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1.
Cano Novillo I Benavent Gordo MI Portela Casalod E Delgado Muñoz MD Aguado Roncero P Vilariño Mosquera A Berchi García FJ 《Cirugía pediátrica : organo oficial de la Sociedad Espa?ola de Cirugía Pediátrica》2000,13(1):20-24
Recurrent gastroesophageal reflux following fundoplication is a challenging problem, because it is usually refractory to medical treatment and a second, technically difficult, antireflux operation is required. Different factors that may contribute to surgery failure have been identified in children. We present 8 cases who underwent redofundoplication after failed procedures, from a total number of 96 patients operated on due to gastroesophageal reflux. Four patient's had their initial fundoplication performed at our institution. Six patients were neurologically impaired, six had chronic pulmonary disease, and two had esophageal atresia. The main presenting symptoms were recurrent vomiting (n = 8) and aspiration (n = 4). Gastroesophageal reflux was confirmed by barium swallow and endoscopy. Operative findings showed wrap breakdown in two cases, warp breakdown associated with hiatal hernia in five, wrap breakdown associated with paraesophageal hernia in two cases, and paraesophageal hernia with normal wrap in one. A second Nissen procedure were performed in five cases, whereas a Collis-Nissen gastroplasty was realized in three with a short esophagus. Six patients had a successful outcome remaining symptom free, one has severe disphagia, and one has recurrent vomiting. In our experience, patients with recurrent gastroesophageal reflux disease should undergo an antireflux procedure tailored to specific anatomic or functional abnormalities. 相似文献
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Anna Szczoczarz Aleksandra Marchwińska Aleksandra Dyś Konrad Boblewski Artur Lehmann Barbara Lewko Apolonia Rybczyńska 《Pharmacological reports : PR》2019,71(3):478-484
BackgroundThe Ca2+ triggered insulin exocytosis in β cells of the pancreatic islets may be the result of Ca2+ influx through L-type voltage dependent calcium channels (VDCC) localized in the plasma membrane, as well as of liberation of Ca2+ from intracellular storages, induced by activation of the calcium receptor (CaR) coupled with the PLC enzyme present in the pancreatic islets. The present study was designated to determine, in in vivo experiments, the effects of CaR activation by R-568 and inhibition of the receptor by NPS 2143 on the plasma glucose and insulin levels in the presence of verapamil, a calcium channel blocker.MethodsWistar rats, after fasting for 14 h before the experiment, were anesthetized with inactin and loaded ip with 1 g/kg glucose.ResultsIn comparison to the control group, the verapamil-induced blockade of the calcium channels in glucose loaded animals increased the blood glucose level and decreased the insulin level, whereas CaR activation with R-568 induced opposite effects. However, in the presence of verapamil, R-568 did not change the concentration of glucose or insulin versus the control animals. Verapamil infusion did not alter elevated glucose concentration in the NPS 2143 animals. At the same time, verapamil reduced the plasma insulin level and potentiated the drop of insulin concentration induced by NPS 2143.ConclusionThe observations suggest that under the in vivo conditions, calcium channel blockade may prevent changes in the blood glucose and insulin concentrations induced by the CaR activation. 相似文献
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Cano Novillo I Benavent Gordo MI García Vázquez A Portela Casalod E 《Cirugía pediátrica : organo oficial de la Sociedad Espa?ola de Cirugía Pediátrica》2004,17(3):113-117
Gastroesophageal reflux is a common chronic disorder that is presented in infants under different clinical pictures. Adolescents with heartburn, dependent on acid supression therapy is a group of patients refered with increased frequency to pediatric surgeons. To date, the accepted methods of management are long term medication or surgery. Recently, different endoscopic techniques have been described to treat gastroesophageal reflux. Endoscopic antireflux suturing is one of this developed methods. In this paper, we present the preliminary results in the treatment of pediatric patients with an endoscopic suturing device. The procedure was accomplished in six patients and the results were analized 6 months after the placement of the sutures. We have obtained an improvement in clinical symptoms reduction, in terms of frequency as well as in intensity. Acid supression therapy was also reduced significantly. There were no complications during the endoscopic procedure, neither in the postoperative course. Patients, were agree with the technique and the clinical results obtained. Endoscopic suturing is a safe procedure that can be an alternative in the treatment of selected patients with gastroesophageal reflux, in the pediatric age group. 相似文献
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García-Patterson A Corcoy R Balsells M Altirriba O Adelantado JM Cabero L de Leiva A 《Diabetes care》2002,25(7):1261; author reply 1261-1261; author reply 1262
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