ABSTRACT
Liver metastasis of colon cancer is a very common clinical entity. Resective surgery can be used to improve the overall survival and disease-free. The problem is that major resections are associated with hepatic failure caused by an inadequate residual volume. Chemotherapy with diagrams as FOLFOX, FOLFIRI associated with antibodies such as bevacizumab, cetuximab or panitumumable added an important role in the conversion of unresectable to resectable tumors. Another widely used technique is portal vein ligation in a first surgical procedure, that generates left hepatic growth, to perform the resection in a second surgical procedure. The liver hypertrophy is achieved in a period of 2 months. The latest new technical procedure is the association of the ligation portal to the liver partition of the hepatic parenchyma without resection, which allows a segmental hypertrophy of the liver remnant between 7 to 10 days. This technique is called ALPPS. Radiofrecuency also has a role in the treatment of liver metastases. However,it is secondary.
La metástasis hepáticas del cáncer de colon es una entidad clínica muy frecuente. La cirugía resectiva permite mejorar la sobrevida global y libre de enfermedad. El problema es que grandes resecciones se asocian a insuficiencia hepática por un inadecuado volumen residual. La quimioterapia con esquemas como FOLFOX, FOLFIRI asociada a anticuerpos como bevacizumab, cetuximab o panitumumable agregan un rol importante en la conversión de tumores irresecables a resecables. Otra técnica utilizada es la ligadura portal en un primer tiempo, que genera crecimiento hepático izquierdo, para realizar la resección en un segundo tiempo quirúrgico. La hipertrofia hepática se logra en un período de 2 meses. La última novedad técnica es la asociación de la ligadura portal a la transección del parénquima hepático sin resección, lo que permite una hipertrofia segmentaria del hígado remanente entre 7 a 10 días. Esta técnica se denomina ALPPS. La radiofrecuencia también tiene un rol en el tratamiento de las metástasis hepáticas, aunque este es secundario.
Subject(s)
Humans , Liver Neoplasms/surgery , Liver Neoplasms/secondary , Colonic Neoplasms/pathology , Combined Modality Therapy , Hepatectomy/methods , Liver Neoplasms/drug therapy , Liver Neoplasms/radiotherapy , Radio WavesABSTRACT
The occurrence of postoperative jaundice should encourage the surgeon to review the wide spectrum of possible causes of jaundice and perform detailed history, physical examination and laboratory tests to define the causes, and take the measures to treat the patient properly. We also emphasize the need to prevent the presence of residual stones in the bile duct and bile duct iatrogenic injuries. This paper describe the possible causes of postoperative jaundice and current recommendations for adequate treatment.
La aparición de ictericia en el postoperatorio debe alertar al cirujano y llevarlo a revisar el gran espectro de causas posibles del cuadro. Se debe realizar una anamnesis y examen físico detallado y complementarlo con exámenes de laboratorio e imágenes según el caso. Además, se insiste en la necesidad de prevenir la presencia de cálculos residuales en colédoco y lesiones iatrogénicas de vía biliar. Se revisan las causas posibles de ictericia postoperatoria y las recomendaciones actuales de manejo.
Subject(s)
Humans , Jaundice/etiology , Jaundice/therapy , Digestive System Surgical Procedures/adverse effects , Postoperative Complications/etiologyABSTRACT
The cytotoxic activity of amino (3a-e), aza-1-antraquinone (4a-e) lapachol derivatives against Ehrlich carcinoma and human K562 leukemia cells was investigated. Cell viability was determined using MTT assay, after 48 (Ehrlich) or 96 h (K562) of culture, and vincristine (for K562 leukemia) and quercetin (for Ehrlich carcinoma) were used as positive controls. The results showed dose-dependent growth-inhibiting activities and that the amino derivatives were active against the assayed cells, whereas the 4a-e derivatives were not. The allylamine derivative 3a was the most active against Ehrlich carcinoma, with IC50 = 16.94 ± 1.25 muM, and against K562 leukemia, with IC50 = 14.11 ± 1.39 muM. The analogous lawsone derivative, 5a, was also active against Ehrlich carcinoma (IC50 = 23.89 ± 2.3 muM), although the 5d and 5e derivatives showed lower activity. The interaction between 3a-d and calf thymus DNA was investigated by fluorimetric titration and the results showed a hyperchromic effect indicating binding to DNA as presented of ethidium bromide, used as positive control. The inhibitory action on DNA-topoisomerase II-a was also evaluated by a relaxation assay of supercoiled DNA plasmid, and the etoposide (200 muM) was used as positive control. Significant inhibitory activities were observed for 3a-d at 200 muM and a partial inhibitory action was observed for lapachol and methoxylapachol.
Subject(s)
Animals , Humans , Mice , Antineoplastic Agents, Phytogenic/pharmacology , Carcinoma, Ehrlich Tumor/enzymology , DNA Topoisomerases, Type II/antagonists & inhibitors , Enzyme Inhibitors/pharmacology , Naphthoquinones/pharmacology , Antineoplastic Agents, Phytogenic/chemistry , Antioxidants/pharmacology , Cell Survival/drug effects , Enzyme Inhibitors/chemistry , /drug effects , Naphthoquinones/chemistry , Quercetin/pharmacology , Vincristine/pharmacologyABSTRACT
Topoisomerase inhibitors are agents with anticancer activity. 7"-O-Methyl-agathisflavone (I) and amentoflavone (II) are biflavonoids and were isolated from the Brazilian plants Ouratea hexasperma and O. semiserrata, respectively. These biflavonoids and the acetyl derivative of II (IIa) are inhibitors of human DNA topoisomerases I at 200 æM, as demonstrated by the relaxation assay of supercoiled DNA, and only agathisflavone (I) at 200 æM also inhibited DNA topoisomerases II-alpha, as observed by decatenation and relaxation assays. The biflavonoids showed concentration-dependent growth inhibitory activities on Ehrlich carcinoma cells in 45-h culture, assayed by a tetrazolium method, with IC50 = 24 ± 1.4 æM for I, 26 ± 1.1 æM for II and 10 ± 0.7 æM for IIa. These biflavonoids were assayed against human K562 leukemia cells in 45-h culture, but only I showed 42 percent growth inhibitory activity at 90 æM. Our results suggest that biflavonoids are targets for DNA topoisomerases and their cytotoxicity is dependent on tumor cell type
Subject(s)
Humans , Animals , Antineoplastic Agents, Phytogenic , DNA Topoisomerases, Type I , Enzyme Inhibitors , Flavonoids , Plants , Antineoplastic Agents, Phytogenic , Brazil , Carcinoma, Ehrlich Tumor , Cell Survival , Electrophoresis, Agar Gel , Enzyme Inhibitors , Flavonoids , K562 Cells , LeukemiaSubject(s)
Humans , Adult , Middle Aged , Brain Neoplasms , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Argentina , Carcinoma, Non-Small-Cell Lung , Cerebrum , Survival Rate , Treatment OutcomeABSTRACT
Background: BICAP tumor probe is a device that consists in an energy source and olives that deliver bipolar electricity. It can be used for the fulguration of esophageal tumors after endoscopic dilatation. Aim: To report the experience in the treatment of malignant esophageal stenoses using the BICAP tumor probe. Patients and methods: Patients with advanced esophageal tumors in aphagia, that were not candidates for palliative surgery were included in this study. After endoscopic dilatation, the tumor was fulgurated with the BICAP tumor probe. Results: Twenty one patients (nine male, aged 43 to 91 years old) were treated with the device. A mean of 1.3 sessions with BICAP were necessary to obtain tumor permeabilization, which was obtained in all patients. One patient died of pneumonia 15 days after the procedure. All other patients were ingesting liquid or semisolid diets after two months of follow up. Mean survival after the procedure was 3.8 months. Conclusions: Electrical fulguration of esophageal tumors is a valid therapeutic alternative in aphagic patients
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Catheters, Indwelling , Palliative Care/methods , Esophageal Stenosis/surgery , Esophageal Neoplasms/surgery , EsophagoscopyABSTRACT
Catharanthus roseus (L.) G Don, es una especie vegetal de gran importancia para la inductria farmaceutica, por ser fuente de dos medicamentos antitumorales, la vincristina y la vinblastina. Estos dos alcaloides indólicos se encuentran en el material vegetal en muy pequeña proporción y su purificación es difícil, lo que los hace muy costosos y justifica así estudios de cultivo de células y tejido in vitro. Se describe la iniciación de callos y suspensiones celulares de esta planta, la obtención de líneas productoras de alcaloides indólicos y la identificación de siete de ellos: ajmalicina, vindolinina, 19-epivindolinina, tetrahidroalstonina, yohimbina, horhammericine y pleiocarpamina, así como se reportan medios de cultivo útiles para crecimiento y producción
Subject(s)
Alkaloids , Cells, Cultured , Culture Media , In Vitro Techniques , Plants, MedicinalABSTRACT
Se estudiaron 45 pacientes supuestamente alergicos a los anestesicos locales, con historia clinica, pruebas alergicas cutaneas y transferencia pasiva. Asi como tambien se hizo un control a 48 personas para revisar las distintas manifestaciones inmunoalergicos que estos anestesicos producen. Se confirma el escaso valor de las testificaciones cutaneas en estos pacientes, asi como se hacen recomendaciones