqiya Governorate, Egypt. A total of 519 rats was collected from the 3 study sites: 46.6% Rattus rattus, and 53.4% Rattus norvegicus. A total of 20,643 ectoparasites was recovered from R. rattus: 33.3% mites, 33.8% fleas, and 32.9% lice. From R. norvegicus a total of 40,997 ectoparasites was recovered: 28.9% mites, 31% fleas, and 40.1% lice. Three common mite species were recovered from both rat hosts, i.e., Ornithonyssus bacoti, Radfordia ensifera, and Laelaps nuttalli. Three common flea species were also recovered from both rat hosts, i.e., Echidnophaga gallinacea, Leptopsylla segnis, and Xenopsylla cheopis. Polyplax spinulosa was the only dominant louse species that infested both rat hosts. Rats did not show a definite breeding season, and the seasonal rat indices were generally low in different study sites. There were no significant differences between the prevalence of each of mites, fleas, and lice in both rat species. The total general indices of mites and fleas, on the other hand, was significantly higher in R. norvegicus. The general index of X. cheopis was high and ranged between 5.9 in R. rattus and 14.5 in R. norvegicus. Season-related changes were observed in the general index of each of L. segnis infesting both rat species and R. ensifera and O. bacoti infesting R. norvegicus. The prevalence and general indices of some ectoparasites showed differences related to the locality of their rat hosts. Seasonal changes in the general indices of some ectoparasites paralleled seasonal changes in the relative abundance of their rat hosts.

Formoterol via Turbuhaler gave better protection than terbutaline against repeated exercise challenge for up to 12 hours in children and adolescents

We aimed to compare the protective effect of single doses of 4.5 and 9 microg of formoterol fumarate (F), 0.5 mg terbutaline sulphate (T) and placebo (P), all via Turbuhaler, against exercise-induced bronchoconstriction (EIB) in children. Twenty-seven asthmatic children, showing a fall of > or =20% in FEV1 after a standardized exercise challenge test (ECT) combined with cold air (-10 degrees C) inhalation, were randomized in this cross-over, double-blind study. They had a mean age of 12.6 years (range 8-17 years), mean baseline FEV1 90% (73.9-105.6%) of predicted normal value. Seventeen children used inhaled glucocorticosteroids (120-750 microg day(-1)). ECTs were performed 15 min and 4, 8, and 12 h after drug administration. F significantly reduced the fall in FEV1 after ECT to 5.4% (15 min), 5.2% (4 h), 8.2% (8 h) and 9.3% (12 h) after 4.5 microg, and 2.5%, 3.0%, 5.0% and 5.4% after 9 microg, compared with a fall of 18.4%, 15.7%, 15.6% and 16.5% in FEV1 after P. The fall after T was 3.3%, 11.6%, 14.4% and 19.1% after 15 min, 4, 8 and 12 h respectively. The difference between F and T was statistically significant from 4 h and onward (P-value for all comparisons < 0.05). Children using a single dose of either formoterol Turbuhaler 4.5 or 9 microg had significantly better bronchoprotection against repeated exercise challenge up to 12 h compared with placebo and from 4 h onward compared with terbutaline Turbuhaler 0.5 mg.

Identical longevity phenotypes are characterized by different patterns of gene expression and oxidative damage

Some years ago we applied simultaneously an identical regime of selection for late-life reproduction to several normal-lived sister lines (Ra and Rb) so as to produce several selected long-lived sister lines (La and Lb). The long-lived La and Lb sister lines had statistically identical longevity phenotypes and paraquat resistance phenotypes; however, we noticed some statistically different responses of the two strains at the biochemical level. Extensive work with the La strain showed that transcriptional alterations in antioxidant gene expression are robustly associated with its extended longevity. We decided to critically test the assumption of phenotypic equivalence by subjecting the Lb strain to the same series of molecular assays as was the La strain. The two sister strains are characterized by significantly different mechanisms and patterns of antioxidant gene expression, antioxidant enzyme activity, and oxidative damage. We find that the Lb strain appears to depend on the transcriptional activation of different genes than does the La strain, and on a post-translational up-regulation of at least one other antioxidant defense gene. The phenotypic equivalence observed at the organism level need not hold at the molecular genetic level. This finding suggests that there is more than one molecular mechanism by which antioxidant defense genes can bring about an increased resistance to oxidative stress. The theoretical and empirical implications of these findings are discussed.

Forward and reverse selection for longevity in Drosophila is characterized by alteration of antioxidant gene expression and oxidative damage patterns

Patterns of antioxidant gene expression and of oxidative damage were measured throughout the adult life span of a selected long-lived strain (La) of Drosophila melanogaster and compared to that of their normal-lived progenitor strain (Ra). Extended longevity in the La strain is correlated with enhanced antioxidant defense system gene expression, accumulation of CuZnSOD protein, and an increase in ADS enzyme activities. Extended longevity is strongly associated with a significantly increased resistance to oxidative stress. Reverse-selecting this long-lived strain for shortened longevity (RevLa strain) yields a significant decrease in longevity accompanied by reversion to normal levels of its antioxidant defense system gene expression patterns and antioxidant enzyme patterns. The significant effects of forward and reverse selection in these strains seem limited to the ADS enzymes; 11 other enzymes with primarily metabolic functions show no obvious effect of selection on their activity levels whereas six other enzymes postulated to play a role in flux control may actually be involved in NADPH reoxidation and thus support the enhanced activities of the ADS enzymes. Thus, alterations in the longevity of these Drosophila strains are directly correlated with corresponding alterations in; 1) the mRNA levels of certain antioxidant defense system genes; 2) the protein level of at least one antioxidant defense system gene; 3) the activity levels of the corresponding antioxidant defense system enzymes, and 4) the ability of the organism to resist the biological damage arising from oxidative stress.

Regional differences in hypoxic depolarization and swelling in hippocampal slices

Pyramidal neurons in the CA1 region of the hippocampus are highly vulnerable to damage from hypoxia-ischemia, whereas neurons in the CA3 region and the dentate gyrus are more resistant. A similar pattern of vulnerability to loss of synaptic and membrane function occurs in the in vitro hippocampal slice preparation, suggesting that intrinsic factors are important in acute neuronal damage. Simultaneous recordings of DC potential and imaging of changes in light transmittance were made in slices from the middle one-third of the hippocampus to characterize the initiation and spread of depolarization and swelling during hypoxia-aglycemia. Hypoxic depolarization (HD) and associated optical changes were initiated simultaneously in the stratum oriens of the CA1 region and thereafter spread to the stratum radiatum of CA1 and later to the upper (inner) blade of the dentate gyrus. A decrease in light transmittance was associated consistently with depolarization in all regions (n = 22 slices). Investigation of the sequence of activation in intact slices showed that activation of the dentate gyrus arose independently of activation of the CA1 region. This was confirmed by recordings made from minislices in which CA1, CA3, and dentate regions were physically separated. HD and optical changes were never observed in the CA3 region, despite exposure to 40-60 min of combined hypoxia and aglycemia. In contrast, exposure to hypoxia after pretreatment of slices with altered tonicity or ion composition, which triggered episodes of spreading depolarization (SD), provoked depolarization and optical changes simultaneously in both CA1 and CA3 regions. Similarly, pretreatment with agents that cause severe metabolic impairment, such as dinitrophenol (DNP), also rendered the CA3 region vulnerable to subsequent hypoxia. This suggests that the CA3 region in hippocampal slices is normally resistant to HD and only becomes vulnerable after severe impairment of metabolic capacity. The similar order of vulnerability of in vitro and in vivo hippocampus to hypoxia-aglycemia supports the use of the hippocampal slice preparation to investigate early changes potentially contributing to hypoxic-ischemic injury.

The use of long-term defunctionalized bladder in renal transplantation: is it safe?

OBJECTIVE

Evaluation of the use of defunctionalized bladder in renal transplantation, concerning surgical complications.

METHODS

In order to assess the complication rate of ureteral reimplantation in long-term defunctionalized bladder, we compared 20 patients on haemodialysis for more than 15 years (group I) with another 20 patients on haemodialysis for less than 5 years (group II). None of these patients had renal failure due to urological causes or neurogenic bladder. Non-stented extravesical ureteroneocystostomy was done routinely in all patients except 1 in group II who underwent Politano-Leadbetter ureteroneocystostomy and 7 patients in group I who underwent Politano-Leadbetter (3 patients) and pyelo-ureteral anastomosis using the recipient's native ureter (4 patients). The amount of residual urine was insignificant (<100 cm(3)) in both groups.

RESULTS

The mean postoperative bladder catheterization period was 7.8 days in group I and 4.2 days in group II. Postoperative urinary tract infections were observed in 9 cases of group I and in 4 cases of group II. No surgical complications occurred in patients of group II, while there were 6 patients with surgical complications in group I: stenosis after a pyelo-ureteral anastomosis (1 case), stenosis after a ureterovesical anastomosis with Politano-Leadbetter technique (1 case), urinary fistulae (3 cases; 1 with Politano-Leadbetter ureteroneocystostomy and 2 cases with pyelo-ureteral anastomosis), and vesico-ureteral reflux (1 case with Politano-Leadbetter ureteroneocystostomy). These 6 cases had the lowest bladder capacity (30-150 cm(3)) among our 40 patients. Graft losses were comparable between the two groups and were not due to surgical complications.

CONCLUSION

Small defunctionalized bladders can be used in kidney transplantation, but it may represent an increased surgical risk due to difficulty in performing ureteral reimplantation.

Depletion of total antioxidant capacity in type 2 diabetes

The purpose of the study was to examine the relationship between antioxidant depletion, glycemic control, and development of chronic complications in a controlled population of type 2 diabetic patients. Fifty age-matched type 2 diabetic patients receiving sulfonylureas but not insulin treatment were screened and assigned to two groups based on the presence or absence of proteinuria. A third group of normal subjects without diabetes were also enrolled in the study. All subjects in the three groups were Egyptians who were matched for body weight, and the two diabetic groups were also age-matched. Plasma glucose and fructosamine levels were higher in the two groups of diabetic patients versus the control group, but lipid peroxide levels were higher only in the patients with proteinuria. Compared with the control group, the total antioxidant capacity was depleted in the two diabetic groups, but the depletion was more severe in patients with proteinuria. Thus, the mean Trolox equivalent antioxidant capacity (TEAC) of the control group was 2.7+/-0.45, versus 1.7+/-0.5 (P < .001) in the patients without proteinuria. Furthermore, the TEAC measured in patients with proteinuria, who also had more diabetic complications, was lower (1.4+/-0.5, P < .001) than the TEAC in patients without urinary protein. In conclusion, a depletion of the total antioxidant capacity is associated with a higher incidence of diabetic complications.

A 3-month comparison of formoterol with terbutaline via turbuhaler. A placebo-controlled study

BACKGROUND AND AIM

Oxis Turbuhaler is a new dry powder formulation of long-acting beta2-agonist formoterol. This study compared the efficacy and safety of regular use of the long-acting beta2-agonist formoterol and the short-acting terbutaline for 3 months in patients with asthma.

METHOD

After 1-week run-in, 343 patients received either formoterol 12 microg bid (F) (delivered dose of 9 microg), terbutaline 500 microg qid (T) or placebo qid, in a parallel-group, double-blind, randomized manner. They had a mean of 61% of predicted forced expiratory volume in 1 second (FEV1) and a mean reversibility of 26%. Eighty-nine percent used inhaled corticosteroids.

RESULTS

During run-in mean morning peak expiratory flow (PEF L/min) for F was 366 and 348 for T, and 344 for placebo (P). The F group improved morning PEF significantly compared with P (P = .0022) and T (P = .0001). Changes from run-in were + 18, -1.5, and +5 L/min after F, T, and P, respectively. The F group was statistically significantly better than P and T in increasing evening PEF and in reducing night-time asthma. The F and T statistically significantly reduced the use of rescue medication compared with P. The bronchodilating response to the study drug and to an additional 1.25 mg terbutaline was of the same magnitude before and throughout the study. No statistically significant treatment-by-time interaction was observed (P > .20). There were no adverse effects of clinical relevance.

CONCLUSION

Formoterol Turbuhaler, 12 microg bid, was more effective than terbutaline Turbuhaler, 0.5 mg qid, and placebo. Regular use of formoterol or terbutaline did not significantly influence the response to additional inhalation of terbutaline.

Low-dose formoterol Turbuhaler (Oxis) b.i.d., a 3-month placebo-controlled comparison with terbutaline (q.i.d.)

This study compared the efficacy of a low dose of formoterol Turbuhaler 6 micrograms b.i.d. (F) with that of terbutaline 0.5 mg q.i.d. (T), and placebo (P) from Turbuhaler. After a 2-week run-in, 397 adults with mild to moderate asthma were randomly allocated to one of the treatments for 12 weeks. During run-in, the mean morning peak expiratory flow (PEF) was 360 (F), 368 (T) and 367 1 min-1 (P). F was better than T (P = 0.014) and P (P = 0.0001) in improving morning PEF [mean changes from run-in: 20 (F), 9 (T), and 21 min-1 (P)]. F was statistically significantly more effective than either T or P in reducing asthma symptoms. F gave also statistically significantly higher evening PEF and less use of rescue medication than P. Bronchodilator response to study drugs and additional 1.25 mg terbutaline was similar before and after the 12-week treatment period. There were no adverse effects of clinical relevance. In conclusion, formoterol Turbuhaler, 6 micrograms b.i.d. was more effective in improving PEF and offered better asthma control than either terbutaline Turbuhaler, 0.5 mg q.i.d. or placebo. Regular use of formoterol did not reduce the bronchodilator response to additional terbutaline. There were no clinically relevant adverse effects.

Safety and efficacy of a high cumulative dose of salbutamol inhaled via Turbuhaler or via a pressurized metered-dose inhaler in patients with asthma

An open, crossover and randomized study was carried out to compare the safety and efficacy of salbutamol inhaled using the dry-powder inhaler Turbuhaler, and using a pressurized metered-dose inhaler (pMDI). Twelve patients with moderate to severe asthma, aged 47-68 years, were included in the study. On two separate days, patients received a total dose of 1600 micrograms of salbutamol administered in a cumulative dose fashion: 100, 100, 200, 400 and 800 micrograms at 3-min intervals. Salbutamol inhaled via Turbuhaler caused a larger decrease in serum potassium concentration than did salbutamol inhaled via pMDI. The estimated relative dose potency of the hypokalaemic effect of salbutamol Turbuhaler vs salbutamol pMDI was 2.0 with a 95% confidence interval of 1.3-3.6. Turbuhaler caused a small (but statistically significantly greater than with pMDI) increase in heart rate, QTc interval and tremor. Blood pressure was unaffected by the treatments. No adverse events of clinical relevance were reported. The estimated relative dose potency of the bronchodilating effect (FEV1) of salbutamol Turbuhaler vs salbutamol pMDI was 3.0 with a 95% confidence interval of 1.8-5.8. In conclusion, salbutamol inhaled via Turbuhaler was more potent and seemed to have a better therapeutic ratio than salbutamol inhaled via pMDI. Both treatments were equally well tolerated.

The impact of inspiratory effort on inspiratory flow through Turbuhaler in asthmatic patients

To investigate the impact of the inhalation effort on the peak inspiratory flow through Turbuhaler, 100 asthmatics having a wide range of asthma severity (baseline forced expiratory volume in one second 28-127% of predicted normal) were studied. Each patient inhaled through four modifications of empty Turbuhaler inhalers, using first a "deep" inhalation and then a "forceful and deep" inhalation manoeuvre. Peak inspiratory flow increased by an average of 20% using a "forceful and deep" as compared to a "deep" inhalation, with a markedly higher increase for the patients who had a low peak inspiratory flow using the deep inhalation. Virtually all patients (97-100%) attained a peak inspiratory flow > or = 40 L x min(-1) after a "forceful and deep" inhalation. This study demonstrates that instructing the patient to take a "forceful and deep" inhalation optimizes the use of Turbuhaler. Irrespective of asthma severity, the vast majority of patients could attain a sufficiently high peak inspiratory flow with a "forceful and deep" inhalation.

The impact of inspiratory effort on inspiratory flow through Turbuhaler in asthmatic patients

To investigate the impact of the inhalation effort on the peak inspiratory flow through Turbuhaler, 100 asthmatics having a wide range of asthma severity (baseline forced expiratory volume in one second 28-127% of predicted normal) were studied. Each patient inhaled through four modifications of empty Turbuhaler inhalers, using first a "deep" inhalation and then a "forceful and deep" inhalation manoeuvre. Peak inspiratory flow increased by an average of 20% using a "forceful and deep" as compared to a "deep" inhalation, with a markedly higher increase for the patients who had a low peak inspiratory flow using the deep inhalation. Virtually all patients (97-100%) attained a peak inspiratory flow > or = 40 L x min(-1) after a "forceful and deep" inhalation. This study demonstrates that instructing the patient to take a "forceful and deep" inhalation optimizes the use of Turbuhaler. Irrespective of asthma severity, the vast majority of patients could attain a sufficiently high peak inspiratory flow with a "forceful and deep" inhalation.

Mycoflora and Fusarium toxins of three types of corn grains in Egypt with special reference to production of trichothecene-toxins

Sixty three species and 2 varieties which belong to 21 genera of fungi were isolated from corn grains (53 + 2, 36 + 1 and 34 species belonging to 19, 13, and 12 genera from white, yellow and popcorn, respectively). Aspergillus (15 species), Penicillium (17) and Fusarium (4) were the dominant genera isolated from the three types of corn. Of four species of Fusarium, F. moniliforme was the dominant species. F. oxysporum and F. solani were detected in all the three substrates, whereas F. subglutinans was isolated exclusively from yellow corn. A biological assay (brine shrimp larvae) and chemical analysis (TLC, UV spectrophotometery and NMR spectroscopy) of chloroform extracts proved that 7 out of 78 samples were toxic. Diacetoxyscirpenol (4 samples, 98.4-128.4 micrograms/kg corn), T-2 toxin (4 samples, 72.8 to 130.4 micrograms/kg) and zearalenone (7 samples, 22.6 to 80.4 micrograms/kg) were detected, whereas 90% methanol-water re-extracts revealed that 3 out of 78 samples were toxic due to presence of fusarin C (1 sample, 76.8 micrograms/kg) in addition to an unidentified toxic factor (3 samples). Of 22 Fusarium isolates (F. moniliforme, F. oxysporum, F. solani and F. subglutinans; 10,5,5 and 2 isolates, respectively grown on corn grains, the chloroform extracts of 6,3,3 and 1 isolates were toxic to brine shrimp larvae. Based on chemical analysis, diacetoxyscirpenol (10/22 isolates; 9.8 - 78.6 micrograms/g dry corn grains), T-2 toxin (5/22; 20.8 - 60.4 micrograms/g), HT-2 toxin (3/22; 12.4 - 18.6 micrograms/g) and zearalenone (13/22; 9.8 - 38.4 micrograms/g) were identified.(ABSTRACT TRUNCATED AT 250 WORDS)