Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis.

Aims: The activity of the sympathetic nervous system (SNS) is crucial at an early stage in the development of an inflammatory reaction. A study of metabolic events globally and locally in the early phase of acute pancreatitis (AP), implying hampered SNS activity, is lacking. We hypothesized that thoracic epidural anaesthesia (TEA) modulates the inflammatory response and alleviates the severity of AP in pigs.

Surface microdialysis on small bowel serosa in monitoring of ischemia.

Background: Ischemic injury of an organ causes metabolic change from aerobic to anaerobic metabolism. It has been shown in experimental studies on the heart and liver that such conversion may be detected by conventional microdialysis probes placed intra-parenchymatously, as well as on organ surfaces, by assaying lactate, pyruvate, glucose, and glycerol in dialysate. We developed a microdialysis probe (S-μD) intended for use solely on organ surfaces.

Outcome of microdialysis sampling on liver surface and parenchyma.

Background: To investigate whether surface microdialysis (μD) sampling in probes covered by a plastic film, as compared to noncovered and to intraparenchymatous probes, would increase the technique's sensitivity for pathophysiologic events occurring in a liver ischemia-reperfusion model. Placement of μD probes in the parenchyma of an organ, as is conventionally done, may cause adverse effects, e.g.

Fast-track program for liver resection--factors prolonging length of stay.

Background/aims: Fast-track programs involving multi-modal measures to enhance recovery after surgery, reduce morbidity and decrease hospital length of stay (LOS) are used for different major surgical procedures. For liver resections, factors influencing LOS within a fast-track program have been studied only to a limited extent, which was the aim of the present study.

Methodology: The present study comprises the first 64 patients included in a fast-track program for liver resections introduced in March 2012.

Microdialysis in early detection of temporary pancreatic ischemia in a porcine model.

Background: Ischemic injury to the pancreas occurs in various clinical conditions. A method for online monitoring of pathophysiological events in pancreatic parenchyma is missing.

Aims: To assess the timing of microdialysis (MD) technique response on temporary changes in pancreatic perfusion, and to evaluate the relationship between MD data and systemic markers of anaerobic metabolism and inflammation.

Surface microdialysis sampling: a new approach described in a liver ischaemia model.

We recently have shown that samples from microdialysis (MD) probes placed on the surface of the heart reflect metabolic events in the myocardium. This new interesting observation challenges us to consider whether surface application of MD applies to other parenchymatous organs and their surfaces. In 13 anesthetized pigs, transient liver ischaemia was achieved by occlusion of arterial and venous inflow to the liver.

Iatrogenic bile duct injury--a cost analysis.

Introduction: Iatrogenic bile duct lesions following cholecystectomy represent a feared complication occurring in up to 0.9%. The aim of the present study was to estimate the total cost associated with both minor and major bile duct injuries.

Pancreaticojejunostomy: a valid operation in chronic pancreatitis?

Objective: Patients with chronic pancreatitis and intractable pain may be candidates for surgical intervention and various types of surgery have been described over time. The objective of this study was to describe long-term outcome following pancreaticojejunostomy in patients with chronic pancreatitis.

Material And Methods: Thirty-two patients with chronic pancreatitis underwent lateral pancreatiocojejunostomy and were then followed-up for 5 years.

Accurate measurement of anhydride fluorhydric acid concentration in controlled gaseous flow with STW sensors.

This paper presents theoretical and experimental developments for the implementation of surface acoustic waves (SAW) sensors able to detect small concentrations of anhydride fluorhydric (HF) acid in air. Solutions based on the use of surface transverse waves (STW) on quartz (YXlt)/36 degrees/90 degrees have been analyzed to evaluate their sensitivity to HF. Devices have been tested first in a NH4F solution to evaluate the kinetics of the reaction.

133Xe clearance estimates the effect of vasopressin on peritoneal blood flow in rats.

Background/aims: When assessing the peritoneal microcirculation with invasive methods, interference with the mechanisms of vaso-regulation may occur. The 133Xe clearance technique renders the possibility, by minimal invasiveness, to estimate the influence of a vasoactive agent on the peritoneal microcirculation.

Methodology: Ten to 15MBq of 133Xe were injected in the abdominal cavity in thirty-eight Wistar-FU (W-FU) rats and 35 Lister-Hooded (LH) rats.

Unique antitumour effects of L-2,4 diaminobutyric acid on cultured hepatoma cells.

A single hepatoma cell line was grown in vitro and incubated with L-2,4 diaminobutyric acid (DAB), a non-metabolizable amino acid, under various conditions. The tumour cells were irreversibly damaged by incubation for 8 hours with 8 mmol/L of DAB. The tumour cell-destroying effect of DAB was dose- and time-dependent with no effect at a DAB concentration of 1.

A comparison between hepatic artery ligation and portal 5-Fu infusion versus 5-Fu intra arterial infusion for colorectal liver metastases.

Aim: A prospective randomized study was executed comparing two regimens of regional therapy for liver metastases from colorectal cancer.

Methods: Eighteen patients were allocated to hepatic artery occlusion for 16 h followed by intraportal 5-fluorouracil (5-Fu) infusion (1000 mg/m(2)) for 5 days every sixth week (HAO). Twenty-one patients received intra-arterial 5-Fu infusion+Leucovorin (100 mg) i.

Treatment of non-resectable pancreatic cancer with intraperitoneal 5-FU and leucovorin IV.

Aim: To explore the feasibility of intraperitoneal (IP) 5-fluorouracil (5-FU) and (IV) leucovorin for patients with advanced pancreatic carcinoma.

Materials And Method: Thirty patients (11 men), median age 65 (range 36-74 years), with a non-resectable pancreatic carcinoma in stage III (n=2) and IV (n=28) were treated with IP 5-FU 750-1000 mg/m(2)and leucovorin IV 100 mg/m(2)for 2 days every 3rd week. Tumour effect was analysed with repeated computed tomography (CT) scans, performance status was estimated with Karnofsky's index (KI) and morphine consumption, and toxicity assessed using World Health Organization (WHO) criteria.

Antitumour effect of L-2,4 diaminobutyric acid on a hepatoma cell line.

Pharmacological treatment of malignant disease is often insufficient highlighting the need for more efficient treatment based on new principles. We have observed that the amino acid analogue diaminobutyric acid (DAB), accumulates in malignant cells apparently without saturation kinetics, leading to hyperosmosis and subsequently to cell lysis. In the first in vitro part of the present study hepatoma cells were incubated with DAB in miniwells in the presence or absence of physiological amino acids.

Diagnostic decision support in suspected acute appendicitis: validation of a simplified scoring system.

Objective: To validate a simplified scoring system as an aid to the diagnosis of acute appendicitis.

Design: Open prospective study.

Setting: County district hospital, and university hospital, Sweden.

The influence of zymosan and indomethacin on liver and kidney tumor growth. An experimental study in rats.

Zymosan, a non-specific macrophage-stimulating agent, modifies favourably tumour growth in the liver but has minor effect on renal tumours. The mechanism accounting for variation is still to be clarified. The effect of zymosan on liver cancer may be mediated by the macrophage-monocyte system.

Carboxylic ester hydrolase and amylase in ischemic pancreatitis in the guinea pig.

The observation that an elevated level of pancreatic carboxylic ester hydrolase (CEH) in serum is a more sensitive and specific marker of acute pancreatitis than is elevated serum amylase activity prompted us to explore whether these findings could be confirmed in an experimental model and, if so, to find the explanation behind this difference. We therefore developed a model for ischemic pancreatitis in the guinea pig and a sandwich enzyme-linked immunosorbent assay for determination of CEH in this species. There was a strong correlation between duration of ischemia and severity of pancreatic inflammation and between severity of inflammation and serum CEH level.

Diagnosis of traumatic pancreatic duct rupture by on-table endoscopic retrograde pancreatography.

We report on two children who sustained blunt abdominal trauma with pancreatic duct rupture diagnosed by ERP (endoscopic retrograde pancreatography). Examinations were done with patients on the operating table anesthetized for laparotomy (on-table ERP). In both patients, duct laceration remained undiagnosed by computerized tomography and ultrasonography.

The value of routine biochemical tests in discriminating between malignant and benign pancreatic tumours.

The probability that routine hematological laboratory tests of liver and pancreatic function can discriminate between malignant and benign pancreatic tumours, incidentally detected during operation, was investigated. The records of 53 patients with a verified diagnosis of pancreatic carcinoma and 19 patients with chronic pancreatitis were reviewed with regard to preoperative total bilirubin, direct reacting bilirubin, alkaline phosphatase, glutamyltranspeptidase, aminotransferases, lactic dehydrogenase and amylase. Multivariate and discriminant analysis were performed to calculate the predictive value for cancer, using SYSTAT statistical package in a Macintosh II computer.