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1.
A new method has been developed by us to observe the movements of the abomasum by using a magnet and digital magnetometer. Four cows with left displacement of the abomasum underwent conventional correction by rolling without tacking. A doughnut‐type magnet was sutured to the pyloric region in a routine operation. The same was done in three control cows. The position of the pyloric region was observed with a digital magnetometer from outside the cow's body. The magnets in the pyloric region of the control cows were located at the right side of the abdominal cavity at 10–30 cm anterior to the udder base, and moved slightly in various directions within the span of a day. On the other hand, the magnets in the pyloric region of cows with abomasal displacement moved widely in the abdominal cavity from the normal right side to the abnormal left front side. A large movement of the magnet from the normal right side to the abnormal left side of the abdominal cavity was observed within 12 h of the onset of abomasal displacement.  相似文献   

2.
The present investigation was undertaken to study the effects of surgical stress on thiobarbituric acid reactive substances (TBARS) and ferric reducing ability of plasma (FRAP) in dairy cows. Ten Holstein–Friesian dairy cows, mean age 5.26 years, admitted for treatment of left abomasal displacement (omentopexy), were used in our study. Blood samples were collected from the jugular vein prior to surgery, immediately and then 15, 30, 60, 90 min, and 2, 5, 10, and 24 h after reposition of abomasum. Surgical stress resulted in a significant increase in plasma cortisol concentrations (P < 0.001) with the highest mean levels 15 min after surgery (32.4 ± 18.1 μg/l) as well as in serum levels of glucose (P < 0.001) and non‐esterified fatty acids (P < 0.001). Similarly, surgery transiently enhanced the plasma levels of TBARS (P < 0.001). The highest TBARS plasma levels (0.91 ± 0.18 μmol/l) were recognized 60 min after reposition of abomasums. There were no significant differences in FRAP in dairy cows before and after reposition of abomasum. In conclusion, these data indicate that stress reaction caused by surgical correction of left displacement of abomasum can be associated with higher production of TBARS.  相似文献   

3.
The objective of this study was to analyse the heritabilitiy of the lactational incidence of displaced abomasum (DA) and the relationships of DA with milk production traits in German Holstein cows. Data were recorded between February 1999 and January 2000 in cooperation with five veterinary practitioners. Their veterinary practices were located in the northern part of Lower Saxony. The investigation included 160 dairy farms under the official milk‐recording scheme with 9315 cows. The lactational incidence of the left abomasal displacement amounted to 1.21%, and of the right abomasal displacement to 0.41%, respectively. The linear heritability estimates for the lactational incidences of left and right DA were h2 =0.05 ± 0.012 and h2 = 0.004 ± 0.005, respectively. Using the Dempster–Lerner‐transformation the corresponding heritabilities were h2 = 0.53 and 0.09, respectively. Milk losses for the lactation when DA was diagnosed were significant and reached 1016 kg milk, 41 kg fat, 36 kg protein and 0.07% protein. Fat content significantly increased by 0.18%. The analysis could not show significant differences between cows diagnosed with DA and cows not diagnosed with DA in the 305‐day milk production traits of the lactation preceding the diagnosis of DA. There was also no indication for an unequal distribution of breeding values for milk performance traits between cows with and without DA. The additive genetic correlations between 305‐day milk performance and left DA were low. The results indicated that cows with a high milk production and superior breeding values for milk performance were not exposed to an increased risk for DA.  相似文献   

4.
The electrical activities in abomasum were studied on the normal and left abomasal displaced cows. Electromyograms were obtained using eight bipolar-needle electrodes fixed by suture in the serosal surface of the various portions of the abomasum; one in the cardia, three in the fundus, and four in the pylorus. The results were summarized as follows: 1. In the cardia and fundus, the repetetive but irregular spikeburst was observed. 2. In the pylorus, the single spike followed by the spikeburst was observed. These spikes were rhythmic and propagative. The propagation velocity in the pylorus was shown the tendency to increase with approach to the pyloric canall. The electomyographic pattern in the cows was similar to goats except the discharge interval was longer in cattles than in goats. 3. The electrical activities in the abomasum received the left abomasal displacement showed the higher amplitude, the more prolonged discharge interval and accerelated propagation velocity than in controls.  相似文献   

5.
Eleven pediatric Wolff-Parkinson-White (WPW) syndrome patients underwent surgery. Four had left, 5 right cardiac type and 2 had right septal type WPW syndrome. Two patients had 2 accessory conduction pathways (ACP). Ebstein's anomaly and secundum type atrial septal defect were the associated congenital cardiac diseases in one patient each. Indications for surgery included repeated and/or long-lasting paroxysmal supraventricular tachycardia (PSVT), ineffective drug therapy, cardiac failure due to frequent tachycardia, short effective refractory period of the ACP, and simultaneous surgery for associated congenital cardiac diseases. Pre- and intra-operative examinations, including ECG, VCG, UCG, body surface mapping, intracavitary recording by catheter electrodes, computerized epicardial mapping, and endocardial mapping, were performed for the precise localization of the ACP. The surgical method was basically the same as is used for adults. Anterior median stermotomy was used primarily in right cardiac and right septal type and left anterior thoracotomy was used in 3 of 4 cases of the left cardiac type. Eight of 11 cases, two of which had 2 ACPs, were completely cured and in 3 there was evidence of postoperative pre-excitation. However, the PSVT attacks disappeared almost completely and drug therapy is not required at present.  相似文献   

6.
We aimed to investigate the ratio of accompanying diseases in cows suffering from clinical hypocalcaemia and their influence on cure rate. In five veterinary practices in different regions of Germany, all recumbent cows around parturition were included in the study for a period of 1 year. After recording the case history a clinical examination was done and a serum sample was taken to measure the concentrations of calcium and phosphorus magnesium, β‐hydroxybutyrate, total bilirubin, cholesterol, urea, and the activities of ASAT, CK, and GLDH. Only cows with hypocalcaemia entered the statistical analysis. Hypocalcaemia was the major cause of recumbency in cows of the second lactation or elder. Muscle damage was the second frequent diagnose in recumbent cows and the major concomitant disease in hypocalcaemic cows. The overall cure rate was between 89.4% and 94.8%. Calcium and phosphorus concentrations did not have an influence on cure rate. Non‐cured cows had higher serum activities of CK (p<0.043) and ASAT (p<0.006). Nevertheless, the activities of CK and ASAT were no good predictors of treatment failure because of their low specificity and the high cure rate of the cows in the five practices.  相似文献   

7.
The goals of the present study were to determine whether the infusion of a glucose solution into the portal vein is tolerated in cows and whether the glucose concentration differs after administration of glucose into the jugular vein and portal vein. Fifteen healthy Swiss Braunvieh cows were used. An indwelling catheter was placed in both jugular veins and a balloon‐tipped indwelling catheter with a diameter of 2 mm was placed in the portal vein under the guidance of ultrasonography. Three cows received 500 ml of 20% glucose solution over 60 min via the left jugular vein. Three other cows received the same solution over 60 min via the portal vein. Blood samples were collected from the right jugular vein before and for 24 h after the infusion of glucose for the determination of the concentrations of glucose and bilirubin and the activities of glutamate dehydrogenase, sorbitol dehydrogenase and γ‐glutamyl transferase. Infusion via the portal vein did not result in abnormalities in the general condition of the cows or increases in the concentration of bilirubin or the activities of liver enzymes. The blood glucose concentration increased to the same extent after both intraportal and intrajugular infusion. Over a 12‐h period, three cows received 10 l of 20% glucose solution via the left jugular vein and three others received the same solution over a 12‐h period via the portal vein. Blood samples were collected from the right jugular vein before and for 30 h after the start of infusion. Infusion via the portal vein did not affect the general condition of the cows or the activities of the liver enzymes. There was no significant difference in the blood glucose concentration between the two groups throughout the study.  相似文献   

8.
We encountered a patient with multiple stenotic lesions. He was treated by percutaneous transluminal angioplasty (PTA). The patient, a 59 year-old male, complained of right motor weakness. CT scan showed a multiple low density area (LDA) in the distribution of the right middle cerebral artery (MCA), but did not reveal LDA in the distribution of the left MCA on the affected side. After hospitalization, right motor weakness gradually worsened and aphasia became apparent. A repeat CT scan, 8 days after the stroke, disclosed a new LDA in the left watershed zone and the basal ganglia. Angiographical findings revealed a right ICA occlusion, left ICA stenosis, right VA anaplasia and left subclavian artery stenosis, which proved inadequate for anatomical collateral supply. We treated both the left ICA stenosis and the left subclavian artery stenosis by Dotter balloon dilatation catheter, and successfully obtained sufficient dilatation of the vessels concerned. No complication occurred. PTA is a useful method to use in patients with multiple stenotic lesions which might result in ischemic injury if surgical procedures were used. It would also be of value in cases where surgery using general anesthesia might be highly risky.  相似文献   

9.
Anatomical differences between right and left kidneys could influence transplant outcome. We compared graft function and survival for left and right kidney recipients transplanted from the same deceased organ donor. Adult recipients of 4900 single kidneys procured from 2450 heart beating deceased donors in Australia and New Zealand from 1995 to 2009 were included in a paired analysis. Right kidneys were associated with more delayed graft function (DGF) (25 vs. 21% for left kidneys, p < 0.001) and, if not affected by DGF, a slower fall in serum creatinine. One‐year graft survival was lower for right kidneys (89.1 vs. 91.1% for left kidneys, p = 0.001), primarily attributed to surgical complications (66 versus 35 failures for left kidneys). Beyond the first posttransplant year, kidney side was not associated with eGFR, graft or patient survival. Receipt of a right kidney is a risk factor for inferior outcomes in the first year after transplantation. A higher incidence of surgical complications suggests the shorter right renal vein may be contributory. The higher susceptibility of right kidneys to injury should be considered in organ allocation.  相似文献   

10.
肺移植术后的结核感染一例   总被引:1,自引:0,他引:1  
目的 探讨肺移植后结核杆菌感染的诊断与治疗。方法 1例接受左单肺移植的患者术后13个月发生胸壁结核感染,曾疑为急性排斥反应而予以激素冲击治疗,后经左前胸季肋部局部肿块穿刺抽吸物(脓液)涂片及培养,发现结核杆菌而诊断为胸壁结核脓肿,后又发生混合感染,给予抗结核药头及头孢他定治疗,同时行脓肿切开引流。结果 经治疗,患者的病情迅速得到控制,体温恢复正常,3个月后伤口愈合。结论 肺移植后发生结核病,其症状  相似文献   

11.
During a period of 7 years, we have aggressively treated liver tumors whether primary or metastatic. Our experience after 43 curative major liver resections has shown an excellent overall survival: 34 of 43 patients still alive a median of 12 months after liver resection (patient ages ranged from 21 to 85 years, median 57 years). Nineteen patients underwent right hepatic lobectomy, 9 trisegmentectomy, 5 left hepatic lobectomy, 5 extended left hepatic lobectomy, 4 right lobectomy plus left lobe wedge resection, and 1 patient underwent a major hilar wedge resection. Two patients died from sepsis and hepatic failure on or before the 60th postoperative day. One patient with no evidence of recurrent colorectal cancer was lost to follow-up after 2.5 years. One patient died without cancer 12 months after left hepatic lobectomy for colon cancer metastases. Cumulative survival for the entire series and for patients after resection of colorectal cancer metastases was the same: 1 year survival 90 percent; 2 year survival 75 percent, and 3 year survival 65 percent. Seventeen of 30 patients remain disease-free after resection of liver metastases. Of the 13 who had recurrence, 8 are still alive. Ten recurrences were outside of the residual liver (predominantly multiple pulmonary metastases). One recurrence was in the right hemidiaphragm, and only three were in the residual or regenerated liver. Serial carcinoembryonic antigen analysis was the best indicator of recurrence in these 13 patients, 12 of whom were asymptomatic. These data confirm that major liver resection can be performed with minimum postoperative mortality (4.7 percent in this series). More importantly, the majority of patients were cured of their liver metastases. The next goal should be the initiation of adjuvant systemic therapy trials after liver resection in such patients.  相似文献   

12.
DATA: Among 139 patients who underwent repair of tetralogy with pulmonary atresia, survival rates at 1 month and at 1, 5, 10, and 20 years were 85%, 82%, 76%, 69%, and 58%, respectively. The hazard function (instantaneous risk of dying) was greatest immediately after operation and declined thereafter, but a low constant hazard persisted for as long as the patients were followed up. Multivariately, the postrepair ratio between peak right ventricular and left ventricular pressures measured in the operating room provided the most information relative to the probability of death after repair, and cardiopulmonary bypass time the next. When morphologic abnormalities of the pulmonary circulation were considered in the multivariate analysis for risk factors for death, the size of the pulmonary arteries provided the most information, followed by the number of large aortopulmonary collateral arteries. The postrepair peak right ventricular/left ventricular pressure ratio was lower the day after operation than in the operating room in 65% of the patients in whom the measurements were made. Recurrent or residual ventricular septal defects necessitating rerepair occurred in four patients (3% of hospital survivors). Most surviving patients were in New York Heart Association class I at the time of follow-up. INFERENCES: Early, intermediate, and long-term survival is less good after repair of tetralogy with pulmonary atresia than after repair of tetralogy with pulmonary stenosis. This is related primarily to the greater prevalence of high peak right ventricular/left ventricular pressure ratio measured in the operating room in the former group. Both the postrepair peak right ventricular/left ventricular pressure ratio in the operating room and the probability of death are inversely related to the size of the pulmonary arteries and directly to the number of large aortopulmonary collateral arteries. This and inferences from other risk factors may be helpful in achieving better results in the future.  相似文献   

13.
Thirty patients (pts) have undergone ventricular assist pumping for up to 25.4 days (mean 6.8 days). Twenty-eight pts could not be weaned from cardiopulmonary bypass (CPB) after open heart operations and two pts sustained myocardial infarctions (MI), with cardiogenic shock unresponsive to medical therapy previous to surgery. Twenty-two pts required left ventricular assistance (LVA); 55% (12/22) were weaned from the pump and 32% (7/22) survived. Two pts required right ventricular assistance (RVA); both were weaned from the pump and survived. Six pts required right and left ventricular assistance (BVA) and none survived. Postoperative survival for program years 1976 through 1979 (14 pts) was 14% (2/14). Postoperative survival for program years 1980 through 1982 (16 pts) was 44% (7/16), reflecting improved pump insertion techniques (left atrial cannulation) and pt management. Since 1980, 12 pts have required LVA, nine have been weaned from the pump, and six pts have survived (50%). One pt has required RVA and has survived, and three pts requiring BVA did not survive. Seven pts have been alive and well 5, 9, 14, 19, 24, 30 and 36 months after surgery. Five are NYHA functional Class I status and two pts are NYHA Class II status. Current data indicates that single ventricular assistance in pts who cannot be weaned from CPB is "reasonable and therapeutic treatment to extend life."  相似文献   

14.
《Transplantation proceedings》2021,53(6):1957-1961
BackgroundWe sought to identify the risk factors involved in survival of and tumor recurrence in patients with hepatocellular carcinoma (HCC) undergoing liver transplant (LTx).MethodsWe conducted a retrospective observational study and analyzed the medical records of 414 patients with HCC undergoing deceased donor LTx in São Paulo between January 2007 and December 2011. Multifactorial analysis of survival and recurrence was performed using clinical, laboratory, and pathology data.ResultsThe mortality rate was 27.5%; mean survival time was 68.1 months (95% confidence interval, 64.7-71.6); and estimated 1-, 3-, and 5-year survival probabilities were 83.8%, 75.8%, and 71.5%, respectively. Altered donor blood glucose, female sex, vascular invasion, advanced age, high Model for End‐Stage Liver Disease, and tumor size were the main risk factors determining survival in LTx recipients. Recurrence was noted in 7.2% of patients during the study period and was more frequent in women (hazard ratio, 2.6). Vascular invasion increased the chance of recurrence by 5.4 times. Each additional 1-year increase in recipient age increased the chance of recurrence by 5.6%, and each 1-mm increase in tumor size increased the chance of recurrence by 3%.ConclusionsRisk factors for reduced survival are donor blood glucose, female recipient, older age, increased Model for End‐Stage Liver Disease score, and nodule size. Tumor recurrence risk factors are vascular invasion, female sex, recipient age, and nodule size.  相似文献   

15.
目的 总结1987-2008年344例通过肝门H沟中阻断肝叶、肝段或肝亚段入肝血管分支施行肝切除的经验.方法 (1)根据病变部位和大小分别实行大型肝切除(66例)、间隔性多个肝亚段切除(15例)、邻接多个肝亚段切除(216例)和单个肝亚段切除(47例),其中含肝尾叶切除29例.(2)肝左外段切除时在肝门左纵沟外侧游离、切断从门静脉左干矢状部外侧发出的左外上、下分支和肝左动脉.肝左内段切除时游离、切断从门静脉左干矢状部内侧发出的左内上、下分支和肝中动脉.肝右前段切除时游离、阻断肝右纵沟前支中的门静脉右前支和肝总管后的肝右动脉.肝右后段切除时阻断右纵沟后支中的门静脉右后支和肝右动脉.(3)断肝时尽量保护相应的肝静脉主干.结果 (1)术后病死10例(2.9%),其中死于肝衰8例,出血2例;(2)肝细胞癌病人(n=200)术后生存11~20年10例,7年4例,5年19例,5年生存率18.3%(33/180).肝内胆管癌(n=13)术后生存1/2~3年.肝门胆管癌(n=14)生存13、6、4年各1例.胆囊癌(n=12)生存1/2~1年.良性肝病(n=92)切肝后皆痊愈.7例肝内胆管结石尚需处理他处残留结石.结论 (1)间隔性多个肝段切除是一次手术治愈多支肝内胆管簇集性结石的有效方法.(2)该手术免去了阻断全入肝血流,缩小了术中肝缺血范围,减少了术中失血,提高了大肝癌切除率,减轻了术后肝功能损害,可以满足各种肝病肝切除要求,是一种合理、有效的切肝手术方法.  相似文献   

16.
Distal latero-circumflex arteries (DLCA) and posterior descending artery (PDA) are anatomically too far and cannot be revascularized with internal mammary artery (IMA) by a conventional procedure. The reimplantation of the right IMA into the left IMA in situ increases (2 times) the length of right IMA graft available. Fifty-five patients underwent this technique. Their preoperative status was: 22 males, 3 females; mean age: 57 years, 38% myocardial infarction (MI). Coronary angiography showed: stenosis of the left main coronary artery: 3; stenosis of 3 vessels: 15; 2 vessels: 10; 2.3 anastomoses by patient were performed with Y right and left IMA procedure: 24 LDA, 8 diagonals, 25 DLCA and 1 PDA anastomosis. No deaths were observed in this short series. Morbidity was: 1 MI, 2 sternal sepsis, 1 bilateral phrenic paralysis (all were cured without sequelae). To date (March 90) 15 patients have been followed for 3 to 12 months, 12 are angina-free, 3 are significantly improved, 11 have a negative exercise test. Thallium test is normal in the revascularized area in 14 patients. Seven angiographies have been performed (6 months to 1 year) and all Y right IMA are patent.  相似文献   

17.
The aim of this study was to determine the effect of parity on the first day of ultrasonic detection of embryo and its organs using 8 MHz frequency. For this purpose, six nulliparous heifers, five primiparous cows and six multiparous cows of the Holstein breed were selected and mated by a single bull from the herd. From day 16 after mating, cows and heifers were examined by ultrasonography thrice weekly for the day of first detection of the embryo and its organs. The mean of first‐day detection in heifers, primiparous and multiparous cows was as follows, respectively: allantois on days 22.3, 23 and 25.8; embryo proper on days 21.8, 23 and 27; heartbeat of embryo on days 26.1, 26.6 and 31.1; amnion on days 31, 31 and 30.8; limb buds on days 29.5, 28.8 and 30.6; stomach (abomasum) on days 32.2, 38.6 and 36.8; spinal column on days 32.6, 33.4 and 37.3; placentomes on days 33.3, 37 and 35.3; eyes on days 35.1, 35.4 and 38.6 and lens on days 40, 41.4 and 44. Although the mean of first day observation of all structures in heifers tends to be earlier than in the other groups, statistically, allantois, the embryo proper and its heartbeat in heifers and primipara were visualized significantly earlier than in multiparous cows. However, there were no differences between heifers and primiparous cows.  相似文献   

18.
We report a case of metachronous bilateral adrenal metastases from mucinous adenocarcinoma of the stomach. A 68-year-old man who had undergone surgery for advanced gastric cancer 5 months earlier had a follow-up computed tomography (CT) scan, which showed a right adrenal tumor. We performed a right adrenalectomy, and histopathological examination revealed a mucinous adenocarcinoma with features consistent with those of gastric cancer. A routine follow-up CT scan done 41 months after the right adrenalectomy showed a left adrenal mass. Chemotherapy had no apparent effect, and left adrenalectomy was performed 65 months after the right adrenalectomy. Histopathological examination also revealed a metastasis from gastric cancer. The patient was alive without recurrence 40 months after the left adrenalectomy. This case suggests that resection of adrenal metastasis from gastric cancer is an effective treatment option that may prolong survival in selected patients.  相似文献   

19.
BACKGROUND: The authors reviewed retrospectively their experience in 30 children with hepatoblastoma (HB). Despite an increased trend in the incidence of HB during the last 2 decades, an encouraging cure rate has been achieved with complete resection of the tumor and chemotherapy before or after surgery with cisplatin plus doxorubicin (Adriamycin) or cisplatin plus vincristine plus 5-Fluorouracil. RESULTS: There were 10 female and 20 male patients. For the period from 1963 to 1980 there were 8 patients, and for the period from 1981 to 1998 there were 22 patients. Their mean age at surgery was 16 months (range, 3.5 months to 5.5 years). Tumors were localized to the right lobe in 10 (42%), to the left lobe in 7 (29%), and in both lobes in 7 (29%) of the resected patients. Tumors were greater than 10 cm in size in 16 (67%) of these patients. Twenty-four patients (80%), underwent liver resection before or after chemotherapy. One patient (3%) with an unresectable tumor received chemotherapy and a liver transplant. In 5 patients (17%) the hepatic involvement was too extensive for resection. The types of resection performed were right lobectomy in 7, left lobectomy in 6, right trisegmentectomy in 8, left trisegmentectomy in 2, and middle hepatectomy in 1. The overall survival rate for 35 years of the study was 60% (18 of 30). With the association of surgery and chemotherapy (1981 through 1998) survival rate is 82% (14 of 17). Overall median follow-up in our study is 8 years (range, 2.5 to 24 years). CONCLUSIONS: There has been a dramatic improvement in the results of treatment of hepatoblastoma. Formerly, only 25% to 30% of patients were cured, whereas today, with combination of chemotherapy and surgery, 75% to 80% may be cured.  相似文献   

20.
《Transplantation proceedings》2023,55(5):1182-1185
BackgroundLiver transplantation (LT) is a treatment modality in the pediatric population for several diseases like biliary atresia, metabolic liver disease, hepatoblastoma, and so on. According to the Organ Procurement and Transplantation Network, 5-year survival was reported as 85.4% to 93.5% by age after pediatric liver transplantation (PLT). This study aimed to evaluate our single-center experience of PLT by analyzing long-term results, comparing the outcomes with the literature, and identifying predictors of patient survival.MethodsThe data of 40 patients who underwent LT at <18 years of age between June 2015 and June 2021 were studied retrospectively. Recipient characteristics such as age, sex, etiology of liver disease follow-up time, postoperative vascular and biliary complications, and donor characteristics were evaluated.ResultsThere were 20 (50%) girls and 20 (50%) boys, and the median age was 42 (IQR = 9-117) months. The most common indications of LT were biliary disorders (45%). A whole liver graft was used in 7 (17%), a right lobe graft in 9 (23%), a left lobe graft in 4 (10%), and a left lateral lobe graft in 20 (50%) of the recipients. The 1-, 3-, 5-, and 7-year survival rates were 85%, 82.1%, 82.1%, and 82.1%, respectively. The multivariate survival analysis revealed that the pediatric end-stage liver disease score, hepatic artery thrombosis, and portal vein thrombosis are associated with overall mortality.ConclusionIn conclusion, our long-term survival is similar to the literature, with satisfactory results. However, reducing the vascular complication rates can provide superior results on PLT.  相似文献   

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