Hepato Gastroenterol
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Hepato Gastroenterol · Jul 2003
Non-linear evaluation of respiratory mechanics during laparoscopic cholecystectomy.
Laparoscopic cholecystectomy is accompanied by significant increase of the respiratory system elastic and resistive properties. These changes are completely abolished after peritoneal deflation. In the present study we examine the volume and flow dependence of respiratory mechanics during four operation phases. ⋯ The pneumoperitoneum and not the body position causes the changes in respiratory mechanics and their dependencies during laparoscopic cholecystectomy, which, although important, do not predispose to major risks (lung overdistension, alveolar collapse) and they are reversed after peritoneal deflation.
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Hepato Gastroenterol · May 2003
Eradication therapy of Helicobacter pylori directly induces apoptosis in inflammation-related immunocytes in the gastric mucosa--possible mechanism for cure of peptic ulcer disease and MALT lymphoma with a low-grade malignancy.
A possibility that the eradication therapy not only eliminates Helicobacter pylori (H. pylori) but also influences some factors regulating pathological changes in the gastric mucosa should be taken into consideration from some phenomena. Such as non-recurrent cases of peptic ulcer long-term in spite of unsuccessful anti-H. pylori eradication therapy and the effectiveness of eradication therapy for mucosa-associated lymphoid tissue with a low-grade malignancy except stomach. We hypothesized and investigated that antibiotic treatment for elimination of H. pylori might directly affect inflammatory cells to induce apoptosis in them and protect against pathological changes of gastric mucosa. ⋯ This observation suggests that H. pylori eradication therapy itself induces apoptosis in mononuclear leukocytes in the gastric mucosa.
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Hepato Gastroenterol · May 2003
Radiofrequency ablation for treatment of hepatocellular carcinoma with cirrhosis.
The majority of hepatocellular carcinoma patients with cirrhosis are not candidates for surgical resection, and local thermal therapy producing destruction of cancer cells was one of the ideal options for treatment. Heat from radiofrequency ablation is generated through agitation caused by an alternating electrical current. The heat of radiofrequency energy results in local cell coagulation and causes cellular ablation necrosis of tumor tissue. ⋯ Radiofrequency ablation resulted in a higher rate of complete necrosis of tumor tissue and the complication rate was low as well. Therefore, we believed that radiofrequency ablation is an ideal treatment modality for most liver tumors, which cannot tolerate the conventional surgical procedures.
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Hepato Gastroenterol · May 2003
Outcome of total pelvic exenteration for locally recurrent rectal cancer.
Local recurrence occurs in 10 to 30% of patients with rectal cancer following curative resection. However treatment of choice remains controversial. We assessed the results of total pelvic exenteration for locally recurrent cancer of the rectum retrospectively. ⋯ Total pelvic exenteration for local recurrence of rectal cancer can achieve long-term survival when curative resection is possible and the disease-free interval is long.
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Hepato Gastroenterol · May 2003
Comparative StudyHepatic resection under in situ hypothermic hepatic perfusion.
Temporary inflow occlusion of the portal triad has been used frequently in hepatectomy to minimize bleeding. On the other hand, Pringle's maneuver produces ischemic-reperfusion injury especially in patients with underlying liver disease. ⋯ Using the technique of in situ hypothermic perfusion, we can prolong the ischemic time safely with minimal systemic influence even in cases with underlying liver diseases. This may compare favorably with intermittent Pringle's maneuver in terms of reducing hepatic sinusoidal endothelial cell damage during hepatectomy and reperfusion.