Assessing the potential risk of rupture of abdominal aortic aneurysms

Abdominal aortic aneurysms (AAAs) involve complex interplays between inflammatory and biomechanical factors that can be elucidated with anatomical and functional imaging. Although AAA size has been well-established in the literature to correlate with risk of rupture (and subsequent need for vascular intervention), there are other less-well-known characteristics about AAAs that also contribute to higher risk of rupture. This review focuses on biomechanical, radiological, and epidemiological characteristics of AAAs that are associated with higher rupture risk. For clinicians, knowing and considering a wide variety of risk factors in addition to AAA size is important to initiate early and proper intervention for AAA repair. Although there is no official quantitative risk score of AAA rupture risk that takes other non-size-related variables into account, if clinicians are aware of these other parameters, it is hoped that intervention can be appropriately performed for higher-risk AAAs that have not met the size-threshold for elective repair.

Beta thalassemia - a review

Thalassemia is a globin gene disorder that results in a diminished rate of synthesis of one or more of the globin chains. About 1.5% of the global population (80 to 90 million people) are carriers of beta Thalassemia. More than 200 mutations are described in beta thalassemia. However not all mutations are common in different ethnic groups. The only effective way to reduce burden of thalassemia is to prevent birth of homozygotes. Diagnosis of beta thalassemia can be done by fetal DNA analysis for molecular defects of beta thalassemia or by fetal blood analysis. Hematopoietic stem cell transplantation is the only available curative approach for Thalassemia. Many patients with thalassemia in underdeveloped nations die in childhood or adolescence. Programs that provide acceptable care, including transfusion of safe blood and supportive therapy including chelation must be established.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11609 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 663-671

Negative regulation of signal transducer and activator of transcription-3 signalling cascade by lupeol inhibits growth and induces apoptosis in hepatocellular carcinoma cells

Background:

Constitutive activation of signal transducer and activator of transcription signalling 3 (STAT3) has been linked with survival, proliferation and angiogenesis in a wide variety of malignancies including hepatocellular carcinoma (HCC).

Methods:

We evaluated the effect of lupeol on STAT3 signalling cascade and its regulated functional responses in HCC cells.

Results:

Lupeol suppressed constitutive activation of STAT3 phosphorylation at tyrosine 705 residue effectively in a dose- and time-dependent manner. The phosphorylation of Janus-activated kinases (JAKs) 1 and 2 and Src was also suppressed by lupeol. Pervanadate treatment reversed the downregulation of phospho-STAT3 induced by lupeol, thereby indicating the involvement of a phosphatase. Indeed, we observed that treatment with lupeol increased the protein and mRNA levels of SHP-2, and silencing of SHP-2 abolished the inhibitory effects of lupeol on STAT3 activation. Treatment with lupeol also downregulated the expression of diverse STAT3-regulated genes and decreased the binding of STAT3 to VEGF promoter. Moreover, the proliferation of various HCC cells was significantly suppressed by lupeol, being associated with substantial induction of apoptosis. Depletion of SHP-2 reversed the observed antiproliferative and pro-apoptotic effects of lupeol.

Conclusions:

Lupeol exhibited its potential anticancer effects in HCC through the downregulation of STAT3-induced pro-survival signalling cascade.

The role of stem cells in osteoarthritis: An experimental study in rabbits

Introduction

Osteoarthritis (OA) is a progressively debilitating disease that affects mostly cartilage, with associated changes in the bone. The increasing incidence of OA and an ageing population, coupled with insufficient therapeutic choices, has led to focus on the potential of stem cells as a novel strategy for cartilage repair.

Methods

In this study, we used scaffold-free mesenchymal stem cells (MSCs) obtained from bone marrow in an experimental animal model of OA by direct intra-articular injection. MSCs were isolated from 2.8 kg white New Zealand rabbits. There were ten in the study group and ten in the control group. OA was induced by unilateral transection of the anterior cruciate ligament of the knee joint. At 12 weeks post-operatively, a single dose of 1 million cells suspended in 1 ml of medium was delivered to the injured knee by direct intra-articular injection. The control group received 1 ml of medium without cells. The knees were examined at 16 and 20 weeks following surgery. Repair was investigated radiologically, grossly and histologically using haematoxylin and eosin, Safranin-O and toluidine blue staining.

Results

Radiological assessment confirmed development of OA changes after 12 weeks. Rabbits receiving MSCs showed a lower degree of cartilage degeneration, osteophyte formation, and subchondral sclerosis than the control group at 20 weeks post-operatively. The quality of cartilage was significantly better in the cell-treated group compared with the control group after 20 weeks.

Conclusions

Bone marrow-derived MSCs could be promising cell sources for the treatment of OA. Neither stem cell culture nor scaffolds are absolutely necessary for a favourable outcome.

Cite this article: Bone Joint Res 2014;3:32–7.

Antidiabetic and Antioxidant Activity of Scoparia dulcis Linn

The hypoglycaemic activity of methanol extract of Scoparia dulcis was performed on both in vitro and in vivo models along with determination of total extractable polyphenol. Methanol extract of Scoparia dulcis contains 4.9% and water extract contains 3.2% of total extractable polyphenol. The antioxidant activity showed very promising result in both the tested methods that is 2,2-diphenyl-1-picrylhydrazyl and ferric ion reducing capacity. The antioxidant activity is directly correlated to the antidiabetic potential of drug. The two enzymes (amylase and glycosidase) found in intestine are responsible for the increasing postprandial glucose in body. In vitro model was performed on these enzymes and the results showed that methanol extract of Scoparia dulcis was effective to check the postprandial glucose level. The in vivo hypoglycaemic activity of methanol extract of Scoparia dulcis was performed on streptozotocin-induced diabetes mellitus showed significant inhibition of blood glucose level as compared to control and similar to that of standard glibenclamide. The overall data potentiates the traditional value of Scoparia dulcis as an antidiabetic drug.

A review on Cressa cretica Linn.: A halophytic plant

Herbal medicine is used by up to 80% of the population in developing countries. Cressa cretica L. is a popular holophytic plant and is used in folklore medicine for ailments including diabetes, ulcers, asthma, anthelmintic, stomachic, tonic and aphrodisiac purposes, enriches the blood, and is useful in constipation, leprosy, and urinary discharges. The plant is traditionally used in Bahrain as expectorant and antibilious agent. Scientific evidence suggests its versatile biological functions such as its antibacterial, antifungal, antitussive, anticancer with some other plants, anti-inflammatory, and improving testicular function in rats. In this article, a comprehensive account of the morphology, phytochemical constituents, ethnobotany, and biological activities are included in view of the recent findings of importance on the plant, C. cretica.

Study of malignant germ cell tumors with special reference to malignant ovarian germ cell tumors: 5 years experience

Background: Germ cell tumors are rare and complex group of heterogenous neoplasms that comprise both benign and malignant histology. The testes and ovaries are the most common sites. This descriptive study focused on distribution of malignant germ cell tumors with more detail study of ovarian malignant germ cell tumors.Materials and Methods: All cases of malignant germ cell tumor reported from department of pathology of Tribhuvan University Teaching Hospital over five years from April 2007 to April 2012 were included in the study.Results: Thirty five cases (24 female and 11 male) were diagnosed as having malignant germ cell tumors. Most patients were below 30 years of age. Ovary was the most common site followed by testes. Malignant ovarian germ cell tumor comprised 54.3% of all malignant germ cell tumors. Age of these patients ranged from 6 years to 32 years. Most common histologic type was yolk sac tumor.Conclusion: Malignant germ cell tumors can be seen in any age group from new born to old age. However malignant ovarian germ cell tumors occur mainly in first three decades of life, are mostly unilateral and are of large size at the time of diagnosis due to rapid growth. However these tumors are often of low stage and managed with conservative surgery.Journal of Pathology of Nepal (2012) Vol. 2, 289-292DOI: http://dx.doi.org/10.3126/jpn.v2i4.6880

Bronchodilatory and mast cell stabilising activity of Cressa cretica L.: evaluation through in vivo and in vitro experimental models

OBJECTIVE

To evaluate the effect of ethylacetate fraction (Fr-Et) and methanolic fraction (Fr-Me) obtained from Cressa cretica L.(C. cretica) L. on experimental models for bronchodilatory activity and mast cell stabilising activity.

METHODS

The effect of Fr-Et and Fr-Me were studied on acetylcholine and histamine aerosol-induced broncospasm using guinea pigs as experimental animals. Also, the effects of these fractions were evaluated on the isolated guinea pig tracheal preparations. Besides this mast cell degranulation effect was assessed using egg albumin and compound 48/80 on rat peritoneal mast cells.

RESULTS

Significant increase in preconvulsion time was observed due to pretreatment with the fractions when guinea pigs were exposed to histamine and acetylcholine aerosol. Fr-Et and Fr-Me significantly increased the preconvulsion in a dose depended manner that suggestive of bronchodilating activity. Fr-Et and Fr-Me exhibited a significant concentration dependant relaxant effect on guinea pig trachea pre-contracted with CCh, K(+) and histamine. The results revealed that Fr-Et to be more potent than Fr-Me in relaxing histamine and K(+) and calcium induced contraction than CCh induced contractions. Studies on the fractions in protecting mast cell degranulation, which were elicited by the egg albumin as well as synthetic compound 48/80 revealed both the fractions significantly protect the mast cell degranulation, which release mediators such as histamine and proinflammatory cytokines through various stimuli in a dose depended manner.

CONCLUSIONS

Thus our study established the bronchodilator activity, and mast cell stabilizing activity which are important mediators that provoke or sustain in asthma.

Phase-contrast MRI and applications in congenital heart disease

A review of phase-contrast magnetic resonance imaging techniques, with specific application to congenital heart disease, is presented. Theory, pitfalls, advantages, and specific examples of multiple, well-described congenital heart disease presentations are discussed.

Correlation between preoperative endometrial sampling and final endometrial cancer histology

OBJECTIVE

We conducted a study to evaluate the correlation between pre-operative endometrial sampling to the final endometrial cancer histology, in particular the non-endometrioid subtypes.

METHODS

This involved 191 hysterectomy specimens of patients undergoing treatment at the Pan-Birmingham Gynaecological Regional Cancer Centre (BGCC) over a two-year period (2006-2007).

RESULTS

The majority of the patients in this study were found to have endometrioid histology subtype (140/191, 73%). However, the non-endometrioid histologic subtypes were well presented in our population (51/191, 27%). We found good correlation for endometriod histology subtype (78%) and certain types of the non-endometrioid cell types (carcinosarcoma 90%, uterine papillary serous carcinoma 67%, clear cell carcinoma 67%) but poor in sarcomas (40%). Our results also demonstrated that both pre-operative endometrial sampling methods (curettage and pipelle biopsy) were reliable in identifying endometrioid and non-endometrioid cancer cell types, with sensitivities of 96.5% and 86.5%, respectively.

CONCLUSION

We concluded that preoperative endometrial sampling had good overall histological correlation to hysterectomised corpus specimen. This is especially so for the endometrioid and certain subtypes of the non-endometrioid endometrial cancer cells.

Lack of promoter IV-driven BDNF transcription results in depression-like behavior

Transcription of Bdnf is controlled by multiple promoters, in which promoter IV contributes significantly to activity-dependent Bdnf transcription. We have generated promoter IV mutant mice [brain-derived neurotrophic factor (BDNF)-KIV] in which promoter IV-driven expression of BDNF is selectively disrupted by inserting a green fluorescent protein (GFP)-STOP cassette within the Bdnf exon IV locus. BDNF-KIV animals exhibited depression-like behavior as shown by the tail suspension test (TST), sucrose preference test (SPT) and learned helplessness test (LHT). In addition, BDNF-KIV mice showed reduced activity in the open field test (OFT) and reduced food intake in the novelty-suppressed feeding test (NSFT). The mutant mice did not display anxiety-like behavior in the light and dark box test and elevated plus maze tests. Interestingly, the mutant mice showed defective response inhibition in the passive avoidance test (PAT) even though their learning ability was intact when measured with the active avoidance test (AAT). These results suggest that promoter IV-dependent BDNF expression plays a critical role in the control of mood-related behaviors. This is the first study that directly addressed the effects of endogenous promoter-driven expression of BDNF in depression-like behavior.

The haemodynamic response to propranolol in cirrhosis with arterial hypertension: a comparative analysis with normotensive cirrhotic patients

BACKGROUND

Cirrhosis with arterial hypertension is not uncommon. Haemodynamic alterations in these patients and the effects of beta-blocker on hepatic venous pressure gradient (HVPG) and systemic haemodynamics have not been evaluated.

AIMS

To compare the systemic haemodynamic alterations in hypertensive and normotensive cirrhotics, and to investigate the effects of propranolol on these parameters.

METHODS

A retrospective analysis of consecutive hypertensive cirrhotic patients (n = 33) who underwent haemodynamic assessment and paired HVPG measurement was done. Normotensive cirrhotics (n = 50) served as controls.

RESULTS

Hypertensive patients had a significantly higher heart rate, systemic (SVRI), and pulmonary vascular resistance. There was a significant reduction in mean arterial pressure (MAP) in the hypertensive cirrhotic group from 112 (107-130) mmHg to 95 (77-114) mmHg (P < 0.01), but no change in the normotensives. SVRI remained the same in the hypertensive cirrhotic group, but it increased in the normotensives. There was no correlation between MAP reduction and HVPG reduction.

CONCLUSIONS

The frequency of HVPG response with propranolol treatment in hypertensive cirrhotics is similar to normotensive cirrhotics. Propranolol treatment reduces MAP significantly in hypertensive patients with cirrhosis. Treatment with a nonselective beta-blocker is a good strategy for hypertensive cirrhotic patients.