A HISTOPATHOLOGICAL STUDY OF DIFFUSE HYPERPLASIA OF GASTRIC ARGYROPHIL CELLS

The present study includes a histopathological and immunohistochemical study of 4 cases of diffuse hyperplasia of gastric argyrophil cells. The mode of proliferation of these cells and the production of hormone by these cells have been documented. The distribution of microacinar nests composed of argyrophil cells was thought to be related to chronic gastritis in which there are atrophy of mucosa and intestinal metaplasia. In the case in which these nests were found only in the corpus ventriculi, there was intestinal metaplasia throughout the stomach. On the other hand, in the case in which these nests appeared only in the pyloric area, atrophy of the mucosa with mild intestinal metaplasia was observed only in the pyloric area. The microacinar nests composed of argyrophil cells were distributed in the deep mucosa at the basal portion of the glands in the area with intestinal metaplasia. Serial sections revealed a sprout composed of argyrophil cells budding from the gland with intestinal metaplastic changes. The sprout buds out from the growth zone of glands with Intestinal metaplasia and then becomes isolated and gives rise to reactive hyperplasia. The peptide hormone contained in these cells differs according to the mucosal environments. Cells containing gastrin were observed in the pyloric area, but not in the corpus ventriculi where there was marked intestinal metaplasia. The cells in this area were assumed to contain other hormones.     

Inflammatory and oxidative stress biomarkers in allergic rhinitis: the effect of smoking

Background Accumulating evidence confirms the presence of pan‐airway inflammation in allergic rhinitis patients. Smoking is known to affect the asthmatic airway inflammation. However, no study has evaluated the impact of smoking on airway inflammation of allergic rhinitis patients. Objective The aim of the present study was to evaluate the impact of smoking on inflammatory and oxidative stress biomarkers in patients with seasonal allergic rhinitis, using non‐invasive methods for sample collection. Methods Forty patients with seasonal allergic rhinitis (20 smokers and 20 non‐smokers) and 30 healthy subjects (15 smokers and 15 non‐smokers) were recruited for the study during pollen season. All subjects were submitted to measurement of the fraction of exhaled NO (FeNO), exhaled breath condensate (EBC) collection, nasal lavage collection, pre‐ and post‐ bronchodilation spirometry and metacholine bronchial challenge testing. pH, leukotriene B₄ (LTB₄) and 8‐isoprostane were determined in EBC and nasal lavage samples. Results Patients with allergic rhinitis presented higher LTB₄ and 8‐isoprostane levels in nasal lavage (P<0.0001 for both comparisons), with no significant differences between smokers and non‐smokers. Patients with allergic rhinitis also presented higher LTB₄ levels and lower pH in EBC (P<0.001 and P=0.004, respectively), with prominent differences between smokers and non‐smokers (P<0.0001 and P=0.003, for LTB₄ and pH, respectively). A significant correlation between nasal lavage and EBC LTB₄ values was observed (r_s=0.313, P=0.048). Conclusions Patients with allergic rhinitis present increased LTB₄ and 8‐isoprostane in their nasal cavity, however, with no significant differences between smokers and non‐smokers. In contrast, smokers with allergic rhinitis present higher LTB₄ levels and lower pH in EBC, suggesting that these patients may be more susceptible to the deleterious effects of smoking, compared with non‐smokers.     

Extra-Anatomic Jump Graft Arterial Reconstruction Using a Great Saphenous Vein Autograft During Living Donor Liver Transplantation

BackgroundIn living-donor liver transplantation (LDLT), successful microsurgical arterial reconstruction is essential but quite challenging. Dissection of the hepatic artery extending to the celiac trunk is a rare complication during liver transplantation. Kazakhstan is an area in which deceased donor grafts are not sufficient for several reasons, and the availability of graft vessels is limited.MethodsWe herein report the case of a 65-year-old patient who underwent LDLT due to hepatitis B + D virus-coinfected liver cirrhosis complicated by hepatic artery dissection extending to the celiac trunk. Because of massive gastric collateral varices, direct anastomosis to the supraceliac aorta was not possible. Therefore, extra-anatomic jump graft reconstruction was performed from the right iliac artery to the graft’s hepatic artery using an autologous graft vein (great saphenous vein).ResultsThe patient’s postoperative period was uneventful. The patient was discharged at 27 days post-transplantation. At the time of writing, the follow-up period is 8 months after transplantation, and the recipient maintains a normal liver function.ConclusionWhen there is no other option for arterial reconstruction, this method is a feasible option for performing extra-anatomic jump graft reconstruction.     

ANAPLASTIC CARCINOMA OF THE ESOPHAGUS

The present report includes the histological, electron microscopical and immunohistochemical findings observed in two cases of anaplastic carcinoma of the esophagus. Anaplastic carcinoma of the eosphagus revealed histological features similar to oat-cell carcinoma and carcinoid. Positive argyrophil reaction, neurosecretory granules, and hormonal activity suggest that both cases come under the category of neuroendocrine cell tumors. Anaplastic carcinoma of the esophagus may be considered as a pluripotential tumor. The biological behavior of this tumor is quite different from that of carcinoid and is a highly malignant tumor.     

Oxidative stress and inflammatory markers in the exhaled breath condensate of children with OSA

Introduction

Obstructive sleep apnea (OSA) in children has been associated with systemic inflammation and oxidative stress. Limited evidence indicates that pediatric OSA is associated with oxidative stress and inflammation in the airway.

Objective

The objective of this study is to assess the hypothesis that levels of oxidative stress and inflammatory markers in the exhaled breath condensate (EBC) of children with OSA are higher than those of control subjects.

Methods

Participants were children with OSA and control subjects who underwent overnight polysomnography. Morning levels of hydrogen peroxide (H₂O₂) and sum of nitrite and nitrate (NO _x ) in EBC of participants were measured.

Results

Twelve subjects with moderate-to-severe OSA (mean age?±?standard deviation: 6.3?±?1.7?years; apnea?Chypopnea index??AHI, 13.6?±?10.1 episodes/h), 22 subjects with mild OSA (6.7?±?2.1?years; AHI, 2.8?±?1 episodes/h) and 16 control participants (7.7?±?2.4?years; AHI, 0.6?±?0.3 episodes/h) were recruited. Children with moderate-to severe OSA had higher log-transformed H₂O₂ concentrations in EBC compared to subjects with mild OSA, or to control participants: 0.4?±?1.1 versus ?0.9?±?1.3 (p?=?0.015), or versus ?1.2?±?1.2 (p?=?0.003), respectively. AHI and % sleep time with oxygen saturation of hemoglobin <95% were significant predictors of log-transformed H₂O₂ after adjustment by age and body mass index z score (p? x levels.

Conclusions

Children with moderate-to-severe OSA have increased H₂O₂ levels in morning EBC, an indirect index of altered redox status in the respiratory tract.