Nanocellulose-Based Passivated-Carbon Quantum Dots (P-CQDs) for Antimicrobial Applications: A Practical Review.

Passivated-carbon quantum dots (P-CQDs) have been attracting great interest as an antimicrobial therapy tool due to their bright fluorescence, lack of toxicity, eco-friendly nature, simple synthetic schemes, and possession of photocatalytic functions comparable to those present in traditional nanometric semiconductors. Besides synthetic precursors, CQDs can be synthesized from a plethora of natural resources including microcrystalline cellulose (MCC) and nanocrystalline cellulose (NCC). Converting MCC into NCC is performed chemically via the top-down route, while synthesizing CODs from NCC can be performed via the bottom-up route. Due to the good surface charge status with the NCC precursor, we focused in this review on synthesizing CQDs from nanocelluloses (MCC and NCC) since they could become a potential source for fabricating carbon quantum dots that are affected by pyrolysis temperature. There are several P-CQDs synthesized with a wide spectrum of featured properties, namely functionalized carbon quantum dots (F-CQDs) and passivated carbon quantum dots (P-CQDs). There are two different important P-CQDs, namely 2,2'-ethylenedioxy-bis-ethylamine (EDA-CQDs) and 3-ethoxypropylamine (EPA-CQDs), that have achieved desirable results in the antiviral therapy field. Since NoV is the most common dangerous cause of nonbacterial, acute gastroenteritis outbreaks worldwide, this review deals with NoV in detail. The surficial charge status (SCS) of the P-CQDs plays an important role in their interactions with NoVs. The EDA-CQDs were found to be more effective than EPA-CQDs in inhibiting the NoV binding. This difference may be attributed to their SCS as well as the virus surface. EDA-CQDs with surficial terminal amino (-NH2) groups are positively charged at physiological pH (-NH3+), whereas EPA-CQDs with surficial terminal methyl groups (-CH3) are not charged. Since the NoV particles are negatively charged, they are attracted to the positively charged EDA-CQDs, resulting in enhancing the P-CQDs concentration around the virus particles. The carbon nanotubes (CNTs) were found to be comparable to the P-CQDs in the non-specific binding with NoV capsid proteins, through complementary charges, π-π stacking, and/or hydrophobic interactions.

Determinants of Choice of Facility-Based Delivery among Mothers in Kwara State, Nigeria.

BACKGROUND: Nigeria has the highest number of maternal deaths in the world, which is a major public health problem. One of the major contributory factors is high prevalence of unskilled birth attendance from low facility delivery. However, the reasons for and against facility delivery are complex and not fully understood. OBJECTIVE: The objective of this study was to identify the facilitators and barriers to facility based deliveries (FBD) among mothers in Kwara state, Nigeria. METHODS: The study was carried out among 495 mothers that delivered in the five years prior to the study in three selected communities from the three senatorial districts of Kwara state using mixed methods. The study design consisted of a cross-sectional study with mixed data collection involving qualitative and quantitative methods. Multistage sampling technique was employed. Primary outcome measures were place of delivery, reasons for and against FBD. RESULTS: Of the 495 respondents that had their last delivery during the study period, 410 respondents delivered in the hospital (83%). Common reasons for hospital delivery were ease and convenience (87.1%), safe delivery (73.6%) and faith in healthcare providers (22.4%). The common barriers to FBD included high cost of hospital delivery (85.9%), sudden birth (58.8%) and distance (18.8%). Other important barriers were availability of cheaper alternatives (traditional birth attendants and community health extension workers practising at home), unavailability of community health insurance and lack of family support. Parity, level of education of respondents and husband had significant influence on choice of delivery (p<0.05). CONCLUSION: These findings provided a good insight into the reasons for and against facility delivery among Kwara women, which can assist policy makers and program interventions that can improve facility deliveries and ultimately improve skilled birth attendance, reduce maternal and newborn morbidity and mortality.

CONTEXTE: Le Nigeria compte le plus grand nombre de décès maternels au monde, ce qui constitue un problème majeur de santé publique. L'un des principaux facteurs contributifs est la forte prévalence de l'assistance à l'accouchement non qualifiée due à un accouchement dans des établissements de faible qualité. Cependant, les raisons pour et contre la prestation en établissement sont complexes et ne sont pas entièrement comprises. OBJECTIF: L'objectif de cette étude était d'identifier les facilitateurs et les obstacles aux accouchements en établissement (FBD) chez les mères de l'État de Kwara, au Nigeria. METHODES: L'étude a été menée auprès de 495 mères qui ont accouché au cours des cinq dernières années précédant l'étude dans trois communautés sélectionnées des trois districts sénatoriaux de l'État de Kwara en utilisant des méthodes mixtes. La conception de l'étude consistait en un entretien avec des informateurs clés et une étude transversale avec une collecte de données mixte impliquant des méthodes qualitatives et quantitatives. La technique d'échantillonnage à plusieurs degrés a été employée. Les principaux critères de jugement étaient le lieu d'accouchement, les raisons pour et contre le FBD. RESULTATS: Parmi les 495 répondantes qui ont eu leur dernier accouchement au cours de la période d'étude, 410 répondantes ont accouché à l'hôpital (83 %). Les raisons courantes de l'accouchement à l'hôpital étaient la facilité et la commodité (87,1 %), la sécurité de l'accouchement (73,6 %) et la confiance dans les prestataires de soins de santé (22,4 %). Les obstacles courants à la FBD comprenaient le coût élevé de l'accouchement à l'hôpital (85,9 %), l'accouchement soudain (58,8 %) et la distance (18,8 %). D'autres obstacles importants étaient la disponibilité d'alternatives moins chères (accoucheuses traditionnelles et agents de vulgarisation de la santé communautaire exerçant à domicile), l'absence d'assurance maladie communautaire et le manque de soutien familial. La parité, le niveau d'éducation des répondants et le mari ont une influence significative sur le choix de l'accouchement (p<0,05). CONCLUSION: Ces résultats ont fourni un bon aperçu des raisons pour et contre l'accouchement en établissement chez les femmes Kwara, ce qui peut aider les décideurs politiques et les interventions de programme qui peuvent améliorer les accouchements en établissement et, en fin de compte, améliorer l'assistance qualifiée à l'accouchement, réduire la morbidité et la mortalité maternelles et néonatales. Mots clés: Prestation en établissement; Facilitateurs; Barrières; État de Kwara; Nigeria.

A Novel Microwave Hot Pressing Machine for Production of Fixed Oils from Different Biopolymeric Structured Tissues.

A microwave hot pressing machine (MHPM) was used to heat the colander to produce fixed oils from each of castor, sunflower, rapeseed, and moringa seed and compared them to those obtained using an ordinary electric hot pressing machine (EHPM). The physical properties, namely the moisture content of seed (MCs), the seed content of fixed oil (Scfo), the yield of the main fixed oil (Ymfo), the yield of recovered fixed oil (Yrfo), extraction loss (EL), six Efficiency of fixed oil extraction (Efoe), specific gravity (SGfo), refractive index (RI) as well as chemical properties, namely iodine number (IN), saponification value (SV), acid value (AV), and the yield of fatty acid (Yfa) of the four oils extracted by the MHPM and EHPM were determined. Chemical constituents of the resultant oil were identified using GC/MS after saponification and methylation processes. The Ymfo and SV obtained using the MHPM were higher than those for the EHPM for all four fixed oils studied. On the other hand, each of the SGfo, RI, IN, AV, and pH of the fixed oils did not alter statistically due to changing the heating tool from electric band heaters into a microwave beam. The qualities of the four fixed oils extracted by the MHPM were very encouraging as a pivot of the industrial fixed oil projects compared to the EHPM. The prominent fatty acid of the castor fixed oil was found to be ricinoleic acid, making up 76.41% and 71.99% contents of oils extracted using the MHPM and EHPM, respectively. In addition, the oleic acid was the prominent fatty acid in each of the fixed oils of sunflower, rapeseed, and moringa species, and its yield by using the MHPM was higher than that for the EHPM. The role of microwave irradiation in facilitating fixed oil extrusion from the biopolymeric structured organelles (lipid bodies) was protruded. Since it was confirmed by the present study that using microwave irradiation is simple, facile, more eco-friendly, cost-effective, retains parent quality of oils, and allows for the warming of bigger machines and spaces, we think it will make an industrial revolution in oil extraction field.

Bioplastic Floss of a Novel Microwave-Thermospun Shellac: Synthesis and Bleaching for Some Dental Applications.

In this paper, crude flakes (CFs) of shellac were converted into purified, nonwoven, thermospun fibers (shellac floss) using two devices, namely, an electric thermospinner (ETS) and a microwave thermospinner (MTS). This conversion was achieved by the action of heating and the centrifugal forces that arose toward the outside of the spinner-head cavity. The dissolved MTS floss was bleached using hydrogen peroxide to produce the bleached MTS floss. The unbleached shellac (CFs, ETS floss, and MTS floss) and the bleached MTS floss were characterized physically and chemically. There was no deterioration in the floss properties due to the heating tools or bleaching process. For the unbleached shellac, although there were no statistical differences in properties among the three shellac types (CFs, ETS floss, and MTS floss), except for insolubility in hot alcohol, acid value, and moisture content, the MTS floss exhibited superior values compared with the other types for nearly all the properties studied. Bleaching the MTS floss produced the greatest color change among other studies, caused a high reduction in insoluble solid matter due to increasing the solubility of some of the solid constituents of shellac, and slightly decreased its Young's modulus (E). The important dental applications were surveyed and it was suggested that the suitability was enhanced by using the bleached MTS floss, based on its superior whiteness, along with the unique properties detected.

Coping strategies among patients attending HIV clinics in a North-central State of Nigeria.

BACKGROUND: Nigeria ranks third among the countries with the highest HIV/AIDS burden in the world, next only to India and South Africa. The North-Central zone which Kwara State belongs to has the highest concentration of HIV prevalence rate of 7.5%, while the North-Western zone recorded the lowest prevalence of 2.1%; Kwara state has a prevalence rate of 2.2%. AIMS: The study assessed the coping strategies adopted by patients attending HIV clinics in a North-central city of Nigeria. METHODS: The study design was descriptive cross-sectional involving 384 HIV-positive patients who were systematically recruited at 5 public service delivery sites in Ilorin- a North-central city, Nigeria was used for the study. Coping strategies were measured using the Brief COPE scale. Data were analyzed using SPSS software version 20.0. Level of significance was pre-determined at P value <0.05 at a confidence level of 95%. RESULTS: Female respondents constituted 222 (58.0%) while males were 162 (42.0%). Respondents experienced varying proportion of coping strategies of which Self-distraction 288 (75.0%), active coping 249 (64.8%), emotional support 228 (59.4%), among others were the major strategies adopted by respondents. CONCLUSION: HIV is a chronic disease with heavy burden on both patients and health facility rendering services for the care of these patients. A good proportion of respondents interviewed adopted varying coping strategies. Sustained social and psychological support will improve further the coping strategies of living with HIV.

Willingness to support antenatal blood donation among married men in a Metropolitan City in North-central Nigeria.

AIMS AND OBJECTIVES: Improving blood availability through voluntary or compulsory antenatal blood donation is pivotal to reducing maternal morbidity and mortality in developing countries. Willingness to donate blood is adjudged to be an important step to the actual practice of donating blood. This study aimed to determine the knowledge, attitude and willingness of men towards antenatal blood donation. PATIENTS AND METHODS: This was a descriptive cross-sectional study. A multi-stage sampling technique was used to recruit 500 married men into the study using interviewer-administered questionnaire. Data analysis was done using SPSS version 16 software package. Pearson's Chi-squared test was used to test for significant associations between variables. A P < 0.05 was considered as statistically significant. RESULTS: More than half 300 (60%) of the respondents had good knowledge of antenatal blood donation in general. Majority (85.8%) of the respondents were willing to support voluntary blood donation. The overall attitude to blood donation was positive in 77.8% of the respondents. A significantly higher proportion 268 (89.3%) of respondents with good knowledge of antenatal blood donation were willing to donate blood (P = 0.0006). CONCLUSIONS: The majority have good knowledge and positive attitude towards antenatal blood donation. However, there is need to urgently transform this positive attitude to action through continual public enlightenment to reduce maternal morbidity and mortality.

Rhinoscleroma: a clinicopathological study from the Gulf region.

INTRODUCTION: Rhinoscleroma is a chronic progressive inflammatory disease of the upper respiratory tract. We report a clinicopathological series from the Gulf region. METHODS: The clinical and pathological features of patients diagnosed with rhinoscleroma at three main hospitals in Saudi Arabia and Bahrain over a 20-year period are presented. Archived glass slides and paraffin blocks from these patients were retrieved from the pathology files for review. Special stains were performed whenever indicated. Biopsy material and clinical data from 25 patients formed the basis of this study. RESULTS: Most of the patients were young females with a median age of 24 years. The nose was involved in all cases with frequent extension to other parts of the upper respiratory tract. The provisional clinical diagnoses included syphilis, midline granuloma and malignancy. The histological differential diagnoses included leprosy, malakoplakia and metastatic renal cell carcinoma. CONCLUSION: Rhinoscleroma is rare in Saudi Arabia and Bahrain. Awareness of possible clinical presentations and early diagnosis will significantly reduce the morbidity caused by this disease.

Clinical and histopathological features of zoonotic cutaneous leishmaniasis in Saudi Arabia.

BACKGROUND: Zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania major is a growing public health problem and endemic in many parts of the Kingdom of Saudi Arabia. The vector is Phlebotomus papatasi and the animal reservoirs are mainly desert rodents. METHODS: In this prospective study, the clinical and histopathological features of ZCL in 120 patients are described and classified. The majority of these patients (n = 84) were non-Saudi expatriate workers who suffered mostly from multiple and severely inflamed nodulo-ulcerative lesions on the exposed parts of the body. Saudi patients were mainly children (n = 21) with few(1-3) lesions on their limbs or sometimes unique erysipeloid facial lesions. RESULTS: Histopathological grouping of ZCL lesions showed four types of granulomatous reactions based on the predominant types of inflammatory cells, presence or absence of necrosis and ranking of parasitic index. CONCLUSION: A possible correlation between histopathologic evolution of ZCL lesions and the immune status of the host is discussed.

A web-based database for diagnosis of haematologic neoplasms using immunophenotyping by flow cytometry.

The interpretation of immunophenotyping results by flow cytometry involves pattern recognition of different haematologic neoplasms that may have similar immunologic marker patterns. The numerous markers available in the flow cytometry laboratory make these patterns difficult to remember, especially for those of uncommon neoplasms. We describe the design and implementation of a Web-based database for diagnosis of haematologic neoplasms using results of immunophenotyping by flow cytometry. This database aims to assist pathology and haematology residents in interpreting flow cytometry data, and is designed to reach a wide base of users who use a variety of browsers on different computer platforms. Five modules are developed in this comprehensive program: (a) differential diagnosis: to generate a list of differential diagnoses that closely match the marker results in a given case; (b) display of disorders: typical results of markers for each disorder; (c) display of markers: relevant information of each immunologic marker; (d) display of archived cases for a disorder: marker results of cases previously diagnosed for a disorder; and (e) display of summary for archived cases: summary of marker results of all the archived cases for each disorder. Our experience with this Web-based database in teaching pathology residents has been very encouraging. Since the World Wide Web is increasingly more accessible to computer users, it has become an ideal medium for distribution of clinical decision-support software.

Dysregulative lymphoma theory revisited; what can we learn from cytokines, CD classes and genes?

Based largely on animal experiments, a dysregulative lymphoma theory was designed some 15 years ago as a basis for computer simulation studies. The basic concept of this theory was that lymphomas arise when persistent immunostimulation coincides with some kind of immune deficiency. The present article reviews exemplary data from human lymphoma cases in an attempt to further support or to reject the hypothesis. T- and B-cell lymphomas according to the REAL classification were reviewed with regard to the functional effects of their CD markers and their ligands, interleukin activities and cytogenetic changes. The results are summarized and further discussed. Essentially in all cases, a combination of enhanced stimulation of lymphoid cells and functional deficiency is identified, thus supporting the general pathogenetic hypothesis of malignant lymphomas. Despite using the most modem lymphoma classification, however, lymphoma entities and theirfunctional changes are so heterogeneous that cases need to be studied individually when it comes to pathogenetic considerations.

Adhesion of B-Cell Chronic Lymphocytic Leukemia Cells to Marrow Stromal Cells is Mediated by α4ß1 but not ß2αL Integrin: MSC also Prevent Apoptosis of B-CLL Cells.

Interactions between MSC and B-CLL cells were investigated to better understand the role of adhesion proteins in the biology of B-CLL. The role of ß1 and ß2 integrins and CD44 in adherence of B-chronic lymphocytic leukemia (CLL) cells to bone marrow stromal cell (MSC) monolayers and the ability of MSC to prevent apoptosis of CLL cells was investigated. Peripheral blood mononuclear cells, from 8 patients with CD5-positive B-CLL, were effectively depleted of CD3-positive cells with an immunomagnetic column. Purity of B-CLL cells, as judged by coexpression of CD19 and CD5 on two-color fluor-ocytometry, was 92±4% (mean±SD) (n = 8). (51)Cr-labelled B-CLL cells, were incubated with isotype murine monoclonal antibodies or blocking MoAb's against the following adhesion proteins: integrins ß1, α4, and αL (chain of LFA-1), CD44 and CD106 (VCAM-1). The B-CLL cell adherence to marrow stromal cell (MSC) monolayers at 2hrs was 29±12% (mean±1SD). MoAb's against CD106, α4, and ß1 caused a significant inhibition of heterotypic adherence in 2/8, 3/8 and 4/8 experiments. Despite universal expression of αL on B-CLL cells, MoAb against αL did not influence adhesion of B-CLL cells in any of the eight experiments. MoAb's against CD44 caused an increase in B-CLL cell adherence to MSC in 1/8 experiments. No correlation between basal adhesion and intensity of α4 expression was noted. The absence of this correlation can be explained by the highly variable expression of α4 on the B-CLL cells from a limited number of patients. Notably, the intensity of α4 and ß1 expression, on the B-CLL cells correlated with the degree of inhibition by anti-α4 and anti-ß1 MoAb. A significant positive correlation was noted between baseline adhesion and intensity of ß1 expression. Thus, α4ß1 and its ligand VCAM-1 are important for adhesion of B-CLL cells to MSC. However, other ligands of α4 and other as yet undescribed adhesion proteins may also play a role in B-CLL cell adhesion to MSC. In addition, when B-CLL cells were cocultured in direct contact with MSC monolayers, the proportion of B-CLL cells undergoing apoptosis decreased significantly.

A web-based teaching program for laboratory diagnosis of coagulation disorders.

OBJECTIVE: To implement an interactive program for teaching coagulation disorders on the World Wide Web. DESIGN AND RESULTS: The core materials in this program were derived from a personal computer software program previously designed by the authors. Three modules were developed in this program: (1) a coagulation profile to display typical results of coagulation screening tests for each disorder; (2) a differential diagnosis module to generate a list of diagnoses that fit the test results in a given case; and (3) a synopsis of coagulopathy and therapy to provide essential information on disorders and therapeutic options. A total of 41 coagulation disorders were included in the knowledge base. CONCLUSIONS: Since the World Wide Web is increasingly more accessible to computer users, it has become an ideal medium for teaching purposes. Our experience with this program in teaching medical students and pathology residents at our institution has been very encouraging.

Pseudo-Gaucher cells in peritoneal fluid: an uncommon manifestation of extramedullary hematopoiesis.

Pseudo-Gaucher cells have been observed in the bone marrow of patients suffering from a variety of hematologic disorders, including chronic myeloid leukemia, multiple myeloma, and immune thrombocytopenic purpura, as well as other conditions, such as rheumatoid arthritis. While the presence and potential clinical significance of pseudo-Gaucher cells have been documented in the hematology literature, references in standard cytology texts and journals are lacking. We report a case of ascites developing in the context of myelofibrosis, in which abdominal paracentesis yielded numerous pseudo-Gaucher cells as part of a mixed cellular population containing immature hematopoietic elements, consistent with extramedullary hematopoiesis.

Squamous cell carcinoma and keratoacanthoma of the lower lip associated with "Goza" and "Shisha" smoking.

BACKGROUND: A positive correlation between lip and buccal cancers and pipe smoking has been suggested. Various types of crude and manufactured tobacco products are consumed by smoking, chewing, and snuff dipping habits. 'Shisha" and 'Goza' smoking are widely practiced in the Middle East. The 'hubble-bubble' method and apparatus are used. These smoking habits are hazardous to health, causing obstructive lung disease, and may be important predisposing factors for the development of oral cancers. CASE REPORTS: Two cases of squamous cell carcinoma and a case of keratoacanthoma localized to the lower lip are presented in well-known 'Shisha' and 'Goza" smokers. CONCLUSIONS: "Shisha" and 'Goza' smoking have adverse effects on general health and may predispose to oral cancer. An extensive epidemiological study should be performed to determine whether this type of smoking habit is associated with a statistically increased incidence of squamous cell carcinoma and keratoacanthoma of the lips.

Worst headache and subarachnoid hemorrhage: prospective, modern computed tomography and spinal fluid analysis.

STUDY OBJECTIVE: This study investigated the hypothesis that modern computed tomographic (CT) imaging is sufficient to exclude subarachnoid hemorrhage (SAH) in patients with severe headache. METHODS: All 38,730 adult patients who presented to Hermann Hospital in Houston, Texas, during a 16-month period were prospectively screened to detect those with "the worst headache of my life." Two neuroradiologists blinded to the study hypothesis interpreted the CT scans. Patients with negative scans underwent comprehensive cerebrospinal fluid (CSF) analysis including cell count in first and last tubes, visual and spectrophotometric detection of xanthochromia, and CSF D-dimer assay. RESULTS: A chief complaint of headache was elicited in 455 patients, and 107 of these had "worst headache" and were enrolled in the study. CT-confirmed SAH was found in 18 of the 107 (17%). Only 2 patients (2.5%, 95% confidence interval, .3% to 8.8%) had SAH detected by CSF analysis among those with negative CT imaging result. CSF spectrophotometric detection was the most sensitive test for blood. Three patients with less than 6 red blood cells in tube 1 had positive spectrophotometric results, but in all 3, tube 4 was negative on spectrophotometric analysis, suggesting a high false-positive rate. CONCLUSION: Modern CT imaging is sufficient to exclude 97.5% of SAH in patients presenting to the ED with "worst headache" symptoms.

Asbestos and silica-induced changes in human alveolar macrophage phenotype.

The mechanism by which fibrogenic particulates induce inflammation that can progress to lung fibrosis is uncertain. The alveolar macrophage (AM) has been implicated in the inflammatory process because of its function and reported release of inflammatory mediators when isolated from fibrotic patients. It has been recently shown that fibrogenic, but not nonfibrogenic, particulates are highly potent in inducing apoptosis of human AM. In this study, we tested the hypothesis that fibrogenic particulates could shift the phenotypic ratio of human AM to a more inflammatory condition. The macrophage phenotypes were characterized by flow cytometry targeting the RFD1 and RFD7 epitopes. Results demonstrated that chrysotile and crocidolite asbestos, as well as crystalline silica, but not titanium dioxide or wollastonite, increased the RFD1+ phenotype (inducer or immune activator macrophages) and decreased the RFD1+ RFD7+ phenotype (suppressor macrophages). These results provide a mechanistic explanation that may link apoptosis (namely, suppressor macrophages) to a shift in the ratio of macrophage phenotypes that could initiate lung inflammation.

Human granulocytic ehrlichiosis in a renal transplant patient: case report and review of the literature.

BACKGROUND: Human ehrlichiosis, a newly described zoonotic infection, can be classified as human monocytic ehrlichiosis (HME) or human granulocytic ehrlichiosis (HGE). Although the clinical manifestations of HME and HGE are similar, the type of leukocyte infected, the etiologic agent, and the tick vector are distinct. METHODS: We report the first case of HGE in a solid organ transplant recipient and review the literature on HGE. RESULTS: Our patient displayed typical epidemiological, clinical, and laboratory features and responded promptly to therapy with doxycycline. CONCLUSIONS: Although opportunistic infections are relatively common in the posttransplant population, one must always consider other infections that occur in normal hosts as well. Human ehrlichiosis should be included in the differential diagnosis for transplant patients with fever, cytopenias, and hepatitis, especially if exposure to ticks in endemic areas has occurred.

Experience in urticaria with patients attending a dermatological clinic in a referral center in the eastern province of Saudi Arabia.

Urticaria is a common cutaneous vascular reaction pattern caused by diverse and multiple factors. However, an etiologic factor can be established in less than 20% of chronic cases. In this study, 274 patients with urticaria were evaluated in the dermatology clinic of King Fahd Hospital of the University (KFHU) between 1989 and 1992. Saudi nationals predominated; 188 patients were males (68.6%) and 86 were females (31.4%) and the peak incidence of urticaria was in young adults. The incidence of urticaria was 3.79% of dermatological cases. The success rate for identification of etiological factors was 41% in acute urticaria and 14% in chronic urticaria. The etiological categories discovered included allergies, physical factors, infections and miscellaneous systemic factors. In conclusion, causative factors remained elusive in the majority of cases. The identification and removal of the possible causative factors is the most aspect of management in urticaria. A detailed history and physical examination are in order; however, extensive laboratory investigations are unnecessary.

The in vivo effects of PIXY321 therapy on human monocyte activity.

In this report we describe the time-dependent effects of PIXY321 (a synthetic hybrid cytokine) treatment (500 and 750 micrograms/m2/day for 14 days) on six sarcoma patients. Blood was taken prior to PIXY321 injection (day 0), on days 1, 7, and 14 of treatment, and 7 days posttreatment (day 21). The number of isolated monocytes quadrupuled by day 7 and sustained a significant increase through day 14. There were significant increases in the percentage of circulating monocytes relative to total mononuclear cells on days 1 and 7 of therapy. There were no significant changes in monocyte cell surface antigens (15 checked), suggesting that the increase in monocyte numbers was not due to increased numbers of immature monocytes. The basal activity of the monocytes was not markedly altered during treatment; however, they were primed for significantly increased phorbol 12,13-dibutyrate-stimulated superoxide anion production and endotoxin-stimulated release of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) on days of 1 and 7 of therapy. There was a significant increase of IL-1 beta mRNA levels (unstimulated cells) on days 1 and 7, but TNF-alpha mRNA levels increased significantly on day 1 only. Consistent with the increase in superoxide anion production, there were increases in monocyte protein kinase C (PKC) levels on all days of therapy. There was a significant increase in PKCII beta mRNA only on the first day of treatment. All significant changes in monocyte number and function produced by PIXY321 infusion were reversible, as there were no sustained effects on day 21 (7 days after therapy). These results indicate that the effects of PIXY321 may be mediated through up-regulation of PKC resulting in monocytes primed for increased functional activity in response to an appropriate second stimulus.