PubMed · 6877320
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1983-08-25. Abdominal surgery.. https://doi.org/10.1056/nejm198308253090818
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BACKGROUND: Venous portal blood contributes essentially to the oxygen supply of the liver. The effect of oxygen enriched water, applied into the stomach, on oxygenation of portal blood was investigated in rabbits. MATERIAL AND METHODS: 15 anaesthetized rabbits were given 30 ml water, containing 45, 80 or 150 mg O2/l, by a gastric tube. Oxygen pressure was monitored continuously by a measuring probe in the stomach, the abdominal cavity and in the gastric as well as in the portal vein. RESULTS: Intragastrically applied water delivered oxygen slowly, according to the increase in its temperature. The released oxygen was found to penetrate into the abdominal cavity, and a dose-response relationship between oxygen pressure in the stomach and the abdominal cavity was established. 45 mg O2/l water resulted in a negligible increase of oxygen concentration in the abdomen, while 80 or 150 mg O2/l lead to an increase of oxygen by 10 rsp. 20 mmHg in the abdomen, and by up to 14 mmHg in the portal vein. Oxygen penetration occurred according to the known physical and physiological parameters of gas diffusion. Diffusion of oxygen was enhanced, if concurrently with oxygen the water was enriched with CO2. CONCLUSIONS: Our results show that intragastrically applied oxygenated water with more than 45 mg O2/l delivers O2 into the abdominal cavity and the portal vein. This effect may be of clinical relevance in states of impaired liver perfusion such as fatty liver or hepatitis.
PURPOSE: To compare the outcome of patients with Stage II seminoma treated with prophylactic mediastinal irradiation, without any supradiaphragmatic irradiation, and with prophylactic left supraclavicular irradiation (PLSCI). METHODS AND MATERIALS: Between 1960 and 1999, 73 men with Stage II seminoma received postorchiectomy radiotherapy. Before 1984, 36 received prophylactic mediastinal irradiation (Series I); between 1984 and 1992, 17 received no supradiaphragmatic irradiation (Series II); and after 1992, 20 received PLSCI (Series III). The outcomes in these series were compared. RESULTS: The abdominal tumor sizes were as follows: Series I, 2 and 5 and 2 and 5 and 2 and 5 and <or=10 cm, n = 5 (p = 0.75). The median duration of follow-up was 14.4, 9.3, and 4.5 years for Series I, II, and III, respectively. The 6-year freedom from relapse was 94%, 71%, and 95% for Series I, II, and III, respectively. The differences between Series I and II (p = 0.014) and between II and III (p = 0.042) were significant. Three patients in Series II had a relapse in their left supraclavicular fossa-a failure pattern abrogated by PLSCI. CONCLUSIONS: PLSCI significantly diminishes the likelihood of relapse for Stage IIA, IIB, and IIC seminoma (mass <or=10 cm).