首页 > 最新文献

The Japanese journal of surgery最新文献

英文 中文
The clinical pharmacokinetics of two different preparations of intrarectal ketoprofen following spinal or local anesthesia for anal surgery. 两种不同制剂的直肠内酮洛芬在脊柱或局部麻醉下用于肛门手术的临床药代动力学。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471046
K Tazawa, S Takemori, S Hirokawa, K Yamamoto, S Katsuki, H Arai, T Kasagi, S Katsuyama, M Fujimaki

Two different preparations of commercially available suppositories containing Ketoprofen (KP) were administered to 49 patients immediately following anal surgery. The KP was prepared as either fatty suppositories (FS) or gelatin capsulated suppositories (GCS) and surgery was performed under either spinal (n = 37) or local anesthesia (n = 12). Similar results were observed in the kinetics of KP after both FS and GCS administration. The extent of bioavailability of the two dosage forms in the patient groups and control subjects (n = 10) were essentially equal. When the pharmacokinetic parameters of KP were compared between patient groups under spinal and local anesthesia, significant differences were found in the values of the peak level (C max), peak time (T max), and terminal phase half-life (t 1/2). The C max decreased by one-half, while the T max and t 1/2 increased twice and four times, respectively, in patient operated on under spinal anesthesia compared to those operated on under local anesthesia. The absorption rate constant (Ka) following spinal anesthesia was significantly less than that following local anesthesia or that of the healthy subjects (p less than 0.01). A "flip-flop" phenomena could be seen in the time profiles of plasma KP concentration following spinal anesthesia.

对49例肛门手术后立即给予两种不同的含酮洛芬(KP)的市售栓剂制剂。将KP制成脂肪栓剂(FS)或明胶胶囊栓剂(GCS),并在脊髓麻醉(n = 37)或局部麻醉(n = 12)下进行手术。在给FS和GCS后KP的动力学中观察到相似的结果。两种剂型在患者组和对照组(n = 10)的生物利用度基本相等。比较脊髓麻醉和局麻两组患者KP的药动学参数,发现峰值水平(C max)、峰值时间(T max)和终末半衰期(T 1/2)的值存在显著差异。与局部麻醉患者相比,脊髓麻醉患者的cmax降低了1/2,而tmax和t1 /2分别增加了2倍和4倍。脊髓麻醉后吸收率常数(Ka)显著低于局麻和健康者(p < 0.01)。在脊髓麻醉后血浆KP浓度的时间谱中可以看到“触发器”现象。
{"title":"The clinical pharmacokinetics of two different preparations of intrarectal ketoprofen following spinal or local anesthesia for anal surgery.","authors":"K Tazawa,&nbsp;S Takemori,&nbsp;S Hirokawa,&nbsp;K Yamamoto,&nbsp;S Katsuki,&nbsp;H Arai,&nbsp;T Kasagi,&nbsp;S Katsuyama,&nbsp;M Fujimaki","doi":"10.1007/BF02471046","DOIUrl":"https://doi.org/10.1007/BF02471046","url":null,"abstract":"<p><p>Two different preparations of commercially available suppositories containing Ketoprofen (KP) were administered to 49 patients immediately following anal surgery. The KP was prepared as either fatty suppositories (FS) or gelatin capsulated suppositories (GCS) and surgery was performed under either spinal (n = 37) or local anesthesia (n = 12). Similar results were observed in the kinetics of KP after both FS and GCS administration. The extent of bioavailability of the two dosage forms in the patient groups and control subjects (n = 10) were essentially equal. When the pharmacokinetic parameters of KP were compared between patient groups under spinal and local anesthesia, significant differences were found in the values of the peak level (C max), peak time (T max), and terminal phase half-life (t 1/2). The C max decreased by one-half, while the T max and t 1/2 increased twice and four times, respectively, in patient operated on under spinal anesthesia compared to those operated on under local anesthesia. The absorption rate constant (Ka) following spinal anesthesia was significantly less than that following local anesthesia or that of the healthy subjects (p less than 0.01). A \"flip-flop\" phenomena could be seen in the time profiles of plasma KP concentration following spinal anesthesia.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"621-6"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical experience of emergency coronary artery bypass grafting following failed percutaneous transluminal coronary angioplasty. 经皮冠状动脉成形术失败后急诊冠状动脉搭桥术的临床体会。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471049
Y Kioka, L Dallan, S Oliveira, A Jatene

From July, 1981 to December, 1988, 2431 percutaneous transluminal coronary angioplasties were performed on 1901 patients at the Heart Institute of São Paulo University Medical School. Seventy-six patients (4.0 per cent) underwent emergency coronary artery bypass grafting for failed angioplasty. The incidence of failed angioplasty was significantly higher in the impending myocardial infarction group (11.5 per cent) than in the angina group (4.8 per cent) and the acute myocardial infarction group (1.3 per cent). The mean age of the seventy-six patients was 54.4 years, and 54 patients were male. The operative mortality was 15.8 per cent, being 9 males and 3 females. Patients who had had a left main trunk dissection during angioplasty and those who were hemodynamically unstable following the failed angioplasty or who had had a cardiac arrest necessitating a cardiac massage during transportation to the operating room, had a higher mortality than patients in whom the failure occurred in other sites and those who were hemodynamically stable. Perioperative myocardial infarction was documented in 50 per cent of the patients. Patients who had had a cardiac arrest during the procedure had a higher rate of perioperative myocardial infarction than those whose preoperative hemodynamic condition was stable.

从1981年7月到1988年12月,在圣保罗大学医学院心脏研究所对1901例患者进行了2431例经皮冠状动脉血管成形术。76例(4.0%)患者因血管成形术失败接受了紧急冠状动脉旁路移植术。血管成形术失败的发生率在即将发生的心肌梗死组(11.5%)明显高于心绞痛组(4.8%)和急性心肌梗死组(1.3%)。76例患者平均年龄54.4岁,男性54例。手术死亡率为15.8%,其中男性9例,女性3例。在血管成形术中发生左主干剥离的患者,在血管成形术失败后出现血流动力学不稳定的患者,或在送往手术室的过程中发生心脏骤停需要心脏按摩的患者,其死亡率高于发生在其他部位的患者和血流动力学稳定的患者。50%的患者有围手术期心肌梗死记录。在手术过程中发生心脏骤停的患者围手术期心肌梗死的发生率高于术前血流动力学状况稳定的患者。
{"title":"Clinical experience of emergency coronary artery bypass grafting following failed percutaneous transluminal coronary angioplasty.","authors":"Y Kioka,&nbsp;L Dallan,&nbsp;S Oliveira,&nbsp;A Jatene","doi":"10.1007/BF02471049","DOIUrl":"https://doi.org/10.1007/BF02471049","url":null,"abstract":"<p><p>From July, 1981 to December, 1988, 2431 percutaneous transluminal coronary angioplasties were performed on 1901 patients at the Heart Institute of São Paulo University Medical School. Seventy-six patients (4.0 per cent) underwent emergency coronary artery bypass grafting for failed angioplasty. The incidence of failed angioplasty was significantly higher in the impending myocardial infarction group (11.5 per cent) than in the angina group (4.8 per cent) and the acute myocardial infarction group (1.3 per cent). The mean age of the seventy-six patients was 54.4 years, and 54 patients were male. The operative mortality was 15.8 per cent, being 9 males and 3 females. Patients who had had a left main trunk dissection during angioplasty and those who were hemodynamically unstable following the failed angioplasty or who had had a cardiac arrest necessitating a cardiac massage during transportation to the operating room, had a higher mortality than patients in whom the failure occurred in other sites and those who were hemodynamically stable. Perioperative myocardial infarction was documented in 50 per cent of the patients. Patients who had had a cardiac arrest during the procedure had a higher rate of perioperative myocardial infarction than those whose preoperative hemodynamic condition was stable.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"643-9"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The bacteriology of cholelithiasis--China versus Japan. 胆石症的细菌学研究——中国与日本。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471044
R X Guo, S G He, K Shen

Cholelithiasis differs considerably from area to area in the world. Calcium bilirubinate stones or brown pigment stones are said to predominate in the Orient, however, this situation may differ within the Orient. In order to compare cases in China and Japan, 102 consecutive cases of cholelithiasis operated on in Shenyang, China were analyzed for the composition of gallstones and bacterial species isolated from bile in relation to the location and composition of gallstones. In Shenyang, calcium bilirubinate stones predominated, occurring in 49.0 per cent of the cholelithiasis cases. This was much higher than in Japan, which had 17.5 per cent. The incidence of bacteria was also very high, ranging from 20 to 96 per cent, with an average of 66.7 per cent depending on the kind of gallstone present. Bacterial species possessing beta-glucuronidase activity were present in nearly all the cases of calcium bilirubinate stones (92.0 per cent). The incidence of bacteria with beta-glucuronidase activity especially of E. coli was much higher than in Japan (50.8 per cent versus 21.8 per cent) in concordance with the higher incidence of calcium bilirubinate stones in China (49.0 versus 17.5 per cent).

胆石症在世界各地差别很大。胆红素钙结石或棕色色素结石据说在东方占主导地位,然而,这种情况在东方可能有所不同。为了比较中国和日本的病例,我们对中国沈阳102例连续手术的胆结石患者进行了胆结石组成和胆汁中分离的细菌种类与胆结石部位和组成的关系的分析。沈阳以胆红素钙结石为主,占胆石症病例的49.0%。这比日本的17.5%要高得多。细菌的发病率也非常高,从20%到96%不等,根据存在的胆结石的种类,平均为66.7%。几乎在所有胆红素钙结石病例中(92.0%)都存在具有β -葡萄糖醛酸酶活性的细菌物种。具有β -葡萄糖醛酸酶活性的细菌,特别是大肠杆菌的发病率远高于日本(50.8%对21.8%),这与中国胆红素钙结石的发病率较高(49.0%对17.5%)相一致。
{"title":"The bacteriology of cholelithiasis--China versus Japan.","authors":"R X Guo,&nbsp;S G He,&nbsp;K Shen","doi":"10.1007/BF02471044","DOIUrl":"https://doi.org/10.1007/BF02471044","url":null,"abstract":"<p><p>Cholelithiasis differs considerably from area to area in the world. Calcium bilirubinate stones or brown pigment stones are said to predominate in the Orient, however, this situation may differ within the Orient. In order to compare cases in China and Japan, 102 consecutive cases of cholelithiasis operated on in Shenyang, China were analyzed for the composition of gallstones and bacterial species isolated from bile in relation to the location and composition of gallstones. In Shenyang, calcium bilirubinate stones predominated, occurring in 49.0 per cent of the cholelithiasis cases. This was much higher than in Japan, which had 17.5 per cent. The incidence of bacteria was also very high, ranging from 20 to 96 per cent, with an average of 66.7 per cent depending on the kind of gallstone present. Bacterial species possessing beta-glucuronidase activity were present in nearly all the cases of calcium bilirubinate stones (92.0 per cent). The incidence of bacteria with beta-glucuronidase activity especially of E. coli was much higher than in Japan (50.8 per cent versus 21.8 per cent) in concordance with the higher incidence of calcium bilirubinate stones in China (49.0 versus 17.5 per cent).</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"606-12"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Resection and double ileostomy as an alternative approach for superior mesenteric venous thrombosis in poor risk patients: a case report. 切除和双回肠造口术作为治疗低危患者肠系膜上静脉血栓形成的替代方法:1例报告。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471061
T Fujita, M Ito, H Fukunari, K Kitago, K Tsukada, Y Mishima

An 85-year-old male with a sudden onset of abdominal pain was operated on under the suspicion of intestinal ischemia and was later diagnosed as acute superior mesenteric venous thrombosis (SMVT). The patient was successfully treated by resecting the entire involved bowel and performing a double ileostomy. These procedures are considered to be the preferred method of choice for improving survival in poor risk patients.

一例85岁男性,因突然腹痛,怀疑肠缺血而行手术治疗,后诊断为急性肠系膜上静脉血栓形成。患者通过切除整个受累肠并进行双回肠造口术成功治疗。这些程序被认为是提高低风险患者生存率的首选方法。
{"title":"Resection and double ileostomy as an alternative approach for superior mesenteric venous thrombosis in poor risk patients: a case report.","authors":"T Fujita,&nbsp;M Ito,&nbsp;H Fukunari,&nbsp;K Kitago,&nbsp;K Tsukada,&nbsp;Y Mishima","doi":"10.1007/BF02471061","DOIUrl":"https://doi.org/10.1007/BF02471061","url":null,"abstract":"<p><p>An 85-year-old male with a sudden onset of abdominal pain was operated on under the suspicion of intestinal ischemia and was later diagnosed as acute superior mesenteric venous thrombosis (SMVT). The patient was successfully treated by resecting the entire involved bowel and performing a double ileostomy. These procedures are considered to be the preferred method of choice for improving survival in poor risk patients.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"706-9"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12951343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The problems encountered in the surgical management of primary hyperparathyroidism. 原发性甲状旁腺功能亢进手术治疗中遇到的问题。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471051
S Kobayashi, A Sugenoya, Y Kasuga, H Masuda, M Fujimori, M Komatsu, S Takahashi, T Shimizu, S Yokoyama, F Iida

The problems encountered in the diagnosis and treatment of primary hyperparathyroidism were studied in 69 cases. The accuracy of imaging for hyperplasia was less than that for adenoma or carcinoma and the major causes for multiple operations were a failure to locate the four glands and mediastinal adenoma. The intravenous administration of high doses of calcitonin could reduce the serum calcium level of patients in hypercalcemic crisis. Carcinoma required ipsilateral modified radical neck dissection because of lymph node metastases, and non-medullary thyroid carcinoma was often associated with primary hyperparathyroidism. We found removal of the parathyroid adenoma and biopsy or extirpation of only one macroscopically normal gland to be a fully satisfactory procedure after bilateral neck exploration and attempting to identify at least four glands.

本文对69例原发性甲状旁腺功能亢进的诊断和治疗中遇到的问题进行了分析。增生的影像学准确度低于腺瘤或癌,多次手术的主要原因是未能定位四个腺体和纵隔腺瘤。静脉给予大剂量降钙素可降低高钙血症危重患者的血钙水平。由于淋巴结转移,癌需要同侧改良根治性颈部清扫术,非髓样甲状腺癌常伴有原发性甲状旁腺功能亢进。我们发现切除甲状旁腺瘤和活检或仅切除一个宏观上正常的腺体是一个完全令人满意的程序,在双侧颈部探查并试图确定至少四个腺体。
{"title":"The problems encountered in the surgical management of primary hyperparathyroidism.","authors":"S Kobayashi,&nbsp;A Sugenoya,&nbsp;Y Kasuga,&nbsp;H Masuda,&nbsp;M Fujimori,&nbsp;M Komatsu,&nbsp;S Takahashi,&nbsp;T Shimizu,&nbsp;S Yokoyama,&nbsp;F Iida","doi":"10.1007/BF02471051","DOIUrl":"https://doi.org/10.1007/BF02471051","url":null,"abstract":"<p><p>The problems encountered in the diagnosis and treatment of primary hyperparathyroidism were studied in 69 cases. The accuracy of imaging for hyperplasia was less than that for adenoma or carcinoma and the major causes for multiple operations were a failure to locate the four glands and mediastinal adenoma. The intravenous administration of high doses of calcitonin could reduce the serum calcium level of patients in hypercalcemic crisis. Carcinoma required ipsilateral modified radical neck dissection because of lymph node metastases, and non-medullary thyroid carcinoma was often associated with primary hyperparathyroidism. We found removal of the parathyroid adenoma and biopsy or extirpation of only one macroscopically normal gland to be a fully satisfactory procedure after bilateral neck exploration and attempting to identify at least four glands.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"655-60"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dysphagia resulting from an upper esophageal web--a case report. 食管上网引起的吞咽困难1例报告。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471054
R Nakamura, M Watanabe, M Terashima, K Saito, T Iwasaki

A circumferential web was located in the proximal portion of the esophagus in a 69 year old female who was admitted to the Iwate Medical University Hospital with severe chronic dysphagia. She had a long history of difficulty in swallowing, intermittently and primarily associated with the ingestion of solid foods. The web was easily ruptured upon endoscopy with subsequent bouginage being performed twice leading to the complete relief of dysphagia. However, dysphagia recurred 6 months postbouginage and the circumferential web, which had regenerated, had less distensibility, making re-dilation impossible. Surgery was elected which revealed esophageal obstruction by a firm circumferential structure. Microscopic examination of the excised web revealed it to consist of a transverse fold of the esophageal mucosa with chronic inflammatory changes and submucosa with marked fibrous tissue proliferation. The patient has remained asymptomatic for the 4 years following her operation.

一例69岁女性患者因严重的慢性吞咽困难住进岩手医科大学医院,其食管近端有圆周网。她有长期的间歇性吞咽困难病史,主要与摄入固体食物有关。在内窥镜下,腹膜很容易破裂,随后进行了两次穿刺,完全缓解了吞咽困难。然而,吞咽困难在成像后6个月复发,再生的周网扩张性较差,无法再扩张。选择手术,发现食管梗阻由一个坚实的环形结构。镜检显示食管粘膜横折伴慢性炎症改变,粘膜下层伴明显纤维组织增生。患者手术后4年无症状。
{"title":"Dysphagia resulting from an upper esophageal web--a case report.","authors":"R Nakamura,&nbsp;M Watanabe,&nbsp;M Terashima,&nbsp;K Saito,&nbsp;T Iwasaki","doi":"10.1007/BF02471054","DOIUrl":"https://doi.org/10.1007/BF02471054","url":null,"abstract":"<p><p>A circumferential web was located in the proximal portion of the esophagus in a 69 year old female who was admitted to the Iwate Medical University Hospital with severe chronic dysphagia. She had a long history of difficulty in swallowing, intermittently and primarily associated with the ingestion of solid foods. The web was easily ruptured upon endoscopy with subsequent bouginage being performed twice leading to the complete relief of dysphagia. However, dysphagia recurred 6 months postbouginage and the circumferential web, which had regenerated, had less distensibility, making re-dilation impossible. Surgery was elected which revealed esophageal obstruction by a firm circumferential structure. Microscopic examination of the excised web revealed it to consist of a transverse fold of the esophageal mucosa with chronic inflammatory changes and submucosa with marked fibrous tissue proliferation. The patient has remained asymptomatic for the 4 years following her operation.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"676-81"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neoadjuvant chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) or cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in 69 cases of locally advanced (stage IIIb) breast cancer. 环磷酰胺、阿霉素和5-氟尿嘧啶(CAF)或环磷酰胺、甲氨蝶呤和5-氟尿嘧啶(CMF)联合新辅助化疗治疗局部晚期(IIIb期)乳腺癌69例
Pub Date : 1991-11-01 DOI: 10.1007/BF02471048
P Gupta, L Bijlani, G K Rath, A Misra, M C Mishra, N K Shukla, A Kriplani, B M Kapur

Sixty nine patients with a median age of 45 years, 62.3 per cent of whom were premenopausal, with locally advanced breast cancer (T 4, N 0-3, M 0; Stage IIIb) were treated with 3 cycles of either neoadjuvant cyclophosphamide, doxorubicin and 5-fluorouracil, being the CAF group: 36 patients, or cyclophosphamide, methotrexate and 5-fluorouracil, being the CMF group: 33 patients. Patients achieving complete response or with residual disease of less than 2 cm in diameter received radical radiotherapy while those with more residual disease underwent radical mastectomy. Nine cycles of adjuvant chemotherapy were administered. Complete responses and disease control by radiotherapy with complete breast preservation were more frequently observed after CAF than CMF, being 25 per cent vs 3 per cent (p = 0.025) and 48.5 per cent vs 12 per cent (p = 0.002), respectively. Overall response rates, adverse effects, disease control following radiotherapy/surgery, local relapses and metastases were similar for both regimes. Relapsing patients were young, with a median age of 38 years, 68.4 per cent of relapses occurred at metastatic sites and 42 per cent of relapses occurred during adjuvant chemotherapy. This study suggests that in locally advanced breast cancer, a greater proportion of patients can be rendered disease free after neoadjuvant CAF and radiotherapy compared to neoadjuvant CMF and radiotherapy.

69例患者中位年龄45岁,其中62.3%为绝经前,局部晚期乳腺癌(T 4, N 0-3, M 0;IIIb期)接受新辅助治疗环磷酰胺、阿霉素和5-氟尿嘧啶3个周期(CAF组36例)或环磷酰胺、甲氨蝶呤和5-氟尿嘧啶3个周期(CMF组33例)。完全缓解或残留病灶直径小于2cm的患者行根治性放疗,残留病灶较多的患者行根治性乳房切除术。给予9个周期的辅助化疗。与CMF相比,CAF术后更常观察到完全缓解和通过完全保留乳房的放疗控制疾病,分别为25%对3% (p = 0.025)和48.5%对12% (p = 0.002)。两种治疗方案的总有效率、不良反应、放疗/手术后的疾病控制、局部复发和转移相似。复发患者年轻,中位年龄为38岁,68.4%的复发发生在转移部位,42%的复发发生在辅助化疗期间。本研究表明,在局部晚期乳腺癌中,与新辅助CMF和放疗相比,新辅助CAF和放疗后更大比例的患者可以实现无病。
{"title":"Neoadjuvant chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) or cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in 69 cases of locally advanced (stage IIIb) breast cancer.","authors":"P Gupta,&nbsp;L Bijlani,&nbsp;G K Rath,&nbsp;A Misra,&nbsp;M C Mishra,&nbsp;N K Shukla,&nbsp;A Kriplani,&nbsp;B M Kapur","doi":"10.1007/BF02471048","DOIUrl":"https://doi.org/10.1007/BF02471048","url":null,"abstract":"<p><p>Sixty nine patients with a median age of 45 years, 62.3 per cent of whom were premenopausal, with locally advanced breast cancer (T 4, N 0-3, M 0; Stage IIIb) were treated with 3 cycles of either neoadjuvant cyclophosphamide, doxorubicin and 5-fluorouracil, being the CAF group: 36 patients, or cyclophosphamide, methotrexate and 5-fluorouracil, being the CMF group: 33 patients. Patients achieving complete response or with residual disease of less than 2 cm in diameter received radical radiotherapy while those with more residual disease underwent radical mastectomy. Nine cycles of adjuvant chemotherapy were administered. Complete responses and disease control by radiotherapy with complete breast preservation were more frequently observed after CAF than CMF, being 25 per cent vs 3 per cent (p = 0.025) and 48.5 per cent vs 12 per cent (p = 0.002), respectively. Overall response rates, adverse effects, disease control following radiotherapy/surgery, local relapses and metastases were similar for both regimes. Relapsing patients were young, with a median age of 38 years, 68.4 per cent of relapses occurred at metastatic sites and 42 per cent of relapses occurred during adjuvant chemotherapy. This study suggests that in locally advanced breast cancer, a greater proportion of patients can be rendered disease free after neoadjuvant CAF and radiotherapy compared to neoadjuvant CMF and radiotherapy.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"637-42"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Pharyngoesophageal bypass using a free jejunal graft for corrosive stricture--a case report. 利用游离空肠移植术治疗腐蚀性狭窄咽食管绕道1例。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471055
H Fujita, Y Inoue, T Kakegawa, H Yamana, Y Tai, M Hirano

The management of corrosive strictures of the esophagus involving the pharynx and/or larynx continues to be a challenge to surgeons. This paper presents a case of a corrosive stricture extending from the hypopharynx to the cervical esophagus associated with complete obstruction of the larynx, which was successfully treated by pharyngoesophageal bypass using a free jejunal graft. Postoperative recovery was smooth without any complications, and swallowing was restored. Three months after the bypass operation, the patient underwent laryngoplasty. Although aspiration occurred immediately after the laryngoplasty, six months later she was again able to tolerate the oral intake of semisolid food without any need for supplementary nutritional support. Reconstruction of a short segment of the pharyngoesophageal stricture by a free jejunal graft restores almost normal swallowing provided that dilatation of the lower esophagus is achieved.

食管腐蚀性狭窄累及咽部和/或喉部的处理一直是外科医生面临的挑战。本文提出一个腐蚀性狭窄从下咽延伸到颈部食管伴喉部完全阻塞的病例,成功地通过使用游离空肠移植物咽食管旁路治疗。术后恢复顺利,无并发症,吞咽恢复。搭桥手术三个月后,患者接受了喉部成形术。虽然喉成形术后立即发生误吸,但6个月后,她再次能够耐受口服半固体食物,无需任何补充营养支持。通过游离空肠移植重建一小段咽食管狭窄,只要实现下食管扩张,即可恢复几乎正常的吞咽。
{"title":"Pharyngoesophageal bypass using a free jejunal graft for corrosive stricture--a case report.","authors":"H Fujita,&nbsp;Y Inoue,&nbsp;T Kakegawa,&nbsp;H Yamana,&nbsp;Y Tai,&nbsp;M Hirano","doi":"10.1007/BF02471055","DOIUrl":"https://doi.org/10.1007/BF02471055","url":null,"abstract":"<p><p>The management of corrosive strictures of the esophagus involving the pharynx and/or larynx continues to be a challenge to surgeons. This paper presents a case of a corrosive stricture extending from the hypopharynx to the cervical esophagus associated with complete obstruction of the larynx, which was successfully treated by pharyngoesophageal bypass using a free jejunal graft. Postoperative recovery was smooth without any complications, and swallowing was restored. Three months after the bypass operation, the patient underwent laryngoplasty. Although aspiration occurred immediately after the laryngoplasty, six months later she was again able to tolerate the oral intake of semisolid food without any need for supplementary nutritional support. Reconstruction of a short segment of the pharyngoesophageal stricture by a free jejunal graft restores almost normal swallowing provided that dilatation of the lower esophagus is achieved.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"682-6"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Experimental studies on the prediction and prevention of stress ulcers using tonometry, reflectance spectrophotometry and oxygenated perfluorochemicals. 利用血压计、反射分光光度法和含氧全氟化学品预测和预防应激性溃疡的实验研究。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471052
A F Matin, S Baba, N A Choudhury

The present study investigates whether oxygenated perfluorochemicals protect the gastric mucosa against hemorrhage-induced stress ulceration. The influence of oxygenated perfluorochemicals on both macroscopic and microscopic lesion formation, gastric intramural pH, index of oxygen saturation and index of hemoglobin saturation of the gastric mucosa was studied. To assess the severity of gastric mucosal ischemia, intramural pH was directly measured using a pH sensitive microelectrode and indirectly by utilizing hollow viscus tonometry, and the indices of oxygen saturation and hemoglobin saturation were measured by reflectance spectrophotometry. Oxygenated perfluorochemicals (30 ml/kg/h) significantly protected the gastric mucosa against both gross (lesion index 0.85 +/- 0.2 vs 2.23 +/- 0.31) and microscopic (lesion index 0.52 +/- 0.02 vs 2.04 +/- 0.03) injuries. This protection was associated with a significantly decreased acidification of the mucosa during shock (intramural pH 7.24 +/- 0.02 vs 6.97 +/- 0.02) and significantly increased oxygen saturation of the gastric mucosa (30 +/- 6 vs 5 +/- 2). These data indicate that topical oxygenated perfluorochemicals protect the gastric mucosa against mucosal damage provoked by hemorrhagic shock, and this protection seems to be mediated by an increased oxygen saturation of the gastric mucosa. Tonometry and reflectance spectrophotometry thus are able to predict the critical level of gastric mucosal ischemia.

本研究探讨含氧全氟化学品是否保护胃黏膜免受出血引起的应激性溃疡。研究了含氧全氟化学品对宏观和微观病变形成、胃粘膜内pH值、胃粘膜氧饱和度指数和血红蛋白饱和度指数的影响。为评价胃粘膜缺血的严重程度,采用pH敏感微电极直接测定胃粘膜内pH值,采用中空黏液血压法间接测定胃粘膜内pH值,采用反射分光光度法测定胃粘膜内氧饱和度和血红蛋白饱和度。含氧全氟化学品(30 ml/kg/h)显著保护胃黏膜免受肉眼损伤(病变指数0.85 +/- 0.2 vs 2.23 +/- 0.31)和显微镜损伤(病变指数0.52 +/- 0.02 vs 2.04 +/- 0.03)。这种保护与休克期间粘膜酸化显著降低(胃壁pH值7.24 +/- 0.02 vs 6.97 +/- 0.02)和胃粘膜氧饱和度显著增加(30 +/- 6 vs 5 +/- 2)有关。这些数据表明,局部含氧全氟化学品保护胃粘膜免受失血性休克引起的粘膜损伤,这种保护似乎是由胃粘膜氧饱和度增加介导的。因此,血压计和反射分光光度法能够预测胃粘膜缺血的临界水平。
{"title":"Experimental studies on the prediction and prevention of stress ulcers using tonometry, reflectance spectrophotometry and oxygenated perfluorochemicals.","authors":"A F Matin,&nbsp;S Baba,&nbsp;N A Choudhury","doi":"10.1007/BF02471052","DOIUrl":"https://doi.org/10.1007/BF02471052","url":null,"abstract":"<p><p>The present study investigates whether oxygenated perfluorochemicals protect the gastric mucosa against hemorrhage-induced stress ulceration. The influence of oxygenated perfluorochemicals on both macroscopic and microscopic lesion formation, gastric intramural pH, index of oxygen saturation and index of hemoglobin saturation of the gastric mucosa was studied. To assess the severity of gastric mucosal ischemia, intramural pH was directly measured using a pH sensitive microelectrode and indirectly by utilizing hollow viscus tonometry, and the indices of oxygen saturation and hemoglobin saturation were measured by reflectance spectrophotometry. Oxygenated perfluorochemicals (30 ml/kg/h) significantly protected the gastric mucosa against both gross (lesion index 0.85 +/- 0.2 vs 2.23 +/- 0.31) and microscopic (lesion index 0.52 +/- 0.02 vs 2.04 +/- 0.03) injuries. This protection was associated with a significantly decreased acidification of the mucosa during shock (intramural pH 7.24 +/- 0.02 vs 6.97 +/- 0.02) and significantly increased oxygen saturation of the gastric mucosa (30 +/- 6 vs 5 +/- 2). These data indicate that topical oxygenated perfluorochemicals protect the gastric mucosa against mucosal damage provoked by hemorrhagic shock, and this protection seems to be mediated by an increased oxygen saturation of the gastric mucosa. Tonometry and reflectance spectrophotometry thus are able to predict the critical level of gastric mucosal ischemia.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"661-8"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12949934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Omental bleeding with spontaneously derotated torsion--a case report. 网膜出血伴自发性扭转1例报告。
Pub Date : 1991-11-01 DOI: 10.1007/BF02471059
Z Nihei, K Kojima, K Uehara, S Sawai, M Kakihana, R Hirayama, Y Mishima

A case of omental torsion seen in a 16 year old male is reported herein. Abdominal pain in the right lower quadrant suddenly developed just after the patient twisted his waist and an emergency laparotomy revealed a hemorrhagic mass at the edge of the right omentum, which was excised. Histological examination of the resected specimen showed hemorrhage without any venous thrombosis or infarction, possibly suggestive of omental torsion with early spontaneous derotation. The patient was successfully treated as a case of omental torsion.

本文报告一例16岁男性大网膜扭转。就在患者扭腰后,右下腹突然出现腹痛,紧急剖腹手术发现右网膜边缘有出血肿块,并将其切除。切除标本的组织学检查显示出血,无静脉血栓形成或梗死,可能提示大网膜扭转伴早期自发性旋转。该患者被成功治疗为大网膜扭转病例。
{"title":"Omental bleeding with spontaneously derotated torsion--a case report.","authors":"Z Nihei,&nbsp;K Kojima,&nbsp;K Uehara,&nbsp;S Sawai,&nbsp;M Kakihana,&nbsp;R Hirayama,&nbsp;Y Mishima","doi":"10.1007/BF02471059","DOIUrl":"https://doi.org/10.1007/BF02471059","url":null,"abstract":"<p><p>A case of omental torsion seen in a 16 year old male is reported herein. Abdominal pain in the right lower quadrant suddenly developed just after the patient twisted his waist and an emergency laparotomy revealed a hemorrhagic mass at the edge of the right omentum, which was excised. Histological examination of the resected specimen showed hemorrhage without any venous thrombosis or infarction, possibly suggestive of omental torsion with early spontaneous derotation. The patient was successfully treated as a case of omental torsion.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 6","pages":"700-2"},"PeriodicalIF":0.0,"publicationDate":"1991-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02471059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12951341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 23
期刊
The Japanese journal of surgery
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1