Hirschisprung’s disease: Factors Affecting the Outcome at The National Ribat University Hospital, Khartoum, Sudan, 2007 to 2011

Background: Hirschsprung's disease (HSD) remains the most frequent cause of child intestinal obstruction.Objectives: to evaluate the effect of different factors at the final outcome, postoperative complications and the hospital stay of children with HSD.Methodology: It is a retro-prospective analytical observational hospital based study, involving all the cases presented initially to the Paediatric Surgery Centre at the National Ribat University Hospital and confirmed to be a case of HSD. The data were collected using a questionnaire and analyzed by the software SPSS version 17.Results: Sixty four patients were involved in this study with male to female ratio of 5:1. The mean age at the first time of presentation was 9 days and the bulk of the patients seen from the center of Sudan. The emergency presentation accounted for 21.9% of the cases with the delayed passage ofmeconium and constipation as the main presenting symptoms. Complications occur mainly at day 13 post operatively with colostomy prolapse as the commonest type of complications. The age of the patients at the time of Pull Through Procedure (PTP) was ranging between 7 to 72 months and the mean body weight found to be 11.94 kg. Complicationsfollowing PTP occur in 18.8% of the cases, with wound infection accounting for 15.6% of the cases. The total duration of hospital stay post operatively after reversal of colostomy was found to range between 6 and 60 days with a mean of 8.77 days and SD of ± 6.657.Conclusion: The average hospital frequency of HSD in our study is  compared to that encountered in European countries and Northern  American countries. Early diagnosis and treatment is essential for better outcome. Emergency presentation, age and the weight at Pull Through Operation and at the time of closure of colostomy, significantly affect the outcome and prolong the hospital stay.Key words: Hirschsprung's Disease, colostomy, Pull Through Operation

Production of functional protein hydrolysates from Egyptian breeds of soybean and lupin seeds

Enzymatic hydrolysis is an agro-processing aid that can be utilized in order to improve nutritional quality of protein extracts from many sources. In this study, protein extracts from ungerminated and/or germinated local Egyptian soybean and lupin flours were hydrolyzed using the enzyme papain. The hydrolysis processes were carried out for 2 h and aliquots were withdrawn at different time intervals. We have analysed the protein hydrolysate after 30 min hydrolysis as an example of a partially hydrolyzed protein, and after 120 min as an example of greatly hydrolyzed protein. The hydrolysate (2 h treatment at 80°C and pH 7.4) from both soybean and lupin flour contained significantly decreased trypsin inhibitor activity and urease activity, and a reduced phytate content, which improved the overall protein quality. Hydrolysis caused almost complete inactivation of urease in all soybean and lupin samples regardless if the seeds were germinated or not. High protein content, nitrogen solubility and invitro protein digestibility was shown after hydrolysis. Total protein content (in g/100 g extract) increased in hydrolyzed samples from 48.1 to 51-60 for soybean (dependent on pre-treatment) and from36.8 to 39.9-48.6 for lupin. Total essential amino acid content was also increased in papain hydrolyzed samples, compared to that in raw and germinated legumes. More specifically, the amount of lysine,sulphur amino acids, histidine, and to a certain extent isoleucine and threonine increased in samples from both legume species. All soybean samples exhibited antioxidant activity while in lupin samples,only those subjected to hydrolysis showed activity. Generally, it was clearly observed that the longer the duration of enzymatic hydrolysis (within the time frame of the experiment), the higher the improvement of the nutritional qualit

Study on glucose tolerance in pregnancy as a screening test and diagnostic tool for gestational diabetes mellitus

Introduction: GDM is a common medical problem that results from an increased severity of insulin resistance as well as an impairment of compensatory increase in insulin secretion. GDM is associated with a variety of maternal and fetal complications. Controversy surrounds the ideal approach for detecting GDM, and the approaches recommended for screening and diagnosis are largely based on expert opinion. Material and Method: This study enrolled 51 pregnant women aged between 20 and 39 years old. All women were invited to do fasting and two hours postprandial blood glucose every two weeks, 2 hr. 75g OGTT every trimester. Plasma glucose measurements were performed with glucose oxidase method using semi-automated spectrophotometer (Biosystems 310). Results and Conclusion: Both normal and GDM cases have normal glucose tolerance in early weeks of pregnancy. However, after 24 weeks of gestation progressive increment of hyperglycemia was obviously observed in GDM cases. Suitable cutoffs in diagnosis of GDM in third trimester are 97 mg/dl for fasting; 174 mg/dl for 1 hour; and 141 mg/dl for 2 hour. Sudan Journal of Medical Science Vol. 1 (2) December 2006: 109-11

Transcriptomic profiling disclosed the role of DNA methylation and histone modifications in tumor-infiltrating myeloid-derived suppressor cell subsets in colorectal cancer

Increased numbers of myeloid-derived suppressor cells (MDSCs) are positively correlated with poor prognosis and reduced survivals of cancer patients. They play central roles in tumor immune evasion and tumor metastasis. However, limited data are available on phenotypic/transcriptomic characteristics of the different MDSCs subsets in cancer. These cells include immature (I-MDSCs), monocytic (M-MDSCs), and polymorphonuclear/granulocytic (PMN-MDSCs). Phenotypic characterization of myeloid subsets from 27 colorectal cancer (CRC) patients was assessed by flow cytometric analyses. RNA-sequencing of sorted I-MDSCs, PMN-MDSCs, and antigen-presenting cells (APCs) was also performed. We found that the levels of I-MDSCs and PMN-MDSCs were increased in tumor tissues (TT), compared with normal tissues (NT) in colorectal cancer. Our functional annotation analyses showed that genes associated with histone deacetylase (HDAC) activation- and DNA methylation-mediated transcriptional silencing were upregulated, and histone acetyl transferase (HAT)-related genes were downregulated in tumor-infiltrating I-MDSCs. Moreover, pathways implicated in cell trafficking and immune suppression, including Wnt, interleukin-6 (IL-6), and mitogen-activated protein kinase (MAPK) signaling, were upregulated in I-MDSCs. Notably, PMN-MDSCs showed downregulation in genes related to DNA methylation and HDAC binding. Using an ex vivo model, we found that inhibition of HDAC activation or neutralization of IL-6 in CRC tumor tissues downregulates the expression of genes associated with immunosuppression and myeloid cell chemotaxis, confirming the importance of HDAC activation and IL-6 signaling pathway in MDSC function and chemotaxis. This study provides novel insights into the epigenetic regulations and other molecular pathways in different myeloid cell subsets within the CRC tumor microenvironment (TME), giving opportunities to potential targets for therapeutic benefits

Transcriptomic profiling of tumor-infiltrating CD4 + TIM-3 + T Cells reveals their suppressive, exhausted, and metastatic characteristics in colorectal cancer patients

T cell immunoglobulin mucin-3 (TIM-3) is an immune checkpoint identified as one of the key players in regulating T-cell responses. Studies have shown that TIM-3 is upregulated in the tumor microenvironment (TME). However, the precise role of TIM-3 in colorectal cancer (CRC) TME is yet to be elucidated. We performed phenotypic and molecular characterization of TIM-3+ T cells in the TME and circulation of CRC patients by analyzing tumor tissues (TT, TILs), normal tissues (NT, NILs), and peripheral blood mononuclear cells (PBMC). TIM-3 was upregulated on both CD4+ and CD3+CD4− (CD8+) TILs. CD4+TIM-3+ TILs expressed higher levels of T regulatory cell (Tregs)-signature genes, including FoxP3 and Helios, compared with their TIM-3− counterparts. Transcriptomic and ingenuity pathway analyses showed that TIM-3 potentially activates inflammatory and tumor metastatic pathways. Moreover, NF-κB-mediated transcription factors were upregulated in CD4+TIM-3+ TILs, which could favor proliferation/invasion and induce inflammatory and T-cell exhaustion pathways. In addition, we found that CD4+TIM-3+ TILs potentially support tumor invasion and metastasis, compared with conventional CD4+CD25+ Tregs in the CRC TME. However, functional studies are warranted to support these findings. In conclusion, this study discloses some of the functional pathways of TIM-3+ TILs, which could improve their targeting in more specific therapeutic approaches in CRC patients

Inter-generational conflict and psychiatric symptoms

Secondary school pupils and their parents were investigated using the scaled version of the General Health Questionnaire (GHQ–28) and by a questionnaire designed to study attitudes involved in inter-generational conflict in psychiatric patients. Parent-pupil and interparental conflict in answers to the attitude questionnaires were taken as measures of inter-generational and intra-generational conflicts respectively. The former significantly exceeded the latter. Parent-student conflict was higher when the students involved were females, Kuwaiti, or had less educated fathers. The tendency of the number of reported GHQ symptoms to be higher in members of families with higher inter-generational conflict did not reach statistical significance. There is an apparent discrepancy between this finding and the prominence of inter-generational conflict in clinical material

Automatic quality control of cardiac MRI segmentation in large-scale population imaging

The trend towards large-scale studies including population imaging poses new challenges in terms of quality control (QC). This is a particular issue when automatic processing tools such as image segmentation methods are employed to derive quantitative measures or biomarkers for further analyses. Manual inspection and visual QC of each segmentation result is not feasible at large scale. However, it is important to be able to detect when an automatic method fails to avoid inclusion of wrong measurements into subsequent analyses which could otherwise lead to incorrect conclusions. To overcome this challenge, we explore an approach for predicting segmentation quality based on reverse classification accuracy, which enables us to discriminate between successful and failed cases. We validate this approach on a large cohort of cardiac MRI for which manual QC scores were available. Our results on 7,425 cases demonstrate the potential for fully automatic QC in the context of large-scale population imaging such as the UK Biobank Imaging Study

Deep Q-Network-Driven Catheter Segmentation in 3D US by Hybrid Constrained Semi-Supervised Learning and Dual-UNet

Catheter segmentation in 3D ultrasound is important for computer-assisted cardiac intervention. However, a large amount of labeled images are required to train a successful deep convolutional neural network (CNN) to segment the catheter, which is expensive and time-consuming. In this paper, we propose a novel catheter segmentation approach, which requests fewer annotations than the supervised learning method, but nevertheless achieves better performance. Our scheme considers a deep Q learning as the pre-localization step, which avoids voxel-level annotation and which can efficiently localize the target catheter. With the detected catheter, patch-based Dual-UNet is applied to segment the catheter in 3D volumetric data. To train the Dual-UNet with limited labeled images and leverage information of unlabeled images, we propose a novel semi-supervised scheme, which exploits unlabeled images based on hybrid constraints from predictions. Experiments show the proposed scheme achieves a higher performance than state-of-the-art semi-supervised methods, while it demonstrates that our method is able to learn from large-scale unlabeled images.Comment: Accepted by MICCAI 202

The ligational behavior of an isatinic quinolyl hydrazone towards copper(II)- ions

<p>Abstract</p> <p>Background</p> <p>The importance of the isatinic quinolyl hydrazones arises from incorporating the quinoline ring with the indole ring. Quinoline ring has therapeutic and biological activities whereas, the indole ring occurs in Jasmine flowers and Orange blossoms. As a ligand, the isatin moiety is potentially ambidentate and can coordinate the metal ions either through its lactam or lactim forms. In a previous study, the ligational behavior of a phenolic quinolyl hydrazone towards copper(II)- ions has been studied. As continuation of our interest, the present study is planned to check the ligational behavior of an isatinic quinolyl hydrazone.</p> <p>Results</p> <p>New homo- and heteroleptic copper(II)- complexes were obtained from the reaction of an isatinic quinolyl hydrazone (HL) with several copper(II)- salts <it>viz. </it>Clˉ, Brˉ, NO₃ˉ, ClO₄^-, SO₄^2-and AcO^-. The obtained complexes have O_h, T_dand D_4h- symmetry and fulfill the strong coordinating ability of Clˉ, Brˉ, NO₃ˉ and SO₄^2-anions. Depending on the type of the anion, the ligand coordinates the copper(II)- ions either through its lactam (NO₃ˉ and ClO₄^-) or lactim (the others) forms.</p> <p>Conclusion</p> <p>The effect of anion for the same metal ion is obvious from either the geometry of the isolated complexes (O_h, T_dand D_4h) or the various modes of bonding. Also, the obtained complexes fulfill the strong coordinating ability of Clˉ, Brˉ, NO₃ˉ and SO₄^2-anions in consistency with the donor ability of the anions. In case of copper(II)- acetate, a unique homoleptic complex (<b>5</b>) was obtained in which the AcO^-anion acts as a base enough to quantitatively deprotonate the hydrazone. The isatinic hydrazone uses its lactim form in most complexes.</p

Transcriptome of tumor-Infiltrating T cells in colorectal cancer patients uncovered a unique gene signature in CD4 + T cells associated with poor disease-specific survival

Colorectal cancer (CRC) is influenced by infiltration of immune cell populations in the tumor microenvironment. While elevated levels of cytotoxic T cells are associated with improved prognosis, limited studies have reported associations between CD4+ T cells and disease outcomes. We recently performed transcriptomic profiling and comparative analyses of sorted CD4+ and CD8+ tumor-infiltrating lymphocytes (TILs) from bulk tumors of CRC patients with varying disease stages. In this study, we compared the transcriptomes of CD4+ with CD8+ TILs. Functional annotation pathway analyses revealed the downregulation of inflammatory response-related genes, while T cell activation and angiogenesis-related genes were upregulated in CD4+ TILs. The top 200 deregulated genes in CD4+ TILs were aligned with the cancer genome atlas (TCGA) CRC dataset to identify a unique gene signature associated with poor prognosis. Moreover, 69 upregulated and 20 downregulated genes showed similar trends of up/downregulation in the TCGA dataset and were used to calculate “poor prognosis score” (ppScore), which was significantly associated with disease-specific survival. High ppScore patients showed lower expression of Treg-, Th1-, and Th17-related genes, and higher expression of Th2-related genes. Our data highlight the significance of T cells within the TME and identify a unique candidate prognostic gene signature for CD4+ TILs in CRC patients