RESUMEN
This experimental study assessed the use of a collagen-coated vicryl mesh tube to reconstruct the esophagus in growing piglets. Initial experiments, in which a segment of thoracic esophagus was excised and replaced by this prosthetic tube, resulted in all the animals succumbing to mediastinitis within the first 3-4 days. This was shown, at post-mortem, to be due to leakage of the prosthesis, secondary to acid reflux, resulting in dissolution of the prosthesis. The collagen-coated vicryl mesh was thereafter treated with glutaraldehyde and in-vitro studies showed that the glutaraldehyde-treated material exhibited a higher resistance to 0.01 M HCl at pH 2.0, when compared with untreated material. In addition, the glutaraldehyde-treated material also showed an increased resistance to digestion by bacterial collagenase. Further experiments to reconstruct the cervical esophagus in growing piglets were performed using the revised glutaraldehyde cross-linked collagen coated vicryl mesh tube. All the animals survived the procedure and the prosthesis were leakproof immediately post-operatively. The animals, however, developed severe stenosis at a mean of 11 days post-operatively. Attempts at neo-epithelialization of the graft were seen histologically. There was considerable granulation tissue and scar tissue formation on the mediastinal aspect of the graft. It is suggested that collagen coated vicryl mesh tube may find applications in the treatment of esophageal atresia only if the problem of stenosis of the prosthesis can be solved.
Asunto(s)
Colágeno/uso terapéutico , Esofagoplastia/métodos , Poliglactina 910 , Prótesis e Implantes , Mallas Quirúrgicas , Anastomosis Quirúrgica , Animales , Atresia Esofágica/cirugía , Complicaciones Posoperatorias , PorcinosRESUMEN
Native collagen, acetylated collagen, collagen/10% chondroitin sulphate, collagen/2.5% hyaluronic acid and collagen/20% hyaluronic acid were implanted both as film and as sponge into rat lumbar muscle for 7 and 14 d. After 7 d implantation, all materials elicited an acute inflammatory cell response characterized by numerous polymorphs and histocytes. The cell population after 14 d was principally mononuclear, i.e. leucocytes, neutrophils, macrophages, lymphocytes and fibroblasts. Both films and sponges followed a similar pattern. Native collagen elicited a subacute inflammatory response after 7 d. However, 14 d after implantation, a marked infiltration by neutrophils was apparent with subsequent degradation of existing collagen material. Acetylated collagen film evoked a much greater inflammatory cell response than native collagen. Both collagen/hyaluronic acid composites elicited a similar response. The collagen/10% chondroitin sulphate composite elicited the least inflammatory cell response at 7 d, whereas infiltration by host fibroblasts after 14 d implantation was clearly seen.
Asunto(s)
Materiales Biocompatibles , Colágeno , Glicosaminoglicanos , Polímeros , Tapones Quirúrgicos de Gaza , Acetilación , Animales , Materiales Biocompatibles/efectos adversos , Colágeno/metabolismo , Colágeno/toxicidad , Glicosaminoglicanos/metabolismo , Glicosaminoglicanos/toxicidad , Ácido Hialurónico/análisis , Inflamación/etiología , Ensayo de Materiales , Colagenasa Microbiana/metabolismo , Músculos/cirugía , Polímeros/metabolismo , Polímeros/toxicidad , Ratas , Tapones Quirúrgicos de Gaza/efectos adversosRESUMEN
The regeneration of smooth muscle appears to take place within the fibrous tissue characteristically found when a biodegradable collagen/Vicryl prosthesis is used to repair full thickness defects in the rabbit urinary bladder. The question of whether the central smooth muscle was the result of myoblastic differentiation in the fibrous tissue or arose from healthy pre-existing detrusor muscle was resolved by serial sectioning and specific staining. Only in situ transmutation, or differentiation, explains the morphology, and the results therefore strongly suggest that this central smooth muscle regenerated from within the repair area.
Asunto(s)
Músculo Liso/fisiología , Regeneración , Vejiga Urinaria/fisiología , Animales , Diferenciación Celular , Músculo Liso/citología , Músculo Liso/cirugía , Conejos , Vejiga Urinaria/citología , Vejiga Urinaria/cirugíaRESUMEN
Media from explants of 120 human breast cancers cultured for 24 h were analysed for breast gross cystic disease protein 15 (GCDFP-15). The protein was detected in media from 94 tumours (73%) in concentrations varying from 1.5 to 2100 ng/ml. Levels were not related to menopausal status of the patient, disease stage, tumour oestrogen receptors or the derivation of tumour material. However, concentrations were significantly related to the degree of apocrine differentiation of the tumour and, in a subset of the cancers, capacity to release GCDFP-15 was positively correlated with incidence of progestogen and androgen receptors. There was also a negative quantitative correlation between production of GCDFP-15 and glycoprotein hormone alpha subunit (but no relationship with CEA). In 10 tumours culture was continued for 48 h. Values for GCDFP-15 were always considerably lower in the 24-48 h media compared with those from 0-24 h and cytosols from post-culture explants contained no detectable GCDFP-15. In contrast, CEA levels were often comparable in 0-24 and 24-48 h media and explants after culture frequently contained substantial amounts of CEA. The high proportion of breast carcinomas producing GCDF-15 in relatively large amounts and its rapid release make it an interesting marker by which the in vitro activity of human breast cancers may be monitored.
Asunto(s)
Apolipoproteínas , Neoplasias de la Mama/análisis , Proteínas Portadoras , Glicoproteínas , Proteínas de Transporte de Membrana , Proteínas de Neoplasias/análisis , Apolipoproteínas D , Biomarcadores de Tumor/análisis , Neoplasias de la Mama/patología , Femenino , Humanos , Receptores de Esteroides/análisisRESUMEN
Metabolism of (7 alpha-3H)testosterone has been measured in 111 human breast cancers and compared retrospectively with the degree of apocrine differentiation in the tumors. Cancers in which apocrine characteristics were a marked feature metabolized significantly more testosterone precursor than those in which apocrine features did not predominate. Higher metabolism was accounted for by increased conversion to 5 alpha-reduced products such as 5 alpha-dihydrotestosterone and 5 alpha-androstanediols.
Asunto(s)
Glándulas Apocrinas/patología , Neoplasias de la Mama/metabolismo , Glándulas Sudoríparas/patología , Testosterona/metabolismo , 3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/análisis , Neoplasias de la Mama/patología , Femenino , HumanosRESUMEN
A prospective study has been carried out in 172 women to determine the sensitivity of methods to detect occult metastatic disease in the skeleton and liver. With the exception of bone scintiscans, the results of these tests bore little relationship to recurrence rates. On the other hand, knowledge of the histopathology of the lower axillary (pectoral) lymph nodes is of value in this respect.A follow-up study is also reported which confirms the importance of accurate measurements of the primary tumour clinical node status and oestrogen receptor contact of the tumour in defining prognostic groups. Elastosis (estimated in 165 tumours) did not prove to be a useful prognostic index.
Asunto(s)
Neoplasias de la Mama/patología , Estadificación de Neoplasias/métodos , Neoplasias Óseas/secundario , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/secundario , Metástasis Linfática , Recurrencia Local de Neoplasia , Pronóstico , Estudios Prospectivos , EscociaAsunto(s)
Neoplasias de la Mama/patología , Metástasis de la Neoplasia/diagnóstico , Axila , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/secundario , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundario , Ganglios Linfáticos/patología , Recurrencia Local de Neoplasia , Pronóstico , Estudios ProspectivosAsunto(s)
Corticoesteroides/metabolismo , Carcinoma Broncogénico/metabolismo , Neoplasias Pulmonares/metabolismo , Anciano , Androstano-3,17-diol/biosíntesis , Androstenodiol/biosíntesis , Androstenodiona/biosíntesis , Deshidroepiandrosterona/metabolismo , Dihidrotestosterona/biosíntesis , Humanos , Técnicas In Vitro , Metástasis Linfática , Masculino , Cuello , Pregnenolona/metabolismo , Progesterona/biosíntesis , Testosterona/metabolismoRESUMEN
The distribution of pectoral (external mammary) nodes identified during the operation and removed with the axillary tail of the breast was studied in 45 patients treated by simple (total) mastectomy. Up to 13 nodes may lie within the axillary tail, and these are continuous with the pectoral nodes. Lymph-nodes were identified in 90 percent of patients treated by simple (total) mastectomy without dissection of the axilla.