Up-regulation of the IL-1-IL-6 network stimulates systemic expression of C-reactive protein (CRP). This cytokine network system plays a pivotal role in inducing angiogenic growth factors in intestinal mucosa. Serum CR...Up-regulation of the IL-1-IL-6 network stimulates systemic expression of C-reactive protein (CRP). This cytokine network system plays a pivotal role in inducing angiogenic growth factors in intestinal mucosa. Serum CRP level and tissue concentrations of cytokines in colorectal cancer patients were determined and an in vitro model was employed to determine the time course of induction of IL-6 in Caco-2 cells. Increased serum CRP was associated with recurrent disease and shorter survival time. Intense surgical stress and the presence of an acute phase reactant were independently associated with overexpression of IL-6 in the tumor. Enhanced IL-6 protein expression in Caco-2 cells induced by the initial treatment with IL-1β or lipopolysaccharide could be abrogated by additional presupplementation of IL-1ra. The presence of an acute phase reactant reflects uncontrolled up-regulation of the local IL-1-IL-6 network system in the tumor, which may enhance the survival and proliferation of remnant cancer cells after tumor resection.展开更多
Background: The safety and efficacy of Seprafilm (Genzyme Corporation, Cambrid ge, Mass) in adult surgery patients have been established. The aim of this study was to evaluate the safety and efficacy of Seprafilm in p...Background: The safety and efficacy of Seprafilm (Genzyme Corporation, Cambrid ge, Mass) in adult surgery patients have been established. The aim of this study was to evaluate the safety and efficacy of Seprafilm in pediatric surgical pati ents. Methods: One hundred twenty-two pediatric abdominal surgery patients were enrolled. Sixty-seven patients received Seprafilm application. Of these patien ts, 18 again received Seprafilm at abdominal closure during a second surgery, an d of the 18, 4 received Seprafilm at closure after a third surgery. Of the 55 co ntrol patients who did not receive Seprafilm, 14 had a second surgery, and of th ese 14 patients, 4 had a third surgery. Adverse events, operation time, and bloo d loss were compared with assessed Seprafilm safety. Seprafilm efficacy evaluati ons included incidence and severity of adhesions in those patients who required relaparotomy. Results: The incidence (Seprafilm, 40.9%; control, 82.4%) and se verity (Seprafilm: 59.1%, grade 0; control: 17.6%, grade 0) of adhesions under the abdominal incision site were significantly reduced in the Seprafilm group ( P = .007 and P = .0009, respectively). In addition, mean relaparotomy operation time was significantly shorter for Seprafilmpatients (P = .004). At relaparotomy , blood loss/body weight ratio for Seprafilm patients compared with control pati ents showed a trend toward but did not reach significance (P = .09). Conclusions : Decreased incidence and severity of postsurgical adhesions with Seprafilmin pe diatric patientsmay lead to reduction of the risks associated with subsequent op eration.展开更多
文摘Up-regulation of the IL-1-IL-6 network stimulates systemic expression of C-reactive protein (CRP). This cytokine network system plays a pivotal role in inducing angiogenic growth factors in intestinal mucosa. Serum CRP level and tissue concentrations of cytokines in colorectal cancer patients were determined and an in vitro model was employed to determine the time course of induction of IL-6 in Caco-2 cells. Increased serum CRP was associated with recurrent disease and shorter survival time. Intense surgical stress and the presence of an acute phase reactant were independently associated with overexpression of IL-6 in the tumor. Enhanced IL-6 protein expression in Caco-2 cells induced by the initial treatment with IL-1β or lipopolysaccharide could be abrogated by additional presupplementation of IL-1ra. The presence of an acute phase reactant reflects uncontrolled up-regulation of the local IL-1-IL-6 network system in the tumor, which may enhance the survival and proliferation of remnant cancer cells after tumor resection.
文摘Background: The safety and efficacy of Seprafilm (Genzyme Corporation, Cambrid ge, Mass) in adult surgery patients have been established. The aim of this study was to evaluate the safety and efficacy of Seprafilm in pediatric surgical pati ents. Methods: One hundred twenty-two pediatric abdominal surgery patients were enrolled. Sixty-seven patients received Seprafilm application. Of these patien ts, 18 again received Seprafilm at abdominal closure during a second surgery, an d of the 18, 4 received Seprafilm at closure after a third surgery. Of the 55 co ntrol patients who did not receive Seprafilm, 14 had a second surgery, and of th ese 14 patients, 4 had a third surgery. Adverse events, operation time, and bloo d loss were compared with assessed Seprafilm safety. Seprafilm efficacy evaluati ons included incidence and severity of adhesions in those patients who required relaparotomy. Results: The incidence (Seprafilm, 40.9%; control, 82.4%) and se verity (Seprafilm: 59.1%, grade 0; control: 17.6%, grade 0) of adhesions under the abdominal incision site were significantly reduced in the Seprafilm group ( P = .007 and P = .0009, respectively). In addition, mean relaparotomy operation time was significantly shorter for Seprafilmpatients (P = .004). At relaparotomy , blood loss/body weight ratio for Seprafilm patients compared with control pati ents showed a trend toward but did not reach significance (P = .09). Conclusions : Decreased incidence and severity of postsurgical adhesions with Seprafilmin pe diatric patientsmay lead to reduction of the risks associated with subsequent op eration.
