Effects of granulocyte colony-stimulating factor on neutrophils and inflammatory cytokines in the early stage of severe acute pancreatitis in rats.

BACKGROUND: The high mortality rate of severe acute pancreatitis (SAP) is closely associated with secondary infections of pancreatic and peripancreatic tissues. It was reported that granulocyte colony-stimulating factor (G-CSF) increased the number of leukocytes and enhanced their functions. However, an inflammatory response may be enhanced by an increased number of leukocytes. Our purpose was to study the roles of G-CSF in peritoneal-exudate neutrophils and inflammatory cytokines in the early stage of experimental SAP. METHODS: SAP was induced by injecting 0.2 ml of 3% taurocholate acid into the biliopancreatic duct in male Wistar rats. G-CSF (90 microg/kg body weight) or saline was administered 1 h before the SAP induction. The number of neutrophils and their phagocytic and bactericidal activities were evaluated, and the concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-1beta in plasma and ascitic fluid were measured 1 h and 3 h after the SAP induction. RESULTS: The number of peritoneal-exudate neutrophils (PENs) at 3 h was increased by G-CSF administration (81 +/- 50 x 10(5) cells/total exudate), as compared with that shown with saline administration (28 +/- 13 x 10(5) cells/total exudate; P < 0.05). The numbers of phagocytic and bactericidal neutrophils were also elevated by G-CSF administration. G-CSF administration did not increase the concentrations of TNF-alpha, IL-6, and IL-1beta in the plasma and ascitic fluid. CONCLUSIONS: G-CSF increases the numbers of neutrophils and enhances their functions against bacteria, but it does not enhance intraabdominal and systemic inflammatory responses in the early stage of SAP.

Effect of granulocyte colony-stimulating factor on opsonin receptor expression in cerulein-induced acute pancreatitis.

OBJECTIVES: Decreased levels of expression of opsonin receptors (CD11b and CD32/16) on peritoneal exudate neutrophils may lead to susceptibility to infection. Granulocyte colony-stimulating factor (G-CSF) increases the expression levels of CD11b on neutrophils and prolongs neutrophil survival. The effects of G-CSF on neutrophils and opsonin receptor expressions of neutrophils were investigated in cerulein-induced acute pancreatitis. METHODS: Forty-two mice were randomly assigned to each group (n = 6). Mice received subcutaneous G-CSF (120 microg/kg body weight) before the induction of acute pancreatitis with cerulein. Saline was used for instead of G-CSF or cerulein solution in control groups. CD11b and CD32/16 expression levels on circulatory and peritoneal exudate neutrophils were investigated 6 and 24 hours after the induction of acute pancreatitis. RESULTS: Treatment with G-CSF did not aggravate the inflammation of pancreatic tissue evaluated by plasma amylase, acinar necrosis. However, it significantly increased the number of peritoneal exudate neutrophils (P < 0.05) and the CD11b- (P < 0.05) and CD32/16-positive (P < 0.05) peritoneal exudate neutrophils in mice with cerulein-induced acute pancreatitis. The means of fluorescence intensity for CD11b and CD32/16 expressions on circulatory and peritoneal exudate neutrophils were also elevated in the G-CSF groups. CONCLUSION: G-CSF administration increases the numbers of neutrophils and improves expression levels of opsonin receptors on neutrophils in mice with cerulein-induced acute pancreatitis.

Laparoscopy-assisted surgery for colorectal neoplasm is justifiable regardless of advanced age.

BACKGROUND/AIMS: Laparoscopy-assisted surgery has been applied in patients with colorectal disease and resulted in favorable outcome compared with open surgery. However, it is not reported exclusively in terms of the curative mean in the geriatric patients with colorectal neoplasm yet. The aim of this study was to confirm the pros and cons of laparoscopy-assisted surgery for colorectal neoplasm in geriatric patients. METHODOLOGY: Seventy-four patients with colorectal neoplasm underwent laparoscopic surgery and all their charts were retrospectively reviewed. Fourteen patients were 75 years of age or older and compared with the remaining non-aged 60 patients in STUDY 1, and also compared with 46 aged patients who underwent open surgery in STUDY 2. RESULTS: In STUDY 1, the compiled total frequency of preoperative concomitant disease was significantly higher in the LAS-aged group. In STUDY 2, the mean operative time of the laparoscopic group was significantly longer than that of the open group. Mean estimated blood loss of the laparoscopic group was significantly smaller than that in the open group. Postoperative oral resumption and duration of hospital stay tended to be shorter in the laparoscopic group than in the open group. CONCLUSIONS: Laparoscopy-assisted surgery is a satisfactory treatment for colorectal neoplasm, even in geriatric patients.