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Digestive Surgery Aug 2010Proximal gastrectomy is a surgical option for proximally located early gastric cancer. We present a new double-stapling method for proximal gastrectomy and...
BACKGROUND
Proximal gastrectomy is a surgical option for proximally located early gastric cancer. We present a new double-stapling method for proximal gastrectomy and esophagogastrostomy.
METHODS
We examined the safety of proximal gastrectomy by analyzing the lymph node metastasis rate in 53 patients who underwent total gastrectomy due to proximally located early gastric cancer from January 2004 to December 2008. We applied the double-stapling method used in distal gastrectomy reversely to proximal gastrectomy and esophagogastrostomy in 15 patients.
RESULTS
Retrospective analysis showed that proximal early gastric cancer metastasizes to only lymph node station 2, 3 and 7 which were completely removed during proximal gastrectomy. Fifteen patients underwent proximal gastrectomy using a new method which left no gastrostomy wound for the insertion of a circular stapler in the remaining stomach. The median operation time was 156.5 min and median postoperative hospital stay was 8.0 days. There were only 2 cases of wound complications during hospital stay. Two cases of anastomosis site strictures which developed after discharge were successfully treated with balloon dilatation.
CONCLUSION
We presented a new 'reverse double-stapling method' for proximal gastrectomy, which seems to be a fast and feasible method that leaves no gastrostomy wound in the remaining stomach.
Topics: Anastomosis, Surgical; Esophagectomy; Esophagus; Female; Gastrectomy; Gastrostomy; Humans; Length of Stay; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Sutures
PubMed: 20571261
DOI: 10.1159/000264658 -
Science (New York, N.Y.) Mar 1992Most neurons have inhibitory synapses both "proximally" near the spike-initiating zone and "distally" on dendrites. Although distal inhibition is thought to be an...
Most neurons have inhibitory synapses both "proximally" near the spike-initiating zone and "distally" on dendrites. Although distal inhibition is thought to be an adaptation for selective inhibition of particular dendritic branches, another important distinction exists between proximal and distal inhibition. Proximal inhibition can attenuate excitatory input absolutely so that no amount of excitation causes firing. Distal inhibition, however, inhibits relatively; any amount of it can be overcome by sufficient excitation. These properties are used as predicted in the circuit-mediating crayfish escape behavior. Many neuronal computations require relative inhibition. This could partly account for the ubiquity of distal inhibition.
Topics: Animals; Astacoidea; Escape Reaction; Nervous System Physiological Phenomena; Neural Inhibition
PubMed: 1553559
DOI: 10.1126/science.1553559 -
Acta Orthopaedica Belgica Dec 2010Although chronic proximal tibiofibular joint instability is a rare condition, it is associated with marked functional impairment. Various surgical options have been...
Although chronic proximal tibiofibular joint instability is a rare condition, it is associated with marked functional impairment. Various surgical options have been reported in literature, all associated with several problems and limitations. We describe a new technique of reconstruction of the proximal tibiofibular joint using the semitendinosus tendon. The key steps of the procedure are the preparation of a proximally released semitendinosus tendon, and its guidance through two transtibial tunnels and one transfibular tunnel. The semitendinosus tendon acts as a soft tissue sling and does not interfere with mobility at the proximal or distal tibiofibular joints as noted after fibular head resection or arthrodesis of the proximal tibiofibular joint. Further advantages are the easy accessibility of the semitendinosus graft and the small surgical scar with better cosmetic results as compared to ligamentous reconstructive procedures using a split biceps femoris tendon or a strip of the iliotibial band.
Topics: Female; Humans; Joint Instability; Knee Joint; Orthopedic Procedures; Postoperative Care; Suture Anchors; Tendons; Young Adult
PubMed: 21302584
DOI: No ID Found -
BMC Veterinary Research Jan 2017Cranial cruciate ligament insufficiency is a common orthopaedic problem in canine patients. This cadaveric and radiographic study was performed with the aim of...
BACKGROUND
Cranial cruciate ligament insufficiency is a common orthopaedic problem in canine patients. This cadaveric and radiographic study was performed with the aim of determining the effect of proximal translation of the tibial tuberosity during tibial tuberosity advancement (TTA) on patellar position (PP) and patellar ligament angle (PLA).
RESULTS
Disarticulated left hind limb specimens harvested from medium to large breed canine cadavers (n = 6) were used for this study. Limbs were mounted to Plexiglass sheets with the stifle joint fixed in 135° of extension. The quadriceps mechanism was mimicked using an elastic band. Medio-lateral radiographs were obtained pre-osteotomy, after performing TTA without proximal translation of the tibial tuberosity, and after proximal translation of the tibial tuberosity by 3mm and 6mm. Radiographs were blinded to the observer for distance of tibial tuberosity proximalization following radiograph acquisition. Three independent observers recorded PP and PLA (tibial plateau method and common tangent method). Comparisons were made between the stages of proximalization using repeated measures ANOVA. Patellar position was found to be significantly more distal than pre-osteotomy, if the tibial tuberosity was not translated proximally (P = 0.001) and if it was translated proximally by 3mm (P = 0.005). The difference between pre-osteotomy PP and 6mm proximalization was not significant. The PLA was significantly larger if the tibial tuberosity was not translated proximally compared to tibial tuberosity proximalization of 6mm using the tibial plateau and the common tangent methods (P = 0.006 and P = 0.015 respectively).
CONCLUSIONS
Proximalizing the tibial tuberosity during TTA helps in maintaining vertical position of the patella in the patellar groove. Proximalization of the tibial tuberosity reduces PLA when compared to TTA without tibial tuberosity proximalization.
Topics: Animals; Cadaver; Dogs; Observer Variation; Osteotomy; Patella; Patellar Ligament; Tibia
PubMed: 28068982
DOI: 10.1186/s12917-017-0942-6 -
Neuroscience May 1995Recent studies indicate that long-term potentiation is accompanied by changes in the waveform of field excitatory postsynaptic potentials in the CA1 field of... (Comparative Study)
Comparative Study
Recent studies indicate that long-term potentiation is accompanied by changes in the waveform of field excitatory postsynaptic potentials in the CA1 field of disinhibited hippocampal slices, suggesting that long-term potentiation alters the kinetics of the glutamate receptor channels that mediate excitatory synaptic responses. The present study examined the effects of stimulating and recording location within stratum radiatum on the magnitude of long-term potentiation and the associated waveform changes. Stimulation of stratum radiatum proximal to the cell body layer evoked field excitatory postsynaptic potentials in proximal stratum radiatum that had decay phases well-fit by single exponentials; long-term potentiation reduced the decay time constant of these potentials, as reported previously. Stimulation of distal stratum radiatum evoked field excitatory postsynaptic potentials in distal stratum radiatum that were contaminated by positive after-potentials; meaningful estimates of decay time constants for these responses could not be obtained. Long-term potentiation of distal responses tended to be smaller than that obtained proximally. Comparisons were also made between responses recorded distally and proximally for either distal or proximal stimulation. For both stimulation loci, the distally-recorded responses had positive after-potentials and the proximally-recorded responses did not. The decay time constants for proximally-recorded responses to distal stimulation decreased significantly after long-term potentiation. Proximal and distal stimulation both produced greater long-term potentiation recorded proximally than distally and the difference was significantly greater for proximal stimulation. When long-term potentiation was induced by stimulation of proximal and distal sites simultaneously, the difference between proximally- and distally-recorded long-term potentiation was significantly reduced. Paired-pulse facilitation was greater when recorded proximally but the variation in facilitation with stimulation and recording position was different from that obtained for long-term potentiation. Paired-pulse facilitation of response amplitude was slightly reduced after long-term potentiation, but the change did not depend on the stimulation-recording arrangement; facilitation of response slope was not reliably affected by long-term potentiation. These results indicate that the shape of the dendritic field excitatory postsynaptic potential is influenced by the relative position of recording electrodes in stratum radiatum; when the position is such that after-potentials are minimized, long-term potentiation produces a decrease in the decay time constant of the synaptic field potential.(ABSTRACT TRUNCATED AT 400 WORDS)
Topics: Animals; Dendrites; Electrophysiology; Hippocampus; Long-Term Potentiation; Membrane Potentials; Rats; Rats, Sprague-Dawley; Time Factors
PubMed: 7477872
DOI: 10.1016/0306-4522(94)00565-m -
Arthroplasty Today Dec 2020The diagnosis of and decision-making for early revision surgery to treat failure of biological fixation with a proximally coated cementless stem are challenging. A...
The diagnosis of and decision-making for early revision surgery to treat failure of biological fixation with a proximally coated cementless stem are challenging. A 73-year-old woman was referred to our hospital with thigh pain 2 years after the initial total hip arthroplasty. Although a plain radiograph showed no signs indicating biological fixation failure, digital tomosynthesis showed a highly radiodense line along the proximal part, and bone scintigraphy showed uptake at the distal part. With the diagnosis of biological fixation failure due to the proximal-distal mismatch, the cementless stem was revised to a cemented stem, and the thigh pain was improved after the revision surgery. Digital tomosynthesis and bone scintigraphy can be helpful for the diagnosis of biological fixation failure due to proximal-distal mismatch.
PubMed: 33204788
DOI: 10.1016/j.artd.2020.09.007 -
The Journal of Arthroplasty Jun 2002A prospective study was carried out on the use of a proximally modular, proximal ingrowth noncemented stem in hip revision surgery. There were 109 short stems and 211...
A prospective study was carried out on the use of a proximally modular, proximal ingrowth noncemented stem in hip revision surgery. There were 109 short stems and 211 long stems. The mean follow-up was 7 years (range, 2-12 years). No revisions were required in the short-stem group for aseptic loosening; 3 (1.4%) revisions were required in the long-stem group. Lucency was absent in 91.7% of short-stem cases, was low grade in 7.2%, and was high grade in 1.1%. In the long-stem group, lucency was absent in 72.9% of cases, was low grade in 24.5%, and was high grade in 2.6%. No measurable subsidence occurred in the short-stem group, and 5 mm of subsidence occurred early in 2 of the long-stem group. This subsidence stabilized subsequently. Osteolysis distal to the sleeve was not observed. A proximal ingrowth, proximally modular stem can be used in revision hip surgery.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Female; Hip Prosthesis; Humans; Male; Middle Aged; Prospective Studies; Prosthesis Design; Prosthesis Failure; Reoperation; Treatment Outcome
PubMed: 12068425
DOI: 10.1054/arth.2002.32462 -
The Journal of Hand Surgery, European... May 2014The purpose of this study was to analyze the palmar plate complex at the proximal interphalangeal joint using a three-dimensional (3D) technique, which makes it easier...
The purpose of this study was to analyze the palmar plate complex at the proximal interphalangeal joint using a three-dimensional (3D) technique, which makes it easier to understand the dimensions of structures and their relationship to the adjacent components. This method allows individual elements to be removed virtually, facilitating clearer observation of each component. Sixteen cadaveric specimens were dissected and reconstructed in a 3D virtual environment. The palmar plate is made up of a distal, fibrous portion and a proximal, membranous portion, which anchors distally on the base of the middle phalanx and is continuous with the bilateral check-rein ligaments proximally. The accessory collateral ligaments and the A3 pulley suspend the palmar plate laterally.
Topics: Aged; Biomechanical Phenomena; Cadaver; Collateral Ligaments; Female; Finger Joint; Humans; Imaging, Three-Dimensional; Male; Palmar Plate
PubMed: 23739145
DOI: 10.1177/1753193413492288 -
Clinical Orthopaedics and Related... May 1992Peroneal nerve impalement is a recognized complication of percutaneous placement of wires, which is gaining increased usage with the application of the techniques of...
Peroneal nerve impalement is a recognized complication of percutaneous placement of wires, which is gaining increased usage with the application of the techniques of Ilizarov, Monticelli, and Spinelli. Dissections of the peroneal nerve in the proximal tibia were performed in ten anatomic specimens (20 legs) to define (1) its relationship to palpable landmarks, (2) distribution of major branches to the musculature, and (3) safe zones of placement of percutaneous wires in the proximal tibia. The anterior recurrent tibial nerve was frequently in an area of risk where it courses proximally in the anterior compartment. A safe zone is located anterior to the palpable portion of the fibular head and up to 2 cm distal to the tip of the fibular head.
Topics: Humans; Leg; Peroneal Nerve; Tibia
PubMed: 1563143
DOI: No ID Found -
European Spine Journal : Official... Jun 2024To assess, in a large population of Adult Spinal Deformity (ASD) patients, the true interest of varying the upper anchors as a protective measure against Proximal...
PURPOSE
To assess, in a large population of Adult Spinal Deformity (ASD) patients, the true interest of varying the upper anchors as a protective measure against Proximal Junctional Kyphosis (PJK), by analyzing and comparing 2 groups of patients defined according to their proximal construct. Another objective of the study is to look for any other factors, radiological or clinical, that would affect the occurrence of the proximal failure.
METHODS
Retrospective review of a prospective ASD database collected from 5 centers. Inclusion criteria were age of at least 18 years, presence of a spinal deformity with instrumentation from T12 or above to the pelvis, with minimum 2 years of follow-up. Demographic data, spinopelvic parameters, functional outcomes and complications were collected. Multiple logistic regression analysis was performed to identify the risk factors that would affect the occurrence of PJK.
RESULTS
254 patients were included. 166 in the group "screws proximally" (SP) and 88 in the group "hooks proximally" (HP). There was no difference between both groups for PJK (p = 0.967). The occurrence of PJK was rather associated with greater age and BMI, higher preoperative kyphosis, worst preoperative SRS22 and SF36 scores, greater postoperative Sagittal Vertical Axis (SVA), coronal malalignment and kyphosis.
CONCLUSION
The use of proximal hooks was not effective to prevent PJK after ASD surgery, when compared to proximal screws. Worse preoperative functional outcomes and worse postoperative sagittal and also coronal malalignment were the main drivers for the occurrence of PJK regardless the type of proximal implant.
PubMed: 38844585
DOI: 10.1007/s00586-024-08332-4