Effect of Anemia on Survival of Myocutaneous Flaps in the Pig

1994 ◽  
Vol 111 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Ilsa Schwartz ◽  
Kun Z. Kim ◽  
David H. Thompson ◽  
Thomas F. George ◽  
Patrick M. McQuillan ◽  
...  
Keyword(s):  
Head And Neck ◽  
Latissimus Dorsi ◽  
Survival Rates ◽  
Surgical Flaps ◽  
Control Group ◽  
Oncologic Surgery ◽  
Flap Survival ◽  
Myocutaneous Flaps ◽  
Significant Difference ◽  
Normovolemic Anemia

The decision to transfuse patients after major head and neck reconstructive surgery has been influenced by the dictum that a hematocrit level of 30% or more is necessary for the survival of surgical flaps. Pedicled myocutaneous flaps are among the most frequently used methods of reconstruction after major head and neck oncologic surgery. No studies have addressed the survival of myocutaneous pedicied flaps in anemic animals. In this study survival of latissimus dorsi myocutaneous flaps in pigs was evaluated in anemic and control groups. A total of 26 pigs were randomly divided into two groups. The pigs in the anemic group were exsanguinated to normovolemic anemia (average hematocrit, 19%), followed by elevation of a latissimus dorsi myocutaneous flap. In the control group the same operation was performed without exsanguination. All other variables were kept constant. The flap survival was judged on postoperative3 days 7, and 14 by two evaluators. Ten pigs from each group were found to have 100% flap survival on postoperative day 14. There was no significant difference in mean flap survival rates between two groups for postoperative3 days 7, and 14. It is concluded that normovolemic anemia does not adversely affect the survival of the myocutaneous flaps. This finding may save unnecessary transfusions in postoperative patients.

Randomized Study of Adjuvant Chemotherapy for Head and Neck Cancer

1985 ◽  
Vol 93 (6) ◽  
pp. 712-717 ◽  
Author(s):  
Paul Y. Holoye ◽  
Thomas W. Grossman ◽  
Robert J. Toohill ◽  
Larry E. Kun ◽  
Roger W. Byhardt ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Head And Neck ◽  
Standard Therapy ◽  
Statistical Significance ◽  
Randomized Study ◽  
Survival Rates ◽  
Distant Metastases ◽  
Control Group ◽  
Preoperative Irradiation ◽  
Significant Difference

The ability of surgery and radiotherapy to control advanced squamous cell carcinoma of the head and neck has reached its maximal potential. We initiated a randomized, prospective, stratified study of adjuvant chemotherapy. Patients with stage II disease of the pyrlform sinus and stage III and IV disease of the oral cavity, larynx, hypopharynx, oropharynx, nasopharynx, and paranasal sinuses were eligible. Patients were randomized to receive either standard therapy alone or two courses of 5-fluorouracil (B-CMF) chemotherapy prior to and two courses after the completion of standard therapy. Standard therapy consisted of preoperative irradiation followed by radical surgery. Of 133 patients with advanced disease, 83 were included In the study—43 In the chemotherapy group and 40 In the control group. Rates of residual and recurrent disease, as well as distant metastases, were similar for the two groups. The survival rates of patients without persistent disease at the end of treatment showed no significant difference for the two groups. The study has been discontinued because statistical analysis Indicated that the addition of more patients would not materially Increase the statistical significance of the study.

Surgical Morbidity of Neck Dissection after Chemoradiotherapy in Advanced Head and Neck Cancer

1997 ◽  
Vol 106 (2) ◽  
pp. 117-122 ◽  
Author(s):  
James P. Newman ◽  
Willard E. Fee ◽  
David J. Terris ◽  
Richard L. Goode ◽  
Harlan A. Pinto ◽  
...  
Keyword(s):  
Head And Neck ◽  
Surgical Procedures ◽  
Complication Rate ◽  
Organ Preservation ◽  
Surgical Complication ◽  
Control Group ◽  
Surgical Morbidity ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Lower Complication

The use of chemotherapy and irradiation for organ preservation attempts to eliminate the need for extensive surgery in patients with advanced squamous cell carcinoma of the head and neck (SCCHN). We sought to characterize the morbidity of surgery in patients who needed surgery after treatment with induction chemotherapy followed by simultaneous chemotherapy and radiotherapy (chemoradiotherapy). The surgical morbidity within the first 30 postoperative days of 17 patients treated in an organ preservation approach between July 1991 and December 1994 was compared with a control group of patients undergoing similar surgical procedures during the same period. The organ preservation study patients underwent surgical procedures consisting of 18 neck dissections and 5 resections of the primary site. Six patients in the organ preservation study group experienced 8 surgical complications within the first 30 postoperative days, and most complications were minor. There was no significant difference in the duration of surgery or length of hospitalization between study patients and matched controls. Our surgical complication rate (35.3%) was higher but not statistically different from that of the control group, and compared favorably to reports of surgical morbidity (44% to 61%) in the literature on patients treated with chemoradiotherapy. The lower complication rate seen in this study may be a reflection of early surgical intervention as part of our organ preservation study scheme, the preponderance of neck dissections performed, and the limited number of pharyngeal procedures performed.

Resident training in head and neck flap reconstruction in U.S. academic otolaryngology programmes

2001 ◽  
Vol 115 (2) ◽  
pp. 119-121 ◽  
Author(s):  
Mahesh H. Bhaya ◽  
Gady Har-El
Keyword(s):  
Head And Neck ◽  
Latissimus Dorsi ◽  
Pearson Correlation ◽  
Inverse Correlation ◽  
Free Flaps ◽  
Resident Training ◽  
Flap Reconstruction ◽  
Pedicled Flaps ◽  
Significant Difference ◽  
Radial Forearm

The main objective of this study was to assess resident training in head and neck flap reconstruction, and to determine the confidence of graduating residents in performing these flaps independently. Questionnaires were distributed to otolaryngology residents graduating in 1997. Respondents recorded the number of pedicled and free flap procedures they performed, or assisted with, and indicated flaps they felt confident about performing independently.Pectoralis major myocutaneous (PMMC) (n = 560, mean 6.59) and radial forearm (RF) (66, 0.78) were the most common pedicled and free flaps performed. There was a significant difference (p = 0.0002, Mann-Whitney U test) between median confidence for pedicled (44.5 per cent) and free flaps (two per cent). Ten of the 17 flaps showed a significant Pearson correlation (p<0.05) between number of procedures performed and confidence in performing them independently. Of the pedicled flaps, latissimus dorsi (LD) showed good correlation (r = 0.67), PMMC showed low correlation (r = 0.19) and other pedicled flaps fair correlation. Of the free flaps, LD (r = 0.64) and fibula (r = 0.50) showed good correlation and rectus abdominis and RF fair correlation. There was a fair inverse correlation (r =−0.29) between numbers of pedicled and free flaps performed.Higher correlation in flaps uncommonly performed reflects greater operative training necessary to achieve the confidence for performing these flaps independently. As respondents perfomed greater numbers of free flaps, the number of pedicled flaps decreased. It might thus be important to train residents in all aspects of pedicled flaps. Most respondents were of the opinion that additional training in free flaps was necessary for those planning a career in head and neck reconstructive surgery.

scholarly journals Association of osteoprotegerin with ascending aortic dissection

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Goliopoulou ◽  
A Antonopoulos ◽  
E Oikonomou ◽  
A Miliou ◽  
P Theofilis ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Survival Rates ◽  
Aortic Disease ◽  
Aortic Aneurysms ◽  
Control Group ◽  
Aortic Dilatation ◽  
Serum Samples ◽  
Significant Difference ◽  
Aortic Aneurysm And Dissection

Abstract Background Thoracic aortic dissections are among the cardiovascular diseases with the highest mortality rates. Their often belated diagnosis and, hence, poor prognosis call for further research of their pathophysiology and possible biomarkers that will aid early diagnosis and increase survival rates. Osteoprotegerin is a known biomarker in cardiovascular disease, but it is yet to be determined whether it participates in aortic disease and thoracic aortic dissection in particular. Purpose This clinical study aimed at researching the role of osteoprotegerin in thoracic aortic aneurysm and dissection. Methods We compared three groups of patients; 20 patients with ascending aortic aneurysm (AAA), 10 patients with acute ascending aortic dissection (AAD) and 16 patients with normal aortic diameter undergoing cardiac surgery for other indication (control group). Serum samples were obtained from patients before surgery and osteoprotegerin levels were measured using the ELISA method. Results One-way analysis of variance revealed a significant association between the examined groups of patients and levels of osteoprotegerin (AAD: 62.72±44.53 pmol/L, AAA: 33.43±8.08 pmol/L, Control: 48.61±29.47 pmol/L, p=0.03). Importantly, after post-hoc analysis osteoprotegerin levels were found to be increased in patients with AAD compared to patients with uncomplicated AAA (62.72±44.53 pmol/L vs 33.43±8.08 pmol/L, p=0.03) (Figure 1), whereas there was no statistically significant difference between patients with AAA and the control group (33.43±8.08 pmol/L vs 48.61±29.47 pmol/L, p=0.34). Conclusions These findings suggest that osteoprotegerin may participate in the pathophysiology of aortic dissection but not in mechanisms of aortic dilatation. Therefore, detection of elevated osteoprotegerin levels in patients with diagnosed ascending aortic aneurysms might suggest an increased probability of dissection and, therefore, aid the decision-making process. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Comparison of subdermal and perforator delay techniques on a rat flap model

2018 ◽  
Vol 51 (02) ◽  
pp. 196-201 ◽  
Author(s):  
Dincer Altinel ◽  
Burcu Biltekin ◽  
Merdan Serin ◽  
Ugur Sahin ◽  
Muzaffer Altindas
Keyword(s):  
Clinical Applications ◽  
Control Group ◽  
Vascular Density ◽  
Lateral Side ◽  
Flap Survival ◽  
Significant Difference ◽  
Perforator Vessels ◽  
Collagen Density ◽  
Silicon Sheet ◽  
Experimental Group

ABSTRACT Background: In this study, we investigated the subdermal and perforator delay phenomena as a method to improve flap survival. Materials and Methods: In this experimental study, we used 24 rats in three groups. In the control group, the dorsal flaps were elevated and reinserted back to their place. In the experimental groups, we practiced the delay phenomena with two different techniques. In the first experimental group, cranial and lateral side incisions were performed; however, the flaps were not cut-off from the underlying fascia. In the second experimental group, we placed a silicon sheet under the planned flap to cut-off the circulation from the perforator vessels. Four weeks after the delay procedure, the flaps were raised completely and reinserted back to their place. Results: The average of necrotic area in the control group was 21.9% (±7.70). There was no necrosis in both experimental groups (P < 0.0001). Histological examination revealed that collagen density in both of the experimental groups was increased in comparison to the control group, it has only been found a significant first experimental group (P = 0.0315). We have not found any significant difference in lymphocyte density between the groups. Angiographic imaging has showed an increase in the vascular density in the flaps of the first experimental group. Conclusion: We believe that both of these delay techniques can be adapted to clinical applications and used safely to increase flap survival.

scholarly journals The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Renata Maria de Oliveira Botelho ◽  
Cássia Regina Vancini Campanharo ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Meiry Fernanda Pinto Okuno ◽  
Aécio Flávio Teixeira de Góis ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
University Hospital ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Significant Difference ◽  
Service Data

ABSTRACT Objective: to compare the rate of return of spontaneous circulation (ROSC) and death after cardiac arrest, with and without the use of a metronome during cardiopulmonary resuscitation (CPR). Method: case-control study nested in a cohort study including 285 adults who experienced cardiac arrest and received CPR in an emergency service. Data were collected using In-hospital Utstein Style. The control group (n=60) was selected by matching patients considering their neurological condition before cardiac arrest, the immediate cause, initial arrest rhythm, whether epinephrine was used, and the duration of CPR. The case group (n=51) received conventional CPR guided by a metronome set at 110 beats/min. Chi-square and likelihood ratio were used to compare ROSC rates considering p≤0.05. Results: ROSC occurred in 57.7% of the cases, though 92.8% of these patients died in the following 24 hours. No statistically significant difference was found between groups in regard to ROSC (p=0.2017) or the occurrence of death (p=0.8112). Conclusion: the outcomes of patients after cardiac arrest with and without the use of a metronome during CPR were similar and no differences were found between groups in regard to survival rates and ROSC.

Immune response after high-intensity focused ultrasound ablation for H22 tumor

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21169-21169 ◽  
Author(s):  
P. Zhou ◽  
M. Fu ◽  
J. Bai ◽  
Z. Wang ◽  
F. Wu
Keyword(s):  
Immune Response ◽  
Tumor Immunity ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Survival Rates ◽  
High Intensity Focused Ultrasound ◽  
Control Group ◽  
Term Survival ◽  
Hifu Ablation ◽  
Significant Difference

21169 Background: Previous results have shown that high intensity focused ultrasound (HIFU) ablation can potentially activate a host anti-tumor immunity. This study was to investigate whether acoustic cavitaion may enhance host immune responses after HIFU treatment for solid malignancy, and to explore the potential mechanisms regarding the enhanced anti-tumor immunity. Methods: (1) Tumor cell vaccine preparation: H22 cells were irradiated with HIFU (0.8MHz, 1050W/cm2, 90s); H22 cells were heated for one hour in 65°C water bath. (2) Animal study: 150 KM mice were randomly divided into three groups: control group, thermal group, and HIFU group. Each group had 50 mice for immune experiments. By using hypodermic injection, the mice in thermal group and HIFU group received either 0.2ml heat-treated H22 vaccine or 0.2ml HIFU-treated H22 vaccine in the left flank of each mouse. Those in control group received only injection with same amount of saline solution. The vaccination times were 4 sessions, once a week for 4 consecutive weeks. One week after last vaccination, each mouse was challenged with H22 tumor cells. All mice were followed up to observe the long-term survival in each group, and peripheral blood was collected to detect changes in T lymphocytes and their subsets by flow cytometry technique. Results: The tumor incidences and 6-week survival rates were observed 100% and 88% of mice in control group, 72.5% and 40% in thermal group, and 42.5% and 14% in HIFU group respectively. Compared to the values in either control group or thermal group, there was a significant decrease of tumor incidences and 6-week survival rates in HIFU group. The volume of tumor was obviously lower in HIFU group, and a significant difference was observed between HIFU group and thermal group or control group. Compared to the values in control group, there were a significant increase of CD4+ levels and CD4+/CD8+ ratio, and a significant decrease of CD8+ level in both HIFU group and thermal group. Conclusions: Antitumor immune response could be enhanced after HIFU ablation for H22 implanted tumor in mice, and acoustic cavitation could play an important role to stimulate host antitumor immune system. No significant financial relationships to disclose.

scholarly journals Different Extracts of Zingiber officinale Decrease Enterococcus faecalis Infection in Galleria mellonella

2015 ◽  
Vol 26 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Lilian Eiko Maekawa ◽  
Rodnei Dennis Rossoni ◽  
Júnia Oliveira Barbosa ◽  
Antonio Olavo Cardoso Jorge ◽  
Juliana Campos Junqueira ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Galleria Mellonella ◽  
Survival Curve ◽  
Survival Rates ◽  
Zingiber Officinale ◽  
Control Group ◽  
Treatment Groups ◽  
Significant Difference ◽  
Group A ◽  
Dried Extract

Dried, fresh and glycolic extracts of Zingiber officinale were obtained to evaluate the action against G. mellonella survival assay against Enterococcus faecalis infection. Eighty larvae were divided into: 1) E. faecalis suspension (control); 2) E. faecalis + fresh extract of Z. officinale (FEO); 3) E. faecalis + dried extract of Z. officinale (DEO); 4) E. faecalis + glycolic extract of Z. officinale (GEO); 5) Phosphate buffered saline (PBS). For control group, a 5 μL inoculum of standardized suspension (107 cells/mL) of E. faecalis (ATCC 29212) was injected into the last left proleg of each larva. For the treatment groups, after E. faecalis inoculation, the extracts were also injected, but into the last right proleg. The larvae were stored at 37 °C and the number of dead larvae was recorded daily for 168 h (7 days) to analyze the survival curve. The larvae were considered dead when they did not show any movement after touching. E. faecalis infection led to the death of 85% of the larvae after 168 h. Notwithstanding, in treatment groups with association of extracts, there was an increase in the survival rates of 50% (GEO), 61% (FEO) and 66% (DEO) of the larvae. In all treatment groups, the larvae exhibited a survival increase with statistically significant difference in relation to control group (p=0.0029). There were no statistically significant differences among treatment groups with different extracts (p=0.3859). It may be concluded that the tested extracts showed antimicrobial activity against E. faecalis infection by increasing the survival of Galleria mellonella larvae.

Proliferating cell nuclear antigen in laryngeal cancer

1998 ◽  
Vol 112 (3) ◽  
pp. 310-313 ◽  
Author(s):  
Tomasz Kręcicki ◽  
Michal Jeleń
Keyword(s):  
Proliferating Cell Nuclear Antigen ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Paraffin Section ◽  
Nuclear Antigen ◽  
Control Group ◽  
Satisfactory Outcome ◽  
Significant Difference ◽  
N Stage ◽  
Proliferating Cell

AbstractThe expression of proliferating cell nuclear antigen in paraffin sections from 154 cases of laryngeal squamous cell carcinoma were examined. There was significant difference in PCNA expression between the control group and cancer patients (p<0.001). The mean score of PCNA was higher in patients with poor prognosis than in patients with satisfactory outcome after treatment (p<0.05). There was no significant correlation between the PCNA count and the patient's age and sex, T and N stage and site of the tumour.Univariate analysis revealed that the PCNA score correlated with the patients' survival rates. In multivariate analysis the prognostic value of PCNA was on the statistical borderline (p = 0.049). In our study clinical features like N and T status had a more important influence on survival rate. Nevertheless it appears that the immunohistological examination of PCNA in paraffin section could be a complementary prognostic tool for laryngeal carcinoma. PCNA expression may also be a valuable tool for differentiating malignant from benign laryngeal epithelium.

CLO19-061: Clinical Features and Prognosis of Head and Neck Cancer in Patients With Esophagus Cancer

2019 ◽  
Vol 17 (3.5) ◽  
pp. CLO19-061
Author(s):  
Weihui Zheng ◽  
Weimin Mao ◽  
Jianlin Lou
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Survival Time ◽  
Neck Cancer ◽  
Survival Rates ◽  
Metachronous Cancer ◽  
Esophagus Cancer ◽  
Mean Survival Time ◽  
Significant Difference ◽  
The Mean

Objective: This study investigated the clinical and prognostic characteristics of head and neck cancer in patients with esophagus cancer. Methods: Information on 124 patients with head and neck cancer with esophagus cancer was collected from head and neck and thoracic surgery departments between January 2007 and December 2016 in Zhejiang Cancer Hospital. The incidence of synchronous and metachronous cancer was described. The clinical characteristics and prognosis were also compared in synchronous and metachronous cancer. The number of hospitalization and different treatments were analyzed the affection on the survival time. Results: 32 cases were synchronous cancer and 72 cases were metachronous cancer. The rate of surgery and the number of hospitalization were significantly different in synchronous and metachronous cancer (χ2=4.661; P<.05). The 1-year, 3-year, and 5-year survival rates were 39.9%, 19.9%, and15.2%, respectively in patients with synchronous cancer and the mean survival time was 18.4±6.2 months. In contrast, the survival rates were 78.7%, 77.8%, and 59.1% respectively in metachronous cancer and the mean survival time was 122.2±17.2 months. There was a significant difference between the 2 groups (χ2=10.934; P=.001). The number of hospitalizations greater than or equal to 5 times were significantly different from those with less than 5 times (χ2=10.574; P=.001). There was no statistically significant difference in the improvement of OS by single operation, chemotherapy, and target treatment. The P value was only slightly less than .05 in the radiation therapy. Conclusions: Head and neck cancer in patients with esophagus cancer have a high survival rate through active combined-modality therapies, especially in metachronous carcinoma.

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