Biomedical subjects

Yi-Yin Jan

Publications and source records attributed to Yi-Yin Jan.

At least 55 records · Page 3Linked to original sources

PubMed2004

Efficacy of gabexate mesilate on disseminated intravascular coagulation as a complication of infection developing after abdominal surgery.

BACKGROUND AND PURPOSE: Gabexate mesilate (GM) is a promising anticoagulation treatment for disseminated intravascular coagulation (DIC). This study was designed to examine the effect of GM on DIC associated with the development of infection after abdominal surgery in the intensive care unit (ICU). METHODS: From January 1999 to March 2002, 50 consecutive ICU patients suffering DIC associated with the development of infection after abdominal surgery were enrolled in this study. Twenty five of the patients were randomized to receive treatment with GM by central intravenous infusion at 1 mg/kg/hour for 5 days or longer, while the remaining 25 were not treated. Blood clotting tests were performed and cytokine levels including tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were examined on days 1, 3, and 7 after admission. General blood tests and D-dimer tests were conducted before and after GM administration. The gender, age, mortality, Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores and severity of DIC were compared between the 2 groups. RESULTS: No significant difference was found between the 2 groups in TNF-alpha and IL-6 concentration on days 1, 3, and 7. The mortality rate was similar between the 2 groups. However, DIC and APACHE-II scores were significantly lower in the GM-treated patients than in controls. CONCLUSION: In this study, GM (1 mg/kg/hour) did not reduce the concentration of TNF-alpha and IL-6, or alter the mortality rate in patients with DIC resulting from infectious complications after surgery. Nevertheless, APACHE-II scores indicated that GM reduced the DIC severity and improved the clinical condition of patients.

APACHE↗

PubMed2003

Thioacetamide-induced intestinal-type cholangiocarcinoma in rat: an animal model recapitulating the multi-stage progression of human cholangiocarcinoma.

Cholangiocarcinoma (CCA) is a lethal disease, afflicting many thousands the world over. Human CCA develops through a multi-step progression model, preceded by the onset of dysplasia in the cholangiolar ductal epithelium. An animal model of multi-step carcinogenesis in the biliary tree will enable the study of genetic changes in human CCA, and provide an avenue for chemoprevention strategies. We describe an oral thioacetamide (TAA)-induced model of rat CCA that recapitulates the histologic progression of human CCA. Male Sprague-Dawley (SD) rats (n = 170), weighing 350 +/- 20 g, were used in this study. Drinking water with TAA 300 mg/l was administered orally, and the liver was harvested and examined histologically at weekly intervals, beginning at 5 weeks after initiation of TAA. Harvested tissues were formalin-fixed and paraffin embedded for morphologic and immunohistochemical studies. Multifocal bile ductular proliferation with intestinal metaplasia (presence of goblet cells) and increasing histologic atypia (biliary dysplasia) was observed by the 9th week of TAA administration. Biliary cytokeratin (CK19)-expressing invasive intestinal-type CCA with stromal desmoplasia was evident at the 16th week, and by the 22nd week, the yield rate for CCAs had increased to 100%. Invasive CCAs preceded the development of hepatic cirrhosis by at least 4 weeks; the earliest incidence of hepatic fibrosis was observed beginning at 20 weeks post-TAA administration. The progression from normal cholangioles to biliary dysplasia to invasive CCA was accompanied by up-regulation of the proto-oncogenes c-met and c-erbB-2, tyrosine kinase receptors over-expressed in human CCAs. The study was terminated at 6 months, at which time no systemic metastases or deaths were observed. Oral administration of TAA in drinking water to male SD rats provides a reproducible animal model for development of CCA with a high yield rate. In particular, the presence of biliary dysplasia beginning at the 9th week, which progresses to invasive CCA, mimics the multi-step model of human CCA. The TAA rat model may serve as a powerful pre-clinical platform for therapeutic and chemoprevention strategies for human CCA.

Animals↗

PubMed2003

Adenosquamous carcinoma of the liver: clinicopathologic study of 10 surgically treated cases.

This investigation presents the clinical features and outcomes of 10 surgically treated primary adenosquamous carcinomas of the liver (ADS-CCC). Peripheral cholangiocarcinoma (CCC) occurs less frequently than hepatocellular carcinoma in most parts of the world. Reports of surgically treated cases of ADS-CCC are sporadic owing to the low resectability rate, difficulty of making an early diagnosis, and its poor prognosis. Furthermore, clinicopathologic studies based on a limited number of surgically treated cases are still lacking. From 1988 to 1999 the clinical features of 10 surgically treated cases of ADS-CCC were reviewed, including clinical features, operative findings, the pathologic picture, and long-term results. The clinical features and outcomes of 171 patients with CCC were also summarized for comparison. Of 181 surgically treated CCC patients, 10 (5.3%) had ADS-CCC. Low bilirubin values and high resectability were prominent in the patients in the ADS-CCC group compared with those in the CCC group. The prognosis for ADS-CCC is dismal, although overall survival did not differ significantly between these two groups. Hepatic resection and curative hepatic resection had significant benefit on the overall survival in the CCC group but only hepatic overall survival in the ADS-CCC group. The 1- and 3-year survival rates of ADS-CCC and CCC patients were 22.2%/0% and 33.7/9.4%, respectively. This investigation presents the clinical features and outcomes of 10 surgically treated ADS-CCC patients. ADS-CCC exhibited higher resectability than CCC. Although hepatic resection might benefit the treatment and prolong the survival of ADS-CCC patients, the prognosis is still dismal because of the specific biologic behavior of the tumor.

Adult↗

PubMed2003

Intrahepatic segmental bile duct patterns in hepatolithiasis: a comparative cholangiographic study between Taiwan and Japan.

BACKGROUND/PURPOSE: We analyzed confluence patterns of intrahepatic segmental bile ducts, seeking to relate hepato-lithiasis to anatomic variation. The comparative study was completed patients with hepatolithiasis in Taiwan and Japan. METHODS: Direct cholangiography was performed in 103 hepatolithiasis patients in Taiwan and 77 in Japan. Segmental ducts patterns were classified as type I, normal configuration; type II, "triad" confluence; type III, posterior segmental duct joining left hepatic duct; or type IV, distal confluence of the right posterior segmental duct. RESULTS: Taiwanese patients had only calcium bilirubinate or black stones, and were mostly female. As overall analysis, types I, II, III, and IV were found in 61, 26, 13, and 3 patients, respectively. In Japanese, types I, II, III, and IV were found in 52, 10, 13, and 2, respectively. There was no difference between the two institutes. Since no patients in Taiwan had cholesterol calculi, Japanese patients were reanalyzed including only 58 patients with calcium bilirubinate or black stones. Differences in those populations remained insignificant. CONCLUSION: Anatomic variations in segmental ducts apparently do not contribute to pathogenesis of hepatolithiasis.

Adolescent↗

PubMed2003

Expression of deleted in malignant brain tumor-1 (DMBT1) molecule in biliary epithelium is augmented in hepatolithiasis: possible participation in lithogenesis.

Deleted in malignant brain tumor-1 (DMBT1) is a mucin-like molecule participating in mucosal immune defense. Given that bovine gallbladder mucin, which accelerates cholesterol crystallization, is a DMBT1 homolog, DMBT1 expression was examined immunohistochemically in biliary epithelial cells in livers with hepatolithiasis (N = 25), primary sclerosing cholangitis (N = 7), large bile duct obstruction (N = 12), and control normal livers (N = 10). DMBT1 protein was determined in the hepatic bile samples of hepatolithiasis (N = 12) and other hepatobiliary diseases (N = 8) by immunoblot. While DMBT1 was faintly expressed in normal livers (20%), it was significantly augmented in hepatolithiasis (76%) (P < 0.05). DMBT1 was mildly expressed in primary sclerosing cholangitis and large bile duct obstruction. DMBT1 protein was detected frequently in hepatic bile samples of hepatolithiasis (50%) (P < 0.05), but in the other bile samples. The percentage of cholesterol in intrahepatic calculi was significantly higher in the patients with DMBT1-positive bile. Augmented expression and secretion of DMBT1 in intrahepatic large bile ducts in hepatolithiasis suggests its role in lithogenesis.

Agglutinins↗

PubMed2003

Laparoscopic resection of malignant gastric polyp-with a particular emphasis on localization by laparoscopic ultrasonography.

Adenomatous polyps of the stomach are rare and usually found on routine endoscopic examination. These polyps should be removed because of their potential for malignant transformation. Endoscopic polypectomy is the preferred treatment modality, but a laparotomy is required to resect large polyps. This study presents a case of a large gastric polyp containing carcinoma in situ that was successfully managed by laparoscopic gastrectomy. With the use of a novel technique, the tumor was localized by intraoperative laparoscopic ultrasonography. The patient had an excellent postoperative recovery, and follow-up endoscopy at 24 months revealed no recurrent tumor.

Adenoma↗

PubMed2003

A phase II trial of tegafur-uracil plus leucovorin (LV) in the treatment of advanced biliary tract carcinomas.

OBJECTIVE: To evaluate the efficacy and safety profile of oral tegafur-uracil (tegafur combined with uracil in a molar of 1:4 ratio) plus leucovorin (LV) in patients with advanced biliary tract carcinoma (BTC). METHODS: Sixteen chemotherapy-naïve patients (nine males and seven females with a median age of 58.0 years) with BTC were prospectively enrolled in this study. The dose of tegafur-uracil (UFUR; TTY Biopharm Co. Ltd, Taipei, Taiwan) was 300 mg/m(2)/d (according to the dose of tegafur) and LV was 60 mg/day on day 1-28, followed by a 1-week break. The site of primary tumor included 10 intrahepatic cholangiocarcinomas (CC), one perihilar CC, four gallbladder cancers and one periampullar cancer. Fourteen patients were evaluated for tumor response. RESULTS: No objective complete or partial responses were observed. Two patients had stable disease and 12 patients had disease progression. The median time to progression was 68 days (8-159 days) and the median survival time was 155 days (69-570 days). Sixteen patients were evaluable for toxicity. Grade III/IV toxicities were found in two patients only; one patient had grade III thrombocytopenia and one patient stopped therapy early due to grade IV diarrhea. CONCLUSIONS: Oral tegafur-uracil plus LV is well tolerated but ineffective in patients with advanced BTC.

Administration, Oral↗

PubMed2003

Small invasive breast carcinomas in Taiwanese women.

BACKGROUND: Female Taiwanese breast cancer patients are younger than their Western counterparts. This study examined the predictors of axillary lymph node metastases in Taiwanese women with T1 breast cancer. METHODS: Data from 394 Taiwanese women with T1 invasive breast carcinoma were retrospectively reviewed. RESULTS: The data contained 6 T1a, 51 T1b, and 337 T1c breast tumors. The patients' ages ranged from 23 to 82 years (mean +/- SD, 48.2 +/- 11.4 years; median, 46.4 years). Axillary nodal metastases were present in 38.3% of the patients (16.7% in T1a, 35.3% in T1b, and 39.2% in T1c tumors). The patients with nodal metastases had significantly greater body weights and S-phase fractions than those without nodal metastases. Univariate analysis revealed that unfavorable pathology, lymphovascular invasion, S-phase fraction >7%, and nondiploid DNA ploidy were significantly associated with lymph node metastases. Lymphovascular invasion was the only significant variable as the independent predictor in the multiple logistic regression analysis. In the Cox proportional hazards regression analysis, axillary nodal status and lymphovascular invasion were significantly associated with survival. CONCLUSIONS: Taiwanese women with small breast cancer displayed a relatively higher incidence of axillary lymph node metastases than Western women. Axillary lymph node dissection or sentinel lymph node biopsy should be conducted on Taiwanese patients with small invasive breast carcinomas, particularly when risk factors exist.

Adult↗

PubMed2003

Profiling of gene expression associated with hepatolithiasis by complementary DNA expression array.

By use of cDNA expression array method, we compared the expression profiles of genes in hepatolithiasis tissues with those of paired normal tissues. Expression of 1176 cancer related genes that include 33 tumor suppressor genes, 100 proto-oncogenes and 37 DNA damage repair genes were examined in this study. We found that expression of tumor suppressor genes and proto-oncogenes was systemically activated in hepatholithiasis tissues, suggesting that expression of genes controlling cell growth becomes unstable in liver lobe of hepatolithiasis. In contrast, expression of DNA damage repair genes were not activated but rather remained unchanged in hepatholithiasis tissues, suggesting that repair process is not strongly activated but rather impaired in hepatholithiasis tissues.

Calculi↗

PubMed2002

Increasing expression of gastrointestinal phenotypes and p53 along with histologic progression of intraductal papillary neoplasia of the liver.

Intraductal papillary neoplasia of the liver (IPN-L) was recently proposed as the name for intraductal papillary proliferation of neoplastic biliary epithelium with a fine fibrovascular stalk resembling intraductal papillary mucinous neoplasm of the pancreas. We histochemically and immunohistochemically examined IPN-L alone or associated with hepatolithiasis, with an emphasis on the gastrointestinal metaplasia, nuclear p53 expression, and histologic progression. A total of 66 cases of IPN-L were divided into 4 groups: group 1, IPN-L with low-grade dysplasia (13 cases); group 2, IPN-L with high-grade dysplasia (20 cases); group 3, IPN-L lined with carcinoma in situ and no or microinvasion (19 cases); and group 4, group 3 with distinct invasive carcinoma (14 cases). It is suggested that IPN-L progresses from group 1 to group 4. As controls, 20 cases of nonneoplastic intrahepatic large bile ducts and 17 cases of nonpapillary invasive intrahepatic cholangiocarcinoma (ICC) were used. Biliary epithelial hypersecretion of sialomucin rather than sulfomucin was prevalent in IPN-L, and this was associated with the progression of INP-L. Immunohistochemically, cytokeratin (CK) 20 and MUC2, a gastrointestinal marker, were expressed more frequently in IPN-L than in nonneoplastic bile ducts and nonpapillary ICC (P <0.01), and their incidence were significantly increased in parallel with the progression of IPN-L (P < 0.01). In contrast, expression of CK 7, a biliary marker, was decreased in IPN-L compared with nonpapillary ICC. Nuclear p53 immunostaining was detected in 30% of IPN-L as a whole and increased in tandem with the progression of IPN-L (P < 0.01). It is suggested that IPN-L forms a spectrum of biliary epithelial neoplasia with frequent gastrointestinal metaplasia, different from the usual nonpapillary ICC, and shows stepwise progression from the perspective of mucin profile, gastrointestinal metaplasia, and p53 nuclear expression.

Adult↗

PubMed2002

Resectable gastric cancer: operative mortality and survival analysis.

BACKGROUND: This study evaluated the survival outcome and determined the prognostic factors for gastric cancer patients who underwent gastric resection in the past 6 years. METHODS: Between 1994 and 2000, a total of 1,322 patients with gastric cancer who underwent gastric resection in our hospital comprised the study subjects. Their mean age was 61.1 (range, 14-92) years. There were 865 male and 457 female patients. Total gastrectomy was performed in 389 (29.4%) and distal gastrectomy in 933 patients. Curative resection was performed in 961, and palliative resection in 361 patients. A D2 or greater lymphadenectomy was required for curative resection. Patients received postoperative chemotherapy if they underwent palliative resection. RESULTS: Early or pT1 gastric cancer accounted for 17.7% and lymph node metastasis for 62.1% of all resected cases. The overall operative mortality and morbidity rates were 3.3% and 18.0%, respectively. The operative mortality for palliative total gastrectomy was particularly high (8.5%). The overall cumulative 5-year survival rate of all resected patients was 45.6%, and it was 57.0% after curative resection. Multivariate analysis revealed that lymph node metastasis, serosal invasion, peritoneal seeding, positive resection margin, liver metastasis, old age, tumor size, and lymphatic invasion were independent prognostic factors. CONCLUSION: The most important prognostic factors for survival were lymph node metastasis, serosal invasion, peritoneal seeding, positive resection margin, liver metastasis, old age, tumor size, and lymphatic invasion. The operative mortality and survival outcome of our gastric cancer patients after gastric resection compared favorably with those of other series in other countries.

Adolescent↗

PubMed2002

Ectopic pancreas with gastric outlet obstruction: report of two cases and literature review.

Ectopic pancreas is a rare entity and is usually an incidental finding in clinical practice. Most patients with an ectopic pancreas are asymptomatic, and if present, symptoms are non-specific according to the site of the lesion and different complications encountered. The most-common site is the stomach, accounting for 25%-38.2% of all patients. An asymptomatic ectopic pancreas is usually of no clinical importance, and there is no surgical indication in such a situation. However if there are complications caused by an ectopic pancreas, a variety of actions becomes necessary. We report 2 cases of ectopic pancreas with gastric outlet obstruction. The first case was a 41-year-old man who suffered from epigastric fullness and dyspepsia for 3 years. Endoscopic examination revealed a submucosal tumor measuring 2.5 cm in diameter in the prepyloric area. The second case was a 53-year-old man, who initially underwent a craniotomy to remove a pituitary adenoma, and laparotomy and duodenorrhaphy due to a perforated peptic ulcer. The postoperative course was not uneventful, and an upper gastrointestinal series showed a 2-cm intramural mass with a mucosal ulcer at the distal antrum. Both cases had symptoms and signs of gastric outlet obstruction, and both cases accepted subtotal gastrectomy with Billroth II anastomosis. A review of the literature revealed few cases of ectopic pancreas with gastric outlet obstruction. An ectopic pancreas must be considered in the differential diagnosis of gastric outlet obstruction.

Adult↗

PubMed2002

Benefits of palliative surgery for far-advanced gastric cancer.

BACKGROUND: The optimum strategy for palliative surgery in gastric cancer patients remains undetermined. METHODS: In total, 525 patients who had undergone palliative surgery between 1994 and 2000 were evaluated in terms of operative mortality, survival, and palliative effect. Patients were grouped according to the UICC's classification of residual tumors (R) after the operation: microscopic residual tumor (R1) (N = 104) and macroscopic residual tumor (R2) (N = 421). Gastric resection was performed in all R1 patients and in 257 of the R2 patients. Non-resection procedures were performed in 164 of the R2 patients, including gastrojejunostomies in 64, gastrostomies in 17, jejunostomies in 60, and laparotomies only in 23. RESULTS: The operative mortality did not significantly differ among R1 distal gastrectomies (4.5%), R2 distal gastrectomies (3.3%), and R1 total gastrectomies (2.9%) (p = 0.919). R2 total gastrectomies showed a particularly higher operative mortality (10.9%) than did the other resection procedures. The survival time and palliative duration were significantly longer in patients after palliative resection than after non-resection operations. Postoperative chemotherapy prolonged the survival time of patients after palliative surgery. CONCLUSION: R1 or R2 distal gastrectomies and R1 total gastrectomies have benefits of survival prolongation and symptomatic palliation. However, the use of a total gastrectomy in R2 patients must be selectively reserved for far-advanced cases, otherwise it should be replaced with less-invasive procedures to avoid a high operative mortality rate. Postoperative chemotherapy is useful for prolonging survival time.

Female↗

PubMedDate not supplied

Malignancy in choledochal cysts.

BACKGROUND/AIMS: Malignancy in choledochal cysts is a rare condition. This study presents our experience with this condition, with emphasis on the clinical presentation, management and outcome. METHODOLOGY: Subjects included 80 adults with choledochal cysts treated from January 1979 to December 1995. Of these patients, eight were found to have malignancy in the cyst and formed the basis of this study. RESULTS: Four patients had synchronous and four had metachronous carcinoma lesions arising in the choledochal cyst. The clinical presentations were: biliary tract infection in 5 patients, gastric outlet obstruction in two and right upper quadrant pain and body weight loss in one. Operations for bile duct malignancy included total excision in two patients, choledochotomy with T-tube drainage in two patients, gastrojejunostomy in two patients, percutaneous transhepatic biliary drainage and gastrojejunostomy in one patient and metastatic lymph node biopsy only in one. One patient died due to septic shock within 30 days of operation (operative mortality). Postoperative survival time ranged from 4 to 9 months with a mean of 6.2 months. One of these patients was still alive at the time of writing (7 months). CONCLUSIONS: The frequency of malignancy in the choledochal cysts was 10% in our series. Malignancy in the choledochal cyst should be highly suspected in patients with cholangitis symptoms, body weight loss and anemia. Prognosis in this disease entity is poor.

Adenocarcinoma↗

PubMedDate not supplied

Adenosquamous carcinoma of the liver: clinicopathologic features in 12 patients and review of the literature.

We present and compare the clinical features and outcomes of 12 patients with primary adenosquamous carcinoma (ADS-CCC) of the liver who underwent hepatic resection at our institution with those of 29 cases whose surgical treatment were reported in the literature. Peripheral cholangiocarcinoma (CCC) occurs less frequently than hepatocellular carcinoma in most parts of the world. Reports of surgically treated cases of ADS-CCC are seen only sporadically because of the low resectability rate, difficulty in making an early diagnosis, and the poor prognosis. Furthermore, a clinicopathological study based on a certain number of surgically treated cases is still lacking. From 1977 to 2001, 12 cases of hepatic ADS-CCC who underwent hepatic resection were reviewed in respect to clinical features and long-term results. The clinical features and outcomes of the 29 patients who underwent hepatic resection reported in the literature are also summarized for comparison. Of 228 surgically treated CCC patients in our institute, 12 (5.3%) were ADS-CCC. A male predominance was observed in our study and in the reported cases. In our series, prominent body weight loss and prominent relationship to hepatolithiasis were observed. The prognosis is dismal in patients with ADS-CCC who undergo hepatic resection; however, there was no significant difference in overall survival between the ADS-CCC and CCC groups. In our series, the 1-, 2-, and 3-year survival rates of ADS-CCC and CCC patients were 18.8%, 0%, and 0% and 32.8%, 14.8%, and 9.5%, respectively. ADS-CCC is prominently related to body weight loss and hepatolithiasis in our series compared with the reported cases. The prognosis of patients with ADS-CCC who undergo hepatic resection is dismal because of the specific biological behavior of ADS-CCC.

Adult↗

PubMedDate not supplied

Pancreatoduodenectomy for chronic pancreatitis with an inflammatory mass of pancreatic head: preoperative and postoperative functional assessment.

BACKGROUND/AIMS: In chronic pancreatitis patients with an inflammatory mass of the pancreatic head receiving pancreatoduodenectomy, postoperative quality of life, including nutritional status, has become important. Pre- and postoperative evaluation of pancreatic function is essential as an effective means of proper nutritional management of patients following pancreatoduodenectomy. METHODOLOGY: Fifteen patients with chronic pancreatitis and inflammatory mass of the pancreatic head who had received standard pancreatoduodenectomy were enrolled in this investigation. All patients had their biliary and pancreatic ducts reconstructed according to Child's arrangement. Furthermore, all patients had smooth postoperative courses and were assessed for the pancreatojejunostomy by magnetic resonance cholangiopancreatography at least a month after the initial operation. Exocrine pancreas functions were clinically assessed with various clinical items and two indirect pancreatic function tests: the fecal elastase test and the Bentiromide test. Endocrine pancreas functions were assessed using serum C-peptide level, HbA1 level and the need for hypoglycemic therapy. RESULTS: The results indicated that the pancreatojejunostomies of all patients are patent magnetic resonance cholangiopancreatography. All patients benefited from the selected symptom relief and various clinical parameters, including medications, dietary restrictions, body mass index and plasma albumin levels, experiencing pain relief and improved exocrine and endocrine functions. CONCLUSIONS: Pancreatic function did not deteriorate after pancreatoduodenectomy for chronic pancreatitis with an inflammatory mass of pancreatic head, while quality of life was significantly improved.

Activities of Daily Living↗

PubMedDate not supplied

Clinicopathological analysis of cystic duct carcinoma.

BACKGROUND/AIMS: Gallbladder carcinoma is the most common malignancy of the biliary tract, while the clinical features of cystic duct carcinoma remain unexplored. METHODOLOGY: Clinicopathological data of 8 cases of cystic duct carcinoma were retrospectively analyzed. RESULTS: The sample included 5 men and 3 women, with a mean age of 66+/-10 years (range, 49-79 years). Clinical manifestations included jaundice (n=6) and/or abdominal pain (n=6). Two of the patients presented as acute cholecystitis. Preoperative work-ups included ultrasonography (n=8), computed tomography (n=7), and endoscopic retrograde cholangiography (n=6)/or magnetic resonance cholangiography (n=2). Meanwhile, the preoperative diagnoses included cystic duct neoplasms (n=3), common hepatic duct neoplasms (n=4), and gallstones with acute cholecystitis (n=1). Radical procedures, including cholecystectomy, resection of extrahepatic bile duct, and lymph node dissection, were performed in six patients, while palliative cholecystectomy was performed in the remaining two. Notably, five of eight cases displayed lymph node metastasis along the hepaticoduodenal ligament. Median survival was 15 months (range, 6 to 26 months). Two cases with no lymph node metastasis were alive and disease free at 23 months and 26 months, respectively. CONCLUSIONS: Cystic duct carcinoma is rare. Neoplasm of the cystic duct should be suspected in patients presenting with cystic duct obstruction accompanied by distended nonfunctioning gallbladder without evidence of stone impaction in the cystic duct. The prognosis of cystic duct carcinoma remains dismal. However, for those patients in whom tumors are detected in early stage, curative radical resections possibly provide the chance of potential curable.

Aged↗

PubMedDate not supplied

Effects of dopexamine on regional blood flow and leukotriene production in multiple splanchnic sites in endotoxemic rats.

BACKGROUND/AIMS: This work examines the effects of lipopolysaccharide (LPS) on splanchnic blood flow and tests the potential effect of dopexamine in preventing LPS-induced decrease in splanchnic blood flow, also analyzing its influence on regional leukotriene production. METHODOLOGY: Male Sprague-Dawley rats were grouped and subjected to i.v. administration (time 0) of the lipopolysaccharide (10mg/kg) or vehicles with some rats receiving dopexamine (2microg/kg/min) (times 2 hrs to 6 hrs) infusion and compared. Microdialysis collection for analyzing leukotrienes concentrations and direct splanchnic laser Doppler flowmetry were started at times 0 to 6 hrs. RESULTS: Mean arterial pressure decreased markedly in LPS-injected animals and it decreased further gradually during observation period. A marked increase in mean arterial pressure was noted following concomitant administration of dopexamine with LPS. CONCLUSIONS: Impaired splanchnic blood flow in the stomach, jejunum and ileum after LPS injection has been attenuated following infusion of dopexamine. The changes in regional blood flow in the specific splanchnic area correlate closely with the systemic mean arterial pressure in this early sepsis model. Increased leukotriene production following LPS injection also has been attenuated in the stomach, jejunum and ileum following dopexamine infusion, and the increase of leukotriene production also correlates closely with systemic mean arterial pressure.

Animals↗