Showing papers by "Michael J. Mack published in 2000"
TL;DR: Intratumoral injection with Adp53 in combination with cisplatin is well tolerated, and there is evidence of clinical activity, in patients with advanced NSCLC.
Abstract: PURPOSE: To determine the safety and tolerability of adenovirus-mediated p53 (Adp53) gene transfer in sequence with cisplatin when given by intratumor injection in patients with non–small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with advanced NSCLC and abnormal p53 function were enrolled onto cohorts receiving escalating dose levels of Adp53 (1 × 106 to 1 × 1011 plaque-forming units [PFU]). Patients were administered intravenous cisplatin 80 mg/m2 on day 1 and study vector on day 4 for a total of up to six courses (28 days per course). Apoptosis was determined by the terminal deoxynucleotidyl- transferase-dUTP nick–end labeling assay. Evidence of vector-specific sequences were determined using reverse-transcriptase polymerase chain reaction. Vector dissemination and biodistribution was monitored using a series of assays (cytopathic effects assay, Ad5 hexon enzyme-linked immunosorbent assay, vector-specific polymerase chain reaction assay, and antibody response assay). RESULTS: Twenty-four ...
333 citations
TL;DR: The increase of right ventricular end-diastolic pressure in all positions suggests that the major cause of hemodynamic changes is disturbed diastolic filling of the right ventricle, especially by direct ventricular compression.
175 citations
TL;DR: Octopus off-pump bypass was demonstrated to be a safe procedure with widening applicability with experience surgeons tend to apply the system to increasing proportions of their patients and are able to revascularize all coronary territories.
126 citations
TL;DR: Direct bronchoscopic injection of Adp53 into endobronchial NSCLC is safe, with acceptable levels of toxicity, and the initial clinical results demonstrating relief of airway obstruction warrant further clinical investigation.
93 citations
TL;DR: Therapeutic VATS resection of colorectal metastases appears efficacious and preoperative CT can identify peripheral colorective metastases amenable to VATS.
Abstract: Objective: Careful patient selection is vital when video-assisted thoracoscopic surgical (VATS) therapeutic pulmonary metastasectomy of colorectal carcinoma is considered. Complete resection of all metastatic disease remains a vital concept. We reviewed our VATS experience for therapeutic metastasectomy of peripheral colorectal pulmonary metastases. Methods: Over 90 months, therapeutic VATS metastasectomy was accomplished upon 80 patients with colorectal metastases. Thin cut computed tomography (CT) was central in identifying lesions. The mean interval from primary carcinoma to VATS resection was 41 months (1‐156 months; median, 33). A solitary lesion was resected in 60 patients and multiple (2‐7) lesions resected in 20 patients. Statistics were obtained using the Student’s t-test. Results: No operative mortality or major postoperative complications occurred. The hospital stay was 4.5 ^ 2.2 days (range, 1‐13). All lesions were resected by VATS, with four conversions to thoracotomy to improve the margins. The mean survival of patients with one lesion was 34.8 months compared with 26.5 months for patients with multiple lesions (Pa 0:37). The mean survival was 20.5 months when metastases occurred ,3 years vs. 28.1 months for .3 years from primary carcinoma resection (Pa 0:20). Twenty-five (31%) patients are disease free; with a mean interval of 38.7 (3‐84; median, 35) months. Sixty-nine percent (55/80) of patients developed a recurrence: 6/80 (8%) local; 19/80 (24%) regional (same hemithorax away from resection); and 30/80 (38%) distant. The overall survival at 1 year was 81.2%, 48.4% at 3 years and 30.8% at 5 years. Conclusions: Therapeutic VATS resection of colorectal metastases appears efficacious. Preoperative CT can identify peripheral colorectal metastases amenable to VATS. Conversion to thoracotomy is indicated when none of the lesions identified by CT are found or when clear surgical margins are jeopardized. q 2000 Elsevier Science B.V. All rights reserved.
84 citations
TL;DR: Off-pump coronary artery bypass (OPCAB, median sternotomy beating heart) presently accounts for approximately 15% of all coronary bypass operations performed in the United States.
11 citations