To be most effective anticancer drugs must penetrate tissue efficiently, reaching all the cancer cells that comprise the target population in a concentration sufficient to exert a therapeutic effect. Most research into the resistance of cancers to chemotherapy has concentrated on molecular mechanisms of resistance, whereas the role of limited drug distribution within tumours has been neglected. We summarize the evidence that indicates that the distribution of many anticancer drugs in tumour tissue is incomplete, and we suggest strategies that might be used either to improve drug penetration through tumour tissue or to select compounds based on their abilities to penetrate tissue, thereby increasing the therapeutic index.

Drug penetration in solid tumours

Physiological Parameter Values for Physiologically Based Pharmacokinetic Models

https://repositorium.sdum.uminho.pt/bitstream/1822/14053/1/file.pdf

Natural–origin polymers as carriers and scaffolds for biomolecules and cell delivery in tissue engineering applications

Initially, a set of guidelines for the use of ultrasound contrast agents was published in 2004 dealing only with liver applications. A second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some non-liver applications. Time has moved on, and the need for international guidelines on the use of CEUS in the liver has become apparent. The present document describes the third iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS) using contrast specific imaging techniques. This joint WFUMB-EFSUMB initiative has implicated experts from major leading ultrasound societies worldwide. These liver CEUS guidelines are simultaneously published in the official journals of both organizing federations (i.e., Ultrasound in Medicine and Biology for WFUMB and Ultraschall in der Medizin/European Journal of Ultrasound for EFSUMB). These guidelines and recommendations provide general advice on the use of all currently clinically available ultrasound contrast agents (UCA). They are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis and improve the management of patients worldwide.

Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver - update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS.

The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer.

There is conflicting evidence concerning the effects of portal hypertension on the gastric mucosa. This paper summarises the histological and haemodynamic alterations which are present in both human and experimental portal hypertension. Despite the fact that histological studies suggests that the gastric mucosa is an oedematous plethoric structure in portal hypertension, haemodynamic studies show that gastric mucosal blood glow is at least maintained if not increased in portal hypertension. The term "active" rather than "passive" congestion is a more appropriate description of the basic change present in the gastric mucosa in portal hypertension.

https://downloads.hindawi.com/archive/1992/034720.pdf

Erosive Gastritis and Portal Hypertension

https://gut.bmj.com/content/gutjnl/60/Suppl_1/A11.full.pdf

Clinical Outcomes and 30-Day Mortality Following Significant Upper Gastrointestinal Bleeding in Users of Anti-Platelet Agents and Non-Steroidal Anti-Inflammatory Drugs

The systemic inflammatory response and liver blood flow in critically-ill patients

P-424 Evaluation of a new prognostic score (GPS) based on the systemic inflammatory response in patients with inoperable non-small cell lung cancer (NSCLC)

https://www.gastrojournal.org/article/S0016-5085(13)60742-8/pdf

Wilson J. Angerson

Papers

Erosive Gastritis and Portal Hypertension

Clinical Outcomes and 30-Day Mortality Following Significant Upper Gastrointestinal Bleeding in Users of Anti-Platelet Agents and Non-Steroidal Anti-Inflammatory Drugs

The systemic inflammatory response and liver blood flow in critically-ill patients

P-424 Evaluation of a new prognostic score (GPS) based on the systemic inflammatory response in patients with inoperable non-small cell lung cancer (NSCLC)

Sa1136 Pre-Endoscopic Intravenous Proton Pump Inhibition and the Outcomes of Acute Upper Gastrointestinal Bleeding