Glioblastoma Cell Malignancy and Drug Sensitivity Are Affected by the Cell of Origin.

The identity of the glioblastoma (GBM) cell of origin and its contributions to disease progression and treatment response remain largely unknown. We have analyzed how the phenotypic state of the initially transformed cell affects mouse GBM development and essential GBM cell (GC) properties. We find that GBM induced in neural stem-cell-like glial fibrillary acidic protein (GFAP)-expressing cells in the subventricular zone of adult mice shows accelerated tumor development and produces more malignant GCs (mGC1) that are less resistant to cancer drugs, compared with those originating from more differentiated nestin- (mGC2) or 2,'3'-cyclic nucleotide 3'-phosphodiesterase (mGC3)-expressing cells.

Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study.

Background: Covered biliary metal stents have been developed to prevent tumor ingrowth. Previous comparative studies are limited and often include few patients.

Objective: To compare differences in stent patency, patient survival, and complication rates between covered and uncovered nitinol stents in patients with malignant biliary obstruction.

Stone clearance and risk factors for failure in laparoscopic transcystic exploration of the common bile duct.

Background: Laparoscopic cholecystectomy has become a gold standard globally. At the time of surgery, 5 to 10% of patients have coexisting stones in the common bile duct (CBD). There are several alternatives in treating these patients.

Discomfort five years after laparoscopic and Shouldice inguinal hernia repair: a randomised trial with 867 patients. A report from the SMIL study group.

Background: In recent years long-term discomfort after inguinal hernia surgery has become an issue of great concern to hernia surgeons. Long-term results on discomfort from large randomised studies are sparse.

Methods: One-thousand one-hundred and eighty-three patients were randomised in a multicentre trial with the primary aim of comparing recurrence rates after laparoscopic TAPP and Shouldice repair.

Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair.

Background: The optimal treatment for recurrent inguinal hernia is of concern due to the high frequency of recurrence.

Methods: This randomized multicenter study compared the short- and long-term results for recurrent inguinal hernia repair by either the laparoscopic transabdominal preperitoneal patch (TAPP) procedure or the Lichtenstein technique.

Results: A total of 147 patients underwent surgery (73 TAPP and 74 Lichtenstein).

Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair.

Background: Laparoscopic herniorrhaphy has emerged as a recognized operative method for inguinal hernia repair. This study compared the short-term results of two tension-free methods of repair: totally extraperitoneal (TEP) laparoscopic patch repair and the open Lichtenstein mesh technique.

Methods: A total of 1513 men from 11 hospitals who presented with a primary unilateral inguinal hernia were randomized to one of the two methods.

Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia.

Background: The Shouldice technique is the 'gold standard' of open non-mesh hernia repair. The aim of this study was to compare 5-year recurrence rates after Shouldice and laparoscopic transabdominal preperitoneal patch (TAPP) repair for primary inguinal hernia.

Method: Men with a primary unilateral inguinal hernia were randomized to either Shouldice or TAPP operation.

Is the learning curve for laparoscopic fundoplication determined by the teacher or the pupil?

Background: For all surgical procedures, a surgeons' learning curve can be anticipated during which complication rates are increased. The aims of this study were to evaluate individual learning curves for a group of surgeons performing laparoscopic fundoplication and to evaluate if the Procedicus MIST-simulator (Mentice Inc., Göteborg, Sweden) accurately predicts surgical performance.

Long-term effects of eradication of Helicobacter pylori on relapse and histology in gastric ulcer patients: a two-year follow-up study.

Background: The main purpose of this study was to compare omeprazole (ome) plus two antibiotics (OMC) with omeprazole plus placebo (OP) with regard to gastric ulcer relapse for a period of 2 years in patients who were Helicobacter pylori-positive at inclusion.

Methods: Using double-blind randomization 125 patients with gastric ulcer were treated with either OMC (ome 20 mg b.i.

Long-term results from laparoscopic common bile duct exploration.

Background: The aim of this study was to evaluate the long-term results after laparoscopic common bile duct exploration (LCBDE).

Methods: A retrospective review of 175 consecutive patients who underwent attempted LCBDE between 1992 and 1999 was conducted. Laparoscopic transcystic exploration was accomplished in 110 patients and laparoscopic choledochotomy in 52 patients.

Postoperative convalescence after inguinal hernia surgery: prospective randomized multicenter study of laparoscopic versus shouldice inguinal hernia repair in 1042 patients.

Interest in inguinal hernia surgery has increased significantly with the introduction of new operating techniques during the past decade. This multicenter study compared short-term results in patients treated by the laparoscopic transabdominal preperitoneal patch technique (TAPP; n = 518) and the Shouldice technique (n = 524). We evaluated demographics, operative data, complications, hospital stay, postoperative pain, use of cs, functional status, sick leave, and complaints up to 3 months postoperatively.

Does training in a virtual reality simulator improve surgical performance?

Background: The development of computerized surgical simulators in a virtual reality environment demands models for proper validation. Recent investigations have shown that a virtual reality simulator (MIST-VR) is a reliable tool for the assessment of laparoscopic psychomotor skills and that it improves the automation of the so-called fulcrum effect. Therefore, we set out to determine whether training with the MIST-VR would improve the surgical performance of surgically inexperienced medical students and to see if results obtained in the simulator would correlate with surgical performance.

Laparoscopic management of common bile duct stones.

There are various techniques available for laparoscopic exploration of the common bile duct, but the most widely used are pharmacological relaxation of the sphincter of Oddi and saline flushing, laparoscopic transcystic exploration, and laparoscopic choledochotomy. Altogether 1319 patients have been reported in retrospective and prospective uncontrolled studies with more than 50 patients in each. The conclusion is that it is possible to make a laparoscopic exploration of the common bile duct in selected cases with low morbidity and mortality.

Increased risk of cancer in ulcerative colitis: a population-based cohort study.

Objective: There is an increased risk of colorectal cancer among patients with ulcerative colitis (UC). However, the overall and site specific cancer risks in these patients have been investigated to a limited extent. To study the association between UC and cancer, a population-based study of 1547 patients with UC in Stockholm diagnosed between 1955 and 1984 was carried out.

Oral budesonide for prevention of postsurgical recurrence in Crohn's disease. The IOIBD Budesonide Study Group.

Background & Aims: Prevention of postoperative recurrence after resection for Crohn's disease (CD) would be of great clinical benefit. The efficacy of oral budesonide for prevention of endoscopic recurrence was evaluated in patients undergoing resection for ileal or ileocecal CD.

Methods: Sixty-three patients received budesonide and 66 received placebo in a double-blind, randomized trial with parallel groups.

Diagnostic laparoscopy in 1043 patients with suspected acute appendicitis.

Objective: To evaluate the efficacy of diagnostic laparoscopy in patients with suspected acute appendicitis, the number of complications associated with the laparoscopic technique, and the effect of leaving a macroscopically normal-looking appendix in place.

Design: Three prospective protocols.

Setting: Three departments of surgery, one in Norway and two in Sweden.

[Laparoscopy possible even in cholelithiasis. Results for 96 patients from three different hospitals are reviewed].

At laparoscopic cholecystectomy, a procedure routinely used at Swedish surgery departments today, common bile duct stones are found to be present in 5-10 per cent of cases. During recent years, several alternative procedures have been evolved for the management of duct stones, such as operative or postoperative endoscopic sphincterolomy, or conversion to open surgery and choledochotomy. The article gives an account of laparoscopic treatment of common bile duct stones, and results obtained in 96 patients from three surgery departments in Sweden.

Survival and cause-specific mortality in inflammatory bowel disease: a population-based cohort study.

Background & Aims: A population-based cohort study of 1251 subjects with Crohn's disease and 1547 subjects with ulcerative colitis, diagnosed in Stockholm between 1955 and 1984, was performed to examine the survival, changes in survival over time, and cause-specific mortality.

Methods: The cohort of patients was followed up in the National Cause-of-Death register until 1990. National mortality rates were used for comparisons.

Decrease in muscle glutamine, ribosomes, and the nitrogen losses are similar after laparoscopic compared with open cholecystectomy during the immediate postoperative period.

Background: The purpose of the study was to compare the postoperative muscle amino acid pattern, the ribosome concentration and size distribution, and postoperative nitrogen balance in patients who underwent either laparoscopic or open cholecystectomy.

Methods: Patients who underwent cholecystectomy by means of either laparoscopy (n=8;LAP) or laparotomy (n=8;OPEN) were studied. The concentrations of amino acids, ribosomes, and polyribosomes, reflecting protein synthesis, were determined in skeletal muscle tissue before operation and on postoperative day 2.

Crohn's disease and cancer: a population-based cohort study.

Background/aims: To study the association between Crohn's disease and cancer, we performed a population-based study of 1251 subjects with Crohn's disease diagnosed in Stockholm from 1955 to 1984 and followed in both the National Cancer Register and the National Cause-of-Death Register until 1989.

Methods: For comparisons, regional cancer incidence rates in Stockholm County were used together with individually computed person-years at risk in the Crohn's disease cohort.

Results: Overall, 69 malignancies occurred among 67 individuals as compared with 59.

Short-term starvation alters the free amino acid content of the human intestinal mucosa.

1. The effects of short-term starvation and refeeding on the free amino acid concentrations of the intestinal mucosa were characterized in male subjects (n = 6), using endoscopically obtained biopsy specimens from the duodenum and from all four segments of the colon. 2.

Free amino acids in biopsy specimens from the human colonic mucosa.

The content of free amino acids and total protein was determined in endoscopic biopsy specimens from the rectum, descending colon, transverse colon, and ascending colon in 10 patients. The amino acids were quantified by ion-exchange chromatography and were detected by fluorescence. The amino acid pattern and the rank order of the individual amino acids in the colon were different compared to those in plasma.

The content of free amino acids in the human duodenal mucosa.

The free amino acid concentrations and the total protein content of the duodenal mucosa were determined in biopsy specimens obtained during endoscopic examinations in 10 healthy subjects. The amino acids were separated and quantified by ion exchange chromatography using fluorescence detection. The protein content was analysed according to Lowry.