Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From August 1986 through July 1990, 20 patients underwent construction of the Kock continent ileal reservoir and were observed for more than three months. The early complications within the first 3 months were wound infection in four patients (20%), leakage at uretero-intestinal anastomosis in three patients (15%), prolapse of efferent limb and ileus in two patients (10%) and reflux, ureteral stenosis, intestinal fistula and postoperative pancreatitis in one patient (5%). The three late complications included stone formation in two patients and stenosis at an afferent limb in one patient. The stenosis occurred at the position of Dacron collar. The patients were divided into two groups and we compared the recent 10 patients with the initial 10 patients on complications and end results. In the initial group, 8 patients (80%) had 14 complications. In the recent group, 4 patients had 4 complications. The early complications have been reduced with the increase of Kock pouch operation. The result of the recent group was better than that of the initial group. Frequency of postoperative hydronephrosis in patients with Kock pouch was investigated. In nine patients (45%) the minimal hydronephrosis occurred within the first two months and in 5 patients (25%) three months after the operation. It had a normalizing tendency. The maximum pouch pressure at the pouch volume of 400 to 500 ml was not significantly high (37.9 +/- 12.2 cmH2O, mean +/- S.D.).
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PMID:Clinical experience of the Kock continent ileal urinary reservoir in 20 cases focusing on complications. 156 49

We analyzed 237 patients who underwent total cystectomy with ileal conduit urinary diversion or cutaneous ureterostomy at the Center for Adult Diseases, Osaka. One-hundred and eighty-eight patients underwent ileal conduit diversion and 49 patients underwent cutaneous ureterostomy. No patient died within 30 days after the operation, but two patients who underwent ileal conduit diversion died of postoperative complications within 2 months. Early complications occurred in 94 patients (50%) in the ileal conduit group and in 18 patients (37%) in the ureterostomy group. Late complications occurred in 85 patients (45%) in the ileal conduit group and in 23 patients (47%) in the ureterostomy group. Frequent early complications in the ileal conduit group were wound infection (29%), and intestinal complications (13%) which included ileus and upper urinary tract complications (12%). The most frequent late complications were stomal complications (26%) which included peristomal dermatitis stomal stenosis, parastomal hernia, and stomal prolapse, and upper urinary tract complications which were noted in 27 patients (14%).
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PMID:[Incontinent urinary diversion]. 178 82

The author detected a traumatic prolapse of stomach into thorax cavity. The X-ray examination was made only after ultrasonography. Two days after the operation, which confirmed the sonographic finding, symptoms of ileus became evident. The following ultrasonographic finding proved to be very similar to that made before the operation. A relapse of the prolapse was assumed to have occurred, but was not confirmed by a new operation. Since the X-ray examination of the stomach two months after the operation revealed a hiatus hernia, the author is of the opinion that a sliding hernia may have been cause of the erroneous diagnosis of the prolapse relapse.
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PMID:[The reliability of ultrasonic diagnosis in diaphragmatic rupture]. 218 76

The results of surgical treatment of rectal prolapse in 50 consecutive adult patients were evaluated. The mean age of the patients was 51.8 +/- 15.9 years. 8 of the patients were males. 13 of the patients had recurrent prolapse after operations performed earlier elsewhere. There were 4 types of operations: Delorme's mucosal sleeve resection (n = 21), perineal rectosigmoidectomy (n = 7), low anterior resection (n = 12) and abdominal rectopexy (n = 10). There was no operative mortality. The main postoperative complications were perforation or stricture of the rectum in the Delorme group and ileus and anastomotic complications in the low anterior resection group. The frequency of postoperative complications was clearly highest in the low anterior resection group (67%). Follow-up examination was performed 5.2 +/- 3.9 years postoperatively. The recurrence rate of prolapse was highest after perineal operations. Fecal incontinence was almost always associated with recurrence of prolapse and its incidence increased with reoperation. In conclusion, abdominal rectopexy was superior to other forms of operation in the treatment of rectal prolapse. Successfull correction of rectal prolapse does not necessarily rule out the need for later surgery for faecal incontinence.
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PMID:Treatment of rectal prolapse. A clinical study of 50 consecutive patients. 367 23

We tried the new method of urinary diversion via a continent ileal reservoir, reported by Kock in 1982, and now being accepted with great enthusiasm and satisfaction not only by doctors, but also by patients in Europe and in the United States. With this method, continency with storage of urine under low pressure is well maintained so that no external appliances are necessary. Ileorenal reflux is also prevented with this nipple valve forming technique, minimizing impairment of renal function. We report for the first time in Japan 13 cases, in which this method of innovative urinary diversion was used, with special attention paid to its demanding surgical technique and early results with its complications. From November, 1984 to August, 1985, we performed urinary diversion via the Kock pouch in 13 cases: 10 males and 3 females, from 35 to 67 years old (mean age 49 years), 11 bladder cancer patients, and 2 rectal cancer patients. The 2 patients with rectal cancer died from cancer and 1 bladder cancer patient with psychosis died from mental crisis 4 months after the operation. Of the 10 cases followed up long enough, 7 cases were in excellent condition with complete continence, 2 cases were in good condition with minor leak due to intermittent prolapse of the nipple valve, and in one case with failure, due to the postoperative ileus and eversion of the nipple valve, which made it difficult to catheterize into the pouch. Excision of the pouch and conversion to the standard ileal conduit was performed by reoperation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Urinary diversion with the Kock continent ileal reservoir: report of 13 cases]. 391 15

The 4 diagnostic stages of Cystic Fibrosis (C.F.) will be dealt with: prenatal diagnosis, singling out of the heterozygotes, clinical diagnosis and finally, the instrumental confirmation with the sweat test. The techniques for the intra-uterine diagnosis and for singling out of the heterozygotes are still in the experimental stage and cannot yet be put to practical use. The BM test on meconium is, among the numerous neonatal screening, no doubt the most widely used because of its simplicity and low cost. However, our personal experience has confirmed the high incidence of false negative (60%) and of false positive responses (0.8 - 0.9%). This has brought about a reconsideration upon the usefulness of neonatal screenings and this goes for the most recent method based on the dosage of blood trypsin levels. Because of the many difficulties imposed by the neonatal screening, there is a trend towards alternative diagnostic route: the clinical diagnosis. One of the most important objective symptoms even if it may seem trivial, is the reduced ponderal growth: in our personal experience, 51% of patients when diagnosed presented with weight below 10th percentile. One of the most frequent clinical pictures in that of a severe obstructive pulmonary disease of the infant. The high incidence of CF (1 in 1,250 live births) and the high mortality rate in the first year of life (50% of patients die during their first year) indicate that CF weighs heavily on the infantile mortality due to lung disease considered globally. This holds true above all for the Emilia-Romagna region, where the infantile mortality due to lung disease has been drastically reduced. One of the most recently discovered clinical manifestations, more frequent in hot climates, is the metabolic alkalosis. There is then a long series of minor clinical signs which should make one suspect a CF: a few of these are prolapse of the rectum, nasal polyposis, the equivalent of meconium ileus, haemorrhagic symptoms due to hypoprothrombinemia etc. An instrumental confirmation, a sweat test carried out with the quantitative method according to Gibson and Cooke, must always follow each clinical suspect. Unfortunately, alternative methods (such as the Orion C1 electrode or the Medtherm conductivity method) which have very high margins of error are still too widely used, in Italy as well, and should be completely abandoned.
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PMID:[Diagnosis of cystic fibrosis]. 664 74

In the years 1972-1995 41 patients suffering from prolapse of the rectum were operated according to the Moore method. The method is based on the observations which suggest that the cause of prolapse is intestinal intussusception which can be prevented by translocating the anus under the pubic joint. The observation time is from 1 to 23 years. Two patients were reoperated; one-as a result of a recurrence of rectal prolapse and one due to a post-operative adhesive ileus. One patient died as result of peritonitis following an overlooked microperforation in the rectal wall. In the case of the remaining patients, the treatment was fully successful. Regular defecation cycle as well as incontination of stool and flatus returned and the anal sphincters almost fully regained their tension in comparison to the pre-operative state. Early and distant results of surgery of prolapse of the rectum are satisfactory.
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PMID:Surgical treatment of prolapse of the rectum--evaluation of distant results. 902 May 65

We report a case of enteric mucocele formation in a 4-year-old boy after endorectal pull-through correction for Hirschsprung's disease with proximal intestinal neuronal dysplasia. On 17 April 1997, when the patient was 2 years old, a loop ileostomy was performed after an ineffective endorectal pull-through operation involving the right colon. Because of frequent prolapse of the stoma, when the child was two-and-a-half years old an end ileostomy was made by a resection of the distal ileotoma and redundant terminal ileum. When he was 4 years old, he was readmitted because of ileus, peritonitis, and a huge abdominal mass. Complete atresia of the colon at the level of pelvic reflection with proximal enteric mucocele formation was noted at laparotomy. He made an uneventful recovery after resection of the mucocele. This is the first reported case of such a complication after an endorectal pull-through operation. The possible causes and techniques for the prevention of this complication are discussed.
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PMID:Enteric mucocele formation after endorectal pull-through: report of a case. 1096 10

Vaginal vault prolapse and enterocele represent challenging forms of female pelvic organ relaxation. These conditions are most commonly associated with other pelvic organ defects. Proper diagnosis and management is essential to achieve long-term successful outcomes. Physical examination should be carried out in the lithotomy and standing positions (if necessary) in order to detect a loss of vaginal vault support. With proper identification of the vaginal cuff, one should assess the degree of mobility of the vaginal cuff with a Valsalva maneuver. If there is significant descent of the vaginal cuff, vaginal vault prolapse is present, and correction should be considered. The abdominal sacral colpopexy is an excellent means to provide vaginal vault suspension. This procedure entails suspension of the vaginal cuff to the sacrum with fascia or synthetic mesh. This procedure should always be accompanied by an abdominal enterocele repair and cul-de-sac obliteration. In addition, many patients require surgical procedures to correct stress urinary incontinence, which is either symptomatic or latent (occurs postoperatively after prolapse correction). Complications include: mesh infection, mesh erosion, bowel obstruction, ileus, and bleeding from the presacral venous complex. If the procedure is carried out using meticulous technique, few complications occur and excellent long-term reduction of vaginal vault prolapse and enterocele are achieved. The purpose of this article is to review the preoperative evaluation of women with pelvic organ prolapse, and provide a detailed description of the surgical technique of an abdominal sacral colpopexy.
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PMID:Abdominal sacral colpopexy and abdominal enterocele repair in the management of vaginal vault prolapse. 1111 64

We report the case of a 55-year-old man with non-small-cell lung cancer who underwent radiation, chemotherapy with carbotaxol and paclitaxel, and left upper lobe removal 2 years prior to evaluation. He was referred for disabling orthostatic hypotension (113/69 mm Hg supine and 66/47 mm Hg standing after 10 minutes) without a compensatory heart rate increase (57 to 59 beats per minute), fatigue, and constipation with episodes of ileus. Clinical examination showed mild ptosis bilaterally, fatiguable neck flexor weakness, and hip flexor weakness. Blood pressure response to Valsalva maneuver was abnormal with an absence of phase 4 overshoot and a Valsalva heart rate ratio of 1.04. Plasma norepinephrine level was low (79 pg/ml supine, 330 pg/ml standing). Single-fiber electromyography of the right extensor digitorum communis revealed normal mean consecutive difference (jitter) but several pairs exceeded a jitter of 100 mus. Antibodies against muscle acetylcholine receptor [(AChR) 0.66 nmol/L, normal <0.02 nmol/L] and ganglionic AChR (0.34 nmol/L, normal <0.02 nmol/L) were present. Treatment with plasma exchange normalized responses to standing posture (105/68 supine to 118/82 mm Hg standing, 66 to 79 beats per minute), to Valsalva (normal blood pressure overshoot, hazard ratio 1.47), norepinephrine (194 pg/ml supine, 763 pg/ml standing), and jitter measurements. We conclude that autoimmune autonomic ganglionopathy and myasthenia gravis can coexist and suggest that the latter should be excluded in patients with autoimmune autonomic ganglionopathy who complain of fatigue that shows improvement with non-supine rest.
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PMID:Coexistent autoimmune autonomic ganglionopathy and myasthenia gravis associated with non-small-cell lung cancer. 1988 40


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