Achieving integrated disease surveillance in the Eastern Mediterranean Region

Access to reliable and timely information is key for healthcare decision-making at the regional, national and sub-national levels. However, lack of access to such information hampers to progress towards achievement of the Sustainable Development Goals (SDGs) in the Eastern Mediterranean Region (EMR), as indicated in the Regional Progress Report on Health-Related Sustainable Development Goals.

Histologic comparison of formocresol, platelet-rich fibrin, and hesperidin in pulpotomy: A randomized trial in dogs

Aims

To histologically assess and compare formocresol (FC), platelet-rich fibrin (PRF), and hesperidin (HPN) as pulpotomy agents in dogs.

Materials and Methods

Pulpotomy was attempted from the buccal surface (class V) of 48 teeth in three mongrel dogs (Canis Lupus). Cavities were randomly allocated for three groups (n = 16) according to the pulpotomy agent used; (group I: FC (control), group II: PRF, and group III: HPN). All cavities were then sealed with zinc oxide eugenol followed by resin-modified glass ionomer restoration. Two months later, dogs were euthanized; the specimens were obtained and prepared for histological assessment followed by statistical analysis.

Results

HPN specimens showed the best dentin bridge formation and the least inflammatory signs and pulp disorganization. Followed without statistically significant difference by PRF (P ≥ 0.05). Both of HPN and PRF, however, showed a significant difference statistically (P ≤ 0.05) to FC that showed no dentin bridging with more pronounced inflammation, necrosis, and pulp disorganization.

Conclusions

For pulpotomy, HPN and PRF seemed histologically to be good substitutes for FC in the dog model.

Impact of miR-155 (rs767649 A>T) and miR-146a (rs57095329 A>G) polymorphisms in System Lupus Erythematosus susceptibility in an Egyptian cohort

OBJECTIVE

Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory disease. miR-155 and miR-146a were expressed in many autoimmune diseases such as rheumatoid arthritis. The aim of this study was to examine miR-155 rs767649 and miR-146a rs57095329 polymorphisms in SLE susceptibility in an Egyptian cohort and to investigate the correlation between them and clinical data and disease activity.

PATIENTS AND METHODS

The two SNPs were analyzed in 120 patients with SLE and 100 healthy controls using RT-PCR.

RESULTS

The TT genotype and T allele of miR-155 rs767649 were associated with a significant increase in the risk of SLE, particularly in females. On the other hand, miR-146a (rs57095329) polymorphism was not associated with SLE risk. The AT/TT genotypes of miR-155 rs767649 showed higher distributions among patients with higher SLEDAI and nephritis.

CONCLUSIONS

This study had demonstrated for the first time the association between miR-155 rs767649 and the risk of development of SLE in an Egyptian cohort, mostly in females.

Prevalence of erectile dysfunction among Saudi type 2 diabetic patients

OBJECTIVES

The present study aimed to determine the prevalence and etiology of erectile dysfunction in Saudi type 2 diabetic patients.

PATIENTS AND METHODS

429 Saudi type 2 diabetic male patients aged more than 30 years were recruited. Total and bio-available serum testosterone, sex hormone binding globulin and free testosterone levels were measured by ELISA-IBL GMBH Germany.

RESULTS

47 (12.6%) subjects had hypogonadism with total testosterone < 8 nmol/l and 109 (29.3%) had possible hypogonadism with a total testosterone between 8 and 12 nmol/l. Similarly, using bioavailable levels, 30 (8%) men had overt hypogonadism with bioavailable testosterone < 2.5 nmol/l and 89 (33.9%) men had possible hypogonadism with bioavailable testosterone between 2.5-4 nmol/l; while 266 (71.6%) patients with free testosterone < 0.255 nmol/l had hypogonadism. BMI and waist circumference were both significantly negatively correlated with testosterone levels in Saudi type 2 diabetic men.

CONCLUSIONS

Testosterone levels are frequently low in Saudi men with type 2 diabetes and majority of these patients have symptoms of hypogonadism. The prevalence of erectile dysfunction (ED) was 86.7% in diabetic men with low testosterone level of 8-12 nmol/L. Obesity is an associated factor with low testosterone levels and ED in Saudi type 2 diabetic patients.

The effect of pulsed electromagnetic radiation from mobile phone on the levels of monoamine neurotransmitters in four different areas of rat brain

BACKGROUND

The use of mobile phones is rapidly increasing all over the world. Few studies deal with the effect of electromagnetic radiation (EMR) on monoamine neurotransmitters in the different brain areas of adult rat.

AIM

The aim of the present study was to investigate the effect of EMR on the concentrations of dopamine (DA), norepinephrine (NE) and serotonin (5-HT) in the hippocampus, hypothalamus, midbrain and medulla oblongata of adult rats.

MATERIALS AND METHODS

Adult rats were exposed daily to EMR (frequency 1800 MHz, specific absorption rate 0.843 W/kg, power density 0.02 mW/cm2, modulated at 217 Hz) and sacrificed after 1, 2 and 4 months of daily EMR exposure as well as after stopping EMR for 1 month (after 4 months of daily EMR exposure). Monoamines were determined by high performance liquid chromatography coupled with fluorescence detection (HPLC-FD) using their native properties.

RESULTS

The exposure to EMR resulted in significant changes in DA, NE and 5-HT in the four selected areas of adult rat brain.

CONCLUSIONS

The exposure of adult rats to EMR may cause disturbances in monoamine neurotransmitters and this may underlie many of the adverse effects reported after EMR including memory, learning, and stress.

Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital

OBJECTIVE

To assess the frequency and nature of adverse events to patients in selected hospitals in developing or transitional economies.

DESIGN

Retrospective medical record review of hospital admissions during 2005 in eight countries.

SETTING

Ministries of Health of Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen; the World Health Organisation (WHO) Eastern Mediterranean and African Regions (EMRO and AFRO), and WHO Patient Safety.

PARTICIPANTS

Convenience sample of 26 hospitals from which 15,548 patient records were randomly sampled.

MAIN OUTCOME MEASURES

Two stage screening. Initial screening based on 18 explicit criteria. Records that screened positive were then reviewed by a senior physician for determination of adverse event, its preventability, and the resulting disability.

RESULTS

Of the 15,548 records reviewed, 8.2% showed at least one adverse event, with a range of 2.5% to 18.4% per country. Of these events, 83% were judged to be preventable, while about 30% were associated with death of the patient. About 34% adverse events were from therapeutic errors in relatively non-complex clinical situations. Inadequate training and supervision of clinical staff or the failure to follow policies or protocols contributed to most events.

CONCLUSIONS

Unsafe patient care represents a serious and considerable danger to patients in the hospitals that were studied, and hence should be a high priority public health problem. Many other developing and transitional economies will probably share similar rates of harm and similar contributory factors. The convenience sampling of hospitals might limit the interpretation of results, but the identified adverse event rates show an estimate that should stimulate and facilitate the urgent institution of appropriate remedial action and also to trigger more research. Prevention of these adverse events will be complex and involves improving basic clinical processes and does not simply depend on the provision of more resources.

Variations in amino acid neurotransmitters in some brain areas of adult and young male albino rats due to exposure to mobile phone radiation

BACKGROUND AND OBJECTIVES

Mobile phone radiation and health concerns have been raised, especially following the enormous increase in the use of wireless mobile telephony throughout the world. The present study aims to investigate the effect of one hour daily exposure to electromagnetic radiation (EMR) with frequency of 900 Mz (SAR 1.165 w/kg, power density 0.02 mW/cm2) on the levels of amino acid neurotransmitters in the midbrain, cerebellum and medulla of adult and young male albino rats.

MATERIALS AND METHODS

Adult and young rats were divided into two main groups (treated and control). The treated group of both adult and young rats was exposed to EMR for 1 hour daily. The other group of both adult and young animals was served as control. The determination of amino acid levels was carried out after 1 hour, 1 month, 2 months and 4 months of EMR exposure as well as after stopping radiation.

RESULTS

Data of the present study showed a significant increase in both excitatory and inhibitory amino acids in the cerebellum of adult and young rats and midbrain of adult animals after 1 hour of EMR exposure. In the midbrain of adult animals, there was a significant increase in glycine level after 1 month followed by significant increase in GABA after 4 months. Young rats showed significant decreases in the midbrain excitatory amino acids. In the medulla, the equilibrium ratio percent (ER%) calculations showed a state of neurochemical inhibition after 4 months in case of adult animals, whereas in young animals, the neurochemical inhibitory state was observed after 1 month of exposure due to significant decrease in glutamate and aspartate levels. This state was converted to excitation after 4 months due to the increase in glutamate level.

CONCLUSION

The present changes in amino acid concentrations may underlie the reported adverse effects of using mobile phones.

Paediatric CT examinations in 19 developing countries: frequency and radiation dose

The aims of this study were to investigate the frequency of computed tomography (CT) examinations for paediatric patients below 15 y of age in 128 CT facilities in 28 developing countries of Africa, Asia and Eastern Europe and to assess the magnitude of CT doses. Radiation dose data were available from 101 CT facilities in 19 countries. The dose assessment was performed in terms of weighted CT dose index (CTDI(w)), volume CT index and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. The results show that on average the frequency of paediatric CT examinations was 20, 16 and 5 % of all CT examinations in participating centres in Africa, Asia and Eastern Europe, respectively. Eleven CT facilities in six countries were found to use adult CT exposure parameters for paediatric patients, thus indicating limited awareness and the need for optimisation. CT images were of adequate quality for diagnosis. The CTDI(w) variations ranged up to a factor of 55 (Africa), 16.3 (Asia) and 6.6 (Eastern Europe). The corresponding DLP variations ranged by a factor of 10, 20 and 8, respectively. Generally, the CTDI(w) and DLP values in Japan are lower than the corresponding values in the three regions in this study. The study has indicated a stronger need in many developing countries to justify CT examinations in children and their optimisation. Awareness, training and monitoring of radiation doses is needed as a way forwards.

Patient doses in CT examinations in 18 countries: initial results from International Atomic Energy Agency projects

The purpose of this prospective study at 73 facilities in 18 countries in Africa, Asia and Eastern Europe was to investigate if the CT doses to adult patients in developing countries are higher than international standards. The dose assessment was performed in terms of weighted computed tomography dose index (CTDIw) and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. Except in one case, the mean CTDIw values were below diagnostic reference level (DRL) while for DLP, 17 % of situations were above DRLs. The resulting CT images were of adequate quality for diagnosis. The CTDIw and DLP data presented herein are largely similar to those from two recent national surveys. The study has shown a stronger need to create awareness and training of radiology personnel as well as monitoring of radiation doses in many developing countries so as to conform to the ALARA principle.

Mechanisms for the diminished neutrophil exudation to secondary inflammatory sites in infected patients with a systemic inflammatory response (sepsis)

OBJECTIVE

To determine the mechanism for the reduced polymorphonuclear neutrophil exudation to secondary inflammatory sites in critically ill patients with infection and systemic inflammatory response (sepsis).

DESIGN

Prospective cohort study.

SETTING

Research laboratory and integrated intensive care unit of a tertiary care university-affiliated teaching hospital.

PATIENTS

Healthy subjects or critically ill patients with confirmed infection and a systemic inflammatory response (septic patients).

MEASUREMENTS AND MAIN RESULTS

We found that polymorphonuclear neutrophil delivery to a secondary inflammatory site (skin window blisters) is reduced by >70% in humans with sepsis, defined as serious infection and a systemic inflammatory response compared with healthy controls. The expression of the endothelial adhesion molecules intercellular adhesion molecule-1, E-selectin and P-selectin in microvessels from skin biopsies was comparable in the two study groups. Also, CD11a and CD11b levels were equal in circulating polymorphonuclear neutrophils (PMNs) from both study groups. Both adhesion molecules were markedly and equally up-regulated during exudation. Circulating PMNs from septic patients showed marked shedding of L-selectin compared to those of healthy controls, with a corresponding increase in their plasma L-selectin levels. An increased concentration gradient between plasma and exudate fluid was found for tumor necrosis factor-alpha and interleukin-8 in septic patients, but not for C5a. The phagocytic and bactericidal capacity of septic patient circulating PMNs was higher then in healthy control patients, but these differences were lost after exudation. There were no major differences in oxidative burst or intracellular calcium flux of circulating PMNs from the two study groups. Polymorphonuclear neutrophil exudation primed both responses to different extents.

CONCLUSIONS

Septic patients deliver fewer PMNs to secondary inflammatory sites. In addition, neutrophil exudation results in loss of the small priming effect for phagocytosis and bactericidal function induced by sepsis. Failure to produce a gradient to C5a and intravascular shedding of L-selectin may be responsible for this sepsis-induced reduction in neutrophil exudation to secondary inflammatory sites.

Double closed loop obstruction and perforation in a previous Roux-en-Y gastric bypass

A healthy 45-year-old woman with a previous Roux-en-Y gastric bypass presented with the signs, symptoms and blood analysis results consistent with acute pancreatitis. She was initially treated nonoperatively and subsequently went into circulatory shock. Computerized tomographic scan and exploratory laparotomy revealed a volvulus of the afferent jejunal limb with secondary obstruction, necrosis, and perforation of the bypassed stomach.

Increased plasma von Willebrand factor in the systemic inflammatory response syndrome is derived from generalized endothelial cell activation

OBJECTIVES

Von Willebrand factor antigen (vWf) is an essential hemostatic protein. Increased plasma levels have been documented in patients suffering from the systemic inflammatory response syndrome (SIRS) and resulted presumably from endothelial cell damage specific to the site of injury. We hypothesize that increased plasma levels result from systemic endothelial cell activation and degranulation.

DESIGN

We compared immunohistochemical vWf staining in dermal biopsy specimens from patients with SIRS to healthy control subjects in the presence and absence of recombinant human tumor necrosis factor (rhTNF)-alpha. Also, we quantified plasma levels of vWf in these groups using a newly available antibody.

SETTING

A tertiary care surgical intensive care unit in a university teaching hospital.

SUBJECTS

Patients with SIRS and healthy controls.

INTERVENTIONS

Biopsies and blood samples were obtained from study groups.

MEASUREMENTS AND MAIN RESULTS

Decreased baseline vWf staining was noted in SIRS patients. The rhTNF-alpha caused a statistically significant decrease in vWf staining in control subjects but not in SIRS patients. Plasma vWf levels were increased an average of 11-fold in SIRS patients compared with control subjects.

CONCLUSION

We postulate that the increased plasma levels of vWf and the decreased staining in the peripheral dermal plexus represent the generalized activation and degranulation of endothelium in vascular beds remote from the original inflammatory focus.

Endothelial cells: role in infection and inflammation

Infection and resulting sepsis continue to be important causes of morbidity and mortality in surgical patients. Although much has been learned about the pathogens and the leukocyte responses to these pathogens, we are only beginning to understand the role of the host in these pathologies. The endothelium is a dynamic participant in cellular and organ function rather than a static barrier as it was once believed. Emerging evidence implicates the endothelium as a central effector in the inflammatory response. Through the expression of surface proteins and secretion of soluble mediators, the endothelium controls vascular tone and permeability, regulates coagulation and thrombosis, and directs the passage of leukocytes into areas of inflammation. Derangements in these normal functions may contribute significantly to a maladaptive inflammatory response leading to systemic inflammation and multiple organ failure.

Reserpine effects on neurotransmitters in chick heart during growth

Effects of tranquilizing agents on neurotransmitters in the heart have not been widely studied. Thus, the effect of intraperitoneal injection of reserpine, (2.5 mg/kg bw) on the concentrations of excitatory (glutamic acid, glutamine, aspartic acid, asparagine), inhibitory (GABA, glycine, alanine, taurine), neurotransmitters as well as the enzymes (GOT and GPT) and total protein were measured in both heart and serum chicks at different ages (1, 7, 30, 90 and 180 days). Reserpine induced a decrease in the excitatory amino acids and an increase in GABA in both heart and serum in most ages. Glycine and alanine increased in the heart and decreased in serum. Taurine increased in the heart of young ages (1 and 7 days) and decreased in older ones (90 and 180 days), however, it decreased in serum of most ages. Both GOT and GPT increased in heart but, in serum, GOT increased and GPT decreased in most ages. Total protein increased in the heart of young chicks and decreased in the 90- and 180-day-old chicks. In conclusion, reserpine induced a parallel decrease in the ratio glutamate, glutamine, aspartate/GABA in both myocardial tissue and serum of the different age groups. Changes observed in neurotransmitters of the heart suggest that these amino acids may play a similar role in the myocardial tissue, as is described in the central nervous system.

Decreased neutrophil L-selectin expression in patients with systemic inflammatory response syndrome

OBJECTIVE

To determine whether the expression of L-selectin is reduced in patients with systemic inflammatory response syndrome (SIRS) compared with control subjects, to test the effect of exudation of neutrophil L-selectin expression, and to measure soluble serum concentrations of shed L-selectin in the two groups.

DESIGN

Prospective study.

SETTING

Intensive care unit in a tertiary care hospital (Royal Victoria Hospital, Montreal).

PATIENTS

Twenty-five patients with SIRS and 20 healthy, age-matched controls.

INTERVENTIONS

Collection of exudate neutrophils from skin window and circulating neutrophils from venous blood.

OUTCOME MEASURES

Neutrophil L-selectin levels, measured with the use of fluorocytometry, and soluble L-selectin levels, measured with the use of enzymelinked immunosorbent assay.

RESULTS

There is a significant reduction in L-selectin expression on circulating neutrophils in patients with SIRS, compared with control subjects. Exudation of neutrophils to an extravascular site resulted in a dramatic down-regulation of L-selectin in both groups. Serum levels of soluble L-selectin were higher in patients with SIRS than in control subjects.

CONCLUSIONS

The loss of L-selectin may be partly responsible for reduced neutrophil exudation to extravascular sites in patients with SIRS.

Shedding of L-selectin as a mechanism for reduced polymorphonuclear neutrophil exudation in patients with the systemic inflammatory response syndrome

BACKGROUND

It has been recently shown that patients with the systemic inflammatory response syndrome (SIRS) have reduced neutrophil exudation.

OBJECTIVE

To determine whether reduced neutrophil exudation, seen in patients with SIRS, is related to differential expression of cell adhesion molecules (CAMs), by studying endothelial and neutrophil CAM expression.

SETTING

A tertiary care surgical intensive care unit in a university teaching hospital.

DESIGN

Twenty-six patients with SIRS were compared with 18 healthy age-matched control subjects. Blister-type skin windows were created. Exudative neutrophils were harvested, and CAM expression was quantitated by using flow cytometry. Endothelial CAM expression was studied with immunohistochemical methods by using skin biopsy specimens that were taken following subdermal injections of saline solution or tumor necrosis factor alpha.

RESULTS

Despite a significant reduction in neutrophil exudation in patients, we found no difference in the baseline expression of the endothelial intercellular adhesion molecule 1, P-selectin, or E-selectin in patients vs that in control subjects. There was a significant increase in E-selectin staining in response to recombinant human tumor necrosis factor alpha in patients with SIRS, but not in control subjects. However, up-regulation of P-selectin did not occur in patients in response to recombinant human tumor necrosis factor alpha, as was observed in control subjects. L-selectin expression on circulating neutrophils was lower in patients than in control subjects, while soluble serum L-selectin levels were higher.

CONCLUSIONS

Alterations in neutrophil L-selectin, not endothelial CAMs, are important in decreased neutrophil exudation. Reduced levels of neutrophil L-selectin associated with increased levels of serum L-selectin in patients with SIRS suggest premature intravascular shedding of neutrophil L-selectin. This would compromise the initial interaction between neutrophils and the endothelium, and, consequently, impede exudation.

Expression of human neutrophil L-selectin during the systemic inflammatory response syndrome is partly mediated by tumor factor alpha

BACKGROUND

Rolling of neutrophils on the vascular endothelium is a requisite step to transmigration to areas of infection or inflammation, and this is regulated in part by the neutrophil cell adhesion molecule L-selectin.

OBJECTIVES

To compare L-selectin expression in patients with systemic inflammatory response syndrome (SIRS) and healthy age-matched control subjects and to determine whether tumor necrosis factor alpha modulates L-selectin expression on human neutrophils.

SETTING

A tertiary care surgical intensive care unit at a university teaching hospital.

SUBJECTS

Patients identified with SIRS (American College of Critical Care Physicians and Society of Critical Care Medicine criteria) were compared with healthy age-matched control subjects. Venous blood samples that were obtained from healthy laboratory control subjects were used to examine the time course of L-selectin expression.

MAIN OUTCOME MEASURES

Neutrophil L-selectin expression was determined by flow cytometry in patients with SIRS and control subjects. Tumor necrosis factor alpha concentrations were determined in blood and exudative fluid from patients with SIRS. Neutrophil L-selectin expression was measured during a 45-minute time course in the presence of recombinant human tumor necrosis factor alpha and N-formyl-methionyl-leucyl-phenylalanine.

RESULTS

Circulating neutrophils from patients with SIRS had significantly less L-selectin expression than did control subjects. Tumor necrosis factor alpha at concentrations similar to those found in exudative fluid caused a dose- and time-dependent decrease in neutrophil L-selectin expression.

CONCLUSION

Tumor necrosis factor alpha may act as a paracrine modulator of site-specific neutrophil rolling, adhesion, and exudation via mechanisms that involve the down-regulation of L-selectin.

Comparative study between different diagnostic techniques in huge splenomegaly cases in El-Minia Province

Fifty four patients presenting by huge splenomegaly were admitted to Tropical Medicine Department, El-Minia University Hospital. Tissue biopsy revealed pure bilharziasis due to S. hematobium in 10 (19%) cases, liver cirrhosis in 23 (42%), mixed schistosomiasis and cirrhosis in 8 (15%), hepatoma in 3 (6%), lymphoma in 6 (11%) and hematological diseases in the form of chronic myeloid leukemia in 2 (3.5%) and thalassemia major in 2 (3.5%) cases. The sensitivity and specificity of abdominal ultrasonography was 100% and 97% in cases of schistosomiasis, 100% and 100% in cases of hepatoma, 87% and 100% in cases of liver cirrhosis, 33% and 100% in cases of lymphoma respectively. There was a positive significant correlation between endoscopic variceal grading, portal vein diameter, splenic vein diameter, size of the spleen and the grading of the portal tract thickenings. The pathological and ultrasonographic diagnosis was the same in 38 (70%) cases. Splenogram was characteristic but not diagnostic in cases of schistosomiasis and liver cirrhosis. It was diagnostic and similar to peripheral blood picture in the 2 cases of chronic myeloid leukemia and was normal in cases of thalassemia major. Splenic aspiration was able to diagnose all cases of lymphomas. It can be considered as a useful adjunct to the usual diagnostic procedures, both in staging and follow up, especially in cases presenting only by splenomegaly.

Effect of cyclic AMP on fructose utilization, progressive motility and protein synthesis by ram spermatozoa

Ejaculated washed ram spermatozoa showed consistent increases in the intracellular concentration of cyclic 3', 5'-adenosine monophosphate (cAMP) after incubation for 15 minutes with the phosphodiesterase (PDE)-inhibitors, theophylline and caffeine. In vitro addition of cAMP or PDE-inhibitors to ram semen also stimulated and maintained sperm motility and enhanced the rate of fructose utilization. The same doses of cAMP or theophylline significantly stimulated the rate of protein synthesis by the washed spermatozoa, while the PDE-stimulator, imidazole, inhibited protein synthesis significantly. The stimulatory effect of cAMP on sperm protein synthesis was not affected by cycloheximide, but was abolished by the mitochondrial inhibitor, chloramphenicol. The present results indicate a positive correlation between the intracellular concentration of cAMP and the rates of progressive motility, fructose utilization, and protein synthesis by ram spermatozoa. The results suggest that the effect of cAMP is associated with the synthesis of mitochndrial proteins which may be involved with the observed enhancement of sperm motility and metabolism. The data also indicate that cAMP map act either as a first or a second messenger in mature spermatoza.

The effects of various hormones on human chorionic gonadotropin production in early and late placental explant cultures

Although human chorionic gonadotropin production peaks in early pregnancy, little is known of the factors regulating it at this time. We have compared human chorionic gonadotropin output in placental explants of 6 to 12 and 37 to 40 weeks' gestational age after addition of hormones on days 4 and 5 of 8 days of culture. Human chorionic gonadotropin production was sevenfold greater in early versus late cultures. In early cultures human chorionic gonadotropin output was increased threefold to fourfold by progesterone, dehydroepiandrosterone, and cortisol whereas late cultures responded only to progesterone and dehydroepiandrosterone. The output of combinations of steroids was additive or better (up to fifteenfold). Gonadotropin-releasing hormone increased human chorionic gonadotropin output only slightly (onefold to twofold) while testosterone was inhibitory (early) or ineffective (late). Estradiol had no effect. These studies demonstrate that explants of early placental tissue provide a useful model for study of human chorionic gonadotropin production, that there are many similarities but some clear differences between early and late secretion, and that steroids exert significant effects on human chorionic gonadotropin production of placental cultures.

Traditional remedies and lead intoxication

Three Saudi children suffered from lead intoxication as a result of ingestion of a preparation prescribed by a traditional practitioner. Two of them showed no symptoms of lead intoxication while the third child gave a history of symptomatic intoxication in the form of convulsions. The blood lead levels were increased in all patients and radiographic lead bands were seen in the long bones of the three children. The blood lead concentration was decreased by Na-Ca-EDTA and BAL treatment in the three patients.

The alterations of rat brain GABA and glutamine induced by the organophosphorus compound cyolane

Levels of the amino acids GABA and glutamine were determined in the whole brain of the white albino rat Rattus norvegicus after daily injection of 1/2, 1/4, 1/8, 1/16, 1/32 and 1/100 LD50 of cyolane. With 1/2 LD50 an increase in the level of both GABA and glutamine in the brain was recorded. Dose levels of 1/4 and 1/8 LD50 caused an increase in the level of GABA and a decrease in glutamine concentration followed by an increase from the 7th and 11th days for 1/4 and 1/8 LD50, respectively. The induced increase in GABA level started from the 2nd week for 1/16 and 1/32 LD50 and from the 3rd week for 1/100 LD50. Dose levels of 1/16, 1/32 and 1/100 LD50 caused a fluctuating increase in glutamine concentration starting from the 2nd, 3rd and 6th weeks, respectively, which was followed by a fluctuating decrease at the 9th week for 1/32 and 1/100 LD50. These findings support previous findings that the enhanced transformation of glutamic acid to GABA and glutamine is a result of a disturbance in the metabolism of the glutamic acid-GABA and the glutamic acid-glutamine systems in the rat brain.

Effect of dieldrin injection on the level of certain amino acids and some enzymes in rat brain

The present investigation revealed the effect of the organochlorine insecticide dieldrin at the dose level 0.25 LD50 at different time intervals on the concentration of 11 rat brain amino acids, on the activities of glutamic oxyacetic transaminase (GOT), glutamic pyruvic transaminase (GpT) and cholinesterase. The study was also extended to include the total protein content during the tested periods. The daily injection of dieldrin caused a marked decrease in the levels of glutamic acid, glutamine and taurine and an increase in the levels of aspartic acid, asparagine, GABA, glycine, lysine, serine, alanine and histidine. However, the maximal increase and decrease were recorded for most of the tested amino acids at the end of the tested period. The activity of the transaminases increased significantly. The recorded values of GOT were usually higher than GPT. Cholinesterase activity was inhibited thoroughly during all the experimental periods. Total protein content was decreased in the experiment; the minimal value was given 3 days after the injection.

Effect of incubation conditions, inhibitors and seminal plasma on protein synthesis in ram spermatozoa

The effects of incubation time (15 min-4 h), rate of semen to buffer dilution (1/10-1/40), and concentration of glucose (5.5-22 mM) on the rate of protein synthesis by ejaculated washed ram spermatozoa were determined. The rate of protein synthesis increased linearly as incubation time, dilution rate, and the glucose concentration increased. Denaturation of sperm protein with 1% HgCl2 caused an almost complete inhibition of amino acid incorporation. Protein synthesis over a period of 4 h was also inhibited by chloramphenicol but was not affected by cycloheximide. Protein synthesis and uptake of [14C]cAMP by washed ram spermatozoa was also significantly inhibited by the inclusion of 2-8% seminal plasma in the buffer. The present results indicate that the authentic protein synthesis by mature ram spermatozoa is mainly of mitochondrial origin. The data also suggest a role for intracellular cAMP in the regulation of sperm protein synthetic activity.

Peptic ulcer: (Analysis of predisposing and associated causes)

Age incidence, food habits and socio-economic condition were studied in a series of 478 predominantly male peptic ulcer patients. Age incidence of peptic ulcer increased in the second decade of life, reached a peak at the third decade and tapered off towards the end of fourth decade. As many as 57% of the patients belonged to the low socio-economic group and 78% were having only two meals a day. A ratio of 21 : 1 for duodenal ulcer to gastric ulcer was revealed from laparotomy findings.