Biomedical subjects

W Graf

Publications and source records attributed to W Graf.

At least 73 records · Page 4Linked to original sources

PubMed1995

Laparoscopic suture rectopexy.

PURPOSE: This article describes a technique for laparoscopic suture rectopexy and assesses the postoperative results. METHODS: The rectum was fixed to the presacral fascia with five to six sutures. The procedure was performed using a laparoscope in four patients. RESULTS: There were no postoperative complications. In one patient a large enterocele was observed during the operation. This patient developed a recurrence about one month postoperatively. CONCLUSION: Laparoscopic suture rectopexy might be an alternative to open rectopexy for patients with isolated rectal prolapse.

Adult↗

PubMed1995

Anorectal manovolumetry in the diagnosis of fecal incontinence.

PURPOSE: This study was designed to investigate rectal reservoir function and anal pressures in patients with fecal incontinence using anorectal manovolumetry and to evaluate the reproducibility of the investigation. METHODS: Forty-eight patients with fecal incontinence were investigated with respect to anal pressures and rectal volume changes and sensibility in response to stepwise increased rectal pressures (5-60 cm of H2O). Patients with known rectal wall diseases were excluded. Results were compared with those of 25 control subjects investigated in a similar manner. In ten individuals in the latter group, investigation was repeated after 5 minutes and 24 hours. RESULTS: Resting pressure (RP), squeezing pressure (SP), and the difference between SP and RP was lower in patients than in controls (P < 0.0001). There was no significant difference between patients and controls concerning rectal sensibility or compliance (P > 0.05), but there was a correlation between RP and rectal compliance (r = 0.25; P < 0.05) and between SP and rectal compliance (r = 0.30; P < 0.01). There was good reproducibility of RP and SP after five minutes (r = 0.88-0.92; P < 0.001). The day-to-day variation was larger for RP (r = 0.52; P > 0.05) compared with SP (r = 0.89; P < 0.001). Rectal compliance at 40 cm of H2O was reproducible after 5 minutes (r = 0.98; P < 0.0001) and 24 hours (r = 0.88; P < 0.01). CONCLUSIONS: These results indicate that the primary defect in incontinent patients is a sphincter dysfunction. Any reduction in rectal compliance is likely to be a secondary phenomenon.

Adult↗

PubMed1995

Cost-effectiveness of palliative chemotherapy in advanced gastrointestinal cancer.

BACKGROUND: Chemotherapy may relieve tumor-related symptoms, may improve quality of life and prolong survival in advanced gastrointestinal cancer. The extent of such improvements is unclear despite the extensive use of this treatment modality, and there are no studies concerning the economic cost of any gain achieved in the quantity and quality of life by chemotherapy. PATIENTS AND METHODS: Between January 1991 and May 1992, 61 patients with inoperable cancer (18 gastric, 22 pancreatic or biliary, and 21 colorectal) were randomized to either primary chemotherapy in addition to best supportive care or to best supportive care. Chemotherapy was allowed in the latter group if the supportive measures did not achieve palliation. All economic costs for medical care were prospectively recorded, and marginal cost-effectiveness analyses were performed. RESULTS: More patients in the primary chemotherapy group (19/33, 58%) had improved/prolonged high quality of life (QoL-patient, minimum duration 4 months) than in the best supportive care group (8/28, 29%, p < 0.05). Overall survival and quality-adjusted survival were significantly longer in the primary chemotherapy group (median 9 vs. 4 months, p < 0.05), and median 7 vs. 2 months, p < 0.05, respectively). When analysed by cancer site, survival was significantly prolonged in gastric cancer patients (median 10 vs. 4 months, p < 0.02), but not in colorectal (median 12 vs. 6 months, p = 0.1) and pancreatic-biliary cancer patients (median 8 vs. 5 months, p = 0.8). The average cost for all medical care was approximately 50% higher in the primary chemotherapy group, but the average cost per day was the same in the two groups. Hospitalization accounted for most of the costs in both groups. The incremental costs per gained year of life was SEK 166,400 ($21,300), per gained quality-adjusted year of life SEK 157,200 ($20,200), and per QoL-patient SEK 160,300 ($20,600). These costs were lower for gastric and colorectal cancer patients, and much higher for pancreatic-biliary cancer patients. CONCLUSIONS: The results of this study suggest that palliative chemotherapy is cost-effective in patients with advanced gastric and colorectal cancer. Knowledge about survival and quality of life benefits is still limited in patients suffering from gastric and pancreatic-biliary cancer.

Adult↗

PubMed1995

Relationships between defecographic findings, rectal emptying, and colonic transit time in constipated patients.

The relations between defecographic findings, rectal emptying, and colonic transit time were analysed in 80 constipated patients (median age 49 years, range 22-87). Patients were classified into three clinically defined groups (slow transit, outlet obstruction, and a mixed group). Rectal evacuation was evaluation was evaluated by computer-based area calculation. There were no differences in defecographic findings except that evacuation was less efficient in the slow transit group compared with the mixed group (p < 0.01) and with the outlet obstruction group (P < 0.05). Transit time was prolonged in the slow transit and mixed groups compared with the outlet group (p < 0.001). Prominent impression of the puborectalis muscle during straining and the size of a rectocoele correlated with rectal emptying (p < 0.01). Perineal descent, anorectal angles, enterocoele, or intussusception were not significantly related to emptying. Prominent impression of the puborectalis muscle (p < 0.05) and impaired rectal emptying (p < 0.05) were more frequent in patients with prolonged transit time (six or more days). There was no significant correlation between transit time and rectal evacuation in the total study population. There was, however, an inverse relation between these variables (r = 0.40, p < 0.02) when all patients who claimed infrequent defecation (two or fewer/week) were analysed separately. These results did not confirm a direct relation between rectal evacuation and colonic transit time in constipated patients overall. The results are consistent with the suggestion that impaired colonic function may develop secondary to outlet obstruction in some patients.

Adult↗

PubMed1995

The orientation of the cervical vertebral column in unrestrained awake animals. II. Movement strategies.

Previously we demonstrated a stereotyped resting posture of the head-neck arrangement in a number of vertebrates: the cervical vertebral column is oriented vertically to form one portion of the partial S-shaped configuration of the entire spine. The present investigation quantified the various strategies of head-neck movements employed by different mammalian species (human, monkeys, cats, rabbits and guinea pigs) using cineradiography. At rest, bipeds and quadrupeds hold their heads at the extreme point of flexion of the passive atlanto-occipital range of motion. In this posture, the horizontal semicircular canals are tilted upward from earth horizontal by 5 to 10 degrees and roughly parallel the plane determined by the two obliquus capitis posterior muscles. Furthermore, at this head position, the utricular maculae become oriented earth-horizontally. In quadrupedal animals, head-neck movements in the sagittal plane result from movement at the atlanto-occipital articulation (head/C1) and at the multi-articular cervico-thoracic junction (C6-Th3). Only very small flexion/extension movements occur within the body of the cervical vertebral column (C2-C5). Lowering the head from the resting position is only possible by flexion at the C6-Th3 vertebrae. Raising of gaze from the resting position is only possible by extension of the head at the atlanto-occipital articulation. By contrast, sagittal plane head movements in bipeds are largely confined to the cervico-thoracic junction. This is related to a significantly reduced range of motion of the atlanto-occipital articulation. In monkeys and humans, it range of motion is about 13 and 8-11 degrees, respectively, compared to 105 degrees in rabbits. Our cineradiographic data demonstrated different strategies for head movements in the sagittal plane between quadrupeds and bipeds. At one end of the spectrum, in the case of rabbits, there was no systematic relationship between head and neck orientation. Rabbits stabilized head posture by using the head-neck structure in a parallelogram fashion, which resulted in head posture being largely independent of cervical vertebral column orientation. In monkeys and humans, however, orientation of the head depended almost entirely on the orientation of the cervical vertebral column. In such case, head movements in the sagittal plane almost exclusively relied on the positioning of the cervico-thoracic junction. These different strategies again correlate with the different ranges of motion of the atlanto-occipital articulation. We suggest that vertebrates use mechanical constraints and preferred planes of action for head-neck movement control to simplify sensory-motor transformations subserving motor control and plasticity and to minimize neuronal operations.

Animals↗

PubMed1995

Anastomotic breaking strength and healing of anastomoses in rat intestine with and without chronic radiation damage.

OBJECTIVE: To assess the influence of chronic radiation damage on anastomotic healing in the small bowel in rats. DESIGN: Controlled laboratory study. SETTING: University hospital, Sweden. MATERIAL: 90 male Sprague-Dawley rats. INTERVENTIONS: A short segment of the distal ileum was exteriorised and irradiated with a single dose (experimental group, n = 45) or exposed only (control group, n = 45). Twenty weeks later resection and anastomosis were done within this segment using 7/0 polypropylene. MAIN OUTCOME MEASURES: The anastomotic breaking strength, the amount of perianastomotic hydroxyproline, and the number of anastomotic complications. RESULTS: The breaking strength and the amount of perianastomotic hydroxyproline were higher in the irradiated than in the non-irradiated group. In contrast, anastomotic complications were significantly more common in irradiated animals. CONCLUSION: Anastomotic complications in irradiated intestine are not related to the amount of perianastomotic collagen or to breaking strength.

Anastomosis, Surgical↗

PubMed1995

Characterization of the alloreactivity and anti-leukemia reactivity of cord blood mononuclear cells.

It has been suggested that cord blood T cells may be less able to mediate GVHD than marrow-derived T cells due to their naive status. A decreased potential for GVHD may be advantageous for allogeneic transplant, but this benefit might be counteracted by loss of the GVHD associated graft-versus-leukemia (GVL) effect. The GVL potential of cord blood could be doubly compromised since cord blood NK cell activity is also decreased. To assess these issues we have performed extensive comparative functional and immunophenotypic evaluations of cord and adult mononuclear cells. We found a somewhat reduced alloproliferative, allostimulatory and allocytolytic capacity of cord blood mononuclear cells in bulk assays but not by limiting dilution assays. Immunophenotyping revealed no significant differences in the proportion of major lymphocyte subsets with the exception of the previously recognized predominance of CD45RA+ cells in both CD4 and CD8 cord blood T cells. Cord blood T cells expressed normal percentages of the cellular adhesion molecules, CD11a, CD18 and LFA-3; however, the antigen density of each of these molecules was less than that found on adult T cells. Fewer resting cord blood T cells expressed CD54, the ligand for LFA-1. Cord blood B cells and monocytes expressed normal levels of HLA-class I and HLA class II DR, DP and DQ antigens, suggesting that the decreased expression of cellular adhesion molecules or their receptors rather than a decrease in expression of HLA might have contributed to the lower alloreactivity of cord blood. Although the percentages of NK cells and NK cell subsets in adult and cord blood were similar our data confirmed that cord blood has very low NK lytic activity. In contrast, LAK activity was much more readily induced in cord blood compared with adult PBMC, a finding which could be explained in part by a higher frequency of LAK precursors and a more rapid expansion of NK cells in response to culture with medium containing of NK cells in response to culture with medium containing IL-2. Cord blood LAK cells were readily able to lyse fresh leukemia targets from patients with ALL, AML and CML. The data indicate that although the alloreactive potential of cord blood cells may be somewhat decreased, it is not absent and must be considered a factor in cord blood transplants. LAKp with the potential to lyse leukemia are present in increased numbers in cord blood and might contribute to the GVL effect of a cord blood transplant.

Adult↗

PubMed1995

Functional results after seton treatment of high transsphincteric anal fistulas.

OBJECTIVE: To evaluate the functional outcome after seton treatment of high transsphincteric anal fistulas. DESIGN: Retrospective study. SETTING: University hospital, Sweden. SUBJECTS: 29 patients (8 women, mean age 46, range 25-71) with high transsphincteric anal fistulas 1983-1992. INTERVENTIONS: Setons were inserted in the anal fistulas in all patients. MAIN OUTCOME MEASURES: Anal continence evaluated by a questionnaire a mean of 46 months postoperatively. Clinical data were collected from the patients' records. RESULTS: All four patients with inflammatory bowel disease had some incontinence. Of the remaining 25 patients, 11 (44%) complained of incontinence and 2 (8%) developed recurrent fistulas. Incontinence was more common when the seton was tightened at the last procedure (7/9) compared with those in which the tissue enclosed by the seton was divided (4/16, p = 0.03). No other preoperative or operative characteristic significantly influenced the risk of incontinence. CONCLUSION: Incontinence is common after seton treatment of high transsphincteric anal fistulas. The risk seems to be higher when the muscle remains viable after a period of seton treatment.

Adult↗

PubMed1995

Functional anatomy of the head-neck movement system of quadrupedal and bipedal mammals.

This biomechanical investigation quantified the range of motion of the different articulations of the head-neck ensemble in man, monkeys, cats, rabbits and guinea pigs. Radiography and dissections were used to establish the degrees of freedom of the system. The erect posture and rigidity of the cervical spine in mammalian vertebrates are possible because the degrees of freedom of the movements of the cervical and upper thoracic vertebrae in passive ranges of motion are asymmetric, and thus significantly restricted, when judged from the resting position. The total range of motion at the atlanto-occipital articulation varies between species. It is approximately 90 degrees-105 degrees in the quadrupedal mammals tested, and only 11 degrees or 13 degrees, respectively, in humans and monkeys. When at rest, bipeds and quadrupeds hold the atlanto-occipital articulation and the upper cervical joints (C1/C2, C2/C3) in a flexed attitude. The total range of motion at the cervicothoracic junction (C6-T2) is approximately 6 degrees-80 degrees in all vertebrates investigated (quadrupeds and bipeds). At rest, the vertebral articulations that form the cervicothoracic junction are held in their extreme extended positions in quadrupeds and monkeys. In man, the vertebrae of the lower cervical spine are kept at a midposition between maximal flexion and maximal extension. This latter observation may be related to the permanent bipedalism of humans. Collectively, our data indicate that biomechanical constraints such as bone structures (e.g. specifically shaped articular processes) and ligaments may maintain the intrinsic configuration and self-supporting structure of the cervical spine. Furthermore, the specialised structures in the cervical joints allow movements more or less in particular planes of space, and thus biomechanical constraints limit the number of possible solutions as to how an animal can perform a given orientating head movement. Although we have not entirely clarified the functional implications for head movement control of the different sagittal-plane ranges of motion in vertebrates, we hypothesise that different mechanical requirements relating to the influence of gravity have caused the observed differences between the investigated bipedal and quadrupedal mammals.

Animals↗

PubMed1994

Quality of life during chemotherapy in patients with symptomatic advanced colorectal cancer. The Nordic Gastrointestinal Tumor Adjuvant Therapy Group.

BACKGROUND: To increase the knowledge about the palliative effects of chemotherapy in patients with symptomatic advanced colorectal cancer, physician- and patient-rated "quality of life" was studied in a randomized multicenter trial comparing a regimen of methotrexate/5-fluorouracil (5-FU) followed by leucovorin rescue (MFL) with a regimen of 5-FU/leucovorin (FLV). METHODS: Between January 1989 and December 1990, 70 patients completed a quality of life questionnaire at randomization and after every fourth treatment course. At one of the hospitals, the evaluation was done as an interview (interview group, n = 24), whereas a questionnaire was used at the other hospitals (questionnaire group, n = 46). RESULTS: Objective responses (complete response plus partial response) were obtained in 15 (21%) patients, subjective responses in 29 (41%) patients, and an overall improved quality of life in 25 (36%) patients. In addition, 16 (23%) patients had unchanged quality of life during at least 4 months. There was a correlation between objective responses, subjective responses, and improvements in quality of life, although discrepancies were noticed, particularly in patients with only slight symptoms. Response rates were higher in the interview group than in the questionnaire group (P < 0.01). This difference could be related to a more favorable outcome when 5-FU was given as a bolus injection, rather than as a short-term infusion (more than 5 minutes). CONCLUSIONS: Improvements or prolonged stabilization of disease in quality of life can be achieved in at least half of the patients with tumor-related symptoms. However, factors related to the administration of chemotherapy may influence this proportion.

Adult↗

PubMed1994

Experimental colonic healing in relation to timing of 5-fluorouracil therapy.

In an experimental study resembling clinical use of adjuvant 5-fluorouracil (5-FU) treatment of colorectal carcinoma, 97 male Wistar rats were operated on with a standardized left colonic resection. Treatment was given as a daily intraperitoneal injection. The animals were randomized to one of four groups: early treatment with 5-FU 20 mg/kg or saline 0.1 mol/l from the day of operation to day 7 after operation, and delayed treatment with 5-FU 20 mg/kg or saline 0.1 mol/l from the third day after operation to the day before killing. The animals were killed in groups on day 7 or 10 after operation. In the group receiving early 5-FU treatment there was an increased rate of anastomotic complications (seven of 26) compared with none in the control or delayed 5-FU groups. The anastomotic breaking strength in animals having early 5-FU treatment (day 7, median 1.45 (range 0.20-2.95) N; day 10, median 1.80 (range 0.95-3.20) N) was significantly lower than that in controls on both day 7 (median 3.20 (range 2.50-3.80)N) and day 10 (median 3.20 (range 2.20-3.60)N). In the delayed 5-FU treatment group anastomotic breaking strength did not differ from that in controls. Colonic healing was not impaired when intraperitoneal 5-FU treatment was started on day 3 after operation, whereas immediate postoperative administration of 5-FU had a detrimental effect on wound healing.

Animals↗

PubMed1994

The roles of nutritional depletion and drug concentration in 5-fluorouracil-induced inhibition of colonic healing.

This study was performed to investigate whether poor nutrition is responsible for 5-fluorouracil (5-FU)-induced inhibition of large bowel healing and if the concentration of intraperitoneal (ip) 5-FU affects anastomotic healing. Male Wistar rats underwent a left colonic resection and were randomly assigned to a control group (n = 9, ip NaCl, normal diet), a nutritional depletion group (n = 12, ip NaCl, restricted diet), or a 5-FU group (n = 12, ip 5-FU, normal diet). Treatment was started immediately after surgery and continued until sacrifice after 7 days. Although the weight loss in the nutritional depletion group exceeded that in the 5-FU group, the anastomotic and skin breaking strength was lower in the latter group compared with that in the former group (P < 0.01 and P < 0.05, respectively). There were no significant differences in breaking strength between the nutritional depletion group and controls. A second series of male Wistar rats were similarly operated on and randomly assigned to a control group (n = 6, ip NaCl), a 5-FU high-concentration group (n = 10, (5 mg/ml ip 5-FU) or a 5-FU low-concentration group (n = 10, (1 mg/ml ip 5-FU). The 5-FU dose was the same in the two latter groups. The anastomotic breaking strength on Day 7 was reduced to a similar extent in the 5-FU groups (P < 0.01). These results indicate that the impaired anastomotic healing after ip 5-FU is not mainly due to nutritional factors or drug concentration.

Anastomosis, Surgical↗

PubMed1994

The influence of early postoperative intraperitoneal chemotherapy on human wound healing.

Cell ingrowth, hydroxyproline accumulation, and mRNA expression of collagen I were measured in two polytetrafluoroethylene grafts implanted subcutaneously at the time of colorectal cancer surgery to evaluate the influence of early postoperative chemotherapy on human wound healing. Eleven patients treated with intraperitoneal 5-fluorouracil and intravenous folinic acid Days 1-6 after operation were compared with 15 patients who underwent surgery alone. At 1 week, chemotherapy-treated patients had accumulated less hydroxyproline (mean 0.35 +/- 0.33 micrograms/cm) compared with untreated patients (mean 0.73 +/- 0.37 micrograms/cm, P < 0.05). By 2 weeks, the hydroxyproline content had increased sixfold in the chemotherapy group (P < 0.01) and threefold in the nonchemotherapy group (P < 0.01) and there was no difference between the groups. Cell and connective tissue ingrowth and total RNA content did not differ between the groups at any point in time, but at 1 week the mRNA expression of collagen I was higher in the chemotherapy group (P < 0.05). These results indicate that collagen accumulation in human subjects is reduced during a short course of postoperative chemotherapy and normalizes after the end of treatment.

Adult↗

PubMed1994

Second-order vestibular neuron morphology of the extra-MLF anterior canal pathway in the cat.

Second-order vestibular neurons form the central links of the vestibulo-oculomotor three-neuron arcs that mediate compensatory eye movements. Most of the axons that provide for vertical vestibulo-ocular reflexes ascend in the medial longitudinal fasciculus (MLF) toward target neurons in the oculomotor and trochlear nuclei. We have now determined the morphology of individual excitatory second-order neurons of the anterior semicircular canal system that course outside the MLF to the oculomotor nucleus. The data were obtained by the intracellular horseradish peroxidase method. Cell somata of the extra-MLF anterior canal neurons were located in the superior vestibular nucleus. The main axon ascended through the deep reticular formation beneath the brachium conjunctivum to the rostral extent of the nucleus reticularis tegmenti pontis, where it crossed the midline. The main axon continued its trajectory to the caudal edge of the red nucleus from where it coursed back toward the oculomotor nucleus. Within the oculomotor nucleus, collaterals reached superior rectus and inferior oblique motoneurons. Some axon branches recrossed the midline within the oculomotor nucleus and reached the superior rectus motoneuron subdivision on that side. Since these neurons did not give off a collateral toward the spinal cord, they were classified as being of the vestibulo-oculomotor type and are thought to be involved exclusively in eye movement control. The signal content and spatial tuning characteristics of this anterior canal vestibulo-oculomotor neuron class remain to be determined.

Animals↗

PubMed1994

Adjuvant intraperitoneal 5-fluorouracil and intravenous leucovorin after colorectal cancer surgery: a randomized phase II placebo-controlled study.

Fifty patients were randomized to receive adjuvant intraperitoneal 5-fluorouracil (5-FU, 500 mg/m2/day) and intravenous leucovorin (60 mg/m2/day) and 51 to receive placebo after curative surgery for colorectal cancer. Treatment started on the day after surgery and continued for 6 days. One case of stomatitis, one of leucopenia and one case of abnormal liver function tests were the only chemotherapy-related toxic effects. From the second day of treatment, pain during intraperitoneal infusions occurred more frequently in the 5-FU group, although statistical significance was only attained on day 2 (P < 0.05). The groups did not differ substantially regarding any other adverse effects, the incidence of surgical complications, second laparotomies, time from surgery to discharge, or premature treatment terminations. The postoperative course after intraperitoneal 5-FU and intravenous leucovorin was thus not more complicated than that in patients treated with placebo. The tolerance was acceptable and chemotherapy-related toxicity was rare. Thus important prerequisites exist for more widespread use of the present regimen in order to evaluate its impact on survival.

Adult↗

PubMed1994

Appraisal of a model for prediction of prognosis in advanced colorectal cancer.

Previously identified prognostic factors in advanced colorectal cancer were tested in an independent population for their relationship to survival by univariate and multivariate analyses. The new population comprised 198 patients included in a randomised chemotherapy trial. The earlier identified prognostic variables were: (1) haemoglobin level (B-Hb), (2) disease-free interval, (3) Karnofsky performance status (KPS), (4) number of symptoms, and (5) whether the primary tumour was removed or not. In the new population, variables (1-3) had significant relationships to survival in both univariate and multivariate analyses, whereas variable (4) was significant only in the univariate analysis. Variable (5) was not significantly related to survival in any analysis. When a group of additional variables (white blood cell count, B-thrombocytes, S-creatinine and liver function tests) was included, S-aspartate aminotransferase (S-ASAT) was a strong predictor of survival. The independent predictive value of B-Hb, disease-free interval and KPS was confirmed in this study. S-ASAT might be an additional important prognostic factor in advanced colorectal cancer. However, the results of this study indicate that any new prognostic factor should be viewed as preliminary until verified in an independent population.

Adult↗

PubMed1994

The relationship between an objective response to chemotherapy and survival in advanced colorectal cancer.

This analysis was conducted to evaluate the independent relationship between survival and response to chemotherapy in advanced colorectal cancer. In order to correct for the guarantee time effect, patients dying before the response evaluation were excluded from the analyses. A previously constructed prognostic model containing 11 variables was applied to 324 patients. When the response categories were analysed together with the prognostic variables, it was found that a response was associated with a definite survival advantage (P < 0.001), whereas the influence of all the other variables decreased. The corrected survival advantage (relative progressive disease) was 11 months after a complete response, 6 months after a partial response and 4 months after stable disease. The survival advantage was of a similar magnitude when the analyses were repeated in an independent population comprising 198 patients in whom the prognostic model was extended to include also a set of laboratory values. The results show that a response to chemotherapy is associated with a longer survival also after correction for the guarantee time effect and the distribution of prognostic variables.

Adult↗

PubMed1994

Computed tomography of experimental liver metastases using an iodinated hepatocyte-specific lipid emulsion. A correlative study in the nude rat.

RATIONALE AND OBJECTIVES: A hepatocyte-specific iodinated lipid emulsion, NRI 757, was used for detection of experimental hepatic metastases. MATERIALS AND METHODS: The study was performed in a correlative model of multiple hepatic metastases from a human colonic cancer implanted in the nude rat. RESULTS: After intravenous injection, normal liver parenchyma remained enhanced for several hours, whereas the uptake in hepatic metastases was negligible. A liver-to-lesion contrast of 45 Hounsfield units (HU) was obtained at a dose of 1 mL NRI 757/kg body weight (BW). In a lesion-by-lesion analysis of 177 metastases ranging in size from 1 to 32 mm, the mean +/- standard deviation overall detection rate for native scanning and contrast-enhanced scanning in vivo and post mortem, 20 +/- 0.4%, 53 +/- 5.2%, and 55 +/- 4.0%, respectively and 28%, 84%, and 82%, retrospectively. When metastatic size also was considered, for native scanning the maximum detection rate of 61% was reached for 8- to 10-mm lesions, whereas for contrast-enhanced computed tomography scanning, 100% of the 5- to 7-mm lesions and 42% of the 1- to 2-mm nodules were detected. CONCLUSION: The use of NRI 757 improved the diagnostic yield considerably.

Adenocarcinoma↗