Cytotoxicity and apoptosis induction of the marine Conus flavidus venom in HepG2 cancer cell line.

Cancer is still an area of continuous research for finding more effective and selective agents, so our study aimed to explore new anticancer medicines from Cone snails' venoms as marine natural products with promising biological activities. Venoms from seven cone snails collected from two locations on the Red Sea coast (Marsa Alam (Ma) and Hurghada (Hu)) were extracted and subjected to SDS for protein concentrations. The venoms of C. vexillum (Ma), C. vexillum (Hu), and C. flavidus were found to have the highest protein concentrations (2.66, 2.618, and 2.611 mg/mL, respectively). The venom of C. vexillum (Ma) was found to be cytotoxic against the lung cancer cell line A549 (IC50 = 4.511 ± 0.03 µg/mL). On the other hand, the venom of C. flavidus showed a strong cytotoxic effect on both liver and lung cancer cell lines (IC50 = 1.593 ± 0.05 and 7.836 ± 0.4 µg/mL, respectively) when compared to their normal cell lines. Investigating the apoptotic cell death of C. flavidus venom on HepG2 cell lines, it showed total apoptotic cell death by 22.42-fold compared to untreated control and arresting the cell cycle at G2/M phase. Furthermore, its apoptotic cell death in HepG2 cells was confirmed through the upregulation of pro-apoptotic markers and down-regulation of Bcl-2 in both gene and protein expression levels. These findings confirmed the cytotoxic activity of C. flavidus venom through apoptotic cell death in HepG2 cells. So, a detailed study highlighting its structure and molecular target for developing new anticancer agents from natural sources is required.Communicated by Ramaswamy H. Sarma.

Schindleria parva, a new species of Schindler's fish (Teleostei: Schindleriidae: Schindleria) from Jeddah, Saudi Arabia, Red Sea.

Schindleria parva, a new species of the family Schindleriidae, is described from two specimens collected from the central Red Sea of Saudi Arabia. The new species is characterized by lack of pigmentation on the body, possession of an inconspicuous gas bladder and the presence of small teeth on the premaxillae. The holotype is a female of 11 mm standard length (SL) (11.9 mm total length) and the paratype is a male of 9 mm SL. Dorsal fin rays 10 (9) anal fin rays 9 (7). The body depth at pectoral-fin origin 5% (4%) of SL, depth at anal-fin origin 8% (7%) SL, predorsal length 63% (65%) SL, preanal length 72% (72%) SL, the first anal-fin ray situated below the fourth dorsal-fin ray), a total of 23 + 16 myomeres. The female contained a series of 30 rectangular eggs in a single row, whereas the male is characterized by a short rod-like urogenital papilla. Species of the genus Schindleria are likely the smallest marine vertebrates on the planet and S. parva is likely the smallest Schindleria species in the Red Sea. The global diversity of Schindleria is likely underestimated due to the paedomorphic features of this genus. Its fast generation times make it a species-rich genus of high turnover rates, thus potentially highly important for the trophic food webs of coral reefs. Thus, this finding advances knowledge on the biodiversity of the Red Sea, highlights its conservation significance, and contributes towards the understanding of the complexity of the coral-reef fish community.

Metals in a northern Nile Delta lake: water, suspended particulates, sediments, and biota.

Lake Edku is one of the important fishing areas in the Nile Delta. It is exposed to different quantities of serious pollutants in particular metals. To overall appraise the risk and status of metals in the lake, a comprehensive study of total concentrations of cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), and zinc (Zn) in sediments and spatial-temporal variations of these metals in the dissolved and suspended particulates, and some tissues of Tilapias niloticus, was conducted from ten sampling sites during 2016. Results showed that none of the investigated metals exceeded the limits considered as hazardous for aquatic life in water. The highest concentrations of Cd, Cu, Ni, and Zn were observed in suspended particulate matter, which may precipitate on the surface of the sediments. Potential ecological risk analysis of the majority of the investigated metals in the sediment indicated that Lake Edku posed a low ecological risk. The estimated values of all metals in tissues of Tilapia niloticus were below the international permissible limits. Moreover, the potential risk of metals to human via the consumption of Tilapia niloticus was estimated using the weekly intake levels, which was lower than the WHO's safe provisional tolerant weekly intake levels. These results prove the importance of performing measurements of contaminants in various compartments of Lake Ecosystem including sediment, biota, and suspended particulate matter for proper management.

Effect of tidal volume on extravascular lung water content during one-lung ventilation for video-assisted thoracoscopic surgery: a randomised, controlled trial.

BACKGROUND: The use of low tidal volume during one-lung ventilation (OLV) has been shown to attenuate the incidence of acute lung injury after thoracic surgery. OBJECTIVE: To test the effect of tidal volume during OLV for video-assisted thoracoscopic surgery on the extravascular lung water content index (EVLWI). DESIGN: A randomised, double-blind, controlled study. SETTING: Single university hospital. PARTICIPANTS: Thirty-nine patients scheduled for elective video-assisted thoracoscopic surgery. INTERVENTIONS: Patients were randomly assigned to one of three groups (n = 13 per group) to ventilate the dependent lung with a tidal volume of 4, 6 or 8 ml  kg(-1) predicted body weight with I:E ratio of 1:2.5 and PEEP of 5 cm H2O. MAIN OUTCOME MEASURES: The primary outcomes were perioperative changes in EVLWI and EVLWI to intrathoracic blood volume index (ITBVI) ratio. Secondary outcomes included haemodynamics, oxygenation indices, incidences of postoperative acute lung injury, atelectasis, pneumonia, morbidity and 30-day mortality. RESULTS: A tidal volume of 4 compared with 6 and 8 ml  kg(-1) after 45 min of OLV resulted in an EVLWI of 4.1 [95% confidence interval (CI) 3.5 to 4.7] compared with 7.7 (95% CI 6.7 to 8.6) and 8.6 (95% CI 7.5 to 9.7) ml  kg(-1), respectively (P < 0.003). EVLWI/ITBVI ratios were 0.57 (95% CI 0.46 to 0.68) compared with 0.90 (95% CI 0.75 to 1.05) and 1.00 (95% CI 0.80 to 1.21), respectively (P < 0.05). The incidences of postoperative acute lung injury, atelectasis, pneumonia, morbidity, hospitalisation and 30-day mortality were similar in the three groups. CONCLUSION: The use of a tidal volume of 4 ml kg during OLV was associated with less lung water content than with larger tidal volumes of 6 to 8 ml kg(-1), although no patient developed acute lung injury. Further studies are required to address the usefulness of EVLWI as a marker for the development of postoperative acute lung injury after the use of a low tidal volume during OLV in patients undergoing pulmonary resection. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT01762709.

Right ventricular function during one-lung ventilation: effects of pressure-controlled and volume-controlled ventilation.

OBJECTIVES: To test the effects of pressure-controlled (PCV) and volume-controlled (VCV) ventilation during one-lung ventilation (OLV) for thoracic surgery on right ventricular (RV) function. DESIGN: A prospective, randomized, double-blind, controlled, crossover study. SETTING: A single university hospital. PARTICIPANTS: Fourteen pairs of consecutive patients scheduled for elective thoracotomy. INTERVENTIONS: Patients were assigned randomly to ventilate the dependent lung with PCV or VCV mode, each in a randomized crossover order using tidal volume of 6 mL/kg, I: E ratio 1: 2.5, positive end-expiratory pressure (PEEP) of 5 cm H2O and respiratory rate adjusted to maintain normocapnia. MEASUREMENTS AND MAIN RESULTS: Intraoperative changes in RV function (systolic and early diastolic tricuspid annular velocity (TAV), end-systolic volume (ESV), end-diastolic volume (EDV) and fractional area changes (FAC)), airway pressures, compliance and oxygenation index were recorded. The use of PCV during OLV resulted in faster systolic (10.1±2.39 vs. 5.8±1.67 cm/s, respectively), diastolic TAV (9.2±1.99 vs. 4.6±1.42 cm/s, respectively) (p<0.001) and compliance and lower ESV, EDV and airway pressures (p<0.05) than during the use of VCV. Oxygenation indices were similar during the use of VCV and PCV. CONCLUSIONS: The use of PCV offers more improved RV function than the use of VCV during OLV for open thoracotomy. These results apply specifically to younger patients with good ventricular and pulmonary functions.

Comparative study of the non-dependent continuous positive pressure ventilation and high-frequency positive-pressure ventilation during one-lung ventilation for video-assisted thoracoscopic surgery.

The application of volume controlled high-frequency positive-pressure ventilation (HFPPV) to the non-dependent lung (NL) may have comparable effects to continuous positive-airway pressure (CPAP) on the surgical conditions during one-lung ventilation (OLV) for video-assisted thoracoscopic surgery (VATS). After local Ethics Committee approval and informed consent, we randomly allocated 30 patients scheduled for elective VATS after the first 15 min of OLV to ventilate the NL with CPAP of 2 cm H(2)O (NL-CPAP(2)) and HFPPV using tidal volume 2 ml/kg, inspiratory to expiratory ratio <0.3 and respiratory rate 60/min (NL-HFPPV) for 30 min, each in a randomized crossover order. Intraoperative adequacy of surgical conditions was evaluated using a visual analog scale and the changes in hemodynamic and arterial oxygen were recorded. The application of NL-CPAP(2) and NL-HFPPV resulted in more improved arterial oxygenation than during OLV for VATS (P<0.001). The operative field was much better during the application of NL-CPAP(2) than during NL-HFPPV (P<0.001). We concluded that the application of CPAP to the NL during OLV offers good quality of operative field and improved arterial oxygenation for VATS.

Primary mediastinal Castleman's disease.

Castleman's disease is a rare entity with an unknown etiology which was first described by Castleman in 1954. It is a lymphoproliferative disorder histologically classified into three types; hyaline-vascular, plasma cell type and mixed type. It might be localized or multicentric and usually involves the mediastinum. We report a case of Castleman's disease discovered accidentally in a case of blunt chest trauma which caused a challenging diagnostic process and management.

Is Routine Spiral CT-Chest Justified in Evaluation of the Major Blunt Trauma Patients?

STUDY: New generation spiral CT scanners permit multiple consecutive CT examinations on the same trauma patient in a short period of time. The purpose of this study was to evaluate the diagnostic role and therapeutic impact of routine spiral CT chest in multiply injured patients or patients with a suspicious mechanism of injury. PATIENTS AND METHODS: This prospective study included 443 patients with blunt chest trauma. All patients underwent a spiral CT chest as part of their routine evaluation. Radiological interpretation of chest x-rays, CT scan findings, and changes in management plan guided by these findings were recorded. RESULTS: The mechanism of injury was road traffic accidents in 422 patients (95.26%). Out of the 167 patients with normal chest radiograph, 136 (81.43%) were found to have an abnormality on chest CT. The management was changed in the form of additional investigations or unplanned intervention in 92 patients (20.76%). Additional investigations included transoesophageal echocardiography (n = 7), bronchoscopy (n = 13), transfer to higher center for aortography (n = 2). Intercostal tubes (n = 55), thoracotomies (n = 4), fixation of sternal fracture (n = 9), laparotomy (n = 1) and spinalfixation (n = 1) were performed following the CT scan. CONCLUSION: Although the incidence of significant injuries identified by the chest CT scan was low, it did prompt immediate intervention in a significant number of patients; some of them had potentially life-threatening injuries. Routine use of CT scanning is warranted in early evaluation of polytrauma patients or patients with severe blunt chest trauma.

Solitary benign fibrous tumors of the pleura.

Solitary benign fibrous tumors of the pleura are very rare. Seven patients (mean age, 52 years) who presented between 1995 and 2005 were studied retrospectively. They had nonspecific chest symptoms and no history of asbestos exposure or smoking. Chest radiography showed a large opacity occupying most of the affected hemithorax, with clear costophrenic angles. Computed tomography of the chest showed a large well-delineated heterogeneous mass directly related to the lateral chest wall. Needle biopsy suggested the benign nature of the lesion. Surgery was performed through a posterolateral thoracotomy. Five tumors arose from visceral pleura, and 2 from parietal pleura. The mean tumor diameter was 7.5 cm (range, 8-14 cm). Complete surgical excision was carried out in all cases. Histopathology and immunohistochemical staining confirmed the benign nature of the tumors. There was no mortality or major complication. The mean follow-up period was 4 years (range, 1-10 years). All patients remained tumor-free during follow-up. Wide local excision, including pulmonary and pleural resection, is recommended as the best therapeutic option.

Gigantic enlargement of the thymus gland.

True massive thymic hyperplasia is a very rare entity, characterized by an increase in the size and weight of the thymus gland, without an apparent cause. Surgery has been required in patients with severe respiratory distress. We present an idiopathic true massive thymic hyperplasia in a 5-month-old boy.