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Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent. Comparison with ligation and excision.

BACKGROUND AND AIMS: Patients with prolapsing internal hemorrhoids were treated with a novel sclerosing agent (OC-108), and the results were compared with surgery of ligation and excision. PATIENTS AND METHODS: This study included 20 years or older patients with prolapsing internal hemorrhoids who visited ten medical institutions in Japan from October 2000 to October 2002. Investigation on surgery was also performed. RESULTS: Comparing OC-108 and surgery in patients with third- and fourth-degree internal hemorrhoids according to the Goligher's classification, for which surgery has been generally indicated, at 28 days after treatment, the disappearance rate of prolapse was similar between OC-108 and surgery, 94% (75/80 patients) and 99% (84/85 patients), respectively. The 1-year recurrence rate was 16% (12/73 patients) in the OC-108 group, and this value was satisfactory because of its less invasive nature while it was more or less higher compared with 2% (2/81 patients) in the surgery group. The incidences of pain and bleeding were lower in the OC-108 group. CONCLUSIONS: OC-108 is a useful alternative treatment for hemorrhoids.

Adult↗

Gingival tissue inflammatory response following treatment with chemical retraction agents in Beagle dogs.

A normal finding of a clinically healthy gingiva is minimal inflammatory infiltration of subepithelial connective tissue which increases after exposure of gingiva to retraction agents. The study investigates and compares the inflammatory potential of four retraction agents on the gingival connective tissue. The gingiva of Beaagle dogs was exposed for 10 minutes to chemical agents. Byopsies were taken one hour, 24 hours and 7 days after treatment. Morphometric analysis of treated and control gingiva was performed on parasagittal tissue sections to compare the gingival tissue inflammatory potential of four retraction chemicals. Retraction agents produced no significant effect on connective tissue under the junctional epithelium. On the other hand the connective tissue under sulcular epithelium exhibits extensive inflammatory infiltration. The most aggressive retraction agent being Racestyptine and the least Visine, which therefore could be recommended for clinical practice.

Adjuvants, Immunologic↗

Inducing protective antibodies against ring-infected erythrocyte surface peptide antigen of Plasmodium falciparum using immunostimulating complex (ISCOMs) delivery.

In the present study, synthetic peptides (EENVEHDA)2 [(oc)2] and (DDEHVEEPTVA)2 [(un)2] of ring-infected erythrocyte surface antigen (RESA) of Plasmodlium filciparum were linked with palmitic acid and entrapped in immunostimulating complexes (ISCOMs). The immunogenicity of the peptide(s) and mixture of peptides were studied in mice with different genetic background. Peptide(s) entrapped in ISCOMs using a low-dose immunization strategy generated high-titer as well as high-affinity antibodies. Interestingly, no genetic restriction of the immune response was observed in any of the strains studied. The IgG subclass pattern with the peptide(s) showed predominately IgG2a/2b isotypes, while with the mixed peptide formulation, (un)2-specific IgG isotype pattern showed induction of both IgG1 and IgG2a/2b isotypes. These cytophilic antibodies inhibited the ring as well as schizont stage and total parasite growth during in vitro merozoite reinvasion inhibition study. In the mixed peptide preparation, the same pattern of immune response was achieved as that of individual peptide(s) using ISCOMs delivery. Therefore, the entrapment of otherwise poorly immunogenic synthetic peptides in ISCOMs resulted in increased immunogenicity followed by strong secondary response and can be adopted for developing subunit immunogen formulation against malarial parasite.

Alum Compounds↗

Comparison between biological and chemical treatment of wastewater containing nitrogen and phosphorus.

The present work compared chemical and biological treatment methods to achieve the most efficient treatment for the reduction or elimination of phosphorus and nitrogen from mixed industrial-domestic wastewaters. Batch chemical precipitation by ferric chloride and aluminum sulfate (alum) and a continuous biological suspended growth system were investigated as well as the optimum operating conditions. Concerning chemical treatment, Alum generally achieved a higher removal efficiency percentage for the investigated pollutants compared with FeCl(3) at their optimum pH and dose, especially with chemical oxygen demand (COD). FeCl(3) treatment achieved success only with phosphorus removal, while none of the COD, 5-day biochemical oxygen demand (BOD(5)), total nitrogen (TN) and N-NH(3) achieved acceptable treatment and remained above the maximum permissible limits (MPL). Thus, for such wastewaters, alum is more efficient than FeCl(3). Biological treatment exhibited higher efficiencies, particularly towards nitrogen. TN removal increased by increasing the flow rate to 30-60 l/day. N-NH(3) removal was effective at the slowest flow rate and decreased with increasing flow rate, while an opposite trend was recorded for N-NO(3). At all flow rates, phosphorus levels were below the accepted MPL for discharging into natural systems. Moreover, there was a general trend for the proposed biological treatment to achieve a high removal efficiency for BOD(5) and COD, bringing them to acceptable levels to be released into watercourses safely, especially at the slowest flow rates. Thus, integration between the proposed chemical and biological treatment is highly recommended, producing high-quality effluents acceptable by the environmental law.

Alum Compounds↗

Aluminum alters cyclic AMP and cyclic GMP levels but not presynaptic cholinergic markers in rat brain in vivo.

Oral administration of 0.3% aluminum (citrate or sulfate salt) for 4 weeks significantly elevated adenosine 3',5'-monophosphate (cyclic AMP) levels in rat cortex, hippocampus, striatum and cerebellum. The largest effect observed was a 60% increase in cortical cyclic AMP levels in rats administered aluminum sulfate. The effects of orally administered aluminum on guanosine 3',5'-monophosphate (cyclic GMP) levels were less widespread. Dietary aluminum citrate only elevated cyclic GMP levels in the hippocampus, while aluminum sulfate caused significant increases in the cerebellum, hippocampus and striatum. Aluminum citrate administered i.c.v. (1 mumol, 2 weeks postadministration) elevated cyclic AMP levels in the cortex, but had no effect on cyclic GMP levels. Aluminum administered either orally or i.c.v. had no effect on in vivo acetylcholine levels. However, dietary aluminum citrate significantly reduced choline levels in the cortex, hippocampus and striatum. Aluminum administered i.c.v. had no effect on choline acetyltransferase activity or on high-affinity choline transport. These results indicate that: the metabolism of cyclic AMP and of cyclic GMP are more sensitive to aluminum than are presynaptic cholinergic processes; the metabolism of cyclic AMP is more sensitive to the effects of aluminum than is the metabolism of cyclic GMP; and cortical cAMP metabolism is the most sensitive to the presence of aluminum. Possible consequences of elevated levels of cyclic nucleotides induced by aluminum in the brain are proposed.

Administration, Oral↗

The polyclonal and antigen-specific IgE and IgG subclass response of mice injected with ovalbumin in alum or complete Freund's adjuvant.

BALB/c mice were injected ip with 1 microgram ovalbumin (OVA) in alum or complete Freund's adjuvant (cFA) and the changes of the IgE and IgG subclass serum levels and isotypes of the anti-OVA specific antibodies determined by radioimmunoassays. By Day 10, OVA in alum had induced a 5- to 10-fold increase of the IgE serum level and an initial decrease of the IgG subclass levels which subsequently increased to two to threefold over the preinjection level. OVA in cFA induced a gradual twofold increase of the IgE serum level, a rapid fourfold increase of the IgG2a level occurring by Day 7, and a gradual two to threefold increase of the other IgG subclasses. Over 90% of the anti-OVA antibodies were of the IgGl isotype with both adjuvants; OVA in alum induced slightly more IgGl anti-OVA antibodies than cFA. In contrast, the OVA in alum injected mice formed significantly more (5- to 10-fold) IgE anti-OVA antibodies than the cFA-injected mice. OVA in alum also induced a large nonspecific increase of the IgE serum level because only approximately 40% of the increase observed on Day 14 was absorbable with OVA, whereas approximately 90% the IgE increase in cFA injected mice was absorbable with OVA. The data demonstrate that mice form mainly IgGl and IgE antibodies to OVA irrespective of the adjuvant. The low specific and lack of nonspecific IgE formation by mice injected with OVA in cFA may be the result of cFA-induced interferon-gamma (IFN-gamma) production because IFN-gamma has been shown to stimulate IgG2a and inhibit IgE secretion in vitro.

Alum Compounds↗

Studies on in vivo induction of HIV-1 envelope-specific cytotoxic T lymphocytes by synthetic peptides from the V3 loop region of HIV-1 IIIB gp 120.

We have previously reported the induction of MHC class I-restricted, CD8+ cytotoxic T lymphocytes (CTLs) specific to human immunodeficiency virus type 1 (HIV-1) in mice by a 15-amino acid peptide (R15K) from the V3 loop in gp120. We now present evidence showing that CTL activity induced by R15K was stable for 8-10 weeks after a single injection and that as little as 20 micrograms peptide was sufficient for efficient CTL induction in vivo. While induction of CTLs was efficient with R15K emulsified in either complete or incomplete Freund's adjuvant, only a low-level CTL response was observed in mice immunized with R15K in either alum or saline. We analyzed a series of carrier-free synthetic peptides ranging in length from 8 to 24 amino acids from the V3 loop region and observed that peptide R10I consisting of 10 amino acids from the middle portion of R15K was more efficient for CTL induction. Additionally, lymph node cells from mice immunized with 24 and 15 amino acid peptides (N24G and R15K, respectively) when restimulated in vitro with R10I exhibited greater HIV-1 env-specific CTL activity than when either of the longer peptides was used for restimulation. A peptide consisting of only 8 amino acids (R8K) was sufficient neither for inducing primary CTLs nor for in vitro restimulation of lymph node CTL precursors. These results establish that a carrier-free 10-amino acid synthetic peptide from the V3 loop region in HIV-1 gp120 has the optimal sequence for efficient induction of HIV env-specific CTLs in mice.

AIDS Vaccines↗

Dependence of the guinea pig IgE and IgG1 immune responses on the inclusion of potassium in the preparation of alum adjuvant.

Primary immunization with alum prepared using AlK(SO4)2 and adjuvant enhanced IgE production in the guinea pig. Alum prepared from Al2 (SO4)3 showed greatly reduced IgE and IgG1 anti-EA titers. This variance in immunoglobulin titer was observed only in the guinea pig. Both rats and mice respond to alum preparations prepared from either AlK(SO4)2 or Al2(SO4)3 equally as well.

Adjuvants, Immunologic↗