Systemic versus local injection of bone marrow mesenchymal stem cells on 5-fluorouracil treated parotid glands of albino rats / Injeção sistêmica e local de células tronco da medula óssea em glandula parotida de ratos albinos tratados com 5-Fluorouracil

Objective: Head and neck cancer is the sixth leading cancer by incidence worldwide and eighth by death. Recent reports revealed that, not only radiotherapy but also chemotherapy may induce xerostomia. The aim of this study was to compare the possible regenerative effect of BMSCs through systemic and local injections. Material and Methods: 52 male Albino rats were randomly divided into 4 groups: Group 1: 10 rats received 0.5 ml of PBS by injection. Group 2: 14 rats received an intraperitoneal injection of 5-FU drug. Group 3: 14 rats were injected the same dose of 5-FU then received an intraglandular transplantation of BMSCs suspended in 0.5 ml of PBS at day 1 after 5-FU administration. Group 4: 14 rats were injected the same dose of 5-FU then received an intravenous injection of BMSCs suspended in 0.5 ml of PBS via the tail vein at day 1 after 5-FU administration. Results: Histological examination showed that group 2 showed features of severe degenerative changes which increased over time. Group 3 showed increasing amelioration in the ductal structure overtime. Group 4 also showed regenerated ductal elements however concerning apoptotic changes, immunohistochemistry results revealed improvement in both group 3 and 4 over group 2 with no statistical difference between groups 3 and 4. Conclusion: Histological and immunohistochemical features in group 3 and group 4 revealed similar amelioration in regenerative potentials. On the other hand, regenerative features of both experimental groups were statistically significant as compared independently to group 1 (AU)

Objetivo: O carcinoma de cabeça e pescoço é o sexto câncer de maior incidência no mundo sendo a oitava causa de morte por cancer. Relatos recentes revelaram que não apenas a radioterapia, mas também a quimioterapia podem induzir xerostomia. O objetivo desse estudo foi comparar a possivel ação regenerative de BMSCs através de injeção local e sistêmica. Material e Métodos: 52 ratos Albino foram aleatoriamente alocados em 4 grupos: Grupo 1: 10 ratos que receberam 0.5 ml de injeção de PBS. Grupo 2: 14 ratos que receberam injeção intraperitoneal da droga 5-FU. Grupo 3: 14 ratos que foram injetados com a mesma dose de 5-FU e receberam transplante intraglandular de BMSCs ressuspendidas em 0.5mL de PBS no dia 1 após a administração do 5-FU. Grupo 4: 14 ratos que foram injetados com a mesma dose de 5-FU e receberam injeção intravenosa de BMSCs ressuspendidas em 0.5mL de PBS via veia caudal 1 dia após a administração de 5-FU. Resultados: O exame histológico demonstrou que o grupo 2 apresentou alterações degenerativas severas que se agravaram com o tempo. O Grupo 3 mostrou melhora da estrutura ductal ao longo do experimento. Group 4 também mostrou elementos ductais regenerados. Referente a alterações apoptóticas,análise imunohistoquimica mostrou melhora nos grupos 3 e 4 comparados ao grupo 2, sendo que os grupos 3 e 4 foram estatisticamente semelhantes. Conclusão: Análises histológicas e imunohistoquímicas mostram que os grupos 3 e 4 apresentam melhora no potencial regenerativo Por outro lado, os resultados observados para os dois grupos foi estatisticamente semlhante quando comparados independentemente ao grupo 1 (AU)

Detection of occult HBV infection by nested PCR assay among chronic hepatitis C patients with and without hepatocellular carcinoma

Occult hepatitis B virus infection [OBI] has been reported among patients with chronic hepatitis C virus [HCV] infection and hepatocellular carcinoma [HCC]. This study aimed to evaluate the prevalence of OBI in chronic hepatitis C patients with and without hepatocellular carcinoma. A total of 40 chronic hepatitis C patients who were negative for HBsAg, were enrolled into the study. They were classified into two groups: Group I which included 20 patients with chronic hepatitis C only whereas Group II included 20 patients with chronic hepatitis C and HCC. Detection of HBV DNA was done by nested-PCR using two sets of primers specific for surface and X viral genomes in serum and liver tissue of patients. Genotyping system based on PCR using type-specific primers was done for HBV-DNA positive intrahepatic samples. OBI was detected in the liver tissue in 23/40 [57.5%] of chronic HCV infected patients, 18 [78.3%] of whom belonged to group II, conferring a 90% prevalence of this group. In serum, HBV-DNA was detected in 9/40 patients [22.5%], 7 [77.8%] of whom belonged to group II. Among the 23 positive intrahepatic HBV-DNA samples studied, HBV-genotype D [34.8%] and B [26.1%] were more predominant, whereas HBV-genotype C [13.1%] and A [8.7%] infections were the least observed, respectively; mixed genotypes were detected in 17.4% [n = 4], 3 of them were with HBV-genotype D and B, and 1 was with HBV-genotype C and A. In conclusion OBI is a fact in our community; it was detected in liver tissue of chronic HCV-infected patients, especially in cases of chronic HCC. In addition, OBI might be related to severity of necroinflammatory activity and fibrosis. Large studies are needed to confirm that co-infection could determine a worse progress of chronic liver disease in this population. Also, detection of intrahepatic HBV-DNA is more useful in diagnosis of OBI

Fiberoptic thoracoscopy in management of exudative pleural effusion

Exudative pleural effusion represents a common diagnostic task to the clinician. The two commonest causes of exudative pleural effusion are parapneumonic followed by malignant ones. However, obtaining a definite diagnosis is essential for proper management of the effusion. The aim of this work was to evaluate the role of the fiberoptic bronchoscope used as a thoracoscope in management of exudative pleural effusion. Eighty-four patients with exudative pleural effusion of undetermined etiology were enrolled in this study. All patients were subjected to full history taking, thorough clinical examination, pleural fluid aspiration and analysis, computed tomography of the chest and ultrasound examination of the pleural cavity. Under conscious sedation and local anaesthesia, fiberoptic thoracoscopy was then carried out using fiberoptic bronchoscope inserted through a rigid large siliconized chest tube. After drainage of the pleural fluid, the pleural cavity was carefully explored and multiple forceps biopsies were taken and sent for histopathological examination. Pleurodesis was then done using iodopovidone in patients with apparent pleural pathology. After lung expansion and pleural fluid drainage of less than 100 cc/day, the chest tube was removed. Successful histopathological diagnosis was achieved in all patients. It revealed that 63 [75%] cases had malignant pathology and 21 [25%] cases had inflammatory pathology. The malignant pathology was caused by: bronchogenic carcinoma in 28 [33.3%] cases, malignant mesothelioma in 2 [2.38%] cases and metastatic malignant deposits from other organs in 33 [39.28%] cases. The inflammatory pathology was tuberculosis in 16 [19%] cases and non-specific pleurisy in 5 [5.95%] cases. Pleurodesis was performed and was successful in all the patients. Two [2.38%] patients developed empyema after the procedure and they were successfully managed by intercostals tube drainage and anitibiotic therapy. Other complications encountered included local wound infection in 3 [3.57%] cases, subcutaneous emphysema in 3 [3.57%] cases and chest pain following pleurodesis in 15 [17.85%] cases. Thoracoscopy using the fibroptic bronchoscope is safe and effective. It is an alternative technique to rigid thoracoscopy with some advantages as it allows better exploration of the pleura. It is equally as efficient as the rigid thoracoscope and hardly more time consuming. With proper handling, there will not be any damage or abuse of the fibroptic bronchoscope