Proinflammatory cytokines in peritonitis.

RATIONALE: We performed this study with the purpose of revealing different aspects of the systemic inflammatory response syndrome in peritonitis. OBJECTIVES: The aim of the presentation was to make a research on some of the immune response mediators in secondary peritonitis and to observe their capacity to anticipate the evolution towards septic complications. METHODS AND RESULTS: We have undertaken a study on a group of 100 patients with acute diffuse peritonitis, between 2009 and 2011, in which we have accomplished the dosage of IL-1 beta, IL-6 and TNF alpha cytokines in the serum of patients, in dynamics, for 7 days by using the Elisa method. Subsequently, we have compared the results to the ones of a control group. The data obtained indicated high levels of proinflammatory cytokines in the patients who subsequently suffered an unfavorable evolution towards septic complications. DISCUSSION: The study of IL-1 beta, IL-6 and TNF alpha blood dynamics, offers valuable information about the severity of a systemic inflammatory response syndrome in peritonitis. They can be valuable biomarkers in establishing the unfavorable evolution of patients, helping the physician to establish a sustained and specific treatment, even from the early phases of the illness.

Endogenous phospholipid metabolite containing topical product inhibits ultraviolet light-induced inflammation and DNA damage in human skin.

BACKGROUND: N-palmitoylethanolamine (PEA) and organic osmolytes are endogenous components of the human epidermis and are generated from phospholipids in the stratum granulosum. PEA has been shown to exert potent antioxidant and anti-inflammatory activities. The endogenous organic osmolytes such as betaine and sarcosine control skin humidity, but have also been shown to inhibit ultraviolet (UV) light-induced oxidative stress in keratinocytes. OBJECTIVES: To investigate the effect of a PEA- and organic osmolyte-containing topical product (Physiogel AI) on the development of UV light-induced erythema, thymine dimer formation and p53 tumor suppressor gene activation, as well as intercellular adhesion molecule 1 (ICAM-1) and Ki67 expression in normal human skin. METHODS: The UV-induced erythema was measured by a spectrofluorometric method. Thymine dimers, p53, ICAM-1 and Ki67 were detected in skin biopsies using immunohistochemistry. RESULTS: Physiogel AI cream significantly inhibited the development of UV light-induced erythema and thymine dimer formation in normal human skin, but did not alter the number of Ki67+ proliferating keratinocytes and the expression of p53 and ICAM-1. CONCLUSIONS: Our results suggest that PEA and organic osmolytes might represent a new generation of compounds which suppress UV-induced photodamage.

A pressure-controlled rat ventilator with electronically preset respirations.

Major experimental surgery on laboratory animals requires adequate anesthesia and ventilation to keep the animal alive throughout the procedure. A ventilator is a machine that helps the anesthesized animal breathe through an endotracheal tube by pumping a volume of gas (oxygen, air, or other gaseous mixtures), comparable with the normal tidal volume, into the animal's lungs. There are two main categories of ventilators for small laboratory rodents: volume-controlled and pressure-controlled ones. The volume-controlled ventilator injects a preset volume into the animal's lungs, no matter the airways' resistance (with the peak inspiratory pressure allowed to vary), while the pressure ventilator controls the inspiratory pressure and allows the inspiratory volume to vary. Here we show a rat pressure ventilator with a simple expiratory valve that allows gas delivery through electronic expiration control and offers easy pressure monitoring and frequency change during ventilation.

[Risk factors for the immediate outcome of gastrointestinal bleeding in patients with cirrhosis]. / Factori de risc in evolutia imediata a hemoragiei digestive la cirotici.

The risk factors in the immediate outcome of gastrointestinal bleeding were examined in a prospective study of 134 patients with liver cirrhosis. The hemorrhagic episode has a negative prognosis in the immediate outcome (p < 0.01), recording 48 (35.82%) deaths. The deaths occurred in the acute phase of bleeding (n = 18; 13.40%), after recurrent hemorrhage (n = 24; 17.23%) and in 6 other cases (4.47%) after sclerotherapy or surgical treatment of varicosities. After varicose veins sclerotherapy (n = 8), 2 deaths were recorded and 4 other after surgery (n = 22). The advanced stage of cirrhosis, Child C stage, (n = 62) was accompanied by most of deaths (n = 38; 61.29%) (p < 0.01). Among the risk factors responsible for death, there were recorded: encephalopathy (p < 0.05), jaundice (p < 0.01), altered general status ((p < 0.01) and increased seric level of bilirubin over 3 mg% (p < 0.001). Jaundice is among the risk factors with the highest sensitivity (83.33%) and seric bilirubin over 3 mg% has the highest positive predictive value (64.28%).

Endothelial cells from hematopoietic stem cells are functionally different from those of human umbilical vein.

Hematopoietic stem cells have a remarkable plastic capacity, which allows them to differentiate into various cells, such as immune cells, nervous cells, muscle cells, bone and cartilaginous cells. The aim of this study was to show the capacity of stem cells to differentiate into endothelial cells, in culture, after addition of endothelial cells growth supplement (ECGS). We also compared the behavior of these cells with that of endothelial cells obtained from human umbilical vein (HUVEC). CD34+ cells obtained by immunomagnetic separation from human umbilical cord and placental blood were used. After 12-15 days of culture in a medium containing ECGS, the cells showed morphological changes characteristic to endothelial cells and immunocytochemical analysis revealed the presence of CD31 surface antigen and von Willebrand factor. The flow-cytometric analysis of endothelial cells adhesion molecules (ECAM) showed that endothelial cells derived from CD34+ cells expressed CD54/ICAM-1 9.65+/-0.2% and CD106/VCAM 7.73+/-0.3%, values similar to those expressed by HUVECs. After TNF incubation, ECAM expression increased only in HUVECs. These data demonstrate that a fraction of circulating CD34+ cells may develop some endothelial cell characteristics when cultured with ECGS, but they are functionally different from HUVECs.

Balkan endemic nephropathy, the haematopoietic system and the environmental connection.

We previously reported the detection of an increased subpopulation of cytotoxic T lymphocytes in patients with Balkan (endemic) nephropathy (BEN) and in area controls (individuals free of clinical syndrome but born in a BEN endemic area and having a family history of BEN). Extending the flow-cytometric analyses to other populations of peripheral blood leucocytes, we found a decrease in the proportion of B lymphocyte subset and an increased proportion of eosinophils in BEN patients and in area controls. Although these numerical alterations cannot be categorically linked to the aetiopathogeny of the disease, it is presumed that they can be induced by the same factor(s) causing the kidney damage, through a direct haemato- and lymphotoxic effect.

P-glycoprotein mediated multidrug resistance assessment by flow-cytometry in malignant hemopathies.

A relatively common and frequent form of multidrug resistance(MDR) in cancer cells is due to membrane overexpression of P-glycoprotein. Mdr phenotype was investigated by flow-cytometry in several types of malignant hemopathies -chronic lymphocytic leukemia, non-Hodgkin lymphomas, acute lymphoblastic and myeloblastic leukemias. We used daunomycin and fluo-3 as fluorochromes, and verapamil as reversor agent. The method is lacking unitary clinical parametrization and in order to improve it, we tried to establish an optimal concentration of verapamil, which was shown to be 14.92 micrograms/ml. The reliability of results obtained with fluo-3 in culture media containing Ca2+ is questionable, as low variations in the intracellular level of this ion dramatically influences light emission by the fluorochrome and possibly the function of P-gp. To avoid such fluorescence intensity variations, Ca(2+)-free cell culture medium for fluo-3-based flow-cytometric assay is suggested to be used.

Surgical treatment of pericyst in liver hydatid cysts.

The results of the surgical treatment of the pericyst in 94 patients with liver hydatid cyst are analyzed. Hepatic resections were performed in 2 patients, subtotal pericystectomy in 2 patients, partial pericystectomy in 65 patients, resection of the cyst dome in 9 patients and pericystodigestivostomy in 16 patients. The postoperative complications were statistically significant in complicated cysts (p < 0.001), in those with rigid walls (p < 0.001) and when lacking the adequate drainage (p < 0.01). The mean period of hospitalization was of 14 days in patients with supple pericyst and 40.1 days in those with rigid pericyst. Only one patient died of pulmonary embolism. In the absence of modern means of investigations and technical equipment in the treatment of the liver hydatid cyst, which is a benign disease, we have applied much simpler methods, but without vital risks.

Factors of prediction of immediate postoperative evolution in cancer of the colon.

A study carried out in 152 patients operated on for cancer of the colon showed that the early postoperative evolution of disease depends on the therapeutic method chosen according to the clinical stage of the tumor. The 31 deaths recorded in the first 30 postoperative days occurred mostly in the first week (45.1%) and were due either to hydro-electrolytic disturbances (69%) or to intraperitoneal septic complications (65%) with 0.66 and respectively 0.60 positive predictive value. Advanced forms of disease, emergency surgeries and presence of associated diseases are statistically significant risk factors.

Influence of age on the surgical treatment of cancer of the colon.

The study of 152 patients with cancer of the colon (CC) showed that age represents a factor of risk in the evolution of disease having a decisive influence on the immediate and delayed results of the surgical treatment. Over two thirds of the cases with advanced clinical stages were detected in subjects over the age of 50. In young agers the evolution of CC was severe and metastases appeared early. In old agers the incidence of disease increased and postoperative mortality was maximum. The mean postoperative survival time in the extreme age groups (young and old agers) was short in all the clinical stages.

Immediate and delayed results in complicated cancer of the colon.

In 34 patients operated on in emergency for complications of cancer of the colon (CC) it was found that complications prevailed in stage III of disease and were mainly represented by occlusions which were more frequent in left colon cancer. Radical surgery proved preferable to the palliative one. The mean survival time in months after emergency surgery for complications of CC was longer for right colon localizations and after radical surgery. The survival after 5 years was of 13%.

Immediate and late results in the surgical treatment of gastric cancer.

The study of 248 patients mostly males, aged over 50 years, operated on for gastric cancer (GC) has shown that the majority were in stages III and IV of disease. The antral localization of the tumor was the most frequent. In 6.45% of the cases acute complications occurred during the evolution of gastric cancer. Association with other diseases was found in proportion of 5.64%. The surgical treatment was differentiated according to the site and evolutive stage of the tumor but the most frequent was radical subtotal gastrectomy. The postoperative complications were either general or local. Postoperative mortality was higher in cancers situated in the upper third of the stomach, after total gastrectomy, and in stage IV of disease. The 5-year survival was 66.66% for stage II and 10.18% for stage III and the 10-year survival decreased to 40 and respectively 1.85%.

Factors predicting postoperative morbidity in biliary calculi.

Statistical analysis of a group of 1,114 patients operated for biliary lithiasis shows that the gravity of the disease, the nature of the complications that accompany it, the need to approach the common bile ducts (CBD) and age, stand at the origin of postoperative complications. To reduce postoperative morbidity elective surgery should be performed in cases of biliary lithiasis with paucity of symptoms during periods free of an attack and before the patient ages.