Extraction, characterization and application of malva nut gum in water treatment.

In view of green developments in water treatment, plant-based flocculants have become the focus due to their safety, degradation and renewable properties. In addition, cost and energy-saving processes are preferable. In this study, malva nut gum (MNG), a new plant-based flocculant, and its composite with Fe in water treatment using single mode mixing are demonstrated. The result presents a simplified extraction of the MNG process. MNG has a high molecular weight of 2.3 × 105 kDa and a high negative charge of -58.7 mV. From the results, it is a strong anionic flocculant. Moreover, it is observed to have a branch-like surface structure. Therefore, it conforms to the surface of particles well and exhibits good performance in water treatment. In water treatment, the Fe-MNG composite treats water at pH 3.01 and requires a low concentration of Fe and MNG of 0.08 and 0.06 mg/L, respectively, when added to the system. It is concluded that for a single-stage flocculation process, physico-chemical properties such as molecular weight, charge of polymer, surface morphology, pH, concentration of cation and concentration of biopolymeric flocculant affect the flocculating performance.

Analysis and optimization of flocculation activity and turbidity reduction in kaolin suspension using pectin as a biopolymer flocculant.

The performance of pectin in turbidity reduction and the optimum condition were determined using Response Surface Methodology (RSM). The effect of pH, cation's concentration, and pectin's dosage on flocculating activity and turbidity reduction was investigated at three levels and optimized by using Box-Behnken Design (BBD). Coagulation and flocculation process were assessed with a standard jar test procedure with rapid and slow mixing of a kaolin suspension (aluminium silicate), at 150 rpm and 30 rpm, respectively, in which a cation e.g. Al(3+), acts as coagulant, and pectin acts as the flocculant. In this research, all factors exhibited significant effect on flocculating activity and turbidity reduction. The experimental data and model predictions well agreed. From the 3D response surface graph, maximum flocculating activity and turbidity reduction are in the region of pH greater than 3, cation concentration greater than 0.5 mM, and pectin dosage greater than 20 mg/L, using synthetic turbid wastewater within the range. The flocculating activity for pectin and turbidity reduction in wastewater is at 99%.

Treatment of hepatitis C virus genotype 4 with peginterferon alfa-2a: impact of bilharziasis and fibrosis stage.

AIM: To evaluate pegylated interferon alpha2a (PegIFN-alpha2a) in Egyptian patients with HCV genotype 4, and the impact of pretreatment viral load, co-existent bilharziasis and histological liver changes on response rate. METHODS: A total of 73 naive patients (61 with history of bilharziasis) with compensated chronic HCV genotype 4 were enrolled into: group A (38 patients) who received 180 mg PegIFN-alpha2a subcutaneously once weekly for a year and group B (35 patients) received IFN alpha-2a 3 MU 3 times weekly. Ribavirin was added to each regimen at a dose of 1200 mg. Patients were followed for 72 wk and sustained response was assessed. RESULTS: Significant improvement in both end of treatment response (ETR) (P < 0.002) and sustained response (SR) (P < 0.05) was noted with pegylated interferon, where ETR was achieved in 29 (76.3%) and 14 patients (40%) in both groups respectively, and 25 patients in group A (65.8%) and 9 (25.7%) in group B could retain negative viraemia by the end of follow up period. Sustained virological response (SVR) showed a significant negative correlation with age and positive correlation with pretreatment inflammation in patients receiving PegIFN. Viral clearance after 3 mo of therapy was associated with high incidence of ETR and SR (P < 0.001), but without significant difference between both forms of interferon. Significant improvement in response was achieved in patients with high grade fibrosis (grade 3 and 4) with PegIFN-alpha2a, where SR was seen in 5 out of 13 patients in group A, but none in group B. There was no significant difference in response between bilharzial and non-bilharzial patients in both groups. In terms of safety and tolerability, neutropenia was the predominant side effect; both drugs were comparable. CONCLUSION: PegIFN-alpha2a combined with ribavirin results in improvement in sustained response in HCV genotype 4, irrespective of history of bilharzial infestation.

Binding sites and endocytosis of heparin and polylysine are changed when the two molecules are given as a complex to Chinese hamster ovary cells.

This paper characterizes the complex formed in vitro between polylysine and heparin in the presence of heparin excess, and investigates the interaction of this complex with the surface of Chinese hamster ovary cells. It examines the kinetics of surface binding and cellular uptake of the complex and shows that both processes can be distinguished from those of free heparin and free polylysine. The view that these three ligands bind to different surface sites is further supported by the fact that their interaction with cells is influenced differently by cell detachment with trypsin, detachment with EGTA or exposure to acid pH. Membrane transport of the complex is a saturable process suggestive of receptor-mediated endocytosis. It is, however, less effective than would be expected on the basis of the binding kinetics. Only 40% of the complex bound at 0 degrees C is internalized during a 2 h reincubation period at 37 degrees C, suggesting some degree of uncoupling between binding and endocytosis. These data confirm prior results obtained with methotrexate-polylysine conjugates. We had shown that the addition of heparin to a medium containing a methotrexate-polylysine conjugate leads unexpectedly to a marked cellular uptake of drug conjugate, which is capable of killing cells that are otherwise resistant to free methotrexate (Shen, W.-C. and Ryser, H.J.-P. (1981) Proc. Natl. Acad. Sci. USA 78, 7589-7593). The polylysine X heparin complex is therefore of interest as a potential carrier for intracellular drug delivery through endocytosis.

Idiopathic retroperitoneal and mediastinal fibrosis mimicking connective tissue disease.

Combined retroperitoneal and mediastinal fibrosis is a rare manifestation of an idiopathic systemic sclerosing disease. This report describes a multisystem illness that clinically could best be described as polyserositis and progressive renal failure. Pathologically, it was characterized by diffuse infiltration of retroperitoneal and mediastinal tissues with plaquelike fibrofatty connective tissue encasing the kidneys, ureters, adrenal glands, and parietal pericardium. These features are diagnostic of a systemic sclerosing disease. It is important to recognize this unusual disorder to avoid confusion with other systemic connective tissue diseases such as systemic lupus erythematosus.

Does hypercapillarization influence the branching pattern of terminal villi in the human placenta at high altitude?

This study tests the hypothesis that exposure of the placenta to hypobaric hypoxia at altitude results in an altered branching pattern of the villous tree. Histological material from 20 term placentae delivered at altitudes over 3000 m was compared with matched controls from 500 m. Estimates of the mean star volume of intermediate and terminal villous domains were 1.40 x 10(6) microns3 (s.d. 0.63) in the high altitude group and 1.90 x 10(6) microns3 (s.d. 0.34) in the controls (F = 9.07, P < 0.005). The volume fraction of the villous tree occupied by trophoblastic bridges and syncytial knots was 8.1 per cent (s.d. 3.5) in the high altitude group and 3.2 per cent (s.d. 1.6) in the controls (F = 29.45, P < 0.0001). Previous studies have shown that the majority (80 per cent) of bridges are artefacts caused by the plane of section passing tangentially through the trophoblast layer at points of villous bending or branching. The results are, therefore, consistent with the hypothesis that peripheral villi are shorter, knob-like protrusions at high altitude, clustered more closely together. This modified branching pattern was confirmed by scanning electron microscopy. The change in architecture may be due to enhanced angiogenesis stimulated by the lower partial pressure of oxygen prevailing at high altitude.

Reaction of human lungs to aspirated animal fat (ghee): a clinicopathological study.

We report the clinical findings and pathological lung changes in four children following a cultural practice of forced feeding with animal fat (ghee) during infancy. The clinical presentation was of acute or chronic chest infection which failed to respond to antimicrobial therapy. The radiographic features ranged from extensive bronchopneumonia to collapse/consolidation and bronchiectasis. The light microscopy findings included diffuse mononuclear interstitial pneumonia, intraalveolar desquamation of pneumocytes, lipid granuloma formation, lung atelectasis and bronchiectasis. In the two children with longstanding reactions, the striking feature was the minimal lipid engulfment by the macrophages, the continuation of the mononuclear interstitial pneumonia, bronchiectasis and minimal lung fibrosis. In these two older children, the lung lymphatics were probably the main channels for drainage of the aspirated ghee.

Non-neoplastic changes in gastric antrum: are they different in distally located intestinal and diffuse-type gastric adenocarcinoma?

A total of 126 cases of primary adenocarcinoma of distal (antrum and/or adjacent body) stomach were reviewed. These cases were collected from the histopathology laboratory of Asir Central Hospital, Southwestern Saudi Arabia over an 8 year period (1987-94). Only gastrectomy specimens with non-neoplastic antral mucosa available for histological examination were included. Of 126 cases, 85 (67.5%) were of the intestinal type and 41 (32.5%) were of the diffuse type. Histological examination of the non-neoplastic antral mucosa showed: gastritis in 100% of these cases; Helicobacter pylori in 103/126 cases (81.8%); multifocal atrophic gastritis (MAG) in 53/126 cases (42.1%); intestinal metaplasia (IM) in 62/126 (49.2%); and type III intestinal metaplasia in 30/62 cases (47.7%). None of these non-neoplastic changes of antral mucosa was significantly different when the prevalence of these changes in intestinal and diffuse type gastric adenocarcinoma were compared using the chi 2 test. The prevalence of these non-neoplastic lesions were calculated in a 126 dyspeptic age- and sex-matched control patients and were as follows: H. pylori 91%; gastritis 78%; MAG 7.4%; IM 19% and type III IM 1.6%. The prevalence of H. pylori bacilli and gastritis was not significantly different between the cancer patients and the controls. The prevalence of MAG, IM and type III IM was significantly higher among cancer patients compared with the control group.

Intra-abdominal pulmonary sequestration: diagnostic difficulties.

This case report describes the unusual occurrence of congenital cystic adenomatoid malformation (CCAM) type 2 in an intra-abdominal pulmonary sequestration as a cause of diagnostic difficulties. The mass was discovered incidentally during a routine prenatal ultrasound in an infant with no other congenital malformation. Extralobar pulmonary sequestrations (EPS) located in the abdomen are rarely diagnosed prior to excision. The presence of CCAM type 2 in this situation might impose difficulties in histologic diagnosis of EPS, especially at the time of frozen section as happened in this case. To our knowledge this case is the sixth reported case of intra-abdominal EPS and the sixteenth case of EPS histologically displaying the feature of CCAM type 2. Pathologists should be aware that EPS in any location might display histologic features of CCAM type 2 even if the EPS is intra-abdominal.

Actinomycosis of the vallecula: report of a case and review of the literature.

A rare case of actinomycosis presenting primarily as a mass in the vallecula is described. The patient was a healthy, 65-year-old Saudi, lady who was not immunocompromised and had no other primary pathology in the oral cavity. The clinical presentation and management of the case are discussed and the relevant literature reviewed.

Histology of gastric antrum in intestinal-type gastric adenocarcinoma from Asir Central Hospital, Saudi Arabia.

The objective of this study was to look at non-neoplastic, precancerous histologic changes in the antrum of 49 resected stomachs with intestinal-type adenocarcinoma. Chronic superficial gastritis was seen in all 49 cases. Focal atrophic gastritis was seen in 32/49 cases (65.3%). Helicobacter pylori bacilli were seen in 41/49 cases (84%) and intestinal metaplasia in 39/49 cases (79.6%). 42/49 cases (85.7%) with chronic superficial gastritis showed non-active quiescent chronic inflammation. None of the 49 cases showed early gastric cancer, i.e. adenocarcinoma restricted to the gastric mucosa. The progressive changes of longstanding chronic superficial gastritis, focal atrophic gastritis and intestinal metaplasia were seen in all cases studied (individually or in combination). Knowledge of these precancerous lesions and their prevalence is fundamental to controlling gastric cancer (early detection) and eventual prevention.

Phytobezoars: a revisit to an unusual cause of acute small bowel obstruction.

Phytobezoars or undigested food concretions in the gastrointestinal tract are mostly due to ingestion of astringent immature fruits following gastric surgery and can lead to the serious complication of acute small bowel obstruction. We are reporting a case of acute small bowel obstruction in a 40 year old Turkish male, 48 months following bilateral vagotomy and pyloroplasty. Important clinical pathological features are emphasised to increase the awareness of this rather uncommon cause of acute intestinal obstruction.

Ultrastructural changes in animal fat associated lipoid pneumonia: report of two cases.

Traditional or cultural practices in different parts of the world where oils are used continue to produce lipoid pneumonia. We report the ultrastructural findings and observations in animal fat associated lipoid pneumonia from two children following a cultural practice of forced feeding with animal fat (ghee). Clinical findings showed an acute or chronic chest infection which failed to respond to anti-microbial therapy. X-ray and chest CT scan revealed collapse/consolidations of the right middle and left lower lobes. Histology and electron microscopy revealed thickening and destruction of the alveolar septa, filling of alveolar spaces with red blood cells and macrophage which contained both primary and secondary lysosomes. The alveolar walls contained mostly type II pneumocyte with most of them surrounded by thickened basement membranes with only a small portion of their surfaces exposed directly to the alveolar space where it showed numerous microvilli.

Lessons to be learned: a case study approach. Paraganglioma of the urinary bladder.

Primary paraganglioma arises infrequently in the urinary bladder. We present here the clinicopathological, immunohistochemical and ultrastructural findings in a 23-year-old Saudi female. She was hospitalised because of gross haematuria over the previous seven days. The intravenous urogram revealed a filling defect in the urinary bladder. Cystoscopy disclosed a non-papillary tumour arising from the roof of the bladder neck. Transurethral resection was, accordingly, performed--but marked fluctuation in blood pressure was observed during the procedure. The histopathological findings of trabeculae and small nests of plump oval to spindle cells with a clear to acidophilic cytoplasm, forming an organoid pattern and demonstrating inconspicuous mitotic activity, were diagnostic of paraganglioma of the urinary bladder, the diagnosis was confirmed by means of immunohistochemical and ultrastructural studies. The endocrine markers chromogranin A and neuron-specific enolase were positive in chief cells; sustentacular cells at the periphery of neoplastic cell clusters were positive for S-100 protein. Neurosecretory granules were identified by electron microscopic examination. It is emphasised that, currently, there are no anatomico-pathological criteria to distinguish benign and malignant forms of the disease. Post-surgical recovery was uneventful in this case. Recurrence and metastases, though infrequent, have been reported in the literature; therefore, radiation therapy may be an important adjunct--and long-term follow-up is mandatory.

Tuberculous cervical lymphadenopathy: should antituberculous therapy be preceded by histological proof?

In this retrospective study, 212 patients with cervical lymphadenopathy (CL) were studied over a 4-year period (1987-1990). Ninety-six (45.3%) were found to be tuberculous, 64 (30.2%) had reactive hyperplasia, 31 (14.6%) had a malignant lymphoma, 12 (5.7%) showed metastatic carcinoma and nine (4.2%) were due to miscellaneous causes. The original provisional diagnosis was incorrect in 20 cases who were later found to have tuberculous lymphadenopathy (TL) and in 12 patients with secondary malignancy who were originally diagnosed as tuberculous. The study shows that treatment should be preceded by histological proof to avoid delay in treatment of serious malignant disorders, to avoid unnecessary antituberculous treatment in patients with benign reactive lymphadenopathy and to prevent delay of antituberculous treatment in tuberculous patients with atypical clinical presentations.

Idiopathic lobular granulomatous mastitis: Is it a form of terminal duct lobular unit duct ectasia?

Full text is available as a scanned copy of the original print version.

Helicobacter pylori infection in gastric cancer: A study of 84 cases from Asir Region.

Gastric cancer can be divided into three histologic types: intestinal and diffuse adenocarcinoma, and malignant lymphoma. To determine whether Helicobacter pylori was associated with either cancer type, we reviewed histologic sections from stomachs of 84 patients with the diagnosis of gastric. Of 63 patients with histologic evidence of intestinal adenocarcinoma, 53 (84%) contained H. pylori n noncancerous tissue compared with six (66.7%) of nine patients with diffuse adenocarcinoma (odds ratio = 2.65; Z=1.048; P>0.05) and with eight (66.7%) of 12 patients with non-Hodgkin malignant lymphoma of the stomach (odds ratio = 2.65; Z=0.826; P>0.05). Our findings are compared with reported data from other countries and we are not aware of similar reports from the Kingdom of Saudi Arabia.

Pattern of malignant skin tumors in Asir region, Saudi Arabia.

The current study describes the pattrn of malignant skin tumors in 137 cases seen in Asir Central Hospital histopathology laboratory over a five year period (1987 to 1991). Ninety percent (90.5%) were Saudis and the mean age was 61.0 years with a male:female ratio of 1.6:1. Squamous cell carcinoma was the most common type of skin cancer presenting (41.6%), followed by basal cell carcinoma (36.5%), and then malignant melanoma (11.7%). Ninety-eight percent of basal cell carcinoma occurred on the head, compared to only 47.4% of squamous cell carcinoma; and 24.6% of squamous cell carcinoma cases occurred in the lower limbs. Eighty-seven percent (87.6%) of malignant melanoma cases occurred in the extremities. The distribution of the other types of malignant skin tumors are also discussed. Our findings were compared with the very few studies from the Kingdom and other parts of the world.

Gastric cancer in southern Saudi Arabia.

A total of 84 cases of primary gastric cancer were diagnosed in the histopathology laboratory of Asir Central Hospital over a five year period (1987 to 1991). Seventy-two patients (86%) were Saudis and 12 cases (14%) were non-Saudis. The mean age of the patients included in this study was 60 years with a range of 22 to 85 years and a male:female ratio of 4.6:1. Intestinal adenocarcinoma occurred in 63 patients (75%) followed by malignant lymphomas in 12 cases (14%) and diffuse adenocarcinoma in nine cases (11%). The gastric antrum was the most common site affected (47%), followed by gastric corpus (27%), cardia (14%), and fundus (12%). Comparisons of our findings to similar reports from other provinces of Saudi Arabia and other countries are discussed.

Peripheral lymphadenopathy as a primary presenting sign: A study of 324 cases from Asir region.

Superficial lymph node biopsies received over a four year-period, 1987 to 1990, at the histopathology laboratory of Asir Central Hospital wre reviewed. Total number of patients was 324, all presented with peripheral lymphadenopathy as the primary sign. Two hundred sixty-six patients (82%) were Saudi nationals and 58 patients (18%) were non-Saudi nationals living in Asir region. Granulomatous lymphadenitis was the most common pattern (43%) followed by: nonspecific lymphoid hyperplasia (33%), malignant lymphoma (13%), metastatic nonlymphoid malignant neoplasm (6.6%), and miscellaneous specific lymphadenopathies (4.4%). The distribution patterns of various histopathologic findings according to age, sex, nationality and lymph node location are included.