Mo1513 High Definition Endoscopy With I-SCAN and Lugol Solution for the Detection of Inflammation in Patients With NERD and Histologic Evaluation in Comparison to a Control Group

Small bowel transplantations (SBT) are increasingly performed to treat patients with irreversible intestinal failure or short-bowel syndrome. Histologic evaluation of small bowel allograft biopsies is important for the diagnosis of acute cellular rejection (ACR). A reliable serological marker of ACR after SBT is still unknown. Recently, citrulline was identified as a potential biomarker of reduced enterocyte mass. The aim of our study was to analyze rejection and plasma citrulline levels early after SBT in pigs. 24 pigs were used and divided into four groups. Group A, autologous SBT (n = 3) as a control group; Group B, allogeneic SBT with tacrolimus monotherapy (n = 7); Group C, allogeneic SBT immunosuppressed with tacrolimus and sirolimus (n = 8); and Group D, without immunosuppresion (n = 6). The observation period was 30 days. Mucosal biopsies were obtained on Days 0, 3, 5, 7, 10, 14, 20, 28 and simultaneously plasma citrulline levels were measured. ACR was classified according to standardized grading schema on a scale of indeterminate, mild, moderate, and severe. There were no significant differences in citrulline plasma levels between cases with mild ACR and indeterminate for ACR. A significant decline in plasma citrulline levels occurred in cases of moderate and severe rejection. Plasma citrulline levels constituted a marker of more advanced injury of small bowel epithelium.

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Análise da Revisão Cochrane: Cromoscopia Versus Colonoscopia Convencional na Deteção de Pólipos ColoRetais. Cochrane Database Syst Rev. 2016;4:CD006439

Acta Médica Portuguesa ◽

10.20344/amp.7968 ◽

2016 ◽

Vol 29 (10) ◽

pp. 583

Author(s):

Diogo Libânio ◽

Luís Filipe Azevedo

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Colorectal Polyps ◽

Control Group ◽

Controlled Trials ◽

Polyp Detection ◽

High Definition ◽

Screening Programs ◽

Randomized Controlled ◽

Cochrane Database

Although colonoscopy is considered the most accurate test for the investigation of colorectal polyps, lesions ≤ 10 mm may be missed in approximately 10%. Chromoscopy may increase the detection of colorectal polyps. A systematic review and meta-analysis was performed to investigate the benefit of cromoscopy in colorectal polyps detection. Seven randomized controlled trials were included (incuding 2,727 participants) comparing polyp detection (both neoplastic and non- neoplastic polyps) in patients submitted to conventional colonoscopy or colonoscopy with chromoscopy. Chromoscopy was associated with a significant improvement in all detection endpoints (number of polyps, number of neoplastic polyps, number of diminutive polyps, number of neoplastic diminutive polyps, proportion of patients with at least one polyp and proportion of patients with at least one neoplastic polyp). However, when highdefinition colonoscopes were used in the control group, chromoscopy benefit does not seem to be significant. Besides, routine use of chromoscopy may have implications in the accessibility of colonoscopy and in the effectiveness of screening programs. Moreover, the benefit of chromoscopy in the era of high-definition colonoscopy is questionable.

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A high-definition 3D exoscope as an alternative to the operating microscope in spinal microsurgery

Journal of Neurosurgery Spine ◽

10.3171/2020.4.spine20374 ◽

2020 ◽

Vol 33 (5) ◽

pp. 705-714

Author(s):

Sebastian Siller ◽

Caroline Zoellner ◽

Manuel Fuetsch ◽

Raimund Trabold ◽

Joerg-Christian Tonn ◽

...

Keyword(s):

Intraoperative Complications ◽

Neck Disability Index ◽

Postoperative Outcome ◽

Comfort Level ◽

Control Group ◽

Operating Microscope ◽

High Definition ◽

Safe Alternative ◽

Spinal Microsurgery ◽

Room Nursing

OBJECTIVESince the 1970s, the operating microscope (OM) has been a standard for visualization and illumination of the surgical field in spinal microsurgery. However, due to its limitations (e.g., size, costliness, and the limited movability of the binocular lenses, in addition to discomfort experienced by surgeons due to the posture required), there are efforts to replace the OM with exoscopic video telescopes. The authors evaluated the feasibility of a new 3D exoscope as an alternative to the OM in spine surgeries.METHODSPatients with degenerative pathologies scheduled for single-level lumbar or cervical spinal surgery with use of a high-definition 3D exoscope were enrolled in a prospective cohort study between January 2019 and September 2019. Age-, sex-, body mass index–, and procedure-matched patients surgically treated with the assistance of the OM served as the control group. Operative baseline and postoperative outcome parameters were assessed. Periprocedural handling, visualization, and illumination by the exoscope, as well as surgeons’ comfort level in terms of posture, were scored using a questionnaire.RESULTSA 3D exoscope was used in 40 patients undergoing lumbar posterior decompression (LPD) and 20 patients undergoing anterior cervical discectomy and fusion (ACDF); an equal number of controls in whom an OM was used were studied. Compared with controls, there were no significant differences for mean operative time (ACDF: 132 vs 116 minutes; LPD: 112 vs 113 minutes) and blood loss (ACDF: 97 vs 93 ml; LPD: 109 vs 55 ml) as well as postoperative improvement of symptoms (ACDF/Neck Disability Index: p = 0.43; LPD/Oswestry Disability Index: p = 0.76). No intraoperative complications occurred in either group. According to the attending surgeon, the intraoperative handling of instruments was rated to be comparable to that of the OM, while the comfort level of the surgeon’s posture intraoperatively (especially during “undercutting” procedures) was rated as superior. In cases of ACDF procedures and long approaches, depth perception, image quality, and illumination were rated as inferior when compared with the OM. By contrast, for operating room nursing staff participating in 3D exoscope procedures, the visualization of intraoperative process flow and surgical situs was rated to be superior to the OM, especially for ACDF procedures.CONCLUSIONSA 3D exoscope seems to be a safe alternative for common spinal procedures with the unique advantage of excellent comfort for the surgical team, but the drawback is the still slightly inferior visualization/illumination quality compared with the OM.

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Expression of Proteinase-Activated Receptor 2 During Colon Volvulus in the Horse

Frontiers in Veterinary Science ◽

10.3389/fvets.2020.589367 ◽

2020 ◽

Vol 7 ◽

Author(s):

Carlotta Lambertini ◽

Augusta Zannoni ◽

Noemi Romagnoli ◽

Cristiano Bombardi ◽

Maria Morini ◽

...

Keyword(s):

Molecular Weight ◽

Quantitative Polymerase Chain Reaction ◽

Control Group ◽

Gene Expressions ◽

Western Blots ◽

Cytokines And Chemokines ◽

Inflammatory Protein ◽

Clear Band ◽

Histologic Evaluation ◽

Colon Volvulus

Large colon volvulus in horses is associated with a poor prognosis, especially when ischemic-reperfusion injury of the affected intestinal tract develops. Proteinase-activated receptor 2 (PAR2) plays an important role in the pathogenesis of inflammation in the gastrointestinal tract. The aim of this study was to evaluate the distribution and expression of PAR2 in colonic pelvic flexure of horses spontaneously affected by large colon volvulus (CVH group). Eight horses admitted for severe abdominal colon volvolus and which underwent surgery were included. Colon samples were collected after enterotomy. Data previously obtained from healthy horses were used as a control group. Histologic evaluation was carried out to grade the severity of the colon lesions. Immunofluorescence, western blot and quantitative polymerase chain reaction (RT-qPCR) were carried out on colon samples to evaluate PAR2 expression. In addition, the transcriptional profile of cytokines and chemokines was evaluated using RT2 Profiler™ PCR Array Horse Cytokines & Chemokines. Three out of the eight patients were euthanised due to clinical deterioration. Immunostaining for PAR2 was observed in the enterocytes, intestinal glands and neurons of the submucosal and myenteric plexi. In the CVH horses, the expression of PAR2 mesenger RNA (mRNA) did not differ significantly from that of the healthy animals; western blots of the mucosa of the colon tracts showed a clear band of the expected molecular weight for PAR2 (~44 kDa) and a band smaller than the expected molecular weight for PAR2 (25kDa), suggesting its activation. The gene expressions for C-X-C motif ligand 1 (CXCL1); interleukin 8 (IL8), macrophage inflammatory protein 2 beta (MIP-2BETA) were upregulated in the colic horses as compared with the colons of the healthy horses. Therefore, in the present study, the expression and activation of PAR2 in the colons of horses in the presence of an inflammatory reaction like that occurring in those with spontaneous colon volvulus was confirmed.

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Autologous Elastic Cartilage for Laryngoplasty: Histologic Evaluation in a Rabbit Model

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940311200815 ◽

2003 ◽

Vol 112 (8) ◽

pp. 734-739 ◽

Cited By ~ 3

Author(s):

Miguel Caballero ◽

Manuel Bernal-Sprekelsen ◽

Carlos Calvo ◽

Xavier Farré ◽

Llucia Alós

Keyword(s):

Vocal Fold ◽

Rabbit Model ◽

Controlled Study ◽

Control Group ◽

Type I ◽

Auricular Cartilage ◽

Tissue Integration ◽

Wide Range ◽

Histologic Evaluation ◽

Surgically Induced

A wide range of materials have been used to achieve medialization of the paralyzed vocal fold. Recently, medialization techniques using autologous cartilage have been described, but little information is available on cartilage integration and viability in this situation. In this prospective, experimental, controlled study, right vocal fold paralysis was surgically induced in 30 New Zealand rabbits. An autologous auricular cartilage transplant was inserted in the vocal fold in 15 animals. In the control group, only the laryngeal nerve was sectioned. Each group was divided into two groups with follow-ups of 6 weeks and 6 months, respectively. Histologic studies revealed no inflammatory reaction against the cartilage transplants. There were no differences in the transplant surfaces in the 6-week and 6-month groups. The results show tissue integration and a low level of initial transplant resorption that stabilizes with time. Autologous auricular cartilage appears to be an appropriate material for type I thyroplasty procedures because of the low absorption rate.

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Supratentorial high-grade gliomas: maximal safe anatomical resection guided by augmented reality high-definition fiber tractography and fluorescein

Neurosurgical FOCUS ◽

10.3171/2021.5.focus21185 ◽

2021 ◽

Vol 51 (2) ◽

pp. E5

Author(s):

Sabino Luzzi ◽

Alice Giotta Lucifero ◽

Andrea Martinelli ◽

Mattia Del Maestro ◽

Gabriele Savioli ◽

...

Keyword(s):

Augmented Reality ◽

White Light ◽

Categorical Variables ◽

Control Group ◽

High Grade ◽

Newly Diagnosed ◽

Fiber Tractography ◽

High Definition ◽

Safety And Efficacy ◽

And Control

OBJECTIVE The theoretical advantages of augmented reality (AR) with diffusion tensor imaging (DTI)–based high-definition fiber tractography (HDFT) and sodium fluorescein (F) in high-grade glioma (HGG) surgery have not been investigated in detail. In this study, the authors aimed to evaluate the safety and efficacy profiles of HDFT-F microscope-based AR cytoreductive surgery for newly diagnosed supratentorial HGGs. METHODS Data of patients with newly diagnosed supratentorial HGGs who underwent surgery using the AR HDFT-F technique were reviewed and compared with those of a cohort of patients who underwent conventional white-light surgery assisted by infrared neuronavigation. The safety and efficacy of the techniques were reported based on the postoperative Neurological Assessment in Neuro-Oncology (NANO) scores, extent of resection (EOR), and Kaplan-Meier curves, respectively. The chi-square test was conducted for categorical variables. A p value < 0.05 was considered statistically significant. RESULTS A total of 54 patients underwent surgery using the AR HDFT-F technique, and 63 underwent conventional white-light surgery assisted by infrared neuronavigation. The mean postoperative NANO scores were 3.8 ± 2 and 5.2 ± 4 in the AR HDFT-F group and control group, respectively (p < 0.05). The EOR was higher in the AR HDFT-F group (p < 0.05) than in the control group. With a mean follow-up of 12.2 months, the rate of progression-free survival (PFS) was longer in the study group (log-rank test, p = 0.006) than in the control group. Moreover, the complication rates were 9.2% and 9.5% in the study and control groups, respectively. CONCLUSIONS Overall, AR HDFT-F–assisted surgery is safe and effective in maximizing the EOR and PFS rate for patients with newly diagnosed supratentorial HGGs, and in optimizing patient functional outcomes.

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Integrating Ultrasound Teaching into Preclinical Problem-based Learning

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.190897 ◽

2016 ◽

Vol 6 ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Eli Tumba Tshibwabwa ◽

Jenifer Cannon ◽

James Rice ◽

Michael G Kawooya ◽

Reza Sanii ◽

...

Keyword(s):

Clinical Teaching ◽

Clinical Medicine ◽

Research Question ◽

Image Interpretation ◽

Ultrasound Image ◽

Problem Based Learning ◽

Control Group ◽

High Definition ◽

Hands On ◽

Experimental Group

Objectives:The aim is to provide students in the preclinical with ultrasound image interpretation skills. Research question: Are students in smaller groups with access to a combination of lectures and hands-on patient contact most likely to have better ultrasound image interpretation skills, than students in larger groups with only interactive didactic lectures?Methodology:First-year students at the preclinical Program of the College of Medicine, participated in two 2-h introductory interactive ultrasound sessions. The study comprised two cohorts: 2012/2013 students, who were offered large group teaching (LGT) sessions (control group), and 2013/2014 students, who received the intervention in small group learning problem-based learning (PBL) sessions (experimental group). The overall learning objectives were identical for both groups. The success of the module was evaluated using pre- and post-tests as well as students’ feedback.Results:The students in the experimental group showed significantly higher scores in interpretations of images than those in the control group. The experimental group showed achievement of learning outcomes along with higher levels of satisfaction with the module compared to the latter.Conclusion:Posttest knowledge of the basics of ultrasound improved significantly over the pretest in the experimental group. In addition, students’ overall satisfaction of the ultrasound module was shown to be higher for the PBL compared to the LGT groups. Small groups in an interactive and PBL setting along with opportunities for hands-on practice and simultaneous visualization of findings on a high definition screen should enhance preclinical student learning of the basics of ultrasound. Despite the potential of ultrasound as a clinical, teaching and learning tool for students in the preclinical years, standardized recommendations have yet to be created regarding its integration into the curricula within academic institutions and clinical medicine. The interactive and PBL is here to stay at the college of medicine. Further research would be carried out to see if this trend persists in the upcoming vertical system-based curriculum of the college of medicine.

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Rapid Ischemic Preconditioning with a Short Reperfusion Time Prevents Delayed Paraplegia in a Rabbit Model

The Heart Surgery Forum ◽

10.1532/hsf98.20111039 ◽

2011 ◽

Vol 14 (5) ◽

pp. 317

Author(s):

Mehmet Ozkokeli ◽

Mehmet Ugur Es ◽

Ugur Filizcan ◽

Murat Ugurlucan ◽

Ahmet Sasmazel ◽

...

Keyword(s):

Spinal Cord ◽

Ischemic Preconditioning ◽

Spinal Cord Ischemia ◽

Rabbit Model ◽

Aortic Aneurysms ◽

Aortic Occlusion ◽

Control Group ◽

Protective Mechanisms ◽

Group 13 ◽

Histologic Evaluation

Background: Surgery for thoracic and thoracoabdominal aortic aneurysms can be complicated by a significant incidence of neurogenic deficits due to spinal cord ischemia. In this study, we investigated whether ischemic preconditioning (IPC) improves neurologic outcome in a rabbit model.Methods: Forty rabbits underwent infrarenal aortic occlusion. The IPC group (n = 20) had 10 minutes of aortic occlusion to induce spinal cord ischemia, 40 minutes of reperfusion, and 30 minutes of ischemia, whereas the control group (n = 20) had only 30 minutes of ischemia. Tarlov scoring (0, paraplegia; 4, normal) was used to evaluate neurologic functions 7 days later, and spinal cord segments (L4-L6) were stained with hematoxylin and eosin for histologic evaluation.Results: Complete paraplegia (grade 0) occurred in 15 (75%) of the 20 control animals, whereas in the IPC group, 13 (65%) of 20 animals were completely normal (grade 4) (P < .05).Conclusion: IPC is beneficial for protecting against neurologic damage after transient aortic occlusion in a rabbit model; however, the protective mechanisms are not clear.

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Effect of lyophilized amniotic membrane, hyaluronic acid, and their combination in preventing adhesion after tendon repair in New Zealand white rabbits

Medical Journal of Indonesia ◽

10.13181/mji.v23i2.932 ◽

2014 ◽

Vol 23 (2) ◽

pp. 65-73 ◽

Cited By ~ 1

Author(s):

Syaiful A. Hadi ◽

Jefri Sukmawan

Keyword(s):

Hyaluronic Acid ◽

New Zealand ◽

Range Of Motion ◽

Amniotic Membrane ◽

Tendon Repair ◽

Control Group ◽

Repair Site ◽

Significant Difference ◽

Histologic Evaluation ◽

Flexor Digitorum

Background: Several promising methods to reduce the peritendinous adhesion after repair include amniotic membrane and hyaluronic acid application on the repaired tendon site. This study aimed to compare the effect of lyophilized amniotic membrane, application of hyaluronic acid, and their combination in preventing peritendinous adhesion after tendon repair in New Zealand white rabbits.Methods: 64 flexor digitorum fibularis tendon from 16 rabbits were cut and then repaired by modified Kessler technique. Samples were allocated into four test groups; group I as control had simple tendon repair, group II had amniotic membrane wrapping at repair site, group III had hyaluronic acid application at repair site, and group IV had combination of amniotic membrane wrapping and hyaluronic acid application. On 6th week, 8 tendon from each group underwent macroscopic and histologic evaluation of peritendon adhesion by Tang scoring system. The rest of samples were evaluated for tendon gliding at tenth week by measuring active and passive range of motion of metatarsophalangeal joint.Results: At 6th week, macroscopic and histologic evaluation showed that groups II, III, and IV had significantly lower peritendinous adhesion compared to control group (p < 0.05). However, there was no significant difference found among groups II, III, and IV (p > 0.05). Similar results were found in tendon gliding evaluation, groups II, III, and IV had significantly better range of motion compared to control group (p < 0.05), but there was no significant difference found between these groups (p > 0.05).Conclusion: The application of lyophilized amniotic membrane, hyaluronic acid, or their combination significantly reduce the formation of peritendinous adhesion in repaired flexor digitorum fibularis tendon in rabbit model.

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