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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The surgical approach to patients with abdominal aortic aneurysm and gastrointestinal malignancy remains controversial. We experienced two cases with abdominal aortic aneurysm and gastric cancer, which were treated by a one-stage operation using a different approach. At first, the operation for the aneurysm was done through a retroperitoneal approach and then, a partial gastrectomy for gastric cancer was done through a transperitoneal approach. The postoperative course of both cases was uneventful. The patients were discharge on the 19th and 21st postoperative days, respectively. This one-stage operation using different isolated approaches, such as the retroperitoneal approach for abdominal aortic aneurysm and transperitoneal approach for gastric cancer, was useful for the patients with abdominal aortic aneurysm and particularly early gastric cancer in terms of preventing an infection of the prosthetic graft.
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PMID:Simultaneous resection of abdominal aortic aneurysms and early gastric cancer by retroperitoneal and transperitoneal approach. 145 21

We experienced two cases of abdominal aortic aneurysm which had intra-abdominal malignancy (early gastric cancer). Case 1 was a 72 year-old man who was treated by two-stage operation of them. Gastrectomy was performed about 7 months prior to the aneurysmectomy. Case 2 was a 70 year-old man who was diagnosed both lethal diseases, renal dysfunction, chronic respiratory failure and multiple ventricular arrhythmia. He was treated by one-stage operation and was discharged with no complications. Coexistence of abdominal aortic aneurysm and intra-abdominal malignancy is rare and it is difficult to decide whether to operate the malignancy first, the aneurysm first or both simultaneously. In Japan, 28 cases were reported and 18 cases could be analyzed in detail. In these cases, most frequent coincidental malignancy was the gastric cancer (13/18, 72.2%) and one-stage operation was performed in 8 (44.4%) cases. In general, the risk of infection during upper gastrointestinal surgery is less than that during lower abdominal surgery. We concluded therefore that concomitant resection of the upper gastrointestinal malignancy, especially early gastric cancer, should be considered.
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PMID:[Coexistence of abdominal aortic aneurysm and intraabdominal malignancy; two case reports]. 268 1

The clinical courses of three cases with various alimentary tract malignant lesions coincidental with abdominal aortic aneurysm were reported. Of those three patients, a simultaneous resection of the malignant lesion and aneurysm was carried out in two patients, while an secondary abdominal aneurysmectomy following the resection of the malignant lesion was done in one patient. A 70-year-old man with cancer of the cecum and an infra-renal abdominal aneurysm, was diagnosed preoperatively, and a simultaneous right hemicolectomy and aneurysmectomy were carried out. In the other patient, a 77-year-old man, presence of the gastric cancer was incidentally found at laparotomy and a 75 percent gastrectomy and an aneurysmectomy were carried out. In the third patient, both gastric cancer and an abdominal aneurysm were detected preoperatively. Distal partial gastrectomy was performed first because of severe epigastralgia and an asymptomatic aneurysm. The abdominal aneurysmectomy was carried out six months later. All patients were treated by daily administration of Cefazolin sodium or cefalotin sodium (4-10 g) and Dibekacin sulfate (200 mg) for seven to ten days postoperatively. In the case of second look operation, however, Fosfomycin 2-4 g/day was added to the above mentioned drug following the aneurysmectomy. All tolerated surgery well without any signs of infections. The first patient died on the 57th postoperative day from panperitonitis carcinomatosa following an episode of intestinal obstruction. Selection of the operative approaches for patients having both an alimentary tract malignant tumor and an abdominal aortic aneurysm was difficult, although the initial surgical intervention for the more life threatening lesion would be better justified.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Surgical approach to abdominal aortic aneurysm with malignant alimentary tract tumor: report of three cases]. 374 94

The existence of Helicobacter pylori in the biliary tract was investigated. Seven bile samples were included in this study. Among them, six bile samples were collected by percutaneous transhepatic cholangiodrainage and the other by needle aspiration during cholecystectomy. Using nested PCR with two sets of primers homologous to the urease A gene, Helicobacter pylori DNA was detected. Three samples, one from a patient with advanced gastric cancer involving the pancreatic head and two from patients with pancreatic head tumor, were found to be positive for Helicobacter pylori DNA. On the other hand, three samples from patients with cholangiocarcinoma and one from a patient with chronic cholecystitis were all negative. To further verify the specificity of our PCR analysis, partial sequences of the PCR products from the three positive samples were analyzed by direct sequencing. Several silent mutations and a missense mutation (AAA to AGA; Lys-164 to Arg-164) were identified in the urease A gene. We conclude that Helicobacter pylori DNA can be easily detected in the bile samples. The possibility of asymptomatic cholangitis caused by this organism requires further investigation.
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PMID:Detection and partial sequence analysis of Helicobacter pylori DNA in the bile samples. 758 92

To examine whether or not acquired alpha 2-plasmin inhibitor deficiency is associated with systemic fibrinogenolysis, we analyzed the fibrin and fibrinogen degradation products in eight patients with this condition in various disease states. The underlying disease was gastric cancer in three patients, metastatic prostatic cancer in two, acute promyelocytic leukemia in two, and abdominal aortic aneurysm in one patient. In all eight patients, the alpha 2-plasmin inhibitor level was reduced to less than 50% of normal, and plasmin-alpha 2-plasmin inhibitor complex levels were increased. Immunoblotting of serum using an antifibrinogen antibody detected a 250 kDa protein (corresponding to fragments X or DY) in all eight patients. Fragment Y and D monomer were detected in seven of the eight patients, indicating the occurrence of systemic fibrinogenolysis. However, they were not detected in one patient with metastatic prostatic cancer. To determine whether or not fibrinogen degradation was also occurring in the patient without fragment Y, we characterized the 250 kDa protein in all eight patients. The protein was found to be fragment X in the metastatic prostatic cancer patient without fragment Y, while it was fragment DY in the other seven patients. Thus, systemic fibrinogenolysis was present in all eight patients. In the two patients with metastatic prostatic cancer, the level of alpha 2-plasmin inhibitor gradually increased with the reduction of tumor size by treatment. Fragment X, fragment Y, and D monomer were not detected when the alpha 2-plasmin inhibitor level exceeded 60% of normal in both patients. In the other six patients fragment Y and D monomer also disappeared when the alpha 2-plasmin inhibitor level exceeded 60% of normal. These findings suggest that systemic fibrinogenolysis only occurs when the plasma levels of alpha 2-plasmin inhibitor falls below 60% of normal due to activation of the fibrinolytic system by various pathological conditions.
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PMID:Direct evidence for systemic fibrinogenolysis in patients with acquired alpha 2-plasmin inhibitor deficiency. 825 8

Selecting the most appropriate surgical approach for patients with abdominal aortic aneurysm (AAA) and gastrointestinal malignancy remains controversial. In an attempt to develop guidelines for the management of patients with these two simultaneous lesions, a retrospective review of patients who had concomitant AAA and gastrointestinal malignancy was undertaken. During the period from January 1985 to February 1993, 229 patients with AAA were admitted to our hospital. Among these, 19 patients (8%) had a gastrointestinal malignancy together with AAA and were divided into 2 groups. Group I was composed of 11 patients who underwent either a 1- or a 2-stage operation for both lesions. Group II was composed of eight patients who either underwent an operation for one lesion (six patients) or did not have any operation (two patients). Among group I, six patients underwent the two-stage operation. In four of the six patients, the malignancy was resected first. In the remaining two patients, the aneurysmectomy was performed first, because, in one patient, the aneurysm was more than 6 cm in diameter, and, in the other patient, the aneurysm was a saccular type. Among group I, five patients (two patients with gastric cancer, and one patient each with esophageal cancer, rectal cancer, and malignant lymphoma of the stomach) underwent a one-stage operation. In three of the five patients (two patients with gastric cancer and one patient with esophageal cancer), simultaneous resection was carried out by using segregated approaches, namely, the retroperitoneal approach for AAA and the transperitoneal approach for malignancy. Although the clinical characteristics of the patients were different, 8 of the 11 patients (73%) in group I are still alive, whereas only 1 of the 8 patients (13%) in group II is still alive. The principles of our surgical approaches for concomitant AAA and gastrointestinal malignancy are as follows: (1) The lesion that absolutely indicated urgent surgery was resected first. (2) If both lesions were asymptomatic, the malignancy was resected first. (3) Simultaneous resection using different approaches was useful in some patients with concomitant upper early gastrointestinal malignancy. (4) Both lesions need to be resected eventually for better long-term survival.
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PMID:Management of concomitant abdominal aortic aneurysm and gastrointestinal malignancy. 835 99

The surgical approach for patients with abdominal aortic aneurysm (AAA) and coexistent abdominal malignancy remains controversial. We report herein three cases of coincident AAA and early gastric cancer, all of whom were treated by a two-stage operation and underwent curative surgery for their gastric cancer. The principles of our surgical approach are as follows: (1) the lesion which requires urgent surgery should be operated on first, and if both lesions show absolute indications, a one-stage surgical procedure should then be performed; (2) a two-stage surgical procedure in which aneurysmectomy is performed first should be undertaken when no absolute indications for urgent surgery exist for either lesion; (3) a one-stage surgical procedure should only be performed when surgery on one lesion makes the other lesion highly dangerous; and (4) in patients with a poor prognosis because of far advanced cancer in whom the AAA shows no sign of rupturing, only a gastrectomy should be performed.
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PMID:The coexistence of abdominal aortic aneurysm and early gastric cancer: report of three cases. 846 66

We report 8 newly established gastric-carcinoma cell lines (SNU-216, 484, 520, 601, 620, 638, 668, 719) from Korean patients. Morphologic study was carried out using light and electron microscopes. CEA, alpha FP, and CA 19-9 and TPA in supernatant and in cell lysate were measured by radioimmunoassay. p53 and c-Ki-ras gene mutations were screened and confirmed by sequencing. The cell lines, derived from tumors with moderate differentiation, grew as a diffuse monolayer, and those from tumors with poor differentiation and minimal desmoplasia grew exclusively as non-adherent. Out of the 8 gastric-cancer cell lines, 5 had detectable levels of CEA both in supernatant and in cell lysate; there was no expression or secretion of alpha FP in these cells; 4 cell lines showed high levels of CA 19-9 in cell pellets. All cell lines except SNU-484 had high concentrations of TPA both in cell lysate and in supernatants. p53 mutation was found in 6 cell lines (75%): 2 (SNU-216 and SNU-668) had mutations in exon 6, and other 3 in exon 8. The c-Ki-ras mutation was found in 2 cell lines (25%), SNU-601 and SNU-668. The former showed GGT-to-GAT transition mutation at codon 12, while the latter showed CAA-to-AAA transversion mutation at codon 61. DNA profiles using restriction endonuclease HinfI and polymorphic DNA probes ChdTC-15 and ChdTC-114 showed different unique patterns; which suggests that these cell lines are unique and not cross-contaminated. We believe that the newly characterized gastric-cancer cell lines presented in this paper will provide a useful in vitro model for studies related to human gastric cancer.
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PMID:Establishment and characterization of human gastric carcinoma cell lines. 903 53

A 76-year-old man with abdominal aortic aneurysm (AAA) and concomitant gastric cancer, who had undergone coronary artery bypass grafting (CABG), presented with recurrent exertional angina. Both lesions, the AAA and advanced gastric cancer, exhibited an absolute indication for urgent surgery. Coronary revascularization with percutaneous transluminal coronary angioplasty (PTCA) was carried out successfully before abdominal surgery. A one-stage abdominal operation was performed safely. The need for coronary revascularization complicates the treatment strategy for these patients with associated coronary artery disease. PTCA is the best option, especially if the patient presents with recurrent angina after prior CABG.
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PMID:The coexistence of abdominal aortic aneurysm and advanced gastric cancer associated with recurrent angina after coronary artery bypass grafting. 939 63

The therapeutic approach to a patient who has an abdominal aortic aneurysm (AAA) and an intraabdominal nonvascular surgical disorder simultaneously remains controversial. To establish guidelines for the management of those patients, a retrospective review of patients who had concomitant AAA and intraabdominal nonvascular surgical disorders was undertaken. During the period January 1988 to December 1997 a series of 162 patients underwent surgical repairs of AAA in our hospital. Among them 16 patients (9.9%) had several kinds of intraabdominal nonvascular surgical disorders, and 13 underwent one-stage operation for both diseases. That is, cholelithiasis coexisted in five patients, inguinal hernia in four, gastric cancer in two, and retroperitoneal tumor and renal tumor in one each. All AAAs were the infrarenal type, and there were no inflammatory or ruptured aneurysms. In cases of cholelithiasis coexistent with AAA, aneurysmectomy was performed first. After tight closure of the retroperitoneum, cholecystectomy was done. In cases of cholelithiasis coexistent with AAA, aneurysmectomy was performed first. After tight closure of the retroperitoneum, cholecystectomy was done. In cases of inguinal hernia coexistent with AAA, the AAA was first replaced with a prosthetic vascular graft and a residual piece of the graft was used as a patch for hernioplasty. This procedure was similar to laparoscopic hernioplasty. In two cases of gastric cancer concomitant with AAA, the AAA was first replaced. Subtotal gastrectomy with D2 lymphatic dissection was done after tight closure of the retroperitoneum. A drain was inserted into the epiploic foramen to detect anastomotic leakage. A retroperitoneal tumor coexisting with AAA was dissected and resected en bloc with the aneurysmal wall because the tumor firmly adhered to the aneurysm. The abdominal aorta was then replaced with a prosthetic graft. In a case of renal tumor concomitant with AAA, nephrectomy was done first to perform a complete lymphatic dissection around the renal artery. Then AAA repair was performed with a conventional procedure. There were no fatal complications, such as pneumonitis, hemorrhage, anastomotic leakage, or graft infection. All 13 patients were discharged from our hospital and are currently free from recurrence of malignancy or hernia. In summary, properly selected one-stage operations for intraabdominal nonvascular surgical disorders and AAA may be safe and bring physical and economic benefit to the patient.
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PMID:Intraabdominal nonvascular operations combined with abdominal aortic aneurysm repair. 1008 95


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