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  • 1
    ISSN: 1530-0358
    Keywords: Rectocele ; Proctography ; Resting anal pressure ; Rectal compliance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clinical, physiologic, and anatomic assessments were carried out in 22 female patients with symptomatic rectocele (Group A), 15 patients with asymptomatic rectocele (Group B), and 14 subjects having no rectocele (Group C). Resting anal pressure, rectal pressure, rectal compliance, anorectal inhibitory reflex, and rectal sensation did not differ among the groups. Proctography revealed that the lengths of the rectocele during attempted defecation in groups A (1.6 [1.0–3.5] cm) (median and range) and B (1.6 [1.0–3.0] cm) were significantly greater than that in Group C (0.4 [0.1–0.9] cm) (P 〈0.001 in both groups). Median pelvic floor descent at rest in Groups A (4.3 [1.6–7.5] cm) (median and range) and B (4.3 [1.3–6.9] cm) were significantly greater than that in Group C (2.5 [1.2–5.0] cm) (P 〈0.001 and P 〈0.02, respectively). These results indicate that rectocele is not associated with any physiologic change apart from a significant increase of pelvic floor descent.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1436-2813
    Keywords: esophageal carcinoma ; postoperative complications ; poor-risk patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During the period between 1979 and 1988, 145 patients with cancer of the esophagus were admitted to our department. They were examined for the preoperative risk factors associated with multiple organ function and classified into three groups according to the risk score. Special attention was paid to postoperative pulmonary complications, mortality and the long term results of surgery in the poor-risk patients and the findings analyzed in reference to the operative procedures. The resection rate for the poor-risk group was 41 per cent, however, esophagectomy was only able to be combined with a right thoracotomy and abdominal approach in 26 per cent of the patients in this group. Postoperative pulmonary complications developed in 64 per cent of the poor-risk patients who underwent a transthoracic esophagectomy and in only 25 per cent of those who received a transhiatal esophagectomy, although there was no significant difference in the overall survival rate beteeen these two subgroups. The present observations therefore raised the possibility that transhiatal esophagectomy may improve the results of surgical treatment for poor-risk patients with esophageal cancer.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1436-2813
    Keywords: acid protease ; platelets ; disseminated intravascular coagulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Lysosomal protease was determined in the serum of patients with disseminated intravascular coagulation (DIC) to clarify whether the platelet count is an appropriate diagnostic index which allows the early initiation of treatment. The platelet count and the serum level of cathepsin D, a lysosomal protease, were determined in 60 patients diagnosed to have DIC. The cathepsin D activity could not be detected in the sera of healthy individuals with a platelet count of 100,000 or above, but was detectable in the serum of DIC patients with a platelet count of 100,000, and this activity increased as the platelet count decreased to 70,000 and 50,000, and was about 5 times higher at a platelet count of 30,000 than at 70,000. In DIC patients, the decrease in the platelet count was correlated with the increase in the serum lysosomal protease activity. The appearance of cathepsin D activity in the serum of DIC patients is considered to reflect the release of lysosomal enzyme activities from damaged organs, and the treatment for DIC must be initiated before the platelet count decrease below 100,000, and cathepsin D activity then appears in the serum. At a platelet count of 30,000 or less, DIC becomes established, and no therapeutic effects can be expected because of the associated multiple organ failure.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1436-2813
    Keywords: antiproteinase ; aprotinin ; metastasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Kallikrein activity in human stomach tissue was measured and found to be about threefold higher in cancer tissue than in normal tissue. To clarify the physiological role of this tissue kallikrein, we investigated its effects on the spontaneous metastasis and tumor growth of Lewis tumors (3LL). Antiprotease, aprotinin, and gabexate mesilate (FOY) inhibited spontaneous metastasis but did not inhibit tumor growth, while tissue kallikrein and plasmin enhanced the spontaneous metastasis of 3LL. The results suggest that the inhibitory effects of aprotinin and FOY on metastasis are not only due to an inhibition of tumor cells released by tissue kallikrein, but that tissue kallikrein, a protease, also participates in metastasis. We thus conclude that aprotinin or FOY should be administered either before or immediately after operation to inhibit spontaneous metastasis.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1436-2813
    Keywords: oesophageal cancer ; surgical stress ; α-human atrial natriuretic polypeptide (α-hANP)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present study examined the effects of subtotal oesophagectomy through a right thoracal and abdominal approach, on the postoperative water-electrolyte metabolism and cardio-pulmonary function of patients with thoracic oesophageal carcinoma. The primary water balance, total sodium intake, urinary NAG index, free-water clearance (CH2O), oxygen diffusion function of the lungs to aerate blood (DLO 2-Index), and α-human atrial natriuretic polypeptide (α-hANP) were measured perioperatively until the seventh day. Subjects were divided by age according to whether they were older or younger than 70 years into 2 groups. In both groups, no change was observed in the primary water balance, total sodium intake, urinary NAG index or CH 2 O. However, all of the patients in the older group exhibited significantly higher α-hANP values than those in the control group, and the DLO 2-Index was also higher in the former subjects during the first 3 days following surgery. It may be concluded that α-hANP is a hormone of considerable importance as it is secreted in large amounts in response to increased stress on the cardio-pulmonary system and serves to normalize the water balance causing this extra load.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1436-2813
    Keywords: childhood ; colon cancer ; acute abdomen ; barium enema ; mucin producing tumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Carcinoma of the colon seen in an 11-year-old boy is reported herein. The patient had advanced carcinoma of the ascending colon and died 8 months after an ileo-transversostomy had been performed as a palliative procedure. Histologically, the tumor was found to be signetring cell carcinoma. 29 cases of colon carcinoma reported in Japanese children under 15 years of age are also reviewed. In 19 of these patients, surgery was done as an elective procedure after the diagnosis of colon cancer had been established, but emergency surgery was performed on 10 patients for perforation or obstruction of the bowel. Curative resection was possible in 14 patients, but of these, only 3 patients survived for more than 10 years.
    Type of Medium: Electronic Resource
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