Percutaneous Cryoablation of Pulmonary Metastases from Colorectal Cancer

Objective: To evaluate the safety and efficacy of cryoablation for metastatic lung tumors from colorectal cancer. Methods: The procedures were performed on 24 patients (36–82 years of age, with a median age of 62; 17 male patients, 7 female patients) for 55 metastatic tumors in the lung, during 30 sessions. The procedural safety, local progression free interval, and overall survival were assessed by follow-up computed tomographic scanning performed every 3–4 months. Results: The major complications were pneumothorax, 19 sessions (63%), pleural effusion, 21 sessions (70%), transient and self-limiting hemoptysis, 13 sessions (43%) and tract seeding, 1 session (3%). The 1- and 3-year local progression free intervals were 90.8 % and 59%, respectively. The 3-years local progression free intervals of tumors #15 mm in diameter was 79.8 % and that of tumors.15 mm was 28.6 % (p = 0.001; log-rank test). The 1- and 3-year overall survival rates were 91% and 59.6%, respectively. Conclusion: The results indicated that percutaneous cryoablation is a feasible treatment option. The local progression fre

Inhibition of Food Transportation in the Rat Stomach from Hepatic Branch Vagotomy

The transportation of residual food particles (RFP) in the stomach after hepatic branch vagotomy (HBV) in rats were examined. Weights of the RFP increased 3 and 7 days after vagotomy, but the RFP response disappeared 14 days later. No significant difference in the food and water intake between control and HBV animals was seen during the experimental periods. The wet weight of the stomach 3 days after vagotomy was greater in the HBV rats than in the HBV control rats. These results suggest that the hepatic vagal nerve participates in the transportation of food in the stomach.departmental bulletin pape

Responses in Portal Venous Flow and Pressure Produced by Cerebral Sympathetic Activation in Rats

Changes in portal venous flow (PVF) and portal venous pressure (PVP) were examined following sympathetic activation with cerebral ischemia in rats. Cerebral ischemia with carotid arterial occlusion (30 s) produced a reduction in PVF concomitant with an increase in PVP, and an inverse relationship between PVF and PVP was detected. Nanomolar quantities of adrenaline injected into the portal vein brought similar responses in PVF and PVP that were seen after cerebral ischemia. The PVF response produced by the ischemia disappeared when the hepatic splanchnic branch or bilateral splanchnic nerve was sectioned. At the same time, the PVP response produced by the ischemia was blocked by sectioning the bilateral splanchnic branches. In contrast, sectioning the hepatic splanchnic branch did not completely abolish the response. In the superior mesenteric vein, blood flow decreased with an increase in pressure after cerebral ischemia; these responses were blocked by sectioning the bilateral splanchnic nerves, but sectioning the hepatic splanchnic branch exerted no influence. Blood flow in the splenic vein was unaffected by the sympathetic activation. The results suggest that values of PVF and PVP following stimulation of splanchnic sympathetic nerve are determined by an increase in flow resistance due to the vasoconstriction of the adrenergic vasculature, and that the pressure in the superior mesenteric vein is tonically reflected in the PVP.departmental bulletin pape

A Case Report of Combined Injury to the Stomach and Duodenum Following Blunt Abdominal Trauma

A case of combined gastric and duodenal injury following blunt trauma is presented. An emergent laparotomy revealed paired gastric perforations in both the anterior and posterior walls of the antrum as well as a huge central retroperitoneal hematoma which obscured a duodenal perforation on the posterior wall of the third portion of the duodenum. Distal gastrectomy, vigorous irrigation, and drainage were performed. The missed duodenal injury resulted in a lateral duodenal fistula. The fistula was managed with conservative measures, subsiding until 35 days after the operation. This report indicates that any trauma surgeon should be aware of this rare combined blunt injury and that discovery of a central retroperitoneal hematoma mandates careful examination of the pancreas and duodenum to exclude injuries.departmental bulletin pape