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61.
Guangpu Ding Sida Cheng Xinfei Li Dong Fang Kunlin Yang Qi Tang Peng Zhang Han Hao Xuesong Li Liqun Zhou 《Translational andrology and urology》2021,10(1):56
BackgroundTo summarize our experience with the Boari flap-psoas hitch and compare the indications, perioperative data and outcomes between open and laparoscopic procedures.MethodsThis study retrospectively reviewed 35 patients with complex distal ureteral stricture between January 2015 and April 2019. All patients were treated with Boari flap-psoas hitch by either an open or a laparoscopic procedure. Selection criteria were based on the etiology, comorbidities, medical history, and patient preference.ResultsAll surgeries were performed successfully. The median operation time was 201 min (range, 120 to 300 min), and the median estimated blood loss was 50 mL (range, 20 to 400 mL). The median postoperative hospitalization was 9 days (range, 3 to 46 days). Nineteen patients were treated by the open procedure, and 16 were treated by the transperitoneal laparoscopic procedure. The surgical indication of open surgery was broader than that for laparoscopic surgery. For patients experiencing iatrogenic injury and ureterovesical reimplantation failure, no significant differences in sex, laterality, operative time, ASA score or postoperative hospitalization stay were observed between the two groups. The median estimated blood loss was lower in the laparoscopic group than in the open group (P=0.047). Patients in the open group had more surgical complications than patients in the laparoscopic group (P=0.049). The postoperative follow-up showed the radiological resolution of hydronephrosis in 33 patients.ConclusionsWith the appropriate surgical considerations, Boari flap-psoas hitch is a valid method to bridge distal ureteral defects. For select patients, laparoscopic surgery had advantages being a minimal invasive surgery with less estimated blood loss and fewer surgical complications. 相似文献
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66.
《Auris, nasus, larynx》2022,49(6):986-994
ObjectiveDysphagia is a common symptom in Parkinson's disease (PD) and it represents a negative prognostic factor because of its complications. This study is to evaluate pharyngeal dysphagia for boluses of various consistencies with Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Pharyngeal High-Resolution Manometry (PHRM) in a group of PD patients, making a comparison between the information provided by the two exams.MethodsGroup of 20 patients affected by PD was selected and initially subjected to a qualitative evaluation of the swallowing performing FEES. Subsequently, they were evaluated by PHRM to identify quantitative measures associated with pressures expressed by pharyngeal organs during swallowing. Values obtained in the study group were compared with those recorded in a group of 20 healthy subjects.ResultsStudy showed that Pmax (the maximum pressure elicited by the single pharyngeal muscle structures involved in swallowing) was significantly lower than the control group (p<0.05) for all the boluses and consistency tested, in particular for the Tongue base and the Cricopharyngeal muscle. Pmean pre-swallowing pressure (represents the mean value of a contraction in which basal and maximal pressure where normally calculated) was significantly higher compared to normal subjects for the Tongue base and the Cricopharyngeal muscle (p<0.05). Mean intra-swallowing pressure was higher for the Velopharynx and the Cricopharyngeal muscle, but lower for the tongue base. Pmax and Pmean at PHRM were altered independently to the degree of dysphagia detected at FEES, and they did not correlate either with the location of the residue or with the type of bolus. Images displayed at the FEES, found the corresponding biomechanical explanations in the PHRM, which also allowed us to quantify the extent of the dysfunction, through the calculation of the pressures generated in the various structures studied.ConclusionPHRM is particularly useful in the early detection of dysphagia, when FEES may still show no evidence of abnormal swallowing. 相似文献
67.
研究诱导型一氧化氮合酶 (inducible nitric oxide synthase, iNOS)在电离辐射导致的神经细胞凋亡中的作用。 方法:以单剂量2.0 Gy γ射线照射出生后 0 d的 Wistar大鼠,用 ABC法检测照射后第 0.5、1、2、4、6、8、12、24、48小时大脑皮质内iNOS的表达。结果:照射组各时间点均有不同程度的iNOS表达,第6小时达峰值。各对照组未见iNOS表达。结论:iNOS所具有的神经毒作用可能是电离辐射导致的发育中脑神经细胞凋亡的重要因素。 相似文献
68.
Kubota T Thomson A Clouston AD Nakazawa Y Steadman C Kerlin P Shimada H Balderson GA Lynch SV Strong RW 《Journal of Hepato-Biliary-Pancreatic Surgery》1999,6(4):377-381
Whether primary sclerosing cholangitis (PSC) occurs after orthotopic liver transplantation is controversial, largely because
the pre-transplant diagnosis of PSC is based on nonspecific radiological and histological findings. We reviewed clinical,
radiological, and histological records of 53 patients who underwent liver transplantation for PSC between 1985 and 1998. Three
patients with patent hepatic arteries and no evidence of chronic rejection had radiological and histological findings that
may have been due to recurrent PSC. Bile duct stricturing in these patients proved permanent and progressive and affected
both the quality of life and graft survival. The first patient, who is 110 months after transplantation, has had repeated
episodes of cholangitis for the last year. The second patient underwent excision of a strictured hepatic duct 45 months after
transplantation and was ultimately retransplanted 95 months after initial transplantation. The third patient underwent left
hemihepatectomy of an atrophied lobe 50 months after transplantation. Although the patient population assessed in this study
is limited, putative recurrent PSC in the allografts has led either to graft loss or to clinically significant hepatobiliary
complications of the graft.
Received for publication on March 8, 1999; accepted on April 30, 1999 相似文献
69.
Narrowing the embryologic window of the adriamycin-induced fetal rat model of esophageal atresia and tracheoesophageal fistula 总被引:2,自引:1,他引:1
We recently reported on a new fetal rat model of esophageal atresia (EA) with tracheoesophageal fistula (TEF) induced by prenatal exposure to adriamycin (1.75 mg/kg i. p. injected daily to the pregnant dam from the 6th to 9th gestational days). With this treatment regime, many fetuses were resorbed and the number of associated malformations was very high. The present study demonstrates that similar doses of the drug administered only on the 8th and 9th gestational days allow higher fetal survival (9.7 3.9 vs. 6.8 4.7 fetuses per litter, P < 0.01) with a similar incidence of EA-TEF (41.2% vs. 56.4%, n. s.) and decreased occurence of associated anorectal and genitourinary malformations. Since this model is an instrument for further investigation of the disturbed cellular and morphogenetic events leading to EA and TEF, the narrowing of the embryologic window obtained by the present study will allow better focusing of the research on the critical period of time involved. 相似文献
70.
Ch. Bruns H. Schäfer B. Wolfgarten H. Pichlmaier 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1996,381(3):175-181
Zusammenfassung Um den Einfluß des chirurgischen Traumas beim Ösophaguskarzinom auf das zelluläre Immunsystem zu erfassen, wurden perioperativ in einer prospektiven Studie die Aktivität der natürlichen Killerzellen sowie die Serumkonzentrationen von Interleukin-2, Interleukin-6 un TNF- bei transmediastinaler Dissektion (n=12) vs. transthorakaler En-bloc-Resektion (n=10) der Speiserörhre im Vergleich zu einer Kontrollgruppe mit thorakoabdominalen chirurgischen Eingriffen bei nicht maligner Grunderkrankung erfaßt. Die Bestimmung der NK-Zell-Aktivität erfolgte präoperativ sowie am 4. und 10. Tag postoperativ durch einen standardisierten Europiumchlorid-release-Assay unter Verwendung von K-562-Targetzellen, die Lymphokine Interleukin-2, Interleukin-6 und TNF- wurden zusätzlich am 1. und 7. Tag postoperativ mit stadardisierten ELISA-Assays bestimmt.In unserem Patientengut sank die NK-Zellaktivität am 4. postoperrativen Tag sowohl in der Kontrollgrupe al auch bei beiden Operations verfahren zur Speiseröhrenresektion signifikant (p<0,05) zum Ausgangswert: in der Kontrollgruppe durchschnittlich um 45%, nach transmediastinaler Speriseröhrendissektion (1-Höhlen-Eingriff) durchschnittlich um 34%, nauch transthorakaler En-bloc-Resektion (2-Höhlen-Eingriff) im Mittel um 63% zum präoperativen Wert. Die transthorakale En-bloc-Resektion der Speiseröhre führte durch das größere chirurgische Trauma zu einer stäkeren Abnahme der zytotoxischen Aktivität der natürlichen Killerzellen. Eine Suppression der immunologischen Tumorabwehr insbesondere in der vulnerablen perioperativen Phase kann damit indirekt das Risiko der Manifestation von hämatogene Metastasen auf dem Boden einer intraoperativen Tumorzelldissemination u. a. bedingt durch Tumormanipulation begünstigen und damit prognostisch relevant werden.
Influence of surgical trauma on natural killer cell activity in esophageal carcinoma following transmediastinal dissection compareed with transthoracic en bloc resection
In order to assess the impact of surgical trauma involved in the therapy of esophageal carcinoma on the cellular immune system, a perspective study was performed involving perioperative hematological parameters. The activity of natural killer cells and the serum concentrations of interleuin-2, interleukin-6 and TNF- were measured in 12 cases of transmediastinal dissection and 10 cases of transthioracic en bloc esophageal resection and compared to values of a control group of thoracic and abdominal surgical patients with non-malignant maladies. Natural killer cells assume a central role in the non-specific immunological response in tumor patients. Their main function is the destruction of tumor cells via cytotoxic activities amplified by the release of interleukin-2 and TNF-. Natural killer cell activity was measured prior to surgery and on postoperative days 4 and 10 using a standardized europium chloride release assay, utilizing K 562 target cells. Lymphokines interleukin-2, interleukin-6, and THF- were also measured on postoperative days 1 and 7 using standardized ELISA assays. The activity of natural killer cells in our patient group sank significantly (P<0.05) on postoperative day 4 and likewise in the control group and both study groups, activity sank to the original values. In the control groups, natural killer cell activity averaged 45% of preoperative values, in comparison with an average of 63% following transmediastinal esophageal carcinoma resection (one cavity procedure), and transthoracic en bloc resection patients only reached 61% of preoperative values, transmediastinal dissection patients assumed 75%, and 77% was achieved by control group members. Transthoracic en bloc resection of the esophagus led to a more extreme reduction in cytotoxic cellular activity owing to the greater surgical trauma. Suppression of the immunological tumor resistance, especially in the vulnerable perisurgical pahse, can have an indirect negative effect on the manifestation risk of hematogenic metastases owing to intraoperative tumor cell dissemination resulting from tumor manipulation and may thus be prognostically relevant.相似文献