Whipple procedure: A review of a 7-year clinical experience in a referral center for hepatobiliary and pancreas diseases

Background: Pancreatic cancer is generally found in the older population Pancreaticoduodenectomy seems to be the only way in resolving these resectable tumors. Allen. O Whipple was the first to describe pancreaticoduodenectomy in 1935 as a modified procedure. This article is a case series with respect to the 7-year experience of the Whipple procedure in Firoozgar Teaching Hospital. Methods: Patient surgery details were gathered from the surgical records of the operating room and their clinical records from the hospital archives. Data was analyzed with SPSS software (version 16.0.1). Those patients, whose tumor had invaded the superior mesenteric artery, had extensive portal vein involvement or distant metastasis was considered as unresectable. Results: The first Whipple procedure was recorded in our hospital in 2008. From 2008 till 20 March 2014, 70 cases were collected and analyzed. The mean age of cases was 58.4 years, the mean hospital stay length was 12.9 days (�±6.23 days), mean operation time was 376 min (�±37.3 min),. The most common presenting symptom was jaundice (78.6 ). Delayed gastric emptying was the most common post-operative complication. The most prevalent cause of reoperation was intra-abdominal abscess. Major morbidities of these patients consisted of cardiac arrhythmias (21.4) and pneumonia (10). Minor complications were wound infection (17.1) and delayed gastric emptying (32.9). The statistics revealed pancreatic anastomosis failure as 2.9 and a decrease in mortality rate from 50 during the first years of this study to 16 to 20 during the last years. Conclusions: In this case series, the time of operation decreased during the recent years .Analysis shows a correlation between operation time and pack cell transfused during the operation, but no correlation was found between operation time and post-operation hospitalization course. It is true that hospital setting, socioeconomic level of the patients including their compliance, and the expertise of the surgeons and surgical staff can have an influence on the result of this operation, but it seems that the magnitude of the surgical stress of this procedure and the (compromised) functional reserve of this patient population can be a notable factor influencing the outcome. �© 2015 Saraee et al

[Bis(2-hydroxyl imino)1-phenyl, 2-(2-qunolile)1-ethanona]Aluminium(III) Complex as Carrier for a Salicylate-Sensitive Electrode

A salicylate-selective electrode based on the complex [bis(2-hydroxyl imino)1-phenyl,2-(2- qunolile)1-ethanona]Aluminium(III) as the membrane carrier was developed. The electrode exhibited a good Nernstian slope of –59.1 ± 0.4 mV / decade (mean value ± standard deviation, n = 5) and a linear range of 1.0 × 10–6– 1.0 × 10–1 mol L–1 for salicylate. The limit of detection was 5.0 × 10–7 mol L–1. The electrode had a fast response time of 15 s and could be used for more than three months. The selectivity coefficients were determined by the fixed interference method (FIM) and could be used in the pH range of 2.0–7.8. It was employed as an indicator electrode for direct the determination of salicylate in pharmaceutical samples

Towards revealing key factors in mechanical instability of bioabsorbable Zn-based alloys for intended vascular stenting

Zn-based alloys are recognized as promising bioabsorbable materials for cardiovascular stents, due to their biocompatibility and favorable degradability as compared to Mg. However, both low strength and intrinsic mechanical instability arising from a strong strain rate sensitivity and strain softening behavior make development of Zn alloys challenging for stent applications. In this study, we developed binary Zn-4.0Ag and ternary Zn-4.0Ag-xMn (where x = 0.2–0.6wt%) alloys. An experimental methodology was designed by cold working followed by a thermal treatment on extruded alloys, through which the effects of the grain size and precipitates could be thoroughly investigated. Microstructural observations revealed a significant grain refinement during wire drawing, leading to an ultrafine-grained (UFG) structure with a size of 700 nm and 200 nm for the Zn-4.0Ag and Zn-4.0Ag-0.6Mn, respectively. Mn showed a powerful grain refining effect, as it promoted the dynamic recrystallization. Furthermore, cold working resulted in dynamic precipitation of AgZn3 particles, distributing throughout the Zn matrix. Such precipitates triggered mechanical degradation through an activation of Zn/AgZn3 boundary sliding, reducing the tensile strength by 74% and 57% for Zn-4.0Ag and Zn-4.0Ag-0.6Mn, respectively. The observed precipitation softening caused a strong strain rate sensitivity in cold drawn alloys. Short-time annealing significantly mitigated the mechanical instability by reducing the AgZn3 fraction. The ternary alloy wire showed superior microstructural stability relative to its Mn-free counterpart due to the pinning effect of Mn-rich particles on the grain boundaries. Eventually, a shift of the corrosion regime from localized to more uniform was observed after the heat treatment, mainly due to the dissolution of AgZn3 precipitates. Statement of Significance Owing to its promising biodegradability, zinc has been recognized as a potential biodegradable material for stenting applications. However, Zn's poor strength alongside intrinsic mechanical instability have propelled researchers to search for Zn alloys with improved mechanical properties. Although extensive researches have been conducted to satisfy the mentioned concerns, no Zn-based alloys with stabilized mechanical properties have yet been reported. In this work, the mechanical properties and stability of the Zn-Ag-based alloys were systematically evaluated as a function of microstructural features. We found that the microstructure design in Zn alloys can be used to find an effective strategy to not only improve the strength and suppress the mechanical instability but also to minimize any damage by augmenting the corrosion uniformity

Downregulation of Mcl-1 has anti-inflammatory pro-resolution effects and enhances bacterial clearance from the lung

Phagocytes not only coordinate acute inflammation and host defense at mucosal sites, but also contribute to tissue damage. Respiratory infection causes a globally significant disease burden and frequently progresses to acute respiratory distress syndrome, a devastating inflammatory condition characterized by neutrophil recruitment and accumulation of protein-rich edema fluid causing impaired lung function. We hypothesized that targeting the intracellular protein myeloid cell leukemia 1 (Mcl-1) by a cyclin-dependent kinase inhibitor (AT7519) or a flavone (wogonin) would accelerate neutrophil apoptosis and resolution of established inflammation, but without detriment to bacterial clearance. Mcl-1 loss induced human neutrophil apoptosis, but did not induce macrophage apoptosis nor impair phagocytosis of apoptotic neutrophils. Neutrophil-dominant inflammation was modelled in mice by either endotoxin or bacteria (Escherichia coli). Downregulating inflammatory cell Mcl-1 had anti-inflammatory, pro-resolution effects, shortening the resolution interval (R(i)) from 19 to 7 h and improved organ dysfunction with enhanced alveolar–capillary barrier integrity. Conversely, attenuating drug-induced Mcl-1 downregulation inhibited neutrophil apoptosis and delayed resolution of endotoxin-mediated lung inflammation. Importantly, manipulating lung inflammatory cell Mcl-1 also accelerated resolution of bacterial infection (R(i); 50 to 16 h) concurrent with enhanced bacterial clearance. Therefore, manipulating inflammatory cell Mcl-1 accelerates inflammation resolution without detriment to host defense against bacteria, and represents a target for treating infection-associated inflammation

Root Cultures of Linum Species Section Syllinum as Rich Sources of 6-Methoxypodophyllotoxin

professor of Pharmacognosy, Tehran Faculty of Pharmacy, Tehran on the occasion of his birthday Linum spp. from section Syllinum are promising for the production of aryltetralin lignans like podophyllotoxin (PTOX) and 6-methoxypodophyllotoxin (MPTOX). MPTOX is a PTOX congener that has cytotoxic activity comparable with PTOX. In this study root cultures of Linum Bungei from section Dasyllinum, L. strictum from section Linastrum, L. album, L. mucronatum ssp. mucronatum and L. nodiflorum from section Syllinum were established and their MPTOX levels were investigated in 1000 ml flasks. Root cultures of L. mucronatum ssp. mucronatum and L. nodiflorum were used to examine cell growth and production of MPTOX during a culture period of 36 days in 250 ml flasks. Considerable amounts of MPTOX in root cultures (1000 ml flasks) of L. album (6 mg/100 g DW), L. mucronatum ssp. mucronatum (770 mg/100 g DW) and L. nodiflorum (91 mg/100 g DW) were detected while it wasn't detected in root cultures of L. Bungei and L. strictum. In time course experiments, the maximum amount of MPTOX in L. nodiflorum root culture was at day 16 with 480 mg/ 100 g DW and the maximum amount of MPTOX in L. mucronatum ssp. mucronatum root culture was at day 12 with 130 mg/100 g DW. The results showed that root cultures of Linum species from section Syllinum are rich sources of MPTOX and since this lignan has remarkable cytotoxic activity, it can be used as a precursor for the production of antitumor agents