Blood schizontocidal activity of azithromycin and its combination with α/β arteether against multi-drug resistantPlasmodium yoelii nigeriensis, a novel MDR parasite model for antimalarial screening

Many different drug-resistant lines of rodent malaria are available as screening models. It is obligatory to screen new compounds for antimalarial activity against a series of resistant lines in order to identify a compound with potential for the treatment of multi-drug resistant (MDR) malaria infections. Instead of using a battery of resistant lines, a single MDRPlasmodium yoelii nigeriensisstrain that shows a wide spectrum of drug resistance to high doses of chloroquine, mepacrine, amodiaquine, mefloquine, quinine, quinidine, halofantrine as well as tetracyclines, fluoroquinolines and erythromycin, was used to assess the blood schizontocidal efficacy of a new macrolide azithromycin and other antibiotics. The present study shows that only azithromycin has the potential to control an MDRP. y. nigeriensisinfection in Swiss mice, provided the treatment with a dose of 50–100 mg/kg/day by oral route is continued for a period of 7 days. Tetracycline, oxytetracycline, doxycyline, erythromycin, ciprofloxacin and norfloxacin, although activein vitro, failed to protect the mice. Tetracycline, ciprofloxacin and norfloxacin combinations with chloroquine did not control the infection. Additionally, the antimalarial efficacy of azithromycin can be potentiated with the addition of arteether, which is an ethyl ether derivative of artemisinin. A total (100%) curative effect has been obtained with a shorter regimen of 4 days only.

Mefloquine resistance reversal action of ketoconazole – a cytochrome P450 inhibitor, against mefloquine-resistant malaria

Plasmodium knowlesi (W1) shows a high level of innate resistance to mefloquine as shown by recrudescence of blood-induced infection in rhesus monkeys, following oral mefloquine treatment with up to 80-160 mg/kg total dose over 3-4 days. Ketoconazole, at a dose of 75 mg/kg/day x 10 days given orally to P. knowlesi-infected rhesus monkeys, exerted a suppressive antimalarial effect in 1 of the 2 monkeys as evidenced by a delayed recrudescence (on day 30) and curative action in case of the other monkey, whereas a lower dose of ketoconazole (25 mg/kg/day x 10 days) failed to suppress infection effectively. When ketoconazole at a low dose (25 mg/kg/day x 10 days) treatment was combined with mefloquine (20 mg/kg/ day x 4), 1 of the 2 infected monkeys was cured, while the combination of a higher dose of ketoconazole (75 mg/kg/day x 10 days) with mefloquine (20 mg/kg/day x 4), had a complete curative effect on P. knowlesi infection in all the treated monkeys (7/7). Besides exerting direct antimalarial action against a mefloquine-resistant P. knowlesi, ketoconazole also acts as an inhibitor of hepatic microsomal CYP4503A, which regulates and slows down mefloquine biotransformation to carboxymefloquine, resulting in a possible elevation of the effective plasma drug level, which seems to be responsible for elimination of the resistant P. knowlesi. The study shows a resistance reversal effect of a ketoconazole - mefloquine combination that could be exploited for the control of mefloquine-resistant malaria infection. The study shows that ketoconazole can reverse mefloquine resistance of P. knowlesi. These findings can also be applied to reverse mefloquine resistance of P.falciparum in areas where mefloquine resistance is already established. The precise role of parasite CYP450 in mefloquine resistance and its possible role, if any, in expelling the intracellular mefloquine from the resistant plasmodia still remains to be elucidated.

Demonstration of a simple technique for determining the M/# of a holographic substrate by use of a single exposure

We propose and demonstrate a simple technique for determining the M/# parameter of a holographic recording material. In this method, divergent object and reference beams are used to produce a spatially varying index modulation. One can analyze the resultant diffraction pattern to find M/# by using only a single grating; existing techniques require many gratings.

Superparallel holographic correlator for ultrafast database searches

We describe a superparallel holographic optical correlator that performs two-dimensional spatial and angular multiplexing simultaneously. The key step in this architecture is the use of a holographic multiplexer to split a query image into many copies before it applies them to the holographic database. A holographic demultiplexer, in conjunction with an aperture, is used to identify the location and the angle of the brightest correlation peak. This architecture uses only O(square root of N) detector elements to search through N unsorted images in a single query. We demonstrate the basic features of this architecture, using three spatial locations with eight angle-multiplexed images in each location.

Synthesis of glycosylated beta-amino acids as new class of antitubercular agents

A series of glycosylated beta-amino acids was prepared and evaluated against Mycobacterium tuberculosis, M. avium, M. fortuitum and M. smegmatis. The compounds were designed to mimic the enzyme D-alanine racemase and glycosyl transferase involved in the biosynthesis of essential cell wall peptidoglycan and arabinogalactan. Though most of the compounds exhibited little activity, however, one showed significant activity against all the strains in cell culture and activity was confirmed by BACTEC method.

Curcumin-induced differentiation of mouse embryonal carcinoma PCC4 cells

Curcumin, a natural component of turmeric extracted from the rhizomes of Curcuma longa, is known to exhibit a number of biological properties. In the present study, curcumin, at low concentration, was shown to induce differentiation in embryonal carcinoma cell line PCC4. In response to curcumin, PCC4 cells ceased to proliferate and showed cell cycle arrest at G1 phase after 4 hours of treatment, followed by their differentiation which is characterized by increase of nuclear/cytoplasmic ratio. The expression of hsp 70 was also seen upon 8 h of curcumin treatment, and it remained constant up to 48 h. Differentiated cells also expressed a series of differentiation markers such as lamin A, well-established actin, and keratin cytoskeleton. We used mRNA differential display analysis to identify the genes that are regulated during curcumin-induced differentiation of PCC4 cells. We cloned and sequenced three partial cDNAs that were differentially expressed in normal and differentiated cells. Sequence comparison of one downregulated cDNA (Al) has shown homology to a gene present on mouse chromosome five, while the two upregulated cDNA (C1 and C7) are homologous to several mouse ESTs clones from organs of mesodermal origin. We have identified the full-length coding sequence of the Cl fragment with a putative amino acid sequence. Tissue-specific Northern with RNA from adult mouse organs with the C1 fragment alone showed hybridization with mRNA from several tissues, whereas the same Northern with only the coding sequence showed expression of C1 gene mainly in the adult kidney. Homology search revealed that C1 sequence is part of the 3' UTR and may be common to several genes expressed in many tissues. Thus, curcumin appears to differentiate embryonal carcinoma cell PCC4, and one of the upregulated genes seems to be expressed mainly in the adult kidney.

Trapdoor internal valvuloplasty--a new technique for primary deep vein valvular incompetence

OBJECTIVES

to describe a new technique of exposure of the valve commissure, called the "Trapdoor" Internal Valvuloplasty (TIV), to treat primary deep vein valvular incompetence.

MATERIAL AND METHODS

the TIV method involves partial transverse incisions which are joined together by a vertical incision to create a virtual "trapdoor" at the target vein valve, providing optimum access to repair the insufficient valve. In 17 consecutive patients (25 limbs) TIV has been successfully employed for 41 valvular repairs since August 1999. All patients had open non-healing or recurrent venous ulcers.

RESULTS

on mean follow-up of six months (clinical assessment of venous ulcer healing and by colour-coded Duplex scans at 1, 3, 6, 9 and 12 months), of the 41 valves repaired by TIV technique, 39 valves (95%) maintained full patency. Thirty-four valves (85%) achieved primarily a VCT <0.5 s without reflux at the target valves on Valsalva manoeuvre in the upright position. Eighty-four percent of all ulcers (n=25) healed within 8 weeks of surgery without recurrence during the follow-up period.

CONCLUSION

the Trapdoor Internal Valvuloplasty (TIV) represents a novel technique, which has the advantages of being both technically less demanding and anatomically better defined. Furthermore, TIV is physiologically acceptable and enables accurate localisation of valve cusp defects while allowing comprehensive, anatomical repair of valvular deficiencies.

Nonlinear processing and fractional-order filtering in a joint fractional fourier-transform correlator: performance evaluation in multiobject recognition

We investigated the correlation performance of a joint fractional Fourier-transform correlator (JFRTC) using computer simulation results. We present a mathematical analysis suggesting use of processing techniques based on a nonlinear transformation and fractional-order fractional-power fringe-adjusted filter to attain improved performance in terms of discrimination sensitivity and input space-bandwidth utilization. Optimal noise performance for the JFRTC is predicted in the presence of additive white Gaussian noise. An all-optical implementation scheme based on incoherent erasure in a photorefractive crystal is proposed.

Serum 25-hydroxyvitamin D and parathyroid hormone in patients with ankylosing spondylitis before and after a three-week rehabilitation treatment at high altitude during winter and spring

Does a sojourn at high altitude during the winter and spring improve vitamin D status (and possibly suppress parathyroid hormone [PTH]) in patients with ankylosing spondylitis (AS)? In 73 patients with AS, serum concentrations of 25-hydroxy-vitamin D [25(OH)D] and PTH were determined before and after a three-week rehabilitation treatment at Bad Gastein (1000 m above sea level). At the first examination, serum 25(OH)D was median (25th, 75th percentile) 15.5 ng mL-1 (10.0 ng mL-1, 20.6 ng mL-1). Thirteen patients (18%) had a 25(OH)D concentration below 8 ng mL-1. In 53 patients (73%) the level was below 20 ng mL-1. After the sojourn, 25(OH)D significantly (p = 0.02) increased to 19.7 (11.3, 24.6) ng mL-1. PTH did not change significantly, being 32 (22.4, 43.9) pg mL-1 before and 30.3 (24.1, 39.9) pg mL-1 after the sojourn. Analysing different periods of sojourn, a significant (p < 0.001) increase in 25(OH)D was found in April but not in the other months. Patients with ankylosing spondylitis may have extremely low levels of 25(OH)D. The results of the present study suggest that a sojourn at high altitude in early spring is liable to reduce vitamin D deficiency.

Antifilarial activity of some 2H-1-benzopyran-2-ones (coumarins)

Six synthetic 2H-1-benzopyran-2-one (cournarin) derivatives (CDRI compounds # 1, 2, 3, 4, 5 and 6) were evaluated for filaricidal activity against Litomosoides carinii and Acanthocheilonema viteae infections in cotton rats (Sigmodon hispidus) and Mastomys coucha respectively. Significant effects on macrofilariae (>80% death/sterilisation) were detected with compounds #2, 3 and 6 against L. carinii and/or A. viteae. Thus detection of filaricidal activity in benzopyrones, which are so far known for anti-inflammatory activity, provides a new lead for development of better filaricidal agents for combating filariasis.

Pyronaridine: an effective antimalarial against multidrug-resistant malaria

Pyronaridine, administered intramuscularly (im) to Swiss mice infected with the lethal multidrug-resistant Plasmodium yoelii nigeriensis, was found to exert high blood schizontocidal activity. The efficacy of doses of pyronaridine ranging from 0.625 to 30 mg (base/kg) was evaluated using a 4 day treatment schedule (drug was administered at 0, 24, 48 and 72 hrs). It was found that doses of 2.5mg/ kg and higher protected animals completely from the lethal effects of the parasite. The same degree of protection was found when the treatment duration was reduced to 3 days. This study shows that pyronaridine is a potentially useful antimalarial drug that could be exploited for the control of multidrug-resistant malaria infection.

Characterization of N-myristoyltransferase from Plasmodium falciparum

The gene coding for myristoyl-CoA:protein N-myristoyltransferase (NMT) has been cloned from the malaria parasite Plasmodium falciparum. The gene appears to be single copy and mRNA is expressed in asexual blood-stage forms. Comparison of cDNA and genomic sequences identified three small introns. The open reading frame codes for a 410-amino-acid protein and no evidence of forms with an extended N-terminal coding sequence was obtained. Residues important in substrate binding and in the catalytic mechanism in other species are conserved. The protein was expressed from a plasmid in Escherichia coli, partially purified and shown to have enzymic activity using a synthetic peptide substrate. Comparison of the malaria parasite protein with that derived from the human gene showed a different pattern of inhibition by chemical modification. Human NMT activity was inhibited by diethylpyrocarbonate and partially inhibited by iodacetamide, whereas P. falciparum NMT activity was not inhibited by either pre-treatment. Since the enzyme in infectious fungi is a target for potential chemotherapeutic drugs, it should also be investigated in the context of parasitic infections such as that responsible for malaria.

Plasmodium yoelii nigeriensis (MDR)-efficacy of oral pyronaridine against multidrug-resistant malaria in Swiss mice

A multidrug-resistant strain of Plasmodium yoelii nigeriensis (MDR) showing a wide spectrum of resistance to chloroquine, amodiaquine, mepacrine, mefloquine, halofantrine, quinine, and quinidine was used in this study for in vivo evaluation of the blood schizontocidal activity of pyronaridine, a topoisomerase II inhibitor, in Swiss mice. The parasite produces 100% lethal infection in mice. The drug was administered orally once a day from day 0 onward. The initial studies showed that low doses of pyronaridine (0.625 to 5.0 mg base/kg x9 days) did not completely control blood-induced P. yoelii nigeriensis infection. Finally a series of doses of pyronaridine ranging from 1.25 to 30.0 mg/kg administered orally for 7 consecutive days were evaluated and in spite of high level of resistance to standard antimalarials, the parasite P. yoelii nigeriensis has shown complete susceptibility to pyronaridine (15 mg/kg dose x7 days). The present paper also compares the merits of a single MDR strain vs a battery of different resistant lines for quick antimalarials screening.

Use of a fluorescence plate reader for measuring kinetic parameters with inner filter effect correction

A general method is presented here for the determination of the Km, kcat, and kcat/Km of fluorescence resonance energy transfer (FRET) substrates using a fluorescence plate reader. A simple empirical method for correcting for the inner filter effect is shown to enable accurate and undistorted measurements of these very important kinetic parameters. Inner filter effect corrected rates of hydrolysis of a FRET peptide substrate by hepatitis C virus (HCV) NS3 protease at various substrate concentrations enabled measurement of a Km value of 4.4 +/- 0.3 microM and kcat/Km value of 96,500 +/- 5800 M-1 s-1. These values are very close to the HPLC-determined Km value of 4.6 +/- 0.7 microM and kcat/Km value of 92,600 +/- 14,000 M-1 s-1. We demonstrate that the inner filter effect correction of microtiter plate reader velocities enables rapid measurement of Ki and Ki' values and kinetic inhibition mechanisms for HCV NS3 protease inhibitors.

Duplication of insertion element IS50 associated with Tn5 transposition in Azospirillum brasilense

The characterization of a DNA fragment with a Tn5 insertion in a regulatory nif gene of Azospirillum brasilense is reported. Restriction endonuclease mapping, Southern hybridization with a Tn5 probe, and nucleotide sequencing revealed that IS50 had duplicated in Tn5. The duplication of an IS50 element suggests the occurrence of a replicative mechanism of transposition. A strategy, based on the bacterial ability of homologous recombination that was used to precisely eliminate Tn5 along with the duplicated IS50 element, is presented.

[Effect of a positive family history on the prognosis in patient with Bechterew disease]

The objective of the present study was to evaluate whether the patients with a family history of ankylosing spondylitis might have a milder course of the disease than patients with a negative family history. We investigated a group of 197 patients with ankylosing spondylitis who had been suffering from symptoms of the disease for > or = 20 years. After exclusion of the patients with a history, or current evidence of colitis or urethritis, the remaining 148 patients with ankylosing spondylitis (none with psoriasis) were divided into 2 groups on the basis of a positive (25 patients) or a negative (123 patients) family history of ankylosing spondylitis. The variables of mobility were compared. Furthermore, the present height was compared with the former (maximum) height. All variables measured in the present study showed slightly better results in the patients with a positive family history, but the differences were not significant. The decrease of height was slightly larger in patients with a positive family history. Evidently, a positive family history does not appear to give a reliable prediction of the long-term prognosis in Austrian and German patients with ankylosing spondylitis.

Gametocytocidal activity of alpha/beta arteether by the oral route of administration

Arteether (alpha/beta) (a mixture of alpha and beta enantioners) has been reported to possess gametocytocidal activity against Plasmodium cynomolgi B when the drug is given by the intramuscular route, but it would be preferable to use oral route therapy for gametocyte carriers. This is a report of a study of the gametocytocidal action of arteether administered by the oral route. The results indicate high levels of activity at 10 mg/kg in a single dose or in two divided doses when given orally.

Sodium beta-artelinate--a new potential gametocytocide

The water-soluble artemisinin analogue sodium beta-artelinate, a fast-acting blood schizontocide, was evaluated for gametocytocidal action against simian malaria Plasmodium cynomolgi B, and a single dose of the compound has been found to be an effective gametocytocide by both oral and intravenous routes. The compound was able to sterilize the circulating gametocytes in rhesus monkey, resulting in loss of mosquito infectivity and oocyst development in the Anopheles stephensi. However, no sporontocidal action has been observed with this compound.

Effectiveness of apraclonidine and acetazolamide in preventing postoperative intraocular pressure spikes after extracapsular cataract extraction

We studied the effectiveness of two prophylactic agents in controlling early postoperative intraocular pressure (IOP) increases after cataract surgery. Fifty-four nonglaucomatous patients received either topical 1% apraclonidine, one drop before and after surgery, or sustained-release acetazolamide, 500 mg, or no medication at the completion of planned extracapsular cataract extraction (ECCE). Mean baseline IOPs were similar among patients randomized to the apraclonidine, acetazolamide, and control groups: 15.29 mm Hg, 15.33 mm Hg, and 14.26 mm Hg, respectively. At 3 hours postoperatively, IOPs were significantly lower in the apraclonidine group (11.13 mm Hg, P = .035), nonsignificantly lower in the acetazolamide group (13.3 mm Hg, P = .17), and significantly increased in the control group (21.32 mm Hg, P = .003). One eye in the apraclonidine group and six in the control group had IOPs greater than 30 mm Hg. At 24 hours, the only statistically significant difference was in the control group, whose mean IOPs remained elevated (21.83 mm Hg, P = .0008). One eye in the apraclonidine group, two in the acetazolamide group, and five in the control group had IOPs greater than 30 mm Hg. We found a significant early IOP reduction with apraclonidine given topically preoperatively and at the completion of planned ECCE.

MR observations on the effects of praziquantel in neurocysticercosis

Eight patients with neurocysticercosis treated with praziquantel (PZQ) were studied with serial MR imaging to demonstrate the early effects of the drug in brain lesions. Increase in cyst size and appearance of pericystic edema were observed as early as 24 hr, followed by gradual degeneration of the scolex and cyst contents. Cysts showed varied degree of response to the drug and in their rate of disappearance. MRI was found to be a sensitive technique to objectively document early changes in the parasite and patterns of response to the cysticidal drug in brain cysticercosis.

Comparison of antimalarial efficacy of alpha, beta, and alpha/beta arteether against Plasmodium cynomolgi B infection in monkeys

The blood schizontocidal activity of alpha and beta arteether has been compared with that of alpha/beta arteether (a 30:70 mixture of alpha and beta isomers), which is a fast-acting blood schizontocide undergoing phase I clinical trials at the Central Drug Research Institute. Both beta and alpha/beta arteether have comparable activity and are curative at a dose of 5 mg/kg for 3 days against blood-induced Plasmodium cynomolgi B infection in the rhesus monkey; alpha arteether alone is slightly less active, with a 50% cure rate at the above dose.

Gametocytocidal activity of the antimalarial alpha/beta arteether against Plasmodium cynomolgi B

A new sesquiterpene lactone alpha/beta arteether (a 30:70 mixture of enantiomers), which possesses very high blood schizontocidal activity, has been evaluated for gametocytocidal/sporontocidal action against Plasmodium cynomolgi B infection in the rhesus monkey. This paper reports gametocytocidal action of this new antimalarial drug at 2.5-5 mg/kg (single im dose) against P. cynomologi B as shown by the complete absence of mosquito infectivity. No sporontocidal action was demonstrable in the vector at a dose of up to 20-50 mg/kg im.

Study of the gametocytocidal/sporontocidal action of qinghaosu (artemisinin) by electron microscopy

The gametocytocidal efficacy of artemisinin (qinghaosu) was evaluated and scanning electron microscopical evidence is given for gametocytocidal action of a single 5-10-mg/kg dose of artemisinin against simian malarial parasite (Plasmodium cynomolgi B). No sporontocidal effect of artemisinin was observed.

Perivascular and intervascular reticular fibers of the retina

We demonstrated the existence in the retina of an argyrophilic perivascular membrane comparable in all respects to that which exists throughout the vascular system. We compared our findings by light microscopy with those previously reported. We identified, by electron microscopy, the normal general location of the network between the basal laminae of the glial and vessel cells and demonstrated its selective staining with silver methenamine. These perivascular fibers, intercapillary strands, and bridges develop in relation to the process of retinal vascularization and the potential for forming these fibers is reactivated in senility and disease, as in diabetes. We summarized the evidence by concluding that these fibers are most likely composed of reticulin; it appears provable that in the past there may have been some confusion with neural fibers.

Pathogenesis of hypertensive retinopathy. An experimental study in the monkey

Retinal changes in accelerated hypertension were studied in seventeen monkeys with experimental hypertension by means of ophthalmoscopy and colour and flourescence photography during life, and by injection and digest preparations and light and electron microscopy after the animals had been killed. Cotton-wool spots developed in all but three monkeys. The arteries became tortuous and dilated and the light reflex decreased in those animals that became hypertensive. The earliest abnormality was a development of many points of fluorescein leakage on terminal arterioles or small arteries. Such leaking points were always present in relation to cotton-wool spots but were not confined to such areas. Focal narrowing of arteries was not observed but arteriolar occlusion and retrograde filling of the distal segment was present in three animals. Superficial linear haemorrhages were noted in five animals. Light microscopy revealed cotton-wool spots which were identical to those observed in man with a collection of swollen axons containing densely staining pseudonuclei. Study of the arterioles by electron microscopy showed findings ranging from normality to extensive necrosis. Many precapillary arteries were constricted and some were virtually occluded. Degenerative changes were present in smooth muscle cells in the wall of many of the constricted arterioles. Many arteries also showed insudation into their wall of plasma which had seeped into the muscular coat displacing and sometimes entirely replacing the smooth muscle cells. Except for arterioles with advanced necrosis, there was no indication of how plasma insudation occurred. Two arterioles with extensive necrosis showed a break within the endothelial cell cytoplasm through which penetration of plasma proteins had probably occurred. The extravascular tissues showed collections of amorphous material, sone of it with the typical banded configuration of fibrin. The sequence of events proposed to explain these features is as follows: (1) The arterioles constrict as the pressure rises, most likely as a result of vascular autoregulation. This may head to occlusion of the precapillary arterioles and is associated with necrosis of vascular smooth muscle. (2) Dilatation then occurs with insudation of plasma into the unsupported wall through a damaged endothelium. This stage probably corresponds to the autoregulatory break-point and is evidenced clinically by focal leakage of fluorescein. (3) Progressive plasma insudation into the vessel wall with further muscle necrosis results in secondary occlusion and the typical picture of advanced fibrinoid necrosis.

Electron microscopical study of Coat's disease

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Kayser-Fleischer ring. A pathological study

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