This prospective pilot study was performed to evaluate the efficacy, safety and tolerability of a single dose of cefodizime as infection prophylaxis in patients undergoing major abdominal surgery. One hundred forty-nine patients received 2g cefodizime, a third-generation cephalosporin, 30 min before abdominal surgery. The mean operation time was 116 +/- 66 min. Eighteen patients received metronidazole additionally. In 8/149 patients (5.4%) the final outcome was considered to be a treatment failure. 94.6% of the patients had no signs of infection. The long half-life of cefodizime allows a single-dose perioperative prophylaxis even in abdominal surgery lasting 3 to 4 h. Cefodizime can be regarded as a safe antibiotic prophylaxis with few side effects.

Abdomen↗

PubMedDate not supplied

Coincidence of Crohn's disease and a high-risk gastrointestinal stromal tumor of the terminal ileum.

A 51-year-old male patient presented with characteristic radiologic features of Crohn's disease in the terminal ileum plus a large tumorous lesion in the right lower abdomen. Because of rapid crescent symptoms of bowel obstruction, the patient underwent surgery revealing a high-risk gastrointestinal stromal tumor (GIST) of the terminal ileum within an area of Crohn's ileitis. Whereas the association of chronic inflammatory bowel disease (IBD) and gastrointestinal adenocarcinoma is well known, other primary intestinal tumors are rare in these patients, particularly at the time of onset of clinical symptoms. This is the 3rd patient reported in the literature with a sarcoma complicating IBD, and in fact, the first description of the coincidence of Crohn's disease and GIST. Though the present case is likely to be a mere coincidence of two pathologically distinct entities (without any potential causal relationship), it should remind one of the possibility of small bowel 'Crohn's carcinoma' in patients with a sudden change in symptomatology as well as in those in whom intestinal obstruction fails to resolve with adequate therapy.

Crohn Disease↗

PubMedDate not supplied

Expression of the multidrug resistance protein (MRP1) in breast cancer.

BACKGROUND: The multidrug resistance protein (MRP1) is expressed in human breast carcinomas but its clinical significance remains unclear. The aim of the present study was to determine the clinical significance of MRP1 in breast cancer patients. MATERIALS AND METHODS: MRP1 expression of primary carcinomas from 100 breast cancer patients was immunohistochemically determined by means of the monoclonal antibodies QCRL-1/QCRL-3. RESULTS: MRP1 was negative in 20 (20%) and positive in 80 (80%) breast carcinomas. MRP1 expression was more frequent in both estrogen receptor-negative carcinomas and progesterone receptor-negative carcinomas (p = 0.1 in both cases), but was independent of tumor size and lymph node involvement. Patients with MRP1-negative carcinomas had prolongations of overall survival (p = 0.01 for death due to any cause, p = 0.04 for breast cancer-related death) and disease-free survival (p = 0.07) as compared to those with MRP1-positive carcinomas. Also in subsets of patients (negative lymph nodes; positive lymph nodes; positive estrogen receptor; T1/T2 tumors), overall survival was longer for patients with MRP1-negative carcinomas. In univariate Cox regression analyses, MRP1 positivity was associated with relative risks of 4.9 (95% CI 1.2-20.6; p = 0.03) for death due to any cause, 6.4 (95% CI 0.9-48.0; p = 0.07) for breast cancer-related death and 3.5 (95% CI 0.8-14.9; p = 0.09) for relapse. In multivariate Cox regression analyses, MRP1 positivity had relative risks of 5.1 (95% CI 1.2-21.7; p = 0.03) for death due to any cause, 6.5 (95% CI 0.8-50.1; p = 0.07) for breast cancer-related death and 3.4 (95% CI 0.8-15.1; p = 0.1) for relapse. CONCLUSIONS: Our results suggest that MRP1 might be an important factor in breast cancer indicating excellent prognosis for patients with MRP1-negative carcinomas.

ATP-Binding Cassette Transporters↗

PubMedDate not supplied

Expression of the lung resistance protein (LRP) in primary breast cancer.

BACKGROUND: To determine the clinical significance of the lung resistance protein (LRP) in breast cancer, we have studied its expression in primary breast carcinomas (n = 99) and assessed the association of this expression with clinical parameters of the patients. MATERIALS AND METHODS: LRP expression was immunohistochemically determined by means of the monoclonal antibody LRP-56 on frozen tumor sections. RESULTS: LRP expression was negative in 12%, low in 20%, intermediate in 47% and high in 21% of the carcinomas. LRP expression was independent of age of the patients, histology, tumor grade, estrogen receptor as well as progesterone receptor status, tumor size and lymph node involvement. Kaplan-Meier analyses revealed that both overall survival and disease-free survival were independent of the degree of LRP expression. CONCLUSIONS: LRP is frequently expressed in breast carcinomas, but is neither associated with known prognostic factors, nor a prognostic factor by itself.

Adult↗

PubMedDate not supplied

Expression of the lung resistance protein in primary colorectal carcinomas.

To assess whether the lung resistance protein (LRP) is of clinical significance in colorectal carcinomas, we immunohistochemically determined LRP expression of colorectal carcinoma specimens (n = 68) by means of the monoclonal antibody LRP-56 and compared this expression with clinical parameters. LRP expression was negative in 7 (10%), low in 36 (52%) and high in 25 (38%) carcinomas. LRP expression was independent of histological grade, tumor size, lymph node involvement and distant metastasis. Survival of the patients with LRP-positive tumors was similar to the survival of patients with LRP-negative tumors. However, patients with high LRP expression in their carcinomas had a prolonged survival. Thus LRP is frequently expressed in colorectal carcinomas and high expression might indicate improved survival.

Aged↗