Colopleural fistula: Case report and review of the literature

We report a 28-year-old woman, pregnant, at 24 weeks, with 3-day history of right-sided chest pain and shortness of breath. Few hours after admission, she delivered a dead baby. She had a history of right partial hepatic lobotomy and cholecystectomy at UK on May 2004 because of multiple pyogenic liver abscesses. Chest examination revealed signs of hydrothorax on the right side. Chest X-ray showed pleural effusion on the right side. Pleural fluid was exudative with high neutrophils. Gram stain and culture showed multiple organisms. CT scan chest and abdomen with contrast, combined with barium enema, revealed right colothorax communication. Colothorax fistula was closed surgically. On the following days, the patient's symptoms resolved, and she was consequently discharged

Apoptosis in the gastric ulceration "Shay rat model": rol of IL-6 modulation by the cytoprotectant compper-glycinate and-nicotinate complexes

So far, the mechanism[s] of the very promising gastric antiulcerogenic acting: copper-nicotinate and copper-glycinate complexes is not yet completely understood. It could be hypothesized that modulation of IL-6 and apoptosis may elucidate one aspect of a common mechanism ['s of their action. Shay Rat" pyloric ligation gastric ulcer model was utilized in this study. To/al IL-6 in gastric juice and blood serum was measured by an ELISA assay. Total DNA content and its percentage of fragmentation in gastric juice and Caspase-3 activity in the non glandular stomach mucosal scraping were measured calorimetrically in the four studied groups [I: control ulcerated untreated, II: ulcerated-treated with copper-glycinate, III: ulcerated treated with copper-nicotinate and, IV. ulcerated treated with Omeprazole therapeutic control ,16 rats each].There was highly significant reduction in the levels of each of IL-6 in gastric juice, serum of treated rats [P<0. 001], fragmented DNA, and similar reduction in the caspase-3 activity [P<0.001] amongst the different treatments compared to untreated rats. Histopathological examination revealed discontinuation of the lining epithelium by aggregated lymph follicles and/or inflammatory cells infiltration ,dilated and congested blood vessels and apoptotic changes affecting epithelial cells mainly, all significantly but differentially prevented by treatments. This study showed for the first time that gastric ulceration augmented IL-6 and promoted caspase-3 activity as a marker for apoptosis confirmed by DNA fragmentation and histopathology in the used "Shay Rat" gastric ulcer model .Ali parameters were greatly alleviated by treatments, with stronger equ1otent ability for each of the copper complexes used compared to the clinical gold-standard treatment of/he disease, omeprazole

Levels of endostatin and some angiogenic indices in both sera and pleural fluids of patients with small cell lung cancer

Angiogenesis plays an important role in growth, progression and metastasis of neoplasms. Levels of vascular endothelial growth factor [VEGF], transforming growth factor-beta1 [TGF-beta 1] and basic fibroblast growth factor [bFGF] [as angiogenic factors] and endostatin [as anti-angiogenic factor] were evaluated in sera of 30 male patients with non small cell lung cancer [NSCLC]. Their ages ranged from 36 to 70 years, average 59.3 years and 10 age and sex matched healthy controls. Pleural fluid levels of these cytokines were estimated in 18 out of 30 cancer patients as well as 10 patients with congestive heart failure pleural effusion as a control group. The present study was designed to determine whether these indices could be used as diagnostic tools for lung cancer and to evaluate their correlation to the stage of the disease. Lung cancer patients showed significant [P<0.001 and P<0.05] increased levels of the studied bioindices in both serum and pleural fluid compared with control subjects. There was no significant difference in the serum and pleural fluid levels of these cytokines between the different histological types of lung cancer. Lung cancer patients with advanced stages [n =24] showed significantly higher serum [P<0.001] levels of angiogenic factors and endostatin compared with those with early stages [n=6]. In patients with lung cancer, a significant positive correlation was found between serum levels of endostatin and each of VEGF [r = 0.58, P<0.0001], TGF-beta1 [r = 0.52, P<0.01]. and bFGF [r = 0.4, P<0.01]. A significant positive correlation between serum VEGF and TGF-beta1 [r = 0.45, P<0. 01] was found in patients with advanced lung cancer. Regarding Pleural effusion, there were significant positive correlations between levels of endostatin and each of VEGF [r = 0.44, P<0.0001], TGF-beta 1 [r = 0.43, P<0.01] and bFGF [r = 0.46, P<0.01]. Similarly, a significant positive correlation between VEGF and TGF-beta 1 [r = 0.45, P<0.01] was found. In conclusion: measurement of VEGF, TGF-beta 1 and bFGF [as angiogenic factors] and endostatin [as anti-angiogenic factor] could be used as tumor markers in NSCLC. Their serum and pleural fluid levels are correlated to disease severity rather than its pathological types. The endogenous pro- and anti-angiogenic factors reveal the complexity of the homeostatic system controlling angiogenesis. Further studies are recommended to follow up these factors in different clinical states and correlate their levels with prognosis

Serological response to immunization with tetanus toxoid.

A total of two hundred women were immunized with tetanus toxoid vaccine. Two batches of toxoid prepared at the Institute of Public Health (IPH), Dhaka and one batch of imported vaccines, were being used by the EPI in Bangladesh for immunization. Each hundred women were immunized by IPH and imported vaccine. Two human doses were given in one month interval. Blood samples from all the study subjects were collected on the day of 1st dose and one month after second dose. Both the preimmunized sera and the sera after vaccination were tested to determine the antibody titre against tetanus toxoid by the haemagglutination method. The preimmunized sera showed the presence of protective antibody in 50(25%) subjects who had the history of previous immunization. Including these initial antitoxin positive cases the seroconversions found among 95% and 96% of the study population respectively after immunization with IPH and imported toxoids, which were 93.05% and 94.87% when these 50 subjects were excluded. No significant difference (p = 1.0) was observed between the immunity of the subjects after receiving IPH and imported vaccine. Antibody titre of initial tetanus-antitoxin positive cases raised eight folds after getting more doses. The result gave fair indication of the antigenicity of all the toxoids used in the study.