Sentinel lymph node biopsy.
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Breast Neoplasms↗
Biomedical subjects
Michael J Kerin
Publications and source records attributed to Michael J Kerin.
Paravertebral analgesia with levobupivacaine increases postoperative flap tissue oxygen tension after immediate latissimus dorsi breast reconstruction compared with intravenous opioid analgesia.
BACKGROUND: Directly measured tissue oxygen tension (Pto2) reflects the adequacy of local tissue oxygenation and influences surgical wound healing. Epidural analgesia increases Pto2 compared with intravenous morphine analgesia after abdominal surgery. The authors tested the hypothesis that paravertebral regional anesthesia and analgesia would increase Pto2 compared with intravenous opioid-based anesthesia and analgesia. METHODS: Twenty patients scheduled to undergo mastectomy with immediate latissimus dorsi breast reconstruction were randomized to receive either general anesthesia with postoperative intravenous morphine analgesia or combined general-paravertebral anesthesia with continuous paravertebral postoperative analgesia using levobupivacaine in this prospective, cohort study. All patients had a local tissue oxygen sensor implanted in the flap muscle. Data were downloaded continuously for 20 h postoperatively. RESULTS: The mean Pto2 over the 20-h period was significantly higher in patients receiving paravertebral anesthesia (75 +/- 38 vs. 44 +/- 23 mmHg [mean +/- SD]; P = 0.03). Intraoperative blood loss was less in paravertebral patients (1.2 +/- 0.4 vs. 1.7 +/- 0.5 l; P = 0.04). Dynamic visual analog scale pain scores were significantly lower in paravertebral patients. Intraoperative and postoperative fluids administered, hemoglobin, core temperature, intraoperative end-tidal carbon dioxide, and mean arterial pressure were similar in both groups. CONCLUSION: The postoperative latissimus dorsi flap Pto2 was higher for 20 h after breast reconstruction with paravertebral analgesia compared with intravenous morphine analgesia.
Adult↗
Intracellular flow cytometric analysis of primary cultured breast tumor cells.
Cell lines are traditionally used as tools for in vitro studies of breast cancer. It is highly debatable however, because of the genetic drift that occurs in such long term cultures how representative these cell lines are of breast cancer in vivo. For this reason primary cultures are generally regarded as a better model. Here we have used a primary culture technique (Int. J. Cancer, 66 (1996) 551; Br. J. Cancer, 78 (1998) 1421) to obtain primary breast cancer cells from 13 breast cancer biopsies. We then describe the development and use of methodology to confirm the purity of the cultures. The acquisition of a highly pure population of epithelial cells was confirmed by flow cytometric analysis of intracellular vimentin and cytokeratin 19. The methodology described will have many applications in studies requiring a highly pure population of epithelial breast cancer cells, as well as wide use in other cancers.
Breast Neoplasms↗
Soluble FLT-1 is detectable in the sera of colorectal and breast cancer patients.
BACKGROUND: VEGF is the key factor in angiogenesis which is essential for the development and progression of solid tumours. VEGF acts via two high affinity receptors: KDR and FLT-1. FLT-1 exists both in membrane-fixed and soluble forms. The soluble form is perhaps the only known natural direct antagonist of VEGF and may have a role in anti-angiogenesis therapy. MATERIALS AND METHODS: We developed an in-house ELISA and have assayed soluble FLT-1 in the sera of cancer patients. We assayed preoperative serum from 50 colorectal and 43 breast cancer patients, and paired serum and plasma from 20 healthy volunteers. Postoperative serum from 17 colorectal cancer patients was also assayed. RESULTS: No s FLT-1 was detected in the samples from the healthy volunteers. Soluble FLT-1 was detected in the serum of both colorectal and breast cancer patients. We did not find any correlation between s FLT-1 and stage of either cancers. There was no significant correlation between serum VEGF and s FLT-1. Serum FLT-1 was markedly decreased in the postoperative serum of patients with detectable preoperative levels and none of the receptor negative sera became positive postoperatively. CONCLUSION: We conclude that s FLT-1, a natural antagonist of VEGF, is detectable in the sera of cancer patients. Larger studies involving long term follow-up are required to determine its prognostic significance.
Adult↗