Effect of pentoxifylline on cell adhesion molecules and extracellular matrix in chronic venous ulcer: a reappraisal of pathogenic mechanism

The pathogenesis of venous ulceration is unknown. It has been early proposed that the pathogenesis of venous ulceration involves formation of pericapillary fibrin cuffs. More recent hypothesis suggests that macromolecules leaking into dermis may bind or trap growth factors. The role of leukocyte and its adherece to endothelial cells by adhesion molecules in damaged tissue of venous diseas has been considered. The purpose of this study was to evaluate the role of pharmacotherapy as pentoxifylline in treatment of non complicated chronic venous ulcer. This was performed through immunohistochemical staining of tissue distribution of fibronectin [FN], transforming growth factor beta-1 [TGF beta 1] and ICAM-1 in damaged skin of 19 patients. Also, plasma level of soluble L-selectin was measured. All these parameters were estimated before and after pentoifylline administration and external compression bandage for 3 months. The results of this study demonstrated that pentoxifylline administration was associated with significant clinical improvement of the uicerative area and induced decrease of 1C AM-1 expression in skin. There were changes of TGF beta1 and fibronectin [FN] distribution from non-healed to the healed ulcer. Also there was significant rise in plasma level SL-selectin [p > 0.001] which decreased after clinical improvement. It could be concluded that the accumulation of activated leukocyte is the key event in venous leg ulcer and TGF beta1 in extracellular matrix is critical in wound healingThe pathogenesis of venous ulceration is unknown. It has been early proposed that the pathogenesis of venous ulceration involves formation of pericapillary fibrin cuffs. More recent hypothesis suggests that macromolecules leaking into dermis may bind or trap growth factors. The role of leukocyte and its adherece to endothelial cells by adhesion molecules in damaged tissue of venous diseas has been considered. The purpose of this study was to evaluate the role of pharmacotherapy as pentoxifylline in treatment of non complicated chronic venous ulcer. This was performed through immunohistochemical staining of tissue distribution of fibronectin [FN], transforming growth factor beta-1 [TGF beta 1] and ICAM-1 in damaged skin of 19 patients. Also, plasma level of soluble L-selectin was measured. All these parameters were estimated before and after pentoifylline administration and external compression bandage for 3 months

Initial experience with lymphatic mapping for breast cancer

Sentinel node detection enables the definition of the most relevant draining lymph nodes of a tumor. The goal of this study was to evaluate technical feasibility of sentinel node detection in breast cancer and its predictivity of axillary node status. Twenty patients with early breast carcinoma were included in this study. Modified radical mastectomy was done for all patients. Lymphatic mapping procedures were performed by injection of patent blue dye in the peripheral portion of the tumor preoperatively .Sentinel lymph nodes were successfully identified in 17 of the 20 cases [85%] In the final histological examination, 15 [88.2%] of the 17 patients where sentinel nodes were identified, were histologically positive. The sentinel node was falsely negative in one case, yielding an accuracy of 94.1%. Sentinel node was the only site of metastases in 3 [20%] of 15 cases. Lymphatic mapping technique proved feasible, successful and the histology of the sentinel node can accurately predict the status of the remaining axillary lymph nodes

Repair of common bile duct defects with stented autologus vein graft: an experiemental study

This experimental study was done to investigate the effectiveness of using an autologus vein graft and stent in the repair of large defects of the common bile duct [CBD] in a canine model. A 3-cm segment of the great saphenous vein and a 2 - cm segment of the [CBD] were removed from five healthy dogs with normal blood biochemistry levels. A stent was passed through the vein segment, and one end was introduced into the proximal end of the [CBD] while the other end was introduced into the distal end. The venous graft was then sutured to the [CBD]. A liver biopsy was taken for histopathological examination during laparotomy and relaparotomy. Blood samples were obtained on postoperative days 7,14 and 20 for biochemical examinations. The defect was effectively repaired by the autologus vein graft and stent in all the five dogs. No change in blood biochemistry was observed postoperatively, and no histopathological change in the liver was found in the preoperative or postoperative periods. These findings indicate that the use of an autologus vein graft and stent to repair [CBD] injuries could be a feasible and an alternative method of treatment