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排序方式: 共有3360条查询结果,搜索用时 15 毫秒
41.
42.
Takeshi Aoki Masahiko Murakami Tomotake Koizumi Yuta Enami Reiko Koike Akira Fujimori Tomokazu Kusano Kazuhiro Matsuda Kosuke Yamada Koji Nogaki Makoto Watanabe Koji Otsuka Haytham Gareer Takashi Kato 《International surgery》2015,100(6):1048-1053
This study describes a novel technique for skeletonization and isolation of Glissonean and venous branches during liver surgery using a harmonic scalpel (HS). Hepatic resections with HS were performed with the skeletonization and isolation technique in 50 patients (HS group). Variables evaluated were blood loss, operative time, biliary leak, and morbidity. The results were compared with 50 hepatic resections that were performed using a previously established technique: Cavitron ultrasonic surgical aspirator with electric cautery, ligatures, and hemoclips (NHS group). The HS group had shorter total operative times (285 versus 358 minutes; P = 0.01), less blood loss (389 versus 871 mL; P = 0.034), and less crystalloid infusion (2744 versus 3299 mL; P = 0.027) compared with the NHS group. Postoperative liver function and complication rates were similar when comparing the two groups. These data demonstrate that HS is a simple, easy, and effective instrument for the skeletonization and isolation of vessels during liver transection.Key words: Liver resection, Ultrasonic scalpel, Skeletonization, Cavitation effectVarious devices are available for liver transection, but the availability of comparative data for transection techniques is limited by the diversity of operative procedures. Clamp crushing (CC) and a Cavitron ultrasonic surgical aspirator are widely used for splitting the liver parenchyma,1,2 and hemostasis is achieved by bipolar coagulation, ligatures, or hemoclips. Various coagulating devices, such as Ligasure,3 Tissuelink,4 and the Harmonic Scalpel (HS),5–7 have recently been developed to aid in liver splitting. The choice of instrument is often based on individual surgeon preference. Higami et al8,9 described a novel technique to skeletonize and harvest the internal thoracic artery with the HS, and the present study capitalizes on their experience to describe a unique method to skeletonize and isolate the Glissonean and venous branches using an HS. 相似文献
43.
44.
Nuclear cyclin D1 overexpression is a critical event associated with cell proliferation and invasive growth in gallbladder carcinogenesis 总被引:2,自引:0,他引:2
Itoi T Shinohara Y Takeda K Nakamura K Takei K Sanada J Horibe T Saito T Kasuya K Ebihara Y 《Journal of gastroenterology》2000,35(2):142-149
Cyclin D1 overexpression is remarkably frequent in several human carcinomas and is believed to be a critical event in oncogenesis.
We examined cyclin D1 expression, p53 expression, and the Ki-67 labeling index by immunostaining in human gallbladder mucosa in conditions varying from normal
to malignant tissue. We also examined K-ras codon 12 mutations in these tissues with a two-step polymerase chain reaction. Nuclear cyclin D1 overexpression was observed
in 48% of carcinomas occurring independently of adenoma, but not in adenomas, carcinomas arising in adenomas, or nonneoplastic
lesions. Cytoplasmic cyclin D1 overexpression was observed in about 15% of abnormal specimens, irrespective of the type of
epithelial abnormality. Carcinomas showing nuclear cyclin D1 overexpression had significantly higher Ki-67 labeling indexes
than those with no overexpression. Moderately to poorly differentiated adenocarcinomas showed a higher incidence of nuclear
cyclin D1 overexpression than papillary to well differentiated carcinomas. Specimens with cyclin D1 overexpression showed
a high incidence of lymph permeation, venous permeation, and lymph node metastasis. We conclude that nuclear cyclin D1 overexpression
is a critical event importantly associated with cell proliferation and invasive growth in gallbladder carcinogenesis, and
that cyclin D1 immunostaining may become a useful marker for evaluating gallbladder carcinomas.
Received: March 9, 1999 / Accepted: July 23, 1999 相似文献
45.
Dr. Yoshio Miura MD Yoshitaka Kato MD Rokuro Seiko MD Mari Nomura MD Kosuke Yamane MD Koichi Fujikawa MD Toshiyuki Iwamoto MD Kiyohiko Dohi MD 《Digestive diseases and sciences》1992,37(10):1619-1623
Summary A case of pancreatic arteriovenous malformation (AVM) with hepatocellular carcinoma is reported. The patient, a 56-year-old Japanese man, was asymptomatic. The pancreatic lesion was found incidentally during an evaluation for hepatocellular carcinoma. Celiac arteriogram demonstrated tortuous feeding arteries, a racemose intrapancreatic stain, which disappeared before the venous phase, and early portal filling. 相似文献
46.
47.
Iwao Sato Kosuke Imura Yoko Miwa Shunji Yoshida Masataka Sunohara 《Journal of cranio-maxillo-facial surgery》2012,40(8):e249-e252
BackgroundSubstance P (SP) and calcitonin gene-related peptide (CGRP) are released by the nociceptive sensory nerve and are involved in blood flow, pain and inflammation in the nasal mucosa. The purpose of this study was to assess the distribution of the SP and CGRP nerve fibres related to blood supply within human Schneiderian membrane of the maxillary sinus (MS).Material and methodsIn this study, the MS from Japanese cadavers was examined by whole-mount immunohistochemistry. Human male cadavers (ranging in age from 80 to 90 years) were used in this study.ResultsSP- and CGRP-positive fibres were found around large vessels of the medialis superior alveolar branches and also within the floor region of the MS. The floor region of the MS was composed of complex branches of these fibres.ConclusionOur results give useful information for surgical sinus floor elevation in this region of the MS. These anatomical features may assist in the execution of a successful surgical procedure. 相似文献
48.
S Yamamoto Y Ebihara S Mochizuki M Tsuda K Yuji K Uchimaru A Tojo K Tsuji 《Acta haematologica》2012,128(4):242-243
No abstract available. 相似文献
49.
50.
Shimizu H Kimura F Yoshidome H Ohtsuka M Kato A Yoshitomi H Nozawa S Furukawa K Mitsuhashi N Takeuchi D Takayashiki T Suda K Miyazaki M 《Hepato-gastroenterology》2012,59(116):1023-1025
Interventional procedure via percutaneous transhepatic route is often performed, as an initial treatment, in patients with benign bilioenteric anastomotic stricture. However, surgical management is required in most cases in which radiological intervention is unsuccessful. In this report, we describe a case of a 67-year-old woman with recurrent bilioenteric anastomotic stricture, accompanying bilateral hepatolitiasis after several times of transhepatic interventions. The patient underwent intrahepatic cholangiojejunostomy (Longmire procedure) and cholangioscopic lithotomy after resection of an atrophic left lateral segment resulting from hepatolithiasis. Although the damaged hilar bile duct had to be isolated and divided from the corresponding vasculature for re-anastomosis, it was quite impossible due to severe inflammatory change at the hepatic hilus. We, therefore, anastomosed the intact biliary stump on the cut surface of the left lateral segment to the jejunal loop with a stent tube. The patient's postoperative course was uneventful and she exhibited no evidence of cholangitis during follow-up period of 1 year after surgery. At present, the indications for intrahepatic cholangiojejunostomy for biliary obstruction, are quite limited, but biliary surgeons should keep this procedure in mind at the time of biliary reconstruction for benign proximal bile duct stricture, particularly in cases of multiply operated hilum. 相似文献