Biomedical subjects
Publications and source records attributed to C Vara-Thorbeck.
Cysts of epithelial bodies are rare causes of hyperparathyroidism. Reported in this paper are 2 patients with clinical symptoms of hyperparathyroidism, high blood calcium levels and established hormones in their epithelial bodies. Cysts of epithelial bodies were diagnosed by means of angiography, computed tomography, and sonography. Various aetiological factors behind cyst formation in epithelial bodies are discussed.
Secondary peritoneal echinococcosis was recorded from 50 in 312 patients (16 per cent) who had been hospitalised for liver echinococcosis. Hydatido and peritoneal hydatidiosis were recorded from 34 of these patients and thus accounted for the two most common pathological forms of secondary peritoneal echinococcosis, according to Dévè. Peritoneal echinococcosis usually is not diagnosed until conspicuous symptoms grow manifest due to cyst growth or other complications. Positive responses were recorded from all the above cases to laboratory tests (eosinophilia in over five to nine per cent) and were also established on the basis of immune reactions, including the complement fixation reaction according to Weinberg, the intracutaneous test by Casoni, and latex echinococcus reaction. Surgery, at present, is the only promising therapeutic approach to the problem. Surgical intervention could not even be avoided by application of mebendazol. Postoperative lethality amounted to four per cent and morbidity to ten per cent. They were comparatively low, measured by the generally poor prognosis of the disease.
UNLABELLED: The experiments were carried out in 125 Wistar rats. The entero-gastric reflux was estimated quantitatively with reference to the bilirubin and the cholic acid (radiolabeled by C 14). The animals were submitted to distal partial gastrectomy in groups after Billroth I operation, after Billroth II operation with and without enteroanastomosis, as well as Billroth II operation with enteroanastomosis and vagotomy. RESULTS: The statistical difference was significant between Billroth I and Billroth II operation with clear smaller reflux in Billroth I. The added enteroanastomosis decreased or increased the reflux of some animals at a time. The additional vagotomy reduced the number of the anastomotic ulcer.
Bile salts undergo an enterohepatic circulation. The relative distribution of labelled cholic acid in portal blood, enterocytes, intestinal contents and feces, following intravenous injection of (carboxylic-14C) cholic acid, can be considered as an indication of the absorptive capacity of the epithelium cells. Seven days after a massive small intestinal resection (60-80 cm), the animal weight and the bile salt absorption were significantly decreased. Nevertheless, thirty days after the operation, weight and radioactivities reached the values found in the controls: in portal and cava blood, liver, intestinal contents and feces. An increase of the absorptive capacity of the intestinal epithelial cells was also observed.
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Our study is prompted by the arrival of laparoscopic cholecystectomy in connection with the evolution of postoperative ileus (PI) and by its avoidance of the intraabdominal handling implied in conventional cholecystectomy. With this aim a prospective, controlled, randomized, and blind clinical trial was designed using 100 patients divided into five groups (n = 20): I, conventional cholecystectomy (CC): II, CC+injection of 20 ml bupivacaine 0.5% into the mesentery root; III, CC + 7.5 mg propranolol i.v. and 0.5 mg neostigmine s.c., postoperatively until the first defecation; IV, II+III; and V, laparoscopic cholecystectomy. The shortest period of PI was observed in group V. This period increases notably in group IV (53 h), group II (72 h), and group III (84 h) relative to the control group with (89 h). This reduction in PI time runs parallel with an improvement in the patient's general state of well-being. We concluded that after laparoscopic cholecystectomy PI is nonexistent. Furthermore, this study confirms the correlation between the avoidance of intraabdominal manipulation and the evolution of postoperative ileus.
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A laparoscopic Heller cardiomyotomy technique was used on five patients whose esophageal achalasia was diagnosed clinically, radiologically manometrically. The physiological principles and operational steps are the same as in open surgery. with the patient in an anti-Trendelenburg 30 degrees position and the surgeon between the patient's legs, a CO2 pneumoperitoneum was produced. Five trocars were used. the esophagus was freed by blunt dissection and an 8 cm longitudinal myotomy was made on the anterior surface of the thoracic esophagus starting a few centimetres above the cardias and parallel and to the left of the anterior vagus, the magnified operative field facilitated more precise myotomy. The myotomy incision ended 2 cm from the esophageal-gastric junction. We closed the angle of His before performing a Dor anterior fundoplication with anchorages to the diaphragmatic crura. Mean operation time was 2 hrs 45 min. Intraoperative blood loss was less than 100 ml. In comparison with open-surgery, patients had less postoperative pain, needed only non-narcotic analgesics for the first 12 hrs, and had no unsightly operation scar. patients tolerated liquids between 24 and 48 hrs. Hospitalization time was 3 to 5 days. Long-term follow-up transit studies, manometry, and 24 hrs pH measurements are needed to fully evaluate the technique. At two months, the symptoms of dysphagia had completely disappeared in three patients: the results were qualified as excellent. As some dysphagia for solids remained in the other two, they were qualified as good.