862 research outputs found
Letter from Karl I. Zimmerman and T.R. Martinez to Toshiko Chuman
No full textA letter to Toshiko Chuman (nee Nakamura) from Karl I. Zimmerman, District Director of Immigration and Naturalization Service (INS) in Philadelphia, and T.R. Martinez, Acting Chief, Detention, Deportation and Parole Section. The letter regards his release from INS into the custody of her attorney, Wayne M. Collins.The Chuman (Hayao "Sam" and Toshiko) Papers documents the World War II experiences of Hayao "Sam" and Toshiko Chuman, who were Kibei Nisei born in the United States but grew up and completed school in Japan, and then returned to the U.S. prior to the war. It chronicles the Chuman's incarceration from the Santa Anita Assembly Center, through Jerome, Rohwer, Tule Lake camps, and the Santa Fe and Crystal City internment camps as well as their struggle for restoring their U.S. citizenships in the 1960s. The digital collection consists of mostly textual material, including correspondence, affidavits, incarceration camp records, lease agreements, financial documents, receipts, pamphlets, and booklets
Letter from Karl I. Zimmerman and T.R. Martinez to Hayao (Sam) Chuman
No full textA letter to Hayao (Sam) Chuman from Karl I. Zimmerman, District Director of Immigration and Naturalization Service (INS) in Philadelphia, and T.R. Martinez, Acting Chief, Detention, Deportation and Parole Section. The letter regards his release from INS into the custody of his attorney, Wayne M. Collins.The Chuman (Hayao "Sam" and Toshiko) Papers documents the World War II experiences of Hayao "Sam" and Toshiko Chuman, who were Kibei Nisei born in the United States but grew up and completed school in Japan, and then returned to the U.S. prior to the war. It chronicles the Chuman's incarceration from the Santa Anita Assembly Center, through Jerome, Rohwer, Tule Lake camps, and the Santa Fe and Crystal City internment camps as well as their struggle for restoring their U.S. citizenships in the 1960s. The digital collection consists of mostly textual material, including correspondence, affidavits, incarceration camp records, lease agreements, financial documents, receipts, pamphlets, and booklets
Nissen Fundoplication for Gastroesophageal Reflux Disease
No full textIn a prospective study, the Nissen fundoplication was shown to be superior to both the Belsey and Hill procedure in the control of reflux symptoms and in the restoration of distal esophageal sphincter competence [2]. Despite these excellent early results, concern was expressed regarding the durability and long-term side effects of this operation. The purpose of this study was to evaluate the results of 100 consecutive primary Nissen fundoplication procedures performed and followed by the same surgeon over a 13-year period. The findings advanced our understanding of the criteria for patient selection, the technique of constructing the fundoplication, and the durability of the Nissen procedure
LINXTM Reflux Management System : magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease
No full textGastroesophageal reflux disease (GERD), commonly manifested by heartburn or regurgitation, is a chronic, progressive condition in which failed sphincter function allows the contents of the stomach to reflux into the esophagus, the airways and the mouth. Chronic GERD affects 10% of Western society. The majority of patients receive adequate relief from proton pump inhibitors, but up to 40% have incomplete relief of symptoms that cannot be addressed by increasing the dose of medications. The laparoscopic Nissen fundoplication is the surgical gold standard; however, the level of technical difficulty and its side effects have limited its use to less than 1% of the GERD population. These factors have contributed to the propensity of patients to persist with medical therapy, even when inadequate to control symptoms and complications of the disease. Consequently, a significant gap in the treatment continuum for GERD remains evident in current clinical practice. The LINXTM Reflux Management System (Torax Medical) is designed to provide a permanent solution to GERD by augmenting the physiologic function of the sphincter barrier with a simple and reproducible laparoscopic procedure that does not alter gastric anatomy and can be easily reversed if necessary
Magnetic augmentation of the lower esophageal sphincter : changing the treatment paradigm in patients with gastroesophageal reflux disease
No full textLINX(®) Reflux Management System in chronic gastroesophageal reflux : a novel effective technology for restoring the natural barrier to reflux
No full textGastroesophageal reflux disease (GERD) results from incompetency of the lower esophageal sphincter that allows the contents of the stomach to reflux into the esophagus, the airways, and the mouth. The disease affects about 10% of the western population and has a profound negative impact on quality of life. The majority of patients are successfully treated with proton-pump inhibitors, but up to 40% have incomplete relief of symptoms even after dose adjustment. The laparoscopic Nissen fundoplication represents the surgical gold standard, but is largely underused because of the level of technical difficulty and the prevalence of side effects. These factors have contributed to the propensity of patients to continue with medical therapy despite inadequate symptom control and complications of the disease. As a consequence, a significant 'therapy gap' in the treatment of GERD remains evident in current clinical practice. The LINX® Reflux Management System (Torax Medical, St. Paul, MN, USA) is designed to provide a permanent solution to GERD by augmenting the sphincter barrier with a standardized, reproducible laparoscopic procedure that does not alter gastric anatomy and is easily reversible. Two single-group trials confirmed that a magnetic device designed to augment the lower esophageal sphincter can be safely and effectively implanted using a standard laparoscopic approach. The device decreased esophageal acid exposure, improved reflux symptoms and quality of life, and allowed cessation of proton-pump inhibitors in the majority of patients
Chronic respiratory symptoms and occult gastroesophageal reflux. A prospective clinical study and results of surgical therapy
No full textSeventy-seven patients with a primary complaint of persistent cough, wheezing, and/or recurrent pneumonia were evaluated for the presence of occult gastroesophageal reflux disease. Fifty-four patients (70%) had increased esophageal acid exposure on 24-hour pH monitoring of the distal esophagus. In 28% of these patients the respiratory symptoms were thought to be due to aspiration because they occurred during or within 3 minutes after a reflux episode. In the other patients, the respiratory symptoms were either induced by or were unrelated to reflux episodes. The number of respiratory symptoms reported by the patients with increased esophageal acid exposure was directly related to the presence of a nonspecific esophageal motility abnormality (p less than 0.05). This suggested that a motility disorder contributes to aspiration by promoting the aboral flow of refluxed gastric juice. Seventeen patients with increased esophageal acid exposure had an antireflux operation to relieve their respiratory complaints. Patients whose respiratory symptoms induced reflux episodes were not helped by the procedure. Of the other patients, symptoms were abolished by the procedure only in those with normal esophageal motility. It is concluded that the majority of patients suffering from chronic unexplained respiratory symptoms have occult gastroesophageal reflux disease, but only a minority of them are helped by surgery. Carefully performed esophageal function studies are needed to select those patients who will benefit from a surgical antireflux procedure
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