Regeneration of skeletal muscles and state of thymus in gamma-irradiated rats under laser therapy of the area of muscle trauma.

The gamma-irradiation of adult rats with a semi-lethal dose (6 Gy) suppressed the posttraumatic regeneration of skeletal muscles and brought about considerable destructive changes in the thymus. The effect of He-Ne laser radiation at a total dose 4.5-5.4 J/cm2 at each operated leg in irradiated rats stimulated the regenerative capacity of skeletal muscle tissue, the healing of skin-muscle wound, and the processes of postradiation recovery in thymus cells (a decrease of chromosome aberrations). The histological structure of regenerates had more muscle pattern. At the same time, the positive dynamics of regenerative processes in muscles was achieved by an increased functional load on the thymus. To stimulate the regeneration of irradiated muscles on the background of a more moderate load on the thymus, the prolonged period of laser therapy and fragmentary distribution of laser exposures during muscle regeneration were preferable. Wound healing improved visibly. Nor formation of chronic radiation ulcers on operated shins was observed.     

P63Stem Cell and Immunotherapy Services, NHS Blood and Transplant, Birmingham, UK

Over 20 years ago, the Birmingham Blood Centre established a facility for the cryopreservation of bone marrow (BM) for patients in the West Midlands suffering from haematopoietic disorders and for whom a bone marrow transplant was indicated. Today, the use of mobilised peripheral blood (PBSC) has overtaken bone marrow as the source of stem cells for transplantation and the numbers of patients benefitting and the diversity of conditions being treated has increased enormously. Allogeneic transplants, using stem cells from healthy donors, have become increasingly successful as a result of an improving understanding of the complexities of the HLA histocompatibility system. Additionally umbilical cord blood (HUC), which in the 1980s was recognised as a source of stem cells, can now be collected and used for transplantation. As scientific knowledge and the clinical management of patients has advanced, so too have laboratory methods for manipulating cell products to enrich or deplete certain cell populations (e.g. by CD34+cell selection) in order to minimise potentially fatal graft-versus-host disease (GVHD) or to eliminate tumour cells in the case of autologous patients. Donor lymphocytes (DLI) may also be collected and used to aid a graft-versus-leukaemia (GVL) effect. The laboratory is currently developing protocols for immunotherapy using virus-specific T cells which can be prepared and infused to combat potentially fatal CMV disease post-transplant. Clinical trials of vaccines employing tumour specific dendritic cells for treating patients with hepatocellular carcinoma (HCC) and metastatic melanoma (MM), which do not respond to conventional treatments, are also underway. The advances and expansion in the Stem Cell and Immunotherapy (SCI) service in Birmingham over the last 10 year period are reflected in the table below:
 

     

Mucosal features and granulocyte–monocyte-apheresis in steroid-dependent/refractory ulcerative colitis

BACKGROUND: Mucosa-infiltrated granulocyte neutrophils are an early characteristic of inflammation and the main histological feature of active ulcerative colitis. Mucosal healing has recently been indicated as an important tool in the evaluation of response to treatment. While several studies have stressed the efficacy of granulocyte-monocyte-apheresis in inducing clinical remission in active ulcerative colitis, few data are available on mucosal features. AIM: Aim of this study was to assess the effects of granulocyte-monocyte-apheresis on clinical and mucosal features in patients with ulcerative colitis, dependent upon or refractory to steroids. MATERIAL AND METHODS: From April 2004 to April 2005, 12 patients (5 females, 7 males, mean age 49 years, range 33-71 years), with mild-moderate ulcerative colitis (six left colitis, six pancolitis) dependent/refractory upon steroids were enrolled. Each patient was treated for a 5-week period with five cycles of granulocyte-monocyte-apheresis. Patients were evaluated at baseline and 1 week after the last apheresis by means of Global Physician Assessment, quality of life features, laboratory tests (erythrocyte sedimentation rate, CRP, full blood count, faecal calprotectine), endoscopy and histology. RESULTS: At week 6 of follow-up, complete mucosal healing was observed in 3 out of 12 patients, partial mucosal healing in 8 patients and no change in 1 patient. Clinical response was complete in 8 out of 12 patients. CONCLUSIONS: These data suggest that granulocyte-monocyte-apheresis induces an improvement both in clinical and mucosal lesions in steroid-dependent/refractory ulcerative colitis. Of note, the reduction in granulocyte infiltration and the improvement in mucosal lesions are accompanied by a reduction in faecal calprotectine.     

Carotid endarterectomy with internal carotid artery segmental resection, temporary shunt and vein patch angioplasty: early and mid-term results.

AIM: The authors report an alternative procedure to carotid endarterectomy with internal carotid artery (ICA) segmental resection and end-to-end anastomosis associated with temporary shunt and venous patch angioplasty. Design: prospective cohort study. METHODS: Between May 1995 and December 2004, 192 patients underwent 200 primary CEAs for significant ICA stenosis. There were 131 men and 61 women with a mean age of 72.4+/-8.4 years. The indications for CEA were asymptomatic lesions in 51.5%, transient ischemic attack in 27.5% and stroke in 21%. RESULTS: The combined early morbidity and mortality rate was 2%. Two patients died, one due to fatal intracerebral hemorrhage and the second patient died of acute mesenteric ischemia. Neurological complications occurred in 2 patients, including 1 TIA and 1 nondisabling cerebrovascular accident. Non-neurological complications occurred in 26 patients (13.5%). Seventeen patients (8.8%) developed hypertension, 3 neck hematomas (1.5%) required surgical evacuation, 1 patient had reversible supraventricular arrhythmia (0.5%) and 1 patient had pneumonia (0.5%). Furthermore, 1 asymptomatic carotid occlusion was identified (0.5%) and 3 patients suffered permanent cranial nerve injury (1.5%). Mean follow-up was 45.7 months and there were 41 late deaths (21.8%). Survival rates at 1 and 5 years were 96.7+/-1.2% and 73.58+/-4.2%, respectively. CONCLUSIONS: CEA with ICA shortening and reanastomosis is a safe and reliable procedure without any increase in morbidity or mortality.