Respiratory effects in children from passive smoking of cigarettes and narghile: ISAAC Phase Three in Syria.

BACKGROUND: The association between environmental tobacco smoke (ETS) and asthma symptoms is well documented, but a causal relationship is inconclusive. International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three was the first to report a dose-response relationship between current wheezing and exposure to parental cigarette smoke. As exposure of children to water pipe (narghile) smoke is of concern in Syria, in the ISAAC Phase Three Tartous Centre we also examined the role of parental smoking of the narghile. METHODS: Parents of children aged 6-7 years completed core written questionnaires about the prevalence of symptoms, and an environmental questionnaire for other risk factors, including parental cigarette smoking. We added questions about narghile to the questionnaire. RESULTS: Among 2 734 pupils (49% females) surveyed, we found an association between exposure to ETS of the mother smoking cigarette or narghile and ever wheezing, nocturnal cough and severe wheeze; however, the strongest association was found when the mother smoked narghile. Mother smoking narghile was also associated with exercise wheeze. Father smoking narghile, but not cigarettes, was associated with nocturnal cough, severe wheeze and exercise wheeze. The association with current wheeze became significant when mother smoked both cigarettes and narghile; however, the effect was addititive and not synergic. CONCLUSION: We recommend that international studies investigating ETS include questions on narghile smoking.

International study of asthma and allergies in childhood: phase 3 in the Syrian Arab Republic.

The International Study of Asthma and Allergies in Childhood (ISAAC) uses standardized symptom-based questionnaires to describe the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema in children worldwide. Three governorates in the Syrian Arab Republic (Aleppo, Lattakia and Tartous) participated in ISAAC phase 3 in 2001-03. Adolescents in the 13-14 year age group and parents of the 6-7-year-old children completed the questionnaire about asthma symptoms. The prevalence of current symptoms of asthma (wheezing in the last 12 months) in different centres ranged from 4.7% to 5.7% for 6-7-year-olds and 3.9% to 6.5% for 13-14-year-olds. In 13-14-year-olds the prevalence of severe speech-limiting wheeze was 2.0%-3.5%, of rhinoconjunctivitis was 8.6%-14.6% and of eczema was 3.3%-4.2%.

International study of asthma and allergies in childhood: Phase 3 in the Syrian Arab Republic

The International Study of Asthma and Allergies in Childhood [ISAAC] uses standardized symptombased questionnaires to describe the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema in children worldwide. Three governorates in the Syrian Arab Republic [Aleppo, Lattakia and Tartous] participated in ISAAC phase 3 in 2001-03. Adolescents in the 13-14 year age group and parents of the 6-7-year-old children completed the questionnaire about asthma symptoms. The prevalence of current symptoms of asthma [wheezing in the last 12 months] in different centres ranged from 4.7% to 5.7% for 6-7-year-olds and 3.9% to 6.5% for 13-14-year-olds. In 13-14-year-olds the prevalence of severe speech-limiting wheeze was 2.0%-3.5%, of rhinoconjunctivitis was 8.6%-14.6% and of eczema was 3.3%-4.2%

[Flow cytometric DNA analysis and cytology in diagnosis and prognosis of bladder tumors: preliminary results of a comparative study of bladder lavage]. / Contenu en ADN par cytométrie en flux et cytologie dans le diagnostic et le pronostic des tumeurs vésicales: résultats préliminaires d'une étude comparative sur lavage de la vessie.

OBJECTIVE: To compare flow cytometric data (ploidy and proliferative activity or percentage SG2M-phase cells) to cytologic and histologic data of the bladder carcinomas. MATERIALS AND METHODS: Cytologic and flow cytometric analysis of DNA content were performed on 48 bladder washings: 28 bladder washings from patients being followed for urothelial carcinomas and 20 control washings from individuals undergoing cytoscopy for other reasons. RESULTS: Cytological sensitivity and specificity of bladder washing were 75% and 91% respectively. Specificity was increased to 94% using flow cytometric DNA analysis whereas sensibility was moderately decreased to 68%. Combination of flow cytometry and cytology increased the diagnostic yield to 100%. The study of the patient group showed an increased abnormalities (aneuploidy and/or proliferate activity SG2M > 10%) according to the tumor grading and tumor staging. A cytometric test was positive in 80% for G3 tumours and in 68% for G2 tumours. The staging tumor was positive in 46%, 89% and 100% of the pTa-pT1, pT2 and pT4 tumours respectively. Otherwise the comparison of control group with patients showed a statistical correlation between cytometric test, staging tumour and tumoral grading as showed in the following groups: control/G1-G2 (p < 0.05), control/G3 (p < 0.001), control/pTa-pT (p < 0.05), control/pT2-pT4 (p < 0.001). CONCLUSION: We confirmed through this study the interest of the flow cytometric DNA analysis in the diagnosis and prognosis of bladder carcinomas, and we showed the importance of the histogram classification in order to facilitate their interpretation and to avoid the trap of false aneuploidy.

Developmental kinetics of hemopoietic progenitors in the avian embryo spleen.

By means of plasma clot clonal cultures, the content of the avian spleen in granulomonocytic progenitors was studied during ontogeny. Serum-free media were used that were supplemented with growth activities produced either by embryonic fibroblasts or adult spleen cells. These two conditioned media not only permitted the growth of M-CFC, G-CFC, and GM-CFC but also F-CFU (fibroblast colony-forming units) from quail or chick embryonic spleen cells. The presence of spleen cell-conditioned medium promoted the development of large colonies of immature granulocytes. In the chick the first hemopoietic progenitors appeared at E9 and their number displayed two peaks, one at E15 and a smaller one at E18. In the quail the first progenitors were detected as early as E7 and their number peaked at E10. In this species, hemopoietic progenitors disappeared definitively before hatching while in the chick some were still present at P3. The progenitor content of the chick embryo spleen was compared to that of the bone marrow. This content remained stable during all of embryonic life, while the bone marrow exhibited a very different profile, where a sharp peak at E16 was followed by an acute decline and a stabilization at a rather low level. The particular profile in the spleen speaks in favor of a special role of this organ in the development of the hemopoietic system.

Ontogeny of the chick embryo spleen--a cytological study.

The differentiation of the chick embryo spleen was investigated from E4 till after hatching, using a number of cytological markers. The reticular fiber network, disclosed by silver staining, was a loose array of short fibers until E15. It developed into a complex pattern closely related to the specialized segments of the vascular tree between E15 and E18. While the very first cells belonging to the hemopoietic lineage could be identified as early as E4, steady state hemopoiesis set in by E10. Of the two cell lineages maturing in the organ, erythroid cells disappeared by E15, and granulocytes emigrated within 3 to 4 days around hatching. The process of lymphocyte homing, detected by specific markers, began just before hatching and was completed within the first week of life. Thus differentiation of the stromal anatomy appears as the prerequisite for the transition of embryonic (= hemopoietic) to adult (= secondary lymphoid) functions.

Relationship between vasculogenesis, angiogenesis and haemopoiesis during avian ontogeny.

Quail-chick intracoelomic grafts of organ rudiments were used to study the origin of endothelia and haemopoietic cells during avian organogenesis in conjunction with the monoclonal antibody QH1 which recognizes the quail haemangioblastic lineage. Results differed according to the germ-layer constitution of the grafted rudiments. In the case of the limb buds, endothelial cells from the host invaded the graft through an angiogenic process. Haemopoietic progenitors from the host also colonized the grafted bone marrow. In contrast, rudiments of internal organs provided their own contingent of endothelial precursors, a process termed vasculogenesis. Nevertheless, haemopoietic cells in these organs were all derived from the host. In the lung, this extrinsic cell population appeared regularly scattered around the parabronchi and had a macrophage-like phenotype. In the pancreas, the granulocytes which differentiate as dense aggregates located in the wall of the largest vessels were extrinsic. Similarly in the spleen, a mesodermal primordium that develops in close association with the pancreatic endoderm, endothelial cells were intrinsic and haemopoietic cells host-derived. This study demonstrates that, in ontogeny, vascularization obeys different rules depending on which germ layer the mesoderm is associated with: in mesodermal/ectodermal rudiments angiogenesis is the rule; in mesodermal/endodermal rudiments, vasculogenesis occurs. However, in these internal organs undergoing vasculogenesis, endothelial and haemopoietic cells have separate origins. We put forward the hypothesis that the endoderm induces the emergence of endothelial cells in the associated mesoderm. Formation of blood stem cells may also involve interactions between endoderm and mesoderm, but in this case the responding capacity of the mesoderm appears restricted to the paraaortic region.

Early haemopoietic stem cells in the avian embryo.

Using 'yolk sac chimaeras', we have previously demonstrated that stem cells, destined to colonize haemopoietic organs other than the yolk sac, arise in the embryo proper. We have now investigated the emergence and potentialities of these cells in vivo and in vitro. The in vivo approach consisted of interspecies grafting between quail and chick embryos. The cell progeny from the grafts was detected by means of QH1, a monoclonal antibody specific for the quail haemangioblastic lineage. When grafted into the dorsal mesentery of the chick embryo, which is a haemopoietic microenvironment, the region of the aorta from E3-E4 quail embryos generated large haemopoietic foci. When associated with a chick attractive thymic rudiment, cells left the quail aorta, entered this rudiment and underwent lymphopoiesis. Cell suspensions prepared from 40-50 chick aortae, seeded in appropriate semi-solid media, yielded macrophage, granulocyte or erythrocyte clones. These colony forming cells were two to eight times more frequent than in cell preparations from hatchling bone marrow. By contrast, cells prepared from the whole embryonic body deprived of the aorta were not clonogenic. By interspecies grafting of somatopleural (ectoderm + mesoderm, e.g. limb bud) or splanchnopleural rudiments (endoderm + mesoderm, e.g. lung, pancreas, intestine), the endothelial lining of blood vessels was shown to arise by two entirely different processes according to the rudiment considered: angiogenesis, i.e. invasion by extrinsic endothelial cells, in the limb bud, and vasculogenesis, i.e. in situ emergence of endothelial cells, in internal organs. The spleen, which first develops as a continuum to the pancreatic mesoderm, acquires its endothelial network by vasculogenesis, and is colonized by extrinsic haemopoietic stem cells. Granulopoietic cells in the pancreas and accessory cells in the lung are also extrinsic. Thus, in the case of endomesodermal rudiments, interspecies grafting reveals separate origins of endothelial and haemopoietic cells.

[Fielding's intervention in vesico-ureteral reflux and its limits]. / L'intervention de Fielding dans le reflux vésico-urétéral et ses limites.

Vesico-ureteric reflux in adult patients with normal and dilated ureters (88 ureters) was treated surgically by Fielding's procedure. The authors describe this technique with their own modifications, and discuss the results.