Targeted Renal Biopsy: Predictors on Imaging

Objectives The renal nephrometry score uses imaging characteristics such as lesion diameter, location, and proximity to hilar vessels to categorize renal masses by complexity for preoperative planning. These characteristics may also be used to determine the best approach to targeted renal biopsy. This study was conducted to investigate the impact of renal lesion characteristics as measured by the renal nephrometry score on the choice of modality used for performing a targeted renal lesion biopsy and increasing the chance of yielding a diagnostic biopsy.

Materials and Methods All targeted computed tomography (CT)/ultrasound-guided renal biopsies performed by our radiology department from January 2017 to February 2020 were reviewed. Radiological characteristics and pathological outcomes were recorded with data on lesion size/ side, location in craniocaudal/anterior–posterior planes, endophytic/exophytic/mixed nature, and skin-lesion distance.

Statistical Analysis Chi-squared tests, multivariate analysis, and t-tests were used in this study.

Results Of the 145 consecutive patients included in the study, 86.2% (125/145) biopsies were diagnostic. About 54.5% (79/145) biopsies were ultrasound-guided, while 45.5% (66/145) were CT-guided. About 62.1% (90/145) biopsies revealed renal cell carcinoma. The highest rate of diagnostic biopsy was in the exophytic, laterally positioned mass either entirely below lower polar or above upper polar line. Ultrasound was preferred for lesions under 4cm and 4 to 7cm (p = 0.06). CT was used for anterior lesions and ultrasound for posterior and lateral lesions (p < 0.001). Of the 20 nondiagnostic biopsies, 7/20 had a repeat biopsy, 7/20 underwent surveillance, 5/20 underwent partial or total nephrectomy, and 1/20 underwent a pathological lymph node biopsy.

Conclusions Our study highlights some factors radiologists should consider when predicting whether CT or ultrasound guidance is more appropriate and the probability of achieving a diagnostic biopsy based on lesion characteristics. At our institution, both modalities achieved high accuracy, although we favored ultrasound in lateral, posterior, and small lesions. These factors should be weighed against local experience and preference.

UV-absorbing benzamide-based dendrimer precursors: synthesis, theoretical calculation, and spectroscopic characterization

Janus (J) and Twin (T) benzamide-based branched structures were synthesized and characterized using theoretical and spectroscopic methods.

Trichoscopic features of hair and scalp in noncomplaining individuals: A descriptive study

BACKGROUND

Trichoscopy is a simple noninvasive tool that is used in calculating different hair parameters and the diagnosis of different hair/scalp diseases at variable magnifications.

OBJECTIVE

The aim of this work is to describe the features and parameters of hair and scalp in a healthy sample of Egyptian population using videodermoscopy. This may help to provide standard range of measurements of normal hair in both males and females.

METHODS

A nonrandomized, observational study for features and parameters of hair structure, performed on 368 healthy Egyptian subjects with no hair/scalp complaint.

RESULTS

Each scalp area has its own vascular pattern. Male subjects showed different values regarding their hair parameters from the female subjects. No significant difference was seen after application of hair dye, except for few values. In both genders, there was a change in hair parameters with age. Smoking had a negative influence on hair parameters.

CONCLUSION

Hair features and parameters observed in our population are different from those reported by other populations. Smoking affects hair thickness and density. Dyed hair has greater thickness mostly due to the protective effect of hair conditioners.

Water quality modeling and management for Rosetta Branch, the Nile River, Egypt

Rosetta Branch (RB) is the Nile western branch, which is considered the main freshwater resource for the western governorates of the Nile Delta, in addition to El-Beheira governorate, Egypt. This work aims to investigate the effectiveness of applying six feasible water quality management scenarios for the RB at Kafr Elzayat (KZ) City, where two major pollution sources (industrial companies and the Tala Drain) are discharging their effluents to the branch. A hydro-ecological model for the branch was developed based on MIKE 11 modeling system (3 modules). The developed model was calibrated using field hydrodynamic and water quality records for the branch during the period from November 2014 to August 2015. The calibrated model results were considered a base case for the simulated management scenarios. According to the study results, diverting the Tala Drain effluents to the nearest main drain will significantly enhance the branch water quality, while diverting of the industrial companies' effluents to the city sewer system will significantly enhance the water quality conditions downstream of the study. The expected scenario of decreasing the RB discharge, due to future climatic changes and/or construction of the new Ethiopian dams, will significantly affect the RB water quality status in a negative way. Urgent management plans, based on the presented scenarios results (or a combination of them), should be applied to enhance the branch water quality. The Tala Drain should be, at least, provided by a water quality treatment plant, and the branch freshwater discharge should be increased.

Upper extremity transvenous access for neuroendovascular procedures: an international multicenter case series

BACKGROUND

Radial artery access for transarterial procedures has gained recent traction in neurointerventional due to decreased patient morbidity, technical feasibility, and improved patient satisfaction. Upper extremity transvenous access (UETV) has recently emerged as an alternative strategy for the neurointerventionalist, but data are limited. Our objective was to quantify the use of UETV access in neurointerventions and to measure failure and complication rates.

METHODS

An international multicenter retrospective review of medical records for patients undergoing UETV neurointerventions or diagnostic procedures was performed. We also present our institutional protocol for obtaining UETV and review the existing literature.

RESULTS

One hundred and thirteen patients underwent a total of 147 attempted UETV procedures at 13 centers. The most common site of entry was the right basilic vein. There were 21 repeat puncture events into the same vein following the primary diagnostic procedure for secondary interventional procedures without difficulty. There were two minor complications (1.4%) and five failures (ie, conversion to femoral vein access) (3.4%).

CONCLUSIONS

UETV is safe and technically feasible for diagnostic and neurointerventional procedures. Further studies are needed to determine the benefit over alternative venous access sites and the effect on patient satisfaction.

Navigating radial artery loops in neurointerventions

BACKGROUND

Although studies continue to demonstrate lower complications in neurointerventions using transradial access (TRA) compared with transfemoral approaches, anatomic radial variants can be difficult to navigate and remain one of the frequent causes of access site conversion.

OBJECTIVE

To evaluate predictors of TRA failure in neuroendovascular patients with radial loops and suggest a protocol for managing these anomalies.

METHODS

A prospective collection of patients undergoing TRA at participating institutions from July 2018 to September 2020 was reviewed. Patients with a radial loop were identified. Patient demographics and procedural characteristics were evaluated to determine predictors of both TRA failure and successful reduction of the radial loop.

RESULTS

We identified 32 transradial neurointerventions in which patients had radial loops. Twenty-two (68.8%) were identified by diagnostic angiography, and the majority were performed for evaluation or treatment of an aneurysm (56.3%). TRA failure occurred in 13 (40.6%) of the cohort and happened more frequently in patients over 60 years of age (p=0.01) and those with recurrent radial artery diameters ≤2 mm (p=0.02). Of the 19 patients who had successful TRA, 12 (63.2%) procedures were performed through the recurrent radial artery.

CONCLUSION

Although radial loops are associated with high transradial failure rates, our results suggest that the presence of a loop is not an absolute contraindication to TRA. Therefore, we recommend attempting loop navigation using our protocol. Patient age, vascular tortuosity, and recurrent radial artery size should help dictate when to convert to an alternative access site.

Multi-modality imaging evaluation of the dorsal arachnoid web

PURPOSE

Dorsal arachnoid web (DAW) is a rare intradural abnormality which is associated with progressive myelopathy. Our objective was to review multi-modality imaging techniques demonstrating the scalpel sign appearance in evaluation of DAW.

METHODS

We retrospectively reviewed various imaging modalities of patients found to have DAW at our institution during January 2015 to February 2020. Five patients underwent surgical decompression with pathological correlation. The remaining patients were presumptively diagnosed based on the characteristic finding of scalpel sign. Clinical data were evaluated and correlated to imaging findings. All imaging modalities demonstrated the characteristic scalpel sign.

RESULTS

Sixteen patients (10 females, and six males) with multi-imaging modalities were evaluated. Their mean age was 52 year (range 23-74 years). Fifteen patients underwent conventional spine MRI. Further high-resolution MR imaging techniques, e.g. 3D T2 myelographic sequence, were utilized with two patients. MRI spine CSF flow study was performed to evaluate the flow dynamic across the arachnoid web in one patient. Eight patients were evaluated with CT myelogram. Syrinx formation was discovered in seven (44%) patients; five (71%) of them underwent surgical resection and decompression. Two patients underwent successful catheter-directed fenestration of the web with clinical improvement. We found a statically significant positive correlation between the degree of cord displacement and compression with syrinx formation (r = 0.55 and 0.65 with p-value of 0.03 and 0.009, respectively).

CONCLUSION

DAW has characteristic scalpel sign independent of imaging modality. Multi-modality imaging evaluation of DAW is helpful for evaluation and surgical planning.

Cross-Sectional Imaging Evaluation of Congenital Temporal Bone Anomalies: What Each Radiologist Should Know

Hearing loss in pediatric age group is associated with many congenital temporal bone disorders. Aberrant development of various ear structures leads into either conductive or sensorineural hearing loss. Knowledge of the embryology and anatomical details of various compartments of the ear help better understanding of such disorders. In general, abnormalities of external and middle ears result in conductive hearing loss. Whereas abnormalities of inner ear structures lead into sensorineural hearing loss. These abnormalities could occur as isolated or part of syndromes. Temporal bone disorders are a significant cause of morbidity and developmental delays in children. Imaging evaluation of children presented with hearing loss is paramount in early diagnosis and proper management planning. Our aim is to briefly discuss embryology and anatomy of the pediatric petrous temporal bones. The characteristic imaging features of commonly encountered congenital temporal bone disorders and their associated syndromes will be discussed.

Neurological involvement and MRI brain findings in an adult with hemolytic uremic syndrome: A case report

Hemolytic uremic syndrome is a frequent complication of shiga toxin producing Escherichia coli in pediatric population. It rarely affects adults with extremely rare neurological manifestation. We present a case of hemolytic uremic syndrome in a 64-year-old male who presented with a bloody diarrhea 30 minutes after eating an expired meat sandwich. Shiga-toxin producing Escherichia coli O157:H7 was confirmed as the causative agent. The patient developed neurological manifestations with persistent encephalopathy that ultimately leads to his death after 22 days of hospitalization. Magnetic resonance imaging findings was significant for signal changes in the thalami, tectum, insulae, and central pons, impressive of hemolytic uremic syndrome.

Implementation of a radial long sheath protocol for radial artery spasm reduces access site conversions in neurointerventions

BACKGROUND

Many neurointerventionalists have transitioned to transradial access (TRA) as the preferred approach for neurointerventions as studies continue to demonstrate fewer access site complications than transfemoral access. However, radial artery spasm (RAS) remains one of the most commonly cited reasons for access site conversions. We discuss the benefits, techniques, and indications for using the long radial sheath in RAS and present our experience after implementing a protocol for routine use.

METHODS

A retrospective review of all patients undergoing neurointerventions via TRA at our institution from July 2018 to April 2020 was performed. In November 2019, we implemented a long radial sheath protocol to address RAS. Patient demographics, RAS rates, radial artery diameter, and access site conversions were compared before and after the introduction of the protocol.

RESULTS

747 diagnostic cerebral angiograms and neurointerventional procedures in which TRA was attempted as the primary access site were identified; 247 were performed after the introduction of the long radial sheath protocol. No significant differences in age, gender, procedure type, sheath sizes, and radial artery diameter were seen between the two cohorts. Radial anomalies and small radial diameters were more frequently seen in patients with RAS. Patients with clinically significant RAS more often required access site conversion (p<0.0001), and in our multivariable model use of the long sheath was the only covariate protective against radial failure (OR 0.061, 95% CI 0.007 to 0.517; p=0.0103).

CONCLUSION

In our experience, we have found that the use of long radial sheaths significantly reduces the need for access site conversions in patients with RAS during cerebral angiography and neurointerventions.

In vivo cerebral aneurysm models

Cerebral aneurysm rupture is a devastating event resulting in subarachnoid hemorrhage and is associated with significant morbidity and death. Up to 50% of individuals do not survive aneurysm rupture, with the majority of survivors suffering some degree of neurological deficit. Therefore, prior to aneurysm rupture, a large number of diagnosed patients are treated either microsurgically via clipping or endovascularly to prevent aneurysm filling. With the advancement of endovascular surgical techniques and devices, endovascular treatment of cerebral aneurysms is becoming the first-line therapy at many hospitals. Despite this fact, a large number of endovascularly treated patients will have aneurysm recanalization and progression and will require retreatment. The lack of approved pharmacological interventions for cerebral aneurysms and the need for retreatment have led to a growing interest in understanding the molecular, cellular, and physiological determinants of cerebral aneurysm pathogenesis, maturation, and rupture. To this end, the use of animal cerebral aneurysm models has contributed significantly to our current understanding of cerebral aneurysm biology and to the development of and training in endovascular devices. This review summarizes the small and large animal models of cerebral aneurysm that are being used to explore the pathophysiology of cerebral aneurysms, as well as the development of novel endovascular devices for aneurysm treatment.

Effect of tramadol addiction alone and its co-abuse with cannabis on urinary excretion of Copper, Zinc, and Calcium among Egyptian addicts

BACKGROUND

The use of illicit drugs has become a worldwide health problem. Substances with the potential to be abused may have direct or indirect effects on physiologic mechanisms that lead to organ system dysfunction and diseases.

OBJECTIVE

The present study aims to investigate the structural and reabsorption integrity of the nephron among Egyptian addicts of tramadol alone and coabused with cannabis.

METHODS

Sixty-five males were included in the study, they were classified into control group (G1=19), tramadol addicts group (G2=18), and tramadol coabused with cannabis addicts group (G3=28). Parameters investigated for structural integrity were urinary levels ofleucineaminopeptidase and N-acetyl-β-D-glucosaminidase, and urinary parameters for reabsorption integrity were levels of copper and zinc as well as calcium, also urinary creatinine was measured. In addition, urinary levels of tramadol and tetrahydrocannabinol were estimated.

RESULTS

Among the two addicted groups, all measured parameters were not significantly different in comparison with the control group except for urinary calcium excretion which was found to be significantly increased among the two addicted groups.

CONCLUSION

Both tramadol addiction alone or coabused with cannabis causes increased urinary excretion of calcium, indicating reabsorption dysfunction of calcium without affecting structural integrity along the nephron.

HIV viral suppression in Oman: Encouraging progress toward achieving the United Nations 'third 90'

OBJECTIVE

To assess the impact of capacity-building interventions introduced by the Oman National AIDS Programme on the quality of HIV care in the country.

METHODS

HIV viral load (VL) suppression and loss to follow-up (LTFU) rates were calculated for the period before (in December 2015; n=1098) and after (in June 2017; n=1185) the introduction of the interventions: training, support, and care pathway development. Three HIV VL cuts-offs at last measurement in the year of interest were used to define VL suppression.

RESULTS

In the intention-to-treat (ITT) analysis, rates of VL <200 copies/ml and <1000 copies/ml increased from 51.9% in 2015 to 65.5% in 2017 (relative risk (RR) 1.26, 95% confidence interval (CI) 1.17-1.36) and from 58.1% in 2015 to 70.9% in 2017 (RR 1.22, 95% CI 1.14-1.30), respectively; p<0.0001 for both. Similarly, in the on-treatment analysis, rates of VL <200 copies/ml and <1000copies/ml increased from 64.2% in 2015 to 76.9% in 2017 (RR 1.20, 95% CI 1.12-1.28) and from 71.9% in 2015 to 83.2% in 2017 (RR 1.16, 95% CI 1.10-1.22), respectively. Fewer patients were LTFU in 2017 than in 2015 (14.7% (157/1061) vs. 19.2% (188/981); RR 0.77, 95% CI 0.64-0.94).

CONCLUSIONS

Achieving the UNAIDS target of 90% of HIV patients on treatment having VL suppression by 2020 is feasible in Oman.

Pyrazole-based compounds in chitosan liposomal emulsion for antimicrobial cotton fabrics

The chemistry of pyrazoles has gained increasing attention due to its diverse pharmacological properties such as antiviral, antagonist, antimicrobial, anticancer, anti-inflammatory, analgesic, anti-prostate cancer, herbicidal, acaricidal and insecticidal activities. 1-Phenyl pyrazole-3, 5-diamine, 4-[2-(4-methylphenyl) diazenyl] and 1H- pyrazole-3 (1), 5-diamine, 4-[2-(4-methylphenyl) diazenyl] (2) were synthesized, characterized and encapsulated into liposomal chitosan emulsions for textile finishing. The chemical modifications of cotton fabrics were demonstrated by infrared analysis. Retention of the fabric mechanical properties was investigated by reporting the tensile strength values. Synthesized pyrazole-based compounds were screened for cytotoxicity against skin fibroblast cell line and showed very limited toxicity for both compounds. Antimicrobial potentials of the treated cotton fabrics were tested against bacterial strains E. coli ATCC 8379 and Staphylococcus aureus ATCC 25923.

Jaundice, phototherapy and DNA damage in full-term neonates

OBJECTIVE

Phototherapy is the standard therapeutic approach for neonatal hyperbilirubinemia. Oxidative effects of phototherapy may have potential harms, including DNA damage. Unconjugated bilirubin (UCB) might also possess antigenotoxic potential. Intensive phototherapy is more efficacious than conventional phototherapy in treating hyperbilirubinemia. This study aimed to assess the impact of hyperbilirubinemia and the two different types of phototherapy on DNA damage in peripheral blood mononuclear cells of neonates.

STUDY DESIGN

The study was conducted on term neonates with non-hemolytic hyperbilirubinemia and control healthy neonates. Genotoxicity was assessed using single-cell gel electrophoresis (Comet assay) in peripheral mononuclear cells. Blood samples were obtained at enrollment in all infants and after intensive or conventional phototherapy in jaundiced infants.

RESULT

DNA damage did not significantly differ between jaundiced and non-jaundiced neonates (11.4±8.7 and 10.9±8.3 arbitrary units (AU), respectively, P=0.58). It increased significantly after exposure to phototherapy compared with prephototherapy values (45.6±14.7 vs 11.4±8.7 AU, respectively, P<0.001). The duration of phototherapy correlated positively with markers of DNA damage (r=0.86, P<0.001); however, the intensity of used light did not significantly impact genotoxicity.

CONCLUSION

Hyperbilirubinemia does not influence DNA damage, whereas both conventional and intensive phototherapy are associated with DNA damage in term infants with hyperbilirubinemia.

Removing arsenic from groundwater in Cambodia using high performance iron adsorbent

In Cambodia, groundwater has been contaminated with arsenic, and purification of the water is an urgent issue. From 2010 to 2012, an international collaborative project between Japan and Cambodia for developing arsenic-removing technology from well water was conducted and supported by the foundation of New Energy and Industrial Technology Development Organization, Japan. Quality of well water was surveyed in Kandal, Prey Veng, and Kampong Cham Provinces, and a monitoring trial of the arsenic removal equipment using our patented amorphous iron (hydr)oxide adsorbent was performed. Of the 37 wells surveyed, arsenic concentration of 24 exceeded the Cambodian guideline value (50 μg L(-1)), and those of 27 exceeded the WHO guideline for drinking water (10 μg L(-1)). Levels of arsenic were extremely high in some wells (>1,000-6,000 μg L(-1)), suggesting that arsenic pollution of groundwater is serious in these areas. Based on the survey results, 16 arsenic removal equipments were installed in six schools, three temples, two health centers, four private houses, and one commune office. Over 10 months of monitoring, the average arsenic concentrations of the treated water were between 0 and 10 μg L(-1) at four locations, 10-50 μg L(-1) at eight locations, and >50 μg L(-1) at four locations. The arsenic removal rate ranged in 83.1-99.7%, with an average of 93.8%, indicating that the arsenic removal equipment greatly lower the risk of arsenic exposure to the residents. Results of the field trial showed that As concentration of the treated water could be reduced to <10 µg L(-1) by managing the As removal equipment properly, suggesting that the amorphous iron (hydr)oxide adsorbent has high adsorbing capacity for As not only in the laboratory environment but also in the field condition. This is one of the succeeding As removal techniques that could reduce As concentration of water below the WHO guideline value for As in situ.

Effect of Physalis peruviana L. on cadmium-induced testicular toxicity in rats

Cadmium (Cd) stimulates the production of reactive oxygen species and causes tissue damage. We investigated here the protective effect of Physalis peruviana L. (family Solanaceae) against cadmium-induced testes toxicity in rats. Twenty-eight Wistar albino rats were used. They were divided into four groups (n=7). Group 1 was used as control. Group 2 was intraperitoneally injected with 6.5 mg/kg body weight (bwt) of cadmium chloride for 5 days. Group 3 was orally treated with 200 mg/kg bwt of methanolic extract of physalis (MEPh). Group 4 was pretreated with MEPh before cadmium for 5 days. Changes in body and testes weights were determined. Oxidative stress markers, antioxidant enzymes, and testosterone level were measured. Histopathological changes of testes were examined, and the immunohistochemical staining for the proapoptotic (caspase-3) protein was performed. The injection of cadmium caused a significant decrease in body weight, while a significant increase in testes weight and testes weight index was observed. Pretreatment with MEPh was associated with significant reduction in the toxic effects of Cd as shown by reduced testicular levels of malondialdehyde, nitric oxide, and caspase-3 expression and increased glutathione content, and the activities of superoxide dismutase, catalase, glutathione reductase, glutathione peroxidase, and testosterone were also increased. Testicular histopathology showed that Cd produced an extensive germ cell apoptosis, and the pretreatment of MEPh in Cd-treated rats significantly reduced Cd-induced testicular damage. On the basis of the above results, it can be hypothesized that P. peruviana L. has a protective effect against cadmium-induced testicular oxidative stress and apoptosis in the rat.

Rapid rituximab infusion, local center experience

Rituximab, a chimeric monoclonal antibody (MoAb) targeting CD20 has been widely used in the management of B-cell lympho-proliferative disorders.(1-3) The usual recommended schedule of regular administration over 3 to 4 hours requires considerable healthcare resources and oftentimes inconvenient for patients. Literature shows the availability of published reports proving the safety and feasibility of rapid infusion of rituximab. This study explored the safety and tolerability of rituximab infusion over a shorter total infusion time. A total of 24 patients diagnosed with CD20+ Non-Hodgkin's lymphoma and planned to receive rituximab at a dose of 375mg/m2 in combination with standard chemotherapy regimens were included in the study from January 2009 to December 2009. The administration of first rituximab dose was unaltered and given as per standard practice of 3-4 hours infusion. The second and subsequent doses were delivered over a total infusion time of only 90 minutes (20% of dose in the first 30 minutes, remaining 80% over the next 60 minutes). These patients, aged between 15 and 79 years, received a total of 152 rituximab infusions with an average of 6.33 (+/-2.37) infusions per patient. Grade 1 infusion related toxicity was reported in 5 infusions (3.2%), and there were no acute reactions or G3/4 toxicity in any infusion episode. A rapid infusion of rituximab is well tolerated, feasible and safe when administered as second and subsequent infusions in the course of therapy for those who tolerate the first dose without significant infusion related toxicity. This shortened infusion method results in a substantial reduction in resource utilization. Our institution has now adopted this as a routine practice.

KEYWORDS

Rituximab, Short infusion, Oman.

Solid State and Dissolution Rate Characterization of Co-Ground Mixtures of Nifedipine and Hydrophilic Carriers

Co-ground powders of the poorly water-soluble drug nifedipine and a hydrophilic carrier, [partially hydrolyzed gelatin (PHG), polyvinylpyrrolidone (PVP), sodium dodecyl sulfate (SDS), hydroxypropyl methylcellulose (HPMC), polyethylene glycol (PEG), urea or Pluronic F108] were prepared in order to improve the dissolution rate of nifedipine. The effects of type of grinding equipment, grinding time, and type of hydrophilic carrier on the crystallinity of nifedipine (x-ray diffraction and differential scanning calorimetry) on the interaction between drug and carriers (differential scanning calorimetry), on the particle size and appearance (scanning electron microscopy), on the wettability (contact angle measurements), and on the drug release were investigated. Grinding nifedipine together with these carriers improved the dissolution rate. PHG-ground mixtures resulted in the fastest dissolution rate followed by PVP, SDS, HPMC, Pluronic, urea, and PEG. This effect was not only due to particle size reduction, which increased in the order PHG<PEG=SDS<Pluronic<drug<urea<HPMC<PVP, but also resulted from the ability of some carriers (PVP and HPMC) to prevent reaggregation of the finely divided drug particles. PVP, HPMC, and PHG formed a powder with amorphous drug. The carriers improved the wettability of the ground products in the order HPMC<drug<urea<PVP<SDS<PHG<PEG<Pluronic. Differential scanning calorimetry (DSC) measurements gave valuable information about the nature of drug crystallinity and the interactions with the carriers within the ground mixtures.

Preparation, characterization and optimization of probucol self-emulsified drug delivery system to enhance solubility and dissolution

The main purposes of this work were to prepare, characterize and optimize a self-emulsified drug delivery system of probucol (PBSEDDS) with enhanced dissolution and better chance for oral absorption. The methods included determination of the solubility of probucol in different oils, surfactants and co-surfactants using saturation solubility method and HPLC for drug analysis. The ingredients showing high drug solubility were used to prepare PBSEDDS after being tested for physical and chemical compatibility with the drug using DSC and FTIR. The prepared formulations were evaluated for droplet size, turbidity, spontaneity of emulsification and dissolution in water. Optimization was performed using a three-factor, three-level Box-Behnken experimental design. The results showed high drug solubility and compatibility with soybean oil (solvent), Labrafil M1944CS (surfactant) and Capmul MCM-C8 (cosurfactant). Oil to surfactant/co-surfactant ratio showed large influence on the characteristics of PBSEDDS. Several fold improvement of drug dissolution was observed compared to drug solution in soybean oil alone. Optimization study showed that observed and predicted values of cumulative percent drug dissolution after 60 min were in reasonable agreement. The experimental design applied helped in understanding the effects and the interaction effects between the independent factors. The prepared PBSEDDS may have the potential to enhance the therapeutic bioavailability of probucol.

A chloroplastic inner envelope membrane protease is essential for plant development

Regulated intramembrane proteolysis (RIP) is a fundamental mechanism for controlling a wide range of cellular functions. Cleavage of membrane embedded proteins results in soluble fragments exerting their function, e.g., as transcription factors and thereby regulating gene expression. This process is highly conserved throughout all kingdom of life as are the involved proteases. RIP has been described in eukaryotes, bacteria and archea though until recently not in plant organelles. Here we describe a chloroplastic membrane protease which belongs to the conserved S2P family of membrane metallo proteases. We show that this protease is localized in the inner envelope membrane and is essential for plant development. It could function in a RIP like process regulating the concordant action in the plant cytosol, nucleus and plastids.

Inner envelope protein 32 is imported into chloroplasts by a novel pathway

The 32 kDa chloroplast inner envelope protein (IEP32) is imported into the organelle in the absence of a cleavable N-terminal pre-sequence. The ten N-terminal amino acids form an essential portion of this targeting information as deduced from deletion mutants. Recognition and translocation of IEP32 is not catalysed by the general chloroplast outer envelope translocon subunits Toc159, Toc75III and Toc34, because IEP32 import is neither inhibited by proteolytic removal of Toc34 and Toc159 nor by inhibition of the Toc75 import channel by CuCl(2) or spermine. Import of IEP32 only requires ATP concentrations of below 20 microM indicating that stromal chaperones are not involved in the process, but that IEP32 might be directly inserted from the intermembrane space into the inner envelope by a so far unidentified pathway. IEP32 may require the assistance of Tic22, an intermembrane space translocon subunit for import as indicated by the presence of a chemical crosslinked product between both polypeptides.

Evaluation of natural radionuclides at Um-Greifat area, eastern desert of Egypt

Air borne radiometric maps and remote sensing techniques were used to explore for the occurrence of radioactive materials. The previous techniques recorded radioactive mineralization for the first time along the NW-SE trending fault zones within the Miocene clastic-carbonate sediments. In the present study, gamma-ray spectrometry was used to confirm the presence of this mineralization. Concentrations of radionuclides, associated within the iron ochre at Um-Greifat area, have been measured, using a hyper-pure germanium spectrometer. The variation in concentration of radionuclides for the area under investigation can be classified into A, B and C regions of high, medium and low natural radioactivity. In region A, average concentration in Bqkg(-1) has been observed to range from 1858 to 4062 for 238U, between 29 and 151 for 232Th, from 60 to 136 for 235U and between 46 and 409 Bqkg(-1) for 40K. Radium equivalent activities (Ra(eq)) in addition to external and internal hazard indices (H(ex), H(in)) have also been determined. Ra(eq) varies between 1901 and 4307Bqkg(-1), which exceeds the permitted value (370Bqkg(-1)) and H(ex) and H(in) are higher than 1. The high activity concentration within region A points to an environmental hazard, while regions B and C have less exposure effect on human beings.

Elemental investigation of some Egyptian vehicle motor alloys using neutron activation analysis

Six samples of different Egyptian motor vehicle alloys have been investigated by neutron activation analysis to estimate the concentrations of their elemental constituents, which affect their quality. A single high resolution hyper-pure germanium HPGe gamma-ray detector and a multichannel analyzer are used to collect the gamma-ray spectra. A HPGe-HPGe coincidence spectrometer was also used to confirm the identity of certain peaks. Thirteen trace elements (Sc, Cr, Fe, Co, Zn, Sn, Sb, La, Sm, Eu, Hf, Pt and Au) were observed in the spectra and their concentrations were determined. A comparative study on the element concentrations for the six samples is given.

Dietary cancer risk from conditional cancerogens (tumor promoters) in produce of livestock fed on species of spurge (Euphorbiaceae). IV. Toxicologic and pathophysiologic observations in lactating goats and their suckling kids fed on the irritant herbs Euphorbia nubica and Euphorbia helioscopia: an etiologic model for investigations on the putative risk of cancer by consumption of food p

The feeding of lactating goats on usual green fodder, contaminated with Euphorbia helioscopia or E. nubica, results in poisoning of the dams as well as their suckling kids. General signs of toxicity were emaciation, depression, shedding of body hair, arching of back, and possible death. Post-mortem changes of dams and dead suckling kids included congestion and hemorrhage in cardiac muscle, lung, liver, and kidneys. Blood analyses of goats exposed to these contaminants showed an increased level of serum alanine amino transferase compared to control samples, indicating cellular destruction in the liver. The latter was confirmed by histopathological changes in the organ which include severe congestion, necrosis, and degenerative changes. The goats also suffered from deterioration of renal function as indicated by increased blood urea nitrogen and creatinine levels. In histopathologic inspections of kidney, severe congestion, hemorrhage in the cortex and medulla, as well as necrosis of epithelial cells of kidney tubules were noticed. Considerable degenerative changes were also observed in heart and lung. The pathophysiological appearances indicate that by feeding on the Euphorbia species mentioned above, the goats are poisoned in a way similar to the case of E. peplus reported previously. Such intoxication most likely is due to irritant and hyperplasiogenic diterpene ester (DTE) toxins, usually present in the aerial parts of Euphorbia species and well known as tumor promoters in mouse skin. After ingestion of the toxic plant parts by the goats, the DTE toxins might be metabolized and thereby partially detoxified. Yet, at least in part, they may show up in the milk of the goats, as indicated by severe poisoning of their suckling kids. As discussed previously in lactating goats fed on fodder contaminated with E. peplus, tumor promoters of the DTE type may enter the human food chain via this source of milk. Such milk may be considered a valuable etiologic model for the investigation of economic, ecologic, and public health problems raised by human diet polluted with tumor promoters, i.e., conditional (non-genotoxic) cancerogens.

Heavy metals and rare earth elements source-sink in some Egyptian cigarettes as determined by neutron activation analysis

Heavy metals and rare earth elements in two types of cigarettes were studied. The contents of trace elements were determined by using delayed neutron activation analysis. In the present study 11 elements have been detected in popular and fine brand cigarettes marketed in Egypt. Evaluation of these elements with their potential hazards for smokers is briefly discussed. The material balance (source and sink) for each element was determined. Also the ratio of element recovery to the total amount was assessed.

Study of environmental isotope distribution in the Aswan High Dam Lake (Egypt) for estimation of evaporation of lake water and its recharge to adjacent groundwater

Oxygen-18 ((18)0) and deuterium isotopes were used to estimate the evaporation from the Aswan High Dam Lake and to investigate the inter-relation between the lake water and adjacent groundwater.According to stable isotopic analysis of samples taken in 1988 and 1989, the lake can be divided into two sections. In the first section extending between Abu Simbel and a point between EI-Alaki and Krosko, a remarkable vertical gradient of (18)0 and deuterium isotopic composition was observed. The second northern sector extending to the High Dam is characterised by a lower vertical isotopic gradient. In this sector in general, higher values of (18)O and deuterium contents were found at the top and lower values at the bottom. Also a strong horizontal increase of the heavy isotope content was observed. Thus, in the northern section evaporation is of dominating influence on the isotopic composition of the lake water.With the help of an evaporation pan experiment it was possible to calibrate the evaporative isotope enrichment in the lake and to facilitate a preliminary estimate of evaporative losses of lake water. The evaporation from the lake was estimated to be about 19% of the input water flow rate.The groundwater around the lake was investigated and samples from production wells and piezometers were subjected to isotopic analysis. The results indicate that recent recharge to the groundwater aquifer is limited to wells near to the lake and up to a maximum distance of about 10 km. The contribution of recent Nile water to the groundwater in these wells was estimated to range between 23 and 70%. Beyond this distance, palaeowater was observed with highly depleted deuterium and (18)0 contents, which was also confirmed by 14c dating. The age of palaeo groundwater in this area can reach values of more than 26,000 years.Recommendations are given for efficient water management of the lake water.

[BCG vaccination of the newborn infant with the 131 Copenhagen strain]

From October 1, 1979 to September 30, 1981 a prospective study on the side-effects of BCG inoculation was conducted in the cities of Duisburg, Essen, and Mülheim, in very close cooperation with practising pediatricians, public health authorities, and obstetric departments. Particular consideration was given to suppurating regional lymphadenitis. In the period covered by the study 21.294 infants from 23.390 live births (i.e., 89%) were BCG-vaccinated using the Copenhagen 1331 strain manufactured by Behringwerke. A suppurating regional lymphadenitis occurred in 66 cases, i.e., a complication rate of 0.3%. The conversion ratio was high. Out of 8.144 documentation forms that could be assessed 6.840 (84%) attested to a positive tuberculin reaction caused by prophylactic test U 4. If the result of this test was negative a second test, after Mendel-Mantoux, strength 10, was used. According to this a total of 7.311, i.e., altogether 98.4% of the inoculation results evaluated, were positive. Both the conversion ratio as well as the incidence of ulcers at the vaccination site depend to a slight degree on the concentration of units in the vaccine which are capable of reproduction, to the extent that at higher concentrations the conversion ratio increases, as does the number of ulcers at the vaccination site.

Rupture of the calcaneal tendon. Treatment by external fixation

Thirty-three consecutive patients with complete ruptures of the calcaneal tendon were treated by external fixation. The patients were assessed both objectively and subjectively, and the results classified as excellent, good, fair and poor. In 30 patients the result was excellent or good. There were no infections or re-ruptures. Two patients with fair results had sural nerve injury. The only patient with a poor result had Sudeck's atrophy. It is felt that this operation satisfies the need for a new technique which is simple and combines the advantages of both surgical and non-surgical treatment without their major complications.