Magnesium concentration in acute asthmatic children

[Mg] is thought to be an important element in the pathogenesis of acute asthma attacks. We hypothesized that erythrocytic Mg would be decreased during an acute asthma exacerbation. We aimed at investigating plasma and erythrocytic Mg in acute asthmatic children. This case-control study included 30 Egyptian outpatients with acute asthma. Thirty healthy matched children were included as controls. All candidates had measurements of plasma and erythrocytic Mg levels before and after treatment. No significant differences were detected in plasma Mg levels between cases and controls [1.53 +/- 0.33 mmol/L versus 1.67 +/- 0.50 mmol/L respectively, P =0.2]. However, erythrocytic Mg levels were significantly reduced in cases when compared to controls [1.06 +/- 0.43 mmol/L versus 2.57 +/- 0.59 mmol/L respectively, P<0.001]. Plasma Mg levels did not significantly change in acute asthmatics before and after their rescue treatment [1.53 +/- 0.33 mmol/L versus 1.68 +/- 0.31mmol/L respectively, P=0.07]. In contrast, the study detected a significant increase in erythrocytic Mg levels in cases after their treatment from acute attacks [1.06 +/- 0.43 mmol/L versus 1.56 +/- 0.23 mmol/L respectively, P<0.001], with significant negative correlation with severity of attack [Spearman's rho=-0.647, P<0.001]. Erythrocytic Mg levels were significantly lower during the acute asthma, and were negatively correlated with severity of exacerbation, while plasma Mg did not significantly change. Only erythrocytic Mg levels were significantly elevated after receiving rescue treatment

Low adherence of Kuwaiti adults to fruit and vegetable dietary guidelines

The study aimed to assess the adherence of Kuwaiti adults to dietary guidelines for daily fruit and vegetable intake. Data were compiled from national cross-sectional studies from 2006 to 2008 including 9350 adults. Demographic data, frequency of fruit and vegetable consumption and anthropometric and lifestyle indicators were collected. Approximately 11% of people reported consuming 5 or more fruits and vegetables daily with a mean consumption of 3.04 times per day. Consumption increased with age and body mass index but decreased with smoking and non-exercising. Minimal change in compliance with 5-per-day fruit and vegetable consumption was observed between 2006 and 2008. However, the average daily consumption of total vegetables and green salads decreased and of total fruits, fruit juices and cooked and fried potatoes increased. The low frequency of fruit and vegetable consumption among Kuwaiti adults indicates the need to adopt more healthy eating patterns to control chronic diseases

Histological study on the effects of electromagnetic field on the liver of albino rats. 2. origin and ultrastructural evaluation of the early proliferated bile duct epithelium-like cells

Proliferation of bile duct-like structures is a hepatic cellular reaction observed in most forms of human liver diseases and in a variety of experimental conditions associated with liver injury and hepatic regeneration. However, the origin, ultrastructural features, means of initiation, and significance of this type of hyperplasia are unknown yet. The present study aims to clarify and evaluate the ultrastructural characteristics of the ductular epithelium-like cells and structures which proliferate after chronic exposure to electromagnetic field [EMF]. Sixteen adult male albino rats [Rattus norvegicus] were utilized to study the effects of EMF equaling 2 ml tesla, on the proliferation of periportal biliary epithelial cells. Magnetic exposure was applied for 60 minutes for 3 days per week for two weeks. The ultrastructural observations showed that the bile duct epithelium-like structures appeared consisted of cells like the bile duct cells with characteristic microvilli, tight junctions and desmosomes. Basal lamina was observed surrounding the bile ductular cells. Each cell clearly established the presence of numerous mitochondria, pinocytic vesicles, tonfilaments, large nucleus and scanty lucent cytoplasm. Small hepatocytes, fibroblasts and collagen fibres were commonly observed in close proximity to the region of the developed ductular structures. The proliferated bile duct-like cells and structures might represent products of the extant biliary epithelium that contribute in retaining its characteristics. Besides, it acts as a transitional structure that develop in the periportal areas of regenerating hepatic nodules, serving as precursors of bile duct and/or hepatic cells. Hence, it seems to represent hepatic stem-like cells

Multiparametric flow cytometric analysis of estrogen receptor: a study on Egyptian breast cancer patients

Precise prognostication of breast cancer based on immunohistochemical features is a challenging assay. Thus, there is a need for more sophisticated prognostic determinants. This work aims to investigate the sensitivity of flow cytometry for the accurate evaluation of steroid receptor positive, tumor cells in formalin-fixed paraffin embedded tissue sections. These sections from forty breast cancer patients were subjected to multiparametric flow cytometric analysis for simultaneous assessment of estrogen receptor and DNA content analysis as well as immunohistochemical staining for steroid receptors. Moreover, tumor markers were estimated in the preoperable sera of these patients. About fifty seven percent of tumors were aneuploid. Seven tumors were interpreted positive for ER by FCM and negative by IHC. Flow cytometric results were confirmed by the traditional prognostic factors. Higher levels of insulin-like growth factor-1 occurred predominantly in aneuploid tumors with lymph nodal metastasis and positively immunostained for both estrogen and progesterone receptors. Multiparametric flow cytometric analysis may allows the detection of specific subset of patients that would otherwise escapes detection

Therapeutic approaches to genetic disorders

Although prevention is the ideal goal for genetic disorders, various types of therapeutic management are available. Such management approaches depend on the nature of the defect, how well it is understood at the genetic and biochemical levels and the practical feasibility of correction. In some conditions certain management is now tailored to the specific genotype. The patient being treated may be the fetus, the infant, the child or the adult. Treatment methods used in genetic disorders may involve surgical, cognitive/behavioral, pharmacologic, dietary, envairomental avoidance, transfusion, plasma exchange, enzyme, behavioral, cell, or gene therapy. Some have been developed on the basis of knowledge of the defect in the gene and its product, whereas others are empirical or aimed at controlling or mediating signs and symptoms without care

Histological study on the effects of electromagnetic field on the liver of albino rats 1. Magnetic stimulatory effect on the proliferation of bile duct epithelium-like cells

Electromagnetic fields [EMF] exposure exists at home, workplaces as a result of all types of electrical equipment and building wiring as well as a result of nearby power lines. It represents one of the invisible environmental pollutant factors that affect animals and human health. The present work aimed to explore the pathogenesis of ductular proliferation and may also allow for better understanding its mechanism in the hepatic regeneration. Twenty eight adult male albino rats [Rattus norvegicus] were utilized to study the effects of EMF equalling 2 ml Tesla, on the proliferation of periportal biliary epithelial cells. Magnetic exposure was applied for 30 minutes a day, 3 days a week for 2 weeks. At the end of the experiment, the animals were sacrificed after 1, 3, 6, 15, 30 and 60 days following exposure Proliferations of numerous ductular structures surrounded by degenerated hepatocytes, hepatic stellate cells and inflammatory cells were observed at the expanded portal areas. Proliferations of ductular structures were observed around the portal area to repopulate the destroyed liver cells. Numerous foci of newly formed hepatocytes that replace damaged hepatocytes were observed adjacent to the ductular structures. The presence of newly formed hepatocytes accompanied with partial disappearance of ductular epithelial cells and replacement of the periportal necrotic cells.The results also revealed that the degree of activation of ductular proliferated reaction was positively correlated with the degree of inflammatory activity and liver damage. Hepatic regeneration is related to ductular proliferated cells. The histological investigation of the nature of these cells will help to understand the mechanism of hepatocytes regeneration

Study of chromosomal abnormalities in childhood epilepsy with dysmorphism

Various chromosomal abnormalities have been found in patients with epilepsy and epileptic syndromes. Genetic linkage and karyotype analysis may provide cytogenetic clues leading to the identification of genes linked to specific types of epilepsy. This study is aimed to evaluate the chromosomal abnormalities and specific chromosomal regions in cases of childhood epilepsy with dysmorphism. The present study included 40 epileptic patients with dysmorphic features, 22 males and 18 females, their ages ranged between 27 months and 9.5 years with mean and standard deviation 4.32 +/- 2.89 years All patients had at least two attacks of unprovoked afebrile seizures greater than 24 hours apart. A thorough history taking about fits, general as well as neurological examination with special emphasis on any associated anomalies. EEG, IQ and CT were carried out in all patients, while MRI brain was done for some cases. Chromosomal study included karyotyping and fluorescence in situ hybridization [FISH] were done for all cases. Our results showed: 22 [55%] patients had normal karyotype [first group] while 18 patients [45%] had chromosomal aberrations [second group]. The frequency of various types of chromosomal aberrations among the studied patients was: Eight patients [44%] had trisomy 21 [Down syndrome], three patients [16.5%] had Turner [45x] syndrome, one patient [5.5%] had trisomy 18 [Edwards syndrome], one patient [5.5%] had deletion of short arm of chromosome 18 one patient [5.5%] had deletion of long arm of chromosome 15 [Angelman syndrome], one patient [5.5%] had deletion of long arm of chromosome 13, one patient [5.5%] had deletion of long arm of chromosome 7 [Williams syndrome], one patient [5.5%] has deletion of long arm of chromosome 4 and one patient [5.5%] had duplication of long arm of chromosome 20. There was significant difference between the two groups in developmental milestones. Consanguineous marriage was found in 22.7% of the first group versus 33% of second group. Cerebral atrophy was found in three patients [13.5%] of the first group and in five patients [27.5%] of the second group. Cerebellar atrophy was found in one patient [5.5%] of the second group. A genesis of corpus callosum was found in one patient [5.5%] of the second group. The present study reinforces the findings of the significant association between some chromosomal aberrations and epilepsy. These include: Trisomy 21, trisomy 18, Turner syndrome and abnormallties of regions 4q, 7q and 15q. Other regions associated with epilepsy were decteded: 13q, 18p and 20q. Further investigation into these regions may lead to discovery of new genes involved in epileptogenesis. The present study directs the attention of the clinicians about the importance of dysmorphic features in the evaluation of epileptic patients. In recommendation, karyotype should be performed in a child with seizures and dysmorphic features. Further advanced molecular studies about genetic basis of epilepsy are recommended

Outcome of surgical management of adenocarcinoma of esophagogastric junction

Adenocarcinoma of the esophagogastric junction [AEG] is a challenging disease for the surgeon. Because of its borderline location, the choice of surgical strategy is controversial. Efforts are currently directed to select patients who may benefit from extensive resection. Therefore, we carried out this prospective study to evaluate the outcome of surgical treatment based on Siewert's classification. From January 2004 to December 2006, 36 patients with AEG underwent resection. The choice of surgical approach was based on the location of the tumor center. The treatment of choice was esophagectomy and proximal gastrectomy for type I tumors and extended gastrectomy and distal esophagectomy for type II and III tumors. The outcome of surgery and prognostic factors were analyzed. Fourteen out of the 36 AEG cases [39%] were diagnosed as having type I tumors, twelve [33%] had type II and 10 [28%] had type Ill AEG tumors. Esophagectomy with proximal gastreetomy was carried out in all patients with type I tumors. Eleven patients with type I tumors underwent transhiatal resection while 3 patients underwent transthoracic resection. All type III tumor patients underwent transabdominal resection by total gastrectomy with transhiatal resection of the distal esophagus. The extent of surgery for type II tumors was the same as type III however, ten patients had a transabdominal resection, while one patient had a thoracotomy and another patient underwent transhiatal esophagectomy. The overall 2-year survival rate was 33.3%. Survival rate was significantly associated with pT stage, pathological node-positive category and tumor stage. Postoperative 30-day mortality and morbidity rates were 30.5%, 36.1%; respectively. Siewert's classification provides a useful tool for selecting the surgical approach but should be tailored to individual patients to achieve R0 resection. Survival is still largely stage dependent and earlier diagnosis holds the key to improve prognosis

Nerve sparing total mesorectal excision for rectal cancer: impact on oncologic results and urogenital functions

The goal of this study was to evaluate the practicability of Total mesorectal excision [TME] and Autonomic nerve preservation [ANP] for patients with rectal cancer, together with their impact on local failure rates and urinary and sexual functions. Surgery for rectal cancer continues to develop towards the ultimate goals of improving local control and overall survival, maintaining quality of life, and preserving sphincter, genitourinary and sexual function. During the planning and conduct of a radical operation for rectal cancer, a number of surgical issues have recently emerged and should be considered. These include: [1] TME; [2] ANP; [3] circumferential resection margin [CRM]; [4] distal resection margin [DRM] and [5] postoperative quality of life. This study was conducted between May 2002 and October 2006 at the department of surgery of the National Cancer Institute and included 50 patients with mid- and low-rectal cancer. Their mean age was 43.7 years. They were 17 males and 33 females. Tumors of the middle 1/3 of the rectum accounted for 54% of cases while those of the lower 1/3 represented 46%. Twenty seven patients had Low anterior resection [LAR] while 23 had Abdomino-perineal resection [APR], all of them with curative intent. These patients were divided into two groups: group A that included 30 patients subjected to subtotal mesorectal excision and that were studied retrospectively and group B that included 20 patients subjected to TME with ANP. Patients were followed up for a period ranging from 6 to 35 months with a median period of 13 months. In group B, median operative duration increased by 45 minutes in LAR and 30 minutes in APR. Blood loss and hospital stay were also higher in group B. Wider CRM and DRM could be achieved in group B. In group A, 20% developed local recurrence of their disease while none of the patients of group B showed recurrence. The postoperative complication rate in group A was 20% whereas in group B it rose to 45%. Postoperatively, 50% of patients in group A and only 15% in group B expressed urinary dysfunction. Abnormal uroflowmetry parameters were found in 33.3% of patients in group A and only 10% of patients in group B. Maintained sexual activity after surgery was noted in only 50% patients in group A while in group B it was maintained in 80% of them. TME with ANP is a tedious procedure requiring painstaking training and it is associated with a higher morbidity rate. Nevertheless the advantages of this technique are so evident as regards the decrease in local recurrence rates and the improvement in voiding and sexual functions that it deserves to be considered as the standard treatment for these tumors

Expression of some apoptosis-controlling proteins in children with acute lymphoblastic leukemia

The aim of this study was to determine the serum levels of some apoptosis-controlling proteins [Bcl-2 and soluble Fas] in children with acute lymphoblastic leukemia [ALL], and to find out the relation between their expression and the clinico-laboratory parameters as well as outcome of the disease. The study included 20 children with ALL [13 males and 7 females], their age ranged from 0.5-13 years. Twelve apparently healthy children were included as a control group. Cases and controls were subjected to full history taking, thorough clinical examination, and determination of serum levels of Bcl-2 and soluble Fas proteins [sFas], and complete blood picture [CBC]. Bone marrow examination, CSF examination, immunophenotyping, and radiological evaluation were done for cases only. One-year follow-up of cases was performed for evaluation of the prognosis and the outcome of the disease. The results showed that serum levels of Fas and Bcl-2 were significantly elevated in patients with ALL when compared to control [P: 0.007 and P: 0.003 respectively]. Serum levels of sFas were significantly elevated in cases with CNS involvement compared to those without CNS involvement [p <0.01], in cases with white blood cell count >50.000/mm[3] in peripheral blood compared to those having lower cell counts [p<0.05], and in patients with T cell lineage compared to those with B lineage [p<0.01]. Serum levels of Bcl-2 were not significantly different as regard these parameters. Serum levels of Bcl-2 were significantly lowered after treatment [P<0.001], while serum sFas didn't differ significantly before and after treatment. Levels of sFas and Bcl-2 were higher in ALL patients resistant to induction chemotherapy compared to those showing complete remission, but the difference did not reach the level of significance. Our study shows that 1] increased serum expression of Bcl-2 and soluble Fas [sFas] can be demonstrated in children with ALL. 2] increased expression of sFas [but not Bcl-2] has been found to be associated with certain unfavorable prognostic features such as T-lineage ALL, CNS involvement, and higher WBCs count and 3] the higher levels of sFas and Bcl-2 in these cases were not associated with poor response to therapy

Prevalence of some lipidosis among Egyptian children with neurodegenerative disorders

The present work comprised 30 patients belonging to 27 families. The age of the studied patients ranged from 7 months to 10 years [mean 43.9 +/- 27.69 months]. The age of onset of the disease ranged from 7 months to 5 years [mean 17.26 +/- 13.3 months]. All patients suffered from developmental delay or progressive loss of previously acquired milestones, with no coarse facial features, organomegaly or ectodermal abnormality. For all patients the following was done: - Full medical history, thorough clinical examination and family pedigree construction. - Fundus examination and nerve conduction velocity [NCV]. - MRI of brain and IQ assessment. - Measurement of arylsulphatase A, galactocerebroside: beta-galactosidase activity in peripheral leucocyte was also done together with chitotriosidase level in plasma. Twenty two patients [73.33%] had normal fundus examination, and eight patients [26.66%] had various fundus findings [three patients [10%] had pale optic disc, and five patients [16.66%] had optic atrophy] - Twenty five patients [83.33%] had normal NCV, and five patients [16.66%] had demyelination. - All patients had +ve MRI findings, 19 patients [63.33%] had dysmyelination and 11 patients [36.33%] had brain atrophy. - Twenty six patients had normal value of Aryl sulphatase A activity [ASA] [51-200 micro mol/g- p/h], while three cases demonstrated decreased activity [one case had pseudodeficiency value [10-50 micro mol/g-p/h], and two cases had actual deficiency of enzyme activity [<10 micro mol/g -p/h] and diagnosed as metachromatic leukodystrophy]. - Twenty eight patients had normal value of Chitotriosidase activity [CT] [4-80 micro mol/l/h] and one patient had high value. - Galactocerebroside beta-galactosidase activity [GALC] was measured in leukocytes for 29 index cases. Normal value was detected in all cases [0.5-4 micro mol/g-p/h]. One case [3.33%] had Gaucher disease, another had aryl sulfatase A pseudodeficiency and a third case had most probably Pelizaeus Merzbach disease, two cases had infantile Metachromatic leukodystrophy [6.66%], while another two had congenital muscular dystrophy. All other patients need further follow up and further investigations

Comprehensive rapid identification of female carriers of DMD/BMD by ion-pair reversed-phase high performance liquid chromatography

The unlabeled ion-pair reversed-phase high performance liquid chromatography [IP-RP-HPLC] was used in this study to develop a simple and rapid method for rapid identification of female carriers of the dystrophin gene. DNA molecular size markers were efficiently used to type the 2-bp short tandem repeat [STR]. In an Egyptian sample of 98 chromosomes, the most common alleles within the DMD gene were 200, 176, 245 and 243 bp due to STR44, 45, 49, and 50 markers, respectively. The true heterozygosity values of these markers ranged from 73.5 to 90.9% and observed allele numbers ranged from 8 to 17 in 98 chromosomes, revealing high polymorphism of the four [CA]n system of the DMD gene

ENG profile in auditory neuropathy

Twelve patients with auditory neuropathy aged 11 - 34 years were subjected to ENG test battery including gaze, random saccades, pursuit, optokinetic, positional and bithermal water caloric tests. Twenty age and gender matched normal subjects were included as a control group. None of the 12 patients had history of vertigo or unsteadiness. Neither gaze evoked nor positional nystagmus was recorded in any patient. 7 patients out of 12 had abnormal gain of pursuit tracking and optokinetic nystagmus [< 0.7] and 2 out of the 7 had abnormal fixation index [> 50%]. Moreover, the average slow phase velocity of the total caloric response in auditory neuropathy patients showed statistically significant reduced values as compared to those obtained from the control group, however none of the 12 patients had total caloric response < 22 degrees/second. These results are suggestive of a potential peripheral vestibular dysfunction in addition to central vestibular dysfunction mainly at the level of brainstem

Cartilage tympanoplasty: audiological and otological outcome

Forty-six patients with chronic suppurative otitis media have been operated upon [using cartilage graft to close tympanic membrane perforation] at ORL Department, Mansoura University Hospital. Otological and Audiological results were compared with the results of 30 tympanoplasties operated at the same period of time [using temporalis fascia graft to close tympanic membrane perforation]. Successful closure of the tympanic membrane perforation was achieved in 91.3% of the cartilage group as compared to 73.3% of the fascia group. The postoperative air-bone gap was smaller in the fascia group than the cartilage group, but the difference was statistically insignificant. According to our results, we concluded that cartilage is a reliable graft material for reconstruction of tympanic membrane perforations especially, large perforations as well as revision cases

Expression of some apoptosis-controlling proteins in pediatric lymphoproliferative malignancies

The aim of this study was to determine the expression [levels] of some apoptosis-controlling proteins [Bcl-2 and soluble Fas] in children with lymphoproliferative malignancies and to find out the relation between their expression and the clinico-laboratory parameters as well as the outcome of the disease. The study included 39 children with lymphoproliferative malignancies [14 with non-Hodgkin lymphoma [NHL], 5 with Hodgkin lymphoma [HD] and 20 with acute lymphoblastic leukemia [ALL]]. Their age ranged from 0.5-14 years, they were 28 males and 11 females. Twelve apparently healthy children were included as a control group. Cases and controls were subjected to full history taking, thorough clinical examination and certain investigations [serum levels of Bcl-2 and soluble Fas proteins and complete blood picture]. For cases only, bone marrow examination, CSF examination, immunophenotyping and radiological evaluation were done. One-year follow-up of cases was performed for the evaluation of the prognosis and the outcome of the disease. The study concluded that increased serum expression of Bcl-2 and soluble Fas can be demonstrated in children with lymphoproliferative malignancies. High serum levels of such apoptotic controlling proteins were correlated with poor prognosis in patients with HL and NHL, while no correlation was found with the prognosis in patients with ALL

Stapes surgery in children and young patients

Thirty two stapes procedures in children and young patients were reviewed. There were 18 males and 14 females. The mean age at the time of surgery was 16 years with a range from 8 to 20 years. Stapedectomy was performed in 12 cases and stapedotomy in 20 cases. Follow up period ranged from 6 monthes to 12 years with an average of 3 years. Our results showed an average postoperative air-bone gap of 9.8 dB and an average hearing improvement of 19.5 dB. The best results were obtained when the small fenestra technique was used. According to our results, we conclude that stapedectomy in children is satisfactory and the results are comparable to the other published results

Determination of heroin and morphine in biological materials and illicit samples

Radioimmunoassay was applied in this work for the estimation of morphine in animal serum and tissues and in serum of heroin addicts. The method proved feasible and efficient. The analysis of an illicit heroin sample was carried out by TLC and GLC and found to be mixture of different alkaloids beside heroin

Pathological versus clinical staging for children with hodgkin's disease comparison of long-term results

This work studied 358 children with pathologically proven diagnosis of Hodgkin's disease. They were either pathologically staged [149 patients] or clinically staged [209 patients]. The characteristics of both groups were comparable with minor differences. Both groups were treated either with involved field radiation therapy alone, chemotherapy alone or combined chemoradiotherapy. Complete response rates were identical in both pathologically and clinically staged groups [90%]. The 10-year overall survival [OS] rates were comparable [88% vs 83%] and the 10-year disease-free survival [DFS] rates were also comparable [52% vs 51%]. The prognostic factors for all patients that determined both DFS and OS were tumor stage, systemic manifestations, mediastinal involvement and type of treatment adopted

Prediction of abdominal involvement in children with Hodgkin's Disease

One hundred fifty six children suffering from pathologically proven Hodgkin's disease [HD] were clinically staged using the conventional laboratory and radiological examinations during the period 1979-1988 in National Cancer Institue, Cairo. All patients were subjected to staging laporatory and splenectomy. After laparotomy 16.7% of children were upstaged and 12.8% were down staged than the original clinical stage. The positive predictive value of bipedal lymphography was 49%, while the negative predicative value was 85%. Addition of abdominal CT scanning of some patients did not improve the predictive vaslue. Splenic involvement was correlated with clinical stage, the histopathological subtype and mediastinal involvement. University analyses of the factors that may predict abdominal disease proved that these factors were in decreasing order of probability; Mediastinal involvement [0.0001], bilaterality [0.0001], splenomegaly [0.001], positive lymphangiography [0.001], systemic manifestation [0.004] and histologic subtypes [0.031]. The laterality of nodal presentation was not statistically significant. The multiple logistic regression proved that the bilaterality of nodal involvement and the histology were not independent predictor factors while the other four factors were working as independent predictors for abdominal Hodgkin's disease involvement