No abstract

The present work was designed to evaluate the functional and ultrastructural changes in platelets during and after major liver resection in healthy pigs as a trial to predict changes occurring in healthy liver donors. Measures to ensure the safety of the donor hepatectomy remain the main concern. Fifteen healthy pigs were prepared for liver resection by right trisegmentectomy. Blood samples were collected as such: one before the operation, two during the operation (one after the mobilization and other after the resection of the liver) and two after the operation (day 7 and day 14). Platelet count and markers of platelet activation, platelet factor 4 and beta-thromboglobulin, were measured. Separated platelets from peripheral blood and the resected liver were examined by electron microscopy. Platelet count was significantly dropped after hepatic mobilization and resection [(P < 0.05) and (P < 0.01), respectively] in comparison to normal level. On day 7, it increased significantly (P < 0.05). On day 14, it increased to become nonsignificantly different from preoperative count. beta-Thromboglobulin and platelet factor 4 were significantly increased after hepatic mobilization and resection [(P < 0.05) and (P < 0.01), respectively]. On day 7, they decreased to become nonsignificantly different from normal level. On day 14, they significantly reincreased (P < 0.01). Electron microscopic examination of platelets revealed all signs of activation after hepatic mobilization and resection. These changes disappeared on day 7 and reobserved on day 14. Liver surgery causes an acute and profound drop in platelet count and an increase in platelet activation. It is necessary to give proper systemic coagulant therapy in addition to platelet transfusion at the end of surgery for 1 week in case of hepatic resection.

Background and Objective: Considering plentiful immunohistochemical (IHC) antibodies, a selection of highly sensitive and specific targeted panels is necessary to differentiate malignant pleural mesothelioma (MPM) from metastatic adenocarcinoma. We aimed to examine the sensitivity and specificity of four markers (podoplanin [PDPN]/D2-40, calretinin, thyroid transcription factor-1 [TTF-1], and carcinoembryonic antigen [CEA]/CD66e) as an initial IHC panel of Egyptian patients with malignant pleural biopsies. Materials and Methods: Forty Egyptian malignant pleural biopsies with histomorphological features of mesothelioma versus adenocarcinoma were immunohistochemically stained by PDPN/D2-40, calretinin, TTF-1, and CEA/CD66e. Results: PDPN/D2-40 and calretinin were positive in 27/27, 100% of mesothelioma cases with 100% sensitivity, 96.4% specificity for PDPN/D2-40, and 100% sensitivity and specificity for calretinin. Membranous PDPN/D2-40 expression was strong in 14 cases (53.85%), moderate in eight cases (30.77%), and weak in four cases (15.38%), while pure cytoplasmic staining was reported in one case. Calretinin was predominantly nuclear in all mesothelioma cases. TTF1 and CEA/CD66e were negative in all mesothelioma cases. In adenocarcinomas, PDPN/D2-40 was only expressed as weak cytoplasmic staining in 1/13 cases, while calretinin was negative in all 13 cases. Nuclear TTF1 and cytoplasmic CEA/CD66e immunostaining positivity were reported in all adenocarcinoma cases (13/13) with 100% sensitivity and specificity for both markers. Conclusion: The combination of PDPN/D2-40, calretinin together with CEA/CD66e, and TTF1 may be highly valuable in differentiating MPM from metastatic adenocarcinoma.