Enhanced cytokine response to surgical trauma in patients with colorectal cancer.

Objective: Cancer is an immunologic challenge, and it was hypothesized that the presence of a cancer could modulate the cytokine response to operative trauma.

Setting: University hospital, Sweden.

Subjects: Patients operated with colonic or rectal resections; 9 patients with colorectal cancer and 16 patients with benign lesions--8 of which were inflammatory.

Expression of tissue-type and urokinase-type plasminogen activator activities in chronic venous leg ulcers.

Background: Chronic wounds have been shown to exhibit elevated levels of several classes of proteinases. Plasminogen activators (PAs) are proteinases which play a major role in the biological processes involved in wound healing and abnormalities in PAs may play a role in the pathology associated with chronic wounds. Here, we investigated the expression of tPA and uPA activities in chronic venous ulcer biopsies.

Experimental colonic healing in relation to timing of 5-fluorouracil therapy.

In an experimental study resembling clinical use of adjuvant 5-fluorouracil (5-FU) treatment of colorectal carcinoma, 97 male Wistar rats were operated on with a standardized left colonic resection. Treatment was given as a daily intraperitoneal injection. The animals were randomized to one of four groups: early treatment with 5-FU 20 mg/kg or saline 0.

The roles of nutritional depletion and drug concentration in 5-fluorouracil-induced inhibition of colonic healing.

This study was performed to investigate whether poor nutrition is responsible for 5-fluorouracil (5-FU)-induced inhibition of large bowel healing and if the concentration of intraperitoneal (ip) 5-FU affects anastomotic healing. Male Wistar rats underwent a left colonic resection and were randomly assigned to a control group (n = 9, ip NaCl, normal diet), a nutritional depletion group (n = 12, ip NaCl, restricted diet), or a 5-FU group (n = 12, ip 5-FU, normal diet). Treatment was started immediately after surgery and continued until sacrifice after 7 days.

Preoperative irradiation and colonic healing.

Objective: To find out if preoperative irradiation of 10 + 10 Gy influences anastomotic healing in the lower left colon of the rat.

Design: Randomised study.

Material: 120 male Wistar rats.

The effect of 5-fluorouracil on wound healing and collagen synthesis in left colon anastomoses. An experimental study in the rat.

In an experimental study resembling clinical use of adjuvant 5-fluorouracil (5-FU) treatment of colorectal carcinoma 86 male Wistar rats were operated with a standardized left colon resection and anastomosis with interrupted sutures. Treatment was given as daily intraperitoneal (i.p.

Quality of life in chronic leg ulcer patients. An assessment according to the Nottingham Health Profile.

Chronic leg ulcer is a disease of long duration, occurring predominantly in elderly people. Traditionally, little interest has been devoted to the study of the impact of this disease on life quality. In the present study the Nottingham Health Profile (NHP) was used to assess disease influence on six areas of daily life, namely: pain, physical mobility, sleep, energy, emotional reactions and social isolation.

Effect of interrupted and continuous suturing on intestinal wound margin strength in rats.

Suture-holding capacity (breaking strength) of small bowel anastomoses made with interrupted or continuous sutures was assessed in two groups of rats. The tightness of the suture line was varied in a standardized manner in both groups. All types of anastomoses had similar strength immediately after surgery.

Analysis of therapy-resistant venous leg ulcers. Can triple-layer treatment initiate healing?

Chronic leg ulcers represent a major health-care problem with considerable socioeconomic impact. Patients with seemingly therapy-resistant leg ulcers are common to all clinics. The purpose of the present study was to (1) examine a group of patients with nonhealing venous leg ulcers treated with a double-layer bandage and (2) evaluate whether the addition of an interactive hydrocolloid wound dressing could initiate healing in these patients.

Radiation effects in the colon. An experimental study in the rat.

In an experimental study, resembling a clinical trial of preoperative irradiation, 10 + 10 Gy was given to the pelvic and lower abdominal region of rats with a 4-day interval. The early effect on the colonic wall was evaluated by myeloperoxidase activity and hydroxyproline content of the bowel wall and correlated to histological findings. Groups of animals were followed up to eight months after irradiation for evaluation of later effects.

Effects of dextran and crystalloids on subcutaneous oxygen tension and collagen accumulation. A randomized study in surgical patients.

Twenty-nine patients, subjected to major abdominal surgery, were randomized to different types of postoperative fluid replacement, given on the basis of subcutaneous oxygen tension measurements (PscO2). One regimen consisted of crystalloids, the other of a combination of crystalloids and colloids (dextran 70). Perioperative fluid replacement was given according to clinical criteria and postoperatively according to polarographic PscO2 measurements.

Effect of tissue perfusion and oxygenation on accumulation of collagen in healing wounds. Randomized study in patients after major abdominal operations.

Objective: To compare the accumulation of collagen in standardised wounds in patients who had abdominal operations and whose postoperative fluid replacement was decided either clinically or by measurements of subcutaneous oxygen tension (PscO2).

Design: Prospective randomised trial.

Setting: University Hospital.

Influence of 5-fluorouracil and folinic acid on colonic healing: an experimental study in the rat.

Male Wistar rats were subjected to colonic resection and randomized to one of four groups: control group (intraperitoneal NaCl, intravenous NaCl); 5-fluorouracil (5-FU) group (intraperitoneal 5-FU, intravenous NaCl); folinic acid group (intraperitoneal NaCl, intravenous folinic acid); and 5-FU-folinic acid group (intraperitoneal 5-FU, intravenous folinic acid). Treatment was started immediately after surgery and continued until the animals were killed at 3 or 7 days. Anastomotic complications (abscesses or dehiscence) occurred in four of 33 animals in the control group, 12 of 36 in the 5-FU group, one of 32 in the folinic acid group and nine of 36 in the 5-FU-folinic acid group.

Importance of dehydration in anastomotic and subcutaneous wound healing: an experimental study in rats.

Objective: To find out if preoperative and postoperative dehydration adversely affect anastomotic and subcutaneous healing.

Design: Randomized study.

Material: 18 Wistar rats.

A demographic survey of leg and foot ulcer patients in a defined population.

By means of a questionnaire sent to all medical units in Malmö, including primary care, homes for the elderly, and industrial health clinics, 275 patients with leg and foot ulcers were identified. With a population of 232,908 in Malmö, this corresponds to a prevalence of 0.12%, which is lower than reported by others.

Leg and foot ulcers. Nursing care in Malmö, Sweden.

Questionnaires concerning nursing care of leg and foot ulcer patients in three major care-giving sectors of the national health service, namely the Department of Dermatology, general hospital wards/clinics, and primary care, have been analysed. The overall response rate was 88% (primary care: 100%). Forms regarding 193 patients with leg ulcers and 64 patients with foot ulcers were analysed.

Bacterial load and inflammatory reaction in the bowel wall after colonic obstruction. An experimental study in rats.

To quantify the inflammatory reaction to obstruction, alkaline phosphatase and myeloperoxidase activities were measured in specimens of colonic wall from 60 rats. Twenty rats had undergone laparotomy and band obstruction, 20 laparotomy without obstruction and 20 had no operation. The mean activities of both enzymes were increased proximal but not distal to the obstruction, that of alkaline phosphatase significantly so.

The effect of diverting colostomy on anastomotic healing after resection of left colon obstruction. An experimental study in the rat.

A standardized stenosis of the left colon was created in the rat model. After four days the stenosis was resected and a primary anastomosis made. Half of the animals (n = 21) were randomized to a proximal diverting colostomy and the other half to a non-colostomy control group.