OBJECTIVE: Diamond-Blackfan anemia is a rare congenital hypoproliferative anemia of infancy and early childhood. Treatment with corticosteroids is commonly used, but with limited success. Trials with cyclosporin-A (CSA) are not frequently reported. Therefore, in this study we analyzed our results in the management of this rare disease by different medical treatments.

DESIGN: The results of 22 patients diagnosed at our Hematology Center in the New Cairo University Children's Hospital during the period 1991-2001 were retrospectively analyzed. Our patients first received prednisolone (2 mg/kg/d) for different courses according to their response. Since the year 2000, the steroid nonresponders received CSA (3-12 mg/kg/d) for 6 months unless treatment complications developed.

RESULTS: The age at the onset of the disease ranged from 1 to 24 months (median: 2.5 months). The mean values of the hemoglobin, the reticulocyte count, and the myeloid/erythroid ratio at the onset of the disease were 4.75 +/- 1.79 g/dL, 0.14 +/- 0.16, and 39.4 +/- 27.08, respectively. Patients received prednisolone from 0.25 to 10 years (median: 2 years). Ten patients were nonresponders (45.5%), and 5 patients (22.7%) responded to corticosteroid therapy. Two of 5 responders are off treatment with a hemoglobin level of >9 g/dL, and 3 of 5 are currently corticosteroid-dependent. Of 10 patients not responding to steroids, 8 received CSA for 6 months. Four patients (50%) responded to CSA therapy. A significant positive association was found between CSA dose and response.

CONCLUSION: CSA therapy should be tried in steroid-resistant Diamond-Blackfan anemia patients before blood transfusion or corticosteroid therapy complications are instituted.

Schistosoma mansoni glyceraldehyde 3-phosphate dehydrogenase (SG3PDH) is a target of cellular and humoral immune responses of Brazilian and Egyptian subjects putatively resistant to reinfection with S. mansoni. In an aim to develop a safe, stable and effective vaccine based on this promising molecule, six peptides derived from its primary sequence were selected based on the lowest homology to human G3PDH. The synthetic peptides were tested by ELISA against plasma of humans putatively susceptible or resistant to reinfection with S. mansoni or S. haematobium following chemotherapeutic cure of previous infection. Repeat experiments indicated that the six peptides bear human B-cell epitopes that bind immunoglobulin (Ig)M, IgG1 and IgG3 antibodies. Resistance to reinfection appeared to be significantly associated with humoral immune responses to multiple peptides. This contention was supported by studies in the murine model, whereby we examined the B cell immune responses of Swiss and inbred BALB/c and C57BL/6 mice immunized with recombinant SG3PDH (rSG3PDH) to the six SG3PDH-derived peptides. The serum antibodies of rSG3PDH-immunized Swiss mice were directed to only one of the six peptides tested by ELISA. Antibodies from rSG3PDH-immunized C57BL/6 and BALB/c mice bound, respectively, to four and six out of six peptides. In contrast to Swiss mice, immunization of C57BL/6 and BALB/c mice with rSG3PDH induced protection against challenge cercariae which reached the level of significance (P < 0.05) for BALB/c mice. The data together indicate that host recognition of multiple peptides of a candidate vaccine antigen is necessary for the expression of its ability to contribute to protective immunity against Schistosomiasis.

Recently we reported that human T- and B-cell recognition of a 42-kDa protein (p42) in soluble extracts of adult Schistosoma mansoni worms correlates with resistance to reinfection with S. mansoni or S. haematobium. Amino acid microsequencing of p42 revealed that it consists predominantly of schistosome glyceraldehyde 3-phosphate dehydrogenase (SG3PDH). We have expressed SG3PDH in Escherichia coli and purified the recombinant protein in a soluble and enzymatically active form. Recombinant SG3PDH (rSG3PDH) reacted with human monospecific antibodies to p42. Lymphoproliferation and production of interleukin-4 and gamma interferon (IFN-gamma) after in vitro stimulation with rSG3PDH and serum isotype responses to rSG3PDH were examined in individuals with extremes of resistance and susceptibility to reinfection after treatment of previous S. mansoni or S. haematobium infection. Lymphoproliferation and IFN-gamma production in response to rSG3PDH and the presence of serum immunoglobulin G1 (IgG1), IgG3, and IgA antibodies to rSG3PDH generally characterized individuals who are resistant to reinfection after chemotherapy. The data indicate that T- and B-cell immune reactivity to rSG3PDH correlates with resistance to reinfection, confirming previous studies identifying SG3PDH as a target of protective immunity in humans, and suggest that SG3PDH should be investigated as a possible vaccine for human schistosomiasis.

Schistosoma mansoni infection proceeds in normal mice in the absence of detectable levels of polyclonal or specific immunoglobulin (Ig)E until worms mature and deposit eggs. Hence, the course of a primary S. mansoni infection is not expected to vary appreciably in mice with defects in the IgE production. Experimental increase of IgE production early after infection may, however, influence worm development. In the first approach towards this goal, BALB/c mice were injected with interleukin(IL)4 to raise the level of endogenously synthesized IgE. A significant increase in serum polyclonal IgE and antischistosome IgG1 during the prepatent period was not associated with significant changes in worm and egg burden or liver pathology. During the second approach, mice were injected with IgE which was affinity purified from serum of BALB/c mice infected for 16 weeks with S. mansoni. The purified IgE bound to carbohydrate-independent epitopes of soluble antigens from 3 h larvae, adult worms and eggs and recognized the schistosomular surface membrane. No differences in worm and egg load or granuloma number and size were noted between untreated and exogenous IgE-injected mice. Together, the data demonstrate that by itself IgE does not influence the outcome of infection in primary murine S. mansoni.

AIMS AND BACKGROUND: An association between human papilloma virus (HPV) and bladder cancer has been reported. However, the role of HPV in bilharzial bladder cancer and its prevalence have not yet been clarified.

STUDY DESIGN: We investigated 50 cases for HPV types 16/18 by in situ hybridization. Also, p53 protein expression by immunohistochemistry was evaluated in 41 of the 50 cases, with correlation of these factors to clinicopathologic parameters and tumor relapse after primary treatment.

RESULTS: HPV was detected in 46% of Egyptian bladder carcinomas (23/50 cases). Positivity was 47.8% for squamous cell carcinoma and 36.4% for transitional cell carcinoma. There was a possible viral-bilharzial association as 52.8% of Bilharzial cases, whereas only 12.5% of non-Bilharzial cases were HPV positive (P <0.05). P53 protein was found in 19/41 (46.3%) cases. There was a concordance between HPV and p53 in 58.5% of cases. Neither factor was related to tumor recurrence after primary treatment.

CONCLUSIONS: HPV may thus be implicated in the etiology of bilharzial bladder cancer, but a definite causal relationship remains to be demonstrated. HPV together with p53 alterations work in synergy to accelerate the carcinogenic process, as there was concordance in the results of both parameters in 24/41 (58.5%) cases.

AIMS AND BACKGROUND: An association between human papilloma virus (HPV) and bladder cancer has been reported. However, the role of HPV in bilharzial bladder cancer and its prevalence have not yet been clarified.

STUDY DESIGN: We investigated 50 cases for HPV types 16/18 by in situ hybridization. Also, p53 protein expression by immunohistochemistry was evaluated in 41 of the 50 cases, with correlation of these factors to clinicopathologic parameters and tumor relapse after primary treatment.

RESULTS: HPV was detected in 46% of Egyptian bladder carcinomas (23/50 cases). Positivity was 47.8% for squamous cell carcinoma and 36.4% for transitional cell carcinoma. There was a possible viral-bilharzial association as 52.8% of Bilharzial cases, whereas only 12.5% of non-Bilharzial cases were HPV positive (P <0.05). P53 protein was found in 19/41 (46.3%) cases. There was a concordance between HPV and p53 in 58.5% of cases. Neither factor was related to tumor recurrence after primary treatment.

CONCLUSIONS: HPV may thus be implicated in the etiology of bilharzial bladder cancer, but a definite causal relationship remains to be demonstrated. HPV together with p53 alterations work in synergy to accelerate the carcinogenic process, as there was concordance in the results of both parameters in 24/41 (58.5%) cases.

PURPOSE: To describe a case of progressive outer retinal necrosis syndrome, successfully treated with a new combination of antiviral drugs.

METHODS: The patient was treated with a combined therapy of antiviral drugs that includes: intravenous acyclovir 10 mg/kg, three intravitreal injections of foscarnet (1200 microg) and a ganciclovir implant in the right eye.

RESULTS: The progressive outer retinal necrosis appeared to response dramatically with the combination of antiviral agents used over a period of 2 weeks with a final visual acuity of 20/80 at 3 months of follow up.

CONCLUSIONS: Intravitreal foscarnet combined with i.v. acyclovir and ganciclovir implant may represent an effective alternative treatment for PORN.

The dielectric constant of Mn-Zn ferrite was measured at different temperature and frequencies as a function of sintering temperature ranging from 1200°C to 1400°C at heating rate of 6°C/min. The resistivities as well as Seebeck coefficient were measured in the same range of temperature. More than one type of polarization is expected to vary the dielectric constant. Hoping mechanism was the predominant one in conduction processes. The grain size was calculated from X-rays and SE micrographs and it was found to decrease with increasing sintering temperature.

X-ray diffraction, the real part (ε′), the imaginary part (ε″) of dielectric constant, and the molar magnetic susceptibility (%M) for Mg1+xTixFe2 - 2xO4 ferrite (0.1≤x≤0.9) were studied. The date of X-ray diffraction showed that the unit cell parameter increases with Ti concentration and ascribed to the predicted variation of the cation distribution, while Mg2+ ions are highly diffusible and very sensitive to heat. The effect of dilution by Ti ions is discussed in terms of increasing superparamagnetic and single domain (SP/SD) grains. The measurements of ε′ were performed at different temperatures as a function of frequency, while the magnetic susceptibility was studied at different magnetic field intensities. The variation of the dielectric properties depends mainly on the valence exchange between the different metal ions in the same site or in different sites. All parameters such as ε′, ε″, %M showed a decrease in value with increasing Ti and Mg concentration. The dispersion in ε′ with frequency disappeared gradually with increasing Ti concentration. © 2001 Elsevier Science B.V.

Intercropping of legumes and non-legumes is considered to improve the quality and quantity of field forage crops. Under semi-arid desert conditions, intercropping of leucaena and sesbania with some annual grasses (barley, pearl millet, and Rhodes-, ryeand sudan-grasses) was evaluated in a series of field trials. Inocula of specific rhizobia for legumes and a composite of associative diazotrophs for non-legumes were applied in the presence or absence of N fertilizers. Rhizobia inoculation was indispensable, and supported better growth of legumes which extended to the neighboring non-legumes. Associative diazotrophs improved biomass and N yields of non-legumes, particularly in the presence of moderate N fertilization for winter barley and rye grass and of higher doses of 300 kg N·ha-1 for summer pearl millet and sudan grass. Intercropping improved productivity of non-legumes, in particular barley mixed with sesbania, and the calculated N-transfer from legumes to non-legumes ranged from 20 to 70 kg N·ha-1.