scholarly journals Study On The Application of Preoperative Three-Dimensional CT Angiography of Perigastric Arteries In Laparoscopic Radical Gastrectomy

Author(s):  
Peng Liu ◽  
Wenbin Yu ◽  
Meng Wei ◽  
Danping Sun ◽  
Xin Zhong ◽  
...  

Abstract Objection: To investigate the clinical value and significance of preoperative three-dimensional computerized tomography angiography (CTA) in laparoscopic radical gastrectomy for gastric cancer.Methods: The clinical data were analyzed retrospectively from 214 gastric cancer patients. We grouped according to whether to perform CTA. The gastric peripheral artery was classified according to CTA images of patients in the CTA group, and we compared and analyzed the difference of the data between the two groups.Results: The celiac trunk was classified according to Adachi classification: Type I (118/125, 94.4%),Type II (3/125, 2.4%),Type III (0/125, 0%),Type IV (1/125, 0.8%),Type V (2/125, 1.6%),Type VI (1/125, 0.8%).Hepatic artery classification was performed according to Hiatt classification standard:Type I (102/125, 81.6%),Type II (9/125, 7.2%),Type III (6/125, 4.8%),Type IV (2/125, 1.6%),Type V (3/125, 2.4%),Type VI (0, 0%),Others (3/125, 2.4%).And this study combined vascular anatomy and clinical surgical risk to establish a new splenic artery classification model. It was found that the operation time and estimated blood loss in the CTA group were significantly lower than those in the non-CTA group. In addition, the blood loss in the CTA group combined with ICG (Indocyanine Green) labeled fluorescence laparoscopy was significantly less than that in the group without ICG labeled. Conclusion: Preoperative CTA can objectively evaluate the vascular course and variation of patients, and then avoid the risk of operation, especially in combination with ICG labeled fluorescence laparoscopy, can further improve the quality of operation.

Synthesis ◽  
2019 ◽  
Vol 51 (14) ◽  
pp. 2737-2758 ◽  
Author(s):  
Hyeonggeun Lim ◽  
Sikwang Seong ◽  
Sunkyu Han

Post-iboga alkaloids are secondary metabolites that are biosynthetically derived from iboga-type alkaloids via rearrangements of the indole and/or isoquinuclidine moieties. Herein, we categorize post-iboga alkaloids into five types based on the biosynthetic mode of transformation of the iboga scaffold. We then describe reported syntheses of post-iboga alkaloids, including our laboratory’s recent contributions, based on our own categorization.1 Introduction1.1 Iboga and Post-Iboga Alkaloids1.2 Classification of Post-Iboga Alkaloids1.2.1 Introduction to Type I Post-Iboga Alkaloids1.2.2 Introduction to Type II Post-Iboga Alkaloids1.2.3 Introduction to Type III Post-Iboga Alkaloids1.2.4 Introduction to Type IV Post-Iboga Alkaloids1.2.5 Introduction to Type V Post-Iboga Alkaloids2 Syntheses of Post-Iboga Alkaloids2.1 Syntheses of Type I Post-Iboga Alkaloids2.1.1 Syntheses of Monomeric Type I Post-Iboga Alkaloids2.1.2 Syntheses of Dimeric Type I Post-Iboga Alkaloids2.2 Syntheses of Type II Post-Iboga Alkaloids2.3 Synthetic Studies Toward Type III Post-Iboga Alkaloids2.4 Syntheses of Type IV Post-Iboga Alkaloids2.5 Synthesis of Type V Post-Iboga Alkaloids3 Conclusion and Outlook


2020 ◽  
pp. 152660282096391
Author(s):  
Tanner I. Kim ◽  
Shant S. Vartanian ◽  
Peter A. Schneider

A growing, but poorly defined subset of patients with chronic limb-threatening ischemia (CLTI) have “no option” for revascularization. One notable subgroup includes patients with severe ischemia and advanced pedal artery occlusive disease, termed “desert foot,” who are at high risk for major amputation due to a lack of conventional revascularization options. Although new therapies are being developed for no-option patients with desert foot anatomy, this subgroup and the broader group of no-option patients are not well defined, limiting the ability to evaluate outcomes. Based on a systematic review, a classification of the no-option CLTI patient was constructed for use in clinical practice and studies. Several no-option conditions were identified, including type I—severe and pedal occlusive disease (desert foot anatomy) for which there is no accepted method of repair; type II—lack of suitable venous conduit for bypass in the setting of an acceptable target for bypass; type III—extensive tissue loss with exposure of vital structures that renders salvage impossible; type IV—advanced medical comorbidities for which available revascularization options would pose a prohibitive risk; and type V—presence of a nonfunctional limb. While type I and type II patients may have no option for revascularization, type III and type V patients have wounds, infection, comorbidities, or functional status that may leave them with few options for revascularization. As treatment strategies continue to evolve and novel methods of revascularization are developed, the ability to identify no-option patients in a standardized fashion will aid in treatment selection and assessment of outcomes.


2018 ◽  
Vol 1 (1) ◽  
pp. 66 ◽  
Author(s):  
Irham Fuadi ◽  
Sutriyono Sutriyono

Abstrak: Penelitian ini bertujuan untuk menganalisis kesalahan siswa dalam menyelesaikan soal cerita materi sistem persamaan linear dua variable. Metode yang digunakan dalam penelitian ini adalah deskiptif kualitatif. Sampel yang diambil adalah siswa kelas VIII H SMP Negeri 7 Salatiga dengan jumlah subjek sebanyak 3 siswa. Hasil penelitian ini menunjukan siswa masih melakukan kesalahan pada type I (reading error) sebesar 0%, kesalahan pada type II (comprehension error) sebesar 19%, kesalahan pada type III (transformasion error) sebesar 14%, kesalahan pada type IV (process skill error) sebesar 24%, dan kesalahan pada type V (enconding error) sebesar 44%. Abstract:  This study aims to analyze students' errors in solving the material story of the system of two linear equations. The method used in this study is descriptive qualitative. The samples are taken from VIII H grade students of SMP Negeri 7 Salatiga with the number of subjects as many as three students. The result of this research showed students still made an error on type I ( reading error ) as much as 0 % , an error on type II ( comprehension error) is approximately 19 % , an error on type III ( transformation error) 14 %  , an error on type IV (process skill error) 24 %, and an error on type V ( enconding error ) as much as 44 % .


Author(s):  
V. Zakharova ◽  
T. Savchuk ◽  
Ya. Truba ◽  
V. Lazoryshynets ◽  
O. Rudenko

Hypoplastic left heart syndrome (HLHS) is one of the most complicated congenital heart defects which leads to the inevitable fatal outcome in the natural course of the disease. Currently, Norwood procedure and fetal aortic valvuloplasty are considered the major approaches for surgical treatment of HLHS. However, the prognosis of such surgeries is often unpredictable. The aim. To study morphological variations of the left ventricle (LV) in HLHS and evaluate the prognostic significance of each of them in the choice of surgical approach. Materials. The main group included 63 hearts of newborns with HLHS, the comparison group included 53 hearts of newborns without cardiac pathology. Methods. The methods used were survey microscopy, as well as macro- and micromorphometry of various parameters of the heart, calculation of the ratio of their absolute values (indices) with subsequent statistical data processing. Results. Five types of LV were identified in HLHS patients based on the size and shape of the cavity, wall thickness, presence or absence of fibroelastosis: slit-like hypoplastic (Type I) (n = 10; 15.9%); slit-like hypertrophic (Type II) (n = 19; 30.2%); cylindrical (Type III) (n = 22; 34.9%); lacunar (Type IV) (n = 6; 9.5% ); lacunar-cylindrical (Type V) (n = 6; 9.5%). In Type I left ventricles, the interventricular index (IVI) (the ratio of the areas of the free walls of the left and right ventricles on the cross sections of the heart) was the smallest: 0.13 ± 0.03 units versus normal 1.96 ± 0.31 units. In Type II left ventricles, the value was equal to 1.69 ± 0.23 units; in Type III it was 1.59 ± 0.64 units; in Type IV it was 1.31 ± 0.03 units; in Type V it was 1.05 ± 0.52 units. The index of the working area of the right ventricular myocardium (RVI) (the ratio of the area of the free wall of the right ventricle to the sum of the areas of the free wall and interventricular septum) in Type I LV was the highest: 81.3 ± 5.7% versus normal 57.1 ± 2.02%; in Type II it was 49.7 ± 6.4%; in Type III it was 39.8 ± 2.9%; in Type IV it was 69.7 ± 16.1%; in Type V it was 41.3 ± 24.4%.Type III–V LVs have always been associated with fibroelastosis, in contrast to Type I and II LVs. Conclusions. In HLHS, Type I hearts are the most eligible for the Norwood procedure, since the LV, due to its minimal size, is not an excess ballast for the working right ventricle. Type II LV is optimal for the fetal aortic valvuloplasty, since during the II-III trimesters of gestation they can join the circulatory system due to remodeling. HLHS with LV fibroelastosis (Types III, IV, V) seem to be the least favorable for both pre- and postnatal surgery, especially in the presence of fibroelastosis of the right ventricle.


2017 ◽  
Vol 23 (6) ◽  
pp. 620-627 ◽  
Author(s):  
Jung Ho Ko ◽  
Young-Joon Kim

We report ischemic complications related to obstruction of the posterior communicating artery (PcomA) and suggest treatment strategies according to the angiographic characteristics of the PcomA and the posterior cerebral artery (PCA). Twenty-one patients with PcomA aneurysm who had initially undergone endovascular treatment and had an identifiable PcomA occlusion on immediate or follow-up angiography were enrolled. We classified PcomA aneurysm according to the characteristics of the PcomA and PCA (P1) on baseline angiography, as follows: type I was defined as PcomA aneurysm with an absent PcomA and a normal-sized P1. Type II was defined as a hypoplastic PcomA and a normal-sized P1. Type III was defined as a normal-sized PcomA and an absent P1. Type IV was defined as a normal-sized PcomA and a hypoplastic P1. Type V was a normal-sized PcomA and a normal-sized P1. Among all cases of PcomA obstruction, 15 (71.4%) were type II PcomA aneurysms, four were type IV, one was type III, and one was type V. Ischemic events related to PcomA obstruction occurred in three cases (type II, III and VI), which included two tuberothalamic infarctions (type III and IV) and one cortical infarction in the territory of the PCA (type II). Follow-up angiographies showed flow change in the PcomA in 14 cases. It is relatively safe to sacrifice type II PcomA if necessary. However, physicians should pay attention to unexpected flow changes, such as recanalization or occlusion of the PcomA, which are possible after treatment.


1977 ◽  
Vol 23 (5) ◽  
pp. 497-509 ◽  
Author(s):  
M. S. Shahrabadi ◽  
R. G. Marusyk ◽  
T. B. Crawford

Sequential changes induced by an equine adenovirus in cultured fetal equine kidney cells were studied by electron microscopy. The first morphological change was the appearance of type I inclusions. These inclusions developed to type II inclusions which appeared as ring forms. Type III inclusions were formed within the central part of type II inclusions and finally filled up most of the nuclear space. As the infection proceeded, type IV inclusions which appeared as dense dark-staining spheres were formed at the center of the type III inclusions and also inside the cytoplasm. These dark-staining spheres developed and their center was filled with light-staining material and virus particles which eventually resulted in the formation of type V inclusions. Autoradiography study showed that types I, II, and III were composed of nucleoprotein and type IV was composed of protein.


2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Trelia Boel ◽  
Dewi Kartika ◽  
Liliana Liliana

Introduction: Permanent mandibular first molars are the most commonly experienced treatment failure. Knowledge of root canal configuration needs to be known to establish the right diagnostics and successful root canal treatment. The aim of this study is to find out the root canal configuration of permanent mandibular first molar based on Vertucci classification using tube shift radiography technique among dental student of University of Sumatera Utara. Materials and Methods: This is an experimental with cross sectional approach. 36 students were selected by purposive sampling and data were collected from questionnaire and x-ray radiograph. Results: The result showed that 97.2% of permanent mandibular first molar have two roots and 2.8% have three roots. Variation of root canal configuration according to Vertucci on mesial root right region, type I 8.3%, type II 27.8%, type III 11.1%, type IV 50%, type II classification Gulabivala 2.8%, on left region type I 5.6%, type II 44.4%, type III 2.8%, type IV 44.4%, type II classification Gulabivala 2.8%. On distal root of first molar right region, type I 86.1%, type II 2.8%, type III 8.3%, type V 2.8%, on left region, type I 100%. Conclusion(s): Root canal configuration of mandibular first molar based on Vertucci classification at mesial roots of the right region, type I, II, III, IV, and type II classification Gulabivala , on left region we found type I, II, III, IV, and type II classification Gulabivala . On distal root of the right region, type I, II, III, and type V, on left region only type I.


1996 ◽  
Vol 85 (5) ◽  
pp. 830-837 ◽  
Author(s):  
Mark A. Davies ◽  
Karel TerBrugge ◽  
Robert Willinsky ◽  
Terry Coyne ◽  
Jamshid Saleh ◽  
...  

✓ A number of classification schemes for intracranial dural arteriovenous fistulas (AVFs) have been published that claim to predict which lesions will present in a benign or aggressive fashion based on radiological anatomy. We have tested the validity of two proposed classification schemes for the first time in a large single-institution study. A series of 102 intracranial dural AVFs in 98 patients assessed at a single institution was analyzed. All patients were classified according to two grading scales: the more descriptive schema of Cognard, et al. (Cognard) and that recently proposed by Borden, et al. (Borden). According to the Borden classification, 55 patients were Type I, 18 Type II, and 29 Type III. Using the Cognard classification, 40 patients were Type I, 15 Type IIA, eight Type IIB, 10 Type IIA+B, 13 Type III, 12 Type IV, and four Type V. Intracranial hemorrhage (ICH) or nonhemorrhagic neurological deficit was considered an aggressive presenting clinical feature. A total of 16 (16%) of 102 intracranial dural AVFs presented with hemorrhage. Eleven of these hemorrhages (69%) occurred in either anterior cranial fossa or tentorial lesions. When analyzed according to the Borden classification, none (0%) of 55 Type I intracranial dural AVFs, two (11%) of 18 Type II, and 14 (48%) of 29 Type III intracranial dural AVFs presented with hemorrhage (p < 0.0001). After exclusion of visual or cranial nerve deficits that were clearly related to cavernous sinus intracranial dural AVFs, nonhemorrhagic neurological deficits were a feature of presentation in one (2%) of 55 Type I, five (28%) of 18 Type II, and nine (31%) of 29 Type III patients (p < 0.0001). When combined, an aggressive clinical presentation (ICH or nonhemorrhagic neurological deficit) was seen most commonly in intracranial dural AVFs located in the tentorium (11 (79%) of 14) and the anterior cranial fossa (three (75%) of four), but this simply reflected the number of higher grade lesions in these locations. Aggressive clinical presentation strongly correlated with Borden types: one (2%) of 55 Type I, seven (39%) of 18 Type II, and 23 (79%) of 29 Type III patients (p < 0.0001). A similar correlation with aggressive presentation was seen with the Cognard classification: none (0%) of 40 Type I, one (7%) of 15 Type IIA, three (38%) of eight Type IIB, four (40%) of 10 Type IIA+B, nine (69%) of 13 Type III, 10 (83%) of 12 Type IV, and four (100%) of four Type V (p < 0.0001). No location is immune from harboring lesions capable of an aggressive presentation. Location itself only raises the index of suspicion for dangerous venous anatomy in some intracranial dural AVFs. The configuration of venous anatomy as reflected by both the Cognard and Borden classifications strongly predicts intracranial dural AVFs that will present with ICH or nonhemorrhagic neurological deficit.


2017 ◽  
Vol 8 (3) ◽  
pp. ar.2017.8.0208 ◽  
Author(s):  
Kengo Kanai ◽  
Mitsuhiro Okano ◽  
Takenori Haruna ◽  
Takaya Higaki ◽  
Ryotaro Omichi ◽  
...  

Objective In 2013, the Japanese Rhinologic Society proposed a simple classification for endoscopic sinus surgery (ESS). This classification consists of five procedures (type I, fenestration of the ostiomeatal complex, with uncinectomy and widening of the natural ostium; type II, single-sinus procedure, with manipulating the inside of the sinus; type III, polysinus procedure; type IV, pansinus procedure; type V, extended procedure beyond the sinus wall). The clinical relevance of this classification in chronic rhinosinusitis (CRS) and paranasal sinus cyst was evaluated. Study Design A retrospective validation study. Methods A total of 122 patients (195 sinuses) who underwent ESS in Okayama University Hospital in 2012 were enrolled. The relationships between the ESS classification and the clinical course, including the operation time, bleeding amounts during surgery and postoperative changes of olfaction, the computed tomography (CT) score, and nasal airway resistance were analyzed. Results A total of 195 ESS procedures were classified into type I (n = 3), type II (n = 17), type III (n = 91), type IV (n = 82), and type V (n = 2). The major phenotypes of type II, III, and IV ESS were paranasal sinus cyst (68%), CRS without nasal polyps (77%), and CRS with nasal polyps (55%), respectively, and the difference was significant. The degree of ESS based on this classification was positively and significantly correlated with the operation time and bleeding amounts. As a whole, olfaction, CT score, and nasal airway resistance were significantly improved after surgery. The degree of improvement was similar between type III and type IV ESS. Conclusion This simple classification for ESS reflected the perioperative burden of the disease.


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