Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were male (60%). Indications were 18 tumors of the distal esophagus and esophagogastric junction (90%) and two with invasion of gastric fundus (10%) in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85%) were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%): a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15%) were due to tumor recurrence and 1 (5%) secondary to bronchopneumonia. The 5-year survival was 15%. the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of life.To analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were426360365sem informaçãosem informaçã

Esophageal mucosal resection versus esophagectomy: a comparative study of surgical results in patients with advanced megaesophagus

The surgical treatment of advanced megaesophagus has no consensus, being esophagectomy the more commonly used method. Since it has high morbimortality--inconvenient for benign disease -, in recent years an alternative has been introduced: the esophageal mucosal resection. To compare early and late results of the two techniques evaluating the operative time, length of ICU stay; postoperative hospitalization; total hospitalization; intra- and postoperative complication rates; mortality; and long-term results. Were evaluated retrospectively 40 charts, 23 esophagectomies and 17 mucosectomies. In assessing postoperative results, interviews were conducted by using a specific questionnaire. Comparing the means of esophagectomy and mucosal resection, respectively, the data were: 1) surgical time--310.2 min and 279.7 min (p > 0.05); 2) length of stay in ICU--5 days and 2.53 days (p 0.05); 4) length of hospital stay after surgery--19.05 days and 14.94 days (p> 0.05); 5) presence of intraoperative complications--65% and 18% (p 0.05). In the assessment of late postoperative score (range 0-10) esophagectomy (n = 5) obtained 8.8 points and 8.8 points also got mucosal resection (n = 5). Esophageal mucosal resection proved to be good alternative for surgical treatment of megaesophagus. It was advantageous in the immediate postoperative period by presenting a lower average time in operation, the total hospitalization, ICU staying and complications rate. In the late postoperative period, the result was excellent and good in both operations.The surgical treatment of advanced megaesophagus has no consensus, being esophagectomy the more commonly used method. Since it has high morbimortality--inconvenient for benign disease -, in recent years an alternative has been introduced: the esophageal m2812831sem informaçãosem informaçã

Laparoscopic antireflux surgery in patients with extra esophageal symptoms related to asthma

Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings. The comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002). Laparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma.Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. W2729295sem informaçãosem informaçã

Calculation Of The Giant Magnetocaloric Effect In The Mnfep 0.45as0.55 Compound

We report the theoretical investigations on the giant magnetocaloric compound MnFeP0.45As0.55. The magnetic state equation used takes into account the magnetoelastic effect that leads the magnetic system to order under first order paramagnetic-ferromagnetic phase transition. The model parameters were determined from the magnetization data adjustment and used to calculate the magnetocaloric thermodynamic quantities. The theoretical calculations are compared with the available experimental data.709944101-094410-5Yu, B.F., Gao, Q., Zhang, B., Mang, X.Z., Chen, Z., (2003) Int. J. Refrig., 26, p. 622Gschneidner Jr., K.A., Pecharsky, V.K., (1997) Rare Earths: Science, Technology and Application III, , edited by R. C. Bautista, C. O. Bounds, T. W. Ellis, and B. T. Kilbourn The Minerals, Metals & Materials Society, WarendaleBrown, G.V., (1976) J. Appl. Phys., 47, p. 3673Pecharsky, V.K., Gschneidner Jr., K.A., (1997) Phys. Rev. Lett., 78, p. 4494Tegus, O., Brück, E., Buschow, K.H.J., De Boer, F.R., (2002) Nature, 415, p. 150. , LondonMorellon, L., Algarabel, P.A., Ibarra, M.R., Blasco, J., García-Landa, B., Arnold, Z., Albertini, F., (1998) Phys. Rev. B, 58, pp. R14721Rodbell, D.S., (1961) Phys. Rev. Lett., 7, p. 1Bean, C.P., Rodbell, D.S., (1961) Phys. Rev., 126, p. 104Bacmann, M., Soubeyroux, J.-L., Barrett, R., Fruchart, D., Zach, R., Niziol, S., Fruchart, R., (1983) J. Magn. Magn. Mater., 134, p. 59Brück, E., Tegus, O., Li, X.W., Deboer, F.R., Buschow, K.H.J., (2003) Physica B, 327, p. 431Tegus, O., Brück, E., Zhang, L., Dagula, Buschow, K.H.J., De Boer, F.R., (2002) Physica B, 319, p. 174Zach, R., Guillot, M., Tobola, J., (1998) J. Appl. Phys., 83, p. 7237Tegus, O., (2003) Novel Materials for Magnetic Refrigeration, , PhD thesis, Van der Waals-Zeeman Instituut, Universiteit van Amsterdam, Printer Partners Ipskamp B. V., ISBN: 9057761076, OctoberVon Ranke, P.J., Grangeia, D.F., Caldas, A., De Oliveira, N.A., (2003) J. Appl. Phys., 93, p. 4055Wada, H., Tanabe, Y., (2001) Appl. Phys. Lett., 79, p. 3302Wada, H., Morikawa, T., Taniguchi, K., Shibata, T., Yamada, Y., Akishige, Y., (2003) Physica B, 328, p. 11

Surgical Gastrostomy: Current Indications And Complications In A University Hospital [gastrostomia Cirúrgica: Indicações Atuais E Complicações Em Pacientes De Um Hospital Universitário]

Objective: To analyze the surgical gastrostomies performed at a public University Hospital, their indications and complications. Methods: We conducted a retrospective, nonrandomized review of medical records of patients who underwent surgical gastrostomy from 2007 to 2011; Results:, In the period of studied, 86 patients underwent surgical gastrostomies for enteral nutrition. The Stamm technique was employed in all cases. Men constituted 76 (88%) of the cases and the mean age was 58.4 years, the maximum age being 87 years and the minimum 19. We observed 16 (18.60%) minor complications, 17 (19.76%) serious complications and 8 (9.3%) perioperative deaths. Conclusion: Surgical gastrostomy, while considered a smaller procedure, is not without complications and mortality. The Stamm technique, despite the complications reported, is easy to perform and to handle, as well as safe.406458462Witzel, O., Zur technik der magenfistulaeinlegung (1891) Zbl Chir, 18, pp. 601-604Stamm, M., Gastrostomy: A new method (1894) Med News, 65, p. 324Grant, J.P., Comparison of percutaneous endoscopic gastrostomy with Stamm gastrostomy (1988) Ann Surg, 207 (5), pp. 598-603Gauderer, M.W., Ponsky, J.L., Izant Jr., R.J., Gastrostomy without laparoscopy: A percutaneous endoscopic technique (1980) J Pediatr Surg, 15 (6), pp. 872-875Kwon, R.S., Banerjee, S., Desilets, D., Diehl, D.L., Farraye, F.A., Enteral nutrition access devices (2010) Gastrointest Endosc, 72 (2), pp. 236-248. , ASGE Technology CommitteeHerman, L.L., Hoskins, W.J., Shike, M., Percutaneous endoscopic gastrostomy for decompression of the stomach and small bowel (1992) Gastrointest Endosc, 38 (3), pp. 314-318Möller, P., Lindberg, C.G., Zilling, T., Gastrostomy by various techniques: Evaluation of indications, outcome, and complications (1999) Scand J Gastroenterol, 34 (10), pp. 1050-1054Wollman, B., D'Agostino, H.B., Walus-Wigle, J.R., Easter, D.W., Beale, A., Radiologic, endoscopic, and surgical gastrostomy: An institutional evaluation and meta-analysis of the literature (1995) Radiology, 197 (3), pp. 699-704Ljungdahl, M., Sundbom, M., Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: A prospective, randomized trial (2006) Surg Endosc, 20 (8), pp. 1248-1251Pisano, G., Calò, P.G., Tatti, A., Farris, S., Erdas, E., Licheri, S., Surgical gastrostomy when percutaneous endoscopic gastrostomy is not feasible: Indications, results and comparison between the two procedures (2008) Chir Ital, 60 (2), pp. 261-266Martins, F.P., Sousa, M.C.B., Ferrari, A.P., New "introducer" PEG-gastropexy with T fasteners: A pilot study (2011) Arq Gastroenterol, 48 (4), pp. 231-235Ocaña, L.F.O., Crocifoglio, V.A., La gastrostomía laparoscópica como una alternative a la gastrostomía endoscópica percutánea (1995) Rev Gastroenterol Mex, 60 (4), pp. 218-220Bergstrom, L.R., Larson, D., Zinsmeister, A.R., Sarr, M.G., Silverstein, M.D., Utilization and outcomes of surgical gastrostomies and jejunostomies in an era of percutaneous endoscopic gastrostomy: A population- based study (1995) Mayo Clin Proc, 70 (9), pp. 829-836Nicholson, F.B., Korman, M.G., Richardson, M.A., Percutaneous endoscopic gastrostomy: A review of indications, complications and outcome (2000) J Gastroenterol Hepatol, 15 (1), pp. 21-25Shellito, P.C., Malt, R.A., Tube gastrostomy. Techniques and complications (1985) Ann Surg, 201 (2), pp. 180-185Cox, W.D., Gillesby, W.J., Gastrostomy in postoperative decompression: Indications and methods (1967) Am J Surg, 113 (2), pp. 298-302Cosentini, E.P., Sautner, T., Gnant, M., Winkelbauer, F., Teleky, B., Jakesz, R., Outcomes of surgical, percutaneous endoscopic, and percutaneous radiologic gastrostomies (1998) Arch Surg, 133 (10), pp. 1076-1083Rustom, I.K., Jebreel, A., Tayyab, M., England, R.J., Stafford, N.D., Percutaneous endoscopic, radiological and surgical gastrostomy tubes: A comparison study in head and neck cancer patients (2006) J Laryngol Otol, 120 (6), pp. 463-466Grilo, A., Santos, C.A., Fonseca, J., Percutaneous endoscopic gastrostomy for nutritional palliation of upper esophageal cancer unsuitable for esophageal stenting (2012) Arq Gastroenterol, 49 (3), pp. 227-231Zorrón, R., Flores, D., Meyer, C.A.F., Castro, L.M., Madureira, F.A.V., Madureira, F.D., Single-wound gastrostomy: A simple method as an option for endoscopy (2005) Rev Col Bras Cir, 32 (3), pp. 153-15

Simulating maize yield in sub-tropical conditions of southern Brazil using Glam model

The objective of this work was to evaluate the feasibility of simulating maize yield in a sub‑tropical region of southern Brazil using the general large area model (Glam). A 16‑year time series of daily weather data were used. The model was adjusted and tested as an alternative for simulating maize yield at small and large spatial scales. Simulated and observed grain yields were highly correlated (r above 0.8; p<0.01) at large scales (greater than 100,000 km2), with variable and mostly lower correlations (r from 0.65 to 0.87; p<0.1) at small spatial scales (lower than 10,000 km2). Large area models can contribute to monitoring or forecasting regional patterns of variability in maize production in the region, providing a basis for agricultural decision making, and Glam‑Maize is one of the alternatives

Magnetocaloric Effect In The Rni5 (r = Pr, Nd, Gd, Tb, Dy, Ho, Er) Series

In this paper, the magnetocaloric effect in the hexagonal intermetallic compounds belonging to the RNi5 series was calculated using a Hamiltonian including the crystalline electrical field, exchange interaction, and the Zeeman effect. Experimental work was performed and the two thermodynamics quantities, namely, isothermal entropy change and adiabatic temperature change were obtained for polycrystalline samples using heat capacity measurements, and compared to the theoretical predictions.70131344281-134428-6Pecharsky, V.K., Gschneidner Jr., K.A., (1997) Phys. Rev. Lett., 78, p. 4494Gschneidner Jr., K.A., Pecharsky, V.K., (1997) Rare Earths: Science, Technology and Application III, , edited by R. C. Bautista, C. O. Bounds, T. W. Ellis, and B. T. Kilbourn (The Minerals, Metals and Materials Society, Warendale, PATegus, O., Bruck, E., Buschow, K.H.J., De Boer, F.R., (2002) Nature (London), 415, p. 150Wada, H., Tanabe, Y., (2001) Appl. Phys. Lett., 79, p. 20(2001) Appl. Phys. Lett., 79, p. 3302Wada, H., Morikawa, T., Taniguchi, K., Shibata, T., Yamada, Y., Akishige, Y., (2003) Physica B, 328, p. 114Von Ranke, P.J., De Oliveira, N.A., Gama, S., (2004) J. Magn. Magn. Mater., 277, p. 78Von Ranke, P.J., De Campos, A., Caron, L., Coelho, A.A., Gama, S., De Oliveira, N.A., unpublishedVon Ranke, P.J., De Oliveira, N.A., Gama, S., (2004) Phys. Lett. A, 320, p. 302Von Ranke, P.J., Lima, A.L., Nóbrega, E.P., Da Silva, X., Guimarães, A.P., Oliveira, I.S., (2001) Phys. Rev. B, 63, p. 024422Von Ranke, P.J., Pecharsky, V.K., Gschneidner, K.A., Korte, B.J., (1998) Phys. Rev. B, 58, p. 14436Buschow, K.H.J., Van Der Goot, A.S., (1971) Acta Crystallogr., Sect. B: Struct. Crystallogr. Cryst. Chem., 27, p. 1085Stevens, K.W.H., (1952) Proc. Phys. Soc., London, Sect. A, 65, p. 209Radwanski, R.J., Kim-Ngan, N.H., Kayzel, F.E., Franse, J.J.M., Gignoux, D., Schmitt, D., Zhang, F.Y., (1992) J. Phys.: Condens. Matter, 4, p. 8853Tishin, A.M., Magnetocaloric effect in the vicinity of phase transitions (1999) Handbook of Magnetic Materials, 12, pp. 395-524. , edited by K. H. J. Buschow (North-Holland Elsevier, Amsterdam, the Netherlands), Chap. 4Marzouk, N., Graig, R.S., Wallace, W.E., (1973) J. Phys. Chem. Solids, 34, p. 15Barthem, V.M.T.S., Gignoux, D., Schmitt, D., (1989) J. Magn. Magn. Mater., 78, p. 56Zhang, F.Y., Gignoux, D., Schmitt, D., Franse, J.J.M., Kayzel, F.E., Kim-Ngan, N.H., Radwanski, R.J., (1994) J. Magn. Magn. Mater., 130, p. 108Morellon, L., Algarabel, P.A., Ibarra, M.R., Del Moral, A., Gignoux, D., Schmitt, D., (1996) J. Magn. Magn. Mater., 153, p. 17Barthem, V.M.T.S., Gignoux, D., Nait-Saada, A., Schmitt, D., Takeuchi, A.Y., (1989) J. Magn. Magn. Mater., 80, p. 142Gignoux, D., Givord, D., Del Moral, A., (1976) Solid State Commun., 19, p. 891Andreeff, A., Valter, V., Grissmann, H., Kaun, L.P., Lipold, B., Mats, V., Franzkhaim, T., (1978) JINR Rapid Commun., 1978, pp. 14-11324Marzouk, N., Graig, R.S., Wallace, W.E., (1973) J. Phys. Chem. Solids, 34, p. 1

The Magnetic And Magnetocaloric Properties Of Gd 5ge 2si 2 Compound Under Hydrostatic Pressure

The Gd5 Ge2 Si2 compound presents a giant magnetocaloric effect with transition temperature at around 276 K and is a very good candidate for application as an active regenerator material in room temperature magnetic refrigerators. Recently it has been shown that pressure induces a colossal magnetocaloric effect in MnAs, a material that presents a giant magnetocaloric effect and a strong magnetoelastic coupling, as also happens with the Gd5 Ge2 Si2 compound. This motivated a search of the colossal effect in the Gd5 Ge2 Si2 compound. This work reports our measurements on the magnetic properties and the magnetocaloric effect of Gd5 Ge2 Si2 under hydrostatic pressures up to 9.2 kbar and as a function of temperature. Contrary to what happens with MnAs, pressure increases the Curie temperature of the compound, does not affect the saturation magnetization and decreases markedly its magnetocaloric effect. © 2005 American Institute of Physics.9710Pecharsky, V.K., Gschneidner Jr., K.A., (1977) Phys. Rev. Lett., 78, p. 4494Pecharsky, V.K., Gschneidner Jr., K.A., (2001) Adv. Mater. (Weinheim, Ger.), 13, p. 683Morellon, L., Algarabel, P.A., Ibarra, M.R., Blasco, J., García-Landa, B., Arnold, Z., Albertini, F., (1998) Phys. Rev. B, 58, p. 14721Del Moral, A., Algarabel, P.A., Arnaudas, J.I., Benito, L., Ciria, M., De La Fuente, C., García-Landa, B., De Teresa, J.M., (2002) J. Magn. Magn. Mater., 242-245, p. 788Pecharsky, A.O., Gschneidner Jr., K.A., Pecharsky, V.K., (2003) J. Magn. Magn. Mater., 267, p. 60Pecharsky, A.O., Gschneidner Jr., K.A., Pecharsky, V.K., (2003) J. Appl. Phys., 93, p. 4722Gama, S., De Campos, A., Carvalho Magnus, A.G., Coelho, A.A., Gandra, F.C.G., Von Ranke, P.J., De Oliveira, N.A., (2004) Phys. Rev. Lett., 93, p. 237202Von Ranke, P.J., De Oliveira, N.A., Gama, S., (2004) J. Magn. Magn. Mater., 277, p. 78Pecharsky, V.K., Gschneidner Jr., K.A., (1998) Adv. Cryog. Eng., 43, p. 1729Menyuk, N., Kafalas, J.A., Dwight, K., Goodenough, J.B., (1969) Phys. Rev., 177, p. 942Morellon, L., Arnold, Z., Algarabel, P.A., Magen, C., Ibarra, M.R., Skorodhod, Y., (2004) J. Phys.: Condens. Matter, 16, p. 162