Myelo-enhancement by astragalus membranaceus in male albino rats with chemotherapy myelo-suppression. Histological and immunohistochemical study.

BACKGROUND AND OBJECTIVES: Myelosuppression is the most common toxicity encountered in the oncology clinic today. This study was planned to investigate the possible protective and therapeutic role of the traditional Chinese Medicinal Herb; Astragalus Membranaceus (AM), on chemotherapy-induced myelosuppression. METHODS AND RESULTS: This study was carried out on thirty six adult male albino rats. They were divided into: Group I Control Group (n=6) received a vehicle of phosphate buffered saline (PBS) solution. Group II (n=12) were injected I.P. with cyclophosphamide (CY) for 3 days (gIIa n =6) and continued for one more week to receive AM orally (gIIb n=6). Group III (n=6) received CY I.P. together with AM orally for 3 days. Group IV (n=12) received AM orally for one week (gIVa n=6) and continued for extra three days receiving CY I.P. with AM orally (gIVb n=6). Blood samples were analysed for Total Leucocytic Count and Lymphocytic Count. Counting of CD34 +ve cells in bone marrow was performed by flowcytometry. Bone marrow sections were subjected to H&E stain as well as immunohistochemical staining for anti- CD20 antibody. The mean area % of cellular bone marrow regions occupied by developing haemopoietic cells, mean area of fat cells and mean number of CD20 immunopositive B lymphocytes in the bone marrow were measured by histomorphometric studies and statistically compared. AM proved to have a myelo-protective and myelo-therapeutic capacity, evidenced at both laboratory and morphological levels. CONCLUSIONS: The greatest myelo-potentiating effect of AM was achieved when supplied before and together with CY therapy.

Perioperative acute phase response and outcome of hepatic resection, an experimental study.

Identification of patients at risk of postoperative complications could have an impact on the indications for a procedure as well as permitting modifications of treatment to reduce the surgical risk. This experimental study evaluated the correlation between peri-operative acute phase response and outcome of hepatic resection. The study was conducted on sixty healthy golden hamsters, which underwent partial hepatectomy. They were arranged in 3 groups (20 per each). One day prior to resection, fracture of the left hind leg was done in group I (G I) & wound infection had been created in group II (GII); while nothing done in group III (GIII) that acted as a control. Blood samples to estimate SGPT and serum albumin (as basic investigations for hamsters liver function) and serum IL-6 and CRP (as acute phase reactants) were taken preoperatively, immediately after resection and for the consecutive 3 days post operatively. The mean serum level of both acute phase reactants increased in GI and GII preoperatively and continues to rise immediately after resection. Post-operatively; among the three groups, the mean serum level of both reactants was higher in GI than in GII that was in turn higher than in GIII except when the postoperative complications were more severe than the other group, then this relation changed.

The effect of in vivo mobilization of bone marrow stem cells on the pancreas of diabetic albino rats (a histological & immunohistochemical study).

BACKGROUND AND OBJECTIVES: The rapidly increasing number of diabetic patients across the world drew the attention to develop more effective therapeutic approaches. Recent investigations on newly differentiated insulin producing cells (IPCs) revealed that they could be derived from embryonic, adult mesenchymal and hematopoietic stem cells. This work was planned to evaluate the role of StemEnhance (Aphanizomenon flos-aquae [AFA] plant extract) in mobilizing naturally occurring bone marrow stem cells as well as in improving streptozotocin-induced diabetic rats. METHODS AND RESULTS: Twenty adult male albino rats were divided into four groups namely the control, the diabetic, the positive control-StemEnhance and the diabetic-StemEnhance groups. After diabetes induction by streptozotocin (STZ), rats received StemEnhance for four weeks. The mean number of blood CD34 immunopositive cells was measured by flowcytometry and random blood sugar was measured weekly. The pancreas was removed from the sacrificed rats and processed for staining with H&E and immunohistochemical staining for CD34+ve and insulin +ve cells. CD34+ve cells increased in the blood after introduction of StemEnhance. CD34+ve cells were observed in the pancreas and the insulin producing cells in the islets of Langerhans were increased from the second to the fourth week of treatment. Blood glucose level improved but it was still higher than the control level after four weeks of StemEnhance treatment. CONCLUSIONS: This work points to the significant role of StemEnhance in stem cell mobilization and the improvement of diabetes mellitus.

Dose related effect of systemic antibiotics in prevention of postoperative intra-abdominal adhesion formation in experimental animals.

Sixty hamsters weighing 100-120 g were randomly assigned to 2 equal groups. GI was injected intramuscularly with saline, half an hour preoperatively as control, and GII was injected with 50 mg/kg Cefepime HCI & 7.5 mg/kg Metronidazole. After a midline lapparotomy, abdominal adhesions were induced in GI & GII. Post-operration, animals in GI was divided according to the numbers of intramuscular saline injections into 2 subgroups. GIa (15) in which animals were injected every 12 hours for 2 doses and GIb (15) where animals were injected every 12 hours for 5 days. Similarly, the antibiotic group was subdivided into GIIa (15) and GIIb (15). On the 14th day, the hamsters were sacrificed and the adhesion score was determined. The 5 day antibiotics course revealed significant reduction in incidence (P < 0.01), extent (P < 0.001) and severity (P < 0.01) of the postoperative peritoneal adhesions, while the short course failed.

Gastrointestinal stromal tumors (GISTs): clinical presentation, diagnosis, surgical treatment and its outcome.

This study included 13 selected patients treated by surgical excision for lesions that proved postoperatively to be gastrointestinal stromal tumors (GISTs) by histopathological and immunohistochemistry studies. The demographic, clinical and operative reports data were collected. Eight cases were gastric GISTs, four cases were small bowel GISTs (jejunum 1 & ileum, 3) and GIST of the sigmoid colon was in one patient. Eight cases presented at the emergency department due to hematemesis (3), gastrointestinal obstruction (3), bowel perforation (1) and severe bleeding per rectum (1). Three cases presented with a feeling of abdominal fullness and ill-defined palpable abdominal mass. Two cases were discovered incidentally during GIT endoscopy for dyspepsia. Diagnosis of GISTs was presumed on clinical basis and operative findings from gross morphological features. Complete resection (R0) was achieved for 12 tumors (92.3%). The immunohistochemistry profile was positive for C-kit for all cases. One operative death was due to massive pulmonary embolism. Postoperative complications occurred in three (23%) as upper GIT bleeding (1), biliary gastritis (1) and wound infection (1), and one (7.69%) of ileum tumor recurrence.

New approach in surgical management of complicated umbilical hernia in the cirrhotic patient with ascites.

A total of 23 consecutive patients operated upon on emergency basis for the treatment of complicated umbilical hernias associated with liver cirrhosis and ascites. The hernia was complicated by strangulation in 11 and ascitic fluid leak in twelve of the patients. Patients were assigned randomly in two groups. In the first group (GI, n = 12) peritoneal drainage at the conclusion of their surgery was done but no drainage was applied in the second group (GII, n=12). All patients were operated upon and when closed system peritoneal drainage was done, it was brought to outside of the abdomen through a separate stab. No negative pressure was applied. The main outcome measures were postoperative wound healing, control of ascites, complications, and hernia recurrence rate at follow up. The male/female ratio, Child's class, ascites severity, and mode of hernia complication were almost matched in both groups. Postoperative wound dehiscence occurred in four patients in G II (23.5%) but in none of GI. Control of ascites was achieved in all patients of GI. The overall mean hospital stay was significantly lower in-patient of GI than those of the G II (P < 0.0 1). Recurrences of the hernia occurred in one patient only of the G I and in three of the G II on a mean follow- up of 19+/-3 months. So, postoperative closed peritoneal drainage in the management of complicated umbilical hernias associated with liver cirrhosis and ascites safe and effective in assuring postoperative wound healing, control of ascites and the prevention of hernia recurrence. It is specifically indicated in cases with bowel resection anastomosis and in patients with low preoperative serum albumin and history of rapid ascites re-accumulation under medical therapy.