ATOPIC DERMATITIS The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 467 478
Expression of CD38 and CXCR3 in children with atopic dermatitis. Fawzia A. EL.Sheshtawy, Naglaa A .Ahmad , Manal Abdul Salam
Departments of Clinical Pathology, Dermatology , Pediatric # , Faculty of
Medicine for Girls- Al Azhar University Abstract
Background : Atopic dermatitis ( AD) is a chronic or chronically relapsing inflammatory skin disease with a prevalence ranging from 10% to 20% in children of developed countries. Skin-infiltrating leukocytes play a pivotal role in the initiation and amplification of atopic skin inflammation. The cytokines produced by T helper- 2 ( Th2) cells are crucial factors in the induction and maintenance of the disease . Aim: to study the percentage of expression and mean fluorescence intensity( MFI) of the activation marker CD38 and the chemokine receptor CXCR3 on peripheral blood CD3+ lymphocytes in children with atopic dermatitis . Also total serum IgE and absolute differential count were evaluated .This might be targets for therapy in disease . Methods: This study was conducted on thirty cases of AD children. Their age range was 3- 10 years. Also non atopic fifteen children age and sex matched with disease group were included as a control group. The percentage of expression of the CD38 , CXCR3 and MFI were analyzed by flow- cytometry on peripheral blood CD3+ T lymphocytes . Also total serum IgE levels was measured by immunonephelometry . The absolute eosinophil , absolute lymphocytes, absolute neutrophil count were evaluated . Results: The mean percentage of CD38 expression on CD3 + lymphocytes and MFI were 70.5% and 5.8 respectively in AD children compared with 17.8 % and 5.1 in non atopic children healthy control ( p < 0.01 and p > 0.05 respectively ) . The mean percentage of CXCR3 expression on CD3+ T lymphocytes and MFI in AD children were 17.9 % and 2.9 respectively compared with 67.93 %and 3.3 in healthy controls (p < 0.01 and p > 0.05 respectively ). The mean of the total serum IgE in the patient group was 199.3 IU/ml compared with 62.27 IU/ml in non-atopic children (p < 0.01). Conclusion : These results suggest that there is a relation between atopic conditions and an increase in peripheral blood T lymphocyte expressing CD38% and decrease expression of CXCR3%.The presence of high expression of CD38 in atopic patients seems to confirm the role of this molecule as an activation marker useful for evaluation of Th2 immune response . whereas CXCR3-expression on CD3+ lymphocytes decreased in AD than normal control as the chemokine receptor profile determine the migratory patterns of leukocytes . These results may suggest the dysbalance between Th1/ Th2 in AD patients . Key words : CD 38 , CXCR3 , Flow- Cytometry , AD . Introduction
Atopic dermatitis (AD) is a common CD38 is a glycoprotein found on the
dermatologic condition that is characterized
surface of many immune cells (white blood
by pruritic and eczematous lesions
cells), including CD4+, CD8+, B and
persisting chronically. As an immunologic
natural killer cells. It is a marker of cell
aspect of AD, there are several reports that
activation.It is a multi-functional ectoenz-
suggest a Th1/Th2 imbalance (i.e., an
yme capable of catalysing multiple
uneven proportion of Th1 and Th2 immune
reactions
(ADP-ribosylcyclase,
NAD-
cells) in AD. This imbalance favors Th2,
glycohydrolase, cADP-ribosyl cyclase) and
and high serum IgE levels as well as blood
generating products involved in calcium
eosinophilia, which are all characteristics of
signalling (4). Furthermore, CD38 is an
AD. High serum IgE and eosinophil are
adhesion molecule. It is hypothesized that
provoked by Th2 cytokines, interleukin-4
the interaction between CD38 and the
(IL-4), IL-5, and IL-13. (.1-2 ).
corresponding
counter-receptor
CD31
467
Electromagnetic Field Effect on Skeletal Muscles and Skin of Albino Rat Embryos The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 479 491
Electromagnetic Field Effect on Skeletal Muscles and Skin of Albino Rat Embryos Histological and Histochemical Studies
Nora Ahmed Obaid Alkaabi
Zoology Department , Girls College of Science, King Faisal
University,Dammam,K.S.A.
Abstract
Aim of the work :The present study aimed to investigate the possible effect of the electromagnetic field (EMF) on the skeletal muscles and skin of fetuses maternally exposed to EMF. Material and Methods: Pregnant Swiss albino rats were exposed to EMF(50Hz&2mT) 8hours day after day 10 days before pregnancy and 20 days, day after day through pregnancy. Results: Exposure of pregnant rats to the electromagnetic field (EMF)of 50 Hz and 2millitesla(2mT), showed many dystrophic changes in the skeletal muscles and skin of their fetuses .Highly thickened and disturbed epidermal layer was noted with decreased number of hair follicles. Some hemorrhagic areas were noted in the dermis. Highly disturbed skeletal muscle fibers were noted with many deleterious changes in the nuclei of their cells. Altered protein content, polysaccharides and collagen bundles were observed in the muscle fibers and skin of fetuses taken from exposed pregnant rats to EMF. Conclusion: It is clear that EMF has a deleterious effect on skin and skeletal muscles of fetuses maternally exposed to EMF.
Introduction
Children in both industrial and
(2001) tried to study the effect of EMFs on
developing countries are exposed to a large
muscle fibers of mice and they stated that
variety of environmental agents including
field intensity of 1mT might be considered
indoor and outdoor air pollution ,water and
as a threshold level for enhancing muscle
food contamination, chemicals (eg,pest-
circulation. In 1996,Detlavs et al; noticed
icides, lead and mercury),and physical
accumulation of collagenous protein in skin
agents such as ultraviolet radiation,
of Wistar rats exposed to53.53GHz.Altered
excessive noise and electromagnetic fields.
protein expression was noticed in human
Exposure to electric and magnetic fields
skin by Karinen et al.(2008)after exposure
from 0-30 Hz has been increasing greatly as
to radiofrequency modulated electromagn-
countries increase their capacity to generate
etic fields. Physiological functions of
and distribute electricity and take advantage
human body are regulated by electric
of many new technologies (Kheifets et
currents,therefore,it is not surprising that al;2005).They added that children have a
placing human body within electromagnetic
large lifetime of exposure than adults ,and
field of sufficient strength may affect
from a physiologic point of view ,they have
physiological and biological processes and
a developing nervous system ,their brain
human health (Karinen et al;2008).They
tissue is more conductive than that of adults
added that EMF are considered as potential
because it has a high water content and ion
cause of ailments as sleep disorders,
concentration .The skin is the heaviest
headache or allergy-like Symptoms. Altered
single organ in the body and it represents
glycogen content, protein content and
about 16% of the total body weight (Hassan
collagenous fibers were noted by Eid and
&Sorour, 2006).
Al-Dossary(2007) in liver of pregnant rats
Many authors noticed skin sensitivity
and their fetuses which exposed to
to EMFs. In 2001 Imaida et al; noticed
EMF(50Hz and2mT) .
relationship
between
mouse
skin
Skin and skeletal muscles were
carcinogenesis and exposure to1.5 GHz
chosen for the present study because skin is
electrom-agnetic near fields. Xu et al.
considered as a mirror for the internal body
974
Nutritional Interaction Effect of Zinc and Coffee on Serum Lipid Profile and Copper in Rats The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 492 502
Nutritional Interaction Effect of Zinc and Coffee on Serum Lipid Profile and Copper in Rats Hanaa, M. Abd El-Fattah
Department of Biochemistry and Nutrition, Women's College, Ain Shams
University, Cairo, Egypt
Abstract Background :Coffee is one of the most popular beverages in the world. The present work was designed to study the effect of dietary coffee and zinc on serum lipid profile , zinc and copper in serum and liver Material and Methods : Forty two adult male albino rats were divided into six groups and fed on different diets ad libitum for 7 weeks as follows: Group (1) fed on standard basal diet , group (2) fed on standard diet supplemented with zinc chloride (ZnCl2) at dose of (20
mg/kg diet) , groups ( 3and 4 ) fed on standard diet supplemented with boiled coffee at two doses ( 15 g and 30 g / kg diet ) respectively , groups (5 and 6 ) fed on the previous two diets respectively but in combination with ZnCl2 (20 mg/kg diet) . At the end of the experiment
some biochemical analyses were measured in serum and liver . Results: The results showed significant elevation of serum total lipids (TL), total cholesterol (TC), triacylglycerols (TG), low density lipoprotein-cholesterol (LDL-c), while a significant decrease of high density lipoprotein-cholesterol (HDL-c) in rats fed diet supplemented with low or high dose of coffee. When rats fed zinc with low or high dose of coffee, improvement in lipid parameters were observed. Also serum lipid peroxides as malondialdehyde (MDA) showed significant increase while blood glutathione (GSH) showed significant decrease in rats fed zinc, coffee (low or high dose) or zinc plus coffee (low or high dose).
Diet supplemented with zinc caused significant increase in serum and liver zinc , on the
other hand significant decrease in serum and liver copper were recorded. Moreover, the high dose of coffee led to significant decrease in liver zinc. On feeding zinc and coffee together resulted in significant elevation of serum and liver zinc levels, but serum and liver copper decreased significantly. Conclusion: So zinc may be able to overcome the adverse effects of coffee also administration of zinc plus coffee could decrease lipid peroxidation. Keywords: Zinc, Chloride, Coffee, Lipid Peroxidation, Zinc, copper Introduction
Coffee (the second most traded commodity
The green coffee composition is
after petroleum) is one of the most popular
carbohydrates, lipids, pentacyclic diterpens
beverages in the world. Seventy five per
(methyl cafestol, cafestol, kahweol), , ,
cent of soft drinks consumed regularly are
tocopherols, and protein content. Coffee
coffee (Rojo Camargo, and Fatah, 1999).
contains several species of xanthines such
Coffee is a commonly consumed
as caffeine, theobromine and theophylline,
beverage with potential health benefits.
also contains polyphenols. The potential
There are three preparations of coffee that
bioactivies are caffeine, the deterpenes
are commonly consumed and thus worthy
(cafestol and kahweol) found in the oil and
of examinations; boiled unfiltered coffee,
the polyphenols (Parras et al., 2007).
filtered coffee, and decaffeinated coffee.
Several clinical and epidemiological
Also coffee has over a thousand chemicals,
studies have suggested that coffee
many are formed during the roasting
consumption is associated with significant
process (Bonita et al., 2007).
increases
in
total
and
low-density
492
Relationship between polymorphisms in thrombophilic genes and preeclampsia In Egyptian population The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 503 509
Relationship between polymorphisms in thrombophilic genes and preeclampsia In Egyptian population Nahla A. Abdelaziz*, Amal H . Abu Saif**, Fawzia A. Alshishtawy *
Clinical Pathology*, Obstet & Gynecol**,Alazhar University Abstract
Background: Hypertensive disorders are a major cause of maternal and fetal death especially in developing nations. Preeclampsia has a familial component suggesting that one or more common alleles may act as susceptibility genes. Some families may have "private" predisposing mutations.Preeclampsia and its association with thrombophilia remain controversial, due to inconsistent results in different studies. Aim: The aim of this study was to evaluate the relationship between thrombophilic genes mutations and preeclampsia in pregnant women in our region. Methods: We compared 15 consecutive women with preeclampsia with 10 normal pregnant women. All women were tested for mutations of factor V lieden , Factor II (prothrombin gene ) , Factor XIII, B fibrinogen , plasminogen activator inhibitor -1 4G/5G (PAI-1 4G/5G ), methylenetetrahydrofolate reductase (MTHR) , angiotensin converting enzyme (ACE) I/D , apolipoproteins (APO E and APO B ) genes. This study was based on reverse hybridization technique using cardiovascular disease strip (CVD ) assay . Results: PAI-1 4G/5G polymorphism was highly significantly increased in patient group as compared to control group (60% versus 0% , p= 0.000) . No significant differences were noticed as regards other thrombophilic genes in control and patient groups. Conclusion We suggest that the pattern of PAI 4G/5G polymorphism might represent a useful marker of increased risk of preeclampsia in our region. Also our findings suggest that women with severe complications of pregnancy should be tested for markers of thrombophilia. Key words : Thrombophilic genes , Preeclampsia, Hybridization .
Introduction
Preeclampsia (PE) greatly contributes
are generally associated with increased risk
to maternal and fetal morbidity and
of arterial and venous thrombosis (4).
mortality. Its cause is unknown, but its
Changes in blood coagulation and
association with impaired placentation and
fibrinolysis during normal pregnancy
activation of coagulative cascade has been
induce a state of hypercoagulability, which
demonstrated (1).
predisposes to development of thrombosis.
PE is a potentially serious condition
In combination with the physiological
which occurs in 2-7% of all pregnancies
changes during pregnancy, hereditary
and can be life threatening for both the
thrombophilic defects may increase the risk
mother and child (2).
of
obstetric
pathologies,
including
PE is also more common in women
preeclampsia (5).
who
have
preexisting
hypertension,
Inherited disorders of hemostasis and
diabetes, autoimmune diseases like lupus,
antiphospholipid syndrome have been
various inherited thrombophilias like Factor
postulated by prior investigators as comm-
V Leiden, or renal disease, in women with a
on causes of thrombophilia. However,
family history of pre-eclampsia, obese
controversies have aroused about their
women, and in women with a multiple
actual mechanisms (6-7). The C677T
gestation (twins, triplets, and more) (3).
polymorphism of the methylene tetrahyd-
The term thrombophilia is used to describe
rofolate reductase (MTHFR) gene, the
a heterogenous group of coagulation
G20210A mutation of prothrombin gene (F
abnormalities (acquired or inherited) that
II), the G1691A mutation of factor V
305
The Protective Effect of Soybean and Thyme on Iron Deficiency Anemia in Rats The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 510 520
The Protective Effect of Soybean and Thyme on Iron Deficiency Anemia in Rats Nora M. El-Sheikh
Department of Biochemistry and Nutrition, Women's College, Ain Shams
University, Cairo, Egypt Abstract
Objective: The present study is carried out to investigate the protective effect and
antioxidant activity of soybean and thyme on iron deficiency anemia. Material and Methods: Thirty five male albino rats were divided into five groups
(7rats each). The first group fed on basal diet, iron sufficient (35 mg Fe / kg), and served as control. Rats of other groups (second - fifth) were induced anemic by placing them on diet containing 3mg Fe / kg for 21 days, then divided to four dietary groups. The second group (anemic) stayed on basal diet with Fe-deficiency. The third group fed on basal diet with sufficient iron in the form of ferrous sulphate. The fourth group fed modified basal diet free from iron and supplemented with soybean. The fifth group fed basal diet free from iron and supplemented with thyme. All three iron sources provide 35 mg iron/kg diet. At the end of experiment (49 days), rats were anesthetized, whole blood was used for determination of hemoglobin (Hb), hematocrit (HCt) and reduced glutathione (GSH) levels. Serum was used for determination of iron and lipid profile as well as lipid peroxidation as malondialdehyde (MDA). The liver was used for determination of iron and copper concentrations. Results: The present results indicated that Fe-deficiency caused many adverse effects
reflected the significant decrease of Hb, HCt, serum iron, liver iron, GSH and high density lipoprotein-cholesterol (HDL-C). Fe-deficiency also caused significant increase in total iron binding capacity (TIBC), liver copper, MDA, triacylglycerols (TG) and total cholesterol (TC). In contrary, administration of ferrous sulphate (FeSO4), soybean or thyme induced a significant
increase of serum and liver iron profile. Conclusion: Soybean and thyme could able to provide iron to correct dietary iron-
deficiency anemiaand powerful antioxidant effect of soybean or thyme was reflected on marked decrease of MDA and increase of GSH and HDL-C. Key words: iron deficiency anemia-soybean- thyme- lipid peroxidation. Introduction
Dietary iron-deficiency is the most
increased hepatic copper accumulation and
common nutritional problem world wide,
impaired cellular growth are important in
affecting approximately two billion people,
addition to the anemia (Cunnane and Mc
mostly infants, children and women of
Adoo, 1987).
reproductive age ( Viteri, 1997).
In biological systems, the steady-state
Iron-deficiency anemia (IDA) effects
level of lipid peroxidation is often assessed
on development and growth, resistance to
by the measurement of lipid peroxidation
infections and association with mortality of
breakdown products such as malond-
infants younger than 2 years, it is
ialdehyde (MDA) (Uehara et al., 1997).
considered a major public health problem.
There is controversy about the
Moreover, IDA has negative effects on
susceptibility of the cells to lipid peroxide-
work capacity and on motor and mental
ation in IDA. Some investigators have
development
in
infants,
children,
claimed; there is no difference in lipid
adolescents, fertile women, pregnant and
peroxidation among patients with IDA as
the elderly (Hass and Brownlie, 2001).
compared with controls (Isler et al., 2002),
Secondary nutritional effects, such as
but others have reported that among
changes in enzyme activity, hyperlipidemia,
patients with IDA, oxidants are increased
010
Intrathecal Ketorolac in Albino Rats;The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 512 503
Intrathecal Ketorolac Injection in Albino Rats; Pharmacological and Histological study *Tarek A. Atia, **Mostafa I. Shalaby, ***Nemat M. Al-Baz *Histology, ** Anesthesiology & ICU, ***Pharmacology Departments; Faculty
of Medicine, Al-Azhar University, Cairo, Egypt Abstract Introduction: Ketorolac tromethamine is a potent injectable non-steroidal anti- inflammatory drug (NSAID). Ketorolac provides successful analgesia after intrathecal or epidural injection. It is frequently used to manage post-operative pain, cancer pain, and arthritis either intrathecally, or intramuscular. However, its long term administration could induce renal toxicity and/or gastro-intestinal ulceration. Aim of the study: The aim of this study was to assess the analgesic potency of ketorolac after intrathecal injection. Also, we aimed to study the histological effect of ketorolac on the spinal cord and the duodenum after treatment in an animal model. Methods: 40 adult male albino rats, weighing 250-350 gm, were used and divided into 4 groups, 10 rats each. Group S (control) received 10l normal saline intrathecally, group K50 received 50g ketorolac intrathecally, group K50 + omeprazole (proton pump inhibitor) received 50g ketorolac intrathecally plus 0.2 mg omeprazole orally, and finally, group K100 received 100g ketorolac intrathecally. All animals were treated for four successive days. Result: The rat tail flick latency was longer in K50, K50 + omeprazole, and K100 groups when compared to normal control (P = 0.002). Also, the hind-paw withdrawal latency was longer in treated groups when compared to those of the control group (P = 0.0001). Moreover, K50 group showed decreased phase II response by 61%, K50 + omeprazole group showed decreased phase II by 62%, while K100 group showed decreased it by 76%. Histological examination revealed no changes in the spinal cord of all treated animals. Also, examination of the duodenum showed normal duodenal mucosa in group K50 and those of group K50 + omeprazole. On the other hand, cellular infiltration as well as destruction of the mucous acini have been noticed in the duodenum of K100 group. Conclusion: Ketorolac could be a good alternative drug used intrathecally to manage pain. Key word; Ketorolac, analgesics, intrathecal, rats Introduction
The study of intrathecal application of
Indeed, the constitutive presence of COX-2
drugs to manage pain is important for two
in the spinal cord has been suggested to
reasons. First, it is directly relevant to
underlie the early analgesic effect of COX
anesthesia practice in that the intrathecal
inhibitors after surgery or other peripheral
space is often instrumented as part of peri-
injury and at times before peripheral COX-
operative, or chronic pain care. Second, it
2 expression is increased. After peripheral
provides important information regarding
injury, spinal COX-2 expression is greatly
mechanisms of analgesic action and of pain
enhanced, leading to increased spinal
transmission,
which
could
guide
release of prostaglandins with resultant
pharmaceutical
development
of
both
increased substance-P release and central
intrathecal and systemic drug development.
sensitization. Gillis and Brogden. (1997)
A good example of these rationales is
For this reason, spinally administered COX
examination of cyclooxygenase (COX)
inhibitors produce analgesia after injury
enzyme expression and inhibition in the
(Conklin and Eisenach, 2003).
spinal cord as it relates to pain treatment.
Ketorolac
tromethamine
is
an
COX is expressed in the normal spinal cord
injectable non-steroidal anti-inflammatory
in small amounts, both isoforms COX-1
drug (NSAID) approved in 1990 for
and COX-2. Brocks and, Jamali (1992).
treating post-operative pain. Ketorolac is
112
Using of Telomerase Enzyme in Urine as a Non invasive Marker for Cancer Bladder Detection The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 531 537
Using of Telomerase Enzyme in Urine as a Non invasive Marker for Cancer Bladder Detection Azza A Hassan*, Fawzia A . El- Sheshtawey** , Seliem A. Seliem***, Mohammed A. Abd El Salam#
Departments of Clinical Pathology* , National Institute of Urology & Nephrology-Cairo,
Clinical Pathology** & Urology***- Faculty of Medicine for Girls-Al Azhar University,
Pathology#-Cairo Faculty of Medicine Abstract
Background: Urinary bladder cancer is one of the major health problem all over the world. Cystoscopy remains the gold standard for identifying bladder cancer but it is invasive and expensive, therefore, a simple, non invasive test for detecting bladder cancer would be helpful. Several biomarkers for bladder cancer have been used, but no single marker has been accurate and conclusive. Aim: The current study aimed to measure telomerase enzyme in urine as a useful non invasive marker for detection of bladder cancer. Methods : Forty eight patients ( 39 males and 9 females) were included, They are complaining of urinary symptoms and undergo cystoscopy with biopsy of bladder lesions and histopathological examination. They were divided into groups:Group I: 16 patients ( 11 males and 5 females) have benign urologic conditions. Group II: 32 patients (28 males and 4 females) have proven bladder cancer patients underwent transurethral resection of bladder tumor or cystoscopy with biopsy of bladder lesions. Also, 15 apparently healthy volunteers with matched age and sex with patients were served as a control group. All subjects were submitted to laboratory estimation of the following in urine: urinary creatinine, urine cytology, telomerase enzyme in urine by telomerase PCR and complete urine examination. Results : The results of this study revealed that a highly significant increase in the frequency of cytolological positive cases for tumor cells in malignant group than each of benign group and healthy subjects, while no significant difference was detected between benign group and healthy subjects. The frequency of telomerase in urine was significantly higher in malignant group than each of benign group and healthy subjects, while no significant difference was detected between benign group and healthy subjects. The telomerase activity has sensitivity of 90.6% for diagnosis of cancer bladder with 93.7% for specificity and PPV was 96.6%, NPV was 83.3% and diagnostic accuracy of 91.6%. While, urine cytology gives a sensitivity of 68.8%, specificity of 87.5%, PPV of 91.6%, NPV 58.3% and diagnostic accuracy of 75%. When combined tests were used the sensitivity raised to 96,8%, and specificity reached to 100%, PPV was 96.6%, NPV was 94.1% and diagnostic accuracy increased to 97.9%. Conclusion: the urinary assay of telomerase could be used as non invasive test to identify the bladder cancer patients and distinguish them from normal subjects and patients with benign tumor of urinary bladder. The low cost of this test may help to be implicated as non invasive screening of bladder cancer. Key words : Cancer Bladder ,Telomerase , PCR
Introduction
Several important risk factors have
matched by a tendency to recur,
been identified for bladder cancer including
necessitating close and regular follow up
cigarette smoking, exposure to chemicals
(Saad et al., 2001). Although the incidence
and the presence of chronic inflammation
of cancer bladder is increasing, methods of
like belharziasis (Boon & Drijver, 1986).
diagnosis have changed little during the last
Bladder cancer has a high incidence
few decades (Pirtskalaishvili et al., 1999).
135
Hematiological and Biochemical Study The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 538 543
Effcts of the herbicide gallant and mercury on liver function of Tilapia zilIi Abdel-Salam Mohamed Ibraik Ohaida
Zoology Department, Faculty of Science, 7th of October University, Misurata, Libya.
Abstract Background: Herbicides are highly toxic for both human and animal health. The increased application of herbicides in agriculture during the last decades has resulted in the contamination of both soil and water. Also do heavy metals, which represent one of the most important group of pollutants produced as a result of many industrial activities which can find their way easily to the normal aquatic environments, disturbing and damaging the existing organisms. Material and Methods: Fishes of the species Tilapiazillii were exposed to sublethal
concentration of herbicide Gallant (haloxyfop-ethopxy ethanol ester) (3 mg/L), mercury as mercuric chloride (6 mg/L) and a combined dose of herbicide (1.5 mg/L) and mercury (3 mg/L) for 96 hrs., in aquaria under controlled laboratory conditions. A comparative physiological study was carried out to test the toxicological effects of these pollutants on glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT) activities & hepatosomatic index of liver. Results: A progressive decrease in enzyme activity as well as total protein content of liver were observed, while hepatosomatic index showed a slight insignificant increase. Key words: Gallant, mercury, glutamic pyruvic transaminase & glutamic oxaloacetic transaminase activities and hepatosomatic index of liver. Introduction
Modern agricultural practices in USA
Numerous environmental pollutants
and many other countries have resulted in
including herbicides, fungicides, rodenti-
nearly unrivaled efficiency and productivity
cides, pesticides (organochlorine, organo-
of pesticides and herbicides. Unfortunately,
phosphorus, carbamate and pyrethroid ) as
there is also the potential for release of
well as heavy metals, have been reported to
these compounds to the environment and
alter liver function (Cashman, 1990;
consequent adverse effects on wildlife and
Riviere et al., 1990 and Saleh et al., 1991).
human populations (Dalton and Frick,
Intensive studies concerning the toxic
2008).
effects of herbicide gallant on fish organs
Numerous herbicides are now widely
are lacking. Therefore, the present study
used in many parts of Egypt to control wide
was undertaken to elucidate the deleterious
variety of grass. Gallant is active against a
effects of herbicide gallant, mercury and a
very wide range of grass weeds. Many of
combined dose of both gallant and mercury
the treated areas contain fresh water reso-
on liver function of the Tilapiazillii.
urces like streams, lakes and ponds which
harbour diverse aquatic fauna and flora. Material and methods
Pollution by mercury represents a
serious problem in the framework of Experimental animals
chemical pollution of aquatic environment Tilapiazillii fishes weighing ~ 36 g
due to its high ability to accumulate in fish
were obtained from Tawarga pond and
organs (Portmann, 1972; Scott and
transported immediately to adequate
Armstrong, 1972 and Saleh, 1982) and
laboratory conditions (temperature 24 ± 1
subsequently may affect the people who
°C & pH 7.5) for at least two weeks in 60
feed on fish.
liters glass aquaria.
538
Evaluation of Hypoglycemic Activity of Opuntia dillenii Haw The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 544 558
Evaluation of Hypoglycemic Activity of Opuntia dillenii Haw Fruit Juice in Streptozotocin-Induced Diabetic Rats Inas Z.A. Abdallah
Nutrition and Food Science Dept., Faculty of Home Economics
Helwan University Abstract:
Background: Opuntia dillenii Haw fruit is used in folk medicine as an antidiabetic agent. The aim of this study was to evaluate the possible curative role of O. dillenii fruit juice using the streptozotocin (STZ)-induced diabetic rats. The nutritive value of the edible portion of the fruit was also assessed. Results: The results showed that O. dillenii fruit is a rich source of fiber, carbohydrates, vitamins B1, B2 and C, in addition to the minerals, Fe, Zn, Cu, Cr, Mn, Ca, and Mg. Biological
results showed that intraperitoneal injection with STZ caused highly significant reduction in body weight gain% , highly significant elevation in blood glucose concentration accompanied by significant reduction in liver glycogen cotent as compared with control group. Diabetic rats also revealed significant elevation in lipid peroxide (MDA) level, highly significant elevation in total cholesterol (TC), triacylglycerols (TAG), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) concurrent with highly significant reduction in high-density lipoprotein cholesterol (HDL-C) as compared with control group. Oral administration of O. dillenii juice had no effect on normal rats. Meanwhile, oral administration of O. dillenii juice to diabetic rats induced siginficant improvement in body weight gain % and lipid profile, it reduced significantly blood glucose and MDA levels as compared with non treated diabetic group. Histopathological investigation of the pancreatic tissue of STZ-diabetic rats represented the presence of necrosis, edema and congested blood vessels in the islets of Langerhans cells. O. dillenii fruit juice treatment overcome the previous changes, the majority of the cells tend to be normal.The improvement in the cells of Langerhans islets may explain the antidiabetic effect of the fruit juice under study. It also may improve the insulin receptors of - cells. Conclusion: It could be concluded that O. dillenii fruit juice had a potent hypoglycemic activity, this effect may be attributed to its antioxidant activity and its high content of chromium which was proved in this study. Therefore, it could be recommended that O. dillenii should be ingested as fresh fruit to diabetic and hypercholesterolemic patients beside the usual therapy. Key words: Opuntia dillenii Haw fruit juice, Nutritive value, Hypoglycemic activity, Streptozotocin, Diabetic rats.
Introduction
of calories rich diet, obesity and sedentary
Diabetes
mellitus,
a
metabolic
life style have lead to tremendous increase
disorder, is characterized by hypergly-
in the number of diabetics worldwide (Wild
cemia, altered metabolism of lipids, et al., 2004). According to WHO projec-
carbohydrates and proteins with an
tions, the prevalence of diabetes is likely to
increased risk of complications of vascular
increase by 35%. Currently there are over
diseases (Petrovsky and Schatz, 2003).
150 million diabetics worldwide and this is
Chronic hyperglycemia during diabetes
likely to increase to 300 million or more by
causes permanent tissue damage, notably to
the year 2025 (Boyle et al., 2001).
the retinas, kidneys and nerve endings
It is apparent that due to the side
(American Diabetes Association, 2007).
effects of the currently used drugs, there is
These may be delayed, decreased or
a need for safe agents with minimal adverse
prevented by maintaining blood glucose
effects, which can be taken for long
values close to normal. The increasing
duration.
Recently,
the
search
for
number of aging population, consumption
appropriate hypoglycemic agents has been
455
EFFECTS OF ORALLY FED DIAZINON ON SOME BIOCHEMICAL PARAMETERS OF MALE ALBINO RATS The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 559 568
Effects Of Orally Fed Diazinon On Some Biochemical Parameters Of Male Albino Rats Mohammed Salah Ab.Ab.AL-Shinnawy
Biological and Geological Sciences Department , Faculty of Education , Ain Shams
University , Cairo , Egypt . Abstract
Background:The current investigation was carried out to study the effect of orally administration of diazinon insecticide on some biochemical blood indices on male albino rats. Material and methods: The organophosphorus insecticide , diazinon was orally administrated at a dose (100mg/kg body weight=1/3LD50) , daily for 10 days (short term) and 20 days (long term) to adult male albino rats . Results: The results revealed the following: 1- Diazinon led to an increase in rat blood serum glucose& T3 (short and long term); AST,ALT, and T4 (long-term). 2- Diazinon reduced the serum content of total cholesterol and protein in shortterm treated rats. 3- Treatment of rats with diazinon did not alter activity of AST, ALT and T4 level at short term period .In addition ; ALP serum levels were not altered in both short and long term treated rats . Key Words: Diazinon , Organophosphorus insecticide , Biochemical changes , Serum
Introduction
The world loses about 6 billion
Diazinon which is the object of this
pounds sterling every year of agricultural
current study is one of the organop-
production due to pests. Farmers have
hosphorus insecticides (Cindy et al., 2007).
therefore invested heavily in pesticides to
It has been used at levels exceed the legal
reduce this loss . The international use of
limits to control a wide variety of sucking
pesticides has increased food production in
and chewing insects and mites on a very
parallel with population growth in many
wide range of crops , including deciduous
parts of the world .Many insect borne
fruit trees , citrus fruit , vines olives
diseases have also been eliminated or
,bananas , pineapples ,etc......Also used as
controlled by the use of insecticides
a veterinary ectoparasiticide .It has
(Sungur and Güven, 2001).
hazardous side effects on humans and
On the other hand ,the extensive use
economic farm animals that accidentally
of insecticides to control agricultural pests
exposed to it (Kalender et al .,2005).
has caused great concern because of the
possible effects of these compounds on Material And Methods
human beings as well as wild and domestic
animals (Ezzat et al.,1991 and Alpalan et
Forty mature male albino rats (Rattus al. ,2006) . norvegicus)ranging in weight from 120 -
The organophosphorus insecticides
140 gm . , were essentially obtained from
comprise a very large group of compounds .
Schistosoma Biological Supply Program
They constitute the most important group of
(SBSP) Theodor Bilharz Research Institute.
modern pesticides , being of wide
The rats were allocated at random into 4
application because they possess a high
equal groups 10 rats each.
insecticidal activity as well as a high initial The first group,were kept as control
action of toxicity on pests (Hassall , 1990 ;
being observed under the same laboratory
Gralewicz & Socko , 1997).
conditions.
555
IntroductionThe Egyptian Journal of Hospital Medicine (2008) Vol., 33: 596 576
Tumor necrosis factor- (TNF- ) in glutathione (GSH)-depleted rats. A possible link to impaired glucose metabolism Sohair A. Moustafa
Department of Zoology, Faculty of Science, Suez Canal University, Ismailia, Egypt.
Abstract
Rats: treated with the glutathione depleting agent, allyl alcohol (AlAl) (1 mmol/kg) was found to induce a marked increase in serum TNF- 45 minutes post treatment. This increase is suggested to play a critical role in the development of impaired glucose metabolism and glucose intolerance in AlAl-treated rats. Impaired glucose metabolism was evidenced by the significant increase in serum creatinine, urea and blood urea nitrogen accounting for accelerated glycolysis and breakdown of creatinine phosphate. These are the metabolic consequences of the activation of a back up system for the generation of ATP when the primary energy forming pathway is impaired. Meanwhile, the present data show a significant decrease in the serum levels of triglycerides and cholesterol in AlAl-treated rats that was accompanied with a concomitant increase in their liver levels indicating the development of fatty livers in these rats. Due to the strong link between TNF- and the GSH status and to the well established role of TNF- in causing insulin resistance, which is potentiated by fat accumulation in different tissues, it is concluded that the combination of TNF- overproduction, GSH depletion and lipid accumulation in the liver caused by AlAl treatment, cooperate making cells more sensitive to AlAl poisoning, therefore, imposing a potent negative impact on glucose metabolism. Added to the deleterious effects of TNF- , enhanced lipid peroxidation observed in AlAl- treated rats suggests possible alterations in the rates of glucose transport and metabolism which may further contribute to AlAl-induced impairment in glucose metabolism. Conclusion: Finally, the selective effect of TNF- in inhibiting insulin secretion give an additional support to its hypothesized role in initiating glucose intolerance in GSH-depleted rats. Key words : TNF- , rats, glutathione depletion, glucose metabolism impaired glucose metabolism
Introduction
Over the past decade, there has been
Since glutathione (GSH) is the major
substantial interest in oxidative stress and
redox buffer of several eukaryotic cell types
its potential role in diabetogenesis,
that detoxifies reactive oxygen species, it is
development of diabetic complications and
hypothesized
that
persistent
TNF-
atherosclerosis (Evans et al., 2003).
secretion could induce oxidative stress
Oxidative stress develops when free radical
through modulation of glutathione (GSH)
generation exceeds the body's antioxidant
metabolism. Actually several studies have
production capacity (Roth, 2000). Tumor
addressed this hypothesis (Fernandez-
necrosis factor (TNF- ) is an inflammatory
Checa et al. , 1987 and Higuchi et al. 1996,
cytokine that causes cell injury by
Adamson and Billings, 1992 and Glosli et
generation of oxidative stress (Adamson al., 2002).Moreover, GSH has been found
and Billings, 1992 & Goosens et al,. 1995).
to exert a protective function against the
Moreover, TNF- has emerged as a key
cytocidal effect of TNF by inhibiting the
player in the progression of insulin
hydroxyl radical production stimulated by
resistance seen in obesity and obesity-
TNF (Yamauchi et al., 1990).
linked type 2 diabetes (Ruan et al,. 2002).
Allyl alcohol (AlAl) is one of the
However, the mechanistic link between
hepatotoxins that readily conjugate with
TNF- and insulin resistance remain
hepatic glutathione to produce extensive
unclear.
GSH depletion followed by cellular
996
PCR detection of Toxoplasma gondii DNA versus serological diagnosis in women suffering from repeated abortionThe Egyptian Journal of Hospital Medicine (2008) Vol., 33: 577 586
PCR detection of Toxoplasma gondii DNA versus serological diagnosis in women suffering from repeated abortion
Abo EL Naga (1), AM; Shaltot (2), AA; Rizk EL- Baz(2), And Eman fayad(1).
(1)Zoology Department, Faculty of Science at Mansoura University, Egypt.
(2) Genetics unit, children Hospital, Mansoura University, Egypt. Abstract
Background: This study was conducted to test the utility of polymerase chain reaction (PCR) assay to detect recent infections with Toxoplasma in pregnant women. T.gondii DNA was detected by using B1 gene as a target for amplification which is highly specific for T.gondii and is well conserved among all of the tested strains. Results: This study revealed the following findings:(1) PCR was positive in 63 subjects,
including 58 high risk cases (77.3%) and 5 of controls (12.5%). (2) 17 high risk cases (24.6%) had false positive IgM and 5 of controls (12.5%) had false negative result for IgM. (3) 17 high risk cases (32.7%) had false positive IgG and 5 of controls (12.5%) had false negative IgG. (4) No significant association between eating raw meat or contact with cats and positive ELISA for PCR but there is highly significant association between women with contact with soil and positive PCR. (5) No significant relation between residency and either ELISA or PCR. (6) Significant negative correlation between the age of the studied women and positivity of PCR. Conclusion: this study highlights the need for a confirmatory test to detect primary acute toxoplasmosis in pregnant women. It demonstrates the possibility of defining and selecting the high-risk cases for mother-to-child transmission of infection by combining specific serology and PCR tests to formulate a specific approach Key words : PCR , Toxoplasma gondii and Repeated abortion.
Introduction
Primary maternal infection during (Remington et al., 1995; Sahwi et al., 1995
pregnancy is frequently associated with and Zargar et al., 1999).
transmission of T.gondii to the fetus (Wong Although serological testing has been and Remington, 1994). Transplacental
one of the major diagnostic techniques for
transmiission of Toxoplasma from an
toxoplasmosis, it has many limations, for
infected, pregnant women to the unborn
example, it may fail to detect specific anti-
results in fetal damage to a degree
toxoplasma immunoglobulin G (IgG) or
depending on the gestational age (kopecky
IgM during the active phase of T.gondii et al., 2001). Early - first trimester
infection, because these antibodies may not
maternal infections are less likely to result
be produced until after several weeks of
in congenital infection but the sequelae are
parasitemia. Therefore the high risk of
more severe (Gagne, 2001).
congenital toxoplasmosis of a fetus may be
Transplacental passage is more
undetected because the pregnant mother
common when maternal infection occurs in
might test negative during the active phase
the latter half of pregnancy, but fetal injury
of T.gondii infection. Several PCR based
is usually much less severe. It may lead to
techniques (Lee et al., 1999 and Pujo-
miscarriage, still birth, or congenital defects Rique et al., 1999) which have been
depending on the stage of gestation when
developed for the diagnosis of Toxoplasma
the infection occurs (Dubey and Beattie,
using various clinical specimens, including 1988). Several studies have suggested its
amniotic fluid (Costa et al., 1997; Hohlfeld
role in the causation of abortion et al., 1994), blood (Ho-yeh et al., 1992;
577
Anatomical, histological and histochemical studies on some organs of true desert rodents in the Egyptian habitatsThe Egyptian Journal of Hospital Medicine (2008) Vol., 33: 578 306
Anatomical, Histological And Histochemical Studies On Some Organs Of True Desert Rodents In The Egyptian Habitats Boshra A. El- Salkh*, Zaki T. Zaki** Mohammad I. Basuony** and Hanaa A. Khidr*
Department of Zoology, Faculty of Science, Al-Azhar University
for Girls(1) and Boys(2) Abstract
Aim of the work: The present study aimed to compare between the anatomy, histology and histochemistry of two species belonging to two different families namely Muridae and Dipodidae. Muridae is the largest family of rodents in the world; it is represented in this work by fat sand rat Psammomys obesus. Four-toed jerboa Allactaga tetradactyla represents the other family, Dipodidae. Psammomys obesus lives in coastal presaharan region; the preferred habitat is saline marshes and wadis where halophytic plants were abundant. However, Allactaga tetradactyla, inhabites the salt marshes and clay desert areas of coastal plains. Material and methods: The investigated animals were collected from desert, weighed and transferred alive to the laboratory in separate cages then anaesthetized with ether, after which they were carefully dissected, organs are taken out and prepared for the histological and histochemical studies. The nucleocytoplasmic index of liver cells was calculated, kidney weighed and the relative thickness of cortex, outer and inner medulla was measured and total glomerular number was recorded. Results: The liver, as in mammalian species, is consists of five separate lobes. The mitotic index of Psammomys obesus is smaller than that found in Allactaga tetradactyla. This may be due to the increased activity of Allactaga tetradactyla. In the kidney, the cortex is classified into three regions namely superficial, midcortical and juxtamedullary zones. Both number and diameter of glomeruli, glomerular volume and relative glomerular blood volume is greater in Psammomys obesus than that in Allactaga tetradactyla. Conclusion: These observations indicate the ability of Psammomys obesus to produce highly concentrated urine than that of Allactaga tetradactyla. Key words: Desert Rodents, Histochemical, Liver, Kidney
Introduction
Fat sand rat Psammomys obesus lives
urine show it is up to four times as salty as
in the coastal and presaharan regions. They
sea water (Happold, 1984)
preferred the habitats of salt marshes and
The previous author added that, the
wadis where halophytic plants are abundant
higher costant relative humidity of the
(Zaime and Guatier, 1989 and Degan 1993).
burrows reduces water evaporation loss,
They build a network of shallow burrows
where at night, burrow temperature are
and because they are frequently diurnal,
warmer than outside.
they may be seen to feeding on halophytic
Fat sand rat Psammomys obesus is
plants. This kind of activity is only possible
normally normoglycemic when eating
provided sand rats possess special
desert vegetation but when allowed free
mechanisms for staying cool, or for
access to standard laboratory foods show
obtaining water which may be used for
obesity, hyperinsulinemia, hyperglycemia
evaporative cooling. The key to their
and occasionally ketoacidosis (Marquie et
success seems to be their ability to eat the al., 1984).
succulent leaves of halophytic plants and
Four-toed jerboa Allactaga tetrad-
then eliminate the excess salts in a more actyla is restricted in coastal areas in Egypt
concentrated urine. Measurements of this
he portal veins, hepatic artery, bile duct and
778
IntroductionThe Egyptian Journal of Hospital Medicine (2008) Vol., 33: 404 421
The Toxicological effects of fenitrothion and vitamin E as antioxidant agent on the biochemical, cytogenetic and histopathological parameters of white rats Fouad Abdel Reheim* Awad Abbas Ragab * Fatma.M. Hammam** ; Hossam El-Din Hamdy**
*Department of Biochemistry, Faculty of Agriculture, Cairo University.
**Department of Mammalian Toxicology, Central Agricultural Pesticides Laboratory,
Agricultural Research Centre.
Abstract
Background: The use of pesticides has been increased considerably nowadays compared to the past. The hazards of using such chemical compounds have been accentuated by the sharp rise of their use in agriculture, industry, by householders and governments. Exposure to organophosphorus insecticides (OPI) in agriculture is one of the occupational hazards. Fenitrothion is one of the most important OPI. The major object of the present study was to evaluated the toxicological (biochemical, mutagenic and histopathological) effects of tested insecticide "fenitrothion" alone or combined to vitamin E as an antioxidant agent to decrease their toxic effect. Material and Method male albino rats were tested orally for 30 days, three doses of fenitrothion were used in absence and presence of vitamin E (1/20, 1/40 and 1/80 LD50). Results the obtained data showed marked changes in biochemical parameter, highly inhibition of AchE activity; highly significant increase in the frequency of micronucleus (PCEM) in rat bone marrow cells at all doses of fenitrothion alone or combined to vitamin compared to control group. Also, the histopathological examination of liver and kidney tissues revealed high alternation in these tissues corresponding to biochemical changes. Conclusion From these results we concluded that fenitrothion exert biochemical, mutagenic and histopathological effects in white rats. In addition, vitamin E has mild role in alleviating these toxicological effects. Key words: Organophosphorus, Fenitrothion, Antioxidant agent, Micronucleus.
Introduction
Organophosphorus (OP) compounds
osphorus (OP) insecticide controlling a
are among the pesticides which are widely
wide range of insects and other pests,
used in agriculture. Their application and
although fenitrothion exhibits low mamm-
usage have increased astronomically in the
alian toxicity, biochemical, morphological
last decade and will likely increase further
and functional alternations in animals
in further. Some of these which are used at
tissues have been reported (El-halwagy et
present in Egypt are dangerous when al., 2008). The prolonged administration of
mishandled or wrongly used (Zahran et al.,
fenitrothion increased the concentration of
2005). OP represents one group of
corticosterone and glucose in plasma of
pesticides that has been shown to have toxic
male rats. It also increased the weight of the
effects in humans (Tastsakis et al., 1998).
adrenal gland of male rats and altered its
The biochemical effects produced by
functions (Khan et al., 1990). Dermal,
pesticides can be enzyme induction or
inhalation and oral exposure to fenitrothion
enzyme inhibition, the effect of pesticides
inhibits acetylchloinestrase enzyme (AchE)
may be detected by ensuring biochemical
in plasma, erythrocytes and brain of
changes even before adverse clinical health
mammals (Ishimats et al., 1988), in
effects can occur (Sivapiriya et al., 2006).
addition to a considerable liver and kidney
Fenitrothion is one of the organoph-
damage evidenced by elevation in serum
404
Introduction:The Egyptian Journal of Hospital Medicine (2008) Vol., 33: 639 649
Nutrition Education intervention in dyslipidemic children and adolescent with insulin-dependent diabetes mellitus (IDDM) Asmaa m. Abdallah*, Zainab B* and Mohamed M. A. Shahat**
* Clinical Nutrition Department, Nutrition Institute. **Department of Zoology, Faculty of Science, AL-Azhar University (Assiut)
Abstract
Background: Diabetes mellitus is the most common endocrine metabolic disorder of childhood and adolescence with important consequences for physical and emotional development. Aim of the study: This study was designed to detect the effect of diet therapy (through nutrition education program) on lipid profile and blood glucose level in diabetic children. Subjects and Methods: The study was carried on 45 diabetic children aged between 8-15 years old at diabetic nutrition clinic of nutrition institute in Cairo from 2003-2005. Children included in the study were divided into two groups: insulin dependent dyslipidemic group (IDDM) (diet control/ group) and insulin dependent non dyslipidemic (control group). All were subjected to full dietetic history by the 24 hour recall for 3 days, thorough clinical examination, they were evaluated for plasma lipids, lipoproteins, fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) levels. The dyslipidemic were measured after three months for the
previously measured parameters. The nutrition education process was performed and continued on weekly intervals for three months. Results: There was significant decrease in serum cholesterol and triglyceride levels in the study group after the program, and insignificant increase in serum HDL and decrease in serum LDL. Also, there was insignificant decrease in FBG but there was statistically significant decrease in HbA1 after the program. These changes occurred in parallel with increases in intakes of protein and total calories with adequate carbohydrate and sometimes a reduction in intakes of total fat. Conclusion: Nutrition therapy for children with IDDM is essential to improve measures of glycemic control and lipoprotein mediated risk for dyslipidemia. More innovative approaches to achieve lifestyle changes are required to meet current recommendations which are likely to produce greater beneficial changes than those observed in this study. Key words: IDDM- Children- dyslipidemia- Diet control
Introduction
Diabetes mellitus is a syndrome of
commonest age of onset of IDDM falls
disturbed energy homeostasis caused by
between 12-14 years, and there appears to
deficiency of insulin or of its action and
be a tendency for IDDM to develop at a
resulting in abnormal metabolism of
younger age among Egyptians (Ibrahim and
carbohydrates, protein and fat. It is the most
Arab, 1992).
common endocrine metabolic disorder of
Hypercholesterolemia and hypertrig-
childhood and adolescence with important
lyceridemia were more frequent among the
consequences for physical and emotional
IDDM patients (Torres et al., 1997). The
development. IDDM is characterized by
dyslipidemia of diabetes also includes low
severe insulinopenia and dependence on
levels of high-density lipoprotein (HDL)
exogenous insulin to prevent ketosis and
cholesterol, alterations in the composition
preserve life (Sperling, 1996 and Franz et
of
low-density
lipoprotein
(LDL), al., 2002).
predominance of triglyceride-rich small
Incidence studies of diabetes for
dense LDL particles, and an increase in
IDDM denote 8.3% and 7.6% per 100.00
apolipoproteins B&E. The potential for
populations below age 15 years, at urban
glycation and oxidation of all lipoproteins
and rural communities respectively. The
(Lp) classes is enhanced, and alterations of
639