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  • 1
    Electronic Resource
    Electronic Resource
    Expression of MMP-2 is associated with progression and lymph node metastasis of gastric carcinoma (2001)
    Oxford UK : Blackwell Science Ltd
    Histopathology 39 (2001), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Expression of MMP-2 is associated with progression and lymph node metastasis of gastric carcinoma Aims: One important step in tumour invasion is the penetration of the basement membrane. Matrix metalloproteinases (MMPs) play a key role in the migration of normal and malignant cells through the basement membrane. The aim of this study was to investigate correlations between matrix metalloproteinase 2 (MMP-2) immunoreactivity and currently used classification systems and possible relationships between lymph node metastasis and MMP-2 expression. Methods and results: This prospective study analysed specimens obtained from 114 gastric cancer patients (mean age 64 years; range 33–86 years) who underwent gastrectomy with extended lymphadenectomy. All specimens were categorized according to UICC classification, WHO classification, tumour differentiation, Laurén classification, Ming classification and Goseki classification. Formalin-fixed paraffin-embedded tumour specimens were stained using an avidin–biotin complex peroxidase assay. MMP-2 expression in the tumour epithelium was studied by immunohistochemistry with semiquantitative (score 0–3) evaluation. The MMP-2 staining pattern was positive (score 1–3) in 93 (81.6%) specimens and negative (score 0) in 21 (18.4%) samples. No significant correlations were found between MMP-2 expression and other variables such as age, tumour differentiation, WHO, Lauren, Goseki, and Ming classifications. In contrast, the intensity of MMP-2 staining in tumour cells correlated significantly with depth of tumour infiltration (T-stage), lymph node metastasis (N-stage), distant metastasis (M-stage), and UICC stage. Conclusions: Expression of MMP-2 is strongly associated with tumour progression and lymph node metastasis in gastric cancer. Therefore MMP-2 staining may be clinically useful as predictor of tumour progression, especially for lymph node metastasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.2001.01306.x
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  • 2
    Electronic Resource
    Electronic Resource
    Comparative evaluation of the prognostic value of MUC1, MUC2, sialyl-Lewisa and sialyl-Lewisx antigens in colorectal adenocarcinoma (2002)
    Oxford UK : Blackwell Science Ltd
    Histopathology 40 (2002), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Comparative evaluation of the prognostic value of MUC1, MUC2, sialyl-Lewisa and sialyl-Lewisx antigens in colorectal adenocarcinoma Aims: The significance of MUC1, MUC2 and sialylated Lewis blood group antigens as prognostic markers in colorectal adenocarcinoma was investigated in a large series of patients because previous investigations revealed inconsistent results due to unrelated tumour samples from different patient groups and methodological differences. Methods and results: Tissues from 243 patients with colorectal adenocarcinoma were stained immunohistochemically. MUC1 showed a strong immunoreactivity (in more than 35% of the tumour area) in 32.5%, MUC2 in 51.0%, sialyl-Lewisx in 67.9% and sialyl-Lewisa in 73.7% of the cases, respectively. MUC1 immunoreactivity displayed a significant correlation with tumour progression as reflected by advancing pTNM staging and poor differentiation. MUC2 expression was significantly stronger in mucinous adenocarcinomas. Sialyl-Lewisx immunostaining correlated with the extent of lymph node metastasis as well as low cytological differentiation. According to univariate and multivariate analysis (P 〈 0.0001) only MUC1 reactivity represented a marker of worse survival probability, opposed to the sialylated Lewis antigens that did not exert a predictive value. Conclusions: According to our data, MUC1 and sialyl-Lewisx immunoreactivity exhibit statistically significant correlations with established markers of tumour progression. However, only MUC1 presents as an independent prognostic factor of colorectal adenocarcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.2002.01389.x
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  • 3
    Electronic Resource
    Electronic Resource
    Immunoreactivity of cytokeratins (CK7, CK20) and mucin peptide core antigens (MUC1, MUC2, MUC5AC) in adenocarcinomas, normal and metaplastic tissues of the distal oesophagus, oesophago–gastric junction and proximal stomach (2003)
    Oxford, UK : Blackwell Science Ltd
    Histopathology 43 (2003), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aims:  Adenocarcinomas of the distal oesophagus and especially the oesophago–gastric junction have shown an increasing incidence during the last decade. Definition of subgroups according to different sites of development, histogenesis or aetiology may prove to be valuable for clinical diagnosis and treatment. Previous studies have shown differences in cytokeratin patterns between Barrett's metaplasia of the oesophagus and intestinal metaplasia in the stomach. The aim of our study was to investigate whether the expression of certain cytokeratins (CK7, CK20) and mucins (MUC1, MUC2, MUC5AC) exhibit clear-cut patterns, thus allowing a subclassification of adenocarcinomas of the oesophago–gastric junction. The possibility of a relationship between antigen expression and the presence or absence of Barrett's metaplastic epithelium was also studied.Methods and results:  CK7, CK20, MUC1, MUC2 and MUC5AC were visualized in six adenocarcinomas of the distal oesophagus, 29 adenocarcinomas of the oesophago–gastric junction and eight adenocarcinomas of the proximal stomach. CK7, CK20 and MUC1 were strongly expressed in the great majority of all neoplasms under study, whereas MUC2 and MUC5AC were absent or only faintly detectable. CK20 exhibited a significantly stronger expression in poorly differentiated tumours (G3) and MUC1 immunoreactivity correlated with tubular and papillary versus signet-ring cell histopathology. Other statistically significant correlations between antigens and histopathological features (pTNM stage, grading, histopathological subtype, presence/absence of Barrett's epithelium) were not observed.Conclusions:  According to our results, most adenocarcinomas of the oesophago–gastric junction show a CK7+, CK20+, MUC1+ phenotype irrespective of the presence or absence of Barrett's epithelium. The immunohistochemical data suggest a similar histogenesis of these tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.2003.01680.x
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  • 4
    Electronic Resource
    Electronic Resource
    Bewirken Leitlinien eine Verbesserung des perioperativen Ablaufs? – Untersuchung anhand der perioperativen Antibioticaprophylaxe (2000)
    Springer
    Der Chirurg 71 (2000), S. 702-706 
    Details
    ISSN: 1433-0385
    Keywords: Keywords: Perioperative antibiotic prophylaxis ; Guidelines ; Quality assurance. ; Schlüsselwörter: Perioperative Antibioticaprophylaxe ; Leitlinienerstellung ; Qualitätssicherung.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Einleitung: Die Effektivität der perioperativen Antibioticagabe ist nachgewiesen, die Prophylaxe wird jedoch häufig inadäquat angewandt. Ziel der Studie war es daher zu überprüfen, inwieweit Leitlinien in der Lage sind, die Qualität der perioperativen Gabe von Antibiotica zu verbessern. Methoden: In einer retrospektiven Analyse stellten wir bei 280 Operationen den Ist-Zustand der Antibioticaprophylaxe hinsichtlich der Kriterienwahl des Antibioticums, Dosis, Zeitpunkt, Stop nach Operationsende und 2. Gabe bei einer Operationsdauer 〉 3 Std fest. Nach Leitlinienerstellung und klinikinterner Fortbildung erfolgte eine erneute Überprüfung im Rahmen einer prospektiven Beobachtungsstudie (n = 245). Gruppenunterschiede wurden mit dem χ 2-Test berechnet. Das Signifikanzniveau wurde auf p 〈 0,05 festgelegt. Ergebnisse: Der Anteil der indizierten, aber nicht durchgeführten Antibioticaprophylaxe konnte von 15,5 % auf 8,4 % (p 〈 0,05) reduziert werden. Die Prophylaxe wurde im Vergleich zur retrospektiven Analyse signifikant häufiger adäquat zur Anwendung gebracht (35,7 % vs. 63,5 %; p 〈 0,05). Dies war vor allem auf die genauere Berücksichtigung der Dosis und der Operationsdauer zurückzuführen. Diskussion: Krankenhausinterne Leitlinien können zu einer Verbesserung der perioperativen Antibioticaprophylaxe beitragen. Um ein optimales Ergebnis zu erreichen, müssen Leitlinien durch weitere Maßnahmen, wie z. B. computerassistierte Programme, ergänzt werden.
    Notes: Abstract. Introduction: Although the effectiveness of perioperative antibiotic prophylaxis is proven, it is not used adequately. The aim of this study was to evaluate whether hospital-based guidelines are useful tools to improve the management of perioperative antimicrobial prophylaxis. Material: In a retrospective study the actual quality of perioperative antibiotic prophylaxis as given by the criteria choice of drugs, dosage, timing, continuation and 2nd dose after 〉 3 h was evaluated. After information and establishment of adequate guidelines we started a prospective analysis to test compliance and rate of adequate prophylaxis. Differences were calculated according to the χ 2-test with P 〈 0.05 significance niveau. Results: The percentage of cases in which antibiotics were indicated but not administered was reduced from 15.5 % to 8.4 %. Compared to the result of the retrospective analysis, the prospective study showed a significantly higher percentage of adequately administered antibiotics (35.7 % vs. 63.5 %). This was mainly due to the compliance with dosage recommendations and to the 2nd dose in longer surgical procedures. Discussion: Guidelines lead to a significant improvement in perioperative antibiotic prophylaxis. To increase this effect, further approaches such as integration of guidelines into computer-based systems should be evaluated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040051123
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  • 5
    Electronic Resource
    Electronic Resource
    Perioperative treatment with Filgrastim stimulates granulocyte function and reduces infectious complications after esophagectomy (2000)
    Springer
    Annals of hematology 79 (2000), S. 143-151 
    Details
    ISSN: 1432-0584
    Keywords: Neutrophil function ; Esophageal cancer ; Filgrastim ; Infection ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: n =27) were measured on days −2, 2, and 10. Neutrophil function was enhanced in the Filgrastim-treated group by factor 1.2 for phagocytosis (p=0.016) and 1.4 for oxidative burst (p=0.154). Leukocyte counts increased from 7.6×109/l (day −2) to a maximum of 45×109/l on day 6. No infection was reported in the study group (mean age 59.7 years; 13 men, seven women) up to 10 days after surgery. In contrast, 23 patients (29.9%) in a historical control group (mean age 56 years; 67 men, ten women) treated at the same center developed infections within the first 10 days (p=0.008). In addition, no postoperative deaths occurred in the study group, compared with 9.1% in the group of historical controls. Thus, in this study, administration of Filgrastim stimulated neutrophil function in patients undergoing esophagectomy, and it might be effective in reducing infectious complications related to the surgical procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050570
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