Off-pump coronary artery grafting in patients necessitating multiple distal anastomoses.

Objectives: Off-pump surgery has become a valuable alternative if a small number of distal anastomoses is required. The aim of the present study was to test the hypothesis that outcome is not altered in multiple distal anastomoses.

Material And Methods: During a 4 year period, 350 patients were operated off-pump.

Migration of culture-expanded human mesenchymal stem cells through bone marrow endothelium is regulated by matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-3.

Background And Objectives: Mesenchymal stem cells (MSC) are adult stem cells that can be expanded many fold in vitro and have the therapeutic potential to restore the bone marrow microenvironment and support hematopoietic recovery after myeloablative conditioning for hematopoietic stem cell transplantation. Successful homing to the target tissue, such as bone marrow, implies that MSC are able to extravasate after systemic administration. However, the extravasation capacity of MSC and the underlying mechanisms are poorly understood to date.

Inadequacy of the one-dimensional fit-model formula for ultrasound volume assessment of the thyroid gland.

The aim of our study is to assess the best fit-model to assess the thyroid gland formula with a calibrated, automated method namely multi-detector CT to evaluate the most correct fit model in measuring thyroid gland volume.

Simulated humeral avulsion of the glenohumeral ligaments: a new instability model.

Humeral avulsion of the glenohumeral ligaments (HAGL) is an infrequent cause of shoulder instability. Experimental studies on this lesion are rare. This study was undertaken to determine the extent of humeral-based capsuloligamentous damage required for dislocation to occur.

Frequent overexpression of aurora B kinase, a novel drug target, in non-small cell lung carcinoma patients.

The serine/threonine protein kinase aurora B, a key regulator of mitosis, is emerging as a novel drug target for cancer treatment. Aurora B overexpression has been previously documented by immunohistochemistry in several types of human tumors. We assessed aurora B expression in a series of 160 non-small cell lung cancer (NSCLC) samples (60% stage I, 21% stage II, 11% stage III, and 8% stage IV).

Isolated tracheoesophageal fistula in a 10-year-old girl.

Isolated tracheoesophageal fistula (H-TOF) is a rare type of tracheoesophageal anomaly and is in most cases diagnosed in the neonatal period because of choking and cyanosis during feeding. Diagnosis may be delayed even until adulthood because of nonspecific and sometimes intermittent symptoms, and because false-negative results of all diagnostic tools are not uncommon. We report a 10-year-old child with H-TOF, whose symptoms had nearly disappeared completely between the ages of 4 and 10 years.

Simulated capsulolabral lesion in cadavers: dislocation does not result from a bankart lesion only.

Purpose: Although an anteroinferior capsulolabral detachment (typical Bankart lesion) has been evaluated in other experimental studies, it has not yet been tested with an apprehension test in an intact shoulder model.

Methods: Adjacent combinations of 4 zones of the capsuloligamentous complex were sequentially detached from the glenoid neck in 50 cadaveric shoulders. Stability was tested before and after each resection step: inferior stability with a sulcus test and anterior stability with an anterior drawer test and with a load-and-shift test in the apprehension position.

Concomitant rotator cuff and capsuloligamentous lesions of the shoulder: a cadaver study.

Purpose: Rotator cuff lesions have not yet been evaluated in association with capsuloligamentous lesions in an otherwise intact shoulder model. Our hypothesis was that less extensive capsuloligamentous lesions are necessary to allow dislocation in the presence of rotator cuff lesions.

Methods: The supraspinatus and infraspinatus, or the subscapularis, or all 3 tendons were carefully detached from their insertion without damage to the underlying capsule.

Acute interstitial nephritis associated with salmonellosis.

Acute interstitial nephritis (AIN) is a common cause of acute renal failure. We report a case of AIN, confirmed by renal biopsy, that developed in a patient with typhoid fever due to a Salmonella hadar infection. AIN secondary to Salmonella infection is a rare complication that has only been described twice in the literature.

The effect of isolated labrum resection on shoulder stability.

The present study was initiated to determine whether glenohumeral instability and dislocation can result from isolated lesions of the glenoid labrum in an arthroscopic cadaver model. Adjacent combinations of four zones of the labrum (superior, anterosuperior, anteroinferior and inferior) were sequentially removed with a motorised shaver, taking great care to leave the capsule intact in 24 cadaver shoulders. Stability was tested before and after inserting the scope and after each resection step.

American Society of Clinical Oncology--35th annual meeting. 15-18 May 1999, Atlanta, GA, USA.

A major focus of this year's meeting was the plenary session on the use of high-dose chemotherapy for the treatment of metastatic breast cancer and the incorporation of adjuvant treatment for poor prognosis primary breast cancer. Four abstracts on large randomized collaborative trials in the US, Scandinavian countries and South Africa were presented in this plenary session and discussed by Dr R Livingston (University of Washington, USA), Dr G Hortobagyi (University of Texas/MD Anderson Cancer Center, USA) and Dr K Antman (Columbia University, USA). In general, high-dose chemotherapy followed by (autologous bone marrow) stem cell support has not yet shown improvement in overall survival and has contributed to substantial side-effects when compared to standard chemotherapy in breast cancer.

Significance of the latissimus dorsi for shoulder instability. II. Its influence on dislocation behavior in a sequential cutting protocol of the glenohumeral capsule.

In a cadaveric instability model that leaves all muscles intact initially, the latissimus dorsi seemed to play a role when complete section of the glenohumeral capsuloligamentous structures did not result in a locked anteroinferior dislocation. The present study was carried out to determine whether the latissimus dorsi does truly affect dislocation in a modified cutting protocol, and to find an anatomic explanation for this apparent behavior. This article (Part II) details the results of a sequential cutting study and relates these results with the anatomic findings of Part I.

Significance of the latissimus dorsi for shoulder instability. I. Variations in its anatomy around the humerus and scapula.

In a cadaveric instability model that leaves all muscles intact initially, we studied anteroinferior glenohumeral dislocation behavior after section of the ligaments on the humeral side of the joint. In this study, the latissimus dorsi seemed to play a role when complete section did not result in a locked anteroinferior dislocation. We therefore initiated a study to test the hypothesis that the latissimus dorsi may, in certain circumstances, depending on variations in its anatomy, influence dislocation behavior.

Reconciling arthroscopic and anatomic morphology of the humeral insertion of the inferior glenohumeral ligament.

Purpose: To clarify the morphology of the humeral insertion of the inferior glenohumeral ligament (IGHL).

Type Of Study: Cadaveric and arthroscopic anatomic analysis.

Methods: The morphology of the humeral insertion was studied in 200 nonembalmed cadavers through open dissection (100 specimens), by arthroscopy (50 specimens), or both (50 specimens).

Lymphedema development following breast cancer surgery with full axillary resection.

Several studies have investigated the influence of disease related, treatment related, and patient related risk factors on the development of postmastectomy edema (PME). The aim of the present study was to determine which factors present a higher risk of developing PME after breast surgery with full axillary resection (level I, II and III). To accomplish this aim, we investigated 245 women who underwent unilateral breast cancer surgery in the Academic Hospital of the Vrije Universiteit, Brussels.

Post-transplantation tumour load in bone marrow, as assessed by quantitative ASO-PCR, is a prognostic parameter in multiple myeloma.

High-dose therapy (HDT) and autologous transplantation prolongs remission duration and survival in multiple myeloma (MM), but relapse still occurs at a median of 2 years post-HDT. In order to investigate whether the number of residual tumour cells in the bone marrow (BM) after transplantation can predict the duration of response, a quantitative allele-specific oligonucleotide polymerase chain reaction (qASO-PCR) assay was used to measure tumour load in BM at 3-6 months post-HDT in 67 patients. The method of maximally selected log-rank statistics was used to test for the existence of a cut-off value in the BM tumour load data set.

Aneurysm of the splenic vein.

Aneurysms of the portal venous system are increasingly reported in the past five years. Congenital weakness of the venous wall, trauma, pancreatitis and portal hypertension are possible etiologies. Surgical intervention is indicated in case of symptomatic aneurysms with or without progressive expansion of the aneurysm diameter.

Adjuvant radiotherapy for breast cancer: effects of longer follow-up.

Background And Purpose: Recent and large trials of adjuvant radiotherapy for breast cancer have shown an overall survival benefit in favour of radiotherapy. However, with longer follow-up the late lethal toxicity of radiotherapy might reduce the overall survival benefits. In this paper we investigate more deeply this hypothesis.

Laparoscopic versus conventional Nissen fundoplication: the influence on plasma insulin-like growth factor-I and insulin-like growth factor binding protein-3.

Background: Conventional surgery is known to influence postoperative insulin-like growth factor-I (IGF-I) levels and to increase protein breakdown. Recent animal data described that laparoscopic surgery, in contrast to conventional surgery, maintains postoperative IGF-I levels, suggesting a reduced postoperative catabolic response.

Aim: The aim of this study was to demonstrate differences in the postoperative catabolic response between laparoscopic and conventional surgery.

Cigarette smoking is associated with an acute impairment of microvascular function in humans.

An effect on microvascular function has been proposed as a possible mechanism explaining the association of acute smoking with increased blood pressure and decreased insulin sensitivity. However, the effects of smoking on microvascular function have not been studied. We have investigated the acute effects of smoking on microvascular function in 12 healthy smokers.

Effect of frequent consumption of a Lactobacillus casei-containing milk drink in Helicobacter pylori-colonized subjects.

Background: Several studies have reported inhibitory effects of lactic acid bacteria on bacterial pathogens.

Aim: To test whether a drink containing Lactobacillus casei strain Shirota inhibits Helicobacter pylori growth.

Methods: The in vitro growth inhibition of H.

Clinical trials in prostatic cancer-interpretations and misinterpretations.

New agents and therapies in prostate cancer, as in other diseases, need to be accurately, comprehensively and logically developed. The golden standard, a prospective, randomised phase III study can only be carried out efficiently if phase I and phase II studies have been completed. The advent of new therapies which will be used in early stage disease, necessitates the development of new methods of measuring their activity and correlating it with an influence on the natural history of the disease.

Partial versus full agonists for opioid-mediated analgesia--focus on fentanyl and buprenorphine.

In contrast to other opioids, fentanyl and buprenorphine share a number of physicochemical properties that render both agents potentially suitable for transdermal delivery. However, there are significant differences between them in terms of their pharmacological profiles, as fentanyl is a full mu opioid receptor agonist capable of exerting a maximal response in certain tissues, while buprenorphine is a partial agonist unable to exert this maximum effect even at high doses. This review examines the hypothesis that partial opioid agonists would confer a number of benefits over full agonists, namely effective analgesia with a better tolerability and a lower propensity for addiction, with respect to fentanyl and buprenorphine.

Multiple cutaneous granular cell tumors in a child in remission for Hodgkin's disease.

Multiple cutaneous granular cell tumors are uncommon among children. We describe a 13-year-old boy with Hodgkin's disease in remission for 3 years who had multiple cutaneous granular cell tumors. We wondered whether this association was real or a coincidence and whether this child was at increased risk of development of malignant granular cell tumors.