No abstract available.
Osteoporosis*

No abstract available.

No abstract available.
Osteoporosis*

No abstract available.

No abstract available.

No abstract available.
Parathyroid Hormone-Related Protein

BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.
Breathing Exercises ; Cough ; Dyspnea ; Heart Rate ; Humans ; Incidence ; Motivation* ; Organization and Administration ; Prospective Studies ; Respiration* ; Spirometry* ; Sputum ; Thorax

No abstract available.
Blister* ; Thoracotomy*

PURPOSE: The purpose of this study was to determine whether Fas-L expression is associated with increased apoptotic induction of tumor-infiltrating lymphocytes (TIL) in human gastric carcinomas. MATERIALS AND METHODS: The author analysed 38 cases of early gastric carcinoma (EGC) and 61 cases of advanced gastric carcinoma (AGC) who received gastric resection, in whom the number of diffuse type was 38 cases and the number of intestinal type was 61 cases. The author used immunohistochemical staining for Fas, Fas-L and CD45, and TUNEL in situ apoptosis detection kit. TIL were detected by CD45 and apoptosis of TIL were detected by CD45 expression and TUNEL positivity on serial histologic sections. RESULTS: Fas-L was localized to neoplastic cells in 61% (23/38) of EGC group and 66% (40/61) of AGC group. The extent of Fas-L expression was variable, with both Fas-L positive and negative neoplastic region occuring within tumors. TIL adjacent to Fas-L expressing tumor region were decreased in number and TIL adjacent to FasL-negative tumor region were increased in number; apoptotic induction of TIL showed just the opposite pattern (p<0.05). Fas expression was found essentially homogeneously throughout the tumor mass independent of tumor stage. Fas expression showed 64% (39/61) of intestinal type and 68% (26/38) of diffuse type. Labeling indices for tumoral apoptosis in EGC and AGC were 6.72% and 7.13%, respectively and this difference was statistically insignificant. Co-expression of Fas-L and Fas, which occurred over large areas of the tumors, did not result in an enhanced rate of tumor cell apoptosis. In addition, factors such as tumor stage and other prognostic factors were not concerned in Fas and Fas-L expression, number of TIL and apoptotic induction. CONCLUSION: These findings suggest Fas-mediated apoptotic depletion of TIL in response to Fas-L expression by stomach cancers, and provide the evidence to support the Fas counterattack as a mechanism of immune escape in gastric cancer. In addition, gastric carcinoma cells of the intestinal and diffuse type did not differ in their expression of the apoptotic receptor Fas.
Apoptosis* ; Humans ; In Situ Nick-End Labeling ; Lymphocytes, Tumor-Infiltrating ; Stomach Neoplasms ; United Nations

A vesicovaginal fistula is a distressing complication which may follow hysterectomy and other extensive pelvic operation. Maligntncies of the uterin cervix or bladder may predispose to erosion and vesicovaginal fistula or such fistulas may occur as a result of extensive radiation therapy. Childbirth, particularly involving prolonged labor with potential necrosis of the vesico vaginal septum or complicated delivery with trauma may also induce a vesicovaginal fistula. In this experience the most common cause of vesicovaginal fistula resulting from surgery was total abdominal hysterectomy. Diagnosis of vesicovaginal fistula is usually made when appearance of methylene blue in the vagina after instillation of the dye into the bladder and further confirmed the presence and definitive localization of the fistula with cystoscopic examination. The operative procedures, the authors utilized were suprapubic transvesical closure in 8 cases, vaginal closure in two cases, and transabdominal approach in one case. The bladder was opened at the dome and then stay sutures were made at 1.0cm from the fistula margin. Then, the fistulous tract was excised making a lateral margin wide enough to leave viable tissue for subsequent closure. Vaginal wall and bladder wall closure were carried out in whole layer using interrupted 2 zero chromic suture. In one case of large fistula with high opening, the patient was underwent transabdominal method interposing a peritoneal flap between vagina and bladder wall. A urethral catheter was placed for 10 to 12 days postoperatively. In 5 cases of ureterovaginal fistula, one patient required the nephrectomy because of pyonephrosis, 2 patients refused further medication, one had ureteral reimplantation and another patient had psoas hitch and Boari operation. The following conclusions were obtained. 1. The most common cause of vesicovaginal fistula was the complication of total hysterectomy. 2. The diameter of fistulous tract was ranging from 1 to 10 mm. 3. For the repair of vesicovaginal fistula transvesical approach were 8 out of in 13 case, vaginal route in 2 cases, intraabdominal approach using a peritonal flap in one case. 4. Urethral catheter had been placed postoperatively was removed on the 12th postoperative day in most cases. Ureteral splint catheter was also placed for 8 to 10 days postoperatively. 5. 12 out of 14 cases, urinary vaginal fistulas were successfully closed on the first surgical attempt and one case healed on the second attempt. One case failed because of infection at the area of closure.
Catheters ; Cervix Uteri ; Diagnosis ; Female ; Fistula ; Humans ; Hysterectomy ; Methylene Blue ; Necrosis ; Nephrectomy ; Parturition ; Pyonephrosis ; Replantation ; Splints ; Surgical Procedures, Operative ; Sutures ; Ureter ; Urinary Bladder ; Urinary Catheters ; Vagina ; Vaginal Fistula* ; Vesicovaginal Fistula