28 research outputs found
PTH-013 Retrospective study on oesophageal stricture after endoscopic submucosal dissection stricture in a regional tertiary referral centre
No full textColorectal cancer prediction via applying recursive cluster elimination with ıntra-cluster feature elimination on metagenomic pathway data
No full textAdvances in next-generation sequencing and in “-omics” technologies enable the characterization of the human gut microbiome. Colorectal cancer (CRC), the third most common cancer worldwide, is caused by genetic mutations, environmental influences, and abnormalities in the gut microbiota. The aim of this study is to identify pathways that influence host metabolism in CRC patients. The CRC-related metagenomic dataset used in this study contains the relative abundance values of 551 pathways calculated for 1262 samples. Here, two different approaches based on the feature grouping reduce the number of features by considering relevant features as groups, eliminate irrelevant features, and perform classification. The recursive cluster elimination with intra-cluster feature elimination (RCE-IFE) approach achieves an AUC of 0.72 using an average of 66.2 features on CRC-associated metagenomics dataset. In these experiments, P163-PWY: L-lysine fermentation to acetate and butanoate and PWY-6151: S-adenosyl-L-methionine cycle I pathways are identified as potential biomarkers associated with CRC. These experiments also reduce the number of features reported by both approaches in P163-PWY: L-lysine fermentation to acetate and butanoate and PWY-6151: Sadenosyl-L-methionine cycle I pathways reported by both approaches are considered possible CRC-related biomarkers. This study contributes to the molecular diagnosis and treatment of colorectal cancer by revealing the pathways associated with CRC. Our results are promising for the study of the gut microbiota and its role in CRC. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2024
Simultaneous laparoscopic totally extraperitoneal repair for concurrent ipsilateral spigelian and indirect inguinal hernia
No full textSimultaneous unilateral spigelian and inguinal hernia is uncommon. Majority of the approaches to repair of spigelian hernia is open surgery. We report our technique of a simultaneous repair of both spigelian and inguinal hernia using the totally extraperitoneal laparoscopic mesh repair. © 2008 by Lippincott Williams & Wilkins.link_to_subscribed_fulltex
A Western single-center experience with endoscopic submucosal dissection for early gastrointestinal cancers
No full text06/03/14 meb. Accepted author manuscript, OK to add.Endoscopic Submucosal Dissection (ESD) has gained worldwide acceptance as a treatment for Early Gastrointestinal Cancers (EGICs). However, the management of these tumors in the Western world is still mainly surgical.
Our aim was to evaluate the safety and feasibility of ESD in a European center.
Based on the knowledge transferred by one of the most experienced Japanese Institutions, we conducted a pilot study on 25 consecutive patients with EGICs located in the esophagus (n=3), stomach (n=7), duodenum (n=1) and colon (n=14) at our tertiary center over a 2-year-period. Main outcome measurements were complete (R0), as were en bloc resection and management of complications.
R0 and en bloc resection rates were 100% and 84% respectively. There were 3 bleeding and 5 perforation cases. With a median follow-up of 15 months, 2 recurrences were observed.
ESD for early esophageal and gastric cancers is feasible and effective while colonic ESD requires more expertise
The Troubles with Essence. On Some Essential and Non-essential Concepts of "Essence" (with Reference to Rev. Jan Salamucha)
No full textThe author considers three groups of concepts of essence, defines them in the modified language of functional calculus and classes calculus, points out connections between them, analyses their difficulties and presents the concepts derived from "essence".
These groups are as follows:1. Three non-essential concepts of "essence" (found in works by Arystoteles, M. A. Krąpiec, T. Czeżowski, A. B. Stępień), i.e.:(i) essence as any property of the object:∧ x ∧ I (I is the essence of x ≡ I x);(ii) essence as the necessary property of the object:∧ x ∧ I is the essence of x ≡ ∧ y [(x = y) → Iy] ;(iii) essence as all properties of the object:∧ x ∧ I I is the essence of x ≡ ∧ P [Px ≡ (P ∈ I) .2. One more essential concept of "essence" (Rev. J. Salamucha, and also: Arystoteles, St. Thomas Aquinas, K. Ajdukiewicz, A. B. Stępień), i.e. essence as the property «common» to all object of the given group (and only to these objects):∧ x ∧ I I is the essence of x as Z ≡ [(x ∈ Z) →/← Ix] .3. Two the most essential concepts of "essence" (K. Ajdukiewicz, T. Kotarbiński), i.e.:(i) the simple essence as a «common» and «characteristic» property (see 2.), from which the other important («characteristic») properties result:∧ x ∧ I ∧ Z ⟨I is the simple essence of x as Z ≡ [(x ∈ Z ≡ Ix] ∧ y ∧ PW [y ∈ Z) → Pwy] → (Iy → PWy) ⟩;(ii) the complex essence as the constitutive intension of a name:∧ x ∧ I ∧ Z ∧ P ∧ Q ⟨I is the complex essence of x as Z ≡ [(x ∈ Z) ≡ Ix] ∼ ∨ P ∧ Q {[Q = (I − P)] → ∧ y [(y ∈ Z ≡ Qy] ⟩
Estimation of outbreak severity and transmissibility : influenza A(H1N1)pdm09 in households
No full textWhen an outbreak of a novel pathogen occurs, some of the most pressing questions from a public-health point of view relate to its transmissibility, and the probabilities of different clinical outcomes following infection, to allow an informed response. Estimates of these quantities are often based on household data due to the high potential for transmission in this setting, but typically a rich spectrum of individual-level outcomes (from uninfected to serious illness) are simplified to binary data (infected or not). We address the added benefit from retaining the heterogeneous outcome information in the case of the 2009-10 influenza pandemic, which posed particular problems for estimation of key epidemiological characteristics due to its relatively mild nature and hence low case ascertainment rates.
Methods
We use mathematical models of within-household transmission and case ascertainment, together with Bayesian statistics to estimate transmission probabilities stratified by household size, the variability of infectiousness of cases, and a set of probabilities describing case ascertainment. This novel approach was applied to data we collected from the early "containment phase" stage of the epidemic in Birmingham, England. We also conducted a comprehensive review of studies of household transmission of influenza A(H1N1)pdm09.
Results
We find large variability in the published estimates of within-household transmissibility of influenza A(H1N1)pdm09 in both model-based studies and those reporting secondary attack rates, finding that these estimates are very sensitive to how an infected case is defined. In particular, we find that reliance on laboratory confirmation alone underestimates the true number of cases, while utilising the heterogeneous range of outcomes (based on case definitions) for household infections allows a far more comprehensive pattern of transmission to be elucidated.
Conclusions
Differences in household sizes and how cases are defined could account for an appreciable proportion of the reported variability of within-household transmissibility of influenza A(H1N1)pdm09. Retaining and statistically analysing the full spectrum of individual-level outcomes (based on case definitions) rather than taking a potentially arbitrary threshold for infection, provides much-needed additional information. In a future pandemic, our approach could be used as a real-time analysis tool to infer the true number of cases, within-household transmission rates and levels of case ascertainment
Early results of a safety and feasibility clinical trial of a novel single-port flexible robot for transoral robotic surgery
No full textpublished_or_final_versio
Prospective clinical trial to evaluate safety and feasibility of using a single port flexible robotic system for transoral head and neck surgery
No full textIntroduction:
The aim of this study was to determine the clinical safety and feasibility of a novel single-port flexible robot for Transoral Robotic Surgery (TORS).
Materials and methods:
This was a prospective phase II / IDEAL stage 2 clinical trial of both benign and malignant lesions of the head and neck. The primary endpoint included conversion rates and perioperative complications within 30 days following surgery. The study was registered on www.ClinicalTrials.gov (NCT03010813). The Fisher’s exact test and Mann-Whitney U test were used to compare categorical, and non-parametric data for the trial. A p value <0.05 was considered to be statistically significant. Statistical analysis was performed with SPSS 20.0 (IBM Corp., Armonk, New York)
Results:
Twenty-one patients safely underwent TORS with the da Vinci SP (Intuitive Surgical Inc., Sunnyvale, CA) demonstrating the feasibility of access to the nasopharynx, oropharynx, larynx and hypopharynx. There were no conversions of the robotic surgical system. There were no serious adverse events or adverse events related to the use of the robot at 30-day follow-up for all patients.
Conclusions:
In a prospective Phase II clinical trial, a novel single-port flexible robotic system appears safe and feasible to use for transoral endoscopic head and neck surgery to access the nasopharynx, oropharynx, larynx and hypopharynx.published_or_final_versio
Push-type percutaneous endoscopic gastrostomy with ultrathin endoscope in patients with severe trismus or obstruction due to head and neck cancers: A case series
No full textAim: Endoscopically-placed, push-type percutaneous endoscopic gastrostomies (PEG) have recently been made possible through the use of a gastropexy device. However, the safety and efficacy of the procedure in patients suffering from severe trismus or malignant obstruction due to head and neck cancers have rarely been reported. The aim of this study was thus to investigate the feasibility, safety and risk of endoscopic push-type PEG in this group of patients. Patients and Methods: Consecutive patients who were indicated for PEG and suffered from severe trismus or malignant obstruction due to head and neck cancers, precluding the introduction of a 9.8mm oesophagogastroduodenoscope were included. Push-type PEG was performed under endoscopic control with a 5-mm endoscope and the loop fixture device. Results: Eleven patients had push-type PEG performed under conscious sedation. All procedures were successful, and minor complications occurred in one patient with a dislodged gastrostomy tube and another with wound infection. There were no mortalities or major morbidities related to the procedure. Conclusions: Push-type PEG with gastropexy inserted under endoscopic control by an ultrathin endoscope is a feasible alternative to open gastrostomy in patients with severe trismus or pharyngeal obstruction. © 2011 The Authors. Surgical Practice © 2011 College of Surgeons of Hong Kong.link_to_subscribed_fulltex
A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy
No full textBackground: The aim of this study was to compare patients who underwent single-site access laparoscopic appendectomy (SSALA) to those who underwent conventional three-port laparoscopic appendectomy (TPLA) in a case-controlled manner. Methods: Consecutive patients who underwent SSALA for suspected acute appendicitis between April and September 2009 were retrospectively compared to those who underwent TPLA between January and December 2008 in a case-controlled manner. The patients were matched for age, gender, and pathological findings. The main outcome measurements included postoperative recovery, morbidities, and mortalities. Results: During the study period, a total of 30 patients underwent SSALA and these were matched with 60 TPLA patients. There were no significant differences in the mean operative time, hospital stay, and 30-day morbidity rate between the two groups. None of the patients required conversion. Two patients with significant contamination and abscess collection noted during SSALA required a relaparotomy for peritoneal lavage and adhesiolysis due to prolonged ileus. Conclusions: SSALA is feasible and the perioperative outcome was comparable to that of TPLA. However, future prospective studies will need to evaluate whether SSALA can adequately tackle patients with significant peritoneal contamination. © 2010 Springer Science+Business Media, LLC.link_to_subscribed_fulltex
