Search

Recurrent and disseminated pityriasis versicolor (RDPV) is a common clinical entity, characterized by its recurrent and disfiguring nature. Studies demonstrated host genetic variations in the immune response, especially the role of IL-17 in antifungal immunity. This study aimed to detect whether IL-17A and F gene polymorphisms are found in cases of RDPV. It included 100 cases of RDPV and 100 age and sex matched controls, from which EDTA blood samples were taken for single-nucleotide polymorphism analysis. IL-17A (rs2275913) and F (rs763780) were associated with a significantly increased incidence of developing RDPV. IL-17A and F gene polymorphism could be implicated as a risk factor for the development of RDPV. [ABSTRACT FROM AUTHOR]

Aim: To assess the effect of Neem versus 2.5% NaOCl as root canal irrigants on the intensity of post‐operative pain and amount of endotoxins following root canal treatment of mandibular molars with necrotic pulps. Methodology: This parallel, prospective, double‐blinded, randomized controlled trial with allocation ratio 1:1 was conducted in the out‐patient clinic of the Endodontic Department, Faculty of Dentistry, Cairo University, Egypt. Fifty healthy patients with mandibular molars with necrotic pulps were randomly assigned into two equal groups using computer software. In the intervention group, root canals were irrigated using Neem; whilst 2.5% NaOCl was used in the control group. A standard root canal treatment was performed in two visits using ProTaper Next rotary files, with no intracanal medication. Pain intensity was assessed using a numerical rating scale (NRS) 6, 12, 24 and 48 h following instrumentation and canal filling. Endotoxin samples were collected using three paper points before and after canal instrumentation and a sandwich ELISA method was used to quantify the level of endotoxins. Demographic, baseline, and outcome data were collected and analysed using chi‐square tests (for the comparisons of categorical variables), Mann–Whitney tests (for non‐normally distributed variables) and Student's t tests (for normally distributed variables), A P‐value < 0.05 was considered to be statistically significant. Results: The mean pain scores within the two groups decreased continually over time. The mean pain scores in the Neem group were lower than those in the 2.5% NaOCl group at 6, 12, 24 and 48 h following instrumentation and canal filling with no significant difference between them except at 24 h following instrumentation (P = 0.012). Both irrigants significantly reduced endotoxin levels compared to the pre‐instrumentation samples (P < 0.001) by 8% for the NaOCL group and 18% for the Neem group. Conclusion: Neem and 2.5% NaOCl were not significantly different in terms of reducing the intensity of post‐operative pain during all follow‐up periods except at 24 h following instrumentation where Neem was associated with lower pain intensity. Both irrigants significantly reduced endotoxin levels but were not effective in eliminating endotoxins completely from root canals of mandibular molars with necrotic pulps. [ABSTRACT FROM AUTHOR]

aimy,3 Shaker O Alreshidi,4 Moustafa S Magliyah,5,6 Hani B Albalawi21Department of Ophthalmology, King Khalid Hospital, Tabuk, Saudi Arabia; 2Department of Ophthalmology, Tabuk University, Tabuk, Saudi Arabia; 3Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Almajmaah University, Almajmaah, Saudi Arabia; 5Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia; 6Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Moustafa S MagliyahVitreoretinal Division, King Khaled Eye Specialist Hospital, Al- Oruba Street, PO. Box 7191, Riyadh, 11462, Saudi ArabiaTel +966 11 482 1234 Ext. 2655Fax +966 11 4821234 Ext. 2764Email [email protected] Purpose: To report the poor visual outcome of ruptured globe caused by camel bites. Observations: A 48-year-old camel caregiver presented to the emergency department after being bitten by a camel in the left side of his face. Ophthalmic examination revealed a superior scleral wound from 9 to 2 o'clock, about 6 mm from the limbus extending to the equator with prolapse of uveal and vitreous tissues, an opaque cornea, total hyphema, diffuse subconjunctival hemorrhage, and a lower lid laceration involving the lid margin and the nasolacrimal duct. The patient has undergone surgical repairs of ruptured globe and lid laceration, followed by retinal detachment surgery. Following these surgical interventions, the patient preserved a light perception vision with flat retina. Conclusion: Camel-related injuries might primarily involve the ophthalmic structures, especially in camel bites. Camel-related eye trauma might lead to poor visual and anatomical outcomes which might not improve following surgical interventions. [ABSTRACT FROM AUTHOR]

Accurate staging of liver fibrosis is important for clinical decision making and personalized management. Liver fibrosis is influenced by patients' genomics, including IFNL3 genotype and micro RNA expression. However, incorporating micro RNAs into fibrosis prediction algorithms has not been investigated. We examined the potential of eight selected serum micro RNAs; miR-122, miR-126, miR-129, miR-199a, miR-155, miR-203a, miR-221, and miR-223 as non-invasive biomarkers to stage liver fibrosis in HCV-associated chronic liver disease ( HCV- CLD). 145 Egyptian HCV- CLD patients were divided according to Metavir fibrosis scores. Micro RNAs and IFNL3 rs12979860 genotype were assayed by RT- qPCR and allelic discrimination techniques, respectively. Serum miR-122 was downregulated, whereas miR-203a and miR-223 were upregulated in significant fibrosis (≥F2) compared with no/mild fibrosis (F0-F1). Serum miR-126, miR-129, miR-203a, and miR-223 were upregulated in severe fibrosis (≥F3) and cirrhosis (F4) compared with F0-F2 and F0-F3, respectively. miR-221 was upregulated in ≥F3, but unchanged in F4. miR-155, miR-199a, and IFNL3 rs12979860 genotype were not significantly different in all comparisons. Differentially expressed serum micro RNAs discriminated ≥F2, ≥F3, and F4 by receiver-operating-characteristic analysis. Multivariate logistic analysis revealed a model combining miR-129, miR-223, AST, and platelet count with high diagnostic accuracy for ≥F3 ( AUC=0.91). The model also discriminated F4 ( AUC=0.96) and ≥F2 ( AUC=0.783), and was superior to APRI and FIB-4 in discriminating ≥F3 and F4, but not ≥F2. In conclusion, combining serum micro RNAs with baseline predictors could serve as a new non-invasive algorithm for staging HCV-associated liver fibrosis. Additional studies are required to confirm this model and test its significance in liver fibrosis of other etiologies. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infection represents a serious health problem. The -174 G/C mutation in the pro inflammatory cytokine interleukin-6 (IL-6) is associated with developing liver diseases. Likewise, the S and Z mutations in the serine protease inhibitor α1-antitrypsin (A1AT) are associated with pulmonary emphysema and/or liver cirrhosis. We explored the distribution of the single nucleotide polymorphisms (SNPs) of IL-6 and A1AT genes in chronic HCV-infected patients and evaluated their impact on the progression of liver cirrhosis. One hundred and fifty Egyptian HCV-infected patients together with 100 healthy controls were enrolled in this study. The patient groups were subdivided into chronic hepatitis patients (n = 85) and cirrhotic patients (n = 65). The SNP of IL-6 (-174 G/C, rs1800795), A1AT Z mutation (342 Glu/Lys, rs28929474) and A1AT S mutation (264 Glu/Val, rs17580) were determined using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Cirrhotic patients exhibited significantly increased frequency of the A1AT S allele compared with the controls (34.6 vs. 5.0%), while the chronic hepatitis patients showed a higher frequency of the A1AT Z allele compared with the controls (14.7 vs. 2.5%). Remarkably, IL-6 (CC genotype) was detected only in the chronic hepatitis patients. Multivariate regression analysis showed that aspartate transaminase (AST) and the S alleles of A1AT, represented as SS+MS genotypes, were significantly independent predictors for development of liver cirrhosis. We concluded that inheritance of deficient S and Z alleles of the A1AT gene but not IL-6 (-174 G/C), were associated with progressive liver diseases. [ABSTRACT FROM AUTHOR]

Background Vitiligo is a disorder characterized by depigmented patches in the skin. Psychological stress can activate the hypothalamic-pituitary-adrenal axis in the brain as well as on the peripheral level and aggravate autoimmune skin diseases. Skin appendages have dual functions dually as prominent targets and sources of the peripheral corticotropin-releasing hormone ( CRH)-proopiomelanocortin axis. Aim To assess the role of CRH and CRHR-1 in vitiligo, and its possible association with psychological stress. Methods In total, 30 patients with vitiligo and 30 healthy controls were collected from the outpatient clinic. Expression of CRH and CRHR-1 was measured by real-time PCR in lesions and control skin. Results A significant increase in CRH and CRHR-1 expression was significantly correlated with psychological stress in vitiligo. Conclusion We conclude that CRH and CRHR-1 are altered by psychological stress and play an important role in the pathogenesis of vitiligo. [ABSTRACT FROM AUTHOR]

Objective This study investigated the use of three salivary micro RNAs (mi RNA-21, mi RNA-184, and mi RNA-145) as possible markers for malignant transformation in oral mucosal lesions. Materials and methods Salivary whole unstimulated samples were collected from a study group of 100 subjects, consisting of 20 clinically healthy controls, 40 patients with oral potentially malignant disorders ( PMDs) [20 with dysplastic lesions and 20 without dysplasia], 20 with biopsy-confirmed oral squamous cell carcinoma ( OSCC), and 20 with recurrent aphthous stomatitis ( RAS) as disease controls. Total RNA was isolated and purified from saliva samples using the micro RNA Isolation Kit ( Qiagen, UL). mi RNA expression analysis was performed using qRT- PCR ( Applied Biosystems). Results There was a highly significant increase in salivary mi RNA-21 and mi RNA-184 in OSCC and PMD (with and without dysplasia) when compared to healthy and disease controls ( P < 0.001). Conversely, mi RNA-145 levels showed a highly significant decrease in OSCC and PMD overall ( P < 0.001). RAS cases showed no significant difference from normal controls in any measured mi RNA ( P > 0.05). The only micro RNA to discriminate between OSCC and PMD with dysplasia was mi RNA-184. When receiver operating characteristic curves were designed for the three mi RNAs, cutoff points delineating the occurrence of malignant change were a fourfold increase in mi RNA-21 with specificity 65% and sensitivity 65%, a 0.6 decrease in mi RNA-145, with specificity 70% and sensitivity 60%, and a threefold increase of mi RNA-184, with specificity 75% and sensitivity 80%. Calculating the area under the curve revealed that mi RNA-184 was the only one among the studied mi RNAs that provided good diagnostic value. Conclusion Salivary determination of the mi RNAs tested might furnish a noninvasive, rapid adjunctive aid for revealing malignant transformation in oral mucosal lesions, particularly mi RNA-184. [ABSTRACT FROM AUTHOR]

Adipose tissue is now considered an endocrine organ secreting different cytokines known as adipocytokines. Lipocalin-2 has been recently identified as an adipokine present in the circulation, it is related to insulin resistance, obesity, atherosclerotic diseases and type 2 diabetes. Lipocalin-2 and psoriasis are assumed to be closely associated with the metabolic syndrome. The aim of the present study is to estimate the level of lipocalin-2 in the serum and tissue of psoriatic patients and to correlate these levels with markers of metabolic syndrome, CRP and disease severity. This study was done on 30 patients of psoriasis and 30 healthy controls. All patients and controls were subjected to clinical examination. Serum, tissue levels of lipocalin-2 and C-reactive protein (CRP) were measured by enzyme linked immunosorbent assay technique. Metabolic syndrome parameters including anthropometric measures, lipid profiles, blood sugar and blood pressure were studied. Patients with psoriasis showed significant association with metabolic syndrome parameters than controls. Tissue lipocalin-2 was significantly higher than serum levels in psoriasis patients. A significant difference was detected in tissue levels of lipocalin-2 and not in the serum between patients and controls. Both tissue and serum lipocalin-2 correlated with CRP. Although there was a correlation between tissue and serum levels of lipocalin-2 in patients, there was no correlation between both of them with metabolic syndrome and related disorders. Our results revealed that patients with psoriasis are at increased risk of metabolic and cardiovascular complications, tissue lipocalin-2 is more specific to psoriasis than serum lipocalin-2. Lipocalin-2 has no role in determining severity of the disease. Neither tissue nor serum lipocalin-2 conveys cardiovascular risk in psoriasis patients. [ABSTRACT FROM AUTHOR]

This study aimed to assess the androgen receptor (AR) codon amino acids glutamine (CAG) repeats in 185 Egyptian men divided into fertile controls ( n = 30), oligoasthenoteratozoospermic (OAT) men ( n = 35), nonobstructive azoospermic (NOA) men ( n = 120; 18 successful testicular sperm extraction (TESE) and 102 unsuccessful TESE cases). They were subjected to history taking, genital examination, semen analysis, testicular biopsies for NOA cases, serum hormones and CAG repeats by PCR. The mean AR-CAG repeats showed significant difference between NOA group compared with fertile controls or OAT groups. Nonsignificant difference was elicited between OAT group and fertile controls. In NOA cases, CAG repeats demonstrated nonsignificant difference between unsuccessful and successful TESE. AR-CAG repeats elicited significant negative correlation with sperm count, significant positive correlation with sperm normal forms percentage and nonsignificant correlations with sperm motility per cent, tested serum hormones or testicular volume. It is concluded that AR-CAG repeats in Egyptian infertile men are in the range of other international or regional studies. AR-CAG repeats have demonstrated nonsignificant difference regarding TESE outcome in NOA cases. [ABSTRACT FROM AUTHOR]

Background The pathogenesis of psoriasis is thought to depend on the activation of immune cells and their secreted cytokines, chemokines and growth factors like IGF-1 which may contribute to the epidermal hyperplasia of psoriasis. Treatment of psoriasis with PUVA and methotrexate are associated with clinical improvement and decrease in epidermal hyperplasia. Objective To examine the effects of PUVA and methotrexate therapy on IGF-1 expression in psoriatic plaques and whether this change correlates with clinical response. Methods For 24 psoriatic patients, the PASI score and levels of lesional IGF-1 and its mRNA were determined by RT-PCR before and after treatment with either methotrexate or PUVA. Skin biopsies from 12 healthy volunteers served as control for IGF-1 levels in normal skin. Results Lesional skin of psoriatic patients showed a statistically significant elevation in IGF-1 and its mRNA levels in comparison to control ( P = 0.0001). Both methotrexate and PUVA treatment were associated with a significant decrease in both PASI scores and lesional IGF-1 after 10 month treatment. Conclusion Both methotrexate and PUVA therapy for psoriasis are associated with a decrease in PASI score and IGF-1. The IGF-1 down-regulation may possibly be a consequence of the decrease in cytokines and inflammatory cellular infiltrate that occur following treatment with either modalities or due to their effect on local fibroblast activity and proliferation. [ABSTRACT FROM AUTHOR]

Skewing of the immune response towards T helper (Th)1 or Th17 and away from regulatory T cells (Tregs) and Th2 cells may be responsible for the development and progression of autoimmune disease. An autoimmune theory has been proposed in the pathogenesis of vitiligo. No previous reports have investigated alterations in IL-17 produced by Th17 cells in lesional skin in vitiligo. To investigate the role of IL-17 in the pathogenesis of vitiligo by assessing its levels in lesional skin and serum of patients with vitiligo compared with controls. In total, 30 patients with vitiligo and 20 controls matched for age and gender were enrolled in the study. Serum and tissue IL-17 levels were measured by ELISA and compared between both groups for correlations with age, gender, family history, disease duration, activity of vitiligo and percentage of involved body surface area. A significant difference between patients and healthy controls was found for both serum and tissue IL-17 levels ( P < 0.001 for both). Significant positive correlations were found between disease duration and IL-17 level in both serum ( r = 0.42, P = 0.02) and lesional skin ( r = 0.45, P < 0.015); between extent of vitiligo and IL-17 levels in both serum ( r = 0.65, P < 0.001) and skin ( r = 0.48, P < 0.05); and between the serum and the tissue IL-17 levels in patients with vitiligo ( r = 0.54, P = 0.002). Multiple factors have been implicated in the pathogenesis of vitiligo. The increased levels of IL-17 we found in serum and lesional skin suggest an important role for this cytokine in the pathogenesis of vitiligo. [ABSTRACT FROM AUTHOR]

The prevalence of hepatitis C virus (HCV) infection varies across the world, with the highest number of infections reported in Egypt. Expression of the MxA gene has been found to be a reliable and sensitive marker for the induction of endogenous type I interferons (IFNs) during viral infections. This study examined the correlation of gene expression of MxA with the response to treatment with pegylated-IFN-alfa2b and ribavirin. Fifty patients with type 4 HCV and 20 healthy volunteers as controls were enrolled in a prospective study designed with strict inclusion criteria to nullify the effect of confounding variables and further minimize selection bias. Quantification of HCV-RNA and MxA gene by real-time PCR was performed for every patient, and quantification of MxA gene was performed for controls. There was a statistically significant difference between patients and control group as regards the quantity of MxA gene expression ( P < 0.05) (Mann-Whitney test) ( P = 0.004). There was a statistically significant difference between responders and nonresponders ( P < 0.05): responders showed a higher percentage of cases with initial MxA <26 ( P < 0.05). We conclude that MxA protein expression is a sensitive biological marker for ongoing virus replication and presence of type 1 IFN. These results highlight the importance of the detection of MxA expression at the start of therapy as a factor for assessing the likelihood of HCV genotype 4 patients to achieving a sustained virological response to treatment with IFN-α2 in combination with ribavirin. [ABSTRACT FROM AUTHOR]

Background Lichen planus (LP) is an inflammatory disease of the skin and oral mucosa. Studies suggested that type I interferons (IFNs) could play an important role in the cytotoxic inflammation in LP. Type I IFNs stimulate the production of several IFN-induced proteins including myxovirus resistance protein A (MxA protein). The association of LP and chronic hepatitis C is well established, with variable prevalence rates among different populations. Many authors have considered hepatitis C virus (HCV) as a possible antigen for inducing cytotoxic immune response in LP. Objectives To investigate the role of type I IFNs in LP through the detection of MxA protein, and to compare the expression of MxA protein between HCV-positive and HCV-negative patients with LP in an attempt to clarify the role of HCV in the pathogenesis of LP. Methods The study included 33 skin biopsies from patients with LP and 10 control biopsies. MxA mRNA was detected by reverse transcription-polymerase chain reaction. HCV-specific antibodies were detected in patient sera by enzyme-linked immunosorbent assay. Results Our analysis revealed a significantly higher level of MxA protein in all the LP skin biopsies compared with controls. The expression was significantly higher in HCV-positive patients than in HCV-negative patients. Conclusions Type I IFNs play a role in the pathogenesis of LP, and HCV could induce LP through increasing the production of type I IFNs. [ABSTRACT FROM AUTHOR]

Background In psoriasis, keratinocyte hyperplasia may be explained by imbalance of growth factors responsible for epidermal proliferation and altered metabolism of their receptors. Transforming growth factor-beta 1 (TGF-β1) implications in the pathogenesis of psoriasis can be attributed to several mechanisms besides keratinocyte cell cycle inhibition. Objectives To evaluate the relation between serum and tissue levels of TGF-β1 in psoriasis and their correlation with disease parameters. Patients and methods Serum and punch biopsy of involved and non-involved skin of 22 patients with psoriasis vulgaris and 10 controls were collected for quantification of TGF-β1 by enzyme-linked immunosorbent assay kit. Results Serum level of TGF-β1 in psoriatic patients was higher than controls in a statistically non-significant manner. Correlations between serum level of TGF-β1 and extent of the disease ( P = 0.007) and Psoriasis Area and Severity Index (PASI) score ( P = 0.005) were observed. Mean tissue levels of TGF-β1 were highest in psoriatic lesions in contrast to normal skin of psoriatic patients and healthy controls, but not statistically significant. Correlation between tissue levels of TGF-β1 in non-involved skin and extent of the disease ( P = 0.007) and PASI score ( P = 0.013) was detected. Correlation was detected between levels of TGF-β1 in psoriatic plaques and serum of patients ( P = 0.035), but not between levels of TGF-β1 in non-involved skin and serum. Conclusions Tissue expression of TGF-β1 in psoriasis may be affected by the stage of development of the lesion. The direct relation between TGF-β1 in psoriatic plaques and serum imply that the mechanisms for TGF-β1 production and release in both these compartments may be related. Conflicts of interest None declared [ABSTRACT FROM AUTHOR]

Background Pigmentary dilution is observed in patients with homocystinuria. Therefore, it is possible that an increase of local homocysteine (Hcy) interferes with normal melanogenesis and plays a role in the pathogenesis of vitiligo. Vitamin B12 and folic acid, levels of which are decreased in vitiligo, are important cofactors in the metabolism of Hcy. Consequently, a nutritional deficiency in either of these two vitamins will result in an increase in homocysteine in the circulation, a finding that we expect to find in vitiligo. Objective To determine the level of Hcy in the blood of patients with vitiligo as a first step in revealing if it has any relationship with the pathogenesis of vitiligo and consequently if this will have an impact on the treatment of vitiligo. Methods Twenty-six patients of both sexes with vitiligo (age range 20–50 years, mean 31·4 ± 8·09) and 26 age-matched healthy controls were included in the study. After excluding factors that may affect serum Hcy levels, blood samples from patients and controls were obtained for homocysteine determination by enzyme immunoassay. Results The mean serum level of Hcy was significantly higher in patients with vitiligo than in controls (21·61 ± 13·28 vs. 13·1 ± 4·88 μmol L−1; P < 0·001). The Hcy level was significantly higher in male patients than in female patients (28·67 ± 15·95 vs. 15·56 ± 6·2 μmol L−1; P < 0·001) and in male controls compared with female controls (15·07 ± 4·61 vs. 12·05 ± 4·82 μmol L−1; P < 0·001). The homocysteine level was related to the activity of vitiligo and was significantly higher in patients with progressive disease than in controls (25·4 ± 14·99 vs. 13·1 ± 4·88 μmol L−1; P < 0·001). No significant difference in Hcy levels was found between either untreated vitiligo patients (22·77 ± 13·36 μmol L−1) or patients receiving ultraviolet therapy (20·45 ± 13·73 μmol L−1) and the total patient group (21·62 ± 13·28 μmol L−1). Conclusion An elevated homocysteine level may be a precipitating factor for vitiligo in predisposed individuals. In view of the biological role of vitamin B12 and folic acid in Hcy metabolism, we present our recommendations regarding the investigation and treatment of this common disease. [ABSTRACT FROM AUTHOR]

Background Morphoea (scleroderma) is a chronic disorder characterized by circumscribed sclerotic plaques with the hallmark of increased fibroblast activation and fibrosis. Through its effect on connective tissue cells and immune cells, insulin-like growth factor (IGF)-I has been found to play a role in some autoimmune connective tissue diseases and has been implicated in the pathogenesis of several fibrotic disorders. Objectives To evaluate the role of IGF-I in the pathogenesis of morphoea. Methods The study was carried out on 15 patients with morphoea and nine healthy controls. Two 5-mm punch skin biopsies were taken from every patient (one from lesional and one from non-lesional skin) and a single biopsy was taken from the normal skin of each control. A 10-mL blood sample was also taken from each patient and control. Quantitative detection of tissue and serum levels of IGF-I was done using an enzyme-linked immunosorbent assay technique. Results IGF-I in lesional skin was significantly higher than in non-lesional and control skin ( P = 0·001 and P = 0·021, respectively). Moreover, a significantly higher level of IGF-I was detected in patient serum when compared with control serum ( P < 0·001). A direct significant correlation existed between lesional and non-lesional skin level ( r = 0·618, P = 0·014), and between lesional skin level and Rodnan score ( r = 0·538, P = 0·039). Conclusions Despite the small sample size, this study suggests that IGF-I plays an important role in the pathogenesis of fibrosis, characteristic of morphoea. Studies on a larger number of patients with morphoea as well as on patients with systemic sclerosis are recommended. Furthermore, therapeutic trials using IGF-I antagonist (octreotide) are highly recommended in patients with morphoea. [ABSTRACT FROM AUTHOR]

Background Behçet disease is a systemic inflammatory disease of unknown aetiology. T cells in this disease proliferate vigorously in response to a specific peptide of heat shock protein (HSP) 60 in an antigen-specific fashion. Vascular endothelial cell growth factor (VEGF) is a cytokine participating in the inflammatory process. One of the prominent features of Behçet disease is vasculitis as a result of endothelial dysfunction. Antiphospholipid antibodies (APA) may play a role in the development of thrombosis by inhibiting production of prostacyclin by endothelial cells. Objectives To investigate the role of HSP60, VEGF and APA in Behçet disease and their relation to clinical manifestations and disease activity. Methods Thirty patients with Behçet disease were included; 17 were in the active stage and 13 were in the inactive. Fifteen age- and sex-matched healthy subjects served as controls. Complete clinical examination and Doppler examination were done. Serum levels of HSP60, VEGF and APA were performed. Results Serum levels of HSP60, VEGF and APA were significantly higher in patients than in controls; however, their level did not correlate with disease activity. The serum level of VEGF correlated significantly with the presence of vascular manifestations and ocular involvement. The serum level of APA was greater in patients with thrombosis. HSP60 has an important role in aetiopathogenesis of Behçet disease, which sheds new light on its autoimmune nature. Conclusions An elevated serum level of VEGF may be a risk factor for the development of ocular disease contributing to poor visual outcome. [ABSTRACT FROM AUTHOR]

Ultraviolet A (UVA) phototherapy proved to be an efficient line of treatment of scleroderma. The mechanism through which it acts is still not clear. To detect the mechanism of action of UVA phototherapy in morphea through measuring its effect on the levels of different parameters related to collagen metabolism. Twenty-one cases of morphea were treated with low-dose broad-band UVA for 20 sessions. Twelve cases received 20 J/cm2/session with a cumulative dose of 400 J/cm2 and nine cases received 10 J/cm2/session with a cumulative dose of 200 J/cm2. The response was assessed clinically every week. Two skin biopsies were taken from the lesional skin of each patient before starting and after the end of therapy. Paraffin sections were examined for quantitative polymerase chain reaction measurement of collagen I, collagen III, collagenase, transforming growth factor-beta (TGF-β) and interferon gamma (IFNγ). Eighteen patients reported remarkable softening of the skin lesions, with variable degrees ranging from moderate in 57.1% of them good in 19% to very good response in 9.5%. After treatment, all the studied parameters revealed statistically significant changes. There was a significant decrease in collagen I, collagen III and TGF-β and a significant increase in collagenase (MMP-1) and IFNγ. The relative change was found to be greatest in collagenase, followed by IFNγ then TGF-β and finally collagen I. The changes in collagen I, collagenase, IFNγ and TGF-β were found to increase gradually with the degree of clinical response. In all the parameters studied the relative change was significantly higher in cases treated with 20 J/cm2/session in contrast to those treated with 10 J/cm2/session although no statistically significant difference could be detected in the clinical response to those doses. The efficacy of low-dose UVA phototherapy in the treatment of localized scleroderma is mainly obtained by the increased production of MMP-1 and IFNγ, and to a lesser extent by decreasing TGF-β and collagen production. Concerning the use of 10 or 20 J/cm2/session those effects are dose dependent, but the clinical response does not significantly differ. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the importance of the free radical release process in the pathogenesis of localized scleroderma and compare it with that in systemic sclerosis. The study was conducted on 20 randomly collected cases of morphea (4 single plaque, 7 linear, and 9 disseminated), 16 cases of systemic sclerosis, and 10 age- and sex-matched healthy volunteers. Blood samples and homogenized skin biopsies from lesional and nonlesional skin of patients and controls were examined for superoxide dismutase (SOD) activity using spectrophotometric assay, and for lipid peroxide level using the thiobarbituric acid assay. Morphea and systemic sclerosis cases showed significant elevation of blood, lesional, and nonlesional skin lipid peroxide levels and SOD activity compared with normal controls. When each of the subtypes of morphea were compared with the controls, a significant elevation of SOD was found in lesional skin in all groups, in plasma of linear and disseminated morphea, and in nonlesional skin of cases of disseminated morphea. A comparison of systemic sclerosis and morphea cases revealed no significant differences in blood or tissue SOD activity or lipid peroxide level. In both groups, the degree of skin induration could be correlated with changes in lesional SOD activity and lipid peroxide levels, respectively, but no correlation could be found between SOD or lipid peroxide and antinuclear antibody titer. The free radical release process is as important in the pathogenesis of morphea as it is in systemic sclerosis, where it appears to be involved in the development of skin induration. [ABSTRACT FROM AUTHOR]

In this work we formulate the state space approach for one-dimensional problems of viscoelastic magnetohydrodynamic unsteady free convection flow through a porous medium past an infinite vertical plate. Laplace transform techniques are used. The resulting formulation is applied to a thermal shock problem and to a problem for the flow between two parallel fixed plates both without heat sources. Also a problem with a distribution of heat sources is considered. A numerical method is employed for the inversion of the Laplace transforms. Numerical results are given and illustrated graphically for the problem considered. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus species are implicated in a wide range of community and hospital-acquired infections, which necessitates rapid provision of antibiotic susceptibility results for patients at risk. The current study evaluated the usefulness of applying broth microdilution (BMD) and agar dilution methods for antimicrobial susceptibility testing of Staphylococci using tetrazolium salts as redox indicators. Methods: Minimum inhibitory concentration (MICs) of eight antimicrobials representing different antibiotic classes as recommended by CLSI; vancomycin (VA), linezolid (LZD), oxacillin (OX), gentamicin (CN), tetracycline (TE), ciprofloxacin (CIP), erythromycin (E) and clindamycin (DA) was investigated for 80 isolates of Staphylococci by a modified BMD with the addition of dimethyl thiazole diphenyl tetrazolium bromide (MTT). As well as agar dilution with the addition of MTT & triphenyl tetrazolium chloride (TTC) at the standard bacterial concentration together with addition of MTT at an experimental bacterial concentration. Results: BMD (MTT) showed the highest agreement regarding most antibiotics among different isolates in comparison with the standard BMD. All performed methods showed significant agreement except agar dilution (TTC) using TE, DA, E, and agar dilution (MTT 108) using DA as well as agar dilution (MTT 104) using E among S. aureus. Conclusions: Colorimetric BMD was rapid, easy to interpret and showed the highest agreement with the standard BMD. Colorimetric agar dilution (MTT) was less tedious than BMD. The colorimetric MIC method using MTT may be a useful surrogate of antimicrobial susceptibility testing among Staphylococcus isolates. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which describes the possible role of interleukin-17 in the pathogenesis of lichen planus in the upper dermis.