Effect of Monopolar Cutting Mode against Bipolar Diathermy on Surgical Dissection of Microvessels

2017 ◽  
Vol 33 (09) ◽  
pp. 660-669 ◽  
Author(s):  
Hyunsuk Suh ◽  
Eun Park ◽  
Joon Hong
Keyword(s):  
Survival Rate ◽  
Flow Velocity ◽  
Skin Flap ◽  
Vessel Diameter ◽  
Surrounding Tissue ◽  
P Value ◽  
Bipolar Diathermy ◽  
Flap Survival ◽  
Significant Difference ◽  
Vessel Dissection

Background An ideal vessel dissection will be to maximize bleeding control through coagulation while minimizing vessel damage. Among the diathermy methods, there has been no report comparing the effect on vessels. This study aims to verify the effect of bipolar diathermy against monopolar diathermy cutting mode for vessel dissection. Methods A total of 18 Sprague–Dawley rats were divided into three groups according to the method of pedicle dissection for 6 × 6 cm sized abdominal flap; (group 0) surgical scissors, (group 1) monopolar diathermy cutting mode and (group 2) bipolar diathermy. They were evaluated for the temperature of device tip and the radiating heat to the surrounding tissue, change in vessel diameter, flow velocity, and perfusion to the skin flap during dissection. Final flap survival rate and pathology of the vessels were also evaluated. Results Significantly higher radiating heat was observed using bipolar diathermy (average: 37.5°C) compared with group using monopolar diathermy (average: 34.4°C) (p value 0.045). However, there were no differences in vessel diameter, skin flap perfusion, flow velocity, and flap survival rate among the groups. Conclusions Both monopolar diathermy cutting mode and bipolar diathermy are safe to use to dissect the pedicle vessels when used adequately. Although it has no significant difference in relations to flap survival, vessel spasm, and perfusion/velocity to the flap, the extent of histologic damage may be less in monopolar diathermy cutting mode. Using monopolar diathermy cutting mode may provide efficiency to achieve ligation in small vessels during pedicle dissection but requires finesse technique and a learning curve.

The Relationship of Hematocrit Levels to Skin Flap Survival Length in the Pig

1981 ◽  
Vol 89 (5) ◽  
pp. 750-752 ◽  
Author(s):  
Jeffrey B. Alperstein ◽  
Howard L. Levine ◽  
Harvey M. Tucker
Keyword(s):  
Human Skin ◽  
Control Animal ◽  
Skin Flap ◽  
Random Pattern ◽  
Skin Flaps ◽  
Flap Survival ◽  
Significant Difference ◽  
Skin Flap Survival ◽  
Relationship Of ◽  
The Relationship

The work of several investigators suggests that anemia may increase the survival length of skin flaps in the dog and the rabbit. The following experiment was designed to study the survival of standardized skin flaps of varying lengths in normocythemic, polycythemic, and anemic pigs. The pig was chosen because of the similarity of its skin to that of human skin. Twenty-nine standardized random-pattern flaps and six standardized arterial flaps were studied in pigs with varying hematocrits. A statistically significant increase was found in the survival lengths of skin flaps in the polycythemic animal as compared with the anemic one. No significant difference was found when the flap survival lengths of the normocythemic control animal were compared with those of the polycythemic animal or with those of the anemic animal. These findings suggest that relative polycythemia may allow improved flap length-survival and, in contradistinction to the findings of previous investigators, that anemia does not result in improved survival length.

scholarly journals 219. Is the modified quick SOFA scale superior to quick SOFA in patients with diagnosed septic shock?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S128-S128
Author(s):  
Deniz Akyol ◽  
Ayşe Uyan Önal ◽  
Uğur Önal ◽  
Damla Akdağ ◽  
Cansu Bulut Avşar ◽  
...  
Keyword(s):  
Septic Shock ◽  
Survival Rate ◽  
Tertiary Care ◽  
University Hospital ◽  
P Value ◽  
Chi Square ◽  
Number Of Patients ◽  
Significant Difference ◽  
Chi Square Test ◽  
Qsofa Score

Abstract Background In this study it was aimed to compare the effects of qSOFA (Quick Sequential Organ Failure Assessment) score with modified qSOFA score (PLoS One. 2018 Sep 26;13(9):e0204608) for predicting one month survival in patients with diagnosed septic shock (SS) in a tertiary-care educational university hospital in a developing country. Methods Modified qSOFA was created by adding age factor (>50 years=1 point) to patients with qSOFA scale 1 or 2 or 3 who had SS (sepsis+hypotension+adrenergic agent) and consulted by Infectious Diseases consultants between December 2013-December 2018. Arterial lactate level of >2 mmol/L criterion was added as an including criteria for SS according to 3rd International Sepsis and Septic Shock Consensus Statement after 23rd February 2016. Statistical analysis was performed via Chi-square test and a p-value <0.05 was considered significant. Results The number of patients with qSOFA score of 1 or 2 or 3 from 527 patients are in Table1 [some of the cases were diagnosed as septic shock according to elder definition (without lactate criterion) and there was a subgroup with qSOFA score 1]. Among the >50-year aged group, the 30-day survival rate was lower in patients with qSOFA3 vs. qSOFA 2 vs. qSOFA 1 (Table1, 3x2 Chi Square test, P = 0.0057). Among the <50 years group, the qSOFA one month survival rate was lower in patients with qSOFA 3 vs. qSOFA 2 vs. qSOFA 1 (Table, 3x2 Chi Square Test, P = 0.0052). According to modified qSOFA, there was a significant difference for one month survival among SS cases with scores of 1, 2, 3 and 4 (12/21 57% vs. Fifty/126 40% vs. 78/269 29% vs. 22/111 20%, 4x2 Chi-square test, P = 0.0003). On the other hand, there was no significant difference in terms of one month survival when we performed subgroup analysis in qSOFA score 1, 2, or 3 subgroups, as ≤50 years vs. >50 years (table, Chi-square test, 12/21 vs. 39/97 P = 0.224, 11/29 vs. 75/244 P = 0.526, 3/25 vs. 22/111 P = 0.572). Conclusion In terms of survival at one month, there was a significant difference between qSOFA score 1, 2, 3 and 4 subgroups. In patients with qSOFA score of 1 or 2 or 3, being under 50 years did not have a significant effect on one-month survival. Modified qSOFA may be beneficial to foresee the probable mortality but these findings need to be validated in larger cohorts Disclosures All authors: No reported disclosures.

Effect of body position and graduated compression stocking length on femoral venous blood flow velocity

2003 ◽  
Vol 18 (4) ◽  
pp. 198-202
Author(s):  
A Limpus ◽  
W P Chaboyer ◽  
C Purcell ◽  
P J Schluter ◽  
H Gibbs ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Body Position ◽  
Venous Blood ◽  
Vessel Diameter ◽  
Compression Stocking ◽  
Venous Blood Flow ◽  
Significant Difference ◽  
Three Body

Objectives: To measure the effect of graduated compression stocking (GCS) length and body position on peak femoral venous blood flow velocity (PVV) and vessel diameter (VD). Methods: Twenty healthy adult volunteers had PVV and VD measured, using colour Doppler ultrasound, at baseline in three body positions. Knee- or thigh-length GCS were assigned randomly.Arandom sequence of the three positions was used to measure PVV and VD. The procedure was repeated, after a two-hour washout period, using the other length GCS. Results: There was no significant difference in the mean change of PVV ( P =0.74) or VD ( P =0.54) measurements from the baseline between thigh- and knee-length GCS. However, significant mean changes in PVV ( P =0.02) and VD ( P <0.001) measurements were observed for the three body positions, after adjusting for baseline values. Conclusions: In healthy volunteers, thigh- and knee-length GCS do not have an effect on PVV or VD, and body position affects PVV significantly, with or without GCS.

Two-dimensional electrospun nanofibrous membranes for promoting random skin flap survival

RSC Advances ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. 9360-9369 ◽  
Author(s):  
Xiaoming Sun ◽  
Reila Zheng ◽  
Liying Cheng ◽  
Xin Zhao ◽  
Rong Jin ◽  
...  
Keyword(s):  
Survival Rate ◽  
Skin Flap ◽  
Two Dimensional ◽  
Natural Materials ◽  
Flap Survival ◽  
Skin Flap Survival ◽  
Nanofibrous Membranes ◽  
Fibrous Membranes

Electrospun fibrous membranes made of natural materials are more advantageous for random skin flap survival, and can be used as carrier implantation materials for improving skin flap survival rate.

scholarly journals Impact of Removable Partial Denture Type on Patient Satisfaction and Abutment Survival Rate-RCT

2019 ◽  
Vol 7 (15) ◽  
pp. 2513-2519
Author(s):  
Sherif A. Sadek ◽  
Dina Elawady
Keyword(s):  
Patient Satisfaction ◽  
Survival Rate ◽  
Dental Treatment ◽  
P Value ◽  
Removable Partial Denture ◽  
Partial Denture ◽  
Patient’S Satisfaction ◽  
Group Iii ◽  
Group I ◽  
Significant Difference

BACKGROUND: Patient’s satisfaction and the preservation of abutments is the most important outcomes that the clinician seeks during fabrication of any dental treatment, especially when it is concerned with removable prosthodontic rehabilitation. AIM: The present study evaluates three different Removable Partial Denture (RPD) types restoring mandibular class II modification I edentulous cases with regards to patient’s satisfaction and abutments survival. METHODS: Forty-two partially edentulous patients were divided into three groups (Group I rehabilitated with Vitallium RPD, Group II rehabilitated with Vitallium RPD where the modification area restored with the surveyed bridge, Group III rehabilitated with Thermopress RPD). The patients were followed up for twenty-four months. Using a questionnaire, prosthodontic maintenance required was documented at the delivery and after 3 months. RESULTS: There was a significant difference regarding patient satisfaction for group III (P-value <0.05) while for groups I and II there was a non-significant difference (P-value >0.05). Regarding the survival rate, there was a non-significant difference between the three groups (P-value >0.05) at the end of twenty-four months of follow up. CONCLUSION: Patient satisfaction and abutment survival were better with Thermopress RPD than conventional Vitallium RPD or Vitallium RPD with a surveyed bridge restoring the modification area. Although a non-statistically significant difference was found in the survival rate of abutments between groups, a clinically important result was revealed as no abutments failures were reported in the Thermopress group.

scholarly journals Determination of Relative Frequency of Calretinin Expression in Patients with Breast Cancer in Yazd, Iran

2020 ◽  
Vol 3 (2) ◽  
pp. 37-40
Author(s):  
Ehsan Arjmandzadeh ◽  
◽  
Fariba Binesh ◽  
◽  
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Breast Carcinoma ◽  
Tumor Size ◽  
Relative Frequency ◽  
P Value ◽  
Significant Difference ◽  
The Mean ◽  
Positive Results ◽  
Ihc Markers

Introduction: Breast cancer is known as the most common type of cancer among women in the world. Several methods have been proposed to predict the behavior of breast carcinoma. Recently calretinin has been found to be a reliable factor in predicting tumor survival rate in breast cancer. The aim of this study was to evaluate the relative frequency of calretinin expression in patients with breast cancer in Yazd,Iran. Material and methods: In this cross-sectional retrospective study, the clinicopathologic features and the outcome of patients with breast cancer from 2017 to 2018 were reviewed at Shahid Sadoughi Hospital, Yazd, Iran. The influence of potential prognostic parameters in the overall survival was investigated by log-rank test and Cox regression analysis. Results: Among 100 cases with breast carcinoma, 14.5% were positive for calretinin. The distribution of the rate of positivity of IHC markers including ER, PR, P53, Ki67 and Her2 was 62.9%, 57.1%, 46.2%, 80.5% and 22.1%, respectively. The most common grade and stage were grade2 and stage3 respectively. There was no significant difference in the status of IHC markers (including ER, PR, Her2 and Ki67) in terms of calretinin. 66.7% of the patients with calretinin positive results were P53 positive. The results of the mean tumor size distribution in the two groups of positive and negative calretinin showed a significant difference (P-value = 0.05). A lower age at the time of diagnosis was found in patients with calretinin positive results (P-value = 0.119). The mean survival rate in calretinin positive group was 6.71 years and 6.62 years in calretinin negative patients which was not statistically significant. Conclusion: The results of this study indicated an association between calretinin expression and other IHC markers (although not statistically significant) in predicting poor prognosis in breast cancer patients. In addition, we found a statistically significant association among calretinin with smaller tumor size and lower age at the time of diagnosis in patients with breast cancer.

Abstract W P217: The Impaired Leptomeningeal Collateral Flow Recruitment in the Type II Diabetic Mice is Independent of Hyperglycemia

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yosuke Akamatsu ◽  
Chih Cheng Lee ◽  
Jialing Liu
Keyword(s):  
Flow Velocity ◽  
Cerebral Artery ◽  
Flow Direction ◽  
Vessel Diameter ◽  
Vascular Pathology ◽  
Collateral Flow ◽  
Type Ii ◽  
Diabetic Mice ◽  
Vascular Networks ◽  
Significant Difference

Introduction: Previously we found that type II diabetic mice db/db strain exhibited impaired collateral flow recruitment between the middle cerebral artery (MCA) and anterior cerebral artery (ACA) vascular networks during MCA occlusion (MCAO)contributed to the worse stroke outcome when compared to their normoglycemic strain. However, it is unclear whether the underlying etiology in the diabetic stroke mice is attributed to hyperglycemia or other vascular pathology. Methods: Adult male db/+ received intraperitoneal injection of dextrose (HG) or normal saline (NG) (n=5-6/group), respectively, 60 minutes prior to distal MCAO. Doppler optical coherence tomography (DOCT) was used to quantify the MCA flow direction and velocity at baseline and 30 min after MCAO. The chosen regions of interest of MCA network were classified according to branching order as segment 1 (seg1), seg2 and seg3, with seg1 most proximal to ACA while most distal to MCA. 5-10 points corresponding to the same location of each segment were selected for quantification. Results: Blood glucose level was maintained at approximately 382± 83.8 mg/dl in the HG group during blood flow imaging, compared to 166± 60.1 mg/ml in the NG group. It fell to 141± 36.3 mg/dl and 142± 46.3 mg/dl at 24h after stroke in both groups. Hyperglycemia didn't change baseline flow velocity (NG: 6.8±0.8/9.2±0.7/12.5±0.5mm in seg1/seg2/seg3; HG: 5.7±0.7/8.2±0.5/12.6±0.9 mm/s, NS in all segments). At 30 min after MCAO, collateral flow was induced in both groups and there was no significant difference in flow velocity between groups (NG: -3.8±0.3/-2.7±0.1/-2.7±0.3mm/s; HG: -4.1±0.2/-3.1±0.3/2.2±0.4mm/s, NS in all segments). There was also no significant difference in vessel diameter between the groups both at baseline (NG: 48.9±3.5/55.1±1.6/61.5±2.7μm; HG: 45.6±1.7/48.8±2.7/59.2±2.7μm, NS in all segments) and 30 min after MCAO (NG: 48.4±2.0/50.8±2.6/55.5±2.6μm, HG: 42.6±2.3/49.9±2.0/52.5±2.6 μm in HG, NS in all segments). Conclusions: Temporary induction of hyperglycemia doesn't affect collateral flow in normoglycemic mice during acute stroke, suggesting that the observed impairment of collateral flow recruitment in the type II diabetic mice is likely attributed to chronic vascular pathology.

scholarly journals Prognosis and Survival Study in Patients with Glioblastoma Multiform and Its Relationship with EGFR Expression

2020 ◽  
Vol 6 (3) ◽  
pp. 113-120
Author(s):  
Zeinab Amirpour ◽  
◽  
Arezoo Bahari ◽  
Behrad Nafisi ◽  
Koorosh Rahmani ◽  
...  
Keyword(s):  
Survival Rate ◽  
Survival Rates ◽  
Growth Factor Receptor ◽  
P Value ◽  
Anatomical Location ◽  
Chi Square ◽  
Egfr Expression ◽  
Significant Difference ◽  
Chi Square Test ◽  
The Mean

Background and Aim: Glioblastoma multiforme (GBM) is the most common malignant and invasive tumor of the brain. The relation between prognosis and survival of GBM patients with Epidermal Growth Factor Receptor (EGFR) expression is challenging. Thus, we aimed to evaluate the prognosis and survival of patients with GBM and its relationship with EGFR expression. Materials and Methods: This single-arm cohort study was conducted on 70 patients with GBM during 2012-2018 in Shahid Rahnemoon and Mortaz hospitals. The immunohistochemistry technique was applied to paraffin blocks of brain tumors for examining EGFR expression. Other data were extracted from medical records. To determine the survival rate, the Kaplan–Meier curves were used. A chi-square test was used for the analysis of data. Statistically, p-value <0.05 was assumed significant. Results: The mean survival of patients with GBM was 22.3 ± 2.5 months (95% CI=17.41 - 27.10). In addition, 1, 2- and 5-year survival rates were 90%, 30% and 5%, respectively. The mean survival of patients with negative and positive EGFR was 27.4±7.3 and 20.6±2.4 months, respectively. Besides, 11.1% and 14.3% of patients in negative and positive EGFR groups were alive. There was no significant difference in patient’s survival in terms of EGFR expression (p=0.36). No significant difference was seen between the two groups (EGFR positive and negative groups), regarding the frequency of age, sex, tumor’s anatomical location, and place of living (p>0.05). Conclusion: Based on our study, it seems that the GBM tumor was associated with poor prognosis and a low survival rate. It was also found that the expression of the EGFR gene did not affect the survival rate of patients with GBM. Therefore, its use as a predictor factor for survival and prognosis is questionable.

scholarly journals Evaluation of Sovodak (Sofosbuvir/Daclatasvir) Treatment Outcome in COVID-19 Patient's Compared with Kaletra (Lopinavir/ritonavir): a Randomized Clinical Trial

2021 ◽  
Author(s):  
Mahdi Yadollahzadeh ◽  
Mohana Eskandari ◽  
Maryam Roham ◽  
Farhad Zamani ◽  
Azadeh Laali ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Treatment Outcome ◽  
Survival Rate ◽  
Severe Acute Respiratory Syndrome ◽  
Randomized Trial ◽  
P Value ◽  
Health Organizations ◽  
Treatment Groups ◽  
Significant Difference ◽  
Significant Health

Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and treatment are significant health organizations' concerns worldwide. Although there is no proven drug license against the virus, a variety of components have under investigation. In this regard, the present study was intended to evaluate the consequences of Sovodak (Sofosbuvir/Daclatasvir) treatment in COVID-19 patients compared with Kaletra (Lopinavir/ritonavir). Methods: This study was conducted as a randomized trial using 120 COVID19 confirmed cases between August 19th and September 19th, 2020, in which subjects were classified into two treatment groups, 58 (Sovodak group) and 54 (Kaletra group). Related statistical operations calculated significant outcomes such as survival rate and hazard ratio via SPSS v.16. Sovodak was composed of Sofosbuvir 400mg and Daclatasvir 60mg, and Kaletra included Lopinavir 400 mg and ritonavir 100 mg. Results: We observed that there was no significant difference concerning the comorbidities, death, ICU admission, remission. Besides, Kaletra had a higher rate of discharge versus Sovodak (HR=1.551 (95% CI=1.008-2.386), P-value=0.046), and a better outcome was observed in patients receiving Conclusion: Sovodak compared to Kaletra by Hazard plot. Sovodak (Sofosbuvir/Daclatasvir) therapy in COVID19 cases was accompanied by a significantly higher survival rate and better outcome than Kaletra (Lopinavir/ritonavir).

The Effect of Sterile Inflammation on Skin Flap Survival

1986 ◽  
Vol 95 (1) ◽  
pp. 90-93 ◽  
Author(s):  
Rebecca N. Gaughan ◽  
Randal A. Otto ◽  
Gregory J. Renner ◽  
Jerry W. Templer ◽  
William E. Davis
Keyword(s):  
Inflammatory Response ◽  
Skin Flap ◽  
Sterile Inflammation ◽  
Matched Pairs ◽  
Chemical Burn ◽  
Face Lift ◽  
Flap Survival ◽  
Miniature Pigs ◽  
Significant Difference ◽  
Skin Flap Survival

Several investigations have suggested that a sterile inflammatory reaction in a skin flap enhances flap survival. A chemical peel produces a mild chemical burn, which is one form of nonbacterial inflammatory response. Some authors advocate the concomitant use of face lift and chemical peel, while others caution that the peel might jeopardize the facial flaps. To determine whether the reaction caused by a chemical peel enhances or impairs skin flap survival, a study using miniature pigs was undertaken. Survival length of flaps treated with a chemical peel was compared to that of untreated flaps. A total of 36 dorsally based random flaps were used on three miniature pigs. Six identical 14 × 4 cm flaps were designed on each side of the pigs. A chemical peel was applied to the area of 18 of the proposed flaps 2 days prior to elevation. Alternate flaps on each side of the pigs were treated. As the flaps were elevated, the tips were examined to document the inflammatory response histologically. After 14 days, the surviving length of the flaps was measured. As determined by the Wilcoxon matched-pairs signed-ranks test, there was no significant difference between the treated and untreated groups. Our study shows that a nonbacterial inflammatory response produced by a chemical peel does not improve skin flap survival, at least not in pigs.

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