RESUMEN
We evaluated the usefulness of fusion vaccine prepared from IL-2-gene-transduced splenic dendritic cells (DCs) and fibrosarcoma tumor cells (QRsP) in treating of lung metastasis. The IL-2 or LacZ gene was transferred into spleen-derived DCs using an adenoviral vector. Irradiated QRsP tumor cells were fused with IL-2 gene transduced DCs (fusion/IL-2) or LacZ gene transduced DCs (fusion/LacZ) by polyethyleneglycol. These fusion cells expressed major histocompatibility complex (MHC) class I and MHC class II, CD86, CD11c and CD8alpha. IFN-gamma and cytotoxic T lymphocyte (CTL) activity of splenic lymphocytes in mice vaccinated with fusion cells increased significantly as compared with those of DC or tumor cells vaccinated mice. CTL levels in fusion/IL-2-vaccinated mice were higher than that in fusion/LacZ-vaccinated mice. The number of lung metastasis in the fusion/IL-2 or fusion/LacZ-vaccineatd mice was significantly lower than that in mice vaccinated with DCs, tumor or PBS. The introduction of the IL-2 gene into fusion cells produced more potent therapeutic effects. Our results suggest that the fusion cells prepared from IL-2 gene transduced spleen derived DCs and tumor cells have the ability to induce therapeutic effect against lung metastasis.
Asunto(s)
Fusión Celular , Células Dendríticas/inmunología , Inmunoterapia Activa , Interleucina-2/genética , Metástasis de la Neoplasia/prevención & control , Animales , Antígeno B7-2/análisis , Antígeno CD11c , Antígenos CD8/análisis , Femenino , Fibrosarcoma/patología , Operón Lac , Neoplasias Pulmonares/secundario , Complejo Mayor de Histocompatibilidad , Ratones , Ratones Endogámicos C57BL , Bazo/citología , Transducción Genética , Células Tumorales Cultivadas , Vacunas/inmunologíaRESUMEN
BACKGROUND: We performed a randomized study to evaluate the differences between upper midline incision and transverse incision for gastrectomy. METHODS: Patients undergoing distal gastrectomy or total gastrectomy for gastric cancer were randomly allocated to have either an upper midline incision or a transverse incision. The times taken to open and close the abdominal cavity, the number of doses of postoperative analgesics, and the incidence of postoperative pneumonia, wound infection, and intestinal obstruction were compared between the patients having the two incisions. RESULTS: Times for both opening and closing the abdominal cavity were longer with a transverse incision, in both the distal gastrectomy group and total gastrectomy group. In the patients in whom continuous epidural analgesia was used postoperatively, the number of additional doses of analgesics was smaller in the transverse-incision group after distal gastrectomy. The incidence of postoperative pneumonia was lower in the transverse-incision group after distal gastrectomy. The number of patients with postoperative intestinal obstruction was smaller in the transverse-incision group than in the midline-incision group after distal gastrectomy. In contrast to distal gastrectomy, there was no significant difference in the number of doses of postoperative analgesics, incidence of postoperative pneumonia, or incidence of postoperative intestinal obstruction between the two study groups after total gastrectomy. CONCLUSION: A transverse incision for distal gastrectomy may be more beneficial than an upper midline incision in attenuating postoperative wound pain, decreasing the incidence of postoperative pneumonia, and preventing postoperative intestinal obstruction.
Asunto(s)
Gastrectomía/métodos , Complicaciones Posoperatorias , Neoplasias Gástricas/cirugía , Anciano , Femenino , Humanos , Obstrucción Intestinal/etiología , Obstrucción Intestinal/prevención & control , Laparotomía , Masculino , Persona de Mediana Edad , Dolor/etiología , Dolor/prevención & control , Neumonía/etiología , Neumonía/prevención & control , Estudios ProspectivosRESUMEN
A 72-year-old woman presented to our hospital with diffuse dilation of the intrahepatic bile ducts. Imaging studies revealed a solitary hepatic cyst, 3 cm in diameter, in segment 4 of Couinaud's category of the liver, riding on the hilar hepatic duct. Deroofing of the hepatic cyst was performed, and the dilation of the intrahepatic bile ducts was attenuated. We concluded that even a very small solitary hepatic cyst might cause stenosis of the common hepatic duct, if it is located just above the hepatic hilum.