Phospholipase D activation mediates growth and migration of colon cancer cells interacting with cancer-associated fibroblasts.

Cancer-associated fibroblasts of the stroma play a major role in tumor promoting processes. In this study we evaluated the significance of Phospholipase D (PLD) enzyme activity in promoting human colon cancer malignant potency when interacting with proximal colonic fibroblasts. Human colon cancer cell lines SW480 and HCT116, and colonic fibroblasts CCD-18Co were used as an in vitro model.

Outcome of stapled hemorrhoidopexy versus doppler-guided hemorrhoidal artery ligation for grade III hemorrhoids.

Purpose: To evaluate the long-term results, early and late complication rates, and overall satisfaction of patients with grade III hemorrhoids treated by stapled hemorrhoidopexy (SH) or Doppler-guided hemorrhoidal artery ligation (DGHAL).

Methods: Operative and follow-up patients' data were prospectively collected for patients undergoing either SH or DGHAL by a single surgeon during a 2-year period. A retrospective comparison between patients' outcome operated by one of the two methods was made based on this data.

Doppler-guided haemorrhoidal artery ligation in patients with Crohn's disease.

Aim: The outcome of Doppler-guided haemorrhoidal artery ligation (DGHAL) was assessed in patients with Crohn's disease (CD) suffering from grade III haemorrhoids.

Method: A retrospective study was carried out of patients with CD and symptomatic Grade III haemorrhoids treated by DGHAL. Perioperative and follow-up data were retrieved from our database of patients undergoing DGHAL.

Laparoscopic surgery for colorectal polyps.

Background: Size, location, and type of colonic polyps may prevent colonoscopic polypectomy. Laparoscopic colectomy may serve as an optimal alternative in these patients. We assessed the perioperative outcome and the risk for cancer in patients operated on laparoscopically for colonic polyps not amenable to colonoscopic resection.

Effects of 5-FU on DNA synthesis and cytotoxicity of human lymphocytes induced by IL-2, TGF-beta3 and PGE2.

Background: Low 5-fluorouracil (5-FU) concentrations cause a significant increase in DNA synthesis in mitogen-activated human lymphocytes.

Materials And Methods: We explored 2.5 microM 5-FU-induced DNA synthesis by testing 5-FU activity in hypoxanthine-aminopterin-thymidine (HAT)-containing medium, and its effect on thymidylate synthase (TS) activity and CD25 expression in interleukin (IL)-2-activated human peripheral blood mononuclear cells (PBMCs) and the combined effects with prostaglandin E(2) (PGE(2)) and transforming growth factor (TGF)-beta3.

Effects of intravenous patient-controlled analgesia with buprenorphine and morphine alone and in combination during the first 12 postoperative hours: a randomized, double-blind, four-arm trial in adults undergoing abdominal surgery.

Background: Intense pain in the first 12 hours after major abdominal surgery requires the use of large amounts of analgesics, mainly opioids, which may produce undesirable effects. Buprenorphine (BUP) is not typically used intravenously in this setting, particularly in combination with morphine (MO), due to concerns that BUP might inhibit the analgesic effect of MO.

Objective: This study compared the analgesic effect of BUP and MO separately and in combination for postoperative pain control in patients undergoing abdominal surgery.

Effects of 5-fluorouracil on human mitogen-activated peripheral blood lymphocytes from healthy individuals.

Background: The effect of 5-fluorouracil (5-FU) on activated lymphocytes was explored.

Materials And Methods: The in vitro effects of 5-FU on DNA synthesis in mitogen-activated lymphocytes from healthy volunteers were compared to those of the antimetabolites doxorubicin, cyclophosphamide and 6-mercaptopurine. These effects were assessed by alterations in the phenotypic profile and the percentage of cells in various phases of the cell cycle, as well as by the secretion of T helper (Th)1 and Th2 cytokines (ELISA).

Extraluminal appendicolith: an indication for interval appendectomy with intraoperative localization and removal of that potential cause of intra-abdominal abscess.

Appendicoliths are formed by calcium salts and fecal debris layered and lodged within the appendix. They are detected on unenhanced X-rays in <10% of patients with appendicitis. When an appendicolith is found extraluminally, it is pathognomonic for perforation of the appendix.

[Anal mucinous adenocarcinoma arising in long standing fistula-in-ano].

Perianal mucinous adenocarcinoma is an unusual but well described malignancy constituting approximately 3 to 11% of all anal carcinoma. The pathology is thought to develop from one of three types, the distal part of the rectum, the mucin-secreting columnar epithelium of the anal glands, and from chronic fistula-in-ano. The association of carcinoma with anal fistula may manifest itself in several ways: a fistula may be associated with cancer elsewhere in the colon; cancer may present as a fistula; or cancer may develop in anal fistula.

Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy in peritoneal carcinomatosis.

Background: Peritoneal carcinomatosis is an advanced form of cancer with poor prognosis that in the past was treated mainly palliatively. Today, the definitive approach to peritoneal surface malignancy involves peritonectomy, visceral resection and perioperative intra-abdominal hyperthermic chemotherapy. The anticipated results range from at least palliative to as far as intent to cure.

Learning curve in laparoscopic colorectal surgery: our first 100 patients.

Background: Recent data confirming the oncologic safety of laparoscopic colectomy for cancer as well as its potential benefits will likely motivate more surgeons to perform laparoscopic colorectal surgery.

Objectives: To assess factors related to the learning curve of laparoscopic colorectal surgery, such as the number of operations performed, the type of procedures, major complications, and oncologic resections.

Methods: We evaluated the data of our first 100 elective laparoscopic colorectal operations performed during a 2 year period and compared the first 50 cases with the following 50.

Multilocular flank abscess due to stone migration following laparoscopic cholecystectomy with spillage of gallstones.

We report a case of a patient who presented with a large flank abscess 18 months after laparoscopic cholecystectomy. The patient underwent repeated percutaneous drainage but the abscess recurred. Further evaluation with ultrasound revealed subcutaneous tracks from the flank leading to the abdominal cavity and suspected stones in one of the tracks.

First 100 cases with Doppler-guided hemorrhoidal artery ligation.

Purpose: This study was designed to examine the benefits of a Doppler-guided hemorrhoidal artery ligation technique in terms of surgical outcome, functional recovery, and postoperative pain.

Methods: Using local, regional, or general anesthesia, 100 patients with symptomatic Grades II or III hemorrhoids underwent sonographic identification and suture ligation of six to eight terminal branches of the superior rectal artery above the dentate line. Visual Analog Scales were used for postoperative pain scoring.

Photodynamic therapy for Bowen's disease and squamous cell carcinoma of the skin.

Background: Photodynamic therapy involves the activation by visible light of a previously administered photosensitizing agent in order to cause tumor necrosis. Skin tumors can be treated with topical photosensitizers and thus avoiding systemic side effects. In this study we evaluate the immediate and long-term effects of photodynamic therapy (PDT), using aminolevulinic acid (ALA) as a photosensitizer and a non-laser light source, on Bowen's disease (intra-epithelial squamous cell carcinoma) and on frank squamous cell carcinoma (SCC) of the skin.

[Proctalgia Fugax--what's new over the last 100 years?].

Proctalgia Fugax is a benign, self-limiting disease characterized by episodes of intense pain in the anorectal area occurring at infrequent intervals. It is common, but most suffers do not seek medical advice. Although its classical symptomatology was describe more than a century ago, the etiology is unclear.

Detection of cancer cells in the axillary drainage using RT-PCR after operations for breast cancer.

The object of this study was to examine whether MUC-1 can be detected in the axillary lymphatic drainage of patients who have undergone conservative surgery for breast cancer and to assess the correlations between the presence of MUC-1 and prognostic factors in breast cancer. Sixty-eight women with invasive ductal carcinoma of the breast underwent wide local excision and axillary lymph node dissection. Axillary drains were inserted in all these cases, and the presence of MUC-1 and beta-actin was evaluated by RT-PCR in the lymphatic fluid collected after the operation.

Lymphoscintigraphy for sentinel node mapping using a hybrid SPECT/CT system.

Unlabelled: Lymphoscintigraphy is performed before sentinel node (SN) biopsy for SN mapping. It is of clinical importance mainly if the tumor is located in body parts with ambiguous lymph node drainage. The purpose of this study was to assess the clinical benefit of fused SPECT/CT images to planar images for SN mapping.

A non-laser light source for photodynamic therapy: in vitro effects on normal and malignant cells.

Aim: Photodynamic therapy (PDT) involves the use of photosensitizing drugs combined with light to treat tumors. Laser systems, the current source of light for PDT, have several inherent drawbacks: the spectrum is essentially monochromatic which may be problematic for second generation photosensitizers, the systems are bulky and nearly impossible to move between hospital locations and require complicated electrical and cooling installations, the cost of a typical system is enormous, and its maintenance and operation require highly trained personnel. We now introduce a new non-laser light system, Versa-Light, which appears to work as effectively and has none of the above drawbacks.

Detection of hepatocyte growth factor/scatter factor receptor (c-Met) in axillary drainage after operations for breast cancer using reverse transcriptase-polymerase chain reaction.

Background: The diverse biological effects of hepatocyte growth factor/scatter factor (HGF/SF) are mediated by c-Met, which is preferentially expressed on epithelial cells. Met signaling has a role in normal cellular activities, and may be associated with the development and progression of malignant processes. In this study we examined whether Met can be detected in the axillary drainage from patients who underwent conservative operations for breast cancer, and its prognostic significance.

Free perforation in Crohn's disease.

Background: Free bowel perforation is one of the indications for emergency surgery in Crohn's disease. It is generally accepted that 1-3% of patients with Crohn's disease will present with a free perforation initially or eventually in their disease course.

Objectives: To evaluate the incidence and treatment results of free perforation in patients with Crohn's disease and, based on our experience, to suggest recommendations.

Photodynamic therapy of murine colon cancer and melanoma using systemic aminolevulinic acid as a photosensitizer.

Background: Side effects of conventional photosensitizers, such as hematoporphyrins, are a limiting factor in the use of photodynamic therapy (PDT). We evaluated the effect of PDT on mice colon carcinoma and melanoma using systemic 5-aminolevulinic acid (ALA).

In Vitro Studies: CT26 colon carcinoma and B16 melanoma cells were incubated with ALA for 48 h.

Effects of intravenous gamma immunoglobulins treatment on severe peritonitis in rats.

Background: Generalized purulent peritonitis is characterized by an early exposure of the immune system to a large number of bacterial antigens. The hypothesis that intravenous IgG treatment may improve the outcome of severe experimental peritonitis was studied.

Methods: Peritonitis was induced in rats by cecal ligation and perforation.

Human colon adenocarcinoma in the SCID/CB6 radiation chimera is susceptible to adoptive transfer of allogeneic human peripheral blood mononuclear cells.

The aim of this study was to develop a murine model of human colon carcinoma (hCC) and to ascertain the potential of cellular immunotherapy in this model. Fragments of hCC obtained at surgery from 6 patients were transplanted under the kidney capsule of lethally irradiated CB6 mice radioprotected with severe combined immunodeficient (SCID) mice bone marrow. Tumor xenografts conserved their malignant behavior in the new environment, invading the mouse kidney parenchyma and expanding into the peritoneal cavity and adjacent tissues.

Isolated rib fractures in elderly patients: mortality and morbidity.

Objectives: To describe the management, morbidity and mortality seen with isolated rib fractures in elderly patients and assess the need for hospitalization.

Design: A case series.

Setting: A tertiary care centre in Tel Aviv.