[Rose-scented geranium essential oil from Algeria (Pelargonium graveolens L'Hérit.): Assessment of antioxidant, anti-inflammatory and anticancer properties against different metastatic cancer cell lines]. / Essence aromatique du Géranium Odorant (Pelargonium graveolens L'Hérit.) d'Algérie : exploration des propriétés antioxydante, anti-inflammatoire et anticancéreuse (anti-angiogénique et cytotoxique), in vitro et in ovo, vis-à-vis de différentes lignées cellulaires cancéreuses métastasiques.

INTRODUCTION: The study of natural products is one of the strategies implemented for the discovery of new compounds that can be used in cancer therapy. Aromatic herbs and medicinal plants found in Algeria and their anti-angiogenesis and cytotoxic potentials against cancer have not been much explored. OBJECTIVES: Our work aimed to evaluate the antioxidant, anti-inflammatory and anticancer properties of the essential oil (EO) extracted from rose-scented geranium (Pelargonium graveolens) and its major (citronellol) and characteristic (linalool) constituents. RESULTS: The chemical composition of EO was determined with chromatographic analysis and revealed the presence of citronellol as the major compound (25.84%). A strong chelating power of terpene alcohols (IC50=1.58±0.23mg/mL for citronellol) was found, with a significant difference (P<0.05) compared with the standard antioxidants used (L-ascorbic acid and butylated hydroxyanisole). The EO is distinguished by an interesting anti-inflammatory effect with the lowest IC50 (4.63±0.3mg/mL), and it constitutes a good stabilizer of the erythrocyte membrane. Citronellol also exhibited the best anti-inflammatory effect (IC50=0.74±0.09mg/mL). We also assessed the anticancer effect of EO on two main pathways involved in cancer development, angiogenesis and cell proliferation, using in ovo bioassays with a chorio-allantoic membrane (CAM) of chicken eggs and in vitro assays of its cytotoxicity on different metastatic breast cancer (MDA-MB-231), gastric (AGS) and melanoma (MV3) cell lines. In the CAM model, the density of micro-vessels is 75±10 in the group supplemented with EO compared to 140±9 for the control group (b-FGF). In addition, the EO significantly reduced the number of newly formed vessels. The cytotoxicity was evaluated using the cell proliferation inhibition method and cell viability was measured using the MTT test. Results revealed that the treatment of cancer lines with different concentrations of EO reduces the rate of cell viability in a dose-dependent manner. EO showed the greatest cytotoxicity on the AGS line with an inhibition rate of 92.87±0.13% at the highest dose (4µL/mL), followed by the MV3 line (88.76±0.96%). CONCLUSION AND PROSPECTS: Data demonstrated that rose-scented geranium EO has an antitumor potential on metastatic cancer cell lines. It is distinguished by its antiproliferative, anti-angiogenic, and anti-inflammatory activities. Medicinal plants might contain new molecules, with new structures, which could become lead candidate among future anticancer drugs.

Limitations of dorsal transpedicular stabilization in unstable fractures of the lower thoracic and lumbar spine: an analysis of 133 patients.

The optimal treatment of thoracic and lumbar fractures remains controversial. While many authors recommend dorsal instrumentation with an internal fixator, others favour an anterior approach. To evaluate the posterior approach and to identify conditions under which an anterior approach should be preferred, 133 patients with unstable thoracic and lumbar fractures of the spine who underwent dorsal instrumentation with an internal fixator were analyzed. Clinical data were recorded prospectively with respect to fracture type, neurological findings, operative complications, spinal deformation correction, and long-term outcome. All fractures were located between the 7th thoracic and the 5th lumbar vertebrae and were considered to be unstable with respect to the three column model. Seventy-six patients (57%) received surgery within the first seven days after the trauma. Postoperatively, 98% of patients with a radicular lesion or an incomplete transverse syndrome (47 patients, 35%) improved. Stable fracture consolidation after fixator removal was obtained in 98% (130 of 133 patients). The preoperative kyphosis angle decreased from an average of 10.1 degrees to 7.4 degrees at the three year follow up. Major operative complications consisted of two isolated nerve root lesions (1.5%), two deep wound infections with need of fixator removal (1.5%), and mallocation of two pedicle screws with need for another procedure in two patients (1.5%). Three patients (2%) suffered from insufficient bony fusion with increase of kyphotic deformation and required subsequent anterior stabilization. These three patients presented with an initial kyphosis or wedge angle of 20 degrees or higher. In conclusion, dorsal stabilization with the internal fixator is a safe and reliable treatment for unstable fractures of the lower thoracic and lumbar spine. The authors recommend this procedure because of its low-invasiveness in conjunction with satisfactory reconstruction and stabilization. However, an anterior approach should be considered in fractures with initial kyphotic deformation or wedge angle of 20 or more degrees.

Hepatitis c and cirrhotic liver disease in the Nile delta of Egypt: a community-based study.

Residents of Egypt's Nile river delta have among the world's highest seroprevalence of hepatitis C virus (HCV) infection. To assess the impact of HCV on chronic liver disease, we studied the association between HCV, other hepatitis viruses, and cirrhotic liver disease in a cross-sectional, community-based survey of 801 persons aged > or = 10 years living in a semi-urban, Nile delta village. Residents were systematically sampled using questionnaires, physical examination, abdominal ultrasonography and serologically for antibodies to HCV (confirmed by a third-generation immunoblot assay) and to hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis E virus (HEV). The seroprevalence of HCV increased with age from 19% in persons 10-19 years old to about 60% in persons 30 years and older. Although no practices that might facilitate HCV transmission were discovered, the seroprevalence of HCV was significantly associated with remote (> 1 year) histories of schistosomiasis. Sonographic evidence of cirrhosis was present in 3% (95% CI: 1%, 4%) of the population (0.7% of persons under 30 years of age and in 5% of older persons), and was significantly associated with HCV seroreactivity. Our findings are consistent with the hypothesis that past mass parenteral chemotherapy campaigns for schistosomiasis facilitated HCV transmission, and that HCV may be a major cause of the high prevalence of liver cirrhosis in this Nile village.

Epidemiology and control of scabies in an Egyptian village.

BACKGROUND: Some studies have addressed the epidemiology of scabies among rural populations in developing countries; however, the epidemiology of scabies among the rural population in Egypt is unknown. We sought to determine the magnitude of scabies infestation in an Egyptian village and to evaluate the control measures after 1 year. METHODS: This study was carried out on 3147 residents of Mit-Moaned village in Dakahlia govemorate, Egypt. It was a cross-sectional follow-up study where the same individuals examined in round I were re-examined in round III. The two rounds were separated by a period of 1 year, during which infested patients were followed up and new cases were discovered (round II). Patients and their household contacts received treatment with topical permethrin. Patients showing resistance to permethrin received a single oral dose of ivermectin. RESULTS: In round III, the overall prevalence rate of scabies was reduced from 5.4% in round I to 1.1%. The incidence of new cases among susceptible persons during round II was 1.1%. Scabies was significantly (P < 0.05) more prevalent among families of large size, high crowding index at night, low socioeconomic standards, and those receiving their water supply from a hand pump. Children younger than 10 years showed the highest prevalence. CONCLUSIONS: Our data provide the first complete picture of the epidemiology of scabies in rural Egypt. The epidemiologic characteristics of the disease should be considered in the design of disease control programs for other villages with scabies epidemics. Our findings revealed that good control was achieved with the following: increased awareness and better case finding, education of the staff at the rural health unit, improved hygiene measures, and massive treatment campaigns using effective drugs such as topical permethrin and oral ivermectin.

Hepatitis G virus in Egyptians infected with other parenterally transmitted hepatitis viruses.

A novel hepatitis-associated virus, hepatitis G virus (HGV) has recently been identified. The virus is known to be parenterally transmitted and has been found frequently in subjects chronically infected with hepatitis C virus (HCV). We investigated the seroprevalence of HGV infection in 91 Egyptians infected with hepatitis C and/or B virus including 52 patients with chronic liver disease and 39 asymptomatic subjects. A newly developed immunoassay was used to detect antibody to HGV envelope protein E2. The overall prevalence of anti-HGV in study subjects was 34.1%. Hepatitis G virus antibody was more frequent in patients with chronic liver disease (36.4%-43.9%) than in asymptomatic persons (23.1%). Analysis of demographic features, risk factors and clinical history of the study population revealed that older age and history of schistosomiasis were the factors significantly associated with anti-HGV positivity. The study demonstrated that HGV is highly prevalent in individuals infected with other parenterally transmitted hepatitis viruses. The impact of such observation rises in view of the endemicity of hepatitis C and B viruses in Egypt.

Association of hepatitis C virus with liver cirrhosis and hepatocellular carcinoma compared with hepatitis B virus in Egyptian patients.

Hepatocellular carcinoma (HCC) is an aggressive malignancy and carries a poor prognosis. Documentation of the wide geographical variation in its incidence has led to clear identification of several risk factors. These include hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in endemic areas. The present study investigated the association of HBV with HCV and cirrhosis, the latter is regarded as a premalignant lesion and underlies most cases with HCC. Serum samples from 94 patients with HCC (n=25) and cirrhosis (n=69) were tested for hepatitis C virus antibody (anti-HCV), hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and serum alphafetoprotein (AFP). Of the 94 patients, 71 (75.5%) had anti-HCV, 6 (6.4%) were positive to HBsAg, while 64 (68.1%) were positive to anti-HBc. These viral markers were more prevalent among HCC patients, 19 (76.0%) had hepatitis C antibody, 3 (12.0%) were positive to HBsAg and 22 (88.0%) were positive to anti-HBc compared with 52 (75.4%), 3 (4.3%) and 42 (60.9%), respectively in patients with cirrhosis. Regarding serum AFP measurement, 14 (56%) of patients with carcinoma and 35 (50.7%) of patients with cirrhosis demonstrated levels above 7 ng/ml. In patients with cirrhosis, elevated serum AFP and presence of anti-HCV in serum were significantly associated. In conclusion, this study shows that viral hepatitis is strongly associated with the development of cirrhosis and HCC in Egyptian patients. Hepatitis C virus seems to play a predominant role compared with hepatitis B virus.

Serum interleukin-2 and soluble interleukin-2 receptor in gestational trophoblastic diseases.

OBJECTIVE: To investigate serum interleukin-2 (IL-2) and soluble interleukin-2 receptor (SIL-2) levels in gestational trophoblastic diseases (GTD). METHODS: Sixty-six patients with GTDs and 23 first-trimester healthy pregnant women (controls) participated in this study. According to the World Health Organization scoring system, GTDs were subgrouped into the following groups: 30 hydatidiform mole spontaneous regression (HMSR), 12 postmolar gestational trophoblastic tumors of high risk (PMHR), 14 low-risk choriocarcinomas, and ten high-risk choriocarcinomas. Before treatment, a blood sample from each case was assayed for beta-hCG by radioimmunoassay, IL-2 by IRMA, and SIL-2R by enzyme-linked immunosorbent assay. Follow-up beta-hCG assays were carried out at weekly intervals after treatment for 3 months, then monthly for 1 year. RESULTS: Serum IL-2 levels in all subgroups of GTD were significantly lower than that of controls. Meanwhile, there were concomitant significant elevations of serum SIL-2R, showing mean rises of 3.86-fold, 3.9-fold, twofold, and 6.1-fold for cases of HMSR, PMHR, low-risk choriocarcinoma, and high-risk carcinoma, respectively. All cases of high-risk choriocarcinoma revealed abnormally high SIL-2R values. There was a significant positive correlation between serum beta-hCG and SIL-2R concentrations. CONCLUSION: The possible causes of IL-2 decreases and SIL-2R increases may indicate a defective immune response in GTDs. The high correlation between SIL-2R level and tumor burden suggests the use of serum SIL-2R assay for disease monitoring: SIL-2R is indirect marker of tumor activity, and it is useful in the differential diagnosis of GTD because a normal value of serum SIL-2R excludes high-risk cases of choriocarcinoma.

Serum cytokines in gestational trophoblastic diseases.

Interleukin 1 beta (IL-1 beta), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were assayed by 125I immunoradiometric assay in sera of 42 cases of vesicular mole (VM), 24 cases of choriocarcinoma and 23 normal pregnant women at their first trimester (controls). According to pathologic diagnosis and serial serum hCG beta assays, the cases with VM and choriocarcinoma were subdivided into remission and progressive tumor groups. The progressive tumor groups--both VM and choriocarcinoma--showed marked elevations of serum IL-1 beta, IL-6 and TNF alpha. For choriocarcinoma in remission this elevation was considerably less pronounced. The VM cases in remission had only a slight increase of the mean serum IL-6 value and none of the cases had elevated IL-1 beta or TNF values. These results may indicate that serum IL-1 beta and TNF-alpha assays are valuable biomarkers in the differential diagnosis of gestational trophoblastic disease (GTD). Moreover, normal values of these cytokines may rule out high-risk GTD, whereas markedly elevated values may indicate poor prognosis.

Study of the high prevalence of HCV in Egypt.

The correlation of schistosomiasis and other variables as a risk factor behind the remarkable high rates of HCV seropositivity in Egypt was studied by examining the sera of 188 subjects (94 apparently healthy villagers and 94 non professional blood donors) for schistosoma antibodies by Falcon assay screening test enzyme linked immunosorbent assay (FAST-ELISA) and for HCV antibodies by the application of screening (ELISA) and confirmatory (RIBA) techniques. The results showed that the overall prevalence of HCV antibodies was 29.8% by ELISA reduced to 21.8% i.e. 73.2% confirmation by RIBA test. HCV-RNA (HCV viraemia) was detected in 76% of 25 ELISA anti-HCV positive sera by P.C.R. technique. After adjustment for age, there was no statistical significant correlation between the remarkable high rates of HCV seropositivity in Egypt and risk factors studied other than blood transfusion, and schistosomiasis.

Hepatitis C and B viruses, and their association with hepatocellular carcinoma in Egypt.

Hepatitis C and B viruses are associated with hepatocellular carcinoma in Europe, Asia and Southern Africa. A study of hepatitis C and hepatitis B virus infection was carried out on 70 patients with HCC, from the National Cancer Institute, Cairo University. Sera from patients were tested for anti-HCV and HBsAg markers. Twenty patients (30%) were anti HCV positive alone, 15 (21.4%) were HBsAg positive alone, 28 (40%) were positive for both anti-HCV and HBsAg and the remaining 6 patients (8.6%) were negative for the two markers. The total positivity for anti-HCV and for HBsAg in these patients was 70% and 61.4% respectively. The comparable figures in a recent study on 90 blood donors from Egypt, were 24.4% for anti-HCV and 4.4% for HBSAg. These data suggest a possible link between HCV and HBV infection and the development of hepatocellular carcinoma in Egypt, as has been found elsewhere in the world.

Effect of treatment with povidone-iodine vaginal pessaries on thyroid function.

Twenty women suffering from candidal, trichomonal and non-specific vaginitis were treated by povidone-iodine vaginal pessaries twice daily for 14 days. Blood samples were obtained from patients before and 7 and 14 days after treatment for the determination of serum thyroid stimulating hormone, total thyroxine, free thyroxine, total triiodothyronine, free triiodothyronine, reverse triiodothyronine, thyroxine binding globulin and thyroglobulin by the corresponding specific 125I radioimmunoassay. In addition serum protein bound iodine was determined by a spectrophotometric method. Post-treatment values of these parameters after 7 and 14 days were not significantly different from the corresponding pretreatment values. Vaginal discharge disappeared in 82% of patients; with partial improvement in the remaining 18%. No clinical side effects and no clinical evidence of thyroid disorder were found in any of the women. These results indicate that treatment with povidone-iodine vaginal pessaries is effective in the treatment of different forms of vaginitis and their daily use in euthyroid, non-pregnant women is safe and has no effect on thyroid function.

Hepatitis C virus infection in blood donors in Egypt.

A study was carried out on 90 serum samples from non-professional blood donors to find out the relative prevalence of HBV and HCV among those blood donors. Results demonstrated overall positivity rate of 14.4% for anti-HCV by RIBA test. The percentage of reactive sera was 6% for the age group of 20 to below 30 years, and 37.5% in those aged above 30 years, and this difference was statistically significant. Considering the combined reactivity of the tested 90 sera for anti-HBs and anti-HCV, the results showed that 41.1% of the sera were positive for anti-HBs; 10% reacted positively with both anti-HBs and anti-HCV, and 4.4% of the sera were positive for anti-HCV only. The high prevalence of anti-HCV in this study (14.4%) exceeds that reported in other countries, and is comparable with that of Saeed and associates (1991). These results may indicate endemicity of HCV in Egypt and/or a possible role of the endemic schistosomiasis. On the basis of data, suggesting that anti-HCV reflects persistent infection rather than immunity, screening for anti-HCV should be included in all blood transfusion services to exclude HCV which is responsible for 90% of PTH (Van der Poel et al., 1990; Weiner et al., 1990; and Esteban et al., 1991). The remarkably high seroprevalence of anti-HCV among Egyptian volunteer blood donors, which has not so far been reported from other countries, should be thoroughly studied. This should cover many aspects including large epidemiological studies, factors pertinent to Egypt as schistosomiasis, and other possible factors that might enhance HCV transmission in Egyptian population. High risk groups as the polytransfused and renal dialysis patients should be studied. Needless to say that, an accurate measure of HCV prevalence depends on specificity and sensitivity of the employed laboratory diagnostic tests; development of new tests for the detection of antibodies to HCV, together with development of tests for other markers such as HCV antigen and the polymerase chain reaction to detect HCV DNA in blood, will be of great help.

Cervical mucus prolactin levels in normal fertile and infertile women.

Cervical mucus and serum samples were obtained from 42 anovular women and 20 normal ovular fertile women (controls) for the determination of prolactin concentration by a solid phase radioimmunoassay. The former group was subgrouped into 14 galactorrhoeic (9 with oligohypomenorrhea and 5 with amenorrhea) and 28 non-galactorrhoeic (19 with oligohypomenorrhea and 9 with amenorrhea). The level of prolactin in cervical mucus of normally menstruating women was significantly higher than that of serum at P less than 0.0125 (11.68 +/- 0.77 ng/ml and 16.09 +/- 1.65 ng/ml, mean +/- SE, respectively). Serum prolactin level in galactorrhoeic amenorrhea cases was 8.2 times that of controls, while cervical mucus prolactin amounted to 32 times its control value. The rise of cervical mucus prolactin in cases of galactorrhea oligohypomenorrhea was 21 times its control value which is markedly higher than that of serum (1.9 times). The average rise of serum prolactin in the whole group of galactorrhea with abnormal menstrual function was about 4 times the control value, while the average rise of cervical mucus prolactin was about 41 times the corresponding control value. In the cases of galactorrhea with menstrual dysfunction, serum prolactin level may be normal in 50% of cases, while cervical mucus prolactin is strikingly elevated in 100% of cases. The possibility of pituitary adenoma should be considered if the level of serum or cervical mucus prolactin exceeds 100 ng/ml and 600 ng/ml respectively. The possible physiological role of cervical mucus prolactin and its source are discussed.

Endocrinologic and psychologic aspects of galactorrhea associated with normal menstrual cycles.

Twelve cases of galactorrhea in women with normal menstrual cycles who were radiologically free of any pituitary adenomas were investigated. Determinations were made for serum thyroid-stimulating hormone (TSH), T3 resin uptake (T3RU), total thyroxine by radioimmunoassay (T4), free thyroxine index (FT4I), norepinephrine, epinephrine, prolactin and urinary luteinizing hormone, total estrogens, pregnanediol and total catecholamines. Psychologic evaluation and assessment were also done using the Middlesex Hospital Questionnaire and the Eysenk, manual dexterity, Bender Gestalt and trial-making scales. Hypothyroidism associated with moderate hyperprolactinemia and anovulation were the main features in eight cases. Associated psychologic disturbances were reported. The other four cases showed significant elevations in serum epinephrine, norepinephrine and urinary total catecholamines with concomitant pathologic scales of anxiety and neuroticism. Thyroxine replacement and psychotherapy are recommended in the treatment of such cases.

Genital tract bleeding in IUD users and its relation to the device state.

PIP: The relationship between the device state of an IUD and genital tract bleeding was investigated. The investigation was based on data collected from a random 1075 insertions of 30-mm Lippes Loops, which constituted a general incidence of bleeding of 15% in IUD users. In 21% of these cases, the bleeding could not be halted by standard treatments, and the IUD was removed. X-ray, hysterography, and ultrasonography were used to diagnose the IUD state in situ. 75% of the cases requiring IUD removal showed abnormal radiological findings, whereas only 20% of the treatable bleeding cases showed radiological device abnormality. Use-duration was the main factor in the findings; users of IUDs for less than 1 year had abnormal radiological findings in 58.3% of resistant cases and in 29.6% of treatable cases. The corresponding figures among users for periods of time varying from 1-3 years and greater than 3 years were 49.6 and 11.4, respectively, and 86.6 and 66, respectively. Device displacement, distortion, and fractures were the most common radiologically detected abnormalities. In the 2 groups studied, the bleeding pattern varied in amount and type. In resistant cases, metrorrhagia was significant. The increase of vaginal discharge (40.4%), uterine colic (88%), tenderness (25.8%), and RVF (35.5%) was detected in the resistant as opposed to the treatable groups. This increase suggests a uterine factor, i.e., the IUD itself.^ieng

Serum sialic acids in the normal menstrual cycle: a possible test for the prediction of ovulation.

PIP: A test for predicting ovulation is described which is based on measurement of serum sialic acids in normal menstrual cycle. In this study of 7 healthy, fertile women, free, bound, and total sialic acids were determined during various menstrual cycle phases. A second experiment was performed on 109 oral contraceptive pill users who were taking combined formulations for less than 1 year, 1-2 years, and 3-5 years. In addition, urinary luteinizing hormone determinations were made throughout the menstrual cycles. Bound and total sialic acids showed significant drops from Day 9-13 of the menstrual cycle, whereas they were at an almost constant level during the remainder of the cycle. Based on luteinizing hormone determinations, this drop was seen to coincide with the preovulatory estrogen peak, and just preceded the luteinizing hormone peak. Pill users, with anovular cycles, did not show such a drop in bound and total sialic acids. Hence, determination of serum sialic acids may be a useful tool for ovulation detection.^ieng