Surgical management in obstructive jaundice still contributes to significant morbidity and mortality. One of complications following surgery in obstructive jaundice is sepsis. This complication is caused by the toxic effects of bilirubin and bile salts, endotoxins, bacterial translocation, modulation of the immune-inflammatory cascade, decreased cellular immunity and/or nutritional status. Many studies have shown the elevated inflammatory response indicator, interleukin-1 (IL-1b), in patients with obstructive jaundice. However, only a few report described the association between the indicators of obstructive jaundice (alkaline phosphatase [ALP], g-glutamyl transpeptidase [GGT], and bilirubin) and the indicator of inflammatory response ). This study aimed to investigate the association between the indicator of obstructive jaundice (ALP, GGT, and bilirubin) and the level of interleukin-1b (IL-1b) in dogs as the animal model. We performed ligation on distal common bile ducts (CBD) to produce a model of obstructive jaundice. Every three days within a month, the blood samples from ten dogs were extracted to determine the ALP, GGT, direct and total bilirubin, and IL-1b levels. We found a significant correlation between the ALP and GGT with IL-1b level with p-value of 0.036 (r=0.626) and 0.003 (r=0.826). However, there was no association between the increased direct bilirubin with the IL-1b level (p=0.068; r=0.537). Moreover, the increased level of ALP and GGT had a strong correlation with the increased level of direct bilirubin with p-value of 0.004 (r=0.810) and p=0.011 (r=0.746). In conclusion, the increased level of GGT was the strongest indicator for inflammatory response in dogs with obstructive jaundice. Furthermore, the increased levels of GGT and ALP might imply the development of obstructive jaundice in dogs.

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Zinc finger E-box binding homeobox 1 (ZEB1) and ZEB2 in the ZEB1/2 isoform complex are known to play an important role in the progression, invasion, and metastasis of colorectal cancer (CRC). In cancer cells, ZEB1 regulates the epithelial-mesenchymal transition (EMT). This study aimed to identify the ZEB1 expression in CRC and its correlation with clinicopathological and metastatic status. Using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), we compared different ZEB1 expressions in fresh-frozen tissue from non-tumor tissue (NT), primary tumor tissue without metastasis (PT), and primary tumor tissue with liver metastasis (PTLM). The correlation between ZEB1 expression and clinicopathological characteristics was also investigated. Statistical analysis revealed that ZEB1 expression is significantly higher in the primary tumor tissues (PT and PTLM) than in NT (p<0.05), and high ZEB1 expression is associated with PTLM (p<0.05). ZEB1 expression is significantly correlated with white blood cells (p=0.005), blood glucose (p=0.017), tumor invasion (p=0.001), pathological grading (p=0.002) and metastasis profile (p=0.001). There was no significant correlation between ZEB1 expression and age, body mass index, hemoglobin, albumin, platelet count, alanine aminotransferase, aspartate aminotransferase, carcinoembryonic antigen and tumor location. These findings suggest that ZEB1 expression has diagnostic value in predicting tumor progression and detecting liver metastases.

Sigmoid vaginoplasty has been popular for neovagina reconstruction in vaginal aplasia. The most common surgical complication was vaginal stenosis caused by inadequate vascularization and tension because of graft length. Therefore, ischemia ensued and disrupted wound healing. The selection of double pedicle artery rotation sigmoid vaginoplasty is expected to reduce this problem. Five patients from April to December 2016 were diagnosed with vaginal aplasia; 4 had history of neovagina stenosis. These patients underwent sigmoid vaginoplasty with double pedicle artery rotation. No complications occurred during or after the procedure. Assessment postsurgery was conducted at 1 year. These results suggest that double pedicle artery rotation sigmoid vaginoplasty is a safe and acceptable technique for management of vaginal aplasia. The procedure decreased tension inside vascular pedicles as a result of maintaining abundant vascularization supply. Consequently, this procedure could avert graft necrosis, leakage, and severe stenosis. All of the patients exhibited regular menstrual cycle and satisfactory sexual activity. The outcomes were excellent with remarkable anatomical and functional results.