Somatostatin Infusions Reduce Post-Operative Bile Leak after Hepatopancreatobiliary Surgery: An Observational Preliminary Study.

Background: Bile leak is a complication of hepatopancreatobiliary surgery and results from injury to the bile ducts. Treatment usually consists of percutaneous drainage combined with the placement of a biliary stent or a nasobiliary draining tube in the biliary tree via endoscopic retrograde cholangiopancreatography. Animal experiments and studies in humans have shown that somatostatin reduces bile secretion. Objective: To evaluate the efficacy of somatostatin as a conservative monotherapy for the successful management of mild to moderate post-operative bile leak. Place and Duration of Study: 2nd Department of at the University General Hospital of Alexandroupolis, during the period of 2010 and 2012. Patients and Methods: Fifteen patients (11male/4 female) with a mean age of 70.1±4.2 years who developed uncomplicated post-operative bile leak with a daily output ranging from 100ml to 800ml were included in the study. Eleven patients were operated for benign diseases of the liver and biliary tract, while the rest 4 patients for pancreatic or biliary tract malignancies. Somatostatin was administered intravenously to all patients in continuous infusions of 3000μg/12hours until complete recession of bile leak along with total parenteral nutrition. Results: Somatostatin treatment was successful in 14 patients (93.3%), with success being defined as the complete cessation of bile leak. Overall, mean duration of bile leak was 13.8±3.9 days. No major adverse reactions or complications were observed and no patients died. Conclusions: Somatostatin appears to be effective in the treatment of post-operative bile leak. The efficacy of somatostatin is observed both in patients with benign or malignant disease.

Evidence of increased chromosomal instability in infertile males after exposure to mitomycin C and caffeine / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To evaluate the genetic instability of 11 fertile and 25 infertile men.</p><p><b>METHODS</b>The methodology of sister chromatid exchanges (SCEs) was applied to cultures of peripheral blood lymphocytes, and the levels of SCEss were analyzed as a quantitative index of genotoxicity, along with the values of the mitotic index (MI) and the proliferation rate index (PRI) as qualitative indices of cytotoxicity and cytostaticity, respectively. The genotoxic and antineoplastic agent, mitomycin C (MMC), and caffeine (CAF)--both well-known inhibitors of DNA repair mechanism--were used in an attempt to induce chromosomal instability in infertile men, so as to more easily detect the probable underlying damage on DNA.</p><p><b>RESULTS</b>Our experiments illustrated that infertile men, compared with fertile ones, demonstrated a statistically significant DNA instability in peripheral blood lymphocytes after being exposed simultaneously to MMC and CAF.</p><p><b>CONCLUSION</b>The current study showed vividly that there was genetic instability in infertile men which probably contributes to the development of an impaired reproductive capacity.</p>