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At least 919 records · Page 51Linked to original sources
PubMed1993

[Laparoscopic adrenalectomy].

Between June and September 1993, laparoscopic adrenalectomy was indicated in five patients (three women, two men; aged 25-50 years). Three had a phaeochromocytoma, two had an adenoma (Conn's syndrome). Four of the five tumours were localized to the right adrenal gland, one to the left. Tumour diameter ranged from 3 to 5 cm. The laparoscopic procedure was successful in four of the patients (three right, one left). In the fifth case the operations had to be completed by conventional surgery, because of non-controllable haemorrhage. Duration of operation ranged between 165 and 360 min for right adrenalectomy and was 135 min for the left one. Rapid convalescence, lower dose of pain-killing drug required, short hospital stay and good cosmetic results characterized the postoperative course after the laparoscopic procedure. This technique thus opens up new perspectives for adrenal surgery.

Adrenal Gland Neoplasms↗
PubMed1988

The response of infants with bronchiolitis to the proteins of respiratory syncytial virus.

Acute phase sera were collected from 28 infants hospitalized with bronchiolitis due to respiratory syncytial (RS) virus and convalescent sera were collected from 24 of them. The sera were assayed for neutralizing antibodies by plaque inhibition, for antibodies to the viral proteins by Western blot against partially purified RS virus, and for their ability to inhibit attachment and fusion. Among the 28 acute phase sera, 27 had antibody to the attachment glycoprotein (G), 16 had antibody to the fusion glycoprotein (F), but none had antibody to the matrix protein (VPM). Both the geometric mean anti-G titre, and the geometric mean anti-F titre correlated with the 50% neutralizing dose (ND50) titre in the acute phase serum. Among the 24 convalescent sera, only four exhibited an increase in neutralizing antibody titre. The response to G appeared to be related to the acute phase ND50 titre. Of 17 infants with acute phase titres of less than 100 ND50/ml, 10 responded to G while there was no response to this protein in seven infants with acute phase titres greater than 100 ND50/ml. While only one infant responded to F, 18 responded to the phosphorylated nucleocapsid protein, VP32, and none responded to VPM. The ability of the acute phase sera to inhibit virus attachment to HeLa cells and to inhibit fusion correlated with the anti-G titre and the anti-F titre, respectively. However, there was no correlation between the inhibition of fusion and the anti-F titre in the convalescent sera, almost all of which inhibited fusion. These results suggest that the infected infants were responding to RS virus, but that their response to the viral proteins was either masked or slowed by residual maternal antibody. The inability to detect VPM in the acute and convalescent phase sera, as well as in 20 paired maternal and cord sera at a 1:50 dilution suggested that VPM, although it is one of the most prevalent viral proteins in both the virion and the infected cell, may be poorly antigenic in humans.

Acute Disease↗
PubMed2000

Three methods for hysterectomy: a randomised, prospective study of short term outcome.

OBJECTIVE: To detect differences in clinical short term outcome between total abdominal hysterectomy, vaginal hysterectomy and laparoscopic assisted vaginal hysterectomy. DESIGN: Randomised controlled trial. SETTING: Department of Obstetrics and Gynaecology, Hospital of Helsingborg, Sweden. SAMPLE: One hundred-twenty women scheduled for hysterectomy for various indications. METHODS: Randomisation into three treatment arms: total abdominal hysterectomy (n = 40); vaginal hysterectomy (n = 40) and laparoscopic assisted vaginal hysterectomy (n = 40). During traditional abdominal and vaginal surgery, laparoscopic assistance was kept to a minimum. Substantial number of cases needed volume-reducing manoeuvres due to uterine size. MAIN OUTCOME MEASURES: Duration of surgery, anaesthesia, time in hospital and recovery time. RESULTS: Mean duration (range) of surgery was significantly longer for laparoscopic assisted vaginal hysterectomy compared with vaginal hysterectomy and total abdominal hysterectomy, 102 min (50-175), 81 min (35-135) and 68 min (28-125), respectively. Mean stay in hospital and mean time to recovery was significantly longer for total abdominal hysterectomy compared with vaginal hysterectomy and laparoscopic assisted vaginal hysterectomy. The difference between vaginal hysterectomy and laparoscopic assisted vaginal hysterectomy was not significant. It was possible to remove uteri under 600 g with all three methods. Four laparoscopic assisted vaginal hysterectomies and one vaginal hysterectomy were converted to open surgery. Reoperation and blood transfusion were required after two vaginal hysterectomies and one laparoscopic assisted vaginal hysterectomy. One woman needed blood transfusion after total abdominal hysterectomy. CONCLUSIONS: Traditional vaginal hysterectomy proved to be feasible and the faster operative technique compared with vaginal hysterectomy with laparoscopic assistance. The abdominal technique was somewhat faster, but time spent in theatre was not significantly shorter. Abdominal hysterectomy required on average a longer hospital stay of one day and one additional week of convalescence compared with traditional vaginal hysterectomy. Vaginal hysterectomy should be a primary method for uterine removal.

Adult↗
PubMed1983

Yersinia enterocolitica pharyngitis.

During the investigation of a large multistate outbreak of milk-borne yersiniosis, 14 patients who presented with pharyngitis had Yersinia enterocolitica isolated from the throat. Their illness was characterized by sore throat and fever without enteritis; 3 needed hospitalization. All patients tested had leukocytosis and an elevated convalescent-phase serum titer against the outbreak strain. In contrast to patients with enteritis, who were children, all patients with pharyngitis were adults. Thus, Y. enterocolitica may be responsible for some sporadic cases of pharyngitis in which the throat culture is negative for other pathogens.

Adolescent↗
PubMed2000

Laparoscopic retroperitoneal live donor right nephrectomy for purposes of allotransplantation and autotransplantation.

PURPOSE: We report the technique of and initial experience with retroperitoneal laparoscopic live donor right nephrectomy for purposes of renal allotransplantation and autotransplantation. MATERIALS AND METHODS: A total of 5 patients underwent retroperitoneoscopic live donor nephrectomy of the right kidney for autotransplantation in 4 and living related renal donation in 1. Indications for autotransplantation included a large proximal ureteral tumor, a long distal ureteral stricture and 2 cases of the loin pain hematuria syndrome. In all cases a 3-port retroperitoneal laparoscopic approach and a pelvic muscle splitting Gibson incision for kidney extraction were used. In patients undergoing autotransplantation the same incision was used for subsequent transplantation. RESULTS: All procedures were successfully accomplished without technical or surgical complications. Total mean operating time was 5.8 hours and average laparoscopic donor nephrectomy time was 3.1 hours. Mean renal warm ischemia time, including endoscopic cross clamping of the renal artery to ex vivo cold perfusion, was 4 minutes. Average blood loss for the entire procedure was 400 cc. Radionuclide scan on postoperative day 1 confirmed good blood flow and function in all transplanted kidneys. Mean analgesic requirement was 58 mg. fentanyl. Mean hospital stay was 4 days (range 2 to 8), and convalescence was completed in 3 to 4 weeks. CONCLUSIONS: In the occasional patient requiring renal autotransplantation live donor nephrectomy can be performed laparoscopically with renal extraction and subsequent transplantation through a single standard extraperitoneal Gibson incision, thus, minimizing the overall operative morbidity. Furthermore, these data demonstrate that live donor nephrectomy of the right kidney can be performed safely using a retroperitoneal approach with an adequate length of the right renal vein obtained for allotransplantation or autotransplantation.

Adult↗
PubMed1992

[New elements in organizing medical care for infectious patients in a mountainous desert locale with a hot climate].

In 1983-1985 the author of this article occupied the post of main infectionist of the 40th Army. During this period a number of new elements were elaborated by him to meet the requirements of medical care to infectious patients. At prehospital phase the nonorganic garrison isolators were deployed with 60-100 patient capacity on the basis of medical companies and separate medical battalions taking into account considerable delays in evacuation of patients. Lately it turned out more rational to deploy the infectious platoons in the organic structure of some medical companies and battalions. That made it possible to reduce the number of unfavourable cases. In addition to the existing structure of specialized medical care to the infectious patients it was planned to deploy 2-5 infectious units in military hospitals, deploy infectious hospitals with 200-500 patient capacity, boxes and intensive care units. The final recovery of convalescents was realized at the rehabilitation centre.

Afghanistan↗
PubMed1992

[The clinical picture and outcome of acute delta infection].

A total of 60 patients were observed with acute hepatitis delta defined at examination of 200 adult subjects with acute HBsAg-positive hepatitis. Moderate and severe forms of the disease occurred more frequently, lethality reached 13.3%. An unfavorable prognosis was related to a short-term prejaundice period with intoxication (high body temperature, head ache, vertigo, recurrent vomiting, IgM antibodies presence in the serum at the height of the disease). No patients achieved cure within 9 months following the discharge from hospital. The process acquired the form of long-term convalescence with transformation into chronic hepatitis delta.

Acute Disease↗
PubMed1979

Endoscopic papillotomy: sphincterotomy or sphincteroplasty.

An ongoing series of patients who were treated with endoscopic papillotomy (EPT) for retained or recurrent common bile duct gallstones or papillary stenosis was analyzed for safety and efficacy of the procedure and compared with accepted surgical technics, sphincterotomy and sphincteroplasty. To date, endoscopic papillotomy was attempted in 77 patients and successful in 71 (92%). The mean hospital stay is 3.1 days (range one to 12 days), convalescence has been short and morbidity has been low. One death has occurred in the series and no patients have been subjected to surgical intervention. Evaluation of the results achieved after papillotomy were compared with surgical technics and revealed that a sphincteroplasty was achieved in 68% of the patients and sphincterotomy in 32%. The results of EPT, therefore, have been extremely encouraging establishing EPT as a first line treatment modality for common bile duct stones and papillary stenosis. As, however, EPT is the only endoscopic procedure with predictable morbidity and mortality, it should be performed by skilled, experienced endoscopists in centers with cooperating surgeons so that it will remain an accepted modality in the treatment of biliary tract disorders.

Adult↗