Expression of receptor activator of nuclear factor -κB ligand,receptor activator of nuclear factor -κB,and osteoprotegerin,following low-level laser treatment on deproteinized bovine bone graft in rats

The aim of this study was to investigate by immunohistochemistry the effects of low-level laser (LLL) irradiation on the expression of the receptor activator of nuclear factor -κB ligand (RANKL), osteoprotegerin (OPG), and the receptor activator of nuclear factor -κB (RANK) in deproteinized bovine bone grafts in rats. Twenty-four male Sprague-Dawley rats aged 15 weeks were allocated to either an experimental group that underwent LLL irradiation during bone healing at the bone graft sites of the rats’ calvarial bone defects or a control group. In the experimental group, gallium–aluminum–arsenide (Ga-Al-As) diode LLL (wavelength 808 nm; output 96 mW) was used to irradiate three areas on and around bone defects. The radiation was administered by the contact method for 10 s at 8.3 J/cm², once a day for 7 days. The total dose over the complete schedule was 40.32 J. The animals were killed on days 7, 14 or 21. The results of immunohistochemical analysis showed that the expression of RANKL (P = 0.199), OPG (P = 0.035), and RANK (P = 0.020) in the experimental group significantly increased from day 7, with a more even distribution than in the control group, and that this difference prevailed until the end of the experiment. Bone density of the experimental group after trichrome staining was also higher than in the control group. These results suggest that LLL irradiation facilitates bone metabolism during bone healing at the sites of deproteinized bovine bone grafts in rats.     

Expression of cell cycle regulators, 14-3-3σ and p53 proteins,and vimentin in canine transitional cell carcinoma of the urinary bladder

ObjectivesThe study of the expression of 14-3-3σ, p53, and vimentin proteins in canine transitional cell carcinoma (TCC) evaluating differences with normal bladder tissues, and the association with clinicopathological variables.MethodsWe analyze by immunohistochemistry in 19 canine TCCs the expression of 14-3-3σ, p53, and vimentin using monoclonal antibodys. A semiquantitative scoring method was employed and statistical analysis was performed to display relationships between variables.ResultsIn contrast to normal urinary bladder epithelium, which showed high levels of 14-3-3σ, its expression was decreased in 53% of the studied tumors (P = 0.0344). The 14-3-3σ protein was expressed by neoplastic emboli and by highly infiltrative neoplastic cells. The p53 protein was expressed in 26% of TCCs, but no significant association between 14-3-3σ and p53 was detected. Neoplastic epithelial cells displayed vimentin immunoreactivity in 21% of TCCs, and a positive correlation with mitotic index was observed (P = 0.042). Coexpression of vimentin and 14-3-3σ by highly infiltrative neoplastic cells was also observed.Conclusions14-3-3σ is deregulated in canine TCCs and its expression by highly infiltrative tumor cells may be related to the acquisition of aggressive behavior. Furthermore, this article reinforce the role of canine TCC as relevant model of human urothelial carcinoma and we suggest 14-3-3σ as a potential therapeutic target. Further studies are necessary to clarify the role of 14-3-3σ in canine TCC.     

Evaluation of results of replantations at the Department of Plastic Surgery, University Hospital Královské Vinohrady, during the period 1994-1999

During the period from 1994-1999, 226 patients were treated, incl. 91 replantations and 135 revascularizations. The group included 199 men and 27 women. The success rate of microsurgical reconstruction operations in replantations was 78%, in revascularizations 93%. As compared with the period 1984-1993, the success rate in replantations improved by 4%, while the indication pattern was preserved.     

Carotid body tumour - an experience of 8?years at SSKM Hospital, IPGME& R, Kolkata, India

Objective

To review our experience of management of carotid body tumours at SSKM hospital, IPGME&R, Kolkata, India.

Material and methods

Seven patients who were operated between years 2003 and 2011 form the basis for this study. Their data was analyzed retrospectively from the hospital records. Diagnosis was made on history, physical examination and investigations such as Colour Doppler, Computed Tomography (CT) Angiography and Magnetic Resonance Imaging (MRI) scan of brain

Results

The most common age for presentation was third to fifth decade. Four patients were male and 3 female. Right side was commonly involved (five of seven). Most common presentation was a painless swelling. Five patients were in Shamblin grade II and two patients in grade III. In two patients external carotid artery was ligated and one patient had injury to internal carotid artery during surgery necessitating repair. In all of the cases internal carotid artery was preserved. No patient suffered cerebral stroke and all were discharged in good general condition.

Conclusion

Carotid body tumour is an uncommontumour. It commonly presents as a slow growing mass, usually on right side of the neck and surgery is the treatment of choice. Meticulous subadventitial dissection and excision is a good technique with low morbidity and mortality. The diagnosis of the tumours at an early stage reduces the risks and complications, associated with increased Shamblin grading of the tumour and allows good post operative results.     

Evaluation of the effectiveness and limits of balneology therapy for arthrosis in Lacu Sărat Health Resort, Brăila, Romania, in the period of 1994-2003

This research tried to estimate the importance of the precocious diagnosis in the arthrosis. It also analyzed the efficiency and limits of the balneology therapy based on the facilities offered by Lacu S?rat Health Resort, Br?ila. The approaching method consisted of a retrospective analysis of 10565 standard records of patients suffering from arthrosis, hospitalized in the health resort, between 1994-2003. The cases fell into various categories, according to the illnesses, as follows: 2854 (27.01%) gonarthrosis, 1247 (11.82%) coxarthrosis, 2001 (18.91%) spondylosis, 2003 (18.87%) peripheral arthrosis. The balneology treatment was applied individually, taking into consideration the location, clinical stage and associated illnesses. The treatment also included physiotherapy and kinetic therapy, adjusted to the stage of disease. The treatment results were good in 73.30% of cases. The patients' recovery aims at stabilizing the development of the illness, removing the objective as well as subjective suffering and maintaining the mobility and ability of the affected segment. The conclusions of the research underline the particular contribution of the clinical evaluation in diagnosis and the efficiency of external balneology in removing the pain and inflammation, maintaining the articular mobility and ability. Thus, the cure can ensure an appropriate articular comfort for most of the patients, taking into consideration the recurrent character of the illness, with repeated periods of suffering and pain.     

A review of K. Kobus: “Atlas of plastic surgery” Medsport Press Warsaw, 2004, p 301, ISBN 83-90870-7-7, US$ 70.00

Book Review

A review of K. Kobus: “Atlas of plastic surgery”Medsport Press Warsaw, 2004, p 301, ISBN 83-90870-7-7, US$ 70.00     

Observations on the use of TachoSil® in cholecystectomy - a multicentre, prospective, single-arm cohort study

An observational study on TachoSil? as used in the gall bladder surgery and an analysis of the experience obtained by employing a haemostatic agent in one of the most common procedures in general and visceral surgery have been carried out. The aim of the study was to answer the following questions. When is TachoSil? in routine use? Does TachoSil? have a positive effect on the perioperative course? Is TachoSil? suitable for the routine application in difficult cholecystectomy? In the present single-arm prospective cohort study only departments with specialisation in general and visceral surgery of 40?clinics in Germany participated. Although 500 planned interventions were to be documented in 2007, only 169?operations were actually reported. The numerical results were statistically analysed and summarised. Before the operation was carried out a classification according to the bleeding history was performed. The surgery was performed in the open, laparoscopic or converted modes. During the intervention the surgeon decided about the application of TachoSil? on the basis of a risk index. According to the collected data, it was significant that TachoSil? was used more frequently when either a cholecystectomy was performed in the open mode or on conversion from laparoscopic to the open mode. Also it was significant that TachoSil? was chosen when a patient had a defect in blood coagulation or when the cholecystectomy was part of a multivisceral resection. 59.7% of the patients where TachoSil? was used had a known risk of haemorrage. 12.4?% of the patients where TachoSil was used underwent at least one intervention to compensate intraoperative blood loss before (10.1?% blood transfusion, 4.7?% blood substitutes). In 97?% TachoSil? was used as a haemostatic agent, in 30.2?% it was chosen to prevent a biliary leak and in 11.24?% to?augment vulnerable tissue (multiple answers possible). Concerning laparoscopic cholecystectomy, it was significant that the surgeons decided to take middle-sized patches (4.8?×?4.8?cm) more frequently. Only in 6 cases were the small-sized patches (3?×?2.5?cm) chosen. 90.5?% of the patches were placed in the liver bed. In 5.3?% of the cases the position was not documented. In 4.1?% the patch was placed upon the hepatoduodenal ligament or a suture of the bile duct. To conclude, in difficult cholecystectomies and cholecystectomies as part of multivisceral resection, the use of TachoSil? is an option for experts to secure the seam, to prevent a bile leakage and to control bleeding in the surgical areas.     

Localizations and expressions of α-1A, α-1B and α-1D adrenoceptors in human ureter

This study was designed to determine the expression and localization of the α-adrenoceptor (AR) subtypes in human ureteral tissue. The expression of the α-AR subtypes was examined by immunohistochemistry using subtype selective antibodies in proximal, mid and distal ureter. Ureter samples were obtained from pathological specimens of nephroureterectomy. A single pathologist scored the expression of receptor (grade 0, no staining; grade 1, 0–25% cells positive; grade 2, 26–50% cells positive; and grade 3, greater than 50%). We compared the mean grades of α-AR 1A, 1B and 1D and the percentage of receptor expression with grade 2 or more between receptor subtypes in each ureter level. The expression levels of all three subtypes are altered according to the level of ureter. In the proximal ureter, the mean grades of the α-1A, -1B and -1D receptors were 1.0 ± 0.5, 1.1 ± 0.6, and 2.1 ± 0.7. Corresponding grades in the mid and distal ureter were 1.1 ± 0.6, 0.8 ± 0.6 and 2.0 ± 0.8, and 2.0 ± 0.7, 1.8 ± 0.6 and 2.5 ± 0.5, respectively. When compared with percentage of high expression, in the proximal and mid ureter, α-1D high expression percentage was significantly higher than α-1A and -1B subtype (80, 10, 20, and 90, 20, 10%, respectively). In the distal ureter, α-1D expression was higher than α-1A and -1B subtype but there was no statistical significance (100, 80, 70%). The distal ureter had higher density of α-AR receptors than proximal and mid ureter. The expression of α-1A and α-1B AR in distal ureter was significantly higher than proximal and mid ureter. α-1D expression in distal ureter was also higher than proximal and mid ureter but was not statistically significant (p = 0.28, 0.19, respectively). Our results show that α-1A, -1B and -1D AR subtypes are localized in human ureter irrespective of location. The expression levels of subtypes are altered according to level of ureter and subtype. This study was supported by Seoul National University Hospital Clinical Research Institute (06-2005-164-0). An erratum to this article can be found at