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Dexamethasone mediates protection against acute pancreatitis via upregulation of pancreatitis-associated proteins

World Journal of Gastroenterology 2006年第42期12卷 6806-6811页

作者： emad kandil Yin-Yao Lin Martin H Bluth Hong Zhang Gabriel Levi Michael E Zenilman Department of Surgery State University of New York Downstate Medical Center Brooklyn New York United States Department of Pathology State University of New York Downstate Medical Center Brooklyn New York United States

AIM: To examine the influence of dexamethasone on pancreatitis-associated protein (PAP) gene expression using both in vitro and in vivo models of acute pancreati- tis and to study how PAP gene expression correlates with severity of pancreatitis. METHODS: In vitro, IL-6 stimulated pancreas acinar AR42J cells were cultured with increasing concentrations of dexamethasone and assayed for PAP expression (RT-PCR). In vivo , pancreatitis was induced in rats by retrograde injection of 40 g/L taurocholate into the pancreatic duct. Animals were pretreated with dexamethasone (2 mg/kg) daily or saline for 4 d. Pancreata and serum were harvested after 24 h and gene expression levels of PAPⅠ, Ⅱ and Ⅲ were measured by RT-PCR. Severity of pancreatitis was based on serum amylase, pancreatic wet weight, and histopathological score. RESULTS: In vitro, dexamethasone and IL-6 induced a marked transcription of PAPⅠ, Ⅱ and Ⅲ genes in AR42J cells at 24 h (P < 0.05 for all comparisons). In vivo, pancreas mRNA levels of PAPⅠ, Ⅱ or Ⅲ increased by 2.6-fold, 1.9-fold, and 1.3-fold respectively after dexa- methasone treatment, compared with saline treated ani- mals. Serum amylase levels and edema were significantly lower in the dexamethasone group compared with the saline group. Histopathologic evaluation revealed less inflammation and necrosis in pancreata obtained from dexamethasone treated animals (P < 0.05). CONCLUSION: Dexamethasone significantly decreases the severity of pancreatitis. The protective mechanism ofdexamethasone may be via upregulating PAP gene ex- pression during injury.

关键词： Pancreatitis Pancreatitis-associated protein Pancreatitis-associated protein Dexamethasone

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Electrophysiological neuromonitoring of the laryngeal nerves in thyroid and parathyroid surgery: A review

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World Journal of Experimental Medicine 2015年第2期5卷 120-123页

作者： Ahmed Deniwar Parisha Bhatia emad kandil Division of Endocrine and Oncologic Surgery Department of SurgeryTulane University School of Medicine

Recurrent laryngeal nerve(RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, it can be of great significance to professional voice users. Recent literature has led to an increase in the use of neuromonitoring as an adjunct to visual nerve identification during thyroid surgery. In our review of the literature, we discuss the application, efficacy and safety of neuromonitoring in thyroid surgery. Although intraoperative neuromonitoring(IONM) contributes to the prevention of laryngeal nerves injury, there was no significant difference in the incidence of RLN injury in thyroid surgery when IONM was used compared with visual identification alone. IONM use is recommended in high risk patients; however, there are no clear identification criteria for what constitutes "high risk". There is no clear evidence that IONM decreases the risk of laryngeal nerve injury in thyroid surgery. However, continuous IONM provides a promising tool that can prevent imminent nerve traction injury by detecting decreased amplitude combined with increased latency.

关键词： Neuromonitoring Superior laryngeal nerve Recurrent laryngeal nerve Thyroid surgery

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Multisystem inflammatory syndrome in pediatric COVID-19 patients:a meta-analysis

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World Journal of Pediatrics 2021年第2期17卷 141-151页

作者： Eman A.Toraih Mohammad H.Hussein Rami M.Elshazli Adam Kline Ruhul Munshi Nasrin Sultana Sharven Taghavi Mary Killackey Juan Duchesne Manal S.Fawzy emad kandil Department of Surgery Tulane UniversitySchool of MedicineNew OrleansLAUSA Genetics Unit Department of Histology and Cell BiologyFaculty of MedicineSuez Canal UniversityIsmailiaEgypt Department of Biochemistry and Molecular Genetics Faculty of Physical TherapyHorus University-EgyptNew Damietta 34517Egypt Tulane University School of MedicineNew OrleansLAUSA Division of Endocrine and Oncologic Surgery Department of SurgerySchool of MedicineTulane UniversityNew OrleansLA 70112USA Department of Medicine Larkin Community HospitalFlorida.MiamiUSA Trauma/Acute Care and Critical Care Department of SurgeryTulane UniversitySchool of MedicineNew OrleansLAUSA Department of Medical Biochemistry and Molecular Biology Faculty of MedicineSuez Canal UniversityIsmailiaEgypt Department of Biochemistry College of MedicineNorthern Border UniversityArarKingdom of Saudi Arabia

Background We aimed to systematically review the clinical and laboratory features of patients with the multisystem inflam-matory syndrome in pediatrics diagnosed during the COVID-19 *** sources A literature search in Web of Science,PubMed,Scopus,and Science Direct was made up to June 29,*** Analysis of 15 articles(318 COVID-19 patients)revealed that although many patients presented with the typical multisystem inflammatory syndrome in pediatrics,Kawasaki-like features as fever(82.4%),polymorphous maculopapular exanthema(63.7%),oral mucosal changes(58.1%),conjunctival injections(56.0%),edematous extremities(40.7%),and cervical lymphadenopathy(28.5%),atypical gastrointestinal(79.4%)and neurocognitive symptoms(31.8%)were also *** had elevated serum lactic acid dehydrogenase,D-dimer,C-reactive protein,procalcitonin,interleukin-6,troponin I levels,and *** 77.0%developed hypotension,and 68.1%went into shock,while 41.1%had acute kidney *** care was needed in 73.7%of cases;13.2%were intubated,and 37.9%required mechanical *** immunoglobulins and steroids were given in 87.7%and 56.9%of the patients,respectively,and anticoagulants were utilized in 67.0%.Pediatric patients were discharged after a hospital stay of 6.77 days on average(95%CI 4.93-8.6).Conclusions Recognizing the typical and atypical presentation of the multisystem inflammatory syndrome in pediatric COVID-19 patients has important implications in identifying children at *** cardiac and renal decompensation and early interventions in patients with multisystem inflammatory syndrome is critical to prevent further morbidity.

关键词： COVID-19 Kawasaki-like syndrome Multisystem inflammatory syndrome in pediatrics SARS-CoV-2

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Stem cell biology in thyroid cancer: Insights for novel therapies

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World Journal of Stem Cells 2014年第5期6卷 614-619页

作者： Parisha Bhatia Koji Tsumagari Zakaria Y Abd Elmageed Paul Friedlander Joseph F Buell emad kandil Departments of Surgery Tulane University School of Medicine New Orleans LA 70112 United States Departments of Otolaryngology Tulane University School of Medicine New Orleans LA 70112 United States

Currently, thyroid cancer is one of the most common endocrine cancer in the United States. A recent involvement of sub-population of stem cells, cancer stem cells, has been proposed in different histological types of thyroid cancer. Because of their ability of self-renewal and differentiation into various specialized cells in the body, these putative cells drive tumor genesis, metastatic activity and are responsible to provide chemo- and radioresistant nature to the cancer cells in the thyroid gland. Our Review was conducted from previously published literature to provide latest apprises to investigate the role of embryonic, somatic and cancer stem cells, and discusses the hypothesis of epithelial-mesenchymal transition. Different methods for their identification and isolation through stemness markers using various in vivo and in vitro methods such as flow cytometry, thyrosphere formation assay, aldehyde dehydrogenase activity and ATP-binding cassette sub-family G member 2 efflux-pump mediated Hoechst 33342 dye exclusion have been discussed. The review also outlines various setbacks that still remain to target these tumor initiating cells. Future perspectives of therapeutic strategies and their potential to treat advanced stages of thyroid cancer are also disclosed in this review.

关键词： Stem cells Cancer Stem cells Thyroid Neoplasms Carcinogenesis Cell Differentiation Epithelial-Mesenchymal transition

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Effect of obesity on perioperative outcomes after laparoscopic hepatectomy

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Hepatoma Research 2016年第1期2卷 323-327页

作者： Seeyuen J.Lee Adam Hauch Erica Kane Christoper DuCoin Michael Darden Geoffrey Parker emad kandil Joseph F.Buell Departments of Surgery Louisiana State University School of MedicineNew OrleansLA 70112USA Departments of Surgery Tulane University School of MedicineNew OrleansLA 70112USA Department of Economics Tulane UniversityNew OrleansLA 70112USA Tuck School of Business Administration Dartmouth CollegeHanoverNH 03755USA

Aim:Laparoscopic hepatectomy is increasing in utilization,however the procedure has not been adequately examined in the obese *** study aims to analyze the effect of obesity on perioperative outcomes after laparoscopic ***:Retrospective analysis of 396 laparoscopic hepatectomies in normal[body mass index(BMI)<25],overweight(BMI≥25),obese(BMI≥30),and severely obese(BMI≥35)patients using multivariate regression models to determine the risk factors for post-operative ***:Normal BMI(n=78;20%),overweight(n=209;52%),obese(n=86;22%),and severely obese(n=23;6%).Demographics were similar except for a higher American Society of Anesthesiologists(ASA)score in the obese *** blood loss and operating time were greatest in the overweight group,while length of stay and complications were statistically similar between *** analysis identified that complications were associated with weight class,ASA score,blood loss,and resection;multivariate analysis revealed ASA and transfusion were best correlated with ***:Obese and overweight patients have similar complication profiles to normal BMI patients while severely obese patients have a higher incidence of complications that are primarily limited to Clavien-Dindo class I and II.

关键词： Liver resection laparoscopy obesity

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Intraoperative endoscopic retrograde cholangiopancreatography: A useful tool in the hands of the hepatobiliary surgeon

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World Journal of Gastroenterology 2015年第2期21卷 609-615页

作者： Ayman El Nakeeb Ahmad M Sultan emad Hamdy Ehab El Hanafy Ehab Atef Tarek Salah Ahmed A El Geidie Tharwat kandil Mohamed El Shobari Gamal El Ebidy Gastroenterology surgical center Mansoura UniversityDaqahlia 35516Egypt

AIM: To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography(ERCP) combined with laparoscopic cholecystectomy(LC) forpatients with gall bladder stones(GS) and common bile duct stones(CBDS).METHODS: Patients treated for GS with CBDS were included. LC and intraoperative transcystic cholangiogram(TCC) were performed in most of the cases. Intraoperative ERCP was done for cases with proven ***: Eighty patients who had GS with CBDS were included. LC was successful in all cases. Intraoperative TCC revealed passed CBD stones in 4 cases so intraoperative ERCP was performed only in 76 patients. Intraoperative ERCP showed dilated CBD with stones in 64 cases(84.2%) where removal of stones were successful; passed stones in 6 cases(7.9%); short lower end stricture with small stones present in two cases(2.6%) which were treated by removal of stones with stent insertion; long stricture lower 1/3 CBD in one case(1.3%) which was treated by open hepaticojejunostomy; and one case(1.3%) was proved to be ampullary carcinoma and whipple's operation was scheduled. CONCLUSION: The hepatobiliary surgeon should be trained on ERCP as the third hand to expand his field of therapeutic options.

关键词： Obstructive jaundice Endoscopic retrograde cholang

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How does epidemiological and clinicopathological features affect survival after gastrectomy for gastric cancer patientssingle Egyptian center experience

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World Journal of Gastrointestinal Surgery 2016年第6期8卷 444-451页

作者： Ehab El Hanafy Ayman El Nakeeb Helmy Ezzat emad Hamdy Ehab Atif Tharwat kandil Amgad Fouad Mohamed Abdel Wahab Ahmed Monier Gastroenterology Surgical Center Mansoura University

AIM:To investigate the clinicopathological features and the significance of different prognostic factors which predict surgical overall survival in patients with gastric ***:This retrospective study includes 80 patients diagnosed and treated at gastroenterology surgical center,Mansoura University,Egypt between February 2009 to February *** factors were assessed by cox proportional hazard ***:There were 57 male and 23 *** median age was 57 years(24-83).One,3 and 5 years survival rates were 71%,69% and 46% *** median survival was 69.96 *** the follow-up period,13 patients died(16%).Hospital morbidity was reported in 10 patients(12.5%).The median number of lymph nodes removed was 22(4-41).Lymph node(LN) involvement was found in 91% of *** R0 resection,depth of wall invasion,LN involvement and the number(> 15) of retrieved LN,LN ratio and tumor differentiation predict *** multivariable analysis,tumor differentiation,curability of resection and a number of resected LN superior to 15 were found to beindependent prognostic ***:Surgery remains the cornerstone of *** differentiation,curability of resection and a number of resected LN superior to 15 were found to be independent prognostic *** LN dissection does not increase the morbidity or mortality rate but markedly improves long term survival.

关键词： Cancer stomach Prognostic factors Lymph node metastasis Recurrence after gastrectomy Lymph node ratio

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Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: A 25-year single-center study of 1000 consecutive cases

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World Journal of Gastroenterology 2017年第38期23卷 7025-7036页

作者： ayman el nakeeb waleed askar ehab atef ehab el hanafy ahmad m sultan tarek salah ahmed shehta mohamed el sorogy emad hamdy mohamed el hemly ahmed a el-geidi tharwat kandil mohamed el shobari talaat abd allah amgad fouad mostafa abu zeid ahmed abu el eneen nabil gad el-hak gamal el ebidy omar fathy ahmed sultan mohamed abdel wahab gastroenterology surgical center mansoura university

AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PDs) for periampullary *** This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed PD was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for PD. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the *** Surgical results of PD significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following PD is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%.

关键词： Pancreaticoduodenectomy Pancreaticogastrostomy Pancreaticojejunostomy Postoperative pancreatic fistula Periampullary tumor

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Post-endoscopic retrograde cholangiopancreatography pancreatitis: Risk factors and predictors of severity

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World Journal of Gastrointestinal Endoscopy 2016年第19期8卷 709-715页

作者： Ayman El Nakeeb Ehab El Hanafy Tarek Salah Ehab Atef Hosam Hamed Ahmad M Sultan emad Hamdy Mohamed Said Ahmed A El Geidie Tharwat kandil Mohamed El Shobari Gamal El Ebidy Gastroenterology Surgical Center Mansoura University

AIMTo detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity. METHODSThis is a prospective cohort study of all patients who underwent ERCP. Pre-ERCP data, intraoperative data, and post-ERCP data were collected. RESULTSThe study population consisted of 996 patients. Their mean age at presentation was 58.42 (± 14.72) years, and there were 454 male and 442 female patients. Overall, PEP occurred in 102 (10.2%) patients of the study population; eighty (78.4%) cases were of mild to moderate degree, while severe pancreatitis occurred in 22 (21.6%) patients. No hospital mortality was reported for any of PEP patients during the study duration. Age less than 35 years (P = 0.001, OR = 0.035), narrower common bile duct (CBD) diameter (P = 0.0001) and increased number of pancreatic cannulations (P = 0.0001) were independent risk factors for the occurrence of PEP. CONCLUSIONPEP is the most frequent and devastating complication after ERCP. Age less than 35 years, narrower median CBD diameter and increased number of pancreatic cannulations are independent risk factors for the occurrence of PEP. Patients with these risk factors are candidates for prophylactic and preventive measures against PEP.

关键词： Pancreatitis Obstructive jaundice Endoscopic retrograde cholangiopancreatography

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Biochemical Liver Functions and Molecular Identification of Fasciola hepatica from Experimentally Infected Rat Model

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Open Journal of Animal Sciences 2024年第2期14卷 88-100页

作者： Omnia M. kandil emad B. Ata Margarita P. Gabrashanska Hatem A. Shalaby Tamer H. Abd El-Aziz Noha M. F. Hassan Soad M. Nasr Mohamed A. Helal Ebtesam M. Al-Olayan Department of Parasitology & Animal Diseases Veterinary Research Institute National Research Centre Giza Egypt Institute of Experimental Morphology Pathology and Anthropology with Museum Bulgarian Academy of Sciences Sofia Bulgaria Department of Zoology Collage of Science King Saud University Riyadh Saudi Arabia

The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 days were randomly allocated into two groups (n = 8). The first group was infected orally with 15 viable encysted metacercaria of F. hepatica per animal. The other group was kept non-infected (control group). At zero time (before infection), the 2nd, 4th, 6th, 8th, 10th, 12th and 14th weeks post-infection (WPI), blood and serum samples were collected via puncture of retro-orbital plexus of veins from each rat. Serum enzyme level (AST and ALT) and total protein were measured, and the serum protein profile was carried out using agarose gel electrophoresis. During the period of the experiment, serum ALT and AST activities and serum total globulins significantly increased while serum total proteins and albumin markedly decreased in the infected group. On the 14th WPI, the data of the electropherogram showed that globulin fractions (α1-, β- and γ-globulin) levels were significantly increased while α2-globulin was markedly decreased in the infected group. The molecular analysis confirmed the amplification of the ITS1, ITS2 and NDI genes of F. hepatica recovered from the infected liver of rats with amplicon sizes of 630, 510 and 560 bp, respectively. Sequencing of the amplified ITS gene resulted in the determination of 3 strains (PP108836, PP108837, and PP108838). Also, analysis of the ITS2 gene resulted in obtaining 3 isolates under the accession numbers (PP109065, PP109066, and PP109067). In conclusion, fasciolosis in the rat model is suitable for routine experimental infections and caused a pronounced liver dysfunction with discharging of the Fasciola eggs in the faeces and the development of adult stages in the bile ducts. Furthermore, molecular techniques are a sensitive

关键词： Fasciola hepatica Liver Functions Serum Enzymes Serum Protein Electrophoresis Molecular Characterization

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