Transfusion-associated graft versus host disease in the immunocompetent patient: an ongoing problem.

Transfusion associated-graft versus host disease (TA-GVHD) is a rare complication of blood transfusion. It carries a very high mortality rate. Although the phenomenon has been well described in immunocompromised patients, this review focuses on the immunocompetent host.

Ulcerative colitis and cancer.

Patients with ulcerative colitis (UC) are at an increased risk for the development of colorectal cancer (CRC). Unlike sporadic CRC, the cancer in UC patients arises from a focal or multifocal dysplastic mucosa in areas of inflammation. The clinical features of UC-associated cancer are similar to those found in patients with hereditary non-polyposis colorectal cancer.

Thermoablation of colorectal liver metastasis.

Thermoablation is a local therapy that is effective in in situ destruction of colorectal liver metastasis while preserving surrounding normal liver tissue. It is less invasive compared to surgery, easy to use, and can be repeated. The therapy provides local control of unresectable disease and is an alternative therapy for small resectable lesions in patients with insufficient hepatic reserve after resection or coexistent comorbid conditions.

Regional treatment of colorectal liver metastasis.

Compared to systemic chemotherapy, intraarterial administration of tumoricidal agents with or without systemic chemotherapy in the treatment of nonresectable metastatic colorectal cancer is associated with superior response rate. The time-to-hepatic progression is also increased but the effect on overall survival is variable. When combined with other treatment modalities the number of patients who benefit from the treatment increases.

Large gaps of midline abdominal incisions and their management.

The operative management of midline full-thickness abdominal wall gaps is difficult, often requires several surgical procedures and is associated with significant short- and long-term complications. A rectus abdominis-posterior sheath (RAPS) flap with skin grafting provides a tension-free one-step repair which was used in three patients successfully with midline abdominal wall (including the skin) gaps who had multiple previous operations related to intra-abdominal malignancy. No complications occurred in these patients in relation to this procedure.

The prognostic superiority of log odds of positive lymph nodes in stage III colon cancer.

Background: Literature showed that lymph node ratio (LNR) and total number of lymph nodes (TNODS) are independent prognostic factors in node-positive colon cancer. Our study assesses the prognostic superiority of the log odds of positive lymph nodes (LODDS) in the same patient population.

Material And Methods: A total of 24,477 stage III colon cancer cases from the SEER registry were reviewed.

Modified anterior compartment resection of the thigh.

For large soft tissue sarcomas of the anterior thigh, an anterior compartment resection is often performed. This may leave the patient with the inability to extend the knee. In our practice, we find that it is usually possible to preserve one of the heads of the quadriceps, usually the vastus medialis, with intact innervation, and thus preserve significant extension function of the knee joint, while the requirements for a radical oncologic procedure are being met.

Transfusion-related acute lung injury.

Transfusion-related acute lung injury (TRALI) refers to a clinical syndrome of acute lung injury that occurs in a temporal relationship with the transfusion of blood products. Because of the difficulty in making its diagnosis, TRALI is often underreported. Three not necessarily mutually exclusive hypotheses have been described to explain its etiogenesis: antibody mediated, non-antibody mediated, and two hit mechanisms.

Lymph node ratio: role in the staging of node-positive colon cancer.

Background: Recent literature has shown that lymph node ratio (LNR) is superior to the number of positive lymph nodes (pLNs) in predicting the prognosis in several malignances other than colon cancer. We hypothesize that LNR may play a similar role in stage III colon cancer.

Methods: We included 24,477 stage III colon cancer cases from the Surveillance, Epidemiology, and End Results cancer registry.

Gene expression profiles of late colonic Crohn's disease.

To determine the genetic program mediating and maintaining the change from susceptibility to Crohn's disease (CD) to ongoing tissue destruction and loss of function, we utilized Affymetrix HG U95 AV2 Gene Chips and analyzed unpooled surgical CD colon specimens from adult patients. Using the patient as his own genetic filter we examined involved versus uninvolved adjacent areas, comparing results within one individual and then performing analysis comparing results between four individuals. Our results interrogated twice as many genes than the previous studies that used pooled unmatched specimens.

What is new in cytokine research related to trauma/critical care.

Cytokines are low molecular weight proteins whose production can be modified by various insults. They have the potential to modify cellular responses to these insults. Recent years have seen a plethora of research in cytokine biology in trauma and critical care.

Embolization as cause of bowel ischemia after endovascular abdominal aortic aneurysm repair.

Objective: We investigated the incidence, cause, and outcome of large bowel and small bowel ischemia after endovascular abdominal aortic aneurysm (AAA) repair.

Methods: Medical records for all patients undergoing endovascular AAA repair from December 1999 to December 2003 were reviewed. The incidence, cause, and outcome of clinically detected postoperative bowel ischemia were analyzed.

Free interferon-alpha/beta receptors in the circulation of patients with adenocarcinoma.

Background: Many viral and neoplastic diseases are resistant to interferon-alpha/beta (IFN-alpha/beta) therapy or develop resistance during the course of IFN treatment. In patients with viral diseases, the authors identified four IFN inhibitors, of which the most important, most likely is a free IFN receptor of type 1 appearing in the circulation that captures and neutralizes IFN-alpha/beta.

Methods: Ninety-one cancer patients and 25 healthy individuals were studied.

Solitary papillary breast carcinoma metastasis to the large bowel presenting as primary colon carcinoma: case report and review of the literature.

Breast carcinoma has the potential for widespread dissemination. Spread to the lower gastrointestinal tract is infrequent, often multifocal, occurs in association with spread to other sites, and most commonly develops from lobular carcinoma. Solitary colorectal metastasis as the first and sole manifestation of spread is a rare occurrence and can be confused with primary intestinal malignancy.

Respiratory distress syndrome: principles and current therapy.

Acute respiratory distress syndrome (ARDS) describes a clinicopathologic disease process that occurs in association with a variety of clinical situations. The severity and outcome of this syndrome varies. Prolonged hospital stay, significant early morbidity and mortality, and long-term pulmonary parenchymal changes that result in reduced, often debilitating, pulmonary functions, typify the outcome of severe form of ARDS.