scholarly journals Minimally-invasive technologies in the treatment of choledocholithiasis complicated by purulent cholangitis

2021 ◽  
Vol 11 (2) ◽  
pp. 317-334
Author(s):  
I. Deikalo ◽  
D. Osadchuk ◽  
O. Karel ◽  
M. Handzhalas
Keyword(s):  
High Efficiency ◽  
Acute Cholangitis ◽  
Surgical Techniques ◽  
Liver Parenchyma ◽  
Minimal Invasive ◽  
Satisfactory Condition ◽  
Biliary Sepsis ◽  
Extrahepatic Bile Ducts ◽  
Group 3 ◽  
Sepsis And Septic Shock

Minimal invasive endoscopic technologies are used in the treatment of patients with choledocholithiasis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014 - 2018, aged 65.5 ± 15.18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) - surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) - by needle. In all cases, subtotal papilloprotectomy was performed [1], supplemented by balloon sphincteroplasty. In the I group, the patients included patients with acute cholangitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock. In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observed during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of cholangitis and biliary sepsis was noted.

scholarly journals Minimally-invasive technologies in the treatment of choledocholithiasis complicated by biliary pancreatitis

2021 ◽  
Vol 11 (3) ◽  
pp. 294-309
Author(s):  
I. Deikalo ◽  
D. Osadchuk ◽  
O. Karel ◽  
M. Handzhalas
Keyword(s):  
High Efficiency ◽  
Surgical Techniques ◽  
Liver Parenchyma ◽  
Minimal Invasive ◽  
Biliary Pancreatitis ◽  
Satisfactory Condition ◽  
Biliary Sepsis ◽  
Extrahepatic Bile Ducts ◽  
Group 3 ◽  
Sepsis And Septic Shock

Minimal invasive endoscopic technologies are used in the treatment of patients with biliary pancreatitis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014 - 2018, aged 65.5 ± 15.18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) - surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) - by needle. In all cases, subtotal papilloprotectomy was performed [1], supplemented by balloon sphincteroplasty. In the I group, the patients included patients with biliary pancreatitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock. In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observed during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of biliary pancreatitis and biliary sepsis was noted.

scholarly journals MINIMALLY-INVASIVE TECHNOLOGIES IN THE TREATMENT OF CHOLEDOCHOLITHIASIS COMPLICATED BY CHOLANGITIS AND BILIARY SEPSIS

2019 ◽  
Vol 42 (3) ◽  
pp. 26-31
Author(s):  
Deikalo I. M. ◽  
Osadchuk D. V. ◽  
Karel O. I. ◽  
Ganjalas M. B.
Keyword(s):  
Minimally Invasive ◽  
High Efficiency ◽  
Acute Cholangitis ◽  
Surgical Techniques ◽  
Liver Parenchyma ◽  
Informative Marker ◽  
Satisfactory Condition ◽  
Biliary Sepsis ◽  
Extrahepatic Bile Ducts ◽  
Group 3

Minimally-invasive endoscopic technologies are used in the treatment of patients with choledocholithiasis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014–2018, aged 65,5 ± 15,18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) – surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) – by needle. In all cases, subtotal papilloprotectomy was performed, supplemented by balloon sphincteroplasty. In the I group, the patients included patients with acute cholangitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock.In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observe during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of cholangitis and biliary sepsis was noted. Keywords: cholecholithiasis, purulent cholangitis, biliary sepsis, septic shock, endoscopic retrograde pancreatic cholangiography, endoscopic papillomotorotomy.

Molecular cloning and biological characterization of the human excision repair gene ERCC-3

1990 ◽  
Vol 10 (6) ◽  
pp. 2570-2581
Author(s):  
G Weeda ◽  
R C van Ham ◽  
R Masurel ◽  
A Westerveld ◽  
H Odijk ◽  
...  
Keyword(s):  
High Efficiency ◽  
Excision Repair ◽  
Alkylating Agents ◽  
Chinese Hamster ◽  
Complementation Group ◽  
Cdna Clones ◽  
Chromosomal Dna ◽  
Dominant Marker ◽  
Mammalian Expression ◽  
Group 3

In this report we present the cloning, partial characterization, and preliminary studies of the biological activity of a human gene, designated ERCC-3, involved in early steps of the nucleotide excision repair pathway. The gene was cloned after genomic DNA transfection of human (HeLa) chromosomal DNA together with dominant marker pSV3gptH to the UV-sensitive, incision-defective Chinese hamster ovary (CHO) mutant 27-1. This mutant belongs to complementation group 3 of repair-deficient rodent mutants. After selection of UV-resistant primary and secondary 27-1 transformants, human sequences associated with the induced UV resistance were rescued in cosmids from the DNA of a secondary transformant by using a linked dominant marker copy and human repetitive DNA as probes. From coinheritance analysis of the ERCC-3 region in independent transformants, we deduce that the gene has a size of 35 to 45 kilobases, of which one essential segment has so far been refractory to cloning. Conserved unique human sequences hybridizing to a 3.0-kilobase mRNA were used to isolate apparently full-length cDNA clones. Upon transfection to 27-1 cells, the ERCC-3 cDNA, inserted in a mammalian expression vector, induced specific and (virtually) complete correction of the UV sensitivity and unscheduled DNA synthesis of mutants of complementation group 3 with very high efficiency. Mutant 27-1 is, unlike other mutants of complementation group 3, also very sensitive toward small alkylating agents. This unique property of the mutant is not corrected by introduction of the ERCC-3 cDNA, indicating that it may be caused by an independent second mutation in another repair function. By hybridization to DNA of a human x rodent hybrid cell panel, the ERCC-3 gene was assigned to chromosome 2, in agreement with data based on cell fusion (L. H. Thompson, A. V. Carrano, K. Sato, E. P. Salazar, B. F. White, S. A. Stewart, J. L. Minkler, and M. J. Siciliano, Somat. Cell. Mol. Genet. 13:539-551, 1987).

scholarly journals Surgery in the Treatment of Acute Pancreatitis — Open Pancreatic Necrosectomy

2005 ◽  
Vol 94 (2) ◽  
pp. 130-134 ◽  
Author(s):  
J. Werner ◽  
W. Hartwig ◽  
T. Hackert ◽  
M. W. Büchler
Keyword(s):  
Acute Pancreatitis ◽  
Late Phase ◽  
Necrotizing Pancreatitis ◽  
Surgical Techniques ◽  
Interventional Therapy ◽  
Minimal Invasive ◽  
Infected Necrosis ◽  
Early Management ◽  
Pancreatic Infection ◽  
The Past

Management of acute necrotizing pancreatitis has changed significantly over the past years. Early management is non-surgically and solely supportive. Today, more patients survive the early phase of severe pancreatitis due to improvements of intensive-care-medicine. Pancreatic infection is the major risk factor with regard to morbidity and mortality in the late phase of severe acute pancreatitis. Whereas early surgery and surgery for sterile necrosis can only be recommended in selected cases, pancreatic infection is a well accepted indication for surgical treatment. Surgery should ideally be postponed until four weeks after the onset of symptoms as necrosis is well demarcated at that time. Four surgical techniques can be performed with comparable results regarding mortality: necrosectomy combined with (1) open packing, (2) planned staged relaparotomies with repeated lavage, (3) closed continuous lavage of the retroperitoneum, and (4) closed packing. However, closed continuous lavage of the retroperitoneum, and closed packing seem to be associated with a lower morbidity compared to the other two approaches. Advances in radiologic imaging, new developments of interventional radiology and other minimal access interventions have revolutionized the management of many surgical conditions over the past decades. However, minimal invasive surgery and interventional therapy for infected necrosis should be limited to specific indications in patients who are critically ill and otherwise unfit for conventional surgery. Open surgical debridement is the “gold standard” for treatment of infected pancreatic and peripancreatic necrosis.

scholarly journals A biomechanical analysis of tibial ACL reconstruction with graft length mismatch

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769098
Author(s):  
Evan B Gaines ◽  
Diana Lau ◽  
Qais Naziri ◽  
Westley Hayes ◽  
Julio J. Jauregui ◽  
...  
Keyword(s):  
Cyclic Loading ◽  
Acl Reconstruction ◽  
Surgical Techniques ◽  
The Other ◽  
Biomechanical Analysis ◽  
Graft Fixation ◽  
Bptb Graft ◽  
Load To Failure ◽  
Group 3 ◽  
Graft Length

Introduction: The incidence of graft length mismatch (GLM) during anterior cruciate ligament (ACL) reconstruction is reported to be up to 13%, with a rate of 20% when using bone-patellar tendon-bone (BPTB) allografts. Multiple techniques have been described to accommodate for the longer BPTB graft. As no study has compared the biomechanical properties of these methods (with cyclic loading), we evaluated the strength of four different surgical techniques used to accommodate for GLM during ACL reconstruction. Methods: A total of 32 fresh-frozen bovine tibiae and patellar tendons were divided into four groups based on the method of tibial graft fixation: (1) sutures tied over a post, (2) bone staples, (3) screws and washers, and (4) soft-tissue conversion with interference screw. Biomechanical testing was performed comparing the tensile properties of graft fixation techniques under cyclic loading. Ability to withstand 1500 cycles of load, the maximum tensile strength at load-to-failure, and the mode-of-failure were evaluated. Results: Only group 4 had all grafts intact after 1500 loading cycles, while the other groups had one graft failure at 338 (group 1), 240 (group 2), and 309 (group 3) cycles. The highest mean load-to-failure was observed in group 3 at 762 ± 173 N, which was found to be significantly higher than the other groups. The mean loads to failure in groups 1–4 were 453 ± 86 N, 485 ± 246 N, 762 ± 173 N, and 458 ± 128 N. Conclusion: While there are multiple viable techniques for fixation of a BPTB graft in the case of GLM, this study demonstrated that direct screw fixation offers the strongest construct.

scholarly journals Transvaginal Appendectomy: A Systematic Review

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Mehmet Ali Yagci ◽  
Cuneyt Kayaalp
Keyword(s):  
Comparative Studies ◽  
Operating Time ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Minimal Invasive ◽  
Morbidly Obese ◽  
Complication Rates ◽  
Study Selection ◽  
History Of ◽  
Patient Selection Criteria

Background. Natural orifice transluminal endoscopic surgery (NOTES) is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina.Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques.Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched.Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal.Main Outcome Measures. Patient selection criteria, surgical techniques, and results.Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes). Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days.Limitations.There are a limited number of comparative studies and an absence of randomized studies.Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary.

scholarly journals MicroRNA Delivery by Graphene-Based Complexes into Glioblastoma Cells

Molecules ◽  
2021 ◽  
Vol 26 (19) ◽  
pp. 5804
Author(s):  
Marta Kutwin ◽  
Malwina Ewa Sosnowska ◽  
Barbara Strojny-Cieślak ◽  
Slawomir Jaworski ◽  
Maciej Trzaskowski ◽  
...  
Keyword(s):  
Gene Expression ◽  
Cancer Cells ◽  
High Efficiency ◽  
Viral Vector ◽  
Surgical Techniques ◽  
Supportive Therapy ◽  
Mirna Sequence ◽  
Serious Adverse Events ◽  
Scanning Transmission ◽  
Microrna Delivery

Glioblastoma (GBM) is the most common primary and aggressive tumour in brain cancer. Novel therapies, despite achievements in chemotherapy, radiation and surgical techniques, are needed to improve the treatment of GBM tumours and extend patients’ survival. Gene delivery therapy mostly uses the viral vector, which causes serious adverse events in gene therapy. Graphene-based complexes can reduce the potential side effect of viral carries, with high efficiency of microRNA (miRNA) or antisense miRNA delivery to GBM cells. The objective of this study was to use graphene-based complexes to induce deregulation of miRNA level in GBM cancer cells and to regulate the selected gene expression involved in apoptosis. The complexes were characterised by Fourier transform infrared spectroscopy (FTIR), scanning transmission electron microscopy and zeta potential. The efficiency of miRNA delivery to the cancer cells was analysed by flow cytometry. The effect of the anticancer activity of graphene-based complexes functionalised by the miRNA sequence was analysed using 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxyanilide salt (XTT) assays at the gene expression level. The results partly explain the mechanisms of miRNA deregulation stress, which is affected by graphene-based complexes together with the forced transport of mimic miR-124, miR-137 and antisense miR-21, -221 and -222 as an anticancer supportive therapy.

Minimal Invasive Surgery and Therapy (MIS and MIT) in Hirschsprung's Patients

2008 ◽  
pp. 882-889
Author(s):  
Nilmini Wickramasinghe ◽  
Giuseppe Turchetti ◽  
Barbara Labella ◽  
Andrea Moglia ◽  
Arianna Menciassi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Invasive Surgery ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Surgical Techniques ◽  
Diagnostic Procedures ◽  
Minimal Invasive ◽  
Surgical Tools ◽  
Economic Perspectives ◽  
Laparoscopic Tools

The generally accepted treatment for Hirschsprung’s disease is through surgical intervention. Currently, the recognized techniques include the Swenson technique, which is less frequently used as the operation is delicate and can give rise to complications; the Duhamel technique, which is arguably the simplest approach and consistently provides good results; and the Soave technique, which also provides good results but is often more complex than the Duhamel approach. However, surgical and diagnostic procedures of the future will evolve from embracing current technologies that enable minimally invasive approaches to extremely targeted, localized, and high-precision endoluminal techniques. This requires entirely new types of surgical tools capable of entering the human body through natural orifices (by insertion, ingestion, or inhalation), very small incisions (injections), or even through skin absorption and maybe configuring themselves in complex kinetic structures at the specific site of intervention. Moreover, such approaches necessitate modification of classic surgical techniques. While the advantages of minimally invasive surgery and minimally invasive therapy (MIS and MIT) are widely acknowledged, this chapter serves to highlight the advantages of such procedures in pediatric medicine, both at the diagnostic and intervention levels and the consequent implications to classic surgical techniques. The particular focus of the chapter pertains to the specific advantages the following techniques can bring into pediatric diagnostic and surgical techniques in the case of Hirschsprung’s disease: (1) endoluminal miniaturized tools for gastrointestinal endoscopy, (2) gastrointestinal capsules for digestion (e.g., M2A capsule), and (3) laparoscopic tools for surgery. Both technological and economic perspectives are discussed.

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