scholarly journals Structure and surgical dissection layers of the bare area of the liver

2019 ◽  
Author(s):  
Takamichi Ishii ◽  
Satoru Seo ◽  
Takashi Ito ◽  
Satoshi Ogiso ◽  
Ken Fukumitsu ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Safety Margin ◽  
Multilayered Structure ◽  
Parietal Peritoneum ◽  
Bare Area ◽  
Visceral Peritoneum ◽  
Macroscopic Structure ◽  
The Right ◽  
Hepatic Development ◽  
Integrated Study

Abstract Background : The bare area, which lies between the right liver and diaphragm, should be dissected to mobilize the right liver. The bare area was reportedly formed by direct adhesion between the liver and diaphragm, meaning that the bare area lacked serosal components. This study aimed to analyze the structure of the bare area by an integrated study of surgical and laparoscopic images and pathological studies and describe surgical procedures focusing on the multilayered structure. Methods : Surgical specimens of hepatectomy were analyzed histologically to evaluate the macroscopic structure of the bare area. Laparoscopic images and cadaver anatomy of the bare area were also examined, changing the dissection layers of the bare area. Results : The bare area comprised a multilayered structure that resulted in fusions in the hepatic development among the parietal peritoneum (peritoneum of the diaphragm part) and the visceral peritoneum (liver serosa). The multilayered structure of the bare area comprised the liver, sub-serosal connective tissue, liver serosa, parietal peritoneum, retroperitoneal connective tissue, epimysium of the diaphragm, and diaphragm, in order from the liver to the diaphragm. Laparoscopic images sometimes enabled us to recognize the multilayered structure of the bare area. Conclusions : Histopathological findings showed the bare area to be a multilayered structure. In cases where tumors are located underneath the bare area, it could be important to dissect the bare area, with careful attention to its multilayered structure. Surgical dissection of the bare area in the outer layer of the fused peritoneum could allow a sufficient safety margin.

scholarly journals Structure and surgical dissection layers of the bare area of the liver

2020 ◽  
Author(s):  
Takamichi Ishii ◽  
Satoru Seo ◽  
Takashi Ito ◽  
Satoshi Ogiso ◽  
Ken Fukumitsu ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Surgical Procedures ◽  
Outer Layer ◽  
Safety Margin ◽  
Multilayered Structure ◽  
Parietal Peritoneum ◽  
Careful Attention ◽  
Bare Area ◽  
Macroscopic Structure ◽  
Integrated Study

Abstract Background: The bare area was reportedly formed by direct adhesion between the liver and diaphragm, meaning that the bare area lacked serosal components. This study aimed to analyze the structure of the bare area by an integrated study of surgical and laparoscopic images and pathological studies and describe surgical procedures focusing on the multilayered structure.Methods: Several surgical specimens of hepatectomy were analyzed histologically to evaluate the macroscopic structure of the bare area. Laparoscopic images and cadaver anatomy of the bare area were also examined.Results: The multilayered structure of the bare area comprised the liver, sub-serosal connective tissue, liver serosa, parietal peritoneum, retroperitoneal connective tissue, epimysium of the diaphragm, and diaphragm, in order from the liver to the diaphragm. The liver serosa and the parietal peritoneum fused with each other. This multilayered structure of the bare area is observed almost constantly. There are two layers in the dissection of the bare area in surgical procedures, an outer layer of the fused peritoneum (near the diaphragm) and an inner layer of the fused peritoneum (near the liver). Laparoscopic images enabled us to recognize the multilayered structure of the bare area.Conclusions: Histopathological findings showed the bare area to be a multilayered structure. In cases where tumors are located underneath the bare area, it could be important to dissect the bare area, with careful attention to its multilayered structure. Surgical dissection of the bare area in the outer layer of the fused peritoneum could allow a sufficient safety margin.

Safe Use of the Assimilative Capacity of the Marine Environment for Waste Disposal – Is It Feasible?

1986 ◽  
Vol 18 (4-5) ◽  
pp. 233-244 ◽  
Author(s):  
J. E. Portmann ◽  
R. Lloyd
Keyword(s):  
Marine Environment ◽  
Salt Marshes ◽  
Safety Margin ◽  
Assimilative Capacity ◽  
Anthropogenic Inputs ◽  
Upper Limit ◽  
Safe Limits ◽  
Control Authority ◽  
The Right ◽  
To Receive

For centuries the sea has absorbed a variety of inputs from rivers, streams, salt marshes and the atmosphere. It is generally accepted that additional limited inputs by man are unlikely to have a significant effect on the marine environment. Various control systems have been constructed to provide a framework within which the regulation of anthropogenic inputs can be achieved. These are briefly reviewed. With care, and in the light of past experience in both freshwater and marine environments, reasonable assumptions or estimations can be applied where uncertainties exist; safe limits can therefore be set for discharges. Case histories are used to illustrate the contention that it is possible to assess the assimilative capacity of a marine area to receive wastes. There is a major distinction to be drawn between contamination and pollution of the marine environment. Moreover, acknowledgement of the assimilative capacity concept in the marine environment does not automatically provide dischargers with the right to utilise that capacity either in part or to the upper limit. What it does is indicate the upper limit which must not be exceeded if pollution is to be avoided, and provide an indication to the control authority of the safety margin involved in the discharge limits they set accordingly.

scholarly journals Laparoscopic Management of Adhesions Developed after Peritoneal Nonclosure in Primary Cesarean Section Delivery

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Emaduldin Seyam ◽  
Emad Moussa Ibrahim ◽  
Ayman Moheb Youseff ◽  
Eissa M. Khalifa ◽  
Enas Hefzy
Keyword(s):  
Adhesion Formation ◽  
Cross Sectional Study ◽  
Parietal Peritoneum ◽  
Reproductive Capacity ◽  
Secondary Infertility ◽  
Cross Sectional ◽  
Cesarean Section Delivery ◽  
Visceral Peritoneum ◽  
Group I ◽  
Group Ii

Objective. The aim of the current study was to laparoscopically investigate the effects of peritoneal nonclosure on the sites, types, and degrees of adhesions developed after primary caesarean section (CS) in women complaining of secondary infertility after first CS delivery. Study Design. This was a cross-sectional study, where 250 women suffering from secondary infertility after their first CS had been recruited. They had been classified into group I (n = 89), where both the visceral and parietal peritoneum had been left opened; group II (n = 75), where only the parietal peritoneum had been closed; and group III (n = 86), where both peritoneal layers had been closed. Laparoscopy had been used to classify those adhesions according to the location, severity, and their adverse impact on the reproductive capacity. Results. Both adnexal and nonadnexal adhesions had been found significantly higher in group I, while adnexal types of adhesions were significantly higher after nonclosure of the visceral peritoneum in group II. Laparoscopic tubal surgery performed included tubo-ovariolysis, fimbrioplasty, and neosalpingostomy. Pregnancy rate was found correlating with the adnexal adhesion location and score. Conclusion. Nonclosure of the peritoneum in CS is associated with more adhesion formation, which might adversely affect the future women reproduction.

scholarly journals Dynamic anatomical study of cardiac shunting in crocodiles using high-resolution angioscopy

1996 ◽  
Vol 199 (2) ◽  
pp. 359-365 ◽  
Author(s):  
M Axelsson ◽  
C E Franklin ◽  
C O Löfman ◽  
S Nilsson ◽  
G C Grigg
Keyword(s):  
High Resolution ◽  
Connective Tissue ◽  
Right Ventricle ◽  
Anatomical Study ◽  
Systemic Circulation ◽  
Outflow Tract ◽  
Aortic Valves ◽  
Aortic Blood Pressure ◽  
The Right

Prolonged submergence imposes special demands on the cardiovascular system. Unlike the situation in diving birds and mammals, crocodilians have the ability to shunt blood away from the lungs, despite having an anatomically divided ventricle. This remarkable cardiovascular flexibility is due in part to three anatomical peculiarities: (1) an 'extra' aorta (the left aorta) that leaves the right ventricle and allows the blood from the right ventricle to take an alternative route into the systemic circulation instead of going to the lungs; (2) the foramen of Panizza, an aperture that connects the right and left aortas at their base immediately outside the ventricle; and (3) a set of connective tissue outpushings in the pulmonary outflow tract in the right ventricle. Using high-resolution angioscopy, we have studied these structures in the beating crocodile heart and correlated their movements with in vivo pressure and flow recordings. The connective tissue outpushings in the pulmonary outflow tract represent an active mechanism used to restrict blood flow into the lungs, thus creating one of the conditions required for a right-to-left shunt. We observed that the foramen of Panizza was obstructed by the medial cusp of the right aortic valve during most of systole, effectively differentiating the left and right aortic blood pressure. During diastole, however, the foramen remained open, allowing pressure equilibration between the two aortas. Contrary to current theories, we found that the left aortic valves were unable to cover the foramen of Panizza during any part of the cardiac cycle, supporting the reversed foramen flow hypothesis. This would ensure a supply of blood to the coronary and cephalic circulation during a complete shut-down of the left side of the heart, such as might occur during prolonged submergence.

scholarly journals Pengaruh Range of Motion (ROM) Aktif Terhadap Fleksibilitas Sendi Lutut Pada Lanjut Usia

2020 ◽  
Vol 1 (1) ◽  
pp. 13-16
Author(s):  
Tavip Indrayana ◽  
Warijan Warijan ◽  
Joni Siswanto
Keyword(s):  
Connective Tissue ◽  
Knee Joint ◽  
Muscle Fibers ◽  
Sampling Technique ◽  
The Elderly ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental ◽  
The Right ◽  
Average Angle

ABSTRACTBackground : Joint flexibility decreases in old age due to a degenerative process resulting in changes in joints, connective tissue and cartilage in the elderly. Decreasing flexibility is also due to reduced elasticity of muscle fibers, where connective tissue in muscle fibers increases (Mariyam, 2008).Objective : The aim of this study was to analyze the effect of active exercise (ROM) on the lower extremities on increasing the flexibility of the knee joint in the elderlyMethods : This study using a quasi-experimental approach with One group pre-test and post-test design. The sampling technique uses the Slovin method of 42 people, obtained a sample of 25 elderly. Exercise is done twice a day for 8 days. Measurements were made on day 1, day 4 and day 8 of the study using a Goniometer measuring instrument..Result : The results of measurement I average of the right knee joint 117.52o, measurement II = 122.24, measurement III = 126, 36o. From the analysis with Paired simple t-Test between the measurements I and II, it was found that the different test measurements I and II t count value was equal to -1.908 with 0.068. Because sig 0.05, it can be concluded that Ho is accepted, meaning that the average angle of ROM before and after training is the same (not different). In the different test measurements II and III the value of t count is equal to -2.152 with sig 0.042.Conclusion : Because sig 0.05, it can be concluded that Ho is rejected, meaning that there is a difference in ROM angle after training between days 4 to 8 with the first day to day 4. Thus it can be stated that active ROM exercises affect the angle of ROM of the knee joint elderly after exercise ROM between day 4 to day 8. Keywords: active ROM exercise, flexibility of knee joint, elderly.

PULMONARY EMPHYSEMA AND OTHER CARDIORESPIRATORY LESIONS AS PART OF THE MARFAN ABIOTROPHY

PEDIATRICS ◽  
1964 ◽  
Vol 33 (3) ◽  
pp. 356-366
Author(s):  
Robert P. Bolande ◽  
Arthur S. Tucker
Keyword(s):  
Connective Tissue ◽  
Left Atrium ◽  
Pulmonary Emphysema ◽  
Left Lung ◽  
Left Main ◽  
Main Stem Bronchus ◽  
Giant Left Atrium ◽  
Left Main Stem Bronchus ◽  
The Right ◽  
Chronic Pulmonary Emphysema

Seven cases of Marfan's syndrome are reviewed clinically, radiologically, and pathologically. Six of the seven cases showed evidence of pulmonary dysaeration: (a) Two of the cases showed compression of the left main-stem bronchus by a giant left atrium with atelectasis of the left lung and compensatory emphysema of the right lung. (b) Two of the cases showed evidence of diffuse chronic pulmonary emphysema. Three cases had bilateral apical bullae. (c) One of the cases developed pneumothorax. The lungs of the children with the Marfan syndrome show precocious maturation of the elastic stroma of the alveolar septae. The pathogenesis of emphysema is discussed in relationship to the Marfan abiotrophy of connective tissue.

scholarly journals Connective Tissue Nevus in a Dog

1973 ◽  
Vol 10 (1) ◽  
pp. 65-68 ◽  
Author(s):  
J. G. Fox ◽  
S. B. Snyder ◽  
L. H. Campbell
Keyword(s):  
Connective Tissue ◽  
Golden Retriever ◽  
Dermal Collagen ◽  
The Right

A 5-year-old male Golden Retriever was examined because of a chronic localized loss of hair and elevated, multiple white nodules 2–8 mm in diameter that coalesced in several areas on the right side of the neck. The principle change was marked hyperplasia of the dermal collagen. The lesion is compatible with the connective tissue nevus described in man.

scholarly journals Mycobacterium intracellulare Infection Mimicking Progression of Scleroderma

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Simon Krabbe ◽  
Merete Engelhart ◽  
Sören Thybo ◽  
Søren Jacobsen
Keyword(s):  
Case Report ◽  
Listeria Monocytogenes ◽  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Connective Tissue Disorder ◽  
High Dose ◽  
Esophageal Dysmotility ◽  
Mycobacterium Intracellulare ◽  
The Right ◽  
Inflammatory Changes

This case report describes a patient with scleroderma who developed Mycobacterium intracellulare infection, which for more than a year mimicked worsening of her connective tissue disorder. The patient was diagnosed with scleroderma based on puffy fingers that developed into sclerodactyly, abnormal nail fold capillaries, interstitial lung disease, Raynaud’s phenomenon, esophageal dysmotility, and positivity for rheumatoid factor and anti-SSA antibodies. She developed massive inflammatory changes of the cutis, the subcutis, and the muscle fasciae of the right leg, that after several failed attempts of immunosuppressive treatments were found to be caused by Mycobacterium intracellulare. While she was receiving high-dose prednisolone, as worsening of her connective tissue disease was suspected to be the cause of the inflammatory changes, she had Listeria monocytogenes meningitis and was hospitalized for several weeks, but she recovered from this without sequelae. After Mycobacterium intracellulare infection was diagnosed, she was treated with clarithromycin and rifampicin. Her skin manifestations, arthralgias, and fatigue improved considerably, and the wounds of the right leg healed, unfortunately with significant scarring. Immunodeficiency testing was unremarkable. In summary, an infection with Mycobacterium intracellulare was mistaken for an unusually severe progression of scleroderma.

scholarly journals Occlusal Hypofunction Induces Atrophic Changes in Rat Gingiva

2008 ◽  
Vol 78 (6) ◽  
pp. 1015-1022 ◽  
Author(s):  
Yuji Ishida ◽  
Zuisei Kanno ◽  
Kunimichi Soma
Keyword(s):  
Connective Tissue ◽  
Structural Integrity ◽  
Lysyl Oxidase ◽  
Tissue Growth ◽  
Gingival Tissue ◽  
Control Group ◽  
Maxillary Molars ◽  
Male Wistar Rats ◽  
Hematoxylin And Eosin ◽  
The Right

Abstract Objective: To clarify the influence of occlusal hypofunction on the integrity of gingival tissue and gingival extracellular matrix biosynthesis. Materials and Methods: Thirteen-week-old male Wistar rats were divided into two groups. To eliminate occlusal forces, all the right maxillary molars were extracted in the hypofunctional group. The control group was anesthetized but not subjected to surgery. The rats were killed at 2 and 4 weeks after the procedure, and the lower right second molars were prepared for histological analysis. To investigate the effect of occlusal hypofunction on collagen biosynthesis, the expression of connective tissue growth factor (CTGF) and lysyl oxidase (LOX) was determined by immunohistochemistry as well as histological examination by hematoxylin and eosin staining. Results: Disorientation of the collagen fibers, proliferation of the connective tissue fibroblasts, and enlargement of epithelial intercellular gaps were observed in gingival tissue of rat molars with experimental occlusal hypofunction. Immunohistochemically, the expression of CTGF and LOX was increased significantly (P < .05) in the hypofunctional group. Conclusion: These results suggest that occlusal hypofunction can affect the structural integrity and the expression of CTGF and LOX in gingival tissue.

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