Surgical treatment of the adenocarcinoma of the cardia

Adenocarcinomas of the esophagogastric junction?should be classified into adenocarcinoma of the distal esophagus (Type I), true carcinoma of the cardia (Type II), and subcardial carcinoma (Type III) in a pathogenic and therapeutic point of view. During a 15-year period (1995 - 2009), 117 surgical laparotomies for adenocarcinoma of the cardia were performed in elective surgery in the First Clinic of General Surgery UHC "Mother Theresa" in Tirana. The classification was performed by summarizing the information obtained from oral contrast radiography, endoscopy, and intra-operative findings. There were 54 (46%) patients of Type I, 40 (34%) of Type II and 23 (20%) of Type III . Surgical procedures included "subtotal esophagectomy and proximal gastrectomy", "distal esophagectomy and proximal gastrectomy", "total gastrectomy and distal esophagectomy".?All anastomoses performed in the above mentioned procedures were hand sewn. Thirty-seven patients (32%) resulted inoperable at the time of laparotomy and 80 (68%) patients were treated with curative intent, those resulting in an operability index of 68%. The overall morbidity and mortality rates of 29% and 4,3% respectively.     

Formation of a Chromophoric Complex Between Alendronate and Copper(II) Ions

Pharmaceutical Research -     

Hemangioma of the rectum: CT appearance

An 18-year-old man who had severe recurrent rectal bleeding and hematuria was found to have a diffuse cavernous hemangioma of the rectosigmoid. A computed tomographic (CT) study was indicated to evaluate tumor extension and therapeutic possibilities. CT scanning revealed a large mass with phleboliths throughout the true pelvis and nodular indentations in the rectosigmoid wall involving the dome and posterior wall of the bladder. A nonhomogeneous and subtle enhancement of the lesion was noticed after injection of contrast medium.     

The grading model for the assessment of the total amount of epidural fibrosis in postoperative lumbar spine

Purpose

To present a new model derived from Ross’s model for the assessment of the total amount of epidural fibrosis and to present inter- and intravariability study.

Methods

Two readers blinded to each other and blinded to their first and second reading retrospectively evaluated the magnetic resonance examinations in 32 postoperative spine surgery patients using this model.

Results

Paired and unpaired two-sided t tests showed no significant difference between the first and second reading, and interclass correlation coefficient revealed good interobserver reliability.

Conclusion

The proposed model enables estimation of the amount of epidural fibrosis in postoperative lumbar spine and does not require any additional software or hardware. It is designed for multi-centered clinical studies where it is necessary to compare the values of epidural fibrosis between the tested and control group. The use of the proposed model is fast and practical and helps to avoid complications arising from image format, calibration and software, which are often encountered in multi-centered studies.     

Effects of guanethidine-induced sympathectomy on the spermatogenic and steroidogenic testicular functions of prepubertal to mature rats

Summary. Selective chemical sympathectomy of the internal genital organs of prepubertal to mature male Wistar rats was performed by chronic treatment with low doses of guanethidine. Sympathetic denervation caused an increase in intratesticular progesterone levels in prepubertal and early pubertal rats in addition to a decrease in androstenedione and testosterone levels in prepubertal animals, thus indicating a decrease in the conversion of progesterone into androgen, probably by blocking the steroidogenic enzymatic pathway at the 17 α-hydroxylase/17,20 desmolase level. A lower degree of testicular maturation, probably related to reduced androgen activity, was observed in prepubertal and early pubertal sympathectomized rats. Concentration of spermatozoa, on the other hand, was increased in the enlarged cauda epididymidis of late pubertal and mature denervated animals. This result is discussed in terms of the impairment of epididymal mechanisms of seminal emission, fluid resorption and spermatozoal disposal.     

Management of testicular rupture after blunt trauma in children

Purpose  

Testicular rupture is a very rare entity in children and adolescents. The aim of this study was to evaluate the outcomes of surgical repair after testicular rupture in children.