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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 14 (1984), S. 472-478 
    ISSN: 1436-2813
    Keywords: funnel chest ; strut method ; AO-plate ; funnel index ; bone-marrow scan
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As an operative procedure for the correction of funnel chest in adult and adolescents, a strut method using AO-plates was used. All of the concaved parts of the sternum, costate, and cartilages contributing to the formation of the deformity were osteotomized to mobilize and elevate the deformed part. A vertical plate was used for fixation of the transected sternum, and three transverse plates were used as the portions which are curved appropriately to remodel the reconstructing chest wall. These plates were removed twelve to eighteen months after implantation. To date, thirty-one patients have undergone this repair. For the first eight, a single transverse plate was used, however, re-retraction of the region around the transverse plate became evident in the long term follow-up. Therefore, two or three plates were inserted for an improvement. When three transverse plates were used, retraction at the costal arch was relieved. Although a second operation is required to removal of the plates, we hold the view that this is the most effective operative procedure for the correction of funnel chest in adults and adolescents.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 12 (1982), S. 61-70 
    ISSN: 1436-2813
    Keywords: brain damage ; hypothermia ; deep hypothermia ; circulatory arrest
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Histopathological and succinic acid dehydrogenase (SAD) activity changes, and the electron spin resonance (ESR) were examined in the brains of dogs exposed to various hypothermic conditions. A simple hypothermic cardiac arrest of 5 min duration occurred in the group subjected to 28°C, and normal SAD activity was noted in dogs exposed to 1-hour extracorporeal circulation under normothermia. In cases of a hypothermia below 28°C, a decrease in enzyme activity, marked histopathological changes and the disappearance of the ESR signal were observed. In dogs killed immediately after induction of 20°C hypothermia, the histopathological changes were primarily ischemic in nature, while in dogs killed at 1–12 month intervals after the experiments, irreversible gliosis was dominant. Our findings suggest that, to avoid brain damage under conditions of deep hypothermic circulatory arrest, the critical range is between 26–28°C for rectal, and approximately 28–30°C for brain temperature.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1436-2813
    Keywords: vein remodeling ; jugular reconstruction ; portal reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Remodeled great saphenous vein grafts were used to reconstruct both jugular and portal veins. The great saphenous vein was split longitudinally and sutured side-to-side to construct a vessel twice the diameter and one half the length of the original vessel. This graft was used with good results for reconstruction of the jugular veins in a patient after a bilateral neck dissection for tongue cancer and for a portal vein in a patient after resection for cancer in the head of the pancreas.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1436-2813
    Keywords: small-sized lung cancer with advanced disease ; T1N2 lung cancer ; mediastinal lymph node involvement ; results of surgical resection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A clinical analysis of small-sized lung cancers with advanced disease was conducted on a total of 58 patients: 34 diagnosed as T1N2, 6 as T1N3, 9 as T1M1, and 9 as T4 due to pleural dissemination. The cumulative 5-year survival rate after surgery for the 34 patients with a T1N2 lesion was 17.4%. Of these 34 patients, 24 underwent a curative operation resulting in a 5-year survival rate of 23.7%, but the remaining 10 patients, who underwent a non-curative operation, had a 5-year survival rate of 0%. Extended lymph node dissection for N3 disease has only been performed in recent years, so it is not yet clear whether it will affect the survival rate or not. T4 disease due to pleural dissemination and T1M1 disease associated with intrapulmonary metastasis encountered at thoracotomy could be expected to have relatively long-term survival with the combined use of systemic immunochemotherapy after surgery. In cases diagnosed as T4 due to pleural dissemination, we have recently employed resection of the primary lesion with parietal pleurectomy as the standard operative procedure. For cases of T1M1 with intrapulmonary metastasis confined to the same lobe as the primary lesion, a lobectomy is usually performed, while for cases with intrapulmonary metastasis extending to another lobe, a lobectomy with enucleation of metastatic nodules or pneumonectomy is most often performed instead of an exploratory thoracotomy.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1436-2813
    Keywords: Key Words: aortoiliac occlusion ; endarterectomy ; aortofemoral bypass ; extraanatomic bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1436-2813
    Keywords: infusion chemotherapy ; bronchial artery ; lung cancer ; neoadjuvant therapy ; epidermoid carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As preoperative adjuvant therapy for advanced lung cancer, bronchial arterial infusion (BAI) of a chemotherapeutic agent was administered to patients with stage IIIa and IIIb hilar lung cancer. The infusion modality was changed for each term, from a single drug infusion, to a two drug infusion and then a three drug infusion, and the combination of infused drugs was selected in accordance with cell types. A significant radiographic shrinkage was observed after BAI therapy by the single, two and three drug infusions, being noted as 40.7 per cent, 61.8 per cent and 83.9 per cent, respectively. The effect on squamous cell carcinoma was more prominent than on other cell types. Upon microscopic examination of the resected specimens, significant histo-pathological effects were observed in 57.7 per cent of the patients who received single or two drug infusions, while the rate increased to as high as 92.2 per cent in the patients who received the three drug infusion. The histological effects of BAI therapy were also most marked in squamous cell carcinoma. It is of special interest that 5 of the 10 patients who received the three drug infusion of Carboquone (CQ)+ Mitomycin C (MMC)+Nimustine-HCL (ACNU) for squamous cell carcinoma, showed complete disappearance of viable cancer cells at the tumor site; something which was never observed after the single and two drug infusions. It was therefore concluded that BAI therapy for advanced lung cancer should be reappraised through the modification of infusion methods.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1436-2813
    Keywords: nucleolar organizer regions ; lung cancer ; tumor grade ; cell atypia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nucleolar organizer regions (NORs) were investigated in lung carcinomas by silver staining. This method was applied to 111 lung carcinoma specimens, including 40 with squamous cell carcinoma (SCC), 42 with adenocarcinoma (ADENO), 8 with adenosquamous carcinoma (ADESQ), 8 with small cell carcinoma (SMCC), 6 with large cell carcinoma (LGCC), and 7 with typical carcinoid tumors (CAOID). The mean AgNOR counts of ADENO, SCC, ADESQ, SMCC, and LGCC were significantly higher than those of the normal bronchial surface and those of the glandular or alveolar epithelium. The mean AgNOR count of CAOID was significantly higher than those of the normal glandular and alveolar epithelium but not that of the surface epithelium. The mean AgNOR count of SCC was significantly higher than that of bronchial squamous metaplasia, and the count of SMCC was significantly higher than that of CAOID. Within the same cancer category, the mean number of AgNORs increased in parallel with the histological tumor grades. These results indicate that the AgNOR method is useful for differentiating lung carcinoma from its normal counterparts and for evaluating histological tumor grades in the same lineage of lung carcinoma.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1436-2813
    Keywords: omental transfer ; postoperative sternal infection ; mediastinitis after cardiac surgery ; median sternotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sternal infection is an uncommon but serious complication following cardiac surgery. We report herein three cases of postoperative sternal osteomyelitis successfully treated by omental transfer. Two patients had undergone valve surgery and the other underwent division of an accessory pathway for Wolff-Parkinson-White syndrome. Gram-positive organisms were identified in cultures of the exudate in all three patients, asStaphylococcus epidermidis in two and Methicillin-resistantStaphylococcus aureus in one, and concomitant me diastinitis was demonstrated by computed tomography in two cases. Each patient initially underwent sternal debridement and closed irrigation with 0.5% povidone-iodine solution, following which the cultured exudate from two of the patients was negative. The omentum was transferred in two of the patients because they had poor granulation tissue and in the third patient to fill a large dead space, and the postoperative course was uneventful in all three patients. Thus, we conclude that omental transfer is a useful technique for the treatment of postoperative sternal osteomyelitis.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Between 1974 and 1995 we encountered 19 cases of bronchial stricture or obliteration caused by endobronchial tuberculous lesions. In 11 the involvements were located at the right bronchus (including involvements of segmental and middle lobe bronchi) and in 8 at the left bronchus. On bronchoscopic biopsy of the stenosed bronchus, 7 patients showed histopathologic findings of tuberculous bronchitis, but 12 patients showed nonspecific inflammatory granular tissue. Five patients were kept under conservative observation because of mild subjective symptoms or refusal to undergo operation. Two patients underwent stent procedures but had poor outcomes. Twelve patients underwent operation. As the bronchial lesions in four of them were confined to the lobar or segmental bronchus, lobectomy was performed. One patient with a history of infantile tuberculosis had developed complete obliteration of the left main bronchus and cystic bronchiectasis in the entire lung parenchyma; pneumonectomy was essential. Seven patients who had strictures involving the main bronchus underwent bronchoplastic surgery with right ( n = 4) or left ( n = 3) upper sleeve lobectomy. None of the patients treated surgically showed any postoperative complication or recurrence of the tuberculosis. These surgical results for endobronchial tuberculosis indicate the need for early detection and operation. Bronchoscopy and computed tomography are the methods of choice for accurate diagnosis of bronchial involvement and assessment of the surgical indications. It is emphasized that bronchoplastic surgery is the best treatment for bronchial stricture involving bilateral main bronchi.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1436-2813
    Keywords: lung cancer ; sleeve lobectomy ; metachronous multiple cancer ; high frequency ventilation ; immunochemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a patient with metachronous multiple primary lung cancer, bilateral lobectomy was performed, using bronchoplastic procedures. This case may be one of very few such cases reported in the literature. A 56-year-old man with squamous cell carcinoma was surgically treated for lung cancer. At the first operation, right upper lobectomy with wedge resection of the right main bronchus was performed, as the tumor occupied the orifice of the right main bronchus. Six months later, re-operation for stricture at the anastomotic line was done because of granulation. By means of sleeve resection of the strictured right main bronchus, the airway was reconstructed. The patient remained well for five years, then a similar cancer at the orifice of the left lower lobe and bulging into the left main bronchus became evident. Left lower sleeve lobectomy was done for the second primary cancer. The postoperative course was uneventful and he is well with no signs of recurrence 6 years and 10 months after the first operation and 19 months after the second sleeve lobectomy
    Type of Medium: Electronic Resource
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