Solitary Rectal Ulcer Syndrome in Children: A Case Series Study.

Information on solitary rectal ulcer syndrome (SRUS) in children is limited and based on case reports only. This study was undertaken with the objective of describing the clinical history, symptoms, diagnostic work-up, and treatment of a large case series of pediatric patients with SRUS. The study was multi-center and retrospective. All pediatric endoscopists in Poland were invited to participate in the study and were asked to look through their endoscopic databases to identify SRUS cases from the last 10 years. The charts of SRUS patients were reviewed with respect to demographic data, and endoscopic and histological findings. Additionally, treatment methods and outcomes were assessed. In total, 31 patients (18 males, mean age of 13 years, range 5-18 years) were included in the study. All patients reported rectal bleeding. Other common symptoms included: abdominal pain (64.5%), perianal pain (54.8%), and passage of mucus (51.6%). The diagnostic work-up lasted from 1 to 48 months. Colonoscopic findings revealed rectal ulceration in 96.8% of patients. Therapeutic approaches included: high fiber diet (64.5%), laxatives (54.8%), topical corticosteroids (63.3%), 5-aminosalicylates administered orally and topically (29.1% and 96.8%, respectively), sucralfate (9.7%), and a biofeedback training (6.6%). Endoscopic argon plasma coagulation was performed in 2 patients and surgical intervention was necessary in 4 of them. Treatment was unsuccessful in 36% of patients. The findings of this study indicate that SRUS is rare in pediatric population, its diagnosis may be considerably delayed, and the treatment applied is often ineffective.

Prevalence of Helicobacter pylori infection in pediatric celiac disease.

OBJECTIVE: A lower risk of celiac disease (CD) in patients with Helicobacter pylori (Hp) infection has been reported when Hp infection prevalence in CD patients was compared against CD-negative symptomatic persons with indications for diagnostic gastroduodenoscopy. Therefore, we aimed to determine Hp infection frequency in a group of pediatric CD patients at diagnosis and to compare obtained results to data coming from age-matched healthy population. PATIENTS AND METHODS: The study population consisted of 74 CD subjects aged 3 to 12 years in whom the presence of Hp was diagnosed routinely in the course of differential diagnosis with the use of stable isotope breath test which is the gold standard. The control group consisted of 296 healthy age-matched subjects. RESULTS: Hp infection was diagnosed in 4 CD patients and 20 healthy subjects. Its prevalence in CD patients and HS did not differ neither in the entire age group undergoing comparison (5.4% vs. 6.8%, p = 0.5713) nor in the selected age subgroups (3-6 years: 2.5% vs. 3.7%, p = 0.8551; 7-12 years: 8.8% vs. 11.0%, p = 0.8742). CONCLUSIONS: The prevalence of Hp infection in CD patients does not seem to be different than that in general population. However, further studies are needed to assess the potential role of Hp in the pathogenesis of CD.

Teratoma formation of human embryonic stem cells in three-dimensional perfusion culture bioreactors.

Teratoma formation in mice is today the most stringent test for pluripotency that is available for human pluripotent cells, as chimera formation and tetraploid complementation cannot be performed with human cells. The teratoma assay could also be applied for assessing the safety of human pluripotent cell-derived cell populations intended for therapeutic applications. In our study we examined the spontaneous differentiation behaviour of human embryonic stem cells (hESCs) in a perfused 3D multi-compartment bioreactor system and compared it with differentiation of hESCs and human induced pluripotent cells (hiPSCs) cultured in vitro as embryoid bodies and in vivo in an experimental mouse model of teratoma formation. Results from biochemical, histological/immunohistological and ultrastuctural analyses revealed that hESCs cultured in bioreactors formed tissue-like structures containing derivatives of all three germ layers. Comparison with embryoid bodies and the teratomas revealed a high degree of similarity of the tissues formed in the bioreactor to these in the teratomas at the histological as well as transcriptional level, as detected by comparative whole-genome RNA expression profiling. The 3D culture system represents a novel in vitro model that permits stable long-term cultivation, spontaneous multi-lineage differentiation and tissue formation of pluripotent cells that is comparable to in vivo differentiation. Such a model is of interest, e.g. for the development of novel cell differentiation strategies. In addition, the 3D in vitro model could be used for teratoma studies and pluripotency assays in a fully defined, controlled environment, alternatively to in vivo mouse models.

Quantitative real-time PCR-based analysis of gene expression.

Quantitative real-time polymerase chain reaction (QRT-PCR) has become an extensively applied technique. It enables quantitative analyses of gene expression applicable to basic molecular biology, medicine, and diagnostics. Nowadays, it is broadly used to describe messenger RNA (mRNA) expression patterns and to compare the relative levels of mRNA within distinct biological samples. The scope of the QRT-PCR technique makes it applicable across a wide range of experimental conditions and allows experimental comparison between normal and abnormal tissue. Most importantly, this technique enables additional independent confirmation of microarray or next generation sequencing (NGS)-based results. An inherent advantage of QRT-PCR is the large dynamic range, remarkable sensitivity, and sequence-specificity. We provide a detailed step by step guide to the principles underlying a successful QRT-PCR experiment.

Antibody response to influenza vaccination in patients suffering from asthma.

The aim of the study was to assess humoral response to influenza vaccination in 20 children with bronchial asthma vaccinated with split inactivated vaccine. Response to influenza hemagglutinin was assessed before vaccination and after 1 month by hemagglutination inhibition test. Antibody titers were significantly higher after vaccination than before vaccination. The mean fold increase of antibody levels ranged after vaccination from 12.2 to 53.7. The post-vaccination percentage of patients with protective antihemagglutinin antibody titers>or=40 ranged from 95% to 100%. The percentage of patients with at least a 4-fold increase of anthemagglutinin antibody titers ranged after vaccination from 90% to 100%. The results confirmed the immunogenicity and safety of inactivated influenza vaccine in children with asthma. The registered values of all parameters of the immunological response (mean fold increase, protection rate, response rate) fulfilled the requirements of the Committee for Proprietary Medicinal Products established for healthy people vaccinated against influenza.