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At least 181 records · Page 10Linked to original sources
PubMed1996

Stress induced disorganization of circadian and ultradian rhythms: comparisons of effects of surgery and social stress.

Persistent autonomic disturbances following stressful events suggest that the rhythmical nature of homeostatic functioning may be disrupted by these experiences. We assessed the effects of two different stressors on circadian and ultradian rhythms of Long-Evans rats by using nonlinear multi-oscillator cosinor analysis. Heart rate and intraperitoneal temperature were monitored continuously in 5-min intervals in two groups of animals via radio-telemetry for 15 days after surgery (n = 9) and 15 days following social defeat (n = 6). Circadian amplitude of heart rate and temperature increased significantly for the first nine days of the recovery from surgery but only circadian temperature amplitude increased following social defeat. Circadian acrophase of temperature but not heart rate changed significantly for a similar period following the surgery but not after the social defeat. A mathematical model incorporating the first five harmonics of the circadian rhythm was found to fit the data significantly better than a circadian model alone with rhythms of 3 and 5 cycles/day in temperature and heart rate entraining significantly to the light-dark schedule. Full recovery of the circadian and ultradian rhythms did not occur until a minimum of nine to twelve days after surgery or social defeat. The results suggest that rhythms with multiple periodicities are involved in homeostatic functioning and that models incorporating these rhythms may aid in understanding an organisms adaptive response to surgical intervention and social defeat, long after the challenges have terminated.

Activity Cycles↗
PubMed1992

Percutaneous intranodular ethanol injection for treatment of autonomously functioning thyroid nodules.

BACKGROUND: The aim of the study is the assessment of percutaneous intranodular ethanol injection (PNEI) as an alternative therapeutic procedure to classic surgery and radioiodine administration in autonomously functioning thyroid nodule treatment. METHODS: Thirty-seven patients with hot nodules (18 pretoxic and 19 toxic) have been treated by means of PNEI under ultrasonographic guide. Ninety-five percent ethanol in a mean dose of 25 ml has been used. RESULTS: Nearly 80% of the patients showed normalization of thyroid-stimulating hormone levels and a complete recovery of extranodular tissue at scintiscan. All nodules decreased strikingly in size, many becoming undetectable. Mild and transient side effects were seen in 9% of the patients. CONCLUSIONS: PNEI seems to be a feasible procedure on outpatients. It is safe when performed by a well-trained staff using ultrasonographic control. It may be carried out at any age and in patients at risk for surgery. PNEI can be considered a useful alternative to surgery and radioiodine administration in all autonomously functioning thyroid nodules and particularly in pretoxic nodules.

Administration, Cutaneous↗
PubMed1986

[A controlled double-blind trial of the possibilities of using nalbuphine in anesthesia in major surgical interventions on the upper abdomen].

A controlled, double-blind assessment of nalbuphine 0.3 mg kg-1 as an analgesic component of anaesthesia was made in 40 patients undergoing major upper abdominal surgery. The unpremedicated patients received thiopentone, alcuronium, nitrous oxide and oxygen, and either nalbuphine or saline. Enflurane was used to suppress autonomic nervous responses to surgery. Nalbuphine 0.3 mg kg-1 failed to influence the course of anaesthesia or the onset of post-operative pain, and produced no side-effects.

Anesthesia, Inhalation↗
PubMed2001

[Optimal lymph node dissection for colorectal cancer].

Previous studies on the distribution of positive lymph nodes have revealed that the colon should be resected 10 cm from the tumor on both sides and that the intermediate nodes along the main vessel should be dissected in patients with colon cancer. In rectal cancer, superior lymphatic spread along the inferior mesenteric artery (IMA) is the main metastatic route. The IMA should be dissected immediately after the bifurcation of the left colic artery, and the intermediate lymph nodes should be removed. The positive rate of the lateral lymph nodes is about 10%. The rate of local failure is high and the prognosis is poor in patients with positive lateral lymph nodes, even if the lateral lymph nodes have been dissected. However, it has been reported that lateral lymph node dissection combined with excision of the internal iliac vessels results in good disease-free survival in patients with positive lateral nodes. Therefore the indications for lateral node dissection remain controversial. Lymphatic spread into the mesorectum on the anal side has been shown to be an important factor in local failure. The mesorectum should be resected for up to 4 or 5 cm from the inferior tumor margin in middle rectal cancer, and the entire mesorectum should be removed in lower rectal cancer. Nerve tissue preserved in pelvic autonomic nerve-preserving surgery contains a small amount of lymphoid tissue and lymph nodes. Therefore the extent of lymph node dissection and the area of autonomic nerves to be preserved based on tumor site or tumor penetration remain controversial.

Colonic Neoplasms↗
PubMed1998

Changes in blood pressure and heart rate variability during dental surgery.

The objective of the present study was to determine the changes in blood pressure, pulse rate, and heart rate variability during dental surgery. The study included 40 patients, 19 to 74 years of age (mean age: 42.7+/-3.0 years), who underwent tooth extraction at our hospital. Holter electrocardiographic monitoring was used to determine the power spectrum of R-R variability before and during dental surgery. The low frequency (LF: 0.041 to 0.140 Hz), high frequency (HF: 0.140 to 0.500 Hz), and total spectral powers (TF; 0.000 to 4.000 Hz) were calculated, and the ratio of LF to HF and percentage of HF relative to TF (%HF: HF/TF x 100) were used as indices of sympathetic and parasympathetic activities, respectively. The baseline blood pressure and pulse rate were 121+/-3/70+/-2 mm Hg and 70+/-1 beats/min, respectively. After the administration of local anesthetic (2% lidocaine) containing 1:80,000 epinephrine, both the blood pressure and pulse rate increased. During dental surgery, blood pressure increased further to 132+/-3/73+/-2 mm Hg. The increase in blood pressure was greater in middle-aged and older patients (> or =40 years old). In young patients (<40 years old), the %HF decreased and the LF/HF increased during local anesthesia. In contrast, in middle-aged and older patients, the LF/HF decreased during local anesthesia. These results suggest 1) that middle-aged and older patients have a greater increase in blood pressure during dental surgery than younger patients, and 2) that the regulation of the autonomic nervous system during dental surgery differs between younger and older patients.

Adult↗
PubMed1998

[Surgery in De Medicina of Celsus].

Rediscovered during the Renaissance, Celsus' work (1st Century AD) is the first latin encyclopaedia. We only have his medical works, and we are indebted to him for his classification of diseases according to treatment: by diet, by drugs and manually, that is by surgery. Although surgery was described in Hippocrate's works, Celsus gave the first latin presentation, outlining, general and localised operations, in the VIIth book of De Medicina. The VIIIth book is devoted to orthopaedic operations which are sometimes quite different from Hippocrate's descriptions. For the first time, he describes many surgical instruments, most of which have been found by archaeologists. Finally, ethical considerations widen the epistemological field of surgery and separate it as autonomous specialty.

Encyclopedias as Topic↗
PubMed2004

Long-term results of high-dose extracorporeal and endocavitary radiation therapy followed by abdominoperineal resection for distal rectal cancer.

PURPOSE: To examine the complications, local effects, survival, and prognostic factors of preoperative high-dose radiation therapy in patients with advanced carcinomas of the distal rectum. METHODS: Forty-one patients with tethered or fixed rectal cancer located a median distance of 3.0 cm from the anal verge were treated with extracorporeal and endocavitary radiation therapy (70 Gy), followed 2 weeks later by abdominoperineal resection (APR). RESULTS: This combined radiotherapy achieved acceptable results. Postoperative complications developed in 18 patients (43.9%), 10 (24.3%) of which involved perineal dehiscence. Two patients (4.8%) suffered more than grade 3 toxicity. Destructive changes were histologically confirmed in all specimens, and there were four (9.8%) sterile specimens. Recurrence developed in 11 patients and there were 6 cancer-related deaths. Among six cases of local recurrence, three were found just outside of the radiation field. The 5-year survival and disease-free survival rates were 82.9% and 71.8%, respectively. Multivariate analysis revealed that nodal involvement was the sole independent prognostic factor for survival. Sexual function was maintained in the most recent patients who underwent APR with autonomic nerve-preserving surgery. CONCLUSION: Although the original aim of our treatment focused on curability, this combination therapy may be an option for selected patients, because of potential prevention of local recurrence, relatively low morbidity, and promising autonomic nerve function.

Adult↗