scholarly journals A Simple Method to Measure Serum Lactate Concentration as A Reliable Parameter to Detect Flaps Blood-flow Patency

1970 ◽  
Vol 1 (4) ◽  
Author(s):  
Siti Handayani
Keyword(s):  
Blood Flow ◽  
Lactate Concentration ◽  
Cost Effective ◽  
Serum Lactate ◽  
Sprague Dawley ◽  
Simple Method ◽  
Baseline Serum ◽  
Group A ◽  
The Mean ◽  
Group B

Background: The change in !ap blood flow patency can be monitored by measures. Subjective clinical observation through flap examinations is greatly biased depending on examiner’s experience. Standardised equipments of assessment are more reliable. This study propose the use of a device to provide an objective, safe,reproducible, simple, portable, and cost-effective method of monitoring flaps vitality by measuring serum concentration of lactic acid. Methods: An experimental lab-based study was conducted utilising Sprague-Dawley rats. Twenty rats were randomly assigned into two groups. In all subjects, bilateral groin-flaps were elevated. In rats of Group A, the vein pedicle of one-side of the flap was occluded while in Group B both the artery and vein on one-side of the flap were occluded. The other side of flaps in each rat were left unoccluded to serve as controls. Baseline serum lactate was measured in all flaps, then remeasured 60 and 120 minutes in all flaps after pedicle manipulations. Results: The mean lactate concentration of Group A rats with vein-occluded !aps was 2.5 ± 0.17 mmol/L at 0-min initially, and increased to 7.9 ± 0.16 mmol/L 120-min after occlusion (p<0.0005). The mean lactate concentration of Group B rats with arterial and venous flap occlusion was 2.55 ± 0.21 at baseline, which increased four-fold at 120-min to 9.86 ± 0.28 mmol/L (p<0.0005). Among the two groups, the lactate difference was also found to be significant. Conclusion: This study demonstrates that the proposed method detects serum lactate changes in flaps with vein and arteriovenous occlusions. This thus can be used as an objective parameter to evaluate compromised blood flow on cutaneous flaps.

scholarly journals The effect of nano-hydroxyapatite/chitosan scaffolds on rat calvarial defects for bone regeneration

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Emmanouil Chatzipetros ◽  
Spyros Damaskos ◽  
Konstantinos I. Tosios ◽  
Panos Christopoulos ◽  
Catherine Donta ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Mean Value ◽  
Parietal Bone ◽  
Female Rats ◽  
Sprague Dawley ◽  
Post Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Right

Abstract Background This study aims at determining the biological effect of 75/25 w/w nano-hydroxyapatite/chitosan (nHAp/CS) scaffolds on bone regeneration, in terms of fraction of bone regeneration (FBR), total number of osteocytes (Ost), and osteocyte cell density (CD), as well as its biodegradability. Methods Two critical-size defects (CSDs) were bilaterally trephined in the parietal bone of 36 adult Sprague-Dawley rats (18 males and 18 females); the left remained empty (group A), while the right CSD was filled with nHAp/CS scaffold (group B). Two female rats died postoperatively. Twelve, 11, and 11 rats were euthanized at 2, 4, and 8 weeks post-surgery, respectively. Subsequently, 34 specimens were resected containing both CSDs. Histological and histomorphometric analyses were performed to determine the FBR, calculated as [the sum of areas of newly formed bone in lateral and central regions of interest (ROIs)]/area of the original defect, as well as the Ost and the CD (Ost/mm2) in each ROI of both groups (A and B). Moreover, biodegradability of the nHAp/CS scaffolds was estimated via the surface area of the biomaterial (BmA) in the 2nd, 4th, and 8th week post-surgery. Results The FBR of group B increased significantly from 2nd to 8th week compared to group A (P = 0.009). Both the mean CD and the mean Ost values of group B increased compared to group A (P = 0.004 and P < 0.05 respectively). Moreover, the mean value of BmA decreased from 2nd to 8th week (P = 0.001). Conclusions Based on histological and histomorphometric results, we support that 75/25 w/w nHAp/CS scaffolds provide an effective space for new bone formation.

scholarly journals Monitoring skin blood flow to rapidly identify alterations in tissue perfusion during fluid removal using continuous veno-venous hemofiltration in patients with circulatory shock

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wasineenart Mongkolpun ◽  
Péter Bakos ◽  
Jean-Louis Vincent ◽  
Jacques Creteur
Keyword(s):  
Blood Flow ◽  
Blood Lactate ◽  
Skin Blood Flow ◽  
Removal Rate ◽  
Lactate Concentration ◽  
Tissue Perfusion ◽  
Fluid Removal ◽  
Hemodynamic Variables ◽  
Group A ◽  
Group B

Abstract Background Continuous veno-venous hemofiltration (CVVH) can be used to reduce fluid overload and tissue edema, but excessive fluid removal may impair tissue perfusion. Skin blood flow (SBF) alters rapidly in shock, so its measurement may be useful to help monitor tissue perfusion. Methods In a prospective, observational study in a 35-bed department of intensive care, all patients with shock who required fluid removal with CVVH were considered for inclusion. SBF was measured on the index finger using skin laser Doppler (Periflux 5000, Perimed, Järfälla, Sweden) for 3 min at baseline (before starting fluid removal, T0), and 1, 3 and 6 h after starting fluid removal. The same fluid removal rate was maintained throughout the study period. Patients were grouped according to absence (Group A) or presence (Group B) of altered tissue perfusion, defined as a 10% increase in blood lactate from T0 to T6 with the T6 lactate ≥ 1.5 mmol/l. Receiver operating characteristic curves were constructed and areas under the curve (AUROC) calculated to identify variables predictive of altered tissue perfusion. Data are reported as medians [25th–75th percentiles]. Results We studied 42 patients (31 septic shock, 11 cardiogenic shock); median SOFA score at inclusion was 9 [8–12]. At T0, there were no significant differences in hemodynamic variables, norepinephrine dose, lactate concentration, ScvO2 or ultrafiltration rate between groups A and B. Cardiac index and MAP did not change over time, but SBF decreased in both groups (p < 0.05) throughout the study period. The baseline SBF was lower (58[35–118] vs 119[57–178] perfusion units [PU], p = 0.03) and the decrease in SBF from T0 to T1 (ΔSBF%) higher (53[39–63] vs 21[12–24]%, p = 0.01) in group B than in group A. Baseline SBF and ΔSBF% predicted altered tissue perfusion with AUROCs of 0.83 and 0.96, respectively, with cut-offs for SBF of ≤ 57 PU (sensitivity 78%, specificity 87%) and ∆SBF% of ≥ 45% (sensitivity 92%, specificity 99%). Conclusion Baseline SBF and its early reduction after initiation of fluid removal using CVVH can predict worsened tissue perfusion, reflected by an increase in blood lactate levels.

The Bronchus First and Vessels Simultaneously Stapled Technique: A Safe and Simple Method for Video-Assisted Right Upper Lobe Lobectomy

2018 ◽  
Vol 67 (02) ◽  
pp. 131-136
Author(s):  
Hao Xu ◽  
Linyou Zhang
Keyword(s):  
Invasive Procedure ◽  
Distant Recurrence ◽  
Massive Hemorrhage ◽  
Simple Method ◽  
Video Assisted ◽  
Novel Approach ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Right

Objective Video-assisted thoracic surgery lobectomy is a minimally invasive procedure for major pulmonary resection. The purpose of this study was to present a novel approach with a thoracoscope in the right upper lobe and to compare different lobectomy methods at our institution. Methods We reviewed the medical records of patients who underwent a thoracoscopic right upper lobectomy for lung cancer between September 2015 and September 2016. We performed 128 thoracoscopic right upper lobectomies: group A (n = 50) was treated with the bronchus-first and vessels simultaneously stapled method and group B (n = 78) was treated with the conventional isolation–ligation method. Preoperative mediastinal staging and lymphadenectomy followed the National Comprehensive Cancer Network guidelines. The intra- and postoperative outcomes were recorded and statistically compared. Results All patients underwent successful thoracoscopic right upper lobectomies. No significant differences in mean intraoperative blood loss, massive hemorrhage (>500 mL), and postoperative complications were observed between the two groups (p < 0.05). The mean operative time of group A was less than that of group B (110.80 ± 34.74 versus 167.01 ± 48.38 minutes, p = 0.000). The mean duration of chest drainage in group A was 4.34 ± 2.06 days, which was shorter than that of group B (5.85 ± 3.13 days, p = 0.017). No significant differences were observed in the local recurrence and distant recurrence between the two groups during the postoperative follow-up. Conclusions Thoracoscopic right upper lobectomy with the lobectomy bronchus-first and vessels simultaneously stapled method is a safe and efficient procedure that leads to better recovery.

Hepatoprotective Role of Virgin Coconut Oil and Neem Extract in Acetaminophen Induced Liver Toxicity

2021 ◽  
Vol 15 (12) ◽  
pp. 3209-3210
Author(s):  
Aftab Abbasi ◽  
Hina Mawani ◽  
Ghulam Nabi Pathan ◽  
Aftab shaikh ◽  
Abdul Samad Sodhar ◽  
...  
Keyword(s):  
Body Weight ◽  
Liver Toxicity ◽  
Coconut Oil ◽  
Sprague Dawley ◽  
Virgin Coconut Oil ◽  
Neem Extract ◽  
Mean Values ◽  
Group A ◽  
The Mean ◽  
Group B

Aim: To study the comparative hepatoprotective effect of Virgin Coconut Oil (VCO) and Neem (Azadirachta indica) leaf extract in acetaminophen (Paracetamol) induced liver toxicity. Methods: About 60 mixed population of rats (male/female) of Wistar and Sprague-Dawley species were randomly selected for the proposed study and are segregated into four equal groups. Every group contains 15 animal subjects. Group A was the control group given normal diet. In Group B, the rats were treated with a single dose of 2gm / kg body weight paracetamol, orally. Simultaneously, Group C were given an oral Neem extract of 500mg/kg body weight for 2 weeks days in combination with single dose of Paracetamol, while Group D were provided with 6.7ml/Kg/body weight Virgin Coconut Oil (VCO) for 15 days. Data was analyzed using SPSS Version 20.0 with level of significance being kept at p-value ≤0.05. Results: The mean values of ALT were 23.1, 100.5, 29.85, and 31.09 U/L in Group A, B, C, and D respectively. While, the mean values of AST were 25.6 U/L (Group A), 41 U/L (Group B), 19.3 U/L (Group C), and 15.2 U/L (Group D). The ALP showed maximum response indicated by the mean values of 221 U/L, 444 U/L, 241 U/L, and 243 U/L in Group A, B, C, and D respectively. Group B suggested the paracetamol induced liver toxicity indicated by the increase in hepatic DMEs right after the acetaminophen induction. Conclusion: Azadirachta Indica and Virgin Coconut Oil displayed hepatoprotective effects on the Wistar and Sprague-Dawley rats that were subjected to Paracetamol. Keywords: hepatic, Drug Metabolizing enzymes, Acetaminophen, Virgin coconut oil, Neem extract, Paracetamol, Wistar

The Effect of Antibiotic Prophylaxis on the Healing of Exit Sites of Peritoneal Dialysis Catheters in Rats

1998 ◽  
Vol 18 (1) ◽  
pp. 60-63 ◽  
Author(s):  
Roberto F.S. Pecoits-Filho ◽  
Zbylut J. Twardowski ◽  
Ramesh Khanna ◽  
Yong-Lim Kim ◽  
Sharad Goel ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Antibiotic Prophylaxis ◽  
Sprague Dawley ◽  
Exit Site ◽  
Sprague Dawley Rats ◽  
Group A ◽  
Catheter Implantation ◽  
The Mean ◽  
Group B

Objective To evaluate the influence of intraperitoneal (IP) antibiotic (AB) prophylaxis on the quality of healing and infection rates of exit sites in peritoneal dialysis catheters. Study Design Twenty-one Sprague-Dawley rats were dialyzed 3 times per day for 6 weeks. Dianeal solution containing AB was used for all the rats during the first 5 days. The animals were randomized on the sixth day into three groups: group A (AB-free after randomization), group B (AB for 3 weeks), and group C (AB during 6 weeks). Scores were given to each exit site according to the observation. Mean scores from each group were compared in an attempt to find significant differences between the groups. Dialysate and exit-site drainage samples were taken weekly for microbiology. Results Eight episodes of peritonitis were diagnosed, six in group A and two in group B. The most common bacteria causing peritonitis were gram-negative rods. The mean scores were not significantly different between groups C and B throughout the study, even after the discontinuation of the prophylaxis. Group A, when compared to the other two groups, had significantly higher scores after the second week and throughout the rest of the study. Conclusion Intraperitoneal antibiotic prophylaxis for 3 weeks after catheter implantation is an effective way to prevent early colonization of exit sites, providing a better healing quality and lower incidence of catheter-related infection. Although the extension of the prophylaxis for 6 weeks seems to be beneficial, it was not statistically proven in this study.

scholarly journals A study of vaginal misoprostol tablet versus intra cervical dinoprostone gel for the induction of labour

2017 ◽  
Vol 6 (4) ◽  
pp. 1404
Author(s):  
Chandni N. Badlani ◽  
Shraddha S. Shastri ◽  
Neelesh S. Risbud
Keyword(s):  
Cost Effective ◽  
Induction Of Labor ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Group A ◽  
The Mean ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

Background: This was a comparative study conducted to compare the effectiveness of 25 microgram of intravaginal misoprostol with intracervical dinoprostone gel in terms of efficacy of drug, feto-maternal outcome, side effects and complications of drugs.Methods: 400 nulliparas at term, admitted for induction of labor were included in this study. They were randomly selected to receive either intravaginal misoprostol or intracervical dinoprostone gel. Group A (200 women) recieved tablet misoprostol 25 micrograms vaginally 4 hrly to a maximum of 3 doses and Group B (200 women) received dinoprostone gel 0.5mg intracervically 6 hrly to a maximum of 3 doses. Comparison was done in terms of Induction to delivery interval, need for augmentation, LSCS and instrumentation rate, need for NICU admissions and cost effectiveness.Results: The mean induction to delivery interval was less in the misoprostol group than dinoprostone group (12.5 hrs vs. 20 hrs). 78% patients delivered in the first 24 hrs in misoprostol group compared to 52 % patients in dinoprostone group. Group A had a higher success rate (81% vs.76%) and also required less augmentation of labor ( 30% vs. 60%) compared to group B. Need for LSCS was also lower in misoprostol group (11% vs. 16%). Need for instrumentation and incidence of NICU admission was similar in both groups. Misoprostol was more cost effective compared to dinoprostone.Conclusions: The misoprostol group had a shorter induction to delivery interval, more number of deliveries in the first 24 hrs of induction and a reduced need of augmentation of labor with oxytocin. There was no significant difference in the rate of caesarean section, hyper-stimulation syndrome, neonatal and maternal morbidity between the two groups. Thus, misoprosol appears to be safer, cheaper and more efficacious alternative for induction of labor especially for non-fetal indications as compared to dinoprostone gel.

Bifrontal encephalogaleosynangiosis for children with moyamoya disease

2012 ◽  
Vol 10 (3) ◽  
pp. 246-251 ◽  
Author(s):  
Hideki Ogiwara ◽  
Nobuhito Morota
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Moyamoya Disease ◽  
Pediatric Patients ◽  
Demographic Data ◽  
Clinical Presentations ◽  
Group A ◽  
The Mean ◽  
Group B

Object Several operative techniques have been reported to increase the cerebral blood flow (CBF) of the anterior cerebral artery (ACA) territory in patients with moyamoya disease. However, the optimal procedure has not yet been determined. This study compared the efficacy of performing bifrontal encephalogaleosynangiosis (EGS) using a craniotomy with performing EGS using bur holes. Methods The authors retrospectively analyzed surgical results of pediatric patients with moyamoya disease treated using encephaloduroarteriosynangiosis (EDAS) and bifrontal EGS with a craniotomy, or EGS with bur holes, for the purpose of improving the ischemia of the ACA territory. Patients' demographic data, clinical presentations, surgical therapies, and clinical outcomes were reviewed. Results Nine patients underwent EDAS with bifrontal EGS using a craniotomy. Three patients underwent EDAS with EGS using bur holes for 5 cerebral hemispheres (1 bur hole in 2 hemispheres, 2 bur holes in 2 hemispheres, and 3 bur holes in 1 hemisphere). The mean follow-up period was 46.8 months (range 7–96 months). Preoperative symptoms improved in all patients in each group. The collateral circulation in the ACA territory made by EGS was divided into 3 groups according to postoperative angiography results: Group A (revascularization of more than two-thirds of the ACA territory), Group B (revascularization between one-third and two-thirds), and Group C (revascularization less than one-third). Of 5 hemispheres treated with EGS using bur holes, 1 was evaluated as Group B and 4 as Group C. Of 18 hemispheres treated with bifrontal EGS using a craniotomy, 8 were evaluated as Group A, 7 as Group B, and 3 as Group C. The patients who underwent bifrontal EGS using a craniotomy showed significantly better revascularization than those who underwent EGS using bur holes (p = 0.0065). Cerebral blood flow in the ACA territory improved in 13 (92.9%) of 14 hemispheres in patients treated with bifrontal EGS. In contrast, only 3 (60%) of 5 hemispheres demonstrated an increase of CBF in patients treated with EGS using bur holes. A trend was demonstrated for better improvement with bifrontal EGS (p = 0.08). Conclusions Encephaloduroarteriosynangiosis with bifrontal EGS using a craniotomy demonstrated better revascularization and improvement of CBF in the ACA territory than with EGS using bur holes. Bifrontal EGS using a craniotomy is considered to be a simple, safe, and effective surgical procedure for improvement of the ischemia of the ACA territory in pediatric patients with moyamoya disease.

scholarly journals Comparative study of laparoscopic and open surgery in management of 50 cases of liver hydatid cyst

2020 ◽  
Vol 7 (4) ◽  
pp. 1099
Author(s):  
Vikram B. Gohil ◽  
Swarnim U. Thakur ◽  
Smit M. Mehta ◽  
Firdaus A. Dekhaiya
Keyword(s):  
Hydatid Cyst ◽  
Open Surgery ◽  
Early Mobilization ◽  
Cost Effective ◽  
Early Discharge ◽  
Liver Hydatid Cyst ◽  
General Complication ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Echinococcosis is caused by parasite called Echinococcus granulosus and Echinococcus multilocularis. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy.Methods: This clinical study was done on 50 patients who had liver hydatid disease admitted in Sir T Hospital, Bhavnagar from August 2013 to February 2016. Patients were divided into two groups consisting of 25 cases in each. Group A: managed by open surgery. Group B: managed by laparoscopic surgery. All patients followed up for 6 months after surgery.Results: The mean operative time in Group A was 65.2 minutes (range 35-100 minutes) while in Group B it was 76.32 minutes (range 50-100 minutes). Group B patients were mobilised early and resumed duty very fast then Group A. The mean duration of stay in hospital was 12.4 days (range 4-20 days) in Group A and  6.2 days (range 4-12 days) in Group B. Wound infection seen in 16% in Group A and 0% in Group B. General complication rate was 32% in Group A and 8% in Group B. No recurrence noticed in either group during follow up.Conclusions: Overall laparoscopic management of liver hydatid cyst is cost effective in terms of early mobilization, early discharge and early resumption of work along with cosmetic benefit.

scholarly journals Focused transhepatic electroporation mediated by hypersaline infusion through the portal vein in rat model. Preliminary results on differential conductivity

2017 ◽  
Vol 51 (4) ◽  
pp. 415-421 ◽  
Author(s):  
Clara Pañella ◽  
Quim Castellví ◽  
Xavier Moll ◽  
Rita Quesada ◽  
Alberto Villanueva ◽  
...  
Keyword(s):  
Portal Vein ◽  
Irreversible Electroporation ◽  
Tumour Tissue ◽  
Therapeutic Window ◽  
Sprague Dawley ◽  
Group A ◽  
Hepatic Tumours ◽  
Tumour Group ◽  
The Mean ◽  
Group B

Abstract Background Spread hepatic tumours are not suitable for treatment either by surgery or conventional ablation methods. The aim of this study was to evaluate feasibility and safety of selectively increasing the healthy hepatic conductivity by the hypersaline infusion (HI) through the portal vein. We hypothesize this will allow simultaneous safe treatment of all nodules by irreversible electroporation (IRE) when applied in a transhepatic fashion. Material and methods Sprague Dawley (Group A, n = 10) and Athymic rats with implanted hepatic tumour (Group B, n = 8) were employed. HI was performed (NaCl 20%, 3.8 mL/Kg) by trans-splenic puncture. Deionized serum (40 mL/Kg) and furosemide (2 mL/Kg) were simultaneously infused through the jugular vein to compensate hypernatremia. Changes in conductivity were monitored in the hepatic and tumour tissue. The period in which hepatic conductivity was higher than tumour conductivity was defined as the therapeutic window (TW). Animals were monitored during 1-month follow-up. The animals were sacrificed and selective samples were used for histological analysis. Results The overall survival rate was 82.4% after the HI protocol. The mean maximum hepatic conductivity after HI was 2.7 and 3.5 times higher than the baseline value, in group A and B, respectively. The mean maximum hepatic conductivity after HI was 1.4 times higher than tumour tissue in group B creating a TW to implement selective IRE. Conclusions HI through the portal vein is safe when the hypersaline overload is compensated with deionized serum and it may provide a TW for focused IRE treatment on tumour nodules.

A STUDY OF VAGINAL MISOPROSTOL TABLET VERSUS INTRACERVICAL DINOPROSTONE FOR INDUCTION OF LABOUR

2021 ◽  
pp. 50-52
Author(s):  
P. Shabana ◽  
R. Asha Latha ◽  
N. M. Riyaz Riyaz
Keyword(s):  
Cost Effective ◽  
Induction Of Labour ◽  
Group 13 ◽  
Group 12 ◽  
Misoprostol Group ◽  
Group A ◽  
The Mean ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B

Background:Induction of labour is the process of initiating the labour by articial means post 24 weeks of gestation. This study was undertaken to compare the efcacy and safety of vaginal Misoprostol [25-50ug] with intracervical Dinoprostone gel (0.5mg) for induction of labour at term in terms of efcacy of drug, feto-maternal outcome, side effects and complications of drugs. Methods: 400 nulliparas at term admitted in the OBG ward were included in this study. They were randomly allocated to two groups A& B. Group A (200 women) received tablet Misoprostol 25 micrograms vaginally 4 hrly to a maximum of 3 doses and Group B (200 women) received Dinoprostone gel 0.5mg intracervically 6 hrly to a maximum of 3 doses. Comparison was done in terms of induction to delivery interval, rates of instrumental and LSCS delivery, need for NICU care and cost-effectiveness. ADRs, if any were documented and proper care taken. Results: The mean induction to delivery interval was less in the Misoprostol group than Dinoprostone group (12 hrs vs. 22 hrs). 82% patients delivered in the rst 24 hrs in Misoprostol group compared to 54 % patients in Dinoprostone group. Group A had a higher success rate (80% vs.75%) and also required less augmentation of labor ( 35% vs. 65%) compared to group B. Need for LSCS was also lower in Misoprostol group (13% vs. 18%). Need for instrumentation and incidence of NICU admission was similar in both groups. Misoprostol was more cost effective compared to Dinoprostone. Conclusions: The Misoprostol group had a shorter induction to delivery interval, more number of deliveries in the rst 24 hrs of induction and a reduced need of augmentation of labor with oxytocin. There was no signicant difference in the rate of caesarean section, hyper-stimulation syndrome, neonatal and maternal morbidity between the two groups. Thus, Misoprostol appears to be safer, cheaper and more efcacious alternative for induction of labor especially for non-fetal indications as compared to Dinoprostone gel.

Sign in / Sign up

Export Citation Format

Share Document