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1.
Masato Sasaki Seiya Hirai Masakazu Kawabe Takahiko Uesaka Kouichi Morioka Akio Ihaya Kuniyoshi Tanaka 《European journal of cardio-thoracic surgery》2005,27(2):307-312
OBJECTIVE: The baseball-diamond principle is generally used for trocar placement during video-assisted thoracic surgery; however, we are unable to treat all peripheral lung lesions using this principle. Therefore, we have developed another method for determining trocar placement based on a modification of the conventional principle. We have termed this method the triangle target principle. This report describes the instrument positioning that we now use for many video-assisted thoracic surgical procedures. METHODS: We position 3 trocars in an equilateral triangle, with the target lesion at the apex. One vertex of the base becomes the site of the first trocar placement for introduction of the thoracoscopic camera. Another vertex of the base becomes the site for the second trocar for forceps or the endoscopic stapler. The third trocar is for forceps and is inserted to create the vicinity of target lesion. Four types of the triangle target principle were developed according to sites of the target lesion. RESULTS: Between January 2000 and December 2002, we used this principle for 161 patients who underwent video-assisted thoracic surgery and all intrathoracic lesions were accessible except in 3 patients requiring intraoperative modifications. CONCLUSIONS: We conclude that video-assisted thoracic surgery by this principle is more effective and easier than the conventional principle to treat intrathoracic disease. 相似文献
2.
Yasuhisa Fujibayashi Hideyuki Taniuchi Kouichi Wada Yoshiharu Yonekura Junji Konishi Akira Yokoyama 《Annals of nuclear medicine》1995,9(1):1-5
The reductive retention of62Cu-PTSM was comparatively studied in the brain and Ehrlich ascites tumor cells by electron spin resonance spectrometry and nonradioactive Cu-PTSM. In the brain, only the mitochondrial fraction showed the ability to reduce Cu-PTSM, and the other subcellular fractions did not. In contrast, the cytosolic fraction of Ehrlich ascites tumor cells was the specific site of Cu-PTSM reduction. It was therefore considered that the retention of Cu-PTSM in the brain is closely related to mitochondrial reduction, most probably involving the mitochondrial electron transport system. 相似文献
3.
We studied choline acetyltransferase (CAT) activity in a rat model of brachial plexus injury. In experiment 1, we found that the CAT activity was remarkably high in the anterior roots and low in the posterior roots. In experiment 2, nerve root segments were extracted and examined for CAT activity in the root avulsion group (group A) and the plexus severance group (group B). CAT activity decreased day by day in group A, reaching about 1/20 of the normal 5 days postoperatively. By contrast, in group B activity decreased only slightly, and even at 90 days postoperatively was about 6,000 cpm (one-half normal level). As a result, CAT activity enabled us to distinghish postganglionic from preganglionic injury of the cervical roots. Furthermore, it was a useful adjunct for minimizing nerve loss in intercostal nerve transfer, distinguishing motor and sensory branches of the intercostal nerve, and evaluating the motor nerve activity. © 1995 Wiley-Liss, Inc. 相似文献
4.
Yutaka Yonemura Masataka Segawa Hisashi Matsumoto Kouichirou Tsugawa Itasu Ninomiya Luis Fonseca Takashi Fujimura Kazuo Sugiyama Kouichi Miwa Itsuo Miyazaki 《Surgery today》1994,24(6):488-493
Because gastric cancers located in the upper third of the stomach are difficult to detect at an early stage, the surgical results remain poor. We performed R4 gastrectomy as a radical procedure for 25 patients, involving complete resection of the latero-aortic and interaorticovenous lymph modes above and below the left renal vein, in combination with the ordinary R2 or R3 gastrectomy (the R4 group). These patients were compared with 156 others who underwent R2 gastrectomy alone (the R2 group). There were no significant differences in operation time, blood loss, or the incidence of complications between the two groups; however, when the survival rates of the patients with tumors invading beyond the subserosa were compared, the 5-year survival rate was found to be significantly higher in the R4 group than in the R2 group. Furthermore, in patients with para-aortic nodal involvement, a significant survival advantage was observed in the R4 group, as compared with the R2 group. These results suggest that the R4 gastrectomy is a rational approach for patients with advanced gastric cancer located in the upper third of the stomach. 相似文献
5.
Takashi Toyonaga Eisei Nishino Takashi Hirooka Chie Ueda Kazu Noda 《Digestive endoscopy》2006,18(Z1):S123-S127
To control intraoperative bleeding is an important key to successful endoscopic submucosal dissection. The distribution of submucosal vessels encountered during the procedure differ in places in the stomach and are roughly categorized into three groups: those located in the antrum, those in the lesser curvature, and those on the anteroposterior corpus wall which consists of oblique muscle layers. Therefore, knowledge of a suitable setting of diathermy and adjusted depth of dissection in the submucosal layer for each site is imperative. The combination of utilizing the distal attachment forced or swift coagulation (trimming with coagulation mode) have enable the treatment with an insulation tipped knife safer. 相似文献
6.
7.
Takashi Toyonaga Eisei Nishino Toshio Dozaiku Chie Ueda Tomoomi Hirooka 《Digestive endoscopy》2007,19(Z1):S14-S18
The gastric vasculature responsible for intraoperative bleeding in endosocpic submucosal dissection (ESD) is the ramified vascular network occupying the middle of the submucosal layer and large vessels penetrating the muscle layer. Appropriate management for these vessels must be addressed. The trimming of the ramified vascular network can be safely performed with coagulation mode following shallow mucosal cutting. A large penetrating vessel usually requires precoagulation prior to dissection. These procedures are effectively performed with the water jet short needle knife (Flush knife). 相似文献
8.
The effects of intraperitoneal
and
methyl ester, specific inhibitors of nitric oxide (NO) synthase, were examined on the pentylenetetrazol (PTZ)-induced seizures in rats. The incidence and latency for the onset of myoclonic jerks, clonic seizures, and tonic generalized extension were observed as specific parameters among PTZ-induced seizures. Both drugs preferentially suppressed the tonic generalized extension and prolonged the latency for the onset of each parameter, suggesting NO has a significant effect on the PTZ-induced seizure. 相似文献
9.
Akiomi Ogawa Masahiro Takano Kouichi Takagi Osamu Tokunaga Kohji Miyazaki 《Surgery today》1997,27(12):1167-1169
We describe herein a rare case of primary malignant melanoma of the rectum in an 85-year-old woman. The patient presented
with intermittent rectal bleeding, and a colonoscopy revealed an ulcerated polypoid mass in the rectum, located 5 cm from
the anal verge. The lesion was histologically characterized by solid growths of small round cells with scanty cytoplasm and
prominent nucleoli. Although no melanin pigment was found in the tumor cells, they were immunohistochemically positive for
HMB-45, a monoclonal antibody highly specific for malignant melanoma. Thus, HMB-45 proved very useful to establish a diagnosis
of amelanotic malignant melanoma of the rectum. 相似文献
10.
Kazuro Sugi Kouichi Nawata Kazuhiro Ueda Yoshikazu Kaneda Sumihiko Nawata Atsunori Oga Kensuke Esato 《Surgery today》1997,27(7):666-668
We report herein the case of a 70-year-old man in whom a chest wall implantation of adenocarcinoma of the lung at the drainage
tube site was found 4 months after a right lower lobectomy with mediastinal lymph node dissection had been performed for adenocarcinoma
of the right lower lobe. The lesion was successfully treated by tumor extirpation. We believe that tumor seeding to the chest
wall occurred at the time of thoracotomy. To prevent such tumor seeding, the pleural cavity should be washed out routinely
with a massive volume of physiological saline solution prior to closure of the chest wall. 相似文献