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Stem Cell Biology And Strategies For Therapeutic Development In Degenerative Diseases And Cancer, Angel A. Alvarez

Electronic Theses and Dissertations

Stem cell biology is an exciting field that will lead to significant advancements in science and medicine. We hypothesize that inducing the expression of stem cell genes, using the embryonic stem cell gene nanog, will reprogram cells and dedifferentiate human mesenchymal stem cells into pluripotent stem cells capable of neural differentiation. The aims of initial studies are as follows: Aim 1: Demonstrate that forced expression of the embryonic stem cell gene nanog induces changes in human mesenchymal stem cells to an embryonic stem cell-like phenotype. Aim 2: Demonstrate that induced expression of nanog up-regulates the expression of multiple embryonic stem …

Nanocarriers For Biomedical Applications, Shuyi Li, Lynsa Nguyen, Hairong Xion, Meiyao Wang, Tom C.-C. Hu, Jin-Xiong She, Steven M. Serkiz, George G. Wicks, William S. Dynan

Journal of the South Carolina Academy of Science

No abstract provided.

Physiological Markers Of Activity-Based Anorexia In Sprague Dawley Rats, Crystal Lange, Michelle Vieyra

Journal of the South Carolina Academy of Science

No abstract provided.

Şerefeddin Sabuncuoğlu’S Drawings Of Gyneco-Obstetric Instruments, Nuri̇ Seli̇m Kadioğlu, Oya Ögenler, İlter Uzel

Turkish Journal of Medical Sciences

The purpose of our study was to determine the contribution of Şerefeddin Sabuncuoğlu's achievement to bring gynecology to the modern knowledge level. The gynecological tools in the achievement of Serefeddin Sabuncuoğlu, who is the late period representative of classical medical paradigm, are examined in connection with the achievement of Zahravi, which belongs to the classical medical literature. It was determined that in the long time interval from Zahravi to Sabuncuoğlu a limited advancement occurred in medical knowledge, and that the differences between the achievements of the 2 doctors are important for reflecting the development between the 2 periods.

Effects Of 50 Hz Electric Field On Malondyaldehide And Nitric Oxide Levels In Spinal Cord Of Rats At Prenatal Plus Postnatal Period, Ertuğrul Uzar, Haci Ramazan Yilmaz, Mustafa Yilmaz, Efkan Uz, Vedat Ali̇ Yürekli̇, Bumi̇n Dündar, Hasan Rifat Koyuncuoglu, Selçuk Çömlekçi̇

Turkish Journal of Medical Sciences

The effect of 50 Hz electric field (EF) on developing neural tissues is not known. We aimed to determine whether there would be any oxidative stress effect of 50 Hz EF on developing spinal cord tissues of pup rats by evaluating malondialdehyde (MDA), nitric oxide (NO) levels, and antioxidant enzyme activities such as superoxide dismutase (SOD) and catalase (CAT) measurement. Materials and methods: In the prenatal+postnatal group, the pregnant rat was exposed to continuous EF at 50 Hz 10 kV/s until delivery. Then the female pups of this group (n = 7) were exposed to EF at the same doses …

Urginea Maritima (L.) Baker (Liliaceae) Extract Induces More Cytotoxicity Than Standard Chemotherapeutics In The A549 Non-Small Cell Lung Cancer (Nsclc) Cell Line, Hakan Bozcuk, Mustafa Özdoğan, Oktay Aykurt, Fati̇h Topçuoğlu, Hasan Öztürk, Deni̇z Eki̇nci̇, Asuman Karadeni̇z, Ayli̇n Mutlu, Durmuş Burgucu

Turkish Journal of Medical Sciences

Urginea maritima (Um) is a plant native to especially Turkey and the Mediterranean area. In this study, we investigated whether Um extract exerted cytotoxicity on cancer cells. Materials and methods: We made various extracts of Um. These extracts in varying concentrations were added to an A549 NSCLC cell culture, alone or with gemcitabine and/or cisplatin. Growth inhibition was tested by the MTT assay and an Annexin V-FITC apoptosis detection kit Results: The onion Um extract (1 µg/mL) was more cytotoxic than cisplatin (1 µg/mL), gemcitabine (1 nm/mL), and leaf Um extract (1 µg/mL) with P < 0.001, P = 0.097, and P < 0.001, respectively. The efficacy of Um extract was further improved by the addition of an antioxidant cocktail to an IC_{50} value of 0.02 µg/mL. Conclusion: Um extract has been shown for the first time to be a strong candidate for drug development in solid tumors. Our studies continue to further define the specific antitumor compound(s) in this extract.

Relationship Between Pon1 Phenotype And Headache Duration In Migraine Patients, Şahbetti̇n Selek, Recep Alp, Selen İlhan Alp, Abdullah Taşkin

Turkish Journal of Medical Sciences

The available data on the activity of paraoxonase-1 (PON1) in patients suffering from migraine without aura (MWoA) is scarce. The present study was conducted to fulfill the objective of investigating the probability of an association between PON1 phenotype distribution and headache duration in patients suffering from MWoA. Materials and methods: Seventy-six patients who suffer from MWoA and were not experiencing attacks at the time and 65 healthy volunteers were enrolled for the purpose of evaluation in the present study. Results: The levels of serum paraoxonase, arylesterase activities, and lipid hydroperoxide (LOOH) were determined for these subjects. The results obtained revealed …

Serum Paraoxonase And Arylesterase Activities In Iron Deficiency Anemia During Pregnancy, Hakan Camuzcuoğlu, Harun Toy, Mehmet Vural, Aysun Camuzcuoğlu, Abdullah Taşkin, Haki̇m Çeli̇k

Turkish Journal of Medical Sciences

To investigate serum paraoxonase and arylesterase activities, and lipid hydroperoxide levels in pregnant women with iron deficiency anemia. Materials and methods: Paraoxonase and arylesterase activities, and lipid hydroperoxide levels were assessed for pregnant women with iron deficiency anemia (n = 50) and controls (n = 70). Serum basal and salt-stimulated paraoxonase, and arylesterase activities were measured spectrophotometrically. The lipid hydroperoxide levels were measured by ferrous ion oxidation xylenol orange assay. In addition, lipid parameters were determined by routine laboratory methods. Results: Basal and salt-stimulated paraoxonase, and arylesterase activities were significantly lower (P = 0.026, P = 0.031, and P = …

Immunomodulatory Role Of Leptin Treatment In Experimental Sepsis Caused By Gram Negative Bacteria, Cemi̇le Koca, Havva Şahi̇n Kavakli, Özlem Alici

Turkish Journal of Medical Sciences

To investigate the effect of leptin treatment on circulating inflammatory cytokines and on tissue damage in experimental rat model of gram-negative sepsis. Materials and methods: Adult male Wistar rats, 28 in total, were randomly divided into 4 groups (n = 7): sham, leptin, sepsis, and sepsis group treated with leptin (sepsis+leptin). Sepsis was induced by intraperitoneal (ip) injection of 2 × 10^{10} CFU of Escherichia coli ATCC 25922. Leptin and sepsis+leptin groups received a single dose ip 0.1 mg/kg leptin, while sham group received 1 mL of ip saline. Rats were sacrificed 24 h after the induction of sepsis. Blood …

Glutamate Dehydrogenase And Triose-Phosphate-Isomerase Coding Genes For Detection And Genetic Characterization Of Giardia Lamblia In Human Feces By Pcr And Pcr-Rflp*, Kareem Hatam Nahavandi, Esmaeel Fallah, Mohammad Asgharzadeh, Nasrin Mirsamadi, Behroz Mahdavipour

Turkish Journal of Medical Sciences

The purpose of this study was comparison of the glutamate dehydrogenase (gdh) and triose phosphate isomerase (tpi) genes for detection and genetic characterization of Giardia lamblia (G. lamblia) in human stool by polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (RFLP). Our assay was specific and distinguished between G. lamblia assemblages A and B. Materials and methods: Among the 325 stool samples obtained from patients with acute gastroenteritis hospitalized in the Pediatric Hospital and infected humans referred to the Tabriz Reference Laboratory (TRL), 34 Giardia-positive stool samples were identified by conventional techniques. Two assays-PCR and PCR-RFLP-targeting the tpi and …

Investigation Of Toxin Genes In Staphylococcus Aureus Strains Isolated In Mustafa Kemal University Hospital, Cemi̇l Demi̇r, Özkan Aslantaş, Ni̇zami̇ Duran, Sabahatti̇n Ocak, Burçi̇n Özer

Turkish Journal of Medical Sciences

The aim of this study was to investigate the presence of genes encoding staphylococcal enterotoxins (SEs), exfoliative toxins (ETAs, ETBs), and toxic shock syndrome toxin-1 (TSST-1) by polymerase chain reaction (PCR) in Staphylococcus aureus strains isolated from various clinical samples from the Mustafa Kemal University Hospital. In addition, PCR-based restriction fragment length polymorphism (RFLP) analysis of the coa gene was employed to genotype the isolates. Materials and methods: A total of 120 S. aureus strains isolated from various clinical samples (blood, wounds, urine, conjuctival swabs, and tracheal aspirate) over a 1 year period, 2007-2008, were used in this study. Results: …

The Protective Effect Of Dexamethasone And Lactate Against Cisplatin-Induced Ototoxicity, Ari̇f Şanli, Sedat Aydin, Zeynep Alev Sarisoy, Mustafa Paksoy, Emi̇n Ayduran, Özlem Çelebi̇ Erdi̇vanli

Turkish Journal of Medical Sciences

To compare the protective effect of dexamethasone and lactate against cisplatin-induced ototoxicity. Materials and methods: Thirty Wistar rats were randomly divided into 4 groups. After the rats were sedated with intraperitoneal (IP) ketamine hydrochloride (50 mg/kg) and xylazine (7.5 mg/kg), baseline ABRs (auditory brainstem evoked responses) were measured in response to clicks and tone pips of 4, 8, 12, and 16 kHz. After auditory thresholds were determined, the animals received drug administration as follows: Group 1 (n: 6) received intratympanic (IT) saline (0.9% NaCl) solution, Group 2 (n: 8) IP cisplatin (20 mg/kg) alone, Group 3 (n: 8) IT dexamethasone …

The Effect Of Alkali Burn On Corneal Glutathione Peroxidase Activities In Rabbits, İlknur Akyol Salman, Ahmet Kiziltunç, Orhan Baykal

Turkish Journal of Medical Sciences

Glutathione peroxidase (GPx) is an important corneal defense enzyme for protecting against hydrogen peroxides and lipid peroxides. In the present study, corneal GPx activities after alkali burn of the cornea were evaluated in rabbits. Materials and methods: Corneal alkali burn was created in the right eye of 10 rabbits by applying a 6 mm round filter paper soaked in 1 N NaOH onto the central cornea for 60 s. The right eyes of 10 healthy rabbits served as controls. The corneal GPx activities were determined by the method of Paglia and Valentina, 10 days after the burn. Results: GPx activities …

The Effect Of Caffeine On Oxidative Stress In Liver And Heart Tissues Of Rats, Hati̇ce Paşaoğlu, Fatma Ebru Ofluoğlu Demi̇r, Canan Yilmaz-Demi̇rtaş, Ahmed Hussein, Özge Tuğçe Paşaoğlu

Turkish Journal of Medical Sciences

To investigate the effect of caffeine on the levels of malondialdehyde (MDA), nitric oxide (NO), and advanced oxidation protein products (AOPP) in the liver and heart tissues of rats. Materials and methods: The current study included 30 rats, which were divided into 3 groups: a control group and 2 caffeine-treated groups. Group 1 was given caffeine at 30 mg/kg and Group 2 was given caffeine at 100 mg/kg (a high nontoxic dose) for 14 days. Results: MDA and AOPP levels in the liver tissue of the caffeine-treated groups decreased significantly as a result of the dose. MDA and AOPP levels …

The Effects Of P53 Inhibition Using Pifithrin-Α On Acute Necrotizing Pancreatitis In Rats, Etem Alhan, Aki̇f Ci̇nel, Mehmet Cengi̇z Erçi̇n, Serdar Türkyilmaz, Bi̇rgül Vani̇zor Kural, Murat Alper, Deni̇z Fi̇li̇nte

Turkish Journal of Medical Sciences

To investigate the effects of p53 inhibition using pifithrin-\alpha (PFA) on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. The role of p53 during acute pancreatitis is unclear. Materials and methods: Rats were divided into 4 groups, 2 of which were initially given only saline (the sham group) and 2 of which were given glycodeoxycholic acid in order to induce ANP. Each group was then identified according to treatment plan: sham+saline, sham+PFA, ANP+saline, or ANP+PFA. The study then investigated the extent of acinar cell injury, apoptosis, mortality, systemic cardiorespiratory variables, functional capillary density (FCD), renal/hepatic functions, and changes …

Anti-Diabetic Effects Of An Alcoholic Extract Of Juglans Regia In An Animal Model, Jamshid Mohammadi, Khalil Saadipour, Hamdollah Delaviz, Bahram Mohammadi

Turkish Journal of Medical Sciences

Many traditional treatments have been recommended in the alternative system of medicine for treatment of diabetes mellitus. Juglans regia is one of the medicinal plants used in traditional Iranian medicine as a treatment for diabetes, but little scientific documentation supports its antidiabetic action. The purpose of this study was to investigate antidiabetic effect of J. regia leaves in type 1 diabetes induced animal model. Materials and methods: Four groups of animals were selected. Group I animals were fed a normal diet. Animals of groups II, III, and IV received streptozotocin. Animals of groups III and IV were treated with J. …

A Comparison Of Intravenous General Anesthesia And Paracervical Block For In Vitro Fertilization: Effects On Oocytes Using The Transvaginal Technique, Sevi̇l Bümen, İlkben Günüşen, Vi̇cdan Firat, Semra Karaman, Ayşi̇n Akdoğan, Ege Nazan Tavmergen Göker

Turkish Journal of Medical Sciences

To compare the effects of 2 different anesthetic techniques used for oocyte retrieval. Comparison was made based on the number of retrieved and fertilized oocytes, metaphase 2 (M2, mature) oocytes, and transferred embryos, as well as fertilization, pregnancy, and live birth rates. Ultrasound-guided transvaginal oocyte retrieval for in vitro fertilization is one of the most common minor surgical procedures. Despite this, it is stressful and painful for the patient; most patients request sedation and/or pain relief. Propofol, which is frequently used for general anesthesia in such procedures, has been suspected to damage oocytes. Materials and methods: Results from 70 patients …

Subclinical Hypoxia Of Infants With Intrauterine Growth Retardation Determined By Increased Serum S100b Protein Levels, Özlem Kirmemi̇ş, Mustafa Mansur Tatli, Cüneyt Tayman, Cemi̇le Koca, Ahmet Karadağ, Nurdan Uras, Uğur Di̇lmen, Hasan Kafali

Turkish Journal of Medical Sciences

To test the hypothesis that serum S100B levels could be useful in detecting neurological damage in infants with intrauterine growth retardation (IUGR). Materials and methods: The study group consisted of infants with IUGR and the control group consisted of age-matched healthy infants. S100B protein levels were measured after birth and compared between groups. Results: For this study, 43 infants with IUGR and 25 infants as a control group were recruited. Gender, gestational age, type of delivery, and maternal age of the groups were statistically insignificant, with the exception of the mean birth weights (2120 ± 450 g in the IUGR …

The Seroprevalence Of Anaplasma Phagocytophilum In Humans From Two Different Climatic Regions Of Turkey And Its Co-Seroprevalence Rate With Borrelia Burgdorferi*, Turabi̇ Güneş, Ömer Poyraz, Mehmet Ataş, Nergi̇z Hacer Turgut

Turkish Journal of Medical Sciences

To investigate the seroprevalence of Anaplasma phagocytophilum in people living in 2 different climatic regions and to evaluate the co-seroprevalence rate of A. phagocytophilum with Borrelia burgdorferi. Sinop and Tokat provinces, both in the middle Black Sea region of Turkey, have distinct climatic features. Materials and methods: In 2006-2007, serum samples were collected from people living in rural areas of Tokat and Sivas, and anti-A. phagocytophilum IgG antibodies were explored by the IFA method. Positive samples were further investigated for the possible presence of B. burgdorferi IgG antibodies. Results: A. phagocytophilum seropositivity was found in 29 (10.62%) out of 273 …

Detection And Genotyping Of Cryptosporidium Spp. In Diarrheic Stools By Pcr/Rflp Analyses, Selma Usluca, Ümi̇t Aksoy

Turkish Journal of Medical Sciences

To compare microscopy and polymerase chain reaction (PCR) as methods for diagnosing Cryptosporidium spp. and identifying the genotype of the parasite in diarrheic stool. Materials and methods: Stool samples from diarrheic patients admitted to Dokuz Eylül University Medical Faculty were collected on a specific day of the week. Stool samples sent to our laboratory from patients affected by a diarrhea epidemic in İzmir were also included in the study. A total of 162 stool samples were examined by microscopic and molecular methods, and the validity of the molecular method was investigated. Results: Using Kinyoun acid-fast dye, Cryptosporidium spp. was found …

Nigrostriatal Dopamine-Neuron Function From Neurotrophic-Like Peptide Treatment And Neurotrophic Factor Depletion, Ofelia Meagan Littrell

Theses and Dissertations--Neuroscience

Trophic factors have shown great promise in their potential to treat neurological disease. In particular, glial cell line-derived neurotrophic factor (GDNF) has been identified as a potent neurotrophic factor for midbrain dopamine (DA) neurons in the substantia nigra (SN), which lose function in Parkinson’s disease (PD). GDNF progressed to phase II clinical trials, which did not meet proposed endpoints. The large size and binding characteristics of GDNF have been suspected to contribute to some of the shortcomings of GDNF related to delivery to target brain regions. Smaller peptides derived from GDNF (Dopamine-Neuron Stimulating Peptides – DNSPs) have been recently investigated …

Lysophosphatidic Acid Production And Signaling In Platelets, Zachary Bennett Fulkerson

Theses and Dissertations--Physiology

Lysophosphatidic acid (LPA) belongs to a class of extracellular lipid signaling molecules. In the vasculature, LPA may regulate platelet activation and modulate endothelial and smooth muscle cell function. LPA has therefore been proposed as a mediator of cardiovascular disease.

The bulk of circulating LPA is produced from plasma lysophosphatidylcholine (LPC) by autotaxin (ATX), a secreted lysophospholipase D (lysoPLD). Early studies suggest that some of the production of circulating LPA is platelet-dependent. ATX possesses an N-terminal somatomedin B-like domain suggesting the hypothesis that ATX interacts with platelet integrins which may localize ATX to substrate in the membrane and/or alter the catalytic …

Evaluation Of The Tick Bites In A Crimean-Congo Haemorrhagic Fever (Cchf) Endemic Area In Turkey, Serpi̇l Erol, Ahmet Yeni̇solak, Göknur Yapar Toros, Ayşe Albayrak

Turkish Journal of Medical Sciences

After the first description of a CCHF outbreak in Turkey, tick bites became an increasing cause of visits to health-care facilities. In this study, we evaluated tick bites in a CCHF endemic region. Materials and methods: The study included cases of tick bites that were referred to 2 hospitals in Erzurum between June and October 2008. All cases were followed-up for 10 days for the results of CCHF. Results: During the study period, 161 patients were admitted for a tick bite. The majority (56.3%) were farmers and housewives. Children ≤ 13 years of age were bitten mostly on the head …

Efficacious And Safe Tissue-Selective Controlled Gene Therapy Approaches For The Cornea, Rajiv R. Mohan, Sunilima Sinha, Ashish Tandon, Rangan Gupta, Jonathan C. K. Tovey, Ajay Sharma

Pharmacy Faculty Articles and Research

Untargeted and uncontrolled gene delivery is a major cause of gene therapy failure. This study aimed to define efficient and safe tissue-selective targeted gene therapy approaches for delivering genes into keratocytes of the cornea in vivo using a normal or diseased rabbit model. New Zealand White rabbits, adeno-associated virus serotype 5 (AAV5), and a minimally invasive hair-dryer based vector-delivery technique were used. Fifty microliters of AAV5 titer (6.561012 vg/ml) expressing green fluorescent protein gene (GFP) was topically applied onto normal or diseased (fibrotic or neovascularized) rabbit corneas for 2-minutes with a custom vector-delivery technique. Corneal fibrosis and neovascularization in rabbit …

Traumatic Brain Injury: Cyclophilin D As A Therapeutic Target And The Neuropathology Caused By Blast, Ryan Douglas Readnower

University of Kentucky Doctoral Dissertations

With an estimated incidence of 1.5 million each year, traumatic brain injury (TBI) is a major cause of mortality and morbidity in the United States. Opening of the mitochondrial permeability transition pore (mPTP) is a key event contributing to TBI pathology. Cyclophilin D (CypD), a matrix peptidyl-prolyl cis-trans isomerase, is believed to be the regulating component of the mPTP. Cyclosporin A, an immunosuppressant drug, inhibits CypD and blocks mPTP formation and has been shown to be neuroprotective following TBI. However, it is unclear if CsA’s neuroprotective mechanism is due to inhibition of CypD and/or immuno-suppression. Therefore to directly assess the …

Post-Transcriptional Control Of Type I Interferon Genes By Ksrp In The Innate Immune Response Against Viral Infection, Wei-Jye Lin

All ETDs from UAB

Several strategies are used in eukaryotic cells in order to determine the gene expression level, including the transcriptional and post-transcriptional mechanisms. One of the post-transcriptional mechanisms is the regulation of mRNA stability, which varies considerably from one mRNA species to another. Previous studies have shown that inherently unstable mRNAs encoding cytokines and proto-oncogenes contain the AU-rich elements (AREs) in the 3' untranslated regions (UTRs). Their decay requires decay-promoting RNA-binding proteins that recognize the AREs and recruit mRNA decay machineries to facilitate the rapid decay of targeting mRNA. KH-type splicing regulatory protein (KSRP) was previously identified as an ARE decay promoting …

Sox2/Parylated Parp1 Complexes Regulate Pluripotency, Yi-Shin Lai

All ETDs from UAB

Embryonic stem cells (ESCs) were first derived from the inner cell mass (ICM) of blastocyst-stage embryos. ESCs are distinguished from other cell types by their pluripotency and unlimited self-replication. ESCs are able to differentiate into multiple cell types that represent all three primary germ layers (ectoderm, mesoderm and endoderm) and can form an entire adult organism. Under defined conditions, ESCs are self-renewable and have an extended life-span without compromising pluripotency. The plasticity of ESCs provides opportunities for regenerative medicine. The recent production of induced pluripotent stem cells (iPSC) offers an ideal "personalized" substitute for ESCs. Overexpression of four transcription factors, …

Understanding Molecular Mechanisms Of Breast Cancer Metastasis Using Genetically-Engineered Mice, Leah M. Cook

All ETDs from UAB

Morbidity and mortality of breast cancer patients are drastically increased when primary tumor cells metastasize to distant organ sites. Effective treatment of metastatic disease has been limited; therefore, an increased molecular understanding to identify biomarkers and therapeutic targets is needed. Breast cancer metastasis suppressor 1 (BRMS1) suppresses development of metastases when expressed in a variety of cancer types, including metastatic mammary carcinoma. Little is known of Brms1 function throughout the initiation and progression of mammary carcinoma. Thus Brms1 transgenic mice (derived on C57BL/6 background) were generated by utilizing MMTV promoter expression (for mammary-selective overexpression) or the beta-actin promoter (for ubiquitous …

Limited Transplantation Of Antigen-Expressing Hematopoietic Stem Cells Induces Long-Lasting Cytotoxic T Cell Responses And Effect Of Altered Suppressive Myeloid Population On Hiv-Disease Progression, Warren L. Denning

All ETDs from UAB

While each type of cancer and chronic viral infection has its own specific pathology, they share two common mechanisms of immune evasion. The first mechanism is the exhaustion or deletion of antigen-specific T cells. The second mechanism is the formation of an immunosuppressive environment responsible for the block of T cell function. Elicitation of antigen-specific T cells be accomplished by immunotherapy in place of conventional treatments such as HAART and chemotherapy. In addition, immunotherapy can alleviate the side-effects associated with long-term use of conventional therapies while reducing the total cost. The results presented here provide an alternative to conventional methods …

Transdermal And Oral Dl-Methylphenidate-Ethanol Interactions In C57bl/6j Mice, Guinevere Hannah Bell

MUSC Theses and Dissertations

The persistence of attention-deficit/hyperactivity disorder (ADHO) into adulthood has been increasingly recognized over the past few decades and the stimulant drug dl-methylphenidate (MPH) has remained a first-line pharmacotherapeutic agent in the treatment of ADHD. Many adult ADHD patients who are prescribed MPH report concomitant use with ethanol. In humans, coadministration of dl-MPH and ethanol results in pharmacokinetic and pharmacodynamic drug - drug interactions. Ethanol elevates biological concentrations of the pharmacologically active d-MPH isomer and yields the metabolic transesterification product ethylphenidate (EPH). EPH appears to be formed through the actions of carboxylesterase 1 (CES1) which exhibits I-MPH substrate enantioselectivity in both …