Transection Procedure Research Articles

SURGICAL TREATMENT OF ESOPHAGEAL VARICES

Between March, 1975, and March, 1988, 51 patients with esophageal varices due to portal hypertension were treated and thirty-eight of these underwent direct interruption surgery. One patient was carried out decompression surgery (distal splenorenal shunt).Twenty-two patients had liver cirrhosis, seventeen were diagnosed as idiopathic portal hypertension.We preferred the one-staged combined procedure of transabdominal transection using an autosuture apparatus, splenectomy and paraesophagogastric devascularization. The direct interruption procedure for the remaining patients were transthoracic esophageal transection, splenectomy with devascularization and others.The overall operative mortality rate within one month was 5/38 or 13%. Five-year survival rate in the 30 cases of transection surgery were 71%.Surgical therapy should be carried out as electively as possible, because of high mortality of emergency operation.

Brain transections differentially alter lordosis and ear wiggling of 6-day-old rats.

Six-day-old male and female rats display lordosis and ear wiggling in response to tactile stimulation of the flanks and rump, without priming by exogenous estrogen. The involvement of various brain regions in these behaviors, which resemble components of adult female sexual behavior, was examined by making acute transections along the neuraxis from the olfactory tract to the medulla in 6-day-old rats. Four to 5 hr after the transection procedure, pups were tested for lordosis and ear wiggling. Lordosis was severely reduced or eliminated in pups with cuts through the hindbrain or diencephalon (above the level of the mammillary bodies) but was relatively unaffected by cuts through the posterior hypothalamus and rostral tegmentum and by cuts rostral to the anterior hypothalamus. Ear wiggling was disrupted by transections throughout the hindbrain and was facilitated only in females by transections throughout the forebrain (anterior to the mammillary bodies). These data suggest that facilitation from the hypothalamus is required for lordosis in the infant rat and the forebrain inhibitory systems for ear wiggling are functional in female infants by 6 days of age. Similarities and differences between the neural control of lordosis and ear wiggling in infant and adult rats suggest that the infant sex-like behaviors may be precursors of adult female sexual behavior.

OBSEVATION OF ESOPHAGEAL VARICES AND PARAESOPHAGEAL COLLATERAL VESSELS BY USING ENDOSCOPIC ULTRASONOGRAPHY BEFORE AND AFTER ESOPHAGEAL TRANSECTION

We used endoscopic ultrasonography to observe the esophageal wall and paraesophageal collateral vessels in a case of esophageal varices, before after the two-staged combined procedure of thransthoracic esophageal transection with paraesophageal devascularization and transabdominal splenectomy with paragastric devascularization. Before the operation, esophageal varices were observed as groups of hypoechoic round vessels, and anastomosis of esophageal varices and paraesophageal veins was also observed by endoscopic ultrasonography. In the transgastric wall, short gastric veins and dilated winding splenic veins were observed. After esophageal transection, only esophageal wall thickness was observed. After an abdominal operation the short gastric veins were diminished, the splenic vein became narrow and a wall thrombus was observed. Endoscopic ultrasonography is useful for observation of the pathophysiology of esophageal varices.

The effect of the surgical procedure of transection on the chronic transsynaptic destruction following inferior alveolar neurotomy in adult rats

The effect of the surgical procedure of transection on the chronic transsynaptic destruction following inferior alveolar neurotomy in adult rats

HEMORRHAGE FROM GASTRITIS IN THE EARLY STAGE AFTER ESOPHAGEAL TRANSECTION WITH DEVASCULARIZATION

Hemorrhage from gastritis occurring within the first month after direct procedure for esophageal varices was studied. Three of 473 cases (0.6%) bled from endoscopically diagnosed gastritis. All 3 cases underwent the one-stage combined procedure of transthoracic esophageal transection and transdiaphragmatic splenectomy and paraesophagogastric devascularization. However, they did not undergo pyloroplasty, as is our usual procedure with paragastric devascularization. Only 4 cases underwent a one-stage operation without pyloroplasty, and 3 of them (75%) had complicating hemorrhagic gastritis. A possible cause of the hemorrhagic gastritis is a combination of decreased gastric mucosal defense factors with changes in gastric mucosal blood flow due to wide paragastric devascularization and increased gastric mucosal attack factors with disturbance of gastric emptying due to vagotomy. It may be conculuded that these changes remain only a short time after operation, because recurrent bleeding has not occurred in the 3 cases.

Successful endoscopic transaction of a partially obstructing antral diaphragm

A 14-yr-old girl presented with long-standing symptoms of partial gastric outlet obstruction due to an antral mucosal diaphragm that had a central aperture of 4–5 mm. The literature of this congenital malformation is reviewed with respect to diagnostic criteria and feasibility of endoscopic transection. The procedure and outcome of this first successful endoscopic transection of a partially obstructing antral diaphragm are reported.

Comparison of neurogenesis and cell replacement in the hamster olfactory system with and without a target (olfactory bulb)

The olfactory sensory neurons are unique in the vertebrate nervous system in that they are replaced following experimentally induced degeneration. Unilateral removal of the olfactory bulb in hamster results in degeneration of all mature receptor neurons followed by a neurogenesis and partial replacement of the receptor cell population. To determine if full recovery requires the presence of normal target tissue, a study of sensory neuron replacement was made following a nerve transection procedure, which leaves the olfactory bulb (target) intact. A comparison of quantitative measurements of cell number and thickness in the sensory epithelium showed that the presence of the target tissue alone did not result in improved recovery. One possible explanation is that complete recovery requires that axons of newly formed receptors must first re-establish synaptic contact with the olfactory bulb. To test this possibility, it will be necessary to include longer postoperative recovery times than those used in the present study.

Long-term results of bladder transection for urge incontinence.

One hundred and four patients with urge incontinence associated with detrusor instability who had failed to respond to standard conservative treatment were treated by a modified bladder transection procedure. Initially 74% were symptomatically cured, 14% were improved and 12% were failures. At 2 to 5 years after operation these results were 65%, 19% and 16% respectively. There was no significant morbidity and no mortality. Bladder transection is still a useful method of treatment for the refractory patient with detrusor instability, although improvements in conservative treatment have reduced the need for it.

Optimized transection: a prelude to oriented sectioning.

A technique is described which permits blocks of tissue to be flat-embedded in euhedral plastic castings and then to be transected along a plane so that sections may be cut which are optimally oriented to the internal ultrastructure of the block. In the transection procedure a hollow plastic cylinder is placed on the specimen trimming block. The cylinder's top prescribes a plane to which the tissue block is accurately oriented and clamped at a predetermined level. Two hand files and a burnisher are worked across the cylinder's top to 1) remove extraneous material above the plane of transection, 2) expose the tissue for sectioning and 3) smooth the block face. The clear plastic at the periphery of the exposed tissue is then easily trimmed away with a razor blade. The result is a block face with a flat, reflective surface which may be quickly aligned to the knife on the ultramicrotome. The effort needed to transect, align and face the block is minimal and 1-micron or semithin sections produced will be precisely parallel to, and at, the plane of transection. Dust produced by the transection procedure is easily eliminated from the work area by use of a small disposable vacuum cleaner. The technique of producing optimally oriented light microscope sections, using the transector, is enhanced by application of solvents to the block face which cause it to develop a temporary low relief, exactly matching the structural detail of sections cut from the block face.(ABSTRACT TRUNCATED AT 250 WORDS)

The Surgical Treatment of Urge Incontinence of Urine

A modified bladder transection procedure was used in 44 patients with severe urge incontinence of urine who had failed to respond to standard conservative treatment. More than 75 per cent of the patients had complete or almost complete relief of symptoms and this improvement has been maintained. Half of the patients with less satisfactory results have been improved by measures that had failed before transection. The reasons for this finding and the mechanism of effect of bladder transection are discussed.

A survey of fish populations at Karikari Peninsula, Northland, by scuba diving

Census data for fishes observed by scuba divers at selected sites on the east coast of Karikari Peninsula, Northland, are given qualitatively in a checklist. Sixty‐four species in 33 families were recorded. Significant new records were those for surgeonfish (Prionurus maculatus Ogilby) and rainbow parrotfish (Suezichthys sp.). A system for quantification of densities by an underwater transect technique is presented and results are given for three sites; this method could be used by amateur divers to obtain data on the status and structure of coastal reef fish populations in New Zealand. A standardised transect procedure for divers to follow to obtain comparable results is given.

Plasticity of the acoustic startle response in the acutely decerebrate rat.

Plasticity of the acoustic startle reflex was measured in rats in which a complete transection between the forebrain and midbrain was made. During a period from 60 to 100 min after surgery, startle amplitude in the transected rats was relatively stable and comparable with that of the controls (which had been anesthetized with halothane and placed in a stereotaxic instrument). During this period the transection did not alter the temporal recovery process (with intervals of 2, 4, 8, or 16 sec) or auditory prepulse inhibition (with intervals of 25, 50, 100, 500, or 1,000 msec) or the normal reduction in startle caused by high levels of background noise. The transection did prevent the normal increase in startle caused by moderate levels of background noise and eliminated within-session habituation. The effect on habituation was particularly convincing since the curves of the transected and nontransected rats actually crossed. The results are discussed in terms of how the transection procedure can be used to evaluate various hypotheses about underlying mechanisms of startle plasticity.

The effect of preventing eruption on the proliferative basal tissues of the rat lower incisor

Eruption was prevented in the continuously growing lower right incisor of 9 male and 10 female Wistar rats by the surgical procedure of either complete or partial root transection, thereby allowing for a separation of the process of tooth eruption from that of basal cell proliferation. The experimental tooth was cut down to the gingival margin immediately following operation to eliminate masticatory stress. Animals were killed 120 days after operation, following which the jaws were dissected out, radiographed and then sectioned. Following cessation of eruption, the outline of the basal portion of the “root” showed one of the following arrangements: (1) in 10 jaws it was in the form of a smooth curve similar to that of controls, (2) in 3 jaws it was more sharply curved than the controls so that the pulp opening faced directly upwards, (3) in the remaining 6 jaws it was completely recurved so that the pulp opening was directed anteriorly. Histological examination revealed the presence of continued enamel and dentine formation in this basal region with the latter tissue completely obliterating the normal pulp cavity except for a small cone-shaped area at the base. These results clearly demonstrate that the proliferative basal region of the rat incisor is capable of generating a force when eruption is prevented, sufficient to cause a significant change in root morphology. In one complete root transection specimen, the proximal segment continued to erupt forwards and penetrated the side of the socket and then the cheek to reach the exterior.