Papers by Eugene Woltering
Surgical forum, 1987
ABSTRACT
Journal of the American College of Surgeons, 2016
BACKGROUND: Neuroendocrine tumors (NETs) of the duodenum are rare, heterogeneous, and often indol... more BACKGROUND: Neuroendocrine tumors (NETs) of the duodenum are rare, heterogeneous, and often indolent neoplasms. We hypothesized that elevated pancreastatin levels are an indicator of a poor prognosis in well-differentiated duodenal NETs. STUDY DESIGN: Data from patients diagnosed with a primary duodenal NET were analyzed. Patients that underwent esophogogastroduodenoscopy, endoscopic ultrasound, or exploratory surgery to localize their neoplasm and whose tumors were confirmed histologically were included.
AJCC Cancer Staging Manual, 2016
Measurement of the following prognostic factors is not required for clinical staging but may assi... more Measurement of the following prognostic factors is not required for clinical staging but may assist the clinician in monitoring the clinical care of patients with well-differentiated gastric NETs.
PubMed, Jun 1, 1997
Objective: To evaluate the ocular toxicity of intravitreous octreotide. Design: New Zealand white... more Objective: To evaluate the ocular toxicity of intravitreous octreotide. Design: New Zealand white rabbits weighing approximately 2 kg were given 5 mg (group 1, two eyes), 2 mg (group 2, four eyes), 1 mg (group 3, four eyes), 0.5 mg (group 4, two eyes), 0.3 mg (group 5, two eyes) or 0.1 mg (group 7, two eyes) of octreotide acetate, two doses of 0.3 mg 1 week apart (group 6, four eyes) or 0.1 mL of balanced salt solution (group 8 [control group], two eyes). Outcome measures: Findings on clinical examination and electroretinography, performed before and 10 days after injection, and on light microscopy. Results: Cataracts developed in groups 1 and 2. No clinical changes were found in groups 3 to 8. Electroretinography showed various degrees of decrease in the b-wave amplitude in groups 1 and 2; the results were normal in groups 3 to 8. Histologic examination showed macrophage and monocyte infiltration in the vitreous and retina in group 1. No histologic change was seen in the eyes in groups 2 to 8. Conclusions: Octreotide injected intravitreally is safe at dosages of 1 mg or less.
Pancreas, Oct 1, 2011
Objectives: International cooperative group trials require specific, sensitive biomarker assays t... more Objectives: International cooperative group trials require specific, sensitive biomarker assays that are validated between continents. Neurokinin A (NKA) has been shown to be a powerful independent predictor of a poor prognosis in well-differentiated midgut neuroendocrine tumors. We hypothesized that NKA concentrations of clinical specimens evaluated in NKA assays in the United States and the United Kingdom would be equivalent, even though assay techniques were significantly different. Methods: Frozen clinical specimen aliquots were shipped from the United States to the United Kingdom (n = 67), and from United Kingdom to the United States (n = 50). In addition, spiked plasma standards and medium-spiked standards were exchanged. Samples from the United States were directly assayed in a radioimmunoassay, whereas the UK specimens were extracted, and the reconstituted specimens assayed in the radioimmunoassay. Neurokinin A values from the 2 studies were analyzed by regression analysis. Results: The NKA values from the US and UK laboratories were essentially identical (United States to United Kingdom, r 2 = 0.88, P G 0.0001; and United Kingdom to United States, r 2 = 0.96, P G 0.0001). Conclusions: Validation of biomarker assays across continents will ensure that laboratory observations made by researchers are equivalent and that prediction of clinical outcomes based on these assays is also reliable.
Southern Medical Journal, Apr 1, 2010
External compression of extracranial/mediastinal vessels has not been reported as an etiology of ... more External compression of extracranial/mediastinal vessels has not been reported as an etiology of pulsatile tinnitus. We present a case in which compression of extracranial vasculature led to long term pulsatile tinnitus which resolved completely with surgical resection of metastatic lymph nodes. This should be included in the list of differential diagnoses when dealing with any patient with a complaint of pulsatile tinnitus. Patients with advanced carcinoid cancer often present with distant metastases to their left superior mediastinum and supraclavicular lymph node chain. We believe a careful search for nodal metastases compressing vascular structures in such patients is warranted as debilitating pulsatile tinnitus may be cured by a simple surgical procedure.
Journal of Clinical Anesthesia, Aug 1, 2016
Study objective: The prophylactic use of a preoperative, intraoperative, and postoperative high-d... more Study objective: The prophylactic use of a preoperative, intraoperative, and postoperative high-dose continuous octreotide acetate infusion was evaluated for its ability to minimize the incidence of carcinoid crises during neuroendocrine tumor (NET) cytoreductive surgeries.
British Journal of Cancer, 2001
We hypothesized that non-proliferating (quiescent) human vascular endothelial cells would not exp... more We hypothesized that non-proliferating (quiescent) human vascular endothelial cells would not express somatostatin receptor subtype 2 (sst 2) and that this receptor would be expressed when the endothelial cells begin to grow. To test this hypothesis, placental veins were harvested from 6 human placentas and 2 mm vein disks were cultured in 0.3% fibrin gels. Morphometric analysis confirmed that 50-75% of cultured vein disks developed radial capillary growth within 15 days. Sst 2 gene expression was determined by reverse transcription-polymerase chain reaction (RT-PCR) analysis of the RNA from veins before culture and from tissue-matched vein disks that exhibited an angiogenic response. The sst 2 gene was expressed in the proliferating angiogenic sprouts of human vascular endothelium. The presence of sst 2 receptors on proliferating angiogenic vessels was confirmed by immunohistochemical staining and in vivo scintigraphy. These results suggest that sst 2 may be a unique target for antiangiogenic therapy with sst 2 preferring somatostatin analogues conjugated to radioisotopes or cytotoxic agents.
AJCC Cancer Staging Manual, 2016
Measurement of the following prognostic factors is not required for clinical staging but may assi... more Measurement of the following prognostic factors is not required for clinical staging but may assist the clinician in monitoring the clinical care of patients with well-differentiated small bowel NETs. Neurokinin A Level Two independent commercial laboratories (one in the United States and one in Northern Ireland) using different radioimmunoassay methods for NKA determined that a plasma NKA level over 50 pg/mL was associated with poor survival. 1-6 AJCC Level of Evidence: III
Investigative Ophthalmology & Visual Science, 2003
Journal of the American College of Surgeons, 2017
Neuroendocrine tumors (NETs) are rare neoplasms. Our group has treated more than 2,000 NET patien... more Neuroendocrine tumors (NETs) are rare neoplasms. Our group has treated more than 2,000 NET patients and has performed more than 1,000 surgical cytoreductive procedures. Records of 834 NET patients who underwent surgical cytoreduction at our institution were reviewed. Demographic information, intraoperative findings, extent of disease, complications, and survival rates were calculated. Eight hundred patients underwent 1,001 cytoreductive operations. Sixty-five percent had small bowel primaries. One hundred and thirty-eight patients presented with an unknown primary site, which was localized intraoperatively in 89% of these cases. The intraoperative complication rate was 9%. The incidence of intraoperative carcinoid crisis was 1%. Mean ± SD operative time was 368 ± 146 minutes. Mean ± SD hospital stay was 9 ± 10 days. Minor postoperative complications occurred after 43% of procedures and major postoperative complications were noted after 19% of procedures. The 30-day postoperative mor...
The American Surgeon, 2012
Brief Reports should be submitted online to www.editorialmanager.com/ amsurg. (See details online... more Brief Reports should be submitted online to www.editorialmanager.com/ amsurg. (See details online under ''Instructions for Authors''.) They should be no more than 4 double-spaced pages with no Abstract or sub-headings, with a maximum of four (4) references. If figures are included, they should be limited to two (2). The cost of printing color figures is the responsibility of the author.
Southern Medical Journal, 1998
Southern Medical Journal, 2010
External compression of extracranial/mediastinal vessels has not been reported as an etiology of ... more External compression of extracranial/mediastinal vessels has not been reported as an etiology of pulsatile tinnitus. We present a case in which compression of extracranial vasculature led to long term pulsatile tinnitus which resolved completely with surgical resection of metastatic lymph nodes. This should be included in the list of differential diagnoses when dealing with any patient with a complaint of pulsatile tinnitus. Patients with advanced carcinoid cancer often present with distant metastases to their left superior mediastinum and supraclavicular lymph node chain. We believe a careful search for nodal metastases compressing vascular structures in such patients is warranted as debilitating pulsatile tinnitus may be cured by a simple surgical procedure.
Pharmaceutical Biology, 2007
... F. Hakan Oner, Yanno Bezerra, Gholam A. Peyman, Mandi D ... Sections were examined by dividin... more ... F. Hakan Oner, Yanno Bezerra, Gholam A. Peyman, Mandi D ... Sections were examined by dividing the corneas into two halves through the center of the lesion and were evaluated with regard to the intensity of new vessels, polymorphonucleated (PMN) leukocytes, edema, and ...
Pancreas, 2012
Proton pump inhibitors (PPIs) are used primarily to treat gastroesophageal reflux disease. Proton... more Proton pump inhibitors (PPIs) are used primarily to treat gastroesophageal reflux disease. Proton pump inhibitorYinduced achlorhydria increases circulating gastrin and chromogranin A (CGA). Chromogranin is a widely used biomarker for the diagnosis and follow-up for gut-based neuroendocrine tumors (NETs). Proton pump inhibitorY induced increases in CGA or gastrin may falsely suggest the presence of a NET when none exists. Pancreastatin, a fragment of CGA, is also commonly used to diagnose and follow NETs. We hypothesized that chronic PPI use would increase circulating plasma gastrin, CGA, and pancreastatin levels. Methods: Thirty patients who used PPIs for 6 months or more (mean T SD duration, 3.1 T 2.5 years) and a separate control group of 30 patients who never used antacid medications were prospectively evaluated with plasma gastrin, CGA, and pancreastatin determinations. Results: Chronic PPI use resulted in significant increases in CGA (15.1 T 11 vs 131 T 207 ng/mL; P = 0.005) and significant increases in gastrin (34.8 T 22.3 vs 167.8 T 136.2 pg/mL; P = 0.001) compared to controls. In contrast, pancreastatin level in nonusers and chronic PPI users were identical (81.6 T 36.4 vs 89.4 T 43.4 pg/mL; P = 0.46). Conclusions: Pancreastatin levels do not change with chronic PPI use and normal pancreastatin levels may be used to distinguish between drug-induced changes in biomarkers and tumorYrelated increases in circulating biomarkers.
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Papers by Eugene Woltering