Mucosal Area Research Articles

Effects of UCMSCs Delivered through Different Transplantation Approaches on Acute Radiation Enteritis in Rats

Radiation enteritis is the most common and serious complication of abdominal or pelvic radiation therapy. Mesenchymal stem cells (MSCs), as well as cell protection agents, inhibit apoptosis and promote the proliferation of injured tissues. 3 human umbilical cords MSCs (UCMSCs) were injected into the tail vein or peritoneal cavity of a rat model of radiation enteritis. The temporary protective effect was assessed by identification of donor cells, detection of cellular immune parameters and inflammatory cytokine levels, quantitation of jejunum mucosal preservation and examination of the rat remaining life. Only the rats in the intraperitoneal injection group exhibited a few positive donor cells 7 days after transplantation. CD4+/CD8+ T cells, a cellular immune parameter, decreased in the abdominal exudate of intraperitoneal injection group, compared with the model-only control and tail vein groups (both P < .05). Both serum and abdominal exudate TNF-α and IL-6 levels in the intraperitoneally injected rats rapidly decreased and were significantly different from those in the model-only control and tail vein injection groups (all P < .05). Mucosal surface area and survival time increased in the intraperitoneal injection group compared with the vehicle and tail vein injection groups (all P = .000). Therefore, the administration of UCMSCs with intraperitoneal injection approach postponed death in a rat model of radiation enteritis, which was associated with reduced serum levels of proinflammatory cytokines (TNF-α, IL-6). However, UCMSCs injected via the tail vein triggered an intense cellular immune response in the serum that adversely affects their survival. This treatment failed to suppress circulating serum and abdominal exudate levels of TNF-α and IL-6 and could not provide a therapeutic benefit for prolonging life against acute radiation enteritis.

Accuracy of intraoral scans of edentulous jaws with different generations of intraoral scanners compared to laboratory scans.

PURPOSEPurpose of this in vitro study was to determine the accuracy of different intraoral scans versus laboratory scans of impressions and casts for the digitization of an edentulous maxilla.MATERIALS AND METHODSA PEEK model of an edentulous maxilla, featuring four hemispheres on the alveolar ridges in region 13, 17, 23 and 27, was industrially digitized to obtain a reference dataset (REF). Intraoral scans using Cerec Primescan AC (PRI) and Cerec AC Omnicam (OMN), as well as conventional impressions (scannable polyvinyl siloxane) were carried out (n = 25). Conventional impressions (E5I) and referring plaster casts were scanned with the inEOS X5 (E5M). All datasets were exported in STL and analyzed (Geomagic Qualify). Linear and angular differences were evaluated by virtually constructed measurement points in the centers of the hemispheres (P13, P17, P23, P27) and lines between the points (P17–P13, P17–P23, P17–P27). Kolmogorov-Smirnov test and Shapiro-Wilk test were performed to test for normal distribution, Kruskal-Wallis-H test, and Mann-Whitney-U test to detect significant differences in trueness, followed by 2-sample Kolmogorov-Smirnov test to detect significant differences in precision (P < .008).RESULTSGroup PRI showed the highest trueness in linear and angular parameters (P < .001), while group E5I showed the highest precision (P < .001).CONCLUSIONIntraoral scan data obtained using Primescan showed the highest trueness while the indirect digitization of impressions showed the highest precision. To enhance the workflow, indirect digitization of the impression itself appears to be a reasonable technique, as it combines fast access to the digital workflow with the possibility of functional impression of mucosal areas.

The Effect of Topical Anesthetic Gel versus Relaxation Exercise in Controlling the Pain of Anterior Maxillary Injection

Background and Aim:Adequate intraoral anesthesia is a major prerequisite for many dental procedures. Bubble breath exercise, distraction, and play therapy technique may be used as relaxation exercises to decrease pain. This study aimed to compare the efficacy of bubble breath exercise versus topical anesthetic gel in controlling the pain of anterior maxillary infiltration.Methods:This crossover clinical trial was performed on 50 children aged 10-12 years. Subjects received a total of 100 maxillary injections (two per person) in the buccal mucosal area of canine teeth of both sides at intervals of 2 to 3 days. On one side, the injection was performed after applying 20% benzocaine gel. On the other side, a similar injection was performed after the bubble breath exercise. The injection solution was 1/4 of 1.8 mL cartridge of 2% lidocaine containing 1:200,000 epinephrine using a 30-gauge needle. The pain was measured immediately after anesthesia injection using a Visual Analogue Scale (VAS). Data analysis was carried out using SPSS Version 18.0 (IBM Inc., Chicago, IL, USA). Wilcoxon signed-rank tests were used to compare with the 10-mm visual analog scale (VAS) scores obtained from all participants. The level of significance was considered at 5% (p &lt;0.05). The correlation between gender and pain score (VAS) for the two methods was analyzed using the Mann-Whitney U test.Results:The results showed no statistically significant difference between injection pain after topical anesthetic gel application and injection pain after bubble breath exercise (p value=0.30). Also, no statistically significant difference was found between injection pain after gel application and injection pain after bubble breath exercise in boys (p value=0.59) or girls (p value=0.32). There were statistically significant differences between boys and girls in terms of injection pain after gel application (p value=0.001) and also injection pain after e bubble breath exercise (pvalue=0.004).Conclusion:There is no significant difference between perceived injection pain after bubble breath exercise and after applying the topical anesthetic gel. Furthermore, future studies should explore the role of age, dental fear, and anxiety, previous painful experiences, the pain thresholds.

Preliminary Volumetric Calculation of the Mucosal Surface in the Nares of Lambs Using a Segmentation of Computed Tomographic Images.

Intranasal vaccinations are becoming more important in both human and animal medicine to generate a localized IgA immune response not seen with parenteral vaccinations. This localized IgA response is more effective at reducing pathogen load on the mucosal surface of a potential host. One prerequisite for a successful nasal vaccination is the need to understand the distribution pattern of the nebulized vaccine, which requires an understanding the volume of the nares as well as the mucosal surface area. The exact mucosal surface area of ruminant nares has not yet been investigated. The aim of this concept study is to provide a detailed breakdown of a new method of volumetric rendering that can be used to calculate the volume and mucosal surface area of ruminant nares from computed tomographic images. The program Seg 3D was used to perform semi-automatic segmentation of a CT scan of a 9-month-old lamb head. Threshold segmentation and manual segmentation were used in combination to select the lamb's nasal cavity. The segmentation process yielded a volumetric rendering that was used to calculate the surface area and volume of the lamb's nasal cavity, with the segmentation process was repeated for each individual side of the lamb's nares. The surface area of the mucosal surface of each nostril is approximately 448 cm2, and the volume is approximately 45 cm3. The methodology described in this study successfully calculated the volume and surface area of a lamb's nares using volumetric rendering.

Improvement of hand hygiene adherence among staff in long-term care facilities for elderly in Japan

IntroductionHand hygiene is crucial for infection control in long-term care facilities for elderly (LTCFEs), because it can be easily implemented in the low-resource settings of LTCFEs. This study investigated the actual status of hand hygiene adherence in LTCFEs, identified the factors inhibiting its appropriate implementation, and evaluated the effectiveness of a hand hygiene promotion program. MethodsIn this before-and-after study, participants were staff members (n = 142) at two LTCFEs in Gunma Prefecture, Japan. We modified the World Health Organization's “five moments for hand hygiene” and assessed participants' hand hygiene adherence rates in four situations: (1) Before touching around a resident's mucous membrane area; (2) Before medical practice or clean/aseptic procedures; (3) After body fluid exposure/risk or after touching around a resident's mucous membrane area; and (4) After touching a resident's contaminated environments. The study was divided into four phases. In Phase 1, participants self-assessed their hand hygiene adherence using a questionnaire. In Phase 2, we objectively assessed participants' pre-intervention adherence rates. In Phase 3, an intervention comprising various hand hygiene promotion measures, such as education and hands-on training on hand hygiene practices and timings, was implemented. In Phase 4, participants' post-intervention adherence rates were objectively measured. ResultsAlthough most participants reported high hand hygiene adherence rate in the self-assessment (93.1%), the pre-intervention evaluation revealed otherwise (16.8%). Participants’ post-intervention adherence rates increased for all four situations (77.3%). ConclusionThe intervention program helped increase participants’ hand hygiene adherence rates, indicating its effectiveness. Similar interventions in other LTCFEs may also improve adherence rates.

Asymmetric crypt fission in colectomy specimens in patients with ulcerative colitis

AimsWe previously found colonic crypts with asymmetric fission bordering regenerating ulcers in ulcerative colitis (UC). The present objective was to assess the frequency of asymmetric crypt-fission in colectomy specimens from...

Long-term model of colitis-associated colorectal cancer suggests tumor spread mechanism and nature of cancer stem cells.

Although chemical-induced animal models of colorectal cancer (CRC) suggest a lot about the disease, more efforts are required to establish metastasis models. Azoxymethane (AOM) and dextran sodium sulfate (DSS)-treated (AOM/DSS) Crl:CD-1 mice were sacrificed after 10 or 20 weeks in our previous study, and most colon tumors exhibited intramucosal adenocarcinomas. Our observations were extended until 30 weeks to study a colitis-associated advanced CRC mouse model, and explore whether linker threonine-phosphorylated Smad2/3 (pSmad2/3L-Thr) immunostaining-positive cells were involved in the progressive course of colitis-associated CRC as cancer stem cells. AOM/DSS mice were sacrificed at 10, 20 and 30 weeks after AOM administration. Following the histopathological analysis, immunohistochemical staining was performed for the following markers: CD34, podoplanin, β-catenin, E-cadherin, Ki67, Bmi1 and pSmad2/3L-Thr. Compared with AOM/DSS mice at 10 and 20 weeks, submucosal tumor infiltration and tumor invasion into vessels were markedly increased at 30 weeks. In the parts of colon tumors from AOM/DSS mice, particularly in mice at 30 weeks, the positive signal of E-cadherin was clearly reduced in the cell membranes. The percentage of Ki67-positive tumor cells in mucosal areas of AOM/DSS mice was higher than that in the sites of submucosal infiltration. In mucosal areas of colon tumors, pSmad2/3L-Thr-positive cells were scattered among tumor cells. At sites of submucosal infiltration and vessel invasion of these tumors, pSmad2/3L-Thr-positive cells were also observed among tumor cells. In colon tumors from AOM/DSS mice at 30 weeks, the percentage of pSmad2/3L-Thr-positive cells among the nuclear β-catenin-positive tumor cells was higher than that among the cytoplasmic β-catenin-positive tumor cells. For both non-neoplastic and neoplastic epithelial cells, pSmad2/3L-Thr-positive cells exhibited immunohistochemical co-localization with Bmi1. The present study developed an advanced CRC mouse model that exhibited tumor infiltration into the submucosa and invasion into vessels. The present study re-confirmed the theory that pSmad2/3L-Thr-positive cells may be cancer stem cells.

Histological diversity and molecular characteristics in gastric cancer: relation of cancer stem cell-related molecules and receptor tyrosine kinase molecules to mixed histological type and more histological patterns.

Gastric cancers (GCs) are still one of the leading causes of cancer-related mortality. The histological and molecular features of GC may differ widely from area to area within the same tumor. Intratumoral heterogeneity has been considered a major obstacle to an efficient diagnosis and successful molecular treatment. We selected and reevaluated 842 GC cases and analyzed the relationship between numbers or composites of histological patterns within tumors, and clinicopathological parameters in mucosal and invasive areas. In addition, we searched for the GC-associated molecules or molecular subtypes marking histological diversities. GC cases with more histological numbers or mixed types in invasive areas showed significantly higher T grade and staging, whereas those in mucosal areas did not show any significant associations. GCs with histological diversities showed poorer prognosis and characteristically expressed cancer stem cell-related molecules (CD44, CD133 or ALDH1) and receptor tyrosine kinase molecules (HER2, EGFR or c-MET) as well as Helicobacter pylori infection. Expressions of CD44, HER2, c-MET, laminin 5·2 or retained E-cadherin in mucosal areas were predictive of more histological numbers and mixed types in invasive areas. In addition, the chromosomal instability subtype of GC showed significant associations with more histological numbers and mixed histological type, whereas the genomic stability subtype of GC showed a significant relationship with pure type. We displayed the relationship between histological diversity and molecular features in GC, and we hope that the present data can contribute to the early diagnosis and prevention, and effective treatment of GC.

Unexplained neoplastic anastomotic recurrence after right hemicolectomy: a case\xa0report

BackgroundAnastomotic recurrences of the colon are postulated to arise due to inadequate margins, tumor implantation by exfoliated cells, altered biological properties of bowel anastomosis, and missed synchronous lesions. In this paper, a case of unexpected early local recurrence after surgery for colon cancer is presented.Case presentationA 68-year-old Caucasian man underwent right hemicolectomy for invasive G2 adenocarcinoma. Two months later, endoscopy revealed a wide and well-functioning anastomosis with a hyperemic, hard, and thickened mucosal area of about 2 cm in diameter. Biopsies showed the presence of an adenocarcinoma with the same grading of the previous lesion. Ten days later, the patient underwent a new intervention; the last 10 cm of the ileum and half of the remaining transverse colon were resected, and the patient started adjuvant therapy. Specimen examination confirmed the presence of an adenocarcinoma (G2) penetrating the muscular layer of the wall; also, in this case, resection edges were free from tumoral invasion, and the removed lymph nodes were exempt from neoplastic colonization. The patient was seen in follow-up for about 5 years, and he did not show local or systemic manifestations.ConclusionsWhenever a neoplastic recurrence on the anastomotic line occurs, in the presence of negative intestinal margins, as usual in right colectomies, the implantation of neoplastic cells could be the possible cause.

Measurement of IgE hypersensitivity among people attending the tertiary allergic center in Kirkuk, Iraq

Immunoglobulin E (IgE) is ordered as the least abundant, but in many regards, the most potent, of the enormous antibody classes found in the mammals. IgE mediates the reactions of type 1 hypersensitivity allergic. Generally, IgE plasma levels are very low with 100,000-fold than those of Immunoglobulin G. However, these levels could be obviously increased in specific conditions of allergy, such as bronchopulmonary aspergillosis, or in case of parasitic diseases like schistosomiasis. Additionally, plasma cells of IgE exist in mucosal areas. In particular, it exists in the respiratory tract, where the secreted IgE mediates reactions of allergic. In this work, the questionnaire was distributed to the study sample, which consisted of both males and females for detecting the numbers of cases of allergy types found at the tertiary allergic center in Kirkuk. The cases were diagnosed by blood tests to determine the amount of IgE in their blood samples. The total number of patients was 40; hence, there were 20 female patients and 20 males. These patients had different types of IgE mediated allergy disease. Most of these types were found in the adult. The results showed that both males and females were equal (each gender scored 20, representing 50% of the total sample). Most of the serum IgE test was negative. Finaly this study demonstrated the low frequency of allergic diseases in children and young people; however, this was high in old people whose ages ranged between 36 and 50 years. Most of the cases were allergic bronchitis and skin allergy.

Evaluating effects of zinc hydroxychloride on biomarkers of inflammation and intestinal integrity during feed restriction

Objectives were to evaluate effects of supplemental zinc hydroxychloride (HYD; Micronutrients, Indianapolis, IN) on gut permeability, metabolism, and inflammation during feed restriction (FR). Holstein cows (n = 24; 159 ± 8 d in milk; parity 3 ± 0.2) were enrolled in a 2 × 2 factorial design and randomly assigned to 1 of 4 treatments: (1) ad libitum fed (AL) and control diet (ALCON; 75 mg/kg Zn from zinc sulfate; n = 6); (2) ad libitum fed and HYD diet (ALHYD; 75 mg/kg Zn from HYD; n = 6); (3) 40% of ad libitum feed intake and control diet (FRCON; n = 6); or (4) 40% of ad libitum feed intake and HYD diet (FRHYD; n = 6). Prior to study initiation, cows were fed their respective diets for 21 d. The trial consisted of 2 experimental periods (P) during which cows continued to receive their respective dietary treatments. Period 1 (5 d) served as the baseline for P2 (5 d), during which cows were fed ad libitum or restricted to 40% of P1 feed intake. In vivo total-tract permeability was evaluated on d 4 of P1 and on d 2 and 5 of P2, using the paracellular permeability marker chromium (Cr)-EDTA. All cows were euthanized at the end of P2 to assess intestinal architecture. As anticipated, FR cows lost body weight (∼46 kg), entered into calculated negative energy balance (-13.86 Mcal/d), and had decreased milk yield. Circulating glucose, insulin, and glucagon decreased, and nonesterified fatty acids and β-hydroxybutyrate increased in FR relative to AL cows. Relative to AL cows, FR increased lipopolysaccharide-binding protein, serum amyloid A (SAA), and haptoglobin (Hp) concentrations (2-, 4-, and 17-fold, respectively); and peak SAA and Hp concentrations were observed on d 5. Circulating SAA and Hp from FRHYD tended to be decreased (47 and 61%, respectively) on d 5 relative to FRCON. Plasma Cr area under the curve increased (32%) in FR treatments on d 2 and tended to be increased (17%) on d 5 of P2 relative to AL treatments. No effects of diet were observed on Cr appearance. Relative to AL cows, FR increased jejunum villus width and decreased jejunum crypt depth and ileum villus height and crypt depth. Relative to FRCON, ileum villus height tended to increase in FRHYD cows. Feed restriction tended to decrease jejunum and ileum mucosal surface area, but the decrease in the ileum was ameliorated by dietary HYD. In summary, FR induced gut hyperpermeability to Cr-EDTA, and feeding HYD appeared to benefit some key metrics of barrier integrity.

S3442 A Trip Through the Pylorus - A Rare Case of a Gastric Adenocarcinoma Invading the Duodenum and Literature Reivew

INTRODUCTION: We present a rare case in a 61-year-old African American who shows one such case an interesting case of multiple gastric adenocarcinoma involving the gastric antrum and pylorus that extended into the duodenum. CASE DESCRIPTION/METHODS: A 61-year-old male without medical history presented with abdominal pain of one month acutely worsening over the 2 weeks. The pain was diffuse in nature, 9/10 in severity, with decreased appetite and 25lbs weight loss without exacerbating or relieving factors. Physical exam showed for RUQ and LUQ tenderness. Hepatomegaly was present with a firm mass palpated below the epigastrium. Labs were unremarkable. CT of abdomen and pelvis with contrast revealed hypoattenuating lesions in liver and spleen. An enlarged, heterogeneous pancreatic head with dilated duct and multiple enlarged lymph nodes, including a necrotic lymph node were found with the latter causing mass effect of structure. The stomach had a suspicious gastric mass with irregular wall thickening along the greater curvature and mesenteric stranding. There were multiple omental masses, peritoneal masses in RUQ and LUQ with significant retroperitoneal and pelvic lymphadenopathy. Subsequent upper endoscopy showed an abnormal nodular mucosal area in the junction of gastric body and antrum with a large gastric polyp in the adjacent area that was biopsied. Initially the top differential was lymphoma on accord that it does not respect the gastric-duodenal junction however, the pathology report of the abnormal gastric tissue revealed a poorly differentiated gastric adenocarcinoma that also involved duodenal mucosa with loss of nuclear expression of PMS-2 and MLH-1. Helicobacter Pylori testing was also noted be positive. Patient was started on FOLFOX therapy without benefit. Treatment was switched to Pembrolizumab therapy as tumor was MMR deficient with good response. DISCUSSION: The incidence of duodenal invasion in lower stomach cancer ranges from 13.5 to 33.2% mainly based on populations of Asian heritage, where the prevalence of gastric cancers is much higher than the rest of the world. Our patient is an African American male, and at the time of writing this case report our search showed that there are a handful of published cases of gastric cancer invading the duodenum in which highlights this rarity. We hypothesize that the reduced presentation of similar presentations may be low due to overall low incidence of gastric cancer in the United States, which has rapidly declined over the past 50 years.Figure 1.: Gastric antrum polyp.Figure 2.: Pre-pyloric tissue extending through pylorus into duodenal bulb.Figure 3.: Duodenal Bulb – Abnormal mucosa.

High Abundance of Intratumoral γδ T Cells Favors a Better Prognosis in Head and Neck Squamous Cell Carcinoma: A Bioinformatic Analysis.

γδ T cells are a small subset of unconventional T cells that are enriched in the mucosal areas, and are responsible for pathogen clearance and maintaining integrity. However, the role of γδ T cells in head and neck squamous cell carcinoma (HNSCC) is largely unknown. Here, by using RNA-seq data from The Cancer Genome Atlas (TCGA), we discovered that HNSCC patients with higher levels of γδ T cells were positively associated with lower clinical stages and better overall survival, and high abundance of γδ T cells was positively correlated with CD8+/CD4+ T cell infiltration. Gene ontology and pathway analyses showed that genes associated with T cell activation, proliferation, effector functions, cytotoxicity, and chemokine production were enriched in the group with a higher γδ T cell abundance. Furthermore, we found that the abundance of γδ T cells was positively associated with the expression of the butyrophilin (BTN) family proteins BTN3A1/BTN3A2/BTN3A3 and BTN2A1, but only MICB, one of the ligands of NKG2D, was involved in the activation of γδ T cells, indicating that the BTN family proteins might be involved in the activation and proliferation of γδ T cells in the tumor microenvironment of HNSCC. Our results indicated that γδ T cells, along with their ligands, are promising targets in HNSCC with great prognostic values and treatment potentials.

Varying starch to fat ratios in pelleted diets: II. Effects on intestinal histomorphometry, Clostridium perfringens and short-chain fatty acids in Eimeria-challenged broiler chickens

ABSTRACT 1. The hypothesis behind the study was that a high dietary starch level (HS) would lead to impaired gut health compared to a low-starch diet (LS) in Eimeria-challenged broilers. The effects of two diets with different starch to fat ratios on intestinal histomorphometry, Clostridium perfringens counts and toxin profile, necrotic enteritis prevalence and abundance of short-chain fatty acids (SCFAs) were examined. 2. A total of 1,920 one-day-old Ross 308 broiler chickens were fed one of two isocaloric diets formulated either with high (32:1) or low (2:1) starch to fat ratios from d 10 to 29 of age. Each treatment group had 12 pen replicates containing 80 broilers each. On d 17, the chickens were challenged with Eimeria vaccine strains. Samples were collected on d 16, 21–23 and 29. 3. Whereas villus length increased gradually throughout the study in the HS group, a peak level was reached on d 21–23 in the LS group. On d 29, the HS group had significantly longer villi than the LS group. 4. Caecal SCFA concentrations were higher in the HS group compared to the LS group on d 16. In both groups, the SCFA level peaked on d 21–23, with the most pronounced increase seen in the LS group. 5. The C. perfringens netB:cpa ratio increased from d 16 to 29 in the HS group. C. perfringens counts and necrotic enteritis prevalence were similar between the two groups. 6. Diet affected the dynamics of small intestinal villus length and caecal SCFA abundance. These findings suggest that structural remodelling of the small intestine is an adaptation to different dietary starch levels, and that caecal SCFA abundance is associated with the availability of substrate for the microbiota in the posterior intestinal segments. Chickens adapted to higher levels of dietary starch might be more robust against Eimeria infections due to increased mucosal surface area. Studies with other dietary starch sources are required to clarify the impact of dietary starch levels on intestinal health in Eimeria–challenged broilers.

Characterization of mucosal cytokine profile in ulcerative colitis patients under conventional and anti-TNF-a treatment.

Cytokines play a pivotal role in inflammatory bowel disease (IBD). We investigated the expression of inflammatory and regulatory cytokines in inflamed and uninflamed mucosal samples of ulcerative colitis patients. Twenty-five ulcerative colitis patients were enrolled. Bioptic samples from inflamed and not inflamed intestinal areas were obtained. Multiplex analysis for inflammatory and regulatory cytokines was performed. Serum C-reactive protein (CRP) was assessed. Endoscopic Mayo score and histological simplified Geboes score were calculated. Interleukin (IL)-1Ra, IL-6, IL-8, IL-17, induced Protein (IP)-10, monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1a, MIP-1b resulted increased in ulcerative colitis inflamed vs ulcerative colitis not inflamed areas. No differences were registered between conventional and anti-tumor necrosis factor-a regimens. No difference with CRP levels was found. IL-7 resulted reduced in patients with endoscopic Mayo score ≥2. All the not inflamed samples had a Geboes score <2A, while all the inflamed specimens had a Geboes score ≥2B. IL-1Ra resulted increased in the group with a Geboes score ≥4. Inflamed and adjacent not inflamed mucosal areas in ulcerative colitis patients share detailed inflammatory molecular pathways, but can be differentiated endoscopically and histologically on the basis of specific cytokines levels. This underlines the complexity of the mucosal cytokine network in ulcerative colitis and highlights the major limitations of a single proinflammatory target therapeutic strategy in IBD.

Effects of Kolaviron on Pneumonia-like Infection Induced in Albino Wistar Rats.

Pneumonia is an acute or chronic inflammatory disorder of the lungs, affecting the mucosal areas of the lung. It can be caused by bacteria, viruses or fungi. In some cases, it may be caused by physical or chemical irritants. Kolaviron, a natural bioflavonoid extract from Garcinia kola seeds, has been shown to possess anti-inflammatory properties in Flu-like conditions which are associated with cough. There has been a paucity of information on the likelihood of the effectiveness of kolaviron against pneumonia infections. To evaluate the antibacterial and anti-inflammatory effects of kolaviron on albino Wistar rats induced with pneumonia using Klebsiella pneumonia. Powdered Garcinia kola seeds were extracted with n-hexane and 100% methanol as solvents by using Soxhlet extractor. A standard method was used to obtain kolaviron from the seed extracts. A total of 24 albino Wistar rats were randomly divided into six groups A to F, each comprising four rats. The rats were allowed to acclimatize for 1 hour in very cold environments using ice packs. A standardized 1.0 x10 -5 mg/ml culture suspension was intranasally inoculated to the rats for 10 days to induce pneumonia-like symptoms. Thereafter, the kolaviron was administered to the rats such that a 500mg/kg kolaviron extract was given once daily to groups A (male rats) and B (female rats). Groups C (male rats) and D (female rats) received 250mg/kg of kolaviron extract once daily, while group E rats were given 0.5 ml of dimethyl sulfoxide (DMSO) once daily, which served as the negative control. The rats in Group F received 2.86 mg/kg of ofloxacin once daily and served as the positive control. All the treatments were done for a period of 5 days. Then 10 days after the treatments, the animals were sacrificed and the lungs were harvested for hydrostatic lung test and histopathological examination. An overnight broth culture of Klebsiella pneumonia was streaked in sterile molten nutrient agar maintained at 37°C for 24hrs. Later, a stock of 500mg/ml of kolaviron was prepared in DMSO. Two-fold dilutions were performed to obtain the following concentrations of 100%, 50%, 25%, 12.5%, 6.25%, 3.125%, and 1.565% with the stock. The anti-Klebsiella pneumonia activity of the kolaviron extract was determined using agar well diffusion methods and incubation was done at 37 o C for 24 hrs. Student t-test and Oneway Analysis of variance (ANOVA) were used for comparison of mean differences between and among the groups. The sensitivity of Klebsiella pneumonia to kolaviron was concentration- dependent. There was an increase in anti-Klebsiella pneumonia activity with a decrease in kolaviron concentration. Kolaviron (KV), at 500mg/kg concentration, was efficacious and showed significant anti-inflammatory effects (P<0.0001). This was also confirmed in the histopathological examinations. The 3.125% concentration of the kolaviron gave IZDs that ranged from 25.68±3.33 mm on day 1 to 27.33±2.78 mm on day 5. Treatment with kolaviron showed to be sex-dependent with a significant difference (p<0.0001), when pre-treatment and post-treatment effects were compared between male and female rats. Kolaviron can be used as an agent in the treatment of pneumonia as it possesses anti- inflammatory and anti-Klebsiella pneumonia activities.

Gut Ischemia Reperfusion Injury Induces Lung Inflammation via Mesenteric Lymph-Mediated Neutrophil Activation.

Gut ischemia/reperfusion (I/R) injury is a common clinical problem associated with significant mortality and morbidities that result from systemic inflammation and remote organ dysfunction, typically acute lung injury. The mechanisms underlying the dissemination of gut-derived harmful mediators into the circulation are poorly understood. The objective of our study was to determine the role of mesenteric lymphatic circulation in the systemic and pulmonary inflammatory response to gut I/R. Using a murine intestinal I/R model, we evaluated whether and how blocking mesenteric lymph flow affects the inflammatory response in local tissues (gut) and remote organs (lungs). We further explored the mechanisms of post-I/R lymph-induced systemic inflammation by examining neutrophil activity and interaction with endothelial cells in vitro. Mice subjected to intestinal I/R displayed a significant inflammatory response in local tissues, evidenced by neutrophil infiltration into mucosal areas, as well as lung inflammation, evidenced by increased myeloperoxidase levels, neutrophil infiltration, and elevated microvascular permeability in the lungs. Mesenteric lymph duct ligation (MLDL) had no effect on gut injury per se, but effectively attenuated lung injury following gut I/R. Cell experiments showed that lymph fluid from post-I/R animals, but not pre-I/R, increased neutrophil surface CD11b expression and their ability to migrate across vascular endothelial monolayers. Moreover, post-I/R lymph upregulated neutrophil expression of pro-inflammatory cytokines and chemokines, which was mediated by a mechanism involving nuclear factor (NF)-κB signaling. Consistently, gut I/R activated NF-κB in lung neutrophils, which was alleviated by MLDL. In conclusion, all these data indicate that mesenteric lymph circulation contributes to neutrophil activation and lung inflammation following gut I/R injury partly through activating NF-κB.

X-ray microtomography is a novel method for accurate evaluation of small-bowel mucosal morphology and surface area

The often poorly orientated small-bowel mucosal biopsies taken for the diagnostics of celiac disease and other intestinal disorders are prone to misinterpretation. Furthermore, conventional histopathology has suboptimal sensitivity for early histopathological changes observed in short-term challenge studies. X-ray microtomography (micro-CT) is a promising new method for accurate imaging of human-derived biological samples. Here, we report that micro-CT could be utilized to create virtual reconstructions of endoscopically obtained intestinal biopsies. The formed digital 3D images enabled selection of always optimal cutting angles for accurate measurement of the mucosal damage and revealed diagnostic lesions in cases interpreted as normal with conventional histomorphometry. We also demonstrate that computer-assisted point cloud analysis can be used to calculate biologically meaningful surface areas of the biopsies in different stages of mucosal damage with excellent replicability and correlation with other disease parameters. We expect the improved diagnostic accuracy and capability to measure the surface areas to provide a powerful tool for the diagnostics of intestinal diseases and for future clinical and pharmaceutical trials.

Nature of Anger, Life Event Stress, Conflict and Defense Mechanism Among Individuals Having Peptic Ulcer: A Comparative Study

Peptic ulcer occurs due to the erosive action of the acid gastric juice upon an area of mucous membrane that may be presumed to have become devitalized in some way and thus to have lost its normal powers of resistance to its own enzymes. Being a psychosomatic illness various psychological factors have been found to be associated with the occurrence and/or persistence of the disease. The present study deals with the nature of anger, life event stress, conflict and defense mechanism of 30 peptic ulcer patients and 30 unaffected individuals. MANOVA and further analysis through ANOVA were computed to statistically analyse the data. The results of the study revealed that peptic ulcer patients had lower trait anger, angry temperament, anger-out and defensive function; and higher anger-in and life event stress than the individuals in the comparative group. Findings also revealed differences in needs, conflicts and defenses between the two groups. Thus it can be concluded that peptic ulcer patients may have a tendency to suppress their anger, experience significantly greater life event stress, experience a significant conflict of autonomy versus compliance along with having low defensive functioning.

Dr. Ahila's Conchal Crusher for Concha Bullosa.

Endoscopic Sinus Surgery is evolving day by day, there is a constant need for improvisation in terms of instrumentation with clear bloodless surgical field and good postoperative results. The applications of Dr. Ahila's Conchal Crusher for managing Concha bullosa in Functional Endoscopic Sinus Surgery (FESS) Surgery are presented. The creation/innovation of Dr. Ahila's conchal crusher will prevent rawmucosal surface area, bleeding and scope fogging with blood during FESS surgery after traditional conchoplasty. This new instrument makes it easy to reduce concha bullosa during nose and sinus surgery creating a bloodless field, no risk of destabilization or fracture of middle turbinate hence no postoperative synechiae which may otherwise lead to iatrogenic frontal sinusitis. Surgical instruments represent a major financial asset to the healthcare facility. Single instrumentation is essential to avoid costly replacements, surgeon satisfaction, reduce costs and delays in the Operating room and enhance patient safety. Dr. Ahila's conchal crusher may facilitate the performance of concha bullosa surgery and advance the art of Endoscopic Sinus surgery to a better level.