Evaluation of two years of mass chemotherapy against ascariasis in Hamadan,Islamic Republic of Iran

OBJECTIVE: To evaluate the mass treatment of ascariasis in rural areas of Hamadan Province, Islamic Republic of Iran. METHODS: A control programme in rural areas of Hamadan Province, which began in November 1997, involved giving all persons a single dose of 400 mg albendazole at intervals of three months. The efficacy of the treatment was evaluated by the formalin-ether concentration technique for stool examination and by the Stoll quantitative method. FINDINGS: The average rate of infection with Ascaris before treatment was 53.3%, ranging from 40% in Hamadan district to 75% in Toysercan. Two areas, Malayer and Nahavand, were excluded from the programme because the infection rates were only 13% and 4%, respectively. After two years of mass treatment the infection rate had decreased to 6%. The proportion of positive cases excreting only unfertilized eggs increased to 32%. No side-effects of mass treatment were observed. CONCLUSION: Systematic mass treatment giving high coverage proved to be very effective in the control of ascariasis, notwithstanding a lack of other preventive measures.     

Mercury exposure among residents of a building block in Shiraz, Iran

Exposure to mercury can cause serious multiorgan damage affecting the central nervous system, kidneys, liver, lungs, spleen, bone marrow, and skin. At the end of the summer of 1999, the accidental leakage of 4 liters of mercury from a container into the waterway canals resulted in mass exposure to elemental mercury among the residents of a building block of a residential area of the city of Shiraz, in the south of Iran. One hundred and eleven individuals who experienced exposure to elemental mercury were investigated. Twenty-four-hour measurement of the urine mercury level-revealed a toxic level of more than 20 microg/L in 6 children and 3 adults (including a pregnant woman). Despite normal physical and laboratory (CBC, renal and liver function tests, and urinalysis) findings, dimercaprol was prescribed. One month later during the course of the follow-up the urine mercury level in 6 patients, including the pregnant woman from the same family, was found to be again at a toxic level. The pregnant mother from the same family aborted her fetus; however, due to the lack of equipment for measuring the serum mercury level, it was not possible to confirm the relation between the mercury toxicity and the abortion. This family had kept mercury in their kitchen against health workers' instructions. The attractive physical and chemical properties of mercury could explain the continuity of exposure and poisoning in these 6 cases. It is concluded that prophylactic therapy in the presence of toxic levels of mercury, despite the presence of an asymptomatic state in exposed residents, is effective in preventing the development of signs and symptoms, though instruction of high-risk cases is the best way to combat it.     

The effect of B-vitamins on hyperhomocysteinemia in patients on antiepileptic drugs

Patients on antiepileptic drugs (AEDs) may have elevated levels of plasma total homocysteine (p-tHcy). The aim of this study was to assess the effect of B-vitamin supplementation on the levels of p-tHcy and markers of endothelial activation and lipid peroxidation. A total of 33 adult patients on AEDs were identified with either fasting (Group 1, n=23) or post methionine load (PML) (Group 2, n=10) hyperhomocysteinemia. Subjects were supplemented with B-vitamins for 30 days: folic acid 0.4 mg, pyridoxine 120 mg and riboflavin 75 mg per day. After supplementation, serum folate and pyridoxal phosphate had increased, while fasting and PML p-tHcy had decreased (P<0.0001) by 36 and 26%, respectively. Prior to supplementation, the Group 1 patients had elevated levels of P-selectin and von Willebrand factor (vWF) (P=0.05 and 0.03, respectively). After supplementation, the levels of intercellular cell adhesion molecules had decreased (P=0.01) and E-selectin decreased nonsignificantly (P=0.07). However, the levels of vascular cell adhesion molecules had increased (P<0.0001), while lipid peroxidation were unchanged. In conclusion, the combined supplementation with folic acid, pyridoxine and riboflavin reduced fasting and PML hyperhomocysteinemia in patients on AEDs. Patients with fasting hyperhomocysteinemia had elevated levels of P-selectin and vWF, which may indicate an increased risk of cardiovascular disease. Furthermore, B-vitamin supplementation influenced endothelial activation, although the clinical implication is uncertain.     

Protoporphyrin-IX accumulation and cutaneous tumor regression in mice using a ferrochelatase inhibitor

The use of endogenously created porphyrins as an alternative to photosensitizer injection for photodynamic therapy (PDT) of cancer is a rapidly evolving area of study. In-situ accumulation of protoporphyrin-IX (PpIX) by hemebiosynthesis inhibition represents a novel method for PDT of cancer cells. The kinetics of PpIX accumulation and cutaneous tumor regression in mice was studied using lead (a known and effective inhibitor of ferrochelatase). Cutaneous tumors were exposed to various doses of ferrochelatase enzyme inhibitor (lead) and to different durations and doses of visible light. The maximum increase in PpIX levels (blood, skin and tumor) was observed 48 h after the parenteral administration of second injection of lead within a period of 1 month. The maximum tumor regression was observed in mice that were exposed to visible light at a light dose of 648J/cm(2) (1h exposure in four sessions of 15 min, with a gap of 10 min between each exposure). Continuous treatment for 6 consecutive days resulted in almost complete regression of the tumors in most of the animals. Histopathological sections of tumors after light exposure showed necrotic tissue with degenerated lymphocytes, monocytes, and neutrophils. Since the ferrochelatase inhibitor (lead) used in the present study is toxic, the search must continue for a safe, non-toxic inhibitor to enhance sensitizer-mediated PDT.     

Gastric cancers overexpress S100A calcium-binding proteins

Serial analysis of gene expression provides quantitative and comprehensive expression profiling in a given cell population. In our efforts to define the genes overexpressed in carcinoma of the stomach, we performed serial analysis of gene expression analyses on dissected neoplastic and normal gastric epithelia. We identified 91,334 expressed tags, including 26,633 that were unique. The 20 most up-regulated genes (P < 0.01) in gastric cancer (GC) compared with normal gastric epithelia included several keratins that are specific for epithelial cells such as keratin 6A, 13, and 17. Interestingly, five calcium-binding proteins (S100A2, S100A7, S100A8, S100A9, and S100A10) were overexpressed. Quantitative real-time PCR on primary GC samples demonstrated overexpression of S100A2 in 18 of 20 tumors (90%). The other calcium-binding proteins were overexpressed in 25-45% of the GC samples that we studied. Our results indicate that S100A proteins may be important for gastric tumorigenesis. Additional investigations are required to elucidate the biological role of calcium-binding proteins in cancer.     

Association of chromosome 19q13.2-3 haplotypes with basal cell carcinoma: tentative delineation of an involved region using data for single nucleotide polymorphisms in two cohorts

We have previously used single nucleotide polymorphisms to detect an association of basal cell carcinoma (BCC) in Caucasian Americans and Danes with the genome region 19q13.2-3, which contains several genes involved in the nucleotide excision repair of DNA. In this exploratory paper we have extended the data and used them in a chromosomal scan. The results indicate the presence of a gene variation modulating the risk of developing BSS in a submegabase region including and surrounding the gene RAI. Specifically, persons that are homozygous for the haplotype RAI intron 1(A) RAI exon 6(A) appear at increased risk for BCC. In addition, we have looked for possible synergisms between all pairs of markers. We find that a marker in GLTSCR1, presumably separated from RAI by several million bases, supplements the most significant marker in RAI in separating cases from controls, which may suggest the presence of an independent, risk-modulating variation in this second gene region.     

Effect of transient hippocampal inhibition on amygdaloid kindled seizures and amygdaloid kindling rate

In this study the effect of transient inhibition of the CA1 region of the dorsal hippocampus by lidocaine on amygdala kindling rate and amygdaloid kindled seizures was investigated. In experiment 1, rats were divided into four groups. In group 1, animals were implanted only with a tripolar electrode into the amygdala but in groups 2-4, two guide cannulae were also implanted into the CA1 regions of the dorsal hippocampi. Animals were stimulated daily to be kindled. In groups 3 and 4, saline or 2% lidocaine (1 microl/2 min) was also injected respectively into the hippocampus, 5 min before each stimulation. Results obtained showed that amygdala kindling rate and the number of stimulations to receive from stage 4 to stage 5 seizure were significantly increased in group 4. In experiment 2, lidocaine (1% and 2%) was infused (1 microl/2 min) into the hippocampus of amygdala kindled rats bilaterally and animals were stimulated at 5, 15 and 30 min after drug injection. Twenty four h before lidocaine injection, saline was also infused (1 microl/2 min) into the hippocampus as control. Obtained results showed that afterdischarge duration was reduced 5 min after lidocaine (1% and 2%) injection. Stage 5 seizure duration was also decreased 5 and 15 min after 2% lidocaine. Thus, it may be suggested that in amygdala kindling, activation of the hippocampal CA1 region has a role in seizure acquisition and seizure severity so that inhibition of this region results in decreasing of seizure severity and retards amygdala kindling rate.     

Coccidioidal meningitis: incidental diagnosis 3 y after ventriculo-peritoneal shunt placement for hydrocephalus

A patient from the American Midwest developed hydrocephalus after a trip to southwest California, necessitating placement of a ventriculo-peritoneal shunt. Coccidioidal meningitis was diagnosed incidentally 3 y later, during evaluation for shunt malfunction.