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Biomedical subjects

John L Bell

Publications and source records attributed to John L Bell.

4 recordsLinked to original sources

Surgical resection for gastric cancer in elderly patients: is there a difference in outcome?

BACKGROUND: Early and long-term outcome of gastrectomy for gastric cancer in elderly adults has been a subject of controversy and debate. MATERIALS AND METHODS: Clinical information was reviewed for patients undergoing gastrectomy for gastric cancer during an 11-year period (1990-2000) at the University of Tennessee Medical Center at Knoxville. Patient demographics, tumor characteristics, operative mortality and morbidity, survival, and length of hospitalization were reviewed. RESULTS: Of 48 patients who underwent gastric resection for gastric adenocarcinoma, 24 were older than 70 and 24 younger than 70. There were no differences between the two groups regarding tumor characteristics, including location, tumor size, grade, gross pathology, lymph node involvement, lymphovascular invasion, and stage. In the elderly group, 75% underwent subtotal gastrectomy and 25% had total gastrectomy with or without resection of adjacent organs. In the younger patients, these numbers were 66.6% and 33.3%, respectively, which was statistically insignificant (P = 0.5). Five-year survival was 16.6% among elderly patients compared to 20.8% in the younger patients (P = 0.45). Half of the elderly patients and 39% of young patients had other comorbidities (P = 0.45). Postoperative mortality and morbidity was 8.33% and 33.3% in elderly patients, compared to 4.2% and 33.3%, respectively, in the younger group. These results were statistically insignificant (P = 0.4). The median postoperative length of stay was 15 days (95 percent confidence interval, 11-19 days) in younger patients compared to 18 days (95 percent confidence interval, 13-22 days) in the elderly group (P = 0.3). CONCLUSION: This study suggests that gastrectomy can be carried out safely in elderly patients. The early and long-term outcomes in elderly patients (over age 70) are comparable to younger patients (under age 70). Age alone should not preclude gastric resection in elderly patients.

Adult↗

Solid-pseudopapillary tumor of the pancreas: two cases in male patients.

Solid-pseudopapillary tumor (SPT) of the pancreas is a rare lesion with low malignant potential occurring predominantly in young women. This is a report of two cases in young male patients. Clinical data were retrieved retrospectively from a prospective database of patients with pancreatic tumors. The two patients were caucasian males, ages 34 years (Pt1) and 41 years (Pt2) at the time of diagnosis. Pt1 presented with intermittent epigastric pain, nausea, and vomiting. Computed tomography (CT) scan showed a 9-cm mass involving the pancreatic head. He underwent pancreaticoduodenectomy, with en bloc segmental colectomy due to mesocolon involvement. Pt2 was asymptomatic, diagnosed with abdominal mass by screening ultrasound. He had an 11-cm tumor involving the pancreatic tail encasing the splenic vessels on CT. He underwent distal pancreatectomy with splenectomy en bloc. Pathology in both cases was reviewed by staff pathologists as well as outside consultants. SPT is a rare tumor of the pancreas that is diagnosed primarily in young women. The cases presented here demonstrate SPT of the pancreas in two men. In both cases, the clinical presentation was relatively unremarkable. Both have had benign late postoperative courses, consistent with the low malignant potential of this lesion.

Adult↗

In vitro inhibition of growth and induction of apoptosis in cancer cell lines by thymoquinone.

Thymoquinone (TQ) is likely responsible for the chemotherapeutic effects of N. sativa extract; however, the cellular mechanisms remain ill-defined. TQ-induced cytotoxicity was investigated using canine osteosarcoma (COS31), its cisplatin-resistant variant (COS31/rCDDP), human breast adenocarcinoma (MCF7), human ovarian adenocarcinoma (BG-1) and Madin-Darby canine (MDCK) cell lines. TQ-induced cytotoxicity was determined using a proliferation assay (MTT assay) and apoptosis assays. Effects of TQ on the cell cycle were determined using flow cytometry. COS31/rCDDP resistant cells were the most sensitive cell line to TQ and MDCK cells were the least sensitive. TQ (25 micro M) induced apoptosis of COS31 cells 6 h after treatment and decreased the number of COS31 cells in S-phase and increased cells in G1-phase, indicating cell cycle arrest at G1. These results suggest that TQ kills cancer cells by a process that involves apoptosis and cell cycle arrest. Non-cancerous cells are relatively resistant to TQ.

Antineoplastic Agents↗