E. T. Condon

Post-traumatic tension faecopneumothorax in a young male: case report

Diaphragmatic rupture due to trauma is both well recognised and uncommon. The difficulties in diagnosing traumatic diaphragmatic rupture at the first admission are the most common causes of latent morbidity and mortality. Herniation of the abdominal viscera is the most common sequel with strangulation and perforation the most serious complication. This case outlines the delayed presentation of diaphragmatic rupture and herniation presenting as an acute tension faecopneumothorax. We review the relevant literature, with particular emphasis on the difficulties in diagnosis at presentation.

The benefits of a laparoscopic approach in ileal pouch anal anastomosis formation: a single institutional retrospective case-matched experience

AimsA laparoscopic approach to ileoanal pouch formation is novel. By using prospectively gathered data, laparoscopic and open restorative proctocolectomy procedures in mucosal ulcerative colitis (UC) and familial adenomatous polyposis (FAP) patients were compared using a case-matched design.MethodsTen consecutive patients have had laparoscopic ileal pouch anal anastomosis (IPAA) since April 2005. Their intraoperative findings, immediate and early postoperative outcomes are compared with ten non-selected patients who had an open IPAA pre April 2005.ResultsLaparoscopic IPAA group had a shorter time to ileostomy function, a reduced mean time to regular diet and a mean shorter hospital stay. Their overall opioid analgesia requirements were 50% that of the open group. There were no re-operations or readmissions in either group. Mean operative time was longer for the laparoscopic group.ConclusionsPatients undergoing laparoscopic IPAA can expect faster postoperative gastrointestinal recovery, reduced blood loss, reduced opioid requirements and improved cosmesis.

Bone marrow micrometastases have upregulation of ICAM-1 and αVβ3 integrins: a putative survival mechanism for tumour dissemination?

ConclusionThis study provides a novel insight into the adhesion molecule profile of micrometastatic epithelial cells in women with breast cancer. The upregulation of ICAM-1 and αVβ3 reveals new evidence for the pro-angiogenic nature of micrometastatic cells and may offer further therapeutic options.

Nodal status does not predict micrometastatic burden in the bone marrow of patients with breast cancer

ConclusionWhile there are increased HEA positive cells in the bone marrow of women with locally advanced tumours, nodal status does not predict bone marrow positivity in breast cancer. This novel finding offers insights into the differing mechanisms of lymphatic and haematogenous spread in breast cancer.

The anti-neoplastic effect of taurolidine confers a survival benefit in an orthotopic breast cancer model

ConclusionTaurolidine therapy led to significant reductions in both primary and metastatic tumour burden resulting in a significant improvement in survival time. This anti-neoplastic property of taurolidine may relate to its ability to regulate cell cycle as well as apoptotic events. These findings indicate a novel role for taurolidine in the clinical setting.

Surgery does not affect the number of circulating tumour cells in the bone marrow of patients with breast carcinoma

ConclusionSurgery does not alter the incidence of cytokeratin positive epithelial cells in the peripheral blood or bone marrow of patients undergoing resection of primary breast tumours.

Green fluorescent protein — a word of caution

ConclusionIn vitro GFP expression in LS174T cells decreases with time despite various attempts at enhancing overall expression. In vivo studies confirm this phenomenon as GFP expression was completely lost in the primary tumour model. Fluorescence was found to be variable in liver micrometastases depending on the time of FACScan analysis.In conclusion, the authors recommend the cautious use of the GFP reporter gene in tumour research. The variable nature of GFP expression in vivo and in vitro significantly limits its use in both quantitative and qualitative studies of tumour biology.

Surgery mobilises endothelial progenitor stem cells for perioperative tumour vasculogenesis

ConclusionBoth laparotomy and LPS are associated with significant mobilisation of endothelial progenitor stem cells. Given the role of endotoxin and VEGF in perioperative tumorogenesis, these findings may identify a novel mechanism whereby surgical trauma may potentiate tumour growth. Anti-VEGF MAb abrogates this effect, suggesting a novel strategy for preventing perioperative exacerbations of residual tumour growth.