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  • 1
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The purpose of this study was to reduce operative mortality after radical operation for carcinoma of the thoracic esophagus without decrease in resectability, keeping our policy to make reconstruction as early as possible after resection of the lesion. A study on postoperative respiratory function showed that prolonged hypoxemia and compensatory hyperventilation occurred in the majority of patients without manifestations of pulmonary complication. Prolonged application of oxygen tent, planned administration of intermittent positive pressure breathing and adequate correction of metabolic acidosis considerably decreased operative mortlaity. Retrospective study disclosed close correlations of operative mortality with location of the lesion and age, VC/m2, hypertension, ECG findings and renal function of patients. Marked decrease in operative mortality was obtained after the criteria of indication for one-stage radical operation was laid down by the retrospective study.
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 1 (1971), S. 232-236 
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A case of adenocarcinoma of the fourth portion of the duodenum is reported. We propose that the term “peripapillary” should be used to indicate the tumors invading the papilla duodeni, and that these tumors should not be included in duodenal carcinoma.
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  • 3
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Prolonged intra-aortic infusion therapy with antitumor agents, especially 5-FU, in the cases of advanced cancer of the stomach, colon and rectum was described. This method seems to be more effective in the cases of cancer of the colon and rectum than in those of the stomach. In the cases of peritoneal dissemination with the presence of a large amount of ascites, marked or moderate improvement can often be achieved. Systemic toxicity of antitumor agents can be anticipated in some degree by determining drug concentration in blood at various sites. Further improvement should be made to avoid local complication such as ulcer formation on aortic wall with 5-FU.
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  • 4
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The new biventricular cardiac assister designed to compress selectively both ventricles of the brain-death dog was evaluated. The parameters determined in the present investigation were cardiac output, aortic pressure, pulmonary arterial pressure, blood gases, blood pH, serum glucose and body temperature. In the brain-death dogs, the cardiac output and the aortic pressure were kept relatively well, but the blood pressure was about 20 per cent lower than that of the non brain-death dogs with ventricular fibrillation, in which blood supply to the brain was intact and EEG was normal. The pulmonary hypertension was not noted, but various changes in blood pH, blood gases, serum glucose and body temperature may have been due to absence of brain function. The lung, heart, liver and kidney can be preserved in situ under mechanical cardiac massage with the use of our new cardiac assister, set in thorax of the brain-death dogs after cardiac arrest. In cases where organ preservation was done at room temperature, each organ can be kept for 6–8 hours in good condition for organ transplantation. But thereafter hypoxic changes were noted in these organs, particularly in liver and kidney, but less in lung and heart. The usefulness of our new cardiac assister for preservation of liver and kidney is at the present time limited to 6 to 8 hours and that for lung preservation is limited to 12 hours at room temperature.
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  • 5
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This is a follow-up study of the second consecutive series of 71 infants during the year of 1965 through 1970. Over-all mortality rate was 15.5 per cent. In the last two years, the result has improved markedly as exemplified by only one death occuring in 33 patients (3 per cent) operated. The striking decrease in the mortality rate during this period was mainly due to the intensive care of postoperative respiratory dysfunction and prevention of low cardiac output especially in infants under one year of age. Permanent heart block and complications of the central nervous system have not been observed in this series. In conclusion, patients with VSD and pulmonary hypertension should be advised to undergo radical operation even in early stage of infancy.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 1 (1971), S. 290-297 
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The pathologic-anatomical features of large bowel carcinoma were compared between Japan and the United States in gross as well as histological type using 197 surgical specimens from western Japan during the period of 1963 through 1970. The result together with the materials collected from the literature suggested that there seemed to be definite difference in the anatomical distribution. A relatively high incidence of carcinoma of the rectum and concomitant low incidence of carcinoma of the sigmoid and descending colons in Japan was found to be the major difference when compared with the data published in the American literature. Some difference was also noted in a relatively high incidence of polypoid-type carcinoma and in a relatively low incidence of annular-type carcinoma among Japanese materials in contrast to those of American materials. The reason for these difference is not clearly understood at present and further collection of materials and pertinent data are necessary.
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  • 7
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Preoperative intra-arterial infusion with methotrexate and mitomycin C was carried out in 17 patients with gastric cancer and its efficacy was confirmed by autoradiography of gastric cancer cells labeledin vitro with3H-thymidine. The average dose of methotrexate administered was about 90 mg and that of mitomycin C was 8 mg. Decrease in grain count and a low percentage of labeled cells in gastric cancer tissues and metastatic lymph nodes were found in the treated patients. On the basis of these findings, it was concluded that this therapy could inhibit remarkably DNA biosynthesis of gastric cancer cells. In addition, the following morphological changes were observed in cancer cells from most of the treated patients; vacuolation and pyknosis of nuclei, cytolysis, and increased cellular debris. A discussion was given of usefulness of this therapy as a prophylactic treatment of cancer metastasis originating from surgery.
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  • 8
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to elucidate the mechanism of the local recurrence at the suture line and to prevent it, the experimental studies were carried out using ascites tumor of rat. 1) In the course of tumor growth at the suture line, there were two different growth patterns spreading to the serosal surface in Yoshida sarcoma and to mucosal surface in AH-109A. 2) A linear relationship was found between tumor growth rate and number of tumor cells by observation of at 5 days sacrifice. 3) The experimental results offer ample evidence to occur easily the implantation of tumor cells at the suture line, resulting in the local recurrence in the varied shapes after colonic resection. 4) For prevention of it, the local irrigation by anticancer agent which brings about the decrease in number of tumor cells and direct effect may be of prophylactic value for local recurrence of carcinoma of the colon and rectum due to implantation of tumor cells.
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  • 9
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Late results of our newly devised controlled splenorenal shunt were mentioned. This procedure involves special technique which confirms patency of the shunt and controls the postshunt blood volume in order to maintain consistently considerable portal blood flows into the liver even after the shunt. Our clinical analysis on 40 cases included 12 of Laennec or septal cirrhosis of the liver (Nagayo B-type), 7 of postnecrotic cirrhosis (Nagayo A-type), 13 of intrahepatic presinusoidal portal hypertension and 8 of prehepatic obstruction and schistosomiasis japonica, and among these 24 elapsed longer than 3 years and 14 longer than 5 years after the operation. Operative mortality, rate of postoperative bleeding, 5-year survival rate ware 15%, 7.5% and 67.5% respectively in over all cases, and should A-type of cirrhosis were omitted from the statistics, the operative mortality was 3% and long term survival rate 82% respectively. Since A-type of liver cirrhosis is apt to fall into circulatory insufficiency of the liver even by the controlled shunting, it is considered not to be adopted as indication of this operation.
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  • 10
    ISSN: 1436-2813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion 1) We presented the following two concepts which will simplify the interpretation of a vast body of data and concepts about pathogenetic mechanism of acute pancreatitis. a) Under physiological conditions, various defensive factors within the pancreas may inhibit activation of pancreatic enzymes and prevent excessive leakage and retention of pancreatic juice into the interstitial space and then protect the pancreatic parenchyma against injurious actions of pancreatic enzymes. A number of triggering factors such as bile reflux may break down the equillibrium between these agressive and defensive factors in favor of aggression, and thereby acute pancreatitis will be initiated. b) The process of acute pancreatis, furthermore, may be aggravated by complicated chain reactions through the mediation of pancreatic enzymes. The chain reactions are assumed to consist of 4 pathological cycles, i.e., autolytic, autodigestive, local vascular, and shock cycles. 2) From these viewpoints, principle of therapy of acute pancreatitis was recommended.
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