Risk factor analysis among Egyptian patients who underwent coronary artery bypass surgery

Bacterial resistance against antibiotic treatment is becoming an increasing problem in medicine. Therefore methods to destroy microorganisms by other means are being investigated, one of which is photodynamic therapy (PDT). It has already been shown that a variety of Gram-positive and Gram-negative bacteria can be killed in vitro by PDT using exogenous sensitizers. An alternative method of photosensitizing cells is to stimulate the production of endogenous sensitizers. The purpose of this study was to investigate the bactericidal efficacy of PDT for Haemophilus parainfluenzae with endogenously produced porphyrins, synthesized in the presence of delta-aminolaevulinic acid (delta-ALA). H. parainfluenzae incubated with increasing amounts of delta-ALA showed decreased survival after illumination with 630 nm light. No photodynamic effect on the bacterial viability was found when H. parainfluenzae was grown without added delta-ALA. H. influenzae, grown in the presence of delta-ALA, but not capable of synthesizing porphyrins from delta-ALA, was not affected by PDT. Of the range of incident wavelengths, 617 nm appeared to be the most efficient in killing the bacteria. Spectrophotometry of the bacterial porphyrins demonstrated that the maximum fluorescence occurred at approximately 617 nm, with a much lower peak around 680 nm. We conclude that a substantial killing of H. parainfluenzae by PDT in vitro after endogenous sensitization with delta-ALA can be achieved.     

The effect of gamma radiation at low doses on the receptor binding of triiodothyronine in the nuclei of rat liver cells

Subacromial bursal specimens from 63 patients undergoing surgery for rotator cuff tearing (n = 43), the impingement syndrome (n = 14), and calcifying tendinitis n = 6) were studied to characterize the reactions that develop at the tendinopathy "lesional" sites. Intensity of the bursal reactions and production of type III collagen vary considerably, with the highest incidence of both seen in patients with rotator cuff tears. The intensity of bursal reactions correlated with the degree of formation of perivascular new collagen and type III collagen expression. In 22 of the 63 patients the bursal reaction distant to the tendon lesion was also studied. It was minimal and did not correlate to the lesional bursal findings. A strong correlation, however, existed between surgical appearance and histologic grading. The term "localized bursal reaction" as opposed to bursitis more correctly describes bursal involvement. Resection of bursal tissues should be limited to the lesional tissue that interferes with subacromial motion.     

New developments in understanding the compensatory hematological reactions and their outcomes in local fractionated therapeutic gamma irradiation

A surgical treatment for central epithelial odontogenic ghost cell tumor is described. A brief review of the literature is given, and histopathology is discussed. The rationale for conservative treatment is presented, along with an illustrative case report.     

Use of polymerase chain reaction in clinical diagnostic laboratories in viral hepatitis B and C]

alpha 1-Antitrypsin deficiency has been associated with a variety of vascular disorders including arterial aneurysms, spontaneous extracranial arterial dissections, and arterial fibromuscular dysplasia. We determined the distribution of alpha 1-antitrypsin phenotypes in patients with intracranial arterial dissections, a rare cause of subarachnoid hemorrhage. The study population consisted of 4 consecutive patients with subarachnoid hemorrhage due to spontaneous intracranial arterial dissections. The vertebral artery was involved in 3 patients and the posterior inferior cerebellar artery in 1 patient. Three of these 4 patients were found to have a heterozygous alpha 1-antitrypsin deficiency (PiMZ or PiMS phenotypes). These data support previous studies suggesting that patients with alpha 1-antitrypsin deficiency may be at an increased risk of developing spontaneous arterial dissections.     

Outcome of nonspecific right iliac fossa pain syndromes

One-third of all cases of abdominal pain and a quarter of cases of right iliac fossa pain urgently admitted to hospital leave hospital with no precise diagnosis. Based on a series of 400 patients hospitalised for right iliac fossa pain, comprising 107 cases with no identified aetiology, this prospective study was designed to assess the medium-term outcome of these patients, with or without surgical exploration. 67 cases were reviewed at five years. No major diagnosis was missed. Over this 5-year period, 30 patients (45%) experienced another episode of abdominal pain. Among the third of patients (21 cases, 31%) reviewed for another episode of right iliac fossa pain, 7 were readmitted to hospital, with 5 operations, for histologically confirmed acute appendicitis in 3 cases (5% of the series). The patient and his attending physician must be informed of the nonspecific diagnosis established during the first hospitalisation. There is no significant evidence to suggest a psychological component in the recurrent nature of the pain. Cancer must be formally excluded in patients over the age of 50. When surgical exploration is performed, nowadays by laparoscopy, appendicectomy is recommended. This procedure does not decrease the risk of recurrent pain, but confirms the real absence of histopathological abnormality and decreases the number of subsequent hospitalisations.     

Volume of extravascular lung fluid determined by blood ultrasound velocity and electrical impedance dilution

A hypertonic sodium chloride bolus passing through the lung has a sound velocity transient that is biphasic when it reaches the carotid artery. This transient is compatible with water moving into the hypertonic bolus from the lung parenchyma, thereby leaving the lung parenchyma hypertonic. Subsequently, as the bolus leaves the lung vasculature, water passes from the blood into the tissue to return the lung tonicity to baseline, giving a moment when net movement is zero, an instant of osmotic equilibrium. Concurrent measurements of impedance track the sodium chloride transient. A theoretic basis for the calculation of extravascular lung water is derived from the water transferred to the blood, the amount of sodium chloride moved from blood to the lung, and the increase in blood osmolarity measured at the moment of equilibrium. Examples from measurements on sheep suggest that two intravenous injections of hypertonic and isotonic sodium chloride, with observations of sound velocity and electrical impedance in the systemic arterial circulation (which could also provide the cardiac output), provide a basis for calculation of lung permeability, water and salt movements, and extravascular lung water estimation.     

The BASP1 family of myristoylated proteins abundant in axonal termini. Primary structure analysis and physico-chemical properties

Proteins BASP1 and GAP-43/B-50, which are abundant in nerve endings, show a number of similar physico-chemical properties. Nevertheless, they belong to different protein families. In this work, complete amino acid sequences of bovine BASP1 and human BASP1 were established. They proved to be very similar to the sequences of rat brain protein NAP-22 and chicken brain protein CAP-23. Relatively to human BASP1 its bovine, rat and chicken analogues show 80%, 70% and 45% sequence identity respectively, confirming their membership of a definite protein family (BASP1 family). All members of BASP1 family contain several 'good' PEST sequences characteristic for short-living proteins. Conservation of PEST sequences in BASP1 of different species points to their significance for BASP1 functions. In contrast to GAP-43/B-50 showing high immunological cross-reactivity between the proteins belonging to different species of mammals, immunological properties of BASP1 are species specific. BASP1 shows both high hydrophilicity and some properties characteristic for hydrophobic proteins. These properties are caused by N-terminal myristoylation of BASP1 molecules. Unlike GAP-43/B-50, BASP1 is present in high amounts also in some non-nervous tissues: testis, kidney and lymphoid organs (spleen, thymus). So far examined characteristics, including myristoylation, peptide maps and detected by isoelectrofocusing microheterogeneity, proved to be the same for BASP1 samples isolated from both brain and non-nervous tissues. Therefore, in spite of different physiological consequences, biochemical functions of BASP1 must also be similar in different tissues.     

The Hydrachnidae water mites of southwestern Siberia in relation to their participation in arbovirus circulation

The phenomenon of Hydrachnidae association with the tick-borne encephalitic viruses complex has been found out during the study of the role of the Hydrachnidae in the arboviruses circulation. We investigated the fauna, studied the quantity variation and trophic relations of these arthropods and blood-sucking Diptera. It was revealed no trophic relations between blood-sucking Diptera and mite species, where TBE strains were isolated from. On the basis of faunistic and virological study we suppose, that Hydroacarinae got an infection with the virus in the nymphal and imago stages, as well as larvae of mosquitos. Authors also note, that trophic relations between blood-sucking Diptera and chiggers (Trombidiidae) may be important in the arboviruses ecology.     

A trial of long-term lovastatin treatment in patients with a heterozygous form of hereditary hypercholesterolemia

Patients with heterozygous family hypercholesterolemia (HFH) were divided into two groups. Group 1 patients received lovastatin in a daily dose 40-60-80 mg under control of lipids and peripheral blood biochemistry. In 17 patients lovastatin was given as monotherapy, in 15 patients it was combined with plasmapheresis. No hypolipidemic therapy was given to ten patients of group 2. The treatment and follow-up lasted for 4.1 +/- 1.9 years, on the average. A marked hypolipidemic effect was seen in the comorbid therapy. 43% of the patients became resistant to lovastatin, the resistance developed more frequently in monotherapy. The blood fibrinogen fell by 40%, spontaneous and induced platelet aggregation returned to normal, being somewhat higher in subjects resistant to lovastatin therapy. The study shows that hypolipidemic therapy has reduced the risk of IHD fatal complications and progression of non-coronary atherosclerosis in patients of group 1.     

Comparative analysis of the informational merits of ergometric and functional indicators of work capacity

Informational merits of ergometric and routine functional indices (MPK, anaerobic threshold--AT, PWC170) were compared by testing performance of 20 young males with high levels of fitness. Criterion for work ability was maximum time of rowing ergometer with incremental loading and two tests with permanent load in the regions of submaximum (about 7 W/kg) and high (about 4 W/kg) loading. Ergometric indices, i.e. individual limits of relative power, were calculated from Muller's equation tlim = eb x W-a. Before, during, and after 5-20 minutes of test session gas exchange, pulse rate, and blood lactate were measured to calculate MPK, AT and PWC170, and oxygen demand fraction. Ergometric indices were found to be no less informative in evaluation of work ability than the common indices involving determination of gas exchange, PR and lactate. Ergometric and functional indices showed high correlation. It was stated that none of the indices can be equally informative regarding all types of work ability testing. Application of two-increment test and subsequent calculation using Muller's equation allows to get around the principle of uncertainty according to which none of the test can be at one and the same time used to assess power and capacity of energy systems of the skeletal muscles. Besides, ergometric tests provide reliable enough characteristics of work ability without resort to expensive and bulky equipment.