TGFbeta family members are key mediators in the induction of myofibroblast phenotype of human adipose tissue progenitor cells by macrophages.

Objective: The present study was undertaken to characterize the remodeling phenotype of human adipose tissue (AT) macrophages (ATM) and to analyze their paracrine effects on AT progenitor cells.

Research Design And Methods: The phenotype of ATM, immunoselected from subcutaneous (Sc) AT originating from subjects with wide range of body mass index and from paired biopsies of Sc and omental (Om) AT from obese subjects, was studied by gene expression analysis in the native and activated states. The paracrine effects of ScATM on the phenotype of human ScAT progenitor cells (CD34(+)CD31(-)) were investigated.

Adipose tissue endothelial cells from obese human subjects: differences among depots in angiogenic, metabolic, and inflammatory gene expression and cellular senescence.

Objective: Regional differences among adipose depots in capacities for fatty acid storage, susceptibility to hypoxia, and inflammation likely contribute to complications of obesity. We defined the properties of endothelial cells (EC) isolated from subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) biopsied in parallel from obese subjects.

Research Design And Methods: The architecture and properties of the fat tissue capillary network were analyzed using immunohistochemistry and flow cytometry.

Interplay between human adipocytes and T lymphocytes in obesity: CCL20 as an adipochemokine and T lymphocytes as lipogenic modulators.

Objective: Adipose tissue (AT) plays a major role in the low-grade inflammatory state associated with obesity. The aim of the present study was to characterize the human AT lymphocytes (ATLs) and to analyze their interactions with adipocytes.

Methods And Results: Human ATL subsets were characterized by flow cytometry in subcutaneous ATs from 92 individuals with body mass index (BMI) ranging from 19 to 43 kg/m(2) and in paired biopsies of subcutaneous and visceral AT from 45 class II/III obese patients.

Fecal continence following partial resection of the anal canal in distal rectal cancer: long-term results after coloanal anastomoses.

Background: The aim of the study was to assess the influence of partial excision of the superior portion of the anal canal (AC) when necessary for tumor margin clearance in distal rectal cancer on fecal continence after coloanal anastomoses.

Methods: Between 1977 to 1993, 209 patients with middle and lower third rectal cancers underwent complete rectal excision and coloanal anastomoses. For very low tumors, located at or below 5 cm from the anal verge (AV), varying portions of the superior segment of the AC were excised for tumor margin clearance.

Coloanal anastomosis for distal third rectal cancer: prospective study of oncologic results.

Purpose: Jeopardizing cure and risking high local recurrence have served as arguments against sphincter-saving resection for patients with distal third rectal cancer. This prospective study examines and compares the local recurrence and survival rates in patients with distal third rectal cancer treated by either coloanal anastomosis or abdominoperineal resection.

Methods: Between 1977 and 1993, 174 patients underwent coloanal anastomoses and 38 patients underwent abdominoperineal resection.

Continent perineal colostomy after abdominoperineal resection: outcome after 63 cases.

Purpose: For patients with distal rectal or anal tumors, quality of life can be compromised after abdominoperineal resection and iliac colostomy. This study examines our experience with a continent perineal colostomy constructed from a colonic smooth-muscle cuff wrap.

Methods: Between 1987 and 1996, 63 patients with distal rectal or anal tumors (0-5 cm from the anal verge) underwent abdominoperineal resection and construction of a colonic smooth-muscle cuff at the site of the perineal colostomy.

Prospective, randomized study comparing clinical results between small and large colonic J-pouch following coloanal anastomosis.

Purpose: Improved functional results can be obtained by construction of a colonic J-pouch after coloanal anastomosis. Variability in pouch size following coloanal anastomosis is prevalent in current literature. In this study, the authors compare clinical bowel function after complete rectal excision with coloanal anastomosis for patients with rectal carcinoma using either a small 6-cm or a large 10-cm colonic J-pouch anastomosis.

Late clinical outcome in a randomized prospective comparison of colonic J pouch and straight coloanal anastomosis.

Background: Functional outcome after rectal excision with coloanal anastomosis is improved by construction of a colonic J pouch. Present prospective randomized studies lack follow-up beyond 1 year. The aim of this study was to assess the clinical outcome at both short- and long-term follow-up.

[Local treatment of "small cancers" of the rectum: excision is preferable to electrocoagulation].

From 1973 to 1990, 50 patients with a "small cancer" of the rectum were treated locally either by electrocoagulation or by local excision using an electrical scalpel. 20 patients were treated by electrocoagulation. Their 5-year actuarial survival was 78.

[Preservation of sexual innervation in the surgery of rectal cancers].

Eighteen out of 55 rectal resections for cancer included preservation of sexual innervation, which was complete in 17 cases and partial in one case. Fourteen patients were evaluated by questionnaire one year after resection; 10 out of 14 (71.4%) did not report any sexual disorders.

Epstein-Barr virus latent and replicative gene expression in gastric carcinoma.

Recent reports demonstrated the presence of Epstein-Barr virus (EBV) in about 10% of gastric carcinoma cases, particularly in Asian populations. We carried out a retrospective assessment of the detection rate of EBV gene products in 59 cases of gastric carcinoma of various histological subtypes. In situ hybridization using non-isotopic EBER and BHLF1 oligoprobes, and immunohistochemistry using antibodies to latent membrane protein 1 (LMP-1) were applied to paraffin-embedded sections.

[Thoughts on the role of celiosurgery in patients with major obesity].

Is coelioscopic surgery an interesting way in massive obese patients? This is well established concerning the post-operative benefit, with a decreased risk of pulmonary and thrombo-embolic complications. But technical difficulties are not well described, whereas we encountered some: incomplete retraction of intra-abdominal organs, weakness and hemorrhagic tendency of the tissues, and most of all an insufficient pneumoperitoneum in all patients preventing sometime the surgical procedure. We analyse those obstacles to propose solutions when the laparoscopic way seems better regarding to the post-operative risk.

[Voluminous inguinal hernias can also be treated under local anesthesia].

In patients with a large inguinal hernia, surgeons are usually reluctant to use a local anesthesia as described in the Shouldice technique. The purpose of this study was to appreciate the efficiency of such a technique. Routine local anesthesia used 200 cc of 0.

[Local antibiotic prophylaxis for repair of inguinal hernia].

A controlled randomized trial was carried out in 324 patients with inguinal hernia. Efficacy was evaluated of a single injection of cefamandole (n = 162) administered at operative site during local anesthesia, using an untreated group as control (n = 162), as prophylaxis against post-operative local infection. Seven patients in the control group developed abscesses at the operative site after discharge, 6 of the 7 during one-month follow up, compared with none in the treated group (n = 0.

Hepatectomy with initial suprahilar control of intrahepatic portal pedicles.

In 1985 Couinaud described an original technique for left hepatectomy. This technique is based on initial control of the left intrahepatic portal pedicle after wedge incision of the hepatic capsule is made and the hilar plate is lowered before the hepatic parenchyma is opened. The vascular and biliary pedicular elements are dissected concomitantly at a point where they are protected by and contained within a sheath emanating from the hepatic capsule.

Local antibiotic prophylaxis in inguinal hernia repair.

We compared the effects of single dose (750 milligrams) prophylactic cefamandole delivered directly into the operative wound with local anesthesia (n = 162) with a control group (no antibiotics) (n = 162) in a randomized trial. No adverse effects were observed. There were seven wound abscesses in the untreated group compared with none in the group receiving antibiotic prophylaxis (p = 0.

Pre-operative radiotherapy as adjuvant treatment in rectal cancer.

From January, 1975 to December, 1987, 241 patients with rectal cancer underwent pre-operative irradiation and surgical resection. The radiation was delivered with 25 MeV photons, 5 days per week by 2.4 grays fractions up to a total dose of 36 grays.

[Cancer of the rectum: distal intramural spread is correlated with lymph node involvement].

Cancers of the rectum are only rarely associated with distal intraparietal microscopic extension situated below the apparent pole of the tumour. When such extension exists, it may be either limited to several millimetres and is generally continuous with the tumour, or it may be extensive and composed of tumour lesions separated from the principal lesion by healthy tissue. On 119 rectal resection specimens for cancer, distal intraparietal extension was found to be significantly correlated with the degree and multiplicity of lymph node involvement.

Distal intramural spread of carcinoma of the rectum correlated with lymph nodal involvement.

One hundred and nineteen operative specimens of carcinoma of the rectum were prospectively studied to evaluate distant microscopic intramural spread with respect to gross tumoral margins and to determine if the degree of spread was related to involvement of the lymph nodes. Eighty-eight of the 119 specimens (74 per cent) did not have intramural extension distal to the gross distal margin of the tumor. Twenty-five (21 per cent) had intramural extension of less than 5 millimeters from the gross distal limit of the tumor.

[Inguinal hernia. The Shouldice parietal repair].

Parietal repair according to the Shouldice technique consists of a double line of sutures on each of three musculo-aponeurotic layers of the groin, i.e. successively: plicature of the transverse muscle and attachments; aponeuroplasty by back-to-back suture of the internal and external oblique muscles, and plicature of the aponeurosis of the external oblique muscle.