Postoperative percutaneous endoscopic gastrostomy/jejunostomy

In order to cure complications appeared in the postoperative period two patients were treated with percutaneous endoscopic gastrostomy/jejunostomy (PEG, PEGJ) with the purpose of long-lasting enteral feeding and decompression. The indications of PEG/PEGJ were the following: external gastric fistula in one case and anastomotic leakage in one case. In the patients the PEG was located by intraoperative X-ray examination, this method was not published earlier. Regarding complications of the early postoperative period the PEG and the PEGJ are considered useful and expedient procedures with the aim of lasting enteral feeding and decompression.     

Evaluation of percutaneous endoscopic gastrostomy in a university hospital

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) has become a commonly performed procedure to provide nutritional support for chronically ill patients. The aim of this study was to review the safety and results of PEG in a teaching hospital. METHODOLOGY: A retrospective review of 44 patients who underwent PEG procedure. The indication was long-term enteral feeding in patients who were unable to maintain adequate nutrition by mouth with an otherwise functioning gut. The most common primary diagnosis was cerebrovascular accident (17 patients). All patients were unable to swallow. RESULTS: There were six (13.6%) minor complications, and two mortalities from peritonitis (4.5%). The most common complication was gastrostomy site infection, which did not require exchange of the feeding tube. CONCLUSIONS: PEG is a useful means of providing nutrition in patients unable to swallow without the necessity for laparotomy and general anesthesia. This method provides an adequate avenue for enteral alimentation in selected patients and is relatively safe. Careful attention to the technique of insertion is important to prevent leakage or bowel perforation.     

Percutaneous radiologic, surgical endoscopic, and percutaneous endoscopic gastrostomy/gastrojejunostomy: comparative study and cost analysis

p27kip1 (p27) protein is an inhibitor of cyclin and cyclin-dependent kinase complexes and prevents progression of cells from G1 to the S phase of the cell cycle. p27 might have tumor suppressor activity, and decreased p27 expression is associated with aggressive tumor behavior in several human malignancies. The object of this study was to evaluate p27 expression in prostatic adenocarcinoma treated by radical prostatectomy and to assess its association with numerous morphologic and clinical features. One hundred thirty-eight prostatic adenocarcinomas were evaluated for p27 expression by quantifying nuclear immunohistochemical staining. p27 expression was tested for association with patient age, family history of prostate cancer, preoperative serum prostate-specific antigen level, Gleason score, extraprostatic extension, seminal vesicle involvement, lymph node metastases, tumor-node-metastasis stage, DNA ploidy by flow cytometric analysis, and subclinical biochemical failure. p27 expression was analyzed as a continuous variable, and we also classified the tumors as low expressors (< 50% of cells p27 positive) or high expressors (> 50% of cells p27 positive) for comparison. Patients with adenocarcinomas that exhibited low p27 expression had higher mean Gleason scores than did high expressors (7 vs. 6.2, respectively; P = .002). Low p27 expression correlated with positive surgical margins (P = .05), seminal vesicle involvement (P = .007), lymph node metastasis (P = .03), and aneuploid cancers (P = .003), but it did not correlate with subclinical biochemical failure. p27 expression correlated with a number of prognostic morphologic features in prostatic adenocarcinoma, and the evaluation of p27 expression might provide additional prognostic information.     

Micturition by functional magnetic stimulation in dogs: a preliminary report

The effectiveness of functional magnetic stimulation (FMS) technology on bladder contraction and bladder emptying was evaluated in ten normal neurologically intact male dogs. In seven animals, FMS of the bladder was performed by using a commercially available magnetic coil (non-water-cooled) for stimulating the sacral nerves or over the suprapubic region. With sacral stimulation, the mean change in bladder pressure (Pves) was 68.0 +/- 12.96 cm H2O; with suprapubic stimulation, the mean change in Pves was 40.7 +/- 8.08 cm H2O. This change in Pves by sacral stimulation was higher than suprapubic stimulation (P < 0.01). In three additional animals, voiding was demonstrated by using a specialized water-cooled magnetic coil and by stimulating the sacral nerves with an intermittent stimulation sequence. Voiding occurred in all three animals and was reproducible. In summary, FMS of the bladder has the potential to be a useful non-invasive technology for bladder emptying and bladder training in patients with neurogenic bladder.     

Contrast-enhanced endoscopic ultrasonography in pancreatic diseases: a preliminary study

OBJECTIVE: The purpose of this study was to clarify the usefulness of contrast-enhanced endoscopic ultrasonography in pancreatic diseases. METHODS: The subjects comprised 37 patients with pancreatic diseases: 11 with ductal cell carcinoma, 10 with mucin-producing tumor, five with pseudo-cyst, four with islet cell tumor, four with chronic pancreatitis, and three with serous cystadenoma. After endoscopic ultrasonography, Albunex (0.22 ml/kg) was injected intravenously at a rate of 1 ml/s into the right median vein, and observation was continued for 10 min. The presence or absence of enhancement of the lesion was determined in each disease. Because all the patients with ductal cell carcinoma, islet cell tumor, chronic pancreatitis, and serous cystadenoma, as well as five with mucin-producing tumor and three with pseudo-cyst, underwent angiography, vascularity was compared between angiographic images and those of contrast-enhanced ultrasonography. RESULTS: Enhancement of the lesion was observed in all patients with islet cell tumor and serous cystadenoma, in eight with mucin-producing tumor, and in three with chronic pancreatitis. However, no enhancement effect was observed in the patients with ductal cell carcinoma and those with pseudo-cyst. Comparison between the images of contrast-enhanced endoscopic ultrasonography and angiographic images showed three patients in whom angiograms were hypovascular, but enhancement effect was observed on ultrasonographic images. CONCLUSION: The combined evaluation of plain and enhanced images of endoscopic ultrasonography may be useful for the diagnosis of pancreatic diseases.     

Bunionette correction by metatarsal osteotomy: preliminary report

A preliminary report is presented of 17 patients who underwent 27 fifth metatarsal osteotomies. Oblique osteotomy without internal fixation was used. Union of the osteotomy without external immobilization occurred in 16 of the patients. Correction was effected in a case of delayed union in one foot because it was symptomatic. Improvement and normal function were the result in 26 of the 27 osteotomies. Delayed union did not seem to mean failure of relief. No painful scars occurred.     

Radioaerosol inhalation lung cine-scintigraphy: a preliminary report

"Radioaerosol inhalation lung cine-scintigraphy", a cinematographic display of the lungs following radioaerosol inhalation has been found to be extremely helpful not only to the visual assessment of mucociliary clearance in the lungs but also to the setting of regions of interest and to the interpretation and analysis of clearance curves over the regions of interest in the lungs. It is expected that this procedure offers an important means to the study of mucociliary clearance in health and disease in man.     

Fine-needle aspiration cytology of the breast: a preliminary report on telepathology through Internet multimedia electronic mail

BACKGROUND AND AIMS OF THE STUDY: Tricuspid valve endocarditis traditionally has been treated with either valve resection or valve replacement. To avoid implantation of foreign material in an infected area and to circumvent anticoagulation, tricuspid valve repair was applied and the results assessed. METHODS: Tricuspid valve repair was performed in five patients with right-sided endocarditis. All patients had tricuspid regurgitation grade 3-4 on preoperative transesophageal echocardiography, and developed progressive deterioration associated with heart failure. The indications for surgery were congestive heart failure, persistent sepsis, recurrent emboli, concomitant left-sided endocarditis, and fungal infection. Surgical procedures included cusp resection, annular plication and annuloplasty, pericardial patch replacement, and construction of artificial chordae. RESULTS: There were no hospital deaths and major associated morbidity. Follow up is complete at a mean of 20.4 months. There were no reoperations or cases of recurrent infections. All patients are in NYHA class I-II. Postoperative echocardiography revealed no signs of major valvular dysfunction. CONCLUSIONS: Valve repair in right-sided endocarditis is a relatively new application for repair techniques, but may become an attractive alternative to tricuspid valve excision or prosthetic valve replacement.     

Cystadenoma of the pancreas: report of a case diagnosed by endoscopic retrograde pancreatography

The first case of a cystadenoma of the pancreas occurring in an African patient is reported. cystadenoma of the pancreas is a rare tumour. It should be suspected when a patient presents with a pancreatic cyst but without a history of pancreatitis, alcoholism or abdominal trauma. Estimation of the serum amylase level, selective coeliac and superior mesenteric arteriograms, and endoscopic retrograde pancreatography (ERP) are helpful in making the preoperative diagnosis. The ERP appearances in cystadenoma of the pancreas are described.     

Imagery as an aid in working through unconscious conflicts: A preliminary report.

Considers a technique designed to aid the working-through process in psychoanalytic treatment. It consists of an analysand, either during or after treatment, imploding psychodynamic themes that have come to be understood as crucially involved in his/her psychology and psychopathology. This process refers to the person conjuring up affect-laden images in which warded-off libidinal and aggressive impulses are expressed and then met with punishment (e.g., abandonment, castration). Clinical material is cited that suggests that the use of implosive imagery as a psychoanalytic treatment adjunct can lead to the mastery of unconscious conflict, the emergence of new insights, and the retrieval of repressed memories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Traumatic biliary stricture successfully treated by percutaneous transhepatic bile duct dilatation: a case report

A 24 year-old woman complained of obstructive jaundice 24 days after blunt abdominal trauma due to a traffic accident. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a stricture, 15 mm in length, at the common bile duct associated with upper bile duct dilatation. Jaundice was reduced by percutaneous transhepatic cholangio-drainage (PTCD). A 7 Fr-sized PTCD tube was exchanged for a larger-sized catheter for percutaneous transhepatic cholangioscopy expecting gradual dilatation of the stricture. Following the confirmation of satisfactory dilatation of the stricture, the catheter was removed. There was no recurrence of jaundice 16 months later in a follow-up study.     

Noninvasive perfusion MRI in Alzheimer's disease: a preliminary report

We performed functional MRI using the echo-planar imaging and signal targeting with alternating radio frequency (EPISTAR) technique in 11 patients with Alzheimer's disease (AD) and 8 age-matched control subjects. Seven of the AD patients had qualitatively apparent focal areas of hypoperfusion in the posterior temporoparietal-occipital regions. At the earliest inversion time producing cortical enhancement, the ratios of parieto-occipital and temporo-occipital to whole slice signal intensity were significantly lower in the AD patients than in the controls. Parieto-occipital hypoperfusion correlated with dementia severity as measured by the Blessed Dementia Scale. EPISTAR may prove to be a rapid, noninvasive alternative to other functional neuroimaging modalities in the evaluation of patients with dementia.     

The Numbing Scale: psychometric properties, a preliminary report

Twenty-one antimicrobial agents were incorporated individually into Frey's agar to evaluate their inhibitory activities against 86 isolates of avian mycoplasmas recently detected in Taiwan. Among them, 45 and 37 isolates were found positive with Mycoplasma gallisepticum and Mycoplasma synoviae fluorescent antibody conjugate, respectively. Twenty-one other isolates were unable to be identified by the above 2 conjugates. All of the field isolates were highly sensitive (with MIC50 < 1 microgram/ml) to enrofloxacin, gentamicin, myplabin, tiamutin and tylosin. However, those field isolates were highly resistant (with MIC50 > 32 micrograms/ml) to apramycin, chlortetracycline (CTC), erythromycin (ER), flumequine (FI), nalidixic acid (NA), oxolinic acid (OA), oxytetracycline (OTC) and spiramycin (SP). The inhibitory activities of the antibiotics which possessed an MIC90 of 50 micrograms/ml or less against local isolates were, in decreasing order, enrofloxacin (< 0.004 microgram/ml), gentamicin (1.53 micrograms/ml), tiamutin (1.81 micrograms/ml), tylosin (3.2 micrograms/ml), streptomycin (SM; 12.0 micrograms/ml), colistin (13.1 micrograms/ml), chloramphenicol (14.0 micrograms/ml), spectinomycin (15.0 micrograms/ml), myplabin (16.0 micrograms/ml), spiramycin (30.0 micrograms/ml), minocycline (32.0 micrograms/ml). The MIC90 of OA, CTC, SM, FI, SP, OTC, ER or NA was greater than 50 micrograms/ml; which work poorly in the control of mycoplasmoses. Since the antibiotic control policy is quite loose in Taiwan, many antimicrobial agents are often freely used in clinics, with a resulting gradual decrease in the inhibitory activity to the avian mycoplasmas.     

Circular stereotactic callosotomy: a preliminary report. Technical note

The authors propose a new method for performing stereotactic callosotomy, which they have named circular callosotomy. The operating device is the original Riechert-Mundinger's string electrode, which can be protruded through a side window and by rotating the probe it is possible to cut the commisural pathways to the extent required. The anatomical results of the operation can be checked using MRI scanning.