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EA Vagner VA Bruns OT Artemov AV Kasatov MV Altyntsev 《Canadian Metallurgical Quarterly》1998,(9):62-64
During 20 years (1972-1994) the authors carried out proximal resections of the stomach in 106 patients for cancer of proximal part of the stomach extended to the esophagus. Morphological verification data are presented. Total lethality rate made up 20.8%. It decreased with gaining of experience and improvement in selection of patients (1972-1982--29.6%, 1983-1994--17.7%). The most common complication in postoperative period was exudative pleuritis: in 16% of operated patients insufficiency of sutures of the esophagogastric anastomosis was observed. For prophylaxis of suture insufficiency pyloroplasty by Heineke-Mikulich and continuous (to 4-5 days) naso-gastral drainage were of principal significance. Great importance was attached to establishment of the anastomosis by the method developed by the authors. The results of the operations depend also on the operative approach: two-stage combined approach (laparotomy, thoracotomy) brings the least lethality. 相似文献
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The double contrast technique is of particular value in the proximal stomach, where one is able to detect ulcers and masses not recognized on a conventional upper gastrointestinal series. Pseudotumors which may occur in the fundus with the conventional barium technique are readily resolved. When a lesion in the proximal stomach is suspected by conventional radiography, immediate use of double contrast radiography may confirm or better delineate the lesion. Double contrast examination of the proximal stomach may thus be used as a primary or immediate secondary procedure to increase radiologic accuracy. 相似文献
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BP Wijnhoven GA Salet JM Roelofs AJ Smout LM Akkermans HG Gooszen 《Canadian Metallurgical Quarterly》1998,85(2):267-271
A novel chitinase gene was isolated from Metarhizium anisopliae grown in a medium containing chitin as the sole carbon source. Comparisons of nucleotide sequence of the isolated gene with those of other fungal chitinase genes showed low sequence identity (24.4-36.4%) except for the active site of chitinase. In addition, molecular mass determination of the fused gene product separated on a gel showed that the fused chitinase seems to be about 70 kDa, while the molecular mass calculated from the deduced amino acid sequence can be about 58 kDa. These molecular masses were different from values of 33 kDa for an endochitinase and 110 kDa for an exochitinase (N-acetylglucosaminidase) from M. anisopliae published previously. 相似文献
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The aim of this study was to determine whether insulin-induced relaxation of the proximal stomach after proximal gastric vagotomy is mediated by vagal release of antral gastrin. In six conscious, fasted dogs following proximal gastric vagotomy, the effects of intravenous insulin (1 U/kg) and intravenous gastrin (1 microg/kg) on proximal gastric motility, as measured by a gastric barostat, on plasma glucose, and on plasma gastrin, as measured by radioimmunoassay, were assessed 1 hour before and for 2 hours after injection. The effects of a cholecystokinin (CCK)-A receptor antagonist and a CCK-B receptor antagonist on insulin-induced or gastrin-induced relaxation of the proximal stomach and on plasma glucose and gastrin were also determined. Intravenous insulin decreased plasma glucose (before [mean +/- SD], 97 +/- 5 mg/dl vs. after, 45 +/- 3 mg/dl; P <0.05), increased plasma gastrin (before, 240 +/- 59 pg/ml vs. peak after, 387 +/- 85 pg/ml; P <0.05), and relaxed the proximal stomach (100% +/- 0% barostat volume vs. 202% +/- 15% volume; P <0.05). Exogenously administered gastrin also relaxed the proximal stomach without decreasing plasma glucose. CCK-B blockade diminished, but did not abolish, the gastric relaxation caused by insulin or gastrin, whereas CCK-A blockade had little effect. It was concluded that insulin-induced relaxation of the proximal stomach after proximal gastric vagotomy is mediated, in part, by vagal release of antral gastrin. 相似文献
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On the basis of experimental and clinical investigations the role of vascular microcirculation disorders of gastric wall in pathogenesis of recurrent and peptic ulcers and, in particular, giant ulcers of the stomach after selective proximal vagotomy was established. Giant ulcers of the stomach are considered as trophic or ischemic ulcers, and are shown to be resistant to therapy. Early surgical treatment is recommended. The method of choice is gastric resection of ladder-type. 相似文献
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R Penagini G Hebbard M Horowitz J Dent H Bermingham K Jones RH Holloway 《Canadian Metallurgical Quarterly》1998,42(2):251-257
Oxytocin (OT) is present in the mammalian testis and has been shown to play a role in the modulation of seminiferous tubule contractility and steroidogenesis. However, stage-specific effects of the peptide have not been previously investigated. In this study, computer-assisted analysis and time-lapse videomicrography were used to investigate basal contractility and the response to OT of seminiferous tubules at specific stages of the spermatogenic cycle. Adult rat testes were placed in fresh oxygenated DMEM F12 medium, decapsulated, and the tubules gently teased apart. Stages were identified by transillumination and a 10 mm section of tubule at each of stages IV-V, VII-VIII and XIII-I was placed in a microslide chamber and perifused with medium. After a control period of 3 h, OT (2 nM) was given for 1 h, followed by another control period of 1 h. The experiment was repeated using tubules from different rats and data were analysed to give arbitrary units of tubule contractility. Contractility was observed in all the tubules studied and the contractile activity was shown to vary depending on the stage of the spermatogenic cycle. Mean basal contractility at stages VII-VIII, the time when sperm are shed from the epithelium, was significantly lower than that at stages IV-V and XIII-I. The response of the tubules to OT was also stage-dependent, with the peptide producing the largest increases in contractile activity at stages VII-VIII and having no effect at stages IV-V. We postulate that these stage-specific differences in basal and OT-stimulated contractility may be important in co-ordinating the movement of developing germ cells towards the lumen of the seminiferous epithelium and in the process of spermiation. 相似文献
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W El-Rifai JC Harper OW Cummings ER Hyytinen HF Frierson S Knuutila SM Powell 《Canadian Metallurgical Quarterly》1998,58(1):34-37
We relate a case history that involved the therapeutic sharing of self with an elderly patient. The potential usefulness of this kind of intervention is discussed in light of the literature on self-disclosure and the use of self in clinical practice. We discuss how these concepts might relate to other well-described phenomena in geriatric nursing, including reminiscence, life review, loneliness, and storytelling. Recommendations for use in clinical practice and for qualitative studies are given. 相似文献
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Simultaneous study of tones of the lower esophageal sphincter and proximal stomach in healthy humans
F Zerbib S Bruley des Varannes DC Rozé JP Galmiche 《Canadian Metallurgical Quarterly》1996,20(12):1078-1083
OBJECTIVES: The aim of this study was to determine the feasibility and tolerance of simultaneous assessment of the proximal gastric and lower esophageal sphincter tones in healthy humans, in fasting and fed conditions. METHODS: Esophageal motility and lower esophageal sphincter tone were measured on two separate days in 7 healthy subjects. During one of these sessions, proximal gastric tone was simultaneously assessed with a balloon placed in the proximal stomach and connected to an electronic barostat. Motility was monitored 1 hour before and 4 hours after a liquid fat meal (400 mL/600 kcal). In four other healthy subjects, simultaneous assessment of proximal gastric and lower esophageal sphincter tones was performed after, suggestion of a 200 mL/200 kcal liquid meal. RESULTS: Simultaneous use of gastric barostat and esophageal motility device was well tolerated in 10/11 healthy subjects. The presence of the barostat balloon did not significantly affect basal lower esophageal sphincter tone and the rate of transient lower esophageal sphincter relaxations. The important fall of lower esophageal sphincter basal tone after ingestion of the 400 mL/600 kcal meal did not allow to detect a post-prandial increase of transient lower esophageal sphincter; relaxations. After ingestion of the 200 mL/200 kcal meal, the incidence of transient lower esophageal sphincter relaxations increased (p < 0.02 vs. fasting). Maximal gastric relaxation was reached 15 min after meal, and appeared shorter (112 +/- 17 min vs. 167 +/- 24 min) and more pronounced (292 +/- 26 mL vs. 190 +/- 51 mL) than after the 400 mL meal, but differences were not statistically significant. CONCLUSIONS: Simultaneous assessment of proximal gastric and lower esophageal sphincter tone is feasible, after oval ingestion of a meal. Since the 400 mL meal induces in important inhibition of lower esophageal sphincter basal tone, the 200 mL meal seems more adequate for assessment of the transient lower esophageal sphincter relaxations. 相似文献
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R Konegawa 《Canadian Metallurgical Quarterly》1978,14(1-2):29-41
The role of the antral gastric vagi and the pyloric sphincter on the residual stomach following proximal gastrectomy were studied electromyographically, using adult mongrel dogs. At the first stage of surgery, proximal gastrectomy was performed preserving the bilateral antral gastric vagi followed by esophagogastrostomy by end-to-side anastomosis. The residual stomach was equipped with four bipolar silver needle electrodes and two waterproof strain gauges on the wall of the stomach. At the second and third stage of surgery, the same dog subsequently underwent trancal vagotomy and pyloromyotomy at 4 weeks intervals. Following proximal vagotomy, the interval of the BER in fasting was prolonged. Dysrhythmia was observed quite frequently, and the amplitude and rhythmicity of contractile activities of the residual stomach became lowered and distorted, however, after feeding the interval of the EBR was shortened and dysrhythmia was altered to a regular rhythmic pattern. Frequent episodes of vomiting were observed following over feeding. Subsequent trancal vagotomy showed increased incidence of dysrhythmia in fasting, and gave no favourable effects on the vomiting episodes or the amount of feeding. After pyloromyotomy, the amount of feeding could be increased by about 50% from the original optimal amount. 相似文献
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M Manfrini A Gasbarrini C Malaguti M Ceruso M Innocenti S Bini R Capanna M Campanacci 《Canadian Metallurgical Quarterly》1999,(358):111-119
From 1989 through 1996, 10 children affected by high grade bone tumors of the proximal tibia underwent an intraepiphyseal intercalary resection. The residual epiphyseal bone segment measured less than 2 cm in thickness in all cases and reconstruction always was performed using the combination of a vascularized fibular autograft and a massive bone allograft. The proximal epiphyseal osteosynthesis was fixed by small fragment screws. The aim of this study was to report the growth pattern of the residual proximal tibial epiphysis and to evaluate any possible lower limb discrepancy and/or deformity after the end of skeletal maturity. At current followup six patients were available for the final evaluation. Radiographic documentation included computed tomography scan of both knees before surgery, a panoramic radiographic view and a computed tomography scan of both lower limbs after the end of skeletal growth. The length of both femurs and tibias, the size of the tibial plateau and of the opposite distal femur, and any possible deformity of femur or tibia were measured and compared with the preoperative data. No patient had a limb length discrepancy greater than 3.5 cm. In all cases the ipsilateral femur had a valgus deformity of the hip develop. In two patients this deformity was associated with an elongation of the femur, partially compensating for the shortening of the tibia. The tibial plateau close to reconstruction grew less than the contralateral one (range 2%-8%) but maintained its normal relationship with the distal femur. None of these patients reported any restriction in recreational activities. They could walk, run, and jump. Their functional result according the International Society of Limb Salvage functional grading system was satisfactory in all cases. 相似文献
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D Korenaga H Orita S Maekawa A Maruoka K Sakai T Ikeda K Sugimachi 《Canadian Metallurgical Quarterly》1997,84(11):1563-1566
BACKGROUND: The pathological findings of the resected stomach after endoscopic mucosal resection (EMR) for early gastric cancer were reviewed. EMR was indicated when a lesion consisting of well or moderately differentiated adenocarcinoma had a diameter of less than 2 cm. METHODS: Of 39 patients with early gastric cancer were treated with EMR between 1990 and 1995, 11 required additional surgery. RESULTS: Malignant tissue in the gastric wall was completely removed in four patients, while cancer cells remained in the mucosa adjacent to the scar in five and infiltrated into the submucosa in two. Most of these residual cancers were characterized by a lesion with a diameter exceeding 15 mm and by the location in the body or cardia of the stomach. Lymph node metastases were observed in one patient whose carcinoma invaded the deeper submucosal layer. Assessment of the depth of entire invasion from the endoscopically-resected specimen was correct for six of 11 patients. CONCLUSION: Gastric carcinomas to be resected by EMR should be smaller, especially if located in the body or cardia. Accurate diagnosis of the width and depth of invasion is indispensable before proceeding to EMR. Surgery may be the treatment of choice when there is submucosal invasion. 相似文献
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Between July 1991 and February 1995, 33 patients underwent bipolar shoulder arthroplasty for painful rotator cuff arthropathy of the shoulder. Twenty-two of these patients have been followed for an average of 28 months (range 24 to 48 months) and comprised the study group. All patients had massive, irreparable rotator cuff tears and presented with preserved passive motion, good deltoid function, and obliterated glenohumeral joint surfaces. Function and comfort were dramatically improved in all patients, with an average increase in active forward elevation of 29 degrees and a gain in active external rotation of 39 degrees. There was one complication requiring reoperation at 4 years. Utilizing the UCLA and Swanson scoring systems, all patients were rated fair or better. 相似文献