摘要:

AbstractThe records of 72 consecutive patients with unresectable pancreatic cancer treated between 1974 and 1986 were evaluated to determine whether gastroenterostomy should be performed on a routine basis at initial intervention or on a therapeutic basis. Fourteen patients underwent an explorative laparotomy, 41 patients underwent biliary bypass, and 17 patients required biliary bypass and therapeutic gastroenterostomy at initial laparotomy. The mortality and morbidity rates in this last group were 18 and 59%, respectively. The most common complication was delayed gastric emptying (29%). Of the 37% of patients who required gastroenterostomy after initial biliary bypass, the mortality rate was 50% and delayed gastric emptying occurred in 57%. The mean survival after biliary bypass was 9.4 months while survival after therapeutic gastroenterostomy averaged 4.2 months. These findings suggest that gastroenterostomy should be performed on a prophylactic basis at initial intervention, unless a limited survival is expected.

ISSN:0022-4790    

DOI:10.1002/jso.2930420303

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractOrnithine decarboxylase (ODC) catalyzes the formation of putrescine from ornithine, which is the first step in the pathway of mammalian polyamine biosynthesis. Tissue activity levels of ODC have been suggested to be a marker of risk for colorectal cancer in hereditary polyposis and in adenoma formers. We analyzed ODC activity in rectal and sigmoid colon mucosal biopsies obtained at 10 cm and at 30 cm in 40 healthy, colon cancer risk factor‐free adults following three endoscopic preparation regimens: (1) no special preparation; (2) two phosphate enemas; and (3) “Colyte” lavage preparation 12 hr previously. Levels of ODC, measured in fresh tissue, were approximately twofold higher for enema preparation vs. no preparation (for log‐transformed data: sigmoid,P<0.0001; rectum,P= 0.0001) and for enema preparation vs. lavage (sigmoid,P= 0.0002; rectum,P= 0.008). Lavage and no preparation ODC levels were not significantly different. ODC activity levels ranged from 0.00 to 352.96 pmo

ISSN:0022-4790    

DOI:10.1002/jso.2930420304

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractTwenty‐five cases of granular cell lesions in the region of the head and neck are presented. The adult form (18 cases) was more frequent in women, and the most frequent sites were the tongue, the skin, and subcutaneous tissues, followed by the lip and buccal mucosa. One lesion occurred in the larynx. The congenital forms (7 cases) all occurred in female infants and involved the mucosa overlying either the anterior ridge of the maxilla or the mandible. Immunohistochemical studies revealed positive staining for S100 protein in all the granular cell tumors of the adult but in none of the congenital granular cell epulides. Embryonic antigen was present in the cells of all the congenital cases and in three‐quarters of the adult cases. The significance of the histological and immunohistochemical findings is discussed. We conclude that the congenital and adult lesions are similar morphologically but are not necessarily of similar histogenesis. The findings with respect to S100 protein favor a neural (Schwann cell) origin of the adult granular cell tumor, but not the congenital f

ISSN:0022-4790    

DOI:10.1002/jso.2930420305

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractA new method of anastomosis after resection of esophageal or cardiac carcinoma was carried out in 141 patients in Anyang Cancer Hospital from February 1983 to September 1985. After resection of the tumor, the proximal end of the esophagus was intussuscepted into the stomach lumen and extroversion sutures were applied on the esophageal mucosa to prevent bleeding and stenosis. In this series, the operative mortality was 0.7% (1/141) and no anastomotic leakage was found. We consider that this modified operative procedure is fairly easy, simple, and beneficial in reducing surgical complications.

ISSN:0022-4790    

DOI:10.1002/jso.2930420306

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractWe have operated upon six patients with cervical esophageal carcinoma and reconstructed these with free jejunal graft. The pathology of all six patients was squamous cell carcinoma, and no patient had apparent distant metastasis. The procedure was a two team approach. While the surgical oncology team resected the esophageal tumor, the microvascular team harvested the jejunal graft. The range of warm ischemia for the free jejunal graft was 1‐2.5 hr, and no graft was lost because of recirculation failure. The range of operative time was 5‐6.5 hr. There was no operative mortality. There were two minor cervical wound infections, both healed with conservative management. Hospital stay ranged from 10 to 15 days. The swallowing mechanism was satisfactory in all patients. We believe that the free jejunal graft is the procedure of choice for reconstruction of the cervical esopha

ISSN:0022-4790    

DOI:10.1002/jso.2930420307

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractSix thousand one hundred twenty‐three cases of carcinoma of the esophagus and gastric cardia were treated surgically from 1965 to 1985. Overall resectability was 89.9%. Postoperative mortality was 3%, and incidence of postoperative complication, 10.3%. Follow‐up rate was 91.3%, with 5 year survival of 36.8% (esophageal nearly twice that of gastric cardia), and 10 year survival of 17.2%. Factors affecting long‐term survival were clinicopathologic staging and preoperative irradiation. Early discovery and timely treatment are the key to high resectability and improved longterm survival. More efficacious combined therapies are needed for the predominant late cases. We propose more radical resection because of the multifocal tendency of esophageal and extensive submucosal infiltration of cardia carcinoma. Continuing refinements of surgical technique helped to reduce postoperative leakage and stru

ISSN:0022-4790    

DOI:10.1002/jso.2930420308

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractCytokeratins are intermediate filaments found within basal and secretory epithelial cells. Antisera raised against cytokeratins are available but frequently differ in specificity. Many are incompletely characterized for their reactivity against epithelial components. Cytokeratin (Cyto) P is a polyclonal antisera specific for 56 and 64 kd cytokeratins. Cyto M is a pool of monoclonals reacting against 40, 46, 50, 52, 58, and 65‐67 kd cytokeratins. Initially, utilizing immunohistologic techniques, we evaluated these two antisera for their ability to distinguish between prostatic tissues of benign (benign prostatic hypertrophy [BPH]) or malignant (carcinoma of the prostate [CAP]) origin in the 34 cases evaluated. Specimens were analyzed for both Cyto P and Cyto M reactivity, as well as for the degree of reactivity. Lastly, in an effort to determine the morphologic relationship of atypical hyperplasia (AH) with either BPH or CAP, nine additional prostate specimens were analyzed. Cyto P was reactive in 8 of 8 (100%) BPH specimens and in 2 of 26 (8%) CAP specimens. Mean Cyto P degree of reactivity in the positive specimens was greater in BPH than in CAP (2.6 vs. 1.0). Cyto M reactivity was present in 8 of 8 (100%) BPH specimens and in 23 of 25 (92%) CAP specimens. Mean Cyto M degree of reactivity in the positive specimens was greater in CAP than in BPH (3.6 vs. 2.8). Cyto P was reactive in 3 of 9 (33%) AH specimens, with a mean degree of reactivity of 2.7. Cyto M was reactive in 9 of 9 (100%) AH specimens, with a mean degree of reactivity of 3.9. Cyto P reacted with only the basal cells, whereas Cyto M reacted with basal as well as secretory cells. These differences appeared to be the result of the differential reactivity of basal cells, which are present in BPH but absent in CAP. In summary, Cyto P and Cyto M are potentially useful markers in differentiating BPH from CAP, and it appears that AH is immunohistopathologically related to bot

ISSN:0022-4790    

DOI:10.1002/jso.2930420309

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractFrom 1976 to 1984, 30 cases of asymptomatic primary liver cancer (subclinical primary liver cancer) have been treated in our hospital. The most important approaches used to uncover subclinical primary liver cancer were (1) the use of alpha‐fetoprotein (AFP) monitoring in patients with liver disease; (2) the use of an AFP survey among high‐risk area populations; and (3) X‐ray examination of the diaphragm and sonography examination.The resectability rate of this series was 50%. The 3 and 5 year survival rates after hepatectomy were 62.5 and 57.1%, respectively. Hepatic arterial ligation combined with irradiation for the nonresectable cases had a better result.We discuss here the approaches and the diagnostic criteria of subclinical primary liver c

ISSN:0022-4790    

DOI:10.1002/jso.2930420310

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractTo compare the activity of pyrimidine nucleoside phosphorylase (PNP), an enzyme involved in the metabolism of 5‐fluorouracil (5‐FU), we used uridine (Urd), deoxyuridine (dUrd), and thymidine (dThd) as substrates and human, rat, and mouse neoplastic and normal tissues. As PNP activity was higher in the tumor tissues than in the normal ones in all species examined, the level of PNP activity is expected to be one critical factor linked to the effectiveness of 5‐FU. In rats and mice, the ratio of the activities of Urd, dUrd, and dThd was about 10:7:1, whereas in humans, the ratio was 1:30:20. The main enzyme of PNP is Urd phosphorylase in rodents and dThd phosphorylase in humans. Therefore, when examining the metabolism of 5‐FU and its analogues for potential clinical application, human tissues should

ISSN:0022-4790    

DOI:10.1002/jso.2930420311

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractIntratumoral injection of I‐125 iododeoxyuridine (IUdR), saline solution, and oil suspension was investigated using Ehrlich ascites tumors in the thighs of mice. The oil suspension was more effective in tumor growth delay than was the saline solution. Single injection of the oil suspension at the dose of 12.5 μCi resulted in 21.5 days growth delay, whereas 50 μCi of the saline solution resulted in 11.5 days growth delay relative to control growth delay.At 40 days after treatment, higher radioactivities were observed in the tumor and the skin of the mice treated with the oil suspension, which represented the prolongation of I‐125 IUdR oil suspension within the tumor. No normal tissue toxicities were obs

ISSN:0022-4790    

DOI:10.1002/jso.2930420312

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY