7 research outputs found
Transanal endoscopic microsurgery: an indispensable component of contemporary coloproctology
No full textPetr Vavra, Petr Andel, Anton Pelikan, Lubomir Martinek, Petra Gunkova, Igor Gunka
Department of Surgery University Hospital of Ostrava,
Ostrava-Poruba, 17. listopadu 1790,
708 52 Ostrava, Czech Republic
E-mail: [email protected]
Background / objective
At many surgical and gastroenterological working places still persists the problem what to do with an adhered tumour in the rectum at an unfavourable distance from the anus. This paper presents the possibilities offered by contemporary coloproctology by means of TEM (transanal endoscopic microsurgery) applied to the lesions that are hardly accessible.
Patients and methods
At the Department of Surgery of University Hospital Ostrava, the TEM method has been used since August 2002. The technique itself was implemented by Buess in the year 1983. His working place in Tübingen, Germany serves also as a training centre for teaching TEM. In the Czech Republic, the TEM method was used for first time in 1992. In TEM methodology the advantages of mini-invasive endoscopic medical help and the advantages of surgical treatment are combined.
Results
At the Department of Surgery of University Hospital of Ostrava in the period between 01/2003 and 12/2003 we carried out 37 operations by means of TEM. Of this number, 15 patients were operated on for benign rectum affection, 18 for malign disease, other 4 operations were twice on periproctal fistula, one operation for rectum stenosis, one introduction of a self-expandible stent. In malign rectum lesions we performed CT and endosonography preoperatively and used TEM twice for carcinoma in situ, 6 times for T1NXM0 lesions, 3 times for T2NXM0 lesions and 4 times for T3NXM0 lesions. These patients were then operated on transabdominally on the basis of definite histological findings. For a palliative effect we used TEM twice in patients with metastatic liver affection T3NXMl and once for a patient with T4NXMl.
Conclusions
The TEM methodology introduced in 2002 has become an inseparable and inevitable component of coloproctological operations at our department. We think the main contribution of this method consists in a safe treatment of wide benign rectum lesions, in treatment of early rectal carcinoma stages, and last but not least, the use of TEM in palliative surgery of rectum while emphasising the quality of life preservation.
Keywords: transanal endoscopic microsurgery, TEM unfavourable distance, indication, harmonic scalpe
Nationalism through Song in Postwar Japan : An Analysis of Themes in Kodama Yoshio's Minzoku no uta
No full textMusic has always played an important role in warfare and dissemination of ideological messages. This study is a thematic analysis of a 1969 Japanese nationalistic song called Minzoku no uta, written by right-wing activist Kodama Yoshio. The aim is to offer possible explanations as to the thematic characteristics of the song, and to identify its core message. To this end, the interdisciplinary approach of critical discourse analysis is applied; in order to fully grasp the song's content, the author of this thesis performs a close reading of its lyrics and also produces a translation into English, which is guided by the skopos of documentary translation. The basic framework for the thematic content analysis is provided by a study by Satoshi Sugita (1972), which examines recurring major themes in Japanese war songs (known in Japanese as gunka), produced prior to and during the Second World War. This present study makes a comparison with Sugita's study, in order to determine thematic similarities and dissimilarities between Minzoku no uta and gunka. Gunka have been, and to some extent still are, a relatively unknown subject in English-language scholarship; this should ring even truer for nationalistic postwar songs such as Minzoku no uta. Therefore, the goal of this study is to shed more light on this niche subject. The primary material used in this research is the lyrics of Minzoku no uta, with Sugita's study and Kodama's autobiography Ware yaburetari constituting the most important secondary sources. The results of this study show that "nation" is the most salient theme in Minzoku no uta, which heavily affects how similar to or dissimilar from gunka the song is. The core message of the song seems to be centered around the appreciation and revival of an ideology called "the Imperial Way", known in Japanese as kōdō
Nationalism through Song in Postwar Japan : An Analysis of Themes in Kodama Yoshio's Minzoku no uta
No full textMusic has always played an important role in warfare and dissemination of ideological messages. This study is a thematic analysis of a 1969 Japanese nationalistic song called Minzoku no uta, written by right-wing activist Kodama Yoshio. The aim is to offer possible explanations as to the thematic characteristics of the song, and to identify its core message. To this end, the interdisciplinary approach of critical discourse analysis is applied; in order to fully grasp the song's content, the author of this thesis performs a close reading of its lyrics and also produces a translation into English, which is guided by the skopos of documentary translation. The basic framework for the thematic content analysis is provided by a study by Satoshi Sugita (1972), which examines recurring major themes in Japanese war songs (known in Japanese as gunka), produced prior to and during the Second World War. This present study makes a comparison with Sugita's study, in order to determine thematic similarities and dissimilarities between Minzoku no uta and gunka. Gunka have been, and to some extent still are, a relatively unknown subject in English-language scholarship; this should ring even truer for nationalistic postwar songs such as Minzoku no uta. Therefore, the goal of this study is to shed more light on this niche subject. The primary material used in this research is the lyrics of Minzoku no uta, with Sugita's study and Kodama's autobiography Ware yaburetari constituting the most important secondary sources. The results of this study show that "nation" is the most salient theme in Minzoku no uta, which heavily affects how similar to or dissimilar from gunka the song is. The core message of the song seems to be centered around the appreciation and revival of an ideology called "the Imperial Way", known in Japanese as kōdō
Tiesiosios žarnos vėžio chirurginis gydymas Ostravos universiteto ligoninėje, Čekijos Respublika
No full textPetr Vavra1, Marie Rydlova3, Anton Pelikan1, Lubomir Martinek1, Petra Gunkova1, Michaela Vavrova2, Igor Gunka1
1 Department of Surgery and 2 Department of Radiology,
University Hospital of Ostrava,
3 Department of Pathology, Medical-Social Faculty
of University of Ostrava,
17 listopadu 1790, 708 52 Ostrava Poruba,
Czech Republic
E-mail: [email protected]
Background / objective
Czech Republic is among the countries with the highest incidence of rectal cancer. The aim of the prospective study was to monitor the surgical treatment of patients with the diagnosis of rectal cancer.
Patients and methods
188 patients (121 males and 67 females) with rectal cancer were operated on within the period of three years (2000–2002). The definitive analysis encompassed 171 patients. The following aspects were observed: the types of operations carried out, the safety distance of the lower resection line during the operation of rectal cancer mainly, the amount of lymphatic nodes spotted in the mesorectum and the possibility of their laparoscopic treatment.
Results
129 patients were operated on by conventional methods and 42 patients (24.6%) by laparoscopical methods (25 anterior resections, 6 abdominoperineal amputations, 10 colostomies, 1 proctocolectomy). At a distance of 2 mm from the aboral edge of the tumour, the distal intramural spread of cancer was detected in 8 (11.8%), at 5 mm in 6 (9%), at 1 cm in 2 (2.6%), at 2 cm in 4 patients (5.8 %) and at 5 cm from the macroscopical edge no distal intramural spread was recorded. Enlarged lymphatic nodes were discovered in 128 patients. In total, there were 1383 lymphatic nodes, i.e. 10.8 lymphatic nodes per patient. 271 lymphatic nodes (19.5%) affected by a tumour process, i.e. 2.1 affected lymphatic nodes per patient were found. The number of the affected lymphatic nodes in the mesorectum was compared in connection with the usage of conventional or laparascopical operation. There was no difference in oncological radicality as far as these types of operations are concerned.
Conclusions
There is no evidence of the spread of well differentiated adenocarcinoma from the aboral edge of the tumour. All positive findings of distal intramural spread were found in the medium and lower differentiated adenocarcinomas. The distal intramural spread of the tumour is quite rare, but when present it signifies a very advanced and aggressive progress of the illness with a bad prognosis. It is too early to formulate the conclusions comparing the conventional and the laparoscopic approaches to rectal cancer
Emergent Carotid Thromboendarterectomy for Acute Symptomatic Occlusion of the Extracranial Internal Carotid Artery
No full textBackground: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. Methods: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015. Primary outcomes were disability at 90 days assessed by the modified Rankin Scale (mRS) and neurological deficit at discharge assessed using the National Institute of Health Stroke Scale (NIHSS). Secondary outcomes were the recanalization rate, 30-day overall mortality, and any intracerebral bleeding. Results: During the study period, a total of 6 patients (5 men and 1 woman) with a median age of 64 years (range: 58-84 years) underwent emergent reconstruction for acute symptomatic ICA occlusion within a median of 5.4 hours (range: 2.9-12.0 hours) after symptoms onset. The median presenting NIHSS score was 10.5 points (range: 4-21). Before surgery, 4 patients (66.7%) had been treated by systemic recombinant tissue plasminogen activator lysis. The median time interval between initiation of intravenous thrombolysis and carotid thromboendarterectomy was 117.5 minutes (range: 65-140 minutes). Patency of the ICA was achieved in all patients. On discharge, the median NIHSS score was 2 points (range: 0-11 points). There was no postoperative intracerebral hemorrhage and zero 30-day mortality rate. At 3 months, 5 patients (83.3%) had a good clinical outcome (mRS ≤ 2). Conclusion: Patients presenting with minor to severe ischemic stroke syndromes due to isolated extracranial ICA occlusion may benefit from emergent carotid revascularization. Thorough preoperative neuroimaging is essential to aid in selecting eligible candidates for acute surgical intervention. </jats:sec
