Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Indications of rethoracotomy after esophagectomy for esophageal cancer are reviewed in this paper. Hemothorax, pneumothorax, pyothorax and chylothorax are the main causes of rethoracotomy. Complications indicating rethoracotomy are summarized as follows: 1) Hemothorax; emergency rethoracotomy is indicated in cases of bleeding through the chest drain over 100ml/hr, which is continuing over 5 hours or in cases when normal blood pressure cannot be maintained without blood transfusion. In many cases the bleeding point is the chest wall, from the branches of the intercostal artery. 2) Pneumothorax; reoperation for pneumothorax is rare. But rethoracotomy and bullectomy or closure of fustula is indicated when a large volume of air leakage and lung collapse continues over a week. 3) Pyothorax; old pyothorax with bronchial fistula is treated by closure of fistula and plombage with omentum or muscle flap. 4) Chylothorax; chylothorax is not a frequent complication of esophageal surgery but when it occurs reoperation is not rare. In cases with 1,500ml/day or more of chyle drainage for over 5 days under fasting with intravenous hyperalimentation, rethoracotomy and ligation of thoracic duct is indicated.
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PMID:[Indications of rethoracotomy after esophagectomy for esophageal cancer]. 877 13

Postoperative bronchial stump failure is a life-threatening complication, and several surgical approaches and procedures have been developed to close the stump. In this report, we describe a case of left mainstem bronchial stump diastasis after pneumonectomy for lung cancer, in which the bronchial stump was re-closed using a contralateral approach with video-assisted thoracic surgery, with good success. The left main bronchus was closed with an automatic stapler device, but the stump reopened and left pyothorax developed postoperatively. Emergent intratracheal intubation and ventilation was required due to rapid progression of right pyothorax. Under strict nutritional management by IV hyperalimentation, administration of antibiotics to which the organisms were sensitive, and drainage, the patient recovered from pneumonia. However, thoracic air leak increased daily, and reoperation for bronchial diastasis was performed. Using this approach, the left main bronchus near the carina was easily exposed extrapleurally, with only the azygos vein being incised. Video-assisted contralateral treatment was effective in avoiding sternal osteomyelitis due to a transpericardial approach via median sternotomy in the case of mainstem bronchial stump failure, only after left pneumonectomy.
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PMID:Video-assisted contralateral treatment for bronchial stump diastasis after left pneumonectomy. 1071 20

'Iatrogenic' Wernicke's encephalopathy has appeared to occur more frequently in Japan, probably induced by the change of our Japanese national health insurance policy in 1992. We report 4 nonalcoholic patients with such Wernicke's encephalopathy, which occurred during the early postoperative oral food intake period following intravenous nutrition without vitamin supplements. We analyzed the medical records of 4 patients, 3 men and 1 woman, aged between 55 and 71 years, who were admitted to our hospital between 1992 and 1995. Three patients underwent gastrointestinal surgery and 1 suffered chronic pyothorax. We diagnosed our patients as having Wernicke's encephalopathy based on typical neurological abnormalities, in addition to typical cranial magnetic resonance image findings, low serum vitamin B(1) levels, or both. Although all of the patients were treated with vitamin B(1) and showed some improvement, 1 patient developed Korsakoff syndrome, 2 made incomplete neurological recovery, and 1 died. We speculated that the body vitamin B(1) stores had been decreasing in our patients who did not receive any vitamin supplements during intravenous hyperalimentation or hydration. Subsequent administration of high calorie and high carbohydrate oral diets increased the demand for vitamin B(1), further depleting the vitamin stores, thereby causing 'iatrogenic' Wernicke's encephalopathy. The change of our national health insurance policy in 1992 discouraged the routine administration of vitamins, probably causing Wernicke's encephalopathy in our patients.
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PMID:'Iatrogenic' Wernicke's encephalopathy in Japan. 1105 64