Multivisceral transplantation for abdominal malignancy: indication, technique, and results in three patients.
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Abdominal Neoplasms↗
Biomedical subjects
J Scheele
Publications and source records attributed to J Scheele.
Cytomegalovirus infection after liver transplantation using different prophylaxes.
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Antiviral Agents↗
[Fibrin pleurodesis of bilateral tension pneumothorax in mucoviscidosis].
A bilateral recurrent tension pneumothorax in an 18-year-old patient with cystic fibrosis was treated by fibrin glue pleurodesis. Within the observation period of 20 months no relapse has occurred.
Adhesives↗
Chlorinated hydrocarbons in human bone marrow of healthy individuals and leukemia patients.
In this pilot study, concentrations of chlorinated hydrocarbons in bone marrow were determined by capillary-column gas chromatography. Bone marrow was obtained from a total of 29 healthy adults and from patients with leukemia or lymphoma. The chlorinated hydrocarbons in adults that occurred in the highest concentrations were dichlorodiphenyltrichloroethane and its derivatives (mean = 129 mg/g DNA). Hexachlorobenzene, the hexachlorohexane isomers, and dieldrin were also found, but in reduced concentrations (i.e., mean concentrations: 49.5 mg/g DNA, 14.9 mg/g DNA, and 5.9 mg/g DNA, respectively). Patients who had leukemia and lymphoma did not have significantly increased concentrations of chlorinated hydrocarbons.
Adult↗
Meizothrombin, an intermediate of prothrombin cleavage potently activates renal carcinoma cells by interaction with PAR-type thrombin receptors.
Recently, meizothrombin (MT), an intermediate enzyme in the prothrombin cleavage cascade has been shown to activate cells of a brain tumor cell line by interaction with PAR-1-type thrombin receptors with a potency comparable to that of thrombin. In this study, we investigated the effect of recombinant human MT (rMT) on calcium mobilization in primary cultures established from surgically resected human renal cell carcinomas. Meizothrombin induced very rapidly transient calcium mobilization in RCC cells comparable to that observed with thrombin. RCC cells stimulated with thrombin after rMT challenge were unable to elicit a new calcium response and vice versa. Therefore, rMT and thrombin seem to activate calcium signaling in primary RCC cultures by similar mechanisms including PAR-1- and PAR-3-type thrombin receptors as shown by using PAR-type specific antibodies. Our results demonstrate rMT as a potent activator of human RCC cells suggesting a function of not only thrombin but also of this catalytically active thrombin precursor enzyme in human renal cell carcinoma.
Calcium↗
Implications of laparoscopic cholecystectomy for surgical residency training.
BACKGROUND: Widespread adoption of minimal access techniques forced a generation of abdominal surgeons to re-learn many standard abdominal procedures. This threatened to reduce the pool of suitable "training" operations for surgical residents. METHODS: Operator grade, duration of operation, acute/elective operation, conversion rate, complications, and postoperative stay were recorded prospectively on all laparoscopic cholecystectomies (LC) since 1992. This data was evaluated to determine how the introduction of LC affected residents' training. RESULTS: The percentage of LCs performed by residents increased progressively to reach 58%. Operating time was longer for trainee surgeons, particularly for acute cases (145+/-50 minutes vs 111+/-54 minutes, p<0.05); however, conversion rate, incidence of complications, and postoperative stay were no different. CONCLUSIONS: LC can be performed by surgical trainees with similar complication rates and outcomes as those of qualified surgeons. Once institutional experience has accumulated, this procedure can be integrated into residency training.
Adolescent↗
Presarcomatous lesions of experimentally induced sarcomas in rats: morphologic, histochemical, and immunohistochemical features.
Morphological studies have been performed mainly on manifest sarcomas, leading to divergent views of its histogenesis. However, histogenesis requires understanding of the tumor precursor cells and cannot be resolved by static morphologic studies. Defining presarcomatous lesions is made more difficult because they do not possess a basement membrane that serves as biologic and nosologic boundary like in epithelial cancers. The present study, therefore, investigated the early phases of experimentally induced rat sarcoma, which closely resembles human malignant fibrous histiocytoma (MFH). Histological, enzyme- and immunohistochemical methods were used to define the sequential events involved in tumorigenesis. A benzo[a]pyrene-oil mixture was injected intramuscularly into the thighs of rats, producing MFH 120 days later. Groups of animals were sacrificed every 10 days. The injections produced soft tissue lesions characterized by three distinct phases that overlapped or existed simultaneously in one animal: an initial acute inflammatory reaction characterized by an infiltration of lymphocytes, monocytes and macrophages, a second mesenchymal fibromatous phase characterized by the predominance of spindle-shaped, focally atypical fibroblast-like cells and collagen, and a third premalignant neovascularization phase characterized by dominant capillary proliferations. Overt MFH developed 120 days after injection and consisted of spindle-shaped fibroblast- and histiocyte-like cells containing atypical mitoses and arranged in a storiform pattern. Control animals injected with olive oil revealed acute inflammatory reactions after 30 days and no signs of chronic inflammation or malignancy after 60 and 120 days. We concluded that these experimentally-induced rat sarcomas develop in a triphasic pattern that resembles non-healing granulation tissue, with neovascularization preceding the occurrence of overt MFH.
Animals↗
Detection of tumor cells in peritoneal lavages from patients with gastrointestinal cancer by multiplex reverse transcriptase PCR.
BACKGROUND/AIMS: Cytological examination of peritoneal lavages is a useful predictor of peritoneal recurrence in gastrointestinal carcinoma patients. Nevertheless, it may be inadequate for those patients with lavages containing only few cancer cells. In the present study, sensitive detection of free cancer cells could be achieved through amplification of cytokeratin 19, carcinoembryonic antigen, alpha-fetoprotein mRNAs by means of multiplex reverse transcriptase polymerase chain reaction and nested polymerase chain reaction. METHODOLOGY: The multiplex reverse transcriptase polymerase chain reaction assay was used to examine lavage samples from 64 patients with various gastrointestinal malignant lesions (colorectal n = 27; duodenal carcinoma n = 1; gastric n = 7; pancreatic n = 4; hepatocellular carcinoma n = 2; gallbladder n = 1; cholangiocellular carcinoma n = 2 and 20 colorectal liver metastases. Specificity was assessed by examination of 15 donors without malignancies. In addition, nested polymerase chain reaction was used to improve the sensitivity of the assay for the detection of alpha-fetoprotein transcripts. RESULTS: Peritoneal lavages from 12 of 64 gastrointestinal carcinoma patients were positive for carcinoembryonic antigen mRNA. Carcinoembryonic antigen proved a specific marker, as no false-positives were detected in any patients without gastrointestinal cancer. alpha-fetoprotein mRNA was detected exclusively in peritoneal lavages from tumor patients, i.e., in 16 of 27 colon cancer patients, 14 of 20 patients with colorectal liver metastasis, 2 of 7 patients with gastric cancer, two patients with hepatocellular carcinoma and 2 of 4 patients with pancreatic cancer. Cytokeratin 19 mRNA was not found a useful marker, since control patients without malignancies were also positive. CONCLUSIONS: Our data suggest that carcinoembryonic antigen- and alpha-fetoprotein mRNA in peritoneal lavage are potentially useful specific markers for early diagnosis of metastasis of gastrointestinal cancer. It has been shown that alpha-fetoprotein-specific nested reverse transcriptase polymerase chain reaction can detect not only hepatocellular carcinoma cells, but also malignant cells from other gastrointestinal carcinomas. In contrast, cytokeratin 19 mRNA lacks specificity for gastrointestinal cancer.
Biomarkers, Tumor↗
Differentiation of positive autofluorescence bronchoscopy findings by comparative genomic hybridization.
Up to 50% of the results of autofluorescence bronchoscopy (AF) of histologically benign lesions are false-positive. For better differentiation of such lesions we have used comparative genomic hybridization (CGH). We studied biopsy material from 47 patients by CGH. For a comparison of findings, the patients were grouped as follows: Group 1, patients with manifest malignant lesions (n=10); group 2, patients with positive autofluorescence and negative (benign) histology (n=16); group 3, patients with negative autofluorescence and negative histology, who belong to a typical high-risk group for lung cancer (n=21). The biopsy specimens of 21/47 patients (45%) showed chromosome aberrations. In 8/10 cases (80%) in group 1, one or several chromosome lesions were detected. Chromosome aberrations were found in 13/16 specimens (81%) taken in group 2. None of the 21 biopsy specimens from the patients of group 3 showed any chromosome lesions. The chromosome aberrations detected in groups 1 and 2 show nearly identical distribution patterns. Lesions of chromosome 3 are the most frequent ones in both groups. The results of the CGH investigation show that regions of the bronchial mucosa with positive AF finding and benign histology frequently are seriously damaged and may develop into potentially malignant lesions.
Biopsy↗
Effects of jejunoileal bypass on oxalate and mineral metabolism in rats.
OBJECTIVE: To reassess the effects of jejunoileal bypass on the gastrointestinal absorption and bone metabolism of certain minerals in rats, and to see if jejunoileal bypass in rats was a suitable model in which to study formation of calcium oxalate renal stones. DESIGN: Controlled study. SETTING: Division of Experimental Surgery, University of Erlangen, Germany. MATERIAL: 43 male Sprague-Dawley rats. INTERVENTION: 23 rate underwent jejunoileal bypass, and 20 laparotomy, with transsection and anastomosis of the jejunum and ileotomy and suture (sham operation). RESULTS: Rats that had undergone jejunoileal bypass ate less and gained less weight than those that had had sham operations. Absorption of calcium and phosphorus from the intestine was impaired, but that of magnesium was unchanged. Absorption of oxalate from the small intestine was unchanged, but that from the colon was increased. There were no signs of hyperoxaluria or urolithiasis. Serum mineral homeostasis was not affected by jejunoileal bypass nor were bone volume, density, or mineral concentrations. Serum concentrations of parathyroid hormone and 1,25-dihydroxycholecalciferol remained low, suggesting that jejunoileal bypass might have induced some calcium flux towards the vascular space. CONCLUSIONS: Jejunoileal bypass halts weight increase in rats; the model may be helpful in elucidating associations between enteric factors and calciotropic hormones, and several metabolic features that are altered by jejunoileal bypass in man are not altered in rats.
Animals↗