RESUMEN
We report a case of a thoracic anastomotic leak after oesophagectomy for cancer treated by surgical debridement, drainage and an endoscopically placed self-expanding stent. Intrathoracic, covered oesophageal stents appears to reduce leak-morbidity after oesophagectomy and may be considered as a cost-effective treatment alternative.
Asunto(s)
Anastomosis Quirúrgica/efectos adversos , Fístula Esofágica/cirugía , Esofagectomía/efectos adversos , Complicaciones Posoperatorias , Stents , Carcinoma de Células Escamosas/cirugía , Desbridamiento , Drenaje , Fístula Esofágica/etiología , Neoplasias Esofágicas/cirugía , Esofagoscopía , Gastroplastia/efectos adversos , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We investigated the possible role of chromosome 10q losses in colorectal cancer metastasis by carrying out an allelic imbalance study on a series of microsatellite instability-negative (MSI-) primary tumours (n=32) and metastases (n=36) from 49 patients. Our results demonstrate that 10q allelic losses are associated with a significant proportion (25%) of MSI- colorectal tumours, but are not involved in the metastatic process. PTEN and BMPR1A, two genes located in the common deleted region, were screened for mutations in samples with loss of heterozygosity. The absence or low frequency of mutations indicates that the inactivation of these genes by deletion of one allele and mutation of the other one plays only a minor role in MSI- tumours.
Asunto(s)
Cromosomas Humanos Par 10 , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/patología , Pérdida de Heterocigocidad , Metástasis de la Neoplasia , Monoéster Fosfórico Hidrolasas/genética , Proteínas Serina-Treonina Quinasas/genética , Receptores de Factores de Crecimiento/genética , Proteínas Supresoras de Tumor/genética , Secuencia de Bases , Receptores de Proteínas Morfogenéticas Óseas de Tipo 1 , Genes Supresores de Tumor , Mutación de Línea Germinal , Humanos , Repeticiones de Microsatélite , Datos de Secuencia Molecular , Fosfohidrolasa PTENRESUMEN
STUDY AIM: The aim of this retrospective study was to report on seven blunt fractures of the pancreas and to emphasize the difficulties of their diagnosis and treatment as well as their severity. PATIENTS AND METHOD: From October 1995 to March 2000, seven cases of blunt fracture of the pancreas were observed. The diagnosis was immediate in two cases, due to an emergency abdominal CT scan, and for the five other patients it was postponed by 4 to 12 days because of the frequency and severity of the associated lesions present in five cases out of seven. A left splenopancreatectomy was performed in four patients; a late necrosectomy with external drainage in two patients; and one patient was not operated on. RESULTS: There was one postoperative death due to associated cerebral lesions. After left splenopancreatectomy a pancreatic fistula dried up in less than a week in two patients. After necrosectomy and drainage, the operation was complicated in the two cases because of repetitive abscesses and a large and long-lasting pancreatic fistula. CONCLUSION: Blunt fractures of the pancreas are rare and serious lesions. The diagnosis is often made during an emergency laparotomy for hemoperitoneum or peritonitis. The existence of a canal rupture confirmed by transpapillary wirsungography, or better by wirsungo-MRI, is a strong arguing point for a left splenopancreatectomy when the patient's state allows it. Simple external drainage is only justified when the left splenopancreatectomy isn't possible.
Asunto(s)
Páncreas/lesiones , Pancreatectomía , Esplenectomía , Heridas no Penetrantes/patología , Adolescente , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Páncreas/patología , Páncreas/cirugía , Estudios Retrospectivos , Rotura , Heridas no Penetrantes/cirugíaRESUMEN
The potent food mutagens and carcinogens 2-amino-3-methylimidazol[4,5-f]quinoline (IQ), 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MEIQ) and 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) are probably the most active bacterial mutagens so far discovered. Important discrepancies were found, however, in the specific mutagenicities published for these compounds. This paper analyzes a number of experimental factors that could explain these differences: purity of the compounds, stability under the experimental conditions employed, solvents used, bacterial toxicity, testing procedure, amount and age of the S9 fraction, dose-effect relationships, day-to-day variability, origin of the compounds investigated or of the bacterial strain and age of the strain culture used. None of these factors was found to play a critical role, when the other experimental conditions were strictly standardized. The in-house testing procedure used probably explains the interlaboratory variations observed.
Asunto(s)
Mutágenos/toxicidad , Quinolinas/toxicidad , Quinoxalinas/toxicidad , Relación Dosis-Respuesta a Droga , Pruebas de Mutagenicidad , Reproducibilidad de los Resultados , Salmonella typhimurium/efectos de los fármacosRESUMEN
The aim of this study was to investigate the role of an arene oxide pathway in the teratogenicity displayed by DPH, a highly effective antiepileptic agent. This approach was carried out by comparing the teratogene potential of DPH and of p2-H-DPH administrated at days 8, 9 and 12 of gestation. The present findings support the hypothesis that substitution of protium by deuterium at the para position of one of the phenyl rings, which favours an arene oxide pathway, causes an increase in some to the teratogenic effects of DPH.
Asunto(s)
Anomalías Inducidas por Medicamentos/epidemiología , Deuterio/efectos adversos , Fenitoína/efectos adversos , Animales , Fisura del Paladar/inducido químicamente , Femenino , Ratones , Ratones Endogámicos BALB C , Embarazo , TeratógenosRESUMEN
A comparison was made, for 40 compounds belonging to different chemical classes, of the mutagenicity as measured by the Salmonella assay and of the SOS-inducing potency as measured by the SOS chromotest kit procedure. It was found that most (78%) of the chemicals described as mutagens/carcinogens (14 compounds) were detected with a simplified Ames test procedure, using 3 strains (TA 97, TA 98, TA 100) and 3 concentrations of the tested material. The SOS chromotest, carried out following the recommendations of the commercially available kits, revealed that only 4 Ames test-positive compounds were mutagenic towards E. coli strain PQ 37.