Mitomycin C application in resistant caustic esophageal stricture

Background/purpose Caustic esophageal strictures still represent a catastrophic problem in children of our country. Management protocol is usually started by regular esophageal dilatation in which multiple sessions may be needed until the resolution of dysphagia; however, in many cases endoscopic dilatation fails and therefore esophageal replacement is eventually required. Our aim is to assess the role of mitomycin C application in the management of caustic esophageal stricture refractory to regular endoscopic dilatation.Patients and methods Patients with resistant caustic esophageal stricture were subjected to topical mitomycin C application on stricture site after endoscopic dilatation. Patients were followed up clinically using validated dysphagia score to assess the improvement of dysphagia, radiologically by contrast esophagogram and endoscopically to confirm resolution of the stricture. Results were analyzed and compared with results of a control group managed at the institution by a regular dilatation protocol.Results During the period January 2008 to June 2010, 12 patients with resistant caustic esophageal stricture were followed at our unit of whom six had a short esophageal stricture (< 3 cm) and six had a long stricture ( >3 cm). Topical mitomycin C application resulted in clinical and radiological resolution of dysphagia and strictures in 83% and 66% respectively, compared with 44 (eight out of 18 patients with short stricture) and 25% (two out of eight patients with long stricture) in the control group.Conclusion Mitomycin C application can markedly improve the outcome of patients with caustic esophageal stricture, reducing the number of required sessions for endoscopic dilatation. However, double-blinded randomized controlled trial is needed to prove its effectiveness.Keywords: caustic esophageal stricture, esophageal dilatation, mitomycin

Monitoring and Assessing the Coastal Ecosystem at Hurghada, Red Sea Coast, Egypt

In the framework of the investment plan, the government of Egypt introduced an accelerated development of Hurghada in collaboration with the private sector, as   early as 1980's.  The government intended to construct tourist resort communities, which required establishment of infrastructures. The  demand  of  such  facilities, in absence of enforced environmental roles led owners  to implement  processes  of  landfilling  and  dredging  for the purpose of smoothing, paving and widening the beach in order to construct swimming pools, marinas and other recreational facilities. Such activities came on the expense of the marine ecosystem and especially assault on the coral reef communities. For monitoring and assessing such oppressive activities;  MSS,  TM,  ETM+,  and SPOT XS 4 satellite images acquired  during  1972,  1984,  1992,  2004  and 2011. Shoreline change detection from 1972 to 2011 reveals landfilling of some 7.56Km2 and dredging of 2.67km2, with loss of 5.34km2 of the reef tracts. At the same period, the region has witnessed expansions in urban and road network by 16.47km2 and 8.738km2 respectively. The Egyptian government issued the essential laws for regulating and saving the coastal ecosystem, yet mostly violated. Activation of such laws, applying judicial officers, toughening penalties and establishment of coastal building front line (CBFL), and a reef protection line (RPL) are important tasks especially south of Hurghada to the Egyptian-Sudanese borders to preserve the remnants of such unique coastal ecosystem. Keywords: Satellite images, Hurghada, Red Sea, coastal ecosystem, shoreline changes, urban, road network, environment law

Gastrografin in the management of adhesive small bowel obstruction in children: a pilot study

Background/purpose Adhesive small bowel obstruction (ASBO) is a common emergency problem in children with previous abdominal surgery. Management protocols usually start with a conservative approach that may be successful in some cases, whereas in others it will end eventually by laparotomy with its associated morbidity and mortality. Our aim was to assess the role of water-soluble contrast, gastrografin, in the conservative management of ASBO. Patients and methods During the period January 2009 to July 2010, 33 patients with ASBO were presented at the Pediatric Surgery Unit at the Ain Shams University Hospitals. Patients who failed to improve after 48 h of conservative management in the absence of signs of strangulation were subjected to gastrografin administration. Patients were evaluated clinically and radiologically to determine the resolution of the adhesive attack, with estimation of hospital stay time. Results An oral administration of gastrografin successfully completed the conservative management in eight of 12 patients (66.6%), thus avoiding surgery and subsequently reducing hospital stay. Conclusion Gastrografin may have a valuable role in the management of ASBO, whether diagnostic or therapeutic, but a randomized controlled trial is needed to prove its effectiveness in reducing surgical intervention rate and hospital stay time.Keywords: adhesive, bowel obstruction, gastrografi

Physiographic Characteristics Along the Ibex Protectorate: Remote Sensing Application, Hotet Bani Tamim, Central Saudi Arabia

Tuwiaq plateau is one of the most characteristic physiographic components of central Saudi Arabia. The Middle Jurassic limestone was the result of the natural harmony between the Tethys sedimentation, tectonics, and climate. The plateau was studied within the Ibex Protectorate of Hotet Bani Tamim area. Remote sensing applications on satellite images of 2019 were able to measure the geomorphology, distinguish the sedimentary units, and emphasized the role of tectonics in dividing the plateau to step-like escarpment, elevated from 1080 m at Al-Onouk the extreme northwest to 600m at Al-Hulwah with an average slope of 0.8cmm-1. The slope at catchment reaches up to 70° while at the downstream not more than 16°. Two basins are detected at the Ibex protectorate, these are Wadi Meta’am basin and Wadi Bowydan- Nokhailan basin who down flow into Wadi Meta’am  and Wadi Berek respectively). Wadi Meta’am derives its water through three tributaries Al-Ghaba, Ghafar, and Al-Agmaa, while Wadi Bowydan, on the other hand, cuts deeper and drain water with Wadi Nokhailan downstream to Wadi Berek. The high-density dendritic drainage pattern with 5th and 6th order tributaries support the vulnerability of the area to flash flood hazards. The heavy rains were able to sculpt such an amazing geomorphosite and leave its finger prints  in the form of deep streams (about 140m depth), channel lags of cobbles and pebbles, Quaternary thick colluvium, water-saturated soils,  and karstic features  such as the small pool, calcretes and travertines. The present study seeks the importance to schedule the area within the program of development according to the vision 2030 and to add among the geoheritage sites Keywords: Remote sensing, GIS, Ibex Protectorate, physiography, land classification DOI: 10.7176/JEES/9-11-04 Publication date: November 30th 201

Efficacy of Mesenchymal Stem Cells in Suppression of Hepatocarcinorigenesis in Rats: Possible Role of Wnt Signaling

<p>Abstract</p> <p>Background</p> <p>The present study was conducted to evaluate the tumor suppressive effects of bone marrow derived mesenchymal stem cells (MSCs) in an experimental hepatocellular carcinoma (HCC) model in rats and to investigate the possible role of Wnt signaling in hepato-carcinogenesis.</p> <p>Methods</p> <p>Ninety rats were included in the study and were divided equally into: Control group, rats which received MSCs only, rats which received MSCs vehicle only, HCC group induced by diethylnitroseamine (DENA) and CCl_<b>4</b>, rats which received MSCs after HCC induction, rats which received MSCs before HCC induction. Histopathological examination and gene expression of Wnt signaling target genes by real time, reverse transcription-polymerase chain reaction (RT-PCR) in rat liver tissue, in addition to serum levels of ALT, AST and alpha fetoprotein were performed in all groups.</p> <p>Results</p> <p>Histopathological examination of liver tissue from animals which received DENA-CCl₄only, revealed the presence of anaplastic carcinoma cells and macro-regenerative nodules type II with foci of large and small cell dysplasia. Administration of MSCs into rats after induction of experimental HCC improved the histopathological picture which showed minimal liver cell damage, reversible changes, areas of cell drop out filled with stem cells. Gene expression in rat liver tissue demonstrated that MSCs downregulated <it>β-catenin</it>, proliferating cell nuclear antigen (<it>PCNA</it>), <it>cyclin D </it>and <it>survivin </it>genes expression in liver tissues after HCC induction. Amelioration of the liver status after administration of MSCs has been inferred by the significant decrease of ALT, AST and Alpha fetoprotein serum levels. Administration of MSCs before HCC induction did not show any tumor suppressive or protective effect.</p> <p>Conclusions</p> <p>Administration of MSCs in chemically induced HCC has tumor suppressive effects as evidenced by down regulation of Wnt signaling target genes concerned with antiapoptosis, mitogenesis, cell proliferation and cell cycle regulation, with subsequent amelioration of liver histopathological picture and liver function.</p

Restoration of impaired intestinal barrier function by the hydrolysed casein diet contributes to the prevention of type 1 diabetes in the diabetes-prone BioBreeding rat

Aims/hypothesis Impaired intestinal barrier function is observed in type I diabetes patients and animal models of the disease. Exposure to diabetogenic antigens from the intestinal milieu due to a compromised intestinal barrier is considered essential for induction of the autoimmune process leading to type I diabetes. Since a hydrolysed casein (HC) diet prevents autoimmune diabetes onset in diabetes-prone (DP)-BioBreeding (BB) rats, we studied the role of the HC diet on intestinal barrier function and, therefore, prevention of autoimmune diabetes onset in this animal model. Methods DP-BB rats were fed the HC diet from weaning onwards and monitored for autoimmune diabetes development. Intestinal permeability was assessed in vivo by lactulose mannitol test and ex vivo by measuring trans-epithelial electrical resistance (TEER). Levels of serum zonulin, a physiological tight junction modulator, were measured by ELISA. heal mRNA expression of Myo9b, Cldn1, Cldn2 and Ocln (which encode the tight junction-related proteins myosin IXb, claudin-1, claudin-2 and occludin) and Il-10, Tgf-beta (also known as Il10 and Tgfb, respectively, which encode regulatory cytokines) was analysed by quantitative PCR. Results The HC diet reduced autoimmune diabetes by 50% in DP-BB rats. In DP-BB rats, prediabetic gut permeability negatively correlated with the moment of autoimmune diabetes onset. The improved intestinal barrier function that was induced by HC diet in DP-BB rats was visualised by decreasing lactulose:mannitol ratio, decreasing serum zonulin levels and increasing ileal TEER. The HC diet modified ileal mRNA expression of Myo9b, and Cldn1 and Cldn2, but left Ocln expression unaltered. Conclusions/interpretation Improved intestinal barrier function might be an important intermediate in the prevention of autoimmune diabetes by the HC diet in DP-BB rats. Effects on tight junctions, ileal cytokines and zonulin production might be important mechanisms for this effect

OSS (Outer Solar System): A fundamental and planetary physics mission to Neptune, Triton and the Kuiper Belt

The present OSS mission continues a long and bright tradition by associating the communities of fundamental physics and planetary sciences in a single mission with ambitious goals in both domains. OSS is an M-class mission to explore the Neptune system almost half a century after flyby of the Voyager 2 spacecraft. Several discoveries were made by Voyager 2, including the Great Dark Spot (which has now disappeared) and Triton's geysers. Voyager 2 revealed the dynamics of Neptune's atmosphere and found four rings and evidence of ring arcs above Neptune. Benefiting from a greatly improved instrumentation, it will result in a striking advance in the study of the farthest planet of the Solar System. Furthermore, OSS will provide a unique opportunity to visit a selected Kuiper Belt object subsequent to the passage of the Neptunian system. It will consolidate the hypothesis of the origin of Triton as a KBO captured by Neptune, and improve our knowledge on the formation of the Solar system. The probe will embark instruments allowing precise tracking of the probe during cruise. It allows to perform the best controlled experiment for testing, in deep space, the General Relativity, on which is based all the models of Solar system formation. OSS is proposed as an international cooperation between ESA and NASA, giving the capability for ESA to launch an M-class mission towards the farthest planet of the Solar system, and to a Kuiper Belt object. The proposed mission profile would allow to deliver a 500 kg class spacecraft. The design of the probe is mainly constrained by the deep space gravity test in order to minimise the perturbation of the accelerometer measurement.Comment: 43 pages, 10 figures, Accepted to Experimental Astronomy, Special Issue Cosmic Vision. Revision according to reviewers comment