High GLI-1 Expression is a Reliable Indicator of Bad Prognosis in Newly Diagnosed Acute Leukemia Patients.

PURPOSE: To explore the expression and prognostic significance of Hedgehog signaling transcription factor GLI-1 in newly diagnosed acute myeloid leukemia (AML) patients. METHODS: Clinical specimens were obtained from 46 recently diagnosed AML patients. Real-time qPCR was used to measure the GLI-1 mRNA expression in bone marrow mononuclear cells.Also, the relationship between GLI-1 mRNA levels and clinical variables and prognostic variables was assessed. RESULTS: GLI-1 was overexpressed in the bone marrow samples of our patients. GLI-1mRNA expression did not differ significantly across different age groups, between both sexes, or between different FAB subtypes (P = 0.882, P = 0.246, and P = 0.890, respectively). GLI-1 expression varied significantly in different risk categories, with the greatest levels observed in 11 patients with poor risk (24.6 versus 22.7) compared to intermediate risk (5.2 versus 3.9; P = 0.006) and favorable risk (4.2 versus 3; P = 0.001). Comparing patients with the wild FLT3 allele to those with the mutant one, GLI-1 gene levels were considerably greater in those with the mutant allele of FLT3.Following induction chemotherapy, the levels of GLI-1 mRNA were significantly higher in 22 patients who did not experience complete remission (CR) diagnosed with de novo non-acute promyelocytic leukemia (APL) compared to 17 patients who did (P = 0.017). Significantly greater levels of expression were observed in each category of the patients with favorable risk; wild FLT3 allele (P = 0.033) and CR failure P = 0.005). CONCLUSION: GLI-1 overexpression is a risk factor for poor prognosis and could be a novel therapeutic target for AML.

Expression of B-cell activating factor in pediatric patients with immune thrombocytopenia: a single institutional series and review of literature.

B-cell-activating factor (BAFF) is a crucial cytokine supporting survival and differentiation of B cells. Dysregulation of BAFF is involved in the pathogenesis of B-cell related autoimmune diseases including immune thrombocytopenia (ITP). The aim of this study was to evaluate the significance of BAFF expression in pediatric ITP patients. Eighty pediatric patients with ITP are subdivided in three groups. Group I included (32 patients) diagnosed with acute ITP less than 3 months, group II (48 patients) diagnosed with persistent ITP (from 3 to 12 months) and chronic ITP (more than 12 months) and group III 20 healthy controls. Complete blood picture, autoimmune profile, antiplatelet antibodies, coagulation profile, bone marrow examination, and RT-PCR were performed to detect the expression for BAF for all participants in this study. BAFF expression levels significantly increased in cases rather than in controls. BAFF Expression Value significantly increased in groups I & II (3.10 ± 1.99&3.29 ± 2.58) compared to controls (0.83 ± 0.45) as p < .001 for both. On the other hand, groups I & II were comparable in BAFF Expression Value (p = .470). BAFF expression increased in ITP patients, implying a function in the disease's pathogenesis.

Influence of esophageal variceal bleeding on iron status in chronic hepatitis C patients.

BACKGROUND: Disorders of serum iron balance are frequently observed in chronic hepatitis C (CHC) patients. Iron overload as well as iron deficiency anemia are common clinical findings in these patients. Variceal bleeding is also a common complication. To date, no study has discussed the influence of esophageal bleeding on iron status in anemic CHC bleeders. OBJECTIVE: Was to study reticulocyte hemoglobin content (CHr) and serum hepcidin levels in anemic CHC and to evaluate the influence of variceal bleeding on patients' iron status. METHODS: Serum hepcidin levels and CHr were assessed in 65 early phase CHC patients (20 nonanemic, 23 anemic nonbleeders, and 22 anemic bleeders), and 20 healthy controls; and were compared with the conventional indices of iron deficiency including mean corpuscular volume, mean corpuscular hemoglobin, red cell distribution width, serum iron, total iron binding capacity, transferrin saturation and ferritin. RESULTS: Hepcidin levels were comparable in patients groups, but were significantly lower in patients than in controls (P = 0.01). Child-Pugh class B patients showed significantly lower hepcidin levels than class A patients. CHr levels were comparable in all groups as well as all iron deficiency indices. Patients with ferritin values or less 100 ng/ml and CHr or less 29 pg/cell or Tfsat or less 16% are more likely to have iron deficiency [odds ratio (OR = 3.93, 95% confidence interval (CI) = 2.54-6.08; OR = 10.50, 95% CI = 1.94-56.55, respectively). CONCLUSION: Esophageal bleeding has an almost no influence on iron status in CHC patients. Serum hepcidin content is influenced by CHC disease rather than by anemia associated with or without esophageal bleeding and it could be used as a marker of early hepatic insufficiency. Assessing CHr content could add a potential utility in the detection of iron deficiency in CHC patients.

A Novel Hardware Systolic Architecture of a Self-Organizing Map Neural Network.

In this article, we propose to design a new modular architecture for a self-organizing map (SOM) neural network. The proposed approach, called systolic-SOM (SSOM), is based on the use of a generic model inspired by a systolic movement. This model is formed by two levels of nested parallelism of neurons and connections. Thus, this solution provides a distributed set of independent computations between the processing units called neuroprocessors (NPs) which define the SSOM architecture. The NP modules have an innovative architecture compared to those proposed in the literature. Indeed, each NP performs three different tasks without requiring additional external modules. To validate our approach, we evaluate the performance of several SOM network architectures after their integration on an FPGA support. This architecture has achieved a performance almost twice as fast as that obtained in the recent literature.

Altered CD19/CD22 balance in Egyptian children and adolescents with systemic lupus erythematosus.

B cells from systemic lupus erythematosus (SLE) patients display signalling defects that may underlie disease pathogenesis activity.CD19 and CD22 play a major role as regulators of B-cell response. The aim of this study was to clarify the relationship between B cell surface markers namely CD19, CD20 and CD22 expression and clinical and laboratory indices of SLE activity. The study included 33 SLE patients and 20 healthy children and adolescents as controls. Flowcytometric assay of dual markers, CD19/CD20, and CD20/CD22 was done. SLE disease activity was assessed by SLEDAI score. CD22% was significantly higher while CD20% was significantly lower in the study compared to the control group. No significant difference was observed in both groups with respect to CD19% or CD19/CD22% ratio. The level of CD22 expression was significantly lower in high and very high active cases than in mild and moderate cases and negatively correlated with SLDEAI score and ESR. Results obtained showed that, B cell surface receptors CD20 and CD22 are significantly affected in patients with SLE, pointing to their possible involvement in the aetiopathogenesis of the disease and in the regulatory mechanisms in response to the immune disturbance.

Evaluation of some biochemical markers as prognostic factors in malignant lymphoma.

Non-Hodgkin lymphoma (NHL) is one of the most important malignant diseases worldwide. Cytokines may contribute to the clinical and histopathological alterations of the disease, while CD44, the lymphocyte homing receptor, is a putative determinant of lymphoma dissemination. To assess their value in NHL, the levels of TNF-alpha, IL-2 and sCD44 were measured in patients with different stages of NHL and the relation between these levels and tumor burden, presence of B symptoms and other prognostic criteria of the disease was evaluated. Fifty-two patients with NHL before administration of treatment as well as 20 age- and gender-matched controls were enrolled in this study. Clinical and laboratory assessment was done for the studied patients and the levels of TNF-alpha, IL-2 and sCD44 were estimated by enzyme immunoassay. Laboratory assessment included measurement of Creactive protein (CRP), lactate dehydrogenase (LDH) and albumin. LDH and CRP levels were more significantly higher, while albumin level was significantly lower among patients with stage IV as compared to that of patients with stages I/II or III. The levels of TNF-alpha, IL-2 and sCD44 were significantly higher in NHL patients than in controls. The levels of both TNF-alpha and IL-2 were positively correlated with LDH and CRP and negatively correlated with albumin. However, TNF-alpha, but not IL-2, was negatively correlated with hemoglobin (HB). The level of sCD44 was negatively correlated with both albumin and HB and positively correlated with CRP. There were significant positive correlation between the levels of TNF-alpha, IL-2 and sCD44. There was a significant association between the levels of both TNF-alpha and sCD44 and the presence of B symptoms. In conclusion, the occurrence of B symptoms in NHL may be attributed, at least in part, to high level of TNF-alpha. The increased levels of TNF-alpha IL-2 and sCD44 are associated with high tumor burden and poor prognostic criteria and it is suggest that they can be used as prognostic markers in NHL.

Episousse: incidence of newly presenting seizures in children in the Region of Sousse, Tunisia.

PURPOSE: To evaluate the incidence of newly presenting seizures in children in the area of Sousse, Tunisia. METHODS: From June 1, 1998, to May 31, 1999, all children aged 1 month to 15 years with first provoked and unprovoked seizures were included. Children with febrile seizures were excluded. All suspected cases were systematically referred to the Department of Functional Explorations of the Nervous System where a detailed questionnaire was filled out by a neurologist. All the patients underwent an EEG. Only 12 patients had a computed tomography (CT) scan. RESULTS: A total of 175 patients were included. Eighteen (10.3%) patients had acute symptomatic seizures, and 157 patients had unprovoked seizures. The incidence rate of first unprovoked seizures was 102.1/100,000. In this latter group, some epileptic syndromes were individualized on strict electroclinical criteria. CONCLUSIONS: However, nearly 75% of the cases remained cryptogenic, one of the major reasons that no predominant risk factor was identified in this population.