Hepato Gastroenterol
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Hepato Gastroenterol · Mar 2002
Randomized Controlled Trial Clinical TrialEffects of IL-2 preoperative immunotherapy on surgery-induced changes in angiogenic regulation and its prevention of VEGF increase and IL-12 decline.
IL-2 preoperative immunotherapy has been proven to abrogate surgery-induced immunosuppression in cancer patients. In contrast, at present there are no data about the possible influence of IL-2 on angiogenesis-related molecular changes determined by the surgical operation. At present, it is known that VEGF (vascular endothelial growth factor) is the main endogenous angiogenic factor, whereas the antitumor cytokine IL-12 has appeared to play an anti-angiogenetic role. On this basis, a study was planned to evaluate the influence of IL-2 presurgical immunotherapy on the perioperative changes in VEGF and IL-12 secretions. ⋯ This preliminary study would suggest that IL-2 preoperative immunotherapy may abrogate surgery decline in IL-12 levels and reduce, although not completely prevent, VEGF increase during the postoperative period in surgically treated cancer patients. These results would suggest that IL-2 presurgical immunotherapy may counteract surgery-induced stimulation of the angiogenesis, by either opposing the decline in blood levels of the anti-angiogenetic cytokine IL-12, or reducing the increase in those of the angiogenic factor VEGF.
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Hepato Gastroenterol · Mar 2002
Case ReportsThree cases of primary sclerosing cholangitis associated with ulcerative colitis; diagnostic usefulness of magnetic resonance cholangiopancreatography.
Primary sclerosing cholangitis is often accompanied by inflammatory bowel disease in western countries. However, the incidence of primary sclerosing cholangitis in patients with ulcerative colitis appears to be much lower in Japan. ⋯ Magnetic resonance cholangiopancreatography is the most safe and convincing tool for the diagnosis of coexistent primary sclerosing cholangitis in the patients with ulcerative colitis.
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Hepato Gastroenterol · Mar 2002
Evaluation of portal vascular resistance using an intraoperative Doppler ultrasound.
To evaluate portal vascular resistance using Doppler ultrasound intraoperatively. ⋯ Simplified portal resistive index evaluated using intraoperative Doppler ultrasound is an easy and reliable index for assessing portal vascular resistance during liver surgery.
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Hepato Gastroenterol · Mar 2002
Significance of SIRS score in therapeutic strategy for acute appendicitis.
The surgical indication for acute appendicitis has been discussed diversely. SIRS (systematic inflammatory response syndrome) is a concept that has been advocated as the clinical criteria on inflammatory diseases. The aim of the current study was to elucidate the significance of SIRS score in deciding therapeutic strategies for acute appendicitis. ⋯ SIRS score is also useful as objective and auxiliary information to determine the surgical indication for acute appendicitis.
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Hepato Gastroenterol · Jan 2002
Case ReportsArterial and vena caval resections combined with pancreaticoduodenectomy in highly selected patients with periampullary malignancies.
To obtain a margin-negative resection and increase the indication for resection of periampullary malignancies, pancreaticoduodenectomy with a SM-PVR (superior mesenterico-portal vein resection) has been performed. However, an arterial resection, other vascular resections except SM-PVR (e.g., an inferior vena caval resection), or a metastatic tumor resection combined with pancreaticoduodenectomy has yet to be fully elucidated because of the high risk of postoperative complications and extremely poor long-term survival in patients undergoing these exceptional procedures. The present report focused on highly selected patients undergoing an arterial resection or a vena caval resection associated with pancreaticoduodenectomy. ⋯ The indication for retropancreatic arterial resection associated with pancreaticoduodenectomy should be carefully evaluated only when a margin-negative resection can be achieved. An appropriate bypass method of arterial reconstruction should be selected because a direct end-to-end anastomosis is not always feasible. Hepatectomy for metastases of pancreatic ductal carcinoma should be also regarded as an exceptional procedure.