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Ileal loop interposition:an alternative biliary bypass technique

Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 654-657页

作者： Felipe JF Coimbra Alessandro l Diniz Heber SC Ribeiro Wilson l Costa Jr. Eduardo NP lima andrél montagnini Abdominal Surgery Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil Nuclear Medicine Imaging Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil

BACKGROUND:Obstructive jaundice is a common condition in advanced digestive *** procedures can improve quality of life and allow patients to attempt a systemic *** anastomosis is still the procedure of choice for patients in many *** a surgical bypass is not possible,biliary drainage can be done by placing endoscopic or transparietal stents,which are less durable methods even when an expandable stent is employed. METHODS:A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice.A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic *** other signs of metastasis were found.A surgical bilioenteric anastomosis was *** surgery,a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically,an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESUlT:The recovery of the patient was uneventful and his bilirubin levels normalized after one *** patient was then referred for systemic chemotherapy. CONClUSIONS:This alternative biliary bypass can be safely and easily performed,and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

关键词： biliary bypass ileal loop interposition biliary cancer

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Biliary tract schwannoma:A rare cause of obstructive jaundice in a young patient

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World Journal of Gastroenterology 2012年第37期18卷 5305-5308页

作者： Gilton Marques Fonseca andré luis montagnini Manoel de Souza Rocha Rosely Antunes Patzina Mário Vinícius Angelete Alvarez Bernardes Ivan Cecconello José Jukemura Digestive Surgery Division Department of GastroenterologySchool of MedicineUniversity of So Paulo

Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastro-intestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumordid not recur in any of the resected cases.

关键词： Schwannoma Neurilemoma Biliary tract Hilar adenocarcinoma Computadorized tomography

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Differential expression of apoptosis related proteins and nitric oxide synthases in Epstein Barr associated gastric carcinomas

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World Journal of Gastroenterology 2006年第31期12卷 4959-4965页

作者： Maria D Begnami andre l montagnini andre l Vettore Sueli Nonogaki Mariana Brait Alex Y Simoes-Sato andrea Q A Seixas Fernando A Soares Department of PathologyHospital do C(a|^)ncer A C Camargo S(a|~)o PauloSPBrazil Department of Abdominal SurgeryHospital do C(a|^)ncer A C Camargo S(a|~)o PauloSPBrazil ludwig Institute for Cancer ResearchS(a|~)o Paulo SPBrazil

AIM： To determine the incidence of Epstein Barr virus associated gastric carcinoma （GC） in Brazil and compare the expressions of apoptosis related proteins and nitric oxide synthases between EBV positive and negative gastric carcinoma. METHODS： In situ hybridization of EBV-encoded small RNA-1 （EBER-1） and PCR was performed to identify the presence of EBV in GCs. Immunohistochemistry was used to identify expressions of bcl-2, bcl-xl, bak, bax, p53, NOS-1, NOS-2, and NOS-3 proteins in 25 EBV positive GCs and in 103 EBV negative GCS. RESUlTS： 12% of the cases of GC （25/208） showed EBER-1 and EBNA-1 expression. The cases were preferentially of diffuse type with intense lymphoid infiltrate in the stroma. EBV associated GCs showed higher expression of bcl-2 protein and lower expression of bak protein than in EBV negative GCs. Indeed, expressions of NOS-1 and NOS-3 were frequently observed in EBV associated GCs. CONClUSION： Our data suggest that EBV infection may protect tumor cells from apoptosis, giving them the capacity for permanent cell cycling and proliferation. In addition, EBV positive GCs show high expression of constitutive NOS that could influence tumor progression and aggressiveness.

关键词： Gastric carcinoma EBV Apoptosis p53 Nitric oxide synthases

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liver resection for the treatment of post-cholecystectomy biliary stricture with vascular injury

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World Journal of Gastroenterology 2015年第7期21卷 2102-2107页

作者： Marcos V Perini Paulo Herman andre l montagnini Jose Jukemura Fabricio F Coelho Jaime A Kruger Telesforo Bacchella Ivan Cecconello Digestive Surgery Division Depar-tment of Gastroenterology University of Sao Paulo Medical School

AIM:To report experience with liver resection in a select group of patients with postoperative biliary stricture associated with vascular ***:From a prospective database of patients treated for benign biliary strictures at our hospital,cases that underwent liver resections were *** cases were referred after one or more attempts to repair bile duct injuries following cholecystectomy(open or laparoscopic).liver resection was indicated in patients with Strasberg E3/E4(hilar stricture)bile duct lesions associated with vascular damage(arterial and/or portal),ipsilateral liver atrophy/abscess,recurrent attacks of cholangitis,and failure of previous ***:Of 148 patients treated for benign biliary strictures,nine(6.1%)underwent liver resection;eight women and one man with a mean age of 38.6 *** patients had previously been submitted to open cholecystectomy and three to laparoscopic *** mean number of surgical procedures before definitive treatment was *** patients had Strasberg E3/E4injuries,and vascular injury was present in all *** patients underwent right hepatectomy and one underwent left lateral sectionectomy without *** time of follow up was 69.1 mo and after longterm follow up,eight patients are ***:liver resection is a good therapeutic option for patients with complex postoperative biliary stricture and vascular injury presenting with liver atrophy/abscess in which previous hepaticojejunostomy has failed.

关键词： Abscess Atrophy Benign Bile ducts Cholecystectomy

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管理森林休闲地:提高“刀耕火种”农业的经济效益

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人类环境杂志 1997年第2期26卷 115-119,109页

作者： Florencia montagnini Robert O.Mendelsohn 刘伟美国耶鲁大学林业与环境学院

对休闲地进行改良已被推荐为热带轮垦农业的管理方法之一。具有经济和生物效益的改良休闲地在美洲分布十分广泛,然而,真正实现上述两种效益的休闲地却很少。在本文中,我们对通过种植用材树来管理休闲地以培肥土壤和生产具有经济价值的... 详细信息

对休闲地进行改良已被推荐为热带轮垦农业的管理方法之一。具有经济和生物效益的改良休闲地在美洲分布十分广泛,然而,真正实现上述两种效益的休闲地却很少。在本文中,我们对通过种植用材树来管理休闲地以培肥土壤和生产具有经济价值的木材这一做法的经济可行性进行了评估。在实际利润率为5%时,从事自给自足农业生产的每公顷培肥休闲地产出价值5000～12000美元。该结果表明,以这一方式经营森林休闲地可使轮垦农业获得持续性发展并使其具有经济竞争力。尽管试验是在具体的立地条件下进行的,但实验中所用树种在拉丁美洲分布广泛,我们希望这一制度能够应用于生态和社会经济条件都相似的其它地区。

关键词：热带刀耕火种经济效益森林休闲地林业

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肝转移性黑色素瘤病人选择性实施肝切除是有益的

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中华肝胆外科杂志 2007年第7期13卷 492-492页

作者： Herman P Machado MA montagnini Al 杜继东（摘）邹一平（校）解放军总医院第二附属医院北京市100091 不详

由于肝切除不能明显提高肝转移性黑色素瘤病人的存活率，人们通常认为它是不可行的。本研究的目的是评价转移性黑色素瘤病人肝切除的临床经验。作者回顾1999年12月至2005年1月巴西***肿瘤医院和圣保罗医科大学收治的肝转移性黑色素瘤病... 详细信息

由于肝切除不能明显提高肝转移性黑色素瘤病人的存活率，人们通常认为它是不可行的。本研究的目的是评价转移性黑色素瘤病人肝切除的临床经验。作者回顾1999年12月至2005年1月巴西***肿瘤医院和圣保罗医科大学收治的肝转移性黑色素瘤病人367例的资料，当中18例有可能施行手术的病人均符合下列标准：

关键词：转移性黑色素瘤肝切除病人选择临床经验医科大学肿瘤医院存活率

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