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Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Systolic time intervals were measured in 10 patients with cancer of the esophagus who required two anaesthetic procedures, before and after an induction dose of thiopentone. The patients were digitalised between the first and the second procedures. Digitalis improved systolic time intervals and reduced the depressant effect of thiopentone on the heart as measured by systolic time intervals.
Anaesthesia 1975 Sep
PMID:Digitalis-thiopentone effects on myocardial function. A study of systolic time intervals in man. 110 45

Within the last generation the application of major advances in drug therapy, intensive care, transfusion techniques, surgery, anaesthesia, and radiotherapy, together with a vast expansion of knowledge due to increased investigative facilities, have led to an unprecedented, dramatic and beneficial increase in the number of persons who would previously have died, or lived with severe handicaps, but can now be cured. Techniques have also been developed to prolong the lives of many people who are now able to enjoy several extra years of productive and meaningful existence, and to alleviate and improve the quality of life of many seriously handicapped persons, enabling them to become integrated as useful and contented members of the community. Choosing from numerous examples of paediatric experience, it is notable that many more extremely premature infants now survive without physical or intellectual damage; infection can almost always be cured, including neonatal and all other forms of pyogenic meningitis and the now rare cases of tuberculous meningitis and miliary tuberculosis. The few remaining new cases of Rh-haemolytic disease are also readily cured. There are outstanding successes in the treatment of childhood malignancy. Paediatric surgery has made great strides. The prognosis of congenital heart disease, of obstructions of the alimentary canal and many other conditions has improved beyond recognition. Unfortunately, the indiscriminate use of advanced techniques of all types has also kept alive those who would have died but now live with distressing physical or mental handicaps or both, often for many years, without hope of ever having an independent existence compatible with human dignity. There are many examples, including those who have sustained major brain or spinal cord injuries.
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PMID:Ethical problems in the management of myelomeningocele and hydrocephalus. The Milroy Lecture 1975. 110 20

When a patient presents with a hard, painless lump in the neck, one should assume that it is a cancer and that it is metastatic from a primary lesion located above the clavicle. A careful physical examination with the appropriate instruments most often will determine the site of the primary lesion. Laryngograms or lateral soft-tissue roentgenograms should not be used as a substitute for visual inspection and careful examination. Examination with the patient under anesthesia is not needed unless the office examination cannot be done or a specimen from the suspected region cannot be obtained and examined microscopically in the office. Taking blind biopsies from normal-appearing mucosa is seldom worthwhile. Excisional biopsy is usually done with the patient under general anesthesia; needle biopsy is seldom used. Pathologic diagnosis by examination of frozen section is mandatory. Definitive treatment depends on the surgical and pathologic findings.
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PMID:Symposium. ENT for nonspecialists. The patient has a lump in the neck. 112 50

If radical surgery is the only rational policy for most cases of rectal cancer, the problem of local treatment in poor surgical risk patients should be discussed in selected cases. Only limited, fairly-well-differentiated tumors, still confined to the rectal wall may have a sufficiently low probability of lymphatic spread to be amenable to local treatment. Rectal cancer, usually regarded as being slightly radiosensitive when treated by external irradiation, proves to be highly radiosensitive in the case of early cancer treated by intracavitary irradiation. This method is able to control a large amount of limited polypoid and ulcerative adenocarcinomas. In a series of 133 cases followed more than 5 years, the rate of death from cancer is only 9%, and the 5-year survival rate is 78%. As compared with local exision or electrocoagulation, intracavitary irradiation has several advantages. It does not require colostomy nor anesthesia. Contact x-ray therapy is an ambulatory treatment applicable even to elderly and fragile patients. There is no danger of fistula in the case of tumor of the anterior wall in female patients. It preserves all the chances of cure by subsequent surgery in case of failure.
Cancer 1975 Aug
PMID:Intracavitary irradiation of early rectal cancer for cure. A series of 186 cases. 115 30

Eighty-nine patients with bladder cancer T3NxMo have been treated by preoperative external irradiation (4000 rads in 4 weeks) followed by cystectomy. Five-year survival is 50%. Of patients with T-reduction (T3 becomes P0, P1, or P2) the 5-year survival is 70%. Treatment mortality has been reduced to 3% during the last 2 years. T-reduction cannot be predicted by histologic grade. A second staging by palpation under general anesthesia ("T" 4000) is reliable when T-reduction is felt; however, fibrosis can simulate a persisting T3 mass.
Cancer 1975 Aug
PMID:Carcinoma of the bladder T3NxMo treated by preoperative irradiation followed by cystectomy. 115 33

Experience with 88 obese pateints undergoing jejunoileal shunt is reviewed, with emphasis on preoperative preparation and assessment, conduct of anesthesia, postoperative care, and anesthesia-related complications. There was no intraoperative mortality, and postoperative morbidity was minimal. The operation can be viewed as a short-term answer to the malignancy of massive obesity, since physiologic abnormalities are reversible; however, only hospitals that can provide full surgical, medical, endocrinologic, and anesthesia services, backed by modern ancillary investigative ability, should perform this operation.
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PMID:Anesthesia for jejunoileal shunt: review of 88 cases. 116 63

Rubidium-86, 125I-human serum albumin and 51Cr-labelled red cells have been used to investigate the effects of the anaesthetics Nembutal (pentobarbitone sodium) and urethane on blood perfusion, blood volume and albumin leakage in 5 types of transplanted mouse tumour and in normal organs. Nembutal was found to increase the relative blood perfusion by a factor of 1-3 to 2-0 in tumours and by a factor of 1-7 to 3-0 in kidneys but muscle perfusion fell to 0-3-0-5 that of controls. The effects of urethane were found to be dose dependent, generally in the same direction as for Nembutal, and smaller. Both anaesthetics reduced the blood volume of tumours (except for the C3H mammary carcinoma) and of kidneys by factors of 0-2 to 0-8. The duration of anaesthesia had no effect on the plateau values of relative blood perfusion and blood volume in either tumours or normal organs, but Nembutal delayed slightly the 86Rb uptake and decreased the rate of albumin leakage.
Br J Cancer 1975 Sep
PMID:The effect of anaesthetics on blood perfusion in transplanted mouse tumours. 123 83

Lung cancer is rarely diagnosed and treated while still localized. Sputum cytology allows detection of radiologically occult tumors but conventional endoscopic procedures frequently prove inadequate for localization. It is the purpose of this report to outline the endoscopic observations and methods we have developed in successfully localizing 17 consecutive, radiologically occult carcinomas discovered in the sputum of 15 patients. A detailed examination of the upper respiratory tract demonstrated occult tumors in two patients. A segment by segment fiberbronchoscopic study under anesthesia allows multiple brushings and meticulous handling of specimens. Lesion localization is provided as well as identification of synchronous second primary tumors. Biopsies at the lobar spur and carina assist in determining the proximal extent of carcinoma in situ at potential surgical margins. Newer methods should enhance our recognition of inapparent carcinoma in situ allowing more efficient and more accurate tumor localization and a better appreciation of its extent.
Cancer 1976 Jan
PMID:New horizons in lung cancer diagnosis. 124 75

The indications for and the results of hypophysectomy for advanced cancer of the breast or prostate gland are reviewed. The technic of open microsurgical transsphenoidal hypophysectomy is described. Since the metabolism of some breast cancers is influenced by estrogenic hormones, the major effect of hypophysectomy seems to be the complete suppression of estrogen production by the gonads and adrenal glands by removal of gonadotropin and ACTH, respectively. Other specific substances, such as growth hormone or prolactin, may also be factors. In cases of prostate cancer which relapse after castration, the adrenals seem to elaborate a significant amount of extradgonadal androgen. Hypophysectomy removes the source of ATCH and thus stops androgen production by the adrenal glands. Other hormones may also be important. In premenopausal patients with advancing cancer of the breast, oophorectomy should be the initial procedure. Most patients after a previous favorable response to oophorectomy get a subsequent objective improvement from hypophysectomy. In postmenopausal patients the effects of hormone therapy should 1st be tried. Many patients responding favorably to hormone therapy will also be benefited later by hypophysectomy. Remission rates are higher in older women. However, hypophysectomy should be carried out relatively early to obtain a useful remission. About 25% of those not responding to other methods will obtain a remission following hypophysectomy. Along interval after the mastectomy before metastases occurs is a favorable prognostic sign. While bony metastases respond best, other sites of metastases do not contraindicate the operation. Most patients with prostatic metastases obtain relief after hypophysectomy, even some of those who have not been benefited by other methods. Advanced age alone is not a contraindication. A preoperative evaluation should be done including a series of endocrine studies. Open microsurgical transsphenoidal hypophysectomy is considered the operation of choice. Complete removal of the gland is accomplished with less disturbance to the patient than an intracranial operation. General anesthesia is used. After the operation tests for pituitary reserve are repeated and a maintenance regimen of hydrocortisone prescribed. Thyroid replacement therapy is often needed. Subjective remissions are more common than objective ones, particularly relief of pain. This operation was done on 20 men with metastatic cancer of the prostate and 23 women and 1 man with metastatic cancer of the breast. Of the prostate cases, 3 patients died during the early postoperative period. Of the other 17, there have been 7 deaths from the cancers after 1-7 months. Of the 23 breast cases, severe body pain was the indication for the operation. Relief occurred in 19 (83%). There have been 7 deaths from the cancers. Hypophysectomy does not predispose to or lead to alterations in emotional state or mental function. Others with larger series of cases have reported that those responding favorably have lived an average of 25.8 months while average survival of those not so responding has been only 5.6 months.
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PMID:Hypophysectomy in the treatment of disseminated carcinoma of the breast and prostate gland. 127 14

During a two-and-one-half year period, 317 women were seen in the Colposcopy Clinic for evaluation of an abnormal Pap smear. Seventy-four (23%) desired to maintain their childbearing potential and were treated conservatively. Ten (14%) had inadequate colposcopy and underwent cold knife conization of the cervx. The remaining 64 were treated by adequate colposcopy, combined with cryosurgery; they are discussed in detail. All were managed economically as outpatients without anesthesia and no serious complications occurred. To date, only four have recurrent abnormal cervical cytology and several have delivered children. Adequate colposcopic examination combined with biopsies must proceed all cryosurgical procedures performed for abnormal cervical cytology.
Cancer 1976 Jul
PMID:Cryosurgery. Its use for the abnormal Pap smear. 127 8


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