P–391 Role of subcutaneous granulocyte colony-stimulating factor infusion in thin endometrium

Study question

To assess the role of subcutaneous granulocyte colony-stimulating factor (G-CSF) in thin endometrium cases.

Summary answer

G CSF has beneficial role to improve the endometrium thickness in thin endometrium.

What is known already

Endometrium is very important for embryo implantation and the endometrial thickness is the marker of receptivity of the endometrium.

Study design, size, duration

Study design - Retrospective analysis

Size - 88 infertile females with thin endometrium (< 7 mm) in the age group of 23 to 40 years Duration - one year.

Participants/materials, setting, methods

In the group 1 of 44 females, subcutaneous infusion of G CSF (300 mcg/ml) was added along with other supplements and if lining was not more than 7 mm in 72 hours, then second infusion was given. In the group 2 of 44 females, only estradiol valerate and sildenafil were given.The efficacy of G CSF was evaluated by assessing the endometrium thickness before embryo transfer, pregnancy rates and clinical pregnancy rates.

Main results and the role of chance

There was no difference between the two groups regarding demographic variables, egg reserve, sperm parameters, number of embryos transferred and embryo quality. . The pregnancy rate was 60% (24 out of 40 cases) in the group 1 that was significantly higher than in-group 2 that was 31% (9 out of 29 cases) with p value < 0.0001. The clinical pregnancy rate was also significantly higher in-group 1 (55%) as compared to group 2 (24%) with p value < 0.0001.

Limitations, reasons for caution

Further larger cohort studies are required to explore the subcutaneous role of G CSF in thin endometrium.

Wider implications of the findings: Granulocyte colony-stimulating factor has beneficial role to improve the endometrium thickness in thin endometrium. In most of previous studies, the intrauterine infusion of G CSF was given to improve the uterine lining. This is one of the few studies done that showed subcutaneous role of G CSF in thin endometrium.

Trial registration number

Not applicable

Duodenal tuberculosis presenting as gatric outlet obstruction

Tuberculosis of stomach and duodenum is very uncommon even in patients with pulmonary and intestinal tuberculosis. Its preoperative diagnosis still remains a challenging problem for surgeons. Herein, we report the case of isolated duodenal tuberculosis in a 42 year old male presenting with gastric outlet obstruction symptoms. Oesophago-gastro-duodenoscopy (UGIE) revealed fold thickening at D3 segment but endoscopic biopsy was inconclusive, CECT abdomen showed ill-defined soft tissue thickening involving the 3(rd) part of duodenum with mesenteric fat stranding. Exploratory laparotomy was done which showed growth at 3rd part of the duodenum and peritoneal seedlings, tissue biopsy was taken and gastro-jejunostomy with jejuno-jejunostomy was done. Histopathological examination was consistent with the features of gastrointestinal tuberculosis. Patient was started on anti-tubercular therapy and was cured of the disease.

Quantification of hypoxia-inducible factor-1α, vascular endothelial growth factor, and angiopoietin-2 expression in hepatocellular carcinoma using a real-time quantitative reverse transcription polymerase chain reaction

223

Background: Hepatocellular carcinoma (HCC) is characteristically a hypervascular tumor and its progression is closely related to angiogenesis. Hypoxia inducible factor-1α (HIF-1 α), vascular endothelial growth factor (VEGF), and angiopioetin-2 (Ang-2) are key angiogenic factors in HCC. In this study, expression of HIF-1α, VEGF, and Ang-2 were analyzed and correlated with clinicopathologic features of HCC.

Methods: Expression of HIF-1α, VEGF, and Ang-2 were analyzed by real-time quantitative reverse transcription polymerase chain reaction in 67 HCC patients (23HBV, 22HCV, 22NBNC) with mean age 59.09 ± 11.13 years (60 M: 7 F), 9 cirrhosis patients (2HBV, 2HCV, 5ALD) with mean age 48.33 ± 11.31 years (8 M:1 F), and 14 chronic hepatitis patients (7HBV, 7HCV) with mean age 48.33 ± 7.17 years (10 M: 4 F), respectively. HCC was diagnosed on the basis of EASL (European Association for the Study of the Liver) criteria.

Results: Expression of HIF-1α and VEGF were found to be significantly higher in patients with HCC compared with cirrhosis and chronic hepatitis. Although Ang-2 expression was higher in HCC compared to cirrhosis and chronic hepatitis but the difference was not statistically significant. The difference in the expression of HIF-1α, VEGF, and Ang-2 in cirrhosis and chronic hepatitis were not significant. Tumor size was positively correlated with HIF-1 α(p = 0.268, p = 0.030)and VEGF (p = 0.546, p = 0.0001). A positive correlation was also seen between the HIF-1α and VEGF expression (p = 0.347, p = 0.0001). However no correlation of HIF-1α, VEGF and Ang-2 was seen with portal vein thrombosis, cirrhosis, etiology, AST, ALT, and platelets.

Conclusions: HIF-1α and VEGF were highly expressed in HCC patients and may be responsible for the HCC growth. Further studies with a larger number of patients need to be done.

No significant financial relationships to disclose.

Vitamin D nutritional status of exclusively breast fed infants and their mothers

BACKGROUND

Vitamin D nutrition has a profound effect on the development of an infant. Vitamin D status of mothers and their infants are closely correlated. While hypovitaminosis D has emerged as a significant public health problem across all age groups, there is limited information of this condition in lactating mothers and their breast fed infants.

AIM

To evaluate the vitamin D status of lactating mothers and their breast fed infants.

SUBJECTS AND METHODS

180 healthy lactating mothers and exclusively breast fed infants, 2-24 weeks old, were recruited for the study. The mother-infant pairs underwent concurrent clinical, biochemical and hormonal evaluation for calcium-vitamin D-PTH axis.

RESULTS

The mean serum 25(OH)D values in lactating mothers was 27.2 +/- 14.6 nmol/l (10.9 +/- 5.8 ng/ml), while that of their infants was 28.9 +/- 20.8 nmol/l (11.6 +/- 8.3 ng/ml). Serum 25(OH)D levels <25 nmol/l (10 ng/ml) were found in 47.8% of the mothers and 43.2% of the infants. Among these, elevated PTH levels (>54 pg/ml) were seen in 59.3% of the mothers and 69.6% of the infants. A highly significant negative correlation was found between serum 25(OH)D and PTH in mothers (r = -0.480, p = 0.01) and their infants (r = -0.431, p = 0.01). A strong positive correlation was seen of 25(OH)D levels in mother-infant pairs (r = 0.324, p = 0.001).

CONCLUSIONS

A high prevalence of vitamin D deficiency was found in lactating mothers and their exclusively breast fed infants. Infants born to mothers with hypovitaminosis D had 3.8 times higher risk of developing hypovitaminosis D as compared to those born to mothers with normal vitamin D levels.

Measuring Surface Hydrophobicity as Compared to Measuring a Hydrophobic Effect on Adhesion Events

Simple contact-angle methods are commonly used to describe surface influences on phenomena including adsorption, adhesion, fouling, and cleaning, However, for the purpose of quantitatively relating surface hydrophobicity to such phenomena, contact-angle analysis may be insufficient. Here we show that even with model hydrophobic and hydrophilic surfaces, measurement of the effect of surface hydrophobicity on adsorption of the antimicrobial proteins nisin and bacteriophage T4 lysozyme yielded conflicting results, apparently because different mechanisms govern events at the interface, depending on surface hydrophobicity. This finding is explained in terms of the presence of two competing mechanisms for attractive associations at these surfaces: hydrophobic and attractive electrostatic associations.