Apoptosis and DNA changes in hepatocytes after selective portal vein embolization; controlled experimental study

Introduction: Extensive hepatic resection could be done by performing pre-operative portal vein embolization [PVE], to induce compensatory hypertrophy in the predicted remnant liver. The aim of this study is to evaluate the effect of selective [PVE] on hepatocytes

Methods: The study was done on 23 adult Shin Sheila rabbits, embolization of the lateral right branch of the portal vein using Histoacryl was done. The animals were divided into 2 groups: [group-A] ; 12 animals sacrificed in < 30 days and [group-B]; 11 animals sacrificed between 30 to 60 days. Biopsies were taken from embolized [E] and non embolized [NE] lobes and examined

Results: Degeneration was remarkable in [E] lobe in [group-A], while it was not noticeable in [group-B]. Regeneration was evident in [E] lobe in [group-B]. Proliferation occurred in [NE] lobes in [group-A] in the [NE] lobes. Regeneration was marked in [group-B] in the [E] lobe. Morphometric DNA study showed apoptosis in the [E] lobe of [group-A] were more than in the [NE] lobes while in [group-B] they were nearly the same in both lobes

Conclusion: PVE induce apoptotic changes in [E] lobe in the early stage this was re-compensated by increased cellular proliferation in late stage evident by increased in S phase fraction of DNA by image analysis study

identification of a novel Helicobacter species in cholecystitis specimens; a preliminary study

This work tried to verify the role if any of helicobacter species in the incidence of cholecystitis. This study was conducted in the General Surgery Department at Theodore Bilharzia Research Institute. 83 patients were included in this study. A full history was taken with emphasis on symptoms suggestive of cholecystitis. The 83 cholecystectomy specimens removed by both laparoscopic and conventional open surgical procedures and collected for histopathological examination. Most of the examined gall bladders contained stones [79 specimens], while the other 4 specimens contained gravel material [biliary mud]. All positive cases for helicobacter were cases of chronic calculus cholecystitis. The study detected histopathologically certain bacterial species similar in morphology, staining characters and cellular distribution to Helicobacter pylori in few cholecystectomy specimens. Six specimens were removed from patients with chronic cholecystitis. These few cases were associated with gastric type metaplasia of gall bladder mucosa. These microorganisms may contribute in the pathogenesis of chronic calcular cholecystitis and or the development of gall stones [lithiasis]. Further bacteriological and molecular studies are recommended to identify the exact nature of these microorganisms, the method of infection and the response to therapy

possible role of helicobacter like species in the aetiology of chronic cholecystitis in patients with positive gastric helicobacter infection

The aim of this study was to correlate between the helicobacter species identified in gall bladder specimens and those in upper GI biopsies. In this study, out of 60 gastric biopsies, 32 were +ve for H. pylori. The H. pylori like organisms were detected in 5 gall bladder specimens. The 5 positive gall bladder specimens were only found among the 32 cases with gastric biopsies +ve for H. pylori. This study suggested that there was no apparent association between colonization of the gall bladder with Hp in relation to chronic calcular cholecystitis. However, wider scale studies with multicentre-controlled investigations may help to establish a more consistent role of helicobacter species in the aetiology of cholecystitis

Appendicitis; appendectomy and the value of endemic parasitic infestation

Schistosomiasis, enterobiasis and amebiasis are endemic parasitic infestations in Egypt, that were condemned by many authors as having a role in the pathogenesis of appendicitis. In the present work 127 appendices removed from patients suffering from symptoms and signs of appendicitis in the emergency surgical unit in Theodore Bilharz Research Institute [TBRI], Egypt, during the period of time from 6/96 to 6/99. Cross and microscopic histopathological examinations were done for all cases in the pathology department [TBRI]. Females were found to be more affected than males with most of patients were at the second decade of life. Parasites were detected in 14.8% of removed appendices. Enterobios vermicularis worms were detected in 10% of cases having no or mild histopathological changes, in 5.3% of cases with histopathological picture of acute appendicitis and in 14.3% of cases with histopathological features of chronic appendicitis. Schistosomiasis infestation was detected in 6.3% of removed appendectomy specimens and in 28.6% cases with histopathological features of chronic appendicitis. Ainebiasis was not detected in any of the examined appendices. We concluded that infestations of the appendix by schistosomiasis and enterobiasis are important factors in the pathogenesis of appendicitis in Egypt, thus early and proper diagnosis as well as treatment of these infestations is indicated to avoid the development of appendicitis with subsequent appendectomy

Clinical, sonographic, histopatholgical and DNA study of predictors for malignancy in chronic calcular cholecystitis

In 31 patients with dyspepsia sonographic examination showed thick wall gallbladder in 26 [83.9%], multiple stones in 21 [67.7%] and single stone in 10 cases [32.2%]. Mucosal chronic inflammatory infiltration and mucosal ulceration were the most common lesions [87.1% and 67.7% respectively]. Dysplasia was found in 3 gallbladders [9.7%], with DNA changes showing aneuploid histogram pattern and higher values of S phase percent of cellular population. Hyperplasia was associated with increased percentage of cells occupying the S phase and increased values of 2C-deviation index and 5C exceeding rate percentage. The DNA changes were more associated with multiple stones with significant differences in S phase percentage cellular population between multiple and single stones. Thus, it is concluded that multiple gallstones is an indicator for preference of cholecystectomy to avoid development difficulty predicting malignancy of gallbladder