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Biomedical subjects

H E Wagner

Publications and source records attributed to H E Wagner.

At least 55 records · Page 3Linked to original sources
PubMed1990

Characterization of the tumorigenic and metastatic potential of a poorly differentiated human colon cancer cell line.

We characterized the tumorigenic and metastatic potential of a poorly differentiated, non-CEA-producing colon cancer cell line, MIP-101, after injection at different sites in athymic mice. After subcutaneous and intrasplenic injection tumor grew locally in 100 and 50%, respectively, but no metastases were found, even after intravenous injection. Intraperitoneal implantation, however, resulted in a high tumor take (10/10) and subsequent liver colonization (8/10 mice). Exogenous CEA prior to intrasplenic injection induced metastasis in 7/8 mice (in 2 mice to the liver and in 5 mice to the lung). Intrasplenic injection of CX-1, a good CEA producer, resulted in hepatic metastases in 100% of the animals. These data suggest a direct or indirect role of CEA in the metastatic process. We conclude that MIP-101 has a high tumorigenic and invasive potential but a low metastatic proclivity, except when grown in the peritoneum, and that pretreatment of tumor-bearing animals with CEA affects the metastatic proclivity.

Adenocarcinoma↗
PubMed1990

Preneoplastic lesions induced by myc and src oncogenes in reconstituted mouse bladder.

To define a role for different oncogenes in bladder neoplastic progression we have introduced viral myc and src oncogenes, singly or in combination, into intact normal urothelium. After incubation with virus, infected mucosa was heterotransplanted under the renal capsule of syngeneic animals and monitored for progression toward malignancy by use of histologic and immunofluorescence techniques. Although v-myc alone induced focal hyperplastic change, more dysplastic lesions were observed after expression of the src oncogene product in urothelial implants. In contrast, lesions induced by myc and src acting cooperatively were highly proliferative, displaying evidence of tumor formation within the 6-week study period. The presence and expression of myc and src oncogenic proteins, associated with preneoplastic and neoplastic lesions, was confirmed by use of Southern blot analysis and an immune complex kinase assay, respectively. These results indicate the formation of histologically distinct preneoplastic change elicited by the action of a single oncogene with induction of neoplastic changes when such oncogenic elements act cooperatively. This model provides an opportunity to study the action of different oncogenes throughout bladder neoplastic progression in vivo.

Animals↗
PubMed1988

Prognosis in synchronous colorectal carcinomas.

The prognosis of synchronous colorectal carcinomas is a matter of controversy. 5-year survival rates are reported to be either better or worse in comparison with single carcinomas. In this study 736 cases with histologically proven malignancies oft the large intestine were reviewed. 22 patients (3 per cent) showed multiple primary tumors. Patients with multiple tumors had associated adenomas in 72 per cent vs 14 per cent of the patients with single cancers (P < 0.01). 77 per cent of the synchronous tumors were located in the left colon. Only in 5 patients (23 per cent) two different lymphatic drainage areas were involved. 15 patients (68 per cent) presented without lymph node or distant metastases. A radical procedure was performed in 82 per cent. The overall 5-year survival rate was 54.5 per cent for multiple and 44.5 per cent for single carcinomas. The better survival rate seems to be due to the higher rate of early detection because of rectal bleeding in patients with synchronous tumors.

Adenomatous Polyps↗
PubMed1988

[Penetrating heart injuries].

On personal experience of 6 cases and literature review the management of penetrating precordial wounds is discussed. The importance of clinical science, as shock and high central venous pressure, in the indication of emergency thoracotomy is outlined.

Adult↗
PubMed1987

[Hepatic portal tumor--today].

Hilar cholangiocarcinoma is relatively rare. Typically it spreads locally, the main manifestation being painless jaundice. Exact preoperative staging includes sonography or CT scan, cholangiography, angiography and aspiration cytology. This assessment should delineate the tumor extent and provide an excellent index of tumors which are clearly unresectable. Therapy has two objectives: firstly, if possible, to eliminate the tumor, and secondly, to restore bile flow. Resection of hilar cholangiocarcinoma can be accomplished in some 20% of cases with a 30 day hospital mortality close to zero for local excision and of approximately 10% for hepatic resections. The median time resected patients remain alive is 24 months, and the 5 year survival rate of resected patients is 12%. The mortality rate for palliative relief of biliary obstruction by any method in hilar cholangiocarcinoma is reported at 16-30%. Survival after intubation averages only 3 to 6 months and for surgical bypass about 8 months.

Adenoma, Bile Duct↗
PubMed1987

[Colorectal carcinoma in old age].

84 patients aged over 80 years with colorectal cancer were evaluated. 54% had underlying associated illnesses. 27% underwent emergency surgery because of ileus or perforation. Resection rate for tumours was 74%, but only 64% of the operations were curative and 36% palliative. An early tumour stage (UICC stage I and II) was found in 51% of the patients. Operative mortality was 14.3%. The 3- and 5-year survival rate was 38% and 30% respectively. This study shows that even in elderly patients with suspicion of colorectal cancer a rapid assessment is mandatory to avoid tumour complications. This is the only way to lower the rate of emergency surgery; by gaining time the patient with risk factors can be prepared preoperatively for the abdominal operation. By early assessment and elective operation the high mortality rate of the elderly patient can be lowered. It would seem that diagnostic and therapeutic nihilism in the elderly is inappropriate. Although the crude 5-year survival rate approaches 30%, cautious assessment is necessary and individual evaluation of cases warranted.

Aged↗
PubMed1987

Prophylactic treatment of acute gastroduodenal stress ulceration. Low-dose antacid treatment without and with additional ranitidine.

Low-dose antacid treatment without and with additional ranitidine in the prevention of acute gastroduodenal stress ulceration in high-risk patients was compared in a randomized, double-blind clinical trial with endoscopic examination of the upper gastrointestinal tract before entry and after the 7-day study period. Of 67 patients who entered the study, 56 could be evaluated. Only one patient, allocated to antacid and placebo, had massive acute upper gastrointestinal bleeding, arising from a gastric ulcer. Although gastric intraluminal pH was better controlled with additional ranitidine treatment, the occurrence of mucosal lesions did not depend on the assigned treatment. We conclude that there is no significant difference between the two regimens in terms of endoscopically visible lesions and clinical outcome.

Acute Disease↗
PubMed1987

[Acute massive gastrointestinal hemorrhage in jejunal diverticulosis].

Two cases which presented with acute massive lower gastrointestinal hemorrhage from jejunal diverticulosis are reported. The various clinical presentations of this rare disease are discussed. The life-threatening complication of massive bleeding is specially outlined. The cases reported in the literature resemble the Dieulafoy ulcer lesion of the stomach.

Aged↗
PubMed1987

Verrucous acanthosis--so-called verrucous carcinoma--of the esophagus.

Verrucous carcinoma of the esophagus is a rare variant of squamous cell carcinoma with a slow, non-invasive growth without formation of metastases. Until today, only 8 cases of verrucous carcinoma of the esophagus have been reported in the literature. All of these tumours showed infiltration of adjacent mediastinal structures or even lymph node metastases. In therefore seems doubtful, wether these tumours were really verrucous carcinomas rather than squamous cell carcinomas of the papillary type. Several authors have questioned the malignant nature of these tumors recently. We report a case of a verrucous lesion of the esophagus the course of which we were able to observe over a period of several years. Transhiatal esophagectomy without thoracotomy is recommended as treatment of choice for verrucous tumours of the esophagus.

Carcinoma, Papillary↗
PubMed1987

Reoperations upon the biliary duct system for benign disorders are still indicated.

During the last 12 years, we performed 78 reoperations upon the biliary tract for benign disorders. Not included were early complications after the initial operation or endoscopic manipulation. The indications for reoperations were obstructive jaundice, recurrent colic and asymptomatic biliary fistula in 57, 18 and three patients, respectively. Endoscopic retrograde cholangiography was found to be the preoperative diagnostic method of choice. Intraoperative examination demonstrated cholangiolithiasis in 48 patients (five patients with stenosis), stenosis of the bile duct in eight, sump syndrome after choledochoduodenostomy in six and cholangitis without any further pathology in three. In three patients, the revision was negative. Several reinterventions were carried out: exploration of the bile ducts (12 per cent with papillotomy), removal of a biliodigestive anastomosis and a biliary enteric anastomosis in 52, 12 and 14 patients, respectively. The postoperative cholangiogram showed residual stones in 12 patients. Two-thirds of the stones disappeared spontaneously and one-third were removed endoscopically. There were local complications in 12 of the patients. The mortality rate was 6.4 per cent. All of these patients were more than 70 years old and were considered at high risk. In spite of endoscopic retrograde cholangiography, the number of operative reinterventions upon the biliary duct system has hardly declined over the last few years. This is partly due to new specific complications in connection with endoscopic retrograde endoscopy (perforation, hemorrhage or pancreatitis).

Bile Duct Diseases↗
PubMed1986

[Acute abdomen in patients under anticoagulant treatment].

Hemorrhagic complications induced by anticoagulants occur in about 10-20% of patients treated. The bleeding source is found in the gastrointestinal tract in 30%. A careful history and physical examination, in combination with radiologic evaluation, serve to localize the bleeding site and avoid unnecessary surgery. Because anticoagulated patients may have the clinical picture of acute abdomen, it is important to differentiate extra-, intra- and retroperitoneal complications. During the past ten years we have treated 16 patients with acute abdomen under anticoagulation therapy: extra-, intra- and retroperitoneal complications were found in three, nine and four cases respectively. Rectus sheath hematomas, intramural bowel hematomas and retroperitoneal hematomas primarily underwent conservative, symptomatic treatment. Only intraperitoneal hemorrhage and psoas hematomas with neurologic manifestations required early surgical treatment. After successful treatment the indication for anticoagulation therapy should be reevaluated.

Abdomen, Acute↗
PubMed1986

Orthotopic liver transplantation in pigs without cold perfusion of the donor liver. Evaluation by quantitative liver function tests.

Orthotopic liver transplantation (OLT) was performed in 12 pigs and liver function assessed before and after transplantation. In 6 pigs OLT was carried out without cold perfusion of the donor liver, whereas in the other 6 animals the donor organ was perfused in situ. 5/6 animals without perfusion and 4/6 with cold perfusion survived for more than 10 days. Significantly better liver function was revealed by the aminopyrine breath test (ABT) and the indocyanine green (ICG) disappearance in the group with the cold perfusion of the liver, whereas no differences in routine liver function tests were seen between the two groups. Although OLT without cold perfusion of the donor liver is feasible and prolonged survival of animals is possible, the function of these organs is markedly reduced compared to the cold perfused organs. This method can, therefore, not be recommended. ABT and ICG disappearance are sensitive tests for the evaluation of the liver function in the post-transplant period.

Aminopyrine↗