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  • 1
    Electronic Resource
    Electronic Resource
    Surgery for Ductal Adenocarcinoma of the Pancreatic Head: Staging, Complications, and Survival after Regional versus Extended Lymphadenectomy (2000)
    Springer
    World journal of surgery 24 (2000), S. 595-602 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to evaluate the influence of regional versus extended lymphadenectomy on survival after partial pancreaticoduodenectomy for pancreatic cancer. From October 1988 to December 1991 (Department of Surgery, University of Hamburg) and from January 1992 to March 1998 (Department of Surgery, University of Kiel) 72 patients with histologically proven ductal adenocarcinoma of the pancreatic head were treated. Partial pancreaticoduodenectomy with regional lymphadenectomy was performed in 26 patients. In 46 patients lymphadenectomy was expanded to include extended retroperitoneal lymphatic and connective tissue clearance. Comparing these two groups and including only patients with R0 resections (n= 58) no significant differences in long-term survival could be shown. The following parameters were shown to have a significant or nearly significant influence on long-term survival: (1) stage of the disease: The 5-year survival of patients with stage I/II pancreatic head cancer was 63%, compared to 15% in patients with stage III/IV a + b of the disease (p= 0.0087). (2) Grading: The 1-year survival of patients with well or moderately differentiated tumors was 55%, compared to 0% for patients with poorly differentiated ductal adenocarcinoma (p= 0.0022). (3) N stage: The 5-year survival of patients in N0 stage was 46.9%, compared with 15% for N1 stage patients. The difference was not quite significant (p= 0.081). (4) Portal vein involvement: The 1-year survival was 0% in patients with R0 resections and histologically proven tumor infiltration of the portal vein, compared to 63% for patients with curative resections without portal vein involvement (p= 0.0063). In conclusion our data indicate that extensive retroperitoneal tissue clearance during pancreaticoduodenectomy for ductal pancreatic cancer does not improve survival compared to regional lymphadenectomy restricted to the right side of the mesenteric artery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689910089
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  • 2
    Electronic Resource
    Electronic Resource
    Quality of Life following Radical Surgical Treatment of Gastric Carcinoma (1999)
    Springer
    World journal of surgery 23 (1999), S. 503-508 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Quality of life (QOL) in patients with gastric cancer who underwent total gastrectomy has so far not been studied using the EORTC QLQ-C30 (Quality of Life Core Questionnaire of the European Organization for Research and Treatment of Cancer) as a standardized European QOL instrument. The aim of this study was to evaluate the effect of radical procedures such as extensive lymph node resection and combined resection of adjacent organs on patients' QOL. From 1992 to 1996, 152 patients underwent total gastrectomy. All patients alive on July 1, 1996 were included in the study (77/152). For assessing QOL, the EORTC QOL questionnaire QLQ-C30 version 2.0 and a validated gastric cancer module were sent home to the patients for self-completion. The response rate was 91%. It was possible to evaluate the questionnaires of 62 patients who had undergone resection with curative intent including 13 extended gastrectomies (21%). Of the 62 resections, 50 were combined with D2 lymphadenectomy (80.6%). The global health status was not negatively influenced by D2 lymphadenectomy and extended gastrectomy. Patients with splenectomy were more affected by treatment than patients without splenectomy. Radical gastrectomy combined with D2 lymphadenectomy is the treatment of choice for gastric cancer patients, concerning not just survival but QOL as well.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00012339
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  • 3
    Electronic Resource
    Electronic Resource
    Studies on the structure and biological effects of pyrotoxins purified from burned skin (1979)
    Springer
    World journal of surgery 3 (1979), S. 361-365 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Chez des souris, une brûlure cutanée a été réalisée dans des conditions contrôlées et avec un modèle standard de brûlure à haute température. Après homogénéisation à grande vitesse de la peau brûlée, une fraction toxique a été isolée par différentes techniques de purification. Nous avons démontré qu'une brûlure à température élevée produit des condensations chimiques et des aggrégats macromoléculaires dans la fraction protéinique de la peau. Les protéines plasmatiques jouent un rôle dans ces réactions. Après purification, les aggrégats macromoléculaires sont récoltés, non pas sous forme de protéines pures, mais sous forme de micelles lipo-protéiniques. Dans la fraction lipidique, on trouve des produits de décomposition thermique. Les effets biologiques de la fraction lipoprotéinique purifiée ont été étudiés sur une perfusion de foie de rat, 5 jours après injection intrapéritonéale du produit; plusieurs activités de biosynthèse du foie isolé ont été étudiées. Nous avons observé une nette réduction de la synthèse de l'urée et une dépression de la glyconéogenèse. Ces résultats biochimiques concordent avec des modifications de l'ultrastructure cellulaire: le complexe lipo-protéinique de la peau brûlée produit une vacuolisation des mitochondries des cellules hépatiques.
    Notes: Abstract Murine skin was thermally injured under controlled conditions in a standard high temperature burn model. After high-speed homogenization of the burned skin, a toxic fraction was isolated applying different purification procedures. It was demonstrated that high temperature burns produced chemical condensations and high molecular aggregates in the protein moiety of the skin. Plasma proteins were involved in these reactions. After the purification process, the high molecular aggregates were obtained not as pure proteins, but as lipid-protein micelles. In the lipid moiety itself, thermal decomposition products were detectable. The biological effects of the purified lipid-protein fraction were studied by aid of rat liver perfusions 5 days after intraperitoneal injection of the material measuring different biosynthetic activities of the isolated organ. Significantly reduced biosynthesis of urea and depressed gluconeogenesis were demonstrable. The biochemical results are paralleled by ultrastructural findings indicating that the lipid-protein complex from burned skin causes mitochondrial vacuolization in liver cells of treated animals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01556594
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  • 4
    Electronic Resource
    Electronic Resource
    The retroperitoneal resection margin and vessel involvement are important factors determining survival after pancreaticoduodenectomy for ductal adenocarcinoma of the head of the pancreas (1998)
    Springer
    Virchows Archiv 433 (1998), S. 237-242 
    Details
    ISSN: 1432-2307
    Keywords: Key words Pancreatic carcinoma ; Duodenopancreatectomy ; Resection margin involvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The prognosis of ductal adenocarcinoma of the pancreas is still poor. We analysed the factors that have a major influence on the survival of patients. Surgical specimens from 51 patients with ductal adenocarcinoma of the head of the pancreas were examined for tumour size, histological type, grade and local extension. In 7 patients the retroperitoneal resection margin was involved either macroscopically or histologically. Their mean survival was 10.6 months (1–17 months), compared with 22.7 months for the 44 patients with curative R0 resection. In 10 patients large vessels (portal and/or mesenteric vein) had to be resected; they survived for only 2-11 months, with a mean of 5 months (P〈0.05). Non-R0-resected patients and patients in whom tumour-invaded vessels had to be resected constitute a high-risk group with a significantly shorter mean survival of 8.8 months, compared with 24.3 months for R0 resected patients without vessel invasion (P〈0.05). Lymph node metastases were seen in 35 of 51 patients. Survival analysis based on nodal status revealed a mean survival of 33 months for patients staged as N0, 21.4 for N1a patients and 14 month for N1b patients. The differences were not statistically significant, however. Our data suggest that tumour invasion of the retroperitoneal resection margin and large vessel involvement are the major factors determining survival in patients with pancreatic cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004280050242
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  • 5
    Electronic Resource
    Electronic Resource
    Growth inhibition of pancreatic tumor cells by modified antisense oligodeoxynucleotides (1998)
    Springer
    Langenbeck's archives of surgery 383 (1998), S. 269-275 
    Details
    ISSN: 1435-2451
    Keywords: Key words Pancreatic cancer ; p53 ; Antisense oligodeoxynucleotides ; Cell culture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Introduction: Pancreatic adenocarcinomas are largely resistant to apoptosis. More than 50% of pancreatic tumors reveal mutations in the p53 tumor suppressor gene. Methods: We investigated the growth of pancreatic tumor cells after downregulation of p53 protein expression by antisense oligodeoxynucleotides. Results: Proliferation and p53 expression of PancTu-I cells overexpressing mutant p53 protein were inhibited by antisense oligodeoxynucleotide treatment. When analyzed, two of three other pancreatic tumor cell lines with mutated p53 were also inhibited in their growth. Two of two wild-type (wt) p53 pancreatic tumor cells were not significantly influenced by p53 expression and were, only to a lesser extent, affected in their proliferation. K562 cells (lacking p53 mRNA) and normal human skin fibroblasts used as a target mismatch control showed no changes in proliferation rates with treatment. The different biological effects in the various cells were not caused by differences in the uptake of the oligodeoxynucleotides as monitored by confocal laser-scanning microscopy. Conclusions: Truncation and 5′- and 3′-lipophilic modifications of the oligodeoxynucleotides drastically enhanced the growth inhibition of PancTu-I cells, which were resistant to apoptosis-inducing agents. Furthermore, a higher sequence-specificity of the observed effects was achieved with these compounds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004230050131
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