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At least 109 records · Page 6Linked to original sources
PubMed1986

[Some problems of treatment of hypopharyngeal and cervical esophageal cancer].

201 cases with hypopharyngeal and cervical esophageal cancer undergoing treatments at our hospital from 1969 to 1985 were analysed from the clinical viewpoints. 112 out of 201 cancer cases received radical operations and the resultant 5 year survival rate was 33.5%. Concerning the resection of primary tumor lesions, both procedures of pharyngo-laryngo-esophagectomy and radical neck dissection were performed for the cases with hypopharyngeal cancer. For cervical esophageal cancer, the operative procedures include partial resection of sternum and upper mediastinal dissection. As for reconstruction of cervical esophagus, we used mainly four materials such as gastric tube, free jejunum, free forearm flap and deltopectoral flap.

Esophageal Neoplasms↗
PubMed1988

Surgical sterilization at the time of cesarean delivery.

The cesarean section operation has been recognized for more than a century as an ideal time for the obstetrician to effect sterilization, usually with minimal morbidity, by way of one of the methods of tubal ligation. The physician must choose between simple, quick methods such as the Pomeroy or Parkland, with their slightly higher but acceptable failure rates, or the more elaborate and foolproof methods that involve burial of the tubal ends, such as the Irving or Uchida, which are technically more difficult and time consuming. The authors stress that whichever procedure is utilized, the surgeon must resist the desire to elaborate on proven techniques; otherwise, higher than published failure rates may result. It is important for the patient to understand the risks, both of immediate morbidity and remote failure, and to give her informed consent. Attentive presterilization counseling may identify the patient who will regret the loss of her fertility.

Cesarean Section↗
PubMed2006

Efficacy of postoperative elective ventilatory support for leakage protection in primary anastomosis of congenital esophageal atresia.

Anastomotic complications after primary repair of congenital esophageal atresia (EA) are recognized and feared complications. A close association exists between anastomotic leakage and the tension of the anastomosis on the suture line. This study aimed to evaluate the efficacy of postoperative elective ventilation support (PEVS) under paralysis with neck flexion after primary repair of EA. Forty-two EA patients; 4 cases with type A and 38 with type C by Gross classification received primary or delayed primary anastomosis between 1979 and 2003. PEVS has been introduced in the postoperative management of all EA cases since 1998. Vecuronium bromide was administered together with fentanyl citrate for five postoperative days. Patients were retrospectively divided into two groups: with or without PEVS management. There was no difference in operation data such as gastrostomy construction, gap between esophageal upper and lower pouch, primary or delayed primary anastomosis. PEVS under paralysis with neck flexion reduced postoperative anastomotic leakages in primary anastomosis with or without a Livaditis procedure. PEVS did not adversely increase anastomotic stricture, atelectasis, severe gastro-esophageal reflux, prolong days on ventilatory support or decrease survival rate. PEVS is an effective management method to decrease anastomotic complications for EA neonates.

Anastomosis, Surgical↗
PubMed1995

Angioscopic detection of residual pulmonary thrombi in the differential diagnosis of pulmonary embolism.

Definite diagnosis of pulmonary embolism (PE) by conventional methods such as angiography is frequently difficult. If residual thromboemboli incorporated into the pulmonary arterial wall or in the distal small segments are visible, differential diagnosis of PE versus primary pulmonary hypertension (PPH) can be made without open-chest pulmonary biopsy. Six patients suspected of having acute PE, 6 suspected of having chronic PE, and 4 with PPH diagnosed by pulmonary biopsy underwent percutaneous pulmonary angioscopy. In patients suspected of having PE, globular and mural thromboemboli were detected by both angioscopy and angiography in 4 and 1 patients, respectively. By angioscopy, emboli incorporated into the arterial wall were detected in 7 and microemboli obstructing the distal small segments were detected in 6. However, these emboli were detected by angiography in none. In patients with PPH, no embolus was detected by angioscopy and angiography. Angioscopically, however, stenoses were observed in the distal small segments in all patients. The results indicate that residual pulmonary thromboemboli in PE and stenoses of distal pulmonary arteries in PPH are detectable by percutaneous angioscopy, and therefore this method is feasible for differential diagnosis of PE.

Acute Disease↗
PubMed1992

[Usefulness of segmental Lp-TAE using lipiodol mixed with anticancer agent for inoperable hepatocellular carcinoma].

To determine the effect of appraising subsegmental or segmental transarterial embolization with Lipiodol mixed with anticancer drugs followed by gelatin particles (Segmental Lp-TAE) on inoperable hepatocellular carcinoma, we examined CT patterns and therapeutic results in 57 patients after Segmental Lp-TAE. Fifty-six tumors including 47 tumors less than 5 cm in size were the nodular type and 1 tumor was the massive type. The mean tumor size was 3.6 cm and the mean amount of Lipiodol was 4.4 ml. Portal veins in the embolized segment were highly visualized by injected Lipiodol on plain film immediately after Segmental Lp-TAE. On the follow-up CT, the size of the tumor with dense Lipiodol accumulation were reduced in all cases, and atrophy of the embolized segment was recognized. Forty-four of the 57 patients are alive, with the longest surviving patient still alive at 4 years and 5 months. Seventeen patients have survived for more than 2 years (direct crude survival rate: 65.0%), with the cumulative survival rates 93.2% at 1 year, 71.6% at 2 years. No recurrence was recognized in 33 of the 41 patients (80.0%) that were followed up for more than 1 year after Segmental Lp-TAE is a useful therapeutic method for hepatocellular carcinoma.

Aged↗
PubMed1984

[Rapid measurement of estriol & estradiol by high performance liquid chromatography (HPLC)].

Measurement of Estriol (E3) and Estradiol (E2) within 25 minutes by high performance liquid chromatography (HPLC) was achieved in this study and the values were compared with those of radioimmunoassay (RIA). A totally computerized HPLC method was developed for measuring unconjugated E3 and E2 in the sera of pregnant women. The sera samples were injected directly into the apparatus and transferred to a pretreatment column where estrogens were absorbed while hydrophilic components such as proteins and carbohydrates were excluded. The estrogens then passed through another separation column containing a new type of polymer gel. The mobile phase consisted of an acetonitrile/water mixture, and separation was achieved by means of a reversed phase mechanism. The eluent was monitored for fluorescence. All these procedures were monitored and controlled with a built-in microcomputer. The sera samples from 61 normal pregnant women at 20 to 41 weeks of pregnancy were simultaneously assayed by HPLC and RIA. The correlation of values obtained from HPLC and RIA was; E3: Y = 0.875X-0.172, the coefficient of correlation was 0.899, E2: Y = 0.972X + 6.791, the coefficient of correlation was 0.841 (Y = RIA values, X = HPLC values). The quick measurements of E3 and E2 by HPLC can be a useful method in evaluating the feto-placental function.

Chromatography, High Pressure Liquid↗
PubMed1998

[A new reconstruction procedure as antireflux surgery after proximal gastrectomy. Interposition of the jejunal pouch with valvuloplasty].

In order to reduce the incidence of reflux esophagitis following proximal gastrectomy, we have developed a new reconstruction procedure with an interposed jejunal pouch with antireflux valvuloplasty between the esophagus and the gastric remnant. After a standard proximal gastrectomy and lymph node dissection, the jejunum is divided at a point 25 cm from the Treitz ligament. The distal jejunum is pulled up through the transverse mesocolon with a mesenterium and anastomosed to the esophagus with a PCEEA stapling device. The pulled through jejunum is doubled up at a point 30 cm from the esophagojejunostomy, and the 5 cm tip of the jejunum is resected. A 5.5 cm autosuture GIA is inserted into the jejunum from both cut ends of the jejunum for side-to-side anastomosis on the antimesenteric side to make a 5 cm long jejunal pouch, and the jejunum is further divided 5 cm distal from the jejunal pouch. As a result, the interposed jejunal segment is omponed of a single-lumen 15 cm jejunum, a parallel lumen 5 cm jejunum, and a double-lumen jejunum. In the double-lumen jejunum, the jejunal pouch plays the role of a pressure absorber in the residual stomach, and the septum of the parallel lumen jejunum that of an anti-reflux valve. Peristalsis of the single lumen 15 cm jejunum prevents reflux to the esophagus. Postoperative examinations showed that this reconstruction method has satisfactory to excellent results.

Adult↗