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PubMedDate not supplied

Incidence of bile leakage after three types of hepatic parenchymal transection.

BACKGROUND/AIMS: Bile leakage is a major morbidity associated with hepatectomies. No study has been performed correlating various methods of liver transection to incidences of bile leakage. METHODOLOGY: The 89 patients with hepatocellular carcinoma who received hepatectomy were classified into 3 groups according to the specific method of liver resection: cavitron ultrasonic surgical aspirator (CUSA), microwave tissue coagulation (MTC), and clamp crushing (CC). Comparisons in the incidences of bile leakage and length of hospital stay were made among these groups. RESULTS: The CC group showed a significantly lower incidence of bile leakage than the MTC group (3% vs. 27%, P = 0.03). In the median postoperative hospitalization length, the CC group demonstrated a significantly shorter period than that in the MTC group (25 vs. 35 days, P = 0.03). No significant differences were found for operation time, amount of blood loss or resected tumor size in the 3 groups. CONCLUSIONS: In view of the incidence of bile leakage, CC is a favorable technique for hepatectomy.

Adult↗
PubMed2003

[Comparison of three-dimensional gradient echo, turbo spin echo and steady-state gradient echo sequences in axial MRI examination of the cervical spine].

PURPOSE: The aim of this study was to assess the detectability of the structures that are affected by cervical spondylosis by different 3D MRI sequences and compare the image quality of those sequences. MATERIALS AND METHODS: Twenty healthy volunteers were examined using a 1.5 T MR unit. T2* weighted 3D-gradient echo sequence with magnetization transfer saturation pulse (3D-FFE-MTC), T2 weighted 3D turbo spin echo (TSE) sequence with and without spectral presaturation inversion recovery pulse (T2-3D-TSE/SPIR+ and T2-3D-TSE/SPIR-) and balanced-FFE (b-FFE) sequences were compared. Spinal cord signal-to-noise ratio (SNR), cerebrospinal fluid (CSF) SNR, and CSF-spinal cord contrast-to-noise ratio (CNR) were calculated quantitatively. The detectability of neural foramina, spinal nerve roots, uncinate process and ligamentum flava were graded on a 5-point scale (0: minimum, 4: maximum) qualitatively. The presence of the artifacts and overall image quality were graded on a 4-point scale (0: minimum, 3: maximum). RESULTS: Balanced-FFE sequence yielded the best results for each of three quantitative evaluation. In terms of qualitative evaluation, for the uncinate process T2-3D-TSE/SPIR- sequence was superior to the other three sequences (p < 0.01). For the ligamentum flava T2-3D-TSE/SPIR- and b-FFE sequences were superior to the other two (p < 0.01). For the neural foramina b-FFE yielded the lowest score (3), however the other three sequences were not significantly different (3.2-3.5) (p > 0.05). Artifacts were most commonly seen using 3D-FFE-MTC. In terms of overall image quality T2-3D-TSE/SPIR- yielded the highest score, followed by b-FFE. CONCLUSION: 3D-FFE-MTC sequence is frequently preferred for cervical spinal MRI studies. However our study yielded best scores for T2-3D-TSE/SPIR, followed by b-FFE in the quantitative and qualitative evaluation of the structures affected by cervical spondylosis.

Adolescent↗
PubMed1992

Biologic and cytogenetic characterization of three human medullary thyroid carcinomas in culture.

Neuroendocrine features and cytogenetic abnormalities of one continuous cell line (MTC-SK) and two long-term cultures (GER, STAH) derived from three sporadic cases of human medullary thyroid carcinomas (MTCs) were studied. Specific neuroendocrine markers (NSE, chromogranins, calcitonin, calcitonin gene-related peptide) were identified by electron microscopy and immunocytochemistry. In situ hybridochemistry and Northern blot analysis confirmed endocrine activity. Cytogenetic studies of the cell line MTC-SK revealed three consistent marker chromosomes, t(3;10), 11p+, and 22p+. Cells of long-term cultures GER and STAH exhibited a consistent translocation t(2;18), a trisomy 7, and two consistent marker chromosomes der3 and 5p+, respectively. Recently, we have isolated 12 stable clones of this MTC-SK cell line, which showed two different growth patterns. Quantitative measurement of mitotic activity flow cytometry and semiquantitative analysis of AgNOR-, Ki67-, and Cyclin/PCNA-(immuno)reactivity showed different DNA composition and duplication rates, indicating at least two subpopulations. Some of our clones developed a new consistent marker (i.e., an unbalanced translocation between mar11p+ and 1q). However, no correlations between chromosome findings, growth rate, and neuroendocrine markers were observed.

Carcinoma↗
PubMed2004

[The RET gene in multiple endocrine neoplasia type 2 (MEN 2)].

Multiple endocrine neoplasia types 2A and 2B(MEN 2A and MEN 2B), and familial medullary thyroid carcinoma(FMTC) are autosomal, dominantly inherited syndromes involving endocrine tumors. MEN 2A is characterized by medullary thyroid carcinoma(MTC), pheochromocytoma(pheo), and parathyroid hyperplasia; MEN 2B is characterized by MTC, pheo, mucosal ganglioneuroma, and marfanoid habitus. Affected individuals in FMTC families develop MTC without any other abnormalities. MEN 2A and MEN 2B and FMTC are caused by germline mutations in the RET proto-oncogene. To investigate the spectrum of RET mutations among Japanese patients, we analyzed the RET gene 118 patients with MEN 2 or FMTC.

Germ-Line Mutation↗
PubMed2003

[An experimental study on the effect of allitridin on inhibiting the expression of HCMV immediate-early antigens in vitro].

OBJECTIVE: To investigate the prophylactic, blocking and therapeutic effects of Allitridin on inhibiting HCMV proliferation by measuring the expression level of HCMV IEA in vitro and explore the mechanism of Allitridin anti-HCMVactivity. METHODS: The cytotocity of Allitridin was evaluated through MTT colorimetry and cell morphology. HCMV IEA levels were quantitatively detected by Flow Cytometry respectively under the following conditions: Allitridin was given before (pretreated for 24 h), during, or after viral inoculation in which serial doses (maximum tolerant concentration, MTC for human embryo lung cells, HEL) of Allitridin was used to treat HCMV infected HLE cells for different durations (24, 48, 72, 96 h) after viral infection. RESULT: The MTC of Allitridin was 9.60 mg x L(-1). Allitridin remarkably inhibited the expression of HCMV IEA in vitro. Within MTC, the inhibitory rate had a significant correlation with its dosage (r = 0.96). At the time of IEA highest expression (72 h after infection), inhibitory effect was the greatest (inhibitory rate: 89.3%). With pretreatment of Allitridin, the inhibitory rate was 28.6%. When Allitridin was used together with HCMV inoculation, IEA inhibitory rate was only 10.3%. CONCLUSION: Allitridin can inhibit HCMV, IEA expression in vitro remarkably which is probably one of the major mechanisms of Allitridin anti-HCMV activity because IEAs are the very important regulatory factors for the expression of all HCMV genes. Its therapeutic effect is the best at the peak stage of IE1 gene expression (72 h after infection) but it has low prophylactic and little blocking effect.

Allyl Compounds↗
PubMed2004

[Partial nephrectomy using microwave tissue coagulator--application for laparoscopic operation].

We report our clinical findings on 12 tumors (11 patients) successfully resected by partial nephrectomy with a microwave tissue coagulator (MTC) without renal pedicle clamping, including laparoscopic operation in 4 patients. All patients presented with a renal tumor detected incidentally by ultrasonography or computed tomography. The mean size of renal tumor was 1.9 (range 0.8-3.4) cm. Pathological diagnosis was renal cell carcinoma in 9 tumors and hemorrhagic cyst in 3 tumors. Mean operative time was 249 minutes. Mean blood loss was 183 ml in cases with a laparoscopic operation, that was statistically less than 486 ml in cases with an open operation (p<0.05), and 376 ml in all cases. There was no significant change in the creatinine clearance of cases with laparoscopic operation, compared with that of cases with an open operation. There were no other serious complications postoperatively. These findings suggested that partial nephrectomy with the MTC can be safely and successfully carried out while sparing renal function. Moreover, partial nephrectomy with the MTC for a laparoscopic operation may provide these patients with more benefits.

Adult↗
PubMedDate not supplied

Clinical outcome of 214 liver resections using microwave tissue coagulation.

BACKGROUND/AIMS: Liver resection is the most effective form of treatment for patients with hepatocellular carcinoma. The use of a microwave tissue coagulator has been reported to enable limited liver resections for the patients with poor hepatic reserve. Herein, we report the clinical outcome of 214 patients with HCC who underwent non-anatomical liver resection using MTC in accordance with the tumor size. METHODOLOGY: A consecutive series of 214 patients who underwent liver resections using MTC were observed over a 10-year study period. The clinical characteristics of patients were evaluated. The operative mortality and morbidity, overall patient survival and disease-free survival were calculated. RESULTS: Seventy-two percent of patients suffered from type C hepatitis and 47% of patients had pathologically proven liver cirrhosis. The overall patient survival rates were 91, 72, and 58% at 1, 3 and 5 years, respectively. Disease-free survival rates were 74, 46, and 28% at 1, 3 and 5 years, respectively. Postoperative morbidity was 36% and hospital mortality was 2.8%. Complications in most patients were well controlled. CONCLUSIONS: Non-anatomical liver resections using MTC, in accordance with tumor sizes, can be achieved safely with acceptable results and without the need to use special techniques.

Aged↗
PubMed2005

A case of tuberculous pyomyositis that caused a recurrent soft tissue lesion localized at the forearm.

We present the case of a 20-year-old male who had a non-traumatic soft tissue lesion (4 x 3 cm) with recurrent discharge at his right posteromedial antebrachial muscles; the patient underwent surgery twice, and antibiotic therapy was administered, but no cure was achieved with these treatments. The patient underwent surgery at our medical center. There was no history of pulmonary, gastrointestinal, or genitourinary tuberculosis (TB). Due to suspected pulmonary, genitourinary, and gastrointestinal TB, radiography and computed tomography scans were performed, and these studies disclosed no evidence of a primary origin. The erythrocyte sedimentation rate and the results of purified protein derivate testing were normal. We also detected submandibular lymphadenopathy (LAP) (2 x 3 cm) localized at a submandibular site in our patient 4 months after his first visit to our clinic. Smears were stained with Ehrlich Ziehl Neelsen (EZN) stain and culture were grown for Mycobacterium tuberculosis complex (MTC); the samples used for these assays had been obtained by incisional biopsy of the forearm lesion and by aspiration of the submandibular lymph node, and they were found to be MTC-positive. Then, a culture for MTC, derived from an induced sputum sample, was found to be positive, despite the negative results obtained with a sputum smear subjected to EZN staining. According to these results, the primary focus of the tuberculous pyomyositis and the submandibular LAP was the lungs. The lesion and submandibular LAP were both treated successfully by the administration of antituberculous chemotherapy.

Adult↗
PubMedDate not supplied

Calcitonin measurements for early detection of medullary thyroid carcinoma or its premalignant conditions in Hashimoto's thyroiditis.

The measurement of basal serum calcitonin (CT) in patients with evidence of Hashimoto's thyroiditis (HT) has been proposed in a recent study demonstrating an increased prevalence of elevated basal and stimulated CT. The aim of this study was to evaluate the frequency and relevance of elevated CT levels in HT. The basal sera CT were measured in 568 consecutive HT patients using a chemiluminescent immuno-assay. Whenever the serum CT was > 10 pg/ml, a pentagastrin (PG) stimulation test was performed. Two patients with abnormal/pathological PG tests were identified. Total thyroidectomy and lymph node dissection revealed for the first patient medullary thyroid carcinoma (MTC) and for the second patient C cell hyperplasia (CCH), together with papillary thyroid carcinoma. Our data showed a low prevalence of MTC and its premalignant condition CCH in HT patients; nevertheless, the patient with MTC presented lymph node metastasis. The fact that both cases presented without evidence of nodular thyroid disease highlights the persistent diagnostic dilemma of CT screening programs.

Adolescent↗
PubMed2006

[Pathophysiology and management of perioperative hypothermia].

The paper is a review of pathophysiology and management of perioperative hypothermia. The advanced methods of rewarming, such as passive and active: external and core used in clinic allow for efficient management ant prophylactics of hypothermia. Thermotherapy with use of infrared ceiling heaters CTS and mobile MTC as well as Infutherm system applying by authors are desirable and even indispensable in contemporary equipment of surgery clinics, cardiovascular surgery clinics and burn centers. The ideal rewarming method should be safe and enable fast, reliable and predictable warming or rewarming. The clinical parameter to determine the efficacy of rewarming is the change of core temperature. There is no doubt that active warming with forced-air warmers (Warm Touch 5700 and Bair Hugger 500) or radiative heaters (IR-A:Hydrosun 500, IR-C radiation: CTC X, MTC) is more effective than use of standard, passive insulation hospital blankets or convectional heaters. Actually the forced-air warmers are counted to be more useful in cardiovascular surgery hypothermia management, because of fast rate core temperature rise and faster rise in mean skin temperature compared to the control group. CTC X and MTC Aragona radiative heaters are useful in burn management being the most effective when the distance of heater from the patient body is less than 80 cm. The observation of 60 consecutive extensive burns leads to conclusion that long-lasting dressings in burn patients when the whole body is not covered and protected, can be performed safely only in conditions excluding heat losses and core temperature drop. While the cold intravenous fluids may significantly contribute to the temperature drop depending on the volume infused, the use of fluids warming systems as well as external heat application is absolutely indicated to improve the heat balance of the patient body.

Burns↗
PubMed2006

Introduction of an in-house PCR for routine identification of M. tuberculosis in a low-income country.

SETTING: National Tuberculosis (TB) Treatment Centre, Makerere University Medical School and Joint Clinical Research Centre, Kampala, Uganda. OBJECTIVE: To evaluate the introduction of a polymerase chain reaction (PCR) based assay for identification of the Mycobacterium tuberculosis complex (MTC) into routine practice. DESIGN: Routine diagnostic specimens were processed and inoculated into Bactec 12B vials and monitored daily. At a growth index (GI) > or =10, 0.5 ml of the 12B broth was removed and assayed with PCR. The same 12B vial was analyzed using the Bactec NAP method at GI > or =500. Vials at various levels of GI were included. Recurrent cost and time required to perform PCR and NAP were compared. RESULTS: Initially, 71 specimens were analyzed; of these, 68 were NAP-positive while 69 were PCR-positive for MTC. PCR resulted in a 75% reduction in cost for a single test compared with Bactec NAP. PCR has been successfully incorporated into routine practice, and 432 samples have been analyzed. In addition, isolates from solid media were also well identified by PCR. With PCR, more samples can be analyzed at a time, it is faster and is less labor intensive. CONCLUSION: PCR is a reliable and cheaper alternative for the identification of MTC.

Costs and Cost Analysis↗
PubMedDate not supplied

[Useful and limits of the biochemical markers for the diagnosis of thyroid carcinoma].

A series of biochemical parameters are useful for the diagnosis and follow-up of differentiated thyroid carcinomas. The measurement of serum thyroglobulin (Tg) is considered for the post-surgical/radioiodine follow-up of papillary/follicular carcinomas. Other than in basal conditions, the importance of Tg levels during TSH stimulation is underlined, either by discontinuation of L-T4 therapy or by recombinant human TSH test. The finding of undetectable Tg levels during TSH stimulation is highly correlated with clinical remission; otherwise, peak Tg levels > 1-2 ng/ml can be suggestive of recurrence/persistence of the disease. The accuracy of Tg measurements for the detection of metastases seems to be higher when compared to 131-1 whole-body scan. The evaluation of basal serum calcitonin levels is recommended for the screening of medullary thyroid carcinoma (MTC). High basal levels suggest the presence of a tumor but a calcitonin increase can be observed also in parafollicular C cell hyperplasia (CCH) and other extra-thyroidal conditions. The pentagastrin test can by pass this obstacle as the calcitonin response seems to be typical of pathological thyroid C cells. The cut-off value of calcitonin response between patients with MTC and CCH remains to be established; the latter condition, however, being considered by some authors as pre-cancerous. After thyroid surgery the measurement of calcitonin constitutes a valid tool for the detection of cure and/or recurrence of the disease. The screening by means of RET oncogene analysis is also described for patients with MTC with Multiple Endocrine Neoplasia (MEN) type 2 syndrome.

Calcitonin↗
PubMed2006

[Thymic basaloid carcinoma].

We report a case of thymic basaloid carcinoma combined with multilocular thymic cyst (MTC). A 72-year-old man was found to have an abnormal shadow on a chest X-ray without pny symptoms. Chest computed tomography (CT) showed a smooth edged anterior mediastinum tumor projecting to the left lung field. After preoperative chemotherapy by irinotecan hydrochloride (CPT-11) and radiotherapy of 40 Gy, chest CT showed a large part of the tumor projecting to the left lung field had changed to a cyst. After the pericardium and upper lobe of the left lung to which the MTC adhered was partially resected via left thoracotomy, the tumor was resected with innominate vein via median sternotomy. The operation was followed by CPT-11 chemotherapy and radiotherapy of 20 Gy. The tumor was thymic basaloid carcinoma 3 x 2.5 x 2 cm in size combined with MTC 8.2 cm maximum in diameter. As he died of another disease 6 months after excision, sufficient postoperative observation was not obtained. Thymic basaloid carcinoma is rare and only 14 cases including the present case have been reported.

Aged↗
PubMedDate not supplied

Peritoneal fluid kinetics during CAPD measured with intraperitoneal dextran 70.

Simultaneous measurement of transcapillary ultrafiltration (TCUF), lymphatic absorption rate (LAR), and intraperitoneal volume (IPV) was performed by means of intraperitoneally-administered polydisperse dextran 70 in nine CAPD patients during a 4 hr dialysis dwell (glucose 1.36%). The recovery of dextran was 88 +/- 1%. LAR, calculated as the amount of dextran lost, divided by the dialysate dextran concentration, was 1.30 +/- 0.12 ml/min. The time course of TCUF could be described as a hyperbola. Therefore, the application of the Lineweaver-Burke plot made it possible to calculate TCUFmax (median 641 mL) and its half-time (t50: median 211 min). delta IPV4h, calculated as the difference between the Lineweaver-Burke adjusted TCUF4h and LA4h, was correlated with measured delta IPV4h after drainage (r = 0.89, p less than 0.001). The latter was dependent upon LAR (r = -0.71) and effective peritoneal surface area, as represented by mass transfer area coefficients (MTC) of low molecular weight solutes (creatinine r = -0.76, glucose r = -0.81). High MTC values of these solutes were exponentially related to a short t50 (creatinine r = -0.76). LAR was correlated with the MTC of intraperitoneally administered inulin (r = 0.83). Dextran 70 had no measurable effect on solute transport. It is concluded that dextran 70 is a useful marker for the measurement of peritoneal fluid kinetics, even during CAPD with a low glucose concentration in the dialysate.

Adult↗
PubMed1991

[Analysis of factors relating to early repairment of the surgical margin following liver resection--factors relating to duration of hospital stay].

To analyze relating factors to early repairment of the surgical margin of the remnant liver we measured plasma fibronectin (FN), coagulation factor XIII (XIII), polymorphonuclear leukocyte elastase (PMNE), platelet counts (Plt), prothrombin time (PT%) before and at the first, third, 7th and 14th days after liver resection in 25 patients. Changes in these factors (1) were compared with their clinical status, such as liver cirrhosis, high fever, abscess formation, duration of drainage and use of microwave tissue coagulator (MTC) (2). The multivariate analysis about the factors influencing the duration of hospital stay (3) were carried out. (1) In the all cases FN, XIII (14th), PT%, Plt decreased and PMNE increased significantly versus pre-operative data. There were significant correlations between FN and XIII, FN and PMNE. (2) In the cirrhotic group FN, XIII, PT% and Plt were significantly lower than those of non cirrhotic group. In the abscess formation group PT% was significantly lower than the no abscess formation group. In the MTC group XIII, PT% and Plt were significantly lower than those of the no-MTC group. In conclusion, FN, XIII, Plt and PT% in the cirrhotic, high fever, abscess formation or longer drainage group were in lower levels compared with the each control group. (3) By the multivariate analyses, abscess formation, high fever and liver cirrhosis were the most influencing factors for the duration of hospital stay.

Adult↗
PubMed1990

Measurement of the peritoneal platelet activity through the effluent betathromboglobulin levels in CAPD patients.

Platelet activity is closely related to endothelium and could release factors able to influence capillary wall and surrounding tissues. BTG is a protein included in platelet vesicles and a measure of its activation. Some alterations of peritoneum could be partially related to platelet activity. BTG peritoneal transport from blood is weight limited (36000) and consequently, high levels in effluent should represent local production. The aim of this study has been to characterize peritoneal effluent BTG.12 patients, on CAPD 27 +/- 15 mon., 5 diabetics were studied. Previous peritonitis was 0.3 +/- 0.4 e/year. Determinations performed: Plasma (P) (BTG, T. protein, albumin, platelet count, Hcto and Fibrinogen) and Effluent (EF) (BTG, T. protein, Fibrinopeptide A, FDP, Fibrinolytic act., Fibrinogen, Plasminogen and Mitogenic induced capacity on Swiss 3T3 mice fibroblasts). To evaluate peritoneal function we used mass transfer coefficients (MTC) and net UF.R.:BTG levels: P 118 +/- 14 EF 34 +/- 14 ng/ml P/EF (%) 31 +/- 13 (6-54%). Regression analysis: P BTG did not show significant relationship with any of the studied parameters. EF BTG showed direct significant correlation (p less than 0.05) with Creatinine-MTC (r: 0.81) and EF Fibrinogen (0.68) and in the limit of significance with EF T. prot (0.57) and EF Mitogenicity (0.62). P/EF BTF showed significant correlation with creatinine-MTC (0.77). The analysis of these values grouping patients showed: diabetes has no influence on BTG values, hypertensive patients show higher P/EF BTG values than normotensive (39 +/- 9 vs 23 +/- 11%, p less than 0.05) and no influences of peritonitis or CAPD period were found.(ABSTRACT TRUNCATED AT 250 WORDS)

Biological Transport↗
PubMed1990

Combined treatment of rat rhabdomyosarcoma R1H with mitomycin C and X-rays.

The effects of mitomycin C (MTC) alone and in combination with radiation on R1H rhabdomyosarcomas in WAG/Rij rats were studied. Growth delay was determined from tumor volume growth curves and proportion of tumor and host cells from flow cytometry measurements. Only minor growth delays were obtained with MTC at doses near the toxic level while irradiation applied in three fractions of 10 Gy in three weeks yielded growth delays of 27, 44, and 51 days measured at volumes of 2, 5, and 10 cm3, respectively. The combination of 1 micrograms/kg b.w. MTC and 10 Gy irradiation given in three weekly fractions resulted in 21, 28, and 29 days growth delay for the above tumor volumes. The lower effect of combination as compared to irradiation alone is discussed with the flow cytometry data. These data show that early after start of treatment the proportion of tumor cells remains constant in contrast to radiation alone where the fraction of tumor cells decreases because of influx of granulocytes and macrophages into the tumor. In contrast to the reduced effect on tumors the combination treatment was considerably more toxic for the animals than the single treatments.

Alkylating Agents↗
PubMed1990

Monoclonal immunoradiometric assay of calcitonin improves investigation of familial medullary thyroid carcinoma.

Calcitonin (CT) assay is essential for recognizing medullary thyroid carcinoma (MTC), particularly occult familial MTC. In previous radioimmunoassays of calcitonin, polyclonal antibodies were used. Here we evaluate a new two-site immunoradiometric assay (IRMA) of calcitonin based on use of monoclonal antibodies. We assayed samples from healthy subjects, patients with renal failure, and subjects from families affected by MTC. Basal values for healthy subjects were all less than 10 ng/L. Renal failure is associated with increased basal CT. The CT peak under pentagastrin stimulation in healthy patients was less than 30 ng/L. In familial screening, basal values greater than 10 ng/L or peak values greater than 30 ng/L correspond to subjects with histologically confirmed MCT or micro-MCT. Polyclonal RIA performed in the same subjects failed to detect the moderate increase of CT that IRMA demonstrated. Preliminary results indicate that this new method may allow earlier detection of CT increase and thus improved diagnosis of MCT, particularly in familial screening. Monitoring surgical patients could also be improved by this new assay.

Adolescent↗