Volume 78 - 2015 - Fasc.1 - Original articles
Effects of rapamycin treatment on pancreatic fibrosis, cellular apoptosis and oxidative stress in experimental chronic pancreatitis model
Purpose: Rapamycin reduces hepatic fibrosis by inhibiting hepatic stellate cell activation. The present study investigated whether rapamycin treatment could modify the degree of fibrosis, cellular apoptosis and oxidative stress (OS) in an experimental model of CP.
Method : Fifty-five male, Sprague-Dawley rats weighing 200- 400g were randomized into four groups. CP was induced by intra- ductal trinitrobenzene sulfonic acid (TNBS) infusion in group A (n = 15) and group B (n = 15). Group C (n = 15) received intraduct- al TNBS and was killed for histologic confirmation at four weeks. Group D (n = 10) received intraductal saline instead of TNBS. Group A and group D received oral rapamycin (2 mg/kg/d) for two weeks after CP was induced while group B received oral tap water instead of rapamycin. Blood and pancreatic tissue specimens were collected and oxidative stress parameters, fibrosis and cellular apoptosis were determined.
Results : Tissue and blood malondialdehyde (MDA) levels were significantly lower in rapamycin treated group compared to controls (p < 0.001). Superoxide dismutase (SOD) and glutathion peroxidase (GSH-Px) activities were also significantly higher in the active treatment group (p < 0.001 for both). Tissue and blood MDA, SOD, GSH-Px measurements was similar in rapamycin group and pancreatic cannulation group (p>0.05). Histopathologic fibrosis scores were similar in rapamycin and control groups. Apoptotic cell counts tended to be lower in rapamycin treated animals.
Conclusion : Administration of rapamycin alleviated OS and, in part, prevented apoptotic cell death in experimental CP, but did not reduce fibrosis. (Acta gastroenterol. belg., 2015, 78, 3-7).
Treatment of chronic hepatitis C in children with pegylated interferon and ribavirin : the impact of dose
Introduction : In the last years children with chronic hepatitis C (CHC) have been treated with Pegylated Interferon a (PEG- IFNa) and ribavirin (RBV). Treatment can cause several side effects that require reduction or interruption of therapy. The relationship between dose of PEG-IFNa and response to therapy has not been clearly evaluated. Aim of this study was to evaluate the impact of the dose of PEG-IFNa2b and RBV on the efficacy of therapy.
Patients and method : All children with CHC treated with PEG- IFNa2b and RBV, observed at the Paediatric Liver Unit of Univer- sity Federico II of Naples from 1996 to 2006 were evaluated.
Results : Sixteen children with CHC treated with combined ther- apy were enrolled. Seven out of 16 patients (43.7%) achieved rapid virological response ; 13/16 patients (81.2%) achieved early viro- logical response ; 5/16 patients (31.25%) relapsed ; 1 patient re- sulted non responder. According to percentage of expected dose, our patients were divided into two groups : the first group included 7 patients that performed an overall dosage of PEG-IFNa2b = 75% of the scheduled full dose ; the second group included 9 patients that performedm PEG-IFNa2b dose < 75% of scheduled full dose. No difference was noted in terms of sustained virological response.
Conclusion : Modifications of therapy due to PEG-IFNa-related adverse events are frequent in children with CHC, but dose adjust- ments do not seem to impair efficacy of therapy. (Acta gastroenterol. belg., 2015, 78, 8-11).
Survival in patients with hypoechoic muscularis propria lesions suggestive of gastrointestinal stromal tumors in gastric wall
Background : Subepithelial lesions (SEL) on upper gastrointesti- nal endoscopy are frequently encountered and referred to endo- scopic ultrasound (EUS). Management of small gastric hypoechoic SELs of muscularis propria (MP) is controversial since EUS-assist- ed fine needle aspiration may be inconclusive, and surgical excision may be too invasive. We aimed to analyze our gastric MP-SELs in terms of survival and confounding factors.
Methods : Data from gastric hypoechoic MP-SELs suggestive of gastrointestinal stromal tumor (GIST) by EUS were retrospective- ly reviewed. Surgically resected GISTs were stratified according to the current pathological risk criteria.
Results : Sixty-one patients were identified. The mean age was 55.5 ± 13.2 years and 45.6% were male. Mean follow-up duration was 53.4 ± 26.7 (12-110) months. Twenty-eight (45.9%) patients were managed conservatively (diameter 15.3 ± 10.1 mm). There were no metastasis- or tumor-related deaths and no significant size changes (= 5 mm) in this group during follow-up. Thirty-three (54.1%) patients underwent complete resection (diameter 34.2 ± 14.1 mm) among which 25 (75.8%) had the final diagnosis of GIST ; 2 (8.0%), 14 (56%) and 6 (24%) patients were classified in no-risk, very-low-risk, low-risk categories respectively, while 2 (8.0%) were in moderate-risk and only 1 (4.0%) was in high-risk category.
Quality assessment of colonoscopy in Flanders : a voluntary survey among Flemish gastroenterologist
Colonoscopy is an important endoscopic examination for the di- agnosis and treatment of pathological conditions of the colon, like polyps and colorectal cancer. However, several factors determine the quality of colonoscopy and thus the quality of polyp and colorectal cancer detection. The Flemish Society of Gastroenterol- ogy (VVGE) performed a voluntary on-line registry among its members to identify quality of colonoscopy in Flanders, Belgium. 64 gastroenterologists voluntarily registered 4276 consecutive colo- noscopies performed during a 3 month study period. Colonoscopy quality indicators were prospectively collected and analysed. Re- sults showed a low voluntary participation rate (17%), acceptable overall adenoma detection rate of 20,5% and colorectal cancer in- terval rate of 5,4%. Complications were low (perforation 0,1% and major bleeding 1,5%). The current study showed that in Flanders, Belgium on-line registration of colonoscopy quality indicators is feasible and that quality of colonoscopy in daily practice meets the expectations of (inter)national guidelines. However, further im- provement of the registry and an open debate on the quality control of colonoscopy in Flanders is warranted (Belgian Registry B30020096548). (Acta gastroenterol. belg., 2015, 78, 18-25).
