bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human pancreatic carcinoma cells are sensitive to photodynamic therapy in vitro and in vivo
Authors: Hajri A , Coffy S , Vallat F , Evrard S , Marescaux J , Aprahamian M 
Published: March 2003

Abstract

Background
The aim of this study was to assess the efficiency of photodynamic therapy (PDT) on human pancreatic cancer cells in vitro and in an animal model.

Methods
Human pancreatic tumour cell lines were submitted to PDT with pheophorbide a (Ph a) a chlorophyll derivative, in culture and after grafting into athymic mice. Ph a was tested in culture (10−10−10–5 mol/l) with a 5-J/cm2 energy treatment and on tumour-bearing Nude mice (30 mg/kg intraperitoneally) with a 100-J/cm2 PDT session. The effect of PDT was assessed in vitro using proliferative, apoptotic and clonogenic tests and in vivo on tumour growth and on the induction of tumour necrosis.

Results
PDT inhibited tumour cell growth in culture by affecting DNA integrity. This tumour cell photodamage started at low concentration (10−7 mol/l) as corroborated by clonogenic and tumour growth tests. A strong necrosis was achieved in vivo with a single PDT session.

Conclusion
PDT destroyed human pancreatic carcinoma after low photosensitizer supply and weak energy application. It exerted this tumoricidal effect via apoptosis induction with a gentle protocol, and apoptosis and/or necrosis with a stronger protocol.
Role of tissue factor expression on tumour cell invasion and growth of experimental pancreatic adenocarcinoma
Authors: Kakkar A K , Chinswangwatanakul V , Lemoine N R , Tebbutt S , Williamson R C N 
Published: March 2003

Abstract

Background
Tissue factor (TF), the physiological procoagulant, is expressed in pancreatic tissue as a result of malignant transformation. The aim of this investigation was to assess its role in pancreatic tumour cell invasion and primary tumour growth.

Methods
The full-length TF gene (1360 base pairs) was cloned into the plasmid DNA vector pcDNA3 in sense and antisense orientations, and these vectors were used to transfect the MIA PaCa-2 human pancreatic adenocarcinoma cell line. TF gene expression was characterized by Northern blot analysis, total cellular antigenic content by enzyme-linked immunosorbent assay and cell surface procoagulant activity by enzymatic assay. Invasion of tumour cells in vitro was determined by a standard Matrigel assay, and primary tumour growth was measured in immunodeficient mice.

Results
Overexpression of the TF gene, confirmed by an increased signal on Northern blotting, was associated with increases in both total antigenic content for TF (P = 0·001) and cell surface procoagulant activity (P = 0·008) in sense cells compared with wild-type cells. Likewise, both in vitro tumour cell invasion (P = 0·001) and primary tumour growth (P = 0·007) were increased in sense transfectants.

Conclusion
Expression of TF enhances in vitro invasion and primary tumour growth of MIA PaCa-2 cells, suggesting that this procoagulant molecule might have a role in pancreatic tumour biology.
During liver regeneration following right portal embolization the growth rate of liver metastases is more rapid than that of the liver parenchyma
Authors: Elias D , de Baere T , Roche A , Ducreux M , Leclere J , Lasser P 
Published: March 2003

Abstract

Background
The relative growth rates of human liver metastases are not known. The aim of this study was to determine in humans the growth rate of liver parenchyma during regeneration and the growth rate of liver metastases during the same process.

Methods
Among 556 patients hepatectomized for a malignant lesion, 48 underwent preoperative selective right portal vein embolization to induce hypertrophy of the left lobe. Five cases were selected because a liver metastasis was present inside the regenerating left lobe. The volumes of the liver metastasis and left lobe were measured with a three-dimensional technique on pre-embolization and postembolization computed tomography (CT) or CT arterial portography. The median interval between the two measurements was 34 (range 28–40) days.

Results
An increase occurred in the volume of the liver metastasis and the left lobe in the four patients with functionally intact liver parenchyma, but not in the patient with an impaired parenchyma. The volumetric increase of the normal liver varied from 59 to 127 per cent, compared with 60 to 970 per cent for the liver metastases. The ratio between the growth rate of the left lobe and the liver metastasis varied from 1·0 to 15·6. The growth rates of two metastases in the left lobe of a single patient were different.

Conclusion
In functionally intact liver parenchyma, during hepatic regeneration or hypertrophy, the growth rate of metastases is more rapid that that of the liver parenchyma. However, a wide variation in growth rate is observed between patients and between metastases.
Modern management of pulmonary embolism
Authors: Tai N R M , Atwal A S , Hamilton G 
Published: March 2003

Abstract

Background
Pulmonary embolism is a significant cause of morbidity and death after operation. The introduction of new technologies in the diagnosis, and thrombolysis in the treatment, of pulmonary embolism has led to a need to reappraise the management of this condition.

Methods
This review encompasses a comprehensive discussion of diagnostic modalities and therapeutic strategies used in the current management of pulmonary embolism. Relevant papers on the diagnosis and treatment of pulmonary embolism were identified from a Medline search for the period 1967–1998. Additional papers were derived from the reference lists of retrieved articles. Articles presenting prospectively gathered data have been referenced preferentially.

Results and conclusion
Algorithms for the diagnosis and treatment of pulmonary embolism are presented.
Adjuvant regional chemotherapy after hepatic resection for colorectal metastases
Authors: Ambiru S , Miyazaki M , Ito H , Nakagawa K , Shimizu H , Nakajima N 
Published: March 2003

Abstract

Background
This study explored the possibility of achieving a better survival rate and reduced recurrence in the remaining liver in patients with colorectal hepatic metastases undergoing hepatic resection. Adjuvant postoperative regional chemotherapy was administered via the hepatic artery or the portal vein.

Methods
A retrospective study was performed on 174 patients after hepatic resection for colorectal metastases. These comprised 78 patients who had hepatic artery infusion (HAI) chemotherapy (HAI group), 30 who had portal vein infusion (PVI) chemotherapy (PVI group) and 66 who had no regional chemotherapy (resection alone group). The three groups were compared with one another in terms of complications, survival rate and patterns of recurrence.

Results
Severe complications did not occur at any point during adjuvant HAI or PVI chemotherapy. The 5-year disease-free survival rate of patients in the HAI, PVI and resection alone groups were 35, 13 and 9 per cent respectively, including six hospital deaths. Patients in the HAI group showed significantly improved recurrence rates in the remaining liver compared with the resection alone group (P = 0·03), and more prolonged disease-free and overall survival than those in the PVI (P = 0·01 and P = 0·02 respectively) and resection alone (P = 0·0001 and P = 0·0006 respectively) groups.

Conclusion
This study suggests that adjuvant HAI chemotherapy after hepatic resection may have therapeutic potential for improved management of patients with colorectal metastases.
Mortality from ruptured abdominal aortic aneurysm in Wales
Authors: Basnyat P S , Biffin A H B , Moseley L G , Hedges A R , Lewis M H 
Published: March 2003

Abstract

Background
The aim of this study was to identify the incidence of, and mortality in, patients with a ruptured abdominal aortic aneurysm (AAA) reaching hospital alive in Wales.

Methods
Patients who presented with a ruptured AAA between September 1996 and August 1997 were analysed. Data were collected prospectively by an independent body, observing strict confidentiality.

Results
Some 233 patients with a confirmed ruptured AAA were identified, giving an incidence of eight per 100 000 total population. Some 133 patients (57 per cent) underwent attempted operative repair; 85 (64 per cent) of these died within 30 days. Of the 233 patients, 92 were admitted under the care of a vascular surgeon and 141 under a non-vascular surgeon. Vascular surgeons operated on 82 patients (89 per cent), of whom 50 (61 per cent) died, whereas non-vascular surgeons operated on 51 patients (36 per cent), of whom 35 (69 per cent) died.

Discussion
This study is unique as it is an independent prospective study of mortality in patients with a ruptured AAA who reached hospital alive. Mortality was independent of the operating surgeon, but vascular surgeons turned down significantly fewer patients than non-vascular surgeons (11 versus 64 per cent, P &lt; 0·001).
Use of colour duplex imaging to diagnose and guide angioplasty of lower limb arterial lesions
Authors: London N J M , Nydahl S , Hartshorne T , Fishwick G 
Published: March 2003

Abstract

Background
The purpose of this study was to investigate whether colour duplex imaging alone could safely and effectively be used to diagnose lower limb arterial lesions and guide subsequent percutaneous transluminal angioplasty (PTA).

Methods
Patients with discrete lower limb arterial lesions, preferably stenoses, which could be visualized clearly by colour duplex imaging were selected for duplex-guided PTA. Duplex-guided PTA was performed in an operating theatre using conventional balloon catheters.

Results
Duplex imaging was used to diagnose and guide PTA of 55 arterial lesions in 50 legs of 45 patients. There were 53 stenoses and two occlusions. The median (range) ankle: brachial pressure index was 0·86 (0·52–1·10) before dilatation and 1·00 (0·83–1·40) immediately after dilatation (P = 0·0001). There were no complications during or after any of the procedures and 46 of the 47 symptomatic legs were markedly improved at a median follow-up of 23 days. Radiographic imaging was not required for any of the procedures.

Conclusion
It is possible to diagnose and angioplasty lower limb arterial lesions using colour duplex imaging alone.
Prognostic significance of anatomical resection and des-γ-carboxy prothrombin in patients with hepatocellular carcinoma
Authors: Imamura H , Matsuyama Y , Miyagawa Y , Ishida K , Shimada R , Miyagawa S , Makuuchi M , Kawasaki S 
Published: March 2003

Abstract

Background
Portal venous tumour extension and intrahepatic metastasis result in a poor prognosis following hepatectomy for hepatocellular carcinoma (HCC). Anatomical resection is, in theory, preferable for eradicating these types of invasion. Des-γ-carboxy prothrombin (DCP) has been reported to be associated with adverse pathological variables. This study investigated the significance of anatomical resection and DCP as predictive factors for postoperative recurrence of HCC.

Methods
A retrospective cohort study was carried out in 138 consecutive patients who underwent hepatectomy for HCC smaller than 5 cm using the Cox proportional hazards model.

Results
Eight factors were univariately related to poor prognosis (in decreasing order of hazard ratio): intrahepatic metastasis, multiple tumours, α-fetoprotein 32 ng/ml or more; DCP greater than 0·1 arbitrary units (AU), tumour-exposed surgical margin, vascular invasion, non-anatomical resection and tumour 2·5 cm or more. Three variables (DCP, vascular invasion and tumour-exposed surgical margin) were excluded by a stepwise procedure in multivariate analysis. Although DCP was not an independent prognostic factor, a model replacing intrahepatic metastasis with DCP showed similar predictive accuracy in a receiver-operating characteristic curve.

Conclusion
Anatomical resection appeared to have a beneficial effect on recurrence-free survival after hepatectomy for HCC. DCP measurement was effective in predicting HCC recurrence and had the advantage that it can be assessed before operation.
Experimental study of liver dysfunction evaluated by direct indocyanine green clearance using near infrared spectroscopy
Authors: El-Desoky A , Seifalian A M , Cope M , Delpy D T , Davidson B R 
Published: March 2003

Abstract

Background
Blood clearance of indocyanine green (ICG) is an objective test of liver function. Hepatic ICG clearance can now be measured directly using near infrared spectroscopy (NIRS). The aim of this study was to evaluate measurement of hepatic ICG clearance by NIRS in an animal model of acute hepatic dysfunction.

Methods
New Zealand white rabbits (n = 36) underwent laparotomy for liver exposure. Hepatic blood flow and microcirculation were measured along with hepatic ICG concentration by NIRS. Hepatic ICG clearance was measured in groups of six animals after reduction of the hepatic blood flow by hepatic artery occlusion and portal vein partial occlusion, lobar ischaemia and reperfusion (I/R), colchicine administration and bile duct ligation. Hepatic ICG uptake and excretion rates were calculated by a non-linear least square curve fitting method from the ICG concentration–time curve.

Results
There was a significant positive correlation between hepatic ICG rate of uptake and both hepatic blood flow and microcirculation (r = 0·79, P = 0·0001; r = 0·59, P = 0·005 respectively). I/R resulted in a significant reduction of both the rates of ICG uptake (mean(s.d.) 0·85(0·59) min−1; P = 0·0002 versus control) and ICG excretion (0·020(0·006) min−1; P = 0·02 versus control). Colchicine decreased the rate of hepatic ICG excretion (0·030(0·010) min−1; P = 0·02 versus control) as did bile duct ligation (0·002(0·001) min−1; P = 0·01 versus control).

Conclusion
Measurement of hepatic ICG clearance by NIRS is a promising technique for assessing hepatic parenchymal dysfunction and may have application in liver surgery and transplantation.
Factors affecting late survival after elective abdominal aortic aneurysm repair
Authors: Yasuhara H , Ishiguro T , Muto T 
Published: March 2003

Abstract

Background
The late prognosis after repair of an abdominal aortic aneurysm (AAA) may be affected by atherosclerosis, which involves various organs including the aorta.

Methods
The influence of organ dysfunction and atherosclerosis on the long-term survival of 338 consecutive patients undergoing successful elective AAA repair between 1980 and 1997 was analysed using Cox hazards model. Survival rate was compared with that of 349 patients undergoing successful revascularization for aortoiliac occlusive disease (AIOD) during the same interval.

Results
Renal dysfunction and a previous history of cerebrovascular events were important variables predicting late death (risk ratio 1·980 and 1·903 respectively), while a history of cardiac disease predicted only cardiac-related death. The survival rate in patients with normal renal function was significantly better than that in those with renal dysfunction (P = 0·0371). Similarly, the survival rate was significantly better in patients without a history of previous cerebrovascular events (P = 0·0414). The survival rate after AAA repair was nearly identical to that of age- and sex-matched patients with grade II or III symptoms who had surgery for AIOD.

Conclusion
Advanced atherosclerosis with underlying organ dysfunction is a true determinant of long-term survival following elective repair of AAA.
Oral contrast with computed tomography in the evaluation of blunt abdominal trauma in children
Authors: Shankar K R , Lloyd D A , Kitteringham L , Carty H M L 
Published: March 2003

Abstract

Background
The use of oral contrast in evaluating children by computed tomography (CT) following blunt trauma is controversial. The aim of this study was to evaluate retrospectively the use of oral contrast with abdominal CT in children with suspected abdominal injury.

Methods
The medical records of 101 children who underwent CT for abdominal trauma between 1993 and 1997 were reviewed for data pertaining to the mechanism of injury, clinical findings and management. Scans were reviewed by a paediatric radiologist and criteria of intestinal injury on CT described by Cox and Kuhn were used: (1) extraluminal air or contrast material, (2) focal area of thickening of bowel wall and mesentery, and (3) free intraperitoneal fluid in the absence of solid organ injury.

Results
CT was performed within a median time of 2·4 (range 1–48) h after the injury. On 37 (62 per cent) of 60 scans in children who had oral contrast, the duodenum was not opacified after a mean delay of 30 min. Intestinal injury was suspected on CT in four children. In two children with CT evidence of intestinal injury (with/without oral contrast) rupture of the duodenojejunal flexure (n = 1) or ileal perforation (n = 1) was found at laparotomy. Two children had a false-positive scan, leading to negative laparotomy; one scan with oral contrast incorrectly suggested a duodenal leak and in another child CT without oral contrast showed thickening of bowel wall with free intraperitoneal fluid but no specific intestinal injury was identified at laparotomy. One patient had two negative CT scans (with and without oral contrast) and underwent laparotomy for clinical suspicion of bowel injury; rupture of the splenic flexure of the colon was found at laparotomy.

Conclusion
CT is not reliable for diagnosing intestinal injuries and this is not improved by use of oral contrast. Omission of oral contrast was not associated with delay in the diagnosis of intestinal injury. Since intestinal injuries are uncommon in children, a prospective multicentre study would determine more precisely the role of the routine use of oral contrast.
Abnormal neurophysiology in patients with oesophageal motility disorders
Authors: Rate A J , Hobson A R , Barlow J , Bancewicz J 
Published: March 2003

Abstract

Background
The pathology of oesophageal motility disorders is poorly understood. Oesophageal manometry provides only a descriptive assessment of luminal pressure changes. This study applied the investigative methods of the neurophysiologist to gain insight into the pathophysiology of these disorders.

Methods
Twelve healthy volunteers and 28 patients with oesophageal motility disorders underwent oesophageal manometry and balloon stimulation studies. Cortical evoked potentials (CEPs) in response to electrical stimulation of the oesophagus and oesophageal motor evoked potentials (MEPs) to transcranial magnetic stimulation of the cerebral cortex were recorded.

Results
Only two patients had abnormalities with a primary defect in muscle function. Fifteen had abnormal responses to balloon stimulation with normal CEPs and MEPs, suggesting a defect in the intrinsic nerves of the oesophagus. Five with achalasia did not respond to balloon stimulation and had abnormal CEPs and MEPs, suggesting widespread neural defects. The remainder had a variety of abnormal responses suggesting possible defects in receptor sensitivity, central processing or sensory neuropathy. There was no correlation between the manometric diagnosis and abnormal neuro-physiology, except in patients with achalasia.

Conclusion
Neurophysiological testing suggests that oesophageal motility disorders are most com-monly due to a variety of neural defects.
Assessment of lower extremity venous function using foot venous pressure measurement
Authors: Fukuoka M , Okada M , Sugimoto T 
Published: March 2003

Abstract

Background
Measurement of foot venous pressure (FVP) is useful for evaluating chronic venous insufficiency (CVI) functionally, because CVI always causes venous hypertension. In the present study, the various FVP parameters were analysed according to the new classification of venous disorders based on clinical, aetiological, anatomical and pathophysiological data (the CEAP classification).

Methods
During the past 7 years, a total of 257 legs in 196 consecutive patients with CVI have been studied. The following FVP parameters were assessed: the percentage decrease in pressure from rest with manual calf compression, the rate of increase of pressure during 4 s after compression (4SR) and the time to 50 per cent recovery of pressure (RT50) after release of compression.

Results
The incidence of skin changes due to venous stasis increased as the percentage pressure drop and RT50 fell. In addition, a pressure drop of less than 72 per cent and an RT50 of less than 20 s could detect legs with skin changes with a sensitivity of 76 per cent and a specificity of 62 per cent. In legs with primary varicose veins, pressure drop, 4SR and RT50 values deteriorated in proportion to the severity of the associated deep venous reflux.

Conclusion
FVP parameters correlate well with the severity of clinical manifestations and venous reflux, and could be used quantitatively to evaluate the severity of CVI.
Randomized controlled trial to examine the influence of thoracic epidural analgesia on postoperative ileus after laparoscopic sigmoid resection
Authors: Neudecker J , Schwenk W , Junghans T , Pietsch S , Böhm B , Müller J M 
Published: March 2003

Abstract

Background
The aim of the study was to evaluate whether perioperative epidural analgesia had any effect on the duration of postoperative ileus after laparoscopic sigmoid resection.

Methods
Twenty patients were randomized to surgery either with (group 1; n = 10) or without (group 2; n = 10) thoracic epidural analgesia. The major endpoint of the study was the time to the first postoperative bowel movement. Secondary endpoints were the interval until oral feeding was tolerated, incidence of postoperative vomiting, postoperative analgesic consumption use of patient-controlled analgesia (PCA) until the fourth day after operation, subjective pain perception and the incidence of epidural-related side-effects.

Results
Age, sex and American Society of Anesthesiologists classification were similar in the two groups. The first bowel movement was documented after a median of 54 (95 per cent confidence interval 32–127) h in group 1 and 77 (31–99) h in group 2 (P = 0·8). Oral feeding without additional parenteral therapy was tolerated after 48 (40–64) h in group 1 and after 56 (48–64) h in group 2 (P = 0·6). Postoperative vomiting occurred in two patients from each group. During epidural therapy the use of PCA was lower in group 1 (0·30 (0·19–0·96) mg morphine per kg) than in group 2 (0·56 (0·37–0·80) mg/kg) (P &lt; 0·05). Postoperative pain perception during rest and while coughing was similar in both groups. Three patients experienced reversible side-effects of epidural therapy (motor deficit, two patients; bladder dysfunction, one).

Conclusion
Perioperative thoracic epidural analgesia did not have a clinically relevant effect on the duration of postoperative ileus after laparoscopic sigmoid resection.