Vol. 1, April, 1998.

1/1 HIGH PERFORMANCE LIQUID CHROMATOGRAPHICAND DIFFERENTIAL SPECTROPHOTOMETRICDETERMINATION OF MITOMYCIN-C

M.M. Mabrouk

Department of Analytical Chemistry, Faculty of Pharmacy, University of Tanta,

Tanta, Egypt.

Highly selisitive, simple aud accurate highperfonnance hq'iid chromato graphic, differeiaial (A4), secoiid derivative (AD?), third derivative (AD 3) and fourth derivative (OD4) spectrophotometric methods for the determination of the antibiotic-antimetabolite mitomycifl-c are descrihed. Tlie I1PLC. method involves chromatography ofnitomycin-c samples on a /j-Bondapak CIS coilim'i using methanol : water : phosphate buffer pH 6.5 (25:70:5) as a mo bile phase flowing at 1.5 mL/min. and a spectrophotometric detection at 361 nm usingphotodiode array detector. The calibration graph is linear from 5-90 ng ml'1. The detection limit is 5 ng mL'1. The differential methods depend on measuring AA, AD2, AD^andADjof mitomycin-c basic solutions agailist their corresponding acidic solutions as blanks. The HPLC method has been applied successfully for the determination of mitomycin-c in human aqueous humor samples withdrawn from vohinteers who have been previously subjected to topical treatment of mitomycin-c. The differential spectrophotometric methods have been, used for the determination of mitomycin-c in some of its dosage forms.

2/1 HIGH PERFORMANCE LIQUID CHROMATOGRAPHICDETERMINATION OF ASTEMIZOLE IN SPIKED HUMAN

PLASMA AND IN DOSAGE FORMS

M.M. Mabrouk

Department of Analytical Chemistry, Faculty of Pharmacy, University of Tanta,

Tanta, Egypt.

Highly sensitive, simple, accurate and specific high performance liquid chromatographic method for the determination of astemizole was described. The method involved chromatography of astemizole samples on a jli Bondapak CIS column using acetonitrile : water (49.95:50) containing 0.05% trimethanolamine as a mobile phase flowing at 2 ml mm1 and a spectrophotometric detection at 254 nm. Pyridoxine phosphate was used as internal standard Retention times were 1.6 and 9.0 minutes for astemizole and pyridoxine phosphate, respectively. A rectilinear relationship existed between the peak area ratios of astemizole to pyridoxine phosphate (internal standard) and its serial standard concentrations in methanolic solutions as well as in spiked human plasma samples in the range of 1-10 ng ml'1. The detection limit was 1 ng mL'1 The method was applied successfully for the determination of astemizole in spiked human plasma samples. The method is recommended for drug monitoring in biological fluids, bioavailability and bioequivalency studies. The method have been also applied for the determination of astimazole in dosage forms. The results were in agreement with those of some other reported methods.


3/1 STREPTOSPORANGIUM SP. A NEW RECORD IN SAUDI

ARABIA DESERT SOIL

Z.K. Abd El-Aziz

Botany and Microbiology Department, Faculty Of Science For Girls,

Al - Azhar University, Cairo, Egypt.

An actinomycete isolate belongs to genus Streptosporangium was isolated from a soil sample collected from virgin desert area, north - west of Saudi Arabia (Tabouk region) is characterized by producing antimicrobial activities against uni- and multicellular fungi, Gram - positive and Gram - negative bacteria. The mass spectrum of the peptide antimicrobial agent recorded 882 a.m.u. (dalton) as molecular weight (for the main fraction), HPLC andamino acid analysis revealed the • presence. of D- alanine, D- valine, L- threonine and L- proline. The cultural, physiological and microscopical investigations using scanning, transmission electron and photomicroscopes indicated that the isolate is characterized by light yellowish pink to yellowish brown aerial hyphae, red orange to yellowish brown substrate mycelium and yellow brown soluble pigments on oatmeal agar medium bearing abundant sporangia which enclose many large cylindrical (rod - like) shape nonmotile spores. The cell wall contains meso - diaminopimelic acid, mannose, arabinose and madurose (cell wall chemotype III and type B whole cell sugar pattern). The isolate exhibited fluoresence excitation and emission spectra when exposed to ultraviolet light. The antimicrobial agent effects on both cdc2 kinase and cdc 25 phosphatase were > 1000 and 125 ug/ml respectively. On the basis of the chemical, physiological and morphological properties of this isolate, it was suggestive of being belonging to Streptosporangium vulgare. In view of all available literature, it seems that isolate is a new record in Saudi Arabia desert.

4/1 CARDIAC ARRHYTHMIA AMONG ASTHMATIC PATIENTS RECEIVING SLOW RELEASE B2 AGONISTS

LA. Atia

Chest Department, Faculty of Medicine, Al-Azhar University

20 patients with stable bronchial asthma [14 males and 6 females] were included in this study, their ages ranged from 19-65 years wit/i a mean age of 42 years. All patients were using salbutainol aerosol (100 ug/pufi) before the study. PEFR was recorded twice daily for every patient. Patients underwent initial 12 hour Holier electrocardiography over night and then weekly diiriiig 2 weeks course of treatment with slow release B2 agonists i.e salbutamol or terbutaline. They were randomly allocated to receive either salbutamol sustained release tablets 8 ing at Hi ght wit/i a salbutainol metered dose inhaler (MDl) (100 Ug/dose) as required or terbutaline So4 sustained release tablets 7.5 mg twice daily with a terbutaline MDI (250 ugfdose) as required for one week. Each course of treatment lasted 7 days. The patients were then changed to the other drug, the ma~mum heart rate dunngECG in the 20 patients increased from a baseline mean, of 110 beats/mm to 121) beaVmin) after terbutaline and 120 beat Imin. (S.D 18) after salbutamol, but neither of these increases were significant.

5/1- TRANSMISSION OF BACTERIAL UROPATHOGEN (E.COLI, KLEBSIELLA AEROGENS) BETWEEN MARRIED

COUPLES:

A MOLECULAR BIOLOGY APPROACH

E.A. Abu-Shady*; E.B., Abd Rabou** and M.M., Hanafy**

Microbiology* and Obstetric and Gynaecology** Departments Faculty of Medicine,

Al Azhar University, (Girls)

Epidemiologic evidence and several case reports suggest that organisms causing urinary tract infection (UT1) (specially E.coli) may be transmitted between married couples. In order to test this propability 74 couples were included in this study (males and their wives). Urine sample, vaginal and rectal swabs were taken from females having UT1 and random mid-stream urine samples were taken from their husbands. Bacterial count of urine samples and culture of all samples on appropriate media was done. Suspected colonies were identified by standard bacteriological methods.Suspected E.Coli and Klebsiella aerogens were further studied by drug sensitivity and gel electrophoresis of their extracted genomic DNA. It was found that 81% and 61% of females and males urinary samples showed significant bacteriuria. Correlation between the presence of bacterial infection and the use of different contraceptive methods revealed that Intrauterine contraceptive device (IUCD) had been found to be the most common contraceptive method correlated with all the organisms detected. It was also found that E. coli and Staph. saprophyticus were the most common organisms present in all samples taken. There was sharing of organisms between males and females in 19 samples (9 Staph saprophyticus, 5 E.coli, 4 Klebsiella aerogens and one Strept faecalis). There was identity between the isolated and shared E. coli and Klebsiella aerogens organisms by the tests used. So these organisms might be transmitted from male to female or vice versa. It was recommended that risky patients with recurrent UTI must use barrier method of contraception to avoid the transmission of uropathogens. Also prospective study is needed to know the exact role of Stapli. saprophyticus and to determine what bacterial or behavioural factors or both are associated with sexual transmission.

6/1 THE ROLE OF NON POLIO-ENTEROVIRUSES ININFANTILE GASTROENTERITIS: CORRELATION BETWEENPOLYMERASE CHAIN REACTION AND TISSUE CULTUREISOLATION.

E.A. Abu-Shady*, E.M. Khaled** and M.A.Aly***

*Microbiology and Pediatric** Departments, Faculty of Medicine (Girls)

Al-Azhar University ***Water Pollution Research Department,

National Research Centre.

This study included forty infants wit/i gastroenteritis. Stool samples were subjected to viral isolation in tissue culture (TC) and confirmation of die isolates by plaque neutralization test and Dot EUSA. Stool samples were subjected also to detection of non poho-enteroviruses by polyinerase chain reaction (PCR). This study showed diat 14/40 (32.5%) of Stool samples produced specific cytopathic effect (CPE) for enteroviruses, but 10 only were con firmed by plaque neutralization test. They were 4 Echo s, 2 CoxB3, 2 CoxB3, 6, one CoxB6andone Cox A. Ten outofforty (25%) of stool sinaples were posit iveft'.- non polio- enteroviruses by PCR While 9/40 (22.5%) stool samples produced CPE specific for respiratory adenovirus ill Vero cell lines. 77iey were confirmed by Dot ELISA tesL There was no statistical difference between infants with non polio enteroviruses and respiratory adenovirus infection and infants with non enteroviruses as regards to history (inedica4 environmental) and clinical examination. However the duration of diarrhoea and last episode of diarrhoea were statistically significantly different being longer in those with respiratory adenovirus injection. Correlation of the results of PCR and TC revealed that all odd ratios were statistically siginificant, however higher risk was found between PCR and culture in RD cell line. 'Pierefore, PCR can be used as an alternative fliture approach to enteroviral diagnosis bypassing virus isolation in tissue culture. Non polio-enteroviruses must be considered as a cause of infantile gastroenteritis, so uses of antibiotics must be limited.

7/1SPUTUM COLLECTION BY TRANSTRACHEAL INJECTION OF SALINE IN CASES OF LOWER RESPIRATORYTRACT INFECTION

LA. Atia and M.A. Abdel-Nasser

Chest & Microbiology Departments, Faculty of Medicine, Al-Azhar University

38 Cases of lower respiratory tract injection unable to bring sputuin for bacteriological study were included in our study. Diagnosis of lower respiratory tract infection was based on clinical and radiological basis. There were 23 niales and 15 females. Their ages ranged between 18 & 70 years. All patients were given a transtracheal ilijection of normal saline and all except 2 produced sputum specimelis from the lower respiratory tracL E~amination ofthese specimens was done by Gram stain, Ziehi Neelsen (ZN) stain and culture on ordinary media & Lowenstein Jensen medium (for suspected TB cases). Pneuniococcus was detected among 10 patients by direct Gram stained film and among 8 cases by culture. Haemephilus influenzae in 6 cases by direct Grain stained filin and S cases by culture while Branhamella catarrhalls was detected in 5 cases by direct Gram stained film and 7 cases by culture. 3 cases yielded Acid-fast bacilli (A FB) by ZN stain and culture on Lowenstein Jensen medium. No organisms were detected ill 15 samples by Gram stain and amotig 14 samples by culture on ordinary media. This study stress on the importance of trn.nstracheal aspiration of specimens after salt, ie injection as a saje and accurate method to avoid comamination by upper respiratory organisms.

8/1- VALUE OF SHORT COURSE OF CORTICOSTEROIDS IN

THE PREVENTION OF EARLY RELAPSE AFTER TREATMENT

OF ACUTE BRONCHIAL ASTHMA

I. A. Atia

Chest Department, Faculty of Medicine, Al-Azhar University

53 Cases treated for acute exacerbations of bronchial asthma were assigned in a randomized, double-blind fashion to receive at discharge either prednison for 8 days or placebo. The overall risk of relapse was significantly lower in the prednisone group (p< 0.05), with a Significantly reduced rate of relapse during the first 10 days of follow - up (3 of 28 as compared with 11 of 25 in the placebo group p< 0.05) There after (days 11 though 21), there was no further significant difference in relapse rates between treatment groups (five in the prednisone group and six in the placebo group). During the first week after discharge , patients receiving prednisone reported Significantly lower mean daily symptom scores for shortness of breath (SOB) and less frequent use of an inhaled bronchodilator than patients receiving placebo We concluded that a short course of prednisone reduced early relapse rates after the treatment of acute asthma an effect limited to the period of steroid administration.

9/1 INHIBITION OF BACTERIAL ADHERENCE AND BIOFILMON CONTACT LENSES

N.E. Yousef and T. H. El-Bromboly*

Department of Microbiology, Faculty of Pharmacy, Zagazig University.

* Department of Ophthalmology, Faculty of Medicine,

Zagazig University

Pseudomonas aeruginosa, Serratia murcescens and Staphylococcus epidermidis were significantly increased during contact lenses (HEMA,PMMA and CAB) wear (P<0.05). They did not be isolated from asymptomatic controls (showing no contact lens related disorders) after 12 months of wear contact lenses. They were isolated only from cases suffered from keratoconjunctivitis, endophthalmitis and keratitis. Inhibition of Ps. aeruginosa, Serratia marcescens and Staph. epidermidis adherence and biofilm formation using different anti-adhesive and antibiofilm agents was demonstrated on the three types of contact lenses. The greatest inhibition was observed on using 2% solution of polomaxer 403 or polomaxer 407 or sodium salicylate as anti-adhesive agent. More than 95 % inhibition ofPs. aeruginosa adherence, more than 9o % inhibition of Serratia marcescens adherence and more than 76 % inhibition of Staph. epidermidis adherence to contact lenses were observed on using these anti-adhesive agents. Polomaxer 407, Polomaxer 403 and sodium salicylate were the best antibiofilm agents for the three types of contact lenses showing inhibition of biofilm on HEMA > PMMA > CAB. Biofilm inhibition by these anti-adhesive agents was more extensive in case of Ps. aeruginosa than Serratia marcescens than Staph. epidermidis and these results were corresponding to the results of adherence inhibition .

10/1 GASTRIC EMPTYING IN CIRRHOTIC PATIENTS WITH OR WITHOUT ASCITES: A RADIONUCLIDE STUDY

M.A. Mansour*; S El-Qk,by*; A. Khodeir** and 0.0. Mohamed*

Departments of Tropical Medicine and **Radiodiagnosjs, Faculty of Medicine,
Ain Shams University, Cairo, Egypt.    _   .

Cirrhoilc patients frequently complain of dyspeptic symptonts, gut dysrnotility has been suggested to be one of the factors responsible for these symptoms. Limited studies have been held to assess the gastric emptying (GE) in patients with liver cirrhosis. However, the results of these studies were divergent. The aim of our present work is to study the GE state in cirrhotic patients with or without ascites. Twenty cirrhotic patients, 10 wit/lout ascites (Group I) and 10 with ascites (Group II) were studied versus 10 healthy controls (Group HI). Cirrhotic patients incladed we re free from any other disease which might ajfi).ct gastric motility andwere not receiving any medications that may alter gastric motility. Allparticij)a'Its were subjected to a dual phase scinti graphic assessment of GE i.e. solid and liquid phase examinations on 2 separate occasions. Cirrhotic patients without ascites silo wed delayed GE as compared to the controls yet this was insignificanL Cirrhotic patients with ascites showed significant delay in GE of both solids and liquids when compared with the controls. There was no significant difference as regards GE between ascitic and non asci tic patients although the fonner have a tendeiwy towards slower GE. Gastric emptyitig, especially ofso lids, showed positive correlation with serum albumin, serum bilirub in, splenic size, grade of oesophageal varices and severity of portal hyperteisive gastropathy. It is concluded diat cirrhotic patients have delayed GE of both solid and liquid (more of solid) which become more pronowiced with advancement of the liver disease and which correlates with the features of the liver disease mentioned above.

11/1 CONSTITUTIVE PROTEASE(S) FROM STAPHYLOCOCCUS AUREUS ISOLATES COLLECTED FROMDIFFERENT CLINICAL SOURCES

S.F.M. El-Kastawy

Microbiology Department, Faculty of Pharmacy, Al-Azhar University, Nasr

City, Cairo, Egypt.

Fifteen isolates of Staph. aureus collected from different clinical sources were tested for their ability to produce protease(s) under various environmental and nutritional conditions. Skimmed milk agar and sugar free Dox'5 cigar gelatin were used as screening media. Gelatin clearing zone (G.C.Z.) assay was used as a confirmatory tesL The highest yield of constitutive protease(s) production by Staph. aureus, 1-10 was obtained when the isolate was grown in sugar free basal mineral salt medium at 37°C, for 24 h. in phosphate buffer (pH 7.2) with gelatin at a concentration of 2% (w/v) as the best substrate and yeast extract at a concentration of 0.2% as a good source of multivitamins with (NH4)2HP04 as a nitrogen source. Supplementing the production medium by different vitamins and amino acids had no effect on protease(s) production, while heavy metals exerted inhibitory effects at all concentrations used. Our results indicated that the G. C.Z technique was described for detecting extracellular proteases directly in the culture medium This assay was simple, inexpensive, straightforward method to assess the presence of the proteolytic activity of a given microorganism with great freedom in substrate selection.

12/1 COMPARISON OF THE EFFICACY OF COMMERCIALLY

MOUTHWASH PREPARATIONS ON DENTAL PLAQUE AND

CARIOGENIC SALIVARY STREPTOCOCCI MUTANS

G.H. Shaker

Department of Microbiology, Faculty of Pharmacy, Zagazig University, Egypt.

The present comparative study was undertaken to compare the efficacy of five commercially available mouthwash preparations in decreasing the levels of Streptococcus mutans (S. mutatis ± in saliva and interdental plaque. Twenty-seven clinical isolates of Streptococci among 45 samples isolated from persons were examined for production of'crude glucosyltransferase enzyme (GTase). S.mutans strain no. J3 gave the highest crude enzyme production about 1164 unit ml. In vitro study: The minimum inhibitory concentrations (MICs) for five selected mouthwashes against the isolate no. 13 was determined in ToddHewitt medium with or without 5% serum. When the medium was supplemented with serum, higher MIC values were observed. In vivo study: The short- term antibacterial effect of the selected mouthwashes on salivary and plaque S. mutans was tested in 25 volunteers. Preparation no. 2 contains cetrimide in combination with chlorhexidine gluconate was the most effective mouthwash preparation in reducing S.mutans levels of oral microorganisms by 9 5% after 180 minutes, while preparation no. 5 contains povidone iodine is the least effective one causing 67% reduction in viable counts ofS. mutans after 180 minutes, as compared to the counts obtained after rinsing with sterile water (control).

13/1 GAS LIQUID CHROMATOGRAPHIC ASSAY OF URINARY

SUGARS FOR ESTIMATING INTESTINAL PERMEABILITY IN

INFLAMMATORY BOWEL DISEASE

S.M. Ghaly and A.A. Al-Sebai*

Department of Internal Medicine and Clinical Pathology* Am Shams University

Determination of intestinal permeability by measuring non-metabolized sugars have been used to assess the integrity of intestinal Inucosa. In the present study, we have compared different measurements of intestinal permeability in 18 patients with Crohn's disease, 27 with ulcerative colitis and 30 controls. After an overnight fast, patients and controls were given a drink containing 5 gin niannitol, 10 gin lactulose, 22 gin glucose and 150 ml water. Urine was collected for 5 hours after dosing and then from 5 till 24 hours. Recoveries ofinannitol and lactulose were expressed as percentages of the amount administered. Permeability index was calculated as the ratio of lactulose:inairnitol recoveries. Within first 5 hours, patients with Crohn's disease had significantly increased urinary recovery for lactulose and permeability index in comparison with that of controls and patients with ulcerative colitis (p<0.01). But over 24 hours urinary recovery for lactulose and permeability index were still elevated significantly in patients with inflammatory bowel disease (p<0.01), but were no longer helpful in distinguishing Crohn's disease from ulcerative colitis patients. Measurement of intestinal permeability is lion invasive and is useful as a complementary tool in diagnosis and differentiation of ulcerative colitis and Crohn's disease.

14/1 ROLE OF SERUM AND TISSUE ALPHA-FETOPROTEIN

IN DIFFERENTIATION BETWEEN PRIMARY AND

SECONDARY HEPATIC MALIGNANCY

A.N. Haseeb, M.M.A. Massoud, M.A. El-Shabrawy and E. Allam

Tropical Medicine and Pathology Departments, Faculty of Medicine, Ain Shams University, Cairo.

Out of 20 patients with sonographic multiple focal lesions, the histopathological examination of the liver biopsies revealed primary hepatocellular carcinoma (HCC) in 10 (50%) cases, other primary liver tumors in 3 (15%), metastatic tumours in 7 (35%). Ten control cases had liver cirrhosis without focal lesions. The specificity of serum AFP was 100% and sensitivity was 89% with diagnostic accuracy of 92.3% at levels above 400 ng/ml to detect HCC among our patients and to differentiate primary HCC from secondaries in the liver. While the specificity of tissue AFP was 91% and sensitivity was 89% and significant (p< 0.01) in differentiating HCC from liver secondaries in our cases. Moreover, its presence can be taken as evidence of hepatocellular origin of the tumor, and the positively for tissue AFP correlates with tumor differentiation. We concluded that, in addition to the important role of serum AFP in early detection (surveillance) and proper diagnosis of HCC, tissue AFP is very helpful in confirming the diagnosis of primary HCC and tumor differentiation in some situation in which pathologic confusion is a problem in differentiating HCC from hepatic secondaries.

15/1 RHEUMATOID ARTHRITIS AND HEPATITIS C VIRUS INFECTION

H.I. Hussin, M.M. Awad, *M.M. Abdel Monem,

and **I.S. Hegazy

Cancer Biology Department, National Cancer Institute, *Medicine and **Community Medicine Departments, Faculty of Medicine, Cairo, Cairo University,

Hepatitis C virus disease is an infective disease that affects several systems of the body. The aim of this work was to investigate the relationship between HCV infection and rheumatoid arthritis among 5 7 rheumatoid factor (RF) positive patients and 41 rheumatoid factor negative patients using enzyme immunoassay 2nd-generation (ELISA-2), immunoblot assay and reverse transcriptase-polymerase chain reaction (RT-PCR). There was no statistically significant difference between the different parameters of the articular index among both studied groups. As regards HCV infection, ELISA-2 assay detected positive anti-HCV among 16.8% of RF positive patients, and 19.5% of RF negative patients without statistically significant difference. These results were confirmed by immunoblot assay and RT-PCR techniques. There was also, no significant difference between both groups, RF positive (14%) and RF negative group (14.6%) and the prevalence of HCV infection among control was 11.25% P>0.05. There is no significant difference between all methods of detection in diagnosis of HCV infection arribng both groups. In conclusion: There is statistically insignificant difference between RF positive patients and RF negative patients and controls as regards prevalence of HCV infection. Also, one can depend on immunoblot assay as a confirmatory method of detection of HCV infection as RT-PCR.

16/1 DIAGNOSIS OF HELICOBACTER PYLORI INFECTION AMONG DYSPEPTIC PATIENTS USING RAPID IMMUNOASSAY TEST:

CORRELATION WITH HISTOPATHOLOGICAL AND MICROBIOLOGICAL RESULTS

H.I. Hussin, *L. Elgharory, M.M. Awad, **Z. Salama

and ***Yahya Fayed

Cancer Biology, National Cancer Institute, *Community Medicine, **Tropical Medicine and ***Pathology Departments, Faculty of Medicine, Cairo University.

H. pylori is an important etiologic factor for chronic gastritis and peptic ulcers and is associated with gastric atrophy which can lead to adeno carcinoma. The rapid Pyloriset Screen test (Orion Diagnostica, Espoo, Finland) was evaluated and compared to standard bacteriological methods in diagrjosis of H. pylori infection in 88 dyspetic patients (54 males and 34 females). Pyloriset Screen showed a sensitivity of 100% and specificity of 93.2% for predicting H. pylori colonization. This serologic rapid test revealed H. pylori infection in 55 (63%) patients while direct test (culture) revealed 49 (56%). Although there is no significant difference (P>0.05) between both methods of detection, Pyloriset Screen helped in revealing H. pylori infection among 6 patients more, who was suffering from dyspeptic syndrome, two of them without abnormal histopathological findings. In addition to 10 out of 39 (26%) patients without abnormal histological findings had H. pylori infection revealed by culture and Pyloriset Screen. However, H. pylori was isolated from all cases (18/18, 100%) having gastritis with ulcers denoting a causative relationship between histopathological aspect and H. pylori infection. According to age or sex distribution of H. pylori infection, there is no significant difference between patients < 45 years (53%) and >45 years (57%) or males (56%) and females (56%). In conclusion, Pyloriset Screen was shown to be 100% sensitive and good specific test. It is reliable, rapid test to screen for H. pylori infection before invasive methods of diagnosis.

17/1 VIRULENCE FACTORS IN ESCHERICHIA COLI ISOLATED FROM DIFFERENT CLINICAL SOURCES

T. R. El-Khamissy

Department of Microbiology, Faculty of Pharmacy, Al-Azhar University, Assiut

Twenty - four isolates of Escherichia coli were isolated from cases of septic burns (13), urinary tract infections (6) and septicaemia (5). These strains were investigated for plasmid profile, mannose-resistant and mannose- sensitive haemaggulti nation property for human and sheep blood, cell - surface hydrophobicity and the production of alpha-hamolysin. One or three plasmids were found in all strains. The haemagglutination property was demonstrated by the strains from septic burns, the cell-surface hydrophobicity by the strains from urinary tract infection and the alpha-haemolysin production by the strains from septicaemia. The plasmid profile was not correlated with the distribution of the tested virulence -factors.

18/1 SYSTEMIC ABSORPTION OF EPINEPHRINE AFTER ENDOSCOPIC SUBMUCOSAL INJECTION IN PATIENTS WITH BLEEDING PEPTIC ULCERS

S.M. Ghaly; MA. El-Maltawy; M.A. Naser; A.M. El-Sayed* and O.M. El-Serafy**

Department of Internal Medicine; Tropical Medicine* and Pharmacology* * Ain Shams University

Local epinephrine (adrenaline tartar ate) injection for bleeding peptic ulcer has been widely used, It is an effective, simple and economical method of endoscopic hemostasis for bleeding peptic ulcer. We measured epinephrine level in 20 patients with actively bleeding ulcer (8 gastric ulcers and 12 duodenal ulcers) treated by endoscopic injection. Injection of epinephrine (1:10,000) has been given until bleeding from the ulcers stopped. Epinephrine level was assayed using the method of Sourke and Murphy (1961), using fluorescence assay (fluorescence spectropholometry). Also, cardiovascular monitoring was done for all patients. Immediately after the injection, the plasma level of epinephrine rose by four to five times above the basal level and returned to the base line in 20 minutes. No cardiovascular complications were seen. Although adverse cardiac events have not been recorded, it seems prudent to monitor these patients closely during and immediately after epinephrine injection.

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