Eur Surg Res

Differential device performances for hepatic arterial chemotherapy: a technical report on totally implantable pumps and ports for both continuous and bolus infusion.

Year 1998
Civalleri D. DeCian F. Pellicci R. Balletto N. Simoni G. Cosimelli M. Mondini G. Bignami P. Cagol PP.
Registro Nazionale dei Sistemi Impiantabili: Clinica Chirurgica I, Universita di Genova, Italia. civa@unige.it
Performances of totally implantable infusion systems were analyzed in patients with colorectal liver metastases undergoing intra-arterial treatment. It consisted of 14-day continuous infusion of 5-fluor-2'deoxyuridine with pumps (pump14, 44 patients) or ports fed by external pumps (port14, 34 patients), or bolus infusion of cisplatin (port21, 57 patients) or epirubicin (port7, 22 patients) every 3rd week and weekly, respectively. Toxicity and disease progression were the most common causes of treatment interruption. System failure occurred in 2 pump14, 9 port14, 6 port21 and 2 port7 cases. Pocket problems were most frequent in the pump14 group (30%), whereas catheter- and infusion-related problems were mostly observed in the port14 group (109%). The devices were still functional after 12 months in 92% of pump14, 24% of port14, 65% of port21 and in 78% of port7 patients. Although implantable ports allow adequate infusion periods, in most cases they appear especially suitable for bolus infusions.

Collagen secretion by human gastric and skin fibroblasts: implications for ulcer healing.

Year 1998
Lanas A. Garcia-Gonzalez A. Esteva F. Piazuelo E. Jimenez P. Morandeira JR.
Unidad Mixta de Investigacion, Hospital Clinico Universitario, Universidad de Zaragoza, Espana. alanas@posta.unizar.es
Fibroblasts (FIB) play an important role in the wound-healing process. It is not known whether human skin and gastric FIB show different responses to regulatory compounds. In this study, we have examined the collagen production by these FIB after different stimuli. In vitro release of collagen into the medium by steady-state confluent human FIB cultures was assessed over a 24-hour period by 3H-proline incorporation into collageneous protein. Serum and epidermal growth factor increased collagen secretion in both types of FIB, but gastric FIB produced less collagen than skin FIB. Prostaglandin E1 inhibited collagen production in both types of FIB, but nonsteroidal anti-inflammatory drugs and interleukin-1beta, a cytokine involved in the wound-healing process, had opposite effects on gastric and skin FIB. The effects of lipoxygenase metabolites on collagen secretion was small, but different in both types of FIB. We conclude that, when compared to skin FIB, human gastric FIB produce less collagen and show pronounced different responses to different agents, which might be relevant to explain (in part) their clinical effects on ulcer healing. These data provide new insights into the wound-healing process.

Autoantibodies against cardiolipin in the serum of patients with colorectal adenocarcinoma: their prognostic significance.

Year 1998
Syrigos KN. Charalampopoulos A. Konstantoulakis MM. Karayiannakis A. Tsibloulis V. Peveretos P.
First Department of Propaedeutic Surgery, Athens Medical School, Hippokration Hospital, Greece.
Using an ELISA method, the sera of 43 patients with colon adenocarcinoma (CA) and of 26 surgical patients with nonmalignant disease of the gastrointestinal tract were studied for the presence of autoantibodies against cardiolipin (CLP) before and 1 month after surgery. Forty healthy volunteers were used as controls. Fourteen CA patients were found to be positive for anti-CLP autoantibodies before surgical treatment, and 15 patients were found to be positive 1 month after surgery. The difference between the group of CA patients and either the group of patients with nonmalignant diseases of the GI tract, or the group of healthy individuals was statistically significant (p = 0.003). The group of CA patients with high anti-CLP serum titer had a better outcome compared with the group of patients without detectable autoantibody titer (p = 0.08), estimated based on the frequency of recurrences, during the follow-up period. Further studies are in progress to evaluate the significance of anti-CLP antibodies as a biological marker of prognosis in CA patients.

Relationship of p53 and vascular endothelial growth factor expression of clinicopathological factors in human scirrhous gastric cancer.

Year 1998
Baba M. Konno H. Maruo Y. Tanaka T. Kanai T. Matsumoto K. Matsuura M. Nishino N. Maruyama K. Nakamura S. Baba S.
Second Department of Surgery, Hamamatsu University School of Medicine, Japan.
Although scrirrhous cancer has the highest malignant potential among various types of gastric cancer, its pathogenesis is still unclear. The relationship between expression of p53 or vascular endothelial growth factor (VEGF) and clinicopathological variables was investigated by immunohistochemical analysis of archival specimens from 40 patients with scirrhous gastric cancer. Staining for p53 and VEGF was observed in the nuclei and cytoplasm of the tumor cells, respectively. There was no significant association between expression of p53 or VEGF and sex, age, depth of invasion, lymph node metastasis or histological stage. Peritoneal dissemination was the most frequent mode of recurrence, and the depth of tumor invasion was a crucial factor. The recurrence rate was 83.9% (2/9) in patients without serosal invasion. Only 7 out of 40 patients (17.5%) survived without recurrence. Among them, the VEGF-positive rate was 14.3% (1/7), whereas it was 52.6% (10/19) in the patients with recurrence. There was no correlation between p53 and VEGF staining. These findings suggest that the progression of scirrhous gastric cancer may be promoted by VEGF overexpression, which is not upregulated by p53 mutation.