Abstract Introduction There has been conclusive evidence that defunctioning stoma with either transverse colostomy or ileostomy mitigates the serious consequences of anastomotic leakage. However,whether transverse colostomy or ileostomy is preferred for defunctioning a rectal anastomosis remains controversial. The present study was designed to identify the best defunctioning stoma for colorectal anastomosis. Objective To improve the quality of life in patients with rectal resection and anastomosis and reduce the morbidity before and after closure of the stoma. Patients and Methods The present study included 48 patients with elective colorectal resection who were randomly arranged into 2 equal groups, with 24 patients each. Group I consisted of patients who underwent ileostomy, and group II consisted of patients who underwent colostomy as a defunctioning stoma for a low rectal anastomosis. All surviving patients were readmitted to have their stoma closed and were followed-up for 6 months after closure of their stomas. All data regarding local and general complications of construction and closure of the stoma of the two groups were recorded and blotted against each other to clarify the most safe and tolerable procedure. Results We found that all nutritional deficiencies, dehydration, electrolytes imbalance, peristomal dermatitis, and frequent change of appliances are statistically more common in the ileostomy group, while stomal retraction and wound infection after closure of the stoma were statistically more common in the colostomy group. There were no statistically significant differences regarding the total hospital stay and mortality between the two groups. Conclusion and Recommendation Ileostomy has much higher morbidities than colostomy and it also has a potential risk of mortality; therefore, we recommend colostomy as the ideal method for defunctioning a distal colorectal anastomosis.

Abstract The production of milk-clotting enzyme (MCE) by free and immobilized Bacillus circulans 25 cells was investigated. The investigation evaluates cell immobilization through entrapment and covalent binding to different carriers. B. circulans 25 cells immobilized covalently via glutaraldehyde (cross-linker) to natural wool exhibited higher effectiveness factor (0.76) compared to other carriers. Immobilized cells produce maximum level of MCE and highest ratio of milk-clotting activity/proteolytic activity (MCA/PA) after 24 h using 0.4g wet weight cells/g wool. In batch operation, decreasing biomass loading to 0.2 g enhanced the MCA/PA ratio and specific productivity by 5.94 and 59.88%, respectively. Immobilized cells on natural wool as an effective and suitable carrier were able to produce the same level of MCA, productivity and MCA/PA ratio for 9 repeated cycles (216 h). Under continuous operation immobilized cells in a packed-bed bioreactor were able to keep producing MCA with MCA/PA ratio for about 7 days at the same level. Moreover, continuous operation demonstrates a very good productivity of 0.385 KU/L/h, which is higher than the other production systems by 7.0-11.7 fold. Immobilized B. circulans 25 cells proved to be fully capable of continuous MCE production in a packed-bed bioreactor.

Abstract Introduction Tracheostomy is the commonest surgical procedure in intensive care units (ICUs). It not only provides stable airway and facilitates pulmonary toilet and ventilator weaning, but also decreases the direct laryngeal injury of endotracheal intubation, and improves patient comfort and daily living activity. Objective The objective of this study is to assess the incidence, indications, timing, complications (early and late), and the outcome of tracheostomy on patients in the intensive care units (ICU) at a university hospital in a developing country. Methods This study is an observational prospective study. It was performed at the otolaryngology department and ICU new surgery hospital on 124 ICU admitted patients. We collected patients' demographic records, cause of admission, indications of tracheostomy, mechanical ventilation, and duration of ICU stay. We also gathered patientś tracheostomy records including the incidence, timing, technique, type, early and late complications, and outcome. All tracheostomized patients received follow-up for 12 months. Results The indication for tracheostomy in ICU patients was mostly prolonged intubation (80.5%), followed by diaphragmatic paralysis (19.5%). All tracheostomies were done by the open approach technique. Tracheostomy for prolonged intubation was done within 17 to 26 days after intubation with a mean of 19.4 ± 2.07 days. Complications after tracheostomy were 13.9% tracheal stenosis and 25% subglottic stenosis. Conclusion Prolonged endotracheal intubation is theman indication of tracheostomy, performed after two weeks of intubation. Although there were no major early complications, laryngotracheal stenosis is still a challenging sequel for tracheostomy that needs to be investigated to be prevented.

<sec><title>Introduction</title><p> Surfactant protein A (SP-A) exhibits antimicrobial properties and interacts with a variety of respiratory tract pathogens.</p></sec><sec><title>Objective</title><p> The objective of this study was to detect the presence of SP-A and measure its alterations in chronic rhinosinusitis (CRS) and primary atrophic rhinitis (PAR) versus healthy controls.</p></sec><sec><title>Methods</title><p> Inferior turbinate and sinus mucosal biopsies were taken from 30 patients with CRS, 30 patients with PAR, and 20 healthy controls. Immunohistochemical staining for SP-A and polymerase chain reaction (PCR) amplification of SP-A messenger RNA were performed on nasal tissue samples.</p></sec><sec><title>Results</title><p> Immunostaining localized SP-A to the mucosa and submucosal glands in CRS specimens but failed to localize it in PAR specimens. Quantitative PCR showed a high, statistically significant increase in the SP-A levels of patients with CRS when compared with controls (<italic>p</italic> < 0.0001) and also demonstrated a significant reduction of SP-A in patients with PAR compared with controls (<italic>p</italic> < 0.005).</p></sec><sec><title>Conclusion</title><p> SP-A is significantly increased in CRS and decreased significantly in PAR and appears to be expressed by respiratory epithelial cells and submucosal glandular elements of the sinonasal mucosa. The potential therapeutic applications of surfactant in the enhancement of mucociliary clearance need to be studied.</p></sec>

Aspergillus niger β-glucosidase was modified by covalent coupling to periodate activated polysaccharides (glycosylation). The conjugated enzyme to activated starch showed the highest specific activity (128.5 U/mg protein). Compared to the native enzyme, the conjugated form exhibited: a higher optimal reaction temperature, a lower Ea (activation energy), a higher Km (Michaelis constant) and Vmax (maximal reaction rate), and improved thermal stability. The calculated t1/2 (half-life) values of heat in-activation at 60 °C and 70 °C were 245.7 and 54.5 min respectively, whereas at these temperatures the native enzyme was less stable (t1/2of 200.0 and 49.5 min respectively). The conjugated enzyme retained 32.3 and 29.7%, respectively from its initial activity in presence of 5 mM Sodium Dodecyl Sulphate (SDS) and p-Chloro Mercuri Benzoate (p-CMB), while the native enzyme showed a remarkable loss of activity (retained activity 1.61 and 13.7%, respectively). The present work has established the potential of glycosylation to enhance the catalytic properties of β-glucosidase enzyme, making this enzyme potentially feasible for biotechnological applications.

The aim of this study was to determine the nutritional composition of Acacia farnesiana, Acacia macilenta and Acacia cochliacantha fruits and determine the intake (FI) the relative palatability index (PI) and its correlation with the nutritional composition of fruit in sheep and goats. Sixteen females of sheep and goats were used: eight sheep (F1 Dorper X Pelibuey body weight 18.5 ± 1.5 kg) and eight Creole goats (body weight 20.6 ± 1.8 kg). Animals were housed in individual pens (1.0 X 1.20 m) and fed on fruits (ad libitum) of the three acacias and corn stover (CS) for 24 hours during 15 days of experiment. Neutral and acid detergent fiber content, total phenols (TP) and condensed tannins (CT) were different (P < 0.01) between the fruits species. Fruits of A. farnesiana and A. cochliacantha had the highest (P < 0.01) intake by goats, and sheep consumed more fruits of A. cochliacantha. On average, the FI was increased in goats (P < 0.05), but the IP was increased in sheep (P < 0.01). The FI and IP were positively correlated with protein content (P < 0.01) and TP (P < 0.05) and negatively with the content of acid and neutral detergents fibers (P < 0.01). It could be concluded that the fruits of A. cochliacantha and A. farnesiana have more nutritional value for sheep and goats because of their lower content of neutral and acid detergent fiber and highest palatability index observed.

El objetivo fue determinar la composición nutricional de los frutos de Acacia farnesiana, Acacia macilenta y Acacia cochliacantha y medir en las cabras y las ovejas el consumo de frutos (CF), el índice de palatabilidad relativo (IP) y su correlación con la composición nutricional de los frutos. Se utilizaron 16 hembras: 8 ovejas F1 Dorper X Pelibuey de 18,5 ± 1,5 kg de peso vivo y 8 cabras Criollas de 20,6 ± 1,8 kg de peso vivo. Los animales fueron alojados en corrales individuales (1,0 x 1,20 m) y se les ofreció a libre acceso los frutos de las tres acacias y rastrojo de maíz (RM) al mismo tiempo las 24 horas durante 15 días. El contenido de fibras detergentes ácida y neutra (P < 0,01), fenoles totales (FT) y taninos condensados (TC) (P < 0,01) fue diferente entre los frutos. Los frutos de A. farnesiana y A. cochliacantha fueron los más consumidos por las cabras (P < 0,01), y las ovejas consumieron más frutos de A. cochliacantha. En promedio el CF fue mayor en las cabras (P < 0,05), pero el IP fue mayor en las ovejas (P < 0,01). El CF y el IP tuvieron correlación positiva con el contenido de proteína (P < 0,01) y FT (P < 0,05) y negativa con el contenido de fibras detergentes ácida y neutra (P < 0,01). Se concluye que los frutos de A. farnesiana y A. cochliacantha tienen más valor alimenticio para ovejas y cabras por el menor contenido de fibras detergentes neutro y ácido y el mayor índice de palatabilidad observado.

β-Glucosidase from Aspergillus niger was immobilized on sponge by covalent binding through a spacer group (glutaraldehyde). Sponge-immobilized enzyme had the highest immobilization yield (95.67%) and retained 63.66% of the original activity exhibited by the free enzyme. The optimum pH of the immobilized enzyme remains almost the same as for the free enzyme (pH 4.0). The optimum temperature for β-glucosidase activity was increased by 10 ºC after immobilization. The activation energy (Ea) of the immobilized β-glucosidase was lower than the free enzyme (3.34 and 4.55 kcal/mol), respectively. Immobilized β-glucosidase exhibited great thermal stability and retained all the initial activity after incubation at 55 ºC for 2 h; however, the free enzyme retained 89.25% under the same condition. The calculated half-life (t½) value of heat inactivation of immobilized enzyme at 60, 65 and 70 ºC was 213.62, 72.95 and 56.80 min, respectively, whereas at these temperatures the free enzyme was less stable (half-life of 200.0, 55.31 and 49.5 min, respectively). The deactivation rate constant at 65 ºC for the immobilized β-glucosidase is 9.5x10-3/ min, which was lower than that of the free form (12.53x10-3/ min). The immobilization process improved the pH stability of the enzyme (immobilized and free enzyme retained 69.35 and 39.86%, respectively, of their initial activity after 45 min at pH 7.5). The effect of some chemical substances on the activity of the immobilized and free β-glucosidase has been investigated. In the presence of sodium dodecyl sulfate (SDS) and p-chloromercuri benzoate (p-CMB) the immobilized enzyme retained 36.13 and 45.34%, respectively, of the initial activity, which is higher than that of free enzyme (13.71 and 1.61%, respectively). The Michaelis constant (Km) value of the free enzyme was 40.0 mM, while the apparent Km value for the immobilized enzyme was 46.51 mM. The maximum reaction rate (v max) of immobilized β-glucosidase was smaller than that of the free enzyme by 7.69%. Sponge-immobilized β-glucosidase was repeatedly used to hydrolyze cellobiose (5 and 8 cycles with retained activity of 67.32 and 51.04%, respectively).

Oxidative stress and proteases have been implicated in several diseases and extensive evidence indicates that antioxidants and protease inhibitors help prevent organ functional damage. Leiurus quinquestriatus (LQQ) scorpion venom causes cellular injuries that may lead to multiple organ failure. Thus, the capability of the antioxidant "natural standardized extract of Gingko biloba leaves (Gin, EGb 761)" and the non-selective protease inhibitor, aprotinin, in ameliorating venom-induced biochemical alterations indicative of cellular injury and oxidative stress was studied to determine their effectiveness in protecting rats from venom-evoked cellular damages. Thus, in this study, rats were treated with LQQ venom (0.3mg.kg-1, subcutaneously) alone or after Gin (150mg.kg-1, orally, daily for 2 weeks before venom) and/or aprotinin (Apr, 46000 KIU.kg-1, intraperitoneally, 30 min before venom). Control groups were injected with saline or treatment modalities. Lungs and hearts were excised after decapitating rats (n=8/group) 60 min after venom injection and the following activities were measured: reduced glutathione (GSH), malondialdehyde (MDA) - an index of lipid peroxidation, glutathione peroxidase (GPx), glucose-6-phosphate dehydrogenase (G6PD), and lactate dehydrogenase (LDH). Our findings demonstrate that LQQ venomsignificantly elevated GSH (p<0.05 vs. control), MDA (p<0.05), G6PD (p<0.05), and LDH activities (p<0.001) in hearts of envenomed rats. The venom also elevated MDA (p<0.05 vs. control) and reduced GSH and GPx (p<0.05) in the lungs of envenomed rats. In general, pretreatment with EGb761 attenuated LQQ venom-evoked increases in GSH (p<0.05 vs. venom), MDA in rat hearts and lungs (p<0.05 vs. venom), plus LDH in the heart (p<0.01). Aprotinin alone significantly reduced the venom-elicited increase in G6PD and LDH activities and the decrease in GPx levels (p<0.05). In general, these protective effects of EGb761 on GSH, MDA (p<0.01 vs. venom) and LDH (p<0.001) in the heart and/or lung were potentiated when combined with aprotinin. We concluded that the effectiveness of EGb761 and Apr in ameliorating venom-evoked biochemical changes indicative of necrosis and free radical generation point out the involvement of oxidative stress and proteases in venom-evoked cellular damages seen in this study in isolated rat hearts and lungs.