Green tea extract modulates lithium-induced thyroid follicular cell damage in rats.

BACKGROUND: The aim of the current work was to clarify the modulation role of green tea extract (GTE) over structural and functional affection of the thyroid gland after long term use of lithium carbonate (LC). The suggested underlying mechanisms participating in thyroid affection were researched. MATERIALS AND METHODS: Twenty-four Sprague-Dawley adult albino rats were included in the work. They were divided into three groups (control, LC, and concomitant LC + GTE). The work was sustained for 8 weeks. Biochemical assays were performed (thyroid hormone profile, interleukin 6 [Il-6]). Histological, histochemical (Periodic Acid Schiff [PAS]) and immunohistochemical (caspase-3, tumour necrosis factor alpha [TNF-α], proliferating cell nuclear antigen [PCNA]) evaluations were done. Oxidative/antioxidative markers (malondialdehyde [MDA]/gluthathione [GSH], superoxide dismutase [SOD]) and Western blot evaluation of the Bcl2 family were done. RESULTS: Lithium carbonate induced hypothyroidism (decreased T3, T4/increased thyroid-stimulating hormone [TSH]). The follicles were distended, others were involuted. Some follicles were disorganised, others showed detached follicular cells. Apoptotic follicular cells were shown (BAX and caspase-3 increased, Bcl2 decreased, BAX/Bcl2 ratio increased). The collagen fibres' content and proinflammatory markers (TNF-α and IL-6) increased. The proliferative nuclear activity was supported by increased expression of PCNA. Oxidative stress was established (increased MDA/decreased GSH, SOD). With the use of GTE, the thyroid hormone levels increased, while the TSH level decreased. Apoptosis was improved as BAX decreased, Bcl2 increased, and BAX/Bcl2 ratio was normal. The collagen fibres' content and proinflammatory markers (TNF-α and IL-6) decreased. The expression of PCNA and caspase-3 were comparable to the control group. The oxidative markers were improved (decreased MDA/increased GSH, SOD). CONCLUSIONS: In conclusion, prolonged use of LC results in hypothyroidism, which is accompanied by structural thyroid damage. LC induced thyroid damage through oxidative stress that prompted sterile inflammation and apoptosis. With the use of GTE, the thyroid gland regained its structure and function. The protecting role of GTE is through antioxidant, antifibrotic, anti-inflammatory, and antiproliferative effects.

Protective effect of resveratrol on acrylamide-induced renal impairment.

BACKGROUND: Acrylamide (ACR) has a wide range of uses. It possesses a renal impairment effect. The work aimed to study the possible protecting role of resveratrol (RVS) over the ACR-mediated renal impairment in rats. The suggested underlying mechanisms participating in such protection were investigated. MATERIALS AND METHODS: Thirty Sprague-Dawley adult albino rats were divided into three groups: control, ACR, and RVS. After 4 weeks, the kidney was removed and prepared for histological, immunohistochemical, and biochemical studies. The activity of tissue oxidative (malondialdehyde [MDA]) and anti-oxidative (glutathione [GSH]) markers were assessed. RESULTS: Acrylamide induced glomerular renal affection in the form of shrinkage and distortion of the glomeruli with wrinkling of their basement membranes and widening of the urinary spaces. Degenerative tubular changes were markedly present in the proximal convoluted tubules. The necrotic tubular cells exhibited cytoplasmic vacuolation with desquamated epithelial cells within the tubular lumen. ACR increases the deposition of collagen fibres in the basement membrane of the glomerular capillaries and induced thickening of the basement membranes of the renal corpuscles and renal tubules. The administration of RVS affords high protection to the kidney. The glomeruli and renal tubules were nearly normal. The content of collagen fibres and the periodic acid Schiff reaction of the basement membrane of the renal tubules were 70% and 19% lower linked to the ACR group. The creatinine and urea levels decreased by 51% and 47%. RVS induced such a protective role through its antioxidant effect as the MDA level decreased by 45%, while the GSH level increased by 83% compared with the ACR group. CONCLUSIONS: Acrylamide causes structural and functional disorders of the kidney. It induces kidney damage through oxidative stress and apoptosis. With the use of RVS, normal kidney architecture was preserved with little structural changes. Adding, functional kidney test became normal. RVS exerts its protective effect through its anti-apoptotic and antioxidant features.

Febuxostat ameliorates methotrexate-induced lung damage.

BACKGROUND: The intention of the present study was to assess the structural affection of the lung following methotrexate (MTX) overdose. The proposed underlying mechanisms involved in lung affection were studied. The possible modulation role of febuxostat over such affection was studied. MATERIALS AND METHODS: Twenty-four rats were divided into three groups: control, MTX-treated, febuxostat-treated. The study was continued for 2 weeks. Lung was processed for histological and immunohistochemical (inducible nitric oxide synthase [iNOS] and cyclooxygenase [COX]-2) studies. Inflammatory markers (tumour necrosis factor alpha [TNF-a], interleukin 1 [IL-1]), Western blot evaluation of nuclear factor kappa B (NF-kB) and oxidative/antioxidative markers were done. RESULTS: Methotrexate-treated group exhibited inflammatory cellular infiltrations, thickened interalveolar septa, dilated congested blood vessels, extravasated blood, and apoptosis. The collagen fibres content increased 3-fold. MTX induced lung affection through oxidative stress (increase MDA/decrease GSH, SOD) and apoptosis. It induced sterile inflammation through an increase of NF-kB (2-fold), IL-1 (3-fold) and TNF-a (3-fold), COX-2 cells (2.5-fold) and iNOS (6-fold). With the use of febuxostat, the normal lung architecture was observed with a bit thickened interalveolar septum and extravasated blood. The collagen fibres content was minimal. Decrement of oxidative stress and sterile inflammation (COX-2 cells and iNOS were comparable to the control group. NF-kB, IL-1 and TNF-a became higher by 34%, 64% and 100%). CONCLUSIONS: The overdose of MTX displays inflammatory lung affection with residual fibrosis. It induces lung affection through oxidative stress, apoptosis and sterile inflammation. With the use of febuxostat, the normal lung architecture was preserved with a little structural affection or fibrotic residue. Febuxostat exerts its lung protection through its anti-inflammatory and antioxidant features.

Anatomical variations of hepatic artery using the multidetector computed tomography angiography.

BACKGROUND: The frequency of normal and aberrant hepatic arteries differs among ethnicities. The aim of our work was to study the frequency of normal and aberrant hepatic arteries among Egyptians using multidetector computed tomography (MDCT) and to compare our prevalence with the prevalence of other nationalities. In addition, the gender differences of such variations were clarified. Moreover, the arterial feeding of hepatic segment IV was determined. MATERIALS AND METHODS: The present study was carried out on 500 patients (409 males and 91 females). Abdominal CT was performed using two MDCT systems, a 64-row, and a 256-slice system. RESULTS: According to Michel's classification, the normal anatomy (type I) was observed in 369 (73.8%) cases, while anomalous hepatic arterial pattern was detected in 131 (26.2%) cases. These anomalies were distributed as follows: type II in 36 (7.2%) cases, type III in 60 (12%) cases, types IV and V in 5 cases for each (1% each), type VI in 14 (2.8%) and types VIII and IX in a single case for each (0.2% each). Neither type VII nor type X was detected. Nine (1.8%) unclassified cases were observed. According to Hiaat's classification, the anomalies were distributed as follows: type II in 41 (8.2%) cases, type III in 74 (14.8%) cases, type IV in 6 (1.2%) cases, type V in a single case (0.2%) and type VI in 2 (0.4%) cases. Finally, 7 (1.4%) unclassified cases were observed. Common hepatic artery (CHA) originated from coeliac trunk in 98% (79.8% males and 18.2% females). It originated from the abdominal aorta in 0.4% and from the superior mesenteric artery (SMA) in 0.4%. It was absent in 1.2%. Right hepatic artery (RHA) originated from the CHA in 86.6% (69.8% males and 16.8% females) and from the SMA in 13.2% (11.8% males and 1.4% females) and from the abdominal aorta in 0.2% (a single male case). Left hepatic artery (LHA) originated from the CHA in 91.2% and from the left gastric artery (LGA) in 8.8%. The most common origin of the segment IV blood supply was the LHA in 60.8%, followed by the RHA in 35%. Less commonly, blood supply derived from the hepatic artery proper (HAP) in 1%. Combined supply derived from RHA and LHA in 0.8%, from the LHA and HAP in 2% and the least encountered was from the RHA and HAP in 0.4%. CONCLUSIONS: Hepatic artery variations among Egyptians have a different distribution when compared to such variations among other species. The normal hepatic arterial pattern was observed in 73.8%, while the anomalous was detected in 26.2%. The CHA originated from the coeliac trunk in 98%, the RHA originated from the CHA in 86.6% and the LHA originated from the CHA in 91.2%. The most common arterial supply of the hepatic segment IV is derived from the LHA (60.2%).

Mesenchymal stem cells pretreated with platelet-rich plasma modulate doxorubicin-induced cardiotoxicity.

The cardiotoxic adverse effect of doxorubicin (DOX) is the major factor limiting its use. Recently, mesenchymal stem cells (MSCs) have been implicated in the preclinical studies of treatment of DOX-induced cardiotoxicity. The question is MSCs pretreated with platelet-rich plasma (PRP) have a better influence on DOX-induced cardiotoxicity compared to the influence of MSCs alone. Twenty-four Wistar rats were categorized into control, DOX-treated, MSC-treated, and PRP/MSC-treated groups. DOX was injected for two consecutive weeks. Light microscopic, biochemical markers (interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-α), and creatine kinase-MB (CK-MB)), immunohistochemical (Bax, Bcl2, vascular endothelial growth factor (VEGF), and cardiac troponin-I (CT-I)), and oxidative/antioxidative markers (malondialdehyde (MDA)/superoxide dismutase (SOD)) were measured. Degenerative cardiac changes were detected in the DOX-treated group with complete loss of the architecture and coagulative necrosis. These changes were accompanied with the elevation of the serum level of CK-MB and loss of CT-I immunoreactivity. The major factors in the DOX-induced cardiotoxicity were the oxidative stress (elevated MDA/decreased SOD), inflammation (elevated TNF-α/decreased IL-10), and cardiac apoptosis (lower Bcl2, higher Bax, and lower Bcl2/Bax ratio). MSCs and PRP/MSCs attenuate DOX-induced cardiotoxicity. Better attenuation was observed in the PRP/MSC-treated group. PRP/MSC combination reduced greatly the MDA and TNF-α and increased IL-10, Bcl2/Bax ratio, and VEGF. PRP had no significant influence over the Bcl2, Bax, and SOD. In conclusion, DOX in its toxic dose induced myocardial injury. This destructive effect is related to oxidative stress, inflammation, and cardiac apoptosis. PRP/MSC possesses a better attenuation over the DOX-induced toxicity compared to MSC alone.

Configuration of the circle of Willis and its two parts among Egyptian: a magnetic resonance angiographic study.

BACKGROUND: We hypothesized that the collateral circulation differs in different ethnic groups. So, the aim of our work was to study variations of the circle of Willis (COW) among Egyptian and to compare our findings with the findings of other nationalities. MATERIALS AND METHODS: One hundred patients were studied using magnetic resonance angiography (3D-TOF-MRA). Frequency and morphologic variations in COW were studied. The diameters of the arteries of the anterior and posterior circle were verified. Finally, the differences among the mean diameters of these arteries regarding age and sex were also studied. RESULTS: Complete, partially complete and incomplete COW were encountered in 28%, 38% and 34% in the studied cases. The incomplete anterior circle was found in 34% (10% isolated incomplete anterior circle and 24% combined incomplete anterior and posterior circles) and the incomplete posterior circle came across in 62% (38% isolated incomplete posterior circle and 24% combined incomplete anterior and posterior circles). Seven anterior circle variations were found. The commonest type was the classical type "a" with a prevalence of 56%, being higher in male (57.1%). The 2nd common type was type "g" (hypoplasia or aplasia of the anterior communicating artery) with a prevalence of 24%, being higher in male (66.7%). Six posterior circle variations were found. The commonest variation was the classic type "a" with a prevalence of 26%, being higher in male (61.5%). Posterior circles types "d, e, h" (18%, 24%, 20%) constituted 62% and were characterised by hypoplasia/absent of the posterior communicating arteries. CONCLUSIONS: The prevalence of complete COW (classic or textbook type) was encountered only 28% of the studied cases. Variations of COW were found to be more common in the posterior circulation (62%). The incomplete anterior circle was found in 34% and it is mostly caused by hypoplasia or aplasia of the anterior communicating artery which was found to be more common compared to the literature.

The differential effects of high-fat and high- -fructose diets on the liver of male albino rat and the proposed underlying mechanisms.

BACKGROUND: The Western-style diet is characterised by the high intake of energy- -dense foods. Consumption of either high-fructose diet or saturated fat resulted in the development of metabolic syndrome. Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Many researchers studied the effect of high-fat diet (HFD), high-fructose diet (HFruD) and high-fructose high-fat diet (HFHF) on the liver. The missing data are the comparison effect of these groups i.e. are effects of the HFHF diet on the liver more pronounced? So, this study was designed to compare the metabolic and histopathological effect of the HFD, HFruD, and HFHF on the liver. The proposed underlying mechanisms involved in these changes were also studied. MATERIALS AND METHODS: Twenty four rats were divided into four groups: con- trol, HFD, HFruD, and HFHF. Food was offered for 6 weeks. Biochemical, light microscopic, immunohistochemical (Inducible nitric oxide synthase [iNOS] and alpha-smooth muscle actin [α-SMA]), real-time polymerase chain reaction (gene expression of TNF-α, interleukin-6, Bax, BCL-2, and caspase 3), histomorphometric analysis and oxidative/antioxidative markers (thiobarbituric acid reactive substances [TBARS], malondialdehyde [MDA]/glutathione [GSH] and superoxide dismutase [SOD]) were done. RESULTS: The HFD, HFruD and HFHF groups developed a cluster of liver disorders; steatosis, necrosis, inflammation, apoptosis, ballooning degeneration and cytopla- smic vacuolations. Internal metabolic impairments include elevated serum levels of glucose, triglycerides, low density lipoprotein and decreased serum levels of high density lipoprotein and albumin. The immunoreaction of the α-SMA and iNOS was strong in these groups. The oxidant markers (MDA and TBARS) were elevated, while the antioxidant markers (SOD and GSH) were decreased. The area per cent of collagen, inflammatory markers, caspase 3 and Bax were elevated, while the BCL-2/Bax ratio was decreased. The decrease in PAS, antioxidant markers and the elevation of the α-SMA, iNOS, inflammatory and oxidant markers were obvious in the HFHF when compared to that of the other groups. CONCLUSIONS: High-fat diet, HFruD, and HFHF developed morphologic hepatic changes ranging from steatosis to necrosis and inflammation, besides the deve- lopment of internal metabolic impairments. The chief factors of hepatic injury were fat accumulation in the hepatocytes, oxidative stress and highly elevated iNOS. Compared to the other groups, HFHF's effect was more prominent.

Evaluation of antioxidant and anti-lipid peroxidation potentials of Nigella sativa and onion extract on nicotine-induced lung damage.

BACKGROUND: The present work aimed to compare the protective effect of Nigella sativa (NS) and onion extract on the nicotine-induced lung damage in rats. The antioxidant and anti-lipid peroxidation potentials of both agents on nicotine-induced lung damage were studied. MATERIALS AND METHODS: Thirty-six Sprague-Dawley albino rats, treated for 18 weeks, were divided into six groups: one negative control group, two positive control groups (oral onion and oral NS), nicotine-treated group, onion extract-treated group (concomitant nicotine and onion extract) and NS-treated group (concomitant nicotine and NS oil). The assessment of lung structure was based on haematoxylin and eosin and transmission electron microscopy. Lung malondialdehyde (MDA), superoxide dismutase activity (SOD), catalase (CAT), lung glutathione (GSH), and epithelial lining fluid GSH (ELF GSH) were used for assessment of the antioxidant and anti-lipid peroxidation potentials of NS and onion extract. RESULTS: The lung of the nicotine-treated group exhibited emphysematous air spaces, collapsed corrugated alveoli with ruptured interalveolar septa in some specimen and thickened septa in the others, massive congestion, extravasation of red blood cells, inflammatory cellular infiltration and fluid exudate. Much improvement was observed in the onion-treated group despite the presence of residual pathological affection. The lung in the NS-treated group showed the nearly normal architecture with slight congestion. Administration of nicotine promoted lipid peroxidation (elevation of MDA) and decreased the level of the antioxidant markers (SOD, CAT, lung GSH and ELF GSH). With the use of onion extract and NS, the level of MDA decreased by 17.85% and 35.71% while the levels of SOD, CAT, GSH, and ELF GSH increased. The increase was more prominent in the NS-treated group. The levels in the NS-treated group reached nearly the level markers of the control group. CONCLUSIONS: Nigella sativa and onion extract attenuate the pathological effect of nicotine in the lung rats through antioxidative and anti-lipid peroxidative mechanisms with higher protection to NS.

Stress-induced changes in the aged-rat adrenal cortex. Histological and histomorphometric study.

BACKGROUND: Stress exposure exerts direct effects on the morphology and functionality of the adrenal cortex. In addition, ageing effects growth, differentiation, apoptosis and cellularity of the cortex. The missing data is the combined effect of stress and ageing on the adrenal cortex. The aim of this study was to demonstrate the structural changes in the adrenal cortex following the exposure to stress in the adult and aged albino rats. MATERIALS AND METHODS: Forty rats were divided into groups I and II (adult and senile). Each group was further subdivided into subgroups a and b (control and stressed). Light and electron microscopic studies were done. Area per cent of collagen fibres (Masson's trichrome-stained sections), number of proliferating cells (optical density immunoreactivity in the Ki67 stained sections) and thickness of the three adrenal zones were also measured. RESULTS: Lamellar separation of the capsule with subcapsular spindle cell hyperplasia and areas of ghost cells were observed in zona glomerulosa (ZG) and zona fasciculata (ZF) in group I-b. Separation and indentation of the capsule with its lamellar separation were observed in group II-a with the existence of multiple scattered degenerative foci in ZF and zona reticularis (ZR). Similar and aggressive was the architectural pattern of ZF in group II-b with the presence of areas of homogenous degeneration. The nuclei of ZG had marginated chromatin in group I-b and were pyknotic with deformed irregular outlines in group II-b. Multiple lysosomes and vacuolar degeneration mitochondria were also seen in group I-b. The nuclei of ZF were irregular with condensed marginated heterochromatin in group I-b, irregular with scattered chromatin in group II-a and indented with areas of chromatin destruction in group II-b. Mitochondria with disrupted cristae and cristolysis were also detected in group I-b. Numerous lipofuscin granules and dilated smooth endoplasmic reticulum were revealed in group II-b. The mean collagen fibre area per cent and the mean number of the proliferating cells in group II-b were significantly higher by 39% and 23%. The thickness of ZG decreased significantly by 20% in group I-b. Contrary, the thickness of both ZF and ZR increased significantly by 10% in group I-b. CONCLUSIONS: Histological alterations occurred in the adrenal cortex in response to stress, especially when coupled with the advance of age. This was accompanied by increase in the area per cent of collagen fibres and increase in the mean number of the proliferating cells in the adrenal cortex.

N-acetylcysteine versus progesterone on the cisplatin-induced peripheral neurotoxicity.

BACKGROUND: Cisplatin-induced peripheral nerve neurotoxicity (CIPN) is the main obstacle in cisplatin treatment. The aim of this study was to compare the modulatory effects of N-acetylcysteine (NAC) and progesterone on CIPN, because there are scarce literature data on the protective effect of the proge-sterone on the CIPN. MATERIALS AND METHODS: Twenty-four rats were divided into four groups: control, cisplatin-treated, concomitant cisplatin-treated and NAC-treated, and concomitant cisplatin-treated and progesterone-treated. Electron microscopic, immunohistochemical, real time polymerase chain reaction and histomorphome-tric analysis; oxidative/antioxidative markers (MDA/GSH and SOD), neurotoxic/ neuroprotective markers (iNOS/nNOS), inflammatory mediators (TNF-a and NF-kB) and BAX were done. RESULTS: The myelin sheath in the cisplatin-treated group elucidated infolding. The myelin was disfigured, degenerated, and extensively split with areas of focal loss. The axoplasm was atrophic. Ballooning and vacuolations of the mitochon-dria with alterations of Remak bundles structures were observed. Fewer of these changes were noted in the NAC and progesterone-treated groups. Decrease of the antioxidant SOD and GSH (81% and 64%) and increase of the oxidant MDA (9 folds), increment of the neurotoxic iNOS (1.9 folds) and decrement of the neuroprotective nNOS (64%) and elevation of the inflammatory mediators' TNF-a and NF-kB (8.3 and 11 folds) in the cisplatin-treated group. Increase of the antioxidant SOD (1.3 and 2.5 folds) and GSH (120% and 79%) and decrease of the oxidant MDA (69% and 88%), decrement of the neurotoxic iNOS (56% and 68%) and increment of the neuroprotective nNOS (1.6 and one folds) and elevation of the inflammatory mediators' TNF-a and NF-kB were observed in the NAC and progesterone-treated groups, respectively. CONCLUSIONS: The toxic effect of CIPN might be attributed to either oxidative or severe inflammatory stress. Progesterone is efficient in ameliorating these effects; however, NAC is better. (Folia Morphol 2018; 77, 2: 234-245).

Effect of subchronic intake of green tea extract on liver of albino rat histomorphometric, ultrastructural and biochemical study.

BACKGROUND: There are conflicting reports on the effect of green tea extract (GTE) on the liver of animals. Some studies failed to show any adverse hepatic effects following administration of GTE to mice, rats, and dogs. Others reported severe hepatic necrosis, resulting in death in female Swiss-Webster mice following its administration. The aim of the study was to examine the subchronic toxicity of GTE on the liver of the adult male albino rats. MATERIALS AND METHODS: Forty male adult Wistar albino rats were used in the study. The rats were divided into four groups; group I (control), group II (low-dose green tea), group III (medium-dose green tea) and group IV (high-dose green tea). Histological, biochemical and histomorphometric analyses were done. RESULTS: Mild hepatic affections were observed in group II. The affections were severe in groups III and IV. The central veins and hepatic sinusoids were congested. The hepatocytes were degenerated. Hypertrophy of the hepatic arteries, dilation of the bile ducts and cellular infiltration were clearly observed in the last two groups. Mild degenerative changes were observed in the hepatocytes in rat's group II; the cytoplasm was rarefied and vacuolated. Some mitochondria were ruptured. The blood sinusoids were congested. The rough endoplasmic retinaculum was fragmented in group III. More degenerative changes were observed in group IV; the hepatic architectures were lost with disruption of cell membranes. Most of the cell organelles were degenerated and most of mitochondria were ballooned. As compared to that of the control groups: the total serum protein values in groups II, III and IV showed a statistically significant decrease (12%, 20% and 21%, respectively), the mean area per cent of collagen fibres in groups III and IV increased 5 and 7 folds. CONCLUSIONS: Subchronic administration of GTE resulted in structural and functional affection of the rats' liver. The dose of 250 mg/kg/day seemed to be safe, while the doses of 500 mg/kg/day and 1000 mg/kg/day had deleterious effect being more evident in the latter dose.

Serious fungal infections in Egypt.

We aimed to estimate the burden of serious fungal infections in Egypt, currently unknown, based on the size of the populations at risk and available epidemiological data. Data were obtained from the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and published reports with clearcut denominators. When no data existed, risk populations were used to estimate frequencies of fungal infections, using previously described methodology. The population of Egypt in 2011 was ∼82,500,000; 31% children, and 8% women >60 years of age. Amongst about 21.8 million women aged 15-50 years, recurrent vulvovaginal candidiasis (≥4 episodes/year) is estimated to occur in 1.3 million (3,169/100,000 females). Using a low international average rate of 5/100,000, we estimate 4,127 cases of candidaemia, and 619 patients with intra-abdominal candidiasis. Amongst the survivors of pulmonary tuberculosis (TB) in Egypt in 2012, 319 new cases of chronic pulmonary aspergillosis (CPA) are likely, a prevalence of 1,005 post-TB and a total prevalence estimate of 3,015 CPA patients in all. Asthma is common in Egypt, affecting 9.4% of adults, 5.35 million, and so ABPA and SAFS were estimated in around 162/100,000 and 214/100,000 respectively. Invasive aspergillosis is estimated to affect 495 patients following leukaemia therapy, there are an estimated 37 cases in renal and liver transplant recipients, and an estimated 132 patients develop IA in the context of lung cancer. Amongst 641,000 COPD admissions to hospital each year, 8,337 patients develop IA. The total HIV-infected population is small, with an estimated 6,500 patients, 2,500 not on antiretroviral therapy. Amongst HIV-infected patients, 38 (0.6%) cases of cryptococcal meningitis and 125 (1.9%) cases of Pneumocystis pneumonia are estimated each year. Fungal keratitis is common, with 28-55% (mean 40%) of corneal infections being fungal, an estimated total of 11,550 cases. The present study indicates that 2% of the Egyptian population is affected by fungal infections. The estimates are certainly incomplete, and need further epidemiological and diagnostic studies.

Study of the human ligamentum flavum in old age: a histological and morphometric study.

BACKGROUND: Ageing is associated with many changes in the ligamentum flavum (LF): ossification, diminish of the cross-sectional area of the elastic fibres, increase of the collagen fibres and change in its mineral and matrix elements. There are limited data about the influence of the ageing process on the structure of the LF at different spinal levels. The aim of the study was to clarify the effect of the ageing process on the LF at different spinal levels. This was done through histological study and morphometric analysis using the image analyser. MATERIALS AND METHODS: Vertebral column specimens were obtained from 10 human cadavers preserved in a mixture of formaldehyde and carbol. Their average age ranged 60-70 years. The vertebral blocks included 4 vertebrae at cervical level (C 3, 4, 5, 6), thoracic level (T 5, 6, 7, 8) and lumbar level (L 2, 3, 4, 5). Sections were stained with haematoxylin and eosin, Masson's trichrome, Orcein and Verhoeff stains. The morphometric measurements included the relative collagen area, relative elastic area, collagen area [%] and elastic area [%]. RESULTS: The relative elastic areas reduced in all the spinal levels. The relative collagen areas increased to become 46.1 ± 2.9 in the cervical region, 51.8 ± 1.3 in the thoracic region, and 49.7 ± 2.5 in the lumbar region. The average elastic area was highest in the cervical region, and lowest in the thoracic region. The ratio of elastic area to collagen area was 1.16:1 in the cervical region, 1.01:1 in the lumbar region and 0.93:1 in the thoracic region. The elastic fibres were regular, diffuse and organised in parallel order in the cervical and thoracic regions. Their orientations were craniocaudal with a variation of some fibres in the cervical region. Most of the elastic fibres in the lumbar region were regular and organized in parallel order. Nevertheless, rupture, fragmentation, and abnormal organization of the elastic fibres were discovered in a few specimens of the lumbar region. Increase of the vasculature and degeneration with abnormal body formations within the lumbar ligaments were observed. The LF midline gaps were present in the cervical, thoracic and lumbar regions. In 10% of lumbar specimens, the ligaments fused in the midline with absence of the midline gaps. Ossification was discovered in the thoracic and lumbar ligaments. CONCLUSIONS: Structural differences have been observed among the LF at the different spinal levels, and all these changes were caused by the ageing process. Decrease of the relative elastic area, an increase of the relative collagen area and reduction of the elastic to collagen area ratio affected all the spinal levels of the ligaments. Many changes took place in the lumbar ligaments such as ossification, increase vasculature, degeneration with abnormal body formation, absence of the midline gaps, fragmentation and rupture of the elastic fibres.

Thyroid hormone dysfunctions affect the structure of rat thoracic aorta: a histological and morphometric study.

BACKGROUND: There are limited data about the influence of hypothyroidism and hyperthyroidism on the connective tissue component and smooth muscle cells of the thoracic aorta. The aim was to study the histological changes of the wall of the thoracic aorta in the hypothyroid and hyperthyroid rats. Morphometric measurements were also done. MATERIALS AND METHODS: Thirty adult rats were used. They were divided into control, hyperthyroid, and hypothyroid groups. Each group consisted of 10 rats. The animals were sacrificed at the end of 8 weeks and the descending aorta was excised. Sections were stained with haematoxylin and eosin, orcein and Masson's trichrome stains. Themorphometric measurement included: number of smooth muscle cell nuclei, number of the elastic lamellae, thickness of the tunica media, elastic fibre optic density, and relative collagen area. RESULTS: Atheromatous plagues had been observed in the hyperthyroid group. Thinning and rupture of the elastic lamellae had been observed in the hypothyroid group; these were accompanied with intimal ulceration and aortic dissection. The average number of smooth muscle cell nuclei in the hyperthyroid group had doubled and tripled compared to their fellows in the control and hypothyroid groups, respectively. The thickness of the tunica media increased in the hyperthyroid and hypothyroid groups by 75% and 35%. In addition, the relative collagen area increased in the previously mentioned groups by 142% and 120%, respectively. On the other hand, the mean elastic fibre optic density decreased in both groups by 30%. CONCLUSIONS: Structure wall affections of the intima and media of the descending aorta were associated with the thyroid hormone dysfunctions. These changes were more severe in the hypothyroid group.

Dermatophyte infections in Cairo, Egypt.

In this study, we examined dermatophyte infections in patients referred to the Department of Dermatology, EL-Houd El-Marsoud Hospital, Cairo, during March 2004 to June 2005. Of 506 patients enrolled in this investigation, 403 (79.6%) were clinically diagnosed as having dermatophytoses (age range 6-70 years; males 240; females 163). Species identification determined by observation of their macroscopic and microscopic characteristics was complemented with sequencing of the internal transcribed spacer ITS1-5.8S-ITS2 rDNA region. The most common dermatophyte infection diagnosed was tinea capitis (76.4%), followed by tinea corporis (22.3%) and tinea unguium (1.2%). The most frequently isolated dermatophyte species was Trichophyton violaceum, which accounted for most (71.1%) of all the recovered dermatophytes, followed by Microsporum canis (21.09%), Trichophyton rubrum (6.2%), and Microsporum boullardii (0.49%); both Epidermophyton floccosum and Trichophyton tonsurans were each only rarely isolated (0.24%).

Keratinophilic fungi recovered from muddy soil in Cairo vicinities, Egypt.

One hundred samples of muddy soil were collected from seven areas in the vicinity of Cairo and screened for the presence of keratinophilic fungi by using hair baiting isolation technique. Forty isolates of keratinophilic fungi were recovered and identified by recognition of their cultures, macro- and micromorphological features. Their physiological and molecular characteristics were studied by determination of their ubiquinone (Coenzyme Q) composition and DNA sequences of (ITS1-5.8S-ITS2) and 18S rRNA region sequences. The Keratinophilic isolates were identified as Chrysosporium carmichaelii, C. queenslandicum, C. zonatum, C. indicum, Aphanoascus mephitalis, and Uncinocarpus reesii. Chrysosporium zonatum was the most prevalent species and represented 42.5% of the total number of isolates. Each of C. carmichaelii and C. queenslandicum were equal in their prevalence and represented 15%. C. indicum comes next constituting 12.5%; followed by Uncinocarpus reesii which represented 10%. The least prevalent species in our study was Aphanoascus mephitalis, which was represented only 5% of the total keratinophilic isolates.

Relation between weaning and gastroenteritis.

PIP: More than 50% of Egyptian children who die before reaching age 2 years perish as a result of acute infantile diarrhea. Most health experts in Egypt recommend that weaning foods be given to infants beginning at age 4-6 months, the point at which breast milk alone cannot meet an infant's nutritional needs. Findings are reported from an evaluation of the relationship between the weaning period and the possible incidence of diarrheal attacks. 60 cases aged 6-24 months presented with diarrhea after the early introduction of foods during the weaning period. 100 healthy infants matched according to age, sex, and socioeconomic status served as controls. 46.6% of cases were among infants under 1 year old. Only 30% of the children were originally breast-fed. Isonatremic dehydration accounted for 75% of all dehydration among the subjects, while E. coli caused 28.3% of cases, E. histolytica 21.6%, and Giardia lamblia 16%. The presence of polymorph nuclear leucocytes in the stool was a predictive test for the bacterial etiology of diarrhea with a positive predictive value of 87%. Finally, the band/neutrophil ratio of the bacterial group was significantly different from that of the control group, although no statistically significant difference was identified when comparing the parasitic diarrheal group to the control group.^ieng