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  • 1
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 8 (2001), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract A case is presented of spontaneous rupture of an ileal orthotopic neobladder due to a large residual urine volume. The present case is the 13th such case reported; however, this case is the first to show lower abdominal phlegmon and in which the perforation site was detected using computed tomography scanning. The indications for neobladder should be considered with great care. If spontaneous rupture is suspected, an early diagnosis of the perforation site and a measure of the extravasation volume using computed tomography are necessary. Appropriate treatment should include laparotomy.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 12 (2005), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: In order to evaluate the indication and usefulness of laparoscopic adrenalectomy, clinical outcomes of laparoscopic adrenalectomy for patients with adrenal tumors were examined. Whether tumor size affects surgical outcome was analysed, along with the long-term clinical outcome for these patients.Patients and methods: A total of 63 patients with adrenal tumor underwent laparoscopic adrenalectomy in our institute between 1999 and 2003. A laparoscopic transperitoneal approach was used in all cases. Underlying pathologies comprised Cushing syndrome (n = 12), pheochromocytoma (n = 13), primary aldosteronism (n = 21), non-functioning adenoma (n = 12) and others (n = 5).Results: No open conversion was performed. Mean operative duration was 239 min, and mean estimated blood loss was 134 mL. Tumor diameter was significantly smaller for primary aldosteronism than for Cushing syndrome, which in turn was significantly smaller than for adrenocorticotropic hormone-independent macronodular hyperplasia (AIMAH). No significant differences in surgical outcome and postoperative recovery were noted between large (≥5 cm) and small (〈5 cm) tumors. Long-term clinical outcome was better for patients with pheochromocytoma or primary aldosteronism than for patients with Cushing syndrome.Conclusions: Laparoscopic adrenalectomy for benign tumor offers excellent surgical outcomes and convalescence. This is true for both small and large tumors.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim:  To evaluate the feasibility and usefulness of extraperitoneal laparoscopic retroperitoneal lymph node dissection (RPLND) in the supine position after chemotherapy for advanced testicular carcinomaMethods:  Three patients with advanced testicular cancer underwent chemotherapy. Although serum markers were decreased compared with the normal range, residual masses requiring surgical resection were recognized by computed tomography scanning. We applied extraperitoneal laparoscopic RPLND. The patients were placed in the supine position and the first trocar was inserted two finger widths medial to the anterior iliac spine. The retroperitoneal space was dilated using a preperitoneal distention balloon. Two more ports were inserted into the retroperitoneal space and surgery proceeded thereafter.Results:  The residual tumors were completely resected by laparoscopy. The procedure required 250–310 min and the bleeding volume was below 50 mL. Although the histopathological findings consisted only of necrosis in all of the patients, one patient recurred at the same place.Conclusions:  Extraperitoneal laparoscopic RPLND in the supine position for residual tumors after chemotherapy is technically feasible and useful in terms of postoperative recovery. With regard to cancer control, further evaluation should be necessary.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 20 (1997), S. 0 
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Concealed conduction is demonstrated to occur in an accessory AV pathway (AP). To test the hypothesis that anterograde and retrograde concealed conduction in the AP would have different characteristics, 35 consecutive patients with single APs were studied. The anterograde or retrograde ERP of the AP could be determined in 23 of those patients. Anterograde concealed conduction in the AP was assessed in the first 13 patients with retrograde AP conduction (8 APs with retrograde conduction only and 5 with both directions) (group A). Retrograde concealed conduction in the AP was evaluated in the remaining 10 patients with anterograde AP conduction (6 APs with anterograde conduction only and 4 with both directions) (group B). The concealed conduction in the AP was quantified by determining the ERP of the AP using a “probe” extrastimulus (Sp) introduced in the opposite chamber. The ERP was determined both during conventional extrastimulus (S1S2 method; ERPc) and during that with an Sp (S1SpS2 method; ERPp). The Sp was delivered before or after the last S1 with various S1Sp intervals. The ERPp was determined at each S1Sp interval. Three distinct patterns in concealed conduction in the AP were noted. In the first pattern, the ERPp was always shorter than the ERPc, whereas the reverse relation was noted in the second pattern. The third pattern showed a combination of the two. In group A, only the first pattern was noted. In group B, the first, second, and third patterns were noted in 4, 2, and 4 patients, respectively. The first pattern was noted only in septal APs and the second and third were seen only in left free-wall APs. The second pattern was seen in patients with retrograde AP conduction, whereas the third one was mainly noted in patients without retrograde AP conduction. These observations indicate that anterograde and retrograde concealed conduction in the AP have different characteristics. Shortening of the ERPp might be due to the “peeling back” phenomenon, and its lengthening might be caused by the presence of the inhomogeneous refractory periods of the AP. (PACE 1997; 20[Pt. I]:1342-1353)
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 7 (1996), S. 0 
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Endoscopy for Ablation Around the CS Ostium. Introduction: Radiofrequency ablation of the slow pathway can prolong atrioventricular (AV) nodal properties and RR intervals during atrial fibrillation (AF) in many patients with AV nodal reentrant tachycardia. However, it is not well elucidated whether these changes are related to the presence of dual AV nodal pathway physiology. The aim of this study was to evaluate changes of AV nodal properties and RR intervals during AF caused by ablation of two specific areas in dogs. Methods and Results: Assisted by fiberoptic endoscopy, linear lesions were created between the coronary sinus ostium and tricuspid valve annulus (area 1) or posterior to the ostium (area 2) in 15 dogs. Three additional dogs served as controls. The measurements were made under autonomic blockade. Catheter ablation could be assisted in all dogs by means of endoscopy. Linear lesions were confirmed at autopsy. AV nodal parameters and RR intervals showed no overall changes. Individual data showed that ablation of area I resulted in modification of AV nodal properties in 54.5% (facilitation in 363% and inhibition in 18.2%), whereas ablation of area 2 induced changes in 50% (facilitation in 10% and inhibition in 40%). The RR intervals were shortened in 33.3% and 20% and prolonged in 44.5% and 40% after ablation of areas 1 and 2, respectively. The RR intervals during AF correlated well with the Wenckebach cycle length and the AV node functional refractory period before and after ablation (r = 0.78 to 0.94, P 〈 0.01 for each). Conclusions: Ablation of the two specific areas around the coronary sinus ostium was equally effective in modifying AV nodal properties and the ventricular response during AF without dual AV nodal pathway physiology. The ventricular rate to AF after ablation correlated well with the residual AV nodal properties.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 14 (2003), S. 0 
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: A rapidly firing or triggered ectopic focus located within a pulmonary vein (PV) or close to the PV ostium could induce atrial fibrillation (AF). The aim of this study was to evaluate the efficacy and safety of a radiofrequency thermal balloon catheter for isolation of the PV from the left atrium (LA). Methods and Results: Twenty patients with drug-resistant paroxysmal AF were treated by isolating the superior PVs using an RF thermal balloon catheter. Using a transseptal approach, the balloon, which had an inflated diameter 5 to 10 mm larger than that of the PV ostium, was wedged at the LA-PV junction. It was heated by a very-high-frequency current (13.56 MHZ) applied to the coil electrode inside the balloon for 2 to 3 minutes, and the procedure was repeated up to four times. The balloon center temperature was maintained at 60° to 75°C by regulating generator output. Successful PV isolation was achieved in 19 of the 20 left superior PVs and in all 20 of the right superior PVs and was associated with a decrease in amplitude of the ostial potentials. Total procedure time was 1.8 ± 0.5 hours, which included 22 ± 7 minutes of fluoroscopy time. After a follow-up period of 8.1 ± 0.8 months, 17 patients were free from AF, with 10 not taking any antiarrhythmic drugs and 7 taking the same antiarrhythmic agent as before ablation. Electron beam computed tomography revealed no complications, such as PV stenosis at ablation sites. Conclusion: The PV and its ostial region can be safely and quickly isolated from the LA by circumferential ablation around the PV ostia using a radiofrequency thermal balloon catheter for treatment of AF. (J Cardiovasc Electrophysiol, Vol. 14, pp. 609-615, June 2003)
    Type of Medium: Electronic Resource
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