17 research outputs found
Consideration regarding Concomitant Operations during Laparoscopic Ventral Hernia Repair: Indications, Management and Trocar Position
No full textKyzer, Jane (Death, 1866-08-08)
No full textAddress: 280 Main St.Age at death: 38 yrs1794/Pg. 64/1866/F W S/Ohio/Dr./F. H./Cem.Original record filed in drawer labeled 'KUHN, G-LACEY'
Correlação entre o anatomopatológico, a técnica operatória e as complicações pós-operatórias imediatas, dos casos de câncer gástrico operados no Hospital Florianópolis.
No full textTrabalho de Conclusão de Curso - Universidade Federal de Santa Catarina. Curso de Medicina. Dapartamento de Clínica Cirúrgica
Rumenectomy-induced proliferation in duodenal villous epithelium is mechanistically related to the disappearance of statin, a non-proliferation-specific nuclear protein.
No full text We undertook this study to determine the effect of rumenectomy (a known cause of duodenal crypt cell hyperplasia) on the epithelial growth kinetics of the crypt-villus axis in rat duodenum. Ten rats were randomly assigned to control (gastrotomy) and experimental (rumenectomy) groups. After 14 days rats were sacrificed and representative sections were stained with the monoclonal antibody to statin, a non-proliferation-specific protein, by the immunoperoxidase procedure. In the control group, the mean percentages of statin-positive cells in the proximal duodenum, distal duodenum, proximal jejunum, and distal jejunum were 79 +/- 8.5, 79.5 +/- 5.7, 85 +/- 1.4, and 83.5 +/- 0.7, respectively. In the rumenectomy group, statin-positive nuclei were found in the region of the villous apices only, and the corresponding values for the above four areas were 26.2 +/- 4.9, 24.5 +/- 3.5, 31.7 +/- 4.5, and 80.5 +/- 2.1. Except for distal jejunum, the differences in statin expression in the control and experimental groups were significant (p less than 0.001). Rumenectomy leads to the disappearance of statin from the villous column cells of the duodenum and proximal small bowel. The lack of expression of statin in the rumenectomy group documents the potential usefulness of this measure in future studies in neoplasia were understanding of the proliferative status is of crucial importance. </jats:p
Plasma protein profiling reveals protein clusters related to BMI and insulin levels in middle-aged overweight subjects
No full textBiomarkers that allow detection of the onset of disease are of high interest since early detection would allow intervening with lifestyle and nutritional changes before the disease is manifested and pharmacological therapy is required. Our study aimed to improve the phenotypic characterization of overweight but apparently healthy subjects and to identify new candidate profiles for early biomarkers of obesity-related diseases such as cardiovascular disease and type 2 diabetes
In vivo imaging of cellular proliferation in colorectal cancer using positron emission tomography
No full textBackground and aims: Positron emission tomography (PET) using 18F labelled 2-fluoro-2-deoxy-D-glucose (18FDG) is an established imaging tool, although the recent development of a biologically stable thymidine analogue [18F] 3'-deoxy-3-fluorothymidine (18FLT) has allowed PET to image cellular proliferation by utilising the salvage pathway of DNA synthesis. In this study, we have compared uptake of 18FLT and 18FDG with MIB-1 immunohistochemistry to evaluate the role of PET in quantifying in vivo cellular proliferation in colorectal cancer (CRC).
Patients and methods: Patients with resectable, primary, or recurrent CRC were prospectively studied. Thirteen lesions from 10 patients (five males, five females), median age 68 years (range 54–87), were evaluated. Patients underwent 18FDG and 18FLT PET scanning. Tracer uptake within lesions was quantified using standardised uptake values (SUVs). Histopathological examination and MIB-1 immunohistochemistry were performed on all lesions, and proliferation quantified by calculating a labelling index (% of MIB-1 positively stained nuclei within 1500 tumour cells).
Results: Histology confirmed adenocarcinoma in 12 of 13 lesions; the remaining lesion was reactive. All eight extrahepatic lesions were visualised using both 18FLT and 18FDG. Three of the five resected liver metastases were also avid for 18FLT and showed high proliferation, while the remaining two lesions which demonstrated no uptake of 18FLT had correspondingly very low proliferation. There was a statistically significant positive correlation (r =0.8, p<0.01) between SUVs of the tumours visualised with 18FLT and the corresponding MIB-1 labelling indices. No such correlation was demonstrated with 18FDG avid lesions (r =0.4).
Conclusions: 18FLT PET correlates with cellular proliferation markers in both primary and metastatic CRC. This technique could provide a mechanism for in vivo grading of malignancy and early prediction of response to adjuvant chemotherapy
Novel applications of biomaterials in the management of parastomal hernia and anal fistula
No full textMD (res)The aim of this thesis was to explore novel applications for both traditional and contemporary biomaterials in the management of parastomal hernia and anal fistula.
Parastomal hernias can be prevented or repaired using synthetic mesh; however, reported complications include infection, fibrosis and potential bowel erosion. The prophylactic role of a cross-linked collagen implant was assessed in terms of safety, feasibility and potential efficacy. Additionally, the human host response to this implant was evaluated. There were no complications related to infection or the implant‟s proximity to the bowel. The implant had excellent biocompatibility and resistance to degradation in most patients, and although fibrovascular in-growth and ECM deposition were limited, it seems to have excellent potential for soft tissue reinforcement and, more specifically, prevention of parastomal hernias.
Anal fistulas are in the main successfully treated by surgical fistulotomy, however damage to the anal sphincter complex and subsequent incontinence have led to the development of other techniques which aim to either lessen or avoid such disturbance. One strategy involves the traditional cutting seton, and a modification of this technique, the „snug‟ silastic seton was assessed. In the short-medium term, this modification was demonstrated to be an effective addition to the fistula surgeon‟s armamentarium, although minor incontinence remained a concern. Other approaches employing contemporary biomaterials, fibrin glue and porcine intestinal submucosa, are aimed at tissue repair, rather than minimizing destruction. Their success rates however are highly variable. A pilot study aiming to assess the safety and potential efficacy of an
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alternative biomaterial, cross-linked collagen in two different physical formats, was presented. In the short-medium term, both formats were shown to be safe, and equally effective. The results justify continued research into the use of biologically derived materials to heal anal fistulas.
In conclusion, although disparate pathologies were addressed, both they and the thesis are unified by demonstrating that an understanding of the specific disease pathology, wound healing, and the host response to materials (synthetic and biological) are central to their successful management
Towards safer colorectal surgery worldwide: Outcomes and benchmarks from the ESCP CORREA 2022 audit
No full textIntroduction: Benchmarking colorectal surgery outcomes informs quality improvement. The ESCP CORREA 2022 snapshot audit aimed to assess contemporary colorectal resection practices and short-term outcomes across European countries and beyond. Methods: An international prospective multicentre audit was conducted in which adults undergoing elective or emergency colorectal resection during a 6-week period (January-April 2022) at participating hospitals were included. Data on patient demographics, indications, surgical approach (open, laparoscopic or robotic) and 30-day postoperative outcomes (complications, reoperation and mortality) were collected for analysis. The outcomes were analysed and compared with those of previous audits to identify trends in colorectal surgery. Results: The study enrolled 3521 patients (56.8% men) from 216 hospitals across 53 countries. In 72.2% of the cases, the indication for resection was malignancy, followed by diverticular disease in 9.0%, Crohn's disease in 3.7% and ulcerative colitis in 2.3% of the cases. Of the surgeries, 74.4% were elective. Minimally invasive surgery was performed in 55.2% of the cases (48.7% laparoscopic and 6.5% robotic). Primary anastomosis was performed in 90.3% of the patients. The 30-day anastomotic leak rate was 7.96%; in malignant and benign diseases, the leak rates were 7.3% and 10.2%, respectively. The leak rates for right, left, anterior rectal resection, pouch and subtotal colectomy were 6.9%, 7.7%, 9.7%, 16.0% and 11.8%, respectively. In the multivariable analysis, the risk factors for leakage included male sex (9.3% vs. 6.3%, OR = 0.69, 95% CI 0.51-0.95, p = 0.023) and emergency surgery (11.4% vs. 7.1%, OR = 1.58, 95% CI 1.10-2.27, p = 0.013). Thirty-day mortality was 2.38%. Conclusions: This large international audit provides the status of the management of colorectal surgery. This shows that minimally invasive techniques are widely adopted, and 30-day mortality is low; however, anastomotic leak rates remain persistently high. These findings highlight the ongoing need for targeted research and quality-improvement initiatives to reduce anastomotic failure and improve outcomes of colorectal surgery
ПРИМЕНЕНИЕ МИКРОХИРУРГИЧЕСКИХ ТЕХНОЛОГИЙ В ХИРУРГИИ ТОНКОЙ И ОБОДОЧНОЙ КИШКИ В УСЛОВИЯХ ЭКСПЕРИМЕНТАЛЬНОЙ КИШЕЧНОЙ НЕПРОХОДИМОСТИ И РАЗЛИТОГО ПЕРИТОНИТА
No full textThe article contains data of morphological analysis of wound healing and anastomosis of small and middle intestine, formed with appliance of microsurgical operative procedures, taking into consideration the stages of pathological process and type of microsurgical sutures. The article shows the meaning of peculiarities of microanatomy of the wall in small and middle intestine in case of obstruction and peritonitis, at implementation of microsurgical administration of operation. It also shows possibility and effectiveness of implementation of microsurgical technology while wound closure of small and middle intestine in peritonitis and application of colonic anastomosis at intestinal obstruction. Possibility of wound and anastomosis healing is proved.Приведены данные морфологического анализа заживления ран и анастомозов тонкой и ободочной кишки, сформированных с применением микрохирургических оперативных приемов с учетом стадии патологического процесса и вида микрохирургического шва. Определено значение особенностей микроанатомии стенки тонкой и ободочной кишки при непроходимости и перитоните, при применении микрохирургических приемов операции. Показана возможность и эффективность применения микрохирургической технологии при ушивании ран тонкой и ободочной кишки на фоне перитонита и наложения толстокишечных анастомозов при кишечной непроходимости. Доказана возможность заживления ран и анастомозов по типу первичного.
