Peripheral blood lymphocyte phenotype can predict rejection episodes after orthotopic liver transplantation.
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Biomedical subjects
Publications and source records attributed to F J Oliveira.
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Some aspects of the ecology of eleven species of Culicidae that were found breeding in recipients in an urban area of Southern Brazil are presented. A great variety of recipients were listed as efficient breeding sites. Apparently Aedes aegypti has been recently introduced into the region and was limited to two areas of the city. Culex quinquefasciatus, Cx. coronator, Ae. aegypti, Ae. fluviatilis e Limatus durhamii were the predominant species.
An original technique for supra-pyloric gastrectomy with preservation of sphincter function of the pylorus was performed in a series of 26 patients with benign ulcer of the lesser curvature. The results were evaluated 3-10 years after the operation. Twenty-five patients obtained a satisfactory results (visick grades I or II). The rate of gastric emptying was tested with a meal labelled with TC 99 in 17 patients. Only one patient suffered from gastric stasis. It is concluded that supra-pyloric gastrectomy with preservation of the pylorus has a place in the treatment of benign ulcers of the lesser curvature.
Bochdalek's hernia, congenital posterolateral diaphragmatic hernia, is common in children but rarely occurs in adults. The authors report two such adult cases. One of the hernias was on the left and the other on the right. Both patients had gastrointestinal symptoms. The approach was abdominal in one and thoracoabdominal in the other. There were no operative or postoperative complications. The possibility of congenital posterolateral diaphragmatic hernia must be considered in the differential diagnosis of patients who have recurrent gastrointestinal and respiratory complaints. A complete roentgenologic examination is necessary in order to make an accurate diagnosis preoperatively. Because of the danger of strangulation of the hernia, operation should be carried out as soon as the diagnosis is made.
The records of 63 patients with small bowel perforation after blunt abdominal trauma admitted to the Department of Surgical Pathology, University Hospital of Coimbra, from 1965 to 1981, have been reviewed to establish patterns of injury and to discuss their pathogenesis and operative management. The authors believe that injuries to the small intestine following blunt abdominal trauma are more common than is generally appreciated. Proper treatment is frequently delayed because these injuries are not recognized promptly. Factors contributing to this delay are the trivial nature of some of the responsible accidents and the often negative results of diagnostic aids.
The authors report the results of the surgical removal of bilestones in 139 patients over 75 years of age, taken from a series of 1 179 cases. The low mortality (4.3%) and morbidity rates are due to a non-aggressive protocol, especially in the treatment of choledocholithiasis. They conclude that advanced age does not necessarily imply a need for systematic alteration of the therapeutic approach.
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From an analysis of 19 patients with traumatic diaphragmatic hernias with respect to the type of injury, associated injuries, clinical and radiologic features, diagnosis, surgical management and causes of death and from a review of the literature, the authors draw a number of conclusions. 1. Careful clinical examination coupled with an accurate interpretation of the roentgenograms should detect most cases of traumatic rupture of the diaphragm. 2. Impairment of respiratory function, possibility of strangulation and incarceration of the abdominal viscera demand early repair. 3. The choice of incision and approach depends on the stage at which the rupture is recognized (early or late), the site of rupture and the associated injuries. 4. Careful assessment of respiratory function should be made in order to prevent postoperative complications; in some cases respiration must be assisted. 5. Although the mortality in patients with traumatic diaphragmatic rupture is still relatively high, the deaths sould not be related to the rupture per se, or to its repair, but rather to the associated injuries.
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BACKGROUND/AIMS: The increased average life expectancy and the changing patterns in gastric carcinoma have resulted in a considerable rise in the number of older patients requiring total gastrectomy. Results of total gastrectomy for gastric cancer in elderly patients are presented. METHODOLOGY: Between January 1987 and December 1996, 115 patients underwent total gastrectomy for gastric adenocarcinoma. At the time of surgery, 25 (21.8%) patients were older than 70 years. The results achieved in these patients were compared with those observed in 90 younger ones. RESULTS: The hospital mortality and morbidity rates for the elderly patients were 16% and 56%, respectively; for the younger ones they were 3.3% and 30%, respectively. No difference was seen between the two age groups concerning the average post-operative hospital stay. CONCLUSIONS: In our series, age was a major determinant with respect to post-operative morbidity and mortality. However, age alone could not be clearly defined as a determining risk factor considering that the accompanying illness and preexisting factors predispose for poor prognosis.
BACKGROUND/AIMS: There was a tendency to use more extensive operations for the treatment of gastric cancer during the last decade particularly in Europe. This retrospective study was carried out to review our recent experience with total gastrectomy for gastric adenocarcinoma. METHODOLOGY: One hundred and fifteen patients treated for gastric cancer by total gastrectomy from 1987 to 1996 were analyzed. At the time of surgery 22.3% of patients were older than 70 years of age. RESULTS: Fifty eight cancers (50.4%) were located in the distal third of the stomach, forty-seven (41%) were smaller than 6 cm and seventy-one (61.7%) were of the diffuse type. In 74.9% the tumor had penetrated through the serosa. The mortality and morbidity rates were 6.1% and 35.1% respectively. Age was a major determining factor with respect to hospital mortality and post-operative complications. CONCLUSIONS: Irrespective of personal attitudes, gastrectomy does not have to be total to be curative, and many total gastrectomies performed in Western countries with "curative intent" are noncurative procedures. Nevertheless, to achieve a curative oncologic resection, total gastrectomy is required with growing frequency.
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