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Biomedical subjects

D Ilstrup

Publications and source records attributed to D Ilstrup.

At least 19 recordsLinked to original sources
PubMed1998

Urinary retention after operations for benign anorectal diseases.

PURPOSE: This study was undertaken to determine the incidence and risk factors for urinary retention after operations for benign anorectal diseases. METHODS: We reviewed 1,026 consecutive operations for benign anorectal diseases from 1989 to 1994. Risk factor analysis was done for patients undergoing hemorrhoidectomy (Group I) and other procedures (Group II) using logistic regression analysis. RESULTS: The number of procedures and urinary retention rate was as follows: 344 (34 percent) hemorrhoidectomies, 159 (2 percent) fistulotomies, 95 (5 percent) incision/drainage, 247 (4 percent) lateral internal sphincterotomy, 181 (17 percent) combinations of the above four procedures, and overall 1,026 (16 percent). In Group I, four-quadrant excision (odds ratio, 3.3; P = 0.0004), three quadrant excision (odds ratio, 2.4; P = 0.003), morphine equivalents >33 (odds ratio, 1.8; P = 0.01), and male gender (odds ratio, 1.7; P = 0.02) were independent risk factors. In Group II, more than one operation (odds ratio, 3.0; P = 0.004), older age (odds ratio, 3.1; P = 0.005), intraoperative fluids (odds ratio, 2.6; P = 0.03), and postoperative fluids (odds ratio, 2.7; P = 0.02) were independent risk factors. Urinary obstructive symptoms for both groups and perioperative fluids for Group I were NOT independent risk factors. Hospital stay was prolonged significantly in patients with urinary retention (P = 0.0001). CONCLUSIONS: Urinary retention is a common postoperative complication that increases hospital stay. It is most common after hemorrhoidectomy. Disease severity (quadrants excised and analgesia requirement for Group I and number of operations for Group II) is an important risk factor for both groups studied. Older age in Group I and perioperative fluid in Group II may be important risk factors.

Abscess↗
PubMed1998

Ileal pouch-anal anastomosis in patients with colorectal cancer: long-term functional and oncologic outcomes.

UNLABELLED: When colorectal cancer complicates chronic ulcerative colitis or familial adenomatous polyposis, the role of ileal pouch-anal anastomosis is uncertain because of concerns that the procedure may compromise oncologic therapy and that oncologic therapy may compromise ileal pouch-anal anastomosis function. AIM: This study was undertaken to investigate the impact both of ileal pouch-anal anastomosis on cancer outcomes and of cancer treatments on ileal pouch-anal anastomosis function. PATIENTS AND METHODS: Of 1,616 patients undergoing ileal pouch-anal anastomosis for chronic ulcerative colitis or familial adenomatous polyposis (1981-1994), 77 patients were identified with adenocarcinoma of the colon (56), rectum (17), or both (4). Data were obtained from an ileal pouch-anal anastomosis registry, case notes, and postal and telephone surveys. RESULTS: Mean age of the 77 index patients was 37 (range, 13-60) years. Stage distribution was as follows: Stage 0, 9; Stage I, 31; Stage II, 15; Stage III, 22 patients. Twelve patients died with systemic disease (6 with a local component) after a mean follow-up of 6 (range, 2-15) years. Twenty-two patients received adjuvant therapy (chemotherapy, 16; radiotherapy, 2; both, 4 patients). Chemotherapy complications requiring dose reduction or interruption occurred in three (15 percent) patients. One patient developed radiation enteritis (17 percent). Pouch failure occurred in 16 percent of cancer patients, compared with 7 percent for the overall registry. There were no differences between cancer and non-cancer groups in operative complications, median stool frequency, incontinence, pad usage, or pouchitis. CONCLUSIONS: Although pouch failure is more common, ileal pouch-anal anastomosis can be performed in the setting of colorectal cancer without significant impact on oncologic outcome or long-term ileal pouch-anal anastomosis function.

Adenocarcinoma↗
PubMed1998

Effects of acetabular abduction on cup wear rates in total hip arthroplasty.

This study was designed to determine the effect of acetabular abduction on the polyethylene wear rates of the acetabular component. The hypothesis of this study is that acetabular placement, in particular abduction, effects contact forces and therefore polyethylene wear. A total of 364 total hip arthroplasties that were performed between 1974 and 1976 were included in this study. The cemented all-polyethylene acetabular components were the same for each case and came from a single supplier. The polyethylene wear rates were calculated by measuring the shortest radius from the center of the prosthetic femoral head to a point on the outer surface of the acetabular cup. An immediate postoperative radiograph was compared with a follow-up radiograph at least 9.5 years later. A standardized radiograph was used to prevent differences due to magnification. The abduction or inclination of the acetabular cups was measured in all of the patients. The amount of acetabular cup abduction was measured relative to the ischial tuberosity line. The mean abduction was 44.1 degrees with a standard deviation of 9.2 degrees and a median of 44 degrees. The range of abduction was from 0 degrees to 85 degrees. This analysis failed to show a correlation between the amount of acetabular abduction and polyethylene wear rates (Pearson's correlation coefficient = 0.0679; P = .20). With a sample size of 364, there is over a 95% change (statistical power) of detecting an underlying true correlation between wear and abduction that is greater than or equal to 0.20. We were unable to demonstrate a difference in wear that would correlate with the differing degrees of abduction of the acetabular socket. We felt that the radiographic measurements of wear were quite accurate. This method of determining acetabular abduction has also been documented and supported in previous literature and has allowed us to accurately determine acetabular abduction. The results of our study demonstrate that within the normal ranges described by our study, polyethylene wear did not significantly increase with increased abduction of the acetabular component.

Acetabulum↗
PubMed1998

Surgical treatment of adenocarcinoma of the rectum.

OBJECTIVE: The authors' aim was to determine survival and recurrence rates in patients undergoing resection of rectal cancer achieved by abdominoperineal resection (APR), coloanal anastomosis (CAA), and anterior resection (AR) without adjuvant therapy. SUMMARY BACKGROUND DATA: The surgery of rectal cancer is controversial; so, too, is its adjuvant management. Questions such as preoperative versus postoperative radiation versus no radiation are key. An approach in which the entire mesorectum is excised has been proposed as yielding low recurrence rates. METHODS: Of 1423 patients with resected rectal cancers, 491 patients were excluded, leaving 932 with a primary adenocarcinoma of the rectum treated at Mayo. Eighty-six percent were resected for cure. Surgery plus adjuvant treatment was performed in 418, surgery alone in 514. These 514 patients are the subject of this review. Among the 514 patients who underwent surgery alone, APR was performed in 169, CAA in 19, AR in 272, and other procedures in 54. Eighty-seven percent of patients were operated on with curative intent. The mean follow-up was 5.6 years; follow-up was complete in 92%. APR and CAA were performed excising the envelope of rectal mesentery posteriorly and the supporting tissues laterally from the sacral promontory to the pelvic floor. AR was performed using an appropriately wide rectal mesentery resection technique if the tumor was high; if the tumor was in the middle or low rectum, all mesentery was resected. The mean distal margin achieved by AR was 3 +/- 2 cm. RESULTS: Mortality was 2% (12 of 514). Anastomotic leaks after AR occurred in 5% (16 of 291) and overall transient urinary retention in 15%. Eleven percent of patients had a wound infection (abdominal and perineal wound, 30-day, purulence, or cellulitis). The local recurrence and 5-year disease-free survival rates were 7% and 78%, respectively, after AR; 6% and 83%, respectively, after CAA; and 4% and 80%, respectively, after APR. Patients with stage III disease, had a 60% disease-free survival rate. CONCLUSIONS: Complete resection of the envelope of supporting tissues about the rectum during APR, CAA, and AR when tumors were low in the rectum is associated with low mortality, low morbidity, low local recurrence, and good 5-year survival rates. Appropriate "tumor-specific" mesorectal excision during AR when the tumor is high in the rectum is likewise consistent with a low rate of local recurrence and good long-term survival. However, the overall failure rate of 40% in stage III disease (which is independent of surgical technique) means that surgical approaches alone are not sufficient to achieve better long-term survival rates.

Adenocarcinoma↗
PubMed1998

Metal-backed patellar component failure in total knee arthroplasty: a possible risk for late infection.

Between 1985 and 1987, 1837 primary total knee arthroplasty (TKA) prostheses were implanted in 1503 patients. Group I included 843 knee with metal-backed patellar components (MBPC), and group II included 994 knees with all polyethylene patellar components (APPC). Follow-up averaged 5.7 years (range, 2 to 11 years). Twenty-four MBPC (2.9%) and 16 APPC TKA cases (1.6%) developed deep infection. In the time interval between arthroplasty and 2-year follow-up, eight MBPC and 11 APPC knees developed deep periprosthetic infection. The difference in the cumulative probability of infection between the two groups during this time interval was not significant (relative risk, 0.9; 95% confidence interval [CI], 0.3-2.1; P = 0.73). However, after the 2-year follow-up, 16 MBPC and 5 APPC knees developed late infection, and the difference in the cumulative probability of infection between the MBPC and APPC knees during this time interval was significant (relative risk, 3.1; 95% CI, 1.1-8.5; P = 0.02). Although the mechanism for this increased risk of these late infections is not well understood, the attendant synovitis, effusion, and relative hyperemia of these knees in the presence of the particulate metal and polyethylene debris may increase the potential of bacterial seeding to these prostheses. Particulate metal debris has been previously shown to suppress bacterial phagocytosis and may play a role in the pathogenesis of these infections. We propose that the presence of metal-backed patellar failure represents a "prosthesis at risk" for the development of late prosthetic infection.

Adolescent↗
PubMed1997

The feasibility and validity of studies comparing orthopedists and non-orthopedists caring for musculoskeletal injuries: results of a pilot study.

OBJECTIVE: To review care provided by orthopedists and non-orthopedists for a variety of common acute injuries to the shoulder, knee, and ankle; and to evaluate the difficulties in assessing results from diagnostic data collected for administrative reporting by comparing these data with data collected by medical record abstraction for the same patients. METHODS: The Rochester Epidemiology Project database was used to identify new cases of Colles fracture, knee sprain, ankle sprain, and shoulder sprain/rotator cuff injury among Olmsted county residents > 18 years of age, who were evaluated between January 1, 1990 and December 31, 1992. Data were collected from an administrative database and medical records. RESULTS: Although the diagnoses recorded in the administrative database and those obtained from medical record review were the same in 94% of the 500 cases reviewed, only 270 (67.7%) actually represented acute injuries. Medical record review showed that (for the shoulder and ankle) injury severity was highly correlated with treatment specialty: 13 of 15 severe injuries were cared for by orthopedists, while 64 of 68 mild injuries were treated by non-orthopedists. Diagnostic uncertainty was more common among non-orthopedists; in 21 of the 149 patients treated by non-orthopedists (15.1%), the final (i.e., recorded for coding) diagnosis was different from the initial diagnosis. In 14 of these cases, an orthopedist made the final diagnosis. None of the diagnoses made by orthopedists were revised. CONCLUSION: Current diagnostic coding does not capture injury acuity, severity, or diagnostic uncertainty. Studies that limit themselves to such data for diagnostic information are likely to suffer from biases which can skew results in unpredictable ways. Conclusions drawn from such studies are likely to be flawed.

Adolescent↗
PubMed1996

Aortic valve replacement in patients aged eighty years and older: early and long-term results.

UNLABELLED: We have studied 322 patients, 80 years of age or older, who underwent aortic valve replacement between June 1971 and December 1992. Two hundred six patients (64%) have had surgery since the end of 1985. Their mean age was 82.7 years (range 80 to 92 years). One hundred seventy-one (53%) were male and most (86%) were in New York Heart Association class III-IV. Fifty-seven patients (18%) required admission to the coronary care unit before the operation. One hundred seventy-nine patients (56%) underwent an urgent or emergency operation. Known cerebrovascular disease was present in 77 (24% of patients), aortic stenosis in 79%, aortic incompetence in 9%, and combined stenosis and incompetence in 12%. Associated procedures included bypass grafting in 139 (43%), mitral valve replacement/repair in 20 (6%), tricuspid valve repair in 6 (2%), and aortic annular enlargement in 38 (12%). Thirty patients (9.3%) were undergoing reoperation. Hospital mortality was 44 of 322 (13.7%). The median hospital stay was 11 days. On univariate analysis, significant predictors of hospital mortality were female sex, preoperative rest pain, New York Heart Association class III-IV, admission to the coronary care unit, heart failure, mitral valve disease, emergency/urgent operation, chronic obstructive pulmonary disease, bypass grafting, valve size, peripheral vascular disease, and ejection fraction less than 0.35. On multivariate analysis the most important independent predictors of operative mortality were female gender (p = 0.0001), renal impairment (p = 0.001), bypass grafting (p = 0.005), ejection fraction less than 0.35 (p = 0.01), and chronic obstructive pulmonary disease (p = 0.028). Age and year of operation did not influence mortality. Five-year survivals for all patients and for operative survivors were 60.2% +/- 3.2% and 70.3% +/- 3.4%, respectively. On univariate analysis, factors that adversely affected long-term survival were coronary bypass grafting (p = 0.007), more than two comorbidities (p = 0.02), male gender (p = 0.04), and ejection fraction less than 0.35 (p = 0.04). On multivariate analysis, no factor was consistently significant for long-term survival. At most recent clinical follow-up 85% were angina free and 82% were in class I-II. At least 92% of patients, both at 1 year and at most recent clinical follow-up, believed they had significantly benefited from the operation: CONCLUSION: Risk factors for aortic valve replacement in octogenarians include female gender, unstable symptoms, poor ejection fraction, renal impairment, and bypass grafting. However, despite a hospital mortality higher than that reported for younger patients, the outlook for operative survivors is excellent, with good relief of symptoms and an expected survival normal for this particular age group. If possible, aortic valve replacement should be done before development of unstable symptoms.

Age Factors↗
PubMed1996

Pouchitis after ileal pouch-anal anastomosis for ulcerative colitis occurs with increased frequency in patients with associated primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC), present in 5% of patients with ulcerative colitis, may be associated with pouchitis after ileal pouch-anal anastomosis. The cumulative frequency of pouchitis in patients with and without PSC who underwent ileal pouch-anal anastomosis for ulcerative colitis was determined. A total of 1097 patients who had an ileal pouch-anal anastomosis for ulcerative colitis, 54 with associated PSC, were studied. Pouchitis was defined by clinical criteria in all patients and by clinical, endoscopic, and histological criteria in 83% of PSC patients and 85% of their matched controls. PSC was defined by clinical, radiological, and pathological findings. One or more episodes of pouchitis occurred in 32% of patients without PSC and 63% of patients with PSC. The cumulative risk of pouchitis at one, two, five, and 10 years after ileal pouch-anal anastomosis was 15.5%, 22.5%, 36%, and 45.5% for the patients without PSC and 22%, 43%, 61%, and 79% for the patients with PSC. In the PSC group, the risk of pouchitis was not related to the severity of liver disease. In conclusion, the strong correlation between PSC and pouchitis suggest a common link in their pathogenesis.

Adolescent↗
PubMed1996

Metachronous colon cancer in persons who have had a large adenomatous polyp.

OBJECTIVE: To determine, among persons who have had a large colon polyp, the risk of subsequent colon cancer at a site distant from that polyp. METHODS: Follow-up was done for 226 persons at the Mayo Clinic who had had a > or = 1-cm polyp demonstrated on barium enema between 1965 and 1970 and for whom yearly colon surveillance examination was recommended. Information was collected from Mayo Clinic records and from contact with patients, physicians, and other hospitals regarding the results of surveillance examinations and the development of colon cancer. Colon surveillance was routinely done at the Mayo Clinic using the technique of single contrast barium enema with vigorous manual fluoroscopic examination and proctoscopy. The expected rate of colorectal cancer (CRC) was calculated based on previously published rates for this community. RESULTS: Patients received, on average, four colon examinations in addition to the examination that discovered the index polyp. During 2126 person-years of follow-up, 16 persons developed a colon cancer at a location other than the site of the index polyp, in comparison with 4.0 expected cases, for a standardized incidence ratio of 4.0 (95% CI,2.3, 6.4). The cancers were large (mean 4.5cm) at presentation, and eight of the 16 cancers had been preceded within 3 yr by at least one negative barium enema. CONCLUSIONS: The rate to develop colon cancer in persons who have had a large colon polyp es about 4 times the expected rate, suggesting that such persons should be considered for aggressive colonoscopic surveillance. The failure to detect early cancer or its precursors by surveillance barium enema is probably explained by inherent insensitivity of single contrast barium enema.

Adenomatous Polyps↗
PubMed1995

Survivorship of uncemented proximally porous-coated femoral components.

Three hundred seventy-five consecutive total hip arthroplasty revisions done using proximally porous-coated femoral components of 6 designs were reviewed a mean of 4.7 years after surgery. Fifty-nine hips have been rerevised for aseptic femoral loosening, and 4 for osteolysis. Moderate or severe pain was present in 23% of surviving hips, and radiographic evidence of femoral loosening was present in 38% of surviving hips at the most recent followup. At 8 years, survivorship free of revision for aseptic femoral failure (for loosening or osteolysis) was 58% (95% confidence intervals, 44.3%, 69.6%); survivorship free of aseptic femoral loosening (revision for aseptic loosening or radiographic loosening) was 20% (95% confidence intervals, 12%, 27%); and survivorship free of symptomatic femoral loosening (revision for aseptic loosening or radiographic femoral loosening with moderate or severe pain) was 45% (95% confidence intervals, 32.3%, 56%). More severe preoperative bone loss correlated with poorer survivorship free of aseptic loosening and subsidence of > or = 5 mm. Differences among the prosthetic-type groups with respect to patient's age, gender, and bone loss severity precluded direct comparison of performance for each prosthetic type; however, all the prostheses had a significant rate of rerevision and aseptic loosening. Stable long-term fixation with the proximally porous-coated femoral components used in this series was not achieved on a predictable and reproducible basis. The damaged, weakened bone often present in the proximal femur during revision probably does not provide an optimal environment for sturdy initial or long-term biologic fixation of these devices that rely on the proximal femoral bone for fixation.

Adult↗
PubMed1994

Charnley low-friction arthroplasty of the hip. Twenty-year results with cement.

The first 333 Charnley (Thackray, United Kingdom) total hip arthroplasties performed at the Mayo Clinic between 1969 and 1970 have been followed since that time. One hundred twelve patients (112 hips) remain alive at 20 years. Clinical results remain excellent. The Mayo clinical and roentgenographic hip scoring system rates the results as good to excellent in 39 of 69 hips (with all necessary data to calculate the entire score), fair in 13 hips, and poor in 17 hips. The clinical score alone showed satisfactory results in 77 of 112 hips. Some clinical deterioration was attributed to the advancing age of the patients (mean age at final follow-up evaluation, 84 years). Probable roentgenographic loosening (component migration, complete bone-cement interface, radiolucent line greater than 1 mm, cement fracture) was noted in 12 of 69 acetabular components (17%) and 28 of 69 femoral components (36%). Two patients had required revision since the last report at 15 years for a total of 38 patients (32 revised, 4 Girdlestone arthroplasties, 2 stem fractures not yet revised). The probability of surviving 20 years without revision of the components was 84% (83% for men, 85% for women). The rates of loosening, revision, and failure (revision, Girdlestone, or symptomatic loosening) remain linear over 20 years of follow-up evaluation. If the probability of revision is based on patient age at the time of the initial total hip arthroplasty, there is a significantly increased probability of revision in those patients less than 59 years of age (27%) compared to those 59-65 years of age (13%), 65-70 years (7.5%), and over 70 years (12%).

Aged↗
PubMed1994

Risk factors in patients having surgery to create an arteriovenous fistula.

Patients requiring creation of an arteriovenous (AV) fistula for long-term dialysis access have a high incidence of cardiovascular risk factors, as well as immunosuppression, neuropathy, and platelet dysfunction related to renal failure. However, the morbidity and mortality of AV fistula creation, and the effect of anesthetic technique on outcome, have not been reported. We therefore retrospectively studied all patients (n = 469) having an AV fistula placed at the Mayo Clinic between 1986 and 1991. Preoperative variables studied were age (mean 63 +/- 14 yr), sex (60% male), diabetes mellitus (26% incidence), hypertension (92%), the presence of a previous AV fistula (31%), coronary artery disease (86%), and previous myocardial infarction (MI) (42%). Outcome variables studied were fistula failure prior to first attempted dialysis (8.7% incidence), infection (3.4%), neuropathy (1.9%), seizure (0.2%), nonfatal cardiac event (MI or arrest) (1.5%), and fatal cardiac event (2.1%). Associations of preoperative factors, outcomes, and anesthetic technique were analyzed by analysis of variance and Wilcoxon rank sum analysis for age, and by exact conditional frequency table analysis for all other factors. A previous AV fistula was associated with infection (P < 0.002) and nonfatal cardiac events (P < 0.003). Increased age (P < 0.025) and previous MI (P < 0.01) were associated with adverse cardiac outcomes. Neither local anesthesia, brachial plexus block, nor general anesthesia were significantly associated with an increased frequency of any adverse outcome. The comparison of general with local and brachial plexus anesthetics was limited by low statistical power.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Sinistral portal hypertension. Splenectomy or expectant management.

Splenectomy has been considered the treatment of choice for patients with bleeding from sinistral portal hypertension (SPH) and varices, but is controversial for asymptomatic patients. To further define the role of splenectomy for SPH, the authors compared the clinical presentations and outcomes of 25 patients treated with splenectomy with those of 12 observed patients. Clinical features were similar except for transfusions administered (60% vs. 25%, p < 0.05), hemoglobin (9.8 +/- 2.2 g/dL vs. 12.5 +/- 2.1 g/dL, p < 0.05), and history of prior bleeding episodes (56% vs. 8%, p < 0.05), splenectomy versus no splenectomy, respectively. At 3 years, neither survival (78% vs. 64%, p = 1.0) nor new or recurrent bleeding (16% vs. 24%, p = 0.2) differed, splenectomy versus no splenectomy, respectively. The authors conclude that in the absence of prior bleeding episodes, anemia, or severe hemorrhage, observation of patients with SPH is justified.

Esophageal and Gastric Varices↗
PubMed1993

[Colorectal cancers associated with ulcero-hemorrhagic rectocolitis. Detection of and prognosis for postoperative patients].

Between January 1976 and December 1986, 86 patients underwent surgery for colorectal adenocarcinoma (AC) complicating ulcerative colitis (UC) at Mayo Medical Center in Rochester, Minnesota. Seventy-two percent were men, contrasting with only 55% in the population operated for UC without AC during the same time period at the same institution (p = 0.001). The mean duration of UC symptoms was 19.2 years. The diagnosis of cancer was established preoperatively in 65% of patients, while the remainder of patients, except for three (n = 30, 35%) were at high risk for cancer. A colonoscopy performed in 16 of those 30 patients less than six months prior to the operation did not detect cancer. Overall, cancer was either proven or highly suspected preoperatively in 96.5% of patients, while the sensitivity of colonoscopy was 78%. During the study period, histological tumor features, such as number of tumors, Dukes' stage, Broder's stage, and curative/palliative ratio, remained unchanged, and the five-actuarial survival of 50% did not improve with time (p = 0.37). Multivariant analysis indicated that Dukes' stage and male gender were two poor prognosis factors. For patients with long-standing UC, we offer either proctocolectomy, possibly with ileal pouch-anal anastomosis, or surveillance colonoscopy, emphasizing their respective hazards and limitations.

Adenocarcinoma↗
PubMed1992

Complications following pancreaticoduodenectomy. Current management.

From 1980 to 1989, 279 patients underwent pancreaticoduodenectomy at a single institution with a postoperative mortality of 4%. The aim of this study was to determine incidence, origin, and present management strategy of early complications following this operation. Significant morbidity occurred in 46% of the patients, including delayed gastric emptying (23%), pancreaticojejunal anastomotic leak (17%), intra-abdominal sepsis (10%), biliary-enteric anastomotic leak (9%), gastrointestinal tract bleeding (5%), and intra-abdominal hemorrhage (3%). Complications were associated with advanced age, prolonged operations, and increased operative blood loss. Most complications were managed nonoperatively. Mortality was increased when a reoperation was required, a biliary-enteric leak occurred, or an intra-abdominal abscess developed. Pancreaticoduodenectomy continues to carry a high postoperative morbidity; however, operative mortality is low, and management of complications has been made simpler with more sophisticated, nonoperative therapeutic options.

Abscess↗
PubMed1992

Heteroconjugated antibodies enhance lymphocyte-mediated tumour cell lysis in vitro and in vivo.

Covalent linkage of an antitumour antibody specific for a tumour cell surface antigen to an antilymphocyte antibody specific for the T lymphocyte receptor complex produces a heteroconjugated antibody that can activate and redirect cytotoxic T lymphocytes to lyse tumour cells. The ability of an antilymphocyte-antitumour heteroconjugate (500A2 x 96.5) to direct the lysis of murine melanoma cells by cultured murine lymphocytes was tested in vitro using a 4-h chromium release assay and in vivo with a tumour neutralization assay. In vitro, the addition of heteroconjugated antibody significantly increased tumour lysis by murine C3H/HeN lymphocytes (median specific lysis 82.7 per cent with lymphocytes plus heteroconjugate versus 9.5 per cent for lymphocytes alone, P less than 0.001). In vivo, treatment with heteroconjugated antibody plus lymphocytes significantly reduced the development of pulmonary metastases after intravenous tumour administration (median number of pulmonary metastases 28.5 for combined treatment versus 250 for heteroconjugate or lymphocytes alone, P less than 0.001).

Animals↗
PubMed1992

Evaluation of DNA nuclear pattern as a prognostic determinant in resected pancreatic ductal adenocarcinoma.

From a cohort of 72 patients who underwent radical resection for ductal adenocarcinoma of the pancreas between 1951 and 1980, 62 paraffin-embedded specimens were analyzed by flow cytometry. Patients were divided into two groups according to the length of survival: long-term survivors (19 patients who survived 3 or more years after operation) and short-term survivors (43 patients who died within 12 months after resection). In 30 specimens (48%), the nuclear DNA pattern was diploid, whereas 32 were nondiploid (two tetraploid and 30 aneuploid). There were no significant differences in the number of diploid/nondiploid patterns, the fraction of cells in DNA synthetic (S) phase, or the DNA index between the two groups. These data suggest that there is no difference in the DNA content analysis of patients with pancreatic ductal adenocarcinoma when comparing long-term with short-term survivors following resection.

Carcinoma, Intraductal, Noninfiltrating↗