Impact of vitamin D on maternal and fetal health: A review

The role of vitamin D in improving maternal health and reducing the risk of developmental disorders in fetus has been an important domain of research since the past few years. Vitamin D, owing to its immunomodulatory, anti‐inflammatory, developmental roles, and regulating calcium homeostasis, is predicted to have a significant influence on maternal and fetal health status. Several observational studies and clinical trials, determining the impact of vitamin D on gestational diabetes, C‐section, postpartum depression, pre‐eclampsia, miscarriages, and preterm delivery, have been elaborated in this review. In addition, fetal birth defects including neurological development, reduced birth weight, respiratory infections, bone development, and altered anthropometrics have also been summarized with available evidences. Other important mechanisms related to the roles of vitamin D in the body are also explained. Furthermore, recent studies determining the effect of vitamin D at genetic level will also help in understanding and future design of research in the area of maternal and fetal health.

Sensitivity of the Cervical Disc Loads, Translations, Intradiscal Pressure, and Muscle Activity Due to Segmental Mass, Disc Stiffness, and Muscle Strength in an Upright Neutral Posture

Musculoskeletal disorders of the cervical spine have increased considerably in recent times. To understand the effects of various biomechanical factors, quantifying the differences in disc loads, motion, and muscle force/activity is necessary. The kinematic, kinetic, or muscle response may vary in a neutral posture due to interindividual differences in segmental mass, cervical disc stiffness, and muscle strength. Therefore, our study aimed to develop an inverse dynamic model of the cervical spine, estimate the differences in disc loads, translations, intradiscal pressure, and muscle force/activity in a neutral posture and compare these results with data available in the literature. A head–neck complex with nine segments (head, C1–T1) was developed with joints having three rotational and three translational degrees of freedom, 517 nonlinear ligament fibers, and 258 muscle fascicles. A sensitivity analysis was performed to calculate the effect of segmental mass (5th to 95th percentile), translational disc stiffness (0.5–1.5), and muscle strength (0.5–1.5) on the cervical disc loads (C2–C3 to C7–T1), disc translations, intradiscal pressure, and muscle force/activity in a neutral posture. In addition, two axial external load conditions (0 and 40 N) were also considered on the head. The estimated intradiscal pressures (0.2–0.56 MPa) at 0 N axial load were comparable to in vivo measurements found in the literature, whereas at 40 N, the values were 0.39–0.93 MPa. With increased segmental mass (5th to 95th), the disc loads, translations, and muscle forces/activities increased to 69% at 0 N and 34% at 40 N axial load. With increased disc stiffness (0.5–1.5), the maximum differences in axial (<1%) and shear loads (4%) were trivial; however, the translations were reduced by 67%, whereas the differences in individual muscle group forces/activities varied largely. With increased muscle strength (0.5–1.5), the muscle activity decreased by 200%. For 40 vs. 0 N, the differences in disc loads, translations, and muscle forces/activities were in the range of 52–129%. Significant differences were estimated in disc loads, translations, and muscle force/activity in the normal population, which could help distinguish between normal and pathological cervical spine conditions.

Up-regulation of GINS1 highlighted a good diagnostic and prognostic potential of survival in three different subtypes of human cancer

Cancer is a fatal malignancy and its increasing worldwide prevalence demands the discovery of more sensitive and reliable molecular biomarkers. To investigate the GINS1 expression level and its prognostic value in distinct human cancers using a series of multi-layered in silico approach may help to establish it as a potential shared diagnostic and prognostic biomarker of different cancer subtypes. The GINS1 mRNA, protein expression, and promoter methylation were analyzed using UALCAN and Human Protein Atlas (HPA), while mRNA expression was further validated via GENT2. The potential prognostic values of GINS1 were evaluated through KM plotter. Then, cBioPortal was utilized to examine the GINS1-related genetic mutations and copy number variations (CNVs), while pathway enrichment analysis was performed using DAVID. Moreover, a correlational analysis between GINS1 expression and CD8+ T immune cells and a the construction of gene-drug interaction network was performed using TIMER, CDT, and Cytoscape. The GINS1 was found down-regulated in a single subtypes of human cancer while commonly up-regulated in 23 different other subtypes. The up-regulation of GINS1 was significantly correlated with the poor overall survival (OS) of Liver Hepatocellular Carcinoma (LIHC), Lung Adenocarcinoma (LUAD), and Kidney renal clear cell carcinoma (KIRC). The GINS1 was also found up-regulated in LIHC, LUAD, and KIRC patients of different clinicopathological features. Pathways enrichment analysis revealed the involvement of GINS1 in two diverse pathways, while few interesting correlations were also documented between GINS1 expression and its promoter methylation level, CD8+ T immune cells level, and CNVs. Moreover, we also predicted few drugs that could be used in the treatment of LIHC, LUAD, and KIRC by regulating the GINS1 expression. The expression profiling of GINS1 in the current study has suggested it a novel shared diagnostic and prognostic biomarker of LIHC, LUAD, and KIRC.

Sero-epidemiology and risk factor analysis of human brucellosis in Punjab, Pakistan: a cross sectional study

Human brucellosis is a neglected zoonotic problem worldwide with a high degree of morbidity in humans and is mostly overlooked due to other febrile conditions. The aim of this study was to evaluate the sero-prevalence and risk factors of human brucellosis among subjects living in Punjab, Pakistan. In this cross-sectional study, human blood samples were collected from seven districts of Punjab, Pakistan. Information regarding personal data, demographic data and potential risk factors was collected through a structured questionnaire. Detection of anti-Brucella antibodies was done through Rose Bengal Plate Test (RBPT) and Enzyme Linked Immunosorbent Assay (ELISA). Descriptive analysis, Chi square test and Odds ratio was applied using STATA software version 12. The sero-prevalence of human brucellosis was 13.13% with significantly higher percentage in males 17.23% and age group 25-40 years 16.50% (P=< 0.001). The demographic factors positively associated with human brucellosis were lack of education (P = 0.003; OR = 1.85) and farming as an occupation (P =<0.001; OR = 2.50) Similarly, among the risk factors studied, keeping animals at home (P =<0.001; OR = 2.03), slaughtering of animals (P =<0.001; OR = 15.87) and consuming raw milk (P =<0.001; OR = 5.42) were the factors strongly connected with human brucellosis. A massive awareness should be given to livestock farmers and individuals directly linked to animals regarding risk factors and transmission of brucellosis. Consumption of unpasteurized milk and its products should be condemned to curtail this neglected disease.

Nanotechnology: A novel tool to enhance the bioavailability of micronutrients

Nanotechnology has revolutionized the field of food systems, diagnostics, therapeutics, pharmaceuticals, the agriculture sector, and nutraceuticals. Nanoparticles are playing important role in giving the solution to enhance bioavailability of oral delivery of bioactive compounds. This review revealed that nanoparticles can improve the bioavailability of micronutrients, for example, vitamin B12, vitamin A, folic acid, and iron. However, toxicity associated with nanoparticle-based delivery systems is still a major concern after ingestion of nano-based supplements. The mode of the mechanism of nanomaterial along with bioactive components in different physiological conditions of the human body is also a major gap in the field of nanoceuticals. In the future, more evidence-based clinical investigations are needed to confirm the exact approach to physiological changes in the human body.

Investigating the structural properties and in vitro digestion of rice flours

The physicochemical properties, swelling power, solubility, and digestibility of flour from four rice varieties (black, brown, white, and waxy rice flour) were analyzed. The results showed that the black and brown rice had high-amylose percentage (21.8% and 20.5%), a relatively low percentage of starch content (68.1% and 79.1%), and lower swelling power (6.6% and 7.6%) and solubility (13.5% and 15.7%), respectively. Waxy rice flour attributed to lower gelatinization temperatures and higher enthalpy values. Meanwhile, the brown, black, and white rice showed higher gelatinization temperature and lower enthalpy value. The black and brown rice flour exhibited lower pasting and viscosity values as compared to waxy rice flour. The results showed that all rice flour had an A-type X-ray diffraction pattern, and after cooking all rice flour showed V-type polymorphs except waxy rice flour. Brown and black rice flour after cooking have lower digestion rate than white rice and waxy rice flour, probably due to its lower expansion and solubility rates, and higher gelatinization temperature.

Preventive role of propolis against hyperglycemia and hyperlipidemia in Sprague dawley rats (Rattus norvegicus) animal modelling system

Human diets with functional ingredients showed promising role in management of diseases of modern age like hyperglycemia and hyperlipidemia and even cancer. The study designed to elucidate role of honeybee propolis for management of hyperglycemia and hyperlipidemia states through animal modeling system. Hydroalcoholic extract of propolis was used for development of functional drink with standard recipe and addition of specified dose of extracts (400mg/500mL). Animals were grouped into three studies including study-I fed on regular diet, study-II fed on sucrose enrich diet and study-III fed on diet enriched with cholesterol and monitored to evaluate the results. Various parameters like feed consumption, liquid intake of animals measured regularly whereas body weight recorded at the end of each week of study. At the end of the study animals were analyzed for different blood indicators like blood lipid indices (cholesterol, LDL, HDL concentration and triglyceride contents)), glucose concentration and insulin contents as well. The maximum feed and drink intake were examined in animals, fed with control diet whereas a non substantial mode of intake was recorded in rest of two groups of animals. The consumption of honeybee propolis based drink reduced cholesterol (6.63% to 10.25%) and LDL (9.96% to 11.23%), whilst a sharp increase in HDL level was ranged as 4.12 to 4.49% among animal groups fed with high cholesterol and high sucrose diet. Blood glucose level was decreased by 10.25% and 6.98% however 6.99% and 4.51% increase were observed in plasma insulin level in both studies, study-II and study-III correspondingly. The overall findings of the study showed that drinks prepared using propolis of propolis found effective for management of hyperglycemia and hypercholesterolemia in present animal modelling system.

Chemical profiling, HPLC characterization and in-vitro antioxidant potential of Pakistani propolis collected from peripheral region of Faisalabad

Propolis is a highly adhesive and resinous product of honey bee (Apis mellifera L.) which is produced from the exudations of plants. Bee propolis being a source of bioactive compounds like polyphenols and flavonoids imparts numerous biological properties including, antioxidant, anti-inflammatory, antimicrobial and anticancer activities. Present study was designed to elucidate the composition and antioxidant status of locally available propolis using in-vitro conditions. Propolis collected from locally found apiaries and its hydroalcoholic extract of propolis was prepared using different concentrations of ethanol and methanol. The results regarding proximate composition of propolis showed a higher proportion of ether extract (85.59±0.87%) and lowest contents of crude fiber (0.31±0.08%). Among the mineral's sodium, potassium and calcium was found in a concentration of 11.33±0.91, 52.10±2.9 and 10.53±0.83.59±0.23mg/Kg respectively whilst zinc was noticed as 3.59±0.23mg/Kg. HPLC characterization indicates a highest concentration of Chlorogenic acid 31.80±2.56mg/Kg whereas gallic acid (0.21±0.01mg/Kg) was found in lowest concentration among the polyphenols. Ethanol extract represents more phenolic contents, DPPH activity and antioxidant status as 327.30±14.89mg/gGAE, 73.18±4.43% and 60.59±4.38% accordingly in comparison to methanol and water extract. Bee propolis found an effective source of natural antioxidants which retards the production of free radicals and reactive oxygen species thus help to cope oxidative stress.

Adolescent Tillaux Fractures: A Systematic Review of the Literature

The Tillaux fracture is an uncommon injury to the anterolateral distal tibial epiphysis. It occurs during a distinct time period when adolescent patients are transitioning to skeletal maturity. Owing to its rarity, the optimal management strategy for this fracture is not well-described. The aim of this review was to assess the outcomes of operatively and nonoperatively managed displaced adolescent Tillaux fractures. We analysed articles from The Cochrane Library, PubMed, MEDLINE, and EMBASE databases that met our predetermined inclusion and exclusion criteria according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. A descriptive data analysis was performed. A total of 461 articles were identified from the data search, of which 13 articles were included for full-text analysis. Five of these studies reported recognised patient outcome measures and the remaining eight reported on radiographic follow-up. The reported studies included a total of 114 patients with Tillaux fractures; 58.8% of patients were female and 34.2% were male. Mean ages ranged from 12.5 to 15 years, with the youngest patient being 12 years old and the oldest 17 years old. Overall mean follow-up was 42.8 months. Of the patients, 40.4% were treated with open reduction internal fixation (ORIF), 14.9% with closed reduction internal fixation (CRIF), and 1.8% arthroscopically. The remainder were treated nonoperatively. Outcome measures were excellent for all patients irrespective of operative management choice. Follow-up radiographic deformity was only evident in Tillaux fractures that were managed nonoperatively; deformity included poor joint congruity, angular deformity, and tibial shortening. These nonoperative patients have a residual fracture displacement of 2 mm. There were no reported instances of premature physeal closure for any patient. This review shows that excellent patient outcomes have been reported for different methods of operative fixation, however, study sizes are small and data is sparse. Further robust comparative studies are required to identify definitive conclusions. The use of established clinical and radiographic outcome measures will help improve the quality of future studies for this relatively rare injury.

Management of Gunshot Injuries of Mandible with Open Reduction and Internal Fixation versus Closed Reduction and Maxillo-mandibular Fixation

Background/objectives

Gunshot injuries are known to cause severe morbidity and mortality when facial regions are involved. Management of the gunshot wounds of the face comprises of securing an airway, controlling hemorrhage, identifying other injuries and definite repair of the traumatic facial deformities. The objective of the present study was to compare the clinical outcome (infection and nonunion) of open reduction and internal fixation versus closed reduction and maxillo-mandibular fixation (CR-MMF) in the treatment of gunshot injuries of the mandible.

Materials & methods

This study was conducted at Oral and Maxillofacial Surgery Department of Shaheed Zulfiqar Ali Bhutto Medical University/Pakistan Institute of Medical Sciences Islamabad, Pakistan. Ninety gunshot mandibular fractures were randomly allocated in two equal groups. In group-A, 45 patients were treated by open reduction and internal fixation while in group-B, 45 patients were also managed by closed reduction and maxillo-mandibular fixation. Post-operative complications (infection, non-union) were evaluated clinically and radiographically in both groups.

Results

Patients treated by open reduction and internal fixation were having more complications in terms of infection (17.8%) as compared to closed reduction (4.4%) with a p-value 0.044. Whereas non-union was more in closed reduction (15.6%) as compared to open reduction and internal fixation group (2.2%) with a significant p-value 0.026.

Conclusion

Both the treatment modalities can be used in the management of gunshot injuries of mandible and there is need for further studies to have clear guideline in this regard in best interest of patients, community and health care providers.

Descriptive Sensory Analysis of Pizza Cheese Made from Mozzarella and Semi-Ripened Cheddar Cheese Under Microwave and Conventional Cooking

The present study used descriptive sensory analysis (DSA) to compare Pizza cheeses prepared from various combinations of fresh Mozzarella and semi-ripened Cheddar cheeses and cooked under conventional and microwave cooking methods. A cheese sensory lexicon was developed, and descriptive sensory profiles of the Pizza cheeses were evaluated using a panel of semi-trained judges (n = 12). The following characteristics, flavor (cheddar, acidic, rancid, bitter, salty, creamy, and moldy), texture (stringiness, stretchability, firmness, and tooth pull), and appearance (meltability, oiliness, edge browning, and surface rupture) of Pizza cheeses were analyzed and compared with control samples. The sensory analysis of Pizza cheeses showed more preference toward a higher level of ripened Cheddar cheese (4 months), which was cooked using the microwave. However, the scores for texture properties were decreased with the addition of the semi-ripened cheese. The scores for stretchability and tooth pull were high in the microwave cooked samples compared with the conventionally cooked samples. The appearance attributes (meltability, oiliness, and edge browning) scores were increased with the increasing of ripened Cheddar cheese content while surface rupture was decreased. Microwave cooked Pizza cheese showed better meltability and oiliness but lower edge browning scores. The results showed that amalgamations of fresh Mozzarella and semi-ripened Cheddar cheese had a significant (p < 0.05) and positive effects on the sensory qualities of Pizza cheeses.

Effect of age and sex on lumbar lordosis and the range of motion. A systematic review and meta-analysis

Lumbar lordosis (LL) and the range of motion (RoM) are important physiological measurements when initiating any diagnosis and treatment plan for patients with low back pain. Numerous studies reported differences in LL and the RoM due to age and sex. However, these findings remain contradictory. A systematic review and meta-analysis were performed to synthesize mean values and the differences in LL and the RoM because of age and sex. The quality assessment tool for quantitative studies was applied to assess the methodological quality of the studies included. We identified 2372 papers through electronic (2309) and physical (63) searches. We assessed 218 full-text studies reporting measurements of LL or the RoM. In total, 65 studies were included, and a normative database for LL and the RoM is provided as supplementary material. Among these, 11 were included in the meta-analysis. LL and the RoM displayed non-monotonic variations with significant age and sex differences. Young females showed a significantly greater LL and the range of extension (RoE), whereas young males exhibited a greater range of flexion (RoF). Sex differences in the range of lateral bending (RoLB) were small but were significant for the axial rotation (RoAR). For the RoF, RoE and RoLB, differences because of age were significant among most of the age groups in both sexes, whereas for the RoAR, differences were significant only between the 20s vs the 30s-40s (males) and 40s vs 50s (females). Significant differences because of age/sex were identified. However, the age-dependent reduction in LL and the RoM was non-monotonic and differed in both sexes. These findings will help to better distinguish between functional deficits caused by spinal disorders and natural factors/conditions related to age and sex.

Predicting intertrochanteric extension of greater trochanter fractures of the hip on plain radiographs

INTRODUCTION

It is important to distinct between isolated greater trochanter (GT) fractures and complete intertrochanteric (IT) extension to prevent unwanted morbidities. Aim of this study was to determine if there was any particular fracture pattern, of GT fractures on a plain radiograph of the hip which could predict IT extension.

METHOD

Retrospective review of radiographs of 49 patients with a GT fracture who presented in the last 10 years (January 2005-December 2015). All images were reviewed by a consultant musculoskeletal radiologist and an orthopaedic surgeon. The AP plain radiographs were assessed to look for fracture angle and length of the fracture. The fracture length was taken as a percentage and was measured as the length of the fracture crossing the intertrochanteric line/the total length of the intertrochanteric line. The fracture angle was measured as the angle between a line drawn from the most superior point of the fracture on the lateral cortex of the GT, to a perpendicular line along the medial cortex of the femoral shaft. The subsequent MRI and CT scans were assessed to see if there was true intertrochanteric extension.

RESULTS

32 patient were female and 17 male. 27 CT scans of which 8 showed complete IT extension. 22 had MRI scan of which 6 showed complete extension. The mean fracture length of patients with complete extension was 56% with a range of 50%-63%. The mean fracture length of patients with incomplete extension was 33% with a range of 12%-55%. The mean fracture angle for patients with complete extension was 39° with a range of 35-42°. The mean fracture angle for patients with incomplete extension was 58° with a range of 44-124°.

CONCLUSION

For greater trochanter fractures that do not cross >50% of the IT line and do not have a fracture angle between 35 and 42° do not require further imaging as they will not have complete intertrochanteric extension.

Serum albumin and fixation failure with cannulated hip screws in undisplaced intracapsular femoral neck fracture

Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%-19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60-101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality.

Mutagenic effect of acridine orange on the expression of penicillin G acylase and beta-lactamase in Escherichia coli

AIMS

The present work aimed to improve the production of penicillin G acylase (PGA) and reduce the beta-lactamase activity through acridine orange (AO) induced mutation in Escherichia coli.

METHODS AND RESULTS

Three wild E. coli strains BDCS-N-FMu10, BDCS-N-S21 and BDCS-N-W50, producing both the enzymes PGA and beta-lactamase were treated by AO. Minimum inhibitory concentration of AO was 10 microg ml(-1) and it was noted that bacterial growth was gradually suppressed by increasing the concentration of AO from 10 to 100 microg ml(-1). The highest concentration that gave permissible growth rate was 50 microg ml(-1). The isolated survivals were screened on the bases of PGA and beta-lactamase activities. Among the retained mutants, the occurrence of beta-lactamase deficient ones (91%) was significantly higher than penicillin acylase deficient ones (27%).

CONCLUSIONS

In seven of the mutants, PGA activity was enhanced with considerable decrease in beta-lactamase activity. One of the mutant strains (BDCS-N-M36) exhibited very negligible expression of beta-lactamase activity and twofold increase in PGA activity [12.7 mg 6-amino-penicillanic acid (6-APA) h(-1) mg(-1) wet cells] compared with that in the wild-type strain (6.3 mg 6-APA h(-1) mg(-1) wet cells).

SIGNIFICANCE AND IMPACT OF THE STUDY

The treatment of E. coli cells with AO resulted in mutants with enhanced production of PGA and inactivation of beta-lactamase. These mutants could be used for industrial production of PGA.

Same admission colostomy closure: a prospective, randomised study in selected patient groups

BACKGROUND

Despite a recent trend towards primary repair, colostomy still has an important place in the management of different colorectal pathologies. Timing of colostomy closure is a debatable issue among general surgeons. We carried out a prospective, randomised study to compare the outcome after same admission colostomy closure (SACC) and conventional delayed colostomy closure (CDCC) in patients with predominantly traumatic injury of the large bowel.

METHODS

Sixty patients, the majority with traumatic colorectal pathologies, were prospectively randomised to SACC [30 patients, 23 men, mean age 27.9 +/- 9.7 (range, 18-65) years] or (CDCC) [30 patients, 24 men, mean age 28.6 +/- 10.6 (range, 18-63) years]. All colostomies were closed using an intraperitoneal closure technique. Pre-operative data and post-operative outcomes were collected and analysed.

RESULTS

A total of seven patients (23.3%) with SACC developed complications compared with eight patients (26.6%) having CDCC (p = 0.83). The mean hospital stay (p < 0.01), as well as the overall cost (p < 0.001), were significantly less in the SACC group.

CONCLUSIONS

Same admission colostomy closure is a safe and cost-effective technique for colostomy closure in selected groups of patients.

School peer relationships of 'minority' children in Scotland

This paper examines selected issues arising from two studies in mainstream education of two minority groupings of children in Scotland-those with serious medical conditions and refugee children-completed in 1997 and 1999, respectively. It draws on first-person accounts of children, parents and teachers and focuses on school-based peer relationships, including friendships. Many of the described peer experiences were unhappy or mixed, only a minority were positive. The paper relates the research and its findings to current social and educational policy contexts and to theories on peer relationships, friendship and rejection. It challenges the problematizing of groups or individuals with minority experiences and school staff's acceptance of inevitable difficulty in these children's peer relationships. It hypothesizes that ways of developing all children's peer relationships need to be addressed in schools if the well-being of children who may be socially vulnerable is to be improved.

Modulation of growth of human prostate cancer cells by the N-acetylcysteine conjugate of phenethyl isothiocyanate

There is growing evidence that thiol conjugates of isothiocyanates present in cruciferous vegetables are effective cancer chemopreventive and potentially active therapeutic agents. The effects of the N-acetylcysteine conjugate of phenethyl isothiocyanate (PEITC-NAC) on tumor cell growth were analyzed in human prostate cancer cell lines LNCaP, androgen-dependent, and DU-145, androgen-independent. Exposure of the cells to PEITC-NAC at high concentrations caused cytolysis, while at lower concentrations PEITC-NAC mediated a dose-dependent growth modulation, with reduction of DNA synthesis and growth rate, inhibition of clonogenicity and induction of apoptosis in both types of prostate cancer cells. PEITC-NAC decreased cells in S and G2M phases of cell cycle, blocking cells entering replicating phases. In parallel, a significant enhancement of cells expressing the cell cycle regulator p21 as well as its intensity was determined using a fluorescent antibody technique. The action of PEITC-NAC was time-dependent, with the magnitude of inhibition increasing to 50-65% after PEITC-NAC exposure for several days. Interaction of tumor cells with dissociation products of PEITC-NAC, PEITC and NAC, are proposed as the mechanism of growth regulation.