Treatment of ischemic colonic anastomoses with systemic transplanted bone marrow derived mesenchymal stem cells.

BACKGROUND: The aim of the study is to investigate the healing effect of the bone-marrow derived mesenchymal stem cells (BM-MSCs) on ischemic colon anastomosis in systemic application and to recovery the adverse effect of ischemia. MATERIALS AND METHODS: Fourty male Wistar Albino rats weigthing 250-300 g were divided into four equal groups (n=10 Group 1: control; ischemic left colonic anastomoses (4th day); Group 2: control; ischemic left colonic anastomoses (7th day); Group 3: ischemic left colonic anastomoses + systemic transplanted BM-MSCs (4th day); Group 4: ischemic left colonic anastomoses + systemic transplanted BM-MSCs (7th day). BMSCs labelled with bromodeoxyuridine (BrdU) were transplanted into the vena cava. Group 1 and group 3 were killed four days after surgery. In group 2 and group 4 were sacrificed seven days after the surgical procedure. Histopathological features, hydroxyproline levels in the tissue, and anastomotic strength were investigated. RESULTS: There was no mortality all of the groups.The mean bursting pressures of ischemic colonic anastomoses in group 3 were higher than in control group 1 (4th day). We found significantly higher hydroxyproline values in group 3 and were significantly higher in group 4 than in control groups. We investigated the early period of wound healing (4th day and 7th day). When comparing between group 1 and group 3, we found higher levels for all of the histological parameters except inflammation in group 3. On day 7, when comparing between group 2 and group 4, we found higher levels for parameters of necrosis, collagen deposition. CONCLUSIONS: BM-MSCs therapy significantly accelerated all of the healing parameters for ischemic colonic anastomosis except for inflammation on fourth day. On the seventh day, BM-MSCs augmented the levels of the hydroxyproline. Histological parameters, necrosis and collagen deposition were also found to be important for healing of ischemic colonic anastomoses. However, they did not accelerate the others histological parameters especially angiogenesis.

Feasibility and acceptance of telemedicine for wound care in patients with chronic leg ulcers.

We examined the feasibility and acceptance of teledermatology for wound management of patients with chronic leg ulcers by home-care nurses. Forty-one chronic leg ulcers of different origin in 14 patients were included. After an initial in-person visit in which leg ulcers were assessed and classified, and underlying diseases noted, follow-up visits were done by home-care nurses. Once a week 1-4 digital images of the wound and surrounding skin and relevant clinical information were transmitted via a secure Website to an expert at the wound care centre. The experts provided an assessment of wound status and therapeutic recommendations. In 89% of the 492 teleconsultations, the quality of images was sufficient or excellent and the experts were confident giving therapeutic recommendations. Treatment modalities were changed or adapted in one-third of the consultations. There was a significant decrease in visits to a general physician or the wound care centre. The acceptance of teledermatology was high in patients, home-care nurses and wound experts. Teledermatology offers great potential for chronic wound care and seems to be accepted both by patients and health-care persons.

Pathological findings suggestive of interclonal stabilization in a case of cutaneous melanoma.

Metastatic spread is a complex process based on manyfold interactions of the tumor cells with each other and with the surrounding stroma. In experimental systems tumor cell heterogeneity and presence of various subpopulations which interact with one another to stabilize their relative proportions within the population has been shown. Here we report a patient with melanoma, showing morphological evidence of two distinct tumor cell populations in the primary tumor and in all subcutaneous metastases. By image analysis, both populations were clearly characterized by minimal nuclear diameter and by nuclear form factor and were demonstrable in each specimen. The fact that these peculiar cell populations were present in all melanoma lesions removed from the patient might indicate that the populations require the presence of each other and that none of them is metastatically competent on its own.

Effect of hypothyroidism in the thyroidectomized rats on immunophenotypic characteristics and differentiation capacity of adipose tissue derived stem cells.

INTRODUCTION: Thyroid hormones influence multiple physiological functions, like growth, differentiation, protein synthesis and metabolic rate. The hypothyroid state is a complex hormonal dysfunction rather than a single hormonal defect. The relation between hypothyroidism after thyroidectomy and stem cells is not clear. AIM: This study was designed to investigate the effect of thyroidectomy on the proliferation, telomerase enzyme activities, immunophenotypic properties and differentiation potentials of adipose tissue-derived (AT-) stem cells (SCs). MATERIALS AND METHODS: AT-SCs after 60 and 120 days of thyroidectomized (Tx) rats were compared to normal rats by flow cytometry and immunocytochemistry analyses, and their telomerase activities were estimated. RESULTS: The telomerase activity was found to be positive for AT-SCs of Tx rats of both 60 and 120 days used in this study, but a decrease was noticed in the cells with the long-term exposure to hypothyroidism. This might indicate the decrease in the regenerative ability of the AT-SCs after 120 days of Tx compared to cells after 60 days of Tx. Both cell lines were induced to differentiate into adipogenic, osteogenic and neurogenic cell lineages, but osteogenic marker expression was not detected in the undifferentiated AT-SCs of the Tx rats. Osteogenic differentiation was also failed in stem cells derived from Tx rats, shown by Alizarin red S staining and alkaline phosphates enzyme assays. DISCUSSION: These results suggest that hypothyroidism affected SCs, altered stem cell characteristics, like telomerase activity and loss of in vitro bone formation, but not adipogenic or neurogenic differentiation ability. CONCLUSIONS: Hypothyroidism after Tx affects the osteogenic differentiation capacity of stem cells, which might be one of the factors of bone loss due to postnatal hypothyroidism.

Pancreatic islet derived stem cells can express co-stimulatory molecules of antigen-presenting cells.

BACKGROUND: Antigen-presenting cells (APCs) are crucial intermediates in the generation of both innate and specific immune responses. It has long been understood that some APCs are resident in islets in situ as well as after isolation. Our aim was to investigate the presence of molecules involved in antigen presentation in rat pancreatic islet-derived stem cells (PI-SCs). METHODS: We used immunocytochemistry and reverse transcription polymerization chain reaction to study immunophenotypic characteristics; pluripotent-related gene expressions; transcripts coding for antigen-presenting surface proteins CD40, CD80, CD86; and major histocompatibility complex class II in addition to genes with known antiapoptotic functions including mitogen-activated protein kinase-activated protein kinase 2 (MAPKAPK2), tumor necrosis factor alpha-induced protein 3 (TNFAIP3) interacting protein 1 (TNIP1) and BCL3 of the PI-SCs. RESULTS: Rat PI-SCs were negative for CD45 as demonstrated by flow cytometry and for CD31, CD34, and CD71 as demonstrated by immunocytochemistry. Therefore, there was no evidence of hematopoietic precursors in the cultures. OCT4, SOX2, and REX1 were expressed by rat PI-SCs. We determined the expression of genes for antigen-presenting surface proteins CD40 and CD80, and genes with known antiapoptotic functions including MAPKAPK2, TNIP1 and BCL3, besides the surface protein, CD80, by flow cytometry. CONCLUSION: Expression of these genes by rat PI-SCs implied that they could be involved in the regulation of immunity in islets, highlighting the influence of protective role-playing antiapoptotic mechanisms on pancreatic islet cells. This study offers the potential to understand the molecular mechanisms of a devastating disease, type-1 diabetes mellitus.

[Eccrine hidradenitis. Case report and review of the literature]. / Ekkrine Hidradenitis. Kasuistik und Literaturübersicht.

Neutrophilic eccrine hidradenitis is a self-limited dermatosis with spontaneous resolution. The clinical presentation and location of the lesions are variable. Histopathologically, neutrophilic eccrine hidradenitis is characterized by a predominantly neutrophilic or mononuclear infiltrate around the eccrine ducts with associated necrosis. Possible causes include malignant hematological disorders, tumors, side effects of chemotherapy and bacteria infections. We report a 16-month-old female patient with idiopathic neutropenia undergoing G-CSF therapy, who suddenly developed numerous papules on her trunk and extremities. The lesions resolved spontaneously within 6 weeks without treatment. The clinical and histopathological findings of the hitherto published 45 cases are reviewed.

Collecting duct carcinoma.

Collecting duct carcinoma of the kidney is a rare variant of renal cell carcinoma. Hematuria is the most common presenting symptom. This tubulopapillary tumor arises from or differentiates forward to medullary collecting tubules. It is typically centered on the medulla of the kidney and extends into the cortex with a desmoplastic reaction. There are few reports documenting the clinical presentation and long-term prognosis. We describe a case of this uncommon tumor with clinical, histological and immunohistochemical features and review the literature.

Automated measurement of melanoma cross-sectional area.

The object of this study was to evaluate the prognostic impact of a cross-sectional area measured in routinely stained slides of cutaneous melanoma using fully automated image analysis. Hematoxylin-eosin stained slides of 238 specimens of primary cutaneous melanoma with Clark levels III to V were evaluated by digital image analysis using color video images, a scanning stage, and autofocus equipment. The cross-sectional area was significantly related to metastasis-free survival. Lesions with a cross-sectional area < or = 12 mm2 showed a 2-year metastasis-free survival rate of 92+/-2% compared with 41+/-8% in lesions with a cross-sectional area > 12 mm2 (log rank test: z = 71, p < 0.0001). The same was true for overall survival (98+/-1% compared with 82+/-6%; z = 42.12, p < 0.0001). In multivariate analysis, the cross-sectional area seems to provide prognostic information in addition to that provided by Breslow's index. In cases with regression and in small melanomas with vertical growth, however, metastatic spread may occur in lesions with a small cross-sectional area. It was concluded that automated measurement of the cross-sectional area may be helpful in assessing prognosis in cutaneous melanoma.