use of microencapsulated hepatocytes transplantation reduces mortality and liver alterations in schistosoma mansoni infected hamsters

Hepatocyte transplantation is an attractive therapeutic modality for liver disease as an alternative for orthotropic liver transplantation. The goal of this work was to study the adequacy of intrasplenic hepatocyte transplantation [HCTx] in fresh and microencapsulated forms, in a hamster model of liver fibrosis by Schistosoma mansoni infected hamsters were divided into 6 groups; untreated for 11 weeks [GI] and for 15 weeks [GII] treated with praziquantel [PZQ] 7 weeks PI, and killed 4 weeks [GUI] and 8 weeks [GIV] post-treatment. Treated with PZQ 7 weeks PI, and then treated orally with immunosuppressive drug "cyclosporine [4 weeks post PZQ treatment], 24 hr. before interasplenic injection with fresh hepatocytes [V]. Treated with PZQ 7 weeks PI, and then injected interasplenically [4 weeks post-treatment] with microencapsulated hepatocytes [GVI]. GI and GUI were killed 11 weeks PI for assessment the anti-schistosomal efficacy of PZQ. The other four groups were killed 15 weeks PI for investigation of liver and spleen histology, serum liver enzymes and hepatic oxidative markers before and after HCTx. Freshly isolated hepatocytes with a mean viability 92.9711.2% were used for microencapsulation and transplantation. Histological study showed the presence of transplanted hepatocytes in spleen of recipient. PZQ accelerated healing of hepatic granulomatous lesions as evidenced parasitologically by the increase in the percentage of dead eggs and histologically showing more gfanuloma circumscription with more ova degeneration and less inflammatory cells. The 25-day survival rates in Gil, GIV, GVand GVI were 5/15 [33.3%], 8/15 [53.3%], 10/15 [66.7%] and 9/15 [60%] respecttively. In addition, there were significantly better outcomes in serum biochemical indexes such as ALT, AST, y-GT, ALP, and hepatic SOD and MDA in the fresh and microencapsulated groups than in PZQ-treated group, without great differences between the microencapsulated and the fresh transplanted groups. Liver pathological staining supported these findings

Efficacy of pentoxifylline as an antifibrotic drug in experimental murine schistosomal hepatic fibrosis

This study evaluated the possible antifibrotic effect of pentoxifylline on experimentally induced schistosomal hepatic fibrosis and its effect on serum leptin and transforming growth fac-tor-pl levels as possible antifibrotic mechanisms in correlation with the hepatic fibrosis indices.A total of ninety clean laboratories bred, males Swiss, albino mice were included, of which ten mice served as a control non-infected, non-treated group and sacrificed at one time. Eighty mice, each was subcutaneously infected with 50 Schistosoma mansoni cercariae and classified into groups: GI [infected and non-treated], Gil [infected and treated with Mirazid], GUI [infected and treated with Pentoxifylline] and GIV [infected and treated with a combination of Mirazid and Pentoxifylline]. Each group was further subdivided into 2 subgroups; subgroup a' which started treatment at 6[th] week post-infection [P.I.] and sacrificed at the end of 9[th] week P.I and subgroup [b] which started treatment at 14[th] week P.I and sacrificed at the end of 17[th] week P.I. The efficacy of the treatment was assessed by histopathological examination of the liver with measurement of granuloma sizes, estimation of hydroxyproline content in the liver, and assessment of serum levels of leptin and transforming growth factor- 61 [TGF- 61]Mirazid [MZD] caused significant reductions in granuloma sizes and hepatic hydroxyproline content and caused non-significant reductions in serum levels of leptin and transforming growth factor- 61 at 9[th] and 17[th] weeks P.I [Gil]. Pentoxifylline [PTX] caused significant reductions in granuloma sizes, hepatic hydroxyproline, and serum levels of leptin and transforming growth factor- 61 at the 9[th]and 17[th] weeks P.I [GUI]. While combined therapy of both MZD and PTX in GIV caused more reductions in granuloma sizes, hepatic hydroxyproline, and serum levels of leptin and TGF- 61 at the 9th and 17th weeks P.I when compared to the other groups

Dexamethasone as adjunctive therapy for treatment of varicella pneumonia

The most common and most serious complication of varicella [chickenpox] in adults is pneumonia, which can lead to severe respiratory failure. Whether addition of corticosteroids to antiviral treatment benefits patients with varicella pneumonia is unclear. To assess the effect of dexamethasone as adjunctive therapy for treatment of varicella pneumonia on the length of hospital stay, which might cause earlier resolution of varicella pneumonia. Forty patients were diagnosed as varicella pneumonia and divided into two groups, the first one involved 20 patients who received dexamethasone and acyclovir, and the second one involved also 20 patients but they received placebo and acyclovir. We measured liver function test, kidney profile, complete blood count, blood glucose, C-reactive protein and the levels of interleukin-6 on the day of presentation, after 4 days of admission and on the day of discharge from the hospital. The mean length of hospital stay in the dexamethasone group was 6.5 days compared with 7.1 days in the placebo group and was significantly different between two groups. The mean time of switching to oral administration of acyclovir was 3.4 days in the dexamethasone group and 4.2 days in the placebo group. The mean time of switching to oral was significantly lower in dexamethasone group than in placebo group. Adding of dexamethasone to acyclovir in patients with varicella pneumonia can reduce the length of hospital stay

Evaluation of serum glypican-3 and a-fetoprotein levels in patients with liver cirrhosis and hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is one of the most common malignant tumors. HCC occurs mainly in patients with chronic liver disease such as in hepatitis B and C infection. HCC lesion of one cm in diameter with high or low echogenicity can be detected by ultrasonography and confirmed by liver needle biopsy, however, it is still very difficult to detect small isoechogenic HCC lesions especially when a-fetoprotein [AFP] is normal. The serum level of Glypican-3 [GPC-3] has been reported as a marker of HCC. The aim of our study was to evaluate the diagnostic value of serum [GPC-3] and a-AFP in patients with liver cirrhosis and HCC. All patients were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasonography and ultrasonography guided percutaneous liver needle biopsy. To evaluate the role of [GPC-3] in the diagnosis of HCC, we simultaneously studied serum [GPC-3] and [AFP] levels in 40 patients with cirrhosis, 40 patients with HCC and 40 healthy subjects as a control. Serum [GPC-3] in patients with HCC [563 +/- 220ng/ml] and in cirrhotic patients [275 +/- 153 ng/ml] was significantly higher than control [206 +/- 127 mg/ml p<0.001] with 300 ng/ml [mean value of controls plus 2 standard deviations] considered as the cut-off point. [GPC-3] was more sensitive [86 vs 65%] but less specific [80.5 vs 90.9%] than [AFP] at level of > 400 ng/ml as a tumour marker of HCC. We conclude that [GPC-3] is useful marker, in conjunction with [AFP] and liver ultrasonography for detecting HCC

Evaluation of toxicity of boric acid in pregnant rats

Boron occurs most frequently in nature as borates and boric acid. Humans consume about a milligram of boron per day in foods such as fruit and vegetables. Boron is essential for the growth of many plants. At high doses, boron is developmentally toxic. The aim of this study was to evaluate signs of toxicity of boric acid administration in pregnant rats. Pregnant Sprague-Dawley rats were administrated oral doses 514, 257, 128, 51mg/kg of boric acid, from 7[th] to 16[th] day and from 1[st] to 20[th] day of gestation. Pregnant rats were evaluated for rate of abortion, weight gain during pregnancy and relative weights of liver, kidneys, placenta and uteri. At 20[th] day. The animals were sacrificed and histological study of liver and kidneys were done . Results showed that the rate of abortion was increased with the high doses meanwhile the weight gain of pregnant rats was decreased, moreover ,the relative weights of liver and kidneys of pregnant rats were increased and the weight of placenta and uteri were decreased in treated groups as compared to control . Histopathological studies of liver and kidneys revealed signs of toxicity in the form of congestion of blood vessels and fatty degeneration with atrophic changes in the parenchyma's cells of liver and kidneys. In conclusion, boric acid administration in pregnant rats induced toxicities in the form of enhanced rate of abortion ,decreased weight gain during pregnancy .Hepatic and renal toxicities of boric acid were confirmed by histopathological abnormalities. Boric acid toxicity in pregnant rats was dose and time dependent

Role of GGT in diagnosis of metabolic syndrome : A clinic-based cross-sectional survey.

Background & objectives: The aim of this study is to know if the liver function tests (LFT), especially gamma glutamyl transferase (GGT), have a predictive value in diagnosis of metabolic syndrome (MS). Methods: A cross-sectional, single-center study was carried out with 908 subjects. Four hundred and forty two of these subjects were diagnosed with MS with IDF criteria; while other 466 were sex and age matched healthy control subjects. Blood pressure, liver function tests, fasting blood glucose levels and lipid profile of the subjects were recorded. Results: The mean values of alanine amino transferase (ALT), aspartate aminotransferase (AST) and GGT levels were statistically significantly higher in MS group. The mean values of liver enzymes, for female/ male subjects in MS group, AST; ALT and GGT respectively, were; 20.5/19.7 U/l; 25.9/28.5 U/l; 35.9/42.1 U/l. When the sample is divided into quartiles of the GGT levels, increase in GGT is positively correlated with increased MS prevalence. In ROC analysis GGT is as strongly associated with the IDF diagnostic components as is each individual IDF component, except elevated systolic blood pressure. In covariance analysis, there was significant relationship between elevated GGT levels and MS presence after adjustment for age, sex and MS diagnostic criteria; but not AST and ALT levels. In multivariance analysis, in MS group, a high GGT was positively associated with CVD prevalance (odds ratio: 2.011, 95% CI 1.10-4.57) compared to low GGT group independent of age, sex and smoking habits. Interpretation & conclusion: Elevated liver enzymes, although in normal ranges, especially at upper quartiles, play a central role in early diagnosis of fat overflow to the liver. Regarding the availability and simplicity of these tests in routine clinical practice, they, especially GGT, have potential to be considered in algorithms for metabolic syndrome.

Improving the two types of diabetes mellitus using cinnamon infusion

The present work was conducted to study the effect of cinnamon extract as traditional infusion on improving the both of type I and II diabetes mellitus. Fifty male albino rats [Sprague Dawley Strain] divided into four main experimental |roups, the first and second main groups used as a negative control groups, the third main group was subjected to type I diabetes and the fourth for type II]. Type I was induced by using streptozotocin [STZ] at dose of 60mg/kg body weight. Type II was induced by feeding rats high fructose diet [HFD] for 15 days. After one week of [STZ] and two week of [HFD] administration blood glucose was determined and the animals of 250-500 mg/dl glucose levels were considered diabetic rats. Then, the third main group of rats divided into the following subgroups [n=5] for type I diabetes: 1[st] subgroup fed basal diet [diabetic control], 2[nd] group fed basal diet + cinnamon infusion [1.5 ml/kg b.w. one time], 3[rd] group fed basal diet + cinnamon infusion [1.5 ml/kg b.w. two times], 4[th] group fed basal diet + cinnamon infusion [1.5 ml/kg b.w. three times]. Concerning type II diabetes, similar scheme was designed. All treatments with cinnamon infusion for10 weeks resulted in highly significant differences in blood glucose, AST and ALT compared with diabetic control for type I diabetes. Concerning type II diabetes, after treatment by cinnamon infusion, the blood glucose, ALT, AST decreased significantly by infusion [1.5 ml/Kg, 10%w/v] for one, two, three times compared with diabetic control. Triglycerides, total cholesterol and LDL-c were decreased due to one, two, three of administration, respectively compared to diabetic control, except HDL-c increased and reached to the control value due to the three times of cinnamon infusion. Regarding Type11 diabetes, a similar trend to type I was found due to cinnamon infusion with a slight variation. The insulin levels increased due to the treatment with cinnamon infusion one, two, three times, respectively for type I diabetes. Meanwhile, it decreased due to the above mentioned treatments for type II diabetes. It could be concluded that cinnamon infusion [10%w/v] about [l00ml/day] may be improved the two types of diabetes

Liver functions changes in acute diarrhea in children

Diarrhea is considered to be one of the most common causes of morbidity and mortality among infants and children in developing countries. The present study was done to evaluate the incidence of hepatic affection or the occurrence of abnormal liver functions in infants and children presented with acute diarrhea with different degrees of dehydration. The study demonstrated that total number of patients with liver function impairment were [22.5% of cases]. All of them had elevated AST, either single elevation in 60% of cases with impaired liver function or combined AST and ALT elevation in 40% of cases with impaired liver function. The mean value of AST was 95 u /1 +/- 75.4, where mean value of ALT was 124 u/l +/- 8-5.8

Utilidad del metabolismo hepático de la lidocaína como prueba de función hepática en pacientes con enfermedades crónicas del hígado / Utility of hepatic metabolism of lidocaine as a test of hepatic function in patients with chronic liver diseases

Los avances alcanzados en el manejo de los pacientes con enfermedades crónicas del hígado han llevado a desarrollar métodos que permitan evaluar en forma no invasiva la función hepática. En este sentido nuestro estudio ha sido dirigido a determinar la utilidad clínica del test de monoetilglicinexilidida (MEGX) en una serie amplia de pacientes con enfermedad crónica de hígado, y su relación con el índice de actividad histológica evaluado mediante el índice de Knodell. Asimismo, se evaluó el papel de esta prueba de función hepática en la monitorización de una pauta terapéutica con interferón. Para ello se incluyeron 35 pacientes con hepatitis crónica, 40 con cirrosis hepática de diferentes etiologías y 10 personas sanas. La concentración plasmática de MEGX fue medida mediante inmunoanálisis de fluorescencia polarizada luego de 15 minutos de haberse administrado lidocaína por vía endovenosa (1 mg/kg). La concentración de MEGX fue significativamente superior en los sujetos sanos (71.8 ñ 7.3 ng/ml) que la observada en pacientes con hepatitis crónica (50.8 ñ 5.3 ng/ml, p<0.05) y cirrosis (14.7 ñ 2.6 ng/ml, p<0.05). Una disminución en la producción de MEGX se observó en forma paralela a un mayor deterioro de la función hepática, evaluada mediante la clasificación Child-Pugh (A: 17.9 ñ 4.6 vs C: 8.8 ñ 1.5 ng/ml, p<0.05). Todos los pacientes con una concentración de MEGX menor a 20 ng/ml presentaron una cirrosis confirmada por el hallazgo histológico. Se observó una correlación inversa entre la producción de MEGX y el índice de actividad histológica (r= 0.63, p<0.05). En pacientes respondedores a la terapia con interferón se comprobó una mejoría en forma paralela del MEGX y el score de Knodell. Nuestros resultados demuestran que el test de MEGX es una prueba cuantitativa simple y segura de función hepática. Asimismo, nos ha permitido tanto identificar diferentes estadios evolutivos de la enfermedad como así también monitorizar la respuesta terapéutica en pacientes con hepatitis crónica

Pronóstico vital en insuficiencia hepática aguda grave: valor de los índices cuantitativos de evaluación / Life prognosis in severe acute hepatic failure: value of assessment quantitative index

The aim of this study was to assess the predictive value for mortality of admission and daily APACHE II score, mortality due to multiple organ failure and the organ failure score in patients with acute hepatic failure. We retrospectively studied 15 such patients admitted to an intensive care unit. Thirteen patients died (87 percent) and their admission APACHE II score was 22ñ7.5 compared to 21ñ8.5 in survovors. Daily APACHE II score, mortality due to multiple organ failure and multiple organ failure score had a 100 percent sensitivity to predict mortality and a 69.2, 76.9 and 76.9 percent specificity respectively. The predictive accuracies of multiple organ failure and multiple organ failure score were 80 percent and significantly better than the accuracy of admission APACHE II score (53 percent). We conclude that these prognostic scores can be useful in the assessment of patients with acute hepatic failure

Nutrición parenteral total en hiperemesis gravídica grave / Total parenteral nutrition in acute hyperemesis gravidarum

La hiperemesis gravídico (HG) grave es una condición poco frecuente asociado al embarazo sin embargo representa un alto riesgo materno-fetal. En estos casos la nutrición parenteral total (NPT) representa una efectiva forma de tratamiento. Se presentan 8 pacientes con HG grave tratados con NPT por vía venosa central. La edad media fue de 27,5 (rango 23 a 36 años), la edad gestacional fluctuó entre las 8-19 semanas (media 15 semanas), y el volumen diario vómito pretratamiento fue de 840 cc (rango 400-1600 cc). Cinco pacientes tenían alteración nutricional calórico-proteica o proteico-visceral con compromiso parcial de la función hepática. Se administró solución glucosada 20-30 por ciento, solución de aminoácidos 8,5 por ciento, emulsión lipídica (3 casos), vitaminas, electrólitos y oligoelementos. El período de NPT hasta la mejoría osciló entre 5-16 días (media=7 días) con un total de 77 días. Los resultados perinatales fueron 7 RN AEG y 1 aborto retenido. Se obtuvo mejoría clínica satisfactoria en todos los casos y no hubo complicaciones