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[This corrects the article DOI: 10.1016/j.heliyon.2022.e09563.].
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Calcium absorption; Vitamin D deficiency; Lack of sunlight; Hikikomori; Vegan.
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BACKGROUND/AIMS: The Pringle maneuver is traditionally used to avoid hemorrhage during hepatectomy for hepatic metastasis. However, metastasis can occur under ischemic conditions due to some unknown mechanism. METHODOLOGY: An orthotopic model of murine colon cancer was established in syngeneic BALB/c mice. Viable CT-26 cells were implanted into the spleen of these mice. The mice underwent a laparotomy 5 days after the implantation and the hepato-duodenal ligament was clamped for 0 or 10 minutes (Pringle maneuver). The mice were sacrificed 7 days after this maneuver and the number of hepatic metastasis were counted. RESULTS: The mice that underwent the maneuver developed a greater number of hepatic metastasis. An immunohistochemical analysis revealed that the expression of microvessel density, VEGF and KDR/Flk-1 were higher in the hepatic metastasis in the mice treated with the maneuver. In addition, the mice which were treated by the maneuver had a higher level VEGF in the serum. CONCLUSION: These data suggest that the Pringle maneuver induces hepatic metastasis by stimulating the overexpression of tumor vasculature.
Subject(s)
Blood Loss, Surgical/prevention & control , Colonic Neoplasms/pathology , Hemostasis, Surgical/methods , Hepatectomy/methods , Liver Neoplasms/surgery , Animals , Disease Models, Animal , Enzyme-Linked Immunosorbent Assay , Immunoenzyme Techniques , Ligation , Liver Neoplasms/blood supply , Liver Neoplasms/secondary , Mice , Mice, Inbred BALB C , Microcirculation , Statistics, Nonparametric , Vascular Endothelial Growth Factor Receptor-2/bloodSubject(s)
Aneurysm, False/diagnosis , Aneurysm, Ruptured/diagnosis , Colonoscopy , Gastrointestinal Hemorrhage/etiology , Hemostasis, Endoscopic/methods , Mesenteric Artery, Superior , Aged, 80 and over , Aneurysm, False/complications , Aneurysm, False/surgery , Aneurysm, Ruptured/complications , Aneurysm, Ruptured/surgery , Diagnosis, Differential , Follow-Up Studies , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/surgery , Humans , Ligation , Male , Tomography, X-Ray ComputedABSTRACT
BACKGROUND/AIMS: Many patients with a complete rectal prolapse tend to be old. Therefore, surgeons tend to choose a surgical procedure associated with minimal stress. However, the recurrence rate is problematic. Altemeier's procedure causes minimal stress. This procedure is often selected for performing a complete rectal prolapse. Usually, a rectosigmoidectomy, is performed with levatoroplasty and anastomosis of the anal tube and the colon under spinal anesthesia. This procedure was applied for a complete rectal prolapse and the outcomes of this procedure were analyzed. METHODOLOGY: From 2000 August to 2006 January, 13 patients underwent this procedure. The patients ranged from 27 to 89 years of age (median 76 years). The length of the escaped enteric canal ranged from 7.0 to 20.0cm. RESULTS: All patients underwent the procedure under spinal anesthesia. The surgical time was 113 +/- 20 minutes. There were two postoperative complications which were both treated conservatively. One recurrent case was recognized. CONCLUSION: Altemeier's procedure was associated with a minimum of stress and the recurrence rate was low (7.6%). Because a complete rectal prolapse is caused by the fragility of the anal sphincter muscle and levator ani muscle, this procedure is considered to be effective and appropriate.
Subject(s)
Digestive System Surgical Procedures/methods , Rectal Prolapse/surgery , Adult , Aged , Aged, 80 and over , Anastomotic Leak/epidemiology , Female , Humans , Male , Middle Aged , Recurrence , Suture TechniquesABSTRACT
BACKGROUND/AIMS: The japanese population have the longest-life expectancy in the world. Accordingly, older patients with colorectal cancer with senile kyphosis caused by aging or osteoporosis also increase. Laparoscopic surgery is minimally-invasive, and performance on severe kyphotic patients may cause difficulty to approach a narrow abdomen. To determine whether laparoscopic surgery is safe and feasible in patients with severe senile kyphosis. METHODS: Laparoscopic operations under general anesthesia were undertaken with the patients in lithotomy position. Intraoperative difficulties were compared with normal laparoscopic approach. RESULTS: Working space was divided by right costal arch during right hemicolectomy for right sided colon cancer. For sigmoid colon cancer, dissection of lymph node and anastomosis were completed with much difficulty because the pelvic space was occupied with small intestine. However, the postoperative course was uneventful despite impaired lung function in all cases. CONCLUSIONS: Severe senile kyphosis is not a contraindication for minimally invasive technique applied to colorectal cancer patients.
Subject(s)
Colorectal Neoplasms/surgery , Kyphosis/complications , Laparoscopy , Aged , Aged, 80 and over , Contraindications , Female , Humans , Minimally Invasive Surgical ProceduresABSTRACT
BACKGROUND/PURPOSE: Endoscopic drainage of pancreatic pseudocysts using transpapillary and transmural approaches has been reported. In this study, endoscopic nasopancreatic drainage (ENPD) and pancreatic stenting were performed in patients with pseudocyst and abscess associated with acute pancreatitis, and the usefulness and problems of the procedures were investigated. METHODS: After endoscopic retrograde pancreatography was done, ENPD and/or pancreatic stenting were performed in 13 patients with pancreatitis and pseudocyst or abscess that communicated with the main pancreatic duct. RESULTS: ENPD was performed in seven patients, and was effective in all five patients with cysts: the cysts disappeared or shrank. However, the condition in the two patients with abscess was unchanged, and percutaneous drainage was performed. Stenting was carried out in six patients, and the cyst disappeared or pancreatitis was improved in all six. The stent was removed from two patients, but no recurrence has been noted so far. CONCLUSIONS: ENPD and stenting are effective therapeutic choices for acute and chronic pancreatitis and pseudocysts, and they are superior to percutaneous drainage to avoid pancreatic fistula, but they may not be effective for pancreatic abscess. Selection of therapeutic methods corresponding to individual cases is important.
Subject(s)
Abscess/therapy , Drainage/methods , Endoscopy, Gastrointestinal , Pancreatic Diseases/therapy , Pancreatic Pseudocyst/therapy , Pancreatitis/therapy , Stents , Abscess/diagnostic imaging , Acute Disease , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pancreatic Diseases/diagnostic imaging , Pancreatic Pseudocyst/diagnostic imaging , Pancreatitis/diagnostic imaging , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
We investigated the efficacy of interferon (IFN)-beta therapy against colon cancer using a novel approach mediated by a lyophilized preparation of High 5 (H5) insect cells transduced with a recombinant baculovirus encoding murine IFN-beta (H5BVIFN-beta). The orthotopic model of CT-26 murine colon cancer in syngeneic BALB/c mice was used in the study, and H5BVIFN-beta was intratumorally delivered. Two injections of H5BVIFN-beta (on days 14 and 21 after tumor cell implantation), but not lyophilized H5 cells (control), significantly reduced the size of cecal tumors and the number of liver metastases. Immunohistochemical analysis revealed that cecal tumors injected with saline or H5 contained many proliferating cells (PCNA+) and few apoptotic cells (TUNEL+). In sharp contrast, H5BVIFN-beta-treated tumors contained fewer PCNA+ cells and significantly more TUNEL+ cells. The H5BVIFN-beta-treated tumors were infiltrated by a large number of CD8+ and F4/80+ cells and expressed a high level of inducible nitric oxide synthase (iNOS). Immunofluorescent double staining technique demonstrated a significant increase of apoptotic endothelial cells (CD-31+/TUNEL+) in tumors treated with H5BVIFN-beta. In conclusion, the data show that intralesional injections of H5BVIFN-beta can suppress the progressive growth of established orthotopic tumors of colon cancer cells and occult liver metastasis. The therapeutic effects directly correlate with destruction of tumor vasculature.
