Suction rectal biopsy (SRB) in Hirschsprung's Disease: Is a single macroscopically adequate sample sufficient?

Hirschsprung's Disease (HD) is a congenital disorder causing severe constipation in infants and children. Suction rectal biopsy (SRB) is the preferred technique for obtaining tissue samples for histopathological evaluation. In low-resource settings like Malaysia, cost-effective diagnostic approaches are necessary, making single sample SRB valuable. This study evaluates the diagnostic accuracy and sufficiency of a single macroscopically adequate sample in suction rectal biopsies for the histopathological confirmation of HD. We conducted a retrospective study of children who underwent suction rectal biopsies for the diagnosis of HD at Hospital Raja Perempuan Zainab II (HRPZII), Kota Bharu, Kelantan. A total of 68 patients were included in the study. The inadequacy rate for bedside SRB was 14%, comparable to current literature. Our study found no statistically significant association between sample inadequacy and gestational age, gender, birth weight, or weight at biopsy. Complication rates were 0%, consistent with literature reports. Calretinin staining, an additional technique, was performed in 23 biopsy episodes, with a 4.3% inadequacy rate, compared to 20% in specimens not subjected to calretinin staining. The cost of SRB almost doubled with each additional sample taken, significant in low-resource environments. In conclusion, single sample SRBs can be adequately diagnostic and cost-effective in low-resource settings, providing valuable insights for healthcare facilities in Malaysia and other developing countries. The use of adjunctive techniques such as calretinin staining may improve diagnostic accuracy while maintaining cost-effectiveness. Further prospective studies with larger sample sizes are needed to validate these findings.

[The current status of nutrition literacy and evaluation tools].

Nutrition literacy is one of essential components of health literacy. A relatively mature health literacy evaluation system has been established in China so far. However, the studies on nutrition literacy evaluation are still limited, especially for specific population, such as children, adolescents, older people, and maternal. The present study introduces the concept of nutrition literacy, and summarizes the evaluation tools of nutrition literacy for both general population and special population (i.e., children, adolescents, older people, and maternal) in China and foreign countries, and their dimension, reliability, validity and applicable scope. This study aim to provide evidence for the development of nutrition literacy evaluation tools for different population according to the current problem of nutrition in China.

Correlation of gastric heterotopia and Meckel's diverticular bleeding in children: a unique association.

PURPOSE: Meckel's diverticular bleeding is the commonest cause of major gastrointestinal (GI) haemorrhage in children. We hypothesise that gastric heterotopia (GH) is associated with increased risk of bleeding and, therefore, may affect initial management. METHODS: Paediatric patients with histological diagnosis of Meckel's diverticulum (MD) following diverticulectomy from 1995 to 2011 were reviewed retrospectively, focusing on histological correlation to bleeding. GH identified on histology was regarded as GH+, and where GH was not found was regarded as GH-. Two-tailed Chi-square test and Fisher's exact test were used, p < 0.05 was statistically significant. RESULTS: Thirty-nine patients underwent Meckel's diverticulectomy. The number of patients with GH+, GH-, and bowel necrosis were 21, 15, and 3. Eighteen children with MD had GI bleeding. GI bleeding was more commonly associated with GH+ (14/21) than GH- (4/15) (67 vs 27 %, p = 0.02). Further analysis revealed all four GH- bleeding originated from other sources than the MD. GH+ had no significant association with other presentations. GH+ was present in 8/8 (100 %) positive Meckel's scans and 2/5 (40 %) negative scans. Meckel's scan had a sensitivity of 8/10 (80 %), and specificity of 3/3 (100 %). CONCLUSION: This study confirmed that GH positive MD is a unique entity presenting typically with GI bleeding.

Isolation, sequence identification and expression profile of three novel genes Rab2A, Rab3A and Rab7A from Black-boned sheep (Ovis aries).

Complete coding sequences of three Black-boned sheep (Ovis aries) genes Rab2A, Rab3A and Rab7A were amplified using reverse transcription polymerase chain reaction (RT-PCR) based on the conserved sequence information of cattle or other mammals known to be highly homologous to sheep ESTs. The Black-boned sheep Rab2A gene encodes a protein of 226 amino acids which contains the conserved putative RabL2 domain and is highly homologous to the Rab2A proteins of seven other species--cattle (96%), human (83%), Sumatran orangutan (82%), rat (81%), mouse (80%), African clawed frog (72%) and zebrafish (71%). The Black-boned sheep Rab3A gene encodes a protein of 220 amino acids that contains the conserved putative Rab3 domain and is very similar to the Rab3A proteins of four species--cattle (99%), African clawed frog (99%), Western clawed frog (98%) and zebrafish (95%). And the Black-boned sheep Rab7A gene encodes a protein of 207 amino acids that contains the conserved putative Rab7 domain and has high homology with the Rab7A proteins of six other species--human (99%), dog (99%), Sumatran orangutan (99%), zebrafish (97%), rabbit (97%) and African clawed frog (96%). Analysis of the phylogenetic tree has demonstrated that the Black-boned sheep Rab2A, Rab3A and Rab7A proteins share a common ancestor and the tissue expression analysis has shown that the corresponding genes are expressed in a range of tissues including leg muscle, kidney, skin, longissimus dorsi muscle, spleen, heart and liver. Our experiment is the first to provide the primary foundation for a further insight into these three sheep genes.

A comparison of open and laparoscopic restorative proctocolectomy in children.

AIM: To compare laparoscopic restorative proctocolectomy (RP) in children with the same operation performed using open surgery. METHODS: Case-control comparison of two consecutive cohorts undergoing procto-colectomy by one surgeon. Outcome variables measured were: operating time, blood loss, hospital stay and complication rates. RESULTS: Twenty-two children, mean age 13 years, underwent RP. Eleven laparoscopic cases were compared with the preceding open case. There was no difference in operating time (443 vs. 403 min, P = 0.479), blood loss (159 vs. 417 ml, P = 0.082), complication rate (4 vs. 1) or hospital stay (14 vs. 19 days, P = 0.192). CONCLUSIONS: Laparoscopic RP is feasible and safe in children. The small number of children recruited may mask benefits in blood loss and hospital stay for laparoscopic surgery.

High-frequency magneto-oscillations in GaAs/AlGaAs quantum wells.

We have observed very high-frequency, highly reproducible magneto-oscillations in modulation doped GaAs/AlGaAs quantum well structures. The oscillations are periodic in an inverse magnetic field (1/B) and their amplitude increases with temperature up to T approximately 700 mK. Being initially most pronounced around the filling factor nu=1/2, they move towards lower nu with increasing T. Front and back-gating data imply that these oscillations require a coupling to a parallel conducting layer. A comparison with existing oscillation models renders no explanation.

Measurement of scattering rate and minimum conductivity in graphene.

The conductivity of graphene samples with various levels of disorder is investigated for a set of specimens with mobility in the range of 1-20x10(3) cm2/V sec. Comparing the experimental data with the theoretical transport calculations based on charged impurity scattering, we estimate that the impurity concentration in the samples varies from 2-15x10(11) cm(-2). In the low carrier density limit, the conductivity exhibits values in the range of 2-12e2/h, which can be related to the residual density induced by the inhomogeneous charge distribution in the samples. The shape of the conductivity curves indicates that high mobility samples contain some short-range disorder whereas low mobility samples are dominated by long-range scatterers.

Landau-level splitting in graphene in high magnetic fields.

The quantum Hall (QH) effect in two-dimensional electrons and holes in high quality graphene samples is studied in strong magnetic fields up to 45 T. QH plateaus at filling factors nu = 0, +/-1, +/-4 are discovered at magnetic fields B > 20 T, indicating the lifting of the fourfold degeneracy of the previously observed QH states at nu = +/-4(absolute value(n) + 1/2), where n is the Landau-level index. In particular, the presence of the nu = 0, +/-1 QH plateaus indicates that the Landau level at the charge neutral Dirac point splits into four sublevels, lifting sublattice and spin degeneracy. The QH effect at nu = +/-4 is investigated in a tilted magnetic field and can be attributed to lifting of the spin degeneracy of the n = 1 Landau level.

Measurements of the density-dependent many-body electron mass in two dimensional GaAs/AlGaAs heterostructures.

We determine the density-dependent electron mass m(*) in two-dimensional electron systems of GaAs/AlGaAs heterostructures by performing detailed low-temperature Shubnikov-de Haas measurements. Using very high-quality transistors with tunable electron densities we measure m(*) in single, high mobility specimens over a wide range of r(s) (6 to 0.8). Toward low densities we observe a rapid increase of m(*) by as much as 40%. For 2>r(s)>0.8 the mass values fall approximately 10% below the band mass of GaAs. Numerical calculations are in qualitative agreement with our data but differ considerably in detail.

[Influence of Salvia miltiorrhizae and Astragalus membranaceus on hemodynamics and liver fibrosis indexes in liver cirrhotic patients with portal hypertension].

OBJECTIVE: To observe the influence of Salvia miltiorrhiza (SM) and Astragalus membranaceus (AM) on hemodynamics and liver fibrosis indexes in patients of liver cirrhosis with portal hypertension. METHODS: Eighty-four cases of liver cirrhosis were enrolled and divided randomly into two groups, 42 in each. The control group was treated with conventional therapy and the tested group treated with SM and AM. The parameters, including diameter of portal vein and splenic vein (Dpv and Dsv), speed of blood flow in portal vein and splenic vein (Spv and Ssv), quantity of blood flow in portal vein and splenic vein (Qpv and Qsv) as well as liver fibrosis indexes, such as HA, PC III and LN, were determined before, 1, 2 and 3 months after treatment. RESULTS: After treatment, in the tested group, Dpv and Dsv decreased, Spv and Ssv increased, and Qpv and Qsv reduced, showing a significant difference in comparison with those in the control group (P < 0.05 or P < 0.01). The liver fibrosis indexes were improved significantly in the tested group, also showed significant difference from those in the control group (P < 0.01). CONCLUSION: SM and AM could improve portal hypertension effectively in liver cirrhosis patients, one of the mechanism may be related with the improvement of liver fibrosis.