Effect of fibrin packing on managing hepatic hemorrhage and liver wound healing in a model of liver stab wound in rat

To evaluate the effect of fibrin perihepatic packing on controlling liver hemorrhage and liver wound healing

Methods: In this animal experimental study, 20 adult male Sprague Dawley rats, weighing 200-220 g, were included. Stab wound injury was created by number 15 scalpel, so that bilateral liver capsules and liver tissue were cut, and acute bleeding was accrued. The animals were divided into 2 study groups: control [with a primary gauze packing treatment] and test group [with fibrin packing treatment]. Serum alanine aminotransferase [ALT], aspartate aminotransferase [AST], and total serum bilirubin [TSB] levels were measured as a liver function test during the treatment period. Blood loss was calculated for estimation of hepatic hemorrhage during surgery. After four weeks, the liver wound repair was evaluated by sampling and Hematoxylin and Eosin staining [Hand E]

Results: In the test group, all of animals were alive [mortality rate=0%]. Significantly, ALT and AST levels were raised after surgery, followed by a decrease ALT [p=0.783] and AST [p=0.947] to the normal level during 4 days. Estimated blood loss was 2.89 +/- 0.73 mL [about 19.65% of estimated blood volume]. Hematocrit levels returned to the normal level [p=0.109] after 48 hours. In the control group, the mortality rate was 50% during 12h after surgery. ALT [p=0.773] and AST [p=0.853] were decreased to normal level during 6 days, and estimated blood loss was 4.98+/-0.77 mL [about 32.98% of estimated blood volume] in the remaining animals. Moreover, hematocrit levels returned to the normal level [p=0.432] after 72 hours. Estimated blood loss in the test group was significantly less than control group [p<0.001]. Total serum bilirubin levels were not significantly different from the normal level, before and after surgery in both groups. Histopathology sections from the post-hepatectomy specimens showed that the site of the previous incision was completely repaired, and a dense fibrous septum was observed in both groups

Conclusion: The fibrin dressing was effective in preventing blood loss and saving lives after a liver stab injury and major internal bleeding in the animal model of rat

Association of ABCB1 [C3435T] and ABCC1 [G2012T] polymorphisms with clinical response to atorvastatin in Iranian patients with primary hyperlipidemia

Background: Atorvastatin is prescribed for the primary and the secondary prevention of coronary artery diseases. A wide variation in inter-individual statin response suggests that genetic differences may contribute to this variation. This study investigated the association of ABCB1 [C3435T] and ABCC1 [G2012T] polymorphisms with clinical response to atorvastatin in Iranian primary hyperlipidemic patients

Methods: Individuals [n=179] with primary hypercholesterolemia were enrolled, and peripheral blood samples were collected. Genotyping of two polymorphisms were performed by amplification refractory mutation system PCR

Results: Following four weeks of treatment, a significant reduction of LDL-C was observed in variant groups [CT+TT] of ABCB1 [P=0.018] and wild-type group [GG] of ABCC1 genes [P=0.029]. Logistic regression analysis revealed a significant difference between male and female responses to 10 mg/day atorvastatin [P=0.004, odds ratio=0.2, CI 95%=0.06-0.6]

Conclusion: Our finding indicated that these polymorphisms may be attributed to LDL-C serum levels in the primary hypercholesterolemia patients receiving atorvastatin

Grafting with cryopreserved amniotic membrane versus conservative wound care in treatment of pressure ulcers: a randomized clinical trial

Objective: to compare the healing process of pressure ulcers treated with cryopreserved human amniotic membrane allograft and routine pressure ulcer care in our hospital

Methods: from January 2012 to December 2013, in a prospective randomized clinical trial [IRCT201612041335N2], 24 patients with second and third stage of pressure ulcers were enrolled in this study. All patients needed split thickness skin grafts for pressure ulcer-wound coverage. Selected patients had symmetric ulcers on both upper and lower extremities. The patients were randomly divided into two groups: amnion and control. In the amnion group, the ulcer was covered with cryopreserved amniotic membrane and in the control group it was treated with local Dilantin powder application. The duration and success rate of complete healing was compared between the two groups

Results: the study group was composed of 24 pressure ulcers in 24 patients [19 males and 5 females] with a mean age of 44+/-12.70 years. The demographic characteristics, ulcer area, and underlying diseases were similar in both groups. The early sign of response, such as decrease in wound discharge, was detected 12-14 days after biological dressing. Complete pressure ulcer healing occurred only in the amnion group [p<0.001]. Partial healing was significantly higher in the amnion group [p<0.03]. Healing time in this group was faster than that the control group [20 days versus 54 days]. No major complication was recorded with amniotic membrane dressing

Conclusion: cryopreserved amniotic membrane is an effective biologic dressing that promotes reepithelialization in pressure ulcers

PAX-5 positive anaplastic large cell lymphoma presenting by dysphagia; a case report

Anaplastic large cell lymphoma [ALCL] is a distinct pathologic entity with characteristic morphologic, im-munophenotypic and cytogenetic features. Obstructive symptoms are rare presentation of ALCL. We report a 16-year-old boy who initially presented with dysphagia. Upper gastrointestinal endoscopy revealed severe stenosis with an infiltrative process starting from 24 cm of incisors in lower esophagus Esophageal mucosal biopsy demonstrated lymphomatous involvement that ancillary tests confirmed the diagnosis of ALCL, ALK [kinase-positive], and PAX5 positive. The patient responded to CHOP-based chemotherapy. This case illustrated an unusual presentation of primary Non Hodgkin lymphoma of esophagus

Prevalence of human papilloma virus in sinonasal papilloma in southern Iranian population

Statement of the Problem: Sinonasal papilloma [SNP] is a rare benign lesion characterized by high recurrence rate and malignant transformation

Purpose: This study aimed to investigate the prevalence of human papilloma virus [HPV] infection in these lesions in South of Iran

Materials and Method: In this cross sectional retrospective study, a total of 41 patients, 38 SNP and 3 SNP/Squamous cell carcinoma cases, from 2007 to 2014 were studied. Human papilloma virus [HPV] DNA detection was performed by nested PCR method and positive cases were analyzed for high risk HPV-16 and HPV-18

Results: HPV was detected in 31.7%; HPV- 16 in 4.9% and HPV 18 was not detected at all. Dysplastic epithelium was detected in 53% that was not associated with HPV. Three cases were accompanied with malignant transformation that HPV genome was detected in only one case and none of them were positive for HPV16 /18 genomic DNA

Conclusion: Current research suggests that HPV may be involved in the development of SNP. But the high risk HPV is not important in malignant transformation. More studies are needed to elucidate the possible etiologic mechanism between HPV, inverted papilloma, and squamous cell carcinoma

Insight into Microenvironment Remodeling in Pancreatic Endocrine Tissue Engineering: Biological and Biomaterial Approaches

The treatment of diabetes mellitus, as a chronic and complicated disease, is a valuable purpose. Islet transplantation can provide metabolic stability and insulin independence in type 1 diabetes patients. Diet and insulin therapy are only diabetes controllers and cannot remove all of the diabetes complications. Moreover, islet transplantation is more promising treatment than whole pancreas transplantation because of lesser invasive surgical procedure and morbidity and mortality. According to the importance of extracellular matrix for islet viability and function, microenvironment remodeling of pancreatic endocrine tissue can lead to more success in diabetes treatment by pancreatic islets. Production of bioengineered pancreas and remodeling of pancreas extracellular matrix provide essential microenvironment for re-vascularization, re-innervation and signaling cascades triggering. Therefore, islets show better viability and function in these conditions. Researchers conduct various scaffolds with different biomaterials for the improvement of islet viability, function and transplantation outcome. The attention to normal pancreas anatomy, embryology and histology is critical to understand the pancreatic Langerhans islets niche and finally to achieve efficient engineered structure. Therefore, in the present study, the status and components of the islets niche is mentioned and fundamental issues related to the tissue engineering of this structure is considered. The purpose of this review article is summarization of recent progress in the endocrine pancreas tissue engineering and biomaterials and biological aspects of it.

Elastofibroma of the face: a case report

Elastofibroma is a rare neoplasm that characteristically occurs in subscapular area in response to microtrauma. There are some reports of this tumor in other sites of the body but, up till now, there has been no report of elastofibroma in the face. A 20-year-old man presented with a slow growing painless mass in the face without any history of trauma. Histopathologic examination revealed a soft tissue mass composed of eosinophilic fibers admixed with aggregation of fat cells, capillary blood vessels, and fibroblasts. Elastic stain and Masson's trichrome stain confirmed the nature of elastic and collagen fibers. It was a case of elastofibroma in the face

Assessment of different permeabilization methods of minimizing damage to the adherent cells for detection of intracellular RNA by flow cytometry

Various fixation and permeabilization techniques have been developed for detection of intracellular antigens by flow cytometry; however, there are few studies using flow cytometry to detect the frequency of intracellular nucleic acids, particularly RNA. We tested six different permeabilization methods in order to gain access to a high quality method with minimal damage to intracellular components focusing on 18S rRNA in HeLa cells. HeLa cells were fixed in 2% paraformaldehyde. A variety of detergents and enzymes including saponin, TritonX-100, Tween-20, NP40, Proteinase K, and streptolysin O were used to optimize a protocol of permeabilization for the flow cytometric enumeration of intracellular 18S rRNA. Treated cells were subjected to standard protocol of flow cytometric in situ hybridization in the presence of FITC-labeled sense and antisense probes to detect 18S ribosomal RNAs. Samples were then analyzed on a FACSCalibur flow cytometer. To evaluate cell morphology, following hybridization the cells were fixed on glass slide, covered with DAPI, and evaluated on a fluorescent microscope with appropriate filter sets. In comparison with other methods, maximum cell frequency in percentage and fluorescent intensity [M1=2.1%, M2=97.9%] were obtained when the cells were treated with 0.2% Tween-20 and incubated for 30 min [p=0.001]. Our study indicated that the highest levels of mean fluorescence could be obtained when the cells were treated with Tween-20. However, it should be taken into consideration that for a successful flow cytometric result, other interfering factors such as hybridization conditions should also be optimized

Interleukin-17 gene expression and serum levels in acute rejected and non-rejected liver transplant patients

Interleukin-17 [IL-17], as a potent proinflammatory cytokine, has a critical role in post liver transplant outcomes. However, there is not much information about the effects of IL-17 cytokine on acute liver rejection. To evaluate the role of IL-17 in post-liver transplant acute rejection. Ninety seven adult liver transplant patients who enrolled in this cross sectional study were divided into Non- Acute Rejected [Non-AR] and Acute Rejected [AR] patient groups. Three blood samples were collected from each patient in days 1, 4 and 7 post liver transplantation. The IL-17 mRNA levels were evaluated using an in-house real time PCR protocol. IL- 17 protein levels were also analyzed in Non-AR, AR and also control groups using ELISA method. The IL-17 mRNA expression level continuously increased in AR patients in all days of follow-up post liver transplantation. IL-17 expression was, however, down regulated after day 4 post-transplant follow-up in Non-AR patients. Both IL-17 mRNA expression and protein levels were also significantly increased in AR patients compared with Non-AR ones. Based on these findings, significant increase of IL-17 mRNA and protein levels in AR patients highlights the important role of IL-17 in acute liver rejection

Isolation and characterization of human mesenchymal stromal cells derived from placental decidua basalis; umbilical cord wharton's jelly and amniotic membrane

Objective: Mesenchymal stromal cells [MSCs] are considered as an excellent source in regenerative medicine, but availability and ethical problems limited their routine use. Therefore, another available source with easy procedure and exempt from ethical debate is important. The purpose of this study is to isolate and characterize the MSCs from human placenta

The stromal cells were isolated from Placental Decidua Basalis [PDB-MSC], Umbilical cord Wharton's Jelly [WJ-MSC] and Amniotic Membrane [AM-MSC]

Methods: Full term human placentas [n=4], from cesarean section delivery were collected. Small fragments from different parts were cultures as explants

The immunophenotyping, mesodermal differentiation, growth kinetics and sternness gene expression was studied

Results: The cultivated cells from three sources expressed CD44, CD105, and CD90. Gene expression of NANOG and OCT4 confirmed the undifferentiated state. The doubling-times for WJ-MSCs, PLC-MSCs and AM-MSCs, respectively, were 21+/-8h, 28+/-9h and 25+/-9h at passage three and 30+/-5h, 45+/-7h and 45+/-7h at passage tenth

The proliferative potential of WJ-MSCs tended to be higher than the other two sources

Conclusion: The fetal derives stromal cells; especially the early passages of WJ-MSCs are available supplies for large scale production of MSC for using in clinical studies or research projects

Anaplastic solitary plasmacytoma of mandible, masquerading as sarcoma

Plasma cell neoplasm is characterized by a monoclonal neoplastic proliferation of plasma cells and solitary plasmocytoma of bone [SPB] is a localized form. It usually occurs in vertebrae and secondarily in long bones. Its presence in mandible is extremely rare event. A 48-year-old man consulted to our clinic with a chief complaint of pain in his mandible. Radiography revealed a destructive lesion in body and ramus. The initial pathologic evaluation revealed a high grade pleomorphic neoplasm. The diagnosis was confirmed by immunohistochemical markers. Overall, plasmacytoma with anaplastic features can be confused with high grade sarcoma clinically and histologically

Comparison of cytotoxic activity of bile on HepG2 and CCRF-CEM Cell lines: an in vitro study

The aim of this study was to examine the effect of crude bile on the human HepG2 and CCRF-CEM cell lines. Cells were exposed to different dilutions of bile. Antiproliferative effects were determined by the cytotoxic MTT assay. Cells undergoing apoptosis were identified by terminal deoxynucleotidyl transferase dUTP nick end labeling [TUNEL] assay. Bile administration resulted in dose-dependent cytotoxicity in both HepG2 and CCRF-CEM cell lines. Incubated cells exhibited morphologic features of apoptosis. Bile has significant cytotoxic activity in HepG2 and CCRF-CEM cancer cells via induction of apoptosis. The mechanism of apoptosis needs to be further evaluated. It may have clinical utility in the treatment of cancer after in vivo confirmation of activity

Chronic morphine consumption increase allograft rejection rate in rat through inflammatory reactions

Although opioids suppressive effects on immune system function have been reported, this study demonstrates inflammatory reactions, such as production of pro-inflammatory cytokines and suppression of anti-inflammatory cytokines, are the main causes at organ's allotransplantation rejection in chronic morphine-treated recipients. 28 rats were categorized in 4groups through intra-peritoneal administrations: control, sham, morphine treated animals [20 mg/kg injected of morphine daily until biopsy day], morphine and naloxane treated animals [20 mg/kg morphine and 2 mg/kg naloxane daily injected until biopsy day], which their donors were normal rats. The grafts were done at the 14[th] day of the experiment. Plasma interleukins levels [IL-6 and IL-10] in three sampling times were mwasured by ELISA, with almost 80% of macroscopic rejection signs in rats of one group, full thickness skin biopsy has been taken and histological parameters like perivascular infiltrates, epidermal changes, and stromal changes were detected. The statistical significance differences between the control and experimental groups were analyzed using the Kruskal-Wallis, followed by ANOVA post hoc test. Accelerated skin allograft rejection by chronic morphine consumption can be resulted of increased IL-6 concentration and decreased IL-10. The enhancing effects of morphine on the graft inflammation were partially antagonized by naloxane. It can illustrate the complexity of opiates and immune system connections and should be considered during organ transplantation of opiate addicts. Expression of skin cell in recipient with chronic morphine administration history maybe resulted in failure

healing effects of Teucrium polium in the repair of indomethacin-induced gastric ulcer in rats

To determine the healing effect of Teucrium polium [T. polium] in indomethacin-induced gastric ulcer in rats. In the fall of 2007, 250 Sprague-Dawley rats provided by the Shiraz University Laboratory Animal Center were divided into 4 equal groups including control [70 rats], and 3 experimental groups [60 rats each], and each group received different doses of T. polium. Ten rats were used to study the induction of gastric ulcer by indomethacin [25 mg/kg/stat]. After 24 hours, their stomachs were evaluated for any mucosal ulcer. The T. polium extract was administered orally, 24 hours after indomethacin administration. In the experimental group, 10 animals were sacrificed after 24, 48, and 72 hours, after administration of T. polium, and at one, 2, and 4 weeks, and in the control group identically after the administration of distilled water. In rats treated with indomethacin, multiple ulcers were evident. After 4 weeks of treatment with T. polium, more re-epithelialization, proliferation, mucosal hyperplasia, migration of the gastric epithelial cells, and decrease in inflammatory cells were observed. The T. polium reduced the ulcer indices by >50% after one week, >80% after 2 weeks, and >90% after 4 weeks. The healing effect of T. polium may be due to antioxidant activity along with the ability to modulate the mucin secretion, prostaglandin synthesis, and epidermal growth factor receptor expression. These results along with the non-toxicity properties of T. polium suggests it as a promising anti-ulcer compound

Effect of lycopene on cyclophosphamide-induced hemorrhagic cystitis in rats

Cylophosphamide is used alone or in combination with other drugs for treatment of neoplastic diseases. Hemorrhagic cystitis is a major potential toxicity and dose limiting side effect of cyclophosphamide. The aim of this study was to evaluate the effects of lycopene compared with some antioxidants for the prevention of cyclophosphamide induced hemorrhagic cystitis in rats. In this study, male Sparague-Dawley rats divided into 17 groups of six animals. Group 1 received saline [10 ml/kg, i.p] as normal control, group 2 received cyclophosphamide [200 mg/kg, i.p] as a single dose, groups 3-10 received Mesna [40 mg/kg, i.p], N-acetylcysteine [100 mg/kg i.p], dithiotheritol [50 mg/kg, i.p], L-carnitine [200 and 400 mg/kg, i.p], grape seed extract [500 mg/kg i.p] and lycopene [0.1 and 0.5 mg/kg, i.p] alone. Groups 11-17 received Mesna [40 mg/kg, i.p], N-acetylcysteine [100 mg/kg, i.p], dithiotheritol [50 mg/kg, i.p], L-carnitine [400 mg/kg, i.p], grape seed extract [500 mg/kg, i.p] and lycopene [0.1 and 0.5 mg/kg, i.p], 5 minutes before, and 2 and 6 hours after administration of 200 mg/kg cyclophosphamide. Pathological and biochemical analysis was evaluated 24 hours after cyclophosphamide administration Mesna and N-acetylcysteine resulted in some but not full protection against cyclophosphamide toxicity compared to the controls. Lycopene [0.1 and 0.5 mg/kg] was efficient in protecting the bladder from cyclophosphamide induced hemorrhagic cystitis. However, dithiotheritol, L- carnitine and grape seed extract did not prevent hemorrhagic cystitis. Our results suggest that pre and co- treatment of lycopene [0.1 and 0.5 mg/kg] with cyclophosphamide may have therapeutic potential to inhibit the hemorrhagic cystitis by cyclophosphamide

Status of estrogen and progesterone receptors in various phases of the menstrual cycle in breast cancer

Expression of hormone receptors is routinely evaluated in predicting tumor response to hormone therapy in breast cancer patients. Normal female genital organs show cyclic changes in the expression of estrogen and progesterone receptors. This study was designed to assess variations in estrogen and progesterone receptor expression rates in breast cancer patients, who were operated in different phases of the menstrual cycle. From 2001 through 2004, 161 premenopausal patients with breast cancer, who were operated on, were enrolled into this study. Immunohistochemistry for the expression of estrogen and progesterone receptors was performed on their tumor paraffin blocks, using antibodies against estrogen and progesterone receptors. Estrogen receptor expression was seen in 24 out of 30 cases [80%] in early luteal phase, which was significantly higher than that of those operated in early follicular [53%], late follicular [51%] and late luteal [49%] phases [P < 0.05]. Progesterone receptor expression also showed a rising trend in the early luteal phase [87%], as compared with the other phases [P = 0.09]. Expression of estrogen/progesterone receptor shows cyclic changes in breast cancer patients, being highest in the early luteal phase of the menstrual cycle. This variation implies that this phase of the cycle could be the golden time for evaluation of estrogen/progesterone receptor status

Allergic fungal sinusitis presenting as a paranasal sinus tumor

We present a case of allergic fungal sinusitis [AFB] in a 20-year old man with few months' history of bilateral nasal obstruction and discharge with unilateral proptosis that underwent maxillary antrostomy due to the mass in paranasal sinuses. Histological examination of tissue showed branching fungal hyphae interspersed with allergic mucin without fungal invasion to soft tissue. The patient received local steroid for 4 months and had no problem during follow up. Fungal culture was performed and Bipolaris fungus grew. Although most dematiaceous fungal infections occur in immunocompetent patients, the incorrect diagnosis and insufficient treatment may be life threatening