EXPRESSION PROFILES OF MIR-155-5P AND MIR-518B MICRORNAS IN CIRCULATING LEUKOCYTES OF THE PREGNANT PATIENTS WITH PREECLAMPSIA AND POLYCYSTIC OVARY SYNDROME.

Context: Polycystic ovary syndrome (PCOS) is associated with increased prevalence of preeclampsia (PE); microRNAs (miRs) could play an important role in the pathogenesis of PE and PCOS. Objective: To investigate the expression levels of miRs 155-5p and 518b in blood leukocytes of patients with PE and PCOS. Design: Using real-time quantitative PCR method, miR-155-5p and miR-518b were examined from PE, PCOS, PE+PCOS, and controls. Subjects and Methods: The relative expression of the target miRs in patient samples was compared to control samples. The results were calculated as relative quantification values. Results: Confounding variables were controlled using analyses for covariance. Significant differences were observed in miR-155-5p (p=0.008) and miRNA-518 (p=0.016) expression levels among the groups. miR-155-5p (p=0.014) and miR-518b (p=0.036) were upregulated in PCOS patients and miR-518b (p=0.028) were increased in cases with PCOS+PE. Near significant difference was found (p=0.06) in miR-518b expression levels in cases with PE, compared to controls. miR-518b was observed to be positively correlated with alanine transaminase in cases with PE (r=0.80; P=0.017) and PE+PCOS (r=0.80, p=0.017). Conclusions: Our preliminary findings suggested that expression profiling of miR-155-5p and miR-518b in blood leukocytes were upregulated in pregnant women with PCOS. Moreover, miR-518b was found to be related to PE in cases with PCOS.

Prevalence of dentine hypersensitivity among adult patients attending a dental hospital clinic in Turkey.

OBJECTIVES: The aim of this study is to determine the prevalence of dentine hypersensitivity (DH) and to examine some associated factors such as the initiating stimuli among adult patients attending the Restorative Clinic of the Kirikkale University Dental Faculty, Turkey. METHODS: Questionnaires for 1169 patients, 678 men and 491 women, were completed and necessary clinical examinations performed during a one-year period and patients who were diagnosed with DH were questioned further about their occupation and smoking habits. Patients with at least two different quadrants which had sensitive teeth with sound exposed cervical dentine on the facial surface, were included in the study. The amount of cervical lesions, buccal gingival recession and initiating factors associated with the sensitive teeth were also recorded. RESULTS: Of the 1169 patients examined, 89 were diagnosed as having dentine hypersensitivity, giving a prevalence of 7.6%. The commonest teeth affected were the upper premolars and the commonest initiating factor was cold drinks. CONCLUSIONS: The prevalence of dentine hypersensitivity in a postgraduate clinic in Turkey was 7.6%. The commonest teeth affected were the upper premolar and the commonest initiating factor was cold drinks.

Periodontal health knowledge and smoking are associated with periodontal treatment need according to tooth brushing levels.

OBJECTIVE: The aim of this study is to determine whether periodontal health knowledge is associated with frequency of tooth brushing and periodontal treatment need. METHODS: Four hundred and two subjects participated in the study. Data on sociodemographic variables (age, gender, marital status, income, and education), general health, smoking behaviour tooth cleaning habits and knowledge on periodontal health/disease were collected with a questionnaire. Periodontal treatment need was examined using the Community Periodontal Index of Treatment Needs (CPITN). According to the CPITN scores, the treatment needs were grouped as minimum (CPITN = 0), low-level (CPITN = 1-2), or high-level (CPITN = 3-4). RESULTS: Statistical differences were found between the frequency of tooth brushing and smoking status, marital status, periodontal health knowledge and periodontal treatment needs. Gender (females), place of residence (urban areas), education and periodontal health knowledge had positive relationship with tooth brushing frequency, while smoking and periodontal treatment need had negative relationship. When multivariate logistic regression analysis was applied, age, marriage and poor periodontal knowledge were associated with increased low-level periodontal treatment needs, and age, marriage and smoking were associated with increased high-level periodontal treatment need. CONCLUSION: In the limits of this study, we suggest that gender, smoking habits, marital status, place of residence, education and periodontal health knowledge are determining factors related to tooth brushing frequency. Periodontal knowledge and smoking are associated with periodontal treatment needs.

Prevalence of dentine hypersensitivity among adult patients attending a dental hospital clinic in Turkey / Prevalencia de la hipersensibilidad dentinaria entre los pacientes adultos que asisten a la clínica del hospital dental en Turquía

OBJECTIVES: The aim of this study is to determine the prevalence of dentine hypersensitivity (DH) and to examine some associated factors such as the initiating stimuli among adult patients attending the Restorative Clinic of the Kirikkale University Dental Faculty, Turkey. METHODS: Questionnaires for 1169 patients, 678 men and 491 women, were completed and necessary clinical examinations performed during a one-year period and patients who were diagnosed with DH were questioned further about their occupation and smoking habits. Patients with at least two different quadrants which had sensitive teeth with sound exposed cervical dentine on the facial surface, were included in the study. The amount ofcervical lesions, buccal gingival recession and initiating factors associated with the sensitive teeth were also recorded. RESULTS: Of the 1169 patients examined, 89 were diagnosed as having dentine hypersensitivity, giving a prevalence of 7.6%. The commonest teeth affected were the upper premolars and the commonest initiating factor was cold drinks. CONCLUSIONS: The prevalence of dentine hypersensitivity in a postgraduate clinic in Turkey was 7.6%. The commonest teeth affected were the upper premolar and the commonest initiating factor was cold drinks.

OBJETIVOS: El objetivo de este estudio fue determinar la prevalencia de la hipersensibilidad dentinaria (HD) y examinar algunos factores asociados con ella, tales como los estímulos iniciadores entre los pacientes adultos que asisten a la Clínica Restaurativa la Facultad Dental Universitaria de Kirikkale, Turquía. MÉTODOS: Cuestionarios entregados a 1169 pacientes, 678 hombres y 491 mujeres, fueron respondidos, y se realizaron los exámenes clínicos necesarios por espacio de un ano. Los pacientes que fueron diagnosticados con HD, fueron interrogados ulteriormente acerca de su ocupación y el hábito defumar. Los pacientes con al menos dos cuadrantes diferentes, que tenían dientes sensibles con exposición de dentina cervical sana sobre la superficie facial, fueron incluidos en este estudio. También se registró la cantidad de lesiones cervicales, la recesión gingival bucal y los factores iniciadores asociados con la sensibilidad de los dientes. RESULTADOS: De los 1169 pacientes examinados, 89 se diagnosticaron con hipersensibilidad de la dentina, para una cifra de prevalencia de 7.6%. Los dientes más comúnmente afectados fueron los premolares superiores y los factores iniciadores más comunes fueron las bebidas frías. CONCLUSIONES: La prevalencia de la hipersensibilidad dentinaria en una clínica postgraduada en Turquía fue de 7.6%. Los dientes más comúnmente afectados fueron los premolares superiores y el facgor iniciador más común fueron las bebidas frías.

Periodontal health knowledge and smoking are associated with periodontal treatment need according to tooth brushing levels / Los conocimientos de salud periodontal y el hábito de fumar se encuentran asociados con la necesidad de tratamiento periodontal de acuerdo con los niveles de cepillado dental

OBJECTIVE: The aim of this study is to determine whether periodontal health knowledge is associated with frequency of tooth brushing and periodontal treatment need. METHODS: Four hundred and two subjects participated in the study. Data on sociodemographic variables (age, gender, marital status, income, and education), general health, smoking behaviour, tooth cleaning habits and knowledge on periodontal health/disease were collected with a questionnaire. Periodontal treatment need was examined using the Community Periodontal Index of Treatment Needs (CPITN). According to the CPITN scores, the treatment needs were grouped as minimum (CPITN = 0), low-level (CPITN = 1-2), or high-level (CPITN = 3-4). RESULTS: Statistical differences were found between the frequency of tooth brushing and smoking status, marital status, periodontal health knowledge and periodontal treatment needs. Gender (females), place ofresidence (urban areas), education and periodontal health knowledge had positive relationship with tooth brushing frequency, while smoking and periodontal treatment need had negative relationship. When multivariate logistic regression analysis was applied, age, marriage and poor periodontal knowledge were associated with increased low-level periodontal treatment needs, and age, marriage and smoking were associated with increased high-level periodontal treatment need. CONCLUSION: In the limits of this study, we suggest that gender, smoking habits, marital status, place of residence, education and periodontal health knowledge are determining factors related to tooth brushing frequency. Periodontal knowledge and smoking are associated with periodontal treatment needs.

OBJETIVO: El objetivo de este estudio fue determinar si el conocimiento de salud periodontal se halla asociado con la frecuencia del cepillado dental y la necesidad de tratamiento periodontal. MÉTODOS: Cuatrocientos dos sujetos participaron en el estudio. Mediante encuestas, se recogieron datos sobre las variables sociodemográficas (edad, género, estado civil, ingreso, y educación), salud general, comportamiento hacia el fumar, hábitos de limpieza de los dientes, y conocimientos en relación con la enfermedad/salud periodontal. Se examinó la necesidad de tratamiento periodontal usando Sin embargo el Índice de Necesidades de Tratamiento Periodontal de la Comunidad (CPITN), De conformidad con las puntuaciones de CPITN, las necesidades de tratamiento se clasificaron como mínimas (CPITN = 0), bajo nivel (CPITN = 1-2), o alto nivel (CPITN = 3-4). RESULTADOS: Se encontraron diferencias estadísticas entre la frecuencia del cepillado dental con el estatus en torno al hábito de fumar, estado civil, conocimiento de salud periodontal y necesidades del tratamiento periodontales. El género (las hembras), lugar de residencia (las áreas urbanas), la edu-cación y el conocimiento de salud periodontal guardaron una relación positiva con la frecuencia del cepillado dental, mientras que el fumar y la necesidad de tratamiento periodontal, guardaban una relación negativa. Al aplicar el análisis de regresión logística multivariante, se halló que la edad, el matrimonio y el pobre conocimiento periodontal se encuentran asociados con el aumento de la necesidad de de alto nivel. CONCLUSIÓN: En los límites de este estudio, se sugiere que el género, hábito defumar, estado civil, lugar de residencia, educación, y conocimientos de salud periodontal, son factores determinantes relacionados con la frecuencia de cepillado dental. El conocimiento periodontal y el hábito de fumar están asociados con las necesidades del tratamiento periodontales.

Epidermal growth factor-containing wound closure enhances wound healing in non-diabetic and diabetic rats.

BACKGROUND: This study was designed to elucidate the in vivo efficacy of epidermal growth factor (EGF) on wound healing in non diabetic and diabetic rats. METHODS: Ninety-six male Wistar-Albino rats were randomly divided into six groups. Saline-moistened gauze, pure gelatin or EGF in gelatin-microsphere dressings were used in a dermal excision model in both normal and streptomycin-induced diabetic rats. Wound healing was evaluated on day 7 and 14. Reduction in wound area, hydroxypyroline content and tensile strength of the wound were evaluated in each rat. Tissue samples taken from the wounds were examined histopathologically for reepithelialisation, cellular infiltration, number of fibroblasts, granulation and neovascularisation. RESULTS: On day 7, the use of EGF-containing dressing was observed to reduce the wound area better when compared with the other dressings tested. This effect was significant in normal rats rather than diabetic rats. The difference in reduction of wound area did not persist on day 14. No significant effect on hydroxyproline content of the wound was found with EGF-containing dressing in either normal or diabetic rats. There was a statistically significant increase in tensile strength values of EGF-applied non diabetic rats over the 14 day period. An increase in tensile strength was prominent in also EGF-applied diabetic rats on day 14. Histological examination revealed higher histopathologic scores in EGF-applied diabetic and non diabetic rats. CONCLUSION: These findings implicate that use of EGF in gelatin-microsphere dressings improves wound healing both in normal and diabetic rats.

Modification of a conventional anaerobic digester for improving the effluent and sludge characteristics.

The aim of this study was to enrich the composition of anaerobic digester sludge in terms of nitrogen and phosphorus by struvite (MgNH4PO4) formation. Waste activated sludge was anaerobically digested in batch reactors under the conditions that the minimum stoichiometric requirement for struvite formation was satisfied in all reactors. For this purpose, different amounts of magnesium (Mg2+) and phosphate (PO4(3-)) ions were added initially to the batch reactors. The results showed the effects of adding Mg2+ and PO4(3-) ions on the performance of anaerobic digestion and on the amounts of ammonium (NH4+) and PO4(3-) ions released during digestion. The results indicated that the performance of the anaerobic digestion in chemical oxygen demand removal changed between -4.0% and 15.4% for a Mg2+ concentration range of 277.2 to 529.3 mg/L and a PO4(3-) concentration range of 377.4 to 2372.4 mg/L. There was an increase in the concentration of NH4+ in all reactors during digestion, but the extent of concentration increase could be controlled by increasing the initial concentrations of Mg2+ and PO4(3-). The maximum removal of NH4+ ions (33.7%) was observed in the reactor dosed initially by Mg2+ and PO4(3-) concentrations of 467.2 and 2123.3 mg/L, respectively. The concentration of PO4(3-) ion was lower than its initial concentration in all reactors, indicating considerable fixation of PO4(3-) as it was released, by struvite and other solid species formation. The decrease in the concentration of Mg2+ ions similar to PO4(3-) was accepted as evidence for the formation of solid species composed of Mg2+ and PO4(3), in addition to struvite. Water

Assessment of alveolar bone levels from bitewing, periapical and panoramic radiographs in periodontitis patients / Evaluación de los niveles de hueso alveolar a partir de radiografías interproximales, periapicales y panorámicas en pacientes con periodontitis

The aim of this study was to determine the relationship between loss of radiographic crestal bone height in panoramic, bitewing and periapical radiography and to probe the attachment loss after periodontal treatment. Radiographic and probing measurements were made at baseline and after one year. The population in the study consisted of 21 individuals, 13 females and 8 males, ages 18-59 [mean 35.7] years. A total of 42 interproximal intra-bony defects of 21 mandibular first molar teeth, treatments of which were planned by subgingival curettage procedures, were selected from among 21 subjects who had signed consent forms. Measurements of the distance between the cemento-enamel junction and the alveolar crest were compared with probing crestal bone level and radiographic measurements before and one year after the procedures. The results of probing pocket depths level before and one year after subgingival curettage were different with the mean average being 1.18 ± 1.51 mm. These changes were statistically significant (p < 0.05). Bitewing radiography showed the highest accuracy among radiographic methods in the assessment of the crestal bone level mean average 0.22 ± 0.87 mm (p < 0.05). There was only a slight mean difference compared to panoramic radiography but this was statistically insignificant, mean average 0.20 ± 1.35 mm (p > 0.05), and the periapical radiography had the lowest accuracy of radiographic methods, changed mean average -0.14 ± 1.19.mm (p > 0.05). In summary, we can say that both bitewing and panoramic radiography are preferred to periapical images for crestal bone assesment.

El objetivo de este estudio fue determinar la relación entre la pérdida de altura radiográfica de hueso crestal en radiografías panorámicas interproximales y periapicales, e investigar la pérdida de inserción tras el tratamiento periodontal. Las mediciones radiográficas y de sondeo fueron realizadas en la situación inicial y luego de un año. La población bajo estudio consistió en 21 individuos, 13 hembras y 8 varones, con edades 18-59 [media 35.7] (años). Un total de 42 defectos intraóseos interproximales de 21 primeros molares mandibulares, cuyos tratamientos fueron planeados mediante procedimientos de curetaje subgingival, fueron seleccionados de entre 21 sujetos que habían firmado su consentimiento. Las mediciones de la distancia entre la unión cemento-esmalte y la cresta alveolar, fueron comparadas sondeando el nivel de hueso crestal y recurriendo a mediciones radiográficas, antes y después (un año más tarde) de los procedimientos. Los resultados del sondeo del nivel de profundidad de la bolsa antes y después del curetaje subgingival, fueron diferentes, siendo la media promedio 1.18 ± 1.51 mm. Estos cambios fueron estadísticamente significativos (p < 0.05). La radiografía inter-proximal mostró la mayor exactitud entre los métodos radiográficos de evaluación del nivel óseo crestal, para una media promedio de 0.22 ± 0.87 mm (p < 0.05). Hubo sólo una ligera diferencia media en comparación con la radiografía panorámica, pero fue estadísticamente insignificante, siendo la media promedio 0.20 ± 1.35 mm (p > 0.05). En cambio, la radiografía periapical resultó ser la de más baja precisión entre los métodos radiográficos, para un cambio en la media promedio de -0.14 ± 1.19.mm (p > 0.05). En resumen, puede decirse que tanto la radiografía interproximal como la panorámica tienen preferencia por sobre las imágenes periapicales a la hora de la evaluación del hueso crestal.

Anaerobic digestion of dairy manure with enhanced ammonia removal.

Poor ammonia-nitrogen removal in methanogenic anaerobic reactors digesting animal manure has been reported as an important disadvantage of anaerobic digestion (AD) in several studies. Development of anaerobic processes that are capable of producing reduced ammonia-nitrogen levels in their effluent is one of the areas where further research must be pursued if AD technology is to be made more effective and economically advantageous. One approach to removing ammonia from anaerobically digested effluents is the forced precipitation of magnesium ammonium phosphate hexahydrate (MgNH4PO4 x 6H2O), commonly called struvite. Struvite is a valuable plant nutrient source for nitrogen and phosphorus since it releases them slowly and has non-burning features because of its low solubility in water. This study investigated coupling AD and controlled struvite precipitation in the same reactor to minimize the nitrogen removal costs and possibly increase the performance of the AD by reducing the ammonia concentration which has an adverse effect on anaerobic bacteria. The results indicated that up to 19% extra COD and almost 11% extra NH3 removals were achieved relative to a control by adding 1750 mg/L of MgCl2 x 6H2O to the anaerobic reactor.

Assessment of alveolar bone levels from bitewing, periapical and panoramic radiographs in periodontitis patients.

The aim of this study was to determine the relationship between loss of radiographic crestal bone height in panoramic, bitewing and periapical radiography and to probe the attachment loss after periodontal treatment. Radiographic and probing measurements were made at baseline and after one year The population in the study consisted of 21 individuals, 13 females and 8 males, ages 18-59 [mean 35.7] years. A total of 42 interproximal intra-bony defects of 21 mandibular first molar teeth, treatments of which were planned by subgingival curettage procedures, were selected from among 21 subjects who had signed consent forms. Measurements of the distance between the cemento-enamel junction and the alveolar crest were compared with probing crestal bone level and radiographic measurements before and one year after the procedures. The results of probing pocket depths level before and one year after subgingival curettage were different with the mean average being 1.18 +/- 1.51 mm. These changes were statistically significant (p < 0.05). Bitewing radiography showed the highest accuracy among radiographic methods in the assessment of the crestal bone level mean average 0.22 +/- 0.87 mm (p < 0.05). There was only a slight mean difference compared to panoramic radiography but this was statistically insignificant, mean average 0.20 +/-1.35 mm (p > 0.05), and the periapical radiography had the lowest accuracy of radiographic methods, changed mean average -0.14 +/- 1.19 mm (p > 0.05). In summary, we can say that both bitewing and panoramic radiography are preferred to periapical images for crestal bone assessment.

Blood pressure, heart rate and temperature variability during periodontal surgery

The aim of the present study is to investigate changes in blood pressure, pulse rate and temperature before and after periodontal surgery. The study included 127 normal healthy patients (43 males, 84 females) with age range 9 to 65 years (mean age: 26 +/- 12 years) who underwent periodontal surgery. After administration of a local anaesthetic agent (Ultracain DS) containing 0.06 mg adrenaline, the blood pressure, pulse rate, and temperature were measured. Based on the type of operation, the patients were divided into four groups. Statistically significant changes (as decreasing) in all parameters were observed (blood pressure: systolic 111.3 +/- 20.1, diastolic 67.7 +/- 13.1, pulse rate: 87.8 +/- 14.9, temperature: 36.3 +/- 0.3 ) but these changes were significantly decreased after operations (blood pressure: systolic 105.9 +/- 19. 7, diastolic 62.6 +/- 11.3, pulse rate: 84.01 +/- 13.1, temperature: 36.2 +/- 0.3). And without age group differentiation in all parameters, statistically significant decreases were found among females (p < or = 0. 05).

Control of trichloroethylene emissions from sparging systems by horizontal bio- and chemo- barriers.

The scope of this study was to develop a continuous system to clean-up a trichloroethylene (TCE) contaminated gas stream, where biotic and abiotic removal mechanisms are undertaken sequentially simulating the horizontal bio- and chemo-barriers proposed for the in-situ remediation of the contaminated sites. The bio- and chemo-barriers were simulated by using glass columns packed with granular anaerobic mixed culture and Fe(0) filings, respectively. The effect of gas residence time, which is adjusted by the gas flowrate, on the TCE removal efficiency of the reactor system was investigated. TCE removal efficiency of over 90% was achieved at gas residence times above 1hr. Furthermore, the effluent of reactor system contained only ethane and ethylene, which are non-toxic by-products of TCE reduction reactions, along with trace amounts of TCE.

Blood pressure, heart rate and temperature variability during periodontal surgery.

The aim of the present study is to investigate changes in blood pressure, pulse rate and temperature before and after periodontal surgery. The study included 127 normal healthy patients (43 males, 84 females) with age range 9 to 65 years (mean age: 26 +/- 12 years) who underwent periodontal surgery. After administration of a local anaesthetic agent (Ultracain DS) containing 0.06 mg adrenaline, the blood pressure, pulse rate, and temperature were measured. Based on the type of operation, the patients were divided into four groups. Statistically significant changes (as decreasing) in all parameters were observed (blood pressure: systolic 111.3 +/- 20.1, diastolic 67.7 +/- 13.1, pulse rate: 87.8 +/- 14.9, temperature: 36.3 +/- 0.3 ) but these changes were significantly decreased after operations (blood pressure: systolic 105.9 +/- 19. 7, diastolic 62.6 +/- 11.3, pulse rate: 84.01 +/- 13.1, temperature: 36.2 +/- 0.3). And without age group differentiation in all parameters, statistically significant decreases were found among females (p < or = 0. 05).

Exotic arteriovenous fistulas for hemodialysis.

The rate of patients with exhausted upper extremity arteriovenous fistula (AVF) sites who have lost all chances for a conventional upper extremity AVF has been increasing in line with the general increase in the hemodialysis patient population. In this prospective study, we report the early and late follow-up results of "exotic" AVFs in which central veins are used for the outflow. Patients having no chance for an upper extremity AVF based on previous catheterization, surgical AVF history, detailed physical examination, and radiological assessment, were included in the study. Between June 1999 and January 2003, 27 central AVFs were created with a 6 mm synthetic vascular graft in 26 patients. The inflow artery was the proximal axillary artery in all except one. All but one operation was done by the same surgeon. The outflow vein was the internal jugular vein in 16 and infraclavicular axillary vein in 11 cases. One-year primary and secondary graft patency rates were 33.33 +/- 10.49 and 57.06 +/- 11.29, respectively. The early complications were facial edema and hemiparesis, both of which resolved spontaneously. The only late complication, pseudoaneursym, was treated by a graft interposition. In selected patients who have no suitable upper extremity vessels for an AVF, the central veins may be used with an acceptable success rate. Another advantage of this procedure is the avoidance of undesired femoral interventions; sometimes it may be the only opportunity and lifesaving for the patient.

Femoral vein transposition versus femoral loop grafts for hemodialysis: a prospective evaluation.

In this first clinical trial femoral vein transposition (FVT) was prospectively compared with its "graft" counterpart. Patients requiring vascular access due to occluded central veins were divided into two groups: group I (n = 17) underwent femoral loop grafts and group II (n = 15), FVT. Complications were recorded prospectively and patency rates were compared by the Kaplan Meier method with statistical comparisons by Mann Whitney U and chi-square tests as appropriate. Between 1999 and 2003 30 patients underwent 32 operations. Mean follow-up was 8.9 months in group I and 6.8 months in group II (P >.05). Three group I patients developed a steal, requiring closure of the fistula in one. Five group II patients developed a steal, requiring closure of the fistula in one. The incidence of steal was similar in both groups (P >.05). The infection rates were similar: 35.3% and 26.7% in group I versus group II (P >.05), respectively. Among the six infections in group I, four patients required excision of the graft due to infection, whereas only one arteriovenous fistula (AVF) was closed in group II for infection. The 1-year primary patency rate in group I was 37.5% versus 86.7% in group II (P <.05). In conclusion, Femoral AVF grafts have been condemned because of the unacceptable high rate of septic complications. FVT obviates the need for a graft and has fewer infectious problems and better patency rates.

Possible role of nitric oxide in the biology of breast carcinoma: review of the available literature.

Nitric oxide was studied to investigate its possible involvement in the promotion of breast carcinoma: both the development of the primary tumour and the process of metastasis seem to be influenced by the presence and the amount of nitric oxide. We review the available literature on this topic, which seems to suggest an influence of nitric oxide on the cancer cell biology in breast carcinoma, but the argument is still controversial. More studies are needed to clarify the sequence of events and the real impact of nitric oxide on the behaviour of the disease.

Mobilization of peripheral blood stem cells with chemotherapy and recombinant human granulocyte colony-stimulating factor (rhG-CSF): a randomized evaluation of different doses of rhG-CSF.

To date, no randomized study has compared different doses of recombinant human granulocyte colony-stimulating factor (rhG-CSF) following submyeloablative mobilization chemotherapy. Therefore, we evaluated the effect of different doses of rhG-CSF following mobilization chemotherapy on yields of CD34+ peripheral blood stem cells (PBSC). Fifty patients were randomized to receive 8 (n = 25) versus 16 microg/kg/d (n = 25) of rhG-CSF following mobilization chemotherapy. The median number of CD34+ cells collected after 8 microg/kg/d of rhG-CSF was 2.36 x 10(6)/kg (range, 0.21-7.80), compared with 7.99 (2.76-14.89) after 16 microg/kg/d (P < 0.001). Twenty out of 25 (80%) patients in the low-dose and 23 out of 25 (92%) in the high-dose rhG-CSF arm underwent high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT). Median days to white blood cell engraftment in patients mobilized with 8 microg/kg and 16 microg/kg of rhG-CSF were 12 (10-20) and 9 (8-11) respectively (P < 0.001). There was no difference between the two groups regarding the other parameters of peritransplant morbidity: days to platelet engraftment (P = 0.10), number of red blood cell (P = 0.56) and platelet transfusions (P = 0.22), days of total parenteral nutrition requirement (P = 0.84), fever (P = 0.93) and antibiotics (P = 0.77), and number of different antibiotics used (P = 0.58). These data showed that higher doses of rhG-CSF following submyeloablative mobilization chemotherapy were associated with a clear dose-response effect based on the collected cell yields. Based on the parameters of peritransplant morbidity, 8 microg/kg/d was as effective as 16 microg/kg/d except for a rapid neutrophil engraftment in the high-dose arm. Therefore, in routine clinical practice, despite some advantage in the use of higher doses of rhG-CSF, lower doses may be used for PBSC collections following chemotherapy-based mobilization regimens in this cost-conscious era.

Effect of granulocyte-macrophage colony-stimulating factor on hepatic regeneration after 70% hepatectomy in normal and cirrhotic rats.

BACKGROUND: Post-hepatectomy liver insufficiency is one of the most serious postoperative problems and its prevention is important after major hepatic resection, especially in the cirrhotic liver. Some growth factors and cytokines appear to play important roles in liver regeneration. In the present study we have investigated the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) on hepatic regeneration after 70% partial hepatectomy (PH) in cirrhotic and non-cirrhotic rats. METHODS: A rat model of liver cirrhosis was prepared using thioacetamide (TAA) (a dose of 20 mg/100 g body w, intra-peritoneally) on three days a week for 12 weeks. Adult male rats were divided into four groups:Group 1 (n=10) no cirrhosis and no GM-CSF; Group 2 (n=10) no cirrhosis and GM-CSF; Group 3 (n=10) cirrhosis and no GM-CSF; and Group 4 (n=10) cirrhosis and GM-CSF. All the rats underwent a 70% hepatectomy, and GM-CSF was administrated immediately after operation in Groups 2 and 4. On postoperative days 2 and 7, fresh samples from the remnant liver were obtained to evaluate its regenerative capacity.The liver regenerative process was estimated by DNA synthesis, using flow cytometry. RESULTS: Proliferation index (PI) of hepatocytes at 48 h was higher in Group 4 rats than Group 3 rats (p<0.05). On postoperative day 7, PI was elevated in Group 3 rats compared with Group 4 rats, but this difference was not statistically significant. In non-cirrhotic rats given GM-CSF, PI was increased compared with Group 1 rats at day 2 (p<0.05), but not at day 7. CONCLUSIONS: The findings suggest that the proliferative capacity of liver cells is impaired and delayed after 70% PH in cirrhotic rat liver. GM-CSF administration might enhance the liver PI in both normal and TAA-induced cirrhotic rats.

Effect of recombinant human granulocyte/macrophage colony-stimulating factor on the healing of colonic anastomosis in rats.

The purpose of this study was to investigate the efficacy of recombinant human granulocyte/macrophage colony-stimulating factor (rHuGM-CSF) on the wound healing of colonic anastomosis in rats. In total, 40 male Wistar rats were taken into this study. The control group (n = 20) received subcutaneous saline injection. The experiment group (n = 20) received rHuGM-CSF at 100 microg/kg subcutaneously. Both groups underwent colonic anastomosis 2 days later. In each group, burst pressure and hydroxyproline levels were determined 3 and 7 days after anastomosis. White blood cell (WBC) and red blood cell (RBC) counts were determined in each group to evaluate the effect of rHuGM-CSF on hematologic parameters in rats. There was no significant difference between the two groups in regard to burst pressure and hydroxyproline levels (p > .05). As expected, WBC counts significantly increased in the experiment group on days 3 (p = .035) and 7 (p = .046) following surgery. In conclusion, rHuGM-CSF administration and increased WBC counts did not have any positive effect on the wound healing of colonic anastomosis.

Anatomical considerations in the surgical management of blunt thoracic aortic injury.

PURPOSE: Blunt aortic injury (BAI) involving the thoracic aorta is usually described as occurring at the isthmus. We hypothesized that injuries 1 cm or less from the inferior border of the left subclavian artery (LSCA) are associated with an increased mortality rate compared with injuries that are more distal. METHODS: A retrospective review of patients admitted with the diagnosis of BAI was performed. Injuries were divided into two groups: group I, injuries that were 1 cm or less from the junction of the LSCA and the thoracic aorta; group II, injuries that were more than 1 cm from the LSCA. Primary outcome measures included cross-clamp time, rupture, and death. RESULTS: In a 14-year period, 122 patients were admitted with BAI. The anatomy relative to the LSCA could be determined in 91 patients who underwent operative repair. Forty-two injuries (46%) were classified as group I, and 49 injuries were classified as group II. Group I injuries were characterized by an increased mortality rate (18/42 or 43% in group I vs 11/49 or 22% in group II, P = .04), intraoperative rupture rate (7/42 or 17% in group I vs 1/49 or 2% in group II, P = .003), and cross-clamp time (39.5 +/- 21.9 minutes in group I vs 28.4 +/- 13 minutes in group II, P = .04). Three ruptures occurred while proximal control was being obtained. CONCLUSION: Increased technical difficulty and risk of rupture characterize injuries that occur proximally in the descending thoracic aorta, 1 cm from the LSCA. These injuries may be better managed by instituting bypass before attempting to obtain proximal control and by routinely clamping proximal to the LSCA.