The perfect state of Trichophyton violaceum

BACKGROUND

Trichophyton violaceum is the most common etiologic agent causing dermatophytosis in Egypt. This report deals with attempts to produce the perfect state of T. violaceum that may play a role in the epidemiology of T. violaceum.

MATERIALS AND METHODS

Ten strains of T. violaceum were inoculated on hair soil culture and on rice agar media.

RESULTS

Cultures on hair soil media failed to produce the ascogenous form of the fungus, but after 6 weeks of culture on rice agar media, fertile cleistothecium were seen and 2 weeks later separate asci appeared.

CONCLUSION

This is the first report on the production of the perfect (sexual) state of T. violaceum. Details of the ascogenous form of this dermatophyte should be studied in the future.

Induction of tumor necrosis factor in severe acute pancreatitis and its subsequent reduction after hepatic passage

BACKGROUND

Tumor necrosis factor (TNF) is rapidly gaining recognition as one of the early, critical mediators of several inflammatory conditions, most notably endotoxic shock. The purposes of this study were to determine whether TNF levels are raised in severe acute pancreatitis, thus pointing to its role as a potential mediator of the inflammatory process, and to determine the possible sites of production and uptake.

METHODS

TNF levels were measured during a 2-hour period in a rat model of acute pancreatitis by using an antegrade infusion of artificial bile. TNF levels were measured with a bioassay.

RESULTS

TNF levels increased proportionately with time and serum amylase level, reaching a mean value of 2700 pg/ml at 2 hours compared with sham operated rats (mean, 125 pg/ml) (p < 0.001). TNF levels in nonoperated controls were undetectable. These measurements were found to be independent of endotoxin production. In addition, selective sampling from the portal vein, hepatic vein, and femoral artery showed hepatic degradation of TNF (p < 0.005), indicating that the liver may play an important role in protecting the host from multiple organ failure.

CONCLUSIONS

Our results showed that TNF levels are elevated in acute pancreatitis and may suggest a role for this cytokine in the pathogenesis of the disease.

Studies on human fascioliasis in Egypt. 2. Serum iron and copper in chronic fascioliasis

Twenty-three patients diagnosed as established fascioliasis were enrolled in the present study. Fasciolia cases were investigated for serum iron, copper and their carrier proteins together with haemoglobin and some blood indices. A significant reduction in serum iron was detected in the examined group. This reveals the occurrence of iron deficiency anaemia in patients with chronic fascioliasis.

Acetyl-L-carnitine corrects electroretinographic deficits in experimental diabetes

Acetyl-L-carnitine reduces the latencies of electroretinogram oscillatory potentials in healthy humans. The effect of acetyl-L-carnitine (50 mg.kg-1.day-1) on the increased electroretinogram latencies found in rats with STZ-induced hyperglycemia of 3-wk duration was evaluated. The aldose reductase inhibitor sorbinil, which has been shown to normalize abnormal electroretinogram tracings associated with STZ-induced diabetes, was used as a positive control. Aldose reductase inhibitors are thought to lower tissue sorbitol while increasing myo-inositol. The electroretinograms of the STZ-induced diabetic rats in this study were abnormal; treatment with acetyl-L-carnitine as well as sorbinil significantly improved electroretinogram b-wave amplitude and decreased the latencies of oscillatory potentials 2 and 3. Acetyl-L-carnitine treatment of STZ-induced diabetic rats did not affect hyperglycemia or erythrocyte polyol pathway activity as reflected by erythrocyte sorbitol levels. In contrast, sorbinil did reduce elevated erythrocyte sorbitol levels. This suggests that the impaired electroretinograms associated with STZ-induced diabetes may not be caused solely by increased polyol pathway activity.

A condom sense approach to AIDS prevention: a historical perspective

Condoms have come a long way since their use in ancient Egypt three millennia ago. Their benefit is well established for the prevention of both contraception and STDs. Although AIDS has revitalized the condom, we must remember that condoms do not prevent the spread of HIV infection, people do. Everyone must take personal responsibility to avoid high risk behavior (e.g.; IV drug use, promiscuous sex, casual sex, etc). If one does engage in high risk sexual behavior, he/she should at least use condom sense.

Adult respiratory distress syndrome: a review for the clinician

Adult respiratory distress syndrome is a common respiratory problem with a wide array of precipitating causes and an overall mortality rate of more than 50%. Signs on physical examination tend to be nonspecific as do laboratory findings associated with the syndrome. Because of its diverse etiology, there is no one specific treatment for adult respiratory distress syndrome. Therapy is primarily supportive and centers around the use of mechanical ventilator support. The authors discuss the pathogenesis and management of this syndrome together with some of the newer approaches to mechanical ventilation.

Effects of beta-adrenoceptors blocking eye drops in patients with chronic bronchitis

Beta-blocker eyedrops used on asthmatic patients are known to enhance asthma which is, as chronic bronchitis, an obstructive disease of the lung, and an authentic bronchoconstriction is always possible. A single blind parallel trial in 3 groups of 10 patients with grade II and III chronic bronchitis, was conducted to evaluate the cardiovascular and bronchial tolerance of 3 beta-blocker eyedrops: timolol, betaxolol and carteolol compared to placebo. The following parameters were measured during a 90 minutes period: heart rate, systolic and diastolic blood pressure, forced expiratory volume in one second, vital capacity. It appeared that only heart rate lowers significantly under the influence of the beta-blocker eyedrop, the other parameters did not change and no difference was noticed between the three eyedrops. However, comparison of individual values showed a significant decrease of forced expiratory volume in one second in certain subjects and this, although betaxolol is a beta 1 selective beta-blocker. Caution should be taken each time beta-blocker eyedrops are prescribed for glaucoma to patients with chronic bronchitis.

Chronic duodenal ulcer in children and response to highly selective vagotomy

The effectiveness of highly selective vagotomy (HSV) in adult duodenal ulcer surgery is confirmed by absence of peroperative mortality or postoperative morbidity and by ulcer healing in the majority of cases. Whether it could be used in children with the same result was the subject of our study in 13 successive cases of complicated duodenal ulcer treated between 1974 and 1987. There was complete ulcer healing in 4 cases. Pain relapsed in 5 cases and there was recurrence of hemorrhage in 2 cases. Although immediate good results lasted for at least 3 years, 2 patients were lost to follow-up. Still, we consider HSV as a safe procedure available for children as it does not "queer the pitch" for a subsequent treatment if it fails.

Verrucae treated by levamisole

To assess the role of levamisole in treatment of different types of warts, a double-blind study was conducted on 40 patients with different types of warts. Patients were divided into two equal groups, A and B. Group A received levamisole 5 mg/kg body weight on 3 consecutive days every 2 weeks for a period up to 5 months, while patients of group B received placebo for the same period. In group A, 12 patients showed complete cure (60%), two showed partial cure (10%), and the remaining six patients showed no response (30%). In group B, complete cure was achieved only in one case. The higher cure rate was observed in plane and common warts, while plantar warts showed no improvement with levamisole treatment.

Colloidal bismuth subcitrate-induced changes on gastric mucosal hemodynamics in the rat: gastric mucosal blood flow after CBS treatment

The belief that blood flow plays a central role in cytoprotection and there being no data available, at present, regarding the possible action of Colloidal bismuth subcitrate (CBS-DENOL) on the gastric mucosal blood flow (GMBF), led us to investigate its influence on mucosal hemodynamics in the rat stomach. Measurements of GMBF were performed in 32 male Wistar rats, treated by either CBS or placebo in drinking water for a 3-wk period, by the use of a laser-Doppler flowmeter, at 14 defined points of the stomach. CBS treated animals revealed a highly statistically significant increase (P less than 0.0005, upaired t-test) of GMBF in comparison with the placebo treated. These findings lead us to suggest that CBS exerts its antiulcer action via the mechanism of increased gastric mucosal blood flow. Additionally the increased blood flow may be associated with the previous findings of increased synthesis of prostaglandins, gastric mucus and bicarbonate secretion by CBS.

Postpartum colposcopy of the cervix: injury and healing

Colposcopic examination was done in 189 successive parturients within 6-48 h of delivery for evidence of type, site, and extent of cervical trauma and its relation to various obstetric factors. There was trauma in 66% of cases, as erosion in 79%, as laceration in 56%, as bruising in 30%, and as yellow areas in 17%. In about two-thirds of cases, the diameter of cervical erosion, or the length of laceration did not exceed 5 mm and 81% of lacerations were of first degree. Cervical injury was significantly more frequent in primiparae, in the anterior cervical lip, in occipito-posterior positions, and with premature rupture of membranes. In 117 parturients with cervical injury another colposcopic examination was done 6-8 weeks postpartum. In 8% there was residual cervical damage.

Glutathione and related enzymes in fascioliasis before and after treatment with bithionol

The present work is an update evaluation of the glutathione status in patients with established fascioliasis before and after treatment with bithionol. Blood glutathione (GSH), erythrocyte glutathione S-transferase (GST) and serum gamma-glutamyl transferase (GGT) activities were studied. After treatment, the variations observed in these parameters were restored to the corresponding normal control values confirming the toxic features resulting from fascioliasis and suggesting no adverse effect of bithionol on the parameters studied. We recommend the use of serum GGT, blood GSH and erythrocyte GST for the early detection of therapeutic response in fascioliasis.

[Preparation of the colon for endoscopic examinations. A clinical study]

The paper gives a short critical bibliographic review of colonic preparation for endoscopy, focusing on the out-patient use of gastrointestinal endoscopy. A method of preparation based on dietary restrictions plus cathartics is proposed that allows the number of enemas used to be reduced to a minimum. The results obtained in 265 out-patients undergoing colonoscopy confirm the efficacy, practicality and tolerability of the method.

The role of selenium-dependent and selenium-independent glutathione peroxidases in the formation of prostaglandin F2 alpha

In recent years, growing evidence suggests that glutathione peroxidases (GSH-Pxs), both selenium-dependent GSH-Px (Se-GSH-Px) and selenium-independent GSH-Px (non-Se-GSH-Px) play an important role in the biosynthesis of prostaglandins and leukotrienes and in the regulation of key enzymes associated with the arachidonic acid cascade. The precise nature of their involvement in eicosanoid metabolism, however, is not yet completely understood. In the study reported here, we have systematically determined the catalytic efficiencies of Se-GSH-Px and non-Se-GSH-Px toward prostaglandin (PG) G2 (PGG2) and PGH2. Se-GSH-Px exhibited high catalytic activity for the reduction of PGG2 as indicated by Km and Vmax values of 12 microM and 78 mumol/min/mg, respectively, whereas PGH2 was found to be a poor substrate, an indication that Se-GSH-Px reduces the hydroperoxide moiety but not the endoperoxide moiety of PGG2. The kinetic constants of Se-GSH-Px toward PGG2 were comparable to those determined for such classical substrates as H2O2 and cumene hydroperoxide. In contrast to Se-GSH-Px, non-Se-GSH-Px associated with cationic isozyme II of glutathione S-transferases (GSTs) from sheep lung cytosol was very active in the conversion of PGH2 to PGF2 alpha with a Vmax of 960 nmol/min/mg and a Km of 77 microM. This study shows that PGF2 alpha formation by non-Se-GSH-Px occurred in a GSH-dependent reduction of either PGG2 or PGH2. When PGG2 was used as the substrate for non-Se-GSH-Px, a novel intermediate compound appeared and was later identified by several methods of structural analysis as 15-hydroperoxy PGF2 alpha. Thus, the reductive cleavage of the endoperoxide occurs faster than the 15-hydroperoxide reduction allowing 15-hydroperoxy PGF2 alpha to accumulate briefly. A study of GSTs from several different tissues and species indicated that the transformation of PG endoperoxides to PGF2 alpha is catalyzed specifically by GST isozymes, which contain Ya size subunits. This specificity of GST isozymes in PG biosynthesis, coupled with their tissue-specific expression, may be a mechanism by which the body modulates the type of PGs produced in these tissues. Also, these results suggest a possible interaction of Se-GSH-Px and non-Se-GSH-Px in the biosynthesis of PGF2 alpha.

[Continuous high-dose corticosteroid pressured aerosol therapy in steroid-dependent asthma]

Two therapeutic trials aimed at determining whether a high-dose inhaled corticosteroid, beclomethasone dipropionate (BDP), could reduce or suppress a long term and continuous treatment with a systemic corticosteroid, triamcinolone acetonide (TA), were carried out in a homogeneous population of severe, steroid-dependent asthmatics. The first one was a controlled, double-blind versus placebo trial involving 25 patients followed up for 5 months. The second one was an open trial involving 105 patients followed up for 12 months. In both trials the mean doses of TA were reduced by 60 to 65 per cent, and TA could be totally or nearly totally suppressed in almost 60 per cent of the cases with clinical and functional results that were equal or superior to those previously obtained with systemic corticosteroid therapy. It is concluded that: (a) continuous systemic corticosteroid therapy in mean doses of more than 5 mg/day of prednisone equivalent is now rarely indicated in patients with steroid-dependent asthma, and (b) inhaled corticosteroid therapy with BDP could be extended to cases of non steroid-dependent asthma inadequately controlled by bronchodilators.

Bithionol (Bitin) treatment in established fascioliasis in Egyptians

The present study is an evaluation of bithionol treatment in established fascioliasis. Eight patients were enrolled in the study. All were passing eggs of Fasciola spp. and seven had concomitant Schistosoma mansoni infection. The clinical and haematological findings conformed with the known picture of fascioliasis. Bitin tablets (200 mg) were administered in the dose of 30 mg kg-1 body wt every other day for five doses. Eggs were counted during and for 4 months after the end of therapy. Fasciola ova disappeared after the second or third dose giving a cure rate of 100%. Ova of S. mansoni did not show any change in number. As regards the liver function tests; bilirubin, SGOT and SGPT values were within the normal range and were not affected by treatment. A raised SAP level was observed before therapy which was significantly higher after bithionol. Creatinine phosphokinase and lactate dehydrogenase enzymes and kidney function tests showed almost normal values and were not altered by therapy. It was concluded that Bitin was a potent fasciolicidal drug in the dose used. No side effects were observed.

Therapeutic evaluation for intralesional injection of bleomycin sulfate in 143 resistant warts

A 1 U/ml solution of bleomycin sulfate in physiologic saline solution was injected intralesionally in 38 patients, and was compared with physiologic saline solution injection into paired warts in the same patient. No patient received more than 2 ml of bleomycin. Ninety-seven of 143 warts (67.8%) showed complete resolution after one or two bleomycin injections, while 25 warts (17.5%) showed incomplete resolution. Bleomycin local injection failed to elicit any therapeutic response in 21 warts (14.7%). The cure rate was 77% for warts on the extremities, 71.4% for periungual warts, and 47.6% for the plantar warts. The responsive warts showed hemorrhagic eschars that healed without scarring. It is concluded that this form of treatment for resistant warts, up to the dose used, is safe, reliable, and accepted by the patient.

Homozygous sickle cell disease and priapism in the eastern province of Saudi Arabia

Two adult sickle cell homozygotes from the eastern oases of the Kingdom of Saudi Arabia presented with severe persistent priapism. Each patient had a high Hb F of 24%, and their red cells were neither hypochromic nor microcytic. Priapism probably occurs more frequently in homozygous sickle cell disease than reported previously from this region. It would appear that a high fetal haemoglobin alone without hypochromia and microcytosis--features suggestive of co-existing alpha-thalassaemia--does not protect against this agonizing vaso-occlusive event.

A short note on praziquantel in human fascioliasis

Ten patients suffering from fascioliasis were treated with praziquantel. In two patients, egg counts dropped to zero following treatment, but there was no significant reduction in egg counts in the other eight.

The in-vitro activity of metronidazole against strains of Escherichia coli with impaired DNA repair systems

The minimal inhibitory concentration (MIC) of metronidazole was lower for strains of Escherichia coli with lesions in their DNA repair systems than for their parent strains. The viable numbers of all strains of E. coli tested were considerably reduced by metronidazole, even at sub-MIC levels, and the effect was greater when DNA repair lesions were more severe. In addition, metronidazole caused cell elongation of E. coli and slowly disappeared from the medium upon incubation with the bacterium. The drug-induced decrease in viable numbers of E. coli was followed by an increase. Most cells in this 'recovery' population were found to be anaerogenic and were relatively unaffected by subsequent exposure to metronidazole. The results show that E. coli consumes and is susceptible to metronidazole, under anaerobic conditions. DNA damage is involved in the antibacterial action of the drug, and E. coli resistant to the drug can be obtained readily in in-vitro incubations.

The efficiency of various solvents in the extraction of chemical mutagens from living tissues: a comparative study

The aim of this study is to find out the best solvent to be used in extraction of chemical pollutants from living organisms. Ethanol, benzene, chloroform, pentane, 1,4-dioxan, acetone, cyclohexane and ether were used in extraction of shrimp and clam samples collected from a Fahaheel site. The tissue extracts were tested for their mutagenic activity using E. coli and Salmonella on tester strains. The results revealed that ethanol was more efficient than other solvent in extraction of chemical mutagens concentrated in clams and shrimps.

Lichen myxedematosus: histochemical study

The case is reported of a diabetic female aged 32 years with lichen myxedematosus. Skin biopsy showed enormous amounts of mast cells (59,000/mm3) and heavy deposition of acid mucopolysaccharides.

Metabolic changes in the serum of partially hepatectomized rats

The factor(s) which trigger the proliferation of liver cells after partial hepatectomy in rats are not yet known with certainty. A series of specific and/or non-specific substances are said to effect the proliferation of liver cells, but metabolic changes after partial hepatectomy possibly also act as a contributory causative factor in the stimulation of those substances. In order to define this question more clearly the changes in the serum concentrations of the following metabolites in the course of time after partial hepatectomy were determined: free fatty acids, cholesterol, triglycerides, glucose, free amino acids and total protein. A reduction in the serum concentrations of some fatty acids and of glucose, and an increase in that of the free amino acids, was observed shortly after partial hepatectomy. The increase in the plasma concentration of immunoreactive glucagon after partial hepatectomy is thus explained and appears not to be of decisive significance for the stimulation of liver cell proliferation after partial hepatectomy.