Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is characterized by a thick grayish-white fibrotic membrane encasing the small bowel. SEP can be classified as idiopathic,also ...Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is characterized by a thick grayish-white fibrotic membrane encasing the small bowel. SEP can be classified as idiopathic,also known as abdominal cocoon,or secondary. It is difficult to make a definite pre-operative diagnosis. We experienced five cases of abdominal cocoon,and the case files were reviewed retrospectively for the clinical presentation,operative findings and outcome. All the patients presented with acute,subacute and chronic intestinal obstruction. Computed tomography (CT) showed characteristic findings of small bowel loops congregated to the center of the abdomen encased by a soft-tissue density mantle in four cases. Four cases had an uneventful post-operative period,one case received second adhesiolysis due to persistent ileus. The imaging techniques may facilitate pre-operative diagnosis. Surgery is important in the management of SEP.展开更多
AIM: To investigate Kupffer cell dynamics and phagocytic activity,using a rat nonalcoholic steatohepatitis (NASH) model. METHODS: Male F344 rats were fed either a control diet or a choline-deficient L-amino acid-defin...AIM: To investigate Kupffer cell dynamics and phagocytic activity,using a rat nonalcoholic steatohepatitis (NASH) model. METHODS: Male F344 rats were fed either a control diet or a choline-deficient L-amino acid-defined (CDAA) diet,followed by contrast enhanced ultrasonography (CEUS) using Levovist. The uptake of latex beads by the Kupffer cells was determined by fluorescent microscopy. The status of the Kupffer cells was compared between the two groups,using the immunohistochemical staining technique. RESULTS: After 4 or more wk of the CDAA diet,CEUS examination revealed a decrease in the signal intensity,20 min after intravenous Levovist. Fluorescent microscopic examination showed that the uptake of latex beads by the Kupffer cells was reduced at week 1 and 2 in the study group,compared with the controls,with no further reduction after 3 wk. Immunohistochemical staining revealed no significant difference in the Kupffer cell counts between the control group and the CDAA group. CONCLUSION: CEUS examination using Levovist demonstrated reduced contrast effect and phagocytic activity in the liver parenchymal phase,although the Kupffer cell numbers were unchanged,indicating reduced phagocytic function of the Kupffer cells in the rat NASH model. We believe that CEUS examination using Levovist is a useful screening modality,which can detect NASH in fatty liver patients.展开更多
AIM:To investigate the feasibility and therapeutic effect of laparoscopic surgery for pyogenic liver abscess(PLA) with biliary pathology.METHODS:From January 2004 to October 2010,31 patients with PLA combined with bil...AIM:To investigate the feasibility and therapeutic effect of laparoscopic surgery for pyogenic liver abscess(PLA) with biliary pathology.METHODS:From January 2004 to October 2010,31 patients with PLA combined with biliary pathology meeting entry criteria received surgical management in our hospital.Of the 31 patients,13 underwent laparoscopic surgery(LS group) and 18 underwent open surgery(OS group).Clinical data including operation time,intraoperative blood loss,postoperative complication rate,length of postoperative hospital stay,and abscess recurrence rate were retrospectively analyzed and compared between the two groups.RESULTS:All patients received systemic antibiotic therapy.Four patients underwent ultrasound-guided percutaneous catheter drainage before operation.Postoperative complications occurred in 5 patients(16.1%,5/31) including 2 in the LS group and 3 in the OS group.One patient had retained calculus in the common bile duct and another had liver abscess recurrence in the OS group.No retained calculus and liver abscess recurrence occurred in the LS group.In the two groups,there was no mortality during the perioperative period.There were no significant differences in operation time,intraoperative blood loss and transfusion,postoperative complication rate and abscess recurrence rate between the two groups.Oral intake was earlier(1.9 ± 0.4 d vs 3.1 ± 0.7 d,P < 0.05) and length of postoperative hospital stay was shorter(11.3 ± 2.9 d vs 14.5 ± 3.7 d,P < 0.05) in the LS group than in the OS group.CONCLUSION:Laparoscopic surgery for simultaneous treatment of PLA and biliary pathology is feasible in selected patients and the therapeutic effect is similar to that of open surgery.展开更多
Objective To summarize the management of anastomotic leak following surgery for esophageal car-cinoma. Methods The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma...Objective To summarize the management of anastomotic leak following surgery for esophageal car-cinoma. Methods The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma in our hospital from January 2003 to March 2011 were retrospectively analyzed. Results A total of 36 patients were included, in whom 13 developed cervical anastomotic leak, 18 had intra-thoracic anastomotic leak, and 5 had intra-thoracic gastric necrosis. Of these patients, 7 were treated with resurgery, 6 with esophageal stent implantation, and 23 with conservative treatment. Treatment lasted for 5 to 181 days, averagely 47.0±31.9 days. After management, 9 patients died (25.0%). Among seven patients with resurgery, four had deceased, two were cured, and one developed leak again and was switched to conservative treatment until discharged. All the 6 patients treated with stent implantation were cured. Of the 24 patients receiving conservative treatment (including one switched from resurgery), 18 (75.0%) were cured and 1 was not cured but survived. Conclusions Anastomotic leak following surgery for esophageal carcinoma should be treated individually based on the onset time, location, size, and extent of the leakage. Conservative treatment is still a safe and effective method.The efficacy of stent implantation needs further investigation to confirm.展开更多
Pancreatic cancer is an aggressive malignancy,relatively resistant to chemotherapy and radiotherapy,which usually presents late. Disease specific mortality approaches unity despite advances in adjuvant therapy. We pre...Pancreatic cancer is an aggressive malignancy,relatively resistant to chemotherapy and radiotherapy,which usually presents late. Disease specific mortality approaches unity despite advances in adjuvant therapy. We present the first reported case of complete pathological response following neoadjuvant therapy in a locally advanced pancreatic adenocarcinoma.展开更多
Heroin is considered potent and addictive and users are often stigmatised as the other. On the internet, however, hegemonic ideas about drugs can be resisted. This study elucidates how efforts to uormalise and demonis...Heroin is considered potent and addictive and users are often stigmatised as the other. On the internet, however, hegemonic ideas about drugs can be resisted. This study elucidates how efforts to uormalise and demonise heroin meet at a Swedish online message board （Flashback Forum）. The study aims at analysing how heroin use is given meaning by discussants in a thread called ＂I will start with heroin＂. The data were perceived and structured as a collaborative, overarching narrative about when, why, and for whom heroin use can make sense. Discussants used stories about pleasure-seekers, miserable junkies, and self-medicating addicts to depict the activity as unproblematic and rational, problematic and irrational, or as problematic and rational. No stories about heroin use departed from the plot-lines of pleasure maximisation and pain minimisation. Results elucidate a discursive battle in which： （1） heroin use as minimisation of pain ＂wins＂ over heroin use as maximisation of pleasure; and （2） there is a general agreement that heroin use cannot be irrational and unproblematic at the same time. It is suggested that these features are central to contemporary drug discourse, and that they probably hinder public understanding of why people use heroin and therefore contribute to keep users stigmatised.展开更多
Functional dyspepsia is a frequently-encountered clinical syndrome, characterized by fullness and pain in the upper abdomen, belching, sour regurgitation, anorexia, nausea, vomiting, without organic pathologic change,...Functional dyspepsia is a frequently-encountered clinical syndrome, characterized by fullness and pain in the upper abdomen, belching, sour regurgitation, anorexia, nausea, vomiting, without organic pathologic change, metabolic or psychic diseases. It is closely related with disturbance of gastric motility. Our previous study has indicated that acupuncture has marked therapeutic effects on disturbance of gastric motility. In the present paper, analysis of time-frequency spectrum of EGG was used as indexes, and the clinical therapeutic effects of acupuncture treatment on functional dyspepsia were assessed objectively. The results are reported in the following.展开更多
文摘Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is characterized by a thick grayish-white fibrotic membrane encasing the small bowel. SEP can be classified as idiopathic,also known as abdominal cocoon,or secondary. It is difficult to make a definite pre-operative diagnosis. We experienced five cases of abdominal cocoon,and the case files were reviewed retrospectively for the clinical presentation,operative findings and outcome. All the patients presented with acute,subacute and chronic intestinal obstruction. Computed tomography (CT) showed characteristic findings of small bowel loops congregated to the center of the abdomen encased by a soft-tissue density mantle in four cases. Four cases had an uneventful post-operative period,one case received second adhesiolysis due to persistent ileus. The imaging techniques may facilitate pre-operative diagnosis. Surgery is important in the management of SEP.
基金Grant-in-Aid for Scientific Research from the Ministry of Education,Culture,Sports,Science,and Technology of Japan,No.19590784
文摘AIM: To investigate Kupffer cell dynamics and phagocytic activity,using a rat nonalcoholic steatohepatitis (NASH) model. METHODS: Male F344 rats were fed either a control diet or a choline-deficient L-amino acid-defined (CDAA) diet,followed by contrast enhanced ultrasonography (CEUS) using Levovist. The uptake of latex beads by the Kupffer cells was determined by fluorescent microscopy. The status of the Kupffer cells was compared between the two groups,using the immunohistochemical staining technique. RESULTS: After 4 or more wk of the CDAA diet,CEUS examination revealed a decrease in the signal intensity,20 min after intravenous Levovist. Fluorescent microscopic examination showed that the uptake of latex beads by the Kupffer cells was reduced at week 1 and 2 in the study group,compared with the controls,with no further reduction after 3 wk. Immunohistochemical staining revealed no significant difference in the Kupffer cell counts between the control group and the CDAA group. CONCLUSION: CEUS examination using Levovist demonstrated reduced contrast effect and phagocytic activity in the liver parenchymal phase,although the Kupffer cell numbers were unchanged,indicating reduced phagocytic function of the Kupffer cells in the rat NASH model. We believe that CEUS examination using Levovist is a useful screening modality,which can detect NASH in fatty liver patients.
文摘AIM:To investigate the feasibility and therapeutic effect of laparoscopic surgery for pyogenic liver abscess(PLA) with biliary pathology.METHODS:From January 2004 to October 2010,31 patients with PLA combined with biliary pathology meeting entry criteria received surgical management in our hospital.Of the 31 patients,13 underwent laparoscopic surgery(LS group) and 18 underwent open surgery(OS group).Clinical data including operation time,intraoperative blood loss,postoperative complication rate,length of postoperative hospital stay,and abscess recurrence rate were retrospectively analyzed and compared between the two groups.RESULTS:All patients received systemic antibiotic therapy.Four patients underwent ultrasound-guided percutaneous catheter drainage before operation.Postoperative complications occurred in 5 patients(16.1%,5/31) including 2 in the LS group and 3 in the OS group.One patient had retained calculus in the common bile duct and another had liver abscess recurrence in the OS group.No retained calculus and liver abscess recurrence occurred in the LS group.In the two groups,there was no mortality during the perioperative period.There were no significant differences in operation time,intraoperative blood loss and transfusion,postoperative complication rate and abscess recurrence rate between the two groups.Oral intake was earlier(1.9 ± 0.4 d vs 3.1 ± 0.7 d,P < 0.05) and length of postoperative hospital stay was shorter(11.3 ± 2.9 d vs 14.5 ± 3.7 d,P < 0.05) in the LS group than in the OS group.CONCLUSION:Laparoscopic surgery for simultaneous treatment of PLA and biliary pathology is feasible in selected patients and the therapeutic effect is similar to that of open surgery.
文摘Objective To summarize the management of anastomotic leak following surgery for esophageal car-cinoma. Methods The medical records of the patients developing digestive tract leak after surgery for esophageal carcinoma in our hospital from January 2003 to March 2011 were retrospectively analyzed. Results A total of 36 patients were included, in whom 13 developed cervical anastomotic leak, 18 had intra-thoracic anastomotic leak, and 5 had intra-thoracic gastric necrosis. Of these patients, 7 were treated with resurgery, 6 with esophageal stent implantation, and 23 with conservative treatment. Treatment lasted for 5 to 181 days, averagely 47.0±31.9 days. After management, 9 patients died (25.0%). Among seven patients with resurgery, four had deceased, two were cured, and one developed leak again and was switched to conservative treatment until discharged. All the 6 patients treated with stent implantation were cured. Of the 24 patients receiving conservative treatment (including one switched from resurgery), 18 (75.0%) were cured and 1 was not cured but survived. Conclusions Anastomotic leak following surgery for esophageal carcinoma should be treated individually based on the onset time, location, size, and extent of the leakage. Conservative treatment is still a safe and effective method.The efficacy of stent implantation needs further investigation to confirm.
文摘Pancreatic cancer is an aggressive malignancy,relatively resistant to chemotherapy and radiotherapy,which usually presents late. Disease specific mortality approaches unity despite advances in adjuvant therapy. We present the first reported case of complete pathological response following neoadjuvant therapy in a locally advanced pancreatic adenocarcinoma.
文摘Heroin is considered potent and addictive and users are often stigmatised as the other. On the internet, however, hegemonic ideas about drugs can be resisted. This study elucidates how efforts to uormalise and demonise heroin meet at a Swedish online message board （Flashback Forum）. The study aims at analysing how heroin use is given meaning by discussants in a thread called ＂I will start with heroin＂. The data were perceived and structured as a collaborative, overarching narrative about when, why, and for whom heroin use can make sense. Discussants used stories about pleasure-seekers, miserable junkies, and self-medicating addicts to depict the activity as unproblematic and rational, problematic and irrational, or as problematic and rational. No stories about heroin use departed from the plot-lines of pleasure maximisation and pain minimisation. Results elucidate a discursive battle in which： （1） heroin use as minimisation of pain ＂wins＂ over heroin use as maximisation of pleasure; and （2） there is a general agreement that heroin use cannot be irrational and unproblematic at the same time. It is suggested that these features are central to contemporary drug discourse, and that they probably hinder public understanding of why people use heroin and therefore contribute to keep users stigmatised.
文摘Functional dyspepsia is a frequently-encountered clinical syndrome, characterized by fullness and pain in the upper abdomen, belching, sour regurgitation, anorexia, nausea, vomiting, without organic pathologic change, metabolic or psychic diseases. It is closely related with disturbance of gastric motility. Our previous study has indicated that acupuncture has marked therapeutic effects on disturbance of gastric motility. In the present paper, analysis of time-frequency spectrum of EGG was used as indexes, and the clinical therapeutic effects of acupuncture treatment on functional dyspepsia were assessed objectively. The results are reported in the following.
