scholarly journals EARLY DRAIN FLUID AMYLASE IS USEFUL TO PREDICT PANCREATIC FISTULA AFTER PANCREATODUODENECTOMY: LESSONS LEARNED FROM A SOUTHERN BRAZILIAN CENTER

2018 ◽  
Vol 55 (2) ◽  
pp. 160-163 ◽  
Author(s):  
Uirá Fernandes TEIXEIRA ◽  
Pablo Duarte RODRIGUES ◽  
Marcos Bertozzi GOLDONI ◽  
José Artur SAMPAIO ◽  
Paulo Roberto Ott FONTES ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Early Stage ◽  
Postoperative Pancreatic Fistula ◽  
Lessons Learned ◽  
High Morbidity ◽  
Patients At Risk ◽  
Drain Fluid ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT BACKGROUND: Pancreatic fistula represents the most feared complication after pancreatoduodenectomies, being the major responsible for the high morbidity and mortality after this operation. Its incidence remains around 10% to 30%. In recent years, several authors have studied the value of amylase in abdominal drains fluid, measured at an early stage after the surgical procedure, as a useful tool to identify patients at risk of developing pancreatic fistula. OBJECTIVE: To analyze the value of early drain fluid amylase as a method to predict the occurrence and severity of postoperative pancreatic fistula in patients undergoing pancreatoduodenectomies. METHODS: We evaluated 102 prospective patients submitted to pancreatoduodenectomies from January 2013 to June 2017. The mensuration of amylase in abdominal drains was performed on days 1, 3, 5 and 7 in all patients. Patients were divided into three groups according to postoperative day 1 (POD1) results: values <270 U/L (group 1); between 271 and 5.000 U/L (group 2); and values >5.000 U/L (group 3). RESULTS: The incidence of pancreatic fistula was 25.5%, being 3.33%, 27.3% and 41.02% in the three groups, respectively. Compared with group 1, the risk of developing pancreatic fistula increased with increasing amylase values on POD1. Amylase values on POD1 and POD3 of patients with pancreatic fistula were higher than in the other ones without this complication (P<0.001). In addition, in group 3, 37.5% of patients with pancreatic fistula evolved to death (P<0.001). Finally, in this group, patients who died had drain fluid amylase values on POD1 significantly higher than the others in the same group (P<0.001). CONCLUSION: Early drain fluid amylase value is a useful test to stratify patients in relation to the risk of developing pancreatic fistula after pancreatoduodenectomies, in addition to correlate with the severity of this complication.

Inoculation of Balb/c mice with live attenuated tachyzoites protects against a lethal challenge ofNeospora caninum

Parasitology ◽  
2007 ◽  
Vol 135 (1) ◽  
pp. 13-21 ◽  
Author(s):  
P. M. BARTLEY ◽  
S. WRIGHT ◽  
F. CHIANINI ◽  
D. BUXTON ◽  
E. A. INNES
Keyword(s):  
Protective Immunity ◽  
Neospora Caninum ◽  
High Morbidity ◽  
Post Challenge ◽  
Lethal Challenge ◽  
Secondary Challenge ◽  
Group 3 ◽  
Group 2 ◽  
Severe Pathology ◽  
Group 1

SUMMARYNeospora caninumtachyzoites attenuated through passage in tissue culture were tested for their ability to induce protective immunity against a lethal challenge dose of parasites. Balb/c mice were each inoculated with either 1×106live virulent tachyzoites (Group 1) or 1×106live attenuated tachyzoites (Group 2), while (Group 3) received a control inoculum. All mice were each challenged 28 days later with 5×106virulent parasites. Histopathological lesions in the brains including necrosis and microgliosis were observed following post-mortem on day 28 post-challenge (p.c.) in 71% of Group 1 and 56% of Group 2. Immunohistochemistry (IHC) of these lesions showed tachyzoites andNeosporaantigens to be associated with moderate brain lesions in 17% of Group 1, while in 11% of Group 2N. caninumtissue cysts were detected, but these were not associated with lesions, Parasite DNA was detected by PCR in the brains of 86% of mice in Group 1 and 56% of mice in Group 2. Following challenge the mice in Group 3 showed high morbidity and 100% mortality within 17 days p.c. Positive IHC forN. caninumwas seen in 88% of the Group 3 mice and parasite DNA was detected in all brain samples. This study shows that it is possible to protect against a lethal challenge ofN. caninumthrough inoculation with attenuated or virulent tachyzoites. However, more severe pathology developed in mice initially inoculated with virulent parasites following a secondary challenge, compared to mice initially inoculated with attenuated parasites.

Abstract 2488: Correlation Between The Severity Of Diastolic Dysfunction And Cardiac Torsion

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sung-Ji Park ◽  
Chinami Miyazaki ◽  
Charles J Bruce ◽  
Diego Bellavia ◽  
Fletcher A Miller ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Early Stage ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Control Group ◽  
Compensatory Mechanism ◽  
Diastolic Velocity ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Backgrounds: Left ventricular torsion (LVtor) is an integral part of systole and untwisting plays an important role in diastole. The aim of this study was to characterize LVtor and untwisting in different grades of diastolic dysfunction. Methods: We studied 135 patients with normal LV EF with various grades of diastolic dysfunction (40 group1:mild,42 group 2:moderate,and 22 group 3:severe dysfunction) and 31 controls with normal diastolic function. Apical and basal short axis rotations were measured by 2D STE. LVtor was defined as net difference between apical and basal rotation. Results: Age, gender, and EF were similar in 3 groups and control. Mitral annulus early diastolic velocity was reduced in all 3 groups (see table ). Peak LVtor was significantly greater in group 1 compared with control, group 2 and group 3. The time from peak LVtor to Mitral valve opening, and to peak early diastolic velocity were significantly delayed in group 1 compared to control (p=0.0030 and 0.0409, respectively). The twisting rate and untwisting rate were found to be highest in group 1. Conclusions: Systolic torsion and diastolic untwisting are significantly increased in patients with mild diastolic dysfunction. In patients with advanced diastolic dysfunction with increased filling pressure, torsion and untwisting are normalized. Hence, vigorous LV torsion appears to be a compensatory mechanism during an early stage of diastolic dysfunction to maintain normal filling in the setting of reduced longitudinal myocardial motion.

The dynamic change of cancer genome and T-cell receptor repertoire of an early gastric cancer cohort.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16553-e16553
Author(s):  
Zhuoran Li ◽  
Jing Bai ◽  
Xi Wu ◽  
Weixun Zhou ◽  
Yaping Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
T Cells ◽  
Early Gastric Cancer ◽  
Early Stage ◽  
Cell Receptor ◽  
Cancer Genome ◽  
Tcr Repertoire ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

e16553 Background: The dynamics of the cancer genome and T-cell receptor (TCR) repertoire are largely unclear during the development of gastric cancer, especially in the early stage. In this study, we studied the characteristics of genome and tumor microenvironment changes chronologically in 15 early gastric cancer (EGC) patients and illustrated their influence on carcinogenesis. Methods: 75 gastric tissues including precancerous lesions, cancer lesions and paired reference gastric samples, and 29 peripheral blood samples were obtained chronologically from 15 patients. All the lesions were categorized into 3 groups according to its pathology type (group1: inflammation or intestinal metaplasia, group 2: low-grade dysplasia (LGD), group 3: EGC). Deep sequencing of whole-exome and CDR3 chain of TCR of each sample was performed. Tumor mutation burden (TMB), TCR repertoire diversity and clonality were evaluated based on the sequencing data. Results: Heterogeneity existed in cancer genome and TCR repertoire among different patients. During carcinogenesis, TMB increased at first and then decreased, reaching its peak at LGD, which was different from what we have known from other advanced cancer. A detailed analysis showed that only part of the driver gene mutations maintained in this process. Compared with T cells infiltrated in reference samples, tumor-infiltrating T cells shared more clones with peripheral blood T cells. Diversity and clonality of TCR repertoire didn’t show significant change with the development of cancer (Shannon index: group 1 = 6.32, group 2 = 6.06, group 3 = 6.09, p = 0.836; Clonality: group 1 = 0.19, group 2 = 0.19, group 3 = 0.17, p = 0.374). Some CDR3 clones appeared in early-stage and maintained during the carcinogenesis process. Conclusions: Our research is the first to analyze the cancer genome and TCR repertoire changes from both the spatial and temporal perspectives during the development of early gastric cancer. Somatic mutations appeared in the very early stage of gastric cancer and may induce the immune microenvironment changes in gastric mucosa.

scholarly journals The Сharacter and Development of photoreceptors photodegeneration combined with alloxan diabetes

2002 ◽  
Vol 1 (2) ◽  
pp. 47-52
Author(s):  
S. V. Logvinov ◽  
E. Yu. Varakuta ◽  
A. V. Potapov
Keyword(s):  
Diabetes Mellitus ◽  
Alloxan Diabetes ◽  
Light Exposure ◽  
Early Stage ◽  
Male Rats ◽  
Control Group ◽  
Group 3 ◽  
Group 2 ◽  
Alloxan Injection ◽  
Group 1

The aim of the research is to determine the character and development of a alterations in photoreceptors, caused by high-intensity light on the early stage of diabetes mellitus. The methods of light and electron microscopy were used. Experiments were obtained from 80 adult white male rats. The rats of group 1 (n = 20) received 1 injection of alloxan (15 mg per 100 g of weight) in order to model diabetes mellitus. The rats of group 2 (n = 20) were exposed for light of luminecent LB-40 lamps (6000 lx) for 6 hours. The rats of group 3 (n = 20) were exposed to the light with the same parameters 1 month after alloxan injection. The last 20 rats made a control group 4. The rats groups 2 and 3 were sacrifised by decapitation 1, 7, 14, 30 days after the light exposure, the rats of group 1 on the 4, 5, 6, 8 week after the alloxan injection. Light exposure combined with diabetes causes destruction pigment epithelium inner and outer processed of photoreceptors followed by pyknosis of nucleus and replacement by vacial glia. On the 7th day after the exposure local disappearance of according retinal layers was obsevred. In these local sites of the most intensive destruction in group 3 there is 1,6 times more cells with caryopyknosis from in according sites of group 2 (just light exposure) rats. Thus, alloxan diabetes on the early stage of its development (1 month) intensifies light damage of retinal photoreceptors. Probably, increase of oxydative processes and antioxidative systems break down play an important role in this synergetic effect.

scholarly journals Effect of direct current electric field on the rate of wound epithelization in patients with diabetic foot syndrome

2020 ◽  
pp. 58-61
Author(s):  
S. O. Yakobchuk ◽  
A. H. Iftodiy ◽  
V. K. Grodetskyi ◽  
V. D. Fundiur ◽  
O. Y. Khomko
Keyword(s):  
Electric Field ◽  
Direct Current ◽  
Postoperative Period ◽  
Diabetic Foot ◽  
Early Stage ◽  
Diabetic Foot Syndrome ◽  
Second Phase ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The aim of the work: to study the development of wound process in dynamics by means of examination of impression smear from the wounds of patients with diabetic foot syndrome by means of Pokrovska-Makarova method, planimetric examination by means of L. M. Popova method in case of treatment by traditional methods combined with galvanization of an afflicted lower limb and application of interstitial Berlithion electrophoresis. Materials and Methods. 113 patients with complicated forms of diabetic foot syndrome were examined and treated. Group 1 of patients underwent a traditional course of treatment, whereas a complex of treatment measures was complemented with galvanization of the affected lower extremity for the patients of group 2 at an early stage of the postoperative period. The patients of group 3 were additionally treated with local interstitial electrophoresis of Berlithion during an early stage of the postoperative period. A control over the dynamics of the wound process was carried out by means of estimating wound impression smears. Results and Discussion. A comparison of the rate of the transition of the cytological picture of impression smears from the inflammatory type to the regenerative, regenerative-inflammatory and finally to the regenerative types demonstrated that these processes among patients of 1st group occurred, on an average, during 20 days, among patients of the group 2 during 16 days and group 3 – during 14 days. Reducing the area of injury in patients of group 1 is ≈ 1 % per day, patients in group 2 – 2 %, followed by – 2.1–2.2 % per day and patients in group 3 speed up wound area reduction on an average 3 %. Therefore, under effect of direct current of electric field an inflammatory type of cytogram was found mainly from the 3–4 to 7–8th days compared with the control group, where these phenomena were found from the 3-4 to the 11–12th days. Approximately similar dynamics was found in case of ISEP action with Berlithion. When the wound process is passed into the second phase which is evidenced by the appearance of inflammatory impression smear, the rate of regeneration appeared to be the highest in the group of patients who received interstitial electrophoresis with Berlithion.

MORINDA CITRIFOLIA EXTRACT MOUTHWASH AS ANTIGINGIVITIS

2016 ◽  
Vol 19 (2) ◽  
pp. 102-109
Author(s):  
Nila Kasuma ◽  
Fildzah Nurul Fajrin ◽  
Yufri Aldi
Keyword(s):  
Placebo Group ◽  
Early Stage ◽  
Morinda Citrifolia ◽  
Clinical Effects ◽  
Mild Form ◽  
Fruit Extract ◽  
The Public ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Gingivitis is a inflamatory mild form of periodontal disease in gingiva. The early stage of gingivitis characterized by the accumulation of plaque, leukocytes, and PMN. Noni (Morinda citrifolia L.) is known to have anti-inflammatory compositions which also affects the activity of leukocytes during inflammation. The research objective was to analyze the clinical effects of mouthwash that contains extracts of noni (Morinda citrifolia L.) on leukocyte levels in the saliva in patients with gingivitis, in order to obtain traditional mouthwash that is economical, readily available, and effective in reducing gingivitis and can be used by the public. Extracts of noni fruit (Morinda citrifolia L.) is given in the form of mouthwashes used for 7 days in a row. Observations conducted on three groups of respondents: group 1 using mouthwash placebo, group 2 using mouthwash noni fruit extract 5%, and group 3 using chlorhexidine 0.1%. The use of mouthwash done in the morning and at night before bed as much as 15 ml for 30 seconds. The results showed a decrease in the number of leukocytes in the group treated with placebo cyst, 5% noni fruit extract, and chlorhexidine 0.1% (p <0.05). Both test preparations equally decreased the number of leukocytes in gingival sulcus in gingivitis patients.

scholarly journals Mortality in tongue cancer patients treated by curative surgery: a retrospective cohort study from CGRD

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2794 ◽  
Author(s):  
Ming-Shao Tsai ◽  
Chia-Hsuan Lai ◽  
Chuan-Pin Lee ◽  
Yao-Hsu Yang ◽  
Pau-Chung Chen ◽  
...  
Keyword(s):  
Tongue Cancer ◽  
Early Stage ◽  
Age Groups ◽  
Advanced Stage ◽  
Old Patients ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
After Cancer ◽  
Group 1

BackgroundOur study aimed to compare the outcomes of surgical treatment of tongue cancer patients in three different age groups.MethodsFrom 2004 to 2013, we retrospectively analyzed the clinical data of 1,712 patients who were treated in the four institutions constituting the Chang Gung Memorial Hospitals (CGMH). We divided and studied the patients in three age groups: Group 1, younger (<65 years); Group 2, young old (65 to <75); and Group 3, older old patients (≥75 years).ResultsMultivariate analyses determined the unfavorable, independent prognostic factors of overall survival to be male sex, older age, advanced stage, advanced T, N classifications, and surgery plus chemotherapy. No significant differences were found in adjusted hazard ratios (HR) of death in early-stage disease (stage I–II) among Group 1 (HR 1.0), Group 2 (HR 1.43, 95% confidence interval (CI) [0.87–2.34],p= 0.158), and Group 3 (HR 1.22, 95% CI [0.49–3.03],p= 0.664) patients. However, amongst advanced-stage patients (stage (III–IV)), Group 3 (HR 2.53, 95% CI [1.46–4.38],p  = 0.001) showed significantly worse survival than the other two groups after other variables were adjusted for. Fourteen out of 21 older old, advanced-staged patients finally died, and most of the mortalities were non-cancerogenic (9/14, 64.3%), and mostly occurred within one year (12/14, 85%) after cancer diagnosis. These non-cancer cause of death included underlying diseases in combination with infection, pneumonia, poor nutrition status, and trauma.ConclusionsOur study showed that advanced T classification (T3–4), positive nodal metastasis (N1–3) and poorly differentiated tumor predicted poor survival for all patients. Outcome of early-stage patients (stage I–II) among three age groups were not significantly different. However, for advanced-stage patients (stage III–IV), the older old patients (≥75) had significantly worse survival than the other two patient groups. Therefore, for early-stage patients, age should not deny them to receive optimal treatments. However, older old patients (≥75) with advanced cancer should be comprehensively assessed by geriatric tools before surgical treatment and combined with intensive postoperative care to improve outcome, especially the unfavorable non-cancerogenic mortalities within one year after cancer diagnosis.

scholarly journals Clinically Relevant Postoperative Pancreatic Fistula rates in two methods of pancreatico-jejunal anastomosis compared: Evolution of surgical technique in a single centre over time

2020 ◽  
Author(s):  
Tommaso Zurleni ◽  
Simone Olmetti ◽  
Luca Marzoli ◽  
Francesco Zurleni
Keyword(s):  
Pancreatic Fistula ◽  
Pancreatic Neoplasm ◽  
Pancreatic Head ◽  
Postoperative Pancreatic Fistula ◽  
Periampullary Neoplasms ◽  
Group A ◽  
Grade Ii ◽  
Group 2 ◽  
Thickness Layer ◽  
Group 1

Abstract Background:Pancreaticoduodenectomy remains the gold standard for management of patients with pancreatic head and periampullary neoplasms. Despite the low mortality, overall morbidity remains high, principally due to the development of a clinically relevant postoperative pancreatic fistula (CR-POPF).The aim of the present study is to compare rates of CR-POPF in two groups of patients treated with two different pancreaticojejunostomy techniques. Methods:Among 264 consecutive patients submitted to surgery for pancreatic neoplasm, 142 pancreaticoduodenectomies with end-to-side pancreaticojejunostomy were analysed. The first group of patients underwent a direct mucosa-to-mucosa anastomosis as described by Longmire and Traverso. In the second group, a duct-to-mucosa anastomosis with an outer seromuscolar and inner full thickness layer as described by Z’graggen, Shrikhande and Buchler was performed. Results:Mortality was 2,8% in the first group (2/71) and zero in the second. In group 1°, 48.5% of patients suffered one or more grade II-V Clavien-Dindo complications; in group 2°, complications were observed in 26,7% of patients. Clinically relevant POPF occurred in 12 patients in group 1° (17%) and in 4 patients in group 2° (5,6%). Conclusions:Changing pancreaticojejunostomy techniques may produce different outcomes. In our experience, a standardized duct-to-mucosa anastomosis, as performed in group 2, significantly reduced the rate of CR-POPF.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

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