Advisability of palliative resections in incurable advanced gastric cancer.

UNLABELLED: Effective treatment is the primary objective of surgeon in the treatment of advanced gastric cancer. Poor prognosis and significant advancement of gastric cancer at the time of diagnosis are decisive factors for the only possible surgical management method being palliative procedures. THE AIM OF THE STUDY: was the evaluation of the value of palliative resection procedures in patients with advanced gastric cancer. MATERIAL AND METHODS: The subject in the study was a group of 105 patients with gastric adenocarcinoma at stage 4 of advancement, in whom curative treatment was not possible. The group constituted 44.5% of patients operated on due to gastric cancer at the Department of General and Oncological Surgery, PUM, in the years 1998-2009. The patients were divided into two groups: the first one comprised 44 patients post palliative resections, the second - 61 patients post non-resection procedures. The subject of analysis were early and late treatment results post palliative resections, and they were compared with the treatment results post non-resection procedures. RESULTS: Palliative resections were performed in 44 patients (19 females and 25 males), while in 61 patients (38 males and 23 females) non-resection procedures were performed. Postoperative complications were observed in 25% of patients in the group post palliative resections and in 11.5% in the group of patients without the resection of primary focus. In-hospital mortality stood at 4.5% in the group post palliative resections and 4.8% in the group post non-resection procedures. The percentage of 1-year and 4-year survival post palliative resections stood at 43% and 8.8%, respectively. In the group without the resection of primary focus, 16% survived 1 year and nobody survived 2 years. CONCLUSIONS: Palliative resections improve the survival of patients with incurable gastric cancer and should be considered if only the loco-regional conditions are favourable.

The immunoexpression of FSH-R in the ductuli efferentes and the epididymis of men and rat: effect of FSH on the morphology and steroidogenic activity of rat epididymal epithelial cells in vitro.

The Sertoli cells were regarded as the only target for FSH in male reproductive system. The expression of FSH receptor (FSH-R) was detected also in epithelial cells of the caput epididymis of rat and monkey. We showed in the immunohistochemistry study the expression of FSH-R in rat and human ductuli efferentes and the caput, corpus, and cauda epididymis, moreover, by Western blot analysis in the caput and cauda epididymis of rat. Additionally, we presented that the morphology of rat epididymal epithelial cells in vitro was affected by FSH, and FSH stimulation resulted in the increase of 17beta-estradiol synthesis by rat caput epididymal cells in dose-depended manner. In conclusion, the identification of FSH receptors in human and rat epididymides supports our results that the epididymis is a target organ not only for LH but additionally for FSH. On the basis of the results we showed for the first time that morphology of epididymal epithelial cells and epididymal steroidogenesis can be regulated by FSH.

[Regulation of steroidogenesis in rat epididymal epithelial cells]. / Regulacja steroidogenezy w komórkach nablonkowych najadrza szczura.

The epididymal epithelial cells of rats in vitro display features of steroidogenic cells. The cells produce and release androgens into the culture medium that are converted to 17beta-estradiol (E2) due to the activity ofcytochrome P450 aromatase. It is probable that steroidogenesis in epididymal epithelial cells of rat is regulated by luteinizing hormone (LH). The aim of the study was to estimate the influence of hCG on the morphology of epididymal epithelial cells and synthesis of E2 by the cells. In conclusion, the hCG stimulation results in changes of the cell morphology, similar to those observed in Leydig cells and increase synthesis of the 17beta-estradiol due to the presence of LH/hCG receptors.

Effect of hCG on the morphology of rat epididymal epithelial cells in vitro.

The epididymis is an androgen-dependent organ. The hormones regulate the morphology and secretory activity of the epididymal epithelial cells. The cells in vitro resume their function as in vivo and also reveal features of steroidogenic cells. It can be expected that, as with Leydig cells, the morphology and function of the cells can be regulated by LH/hCG. The aim of the study was to assess the morphology of epididymal epithelial cells in vitro after stimulation with hCG. The experiment was performed on cells isolated from sexually mature rats. The epididymal epithelial cells were cultured in a medium with the addition of dihydrotestosterone (DHT). Moreover, the cells were cultured in the medium with DHT and without DHT but enriched with hCG. The epididymal epithelial cells cultured with DHT formed a monolayer and accumulated glycogen, a PAS-positive substance and lipid droplets. The cells cultured without DHT were stellate in shape and low in glycogen and PASpositive substance but they contained lipid droplets. The morphology of epididymal epithelial cells cultured without DHT but after stimulation with hCG was similar to the morphology of the cells cultured with DHT. This was the first sign that the morphology of the cells can be influenced by hCG.