Long-term survival of patients with stage IV hypopharyngeal cancer: impact of fundus rotation gastroplasty.

Stage IV circular hypopharyngeal cancer is a disease with poor long-term survival, and the only means of cure-surgery-is associated with high morbidity. All patients admitted with circular hypopharyngeal cancer and extension to the esophagus were enrolled in a multidisciplinary treatment protocol, including circular laryngopharyngoesophagectomy with tracheostomy, neck dissection, and pull-up of a fundus rotation gastric tube that was anastomosed to the oropharynx. Five weeks postoperatively high-dose radiotherapy (60 Gy) was given to the cervical region.

[Stomach carcinoma as a surgical emergency].

Perforated or bleeding gastric cancer is a life threatening situation that occurs in less than 10% of all patients with gastric cancer in the Western world. Three quarters of these complicated gastric carcinomas show advanced stages (UICC stages III and IV). Diagnosis is made intraoperatively only in the majority of patients.

Substitution at codon 22 reduces clearance of Alzheimer's amyloid-beta peptide from the cerebrospinal fluid and prevents its transport from the central nervous system into blood.

A point mutation of G to C at codon 693 of the amyloid-beta (Abeta) precursor protein gene results in Glu to Gln substitution at position 22 of the Abeta (AbetaQ22) associated with hereditary cerebrovascular amyloidosis with hemorrhage Dutch type. Factors that regulate AbetaQ22 levels in the central nervous system (CNS) are largely unknown. By using ventriculo-cisternal perfusion technique in guinea pigs, we demonstrated that clearance from the cerebrospinal fluid and transport from the CNS to blood of [(125)I]-AbetaQ22 (1 nM) were reduced by 36% and 52%, respectively, in comparison to the wild type Abeta(1-40) peptide.

Acute radiation colitis in patients treated with short-term preoperative radiotherapy for rectal cancer.

The histopathologic features of acute radiation-induced colitis in humans have been described in occasional, >20-year-old studies, but they have not been analyzed in detail. We characterize such findings in 34 patients with rectal cancer who underwent surgery a few days after preoperative irradiation with 25 Gy given over 5-7 days, and we compare the results to the histopathologic features detected in 18 patients treated by a conventional preoperative irradiation protocol consisting of 45 Gy during 5 weeks followed by surgery after a time interval of at least 3 weeks. Short-term preoperative irradiation therapy generally induced severe mucosal inflammation characterized by increased cellularity of the lamina propria, prominent eosinophilic infiltrates, crypt disarray, surface and crypt epithelial damage, nuclear abnormalities, and presence of apoptotic bodies in the crypt epithelium.

[The transverse coloplasty pouch. Review of experimental data and clinical application].

The transverse coloplasty pouch. Review of experimental data and clinical application. The transverse coloplasty pouch is a novel technique for sphincter preserving colonic reconstruction after total mesorectal excision.

[Esophageal resection with fundus rotation gastroplasty].

Esophageal resection with fundus rotation gastroplasty. Anastomotic failure after esophageal resection remains a surgical problem with high clinical relevance. Anastomotic failure can be attributed to tension at the anastomosis especially in cervical anastomoses, as well as a perfusion deficit due to resection of the arterial arcade along the gastric lesser curvature.

A new surgical concept for rectal replacement after low anterior resection: the transverse coloplasty pouch.

Objective: To analyze the feasibility, safety, complication and death rates, and early functional results of the transverse coloplasty pouch procedure after low anterior rectal resection and total mesorectal excision.

Summary Background Data: The authors previously developed a novel neorectal reservoir, the transverse coloplasty pouch, in an animal model; they report the first clinical data of a prospective phase 1 study.

Methods: Forty-one patients underwent low anterior rectal resection with total mesorectal excision for rectal cancer (n = 37) or benign pathology (n = 4).

Visual object localisation in space. Interaction of retinal, eye position, vestibular and neck proprioceptive information.

Perceptual updating of the location of visual targets in space after intervening eye, head or trunk movements requires an interaction between several afferent signals (visual, oculomotor efference copy, vestibular, proprioceptive). The nature of the interaction is still a matter of debate. To address this problem, we presented subjects (n=6) in the dark with a target (light spot) at various horizontal eccentricities (up to +/-20 degrees ) relative to the initially determined subjective straight-ahead direction (SSA).

Total mesorectal excision preserves male genital function compared with conventional rectal cancer surgery.

Background: The introduction of total mesorectal excision (TME) has been shown to improve local recurrence rates in rectal cancer. The present study investigated the impact of this more extensive and radical procedure with regard to autonomic pelvic nerve function.

Methods: Patients with resected primary rectal cancer were interviewed by means of a questionnaire asking about preoperative and postoperative urinary bladder and genital function.

Overexpression of activin A in stage IV colorectal cancer.

Background And Aims: Activins and inhibins are dimeric polypeptides that belong to the transforming growth factor beta (TGF-beta) superfamily and that bind to transmembrane receptors with serine/threonine kinase activity. The aim of this study was to characterise, in colon cancer cell lines and in normal and malignant human colon tissues, levels of expression of inhibin subunits that are involved in activin/inhibin dimer formation, and of the type I and II activin receptors (actRI and actRII).

Methods: Expression of inhibin subunits and activin receptors was analysed by northern blot analysis.

Effect of bilateral subthalamic nucleus stimulation on gait in Parkinson's disease.

The fundamental disturbance of the parkinsonian gait is the reduction in walking velocity. This is mainly due to reduction in stride length, while cadence (steps/min) is slightly enhanced. Treatment with L-dopa increases stride length while cadence is unchanged.

Ketoconazole and pulmonary failure after esophagectomy: a prospective clinical trial.

Thromboxane is a key mediator in pulmonary injury after esophageal resection. In this prospective trial we studied the clinical course and development of pulmonary alterations in patients undergoing esophagectomy and prophylactic treatment with a thromboxane synthase inhibitor. Thirty-eight consecutive patients undergoing esophageal resection were treated pre- and perioperatively with 3 x 200 mg ketoconazole.

[Aspergillous bronchitis in an immunocompetent patient].

We report a case of aspergillous bronchitis in an immunocompetent patient, recalling the clinical signs, laboratory findings and therapeutic management of this uncommon bronchopulmonary disorder related to aspergillus.

[Severe pulmonary sarcoidosis].

Mediastinal and pulmonary localizations are found in 90% of al patients with sarcoidosis. In half the cases, the disease is not severe and is reversible without treatment. In the other half of cases, early or late respiratory complications can be seen.

Primary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey Stage III and IV): a prospective outcome and cost analysis.

Purpose: Our hypothesis was that in patients with perforated sigmoid colon diverticulitis and peritonitis (Hinchey Stage III and IV) a one-stage sigmoid colon resection is safe and cost effective when performed by an experienced colorectal surgeon. We evaluated outcome and cost of one-stage vs. two-stage sigmoid colon resection after diverticulitis perforation and peritonitis.

Fiducial point placement and the accuracy of point-based, rigid body registration.

Objective: To demonstrate that the shape of the configuration of fiducial points is an important factor governing target registration error (TRE) in point-based, rigid registration.

Methods: We consider two clinical situations: cranial neurosurgery and pedicle screw placement. For cranial neurosurgery, we apply theoretical results concerning TRE prediction, which we have previously derived and validated, to three hypothetical fiducial marker configurations.

Improved activity of an actin-resistant DNase I variant on the cystic fibrosis airway secretions.

In cystic fibrosis (CF), actin and DNA originating from inflammatory cells contribute to the thickness of airway secretions. Actin can bind to DNA-rich fibers and potently inhibit the enzymatic activity of rhDNase. The in vitro effects of the actin-resistant rhDNase variant (A114R) were analyzed and compared with those of the wild-type rhDNase.

[Modern surgical treatment of esophageal carcinoma].

Curability of esophageal cancer has increased significantly during the last two decades by inducing stage adapted multimodal treatment strategies and radical resections. This overview summarizes advantages and disadvantages of various operative approaches, the extend of resection and methods to substitute the esophagus.

Human balance control during cutaneous stimulation of the plantar soles.

Previous work on human postural control of upright stance, performed in the absence of visual and vestibular orientation cues, suggests that somatosensory cues in the feet enable subjects to maintain equilibrium during low-frequency platform tilts. Here we confirm earlier studies which indicated that stimulation of plantar cutaneous mechanoreceptors can lead to postural responses. Yet, this stimulation did not modify considerably the postural reactions of normal subjects and vestibular loss patients during platform tilts.

[2-year evaluation of a cooperation model between a surgical university clinic and a general hospital].

Introduction: On 1 January 1998 a cooperation between an university hospital and a peripheral general hospital was initiated with the aim of reducing waiting lists and health care costs. Surgical patients initially referred to the Department of Visceral and Transplantation Surgery of the University of Bern (Inselspital) were evaluated and selected in the outpatient clinic for an operation in the peripheral hospital Grosshöchstetten. The operation and postoperative care in Grosshöchstetten was performed by a team from the university department according to the standard concept also utilized at the university hospital.

Design and evaluation of a system for microscope-assisted guided interventions (MAGI).

The problem of providing surgical navigation using image overlays on the operative scene can be split into four main tasks--calibration of the optical system; registration of preoperative images to the patient; system and patient tracking, and display using a suitable visualization scheme. To achieve a convincing result in the magnified microscope view a very high alignment accuracy is required. We have simulated an entire image overlay system to establish the most significant sources of error and improved each of the stages involved.

Response of psoriasis to interleukin-10 is associated with suppression of cutaneous type 1 inflammation, downregulation of the epidermal interleukin-8/CXCR2 pathway and normalization of keratinocyte maturation.

Psoriasis is a chronic inflammatory skin disease in which epidermal hyperplasia results from the release of cytokines by infiltrating type 1 T cells. Up- regulation of endogenous interleukin-10 controls type 1 skin responses in animal models; however, interleukin-10 production is low in psoriatic lesions. Consistent with an important role of interleukin-10 in psoriasis, we and colleagues have recently demonstrated clinical efficacy of subcutaneous administration of recombinant interleukin-10 to affected patients.

Adaptive changes of saccadic eye-head coordination resulting from altered head posture in torticollis spasmodicus.

We asked whether and how the abnormal head posture in torticollis patients affects saccadic gaze shifts and impairs the associated head movements. We wanted to learn to what extent observed changes directly result from the disease or reflect compensatory mechanisms, secondary to the altered head posture. We compared the results of patients with those of normal subjects.