Unilateral Resection Research Articles

Results following surgical treatment of hyperthyroidism.

In the years 1965-1978 1,222 patients with different types of thyrotoxicosis underwent surgical treatment at the 1st Department of Surgery, University of Vienna. Wherever possible a sparing selective surgical approach was considered preferable: autonomous adenoma (45%) enucleation resection or subtotal uni-lateral resection; multinodular toxic goiter (36%) and Graves disease (5%) uni- or bilateral subtotal resection. The remaining 5% were rather rare types of goiter (recurrent goiter, thyroiditis, adenocarcinoma). Overall mortality due was 0.7%. One-hundred and seven patients (8.76%) were over 70 years old at the time of the operation. Post-operative death occurred in the group of patients with toxic adenomas (2.7%). Four-hundred and ninety-five patients were followed up from 3-13 years postoperatively: the rate of recurrent thyrotoxicosis was 4.4%, 4.8% of the patients with hypothyroidism. In this paper the significance of the rapid effect of surgery in cases of hyperthyroidism is discussed and the results are compared with findings in other studies.

Die endolaryngeale Lateralfixation der Stimmlippe zur operativen Behandlung der beiderseitigen Recurrensparese (Langnikkel?Koburg)

The film demonstrates our modification of Thornell's operation for patients with bilateral vocal cord paralysis. The procedure involves a unilateral arytenoidectomy and triangular resection of the posterior half to 2/3 of ipsilateral false cord as well as part of the thyroarytenoid muscle. The vocal cord is then sutured into its new position which is superior and lateral of its original position. The good functional results are attributed to the fact the vocal cord substance is retained and that a functionally active vocal cord is achieved.

Decreased exercise hyperpnea in patients with bilateral carotid chemoreceptor resection.

Exercise hyperpnea was compared in 5 asthmatics 25 yr after bilateral carotid body resection (BR), 4 others 19 yr after unilateral resection (UR), and 12 controls (C) matched for age and pulmonary flow limitation. In the BR group, ventilation rose less with exercise, mostly because BR experienced less tachypnea. End-tidal PCO2 rose 5.8 +/- 3.2 (P less than 0.05) to 46 Torr at 50 W. In UR and C the same load did not increase PETCO2 significantly (+2.1 and +1.4 Torr, respectively). Arterial-end-tidal PCO2 differences before and 15--45 s postexercise were insignificant in all three groups. Heart rate and blood pressure rose equally in the three groups, suggesting that the ventilatory effects were not secondary to blood flow differences and disclosing no evidence of baroreceptor denervation during glomectomy.

Extended Indications for Median Sternotomy in Patients Requiring Pulmonary Resection

We have employed median sternotomy in 9 patients for resection of both benign and malignant lung lesions. The most frequent use of this approach was for bilateral wedge resection, though unilateral resection was done in 2 patients. Our experience supports the previously documented usefulness of median sternotomy for minor bilateral resections and suggests that more complex pulmonary resections are possible when an appropriate indication exists. We compared the effects of median sternotomy with those of lateral thoracotomy on postoperative vital capacity and peak airway flow. Both incisions result in a marked loss of measured lung function, but recovery occurs notably sooner after median sternotomy than after lateral thoracotomy.

Prenatal removal of frontal association cortex in the fetal rhesus monkey: anatomical and functional consequences in postnatal life.

Anatomical and behavioral consequences were examined following bilateral or unilateral resections of the presumptive dorsolateral prefrontal cortex in 4 rhesus monkey fetuses at E102 (102nd embryonic day), E104, E106 and E119, with subsequent replacement in utero and delivery at later stages of development. Unoperated monkeys of appropriate pre- and postnatal ages served as controls for certain features of morphogenesis and tectogenesis. Monkeys given comparable unilateral or bilateral lesions at selected postnatal ages were used as controls for the behavioral effects of prenatal resection as well as for neuropathological examination. The behavioral evaluation provided evidence for extraordinary preservation of function after frontal cortical resection in the prenatal period. During the entire course of its postnatal development, a monkey that sustained bilateral resection as a fetus at E106 performed surprisingly well and clearly with the competence of unoperated monkeys of identical or older ages on tasks selective for dorsolateral prefrontal cortical function; it did not exhibit deficits characteristic of animals that have comparable or even smaller resections as juveniles or adults. Following either unilateral or bilateral resection prior to E106, ectopic sulci and gyri appeared in intact regions of the frontal lobe of each hemisphere, as well as in locations at a considerable distance from the lesions, such as the temporal and occipital lobes. The cytoarchitectonic characteristics of the cortex in these anomalous gyri were typical of adjacent cortex in the regions in which they appeared. Examination of the parvocellular subdivision of the mediodorsal thalamic nucleus yielded the novel finding that this principal source of essential projections to the dorsolateral prefrontal cortex contained a virtually normal number of neurons in postnatal monkeys, following unilateral or bilateral lesions performed at or before E106, and exhibited only a partial loss of neurons after surgery at E119. The same cells regularly degenerate following comparable resections in the postnatal period. The survival of these neurons in prenatally operated monkeys is unprecedented, and can be explained by several hypotheses, including the possibility that their axons become rerouted to their structures in the absence of their normal targets. The present results thus demonstrate that ablation of a circumscript area of the frontal cortex in a non-human primate a full two months before birth may leave the functions later to be subserved by that area unaffected. Such early surgical intervention results in significant alteration in the gross morphological characteristics of the cortex, and apparently induces a functionally compensatory reorganization of thalamocortical connections. Similar principles may account for sparing of function following early damage to the human brain.

Differential craniofacial skeletal changes after postnatal experimental surgery in young and adult animals.

To find answers to the many questions about abnormal postnatal growth and change of the craniofacial skeleton, a series of surgical experiments was carried out in both young and adult animals. The purpose of this review is to relate this information to basic ideas about bone change and some local factors which may or may not affect skeletal changes. No gross regional deformity was noted after resection of sutures in young animals. The growth of bone at sutures was secondary or compensatory to other factors. In young animals, increase in size of the nasal or orbital cavities decelerated considerably after resection of either nasal septum or orbital tissues. With an increase in volume of orbital contents, orbital volume increased. These prominent gross changes in young animals were not noted in adult animals after resection of nasal septum, enucleation of the eye, or intrabulbar injection of silicone. After unilateral resection of the mandibular condyle in both young and adult monkeys, an extreme unilateral facial skeletal deformity developed. The important factor apparently was loss of integrity of the temporomandibular joint rather than loss of a growth site. The craniofacial skeleton, a three-dimensional mosaic of bones and cavities, develops as a result of the synchronous coordination of the differential activities at various sites. The dynamics of the growth and change are a fascinating, complex, incomplete chapter of biology. An understanding of factors that may or may not influence the craniofacial skeleton in both young and adult animals can aid diagnosis and surgical treatment.

Antagonistic compensation as a function of reduced weight bearing

The principle of antagonistic compensation was presented by RIESENFELD in 1966 to explain the relative shortening and broadening of hypofunctional bones. Few studies have concerned themselves with this phenomenon, even though the causative agent(s) have not been delineated. In this study, RIESENFELD induced the hypofunction by complete unilateral bilateral forelimb amputation. The resulting hypofunctional condition may be attributed to the lack of muscle function or to the lack of weight bearing or both in combination. In the present study weight bearing was eliminated in such a manner as to preserve muscle functioning. This was accomplished by two techniques: (1) unilateral forearm amputation and (2) unilateral humeral resection. Statistically significant differences in interindividual scapular length and breadth as well as humeral and ulnar lengths are reported. In all cases, the bones of the operated side were shorter than those of the unoperated side and the scapular breadth of the unoperated side was relatively greater. This confirms the hypothesis that weight bearing is, at least, partially responsible for the morphological changes induced by hypofunction and described by the principle of antagonistic compensation. However, as the reduction in length was of a lesser magnitude than that reported by RIESENFELD, the input of muscle function cannot be ignored. Rather, as both muscle functioning and weight bearing induce compressive force on long bones (including the scapula), both may serve to initiate the observed morphological changes through the vehicle of reduced compression.

The problem of unilateral and bilateral neck dissection.

270 unilateral and bilateral neck resections have been performed in different primary localisations of tumours in the head and the neck at the Ear, Nose and Throat Department of the Medical Faculty in Zagreb in the period 1960-70. Of 209 patients with unilateral resection, only 78 survived (37%), while only 3 patients (4.9%) survived of a total of 61 patients where bilateral resection was performed. An analysis is given separately of radical resection in carcinoma of the larynx, the hypopharynx and the skin. From this analysis and from immunologic considerations, the following conclusions are derived: (i) The authors are not in favour of prophylactic block resection as this would be contrary to our knowledge of the role played by the immunobiological factors in the struggle against the malignant lesion. (ii) Evacuation of the neck must be performed in carcinoma of the larynx T3 and in hypopharyngeal carcinoma, as histologically positive lymph nodes are usually found in this site in large numbers.

Urographic kidney appearances secondary to upper pole resection

In a series consisting of 40 pediatric patients submitted to unilateral resection of the upper renal pole, preand postoperative intravenous urograms were compared. Positional alterations secondary to the heminephrectomy were assessed by analysis of urographic appearances. Generally, rotation around the long axis of the kidney was the most marked change noted and tilting of the kidney in the frontal or saggital plane was usually less apparent. The movement was commonly multidirectional. Postoperative changes of the kidney configuration were recorded. The practical implications of the findings are discussed.

Tubal surgery in the rabbit: fertilization and polyspermy after resection of the isthmus.

AbstractTransport and capacitation of spermatozoa, and the normality of the process of fertilization, were examined after unilateral resection of the isthmus and end‐to‐end anastomosis of the remaining portions of the Fallopian tube. The operation was performed in eighteen rabbits, in each of which the contralateral tube remained intact to serve as a control.Recent ovulations were present in fourteen animals at autopsy, although in only eleven were ovulations detectable on the side of the anastomosis. Thirteen animals yielded a total of 89 eggs, the proportion recovered from the control tube (79.3%) being significantly higher than that from the anastomosed tube (57.2%). Six of nine anastomosed tubes yielding eggs were patent to sperm passage, and 67% of the eggs recovered from this side were fertilized compared with 91% from the control tubes. Three eggs recovered from the anastomosed tube of three animals were dispermic. It is concluded that normal fertilization and early cleavage of rabbit eggs can take place in the absence of the isthmus, and that the rate of cleavage is not retarded under such conditions. An increased number of spermatozoa on the eggs from the anastomosed tube, together with the incidence of dispermic eggs, indicates that the isthmus exerts considerable control over sperm transport to the site of fertilization.

Polyspermic fertilization following tubal surgery in pigs, with particular reference to the rôle of the isthmus.

Unilateral resection of the isthmus of the Fallopian tube followed by end-to-end anastomosis of the remaing parts was done in 21 naive pigs to determine if fertilization of eggs could occur in the absence of the isthmus. Following surgery ovulation and subsequent mating occurred. The animals were slaughtered immediately following estrus eggs from sor the anastomosed and the control tube were recovered. 15 of 18 animals exhibited newly formed corporea lutea on left ovaries. In 3 animals adhesions probably caused by dehydration during surgery inhibited or retarded ovulation. Ovulations occurred on both ovaries when sufficient saline irrigation during surgery reduced the number of adhesions. Prese nce of spermatozoa in the zona pellucida after recovery of cleaved and single celled eggs means that the egg-bearing Fallopian tubes were patent above and below the anastomosis and that fertilization had indeed occurred without the presence of the isthmus. Normally the isthmus limits passage of spermatozoa to the fertilization site. In cases where the isthmus was removed there was an increase of up to 10 times as many spermatozoa on the eggs. It is believed that the isthmus normally acts as a reservoir from which spermatozoa are released during estrus. Although tube patency was evident and fertilization did occur egg transport through scarred portions of the anastomosis may be hindered. It is questionable whether or not infertility in women with occluded Fal lopian tubes can be alleviated via tubal surgerty.

Effects of Olfactory Bulb Resection Upon the Hair Waves in Mice

Bilateral and unilateral resection of the olfactory bulbs was performed in groups of male C3H/Ep mice while the controls were sham-operated. All the animals were clipped along the back from the neck to the base of the tail. The advance of the hair waves was observed at weekly intervals and the denuded area covered by hair measured for 48 days. The animals were clipped again and observed in the same way during a 77 day period, at the end of which a complete autopsy was performed and the endocrine organs were weighed. The rate of advance of the hair waves was slower in the animals with bilateral resection of the olfactory bulbs, intermediate in those with unilateral resection and faster in the sham-operated controls in both experimental periods. There was atrophy of the adrenals, testicles, pituitary, thyroid and thymus in the animals with olfactory bulb removal.

Effects of Microsurgical Removal of the Rabbit Uterotubal Junction

25 mature New Zealand white rabbit does (weighing between 3500 and 4500 grams) were used in an investigation to determine whether resection of the uterotubal junction (UTJ) alters the postovulatory functional blocking mechanism which keeps newly fertilized ova in the oviduct from 72-96 hours. A unilateral resection of the UTJ was performed in each animal. 2 of the 25 rabbits died 1-3 days following the anastomosis. 2 other rabbits refused the male although isolated on 2 occasions for a period of 21 days. In these 2 rabbits laparotomy disclosed a paucity of follicles in either ovary; no corpora lutea or adhesions were found and the anastomosis was patent. 10 additional rabbits failed to have pregnancies in either side despite many corpora lutea present in their ovaries. Many adhesions had formed in these 10 animals immobilizing their oviducts. Dissection of these adhesions around the oviducts revealed that the fallopian tubes were not distended with accumulated fluid and the anastomosed area was patent. 11 of the rabbits were pregnant on both sides. 8 of these animals were in good condition. In 2 there were fine adhesions between omentum and bladder and between intestines. In all instances the oviducts and uterine horns were free and mobile. A good correlation between the number of corpora lutea and the number of implantations of the control side was found.

UNILATERAL GLAUCOMA FOLLOWING RESECTION OF A TUMOR OF THE SUPERIOR FORNIX.

Introduction The excellent editorial on secondary openangle glaucoma in the April, 1963,Archives of Ophthalmology 1 prompted this paper. To quote, it has become increasingly clear that many chronic open angle glaucomas formerly considered to be primary are in fact secondary. The purpose of this report is to describe a case of unilateral open-angle glaucoma which occurred in association with a large tumor of the superior fornix and became worse after repeated resection of the tumor. Case. —I first saw the patient in April, 1958. One year previously he had had a tumor removed from the left superior fornix. He was asymptomatic until February of 1958 when he noted a mass beneath the left upper lid at the site of the previous surgery. His general health and family history were noncontributory. Ocular examination revealed corrected vision of 20/20 in each eye. Extraocular muscles were within normal limits. Ocular fundi were

Experimental progressive scoliosis in the rabbit.

1. By unilateral resection of the posterior ends of the sixth to eleventh ribs including the costal parts of both costo-vertebral joints, progressive scoliosis can regularly be provoked in young rabbits. Rotation of the vertebrae is prominent in the experimental deformity. 2. Although severe progressive scoliosis can be provoked by a surgical procedure we do not yet know the deforming forces which are released by the operation, but the way lies open for accurate studies on these factors. 3. It seems possible that studies on experimental progressive scoliosis may provide us with new methods to counteract or cure scoliosis in children. The goal is a means to reverse the deforming forces during growth so that the child's spine is straight when growth ceases.

Unilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Unilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Chapter 6. Unilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Chapter 6. Unilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Chapter 8. Bilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Chapter 8. Bilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Bilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Bilateral Bronchiectasis Treated by Unilateral Lobectomy and/or Unilateral Segmental Resection

Report of a case of partly cancerous enamelblastoma with special referene to jaw prosthetic after unilateral resection of the mandible

Report of a case of partly cancerous enamelblastoma with special referene to jaw prosthetic after unilateral resection of the mandible