A novel wound healing accelerator: Effect of vitreous gel of cow eyeball on a chronic wound model.

INTRODUCTION: Several studies have reported the disturbance in the process of wound healing after administration of mitomycin-C, which inhibits granulation tissue formation and collagen synthesis, resulting in chronic wounds. The vitreous gel of cow eyeballs contains a high level of hyaluronic acid, which has a role in inflammation, granulation, re-epithelialization, and remodelling. This study aims to understand the effect of 1% povidone iodine and vitreous gel of cow eyeballs on wound healing after administration of mitomycin-C. METHODS: This was an in vivo study with quasi-experimental methods on 32 Wistar mice. Full-thickness wounds were made and then treated with mitomicyn-C. The mice were divided into 4 groups: a control group with NaCl 0.9% vitreous gel of cow eyeball (VGCE), 1% povidone-iodine, and a combination of VGCE and 1% povidone-iodine groups. Macroscopic and microscopic observations of the process of wound healing were performed on days 3, 7, and 14. RESULTS: Vitreous gel administration produced significant wound healing rates within the first three days, and histological analysis revealed an increased number of fibroblasts and polymorphonuclear cells. However, the povidone iodine group and the combination group with vitreous gel did not produce significant results. CONCLUSION: The single administration of VGCE can accelerate the wound healing process, increase the number of fibroblasts, and reduce inflammation in a chronic wound model.

The impact of serum total bilirubin, alanine transaminase and gamma-glutamyl transferase on survival of biliary atresia patients following Kasai procedure.

BACKGROUND: Many prognostic factors have been reported for the outcomes of biliary atresia (BA) patients after Kasai procedure, however, it still shows a conflicting result. Our study was to determine the impact of total bilirubin postoperative day-7 and pre-operative ratio (TB7/TB0), gammaglutamyl transferase post-operative day-7 and pre-operative ratio (GGT7/GGT0), and alanine transaminase post-operative day-7 and pre-operative ratio (ALT7/ALT0) on the survival of BA patients following Kasai surgery. METHODS: We reviewed the medical records of BA patients who underwent Kasai procedure at the Dr. Sardjito Hospital, Indonesia from August 2012 to December 2018. The cut-off values of TB7/TB0, GGT7/GGT0, and ALT7/ALT0 for prediction of patients' survival were determined by receiver operating characteristics (ROC) curves. Log-rank tests were utilised to test the association between cut-off values and overall survival. RESULTS: In all 46 BA patients (23 males and 23 females) after Kasai procedure were included, consisting of one type 1, 17 type 2A, seven type 2B, and 21 type 3. The cut-off values of TB7/TB0, ALT7/ALT0 and GGT7/GGT0 for overall survival was 0.455 (sensitivity 87.5%, specificity 22.7%, area under curve (AUC) 0.59; 95% Confidence Interval (95%CI): 0.42, 0.75), 0.481 (sensitivity 87.5%, specificity 18.2%, AUC 0.49; 95%CI: 0.31, 0.65), and and 0.31 (sensitivity 79.2%, specificity 9.1%, AUC 0.34; 95%CI: 0.18, 0.50), respectively. However, these cut-off values were not significantly associated with overall survival, with p-values of 0.18, 0.49, and 0.56, respectively. CONCLUSION: The TB7/TB0, ALT7/ALT0, and GGT7/GGT0 might not predict the overall survival of BA patients after Kasai procedure. Further multicentre studies with a larger sample size is needed to clarify our findings.