Osteoprotegerin in juvenile rheumatoid arthritis: cross talk between the immune and the skeletal systems

Background: Previous studies have linked the decreased local production of osteoprotegerin (OPG), an osteoclastogenesis blocking agent, in the inflamed joints of rheumatoid arthritis patients to the development of bone erosion. Objective: We sought to assess OPG expression in juvenile rheumatoid arthritis (JRA) and to determine its relation to clinical and laboratory markers of disease activity, and radiologic evidence of bone resorption, as well as its relation to the type of onset, duration of illness and different therapeutic modalities. Methods: The study included 40 children and adolescents with JRA, as well as, 20 clinically healthy age- and sex- matched subjects for comparison. The patients underwent clinical evaluation for disease activity by the summed joint index and investigations including assessment of ESR, CRP, antinuclear antibodies and rheumatoid factor. were Serum levels of osteoprotegerin were assayed by ELISA in the patient and control groups. Joints were evaluated radiologically using the modified Larsen index (LI). Results: The serum levels of OPG in the patients [ median (interquartile range): 0.474 (0.4) ng/ml] were comparable to those of the control group [0.495 (0.41) ng/ml] (p=0.29). However, patients with pauciarticular onset JRA had significantly lower OPG levels [0.3 (0.23) ng/ml] than the control group (p= 0.007). The OPG levels were below the 5th percentile of the control value in 60% of pauciarticular and 16.7% of polyarticular JRA cases. Patients with polyarticular JRA had significantly higher values of ESR, activity score and Larsen indices as well as serum OPG levels (p= 0.001, 0.001, 0.002 and 0.02, respectively). OPG levels did not correlate to the ESR or the activity score index values. On the other hand, the duration of illness showed a tendency to be negatively correlated to serum OPG (r= -0.309, p=0.05). LI correlated positively to the activity score index and to the ESR in the JRA patients, whether compiled in one group or classified into subgroups according to disease onset. However, OPG was not significantly correlated to the LI (r= 0.023). The different modalities of therapy did not seem to influence the serum levels of OPG (χ2 = 4.21). Conclusion: Serum OPG expression was low in JRA, especially in the pauciarticular variety. OPG levels were higher in polyarticular JRA, but this does not necessarily have a protective effect since the proinflammatory process is known to promote also the expression of RANKL, an osteoclastogenesis enhancer. While clinical and biochemical parameters of activity, and LI did not correlate to OPG, the latter seemed to be adversely affected by increased disease duration.Keywords: Osteoprotegerin, JRA, osteoclastogenesis, RANKL, bone resorptionEgypt J Pediatr Allergy Immunol 2004; 2(1): 38-4

The Effect of Fungal Decay on Ficus Sycomorus Wood

The deterioration of wood on account of microbiological agents is an acknowledged fact. Botryodiplodia theobromae - Trichoderma longibrachiatum - Aspergillus candidus - Aspergillus ustus and Aspergillus terreus were isolated from two wooden masks dating back to the Greek- Roman period in Egypt. The chemical composition of wood is easily affected after any attack and visible changes can be noticed clearly after some time, but the degree of deterioration of wood constituents cannot be estimated unless the wood is closely studied. Ficus sycomorus wood samples, which had been infected by the fungi isolated from the masks, were studied by using X Ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy with Attenuation Total Reflection (FTIR-ATR)

Plasma Adrenomedullin level in Egyptian children and Adolescents with type 1 diabetes mellitus: relationship to microvascular complications

<p>Abstract</p> <p>Background</p> <p>Adrenomedullin (AM) is known to be elevated in different clinical situations including diabetes mellitus (DM), but its potential role in the pathogenesis of vascular complications in diabetic children and adolescents is to be clarified. Hence, the study aimed at assessment of plasma adrenomedullin levels in children and adolescents with type 1 DM and correlation of these levels with metabolic control and diabetic microvascular complications (MVC).</p> <p>Methods</p> <p>The study was performed in the Diabetes Specialized Clinic, Children's Hospital of Ain Shams University in Cairo, Egypt. It included 55 diabetic children and adolescents (mean age 13.93 ± 3.15 years) who were subdivided into 40 with no MVC and 15 with MVC. Thirty healthy subjects, age-and sex- matched were included as control group (mean age 12.83 ± 2.82 years). Patients and controls were assessed for glycosylated hemoglobin (HbA1c) and plasma adrenomedullin assay using ELISA technique.</p> <p>Results</p> <p>Mean plasma AM levels were significantly increased in patients with and without MVC compared to control group, (110.6 pg/mL, 60.25 pg/mL and 39.2 pg/mL respectively) (P < 0.01) with higher levels in those with MVC (P < 0.05). Plasma AM levels were positively correlated with both duration of diabetes (ρ = 0.703, P < 0.001) and glycemic control (HbA1c) (ρ = 0.453, P < 0.001).</p> <p>Conclusion</p> <p>Higher plasma AM levels in diabetics particularly in those with MVC & its correlation with diabetes duration and metabolic control may reflect the role of AM in diabetic vasculopathy in the pediatric age group.</p

Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?

Contains fulltext : 87916.pdf (publisher's version ) (Closed access)PURPOSE: After 25 years of practice and positive results of the Rehbein-procedure (RB) for children with Hirschsprung Disease (HD), we changed to the less invasive transanal endorectal pull through (TERPT). The aim of this study was to compare short- and mid-term complications of these two procedures in our patients with HD. METHODS: Retrospective data of 50 HD patients were analyzed. Of these patients, 25 underwent RB (2000-2006) and in 25 the TERPT was performed (2005-2009). Medical records were reviewed to score complications and outcomes. Differences were analyzed using Chi-Square and Mann-Whitney U tests. RESULTS: All RB patients (100%) were given a colostomy compared with four patients (16%) in the TERPT group (p < 0.001). The average age at surgery in the RB group was 191 days whereas this was 72 days in the TERPT group (p < 0.01). The mean length of time of surgery in the RB group (158 min) was not significantly different from that in the TERPT group (183 min). Ganglion cells were located in all specimens at the proximal end of the specimens. The median time to first feeding significantly decreased from 2 days (range 1-11) in the RB group to 1 day (range 1-3) in the TERPT group (p < 0.01). The median length of hospital stay decreased in the TERPT group (8 days) compared with the RB group (10 days) (p < 0.001). There was a significant reduction in postoperative obstructive symptoms during the first 6 months in the TERPT group (48%) compared with the RB group (84%) (p = 0.016). Postoperative enterocolitis decreased from 40% in the RB group to 24% in the TERPT group although this was not statistically significant. CONCLUSIONS: The introduction of TERPT reduced the need for colostomies; it shortened days to first feeding after surgery and reduced hospital stay. It also improved short-term outcome with less obstructive symptoms. We recommend TERPT surgery as a first choice in children with HD. we consider the RB now to be obsolete.1 november 201

Software For On-Line Monitoring Of E10-B Telephone Exchange

The proposed software aims at enhancing the monitoring of the E10-B telephone exchange. It combines functions normally performed by two dedicated hardware devices and facilitates access to detailed maintenance information contained in manuals. The equipment required to run the software is a standard IBM-compatible XT (or higher) computer. Field trials of the software demonstrate its successful operation. In addition, a demo version has been compiled to illustrate the program features on any standard IBM compatible PC

Therapeutic Role of Mobilized Bone Marrow Cells in Children with Nonischemic Dilated Cardiomyopathy

Copyright © 2012 Nevin M. Habeeb et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dilated cardiomyopathy is an important cause of congestive cardiac failure in infants and children. Mobilizing hematopoietic progenitor cells is a promising intervention to this deadly disease. Aim. Evaluate granulocyte colony stimulating factor (GCSF) as therapeutic modality in children with idiopathic dilated cardiomyopathy (IDCM). Subjects and Methods. This case-control prospective study was conducted on 20 children with IDCM following up at Cardiology Clinic Children’s Hospital, Ain Shams University (group 1) who were compared to another 10 age-, sex-, duration-of-illness-, and systolic-function-matched children with IDCM as control (group 2). They were subjected to history taking, clinical examination, echocardiography, and peripheral blood CD34+ cell assessment before and one week after GCSF intake for 5 consecutive days (by group 1 but not group 2). Results. A significant improvement in echocardiographic data and CD34+-T-cell increase was found in group 1 one week after GCSF intake and for the next 6 months CD34+ T cells percentage of change showed no significant correlation with the that of the left ventricular dimensions and systolic function. Conclusion. Administration of GCSF to children with IDCM resulted in clinical and echocardiographic improvement not correlated to mobilized CD34+ T cells, implying involvement of additional mechanisms over simple stem cell mobilization. 1

Design Of An E-Mail System For Personal Computers

The design of an Electronic-Mail system that can operate in a personal computer (PC) environment is presented. The underlying philosophy is based on a centralized mailbox approach, wherein a dedicated SERVER stores the mail submitted by an originating USER, and then delivers it to the recipient USER upon request. The software components for each of the USER and the SERVER are described in some detail, and the communication protocol governing the interaction between them is also presented