Erythropoietin restores bowel damage and hypoperistalsis in gastroschisis.

BACKGROUND AND PURPOSE: Despite the decreased mortality in gastroschisis (Gx), patients experience postoperative intestinal hypoperistalsis, malabsorption, and shortened bowel length. The trophic effects of recombinant human erythropoietin (rEpo) in the developing small bowel have been reported, increasing the length and height of the villi, and villous surface area. This study investigated the effects of rEpo on intestinal malfunction in the chick embryos with Gx. METHODS: Thirteen-day-old fertilized chicken eggs were used to create Gx model. Study groups included the following: group 1, control; group 2, Gx-only; group 3, Gx + 0.075% saline exchange; group 4, Gx + 10 IU rEpo exchange; group 5, Gx + 20 IU rEpo exchange. The bowels were evaluated by in vitro muscle strip technique, and the response was expressed as a percentage of the maximum carbachol-evoked contraction (Emax). In addition, parasympathetic ganglion cells per 10 plexuses and villi height were determined by light microscopy. Results were evaluated statistically by Mann-Whitney U, chi2, and Fisher's Exact test tests. RESULTS: Saline exchange had no effect on ganglion cell number (P = .63) and villi height (P = .10). In group 4, ganglion cell number was not increased (P = .82), but villi height increase was significant (P = .03). In Gx + 20 IU rEpo group, both the number of ganglia (P = .0001) and villi height (P = .002) were significantly increased. The decrease in contractility in group 2 (P = .0121) was significantly reversed by rEpo 20 IU treatment (P = .0216), no significant difference was obtained in groups 3 (P = .0809) and 4 (P = .1516) compared with group 2. CONCLUSION: These data suggest that rEpo has prokinetic effects on hypoperistalsis and restores bowel damage in Gx.

The effectiveness of sucralfate against stricture formation in experimental corrosive esophageal burns.

PURPOSE: In this study, the effectiveness of sucralfate against stricture formation in experimental corrosive esophageal burn is reported. METHODS: Sixty-four Swiss albino adult male rats were divided into three groups, group A (control; n, 7), group B (esophageal burn induced but not treated; n, 25), and group C (esophageal burn induced and treated with sucralfate, n, 32). Groups B and C were further subdivided into subgroups for evaluation on days 2, 7, and 28. A standard esophageal burn was performed by the method of Gehanno, using 50% NaOH. Oral sucralfate treatment was given to group C at a dosage of 50 mg/100 g twice daily. The rats were then killed after 2, 7, or 28 days. Levels of tissue hydroxyproline were measured in excised abdominal esophageal segments, and a histopathological evaluation was performed with hematoxylin-eosin and Masson's trichrome staining. RESULTS: The tissue hydroxyproline levels were significantly lower in group C than in group B (P = 0.017). There was a significant difference in the stenosis index between groups B and C (P = 0.016). When compared with group B, the collagen deposition in the submucosa and tunica muscularis was significantly lower in group C (P = 0.02). CONCLUSION: Sucralfate has an inhibitory effect on stricture formation in experimental corrosive burns and can be used in the treatment of corrosive esophageal burns to enhance mucosal healing and suppress stricture formation.

Do alterations in collagen synthesis play an etiologic role in childhood inguinoscrotal pathologies: an immunohistochemical study.

BACKGROUND/PURPOSE: Previous findings have suggested that the development of adult inguinal hernias could be related to alterations in fibrillar collagen synthesis in the hernial sac as a decrease in the ratio of the relative amounts of type I/III collagen. The aim of this study was to investigate whether an alteration in type I and type III collagen synthesis was associated with the development of childhood inguinoscrotal pathologies. METHODS: The authors analyzed sacs from patients with inguinal hernia (n = 20), hydrocele (n = 10) and undescended testis (n = 10) immunohistochemically using monoclonal antibodies against alpha-smooth muscle actin, collagen type I and III. Peritoneal samples (n = 10) obtained from age-matched patients served as controls. Immunostaining was evaluated by semiquantitative scoring and chi2 test. RESULTS: The expression pattern of type I and III collagen did not differ among sacs obtained from patients with inguinal hernia, hydrocele, and undescended testis when compared with that of controls. However, strong expression of type III collagen was observed in the hernial sacs of right-sided male inguinal hernia compared with left side. CONCLUSIONS: Although altered collagen synthesis was reported to play an important role in the development of adult inguinal hernias, our results indicate that a pivotal role in childhood inguinoscrotal pathologies is not likely.