Effectiveness of extended lymphadenectomy in early gastric cancer.
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Biomedical subjects
Publications and source records attributed to A M Kappas.
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Phosphatidylcholine (PC), which has successfully been used in the past to increase ultrafiltration in continuous ambulatory peritoneal dialysis (CAPD) patients, has recently been found to prevent experimental adhesion formation after intraperitoneal irrigation with warm saline. The aim of this study was to determine the most effective route(s) of PC administration in the aforementioned model. Eighty Wistar rats underwent laparotomy and intraperitoneal irrigation with saline at 40 degrees C, which in 20 rats was followed by closure of the abdomen (control group, GC). In another 20 rats PC was given per os before and after irrigation (per os PC group, GOPC). In the third group PC was diluted in the irrigation fluid (intraperitoneal PC group, GIPC), and in the last group PC was given per os and intraperitoneally (combined PC group, GCPC). Assessment of adhesions was performed 2 weeks after the irrigation. Adhesions were found in 12 rats in the GC, 5 rats in the GOPC (p = 0.05, Fisher's test), 17 rats in the GIPC, and 3 rats in the GCPC (p = 0.007, Fisher's test). The difference between GOPC and GCPC was not statistically significant. The decreased adhesion formation after PC administration combined with the increased ultrafiltration may be of considerable importance in CAPD patients.
OBJECTIVE: To assess the effectiveness of verapamil, hydrocortisone sodium succinate, and phosphatidylcholine in the prevention of experimental adhesions. DESIGN: Randomized trial. MATERIAL: 80 rats. INTERVENTIONS: Laparotomy and intraperitoneal irrigation with saline 40 degrees C, then verapamil hydrochloride 1 mg/kg intravenously 15 min before, during, and after irrigation; or hydrocortisone sodium succinate 50 mg/kg intravenously half an hour before irrigation; or phosphatidylcholine 5.5 mg/kg orally eight days before and seven days after irrigation plus 0.5 mg/ml in the irrigation fluid; or no further intervention. MAIN OUTCOME MEASURES: Development of adhesions two weeks after irrigation, and completeness of wound healing. RESULTS: Adhesions developed in 13 of 19 control animals; 7 of 20 that were given verapamil; 6 of 20 that were given hydrocortisone; and 3 of 20 given phosphatidylcholine. CONCLUSION: Adhesions that developed in rats after laparotomy and intraperitoneal irrigation with saline at 40 degrees C can be significantly reduced by phosphatidylcholine.
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This study was designed to examine the influence of saline irrigation at different temperatures on adhesion/formation in the rat. Saline irrigation through a laparotomy incision was performed at the following temperatures: 30 degrees C, 34 degrees C, 37 degrees C, 40 degrees C, 45 degrees C, 50 degrees C, 55 degrees C, and 60 degrees C. The control group (Gc, n = 20) underwent laparotomy without irrigation. Adhesions were found in: 5/20 animals of the Gc (all slight); 6/20 of the 30 degrees C group (all slight); 6/20 of the 34 degrees C group (all slight); 6/20 of the 37 degrees C group (all slight); 12/20 of the 40 degrees C group (all slight); 12/20 of the 45 degrees C group (11 slight, 1 moderate); 14/20 of the 50 degrees C group (12 slight, 2 moderate); 18/19 of the 55 degrees C group (2 slight, 6 moderate, 10 marked); and 18/18 of the 60 degrees C group (1 moderate, 8 marked, 9 massive). These results indicate that saline irrigation below body temperature does not prevent adhesions whereas warmed saline encourages adhesion formation in the rat.
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The data of nine children with post-traumatic intramural haematoma of the duodenum treated in Aghia Sophia Children's Hospital of Athens from 1967 to 1980 were retrospectively analysed. Diagnosis was preoperative in all but two children, in whom diagnosis was made during laparotomy. All but one were managed by operative intervention which consisted of simple evacuation of the haematoma and closure of the serosal incision in two out of eight children. Six out of eight children operated on were followed up for 15 years, during which they were free of symptoms. Hypotonic duodenography performed in the above patients was negative for deformity or stricture of the duodenum.
The immunohistochemical Cathepsin D (CD) expression of tumour and stromal cells was investigated in a series of 93 human colorectal adenocarcinomas and 22 adenomas with the intention to evaluate its prognostic significance and its contribution in the metastatic potential of colorectal cancer. CD expression was correlated with the expression of extracellular matrix components (collagen type IV, laminin and fibronectin), p53 protein, pRb, bcl-2, c-erbB-2, EGFR, proliferation indices (Ki-67, PCNA) as well as with other conventional clinicopathological features. CD expression (> 10% of positive tumour cells) was observed in 60.2% of carcinomas and in 72.7% of adenomas. Stromal CD expression was detected in all cases. A statistically significant positive correlation between neoplastic cells CD and stromal cells CD (SCCD) was observed in both carcinomas and adenomas. Cancer cells CD (CCCD) was positively correlated with collagen type IV and pRb expression as well as with PCNA score. In carcinomas, SCCD expression was statistically correlated with p53 protein and pRb expression and a trend for correlation with PCNA score was found. These data suggest that Cathepsin D of cancer and stromal cells, especially in combination with other markers, may provide more information about the biological behaviour of colorectal cancer.