Immunoprotective Effects of Cyclooxygenase Inhibition in Patients with Major Surgical Trauma

1990 ◽  
Vol 30 (1) ◽  
pp. 8-18 ◽  
Author(s):  
E. FAIST ◽  
W. ERTEL ◽  
T. COHNERT ◽  
P. HUBER ◽  
D. INTHORN ◽  
...  
Keyword(s):  
Surgical Trauma ◽  
Cyclooxygenase Inhibition

IMMUNE PROTECTIVE EFFECTS OF CYCLOOXYGENASE INHIBITION IN PATIENTS WITH MAJOR SURGICAL TRAUMA

1988 ◽  
Vol 28 (7) ◽  
pp. 1084 ◽  
Author(s):  
E. Faist ◽  
W. Ertel ◽  
T. Cohnert ◽  
P. Huber ◽  
D. Inthorn ◽  
...  
Keyword(s):  
Surgical Trauma ◽  
Protective Effects ◽  
Cyclooxygenase Inhibition

Invasive therapeutic options in truncal varicosity of the great saphenous vein

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Hach-Wunderle ◽  
Hach
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Stage Iii ◽  
High Ligation ◽  
Surgical Trauma ◽  
Disease Stages

It is known from current pathophysiology that disease stages I and II of truncal varicosity of the great saphenous vein do not cause changes in venous pressure on dynamic phlebodynamometry. This is possibly also the case for mild cases of the disease in stage III. In pronounced cases of stage III and all cases of stage IV, however, venous hypertension occurs which triggers the symptoms of secondary deep venous insufficiency and all the complications of chronic venous insufficiency. From these facts the therapeutic consequence is inferred that in stages I and II and perhaps also in very mild cases of stage III disease, it is enough "merely" to remove varicose veins without expecting there to be any other serious complications in the patient’s further life caused by the varicosity. Recurrence rates are not included in this analysis. In marked cases of disease stages III and IV of the great saphenous vein, however, secondary deep venous insufficiency is to be expected sooner or later. The classical operation with saphenofemoral high ligation ("crossectomy") and stripping strictly adheres to the recognized pathophysiologic principles. It also takes into account in the greatest detail aspects of minimally invasive surgery and esthetics. In the past few years, developments have been advanced to further minimize surgical trauma and to replace the stripping maneuver using occlusion of the trunk vein which is left in place. Obliteration of the vessel is subsequently performed via transmission of energy through an inserted catheter. This includes the techniques of radiofrequency ablation and endovenous laser treatment. High ligation is not performed as a matter of principle. In a similar way, sclerotherapy using microfoam is minimally invasive in character. All these procedures may be indicated for disease stages I and II, and with reservations also in mild forms of stage III disease. Perhaps high ligation previously constituted overtreatment in some cases. Targeted studies are still needed to prove whether secondary deep venous insufficiency can be avoided in advanced stages of varicose vein disease without high ligation and thus without exclusion of the whole recirculation circuit.

Antithrombotic Effect of Two Low Molecular Weight Thrombin Inhibitors and a Low-Molecular Weight Heparin in a Caval Vein Thrombosis Model in the Rat

1997 ◽  
Vol 78 (05) ◽  
pp. 1404-1407 ◽  
Author(s):  
B I Eriksson ◽  
S Carlsson ◽  
M Halvarsson ◽  
B Risberg ◽  
C Mattsson
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Clinical Situation ◽  
Thrombin Inhibitors ◽  
Thrombin Inhibitor ◽  
Low Molecular Weight ◽  
Surgical Trauma ◽  
Antithrombotic Effect ◽  
Caval Vein ◽  
Thrombosis Model

SummaryA sensitive thrombosis model with a high reproducibility was developed in the rat, utilizing stasis of the caval vein and a standardized surgical trauma as the only thrombogenic stimuli. Since no procoagulant substances were used, the results of the present study might be relevant in a clinical situation. The antithrombotic effect of two recently synthesized low-molecular-weight thrombin inhibitors have been compared to dalteparin, (Fragmin) a low-molecular-weight heparin fragment. Each compound was studied at 8 different doses with 10 rats in each group. On a gravimetric basis, the thrombin inhibitor melagatran was twice as potent as dalteparin (ED50 16 and 33 µ/kg per h, respectively). The second thrombin inhibitor, inogatran, had an intermediate effect, with an ED50 of 24 µLg/kg per h. No differences in antithrombotic effect were, however, found when the compounds were compared at anticoagulant equivalent doses (same APTT prolongation). A 50% reduction in the mean thrombus weight was obtained when APTT was prolonged to 1.2 to 1.3 times the pretreatment value.

Hearing Outcome of Stapes Surgery in NIENT, Bangladesh

2020 ◽  
Vol 26 (1) ◽  
pp. 31-36
Author(s):  
Md Zakaria Sarkar ◽  
AHM Ferdows Nur ◽  
Utpal Kumar Dutta ◽  
Muhammad Rafiqul Islam ◽  
Debabrota Roy ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cross Sectional Study ◽  
Surgical Trauma ◽  
Group 14 ◽  
Progressive Hearing Loss ◽  
Cross Sectional ◽  
Hearing Gain ◽  
Hearing Outcome

Objective: The aim of this study was to evaluate hearing outcome after stapedotomy in patients with Otosclerosis. Methods: This cross sectional study was carried out from July 2017 to January 2019 in National Institute of ENT, Unit V. About 22 patients with Otosclerosis were included in this study. Diagnosis of Otosclerosis was based on the history, medical status with Otoscopy, Tuning fork tests and Audiometric tests. We compiled data on the pre and post operative air-bone gap (ABG) at 0.5, 1, 2 KHZ. The ABG was Calculated using AC and BC thresholds on the same audiogram. Post operative hearing gain was then Calculated from the ABG before the operation minus the ABG of the last follow up examination Results: In this study most of the cases were age group 14-30 years (72.7%), female (54.5%). Most common symptoms was progressive hearing loss, tinnitus (77.8%).The average preoperative hearing loss in this study was (AC) was 48.31±7.68. The average post opt. hearing (AC) at follow up was 28.95±10.30 with an average hearing gain of 15.40±8.53 dB which was significant. The average pre-operative ABG was 28.99 dB ± 8.10. The average post opt. ABG was analyzed at 1 follow up showed ABG 13.18±8.09 dB which was found to be significant. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patient’s quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 31-36

A Transapical or Transluminal Approach to Aortic Valve Implantation Does Not Attenuate the Inflammatory Response

2011 ◽  
Vol 14 (2) ◽  
pp. 110 ◽  
Author(s):  
Benjamin O'Brien ◽  
Miralem Pasic ◽  
Hermann Kuppe ◽  
Roland Hetzer ◽  
Helmut Habazettl ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Aortic Valve ◽  
Inflammatory Response ◽  
Pulmonary Disease ◽  
Outcome Data ◽  
Surgical Trauma ◽  
Retrospective Case ◽  
Study Population ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Background: Cardiopulmonary bypass (CPB) and cardiac surgery cause an inflammatory response, as measurable by an increase in the concentration of C-reactive protein (CRP), a nonspecific inflammation marker. Previous publications have demonstrated typical perioperative CRP concentration profiles in cases of uncomplicated aortic valve replacement (AVR) with CPB. A regression analysis for modifying factors showed that chronic disease (heart failure, diabetes, and pulmonary disease), along with obesity and sex, all tend to influence the CRP response. We analyzed the inflammatory response to aortic valve implantation (AVI) with interventional techniques, mainly transapical but also transfemoral and transaxillary approaches, in a retrospective case-control study design.Methods: Sixty-eight patients who underwent AVI by the transapical (59 patients), transfemoral (7 patients), or transaxillary (2 patients) approach were matched by age, sex, body mass index (BMI), and chronic-disease state (absence or presence of diabetes, pulmonary disease, and renal impairment) with 68 patients who underwent conventional AVR with CPB. We compared the 2 groups with respect to perioperative CRP concentration, EuroSCORE, and outcome data (time to extubation and 30-day mortality). All data were collected prospectively and analyzed retrospectively.Results: The 2 groupsthe study population (interventional) and the control population (conventional)were similar in age, sex distribution, BMI, and chronic-disease status. As expected, the study population had a significantly higher median EuroSCORE. The 2 groups had similar postoperative CRP profiles over time, but the interventional group had significantly higher peak concentrations on days 2, 3, and 4. The short-term outcomes, as assessed by ventilation time and 30-day mortality, were similar for the 2 groups.Conclusions: Using an interventional transcatheter approach to AVI (thereby eliminating CPB from the procedure and reducing surgical trauma) does not attenuate the patient's innate inflammatory response.

Recovery of the Venous Wall from Leukocyte Induced Injury

1975 ◽  
Author(s):  
G. J. Stewart ◽  
W. G. M. Ritchie ◽  
P. R. Lynch
Keyword(s):  
Smooth Muscle ◽  
Surface Membrane ◽  
Uranyl Acetate ◽  
Surgical Trauma ◽  
Luminal Surface ◽  
Lead Citrate ◽  
Jugular Veins ◽  
Acetate Lead ◽  
Partial Covering ◽  
Venous Wall

Surgical trauma to tissue adjacent to canine jugular veins combined with brief local stasis caused massive leukocyte invasion of venous walls. This resulted in the entrapment of pockets of leukocytes between the endothelium and basement membrane and subsequent detachment of patches of endothelium.By an hour smooth muscle showed a decrease in myofibrils and an increase in rough endoplasmic reticulum and collagen lost its ability to stain with uranyl acetate-lead citrate.By 24 hours smooth muscle cells had undergone various changes and formed a partial covering layer over the surface of denuded areas, often by extending long “arms” from a bulky, fibroblast-like “body”. Various stages of de-differentiation and re-differentiation were abundant. By 72 hours these cells had become thinner and resembled the “immature” endothelium of Florey and others. However, the sheet was still discontinuous. By 7 days and thereafter to 28 days the endothelium was continuous and typical of “immature” endothelium morphologically but the surface membrane stained intensely in some instances.At 24 hours there was a perivascular zone of edema with cell ghosts and amorphous debris which decreased thereafter. Collagen staining was again typical by 7 days.These observations indicate that the luminal surface of blood veins can be initially repaired by the rapid de-differentiation and re-differentiation of smooth muscle rather than waiting for the ingrowth of endothelial cells from the margins of the denuded areas.(Supported by N. I. H. Grants ≠ HL 14217 and HL 08886.)

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