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Celiac arterial aneurysms are very unusual and often lack clinical manifestations. According to our review of the literature, this is the first report of a patient with a large celiac arterial aneurysm who exhibited hematemesis from gastric varices. Arteriography, as well as color Doppler ultrasonography and enhanced computed tomography, contributed to the diagnosis of this aneurysm, which was best...
Background. Hepatocellular carcinoma (HCC) is common in Asian countries, and tumor recurrence is the most common cause of treatment failure after curative resection. Repeated hepatectomy is performed only for selected patients because most patients with HCC also have liver cirrhosis and poor liver function reserve. The purposes of this study were to clarify the outcome of the patients after second...
Background. Burn excision followed by immediate wound coverage has become the clinical standard for managing extensive burn injuries in much of the world. When sufficient autograft skin to achieve permanent wound closure is unavailable, cell culture technology has made the use of cultured human keratinocyte (HK) sheets clinically feasible. Whereas previous techniques have focused on development of...
Background. Splenectomy often is performed simultaneously with total gastrectomy for gastric carcinoma to facilitate dissection of splenic hilar lymph nodes. Splenectomy, however, should be avoided as frequently as possible because of its important role in the reticuloendothelial system and because of its sometimes severe complications. We evaluated the end results of simultaneous splenectomy with...
Background. Radiologic diagnosis of pancreatic tumors exhibits limited precision. The aim of this study was to investigate the outcome and complications of pancreatic core biopsy in patients with suspected pancreatic neoplasms.Methods. One hundred patients underwent ultrasonography-guided core biopsy of 1.2 mm external diameter. Medical charts were examined for biochemical and clinical signs of complications...
Background Physiopathology of hepatic encephalopathy remains unclear. Recent studies have suggested that ammonia would not act by itself but through an increase in glutamine in the brain. We have previously demonstrated that transplantation of syngeneic hepatocytes into the spleen was able to correct both behavioral deficits and plasma amino acid changes observed in portacaval shunted rats. The aim...
Background. The technique of decision analysis is often applied to clinical policy and economic issues in surgery. Because surgeons may be unfamiliar with such work, this article catalogues decision analysis studies in the surgical specialties.Methods. We reviewed the medical literature (1966 to 1994) to identify surgical decision analysis studies and to assess trends over time. Each article was categorized...
Background. Carotid artery resection has been shown to yield a chance of cure in patients with advanced head and neck carcinoma involving the carotid artery. However, the criteria for the identification of those who are vulnerable to neurologic injury after resection have not been established. Interposition grafting may minimize the risk of neurologic morbidity, although it is technically difficult...
Background This study examined whether acute ethanol (EtOH) intoxication could alter the systemic inflammatory response evoked by endotoxin (lipopolysaccharide, LPS).Methods. Anesthetized (fentanyl) and mechanically ventilated mongrel pigs were administered 20% EtOH (3 gm/kg) or its vehicle (VEH) by means of gastric lavage. After 60 minutes of equilibration, blood levels were 110 to 130 mg/dl, and...
Background. The purpose of this study was to evaluate and analyze arterial inflow (AI) in lower extremities of patients with symptoms of chronic venous insufficiency (CVI) and of members of a healthy control group.Methods. Foot mercury-in-silicone strain-gauge plethysmography was used to measure AI, venous reflux, and muscle pump efficiency in 388 extremities of 194 patients with symptoms of CVI....
Background. Patients with acute and chronic hepatitis B virus infection have elevated serum levels of soluble interleukin-2 receptor. This study examined patients with chronic hepatitis C virus infection to determine whether serum soluble interleukin-2 receptor levels were elevated and whether the degree of these elevations in serum levels correlated with histologic severity of hepatitis-related liver...
Background. Laparoscopic appendectomy has now gained wider acceptance in clinical practice, particularly in the treatment of women with right iliac fossa pain. However, the precise role of laparoscopic appendectomy in men is unclear, and this study was therefore undertaken to examine this specific issue in a prospective randomized trial.Methods. One hundred men between the ages of 16 and 65 years...
Background. Resection for hepatocellular carcinoma in patients with cirrhosis and impaired liver function is usually unjustified because of higher surgical risks and poorer long-term prognosis.Methods. A retrospective comparison of the background and resectional results of patients with cirrhosis and hepatocellular carcinoma was carried out between those with preoperative indocyanine green 15-minute...
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