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Extensive multiarterial resection attending total duodenopancreatectomy and adrenalectomy for MEN-1-associated neuroendocrine carcinomas

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World Journal of Gastrointestinal Surgery 2012年第10期4卷 238-245页

作者： vyacheslav ivanovich egorov Alexander Felixovich Kharazov Alla Ivanovna Pavlovskaya Roman Valeryevich Petrov Natalia Sergeevna Starostina Eugeny Valerievich Kondratiev Ekaterina Mikhailovna Filippova Department of Hepatopancreatobiliary Surgery Vishnevsky Institute of Surgery117997 MoscowRussia Department of Vascular Surgery Vishnevsky Institute of Surgery117997 MoscowRussia Department of Pathology Blokhin Cancer Research Centre Moscow117997 MoscowRussia Department of Radiology Vishnevsky Institute of Surgery117997 MoscowRussia Department of Pathology Vishnevsky Institute of Surgery117997 MoscowRussia

Pancreatic neuroendocrine tumors(PNTs) are relatively uncommon although these neoplasms have been noted to grow in occurrence in recent *** removal of locally advanced PNTs involving major vessels and adjacent organs is warranted by reason of an appreciably more favorable prognosis as compared to exocrine pancreas *** are reporting a case of successful multi-organ resection combined with a wide excision of the superior mesenteric,common,proper,left and right hepatic arteries(in the presence of the hepatomesenteric trunk variant of aberrant arterial anatomy) for multifocal PNTs in the setting of multiple neuroendocrine neoplasia type 1 *** procedure resulted in pain abolition,a significant improvement in the patient's life quality and allowed her to return to ***-up computed tomography at 15 mo post-surgery showed no evidence of disease recurrence.

关键词： Total duodenopancreatectomy Pancreatic neuroendocrine tumors Islet cell tumors Neuroendocrine carcinoma Multiple endocrine neoplasia type 1 syndrome

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Reperfusion injury after critical intestinal ischemia and its correction with perfluorochemical emulsion "perftoran"

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World Journal of Gastroenterology 2005年第45期11卷 7084-7090页

作者： vyacheslav Leontjevich Kozhura Dmitriy Alexeevich Basarab Marina Innokentievna Timkina Arkadiy Mikhailivich Golubev Vasiliy ivanovich Reshetnyak Viktor Vasiljevich Moroz Research Institute of General Reanimatology

AIM： To investigate the anti-ischemic properties of perfluorochemical emulsion ＂perftoran＂ in mesenteric region. METHODS： Experiments were conducted on 146 nonlinear white male rats weighing 200-350 g. Partial critical intestinal ischemia was induced by thorough atraumatic strangulation of 5-6 cm jejunal loop with its mesentery for 90 rain. Global critical intestinal ischemia was made by atraumatic occlusion of the cranial mesenteric artery （CMA） for 90 rain also. Perftoran （PF, 0.8-1.0 mL per 100 g） in experimental groups or 0.9% sodium chloride in control groups was injected at 75 rain of ischemic period. Mean systemic arterial blood pressure （BPM） registration, intravital microscopy and morphological examination of ischemic intestine and its mesentery were performed in both groups. RESULTS： During 90 min of reperfusion, BPM progressively decreased to 27.3±7.4% after PF administration vs 38.6±8.0% in the control group of rats with partial intestinal ischemia （NS） and to 50.3±6.9% vs 53.1±5.8% in rats after global ischemia （NS）. During the reperfusion period, full restoration of microcirculation was never registered; parts with restored blood flow had leukocyte and erythrocyte stasis and intra-vascular clotting, a typical ＂non-reflow＂phenomenon. The reduction of mesenteric 50-400 μm feeding artery diameter was significantly less in the PF group than in the control group （24±5.5% vs 45.2±3.6%, P〈0.05） 5 min after partial intestinal ischemia. This decrease progressed but differences between groups minimized at the 90th min of reperfusion （41.5±4.2% and 50.3±2.8%, respectively）. In reperfusion of rat＇s intestine, a significant mucosal alteration was registered. Villous height decreased 2.5-3 times and the quantity of crypts decreased more than twice. In the group of rats administered PF, intestinal mucosal layer was protected from irreversible post-ischemic derangement during reperfusion. Saved cryptal epithelial cells were the source of regeneration of the epithelium

关键词： Rats Ischemia-reperfusion injury Gut Intestine Perfluorocarbon emulsions

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