摘要:

We have performed percutaneous transhepatic portal catheterization (PTPC) with measurement of insulin concentration in 9 patients for 11 years, and could localize tumors in 8 of the 9 patients by the first PTPC. Even in the only case where we failed to localize a tumor by the first PTPC, we succeeded in localizing it with the second PTPC with 24 blood samples. In this case, only 1 blood sample drawn from the confluence of two veins, the dorsal pancreatic vein and splenic vein, showed an extremely high plasma insulin level (1,121 µU/ml), while the other 23 blood samples showed much lower insulin levels. In 2 of these 9 patients, the tumors were not palpable at operation, and PTPC was the only method that could localize them. This study indicates that PTPC is an excellent method for preoperative localization of insulinomas. Precise serial blood sampling covering the whole portosplenic venous system is indispensable to avoid a false-negative diagnosis

ISSN:0253-4886    

DOI:10.1159/000171985

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Patients with malignant obstructive jaundice were treated by converting percutaneous transhepatic cholangio-drainage (PTCD) to internal drainage, using a new apparatus and technique. All patients had unresectable neoplasms. This procedure was devised because of the disadvantages of permanent percutaneous external drainage, and it was indicated when palliative surgical drainage was unsuccessful. No severe complications were encountered, except for cholangitis in 2 cases. Many patients remained stable during several months of close clinical monitoring as outpatients. We concluded that nonsurgical diversion of PTCD to internal drainage is safe and effective for palliative decompression of bile ducts in patients with inoperable malignant obstructive jaundice.

ISSN:0253-4886    

DOI:10.1159/000171986

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Six patients with well-consolidated J-shaped ileal pouch-anal anastomosis were studied. Manometric recordings were obtained from within the pouch and 5 and 10 cm above the reservoir, for an average of 1.5 h during fasting and 1 h after a 450-kcal meal. Analysis of tracings revealed no migrating motor complex during fasting, but frequent (one every 5–10 min) high-amplitude prolonged simultaneous contractions were present in the 4 patients who had the worst clinical outcome and complained of frequent stools. There was no response to food after the meal in any subject. It is concluded that patients undergoing restorative proctocolectomy may share motor abnormalities of the ileal pouch, and that these abnormalities may be responsible for poor clinical outcom

ISSN:0253-4886    

DOI:10.1159/000171987

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

By means of actuarial analysis the life course of 222 patients with neoplastic colorectal polyps was followed up to 200 months (mean 153 months) after primary polypectomy. Eleven patients developed subsequent colorectal cancer. In the group of patients with villous elements in the primary polyp (n = 133), the incidence of subsequent colorectal cancer (10 patients) was three times higher than in the background population, and significantly higher than the incidence of subsequent cancer (1 patient) in the group of patients with primary pure tubular adenomas (n = 89). The incidence of cancer was not related to the size or number of primary polyps. It is concluded that patients with adenomas with villous elements need control of their colonic mucosa following primary polypectomy.

ISSN:0253-4886    

DOI:10.1159/000171988

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Immunoreactive staining for the c-myc oncoprotein (p62) was examined in 58 colorectal carcinomas, 17 colorectal adenomas, and 64 samples of normal colon mucosa using a mouse monoclonal antibody against the product of the myc oncogene (MYC1–6E10). Intense immunoreactivity for p62 oncoprotein was detected in 25 of the 58 carcinomas, in 10 of the 17 adenomas, and in 5 of the 64 samples of normal colon mucosa. The immunoreactivity for the p62 oncoprotein did not differ between carcinomas and adenomas, and immunoreactivity was not correlated with clinical stage of colorectal carcinoma

ISSN:0253-4886    

DOI:10.1159/000171989

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In a retrospective study 403 patients with colorectal carcinoma and elective gut resection were investigated with respect to postoperative complications and mortality depending on the age and accompanying risk factors (pulmonary diseases, cardiac diseases, diabetes mellitus, renal failure, arterial circulatory disturbances). Postoperative mortality was 1.3% in younger patients ( 75 years). In the presence of one risk factor none of the younger but 10% of the older and old patients died postoperatively. In the presence of two or more risk factors mortality was 0, 12.5 and 15%, respectively. In a multivariate analysis age alone showed no statistically significant influence on the lethal outcome. The important fact for the higher mortality not only in the old but already in the older patients was the presence of risk factor

ISSN:0253-4886    

DOI:10.1159/000171990

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Progressive lobectomies of the liver were performed in dogs to evaluate hemodynamic changes in lobectomized liver. Portal venous blood flow (PVF) and hepatic arterial blood flow (HAF) were decreased, whereas PVF per 100 g liver tissue, portal venous pressure and portal venous resistance in 100 g liver tissue were increased. These changes were significantly (p < 0.01) correlated to the remnant percentage of the liver. HAF per 100 g liver tissue was not significantly altered. These results show characteristic changes in the portal venous blood flow in correlation with the remnant percentage of the liver.

ISSN:0253-4886    

DOI:10.1159/000171991

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The fast growth of AIDS augurs, in the coming years, that the surgical complications will become more frequent. Of some 680 patients under medical treatment for HIV, in Laennec’s Hospital, 106 were operated, of whom 43 required an abdominal operation. Out of them 25 have shown an abdominal event related to the HIV virus. Nineteen were surgically operated, 1 by endoscopy; 6 were not operated, 1 because of a successful antibiotic treatment, the 5 others because of an increasing status to the dying point. The semiologic interpretation and analysis were always difficult. In the context we tried to show that the surgeon will often be confronted with the difficult situation, having to discriminate the point from where it will be necessary to bring his help to these young men and women, overwhelmed by successive complications, treatments, and justly concerned by their ingravescent diseas

ISSN:0253-4886    

DOI:10.1159/000171992

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We present the reports of 2 patients who underwent radical operation for synchronous primary cancers of the pancreas and stomach. The 1 st case underwent a total pancreatectomy and a distal gastrectomy with vascular reconstruction, and survived for 23 months. The second case underwent a radical pancreatoduodenectomy with a total gastrectomy. He died in the 11th postoperative month. The gastric lesions in these patients were diagnosed correctly before surgery by repeated endoscopic biopsies. The pancreatic lesions were also diagnosed correctly before operation. Only 9 cases were reported, in whom primary cancers of the pancreas and stomach were resected at the same operation. We reviewed these 11 cases including our cases from the standpoint of clinical statistics, pathological findings, preoperative diagnosis and prognosis.

ISSN:0253-4886    

DOI:10.1159/000171993

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Two cases of superior mesenteric artery syndrome are presented. In both, conclusive diagnosis was made noninvasively in the presence of acute symptoms by obtaining details of the duodenum and vessels in a sonographic investigation.

ISSN:0253-4886    

DOI:10.1159/000171994

出版商:S. Karger AG    

年代:1991

数据来源: Karger