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  • 1
    Electronic Resource
    Electronic Resource
    Allograft Rejection of Small Bowel Transplantation in Pigs (1998)
    Springer
    Surgery today 28 (1998), S. 1138-1145 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: small bowel transplantation ; allograft rejection ; mucosal biopsy ; pig
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: n = 9): nonimmunosuppressed recipients; (2) group 2 (n = 8): FK506-immunosuppressed recipients; (3) group 3 (n = 2): autotransplant controls; and (4) donors (n = 17). Orthotopic small bowel transplantations were performed with Thiry-Vella loops for daily biopsies. The survival rate of group 2 was significantly longer than that of group 1 (P 〈 0.05). One best survivor in group 2 was killed at postoperative day (POD) 365. Treatment by FK506 prevented rejection, but most of the pigs died of pneumonia. In group 1, rejection began on POD 3 and progressed to severe rejection rapidly within 7 days. In group 2, rejection began from POD 6 to POD 8, but either remained mild or spontaneously improved. The differences in the routine laboratory data and the tumor necrosis factor-α level were not evident between the groups. Histological studies of repeated graft biopsies are thus considered to be essential for detecting signs of graft rejection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950050301
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  • 2
    Electronic Resource
    Electronic Resource
    Long-Term survivor of ruptured hepatocellular carcinoma after two hepatic resections (1994)
    Springer
    Journal of hepato-biliary-pancreatic surgery 1 (1994), S. 289-293 
    Details
    ISSN: 1436-0691
    Keywords: ruptured HCC
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report here a long-term survivor of ruptured hepatocellular carcinoma (HCC). A 37-year-old Japanese man complained of sudden abdominal pain after taking an alcoholic drink. Ultrasonographic examination showed a large amount of fluid in the abdominal cavity. Emergency laparotomy was performed. A solid mass showing extrahepatic growth was present in the right lobe of the liver. No active bleeding site was detected, but the tumor was covered with old blood coagula. The tumor was covered with the greater omentum to prevent further hemorrhage. Following assessment of the extent of the tumor and of liver function, delayed hepatectomy was performed. Histological examination indicated the tumor to be HCC. Twenty-six months after initial hepatic resection, partial resection of the liver was performed again for recurrent tumor. The patient has survived without recurrence for more than 5 years. The long survival was due, we believe to the liver being non-cirrhotic, the delayed hepatic resection, and the early detection of the recurrent tumor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02391083
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  • 3
    Electronic Resource
    Electronic Resource
    Long-term survival with carcinoma arising from a congenital choledochal cyst (1996)
    Springer
    Journal of hepato-biliary-pancreatic surgery 3 (1996), S. 74-77 
    Details
    ISSN: 1436-0691
    Keywords: congenital choledochal cyst ; pancreaticobiliary maljunction ; neoplasm of biliary tract
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of 11-year survival with carcinoma arising from a congenital choledochal cyst. A 34-year-old Japanese woman was admitted due to epigastric discomfort. Ultrasonography revealed a choledochal cyst involving a polypoid tumor. Endoscopic retrograde cholangiopancreatography revealed pancreaticobiliary maljunction in which the main pancreatic duct joined the dilated common bile duct 2 cm above the papilla of Vater. A choledochal cyst containing a polypoid tumor was resected with the regional lymph nodes. Grossly, a 2×2-cm papillary tumor was noted in the posterior wall of the choledochal cyst. Microscopically, the tumor was well-differentiated tubular adenocarcinoma invading the mucosa and fibromuscular layer. Neither anticancer chemotherapy nor radiotherapy was performed. The patient recovered uneventfully after the operation and has been well for 11 years without evidence of recurrent cancer. The good results in this patient may have been due to the early stage of the cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01212785
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  • 4
    Electronic Resource
    Electronic Resource
    Abdominal multivisceral transplantation in pigs (2000)
    Springer
    Journal of hepato-biliary-pancreatic surgery 7 (2000), S. 188-192 
    Details
    ISSN: 1436-0691
    Keywords: Key words: multiple organ procurement, multivisceral transplantation, pump perfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We investigated the technical aspects of porcine abdominal multivisceral transplantation, in terms of pathophysiological features in animals given no immunosuppresant. The splanchnic organs of the donor animal were flushed in situ with University of Wisconsin solution via the abdominal aorta, using a pump. After a relatively short period of cold storage in saline, multivisceral grafts, including the liver, pancreas, and gastrointestinal tract, were transplanted orthotopically. Of the 18 recipient pigs that underwent the operation, 9 (50%) died within 24 h, mainly because of respiratory insufficiency (n = 5) and circulatory shock (n = 3). Three animals (17%) were lost to acute renal failure between the second and fifth postoperative days. Six pigs (33%) survived for more than 1 week, and the causes of death in these animals were bowel obstruction (n = 1), pneumonia (n = 2), rejection of the intestinal graft (n = 2), and deterioration (n = 1). Although the results of this study were not satisfactory, abdominal multivisceral transplantation using pigs is practical and may lead to the possible resolution of various problems, in regard to the immunologic aspects and the interrelationship of transplanted complex organs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005340050174
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  • 5
    Electronic Resource
    Electronic Resource
    Kidney metastasis from gallbladder cancer (1996)
    Springer
    Journal of hepato-biliary-pancreatic surgery 3 (1996), S. 502-505 
    Details
    ISSN: 1436-0691
    Keywords: gallbladder cancer ; metastatic renal tumor ; recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of kidney metastasis from primary gallbladder cancer is presented. Five years after operation for gallbladder cancer, a 73-year-old woman exhibited hematuria. Imaging disclosed a 5×4cm solid mass in the right kidney and enlarged lymph nodes behind the inferior vena cava adjacent to the right renal vein. The right kidney and adjacent tissues, including retroperitoneum and regional lymph nodes, were resected en bloc. The renal tumor was diagnosed as a metastasis from the primary adenocarcinoma of the gallbladder, based on histological similarities, absence of other primary adenocarcinoma, and fluctuations in CA19-9 levels during the progress and after the resection of the metastatic tumor. The initial operation had been an extended cholecystectomy with wedge resection of the liver bed, plus regional lymphadenectomy. The excised gallbladder had a 2.3 ×1.2cm nodular tumor in the fundus. Histological examination indicated the gallbladder tumor to be a moderately differentiated tubular adenocarcinoma invading the subserosal layer. Mild lymphatic invasion was recognized in the gallbladder wall, although lymph node metastasis was negative. We believe this patient represents the first case of kidney metastasis from gallbladder cancer. The mode of spread of the gallbladder cancer to the kidney appeared to be lymphogenous.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02349801
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  • 6
    Electronic Resource
    Electronic Resource
    Retractile mesenteritis of the large bowel: Report of a case and review of the literature (1996)
    Springer
    Surgery today 26 (1996), S. 435-438 
    Details
    ISSN: 1436-2813
    Keywords: retractile mesenteritis ; mesenteric panniculitis ; intestinal stenosis ; mesenteric tumefaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein the case of a 46-year-old woman found to have retractile mesenteritis of the rectosigmoid colon. A review of 52 cases of retractile mesenteritis of the large bowel collected from the literature is discussed following our case report. The average age of the patients was 54.5 years and the male:female ratio was 37:15. The majority of lesions (61.5%) were located in the rectosigmoid colon, with abdominal pain, an abdominal mass, constipation, and fever being the most common symptoms. The diagnosis was only able to be made at the time of laparotomy in 90.4% of the patients. The gross appearance at surgery was characterized by a thickened, shortened, and retractile mesentery, forming nodular masses involving the appendices epiploicae of the colon. Microscopically, fibrosis, inflammatory cell infiltrations, degeneration of the fatty tissue or fat necrosis, and aggregations of lipid-laden foamy cells were observed in most patients. The mass involving the colon was resected in 59.6% of the patients, but even external or bypass colostomy demonstrated favorable results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00311932
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  • 7
    Electronic Resource
    Electronic Resource
    The development of a pyogenic liver abscess following radical resection of cholangiocellular carcinoma with ligation of the right hepatic artery: Report of a case (1994)
    Springer
    Surgery today 24 (1994), S. 659-662 
    Details
    ISSN: 1436-2813
    Keywords: pyogenic liver abscess ; hepatic ischemia ; arterial ligation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present herein the case of a pyogenic liver abscess developing from hepatic ischemia caused by resection of the right hepatic artery when a left hemihepatectomy with caudate lobectomy and extrahepatic bile duct resection was performed for cholangiocellular carcinoma. Postoperative cholangiography revealed communication between the abscess cavity and the intrahepatic bile duct. The liver abscess was successfully treated by percutaneous transhepatic drainage. Thus, breakdown of the intrahepatic bile duct due to ischemia may play an important role in the development of a pyogenic liver abscess following hepatic arterial occlusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01833737
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  • 8
    Electronic Resource
    Electronic Resource
    Late massive hemorrhage following cystogastrostomy for pancreatic pseudocyst: Report of a case (1995)
    Springer
    Surgery today 25 (1995), S. 79-82 
    Details
    ISSN: 1436-2813
    Keywords: pancreatic pseudocyst ; cystogastrostomy ; postoperative hemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the case of a man who developed life-threatening massive gastric hemorrhage 3 months after undergoing cystogastrostomy for a pancreatic pseudocyst. After cystogastrostomy, the pancreatic pseudocyst became remarkably reduced in size, having the appearance of a shallow ulcer by barium study. However, tarry stools and hematemesis developed 3 months later, 6 days after which sudden massive hematemesis and melena occurred with severe hypotension. At emergency operation, a large artery at the bottom of the reduced cyst wall was found to have ruptured and hemostasis was achieved by suture ligation. The splenic artery was suspected as the bleeding point because a 95% abrupt stenosis was seen on angiography-performed the next day. Thus, the risk of hemorrhage occurring after internal drainage of a pancreatic pseudocyst even in the late postoperative period should always be borne in mind.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00309393
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  • 9
    Electronic Resource
    Electronic Resource
    Perianal extramammary paget's disease associated with primary linitis plastica of the rectum: Report of a case (1996)
    Springer
    Surgery today 26 (1996), S. 711-714 
    Details
    ISSN: 1436-2813
    Keywords: primary linitis plastica ; perianal extramammary Paget's disease ; anorectal neoplasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein a case of perianal extramammary Paget's disease associated with primary linitis plastica of the rectum. An 82-year-old woman was admitted to our hospital for investigation and treatment of a perianal eczematous lesion. A skin biopsy of the lesion revealed perianal extramammary Paget's disease and a barium enema demonstrated diffuse narrowing with an irregular contour at the ampulla recti. Under a suspected diagnosis of linitis plastica of the rectum, an abdominoperineal resection was performed to resect both the rectal and perianal lesions with regional lymphadenectomy. Grossly, marked narrowing and wall thickness were observed at the lower rectum, and a histological diagnosis of signet ring cell carcinoma was confirmed. The perianal eczematous lesion revealed many atypical cells with clear cytoplasm, being Paget cells, throughout the entire epidermis. Sparse distributions of signet ring cells were also observed in the subcutaneous tissue beneath the perianal eczematous lesion. The pathogenesis of perianal extramammary Paget's disease in this patient was therefore considered to be an intraepidermal extension of primary linitis plastica of the rectum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00312090
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  • 10
    Electronic Resource
    Electronic Resource
    Spontaneous subcapsular hepatic hemorrhage associated with pregnancy: Report of a case (1997)
    Springer
    Surgery today 27 (1997), S. 657-660 
    Details
    ISSN: 1436-2813
    Keywords: hepatic hemorrhage ; pregnancy ; CO2 angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein a case of spontaneous subcapsular hepatic hemorrhage which occurred in a 33-year-old woman 1 day after she had been delivered of her second child by cesarean section following an uneventful pregnancy. She complained of right upper quadrant pain on the 1st postoperative day, and computed tomography (CT) showed subcapsular low-density masses in both liver lobes, while extravasation was demonstrated by CO2 intraarterial digital subtraction angiography (IADSA). The hemorrhage was successfully controlled by transcatheter arterial embolization (TAE). However, on the 3rd day after TAE, an exploratory laparotomy was performed to establish an exact diagnosis to explain the persistent abdominal pain and abnormal liver function tests. Subcapsular hematomas in both lobes were confirmed and no visible laceration was present. The patient recovered gradually by spontaneous absorption of the hematomas and was discharged on the 22nd postoperative day. Spontaneous hepatic hemorrhage associated with pregnancy is a very rare complication, and establishing a correct diagnosis and initiating appropriate therapy are essential for this life-threatening disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02388225
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