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At least 865 records · Page 48Linked to original sources
PubMedDate not supplied

[Axillary dissection in cancer of the breast: a conservative approach].

It is common in oncology to have more than one alternative treatment for the same clinical situation. This is particularly true in breast cancer. Traditional treatments such as Halsted Radical Mastectomies are difficult to change. It is not uncommon to see this approach in Brazil, even in initial tumors, although it is considered unnecessary unless the pectoralis muscle is involved. Radical dissection of the axilla is another controversial issue in breast cancer today. Recent publications have given support to question the routine recommendation of axillary dissection in breast cancer. It is reasonable, under certain circumstances, not to perform axillary dissection or treat the axilla with other methods. Limited axillary dissection, for instance, may present good results with less risk of arm lymphedema. This paper illustrates this point showing preliminary results of 147 breast cancer patients with local tumor treated with conservative management. Half of the patients (74) had axillary surgery while the other 73 did not. Multivariate analysis using Cox's regression was performed and showed that axillary dissection did not change survival. This information confirms similar data published in the literature.

Adult↗
PubMed1989

[Characteristics of the formation of fat deposits in circumscribed lipomatosis of the neck and variants of surgical approaches to them].

During 15 years operations for circular lipomatosis of the neck (Madelung syndrome) were performed to 73 patients. Three variants of incisions (accesses) for removal of the fat accumulation from anterior areas of the neck are developed and described: 1) auriculo-mastoido-hypoglossal; 2) supraclaviculo-sternal; 3) cleidosternal The occipito-suprascapular incision is proposed for removal of fat accumulations from posterior areas of the neck.

Adult↗
PubMed1989

[Changing trends in the surgical management of breast carcinoma in Japan].

Modified mastectomy, which involved removal of the breast, overlying skin and axillary contents but spares the pectoralis muscle, has recently been established as an entirely satisfactory approach for Stage I and Stage II breast carcinoma. In a sequential series of patients, we noted that the traditional mastectomy followed by radiation to axilla and adjacent area failed to confirm the efficacy to support the prevention for local relapse in the past decade. The concepts of adjuvant chemotherapy evolved primarily from clinical trials: CMF and CAMF have been shown to influence favorably the therapy of premenopausal women with positive. nodes. Additional endocrine adjuvant treatment in postmenopausal women with positive nodes was significantly superior to that with CAMF. Immediate breast reconstruction following modified mastectomy or subcutaneous mastectomy was safe, simple, and possible to produce the patient's satisfaction. There was a positive effect on life style and on sexual, social or work relationships. Finally, in recent years, several studies have reported that more conservative treatment, such as partial mastectomy and nodes dissection with postsurgical radiotherapy are as effective as modified mastectomy. Present research will likely continue to modified current treatment as more data are gathered and analyzed clinically and histologically.

Adult↗
PubMed1989

[Autotransplantation of parathyroid glands in thyroid carcinoma surgery and their postoperative function].

Total removal and subsequent autotransplantation of parathyroid glands were carried out in operations for thyroid carcinoma in 25 cases. For the purpose of fine dissection of paratracheal lymph nodes, before thyroidectomy more than 2 parathyroid glands were found and transplanted into greater pectoralis muscle. The patients who underwent surgery were studied for more than one year following operation to determine the short term and long term outcomes of the procedure. None of the patients received prophylactic calcium supplement therapy except for hypocalcemic symptoms. In thirteen patients, the parathyroid function was almost completely restored within 3 weeks without any postoperative substitution therapy, with an obvious surge in the plasma PTH level on 5P.O.D. The serum Ca level started to elevate on 7P.O.D. and recovered to 97.4% of the preoperative value 3 weeks after transplantation. As for the 12 patients who exhibited hypocalcemic symptoms, Ca lactate and hydroxycholecalciferol were administered for only 24.7 and 17.0 days, respectively. Serum levels of Ca and P, as well as the index of bone mineral content, were all within the extremely excellent range even one year after operation. None of the patients was on a substitution regimen. These results suggest that autotransplantation is a valuable alternative for the preservation of the parathyroid function in operations for thyroid carcinoma.

Adult↗
PubMed1988

[Effect of a brain extract containing the postural asymmetry factor on the frog neuromuscular synapse].

The influence of the rat brain extract containing a postural asymmetry factor on the synaptic transmission in the right and left preparations of the frog cutaneus-pectoralis muscle was studied. The extract (2.10(-4) mg/ml) increased the quantal content of end-plate potentials (e.p.p.) in synapses of the right muscle and decreased it in synapses of the left muscle. In both right and left muscles relative changes in quantal content of e.p.p. correlated with relative changes in binomial parameter n. The results indicate an asymmetrical influence of the extract containing a postural asymmetry factor on the transmitter release in synapses of the right and left muscles.

Animals↗
PubMed1985

[Clinical and roentgenological study of the hands in synbrachydactyly, constriction band syndrome and cleft hand complex].

One hundred and six cases of synbrachydactyly, 63 cases of constriction band syndrome and 69 cases of cleft hand complex were clinically and roentgenologically studied and the following results were obtained. Synbrachydactyly is a group of hand anomalies in which the bone reduction appears transversely, and its severest form is a hand missing all the hand bones and the distal portion of the forearm, and with rudimentary digits on the stump. The association of dermal syndactyly or pectoralis muscle defect frequently seen in the milder cases of synbrachydactyly would be a secondary change to mesodermal hypoplasia or a related, but isolated malformation. Cleft hand complex which includes ordinary cleft hand, central ray polydactyly and central ray osseous syndactyly is a group of hand anomalies basically due to an ectodermal abnormality of separation of the digits. However, it is frequently associated with mesodermal hypoplasia or defect of various severity. The hand malformation in constriction band syndrome has a definite characteristic that the area of bone reduction is limited in phalanges.

Female↗
PubMed1987

Posterior wall disruption of the left ventricle after mitral valve replacement: management of bleeding and cardiac enlargement.

Two patients who underwent mitral valve replacement sustained posterior left ventricular disruption postoperatively and survived. Management consisted of repair from outside the heart without removal of the mitral prosthesis. This was achieved with a running Prolene suture in the atrioventricular junction in one patient and pledgeted sutures in the other who had transverse midventricular disruption. Biologic glue was crucial in controlling hemorrhage after the repair in both cases. The patient with transverse midventricular disruption required placement bilaterally of pectoralis muscle flaps to close the sternal wound because of swelling and dilatation of the heart.

Aged↗
PubMed1986

[Morphologico-functional study of the locomotor system of penguins as a principle of the general motor model of "underwater flight." II].

Based on the statements in part I according to the evolution of the underwater flight, its biophysical consequences and summarizing our knowledge on swimming performances of Penguins, the active and passive apparatus of movement was studied by dissection of 26 individuals of Pygoscelis papua, P. antarctica, P. adeliae, Eudyptes chrysolophus, and Aptenodytes forsteri. Besides the functional explanation of the Articulatio sternocoracoidea (diverging considerably from the usual type in birds), a new interpretation is given for the structures of the Articulatio humeri. In this context, the role of the Ligamentum acrocoracohumerale as an important element for co-ordination of the motion processes in the shoulder joint is elucidated. The essential curvature of the Caput humeri is found to be satisfactorily approximated by a logarithmic spiral. The understanding of the mechanics of bones and tendons leads to a reinterpretation of the role of several groups of muscles which is described in detail. Besides of the preponderant thrust producing (flapping) muscles working mainly in the isotonic manner, muscles can be distinguished which are managing the transfer of the produced forces to the body operating thereby in the isometric way. Another group of muscles has to control the position of the humerus adjusting in this way, the hydrodynamic angle of attack corresponding to the respective flow conditions.

Animals↗
PubMed1979

Reconstruction of the breast without additional skin or muscle flaps.

After mastectomy (usually simple or modified radical) many breasts may be reconstructed without additional tissue. However, in any patient in whom the skin flaps are very thin and/or tight, especially if the flaps have been irradiated, we urge use of the thoracoepigastric flap, latissimus dorsi muscle, or myocutaneous flap to achieve a pleasing result.

Adult↗